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Preas E, Carroll RA, Van Den Elzen G, Halbur M, Harper M. Evaluating the Use of Video Modeling With Voiceover Instructions to Train Therapists to Deliver Caregiver Training Through Telehealth. Behav Modif 2023; 47:402-431. [PMID: 35850543 DOI: 10.1177/01454455221111988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Caregiver training is an important component of behavioral intervention; however, many barriers exist for in-person training. Alternatively, behavioral therapists may use telehealth as a service delivery method. To effectively train caregivers through telehealth, therapists should receive explicit training, but there has been limited research on effective methods for teaching this skill. The purpose of the current study was to evaluate video modeling with voice-over instruction (VMVO) to train therapists to implement 11 component skills of caregiver training through telehealth to teach confederate caregivers to implement a guided compliance procedure. We measured the therapist's implementation of the component skills during a scripted role-play before and after video-model training within a multiple baseline design across participants. We also conducted maintenance and generalization probes to a novel skill. All seven therapists learned the skill, but three therapists required a feedback component in addition to the VMVO. The results suggest that VMVO may be an efficient and effective method for training therapists to conduct caregiver training via telehealth. Furthermore, results indicate that component skill analyses may be valuable to monitor skills that require remediation.
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Affiliation(s)
- Elizabeth Preas
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | - Regina A Carroll
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | | | - Mary Halbur
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | - Megan Harper
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
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2
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Pankewich A, Martin TL, Walters KL, Dubé C. Accuracy and acceptability of eHealth data collection for an early intensive behavioral intervention program. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Amy Pankewich
- Department of Psychology University of Manitoba Winnipeg Manitoba Canada
| | - Toby L. Martin
- Department of Psychology University of Manitoba Winnipeg Manitoba Canada
- St. Amant Research Centre Winnipeg Manitoba Canada
| | - Kerri L. Walters
- Department of Psychology University of Manitoba Winnipeg Manitoba Canada
- St. Amant Research Centre Winnipeg Manitoba Canada
| | - Charmayne Dubé
- Department of Psychology University of Manitoba Winnipeg Manitoba Canada
- New Directions Mississauga Ontario Canada
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3
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Popow C, Ohmann S, Plener P. Practitioner's review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2021; 35:113-134. [PMID: 34160787 PMCID: PMC8429404 DOI: 10.1007/s40211-021-00395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/15/2021] [Indexed: 11/14/2022]
Abstract
Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders.
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Affiliation(s)
- Christian Popow
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Susanne Ohmann
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Paul Plener
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
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4
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Long M, Register-Brown K. Autism Spectrum Disorder. Pediatr Rev 2021; 42:360-374. [PMID: 34210755 DOI: 10.1542/pir.2020-000547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Kelly Register-Brown
- Division of Psychiatry and Behavioral Health Sciences, Children's National Hospital, Washington, DC
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5
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White K, Stetson L, Hussain K. Integrated Behavioral Health Role in Helping Pediatricians Find Long Term Mental Health Interventions with the Use of Assessments. Pediatr Clin North Am 2021; 68:685-705. [PMID: 34044994 DOI: 10.1016/j.pcl.2021.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article explores the role of assessments in integrated behavioral health within a pediatric primary care setting, specifically exploring what valid and reliable standardized assessments may be used and for what concerns the assessment be of most use. The article also considers how assessments used by integrated behavioral health may inform the type of evidenced-based intervention that would be most appropriate and efficacious for the patient, as well as assist in determining if longer term or more formal mental health treatment may be required.
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Affiliation(s)
- Katie White
- Division of Pediatric Psychology, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA.
| | - Lydia Stetson
- Division of Pediatric Psychology, Western Michigan University School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
| | - Khadijah Hussain
- MD Candidate Class of 2022, Western Michigan University Homer Stryker, MD School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, USA
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6
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Canu D, Van der Paelt S, Canal-Bedia R, Posada M, Vanvuchelen M, Roeyers H. Early non-social behavioural indicators of autism spectrum disorder (ASD) in siblings at elevated likelihood for ASD: a systematic review. Eur Child Adolesc Psychiatry 2021; 30:497-538. [PMID: 32088859 PMCID: PMC8041710 DOI: 10.1007/s00787-020-01487-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
We aimed at identifying early non-social behavioural indicators that predict later ASD. Likewise, we were interested in the moment in which non-social signs discriminate between children at elevated likelihood for ASD with a later diagnosis of ASD, and children at elevated likelihood for ASD with a typical developmental outcome. In addition, we intended to explore the developmental evolution of children's symptomatology over time. A systematic literature search was conducted for longitudinal studies on early non-social behavioural indicators among siblings at elevated likelihood for ASD. The following databases were searched: PUBMED, Web of Science, PsycINFO, CINAHL and EMBASE. The study identification process was conducted by two reviewers independently. Compared to siblings at elevated likelihood for ASD with a typical developmental outcome, siblings at elevated likelihood for ASD with later ASD show impairments in attention disengagement, in gross and fine motor development and characteristic restricted and repetitive interests and behaviours, starting at 12 months of age. Moreover, early attention disengagement exerts a predictive role towards a later ASD diagnosis, given that from 12 months siblings at elevated likelihood for ASD who will receive an independent ASD diagnosis towards 24-36 months present marked difficulties in disengaging in comparison with siblings at elevated likelihood for ASD that will not satisfy the criteria for an ASD diagnosis. The findings call for a more comprehensive vision on early indicators of ASD. Further research is needed to extend results to other behavioural domains.
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Affiliation(s)
- Daniela Canu
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt Unversity, Agoralaan, Building A, 3590 Diepenbeek, Hasselt, Belgium.
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
- Clinic for Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
| | - Sara Van der Paelt
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Ricardo Canal-Bedia
- Instituto Universitario de Integración en la Comunidad (INICO), University of Salamanca, Salamanca, Spain
| | - Manuel Posada
- Institute of Rare Diseases Research & CIBERER, Instituto de Salud Carlos III, Madrid, Spain
| | - Marleen Vanvuchelen
- Faculty of Rehabilitation Sciences, Rehabilitation Research Center (REVAL), Hasselt Unversity, Agoralaan, Building A, 3590 Diepenbeek, Hasselt, Belgium
| | - Herbert Roeyers
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Lim J, Greenspoon D, Hunt A, McAdam L. Rehabilitation interventions in Rett syndrome: a scoping review. Dev Med Child Neurol 2020; 62:906-916. [PMID: 32472972 DOI: 10.1111/dmcn.14565] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 02/06/2020] [Accepted: 03/02/2020] [Indexed: 12/20/2022]
Abstract
AIM To summarize existing interventions and their outcomes in Rett syndrome (RTT) rehabilitation and identify gaps in the literature. METHOD Five databases (Ovid MEDLINE, Ovid Embase Classic, Ovid PsycINFO, EBSCO CINAHL Plus, and ProQuest ERIC) were systematically searched up to 23rd July 2018 for studies describing rehabilitation interventions. Data on study participants, design, and outcomes were extracted. RESULTS Sixty-two articles were included in the final review. Evidence consistently demonstrated that females with RTT can improve their gross motor, fine motor, and communicative skills with rehabilitation. All 11 interventions targeting gross motor function, namely ambulation, achieved functional improvements. Twenty of 24 articles describing fine motor rehabilitation studies succeeded in decreasing stereotypies, improving functional hand use, and/or reducing self-injurious behaviors. Twenty-one of 22 studies describing communication interventions succeeded in training choice-making, communicative language, or socialization behavior. Other key findings include the positive interplay between physical and communicative rehabilitation outcomes, and the ability of females with RTT to improve their cognitive abilities during intervention. INTERPRETATION Rehabilitation can impact the daily lives of females with RTT and their caregivers in clinically meaningful ways.
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Affiliation(s)
- Jan Lim
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Dayna Greenspoon
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Anne Hunt
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Laura McAdam
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Pediatrics, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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8
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Sanchez MJ, Constantino JN. Expediting clinician assessment in the diagnosis of autism spectrum disorder. Dev Med Child Neurol 2020; 62:806-812. [PMID: 32239502 PMCID: PMC7540056 DOI: 10.1111/dmcn.14530] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/13/2020] [Indexed: 12/01/2022]
Abstract
AIM To investigate a novel observational rating protocol designed to expedite clinical diagnosis of autism spectrum disorder (ASD). METHOD Two hundred and forty patients referred to a tertiary autism center (median age 8y 9mo, range 2y 6mo-34y 8mo; 188 males, 52 females) were rated using an adaptation of the Childhood Autism Rating Scale, Second Edition (CARS-2) based exclusively on patient observation (CARS-2obs ). Scores were compared to expert diagnosis of ASD, parent-reported Social Responsiveness Scale, Second Edition (SRS-2) and, in a selected subset of patients, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). RESULTS CARS-2obs distinguished patients with a clinical diagnosis of ASD from those with non-ASD neuropsychiatric disorders (mean score=18 vs 11.7, p<0.001). Severity ratings on the CARS-2obs correlated with the ADOS-2 (r=0.68, ρ=0.64) and SRS-2 (r=0.31, ρ=0.32). A CARS-2obs cutoff point equal to or greater than 16 demonstrated 95.8% specificity and 62.3% sensitivity in discriminating individuals with ASD from individuals without ASD in a specialty referral setting. INTERPRETATION The CARS-2obs allows the rapid acquisition of quantitative ratings of autistic severity by direct observation. Coupled with parent/teacher-reported symptoms and developmental history, the measure may contribute to a low-cost diagnostic paradigm in clinical and public health settings, where positive results might help reduce delays in diagnosis, and negative results could prompt further specialty assessment. WHAT THIS PAPER ADDS The Childhood Autism Rating Scale, Second Edition based on patient observation distinguished individuals with versus without autism spectrum disorder (ASD). A score equal to or greater than 16 on this assessment showed high specificity for a diagnosis of ASD.
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Affiliation(s)
- Matthew J Sanchez
- Department of PsychiatrySchool of MedicineCase Western Reserve UniversityClevelandOHUSA
- University Hospitals Cleveland Medical CenterClevelandOHUSA
| | - John N Constantino
- Departments of Psychiatry and PediatricsWashington University in St LouisSt LouisMOUSA
- St Louis Children’s HospitalSt LouisMOUSA
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Martin F, Oliver T. Behavioral activation for children and adolescents: a systematic review of progress and promise. Eur Child Adolesc Psychiatry 2019; 28:427-441. [PMID: 29476253 PMCID: PMC6445819 DOI: 10.1007/s00787-018-1126-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 02/09/2018] [Indexed: 12/13/2022]
Abstract
Behavioral activation (BA) effectively treats depression in adults, and shows promise in treating anxiety. Research into its application to children and adolescents is emerging. This review aimed to explore the scope of studies, current evidence of effectiveness and how the intervention has been delivered and adapted, to inform future research. A systematic review was undertaken searching PsycInfo, PubMed including Medline, EMBASE, and Scopus for terms relating to BA and children and adolescents. Two researchers scored abstracts for inclusion. Data extraction was completed by one researcher and checked by another. 19 studies were identified, across 21 published articles. 12 were case studies, with three pre-post pilot designs and four randomized-controlled trials. Case studies found early support for the feasibility and potential effectiveness of BA to address both anxiety and depression. The RCTs reported largely positive outcomes. Meta-analysis of depression scores indicated that BA may be effective; however, high heterogeneity was observed. Sample sizes to date have been small. BA has been delivered by trained therapists, doctoral trainee psychologists, social workers, or psychology graduates. Studies are uniquely in high-income settings. Adaptations include flexibility in content delivery, youth friendly materials, and parental involvement. There is some limited evidence to support BA as effective for young people. Feasibility and acceptability are supported. Fully powered trials are now required, with expansion to delivery in low- and middle-income settings, and detailed consideration of implementation issues that consider culture and environment.
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Affiliation(s)
- Faith Martin
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
| | - Thomas Oliver
- University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY UK
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Chin WC, Li HM, Chao KY, Chang HL. Stressors experienced by children with autism spectrum disorder in Taiwan: Perspectives of children and their parents. Nurs Health Sci 2018; 21:206-213. [PMID: 30548420 DOI: 10.1111/nhs.12583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 09/13/2018] [Accepted: 10/21/2018] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder has only recently been recognized as a developmental disability in Taiwan. We conducted an exploratory qualitative descriptive study with children (n = 14, mean age = 13.57 years) and their parents to understand stressors experienced by children with autism spectrum disorder in Taiwan. An analysis of face-to-face interviews revealed that children with autism spectrum disorder experienced stressors of daily living, which included environmental stimuli, academic and behavioral expectations, deviations in routine, behavioral expectations, and emotional control, and stressors of socializing, which included bullying, communication, personal interactions, conflict resolution, and difficulty understanding others' emotions. Stressors resulted from the core symptoms and characteristic behaviors of autism spectrum disorders, and also Taiwanese cultural expectations. Our findings could help develop individualized educational plans and culturally-sensitive behavioral interventions. Facilitation of these interventions could be used by nurses and health-care professionals to help facilitate problem solving and communication skills, which could reduce the stress for children with autism spectrum disorder in Taiwan.
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Affiliation(s)
- Wei-Chih Chin
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsin-Mei Li
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Kuo-Yu Chao
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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11
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Muller K, Brady NC, Warren SF, Fleming KK. Mothers' perspectives on challenging behaviours in their children with fragile X syndrome. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2018; 44:481-491. [PMID: 31896952 PMCID: PMC6939860 DOI: 10.3109/13668250.2018.1496379] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Individuals with intellectual and developmental disabilities are more likely to engage in problem behaviours than peers with typical development. The purpose of this study was to provide descriptive and qualitative information about problem behaviours in children with fragile X syndrome (FXS) and how families respond to these behaviours. METHOD We examined interview responses from 53 mothers of 9-year-old children with FXS. RESULTS Defiance, tantrums, inattention, stereotypy, and aggression were the most frequently reported problem behaviours of children with FXS. Stereotypy, physical aggression, self-injury, and elopement were reported more often by mothers of children with dual diagnoses of FXS and autism than by mothers of children with a single diagnosis of FXS. CONCLUSIONS Results indicated that for many families, by 9 years of age, problem behaviours led to frustration and altered family activities.
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Affiliation(s)
- Kristen Muller
- Department of Speech-Language-Hearing: Sciences and Disorders, The University of Kansas, Schiefelbusch Institute for Life Span Studies, Lawrence, KS 66045, USA
| | - Nancy C. Brady
- Department of Speech-Language-Hearing: Sciences and Disorders, The University of Kansas, Schiefelbusch Institute for Life Span Studies, Lawrence, KS 66045, USA
| | - Steven F. Warren
- Department of Speech-Language-Hearing: Sciences and Disorders, The University of Kansas, Schiefelbusch Institute for Life Span Studies, Lawrence, KS 66045, USA
| | - Kandace K. Fleming
- Research Design and Analysis Unit, The University of Kansas, Schiefelbusch Institute for Life Span Studies, Lawrence, KS 66045, USA
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12
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Hosseinpour M, Mashayekhi F, Bidabadi E, Salehi Z. Neuropilin-2 rs849563 gene variations and susceptibility to autism in Iranian population: A case-control study. Metab Brain Dis 2017; 32:1471-1474. [PMID: 28484884 DOI: 10.1007/s11011-017-0024-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 04/28/2017] [Indexed: 10/19/2022]
Abstract
Autism spectrum disorders (ASD) are neurodevelopmental disruptions usually diagnosed in the first three years of child's life that characterized by some impairments in verbal and nonverbal communication, problems in social interactions and repetitive behaviors. The neuropilin-2 (NRP2) gene has been shown to both guide axons and control neuronal migration in the central nervous system (CNS). In this study the association between the NRP2 gene and autism using a cohort of 120 Iranian children (50 cases with autism and 70 control cases) was analyzed. Single nucleotide polymorphism (SNP) was genotyped by the polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) analyses. There was significant difference between the genotype and allele frequency between control and patient groups (P = 0.003 and P = 0.01, respectively). The prevalence of genotype frequencies of TT and TG in autistic children were 40% and 60%, respectively, while in controls were 68.5% and 31.5%, respectively. The heterozyote TG was associated with an increased risk of autism compared with TT genotype (OR = 3.72, 95%CI = 1.53-6.95, P = 0.02). The allele frequencies of T and G in autistic children were 78.5% and 21.4%, respectively and in controls were 84.2% and 15.7%, respectively. The NRP2 G allele conferred a 2.29-fold increased risk to autism relative to the T allele (OR = 2.29, 95%CI = 1.23-4.29, P = 0.009). The results of this study showed that there is a significant association between rs849563 polymorphism and autism in the studied population. However in order to obtain a definitive conclusion larger studies with more samples are required to confirm the results of this study.
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Affiliation(s)
| | - Farhad Mashayekhi
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran.
| | - Elham Bidabadi
- Faculty of Medicine, Department of Child Neurology, Guilan University of Medical Sciences, Rasht, Iran
| | - Zivar Salehi
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran
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Sleeper JD, LeBlanc LA, Mueller J, Valentino AL, Fazzio D, Raetz PB. The Effects of Electronic Data Collection on the Percentage of Current Clinician Graphs and Organizational Return on Investment. JOURNAL OF ORGANIZATIONAL BEHAVIOR MANAGEMENT 2017. [DOI: 10.1080/01608061.2016.1267065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Chun TH, Mace SE, Katz ER. Evaluation and Management of Children With Acute Mental Health or Behavioral Problems. Part II: Recognition of Clinically Challenging Mental Health Related Conditions Presenting With Medical or Uncertain Symptoms. Pediatrics 2016; 138:peds.2016-1573. [PMID: 27550976 DOI: 10.1542/peds.2016-1573] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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15
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Cagetti MG, Mastroberardino S, Campus S, Olivari B, Faggioli R, Lenti C, Strohmenger L. Dental care protocol based on visual supports for children with autism spectrum disorders. Med Oral Patol Oral Cir Bucal 2015; 20:e598-604. [PMID: 26241453 PMCID: PMC4598930 DOI: 10.4317/medoral.20424] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/14/2015] [Indexed: 12/27/2022] Open
Abstract
Background Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments. Material and Methods 83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in order to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and, if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a psychologist (stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender, intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate. Results Seventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44 subjects who need restorative treatments, only three refused it. The acceptance rate at each stage was statistically significant associated to the verbal fluency (p=0.02; p=0.04; p=0.01, respectively for stage 1, 3 and 4). In stage 2 all subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically associated to the acceptance rate (p<0.01). Conclusions The use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used as the first strategy to treat patients with ASDs in dental setting. Key words:Autism spectrum disorders, behaviour management, paediatric dentistry, visual learning methods.
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Favre MR, La Mendola D, Meystre J, Christodoulou D, Cochrane MJ, Markram H, Markram K. Predictable enriched environment prevents development of hyper-emotionality in the VPA rat model of autism. Front Neurosci 2015; 9:127. [PMID: 26089770 PMCID: PMC4452729 DOI: 10.3389/fnins.2015.00127] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/27/2015] [Indexed: 12/27/2022] Open
Abstract
Understanding the effects of environmental stimulation in autism can improve therapeutic interventions against debilitating sensory overload, social withdrawal, fear and anxiety. Here, we evaluate the role of environmental predictability on behavior and protein expression, and inter-individual differences, in the valproic acid (VPA) model of autism. Male rats embryonically exposed (E11.5) either to VPA, a known autism risk factor in humans, or to saline, were housed from weaning into adulthood in a standard laboratory environment, an unpredictably enriched environment, or a predictably enriched environment. Animals were tested for sociability, nociception, stereotypy, fear conditioning and anxiety, and for tissue content of glutamate signaling proteins in the primary somatosensory cortex, hippocampus and amygdala, and of corticosterone in plasma, amygdala and hippocampus. Standard group analyses on separate measures were complemented with a composite emotionality score, using Cronbach's Alpha analysis, and with multivariate profiling of individual animals, using Hierarchical Cluster Analysis. We found that predictable environmental enrichment prevented the development of hyper-emotionality in the VPA-exposed group, while unpredictable enrichment did not. Individual variation in the severity of the autistic-like symptoms (fear, anxiety, social withdrawal and sensory abnormalities) correlated with neurochemical profiles, and predicted their responsiveness to predictability in the environment. In controls, the association between socio-affective behaviors, neurochemical profiles and environmental predictability was negligible. This study suggests that rearing in a predictable environment prevents the development of hyper-emotional features in animals exposed to an autism risk factor, and demonstrates that unpredictable environments can lead to negative outcomes, even in the presence of environmental enrichment.
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Affiliation(s)
- Mônica R Favre
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Deborah La Mendola
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Julie Meystre
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Dimitri Christodoulou
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Melissa J Cochrane
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Henry Markram
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
| | - Kamila Markram
- Laboratory of Neural Microcircuits, Brain Mind Institute, École Polytechnique Fédérale de Lausanne Lausanne, Switzerland
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Alfieri P, Caciolo C, Piccini G, D'Elia L, Valeri G, Menghini D, Tartaglia M, Digilio MC, Dallapiccola B, Vicari S. Behavioral phenotype in Costello syndrome with atypical mutation: a case report. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:66-71. [PMID: 25367099 DOI: 10.1002/ajmg.b.32279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 09/30/2014] [Indexed: 01/09/2023]
Abstract
Costello syndrome (CS) is a rare genetic disorder caused, in the majority of cases, by germline missense HRAS mutations affecting Gly(12) promoting enhanced signaling through the MAPK and PI3K-AKT signaling cascades. In general, the cognitive profile in CS is characterized by intellectual disability ranging from mild to severe impairment. The first published descriptions of behavior in CS children underlined the presence of irritability and shyness at younger ages with sociable personality and good empathic skills after 4-5 years of age, however some recent studies have reported autistic traits. We report on a 7-year-old boy heterozygous for a rare duplication of codon 37 (p.E37dup) in HRAS, manifesting impaired social interaction and non-verbal communication and with circumscribed interests. These additional features improve phenotype delineation in individuals with rare HRAS mutations, facilitating the development of specific behavioral treatments which could lead to improvement in cases of autism spectrum disorder.
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Affiliation(s)
- Paolo Alfieri
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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18
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Gillies D, Carroll L, Loos M. Commentary on 'Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD)'. ACTA ACUST UNITED AC 2014; 8:316-7. [PMID: 23877885 DOI: 10.1002/ebch.1902] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This is a commentary on a Cochrane review, published in this issue of EBCH, first published as: Reichow B, Steiner AM, Volkmar F. Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews 2012, Issue 7. Art. No.: CD008511. DOI: 10.1002/14651858.CD008511.pub2. Further information for this Cochrane review is available in this issue of EBCH in the accompanying Summary article.
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Affiliation(s)
- Donna Gillies
- Mental Health Service, Western Sydney Local Health District, Sydney, Australia.
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19
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Possible use of Trichuris suis ova in autism spectrum disorders therapy. Med Hypotheses 2013; 81:1-4. [PMID: 23597946 DOI: 10.1016/j.mehy.2013.03.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/01/2013] [Accepted: 03/17/2013] [Indexed: 12/24/2022]
Abstract
Autism and autism spectrum disorders (ASDs) are heterogeneous, severe neurodevelopmental pathologies. The main core symptoms are: dysfunctions in social interactions and communication skills, restricted interests, repetitive and stereotypic verbal and non-verbal behaviors. Several biochemical processes are associated with ASDs: oxidative stress; endoplasmic reticulum stress; decreased methylation capacity; limited production of glutathione; mitochondrial dysfunction; intestinal dysbiosis; increased toxic metal burden; immune dysregulation. Current available treatments for ASDs can be divided into behavioral, nutritional and medical approaches, although no defined standard approach exists. Current drugs fail to benefit the ASD core symptoms and can have marked adverse effects, are mainly palliative and only sometimes efficacy in attenuating specific autistic behaviors. Helminthic therapy shows potential for application as anti-inflammatory agent. Several human diseases can be treated by helminths (i.e. inflammatory bowel disease, asthma, multiple sclerosis and autoimmune diabetes). Trichuris suis ova (TSO) show strong immunomodulatory properties. Authors hypothesize that TSO could be useful in addressing ASD immune dysregulations. TSO could be a novel therapeutic option for ASD management.
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Oddi D, Crusio WE, D'Amato FR, Pietropaolo S. Monogenic mouse models of social dysfunction: implications for autism. Behav Brain Res 2013; 251:75-84. [PMID: 23327738 DOI: 10.1016/j.bbr.2013.01.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 12/14/2012] [Accepted: 01/05/2013] [Indexed: 12/21/2022]
Abstract
Autism is a pervasive disorder characterized by a complex symptomatology, based principally on social dysfunction. The disorder has a highly complex, largely genetic etiology, involving an impressive variety of genes, the precise contributions of which still remain to be determined. For this reason, a reductionist approach to the study of autism has been proposed, employing monogenic animal models of social dysfunction, either by targeting a candidate gene, or by mimicking a single-gene disorder characterized by autistic symptoms. In the present review, we discuss this monogenic approach by comparing examples of each strategy: the mu opioid receptor knock-out (KO) mouse line, which targets the opioid system (known to be involved in the control of social behaviors); and the Fmr1-KO mouse, a model for Fragile X syndrome (a neurodevelopmental syndrome that includes autistic symptoms). The autistic-relevant behavioral phenotypes of the mu-opioid and Fmr1-KO mouse lines are described here, summarizing previous work by our research group and others, but also providing novel experimental evidence. Relevant factors influencing the validity of the two models, such as sex differences and age at testing, are also addressed, permitting an extensive evaluation of the advantages and limits of monogenic mouse models for autism.
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Affiliation(s)
- D Oddi
- CNR, Cell Biology and Neurobiology Institute, Rome, Italy; IRCCS, Santa Lucia Foundation, Rome, Italy
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Mizejewski GJ. Biomarker testing for suspected autism spectrum disorder in early childhood: is such testing now feasible? Biomark Med 2013; 6:503-6. [PMID: 22917150 DOI: 10.2217/bmm.12.34] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Gerald J Mizejewski
- Wadsworth Center, Division of Translational Medicine, New York State Health Department, Empire State Plaza, Albany, NY 12201, USA.
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Tumiran MA, Mohamad SP, Saat RM, Mohd Yusoff MYZ, Abdul Rahman NN, Hasan Adli DS. Addressing sleep disorder of autistic children with Qur’anic sound therapy. Health (London) 2013. [DOI: 10.4236/health.2013.58a2011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Masino SA, Kawamura M, Cote JL, Williams RB, Ruskin DN. Adenosine and autism: a spectrum of opportunities. Neuropharmacology 2012; 68:116-21. [PMID: 22940000 DOI: 10.1016/j.neuropharm.2012.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 08/02/2012] [Accepted: 08/16/2012] [Indexed: 11/26/2022]
Abstract
In rodents, insufficient adenosine produces behavioral and physiological symptoms consistent with several comorbidities of autism. In rodents and humans, stimuli postulated to increase adenosine can ameliorate these comorbidities. Because adenosine is a broad homeostatic regulator of cell function and nervous system activity, increasing adenosine's influence might be a new therapeutic target for autism with multiple beneficial effects. This article is part of the Special Issue entitled 'Neurodevelopmental Disorders'.
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Affiliation(s)
- Susan A Masino
- Neuroscience Program, Trinity College, 300 Summit St., Life Sciences Center, Hartford, CT 06106, USA.
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Davis NO, Kollins SH. Treatment for co-occurring attention deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics 2012; 9:518-30. [PMID: 22678458 PMCID: PMC3441928 DOI: 10.1007/s13311-012-0126-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Interest in the co-occurrence of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) has grown in the last decade. Research on clinical populations supports the frequent co-occurrence of ADHD traits (e.g., hyperactivity) in individuals with ASD and ASD traits (e.g., social communication deficits) in individuals with ADHD. Similar trends in co-occurring traits have been observed in population-based samples, as well as family and genetic studies of affected individuals. Despite increased interest in co-occurring ADHD and ASD, relatively little research has been devoted to treatment considerations. The vast majority of intervention research has examined pharmacological treatment using traditional ADHD medications. Relatively few psychosocial interventions have directly addressed co-occurring symptoms. Treatment development will benefit from enhanced understanding of the phenomenon of co-occurring ADHD and ASD. Key topics for future research include examining developmental trajectories of co-occurring disorders, comorbid psychiatric conditions, deficits in social skills, and the nature of executive functioning impairment in individuals with co-occurring ADHD and ASD. In the current review, research in these areas is reviewed along with recommendation for future study. Given that clinicians are routinely observing and treating individuals with co-occurring symptoms, further research will yield needed information to inform intervention development and maximize benefits for affected individuals.
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Affiliation(s)
- Naomi Ornstein Davis
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, 2608 Erwin Rd., Pavilion East, Suite 300, Durham, NC 27705, USA.
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