Moderators of Parent Training for Disruptive Behaviors in Young Children with Autism Spectrum Disorder

We conducted a 6 month, randomized trial of parent training (PT) versus a parent education program (PEP) in 180 young children (158 boys, 22 girls), ages 3–7 years, with autism spectrum disorder (ASD). PT was superior to PEP in decreasing disruptive and noncompliant behaviors. In the current study, we assess moderators of treatment response in this trial. Thirteen clinical and demographic variables were evaluated as potential moderators of three outcome variables: the Aberrant Behavior Checklist-Irritability subscale (ABC-I), Home Situations Questionnaire (HSQ), and Clinical Global Impressions-Improvement Scale (CGI-I). We used an intent-to-treat model and random effects regression. Neither IQ nor ASD severity moderated outcome on the selected outcome measures. Severity of Attention Deficit Hyperactivity Disorder (ADHD) and anxiety moderated outcomes on the ABC-I and HSQ. For instance, there was a 6.6 point difference on the ABC-I between high and low ADHD groups (p?=?.05) and a 5.3 point difference between high and low Anxiety groups (p?=?.04). Oppositional defiant disorder symptoms and household income moderated outcomes on the HSQ. None of the baseline variables moderated outcome on the CGI-I. That IQ and ASD symptom severity did not moderate outcome suggests that PT is likely to benefit a wide range of children with ASD and disruptive behavior.     

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.     

Experiences Delivering a Marital Intervention for Couples With Children With Autism Spectrum Disorder

Previous researchers have indicated that parents of children with autism spectrum disorder (ASD) are vulnerable to relationship stress, lower marital satisfaction, and potential relationship dissolution. We describe the experiences of three couples who participated in a 10-week, in-home couples therapy intervention using Emotionally Focused Therapy (EFT). Each couple and their progress through the intervention are described using therapist and supervisor reflections, and qualitative evaluation interviews with the participants after termination. Based on the experiences of the couples, we conclude that couples would benefit from an in-home couples therapy intervention aimed to strengthen their relationships.     

A Pilot Study of a Co-parenting Intervention for Parents of Children with Autism Spectrum Disorder

Journal of Child and Family Studies - The aims of this pilot study are to evaluate the feasibility, acceptability, and preliminary efficacy of a peer-delivered co-parenting program, Autism Parent...     

Social Validity of a Training and Coaching Program for Parents of Children With Autism Spectrum Disorder on a Waiting List for Early Behavioral Intervention

Due to limited public resources, many children with autism spectrum disorder and their families must wait several months, if not years, to access early behavioral intervention (EBI) services. Service providers must thus develop alternative support models to assist families placed on waiting lists. The present study assessed the social validity of one such initiative, a training and coaching program for parents whose children had been put on a waiting list for EBI services. This program consisted of group training sessions on strategies to cope with their child’s disorder based on applied behavioral analysis and on one-hour, weekly follow-up meetings to support parents’ interventions with their child over the course of 12 months. Social validity was assessed through parental satisfaction with this program and their perception of its effects on themselves, the family, the child, and parental stress. The 94 participants were generally satisfied with the program overall, although they wished for more frequent and intensive interventions. They reported that the program had positive effects on their psychological well-being, their family’s quality of life, and their child’s behavior. However, parenting stress levels were found to have increased over the 12-month period. These results demonstrate that training and individually supporting parents can be beneficial for families of children with ASD who cannot have access to early behavioral intervention immediately upon receiving a diagnosis. Importantly, however, these lower-cost, parent-focused programs cannot be considered a substitute for more intensive and children-driven services.     

Increasing Behavioral Variability and Social Skill Accuracy in Children with Autism Spectrum Disorder

Although social skills training for children with autism spectrum disorder (ASD) often addresses deficits in social communication, restricted and repetitive social behaviors are less frequently targeted in the literature. The present study evaluated a manualized social skills training program, modified to incorporate lag schedules of reinforcement, to promote appropriate and variable responding in three children in a school setting. Participants attended social skills once weekly, with probes of social skills taking place daily. A multiple baseline design across target skills was used to determine intervention efficacy. Results of the study indicated that the social skills curriculum incorporating lag schedules of reinforcement resulted in substantial increases in the number of appropriate and variable responses demonstrated by participants during each probe session, as well as the number of appropriate and variable responses demonstrated overall.     

Alliance-Outcome Associations in a Community-Based Social Skills Intervention for Youth With Autism Spectrum Disorder

Although the alliance is a consistent predictor of treatment outcomes in psychosocial interventions, few studies have examined this association among youth with autism spectrum disorder (ASD). In particular, youth-therapist alliance has never been examined in social skills interventions (SSIs), a common modality for this population. In this study, thirty-four youth with ASD (M_age = 12.41; 79% male) participated in a community-delivered, group-based SSI in a summer camp format led by eight Head Therapists (M_age = 32.12; 50% male). Early alliance and change in alliance over the course of the treatment were assessed via self- and observer-reported measures. Both self- and observer-rated alliance were associated with positive treatment outcomes as reported by parents (decreased problem behaviors) and other peers in the group (reciprocated friendship and social preference). These results provide the first evidence of the role of the alliance in an SSI for youth with ASD and add to the growing body of literature that demonstrates the importance of assessing and addressing the alliance in treatment for this population.     

情绪主题绘本阅读对自闭症谱系障碍儿童情绪理解障碍的干预效果

本研究选取一名15岁的重度自闭症谱系障碍儿童为研究对象，采用眼动追踪技术考察其情绪主题绘本阅读的眼动特征，并制定情绪主题绘本阅读方案，对该儿童的情绪理解障碍进行干预。结果显示：（1）在干预前，这名儿童阅读情绪主题绘本时更加关注背景区域，而较少注意主角形象区域，在整体画面中最后关注甚至忽视主角表情这一重要信息。（2）通过情绪主题绘本阅读干预，这名儿童对主角表情的首次注视前时间减少，注意分配时间和注视次数显著增加；情绪理解能力也显著提高。     

Matrix Training for Generative Spelling in Children with Autism Spectrum Disorder

Children with autism often have difficulty in generative learning. Effective training program for generative learning in these children is needed. In this study, we examined the effectiveness of matrix training for generative spelling in two children with autism spectrum disorder (ASD). Matrix training is a procedure in which stimuli used in teaching are arranged with overlapping within‐syllable units. After training with a Constructed‐Response Matching to Sample (CRMTS) with matrix training, both participants' generative spelling was assessed by CRMTS test using untrained combinations of characters. In this study, spoken syllables (auditory stimuli) are presented as the sample stimulus, and written characters (visual stimuli) are presented as comparison stimuli in CRMTS task. As a result, both participants showed generative spelling by matrix training, however, one of the two participants needed additional matrix training. The results discussed the effectiveness of matrix training as a procedure for teaching generative spelling and some issues to be conducted in applying this procedure for Japanese reading and spelling in children with ASD. Copyright © 2011 John Wiley & Sons, Ltd.     

Evaluating the Emergence of Reverse Intraverbals Following Intraverbal Training in Young Children with Autism Spectrum Disorder

The purpose of the proposed study was to replicate and extend prior research on intraverbal training by evaluating whether teaching sets of original and reverse intraverbals from the same category (e.g., animal sounds) would result in the emergence of novel, reverse intraverbals. Three children with autism spectrum disorder participated in the study. We used a multiple baseline across categories design with a constant‐series control to evaluate the effects of training original and reverse intraverbals on subsequent trained and untrained reverse intraverbals. Copyright © 2015 John Wiley & Sons, Ltd.     

Mathematical Abilities in Elementary School Children with Autism Spectrum Disorder

Although clinical practitioners often express concerns about the mathematical functioning of children with autism spectrum disorder (ASD), the field of mathematics remains a relatively unexplored topic in individuals with ASD. Moreover, research findings are fragmentary and hold inconclusive results. The present study aimed to examine whether grade 1 (aged 6–7 years) to 4 (aged 9–10 years) elementary school children with ASD scored significantly different from age‐adequate norms on mathematics. To this end, a multi‐componential approach of mathematics was used. Four domains of mathematics were assessed in 121 children with ASD: procedural calculation, number fact retrieval, word/language problems, and time‐related competences. All children attended general education classrooms, following the standard curriculum, and were coached by integrated educational services. Children with ASD showed a strength in word/language problems in second and fourth grade. There was evidence of a weakness for procedural calculation in first grade and for time‐related competences in first and third grade. In all other cases, average scores were shown. As such, results revealed a profile of strengths, average abilities, and weaknesses in mathematics and highlighted the importance of focusing on different domains of mathematics. Because a high variability in mathematical performance could be observed, we recommend an individual assessment when considering the mathematical trajectory of children with ASD. Copyright © 2015 John Wiley & Sons, Ltd.     

Behavioral Telehealth Consultation with Families of Children with Autism Spectrum Disorder

In this study, desktop video teleconferencing was used to facilitate behavioral consultation at a distance with three parents of school‐age children with autism spectrum disorders. Parents were supported via desktop video teleconferencing as they conducted functional analyses and learned to implement an antecedent manipulation strategy, functional communication training, and a consequence‐based strategy. Parents then conducted a brief multi‐element treatment comparison to evaluate the preliminary effectiveness of each intervention strategy on their child's challenging behavior. The results of this study provide additional support to previous research suggesting that a telehealth model of behavioral consultation may be an effective way to assist parents of children with autism spectrum disorders address challenging behavior that disrupts family routines. Suggestions for future research are discussed. Copyright © 2016 John Wiley & Sons, Ltd.     

Family Experience of Safe: A New Intervention for Families of Children with a Diagnosis of Autism Spectrum Disorder

Systemic Autism-related Family Enabling (SAFE) is a new intervention for families of children with a diagnosis of Autism Spectrum Disorder (ASD). SAFE responds to international and national recommendations for improved care and the reported needs of families. SAFE draws from Family Therapy techniques, Attachment Narrative Therapy and known preferences of individuals with autism. Twenty two families of a child with a diagnosis of ASD severity level 1 or 2 were recruited. The families attended five 3-hour sessions. Family members completed the Helpful Aspects of Therapy Questionnaire (HAT) after each session. Analysis of the HAT data revealed that adults and children experienced SAFE to be helpful which was elaborated in terms of the following themes: therapist as helping reflection, increased understanding, feeling closer, more confident to reflect and problem solve, improved communication and feeling less alone and isolated. The findings are discussed to consider how SAFE can be improved and implemented to offer support for families. SAFE is a good candidate to fill a gap in autism related care.

     

Electrodermal Activity Moderates Sleep-Behavior Associations in Children with Autism Spectrum Disorder

Research on Child and Adolescent Psychopathology - Relative to children without autism spectrum disorder (ASD), children with ASD experience elevated sleep problems that can contribute to...     

Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.     

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。     

自闭症谱系障碍的早期筛查工具

基于35项实证研究, 遵循诊断准确性研究的质量评估(QUADAS-2)的循证程序对自闭症谱系早期预警特征筛查工具开展质量评估, 包括婴儿阶段(10个筛查工具, 159388人)、幼儿阶段(14项筛查工具, 11712人), 旨在为自闭症谱系风险的早期识别提供全面的理解。结果表明：幼儿阶段的筛查工具的分类准确性要高于婴儿阶段, 在婴儿阶段达到良好水平的筛查工具有M-CHAT-R/F、PDQ-1; 在幼儿阶段达到优秀水平的筛查工具有OERA、TIDOS。其中, “改良的幼儿自闭症检查表-有修订的后续随访” (M-CHAT-R/F)是目前最具潜力的自闭症谱系风险筛查工具之一。最后, 我们探讨了应用QUADAS-2评估研究质量的局限性, 强调需要规范工具的质量评估标准与进一步验证研究的必要性。