1
|
Pizzano M, Shire S, Shih W, Levato L, Landa R, Lord C, Smith T, Kasari C. Profiles of minimally verbal autistic children: Illuminating the neglected end of the spectrum. Autism Res 2024; 17:1218-1229. [PMID: 38803132 PMCID: PMC11186722 DOI: 10.1002/aur.3151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 05/03/2024] [Indexed: 05/29/2024]
Abstract
Heterogeneity among individuals on the autism spectrum is widely acknowledged as a barrier to develop effective interventions. Overcoming this challenge requires characterization of individual differences, especially for children that are minimally verbal and often excluded from research studies. Most studies that describe autistic subgroups identify a single minimally verbal verbal group based on a single identifying measure (e.g., ADOS module one or single item indicating absence of phrase speech). Determining personalized courses of intervention requires a more detailed understanding since a single intervention will not be effective for all who are minimally verbal. The present study identified comprehensive profiles of cognitive, language, and social communication skills within a large, diverse, group of minimally verbal children with autism. The analysis combined baseline data from two studies to yield a sample of 344 participants, who were 3 to 8 years old at the time of study onset, with 60% who identified as having a race/ethnicity other than White. Via latent profile analysis (LPA), a three-group model was identified as best fit to the data. Profile identification was dependent on a participant's combination of cognitive, expressive, and social communication characteristics, rather than a single domain. One group (n = 206) had global delays, while the other two groups (n = 95 and n = 43) had variable strengths in cognition and communication. Findings suggest that low-frequency/minimally verbal communicators with autism have heterogeneous characteristics that can be systematically organized.
Collapse
Affiliation(s)
- Maria Pizzano
- Department of Psychiatry, UCLA, Los Angeles, CA
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, USA
| | - Stephanie Shire
- School of Education, University of Oregon, Eugene, Oregon, USA
| | - Wendy Shih
- Department of Psychiatry, UCLA, Los Angeles, CA
| | - Lynne Levato
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
| | - Rebecca Landa
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Tristram Smith
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, USA
| | - Connie Kasari
- Department of Psychiatry, UCLA, Los Angeles, CA
- Department of Education and Information Studies, UCLA, Los Angeles, CA
| |
Collapse
|
2
|
Préfontaine I, Lanovaz MJ, Rivard M. Brief Report: Machine Learning for Estimating Prognosis of Children with Autism Receiving Early Behavioral Intervention-A Proof of Concept. J Autism Dev Disord 2024; 54:1605-1610. [PMID: 35764770 DOI: 10.1007/s10803-022-05641-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
Although early behavioral intervention is considered as empirically-supported for children with autism, estimating treatment prognosis is a challenge for practitioners. One potential solution is to use machine learning to guide the prediction of the response to intervention. Thus, our study compared five machine algorithms in estimating treatment prognosis on two outcomes (i.e., adaptive functioning and autistic symptoms) in children with autism receiving early behavioral intervention in a community setting. Each machine learning algorithm produced better predictions than random sampling on both outcomes. Those results indicate that machine learning is a promising approach to estimating prognosis in children with autism, but studies comparing these predictions with those produced by qualified practitioners remain necessary.
Collapse
Affiliation(s)
- Isabelle Préfontaine
- École de psychoéducation, Université de Montréal, Montréal, QC, Canada.
- École de Psychoéducation, Université de Montréal, succursale Centre-Ville, C.P. 6128, H3C 3J7, Montréal, QC, Canada.
| | - Marc J Lanovaz
- École de psychoéducation, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | - Mélina Rivard
- Centre de recherche de l'institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| |
Collapse
|
3
|
van der Wurff I, Oenema A, de Ruijter D, Vingerhoets C, van Amelsvoort T, Rutten B, Mulkens S, Köhler S, Schols A, de Groot R. A Scoping Literature Review of the Relation between Nutrition and ASD Symptoms in Children. Nutrients 2022; 14:nu14071389. [PMID: 35406004 PMCID: PMC9003544 DOI: 10.3390/nu14071389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
Autism spectrum disorder (ASD) is characterized by impairments in social interaction, communication skills, and repetitive and restrictive behaviors and interests. Even though there is a biological basis for an effect of specific nutrition factors on ASD symptoms and there is scientific literature available on this relationship, whether nutrition factors could play a role in ASD treatment is unclear. The goal of the current literature review was to summarize the available scientific literature on the relation between nutrition and autism spectrum disorder (ASD) symptoms in childhood, and to formulate practical dietary guidelines. A comprehensive search strategy including terms for ASD, nutrition factors (therapeutic diets, dietary patterns, specific food products, fatty acids and micronutrients) and childhood was developed and executed in six literature databases (Cinahl, Cochrane, Ovid Embase, PsycInfo, PubMed and Web of Science). Data from meta-analyses, systematic reviews and original studies were qualitatively summarized. A total of 5 meta-analyses, 29 systematic reviews and 27 original studies were retrieved that focused on therapeutic diets, specific food products, fatty acids and micronutrients and ASD symptoms during childhood. Results of the available studies were sparse and inconclusive, and hence, no firm conclusions could be drawn. There is currently insufficient evidence for a relation between nutrition and ASD symptoms in childhood, making it impossible to provide practical nutrition guidelines; more methodological sound research is needed.
Collapse
Affiliation(s)
- Inge van der Wurff
- Health Psychology, Faculty of Psychology, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands;
- Correspondence:
| | - Anke Oenema
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.O.); (D.d.R.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
| | - Dennis de Ruijter
- Department of Health Promotion, Maastricht University, 6200 MD Maastricht, The Netherlands; (A.O.); (D.d.R.)
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
| | - Claudia Vingerhoets
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Bart Rutten
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Sandra Mulkens
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Clinical Psychological Science, Maastricht University, 6200 MD Maastricht, The Netherlands
- SeysCentra, 6581 TE Malden, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, Maastricht University, 6200 MD Maastricht, The Netherlands; (C.V.); (T.v.A.); (B.R.); (S.M.); (S.K.)
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Annemie Schols
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Respiratory Medicine, Maastricht University, 6202 AZ Maastricht, The Netherlands
| | - Renate de Groot
- Conditions for Lifelong Learning, Faculty of Educational Sciences, Open University of the Netherlands, 6419 AT Heerlen, The Netherlands;
| |
Collapse
|
4
|
Screening, Diagnosis and Early Intervention in Autism Spectrum Disorders. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020153. [PMID: 35204874 PMCID: PMC8870449 DOI: 10.3390/children9020153] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/04/2022] [Indexed: 02/05/2023]
|
5
|
Parker ML, Diamond RM, Auwood LH. Exploring Exceptions and Discovering Solutions: A Case Presentation of Autism and the Family. FAMILY PROCESS 2020; 59:1891-1902. [PMID: 31613401 DOI: 10.1111/famp.12500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence-based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem-focused lens. There is a growing body of research calling for strength-based, relational interventions that build on existing resources to enhance coping, efficacy, and well-being among families affected by ASD. Solution-Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism-associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution-focused approach by modifying commonly used SFBT interventions to address family-driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.
Collapse
|
6
|
Kitzerow J, Hackbusch M, Jensen K, Kieser M, Noterdaeme M, Fröhlich U, Taurines R, Geißler J, Wolff N, Roessner V, Bast N, Teufel K, Kim Z, Freitag CM. Study protocol of the multi-centre, randomised controlled trial of the Frankfurt Early Intervention Programme A-FFIP versus early intervention as usual for toddlers and preschool children with Autism Spectrum Disorder (A-FFIP study). Trials 2020; 21:217. [PMID: 32093772 PMCID: PMC7038602 DOI: 10.1186/s13063-019-3881-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 11/04/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Naturalistic developmental behavioural interventions (NDBI) have been shown to improve autism-specific symptoms in young children with Autism Spectrum Disorder (ASD). NDBI approaches, such as the ASD-specific Frankfurt Early Intervention Programme for ASD (A-FFIP), are based on ASD-specific developmental and learning aspects. A-FFIP is a low-intensity intervention which can easily be implemented in the local health care/social welfare system. The aim of the present study is to establish 1-year efficacy of the manualised early intervention programme A-FFIP in toddlers and preschool children with ASD. It is hypothesised that A-FFIP will result in improved ASD-specific symptoms compared to early intervention as usual (EIAU). Child- and family-specific secondary outcomes, as well as moderators and mediators of outcome, will be explored. METHODS/DESIGN A prospective, multi-centre, parallel-group, randomised controlled, phase-III trial comparing A-FFIP versus EIAU. A total of 134 children (A-FFIP: 67, EIAU: 67) aged 24-66 months at baseline assessment meeting the criteria for ASD (DSM-5) will be included. The primary outcome is the absolute change of the total score of the Brief Observation of Social Communication Change (BOSCC-AT) between baseline (T2) and 1-year follow-up (T6). The treatment effect will be tested, adjusted for relevant covariates applying a mixed model for repeated measures. Secondary outcomes are BOSCC social communication and repetitive-behaviour scores, single ASD symptoms, language, cognition, psychopathology, parental well-being and family quality of life. Predictors, moderators and mediating mechanisms will be explored. DISCUSSION If efficacy of the manualised A-FFIP early intervention is established, the current study has the potential to change clinical practice strongly towards the implementation of a low-intensity, evidence-based, natural early intervention in ASD. Early intervention in ASD requires specialist training, which subsequently needs to be developed or included into current training curricula. TRIAL REGISTRATION German Registry for Clinical Trials (Deutscher Register Klinischer Studien, DRKS); ID: 00016330. Retrospectively registered on 4 January 2019. URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016330.
Collapse
Affiliation(s)
- Janina Kitzerow
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Therapy and Research Centre of Excellence, University Hospital Frankfurt Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Matthes Hackbusch
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Katrin Jensen
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics (IMBI), University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Michele Noterdaeme
- Department of Child and Adolescent Psychiatry and Psychotherapy, Josefinum Augsburg, Kapellenstrasse 30, 86154, Augsburg, Germany
| | - Ulrike Fröhlich
- Department of Child and Adolescent Psychiatry and Psychotherapy, Josefinum Augsburg, Kapellenstrasse 30, 86154, Augsburg, Germany
| | - Regina Taurines
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Julia Geißler
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Nicole Wolff
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Medical Faculty Carl Gustav Carus, Technische Universitaet Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Nico Bast
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Therapy and Research Centre of Excellence, University Hospital Frankfurt Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Karoline Teufel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Therapy and Research Centre of Excellence, University Hospital Frankfurt Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Ziyon Kim
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Therapy and Research Centre of Excellence, University Hospital Frankfurt Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Therapy and Research Centre of Excellence, University Hospital Frankfurt Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany.
| |
Collapse
|
7
|
Parker ML, Diamond RM, Del Guercio AD. Care Coordination of Autism Spectrum Disorder: A Solution-Focused Approach. Issues Ment Health Nurs 2020; 41:138-145. [PMID: 31322982 DOI: 10.1080/01612840.2019.1624899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The expanding practice of multi-disciplinary care to address the complex nature of Autism Spectrum Disorder (ASD) suggests that there is a need for a means of coordinating care that transcends the disciplinary distinctions of relevant ASD treatment providers. As ASD services become more specialized, there is a growing need for effective care coordination with providers across the systems of care. Nursing professionals are ideally qualified to support families affected by ASD, as they provide a necessary holistic lens of health and wellbeing to obtain the appropriate treatments. Solution-focused brief therapy has been applied to a growing number of clinical settings, indicating solution-focused techniques are applicable to the various contexts associated with ASD treatments. We provide a case presentation to demonstrate a solution-focused approach to address ASD-related concerns within the family that are generalizable to coordination of care.
Collapse
Affiliation(s)
- M L Parker
- Department of Family and Child Sciences, Florida State University, Tallahassee, Florida, USA
| | - Rachel M Diamond
- Department of Couples and Family Therapy, Adler University, Chicago, Illinois, USA
| | - Ashley D Del Guercio
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
| |
Collapse
|
8
|
Rubenstein E, Schieve L, Wiggins L, Rice C, Van Naarden Braun K, Christensen D, Durkin M, Daniels J, Lee LC. Trends in documented co-occurring conditions in children with autism spectrum disorder, 2002-2010. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:168-178. [PMID: 30227350 PMCID: PMC6741291 DOI: 10.1016/j.ridd.2018.08.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 08/28/2018] [Indexed: 06/01/2023]
Abstract
BACKGROUND Autism spectrumdisorder (ASD) commonly presents with co-occurring medical conditions (CoCs). Little is known about patterns in CoCs in a time of rising ASD prevalence. AIMS To describe trends in number and type of documented CoCs in 8-year-old children with ASD. METHODS We used Autism and Developmental Disabilities Monitoring Network (ADDM) data, a multi-source active surveillance system monitoring ASD prevalence among 8-year-old children across the US. Data from surveillance years 2002, 2006, 2008, and 2010 were used to describe trends in count, categories, and individual CoCs. RESULTS Mean number of CoCs increased from 0.94 CoCs in 2002 to 1.06 CoCs in 2010 (p < 0.001). The percentage of children with ASD with any CoC increased from 44.5% to 56.4% (p < 0.001). CoCs with the greatest increases were in general developmental disability (10.4% to 14.5%), language disorder (18.9% to 23.6%), and motor developmental disability (10.5% to 15.6%). Sex modified the relationship between developmental (P = 0.02) and psychiatric (P < 0.001) CoCs and surveillance year. Race/ethnicity modified the relationship between neurological conditions (P = 0.04) and surveillance year. CONCLUSIONS The increase in the percentage of children with ASD and CoCs may suggest the ASD phenotype has changed over time or clinicians are more likely to diagnose CoCs.
Collapse
Affiliation(s)
- Eric Rubenstein
- Department of Epidemiology, University of North Carolina at Chapel Hill, 116A South Merrit Mill, Chapel Hill, NC 27516, United States.
| | - Laura Schieve
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Lisa Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Catherine Rice
- Department of Psychiatry, Emory University School of Medicine, 1551 Shoup Court, Atlanta, GA 30322, United States
| | - Kim Van Naarden Braun
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Deborah Christensen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E-86, Atlanta, GA 30333, United States
| | - Maureen Durkin
- Department of Population Health Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI 53726, United States
| | - Julie Daniels
- Department of Epidemiology, University of North Carolina at Chapel Hill, 116A South Merrit Mill, Chapel Hill, NC 27516, United States
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, United States
| |
Collapse
|
9
|
Usta MB, Karabekiroglu K, Sahin B, Aydin M, Bozkurt A, Karaosman T, Aral A, Cobanoglu C, Kurt AD, Kesim N, Sahin İ, Ürer E. Use of machine learning methods in prediction of short-term outcome in autism spectrum disorders. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1545334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mirac Baris Usta
- Department of Child and Adolescent Psychiatry, Education and Research Hospital, Samsun, Turkey
| | - Koray Karabekiroglu
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
| | - Berkan Sahin
- Department of Child and Adolescent Psychiatry, State Hospital, Igdir, Turkey
| | - Muazzez Aydin
- Department of Child and Adolescent Psychiatry, Education and Research Hospital, Samsun, Turkey
| | - Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Education and Research Hospital, Konya, Turkey
| | - Tolga Karaosman
- Department of Child and Adolescent Psychiatry, State Hospital, Amasya, Turkey
| | - Armagan Aral
- Department of Child and Adolescent Psychiatry, Mental Hospital, Samsun, Turkey
| | - Cansu Cobanoglu
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
| | - Aysegül Duman Kurt
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
| | - Neriman Kesim
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
| | - İrem Sahin
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ondokuz Mayis, Samsun, Turkey
| | - Emre Ürer
- Department of Child and Adolescent Psychiatry, Medical Faculty, University of Ankara, Ankara, Turkey
| |
Collapse
|
10
|
Ure A, Rose V, Bernie C, Williams K. Autism: One or many spectrums? J Paediatr Child Health 2018; 54:1068-1072. [PMID: 30294997 DOI: 10.1111/jpc.14176] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 12/28/2022]
Abstract
Our conceptualisation of autism spectrum disorder has changed over time, with recent classifications reflecting a heterogeneous clinical presentation now regularly encountered in routine general paediatric practice. As the prevalence of autism and associated demands for services have increased so has research into understanding the cause and trials aimed at providing best care and intervention. However, the heterogeneity of autism has meant that no single aetiology can account for all differences in presentation, and not all children benefit from broad-based interventions. Now is the time to rethink how best to understand individual differences in order to focus research efforts and take steps towards more sophisticated strategies that go beyond the behaviours we look for when making an autism diagnosis. We suggest adopting a dimensional approach to autism assessment, with the consideration of eight spectrums of abilities, ways of thinking and behaviour. This eight-spectrum approach will assist clinicians to consider each individual's strengths and needs and personalise interventions and support accordingly. Profiling individual skills across these dimensions may also provide researchers with a greater capacity to link causal pathways with specific phenotypes, which is needed to develop precision medicine for autism.
Collapse
Affiliation(s)
- Alexandra Ure
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Allied Health Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Veronica Rose
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Charmaine Bernie
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Allied Health Department, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Katrina Williams
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Allied Health Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Developmental Disability and Rehabilitation Research, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
11
|
Croen LA, Shankute N, Davignon M, Massolo ML, Yoshida C. Demographic and Clinical Characteristics Associated with Engagement in Behavioral Health Treatment Among Children with Autism Spectrum Disorders. J Autism Dev Disord 2018; 47:3347-3357. [PMID: 28748332 PMCID: PMC5633658 DOI: 10.1007/s10803-017-3247-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This study investigates demographic and clinical factors associated with initiation, continuation, and adherence to behavioral health treatment (BHT) among children with autism spectrum disorder. Among 293 insured children referred for applied behavior analysis (ABA) based BHT, 23% never initiated treatment. Among those initiating treatment, 31% discontinued treatment within 1 year of treatment initiation, and only 15% received 80% or more of recommended treatment hours. Younger age at referral to treatment, private health insurance, and receiving more than 10 h/week of BHT were associated with treatment engagement. Co-occurring psychiatric and medical conditions were related to treatment discontinuation among children 5 years or older. These findings suggest specific subgroups that may benefit from additional support with engaging in recommended behavioral health treatment.
Collapse
Affiliation(s)
- Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
| | - Naomi Shankute
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.,Quality and Operations Support, Kaiser Permanente California, Oakland, CA, 94612, USA
| | - Meghan Davignon
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.,Kaiser Roseville Medical Center, Pediatric Specialties, Roseville, CA, USA
| | - Maria L Massolo
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| | - Cathleen Yoshida
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA
| |
Collapse
|
12
|
Rivard M, Morin M, Mello C, Terroux A, Mercier C. Follow-Up of Children With Autism Spectrum Disorder 1 Year After Early Behavioral Intervention. Behav Modif 2018; 43:490-517. [PMID: 29726269 DOI: 10.1177/0145445518773692] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effectiveness of early intensive behavioral intervention (EIBI) for children with autism spectrum disorders (ASDs) has been demonstrated by many studies and meta-analyses. Although it is considered an exemplary practice in several countries, few studies have investigated the maintenance of gains made in EIBI over time. Thirty-two children were assessed at posttreatment and 1-year follow-up after they attended a low-to-moderate-intensity (10 to 20 hr per week) EIBI program delivered by a public rehabilitation center. Between baseline and posttreatment, children showed significant gains in most areas of intellectual functioning and a significant decrease of autism symptom severity, but no change in adaptive behavior. Gains in intellectual functioning were maintained over a 1-year period after treatment termination, but autism symptom severity had increased to approximately pretreatment levels during that interval. Considerable individual variability was noted in the evolution of outcomes.
Collapse
Affiliation(s)
| | | | - Catherine Mello
- 2 The Pennsylvania State University - Berks, Reading, PA, USA
| | - Amélie Terroux
- 3 Centre de réadaptation en déficience intellectuelle et trouble envahissant du développement de la Montérégie-Est, St-Hubert, Québec, Canada
| | | |
Collapse
|
13
|
Linstead E, Dixon DR, Hong E, Burns CO, French R, Novack MN, Granpeesheh D. An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Transl Psychiatry 2017; 7:e1234. [PMID: 28925999 PMCID: PMC5639250 DOI: 10.1038/tp.2017.207] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/14/2017] [Accepted: 07/13/2017] [Indexed: 11/12/2022] Open
Abstract
Applied behavior analysis (ABA) is considered an effective treatment for individuals with autism spectrum disorder (ASD), and many researchers have further investigated factors associated with treatment outcomes. However, few studies have focused on whether treatment intensity and duration have differential influences on separate skills. The aim of the current study was to investigate how treatment intensity and duration impact learning across different treatment domains, including academic, adaptive, cognitive, executive function, language, motor, play, and social. Separate multiple linear regression analyses were used to evaluate these relationships. Participants included 1468 children with ASD, ages 18 months to 12 years old, M=7.57 years, s.d.=2.37, who were receiving individualized ABA services. The results indicated that treatment intensity and duration were both significant predictors of mastered learning objectives across all eight treatment domains. The academic and language domains showed the strongest response, with effect sizes of 1.68 and 1.85 for treatment intensity and 4.70 and 9.02 for treatment duration, respectively. These findings are consistent with previous research that total dosage of treatment positively influences outcomes. The current study also expands on extant literature by providing a better understanding of the differential impact that these treatment variables have across various treatment domains.
Collapse
Affiliation(s)
- E Linstead
- Machine Learning and Assistive Technology Laboratory, Schmid College of Science and Technology, Chapman University, Orange, CA, USA
| | - D R Dixon
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| | - E Hong
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| | - C O Burns
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - R French
- Machine Learning and Assistive Technology Laboratory, Schmid College of Science and Technology, Chapman University, Orange, CA, USA
| | - M N Novack
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| | - D Granpeesheh
- Department of Research and Development, Center for Autism and Related Disorders, Woodland Hills, CA, USA
| |
Collapse
|
14
|
Caron V, Bérubé A, Paquet A. Implementation evaluation of early intensive behavioral intervention programs for children with autism spectrum disorders: A systematic review of studies in the last decade. EVALUATION AND PROGRAM PLANNING 2017; 62:1-8. [PMID: 28189054 DOI: 10.1016/j.evalprogplan.2017.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 12/02/2016] [Accepted: 01/13/2017] [Indexed: 05/22/2023]
Abstract
UNLABELLED For young children with autism spectrum disorders, one of the choice interventions is Early Intensive Behavioral Intervention. Over the past ten years, its effectiveness has been abundantly evaluated based on various parameters, including the intensity and duration of the intervention. Despite major advances in effectiveness evaluation, data concerning the implementation of the intervention are often described briefly, and the active ingredients of the intervention are but rarely linked to the documented effects. OBJECTIVES This study aims at reviewing with a systematic method, the studies pertaining to EIBI provided to children with autism spectrum disorders over the past ten years (2005-2015) and at documenting the program implementation components described in the studies, based on Dane and Schneider's (1998) model in accordance with PRISMA guidelines. RESULTS The results show that, although the variables related to intervention dosage and protocol are relatively well described, the authors do not always consider them in the effects analysis. Furthermore, the majority of the studies did not report information on intervention participation, differentiation or quality. CONCLUSIONS Data concerning the implementation of the intervention are partially described in the articles retained. In this regard, a better description of the intervention provided and a more systematic evaluation of its implementation seem necessary to detect the subtle differences in the effects of the intervention.
Collapse
Affiliation(s)
- Valérie Caron
- Université du Québec à Trois-Rivières, Département de psychoéducation, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7, Canada.
| | - Annie Bérubé
- Université du Québec en Outaouais, Département de psychoéducation, Pavillon Alexandre Taché, 283 Boulevard Alexandre-Taché, Gatineau, QC J9A 1L8, Canada.
| | - Annie Paquet
- Université du Québec à Trois-Rivières, Département de psychoéducation, 3351 Boulevard des Forges, Trois-Rivières, QC G9A 5H7, Canada.
| |
Collapse
|
15
|
Resilience and Autism Spectrum Disorder: Applying Developmental Psychopathology to Optimal Outcome. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0106-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
16
|
Touzet S, Occelli P, Schröder C, Manificat S, Gicquel L, Stanciu R, Schaer M, Oreve MJ, Speranza M, Denis A, Zelmar A, Falissard B, Georgieff N, Bahrami S, Geoffray MM. Impact of the Early Start Denver Model on the cognitive level of children with autism spectrum disorder: study protocol for a randomised controlled trial using a two-stage Zelen design. BMJ Open 2017; 7:e014730. [PMID: 28348195 PMCID: PMC5372147 DOI: 10.1136/bmjopen-2016-014730] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Early intervention for autism spectrum disorder (ASD) in the European French-speaking countries is heterogeneous and poorly evaluated to date. Early intervention units applying the Early Start Denver Model (ESDM) for toddlers and young children with ASD have been created in France and Belgium to improve this situation. It is essential to evaluate this intervention for the political decision-making process regarding ASD interventions in European French-speaking countries. We will evaluate the effectiveness of 12 hours per week ESDM intervention on the cognitive level of children with ASD, over a 2-year period. METHODS AND ANALYSIS The study will be a multicentre, randomised controlled trial, using a two-stage Zelen design. Children aged 15-36 months, diagnosed with ASD and with a developmental quotient (DQ) of 30 or above on the Mullen Scale of Early Learning (MSEL) will be included. We will use a stratified minimisation randomisation at a ratio 1:2 in favour of the control group. The sample size required is 180 children (120 in the control and 60 in the intervention group). The experimental group will receive 12 hours per week ESDM by trained therapists 10 hours per week in the centre and 2 hours in the toddlers' natural environment (alternatively by the therapist and the parent). The control group will receive care available in the community. The primary outcome will be the change in cognitive level measured with the DQ of the MSEL scored at 2 years. Secondary outcomes will include change in autism symptoms, behavioural adaptation, communicative and productive language level, sensory profile and parents' quality of life. The primary analysis will use the intention-to-treat principle. An economic evaluation will be performed. DISSEMINATION Findings from the study will be disseminated through peer reviewed publications and meetings. TRIAL REGISTRATION NUMBER NCT02608333 (clinicaltrials.gov); Pre-results.
Collapse
Affiliation(s)
- Sandrine Touzet
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon F-69003, France
- Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université de Lyon, Lyon F-69008France
| | - Pauline Occelli
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon F-69003, France
- Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université de Lyon, Lyon F-69008France
| | - Carmen Schröder
- Department of Child and Adolescent Psychiatry, Hopitaux universitaires de Strasbourg, Strasbourg F-67000, France
- CNRS UPR 3212—Team 9, Strasbourg University, Strasbourg F-67000, France
| | | | - Ludovic Gicquel
- Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Spécialisé Henri Laborit, Saint Benoît F-86280, France
- Child and Adolescent Psychiatry Department, Unité de Recherche Clinique, Université de Poitiers, Poitiers F-86000, France
| | - Razvana Stanciu
- Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Bruxelles 1020, Belgium
| | - Marie Schaer
- Office Médico-Pédagogique, University of Geneva, Geneva, Switzerland
| | - Marie-Joelle Oreve
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Le Chesnay F-78150, France
| | - Mario Speranza
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Le Chesnay F-78150, France
- EA 4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Versailles F-78000, France
| | - Angelique Denis
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon F-69003, France
- Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université de Lyon, Lyon F-69008France
| | - Amelie Zelmar
- Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon F-69003, France
- Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université de Lyon, Lyon F-69008France
| | - Bruno Falissard
- Université Paris-Sud, CESP, INSERM, UVSQ, Université Paris-Saclay, U1178, Maison de Solenn, Paris cedex 14, France
- Department of Public Health, AP-HP, Hôpital Paul Brousse, Villejuif F-94800, France
| | - Nicolas Georgieff
- Department of child and adolescent psychiatry, Centre Hospitalier le Vinatiers, Bron F-69500, France
- Université de Lyon, Lyon F-69008, France
| | - Stephane Bahrami
- EA 4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Versailles F-78000, France
- CIC 1429, INSERM, AP-HP, Hôpital Raymond-Poincare, Garches F-92380, France
| | - Marie-Maude Geoffray
- Department of child and adolescent psychiatry, Centre Hospitalier le Vinatiers, Bron F-69500, France
- Université de Lyon, Lyon F-69008, France
| |
Collapse
|
17
|
Abstract
Autism spectrum disorders (ASDs) are neurodevelopmental disorders with early onset, characterized by deficits in social communication and repetitive and restricted interests and activities. A growing number of studies over the last 10 years support the efficacy of behaviorally based interventions in ASD for the improvement of social communication and behavioral functioning. In contrast, research on neurobiological based therapies for ASD is still at its beginnings. In this article, we will provide a selective overview of both well-established evidence-based treatments and novel interventions and drug treatments based on neurobiological principles aiming at improving core symptoms in ASD. Directions and options for future research on treatment in ASD are discussed.
Collapse
Affiliation(s)
- L Poustka
- Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - I Kamp-Becker
- Clinic for Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| |
Collapse
|
18
|
Dixon DR, Burns CO, Granpeesheh D, Amarasinghe R, Powell A, Linstead E. A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder. Behav Anal Pract 2016; 10:307-312. [PMID: 29021944 DOI: 10.1007/s40617-016-0155-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The present study aimed to retrospectively compare the relative rates of mastery of exemplars for individuals with ASD (N = 313) who received home-based and center-based services. A between-group analysis found that participants mastered significantly more exemplars per hour when receiving center-based services than home-based services. Likewise, a paired-sample analysis found that participants who received both home and center-based services had mastered 100 % more per hour while at the center than at home. These analyses indicated that participants demonstrated higher rates of learning during treatment that was provided in a center setting than in the participant's home.
Collapse
Affiliation(s)
- Dennis R Dixon
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Claire O Burns
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Doreen Granpeesheh
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Roshan Amarasinghe
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Alva Powell
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Erik Linstead
- Chapman University, Schmid College of Science and Technology, One University Drive, Orange, CA 92866 USA
| |
Collapse
|
19
|
Intensity and Learning Outcomes in the Treatment of Children With Autism Spectrum Disorder. Behav Modif 2016; 41:229-252. [DOI: 10.1177/0145445516667059] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ample research has shown that intensive applied behavior analysis (ABA) treatment produces robust outcomes for individuals with autism spectrum disorder (ASD); however, little is known about the relationship between treatment intensity and treatment outcomes. The current study was designed to evaluate this relationship. Participants included 726 children, ages 1.5 to 12 years old, receiving community-based behavioral intervention services. Results indicated a strong relationship between treatment intensity and mastery of learning objectives, where higher treatment intensity predicted greater progress. Specifically, 35% of the variance in mastery of learning objectives was accounted for by treatment hours using standard linear regression, and 60% of variance was accounted for using artificial neural networks. These results add to the existing support for higher intensity treatment for children with ASD.
Collapse
|
20
|
Dixon DR, Linstead E, Granpeesheh D, Novack MN, French R, Stevens E, Stevens L, Powell A. An Evaluation of the Impact of Supervision Intensity, Supervisor Qualifications, and Caseload on Outcomes in the Treatment of Autism Spectrum Disorder. Behav Anal Pract 2016; 9:339-348. [PMID: 27920965 DOI: 10.1007/s40617-016-0132-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Ample research has shown the benefits of intensive applied behavior analysis (ABA) treatment for autism spectrum disorder (ASD); research that investigates the role of treatment supervision, however, is limited. The present study examined the relationship between mastery of learning objectives and supervision hours, supervisor credentials, years of experience, and caseload in a large sample of children with ASD (N = 638). These data were retrieved from a large archival database of children with ASD receiving community-based ABA services. When analyzed together via a multiple linear regression, supervision hours and treatment hours accounted for only slightly more of the observed variance (r2 = 0.34) than treatment hours alone (r2 = 0.32), indicating that increased supervision hours do not dramatically increase the number of mastered learning objectives. In additional regression analyses, supervisor credentials were found to have a significant impact on the number of mastered learning objectives, wherein those receiving supervision from a Board Certified Behavior Analyst (BCBA) mastered significantly more learning objectives. Likewise, the years of experience as a clinical supervisor showed a small but significant impact on the mastery of learning objectives. A supervisor's caseload, however, was not a significant predictor of the number of learning objectives mastered. These findings provide guidance for best practice recommendations.
Collapse
Affiliation(s)
- Dennis R Dixon
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Erik Linstead
- Schmid College of Science and Technology, Chapman University, One University Drive, Orange, CA 92866 USA
| | - Doreen Granpeesheh
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Marlena N Novack
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| | - Ryan French
- Schmid College of Science and Technology, Chapman University, One University Drive, Orange, CA 92866 USA
| | - Elizabeth Stevens
- Schmid College of Science and Technology, Chapman University, One University Drive, Orange, CA 92866 USA
| | - Laura Stevens
- Schmid College of Science and Technology, Chapman University, One University Drive, Orange, CA 92866 USA
| | - Alva Powell
- Center for Autism and Related Disorders, 21600 Oxnard Street, Suite 1800, Woodland Hills, CA 91367 USA
| |
Collapse
|
21
|
Strauss K, Benvenuto A, Battan B, Siracusano M, Terribili M, Curatolo P, Fava L. Promoting Shared Decision Making to strengthen outcome of young children with Autism Spectrum Disorders: the role of staff competence. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 38:48-63. [PMID: 25544428 DOI: 10.1016/j.ridd.2014.11.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/21/2014] [Accepted: 11/25/2014] [Indexed: 06/04/2023]
Abstract
Little is known on how the conceptual description of Shared Decision Making (SDM) accomplishes clinical practice in the context of lifetime disabilities as in particular Autism Spectrum Disorders (ASD), when intervention is long-lasting and requires constant family involvement. This study aimed mainly to investigate to what extent the staff's competence in SDM contributes to positive child and parent improvement when involving parents in Early Intensive Behavior Interventions (EIBI). It was also geared to verify whether SDM staff competence contributes to a child's treatment responsiveness. A total of 25 young children with ASD (23 male, 3 female, age range 34-92 months, mean age 51.4±13.6) were included in the study. Of these, nine children were allocated to a Parent Involvement condition accompanied by SDM Staff Training (PI-SDM), and eight children to a Parent Inclusion in Treatment Delivery Only condition without SDM Staff Training (PI-DO). Nine months treatment outcomes of severity, developmental and adaptive measures were compared to Treatment As Usual (n=8). PI-SDM was associated with improvement of autistic symptoms (p≤.05), adaptive functioning (p≤.01) and developmental outcome (p≤.01), as well as parent (p≤.05) and staff competence (p≤.001). The magnitude of outcome was inferior in the PI-PO and TAU group. A Reliable Change was identified in more than 40% of children included in PI-SDM, while PI-PO (>20%) and TAU (>12%) let to little Reliable Change and partially skill deterioration. Staff's SDM skill competence predicts reduced parental stress (β=-.500, p≤.05) and contributes significantly to a positive treatment responder trajectory (p≤.01), besides lower severity (p≤.05), higher adaptive (p≤.01) and communication skills (p≤.05). The study indicates that parent inclusion should be conceptualized as a collaborative partnership model rather than as adherence in treatment provision, based on a target SDM staff training that may constitute an external contributor to treatment responsiveness and positive child as well as parent outcome.
Collapse
Affiliation(s)
- Kristin Strauss
- Association for Treatment and Research in Autism and Related Conditions "Umbrella", Rome, Italy
| | - Arianna Benvenuto
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Barbara Battan
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Martina Siracusano
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Monica Terribili
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Paolo Curatolo
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Leonardo Fava
- Association for Treatment and Research in Autism and Related Conditions "Umbrella", Rome, Italy.
| |
Collapse
|