Brain responses to biological motion predict treatment outcome in young adults with autism receiving Virtual Reality Social Cognition Training: Preliminary findings.
Yang Y J Daniel,Allen Tandra,Abdullahi Sebiha M,Pelphrey Kevin A,Volkmar Fred R,Chapman Sandra B
Behaviour research and therapy
Autism Spectrum Disorder (ASD) is characterized by remarkable heterogeneity in social, communication, and behavioral deficits, creating a major barrier in identifying effective treatments for a given individual with ASD. To facilitate precision medicine in ASD, we utilized a well-validated biological motion neuroimaging task to identify pretreatment biomarkers that can accurately forecast the response to an evidence-based behavioral treatment, Virtual Reality-Social Cognition Training (VR-SCT). In a preliminary sample of 17 young adults with high-functioning ASD, we identified neural predictors of change in emotion recognition after VR-SCT. The predictors were characterized by the pretreatment brain activations to biological vs. scrambled motion in the neural circuits that support (a) language comprehension and interpretation of incongruent auditory emotions and prosody, and (b) processing socio-emotional experience and interpersonal affective information, as well as emotional regulation. The predictive value of the findings for individual adults with ASD was supported by regression-based multivariate pattern analyses with cross validation. To our knowledge, this is the first pilot study that shows neuroimaging-based predictive biomarkers for treatment effectiveness in adults with ASD. The findings have potentially far-reaching implications for developing more precise and effective treatments for ASD.
10.1016/j.brat.2017.03.014
Design of a Physiology-Sensitive VR-Based Social Communication Platform for Children With Autism.
Kuriakose Selvia,Lahiri Uttama
IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
Individuals with autism are often characterized by impairments in communication, reciprocal social interaction and explicit expression of their affective states. In conventional techniques, a therapist adjusts the intervention paradigm by monitoring the affective state e.g., anxiety of these individuals for effective floor-time-therapy. Conventional techniques, though powerful, are observation-based and face resource limitations. Technology-assisted systems can provide a quantitative, individualized rehabilitation platform. Presently-available systems are designed primarily to chain learning via aspects of one's performance alone restricting individualization. Specifically, these systems are not sensitive to one's anxiety. Our presented work seeks to bridge this gap by developing a novel VR-based interactive system with Anxiety-Sensitive adaptive technology. Specifically, such a system is capable of objectively identifying and quantifying one's anxiety level from real-time biomarkers, along with performance metrics. In turn it can adaptively respond in an individualized manner to foster improved social communication skills. In our present research, we have used Virtual Reality (VR) to design a proof-of-concept application that exposes participants to social tasks of varying challenges. Results of a preliminary usability study indicate the potential of our VR-based Anxiety-Sensitive system to foster improved task performance, thereby serving as a potent complementary tool in the hands of therapist.
10.1109/TNSRE.2016.2613879
Characterization of an Animal Model of Autism and Social Interaction.
Iwata Keiko
Methods in molecular biology (Clifton, N.J.)
Autism is a pervasive developmental disorder characterized by severe and sustained impairment of social interaction and communication, and restricted or stereotyped patterns of behavior and interest. Though multiple risk factors such as genetic and environmental components and interaction of these factors are suggested, the exact etiology is still not known. Many risk factors have been used to established animal models of psychiatric and neurodevelopmental disorders. These models can be useful tools for testing epidemiological findings and investigating the molecular mechanisms underlying the neuropathology of these disorders. To improve the validity of animal models, three criteria including behavioral similarity has been proposed. The method described here is for evaluating the impairment of social interaction, one of the three core symptoms of autism.
10.1007/978-1-4939-8994-2_14
Electroencephalographic Correlate of Mexican Spanish Emotional Speech Processing in Autism Spectrum Disorder: To a Social Story and Robot-Based Intervention.
Duville Mathilde Marie,Alonso-Valerdi Luz Maria,Ibarra-Zarate David I
Frontiers in human neuroscience
Socio-emotional impairments are key symptoms of Autism Spectrum Disorders. This work proposes to analyze the neuronal activity related to the discrimination of emotional prosodies in autistic children (aged 9 to 11-year-old) as follows. Firstly, a database for single words uttered in Mexican Spanish by males, females, and children will be created. Then, optimal acoustic features for emotion characterization will be extracted, followed of a cubic kernel function Support Vector Machine (SVM) in order to validate the speech corpus. As a result, human-specific acoustic properties of emotional voice signals will be identified. Secondly, those identified acoustic properties will be modified to synthesize the recorded human emotional voices. Thirdly, both human and synthesized utterances will be used to study the electroencephalographic correlate of affective prosody processing in typically developed and autistic children. Finally, and on the basis of the outcomes, synthesized voice-enhanced environments will be created to develop an intervention based on social-robot and Social Story for autistic children to improve affective prosodies discrimination. This protocol has been registered at BioMed Central under the following number: ISRCTN18117434.
10.3389/fnhum.2021.626146
[A longitudinal (3 years) study of the development of four children with autism without mental retardation after 90 sessions of social skills training].
Liratni M,Blanchet C,Pry R
L'Encephale
INTRODUCTION:Few studies on social skills training essentially based on ABA techniques are dedicated to children with autism aged 5 to 10 years whereas autistic disorders can be diagnosed in very early childhood. Generally, the main criticisms about these social skills training are: shortness of programs (around 20 sessions), no manual with precise descriptions of sessions and used techniques, and a lack of generalization of the learned skills in everyday life. OBJECTIVES:To describe the evolution (before/after) of symptoms and sociocommunicative skills of 7 children with autism and no mental retardation (mean age=7.08) who participated in 90 sessions (during 3 years) in a learning group of communication and socialization (or LGCS). METHOD:To develop these sessions, we referred to intellectual and verbal levels obtained by the children on The Wechsler Intelligence Scales. We proposed activities such as open discussion, telling about events or vacations, learning of and communicative social rules, social games, outdoor exercises at home or in parks/shops/supermarkets/restaurants with known/unknown children/adults/sellers. To target the social and communicative skills, we also referred to their intellectual level and to Assessment of basic language and learning skills (ABBLS). To practice these sessions, we referred to: (1) TEACCH cognitive ergonomics principles (Treatment and education of autistic and related communication handicapped children developed by Schopler); and especially (2) ABA techniques (Applied behavior analysis) which are rarely mentioned as such. In particular, we used techniques such as: (a) concrete reinforcements which were frequently evaluated; (b) precise levels of verbal incentives and (c) error corrections. To measure the changes, we assessed children with psychometric tests before and after 90 sessions (ADOS and VABS). RESULTS:The scores show significant improvements in autistic symptoms related to communication (ADOS, P=0.03) and significant improvements in both socialization and communication domains (VABS, P=0.00). From a symptomatic point of view (ADOS), we clinically observe better conversation skills and more social initiatives. About socialization and communication behaviors, parents reported (VABS): better listening, better verbal expression, more social relationships and a start of friendship for most of the children. CONCLUSION:This three-year longitudinal follow-up is the first known study about the evolution of children with autistic disorders after a great number of sessions of social skills training. It shows that it is possible to adapt social skills training to young children. In addition, our program and our results (VABS) show clear examples of generalization which is targeted as a weakness in the specialized studies. However, the absence of a control group and of a base line strongly limit our results in terms of effectiveness.
10.1016/j.encep.2016.03.008
Linguistic markers of autism in girls: evidence of a "blended phenotype" during storytelling.
Molecular autism
Background:Narrative abilities are linked to social impairment in autism spectrum disorder (ASD), such that reductions in words about cognitive processes (e.g., , ) are thought to reflect underlying deficits in social cognition, including Theory of Mind. However, research suggests that typically developing (TD) boys and girls tell narratives in sex-specific ways, including differential reliance on cognitive process words. Given that most studies of narration in ASD have been conducted in predominantly male samples, it is possible that prior results showing reduced cognitive processing language in ASD may not generalize to autistic girls. To answer this question, we measured the relative frequency of two kinds of words in stories told by autistic girls and boys: nouns (words that indicate object-oriented storytelling) and cognitive process words (words like and that indicate mentalizing or attention to other peoples' internal states). Methods:One hundred two verbally fluent school-aged children [girls with ASD ( = 21) and TD ( = 19), and boys with ASD ( = 41) and TD ( = 21)] were matched on age, IQ, and maternal education. Children told a story from a sequence of pictures, and word frequencies (nouns, cognitive process words) were compared. Results:Autistic children of both sexes consistently produced a greater number of nouns than TD controls, indicating object-focused storytelling. There were no sex differences in cognitive process word use in the TD group, but autistic girls produced significantly more cognitive process words than autistic boys, despite comparable autism symptom severity. Thus, autistic girls showed a unique narrative profile that overlapped with autistic boys typical girls/boys. Noun use correlated significantly with parent reports of social symptom severity in all groups, but cognitive process word use correlated with social ability in boys only. Conclusion:This study extends prior research on autistic children's storytelling by measuring sex differences in the narratives of a relatively large, well-matched sample of children with and without ASD. Importantly, prior research showing that autistic children use fewer cognitive process words is true for boys only, while object-focused language is a sex-neutral linguistic marker of ASD. These findings suggest that sex-sensitive screening and diagnostic methods-preferably using objective metrics like natural language processing-may be helpful for identifying autistic girls, and could guide the development of future personalized treatment strategies.
10.1186/s13229-019-0268-2
[Sensory-psychomotor evaluation in Autism: A new tool for functional diagnosis].
Le Menn-Tripi C,Vachaud A,Defas N,Malvy J,Roux S,Bonnet-Brilhault F
L'Encephale
INTRODUCTION:Psychomotor impairments in Autism Spectrum Disorders (ASD) have frequently been described in scientific literature. Such deficits impact upon the development of social motor function and interfere with the ability to adjust to everyday life. The inclusion of sensory-motor signs in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) confirms their importance in the diagnosis of ASD. Previous literature has shown the presence precocity of these signs, sometimes before the alteration of the social communication. To our knowledge, there are no existing clinical tools to measure sensory-psychomotor deficit, specifically in ASD. The current paper presents the construction and validation of a new scale, designed to evaluate sensory-psychomotor signs in Autism: 'the Sensory-psychomotor Particularities Scale in Autism' (SPSA). METHOD:The scale is composed of 160 items describing common sensory-psychomotor signs in autism. These items are grouped into 20 variables: touch, nociception, vestibular sensitivity, proprioceptive sensitivity, vision, auditory, multimodality, tone, posture, balance, global coordination, manual dexterity, body schema, bodily self-consciousness, relational adjustment, emotional expression, use of objects, space, time and tonico-emotional regulation. For each item, the psychomotor therapist evaluated sensori-psychomotor signs according to a five-level Likert scale (0="the sign is never expressed by the person", 1="weakly expressed", 2="moderately expressed", 3="severely expressed" and 4="the sign is very characteristic of the person and very severely expressed"). This is completed by a family interview in order to assess the impact of these signs on everyday situations. The study included 111 children with autism. The presence of neurological and genetic diseases was exclusion criteria. For each child, a global developmental evaluation was carried out by an expert clinical team specializing in ASD. Standardized clinical tools were used: Autism Diagnostic Observation Schedule (ADOS), Childhood Autism Rating Scale (CARS), Behavior Summarized Evaluation scale (BSE-R), Repeated and Restricted Behavior scale (RRB), Movement Assessment Battery for Children (M-ABC), Motor Development Rating scale (MDR), Sensory Profile (SP). Developmental quotients (DQ) were evaluated using various tests depending on age and ability. RESULTS:Factor analysis produced three clinically relevant factors: F1: "sensory-emotional synchronization", F2: "multisensory integration" and F3: "motor skills": each containing a similar quantity of items. They account for roughly equal percentages of variance (18.9%, 18.0%, 16.8%, respectively). The factorial structure does not change if the 26 children with comorbid developmental coordination disorder are removed. The three factors show good internal consistency and excellent inter-rater reliability. F1 is comprised of 6 items: touch, nociception, proprioceptive sensitivity, vision, emotional expression and tonico-emotional regulation. This factor is significantly associated with items of the Sensory Profile (touch processing, poor registration, sensory seeking). F2 is comprised of 5 items: multimodality, bodily self-consciousness, relational adjustment, use of objects and space. This factor is associated with ADOS, BSE-R and RRB scores, and the item "touch processing" of the Sensory Profile. F3 is comprised of 4 items: tone, posture, global coordination, manual dexterity. This factor is associated with the M-ABC, the MDR and the item "low endurance" of the Sensory Profile. CONCLUSION:The SPSA is a relevant clinical tool to assess the severity of sensory-psychomotor clinical signs in order to describe the individual profiles of children with ASD. It represents a critical step in advancing knowledge of the complex and heterogeneous pattern of psychomotor development in autism. It could make a valuable contribution to the field, both in research and clinical practice.
10.1016/j.encep.2018.12.003
Zebrafish knockout of Down syndrome gene, , shows social impairments relevant to autism.
Molecular autism
BACKGROUND: maps to the Down syndrome critical region at 21q22. Mutations in this kinase-encoding gene have been reported to cause microcephaly associated with either intellectual disability or autism in humans. Intellectual disability accompanied by microcephaly was recapitulated in a murine model by overexpressing which mimicked Down syndrome phenotypes. However, given embryonic lethality in homozygous knockout (KO) mice, no murine model studies could present sufficient evidence to link dysfunction with autism. To understand the molecular mechanisms underlying microcephaly and autism spectrum disorders (ASD), we established an in vivo KO model using zebrafish. METHODS:We identified a patient with a mutation in the gene using microarray analysis. Circumventing the barrier of murine model studies, we generated a KO zebrafish using transcription activator-like effector nuclease (TALEN)-mediated genome editing. For social behavioral tests, we have established a social interaction test, shoaling assay, and group behavior assay. For molecular analysis, we examined the neuronal activity in specific brain regions of KO zebrafish through in situ hybridization with various probes including and which are the molecular markers for stress response. RESULTS:Microarray detected an intragenic microdeletion of in an individual with microcephaly and autism. From behavioral tests of social interaction and group behavior, KO zebrafish exhibited social impairments that reproduce human phenotypes of autism in a vertebrate animal model. Social impairment in KO zebrafish was further confirmed by molecular analysis of and expression. Transcriptional expression of and was lower than that of wild type fish in specific hypothalamic regions, suggesting that KO fish brains are less activated by social context. CONCLUSIONS:In this study, we established a zebrafish model to validate a candidate gene for autism in a vertebrate animal. These results illustrate the functional deficiency of as an underlying disease mechanism for autism. We also propose simple social behavioral assays as a tool for the broader study of autism candidate genes.
10.1186/s13229-017-0168-2
'It's different for girls': Gender differences in the friendships and conflict of autistic and neurotypical adolescents.
Sedgewick Felicity,Hill Vivian,Pellicano Elizabeth
Autism : the international journal of research and practice
This mixed-methods study examined gender differences in the friendships and conflict experiences of autistic girls and boys relative to their neurotypical peers. In total, 102 adolescents (27 autistic girls, 26 autistic boys, 26 neurotypical girls, and 23 neurotypical boys), aged between 11 and 18 years completed the Friendship Qualities Scale, the Revised Peer Experiences Questionnaire and were interviewed about their friendships. Results demonstrated that in many ways, the friendships and social experiences of autistic girls are similar to those of neurotypical girls. Autistic girls, however, have significantly more social challenges than their neurotypical peers, experiencing more conflict and finding that conflict harder to manage successfully. Autistic boys showed quantitatively different friendship patterns to all other groups. There were consistent gender differences in the type of conflict which boys and girls experienced, regardless of diagnostic status. These findings suggest that gender, rather than diagnosis per se, plays a critical role in the way that autistic adolescents perceive and experience their social relationships.
10.1177/1362361318794930
"In Their Own Time": Parents Gently Push Their Autistic Youth Towards Independent Community Mobility and Participation.
Kersten Michelle,Coxon Kristy,Lee Hoe,Wilson Nathan J
Journal of autism and developmental disorders
Autistic adults have decreased independence in community mobility and driving, which is associated with decreased participation in work, education and community participation. This is the first exploration of the development of community mobility, driving and participation skills over adolescence and emerging adulthood. Interviews with 15 mothers of autistic youth, capable of independence, were qualitatively analysed using grounded theory. Four major themes emerged: mothers gently pushing, teaching, letting go and working towards hopes and dreams. These results suggest earlier intervention across adolescence to address social skills, communication and anxiety in normative community environments, is required for successful development of community mobility and driving skills. Further understanding the critical role of confidence, feeling safe and accepted, could ultimately improve independence.
10.1007/s10803-020-04384-9
High autistic trait individuals do not modulate gaze behaviour in response to social presence but look away more when actively engaged in an interaction.
von dem Hagen Elisabeth A H,Bright Naomi
Autism research : official journal of the International Society for Autism Research
Autism is characterised by difficulties in social functioning, notably in interactions with other people. Yet, most studies addressing social difficulties have used static images or, at best, videos of social stimuli, with no scope for real interaction. Here, we study one crucial aspect of social interactions-gaze behaviour-in an interactive setting. First, typical individuals were shown videos of an experimenter and, by means of a deception procedure, were either led to believe that the experimenter was present via a live video-feed or was pre-recorded. Participants' eye movements revealed that when passively viewing an experimenter they believed to be "live," they looked less at that person than when they believed the experimenter video was pre-recorded. Interestingly, this reduction in viewing behaviour in response to the believed "live" presence of the experimenter was absent in individuals high in autistic traits, suggesting a relative insensitivity to social presence alone. When participants were asked to actively engage in a real-time interaction with the experimenter, however, high autistic trait individuals looked significantly less at the experimenter relative to low autistic trait individuals. The results reinforce findings of atypical gaze behaviour in individuals high in autistic traits, but suggest that active engagement in a social interaction may be important in eliciting reduced looking. We propose that difficulties with the spatio-temporal dynamics associated with real social interactions rather than underlying difficulties processing the social stimulus itself may drive these effects. The results underline the importance of developing ecologically valid methods to investigate social cognition. Autism Res 2017, 10: 359-368. © 2016 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.
10.1002/aur.1666
Social Bayes: Using Bayesian Modeling to Study Autistic Trait-Related Differences in Social Cognition.
Sevgi Meltem,Diaconescu Andreea O,Henco Lara,Tittgemeyer Marc,Schilbach Leonhard
Biological psychiatry
BACKGROUND:The autistic spectrum is characterized by profound impairments of social interaction. The exact subpersonal processes, however, that underlie the observable lack of social reciprocity are still a matter of substantial controversy. Recently, it has been suggested that the autistic spectrum might be characterized by alterations of the brain's inference about the causes of socially relevant sensory signals. METHODS:We used a novel reward-based learning task that required integration of nonsocial and social cues in conjunction with computational modeling. Thirty-six healthy subjects were selected based on their score on the Autism-Spectrum Quotient (AQ), and AQ scores were assessed for correlations with cue-related model parameters and task scores. RESULTS:Individual differences in AQ scores were significantly correlated with participants' total task scores, with high AQ scorers performing more poorly in the task (r = -.39, 95% confidence interval = -0.68 to -0.13). Computational modeling of the behavioral data unmasked a learning deficit in high AQ scorers, namely, the failure to integrate social context to adapt one's belief precision-the precision afforded to prior beliefs about changing states in the world-particularly in relation to the nonsocial cue. CONCLUSIONS:More pronounced autistic traits in a group of healthy control subjects were related to lower scores associated with misintegration of the social cue. Computational modeling further demonstrated that these trait-related performance differences are not explained by an inability to process the social stimuli and their causes, but rather by the extent to which participants consider social information to infer the nonsocial cue.
10.1016/j.biopsych.2019.09.032
Parent-Mediated Interventions for Children With Autism Spectrum Disorder: A Systematic Review.
Althoff Colleen E,Dammann Caitlin P,Hope Sarah J,Ausderau Karla K
The American journal of occupational therapy : official publication of the American Occupational Therapy Association
OBJECTIVE:The purpose of this systematic review was to evaluate the evidence for the effectiveness of parent-mediated interventions on occupational performance of children with autism spectrum disorder (ASD). METHOD:We conducted a search of academic databases using terms such as autism spectrum disorder, parent, caregiver, and intervention. Five hundred eighty-two articles were reviewed, and 109 were selected for full-text review. The final analysis included 13 articles. RESULTS:Strong evidence was found for the efficacy of parent-mediated intervention for increasing child joint attention. Moderate evidence was found for the improvement of language scores, expressive language, nonverbal communication, initiation and response to interaction, behavior, play, adaptive functioning, ASD symptoms, and social communication. CONCLUSION:This systematic review suggests that parent-mediated interventions for children with ASD can improve various aspects of communication and ASD symptoms, with emerging support for occupational performance. Occupational therapy practitioners are well suited to facilitate these interventions to support families with children with autism.
10.5014/ajot.2019.030015
A social competence intervention for young children with high functioning autism and Asperger syndrome: a pilot study.
Minne Elizabeth Portman,Semrud-Clikeman Margaret
Autism : the international journal of research and practice
The key features of Asperger Syndrome (AS) and high functioning autism (HFA) include marked and sustained impairment in social interactions. A multi-session, small group program was developed to increase social perception based on the assumption perceptual or interpretive problems underlying these social difficulties. Additionally, the group format espoused a play therapy orientation and the use of sociodramatic play was the primary therapeutic modality used. Qualitative analyses of the data resulted in an explanation of the key changes in social interactions that took place through the course of the intervention. Although each participant's experience in this group was unique, all children in this program demonstrated improvements in their social interactions, as they experienced development both emotionally and behaviorally. Findings suggest that, despite their rigid interests and behavior patterns, the social limitations of these children improved when provided with the necessary environmental resources.
10.1177/1362361311423384
Gender Differences in the Social Motivation and Friendship Experiences of Autistic and Non-autistic Adolescents.
Sedgewick Felicity,Hill Vivian,Yates Rhiannon,Pickering Leanne,Pellicano Elizabeth
Journal of autism and developmental disorders
This mixed-methods study examined gender differences in the social motivation and friendship experiences of adolescent boys and girls with autism relative to those without autism, all educated within special education settings. Autistic girls showed similar social motivation and friendship quality to non-autistic girls, while autistic boys reported having both qualitatively different friendships and less motivation for social contact relative to boys without autism and to girls with and without autism. Semi-structured interviews with the adolescents corroborated these findings, with one exception: autistic girls reported high levels of relational aggression within their friendships, suggesting that girls on the autism spectrum in particular may struggle with identifying and dealing with conflict in their social lives.
10.1007/s10803-015-2669-1
"Bill is now singing": joint engagement and the emergence of social communication of three young children with autism.
Vaiouli Potheini,Grimmet Kharon,Ruich Lawrence J
Autism : the international journal of research and practice
Young children with autism spectrum disorder meet significant challenges in joint attention skills and in social communication. A child-centered, improvisational, music therapy intervention model was implemented to promote engagement in three young children with autism in a kindergarten classroom. A multiple baseline design compared the children's performance through three phases of intervention: focus on faces, response to joint attention, and initiation of joint attention. A complimentary qualitative analysis of teacher and parent experiences allowed for an in-depth understanding of the role of social environment in supporting emerging social communication skills among three children. As all children showed improvement in joint attention and actions of social engagement, this study bears evidence on the potential of music therapy as a promising intervention for promoting social skills of young children with autism spectrum disorder.
10.1177/1362361313511709
Social relationship difficulties in autism and reactive attachment disorder: Improving diagnostic validity through structured assessment.
Davidson Claire,O'Hare Anne,Mactaggart Fiona,Green Jonathan,Young David,Gillberg Christopher,Minnis Helen
Research in developmental disabilities
BACKGROUND:Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. METHODS:Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. RESULTS:Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. CONCLUSIONS:Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
10.1016/j.ridd.2015.01.007
Joint attention, language, social relating, and stereotypical behaviours in children with autistic disorder.
Delinicolas Erin K,Young Robyn L
Autism : the international journal of research and practice
This study aimed to investigate the relationships between abilities to initiate and respond to joint attention and symptoms of autism that have, and have not, been theoretically linked to joint attention. Participants were 51 boys and five girls with autistic disorder, aged between 2 years and 6 years 5 months. Measures of joint attention behaviours, language, social relating, and stereotypical behaviour were administered during a single assessment. As predicted, the correlations between joint attention and the two behaviours theoretically linked to joint attention (i.e. social relating and language) were significantly stronger than those between joint attention and the behaviour not theoretically linked (i.e. stereotypical behaviour). While causation cannot be inferred from this study, these results support the suggestion that difficulties with joint attention behaviours commonly found among children with autism are linked to language and social relating, beyond what might be expected simply due to their co-occurrence as symptoms.
10.1177/1362361307079595
Psychometric properties of the French Version of the Social Responsiveness Scale in autism spectrum disorder with or without attention deficit hyperactivity disorder.
Stordeur C,Boele A,Peyre H,Delorme R,Acquaviva E
L'Encephale
OBJECTIVES:The Social Responsiveness Scale (SRS) is an instrument that is commonly used to screen for Autism Spectrum Disorder (ASD). Attention Deficit Hyperactive Disorder (ADHD) frequently occurs with ASD and both disorders share some phenotypic similarities. In the present study, we aimed to determine the psychometric properties of the French version of the Social Responsiveness Scale (SRS) and its 5 subscales (social awareness, social cognition, social communication, social motivation, and autistic mannerisms) to discriminate between children with ADHD and those with ASD (differential diagnosis) and children with ADHD from those with a dual diagnosis of ADHD and ASD (comorbid diagnosis). METHOD:SRS total scores and the 5 subscores of the SRS were compared between 4 groups of children: ADHD (n=32), ASD+ADHD (n=30), ASD (n=31) and typical neurodevelopment (TD; n=30) children. The discriminant validity was estimated using the Area Under the ROC Curves (AUC). RESULTS:SRS Social cognition (AUC=0.73) and Autistic mannerisms (AUC=0.70) subscores were the most discriminating for differential diagnosis of ASD and ADHD. SRS total scores (AUC=0.70), and Social communication (AUC=0.66) and Autistic mannerisms (AUC=0.75) subscores were the most discriminating for comorbid diagnosis of ASD among ADHD children. CONCLUSION:The SRS autistic mannerisms subscore was found to be clinically relevant for both differential diagnosis of ASD and ADHD and comorbid diagnoses of ASD among ADHD children but with a modest discriminant power.
10.1016/j.encep.2018.08.004
Dog training intervention improves adaptive social communication skills in young children with autism spectrum disorder: A controlled crossover study.
Ben-Itzchak Esther,Zachor Ditza A
Autism : the international journal of research and practice
LAY ABSTRACT:There is some evidence that using therapy dogs for children with autism spectrum disorder generally results in improved social communication skills and reduced behavioral problems. However, well-controlled studies that examine its effectiveness are scarce. This study examined the effectiveness of a "Dog Training Intervention." The study included 73 participants diagnosed with autism spectrum disorder (61 males, 12 females) with age range of 2:10-7:6 years ( = 4:10 ± 1:0) who attend autism spectrum disorder-specific special education schools. The study population was divided into two groups. Each group received the dog training intervention during one part of the school year (first half or second half) in addition to the standard interventions provided by the special education school settings. The dog training intervention was given twice weekly for 4 months within the school setting. The group that received the dog training intervention first showed a significant increase in adaptive social and communication skills in comparison to the second group that did not receive the intervention in this period. This improvement was maintained after the dog training intervention. The second group, which received intervention at the second half of the year, showed improvement in communication and socialization adaptive skills only during the period in which they received the dog training intervention. The positive impact on social communication adaptive skills of the dog training intervention among young children with autism spectrum disorder suggests that dogs may serve as an effective model for establishing social interaction. Dog training intervention appears to be an effective adjunct treatment to the interventions provided in special education schools for young children with autism spectrum disorder.
10.1177/13623613211000501
Utility of the Autism Diagnostic Observation Schedule and the Brief Observation of Social and Communication Change for Measuring Outcomes for a Parent-Mediated Early Autism Intervention.
Carruthers Sophie,Charman Tony,El Hawi Nicole,Kim Young Ah,Randle Rachel,Lord Catherine,Pickles Andrew,
Autism research : official journal of the International Society for Autism Research
Measuring outcomes for autistic children following social communication interventions is an ongoing challenge given the heterogeneous changes, which can be subtle. We tested and compared the overall and item-level intervention effects of the Brief Observation of Social Communication Change (BOSCC), Autism Diagnostic Observation Schedule (ADOS-2) algorithm, and ADOS-2 Calibrated Severity Scores (CSS) with autistic children aged 2-5 years from the Preschool Autism Communication Trial (PACT). The BOSCC was applied to Module 1 ADOS assessments (ADOS-BOSCC). Among the 117 children using single or no words (Module 1), the ADOS-BOSCC, ADOS algorithm, and ADOS CSS each detected small non-significant intervention effects. However, on the ADOS algorithm, there was a medium significant intervention effect for children with "few to no words" at baseline, while children with "some words" showed little intervention effect. For the full PACT sample (including ADOS Module 2, total n=152), ADOS metrics evidenced significant small (CSS) and medium (algorithm) overall intervention effects. None of the Module 1 item-level intervention effects reached significance, with largest changes observed for Gesture (ADOS-BOSCC and ADOS), Facial Expressions (ADOS), and Intonation (ADOS). Significant ADOS Module 2 item-level effects were observed for Mannerisms and Repetitive Interests and Stereotyped Behaviors. Despite strong psychometric properties, the ADOS-BOSCC was not more sensitive to behavioral changes than the ADOS among Module 1 children. Our results suggest the ADOS can be a sensitive outcome measure. Item-level intervention effect plots have the potential to indicate intervention "signatures of change," a concept that may be useful in future trials and systematic reviews. LAY SUMMARY: This study compares two outcome measures in a parent-mediated therapy. Neither was clearly better or worse than the other; however, the Autism Diagnostic Observation Schedule produced somewhat clearer evidence than the Brief Observation of Social Communication Change of improvement among children who had use of "few to no" words at the start. We explore which particular behaviors are associated with greater improvement. These findings can inform researchers when they consider how best to explore the impact of their intervention.
10.1002/aur.2449
Deficits in mesolimbic reward pathway underlie social interaction impairments in children with autism.
Brain : a journal of neurology
Lack of interest in social interaction is a hallmark of autism spectrum disorder. Animal studies have implicated the mesolimbic reward pathway in driving and reinforcing social behaviour, but little is known about the integrity of this pathway and its behavioural consequences in children with autism spectrum disorder. Here we test the hypothesis that the structural and functional integrity of the mesolimbic reward pathway is aberrant in children with autism spectrum disorder, and these aberrancies contribute to the social interaction impairments. We examine structural and functional connectivity of the mesolimbic reward pathway in two independent cohorts totalling 82 children aged 7-13 years with autism spectrum disorder and age-, gender-, and intelligence quotient-matched typically developing children (primary cohort: children with autism spectrum disorder n = 24, typically developing children n = 24; replication cohort: children with autism spectrum disorder n = 17, typically developing children n = 17), using high angular resolution diffusion-weighted imaging and functional MRI data. We reliably identify white matter tracts linking-the nucleus accumbens and the ventral tegmental area-key subcortical nodes of the mesolimbic reward pathway, and provide reproducible evidence for structural aberrations in these tracts in children with autism spectrum disorder. Further, we show that structural aberrations are accompanied by aberrant functional interactions between nucleus accumbens and ventral tegmental area in response to social stimuli. Crucially, we demonstrate that both structural and functional circuit aberrations in the mesolimbic reward pathway are related to parent-report measures of social interaction impairments in affected children. Our findings, replicated across two independent cohorts, reveal that deficits in the mesolimbic reward pathway contribute to impaired social skills in childhood autism, and provide fundamental insights into neurobiological mechanisms underlying reduced social interest in humans.
10.1093/brain/awy191
Fostering a social child with autism: a moment-by-moment sequential analysis of an early social engagement intervention.
Vernon Ty W
Journal of autism and developmental disorders
Young children with autism often experience limited social motivation and responsiveness that restricts establishment of crucial social momentum. These characteristics can lead to decreased opportunities for parental engagement and the social learning associated with these moments. Early social interventions that capitalize on pre-existing interests may be able to re-establish this developmentally critical feedback loop, in which both child and parent social behaviors simultaneously increase and influence one another. This investigation examined the moment-by-moment, micro-transactional relationship between parent and child social behavior gains observed in an early intervention study. Time-window sequential analyses revealed the presence of clinically and statistically significant sequential associations between parent and child social behaviors during an embedded social interaction intervention, but not in a comparable motivational intervention that utilized highly preferred toys and objects. Specifically, the onset of parent eye contact, directed positive affect, or offer of a reinforcing incentive predicted the immediate occurrence of child eye contact and positive affect in the experimental social intervention condition. Additionally, child verbal initiations, positive affect, and eye contact immediately predicted the onset of parent positive affect during this social intervention paradigm. Theoretical implications for the social developmental trajectory of autism are discussed.
10.1007/s10803-014-2173-z
A Mixed-Methods Evaluation of Parent-Assisted Children's Friendship Training to Improve Social Skills and Friendship Quality in Children with Autism in Malaysia.
International journal of environmental research and public health
: This study evaluates the effectiveness of parent-assisted children's friendship training intervention for enhancing friendship quality and social skills among children with autism spectrum disorders (ASD). We conducted a quasi-experimental study to investigate the effective outcomes of social skills and friendship quality in the pre-and post-parent-assisted CFT intervention phases; : to conduct a 12-week field session, 30 children with their parents were selected. The Social Skills Improvement System Rating Scales and the Quality of Play Questionnaire-Parent were used to assess the effectiveness of the parent-assisted children's friendship training during pre-and post-intervention. A semi-structured interview with parents was conducted at the end of the session; : findings revealed that intervention improved the social skills of these children. Additionally, the friendship quality of children with ASD improved before and after the intervention, however, engagement remained unchanged. Parents also showed some sort of improvement after the session as they reported a heightened sense of fear and resistance, awareness, learning and adjustment, change is not easy, and identifying support; : there was clear evidence that children with ASD benefitted from parent-assisted CFTs in terms of social skills and friendship quality. However, larger and controlled studies are required to draw firm conclusions about this kind of intervention.
10.3390/ijerph18052566
Point OutWords: protocol for a feasibility randomised controlled trial of a motor skills intervention to promote communicative development in non-verbal children with autism.
Trials
BACKGROUND:Point OutWords is a caregiver-delivered, iPad-assisted intervention for non-verbal or minimally verbal children with autism. It aims to develop prerequisite skills for communication such as manual and oral motor skills, sequencing, and symbolic representation. This feasibility trial aims to determine the viability of evaluating the clinical efficacy of Point OutWords. METHODOLOGY:We aim to recruit 46 non-verbal or minimally verbal children with autism and their families, approximately 23 per arm. Children in the intervention group will use Point OutWords for half an hour, five times a week, for 8 weeks. Children in the control group will have equal caregiver-led contact time with the iPad using a selection of control apps (e.g. sensory apps, drawing apps). Communication, motor, and daily living skills are assessed at baseline and post-intervention. Parents will keep diaries during the intervention period and will take part in focus groups when the intervention is completed. DISCUSSION:Point OutWords was developed in collaboration with children with autism and their caregivers, to provide an intervention for a subgroup of autism that has been historically underserved. As autism is a heterogeneous condition, it is unlikely that one style of intervention will address all aspects of its symptomatology; the motor skills approach of Point OutWords can complement other therapies that address core autistic symptoms of social cognition and communication more directly. The current feasibility trial can inform the selection of outcome measures and design for future full-scale randomised controlled trials of Point OutWords and of other early interventions in autism. TRIAL REGISTRATION:ISRCTN, ISRCTN12808402. Prospectively registered on 12 March 2019.
10.1186/s13063-019-3931-1
A systematic review of parent-infant interaction in infants at risk of autism.
Wan Ming Wai,Green Jonathan,Scott Jordan
Autism : the international journal of research and practice
Social communicative precursors to autism spectrum disorder may influence how infants who are later diagnosed with autism spectrum disorder interact with their social partners and the responses they receive, thus bidirectionally influencing early social experience. This systematic review aimed to identify a developmental timeline for parent-infant interaction in the first 2 years of life in at-risk infants and in emergent autism spectrum disorder, and to examine any parent-infant interaction associations with later social-communicative outcomes. In total, 15 studies were identified investigating parent-infant interaction in infants at familial autism risk (i.e. with an older sibling with autism spectrum disorder). Starting from the latter part of the first year, infants at risk of autism spectrum disorder (and particularly infants with eventual autism spectrum disorder) showed parent-infant interaction differences from those with no eventual autism spectrum disorder, most notably in infant gesture use and dyadic qualities. While parental interactions did not differ by subsequent child autism spectrum disorder outcome, at-risk infants may receive different 'compensatory' socio-communicative inputs, and further work is needed to clarify their effects. Preliminary evidence links aspects of parent-infant interaction with later language outcomes. We discuss the potential role of parent-infant interaction in early parent-mediated intervention.
10.1177/1362361318777484
Effects of a Therapeutic Horseback Riding Program on Social Interaction and Communication in Children with Autism.
Zhao Mengxian,Chen Shihui,You Yonghao,Wang Yongtai,Zhang Yanjie
International journal of environmental research and public health
Various therapeutic interventions have been studied and found to be effective in reducing the stereotypical behaviors of children with autism spectrum disorder (ASD). There has been increasing interest in using animal-assisted interventions (AAIs) as an alternative approach to therapeutic rehabilitation for children with ASD, and many studies have reported that AAI has significant benefits for the cognitive, psychological, and social behavior of children with ASD. The present study was designed to examine the effects of a 16 weeks therapeutic horseback riding program on social interaction and communication skills in children with autism. Eighty-four children diagnosed with ASD, aged between 6 and 12 years old, were recruited for this study. All selected participants met the DSM-V criteria, and a total of sixty-one participants ( = 61) completed the study. A quasi-experimental design with an experimental group and control group was implemented for this study, taking measurements at pre-test, interim-test, and post-test to monitor the behavior changes in social and communication throughout the 16-week intervention. Repeated measures ANOVA and the independent sample -test were used for data analysis, to assess the difference between the experimental group and control group. The results indicated that the THR program had positive influences on overall social skills and communication, based on the SSIS and the ABLLS-R scores, compared to the control group ( < 0.05). A notable improvement in the overall social interaction score was observed from the interim-testing point to post-test. In addition, participants in the therapeutic horseback riding (THR) group achieved significant improvements on six out of seven items in their communication evaluations. In conclusion, after 16 weeks of intervention, the THR program significantly enhanced the subdomains of social and communication skills in the areas of social interaction, communication, responsibility, and self-control, compared to the control group.
10.3390/ijerph18052656
Beyond intervention into daily life: A systematic review of generalisation following social communication interventions for young children with autism.
Autism research : official journal of the International Society for Autism Research
Researchers have generally considered autistic individuals to have difficulties generalising learned skills across novel contexts. Successful generalisation is necessary for an intervention to have benefits in everyday life beyond the original learning environment. We conducted a systematic review of randomised controlled trials of early social communication interventions for children with autism in order to explore generalisation and its measurement. We identified nine RCTs that provided evidence of initial target learning and measured generalisation, of which eight demonstrated at least some successful generalisation across people, settings, and/or activities. The findings did not support the widely reported generalisation 'difficulties' associated with autism. However, generalisation was not consistent across all skills within studies, and one study found no generalisation despite evidence for initial target learning within the intervention context. In general, there are few methodologically sound social communication intervention studies exploring generalisation in autism and no consensus on how it should be measured. In particular, failure to demonstrate initial learning of target skills within the intervention setting and an absence of formal mediation analyses of the hypothesised mechanisms limit current research. We outline a framework within which measurement of generalisation can be considered for use in future trials. To maximise the effectiveness of interventions, the field needs to gain a better understanding of the nature of generalisation among autistic individuals and what additional strategies may further enhance learning. Autism Res 2020, 13: 506-522. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: It is generally considered that autistic individuals experience difficulties applying things they have learned in one context into different settings (e.g. from school to home). This is important to consider for intervention studies. Our review does not support a complete lack of generalisation but instead suggests that after early social communication intervention, autistic children can transfer some skills to new contexts. Overall, there is limited research in this area and further work is needed.
10.1002/aur.2264
Meta-Analysis on Intervention Effects of Physical Activities on Children and Adolescents with Autism.
Huang Jinfeng,Du Chunjie,Liu Jianjin,Tan Guangxin
International journal of environmental research and public health
This paper aimed to discuss the intervention effects of physical activities on children and adolescents with autism with a meta-analysis so as to serve as a reference to further relevant research on the same topic. As for research methods, by searching in CNKI (China National Knowledge Infrastructure), WanFang data, VIP Database for Chinese Technical Periodicals, PubMed, Scopus, Web of Science, and other databases, this study collected randomized controlled trials (RCTs) on the intervention of physical activities on children and adolescents with autism and used Review Manager 5.3 software to process and analyze the outcome indicators of the literature. As for the result, a total of 12 papers and 492 research targets were selected. The results of the meta-analysis show that physical activity had a significant positive impact on social interaction ability, communication ability, motor skills, and autism degree of autistic children as well as the social skills and communication skills of autistic adolescents. On the other hand, physical activity had no significant effect on the stereotyped behavior of autistic children and adolescents. In conclusion, physical activity intervention is beneficial to children and adolescents with autism, and continuous physical activity intervention can produce greater intervention effect.
10.3390/ijerph17061950
Using Peer-Mediated LEGO® Play Intervention to Improve Social Interactions for Chinese Children with Autism in an Inclusive Setting.
Hu Xiaoyi,Zheng Qunshan,Lee Gabrielle T
Journal of autism and developmental disorders
The purpose of this study was to examine the effects of a peer-mediated LEGO® play intervention on improving social skills for children with ASD in an inclusive preschool in China. Three boys with ASD and 13 typically developing children participated in this study. A multiple-probe across participants design was used. The intervention consisted of LEGO® construction activities incorporated with peer-mediated strategies for one child with ASD and two typically developing peers. The intervention sessions were conducted two sessions per week with a total of 28-31 sessions for each participant. Results indicated that all three children with ASD increased their social initiations and responses following the completion of the intervention. Social validity was also obtained.
10.1007/s10803-018-3502-4
A Pilot Randomised Control Trial of Digitally-Mediated Social Stories for Children on the Autism Spectrum.
Hanrahan R,Smith E,Johnson H,Constantin A,Brosnan M
Journal of autism and developmental disorders
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.
10.1007/s10803-020-04490-8
Child characteristics associated with outcome for children with autism in a school-based behavioral intervention.
Pellecchia Melanie,Connell James E,Kerns Connor M,Xie Ming,Marcus Steven C,Mandell David S
Autism : the international journal of research and practice
This study examined the extent to which clinical and demographic characteristics predicted outcome for children with autism spectrum disorder. Participants included 152 students with autism spectrum disorder in 53 kindergarten-through-second-grade autism support classrooms in a large urban public school district. Associations between child characteristics (including age, language ability, autism severity, social skills, adaptive behavior, co-occurring psychological symptoms, and restrictive and repetitive behavior) and outcome, as measured by changes in cognitive ability following one academic year of an intervention standardized across the sample were evaluated using linear regression with random effects for classroom. While several scales and subscales had statistically significant bivariate associations with outcome, in adjusted analysis, only age and the presence of symptoms associated with social anxiety, such as social avoidance and social fearfulness, as measured through the Child Symptom Inventory-4, were associated with differences in outcome. The findings regarding the role of social anxiety are new and have important implications for treatment. Disentangling the construct of social anxiety to differentiate between social fearfulness and social motivation has important implications for shifting the focus of early treatment for children with autism spectrum disorder.
10.1177/1362361315577518
Social skills group training in high-functioning autism: A qualitative responder study.
Choque Olsson Nora,Rautio Daniel,Asztalos Jenny,Stoetzer Ulrich,Bölte Sven
Autism : the international journal of research and practice
Systematic reviews show some evidence for the efficacy of group-based social skills group training in children and adolescents with autism spectrum disorder, but more rigorous research is needed to endorse generalizability. In addition, little is known about the perspectives of autistic individuals participating in social skills group training. Using a qualitative approach, the objective of this study was to examine experiences and opinions about social skills group training of children and adolescents with higher functioning autism spectrum disorder and their parents following participation in a manualized social skills group training ("KONTAKT"). Within an ongoing randomized controlled clinical trial (NCT01854346) and based on outcome data from the Social Responsiveness Scale, six high responders and five low-to-non-responders to social skills group training and one parent of each child (N = 22) were deep interviewed. Interestingly, both high responders and low-to-non-responders (and their parents) reported improvements in social communication and related skills (e.g. awareness of own difficulties, self-confidence, independence in everyday life) and overall treatment satisfaction, although more positive intervention experiences were expressed by responders. These findings highlight the added value of collecting verbal data in addition to quantitative data in a comprehensive evaluation of social skills group training.
10.1177/1362361315621885
The impact of a school-based musical contact intervention on prosocial attitudes, emotions and behaviours: A pilot trial with autistic and neurotypical children.
Cook Anna,Ogden Jane,Winstone Naomi
Autism : the international journal of research and practice
Children with autism are more likely to be socially excluded than their neurotypical peers. Since the majority of children with autism attend mainstream schools, interventions are needed to improve the attitudes and behaviours of their peers. Many studies highlight the influence of contact on positive attitudes and reduced discrimination. Group music-making provides an ideal opportunity for positive contact to occur in the classroom. This study evaluated the impact of music-based contact with autistic peers on the attitudes, emotions and behaviours of neurotypical children. Changes in those with autism were also assessed. Neurotypical participants ( n = 55) aged 10-11 years took part in an 11-week music programme designed to increase social interaction, which either did or did not include contact with autistic children ( n = 10). Measures of attitudes, emotions and behaviours were assessed at baseline and follow-up. In response to a hypothetical scenario depicting social exclusion of a child with autism, neurotypical participants in the contact group showed a greater increase in prosocial emotions and a greater decrease in tendency to be a victim than those in the no-contact group. Participants with autism also showed a 19.7% decrease in victimisation. Implications of group music-making for tackling social exclusion of children with autism are discussed.
10.1177/1362361318787793
Does the Brief Observation of Social Communication Change help moving forward in measuring change in early autism intervention studies?
Pijl Mirjam Kj,Rommelse Nanda Nj,Hendriks Monica,De Korte Manon Wp,Buitelaar Jan K,Oosterling Iris J
Autism : the international journal of research and practice
The field of early autism research is in dire need of outcome measures that adequately reflect subtle changes in core autistic behaviors. This article compares the ability of a newly developed measure, the Brief Observation of Social Communication Change (BOSCC), and the Autism Diagnostic Observation Schedule (ADOS) to detect changes in core symptoms of autism in 44 toddlers. The results provide encouraging evidence for the Brief Observation of Social Communication Change as a candidate outcome measure, as reflected in sufficient inter- and intra-rater reliability, independency from other child characteristics, and sensitivity to capture change. Although the Brief Observation of Social Communication Change did not evidently outperform the Autism Diagnostic Observation Schedule on any of these quality criteria, the instrument may be better able to capture subtle, individual changes in core autistic symptoms. The promising findings warrant further study of this new instrument.
10.1177/1362361316669235
Development, feasibility, and preliminary efficacy of an employment-related social skills intervention for young adults with high-functioning autism.
Sung Connie,Connor Annemarie,Chen June,Lin Chien-Chun,Kuo Hung-Jen,Chun Jina
Autism : the international journal of research and practice
This article details the iterative development, feasibility, and preliminary efficacy of an 8-week work-related social skills intervention, Assistive Soft Skills and Employment Training, for young adults with high-functioning autism spectrum disorder. In this mixed-methods study, pre- and post-intervention surveys, interviews, and functional measures were used to gather information on the program's feasibility, user acceptability, practicality, and preliminary efficacy. Results indicate that Assistive Soft Skills and Employment Training graduates showed significant improvements in work-related social skills knowledge, social functioning, and social/empathy self-efficacy. Participants and group facilitators also reported high satisfaction with program activities, training modalities, frequency, and duration of the intervention. Results support expanded use of group-based, work-related, social skills interventions for young adults with high-functioning autism spectrum disorder. Moreover, these findings, though preliminary, suggest that manualized, empirically based programs like Assistive Soft Skills and Employment Training promote improved social functioning, self-confidence, engagement, and adherence to training, as well as broader impacts, including improved sense of belonging and greater employability in this traditionally underserved population.
10.1177/1362361318801345
A novel group parenting intervention to reduce emotional and behavioural difficulties in young autistic children: protocol for the Autism Spectrum Treatment and Resilience pilot randomised controlled trial.
BMJ open
INTRODUCTION:The majority of young autistic children display impairing emotional and behavioural difficulties that contribute to family stress. There is some evidence that behavioural parenting interventions are effective for reducing behavioural difficulties in autistic children, with less evidence assessing change in emotional difficulties. Previous trials have tended to use unblinded parent-report measures as primary outcomes and many do not employ an active control, limiting the conclusions that can be drawn. METHODS AND ANALYSIS:The Autism Spectrum Treatment and Resilience study is a pilot randomised controlled trial (RCT) testing the specific effect of a 12-week group parenting intervention (Predictive Parenting) on primary and secondary outcomes, in comparison to an attention control condition consisting of psychoeducation parent groups. Following a feasibility study to test research procedures and the interventions, the pilot RCT participants include 60 parents of autistic children aged 4-8 years who are randomised to Predictive Parenting versus the attention control. Measures are administered at baseline and post intervention to assess group differences in child and parent outcomes, costs and service use and adverse events. The primary outcome is an objective measure of child behaviours that challenge during interactions with their parent and a researcher. The trial aims to provide data on recruitment, retention, completion of measures and acceptability of the intervention and research protocol, in addition to providing a preliminary indication of potential efficacy and establishing an effect size that could be used to power a larger-scale efficacy trial. We will also provide preliminary estimates of the cost-effectiveness of the interventions. ETHICS AND DISSEMINATION:Ethical approval was granted from NHS Camden and Kings Cross Research Ethics Committee (ref: 16/LO/1769) along with NHS R&D approval from South London and Maudsley, Guy's and St Thomas', and Croydon Health Services NHS Trusts. The findings will be disseminated through publication in peer-reviewed journals and presentations at conferences. TRIAL REGISTRATION NUMBER:ISRCTN91411078.
10.1136/bmjopen-2019-029959
An exploratory longitudinal study of social and language outcomes in children with autism in bilingual home environments.
Zhou Vanessa,Munson Jeffrey A,Greenson Jessica,Hou Yan,Rogers Sally,Estes Annette M
Autism : the international journal of research and practice
Little is known about outcomes of early intervention for children with autism spectrum disorder reared in bilingual homes. There are concerns that social communication deficits among children with autism spectrum disorder may reduce the developmental benefits of early intervention for children with autism spectrum disorder raised in bilingual environments. We conducted an exploratory analysis of cross-sectional and longitudinal data from a larger study to explore associations between home language environment and language ability and social skills in response to early autism spectrum disorder intervention. Participants, aged 12-26 months when recruited, were a subset of a larger 2-year, randomized intervention trial (ClinicalTrials.gov identifier: NCT00698997). Children from bilingual homes ( n = 13) began intervention with lower gesture use but otherwise demonstrated equal baseline language and social abilities as compared with age and nonverbal IQ-matched children from monolingual homes ( n = 24). Significant language growth was exhibited by children from both language groups and there was no moderating effect of home language environment. The bilingual home group demonstrated increased gesture use over the course of intervention as compared with the monolingual home group. Preliminary data revealed no basis for concerns regarding negative impact of a bilingual home environment on language or social development in young children with autism spectrum disorder.
10.1177/1362361317743251
The impact of implementation support on the use of a social engagement intervention for children with autism in public schools.
Locke Jill,Shih Wendy,Kang-Yi Christina D,Caramanico Julie,Shingledecker Travis,Gibson Jordan,Frederick Lindsay,Mandell David S
Autism : the international journal of research and practice
Several interventions have demonstrated efficacy in improving social outcomes for children with autism; however, few have been successfully implemented in schools. This study compared two implementation strategies to improve the use of a social engagement intervention for children with autism in public schools. In total, 31 children with autism in grades K-5 and 28 school personnel participated in a randomized controlled trial. Schools were randomized to (1) training in Remaking Recess, a social engagement intervention, or (2) training in Remaking Recess with implementation support. Linear regression with random effects was used to test the intervention effects on implementation fidelity and social outcomes (peer engagement, social network inclusion, and friendship nominations). In both groups, implementation fidelity improved after training but remained low. Children in the Remaking Recess with implementation support condition had significantly higher social network inclusion and received more friendship nominations than children in the Remaking Recess-only condition (p = 0.03). Children in both groups experienced reduced solitary engagement (p < 0.001) and increased joint engagement (p < 0.001). The results suggest that implementation supports may have an effect on outcomes above and beyond the intervention, and that further research is needed into the active intervention mechanisms.
10.1177/1362361318787802
Generalized Effects of Naturalistic Social Communication Intervention for Minimally Verbal Children with Autism.
Hampton Lauren H,Kaiser Ann P,Nietfeld Jennifer P,Khachoyan Ani
Journal of autism and developmental disorders
JASP-EMT, the combined Enhanced Milieu Teaching (EMT) and Joint Attention, Structured Play, and Emotion Regulation (JASPER) interventions, has been found to be effective for promoting social communication in young children with autism (Kasari et al. in J Am Acad Child Adolesc Psychiatry 53(6):635-646, https://doi.org/10.1016/j.jaac.2014.01.019 , 2014). The current study examined the effects of this naturalistic intervention on social language use in three children with autism who were in the early stages of language acquisition. Generalization to communication partners who did not utilize the intervention strategies was systematically examined using a multiple-baseline design. The results from this study indicate that this blended intervention is effective in increasing target social language for young children with autism, however, generalization to communication partners does not readily occur. Implications for practice and future research are discussed.
10.1007/s10803-020-04521-4
A trial of an iPad™ intervention targeting social communication skills in children with autism.
Fletcher-Watson Sue,Petrou Alexandra,Scott-Barrett Juliet,Dicks Pamela,Graham Catherine,O'Hare Anne,Pain Helen,McConachie Helen
Autism : the international journal of research and practice
This study evaluated a technology-based early intervention for social communication skills in pre-schoolers in a randomised controlled trial. Participants were 54 children aged under 6 years with a diagnosis of autism, assigned to either intervention or control conditions. The app engaged children, who played consistently, regardless of developmental level, and was rated highly by parents. There were no significant group differences in parent-report measures post-intervention, nor in a measure of parent-child play at follow-up. Therefore, this intervention did not have an observable impact on real-world social communication skills and caution is recommended about the potential usefulness of iPad(™) apps for amelioration of difficulties in interaction. However, positive attitudes among participants, lack of harms and the potential of apps to deliver therapeutic content at low economic cost suggest this approach is worth pursuing further, perhaps targeting other skill domains.
10.1177/1362361315605624