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Snijder MIJ, Dietz C, van Andel M, Ruiter ELM, Buitelaar JK, Oosterling IJ. Social COmmunication Program supported by E-health (SCOPE) for infants and toddlers at elevated likelihood of autism spectrum disorder: study design of a cluster randomized controlled trial. BMC Psychiatry 2022; 22:772. [PMID: 36482453 PMCID: PMC9733381 DOI: 10.1186/s12888-022-04351-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although the importance of early detection and early intervention of autism spectrum disorders (ASD) is widely recognized, multiple barriers exist in accessing early intervention services. As an alternative to these barriers, the SCOPE project presents a new, easy accessible and blended intervention called BEAR (Blended E-health for children at eArly Risk). This paper describes this BEAR intervention and study design of an ongoing two arm cluster randomized controlled trial (RCT). METHODS BEAR (Blended E-health for children at eArly Risk) is a blended e-health intervention, based on evidence-based naturalistic developmental behavioral interventions (NDBI's) and can be offered to parents and infants/toddlers at high likelihood for ASD. During the ongoing RCT, N = 88 high risk infants and toddlers will be cluster randomized over the BEAR intervention and care-as-usual (CAU) conditions. The finalized version of the intervention protocol and study design are presented in this paper. The primary outcome measure is joint engagement measured by the Joint Engagement Rating Inventory (JERI) during videotaped parent-child interaction. Secondary outcome measures include severity of ASD symptoms, global level of adaptive functioning, parental well-being, parental skills and satisfaction with healthcare. Also, costs will be estimated from society's perspective. Assessments take place at the start of the study (T1), after eight weeks (T2) and after six months (T3) and include behavioral home observations and parental questionnaires. DISCUSSION The SCOPE project aims to contribute to improved early identification and timely start of suitable interventions for infants and toddlers at elevated likelihood for ASD. This ongoing RCT will offer insight in the feasibility, short-term and six months effects of the innovative BEAR intervention. It is estimated that inclusion for the trial (N = 88) is completed in spring 2023. TRIAL REGISTRATION Dutch Trial Register, NTR7695. Registered at December 17th, 2018, www.trialregister.nl .
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Affiliation(s)
- Michelle I. J. Snijder
- grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands ,grid.5590.90000000122931605Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Claudine Dietz
- grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | - Mieke van Andel
- grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
| | | | - Jan K. Buitelaar
- grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands ,grid.5590.90000000122931605Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Iris J. Oosterling
- grid.461871.d0000 0004 0624 8031Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, the Netherlands
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Alfawaz HA, El-Ansary A, Al-Ayadhi L, Bhat RS, Hassan WM. Protective Effects of Bee Pollen on Multiple Propionic Acid-Induced Biochemical Autistic Features in a Rat Model. Metabolites 2022; 12:metabo12070571. [PMID: 35888695 PMCID: PMC9323335 DOI: 10.3390/metabo12070571] [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] [Received: 06/06/2022] [Revised: 06/16/2022] [Accepted: 06/19/2022] [Indexed: 11/26/2022] Open
Abstract
Autism spectrum disorders (ASDs) are neurodevelopmental disorders that clinically presented as impaired social interaction, repetitive behaviors, and weakened communication. The use of bee pollen as a supplement rich in amino acids amino acids, vitamins, lipids, and countless bioactive substances may lead to the relief of oxidative stress, neuroinflammation, glutamate excitotoxicity, and impaired neurochemistry as etiological mechanisms autism. Thirty young male Western albino rats were randomly divided as: Group I-control; Group II, in which autism was induced by the oral administration of 250 mg propionic acid/kg body weight/day for three days followed by orally administered saline until the end of experiment and Group III, the bee pollen-treated group, in which the rats were treated with 250 mg/kg body weight of bee pollen for four weeks before autism was induced as described for Group II. Markers related to oxidative stress, apoptosis, inflammation, glutamate excitotoxicity, and neurochemistry were measured in the brain tissue. Our results indicated that while glutathione serotonin, dopamine, gamma-aminobutyric acid (GABA), GABA/Glutamate ratio, and vitamin C were significantly reduced in propionic acid-treated group (p < 0.05), glutamate, IFN-γ, IL-1A, IL-6, caspase-3, and lipid peroxide levels were significantly elevated (p < 0.05). Bee pollen supplementation demonstrates protective potency presented as amelioration of most of the measured variables with significance range between (p < 0.05)−(p < 0.001).
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Affiliation(s)
- Hanan A. Alfawaz
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh 11495, Saudi Arabia;
| | - Afaf El-Ansary
- Central Research Laboratory, Female Center for Medical Studies and Scientific Section, King Saud University, Riyadh 11495, Saudi Arabia
- Correspondence: ; Tel.: +966-508462529; Fax: +966-11-4682184
| | - Laila Al-Ayadhi
- Department of Physiology, Faculty of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Ramesa Shafi Bhat
- Biochemistry Department, College of Sciences, King Saud University, Riyadh 11495, Saudi Arabia;
| | - Wail M. Hassan
- Department of Biomedical Sciences, School of Medicine, University of Missouri Kansas City, Kansas City, MO 64108, USA;
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van 't Hof M, van Nieuwenhuyzen ADY, van Berckelaer-Onnes I, Deen M, Hoek HW, Ester WA. Autism Spectrum Disorder Alertness in Dutch Youth and Family Center Physicians: Effects of a Live Online Educational Program. J Autism Dev Disord 2021; 51:3401-3411. [PMID: 33420937 DOI: 10.1007/s10803-020-04842-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 11/24/2022]
Abstract
We investigated the effect of a live online educational program in 93 Dutch Youth and Family Center (YFC) physicians who were screening for Autism Spectrum Disorder (ASD) in the general child population. The educational program raised the physicians' level of specific ASD knowledge and it remained higher at six months follow-up (p < .01). Their self-confidence in detecting ASD was also higher and maintained at follow-up (p < .01). The educational program had no effect on the physicians' stigmatizing attitudes toward mental illness nor on the number of potential ASD referrals in children of 4-6 years of age. In conclusion, the online educational program on early detection of ASD has a six month long effect on YFC physicians' level of ASD knowledge and self-confidence.
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Affiliation(s)
- Maarten van 't Hof
- Sarr Expert Centre for Autism, Lucertis Child and Adolescence Psychiatry, Dynamostraat 18, 3083 AK, Rotterdam, The Netherlands.,Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands
| | - Annemyn D Y van Nieuwenhuyzen
- Sarr Expert Centre for Autism, Lucertis Child and Adolescence Psychiatry, Dynamostraat 18, 3083 AK, Rotterdam, The Netherlands
| | - Ina van Berckelaer-Onnes
- Sarr Expert Centre for Autism, Lucertis Child and Adolescence Psychiatry, Dynamostraat 18, 3083 AK, Rotterdam, The Netherlands.,Faculty of Social and Behavioural Sciences, Clinical Child and Adolescent Studies, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands.,Faculty of Social and Behavioural Sciences, Institute of Psychology, Methodology and Statistics Unit, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Hans W Hoek
- Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands.,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.,Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, New York, NY, 10032, USA
| | - Wietske A Ester
- Sarr Expert Centre for Autism, Lucertis Child and Adolescence Psychiatry, Dynamostraat 18, 3083 AK, Rotterdam, The Netherlands. .,Parnassia Psychiatric Institute, Kiwistraat 30, 2552 DH, The Hague, The Netherlands. .,Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Endegeesterstraatweg 27, 2342 AK, Oegstgeest, The Netherlands.
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Brewer N, Young RL, Lucas CA. Autism Screening in Early Childhood: Discriminating Autism From Other Developmental Concerns. Front Neurol 2020; 11:594381. [PMID: 33362696 PMCID: PMC7758341 DOI: 10.3389/fneur.2020.594381] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/23/2020] [Indexed: 12/27/2022] Open
Abstract
Early identification of autism, followed by appropriate intervention, has the potential to improve outcomes for autistic individuals. Numerous screening instruments have been developed for children under 3 years of age. Level 1 screeners are used in large-scale screening to detect at-risk children in the general population; Level 2 screeners are concerned with distinguishing children with signs of autism from those with other developmental problems. The focus here is evaluation of Level 2 screeners. However, given the contributions of Level 1 screeners and the necessity to understand how they might interface with Level 2 screeners, we briefly review Level 1 screeners and consider instrument characteristics and system variables that may constrain their effectiveness. The examination of Level 2 screeners focuses on five instruments associated with published evaluations in peer-reviewed journals. Key criteria encompass the traditional indices of test integrity such as test reliability (inter-rater, test-retest) and construct validity, including concurrent and predictive validity, sensitivity (SE), and specificity (SP). These evaluations reveal limitations, including inadequate sample sizes, reliability issues, and limited involvement of independent researchers. Also lacking are comparative test evaluations under standardized conditions, hindering interpretation of differences in discriminative performance across instruments. Practical considerations constraining the use of such instruments—such as the requirements for training in test administration and test administration time—are canvassed. Published Level 2 screener short forms are reviewed and, as a consequence of that evaluation, future directions for assessing the discriminative capacity of items and measures are suggested. Suggested priorities for future research include targeting large and diverse samples to permit robust appraisals of Level 2 items and scales across the 12–36 month age range, a greater focus on precise operationalization of items and response coding to enhance reliability, ongoing exploration of potentially discriminating items at the younger end of the targeted age range, and trying to unravel the complexities of developmental trajectories in autistic infants. Finally, we emphasize the importance of understanding how screening efficacy is dependent on clinicians' and researchers' ability not only to develop screening tests but also to negotiate the complex organizational systems within which screening procedures must be implemented.
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Affiliation(s)
- Neil Brewer
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
| | - Robyn L Young
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
| | - Carmen A Lucas
- College of Education, Psychology & Social Work, Flinders University, Adelaide, SA, Australia
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van der Gaag RJ. Dépistage précoce et aide à la famille. ENFANCE 2019. [DOI: 10.3917/enf2.191.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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