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Ham LM, Staunton H, Schulz JM, Tillmann J, Volz D, Murtagh L, Chatham C, O'Connor EC, Chamberlain S, Schoenenberger P, Pandina G, Wang P, Kas MJH, Arango C, Murphy D. Points to consider when initiating clinical investigations in autistic paediatric populations-A White Paper. Eur Neuropsychopharmacol 2024; 86:35-42. [PMID: 38917772 DOI: 10.1016/j.euroneuro.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 05/16/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024]
Abstract
Many individuals with autism spectrum disorder (ASD) experience various degrees of impairment in social interaction and communication, restricted, repetitive behaviours, interests/activities. These impairments make a significant contribution to poorer everyday adaptive functioning. Yet, there are no pharmacological therapies to effectively treat the core symptoms of ASD. Since symptoms of ASD likely emerge from a complex interplay of vulnerabilities, environmental factors and compensatory mechanisms during the early developmental period, pharmacological interventions arguably would have the greatest impact to improve long-term outcomes when implemented at a young age. It is essential therefore, that clinical development programmes of investigational drugs in ASD include the paediatric population early on in clinical trials. Such trials need to offer the prospect of direct benefit (PDB) for participants. In most cases in drug development this prospect is supported by evidence of efficacy in adults. However, the effectiveness of treatment approaches may be age-dependent, so that clinical trials in adults may not provide sufficient evidence for a PDB in children. In this white paper, we consolidate recommendations from regulatory guidelines, as well as advice from the Food and Drug Administration, USA (FDA) and the Committee for Human Medicinal Products (CHMP) consultations on various development programmes on: 1) elements to support a PDB to participants in early paediatric clinical trials in ASD, including single-gene neurodevelopment disorders, 2) aspects of study design to allow for a PDB. This white paper is intended to be complementary to existing regulatory guidelines in guiding industry and academic sponsors in their conduct of early paediatric clinical trials in ASD.
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Affiliation(s)
| | | | - Jan Michael Schulz
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Julian Tillmann
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | | | - Lorraine Murtagh
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | | | - Eoin C O'Connor
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Stormy Chamberlain
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | - Philipp Schoenenberger
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, Basel, Switzerland
| | | | - Paul Wang
- Clinical Research Associates LLC, Simons Foundation, Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA
| | - Martien J H Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Nijenborgh, Groningen, the Netherlands
| | - Celso Arango
- Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, Universidad Complutense, School of Medicine, Madrid, Spain
| | - Declan Murphy
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Callahan PA, Jeglic EL, Calkins C. Sexual Offenders With Intellectual Disabilities: An Exploratory Comparison Study in an Incarcerated U.S. Sample. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2024; 68:1052-1073. [PMID: 34963349 DOI: 10.1177/0306624x211066825] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research indicates that individuals with intellectual disabilities (ID) are overrepresented among sexual offenders, and that those with ID might differ from those without ID in terms of the etiology of offending behavior. Despite this, few studies have explored ID using incarcerated U.S. samples. The present study sought to identify relevant characteristics of this population by comparing individuals with and without ID who are incarcerated in the U.S. for sexual offenses. Archival records for 3,066 participants were used to determine demographic, historical, and offense-related characteristics. Participants with ID, including those with borderline ID, comprised 19.1% of the sample and displayed elevated rates of adverse childhood experiences and psychopathology. Contrary to previous research, participants with ID were no more likely to offend against children than those without ID. These findings help to elucidate the etiology of offending behavior among those with ID and inform on potential targets for intervention.
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Petropoulos A, Anesiadou S, Michou M, Lymperatou A, Roma E, Chrousos G, Pervanidou P. Functional Gastrointestinal Symptoms in Children with Autism and ADHD: Profiles of Hair and Salivary Cortisol, Serum Leptin Concentrations and Externalizing/Internalizing Problems. Nutrients 2024; 16:1538. [PMID: 38794776 PMCID: PMC11124526 DOI: 10.3390/nu16101538] [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: 04/26/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Functional Gastrointestinal Disorders (FGIDs) present a higher prevalence in individuals with Neurodevelopmental Disorders (NDDs). The Stress System and the Gut-Brain axis (GBA) may mediate these relations. We aimed to assess the prevalence and profile of FGIDs in a clinical sample of children with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) compared to typically developing children (TD) as well as to investigate possible relations between stress-related biomarkers and internalizing/externalizing problems in children with NDDS. METHODS In total, 120 children, aged between 4 and 12 years old, formed three groups (N = 40, each): ADHD, ASD and TD. Salivary cortisol, hair cortisol and serum leptin were measured. RESULTS The ASD group had more FGID problems than the TD group (p = 0.001). The ADHD and ASD groups had higher total internalizing/externalizing problems than the TD group (p < 0.0001, p < 0.0001, p = 0.005, respectively). Children with FGIDs showed more total, internalizing and externalizing problems compared to children without FGIDs (p < 0.0001, p < 0.0001, p = 0.041, respectively). The ADHD group showed lower AUCg values (p < 0.0001), while the hair cortisol was higher for the TD group (p < 0.0001). CONCLUSION In conclusion, children with NDDs had more FGID symptoms and present higher internalizing and externalizing problems. Children with ADHD and FGIDs had more internalizing problems compared to those without FGIDs. No differences in stress-related biomarkers were shown to differentiate children with NDDs with and without FGIDs. Future prospective studies including a greater number of children may elucidate the biological pathways linking these comorbidities.
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Affiliation(s)
- Andreas Petropoulos
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (A.P.); (S.A.); (A.L.)
- School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (E.R.); (G.C.)
| | - Sophia Anesiadou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (A.P.); (S.A.); (A.L.)
- School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (E.R.); (G.C.)
| | - Maria Michou
- Human Ecology Laboratory, Department of Home Economics and Ecology, Harokopio University, 17676 Athens, Greece;
| | - Aikaterini Lymperatou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (A.P.); (S.A.); (A.L.)
- Postgraduate Program “The Science of Stress and Stress Promotion”, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
| | - Eleftheria Roma
- School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (E.R.); (G.C.)
| | - George Chrousos
- School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (E.R.); (G.C.)
| | - Panagiota Pervanidou
- Unit of Developmental and Behavioral Pediatrics, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (A.P.); (S.A.); (A.L.)
- School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece; (E.R.); (G.C.)
- Postgraduate Program “The Science of Stress and Stress Promotion”, School of Medicine, National and Kapodistrian University of Athens, “Aghia Sophia” Children’s Hospital, 11527 Athens, Greece
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Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social interaction and communication and the presence of restricted interests and repetitive behaviors. The importance of early detection of ASD and subsequent early intervention is well documented. Efforts have been made over the years to clarify ASD diagnostic criteria and develop predictive, accurate screening tools and evidence-based, standardized diagnostic instruments to aid in the identification of ASD. In this article, we review the most recent changes in ASD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, summarize evidence-based instruments for ASD screening and diagnostic evaluations as well as the assessment of co-occurring conditions in ASD, the impact of COVID-19 on ASD assessment, and directions for future research in the field of ASD assessment.
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Affiliation(s)
- Yue Yu
- University of California, Davis, Sacramento, USA
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5
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Rosen NE, Schiltz HK, Lord C. Teacher- and parent-reported trajectories of maladaptive behaviors among individuals with autism and non-spectrum delays. Autism Res 2023; 16:174-189. [PMID: 36367328 PMCID: PMC9839568 DOI: 10.1002/aur.2854] [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: 06/15/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
People with autism spectrum disorder (ASD) and non-spectrum developmental delays frequently exhibit maladaptive behaviors throughout the lifespan, which can have pervasive effects on quality of life. Maladaptive behaviors have been shown to change over time as a function of various individual-level factors (e.g., cognitive ability), yet research is primarily limited to parent-reported measures. To expand upon this work, the present study aimed to examine trajectories of teacher- and parent-reported maladaptive behaviors (i.e., hyperactivity, irritability, social withdrawal) and to test whether individual-level predictors (e.g., autism features, verbal intelligence quotient) and school-related predictors (e.g., teacher type, student-adult ratio, personal aide, school type) impact these trajectories among 165 individuals with ASD or non-spectrum delays from ages 9 to 18. Multilevel models revealed that, according to both teacher and parent report, participants showed the greatest improvement in hyperactivity, less but still notable improvement in irritability, and stable levels of social withdrawal over time. Higher verbal ability and fewer ASD features, in addition to mainstream school placement, emerged as important individual- and school-related differences associated with fewer maladaptive behaviors over time. The multi-informant perspective and longitudinal design provide novel insight into the manifestations of these maladaptive behaviors across different contexts and across time. Findings highlight the consistency of teacher- and parent-reported trajectories over time and further emphasize the importance of targeting maladaptive behaviors using a multisystem intervention approach in both school and home contexts.
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Arpone M, Bretherton L, Amor DJ, Hearps SJC, Rogers C, Field MJ, Hunter MF, Santa Maria L, Alliende AM, Slee J, Godler DE, Baker EK. Agreement between parents' and clinical researchers' ratings of behavioral problems in children with fragile X syndrome and chromosome 15 imprinting disorders. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104338. [PMID: 36179574 DOI: 10.1016/j.ridd.2022.104338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/04/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Despite the increasing number of clinical trials involving children with neurodevelopmental disorders, appropriate and objective outcome measures for behavioral symptoms are still required. AIM This study assessed the agreement between parents' and clinical researchers' ratings of behavioral problem severity in children with fragile X syndrome (FXS) and chromosome 15 imprinting disorders. METHODS AND PROCEDURES The cohort comprised 123 children (64% males), aged 3-17 years, with FXS (n = 79), Prader-Willi (PWS; n = 19), Angelman (AS; n = 15), and Chromosome 15q duplication (n = 10) syndromes. Specific items from the Autism Diagnostic Observation Schedule-Second Edition and Aberrant Behavior Checklist-Community Edition mapping to corresponding behavioral domains were selected ad-hoc, to assess behavioral problems. OUTCOMES AND RESULTS Inter-rater agreement for the cohort was slight for self-injury (Intraclass Correlation Coefficient (ICC) = 0.12), fair for tantrums/aggression (0.24) and mannerisms/stereotypies (0.25), and moderate for hyperactivity (0.48). When stratified by diagnosis, ICC ranged from poor (0; self-injury, AS and PWS) to substantial (0.48; hyperactivity, females with FXS). CONCLUSIONS AND IMPLICATIONS The high level of inter-rater disagreement across most domains suggests that parents' and researchers' assessments led to discrepant appraisal of behavioral problem severity. These findings have implications for treatment targets and outcome measure selection in clinical trials, supporting a multi-informant approach.
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Affiliation(s)
- Marta Arpone
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Lesley Bretherton
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - David J Amor
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia
| | - Stephen J C Hearps
- Brain and Mind, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Carolyn Rogers
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW, Australia
| | - Michael J Field
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW, Australia
| | - Matthew F Hunter
- Monash Genetics, Monash Health, Melbourne, VIC, Australia; Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Lorena Santa Maria
- Laboratory of Molecular Cytogenetics, Department of Genetics and Metabolic Diseases, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Angelica M Alliende
- Laboratory of Molecular Cytogenetics, Department of Genetics and Metabolic Diseases, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Jennie Slee
- Department of Health, Government of Western Australia, Genetic Services of Western Australia, Perth, Australia
| | - David E Godler
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Emma K Baker
- Diagnosis and Development, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, VIC, Australia; Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia.
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Chandler S, Carter Leno V, White P, Yorke I, Hollocks MJ, Baird G, Pickles A, Simonoff E, Charman T. Pathways to adaptive functioning in autism from early childhood to adolescence. Autism Res 2022; 15:1883-1893. [PMID: 35899846 PMCID: PMC9796413 DOI: 10.1002/aur.2785] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/15/2022] [Indexed: 01/07/2023]
Abstract
Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. This study examines longitudinal and contemporaneous associations of adaptive functioning in autistic youth across a wide ability range. Parent-reported autism symptoms, co-occurring emotional, behavioral and attention deficit hyperactivity disorder (ADHD) symptoms, and IQ were assessed in early childhood (M age 7 years; T1) and 6 years later in adolescence (M age 13 years; T2) in 179 autistic youth. Adaptive functioning was assessed at T2. Structural equation modeling estimated pathways to adaptive functioning from autism, and psychiatric symptoms at T1 and T2, testing whether associations were driven by continuity of behaviors from T1 to T2 or their contemporaneous effect at T2, or both, controlling for T1 IQ. Lower adaptive functioning at T2 was associated with higher T1 and T2 ADHD symptoms (β = -0.14, and β = -0.21) but not behavioral nor emotional symptoms at either timepoint. Lower adaptive functioning at T2 was also associated with lower T1 IQ (β = 0.43) and higher social communication symptoms (β = -0.37) at T2 but not T1, but the relationship with ADHD symptoms remained. Paths were not moderated by sex or IQ. Increased symptoms of ADHD, both in early childhood and contemporaneously, were associated with reduced adaptive functioning in adolescence. Co-occurring ADHD may be a modifiable risk factor for adaptive function impairments and should be routinely assessed and when present evidence-based treatments initiated which may benefit adaptive functioning outcomes. LAY SUMMARY: Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. In a community sample higher attention deficit/hyperactivity disorder (ADHD) symptoms, but not emotional or behavioral symptoms, in both early childhood and contemporaneously were associated with lower adaptive functioning in autistic adolescents. Co-occurring ADHD may be a modifiable risk factor for adaptive function difficulties in autism.
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Affiliation(s)
- Susie Chandler
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | | | - Philippa White
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Isabel Yorke
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Matthew J. Hollocks
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK
| | | | - Andrew Pickles
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,Maudsley Biomedical Research Centre for Mental HealthLondonUK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK,Maudsley Biomedical Research Centre for Mental HealthLondonUK
| | - Tony Charman
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK,South London and Maudsley NHS Foundation Trust (SLaM)LondonUK
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Rosen NE, Schiltz HK, Lord C. Sibling Influences on Trajectories of Maladaptive Behaviors in Autism. J Clin Med 2022; 11:5349. [PMID: 36142996 PMCID: PMC9502075 DOI: 10.3390/jcm11185349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
Siblings play an important role in the behavioral trajectories of individuals with autism spectrum disorder (ASD). While having siblings has been associated with positive outcomes in ASD, including stronger adaptive functioning, social and non-verbal communication, and theory of mind, little is known about the impact of siblings on more negative outcomes, such as maladaptive behaviors. To address this gap, the present longitudinal study tested sibling predictors of trajectories of maladaptive behaviors (e.g., teacher- and parent-reported hyperactivity, irritability, and social withdrawal) from childhood through early adulthood among individuals with ASD and non-spectrum delays. Multilevel models revealed that, while the mere presence of a sibling did not impact maladaptive behavior trajectories apart from teacher-reported hyperactivity, the diagnostic profile of the sibling (e.g., emotional/behavioral disorder, ASD, medical condition) emerged as an important predictor. Specifically, although findings varied across teacher and parent reports, more hyperactivity and irritability across time was identified when the sibling had diagnoses of an emotional/behavioral disorder, ASD, and/or a medical condition. Overall, this study provides novel insight into the broader family-level factors that influence the presentation of maladaptive behaviors across time and across contexts.
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Affiliation(s)
- Nicole E. Rosen
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA 90095, USA
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9
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Lundy KM, Wenzbauer MA, Illapperuma CR, Fischer AJ, Feng MJ, Jensen RL, Maldonado AF, Mathis SN, Meservy JO, Heller HN. Evaluating the Acceptability and Social Validity of a Caregiver-Led Technology-Based Menstrual Hygiene Management Intervention for Youth on the Autism Spectrum. ADVANCES IN NEURODEVELOPMENTAL DISORDERS 2022; 6:315-330. [PMID: 35669343 PMCID: PMC9156825 DOI: 10.1007/s41252-022-00261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Menstrual hygiene management (MHM) is a critical area of daily living skills for neurodiverse menstruators in which few evidence-based interventions exist. This study evaluated the acceptability and social validity of a caregiver-mediated intervention for youth on the autism spectrum utilizing behavior skills training, animated video modeling, task analysis, and telehealth services to improve changing a menstrual pad. METHODS The consultant recruited three youth and caregiver dyads to test the intervention and collect acceptability and social validity assessments. Materials varied based on the phase of the study; however, a typical trial required data collection sheets, youth's underwear, a menstrual pad, and, during intervention, the video model and hardware technology. A multiple baseline design across participants and reversal design were used to demonstrate experimental effects. Due to the sensitive nature of the study, independence and accuracy data were collected by caregivers and analyzed later by the consultant through visual analysis. RESULTS Overall, youth participants improved their percentage of independent and accurate steps of changing a menstrual pad. Furthermore, caregivers reported moderate to high levels of acceptability of the telehealth service delivery and animated video modeling, as well as the overall MHM training program measured by the Technology Acceptability Model-Fast Form (FF-TAM) and the Behavior Intervention Rating Scale (BIRS), respectively. Youth reported high levels of acceptability of the MHM training program as measured by the Child Intervention Rating Profile (CIRP). CONCLUSIONS Results suggest that a technology-based, caregiver-mediated MHM intervention for neurodiverse youth would be considered acceptable and socially valid by caregiver and youth participants. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s41252-022-00261-x.
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Affiliation(s)
- Keely M. Lundy
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | - M. Allison Wenzbauer
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | | | - Aaron J. Fischer
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | - Merry J. Feng
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | - Rylee L. Jensen
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | | | - Sara N. Mathis
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | - Jeremy O. Meservy
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
| | - Haylee N. Heller
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
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Moore HL, Couteur AL, Charman T, Green J, Parr JR, Grahame V. What is the concordance between parent- and education professional-reported adaptive functioning in autistic children using the VABS-II? J Autism Dev Disord 2022:10.1007/s10803-022-05602-2. [PMID: 35579790 DOI: 10.1007/s10803-022-05602-2] [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: 05/02/2022] [Indexed: 11/29/2022]
Abstract
Adaptive functioning of autistic children is traditionally measured through informant-report, often from parents. Behaviour varies across settings though, and context-specific reports should be considered. Limited and inconsistent results show low parent-education professional concordance, but no research has yet explored item level response variation. We investigated Vineland Adaptive Behaviour Scales-II concordance using 233 lower ability autistic children from the PACT-G sample. Domain and item level agreement was low, but better on objectively measured behaviours. Higher child nonverbal ability improved concordance. Where disagreements occurred, education professionals identified emergent skills more and parents were more likely to rate present/absent. Parents and education professionals view the adaptive abilities of autistic children differently and both should be considered when developing personalised interventions and support.
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Affiliation(s)
- Heather L Moore
- School of Psychology, 4.28, Dame Margaret Barbour Building, Wallace Street, Newcastle upon Tyne, NE2 4DR, England, UK.
| | - Ann Le Couteur
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Level 3, Queen Victoria Road, NE1 4LP, Newcastle upon Tyne, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Box PO77, Henry Wellcome Building, De Crespigny Park, Denmark Hill, SE5 8AF, London, UK
| | - Jonathan Green
- Division of Neuroscience and Experimental Psychology, University of Manchester, PACT-G Trial Office, Room 3.312, Jean McFarlane Building, Oxford Road, M13 9PL, Manchester, UK.,Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Oxford Road, M13 9WL, Manchester, UK
| | - Jeremy R Parr
- Population Health Sciences Institute, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Level 3, Queen Victoria Road, NE1 4LP, Newcastle upon Tyne, UK.,Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Walkergate Park, Benfield Rd, NE6 4QD, Newcastle upon Tyne, UK
| | - Victoria Grahame
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Walkergate Park, Benfield Rd, NE6 4QD, Newcastle upon Tyne, UK
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11
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Rosenblat O, Furman Y, Kimhi G, Leibovitch L, Mazkereth R, Yinon Y, Lipitz S, Strauss T, Weisz B. In-utero treatment of prenatal thoracic abnormalities by thoraco-amniotic shunts, short and long term neuro developmental outcome: A single center experience. J Pediatr Surg 2022; 57:364-368. [PMID: 34588133 DOI: 10.1016/j.jpedsurg.2021.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/12/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Severe primary fetal hydrothorax (PFH) and fetal lung lesions (FLL) such as congenital pulmonary airway malformation (CPAM) and Bronchopulmonary sequestration (BPS) are often treated by thoraco-amniotic shunt (TAS). OBJECTIVES To compare short and long-term outcome of fetuses treated by TAS due to FLL to those treated due to PFH. METHOD A retrospective analysis was performed for all fetuses treated by TAS, between the years 2004-2015, evaluating the short and long term neurodevelopmental outcome. Long term neurodevelopment was additionally analyzed prospectively by Vineland adaptive behavioral scale (VABS) standardized questionnaires. RESULTS 38 fetuses were treated by 52 TAS insertions; of which 13 (35%) due to FLL and 25 due to PFH. Perinatal survival was high (87.9%) with 3 neonatal death and one termination of pregnancy (TOP). High survival rate persisted even in cases requiring recurrent shunt insertion (80% survival). There was no significant difference in short or long term outcome including perinatal survival (84% Vs 90%, P = 0.64) and hydrops resolution (91% Vs 63%, p = 0.19). Long term outcome, including rate of neurodevelopmental abnormalities (23.5% Vs 20%) and VABS score (91.3 ± 13.3 Vs 96.4 ± 14.7), were similar for both groups. CONCLUSION TAS insertion is effective and resulting in high perinatal survival even in cases when sequential insertion is needed. Short and long- term outcome of neonates with FLL treated by TAS are comparable to neonates treated due to PFH.
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Affiliation(s)
- Orgad Rosenblat
- The institute of obstetrical and gynaecological imaging, Department Obstetrics and Gynecology, The Chaim Sheba Medical Center at Tel Hashomer, Tel-Aviv University, Ramat Gan, 5262000, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Yael Furman
- Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Gal Kimhi
- Neonatology, The Chaim Sheba Medical Center at Tel Hashomer, Israel
| | - Leah Leibovitch
- Neonatology, The Chaim Sheba Medical Center at Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Ram Mazkereth
- Neonatology, The Chaim Sheba Medical Center at Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Yoav Yinon
- The institute of obstetrical and gynaecological imaging, Department Obstetrics and Gynecology, The Chaim Sheba Medical Center at Tel Hashomer, Tel-Aviv University, Ramat Gan, 5262000, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Shlomo Lipitz
- The institute of obstetrical and gynaecological imaging, Department Obstetrics and Gynecology, The Chaim Sheba Medical Center at Tel Hashomer, Tel-Aviv University, Ramat Gan, 5262000, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Tzipora Strauss
- Neonatology, The Chaim Sheba Medical Center at Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - Boaz Weisz
- The institute of obstetrical and gynaecological imaging, Department Obstetrics and Gynecology, The Chaim Sheba Medical Center at Tel Hashomer, Tel-Aviv University, Ramat Gan, 5262000, Israel; Sackler School of Medicine, Tel Aviv University, Israel.
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12
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Uljarević M, Spackman EK, Cai RY, Paszek KJ, Hardan AY, Frazier TW. Daily living skills scale: Development and preliminary validation of a new, open-source assessment of daily living skills. Front Psychiatry 2022; 13:1108471. [PMID: 36756637 PMCID: PMC9900738 DOI: 10.3389/fpsyt.2022.1108471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/30/2022] [Indexed: 01/25/2023] Open
Abstract
Autistic individuals and individuals with a range of other neurodevelopmental conditions (NDD) often present with lower levels of daily living skills (DLS) when compared to their neurotypical peers. Importantly, lower levels of DLS have been linked to a range of negative outcomes, including lower rates of post-secondary education, lower employment rates, and higher daily support needs across autism and NDD. However, there are currently no open-source informant-reported instruments for capturing key aspects of DLS. This study describes the development, refinement, and initial psychometric evaluation of a new, relatively brief (53-item). Daily Living Skills Scale (DLSS) in a sample of 1,361 children aged 2-17 years, Confirmatory Factor Analysis demonstrated an excellent fit of unidimensional model to the data (CFI = 0.953, TLI = 0.951, RMSEA = 0.073 [95% CI: 0.071-0.074]). The single-factor CFA model showed evidence of measurement invariance of factor loadings, thresholds, and residual variance (strict invariance) across sex, age, race, and ethnicity. Model reliability and internal consistency were excellent (ω = 0.98; α = 0.97). Conditional reliability estimates indicated very good reliability (= 0.80) for the total DLS scale from very low (θ = -4.2) to high (θ = +2.4) scores. Conceptually derived self-care, homecare, and community participation subscales also showed strong reliability and internal consistency. With further replication, the EFS has excellent potential for wide adoption across research and clinical contexts.
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Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Emily K Spackman
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Ru Ying Cai
- Aspect Research Centre for Autism Practice, French's Forest, Sydney, NSW, Australia
| | - Katherine J Paszek
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights, OH, United States
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Duncan A, Liddle M, Adams R. A cluster analysis of daily living skills in school aged children with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 69:593-601. [PMID: 37484209 PMCID: PMC10358589 DOI: 10.1080/20473869.2021.1980350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/07/2021] [Accepted: 09/08/2021] [Indexed: 07/25/2023]
Abstract
For individuals with autism spectrum disorder (ASD) daily living skills (DLS) fall below chronological age and have been linked to factors such as language. Given the impact of DLS on daily life, it is critical to gain a comprehensive understanding of DLS profiles in children to guide effective treatment. Using a large dataset from the Autism Speaks Autism Treatment Network, the current study sought to (1) examine whether there are subgroups of children with ASD defined by both their Vineland-II DLS scores and language abilities and (2) explore the relationship between internalizing and externalizing symptoms on subgroups using the Child Behavior Checklist. A five-cluster solution was found, but one group was subsequently dropped. Four clusters were examined: Low Language-Low DLS (n = 143); Low-Language High DLS (n = 170); High Language-Low DLS (n = 189); and High Language-High DLS (n = 203). The High Language-Low DLS group had significantly higher internalizing and externalizing symptoms as compared to the other groups. The results highlight the importance of targeting DLS in school-age children with ASD, especially for those with comorbid internalizing and externalizing symptom to ensure that the gap between age and functional DLS does not continue to widen.
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Affiliation(s)
- Amie Duncan
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Melissa Liddle
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Ryan Adams
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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14
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Neufeld J, Hederos Eriksson L, Hammarsten R, Lundin Remnélius K, Tillmann J, Isaksson J, Bölte S. The impact of atypical sensory processing on adaptive functioning within and beyond autism: The role of familial factors. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:2341-2355. [PMID: 34340600 DOI: 10.1177/13623613211019852] [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] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Individuals diagnosed with autism tend to process sensory information differently than individuals without autism, resulting for instance in increased sensitivity to sounds or smells. This leads to challenges in everyday life and may restrict the individual's daily functioning. How direct this link is, however, is currently unclear. We investigated this question in 289 twins of whom 60 were diagnosed with autism and further 61 were diagnosed with other neurodevelopmental disorders. We looked at the association between unusual sensory processing and adaptive skills, both across individuals and within-twin pairs, testing whether individuals with higher levels of atypical sensory processing showed reduced adaptive skills compared to their twins. Since twins share 50%-100% of their genes and part of their environment (e.g. family background), associations within-twin pairs are free from effects of these familial factors. We found that an increased sensitivity to, as well as the avoiding of, sensory input (hyper-responsiveness) was linked to reduced adaptive skills across individuals-but not within-twin pairs. We also found an association between the degree to which individuals seek for sensory input (sensation seeking) and reduced adaptive skills, but only in individuals diagnosed with autism. The results suggest that sensory hyper-responsiveness has negative effects on individuals' general ability to function, but that this link is influenced by familial factors and hence not direct. In addition, sensation seeking behaviors might have a negative impact on adaptive skills specifically in autistic individuals.
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Affiliation(s)
| | | | | | | | | | - Johan Isaksson
- Karolinska Institutet, Sweden.,Uppsala University, Sweden
| | - Sven Bölte
- Karolinska Institutet, Sweden.,Region Stockholm, Sweden.,Curtin University, Australia
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15
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Alvares GA, Licari MK, Stevenson PG, Bebbington K, Cooper MN, Glasson EJ, Tan DW, Uljarević M, Varcin KJ, Wray J, Whitehouse AJO. Investigating associations between birth order and autism diagnostic phenotypes. J Child Psychol Psychiatry 2021; 62:961-970. [PMID: 33164221 DOI: 10.1111/jcpp.13349] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/05/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Birth order effects have been linked to variability in intelligence, educational attainment and sexual orientation. First- and later-born children have been linked to an increased likelihood of an Autism Spectrum Disorder (ASD) diagnosis, with a smaller body of evidence implicating decreases in cognitive functioning with increased birth order. The present study investigated the potential association between birth order and ASD diagnostic phenotypes in a large and representative population sample. METHODS Data were obtained from an ongoing prospective diagnostic registry, collected between 1999 and 2017, including children (1-18 years of age, n = 5,404) diagnosed with ASD in the state of Western Australia. Children with ASD were ranked relative to sibling's birth to establish birth order within families at time of ASD diagnosis. Information reported to the registry by health professionals at the time of diagnostic evaluation included demographic and family characteristics, functional abilities and intellectual capacity. RESULTS Adaptive functioning and intelligence scores decreased with increasing birth order, with later-born children more likely to have an intellectual disability. Compared to first-born children with siblings, first-born children without siblings at the time of diagnosis also exhibited decreased cognitive functioning. CONCLUSIONS These findings demonstrate for the first time an association between increasing birth order and variability in ASD clinical phenotypes at diagnosis, with potential evidence of reproductive curtailment in children without siblings. Taken together, these findings have significant implications for advancing understanding about the potential mechanisms that contribute to heterogeneity in ASD clinical presentations as a function of birth order and family size.
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Affiliation(s)
- Gail A Alvares
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Melissa K Licari
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Paul G Stevenson
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Keely Bebbington
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Matthew N Cooper
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Emma J Glasson
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Diana W Tan
- School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Mirko Uljarević
- Melbourne School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Kandice J Varcin
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - John Wray
- Child and Adolescent Health Service, Western Australia Department of Health, Perth, WA, Australia
| | - Andrew J O Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
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16
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Channell MM, Mattie LJ, Hamilton DR, Capone GT, Mahone EM, Sherman SL, Rosser TC, Reeves RH, Kalb LG. Capturing cognitive and behavioral variability among individuals with Down syndrome: a latent profile analysis. J Neurodev Disord 2021; 13:16. [PMID: 33874886 PMCID: PMC8056665 DOI: 10.1186/s11689-021-09365-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 04/03/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a high degree of inter- and intra-individual variability observed within the phenotype of Down syndrome. The Down Syndrome Cognition Project was formed to capture this variability by developing a large nationwide database of cognitive, behavioral, health, and genetic information on individuals with Down syndrome, ages 6-25 years. The current study used the Down Syndrome Cognition Project database to characterize cognitive and behavioral variability among individuals with Down syndrome. METHODS Latent profile analysis was used to identify classes across a sample of 314 participants based on their cognition (IQ and executive functioning), adaptive and maladaptive behavior, and autism spectrum disorder symptomatology. A multivariate multinomial regression model simultaneously examined demographic correlates of class. RESULTS Results supported a 3-class model. Each class demonstrated a unique profile across the subdomains of cognition and behavior. The "normative" class was the largest (n = 153, 48%) and displayed a relatively consistent profile of cognition and adaptive behavior, with low rates of maladaptive behavior and autism symptomatology. The "cognitive" class (n = 109, 35%) displayed low cognitive scores and adaptive behavior and more autism symptomatology, but with low rates of maladaptive behavior. The "behavioral" class, the smallest group (n = 52, 17%), demonstrated higher rates of maladaptive behavior and autism symptomatology, but with cognition levels similar to the "normative" class; their adaptive behavior scores fell in between the other two classes. Household income and sex were the only demographic variables to differ among classes. CONCLUSIONS These findings highlight the importance of subtyping the cognitive and behavioral phenotype among individuals with Down syndrome to identify more homogeneous classes for future intervention and etiologic studies. Results also demonstrate the feasibility of using latent profile analysis to distinguish subtypes in this population. Limitations and future directions are discussed.
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Affiliation(s)
- Marie Moore Channell
- University of Illinois at Urbana-Champaign, 901 S. Sixth St, Champaign, IL, 61820, USA.
| | - Laura J Mattie
- University of Illinois at Urbana-Champaign, 901 S. Sixth St, Champaign, IL, 61820, USA
| | | | - George T Capone
- Kennedy Krieger Institute, 801 N Broadway, Baltimore, MD, 21205, USA
| | - E Mark Mahone
- Kennedy Krieger Institute, 1750 E. Fairmount Ave, Baltimore, MD, 21231, USA
| | | | | | - Roger H Reeves
- Johns Hopkins School of Medicine, 725 N Washington St, Baltimore, MD, 21205, USA
| | - Luther G Kalb
- Kennedy Krieger Institute, Johns Hopkins School of Public Health, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA
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17
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Hodge MA, Boulton KA, Sutherland R, Barnett D, Bennett B, Chan E, Cramsie J, Drevensek S, Eapen V, Ganesalingam K, Masi A, Ong N, Williamsz M, Guastella AJ, Silove N. Predictors of adaptive functioning in preschool aged children with autism spectrum disorder. Autism Res 2021; 14:1444-1455. [PMID: 33749170 DOI: 10.1002/aur.2501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/06/2021] [Indexed: 12/22/2022]
Abstract
Difficulties in adaptive functioning are common in autism spectrum disorder (ASD) and contribute to negative outcomes across the lifespan. Research indicates that cognitive ability is related to degree of adaptive functioning impairments, particularly in young children with ASD. However, the extent to which other factors, such as socioeconomic status (SES) and ASD symptom severity, predict impairments in adaptive functioning remains unclear. The goal of this study was to determine the extent to which SES, ASD symptom severity, and cognitive ability contribute to variability in domain-specific and global components of adaptive functioning in preschool-aged children with ASD. Participants were 99 preschool-aged children (2-6 years) with ASD who attended a tertiary diagnostic service. Results demonstrate that cognitive ability accounted for a significant proportion of variance in domain-specific and global components of adaptive functioning, with higher cognitive ability predicting better adaptive functioning. Results also demonstrate that SES accounted for some variability in domain-specific communication skills and global adaptive functioning when compared to basic demographic factors alone (age and gender). By contrast, ASD symptom severity did not predict variability in domain-specific or global components of adaptive functioning. These findings provide support for a relationship between cognitive ability and adaptive functioning in preschool-aged children with ASD and help to explain specific contributions of verbal and nonverbal ability to adaptive functioning; from this, we can better understand which children are likely to show the greatest degree of impairments across components of adaptive functioning early in development. LAY SUMMARY: People with autism often have difficulties with everyday communication, daily living, and social skills, which are also called adaptive functioning skills. This study investigated factors that might be related to these difficulties in preschoolers with autism. We found that better cognitive ability, but not autism symptoms, were associated with better adaptive functioning. This suggests that interventions for young children with autism should take into account cognitive ability to better understand which children are likely to have difficulties with adaptive functioning.
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Affiliation(s)
- Marie Antoinette Hodge
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kelsie A Boulton
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Sutherland
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Diana Barnett
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Beverley Bennett
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Esther Chan
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Jane Cramsie
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Suzi Drevensek
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Kalaichelvi Ganesalingam
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Anne Masi
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Natalie Ong
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Marcia Williamsz
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Adam J Guastella
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Natalie Silove
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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18
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Which Factors Influence Teacher Report of Adaptive Functioning in Autistic Children? J Autism Dev Disord 2021; 52:463-472. [PMID: 33710469 PMCID: PMC8732898 DOI: 10.1007/s10803-021-04930-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 11/16/2022]
Abstract
A wealth of parent-report research shows adaptive functioning difficulties in autistic children, with parent-report influenced by a number of child factors. Adaptive functioning in autistic children is known to vary across settings; however, no research has yet explored factors influencing education professional-report. This study investigated the rate and profile of impairment, and child factors influencing education professional-reported adaptive skills in 248 autistic children. Twelve children were < 3 years (min age for available normative data on the adaptive function measure), so were removed from the analyses. Results replicated parent-literature; adaptive skills were negatively associated with age and informant-reported autism severity, and positively associated with nonverbal ability and expressive language. Adaptive functioning is important for real-world outcomes, e.g. educational attainment, independence, and support needs. Improving our understanding of adaptive functioning in the education context may support opportunities for shared learning and enhance personalised support .
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Camacho R, Castejón-Riber C, Requena F, Camacho J, Escribano BM, Gallego A, Espejo R, De Miguel-Rubio A, Agüera EI. Quality of Life: Changes in Self-Perception in People with down Syndrome as a Result of Being Part of a Football/Soccer Team. Self-Reports and External Reports. Brain Sci 2021; 11:brainsci11020226. [PMID: 33673165 PMCID: PMC7918076 DOI: 10.3390/brainsci11020226] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 01/10/2023] Open
Abstract
The hypothesis posed was whether being part of a football/soccer team influenced the quality of life (QL) of the people who participated in it since their perception of themselves is enhanced by factors, such as self-determination, social inclusion, emotional well-being, physical well-being, material well-being, rights, personal development, and internal relationships. The objective was to evaluate the QL of people with Down Syndrome (DS) using their self-perception (n = 39) and the perception of the informants (family members, teachers) (n = 39). The KidsLife-Down Scale, with a few modifications, was used. In general, differences of opinion between the subgroups of participants with DS and informants showed that results were higher in terms of perception for participants in the DS subgroup. Scores for all variables were higher for those participants with DS who said they did engage in practicing competitive football/soccer. Although the perception of informants provides a great deal of information regarding the QL of participants with DS, participants with DS should also be involved in the evaluation process and their self-perceptions taken into account. It is not participating in a football team that causes the conclusions of the study, but training (which includes the friendly matches that are played), the cause correlated with the improvements detected in the athlete’s DS.
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Affiliation(s)
- Rocío Camacho
- Department of Cellular Biology, Physiology and Immunology, University of Cordoba, 14071 Cordoba, Spain; (R.C.); (J.C.); (B.M.E.); (E.I.A.)
| | | | - Francisco Requena
- Department of Cellular Biology, Physiology and Immunology, University of Cordoba, 14071 Cordoba, Spain; (R.C.); (J.C.); (B.M.E.); (E.I.A.)
- Correspondence: ; Tel.: +34-(66)-9588756
| | - Julio Camacho
- Department of Cellular Biology, Physiology and Immunology, University of Cordoba, 14071 Cordoba, Spain; (R.C.); (J.C.); (B.M.E.); (E.I.A.)
| | - Begoña M. Escribano
- Department of Cellular Biology, Physiology and Immunology, University of Cordoba, 14071 Cordoba, Spain; (R.C.); (J.C.); (B.M.E.); (E.I.A.)
| | - Arturo Gallego
- Department of Statistics, University of Cordoba, 14071 Cordoba, Spain; (A.G.); (R.E.)
| | - Roberto Espejo
- Department of Statistics, University of Cordoba, 14071 Cordoba, Spain; (A.G.); (R.E.)
| | - Amaranta De Miguel-Rubio
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, 14004 Cordoba, Spain;
| | - Estrella I. Agüera
- Department of Cellular Biology, Physiology and Immunology, University of Cordoba, 14071 Cordoba, Spain; (R.C.); (J.C.); (B.M.E.); (E.I.A.)
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20
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Sterkenburg PS, Kempelmann GEM, Hentrich J, Vonk J, Zaal S, Erlewein R, Hudson M. Scale of emotional development-short: Reliability and validity in two samples of children with an intellectual disability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103821. [PMID: 33310399 DOI: 10.1016/j.ridd.2020.103821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/21/2020] [Accepted: 11/21/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND Intellectual disability (ID) is often accompanied by more significant delays in emotional development than in cognitive development. Diagnostic assessment can provide insight into emotional functioning. However, few standardized assessment instruments are available. AIMS Examine the reliability and validity of the Scale of Emotional Development-Short (SED-S) in children with ID. METHODS AND PROCEDURES This methodological instrument validation study was conducted in the Netherlands and Switzerland with children (N = 118) older than 3 and younger than 18 years with ID ranging from profound to mild. Measures included: demographic and medical data, SED-S, and the Vineland. Coherence and reliability of the SED-S were determined using Cronbach's alpha, and validity was examined using Goodman and Kruskal's γ, Kruskal-Wallis H, and Mann-Whitney U tests. OUTCOMES AND RESULTS The reliability of the SED-S was high, the convergent validity was good, and divergent validity was indicated in relation to autism spectrum disorder (ASD), visual and/or auditory impairment, and adaptive functioning. FURTHER RESEARCH Research is needed to better understand the implications of ASD and visual and/or auditory impairment on emotional development and their association with (normal) intelligence. Children with ID may also benefit from (more) detailed guidelines for imbalanced profiles on the SED-S.
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Affiliation(s)
- P S Sterkenburg
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands; Bartiméus, Doorn, The Netherlands.
| | - G E M Kempelmann
- Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - J Hentrich
- Heilpädagogisches Zentrum Hohenrain, Switzerland
| | - J Vonk
- ORO, Helmond, The Netherlands
| | - S Zaal
- Cordaan, Amsterdam, The Netherlands
| | - R Erlewein
- Luzerner Psychiatrie, Heilpädagogisch-Psychiatrische Fachstelle Sonderschulen, Switzerland
| | - M Hudson
- Division of Psychiatry & Applied Psychology, University of Nottingham, United Kingdom
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21
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The socio-emotional world of adolescents with intellectual disability: A drama therapy-based participatory action research. ARTS IN PSYCHOTHERAPY 2020. [DOI: 10.1016/j.aip.2020.101679] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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22
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Matson JL, Dempsey T, Wilkins J. Rett syndrome in adults with severe intellectual disability: Exploration of behavioral characteristics. Eur Psychiatry 2020; 23:460-5. [DOI: 10.1016/j.eurpsy.2007.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2007] [Revised: 11/03/2007] [Accepted: 11/05/2007] [Indexed: 10/22/2022] Open
Abstract
AbstractRett syndrome is a genetically linked form of autism spectrum disorder (ASD) accompanied by intellectual disability (ID). The disorder is also characterized by cardiorespiratory dysregulation, disturbance in muscle tone, reduced brain growth and scoliosis. Over 300 studies have been published on the disorder, most of which has focused on identification of causative factors, which appears to be the result of mutations of gene MECP2. Rarely have adults with Rett syndrome been studied, and behavioral characteristics in these individuals are largely unknown. The present study aimed to extend what little is known about behavioral characteristics of Rett syndrome in adults, with particular emphasis on social, communicative, and adaptive behavior. Rett syndrome adults with severe ID were matched to autistic adults with ID and ID only controls. The implications of these data for more fully describing and diagnosing the condition in adults are discussed.
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Eby NS, Griffith JL, Gutmann DH, Morris SM. Adaptive functioning in children with neurofibromatosis type 1: relationship to cognition, behavior, and magnetic resonance imaging. Dev Med Child Neurol 2019; 61:972-978. [PMID: 30659594 DOI: 10.1111/dmcn.14144] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2018] [Indexed: 12/17/2022]
Abstract
AIM To characterize the adaptive behavior profile of children with neurofibromatosis type 1 (NF1) and determine its relationship to neuropsychological functioning and non-neoplastic T2-weighted hyperintense brain lesions on brain magnetic resonance imaging (MRI). METHOD In this cross-sectional study, we retrospectively reviewed neuropsychological reports from 104 children with NF1 (56 males, 48 females; mean age 10y 4mo; standard deviation [SD] 3y 4mo; range 3y 5mo-17y 6mo), and extracted data from a range of cognitive and behavioral measures, including the Adaptive Behavior Assessment System (ABAS). Brain MRI was retrospectively reviewed in 42 individuals. RESULTS Adaptive Behavior Assessment System scores were continuously distributed and pathologically shifted by 0.79 to 1.26SD across Conceptual, Social, and Practical domains, and 46.5% of individuals had a composite score in the borderline or impaired range. Impairment in adaptive functioning was correlated with deficits in executive function (r=-9.543, p<0.001), externalizing problems (r=-0.366, p<0.001), and attention (r=-9.467, p=0.001). Cluster analysis revealed three distinct phenotypic subgroups, one of which exhibited normal cognitive ability, but impaired adaptive functioning, with persistent deficits in executive function, behavioral problems, and attention-deficit/hyperactivity disorder symptomatology. There was no relationship between ABAS scores and the number or location of unidentified bright objects. INTERPRETATION Adaptive functioning deficits are common among children with NF1 and are associated with impairment in other cognitive/behavioral domains, independent of general cognitive ability. WHAT THIS PAPER ADDS Deficits in adaptive behavior are common in children with neurofibromatosis type 1 (NF1). Poor adaptive functioning is associated with impairments in executive function, externalizing behaviors, and attention, regardless of cognitive ability. The presence or location of unidentified bright objects do not predict adaptive behavior skills in children with NF1.
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Affiliation(s)
- Noah S Eby
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Jennifer L Griffith
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - David H Gutmann
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephanie M Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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Oñate L, Calvete E. The moderating role of age in the relationship between different stressors and the quality of life of the relatives of people with intellectual disabilities. Qual Life Res 2019; 28:2969-2978. [PMID: 31250337 DOI: 10.1007/s11136-019-02239-0] [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: 05/18/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The level of support needed for adaptive functioning and behavioral problems of individuals with intellectual disabilities (ID) can be a source of stress for caregivers. The aim of this study was to explore the moderating role of caregivers' age on the associations between these stressors and quality of life (QoL) of the family caregivers. As these sources of stress in people with ID can coexist, the triple interaction between stressors and age was also examined. METHODS 208 relatives (mean age = 50.98 years, SD = 12.86) of people with ID participated in the research. Participants answered a questionnaire with sociodemographic variables, measures of stressors (level of support for adaptive functioning of the people with ID and behavioral problems) and measures of QoL (WHOQOL-BREF). RESULTS The association between the level of support needed for adaptive functioning and lower QoL was only significant among older relatives, whereas the association between behavioral problems and lower QoL was only significant among younger relatives. A three-way interaction between behavioral problems, level of support needed, and age indicated that the association between the level of support for adaptive functioning and QoL in older relatives was greater when there were higher levels of behavioral problems. CONCLUSIONS The role of caregivers' age in their QoL differs depending on the nature of the stressor, and an accumulation of stressors can have a particularly negative impact on older caregivers. Interventions should be adapted for caregivers of different ages and take into account the particular sources of stress they have to cope with.
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Affiliation(s)
- Lucía Oñate
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Apdo. 1, 48080, Bilbao, Biscay, Spain.
| | - Esther Calvete
- Department of Personality, Psychological Assessment and Treatment, University of Deusto, Apdo. 1, 48080, Bilbao, Biscay, Spain
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Sappok T, Böhm J, Birkner J, Roth G, Heinrich M. How is your mind-set? Proof of concept for the measurement of the level of emotional development. PLoS One 2019; 14:e0215474. [PMID: 30998731 PMCID: PMC6472796 DOI: 10.1371/journal.pone.0215474] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/02/2019] [Indexed: 11/18/2022] Open
Abstract
Background In persons with intellectual and developmental disabilities, not only cognitive brain functions, but also socio-emotional processing networks may be impaired. This study aims to validate the Scale of Emotional Development—Short (SED-S) to provide an instrument for the assessment of socio-emotional brain functions. Method The SED-S was applied in 160 children aged 0–12 years. Criterion validity was investigated at item and scale level in terms of the agreement between the scale classification and the child’s chronological age. Additionally, interrater reliability and internal consistency were assessed. Results For the majority of items, the expected response pattern emerged, showing the highest response probabilities in the respective target age groups. Agreement between the classification of the different SED-S domains and chronological age was high (κw = 0.95; exact agreement = 80.6%). Interrater reliability at domain level ranged from κw = .98 to 1.00 and internal consistency was high (α = .99). Conclusion The study normed the SED-S in a sample of typically developing children and provides evidence for criterion validity on item, domain and scale level.
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Affiliation(s)
- Tanja Sappok
- Ev. Krankenhaus Königin Elisabeth Herzberge, Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Berlin, Germany
- * E-mail:
| | - Julia Böhm
- Ev. Krankenhaus Königin Elisabeth Herzberge, Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Berlin, Germany
- Freie Universität Berlin, Fakultät für Erziehungswissenschaft und Psychologie, Berlin, Germany
| | - Joana Birkner
- Ev. Krankenhaus Königin Elisabeth Herzberge, Behandlungszentrum für psychische Gesundheit bei Entwicklungsstörungen, Berlin, Germany
| | - Gerhard Roth
- Universität Bremen, Fachbereich 2 Biologie, Neurobiologie, Institut für Hirnforschung, Bremen, Germany
| | - Manuel Heinrich
- Freie Universität Berlin, Fakultät für Erziehungswissenschaft und Psychologie, AB Klinisch-Psychologische Intervention, Berlin, Germany
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26
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Tillmann J, San José Cáceres A, Chatham CH, Crawley D, Holt R, Oakley B, Banaschewski T, Baron-Cohen S, Bölte S, Buitelaar JK, Durston S, Ham L, Loth E, Simonoff E, Spooren W, Murphy DG, Charman T. Investigating the factors underlying adaptive functioning in autism in the EU-AIMS Longitudinal European Autism Project. Autism Res 2019; 12:645-657. [PMID: 30741482 PMCID: PMC6519242 DOI: 10.1002/aur.2081] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/23/2018] [Accepted: 01/16/2019] [Indexed: 12/27/2022]
Abstract
Individuals with autism spectrum disorder (ASD) exhibit significant impairments in adaptive functioning that impact on their ability to meet the demands of everyday life. A recurrent finding is that there is a pronounced discrepancy between level of cognitive ability and adaptive functioning, and this is particularly prominent among higher‐ability individuals. However, the key clinical and demographic associations of these discrepancies remain unclear. This study included a sample of 417 children, adolescents, and adults with ASD as part of the EU‐AIMS LEAP cohort. We examined how age, sex, IQ, levels of ASD symptom and autistic trait severity and psychiatric symptomatology are associated with adaptive functioning as measured by the Vineland Adaptive Behavior Scales‐Second Edition and IQ‐adaptive functioning discrepancies. Older age, lower IQ and higher social‐communication symptoms were associated with lower adaptive functioning. Results also demonstrate that older age, higher IQ and higher social‐communication symptoms are associated with greater IQ‐adaptive functioning discrepancy scores. By contrast, sensory ASD symptoms, repetitive and restricted behaviors, as well as symptoms of attention deficit/hyperactivity disorder (ADHD), anxiety and depression, were not associated with adaptive functioning or IQ‐adaptive functioning discrepancy scores. These findings suggest that it is the core social communication problems that define ASD that contribute to adaptive function impairments that people with ASD experience. They show for the first time that sensory symptoms, repetitive behavior and associated psychiatric symptoms do not independently contribute to adaptive function impairments. Individuals with ASD require supportive interventions across the lifespan that take account of social‐communicative ASD symptom severity. Autism Res 2019, 12: 645–657. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay summary This study investigated key clinical and demographic associations of adaptive functioning impairments in individuals with autism. We found that older age, lower IQ and more severe social‐communicative symptoms, but not sensory or repetitive symptoms or co‐occurring psychiatric symptoms, are associated with lower adaptive functioning and greater ability‐adaptive function discrepancies. This suggests that interventions targeting adaptive skills acquisition should be flexible in their timing and intensity across developmental periods, levels of cognitive ability and take account of social‐communicative ASD symptom severity.
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Affiliation(s)
- Julian Tillmann
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Applied Psychology: Health, Development, Enhancement, and Intervention, University of Vienna, Vienna, Austria
| | - Antonia San José Cáceres
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Chris H Chatham
- F. Hoffmann La Roche, Innovation Center Basel, Basel, Switzerland
| | - Daisy Crawley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rosemary Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Bethany Oakley
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Sven Bölte
- Child and Adolescent Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.,Center for Neurodevelopmental Disorders (KIND), Division of Neuropsychiatry, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Jan K Buitelaar
- Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Stockholm, Sweden.,Radboud University Nijmegen Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Sarah Durston
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Lindsay Ham
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Eva Loth
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - Will Spooren
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Declan G Murphy
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK
| | - Tony Charman
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust (SLaM), London, UK
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Kilincaslan A, Kocas S, Bozkurt S, Kaya I, Derin S, Aydin R. Daily living skills in children with autism spectrum disorder and intellectual disability: A comparative study from Turkey. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 85:187-196. [PMID: 30576945 DOI: 10.1016/j.ridd.2018.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Better daily living skills (DLS) are associated with increased independence and positive functional outcomes in Autism Spectrum Disorder (ASD). METHOD The present study aimed to investigate daily living skills (DLS) and the associated factors in 51 children with ASD and intellectual disability (ASD group) and 51 age- and gender-matched controls with intellectual disability (ID group). The severity of the autistic symptoms was measured with the clinician-rated Childhood Autism Rating Scale and the parent-reported Autism Behavior Checklist (ABC) in all children. The mothers also completed the Pediatric Quality of Life Inventory and the Basic DLS Questionnaire. RESULTS The ASD group scored lower than the comparison group in the total DLS score, personal hygiene, dressing, safety and interpersonal skills, despite being comparable in the parent-reported quality of life. Regression analysis of the whole sample demonstrated that the child's age, intellectual level, speech level, autism symptom severity and the monthly household income were independent correlates of the total DLS. Exploratory analyses for each group revealed differential effects of these variables: in the ASD group; a higher speech level and monthly income, while in the ID group; an older age, a higher intellectual level and monthly income and a lower ABC score emerged as significant predictors of higher DLS. CONCLUSIONS Deficient DLS in Turkish children with ASD, given their IQ, suggest that lower level of adaptive skills is inherent in ASD, rather than culture-specific to US and Western Europe.
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Affiliation(s)
- Ayse Kilincaslan
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | - Sule Kocas
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Sumeyye Bozkurt
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilyas Kaya
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Songül Derin
- Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Resa Aydin
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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28
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Chatham CH, Taylor KI, Charman T, Liogier D'ardhuy X, Eule E, Fedele A, Hardan AY, Loth E, Murtagh L, Del Valle Rubido M, San Jose Caceres A, Sevigny J, Sikich L, Snyder L, Tillmann JE, Ventola PE, Walton-Bowen KL, Wang PP, Willgoss T, Bolognani F. Adaptive behavior in autism: Minimal clinically important differences on the Vineland-II. Autism Res 2018; 11:270-283. [PMID: 28941213 PMCID: PMC5997920 DOI: 10.1002/aur.1874] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 08/09/2017] [Accepted: 08/16/2017] [Indexed: 12/28/2022]
Abstract
Autism Spectrum Disorder (ASD) is associated with persistent impairments in adaptive abilities across multiple domains. These social, personal, and communicative impairments become increasingly pronounced with development, and are present regardless of IQ. The Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) is the most commonly used instrument for quantifying these impairments, but minimal clinically important differences (MCIDs) on Vineland-II scores have not been rigorously established in ASD. We pooled data from several consortia/registries (EU-AIMS LEAP study, ABIDE-I, ABIDE-II, INFOR, Simons Simplex Collection and Autism Treatment Network [ATN]) and clinical investigations and trials (Stanford, Yale, Roche) resulting in a data set of over 9,000 individuals with ASD. Two approaches were used to estimate MCIDs: distribution-based methods and anchor-based methods. Distribution-based MCID [d-MCID] estimates included the standard error of the measurement, as well as one-fifth and one-half of the covariate-adjusted standard deviation (both cross-sectionally and longitudinally). Anchor-based MCID [a-MCID] estimates include the slope of linear regression of clinician ratings of severity on the Vineland-II score, the slope of linear regression of clinician ratings of longitudinal improvement category on Vineland-II change, the Vineland-II change score maximally differentiating clinical impressions of minimal versus no improvement, and equipercentile equating. Across strata, the Vineland-II Adaptive Behavior Composite standardized score MCID estimates range from 2.01 to 3.2 for distribution-based methods, and from 2.42 to 3.75 for sample-size-weighted anchor-based methods. Lower Vineland-II standardized score MCID estimates were observed for younger and more cognitively impaired populations. These MCID estimates enable users of Vineland-II to assess both the statistical and clinical significance of any observed change. Autism Res 2018, 11: 270-283. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY The Vineland Adaptive Behavior Scales (2nd edition; Vineland-II) is the most widely used scale for assessing day-to-day "adaptive" skills. Yet, it is unknown how much Vineland-II scores must change for those changes to be regarded as clinically significant. We pooled data from over 9,000 individuals with ASD to show that changes of 2-3.75 points on the Vineland-II Composite score represent the "minimal clinically-important difference." These estimates will help evaluate the benefits of potential new treatments for ASD.
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Affiliation(s)
- C H Chatham
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - K I Taylor
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - T Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - X Liogier D'ardhuy
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - E Eule
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - A Fedele
- Autism Speaks, New York, New York, 10016
| | - A Y Hardan
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, 94305-5717
| | - E Loth
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - L Murtagh
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - M Del Valle Rubido
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - A San Jose Caceres
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - J Sevigny
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - L Sikich
- Duke Center for Autism and Brain Development, Pavilion East at Lakeview, Durham, North Carolina, 27705
| | - L Snyder
- Simons Foundation, New York, New York, 10010
| | - J E Tillmann
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, Camberwell, London, SE5 8AF, UK
| | - P E Ventola
- Yale Child Study Center, New Haven, CT, 06520
| | | | - P P Wang
- Simons Foundation, New York, New York, 10010
| | - T Willgoss
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
| | - F Bolognani
- F. Hoffmann La Roche, Innovation Center Basel, Hoffmann La Roche, Basel, 4070, Switzerland
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29
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Nouwens PJG, Smulders NBM, Embregts PJCM, van Nieuwenhuizen C. Meeting the support needs of persons with mild intellectual disability or borderline intellectual functioning: still a long way to go. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:1104-1116. [PMID: 29047184 DOI: 10.1111/jir.12427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 07/22/2017] [Accepted: 09/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Among persons with a mild intellectual disability or borderline intellectual functioning, differences in their characteristics imply that a differentiated approach is required to meet their needs. This retrospective study examined whether the history of support/treatment programs and the type of healthcare providers involved matched the specific support needs of persons with a mild intellectual disability or borderline intellectual functioning. METHOD Five (previously identified) profiles of persons with a mild intellectual disability or borderline intellectual functioning were used to investigate to what extent the support needs of this group had been met. For the 250 persons with mild intellectual disability or borderline intellectual functioning who matched these five profiles, data were collected retrospectively from their case files. RESULTS Persons with mild intellectual disability or borderline intellectual functioning received a very similar amount and type of support/treatment programs. Differences between the profiles were found for non-verbal therapy, residential treatment and contacts with social work. Regarding the type of healthcare providers involved, differences between the profiles emerged for specialised intellectual disability services, youth services and specialised addiction services. CONCLUSIONS The support programs for a heterogeneous population of persons with mild intellectual disability or borderline intellectual functioning seem to be suboptimal, indicating that more differentiation is required in the services offered to these individuals.
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Affiliation(s)
- P J G Nouwens
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Netherlands
| | - N B M Smulders
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Netherlands
- Prisma, Waalwijk, Netherlands
| | - P J C M Embregts
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Netherlands
- Dichterbij Innovation and Science, Gennep, Netherlands
| | - C van Nieuwenhuizen
- Department of Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Netherlands
- GGzE, Institute for Forensic Mental Health Care, Centre for Child & Adolescent Psychiatry, Eindhoven, Netherlands
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30
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Nouwens PJG, Lucas R, Smulders NBM, Embregts PJCM, van Nieuwenhuizen C. Identifying classes of persons with mild intellectual disability or borderline intellectual functioning: a latent class analysis. BMC Psychiatry 2017; 17:257. [PMID: 28716016 PMCID: PMC5512980 DOI: 10.1186/s12888-017-1426-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 07/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Persons with mild intellectual disability or borderline intellectual functioning are often studied as a single group with similar characteristics. However, there are indications that differences exist within this population. Therefore, the aim of this study was to identify classes of persons with mild intellectual disability or borderline intellectual functioning and to examine whether these classes are related to individual and/or environmental characteristics. METHODS Latent class analysis was performed using file data of 250 eligible participants with a mean age of 26.1 (SD 13.8, range 3-70) years. RESULTS Five distinct classes of persons with mild intellectual disability or borderline intellectual functioning were found. These classes significantly differed in individual and environmental characteristics. For example, persons with a mild intellectual disability experienced fewer problems than those with borderline intellectual disability. CONCLUSIONS The identification of five classes implies that a differentiated approach is required towards persons with mild intellectual disability or borderline intellectual functioning.
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Affiliation(s)
- Peter J. G. Nouwens
- 0000 0001 0943 3265grid.12295.3dTranzo Department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Rosanne Lucas
- 0000 0001 0943 3265grid.12295.3dTranzo Department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands ,Prisma Foundation, Waalwijk, the Netherlands
| | - Nienke B. M. Smulders
- 0000 0001 0943 3265grid.12295.3dTranzo Department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands ,Prisma Foundation, Waalwijk, the Netherlands
| | - Petri J. C. M. Embregts
- 0000 0001 0943 3265grid.12295.3dTranzo Department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands ,0000 0001 0943 3265grid.12295.3dDepartment of Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands ,Dichterbij Innovation and Science, Gennep, the Netherlands
| | - Chijs van Nieuwenhuizen
- 0000 0001 0943 3265grid.12295.3dTranzo Department, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands ,GGzE Research Group Forensic Mental Health Care, GGzE Centre for Child & Adolescent Psychiatry and De Catamaran, Hospital for Youth Forensic Psychiatry & Orthopsychiatry, GGzE, Eindhoven, The Netherlands
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Laborde S, Allen MS, Göhring N, Dosseville F. The effect of slow-paced breathing on stress management in adolescents with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:560-567. [PMID: 27933677 DOI: 10.1111/jir.12350] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 09/27/2016] [Accepted: 10/12/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND Intellectual disabilities often create a state of chronic stress for both the person concerned and their significant others (family, caregivers). The development of stress management methods is therefore important for the reduction of stress in persons with intellectual disability. The aim of this experiment was to investigate the effect of slow-paced breathing on stress symptoms experienced by adolescents with intellectual disabilities during a cognitive task under time pressure. METHOD Fourteen adolescents with intellectual disabilities (Mage = 17.39 years, range 15-19 years) took part in two laboratory sessions - a slow-paced breathing session (experimental condition) and an audiobook session (control condition) - the order of which was counterbalanced across participants. Vagal tone was measured through heart rate variability to index stress management. RESULTS No difference in vagal tone was observed at baseline between experimental and control conditions. Compared with the control condition, vagal tone was significantly higher during the experimental condition. CONCLUSIONS The slow-paced breathing task enhanced stress management to a greater extent than did listening to an audiobook. Slow-paced breathing seems to be an easy to learn stress management technique that appears as an effective auxiliary method of lowering stress in adolescents with intellectual disabilities.
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Affiliation(s)
- S Laborde
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany
- University of Caen, Caen, France
| | - M S Allen
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - N Göhring
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany
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Behavioral intention in social networking sites ethical dilemmas: An extended model based on Theory of Planned Behavior. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2016.04.024] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Woodman AC, Mailick MR, Greenberg JS. Trajectories of internalizing and externalizing symptoms among adults with autism spectrum disorders. Dev Psychopathol 2016; 28:565-81. [PMID: 26612272 PMCID: PMC4828272 DOI: 10.1017/s095457941500108x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Individuals with autism spectrum disorder (ASD) experience higher rates of psychopathology than their typically developing peers or peers with other intellectual or developmental disabilities. Little is known about the developmental course of psychiatric symptoms such as internalizing and externalizing behaviors in this population. Individual characteristics and aspects of the family environment may explain variability in outcomes for adults with ASD. The present study extends our current understanding of psychopathology among individuals with ASD by examining group-based trajectories of internalizing and externalizing symptoms in adulthood. Overall, the results showed that symptoms became less severe over time. Distinct patterns of change in psychopathology were observed and associated with differential profiles of psychotropic medication use, comorbid mental health diagnoses, and residential placement. The likelihood of following each developmental trajectory was estimated based on characteristics of the adults with ASD (gender, adaptive behavior, and autistic symptoms) and maternal expressed emotion (criticism and warmth). Maternal criticism and warmth were identified as key risk and protective factors, respectively, with important implications for future research and intervention for individuals with ASD.
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Abstract
Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) often co-occur. Children with ASD and ADHD demonstrate deficits in adaptive functioning, yet pure and comorbid groups have not been directly compared. Vineland Adaptive Behaviour Scales (VABS-II) data were examined in boys with ASD (n = 17), ADHD (n = 31) and ASD + ADHD (n = 38). Results demonstrated lower socialisation and composite scores and greater discrepancy between cognitive and adaptive abilities in the ASD + ADHD group compared to the ADHD-only group. Significant associations were shown between reduced adaptive functioning and autism symptoms, but not ADHD symptoms. Children with ASD + ADHD present with exacerbated impairments in adaptive functioning relative to children with ADHD, associated with ASD symptoms. Disentangling variation in adaptive skills may aid the assessment of complex cases.
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Makary AT, Testa R, Tonge BJ, Einfeld SL, Mohr C, Gray KM. Association between adaptive behaviour and age in adults with Down syndrome without dementia: examining the range and severity of adaptive behaviour problems. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:689-702. [PMID: 25414060 DOI: 10.1111/jir.12172] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Studies on adaptive behaviour and ageing in adults with Down syndrome (DS) (without dementia) have typically analysed age-related change in terms of the total item scores on questionnaires. This research extends the literature by investigating whether the age-related changes in adaptive abilities could be differentially attributed to changes in the number or severity (intensity) of behavioural questionnaire items endorsed. METHODS The Adaptive Behaviour Assessment System-II Adult (ABAS-II Adult) was completed by parents and caregivers of 53 adults with DS aged between 16 and 56 years. Twenty adults with DS and their parents/caregivers were a part of a longitudinal study, which provided two time points of data. In addition 33 adults with DS and their parents/caregivers from a cross-sectional study were included. Random effects regression analyses were used to examine the patterns in item scores associated with ageing. RESULTS Increasing age was found to be significantly associated with lower adaptive behaviour abilities for all the adaptive behaviour composite scores, expect for the practical composite. These associations were entirely related to fewer ABAS-II Adult items being selected as present for the older participants, as opposed to the scores being attributable to lower item severity. CONCLUSIONS This study provides evidence for a differential pattern of age-related change for various adaptive behaviour skills in terms of range, but not severity. Possible reasons for this pattern will be discussed. Overall, these findings suggest that adults with DS may benefit from additional support in terms of their social and conceptual abilities as they age.
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Affiliation(s)
- A T Makary
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
| | - R Testa
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Parkville, Victoria, Australia
| | - B J Tonge
- Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, Victoria, Australia
| | - S L Einfeld
- Brain and Mind Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - C Mohr
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
| | - K M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Notting Hill, Victoria, Australia
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Fu TJ, Lincoln AJ, Bellugi U, Searcy YM. The Association of Intelligence, Visual-Motor Functioning, and Personality Characteristics With Adaptive Behavior in Individuals With Williams Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:273-288. [PMID: 26161466 DOI: 10.1352/1944-7558-120.4.273] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Williams syndrome (WS) is associated with deficits in adaptive behavior and an uneven adaptive profile. This study investigated the association of intelligence, visual-motor functioning, and personality characteristics with the adaptive behavior in individuals with WS. One hundred individuals with WS and 25 individuals with developmental disabilities of other etiologies were included in this study. This study found that IQ and visual-motor functioning significantly predicted adaptive behavior in individuals of WS. Visual-motor functioning especially predicted the most amount of unique variance in overall adaptive behavior and contributed to the variance above and beyond that of IQ. Present study highlights the need for interventions that address visual-motor and motor functioning in individuals with WS.
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Predictors and course of daily living skills development in toddlers with autism spectrum disorders. J Autism Dev Disord 2014; 44:256-63. [PMID: 21598046 DOI: 10.1007/s10803-011-1275-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Self-sufficiency is central to child and family well-being. This report focuses on predictors of adaptive daily living skills (DLS) development in young children with ASD and whether DLS gains predict decreases in parenting stress. Participants were 162 toddlers with ASD and their parents, assessed at 3 annual timepoints. Hierarchical Linear Models showed that age, DQ, and autism symptom severity uniquely predicted initial DLS and DLS growth. Child problem behaviors predicted initial DLS only. DLS was associated with change in parenting stress above and beyond DQ, autism symptom severity, and problem behaviors. Children with lower IQ and more severe symptoms showed slower DLS gains. Given its relation to parenting stress, DLS are an important intervention target in young children with ASD.
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Kourkounasiou MA, Skordilis EK. Validity and Reliability Evidence of the TOCA–C in a Sample of Greek Students. Psychol Rep 2014; 115:766-83. [DOI: 10.2466/08.11.pr0.115c31z5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Validity and reliability evidence of the Teacher Observation of Classroom Adaptation–Checklist (TOCA–C) was examined in 186 Greek students through exploratory factor analysis, divergent and concurrent validity, internal consistency, and test-retest reliability. The TOCA–C showed a high internal consistency for the three factors of Concentration Problems, Disruptive/Aggressive Behaviour, and Prosocial Behaviour (αs = .89−.96), and acceptable two-week test-retest reliability. The three-factor solution explained 74.50% of the total variance. Regarding divergent validity, a significant Sex × Disability interaction was evident for Disruptive Behaviour, with women scoring higher in ‘special’ and lower in ‘general’ schools compared to men. Main effects were significant across disability, but not across sex. Correlations with the Strengths and Difficulties Questionnaire suggested convergent and divergent validity evidence. The TOCA–C should be useful in testing Greek students with and without disabilities.
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Affiliation(s)
- Maria A. Kourkounasiou
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens
| | - Emmanouil K. Skordilis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens
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Brawn G, Porter M. Adaptive functioning in Williams syndrome and its relation to demographic variables and family environment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3606-3623. [PMID: 25310713 DOI: 10.1016/j.ridd.2014.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 08/07/2014] [Accepted: 08/12/2014] [Indexed: 06/04/2023]
Abstract
This study assessed adaptive functioning in children and adults with Williams syndrome. The aims were to: (1) profile adaptive functioning; (2) investigate the relationship between adaptive functions and gender, CA, and IQ; (3) investigate the relationship between levels of adaptive functioning and family environment characteristics. In line with predictions: (1) there was extensive variability in adaptive functions; (2) neither gender nor IQ were significantly related to adaptive skills, but Communication skills and Interpersonal Relationship skills failed to make appropriate gains relative to same aged peers and (3) adaptive functioning was significantly related to family environment. Practical and clinical implications are discussed.
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Affiliation(s)
- Gabrielle Brawn
- Psychology Department, Macquarie University, Sydney 2109, NSW, Australia
| | - Melanie Porter
- Psychology Department, Macquarie University, Sydney 2109, NSW, Australia; ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney 2109, NSW, Australia.
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Murray A, McKenzie K, Murray G. To what extent does g impact on conceptual, practical and social adaptive functioning in clinically referred children? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2014; 58:777-785. [PMID: 24001218 DOI: 10.1111/jir.12092] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/15/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Previous analyses have found variable results when evaluating the size of the association between intellectual ability and adaptive functioning in individuals with impaired function. METHODS We assessed the association between intellectual ability measured as a latent higher-order g and three different areas of adaptive functioning in a sample of clinically referred individuals with low IQ. RESULTS Regressing g on conceptual, practical and social adaptive functioning yielded standardised regression coefficients of 0.65, 0.60 and 0.51 respectively. CONCLUSIONS Results suggests that even at low levels of ability, increments in g still have important consequences for human functioning. Further, the influence of g may not be equally strong across different areas of human functioning.
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Affiliation(s)
- A Murray
- Centre for Cognitive Ageing & Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
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Relationships Between Feeding Problems, Behavioral Characteristics and Nutritional Quality in Children with ASD. J Autism Dev Disord 2014; 44:2175-84. [DOI: 10.1007/s10803-014-2095-9] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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McNellis CA, Harris T. Residential treatment of serious behavioral disturbance in autism spectrum disorder and intellectual disability. Child Adolesc Psychiatr Clin N Am 2014; 23:111-24. [PMID: 24231171 DOI: 10.1016/j.chc.2013.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
For children diagnosed with an autism spectrum disorder and/or intellectual disability, the co-occurrence of serious behavioral disturbance can pose significant health and safety risks, impede normal learning and development, and put great stress on family systems. The complexity and seriousness of the clinical concerns often tax the existing service and funding systems. Although residential treatment has been criticized as an outdated and ineffective mode of treatment, newer models of residential treatment that combine specialized comprehensive services, evidence-based interventions, intensive family support and training, and treatment overlap with community providers can offer an effective and efficient treatment option.
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Affiliation(s)
- Carol Anne McNellis
- Devereux Pennsylvania Children's ID/D Services, 390 East Boot Road, West Chester, PA 19380, USA.
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Hahn LJ, Fidler DJ, Hepburn SL. Adaptive behavior and problem behavior in young children with Williams syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2014; 119:49-63. [PMID: 24450321 DOI: 10.1352/1944-7558-119.1.49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The present study compares the adaptive behavior profile of 18 young children with Williams syndrome (WS) and a developmentally matched group of 19 children with developmental disabilities and examines the relationship between adaptive behavior and problem behaviors in WS. Parents completed the Vineland Adaptive Behavioral Scales-Interview edition and the Developmental Behavior Checklist-Primary Caregiver version (WS only). Children with WS had higher adaptive communication scores than children with other developmental disabilities. Children with WS demonstrated relative strengths in adaptive communication and socialization, coupled with relative weaknesses in daily living. Adaptive communication and socialization were negatively associated with problem behaviors in social relating in WS.
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Sappok T, Budczies J, Bölte S, Dziobek I, Dosen A, Diefenbacher A. Emotional development in adults with autism and intellectual disabilities: a retrospective, clinical analysis. PLoS One 2013; 8:e74036. [PMID: 24066092 PMCID: PMC3774757 DOI: 10.1371/journal.pone.0074036] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 07/26/2013] [Indexed: 12/28/2022] Open
Abstract
Individuals with intellectual disability (ID) are at risk for additional autism spectrum disorders (ASD). A large amount of research reveals deficits in emotion-related processes that are relevant to social cognition in ASD. However, studies on the structure and level of emotional development (ED) assessing emotional maturity according to the normative trajectory in typically developing children are scares. The level of ED can be evaluated by the 'Scheme of Appraisal of Emotional Development' (SAED), a semi-structured interview with a close caregiver. The SAED assesses the level of emotional developmental based on a five stage system in 10 domains, for example, 'interaction with peers' or 'object permanence', which are conducive to the overall emotional developmental level. This study examined the ED as measured by the SAED in 289 adults (mean age: 36 years) with ID with and without additional ASD. A lower level in ED was observed in ASD/ID combined that corresponded to the ED of typically developing children aged 1.5-3 years versus an ED with a corresponding age of 3-7 years in ID individuals without ASD. Moreover, distinct strengths in 'object permanence', and weaknesses in 'interaction', 'verbal communication', 'experience of self', 'affect differentiation', 'anxiety', and 'handling of material objects' led to a characteristic pattern of ED in ASD. SAED domains with highest discriminative power between ID individuals with and without ASD (5/10) were used to predict ASD group membership. The classification using a selection of SAED domains revealed a sensitivity of 77.5% and a specificity of 76.4%. ASD risk increased 2.7-fold with every SAED level. The recognition of delayed and uneven pattern of ED contributes to our understanding of the emotion-related impairments in adults with ID and ASD these individuals. Assessment of intra-individual ED could add value to the standard diagnostic procedures in ID, a population at risk for underdiagnosed ASD.
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Affiliation(s)
- Tanja Sappok
- Evangelisches Krankenhaus Königin-Elisabeth-Herzberge, Department of Psychiatry, Berlin, Germany
| | - Jan Budczies
- Charité, Institute of Pathology, Berlin, Germany
| | - Sven Bölte
- Department of Women’s and Children’s Health, Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Stockholm, Sweden
| | - Isabel Dziobek
- Cluster of Excellence Languages of Emotion, Freie Universität Berlin, Berlin, Germany
| | - Anton Dosen
- Department of Psychiatry, University Hospital, Radboud University, Nijmegen, The Netherlands
| | - Albert Diefenbacher
- Evangelisches Krankenhaus Königin-Elisabeth-Herzberge, Department of Psychiatry, Berlin, Germany
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Sappok T, Budczies J, Dziobek I, Bölte S, Dosen A, Diefenbacher A. The Missing Link: Delayed Emotional Development Predicts Challenging Behavior in Adults with Intellectual Disability. J Autism Dev Disord 2013; 44:786-800. [DOI: 10.1007/s10803-013-1933-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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46
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Berg AT, Caplan R, Baca CB, Vickrey BG. Adaptive behavior and later school achievement in children with early-onset epilepsy. Dev Med Child Neurol 2013; 55:661-7. [PMID: 23534842 PMCID: PMC3676436 DOI: 10.1111/dmcn.12143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/10/2013] [Indexed: 11/30/2022]
Abstract
AIM To determine whether early measures of adaptive behavior are predictive of later school difficulties and achievement in otherwise neurotypical (unimpaired) children with onset of epilepsy during the preschool years. METHOD In a prospective cohort study, parents completed the Vineland Adaptive Behavior Scales (VABS) for children who were aged 5 years or less at epilepsy diagnosis. Eight to 9 years later, the children were assessed using the Wechsler Intelligence Scales for Children (WISC), the Wide Range Achievement Test (WRAT), and the Child Behavior Checklist (CBCL). Associations of VABS scores with later WRAT and CBCL scores were tested. RESULTS A total of 108 neurotypical children (64 males, 44 females; mean age at testing 11 y 11 mo, SD 2 y) were studied. After adjustment for IQ and other factors, there was an increase of 0.15 points (95% confidence interval [CI] 0.03-0.27 points; p=0.03) and 0.14 points (95% CI 0.0-0.28 points; p=0.05) in WRAT reading and spelling scores for each 1-point increment in the VABS communication score. Corresponding numbers for the VABS socialization score were 0.20 (95% CI 0.08-0.32; p=0.005) and 0.17 (95% CI 0.05-0.29; p=0.005). CONCLUSION In neurotypical preschool children with epilepsy, early social and communication scores predict later school performance. These findings raise questions about opportunities for early identification and intervention for children at greatest risk.
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Affiliation(s)
- Anne T Berg
- Ann & Robert H Lurie Children’s Hospital of Chicago, Epilepsy Center, Chicago, IL
| | - Rochelle Caplan
- Department of Psychiatry, University of California Los Angeles, CA
| | - Christine B Baca
- Department of Neurology, University of California Los Angeles, CA,Department of Neurology, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
| | - Barbara G Vickrey
- Department of Neurology, University of California Los Angeles, CA,Department of Neurology, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA
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Bornstein MH, Hahn CS, Suwalsky JTD. Developmental Pathways among Adaptive Functioning and Externalizing and Internalizing Behavioral Problems: Cascades from Childhood into Adolescence. APPLIED DEVELOPMENTAL SCIENCE 2013; 17:76-87. [PMID: 23585713 PMCID: PMC3622712 DOI: 10.1080/10888691.2013.774875] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A developmental cascade describes a longitudinal cross-domain unique relation. Here, a 3-wave multivariate design and developmental cascade analysis were used to investigate pathways among adaptive functioning and externalizing and internalizing behavioral problems in a community sample of 134 children seen at 4, 10, and 14 years. Children, mothers, and teachers provided data. Nested path analytic models tested the plausible cascades among the three domains apart from their covariation at each age and rank-order stability across age. Adaptive functioning in early adolescence was predicted by early childhood adaptive functioning and externalizing behavioral problems, with both effects mediated by late childhood adaptive functioning and internalizing behavioral problems; externalizing behavioral problems in early adolescence were predicted by early childhood internalizing behavioral problems with the effect mediated by late childhood externalizing behavioral problems. These developmental cascades obtained independent of child intelligence; child age and maternal education and social desirability were also considered but were not related to any outcome variables. The findings suggest that strategically timed and targeted interventions designed to address young children's behavioral problems may return investment in terms of an enhanced epidemiology of adaptively functioning teens.
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Affiliation(s)
- Marc H Bornstein
- Child and Family Research Eunice Kennedy Shriver National Institute of Child Health and Human Development
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48
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Hall HR, Graff JC. Maladaptive Behaviors of Children with Autism: Parent Support, Stress, and Coping. ACTA ACUST UNITED AC 2012; 35:194-214. [DOI: 10.3109/01460862.2012.734210] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Sikora DM, Vora P, Coury DL, Rosenberg D. Attention-deficit/hyperactivity disorder symptoms, adaptive functioning, and quality of life in children with autism spectrum disorder. Pediatrics 2012; 130 Suppl 2:S91-7. [PMID: 23118259 DOI: 10.1542/peds.2012-0900g] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of the current study was to evaluate the frequency of co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms in a well-defined cohort of children with autism spectrum disorders (ASDs) and to examine the relationship between ADHD symptoms and both adaptive functioning and health-related quality of life as reported by parents or other primary caregivers. METHODS T scores on 2 ADHD-related scales from the Child Behavior Checklist were used to indicate the presence of ADHD symptoms. Participants were divided into groups based on whether their parents/caregivers rated them as having clinically significant T scores on the Attention Problem and Attention Deficit Hyperactivity Problem subscales. Standard scores from the Vineland Adaptive Behavior Scales, Second Edition and raw scores from the Pediatric Quality of Life Inventory were then compared between groups with the use of multivariate analyses. RESULTS Approximately 40% of participants had 1 elevated T score, and 19% had both ADHD-related T scores elevated on the Child Behavior Checklist. The ASD + ADHD group had lower scores on the Vineland Adaptive Behavior Scales, Second Edition and the Pediatric Quality of Life Inventory in comparison with the ASD alone group. CONCLUSIONS Results suggest greater impairment in adaptive functioning and a poorer health-related quality of life for children with ASDs and clinically significant ADHD symptoms in comparison with children with ASDs and fewer ADHD symptoms. Physicians are encouraged to evaluate for the presence of ADHD symptoms in their patients with ASDs and, if present, include symptom treatment in the overall care plan.
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Affiliation(s)
- Darryn M Sikora
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.
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Buelow JM, Perkins SM, Johnson CS, Byars AW, Fastenau PS, Dunn DW, Austin JK. Adaptive functioning in children with epilepsy and learning problems. J Child Neurol 2012; 27:1241-9. [PMID: 23007297 DOI: 10.1177/0883073811432750] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the study we describe adaptive functioning in children with epilepsy whose primary caregivers identified them as having learning problems. This was a cross-sectional study of 50 children with epilepsy and learning problems. Caregivers supplied information regarding the child's adaptive functioning and behavior problems. Children rated their self-concept and completed a battery of neuropsychological tests. Mean estimated IQ (PPVT-III) in the participant children was 72.8 (SD = 18.3). On average, children scored 2 standard deviations below the norm on the Vineland Adaptive Behavior Scale-II and this was true even for children with epilepsy who had estimated IQ in the normal range. In conclusion, children with epilepsy and learning problems had relatively low adaptive functioning scores and substantial neuropsychological and mental health problems. In epilepsy, adaptive behavior screening can be very informative and guide further evaluation and intervention, even in those children whose IQ is in the normal range.
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Affiliation(s)
- Janice M Buelow
- Department of Biostatistics, Indiana University School of Nursing, Indianapolis, IN 46202, USA.
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