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Abstract: Objectives A characteristic of some individuals with autism is described as an “insistence on sameness.” For these individuals, a violation of sameness may occasion problem behavior. Given this, a more precise understanding of the construct of sameness from a behavioral perspective is desirable for assessment and intervention purposes. In this paper, we first examined the role of an existing behavioral theory, stimulus overselectivity, in relation to this issue. A detailed stimulus control analysis led to the conclusion that this theory does not adequately account for problem behavior occasioned by violations of sameness. Based on this analysis, we developed a conceptual model for assessing and treating problem behavior associated with insistence on sameness. Methods Three representative cases from our past clinical experience with children with autism were employed to develop the conceptual model: (a) paying attention to too few stimuli, (b) paying to too many stimuli, and (c) paying attention to sequentially presented stimuli. Following a detailed stimulus control analysis of each case, we introduce a competing behavior pathways framework for organizing a functional assessment of child problem behavior occasioned by violations of sameness, and for developing a behavior support plan that emphasizes prevention, teaching, and positive reinforcement. We then apply the framework to the three cases, and illustrate its utility for developing an individualized, multicomponent positive behavior support plan for each of the children. Conclusions We conclude the paper with considerations for future research to empirically examine the proposed conceptual framework for understanding and treating problem behavior in individuals with autism associated with violations of sameness. PubDate: 2023-06-01
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Abstract: Objectives Autism spectrum disorder (ASD) symptoms can become more evident because of different factors. Among these, depression, anxiety, and stress play an important role. Additionally, several studies have revealed the impact of the COVID-19 pandemic on participants with ASD. In previous studies, two noninvasive neurobiological stimulation treatments with radio electric asymmetric conveyer (REAC) technology, called neuropostural optimization (NPO) and neuropsychophysical optimization (NPPO), were shown to be effective in improving the subjective response to environmental stressors in the general population and in ASD population. Based on the proven efficacy of REAC NPO and NPPOs treatments in alleviating anxiety, stress, and depression, the purpose of this study is to verify how these treatments can reduce the severity of ASD symptoms expression, which is aggravated by depression, anxiety, and stress. The treatments’ effects were perceived by caregivers and assessed by the Autism Treatment Evaluation Checklist (ATEC). Methods This study involved 46 children with a previous diagnosis of ASD made using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. The participants received one session of NPO treatment and one NPPOs treatment cycle of 18 sessions, administered within approximately 3 weeks. The Autism Treatment Evaluation Checklist (ATEC) was used to evaluate the efficacy of the REAC treatments. ATEC allows to evaluate four clusters (speech or language communication; sociability; sensory or cognitive awareness; and health/physical/behavior) through a numerical scale that measures increasing levels of ASD severity. Results The comparison between the scores of the ATEC administered pre- and post-REAC treatments highlighted an improvement of ASD symptoms in each of the four clusters of ATEC. Conclusions The results confirm the usefulness of REAC treatments to optimize the individual response to environmental stressors and reduce the symptomatic expression and deficits present in ASD. PubDate: 2023-06-01
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Abstract: Objectives Many countries throughout the world have achieved significant advances in Augmentative and Alternative Communication, whereas in Cyprus the evidence suggests that it is still in its early stages of development. The focus of this study was on assessment methods, which are the foundation for a successful intervention. Methods For the study objectives, aspects from the participation model relating to opportunity and access barriers and existing literature on AAC assessment were used to create a questionnaire with multiple-choice answers. A total of 89 speech and language therapists working in a public school setting participated in the study. Results The results show that AAC assessment is mainly for pupils with autism spectrum disorder. During the evaluation process, participants used various stimuli, but mostly hearing and visual, whilst using touch, smell, and taste to a much lesser extent. As part of the evaluation process, the participants reported that they focused on whether the individual could express yes/no and voice their basic needs, whereas language domains were not thoroughly assessed. Lastly, the participants focused on the ability of pupils to follow instructions, with other behaviors being assessed to a lesser extent. Conclusion Various ideas have emerged regarding how to improve AAC assessment practices in schools. PubDate: 2023-06-01
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Abstract: Objectives Parents of children with developmental disabilities (DDs) experience greater psychological distress (e.g., stress and depression) compared to parents of children without DDs. Self-compassion (i.e., responding with compassion to oneself during times of stress and difficulty) is associated with greater self-care as well as lower levels of stress, depression, and internalized stigma among parents of children with DDs. In this study, we tested the feasibility of a 4-week brief, asynchronous, online intervention targeting self-compassion among parents of children with DDs. Methods Participants were fifty parents (48 mothers; 2 fathers) of children with DDs. Participants’ ages ranged from 25 to 62 years (M = 42.1 years, SD = 7.9 years), and 88% of participants had one child with a DD, and the remaining parents had two or more children with DDs. Child diagnoses included Down syndrome, autism spectrum disorder, and intellectual disability. Feasibility was assessed in five domains (i.e., acceptability, demand, implementation, practicability, and limited efficacy) using a combination of self-report measures, qualitative feedback, and data on attrition. Results Most parents (84%) completed ≥ 3 modules, and 74% completed all four modules. Almost all parents (> 90%) reported that they would recommend the intervention to others. Paired-samples t-tests demonstrated significant pre-intervention to post-intervention increases in self-compassion and well-being, and significant reductions in parent depression and stress. Conclusions Overall, data support feasibility of the 4-week intervention targeting parent self-compassion and provide preliminary efficacy data that need to be followed up in a larger randomized control trial. PubDate: 2023-06-01
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Abstract: Objectives The current study analyzed the data from a 1-year pragmatic clinical trial on the effectiveness of a naturalistic implementation of the PEAK Relational Training System in a public school setting. Methods We accessed student records from two classrooms at the same grade level within one public school. Students’ assignments in these two classrooms were based on the severity of their diagnosis. Students in both classrooms received conventional special education services and applied behavior analysis intervention based on the PEAK Relational Training System. Post hoc analyses were conducted after one school year to compare students’ behavior skill levels, school readiness skills, and their relationship with their daily dosage of ABA intervention. Results Post hoc analyses indicated a significant difference in students’ behavior skill level and school readiness skills at the beginning of the school year. Significant differences were also found in the amount of PEAK interventions delivered to each classroom. At the end of the school year, all students demonstrated improvements on the PEAK pre-assessment (p < .001) and the Bracken School Readiness Assessment (BSRA; p < .001). A secondary analysis examined variables that predicted students’ progress and showed that their daily ABA dosage (R2 = .278) was a significant predictor of their BSRA improvement. Conclusions The current study added to a growing body of research demonstrating the utility and feasibility of implementing PEAK-based interventions in special education settings. Behavior interventions along with special education practices produced significant outcomes on students’ overall skill level and school readiness. Implications of applying a low dosage of ABA intervention are discussed. PubDate: 2023-06-01
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Abstract: Objectives Robots have the potential to enable new ways to improve the lives of people with special needs. This bibliometric review explored the nature of research that had referred to robots in the context of neurodevelopmental disorders and psychology, outlining the range of research areas, most prolific researchers, outlets for research dissemination, and trends. Method Using the database Scopus, publications were identified that mentioned in the abstract robot as well as one of several common neurodevelopmental disorders. Results were analyzed and visually presented using the software VOSviewer. An additional search identified publications about robots in the context of psychological research more broadly. Results Studies about autism spectrum disorder and social communication skills were the most frequent. Much of this work is disseminated as publications related to engineering and neuroscience, which is also consistent with the background of the most prolific and cited researchers of this bibliometric search. A notable trend is the increasing role played by psychology in robotics research. Conclusions Research work on robots in the context of neurodevelopmental disorders and psychology has traditionally been developed by researchers with a background primarily in engineering and computer science. As psychology is getting ready to play a more prominent role, there is a chance to apply specific psychological theory and methods. Such application may be facilitated by the establishment of a relevant scientific infrastructure, such as through a specialist journal on robopsychology. PubDate: 2023-06-01
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Abstract: Objectives We aimed to analyze the state of mindfulness-related single-subject design research through a behavior analytic lens. Methods Studies included empirical, quantitative, peer-reviewed single-subject design experiments training on mindfulness meditation, mindfulness-based practices, or mindfulness activities as a behavior change strategy for individuals. We excluded studies assessing effects of spillover or mindfulness only in combination with other techniques. Results Data from 28 studies included participant demographics, setting, implementor characteristics, dependent and independent variables, training techniques, and practice descriptions, and intervention relations, research methods, replicability, experimental design, reported reliability, validity, fidelity, generalization, and analyses of functional control. Some authors hypothesized the behavior change principles’ underlying outcomes. Few included treatment adherence or integrity data; behavioral repertoires were somewhat unclear. Many demonstrated functional control between intervention and behavior, but none examined contingencies related to training. Conclusions Several studies reported decreased problem behaviors or increased desirable behaviors, particularly for people with learning, behavior, or developmental differences. All authors described results somewhat behaviorally, but questions remain about repertoires of practice, underlying principles, and measurement. Cross-disciplinary practitioners can explore new procedures, clarify aspects of studies, and enhance methodology. We call for further development of a behavioral model of mindfulness interventions. PubDate: 2023-06-01
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Abstract: Objectives Within the autism intervention literature, there is a need for research focused on training teachers to implement and monitor the use of evidence-based strategies in regular classroom settings. This study assessed the effects of a teacher facilitated peer-mediated intervention (PMI) on the cooperative play, initiations, and responses of three upper elementary students with autism and three typically developing peers attending a Title 1 school. Methods Using a concurrent multiple probe across dyads design, we implemented a cascading coaching model and behavioral skills training (BST) package to teach one special educator to train peers in strategies to support and maintain play and interaction with their classmates with autism. Fidelity and social validity were assessed. Results A functional relation between the intervention and cooperative play was demonstrated. Initiations increased for all peers. Participant initiations and responses increased but were variable, with substantial increases for two participants and modest increases for one participant. Peers implemented the support strategies with a high degree of fidelity, and the teacher accurately monitored peer strategy use and intervention effects. Feedback from the teacher, participants, and peers demonstrated a high level of social validity and satisfaction with the training procedures, intervention, and outcomes. Conclusion A cascading coaching model using BST is a promising approach for training teachers to implement and monitor PMI in the natural classroom environment. Limitations and considerations for practice and future research are discussed. PubDate: 2023-06-01
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Abstract: It is two decades since the start of controversy around the FDA’s warnings of SSRI use in children and adolescents. A detailed review of these debates provides information on many serious methodological limitations, omissions, and commissions. In the last decade, the knowledge of highly comorbid conditions with MDD like ASD has grown exponentially. The higher-than-ever prevalence and diagnostic overshadowing in higher functioning ASD are now widely accepted; likewise, late and missed diagnoses are common and more in females with HF-ASD. The FDA signal has clinical implications, and if a small proportion of undiagnosed ASD comorbid with MDD was confounded in the data remains unanswered. A scientific inquiry is needed to understand the relationship between ASD, affective illness, and suicide. PubDate: 2023-06-01
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Abstract: Objectives Adults with autism often need support to detect their stress and to apply adequate coping strategies for dealing with daily stress. The personalized mobile application Stress Autism Mate (SAM) is developed for and by adults with autism to detect and cope with daily life stress. SAM measures stress four times daily, generates an overview of the patients’ stress level and gives personalized advice to reduce stress. Methods With a pre-to post-treatment design, the level of perceived stress, coping self-efficacy and self-rated quality of life (QoL) was assessed at baseline (pre-test), after the four-week intervention (post-test) and after eight-week follow-up. Data was analysed using multilevel analysis taking within subject variance into account. Results At post-test measurement, there was a significant decrease in perceived stress. At post-test as well as follow-up, a significant improvement in coping self-efficacy and improvement in self-rated QoL was seen. Conclusions The results of this pilot study suggest that the personalized mHealth tool SAM can support adults with autism in detecting stress, improving their stress coping skills and improving their self-rated quality of life. In practice, SAM can be seen as an external stress monitor that can easily be integrated in the lives of adults with autism, to detect and cope with stress. PubDate: 2023-06-01
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Abstract: Objectives Limited research has examined the experiences of children on the autism spectrum who have verbal expressive language, and no research to date has explored the physical activity (PA) preferences of children and the autism spectrum with complex communication needs (CCN). This exploratory qualitative study aimed to understand the PA preferences of children on the autism spectrum with CCN, based on previous PA experiences and the PA experiences of these families. Methods A picture preference chart interview was utilized to capture the PA preferences of the child participants. Pictures were coded based on activity type to explore themes in preferences. Semi-structured interviews were conducted with the children’s parents to explore PA experiences for the family and coded using thematic analysis. Results Children on the autism spectrum with CCN were able to express preferences for certain physical activities. Preferences were triangulated with semi-structured parent interviews and parental perceived child preferences. Additional semi-structured parental interviews presented the following themes regarding PA participation for family engagement: (a) the importance of PA and exercise, (b) sensory experiences participating in PA, and (c) atypical struggles. Conclusions Children on the autism spectrum with CCN were able to convey PA preferences (as triangulated by parental reports), and their opinions should be incorporated when designing physical activity programs and physical education experiences. PA participation of families who have a child on the autism spectrum with CCN provides for unique challenges, and more support is needed to promote engagement and improve health outcomes for both these affected individuals and their families. PubDate: 2023-06-01
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Abstract: Objectives To evaluate the effects of cognitive behavioral intervention (CBI) alone versus cognitive behavioral intervention plus emotional enhancement intervention (EEI) on adaptive behavior, social interaction, and emotional reciprocity among a sample of children with autism spectrum disorder. Methods Thirty-four children (aged 4 to 10 years) were randomly assigned to an experimental group receiving CBI plus EEI versus a CBI-only control group. Children in both groups received 24 one-hour sessions of intervention over 6 months. They were assessed on the functioning level of autism, specifically in the areas of adaptive behavior, social interaction, and emotional reciprocity, before intervention and at 3 and 6 months using the Indian Scale for Assessment of Autism (ISAA) and the Gilliam Autism Rating Scale, third edition (GARS-3). Results Children in the experimental group showed significantly greater improvement in adaptive behavior, social interaction, and emotional reciprocity than children in the CBI-only control group. Conclusions Adding EEI enhances the effectiveness of CBI for improving adaptive behavior, social interaction, and emotional reciprocity in children with autism spectrum disorder. Trial Registration Clinical Trials Registry of India CTRI/2021/03/031763. PubDate: 2023-06-01
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Abstract: Objectives Many autistic children exhibit challenging and disruptive behaviors that can present challenges for both children and their families by interfering with acquisition of adaptive skills and affecting family and peer relationships. Behavioral parent training (BPT) is an evidence-based approach to reducing autistic children’s disruptive behavior, but many families face a number of barriers to accessing BPT, such as availability of BPT in their community, and transportation and scheduling challenges. Therefore, we sought to explore the feasibility and promise of effectiveness of adapting an established BPT program to a telehealth format during the COVID-19 pandemic. Methods A feasibility trial of BPT via telehealth was conducted with fourteen parents of autistic children. Results Parents and clinicians were able to implement BPT via telehealth with a high degree of fidelity, and parents rated both BPT and the telehealth format favorably. The program also showed promise of effectiveness in reducing autistic children’s disruptive behavior, improving their adaptive skills, as well as reducing parents’ stress, and improving parents’ sense of parenting competence. Conclusions The findings replicate and extend findings from previous studies, further demonstrating the promise of telehealth as a viable alternative format for delivering BPT. We also explore implications for future research, including the opportunity for more thorough evaluation of the effectiveness of BPT via telehealth. PubDate: 2023-05-12
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Abstract: Objectives Developmental Coordination Disorder (DCD) is a common condition with core difficulties in motor skills. Recent research has identified links between DCD symptoms and negative outcomes for mental and physical health. Despite this, DCD appears to still not be well known, even to many clinicians. To date, this has been documented among specific groups of clinicians (e.g., occupational therapists) in primarily English-speaking regions, but has not been compared across specific clinical professions or across countries. Therefore, we conducted a cross-national study to examine if clinicians in primarily English-speaking and German-speaking communities of various professions are sufficiently informed about characteristics of DCD in comparison with ADHD and other neurodevelopmental disorders. Methods N = 346 clinicians responded to questions in an online survey about general awareness and their experience in treating neurodevelopmental disorders, especially regarding specific characteristics of DCD and ADHD. Moreover, we asked them to classify a case vignette with DCD. Results Overall, 58% of participants had heard of DCD but only 42% had treated individuals with DCD. More specific knowledge about DCD and ADHD was low, varied by profession, and was generally reduced among clinicians working in primarily German-speaking communities. Participants often gave an incorrect diagnosis for the case vignette (35% correct responses) but still offered correct treatment recommendations (61% correct responses). Conclusions Awareness of the specific nature of DCD is still lacking for many clinicians. More training about DCD and other neurodevelopmental disorders should be disseminated in clinical training. PubDate: 2023-05-03
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Abstract: Objectives Children with autism spectrum disorder experience communication difficulties that can make it challenging to engage in conversations. Their caregivers also often struggle with finding ways to support the child’s communication. Parent-implemented interventions and visual supports are evidence-based practices to support the communication skills of children with autism. Method A multi-method design (single-case multiple probe and qualitative) was used to evaluate the effects of family photographs, training, and telecoaching on parental implementation of communication strategies. Three parents and their children with and at risk for autism participated. Results Results indicate that the use of photographs increased the communication strategies used by all parents. Telecoaching further increased the overall strategy use for two parents. Interviews with the parents indicate spontaneous generalization and maintenance of strategy use. Conclusion Family photos and naturalistic developmental behavior intervention approaches have the potential to improve communication about past events between parents and children with and at risk for ASD. PubDate: 2023-05-02
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Abstract: Objectives The quality of parenting arguably determines the quality of life that a child will live in the future. Although both mothers and fathers are expected to contribute toward raising their children, in the cultural context of sub-Saharan Africa, mothers automatically become the primary caregivers and managers of domestic affairs. In the event that there are children with disabilities in a family, the mother is expected to be the carer. While having a child with a disability places an additional burden on mothers due to the child’s unique characteristics, there is only a small body of literature on mothering children with visual impairments (VI) in the African context. In a cultural environment such as that of Ghana, it is important to understand mothering experiences. Methods Twenty mothers of children with VI who were at least 18 years old took part in this qualitative descriptive study. A semi-structured interview guide was developed and used to collect the data, which were then subjected to thematic analysis. Results Three themes were identified: opportunities for development, support services, and challenges faced by mothers. While the sample of mothers demonstrated high expectations, resilience, and a commitment toward raising their children, support services were unavailable to them. Conclusions While shouldering all the caregiving responsibilities, the participants remained resilient, did not appear to be stressed, and were committed to raising their children with VI. PubDate: 2023-04-28
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Abstract: Objectives Support for adults with congenital corpus callosum disorders (CCDs) is impeded by poor understanding of the impacts of a CCD on day-to-day functioning and quality of life. This scoping review examines existing literature to establish the evidence-based impacts of congenital CCDs in adults and identify gaps to inform future research, policy development, and service delivery. Methods We conducted searches in Scopus, Medline Ovid, PsycInfo, Discovery, and ERIC. Studies meeting selection criteria were peer-reviewed, in English, published from 1980 to 2021, reported predominantly on participants 16 years or older who were diagnosed with a CCD by magnetic resonance imaging (MRI). Results The thirty-eight included articles comprised 14 single/dual participant case studies and 24 group studies, comparing adults with a CCD with normative data or matched controls. Although most participants were of average IQ, CCDs affected day-to-day executive functioning, social interaction, and meeting expectations of adulthood. Cognitive impacts included difficulties with learning and memory, linguistic and emotional processing, and complex reasoning, with functional capacity typically decreasing as tasks and situations increased in complexity. Psychological impacts pertaining to feelings, emotions, and social awareness were reported in addition to associated mental health, psychiatric mood, and developmental and psychotic disorders including autism, anxiety, depression, and schizophrenia. Conclusions Impacts were extremely heterogenous, presenting interwoven challenges to learning, executive functioning, social interaction, and mental health. Knowledge of these circumstances is vital for adults with CCDs, professionals, and family members to ensure appropriate services and support are available to promote good quality, inclusive lives for all adults with a CCD. PubDate: 2023-03-14 DOI: 10.1007/s41252-023-00323-8
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