Parenting Interventions for Children with Autism Spectrum and Disruptive Behavior Disorders: Opportunities for Cross-Fertilization

Empirical support exists for parent training/education (PT/PE) interventions for children with disruptive behavior disorders (DBD) and autism spectrum disorders (ASD). While the models share common roots, current approaches have largely developed independently and the research findings have been disseminated in two different literature traditions: mental health and developmental disabilities. Given that these populations often have overlapping clinical needs and are likely to receive services in similar settings, efforts to integrate the knowledge gained in the disparate literature may be beneficial. This article provides a systematic overview of the current (1995–2005) empirical research on PT/PE for children with DBD and ASD; attending to factors for cross-fertilization. Twenty-two ASD and 38 DBD studies were coded for review. Literature was compared in three main areas: (1) research methodology, (2) focus of PT/PE intervention, and (3) PT/PE procedures. There was no overlap in publication outlets between the studies for the two populations. Results indicate that there are opportunities for cross-fertilization in the areas of (1) research methodology, (2) intervention targets, and (3) format of parenting interventions. The practical implications of integrating these two highly related areas of research are identified and discussed.     

Story Recall and Narrative Coherence of High-Functioning Children with Autism Spectrum Disorders

Previous research has found few quantitative differences between children with high-functioning autism spectrum disorders (ASDs) and well-matched controls in the length, complexity, and structure of their narratives. Researchers have noted, however, that narratives of children with ASDs have an unusual and idiosyncratic nature. This study provides an analysis of narratives in 17 children with high-functioning ASDs and 17 typically developing children matched on age, gender, language abilities, and cognitive abilities. We examined story recall and narrative coherence. The study revealed no group differences in story length or syntactic complexity. Children with ASDs also did not differ from controls in their use of the gist of a story to aid recall, or in their sensitivity to the importance of story events. Children with ASDs did, however, produce narratives that were significantly less coherent than the narratives of controls. Children with ASDs appeared less likely to use the gist of the story to organize their narratives coherently. These findings are discussed with regard to their relationship to other cognitive and linguistic difficulties of children with ASDs.     

Using a Behavioral Treatment Package for Sleep Problems in Children With Autism Spectrum Disorders

This study investigated the effectiveness of a behavioral treatment package for sleep problems in children diagnosed with Autism Spectrum Disorders. Treatment consisted of four behaviorally based components: circadian rhythm management, positive bedtime routines, white noise, and graduated extinction. A multiple-baseline design across three participants was used. Families completed a baseline of various lengths followed by 1 month of intervention. Results indicated the treatment package was effective in decreasing sleep onset latency and the frequency of night awakenings. A week of follow-up data showed continued improvement. Parents reported their children slept better and satisfaction with the four intervention components.     

The Internal Structure of the Aberrant Behavior Checklist Irritability Subscale: Implications for Studies of Irritability in Treatment-Seeking Youth With Autism Spectrum Disorders

Given the prominence of the Aberrant Behavior Checklist (ABC), Irritability Subscale (ABC-I), in treatment outcome studies, we conducted a critical examination of its internal consistency and relationship to other measures of irritability in 758 psychiatrically hospitalized youth with autism spectrum disorder. In exploratory and confirmation samples, we conducted factor and bifactor analyses to describe the internal structure of the ABC-I. Our results suggest that the ABC-I roughly represents a unidimensional construct of irritability, as indicated by a general factor in bifactor analysis. In addition to irritability, subordinate factors are presented that represent tantrums, verbal outbursts, self-harm, and negative affect. Notably, self-harm items explain a large proportion of variance independent of irritability. Therefore, their contribution in analyses of treatment effects should be considered. Further study or revision of the ABC-I may improve convergent validity with transdiagnostic formulations of irritability as well as prevent confound from self-harm in treatment studies for irritability in ASD     

Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder

The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2–6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.     

幼儿的自我投射能力对情景预见的影响:来自典型发展儿童和孤独症谱系障碍儿童的证据

情景预见是个体将自我投射到未来某个特定时间和地点预先体验可能发生的未来事件的一种能力。为了考察幼儿的自我投射能力在情景预见中的可能作用,本研究通过两个实验比较了从自己的视角和从他人视角完成情景预见任务时幼儿的表现。实验1选取236名3~5.5岁典型发展（Typically Developing,TD）幼儿,采用被试间设计发现,总体而言,幼儿为他人做预见优于为自己做预见。实验2采用被试内设计,在TD儿童身上验证了实验1的结果,同时发现,孤独症谱系障碍（Autism Spectrum Disorder,ASD）儿童为自己做预见与为他人做预见没有差异。综上,幼儿不成熟的自我投射能力会干扰其自我卷入的情景预见,而自我投射能力受损的ASD儿童则没有表现出这种影响。     

ABA-Based Programs for Children Diagnosed With Autism Spectrum Disorder: Parental and Professional Experiences at School and at Home

Having a child diagnosed with Autism Spectrum Disorder (ASD) poses a range of challenges to families, many of which can be addressed through appropriate intervention. A study of parental (n = 95) and professional (n = 67) experiences was carried out in relation to two settings: (a) schools that provided intensive interventions based on the science of Applied Behavior Analysis (ABA), and (b) non-intensive ABA-based home programs. Results show that parents whose children attend ABA-based schools were generally more satisfied with their child's educational provision, monitoring procedures, and level of staff training, than parents who were not offered ABA-based education in schools.     

自闭症谱系障碍个体的焦虑：发生机制、评估与治疗

自闭症谱系障碍是一种神经发育性障碍, 主要表现为社会交往互动障碍和重复刻板性行为。焦虑或焦虑障碍常被认为是自闭症个体最普遍的共病之一。焦虑与自闭症之间的关系尚不明确, 自闭症个体的焦虑与无法忍受不确定性、杏仁核功能和体积、情绪调节策略、消极思维存在一定关联; 目前已经开发出专门用于自闭症个体焦虑的评估工具; 修订版认知行为疗法对自闭症个体焦虑的治疗取得了良好效果。未来的研究应着重探索自闭症个体焦虑的认知与神经机制, 检验专用评估工具的有效性, 继续关注现代技术(如虚拟现实技术)对自闭症个体焦虑的治疗效果。     

自闭症谱系障碍儿童对环境图片威胁知觉的眼动研究

以30名自闭症谱系障碍（ASD）儿童为被试,通过环境图片视觉搜索方式,借助Tobii X120眼动仪记录被试的注视时间和注视次数探讨ASD儿童威胁知觉的特点。结果发现：（1）相比于非威胁目标,ASD儿童对威胁目标对象存在知觉优势,其威胁知觉受刺激类型及矩阵大小的影响。（2）ASD儿童对于全威胁刺激（蛇）的负性图片存在注意固着现象,表现在对全威胁刺激环境图片的注视时间显著增加。（3）眼动技术能够有效地应用于部分ASD儿童的威胁知觉研究。     

Children with Autism and Their Friends: A Multidimensional Study of Friendship in High-Functioning Autism Spectrum Disorder

This study of Israeli and American preadolescent children examined characteristics of friendship in 44 children with high-functioning autism spectrum disorder (HFASD) compared to 38 typically developing children (TYP), as they interacted with a close friend Participants were 8-12 years of age (HFASD: Israel, n = 24; USA, n = 20; TYP: Israel, n = 23; USA, n = 15), and were matched on SES, receptive language vocabulary, child age, and gender (each study group included one girl). Multidimensional assessments included: individual behaviors of target children and observed child-friend interactions during construction and drawing scenarios; target child's and friend's self-perceived mutual friendship qualities; and mother-reported characteristics (friendship's duration/frequency; friend's age/gender/disability status). Overall, children with HFASD displayed a number of differences on individual and dyadic friendship measures. Both age and verbal abilities affected friendship behaviors. Children with HFASD and their friends perceived friendship qualities similarly, suggesting that preadolescents with HFASD have capacities for interpersonal awareness. Between-group similarities also emerged on several complex social behaviors, suggesting that friendship follows a developmental trajectory in autism and may enhance social interaction skills in autism.     

5～7岁自闭症谱系障碍幼儿数感的特点

本研究采用《幼儿数感测评量表》对26名自闭症谱系障碍（autism spectrum disorders,ASD）幼儿、20名智力障碍幼儿及32名正常幼儿进行数感能力测评,并比较三组幼儿的数感特点。结果发现：（1）ASD幼儿的数感整体和各维度水平均显著低于正常幼儿,但与智力障碍幼儿相当;（2）三组幼儿数感各维度水平在5～7岁之间无明显变化;（3）三组幼儿在数量比较、数量估算和大小比较的能力水平均领先于其他维度,而类比推理和大小推理均相对落后。另外,ASD幼儿和智力障碍幼儿的体积比较与大小推理、类比推理的能力较为接近,而正常幼儿的体积比较能力显著优于大小推理和类比推理。研究表明5～7岁ASD幼儿的数感能力整体落后于同龄正常幼儿,且数感各维度的能力发展不均衡、不同步。本研究揭示了5～7岁ASD幼儿数感能力发展的特点及需求,可为制定相应数感干预方案、促进其数学学习提供参考。     

Evolution of Research on Interventions for Individuals with Autism Spectrum Disorder: Implications for Behavior Analysts

The extraordinary success of behavior-analytic interventions for individuals with autism spectrum disorder (ASD) has fueled the rapid growth of behavior analysis as a profession. One reason for this success is that for many years behavior analysts were virtually alone in conducting programmatic ASD intervention research. However, that era has ended. Many investigators from other disciplines are now carrying out large-scale intervention studies and beginning to report successes of their own. The increasing number and range of studies has the potential to improve services for individuals with ASD, and it challenges behavior analysts to intensify their research efforts.     

孤独症个体的公平决策：心理理论和自我/他人情绪识别的作用

研究通过最后通牒任务,考查孤独症儿童在公平任务中的决策,以及心理理论和识别自我/他人情绪对决策的影响。29名孤独症儿童和三组对照组儿童参加实验结果发现,孤独症儿童在任务中面对不同分配比例的接受率（2:8、3:7）与对照组之间存在显著差异。心理理论能力和自我情绪识别都与决策存在相关：当处于不公平的情况下（1:9、2:8、3:7）,通过心理理论任务的孤独症儿童才会拒绝接受不公平分配,儿童也会感觉到不高兴并且做出拒绝的决定。     

自闭症谱系障碍者面孔识别的神经机制

自闭症谱系障碍（ASD）是一种心理状况的谱系障碍,其症状是社交及沟通上的广泛性异常、异常局限性的兴趣和高度重复性的刻板行为。包括自闭症、亚斯伯格症候群和待分类的广泛性发展障碍3类。研究主要以事件相关电位和功能性磁共振成像两种技术为线索,通过深入分析ASD患者在面孔识别认知过程中脑的异常变化,探讨其面孔识别障碍的神经机制问题。研究表明,ASD患者面孔识别能力的损伤主要与N170、N300、P400和Nc等ERPs成份异常及梭状回面孔区和杏仁核的低激活有关。研究推论ASD患者面孔识别障碍是多个异常脑区联合作用的结果,且主要受异常脑区的数量和损伤程度的影响。     

Complex Trauma in Children and Youth: A Scoping Review of Sensory-Based Interventions

Emerging evidence in neuroscience indicates exposure to complex trauma in children and youth affects brain development—particularly with the ability to process sensory information. This sensory processing challenge has been shown to negatively impact emotional and self-regulation. A developing area of trauma treatment utilizes sensory-based interventions to target these concerns. A scoping review of the literature indicates there is limited, although promising, evidence for the use of these interventions when used as part of an integrated treatment approach. Occupational therapy is in a unique position to contribute to this area of practice due to a background in sensory-based approaches.     

Parental Attitudes,Attachment Styles,Social Networks,and Psychological Processes in Autism Spectrum Disorders: A Cross-Cultural Perspective

In this study the authors used a cross-cultural approach to examine parental attitudes, attachment styles, social networks, and some of the psychological processes involved in Autism Spectrum Disorders (ASD). Fifty-two children (aged 4–11 years) took part in the study: 30 Italians (15 with ASD and 15 controls) and 22 Cubans (11 with ASD and 11 controls). Findings indicated significant differences between the two cultural groups in terms of the structure of the children's social network and parental attitudes toward their children. However, the mother–child attachment relationship and cognitive and emotional functioning of the study participants were independent of culture.     

Intensive Child-Centered Play Therapy for Children on the Autism Spectrum: A Pilot Study

To investigate the effectiveness of intensive child-centered play therapy (CCPT) for children diagnosed with autism spectrum disorder (ASD), the authors randomly assigned 23 children with diagnosed ASD and symptoms of ASD on the Social Responsiveness Scale–2nd Edition (Constantino, 2012), to an intensive CCPT condition (n = 12) or a no-intervention control group (n = 11). Children who participated in 24 sessions of CCPT showed a statistically significant decrease in ASD core symptoms and behavioral symptoms, such as externalizing problems, attention problems, and aggression, compared with children in the control group. Implications are discussed.     

The Role for Occupational Therapists in Community Mobility Training for People With Autism Spectrum Disorders

Symptoms and behaviors of Autism Spectrum Disorders can challenge community mobility, thus hindering independence and participation in occupation. Community mobility, also called travel training, helps people make journeys safely using public transportation, enabling engagement in activities/services otherwise unavailable. Yet, few articles have been written about this topic for people with Autism Spectrum Disorders. The purpose of the authors in this article is to: (1) explain the need for travel training with people diagnosed with Autism Spectrum Disorders; (2) describe specific travel training assessments; (3) review literature on travel training programs; and (4) define a role for occupational therapy in travel training with individuals diagnosed with Autism Spectrum Disorders.     

Improving Social Skills of Adults With Autism Spectrum Disorder Through Physical Activity,Sports, and Games: A Review of the Literature

Socialization skill deficiencies among adults with autism spectrum disorder (ASD) can lead to depression, anxiety, aggression, and physical health problems. Clinical interventions must treat primary deficiencies and prevent secondary conditions. A treatment model emphasizing the integration of physical activity with social intervention strategies for adults with ASD is proposed.