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Kushner EH, Hendrix N, Islam N, Pickard K. Addressing disruptive behaviors within naturalistic developmental behavioral interventions: Clinical decision-making, intervention outcomes, and implications for practice. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1441-1456. [PMID: 37840216 DOI: 10.1177/13623613231203308] [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] [Indexed: 10/17/2023]
Abstract
LAY ABSTRACT Naturalistic developmental behavioral interventions are a common and well-researched type of intervention for young autistic children that focus on supporting social communication. These interventions often do not include formal guidelines on how to address disruptive behaviors, even though they are common among autistic children. This study measured how often clinicians delivering a specific naturalistic developmental behavioral intervention, Project ImPACT, adapted how they delivered the program to address disruptive behavior, and how these adaptations related to children's social communication outcomes at the end of their participation in the intervention. We also spoke with clinicians about how they address disruptive behavior and emotion regulation during their sessions. In this study, clinicians adapted Project ImPACT to address disruptive behaviors in about one-third of all sessions. These adaptations did not affect children's social communication outcomes. Clinicians discussed how they felt social communication, disruptive behavior, and emotion regulation are linked to one another and that they often try to integrate intervention strategies to address each of these areas. However, they note that a clinicians' approach to addressing disruptive behavior might vary depending on their level of training and experience. These results indicate several future directions for supporting clinicians in addressing behavior and regulation effectively within these types of interventions.
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Affiliation(s)
| | - Nicole Hendrix
- Emory University, USA
- Children's Healthcare of Atlanta, USA
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2
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Asta L, Di Bella T, La Fauci Belponer F, Bruschetta M, Martines S, Basile E, Boncoddo M, Bellomo F, Cucinotta F, Ricciardello A, Turriziani L, Colombi C, Banchelli F, Cuoghi Costantini R, D’Amico R, Persico AM. Cognitive, behavioral and socio-communication skills as predictors of response to Early Start Denver Model: a prospective study in 32 young children with Autism Spectrum Disorder. Front Psychiatry 2024; 15:1358419. [PMID: 38873535 PMCID: PMC11170145 DOI: 10.3389/fpsyt.2024.1358419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/10/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction The effectiveness of early interventions in young autistic children is well established, but there is great interindividual variability in treatment response. Predictors of response to naturalistic developmental behavioral interventions (NDBI), like the Early Start Denver Model (ESDM), are needed. Methods We conducted an exploratory study to prospectively seek predictors of response in 32 young children treated with ESDM after receiving an ASD diagnosis. All children were less than 39 months old (mean age: 29.7 mo), and received individualized ESDM for nine months. Tests were administered at the beginning, after 4 months, and at the end of treatment. Results Four children (12.5%) were "strong responders", 8 children (25.0%) were "moderate responders", and 20 children (62.5%) were "poor responders". A more favorable response to ESDM was significantly predicted by higher PEP-3 Expressive Language, Receptive Language, Cognitive Verbal/Preverbal, Visuo-Motor Imitation scores, higher GMDS-ER Personal/Social, and VABS-II Communication scores, by lower ADI-R C restricted/stereotypic behaviors, and by joint attention level. Discussion Most predictors showed a linear association with increasing response to ESDM, but GMDS-ER Personal-Social and joint attention level predicted strong response, while PEP-3 receptive language equally predicted moderate or strong response. Although larger samples will be necessary to reach definitive conclusions, in conjunction with prior reports our findings begin providing information able to assist clinicians in choosing the most appropriate treatment program for young autistic children.
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Affiliation(s)
- Lisa Asta
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Tiziana Di Bella
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | | | - Marianna Bruschetta
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Silvia Martines
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Enrica Basile
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Maria Boncoddo
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Fabiana Bellomo
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | | | - Arianna Ricciardello
- Interdepartmental Program “Autism 0–90”, “G. Martino” University Hospital, Messina, Italy
| | - Laura Turriziani
- Center for Autism “Dopo di noi”, Barcellona Pozzo di Gotto, Messina, Italy
| | | | - Federico Banchelli
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, Modena University Hospital, Modena, Italy
| | - Riccardo Cuoghi Costantini
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, Modena University Hospital, Modena, Italy
| | - Roberto D’Amico
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Unit of Statistical and Methodological Support to Clinical Research, Modena University Hospital, Modena, Italy
| | - Antonio M. Persico
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Child and Adolescent Neuropsychiatry Program, Modena University Hospital, Modena, Italy
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Kauley N, John JR, Barr KR, Wu WT, Grove R, Masi A, Eapen V. Predicting Communication Skills Outcomes for Preschool Children with Autism Spectrum Disorder Following Early Intervention. Neuropsychiatr Dis Treat 2024; 20:35-48. [PMID: 38223372 PMCID: PMC10785686 DOI: 10.2147/ndt.s435740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/25/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose This study aims to assess changes in the receptive and expressive language skills and to determine if the baseline characteristics such as communication, cognitive and motor skills, predict outcomes in preschool children with Autism Spectrum Disorder (ASD) following early intervention. Methods We recruited 64 children participating in the Early Start Denver Model (ESDM) early intervention program at an Autism Specific Early Learning and Care Center (ASELCC) in Australia. Baseline characteristics across various developmental domains was measured using the Mullen Scales of Early Learning (MSEL), Vineland Adaptive Behaviour Scales, 2nd Edition (VABS-II), and the ESDM Curriculum Checklist. Linear mixed-effects models were used to examine the effects of the intervention on outcomes. Fixed-effects such as time, groups (verbal and minimally verbal), and time-by-group interactions were assessed whilst adjusting for covariates. Further, multiple linear regression models were used to determine if the baseline characteristics were significant predictors of the outcomes following the early intervention. Results Among the 64 children who participated in this study, 38 children were verbal, whereas 26 were deemed to have minimal verbal skills. The mean age of the sample was 4.1 years with a significant male predilection (83%) and from a culturally and linguistically diverse (CALD) background (64%). Findings of the linear mixed effects model showed significant within and between group differences in the ESDM subscales, indicating higher magnitude of changes in the verbal group compared to the minimally verbal group. Finally, the multiple linear regression models suggested that baseline MSEL visual reception and expressive language scores were predictive of changes in the ESDM receptive and expressive communication scores. Conclusion Understanding a child's baseline skill levels may provide valuable clues regarding what interventions would work best, or which interventions may be less suitable for individual preschool-aged children with ASD.
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Affiliation(s)
- Nadine Kauley
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - James Rufus John
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Karlen R Barr
- South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Weng Tong Wu
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Rachel Grove
- School of Public Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Anne Masi
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Valsamma Eapen
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
- South Western Sydney Local Health District, Liverpool, NSW, Australia
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Chung KM, Chung E, Lee H. Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis. Soa Chongsonyon Chongsin Uihak 2024; 35:29-38. [PMID: 38204739 PMCID: PMC10774556 DOI: 10.5765/jkacap.230019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/21/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.
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Affiliation(s)
- Kyong-Mee Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Eunsun Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Hoomyung Lee
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
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Yang Y, Wang H, Xu H, Yao M, Yu D. Randomized, controlled trial of a mixed early start Denver model for toddlers and preschoolers with autism. Autism Res 2023; 16:1640-1649. [PMID: 37565317 DOI: 10.1002/aur.3006] [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: 12/14/2022] [Accepted: 07/22/2023] [Indexed: 08/12/2023]
Abstract
The early start Denver model (ESDM) has been extensively studied as a promising early intervention approach for young children with autism spectrum disorder (ASD). Various methodological drawbacks from earlier ESDM investigations must be rectified to expand the application scopes. For this purpose, the present study recruited a very large sample of 249 autistic children (aged 24-47 months), and used a randomized controlled design to compare outcomes from a mixed ESDM (M-ESDM) intervention with a mixed discrete trial teaching (M-DTT) intervention which remains one of the most commonly-used programming for early intervention. Over the course of a 12-week period, both groups (i.e., M-ESDM and M-DTT groups) received 25 h of intensive intervention per week using individual, group, and parent coaching techniques. Findings showed that: (i) the M-ESDM significantly outperformed the M-DTT in enhancing children's developmental abilities in gross motor and personal-social skills for toddlers and preschoolers, as well as in language for preschoolers with mild/moderate ASD and toddlers; and (ii) the M-ESDM dramatically reduced the severity of autistic symptoms in toddlers with severe ASD only, when compared to the M-DTT. However, the M-ESDM did not outperform the M-DTT in terms of improving children's developmental abilities in adaptability and fine motor for toddlers and preschoolers, as well as in language for preschoolers with severe ASD. In addition, when compared to the M-DTT, the M-ESDM did not show an advantage in reducing the severity of autistic symptoms in toddlers with mild/moderate ASD and preschoolers. Clinical Trial Registration: Chinese Clinical Trial Registry. Registration number ChiCTR200039492.
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Affiliation(s)
- Yanyan Yang
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Haiping Xu
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Meiling Yao
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Dongchuan Yu
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
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6
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Asta L, Persico AM. Differential Predictors of Response to Early Start Denver Model vs. Early Intensive Behavioral Intervention in Young Children with Autism Spectrum Disorder: A Systematic Review and Meta-Analysis. Brain Sci 2022; 12:1499. [PMID: 36358426 PMCID: PMC9688546 DOI: 10.3390/brainsci12111499] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/23/2022] [Accepted: 10/27/2022] [Indexed: 08/12/2023] Open
Abstract
The effectiveness of early intensive interventions for Autism Spectrum Disorder (ASD) is now well-established, but there continues to be great interindividual variability in treatment response. The purpose of this systematic review is to identify putative predictors of response to two different approaches in behavioral treatment: Early Intensive Behavioral Interventions (EIBI) and the Early Start Denver Model (ESDM). Both are based upon the foundations of Applied Behavioral Analysis (ABA), but the former is more structured and therapist-driven, while the latter is more naturalistic and child-driven. Four databases (EmBase, PubMed, Scopus and WebOfScience) were systematically screened, and an additional search was conducted in the reference lists of relevant articles. Studies were selected if participants were children with ASD aged 12-48 months at intake, receiving either EIBI or ESDM treatment. For each putative predictor, p-values from different studies were combined using Fisher's method. Thirteen studies reporting on EIBI and eleven on ESDM met the inclusion criteria. A higher IQ at intake represents the strongest predictor of positive response to EIBI, while a set of social cognitive skills, including intention to communicate, receptive and expressive language, and attention to faces, most consistently predict response to ESDM. Although more research will be necessary to reach definitive conclusions, these findings begin to shed some light on patient characteristics that are predictive of preferential response to EIBI and ESDM, and may provide clinically useful information to begin personalizing treatment.
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Affiliation(s)
| | - Antonio M. Persico
- Child & Adolescent Neuropsychiatry Program, Modena University Hospital, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Frost KM, Ingersoll B, Venker CE. Revisiting the simplification of adult language input in the context of naturalistic developmental behavioral interventions: A commentary. Autism Res 2022; 15:1799-1809. [PMID: 35983824 PMCID: PMC9561015 DOI: 10.1002/aur.2796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 08/09/2022] [Indexed: 01/09/2023]
Abstract
Naturalistic developmental behavioral interventions (NDBI) are an evidence-based class of early interventions for improving language and social communication skills in autistic children. However, relatively little is known about how individual elements of NDBI support child development. This commentary focuses on one common element across NDBI models: the simplification of adult language input. Advances in developmental science focusing on the length and complexity of adult spoken utterances suggests that natural, grammatical utterances facilitate comprehension and expressive language development in autistic and nonautistic children. Yet, NDBI tend to recommend shorter and simpler adult utterances. We close by describing directions for future research which would inform recommendations around adult language input in NDBI to optimally support child language and communication development.
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Affiliation(s)
- Kyle M. Frost
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Brooke Ingersoll
- Department of PsychologyMichigan State UniversityEast LansingMichiganUSA
| | - Courtney E. Venker
- Department of Communicative Sciences and DisordersMichigan State UniversityEast LansingMichiganUSA
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8
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Griffin ZAM, Boulton KA, Thapa R, DeMayo MM, Ambarchi Z, Thomas E, Pokorski I, Hickie IB, Guastella AJ. Atypical sensory processing features in children with autism, and their relationships with maladaptive behaviors and caregiver strain. Autism Res 2022; 15:1120-1129. [PMID: 35297186 PMCID: PMC9544661 DOI: 10.1002/aur.2700] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 01/05/2023]
Abstract
Atypical sensory processing occurs in up to 97% of children on the autism spectrum. Children who are on the autism spectrum also commonly demonstrate challenging behaviors, and their caregivers report increased levels of strain in daily life. The aim of this study was to explore four sensory processing features; seeking, avoiding, sensitivity, and registration, and their relationships with maladaptive behaviors in children with autism, as well as with caregiver strain. Participants comprised 75 children with autism aged 7–12 years (M = 7.81). Caregivers completed three questionnaire measures examining child sensory processing, maladaptive behaviors, and perceptions of caregiver strain. We found avoiding significantly associated with irritability. Avoiding also displayed the strongest relationship with global caregiver strain. Avoiding and seeking were strongly related to hyperactivity/noncompliance (components of maladaptive behavior). A multiple regression was performed to explore how atypical sensory processing features and maladaptive behaviors together predicted caregiver strain. Together, maladaptive behaviors and sensory features accounted for 58% of the variance in total caregiver strain. The only significant individual predictor of total caregiver strain was sensory avoiding, which uniquely accounted for 5.76% of the variation. The findings suggest that atypical sensory processing is associated with overall caregiver strain, above that explained by maladaptive behaviors. Implications for targeted support for the benefit of the child, parents and family unit are discussed.
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Affiliation(s)
- Zoe A M Griffin
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Kelsie A Boulton
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Rinku Thapa
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Marilena M DeMayo
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Zahava Ambarchi
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Emma Thomas
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Izabella Pokorski
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Ian B Hickie
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Adam J Guastella
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
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Mirenda P, Colozzo P, Smith V, Kroc E, Kalynchuk K, Rogers SJ, Ungar WJ. A Randomized, Community-Based Feasibility Trial of Modified ESDM for Toddlers with Suspected Autism. J Autism Dev Disord 2022; 52:5322-5341. [PMID: 35022943 PMCID: PMC8754545 DOI: 10.1007/s10803-021-05390-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 12/22/2022]
Abstract
A randomized feasibility trial of a parent coaching (PC) intervention was conducted across 16 community agencies in a Canadian province. Parents of toddlers with suspected autism were assigned to either a PC group (n = 24) or an enhanced community treatment (ECT) group (n = 25). PC participants received 24 weeks of coaching support from community service providers trained in the project. Children in both groups also received available community services and supplementary materials. PC children made significantly greater gains in word understanding and PC parents had significantly higher quality of life, satisfaction, and self-efficacy scores. Results are discussed in terms of the challenges of conducting feasibility studies in community settings and the lessons learned in the project.
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Affiliation(s)
- Pat Mirenda
- University of British Columbia, 1948 Turner St, Vancouver, BC, V5L 2A1, Canada.
| | - Paola Colozzo
- University of British Columbia, 1948 Turner St, Vancouver, BC, V5L 2A1, Canada
| | | | - Ed Kroc
- University of British Columbia, 1948 Turner St, Vancouver, BC, V5L 2A1, Canada
| | - Karen Kalynchuk
- University of British Columbia, 1948 Turner St, Vancouver, BC, V5L 2A1, Canada
| | - Sally J Rogers
- University of California MIND Institute, Sacramento, USA
| | - Wendy J Ungar
- The Hospital for Sick Children Research Institute/University of Toronto, Toronto, Canada
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Abstract
The Early Start Denver Model (ESDM) is an evidence-based early intervention approach for young children with autism spectrum disorder. Although the ESDM is described by its authors as being rooted in applied behavior analysis (ABA), some states, agencies, and scholars consider the ESDM to qualify as ABA practice, whereas others do not. The purpose of this article is to examine the status of the ESDM in relation to the 7 dimensions established by Baer, Wolf, and Risley ("Some Current Dimensions of Applied Behavior Analysis," Journal of Applied Behavior Analysis, 1(1): 91-97, 1968) to define applied behavior-analytic research and intervention, as well as to discuss implications for the field.
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Affiliation(s)
- Giacomo Vivanti
- A.J. Drexel Autism Institute, Drexel University, 3020 Market St., Suite 560, Philadelphia, PA 19104-3734 USA
| | - Aubyn C. Stahmer
- UC Davis MIND Institute, University of California, Davis, 2825 50th St, Sacramento, CA 95817 USA
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A Pilot Randomised Control Trial of Digitally-Mediated Social Stories for Children on the Autism Spectrum. J Autism Dev Disord 2021; 50:4243-4257. [PMID: 32266683 PMCID: PMC7677143 DOI: 10.1007/s10803-020-04490-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Social stories is a widely used intervention for children on the autism spectrum, particularly within an educational context. To date, systematic reviews and meta analyses of the research evaluating social stories has produced mixed results, often due to a lack of methodological rigour and variability in the development and delivery of the social stories. To address the gap in methodological rigour, a pilot Randomised Control Trial (RCT) was conducted, incorporating a social stories intervention group (n = 9 children on the autism spectrum) and an attentional control group who received a poem (n = 6 children on the autism spectrum) using a digital platform to address variability. Digitally-mediated social stories were found to be effective in producing beneficial changes in behaviour outcomes, which were sustained at a six-week follow up.
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12
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Wang Z, Loh SC, Tian J, Chen QJ. A meta-analysis of the effect of the Early Start Denver Model in children with autism spectrum disorder. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:587-597. [PMID: 36210899 PMCID: PMC9542560 DOI: 10.1080/20473869.2020.1870419] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 12/23/2020] [Accepted: 12/28/2020] [Indexed: 05/26/2023]
Abstract
Objectives: To examine and analyse the intervention effects of the Early Start Denver Model (ESDM) on children with autism spectrum disorder (ASD). Methods: This meta-analysis evaluated the effect sizes in four major domains of measurement (autism symptoms, language, cognition, and social communication). A total of 624 participants with ASD were included in 11 high-quality randomized controlled trial studies. Results: The results indicated that the ESDM intervention resulted in significant improvement with moderate effect sizes in the cognition (g = 0.28), autism symptoms (g = 0.27), and language (g = 0.29) domains. The effect sizes of autism symptoms and language were moderated by country (Western versus Asian countries). However, there were no significant effects observed for the social communication domain. Conclusion: The ESDM intervention significantly improved autism symptoms, language, and cognition. The effect sizes of autism symptoms and language were larger in Asian countries than in Western countries.
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Affiliation(s)
- Zhi Wang
- Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
| | - Sau Cheong Loh
- Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
| | - Jing Tian
- School of Education, Guizhou Education University, Guiyang City, Guizhou Province, China
| | - Qian Jiang Chen
- School of Management, Guizhou University, Guiyang City, Guizhou Province, China
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Gibson JL, Pritchard E, de Lemos C. Play-based interventions to support social and communication development in autistic children aged 2-8 years: A scoping review. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2021; 6:23969415211015840. [PMID: 36381525 PMCID: PMC9620698 DOI: 10.1177/23969415211015840] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND AND AIMS Play is used by practitioners from across disciplinary backgrounds as a natural and enjoyable context for providing intervention and support in early childhood. In the case of autism interventions, many therapies are based on the association between social play and the development of social skills, language development, and communication skills, as these are often particular areas of challenge for autistic children. However, play is a wide-ranging concept and the extant literature on play-based interventions is large and heterogeneous. This means it is challenging for practitioners and families to navigate the evidence base and make choices about differing intervention strategies. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform clinical decision-making. METHODS An initial stakeholder consultation confirmed the relevance of the topic to practitioners and autistic people. A scoping review methodology (preregistered) was used to identify relevant literature. We systematically searched seven databases to find peer-reviewed primary intervention studies of play-based approaches targeting language, social and communication outcomes for autistic children aged 2-8 years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs). The literature was summarised according to a range of characteristics, including study design, population characteristics, agent of intervention and outcomes measured, among others. These summaries were then used to develop a framework for some key considerations for practitioners appraising play-based approaches. RESULTS 388 studies met inclusion criteria. Approximately 21% of studies were RCTs, and over 50% had ≤10 participants. Over 45% of studies reported multiple relevant outcomes, with social play skills being the most common single intervention target. Girls and minority background groups are under-represented. A range of intervention types were identified, and some high-level categorisations are proposed.Main contribution: On the basis of the evidence synthesis we suggest important dimensions for appraisal of play-based interventions, including the role of play within an intervention (as a context, a key developmental mechanism, or a component of a larger approach), the underpinning philosophy (e.g. behaviourist or developmental), and the role of the practitioner (providing parent feedback, 1:1 intervention, group facilitation). CONCLUSIONS The wide range of approaches uncovered by this review is a testament to the wonderful diversity inherent to both play and autism. However, research could usefully focus on consolidating the evidence base for existing approaches, rather than aiming for further diversification. Implications: The conceptual framework proposed in this review can help practitioners appraise the literature and aid their advice to families when making shared intervention decisions.
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Affiliation(s)
- Jenny L Gibson
- Jenny L Gibson, Play & Communication
Lab, Play in Education Development and Learning Research Centre, Faculty of
Education, University of Cambridge, Cambridge, UK.
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14
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Tateno Y, Kumagai K, Monden R, Nanba K, Yano A, Shiraishi E, Teo AR, Tateno M. The Efficacy of Early Start Denver Model Intervention in Young Children with Autism Spectrum Disorder Within Japan: A Preliminary Study. Soa Chongsonyon Chongsin Uihak 2021; 32:35-40. [PMID: 33424240 PMCID: PMC7788666 DOI: 10.5765/jkacap.200040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/25/2020] [Accepted: 12/17/2020] [Indexed: 11/29/2022] Open
Abstract
Objectives Among the many intervention programs for children with autism spectrum disorder (ASD), the Early Start Denver Model (ESDM) is one of the few approaches that has succeeded in demonstrating clinical efficacy in randomized control trials. Here, we investigate the clinical efficacy of ESDM intervention in young children with ASD in a community setting within Japan. Methods All subjects were children with ASD who received ESDM intervention during the study period. Each ESDM session lasted 75 min and occurred once per week for at least 12 weeks. The outcome measures consisted of the Kyoto Scale of Psychological Development (K-test), Aberrant Behavior Checklist-Japanese version (ABC-J), and the Clinical Global Impression-Severity scale (CGI-S). Results Twenty-seven subjects (29.4±6.4 months old) received ESDM intervention that lasted for 8.0±2.6 months on average. The score on Language and Social developmental quotient on the K-test increased significantly after the intervention. The total scores on the ABC-J and CGI-S significantly decreased after completion of the ESDM intervention. Conclusion Our results suggest that ESDM intervention could reduce the severity of distinct clinical features of ASD, such as impairments in social interaction and communication assessed by the K-test, and maladaptive behavior rated by the ABC-J and CGI-S. We believe that the ESDM adapted to each institution might become one of the standard options for children with ASD in Japan.
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Affiliation(s)
- Yukie Tateno
- Tokiwa Child Development Center (Division Child Psychiatry of Tokiwa Hospital), Sapporo, Japan.,Tokiwa Developmental Support Center (Division Child Welfare of Tokiwa Hospital), Sapporo, Japan.,Department of Psychiatry, Tokiwa Hospital, Sapporo, Japan
| | - Kahoru Kumagai
- Tokiwa Developmental Support Center (Division Child Welfare of Tokiwa Hospital), Sapporo, Japan
| | - Ryunosuke Monden
- Tokiwa Child Development Center (Division Child Psychiatry of Tokiwa Hospital), Sapporo, Japan
| | - Kotaro Nanba
- Tokiwa Child Development Center (Division Child Psychiatry of Tokiwa Hospital), Sapporo, Japan.,Department of Psychiatry, Tokiwa Hospital, Sapporo, Japan
| | - Ayumi Yano
- Tokiwa Child Development Center (Division Child Psychiatry of Tokiwa Hospital), Sapporo, Japan
| | - Eri Shiraishi
- Tokiwa Child Development Center (Division Child Psychiatry of Tokiwa Hospital), Sapporo, Japan
| | - Alan R Teo
- VA Portland Health Care System, HSR&D Center to Improve Veteran Involvement in Care, Portland, OR, USA.,Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA.,School of Public Health, Oregon Health & Science University, and Portland State University, Portland, OR, USA
| | - Masaru Tateno
- Tokiwa Child Development Center (Division Child Psychiatry of Tokiwa Hospital), Sapporo, Japan.,Department of Psychiatry, Tokiwa Hospital, Sapporo, Japan
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15
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Abouzeid N, Rivard M, Mello C, Mestari Z, Boulé M, Guay C. Parent coaching intervention program based on the Early Start Denver Model for children with autism spectrum disorder: Feasibility and acceptability study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 105:103747. [PMID: 32763654 DOI: 10.1016/j.ridd.2020.103747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 07/11/2020] [Accepted: 07/19/2020] [Indexed: 06/11/2023]
Abstract
A parent coaching intervention program was launched in a Quebec community-based organization for autism spectrum disorder. This initiative was intended to support families following the child's diagnosis, as they awaited public early intensive behavioral intervention services. The parent-mediated intervention program, based on the Early Start Denver Model, included a 3 h parent group training, an initial assessment followed by the development of an individualized intervention plan, 8 weeks of live coaching, a final assessment to evaluate children's progress, and a feedback meeting with families. The present study used a mixed-method design to assess the feasibility and acceptability of the program. Ten families (ten mothers and three fathers) and four coaches participated in the present study. Parents and coaches perceived and achieved high levels of implementation overall (91 %) and there was a moderate improvement of parents' teaching skills. All participating families and coaches were satisfied or highly satisfied with the program and found it acceptable.
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Affiliation(s)
- Nadia Abouzeid
- Department of Psychology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville Montréal Québec H3C 3P8 Canada.
| | - Mélina Rivard
- Department of Psychology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville Montréal Québec H3C 3P8 Canada
| | - Catherine Mello
- Departments of Applied Psychology and Rehabilitation and Human Services, Penn State Berks, P.O. Box 7009, Tulpehocken Road, Reading, PA 19610, United States
| | - Zakaria Mestari
- Department of Psychology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville Montréal Québec H3C 3P8 Canada
| | - Mélina Boulé
- Department of Psychology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville Montréal Québec H3C 3P8 Canada
| | - Claudia Guay
- Department of Psychology, Université du Québec à Montréal, Case postale 8888, succursale Centre-ville Montréal Québec H3C 3P8 Canada
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[Effect of parental training based on Early Start Denver Model combined with intensive training on children with autism spectrum disorder and its impact on parenting stress]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020. [PMID: 32051084 PMCID: PMC7390010 DOI: 10.7499/j.issn.1008-8830.2020.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To explore the effect of parental training based on the Early Start Denver Model (ESDM) combined with intensive training on the treatment outcome of children with autism spectrum disorder (ASD) and its impact on parenting stress. METHODS Seventy children aged 2-5 years who were diagnosed with ASD were enrolled in the study. They were divided into an ESDM group and a parental training group by the random number table method (n=35 each). The ESDM group received intensive training based on ESDM. In addition to intensive ESDM-based training, parents of the children in the parental training group received ESDM skills training. Both groups were assessed by Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Autism Treatment Evaluation Checklist (ATEC) and Parenting Stress Index-Short Form (PSI-SF) before and after the intervention of 3 months. RESULTS After 3 months of intervention, the total scores of ABC, CARS and ATEC were both significantly decreased in the two groups (P<0.05). There was no significant difference in the total scores of ABC, CARS and ATEC between the two groups before and after intervention (P>0.05). The change between ABC, CARS and ATEC total scores in the two groups had no significant difference (P>0.05). After 3 months of intervention, the total scores of PSI-SF were both significantly decreased in the two groups (P<0.05). The difficult child sub-scale scores in PSI-SF were significantly decreased in the ESDM group (P<0.05). While three sub-scale scores of parent distress, parent-child dysfunctional interaction and difficult child in PSI-SF were significantly decreased in the parental training group (P<0.05). Before and after intervention of 3 months, no significant difference was found in PSI-SF total scores between the two groups. Compared with the ESDM group, the change between PSI-SF total scores and two sub-scales of PSI-SF (parent distress and difficult child) were significantly bigger in the parental training group (P<0.05). CONCLUSIONS Both the combination of intensive training and parent training based on ESDM and ESDM intensive training alone can improve the core symptoms of children with ASD aged 2-5 years and relieve the parenting stress, however, the former is more effective in relieving parenting stress.
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Tupou J, Waddington H, van der Meer L, Sigafoos J. Effects of a low-intensity Early Start Denver Model-based intervention delivered in an inclusive preschool setting. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:107-121. [PMID: 35309698 PMCID: PMC8928834 DOI: 10.1080/20473869.2019.1707434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/17/2019] [Accepted: 12/17/2019] [Indexed: 06/14/2023]
Abstract
The Early Start Denver Model (ESDM) is a promising early intervention for promoting improved social, cognitive, and communication outcomes for young children with autism spectrum disorder (ASD). However, most studies evaluating group-based delivery of this program have used 15-25 h per week of intervention in specialized ESDM preschools with low child-teacher ratios. Thus, the positive results from such studies might not be obtained when this intervention model is evaluated in more typical inclusive preschool settings. In this study, a low-intensity version of the ESDM was delivered to three young children with ASD in their regular inclusive preschool by a certified therapist who did not typically work at any of the preschools. The intervention procedures were implemented for 3 h per week over an 8- to 10-week period. Data were gathered on children's levels of participation, imitation, and communication from weekly 10-min video recordings. The effects of the intervention were evaluated using a multiple probe across participants design with 3 weekly follow-up probes, 3 weeks after the intervention ended. All participants showed improvement in active participation, imitation and either intentional vocalizations or spontaneous functional utterances. These results were generally maintained at follow-up. This low-intensity version of the ESDM would seem effective for use in real-world preschool environments.
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Affiliation(s)
- Jessica Tupou
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Hannah Waddington
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | | | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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18
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Contaldo A, Colombi C, Pierotti C, Masoni P, Muratori F. Outcomes and moderators of Early Start Denver Model intervention in young children with autism spectrum disorder delivered in a mixed individual and group setting. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:718-729. [PMID: 31747799 DOI: 10.1177/1362361319888344] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Several studies have shown the efficacy and effectiveness of the Early Start Denver Model, both in university and in community-based settings. However, a limited number of studies have investigated predictors of outcomes. In this study, we examined outcomes in 32 children diagnosed with autism spectrum disorder after 1 year of community-based Early Start Denver Model intervention, with the aim to identify predictors of treatment objectives acquisition, as measured by the Early Start Denver Model Curriculum Checklist. At a group level, the participants demonstrated improvement in their communication as well as adaptive functioning skills, while they showed a decrease in symptom severity. The large heterogeneity in outcomes identified was related to the pre-treatment non-verbal abilities, symptom severity, action and gesture repertoire, and lexical comprehension. We discussed our results in terms of implications for developing "personalized" interventions for children with autism spectrum disorder.
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Affiliation(s)
| | | | | | | | - Filippo Muratori
- IRCCS Stella Maris Foundation, Pisa, Italy.,University of Pisa, Italy
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19
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Franchini M, Zöller D, Gentaz E, Glaser B, Wood de Wilde H, Kojovic N, Eliez S, Schaer M. Early Adaptive Functioning Trajectories in Preschoolers With Autism Spectrum Disorders. J Pediatr Psychol 2019; 43:800-813. [PMID: 29701857 DOI: 10.1093/jpepsy/jsy024] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 03/13/2018] [Indexed: 11/14/2022] Open
Abstract
Background In preschoolers with autism spectrum disorder (ASD) symptom, severity has a negative impact on the development of adaptive functioning, with critical consequences on the quality of life of those children. Developmental features such as reduced social interest or the presence of behavioral problems can further impede daily life learning experiences. Objectives The first aim of this study is to confirm the negative impact of high symptom severity on adaptive functioning trajectories in preschoolers with ASD. The second objective intends to explore whether reduced social interest and severe behavioral problems negatively affect developmental trajectories of adaptive functioning in young children with ASD. Methods In total, 68 children with ASD and 48 age and gender-matched children with typical development (TD) between 1.6 and 6 years were included in our study, and longitudinal data on adaptive functioning were collected (mean length of the longitudinal data collection was 1.4 years ± 0.6). Baseline measures of symptom severity, social interest, and behavioral problems were also obtained. Results We confirmed that children with ASD show parallel developmental trajectories but a significantly lower performance of adaptive functioning compared with children with TD. Furthermore, analyses within ASD children demonstrated that those with higher symptom severity, reduced social interest, and higher scores of behavioral problems exhibited especially lower or faster declining trajectories of adaptive functioning. Conclusions These findings bolster the idea that social interest and behavioral problems are crucial for the early adaptive functioning development of children with autism. The current study has clinical implications in pointing out early intervention targets in children with ASD.
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Affiliation(s)
- Martina Franchini
- Developmental Imaging and Psychopathology Lab, University of Geneva.,Laboratory of Sensorimotor, Affective, and Social Development, Psychology and educational sciences, University of Geneva.,Department of Pediatrics, Dalhousie University and IWK Health Centre
| | - Daniela Zöller
- Developmental Imaging and Psychopathology Lab, University of Geneva.,Medical Image Processing Lab, Institute of Bioengineering, EPFL
| | - Edouard Gentaz
- Laboratory of Sensorimotor, Affective, and Social Development, Psychology and educational sciences, University of Geneva
| | - Bronwyn Glaser
- Developmental Imaging and Psychopathology Lab, University of Geneva
| | | | - Nada Kojovic
- Developmental Imaging and Psychopathology Lab, University of Geneva
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, University of Geneva.,Department of Medical Genetics, Geneva University Medical School
| | - Marie Schaer
- Developmental Imaging and Psychopathology Lab, University of Geneva
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20
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Song Y, Nie T, Shi W, Zhao X, Yang Y. Empathy Impairment in Individuals With Autism Spectrum Conditions From a Multidimensional Perspective: A Meta-Analysis. Front Psychol 2019; 10:1902. [PMID: 31649570 PMCID: PMC6794557 DOI: 10.3389/fpsyg.2019.01902] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/02/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Although empathy has always been considered to be impaired in individuals with autism spectrum conditions (ASCs), the relevant findings have been inconsistent. The present meta-analysis aims to determine which empathy components are impaired and how culture, gender, and age moderate such empathy impairment. Methods: By using “Autism,” “Asperger Syndrome,” “Empathy,” and related Chinese synonyms as keywords, we searched the databases of Weipu, Wanfang, CNKI, Web of Science, Science Direct, SpringerLink, and Elsevier through “subject” and “keyword” searches. We also conducted a manual search according to the references. In total, 51 studies from Eastern and Western countries were included in this meta-analysis, which comprised 144 independent effects, 2,095 individuals with ASCs and 2,869 controls without ASCs. For the retrieved data, Hedge's g was taken as the quantitative measure of effect, and CMA V2.0 software was used for publication bias tests (by using Rosenthal's Classic Failsafe-N and Egger's methods), heterogeneity tests (by using a Q-test, I2-test, and H-test) and a moderating effect test (by using a univariate regression model). Results: The results showed that the empathy impairment evident in individuals with ASCs is component specific; that is, trait-cognitive empathy, trait-empathic concern, state-cognitive empathy, and state-empathic concern are impaired, whereas state-empathic accuracy remains intact, and trait-empathic accuracy is superior to the trait-empathic accuracy in neurotypical individuals. The univariate regression model showed that gender moderates the impairment of the trait-empathic concern, trait-empathic accuracy, and state-cognitive empathy in autistic individuals and that age moderates the impairment of the trait-cognitive empathy, trait-empathic accuracy, state-empathic concern, and state-empathic accuracy in autistic individuals. However, culture does not moderate any empathy components (trait-cognitive empathy, trait-empathic concern, or state-cognitive empathy) involved in the present meta-analysis. Conclusions: These findings contribute to ending the controversy over the empathic integrity of individuals with ASCs and shed some light on future research about the empathy impairment of autistic individuals. More specifically, subsequent studies should distinguish specific empathy components and consider the role of gender and age when demonstrating empathy impairment in individuals with ASCs. Moreover, related studies based on Asian collectivist cultural samples and female samples should be further enriched.
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Affiliation(s)
- Youming Song
- Department of Psychology, School of Education, Shanghai Normal University, Shanghai, China
| | - Tingting Nie
- Department of Psychology, School of Education, Shanghai Normal University, Shanghai, China
| | - Wendian Shi
- Department of Psychology, School of Education, Shanghai Normal University, Shanghai, China
| | - Xudong Zhao
- Department of Psychology, School of Education, Shanghai Normal University, Shanghai, China
| | - Yongyong Yang
- Department of Psychology, School of Education, Shanghai Normal University, Shanghai, China
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21
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Hernandez-Ruiz E. Parent coaching of music interventions for children with ASD: A conceptual framework. NORDIC JOURNAL OF MUSIC THERAPY 2019. [DOI: 10.1080/08098131.2019.1647447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Eapen V, McPherson S, Karlov L, Nicholls L, Črnčec R, Mulligan A. Social communication deficits and restricted repetitive behavior symptoms in Tourette syndrome. Neuropsychiatr Dis Treat 2019; 15:2151-2160. [PMID: 31440054 PMCID: PMC6666375 DOI: 10.2147/ndt.s210227] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 07/01/2019] [Indexed: 12/15/2022] Open
Abstract
Background: Autism spectrum disorders (ASD) have been found to occur more frequently in individuals with Tourette syndrome (TS) than in the general population. Similarities exist between ASD and TS clinically, which suggests a potential relationship between the two conditions. Purpose: The purpose of this study was to explore the occurrence of autism-related features in ASD and TS, focusing on areas of overlap and difference. Patients and methods: This study examined the nature and extent of autistic traits as measured by the Social Communication Questionnaire (SCQ) in a sample with a diagnosis of TS, a sample diagnosed to have ASD, and a normative general population sample. Results: The TS sample had significantly higher mean SCQ scores than the general population, but generally lower scores than the ASD sample. The group differences in mean SCQ scores between the TS and ASD sample were significant except in the domain of restricted repetitive behaviours (RRB). Conclusion: This suggests that ASD traits occur commonly in the TS population, with a significant overlap in certain clinical features. This was especially the case for complex movements or repetitive behaviours, which may represent either: i) a shared phenotype which is subclinical, ii) a phenocopy where some clinical symptoms mimic each other, or iii) a co-morbidity. Awareness of this association can be useful in identifying these symptoms as part of the comprehensive assessment of TS and addressing these to improve the overall clinical outcomes in these patients.
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Affiliation(s)
- Valsamma Eapen
- School of Psychiatry , University of New South Wales, Sydney, NSW, Australia
| | - Sarah McPherson
- Medical Oncology, The Canberra Hospital, Canberra, ACT, Australia
| | - Lisa Karlov
- School of Psychiatry , University of New South Wales, Sydney, NSW, Australia
| | - Laura Nicholls
- School of Psychiatry , University of New South Wales, Sydney, NSW, Australia
| | - Rudi Črnčec
- Penrith Therapy Centre, Penrith, NSW, Australia
| | - Aisling Mulligan
- Department of Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
- Dublin North City and County Child and Adolescent Mental Health Service, Health Services Executive, Dublin, Ireland
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[Preliminary application of Early Start Denver Model in children with autism spectrum disorder]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20. [PMID: 30369351 PMCID: PMC7389043 DOI: 10.7499/j.issn.1008-8830.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To investigate the clinical effect of the Early Start Denver Model (ESDM) in children with autism spectrum disorder (ASD). METHODS Forty children aged 2-5 years who were diagnosed with ASD from September 2017 to January 2018 were enrolled in the study and were randomly divided into conventional intervention group and ESDM intervention group (n=20 each). Both groups were assessed by the Aberrant Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Clinical Global Impression-Severity (CGI-S) scale before intervention and by the ABC, CARS, CGI-S scale, and Clinical Global Impression-Improvement (CGI-I) scale after 3 months of intervention. RESULTS After 3 months of intervention, the total scores of ABC and CARS were both significantly decreased in the two groups (P<0.01); the scores on the social withdrawal and hyperactivity subscales of ABC were significantly decreased in the conventional intervention group (P<0.01), and the scores on the mood swings, social withdrawal, hyperactivity, and stereotyped behavior subscales of ABC were significantly decreased in the ESDM intervention group (P<0.01). Compared with the conventional intervention group, the ESDM intervention group had significantly greater changes in total score of ABC, scores on three subscales of ABC (mood swings, social withdrawal, and hyperactivity), and total score of CARS after intervention (P<0.05). After 3 months of intervention, the CGI-I scoring system showed that the disease improvement was significantly better in the ESDM intervention group than in the conventional intervention group (P<0.05). CONCLUSIONS Both conventional intervention and ESDM intervention can improve the social withdrawal and hyperactivity in children with ASD aged 2 to 5 years, but ESDM is more effective in improving the aberrant behavior of children with ASD.
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Dixon MR, Wiggins SH, Belisle J. The effectiveness of the peak relational training system and corresponding changes on the VB-MAPP for young adults with autism. J Appl Behav Anal 2018; 51:321-334. [PMID: 29509278 DOI: 10.1002/jaba.448] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 04/07/2017] [Indexed: 11/11/2022]
Abstract
The current investigation sought to extend prior research evaluating the use of the PEAK Relational Training System as a comprehensive treatment model in improving language skills demonstrated by individuals with autism. Baseline PEAK-Direct Training and Verbal Behavior Milestone Assessment and Placement Program (VB-MAPP) assessments were conducted across 3 adult male participants, and scores on the PEAK-Direct Training assessment were used to select targets for intervention. Language instruction guided by the PEAK-Direct Training module was implemented for 45 to 69 days across participants. Results suggest that participants mastered target skills throughout the training phase, and VB-MAPP test probes showed an increasing trend. Follow-up probes suggested that scores on the VB-MAPP maintained when training was discontinued. In addition, participants demonstrated an increase in assessment scores on the PEAK-Direct Training assessment in the follow-up phase, including the mastery of untargeted verbal skills.
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García-Villamisar D, Dattilo J, Muela C. Effects of therapeutic recreation on adults with ASD and ID: a preliminary randomized control trial. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:325-340. [PMID: 27465318 DOI: 10.1111/jir.12320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/02/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND The purpose of this research was to examine effects of a therapeutic recreation (TR) program designed to increase executive function (EF), social skills, adaptive behaviours and well-being of adults with autism spectrum disorder (ASD) and intellectual disability (ID). METHOD A preliminary pre-test, post-test randomized control group experimental design was used to measure effects of a 40-week TR program designed to increase EF (TR-EF). The TR-EF used instructional electronically based games delivered during 200 1-h sessions (5/week). RESULTS Participants (experimental group, n = 19; wait-list group, n = 18) were evaluated at baseline and 10 months later. There was a positive and direct impact of the program on several EF and indirect effect on social skills, adaptive behaviour and personal well-being. CONCLUSIONS Findings provide support for inclusion of EF enrichment as a way to enhance effects of TR interventions for adults with ASD and ID. Preliminary results of this study can be considered in planning TR services in the future. In addition to TR-EF program primary effects on EF, there were indirect benefits on adaptive behaviours, personal well-being and social skills.
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Affiliation(s)
- D García-Villamisar
- Universidad Complutense, Department of Personality and Clinical Pschology, Madrid, Madrid, Spain
| | - J Dattilo
- The Pennsylvania State University, Department of Recreation, Park, and Tourism Management, University Park, PA, USA
| | - C Muela
- Asociacion Nuevo Horizonte, Technical Direction, Las Rozas, Madrid, Spain
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Social communication in children with autism spectrum disorder (asd): Correlation between DSM-5 and autism classification system of functioning-social communication (ACSF:SC). Autism Res 2017; 10:1249-1258. [DOI: 10.1002/aur.1772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/31/2017] [Accepted: 02/04/2017] [Indexed: 12/29/2022]
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Zander E, Bölte S. The New DSM-5 Impairment Criterion: A Challenge to Early Autism Spectrum Disorder Diagnosis? J Autism Dev Disord 2016; 45:3634-43. [PMID: 26123009 DOI: 10.1007/s10803-015-2512-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The possible effect of the DSM-5 impairment criterion on diagnosing autism spectrum disorder (ASD) in young children was examined in 127 children aged 20-47 months with a DSM-IV-TR clinical consensus diagnosis of ASD. The composite score of the Vineland Adaptive Behavior Scales (VABS) served as a proxy for the DSM-5 impairment criterion. When applying a mild level of impairment (cutoff: 1 SD below the mean on the VABS), 88 % of the cases fulfilled the impairment criterion. Sixty-nine percent fulfilled the impairment criterion at a moderate level (1.5 SDs) and 33 % at a severe level (2 SDs). Findings indicate that a strict application of the new DSM-5 impairment criterion might compromise early diagnosis of ASD.
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Affiliation(s)
- Eric Zander
- Pediatric Neuropsychiatry Unit, Department of Children's and Women's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden.
- Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden.
| | - Sven Bölte
- Pediatric Neuropsychiatry Unit, Department of Children's and Women's Health, Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet, Gävlegatan 22B, 113 30, Stockholm, Sweden
- Child and Adolescent Psychiatry, Centre for Psychiatry Research, Stockholm County Council, Stockholm, Sweden
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28
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Effectiveness of the Early Start Denver Model: a Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2016. [DOI: 10.1007/s40489-015-0068-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Boggio PS, Asthana MK, Costa TL, Valasek CA, Osório AAC. Promoting social plasticity in developmental disorders with non-invasive brain stimulation techniques. Front Neurosci 2015; 9:294. [PMID: 26388712 PMCID: PMC4555066 DOI: 10.3389/fnins.2015.00294] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 08/05/2015] [Indexed: 12/11/2022] Open
Abstract
Being socially connected directly impacts our basic needs and survival. People with deficits in social cognition might exhibit abnormal behaviors and face many challenges in our highly social-dependent world. These challenges and limitations are associated with a substantial economical and subjective impact. As many conditions where social cognition is affected are highly prevalent, more treatments have to be developed. Based on recent research, we review studies where non-invasive neuromodulatory techniques have been used to promote Social Plasticity in developmental disorders. We focused on three populations where non-invasive brain stimulation seems to be a promising approach in inducing social plasticity: Schizophrenia, Autism Spectrum Disorder (ASD) and Williams Syndrome (WS). There are still very few studies directly evaluating the effects of transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS) in the social cognition of these populations. However, when considering the promising preliminary evidences presented in this review and the limited amount of clinical interventions available for treating social cognition deficits in these populations today, it is clear that the social neuroscientist arsenal may profit from non-invasive brain stimulation techniques for rehabilitation and promotion of social plasticity.
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Affiliation(s)
- Paulo S Boggio
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
| | - Manish K Asthana
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
| | - Thiago L Costa
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
| | - Cláudia A Valasek
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
| | - Ana A C Osório
- Social and Cognitive Neuroscience Laboratory and Developmental Disorders Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University Sao Paulo, Brazil
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Le modèle de Denver (Early Start Denver Model). Une approche d’intervention précoce pour les troubles du spectre autistique. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.neurenf.2015.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Canitano R, Bozzi Y. New treatment perspectives in autism spectrum disorders. Front Pediatr 2015; 3:22. [PMID: 25853112 PMCID: PMC4364165 DOI: 10.3389/fped.2015.00022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 03/06/2015] [Indexed: 01/12/2023] Open
Affiliation(s)
- Roberto Canitano
- Division of Child Neuropsychiatry, University Hospital of Siena , Siena , Italy
| | - Yuri Bozzi
- Laboratory of Molecular Neuropathology, Centre for Integrative Biology (CIBIO), University of Trento , Trento , Italy ; CNR Neuroscience Institute , Pisa , Italy
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32
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Matson JL, Jang J. Treating aggression in persons with autism spectrum disorders: a review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3386-3391. [PMID: 25194514 DOI: 10.1016/j.ridd.2014.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 08/19/2014] [Indexed: 06/03/2023]
Abstract
Aggression is one of the most frequent and debilitating problems observed among persons with autism spectrum disorders (ASD). It is common and can be more problematic than many core symptoms of ASD. Thus, treating the behavior is a high priority. A surprisingly limited number of studies have addressed treatment when taken in the context of the vast ASD literature. This paper reviews many of these papers and describes the types of interventions that have been used and the characteristics of the people who have been studied.
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Affiliation(s)
| | - Jina Jang
- Louisiana State University, United States.
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33
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Matson JL, Cervantes PE. Assessing aggression in persons with autism spectrum disorders: an overview. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:3269-3275. [PMID: 25178710 DOI: 10.1016/j.ridd.2014.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 08/04/2014] [Indexed: 06/03/2023]
Abstract
Aggression is a commonly co-occurring problem with autism spectrum disorders (ASD). Comorbid aggression can be every bit as debilitating as core symptoms of ASD itself. As a result, careful identification of aggression, the context in which it occurs, and factors that maintain the behavior all have important implications for treatment. As a result, researchers have begun to develop methods and measures to assess aggression among persons with ASD. The purpose of this paper was to review measures that have been used to assess aggression among persons with ASD. We located 25 different assessment methods for both children and adults. The current status and future directions of this area of research are discussed.
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Sullivan K, Stone WL, Dawson G. Potential neural mechanisms underlying the effectiveness of early intervention for children with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2921-32. [PMID: 25108609 PMCID: PMC4163495 DOI: 10.1016/j.ridd.2014.07.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/08/2014] [Accepted: 07/14/2014] [Indexed: 05/15/2023]
Abstract
Although evidence supports the efficacy of early intervention for improving outcomes for children with autism spectrum disorder (ASD), the mechanisms underlying their effectiveness remain poorly understood. This paper reviews the research literature on the neural bases of the early core deficits in ASD and proposes three key features of early intervention related to the neural mechanisms that may contribute to its effectiveness in improving deficit areas. These features include (1) the early onset of intensive intervention which capitalizes on the experience-expectant plasticity of the immature brain, (2) the use of treatment strategies that address core deficits in social motivation through an emphasis on positive social engagement and arousal modulation, and (3) promotion of complex neural networks and connectivity through thematic, multi-sensory and multi-domain teaching approaches. Understanding the mechanisms of effective early intervention will enable us to identify common or foundational active ingredients for promoting optimal outcomes in children with ASD.
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Affiliation(s)
- Katherine Sullivan
- Department of Psychology, University of Washington, Seattle, WA 98195, USA.
| | - Wendy L Stone
- Department of Psychology, University of Washington, Seattle, WA 98195, USA.
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences and Duke Institute for Brain Sciences, Duke University, Durham, NC 27708, USA.
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