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Nicholas DB, Zulla RT, Cielsielski J, Zwaigenbaum L, Conlon O. COVID-19 Pandemic Experiences of Families in Which a Child/Youth Has Autism and Their Service Providers: Perspectives and Lessons Learned. J Autism Dev Disord 2024:10.1007/s10803-024-06402-6. [PMID: 38767817 DOI: 10.1007/s10803-024-06402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE The impacts of the COVID-19 pandemic on autistic children/youth and their families and on service providers are not yet well-understood. This study explored the lived experiences of families with an autistic child and service providers who support them regarding the impacts of the pandemic on service delivery and well-being. METHODS In this qualitative study, families and service providers (e.g., early intervention staff, service providers, school personnel) supporting autistic children/youth were interviewed. Participants were recruited from a diagnostic site and two service organizations that support autistic children/youth. RESULTS Thirteen parents and 18 service providers participated in either an individual or group interview. Findings indicate challenges associated with pandemic restrictions and resulting service shifts. These challenges generally imposed negative experiences on the daily lives of autistic children/youth and their families, as well as on service providers. While many were adversely affected by service delivery changes, families and service agencies/providers pivoted and managed challenges. Shifts have had varied impacts, with implications to consider in pandemic planning and post-pandemic recovery. CONCLUSION Results highlight the need for autism-focused supports, as well as technology and pandemic preparedness capacity building within health, therapeutic and educational sectors in order to better manage shifts in daily routines during emergencies such as a pandemic. Findings also offer instructive consideration in service delivery post-pandemic.
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Affiliation(s)
- David B Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada.
| | - Rosslynn T Zulla
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Jill Cielsielski
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Olivia Conlon
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Edmonton, AB, Canada
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Richard Williams N, Hurt-Thaut C, Brian J, Tremblay L, Pranjić M, Teich J, Tan M, Kowaleski J, Thaut M. Improved motor skills in autistic children after three weeks of neurologic music therapy via telehealth: a pilot study. Front Psychol 2024; 15:1355942. [PMID: 38778884 PMCID: PMC11110893 DOI: 10.3389/fpsyg.2024.1355942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
Background Many autistic children experience motor skill deficits which can impact other areas of functioning, and research on therapeutic interventions for motor skills in autism is in a preliminary stage. Music-based therapies have been used extensively to address motor skills in non-autistic populations. Though a handful of studies exist on the effects of music-based therapies for movement in autistic children, none have investigated the possibility of administering sessions via telehealth. This mixed-methods pilot study investigated whether nine Neurologic Music Therapy (NMT)® sessions via telehealth would improve motor and attention skills in autistic children. Methods Five autistic children between five and 10 years of age participated in the study, with support from their caregivers. Motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency second edition, short form (BOT-2 SF), and a selective attention and sustained attention task were taken from the Test of Everyday Attention for Children, Second Edition (TEA-Ch2). Caregivers and the two neurologic music therapists involved in the study provided qualitative input about the perceived effectiveness of telehealth NMT for the children involved. Their responses were analyzed using qualitative content analysis. Caregivers also filled out a Sensory Profile 2 assessment prior to the onset of sessions so that each child's sensory profile could be compared to their motor and attention results. Results Statistically significant improvements in motor skills were observed between pre-test assessment and a two-week follow-up assessment. Results from attention test scores were not significant. Caregivers and neurologic music therapists generally perceived sessions positively and noted the importance of having caregivers actively involved. When compared with individual progress on the BOT-2 SF assessment, sensory profile results revealed that children with fewer sensory sensitivities tended to improve the most on motor skills. The improvements in motor skills and positive caregiver and therapist views of telehealth indicate that NMT motor interventions administered via telehealth are a promising avenue of therapeutic support for movement skill development in autistic children.
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Affiliation(s)
- Nicole Richard Williams
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- College of Music and Performing Arts, Belmont University, Nashville, TN, United States
| | - Corene Hurt-Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Jessica Brian
- Bloorview Research Institute, University of Toronto, Toronto, ON, Canada
| | - Luc Tremblay
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Marija Pranjić
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Jessica Teich
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Melissa Tan
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Julia Kowaleski
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Michael Thaut
- Music and Health Science Research Collaboratory, Faculty of Music, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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Montenegro MC, Ramírez AC, Hernandez Rodriguez J, Villalobos BT, Garrido G, Amigo C, Valdez D, Barrios N, Cukier S, Rattazzi A, Rosoli A, García R, Paula CS, Liz GP, Montiel-Nava C. Where I am from matters: factors influencing behavioral and emotional changes in autistic individuals during COVID-19 in Latin America. Front Psychiatry 2023; 14:1283326. [PMID: 38188048 PMCID: PMC10770844 DOI: 10.3389/fpsyt.2023.1283326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Background The COVID-19 pandemic brought an increased incidence of disease and mortality in the world at large, making it a particularly salient and stressful life event. For those individuals residing in Latin America, the pandemic was met with fragmented healthcare systems, economic downturn, and sociopolitical crisis which puts autistic individuals at risk for more detrimental outcomes. Behavioral and emotional challenges experienced by autistic individuals at the beginning of the pandemic could later develop into more severe symptomatology as the pandemic progresses. The present study aimed to explore changes in dysregulated (overt and internalizing) behaviors and preoccupation with getting sick during the COVID-19 pandemic among autistic children in 7 Latin American countries. Method Sample consisted of 1,743 caregivers, residing in: Argentina (n = 677, 38.8%) Brazil (n = 156, 9%), Chile (n = 251, 14.4%), Dominican Republic (n = 171, 9.8%), Mexico (n = 126, 7.2%), Uruguay (n = 259, 14.9%) and Venezuela (n = 103, 5.9%). The majority of caregivers who completed the questionnaire were mothers (85.1%), and most had a male autistic child (81.6%). A series of independent sample t-tests were conducted to assess country differences in dysregulated behaviors and preoccupation with getting sick. Linear regressions were conducted to identify which demographic characteristics and micro-level contextual factors predicted dysregulated overt behaviors and psychological changes. Results Contextual factors, such as country of residence, were related to preoccupation with getting sick and dysregulated behavior. Particularly, residing in Mexico and Brazil were related to changes in preoccupation with getting sick and mental health concerns. Coexistence predicted dysregulated internalizing behaviors, while being older significantly predicted preoccupation with getting sick. Increased screen time only predicted anxiety. Conclusion Our findings highlight differences and predictions of behavioral challenges and psychological changes based on certain contextual factors and individual characteristics while experiencing severe life stressors such as a worldwide pandemic. This knowledge could help inform policies and decrees aimed at protecting those most vulnerable due to their increased difficulty adapting to change.
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Affiliation(s)
- María Cecilia Montenegro
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | - Ana C. Ramírez
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | | | - Bianca T. Villalobos
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, United States
| | | | | | - Daniel Valdez
- Facultad Latinoamericana de Ciencias Sociales (FLACSO), Ayacucho, Argentina
| | - Natalia Barrios
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Buenos Aires, Argentina
| | - Sebastián Cukier
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Buenos Aires, Argentina
| | - Alexia Rattazzi
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Buenos Aires, Argentina
| | - Analía Rosoli
- Organización Estados Iberoamericanos para la Educación, la Ciencia y la Cultura (OEI), Santo Domingo, Dominican Republic
| | | | - Cristiane S. Paula
- Developmental Disorder Program, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Georgina Pérez Liz
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Cecilia Montiel-Nava
- Department of Psychological Science, University of Texas Rio Grande Valley, Edinburg, TX, United States
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Kolb RL, McComas JJ, Girtler SN, Simacek J, Dimian AF, Unholz-Bowden EK, Shipchandler AH. Teaching Requesting to Individuals with Rett Syndrome Using Alternative Augmentative Communication (AAC) Through Caregiver Coaching via Telehealth. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023; 35:1063-1090. [PMID: 38053943 PMCID: PMC10697698 DOI: 10.1007/s10882-023-09894-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 12/07/2023]
Abstract
Rett syndrome is a severe neurodevelopmental disorder that results in both motor and language skill regression with a wide range of severity in symptom presentation. Communication intervention may be particularly challenging for this population due to the decline in speech, motor skills, and motor planning difficulties that characterize the disorder (Townend et al., 2020), often resulting in the need for augmentative and alternative communication (AAC) technology. Very limited research has evaluated communication interventions for individuals with Rett syndrome and even fewer have targeted expressive communication, an important skill required for improved autonomy and quality of life (Sigafoos et al., 2009; Townend et al., 2020). The current study sought to systematically replicate the Simacek et al. (2017) mand training procedures to teach three girls with Rett Syndrome to use AAC to make requests through caregiver coaching by researchers via telehealth. Results suggest that mand training was successful in increasing AAC use for all three participants. Barriers to intervention for this population and implications of results for future research and clinical practice are discussed.
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Affiliation(s)
- Rebecca L. Kolb
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Jennifer J. McComas
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Shawn N. Girtler
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Jessica Simacek
- Institute on Community Integration, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN 55414, USA
| | - Adele F. Dimian
- Institute on Community Integration, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN 55414, USA
| | - Emily K. Unholz-Bowden
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Alefyah H. Shipchandler
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
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Carroll R, Halbur M, Preas E. Developing and Delivering Behavioral Interventions Through Telehealth. Behav Modif 2023; 47:291-296. [PMID: 36738177 DOI: 10.1177/01454455231153784] [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: 02/05/2023]
Abstract
This special issue on telehealth in Behavior Modification features 10 studies related to developing and delivering behavioral interventions through telehealth. The studies in this issue cover a variety of topics including using telehealth to train caregivers, training clinicians to use telehealth, and directly implementing interventions or assessments through telehealth. The special issue concludes with a comprehensive literature review examining variables that impact the effectiveness of telehealth as a service-delivery tool.
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Affiliation(s)
- Regina Carroll
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
| | - Mary Halbur
- University of Nebraska Medical Center's Munroe-Meyer Institute, Omaha, USA
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Meadan H, Lee JD, Chung MY. Parent-Implemented Interventions via Telepractice in Autism Research: A Review of Social Validity Assessments. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2022; 9:213-219. [PMID: 36405977 PMCID: PMC9640782 DOI: 10.1007/s40474-022-00259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/09/2022]
Abstract
Purpose of Review Parent-implemented autism interventions are considered empirically validated interventions and the use of telepractice in these interventions is reported as effective. However, little is known about the social validity assessments and outcomes of these interventions. The purpose of this review is to explore the current practices of conducting social validity assessment and reporting its outcomes within parent-implemented telepractice autism interventions. Recent Findings The 11 reviewed studies included caregivers as participants, telepractice intervention focusing on social communication outcomes of young autistic children, and were published in a peer-reviewed journal within the past five years. Summary The researchers in the reviewed articles reported positive outcomes for parent-implemented telepractice autism interventions. Notably, however, information about social validity assessments of the interventions was limited. Researchers are encouraged to evaluate the social validity of interventions using multiple data sources and methods, and report on their findings as they relate to other types of data.
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Affiliation(s)
- Hedda Meadan
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL 61820 USA
| | - James D. Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA USA
| | - Moon Y. Chung
- Department of Education Studies, Stonehill College, Easton, MA USA
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