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Byrne K, Sterrett K, Holbrook A, Kim SH, Grzadzinski R, Lord C. Extending the Usefulness of the Brief Observation of Social Communication Change (BOSCC): Validating the Phrase Speech and Young Fluent Version. J Autism Dev Disord 2024; 54:1009-1023. [PMID: 36547793 PMCID: PMC9772597 DOI: 10.1007/s10803-022-05877-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
The current study investigated the utility of the Brief Observation of Social Communication Change-Phrase Speech Young Fluent (BOSCC-PSYF) as an outcome measure of treatment response by analyzing the measure's psychometric properties and initial validity. The BOSCC coding scheme was applied to 345 administrations from 160 participants diagnosed with autism. Participants included individuals of any age with phrase speech, or individuals under the age of 8 years with complex sentences. All were receiving behavioral intervention throughout the study. Test-retest and inter-rater reliability were good for the Early Communication and Social Reciprocity/Language domains, and fair for the Restricted and Repetitive Behavior domain. Significant changes occurred over time in the Early Communication and Social Reciprocity/Language domains, and Core Total scores. The BOSCC-PSYF may provide a low-cost, flexible, and user-friendly outcome measure that reliably measures changes in broad social communicative behaviors in a short period of time.
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Affiliation(s)
| | - Kyle Sterrett
- University of California, Los Angeles, California, USA
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2
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Norris LA, Rabner JC, Storch EA, Wood JJ, Kerns C, Lewin AB, Small BJ, Kendall PC. Idiographic Coping Outcomes in Youth with Autism Spectrum Disorder and Co-Occurring Anxiety: Results from the TAASD Study. J Autism Dev Disord 2023; 53:4711-4718. [PMID: 36129626 PMCID: PMC10027616 DOI: 10.1007/s10803-022-05716-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
Versions of cognitive behavioral therapy (Coping Cat, CC; Behavioral Interventions for Anxiety in Children with Autism, BIACA) have shown efficacy in treating anxiety among youth with autism spectrum disorder. Measures of efficacy have been primarily nomothetic symptom severity assessments. The current study examined idiographic coping outcomes in the Treatment of Anxiety in Autism Spectrum Disorder study (N = 167). Longitudinal changes in coping with situations individualized to youth fears (Coping Questionnaire) were examined across CC, BIACA and treatment as usual (TAU) in a series of multilevel models. CC and BIACA produced significantly greater improvements than TAU in caregiver-reported coping. Youth report did not reflect significant differences. Results show the efficacy of CC and BIACA in improving idiographic caregiver-, but not youth-, reported youth coping.
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Affiliation(s)
- Lesley A Norris
- Temple University, Philadelphia, PA, USA.
- Department of Psychiatry and Human Behavior, Brown University, Providence, USA.
| | | | | | - Jeffrey J Wood
- University of California, Los Angeles, Los Angeles, CA, USA
| | - Connor Kerns
- University of British Columbia, Vancouver, BC, Canada
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3
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Johnson CR, Barto L, Worley S, Rothstein R, Alder ML. Telehealth parent training for sleep disturbances in young children with autism spectrum disorder: A randomized controlled trial. Sleep Med 2023; 111:208-219. [PMID: 37806263 DOI: 10.1016/j.sleep.2023.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/29/2023] [Accepted: 08/30/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND AND PURPOSE Young children with autism spectrum disorder (autism) have bedtime and sleep disturbances at much higher frequency and persistency than their neurotypical counterparts. Hence, access to early, effective treatment is critical in view of the importance of sleep in early childhood. Telehealth delivery could be a means to expand access to such early treatment if efficacious. The aim of this randomized control trial (RCT) was to compare a manualized, telehealth delivered, behaviorally based sleep parent training (SPT) intervention for parents of young children with autism and sleep disturbances to a control condition, a telehealth delivered parent education program with one sleep focused session (SPE). We hypothesized that the SPT group would show more improvements on child measures of sleep outcome measures, and daytime behaviors and parent measures of stress and sense of competence. We further aimed to explore the overall feasibility of telehealth delivery of SPT and SPE. PARTICIPANTS AND METHODS Parents of 77 young children, ages 2-7 years, with autism and co-occurring sleep disturbances were enrolled in this study. Participants were randomized to either SPT or a comparison arm that included non-sleep related parent education except for one session. Each participant was individually administered a 5 session program delivered over 10 weeks. Outcome measures, including child sleep measures, child daytime behavior and parent stress and sense of competency were collected at weeks 5 and 10 after the baseline time point. Feasibility indicators (treatment fidelity, parent adherence, and parent attendance), and safety measures were also collected. RESULTS Of 77 randomized participants, data were available for 36 participants randomized to SPT and 38 participants randomized to SPE. The mean age was 3 years, 8 months. Results support the efficacy of this manualized SPT intervention for bedtime and sleep disturbances. Sleep outcome measures were significantly improved in the SPT group compared to SPE on the Modified Simonds & Parraga Sleep Questionnaire-Composite Sleep Index (MSPSQ - CSI) (p < 0.001) with a large effect size of 0.83 at week 10. Positive response to treatment, as determined from the Clinical Global Impression-Improvement scale (CGI-I) at week 10 was observed in 56% of SPT participants compared to 32% in SPE (p = 0.037). There were no significant group differences in either the ABC-I as measure of daytime behaviors or in parental stress. There were group differences in favor of SPT over SPE on the PSOC, a measure of parent sense of competency. Feasibility and safety were further demonstrated with telehealth delivery. CONCLUSIONS This RCT demonstrated the efficacy of a telehealth delivered parent training intervention for bedtime and sleep disturbances in young autistic children compared to an active control condition. Further, parents in SPT reported more confidence in their parenting role than those in the SPE group, but SPT did not result in overall decreases in parental stress. Telehealth delivery allowed for a much broader reach with enrolled participants from 24 states. This study supports a telehealth approach to a manualized behavioral parent mediated intervention for sleep disturbance in young autistic children and offers an alternative to in-person delivered approaches. This telehealth delivery has the potential to improve access for families who have a young autistic child with sleep disturbances. Given the small sample size, determining predictors and moderators of treatment response was not possible and should be examined in a larger trial.
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Rivera-Figueroa K, Marfo NYA, Eigsti IM. Parental Perceptions of Autism Spectrum Disorder in Latinx and Black Sociocultural Contexts: A Systematic Review. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:42-63. [PMID: 34979034 PMCID: PMC8740628 DOI: 10.1352/1944-7558-127.1.42] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 03/30/2021] [Indexed: 05/15/2023]
Abstract
Parents of children with autism spectrum disorder (ASD) face challenges in accessing diagnostic and treatment services; these challenges vary by race, ethnicity, and culture. This systematic review examines parental perceptions of ASD within Latinx and Black American communities. Findings indicate that interconnections with family and religious groups promoted positive coping and describe positive impacts of having a child with ASD. Relative to White families, community members reported reduced access to information and more inaccurate beliefs about ASD, higher levels of ASD-related stigma, and more negative experiences with healthcare providers, which serve to exacerbate healthcare disparities. Conclusions are limited by an underrepresentation of minority groups in research. We call for efforts to address the specific needs of racial and ethnic minorities.
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Affiliation(s)
- Karla Rivera-Figueroa
- Karla Rivera-Figueroa, Nana Yaa A. Marfo, and Inge-Marie Eigsti, University of Connecticut
| | - Nana Yaa A Marfo
- Karla Rivera-Figueroa, Nana Yaa A. Marfo, and Inge-Marie Eigsti, University of Connecticut
| | - Inge-Marie Eigsti
- Karla Rivera-Figueroa, Nana Yaa A. Marfo, and Inge-Marie Eigsti, University of Connecticut
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5
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Klinger LG, Cook ML, Dudley KM. Predictors and Moderators of Treatment Efficacy in Children and Adolescents with Autism Spectrum Disorder. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:517-524. [DOI: 10.1080/15374416.2020.1833735] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Laura Grofer Klinger
- Department of Psychiatry, TEACCH Autism Program, University of North Carolina at Chapel Hill
| | - Michal L. Cook
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
| | - Katerina M. Dudley
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
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6
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Grzadzinski R, Janvier D, Kim SH. Recent Developments in Treatment Outcome Measures for Young Children With Autism Spectrum Disorder (ASD). Semin Pediatr Neurol 2020; 34:100806. [PMID: 32446440 PMCID: PMC7248125 DOI: 10.1016/j.spen.2020.100806] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Significant advancements have been made in early intervention programs for children with Autism spectrum disorder (ASD). However, measuring treatment response for children with ASD is difficult due to the heterogeneity of changes in symptoms, which can be subtle, especially over a short period of time. Here we outline the challenge of evaluating treatment response with currently available measures as well as newly developed or refined measures that may be useful in clinical trials for young children with ASD. Continued development of treatment outcome measures will help the field identify and compare efficacious interventions and tailor treatments for children with ASD.
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Affiliation(s)
- Rebecca Grzadzinski
- University of North Carolina, Carolina Institute for Developmental Disabilities, Chapel Hill, NC.
| | - Denisse Janvier
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY
| | - So Hyun Kim
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, White Plains, NY
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7
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Långh U, Perry A, Eikeseth S, Bölte S. Quality of Early Intensive Behavioral Intervention as a Predictor of Children's Outcome. Behav Modif 2020; 45:911-928. [PMID: 32436396 DOI: 10.1177/0145445520923998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research has directed surprisingly little attention to the quality of Early Intensive Behavioral Intervention (EIBI) in autism spectrum disorder (ASD) as a potential predictor of outcome. Therefore, using a preschool delivery model within a sample of 30 children, we examined the predictive power of EIBI quality on treatment outcome. EIBI quality was assessed at baseline by the York Measure of Quality of Intensive Behavioral Intervention (YMQI) and treatment outcome was evaluated after a period of 4 to 6 months using a battery of behavioral tests and scales to evaluate treatment success. Multinomial logistic regressions demonstrated that general EIBI quality predicted clinically significant change at follow-up. Particularly improvements in basic language and learning skills and global clinical impression were observed. Specific quality indicators that influenced overall treatment success were treatment organization, teaching level and differential reinforcement. In addition to previously examined predictors of EIBI treatment effects, such as child characteristics and intervention quantity, our findings highlight the importance of adequate EIBI quality assurance.
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Affiliation(s)
- Ulrika Långh
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Karolinska Institutet, Stockholm, Sweden.,Autism Center for Young Children, Habilitation & Health, Stockholm County Council, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Adrienne Perry
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Svein Eikeseth
- Department of Behavioral Science, Oslo Metropolitan Uninversity, Norway
| | - Sven Bölte
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Karolinska Institutet, Stockholm, Sweden.,Center for Psychiatry Research, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.,Child and Adolescent Psychiatry, Region Stockholm, Stockholm, Sweden
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8
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McConachie H, Livingstone N, Morris C, Beresford B, Le Couteur A, Gringras P, Garland D, Jones G, Macdonald G, Williams K, Parr JR. Parents Suggest Which Indicators of Progress and Outcomes Should be Measured in Young Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:1041-1051. [PMID: 28861649 PMCID: PMC5861173 DOI: 10.1007/s10803-017-3282-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Evaluation of interventions for children with autism spectrum disorder (ASD) is hampered by the multitude of outcomes measured and tools used. Measurement in research with young children tends to focus on core impairments in ASD. We conducted a systematic review of qualitative studies of what matters to parents. Parent advisory groups completed structured activities to explore their perceptions of the relative importance of a wide range of outcome constructs. Their highest ranked outcomes impacted directly on everyday life and functioning (anxiety, distress, hypersensitivity, sleep problems, happiness, relationships with brothers and sisters, and parent stress). Collaboration between professionals, researchers and parents/carers is required to determine an agreed core set of outcomes to use across evaluation research.
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Affiliation(s)
- Helen McConachie
- Institute of Health and Society, Newcastle University, Sir James Spence Institute 3rd floor, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK.
| | - Nuala Livingstone
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK.,Cochrane Editorial Unit, London, UK
| | - Christopher Morris
- PenCRU, Child Health Group, University of Exeter Medical School, Exeter, UK
| | | | - Ann Le Couteur
- Institute of Health and Society, Newcastle University, Sir James Spence Institute 3rd floor, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Paul Gringras
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Deborah Garland
- National Autistic Society, North East Resource Centre, Newcastle upon Tyne, UK
| | - Glenys Jones
- School of Education, University of Birmingham, Birmingham, UK
| | - Geraldine Macdonald
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK.,University of Bristol, Bristol, UK
| | - Katrina Williams
- Developmental Medicine, Royal Children's Hospital, University of Melbourne and Murdoch Childrens Research Institute, Parkville, Australia
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
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9
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Cohen SR, Miguel J. Amor and Social Stigma: ASD Beliefs Among Immigrant Mexican Parents. J Autism Dev Disord 2018; 48:1995-2009. [DOI: 10.1007/s10803-017-3457-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Grzadzinski R, Carr T, Colombi C, McGuire K, Dufek S, Pickles A, Lord C. Measuring Changes in Social Communication Behaviors: Preliminary Development of the Brief Observation of Social Communication Change (BOSCC). J Autism Dev Disord 2017; 46:2464-79. [PMID: 27062034 DOI: 10.1007/s10803-016-2782-9] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Psychometric properties and initial validity of the Brief Observation of Social Communication Change (BOSCC), a measure of treatment-response for social-communication behaviors, are described. The BOSCC coding scheme is applied to 177 video observations of 56 young children with ASD and minimal language abilities. The BOSCC has high to excellent inter-rater and test-retest reliability and shows convergent validity with measures of language and communication skills. The BOSCC Core total demonstrates statistically significant amounts of change over time compared to a no change alternative while the ADOS CSS over the same period of time did not. This work is a first step in the development of a novel outcome measure for social-communication behaviors with applications to clinical trials and longitudinal studies.
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Affiliation(s)
- Rebecca Grzadzinski
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, 21 Bloomingdale Road, Rogers Building, White Plains, NY, 10605, USA
- Teachers College, Columbia University, New York, NY, USA
| | - Themba Carr
- Center for Autism Research and Treatment, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | - Kelly McGuire
- Center for Autism and Developmental Disorders, Maine Behavioral Health Care, South Portland, ME, USA
- New York Presbyterian Hospital, Columbia University Medical Center and New York State Psychiatric Institute, New York, NY, USA
| | - Sarah Dufek
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, 21 Bloomingdale Road, Rogers Building, White Plains, NY, 10605, USA
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Catherine Lord
- Center for Autism and the Developing Brain, Weill Cornell Medical College, New York-Presbyterian Hospital, 21 Bloomingdale Road, Rogers Building, White Plains, NY, 10605, USA.
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11
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Långh U, Cauvet E, Hammar M, Bölte S. Cross-Cultural Validation of the York Measure of Quality of Intensive Behavioral Intervention. Behav Modif 2017; 41:808-828. [PMID: 28691542 DOI: 10.1177/0145445517719397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Early intensive behavioral intervention (EIBI) is widely applied in young children with autism spectrum disorder. Little research has addressed the significance of adherence to EIBI practices for treatment outcomes. The York Measure of Quality of Intensive Behavioral Intervention (YMQI) was designed to assess EIBI quality delivery in Ontario, Canada. The objective of this study was to examine the cross-cultural validity of the YMQI in a clinical Swedish community sample of 30 boys and four girls with autism aged 2.5 to 6 years. Internal consistency was alpha = .87 for the full scale YMQI. Interrater reliability among three raters on 97 video-recorded therapy sequences was .71 (intraclass correlation coefficient [ICC]), and intrarater reliability of two raters re-scoring 15 sequences after 6 months was ICC = .87. The convergent validity of the YMQI with EIBI expert ratings was r = .49. Findings endorse the psychometric properties of the YMQI and its usability outside of Anglo-Saxon countries.
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Affiliation(s)
- Ulrika Långh
- 1 Karolinska Institutet, Stockholm, Sweden.,2 Stockholm County Council, Stockholm, Sweden
| | - Elodie Cauvet
- 1 Karolinska Institutet, Stockholm, Sweden.,2 Stockholm County Council, Stockholm, Sweden
| | - Martin Hammar
- 1 Karolinska Institutet, Stockholm, Sweden.,2 Stockholm County Council, Stockholm, Sweden
| | - Sven Bölte
- 1 Karolinska Institutet, Stockholm, Sweden.,2 Stockholm County Council, Stockholm, Sweden
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12
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13
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Williams KR. The Son-Rise Program® intervention for autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2016; 10:86-102. [PMID: 16522712 DOI: 10.1177/1362361306062012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With increasing availability of interventions for children with autism, it is important that these are backed by rigorous evaluation data that have high levels of ecological validity. To achieve this, a key prerequisite for any evaluation is to gather data on typical consumers and typical implementation patterns of the intervention. This study collected such data longitudinally in relation to the Son-Rise Program®, a home-based parent-run intervention for autism. Questionnaires and interview data on family demographics, implementation patterns, and perceived treatment fidelity were gathered three times over the course of a year from families who had attended a Son-Rise® initial training course. Although it proved possible to produce a profile of intervention use, findings indicated that the programme is not always implemented as it is typically described in the literature. The study also highlighted methodological challenges likely to be encountered in any future evaluation of this and similar interventions for autism.
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Affiliation(s)
- K R Williams
- Moray House School of Education, University of Edinburgh, Scotland.
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14
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Abstract
PURPOSE To describe the use of practice-based evidence research methodology in a prospective, multisite observational study to investigate changes in students' participation in school activity, self-care, posture/mobility, recreation/fitness, and academic outcomes, and the relationships of these changes to characteristics of school-based physical therapy. METHODS One hundred nine physical therapists completed the training and data collection and 296 students, 5 to 12 years of age (mean age = 7.3 years) had 6 months of complete data. Therapists completed individualized (Goal Attainment Scaling) and standardized (School Function Assessment) outcome measures for students at the beginning and end of the school year and during the year collected weekly data on services to and on behalf of the students. SUMMARY This research design enabled the investigation of complex research questions related to school-based practice. The findings of this study, to be reported later, should influence school-based therapy by providing guidance related to what activities, interventions, and services influence student outcomes.
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15
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McConachie H, Parr JR, Glod M, Hanratty J, Livingstone N, Oono IP, Robalino S, Baird G, Beresford B, Charman T, Garland D, Green J, Gringras P, Jones G, Law J, Le Couteur AS, Macdonald G, McColl EM, Morris C, Rodgers J, Simonoff E, Terwee CB, Williams K. Systematic review of tools to measure outcomes for young children with autism spectrum disorder. Health Technol Assess 2015; 19:1-506. [PMID: 26065374 PMCID: PMC4781156 DOI: 10.3310/hta19410] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact. OBJECTIVES To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. METHODS The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. RESULTS The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed tools was combined with information about their accessibility and presentation. Twelve tools were identified as having the strongest supporting evidence, the majority measuring autism characteristics and problem behaviour. The patchy evidence and limited scope of outcomes measured mean these tools do not constitute a 'recommended battery' for use. In particular, there is little evidence that the identified tools would be good at detecting change in intervention studies. The obvious gaps in available outcome measurement include well-being and participation outcomes for children, and family quality-of-life outcomes, domains particularly valued by our informants (young people with ASD and parents). CONCLUSIONS This is the first systematic review of the quality and appropriateness of tools designed to monitor progress and outcomes of young children with ASD. Although it was not possible to recommend fully robust tools at this stage, the review consolidates what is known about the field and will act as a benchmark for future developments. With input from parents and other stakeholders, recommendations are made about priority targets for research. FUTURE WORK Priorities include development of a tool to measure child quality of life in ASD, and validation of a potential primary outcome tool for trials of early social communication intervention. STUDY REGISTRATION This study is registered as PROSPERO CRD42012002223. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Magdalena Glod
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Hanratty
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Nuala Livingstone
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Inalegwu P Oono
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Shannon Robalino
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian Baird
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Deborah Garland
- National Autistic Society North East Autism Resource Centre, Newcastle upon Tyne, UK
| | - Jonathan Green
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Paul Gringras
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Glenys Jones
- School of Education, University of Birmingham, Birmingham, UK
| | - James Law
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ann S Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Geraldine Macdonald
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Elaine M McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Morris
- PenCRU, Child Health Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Jacqueline Rodgers
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Katrina Williams
- University of Melbourne, Royal Children's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia
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16
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Ginn NC, Clionsky LN, Eyberg SM, Warner-Metzger C, Abner JP. Child-Directed Interaction Training for Young Children With Autism Spectrum Disorders: Parent and Child Outcomes. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:101-109. [PMID: 25785646 DOI: 10.1080/15374416.2015.1015135] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined the efficacy of the Child-Directed Interaction Training (CDIT) phase of Parent-Child Interaction Therapy for children with an Autism Spectrum Disorder (ASD). Thirty mother-child dyads with children ages 3-7 years with a diagnosis of ASD participated in this randomized controlled study. Following manualized CDIT, statistically significant and meaningful improvements in child disruptive behavior and social awareness as well as maternal distress associated with child disruptive behavior occurred. Across 8 sessions, mothers learned to provide positive attention to their children's appropriate social and play behaviors. Both child and parent changes were maintained at 6-week follow-up. A relatively brief, time-limited, and accessible intervention may be efficacious for improving child and parent behaviors in families of young children with ASD. By decreasing child disruptive behaviors, CDIT may also help to prepare children to benefit further from future interventions.
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Affiliation(s)
- Nicole C Ginn
- a Department of Clinical and Health Psychology , University of Florida ,
| | - Leah N Clionsky
- a Department of Clinical and Health Psychology , University of Florida ,
| | - Sheila M Eyberg
- a Department of Clinical and Health Psychology , University of Florida ,
| | | | - John-Paul Abner
- c Occupational Therapy, Psychology and Counseling , Milligan College ,
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Howard JS, Stanislaw H, Green G, Sparkman CR, Cohen HG. Comparison of behavior analytic and eclectic early interventions for young children with autism after three years. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3326-44. [PMID: 25190094 DOI: 10.1016/j.ridd.2014.08.021] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 08/06/2014] [Accepted: 08/12/2014] [Indexed: 05/26/2023]
Abstract
In a previous study, we compared the effects of just over one year of intensive behavior analytic intervention (IBT) provided to 29 young children diagnosed with autism with two eclectic (i.e., mixed-method) interventions (Howard, Sparkman, Cohen, Green, & Stanislaw, 2005). One eclectic intervention (autism programming; AP) was designed specifically for children with autism and was intensive in that it was delivered for an average of 25-30 h per week (n = 16). The other eclectic intervention (generic programming; GP) was delivered to 16 children with a variety of diagnoses and needs for an average of 15-17 h per week. This paper reports outcomes for children in all three groups after two additional years of intervention. With few exceptions, the benefits of IBT documented in our first study were sustained throughout Years 2 and 3. At their final assessment, children who received IBT were more than twice as likely to score in the normal range on measures of cognitive, language, and adaptive functioning than were children who received either form of eclectic intervention. Significantly more children in the IBT group than in the other two groups had IQ, language, and adaptive behavior test scores that increased by at least one standard deviation from intake to final assessment. Although the largest improvements for children in the IBT group generally occurred during Year 1, many children in that group whose scores were below the normal range after the first year of intervention attained scores in the normal range of functioning with one or two years of additional intervention. In contrast, children in the two eclectic treatment groups were unlikely to attain scores in the normal range after the first year of intervention, and many of those who had scores in the normal range in the first year fell out of the normal range in subsequent years. There were no consistent differences in outcomes at Years 2 and 3 between the two groups who received eclectic interventions. These results provide further evidence that intensive behavior analytic intervention delivered at an early age is more likely to produce substantial improvements in young children with autism than common eclectic interventions, even when the latter are intensive.
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Affiliation(s)
- Jane S Howard
- California State University, Stanislaus, Psychology Department, 1 University Circle, Turlock, CA 95382, USA; The Kendall Centers/Therapeutic Pathways, Modesto, CA 95354, USA.
| | - Harold Stanislaw
- California State University, Stanislaus, Psychology Department, 1 University Circle, Turlock, CA 95382, USA.
| | - Gina Green
- Association of Professional Behavior Analysts, 6977 Navajo Road #176, San Diego, CA 92119, USA.
| | | | - Howard G Cohen
- Valley Mountain Regional Center, 702 North Aurora St, Stockton, CA 95202, USA
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MacDonald R, Parry-Cruwys D, Dupere S, Ahearn W. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3632-3644. [PMID: 25241118 DOI: 10.1016/j.ridd.2014.08.036] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/22/2014] [Accepted: 08/28/2014] [Indexed: 06/03/2023]
Abstract
Intensive behavioral intervention for young children diagnosed with autism can produce large gains in social, cognitive, and language development. Although several studies have identified behaviors that are possible indicators of best outcome, changes in performance are typically measured using norm-referenced standardized scores referencing overall functioning level rather than via repeated observational measures of autism-specific deficits (i.e., social behavior). In the current study, 83 children with autism (CWA), aged 1, 2 and 3 years, and 58 same-aged typically developing children (TDC) were directly observed in the areas of cognitive skills, joint attention (JA), play, and stereotypic behavior using a measure called the Early Skills Assessment Tool (ESAT; MacDonald et al., 2006). CWA were assessed at entry into an EIBI program and again after 1 year of treatment. Changes in performance were compared pre- and post-treatment as well as to the normative data by age. Results indicate significant gains on the ESAT across all age groups with the greatest gains seen in the children who entered treatment prior to their second birthday. Increases were seen on direct measures of JA, play, imitation and language while decreases were seen in stereotypy regardless of level of performance at entry into EIBI. The ESAT, a direct measurement tool, served as a sensitive tool to measure changes in autism symptomatology following EIBI treatment.
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Affiliation(s)
| | | | - Sally Dupere
- The New England Center for Children, Southborough, USA
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19
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Stahmer AC, Reed S, Lee E, Reisinger EM, Connell JE, Mandell DS. Training Teachers to use Evidence-Based Practices for Autism: Examining Procedural Implementation fidelity. PSYCHOLOGY IN THE SCHOOLS 2014; 52:181-195. [PMID: 25593374 DOI: 10.1002/pits.21815] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to examine the extent to which public school teachers implemented evidence-based interventions for students with autism in the way these practices were designed. Evidence-based practices for students with autism are rarely incorporated into community settings, and little is known about the quality of implementation. An indicator of intervention quality is procedural implementation fidelity (the degree to which a treatment is implemented as prescribed). Procedural fidelity likely affects student outcomes. This project examined procedural implementation fidelity of three evidence-based practices used in a randomized trial of a comprehensive program for students with autism in partnership with a large, urban school district. Results indicate that teachers in public school special education classrooms can learn to implement evidence-based strategies; however they require extensive training, coaching, and time to reach and maintain moderate procedural implementation fidelity. Procedural fidelity over time, and across intervention strategies is examined.
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Affiliation(s)
- Aubyn C Stahmer
- Child and Adolescent Services Research Center & Autism Discovery Institute, Rady Children's Hospital, San Diego, 3020 Children's Way, MC5033, San Diego, CA 92123 ; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0812, La Jolla, CA 92073-0812
| | - Sarah Reed
- Child and Adolescent Services Research Center & Autism Discovery Institute, Rady Children's Hospital, San Diego, 3020 Children's Way, MC5033, San Diego, CA 92123 ; Department of Psychiatry, University of California, San Diego, 9500 Gilman Drive, 0812, La Jolla, CA 92073-0812
| | - Ember Lee
- Child and Adolescent Services Research Center & Autism Discovery Institute, Rady Children's Hospital, San Diego, 3020 Children's Way, MC5033, San Diego, CA 92123
| | - Erica M Reisinger
- Penn Medicine, Dept. of Psychiatry, The Children's Hospital of Philadelphia Center for Autism Research, 3535 Market Street, 8th floor, Philadelphia, PA 19104
| | - James E Connell
- AJ Drexel Autism Institute, 3020 Market Street, Suite 560, Philadelphia, PA 19104
| | - David S Mandell
- Penn Medicine, Dept. of Psychiatry, The Children's Hospital of Philadelphia Center for Autism Research, 3535 Market Street, 8th floor, Philadelphia, PA 19104
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20
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D'Elia L, Valeri G, Sonnino F, Fontana I, Mammone A, Vicari S. A longitudinal study of the teacch program in different settings: the potential benefits of low intensity intervention in preschool children with autism spectrum disorder. J Autism Dev Disord 2014; 44:615-26. [PMID: 23949000 DOI: 10.1007/s10803-013-1911-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
We conducted a longitudinal study of 30 preschool children with autism spectrum disorders (ASDs) to evaluate the potential benefits of the Treatment and Education of Autistic and related Communication Handicapped Children (TEACCH). Fifteen children following a low intensity TEACCH program were assessed four times for autism severity, adaptive functioning, language skills, maladaptive behaviors and parental stress and compared with a control group of 15 children following a non-specific approach. Findings suggest that a low intensity home and school TEACCH program may provide benefits for children with ASD by reducing autistic symptoms and maladaptive behaviors. Furthermore, a decrease in parental stress indicates that parents' involvement in the rehabilitation program is a crucial factor and contributes greatly to treatment efficacy.
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Affiliation(s)
- Lidia D'Elia
- Department of Neuroscience, Children's Hospital Bambino Gesù, Piazza Sant'Onofrio 4, 00165, Rome, Italy,
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21
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Fava L, Strauss K. Response to Early Intensive Behavioral Intervention for autism—An umbrella approach to issues critical to treatment individualization. Int J Dev Neurosci 2014; 39:49-58. [DOI: 10.1016/j.ijdevneu.2014.05.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/16/2014] [Accepted: 05/16/2014] [Indexed: 11/27/2022] Open
Affiliation(s)
- Leonardo Fava
- Association for Treatment and Research in Autism and Related Conditions “Umbrella”RomeItaly
| | - Kristin Strauss
- Association for Treatment and Research in Autism and Related Conditions “Umbrella”RomeItaly
- Department of Health and PreventionErnst‐Moritz‐Arndt UniversityGreifswaldGermany
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22
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Stevenson RA, Segers M, Ferber S, Barense MD, Wallace MT. The impact of multisensory integration deficits on speech perception in children with autism spectrum disorders. Front Psychol 2014; 5:379. [PMID: 24904448 PMCID: PMC4033130 DOI: 10.3389/fpsyg.2014.00379] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/10/2014] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Magali Segers
- Department of Psychology, York UniversityToronto, ON, Canada
| | - Susanne Ferber
- Department of Psychology, University of TorontoToronto, ON, Canada
| | - Morgan D. Barense
- Department of Psychology, University of TorontoToronto, ON, Canada
- Rotman Research InstituteToronto, ON, Canada
| | - Mark T. Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University Medical CenterNashville, TN, USA
- Vanderbilt University Medical Center, Vanderbilt Brain InstituteNashville, TN, USA
- Vanderbilt Kennedy CenterNashville, TN, USA
- Department of Psychology, Vanderbilt UniversityNashville, TN, USA
- Department of Psychiatry, Vanderbilt University Medical CenterNashville, TN, USA
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23
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Zachor DA, Curatolo P. Recommendations for early diagnosis and intervention in autism spectrum disorders: an Italian-Israeli consensus conference. Eur J Paediatr Neurol 2014; 18:107-18. [PMID: 24095105 DOI: 10.1016/j.ejpn.2013.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/12/2013] [Indexed: 12/22/2022]
Abstract
On April 2013 experts in the field of autism from Italy and Israel convened in Jerusalem to discuss and finalize clinical recommendations for early diagnosis and intervention in Autism Spectrum Disorders (ASDs). In this paper, we summarize the results of this Italian-Israeli consensus conference. ASDs constitute a class of severe and heterogeneous neurodevelopmental conditions caused by atypical brain development beginning during early prenatal life, reflecting many genetic, neurobiological and environmental influences. The first clinical signs of ASDs begin to be evident in children between 12 and 18 months of age, often after a period of relatively typical postnatal development. Recent longitudinal studies reveal substantial diversity in developmental trajectories through childhood and adolescence. Some intervention approaches have been demonstrated to be effective in improving core symptoms of ASDs, even if the heterogeneity and developmental nature of the disorder make it implausible that only one specific treatment will be best for all children with ASDs. More randomized control trials (RCTs) on early intervention are needed to identify the most effective strategies and provide the most efficient allocation of resources during the critical early intervention time period. Future research should focus on linking biological phenotypes with specific genotypes, thus establishing a foundation for the development of diagnostic screening tools and individualization of treatments.
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Affiliation(s)
- Ditza A Zachor
- Department of Pediatrics, The Autism Center, Assaf Harofe Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Paolo Curatolo
- Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University of Rome, Tor Vergata University, via Montpellier 1, 00133 Rome, Italy.
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24
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Wigham S, McConachie H. Systematic review of the properties of tools used to measure outcomes in anxiety intervention studies for children with autism spectrum disorders. PLoS One 2014; 9:e85268. [PMID: 24465519 PMCID: PMC3897429 DOI: 10.1371/journal.pone.0085268] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 11/25/2013] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Evidence about relevant outcomes is required in the evaluation of clinical interventions for children with autism spectrum disorders (ASD). However, to date, the variety of outcome measurement tools being used, and lack of knowledge about the measurement properties of some, compromise conclusions regarding the most effective interventions. OBJECTIVES This two-stage systematic review aimed to identify the tools used in studies evaluating interventions for anxiety for high-functioning children with ASD in middle childhood, and then to evaluate the tools for their appropriateness and measurement properties. METHODS Electronic databases including Medline, PsychInfo, Embase, and the Cochrane database and registers were searched for anxiety intervention studies for children with ASD in middle childhood. Articles examining the measurement properties of the tools used were then searched for using a methodological filter in PubMed, and the quality of the papers evaluated using the COSMIN checklist. RESULTS Ten intervention studies were identified in which six tools measuring anxiety and one of overall symptom change were used as primary outcomes. One further tool was included as it is recommended for standard use in UK children's mental health services. Sixty three articles on the properties of the tools were evaluated for the quality of evidence, and the quality of the measurement properties of each tool was summarised. CONCLUSIONS Overall three questionnaires were found robust in their measurement properties, the Spence Children's Anxiety Scale, its revised version - the Revised Children's Anxiety and Depression Scale, and also the Screen for Child Anxiety Related Emotional Disorders. Crucially the articles on measurement properties provided almost no evidence on responsiveness to change, nor on the validity of use of the tools for evaluation of interventions for children with ASD. PROSPERO REGISTRATION NUMBER CRD42012002684.
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Affiliation(s)
- Sarah Wigham
- Institute of Health & Society, Newcastle University, Newcastle, United Kingdom
| | - Helen McConachie
- Institute of Health & Society, Newcastle University, Newcastle, United Kingdom
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25
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White SW, Smith LA, Schry AR. Assessment of global functioning in adolescents with autism spectrum disorders: utility of the Developmental Disability-Child Global Assessment Scale. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2013; 18:362-9. [PMID: 23965288 DOI: 10.1177/1362361313481287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment Scale in a sample of higher functioning adolescents with autism spectrum disorders and comorbid anxiety disorders enrolled in a randomized controlled trial (n = 30). Pretreatment Developmental Disability-Child Global Assessment Scale scores correlated with severity of autism spectrum disorders core symptoms (r = -.388, p = .034), pragmatic communication (r = .407, p = .032), and verbal ability (r = .449, p = .013) and did not correlate with severity of anxiety symptoms or with parent-reported adaptive behavior. Change in Developmental Disability-Child Global Assessment Scale scores during treatment was associated with autism spectrum disorders symptomatic improvement (r = .414, p = .040) and with improved general communication (r = .499, p = .013). Results support the importance of assessing global functioning in addition to symptom change and treatment response in clinical trials.
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26
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van Haaren F, Weeden M. Some guidelines for conducting research in applied behavioral pharmacology. J Appl Behav Anal 2013; 46:498-506. [PMID: 24114163 DOI: 10.1002/jaba.47] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Accepted: 09/05/2012] [Indexed: 11/05/2022]
Abstract
The Journal of Applied Behavior Analysis (JABA) has published a number of articles on the behavioral effects of psychomotor stimulant drugs in individuals with attention deficit hyperactivity disorder. Some additional JABA publications have included investigations of the behavioral effects of other drugs. However, a review of these articles revealed many methodological differences among studies, which makes it difficult to evaluate the relative contribution of each research effort to the overall database. In this context, we offer some guidelines to solidify the methodological rigor of behavior pharmacological research published in JABA.
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Abstract
Designing effective treatments for improving early social behaviors in autism has been identified as a critical research need. One barrier to drawing conclusions about optimal treatments for children with autism is the use of highly varied dependent measures in the treatment literature. Contributing to this is the absence of "gold standard" assessment batteries. This is particularly true for assessing changes in social interaction impairments in very young children with autism. This paper addresses this issue by reviewing variables important in the development and evaluation of assessment measures, discussing previous studies' choices of socially-related dependent measures, and the strengths, limitations, and research questions pertaining to them. It concludes with recommendations for measurement selection and future directions for research.
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28
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Hamilton D, Zoitas A. The Social Validity of Interventions for Promoting Preschool Children's Peer Interactions. BEHAVIOUR CHANGE 2012. [DOI: 10.1375/bech.20.4.208.29380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThis analogue study investigated the social validity of classroom interventions designed to promote peer interactions in young children. The influences of child characteristics and diagnostic labels on social validity ratings were examined, as were the relationships among three components of social validity. Forty-two preschool teachers completed a 15-item social validity scale that yielded scores pertaining to intervention goals, procedures and effects. Participants rated three types of intervention, which varied according to individuals targeted and intensity of programming procedures, with reference to one of three case descriptions of children with social interaction problems. Half the participants were provided with the child's diagnostic label. Results indicated that social validity is affected by interactions between intervention methods and child characteristics. The inclusion of diagnostic labels in the case descriptions had no effect on social validity ratings. Strong positive relationships were found among the components of social validity. Implications for the use of empirically validated interventions in inclusive preschools are discussed.
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29
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Wang HT, Sandall SR, Davis CA, Thomas CJ. Social skills assessment in young children with autism: a comparison evaluation of the SSRS and PKBS. J Autism Dev Disord 2012; 41:1487-95. [PMID: 21225453 DOI: 10.1007/s10803-010-1175-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Impairment in the development of reciprocal social interaction and other social skills is one of the defining characteristics of Autism Spectrum Disorders (ASD). There is a need for assessment tools that will help guide social skills interventions and document outcomes. The purpose of this study was to examine the potential usefulness of two behavior rating scales with young children with ASD in an early childhood program. The results showed that the two social skills measures, the SSRS and PKBS, had adequate psychometric properties in terms of internal consistency, construct validity, convergent validity, and criterion validity with the AEPS, and were found to be predictive of how the tests would function when assessing young children with ASD in a natural setting. However, their usefulness in detecting social skills progress over time or intervention outcomes for young children with ASD may not be satisfactory.
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Affiliation(s)
- Hui-Ting Wang
- Department of Special Education, National Taiwan Normal University, No. 162 Heping East Road, Sec. 1, Taipei 106, Taiwan.
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30
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White SW, Oswald D, Ollendick T, Scahill L. Anxiety in children and adolescents with autism spectrum disorders. Clin Psychol Rev 2009; 29:216-29. [PMID: 19223098 PMCID: PMC2692135 DOI: 10.1016/j.cpr.2009.01.003] [Citation(s) in RCA: 741] [Impact Index Per Article: 49.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 01/13/2009] [Accepted: 01/20/2009] [Indexed: 11/17/2022]
Abstract
Anxiety and poor stress management are common concerns in clinical samples of children with autism spectrum disorders (ASD). Anxiety may worsen during adolescence, as young people face an increasingly complex social milieu and often become more aware of their differences and interpersonal difficulties. This review summarizes the state of research on the prevalence, phenomenology, and treatment of anxiety in youth with autism and related conditions such as Asperger's Disorder. Using search words autism, asperger(s), or pervasive developmental disorder and anxiety or anxious to find reports published between 1990 and 2008, this review identified 40 papers. The results of the review suggest that anxiety, whether measured categorically or dimensionally, is indeed common in children and adolescents with autism spectrum disorders and may be a source of additional morbidity. The assessment of anxiety disorders in ASD should be conducted using multiple informants and modalities, as children with ASD often do not display age-typical symptoms of anxiety. To date, relatively few controlled intervention studies using well-characterized samples have been conducted despite preliminary evidence for efficacy of select pharmacological and psychosocial approaches. Recommendations for future applied research are presented and clinical implications are explored.
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Affiliation(s)
- Susan W. White
- Virginia Polytechnic Institute and State University, Department of Psychology, 109 Williams Hall (0436), Blacksburg, VA 24061, ,
| | - Donald Oswald
- Virginia Treatment Center for Children, Virginia Commonwealth University, 515 North 10 Street, PO Box 980489, Richmond, VA 23298-0489,
| | - Thomas Ollendick
- Virginia Polytechnic Institute and State University, Department of Psychology, 109 Williams Hall (0436), Blacksburg, VA 24061, ,
| | - Lawrence Scahill
- Yale Child Study Center, Yale University, 230 South Frontage Street, New Haven, CT 06520,
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31
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Morris EK. A case study in the misrepresentation of applied behavior analysis in autism: the gernsbacher lectures. THE BEHAVIOR ANALYST 2009; 32:205-40. [PMID: 22478522 PMCID: PMC2686987 DOI: 10.1007/bf03392184] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
I know that most men, including those at ease with problems of the greatest complexity, can seldom accept the simplest and most obvious truth if it be such as would oblige them to admit the falsity of conclusions which they have proudly taught to others, and which they have woven, thread by thread, into the fabrics of their life. (Tolstoy, 1894)This article presents a case study in the misrepresentation of applied behavior analysis for autism based on Morton Ann Gernsbacher's presentation of a lecture titled "The Science of Autism: Beyond the Myths and Misconceptions." Her misrepresentations involve the characterization of applied behavior analysis, descriptions of practice guidelines, reviews of the treatment literature, presentations of the clinical trials research, and conclusions about those trials (e.g., children's improvements are due to development, not applied behavior analysis). The article also reviews applied behavior analysis' professional endorsements and research support, and addresses issues in professional conduct. It ends by noting the deleterious effects that misrepresenting any research on autism (e.g., biological, developmental, behavioral) have on our understanding and treating it in a transdisciplinary context.
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Rogers SJ, Vismara LA. Evidence-based comprehensive treatments for early autism. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2008; 37:8-38. [PMID: 18444052 DOI: 10.1080/15374410701817808] [Citation(s) in RCA: 392] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Early intervention for children with autism is currently a politically and scientifically complex topic. Randomized controlled trials have demonstrated positive effects in both short-term and longer term studies. The evidence suggests that early intervention programs are indeed beneficial for children with autism, often improving developmental functioning and decreasing maladaptive behaviors and symptom severity at the level of group analysis. Whether such changes lead to significant improvements in terms of greater independence and vocational and social functioning in adulthood is also unknown. Given the few randomized controlled treatment trials that have been carried out, the few models that have been tested, and the large differences in interventions that are being published, it is clear that the field is still very early in the process of determining (a) what kinds of interventions are most efficacious in early autism, (b) what variables moderate and mediate treatment gains and improved outcomes following intervention, and (c) the degree of both short-term and long-term improvements that can reasonably be expected. To examine these current research needs, the empirical studies of comprehensive treatments for young children with autism published since 1998 were reviewed. Lovaas's treatment meet Chambless and colleague's (Chambless et al., 1998; Chambless et al., 1996) criteria for "well-established" and no treatment meets the "probably efficacious" criteria, though three treatments meet criteria for "possibly efficacious" (Chambless & Hollon, 1998). Most studies were either Type 2 or 3 in terms of their methodological rigor based on Nathan and Gorman's (2002) criteria. Implications of these findings are also discussed in relation to practice guidelines as well as critical areas of research that have yet to be answered.
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Affiliation(s)
- Sally J Rogers
- M.I.N.D. Institute, University of California Davis, CA 95817, USA.
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33
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Matson JL, Dempsey T, Lovullo SV, Wilkins J. The effects of intellectual functioning on the range of core symptoms of autism spectrum disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2008; 29:341-50. [PMID: 17646082 DOI: 10.1016/j.ridd.2007.06.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Autism spectrum disorders (ASD) are a class of conditions categorized by communication problems, ritualistic behaviors, and inappropriate social behaviors. While there is much evidence to support a genetic link for ASD, an identified genetic marker remains elusive. As such, practitioners place considerable emphasis on traditional measures of intelligence and adaptive behavior to aid in diagnosis. Despite the fact that these measures are commonplace, little research has been conducted to shed light on whether deficits in intellectual functioning affect the range of core symptoms for ASD. This study represents a first attempt to determine whether level of IQ has an effect on the expression of ASD symptoms in adults with intellectual disability (ID). Three hundred and six adults, 151 with both ASD and ID and 155 with ID alone, were evaluated with respect to the nature and extent of their ASD symptoms and intellectual functioning. Individuals with autism displayed a higher number of symptoms than those with pervasive developmental disorder-not otherwise specified (PDD-NOS) on all three domains of impairment (social, communication, repetitive behaviors). As expected, persons with ID alone evinced far fewer symptoms than both these groups. IQ level was found to be a moderator for expression of ASD symptoms for the entire sample but not for the autism group.
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Affiliation(s)
- Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
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34
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Reichow B, Wolery M. Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. J Autism Dev Disord 2008; 39:23-41. [PMID: 18535894 DOI: 10.1007/s10803-008-0596-0] [Citation(s) in RCA: 159] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Accepted: 05/15/2008] [Indexed: 12/15/2022]
Abstract
A 3-part comprehensive synthesis of the early intensive behavioral intervention (EIBI) for young children with autism based on the University of California at Los Angeles Young Autism Project method (Lovaas in Journal of Consulting and Clinical Psychology, 55, 3-9, 1987) is presented. The three components of the synthesis were: (a) descriptive analyses, (b) effect size analyses, and (c) a meta-analysis. The findings suggest EIBI is an effective treatment, on average, for children with autism. The conditions under which this finding applies and the limitations and cautions that must be taken when interpreting the results are discussed within the contextual findings of the moderator analyses conducted in the meta-analysis.
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Affiliation(s)
- Brian Reichow
- Department of Special Education, Vanderbilt University, Nashville, TN 37203, USA.
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Song SY, Stoiber KC. Children Exposed to Violence at School: An Evidence-based Intervention Agenda for the “Real” Bullying Problem. ACTA ACUST UNITED AC 2008. [DOI: 10.1080/10926790801986205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Matson JL, Wilkins J, Ancona M. Autism in adults with severe intellectual disability: an empirical study of symptom presentation. JOURNAL OF INTELLECTUAL & DEVELOPMENTAL DISABILITY 2008; 33:36-42. [PMID: 18300165 DOI: 10.1080/13668250701829837] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Autism is one of the most intriguing and highly studied conditions in the field of mental health. However, most research has been carried out with young children to the exclusion of adults, particularly adults with intellectual disability (ID). The present study represents a first attempt to describe symptom patterns of autism for adults with severe ID. METHOD Fifty-seven adults with ID who met DSM-IV-TR and ICD-10 diagnostic criteria for autism were compared to 57 matched controls with ID only (no Axis I diagnosis). RESULTS Marked differences were noted in a range of symptoms, particularly with respect to impairments in social interaction and restricted or repetitive behaviours and interests. These items were able to predict the presence or absence of autism at a high rate of diagnostic accuracy. CONCLUSIONS Based on these findings, it appears that adults with ID and autism evince a distinct pattern of impairment when compared to controls with ID alone.
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Affiliation(s)
- Johnny L Matson
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA.
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Abstract
Facilitating the learning and participation of pupils with Asperger syndrome and high-functioning autism (herein referred to as AS) in mainstream schools is complex and poorly understood. We report on a small-scale qualitative study of the views and experiences of 20 such pupils drawn from four secondary schools in north-west England. Data were collected through semi-structured interviews and pupil diaries. Interpretive phenomenological analysis was used to explore how pupils with AS make sense of their educational experiences. The central theme was how participants constructed their understanding of what their AS meant to them. This was often characterized by negative perceptions of their differences, such as being `retarded' or having a `bad brain'. The links between this understanding and reported difficulties with peers and teachers, the desire to `fit in', and other themes are discussed. The implications of these findings for policy and practice in this area are also presented.
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Abstract
Engagement is a core component of effective educational programs for children with autism. Analysis of 711 naturalistic goal-directed classroom behaviors of four school-age children with autism and four comparable children with Down syndrome (DS) was conducted. The definition of engagement was expanded to include child compliance and congruence. A main finding was both child and environmental factors influenced type of engagement. Children with DS produced 20% more goal-directed behaviors that were both congruent and compliant compared to children with autism. Large group instruction was associated with less congruent engagement but more compliant engagement for children with autism. These findings suggest specific types of engagement which may lead to advances in developing evidence-based practices for specific developmental disorders.
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Affiliation(s)
- Lisa A Ruble
- Department of Pediatrics, University of Louisville, WCEC-STAR, 571 S. Floyd, Suite 100, Louisville, KY 40202, USA.
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Lee LC, Harrington RA, Louie BB, Newschaffer CJ. Children with autism: quality of life and parental concerns. J Autism Dev Disord 2007; 38:1147-60. [PMID: 18058214 DOI: 10.1007/s10803-007-0491-0] [Citation(s) in RCA: 155] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 10/24/2007] [Indexed: 12/16/2022]
Abstract
Past research has shown that children with autism and their families have compromised quality of life (QOL) in several domains. This study examined QOL and parental concerns in children with autism during early childhood, childhood, and adolescence compared to children with Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) and to typical controls from a US national sample. Families with children diagnosed with autism reported more profound QOL effects than families of children with ADD/ADHD or unaffected controls. Children with autism were significantly less likely to attend religious services, more likely to miss school, and less likely to participate in organized activities. Parental concerns over learning difficulty, being bullied, stress-coping, and achievement were overwhelming in the autism group relative to the comparison groups.
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Affiliation(s)
- Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Suite E6032, Baltimore, MD 21205, USA.
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Ben-Itzchak E, Zachor DA. The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism. RESEARCH IN DEVELOPMENTAL DISABILITIES 2007; 28:287-303. [PMID: 16730944 DOI: 10.1016/j.ridd.2006.03.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2006] [Revised: 03/02/2006] [Accepted: 03/28/2006] [Indexed: 05/09/2023]
Abstract
UNLABELLED This study assessed the relation between pre-intervention variables (cognition, socialization and communication) to outcome in young children with autism. METHOD Twenty five children with autism (20-32 months) were enrolled in intensive behavior intervention. The children were divided into groups based on their IQ scores and on the severity of their social interaction and communication deficits [per autism diagnostic observation schedule (ADOS) scores]. Six developmental-behavioral domains including, imitation, receptive language, expressive language, nonverbal communication skills, play skills and stereotyped behaviors were assessed at pre- and post-1 year of intervention times. RESULTS Significant progress was noted in all the six developmental-behavioral domains after 1 year of intervention. Children with higher initial cognitive levels and children with fewer measured early social interaction deficits showed better acquisition of skills in three developmental areas, receptive language, expressive language and play skills. Both groups showed better progress in Receptive language skills. Better progress in expressive language was associated with the child's social abilities, while more significant progress in play skills was related to pre-intervention cognitive level. CONCLUSIONS These findings emphasize the importance of early intensive intervention in autism and the value of pre-intervention cognitive and social interaction levels for predicting outcome.
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Affiliation(s)
- Esther Ben-Itzchak
- School of Education, Bar-Ilan University, Autism Center, Assaf Harofeh Medical Center and ALUT-Israeli National Alliance for children with autism, Ramat-Gan, Israel.
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Crockett JL, Fleming RK, Doepke KJ, Stevens JS. Parent training: acquisition and generalization of discrete trials teaching skills with parents of children with autism. RESEARCH IN DEVELOPMENTAL DISABILITIES 2007; 28:23-36. [PMID: 16338118 DOI: 10.1016/j.ridd.2005.10.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Revised: 10/05/2005] [Accepted: 10/10/2005] [Indexed: 05/05/2023]
Abstract
This study examined the effects of an intensive parent training program on the acquisition and generalization of discrete trial teaching (DTT) procedures with two parents of children with autism. Over the course of the program, parents applied the DTT procedures to teach four different functional skills to their children, which allowed for an assessment of "free" and programmed generalization across stimulus exemplars. Parent training was conducted by the first author utilizing instructions, demonstrations, role-play, and practice with feedback. Parents' use of DTT skills and children's correct and incorrect responding were measured. A within-subject multiple-baseline across stimulus exemplars (functional skills taught) design was employed both to demonstrate control of the training program over parents' correct use of DTT, and to allow a preliminary investigation of the generalized effects of training to multiple stimulus exemplars. Results demonstrate initial control of the training program over parent responding, and the extent to which each parent extended her use of DTT procedures across untrained and topographically different child skills. The potential for designing more generalizable and thus more cost-effective parent training programs is discussed.
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Williams White S, Keonig K, Scahill L. Social skills development in children with autism spectrum disorders: a review of the intervention research. J Autism Dev Disord 2006; 37:1858-68. [PMID: 17195104 DOI: 10.1007/s10803-006-0320-x] [Citation(s) in RCA: 306] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Accepted: 10/30/2006] [Indexed: 11/30/2022]
Abstract
Social reciprocity deficits are a core feature of the autism spectrum disorders (ASD). This review summarizes the state of research in group-based social skills training programs for school-age children and adolescents with ASD. All published studies of group social skills interventions between 1985 and 2006 were reviewed, as well as dissertations examining group-based social skills intervention programs. To assess the state of the science, a template developed by an NIMH work group was applied to 14 identified studies. Based on this review, the empirical support for this approach is incomplete, but promising intervention strategies were identified. Recommendations for the design of future treatment trials to guide clinical practice are offered.
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Affiliation(s)
- Susan Williams White
- School of Medicine, Virginia Treatment Center for Children, Virginia Commonwealth University, 515 North 10th Street, Richmond, VA 23298, USA.
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Kasari C, Freeman S, Paparella T. Joint attention and symbolic play in young children with autism: a randomized controlled intervention study. J Child Psychol Psychiatry 2006; 47:611-20. [PMID: 16712638 DOI: 10.1111/j.1469-7610.2005.01567.x] [Citation(s) in RCA: 396] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Delays and deficits in joint attention and symbolic play constitute two important developmental problems in young children with autism. These areas of deficit have been well studied in autism but have rarely been the focus of treatment efforts (see Kasari, Freeman, & Paparella, 2001). In this study, we examine the efficacy of targeted interventions of joint attention and symbolic play. METHODS Participants were 58 children with autism aged 3 and 4 years (46 boys). Children were randomized to a joint attention intervention, a symbolic play intervention, or control group. Interventions were conducted 30 minutes daily for 5-6 weeks. Both structured assessments of joint attention and play skills and mother-child interactions were collected pre and post intervention by independent assessors. RESULTS Results indicate that both intervention groups improved significantly over the control group on certain behaviors. Children in the joint attention intervention initiated significantly more showing and responsiveness to joint attention on the structured joint attention assessment and more child-initiated joint attention in the mother-child interaction. The children in the play group showed more diverse types of symbolic play in interaction with their mothers and higher play levels on both the play assessment and in interaction with their mothers. CONCLUSIONS This randomized controlled trial provides promising data on the specificity and generalizability of joint attention and play interventions for young children with autism. Future studies need to examine the long-term effects of these early interventions on children's development.
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Williams SK, Scahill L, Vitiello B, Aman MG, Arnold LE, McDougle CJ, McCracken JT, Tierney E, Ritz L, Posey DJ, Swiezy NB, Hollway J, Cronin P, Ghuman J, Wheeler C, Cicchetti D, Sparrow S. Risperidone and adaptive behavior in children with autism. J Am Acad Child Adolesc Psychiatry 2006; 45:431-9. [PMID: 16601648 DOI: 10.1097/01.chi.0000196423.80717.32] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the impact of risperidone on adaptive behavior in children with autistic disorder who have serious behavior problems and to examine different methods of scoring the Vineland Adaptive Behavior Scales to measure change. METHOD Forty-eight children (5 years to 16 years, 5 months) who showed behavioral improvement during acute treatment with risperidone were followed for 6 months and assessed with the Vineland Scales. RESULTS Raw scores, age-equivalents, and special norm percentile scores all showed significant increases in adaptive behavior in the areas of communication, daily living skills, and socialization (p <.01). During a period of 6 to 8 months, children gained an average of 7.8 age-equivalent months in the area of socialization, a > 6% improvement beyond what would be expected based on baseline growth rates. CONCLUSIONS Although limited by the absence of a control group, these results suggest that risperidone may improve adaptive skills in children with autistic disorder accompanied by serious behavioral problems. Vineland age-equivalent scores appear to be most useful in assessing change with treatment over time.
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Symes MD, Remington B, Brown T, Hastings RP. Early intensive behavioral intervention for children with autism: therapists' perspectives on achieving procedural fidelity. RESEARCH IN DEVELOPMENTAL DISABILITIES 2006; 27:30-42. [PMID: 15935615 DOI: 10.1016/j.ridd.2004.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2004] [Revised: 06/30/2004] [Accepted: 07/05/2004] [Indexed: 05/02/2023]
Abstract
The variability in outcomes observed in home-based early intensive behavioral intervention for children with autism is likely in part to be the result of the quality of therapist performance. Therapist behavior in this context, however, is poorly understood. To achieve such an understanding, it will be necessary to specify how factors such as therapist, child and intervention program characteristics, as well as supervision and training provision, influence therapists' interactions with children. This study identified facilitating factors and barriers that therapists considered to influence their capacity to deliver early intensive behavioral intervention to young children with autism. Nineteen therapists associated with various service providers in the South of England were interviewed. In general, responses represented opposite poles of the same construct. For example, child factors such as compliance and competence were considered to facilitate instruction, whereas challenging behavior and lack of progress were perceived to hinder it. These issues are considered in the light of previous research on staff behavior in related contexts. The factors identified suggest specific avenues for questionnaire and experimental research to validate these findings, have implications for routine service provision and may help improve the outcomes of children receiving early intensive behavioral intervention.
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Affiliation(s)
- Matthew D Symes
- Center for Behavioural Research Analysis and Intervention in Developmental Disabilities, School of Psychology, University of Southampton, Highfield, Southampton, SO17 1BJ, UK.
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Perry A, Prichard EA, Penn HE. Indicators of quality teaching in intensive behavioral intervention: a survey of parents and professionals. BEHAVIORAL INTERVENTIONS 2006. [DOI: 10.1002/bin.212] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ozonoff S, Goodlin-Jones BL, Solomon M. Evidence-Based Assessment of Autism Spectrum Disorders in Children and Adolescents. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2005; 34:523-40. [PMID: 16083393 DOI: 10.1207/s15374424jccp3403_8] [Citation(s) in RCA: 183] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
This article reviews evidence-based criteria that can guide practitioners in the selection, use, and interpretation of assessment tools for autism spectrum disorders (ASD). As Mash and Hunsley (2005) discuss in this special section, evidence-based assessment tools not only demonstrate adequate psychometric qualities, but also have relevance to the delivery of services to individuals with the disorder (see also Hayes, Nelson, & Jarrett, 1987). Thus, we use what is known about the symptoms, etiologies, developmental course, and outcome of ASD to evaluate the utility of particular assessment strategies and instruments for diagnosis, treatment planning and monitoring, and evaluation of outcome. The article begins with a review of relevant research on ASD. Next we provide an overview of the assessment process and some important issues that must be considered. We then describe the components of a core (minimum) assessment battery, followed by additional domains that might be considered in a more comprehensive assessment. Domains covered include core autism symptomatology, intelligence, language, adaptive behavior, neuropsychological functions, comorbid psychiatric illnesses, and contextual factors (e.g., parent well-being, family functioning, quality of life). We end with a discussion of how well the extant literature meets criteria for evidence-based assessments.
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Affiliation(s)
- Sally Ozonoff
- M.I.N.D. Institute, University of California Medical Center, Sacramento 95817, USA.
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Abstract
Although initially described as an inborn disorder of affective contact, information on autism as it exists in infants has been limited. Delays in diagnosis, lack of information about the condition, and reliance on retrospective research strategies have been problematic. An awareness of the increased risk for siblings is now allowing the development of new, prospective approaches. Consistent with Kanner's original hypothesis, the available information strongly suggests a fundamental difficulty in the earliest social processes, which, in turn, impacts many other areas of development. New approaches to screening have lowered the age of initial diagnosis; this presents new challenges for early intervention. Directions for future research are highlighted.
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Affiliation(s)
- Fred Volkmar
- Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA.
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Hsieh P(PH, Acee T, Chung WH, Hsieh YP, Kim H, Thomas GD, You JI, Levin JR, Robinson DH. Is Educational Intervention Research on the Decline? JOURNAL OF EDUCATIONAL PSYCHOLOGY 2005. [DOI: 10.1037/0022-0663.97.4.523] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Autism is a neurologic disorder with impairments in language, social communication, and behavior, which may improve over time, but which persist throughout the lifetime. The evaluation of autism requires a separation of clinical and research objectives and is done best in close cooperation with professionals in the fields of communication, education, and psychology. There are no biologic markers of autism. Regression in language and social communication is present in approximately 30% of children with autism and is most likely to occur between 18 and 24 months of age. Early deficits in social communication can be identified by the assessment of joint attention, affective reciprocity, and metacognition. Current evidence suggests that deficits in social cognition and communication in autism may be related to dysfunction in the amygdala, hippocampus, and related limbic and cortical structures. Other neuroanatomic structures, such as the cerebellum, also may form part of a distributed neuronal network responsible for social cognition and communication. Genetics play a major role in autism, but what is inherited and how broad the inheritable phenotype is remain unclear. At a neurochemical level, the principal neurotransmitter implicated in autism is serotonin. Seizures and epileptiform discharges are common in autism and are linked to cognitive dysfunction. The role of medication is to target specific symptoms and open windows of opportunity that allow implementation of a multimodal individualized educational plan.
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Affiliation(s)
- Roberto Tuchman
- Dan Marino Center, Department of Neurology, Miami Children's Hospital, 2900 South Commerce Parkway, Weston, FL 33331, USA.
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