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Conrad CE, Jørgensen R, Amstrup C, Gottschau TE, Thomsen PH, Lauritsen MB. "It Seems Much More Enjoyable Now": Parental Perception of Relational Change from Participating in Paediatric Autism Communication Therapy (PACT). CHILDREN (BASEL, SWITZERLAND) 2024; 11:838. [PMID: 39062287 PMCID: PMC11276199 DOI: 10.3390/children11070838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/07/2024] [Accepted: 07/09/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES This qualitative study aims to examine parental experiences of feasibility and relational changes from participating in the Paediatric Autism Communication Therapy (PACT) intervention. METHODS Thirteen parents of children diagnosed with autism spectrum disorder (mean age 3.89 years) participated in semi-structured interviews. Thematic analysis was performed, inspired by an abductive approach informed by the theories of the attachment system, the caregiving system and mentalisation. RESULTS Three overarching themes were identified: the struggle of fitting PACT into everyday life, the fruit of relational connection and the cascading relational effects of PACT. Parents were challenged regarding finding time for the intervention but adapted PACT to their individual needs and possibilities. All parents experienced relational improvement, and a cycle of positive relational change through PACT was identified. CONCLUSIONS This study has several clinical implications. Therapists and clinics offering PACT interventions should encourage and support parents in their individual journey of implementing PACT into their everyday lives. Some of the parents described improvements in parental mentalisation, child attachment and mutual enjoyment in the parent-child relationship. Children with autism could benefit from parents increasing their sensitivity when caregiving, and clinicians may through interventions such as PACT facilitate this development.
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Affiliation(s)
- Charlotte Engberg Conrad
- Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark; (R.J.); (C.A.); (M.B.L.)
- Department of Clinical Medicine, Aalborg University, 9260 Gistrup, Denmark
| | - Rikke Jørgensen
- Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark; (R.J.); (C.A.); (M.B.L.)
- Department of Clinical Medicine, Aalborg University, 9260 Gistrup, Denmark
| | - Cecilie Amstrup
- Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark; (R.J.); (C.A.); (M.B.L.)
| | - Tine Ellitsgaard Gottschau
- Research Unit, Department of Child and Adolescent Psychiatry, Copenhagen University Hospital—Psychiatry Region Zealand, 4000 Roskilde, Denmark;
| | - Per Hove Thomsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, 8200 Aarhus, Denmark;
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
| | - Marlene Briciet Lauritsen
- Psychiatry, Aalborg University Hospital, 9000 Aalborg, Denmark; (R.J.); (C.A.); (M.B.L.)
- Department of Clinical Medicine, Aalborg University, 9260 Gistrup, Denmark
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Matsushima K, Kato T. An Exploratory Study on the Association between Atypical Behavioral Responses to Tickling and Autistic Traits in Japanese Children. Occup Ther Health Care 2024; 38:666-685. [PMID: 38174406 DOI: 10.1080/07380577.2023.2297358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024]
Abstract
Although play is an essential occupation for children, parents of children with autistic traits tend to struggle with play-based interpersonal interaction with them. Tickling play appears to be one of the most interpersonal forms of play because nobody can tickle themselves. However, atypical tactile processing (e.g. tactile sensitivity) has been reported in children with autistic traits, who may exhibit atypical behavioral responses during tickling play. Our aim was to investigate the association between autistic traits and behavioral responses during parent-child tickling play in Japanese young children. We recorded tickling interaction between children and their parents using behavior coding with six behavioral items. Autistic traits and tactile sensitivity were measured using parent-reported questionnaires. Results showed two behavioral responses were significantly associated with autistic traits in all children: "approach with positive emotional response" and "no response" were negatively and positively correlated with autistic traits, respectively. This exploratory study suggests that behavioral responses during tickling play may be associated with autistic traits.
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Affiliation(s)
- Kanae Matsushima
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Toshihiro Kato
- Faculty of Rehabilitation, Kansai Medical University, Hirakata, Japan
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Aldosari MS, Alzhrani AJ. Evaluating Saudi Parental Interagency on Collaborative Initiatives for Successful Post-Secondary Transition of Students with Intellectual Disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241262565. [PMID: 38881272 DOI: 10.1177/17446295241262565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Effective collaboration between schools and community agencies is paramount for the successful transition of students with disabilities to post-secondary educational settings. This study, conducted in Riyadh, Saudi Arabia, focuses on assessing the level of collaboration from the perspective of parents of students with intellectual disabilities. Using descriptive analysis, data was gathered from 191 parents, and the results indicate a perceived low level of collaboration between schools and various agencies in planning and supporting the transition to post-secondary environments. The study results evaluate collaboration in three dimensions: (a) universities rank lowest with x ¯ =1.61 and SD=1.102). (b) vocational training centers ranking highest (1st rank) with an x ¯ = 1.97 and SD = 1.079), and (c) other relevant service centers 2nd rank with x ¯ =1.69 and SD= 1.177. The findings emphasize the necessity for legislative measures directing agencies to engage in collaborative agreements with secondary schools. This proactive approach aims to enhance opportunities for students with intellectual disabilities during their transition to post-secondary education and training. The study concludes with implications for future research and recommendations for fostering improved collaboration and support mechanisms.
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Affiliation(s)
- Mubarak S Aldosari
- Department of Special Education, Prince Sattam Bin Abdulaziz University, Saudi Arabia
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4
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Pfeiffer DL, Hess CR, Landa RJ. Seeking Validation and Creating Meaningful Interactions: Perceptions of a Parent-Mediated Infant Intervention. INFANTS AND YOUNG CHILDREN 2024; 37:85-100. [PMID: 39006999 PMCID: PMC11244628 DOI: 10.1097/iyc.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Infancy, a formative period for development, has been identified as an advantageous time to provide family-centered support for children with delays. Families should be included as stakeholders during development of such interventions to ensure social value. We describe a preliminary randomized controlled trial evaluating Infant Achievements (IA), an 8-week (16-session) parent-mediated intervention for parents of infants 8-12 months old with social communication delays. This study reports our qualitative examination of the intervention's social validity. We conducted focus groups with 7 IA parent participants and analyzed their responses using conventional content analysis. Five themes emerged: (a) difficulty identifying resources to address concerns, (b) seeking validation of concerns, (c) seeking support to enhance children's development, (d) experiencing a supportive coaching relationship, and (e) creating meaningful interactions to support children's communication and social skills. Our results emphasize the necessity of partnering with families in the development of evidence-based family-centered interventions for infants with developmental delays to maximize their social value.
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Affiliation(s)
- Danika L Pfeiffer
- School of Communication Sciences and Disorders, Old Dominion University
| | - Christine Reiner Hess
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University School of Medicine
| | - Rebecca J Landa
- Center for Autism and Related Disorders, Kennedy Krieger Institute, Johns Hopkins University School of Medicine
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
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5
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Hladik L, St John BM, Korbel A, Nelson N, Umana M, Kant S, Ausderau KK. "Giving Me the Self-Confidence to Tackle It": Mothers' Experiences Participating In The Engaged Eaters Program, A Caregiver-Mediated Feeding Intervention. J Autism Dev Disord 2024:10.1007/s10803-024-06250-4. [PMID: 38400894 DOI: 10.1007/s10803-024-06250-4] [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: 01/16/2024] [Indexed: 02/26/2024]
Abstract
The purpose of this study was to understand caregivers' experience of participating in a caregiver-mediated in-home feeding intervention, the Engaged Eaters Program, for their young autistic child. This qualitative study utilized a thematic approach to analyze post-intervention semi-structured interviews with thirteen mothers of autistic children between the ages of 2 to 7 years after they participated in the intervention. Interview questions focused on the child and family experience, what worked well, what could be improved, and how the intervention integrated into family routines. Four major themes were identified: In-Home Intervention, Parent Skill and Knowledge, Increased Social Participation, and Parent Responsibilities and Challenges. Sub-themes provided descriptions of learning practical tools to support their child, increasing self-efficacy, and impacts on family life. Mothers described an increase in tangible skills that were easily practiced in the home environment that improved their confidence and self-efficacy in feeding their children. They also described how participation did require more work and time commitment for them beyond their regular responsibilities. The caregiver experience is essential to understand for intervention effectiveness while simultaneously addressing child, caregiver, and family needs. By focusing on the mothers' experiences, individualized needs, and self-efficacy, we were able to better understand how integrating an intervention into the family context and daily routines may be beneficial for the whole family.
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Affiliation(s)
- Libby Hladik
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA
| | - Brittany M St John
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA
| | - Allie Korbel
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA
| | - Nicole Nelson
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA
| | - Molly Umana
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA
| | - Shannon Kant
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA
| | - Karla K Ausderau
- Department of Kinesiology, Occupational Therapy Program, University of Wisconsin at Madison, Madison, WI, USA.
- Waisman Center, University of Wisconsin at Madison, Madison, WI, USA.
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Murphy AN, Moskowitz K, Fernandez F, Risser HJ. Perceived Parent Needs for Improving Parent Participation in School-Based Therapies for Children with Disabilities Using the Parent-Therapist Partnership Survey. J Autism Dev Disord 2024:10.1007/s10803-024-06282-w. [PMID: 38393438 DOI: 10.1007/s10803-024-06282-w] [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: 02/10/2024] [Indexed: 02/25/2024]
Abstract
Rehabilitative and habilitative therapies can help children with disabilities increase independence and overall wellbeing. However, children and their caregivers face many barriers to accessing these therapies and often rely on the school for therapy access. Given the limited resources available within the special education system, increasing parent involvement in special education therapies could improve service delivery. However, providers must first understand what parents need to participate in therapies before attempting to engage families. 217 parents completed an online survey consisting of the Parent-Therapist Partnership Survey and demographic questionnaires about theirfamiliesand their child[ren] with disabilities. The percentage of needs parents endorsed as important and thepercentageofimportantneedsendorsedasunmetwere calculated. Differences across demographic variables were assessed. Overall, parents reported an average of 75% of needs as important with significantly more needs endorsed as important regarding being an informed, engaged member of the child's care team (M = 83%) than needs related to support and guidance (M = 65%, p < 0.001). Furthermore, parentsreportedan average of 58% of important needs as unmet, with no significant differences in subscale averages. Significant associations were found for race/ethnicity, education, income, partner availability, number of children with disabilities in the household, transportation access, neighborhood opportunities, parent efficacy and social, emotional, and behavioral concerns. Parents reported a high percentage of needs as important, but a large percentage of these important needs were considered unmet. Significant disparities based on racial/ethnic identities and access to resources were found. In order to successfully engage parents in special education therapy activities, providers must work to understand and address parents' engagement needs, paying special attention to each family's unique circumstances to optimize engagement.
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Affiliation(s)
- Ashley N Murphy
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA.
| | - Kathleen Moskowitz
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA
| | - Francesca Fernandez
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA
| | - Heather J Risser
- Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 710 N. Lake Shore Drive, Suite 1200, Chicago, IL, 60611, USA
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Fante C, De Luca Picione R, Dioni B, Manari T, Raffin C, Capelli F, Franceschini C, Lenzo V, Musetti A. Parental Quality of Life and Impact of Multidisciplinary Intervention for Children with Autism Spectrum Disorders: A Qualitative Study. J Autism Dev Disord 2024:10.1007/s10803-023-06225-x. [PMID: 38170430 DOI: 10.1007/s10803-023-06225-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
The presence of a child with Autism Spectrum Disorder (ASD) in the family can have a negative impact on parental Quality of Life (QoL), but evidence on how treatments for children with ASD can affect parental QoL is currently limited. In this qualitative study, we develop a semi-structured interview in order to investigate the impact of ASD on the QoL of mothers and fathers from a subjective perspective, as well as the effect of the intervention on their QoL and adjustment process. The sample consisted of 31 parents of children with ASD severity 2 or 3, aged 5 to 11 years, undergoing a multidisciplinary intervention. In order to identify emerging themes from the interview transcripts, a Thematic Analysis was conducted using a bottom-up approach. We identified three main themes relating to parental QoL (ASD impact on QoL, useful external resources, QoL improvement-related factors) and five themes relating to parents' views on the intervention (positive impact on parent, dissatisfaction with previous interventions, parental involvement, useful features, critical issues). The results provide indications of the process of parental adaptation and the components of interventions that foster an improvement in their QoL. In conclusion, living with a child with ASD can have a significant influence on a parents' QoL, not just physically and emotionally, but also in terms of general goals, family structure, and social interactions.
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Affiliation(s)
- Chiara Fante
- Institute for Educational Technologies, National Research Council, Via De Marini 6, Torre di Francia, Genoa, Italy.
| | | | - Barbara Dioni
- Fondazione Bambini e Autismo Onlus, Pordenone, Italy
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy
| | - Cinzia Raffin
- Fondazione Bambini e Autismo Onlus, Pordenone, Italy
| | | | | | - Vittorio Lenzo
- Department Educational Sciences, University of Catania, Catania, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, Parma, Italy.
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Brandi Gomes Godoy P, McWilliams L, Rodrigues da Silveira L, de Cesaro Revers Biasão M, Speggiorin Pereira Alarcão F, Seda L, Generoso Campoli R, Liang H, Divan G, Leadbitter K, Green J, Shephard E. Acceptability and feasibility of a parent-mediated social-communication therapy for young autistic children in Brazil: A qualitative implementation study of Paediatric Autism Communication Therapy. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:123-137. [PMID: 36588298 DOI: 10.1177/13623613221144501] [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] [Indexed: 01/03/2023]
Abstract
LAY ABSTRACT Parents of autistic children and health professionals who work with autistic children in Brazil had positive views about introducing Paediatric Autism Communication Therapy as a therapy for autistic children in Brazil. The parents and clinicians also mentioned some difficulties about using Paediatric Autism Communication Therapy in Brazil. We made adaptations to Paediatric Autism Communication Therapy to address these difficulties. Paediatric Autism Communication Therapy is a therapy to support the development of social and communication skills for autistic children aged 2-10 years. The therapy is conducted with the autistic child's parent. Paediatric Autism Communication Therapy has not been used in Brazil before. There are few therapy options available for autistic children in Brazil and we believed that Paediatric Autism Communication Therapy may be useful. We asked three groups of people in Brazil about their views of Paediatric Autism Communication Therapy, after explaining how the therapy works. Group 1 included 18 parents of autistic children aged 2-10 years. Group 2 included 20 health professionals such as psychologists who work with autistic children. Group 3 included 15 parents of autistic children aged 2-7 years who received the Paediatric Autism Communication Therapy. We learned that parents and clinicians felt that Paediatric Autism Communication Therapy would be a beneficial therapy for autistic children in Brazil. We also found out about the challenges of using Paediatric Autism Communication Therapy in Brazil. We used these findings to make small cultural adaptations to Paediatric Autism Communication Therapy to make it more suitable for Brazil.
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Affiliation(s)
| | | | | | | | | | | | | | - Holan Liang
- UCL Great Ormond Street Institute of Child Health, UK
| | | | | | - Jonathan Green
- The University of Manchester, UK
- Royal Manchester Children's Hospital, UK
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Tinelli M, Roddy A, Knapp M, Arango C, Mendez MA, Cusack J, Murphy D, Canitano R, Oakley B, Quoidbach V. Economic analysis of early intervention for autistic children: findings from four case studies in England, Ireland, Italy, and Spain. Eur Psychiatry 2023; 66:e76. [PMID: 37732502 PMCID: PMC10594363 DOI: 10.1192/j.eurpsy.2023.2449] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Many autistic children experience difficulties in their communication and language skills development, with consequences for social development into adulthood, often resulting in challenges over the life-course and high economic impacts for individuals, families, and society. The Preschool Autism Communication Trial (PACT) intervention is effective in terms of improved social communication and some secondary outcomes. A previously published within-trial economic analysis found that results at 13 months did not support its cost-effectiveness. We modeled cost-effectiveness over 6 years and across four European countries. METHODS Using simulation modeling, we built on economic analyses in the original trial, exploring longer-term cost-effectiveness at 6 years (in England). We adapted our model to undertake an economic analysis of PACT in Ireland, Italy, and Spain. Data on resource use were taken from the original trial and a more recent Irish observational study. RESULTS PACT is cost-saving over time from a societal perspective, even though we confirmed that, at 13 months post-delivery, PACT is more expensive than usual treatment (across all countries) when given to preschool autistic children. After 6 years, we found that PACT has lower costs than usual treatment in terms of unpaid care provided by parents (in all countries). Also, if we consider only out-of-pocket expenses from an Irish study, PACT costs less than usual treatment. DISCUSSION PACT may be recommended as a cost-saving early intervention for families with an autistic child.
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Affiliation(s)
- Michela Tinelli
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Aine Roddy
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
- Atlantic Technological University, Sligo, Ireland
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | - Maria Andreina Mendez
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Madrid, Spain
| | | | | | - Roberto Canitano
- University Hospital of Siena – Azienda ospedaliero-universitaria Senese, Siena, Italy
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Pacia C, Gunning C, McTiernan A, Holloway J. Developing the Parent-Coaching Assessment, Individualization, and Response to Stressors (PAIRS) Tool for Behavior Analysts. J Autism Dev Disord 2023; 53:3319-3342. [PMID: 35768672 PMCID: PMC10465672 DOI: 10.1007/s10803-022-05637-5] [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] [Accepted: 06/06/2022] [Indexed: 11/25/2022]
Abstract
Parent engagement in early behavioral intervention is essential to achieving meaningful intervention outcomes. However, parents may experience multiple barriers to engagement. The Parent-coaching Assessment, Individualization, and Response to Stressors (PAIRS) was developed to help practitioners assess families' barriers and facilitators, individualize their intervention, and respond to stressors using a contextual, functional approach. An expert panel of Board Certified Behavior Analysts ® (BCBAs) evaluated the content validity of the PAIRS. Average scale values (S-CVI/Ave) were 0.92 for relevance, 0.85 for effectiveness, and 0.91 for appropriateness. The PAIRS was revised, and a follow-up evaluation was conducted to rate the tool's utility. This led to the final version of the PAIRS. Clinical implications and future directions are discussed.
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Affiliation(s)
- Cressida Pacia
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Ciara Gunning
- School of Psychology, National University of Ireland Galway, Galway, Ireland.
| | - Aoife McTiernan
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jennifer Holloway
- School of Psychology, National University of Ireland Galway, Galway, Ireland
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Im-Bolter N, de la Roche L. What parents want: A qualitative analysis of a parent-implemented intervention for autistic children. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2023; 8:23969415231189606. [PMID: 37546520 PMCID: PMC10399253 DOI: 10.1177/23969415231189606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background and aims Guidelines regarding social cognitive interventions for autistic children suggest incorporating a holistic approach. This includes increasing the family's understanding of difficulties associated with autism, integrations of natural environments, and parents as active agents in the intervention while being supported for their well-being. The current availability of holistic parent-implemented interventions for autistic children is limited, with no qualitative understanding of how parents view the benefits for themselves or their children. Method The current study expands the literature regarding holistic approaches through a qualitative understanding of parent perceptions of a parent-implemented social communication intervention for autistic children (TalkAbility™), which incorporates a 6-month follow-up. This study sought to gain a deeper understanding from parents on their perceptions of a holistic approach, including the impact on themselves, their families, and their autistic child. Results Following Braun and Clarke's model of thematic analysis, data was coded into four themes: (a) communication difficulties, frustrations, and progress, (b) social relationships and concerns, (c) communication strategies, and (d) thoughts and emotions surrounding TalkAbility™. Conclusions Parents report that many components of a holistic approach are instrumental in encouraging social communication in their autistic child. Results highlight the importance of considering parent experiences regarding interventions for their child's social communication skills through a qualitative viewpoint. Implications Knowing the intervention aspects that parents view as most valuable allows targeted program modifications that reflect actual parent needs. Further understanding regarding the influence of holistic parent-implemented social communication interventions on child communication skills, parenting frustrations, and parent-child relationships is needed.
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Affiliation(s)
- Nancie Im-Bolter
- Department of Psychology, Trent University, Peterborough, ON, Canada; Department of Psychology, Queen's University, Kingston, ON, Canada
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Pattison E, Mantilla A, Fuller-Tyszkiewicz M, Marks D, Sciberras E, McGillivray J, Papadopoulos N, Rinehart N. Acceptability of a behavioural sleep intervention for autistic children: A qualitative evaluation of Sleeping Sound. Sleep Med 2022; 100:378-389. [PMID: 36201889 DOI: 10.1016/j.sleep.2022.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The aim of the current study was to evaluate parental perceptions of the acceptability of a brief behavioural sleep intervention for autistic children (aged 5-13 years) using the Theoretical Framework of Acceptability (TFA). METHODS Qualitative data were collected during a large randomised controlled trial evaluating the efficacy of the Sleeping Sound intervention: 123 families were randomised to the intervention group, of which 115 (93%) completed at least one intervention session and 82 (67%) provided qualitative evaluation data in the 3-month follow-up survey. Consultation records from intervention sessions and parent surveys were qualitatively analysed post hoc using a hybrid approach to thematic analysis. RESULTS Findings were categorised under the seven themes of the TFA (affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, self-efficacy) in addition to three themes that were defined following inductive and deductive coding (barriers to implementation, facilitators to implementation, suggestions for improvement). Participants spoke positively about their experience participating in the intervention and perceived the intervention to be appropriate and effective. Most parents (95.5%) reported that they would recommend the Sleeping Sound intervention to other families of autistic children. Barriers to implementation included child and parent anxiety, child health problems, parental preferences, family circumstances, and other (e.g., school holidays). Facilitators to implementation included family support and consistency with strategies. CONCLUSIONS The Sleeping Sound intervention was considered acceptable to parents of autistic children as evidenced by largely positive feedback regarding their experience. The results highlighted areas for improvement which can be used to inform future iterations of the intervention.
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Affiliation(s)
- Emily Pattison
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Ana Mantilla
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia.
| | - Deborah Marks
- Royal Children's Hospital, 50 Flemington Road, Parkville, Victoria, 3052, Australia
| | - Emma Sciberras
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia; Murdoch Children's Research Institute, 50 Flemington Road, Parkville, Victoria, 3052, Australia; Department of Paediatrics, University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia
| | - Jane McGillivray
- School of Psychology, Faculty of Health, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Nicole Papadopoulos
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
| | - Nicole Rinehart
- Krongold Clinic, School of Educational Psychology and Counselling, Faculty of Education, Monash University, 19 Ancora Imparo Way, Clayton, Victoria, 3800, Australia
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Carruthers S, Mleczko N, Page S, Ahuja S, Ellis C, Howlin P, Leadbitter K, Taylor L, Slonims V, Charman T. Using implementation science frameworks to explore barriers and facilitators for parents' use of therapeutic strategies following a parent-mediated autism intervention. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:1011-1025. [PMID: 36314780 PMCID: PMC10115939 DOI: 10.1177/13623613221125630] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Many early autism interventions teach parents therapeutic strategies to help them adjust their communication style with their children. Research has shown that this behaviour change in parents leads to improvements in child communication. It is, therefore, important to learn what factors support or hinder parents in their use of therapeutic strategies learned in such interventions. This study set out to interview parents who had participated in a research trial of the Paediatric Autism Communication Therapy-Generalised intervention. We interviewed 27 caregivers and explored their use of the strategies up to 2 years after the end of the research trial. Qualitative frameworks were used to inform interview questions and data analysis. These frameworks focused on a range of contextual factors, including parents' characteristics, their context and features of the intervention. Parents reported barriers and facilitators to using Paediatric Autism Communication Therapy-Generalised strategies across three themes: Motivating Factors; Opportunity and Support; Parent Characteristics. One of these themes, Motivating Factors, was further divided into the subthemes Compatibility and Buy-In and Alignment of Goals and Outcomes. Almost all parents reported continued use of the Paediatric Autism Communication Therapy-Generalised strategies. Facilitators included parental confidence in using the strategies and barriers included child's behaviour. Consideration of these factors can inform ways to better support parents in future autism interventions.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Vicky Slonims
- King's College London, UK
- Guy's and St Thomas' NHS Foundation Trust, UK
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14
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Jurek L, Leadbitter K, Falissard B, Colin C, Touzet S, Geoffray MM. Parental experience of parent-mediated intervention for children with ASD: A systematic review and qualitative evidence synthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:647-666. [PMID: 35899918 DOI: 10.1177/13623613221112204] [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: 11/17/2022]
Abstract
LAY ABSTRACT The effectiveness of parent-mediated interventions in the field of autism spectrum disorder is well documented but information on the experience of parents involved in parent-mediated interventions is limited.This study is the first synthesis of evidence concerning the experience of parents involved in parent-mediated interventions. It synthesizes the voice of 345 parents across the world into four general themes: barriers to implementation and logistical issues, feeling overwhelmed and stressed (a need for support), facilitators of implementation, and empowerment in the parent and improvement in the child.The findings of our study provide evidence that parent-mediated interventions should be adapted to the needs of each family. Specific care and support should be offered to parents in addition to parent-mediated interventions. Our study, however, highlights which outcomes are important to parents and should be considered in future studies.
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Affiliation(s)
- Lucie Jurek
- Centre Hospitalier Le Vinatier, France.,RESHAPE, Research on Healthcare Performance, U1290, Claude Bernard Lyon 1 University (CBL1), France
| | | | - Bruno Falissard
- Centre de Recherche en Epidémiologie et en Santé des Populations, INSERM U1018, Université Paris-Saclay, France
| | - Cyrille Colin
- RESHAPE, Research on Healthcare Performance, U1290, Claude Bernard Lyon 1 University (CBL1), France.,Hospices Civils de Lyon, France
| | - Sandrine Touzet
- Hospices Civils de Lyon, France.,Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE) UMR T9405, Université Claude Bernard Lyon 1, France
| | - Marie-Maude Geoffray
- Centre Hospitalier Le Vinatier, France.,RESHAPE, Research on Healthcare Performance, U1290, Claude Bernard Lyon 1 University (CBL1), France
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15
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Hernandez-Ruiz E, Lehrer G. "Music Therapy Was Never on the Table": Perspectives of Parents of Young Autistic Children. J Music Ther 2022; 59:307-339. [PMID: 35876192 DOI: 10.1093/jmt/thac008] [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: 11/13/2022]
Abstract
Parent coaching of music interventions is emerging as a viable model for families with young autistic children, yet recruitment difficulties have been apparent in previous studies. Understanding parent perspectives of early intervention services is critical to ensure that interventions are acceptable, feasible, and effective for all family members. In order to understand possible parental resistance to this type of parent education, we explored perspectives regarding music therapy, research, and parent coaching in parents of young autistic children. Fourteen parents attended virtual focus groups to discuss their experiences. We used a descriptive phenomenological approach to uncover the essence of their experience. Our findings indicate that, contrary to our preconceptions, participants did not show negative dispositions towards music therapy, research, or parent coaching. Instead, most participants had very little or no knowledge of music therapy services. They had limited experience with research in general, and only two participants had experienced music therapy directly. Several participants had varying amounts of experience with parent participation or parent coaching outside of music therapy and shared positive experiences with it. Parents seemed willing and eager to learn music strategies to support their children and saw value in the use of music for their child's development. First-contact providers (i.e., early interventionists and diagnosticians) and social media seem influential in parents' decision-making as they navigate early intervention services soon after diagnosis. Music therapy organizations are encouraged to design targeted efforts to make information on music therapy available through these sources.
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16
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Li F, Tang Y, Li F, Fang S, Liu X, Tao M, Wu D, Jiang L. Psychological distress in parents of children with autism spectrum disorder: A cross-sectional study based on 683 mother-father dyads. J Pediatr Nurs 2022; 65:e49-e55. [PMID: 35249769 DOI: 10.1016/j.pedn.2022.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 12/22/2022]
Abstract
PURPOSE This study aimed to assess psychological distress and its gender difference in parents of children with ASD. Predictive factors for parental psychological distress and interaction effects between parents were also explored. DESIGN AND METHODS A cross-sectional study was conducted for parents of children with ASD and 683 mother-father dyads were included in the analyses. RESULTS Mothers of children with severe autistic symptoms reported significantly higher levels of stress, anxiety, and depression than fathers. The prevalence of moderate-to-severe anxiety and depression for mothers was 13.8% and 13.1%, respectively. The corresponding prevalence for fathers was 9.9% and 8.0%, respectively. A college education or above protected against maternal stress and an only child predicted paternal stress. Child social impairment predicted maternal but not paternal psychological distress. Stress was a significant predictor of anxiety and depression for both parents. Paternal stress and anxiety moderated the relationship between child's social impairment and maternal stress, and paternal anxiety moderated the relationship between child's social impairment and maternal depression. CONCLUSIONS The gender difference in the parental psychological distress depends on the severity of children's autistic symptoms. Child social impairment exerts significant effects on mothers' psychological distress and parental stress contributes to anxiety and depression for both parents. The psychological distress of fathers moderates the relationship between child social impairment and maternal psychological distress. IMPLICATIONS Health-care professionals should pay special attention to parents who are susceptible to psychological distress. Social skill interventions for children and stress reduction programs for parents are recommended to promote parental psychological well-being.
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Affiliation(s)
- Fēi Li
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Developmental and Behavioral Pediatric & Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Tang
- Faculty of Education, Yunnan Normal University, Kunming, China; Department of Developmental and Behavioral Pediatric & Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei Li
- Department of Developmental and Behavioral Pediatric & Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Shuanfeng Fang
- Department of Child Health, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Xin Liu
- Department of Developmental and Behavioral Pediatric & Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minyi Tao
- Department of Developmental and Behavioral Pediatric & Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Danping Wu
- Department of Developmental and Behavioral Pediatric & Child Primary Care, Brain and Behavioral Research Unit of Shanghai Institute for Pediatric Research, MOE-Shanghai Key Laboratory for Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liping Jiang
- Department of Nursing, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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17
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Green J, Leadbitter K, Ainsworth J, Bucci S. An integrated early care pathway for autism. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:335-344. [PMID: 35303486 DOI: 10.1016/s2352-4642(22)00037-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 01/17/2023]
Abstract
In this Viewpoint, we argue for the need to reconceptualise an integrated early-care provision for autistic children in the light of their enduring support needs and relevant new findings from developmental and intervention research. This model goes beyond short-term reactive care to outline an early proactive, evidenced, developmentally phased, and scalable programme of support for autistic children and their families from the earliest opportunity, with timely access to later step-up care when needed. We also integrate this model with emerging opportunities from data science and digital health technologies as a potential facilitator of such a pathway. Building on this work, we argue that the best current autism intervention evidence can be integrated with concepts and evidence gained in the management of other enduring health conditions to support an autistic child and their family through their early development. The aim is to improve those children's social communication abilities, expand their range and flexibility of interests, and mitigate any negative impacts of sensory difficulties and restricted, repetitive behaviours on the child and their family wellbeing. The pathway solutions described could also be adapted for older adolescents and adults and could be used within the health systems of different countries, including within low-income and middle-income contexts.
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Affiliation(s)
- Jonathan Green
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester, UK; Department of Child and Adolescent Mental Health, Manchester Royal Children's Hospital, Manchester, UK.
| | - Kathy Leadbitter
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester, UK
| | - John Ainsworth
- Division of Imaging, Informatics and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Sandra Bucci
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine, and Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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18
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Pivotal Response Treatment (PRT) - Parent Group Training for Young Children with Autism Spectrum Disorder: A Qualitative Study on Perspectives of Parents. J Autism Dev Disord 2022; 52:5414-5427. [PMID: 35083605 PMCID: PMC8791680 DOI: 10.1007/s10803-021-05397-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 01/31/2023]
Abstract
Pivotal Response Treatment (PRT) is considered to be an empirically supported parent-mediated treatment for children with autism spectrum disorder (ASD), but research on parental experiences is lacking. This qualitative study examined the perspectives of parents of young children with ASD who participated in a 14-week PRT with parent group training (PRT-PG). Semi-structured interviews (n = 12) were carried out, based on Grounded Theory principles. Results indicated that facilitators and barriers were related to timing and expectations, training setting and characteristics, and participant characteristics. Perceived effects were related to improved child’s social-communication skills and well-being, parental insights into their child’s needs and own habitual patterns in communication and behavior, and positive changes in family cohesion. The findings indicate that in general parents value PRT-PG as feasible and effective.
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19
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Abstract
The current epistemology of autism as a phenotype derives from the consistency of historical accounts and decades of work within the tradition of descriptive epidemiology, culminating in current categorical descriptions within DSM and ICD nosologies and the concept of "prototypical autism." The demonstrated high heritability of this phenotype has led to an essentialist theory of autism as a biological entity and the concerted search within the developmental brain and genetic science for discrete biological markers. This search has not revealed simple markers explaining autistic outcomes and has led to moves towards a more dimensional account. This article proposes an alternative transactional approach. It proposes to understand autistic states as an emergent property within a complex developmental system; as the neurodivergent brain, and mind and body, encounter their social and physical environment within early development. Key evidence in support of this approach comes from random allocation intervention trials based on such transactional development theory, both in the infancy pre-diagnostic prodrome and the early post-diagnostic period. In replicated evidence, these intervention trials show that a targeted alteration in the quality of social transactional environment available for the child leads to significant, predictable, and sustained alterations in the outcome dimensional autistic phenotype over time; and further, in one prodromal trial, to a significant reduction in later categorical classification status. The inference from this evidence is that the prototypical autistic phenotype is to a degree malleable with a changed experienced social environment and that it is emergent from its constituent traits. Such a transactional approach enlarges our notion of the phenotype and brings the study of autism within mainstream individual difference developmental science. It challenges essentialist views, for instance as to intrinsic autistic "social avoidance" or theory of mind empathy deficits, integrates dimensional and categorical perspectives, and is consistent with the lived experience of autistic people and their advocacy for improved understanding within a social model.
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20
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Chang WW, Shi LX, Zhang L, Jin YL, Yu JG. The Mental Health Status and Associated Factors Among Medical Students Engaged in Online Learning at Home During the Pandemic: A Cross-Sectional Study From China. Front Psychiatry 2021; 12:755503. [PMID: 35002796 PMCID: PMC8732944 DOI: 10.3389/fpsyt.2021.755503] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/06/2021] [Indexed: 12/30/2022] Open
Abstract
Background: The purpose of this study was to assess the mental health status of medical students engaged in online learning at home during the pandemic, and explore the potential risk factors of mental health. Methods: A cross-sectional study was conducted via an online survey among 5,100 medical students from Wannan Medical College in China. The Depression, Anxiety and Stress scale (DASS-21) was used to measure self-reported symptoms of depression, anxiety, and stress among medical students during online learning in the pandemic. Results: In total, 4,115 participants were included in the study. The prevalence symptoms of depression, anxiety, and stress were 31.9, 32.9, and 14.6%, respectively. Depression was associated with gender, grade, length of schooling, relationship with father, students' daily online learning time, and students' satisfaction with online learning effects. Anxiety was associated with gender, length of schooling, relationship with father, relationship between parents, students' daily online learning time, and students' satisfaction with online learning effects. Stress was associated with grade, relationship with father, relationship between parents, students' daily online learning time, and students' satisfaction with online learning effects. Conclusions: Nearly one-third of medical students survived with varying degrees of depression, anxiety, and stress symptoms during online learning of the COVID-19 pandemic. Gender, grade, length of schooling, family environment, and online learning environment play vital roles in medical students' mental health. Families and schools should provide targeted psychological counseling to high-risk students (male, second-year and third-year, four-year program). The findings of this study can provide reference for educators to cope with the psychological problems and formulate the mental health curriculum construction among medical students during online learning.
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Affiliation(s)
- Wei-wei Chang
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Liu-xia Shi
- Department of Oral Medicine, School of Stomatology, Wannan Medical College, Wuhu, China
| | - Liu Zhang
- Department of Hospital Infection Management Office, Wuhu Hospital of Traditional Chinese Medicine, Wuhu, China
| | - Yue-long Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Wannan Medical College, Wuhu, China
| | - Jie-gen Yu
- School of Humanities and Management, Wannan Medical College, Wuhu, China
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21
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Sengupta K, Shah H, Ghosh S, Sanghvi D, Mahadik S, Dani A, Deshmukh O, Pacione L, Dixon P, Salomone E, Servili C. World Health Organisation-Caregiver Skills Training (WHO-CST) Program: Feasibility of Delivery by Non-Specialist Providers in Real-world Urban Settings in India. J Autism Dev Disord 2021; 53:1444-1461. [PMID: 34853959 DOI: 10.1007/s10803-021-05367-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 10/19/2022]
Abstract
The World Health Organization-Caregiver Skills Training Program, a parent-mediated early intervention facilitated by non-specialist providers piloted in urban India was evaluated using mixed-methods for feasibility and effects on child and caregiver outcomes. Caregivers (n = 22) of children (2-9 years) with social-communication delays participated in a single-group pre-post study. High rates of caregiver attendance, improved caregiver fidelity, and facilitator competency suggested program feasibility. Caregivers voiced acceptability of various intervention-components. The intervention was associated with improved caregiver-reported skills and knowledge (p < 0.00), reduction in stress (p = 0.03), improved child developmental outcomes on communication and social interaction (p < 0.00), and adaptive behaviors (p < 0.00). Challenges about logistics and availability of time were highlighted. Implications of results in resource-poor settings and recommendations for future feasibility trials are discussed.
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Affiliation(s)
- Koyeli Sengupta
- Autism Intervention Services, Ummeed Child Development Center, Ground Floor, Mantri Pride, 1-B, 1/62 N.M. Joshi Marg, Subhash Nagar, Near Chinchpokli Station, Lower Parel, Mumbai, 400011, India.
| | - Henal Shah
- Department of Psychiatry, T. N. Medical College & BYL Nair Ch. Hospital, Mumbai, India
| | - Subharati Ghosh
- Research Insights and Innovation, Population Health and Safety, SEIU 775 Benefits Group, Seattle, USA
| | - Disha Sanghvi
- Autism Intervention Services, Ummeed Child Development Center, Ground Floor, Mantri Pride, 1-B, 1/62 N.M. Joshi Marg, Subhash Nagar, Near Chinchpokli Station, Lower Parel, Mumbai, 400011, India
| | - Sanchita Mahadik
- Autism Intervention Services, Ummeed Child Development Center, Ground Floor, Mantri Pride, 1-B, 1/62 N.M. Joshi Marg, Subhash Nagar, Near Chinchpokli Station, Lower Parel, Mumbai, 400011, India
| | - Allauki Dani
- Department of Psychiatry, T. N. Medical College & BYL Nair Ch. Hospital, Mumbai, India
| | - Oshin Deshmukh
- Autism Intervention Services, Ummeed Child Development Center, Ground Floor, Mantri Pride, 1-B, 1/62 N.M. Joshi Marg, Subhash Nagar, Near Chinchpokli Station, Lower Parel, Mumbai, 400011, India
| | - Laura Pacione
- Division of Child and Youth Mental Health, Department of Psychiatry, University of Toronto, Toronto, Canada.,Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Pamela Dixon
- Autism Speaks, 1060 State Rd, Princeton, NJ, USA
| | - Erica Salomone
- Department of Psychology, University of Milan-Bicocca, Milan, Italy.,Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | | | - Chiara Servili
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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22
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Musetti A, Manari T, Dioni B, Raffin C, Bravo G, Mariani R, Esposito G, Dimitriou D, Plazzi G, Franceschini C, Corsano P. Parental Quality of Life and Involvement in Intervention for Children or Adolescents with Autism Spectrum Disorders: A Systematic Review. J Pers Med 2021; 11:894. [PMID: 34575671 PMCID: PMC8469292 DOI: 10.3390/jpm11090894] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/05/2021] [Accepted: 09/06/2021] [Indexed: 11/24/2022] Open
Abstract
Previous research has examined several parental, child-related, and contextual factors associated with parental quality of life (QoL) among parents with a child or an adolescent with autism spectrum disorders (ASD); however, no systematic review has examined the relationship between parental QoL and parental involvement in intervention. To fill this gap, a systematic review was conducted using four electronic databases and checked reference lists of retrieved studies. Records were included in the systematic review if they presented original data, assessed parental QoL, and involvement in intervention for children or adolescents with ASD, were published in peer-reviewed journals between 2000 and 2020, and were written in English. Among the 96 screened full-texts, 17 articles met the eligibility criteria. The selected studies included over 2000 parents of children or adolescents with ASD. Three categories of parental involvement (i.e., none, indirect, direct) were identified, which varied across studies, although most had direct parental involvement. The results from this review show that increased parental involvement in the intervention for children or adolescents with ASD may be one way to promote their QoL. However, further research specifically focused on parental involvement during the intervention for children and adolescents with ASD is warranted.
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Affiliation(s)
- Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Tommaso Manari
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
| | - Barbara Dioni
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
- Fondazione Bambini e Autismo Onlus, 33170 Pordenone, Italy
| | - Cinzia Raffin
- Fondazione Bambini e Autismo Onlus, 33170 Pordenone, Italy
| | - Giulia Bravo
- Fondazione Bambini e Autismo Onlus, 33170 Pordenone, Italy
| | - Rachele Mariani
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Gianluca Esposito
- Social and Affective Neuroscience Lab, Psychology Program-SSS, Nanyang Technological University, Singapore 639818, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
- Affiliative Behaviour and Physiology Lab, Department of Psychology and Cognitive Science, University Trento, 38068 Rovereto, Italy
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Department of Psychology and Human Development, UCL-Institute of Education, London WC1H 0AA, UK
- The National Institute for Stress, Anxiety, Depression and Behavioural Change (NISAD), 252 21 Helsingborg, Sweden
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- IRCCS Institute of Neurological Sciences of Bologna (ISNB), 40139 Bologna, Italy
| | | | - Paola Corsano
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Borgo Carissimi 10, 43121 Parma, Italy
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23
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O'Toole C, Lyons R, Houghton C. A Qualitative Evidence Synthesis of Parental Experiences and Perceptions of Parent-Child Interaction Therapy for Preschool Children With Communication Difficulties. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:3159-3185. [PMID: 34289311 DOI: 10.1044/2021_jslhr-20-00732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Parent-child interaction therapy refers to a number of interventions mediated by trained parents to treat developmental difficulties, including speech, language, and communication. Understanding the experiences of parents who take part in parent-child interaction therapy is a key aspect of determining how this intervention can be implemented successfully. However, to date, there has been limited work on synthesizing parental views of this intervention. Method We used qualitative evidence synthesis that involved searching the literature for qualitative studies addressing the experiences and perceptions of parent-child interaction therapy for parents of preschool children with communication difficulties. We identified 27 studies (from 32 publications) and synthesized the data using thematic synthesis. We appraised the quality of included studies using Critical Appraisal Skills Programme (CASP) and assessed our confidence in the review findings using GRADE Confidence in the Evidence from Reviews of Qualitative research (CERQual). Results At the beginning of this intervention, parents may have competing demands and varied expectations about the intervention. Their engagement is facilitated when the intervention is tailored to their individual family, their preferences for learning, and when they have a trusting relationship with the clinician. At the end of the intervention, although most parents perceive an improvement in their child's communication and feel empowered to facilitate this, they have concerns about their child's future needs. Conclusions It is important that clinicians explore parents' readiness for this intervention by discussing their needs and preferences openly, and that they facilitate their engagement through a supportive relationship. They also need to consider how parents will transition out of the intervention and continue to support their child's language development. Supplemental Material https://doi.org/10.23641/asha.14978454.
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Affiliation(s)
- Ciara O'Toole
- Department of Speech and Hearing Sciences, University College Cork, Ireland
| | - Rena Lyons
- Discipline of Speech and Language Therapy, National University of Ireland Galway
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Purpura G, Tagliabue L, Petri S, Cerroni F, Mazzarini A, Nacinovich R. Caregivers' Burden of School-Aged Children with Neurodevelopmental Disorders: Implications for Family-Centred Care. Brain Sci 2021; 11:brainsci11070875. [PMID: 34208983 PMCID: PMC8301981 DOI: 10.3390/brainsci11070875] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 01/16/2023] Open
Abstract
Caregivers of children with neurodevelopmental disorders play a central role during the rehabilitation and education processes, but they have an increasing risk of psychosocial problems even if the literature is not so agreed upon the specific and predisposing factors to that. The aim of this study was to examine possibly differences of burden levels in an Italian sample of principal caregivers of children with different kinds of neurodevelopmental disorders and to investigate the possible links between some clinical and sociodemographic variables and the levels of caregiver’s burden. 105 caregivers of school-aged children with neurodevelopmental disorders were included in the study and completed three online questionnaires (General Questionnaire, Caregiver Burden Inventory, Zarit Caregiver Burden Scale). Results highlighted that about the half of caregivers show from moderate to high levels of stress, but parents of children with Autism Spectrum Disorder and Intellectual Disability show greater difficulties than parents of children with Attention-Deficit Hyperactivity Disorder, Language and/or Learning Disorder, and Developmental Coordination Disorder. Moreover, it was evident a negative correlation between the burden levels and the age of children, but also a direct correlation between the burden levels and the weekly hours of rehabilitation. These findings show that severity of caregiver’s burden is dependent by the type of neurodevelopmental disorder and suggest that an ecological and family-centred approach is necessary to guarantee the life health developmental course of these children.
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Affiliation(s)
- Giulia Purpura
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy;
- Correspondence: ; Tel.: +39-039-233-9279
| | - Luca Tagliabue
- Child and Adolescent Health Department, S. Gerardo Hospital, ASST of Monza, 20900 Monza, Italy;
| | - Stefania Petri
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, 56128 Pisa, Italy;
| | - Francesco Cerroni
- Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania “Luigi Vanvitelli”, 80100 Naples, Italy;
| | - Andrea Mazzarini
- Clinic of Rehabilitation “A Ruota Libera”, 00069 Trevignano Romano, Italy;
| | - Renata Nacinovich
- School of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy;
- Child and Adolescent Health Department, S. Gerardo Hospital, ASST of Monza, 20900 Monza, Italy;
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Klein CB, Swain DM, Vibert B, Clark-Whitney E, Lemelman AR, Giordano JA, Winter J, Kim SH. Implementation of Video Feedback Within a Community Based Naturalistic Developmental Behavioral Intervention Program for Toddlers With ASD: Pilot Study. Front Psychiatry 2021; 12:763367. [PMID: 34925094 PMCID: PMC8674462 DOI: 10.3389/fpsyt.2021.763367] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
Video feedback (VF) is an intervention delivery technique that complements naturalistic developmental behavioral interventions (NDBI) and parent-mediated interventions (PMI) by using caregiver-child interaction videos reviewed with a clinician to facilitate behavioral change in caregivers. Although VF has been implemented in PMI with young children with ASD, examinations of feasibility and acceptability, as well as the potential effectiveness of VF in community settings, have been limited. In this pilot randomized control trial (NCT03397719; https://clinicaltrials.gov/ct2/show/NCT03397719), families were randomized into a state-funded Early Intervention (EI) NDBI program or the NDBI program augmented with VF. Results demonstrated high levels of implementation and acceptability of VF augmenting the community-based EI program in caregivers and clinicians. Both groups showed significant improvements after 6 months in social communication symptoms and some areas of developmental and adaptive skills. Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03397719, identifier: NCT03397719.
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Affiliation(s)
- Claire B Klein
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
| | - Deanna M Swain
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
| | - Bethany Vibert
- Autism Center, Child Mind Institute, New York, NY, United States
| | - Elysha Clark-Whitney
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
| | - Amy R Lemelman
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States.,NewYork-Presbyterian Hospital, White Plains, NY, United States
| | | | - Jamie Winter
- NewYork-Presbyterian Hospital, White Plains, NY, United States
| | - So Hyun Kim
- Center for Autism and the Developing Brain, Weill Cornell Medicine, White Plains, NY, United States
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