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Ke F, Moon J, Sokolikj Z. Designing and deploying a virtual social sandbox for autistic children. Disabil Rehabil Assist Technol 2024; 19:1178-1209. [PMID: 36524469 DOI: 10.1080/17483107.2022.2156630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE This exploratory study was intended to investigate the design and feasibility of using a web virtual reality based social learning space for autistic children at home. MATERIALS AND METHODS The researchers of the current study developed and implemented an open-source, web virtual reality based learning program for children with autism. Endorsing mixed-method convergent parallel design, we collected both qualitative and quantitative data from four autistic children, including repeated measures of social skills performance, self- and parent-reported social and communication competence, observation notes, and individual interviews. RESULTS The study found preliminary evidence for a positive impact of deploying a virtual reality-based social sandbox on the practice and development of complex social skills for autistic children. All participants showed significant reduced social communication impairments from the pre- to the post-intervention phases. Nevertheless, participants' social skills performance in the virtual world was mediated by two social task design features-external goal structure and individualization. CONCLUSIONS Play- and design-oriented social tasks in the three-dimensional virtual world framed meaningful social experiences or the naturalistic intervention for social skills development.
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Affiliation(s)
- Fengfeng Ke
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, USA
| | - Jewoong Moon
- Department of Educational Leadership, Policy, and Technology Studies, University of Alabama, Tuscaloosa, AL, USA
| | - Zlatko Sokolikj
- Department of Scientific Computing, Florida State University, Tallahassee, FL, USA
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2
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Henderson TB, Ludden BJ, Romero RA. The Ethical Obligations, Barriers, and Solutions for Interprofessional Collaboration in the Treatment of Autistic Individuals. Behav Anal Pract 2023; 16:963-976. [PMID: 38076742 PMCID: PMC10700230 DOI: 10.1007/s40617-023-00787-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 04/28/2024] Open
Abstract
With an estimated 1 in 44 children having been diagnosed with autism and given the variety of types of service providers that treat autism, collaboration among these professionals is a necessary part of the overall treatment package for an autistic individual. However, like with any professional skill, competence in collaborating effectively must be developed, especially because behavior analysts have been criticized for being resistant to collaboration. Competence with collaboration may be developed through coursework, professional development opportunities, and supervision by someone who has demonstrated competence with collaboration. With the 2020 update to the Ethics Code for Behavior Analysts, the behavior analyst's role in collaborating with other professionals has been clarified by several expectations. Current literature also provides additional guidance on the potential barriers to collaboration as well as recommendations for how to support a collaborative team. In order to facilitate successful collaboration, it is also important to evaluate the effectiveness of the collaborative team and to take advantage of opportunities to learn about the methodologies and perspectives of the other professionals to ensure that the client's best interests are met.
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Affiliation(s)
| | | | - Regilda A. Romero
- UF Department of Psychiatry, Division of Psychology, University of Florida, Gainesville, FL USA
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3
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Schendel D, Roux AM, McGhee Hassrick E, Lyall K, Shea L, Vivanti G, Wieckowski AT, Newschaffer C, Robins DL. Applying a public health approach to autism research: A framework for action. Autism Res 2022; 15:592-601. [PMID: 35199493 DOI: 10.1002/aur.2689] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/20/2021] [Accepted: 02/08/2022] [Indexed: 12/26/2022]
Abstract
Most published autism research, and the funding that supports it, remains focused on basic and clinical science. However, the public health impact of autism drives a compelling argument for utilizing a public health approach to autism research. Fundamental to the public health perspective is a focus on health determinants to improve quality of life and to reduce the potential for adverse outcomes across the general population, including in vulnerable subgroups. While the public health research process can be conceptualized as a linear, 3-stage path consisting of discovery - testing - translation/dissemination/implementation, in this paper we propose an integrated, cyclical research framework to advance autism public health objectives in a more comprehensive manner. This involves discovery of primary, secondary and tertiary determinants of health in autism; and use of this evidence base to develop and test detection, intervention, and dissemination strategies and the means to implement them in 'real world' settings. The proposed framework serves to facilitate identification of knowledge gaps, translational barriers, and shortfalls in implementation; guides an iterative research cycle; facilitates purposeful integration of stakeholders and interdisciplinary researchers; and may yield more efficient achievement of improved health and well-being among persons on the autism spectrum at the population-level. LAY SUMMARY: Scientists need better ways to identify and address gaps in autism research, conduct research with stakeholders, and use findings to improve the lives of autistic people. We recommend an approach, based in public health science, to guide research in ways that might impact lives more quickly.
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Affiliation(s)
- Diana Schendel
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | - Anne M Roux
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | | | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | - Lindsay Shea
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | - Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
| | | | - Craig Newschaffer
- College of Health and Human Development, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Diana L Robins
- A.J. Drexel Autism Institute, Drexel University, University Park, Pennsylvania, Pennsylvania, USA
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4
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A Systematic Review of Play-Based Interventions Targeting the Social Communication Skills of Children with Autism Spectrum Disorder in Educational Contexts. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00286-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractChildren with autism spectrum disorder (ASD) experience social communication difficulties which can be compounded by increased social demands and expectations of the school environment. Play offers a unique context for social communication development in educational settings. This systematic review aimed to synthesize play-based interventions for the social communication skills of children with ASD in educational contexts and identified nine studies. Overall, studies in this review provided a promising evidence base for supporting social communication skills through play in education for children with ASD. The review also highlighted gaps in research on play-based interventions for the social communication skills of children with ASD within naturalistic educational settings.
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A Systematic Review of Randomized Controlled Trials on Healthy Relationship Skills and Sexual Health for Autistic Youth. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00274-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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6
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Abstract
The Early Start Denver Model (ESDM) is an evidence-based early intervention approach for young children with autism spectrum disorder. Although the ESDM is described by its authors as being rooted in applied behavior analysis (ABA), some states, agencies, and scholars consider the ESDM to qualify as ABA practice, whereas others do not. The purpose of this article is to examine the status of the ESDM in relation to the 7 dimensions established by Baer, Wolf, and Risley ("Some Current Dimensions of Applied Behavior Analysis," Journal of Applied Behavior Analysis, 1(1): 91-97, 1968) to define applied behavior-analytic research and intervention, as well as to discuss implications for the field.
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Affiliation(s)
- Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University, 3020 Market St., Suite 560, Philadelphia, PA 19104-3734 USA
| | - Aubyn C. Stahmer
- UC Davis MIND Institute, University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA
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7
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Vivanti G, Messinger DS. Theories of Autism and Autism Treatment from the DSM III Through the Present and Beyond: Impact on Research and Practice. J Autism Dev Disord 2021; 51:4309-4320. [PMID: 33491120 DOI: 10.1007/s10803-021-04887-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 12/14/2022]
Abstract
The purely descriptive definition of autism introduced by the DSM III in 1980 marked a departure from previous DSM editions, which mixed phenomenological descriptions with psychoanalytic theories of etiology. This provided a blank slate upon which a variety of novel theories emerged to conceptualize autism and its treatment in the following four decades. In this article we examine the contribution of these different theoretical orientations with a focus on their impact on research and practice, areas of overlap and conflict between current theories, and their relevance in the context of the evolving landscape of scientific knowledge and societal views of autism.
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Affiliation(s)
- Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Daniel S Messinger
- Departments of Psychology, Pediatrics, Music Engineering, Electrical and Computer Engineering, University of Miami, Coral Gables, FL, USA
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Valeri G, Casula L, Menghini D, Amendola FA, Napoli E, Pasqualetti P, Vicari S. Cooperative parent-mediated therapy for Italian preschool children with autism spectrum disorder: a randomized controlled trial. Eur Child Adolesc Psychiatry 2020; 29:935-946. [PMID: 31549310 DOI: 10.1007/s00787-019-01395-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 08/19/2019] [Indexed: 01/02/2023]
Abstract
Parent-mediated intervention is widely used for pre-schoolers with autism spectrum disorder (ASD). Previous studies indicate small-to-moderate effects on social communication skills, but with a wide heterogeneity that requires further research. In this randomized controlled trial (RCT), cooperative parent-mediated therapy (CPMT) an individual parent coaching program for young children with ASD was administered to preschool children with ASD. All children received the same low-intensity psychosocial intervention (LPI) delivered in community settings, to evaluate the potential additional benefit of CPMT. Thirty-four participants with ASD (7 females; 27 males; aged 2, 6, 11 years) and their parents were included in the trial. The primary blinded outcome was social communication skills, assessed using the ADOS-G social communication algorithm score (ADOS-G SC). Secondary outcomes included ASD symptom severity, parent-rated language abilities and emotional/behavioral problems, and self-reported caregiver stress. Evaluations were made at baseline and post-treatment (at 6 months) by an independent multidisciplinary team. Results documented that CPMT showed an additional benefit on LPI with significant improvements of the primary blinded outcome, socio-communication skills, and of some secondary outcomes such as ASD symptom severity, emotional problems and parental stress related to parent-child dysfunctional interaction. No additional benefit was found for language abilities. Findings of our RCT show that CPMT provide an additional significant short-term treatment benefit on ASD core symptoms, when compared with active control group receiving only LPI.
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Affiliation(s)
- Giovanni Valeri
- Department of Neuroscience, IRCCS Children's Hospital Bambino Gesù, Piazza Sant' Onofrio, 4 00165, Rome, Italy
| | - Laura Casula
- Department of Neuroscience, IRCCS Children's Hospital Bambino Gesù, Piazza Sant' Onofrio, 4 00165, Rome, Italy
| | - Deny Menghini
- Department of Neuroscience, IRCCS Children's Hospital Bambino Gesù, Piazza Sant' Onofrio, 4 00165, Rome, Italy
| | | | - Eleonora Napoli
- Department of Neuroscience, IRCCS Children's Hospital Bambino Gesù, Piazza Sant' Onofrio, 4 00165, Rome, Italy
| | - Patrizio Pasqualetti
- Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy
| | - Stefano Vicari
- Department of Neuroscience, IRCCS Children's Hospital Bambino Gesù, Piazza Sant' Onofrio, 4 00165, Rome, Italy.
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Nuske HJ, Pellecchia M, Lushin V, Rump K, Seidman M, Ouellette RR, Cooney D, Maddox BB, Lawson GM, Song A, Reisinger EM, Mandell DS. Do Student Characteristics Affect Teachers' Decisions to Use 1:1 Instruction? J Autism Dev Disord 2019; 49:2864-2872. [PMID: 30972654 DOI: 10.1007/s10803-019-04004-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
One-to-one instruction is a critical component of evidence-based instruction for students with autism spectrum disorder, but is not used as often as recommended. Student characteristics may affect teachers' decisions to select a treatment and/or implement it. This study examined the associations between students' clinical and demographic characteristics and teachers' reported use of discrete trial training (DTT) and pivotal response training (PRT). Children's higher sensory symptoms, lower social approach, lower verbal skills and higher self-regulation difficulties were associated with more frequent 1:1 DTT and PRT. Results suggest that teachers give more frequent 1:1 instruction to children with more observable impairments, do not match children to type of 1:1 intervention, and may inadvertently neglect other students for whom individualized intervention may still be beneficial.
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Affiliation(s)
- Heather J Nuske
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Melanie Pellecchia
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Viktor Lushin
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Keiran Rump
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Max Seidman
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rachel R Ouellette
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Diana Cooney
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brenna B Maddox
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Gwendolyn M Lawson
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amber Song
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica M Reisinger
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David S Mandell
- Penn Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Smith IM, Flanagan HE, Ungar WJ, D'Entremont B, Garon N, den Otter J, Waddell C, Bryson SE, Tsiplova K, Léger N, Vezina F, Murray P. Comparing the 1-year impact of preschool autism intervention programs in two Canadian provinces. Autism Res 2019; 12:667-681. [PMID: 30632299 DOI: 10.1002/aur.2072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 12/03/2018] [Accepted: 12/10/2018] [Indexed: 12/25/2022]
Abstract
Autism spectrum disorder (ASD) is associated with early differences in children's social interactions, communication, and play/interests. In many countries, considerable resources are invested in early intensive behavioral intervention (EIBI) programs for children with ASD, which aim to build adaptive skills and prevent or treat problem behavior. However, these programs vary widely in structure and delivery. Research evidence supports the efficacy of EIBI, but large knowledge gaps remain about the effectiveness of publicly funded EIBI programs. With policy-makers as formal research partners, we compared children's progress over 1 year in public preschool programs in adjacent Canadian provinces, New Brunswick (NB) and Nova Scotia (NS). In NB, children received up to 20 hr/week of comprehensive EIBI in a publicly funded, privately provided program. In NS, children received up to 15 hr/week of Pivotal Response Treatment and Positive Behavior Support delivered through the publicly funded healthcare system. In this observational parallel cohort study, we collected parent-reported data on 298 NB preschoolers (76.5% boys) and 221 NS preschoolers (86.9% boys) at EIBI start and 1 year later. Multilevel analysis revealed significant differences at baseline: NS children were older, with lower adaptive functioning and more severe ASD symptoms than NB children. Despite these pre-treatment differences that favor NB, children in both provinces showed similar adaptive functioning gains and reductions of maladaptive behavior. No changes were seen in mean ASD symptom severity in either province over time. Results highlight the value of evaluating interventions in their implementation contexts, and have important implications for devising optimal ASD policy. Autism Research 2019, 12: 667-681. © 2019 International Society for Autism Research,Wiley Periodicals, Inc. LAY SUMMARY: We need to know more about the impact of different forms of early intensive behavioral intervention (EIBI) for young children with autism spectrum disorder (ASD). We showed that preschoolers with ASD gained important skills while in public EIBI programs in two Canadian provinces. We also saw that differences in how EIBI programs are structured and characteristics of children who are served may affect outcomes. For these reasons, policy making requires evidence that fits the local context.
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Affiliation(s)
- Isabel M Smith
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.,Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Helen E Flanagan
- Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,The Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Barbara D'Entremont
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Nancy Garon
- Department of Psychology, Mount Allison University, Sackville, New Brunswick, Canada
| | - Jeffrey den Otter
- Department of Education and Early Childhood Development, Government of New Brunswick, Fredericton, New Brunswick, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Susan E Bryson
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.,Autism Research Centre, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Kate Tsiplova
- Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Natalie Léger
- Department of Education and Early Childhood Development, Government of New Brunswick, Fredericton, New Brunswick, Canada
| | - Francine Vezina
- Department of Health and Wellness, Government of Nova Scotia, Halifax, Nova Scotia, Canada
| | - Patricia Murray
- Department of Health and Wellness, Government of Nova Scotia, Halifax, Nova Scotia, Canada
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Colombi C, Vivanti G, Rogers S. Evidenced-Based Practices. HANDBOOK OF INTERDISCIPLINARY TREATMENTS FOR AUTISM SPECTRUM DISORDER 2019. [DOI: 10.1007/978-3-030-13027-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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12
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Vivanti G, Hamner T, Lee NR. Neurodevelopmental Disorders Affecting Sociability: Recent Research Advances and Future Directions in Autism Spectrum Disorder and Williams Syndrome. Curr Neurol Neurosci Rep 2018; 18:94. [DOI: 10.1007/s11910-018-0902-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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13
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Vivanti G, Kasari C, Green J, Mandell D, Maye M, Hudry K. Implementing and evaluating early intervention for children with autism: Where are the gaps and what should we do? Autism Res 2017; 11:16-23. [DOI: 10.1002/aur.1900] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/09/2017] [Accepted: 11/14/2017] [Indexed: 01/27/2023]
Affiliation(s)
- Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University; Philadelphia PA
| | - Connie Kasari
- Center for Autism Research and Treatment, UCLA; Los Angeles CA
| | | | - David Mandell
- Center for Mental Health Policy and Services Research, University of Pennsylvania; Philadelphia PA
| | | | - Kristelle Hudry
- Victorian Autism Specific Early Learning and Care Centre; and Olga Tennison Autism Research Centre, La Trobe University; Melbourne Australia
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