Journal of Developmental and Physical Disabilities最新文献

Many children with autism spectrum disorder experience feeding difficulties that can lead to increased health risks (e.g., severe nutrition deficiencies, obesity-related illnesses) if left untreated. Intensive feeding programs that use behavior-analytic interventions have reported positive outcomes for treating challenging behavior associated with pediatric feeding disorders at discharge and up to 1 year post discharge. Whether these children achieve and maintain long-term goals is unknown. The purpose of the current study was to evaluate outcomes of behavior-analytic intervention for pediatric feeding disorders among children with and without autism spectrum disorder in an intensive feeding program post discharge. Caregivers of former patients reported on the positive and negative impact of the program and their child’s growth and diet variety at follow-up. 85% of caregivers reported the program had a positive impact. Increases in height-for-age z scores were significant from admission to discharge from the intensive program, and progress in growth and diet variety remained the same or improved for most children at follow-up. Results suggest that behavior-analytic intervention in an intensive feeding program produced positive short- and long-term outcomes for children and their families.

Parent advocacy is often critical for families of individuals with disabilities. Prior research has suggested that parent advocacy occurs across three levels: individual, peer, and systemic. Yet, little empirical research has identified the correlates of advocacy for each level. For this study, we examined the survey responses of 246 parents of individuals with disabilities who were interested in participating in a legislative advocacy program. Analyses included hierarchical regressions to identify the correlates of individual, peer, and systemic advocacy. Parents of children with autism were significantly more likely to engage in individual advocacy. Parents who identified as Black (versus other racial groups) advocated significantly more on a systemic level. Further, malleable factors such as empowerment and motivation correlated positively with advocacy. Implications for research and practice are discussed.

Abstract

Researchers have shown that behavioral interventions that incorporate communication as a focus have demonstrated efficacy for individuals with intellectual and developmental disabilities (IDD). Researchers have demonstrated that individuals with IDD allocate responding to one communicative response modality over others when multiple communicative modalities produce reinforcement in the context of a concurrent-schedules arrangement. Identifying preference for communicative response modality provides one approach to incorporating aspects of social validity in the design of behavioral interventions for individuals with IDD, placing additional importance on demonstrations of the robustness of this preference. In the current study, we evaluated preference among concurrently available communication modalities for 14 individuals with IDD. Results of the study replicated previous, similar research in that the vast majority of individuals demonstrated a preference between communicative response modalities. We discuss the results within the context of social validity and implications for intervention.

To observe changes in three clients with intellectual disabilities and severe behavioral problems and staff in a long-term care residential facility after redesigning the clients’ rooms by making them more personal and homely, adjusting the amount of stimuli, changing the layout, connecting to the outdoor area, and using high-quality natural materials. Relatively many clients with intellectual disabilities exhibit severe problem behaviors, including self-harm, aggression toward others, and repeated destruction of their own rooms, which can eventually result in a barren, inhumane living environment. Research on these clients is limited. Data were collected in a mixed methods study in which quantitative and qualitative data were analyzed. After the redesigns, positive changes were observed in the well-being and behavior of all three clients, for example, with respect to quality of life, privacy, freedom of choice, problem behavior, mood, cognition, activities of daily living, leisure activities, social behavior, self-harm, and constraints. There were no changes in the use of psychotropic medication. Quality of life scores increased in two cases, but were significant in only one. Emotional and behavioral problem scores decreased significantly in two cases, but in only one case these results were maintained at follow-up. Staff experienced a more pleasant, safe, and functional work environment, with improved provision of indicated care and interaction. Absenteeism decreased significantly in two of the three cases. Redesigning clients’ rooms could potentially be a promising intervention for clients with intellectual disabilities and severe chronic behavioral problems.

There are inequities in engagement with established early childhood developmental surveillance programs, eclipsing disadvantaged families. The current study sought to address this by dovetailing developmental surveillance with immunization visits and other opportunistic contacts with children at general practices). While 53 General Practices were recruited, significant COVID-19 disruptions resulted in only 81 children being screened (both parent-administered and GP completed). Of the 81 children, 11 screened positive and all of them along with 5% of screen negatives (i.e. 4 children) received clinician-administered reference-standard assessment for autism and developmental delay (DD) using Autism Diagnostic Observation Schedule (ADOS), Autism Diagnostic Interview Schedule –Revised (ADI-R), and Mullen Scales of Early Learning (MSEL). All children found by reference-standard assessment to have probable autism and/or DD had screened positive during the screening process, and 90.9% of children who screened positive were found by reference-standard assessment to have probable DD or autism. The findings provide early evidence for the feasibility and usefulness of parent completed and GP administered developmental measures during opportunistic contacts with GPs as a promising method to facilitate early identification of DD or autism.

Despite strong evidence in favor of physical activity (PA), adults with autism spectrum disorder (ASD) are not meeting established PA guidelines to engage in at least 150 min of moderate to vigorous PA per week. Barriers to daily PA engagement include limited access to health services, transportation, and reduced self-determined motivation. Telehealth provides a potential alternative to deliver PA programming in a more accessible platform for adults with ASD. This pilot randomized controlled trial (RCT) assessed the preliminary efficacy of a 10-week PA intervention program called Physical Activity Connections via Telehealth (PACT) that utilized telehealth and remote technology, including Fitbit wearable device use, peer-guidance, and individualized home exercise program among adults with ASD. Primary health outcomes, collected at baseline before randomization and post-intervention, included self-determined motivation assessment via Behavioral Exercise Regulation Scale (BREQ-2), self-report PA via Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLT-PAQ), steps per day PA via Fitbit device, body mass index (BMI), and waist-to-height ratio (WtHR). A total of 18 adults, 11 males, with a mean age of 26.4 years, with a primary diagnosis of ASD participated in the study. Although there were no changes in BMI or WtHR at post-intervention, participants receiving PACT, significantly increased both their self-report PA scores (GSLT-PAQ) from 26 to 68, (p = 0.002), and steps per day from 5,828 to 7,443, (p = 0.015) with a moderate effect size (d = 0.72). The results of this pilot study support peer supported telehealth-based PA intervention for adults with ASD to increase PA.

Increasingly, interventions are being developed and tested with families of color, including Latino families of transition-aged youth with autism. However, without culturally responsive measures, it is difficult to determine whether an intervention is effective. The purpose of this study was to improve the cultural responsiveness of measures related to: knowledge of adult disability services, advocacy, and family empowerment. Altogether, 30 Latinx parents of youth with autism participated in this study. Participants completed surveys and interviews to inform changes to the measures. Changes were made in relation to: wording, format, and concepts. The revised measures were demonstrated to have high reliability. Implications for future research and practice are discussed.

Abstract

Sibling relationships may be strained when one sibling is diagnosed with autism and the other is not. The way that siblings interact during play is one indicator of the quality of this relationship. Non-autistic siblings have been taught to encourage play in their autistic siblings, but there is limited literature examining the impact of intervention on the quality of the siblings’ relationships. In this study, we taught four non-autistic siblings to encourage and praise play with their autistic siblings as well as self-monitor those play skills. We also measured changes in social-communicative behaviors during siblings’ interactions. All non-autistic siblings learned the targeted play skills and the majority increased social-communicative behaviors. Only one autistic child increased their social-communicative behaviors toward their non-autistic sibling. On average, sibling dyads engaged in more interactions, with an increase in the duration of interactions during play. Future sibling intervention research should evaluate child characteristics and intervention factors that may influence children’s response to intervention, additional interventions, and continue to incorporate other measures of relationship quality.

Mumbai is home to over 22 million people, of which 41.3% are estimated to live in bastis with limited access to basic facilities and support. The number of people with disabilities living in Mumbai was 0.48 million in 2011, expected to rise to 4 million by 2025. For people with disabilities to live a better quality of life, they require a combination of support from the community for their day-to-day living and formal support for their rehabilitation. This study used a qualitative exploratory approach and explored the benefit of integrated support (natural + formal) for people with disabilities. Fifteen people with diverse disabilities and thirteen support providers were purposely recruited from five bastis, and data was collected through face-to face interviews and through a psycho-social helpline. Three themes, i) understanding formal and natural supports in Bastis, ii) the role of the community, and iii) the Intersection of formal and natural support. Findings indicate that while formal and natural supports have their independent benefits, yet together these supports make life easier and more meaningful for people with disabilities.

Applied Behavior Analysis (ABA) is the branch of behavior science focused on solving problems of social significance. For over six decades, ABA researchers and practitioners have sought to improve the lives of people with intellectual and developmental disabilities (IDD) through application of evidence-based supports. Influenced by the disability rights movement which gained momentum in 1970s and 80 s, the field of ABA has developed an array of procedures to enhance autonomy and choice of people with IDD. These include assessing individual preferences, teaching choice making, augmentative and alternative communication, and techniques for supporting greater self-control. We present behavior analytic definitions of autonomy and choice, illustrate how each of these strategies enable greater autonomy and choice of people with IDD, and discuss unresolved issues and future directions.