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Abstract: Objectives Dyslexia is a learning disability with a prevalence of between 5 and 10% in Spain. There is a relationship between the cognitive and motor aspects, which is manifested in dyslexic children due to deficits in coordination, motor control, and balance, caused by a lack of integration of inputs from the cerebellum. Rhythmic movement therapy (RMT) seems to improve not only motor deficits in dyslexic children but also educational skills. The aim of the present study was to apply an exercise programme based on RMT and to analyse the effects on coordination, motor control, and reading ability in children diagnosed with dyslexia. Method A prospective, longitudinal, and descriptive case series (n = 6) intra-subject intervention study was conducted. Tests assessing motor control, balance, coordination, reading ability, and primitive asymmetric tonic neck reflex (ATNR), symmetric tonic neck reflex (STNR), and tonic labyrinthine reflex (TLR) were performed. An 11-week home exercise programme based on RMT was prescribed, and a post-intervention assessment was performed. Results Improvements in stability and reading ability were found, as well as a negativisation of several primitive reflexes. No statistically significant differences were found in motor control and coordination. Conclusions RMT-based exercise programme appears to be effective in improving balance and reading skills in dyslexic children. PubDate: 2024-09-01
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Abstract: Objectives To provide an overview of the current literature regarding the neurobiological treatments of psychopharmacology, neuromodulation, oxytocin therapy, and psychological resilience, as treatments for autism-related difficulties, and to distil the research findings from those treatments for everyday clinical application. Methods Instead of producing another specific systematic summary of the efficacy of these treatments, this review took an overview of each field of research, identified its key research findings, and evaluated the treatment-ready status of each of them in terms of their evidence base. From this information, a set of recommendations were derived for their clinical applications, so as to inform practice in the field. Results These treatments represent relatively recent and neurobiologically based approaches to the challenges of autism, and are in the development stage. Each treatment is promising, and has some evidential basis for its success, but all need further research to establish their evidence-based validity for everyday clinical usage. Conclusions While most of these treatments can be applied with caution, clinicians should acknowledge their restrictive benefits and costs, that are described herein. Within those caveats, each of these treatments should be considered as an emerging therapy that clinicians should consider utilising in appropriate settings and with specific cases. PubDate: 2024-09-01
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Abstract: Objectives Neurodiversity affirming frameworks are a paradigm shift from a deficit-focused approach to autism to recognizing autism as a heterogeneous constellation of differences in abilities and strengths. This article completed a literature review and data synthesis to (1) identify autistic strengths used in the design of psychosocial interventions, (2) propose mechanisms of change that explain strength-based psychosocial intervention effects on mental health and wellbeing outcomes, and (3) integrate findings in a conceptual model for testing in future research studies. Methods A search for articles was completed in June 2023 and resulted in 24 articles that met the inclusion criteria. The Distillation and Matching Model methods were used to code articles and subsequent conceptual groupings generated categorical domains included in the conceptual model. Results Autistic strengths identified in the design of psychosocial interventions were grouped into four domains: (1) perceptual, (2) reasoning, (3) expertise, and (4) character strengths. Mechanisms of change were grouped into four domains: (1) affective, (2) behavioral, (3) cognitive, and (4) physiological. The resulting conceptual model presents autistic strengths that can be leveraged in psychosocial interventions and potential mechanisms of change that explain intervention effects on mental health and wellbeing. Conclusions Growing focus on the translation of positive psychology has resulted in strength-based psychosocial intervention programs. However, intervention strategies have not leveraged the diverse array of autistic strengths identified by autistic individuals, their families, and their communities. Furthermore, research is needed to determine mechanistic paths by which strength-based interventions achieve positive effects on mental health outcomes in autistic children and adolescents. PubDate: 2024-09-01
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Abstract: Objectives This study presents a cohort of individuals in a natural history study with de novo pathogenic missense variants in HNRNPH2 causative of HNRNPH2-related neurodevelopmental disorder (NDD) to describe individuals’ adaptive functional abilities. Methods We measured adaptive function using the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) and the Vineland Adaptive Behavior Scale (VABS-III). Results were compared using inferential statistics and regression analysis. Results Sixty-seven individuals carried known pathogenic or likely pathogenic variants in HNRNPH2. Thirty-five participants (2.89–42.04 years, 83% female) and caregivers completed PEDI-CAT assessments with 25 of these participants completing the VABS-III. Sixteen, three and two participants completed a follow-up PEDI-CAT assessment at one, two and three years respectively. Individuals had mean normative scores less than age-matched peers across all domains on both PEDI-CAT and VABS-III measures, with 91% participants < 5th percentile on both the PEDI- CAT and VABS-III. Verbal and ambulatory participants had significantly higher PEDI-CAT scores across all domains, using both raw and normative data. There was no significant change in PEDI-CAT scores over 3 years. Conclusions Overall scores, both raw and normative, are low across all individuals with HNRNPH2-related NDD using both the PEDI-CAT and VABS-III. PEDI-CAT normative scores do not likely represent the clinical variability, but raw scores may be able to capture functional variability. In a small sample, longitudinal data from the PEDI-CAT domain scores demonstrate stability in performance at 3 years. Trial Registration: ClinicalTrials.gov NCT03492060. PubDate: 2024-09-01
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Abstract: Objectives The purpose of this research was to expand upon the available normative data on the Stress Survey Schedule (SSS) for a group of adults with intellectual disabilities and autism spectrum disorder (ASD). This scale was originally designed in 2001 to measure stress in persons with ASD. Normative data were previously collected for a group of children and adolescents, and a secondary aim of this study was to compare the present adult data set to the historical child/adolescent data set. Methods This was a retrospective observational study that utilized SSS collected between 2021 and 2023. Survey response data were collected on 89 adults with intellectual disability and ASD, ages 22 to 66. Normative data were generated and explored and then compared to the historic child/adolescent sample. Results The average “Ritual-related” subscale score was significantly higher and the “Pleasant Events” subscale score was significantly lower compared to all other average subscale scores in the overall adult group. There were very few differences in the average subscale, average total, or raw total scores by age group or autism diagnosis status. Survey items frequently scored as high or low stress were consistent with these results. In comparing younger and older participant data, significant differences were found in average subscale scores in a number of areas, mainly with higher scores for the adult sample. Conclusions For adults, high stress often stems from events related to ritualized behavior, and events that are pleasant are typically endorsed as low stress for both adult and child samples. Stress levels appear to peak in early adulthood and then slowly diminish. There are significant differences between the child and adult samples, but social and environmental changes since the SSS was created in 2001 suggest the need for separate and revised versions of the survey. PubDate: 2024-09-01
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Abstract: Objectives Martial arts, such as judo, may improve health outcomes in youth with autism spectrum disorder (ASD); however, the inclusion of parents in this activity may offer additional benefits. The purpose of this study was to examine the feasibility and acceptability of a 15-week family judo program for autistic youth. Methods Nine children and their parents participated in the family class, and eight children participated in a child-only class as a comparison group. Judo sessions were held weekly for 45 min. Seven areas of feasibility (acceptability, demand, implementation, practicality, adaptation, expansion, preliminary efficacy) were assessed using attendance records, retention and recruitment rates, observation notes, and parent/instructor open-ended surveys. The Autism Behavior Inventory Short-Form (ABI-SF) was administered at baseline and post-judo to assess changes in ASD-related behaviors. Results The family class had a significantly higher attendance rate (13.22 ± .44 classes) compared to the child-only class (9.9 ± 2.5 classes, p = 0.007), with 100% of the family class attending at least 80% of the sessions, compared to 38% of the child-only class (p = 0.005). There was a significant improvement in social communication and self-regulation subscales from the ABI-SF post-judo in the family class, but no changes were observed in the child-only class. Parent open-ended survey responses indicated an observed increase in child physical activity and self-confidence post program in the family class. Conclusions The family judo class appeared both feasible and acceptable to participating families. Future studies should examine the physical and psychosocial benefits of a family program using larger samples. PubDate: 2024-09-01
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Abstract: Objectives Previous studies on the comprehension and appreciation of humour in individuals with Williams syndrome (WS) have only included complex types of humour that required complex cognitive abilities. Additionally, although individuals with WS have been described as having a bias towards positive emotions, no study has investigated their expressive responses to humour. Methods The present study examined basic humour processing skills, as well as expressive responses to simple humorous and non-humorous stimuli in individuals with WS (N = 8) compared to mental-age matched typically developing (TD) children (N = 9). Participants were shown short funny and non-funny excerpts of the movies “Ice Age” and “Madagascar” and were asked to rate their level of amusement. Their expressive responses, namely smiles and laughs, were coded and analysed. Results Individuals with WS seem to be able to discriminate between humorous and non-humorous conditions and appreciate simple humorous content as much as TD individuals. As such, they are equally able to process simple types of humour as their mental-age matched counterparts. Additionally, and in line with their positivity bias, individuals with WS expressed more frequent and more intense laughter than the control group. Conclusion Individuals with WS appreciate simple humour as much as TD individuals, and they seem to display a particularly high expressivity in response to humorous stimuli. PubDate: 2024-09-01
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Abstract: Objectives Individuals with developmental disabilities (DD) may have limited vocational preference choice making opportunities. The utility of vocational preference assessments (VPA) is receiving more attention. The purpose of this review was to evaluate VPA research and assess study characteristics, participant characteristics, VPA procedures, validation of VPAs, acquisition of vocational skills, generalization, maintenance, and social validity. Method A systematic review of peer-reviewed vocational preference research using PsycINFO and ERIC databases. Inclusionary criteria required articles to be published in a peer-reviewed journal, in English, have keywords related to vocation and preference within titles, abstracts, or key words, include at least one participant diagnosed with a developmental disability, intellectual disability, or an IQ below 70, and a primary purpose of assessing vocational preference (either direct or indirect measures) and/ or correspondence with preference and vocational performance. Results Thirty articles published between 1978–2023 were reviewed. We found that VPA research included participants with a range of ages and diagnoses. The majority of VPAs have been conducted using a paired-choice format and have included a range of stimulus modalities (e.g., pictures and videos). Limitations include inadequate descriptions of participant repertoires, varied terminology or criteria to identify preferred tasks, and few formal evaluations of skill acquisition. Conclusions This review shows s range of procedures have successfully identified vocational preferences for individuals with DD. Additional research is needed to enhance emerging (e.g., necessity of contingent access) and limited areas (e.g., role of history on preference) within VPA literature. PubDate: 2024-09-01
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Abstract: Objectives While socio-communicative difficulties are identified as a core diagnostic criterion for autism spectrum disorder (ASD), there is growing evidence that social difficulties could be context-dependent and could be overcome by the use of online communication. Beyond the spectrum, the symptoms of ASD can be met in the general population at a milder scale, leading researchers to extend their work to subjects with high autistic traits, also called the broader autism phenotype. The present study explored online versus real life social skills in the general population according to the level of autistic traits. Method Seventy-one adults without ASD (from 18 to 55 years old) reporting using social networks completed a questionnaire assessing their real-life and online social skills. Their autistic traits were assessed using the autistic quotient (AQ). Results Results showed a direct influence of the level of autistic traits on real-life and online social skills: Participants having high autistic traits demonstrated a lower level of real-life social skills (r = − 0.26, p < 0.05) and conversely higher online social skills (r = 0.28, p < 0.05), suggesting that social difficulties might be context-dependent. Conclusions While further studies are needed in a population with ASD, our results report preliminary evidence of the potential benefit of online social interactions within the autistic spectrum. Further studies in ASD could consider the potential for using an electronic mediator within social remediations. PubDate: 2024-09-01
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Abstract: Objectives The study objective was to assess the attitudes and opinions of direct service providers (DSPs) about their data recording responsibilities, training, and supervision at a human services organization for children and adults with intellectual and developmental disabilities. Methods The DSPs (n = 42) completed a 10-item questionnaire with Likert-scale ratings and open-ended comments during in-person group meetings at program settings. Results Quantified ratings revealed that the DSPs generally understood and approved most facets of data recording but were more equivocal concerning the clarity of behavior definitions, process of data evaluation by clinicians, consistency among co-workers, and impact of competing activities. Some differences in average ratings were apparent between DSPs from child and adult programs. Conclusions Findings from the study suggested several strategies human services organizations can implement to train and supervise DSPs in data recording and the benefits of social validity assessment for addressing performance improvement among practitioners. PubDate: 2024-09-01
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Abstract: Objectives Neurodevelopmental disorders present deficits in executive functions (EFs). Before 36 months old, EFs act as basic abilities that allow adequate executive functioning at later ages. Three basic EFs are assessable before the child reaches 36 months old: working memory, inhibition, and cognitive flexibility. This review aims to provide an overview of the progress and difficulties in assessing these three basic executive functions before children reach 36 months old. Methods Four databases were systematically searched without time or language limitations. The selection process was done using a PRISMA flowchart for scoping reviews. Sixteen studies were included, all in English and published between 2004 and 2021. Results Out of 277 studies, 16 met the inclusion criteria. The general data of the studies were summarized, such as sample age, type of study, measurement features, types of EFs assessed, task names, internal structure, reliability, and main contributions. The findings on available tasks and scales, factor structure, biological and environmental factors, and the variables influencing EFs before 36 months old are described. Conclusions Multiple factors influenced the evolution of EFs. The unidimensional model seems to better explain EFs before 36 months old. Expanding psychometric research with large samples and studying samples of children with symptoms at risk for neurodevelopmental disorders may help to improve the measurement of EFs before 36 months old. PubDate: 2024-09-01
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Abstract: Objectives Happiness is paramount to an improved quality of life (QoL), but there are barriers to assessing the happiness and overall QoL of autistic children using traditional measures. To address this, Study 1 aimed to identify and validate the idiosyncratic mood indices of three autistic children. In Study 2, these indices were measured as QoL indicators during discrete trial teaching (DTT) sessions that followed presession pairing. Task engagement was recorded as a secondary measure. Methods Three preschool boys on the autism spectrum participated in both studies. Their individualized indices of happiness and unhappiness were first identified and validated using an abbreviated procedure that extended previous research. The effects of presession pairing were then examined using a concurrent multiple baseline design across participants. The idiosyncratic mood indices were measured using 10-s partial interval recording, while task engagement was measured using 15-s whole interval recording. Results Study 1 demonstrated that the abbreviated procedure was efficient for identifying and validating the idiosyncratic mood indices of the participants. Study 2 found that presession pairing improved the mood of all three children during DTT, but there were minimal increases in task engagement. Percentage of nonoverlapping data (PND) scores initially revealed no effects for indices of happiness (M = 43.2%), large effects for indices of unhappiness (M = 76.4%), and no effects for task engagement (M = 37.6%). Contrary to this, omnibus Tau-U scores suggested large effects for indices of happiness (Tau-U = 0.7), very large effects for indices of unhappiness (Tau-U = 0.9), and moderate effects for task engagement (Tau-U = 0.5). Conclusions Individualized indices of happiness and unhappiness can and should be used as QoL indicators during behavioral interventions for autistic children. PubDate: 2024-09-01
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Abstract: Objectives While studies examining the effectiveness of virtual reality (VR) systems in autism spectrum disorder (ASD) intervention have seen significant growth, research on their application as tools to improve assessment and diagnosis remains limited. This systematic review explores the potential of VR systems in speeding-up and enhancing the assessment process for ASD. Methods We conducted a systematic search of peer-reviewed research to identify studies that compared characteristics of autistic and neurotypical participants performing tasks in virtual environments. Pubmed and IEE Xplore databases were searched and screened using predetermined keywords and inclusion criteria related to ASD and virtual reality, resulting in the inclusion of 20 studies. Results Studies reviewed revealed that VR technologies may serve as a booster of ASD “traits” that might otherwise go unnoticed when using traditional tools. Specifically, results indicated that ASD individuals exhibited distinct behavioral nuances compared to typically developing participants across four main domains: communication and social interaction skills, cognitive functioning and neurological pattern, sensory and physiological processing, and motor behavior and body movements. Also, recent studies analyzed here underscored the potential of integrating machine learning with VR technologies to enhance accuracy in identifying ASD based on motor behavior, eye gaze, and electrodermal activity. Conclusions The integration of VR technologies can complement traditional tools in ASD diagnosis, providing more objective and reliable assessment within a controlled, ecological, and motivating virtual environment. In addition, the reviewed literature suggests machine learning models combined with VR technologies may support phenotypic diagnosis, offering a more refined classification of ASD subgroups within immersive virtual contexts. PubDate: 2024-08-05
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Abstract: Objectives To determine the childhood prevalence and characteristics of ASD in Cyprus and identify the factors associated with it. Methods This was a large-scale cross-sectional study of children 5 to 12 years of age attending schools across all Cyprus districts. Data were collected between February 20, 2023, and June 23, 2023, through a school questionnaire obtaining school information, student demographics, ASD characteristics, and language information, based on schools’ special education databases. Results Out of 9990 participants from 117 schools, a 1.8% prevalence of ASD was identified, with a substantial male predominance (80.3%, gender ratio 4.1). ASD prevalence was significantly lower in primary schools (1.3%, p<0.001) and markedly higher in special schools (41.9%, p<0.001) compared to pre-primary schools (2.7%, p<0.001). No significant differences were observed across age groups or school types (p>0.05). Most children with ASD (90.4%) received support primarily through speech-language therapy and special education (93.8%). Approximately 55.6% were reported as nonverbal/minimally verbal. Common comorbidities included attention-deficit/hyperactivity disorder (37.6%) and intellectual disability (10.7%). Multivariate logistic regression analysis highlighted gender (OR 0.26, 95% C.I. 0.18–0.38), school system (OR 21.04, 95% C.I. 9.94–44.26), and school level (OR 0.48, 95% C.I. 0.34–0.67) as significant factors associated with ASD prevalence (p<0.001). Conclusions A 1.8% prevalence of ASD was identified, with 80.3% male representation and a 4.1 gender ratio. The likelihood of ASD was greater among males and those attending pre-primary or special schools. We displayed the need for ASD public policy enforcement in Cyprus mandating screenings in pre-primary schools for early identification, and monitoring prevalence rates through a central database, for adequate service planning. PubDate: 2024-07-19
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Abstract: Objectives In mental healthcare, there is a growing emphasis on one’s strengths and context instead of focusing primarily on individual deficiencies, pathologies, risks, and negative emotions. Using the visual and tactile Yucel method, this study gains insight into strengths, burdens, and desires of neurodivergent children in residential care and their parents from different perspectives. Methods In this qualitative study, a total of 45 interviews with the Yucel method were conducted with nine neurodivergent children, their parents, and involved professionals. All built a constellation of the child and family’s strengths, burdens, and desires using the Yucel method. To explore if by applying this visual and tactile method additional information is provided to that gathered in the standard diagnostic process, the information of the Yucel method was compared to the information found in the multidisciplinary reports of the children. Results Thematic analysis showed that besides common mentioned strengths (e.g., mother, sports and activities) and burdens (mental health problems), differences in the informants' perspectives were found. Parents mentioned strengths and burdens that were not addressed by other informants and a diversity in needs was found. The comparison of the results from the interviews with the Yucel method with the information in the multidisciplinary reports showed that the Yucel method provided additional information. Conclusions The Yucel method brought more strengths and perspectives into view than diagnostics as usual in the first three months of residential care. This study contributes to the knowledge regarding personal, strength-based, and family-oriented diagnostics in mental healthcare of neurodivergent children and their families. PubDate: 2024-07-10
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Abstract: Objectives Clinical decision support systems (CDSS) are increasingly utilised within healthcare settings to enhance decision making. However, few studies have investigated their application in the context of clinical services for autistic people, with no research to date exploring the perspectives of the key stakeholders who are, or in the future may be, impacted by their use. Given the importance of stakeholder perspectives in ensuring that CDSSs are relevant, feasible, and acceptable to those who use them, the aim of this study was to examine the views of key stakeholders in relation to support preferences and a proposed CDSS intended to aide in the selection of the most appropriate supports for autistic children. Method Using a co-designed, mixed-methods approach, 20 participants comprising autistic adults, parents of autistic children, and practitioners providing services to autistic children were invited to participate in focus groups, or an open-ended online survey, to explore views regarding support provision and any opportunities, barriers, recommendations, and support for the use of CDSSs in clinical practice. Results Participants highlighted potential benefits of using a CDSS in clinical practice, such as creating efficiencies and consistency in decision making when selecting therapies and supports, provided it was part of a holistic approach to working with autistic children. Potential barriers largely centred on concerns about the safety of data to be utilised within the system. Conclusions The findings indicate that CDSS have the potential to play a valuable role in selecting supports for autistic children, providing appropriate safeguarding occurs. PubDate: 2024-07-05
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Abstract: Objectives Many school-aged children with autism spectrum disorders (ASD) are functionally nonverbal or minimally verbal and need ongoing speech intervention to improve their vocalizations. Research has demonstrated the effectiveness of integrating speech-generating devices (SGDs) with evidence-based practices to facilitate natural speech development in children with ASD. However, little is known about the extent to which the impact of the procedural fidelity of caregiver-delivered naturalistic intervention on the expressive language of children with ASD, particularly in the context of comprehensive interventions incorporating SGDs. Methods The current study employed a multiple probe design to examine language outcomes in four children aged 3–6 years old who progressed in parent-mediated interventions involving SGDs. The study aims to evaluate the implementation fidelity of naturalistic developmental interventions, delivered by caregivers after receiving one-on-one training and coaching on an intervention package that involves SGDs and other EBPs. After caregivers met the implementation criteria, researchers continued to assess the speech changes in the child participants. Results The results suggest that the training could facilitate parents’ acquisition of interventional strategies. A positive functional relation was identified between parents’ implementation fidelity of intervention strategies and children’s speech gains. The Tau-U statistical analysis revealed a large effect size, indicating the statistical significance of the intervention’s impact on the dependent variables. Conclusions Leveraging the elements of naturalistic developmental intervention and integrating SGDs with EBPs, parents have the capacity to deliver effective routine interventions to improve the natural speech of children with ASD and speech impairment. PubDate: 2024-06-29
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Abstract: Objectives Attention deficit hyperactivity disorder (ADHD) affects around 7% of children/adolescents and 3% of adults. Treatment guidelines propose a combination of pharmacological and non-pharmacological approaches. Despite this, research has focused on the use of medication, including how this varies between countries, with differences found between high-income countries (HIC) and low- and middle-income countries (LMIC). Studies have also identified that the role of practitioners is critical with their clinical ambivalence around ADHD impacting treatment. The present study aimed to examine the views of practitioners towards psychosocial treatments for ADHD in the UK (HIC) and Malaysia (LMIC). Methods Data was collected from health practitioners in the UK and Malaysia using an online survey to assess (i) demographics and employment characteristics, (ii) practitioners’ attitudes to psychosocial treatments for ADHD, and (iii) practitioners’ beliefs about ADHD. Results Respondents in Malaysia held more positive attitudes towards psychosocial interventions, despite having similar beliefs about the condition. Furthermore, attitude to psychosocial interventions was predicted by age of the practitioner, their qualification, and belief in ADHD as a real condition with biological markers. Conclusions This study has revealed some cross-cultural differences in attitudes towards non-pharmacological treatment for ADHD and provides a starting point for future research to move beyond examination of decision-making for pharmacological treatments only. PubDate: 2024-06-26
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Abstract: Objectives Rett syndrome, a rare genetic disorder, may impact language development and be associated with severe communication deficits. Communication partners, such as parents and health professionals involved in children’s daily lives with RTT, are the most relevant for understanding their communication needs. This article aimed to provide an overview of the identification of communication abilities in children with RTT in their daily routine from the perspectives of communication partners who interact with individuals diagnosed with RTT. Methods A scoping review was used to comprehensively search and gather evidence from existing literature on how communication partners understand, define, and classify the communication abilities of children with RTT in their daily routines. The quality of each selected study was assessed using the modified critical appraisal skills program (CASP) checklist. Results This scoping review revealed specific communication abilities in children with RTT as described by the communication partners interacting with them daily. Accurate assessment outcomes rely on the communication partners’ perspectives on the communication skills of children with RTT. Conclusions This review highlights the need for future studies to support and identify preassigned communicative acts in the communication assessment of children with RTT. PubDate: 2024-06-19
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