1
|
Li M, Wang Y, Gao H, Xia Z, Zeng C, Huang K, Zhu Z, Lu J, Chen Q, Ke X, Zhang W. Exploring autism via the retina: Comparative insights in children with autism spectrum disorder and typical development. Autism Res 2024; 17:1520-1533. [PMID: 39075780 DOI: 10.1002/aur.3204] [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: 04/28/2024] [Accepted: 07/11/2024] [Indexed: 07/31/2024]
Abstract
Autism spectrum disorder (ASD) is a widely recognized neurodevelopmental disorder, yet the identification of reliable imaging biomarkers for its early diagnosis remains a challenge. Considering the specific manifestations of ASD in the eyes and the interconnectivity between the brain and the eyes, this study investigates ASD through the lens of retinal analysis. We specifically examined differences in the macular region of the retina using optical coherence tomography (OCT)/optical coherence tomography angiography (OCTA) images between children diagnosed with ASD and those with typical development (TD). Our findings present potential novel characteristics of ASD: the thickness of the ellipsoid zone (EZ) with cone photoreceptors was significantly increased in ASD; the large-caliber arteriovenous of the inner retina was significantly reduced in ASD; these changes in the EZ and arteriovenous were more significant in the left eye than in the right eye. These observations of photoreceptor alterations, vascular function changes, and lateralization phenomena in ASD warrant further investigation, and we hope that this work can advance interdisciplinary understanding of ASD.
Collapse
Affiliation(s)
- Mingchao Li
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
- Future Lab, Tsinghua University, Beijing, China
| | - Yuexuan Wang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Huiyun Gao
- Child Mental Health Research Center, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Zhengwang Xia
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Chaofan Zeng
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Kun Huang
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Zhaoqi Zhu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jianfeng Lu
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Qiang Chen
- School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, China
| | - Xiaoyan Ke
- Child Mental Health Research Center, Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Weiwei Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| |
Collapse
|
2
|
Davis JM, Harrington MB, Howie FR, Mohammed KS, Gunderson JA. Reducing Time to Diagnosis of Autism Spectrum Disorder Using an Integrated Community Specialty Care Model: A Retrospective Study. J Pediatr 2024; 270:114009. [PMID: 38492915 DOI: 10.1016/j.jpeds.2024.114009] [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] [Received: 09/13/2023] [Revised: 03/07/2024] [Accepted: 03/10/2024] [Indexed: 03/18/2024]
Abstract
OBJECTIVE To evaluate a fast-track triage model in an integrated community specialty clinic to reduce the age of diagnosis for patients with autism spectrum disorder (ASD). STUDY DESIGN A retrospective chart review was performed for patients seen in an integrated community specialty pediatric practice using a fast-track screening and triage model. The percentage of ASD diagnoses, age at diagnosis, and time from referral to diagnosis were evaluated. The fast-track triage model was compared with national and statewide estimates of median age of first evaluation and diagnosis. RESULTS From January 1, 2020, through December 31, 2021, 189 children with a mean (SD) age of 32.2 (12.4) months were screened in the integrated community specialty. Of these, 82 (43.4%) children were referred through the fast-track triage for further evaluation in the developmental and behavioral pediatrics (DBP) department, where 62 (75.6%) were given a primary diagnosis of ASD. Average wait time from referral to diagnosis using the fast-track triage model was 6 months. Mean (SD) age at diagnosis was 37.7 (13.5) months. The median age of diagnosis by the fast-track triage model was 33 months compared with the national and state median ages of diagnosis at 49 and 59 months, respectively. CONCLUSIONS With the known workforce shortage in fellowship-trained developmental behavioral pediatricians, the fast-track triage model is feasible and maintains quality of care while resulting in more timely diagnosis, and reducing burden on DBP by screening out cases who did not require further multidisciplinary DBP evaluation as they were appropriately managed by other areas.
Collapse
Affiliation(s)
- Jessica M Davis
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Molly B Harrington
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Flora R Howie
- Division of Developmental-Behavioral Pediatrics, Mayo Clinic, Rochester, MN
| | - Khaled S Mohammed
- Division of Community Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Jaclyn A Gunderson
- Division of Developmental-Behavioral Pediatrics, Mayo Clinic, Rochester, MN.
| |
Collapse
|
3
|
Tönis KJM, Drossaert CHC, Ten Klooster PM, Schaer M, Bourgeron T, Buitelaar JK, Sadaka Y, Freitag CM, Lapidus KM, Chiocchetti AG, Staal WG, Bohlmeijer ET. Effectiveness of a positive psychology and mindfulness-based app on mental health for parents of children with a neurodevelopmental disorder: study protocol of a pragmatic international randomized controlled trial. Trials 2024; 25:412. [PMID: 38926739 PMCID: PMC11210113 DOI: 10.1186/s13063-024-08256-w] [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: 04/29/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Parents of children with a neurodevelopmental disorder (NDD) experience more stress than parents of typically developing children. In a cocreation process with experts and parents, a low-threshold application that uses exercises based on the principles of positive psychology and mindfulness was developed. This application, called "Adappt," aims at enhancing the ability to adapt of the parents and caregivers of children with NDDs and at supporting their mental health. This protocol describes the evaluation study of the effectiveness of Adappt, its core working mechanisms and user experiences. METHOD A pragmatic international multicenter randomized controlled trial will compare the effectiveness of Adappt with a (delayed) waitlist control condition. At least 212 parents or primary caregivers of children younger than 18 years diagnosed with or suspected of a NDD will be randomly assigned to the intervention or waitlist control condition. Participants are excluded if they have severe anxiety or depression levels or are in treatment for mental health issues. Measures will be collected online at baseline, post-intervention (1 month after baseline), and 4 and 7 months after baseline. The primary outcome is the improvement in generic sense of ability to adapt as measured with the Generic Sense of Ability to Adapt Scale (GSAAS; (Front Psychol 14:985408, 2023)) at 4-month follow-up. Secondary outcomes are mental well-being, (parental) distress, and client satisfaction with "Adappt." DISCUSSION Results of this study will contribute to knowledge on the effectiveness of a low-threshold application for parents of children with a NDD in multiple countries. If the application is found to be effective in improving mental health, recommendations will be made for implementation in health care. TRIAL REGISTRATION This study is registered on clinicaltrials.gov (NCT06248762) on February 8, 2024, and the Open Science Framework ( https://osf.io/5znqv ).
Collapse
Affiliation(s)
- Kim J M Tönis
- Faculty of Behavioural, Management and Social Sciences, Section of Psychology, Health and Technology, University of Twente, 217 , Enschede, The Netherlands.
| | - Constance H C Drossaert
- Faculty of Behavioural, Management and Social Sciences, Section of Psychology, Health and Technology, University of Twente, 217 , Enschede, The Netherlands
| | - Peter M Ten Klooster
- Faculty of Behavioural, Management and Social Sciences, Section of Psychology, Health and Technology, University of Twente, 217 , Enschede, The Netherlands
| | - Marie Schaer
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Thomas Bourgeron
- Human Genetics and Cognitive Functions, Institut Pasteur, UMR3571 CNRS, IUF, Université Paris Cité, Paris, France
| | - Jan K Buitelaar
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Yair Sadaka
- Pediatric Neurology Unit, Pediatric Division, Soroka Medical Center of the Negev, Beer Sheva, Israel
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Goethe University, Frankfurt Am Main, Germany
| | - Keren Mayer Lapidus
- Negev Child Development Center of the Israel Ministry of Health, Beer Sheva, Israel
| | - Andreas G Chiocchetti
- Department of Child and Adolescent Psychiatry, Goethe University, Frankfurt Am Main, Germany
| | - Wouter G Staal
- Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
- Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Ernst T Bohlmeijer
- Faculty of Behavioural, Management and Social Sciences, Section of Psychology, Health and Technology, University of Twente, 217 , Enschede, The Netherlands
| |
Collapse
|
4
|
Ashrafun L, Uddin MJ, Debnath D. Caregiver Narratives of Children with Autism Spectrum Disorder: Exploring Symptom Recognition, Diagnosis, and Interventions. J Autism Dev Disord 2024:10.1007/s10803-024-06440-0. [PMID: 38907780 DOI: 10.1007/s10803-024-06440-0] [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: 06/11/2024] [Indexed: 06/24/2024]
Abstract
The diagnosis of autism spectrum disorder (ASD) poses myriad challenges for families, yet there is a scarcity of research focusing on their journey from recognizing initial anomalies to implementing interventions. This qualitative study examines how caregivers in Sylhet, Bangladesh, perceive and manage ASD in their children, including early symptom identification, diagnostic processes, and intervention strategies. Data for this study were collected through semi-structured interviews, case studies, and observations involving 22 caregivers of children with ASD. Participants were chosen using purposive-convenience sampling, and data collection continued until interpretive saturation was achieved. The study findings unveil nuanced caregiver perceptions of ASD causation, influenced by sociocultural factors, religious beliefs, and genetic predispositions. These determinants wield significant influence over treatment modalities and the child's developmental trajectory. Importantly, the prevalence of supernatural beliefs and myths often surpasses biomedical explanations, highlighting gaps in awareness, educational outreach, and understanding of ASD. Nevertheless, religious beliefs and rituals concurrently serve as adaptive coping mechanisms, offering solace amidst uncertainty. Furthermore, a striking observation emerges: despite parents frequently identifying anomalies in their children within a 24-month, a substantial delay of 3 to 5 years persists between initial symptom recognition and formal diagnosis. This delay predominantly stems from caregiver hesitancy driven by societal stigmatization, familial dismissal attitudes, and limited diagnostic and specialized services. This study highlights the challenging diagnostic journey and caregiving for children with ASD in Bangladesh, stressing the need for systemic improvements in services, awareness, and research to enhance the well-being of individuals with ASD.
Collapse
Affiliation(s)
- Laila Ashrafun
- Department of Sociology, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| | - Mohammad Jasim Uddin
- Department of Sociology, Shahjalal University of Science & Technology, Sylhet, Bangladesh.
| | - Dipa Debnath
- Department of Sociology, Shahjalal University of Science & Technology, Sylhet, Bangladesh
| |
Collapse
|
5
|
Kanamori K, Suzuki T, Ota C. Parenting attitude towards children with autism spectrum disorders: the Japan environment and children's study. BMJ Paediatr Open 2024; 8:e002360. [PMID: 38575170 PMCID: PMC11002392 DOI: 10.1136/bmjpo-2023-002360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/20/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE The primary objective of this study was to investigate the parenting attitudes towards children with autism spectrum disorders in early childhood in Japan. DESIGN This study was a cohort study. The participants were enrolled from January 2011 to March 2014. We obtained the prevalence of autism spectrum disorders at 3 years of age, parenting attitudes and other factors from questionnaires. We divided the participants into two groups, an autism spectrum disorders group and a non-autism spectrum disorders group, and compared the parenting attitudes. SETTING This study used data from a Japanese birth cohort study: the Japan Environment and Children's Study, conducted across 15 regional centres in Japan. PARTICIPANTS The full dataset of the Japan Environment and Children's Study comprised 104 059 records. We excluded 17 889 records because the answer for the autism spectrum disorders in the questionnaire was blank. As a result, we analysed the remaining 82 411 mother-child pairs. MAIN OUTCOME MEASURES The primary outcome variable was parenting attitudes at 3.5 years of age, which was assessed using a questionnaire. We asked respondents 16 questions related to parenting attitudes, and they answered based on their behaviours. The independent variable was the prevalence of autism spectrum disorders at 3 years of age. RESULTS Of the 82 411 participants, the children with autism spectrum disorders at 3 years of age were 372 (0.45%). In most questions about parenting attitudes, the autism spectrum disorders group had unfavourable responses. The difference was particularly noticeable when the parents taught their children social discipline. Unfavourable parenting attitudes were 16.6% in the autism spectrum disorders group and 0.8% in the non-autism spectrum disorders group in the question item with the largest difference between the two groups, a significant difference. CONCLUSIONS Parents of children with autism spectrum disorders tended to have unfavourable attitudes, suggesting the importance of parental training.
Collapse
Affiliation(s)
- Keita Kanamori
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Pediatrics, Iwate Prefectural Iwai Hospital, Ichinoseki, Japan
| | - Tomohisa Suzuki
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Chiharu Ota
- Department of Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Japan
| |
Collapse
|
6
|
Préfontaine I, Lanovaz MJ, Rivard M. Brief Report: Machine Learning for Estimating Prognosis of Children with Autism Receiving Early Behavioral Intervention-A Proof of Concept. J Autism Dev Disord 2024; 54:1605-1610. [PMID: 35764770 DOI: 10.1007/s10803-022-05641-9] [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] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
Although early behavioral intervention is considered as empirically-supported for children with autism, estimating treatment prognosis is a challenge for practitioners. One potential solution is to use machine learning to guide the prediction of the response to intervention. Thus, our study compared five machine algorithms in estimating treatment prognosis on two outcomes (i.e., adaptive functioning and autistic symptoms) in children with autism receiving early behavioral intervention in a community setting. Each machine learning algorithm produced better predictions than random sampling on both outcomes. Those results indicate that machine learning is a promising approach to estimating prognosis in children with autism, but studies comparing these predictions with those produced by qualified practitioners remain necessary.
Collapse
Affiliation(s)
- Isabelle Préfontaine
- École de psychoéducation, Université de Montréal, Montréal, QC, Canada.
- École de Psychoéducation, Université de Montréal, succursale Centre-Ville, C.P. 6128, H3C 3J7, Montréal, QC, Canada.
| | - Marc J Lanovaz
- École de psychoéducation, Université de Montréal, Montréal, QC, Canada
- Centre de recherche de l'institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
| | - Mélina Rivard
- Centre de recherche de l'institut universitaire en santé mentale de Montréal, Montréal, QC, Canada
- Département de psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| |
Collapse
|
7
|
Dahlberg A, Levin A, Fäldt AE. Implementation of the Infant-Toddler Checklist in Swedish child health services at 18 months: an observational study. BMJ Paediatr Open 2024; 8:e002406. [PMID: 38531549 DOI: 10.1136/bmjpo-2023-002406] [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: 11/24/2023] [Accepted: 03/10/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Communication and language disorders are common conditions that emerge early and negatively impact quality of life across the life course. Early identification may be facilitated using a validated screening tool such as the Infant-Toddler Checklist (ITC). We introduced the ITC at the 18-month visit to child health services (CHS) in a Swedish county. Using the RE-AIM implementation framework, this study assessed the implementation of the ITC according to five key dimensions: reach, effectiveness, adoption, implementation and maintenance. METHODS This observational study used medical records at CHS as data source. Data were collected from children who visited a child health nurse at 17-22 months. The sample included 2633 children with a mean age of 17.8 months, 1717 in the pre-implementation group and 916 in the post implementation group. We calculated the ITC completion rate (reach) and use at each site (adoption). We compared rates of referral to speech and language therapy (effectiveness) before and after implementation of the ITC using OR and 95% CIs. We described actions to facilitate implementation and maintenance of ITC screening over time. RESULTS The overall screening rate was 93% (reach) which increased from 80% initially to 94% at the end of the 2-year period (maintenance). All centres used the ITC (adoption). The ITC screen positive rate was 14%. Of children who had reached at least 24 months (n=2367), referral rate was 0.4% pre-implementation versus 6.9% post implementation (OR=18.17, 95% CI 8.15, 40.51, p<0.001) (effectiveness). Implementation strategies included training sessions, collaboration, written and automatic procedures and modifications to the medical records system. CONCLUSION The implementation of the ITC was associated with high reach, higher referral rate, complete adoption, and sustained maintenance over time.
Collapse
Affiliation(s)
- Anton Dahlberg
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Levin
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Erica Fäldt
- Child Health and Parenting (CHAP), Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|
8
|
Alshaban FA, Ghazal I, Al-Harahsheh ST, Lotfy M, Al-Shammari H, Al-Faraj F, Thompson IR, Ratto AB, Nasir A, Tolefat M. Effects of COVID-19 on Autism Spectrum Disorder in Qatar. Front Psychiatry 2024; 15:1322011. [PMID: 38445086 PMCID: PMC10913057 DOI: 10.3389/fpsyt.2024.1322011] [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: 10/15/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction The unprecedented impact of the coronavirus pandemic (COVID-19) has had profound implications on the ASD community, including disrupting daily life, increasing stress and emotional dysregulation in autistic children, and worsening individual and family well-being. Methods This study used quantitative and qualitative survey data from parents in Qatar (n=271), to understand the impact of the COVID-19 pandemic on autistic children and their families in Qatar. The questionnaire was a combination of open-ended (qualitative) and closed-ended (quantitative) questions to explore patterns in the experiences of the different families, as well as to contrive themes. The survey was created in a way to evaluate the psychological, academic/intervention, economic, and other impacts of the pandemic related measures on a sample of multicultural families residing in the State of Qatar during the peak period of confinement and physical distancing in 2020. Data acquisition involved the utilization of Google Forms. Subsequent quantitative analysis employed the SPSS software and chi-square analysis for numerical examination, enabling the characterization of the studied population and exploration of associations between parental stress levels and variables such as employment status, therapy accessibility, presence of hired assistance, and alterations in their childs skills. Concurrently, qualitative data from written responses underwent thorough categorization, encompassing themes such as emotional isolation, mental or financial challenges, and difficulties in obtaining support. Results Parents expressed distress and disturbance in their daily lives, including profound disruptions to their childrens access to treatment, education, and activities. Most parents reported deteriorations in their childrens sleep (69.4%), behavioral regulation (52.8%), and acquired skills across multiple domains (54.2%). Parents also reported decreased access to family and social support networks, as well as decreased quality of clinical and community support. Qualitative analysis of parental responses revealed that child developmental regression was an important source of parental stress. Discussion and conclusion The greater impact of the pandemic on autistic children and their families emphasizes the need for accessible and affordable health, education, and family services to manage their special needs.
Collapse
Affiliation(s)
- Fouad A. Alshaban
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Iman Ghazal
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | | | - Mustafa Lotfy
- Community Outreach, Qatar Autism Family Association, Doha, Qatar
| | - Hawraa Al-Shammari
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - Fatema Al-Faraj
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - I. Richard Thompson
- Qatar Biomedical Research Institute, Hamad bin Khalifa University, Doha, Qatar
| | - Allison B. Ratto
- Center for Autism Spectrum Disorders, Childrens National Health System, Rockville, MD, United States
| | - Assal Nasir
- Department of Biological Sciences, Drexel University, Philadelphia, PA, United States
| | - Mohamed Tolefat
- Autism Department, Shafallah Center for Children with Disabilities, Doha, Qatar
| |
Collapse
|
9
|
Rivard M, Mello C, Patel S, Morin M, Morin D. A Window into the Use of Post-diagnostic Services for Autism and Parents' Perspective on the Quality of Early Childhood Services Trajectory in a Canadian Province. J Autism Dev Disord 2024:10.1007/s10803-024-06265-x. [PMID: 38367101 DOI: 10.1007/s10803-024-06265-x] [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: 01/23/2024] [Indexed: 02/19/2024]
Abstract
The pathway for post-diagnostic services for autism tends to be complex, heterogeneous, and fraught with delays. This situation has repercussions for families' experience with care systems, the quality of early interventions, and family adjustment. To date, studies of parents' point of view on autism services have predominantly focused on the diagnostic phase of the services trajectory. The goal of the present study was to investigate the perspective of parents on autism early childhood services within a public healthcare and social services system in a Canadian province (Québec). Participants were 91 parents who completed a structured framework for the evaluation of the quality of services trajectories, the Evaluation of the services Trajectory in Autism by Parents (ETAP; Mello et al., in Research in Developmental Disabilities 133, 2023). Approximately three-quarters of families received interim services (e.g., punctual speech therapy interventions) for which they had overall neutral-to-positive appraisals but viewed as having comparably low validity and continuity. Although all children diagnosed with autism are entitled to receive early behavioral intervention (EBI) dispensed by the public health and social services system, approximately a quarter of families did not receive this service. Families who received EBI evaluated this service positively on all ETAP dimensions. The empathy (i.e., parent-provider relationships) dimension was rated highest for both interim and EBI services. Some systemic, family, and child-related factors were associated with the perceived quality of services for both interim and early childhood services. Our results emphasize the need for services for children and families as soon as possible, both during assessment and after diagnosis.
Collapse
Affiliation(s)
- Mélina Rivard
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada.
| | - Catherine Mello
- Department of Psychology, The Pennsylvania State University - Berks, State College, USA
| | - Shaneha Patel
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada
| | - Marjorie Morin
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada
| | - Diane Morin
- Département de Psychologie, succursale Centre-ville, Université du Québec à Montréal, Montréal, Québec, C.P. 8888, H3C 3P8, Canada
| |
Collapse
|
10
|
Grey I, Brennan D, Cody B. Outcomes for children with autism spectrum disorder and their families after two years of school based early intensive behavioural intervention. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024:17446295241231039. [PMID: 38346005 DOI: 10.1177/17446295241231039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The effectiveness of a school based Early Intensive Behavioural Intervention (EIBI) program was assessed over a two-year period for a cohort of 16 pre-school children with autism spectrum disorder (ASD) and their families. Children with a mean age of 40 months, were assessed prior to intervention, after 1 year of intervention, and again after 2 years. Significant improvements were observed on measures of adaptive behaviour, communication ability and challenging behaviour. Parents of children attending the program also reported increased familial quality of life, specifically improved emotional and physical well-being and increased parenting capacity over the duration of the program. The current study suggests that EIBI for young children with ASD can be effective in facilitating improvements in communication ability, reducing challenging behaviours and improving quality of life for families. Children's pre-intervention adaptive skills appeared to be the strongest predictor of post intervention gains as initial level of adaptive ability was positively related to improved post-intervention outcomes.
Collapse
Affiliation(s)
- Ian Grey
- Department of Cognitive Science, College of Humanities and Social Sciences, United Arab Emirates University, United Arab Emirates
| | | | - Brettjet Cody
- Department of Cognitive Science, College of Humanities and Social Sciences, United Arab Emirates University, United Arab Emirates
| |
Collapse
|
11
|
Gore K, Gilbert M, Hawke M, Barbaro J. Investigating autism knowledge, self-efficacy, and confidence following maternal and child health nurse training for the early identification of autism. Front Neurol 2024; 14:1201292. [PMID: 38264089 PMCID: PMC10803615 DOI: 10.3389/fneur.2023.1201292] [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: 04/06/2023] [Accepted: 11/17/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Early identification of children with a high likelihood of autism can lead to referral for diagnostic services and access to early supports, resulting in improved outcomes for children and families. Maternal and Child Health Nurses (MCHNs) in Victoria, Australia, are well-placed to monitor infants and toddlers for signs of autism, given children and caregivers attend free, regular, well-baby consultations from birth through to school age. This study aimed to identify the impact of personal and workplace factors on MCHNs' competencies of autism knowledge, self-efficacy in identifying autistic infants and toddlers, and confidence in speaking to parents/caregivers about autism. Additionally, the study sought to identify which personal and workplace factors might predict increased competency in these areas. Methods After identifying training needs and current competency levels via a training needs analysis (TNA), 1,428 MCHNs received training on the early signs of autism and in the use of the Social Attention and Communication Surveillance-Revised (SACS-R) tool for early autism identification; the training program was known as Monitoring of Social Attention, Interaction, and Communication (MoSAIC). Results Previous MCHN autism training and knowledge of autism community resources significantly contributed to increased MCHN self-efficacy in identifying autistic infants and toddlers, while knowledge of community resources was the best predictor of confidence in speaking with parents/caregivers about autism. Perceived self-efficacy and confidence in speaking with parents/caregivers about autism significantly increased following the MoSAIC autism training. Discussion Targeted autism training for primary health practitioners is an important first step for early autism identification and initiating conversations with parents/caregivers.
Collapse
Affiliation(s)
- Katherine Gore
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | | | | | - Josephine Barbaro
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| |
Collapse
|
12
|
Hisaizumi M, Tantam D. Enhanced sensitivity to pitch perception and its possible relation to language acquisition in autism. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415241248618. [PMID: 38817731 PMCID: PMC11138189 DOI: 10.1177/23969415241248618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Background and aims Fascinations for or aversions to particular sounds are a familiar feature of autism, as is an ability to reproduce another person's utterances, precisely copying the other person's prosody as well as their words. Such observations seem to indicate not only that autistic people can pay close attention to what they hear, but also that they have the ability to perceive the finer details of auditory stimuli. This is consistent with the previously reported consensus that absolute pitch is more common in autistic individuals than in neurotypicals. We take this to suggest that autistic people have perception that allows them to pay attention to fine details. It is important to establish whether or not this is so as autism is often presented as a deficit rather than a difference. We therefore undertook a narrative literature review of studies of auditory perception, in autistic and nonautistic individuals, focussing on any differences in processing linguistic and nonlinguistic sounds. Main contributions We find persuasive evidence that nonlinguistic auditory perception in autistic children differs from that of nonautistic children. This is supported by the additional finding of a higher prevalence of absolute pitch and enhanced pitch discriminating abilities in autistic children compared to neurotypical children. Such abilities appear to stem from atypical perception, which is biased toward local-level information necessary for processing pitch and other prosodic features. Enhanced pitch discriminating abilities tend to be found in autistic individuals with a history of language delay, suggesting possible reciprocity. Research on various aspects of language development in autism also supports the hypothesis that atypical pitch perception may be accountable for observed differences in language development in autism. Conclusions The results of our review of previously published studies are consistent with the hypothesis that auditory perception, and particularly pitch perception, in autism are different from the norm but not always impaired. Detail-oriented pitch perception may be an advantage given the right environment. We speculate that unusually heightened sensitivity to pitch differences may be at the cost of the normal development of the perception of the sounds that contribute most to early language development. Implications The acquisition of speech and language may be a process that normally involves an enhanced perception of speech sounds at the expense of the processing of nonlinguistic sounds, but autistic children may not give speech sounds this same priority.
Collapse
Affiliation(s)
| | - Digby Tantam
- Middlesex University, Existential Academy, London, UK
| |
Collapse
|
13
|
Montiel-Nava C, Montenegro MC, Ramirez AC, Valdez D, Rosoli A, Garcia R, Garrido G, Cukier S, Rattazzi A, Paula CS. Age of autism diagnosis in Latin American and Caribbean countries. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:58-72. [PMID: 36602228 DOI: 10.1177/13623613221147345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
LAY ABSTRACT An earlier diagnosis of autism spectrum disorder might lead to earlier intervention. However, people living in Latin American and Caribbean countries do not have much knowledge about autism spectrum disorder symptoms. It has been suggested that the older a child is when diagnosed, the fewer opportunities he or she will have to receive services. We asked 2520 caregivers of autistic children in six different Latin America and Caribbean Countries, the child's age when they noticed some developmental delays and their child's age when they received their first autism spectrum disorder diagnosis. Results indicate that, on average, caregivers were concerned about their child's development by 22 months of age; however, the diagnosis was received when the child was 46 months of age. In addition, older children with better language abilities and public health coverage (opposed to private health coverage) were diagnosed later. On the contrary, children with other medical problems and more severe behaviors received an earlier diagnosis. In our study, children were diagnosed around the time they entered formal schooling, delaying the access to early intervention programs. In summary, the characteristics of the autistic person and the type of health coverage influence the age of diagnosis in children living in Latin America and Caribbean Countries.
Collapse
Affiliation(s)
| | | | | | - Daniel Valdez
- FLACSO, Argentina
- Universidad de Buenos Aires, Argentina
| | - Analia Rosoli
- Organización Estados Iberoamericanos para la Educación, la Ciencia y la Cultura (OEI), Dominican Republic
| | | | | | - Sebastian Cukier
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Argentina
| | - Alexia Rattazzi
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista (PANAACEA), Argentina
| | | |
Collapse
|
14
|
Sarigul N, Bozatli L, Kurultak I, Korkmaz F. Using urine FTIR spectra to screen autism spectrum disorder. Sci Rep 2023; 13:19466. [PMID: 37945643 PMCID: PMC10636094 DOI: 10.1038/s41598-023-46507-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023] Open
Abstract
Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental disorder caused by multiple factors, lacking clear biomarkers. Diagnosing ASD still relies on behavioural and developmental signs and usually requires lengthy observation periods, all of which are demanding for both clinicians and parents. Although many studies have revealed valuable knowledge in this field, no clearly defined, practical, and widely acceptable diagnostic tool exists. In this study, 26 children with ASD (ASD+), aged 3-5 years, and 26 sex and age-matched controls are studied to investigate the diagnostic potential of the Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy. The urine FTIR spectrum results show a downward trend in the 3000-2600/cm region for ASD+ children when compared to the typically developing (TD) children of the same age. The average area of this region is 25% less in ASD+ level 3 children, 29% less in ASD+ level 2 children, and 16% less in ASD+ level 1 children compared to that of the TD children. Principal component analysis was applied to the two groups using the entire spectrum window and five peaks were identified for further analysis. The correlation between the peaks and natural urine components is validated by artificial urine solutions. Less-than-normal levels of uric acid, phosphate groups, and ammonium ([Formula: see text]) can be listed as probable causes. This study shows that ATR-FTIR can serve as a practical and non-invasive method to screen ASD using the high-frequency region of the urine spectrum.
Collapse
Affiliation(s)
- Neslihan Sarigul
- Institute of Nuclear Science, Hacettepe University, Ankara, Turkey.
| | - Leyla Bozatli
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Ilhan Kurultak
- Department of Nephrology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - Filiz Korkmaz
- Biophysics Laboratory, Faculty of Engineering, Atilim University, Ankara, Turkey
| |
Collapse
|
15
|
Clements CC, Ascunce K, Nelson CA. In Context: A Developmental Model of Reward Processing, With Implications for Autism and Sensitive Periods. J Am Acad Child Adolesc Psychiatry 2023; 62:1200-1216. [PMID: 36336205 DOI: 10.1016/j.jaac.2022.07.861] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/15/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Differences in reward processing have been associated with numerous psychiatric disorders, including autism and attention-deficit/hyperactivity disorder (ADHD). Many attempts to understand reward processing characterize differences in clinical populations after disorder onset; however, divergence may begin much earlier. In fact, the typical developmental progression of reward processing in infancy and early childhood is poorly understood. We re-conceptualize classic infant developmental constructs such as preferential looking into a Six-Component Developmental Model of Reward Processing: an infant- and young child-focused framework to guide research and assessment of reward processing across development. METHOD The extant developmental literature including recent textbooks, systematic reviews, and meta-analyses was reviewed to build a conceptual framework. We describe experimental paradigms to assess each developmental component of reward processing longitudinally from infancy. A timeline of each component's emergence was estimated. RESULTS Six components of reward processing were identified-association, discrimination, preference/valuation, effort, anticipation, and response. Selected evidence suggests emergence between birth and 6 months. Application of this model to autism led to a reinterpretation of existing disparate results, and illuminated a path to study the developmental processes underlying a popular hypothesis of autism, the motivation hypothesis. Current evidence further suggests that a sensitive period may exist for the emergence of reward processing. CONCLUSION The proposed framework offers a useful reconceptualization of the extant literature. Future longitudinal work using the suggested experimental paradigms with high-risk populations could elucidate the developmental trajectory of the components and timing of potential sensitive period(s) for each component.
Collapse
Affiliation(s)
- Caitlin C Clements
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Massachusetts.
| | | | - Charles A Nelson
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Massachusetts; Harvard Medical School, Boston, Massachusetts; Harvard Graduate School of Education, Cambridge, Massachusetts
| |
Collapse
|
16
|
Cheng WM, Smith TB, Butler M, Taylor TM, Clayton D. Effects of Parent-Implemented Interventions on Outcomes of Children with Autism: A Meta-Analysis. J Autism Dev Disord 2023; 53:4147-4163. [PMID: 35996037 PMCID: PMC10539413 DOI: 10.1007/s10803-022-05688-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/11/2022]
Abstract
Children with autism spectrum disorder (ASD) have been shown to benefit from parent-implemented interventions (PIIs). This meta-analysis improved on prior reviews of PIIs by evaluating RCTs and multiple potential moderators, including indicators of research quality. Fifty-one effect sizes averaged moderately strong overall benefits of PIIs (g = 0.553), with studies having lower risk of research bias yielding lower estimates (g = 0.47). Parent and observer ratings yielded similar averaged estimates for positive behavior/social skills (g = 0.603), language/communication (g = 0.545), maladaptive behavior (g = 0.519), and to a lesser extent, adaptive behavior/life skills (g = 0.239). No other study, intervention, or participant characteristic moderated outcomes. PIIs with children with ASD tend to be effective across a variety of circumstances.
Collapse
Affiliation(s)
- Wai Man Cheng
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA.
| | - Timothy B Smith
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA.
| | - Marshall Butler
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| | - Tina M Taylor
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| | - Devan Clayton
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| |
Collapse
|
17
|
Horiuchi S, Nomura O, Curry L, Kushima M, Arnold L, Yamagata Z. 'Caregivers' awareness matters': Call for a child-centred approach to early detection of autism spectrum disorder through well-child visits in Japan. Child Care Health Dev 2023; 49:985-994. [PMID: 36807909 DOI: 10.1111/cch.13107] [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] [Received: 08/30/2022] [Revised: 02/08/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Early detection of autism spectrum disorder (ASD) is essential to provide children with timely treatment and support. Evidence-based screening measures make it possible to identify children with suspected ASD at an early stage. Although Japan has a universal healthcare system that covers well-child visits, detection rates of developmental disorders, including ASD, at 18 months vary widely between municipalities (0.2%-48.0%). The reasons for this high level of variation are poorly understood. The present study aims to describe the barriers and facilitators of incorporating ASD identification during well-child visits in Japan. METHODS This is a qualitative study that conducts semi-structured in-depth interviews in two municipalities of Yamanashi Prefecture. We recruited all public health nurses (n = 17) and paediatricians (n = 11) involved in the well-child visit in each municipality and caregivers of children who also participated in the visits during the study period (n = 21). RESULTS We identified four themes characterizing the process of ASD identification in the target municipalities: (1) Identification of children with ASD is driven by caregivers' sense of concern, acceptance and awareness. (2) Multidisciplinary cooperation and shared decision-making is limited. (3) Skills and training for developmental disabilities screening are underdeveloped. (4) Caregivers' expectations shape the interaction in important ways. CONCLUSIONS Non-standardization of screening methods, limited knowledge and skills on screening and child development among healthcare providers and poor coordination among healthcare providers and caregivers are the main barriers to effective early detection of ASD through well-child visits. The findings suggest the importance of promoting a child-centred care approach through the application of evidence-based screening measures and effective information sharing.
Collapse
Affiliation(s)
- Sayaka Horiuchi
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, Yamanashi, Japan
| | - Osamu Nomura
- Department of Health Sciences Education, Hirosaki University, Aomori, Japan
- Centre for Community-based Health Professions Education, Hirosaki University, Aomori, Japan
| | - Leslie Curry
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, Connecticut, USA
| | - Megumi Kushima
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
| | - Linda Arnold
- Global Health Leadership Initiative, Yale School of Public Health, New Haven, Connecticut, USA
- International Pediatric Association (IPA), IPA-LEAD program, Marengo, Illinois, USA
| | - Zentaro Yamagata
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, Yamanashi, Japan
- Center for Birth Cohort Studies, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
18
|
Morrier MJ, Schwartz AJ, Rice CE, Platner A, Ousley OY, Kassem S, Krishnan AV, Lord C, Smith CJ, Oberleitner R. Validation of an Enhanced Telehealth Platform for Toddlers at Increased Likelihood for a Diagnosis of Autism Spectrum Disorder (ASD). J Autism Dev Disord 2023:10.1007/s10803-023-06116-1. [PMID: 37740876 DOI: 10.1007/s10803-023-06116-1] [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: 08/14/2023] [Indexed: 09/25/2023]
Abstract
Use of telehealth assessments for toddlers at increased likelihood of autism spectrum disorder (ASD) began prior to the global COVID-19 pandemic; however, the value of telehealth assessments as an alternative to in-person assessment (IPA) became clearer during the pandemic. The Naturalistic Observation Diagnosis Assessment (NODA™), previously demonstrated as a valid and reliable tool to evaluate asynchronous behaviors for early diagnosis, was enhanced to add synchronous collection of behaviors to assist clinicians in making a differential diagnosis of ASD. This study was conducted to validate the information gathered through NODA-Enhanced (NODA-E™) as compared to a gold standard IPA. Forty-nine toddlers aged 16.0-32.1 months of age, recruited through community pediatric offices and a tertiary ASD clinic, participated in both NODA-E and IPA assessments. There was high agreement between the two assessment protocols for overall diagnosis (46 of 49 cases; 93.6%; κ = .878), specific diagnostic criteria for social communication and social interaction (SCI; range 95.9-98%; κ = .918-.959), and for two of four criteria specified for restricted and repetitive behaviors (RRB; range 87.8-98%; κ = .755 and .959). There was lower agreement for two subcategories of RRBs (range 65.3-67.3%; κ = .306 and .347). NODA-E is a tool that can assist clinicians in making reliable and valid early ASD diagnoses using both asynchronous and synchronous information gathered via telehealth and offers an additional tool within a clinician's assessment toolbox.
Collapse
Affiliation(s)
- Michael J Morrier
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA.
| | - Allison J Schwartz
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Catherine E Rice
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Amanda Platner
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Opal Y Ousley
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | - Sara Kassem
- Emory Autism Center, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1551 Shoup Court, Decatur, GA, 30033, USA
| | | | - Catherine Lord
- Center for Autism Research and Treatment, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | | | | |
Collapse
|
19
|
Wagner L, Corona L, Khan N, Hooper M, Dixon A, Munoz Lavanderos A, Zheng Z, Sarkar N, Sarkar N, Warren Z. Development of an App for Tracking Family Engagement With Early Intervention Services: Focus Groups and Pilot Evaluation Study. JMIR Hum Factors 2023; 10:e45957. [PMID: 37698912 PMCID: PMC10523211 DOI: 10.2196/45957] [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: 01/23/2023] [Revised: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Expedient access to early intervention (EI) systems has been identified as a priority for children with developmental delays, identified disabilities, and other special health care needs. Despite the mandated availability of EI, it remains challenging for families to navigate referral processes and establish appropriate services. Such challenges disproportionately affect families from traditionally underserved communities. Mobile health apps can improve clinical outcomes, increase accessibility to health services, and promote adherence to health-related interventions. Though promising, the implementation of apps within routine care is in its infancy, with limited research examining the components of what makes an effective app or how to reach families most impacted by inequities in health care delivery. OBJECTIVE In study 1, we conducted focus groups to access a broad range of perspectives on the process of navigating the EI system, with the dual goals of identifying ways in which a patient-facing app might facilitate this process and identifying barriers to use with traditionally underrepresented and underserved groups. In study 2, focus group findings informed the development of a patient-facing app, which was subsequently tested with a pilot sample of 5 families. METHODS In study 1, the focus groups included 29 participants from 4 shareholder groups. Targeted sampling was used to recruit participants from traditionally underrepresented groups. Focus group questions sought information about barriers families experience as they navigate the EI system, ideal features of a patient-facing app designed to track family engagement with the EI system, and potential barriers. Focus group procedures were informed by the Consolidated Framework for Implementation Research framework. In study 2, a pilot app was developed. The app was tested with a sample of 5 families of young children involved in the EI system. Families provided information on app functionality and usability. RESULTS Qualitative analysis revealed a desire for increased communication and information about the process of accessing EI services, potential utility of an app for communication purposes, and clear recommendations for app features. Insights from focus groups were used to inform the development of the Family on Track app and related implementation supports. App features included survey customization, timing and delivery of prompts, and questions related to barriers and service satisfaction. Implementation supports include a visual guide for app installation, resources related to common family questions, and availability of study personnel to guide families through installation and provide ongoing support. Field testing provided preliminary information about app usability, including identifying future directions. CONCLUSIONS The results of this study could support the development of a new way for the EI system to communicate and connect with families, provide families with a means to communicate satisfaction and frustration, and access the supports they need to be active participants in their child's care.
Collapse
Affiliation(s)
- Liliana Wagner
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Laura Corona
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Nibraas Khan
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Madison Hooper
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Alexa Dixon
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Ambar Munoz Lavanderos
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Zhaobo Zheng
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | | | - Nilanjan Sarkar
- School of Engineering, Vanderbilt University, Nashville, TN, United States
| | - Zachary Warren
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States
| |
Collapse
|
20
|
Gilbert M, Gore K, Hawke M, Barbaro J. Development, delivery, and evaluation of a training program for the early identification of autism: Monitoring of Social Attention, Interaction, and Communication. Front Neurol 2023; 14:1201265. [PMID: 37483439 PMCID: PMC10361691 DOI: 10.3389/fneur.2023.1201265] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Early identification of Autistic children is an important precursor to diagnosis, and access to supports and services. Here we describe the training of the maternal and child health (MCH) workforce in the state of Victoria, Australia in the early identification of infants and toddlers with a high likelihood of autism. Methods In 2019, 1,428 MCH nurses completed early autism training held at venues across the state, with an additional 82 nurses completing online-only training. A training needs analysis enabled the research team to determine the workforce's current skill and knowledge levels, and to identify knowledge gaps, training needs and workplace barriers. The professional development program, known as Monitoring of Social Attention, Interaction, and Communication (MoSAIC), comprised: online pre-workshop modules; a face-to-face instructor-led workshop, which included the use of the Social Attention and Communication-Revised (SACS-R) tool; and online post-workshop modules, which included a recording of a face-to-face workshop with all accompanying resources. This was the first time that the MCH workforce received this training package. Attendees were asked to complete a training satisfaction survey immediately following the face-to-face instructor-led workshop and a follow-up survey regarding their autism knowledge and SACS-R implementation 4-6 weeks after the workshop. Results Over 90% (n = 325) of MCH nurses who completed the training satisfaction survey agreed or strongly agreed with statements that the training was clear and of high quality. Most nurses also reported that the training was well-presented and that they would recommend it to a colleague. In the 6 months following the training, a total of 82,581 SACS-R assessments were conducted by the MCH workforce, reflecting that MCH nurses had successfully integrated SACS-R assessments into their work practice after receiving the early autism identification training. Discussion This study demonstrated that training on the early identification of autism can be successfully designed, customized, and delivered to a large primary healthcare workforce for universal developmental surveillance of autism.
Collapse
|
21
|
Rivard M, Morin M, Rochefort C, Morin D, Mello C. Barriers and facilitators to accessibility, continuity, validity, flexibility, and provider-family relationship along the diagnostic pathway in developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104570. [PMID: 37423052 DOI: 10.1016/j.ridd.2023.104570] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/12/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Parents of children with developmental disabilities must navigate a complex network to obtain a diagnosis and interventions for their child. However, their subjective experience of this journey has yet to be analyzed through the lens of a theorical framework that could support research, organizational program evaluation, and facilitate providers' reflection on how to enhance families' diagnostic services trajectory. AIMS This study sought to examine the diagnostic journey as experienced by 77 parents whose children were recently diagnosed with developmental disabilities (e.g., autism, intellectual disability) in the metropolitan area of Montréal, Québec (Canada). METHODS AND PROCEDURES A mixed qualitative content analysis approach was used to describe their perspective on barriers and facilitators in reference to the five dimensions of the Evaluation of the Trajectory Autism for Parents (ETAP) model (Rivard et al., 2020): accessibility, continuity, validity, flexibility, and provider-family relationship. OUTCOMES AND RESULTS The barriers and facilitators related to systemic factors identified by parents were consistent with the five dimensions outlined by the ETAP model. However, beyond these characteristics of the service delivery system, parents additionally identified their own, personal facilitators CONCLUSIONS AND IMPLICATIONS: This study supports the relevance of the ETAP framework to understanding the experience of families seeking a diagnosis. It also reinforces the potential contributions of this model to organize extant and future research as well as structure program evaluation and improvements.
Collapse
Affiliation(s)
- Mélina Rivard
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada.
| | - Marjorie Morin
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada
| | - Corinne Rochefort
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada
| | - Diane Morin
- Université du Québec à Montréal, Canada, 100 Sherbrooke E Street, Montréal H2X 1C3, Canada
| | - Catherine Mello
- The Pennsylvania State University - Berks, State College, Reading, PA 16801, United States
| |
Collapse
|
22
|
Fox KE, Maribona AS, Quintero J, Lange C, Semidey K. Addressing Health Inequities in the United States: A Case Report on Autism Spectrum Disorder (ASD) and Social Determinants of Health. Cureus 2023; 15:e42539. [PMID: 37637658 PMCID: PMC10460124 DOI: 10.7759/cureus.42539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that presents with delays in developmental milestones, social impairment, and behavioral difficulties. Treatment relies upon an intensive individualized multidisciplinary medical and therapeutic approach. This case presents a child affected by ASD and other associated conditions, whose care was significantly limited by the effects of social determinants of health, including lack of transportation, housing instability, low income, and most importantly, lack of health insurance. Without universal health coverage, the US healthcare system requires that patients have insurance or pay out-of-pocket to access medical care. It is vital that healthcare providers are able to recognize and address these barriers in order to help pediatric patients and their families navigate a difficult and often inequitable healthcare system. It is also crucial to emphasize the importance of healthcare providers, policymakers, and advocacy organizations to work together to address the systemic barriers that limit access to quality care for children with ASD.
Collapse
Affiliation(s)
- Kristen E Fox
- Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Adriana S Maribona
- Florida Medical Student Research Journal (FMSRJ), Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Juliana Quintero
- Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Carlos Lange
- Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| | - Katherine Semidey
- Pediatrics, Florida International University, Herbert Wertheim College of Medicine, Miami, USA
| |
Collapse
|
23
|
Vinen Z, Clark M, Dissanayake C. Social and Behavioural Outcomes of School Aged Autistic Children Who Received Community-Based Early Interventions. J Autism Dev Disord 2023; 53:1809-1820. [PMID: 35182258 PMCID: PMC10123039 DOI: 10.1007/s10803-022-05477-3] [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] [Accepted: 02/01/2022] [Indexed: 10/19/2022]
Abstract
The school-age outcomes of autistic children who received early interventions (EI) remains limited. Adaptive functioning, social, peer play skills, problem behaviours, and attitudes towards school of 31 autistic children who received community-based group early start Denver model (G-ESDM) were compared to 28 age matched autistic children who received other community interventions. Similar adaptive behaviours, social skills, problem behaviours and attitudes towards school were found. Play disruption was the only dimension of play to differ; children that received community interventions demonstrated higher levels of play disruption compared to the G-ESDM group. Children had pervasive challenges in adaptive behaviour, social and play behaviour at school, irrespective of EI type. Thus, ongoing provisions are needed to support development into the school years.
Collapse
Affiliation(s)
- Zoe Vinen
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
- Autism Specific Early Learning and Care Centre, La Trobe University Melbourne, Bundoora, Melbourne, VIC, 3086, Australia
| | - Megan Clark
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia.
- Autism Specific Early Learning and Care Centre, La Trobe University Melbourne, Bundoora, Melbourne, VIC, 3086, Australia.
| | - Cheryl Dissanayake
- Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia
| |
Collapse
|
24
|
Mesleh A, Ehtewish H, de la Fuente A, Al-Shamari H, Ghazal I, Al-Faraj F, Al-Shaban F, Abdesselem HB, Emara M, Alajez NM, Arredouani A, Decock J, Albagha O, Stanton LW, Abdulla SA, El-Agnaf OMA. Blood Proteomics Analysis Reveals Potential Biomarkers and Convergent Dysregulated Pathways in Autism Spectrum Disorder: A Pilot Study. Int J Mol Sci 2023; 24:ijms24087443. [PMID: 37108604 PMCID: PMC10138652 DOI: 10.3390/ijms24087443] [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] [Received: 02/23/2023] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 04/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is an umbrella term that encompasses several disabling neurodevelopmental conditions. These conditions are characterized by impaired manifestation in social and communication skills with repetitive and restrictive behaviors or interests. Thus far, there are no approved biomarkers for ASD screening and diagnosis; also, the current diagnosis depends heavily on a physician's assessment and family's awareness of ASD symptoms. Identifying blood proteomic biomarkers and performing deep blood proteome profiling could highlight common underlying dysfunctions between cases of ASD, given its heterogeneous nature, thus laying the foundation for large-scale blood-based biomarker discovery studies. This study measured the expression of 1196 serum proteins using proximity extension assay (PEA) technology. The screened serum samples included ASD cases (n = 91) and healthy controls (n = 30) between 6 and 15 years of age. Our findings revealed 251 differentially expressed proteins between ASD and healthy controls, of which 237 proteins were significantly upregulated and 14 proteins were significantly downregulated. Machine learning analysis identified 15 proteins that could be biomarkers for ASD with an area under the curve (AUC) = 0.876 using support vector machine (SVM). Gene Ontology (GO) analysis of the top differentially expressed proteins (TopDE) and weighted gene co-expression analysis (WGCNA) revealed dysregulation of SNARE vesicular transport and ErbB pathways in ASD cases. Furthermore, correlation analysis showed that proteins from those pathways correlate with ASD severity. Further validation and verification of the identified biomarkers and pathways are warranted.
Collapse
Affiliation(s)
- Areej Mesleh
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Hanan Ehtewish
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Alberto de la Fuente
- Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha P.O. Box 34110, Qatar
| | - Hawra Al-Shamari
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Iman Ghazal
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Fatema Al-Faraj
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Fouad Al-Shaban
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Houari B Abdesselem
- Proteomics Core Facility, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Mohamed Emara
- Basic Medical Sciences Department, College of Medicine, QU Health, Qatar University (QU), Doha P.O. Box 2713, Qatar
| | - Nehad M Alajez
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Translational Cancer and Immunity Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Abdelilah Arredouani
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Diabetes Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Doha P.O. Box 34110, Qatar
| | - Julie Decock
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Translational Cancer and Immunity Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Omar Albagha
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Lawrence W Stanton
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Sara A Abdulla
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| | - Omar M A El-Agnaf
- College of Health and Life Sciences (CHLS), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
- Neurological Disorders Research Center, Qatar Biomedical Research Institute (QBRI), Hamad Bin Khalifa University (HBKU), Qatar Foundation (QF), Doha P.O. Box 34110, Qatar
| |
Collapse
|
25
|
Han C, Guo M, Ke X, Zeng L, Li M, Haihambo N, Lu J, Wang L, Wei P. Oscillatory biomarkers of autism: evidence from the innate visual fear evoking paradigm. Cogn Neurodyn 2023; 17:459-466. [PMID: 37007195 PMCID: PMC10050250 DOI: 10.1007/s11571-022-09839-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with multiple associated deficits in both social and cognitive functioning. Diagnosing ASD usually relies on subjective clinical competencies, and research on objective criteria for diagnosing ASD in the early stage is still in its infancy. A recent animal study showed that the looming-evoked defensive response was impaired in mice with ASD, but whether the effect will be observed in human and contribute to finding a robust clinical neural biomarker remain unclear. Here, to investigate the looming-evoked defense response in humans, electroencephalogram responses toward looming and corresponding control stimuli (far and missing type) were recorded in children with ASD and typical developed (TD) children. Results revealed that alpha-band activity in the posterior brain region was strongly suppressed after looming stimuli in the TD group, but remained unchanged in the ASD group. This method could be a novel, objective way to detect ASD earlier. These findings suggest that further investigation of the neural mechanism underlying innate fear from the oscillatory view could be a helpful direction in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s11571-022-09839-6.
Collapse
Affiliation(s)
- Chuanliang Han
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Mingrou Guo
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Xiaoyin Ke
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Lanting Zeng
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Jianping Lu
- Department of Child Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Liping Wang
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| | - Pengfei Wei
- Shenzhen Key Laboratory of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen Fundamental Research Institutions, Shenzhen, 518055 China
- University of Chinese Academy of Sciences, Beijing, 100049 China
| |
Collapse
|
26
|
Bejnö H, Roll-Pettersson L, Klintwall L, Långh U, Odom SL, Bölte S. Adapting the preschool environment to the needs of children on the autism spectrum in Sweden: A quasi-experimental study. Scand J Occup Ther 2023; 30:278-297. [PMID: 34696666 DOI: 10.1080/11038128.2021.1993330] [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: 10/20/2022]
Abstract
BACKGROUND Children on the autism spectrum may receive Early Intensive Behavioural Intervention (EIBI) in Sweden to support development by providing learning opportunities. However, research suggests a need to improve the quality of their learning environment. AIM This pre-registered study (#NCT03634761) aimed to evaluate the Swedish Autism Program Environment Rating Scale (APERS-P-SE) as a means to promote the quality of the pre-school learning environment for children on the autism spectrum, along with outcomes for these children, and their pre-school staff. MATERIAL AND METHODS In a quasi-experimental study, pre-school staff (n = 35) conducted either EIBI supported by in-service training and on-site coaching based on APERS-P-SE assessment (at k = 9 preschools) or EIBI only (k = 8), during an 8-months period. RESULTS The quality of the immediate learning environment (primary outcome) increased significantly in the EIBI/APERS-P-SE preschools. However, changes in child and pre-school staff measures were not significant. CONCLUSIONS AND SIGNIFICANCE In-service training and on-site coaching based on APERS-P-SE assessments can increase the quality of the learning environment in Swedish pre-school. Studies of longer duration and larger sample size are required to determine if using the APERS-P-SE can also achieve desired behavioural change for children-, and impact pre-school staff applying EIBI.
Collapse
Affiliation(s)
- Hampus Bejnö
- Department of Special Education, Stockholm University, Stockholm, Sweden
| | | | - Lars Klintwall
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Ulrika Långh
- Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, CAP Research Centre, Stockholm, Sweden
- Autism Center for Young Children, Habilitation & Health, Stockholm County Council, Stockholm, Sweden
| | - Samuel L Odom
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sven Bölte
- Child and Adolescent Psychiatry, Stockholm County Council, Stockholm, Sweden
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| |
Collapse
|
27
|
Paquet A, Dionne C, Joly J, Rousseau M, Rivard M, Lemire C. Competency drivers to support implementation of early intensive behavioral intervention in large-scale community-based services: Perspectives of caseworkers and organization representatives. EVALUATION AND PROGRAM PLANNING 2023; 97:102211. [PMID: 36592543 DOI: 10.1016/j.evalprogplan.2022.102211] [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: 06/01/2021] [Revised: 09/23/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Implementing evidence-based practices in "real-world" settings poses significant challenges. Organizations involved must address this issue by providing supportive infrastructures. Among the elements to consider are competency drivers, which refer to the selection, training, and supervision of caseworkers. The purpose of this study was to describe the perspectives of caseworkers and representatives on competency drivers that organizations put in place to support the implementation of early intensive behavioral intervention (EIBI) in large-scale community-based services. The sample consisted of 109 caseworkers and 23 organization representatives who completed questionnaires. Results demonstrated that respondents consider clinical support and training as key elements in EIBI implementation. However, despite recognizing these factors, respondents reported considerable variability in practices. It appears necessary to better define and plan the implementation of these competency drivers with a view to improving EIBI implementation.
Collapse
Affiliation(s)
- Annie Paquet
- Département de psychoéducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, Québec G8Z 4M3, Canada.
| | - Carmen Dionne
- Département de psychoéducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, Québec G8Z 4M3, Canada.
| | - Jacques Joly
- Département de psychoéducation, Université de Sherbrooke, 2500, boulevard de l'Université, Sherbrooke, Québec J1K 2R1, Canada.
| | - Myriam Rousseau
- CIUSSS Mauricie Centre-du-Québec, 3090, rue Foucher, Trois-Rivières, Québec G8Z 1M3, Canada.
| | - Mélina Rivard
- Département de psychologie, Université du Québec à Montréal, 100 rue Sherbrooke Ouest, Montréal, Québec H2X 3P2, Canada.
| | - Colombe Lemire
- Département de psychoéducation, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, Québec G8Z 4M3, Canada.
| |
Collapse
|
28
|
Kochav-Lev M, Bennett-Back O, Lotan M, Stein-Zamir C. The Use of the Alberta Infant Motor Scale (AIMS) as a Diagnostic Scale for Infants with Autism. Diagnostics (Basel) 2023; 13:diagnostics13061045. [PMID: 36980353 PMCID: PMC10047290 DOI: 10.3390/diagnostics13061045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Abstract
Autism spectrum disorder (ASD) is a group of developmental disabilities presenting difficulties in social interaction and language and an increased occurrence of cognitive, sensory, and motor gaps. Early intervention has been reported to improve the function of children with ASD. However, motor screening for children with ASD is difficult, as there are no specific tools for identifying this specific population. This study reports the results of using the Alberta Infant Motor Scale (AIMS), which assesses gross infant motor skills from ages 0 to 18 months, as a screening tool for detecting motor developmental delay (MDD) in small children with ASD. Methods: This retrospective cohort study included all children registered at one health care organization in Israel born between 2011 and 2017 (N = 240,299). Early childhood MDD was defined as having at least one recorded developmental physiotherapy (DPT) visit before the age of 2 years. Reasons for referral to DPT and the results of using AIMS as an appropriate tool for revealing developmental delays in infants with ASD are presented. Results: ASD diagnosis was reported in 1821 children (prevalence rate 0.75%). Of those, 388 (odds ratio 4.1, 95% CI 3.6–4.6) children were referred to DPT. Children with ASD mostly received DPT for motor delays (46.19%), torticollis (19.52%), developmental delay (15.48%), and preterm birth (7.38%). The use of AIMS as an early detection tool suggests that more than 87% of children with ASD and MDD present with a developmental delay or risk for one when using this scale. Conclusions: The prevalence of ASD among children referred to DPT for MDD is higher than its prevalence within the general population. The most common reasons for a child with ASD to be referred for DPT services are MMDs. AIMS was found to be a sensitive tool to pinpoint relevant candidates for ASD screening among children treated in DPT. Possible effects of the study: The use of AIMS as a relevant assessment scale for this group of clients is recommended. Training DPTs in identifying initial ASD signs and developing their clinical reasoning abilities will increase the chance of implementing early intervention with this group of clients.
Collapse
Affiliation(s)
- Mooly Kochav-Lev
- Child Development Institute, Meuhedet Health Services, Jerusalem 95464, Israel
- Correspondence:
| | - Odeya Bennett-Back
- Child Development Institute, Meuhedet Health Services, Jerusalem 95464, Israel
| | - Meir Lotan
- Department of Physiotherapy, Ariel University, Ariel 40700, Israel
| | - Chen Stein-Zamir
- Braun School of Public Health and Community Medicine, The Hebrew University, Jerusalem 91120, Israel
- Jerusalem District Health Office, Israel Ministry of Health, Jerusalem 9101002, Israel
| |
Collapse
|
29
|
Hunter P. Autism therapy at crossroads: Autism research requires stronger and more reliable evidence base for efficiently applying therapeutic interventions: Autism research requires stronger and more reliable evidence base for efficiently applying therapeutic interventions. EMBO Rep 2023; 24:e56915. [PMID: 36799071 PMCID: PMC9986808 DOI: 10.15252/embr.202356915] [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: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/18/2023] Open
Abstract
Various studies that have questioned the scientific evidence for established autism treatments have attracted both criticisms but also inspired new research to apply treatment more efficiently.
Collapse
|
30
|
Changes in Autistic Symptoms and Adaptive Functioning of Children Receiving Early Behavioral Intervention in a Community Setting: A Latent Growth Curve Analysis. J Autism Dev Disord 2023; 53:901-917. [PMID: 34813033 DOI: 10.1007/s10803-021-05373-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
Despite showing effects in well-controlled studies, the extent to which early intensive behavioral intervention (EBI) produces positive changes in community-based settings remains uncertain. Thus, our study examined changes in autistic symptoms and adaptive functioning in 233 children with autism receiving EBI in a community setting. The results revealed nonlinear changes in adaptive functioning characterized by significant improvements during the intervention and a small linear decrease in autistic symptoms from baseline to follow-up. The intensity of intervention, initial age, IQ and autistic symptoms were associated either with progress during the intervention or maintenance during the follow-up. The next step to extend this line of research involves collecting detailed data about intervention strategies and implementation fidelity to produce concrete recommendations for practitioners.
Collapse
|
31
|
Cultural adaptation of ACT to support caregivers of autistic Latino children: A pilot study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
|
32
|
Pérez-Cano L, Azidane Chenlo S, Sabido-Vera R, Sirci F, Durham L, Guney E. Translating precision medicine for autism spectrum disorder: A pressing need. Drug Discov Today 2023; 28:103486. [PMID: 36623795 DOI: 10.1016/j.drudis.2023.103486] [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: 08/18/2022] [Revised: 12/01/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
Autism spectrum disorder (ASD) is a heterogenous group of neurodevelopmental disorders (NDDs) with a high unmet medical need. Currently, ASD is diagnosed according to behavior-based criteria that overlook clinical and genomic heterogeneity, thus repeatedly resulting in failed clinical trials. Here, we summarize the scientific evidence pointing to the pressing need to create a precision medicine framework for ASD and other NDDs. We discuss the role of omics and systems biology to characterize more homogeneous disease subtypes with different underlying pathophysiological mechanisms and to determine corresponding tailored treatments. Finally, we provide recent initiatives towards tackling the complexity in NDDs for precision medicine and cost-effective drug discovery.
Collapse
Affiliation(s)
- Laura Pérez-Cano
- Discovery and Data Science (DDS) Unit, STALICLA SL, Moll de Barcelona, s/n, Edif Este, 08039 Barcelona, Spain
| | - Sara Azidane Chenlo
- Discovery and Data Science (DDS) Unit, STALICLA SL, Moll de Barcelona, s/n, Edif Este, 08039 Barcelona, Spain
| | - Rubén Sabido-Vera
- Discovery and Data Science (DDS) Unit, STALICLA SL, Moll de Barcelona, s/n, Edif Este, 08039 Barcelona, Spain
| | - Francesco Sirci
- Discovery and Data Science (DDS) Unit, STALICLA SL, Moll de Barcelona, s/n, Edif Este, 08039 Barcelona, Spain
| | - Lynn Durham
- Discovery and Data Science (DDS) Unit, STALICLA SL, Moll de Barcelona, s/n, Edif Este, 08039 Barcelona, Spain; Drug Development Unit (DDU), STALICLA SA, Avenue de Sécheron 15, 1202 Geneva, Switzerland.
| | - Emre Guney
- Discovery and Data Science (DDS) Unit, STALICLA SL, Moll de Barcelona, s/n, Edif Este, 08039 Barcelona, Spain.
| |
Collapse
|
33
|
A Review on Early Intervention Systems. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023; 10:147-153. [PMID: 36845328 PMCID: PMC9937857 DOI: 10.1007/s40474-023-00274-8] [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: 01/31/2023] [Indexed: 02/20/2023]
Abstract
Purpose of Review Early intervention programs have been shown to increase the overall socio-emotional and physical wellbeing of children in early childhood and educational settings. The goal of this narrative review is to explore recent literature that describes implementation of these systems and highlights innovative practices in the early childhood intervention sector. Recent Findings Twenty-three articles were included, and we identified three themes in this review. The literature addressed concepts of innovative techniques in relation to childhood disability interventions; policy practices that promote child, family, and practitioner wellbeing; and attention to the importance of trauma-informed care in education for children and families who face the impacts of social marginalization such as racism and colonization. Summary Notable shifts in the current early intervention paradigms are approaches to understanding disability informed by intersectional and critical theories, as well as systems level thinking that goes beyond focusing on individual intervention by influencing policy to advance innovative practice in the sector.
Collapse
|
34
|
Poustka L. Autismus-Spektrum-Störungen. Monatsschr Kinderheilkd 2023. [DOI: 10.1007/s00112-023-01700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
|
35
|
Mounzer W, Stenhoff DM, Alkhateeb JM, Al Khatib AJ. A follow-up study of early intensive behavioral intervention program for children with Autism in Syria. Sci Rep 2023; 13:70. [PMID: 36593287 PMCID: PMC9807639 DOI: 10.1038/s41598-022-27198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
We examined the sustained effects of early intensive behavioral intervention (EIBI) on 66 children with autism spectrum disorder who participated in the Future Center's EIBI program. Children were assessed using the childhood autism rating scale (CARS), autism behavior checklist (ABC), and adaptive behavior scale (ABS-Arabic) 3 years after leaving the program. Continued positive effects were observed in several areas, including adaptive behavior and autism symptoms. However, participants' social skills might have declined on the ABS-Arabic after service withdrawal. Additionally, a significant negative association (p < .001) was found between participants' performance on the CARS and the number of weekly trials. This is encouraging, given the lack of EIBI services and regional instability. Future research should increase the sample size and use a more rigorous design.
Collapse
Affiliation(s)
- Wissam Mounzer
- Department of Psychology, Damascus University, Damascus, Syria.
- Department of Special Education, Stockholm University, Stockholm, Sweden.
| | | | - Jamal M Alkhateeb
- Department of Special Education, The University of Jordan, Amman, Jordan
| | - Amal J Al Khatib
- Department of Early Childhood Education, Queen Rania Faculty for Childhood, Hashemite University, Zarqa, Jordan
| |
Collapse
|
36
|
Yang J, Shen Y, Tian Y, Peng J, Fu X, Li Y, Ou J. Investigating and comparing the psychometric properties of the Chinese Mandarin version of social responsiveness scale-2 and its shortened version in preschool-age children with autism spectrum disorder. Asian J Psychiatr 2023; 79:103395. [PMID: 36495828 DOI: 10.1016/j.ajp.2022.103395] [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: 07/31/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 12/12/2022]
Abstract
We aimed to investigate and compare the psychometric properties of the Chinese Mandarin Social Responsiveness Scale-2 (SRS-2) and its shortened version. The study assessed 670 children with autism spectrum disorder (ASD) aged 30-54 months and 138 typical developmental (TD) children of the same age in mainland China. Our item reliability test revealed that only 36 items of the 65 items in the Chinese Mandarin SRS-2 (Preschool) met the reliability criteria. Moreover, the shortened version of SRS-2 (Preschool) with four subscales and 30 items maintained strong correlations (r = 0.961) with the Chinese Mandarin SRS-2 (Preschool), and demonstrated improved psychometric performance on the 4-week test-retest reliability (intraclass correlations was 0.70), internal consistency (Cronbach's alpha 0.71-0.91), construct validity, and convergent validity with the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, and Child Behavior Checklist. Receiver operating characteristics (ROC) analyses showed excellent and comparable discriminant validity of the shortened version with an area under the curve of 0.992. Our data suggested a cutoff ≥ 22.5 for the shortened version, with good accuracy in screening autism symptoms (sensitivity=96.9 %, specificity=94.2 %). Our findings demonstrated that the shortened version of SRS-2 (Preschool) was a reliable and valid instrument for identifying preschoolers with ASD in mainland China.
Collapse
Affiliation(s)
- Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Yidong Shen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; National Clinical Research Center for Mental Disorders, Department of Psychiatry and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Juan Peng
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Xi Fu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
| | - Jianjun Ou
- National Clinical Research Center for Mental Disorders, Department of Psychiatry and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China.
| |
Collapse
|
37
|
Tsiplova K, Ungar WJ, Szatmari P, Cost K, Pullenayegum E, Duku E, Volden J, Smith IM, Waddell C, Zwaigenbaum L, Bennett TA, Elsabbagh M, Georgiades S, Zaidman-Zait A. Measuring the association between behavioural services and outcomes in young children with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 132:104392. [PMID: 36493738 DOI: 10.1016/j.ridd.2022.104392] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) receive a wide range of services. AIMS To examine the association between behavioural services received by children with ASD between ages 2 and 5 years and outcomes during primary school years. METHODS A total of 414 preschool-aged children diagnosed with ASD were enrolled at five Canadian sites and were assessed within four months of diagnosis (T1), six months later (T2), 12 months later (T3), at school entry (T4), and then annually (T5-T8) to 11 years of age. The association between the receipt of behavioural services during T1 to T3 and T8 outcomes related to adaptive behaviour and behavioural problems was modelled using linear regressions adjusted for immigrant status, family income, child's age at diagnosis, site, sex assigned at birth, and baseline (T1) outcome. RESULTS Children who received behavioural services during at least one time period from T1 to T3 did not have significantly different outcomes at T8 than children who did not receive any behavioural services. IMPLICATIONS Pre-school use of behavioural services was not found to affect outcomes during later childhood. Numerous challenges accompany studies of the association between pre-school service use and later outcomes in a heterogeneous ASD sample. Recommendations for study design are provided.
Collapse
Affiliation(s)
- Kate Tsiplova
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
| | - Peter Szatmari
- Centre for Addiction and Mental Health, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, University of Toronto, 250 College Street, Toronto, Ontario M5T 1R8, Canada; Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Katherine Cost
- Department of Psychiatry, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1×8, Canada
| | - Eleanor Pullenayegum
- Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 11th floor, 686 Bay Street, Toronto, Ontario, M5G 0A4, Canada; Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Eric Duku
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Joanne Volden
- Faculty of Rehabilitation Medicine, University of Alberta, 8205 114 Street, 3-48 Corbett Hall, Edmonton, Alberta T6G 2G4, Canada
| | - Isabel M Smith
- Department of Pediatrics, Dalhousie University, IWK Health Centre, 5850 University Avenue, P. O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada; Autism Research Centre, IWK Health Centre, 4th Floor Link Building, 5850/5980 University Avenue, P.O. Box 9700, Halifax, Nova Scotia B3K 6R8, Canada
| | - Charlotte Waddell
- Children's Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Room 2435, 515 West Hastings Street Vancouver, British Columbia V6B 5K, Canada
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue Edmonton, Alberta T6G 1C9, Canada
| | - Teresa A Bennett
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Mayada Elsabbagh
- Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec H3A 2B4, Canada
| | - Stelios Georgiades
- Offord Centre for Child Studies, McMaster University, 1280 Main St. W. - MIP 201A, Hamilton, Ontario L8S 4K1, Canada; Department of Psychiatry and Behavioural Neuroscience, McMaster University, St. Joseph's Healthcare Hamilton, West 5th Campus, Administration B3, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada
| | - Anat Zaidman-Zait
- Department of School Counseling and Special Education, Constantiner School of Education, Tel Aviv University, Tel Aviv University, P.O. Box 39040, Tel Aviv 6997801, Israel; The School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada
| |
Collapse
|
38
|
Sun CK, Cheng YS, Chen IW, Chiu HJ, Chung W, Tzang RF, Fan HY, Lee CW, Hung KC. Impact of parental rheumatoid arthritis on risk of autism spectrum disorders in offspring: A systematic review and meta-analysis. Front Med (Lausanne) 2022; 9:1052806. [PMID: 36438039 PMCID: PMC9687371 DOI: 10.3389/fmed.2022.1052806] [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] [Received: 09/24/2022] [Accepted: 10/28/2022] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND To investigate the association of risk of offspring autism spectrum disorder (ASD) with both maternal and paternal rheumatoid arthritis (RA). METHODS The Embase, Medline, Cochrane Library databases were searched for studies that investigated the association of parental RA with risk of offspring ASD. The primary outcome was the associations of maternal/paternal RA with the risk of offspring ASD. Subgroup analyses were conducted based on the timing of maternal RA diagnosis (i.e., before/after childbirth) and geographical location (i.e., Western vs. Asian countries) of studies. RESULTS Ten studies published between 2005 and 2022 involving 6,177,650 participants were analyzed. Pooled results revealed a significant association between maternal RA and the risk of ASD (OR = 1.246, p < 0.001, 10 studies), while there was no association of paternal RA with the risk of offspring ASD (OR = 1.104, p = 0.253, four studies). Subgroup analysis demonstrated no correlation between diagnosis of maternal RA before childbirth and the risk of offspring ASD (OR = 1.449, p = 0.192, four studies), while there was a significant association of maternal RA regardless of the timing of diagnosis with the risk of offspring ASD (OR = 1.227, p = 0.001, six studies). Subgroup analysis on geographical location showed a significant association of maternal RA with the risk of offspring ASD regardless of the study location (all p < 0.05). CONCLUSION Our findings supported an association between maternal RA and an elevated risk of ASD in offspring. However, given the limited numbers of studies investigating the risk of offspring ASD in mothers diagnosed with RA before childbirth, further studies are warranted to elucidate this issue. SYSTEMATIC REVIEW REGISTRATION [www.crd.york.ac.uk/prospero/], identifier [CRD42022358470].
Collapse
Affiliation(s)
- Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital, Kaohsiung City, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung City, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - Hsien-Jane Chiu
- Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei City, Taiwan
| | - Weilun Chung
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung City, Taiwan
| | - Ruu-Fen Tzang
- Department of Psychiatry, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Hsin-Yi Fan
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung City, Taiwan
| | - Chia-Wei Lee
- Department of Neurology, Chi-Mei Medical Center, Tainan City, Taiwan
| | - Kuo-Chuan Hung
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
| |
Collapse
|
39
|
Fang Z, Lachman JM, Zhang C, Qiao D, Barlow J. A virtuous circle: Stakeholder perspectives of a short-term intensive parent training programme delivered within the context of routine services for autism in China. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1973-1986. [PMID: 35068174 PMCID: PMC9597148 DOI: 10.1177/13623613211070869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
While much knowledge about autism derives from high-income countries, most people diagnosed with autism reside in low- and middle-income countries, where little is documented in terms of local interventions. This is also true for parent training programmes for families of autistic children. An evaluation was conducted to understand the effects of a short-term intensive parent training programme delivered in routine services for families of autistic children in China. This study reported results from the in-depth interviews with 14 participating caregivers and group discussions with eight group leaders. The interviews and discussions were aimed at learning (1) to what extent the programme components were deemed acceptable, (2) what affected caregivers' attendance and engagement in the programme and (3) what affected group leaders' delivery of the programme. Findings suggested that future parent training programmes provide adequate opportunities for caregivers to practice and receive feedback; group support; coaching experience tailored to individual challenges; more autism-related knowledge, resources and activities for children and extended family members; and organisational support to group leaders. This study highlights the value of qualitative research and points to the need for more empirical studies to address the recommendations, so that research findings can be better utilised to promote practices.
Collapse
|
40
|
Bettencourt C, Garret-Gloanec N, Pellerin H, Péré M, Squillante M, Roos-Weil F, Ferrand L, Pernel AS, Apter G, Cohen D. Migration is associated with baseline severity and progress over time in autism spectrum disorder: Evidence from a French prospective longitudinal study. PLoS One 2022; 17:e0272693. [PMID: 36201564 PMCID: PMC9536617 DOI: 10.1371/journal.pone.0272693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/22/2022] [Indexed: 11/06/2022] Open
Abstract
Background The prevalence of autism-spectrum disorder (ASD) has been shown to be higher in migrant families, but it is also a challenge for health care professionals to offer adequate services to families that face multiple challenges. In the context of the EPIGRAM study (a French prospective, multisite, longitudinal observational study implementing integrative care practices (ICPs) for children with ASD), we aimed to assess the impact of migration on children with ASD. Method and findings 89 children with ASD aged 3 to 6 years old (92% males) were recruited and followed up for 12 months. The children were clinically assessed using several instruments. At baseline, children had severe autism on average on the Children Autism Rating Scale (CARS, mean = 44; SD = 6.51) and moderate autism on the PsychoEducational profile-3-R (PEP-3-R) maladaptive behavior category (mean = 30; SD = 29.89). Thirty percent of the families had a low socio-economic status, and 56% were first-generation immigrants. For all clinical variables, children of immigrant parents had more severe autism and developmental delays at baseline. A linear mixed model established an improvement in all clinical characteristics over the 12 months of the study. This trend may be attributed to ICPs or any naturally occurring event during that period. Families shared this positive view over time. However, the improvements were slower for two clinical dimensions of the PEP-3-R in children from migrant families. For the inappropriate behavior category, the time effect diminished by an average of 0.83 percentile/month for children whose parents were migrants vs. children whose parents were non-migrants. Similarly, for verbal behavior characteristics, the time effect diminished by an average of 1.32 percentile/month for children whose parents were migrants vs. children whose parents were non-migrants. Conclusion Despite an overall positive improvement, we found that migration is associated baseline severity and progress over time in children with ASD. There is an urgent need to target the migrant population with specific research and understand the avenues that carry such higher severity. Clinical trial registration Study registration on clinicaltrials.gov under the number NCT02154828.
Collapse
Affiliation(s)
- Carlotta Bettencourt
- Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Institut des pathologies du Développement de l’Enfant et de l’AdoLescent (IDEAL), APHP. SU, Paris, France
- Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7222, Institut des Systèmes Intelligents et Robotiques, Sorbonne Université, Paris, France
| | - Nicole Garret-Gloanec
- Centre Nantais de Parentalité, 1 rue Marmontel, Centre Hospitalo-Universitaire, Nantes, France
| | - Hugues Pellerin
- Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Institut des pathologies du Développement de l’Enfant et de l’AdoLescent (IDEAL), APHP. SU, Paris, France
| | - Morgane Péré
- Direction de la recherche, Plateforme de Méthodologie et Biostatistique, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | | | | | - Léa Ferrand
- Direction de la Recherche—Département promotion, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | | | - Gisèle Apter
- Groupe Hospitalier du Havre, Université de Rouen Normandie, Le Havre, France
| | - David Cohen
- Groupe Hospitalo-Universitaire Pitié-Salpêtrière, Institut des pathologies du Développement de l’Enfant et de l’AdoLescent (IDEAL), APHP. SU, Paris, France
- Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7222, Institut des Systèmes Intelligents et Robotiques, Sorbonne Université, Paris, France
- * E-mail:
| |
Collapse
|
41
|
Franz L, Goodwin CD, Rieder A, Matheis M, Damiano DL. Early intervention for very young children with or at high likelihood for autism spectrum disorder: An overview of reviews. Dev Med Child Neurol 2022; 64:1063-1076. [PMID: 35582893 PMCID: PMC9339513 DOI: 10.1111/dmcn.15258] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/19/2022]
Abstract
AIM To identify which interventions are supported by evidence and the quality of that evidence in very young children with or at high likelihood for autism spectrum disorder (ASD) to improve child outcomes. METHOD We conducted an overview of reviews to synthesize early intervention literature for very young children with or at high likelihood for ASD. Cochrane guidance on how to perform overviews of reviews was followed. Comprehensive searches of databases were conducted for systematic reviews and meta-analyses between January 2009 and December 2020. Review data were extracted and summarized and methodological quality was assessed. Primary randomized controlled trial evidence was summarized and risk of bias assessed. This overview of reviews was not registered. RESULTS From 762 records, 78 full texts were reviewed and seven systematic reviews and meta-analyses with 63 unique studies were identified. Several interventional approaches (naturalistic developmental behavioral intervention, and developmental and behavioral interventions) improved child developmental outcomes. Heterogeneity in design, intervention and control group, dose, delivery agent, and measurement approach was noted. Inconsistent methodological quality and potential biases were identified. INTERPRETATION While many early interventional approaches have an impact on child outcomes, study heterogeneity and quality had an impact on our ability to draw firm conclusions regarding which treatments are most effective. Advances in trial methodology and design, and increasing attention to mitigating measurement bias, will advance the quality of the ASD early intervention evidence base. WHAT THIS PAPER ADDS Naturalistic developmental behavioral interventions, as well as developmental and behavioral interventions, improve child outcomes in autism spectrum disorder (ASD). If only randomized controlled trials are considered, guidelines for early intensive behavioral intervention in younger children should be revisited. The greatest intervention impacts were on proximal, intervention-specific outcomes. Inadequacies in the quality of the early ASD intervention evidence base were observed.
Collapse
Affiliation(s)
- Lauren Franz
- Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke Global Health Institute, Duke University, Durham, NC, USA
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, Cape Town, South Africa
| | | | - Amber Rieder
- Duke Global Health Institute, Duke Institute for Brain Sciences, Duke University, Durham, NC, USA
| | - Maya Matheis
- Center on Disability Studies, College of Education, University of Hawai’i at Mānoa, Honolulu, Hawai’i, USA
| | | |
Collapse
|
42
|
Daniolou S, Pandis N, Znoj H. The Efficacy of Early Interventions for Children with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:5100. [PMID: 36079029 PMCID: PMC9457367 DOI: 10.3390/jcm11175100] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/12/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
The superiority of early interventions for children with autism spectrum disorders (ASDs) compared to treatment as usual (TAU) has recently been questioned. This study was aimed to investigate the efficacy of early interventions in improving the cognitive ability, language, and adaptive behavior of pre-school children with ASDs through a systematic review of randomized controlled trials (RCTs). In total, 33 RCTs were included in the meta-analysis using the random effects model. The total sample consisted of 2581 children (age range: 12-132 months). Early interventions led to positive outcomes for cognitive ability (g = 0.32; 95% CI: 0.05, 0.58; p = 0.02), daily living skills (g = 0.35; 95% CI: 0.08, 0.63; p = 0.01), and motor skills (g = 0.39; 95% CI: 0.16, 0.62; p = 0.001), while no positive outcomes were found for the remaining variables. However, when studies without the blinding of outcome assessment were excluded, positive outcomes of early interventions only remained for daily living skills (g = 0.28; 95% CI: 0.04, 0.52; p = 0.02) and motor skills (g = 0.40; 95% CI: 0.11, 0.69; p = 0.007). Although early intervention might not have positive impacts on children with ASDs for several outcomes compared to controls, these results should be interpreted with caution considering the great variability in participant and intervention characteristics.
Collapse
Affiliation(s)
- Sofia Daniolou
- Department of Psychology, University of Bern, 3012 Bern, Switzerland
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, 3010 Bern, Switzerland
| | - Hansjörg Znoj
- Department of Psychology, University of Bern, 3012 Bern, Switzerland
| |
Collapse
|
43
|
Pervin M, Ahmed HU, Hagmayer Y. Effectiveness of interventions for children and adolescents with autism spectrum disorder in high-income vs. lower middle-income countries: An overview of systematic reviews and research papers from LMIC. Front Psychiatry 2022; 13:834783. [PMID: 35990045 PMCID: PMC9386527 DOI: 10.3389/fpsyt.2022.834783] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/11/2022] [Indexed: 12/21/2022] Open
Abstract
Background There is a multitude of systematic reviews of interventions for children and adolescents with autism spectrum disorder (ASD). However, most reviews seem to be based on research conducted in High-Income Countries (HIC). Thus, summary findings may not directly apply to Lower Middle-Income Countries (LMIC). Therefore, we conducted a Meta-Review analyzing systematic reviews on the effectiveness of interventions for target outcomes in children and adolescents with ASD to find out whether there are differences in effectiveness between HIC and LMIC and which interventions can be considered evidence-based in LMIC. Methods Electronic databases (PsycINFO, PubMed, Cochrane database of systematic reviews) were searched for reviews on interventions for ASD in children and adolescents from January 2011 through December 2021, which included studies not coming from HIC. Systematic reviews with qualitative and quantitative syntheses of findings were included. Two investigators independently assessed studies against predetermined inclusion/exclusion criteria and extracted relevant data including quality and evidence assessments. Evidence for different types of interventions in HIC vs. LMIC was planned to be compared, but none of the reviews assessed potential differences. Therefore, a narrative review of the studies from LMIC was conducted including an assessment of quality and evidence. Results Thirty-five reviews fulfilled the inclusion criteria. Eleven considered findings from HIC and LMIC. Sixty-nine percent included studies with various research designs; 63% provided a qualitative synthesis of findings; 77% percent assessed the quality of studies; 43% systematically assessed the level of evidence across studies. No review compared evidence from HIC and LMIC. A review of the studies from LMIC found some promising results, but the evidence was not sufficient due to a small number of studies, sometimes poor quality, and small sample sizes. Conclusion Systematic reviews on interventions for children and adolescents with ASD did not look for potential differences in the effectiveness of interventions in HIC and LMIC. Overall, there is very little evidence from LMIC. None of the interventions can be considered evidence-based in LMIC. Hence, additional research and mutually agreed methodological standards are needed to provide a more secure basis for evidence-based treatments in LMIC trying to establish evidence-based practices.
Collapse
Affiliation(s)
- Maleka Pervin
- Institute of Psychology, Georg August University of Goettingen, Göttingen, Germany
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Helal Uddin Ahmed
- Department of Child Adolescent and Family Psychiatry, National Institute of Mental Health, Dhaka, Bangladesh
| | - York Hagmayer
- Institute of Psychology, Georg August University of Goettingen, Göttingen, Germany
| |
Collapse
|
44
|
Ayaz H, Baker WB, Blaney G, Boas DA, Bortfeld H, Brady K, Brake J, Brigadoi S, Buckley EM, Carp SA, Cooper RJ, Cowdrick KR, Culver JP, Dan I, Dehghani H, Devor A, Durduran T, Eggebrecht AT, Emberson LL, Fang Q, Fantini S, Franceschini MA, Fischer JB, Gervain J, Hirsch J, Hong KS, Horstmeyer R, Kainerstorfer JM, Ko TS, Licht DJ, Liebert A, Luke R, Lynch JM, Mesquida J, Mesquita RC, Naseer N, Novi SL, Orihuela-Espina F, O’Sullivan TD, Peterka DS, Pifferi A, Pollonini L, Sassaroli A, Sato JR, Scholkmann F, Spinelli L, Srinivasan VJ, St. Lawrence K, Tachtsidis I, Tong Y, Torricelli A, Urner T, Wabnitz H, Wolf M, Wolf U, Xu S, Yang C, Yodh AG, Yücel MA, Zhou W. Optical imaging and spectroscopy for the study of the human brain: status report. NEUROPHOTONICS 2022; 9:S24001. [PMID: 36052058 PMCID: PMC9424749 DOI: 10.1117/1.nph.9.s2.s24001] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions.
Collapse
Affiliation(s)
- Hasan Ayaz
- Drexel University, School of Biomedical Engineering, Science, and Health Systems, Philadelphia, Pennsylvania, United States
- Drexel University, College of Arts and Sciences, Department of Psychological and Brain Sciences, Philadelphia, Pennsylvania, United States
| | - Wesley B. Baker
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania, United States
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Giles Blaney
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - David A. Boas
- Boston University Neurophotonics Center, Boston, Massachusetts, United States
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Heather Bortfeld
- University of California, Merced, Departments of Psychological Sciences and Cognitive and Information Sciences, Merced, California, United States
| | - Kenneth Brady
- Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Department of Anesthesiology, Chicago, Illinois, United States
| | - Joshua Brake
- Harvey Mudd College, Department of Engineering, Claremont, California, United States
| | - Sabrina Brigadoi
- University of Padua, Department of Developmental and Social Psychology, Padua, Italy
| | - Erin M. Buckley
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia, United States
| | - Stefan A. Carp
- Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Robert J. Cooper
- University College London, Department of Medical Physics and Bioengineering, DOT-HUB, London, United Kingdom
| | - Kyle R. Cowdrick
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Joseph P. Culver
- Washington University School of Medicine, Department of Radiology, St. Louis, Missouri, United States
| | - Ippeita Dan
- Chuo University, Faculty of Science and Engineering, Tokyo, Japan
| | - Hamid Dehghani
- University of Birmingham, School of Computer Science, Birmingham, United Kingdom
| | - Anna Devor
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Turgut Durduran
- ICFO – The Institute of Photonic Sciences, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
- Institució Catalana de Recerca I Estudis Avançats (ICREA), Barcelona, Spain
| | - Adam T. Eggebrecht
- Washington University in St. Louis, Mallinckrodt Institute of Radiology, St. Louis, Missouri, United States
| | - Lauren L. Emberson
- University of British Columbia, Department of Psychology, Vancouver, British Columbia, Canada
| | - Qianqian Fang
- Northeastern University, Department of Bioengineering, Boston, Massachusetts, United States
| | - Sergio Fantini
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - Maria Angela Franceschini
- Massachusetts General Hospital, Harvard Medical School, Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States
| | - Jonas B. Fischer
- ICFO – The Institute of Photonic Sciences, The Barcelona Institute of Science and Technology, Castelldefels, Barcelona, Spain
| | - Judit Gervain
- University of Padua, Department of Developmental and Social Psychology, Padua, Italy
- Université Paris Cité, CNRS, Integrative Neuroscience and Cognition Center, Paris, France
| | - Joy Hirsch
- Yale School of Medicine, Department of Psychiatry, Neuroscience, and Comparative Medicine, New Haven, Connecticut, United States
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Keum-Shik Hong
- Pusan National University, School of Mechanical Engineering, Busan, Republic of Korea
- Qingdao University, School of Automation, Institute for Future, Qingdao, China
| | - Roarke Horstmeyer
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
- Duke University, Department of Electrical and Computer Engineering, Durham, North Carolina, United States
- Duke University, Department of Physics, Durham, North Carolina, United States
| | - Jana M. Kainerstorfer
- Carnegie Mellon University, Department of Biomedical Engineering, Pittsburgh, Pennsylvania, United States
- Carnegie Mellon University, Neuroscience Institute, Pittsburgh, Pennsylvania, United States
| | - Tiffany S. Ko
- Children’s Hospital of Philadelphia, Division of Cardiothoracic Anesthesiology, Philadelphia, Pennsylvania, United States
| | - Daniel J. Licht
- Children’s Hospital of Philadelphia, Division of Neurology, Philadelphia, Pennsylvania, United States
| | - Adam Liebert
- Polish Academy of Sciences, Nalecz Institute of Biocybernetics and Biomedical Engineering, Warsaw, Poland
| | - Robert Luke
- Macquarie University, Department of Linguistics, Sydney, New South Wales, Australia
- Macquarie University Hearing, Australia Hearing Hub, Sydney, New South Wales, Australia
| | - Jennifer M. Lynch
- Children’s Hospital of Philadelphia, Division of Cardiothoracic Anesthesiology, Philadelphia, Pennsylvania, United States
| | - Jaume Mesquida
- Parc Taulí Hospital Universitari, Critical Care Department, Sabadell, Spain
| | - Rickson C. Mesquita
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Brazilian Institute of Neuroscience and Neurotechnology, Campinas, São Paulo, Brazil
| | - Noman Naseer
- Air University, Department of Mechatronics and Biomedical Engineering, Islamabad, Pakistan
| | - Sergio L. Novi
- University of Campinas, Institute of Physics, Campinas, São Paulo, Brazil
- Western University, Department of Physiology and Pharmacology, London, Ontario, Canada
| | | | - Thomas D. O’Sullivan
- University of Notre Dame, Department of Electrical Engineering, Notre Dame, Indiana, United States
| | - Darcy S. Peterka
- Columbia University, Zuckerman Mind Brain Behaviour Institute, New York, United States
| | | | - Luca Pollonini
- University of Houston, Department of Engineering Technology, Houston, Texas, United States
| | - Angelo Sassaroli
- Tufts University, Department of Biomedical Engineering, Medford, Massachusetts, United States
| | - João Ricardo Sato
- Federal University of ABC, Center of Mathematics, Computing and Cognition, São Bernardo do Campo, São Paulo, Brazil
| | - Felix Scholkmann
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zürich, Switzerland
| | - Lorenzo Spinelli
- National Research Council (CNR), IFN – Institute for Photonics and Nanotechnologies, Milan, Italy
| | - Vivek J. Srinivasan
- University of California Davis, Department of Biomedical Engineering, Davis, California, United States
- NYU Langone Health, Department of Ophthalmology, New York, New York, United States
- NYU Langone Health, Department of Radiology, New York, New York, United States
| | - Keith St. Lawrence
- Lawson Health Research Institute, Imaging Program, London, Ontario, Canada
- Western University, Department of Medical Biophysics, London, Ontario, Canada
| | - Ilias Tachtsidis
- University College London, Department of Medical Physics and Biomedical Engineering, London, United Kingdom
| | - Yunjie Tong
- Purdue University, Weldon School of Biomedical Engineering, West Lafayette, Indiana, United States
| | - Alessandro Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Milan, Italy
- National Research Council (CNR), IFN – Institute for Photonics and Nanotechnologies, Milan, Italy
| | - Tara Urner
- Georgia Institute of Technology, Wallace H. Coulter Department of Biomedical Engineering, Atlanta, Georgia, United States
| | - Heidrun Wabnitz
- Physikalisch-Technische Bundesanstalt (PTB), Berlin, Germany
| | - Martin Wolf
- University of Zurich, University Hospital Zurich, Department of Neonatology, Biomedical Optics Research Laboratory, Zürich, Switzerland
| | - Ursula Wolf
- University of Bern, Institute of Complementary and Integrative Medicine, Bern, Switzerland
| | - Shiqi Xu
- Duke University, Department of Biomedical Engineering, Durham, North Carolina, United States
| | - Changhuei Yang
- California Institute of Technology, Department of Electrical Engineering, Pasadena, California, United States
| | - Arjun G. Yodh
- University of Pennsylvania, Department of Physics and Astronomy, Philadelphia, Pennsylvania, United States
| | - Meryem A. Yücel
- Boston University Neurophotonics Center, Boston, Massachusetts, United States
- Boston University, College of Engineering, Department of Biomedical Engineering, Boston, Massachusetts, United States
| | - Wenjun Zhou
- University of California Davis, Department of Biomedical Engineering, Davis, California, United States
- China Jiliang University, College of Optical and Electronic Technology, Hangzhou, Zhejiang, China
| |
Collapse
|
45
|
Do Autism-Specific and General Developmental Screens Have Complementary Clinical Value? J Autism Dev Disord 2022:10.1007/s10803-022-05541-y. [PMID: 35579791 PMCID: PMC10214166 DOI: 10.1007/s10803-022-05541-y] [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: 03/16/2022] [Indexed: 10/18/2022]
Abstract
Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n = 167) and age, gender, and practice-matched children passing screens (n = 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone. Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development.
Collapse
|
46
|
Rivard M, Mestari Z, Morin D, Coulombe P, Mello C, Morin M. Cluster Analysis of Clinical Features of Children Suspected to Have Neurodevelopmental Disorders. J Autism Dev Disord 2022; 53:2409-2420. [DOI: 10.1007/s10803-022-05533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/24/2022]
|
47
|
Jenks CM, Hoff SR, Haney J, Tournis E, Thomas D, Young NM. Cochlear Implantation Can Improve Auditory Skills, Language and Social Engagement of Children With Autism Spectrum Disorder. Otol Neurotol 2022; 43:313-319. [PMID: 34935761 PMCID: PMC8843363 DOI: 10.1097/mao.0000000000003463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To review outcomes of cochlear implantation (CI) in children diagnosed with autism spectrum disorder (ASD). STUDY DESIGN Retrospective case review and parent survey. SETTING Tertiary care children's hospital. PATIENTS Thirty children with ASD who underwent CI between 1991 and 2018. Mean age at CI = 3.5 years (0.8-11.8), mean age at diagnosis of ASD = 5.1 years (2.0-15.0) (22/30 diagnosed after CI), mean follow-up = 10.5 years (1.4-21.6). Parents of 7 children returned a survey. INTERVENTION Unilateral or bilateral cochlear implantation. MAIN OUTCOME MEASURES Speech perception; expressive communication mode; educational placement; social engagement; consistency of CI use; parent survey of child behavior change. RESULTS Thirty-three percent of all and 45% of the 22 consistent device users developed measurable open-set speech perception by an average of 4.5 years of device use. Educational placement at last follow-up included 13% mainstreamed without interpreter, 50% Special Education programs, 10% therapeutic residential or day programs, 23% total communication programs, and one home schooled. Spoken language alone was used by 31% and spoken plus sign by 14%, with the remainder using sign alone, augmentative communication devices or no mode of communication. By parent report, 86% showed improvement in social engagement compared to pre-CI. Survey results showed the behaviors most frequently ranked as most affected by CI were communication and attention, while awareness of environment had the lowest (most affected) mean ranking. CONCLUSIONS Findings support a growing body of literature that cochlear implantation has the potential to improve auditory skills, language, and enhance social engagement in some deaf children with autism spectrum disorder.
Collapse
Affiliation(s)
- Carolyn M. Jenks
- Department Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine
- Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Ann & Robert H Lurie Children's Hospital of Chicago
| | - Stephen R. Hoff
- Department Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine
- Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Ann & Robert H Lurie Children's Hospital of Chicago
| | - Jennifer Haney
- Department of Children's Services, Ann & Robert H Lurie Children's Hospital of Chicago
| | - Elizabeth Tournis
- Department of Audiology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Denise Thomas
- Department of Audiology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Nancy M. Young
- Department Otolaryngology – Head and Neck Surgery, Johns Hopkins Medicine, Northwestern University Feinberg School of Medicine
- Division of Otolaryngology – Head and Neck Surgery, Section of Otology and Ann & Robert H Lurie Children's Hospital of Chicago
- Knowles Hearing Center, Northwestern University School of Communication, Evanston, Illinois
| |
Collapse
|
48
|
Meza N, Rojas V, Escobar Liquitay CM, Pérez I, Aguilera Johnson F, Amarales Osorio C, Irarrázaval M, Madrid E, Franco JVA. Non-pharmacological interventions for autism spectrum disorder in children: an overview of systematic reviews. BMJ Evid Based Med 2022:bmjebm-2021-111811. [PMID: 35217568 DOI: 10.1136/bmjebm-2021-111811] [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] [Accepted: 01/25/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the effectiveness of non-pharmacological interventions for the treatment of autism spectrum disorder (ASD) in children. DESIGN Overview of systematic reviews (SRs). PARTICIPANTS Children aged 12 years and under with ASD. SEARCH METHODS In October 2021, we searched Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO and Epistemonikos placing no restrictions on language or date of publication. INTERVENTIONS 17 non-pharmacological interventions compared with placebo, no-treatment (including waiting list) or other interventions (ie, usual care, as defined by the authors of each study). DATA COLLECTION AND ANALYSIS We rated the methodological quality of the included SRs using A Measurement Tool to Assess Systematic Reviews (AMSTAR 2). We reported the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) certainty of the evidence (CoE) according to the analysis conducted by the authors of the included SRs. MAIN OUTCOME MEASURES A multidisciplinary group of experts agreed on analysing nine critical outcomes evolving core and non-core ASD symptoms. PUBLIC AND PATIENT INVOLVEMENT STATEMENT Organisations of parents of children with ASD participated in external revision of the final version of the report. RESULTS We identified 52 reports that were within our scope, of which 48 were excluded for various reasons. After excluding less reliable SRs, we included four SRs. Non-pharmacological interventions (ie, Early Intensive Behavioural Intervention, Applied Behaviour Analysis, Picture Exchange Communication System and Naturalistic Developmental Behavioural Interventions) may have favourable effects on some core outcomes including language, social and functioning, play or daily living skills in children with ASD (with either no GRADE assessment, very low or low CoE). In addition, we identified a lack of report for other key outcomes in the included SRs (ie, restricted, repetitive behaviour; play and sensory processing). CONCLUSIONS Synthesised evidence regarding the efficacy of non-pharmacological interventions for children with ASD is scarce. High-quality SRs addressing the variety of both non-pharmacological interventions and relevant outcomes are needed. PROSPERO REGISTRATION NUMBER CRD42020206535.
Collapse
Affiliation(s)
- Nicolás Meza
- Interdisciplinary Centre for Health Studies (CIESAL), Cochrane Chile Associate Centre, Universidad de Valparaíso, Viña del Mar, Chile
| | - Valeria Rojas
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
- Autism program, Hospital Dr Gustavo Fricke, Viña del Mar, Chile
| | | | - Ignacio Pérez
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
| | | | - Claudia Amarales Osorio
- School of Medicine, Universidad de Valparaíso, Viña del Mar, Chile
- Pediatric Neurology Unit, Hospital Carlos van Buren, Valparaíso, Chile
| | - Matías Irarrázaval
- Department of Mental Health, Ministry of Health, Santiago, Chile
- Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Eva Madrid
- Interdisciplinary Centre for Health Studies (CIESAL), Cochrane Chile Associate Centre, Universidad de Valparaíso, Viña del Mar, Chile
| | - Juan Victor Ariel Franco
- Associate Cochrane Centre - Research Department, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
49
|
Lepistö SJ, Ellonen N, Rantanen HE, Vuorenmaa MK, Helminen MT, Paavilainen E. Parental Worries, Child Maltreatment Risk and Empowerment: How Are They Noticed in Child and Family Services? CHILDREN 2022; 9:children9020269. [PMID: 35204989 PMCID: PMC8870057 DOI: 10.3390/children9020269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
Abstract
Parental empowerment has been related to their well-being and self-efficacy. Learning more about the signs describing child maltreatment risk are crucial for the welfare of children and families. The aim of this study was to assess the risk of child maltreatment (CM) and related worrying factors of parents and associations between the CM risk, worries and parental empowerment. The study is based on self-report surveys administered to parents in primary health care and hospital settings. The risk of CM and related worrying factors were measured by the Brief Child Abuse Potential Inventory (BCAP) from 453 parents. Family empowerment was measured by The Generic Family Empowerment Scale (G-FES). Parents expressed worries such as loneliness and distress (20%), feelings of persecution (9%), family conflict (17%), rigidity (21%) and financial insecurity (4%). The BCAP found 27 parents with increased risk. Parents with CM risk expressed more empowerment in connection to services for their child and family. It is crucial to discuss worries in child and family services before they raise the risk level. Tools such as the BCAP are useful in systematically identifying the child maltreatment risk and parental worries under discussion, offering possibilities for preventing child maltreatment and increasing well-being of children.
Collapse
Affiliation(s)
- Sari Johanna Lepistö
- Faculty of Social Sciences, Nursing Sciences, Tampere University, 33520 Tampere, Finland;
- Correspondence: ; Tel.: +358-50-911-3289
| | - Noora Ellonen
- Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland;
| | | | | | - Mika Tapio Helminen
- Tays Reseach Services, Tampere University Hospital, 33520 Tampere, Finland;
- Faculty of Social Sciences, Health Sciences, Tampere University, 33520 Tampere, Finland;
| | - Eija Paavilainen
- Faculty of Social Sciences, Health Sciences, Tampere University, 33520 Tampere, Finland;
- South Ostrobothnia Hospital District, 60220 Seinäjoki, Finland
| |
Collapse
|
50
|
Safety and target engagement of an oral small-molecule sequestrant in adolescents with autism spectrum disorder: an open-label phase 1b/2a trial. Nat Med 2022; 28:528-534. [DOI: 10.1038/s41591-022-01683-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/05/2022] [Indexed: 02/06/2023]
|