Pub Date : 2018-01-29DOI: 10.1177/2396941518764760
K. Hudry, H. McConachie, A. Le Couteur, P. Howlin, B. Barrett, V. Slonims
Background and aims Despite recent gains in the amount and quality of early autism intervention research, identifying what works for whom remains an ongoing challenge. Exploiting data from the Preschool Autism Communication Trial (PACT), we undertook secondary analysis to explore prognostic indicators and predictors of response to one year of PACT therapy versus treatment as usual within this large and rigorously characterised cohort recruited across three UK trial sites. Methods In this secondary analysis of variability in child gains on the primary trial outcome measure – social-communication symptom severity – we used a pragmatic and data-driven approach to identify a subgroup of children who showed reliable improvement and a subgroup showing clear lack thereof. We then tested which among several baseline child and family factors – including measures routinely collected in research trials and clinical practice – varied as a function of child outcome status and treatment group. Results Greater baseline child non-verbal ability was a significant prognostic indicator of symptom reduction over time (i.e. irrespective of treatment group). By contrast, parent synchrony presented as marginal predictor, and trial recruitment site as a significant predictor, of differential outcome by treatment group. Specifically, lower parent synchrony showed some association with poorer outcomes for children from families assigned to treatment as usual (but with no such effect for those assigned to PACT). Similarly, children at one recruitment site were more likely to have poorer outcomes if assigned to treatment as usual, compared to children at the same site assigned to PACT. Conclusions The current data contribute to an evidence base indicting that early non-verbal ability is a robust indicator of generally better prognosis for young children with autism. Lower parent synchrony and a broadly more deprived socio-geographical context may inform the appropriate targeting of PACT. That is, given that the former factors predicted poorer outcome in children from families assigned to treatment as usual, the receipt of a relatively low-dose, parent-mediated and communication-focused therapy might be developmentally protective for young children with autism. Nevertheless, results from this study also highlight the paucity of meaningful predictors of outcome among routine clinical characterisation measures such as those investigated here. Implications Understanding the factors associated with differential treatment outcomes is critical if we are to individualise treatment decisions for children with autism. Inherently tied to this objective is a need to delineate those factors which specifically predict positive response (or lack of response) to one or other treatment option, versus those that indicate generally better (or poorer) prognosis, irrespective of treatment.
{"title":"Predictors of reliable symptom change: Secondary analysis of the Preschool Autism Communication Trial","authors":"K. Hudry, H. McConachie, A. Le Couteur, P. Howlin, B. Barrett, V. Slonims","doi":"10.1177/2396941518764760","DOIUrl":"https://doi.org/10.1177/2396941518764760","url":null,"abstract":"Background and aims Despite recent gains in the amount and quality of early autism intervention research, identifying what works for whom remains an ongoing challenge. Exploiting data from the Preschool Autism Communication Trial (PACT), we undertook secondary analysis to explore prognostic indicators and predictors of response to one year of PACT therapy versus treatment as usual within this large and rigorously characterised cohort recruited across three UK trial sites. Methods In this secondary analysis of variability in child gains on the primary trial outcome measure – social-communication symptom severity – we used a pragmatic and data-driven approach to identify a subgroup of children who showed reliable improvement and a subgroup showing clear lack thereof. We then tested which among several baseline child and family factors – including measures routinely collected in research trials and clinical practice – varied as a function of child outcome status and treatment group. Results Greater baseline child non-verbal ability was a significant prognostic indicator of symptom reduction over time (i.e. irrespective of treatment group). By contrast, parent synchrony presented as marginal predictor, and trial recruitment site as a significant predictor, of differential outcome by treatment group. Specifically, lower parent synchrony showed some association with poorer outcomes for children from families assigned to treatment as usual (but with no such effect for those assigned to PACT). Similarly, children at one recruitment site were more likely to have poorer outcomes if assigned to treatment as usual, compared to children at the same site assigned to PACT. Conclusions The current data contribute to an evidence base indicting that early non-verbal ability is a robust indicator of generally better prognosis for young children with autism. Lower parent synchrony and a broadly more deprived socio-geographical context may inform the appropriate targeting of PACT. That is, given that the former factors predicted poorer outcome in children from families assigned to treatment as usual, the receipt of a relatively low-dose, parent-mediated and communication-focused therapy might be developmentally protective for young children with autism. Nevertheless, results from this study also highlight the paucity of meaningful predictors of outcome among routine clinical characterisation measures such as those investigated here. Implications Understanding the factors associated with differential treatment outcomes is critical if we are to individualise treatment decisions for children with autism. Inherently tied to this objective is a need to delineate those factors which specifically predict positive response (or lack of response) to one or other treatment option, versus those that indicate generally better (or poorer) prognosis, irrespective of treatment.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941518764760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49475238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1177/2396941517747468
Elizabeth Alexander, Lisa Dille
Background & aims This study investigated the perceptions of educational professionals in regard to the effectiveness of visual communication systems and their applications as a functional communication intervention for individuals with Autism Spectrum Disorder (ASD). Methods One hundred and one individuals from diverse educational backgrounds, school districts, educational services, and various states were surveyed for this study. All participants in this study served individuals with Autism Spectrum Disorder in a clinical and/or school setting. Results The study found that aided augmentative and alternative communication (AAC) systems were widely utilized, and participants perceived these systems as the most effective for individuals with Autism Spectrum Disorder. It also found that the use of low level tech aided augmentative communication systems such as Picture Exchange System and high level tech systems such as voice output systems that were strictly computer based, were dependent on the individual's abilities and needs. Finally, the study found that the use of photography and photo journaling techniques had positive outcomes for individuals diagnosed with Autism Spectrum Disorder and other students in the learning environment. Conclusions The results revealed that the overall consensus of educational professionals that serve individuals with ASD agreed that aided AAC systems were more effective methods to foster and enhance functional communication. In terms of effectiveness of the level of technology utilized within the system, it depends on the needs and abilities of the individual with ASD. Participants, however, did agree that photography and photo journaling techniques may provide positive attributes to all students and not only those diagnosed with ASD. Implications The ability to modify or alter the ways in which AAC systems are created and implemented may address the need to individualize the systems in terms of the needs and abilities of the individual with ASD. The results inform educational practices as they highlight that a majority of the professionals that participated in this study need further professional development with the understanding and application of these systems in order to better understand their benefits and what they have to offer individuals with ASD. The results also provided a lens through the professionals' experiences into the classrooms by providing information from professionals that utilize and implement these systems daily including their successes in aiding communication effectively.
{"title":"Professional perceptions of the effectiveness of visual communication systems and their applications for functional communication interventions for individuals with Autism Spectrum Disorder","authors":"Elizabeth Alexander, Lisa Dille","doi":"10.1177/2396941517747468","DOIUrl":"https://doi.org/10.1177/2396941517747468","url":null,"abstract":"Background & aims This study investigated the perceptions of educational professionals in regard to the effectiveness of visual communication systems and their applications as a functional communication intervention for individuals with Autism Spectrum Disorder (ASD). Methods One hundred and one individuals from diverse educational backgrounds, school districts, educational services, and various states were surveyed for this study. All participants in this study served individuals with Autism Spectrum Disorder in a clinical and/or school setting. Results The study found that aided augmentative and alternative communication (AAC) systems were widely utilized, and participants perceived these systems as the most effective for individuals with Autism Spectrum Disorder. It also found that the use of low level tech aided augmentative communication systems such as Picture Exchange System and high level tech systems such as voice output systems that were strictly computer based, were dependent on the individual's abilities and needs. Finally, the study found that the use of photography and photo journaling techniques had positive outcomes for individuals diagnosed with Autism Spectrum Disorder and other students in the learning environment. Conclusions The results revealed that the overall consensus of educational professionals that serve individuals with ASD agreed that aided AAC systems were more effective methods to foster and enhance functional communication. In terms of effectiveness of the level of technology utilized within the system, it depends on the needs and abilities of the individual with ASD. Participants, however, did agree that photography and photo journaling techniques may provide positive attributes to all students and not only those diagnosed with ASD. Implications The ability to modify or alter the ways in which AAC systems are created and implemented may address the need to individualize the systems in terms of the needs and abilities of the individual with ASD. The results inform educational practices as they highlight that a majority of the professionals that participated in this study need further professional development with the understanding and application of these systems in order to better understand their benefits and what they have to offer individuals with ASD. The results also provided a lens through the professionals' experiences into the classrooms by providing information from professionals that utilize and implement these systems daily including their successes in aiding communication effectively.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":"29 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517747468","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41246226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1177/2396941517751892
Twyla Perryman, L. Watson, Frances L. Chumney
Background and aims This study investigated timing of diagnosis for African American (n = 50) and European American (n = 118) children with autism spectrum disorder in a North Carolina sample. Methods Using survey methods, a total of 168 North Carolina families were recruited. Results The two racially diverse groups did not differ significantly in the age at diagnosis of autism spectrum disorder (African American: M = 49.72, SD = 25.83; European American: M = 43.78, SD = 20.16; t(75) = 1.45, p = .15, 95% CI [−14.10, 2.22], d = .27; BF10 = .582). Exploratory analyses revealed that within the African American sample, the age of diagnosis was positively correlated with parental ratings of Social Motivation from the Social Responsiveness Scale (r = .30, p < 0.05). This correlation was non-significant and close to zero (r = −0.03, p > 0.05) for the European American sample. Additionally, children who received another initial diagnostic label had a later age of diagnosis for autism spectrum disorder. This finding had a larger effect size in the African-American group. Conclusions The differential findings for the two groups may reflect variable interpretations of autism spectrum disorder symptoms, or a greater impact of later diagnosis on symptom severity in certain populations. Implications Our findings reflect the need for continued exploration of symptom interpretation among various racial/ethnic groups.
{"title":"Predictors of the age of autism spectrum disorder diagnosis: A North Carolina Cohort","authors":"Twyla Perryman, L. Watson, Frances L. Chumney","doi":"10.1177/2396941517751892","DOIUrl":"https://doi.org/10.1177/2396941517751892","url":null,"abstract":"Background and aims This study investigated timing of diagnosis for African American (n = 50) and European American (n = 118) children with autism spectrum disorder in a North Carolina sample. Methods Using survey methods, a total of 168 North Carolina families were recruited. Results The two racially diverse groups did not differ significantly in the age at diagnosis of autism spectrum disorder (African American: M = 49.72, SD = 25.83; European American: M = 43.78, SD = 20.16; t(75) = 1.45, p = .15, 95% CI [−14.10, 2.22], d = .27; BF10 = .582). Exploratory analyses revealed that within the African American sample, the age of diagnosis was positively correlated with parental ratings of Social Motivation from the Social Responsiveness Scale (r = .30, p < 0.05). This correlation was non-significant and close to zero (r = −0.03, p > 0.05) for the European American sample. Additionally, children who received another initial diagnostic label had a later age of diagnosis for autism spectrum disorder. This finding had a larger effect size in the African-American group. Conclusions The differential findings for the two groups may reflect variable interpretations of autism spectrum disorder symptoms, or a greater impact of later diagnosis on symptom severity in certain populations. Implications Our findings reflect the need for continued exploration of symptom interpretation among various racial/ethnic groups.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517751892","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44886366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.1177/2396941517751891
S. S. Manwaring, A. L. Stevens, Alfred Mowdood, Mellanye J Lackey
Background and aims Young children use deictic gestures, such as pointing, to indicate referents in their immediate environment. Early deictic gesture use is important in facilitating the development of language. In toddlers with or at-risk for autism spectrum disorder, the emergence and use of gestures may be delayed, and deficits in deictic gesture may inform clinical practice regarding early identification, differential diagnosis, and early intervention. The aim of this scoping review was to investigate the extent to which deictic gesture use has been examined in young children with or at-risk for autism spectrum disorder ≤ 36 months of age. Methods Four databases (PubMed, PsycINFO, CINAHL, and ERIC) were comprehensively searched for relevant articles. Articles were reviewed in two phases: titles and abstracts followed by full text. Key variables related to participant/study characteristics and group differences on deictic gesture use were extracted. A narrative review was used to synthesize findings across studies. Main contribution Nineteen studies met inclusion criteria – 12 studies of toddlers with autism spectrum disorder and 7 studies of high-risk infant siblings of children diagnosed with autism spectrum disorder. Overall, toddlers with autism spectrum disorder were found to demonstrate reduced gesture use across deictic gesture types and ages compared to those with typical development. Findings were more variable when comparing toddlers with autism spectrum disorder to those with other developmental delays and in high-risk infant sibling studies. Although only measured in a limited number of studies, results suggest differences in gesture use in toddlers with autism spectrum disorder based on communicative function. Conclusions This review provides insight into the gesture use of toddlers with or at-risk for autism spectrum disorder. Results indicate the particular types of deictic gestures that may be delayed and the age ranges we might expect to observe these deficits in toddlers with autism spectrum disorder compared to those with typical development and other developmental delay groups. Results also reveal variability across studies in the measurement of gestures, and highlight where gaps remain in understanding deictic gesture use in young children with autism spectrum disorder. Implications Findings have research and clinical implications related to profiling and targeting gesture use as part of the assessment and treatment process, including identifying patterns of strength and weakness in deictic gesture use of young children with or at-risk for autism spectrum disorder.
{"title":"A scoping review of deictic gesture use in toddlers with or at-risk for autism spectrum disorder","authors":"S. S. Manwaring, A. L. Stevens, Alfred Mowdood, Mellanye J Lackey","doi":"10.1177/2396941517751891","DOIUrl":"https://doi.org/10.1177/2396941517751891","url":null,"abstract":"Background and aims Young children use deictic gestures, such as pointing, to indicate referents in their immediate environment. Early deictic gesture use is important in facilitating the development of language. In toddlers with or at-risk for autism spectrum disorder, the emergence and use of gestures may be delayed, and deficits in deictic gesture may inform clinical practice regarding early identification, differential diagnosis, and early intervention. The aim of this scoping review was to investigate the extent to which deictic gesture use has been examined in young children with or at-risk for autism spectrum disorder ≤ 36 months of age. Methods Four databases (PubMed, PsycINFO, CINAHL, and ERIC) were comprehensively searched for relevant articles. Articles were reviewed in two phases: titles and abstracts followed by full text. Key variables related to participant/study characteristics and group differences on deictic gesture use were extracted. A narrative review was used to synthesize findings across studies. Main contribution Nineteen studies met inclusion criteria – 12 studies of toddlers with autism spectrum disorder and 7 studies of high-risk infant siblings of children diagnosed with autism spectrum disorder. Overall, toddlers with autism spectrum disorder were found to demonstrate reduced gesture use across deictic gesture types and ages compared to those with typical development. Findings were more variable when comparing toddlers with autism spectrum disorder to those with other developmental delays and in high-risk infant sibling studies. Although only measured in a limited number of studies, results suggest differences in gesture use in toddlers with autism spectrum disorder based on communicative function. Conclusions This review provides insight into the gesture use of toddlers with or at-risk for autism spectrum disorder. Results indicate the particular types of deictic gestures that may be delayed and the age ranges we might expect to observe these deficits in toddlers with autism spectrum disorder compared to those with typical development and other developmental delay groups. Results also reveal variability across studies in the measurement of gestures, and highlight where gaps remain in understanding deictic gesture use in young children with autism spectrum disorder. Implications Findings have research and clinical implications related to profiling and targeting gesture use as part of the assessment and treatment process, including identifying patterns of strength and weakness in deictic gesture use of young children with or at-risk for autism spectrum disorder.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517751891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41505036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-12-01DOI: 10.1177/2396941517745674
A. Shield, K. Knapke, Morgan Henry, S. Srinivasan, A. Bhat
Background and aims Praxis, the ability to plan and execute a series of gestures or motor sequences, is impaired in individuals with autism spectrum disorder. In this paper, we present the first study of praxis during a gesture imitation task in a unique population of children with autism spectrum disorder: deaf children who have been exposed to American Sign Language from birth by their Deaf parents. Lifelong exposure to sign language in deaf individuals entails practice with gesture imitation. We ask if deaf, signing children with autism spectrum disorder present with praxis impairments similar to those reported in the literature for hearing children with autism spectrum disorder not exposed to sign. Methods Thirty deaf children of Deaf parents (16 typically developing and 14 with autism spectrum disorder), matched for chronological and mental age, were tested on a simple gesture imitation task. Children were asked to imitate 24 gestures performed by an adult model on a laptop computer that varied along dimensions of movement type (16 trials) and palm orientation direction (eight trials). Data were coded for nine praxis parameters (five formation parameters and four manner parameters) and three timing measures. Results Results showed that the deaf children with autism spectrum disorder produced more errors than the typically developing deaf children on six of the nine praxis dimensions (hand orientation, final orientation, modulation, directness, pace, and overflow) and were more impaired on manner parameters than formation parameters, suggesting underlying deficits in motor control/coordination leading to dyspraxia. Praxis scores were strongly related to severity of autism spectrum disorder symptoms and receptive sign language scores. Conclusions We thus find evidence that praxis is impaired in deaf, signing children with autism spectrum disorder, despite lifelong exposure to a gestural language and extensive practice with gesture imitation. Implications Our findings suggest that interventions targeted toward enhancing praxis and coordination of finger and hand movements could help facilitate language development in children with autism spectrum disorder.
{"title":"Impaired praxis in gesture imitation by deaf children with autism spectrum disorder","authors":"A. Shield, K. Knapke, Morgan Henry, S. Srinivasan, A. Bhat","doi":"10.1177/2396941517745674","DOIUrl":"https://doi.org/10.1177/2396941517745674","url":null,"abstract":"Background and aims Praxis, the ability to plan and execute a series of gestures or motor sequences, is impaired in individuals with autism spectrum disorder. In this paper, we present the first study of praxis during a gesture imitation task in a unique population of children with autism spectrum disorder: deaf children who have been exposed to American Sign Language from birth by their Deaf parents. Lifelong exposure to sign language in deaf individuals entails practice with gesture imitation. We ask if deaf, signing children with autism spectrum disorder present with praxis impairments similar to those reported in the literature for hearing children with autism spectrum disorder not exposed to sign. Methods Thirty deaf children of Deaf parents (16 typically developing and 14 with autism spectrum disorder), matched for chronological and mental age, were tested on a simple gesture imitation task. Children were asked to imitate 24 gestures performed by an adult model on a laptop computer that varied along dimensions of movement type (16 trials) and palm orientation direction (eight trials). Data were coded for nine praxis parameters (five formation parameters and four manner parameters) and three timing measures. Results Results showed that the deaf children with autism spectrum disorder produced more errors than the typically developing deaf children on six of the nine praxis dimensions (hand orientation, final orientation, modulation, directness, pace, and overflow) and were more impaired on manner parameters than formation parameters, suggesting underlying deficits in motor control/coordination leading to dyspraxia. Praxis scores were strongly related to severity of autism spectrum disorder symptoms and receptive sign language scores. Conclusions We thus find evidence that praxis is impaired in deaf, signing children with autism spectrum disorder, despite lifelong exposure to a gestural language and extensive practice with gesture imitation. Implications Our findings suggest that interventions targeted toward enhancing praxis and coordination of finger and hand movements could help facilitate language development in children with autism spectrum disorder.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517745674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43563069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.1177/2396941517743418
Jan Lobban-Shymko, Nancie Im-Bolter, Nancy L. Freeman
Background and aims Early diagnosis of autism spectrum disorder, while providing many benefits, also presents challenges. Accurately predicting symptom severity allows clinicians to confidently diagnose and assign the most appropriate intervention. Little available research predicts symptom severity in children with autism spectrum disorder who have not been exposed to significant levels of intervention. Methods The present file review study examined preverbal skills as predictors of symptom severity, approximately one year later, in a group of young children (18–64 months) with autism spectrum disorder (n = 199). Results Of the two core diagnostic features (social communicative deficits and restricted repetitive behaviors), social communicative skills best predicted symptom severity. Furthermore, social communicative gestures predicted symptom severity after age, adaptive behavior, restricted repetitive behaviors, and functional gestures had been accounted for. Conclusions Social communicative gestures are excellent predictors of future symptom severity independent of intervention effects in very young children with autism spectrum disorder. Implications Previously, the social aspect of gestures has been missing in the literature on language and symptom prediction in children with autism spectrum disorder. Careful attention to social communicative gestures in the future may help with early diagnosis and more accurate predictions of symptom and developmental trajectories.
{"title":"Early social communicative skills as predictors of symptom severity in autism spectrum disorder","authors":"Jan Lobban-Shymko, Nancie Im-Bolter, Nancy L. Freeman","doi":"10.1177/2396941517743418","DOIUrl":"https://doi.org/10.1177/2396941517743418","url":null,"abstract":"Background and aims Early diagnosis of autism spectrum disorder, while providing many benefits, also presents challenges. Accurately predicting symptom severity allows clinicians to confidently diagnose and assign the most appropriate intervention. Little available research predicts symptom severity in children with autism spectrum disorder who have not been exposed to significant levels of intervention. Methods The present file review study examined preverbal skills as predictors of symptom severity, approximately one year later, in a group of young children (18–64 months) with autism spectrum disorder (n = 199). Results Of the two core diagnostic features (social communicative deficits and restricted repetitive behaviors), social communicative skills best predicted symptom severity. Furthermore, social communicative gestures predicted symptom severity after age, adaptive behavior, restricted repetitive behaviors, and functional gestures had been accounted for. Conclusions Social communicative gestures are excellent predictors of future symptom severity independent of intervention effects in very young children with autism spectrum disorder. Implications Previously, the social aspect of gestures has been missing in the literature on language and symptom prediction in children with autism spectrum disorder. Careful attention to social communicative gestures in the future may help with early diagnosis and more accurate predictions of symptom and developmental trajectories.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517743418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43021601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.1177/2396941517737511
Janina Brede, A. Remington, Lorcan Kenny, Katy Warren, E. Pellicano
Background and aims All children have the right to receive an education and to be included in school. Yet young people on the autism spectrum, who are already vulnerable to poor health and social outcomes, are at increased risk of school exclusion. The current study sought to understand the key factors surrounding the school exclusion experiences of a group of autistic students with particularly complex needs, and their subsequent re-integration into education. Method We interviewed nine intellectually able students (eight male, one female; M age = 13.3 years), all with a diagnosis of autism and the majority with a history of demand avoidant behaviour. We also interviewed their parents and teaching staff about the students’ past and current school experiences. All students were currently being educated within an ‘Inclusive Learning Hub’, specially designed to re-integrate excluded, autistic students back into school, which was situated within a larger autism special school. Results Young people and their parents gave overwhelmingly negative accounts of the students’ previous school experiences. Children’s perceived unmet needs, as well as inappropriate approaches by previous school staff in dealing with children’s difficulties, were felt to cause decline in children’s mental health and behaviour and, ultimately, led to their exclusion from school. Four key factors for successful reintegration into school were identified, including (i) making substantial adjustments to the physical environment, (ii) promoting strong staff–student relationships, (iii) understanding students’ specific needs, and (iv) targeted efforts towards improving students’ wellbeing. Conclusion The culmination – and escalation – of challenges students experienced in the students’ previous placements could suggest that the educational journey to exclusion from school is an inevitable consequence for at least some autistic children, including those with particularly complex behaviour, as sampled here. Yet, our study encouragingly showed that this was not necessarily the case. All the young people we spoke to reported being happy, safe and secure in their current placement, and re-engaged with school life. Outstanding issues remain, however, with regard to children’s reportedly slow academic progress and difficulties generalising the positive behaviour shown in school across home and community contexts. Implications More remains to be done to ensure that autistic children and young people’s progress at school is also mirrored in other settings. Future research also needs to develop more preventative approaches to avoid exclusion from school, including efforts towards improving education professionals’ knowledge and awareness of autism, and effective ways of responding to these students’ needs.
{"title":"Excluded from school: Autistic students’ experiences of school exclusion and subsequent re-integration into school","authors":"Janina Brede, A. Remington, Lorcan Kenny, Katy Warren, E. Pellicano","doi":"10.1177/2396941517737511","DOIUrl":"https://doi.org/10.1177/2396941517737511","url":null,"abstract":"Background and aims All children have the right to receive an education and to be included in school. Yet young people on the autism spectrum, who are already vulnerable to poor health and social outcomes, are at increased risk of school exclusion. The current study sought to understand the key factors surrounding the school exclusion experiences of a group of autistic students with particularly complex needs, and their subsequent re-integration into education. Method We interviewed nine intellectually able students (eight male, one female; M age = 13.3 years), all with a diagnosis of autism and the majority with a history of demand avoidant behaviour. We also interviewed their parents and teaching staff about the students’ past and current school experiences. All students were currently being educated within an ‘Inclusive Learning Hub’, specially designed to re-integrate excluded, autistic students back into school, which was situated within a larger autism special school. Results Young people and their parents gave overwhelmingly negative accounts of the students’ previous school experiences. Children’s perceived unmet needs, as well as inappropriate approaches by previous school staff in dealing with children’s difficulties, were felt to cause decline in children’s mental health and behaviour and, ultimately, led to their exclusion from school. Four key factors for successful reintegration into school were identified, including (i) making substantial adjustments to the physical environment, (ii) promoting strong staff–student relationships, (iii) understanding students’ specific needs, and (iv) targeted efforts towards improving students’ wellbeing. Conclusion The culmination – and escalation – of challenges students experienced in the students’ previous placements could suggest that the educational journey to exclusion from school is an inevitable consequence for at least some autistic children, including those with particularly complex behaviour, as sampled here. Yet, our study encouragingly showed that this was not necessarily the case. All the young people we spoke to reported being happy, safe and secure in their current placement, and re-engaged with school life. Outstanding issues remain, however, with regard to children’s reportedly slow academic progress and difficulties generalising the positive behaviour shown in school across home and community contexts. Implications More remains to be done to ensure that autistic children and young people’s progress at school is also mirrored in other settings. Future research also needs to develop more preventative approaches to avoid exclusion from school, including efforts towards improving education professionals’ knowledge and awareness of autism, and effective ways of responding to these students’ needs.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517737511","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45624118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.1177/2396941517737536
Katherine Ledbetter-Cho, R. Lang, Laci Watkins, M. O'Reilly, Claudia Zamora
A collateral intervention effect refers to changes in behaviors which were not directly targeted during intervention. Using predetermined search and inclusion procedures, this systematic review identified 46 studies involving children with autism spectrum disorder and 14 desirable collateral effects across multiple domains of functioning. Collateral effects were associated with: (a) interventions involving naturalistic behavioral strategies; (b) participants with limited communication and/or cognitive deficits; (c) performance deficits (i.e. there was some evidence of the collateral behavior in baseline); and (d) interventions directly targeting play, communication, joint attention, and/or stereotypy. Overall, this systematic review indicates that collateral effects arising from focused interventions warrant consideration by practitioners during intervention planning and require additional research to identify mechanisms responsible for the observed changes.
{"title":"Systematic review of collateral effects of focused interventions for children with autism spectrum disorder","authors":"Katherine Ledbetter-Cho, R. Lang, Laci Watkins, M. O'Reilly, Claudia Zamora","doi":"10.1177/2396941517737536","DOIUrl":"https://doi.org/10.1177/2396941517737536","url":null,"abstract":"A collateral intervention effect refers to changes in behaviors which were not directly targeted during intervention. Using predetermined search and inclusion procedures, this systematic review identified 46 studies involving children with autism spectrum disorder and 14 desirable collateral effects across multiple domains of functioning. Collateral effects were associated with: (a) interventions involving naturalistic behavioral strategies; (b) participants with limited communication and/or cognitive deficits; (c) performance deficits (i.e. there was some evidence of the collateral behavior in baseline); and (d) interventions directly targeting play, communication, joint attention, and/or stereotypy. Overall, this systematic review indicates that collateral effects arising from focused interventions warrant consideration by practitioners during intervention planning and require additional research to identify mechanisms responsible for the observed changes.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517737536","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45066955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-01DOI: 10.1177/2396941517737418
Julie Longard, J. Brian, L. Zwaigenbaum, E. Duku, C. Moore, I. Smith, N. Garon, P. Szatmari, T. Vaillancourt, S. Bryson
Background & aims In response to limited research on early language development in infants at high risk for Autism Spectrum Disorder (ASD), the current prospective study examined early expressive and receptive language trajectories in familial high-risk (HR) infants who were and were not later diagnosed with ASD (HR-ASD and HR-N, respectively), and low-risk (LR) controls with no family history of ASD. Methods Participants were 523 children (371 HR siblings, 56% boys; 152 LR controls, 52% boys) followed from age 6 or 12 months to 36 months. Based on independent, best-estimate clinical diagnoses at 36 months, HR participants were classified as HR-ASD (n = 94; 69% boys), or HR-N (n = 277; 52% boys); the sample also included 152 LR controls (52% boys). Expressive and receptive language trajectories were examined based on corresponding domain standard scores on the Mullen Scales of Early Learning (MSEL) at 6, 12, 24, and 36 months. In the combined sample of HR and LR infants, semi-parametric group-based modeling was used to identify distinct trajectories in MSEL standard scores. Results A 3-group solution provided optimal fit to variation in both expressive and receptive language, with the following patterns of scores: (1) inclining from average to above average, (2) stable-average, and (3) declining from average to well below average. For both expressive and receptive language, membership in these trajectories was related to 3-year diagnostic outcomes. Conclusions Although HR-ASD, HR-N, and LR control infants were in each trajectory group, membership in the declining trajectory (expressive and/or receptive) was associated with an ASD diagnosis. Implications Evidence of declining trajectories in either expressive or receptive language may be a risk marker for ASD in a high-risk sample.
{"title":"Early expressive and receptive language trajectories in high-risk infant siblings of children with autism spectrum disorder","authors":"Julie Longard, J. Brian, L. Zwaigenbaum, E. Duku, C. Moore, I. Smith, N. Garon, P. Szatmari, T. Vaillancourt, S. Bryson","doi":"10.1177/2396941517737418","DOIUrl":"https://doi.org/10.1177/2396941517737418","url":null,"abstract":"Background & aims In response to limited research on early language development in infants at high risk for Autism Spectrum Disorder (ASD), the current prospective study examined early expressive and receptive language trajectories in familial high-risk (HR) infants who were and were not later diagnosed with ASD (HR-ASD and HR-N, respectively), and low-risk (LR) controls with no family history of ASD. Methods Participants were 523 children (371 HR siblings, 56% boys; 152 LR controls, 52% boys) followed from age 6 or 12 months to 36 months. Based on independent, best-estimate clinical diagnoses at 36 months, HR participants were classified as HR-ASD (n = 94; 69% boys), or HR-N (n = 277; 52% boys); the sample also included 152 LR controls (52% boys). Expressive and receptive language trajectories were examined based on corresponding domain standard scores on the Mullen Scales of Early Learning (MSEL) at 6, 12, 24, and 36 months. In the combined sample of HR and LR infants, semi-parametric group-based modeling was used to identify distinct trajectories in MSEL standard scores. Results A 3-group solution provided optimal fit to variation in both expressive and receptive language, with the following patterns of scores: (1) inclining from average to above average, (2) stable-average, and (3) declining from average to well below average. For both expressive and receptive language, membership in these trajectories was related to 3-year diagnostic outcomes. Conclusions Although HR-ASD, HR-N, and LR control infants were in each trajectory group, membership in the declining trajectory (expressive and/or receptive) was associated with an ASD diagnosis. Implications Evidence of declining trajectories in either expressive or receptive language may be a risk marker for ASD in a high-risk sample.","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517737418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48022303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-01DOI: 10.1177/2396941517722139
L. Henry, D. Messer, Rachel Wilcock, Gilly Nash, Mimi Kirke-Smith, Zoe Hobson, L. Crane
Background and aims There are few investigations of the relationship between cognitive abilities (memory, language, and attention) and children’s eyewitness performance in typically developing children, and even fewer in children on the autism spectrum. Such investigations are important to identify key cognitive processes underlying eyewitness recall, and assess how predictive such measures are compared to intelligence, diagnostic group status (autism or typically developing) and age. Methods A total of 272 children (162 boys, 110 girls) of age 76 months to 142 months (M = 105 months) took part in this investigation: 71 children with autism and 201 children with typical development. The children saw a staged event involving a minor mock crime and were asked about what they had witnessed in an immediate Brief Interview. This focused on free recall, included a small number of open-ended questions, and was designed to resemble an initial evidence gathering statement taken by police officers arriving at a crime scene. Children were also given standardised tests of intelligence, memory, language, and attention. Results & conclusions Despite the autism group recalling significantly fewer items of correct information than the typically developing group at Brief Interview, both groups were equally accurate in their recall: 89% of details recalled by the typically developing group and 87% of the details recalled by the autism group were correct. To explore the relationship between Brief Interview performance and the cognitive variables, alongside age, diagnostic group status and non-verbal intelligence quotient, multiple hierarchical regression analyses were conducted, with Brief Interview performance as the dependant variable. Age and diagnostic group status were significant predictors of correct recall, whereas non-verbal intelligence was less important. After age, non-verbal intelligence, and diagnostic group status had been accounted for, the only cognitive variables that were significant predictors of Brief Interview performance were measures of memory (specifically, memory for faces and memory for stories). There was little evidence of there being differences between the autism and typically developing groups in the way the cognitive variables predicted the Brief Interview. Implications The findings provide reassurance that age – the most straightforward information to which all relevant criminal justice professionals have access – provides a helpful indication of eyewitness performance. The accuracy of prediction can be improved by knowing the child’s diagnostic status (i.e. whether the child is on the autism spectrum), and further still by using more specific assessments (namely memory for faces and memory for stories), possibly via the input of a trained professional. Importantly, the findings also confirm that whilst children with autism may recall less information than typically developing children, the information they do recall is just as acc
{"title":"Do measures of memory, language, and attention predict eyewitness memory in children with and without autism?","authors":"L. Henry, D. Messer, Rachel Wilcock, Gilly Nash, Mimi Kirke-Smith, Zoe Hobson, L. Crane","doi":"10.1177/2396941517722139","DOIUrl":"https://doi.org/10.1177/2396941517722139","url":null,"abstract":"Background and aims There are few investigations of the relationship between cognitive abilities (memory, language, and attention) and children’s eyewitness performance in typically developing children, and even fewer in children on the autism spectrum. Such investigations are important to identify key cognitive processes underlying eyewitness recall, and assess how predictive such measures are compared to intelligence, diagnostic group status (autism or typically developing) and age. Methods A total of 272 children (162 boys, 110 girls) of age 76 months to 142 months (M = 105 months) took part in this investigation: 71 children with autism and 201 children with typical development. The children saw a staged event involving a minor mock crime and were asked about what they had witnessed in an immediate Brief Interview. This focused on free recall, included a small number of open-ended questions, and was designed to resemble an initial evidence gathering statement taken by police officers arriving at a crime scene. Children were also given standardised tests of intelligence, memory, language, and attention. Results & conclusions Despite the autism group recalling significantly fewer items of correct information than the typically developing group at Brief Interview, both groups were equally accurate in their recall: 89% of details recalled by the typically developing group and 87% of the details recalled by the autism group were correct. To explore the relationship between Brief Interview performance and the cognitive variables, alongside age, diagnostic group status and non-verbal intelligence quotient, multiple hierarchical regression analyses were conducted, with Brief Interview performance as the dependant variable. Age and diagnostic group status were significant predictors of correct recall, whereas non-verbal intelligence was less important. After age, non-verbal intelligence, and diagnostic group status had been accounted for, the only cognitive variables that were significant predictors of Brief Interview performance were measures of memory (specifically, memory for faces and memory for stories). There was little evidence of there being differences between the autism and typically developing groups in the way the cognitive variables predicted the Brief Interview. Implications The findings provide reassurance that age – the most straightforward information to which all relevant criminal justice professionals have access – provides a helpful indication of eyewitness performance. The accuracy of prediction can be improved by knowing the child’s diagnostic status (i.e. whether the child is on the autism spectrum), and further still by using more specific assessments (namely memory for faces and memory for stories), possibly via the input of a trained professional. Importantly, the findings also confirm that whilst children with autism may recall less information than typically developing children, the information they do recall is just as acc","PeriodicalId":36716,"journal":{"name":"Autism and Developmental Language Impairments","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2396941517722139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42157947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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