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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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West KM. Treating Pediatric Feeding Disorders and Dysphagia: Evidence-Based Interventions for School-Based Clinicians. Lang Speech Hear Serv Sch 2024; 55:444-457. [PMID: 38198285 DOI: 10.1044/2023_lshss-23-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
PURPOSE Children with pediatric feeding disorder (PFD) and dysphagia are increasingly prevalent in school-based caseloads. This tutorial discusses the current best practices for treating children with PFD and dysphagia as well as considerations for service delivery in educational settings. METHOD The rationale for treating PFD and dysphagia in an educational setting is discussed. A review of various interventions for PFD and dysphagia and a discussion of the available evidence are provided. The principles of experience-dependent neuroplasticity and theory-driven practice are discussed in light of the need for additional empirical research. Practical considerations to enhance evidence-based practice for PFD and dysphagia in educational settings are explored. RESULTS The reader will be able to identify evidence-based interventions for students with PFD and dysphagia and plan for the implementation of these approaches in the school setting. CONCLUSIONS Students with PFD and dysphagia require skilled interventions to support their participation in educationally relevant activities and to promote continued development of feeding and swallowing skills while at school. A discussion of the current evidence for various interventions is provided to promote the utilization of evidence-based interventions in school-based settings.
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Affiliation(s)
- Kristen M West
- Department of Communication Sciences and Disorders, Pennsylvania Western University Edinboro, PA
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Bone ME, O'Connor Leppert ML. Autism Spectrum Disorder at Home and in School. Pediatr Clin North Am 2024; 71:223-239. [PMID: 38423717 DOI: 10.1016/j.pcl.2024.01.008] [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] [Indexed: 03/02/2024]
Abstract
The diagnosis of autism spectrum disorder (ASD) brings a lifetime of considerations for individuals and their families. The core symptoms of ASD vary in severity and influence behavior and function across all environments. Co-occurring medical, mental health, cognitive, language, learning, and behavioral differences add challenges to those associated with core symptoms. Navigating the preschool, school, and transition ages in the educational setting requires continual reassessment of the strengths, weaknesses, and needs of the student to provide appropriate placement and services.
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Affiliation(s)
- Megan E Bone
- Department of Neurology, Johns Hopkins University School of Medicine; Department of Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA.
| | - Mary L O'Connor Leppert
- Department of Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins University School of Medicine
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Riedelbauch S, Gaigg SB, Thiel T, Roessner V, Ring M. Examining a model of anxiety in autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:565-579. [PMID: 37329157 PMCID: PMC10913331 DOI: 10.1177/13623613231177777] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
ABSTRACT Anxiety disorders commonly occur in autism. Existing studies implicate intolerance of uncertainty, alexithymia, sensory processing differences and emotion regulation difficulties as influencing factors of anxiety in autism. To date, a few studies have considered the combination of these factors within the same sample. This study used structural equation modelling to test the prediction that intolerance of uncertainty and emotion regulation constitute more direct causes of anxiety in autism that mediate the influences of sensory processing difference and alexithymia as more sequential contributing factors. Autistic (n = 86) and non-autistic adults (n = 100) completed a battery of self-report questionnaires. Only when applied to each group separately, the broad predictions of the model were confirmed for the autistic group following data-driven additions of paths between sensory processing difference and anxiety and alexithymia implying that sensory processing difference contribute indirectly as well as directly to individual differences in anxiety. For the non-autistic group, model fit could only be achieved after removing autism-related traits and sensory processing differences as predictors of anxiety. These results suggest that aetiology and expression of anxiety in autism partially overlap with what is observed in the general population except that sensory processing differences appear to play a relatively unique role in the context of autism.
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Affiliation(s)
- Saskia Riedelbauch
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | | | - Tobias Thiel
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
| | - Melanie Ring
- Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Medizinische Fakultät, Technische Universität Dresden, Dresden, Germany
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Heffler KF, Acharya B, Subedi K, Bennett DS. Early-Life Digital Media Experiences and Development of Atypical Sensory Processing. JAMA Pediatr 2024; 178:266-273. [PMID: 38190175 PMCID: PMC10775079 DOI: 10.1001/jamapediatrics.2023.5923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/30/2023] [Indexed: 01/09/2024]
Abstract
Importance Atypical sensory processing is challenging for children and families, yet there is limited understanding of its associated risk factors. Objective To determine the association between early-life digital media exposure and sensory processing outcomes among toddlers. Design, Setting, and Participants This multicenter US study used data that were analyzed from the National Children's Study (NCS), a cohort study of environmental influences on child health and development, with enrollment from 2011 to 2014. Data analysis was performed in 2023. The study included children enrolled in the NCS at birth whose caregivers completed reports of digital media exposure and sensory processing. Exposures Children's viewing of television or video at 12 months (yes or no), 18 months, and 24 months of age (hours per day). Main Outcomes and measures Sensory processing was reported at approximately 33 months of age on the Infant/Toddler Sensory Profile. Quadrant scores (low registration, sensation seeking, sensory sensitivity, and sensation avoiding) were categorized into groups representing typical, high, and low sensory-related behaviors, and multinomial regression analyses were performed. Results A total of 1471 children (50% male) were included. Screen exposure at 12 months of age was associated with a 2-fold increased odds of being in the high category of low registration (odds ratio [OR], 2.05; 95% CI, 1.31-3.20), while the odds of being in the low category instead of the typical category decreased for sensation seeking (OR, 0.55; 95% CI, 0.35-0.87), sensation avoiding (OR, 0.69; 95% CI, 0.50-0.94), and low registration (OR, 0.64; 95% CI, 0.44-0.92). At 18 months of age, greater screen exposure was associated with increased risk of high sensation avoiding (OR, 1.23; 95% CI, 1.03-1.46) and low registration (OR, 1.23; 95% CI, 1.04-1.44). At 24 months of age, greater screen exposure was associated with increased risk of high sensation seeking (OR, 1.20; 95% CI, 1.02-1.42), sensory sensitivity (OR, 1.25; 95% CI, 1.05-1.49), and sensation avoiding (OR, 1.21; 95% CI, 1.03-1.42). Conclusions and Relevance In this cohort study, early-life digital media exposure was associated with atypical sensory processing outcomes in multiple domains. These findings suggest that digital media exposure might be a potential risk factor for the development of atypical sensory profiles. Further research is needed to understand the relationship between screen time and specific sensory-related developmental and behavioral outcomes, and whether minimizing early-life exposure can improve subsequent sensory-related outcomes.
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Affiliation(s)
- Karen Frankel Heffler
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
- Tower Health, West Reading, Pennsylvania
| | - Binod Acharya
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania
| | - Keshab Subedi
- Institute for Research on Equity and Community Health (iREACH), Christiana Care Health Systems, Newark, Delaware
| | - David S Bennett
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, Pennsylvania
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Randell E, McNamara R, Busse M, Delport S, Williams-Thomas R, Maboshe W, Gillespie D, Milosevic S, Brookes-Howell L, Wright M, Hastings RP, McKigney AM, Glarou E, Ahuja A. Exploring critical intervention features and trial processes in the evaluation of sensory integration therapy for autistic children. Trials 2024; 25:131. [PMID: 38368387 PMCID: PMC10873975 DOI: 10.1186/s13063-024-07957-6] [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: 07/17/2023] [Accepted: 01/30/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND We evaluated the clinical and cost-effectiveness of manualised sensory integration therapy (SIT) for autistic children with sensory processing difficulties in a two-arm randomised controlled trial. Trial processes and contextual factors which may have affected intervention outcomes were explored within a nested process evaluation. This paper details the process evaluation methods and results. We also discuss implications for evaluation of individual level, tailored interventions in similar populations. METHODS The process evaluation was conducted in line with Medical Research Council guidance. Recruitment, demographics, retention, adherence, and adverse effects are reported using descriptive statistics. Fidelity of intervention delivery is reported according to the intervention scoring manual. Qualitative interviews with therapists and carers were undertaken to explore the acceptability of the intervention and trial processes. Qualitative interviews with carers explored potential contamination. RESULTS Recruitment, reach and retention within the trial met expected thresholds. One hundred thirty-eight children and carers were recruited (92% of those screened and 53.5% of those who expressed an interest) with 77.5% retained at 6 months and 69.9% at 12 months post-randomisation. The intervention was delivered with structural and process fidelity with the majority (78.3%) receiving a 'sufficient dose' of intervention. However, there was considerable individual variability in the receipt of sessions. Carers and therapists reported that trial processes were generally acceptable though logistical challenges such as appointment times, travel and COVID restrictions were frequent barriers to receiving the intervention. No adverse effects were reported. CONCLUSIONS The process evaluation was highly valuable in identifying contextual factors that could impact the effectiveness of this individualised intervention. Rigorous evaluations of interventions for autistic children are important, especially given the limitations such as limited sample sizes and short-term follow-up as faced by previous research. One of the challenges lies in the variability of outcomes considered important by caregivers, as each autistic child faces unique challenges. It is crucial to consider the role of parents or other caregivers in facilitating access to these interventions and how this may impact effectiveness. TRIAL REGISTRATION This trial is registered as ISRCTN14716440. August 11, 2016.
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Affiliation(s)
| | | | - Monica Busse
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | | | | | | | | | - Melissa Wright
- School of Medicine, Cardiff University, Ty Dewi Sant, Heath Park, Cardiff, UK
| | - Richard P Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR), University of Warwick, Coventry, UK
| | | | - Eleni Glarou
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Alka Ahuja
- Aneurin Bevan University Health Board, Newport, UK
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Kalathil Balakrishnan H, Schultz AG, Lee SM, Alexander R, Dumée LF, Doeven EH, Yuan D, Guijt RM. 3D printed porous membrane integrated devices to study the chemoattractant induced behavioural response of aquatic organisms. LAB ON A CHIP 2024; 24:505-516. [PMID: 38165774 DOI: 10.1039/d3lc00488k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Biological models with genetic similarities to humans are used for exploratory research to develop behavioral screening tools and understand sensory-motor interactions. Their small, often mm-sized appearance raises challenges in the straightforward quantification of their subtle behavioral responses and calls for new, customisable research tools. 3D printing provides an attractive approach for the manufacture of custom designs at low cost; however, challenges remain in the integration of functional materials like porous membranes. Nanoporous membranes have been integrated with resin exchange using purpose-designed resins by digital light projection 3D printing to yield functionally integrated devices using a simple, economical and semi-automated process. Here, the impact of the layer thickness and layer number on the porous properties - parameters unique for 3D printing - are investigated, showing decreases in mean pore diameter and porosity with increasing layer height and layer number. From the same resin formulation, materials with average pore size between 200 and 600 nm and porosity between 45% and 61% were printed. Membrane-integrated devices were used to study the chemoattractant induced behavioural response of zebrafish embryos and planarians, both demonstrating a predominant behavioral response towards the chemoattractant, spending >85% of experiment time in the attractant side of the observation chamber. The presented 3D printing method can be used for printing custom designed membrane-integrated devices using affordable 3D printers and enable fine-tuning of porous properties through adjustment of layer height and number. This accessible approach is expected to be adopted for applications including behavioural studies, early-stage pre-clinical drug discovery and (environmental) toxicology.
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Affiliation(s)
- Hari Kalathil Balakrishnan
- Centre for Rural and Regional Futures, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia.
- Institute for Frontier Materials, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia
| | - Aaron G Schultz
- School of Life and Environmental Sciences, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia
| | - Soo Min Lee
- Centre for Rural and Regional Futures, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia.
| | - Richard Alexander
- Centre for Rural and Regional Futures, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia.
| | - Ludovic F Dumée
- Department of Chemical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
- Research and Innovation Centre on CO2 and Hydrogen, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Egan H Doeven
- School of Life and Environmental Sciences, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia
| | - Dan Yuan
- Centre for Rural and Regional Futures, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia.
- School of Mechanical and Mining Engineering, The University of Queensland, Brisbane, QLD 4072, Australia.
| | - Rosanne M Guijt
- Centre for Rural and Regional Futures, Deakin University, Locked Bag 20000, Geelong, VIC 3320, Australia.
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Dollion N, Poirier M, Auffret F, François N, Plusquellec P, Grandgeorge M. Effects of service dogs on children with ASD's symptoms and parents' well-being: On the importance of considering those effects with a more systemic perspective. PLoS One 2024; 19:e0295702. [PMID: 38170689 PMCID: PMC10763939 DOI: 10.1371/journal.pone.0295702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
The integration of a service dog can have numerous benefits for children with Autism Spectrum Disorder (ASD). However, although integration takes place within a family, little is known about the dynamics of these benefits on the family microsystem. Thus, the aim of our study was to propose a more systemic perspective, not only by investigating the benefits of SD integration, but also by exploring the relationships between improvements in children with ASD, parents' well-being, parenting strategies and the quality of the child-dog relationship. Twenty parent-child with ASD dyads were followed before, as well as 3 and 6 months after service dog integration. At each stage, parents completed an online survey which included: the Autism Behavior Inventory (ABI-S), the State-Trait Anxiety Inventory (STAI-Y), the Parenting Stress Index Short Version (PSI-SF), the Monash Dog Owner Relationship Scale (MDORS) and the Parenting Styles and Dimensions Questionnaire (PSDQ). First, repeated measure one-way ANOVAs revealed that both children's ASD symptoms and parents' anxiety decreased significantly after service dog integration. Additionally, Spearman correlations revealed that the more ASD symptoms decreased, the more parent's anxiety and parenting stress also decreased. Second, the quality of the child-dog relationship appeared to contribute to those benefits on both children's ASD symptoms and parents' well-being. Interestingly, parenting strategies seemed to adapt according to these benefits and to the quality of the child-dog relationship. Through a more systemic perspective, this study highlighted that the integration of a service dog involved reciprocal and dynamic effects for children with ASD and their parents, and shed new light on the processes that may underlie the effects of a service dog for children with ASD.
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Affiliation(s)
- Nicolas Dollion
- Laboratoire C2S (Cognition Santé Société)–EA6291, Université Reims Champagne-Ardenne, Reims, France
| | - Margot Poirier
- CNRS, EthoS (Éthologie animale et humaine)—UMR6552, Normandie Univ, Univ Rennes, Rennes, France
| | | | | | - Pierrich Plusquellec
- Centre d’études en sciences de la communication non verbale, Research Centre, Montréal Mental Health University Institute, CIUSSS Est, Montréal, Canada
- School of Psychoeducation, University of Montréal, Montréal, QC, Canada
| | - Marine Grandgeorge
- CNRS, EthoS (Éthologie animale et humaine)—UMR6552, Normandie Univ, Univ Rennes, Rennes, France
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Choudhury I, Tarver T, Davis M, Reynolds S. Studying the Specificity of Research Reporting for Ayres Sensory Integration® Interventions in the Published Literature: A Scoping Review. Am J Occup Ther 2024; 78:7801205010. [PMID: 38272010 DOI: 10.5014/ajot.2024.050558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
IMPORTANCE A contributing factor to the gap between research publication and clinical implementation is the lack of specificity used when reporting findings. OBJECTIVE This scoping review used the Rehabilitation Treatment Specification System (RTSS) to determine which elements of specificity are most often present and omitted from research using Ayres Sensory Integration® (ASI). DATA SOURCES The following databases were searched: PubMed, CINAHL, PsycINFO, Cochrane Library, and ERIC. STUDY SELECTION AND DATA COLLECTION Eligible studies used ASI in an outpatient setting with children who had sensory integration or processing difficulties. Studies selected were quantitative (Level 1, 2, 3, or 4), available in full text, peer reviewed, and published in English within the past 20 yr. FINDINGS Of the 22 studies that met inclusion criteria, 100% included ingredients (actions of the therapist), 63% included mechanisms of action (reasoning behind these actions), 86% included targets, and 23% described client progression. We also found that 49% of all ingredients were listed in conjunction with a target, 15% were listed in conjunction with a mechanism of action, and 11% were listed in conjunction with both a target and a mechanism of action. CONCLUSIONS AND RELEVANCE Findings indicate that many studies list ingredients but often omit the mechanism of action. This omission makes replication of the intervention increasingly difficult and prevents a deeper understanding of the clinical reasoning process behind the intervention. Plain-Language Summary: Gaps identified in this scoping review highlight inconsistencies in the reporting of treatment specificity that may affect the replication and translation of Ayres Sensory Integration® (ASI) research into practice.
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Affiliation(s)
- Ishanie Choudhury
- Ishanie Choudhury, BS, is Student, Occupational Therapy Department, Virginia Commonwealth University, Richmond
| | - Talicia Tarver
- Talicia Tarver, MEd, MLIS, is Associate Professor and Research and Education Librarian, Health Sciences Library, Virginia Commonwealth University, Richmond
| | - Mary Davis
- Mary Davis, BS, is Student, Occupational Therapy Department, Virginia Commonwealth University, Richmond
| | - Stacey Reynolds
- Ishanie Choudhury, BS, is Student, Occupational Therapy Department, Virginia Commonwealth University, Richmond
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Chung KM, Chung E, Lee H. Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis. Soa Chongsonyon Chongsin Uihak 2024; 35:29-38. [PMID: 38204739 PMCID: PMC10774556 DOI: 10.5765/jkacap.230019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/21/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.
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Affiliation(s)
- Kyong-Mee Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Eunsun Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Hoomyung Lee
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
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Fan MSN, Li WHC, Ho LLK, Phiri L, Choi KC. Nature-Based Interventions for Autistic Children: A Systematic Review and Meta-Analysis. JAMA Netw Open 2023; 6:e2346715. [PMID: 38060224 DOI: 10.1001/jamanetworkopen.2023.46715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
Importance There is a gap in the evidence regarding nature-based interventions (NBIs) for children with autism spectrum disorder (ASD). Objective To systematically review and meta-analyze available evidence on the health-related outcomes in NBIs for children with ASD. Data Sources The Cumulative Index to Nursing and Allied Health Literature, Cochrane, Embase, Emcare, Education Resources Information Center, Global Health, MEDLINE, PsycInfo, SPORTDiscus, and Web of Science were searched from inception until May 2023. Google Scholar and references from included studies were searched for additional studies. Study Selection Included studies were randomized clinical trials (RCTs), controlled studies, and single-group before-and-after studies that reported health-related outcomes. Data Extraction and Synthesis This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guidelines. Random-effects meta-analyses were used to synthesize the data. The findings of studies that were ineligible for meta-analysis were summarized according to the Synthesis Without Meta-analysis (SWIM) reporting guidelines. Main Outcomes and Measures The outcomes of interest were health-related outcomes (ie, social functioning, behavioral functioning, emotional functioning, sensory functioning) and the self-reported well-being of children with ASD. Results A total of 24 studies with 717 participants (mean age range, 5.3 to 17.8 years; 141 [21.9%] female) were included. A meta-analysis from 13 studies indicated a significant negative moderate association between NBIs and social communication (standardized mean difference [SMD], -0.59; 95% CI, -0.85 to -0.34). For behavioral functioning outcomes, NBIs showed a significant moderate association with reduced hyperactivity (SMD, -0.56; 95% CI, -0.86 to -0.26) and a small to moderate association with reduced irritability (SMD, -0.49; 95% CI, -0.79 to -0.19). For sensory functioning, NBIs were significantly associated with improved inattention and distractibility (SMD, 1.13; 95% CI, 0.67 to 1.60). Significant moderate associations were observed in sensory seeking (SMD, 0.77; 95% CI, 0.33 to 1.22; P < .001; I2 = 0%) and sensory sensitivity (SMD, 0.56; 95% CI, 0.12 to 1.00; P = .01; I2 = 0%). Heterogeneity of the intervention effects was not high, and I2 ranged from 0% to 67%. Conclusions and Relevance The findings of this systematic review and meta-analysis suggested an association of NBIs in group-based recreational therapy with experiential learning with positive short-term outcomes on sensory, social, and behavioral functioning for children with ASD. Future evidence using robust study design to aid the health and functional trajectories of children with ASD is recommended.
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Affiliation(s)
| | | | | | - Lophina Phiri
- The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- The Chinese University of Hong Kong, Hong Kong, China
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Sandbank M, Bottema-Beutel K, Crowley LaPoint S, Feldman JI, Barrett DJ, Caldwell N, Dunham K, Crank J, Albarran S, Woynaroski T. Autism intervention meta-analysis of early childhood studies (Project AIM): updated systematic review and secondary analysis. BMJ 2023; 383:e076733. [PMID: 37963634 PMCID: PMC10644209 DOI: 10.1136/bmj-2023-076733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/29/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE To summarize the breadth and quality of evidence supporting commonly recommended early childhood autism interventions and their estimated effects on developmental outcomes. DESIGN Updated systematic review and meta-analysis (autism intervention meta-analysis; Project AIM). DATA SOURCES A search was conducted in November 2021 (updating a search done in November 2017) of the following databases and registers: Academic Search Complete, CINAHL Plus with full text, Education Source, Educational Administration Abstracts, ERIC, Medline, ProQuest Dissertations and Theses, PsycINFO, Psychology and Behavioral Sciences Collection, and SocINDEX with full text, Trials, and ClinicalTrials.gov. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Any controlled group study testing the effects of any non-pharmacological intervention on any outcome in young autistic children younger than 8 years. REVIEW METHODS Newly identified studies were integrated into the previous dataset and were coded for participant, intervention, and outcome characteristics. Interventions were categorized by type of approach (such as behavioral, developmental, naturalistic developmental behavioral intervention, and technology based), and outcomes were categorized by domain (such as social communication, adaptive behavior, play, and language). Risks of bias were evaluated following guidance from Cochrane. Effects were estimated for all intervention and outcome types with sufficient contributing data, stratified by risk of bias, using robust variance estimation to account for intercorrelation of effects within studies and subgroups. RESULTS The search yielded 289 reports of 252 studies, representing 13 304 participants and effects for 3291 outcomes. When contributing effects were restricted to those from randomized controlled trials, significant summary effects were estimated for behavioral interventions on social emotional or challenging behavior outcomes (Hedges' g=0.58, 95% confidence interval 0.11 to 1.06; P=0.02), developmental interventions on social communication (0.28, 0.12 to 0.44; P=0.003); naturalistic developmental behavioral interventions on adaptive behavior (0.23, 0.02 to 0.43; P=0.03), language (0.16, 0.01 to 0.31; P=0.04), play (0.19, 0.02 to 0.36; P=0.03), social communication (0.35, 0.23 to 0.47; P<0.001), and measures of diagnostic characteristics of autism (0.38, 0.17 to 0.59; P=0.002); and technology based interventions on social communication (0.33, 0.02 to 0.64; P=0.04) and social emotional or challenging behavior outcomes (0.57, 0.04 to 1.09; P=0.04). When effects were further restricted to exclude caregiver or teacher report outcomes, significant effects were estimated only for developmental interventions on social communication (0.31, 0.13 to 0.49; P=0.003) and naturalistic developmental behavioral interventions on social communication (0.36, 0.23 to 0.49; P<0.001) and measures of diagnostic characteristics of autism (0.44, 0.20 to 0.68; P=0.002). When effects were then restricted to exclude those at high risk of detection bias, only one significant summary effect was estimated-naturalistic developmental behavioral interventions on measures of diagnostic characteristics of autism (0.30, 0.03 to 0.57; P=0.03). Adverse events were poorly monitored, but possibly common. CONCLUSION The available evidence on interventions to support young autistic children has approximately doubled in four years. Some evidence from randomized controlled trials shows that behavioral interventions improve caregiver perception of challenging behavior and child social emotional functioning, and that technology based interventions support proximal improvements in specific social communication and social emotional skills. Evidence also shows that developmental interventions improve social communication in interactions with caregivers, and naturalistic developmental behavioral interventions improve core challenges associated with autism, particularly difficulties with social communication. However, potential benefits of these interventions cannot be weighed against the potential for adverse effects owing to inadequate monitoring and reporting.
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Affiliation(s)
- Micheal Sandbank
- Division of Occupational Science and Occupational Therapy, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Jacob I Feldman
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
| | | | - Nicolette Caldwell
- Department of Curriculum and Instruction, University of Arkansas, Fayetteville, AR, USA
| | - Kacie Dunham
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | | | - Suzanne Albarran
- Department of Special Education, University of Texas at Austin, Austin, TX, USA
| | - Tiffany Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Kennedy Center, Nashville, TN, USA
- Department of Communication Sciences and Disorders, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
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Su WC, Cleffi C, Srinivasan S, Bhat A. Telehealth Versus Face-to-Face Fine Motor and Social Communication Interventions for Children With Autism Spectrum Disorder: Efficacy, Fidelity, Acceptability, and Feasibility. Am J Occup Ther 2023; 77:7706205130. [PMID: 38048263 PMCID: PMC10846418 DOI: 10.5014/ajot.2023.050282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
IMPORTANCE The efficacy of telehealth (TH) interventions needs to be studied. OBJECTIVE To compare the efficacy, fidelity, acceptability, and feasibility of face-to-face (F2F) versus TH seated play (SP) interventions among children with autism spectrum disorder (ASD). DESIGN As part of a larger randomized controlled trial, children were assigned to the SP group and received TH and F2F interventions over 8 wk using a pretest-posttest study design. SETTING A research lab or through videoconferencing. PARTICIPANTS Fifteen children with ASD (ages 5-14 yr) were randomly assigned to the SP group and received the intervention F2F or through TH. INTERVENTION Children received 16 SP intervention sessions (2 sessions per week for 8 wk). OUTCOMES AND MEASURES Pretests and posttests included standardized fine motor assessments. Video coding compared socially directed verbalization during training sessions. Parents and trainers provided feedback on their experiences. RESULTS Seven children received the intervention F2F, whereas 8 received TH intervention. Children in both subgroups showed similar training improvements in fine motor skills and socially directed verbalizations (ps > .01). Parents rated both interventions as acceptable and feasible; however, they reported longer preparation time and effort during TH interventions (ps < .01). Trainers reported greater parental involvement but more communication and technological issues during TH interventions. Fidelity checks indicated fewer reinforcements during TH versus F2F sessions. CONCLUSIONS AND RELEVANCE TH intervention is feasible and effective in improving fine motor and social communication performance. Clinicians should reduce parental burden and overcome technological issues. What This Article Adds: This study confirmed the efficacy, fidelity, acceptability, and feasibility of delivering seated play, standard of care interventions for children with autism spectrum disorder via telehealth. However, clinicians should work on reducing parental burden and overcoming communication and technological issues related to telehealth.
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Affiliation(s)
- Wan-Chun Su
- Wan-Chun Su, PhD, MS, PT, is Postdoctoral Fellow, National Institutes of Health, Bethesda, Maryland
| | - Corina Cleffi
- Corina Cleffi, BS, is Graduate Student, Department of Physical Therapy and Biomechanics and Movement Science Program, University of Delaware, Newark
| | - Sudha Srinivasan
- Sudha Srinivasan, PhD, MS, PT, is Assistant Professor, Physical Therapy Program, Department of Kinesiology; Institute for Health, Intervention, and Policy; and Institute for the Brain and Cognitive Sciences, University of Connecticut, Storrs
| | - Anjana Bhat
- Anjana Bhat, MS, PhD, PT, is Professor, Department of Physical Therapy, Biomechanics and Movement Science Program, and Department of Psychological and Brain Sciences, University of Delaware, Newark;
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Taels L, Feyaerts J, Lizon M, De Smet M, Vanheule S. 'I felt like my senses were under attack': An interpretative phenomenological analysis of experiences of hypersensitivity in autistic individuals. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2269-2280. [PMID: 36876409 DOI: 10.1177/13623613231158182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
LAY ABSTRACT Research shows that the way autistic individuals perceive and process sensory stimuli differs from those of non-autistic people. However, while current research often focuses on what sensory differences in autism are and which neurocognitive processes may explain these, it often does not explicitly address what it is like to experience the world through the senses of an autistic person. To explore this understudied dimension, we conducted 18 in-depth interviews with autistic individuals in order to better understand how they personally experienced hypersensitivity from a first-person perspective. Participants described hypersensitivity as a feeling of being bombarded by intrusive stimuli that seemed to invade their bodies and from which they had difficulties distancing themselves. They also indicated how due to hypersensitivity they often perceived their (social) environment as invasive, chaotic, unpredictable or threatening. Hypersensitivities were thus not only described as unsettling bodily experiences but also related to challenges in perceiving, understanding and interacting with the (social) world. By focussing on the subjective dimension of sensory processing in autism, our study thus highlights how sensory difficulties are not peripheral features of autism but play an essential part in the daily challenges faced by autistic individuals.
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Affiliation(s)
| | | | | | - Melissa De Smet
- Ghent University, Belgium
- Tilburg University, The Netherlands
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Cardon G, Buckhannon M, Rojas D. Fundamental behavioral and neurophysiologic relationships between sensory processing, intolerance of uncertainty, and autistic traits in children: A hybrid approach. Biol Psychol 2023; 184:108712. [PMID: 37839521 PMCID: PMC10842387 DOI: 10.1016/j.biopsycho.2023.108712] [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: 01/25/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/17/2023]
Abstract
Sensory differences are common and often challenging for autistic children. Furthermore, atypical sensory processing is associated with autistic traits and other autism-related behaviors, such as intolerance of uncertainty (IU). Such traits and their relatedness vary continuously across autistic and non-autistic children alike. However, the underlying neural correlates of these continuous variables, and their associations, are not well understood. Therefore, this study examined relationships between sensory processing, IU, autistic traits, and associated resting state brain connectivity, across a sample of both autistic (n = 30) and non-autistic (n = 26) children. In addition to computing behavioral correlations between these factors, we carried out independent component network functional connectivity analysis to investigate associations between cortical and cerebellar networks and behavioral results between groups and across our entire sample. Across-group correlations between sensory processing, autistic traits, and IU were significant. In addition, data demonstrated overlapping sensory processing and intolerance of uncertainty scores, spanning the groups. Brain (rs-fMRI)-behavioral relationships revealed strong associations between sensory, large-scale resting state, and cerebellar networks and behavioral scores. Overall, our findings suggest that sensory differences are related to IU and autistic traits across the population. Neurophysiologic data pointed to functional connectivity between sensory cortices and supramodal brain networks. These findings provide evidence for the continuous variation of behaviors common to autism throughout the entire population and their neurobiological correlates.
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Affiliation(s)
- Garrett Cardon
- Department of Communication Disorders, Brigham Young University, Provo, UT, USA.
| | - Maggie Buckhannon
- Department of Communication Disorders, Brigham Young University, Provo, UT, USA
| | - Don Rojas
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
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Lachiewicz AM, Stackhouse TM, Burgess K, Burgess D, Andrews HF, Choo TH, Kaufmann WE, Kidd SA. Sensory Symptoms and Signs of Hyperarousal in Individuals with Fragile X Syndrome: Findings from the FORWARD Registry and Database Multisite Study. J Autism Dev Disord 2023:10.1007/s10803-023-06135-y. [PMID: 37840096 DOI: 10.1007/s10803-023-06135-y] [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: 09/06/2023] [Indexed: 10/17/2023]
Abstract
This study was designed to increase our understanding about characteristics and the impact of sensory symptoms (SS) and signs of hyperarousal (HA) in individuals with fragile X syndrome (FXS) from childhood through early adulthood and by gender. Data derived from the Fragile X Online Registry With Accessible Research Database (FORWARD), a natural history study of FXS, were analyzed using descriptive statistics and multivariate linear and logistic regression models to examine SS and signs of HA, their impact on behavioral regulation and limitations on the subject/family. The sample (N = 933) consisted of 720 males and 213 females. More males were affected with SS (87% vs. 68%) and signs of HA (92% vs. 79%). Subjects who were endorsed as having a strong sensory response had more comorbidities, including behavioral problems. The predominant SS was difficulty with eye gaze that increased with age in both genders. As individuals age, there was less use of non-medication therapies, such as occupational therapy (OT)/physical therapy (PT), but there was more use of psychopharmacological medications and investigational drugs for behaviors. Multiple regression models suggested that endorsing SS and signs of HA was associated with statistically significantly increased ABC-C-I subscale scores and limited participation in everyday activities. This study improves our understanding of SS and signs of HA as well as their impact in FXS. It supports the need for more research regarding these clinical symptoms, especially to understand how they contribute to well-known behavioral concerns.
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Affiliation(s)
- Ave M Lachiewicz
- Department of Pediatrics, Duke University Health System, Durham, NC, USA.
| | | | | | - Debra Burgess
- Department of Pediatrics, Duke University Health System, Durham, NC, USA
| | - Howard F Andrews
- Departments of Psychiatry and Biostatistics, Mailman School of Public Health, Columbia University, Irving Medical Center, New York, NY, USA
| | - Tse-Hwei Choo
- Division of Mental Health Data Science, New York State Psychiatric Institute, New York, NY, USA
| | - Walter E Kaufmann
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Sharon A Kidd
- Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
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Bossavit B, Arnedillo-Sánchez I. Motion-based technology to support motor skills screening in developing children: A scoping review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2023; 240:107715. [PMID: 37517185 DOI: 10.1016/j.cmpb.2023.107715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND Acquiring motor skills is fundamental for children's development since it is linked to cognitive development. However, access to early detection of motor development delays is limited. AIM This review explores the use and potential of motion-based technology (MBT) as a complement to support and increase access to motor screening in developing children. METHODS Six databases were searched following the PRISMA guidelines to search, select, and assess relevant works where MBT recognised the execution of children's motor skills. RESULTS 164 studies were analysed to understand the type of MBT used, the motor skills detected, the purpose of using MBT and the age group targeted. CONCLUSIONS There is a gap in the literature aiming to integrate MBT in motor skills development screening and assessment processes. Depth sensors are the prevailing technology offering the largest detection range for children from age 2. Nonetheless, the motor skills detected by MBT represent about half of the motor skills usually observed to screen and assess motor development. Overall, research in this field is underexplored. The use of multimodal approaches, combining various motion-based sensors, may support professionals in the health domain and increase access to early detection programmes.
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Affiliation(s)
- Benoit Bossavit
- School of Computer Science & Statistics, Trinity College Dublin, Ireland; School of Computer Science & Programming Languages, Universidad de Málaga, Spain.
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May-Benson TA, Easterbrooks-Dick O, Teasdale A. Exploring the Prognosis: A Longitudinal Follow-Up Study of Children with Sensory Processing Challenges 8-32 Years Later. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1474. [PMID: 37761435 PMCID: PMC10529144 DOI: 10.3390/children10091474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/29/2023]
Abstract
Sensory integration and processing challenges have been long recognized in children and, more recently, in adults. To understand the long-term prognosis of these challenges, more research is needed on what children with sensory integration and processing challenges look like as adults. Using the Adult/Adolescent Sensory History, researchers followed up with 102 adults who had known sensory integration and processing challenges as children to examine the following questions: What is the current sensory processing status of adults who received sensory-integration-based occupational therapy services as children? And how has the sensory processing status of adults who received sensory-integration-based services changed since childhood? This study compared performance on sensory processing measures completed as children and as adults for a follow-up group of adults. The results revealed that the severity of sensory integration and processing challenges experienced by the follow-up group decreased from childhood, with 51% of the follow-up group now scoring in the "typical" range of sensory processing. Our findings suggest that those children with sensory integration and processing challenges who are recognized and seek occupational therapy services using an ASI approach are likely to have a good long-term prognosis regarding the severity of their sensory processing functioning.
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Affiliation(s)
| | - Olivia Easterbrooks-Dick
- Spiral Foundation, Newton, MA 02458, USA; (O.E.-D.); (A.T.)
- OTA The Koomar Center, Newton, MA 02458, USA
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Bonete S, Molinero C, Ruisanchez D. Emotional Dysfunction and Interoceptive Challenges in Adults with Autism Spectrum Disorders. Behav Sci (Basel) 2023; 13:bs13040312. [PMID: 37102826 PMCID: PMC10136046 DOI: 10.3390/bs13040312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/26/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023] Open
Abstract
People with autism spectrum disorder (ASD) frequently show impaired sensory processing in different senses, including the interoceptive system. Recent findings suggest that interoception is a fundamental component of emotional experience and that impaired interoception is associated with alexithymia. This study aims to explore the association and interrelation between interoceptive confusion, alexithymia, and the capacity for emotional regulation among a sample of 33 adults with ASD compared to a control group of 35 adults with neurotypical development and its mutual impact. The participants answered a series of questionnaires addressing these three variables. The results showed (1) significant differences between the groups in all dimensions, with dysfunctional emotional regulation, impaired interoception, and alexithymia in the ASD group, (2) significant correlations between interoceptive confusion, emotional clarity, and alexithymia in the ASD group but only positive correlations between interoceptive confusion and alexithymia in the CG, and (3) that emotional clarity, alexithymia, and autism explain 61% of the variance in interoceptive confusion. These results are in line with previous studies and suggest that training interoceptive ability may enhance emotional clarity and reduce alexithymia among those diagnosed with ASD, with significant implications in the planning of treatment.
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Affiliation(s)
- Saray Bonete
- Department of Psychology, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Clara Molinero
- Department of Psychology, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
| | - Daniela Ruisanchez
- Department of Psychology, Universidad Francisco de Vitoria, 28223 Pozuelo de Alarcón, Spain
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Smith J, Halliwell N, Laurent A, Tsotsoros J, Harris K, DeGrace B. Social Participation Experiences of Families Raising a Young Child With Autism Spectrum Disorder: Implications for Mental Health and Well-Being. Am J Occup Ther 2023; 77:24095. [PMID: 37083974 PMCID: PMC10137595 DOI: 10.5014/ajot.2023.050156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
IMPORTANCE Social participation (SP) is an important facilitator of positive mental health for children and families. Children are dependent on their families to mediate SP, yet families of children with autism spectrum disorder (C-ASD) seemingly limit SP because of behavioral and functional challenges in community environments. The resulting isolation can affect the child's and the family's mental health. OBJECTIVE To distill the essence of everyday SP experiences in the community of families raising C-ASD. DESIGN Data collected via in-depth, semistructured interviews with a purposive sample and analyzed in the phenomenological tradition. SETTING Community. PARTICIPANTS We recruited seven families with English-speaking parents (ages 18-64 yr) raising one C-ASD (age 2-8 yr). Families with more than one C-ASD or those whose C-ASD was diagnosed with complex medical condition or a neurological or genetic disorder were excluded. RESULTS The essence of experiences of SP emerged in the form of three themes depicting the mismatch between societal expectations for SP and families' experience: (1) "the struggle," (2) "it's hard to feel like you belong," and (3) what we "have to do." CONCLUSIONS AND RELEVANCE As a collective, families expressed desire for everyday community SP and could do so only in select environments with core groups. The findings, as interpreted through the lens of mental health promotion, reveal opportunities to reduce barriers and to promote meaningful family SP so as to facilitate positive mental health and well-being through the transactional intersecting characteristics of the child with ASD, the family, and the community. What This Article Adds: This study illuminates the experience of SP of families raising a young C-ASD, highlighting both supports and barriers. Practitioners can use this information to potentially prevent isolation and promote both child and family mental health and well-being.
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Affiliation(s)
- Julie Smith
- Julie Smith, DSc, OTR/L, is Early Intervention Lead, Oklahoma County, Family Health Services, Oklahoma State Department of Health, Oklahoma City, OK. At the time of the study, Smith was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
| | - Nicole Halliwell
- Nicole Halliwell, DSc. OTR/L, is Assistant Professor, Occupational Therapy Department, Marjorie K. Unterberg School of Nursing and Health Sciences, Monmouth University, West Long Branch, NJ. At the time of the study, Halliwell was Doctoral Student, Rehabilitation Sciences Program, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City;
| | - Amy Laurent
- Amy Laurent, PhD, OTR/L, is Codirector, Autism Level UP!, North Kingstown, RI. At the time of the study, Laurent was Adjunct Faculty, Department of Psychology, University of Rhode Island, Kingston
| | - Jessica Tsotsoros
- Jessica Tsotsoros, PhD, OTR/L, is Associate Professor and International Experience Coordinator, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Tulsa
| | - Katelyn Harris
- Katelyn Harris, OTR/L, is Occupational Therapist, Intervention Center for Early Childhood, Irvine, CA
| | - Beth DeGrace
- Beth DeGrace, PhD, OTR/L, FAOTA, is Director of Kids Ministry, Crossings Community Church, Oklahoma City, OK. At the time of the study, DeGrace was Associate Professor, Department of Rehabilitation Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City
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Hirschmann S, Magnezi R, Bassan H, Tal O. Group versus individual occupational therapy for toddlers with autism as a means to improve access to public health-care services. Randomised controlled pilot study. Aust Occup Ther J 2023. [PMID: 36808629 DOI: 10.1111/1440-1630.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 01/28/2023] [Accepted: 02/07/2023] [Indexed: 02/23/2023]
Abstract
INTRODUCTION In recent years, the increasing prevalence of autism-spectrum disorder has resulted in an increased demand for therapies including occupational therapy. In this pilot trial, we aimed to compare the efficacy of group versus individual occupational therapy among toddlers with autism as a means to improve accessibility to care. METHODS Toddlers (2-4 years) undergoing autism evaluation in our public child developmental centre were recruited and randomised to receive 12 weekly sessions of group or individual occupational therapy based on the same mode of intervention: Developmental, Individual-Differences and Relationship-based (DIR). Primary outcomes related to intervention implementation included waiting days, nonattendance, intervention period, number of sessions attended and therapist satisfaction. Secondary outcomes were the Adaptive Behaviour Assessment System questionnaire, the Paediatric Quality of Life Inventory and the Peabody Developmental Motor Scale (PDMS-2). RESULTS Twenty toddlers with autism were included, 10 in each occupational therapy mode of intervention. Children waited fewer days before beginning group occupational therapy compared to individual therapy (52.4 ± 28.1 vs. 108.8 ± 48.0 days p < 0.01). Mean numbers of nonattendance was similar for both interventions (3.2 ± 2.82 vs. 2 ± 1.76, p > 0.05). Worker satisfaction scores were similar at the beginning and end of the study (6.1 ± 0.4 vs. 6.07 ± 0.49, p > 0.05). There were no significant differences between the percentage changes in individual and group therapy outcomes for adaptive score (6.0 ± 16.0 vs. 4.5 ± 17.9, p > 0.05), quality of life (1.3 ± 20.9 vs. 18.8 ± 24.5, p > 0.05) and fine motor skills (13.7 ± 36.1 vs. 15.1 ± 41.5, p > 0.05). CONCLUSIONS In this pilot study, the group DIR-based occupational therapy for toddlers with autism improved access to services and allowed earlier interventions, with no clinical inferiority to individual therapy. Further research is required to examine group clinical therapy benefit.
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Affiliation(s)
- Sivan Hirschmann
- Department of Management, Bar-Ilan University, Ramat Gan, Israel.,Occupational Therapy Service, Shamir Medical Center (Assaf Harofe), Tzrifin, Israel
| | - Racheli Magnezi
- Department of Management, Bar-Ilan University, Ramat Gan, Israel
| | - Haim Bassan
- Pediatric Neurology & Development Center, Shamir Medical Center (Assaf Harofe), Tzrifin, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orna Tal
- Department of Management, Bar-Ilan University, Ramat Gan, Israel.,Shamir Medical Center (Assaf Harofe), Zrifin, Israel
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Raubenheimer M, Geertsema S, Le Roux M, Graham MA. The Influence of Vestibular Input on the Responses of Children with Autism Spectrum Disorder Using Picture Exchange Communication to Request. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2023. [DOI: 10.1080/19411243.2023.2177238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Marinda Raubenheimer
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Cnr Lynnwood and University Roads Hatfield, Pretoria, South Africa
| | - Salomé Geertsema
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Cnr Lynnwood and University Roads Hatfield, Pretoria, South Africa
| | - Mia Le Roux
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Cnr Lynnwood and University Roads Hatfield, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, Groenkloof Campus, University of Pretoria, Pretoria, South Africa
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Roberts MA, Abery BH. A person-centered approach to home and community-based services outcome measurement. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1056530. [PMID: 36817716 PMCID: PMC9929050 DOI: 10.3389/fresc.2023.1056530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023]
Abstract
In the United States, over 2.5 million people with disabilities are recipients of supports through the Center for Medicare and Medicaid Services (CMS) Home and Community-Based Services (HCBS) program. Recent decades have seen a growing focus on providing HCBS in a person-centered manner thereby supporting outcomes that are both important for and to the person. HCBS outcome measurement, however, has not kept pace with advancements in person-centered thinking as it relates to providing supports to people with disabilities. The concept of person-centered outcome measurement has been inadequately defined and is frequently misunderstood including by those in the measurement field. The authors first operationally define person-centered measurement and establish its importance within the context of HCBS and the recent CMS's Final Settings Rule. The important role that person-centered measurement has to play in quality improvement efforts in this area is then explored. A discussion is subsequently provided as to the challenges that are faced in person-centered measurement specific to the disability field. In addition to further conceptualizing and defining this form of measurement, recommendations are provided for moving the field forward.
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Gunderson J, Worthley E, Byiers B, Symons F, Wolff J. Self and caregiver report measurement of sensory features in autism spectrum disorder: a systematic review of psychometric properties. J Neurodev Disord 2023; 15:5. [PMID: 36698071 PMCID: PMC9875408 DOI: 10.1186/s11689-022-09473-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/16/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Unusual responses to sensory stimuli are considered a diagnostic symptom of autism spectrum disorder with mounting research efforts put towards understanding, characterizing, and treating such symptoms. METHODS This paper examines self and caregiver report tools used to measure sensory features in ASD through a systematic review of the psychometric evidence for their use. A total of 31 empirical papers were reviewed across 20 assessment tools. Substantial differences were identified in the specific sensory features defined across assessment tools. Sensory assessment questionnaires were evaluated against quality psychometric evidence criteria to provide a use recommendation. RESULTS Five assessments were identified to be "appropriate with conditions," while no sensory assessment tools were identified to have sufficient quality psychometric evidence to provide a recommendation of "Appropriate" for measuring sensory features in ASD. CONCLUSION Evidence from this review highlights potentially significant shortcomings among the current methods used to measure sensory features in ASD and suggests the need for more efforts in developing psychometrically sound sensory assessment tools for use in ASD populations.
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Affiliation(s)
- Jaclyn Gunderson
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA ,grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, 200 1St Street Southwest, Rochester, MN 55902 USA
| | - Emma Worthley
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Breanne Byiers
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Frank Symons
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
| | - Jason Wolff
- grid.17635.360000000419368657Department of Educational Psychology, Educational Sciences Building College of Education and Human Development, University of Minnesota, 56 River Road, Minneapolis, MN 55455 USA
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Sensory Processing and Autistic Traits: Mediation Effect of Frontal Alpha Asymmetry. Occup Ther Int 2023; 2023:5065120. [PMID: 36721758 PMCID: PMC9884162 DOI: 10.1155/2023/5065120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 12/30/2022] [Accepted: 01/11/2023] [Indexed: 01/22/2023] Open
Abstract
A sensory processing approach can be used to intervene with behaviours in individuals with autistic symptoms. However, neural mechanisms linking sensory processing patterns and autistic features are less understood. The purpose of this study was to investigate whether frontal alpha asymmetry could mediate the relationship between atypical sensory processing and autistic traits. Seventy-three neurotypical young adults were included in this study. Resting-state brain activity was recorded using electroencephalography. After the recording, participants completed the Adolescent/Adult Sensory Profile and the Autism-Spectrum Quotient. Frontal alpha asymmetry was calculated by subtracting left frontal alpha power from right frontal alpha power. Correlation analysis was performed to find which sensory processing patterns were related to frontal alpha asymmetry and autistic traits. Mediation analysis was then conducted with sensory avoiding patterns as an independent variable, autistic traits as a dependent variable, and frontal alpha asymmetry as a mediator. Interrelations between higher sensation avoiding patterns, greater right-sided cortical activity, and increased autistic traits were found. The sensation avoiding patterns affected autistic traits directly and indirectly through right-sided cortical activity. Findings of the current study demonstrate a mediating role of frontal alpha asymmetry in the relationship between sensation avoiding patterns and autistic traits in neurotypical adults. This study suggests that sensation avoiding patterns and withdrawal-related emotions, which are associated with right-sided cortical activity, need to be considered to improve autism symptoms.
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Zhai J, Li X, Zhou Y, Fan L, Xia W, Wang X, Li Y, Hou M, Wang J, Wu L. Correlation and predictive ability of sensory characteristics and social interaction in children with autism spectrum disorder. Front Psychiatry 2023; 14:1056051. [PMID: 37091701 PMCID: PMC10117963 DOI: 10.3389/fpsyt.2023.1056051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/13/2023] [Indexed: 04/25/2023] Open
Abstract
Background Individuals with autism spectrum disorder (ASD) often have different social characteristics and particular sensory processing patterns, and these sensory behaviors may affect their social functioning. The objective of our study is to investigate the sensory profiles of children with ASD and their association with social behavior. Specifically, we aim to identify the predictive role of sensory processing in social functioning. Methods The Short Sensory Profile (SSP) was utilized to analyze sensory differences between ASD children and their peers. The Social Responsiveness Scale (SRS) and other clinical scales were employed to assess the social functioning of children with ASD. Additionally, the predictive ability of sensory perception on social performance was discussed using random forest and support vector machine (SVM) models. Results The SSP scores of ASD children were lower than those of the control group, and there was a significant negative correlation between SSP scores and clinical scale scores (P < 0.05). The random forest and SVM models, using all the features, showed higher sensitivity, while the random forest model with 7-feature factors had the highest specificity. The area under the receiver operating characteristic (ROC) curve (AUC) for all the models was higher than 0.8. Conclusion Autistic children in our study have different patterns of sensory processing than their peers, which are significantly related to their patterns of social functioning. Sensory features can serve as a good predictor of social functioning in individuals with ASD.
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Affiliation(s)
- Jinhe Zhai
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xiaoxue Li
- School of Public Health, Harbin Medical University, Harbin, China
| | - Yong Zhou
- Heilongjiang Provincial Center for Disease Control and Prevention, Harbin, China
| | - Lili Fan
- School of Public Health, Harbin Medical University, Harbin, China
| | - Wei Xia
- School of Public Health, Harbin Medical University, Harbin, China
| | - Xiaomin Wang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Yutong Li
- School of Public Health, Harbin Medical University, Harbin, China
| | - Meiru Hou
- School of Public Health, Harbin Medical University, Harbin, China
| | - Jia Wang
- School of Public Health, Harbin Medical University, Harbin, China
- *Correspondence: Jia Wang,
| | - Lijie Wu
- School of Public Health, Harbin Medical University, Harbin, China
- Lijie Wu,
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Effects of Integrative Autism Therapy on Multiple Physical, Sensory, Cognitive, and Social Integration Domains in Children and Adolescents with Autism Spectrum Disorder: A 4-Week Follow-Up Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121971. [PMID: 36553414 PMCID: PMC9776954 DOI: 10.3390/children9121971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
This study aimed to compare the effects of conventional autism therapy (CAT) and integrative autism therapy (IAT) in children and adolescents with autism spectrum disorder (ASD). A convenience sample of 24 children with ASD was recruited and underwent either CAT or IAT for 60 min/day, twice a week, for 20 sessions over 10 weeks. Outcome measures included the following: (1) physical domain (pediatric balance scale, PBS), (2) sensory domain (short sensory profile), (3) cognitive domains (functional independence measure, FIM; and childhood autism rating scale), and (4) social integration domain (Canadian occupational performance measure, COPM; short falls efficacy scale; and pediatrics quality of life questionnaire). Two-way repeated analysis of variance (ANOVA) was used to determine the intervention-related changes in the four domains across the pre-test, post-test, and follow-up test at p < 0.05. ANOVA showed significant interaction effects on the PBS, FIM, and COPM (p < 0.05) variables. Moreover, time main effects (p < 0.05) were observed in all four domain variables, but no group main effect was noted. This study provides promising evidence that IAT is more effective than CAT for managing children and adolescents with ASD.
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Edwards T, Skuthan A. School-Based Occupational Therapists’ Perceptions of Sensory Processing Interventions for Students With Autism Spectrum Disorder. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2022. [DOI: 10.1080/19411243.2022.2156423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- T.A. Edwards
- Division of Occupational Therapy, Shenandoah University, Shenandoah, VA, USA
| | - A. Skuthan
- Division of Occupational Therapy, Shenandoah University, Shenandoah, VA, USA
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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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Weber C, Krieger B, Häne E, Yarker J, McDowall A. Physical Workplace Adjustments to Support Neurodivergent Workers: A Systematic Review. APPLIED PSYCHOLOGY-AN INTERNATIONAL REVIEW-PSYCHOLOGIE APPLIQUEE-REVUE INTERNATIONALE 2022. [DOI: 10.1111/apps.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Clara Weber
- Institute of Facility Management, School of Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, Switzerland; and Environmental Psychology Department School of Psychology University of Surrey Guildford UK
- Department of Environmental Psychology, School of Psychology University of Surrey Guildford UK
| | - Beate Krieger
- Institute of Occupational Therapy, School of Health Science Zurich University of Applied Sciences Winterthur Switzerland
| | - Eunji Häne
- Institute of Facility Management, School of Life Sciences and Facility Management, Zurich University of Applied Sciences, Wädenswil, Switzerland; and Environmental Psychology Department School of Psychology University of Surrey Guildford UK
| | - Joanna Yarker
- Department of Organizational Psychology Birkbeck University of London London United Kingdom
| | - Almuth McDowall
- Department of Organizational Psychology Birkbeck University of London London United Kingdom
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Raditha C, Handryastuti S, Pusponegoro HD, Mangunatmadja I. Positive behavioral effect of sensory integration intervention in young children with autism spectrum disorder. Pediatr Res 2022; 93:1667-1671. [PMID: 36030319 DOI: 10.1038/s41390-022-02277-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/08/2021] [Accepted: 06/22/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Sensory integration occupational therapy (SI-OT) might be useful for autism spectrum disorders (ASD) in younger age, according to Pusponegoro. Previous studies were still limited, especially in younger age. This study evaluated the effect of SI-OT in improving positive behaviors of ASD children aged 2-5 years. METHODS Non-randomized controlled trial of SI-OT evaluation, assessed with Vineland Adaptive Behavior Scale-II. RESULTS A total of 72 subjects were studied. Following SI-OT, communication skills (expressive, receptive), socialization (coping skills), and daily living skills (personal, community) were improved significantly. CONCLUSIONS SI-OT with Ayres theory in 60 min, twice a week for 12 weeks improved positive behaviors. IMPACT To address the effectivity of sensory integration occupational therapy (SI-OT) in improving positive behaviors of autism spectrum disorders (ASD) children aged 2-5 years. The first study to evaluate evidence of SI-OT in ASD younger than 3 years. Non-randomized controlled trial of SI-OT evaluation of ASD in younger children aged 2-5 years with Vineland Adaptive Behavior Scale-II. SI-OT of Ayres theory in 60 min, twice a week for 12 weeks improves communication domain (expressive, receptive, written) aged 2-4 years, and socialization domain (interpersonal relationship, play, and leisure time) aged 2 years of ASD children.
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Affiliation(s)
- Citra Raditha
- Division of Neurology, Department of Child Health, Faculty of Medicine, Universitas Indonesia Cipto Mangunkusumo National Hospital, Salemba Street No. 6, 10430, Jakarta, Indonesia. .,Division of Neurology, Department of Child Health, Harapan Kita National Women and Children Health Center, Letjend. S Parman Street No. 87, 11420, Jakarta, Indonesia.
| | - Setyo Handryastuti
- Division of Neurology, Department of Child Health, Faculty of Medicine, Universitas Indonesia Cipto Mangunkusumo National Hospital, Salemba Street No. 6, 10430, Jakarta, Indonesia
| | - Hardiono D Pusponegoro
- Division of Neurology, Department of Child Health, Faculty of Medicine, Universitas Indonesia Cipto Mangunkusumo National Hospital, Salemba Street No. 6, 10430, Jakarta, Indonesia
| | - Irawan Mangunatmadja
- Division of Neurology, Department of Child Health, Faculty of Medicine, Universitas Indonesia Cipto Mangunkusumo National Hospital, Salemba Street No. 6, 10430, Jakarta, Indonesia
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Croley KE, Drevon DD, Decker DM, Hixson MD, Radley KC. The Effect of the Fidget Cube on Classroom Behavior among Students with Perceived Attention Difficulties. Behav Anal Pract 2022; 16:547-557. [PMID: 35999944 PMCID: PMC9388206 DOI: 10.1007/s40617-022-00734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 12/01/2022] Open
Abstract
Fidget toys, one class of sensory-based interventions, enjoy favorable coverage in popular media outlets supporting their impact on attention, memory, and stress. However, there is minimal data supporting their use in the classroom. The present study used an ABAB withdrawal design to investigate the impact of noncontingent access to a commercially available fidget toy, the Fidget Cube, on academically engaged behavior, off-task behavior, Fidget Cube engagement, math problems attempted, and math problems completed accurately during independent seatwork. Participants were three 3rd-graders referred for having attention difficulties. Results indicated that noncontingent access to the Fidget Cube during independent seatwork did not improve study outcomes. Participants engaged with the Fidget Cube less in the second intervention phase than the first. Results suggest school personnel should consider alternative strategies for students with perceived attention difficulties. Limitations of the study are discussed, along with future directions for research.
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Affiliation(s)
- Kelsi E. Croley
- Department of Psychology, Central Michigan University, Mt Pleasant, MI 48859 USA
| | - Daniel D. Drevon
- Department of Psychology, Central Michigan University, Mt Pleasant, MI 48859 USA
| | - Dawn M. Decker
- Department of Counseling & Special Education, Central Michigan University, Mt Pleasant, MI USA
| | - Michael D. Hixson
- Department of Psychology, Central Michigan University, Mt Pleasant, MI 48859 USA
| | - Keith C. Radley
- Department of Educational Psychology, University of Utah, Salt Lake City, UT USA
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Chan PLC, Poon MYC, Bux V, Wong SKF, Chu AWY, Louie FTM, Wang AQL, Yang HLC, Yu ELM, Fong SSL. Occupational therapy using an Ayres Sensory integration® approach for school-age children – a randomized controlled trial. WORLD FEDERATION OF OCCUPATIONAL THERAPISTS BULLETIN 2022. [DOI: 10.1080/14473828.2022.2097814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Phoebe L. C. Chan
- Occupational Therapy Department, Integrated Rehabilitation Centre, 2/F, Tower A, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | | | - Vivian Bux
- Occupational Therapy Department, Kwai Chung Hospital, Hong Kong, Hong Kong
| | - Shiren K. F. Wong
- Occupational Therapy Department, Castle Peak Hospital, Tuen Mun, N.T., Hong Kong
| | - Aileen W. Y. Chu
- Occupational Therapy Department, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Frances T. M. Louie
- Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital, Tai Po, N.T., Hong Kong
| | - Apple Q. L. Wang
- Occupational Therapy Department, Kowloon Hospital, Kowloon, Hong Kong
| | - Hellen L. C. Yang
- Occupational Therapy Department, Integrated Rehabilitation Centre, 2/F, Tower A, Hong Kong Children’s Hospital, Kowloon, Hong Kong
| | - Ellen L. M. Yu
- Clinical Research Centre, Princess Margaret Hospital, Kowloon, Hong Kong
| | - Sanne S. L. Fong
- Occupational Therapy Department, Integrated Rehabilitation Centre, 2/F, Tower A, Hong Kong Children’s Hospital, Kowloon, Hong Kong
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Schoen SA, Schaaf RC, Mailloux Z, Bundy A, Lane S, May-Benson TA, Parham LD, Roley SS. Response: Commentary: Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis. Front Integr Neurosci 2022; 16:874320. [PMID: 35747497 PMCID: PMC9211064 DOI: 10.3389/fnint.2022.874320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sarah A. Schoen
- STAR Institute for Sensory Processing, Centennial, CO, United States
- Rocky Mountain University of Health Professions, Provo, UT, United States
| | - Roseann C. Schaaf
- Jefferson Autism Center of Excellence, Thomas Jefferson University School of Rehabilitation Sciences and Department of Occupational Therapy, Philadelphia, PA, United States
| | - Zoe Mailloux
- Jefferson Autism Center of Excellence, Thomas Jefferson University School of Rehabilitation Sciences and Department of Occupational Therapy, Philadelphia, PA, United States
| | - Anita Bundy
- Department of Occupational Therapy, Colorado State University College of Health and Human Sciences, Fort Collins, CO, United States
| | - Shelly Lane
- Department of Occupational Therapy, Colorado State University College of Health and Human Sciences, Fort Collins, CO, United States
| | - Teresa A. May-Benson
- TMB Education, LLC, Norristown, PA, United States
- Institute of Occupational Therapy Education, Widener University, Chester, PA, United States
| | | | - Susanne Smith Roley
- Collaborative for Leadership in Ayres Sensory Integration, Aliso Viejo, CA, United States
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Exploring Effects of Sensory Garments on Participation of Children on the Autism Spectrum: A Pretest-Posttest Repeated Measure Design. Occup Ther Int 2022; 2022:3540271. [PMID: 35800976 PMCID: PMC9192327 DOI: 10.1155/2022/3540271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Autistic children experience sensory challenges that interfere with participation and increase parent stress. Sensory-based interventions are used to address children's behaviors affected by sensory processing difficulties, but research is limited regarding use of sensory garments to support participation of autistic children. This study explored sensory garment effects on participation, parental competence, and perceived stress of autistic children and their parents. Method Twenty-one children were recruited and 17 males with ASD and atypical sensory processing patterns completed the 14-week study. The Canadian Occupational Performance (COPM) and Goal Attainment Scaling (GAS) were used to set and monitor participation goals. After a baseline period, children wore sensory garment(s) for 8 weeks. The COPM, GAS, Parent Stress Index-Short Form (PSI-SF), and Parent Sense of Competence Scale (PSOC) were administered four times (prebaseline, before and after the intervention, and three weeks postintervention). Results There were moderate to large significant differences in both COPM and GAS scores after the intervention and from the beginning to the end of the study indicating sensory garments may improve participation of autistic children. There were no significant differences in PSI or PSOC at any timepoint. Two children rejected the garments. Conclusions Parent- or child-selected sensory garments may improve participation in individually meaningful activities for children who can tolerate wearing them. Children's improvement in participation did not improve parent stress or competence, possibly due to the passive nature of the intervention. More research is needed explore the influence of heterogeneous sensory patterns on response to intervention.
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Randell E, Wright M, Milosevic S, Gillespie D, Brookes-Howell L, Busse-Morris M, Hastings R, Maboshe W, Williams-Thomas R, Mills L, Romeo R, Yaziji N, McKigney AM, Ahuja A, Warren G, Glarou E, Delport S, McNamara R. Sensory integration therapy for children with autism and sensory processing difficulties: the SenITA RCT. Health Technol Assess 2022; 26:1-140. [PMID: 35766242 DOI: 10.3310/tqge0020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Carers report unmet need for occupational therapy services addressing sensory difficulties in autism, yet insufficient evidence exists to recommend a therapeutic approach. OBJECTIVES Our aim was to determine the clinical effectiveness and cost-effectiveness of sensory integration therapy for children with autism and sensory difficulties across behavioural, functional and quality-of-life outcomes. DESIGN We carried out a parallel-group randomised controlled trial, incorporating an internal pilot and a process evaluation. Randomisation utilised random permuted blocks. SETTING AND PARTICIPANTS Children were recruited via services and self-referral in Wales and England. Inclusion criteria were having an autism diagnosis, being in mainstream primary education and having definite/probable sensory processing difficulties. Exclusion criteria were having current/previous sensory integration therapy and current applied behaviour analysis therapy. INTERVENTION The intervention was manualised sensory integration therapy delivered over 26 weeks and the comparator was usual care. OUTCOMES The primary outcome was problem behaviours (determined using the Aberrant Behavior Checklist), including irritability/agitation, at 6 months. Secondary outcomes were adaptive behaviour, functioning and socialisation (using the Vineland Adaptive Behavior Scales); carer stress (measured using the Autism Parenting Stress Index); quality of life (measured using the EuroQol-5 Dimensions and Carer Quality of Life); functional change (according to the Canadian Occupational Performance Measure); sensory processing (determined using the Sensory Processing Measure™ at screening and at 6 months to examine mediation effects); and cost-effectiveness (assessed using the Client Service Receipt Inventory). Every effort was made to ensure that outcome assessors were blind to allocation. RESULTS A total of 138 participants were randomised (n = 69 per group). Usual care was significantly different from the intervention, which was delivered with good fidelity and adherence and minimal contamination, and was associated with no adverse effects. Trial procedures and outcome measures were acceptable. Carers and therapists reported improvement in daily functioning. The primary analysis included 106 participants. There were no significant main effects of the intervention at 6 or 12 months. The adjusted mean difference between groups on the Aberrant Behavior Checklist - irritability at 6 months post randomisation was 0.40 (95% confidence interval -2.33 to 3.14; p = 0.77). Subgroup differences in irritability/agitation at 6 months were observed for sex of child (intervention × female = 6.42, 95% confidence interval 0.00 to 12.85; p = 0.050) and attention deficit hyperactivity disorder (intervention × attention deficit hyperactivity disorder = -6.77, 95% confidence interval -13.55 to -0.01; p = 0.050). There was an effect on carer stress at 6 months by region (intervention × South England = 7.01, 95% confidence interval 0.45 to 13.56; p = 0.04) and other neurodevelopmental/genetic conditions (intervention × neurodevelopmental/genetic condition = -9.53, 95% confidence interval -18.08 to -0.98; p = 0.030). Carer-rated goal performance and satisfaction increased across sessions (p < 0.001), with a mean change of 2.75 (95% confidence interval 2.14 to 3.37) for performance and a mean change of 3.34 (95% confidence interval 2.63 to 4.40) for satisfaction. Health economic evaluation suggests that sensory integration therapy is not cost-effective compared with usual care alone. LIMITATIONS Limitations included variability of the intervention setting (i.e. NHS vs. private), delay for some receiving therapy, an error in administration of Vineland Adaptive Behavior Scales and no measurement of comparator arm goal performance. CONCLUSIONS The intervention did not demonstrate clinical benefit above standard care. Subgroup effects are hypothesis-generating only. The intervention is likely to be effective for individualised performance goals, although it is unclear whether effects were in addition to standard care or were maintained. FUTURE WORK Further investigation of subgroup effects is needed. TRIAL REGISTRATION This trial is registered as ISRCTN14716440. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 29. See the NIHR Journals Library website for further project information.
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Affiliation(s)
| | - Melissa Wright
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | | | | | - Richard Hastings
- Centre for Educational Development, Appraisal, and Research (CEDAR) University of Warwick, Coventry, UK
| | | | | | - Laura Mills
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Renee Romeo
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Nahel Yaziji
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | | | - Alka Ahuja
- Aneurin Bevan University Health Board, Newport, UK
| | | | - Eleni Glarou
- Centre for Trials Research, Cardiff University, Cardiff, UK.,Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Sue Delport
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
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Abdel Hameed M, Hassaballah M, Hosney ME, Alqahtani A. An AI-Enabled Internet of Things Based Autism Care System for Improving Cognitive Ability of Children with Autism Spectrum Disorders. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2247675. [PMID: 35655510 PMCID: PMC9152382 DOI: 10.1155/2022/2247675] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/25/2022]
Abstract
Smart monitoring and assisted living systems for cognitive health assessment play a central role in assessment of individuals' health conditions. Autistic children suffer from some difficulties including social skills, repetitive behaviors, speech and nonverbal communication, and accommodating to the environment around them. Thus, dealing with autistic children is a serious public health problem as it is hard to determine what they feel with a lack of emotional cognitive ability. Currently, no medical treatments have been shown to cure autistic children, with most of the social assistive research to date focusing on Autism Spectrum Disorder (ASD) without suggesting a real treatment. In this paper, we focus on improving cognitive ability and daily living skills and maximizing the ability of the autistic child to function and participate positively in the community. Through utilizing intelligent systems based Artificial Intelligence (AI) and Internet of Things (IoT) technologies, we facilitate the process of adaptation to the world around the autistic children. To this end, we propose an AI-enabled IoT system embodied in a sensor for measuring the heart rate to predict the state of the child and then sending the state to the guardian with feeling and expected behavior of the child via a mobile application. Further, the system can provide a new virtual environment to help the child to be capable of improving eye contact with other people. This way is represented in pictures of these persons in 3D models that break this child's fear barrier. The system follows strategies that have focused on social communication skill development particularly at young ages to be more interactive with others.
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Affiliation(s)
- Mohamed Abdel Hameed
- Department of Computer Science, Faculty of Computers and Information, Luxor University, Luxor, Egypt
| | - M. Hassaballah
- Department of Computer Science, Faculty of Computers and Information, South Valley University, Qena, Egypt
- Department of Computer Science, College of Information Technology, Misr University for Science & Technology, Giza, Egypt
| | - Mosa E. Hosney
- Department of Information System, Faculty of Computers and Information, Luxor University, Luxor, Egypt
| | - Abdullah Alqahtani
- College of Computer Engineering and Sciences, Prince Sattam Bin Abdulaziz University, Alkhrj, Saudi Arabia
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Guénoun T, Tiberghien C, Vaillant-Juteau AM. Les dessins animés pour transformer les atypies sensorielles des enfants avec autisme : le dispositif thérapeutique du Vidéodrame. PSYCHIATRIE DE L ENFANT 2022. [DOI: 10.3917/psye.651.0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Effects of Sensory Garments on Sleep of Children with Autism Spectrum Disorder. Occup Ther Int 2022; 2022:2941655. [PMID: 35241995 PMCID: PMC8858038 DOI: 10.1155/2022/2941655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/15/2022] [Indexed: 11/30/2022] Open
Abstract
Objective The purpose of this study is to assess the effectiveness of the use of sensory garments for improving sleep in children with autism spectrum disorder. Method Using a single-subject ABAB reversal design, the researchers evaluated the effectiveness of a sensory garment on sleep duration, sleep latency, and parental stress related to a child's sleep. Four children aged 4–10 participated. We measured sleep duration and sleep latency using the Garmin watches and parent-report sleep logs, parent stress using the Parenting Stress Index Short Form, and sleep behaviors using the Children's Sleep Habits Questionnaire. Results/Discussion. Data showed variable effects on sleep duration and latency across children. The oldest child with the hyposensitive sensory patterns experienced the greatest sleep improvements. All parents experienced stress from daily life, and some reported increased stress due to study participation. Future research is recommended to further investigate the effectiveness of sensory garments on sleep for children with ASD. Therapists are encouraged to evaluate children's development and sensory preferences prior to recommending sensory garments for sleep.
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Sun C, Zhao Z, Cheng L, Tian R, Zhao W, Du J, Zhang Y, Wang C. Effect of Transcranial Direct Current Stimulation on the Mismatch Negativity Features of Deviated Stimuli in Children With Autism Spectrum Disorder. Front Neurosci 2022; 16:721987. [PMID: 35221894 PMCID: PMC8863939 DOI: 10.3389/fnins.2022.721987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is a devastating mental disorder in children. Currently, there is no effective treatment for ASD. Transcranial direct current stimulation (tDCS), which is a non-invasive brain stimulation neuromodulation technology, is a promising method for the treatment of ASD. However, the manner in which tDCS changes the electrophysiological process in the brain is still unclear. In this study, we used tDCS to stimulate the dorsolateral prefrontal cortex area of children with ASD (one group received anode tDCS, and the other received sham tDCS) and investigated the changes in evoked EEG signals and behavioral abilities before and after anode and sham stimulations. In addition to tDCS, all patients received conventional rehabilitation treatment. Results show that although conventional treatment can effectively improve the behavioral ability of children with ASD, the use of anode tDCS with conventional rehabilitation can boost this improvement, thus leading to increased treatment efficacy. By analyzing the electroencephalography pre- and post-treatment, we noticed a decrease in the mismatch negativity (MMN) latency and an increase in the MMN amplitude in both groups, these features are considered similar to MMN features from healthy children. However, no statistical difference between the two groups was observed after 4 weeks of treatment. In addition, the MMN features correlate well with the aberrant behavior checklist (ABC) scale, particularly the amplitude of MMN, thus suggesting the feasibility of using MMN features to assess the behavioral ability of children with ASD.
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Affiliation(s)
- Changcheng Sun
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
| | - Zhuoyue Zhao
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
| | - Longlong Cheng
- China Electronics Cloud Brain (Tianjin) Technology Co., Ltd., Tianjin, China
| | - Rong Tian
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
| | - Wenchang Zhao
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
| | - Jingang Du
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
| | - Ying Zhang
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
| | - Chunfang Wang
- Department of Rehabilitation Medical, Tianjin Union Medical Centre, Tianjin, China
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Djordjević M, Memisevic H, Potic S, Djuric U. Exercise-Based Interventions Aimed at Improving Balance in Children with Autism Spectrum Disorder: A Meta-Analysis. Percept Mot Skills 2021; 129:90-119. [PMID: 34936828 DOI: 10.1177/00315125211060231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Children with Autism Spectrum Disorder (ASD) often have deficits in motor skills, especially balance. This article presents a meta-analytic review of 15 intervention studies that aimed to improve balance in children and adolescents with ASD. Across these studies, there were 195 participants with ASD for whom pre-intervention and post-intervention balance scores were available. We measured the standardized mean difference (Hedges' g) between their pre-intervention and post-intervention balance scores and found a large, positive effect from these balance interventions (standardized mean difference-1.82 (95% CI [1.34, 2.29])). Various balance intervention procedures were shown to be very efficacious for children and adolescents with ASD. Clearly, balance is a motor skill that is very susceptible to intervention efforts. We also provided recommendations to researchers regarding what information to include when conducting intervention studies.
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Affiliation(s)
- Mirjana Djordjević
- Faculty of Special Education and Rehabilitation, 54801University of Belgrade, Beograd, Serbia
| | - Haris Memisevic
- Faculty of Educational Sciences, 112354University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Srecko Potic
- High Medical College for Professional Studies "Milutin Milanković", Belgrade, Serbia
| | - Uros Djuric
- Faculty of Special Education and Rehabilitation, 54801University of Belgrade, Beograd, Serbia
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Tu T, Zhao C. Treating autism spectrum disorder by intervening with gut microbiota. J Med Microbiol 2021; 70. [PMID: 34898421 DOI: 10.1099/jmm.0.001469] [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: 11/18/2022] Open
Abstract
Autism spectrum disorder (ASD) comprises a group of neurodevelopmental disorders with a high prevalence in childhood. The gut microbiota can affect human cognition and moods and has a strong correlation with ASD. Microbiota transplantation, including faecal microbiota transplantation (FMT), probiotics, breastfeeding, formula feeding, gluten-free and casein-free (GFCF) diet and ketogenic diet therapy, may provide satisfying effects for ASD and its related various symptoms. For instance, FMT can improve the core symptoms of ASD and gastrointestinal symptoms. Probiotics, breastfeeding and formula feeding, and GFCF diet can improve gastrointestinal symptoms. The core symptom score still needs to be confirmed by large-scale clinical randomized controlled studies. It is recommended to use a ketogenic diet to treat patients with epilepsy in ASD. At present, the unresolved problems include which of gut the microbiota are beneficial, which of the microorganisms are harmful, how to safely and effectively implant beneficial bacteria into the human body, and how to extract and eliminate harmful microorganisms before transplantation. In future studies, large sample and randomized controlled clinical studies are needed to confirm the mechanism of intestinal microorganisms in the treatment of ASD and the method of microbial transplantation.
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Affiliation(s)
- Tingting Tu
- Department of Rehabilitation Treatment, Health Science College, Guangdong Pharmaceutical University, Guangzhou 51006, PR China
| | - Changlin Zhao
- Department of Rehabilitation Treatment, Health Science College, Guangdong Pharmaceutical University, Guangzhou 51006, PR China
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Habata K, Cheong Y, Kamiya T, Shiotsu D, Omori IM, Okazawa H, Jung M, Kosaka H. Relationship between sensory characteristics and cortical thickness/volume in autism spectrum disorders. Transl Psychiatry 2021; 11:616. [PMID: 34873147 PMCID: PMC8648722 DOI: 10.1038/s41398-021-01743-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/09/2022] Open
Abstract
Individuals with autism spectrum disorders (ASDs) exhibit atypical sensory characteristics, impaired social skills, deficits in verbal and nonverbal communication, and restricted and repetitive behaviors. The relationship between sensory characteristics and brain morphological changes in ASD remains unclear. In this study, we investigated the association between brain morphological changes and sensory characteristics in individuals with ASD using brain image analysis and a sensory profile test. Forty-three adults with ASD and 84 adults with typical development underwent brain image analysis using FreeSurfer. The brain cortex was divided into 64 regions, and the cortical thickness and volume of the limbic system were calculated. The sensory characteristics of the participants were evaluated using the Adolescent/Adult Sensory Profile (AASP). Correlation analysis was performed for cortical thickness, limbic area volume, and AASP scores. In the ASD group, there was a significant positive correlation between visual sensory sensitivity scores and the right lingual cortical thickness (r = 0.500). There were also significant negative correlations between visual sensation avoiding scores and the right lateral orbitofrontal cortical thickness (r = -0.513), taste/smell sensation avoiding scores and the right hippocampal volume (r = -0.510), and taste/smell sensation avoiding scores and the left hippocampal volume (r = -0.540). The study identified associations among the lingual cortical thickness, lateral orbitofrontal cortical thickness, and hippocampal volume and sensory characteristics. These findings suggest that brain morphological changes may trigger sensory symptoms in adults with ASD.
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Affiliation(s)
- Kaie Habata
- grid.163577.10000 0001 0692 8246Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui, Japan
| | - Yongjeon Cheong
- grid.452628.f0000 0004 5905 0571Cognitive Science Research Group, Korea Brain Research Institute, Daegu, South Korea
| | - Taku Kamiya
- grid.163577.10000 0001 0692 8246Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui, Japan
| | - Daichi Shiotsu
- grid.163577.10000 0001 0692 8246Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui, Japan
| | - Ichiro M. Omori
- grid.163577.10000 0001 0692 8246Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui, Japan
| | - Hidehiko Okazawa
- grid.163577.10000 0001 0692 8246Biomedical Imaging Research Center, University of Fukui, Eiheiji, Fukui, Japan ,grid.163577.10000 0001 0692 8246Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui, Japan ,grid.163577.10000 0001 0692 8246Division of Developmental Higher Brain Functions, Department of Child Development, United Graduate School of Child Development, University of Fukui, Japan, Eiheiji, Fukui, Japan
| | - Minyoung Jung
- Cognitive Science Research Group, Korea Brain Research Institute, Daegu, South Korea.
| | - Hirotaka Kosaka
- Department of Neuropsychiatry, University of Fukui, Eiheiji, Fukui, Japan. .,Research Center for Child Mental Development, University of Fukui, Eiheiji, Fukui, Japan. .,Division of Developmental Higher Brain Functions, Department of Child Development, United Graduate School of Child Development, University of Fukui, Japan, Eiheiji, Fukui, Japan.
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Odom SL, Hall LJ, Morin KL, Kraemer BR, Hume KA, McIntyre NS, Nowell SW, Steinbrenner JR, Tomaszewski B, Sam AM, DaWalt L. Educational Interventions for Children and Youth with Autism: A 40-Year Perspective. J Autism Dev Disord 2021; 51:4354-4369. [PMID: 33866461 PMCID: PMC8531076 DOI: 10.1007/s10803-021-04990-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 01/18/2023]
Abstract
Commemorating the 40 th anniversary of the Diagnostic and Statistical Manual (DSM) III, the purpose of this commentary is to describe school-based and school-relevant interventions and instructional approaches for children and youth with autism that have been developed and employed during that time period. The commentary begins with a brief description of foundational research that provides an historical context. Research themes shaped by science, ethics, social policy, and the changes in the DSM provide an organization for describing the evolution of intervention and instructional practices over the four previous decades. The commentary concludes with a discussion of school-contextual variables that influence implementation and the promise of the "iSciences" for closing the research to practice gap in the future.
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Affiliation(s)
- Samuel L Odom
- University of North Carolina At Chapel Hill, Chapel Hill, NC, USA.
- San Diego State University, San Diego, CA, USA.
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, CB 8040, Chapel Hill, NC, 27599-8040, USA.
| | | | | | | | - Kara A Hume
- University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | | | - Sallie W Nowell
- University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Ann M Sam
- University of North Carolina At Chapel Hill, Chapel Hill, NC, USA
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Hume K, Steinbrenner JR, Odom SL, Morin KL, Nowell SW, Tomaszewski B, Szendrey S, McIntyre NS, Yücesoy-Özkan S, Savage MN. Evidence-Based Practices for Children, Youth, and Young Adults with Autism: Third Generation Review. J Autism Dev Disord 2021; 51:4013-4032. [PMID: 33449225 PMCID: PMC8510990 DOI: 10.1007/s10803-020-04844-2] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 12/21/2022]
Abstract
This systematic review describes a set of practices that have evidence of positive effects with autistic children and youth. This is the third iteration of a review of the intervention literature (Odom et al. in J Autism Dev Disorders 40(4):425-436, 2010a; Prevent School Fail 54(4):275-282, 2010b; Wong et al. in https://autismpdc.fpg.unc.edu/sites/autismpdc.fpg.unc.edu/files/imce/documents/2014-EBP-Report.pdf ; J Autism Dev Disorders 45(7):1951-1966, 2015), extending coverage to articles published between 1990 and 2017. A search initially yielded 31,779 articles, and the subsequent screening and evaluation process found 567 studies to include. Combined with the previous review, 972 articles were synthesized, from which the authors found 28 focused intervention practices that met the criteria for evidence-based practice (EBP). Former EBPs were recategorized and some manualized interventions were distinguished as meeting EBP criteria. The authors discuss implications for current practices and future research.
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Affiliation(s)
- Kara Hume
- School of Education, The University of North Carolina at Chapel Hill, CB 3500 Peabody Hall, Chapel Hill, NC, 27599, USA.
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA.
| | - Jessica R Steinbrenner
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Samuel L Odom
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Kristi L Morin
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Education, Lehigh University, Iacocca Hall, 111 Research Drive, Bethlehem, PA, 18015, USA
| | - Sallie W Nowell
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Brianne Tomaszewski
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
| | - Susan Szendrey
- Department of Allied Health Sciences, The University of North Carolina at Chapel Hill, Bondurant Hall, Campus Box 7120, Chapel Hill, NC, 27599-7120, USA
| | - Nancy S McIntyre
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Health Professionals and Sciences, University of Central Florida, 12805 Pegasus Drive, Orlando, FL, 32816, USA
| | - Serife Yücesoy-Özkan
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- Department of Special Education, Anadolu Üniversitesi, Eğitim Fakültesi, Özel Eğitim Bölümü, Tepebaşı, Eskisehir, 26470, Turkey
| | - Melissa N Savage
- Frank Porter Graham Child Development Institute, The University of North Carolina at Chapel Hill, Campus Box 8040, Chapel Hill, NC, 27599-8040, USA
- College of Education, University of North Texas, 1300 W. Highland St., Denton, TX, 76201, USA
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Merritt J, Kernot J, Dizon J, Boshoff K. Facilitating practices to support children's self-regulation in classrooms: a scoping review protocol. JBI Evid Synth 2021; 20:882-889. [PMID: 34580269 DOI: 10.11124/jbies-21-00067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this scoping review is to describe practices for supporting children's self-regulation in the classroom. INTRODUCTION Self-regulation is an integral component of children's well-being and learning in the classroom. Self-regulation is a broad concept that encompasses behavioral, emotional, cognitive, or sensory regulation processes. Children often struggle to self-regulate in class and teachers have difficulty supporting them, which impacts on children's participation and academic achievement, and teachers' self-efficacy and well-being. INCLUSION CRITERIA This review will consider studies that include mainstream primary school children regardless of diagnosis or disability, classroom teachers, and allied health professionals who provide services in mainstream public or private school settings. Self-regulation-support practices may include pedagogical, classroom- or curriculum-based practices, environmental modifications, class-management strategies, adult-child relationships, and trauma-informed classroom practices. METHODS The review will be conducted using the JBI three-step search strategy. The databases to be searched include MEDLINE (Ovid), PsycINFO (Ovid), Scopus, CINAHL (Ovid), OTSeeker, and ERIC (ProQuest). Documents from 2010 to the present in English will be included. Data will be extracted and charted by two reviewers using a data extraction tool based on JBI recommendations. Study findings will be presented in tabular or diagrammatic format that aligns with the objective and a narrative summary will be provided.
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Affiliation(s)
- Judith Merritt
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia International Centre for Allied Health Evidence: A JBI Affiliated Group, Adelaide, SA, Australia JBI, The University of Adelaide, Adelaide, SA, Australia
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Evidence of shared and distinct functional and structural brain signatures in schizophrenia and autism spectrum disorder. Commun Biol 2021; 4:1073. [PMID: 34521980 PMCID: PMC8440519 DOI: 10.1038/s42003-021-02592-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/06/2021] [Indexed: 02/08/2023] Open
Abstract
Schizophrenia (SZ) and autism spectrum disorder (ASD) share considerable clinical features and intertwined historical roots. It is greatly needed to explore their similarities and differences in pathophysiologic mechanisms. We assembled a large sample size of neuroimaging data (about 600 SZ patients, 1000 ASD patients, and 1700 healthy controls) to study the shared and unique brain abnormality of the two illnesses. We analyzed multi-scale brain functional connectivity among functional networks and brain regions, intra-network connectivity, and cerebral gray matter density and volume. Both SZ and ASD showed lower functional integration within default mode and sensorimotor domains, but increased interaction between cognitive control and default mode domains. The shared abnormalties in intra-network connectivity involved default mode, sensorimotor, and cognitive control networks. Reduced gray matter volume and density in the occipital gyrus and cerebellum were observed in both illnesses. Interestingly, ASD had overall weaker changes than SZ in the shared abnormalities. Interaction between visual and cognitive regions showed disorder-unique deficits. In summary, we provide strong neuroimaging evidence of the convergent and divergent changes in SZ and ASD that correlated with clinical features.
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Lenart A, Pasternak J. Resources, Problems and Challenges of Autism Spectrum Disorder Diagnosis and Support System in Poland. J Autism Dev Disord 2021; 53:1629-1641. [PMID: 34345979 PMCID: PMC10066150 DOI: 10.1007/s10803-021-05142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 11/30/2022]
Abstract
The article refers to resources, problems and challenges of autism diagnosis and support system in Poland. The resources include: the increasing number of specialists, diagnostic and therapeutic centres, well-established course of education for people working with youths, standardised and normalised diagnostic tools. The diagnostic process is not without some areas in need of our focus: the tendency of some specialists to make unauthorised diagnosis, overshadowing; underestimation of comorbidity of ASD with other disorders. The challenges refer to introducing an effective system of monitoring the services provided in form of certification and control in order to prevent their abuse, initiating category of temporary diagnosis; paying more attention on individual's resources, better cooperation among specialists, teachers and families, developing and unifying diagnostic standards.
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Affiliation(s)
- Anna Lenart
- College of Social Sciences, Institute of Pedagogy, Department of Psychology, University of Rzeszow, ul. Ks. Jalowego 24, 35-010, Rzeszow, Poland
| | - Jacek Pasternak
- College of Social Sciences, Institute of Pedagogy, Department of Psychology, University of Rzeszow, ul. Ks. Jalowego 24, 35-010, Rzeszow, Poland.
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Sensory Processing in Williams Syndrome: Individual differences and changes over time. J Autism Dev Disord 2021; 52:3129-3141. [PMID: 34287736 PMCID: PMC8294303 DOI: 10.1007/s10803-021-05197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 11/17/2022]
Abstract
This study examined individual differences as well as the development of sensory processing difficulties in children with Williams syndrome (WS) using a cross-sectional (Experiment 1) and longitudinal design (Experiment 2). In Experiment 1, a clustering approach of sensory processing scores suggested two groups. Experiment 2 showed that the clusters identified in Experiment 1 were not stable across development, especially for those with high sensory impairments at either time point. Yet, most children experienced high impairments in sensory registration at both time points, suggesting impaired registration is a core phenotype of sensory processing in children with WS across development. Possible mechanisms, limitations and implications are discussed.
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Implication of the Sensory Environment in Children with Autism Spectrum Disorder: Perspectives from School. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147670. [PMID: 34300120 PMCID: PMC8306690 DOI: 10.3390/ijerph18147670] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 01/20/2023]
Abstract
(1) Background: Children with Autism Spectrum Disorder (ASD) frequently have difficulties in processing sensory information, which is a limitation when participating in different contexts, such as school. The objective of the present study was to compare the sensory processing characteristics of children with ASD in the natural context of school through the perception of professionals in the field of education, in comparison with neurodevelopmental children (2) Methods: A cross-sectional descriptive study as conducted with study population consisting of children between three and ten years old, 36 of whom were diagnosed with ASD and attended the Autismo Burgos association; the remaining 24 had neurotypical development. The degree of response of the children to sensory stimuli at school was evaluated using the Sensory Profile-2 (SP-2) questionnaire in its school version, answered by the teachers. (3) Results: Statistically significant differences were found in sensory processing patterns (p = 0.001), in sensory systems (p = 0.001) and in school factors (p = 0.001). Children with ASD who obtained worse results. (4) Conclusions: Children with ASD are prone to present sensory alterations in different contexts, giving nonadapted behavioral and learning responses.
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