Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training

Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.

A Functional Developmental Approach to Autism Spectrum Disorders

Historically, severe developmental disabilities, including autism, have been approached from the point of view of presenting symptoms as well as the overall syndrome. Although individual practitioners, such as speech pathologists, occupational and physical therapists, and educators have worked with the child's individual capacities, a developmentally based functional approach has not been sufficiently articulated and systematized to guide assessment, intervention, and research efforts. In this article, we describe a dynamic, developmental model that conceptualizes the child's functional emotional developmental capacities, individual differences in sensory processing and modulation, motor planning and sequencing, as well as child/caregiver and family interaction patterns. Because each child with developmental challenges is unique, the functional developmental approach will capture the child's special strengths and challenges, as well as provide a more comprehensive and individualized framework for clinical work with a child and his or her family.

Play Behaviors of Young Children with Autism

Autism has been shown to be associated with deficits in play behavior. The play behaviors of children with autism indicate that they tend to have severe deficits in play, both with toys and with regard to social behaviors. A consistent finding in the literature has been that both symbolic play and symbolic language are areas in which children with autism show specific impairments. Interventions to promote the play behaviors of these children have involved the use of either nonhandicapped or disabled peers, the use of specific instructions or verbal and physical prompts, highly structured one-to-one interactions involving adults and peers, or manipulation of the setting. Although different intervention techniques have been successful in promoting play behaviors, there is some concern about lasting effects after the intervention.

A Synthesis of "Best Practice" Guidelines for Early Childhood Services

"Best practice" guidelines drawn from recent advances within the field of disability are reviewed and synthesized for the purpose of defining exemplary early childhood special education services. With both empirical and ideological support, the paper identifies six major characteristics of exemplary programs. Such programs provide services that are (a) integrated, (b) comprehensive, (c) normalized, (d) adaptable. (e) peer and family-referenced, and (f) outcome-based. Programmatic guidelines are addressed for each characteristic.

Views and attitudes of teachers on the educational integration of students with autism spectrum disorders

OBJECTIVES

To investigate the views and attitudes of Greek teachers on educational and vocational integration of students with autism spectrum disorders (ASD).

METHODS

A statistically reliable sample of questionnaires distributed towards a diversified teacher population is evaluated. The mean values of teachers' responses are analyzed with respect to critical independent variables: previous relevant training; and/or experience.

RESULTS

The majority of the sample had a positive view towards the educational and vocational integration of students with ASD. Nevertheless, teachers appear to be sceptical in assuming that these students can be efficiently treated in their classroom. The vast majority of teachers maintain that students with ASD can be trained in technical vocation. However, the absence of support services is highly ranked as the most serious constraint for vocational integration.

CONCLUSION

Training and experience substantially influenced teachers' views and attitudes in a positive way towards the integration of students with ASD.

Comparative efficacy of LEAP, TEACCH and non-model-specific special education programs for preschoolers with autism spectrum disorders

LEAP and TEACCH represent two comprehensive treatment models (CTMs) that have been widely used across several decades to educate young children with autism spectrum disorders. The purpose of this quasi-experimental study was to compare high fidelity LEAP (n = 22) and TEACCH (n = 25) classrooms to each other and a control condition (n = 28), in which teachers in high quality special education programs used non-model-specific practices. A total of 198 children were included in data analysis. Across conditions, children's performances improved over time. This study raises issues of the replication of effects for CTMs, and whether having access to a high quality special education program is as beneficial as access to a specific CTM.

Toddler autism screening questionnaire: Development and potential clinical validity

No feasible screening instrument is available for early detection of children with autism in Taiwan. The existing instruments may not be appropriate for use in Taiwan due to different health care systems and child-rearing cultures. The purpose of this study was to develop and test a screening questionnaire for generic autism. The initial 18-item screening questionnaire was developed by a child psychiatrist using face-to-face interviews with 10 families of children with autism and then tested on a sample of families of 18 children with autism and of 59 typically developing children. Of these 18 items, 15 had fair or better item discrimination (kappa >0.20) and were selected for the revised screening questionnaire. In the revised questionnaire, cutoff scores of 5 and 6 offered 100% sensitivity and 96.5% specificity, with the area under the receiver operating characteristic curve of 0.983. The revised screening instrument has high sensitivity and specificity, making it potentially useful for screening Taiwanese children at risk for autism. This instrument should be further tested in a population-based study.

Follow-up of children with autism spectrum disorders from age 2 to age 9

The purpose of the present study was to examine the developmental outcomes of children 7 years after their initial diagnosis. Children diagnosed with autism or PDD-NOS at age 2 received follow-up evaluations at age 9. Diagnostic stability was high, with 88 percent of the sample obtaining autism spectrum diagnoses at age 9. Cognitive scores improved considerably for a large segment of the sample, with over 50 percent obtaining scores in the average range at follow-up. Language outcomes were also positive at follow-up; 88 percent of the sample demonstrated at least some functional language, and 32 percent were able to engage in conversational exchanges. Early characteristics that predicted outcome status were: age of diagnosis, age 2 cognitive and language scores, and total hours of speech-language therapy between ages 2 and 3. These findings highlight the potential long-term benefits of both early identification and early intervention, and provide additional evidence for the importance of promoting public awareness of the early signs of autism.

Psychometric properties of the STAT for early autism screening

The STAT is an interactive screening measure for autism that assesses behaviors in the areas of play, communication, and imitation skills. In Study 1, signal detection procedures were employed to identify a cutoff score for the STAT using developmentally matched groups of 2-year-old children with autism and with nonspectrum disorders. The resulting cutoff yielded high sensitivity, specificity, and predictive values for the development sample as well as for an independent validation sample. Study 2 examined psychometric properties of the STAT and revealed acceptable levels of interrater agreement, test-retest reliability, and agreement between STAT risk category and ADOS-G classification. The STAT demonstrates strong psychometric properties and shows promising utility as a Level 2 screening measure for autism.

Full inclusion and students with autism

The concept of "full inclusion" is that students with special needs can and should be educated in the same settings as their normally developing peers with appropriate support services, rather than being placed in special education classrooms or schools. According to advocates the benefits of full inclusion are increased expectations by teachers, behavioral modeling of normally developing peers, more learning, and greater self-esteem. Although the notion of full inclusion has appeal, especially for parents concerned about their children's rights, there is very little empirical evidence for this approach, especially as it relates to children with autism. This manuscript addresses the literature on full inclusion and its applicability for students with autism. Although the goals and values underlying full inclusion are laudable, neither the research literature nor thoughtful analysis of the nature of autism supports elimination of smaller, highly structured learning environments for some students with autism.

Variant and invariant high-probability requests: increasing appropriate behaviors in children with emotional-behavioral disorders

This study examined the effects of variant versus invariant high-probability (high-p) request sequences on the performance of requests to initiate a social bid by young children with emotional-behavioral disorders. In the initial phases of the investigation, a multiple baseline design showed that the delivery of invariant sequences (i.e., high-p requests delivered in the same sequence) produced initial increases in compliance to requests to initiate a social bid to a peer. However, increases were not maintained across the invariant condition. The delivery of variant high-p sequences produced increases in compliance to requests to initiate social bids that were maintained across the variant condition. In a follow-up condition, the number of requests within the pool of the variant and invariant high-p requests were controlled. Results of the follow-up condition replicated those found in the initial condition. Implications for applied use and future research are discussed.

A structured parent interview for identifying young children with autism

This study evaluated the psychometric properties of the Parent Interview for Autism (PIA), a structured interview for gathering diagnostic information from parents of young children with autism. Internal consistency was evaluated in a sample of 165 children under 6 years old, and test-retest reliability and construct validity were evaluated in subsamples of the original group. Results revealed internal consistency and test-retest reliability above .60 for 9 of the 11 dimensions constituting the PIA, as well as significant correlations between the PIA and other measures of autism. Six of the PIA dimensions differentiated a group of young children with autism from a developmentally comparable group with mental retardation. Implications of these findings and suggestions for future research are discussed.

The effectiveness of early intervention: a critical review

The following principles are now clearly defined in the management of children with developmental delay: (1) Multidisciplinary teams are more effective than individual therapeutic approaches. (2) The whole development of the child needs to be considered rather than a single deficient area alone. (3) Home-based programmes are more effective in the young preschool child than centre-based programmes alone. (4) Parent involvement in partnership with professionals is essential for sustained progress. (5) Maximum effectiveness is achieved when parental skills are increased. (6) Programmes commencing earlier in preschool years are more effective than those that commence late. This concept has been recently challenged and evidence supports benefits for the disadvantaged rather than the disabled. White also contends that there is 'simply not enough information to be confident about the long-term impact of early intervention with handicapped children and evidence in support of many of the commonly held positions about mediating variables (e.g. parental involvement, age at start) is either non-existent or contradictory. Early intervention is clearly effective in offering parental support, fostering parent/child relationships and diminishing anxiety even for those programmes that have not at present been proven in altering the developmental disability. Programmes that involve high cost, disrupt total family functioning, deflect scarce resources away from more proven areas of effectiveness should be discouraged, and they should never cause guilt in either parent or professional when they seem ineffective. Future research should include investigation of outcomes other than cognitive and physical functioning alone. We should be warned from the somewhat crisp statement of Mark Twain: 'There is something fascinating about science. One gets such wholesale returns of conjecture out of such a trifling investment in fact'.(ABSTRACT TRUNCATED AT 250 WORDS)

Generalization and maintenance of preschool children's social skills: a critical review and analysis

This paper summarizes the results of a retrospective review of generalization in the context of social skills research with preschool children. A review of studies from 22 journals (1976 to 1990) that assessed generalization as part of social interaction research provided information concerning the prevalence of studies that have assessed generalization, common practices concerning the production and assessment of generalization, and the overall success of obtaining generalization and maintenance of social behaviors. A comparison of the most and least successful studies, with respect to generalization, revealed some differences concerning the practices employed by studies within each group. Differences differentially related to the production of generalization are discussed and recommendations are provided to guide and support future research efforts.

Changes in cognitive and language functioning of preschool children with autism

Preschool children with autism and their normally developing peers were compared on the Stanford-Binet IV and Preschool Language Scale before and after 1 school year. Both measures showed that although the children with autism functioned at a lower level than their normally developing peers, the children with autism had narrowed this gap after treatment, making a nearly 19-point increase in IQ and an 8-point gain in language quotient. The IQ measure remained stable for the normally developing peers while their language showed a 7.73-point increase. The data support the notion that young children with autism can make very significant developmental gains.

A Specialized Program for Preschool Children With Autism

In this paper, the work being conducted at the Douglass Developmental Disabilities Center of Rutgers University is described. Specifically, the recent results of research supporting the value of group-focused instruction for some young children with autism is reported. These findings just begin to address some of the questions about that small group of students who comprise the spectrum of autism. Further research and experience should continue to facilitate current efforts to design and implement the most comprehensive continuum of services.

Changes in language development among autistic and peer children in segregated and integrated preschool settings

Five young children with autism enrolled in a segregated class, five other children with autism in an integrated class, and four normally developing peer children in the integrated class were compared for developmental changes in language ability as measured by the Preschool Language Scale before and after training. The results, based on Mann-Whitney U tests, showed that (a) all of the children as a group made better than normative progress in rate of language development, (b) the scores of the autistic children were significantly lower than the peers before and after treatment, and (c) there were no significant differences in changes in language ability between the autistic children in the segregated and integrated classes.