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Horan MR, Latendresse SJ, Limbers CA. Mental Health in Mothers of Autistic Children with a Medical Home: The Potentially Mechanistic Roles of Coping and Social Support. J Autism Dev Disord 2024; 54:2682-2692. [PMID: 37142909 DOI: 10.1007/s10803-023-05997-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
Mothers of autistic children often report poor mental health outcomes. One established risk factor for these outcomes is the child having a medical home. This study examined possible mediating variables (coping, social support) in this relationship in 988 mothers of autistic children from the 2017/2018 National Survey of Children's Health (NSCH). The results of the multiple mediation model suggest the relationship between having a medical home and maternal mental health is largely explained by indirect associations with coping and social support. These findings suggest that clinical interventions for coping and social support provided by the medical home for mothers of autistic children may improve maternal mental health outcomes over and above implementation of a medical home.
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Affiliation(s)
- Madeline R Horan
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS735, 38105, Memphis, TN, USA.
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Li X, Lin Z, Liu C, Bai R, Wu D, Yang J. Glymphatic Imaging in Pediatrics. J Magn Reson Imaging 2024; 59:1523-1541. [PMID: 37819198 DOI: 10.1002/jmri.29040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
The glymphatic system, which facilitates cerebrospinal fluid (CSF) flow through the brain parenchyma, is important for brain development and waste clearance. Advances in imaging techniques, particularly magnetic resonance imaging, have make it possible to evaluate glymphatic structures and functions in vivo. Recently, several studies have focused on the development and alterations of the glymphatic system in pediatric disorders. This review discusses the development of the glymphatic system, advances of imaging techniques and their applications in pediatric disorders. First, the results of the reviewed studies indicate that the development of the glymphatic system is a long-lasting process that continues into adulthood. Second, there is a need for improved glymphatic imaging techniques that are non-invasive and fast to improve suitability for pediatric applications, as some of existing methods use contrast injection and are susceptible to motion artifacts from long scanning times. Several novel techniques are potentially feasible for pediatric patients and may be used in the future. Third, the glymphatic dysfunction is associated with a large number of pediatric disorders, although only a few have recently been investigated. In conclusion, research on the pediatric glymphatic system remains an emerging field. The preliminary applications of glymphatic imaging techniques have provided unique insight into the pathological mechanism of pediatric diseases, but mainly limited in visualization of enlarged perivascular spaces and morphological measurements on CSF volumes. More in-depth studies on glymphatic functions are required to improve our understanding of the mechanisms underlying brain development and pediatric diseases. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Xianjun Li
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zixuan Lin
- Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Congcong Liu
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ruiliang Bai
- Interdisciplinary Institute of Neuroscience and Technology, School of Medicine, Zhejiang University, Hangzhou, China
| | - Dan Wu
- Department of Biomedical Engineering, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Jian Yang
- Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Shaanxi Engineering Research Center of Computational Imaging and Medical Intelligence, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Lagang-Buenaventura MKC, Ang-Nolasco VDC. Needs and Coping during the COVID-19 Pandemic among Families of Children with Autism Spectrum Disorder in a Government Tertiary Hospital. ACTA MEDICA PHILIPPINA 2024; 58:152-162. [PMID: 38882907 PMCID: PMC11168959 DOI: 10.47895/amp.v58i7.6331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Background The COVID-19 pandemic has affected the well-being of children with Autism Spectrum Disorder (ASD) and their families. The core deficits of the condition and increased parental stress during this time made them more vulnerable. Objectives This study aims to explore how the pandemic has affected these families by identifying their needs and capabilities in order to provide support. Methods A total of 227 parents of children with ASD completed an online survey consisting of items on socio-demographics, family needs, and coping strategies. Descriptive statistics were used and t-test and ANOVA/Kruskal Wallis were used to determine the relationship between parent and child factors with needs and coping. Results Needs for Information, Community Services, and Finances are the top categories while the greatest identified need during this pandemic was for financial assistance. Religiosity, Problem-Solving, and Cognitive Reappraisal were the widely used coping strategies by the parents. Fathers, younger children, daughters with ASD, and having more than one child with ASD showed significant association with needs. Parents with primary and tertiary education were associated with use of the cognitive reappraisal strategy and those with jobs were associated with substance use. Conclusion Families of children with ASD have multiple needs during this pandemic, from autism-specific information and services, to more generic concerns such as financial assistance. Despite these challenges, these families have positive strategies in place to facilitate coping mechanisms.
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Affiliation(s)
- Marie Khatrina C Lagang-Buenaventura
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
| | - Victoria Dominique C Ang-Nolasco
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila
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Nayak A, Khuntia R. Development and Content Validation of a Measure to Assess the Parent-Child Social-emotional Reciprocity of Children with ASD. Indian J Psychol Med 2024; 46:66-71. [PMID: 38524962 PMCID: PMC10958071 DOI: 10.1177/02537176231207763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Background As no scales are currently available to assess the social-emotional reciprocity (SER) between children with autism spectrum disorder (ASD) and their parents, we aimed to develop a questionnaire for this. Methods Both quantitative and qualitative techniques were used for content validation. All stages of this study used purposive sampling to choose various groups of experts, mental health professionals, and parents of children with ASD to participate in the development, judgment-quantifying, and pretest stages. Data from 30 parents of children with ASD were gathered for the field test. Results Thirty items were retained after content validation. The proportion of consensus regarding the comprehensiveness of the entire questionnaire was 1.00. The scale-level content validity index (CVI) by averaging calculation method and universal agreement calculation method were 0.95 and 0.50, respectively. Following the pretest, a total of 23 questions, on a five-point scale, were retained. Conclusion Given the significance of SER between children with ASD and their parents, mental health practitioners should use this questionnaire to understand it to maximize the efficacy of any intervention.
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Affiliation(s)
- Asmita Nayak
- National Institute of Science Education and Research, An OCC of Homi Bhabha National Institute, Bhubaneswar, Odisha, India
| | - Rooplekha Khuntia
- National Institute of Science Education and Research, An OCC of Homi Bhabha National Institute, Bhubaneswar, Odisha, India
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Pandya S, Jain S, Verma J. A comprehensive analysis towards exploring the promises of AI-related approaches in autism research. Comput Biol Med 2024; 168:107801. [PMID: 38064848 DOI: 10.1016/j.compbiomed.2023.107801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/09/2023] [Accepted: 11/29/2023] [Indexed: 01/10/2024]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that presents challenges in communication, social interaction, repetitive behaviour, and limited interests. Detecting ASD at an early stage is crucial for timely interventions and an improved quality of life. In recent times, Artificial Intelligence (AI) has been increasingly used in ASD research. The rise in ASD diagnoses is due to the growing number of ASD cases and the recognition of the importance of early detection, which leads to better symptom management. This study explores the potential of AI in identifying early indicators of autism, aligning with the United Nations Sustainable Development Goals (SDGs) of Good Health and Well-being (Goal 3) and Peace, Justice, and Strong Institutions (Goal 16). The paper aims to provide a comprehensive overview of the current state-of-the-art AI-based autism classification by reviewing recent publications from the last decade. It covers various modalities such as Eye gaze, Facial Expression, Motor skill, MRI/fMRI, and EEG, and multi-modal approaches primarily grouped into behavioural and biological markers. The paper presents a timeline spanning from the history of ASD to recent developments in the field of AI. Additionally, the paper provides a category-wise detailed analysis of the AI-based application in ASD with a diagrammatic summarization to convey a holistic summary of different modalities. It also reports on the successes and challenges of applying AI for ASD detection while providing publicly available datasets. The paper paves the way for future scope and directions, providing a complete and systematic overview for researchers in the field of ASD.
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Affiliation(s)
- Shivani Pandya
- Department of Computer Science and Engineering, Nirma University, Ahmedabad, Gujarat 382481, India.
| | - Swati Jain
- Department of Computer Science and Engineering, Nirma University, Ahmedabad, Gujarat 382481, India.
| | - Jaiprakash Verma
- Department of Computer Science and Engineering, Nirma University, Ahmedabad, Gujarat 382481, India.
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Sommer M, Glaser B, Soldini E, Weber P, Ramelli GP. Age at initial diagnosis of autism spectrum disorders: a retrospective comparison of screening techniques between the southern and northwestern regions of Switzerland. Swiss Med Wkly 2023; 153:40131. [PMID: 38037847 DOI: 10.57187/smw.2023.40131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
AIMS Early diagnosis of autism spectrum disorders (ASD) offers the possibility of early intervention and, in turn, gains in adaptive behaviour, language and cognition. The aim of the present study was to analyse whether age at diagnosis of autism spectrum disorders decreased in two regions of Switzerland from 2006 to 2016 following the implementation of different screening and referral techniques. In southern Switzerland, systematic paediatric screening using the Modified Checklist for Autism (M-CHAT) in toddlers was implemented in 2013, whereas in northwestern Switzerland, periodic trainings were used to increase paediatrician awareness of ASD. We investigated which method was associated with a younger average age at diagnosis. METHODS We conducted a retrospective, two-centre study searching clinical records of children and adolescents (aged 0-16 years) diagnosed with ASD in two neuropaediatric departments at Swiss hospitals between January 2006 and December 2016. All patients were diagnosed via a standardised evaluation based on two approved diagnostic tests: the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) and the Autism Diagnostic Interview-Revised (ADI-R). RESULTS In southern Switzerland, training and subsequent widespread use of the M-CHAT among paediatricians appeared to contribute to a significantly younger age at diagnosis. Age at diagnosis did not significantly decrease during the same period in northwestern Switzerland. CONCLUSION Our results point to the possibility of successfully reducing age at diagnosis in specific geographic areas through the implementation of screening questionnaires, such as the M-CHAT, at year 2 well-baby visits.
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Affiliation(s)
- Michael Sommer
- Department of Paediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital, Basel, Switzerland
| | - Bronwyn Glaser
- Neuropediatrics Unit, Paediatric Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
| | - Emiliano Soldini
- Competence Centre for Healthcare Practices and Policies, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Peter Weber
- Department of Paediatric Neurology and Developmental Medicine, University of Basel, Children's Hospital, Basel, Switzerland
| | - Gian Paolo Ramelli
- Neuropediatrics Unit, Paediatric Institute of Southern Switzerland, EOC, Bellinzona, Switzerland
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Cui J, Xie H, He X. Evaluation of the Integrated Therapy Model in Preschool Education for Children with Autism Spectrum Disorder in China. J Autism Dev Disord 2023; 53:4474-4482. [PMID: 36083394 DOI: 10.1007/s10803-022-05737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
The Integrated Therapy Model is a practice framework designed to promote multi-disciplinary collaboration to accommodate the holistic needs of children with special education needs. This study evaluated the effectiveness of the model adopted in a pilot preschool in China on children with autism spectrum disorder (ASD). A single-case, ABAB reversal design was employed with three children with ASD, and data were collected using direct observation and semi-structured interviews. The results demonstrated that while the model piloted in China was effective at improving fine motor ability, gross motor ability, imitation and problem behavior, it had mild to questionable effects on self-care and independent living capacity. The implications for the practice and for research on preschool interventions in mainland China is discussed.
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Affiliation(s)
- Jialiang Cui
- Department of Social Work, The Chinese University of Hong Kong, Ma Liu Shui, Hong Kong
| | - Han Xie
- Department of Social Work and Social Policy, School of Sociology and Population Study, Renmin University of China, Chongde West Building, No.59 Zhongguancun Street, Haitian District, 1002, Beijing, China
| | - Xin He
- Department of Social Work and Social Policy, School of Sociology and Population Study, Renmin University of China, Chongde West Building, No.59 Zhongguancun Street, Haitian District, 1002, Beijing, China.
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Hirst K, Zamzow RM, Stichter JP, Beversdorf DQ. A Pilot Feasibility Study Assessing the Combined Effects of Early Behavioral Intervention and Propranolol on Autism Spectrum Disorder (ASD). CHILDREN (BASEL, SWITZERLAND) 2023; 10:1639. [PMID: 37892301 PMCID: PMC10605265 DOI: 10.3390/children10101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023]
Abstract
Autism spectrum disorder (ASD), a neurodevelopmental disorder typified by differences in social communication as well as restricted and repetitive behaviors, is often responsive to early behavioral intervention. However, there is limited information on whether such intervention can be augmented with pharmacological approaches. We conducted a double-blinded, placebo-controlled feasibility trial to examine the effects of the β-adrenergic antagonist propranolol combined with early intensive behavioral intervention (EIBI) for children with ASD. Nine participants with ASD, ages three to ten, undergoing EIBI were enrolled and randomized to a 12-week course of propranolol or placebo. Blinded assessments were conducted at baseline, 6 weeks, and 12 weeks. The primary outcome measures focusing on social interaction were the General Social Outcome Measure-2 (GSOM-2) and Social Responsiveness Scale-Second Edition (SRS-2). Five participants completed the 12-week visit. The sample size was insufficient to evaluate the treatment efficacy. However, side effects were infrequent, and participants were largely able to fully participate in the procedures. Conducting a larger clinical trial to investigate propranolol's effects on core ASD features within the context of behavioral therapy will be beneficial, as this will advance and individualize combined therapeutic approaches to ASD intervention. This initial study helps to understand feasibility constraints on performing such a study.
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Affiliation(s)
- Kathy Hirst
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO 65211, USA; (K.H.); (J.P.S.)
| | - Rachel M. Zamzow
- Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO 65211, USA;
| | - Janine P. Stichter
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO 65211, USA; (K.H.); (J.P.S.)
| | - David Q. Beversdorf
- Thompson Center for Autism and Neurodevelopment, University of Missouri, Columbia, MO 65211, USA; (K.H.); (J.P.S.)
- Interdisciplinary Neuroscience Program, University of Missouri, Columbia, MO 65211, USA;
- Departments of Radiology, Neurology, and Psychological Sciences, William and Nancy Thompson Endowed Chair in Radiology, University of Missouri, Columbia, MO 65211, USA
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Gurevitz M, Leisman G. Factors in Infancy That May Predict Autism Spectrum Disorder. Brain Sci 2023; 13:1374. [PMID: 37891743 PMCID: PMC10605556 DOI: 10.3390/brainsci13101374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
The global increase in the prevalence of ASD (Autism Spectrum Disorder) is of great medical importance, but the reasons for this increase are still unknown. This study sought to identify possible early contributing factors in children who were later diagnosed with ASD. In this retrospective cohort study, postnatal records of 1105 children diagnosed with ASD were analyzed to determine if any signs of ASD could be found in a large database of births and well-baby care programs. We compared the recordings of typically developing children and analyzed the differences statistically. Rapid increases in weight, height, and head circumference during early infancy predict the development of ASD. In addition, low birth weight, older maternal age, and increased weight and height percentiles at six months of age together predict the development of ASD. At two years of age, these four parameters, in addition to impaired motor development, can also predict the development of ASD. These results suggest that the recent increase in ASD prevalence is associated with the "obesity epidemic" and with recommendations of supine sleeping to prevent Sudden Infant Death Syndrome, associated with atypical neural network development in the brain.
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Affiliation(s)
- Mina Gurevitz
- Well Baby Clinic Physician, Maccabi Health Services, Herzliya 4649713, Israel;
| | - Gerry Leisman
- Movement and Fetal Cognition Laboratory, Department of Physical Therapy, University of Haifa, Haifa 3498838, Israel
- Department of Neurology, University of the Medical Sciences of Havana, Havana 11600, Cuba
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Bahry S, Gerhardt PF, Weiss MJ, Leaf JB, Putnam RF, Bondy A. The Ethics of Actually Helping People: Targeting Skill Acquisition Goals That Promote Meaningful Outcomes for Individuals with Autism Spectrum Disorder. Behav Anal Pract 2023; 16:672-695. [PMID: 37680332 PMCID: PMC10480108 DOI: 10.1007/s40617-022-00757-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2022] [Indexed: 12/14/2022] Open
Abstract
As a field that predominately supports individuals with autism spectrum disorder (ASD), we have an ethical duty as behavior analysts to ensure that the goals we write and interventions we prescribe promote best outcomes across the lifespan. This is critical, given that as it stands now, outcomes in adulthood for individuals with ASD are poor in every area assessed. The Ethics Code for Behavior Analysts can be interpreted to provide support for teaching the right goals, the right way, with respect to inherent rights of those we serve, in order to help affect positive changes in these outcomes. The present article highlights ethical themes that are relevant in order to affect these changes that are supported by the Code, as well as actionable steps to take next. The aim is to provide a resource for practitioners to use in clinical practice and in making ethical decisions that will help to improve outcomes for individuals with autism in adulthood. In addition, recommendations are made about integrating these values and approaches in terms of training, supervision, advocacy, and research.
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Affiliation(s)
- Shanna Bahry
- Endicott College, Beverly, MA USA
- Meaningful HOPE, East Providence, RI USA
| | | | | | - Justin B. Leaf
- Endicott College, Beverly, MA USA
- Autism Partnership Foundation, Seal Beach, CA USA
| | - Robert F. Putnam
- Endicott College, Beverly, MA USA
- May Institute, Randolph, MA USA
| | - Andy Bondy
- Pyramid Educational Consultants, New Castle, DE USA
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Han C, Guo M, Ke X, Zeng L, Li M, Haihambo N, Lu J, Wang L, Wei P. Oscillatory biomarkers of autism: evidence from the innate visual fear evoking paradigm. Cogn Neurodyn 2023; 17:459-466. [PMID: 37007195 PMCID: PMC10050250 DOI: 10.1007/s11571-022-09839-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with multiple associated deficits in both social and cognitive functioning. Diagnosing ASD usually relies on subjective clinical competencies, and research on objective criteria for diagnosing ASD in the early stage is still in its infancy. A recent animal study showed that the looming-evoked defensive response was impaired in mice with ASD, but whether the effect will be observed in human and contribute to finding a robust clinical neural biomarker remain unclear. Here, to investigate the looming-evoked defense response in humans, electroencephalogram responses toward looming and corresponding control stimuli (far and missing type) were recorded in children with ASD and typical developed (TD) children. Results revealed that alpha-band activity in the posterior brain region was strongly suppressed after looming stimuli in the TD group, but remained unchanged in the ASD group. This method could be a novel, objective way to detect ASD earlier. These findings suggest that further investigation of the neural mechanism underlying innate fear from the oscillatory view could be a helpful direction in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-022-09839-6.
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Affiliation(s)
- Chuanliang Han
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Mingrou Guo
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Xiaoyin Ke
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Lanting Zeng
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Jianping Lu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Liping Wang
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Pengfei Wei
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
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Bharat R, Uzaina, Yadav T, Niranjan S, Kurade P. mHealth Apps Delivering Early Intervention to Support Parents of Children With Autism Spectrum Disorder: A Scoping Review. Indian Pediatr 2023. [DOI: 10.1007/s13312-023-2840-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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13
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Espín-Tello SM, Gardeazabal X, Abascal J. The use of robots for augmentative manipulation during play activities among children with motor impairment: a scoping review. Disabil Rehabil 2023; 45:896-910. [PMID: 35260000 DOI: 10.1080/09638288.2022.2046185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE To describe the extent, type, and quality of studies involving robots for augmentative manipulation during play by children with severe motor impairments (CwSMI), and to explore how they influenced children's cognitive skills and engagement. METHODS Web of Science, Scopus, PubMed & EBSCO were systematically searched for articles published until March 2021, that reported cognitive skills and/or engagement outcomes from interventions involving the use of robots in play activities, where participants included CwSMI, and full-text was available. Data extracted comprised characteristics of participants, study design, purpose of the study, outcomes assessed, collection methods, and intervention carried out (robot-environment interaction and robot used). RESULTS Eight mobile robots and five robotic arms were reported in the 17 included and reviewed articles. Most of them informed a positive impact on CwSMI's cognitive skills and/or engagement. However, the studies scored poorly on a five-criteria quality assessment, and only one single-case design proved strong evidence of treatment. None of the analysed interventions was an evidence-based practice. CONCLUSION The use of manipulative robots during play activities may have a positive impact on the CwSMI's cognitive skills and engagement in activities. However, further studies with higher internal and external validity are needed to support stronger evidence.Implications for rehabilitationThe use of robots for augmentative manipulation during play activities may have a positive influence on the cognitive functions and the engagement in activities of children with severe motor impairments.Through manipulative robots, this population could be able to show the abilities that are hidden due to their motor impairments, and subsequently, receive educational and physical training more aligned with their real capacities and potential.
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Affiliation(s)
- Sandra Martina Espín-Tello
- University of the Basque Country - Gipuzkoa Campus, Computer Architecture and Technology, Donostia, Spain
| | - Xabier Gardeazabal
- University of the Basque Country - Gipuzkoa Campus, Computer Architecture and Technology, Donostia, Spain
| | - Julio Abascal
- University of the Basque Country - Gipuzkoa Campus, Computer Architecture and Technology, Donostia, Spain
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14
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Ilan M, Faroy M, Zachor D, Manelis L, Waissengreen D, Michaelovski A, Avni I, Menashe I, Koller J, Dinstein I, Meiri G. Children with autism exhibit similar longitudinal changes in core symptoms when placed in special or mainstream education settings. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613221142394. [PMID: 36632654 PMCID: PMC10375002 DOI: 10.1177/13623613221142394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
LAY ABSTRACT Today, children with autism spectrum disorder (ASD) are placed in mainstream or special education settings somewhat arbitrarily with no clear clinical recommendations. Here, we compared changes in core ASD symptoms, as measured by the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) clinical assessment, across ASD preschool children placed in special or mainstream education. Longitudinal changes in ADOS-2 scores did not differ significantly across settings over a 1- to 2-year period. While some children improved in core ASD symptoms, others deteriorated in both settings. This highlights the need to identify specific criteria for establishing meaningful placement recommendations.
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Affiliation(s)
- Michal Ilan
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | - Michal Faroy
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel.,The Academic College of Tel Aviv-Yaffo, Israel
| | | | - Liora Manelis
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | - Danel Waissengreen
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
| | | | - Inbar Avni
- Ben-Gurion University of the Negev, Israel
| | | | | | | | - Gal Meiri
- Ben-Gurion University of the Negev, Israel.,Soroka University Medical Center, Israel
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15
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Parent-Child Interaction Therapy for Children with Disruptive Behaviors and Autism: A Randomized Clinical Trial. J Autism Dev Disord 2023; 53:390-404. [PMID: 35076832 PMCID: PMC9889513 DOI: 10.1007/s10803-022-05428-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 02/04/2023]
Abstract
A relatively large number of children with autism spectrum disorder (ASD) exhibit disruptive behavioral problems. While accumulating data have shown behavioral parent training programs to be efficacious in reducing disruptive behaviors for this population, there is a dearth of literature examining the impact of such programs across the range of ASD severity. To evaluate the effectiveness of Parent-Child Interaction Therapy (PCIT), an evidence-based treatment for children with problem behaviors and their families, in reducing disruptive behaviors among children (4-10 years) with ASD (without intellectual disabilities). Fifty-five children (85.5% male, 7.15 years; SD 1.72) were enrolled from pediatric offices and educational settings into a randomized clinical trial (PCIT: N = 30; Control: N = 25). PCIT families demonstrated a significant reduction in child disruptive behaviors, increase in positive parent-child communication, improvement in child compliance, and reduction in parental stress compared to the control group. Exploratory analyses revealed no differential treatment response based on ASD severity, receptive language, and age. Results are promising for the use of PCIT with children demonstrating disruptive behaviors across the autism spectrum.
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16
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Williams LN, Wieckowski AT, Dieckhaus MFS, Dai YG, Zhang F, Dumont-Mathieu T, Barton M, Fein D, Robins DL. Primary Care Clinician and Child Characteristics Impacting Autism Surveillance. Brain Sci 2022; 13:brainsci13010018. [PMID: 36672000 PMCID: PMC9855901 DOI: 10.3390/brainsci13010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/12/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Early detection of autism provides access to early intervention and subsequently fewer lifelong challenges. However, disparities in screening have been associated with socioeconomic status (SES) and race, and disparities in surveillance have been associated with clinician knowledge and beliefs about autism identification. The present study examines associations between demographic variables and clinician beliefs, and agreement between screening results and clinician surveillance. Surveillance included activities used by the primary care clinicians (PCCs) to assess risk for autism. PCCs reported their beliefs about autism screening and identification, their sex, race, years in practice, and racial distribution of their patient population. Children's demographic information was also collected. PCCs identified children as having, or not having, an increased likelihood of autism, and parents of children completed an autism screener. Agreement between screening and surveillance results were examined across PCC, practice, and child demographics. Higher confidence in autism knowledge and screening resources, female PCC sex, and majority White practice patient demographics all predicted agreement between screening and surveillance. Female child sex and higher maternal education also predicted agreement between screening and surveillance. These findings highlight the importance of PCC screening beliefs and child and PCC demographics on the autism identification process.
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Affiliation(s)
- Lashae N. Williams
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA 19104, USA
- Correspondence:
| | | | - Mary F. S. Dieckhaus
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Yael G. Dai
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Fengqing Zhang
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA 19104, USA
| | - Thyde Dumont-Mathieu
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT 06032, USA
| | - Marianne Barton
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Deborah Fein
- Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA 19104, USA
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17
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Goldstein S, Sellars T, Velez A. From eligibility assessment to intervention for students with autism spectrum disorder. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sam Goldstein
- Neurology, Learning and Behavior Center Salt Lake City Utah USA
| | - Tiffany Sellars
- Neurology, Learning and Behavior Center Salt Lake City Utah USA
| | - Alexandro Velez
- Neurology, Learning and Behavior Center Salt Lake City Utah USA
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18
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Maria Pani S, Saba L, Fraschini M. Clinical applications of EEG power spectra aperiodic component analysis: a mini-review. Clin Neurophysiol 2022; 143:1-13. [DOI: 10.1016/j.clinph.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/03/2022]
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19
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da Hora CL, Sella AC. Evaluation parameters for evidence-based practices for people with autism spectrum disorder: a narrative review of group and single-subject design studies. PSICOLOGIA, REFLEXAO E CRITICA : REVISTA SEMESTRAL DO DEPARTAMENTO DE PSICOLOGIA DA UFRGS 2022; 35:23. [PMID: 35857210 PMCID: PMC9300806 DOI: 10.1186/s41155-022-00213-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
Recommendations for using evidence-based practices have become increasingly common in services for individuals diagnosed with autistic spectrum disorder (ASD). The aim of this study was to conduct a narrative literature review to identify differences and similarities in evidence-evaluation criteria for group and single-subject designs that empirically support interventions for people with ASD. Data sources used in this analysis were reports and articles elaborated by different clearinghouses (i.e., National Autism Center, National Professional Development Center, and the National Clearinghouse on Autism Evidence and Practice). The criteria for evaluating evidence, as defined by these documents, contained specific components or quality indicators for each type of study design. The different criteria for evaluating evidence and for classifying the interventions (once evidence was evaluated) were identified and described. This manuscript discusses the need for (a) expanding the analysis beyond the evidence identified by different researchers and organizations such as the clearinghouses, (b) proposing interventions that are based not only on scientific evidence but also on social validity — which is directed by client idiosyncrasies, and (c) attention to the fact that EBPs should not be seen as static information regarding interventions with empirical support: evidence-based practices are the result of constant analysis of the intervention implementation data added to professional training and client values and context. Some additional issues and the study limitations are also presented.
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Affiliation(s)
- Cássia Leal da Hora
- Paradigma, Behavioral Science and Technology Center, Rua Bartira, 1294, Perdizes, São Paulo, SP, CEP: 05011-001, Brazil.
| | - Ana Carolina Sella
- Aprendizagem em Pauta, Rua Olindina Campos Teixeira, 172/601, Maceió, Alagoas, CEP: 57036-690, Brazil
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20
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Bowden N, Gibb S, Audas R, Clendon S, Dacombe J, Kokaua J, Milne BJ, Mujoo H, Murray SW, Smiler K, Stace H, van der Meer L, Taylor BJ. Association Between High-Need Education-Based Funding and School Suspension Rates for Autistic Students in New Zealand. JAMA Pediatr 2022; 176:664-671. [PMID: 35576000 PMCID: PMC9112133 DOI: 10.1001/jamapediatrics.2022.1296] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Autistic students often experience poor educational outcomes that have implications for later life, including unemployment, interactions with the criminal justice system, increased risk for substance abuse, and low socioeconomic status. Improving educational outcomes is critical for ensuring that autistic young people can reach their potential. OBJECTIVE To quantify differences in suspension rates between autistic and nonautistic students and to assess whether high-need education-based funding for autistic students is associated with reduced rates of school suspension. DESIGN, SETTING, AND PARTICIPANTS This national cohort study used linked health and education data from New Zealand's Integrated Data Infrastructure. Data were obtained for students aged 5 to 16 years from January 1 to December 31, 2018, and analyzed July 7, 2021, to January 1, 2022. A novel case identification method was used to identify autistic students. EXPOSURES High-need education-based funding (Ongoing Resourcing Scheme [ORS]) obtained before 2019. MAIN OUTCOMES AND MEASURES Rates of suspension from school. Crude and adjusted analyses of the association between suspension rates and autism among the full population with adjustment made for sociodemographic characteristics (sex, age, ethnicity, deprivation, and urban or rural profile of residence) were conducted using complete-case, 2-level random intercept logistic multivariable regressions. To assess the association between ORS funding and suspension, analysis was restricted to autistic students. RESULTS Of the 736 911 students in the study population, 9741 (1.3%) were identified as autistic (median [SD] age, 10 [3.2] years; 7710 [79.1%] boys), and 727 170 (98.7%) as nonautistic (median [SD] age, 10 [3.4] years; 369 777 [50.9%] boys). School suspension was experienced by 504 autistic students (5.2%) and 13 845 nonautistic students (1.9%). After adjustment for demographic characteristics, autistic students had significantly higher odds of suspension than their nonautistic peers (adjusted odds ratio, 2.81; 95% CI, 2.55-3.11). Of the 9741 autistic students, 2895 (29.7%) received high-need education-based (ORS) funding. Suspensions were experienced by 57 autistic students (2.0%) with high-need funding and 447 autistic students (6.5%) without high-need funding. After adjustment for demographic characteristics, co-occurring conditions, and level of disability support need, autistic students with high-need funding had significantly lower odds of suspension than autistic students without high-need funding (adjusted odds ratio, 0.29; 95% CI, 0.21-0.40). CONCLUSIONS AND RELEVANCE In this cohort study, the findings of disparities in suspension rates between autistic and nonautistic students underscore the challenges faced in providing inclusive education for all young people, regardless of disability status. This study found that high-need funding was associated with reduced suspension rates among autistic students, suggesting that if appropriate supports are afforded to autistic students, a more inclusive education can be provided.
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Affiliation(s)
- Nicholas Bowden
- A Better Start National Science Challenge, Auckland, New Zealand,Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Sheree Gibb
- A Better Start National Science Challenge, Auckland, New Zealand,Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Richard Audas
- A Better Start National Science Challenge, Auckland, New Zealand,Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Sally Clendon
- Institute of Education, Massey University, Auckland, New Zealand
| | - Joanne Dacombe
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand,Autism New Zealand, Wellington, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, Auckland, New Zealand,Va’a O Tautai, Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Barry J. Milne
- A Better Start National Science Challenge, Auckland, New Zealand,Centre of Methods and Policy Application in the Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand,School of Social Sciences, Faculty of Arts, University of Auckland, Auckland, New Zealand
| | - Himang Mujoo
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | | | - Kirsten Smiler
- School of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Hilary Stace
- Health Services Research Centre, Victoria University of Wellington, Wellington, New Zealand
| | - Larah van der Meer
- Autism New Zealand, Wellington, New Zealand,Faculty of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Barry James Taylor
- A Better Start National Science Challenge, Auckland, New Zealand,Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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21
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de Korte MWP, van Dongen-Boomsma M, Oosterling IJ, Buitelaar JK, Staal WG. Pivotal Response Treatment (PRT) parent group training for young children with autism spectrum disorder: a pilot study. Sci Rep 2022; 12:7691. [PMID: 35546154 PMCID: PMC9095862 DOI: 10.1038/s41598-022-10604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 03/15/2022] [Indexed: 11/23/2022] Open
Abstract
Pivotal Response Treatment (PRT) is a promising intervention addressing core symptoms of autism spectrum disorder (ASD), with parent involvement as key component. Parent group-delivered PRT may be an effective treatment model, but currently the evidence is limited. Also, little attention has been paid to therapeutic involvement of multiple important contexts (e.g. home, school, community) of the young child. The current study explores a 14-week protocol of PRT parent group training (PRT-PG), complemented with individual parent–child sessions and involvement of teachers and other childcare providers. Children aged 2–6 years old with ASD and their parents (n = 20) were included. Preliminary results showed a significant increase in spontaneous initiations during a semi-structured therapist-child interaction together with widespread gains in clinical global functioning. No significant improvement on parent-rated general social-communication skills was observed. These findings justify further research on parent group delivered PRT models.
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Affiliation(s)
- Manon W P de Korte
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands. .,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | | | - Iris J Oosterling
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands.,Leiden University, Leiden, The Netherlands
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22
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Yaylaci F, Guller B. Diagnostic evaluation of patients referred by family physicians with the suspicion of autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 69:936-945. [PMID: 37885848 PMCID: PMC10599202 DOI: 10.1080/20473869.2022.2070419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/18/2022] [Indexed: 10/28/2023]
Abstract
Current evidence shows that early interventions in children with autism spectrum disorder (ASD) are more efficient and associated with better long-term outcomes. This also highlights the need for early recognition of children with ASD symptoms by family physicians and referral to child psychiatrists. This study aimed to evaluate how family physicians' knowledge about ASD is reflected in clinical practice by making a diagnostic evaluation of the cases referred with suspected ASD. The study included 149 cases that family physicians referred to child psychiatrists regarding the assessment for ASD. Diagnostic evaluation of the subjects was carried out using the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) were used in the evaluation process. Denver II developmental screening inventory was used to evaluate all subjects under six. The mean age of all participants was 39.1 (±13.2) months, and in ASD cases, it was 34.6 (±7.8) months. Of all referred cases, 72,5% were diagnosed according to the DSM-5 criteria. The most common diagnoses were global developmental delay (28.9%), language disorder (15.4%), ASD (15.4%), and attention deficit hyperactivity disorder (8.7%), respectively. The most common reason for referral specified on the consultation note was delayed speech, with a rate of 87.2%. In addition, 148 (99.3%) of the symptoms noted on the referral note were clustered within the DSM-5 ASD A criteria and 19 (12.8%) within the ASD B criteria. Developmental delay was more prominent in cases with ASD when compared to those with global developmental delay and language disorder. The most common diagnosis was a global developmental delay in referred cases, and only some of the symptoms seen in ASD from the referral notes of family physicians stood out as the reason for referral. These results underline the necessity of continuing ASD training for family physicians.
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Affiliation(s)
- Ferhat Yaylaci
- Department of Child and Adolescent Psychiatry, Bursa Dörtcelik Child Hospital, Bursa, Turkey
| | - Baris Guller
- Department of Child and Adolescent Psychiatry, Bursa Dörtcelik Child Hospital, Bursa, Turkey
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23
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Bharat R, Uzaina U, Yadav T, Niranjan S, Kurade P. mHealth apps delivering early intervention to support parents of children with autism: a scoping review protocol. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001358. [PMID: 36053590 PMCID: PMC9062798 DOI: 10.1136/bmjpo-2021-001358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/18/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This review aims to identify the mhealth apps delivering early intervention to support parents of children with autism spectrum disorders (ASD). We aim to explore the concept, context and methodology of implementation that is, theoretical framework, feasibility, quality of evidence, for such apps. BACKGROUND To improve outcomes for children with autism, early intervention has been found to be promising. Parental training, parent psychoeducation and parent-mediated intervention are regarded as the gold standard, to achieve early childhood development goals. Digital health technologies like tele-health, web-based services, have been used to deliver this at a reduced cost. There is little evidence about their use and efficacy in empowering parents of children with ASD. INCLUSION CRITERIA The studies reporting the use of mhealth apps to support parents of children with ASD, in community settings, school settings, special schools, clinics, hospitals or child development centres. There will be no exclusion based on region, gender or sociocultural factors. The types of studies included will be quantitative, qualitative, mixed-methods study designs, case reports, grey literature, systematic reviews, clinical trials and studies reporting feasibility of digital mhealth applications. METHOD Using the NICE Healthcare Databases Advanced Search, we will search the following databases: MEDLINE, PUBMED, CINAHL, EMBASE, PsycINFO, Cochrane Library, EbscoHost, Sabinet, SAGE Journals, Directory of Open Access Journals, BioMed Central, Scopus, ScienceDirect. Furthermore, grey literature will be searched through Google Scholar, ShodhGanga, JSTOR, CORE, EBSCO, DOAJ, BASE. The searches will be limited to the age range of children between 2 and 6 years with ASD, and the date range is from the inception of the database to the current date. The terms for the ASD will be combined with terms for parent, early intervention and digital mhealth to identify eligible studies.
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Affiliation(s)
- Rahul Bharat
- Community Paediatrics Hillingdon Hospital, Central and North West London NHS Foundation Trust Hillingdon, Hillingdon, UK
| | - Uzaina Uzaina
- Research and Training, Geniuslane Child Development Centre, Lucknow, Uttar Pradesh, India
| | - Tribhuvanesh Yadav
- Paediatrics, T.S.Misra Medical College & Hospital, Lucknow, Lucknow, India
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24
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Kamali M, Sivapalan S, Kata A, Kim N, Shanmugalingam N, Duku E, Zwaigenbaum L, Georgiades S. Program evaluation of a pilot mobile developmental outreach clinic for autism spectrum disorder in Ontario. BMC Health Serv Res 2022; 22:426. [PMID: 35361202 PMCID: PMC8973535 DOI: 10.1186/s12913-022-07789-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/16/2022] [Indexed: 04/13/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence worldwide. Early identification of ASD through developmental screening is critical for early intervention and improved behavioural outcomes in children. However due to long wait times, delays in diagnosis continue to occur, particularly among minority populations who are faced with existing barriers in access to care. A novel Mobile Developmental Outreach Clinic (M-DOC) was implemented to deliver culturally sensitive screening and assessment practices to increase access to developmental health services, reduce wait times in diagnoses, and aid in equitable access to intervention programs among vulnerable populations in Ontario. Methods This study applied two evaluation frameworks (process and outcome evaluation) to determine whether the delivery model was implemented as intended, and if the program achieved its targeted goals. A mixed-methods design was undertaken to address the study objectives. Results Between September 2018–February 2020, M-DOC reached 227 families with developmental health concerns for their child, while successfully targeting the intended population and achieving its goals. The mean age of the child-in-need at intake was 31.6 months (SD 9.9), and 70% of the sample were male. The program’s success was attributed to the use of cultural liaisons to break cultural and linguistic barriers, the creation of multiple points of access into the diagnosis pathway, and delivery of educational workshops in local communities to raise awareness and knowledge of autism spectrum disorder. Conclusions The findings underscore the need for community-based intervention programs that focus on cultural barriers to accessing health services. The model of delivery of the M-DOC programs highlights the opportunity for other programs to adopt a similar mobile outreach clinic approach as a means to increase access to services, particularly in targeting hard-to-reach and vulnerable populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07789-7.
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Affiliation(s)
- Mahdis Kamali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada. .,Offord Centre for Child Studies, Hamilton, Canada.
| | | | - Anna Kata
- Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Nicole Kim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | - Eric Duku
- Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Stelios Georgiades
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Offord Centre for Child Studies, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.,McMaster Children's Hospital, Hamilton, Canada
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25
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Toolan C, Holbrook A, Schlink A, Shire S, Brady N, Kasari C. Using the Clinical Global Impression scale to assess social communication change in minimally verbal children with autism spectrum disorder. Autism Res 2022; 15:284-295. [PMID: 34800004 PMCID: PMC8821201 DOI: 10.1002/aur.2638] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/04/2021] [Accepted: 10/30/2021] [Indexed: 02/03/2023]
Abstract
Assessing improvements in social communication behaviors in minimally verbal children with autism spectrum disorder (ASD) is often challenging. The Clinical Global Impression Scale (CGI) is a 7-point scale that has been adapted so that clinicians can easily and quickly rate social communication behaviors. The current study evaluated the CGI-Improvement (CGI-I) subscale as a measure of social communication change in minimally verbal children with ASD. The sample included 54 minimally verbal school-age children with ASD enrolled in a social communication intervention trial. CGIs were rated by interventionists and the study coordinator at baseline and at Week 6 of intervention, and were compared to scores on the Communication Complexity Scale (CCS). Results indicated that CGI ratings corresponded with CCS scores at baseline and Week 6. Children who were rated as more severe on social communication at baseline demonstrated lower complexity of communication compared to those who were rated as less severe. Those who demonstrated fast response to intervention at Week 6 showed greater improvement in their joint attention than those who were slower responders. These results provide support for the utility and validity of the CGI-I as a measure of social communication change in minimally verbal children. This study tested the CGI, a clinician rating scale, with a group of children with ASD with limited language who received intervention to improve social interactions and communication. Children's CGI ratings were comparable to other assessments in measuring social communication. The CGI may be a useful tool for those interested in quickly and easily tracking changes in children's social communication over the course of treatment. LAY SUMMARY: This study tested the Clinical Global Impression (CGI), a clinician rating scale, with a group of children with ASD with limited language who received intervention to improve social interactions and communication. Children's CGI ratings were comparable to other assessments in measuring social communication. The CGI may be a useful tool for those interested in quickly and easily tracking changes in children's social communication over the course of treatment.
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Affiliation(s)
- Christina Toolan
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, UCLA Semel Institute 68-265, 760 Westwood Plaza, Los Angeles, CA 90095
| | - Alison Holbrook
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, UCLA Semel Institute 68-265, 760 Westwood Plaza, Los Angeles, CA 90095
| | - Andrew Schlink
- Department of Education, University of California, Los Angeles, Los Angeles, CA, UCLA Semel Institute 68-268, 760 Westwood Plaza, Los Angeles, CA 90095
| | - Stephanie Shire
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, OR, 373 HEDCO Education Bldg, 1215 University of Oregon, Eugene, OR 97403
| | - Nancy Brady
- Department of Speech Language Hearing Sciences and Disorders, University of Kansas, Lawrence, KS, Dole Human Development Center, 3008, University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045
| | - Connie Kasari
- Department of Education, University of California, Los Angeles, Los Angeles, CA, UCLA Semel Institute 68-268, 760 Westwood Plaza, Los Angeles, CA 90095
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26
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Development of a visual attention based decision support system for autism spectrum disorder screening. Int J Psychophysiol 2022; 173:69-81. [PMID: 35007668 DOI: 10.1016/j.ijpsycho.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
Visual attention of young children with autism spectrum disorder (ASD) has been well documented in the literature for the past 20 years. In this study, we developed a Decision Support System (DSS) that uses machine learning (ML) techniques to identify young children with ASD from typically developing (TD) children. Study participants included 26 to 36 months old young children with ASD (n = 61) and TD children (n = 72). The results showed that the proposed DSS achieved up to 87.5% success rate in the early assessment of ASD in young children. Findings suggested that visual attention is a unique, promising biomarker for early assessment of ASD. Study results were discussed, and suggestions for future research were provided.
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27
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Chen S, Zhao J, Hu X, Tang L, Li J, Wu D, Yan T, Xu L, Chen M, Huang S, Hao Y. Children neuropsychological and behavioral scale-revision 2016 in the early detection of autism spectrum disorder. Front Psychiatry 2022; 13:893226. [PMID: 35935438 PMCID: PMC9354041 DOI: 10.3389/fpsyt.2022.893226] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) is a widely used developmental assessment tool for children aged 0-6 years in China. The communication warning behavior subscale of CNBS-R2016 is used to assess the symptoms of autism spectrum disorder (ASD), and its value of >30 points indicates ASD based on CNBS-R2016. However, we observed that children with relatively lower values were also diagnosed with ASD later on in clinical practice. Thus, this study aimed to identify the suitable cutoff value for ASD screening recommended by the communication warning behavior of CNBS-R2016. MATERIALS AND METHODS A total of 90 typically developing (TD) children and 316 children with developmental disorders such as ASD, developmental language disorder (DLD), and global developmental delay (GDD; 130 in the ASD group, 100 in the DLD group, and 86 in the GDD group) were enrolled in this study. All subjects were evaluated based on the CNBS-R2016. The newly recommended cutoff value of communication warning behavior for screening ASD was analyzed with receiver operating curves. RESULTS Children in the ASD group presented with lower developmental levels than TD, DLD, and GDD groups in overall developmental quotient assessed by CNBS-R2016. We compared the consistency between the scores of communication warning behavior subscale and Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Autism Diagnostic Observation Schedule, second edition (ADOS-2), and clinical diagnosis for the classification of ASD at a value of 30 based on the previously and newly recommended cutoff value of 12 by the CNBS-R2016. The Kappa values between the communication warning behavior and ABC, CARS, ADOS-2, and clinical diagnosis were 0.494, 0.476, 0.137, and 0.529, respectively, with an agreement rate of 76.90%, 76.26%, 52.03%, and 82.27%, respectively, when the cutoff point was 30. The corresponding Kappa values were 0.891, 0.816, 0.613, and 0.844, respectively, and the corresponding agreement rate was 94.62%, 90.82%, 90.54%, and 93.10%, respectively, when the cutoff point was 12. CONCLUSION The communication warning behavior subscale of CNBS-R2016 is important for screening ASD. When the communication warning behavior score is 12 points or greater, considerable attention and further comprehensive diagnostic evaluation for ASD are required to achieve the early detection and diagnosis of ASD in children.
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Affiliation(s)
- Shuling Chen
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Child Health Care, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinzhu Zhao
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaolin Hu
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lina Tang
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhui Li
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dandan Wu
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Yan
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Xu
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Min Chen
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Huang
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Hao
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Wittenborn AK, Holtrop K. Introduction to the special issue on the efficacy and effectiveness of couple and family interventions: Evidence base update 2010-2019. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:5-22. [PMID: 34904252 DOI: 10.1111/jmft.12576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 05/14/2023]
Abstract
This is the fourth Journal of Marital and Family Therapy (JMFT) special issue on the efficacy and effectiveness of couple and family therapy. Articles in this issue review studies published from 2010 to 2019 on couple and family interventions for prevalent mental and behavioral disorders and health conditions. The final article on mental health disparities tracks progress in the field and emphasizes the need for additional attention. In the current article, we provide a description of our methodological approach for the special issue and an overview of the state of the evidence for couple and family interventions across the conditions reviewed. We also offer recommendations to inspire researchers to further expand the empirical support for couple and family interventions to address pressing public health needs.
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Affiliation(s)
- Andrea K Wittenborn
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, Michigan, USA
| | - Kendal Holtrop
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan, USA
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Sánchez-Cueva S, Alonso-Esteban Y, Alcantud-Marín F. Assessment of Anxiety in Cognitive-Behavior Therapy in Young University Students with Autism Spectrum Disorders: A Review. Eur J Investig Health Psychol Educ 2021; 11:1571-1580. [PMID: 34940389 PMCID: PMC8699995 DOI: 10.3390/ejihpe11040111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 02/05/2023] Open
Abstract
The university provides academic support to disabled students, however, few institutions provide academic, extra-academic or preventive support to students with Autism Spectrum Disorders High-Functioning (ASD-HF). Among the most commonly requested needs is support for coping with anxiety arising from academic and social activity itself. When planning an intervention program, it is necessary to screen those who have problems and are likely to benefit from such a program. In this article we propose a systematic search for measures of anxiety for young people and adults with ASD-HF. Of a total of 683 documents, only 7 met the selection criteria. Of these, a total of 35 tools were detected, of which only 11 mediated anxiety. Screening should be carried out for all students, so that we can detect the "risk" of anxiety disturbance in all cases and, in particular, in students with ASD-HF. However, the instruments eligible for assessing intervention outcomes should be agreed upon in order to be able to compare results from different trials.
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Affiliation(s)
| | | | - Francisco Alcantud-Marín
- Department of Developmental and Educational Psychology, University of Valencia, 46010 Valencia, Spain; (S.S.-C.); (Y.A.-E.)
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Crepeau-Hobson MF, Leech N, Russell C. CLEAR Autism Diagnostic Evaluation (CADE): Evaluation of Reliability and Validity. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2021; 34:853-869. [PMID: 34873387 PMCID: PMC8636580 DOI: 10.1007/s10882-021-09828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
Recent surveillance efforts indicate that 1 in 54 American children meet the criteria for Autism Spectrum Disorder (ASD), making it the fastest growing neurodevelopmental disorder in the U.S. Despite evidence that ASD can be reliably diagnosed as early as 24 months, the median age at ASD diagnosis in 2016 in the U.S. was 51 months. The CLEAR Autism Diagnostic Evaluation (CADE; Willard & Kroncke, 2019), was developed in response to the need to improve, shorten, and standardize the clinical ASD evaluation process. The CADE is a 33-item rating scale designed to be completed by caregivers and clinicians. The current study was conducted to examine the reliability and validity of the CADE using a sample of 191 individuals who received a private evaluation for ASD. Using the client's evaluation records, clinicians completed the CADE items. The coefficient alpha was .94, which indicates that the items form a scale that has high internal consistency. The CADE total scores were highly correlated with ADOS scores, with r values ranging from .52-.86, and discriminated between those participants with a diagnosis of ASD and those without (p < .001). Receiver operator characteristic (ROC) curve analyses indicated excellent diagnostic accuracy of the CADE total score (ROC area under the curve = .998). Results suggest that the CADE can be used as an efficient and accurate means of evaluating ASD. Limitations and implications for use of the CADE are discussed.
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Affiliation(s)
| | - Nancy Leech
- School of Education and Human Development, University of Colorado Denver, Denver, CO USA
| | - Courtney Russell
- School of Education and Human Development, University of Colorado Denver, Denver, CO USA
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Autism risk in neonatal intensive care unit patients associated with novel heart rate patterns. Pediatr Res 2021; 90:1186-1192. [PMID: 33603208 PMCID: PMC8371053 DOI: 10.1038/s41390-021-01381-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 12/30/2020] [Accepted: 12/31/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Neonatal intensive care unit (NICU) patients are at increased risk for autism spectrum disorder (ASD). Autonomic nervous system aberrancy has been described in children with ASD, and we aimed to identify heart rate (HR) patterns in NICU patients associated with eventual ASD diagnosis. METHODS This retrospective cohort study included NICU patients from 2009 to 2016 with archived HR data and follow-up beyond age 3 years. Medical records provided clinical variables and ASD diagnosis. HR data were compared in infants with and without ASD. RESULTS Of the 2371 patients, 88 had ASD, and 689,016 h of data were analyzed. HR skewness (HRskw) was significantly different between ASD and control infants. Preterm infants at early postmenstrual ages (PMAs) had negative HRskw reflecting decelerations, which increased with maturation. From 34 to 42 weeks PMA, positive HRskw toward accelerations was higher in males with ASD. In 931 males with at least 4 days of HR data, overall ASD prevalence was 5%, whereas 11% in the top 5th HRskw percentile had ASD. CONCLUSION High HRskw in NICU males, perhaps representing autonomic imbalance, was associated with increased ASD risk. Further study is needed to determine whether HR analysis identifies highest-risk infants who might benefit from earlier screening and therapies. IMPACT In a large retrospective single-center cohort of NICU patients, we found that high positive skewness of heart rate toward more accelerations was significantly associated with increased risk of eventual autism spectrum disorder diagnosis in male infants but not in females. Existing literature describes differences in heart rate characteristics in children, adolescents, and adults with autism spectrum disorders, but the finding from our study in NICU infants is novel. Heart rate analysis during the NICU stay might identify, among an inherently high-risk population, those infants with especially high risk of ASD who might benefit from earlier screening and therapies.
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Ebrahimi A, Ahmadi H, Ghasrodashti ZP, Tanideh N, Shahriarirad R, Erfani A, Ranjbar K, Ashkani-Esfahani S. Therapeutic effects of stem cells in different body systems, a novel method that is yet to gain trust: A comprehensive review. Bosn J Basic Med Sci 2021; 21:672-701. [PMID: 34255619 PMCID: PMC8554700 DOI: 10.17305/bjbms.2021.5508] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022] Open
Abstract
Stem cell therapy has been used to treat several types of diseases, and it is expected that its therapeutic uses shall increase as novel lines of evidence begin to appear. Furthermore, stem cells have the potential to make new tissues and organs. Thus, some scientists propose that organ transplantation will significantly rely on stem cell technology and organogenesis in the future. Stem cells and its robust potential to differentiate into specific types of cells and regenerate tissues and body organs, have been investigated by numerous clinician scientists and researchers for their therapeutic effects. Degenerative diseases in different organs have been the main target of stem cell therapy. Neurodegenerative diseases such as Alzheimer's, musculoskeletal diseases such as osteoarthritis, congenital cardiovascular diseases, and blood cell diseases such as leukemia are among the health conditions that have benefited from stem cell therapy advancements. One of the most challenging parts of the process of incorporating stem cells into clinical practice is controlling their division and differentiation potentials. Sometimes, their potential for uncontrolled growth will make these cells tumorigenic. Another caveat in this process is the ability to control the differentiation process. While stem cells can easily differentiate into a wide variety of cells, a paracrine effect controlled activity, being in an appropriate medium will cause abnormal differentiation leading to treatment failure. In this review, we aim to provide an overview of the therapeutic effects of stem cells in diseases of various organ systems. In order to advance this new treatment to its full potential, researchers should focus on establishing methods to control the differentiation process, while policymakers should take an active role in providing adequate facilities and equipment for these projects. Large population clinical trials are a necessary tool that will help build trust in this method. Moreover, improving social awareness about the advantages and adverse effects of stem cell therapy is required to develop a rational demand in the society, and consequently, healthcare systems should consider established stem cell-based therapeutic methods in their treatment algorithms.
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Affiliation(s)
- Alireza Ebrahimi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hanie Ahmadi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Pourfraidon Ghasrodashti
- Molecular Pathology and Cytogenetics Laboratory, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Tanideh
- Stem Cells Technology Research Center, Department of Pharmacology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amirhossein Erfani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Keivan Ranjbar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheil Ashkani-Esfahani
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Amonkar N, Su WC, Bhat AN, Srinivasan SM. Effects of Creative Movement Therapies on Social Communication, Behavioral-Affective, Sensorimotor, Cognitive, and Functional Participation Skills of Individuals With Autism Spectrum Disorder: A Systematic Review. Front Psychiatry 2021; 12:722874. [PMID: 34867515 PMCID: PMC8637167 DOI: 10.3389/fpsyt.2021.722874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies (N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.
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Affiliation(s)
- Nidhi Amonkar
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
| | - Wan-Chun Su
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
| | - Anjana N. Bhat
- Department of Physical Therapy, University of Delaware, Newark, DE, United States
- Biomechanics and Movement Science Program, University of Delaware, Newark, DE, United States
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Sudha M. Srinivasan
- Physical Therapy Program, Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
- The Connecticut Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs, CT, United States
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Nicolosi M, Dillenburger K. The University of California at Los Angeles‐Young Autism Project: A systematic review of replication studies. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Michael Nicolosi
- Centre for Behaviour Analysis Queen's University Belfast Belfast UK
- Voce nel Silenzio Onlus Varese Italy
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Hume K, Steinbrenner JR, Odom SL, Morin KL, Nowell SW, Tomaszewski B, Szendrey S, McIntyre NS, Yücesoy-Özkan S, Savage MN. Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review. J Autism Dev Disord 2021; 51:4013-4032. [PMID: 33449225 PMCID: PMC8510990 DOI: 10.1007/s10803-020-04844-2] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 12/21/2022]
Abstract
This systematic review describes a set of practices that have evidence of positive effects with autistic children and youth. This is the third iteration of a review of the intervention literature (Odom et al. in J Autism Dev Disorders 40(4):425-436, 2010a; Prevent School Fail 54(4):275-282, 2010b; Wong et al. in https://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/imce/documents/2014-EBP-Report.pdf ; J Autism Dev Disorders 45(7):1951-1966, 2015), extending coverage to articles published between 1990 and 2017. A search initially yielded 31,779 articles, and the subsequent screening and evaluation process found 567 studies to include. Combined with the previous review, 972 articles were synthesized, from which the authors found 28 focused intervention practices that met the criteria for evidence-based practice (EBP). Former EBPs were recategorized and some manualized interventions were distinguished as meeting EBP criteria. The authors discuss implications for current practices and future research.
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Affiliation(s)
- Kara Hume
- School of Education, The University of North Carolina at Chapel Hill, CB 3500 Peabody Hall, Chapel Hill, NC, 27599, USA.
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA.
| | - Jessica R Steinbrenner
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Samuel L Odom
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Kristi L Morin
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Education, Lehigh University, Iacocca Hall, 111 Research Drive, Bethlehem, PA, 18015, USA
| | - Sallie W Nowell
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Brianne Tomaszewski
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Susan Szendrey
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Bondurant Hall, Campus Box 7120, Chapel Hill, NC, 27599-7120, USA
| | - Nancy S McIntyre
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Health Professionals and Sciences, University of Central Florida, 12805 Pegasus Drive, Orlando, FL, 32816, USA
| | - Serife Yücesoy-Özkan
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- Department of Special Education, Anadolu Üniversitesi, Eğitim Fakültesi, Özel Eğitim Bölümü, Tepebaşı, Eskisehir, 26470, Turkey
| | - Melissa N Savage
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Education, University of North Texas, 1300 W. Highland St., Denton, TX, 76201, USA
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Popow C, Ohmann S, Plener P. Practitioner's review: medication for children and adolescents with autism spectrum disorder (ASD) and comorbid conditions. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2021; 35:113-134. [PMID: 34160787 PMCID: PMC8429404 DOI: 10.1007/s40211-021-00395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/15/2021] [Indexed: 11/14/2022]
Abstract
Alleviating the multiple problems of children with autism spectrum disorder (ASD) and its comorbid conditions presents major challenges for the affected children, parents, and therapists. Because of a complex psychopathology, structured therapy and parent training are not always sufficient, especially for those patients with intellectual disability (ID) and multiple comorbidities. Moreover, structured therapy is not available for a large number of patients, and pharmacological support is often needed, especially in those children with additional attention deficit/hyperactivity and oppositional defiant, conduct, and sleep disorders.
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Affiliation(s)
- Christian Popow
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Susanne Ohmann
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
| | - Paul Plener
- Dept. Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria
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London EB, Yoo JH. From Research to Practice: Toward the Examination of Combined Interventions for Autism Spectrum Disorders. Brain Sci 2021; 11:1073. [PMID: 34439691 PMCID: PMC8391105 DOI: 10.3390/brainsci11081073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 12/04/2022] Open
Abstract
The use of biological (i.e., medications) in conjunction with applied behavior analysis is relatively common among people with ASD, yet research examining its benefit is scarce. This paper provides a brief overview of the existing literature on the combined interventions, including promising developments, and examines the existing barriers that hinder research in this area, including the heavy reliance on RCTs. Recommendations for possible solutions, including the creation of health homes, are provided in order to move toward a more integrated approach.
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Affiliation(s)
- Eric Bart London
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, 1050 Forest Hill Road Staten Island, New York, NY 10314, USA;
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Torres A, Lecusay D, Valdez D, Rosoli A, Garrido G, Cukier S, Paula CS, Garcia R, Rattazzi A, Montiel-Nava C. Use of allied-health services and medication among adults with ASD in Latin America. Autism Res 2021; 14:2200-2211. [PMID: 34338424 DOI: 10.1002/aur.2583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/04/2021] [Accepted: 07/17/2021] [Indexed: 11/10/2022]
Abstract
ASD is a neurodevelopmental disorder that affects people across the entire lifespan, yet most of the research identifying the health and medical needs for autistic individuals have been among minors. As individuals with ASD transition to emerging adulthood, the services, already limited, become less available. This study aimed to identify the use of services for Latin American adults on the spectrum. We surveyed 295 caregivers of adults with ASD from six Latin American countries. Comparing the results for all the possible services observed in this study, the adults in our sample were primarily underserved: 84.4%-95.9% were receiving zero hours per week, 3.7%-12.9% 1%-10 h, 0%-1.7% 11-20, and only 0%-1% above 20 h of services. Almost half of the sample used medication, and neurologists were the most consulted health providers. Next to inexistent health care usage in Latin American adults with ASD highlights socioeconomic and health disparities in service provision for ASD in the region. The lack of services places adults with ASD in Latin America at a higher risk of worse symptom severity than autistic adults from regions with broader access to services. LAY SUMMARY: This study aimed to identify the quantity of services received by adults with autism in Latin America. Most of our sample was not receiving health services yet almost half had access to medication. This could mean that adults with autism in Latin America are at higher risk for poorer health.
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Affiliation(s)
- Andy Torres
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Denise Lecusay
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Daniel Valdez
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Analía Rosoli
- Organización Estados Iberoamericanos para la Educación la Ciencia y la Cultura (OEI), Santo Domingo, Dominican Republic
| | | | - Sebastián Cukier
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista, Buenos Aires, Argentina
| | - Cristiane Silvestre Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento Universidade Presbiteriana Mackenzie (UPM), São Paulo, SP, Brazil
| | | | - Alexia Rattazzi
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista, Buenos Aires, Argentina
| | - Cecilia Montiel-Nava
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
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Akhani A, Dehghani M, Gharraee B, Hakim Shooshtari M. Parent training intervention for autism symptoms, functional emotional development, and parental stress in children with autism disorder: A randomized clinical trial. Asian J Psychiatr 2021; 62:102735. [PMID: 34171493 DOI: 10.1016/j.ajp.2021.102735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/31/2021] [Accepted: 06/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Today, early interventions to treat autistic children through parent training interventions is of outmost importance. Interventions are focused on developmental or behavioral approaches and are mostly individual or group ones. In the present study, both proposed approaches in the form of structured individual and group parent training sessions among Iranian families are investigated. METHOD This study was a randomized clinical trial which was performed in 2019-2020 in Tehran. Forty four 3-5 year-old children with autism participated in the study and were assigned to experimental (n = 22) and control (n = 22) groups through block randomization method. To evaluate the effectiveness of therapy on autism symptoms, Gilliam Autism Rating and Functional Emotional Assessment Scales were used. Also, Parenting Stress Index and Quality of Life Questionnaire were implemented to investigate the secondary effects of the therapy. After 12 therapy sessions, both groups took the posttest and 3 months later, follow up evaluations were performed. RESULTS The treatment group manifested significant improvement regarding autism symptoms in both the posttest and follow up (ŋ2 = .77, P < .05) as well as Functional Emotional Development (ŋ2 = .62, P < .05). Comparing the means indicates that the experimental group mean score is significantly higher in quality of life and lower in parenting stress than the control group's. CONCLUSION Parent training is effective on autism symptoms and functional emotional development. Regarding the fact that the follow-up phase coincided with Covid-19 pandemic and quarantine, it can be concluded that the therapy has been successful in maintaining the attained capabilities.
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Affiliation(s)
- Afsaneh Akhani
- Clinical Psychology Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
| | - Mahmood Dehghani
- Clinical Psychology Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
| | - Banafsheh Gharraee
- Clinical Psychology Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
| | - Mitra Hakim Shooshtari
- Department of Psychiatry, School of Sciences and Mental Health (Tehran Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Gardner-Hoag J, Novack M, Parlett-Pelleriti C, Stevens E, Dixon D, Linstead E. Unsupervised Machine Learning for Identifying Challenging Behavior Profiles to Explore Cluster-Based Treatment Efficacy in Children With Autism Spectrum Disorder: Retrospective Data Analysis Study. JMIR Med Inform 2021; 9:e27793. [PMID: 34076577 PMCID: PMC8209527 DOI: 10.2196/27793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Challenging behaviors are prevalent among individuals with autism spectrum disorder; however, research exploring the impact of challenging behaviors on treatment response is lacking. Objective The purpose of this study was to identify types of autism spectrum disorder based on engagement in different challenging behaviors and evaluate differences in treatment response between groups. Methods Retrospective data on challenging behaviors and treatment progress for 854 children with autism spectrum disorder were analyzed. Participants were clustered based on 8 observed challenging behaviors using k means, and multiple linear regression was performed to test interactions between skill mastery and treatment hours, cluster assignment, and gender. Results Seven clusters were identified, which demonstrated a single dominant challenging behavior. For some clusters, significant differences in treatment response were found. Specifically, a cluster characterized by low levels of stereotypy was found to have significantly higher levels of skill mastery than clusters characterized by self-injurious behavior and aggression (P<.003). Conclusions These findings have implications on the treatment of individuals with autism spectrum disorder. Self-injurious behavior and aggression were prevalent among participants with the worst treatment response, thus interventions targeting these challenging behaviors may be worth prioritizing. Furthermore, the use of unsupervised machine learning models to identify types of autism spectrum disorder shows promise.
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Affiliation(s)
- Julie Gardner-Hoag
- Schmid College of Science and Technology, Chapman University, Orange, CA, United States
| | - Marlena Novack
- Center for Autism and Related Disorders, Woodland Hills, CA, United States
| | | | - Elizabeth Stevens
- Fowler School of Engineering, Chapman University, Orange, CA, United States
| | - Dennis Dixon
- Center for Autism and Related Disorders, Woodland Hills, CA, United States
| | - Erik Linstead
- Fowler School of Engineering, Chapman University, Orange, CA, United States
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Kotsopoulos SI, Karaivazoglou K, Florou IS, Gyftogianni MI, Papadaki EJ, Kotsopoulou A. Systematic Intervention for Children with Autism Spectrum Disorder and Integration in Regular School Classes: A Naturalistic Study. Glob Pediatr Health 2021; 8:2333794X211012988. [PMID: 34017906 PMCID: PMC8114291 DOI: 10.1177/2333794x211012988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/01/2021] [Indexed: 11/16/2022] Open
Abstract
Objective of the present study was the assessment of the effect of a systematic community intervention offered at an early age to 32 children with autism spectrum disorder (ASD), 2 to 5 year after completion of treatment while attending public school classes. The intervention had been offered at a community Day Centre and lasted 3 years. On assessment all children showed clinical improvement and significant results on Childhood Autism Rating Scale (CARS) and Vineland Adaptive Scales and 13 scored below criteria for autism on Autism Diagnostic Observation Scale-2 (ADOS-2). Most performed adequately at school whilst 12 required academic assistance. No major disruptive behavior difficulties were reported.
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Affiliation(s)
| | | | - Irene S Florou
- Day Centre for Children with Developmental Disorders, EPSYPEA, Messolonghi, Greece
| | - Maria I Gyftogianni
- Day Centre for Children with Developmental Disorders, EPSYPEA, Messolonghi, Greece
| | - Ermioni J Papadaki
- Day Centre for Children with Developmental Disorders, EPSYPEA, Messolonghi, Greece
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Venkatachalam K, Eissa N, Awad MA, Jayaprakash P, Zhong S, Stölting F, Stark H, Sadek B. The histamine H3R and dopamine D2R/D3R antagonist ST-713 ameliorates autism-like behavioral features in BTBR T+tf/J mice by multiple actions. Biomed Pharmacother 2021; 138:111517. [PMID: 33773463 DOI: 10.1016/j.biopha.2021.111517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/07/2021] [Accepted: 03/14/2021] [Indexed: 12/13/2022] Open
Abstract
Several brain neurotransmitters, including histamine (HA), acetylcholine (ACh), and dopamine (DA) are suggested to be involved in several brain disorders including cognitive deficits, depression, schizophrenia, anxiety, and narcolepsy, all of which are comorbid with Autism spectrum disorder (ASD). Therefore, the ameliorative effects of the novel multiple-active compound ST-713 with high binding affinities at histamine H3 receptor (H3R), dopamine D2sR and D3R on ASD-like behaviors in male BTBR T+tf/J mice model were assessed. ST-713 (3-(2-chloro-10H-phenothiazin-10-yl)-N-methyl-N-(4-(3-(piperidin-1-yl)propoxy)benzyl)propan-1-amine; 2.5, 5, and 10 mg/kg, i.p.) ameliorated dose-dependently social deficits, and significantly alleviated the repetitive/compulsive behaviors of BTBR mice (all P < 0.05). Moreover, ST-713 modulated disturbed anxiety levels, but failed to obliterate increased hyperactivity of tested mice. Furthermore, ST-713 (5 mg/kg) attenuated the increased levels of hippocampal and cerebellar protein expressions of NF-κB p65, COX-2, and iNOS in BTBR mice (all P < 0.05). The ameliorative effects of ST-713 on social parameters were entirely reversed by co-administration of the H3R agonist (R)-α-methylhistamine or the anticholinergic drug scopolamine. The obtained results demonstrate the potential of multiple-active compounds for the therapeutic management of neuropsychiatric disorders, e.g. ASD.
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Affiliation(s)
- Karthikkumar Venkatachalam
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates; Zayed Center for Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates
| | - Nermin Eissa
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates; Zayed Center for Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates; Department of Applied Sciences, College of Arts and Sciences, Abu Dhabi University, P.O. Box 59911, Abu Dhabi, United Arab Emirates
| | - Mohamed Al Awad
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates; Zayed Center for Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates
| | - Petrilla Jayaprakash
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates; Zayed Center for Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates
| | - Sicheng Zhong
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Universitaetsstr. 1, 40225 Düsseldorf, Germany
| | - Frauke Stölting
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Universitaetsstr. 1, 40225 Düsseldorf, Germany
| | - Holger Stark
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Universitaetsstr. 1, 40225 Düsseldorf, Germany
| | - Bassem Sadek
- Department of Pharmacology & Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates; Zayed Center for Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
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Di Renzo M, di Castelbianco FB, Alberto V, Antonio DV, Giovanni C, Vanadia E, Petrillo M, Davide T, Racinaro L, Rea M. Prognostic factors and predictors of outcome in children with autism spectrum disorder: the role of the paediatrician. Ital J Pediatr 2021; 47:67. [PMID: 33736673 PMCID: PMC7977604 DOI: 10.1186/s13052-021-01008-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/22/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Autism spectrum disorder is a complex condition with wide variation in type and severity that involves persistent challenges in social interaction, speech and nonverbal communication, restricted/repetitive behaviours and adaptive behaviours. In recent years, research has deepened the study of the predictive factors of optimal outcome, intended as indicators of positive trajectory in children with a previous diagnosis of autism who, after a therapeutic path, show a significant reduction in the "core" symptoms of autism and a positive evolution in social, adaptive, affective, and relational skills. METHODS The study included 40 children aged 21 to 66 months, enrolled between 2015 and 2016 for an autism spectrum disorder clinical suspicious. Children were re-evaluated after at least 2 years of therapy and they were divided into two groups: the ASD-ASD group included children with a confirmed diagnosis of ASD, and the ASD-OO comparison group included children who no longer met the criteria for an autism classification. The aim of this retrospective study was to investigate the presence of cognitive, emotional and relational predictors capable of predicting the presence of optimal outcome in with a diagnosis of autism; the predictors taken into consideration were the intelligence quotient, the play, the emotional contagion and the understanding of other's intentions. In this way, it is possible to support clinicians in defining a more complete diagnostic framework of autism, using assessment tools that can be administered quickly and therefore suitable for short observation sessions in paediatric patients. RESULTS The findings showed that 15 out of 40 children, after at least for 2 years, no longer fell into the diagnostic ASD category based on the ADOS-2, DSM-5 and clinical criteria. The children in the ASD-OO group initially had a higher IQ than those in the ASD-ASD group, lower severity of autistic symptoms, greater understanding of intentions, more emotional contagion, and better quality of play. The results suggest that the initial coexistence of skills in these areas at the time of the first diagnostic assessment may allow us to predict the possibility of achieving optimal outcome after 2 years of therapy. CONCLUSIONS The data of this study highlight the importance of considering, during assessment, intelligence quotient, play, emotional contagion, and understanding of the intentions of others as potential prognostic predictors that can become useful tools for clinicians and paediatricians. This allows us to focus attention, in both the diagnostic and prognostic phases, on emotional-relational variables that can support the clinician in defining a more complete diagnostic framework and in planning a more personalized therapeutic path.
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Affiliation(s)
- Magda Di Renzo
- Institute of Ortofonologia (IdO), Via Salaria 30, 00198 Rome, Italy
| | | | - Villani Alberto
- Società Italiana di Pediatria, Rome, Italy
- Dipartimento Emergenza Accettazione Pediatria Generale, IRCCS – Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Del Vecchio Antonio
- Società Italiana di Pediatria, Rome, Italy
- Terapia Intensiva Neonatale e Neonatologia, Ospedale Di Venere, Bari, Italy
| | - Corsello Giovanni
- Società Italiana di Pediatria, Rome, Italy
- Clinica Pediatrica Università di Palermo, Palermo, Italy
| | - Elena Vanadia
- Institute of Ortofonologia (IdO), Via Tagliamento 25, 00198 Rome, Italy
| | | | - Trapolino Davide
- Institute of Ortofonologia (IdO), Via Tagliamento 25, 00198 Rome, Italy
| | - Lidia Racinaro
- Institute of Ortofonologia (IdO), Via Tagliamento 25, 00198 Rome, Italy
| | - Monica Rea
- Institute of Ortofonologia (IdO), Via Tagliamento 25, 00198 Rome, Italy
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Ozsahin I, Mustapha MT, Albarwary S, Sanlidag B, Ozsahin DU, Butler TA. An investigation to choose the proper therapy technique in the management of autism spectrum disorder. J Comp Eff Res 2021; 10:423-437. [PMID: 33709772 DOI: 10.2217/cer-2020-0162] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: Autism spectrum disorder is a class of neurological disorders that affect the development of brain functions. This study aims to evaluate, compare and rank the therapy techniques used in the management of autism spectrum disorder using multicriteria decision-making approaches. Materials & methods: Fuzzy PROMETHEE and fuzzy TOPSIS approaches were used. Fuzzy PROMETHEE utilizes a pair-wise comparison of alternatives under the fuzzy environment while fuzzy TOPSIS utilizes geometric distance from the positive ideal solution under the fuzzy environment for the evaluation of the effectiveness of the alternatives.The techniques selected for evaluation are applied behavioral analysis, cognitive behavioral therapy, speech therapy and pharmacological therapy such as Risperidone and Aripiprazole. Criteria used in this study include efficacy, cost and side effects, and their weights are assigned based on specific patient conditions. Results: The results indicate that applied behavioral analysis, cognitive behavioral therapy and speech therapy are the most preferred techniques, followed by Aripiprazole and Risperidone. Conclusion: More criteria could be considered and the weights could be assigned according to the patient profile.
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Affiliation(s)
- Ilker Ozsahin
- Department of Biomedical Engineering, Faculty of Engineering & DESAM Institute, Near East University, Nicosia, Turkish Republic of Northern Cyprus 99138, Turkey.,Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Mubarak T Mustapha
- Department of Biomedical Engineering, Faculty of Engineering & DESAM Institute, Near East University, Nicosia, Turkish Republic of Northern Cyprus 99138, Turkey
| | - Safa Albarwary
- Department of Biomedical Engineering, Faculty of Engineering & DESAM Institute, Near East University, Nicosia, Turkish Republic of Northern Cyprus 99138, Turkey
| | - Burcin Sanlidag
- Faculty of Medicine, Near East University, Nicosia, Turkish Republic of Northern Cyprus 99138, Turkey
| | - Dilber Uzun Ozsahin
- Department of Biomedical Engineering, Faculty of Engineering & DESAM Institute, Near East University, Nicosia, Turkish Republic of Northern Cyprus 99138, Turkey.,Department of Medical Diagnostic Imaging, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Tracy A Butler
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, New York, NY 10065, USA
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45
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Dai YG, Porto KS, Skapek M, Barton ML, Dumont-Mathieu T, Fein DA, Robins DL. Comparison of the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/F) Positive Predictive Value by Race. J Autism Dev Disord 2021; 51:855-867. [PMID: 32125566 PMCID: PMC7483574 DOI: 10.1007/s10803-020-04428-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) is the most widely used screener for ASD. Despite the comparable rate of ASD in Black and White children, the M-CHAT-R/F was validated on a primarily White, Non-Hispanic sample. Few studies have assessed whether the screener performs adequately with racial minorities. This study compared the M-CHAT-R/F Positive Predictive Value (PPV), for ASD, and for any developmental condition, in Black and White children. We also examined M-CHAT-R/F item-level PPV by race. The PPVs for ASD and other developmental disorders were similar in both racial groups for total score and individual items. Therefore, our findings support the use of the M-CHAT-R/F with Black and White children.
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Affiliation(s)
- Yael G Dai
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA.
| | - Katelynn S Porto
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Mary Skapek
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Marianne L Barton
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Thyde Dumont-Mathieu
- Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT, 06106, USA
| | - Deborah A Fein
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269-1020, USA
| | - Diana L Robins
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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Hewitson L, Mathews JA, Devlin M, Schutte C, Lee J, German DC. Blood biomarker discovery for autism spectrum disorder: A proteomic analysis. PLoS One 2021; 16:e0246581. [PMID: 33626076 PMCID: PMC7904196 DOI: 10.1371/journal.pone.0246581] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/22/2021] [Indexed: 12/12/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and social interaction and restricted, repetitive patterns of behavior, interests, or activities. Given the lack of specific pharmacological therapy for ASD and the clinical heterogeneity of the disorder, current biomarker research efforts are geared mainly toward identifying markers for determining ASD risk or for assisting with a diagnosis. A wide range of putative biological markers for ASD is currently being investigated. Proteomic analyses indicate that the levels of many proteins in plasma/serum are altered in ASD, suggesting that a panel of proteins may provide a blood biomarker for ASD. Serum samples from 76 boys with ASD and 78 typically developing (TD) boys, 18 months-8 years of age, were analyzed to identify possible early biological markers for ASD. Proteomic analysis of serum was performed using SomaLogic’s SOMAScanTM assay 1.3K platform. A total of 1,125 proteins were analyzed. There were 86 downregulated proteins and 52 upregulated proteins in ASD (FDR < 0.05). Combining three different algorithms, we found a panel of 9 proteins that identified ASD with an area under the curve (AUC) = 0.8599±0.0640, with specificity and sensitivity of 0.8217±0.1178 and 0.835±0.1176, respectively. All 9 proteins were significantly different in ASD compared with TD boys, and were significantly correlated with ASD severity as measured by ADOS total scores. Using machine learning methods, a panel of serum proteins was identified that may be useful as a blood biomarker for ASD in boys. Further verification of the protein biomarker panel with independent test sets is warranted.
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Affiliation(s)
- Laura Hewitson
- The Johnson Center for Child Health and Development, Austin, TX, United States of America
| | - Jeremy A Mathews
- Departments of Mathematical Sciences and Biological Sciences, Bioinformatics & Computational Biology Program, University of Texas at Dallas, Dallas, TX, United States of America
| | - Morgan Devlin
- The Johnson Center for Child Health and Development, Austin, TX, United States of America
| | - Claire Schutte
- The Johnson Center for Child Health and Development, Austin, TX, United States of America
| | - Jeon Lee
- Lyda Hill Department of Bioinformatics, UT Southwestern Medical Center, Dallas, TX, United States of America
| | - Dwight C German
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States of America
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Dai YG, Thomas RP, Brennan L, Helt MS, Barton ML, Dumont-Mathieu T, Fein DA. Development and Acceptability of a New Program for Caregivers of Children with Autism Spectrum Disorder: Online Parent Training in Early Behavioral Intervention. J Autism Dev Disord 2021; 51:4166-4185. [PMID: 33527164 DOI: 10.1007/s10803-020-04863-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2020] [Indexed: 10/22/2022]
Abstract
Early intervention with parent participation is important for facilitating skill development in children with Autism Spectrum Disorder (ASD). However, many barriers delay or prohibit families from accessing care. We describe the development and acceptability of a novel, comprehensive, self-directed online program for caregivers of children with ASD. Program effectiveness will be presented in a subsequent manuscript. The program is based on behavioral, naturalistic, and developmental principles, and teaches caregivers to use evidence-based interventions to teach developmentally appropriate targets. Approximately two-thirds of enrolled parents completed all 14 modules; barriers to completion for the additional families are described. Parents reported that the program was clear, enjoyable, and useful in teaching them interventions and in improving their children's skills and behavior.
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Affiliation(s)
- Yael G Dai
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA.
| | - Rebecca P Thomas
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | | | - Molly S Helt
- Department of Psychology and Neuroscience, Trinity College, Hartford, CT, USA
| | - Marianne L Barton
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | | | - Deborah A Fein
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
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48
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Choi KR, Knight EA, Stein BD, Coleman KJ. Autism Insurance Mandates in the US: Comparison of Mandated Commercial Insurance Benefits Across States. Matern Child Health J 2021; 24:894-900. [PMID: 32356129 DOI: 10.1007/s10995-020-02950-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Autism mandates are laws that require commercial insurers to cover certain evidence-based treatments for Autism Spectrum Disorder (ASD). The purpose of this study was to review state variability in autism insurance mandates and the benefits they cover and to discuss recommendations for research and policy to improve ASD services across states. METHODS Data were extracted from 2001 to 2020 from all 50 states plus the District of Columbia (N = 51) from policy text. News articles and websites of ASD advocacy organizations were also reviewed to ensure inclusion of the most recent policy changes. Descriptive statistics and heatmaps were used to characterize the autism mandate landscape and visualize variability in benefit parameters across states. RESULTS Autism mandates vary greatly in benefit parameters across US states, but there is a common set of benefits that most states have adopted. These include coverage of provider-recommended ASD services except for medical equipment, coverage up to an age limit of 18 to 21, an annual dollar limit of $36,000 with no restriction on the number of hours or visits, no lifetime cap on benefits, and requirement of BCBA® certification or its equivalent for providers of ABA. DISCUSSION There is a need for continued research evaluating the impact of autism mandates and benefit parameters on access to care, service utilization, and clinical outcomes for the ASD population. Stakeholder engagement and understanding the impact of autism mandates on clinical and patient-centered outcomes may provide direction for policy advocacy and public health initiatives.
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Affiliation(s)
- Kristen R Choi
- UCLA School of Nursing, 700 Tiverton Ave, Factor Bldg Room 3-238, Los Angeles, CA, 90095, USA. .,Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave, Pasadena, CA, 91101-2453, USA.
| | - Elizabeth A Knight
- Utility for Care Data Analysis, Kaiser Foundation Health Plan, Program Office, One Kaiser Plaza - 21 Bayside, Oakland, CA, 94612, USA
| | - Bradley D Stein
- RAND Corporation, 4570 Fifth Avenue, Suite 600, Pittsburgh, PA, 15213, USA
| | - Karen J Coleman
- Department of Research & Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles Ave, Pasadena, CA, 91101-2453, USA
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Miller LE, Dai YG, Fein DA, Robins DL. Characteristics of toddlers with early versus later diagnosis of autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:416-428. [PMID: 32981352 PMCID: PMC7870497 DOI: 10.1177/1362361320959507] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
LAY ABSTRACT The emergence of autism symptoms in childhood is variable, with some children showing signs of autism spectrum disorder very early, and others not being identified until much later. Although most children in the United States are not diagnosed with autism spectrum disorder until preschool, at ages 3-4 years, symptoms can be reliably detected at 14 months. It is less certain how those toddlers diagnosed with autism spectrum disorder earlier versus later differ from each other clinically. This study revealed that young children diagnosed later in development, between ages 25 and 41 months, are more impaired on measures of cognitive, adaptive, and social functioning than their counterparts who are diagnosed with autism spectrum disorder earlier. All young children with autism spectrum disorder are impaired in communication to a similar degree, however. Universal autism screening at 18 months may identify toddlers with autism spectrum disorder when their symptoms are milder and more readily amenable to intervention. Repeated screening at 24 months is supported to detect those children missed by an earlier screening, who may be more severely affected. Caregivers should be encouraged to pursue diagnostic evaluation at an initial positive screening result to ensure timely diagnosis and treatment.
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Affiliation(s)
- Lauren E. Miller
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Yael G. Dai
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Deborah A. Fein
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT, 06269, USA
| | - Diana L. Robins
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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50
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Lewon AB, Ghezzi PM. An evaluation of the Early Learning Measure as a predictor of outcomes in early intensive behavioral intervention. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1768] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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