Prediction of treatment outcomes and longitudinal analysis in children with autism undergoing intensive behavioral intervention

Outcome prediction is an important component of treatment planning and prognosis. However, reliable predictors of intensive behavioral intervention (IBI) have not been clearly established. IBI is an evidence-based approach to the systematic teaching of academic, social, verbal, and daily living skills to individuals with autism spectrum disorder. Incorporating longitudinal analysis to IBI outcome studies may help to identify outcome predictors of clinical value. Twenty-four children with autism underwent on average two years of IBI and completed language, daily living skills, cognitive, and motor assessments (Early Learning Accomplishment Profile and the Learning Accomplishment Profile-Diagnostic, 3rd edition) every six months. We used multilevel analysis to identify potential longitudinal predictors including gender, age, intervention intensity, intervention duration, total intervention time, and pre-intervention functioning. Results indicated that total intervention time, pre-intervention functioning, and age caused the greatest increase in goodness-of-fit of the longitudinal multilevel models. Longitudinal analysis is a promising analytical strategy to identify reliable predictors of the clinical outcome of IBI.     

El lenguaje autista desde una perspectiva correlacional

Resumen

A pesar del interés reciente por las alteraciones del lenguaje en autismo infantil, es notable la carencia de investigaciones en que se analicen las correlaciones de las variables de lenguaje entre sí y con otra variables comportamentales. En este artículo se realiza tal análisis, correlacionando variables lingüísticas entre sí (L.M.E., complejidad estructural, comprensión, porcentaje de ecos y habla socializada, etc.) y con variables no lingüísticas (cociente global de desarrollo, niveles de imitación, percepción, motricidad, integración óculo-manual y cognitivo y cognitivo-verbal, P.P.O.D.). El análisis de los datos intragrupales permite identificar índices lingüísticos, de interés para guiar la evaluación clínica, porporciona una base para la valoración pronostica y permite situar las alteraciones de lenguaje en un contexto global de anomalías que afectan a la construcción de la conducta intencional, el desarrollo de los códigos simbólicos y las conductas de relación e interacción presimbólica.     

El lenguaje autista desde una perspectiva correlacional

Resumen

A pesar del interés reciente por las alteraciones del lenguaje en autismo infantil, es notable la carencia de investigaciones en que se analicen las correlaciones de las variables de lenguaje entre sí y con otras variables comportamentales. En este artículo se realiza tal análisis, correlacionando variables lingüísticas entre sí (L.M.E., complejidad estructural, comprensión, porcentaje de ecos y habla socializada, etc.) y con variables no lingüísticas (cociente global de desarrollo, niveles de imitación, percepción, motricidad, integración óculo-manual, cognitivo y cognitivo-verbal, P.A.O.D.). El análisis de los datos intragrupales permite identificar índices lingüísticos de interés para guiar la evaluación clínica, proporciona una base para la valoración pronóstica y permite situar las alteraciones de lenguaje en un contexto global de anomalías que afectan a la construcción de la conducta intencional, el desarrollo de los códigos simbólicos y las conductas de relación e interacción presimbólica.     

EARLY REGULATION IN CHILDREN WHO ARE LATER DIAGNOSED WITH AUTISM SPECTRUM DISORDER. A LONGITUDINAL STUDY WITHIN THE DANISH NATIONAL BIRTH COHORT

Studies have shown that children later diagnosed with autism spectrum disorders (ASD) in their first years of life might show symptoms in main developmental areas and that these signs might be sensed by the parents. The present study investigated in a large birth cohort if children later diagnosed with ASD had deviations at 6 and 18 months in areas such as the ability to self‐regulate emotions, feeding, and sleeping. The study was based on prospective information collected from 76,322 mothers who participated in the Danish National Birth Cohort. When the children reached an average age of 11 years, 973 children with ASD and a control group of 300 children with intellectual disability (IDnoASD) were identified via Danish health registries. Associations were found between short periods of breast‐feeding and the children later diagnosed with ASD and IDnoASD as well as associations at 18 months to deviations in regulation of emotions and activity. The similarities in these associations emphasize how difficult it is to distinguish between diagnoses early in life.     

Exploring Exceptions and Discovering Solutions: A Case Presentation of Autism and the Family

As the prevalence of autism spectrum disorder (ASD) continues to rise, there is a rapidly increasing need for treatment services among individuals diagnosed with ASD and families. Currently, the majority of the evidence-based treatments, such as Applied Behavior Analysis, overlook the notable systemic effects of ASD and maintain a problem-focused lens. There is a growing body of research calling for strength-based, relational interventions that build on existing resources to enhance coping, efficacy, and well-being among families affected by ASD. Solution-Focused Brief Therapy (SFBT) is a widely practiced clinical approach that is increasingly being used among clinicians to address the systemic effects of developmental disabilities in the family. However, particular modifications to specific interventions may better accommodate autism-associated deficits in executive functioning (e.g., goal development and impulsivity), perspective taking, or restricted interests when using an SFBT approach. This article offers recommendations for adapting a solution-focused approach by modifying commonly used SFBT interventions to address family-driven treatment goals using a collaborative stance with families of children with ASD. A case presentation is included to demonstrate SFBT as informed by the unique challenges and inherent resources of families affected by ASD that have been identified in the extant literature.     

El paradigma autista. Una hipótesis de trabajo y una aproximación terapéutica

RESUMEN

En el presente artículo tiene por objetivo presentar una hipótesis que vincula las conductas autistas con alteraciones de tipo fóbico y paranoide, además de presentar una aproximación terapéutica a esta hipótesis. Se define el paradigma de funcionamiento autista como fóbico-paranoide, que a través de sus consecuencias generales genera el tipo de comportamiento propio del niño con este cuadro. Teóricamente se ve una continuidad entre los aspectos paranoides y los fóbicos más primitivos, inmaduros y/o patológicos, siendo los primeros más evolucionados que los segundos. En el paradigma paranoide se pierde o no se alcanza el sentido de la realidad, la separación real del sujeto y los objetivos percibidos, en el fóbico se mantienen más allá de la respuesta de ansiedad que genera.