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Burnley A, St Clair M, Dack C, Thompson H, Wren Y. Exploring the Psychosocial Experiences of Individuals with Developmental Language Disorder During Childhood: A Qualitative Investigation. J Autism Dev Disord 2024; 54:3008-3027. [PMID: 37338728 PMCID: PMC11300631 DOI: 10.1007/s10803-023-05946-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 06/21/2023]
Abstract
Children with Developmental Language Disorder (DLD) often experience co-occurring psychosocial difficulties, the developmental trajectories of which are still not fully understood. This study sought to explore the manifestation of such difficulties during childhood, through first-hand accounts of those with DLD and their close relatives. Individual semi-structured interviews were conducted with 11 mothers of children with DLD (aged 6-12 years old) and were analysed alongside the secondary data from interviews of five adults with DLD. Interviews were conducted online; all participants resided in Europe and were fluent in spoken and written English. A process of interpretive phenomenological analysis resulted in the development of five overall themes: experiencing anxiety, social frustrations, maintaining factors, childhood strengths and the parenting experience. Cognitive appraisals appeared particularly important during childhood in both escalating and maintaining anxiety, low self-esteem, emotion dysregulation and social frustrations. High levels of isolation and stress were experienced by all mothers. The findings suggest parents in the United Kingdom and Ireland require more support and guidance at the point of diagnosis than is currently provided. Emphasis was given to the link between children's experience of anxiety and social behaviours, such as withdrawal, as well as their intolerance of uncertainty. Internalising symptoms were a prioritisation for intervention during childhood by both parents and adults with DLD.
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Affiliation(s)
- Annabel Burnley
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK.
| | - Michelle St Clair
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK
| | - Charlotte Dack
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK
| | - Hannah Thompson
- Department of Psychology, University of Bath, 10 West, Claverton Down, Bath, BA2 7AY, UK
| | - Yvonne Wren
- Bristol Dental School, University of Bristol, Bristol, UK
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2
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Woodhouse E, Hollingdale J, Davies L, Al-Attar Z, Young S, Vinter LP, Agyemang K, Bartlett C, Berryessa C, Chaplin E, Deeley Q, Freckelton I, Gerry F, Gudjonsson G, Maras K, Mattison M, McCarthy J, Mills R, Misch P, Murphy D, Allely C. Identification and support of autistic individuals within the UK Criminal Justice System: a practical approach based upon professional consensus with input from lived experience. BMC Med 2024; 22:157. [PMID: 38609939 PMCID: PMC11015650 DOI: 10.1186/s12916-024-03320-3] [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: 06/25/2023] [Accepted: 02/26/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Autism spectrum disorder (hereafter referred to as autism) is characterised by difficulties with (i) social communication, social interaction, and (ii) restricted and repetitive interests and behaviours. Estimates of autism prevalence within the criminal justice system (CJS) vary considerably, but there is evidence to suggest that the condition can be missed or misidentified within this population. Autism has implications for an individual's journey through the CJS, from police questioning and engagement in court proceedings through to risk assessment, formulation, therapeutic approaches, engagement with support services, and long-term social and legal outcomes. METHODS This consensus based on professional opinion with input from lived experience aims to provide general principles for consideration by United Kingdom (UK) CJS personnel when working with autistic individuals, focusing on autistic offenders and those suspected of offences. Principles may be transferable to countries beyond the UK. Multidisciplinary professionals and two service users were approached for their input to address the effective identification and support strategies for autistic individuals within the CJS. RESULTS The authors provide a consensus statement including recommendations on the general principles of effective identification, and support strategies for autistic individuals across different levels of the CJS. CONCLUSION Greater attention needs to be given to this population as they navigate the CJS.
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Affiliation(s)
- Emma Woodhouse
- Compass Psychology Services Ltd, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Zainab Al-Attar
- University of Oxford, London, UK
- University College London, London, UK
- Victoria University, Melbourne, Australia
- University of Central Lancashire, Preston, UK
| | - Susan Young
- Psychology Services Limited, London, UK
- University of Reykjavík, Reykjavík, Iceland
| | - Luke P Vinter
- Department of Criminology, University of Derby, Derby, UK
| | | | | | | | - Eddie Chaplin
- London South Bank University, Institute of Health and Social Care, London, UK
| | - Quinton Deeley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Autism Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Ian Freckelton
- Law Faculty and Department of Psychiatry, University of Melbourne, Melbourne, Australia
- Castan Chambers, Melbourne, Australia
| | - Felicity Gerry
- Libertas Chambers, London, UK
- Crockett Chambers, Melbourne, Australia
| | - Gisli Gudjonsson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | | | - Jane McCarthy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University of Auckland, Auckland, New Zealand
| | - Richard Mills
- AT-Autism, London, UK
- Department of Psychology, University of Bath, Bath, UK
| | | | - David Murphy
- Broadmoor Hospital, West London NHS Trust, London, UK
| | - Clare Allely
- School of Health and Society, University of Salford, Manchester, UK.
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Holeva V, Nikopoulou VA, Lytridis C, Bazinas C, Kechayas P, Sidiropoulos G, Papadopoulou M, Kerasidou MD, Karatsioras C, Geronikola N, Papakostas GA, Kaburlasos VG, Evangeliou A. Effectiveness of a Robot-Assisted Psychological Intervention for Children with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:577-593. [PMID: 36331688 PMCID: PMC9638397 DOI: 10.1007/s10803-022-05796-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
Difficulties with social interaction characterise children with Autism Spectrum Disorders and have a negative impact in their everyday life. Integrating a social-humanoid robot within the standard clinical treatment has been proven promising. The main aim of this randomised controlled study was to evaluate the effectiveness of a robot-assisted psychosocial intervention and the secondary aim was to investigate potential differences between a robot-assisted intervention group and a control group receiving intervention by humans only. The analysis of the results showed that robot-assisted intervention could be beneficial by improving children's psychosocial skills. This improvement was highlighted by neuropsychological testing and parent reporting. Group comparison only presented minimal statistically significant differences. The study underpins the potential of robot-assisted interventions to augment standard care.
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Grants
- Τ1ΕDΚ-00929 Action "RESEARCH - DEVELOP - INNOVATE", cycle A, Intervention II, Operational Programme "Competitiveness, Entrepreneurship and Innovation", NSRF (National Strategic Reference Framework) of Greece 2014-2020
- Action “RESEARCH – DEVELOP - INNOVATE”, cycle A, Intervention II, Operational Programme “Competitiveness, Entrepreneurship and Innovation”, NSRF (National Strategic Reference Framework) of Greece 2014-2020
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Affiliation(s)
- Vasiliki Holeva
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece.
| | - V A Nikopoulou
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece
| | - C Lytridis
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - C Bazinas
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - P Kechayas
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece
| | - G Sidiropoulos
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - M Papadopoulou
- Division of Child Neurology and Metabolic Disorders, 4th Department of Paediatrics, AUTH, Papageorgiou General Hospital, Periferiaki Odos, N. Efkarpia, Thessaloniki, Greece
| | - M D Kerasidou
- Clinical Psychology Department, Papageorgiou General Hospital, Periferiaki Odos, Ring Road, N. Efkarpia, 54603, Thessaloniki, Greece
| | - C Karatsioras
- "Praxis" Novel Consulting and Therapy Centre for Children, Kavala, Greece
| | | | - G A Papakostas
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - V G Kaburlasos
- HUman-MAchines INteraction Laboratory (HUMAIN-Lab), International Hellenic University, Agios Loukas, Kavala, Greece
| | - A Evangeliou
- Division of Child Neurology and Metabolic Disorders, 4th Department of Paediatrics, AUTH, Papageorgiou General Hospital, Periferiaki Odos, N. Efkarpia, Thessaloniki, Greece
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Scherf KS, Griffin JW, Geier CF, Smyth JM. Social visual attention as a treatment outcome: evaluating the social games for autistic adolescents (SAGA) intervention. Sci Rep 2024; 14:619. [PMID: 38182792 PMCID: PMC10770023 DOI: 10.1038/s41598-024-51332-z] [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: 06/15/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024] Open
Abstract
A core feature of autism involves difficulty perceiving and interpreting eye gaze shifts as nonverbal communicative signals. A hypothesis about the origins of this phenotype is that it emerges from developmentally different social visual attention (SVA). We developed Social Games for Autistic Adolescents (SAGA; Scherf et al. BMJ Open 8(9):e023682, 2018) as a serious game intervention for autistic individuals to discover the significance of eye gaze cues. Previously, we demonstrated the effectiveness of SAGA to improve the perception and understanding of eye gaze cues and social skills for autistic adolescents (Griffin et al. JCPP Adv 1(3):e12041, 2021). Here, we determine whether increases in social visual attention to faces and/or target gazed-at objects, as measured via eye tracking during the same Gaze Perception task in the same study sample, moderated this improvement. In contrast to predictions, SVA to faces did not differentially increase for the treatment group. Instead, both groups evinced a small increase in SVA to faces over time. Second, Prior to the SAGA intervention, attention to faces failed to predict performance in the Gaze Perception task for both the treatment and standard care control groups. However, at post-test, autistic adolescents in the treatment group were more likely to identify the object of directed gaze when they attended longer to faces and longer to target objects. Importantly, this is the first study to measure social visual attention via eye tracking as a treatment response in an RCT for autism. NCT02968225.
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Affiliation(s)
- K Suzanne Scherf
- Department of Psychology, Pennsylvania State University, 113 Moore Building, University Park, 16802, USA.
| | - Jason W Griffin
- Department of Psychology, Pennsylvania State University, 113 Moore Building, University Park, 16802, USA
| | - Charles F Geier
- Department of Psychology, Pennsylvania State University, 113 Moore Building, University Park, 16802, USA
- Department of Human Development and Family Studies, University of Georgia, Athens, USA
| | - Joshua M Smyth
- Department of Psychology, Pennsylvania State University, 113 Moore Building, University Park, 16802, USA
- Department of Psychology, Ohio State University, Columbus, USA
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Cooper CM, Rosen T, Kim H, Eaton NR, Cohn E, Drahota A, Moskowitz LJ, Lerner MD, Kerns CM. Predictors of expert providers' familiarity with intervention practices for school- and transition-age youth with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:331-343. [PMID: 35722950 DOI: 10.1177/13623613221100787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
LAY ABSTRACT School-age children, adolescents, and young adults with autism spectrum disorder encounter many different types of providers in their pursuit of treatment for anxiety, behavior problems, and social difficulties. These providers may all be familiar with different types of intervention practices. However, research has not yet investigated patterns in expert providers' familiarity with different practices nor how these patterns are related to the characteristics of providers (years in practice, academic discipline, setting) and the youth (age and intellectual disability) they typically support. A panel of 53 expert transdisciplinary providers rated their familiarity with 55 intervention practices (derived from research and expert nominations) via an online Delphi poll. Advanced statistical methods were used to identify types of intervention practices with which providers were familiar, which included two approaches (cognitive and behavioral) and two strategies (engagement and accessibility). Providers who practiced outside a school setting or treated clients without intellectual disability were more familiar with cognitive approaches. Clinical psychologists, behavior analysts, and school-based providers were more familiar with behavioral approaches. Providers practicing outside school settings were also more familiar with engagement strategies, and providers with more years in practice were more familiar with accessibility strategies. These results may help families and researchers to better anticipate how services may vary depending on the types of autism spectrum disorder providers seen and work to reduce disparities in care that may result.
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6
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Zwilling M, Romano A, Hoffman H, Lotan M, Tesler R. Development and validation of a system for the prediction of challenging behaviors of people with autism spectrum disorder based on a smart wearable shirt: A mixed-methods design. Front Behav Neurosci 2022; 16:948184. [DOI: 10.3389/fnbeh.2022.948184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 11/10/2022] [Indexed: 11/30/2022] Open
Abstract
BackgroundMost people with autism spectrum disorder (ASD) present at least one form of challenging behavior (CB), causing reduced life quality, social interactions, and community-based service inclusion.ObjectivesThe current study had two objectives: (1) to assess the differences in physiological reaction to stressful stimuli between adults with and without high-functioning ASD; (2) to develop a system able to predict the incoming occurrence of a challenging behaviors (CBs) in real time and inform the caregiver that a CB is about to occur; (3) to evaluate the acceptability and usefulness of the developed system for users with ASD and their caregivers.MethodsComparison between physiological parameters will be conducted by enrolling two groups of 20 participants with and without ASD monitored while watching a relaxing and disturbing video. To understand the variations of the parameters that occur before the CB takes place, 10 participants with ASD who have aggressive or disruptive CBs will be monitored for 7 days. Then, an ML algorithm capable of predicting immediate CB occurrence based on physiological parameter variations is about to be developed. After developing the application-based algorithm, an efficient proof of concept (POC) will be carried out on one participant with ASD and CB. A focus group, including health professionals, will test the POC to identify the strengths and weaknesses of the developed system.ResultsHigher stress level is anticipated in the group of people with ASD looking at the disturbing video than in the typically developed peers. From the obtained data, the developed algorithm is used to predict CBs that are about to occur in the upcoming 1 min. A high level of satisfaction with the proposed technology and useful consideration for further developments are expected to emerge from the focus group.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT05340608].
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Gitimoghaddam M, Chichkine N, McArthur L, Sangha SS, Symington V. Applied Behavior Analysis in Children and Youth with Autism Spectrum Disorders: A Scoping Review. Perspect Behav Sci 2022; 45:521-557. [PMID: 36249174 PMCID: PMC9458805 DOI: 10.1007/s40614-022-00338-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 12/18/2022] Open
Abstract
This manuscript provides a comprehensive overview of the impact of applied behavior analysis (ABA) on children and youth with autism spectrum disorders (ASD). Seven online databases and identified systematic reviews were searched for published, peer-reviewed, English-language studies examining the impact of ABA on health outcomes. Measured outcomes were classified into eight categories: cognitive, language, social/communication, problem behavior, adaptive behavior, emotional, autism symptoms, and quality of life (QoL) outcomes. Improvements were observed across seven of the eight outcome measures. There were no included studies that measured subject QoL. Moreover, of 770 included study records, only 32 (4%) assessed ABA impact, had a comparison to a control or other intervention, and did not rely on mastery of specific skills to mark improvement. Results reinforce the need for large-scale prospective studies that compare ABA with other non-ABA interventions and include measurements of subject QoL to provide policy makers with valuable information on the impacts of ABA and other existing and emerging interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s40614-022-00338-x.
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Affiliation(s)
- Mojgan Gitimoghaddam
- University of British Columbia Faculty of Medicine, Vancouver, British Columbia Canada
| | | | - Laura McArthur
- Club Aviva Recreation Ltd., Coquitlam, British Columbia Canada
| | - Sarabjit S Sangha
- Club Aviva Recreation Ltd., Coquitlam, British Columbia Canada
- University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Australia
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8
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Sakdalan J, Maxwell Y. The application of adapted dialectical behaviour therapy concepts and skills in the treatment of adults with autistic spectrum disorder who display challenging or offending behaviours. ADVANCES IN AUTISM 2022. [DOI: 10.1108/aia-01-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Despite some advances in the assessment and treatment of autism spectrum disorder (ASD), there remains a paucity of intervention and research literature in treating adults with ASD. There is growing evidence supporting a relationship between the core features of ASD and emotion dysregulation. There is an overlap between ASD and borderline personality disorder (BPD) characteristics such as emotional dysregulation, sensory issues and social skills deficits. This paper aims to explore the applications of dialectical behaviour therapy (DBT) concepts and skills in treating ASD individuals who display challenging or offending behaviours. The similarities in characteristics between ASD and BPD and the core issue of emotion dysregulation hold promise in the utility of DBT with ASD.
Design/methodology/approach
This is a conceptual paper that includes a case vignette.
Findings
A DBT-informed treatment approach using the adaptations and reconceptualization, i.e. risky mind–wise mind outlined in this paper, can be considered promising in addressing issues for ASD individuals, particularly those with challenging and/or offending behaviours. DBT incorporates different elements of applied behaviour analysis, cognitive behavioural therapy, mindfulness skills, sensory-based treatments, psychosocial interventions and emotion regulation skills, which makes it a more cohesive and integrated approach to treatment. The authors assert that DBT can be considered a more integrated, strengths-based, habilitative and trauma-informed approach which can be promising in its application to address challenging behaviours or offending in ASD individuals.
Research limitations/implications
It is recommended that research be carried out to evaluate the effectiveness of adapted DBT programs in treating ASD individuals presenting with challenging and/or offending behaviours. Future research can focus on evaluating the effectiveness of the different DBT concepts and skills and the different DBT modules to determine which components of the program are particularly useful for this client group.
Practical implications
Treatment manuals have already been developed for clients with intellectual disability and developmental disabilities who exhibit challenging and/or offending behaviour; hence, it is recommended that modifications be made to make it more applicable and appropriate for ASD individuals. Modifications should address ASD-specific issues (e.g. black and white thinking, cognitive rigidity, sensory issues, impaired theory of mind, emotion dysregulation issues, social skills deficits and anxiety issues). The use of DBT has much wider implications regarding addressing comorbid mental health conditions and personality issues in this client group.
Originality/value
There are limited psychological interventions that prove to be useful for individuals with ASD with complex presentations and challenging or offending behaviours. This paper discusses the application of adapted DBT concepts and skills that appear to be promising in the treatment of this client group.
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da Hora CL, Sella AC. Evaluation parameters for evidence-based practices for people with autism spectrum disorder: a narrative review of group and single-subject design studies. PSICOLOGIA, REFLEXAO E CRITICA : REVISTA SEMESTRAL DO DEPARTAMENTO DE PSICOLOGIA DA UFRGS 2022; 35:23. [PMID: 35857210 PMCID: PMC9300806 DOI: 10.1186/s41155-022-00213-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
Recommendations for using evidence-based practices have become increasingly common in services for individuals diagnosed with autistic spectrum disorder (ASD). The aim of this study was to conduct a narrative literature review to identify differences and similarities in evidence-evaluation criteria for group and single-subject designs that empirically support interventions for people with ASD. Data sources used in this analysis were reports and articles elaborated by different clearinghouses (i.e., National Autism Center, National Professional Development Center, and the National Clearinghouse on Autism Evidence and Practice). The criteria for evaluating evidence, as defined by these documents, contained specific components or quality indicators for each type of study design. The different criteria for evaluating evidence and for classifying the interventions (once evidence was evaluated) were identified and described. This manuscript discusses the need for (a) expanding the analysis beyond the evidence identified by different researchers and organizations such as the clearinghouses, (b) proposing interventions that are based not only on scientific evidence but also on social validity — which is directed by client idiosyncrasies, and (c) attention to the fact that EBPs should not be seen as static information regarding interventions with empirical support: evidence-based practices are the result of constant analysis of the intervention implementation data added to professional training and client values and context. Some additional issues and the study limitations are also presented.
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Affiliation(s)
- Cássia Leal da Hora
- Paradigma, Behavioral Science and Technology Center, Rua Bartira, 1294, Perdizes, São Paulo, SP, CEP: 05011-001, Brazil.
| | - Ana Carolina Sella
- Aprendizagem em Pauta, Rua Olindina Campos Teixeira, 172/601, Maceió, Alagoas, CEP: 57036-690, Brazil
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King G, Smart E, Bowman L, Pinto M. Social participation interventions targeting relational outcomes for young people with physical and developmental disabilities: an umbrella review and narrative synthesis. Disabil Rehabil 2022:1-14. [PMID: 35695048 DOI: 10.1080/09638288.2022.2085332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: To synthesize knowledge about social participation interventions targeting relational outcomes for young people with physical and developmental disabilities.Method: An umbrella review with a narrative synthesis was conducted to integrate findings of review articles examining social participation interventions targeting relational outcomes (e.g., peer interaction and friendships). Six databases were searched to identify reviews published between 2010 and 2021.Results: Five reviews were identified, examining participation interventions, social/community integration interventions, recreational sport programs, online peer mentorship programs, and augmentative and alternative communication interventions to promote social interaction with peers. Interventions associated with improvements in relational outcomes included group-based programs, programs involving personalized goals, arts-based programs, and multi-component social communication interventions. Recommendations for future research included better description of interventions to identify active ingredients and key mechanisms, measurement of participants' experiences, and the need for interventions to be aligned with the nature of the outcomes examined. Preliminary intervention principles are proposed to guide the design of social participation interventions: individualizing, contextualizing, and immersion in social settings.Conclusions: There are multiple pathways by which to influence the relational outcomes of young people with disabilities. There are implications for the design of social participation interventions based on an ecological/experiential and relational perspective.IMPLICATIONS FOR REHABILITATIONImprovements in relational outcomes are associated with participation in group-based programs, programs involving personalized goals, arts-based programs, and multi-component social communication interventions.Three evidence-informed principles can help guide the design of social participation interventions: (1) personalizing, (2) contextualizing, and (3) immersion in social settings.Greater attention to aligning the nature of intervention with desired outcomes is needed to more effectively measure and promote relational outcomes.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Eric Smart
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Laura Bowman
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Madhu Pinto
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
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Gosling CJ, Cartigny A, Mellier BC, Solanes A, Radua J, Delorme R. Efficacy of psychosocial interventions for Autism spectrum disorder: an umbrella review. Mol Psychiatry 2022; 27:3647-3656. [PMID: 35790873 PMCID: PMC9708596 DOI: 10.1038/s41380-022-01670-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 05/31/2022] [Accepted: 06/09/2022] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The wide range of psychosocial interventions designed to assist people with Autism Spectrum Disorder (ASD) makes it challenging to compile and hierarchize the scientific evidence that supports the efficacy of these interventions. Thus, we performed an umbrella review of published meta-analyses of controlled clinical trials that investigated the efficacy of psychosocial interventions on both core and related ASD symptoms. METHODS Each meta-analysis that was identified was re-estimated using a random-effects model with a restricted maximum likelihood estimator. The methodological quality of included meta-analyses was critically appraised and the credibility of the evidence was assessed algorithmically according to criteria adapted for the purpose of this study. RESULTS We identified a total of 128 meta-analyses derived from 44 reports. More than half of the non-overlapping meta-analyses were nominally statistically significant and/or displayed a moderate-to-large pooled effect size that favored the psychosocial interventions. The assessment of the credibility of evidence pointed out that the efficacy of early intensive behavioral interventions, developmental interventions, naturalistic developmental behavioral interventions, and parent-mediated interventions was supported by suggestive evidence on at least one outcome in preschool children. Possible outcomes included social communication deficits, global cognitive abilities, and adaptive behaviors. Results also revealed highly suggestive indications that parent-mediated interventions improved disruptive behaviors in early school-aged children. The efficacy of social skills groups was supported by suggestive evidence for improving social communication deficits and overall ASD symptoms in school-aged children and adolescents. Only four meta-analyses had a statistically significant pooled effect size in a sensitivity analysis restricted to randomized controlled trials at low risk of detection bias. DISCUSSION This umbrella review confirmed that several psychosocial interventions show promise for improving symptoms related to ASD at different stages of life. However, additional well-designed randomized controlled trials are still required to produce a clearer picture of the efficacy of these interventions. To facilitate the dissemination of scientific knowledge about psychosocial interventions for individuals with ASD, we built an open-access and interactive website that shares the information collected and the results generated during this umbrella review. PRE-REGISTRATION PROSPERO ID CRD42020212630.
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Affiliation(s)
- Corentin J. Gosling
- Paris Nanterre University, DysCo Laboratory, F-92000 Nanterre, France ,grid.508487.60000 0004 7885 7602Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France ,grid.5491.90000 0004 1936 9297Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Ariane Cartigny
- grid.508487.60000 0004 7885 7602Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, F-92100 Boulogne-Billancourt, France ,grid.413235.20000 0004 1937 0589Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France
| | | | - Aleix Solanes
- grid.10403.360000000091771775Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain
| | - Joaquim Radua
- grid.10403.360000000091771775Imaging of Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain ,grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
| | - Richard Delorme
- grid.413235.20000 0004 1937 0589Department of Child and Adolescent Psychiatry, Robert Debré Hospital, APHP, Paris, France ,grid.428999.70000 0001 2353 6535Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
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Bieleninik Ł, Ettenberger M, Epstein S, Elefant C, Arnon S. Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8557. [PMID: 34444304 PMCID: PMC8394319 DOI: 10.3390/ijerph18168557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant's response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic-pituitary-adrenal axis' role in stabilization of behavioral state, the autonomic nervous system's role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Mark Ettenberger
- Music Therapy Service, University Hospital Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia;
- SONO—Centro de Musicoterapia, Bogotá 110221, Colombia
| | - Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba 44281, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Crowe B, Machalicek W, Wei Q, Drew C, Ganz J. Augmentative and Alternative Communication for Children with Intellectual and Developmental Disability: A Mega-Review of the Literature. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2021; 34:1-42. [PMID: 33814873 PMCID: PMC8009928 DOI: 10.1007/s10882-021-09790-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/11/2021] [Indexed: 05/06/2023]
Abstract
Establishing evidence- and research-based practices relies upon research synthesis of individual studies in reviews and meta analyses. Further summarizing scientific evidence about a specific topic by synthesizing reviews is an area of need to determine practices that have a strong evidence base and to identify areas of methodological weakness and gaps in the literature. A mega-review of literature reviews, systematic reviews, and meta-analyses on interventions using aided augmentative and alternative communication (AAC) interventions for children with intellectual and developmental disabilities from 2000 to mid-2020 was conducted. Participant and interventionist demographics, interventions, settings, outcomes, and recommendations of each review were reported and summarized. A MeaSurement Tool to Assess systematic Reviews Revised (AMSTAR 2; Shea et al., 2017) was used to examine the methodological rigor of 84 included reviews. Over the past 20 years, published reviews have increased slightly in methodological rigor but demonstrate a number of methodological weaknesses that detract from the strength of evidence for AAC interventions with this population. Suggestions for improving the methodological rigor of literature reviews and areas for future research specific to AAC interventions are discussed.
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Affiliation(s)
- Becky Crowe
- Department of Special Education and Clinical Sciences, University of Oregon, 1589 E 15th Street, Eugene, OR 97403 USA
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, 1589 E 15th Street, Eugene, OR 97403 USA
| | - Qi Wei
- Department of Special Education and Clinical Sciences, University of Oregon, 1589 E 15th Street, Eugene, OR 97403 USA
| | - Christine Drew
- Department of Special Education, Rehabilitation and Counseling, Auburn University, Auburn, AL USA
| | - Jay Ganz
- Department of Special Education and Educational Psychology, Texas A&M University, College Station, TX USA
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Hastings SE, Hastings RP, Swales MA, Hughes JC. Emotional and behavioural problems of children with autism spectrum disorder attending mainstream schools. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:633-640. [PMID: 36210888 PMCID: PMC9542324 DOI: 10.1080/20473869.2020.1869414] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 12/18/2020] [Accepted: 12/20/2020] [Indexed: 05/30/2023]
Abstract
Emotional and behavioural problems occur more commonly in children with Autism Spectrum Disorder (ASD) compared to other children. Few studies have focused on these problems in children with ASD attending mainstream schools. We assessed via parent report the emotional and behavioural problems in 160 children aged 4-17 years with ASD attending mainstream schools and investigated differences between the primary and secondary aged children. Children with ASD had higher levels of problems across all domains of the Strengths and Difficulties Questionnaire (SDQ) compared to UK norms. Within the ASD sample, SDQ scores were associated with male sex, living in a household with more children, more severe autism symptoms and fewer adaptive skills, and higher levels of family socio-economic risk. No robust primary-secondary school differences were found. Implications for future research and the support of children with ASD in mainstream school settings are discussed.
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Affiliation(s)
| | | | | | - J Carl Hughes
- School of Education and Human Development, Bangor University, Bangor, Gwynedd, UK
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Chaliha D, Mamo JC, Albrecht M, Lam V, Takechi R, Vaccarezza M. A Systematic Review of the MDMA Model to Address Social Impairment in Autism. Curr Neuropharmacol 2021; 19:1101-1154. [PMID: 33388021 PMCID: PMC8686313 DOI: 10.2174/1570159x19666210101130258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/27/2020] [Accepted: 12/13/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by repetitive behaviours, cognitive rigidity/inflexibility, and social-affective impairment. Unfortunately, no gold-standard treatments exist to alleviate the core socio-behavioural impairments of ASD. Meanwhile, the prosocial empathogen/entactogen 3,4-methylene-dioxy-methamphetamine (MDMA) is known to enhance sociability and empathy in both humans and animal models of psychological disorders. OBJECTIVE We review the evidence obtained from behavioural tests across the current literature, showing how MDMA can induce prosocial effects in animals and humans, where controlled experiments were able to be performed. METHODS Six electronic databases were consulted. The search strategy was tailored to each database. Only English-language papers were reviewed. Behaviours not screened in this review may have affected the core ASD behaviours studied. Molecular analogues of MDMA have not been investigated. RESULTS We find that the social impairments may potentially be alleviated by postnatal administration of MDMA producing prosocial behaviours in mostly the animal model. CONCLUSION MDMA and/or MDMA-like molecules appear to be an effective pharmacological treatment for the social impairments of autism, at least in animal models. Notably, clinical trials based on MDMA use are now in progress. Nevertheless, larger and more extended clinical studies are warranted to prove the assumption that MDMA and MDMA-like molecules have a role in the management of the social impairments of autism.
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Affiliation(s)
| | | | | | | | | | - Mauro Vaccarezza
- Address correspondence to this author at the Curtin Medical School, Curtin Health Innovation Research Institute, P.O. Box 6845, WA 6102 Perth, Australia; Tel: 08 9266 7671; E-mail:
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16
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Goossen K, Hess S, Lunny C, Pieper D. Database combinations to retrieve systematic reviews in overviews of reviews: a methodological study. BMC Med Res Methodol 2020; 20:138. [PMID: 32487023 PMCID: PMC7268249 DOI: 10.1186/s12874-020-00983-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 04/20/2020] [Indexed: 12/30/2022] Open
Abstract
Background When conducting an Overviews of Reviews on health-related topics, it is unclear which combination of bibliographic databases authors should use for searching for SRs. Our goal was to determine which databases included the most systematic reviews and identify an optimal database combination for searching systematic reviews. Methods A set of 86 Overviews of Reviews with 1219 included systematic reviews was extracted from a previous study. Inclusion of the systematic reviews was assessed in MEDLINE, CINAHL, Embase, Epistemonikos, PsycINFO, and TRIP. The mean inclusion rate (% of included systematic reviews) and corresponding 95% confidence interval were calculated for each database individually, as well as for combinations of MEDLINE with each other database and reference checking. Results Inclusion of systematic reviews was higher in MEDLINE than in any other single database (mean inclusion rate 89.7%; 95% confidence interval [89.0–90.3%]). Combined with reference checking, this value increased to 93.7% [93.2–94.2%]. The best combination of two databases plus reference checking consisted of MEDLINE and Epistemonikos (99.2% [99.0–99.3%]). Stratification by Health Technology Assessment reports (97.7% [96.5–98.9%]) vs. Cochrane Overviews (100.0%) vs. non-Cochrane Overviews (99.3% [99.1–99.4%]) showed that inclusion was only slightly lower for Health Technology Assessment reports. However, MEDLINE, Epistemonikos, and reference checking remained the best combination. Among the 10/1219 systematic reviews not identified by this combination, five were published as websites rather than journals, two were included in CINAHL and Embase, and one was included in the database ERIC. Conclusions MEDLINE and Epistemonikos, complemented by reference checking of included studies, is the best database combination to identify systematic reviews on health-related topics.
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Affiliation(s)
- Käthe Goossen
- Institute for Research in Operative Medicine (IFOM), Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany.
| | - Simone Hess
- Institute for Research in Operative Medicine (IFOM), Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Carole Lunny
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, Cochrane Hypertension Review Group and the Therapeutics Initiative, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada
| | - Dawid Pieper
- Institute for Research in Operative Medicine (IFOM), Faculty of Health, School of Medicine, Witten/Herdecke University, Ostmerheimer Str. 200, 51109, Cologne, Germany
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Hartman RE, Patel D. Dietary Approaches to the Management of Autism Spectrum Disorders. ADVANCES IN NEUROBIOLOGY 2020; 24:547-571. [PMID: 32006373 DOI: 10.1007/978-3-030-30402-7_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This chapter reviews the literature surrounding autism spectrum disorders (ASD) and their relation to gastrointestinal (GI), behavioral, neurological, and immunological functioning. Individuals with ASD often have poor GI health, including bowel motility issues, autoimmune and/or other adverse responses to certain foods, and lack of necessary nutrient absorption. These issues may be caused or exacerbated by restrictive behavioral patterns (e.g., preference for sweet and salty foods and/or refusal of healthy foods). Those individuals with GI issues tend to demonstrate more behavioral deficits (e.g., irritability, agitation, hyperactivity) and also tend to have an imbalance in overall gut microbiome composition, thus corroborating several studies that have implicated brain-gut pathways as potential mediators of behavioral dysfunction.We examine the literature regarding dietary approaches to managing ASDs, including elimination diets for gluten, casein, or complex carbohydrates, a ketogenic diet, and a low oxalate diet. We also explore the research examining dietary supplements such as fatty acids, pro- and prebiotics, vitamins, minerals, glutathione, phytochemicals, and hormones. The research on dietary approaches to managing ASDs is limited and the results are mixed. However, a few approaches, such as the gluten-free/casein-free diet, fatty acid supplementation, and pre/probiotics have generally demonstrated improved GI and associated behavioral symptoms. Given that GI issues seem to be overrepresented in ASD populations, and that GI issues have been associated with a number behavioral and neurological deficits, dietary manipulation may offer a cheap and easily implemented approach to improve the lives of those with ASD.
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Affiliation(s)
- Richard E Hartman
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA.
| | - Dhira Patel
- Department of Psychology, Loma Linda University, Loma Linda, CA, USA
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Duggal C, Dua B, Chokhani R, Sengupta K. What works and how: Adult learner perspectives on an autism intervention training program in India. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:246-257. [DOI: 10.1177/1362361319856955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A significant treatment gap exists in low and middle income countries such as India for children with autism spectrum disorder. The Autism Intervention Training Program, a comprehensive 6-month program for training professionals in transdisciplinary evidence-based practices to address concerns associated with autism spectrum disorder, was piloted in India to address this gap. This study attempted to capture the perspectives of trainees on the effectiveness of andragogical approaches adopted in the Autism Intervention Training Program and the impact of this training on their work. An exploratory qualitative study was conceptualized, and in-depth interviews were conducted with 11 Autism Intervention Training Program trainees. Trainees highlighted the benefits of a blended training format, peer learning, and a responsive, reflective, experiential, and respectful approach to teaching and supervision. The impact of the program was perceived through an increase in trainees’ knowledge and skills, impact on their organizations, and positive outcomes for children with autism spectrum disorder and their families. There is a need to develop and document comprehensive, contextualized, and evidence-based training programs for autism spectrum disorder professionals in low and middle income countries. Focusing on andragogical frameworks while conceptualizing and delivering these training programs is underscored, as approaches that promote self-efficacy in learners and enable transformative learning can lead to a cascading impact in resource-constrained settings.
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19
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Novakovic N, Milovancevic MP, Dejanovic SD, Aleksic B. Effects of Snoezelen-Multisensory environment on CARS scale in adolescents and adults with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 89:51-58. [PMID: 30933867 DOI: 10.1016/j.ridd.2019.03.007] [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: 07/23/2018] [Revised: 12/30/2018] [Accepted: 03/16/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND New classification system Diagnostic and statistical manual of mental disorders. 5th ed.(DSM - 5) includes sensory problems as one of the symptoms in diagnostic profile of Autism Spectrum Disorder (ASD). Researching the effects of sensory integration treatment may improve new approaches to the individuals with ASD. The objective of this study is to determine the effects of Snoezelen, multisensory environment on the severity of ASD and stereotyped/repetitive behaviours in adolescents and adults using CARS scale. METHOD The study involved 40 subjects with ASD associated with intellectual difficulties of both sexes, aged 15-35. The subjects were randomly divided into two groups: a control one (without treatment) and an experimental one (with treatment). The assessments were rated by CARS (Childhood Autism Rating Scale) before and after the three-month treatment. RESULTS In the experimental group, there was a statistically significant difference of the total CARS score before and after the treatment (p < 0.0005). Comparing the results of both experimental and control groups, a statistically significant difference was found on total CARS score (p < 0.0005). Conslusion: The results in the present study indicate that the continual sessions in Snoezelen room had effects on reducing severity of ASD and repetitive and stereotyped behaviours on CARS scale.
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Affiliation(s)
- Neda Novakovic
- Day Care Centre for Children and Adolescents with Developmental Disabilities, Svetozara Markovica 85a, 11 000 Belgrade, Serbia.
| | | | - Slavica Djukic Dejanovic
- Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovica 69, 34 000 Kragujevac, Serbia.
| | - Branko Aleksic
- Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
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Commentary on Social Skills Training Curricula for Individuals with ASD: Social Interaction, Authenticity, and Stigma. J Autism Dev Disord 2019; 48:953-964. [PMID: 29170937 DOI: 10.1007/s10803-017-3400-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
By teaching social rules thought to be necessary for social competence, social skills training (SST) curricula aim to improve indicators of well-being for individuals with autism spectrum disorder (ASD), such as the attainment of meaningful friendships. However, several recent meta-analyses indicate that SST curricula may fall short of these goals. We offer an explanation for these potentially null effects by illustrating how the content of these curricula diverge from empirical evidence derived from disciplines that take social interaction as their object of study. Next, we argue that employing the social rules advocated for by SST curricula may work counterproductively by inhibiting authenticity, while at the same time increasing stigma associated with ASD. We close with suggestions for future intervention research.
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21
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Tan VXL, Simmonds JG. Parent Perceptions of Psychosocial Outcomes of Equine-Assisted Interventions for Children with Autism Spectrum Disorder. J Autism Dev Disord 2019; 48:759-769. [PMID: 29196865 DOI: 10.1007/s10803-017-3399-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This research explored parents' perceptions of the psychosocial outcomes of their children's experience of receiving equine-assisted interventions (EAI). Participants were the parents of six children (aged 3-14) diagnosed with autism spectrum disorder. Five semi-structured interviews were conducted and the transcript data was analysed using Interpretative phenomenological analysis. Four super-ordinate themes emerged from the analysis: (1) child's improved self-concept and enhanced emotional well-being, (2) child's improved self-regulatory ability, (3) social benefits for the child, and (4) unexpected outcomes. EAI was perceived by the parents as having several levels of psychosocial benefits for their children. These benefits may also extend to parents and family through ecopsychological and "flow on" effects associated with the children's involvement in EAI programs.
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Affiliation(s)
- Vanessa Xue-Ling Tan
- Psychology Programs, Faculty of Education, Monash University, Melbourne, VIC, Australia
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22
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Su Maw S, Haga C. Effectiveness of cognitive, developmental, and behavioural interventions for Autism Spectrum Disorder in preschool-aged children: A systematic review and meta-analysis. Heliyon 2018; 4:e00763. [PMID: 30211331 PMCID: PMC6129682 DOI: 10.1016/j.heliyon.2018.e00763] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/04/2018] [Accepted: 08/24/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is characterised by significant impairment in social communication and the presence of restrictive and repetitive behaviour or interest. Intervention during early childhood could decrease ASD symptoms. We aimed to identify the most effective intervention based on cognitive, developmental, and behavioural approaches and the factors that impact the effectiveness of the intervention. METHODS We performed a systematic review and meta-analysis of existing interventions for ASD in preschool-aged children. Electronic databases were searched for related articles with randomised controlled trial (RCT) designs published between 2001 to 2015. Outcome measures were communication, behavioural and cognitive skills, reported as standardised mean differences (SMD) compared to a control group. A Random-effects model was utilised to calculate the pooled estimate effect. Between-study variability was also assessed. The registering number of this study is CRD42017035354. FINDINGS Out of the initial 5174 studies that were identified, there were 14 RCTs (746 children) that were included in the final systematic review and meta-analysis. Pooled estimate effect provided by random-effects model was 0.23 (95% confidence interval, CI [0.08-0.37]) with no between-study heterogeneity (I2 = 0.00%, p = 0.0018). Three studies of music therapy interventions provided the greatest outcome effects with a shorter duration and lower intensity. SMD for music therapies ranged from 0.40 to 0.62 with 95% CI [0.22 to 1.85]. The quality of the health care provider, the duration, and the intensity of intervention played an important role in the effectiveness of the intervention. INTERPRETATION Music therapy appears to be an effective tool for improving social interaction in preschool-aged children with ASD. However, more evidence-based trials are required to further validate the effectiveness of music therapy in ASD.
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Affiliation(s)
- Su Su Maw
- Graduate School of Health Sciences, Okayama University, Shikata cho, Kita-ku, 700-8558, Okayama city, Japan
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23
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Facilitating Neurofeedback in Children with Autism and Intellectual Impairments Using TAGteach. J Autism Dev Disord 2018; 48:2090-2100. [PMID: 29380270 DOI: 10.1007/s10803-018-3466-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Individuals with autism and intellectual impairments tend to be excluded from research due to their difficulties with methodological compliance. This study focuses on using Teaching with Acoustic Guidance-TAGteach-to behaviorally prepare children with autism and a IQ ≤ 80 to participate in a study on neurofeedback training (NFT). Seven children (ages 6-8) learned the prerequisite skills identified in a task analysis in an average of 5 h of TAGteach training, indicating that this is a feasible method of preparing intellectually-impaired children with autism to participate in NFT and task-dependent electroencephalography measures. TAGteach may thus have the potential to augment this population's ability to participate in less accessible treatments and behavioral neuroscientific studies.
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Pina-Camacho L, Parellada M, Kyriakopoulos M. Autism spectrum disorder and schizophrenia: boundaries and uncertainties. BJPSYCH ADVANCES 2018. [DOI: 10.1192/apt.bp.115.014720] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
SummaryAutism and schizophrenia were placed in different diagnostic categories in DSM-III, having previously been considered as related diagnostic entities. New evidence suggests that these disorders show clinical and cognitive deficit overlaps and shared neurobiological characteristics. Furthermore, children presenting with both autism spectrum disorder (ASD) and psychotic experiences may represent a subgroup of ASD more closely linked to psychosis. The study of ASD and childhood schizophrenia, and their clinical boundaries and overlapping pathophysiological characteristics, may clarify their relationship and lead to more effective interventions. This article discusses the relationship through a critical review of current and historical dilemmas surrounding the phenomenology and pathophysiology of these disorders. It provides a framework for working with children and young people with mixed clinical presentations, illustrated by three brief fictional case vignettes.
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van den Berk-Smeekens I, Oosterling IJ, den Boer JC, Buitelaar JK, Staal WG, van Dongen-Boomsma M. Pivotal Response Treatment for autism spectrum disorder (ASD). Hippokratia 2017. [DOI: 10.1002/14651858.cd012887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Iris van den Berk-Smeekens
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour; Radboud University Nijmegen Medical Centre; Nijmegen Netherlands
- Karakter Child and Adolescent Psychiatry University Centre; Nijmegen Netherlands
| | - Iris J Oosterling
- Karakter Child and Adolescent Psychiatry University Centre; Nijmegen Netherlands
| | - Jenny C den Boer
- Karakter Child and Adolescent Psychiatry Centre; Ede Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour; Radboud University Nijmegen Medical Centre; Nijmegen Netherlands
- Karakter Child and Adolescent Psychiatry University Centre; Nijmegen Netherlands
| | - Wouter G Staal
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour; Radboud University Nijmegen Medical Centre; Nijmegen Netherlands
- Karakter Child and Adolescent Psychiatry University Centre; Nijmegen Netherlands
| | - Martine van Dongen-Boomsma
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour; Radboud University Nijmegen Medical Centre; Nijmegen Netherlands
- Karakter Child and Adolescent Psychiatry University Centre; Nijmegen Netherlands
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Developing Autism Screening Criteria for the Brief Infant Toddler Social Emotional Assessment (BITSEA). J Autism Dev Disord 2017; 47:1269-1277. [PMID: 28181053 DOI: 10.1007/s10803-017-3044-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
There is a critical need for evidence-based, broadband behavioral, and ASD screening measures for use in pediatric and early educational settings to ensure that young children at risk for developing social-emotional disorders and/or ASD are provided with early intervention services to optimize long-term outcomes. The BITSEA is a 42-item screener designed to identify social-emotional/behavioral problems and delays/deficits in social-emotional competence among 11-48-month-olds; 19 items describe behaviors consistent with ASD. Secondary data analysis was employed to develop cut-scores for ASD subscales using Receiver Operating Curves, discriminating children with (n = 223) and without (n = 289) ASD. Cut-scores demonstrated moderate-to-high discriminative power, sensitivity, specificity, and PPV. Findings highlight feasibility of using a broadband social-emotional competence and behavior problem screener to improve early detection of ASD.
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27
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Beadle-Brown J, Wilkinson D, Richardson L, Shaughnessy N, Trimingham M, Leigh J, Whelton B, Himmerich J. Imagining Autism: Feasibility of a drama-based intervention on the social, communicative and imaginative behaviour of children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 22:915-927. [PMID: 28901162 DOI: 10.1177/1362361317710797] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report the feasibility of a novel, school-based intervention, coined 'Imagining Autism', in which children with autism engage with drama practitioners though participatory play and improvisation in a themed multi-sensory 'pod' resembling a portable, tent-like structure. A total of 22 children, aged 7-12 years, from three UK schools engaged in the 10-week programme. Measures of social interaction, communication and emotion recognition, along with parent and teacher ratings, were collected before and up to 12 months after the intervention. Feasibility was evaluated through four domains: (1) process (recruitment, retention, blinding, inter-rater reliability, willingness of children to engage), (2) resources (space, logistics), (3) management (dealing with unexpected changes, ease of assessment) and (4) scientific (data outcomes, statistical analyses). Overall, the children, parents and teachers showed high satisfaction with the intervention, the amount of missing data was relatively low, key assessments were implemented as planned and evidence of potential effect was demonstrated on several key outcome measures. Some difficulties were encountered with recruitment, test administration, parental response and the logistics of setting up the pod. Following several protocol revisions and the inclusion of a control group, future investigation would be justified to more thoroughly examine treatment effects.
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Affiliation(s)
- Bill Matney
- Division of Music Education and Music Therapy, University of Kansas, Lawrence, KS, USA
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Wang M, Jiang L, Tang X. Levetiracetam is associated with decrease in subclinical epileptiform discharges and improved cognitive functions in pediatric patients with autism spectrum disorder. Neuropsychiatr Dis Treat 2017; 13:2321-2326. [PMID: 28919764 PMCID: PMC5587198 DOI: 10.2147/ndt.s143966] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Subclinical epileptiform discharges (SEDs) are common in pediatric patients with autism spectrum disorder (ASD), but the effect of antiepileptic drugs on SEDs in ASD remains inconclusive. This physician-blinded, prospective, randomized controlled trial investigated an association between the anticonvulsant drug levetiracetam and SEDs in children with ASD. METHODS A total of 70 children with ASD (4-6 years) and SEDs identified by electroencephalogram were randomly divided into two equal groups to receive either levetiracetam and educational training (treatment group) or educational training only (control). At baseline and after 6 months treatment, the following scales were used to assess each individual's behavioral and cognitive functions: the Chinese version of the Psychoeducational Profile - third edition (PEP-3), Childhood Autism Rating Scale (CARS), and Autism Behavior Checklist (ABC). A 24-hour electroencephalogram was recorded on admission (baseline) and at follow-up. The degree of satisfaction of each patient was also evaluated. RESULTS Relative to baseline, at the 6-month follow-up, the PEP-3, CARS, and ABC scores were significantly improved in both the treatment and control groups. At the 6-month follow-up, the PEP-3 scores of the treatment group were significantly higher than those of the control, whereas the CARS and ABC scores were significantly lower, and the rate of electroencephalographic normalization was significantly higher in the treatment group. CONCLUSION Levetiracetam appears to be effective for controlling SEDs in pediatric patients with ASD and was also associated with improved behavioral and cognitive functions.
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Affiliation(s)
- Minjian Wang
- Department of Psychology.,Ministry of Education Key Laboratory of Child Development and Disorders.,Key Laboratory of Pediatrics in Chongqing.,Chongqing International Science and Technology Cooperation Center for Child Development and Disorders
| | - Li Jiang
- Ministry of Education Key Laboratory of Child Development and Disorders.,Key Laboratory of Pediatrics in Chongqing.,Chongqing International Science and Technology Cooperation Center for Child Development and Disorders.,Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Xiaoju Tang
- Department of Neurology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
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Abstract
Autism spectrum disorder (ASD) is a group of complex neurodevelopmental conditions characterized by deficits in social communication and by repetitive and stereotypic patterns of behaviors, with no pharmacological treatments available to treat these core symptoms. Oxytocin is a neuropeptide that powerfully regulates mammalian social behavior and has been shown to exert pro-social effects when administered intranasally to healthy human subjects. In the last decade, there has been a significant interest in using oxytocin to treat social behavior deficits in ASD. However, little attention has been paid to whether the oxytocin system is perturbed in subgroups of individuals with ASD and whether these individuals are likely to benefit more from an oxytocin treatment. This oversight may in part be due to the enormous heterogeneity of ASD and the lack of methods to carefully probe the OXT system in human subjects. Animal models for ASD are valuable tools to clarify the implication of the oxytocin system in ASD and can help determine whether perturbation in this system should be considered in future clinical studies as stratifying biomarkers to inform targeted treatments in subgroups of individuals with ASD. In this chapter, we review the literature on genetic- and environmental-based animal models for ASD, in which perturbations in the oxytocin system and/or the effect of oxytocin administration on the ASD-associated phenotype have been investigated.
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Psychosocial intervention for carers of people with dementia: What components are most effective and when? A systematic review of systematic reviews. Int Psychogeriatr 2017; 29:31-43. [PMID: 27666669 DOI: 10.1017/s1041610216001447] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Psychosocial interventions for carers of people with dementia are increasingly recognized as playing an important role in dementia care. We aim to systematically review the evidence from existing systematic reviews of psychosocial interventions for informal carers of people with dementia. METHODS Thirty-one systematic reviews were identified; following quality appraisal, data from 13 reviews, rated as high or moderate quality, were extracted. RESULTS Well-designed, clearly structured multi-component interventions can help maintain the psychological health of carers of people with dementia and delay institutionalization of the latter. To be most effective, such interventions should include both an educational and a therapeutic component; delivery through a support group format may further enhance their effectiveness. CONCLUSIONS Successful translation of evidence into practice in this area remains a challenge. Future research should focus on determining the most cost-effective means of delivering effective multi-component interventions in real-world settings; the cost-effective potential of technology-based interventions is considerable.
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Predictors of Successful Employment Outcomes for Adolescents with Autism Spectrum Disorders: a Systematic Literature Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-016-0092-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Soto T, Giserman Kiss I, Carter AS. SYMPTOM PRESENTATIONS AND CLASSIFICATION OF AUTISM SPECTRUM DISORDER IN EARLY CHILDHOOD: APPLICATION TO THE DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD (DC:0-5). Infant Ment Health J 2016; 37:486-97. [PMID: 27556740 PMCID: PMC5959016 DOI: 10.1002/imhj.21589] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/16/2016] [Accepted: 06/25/2016] [Indexed: 11/07/2022]
Abstract
Over the past 5 years, a great deal of information about the early course of autism spectrum disorder (ASD) has emerged from longitudinal prospective studies of infants at high risk for developing ASD based on a previously diagnosed older sibling. The current article describes early ASD symptom presentations and outlines the rationale for defining a new disorder, Early Atypical Autism Spectrum Disorder (EA-ASD) to accompany ASD in the new revision of the ZERO TO THREE Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5) (in press) alternative diagnostic classification manual. EA-ASD is designed to identify children who are 9 to 36 months of age presenting with a minimum of (a) two social-communication symptoms and (b) one repetitive and restricted behavior symptom as well as (c) evidence of impairment, with the intention of providing these children with appropriately tailored services and improving the likelihood of optimizing their development.
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Outcome of Home-Based Early Intervention for Autism in Sri Lanka: Follow-Up of a Cohort and Comparison with a Nonintervention Group. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3284087. [PMID: 27419131 PMCID: PMC4933858 DOI: 10.1155/2016/3284087] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/15/2016] [Accepted: 05/24/2016] [Indexed: 11/30/2022]
Abstract
This paper presents the outcome of a home-based autism intervention program (HBAIP) in 18- to 40-month-old children newly diagnosed and treatment naïve. Intervention was exclusively implemented at home. Outcome was measured at 3 months and 6 months after intervention and compared with a group of newly diagnosed children with autism who were >40 months at intake but had not received any autism specific clinical management. Aim was also to estimate whether natural development would contribute to gain in skills and compare with the effect of intervention. Five selected parameters of behavior representing social interaction and social communication were used to assess outcome. Results showed a statistically significant improvement between preintervention and postintervention in all the measured parameters. The effect size was large when compared to preintervention and gains were indicated by changes in mean scores and p values within a narrow confidence interval. Highest gains were in first 3 months of postintervention which continued up to 6 months. Although the comparison group was more advanced in the measured skills at intake, they were significantly below the level reached by experimental group at 3 months and 6 months after intervention. This study was registered in the Sri Lanka Clinical Trials Registry (SLCTR/2009/011).
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Henning B, Cordier R, Wilkes-Gillan S, Falkmer T. A pilot play-based intervention to improve the social play interactions of children with autism spectrum disorder and their typically developing playmates. Aust Occup Ther J 2016; 63:223-32. [DOI: 10.1111/1440-1630.12285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Belindi Henning
- School of Occupational Therapy; James Cook University; Townsville Queensland Western Australia
| | - Reinie Cordier
- School of Occupational Therapy; James Cook University; Townsville Queensland Western Australia
- School of Occupational Therapy and Social Work; Curtin University; Bentley Western Australia
| | - Sarah Wilkes-Gillan
- School of Allied Health; Australian Catholic University; North Sydney NSW Australia
| | - Torbjorn Falkmer
- School of Occupational Therapy and Social Work; Curtin University; Bentley Western Australia
- Department of Medical and Health Sciences; Faculty of Medicine and Health Sciences; Linköping University; Pain and Rehabilitation Center; Anaesthetics, Operations and Specialty Surgery Center; Region Östergotland Linköping Sweden
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Tanner K, Hand BN, O'Toole G, Lane AE. Effectiveness of Interventions to Improve Social Participation, Play, Leisure, and Restricted and Repetitive Behaviors in People With Autism Spectrum Disorder: A Systematic Review. Am J Occup Ther 2015; 69:6905180010p1-12. [PMID: 26356653 DOI: 10.5014/ajot.2015.017806] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People with autism spectrum disorder (ASD) commonly experience difficulties with social participation, play, and leisure along with restricted and repetitive behaviors that can interfere with occupational performance. The objective of this systematic review was to evaluate current evidence for interventions within the occupational therapy scope of practice that address these difficulties. Strong evidence was found that social skills groups, the Picture Exchange Communication System, joint attention interventions, and parent-mediated strategies can improve social participation. The findings were less conclusive for interventions to improve play and leisure performance and to decrease restricted and repetitive behaviors, but several strategies showed promise with moderately strong supporting evidence. Occupational therapists should be guided by evidence when considering interventions to improve social participation, play, leisure, and restricted and repetitive behaviors in people with ASD. Additional research using more robust scientific methods is needed for many of the currently available strategies.
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Affiliation(s)
- Kelly Tanner
- Kelly Tanner, PhD, OTR/L, is Occupational Therapy Research Coordinator, Nationwide Children's Hospital, Columbus, OH, and Lecturer, Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus;
| | - Brittany N Hand
- Brittany N. Hand, MOT, OTR/L, is PhD Student, Occupational Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus
| | - Gjyn O'Toole
- Gjyn O'Toole, MEdStud, GradDip TEFL, BA, Dip Occ Therapy, is Senior Lecturer, School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Alison E Lane
- Alison E. Lane, PhD, OTR/L, is Associate Professor, University of Newcastle, Callaghan, New South Wales, Australia
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Harony-Nicolas H, De Rubeis S, Kolevzon A, Buxbaum JD. Phelan McDermid Syndrome: From Genetic Discoveries to Animal Models and Treatment. J Child Neurol 2015; 30:1861-70. [PMID: 26350728 PMCID: PMC5321557 DOI: 10.1177/0883073815600872] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 07/15/2015] [Indexed: 01/16/2023]
Abstract
Phelan-McDermid syndrome or 22q13.3 deletion syndrome is a rare neurodevelopmental disorder characterized by generalized developmental delay, intellectual disability, absent or delayed speech, seizures, autism spectrum disorder, neonatal hypotonia, physical dysmorphic features, and recurrent medical comorbidities. Individuals with Phelan-McDermid syndrome have terminal deletions of the chromosomal region 22q13.3 encompassing SHANK3, a gene encoding a structural component of excitatory synapses indispensable for proper synaptogenesis and neuronal physiology, or point mutations within the gene. Here, we review the clinical aspects of the syndrome and the genetic findings shedding light onto the underlying etiology. We also provide an overview on the evidence from genetic studies and mouse models that supports SHANK3 haploinsufficiency as a major contributor of the neurobehavioral manifestations of Phelan-McDermid syndrome. Finally, we discuss how all these discoveries are uncovering the pathophysiology of Phelan-McDermid syndrome and are being translated into clinical trials for novel therapeutics ameliorating the core symptoms of the disorder.
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Affiliation(s)
- Hala Harony-Nicolas
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Silvia De Rubeis
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Kolevzon
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph D Buxbaum
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Demeestere D, Libert C, Vandenbroucke RE. Therapeutic implications of the choroid plexus-cerebrospinal fluid interface in neuropsychiatric disorders. Brain Behav Immun 2015; 50:1-13. [PMID: 26116435 DOI: 10.1016/j.bbi.2015.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 05/29/2015] [Accepted: 06/13/2015] [Indexed: 12/31/2022] Open
Abstract
The choroid plexus (CP) comprises an epithelial monolayer that forms an important physical, enzymatic and immunologic barrier, called the blood-cerebrospinal fluid barrier (BCSFB). It is a highly vascularized organ located in the brain ventricles that is key in maintaining brain homeostasis as it produces cerebrospinal fluid (CSF) and has other important secretory functions. Furthermore, the CP-CSF interface plays a putative role in neurogenesis and has been implicated in neuropsychiatric diseases such as the neurodevelopmental disorders schizophrenia and autism. A role for this CNS border was also implicated in sleep disturbances and chronic and/or severe stress, which are risk factors for the development of neuropsychiatric conditions. Understanding the mechanisms by which disturbance of the homeostasis at the CP-CSF interface is involved in these different chronic low-grade inflammatory diseases can give new insights into therapeutic strategies. Hence, this review discusses the different roles that have been suggested so far for the CP in these neuropsychiatric disorders, with special attention to potential therapeutic applications.
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Affiliation(s)
- Delphine Demeestere
- Inflammation Research Center, VIB, Technologiepark 927, B-9052 Zwijnaarde, Ghent, Belgium; Department of Biomedical Molecular Biology, Ghent University, Technologiepark 927, B-9052 Zwijnaarde, Ghent, Belgium
| | - Claude Libert
- Inflammation Research Center, VIB, Technologiepark 927, B-9052 Zwijnaarde, Ghent, Belgium; Department of Biomedical Molecular Biology, Ghent University, Technologiepark 927, B-9052 Zwijnaarde, Ghent, Belgium
| | - Roosmarijn E Vandenbroucke
- Inflammation Research Center, VIB, Technologiepark 927, B-9052 Zwijnaarde, Ghent, Belgium; Department of Biomedical Molecular Biology, Ghent University, Technologiepark 927, B-9052 Zwijnaarde, Ghent, Belgium.
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Chown N. Do Researchers Evaluate Psychosocial Interventions for Autism from the Perspective of the Three Dominant Cognitive Autism Theories? REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2015. [DOI: 10.1007/s40489-015-0049-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Ouhtit A, Al-Farsi Y, Al-Sharbati M, Waly M, Gupta I, Al-Farsi O, Al-Khaduri M, Al-Shafaee M, Al-Adawi S. Underlying Factors Behind the Low Prevalence of Autism Spectrum Disorders in Oman: Sociocultural perspective. Sultan Qaboos Univ Med J 2015; 15:e213-e217. [PMID: 26052454 PMCID: PMC4450784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 09/28/2014] [Accepted: 12/04/2014] [Indexed: 06/04/2023] Open
Abstract
Epidemiological surveys from various countries indicate an increased prevalence of autism spectrum disorders (ASD), leading researchers to debate whether there are now 'more affected' or 'more detected'. The epidemiology of ASD in developing countries, such as Oman, has generally indicated a lower prevalence compared to developed countries in the West. In Oman, the prevalence is low; however, this article highlights some of the factors that could contribute to the appearance of a low ASD rate: cross-cultural variations in the presentation of distress; a lack of reliable biological markers for diagnosing ASD, and a lack of health services for children with ASD, thus limiting the number of participants in epidemiological surveys. While the defining features of ASD have yet to be established, pilot studies in Oman indicate a substantial number of children with these disorders. Therefore, it is important that these discrepancies be addressed and the need for appropriate services for this patient population in Oman be highlighted.
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Affiliation(s)
- Allal Ouhtit
- Departments of Genetics, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Yahya Al-Farsi
- Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Marwan Al-Sharbati
- Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Mostafa Waly
- Department of Food Science & Nutrition, College of Agricultural & Marine Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ishita Gupta
- Departments of Genetics, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Omar Al-Farsi
- Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Maha Al-Khaduri
- Obstetrics & Gynaecology, College of Medicine & Health Sciences, Sultan Qaboos University
| | - Mohammed Al-Shafaee
- Family Medicine & Public Health, College of Medicine & Health Sciences, Sultan Qaboos University
- Vice Dean for Clinical Affairs, Oman Medical College, Sohar, Oman
| | - Samir Al-Adawi
- Behavioural Medicine, College of Medicine & Health Sciences, Sultan Qaboos University
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Paré G, Trudel MC, Jaana M, Kitsiou S. Synthesizing information systems knowledge: A typology of literature reviews. INFORMATION & MANAGEMENT 2015. [DOI: 10.1016/j.im.2014.08.008] [Citation(s) in RCA: 575] [Impact Index Per Article: 63.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Sprenger L, Becker K, Heinzel-Gutenbrunner M, Mingebach T, Otterbach S, Peters M, Kamp-Becker I. Ist das „Stepping-Stones/Triple P”-Elterntraining eine sinnvolle, ergänzende Intervention in der Behandlung von Kindern mit Autismus-Spektrum-Störungen? KINDHEIT UND ENTWICKLUNG 2015. [DOI: 10.1026/0942-5403/a000156] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Die Effektivität des Elterntrainings „Stepping Stones/Triple P” als ergänzende Behandlung von Kindern mit einer Autismus-Spektrum-Störung (ASS) wurde untersucht. Die Eltern von 13 Kindern mit ASS (neun Jungen, vier Mädchen) zwischen vier und zwölf Jahren (M=6.7 Jahre, SD=2.61) nahmen an der Studie teil. Das Training fand über einen Zeitraum von 14 Wochen mit acht Gruppensitzungen à zwei Stunden statt. Die Eltern wurden zum Prä- und Postzeitpunkt, sowie sechs Monate später bezüglich komorbider Verhaltensauffälligkeiten und dem Erziehungsverhalten befragt. Außerdem wurden die autistische Kernsymptomatik sowie die elterliche Belastung zum Prä- und Postzeitpunkt erhoben. Ein Teil der Eltern wurde zusätzlich als Eigenwarteliste-Kontrollgruppe erfasst. Durch das Elterntraining konnten die komorbiden Verhaltensauffälligkeiten der Kinder reduziert werden (d=.65), außerdem verbesserten sich die Erziehungsfertigkeiten (d=.97). Keine Veränderungen ergaben sich hinsichtlich der elterlichen Belastung und der autistischen Kernsymptomatik. Insgesamt zeigt sich das Elterntraining nach „Stepping Stones/Triple P” als sinnvolle begleitende Intervention in der Behandlung von Kindern mit einer ASS.
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Affiliation(s)
- Linda Sprenger
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Katja Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Monika Heinzel-Gutenbrunner
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Tanja Mingebach
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Saskia Otterbach
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Mira Peters
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
| | - Inge Kamp-Becker
- Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Marburg und Philipps-Universität Marburg
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Daniels AM, Mandell DS. Children's compliance with American Academy of Pediatrics' well-child care visit guidelines and the early detection of autism. J Autism Dev Disord 2014; 43:2844-54. [PMID: 23619952 DOI: 10.1007/s10803-013-1831-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study estimated compliance with American Academy of Pediatrics (AAP) guidelines for well-child care and the association between compliance and age at diagnosis in a national sample of Medicaid-enrolled children with autism (N = 1,475). Mixed effects linear regression was used to assess the relationship between compliance and age at diagnosis. Mean age at diagnosis was 37.4 (SD 8.4) months, and mean compliance was 55 % (SD 33 %). Children whose care was compliant with AAP guidelines were diagnosed 1.6 months earlier than children who received no well-child care. Findings support that the timely receipt of well-child care may contribute to earlier detection. Additional research on the contribution of compliance, well-child visit components and provider characteristics on the timely diagnosis of autism is needed.
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Affiliation(s)
- Amy M Daniels
- Autism Speaks, 1 East 33rd Street, 4th Floor, New York, NY, 10016, USA,
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A quarter century of progress on the early detection and treatment of autism spectrum disorder. Dev Psychopathol 2014; 25:1455-72. [PMID: 24342850 DOI: 10.1017/s0954579413000710] [Citation(s) in RCA: 92] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The last 25 years have witnessed tremendous changes in our ability to detect autism very early in life and provide interventions that can significantly influence children's outcomes. It was once questioned whether autism could be recognized before children had developed language and symbolic play skills; now changes in early behaviors, as well as structural brain changes, have been documented in infants 6-12 months of age who later develop autism. Advances in brain imaging and genetics offer the possibility of detecting autism before the syndrome is fully manifest, thereby reducing or preventing symptoms from developing. Whereas the primary mode of behavioral intervention a few decades ago relied on operant conditioning, recent approaches integrate the methods of applied behavioral analysis within a developmental, relationship-focused intervention model that are implemented by both parents and clinicians. These interventions have been found to have positive effects on children's developmental trajectory, as measured by both behavioral and neurophysiological assessments. Future approaches will likely combine both behavioral and pharmacological treatments for children who have less robust responses to behavioral interventions. There has been a paradigm shift in the way that autism is viewed, evolving from a lifelong condition with a very poor prognosis to one in which significant gains and neuroplasticity is expected, especially when the condition is detected early and appropriate interventions are provided. The grand challenge for the future is to bridge the tremendous gap between research and the implementation of evidence-based practices in the broader community, both in the United States and worldwide. Significant disparities in access to appropriate health care for children with autism exist that urgently require advocacy and more resources.
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Screening for autism spectrum disorders with the brief infant-toddler social and emotional assessment. PLoS One 2014; 9:e97630. [PMID: 24851868 PMCID: PMC4031151 DOI: 10.1371/journal.pone.0097630] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 04/17/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Using parent-completed questionnaires in (preventive) child health care can facilitate the early detection of psychosocial problems and psychopathology, including autism spectrum disorders (ASD). A promising questionnaire for this purpose is the Brief Infant-Toddler Social and Emotional Assessment (BITSEA). The screening accuracy with regard to ASD of the BITSEA Problem and Competence scales and a newly calculated Autism score were evaluated. METHOD Data, that was collected between April 2010 and April 2011, from a community sample of 2-year-olds (N = 3127), was combined with a sample of preschool children diagnosed with ASD (N = 159). For the total population and for subgroups by child's gender, area under the Receiver Operating Characteristic (ROC) curve was examined, and across a range of BITSEA Problem, Competence and Autism scores, sensitivity, specificity, positive and negative likelihood ratio's, diagnostic odds ratio and Youden's index were reported. RESULTS The area under the ROC curve (95% confidence interval, [95%CI]) of the Problem scale was 0.90(0.87-0.92), of the Competence scale 0.93(0.91-0.95), and of the Autism score 0.95(0.93-0.97). For the total population, the screening accuracy of the Autism score was significantly better, compared to the Problem scale. The screening accuracy of the Competence scale was significantly better for girls (AUC = 0.97; 95%CI = 0.95-0.98) than for boys (AUC = 0.91; 95%CI = 0.88-0.94). CONCLUSION The results indicate that the BITSEA scales and newly calculated Autism score have good discriminative power to differentiate children with and without ASD. Therefore, the BITSEA may be helpful in the early detection of ASD, which could have beneficial effects on the child's development.
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Williams K, Woolfenden S, Roberts J, Rodger S, Bartak L, Prior M. Autism in context 2: Assessment, intervention and services in Australia. J Paediatr Child Health 2014; 50:341-6. [PMID: 24422663 DOI: 10.1111/jpc.12456] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/27/2013] [Indexed: 11/27/2022]
Abstract
Continuing from part 1, part 2 of the autism spectrum disorders review explores clinical practice and service delivery aspects of autism spectrum disorders including current assessment approaches in Australia, family-centred models of care, and key service structure and delivery issues. Treatments including behavioural interventions, established and emergent medication, and complementary and alternative therapies are discussed. The key role of paediatricians as both individual child and family care providers and advocates, as well as agents of service reform in Australia, is evident. Much still needs to be done.
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Affiliation(s)
- Katrina Williams
- Developmental Medicine, Royal Children's Hospital, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Victoria, Australia
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Damiano CR, Mazefsky CA, White SW, Dichter GS. Future directions for research in autism spectrum disorders. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2014; 43:828-43. [PMID: 25216048 PMCID: PMC4163956 DOI: 10.1080/15374416.2014.945214] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article suggests future directions for research aimed at improving our understanding of the etiology and pathophysiology of autism spectrum disorder (ASD) as well as pharmacologic and psychosocial interventions for ASD across the lifespan. The past few years have witnessed unprecedented transformations in the understanding of ASD neurobiology, genetics, early identification, and early intervention. However, recent increases in ASD prevalence estimates highlight the urgent need for continued efforts to translate novel ASD discoveries into effective interventions for all individuals with ASD. In this article we highlight promising areas for ongoing and new research expected to quicken the pace of scientific discovery and ultimately the translation of research findings into accessible and empirically supported interventions for those with ASD. We highlight emerging research in the following domains as particularly promising and pressing: (a) preclinical models, (b) experimental therapeutics, (c) early identification and intervention, (d) psychiatric comorbidities and the Research Domain Criteria initiative, (e) ecological momentary assessment, (f) neurotechnologies, and (g) the needs of adults with ASD. Increased research emphasis in these areas has the potential to hasten the translation of knowledge on the etiological mechanisms of ASD to psychosocial and biological interventions to reduce the burden of ASD on affected individuals and their families.
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Affiliation(s)
- Cara R. Damiano
- Department of Psychology, University of North Carolina, Chapel Hill, NC
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC
| | - Carla A. Mazefsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Susan W. White
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | - Gabriel S. Dichter
- Department of Psychology, University of North Carolina, Chapel Hill, NC
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC
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Fulton E, Eapen V, Crnčec R, Walter A, Rogers S. Reducing maladaptive behaviors in preschool-aged children with autism spectrum disorder using the early start denver model. Front Pediatr 2014; 2:40. [PMID: 24847474 PMCID: PMC4023017 DOI: 10.3389/fped.2014.00040] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 04/25/2014] [Indexed: 11/13/2022] Open
Abstract
The presence of maladaptive behaviors in young people with autism spectrum disorder (ASD) can significantly limit engagement in treatment programs, as well as compromise future educational and vocational opportunities. This study aimed to explore whether the Early Start Denver Model (ESDM) treatment approach reduced maladaptive behaviors in preschool-aged children with ASD in a community-based long day care setting. The level of maladaptive behavior of 38 children with ASD was rated using an observation-based measure on three occasions during the intervention: on entry, 12 weeks post-entry, and on exit (post-intervention) over an average treatment duration of 11.8 months. Significant reductions were found in children's maladaptive behaviors over the course of the intervention, with 68% of children showing a treatment response by 12 weeks and 79% on exit. This change was accompanied by improvement in children's overall developmental level as assessed by the Mullen scales of early learning, but not by significant changes on the Vineland Adaptive Behavior Scales-II or Social Communication Questionnaire. Replication with a larger sample, control conditions, and additional measures of maladaptive behavior is necessary in order to determine the specific factors underlying these improvements; however, the findings of the present study suggest that the ESDM program may be effective in improving not only core developmental domains, but also decreasing maladaptive behaviors in preschool-aged children with ASD.
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Affiliation(s)
- Elizabeth Fulton
- KU Marcia Burgess Autism Specific Early Learning and Care Centre (ASELCC) , Liverpool, NSW , Australia ; Academic Unit of Child Psychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW , Australia
| | - Valsamma Eapen
- Academic Unit of Child Psychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW , Australia ; Infant, Child and Adolescent Mental Health (ICAMHS), South Western Sydney Local Health District , Liverpool, NSW , Australia
| | - Rudi Crnčec
- Academic Unit of Child Psychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW , Australia
| | - Amelia Walter
- Academic Unit of Child Psychiatry, School of Psychiatry, University of New South Wales , Sydney, NSW , Australia ; Infant, Child and Adolescent Mental Health (ICAMHS), South Western Sydney Local Health District , Liverpool, NSW , Australia
| | - Sally Rogers
- School of Psychiatry and Behavioral Sciences, University of California Davis Medical Center MIND Institute , Davis, CA , USA
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Houghton K, Schuchard J, Lewis C, Thompson CK. Promoting child-initiated social-communication in children with autism: Son-Rise Program intervention effects. JOURNAL OF COMMUNICATION DISORDERS 2013; 46:495-506. [PMID: 24209427 DOI: 10.1016/j.jcomdis.2013.09.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 08/15/2013] [Accepted: 09/23/2013] [Indexed: 06/02/2023]
Abstract
UNLABELLED This study examined the effects of the Son-Rise Program (SRP), an intensive treatment aimed to improve child-initiated social communication in children with autism. Six children between the ages of 47 and 78 months were provided with 40 h of SRP, with pre- to post-treatment behavioral changes tested using a novel passive interaction probe task. Results showed an increase in the frequency of spontaneous social orienting and gestural communication for the experimental children, compared to six age- and behaviorally-matched control children with autism. In addition, for the children who received treatment, the duration of social dyadic interactions and total time spent engaged in social interaction increased from pre- to post-treatment. These findings suggest that intensive intervention focused on fostering child-initiated interaction increases social-communicative behaviors in children with autism. LEARNING OUTCOMES Readers will be able to describe the principles underlying the Son-Rise Program, a developmental approach to treatment for autism. Readers will be able to explain the methods of the investigation of a 5-day intensive Son-Rise Program and the results that report change in social communication in children with autism.
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Affiliation(s)
- Kat Houghton
- Department of Psychology, Lancaster University, Fylde College, Lancaster LA1 4YF, United Kingdom.
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