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Perlstein SC, Njoroge WFM, White LK, Parish-Morris J, Williams AI, Malone KS, Rodriguez Y, Sun S, Wisniewski K, Popoola A, Flum M, Kornfield SL, Seidlitz J, Chaiyachati BH, Barzilay R, Gur RE, Waller R. Characterizing Social Communication Difficulties in Young Children within a Longitudinal Ecological Systems Framework. Res Child Adolesc Psychopathol 2025; 53:485-497. [PMID: 40122964 PMCID: PMC12031844 DOI: 10.1007/s10802-025-01308-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2025] [Indexed: 03/25/2025]
Abstract
Social communication difficulties are a transdiagnostic risk factor for psychopathology. However, few studies have examined prospective risk for social communication difficulties in young children within an ecological systems framework. Our sample was 251 parent-child dyads assessed during pregnancy, postpartum, and toddlerhood (child ages 1 and 2). We leveraged observer ratings of child behavior, parent-reported questionnaires, and geocoded data. We examined prospective risk factors for social communication difficulties at ages 1 and 2, including at the level of the child (gestational age), family (household income, maternal mental health, maternal-child bonding), and neighborhood (neighborhood resources). Fewer neighborhood resources were associated with more social communication difficulties at age 1, but only among dyads with impaired maternal bonding. Lower gestational age, lower household income, and impaired maternal bonding were associated with more child social communication difficulties at age 2. Fewer neighborhood resources were also related to more social communication difficulties at age 2, specifically among families with low household incomes. Findings provide insight into families who may benefit from early intervention to reduce transdiagnostic risk for child psychopathology across ecological systems, including efforts to target maternal bonding and poverty.
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Affiliation(s)
- Samantha C Perlstein
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
| | - Wanjikũ F M Njoroge
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
| | - Lauren K White
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
| | - Julia Parish-Morris
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Alasia I Williams
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
| | - Kayla S Malone
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
| | - Yuheiry Rodriguez
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
| | - Sydney Sun
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
| | - Kate Wisniewski
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Ayomide Popoola
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
| | - Michaela Flum
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA
| | - Sara L Kornfield
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
- Penn Center for Women's Behavioral Wellness, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Jakob Seidlitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, USA
| | - Barbara H Chaiyachati
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
- Division of General Pediatrics, Department of Pediatrics, Perelman School of Medicine, Children'S Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
| | - Raquel E Gur
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Children's Hospital of Philadelphia and Penn Medicine, Lifespan Brain Institute (Libi), University of Pennsylvania, Philadelphia, USA
| | - Rebecca Waller
- Department of Psychology, University of Pennsylvania, Stephen A. Levin Building, 425 South University Avenue, Philadelphia, PA, 19104, USA.
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Gan M, Zhu X, Wang W, Ye K, Jiang Y, Jiang T, Lv H, Lu Q, Qin R, Tao S, Huang L, Xu X, Liu C, Dou Y, Ke K, Sun T, Liu Y, Jiang Y, Han X, Jin G, Ma H, Shen H, Hu Z, Guan Y, Lin Y, Du J. Associations of inflammation related prenatal adversities with neurodevelopment of offspring in one year: a longitudinal prospective birth cohort study. BMC Pregnancy Childbirth 2024; 24:636. [PMID: 39358694 PMCID: PMC11445952 DOI: 10.1186/s12884-024-06839-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 09/17/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND The recent Maternal Immune Activation (MIA) theory suggests maternal systemic inflammation may serve as a mediator in associations between prenatal maternal adversities and neurodevelopmental diseases in offspring. Given the co-exposure to multiple adversities may be experienced by pregnant person, it is unclear whether a quantitative index can be developed to characterize the inflammation related exposure level, and whether this index is associated with neurodevelopmental delays in offspring. METHODS Based on Jiangsu Birth Cohort (JBC), a total of 3051 infants were included in the analysis. Inflammation related Prenatal Adversity Index (IPAI) was constructed using maternal data. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, third edition, screening test in one year. Multivariate linear regression and Poisson regression model were performed to analyze the associations between IPAI and neurodevelopment in offspring. RESULTS Compared with "low IPAI" group, offspring with "high IPAI" have lower scores of cognition, receptive communication, expressive communication, and fine motor. The adjusted β were - 0.23 (95%CI: -0.42, -0.04), -0.47 (95%CI: -0.66, -0.28), -0.30 (95%CI: -0.49, -0.11), and - 0.20 (95%CI: -0.33, -0.06). Additionally, the elevated risk for noncompetent development of cognition and receptive communication among "high IPAI" group was observed. The relative risk [RR] and 95% confidence interval [CI] were 1.35 (1.01, 1.69) and 1.37 (1.09, 1.72). CONCLUSIONS Our results revealed a significant association between higher IPAI and lower scores across cognition, receptive communication, expressive communication, and fine motor domains, and an increased risk of noncompetent development in the cognition and receptive communication domains.
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Affiliation(s)
- Ming Gan
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Taizhou People's Hospital, Affiliated to Nanjing Medical University, Taizhou, 225300, Jiangsu, China
| | - Xianxian Zhu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Weiting Wang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Kan Ye
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Yangqian Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Tao Jiang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Hong Lv
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Qun Lu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Rui Qin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Shiyao Tao
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Lei Huang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Xin Xu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Cong Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yuanyan Dou
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Kang Ke
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Tianyu Sun
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yuxin Liu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Yue Jiang
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Xiumei Han
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Guangfu Jin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Hongxia Ma
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Hongbing Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Zhibin Hu
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215002, Jiangsu, China
| | - Yichun Guan
- Department of Reproductive Medicine Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
- State Key Laboratory of Reproductive Medicine (Henan Centre), The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
| | - Yuan Lin
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- Department of Maternal, Child and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215002, Jiangsu, China.
- Department of Maternal, Child and Adolescent Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Jiangbo Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
- State Key Laboratory of Reproductive Medicine (Suzhou Centre), Suzhou Municipal Hospital, Gusu School, The Affiliated Suzhou Hospital of Nanjing Medical University, Nanjing Medical University, Suzhou, 215002, Jiangsu, China.
- Taizhou People's Hospital, Affiliated to Nanjing Medical University, Taizhou, 225300, Jiangsu, China.
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Cahill S, Hager R, Shryane N. Patterns of resilient functioning in early life: Identifying distinct groups and associated factors. Dev Psychopathol 2024; 36:1789-1809. [PMID: 37848396 DOI: 10.1017/s0954579423001165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
Resilience, the capacity to maintain or regain functionality in the face of adversity, is a dynamic process influenced by individual, familial, and community factors. Despite its variability, distinct resilience trajectories can be identified within populations, yet the predictors defining these distinct groups remains largely unclear. Here, using data from the Avon Longitudinal Study of Parents and Children (ages 0-18), we quantify resilience as the remaining variance in psychosocial functioning after taking into account the exposure to adversity. Growth mixture modeling identified seven distinct resilience trajectories, with over half of the study population maintaining resilience throughout early life. Factors increasing the likelihood of resilient trajectory membership included a less emotional temperament, high cognitive abilities, high self-esteem, low levels of autistic social traits, strong sibling relationships, high maternal care, and positive school experiences. Among the socioeconomic factors considered, maternal education - a significant indicator of socioeconomic status - and birth-order were associated with resilient trajectories. Our findings underscore the importance of fostering cognitive abilities, self-esteem, social relationships, positive school experiences, and extracurricular engagement to bolster resilience in adversity-exposed individuals and communities. This research informs resilience-focused interventions in mental health, education, and social policy sectors, and prompts further exploration of socioeconomic influences on resilience trajectories.
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Affiliation(s)
- Stephanie Cahill
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, MA, UK
- Faculty of Humanities, Cathie Marsh Institute for Social Research, University of Manchester, Manchester, MA, UK
| | - Reinmar Hager
- Evolution, Infection and Genomics, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, MA, UK
| | - Nick Shryane
- Faculty of Humanities, Cathie Marsh Institute for Social Research, University of Manchester, Manchester, MA, UK
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Murphy S, Bell K, Cook EJ, Crafter S, Davidson R, Fairhurst C, Hicks K, Joffe V, Messer D, Robinson-Smith L, Strachan L, Torgerson D, Welch C. Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial: study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children. BMC Psychol 2024; 12:266. [PMID: 38741221 DOI: 10.1186/s40359-024-01749-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention ('E-PLAYS') aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools. METHODS The aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools' teaching assistants. Teachers will select suitable children (ages 5-7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual. The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS. DISCUSSION The aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children. TRIAL REGISTRATION ISRCTN 17561417, registration date 19th December 2022. PROTOCOL VERSION v1.1 19th June 2023.
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Affiliation(s)
- Suzanne Murphy
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK.
| | - Kerry Bell
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Erica Jane Cook
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | - Sarah Crafter
- Open University, Walton Hall, Kents Hill, Milton Keynes, Milton, MK7 6AA, UK
| | - Rosemary Davidson
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | | | - Kate Hicks
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Victoria Joffe
- University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
| | - David Messer
- Open University, Walton Hall, Kents Hill, Milton Keynes, Milton, MK7 6AA, UK
| | | | - Luke Strachan
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - David Torgerson
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Charlie Welch
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
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Keating J, Uljarević M, van Goozen SHM, Abbot-Smith K, Hay DF, Leekam SR. Assessing pragmatic language difficulties using the Revised Children's Communication Checklist-2. Exploratory structural equation modeling and associations with restricted and repetitive behaviors. Autism Res 2024; 17:584-595. [PMID: 38311962 DOI: 10.1002/aur.3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
In this paper, we investigated the psychometric properties of the Child Communication Checklist-Revised (CCC-R) for the first time with an English-speaking sample. We used a confirmatory application of exploratory structural equation modeling (ESEM) to re-evaluate the CCC-R's psychometric properties. We found strong support for its use as an assessment for pragmatic and structural language. Our second main aim was to explore associations between pragmatic and structural language and restricted and repetitive behaviors (RRBs), two hallmark characteristics of autism. We used the CCC-R and Repetitive Behavior Questionnaire (RBQ-2) to investigate these associations in a diverse non-clinical sample of children, taking a transdiagnostic approach. We intentionally excluded autism and other neurodevelopmental diagnoses to test, (1) the CCC-R in a broad sample and (2) the association between pragmatic language and RRB in children not already selected for that association. The sample comprised two groups of children, one was community sampled (n = 123) and the other (n = 143) included children with non-specific behavioral, emotional and/or cognitive difficulties referred to an assessment unit by schools. We found clear associations between pragmatic language difficulties and RRBs in both groups. Regression analysis showed that pragmatic language was the only significant contributor to RRBs even after Grammatical-Semantic score, age, sex, and socioeconomic status were controlled. The pattern was the same for both recruitment groups. However, the effects were stronger for the school-referred group which also had more pragmatic difficulties, grammatical-semantic difficulties and RRBs. A robust link between pragmatic language and RRBs, established in autism, has continuity across the broader non-clinical population.
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Affiliation(s)
- Jennifer Keating
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Mirko Uljarević
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Stephanie H M van Goozen
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | | | - Dale F Hay
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Susan R Leekam
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
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Hou Y, Yan T, Deng M, Li Y, Zhang J. The development and validation of a questionnaire on parental involvement in the transition from kindergarten to primary school for children with developmental disabilities in China. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104494. [PMID: 36963310 DOI: 10.1016/j.ridd.2023.104494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 10/14/2022] [Accepted: 03/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND At present, there is a lack of valid and reliable instruments that can measure parental involvement in the transition from kindergarten to primary school of children with developmental disabilities (DD) in China. AIM This study seeks to develop and validate the questionnaire on Parental Involvement in Transition from Kindergarten to Primary School (PITKPS) for children with DD in China. METHODS A total of 241 parents of children with DD participated in Study 1, and another 247 parents participated in Study 2. In study 1, we used item analysis and exploratory factor analysis to screen items and explore the factor structure of the PITKPS questionnaire. In study 2, three types of validity were examined: construct validity; convergent and discriminative validity; and criterion-related validity. Internal consistency was used to measure reliability. RESULTS The final version of the PITKPS questionnaire comprised 37 items that examined six factors. Confirmatory factor analysis supported the use of the six-factor model, and the results indicated that the questionnaire had good reliability and validity. CONCLUSIONS The PITKPS questionnaire can be used as a valid tool to assess the involvement of Chinese parents in the transition from kindergarten to primary school of children with DD.
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Affiliation(s)
- Yujia Hou
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People's Republic of China
| | - Tingrui Yan
- Special Education Department, Faculty of Education, East China Normal University, Shanghai, People's Republic of China.
| | - Meng Deng
- Special Education Department, Faculty of Education, East China Normal University, Shanghai, People's Republic of China
| | - Yan Li
- Shanghai Institute of Early Childhood Education, Shanghai Normal University, Shanghai, People's Republic of China
| | - Junfang Zhang
- Department of Special Education, Binzhou Medical College, Yantai, People's Republic of China
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Lawson C, Prentice K, Jennings J, Johnston K. First steps towards a mental health and neurodevelopmental screening of secondary school children following two fixed-term school exclusions in the UK. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2022. [DOI: 10.1080/13632752.2022.2141871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Caron Lawson
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
| | - Kate Prentice
- Adolescent At-Risk & Forensic Service, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Janine Jennings
- Adolescent At-Risk & Forensic Service, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kate Johnston
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King’s College London, London, UK
- Adolescent At-Risk & Forensic Service, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, UK
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Holzinger D, Weber C, Bölte S, Fellinger J, Hofer J. Assessment of Autism Spectrum Disorder in Deaf Adults with Intellectual Disability: Feasibility and Psychometric Properties of an Adapted Version of the Autism Diagnostic Observation Schedule (ADOS-2). J Autism Dev Disord 2022; 52:3214-3227. [PMID: 34322824 PMCID: PMC9213306 DOI: 10.1007/s10803-021-05203-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 01/13/2023]
Abstract
This study describes the adaptation of the autism diagnostic observation schedule (ADOS-2) to assess autism spectrum disorder (ASD) in adults with intellectual disability (ID) and hearing loss who communicate primarily visually. This adapted ADOS-2 was applied to residents of specialized therapeutic living communities (n = 56). The internal consistency of the adapted ADOS-2 was excellent for the Social Affect of modules 2 and 3 and acceptable for Restricted and Repetitive Behaviors subscale of module 2, but poor for module 3. Interrater reliability was comparable to standard ADOS-2 modules 1-3. Results suggest that autism symptoms of deaf adults with ID can be reliably identified by an adapted ADOS-2, provided adequate expertise in deafness, ID, ASD and proficiency in signed language by the administrator.
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Affiliation(s)
- D Holzinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria
- Institut für Sprachwissenschaft, Karl-Franzens-Universität Graz, Graz, Austria
| | - C Weber
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria
- Institut für Inklusive Pädagogik, Pädagogische Hochschule OÖ, Linz, Austria
| | - S Bölte
- Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - J Fellinger
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria
- Abteilung für Sozialpsychiatrie der Universitätsklinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Vienna, Austria
| | - J Hofer
- Forschungsinstitut für Entwicklungsmedizin, Johannes Kepler Universität Linz, Linz, Austria.
- Institut für Sinnes- und Sprachneurologie, Konventhospital Barmherzige Brüder, Seilerstätte 2, 4021, Linz, Austria.
- Abteilung für Pädiatrie I, Medizinische Universität Innsbruck, Innsbruck, Austria.
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9
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Developmental trajectories of social cognition from preschool to adolescence. Eur Child Adolesc Psychiatry 2022; 31:819-828. [PMID: 33492481 DOI: 10.1007/s00787-021-01719-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
This longitudinal study aims to define the developmental trajectories of social cognition (SC) in a community sample (N = 378) assessed from preschool (3 years old) to preadolescence (12 years old). Parents and teachers reported on a SC measure at ages 5, 10, and 12. We tested the existence of different trajectories and whether they discriminated outcomes in early adolescence. The data were collected from different sources, the children, the parents, and teachers, by means of different methods. Using Growth Mixture Modeling (GMM), we identified three distinct social cognition trajectories: persistently mild difficulties reported by parents and teachers (7.9% of the children), stable low problems reported by parents and increased difficulties reported by teachers (10.5% of the sample), and stable low problems reported by both informants for most of the participants (81.5%). Comparison of the psychological outcomes between classes using regression models showed that the two trajectories including children with any level of problems differ from the normative one as regards their association with psychological problems, daily functioning, and variables, such as aggressive behavior and callousness. The two non-normative trajectories also differ from each other in terms of the personal characteristics of the adolescents included in them. Adolescents in the increasing problematic class in the school have a tougher and more problematic style of social relating, while children with persistent and non-context-dependent difficulties are more anxious. These results might help to better detect and design specific interventions for children with deficits in SC that might respond to different personal characteristics leading to different outcomes.
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10
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Hofer J, Tillmann J, Salzmann J, Bölte S, Fellinger J, Holzinger D. Screening for autism spectrum disorder in deaf adults with intellectual disability: Feasibility and accuracy of two autism screening instruments. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 122:104167. [PMID: 34998116 DOI: 10.1016/j.ridd.2021.104167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/22/2021] [Accepted: 12/28/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is a lack of autism screening instruments for deaf or hard of hearing (DHH) adults with intellectual disability. AIMS This study examined the diagnostic validity of the Pervasive Developmental Disorder in Mental Retardation Scale and the Diagnostic Behavioral Assessment for autism spectrum disorder - Revised in this rare population. METHODS AND PARTICIPANTS 56 DHH adults with intellectual disability living in three specialized therapeutic communities were examined, 9 of whom met criteria for autism. OUTCOMES AND RESULTS With minimal adaptions regarding item interpretation, both tools showed good diagnostic and high convergent validity. Items probing for difficulties in reciprocal social interaction and restricted interests were discriminant between individuals with and without autism. CONCLUSION These data suggest that both autism screening tools are feasible and psychometrically sound when used with appropriate adaptations for DHH adults with intellectual disability.
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Affiliation(s)
- J Hofer
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Department of Pediatrics I, Medical University of Innsbruck, Austria
| | - J Tillmann
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria
| | - J Salzmann
- Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria
| | - S Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institute & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden; Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - J Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Division of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - D Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University, Linz, Austria; Institute of Neurology of Language and Senses, Hospital of St. John of God, Linz, Austria; Institute of Linguistics, University of Graz, Graz, Austria.
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11
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A Systematic Review of Intervention Intensity in Pivotal Response Training and Scripting Research. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2021. [DOI: 10.1007/s40489-021-00296-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Wilson AC. Do animated triangles reveal a marked difficulty among autistic people with reading minds? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1175-1186. [PMID: 33618541 PMCID: PMC8264645 DOI: 10.1177/1362361321989152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Autistic people are thought to have difficulty with mentalising (our drive to track and understand the minds of other people). Mentalising is often measured by the Frith-Happé Animations task, where individuals need to interpret the interactions of abstract shapes. This review article collated results from over 3000 people to assess how autistic people performed on the task. Analysis showed that autistic people tended to underperform compared to non-autistic people on the task, although the scale of the difference was moderate rather than large. Also, autistic people showed some difficulty with the non-mentalising as well as mentalising aspects of the task. These results raise questions about the scale and specificity of mentalising difficulties in autism. It also remains unclear how well mentalising difficulties account for the social challenges diagnostic of autism.
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13
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Zheng S, Kaat A, Farmer C, Kanne S, Georgiades S, Lord C, Esler A, Bishop SL. Extracting Latent Subdimensions of Social Communication: A Cross-Measure Factor Analysis. J Am Acad Child Adolesc Psychiatry 2021; 60:768-782.e6. [PMID: 33027686 PMCID: PMC8019433 DOI: 10.1016/j.jaac.2020.08.444] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/12/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Social communication deficits associated with autism spectrum disorder (ASD) are commonly represented as a single behavioral domain. However, increased precision of measurement of social communication is needed to promote more nuanced phenotyping, both within the autism spectrum and across diagnostic boundaries. METHOD A large sample (N = 1,470) of 4- to 10-year-old children was aggregated from across 4 data sources, and then randomly split into testing and validation samples. A total of 57 selected social communication items from 3 widely used autism symptom measures (the Autism Diagnostic Observation Scale [ADOS], Autism Diagnostic Interview-Revised [ADI-R], and Social Responsiveness Scale [SRS]) were analyzed in the multi-trait/multi-method factor analysis framework. The selected model was then confirmed with the validation sample. RESULTS The 4-substantive factor model, with 3 orthogonal method factors, was selected using the testing sample based on fit indices and then confirmed with the validation sample. Two of the factors, "Basic Social Communication Skills" and "Interaction Quality," were similar to those identified in a previous analysis of the ADOS, Module 3. Two additional factors, "Peer Interaction and Modification of Behavior" and "Social Initiation and Affiliation," also emerged. Factor scores showed nominal correlations with age and verbal IQ. CONCLUSION Identification of subdimensions could inform the creation of better conceptual models of social communication impairments, including mapping of how the cascading effects of social communication deficits unfold in ASD versus other disorders. Especially if extended to include both older and younger age cohorts and individuals with more varying developmental levels, these efforts could inform phenotype-based exploration for biological and genetic mechanisms by pinpointing specific mechanisms that contribute to various types of social communication deficits.
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Affiliation(s)
- Shuting Zheng
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA.
| | - Aaron Kaat
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Cristan Farmer
- Pediatrics & Developmental Neuroscience Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Stephen Kanne
- Center for Autism and the Developing Brain, Weill Cornell Medicine College, White Plains, New York
| | - Stelios Georgiades
- McMaster University and Offord Centre for Child Studies, Ontario, Canada
| | - Catherine Lord
- UCLA Semel Institute for Neuroscience & Human Behavior, Center for Autism Research and Treatment, David Geffen School of Medicine, University of California, Los Angeles
| | - Amy Esler
- Center for Neurobehavioral Development, Division of Clinical Behavioral Neuroscience, University of Minnesota, Minneapolis
| | - Somer L. Bishop
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
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14
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Murphy S, Joffe V, Donald L, Radley J, Sunthararajah S, Welch C, Bell K, Messer D, Crafter S, Fairhurst C, Corbacho B, Rodgers S, Torgerson D. Evaluating 'Enhancing Pragmatic Language skills for Young children with Social communication impairments' (E-PLAYS): a feasibility cluster-randomised controlled trial. Pilot Feasibility Stud 2021; 7:5. [PMID: 33390188 PMCID: PMC7780650 DOI: 10.1186/s40814-020-00724-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This article reports the results from a feasibility study of an intervention ('E-PLAYS') aimed at supporting children who experience difficulties with social communication. E-PLAYS is based around a dyadic computer game, which aims to develop collaborative and communication skills. A pilot study found that when E-PLAYS was delivered by researchers, improvements on communication test scores and on collaborative behaviours were observed. The aim of this study was to ascertain the feasibility of running a full-scale trial to test the effectiveness of E-PLAYS in a National Health Service (NHS) setting with delivery by speech and language therapists and teaching assistants. METHODS The study was a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with a treatment as usual control arm. Data relating to recruitment and retention, treatment fidelity, acceptability to participants, suitability of outcomes and feasibility of collecting health economic measures and of determining cost-effectiveness were collected. Speech and language therapists selected suitable children (ages 4-7 years old) from their caseload. E-PLAYS intervention (experimental group) was then delivered by teaching assistants overseen by speech and language therapists. The control group received usual care. Assessments included blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and non-blinded parent-reported use of health and education resources and quality of life. RESULTS Planned recruitment was for 70 children, in the event, 50 children were recruited which was sufficient for feasibility purposes. E-PLAYS was very highly rated by children, teaching assistants and speech and language therapists and treatment fidelity did not pose any issues. We were able to collect health economic data which suggests that E-PLAYS would be a low-cost intervention. CONCLUSION Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial estimated appears feasible and warranted to assess the effectiveness of E-PLAYS for use by the NHS and schools. TRIAL REGISTRATION ISRCTN 14818949 (retrospectively registered).
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Affiliation(s)
- Suzanne Murphy
- Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Victoria Joffe
- University of Essex, Wivenhoe Park, Colchester, CO4 3SQ UK
| | - Louisa Donald
- Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Jessica Radley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Sailaa Sunthararajah
- Research and Development Office, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford, IG3 8XJ UK
| | - Charlie Welch
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Kerry Bell
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Messer
- Education & Language Studies, Faculty of Wellbeing, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Sarah Crafter
- School of Psychology, Faculty of Arts & Social Sciences, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Caroline Fairhurst
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Belen Corbacho
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Sara Rodgers
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Torgerson
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
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15
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Adams C, Gaile J. Evaluation of a parent preference-based outcome measure after intensive communication intervention for children with social (pragmatic) communication disorder and high-functioning autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 105:103752. [PMID: 32771922 DOI: 10.1016/j.ridd.2020.103752] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 06/30/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND/OBJECTIVES Children with Social (Pragmatic) Communication Disorder (SPCD) or High-Functioning Autism Spectrum Disorder (HFASD) have persistent deficits in language structure and language use (pragmatics). This feasibility study evaluated a novel parent preference-based outcome measure and secondary outcomes associated with the Social Communication Intervention Programme (SCIP). METHODS 15 UK speech and language practitioners identified 20 children aged 5-11 years with pragmatics/language needs. Practitioners received SCIP training and supervision. Children received 20 SCIP therapy sessions. Primary endpoint was a goal attainment scale (SCIP-GAS). Before intervention (T1), parents provided three prioritised communication goals, refined into a series of steps. After intervention (T2) parents and practitioners rated each goal compared to T1 and parents provided a narrative on outcomes. SECONDARY OUTCOMES Children's Communication Checklist-2, Social Language Development Test (SLDT), and observational ratings of conversational interaction (TOPICC-2). RESULTS All children except one progressed on T2 SCIP-GAS parent outcomes. All children progressed on practitioner SCIP-GAS ratings. 82.5 % of parent comments supported their own SCIP-GAS ratings. Secondary outcomes measures: Only SLDT Making Inferences scores and TOPICC-2 ratings showed improvement at T2. CONCLUSIONS A preference-based social communication measure showed feasibility as an outcome measure following social communication intervention for children who have HFASD or SPCD.
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16
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Chen N, Miller S, Milbourn B, Black MH, Fordyce K, Van Der Watt G, Alach T, Masi A, Frost G, Tucker M, Eapen V, Girdler S. "The big wide world of school": Supporting children on the autism spectrum to successfully transition to primary school: Perspectives from parents and early intervention professionals. Scand J Child Adolesc Psychiatr Psychol 2020; 8:91-100. [PMID: 33520781 PMCID: PMC7685497 DOI: 10.21307/sjcapp-2020-009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: The transition to primary school is often a complex and uncertain time for autistic children and their families. Understanding how best to develop school readiness and support transition to primary school for autistic children is essential. School readiness and transition planning are influenced by a range of personal and contextual factors, and it is important to understand the perspectives of the various stakeholders involved in the transition process. Methods: A qualitative exploration employing focus groups and interviews was undertaken with early intervention (EI) staff (n = 45) and parents (n = 18) across Australia to understand their perspectives on school readiness and the transition to primary school. Results: Thematic analysis identified four emerging themes facilitating transition including: 1) building the child; 2) building the parents; 3) building the receiving school; and, 4) connecting the system. Conclusion: Findings highlight the need to consider school readiness and transition planning from a holistic perspective, ensuring clear, collaborative and ongoing communication between parents, teachers and EI staff, using a strength-based approach, and individualizing transition planning.
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Affiliation(s)
- Nigel Chen
- School of Occupational Therapy Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Scott Miller
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,Autism Association of Western Australia, Perth, Western Australia, Australia.,Autism Specific Early Learning and Care Centre, Perth, Western Australia, Australia
| | - Ben Milbourn
- School of Occupational Therapy Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Melissa H Black
- School of Occupational Therapy Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Kathryn Fordyce
- St Giles Society North West Tasmania Autism Specific Early Learning and Care Centre, Burnie, Tasmania, Australia
| | - Gerdamari Van Der Watt
- Autism Association of Western Australia, Perth, Western Australia, Australia.,Autism Specific Early Learning and Care Centre, Perth, Western Australia, Australia
| | - Tasha Alach
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,Autism Association of Western Australia, Perth, Western Australia, Australia.,Autism Specific Early Learning and Care Centre, Perth, Western Australia, Australia
| | - Anne Masi
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Grace Frost
- Anglicare SA Daphne St Autism Specific Early Learning and Care Centre, Prospect South Australia, Australia
| | - Madonna Tucker
- AEIOU Foundation, Queensland Autism Specific Early Learning and Care Centre, Nathan, Queensland, Australia
| | - Valsamma Eapen
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, Liverpool, New South Wales, Australia
| | - Sonya Girdler
- School of Occupational Therapy Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket, Brisbane, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
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17
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Wright B, Teige C, Watson J, Hodkinson R, Marshall D, Varley D, Allgar V, Mandefield L, Parrott S, Kingsley E, Hargate R, Mitchell N, Ali S, McMillan D, Wang H, Hewitt C. Autism Spectrum Social Stories In Schools Trial 2 (ASSSIST2): study protocol for a randomised controlled trial analysing clinical and cost-effectiveness of Social Stories™ in primary schools. BMC Psychol 2020; 8:60. [PMID: 32532354 PMCID: PMC7291714 DOI: 10.1186/s40359-020-00427-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/05/2020] [Indexed: 11/14/2022] Open
Abstract
Background Interventions designed to support children with a diagnosis of Autism Spectrum Conditions (ASC) can be time consuming, needing involvement of outside experts. Social Stories™ are a highly personalised intervention aiming to give children with ASC social information or describing an otherwise difficult situation or skill. This can be delivered daily by staff in education settings. Studies examining Social Story™ use have yielded mostly positive results but have largely been single case studies with a lack of randomised controlled trials (RCTs). Despite this numerous schools are utilising Social Stories™, and a fully powered RCT is timely. Methods A multi-site pragmatic cluster RCT comparing care as usual with Social Stories™ and care as usual. This study will recruit 278 participants (aged 4–11) with a clinical diagnosis of ASC, currently attending primary school in the North of England. Approximately 278 school based staff will be recruited to provide school based information about participating children with approximately 140 recruited to deliver the intervention. The study will be cluster randomised by school. Potential participants will be screened for eligibility prior to giving informed consent. Follow up data will be collected at 6 weeks and 6 months post randomisation and will assess changes in participants’ social responsiveness, goal based outcomes, social and emotional health. The primary outcome measure is the Social Responsiveness Scale Second Edition (SRS-2) completed by school based staff at 6 months. Approvals have been obtained from the University of York’s Research Governance Committee, Research Ethics Committee and the Health Research Authority. Study results will be submitted for publication in peer-reviewed journals and disseminated to participating families, educational staff, local authority representatives, community groups and Patient and Participant Involvement representatives. Suggestions will be made to NICE about treatment evidence dependent on findings. Discussion This study addresses a much used but currently under researched intervention and results will inform school based support for primary school children with a diagnosis of ASC. Trial registration The trial is registered on the ISRCTN registry (registration number: ISRCTN11634810). The trial was retrospectively registered on 23rd April 2019.
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Affiliation(s)
- B Wright
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK. .,Hull York Medical School, University of York, York, UK. .,COMIC, IT Centre, Innovation Way, Heslington, York, YO10 5NP, UK.
| | - C Teige
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - J Watson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - R Hodkinson
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - D Marshall
- Centre for Reviews and Dissemination, University of York, York, UK
| | - D Varley
- Department of Health Sciences, University of York, York, UK
| | - V Allgar
- Department of Health Sciences, University of York, York, UK
| | - L Mandefield
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - S Parrott
- Department of Health Sciences, University of York, York, UK
| | - E Kingsley
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - R Hargate
- Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK
| | - N Mitchell
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - S Ali
- Department of Health Sciences, University of York, York, UK.,Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
| | - D McMillan
- Department of Health Sciences, University of York, York, UK
| | - H Wang
- Department of Health Sciences, University of York, York, UK
| | - C Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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18
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Murphy S, Joffe V, Messer D, Crafter S, Radley J, Sunthararajah S, Bell K, Corbacho B, Fairhurst C, Rodgers S, Torgerson D, Welch C. Evaluating 'enhancing pragmatic language skills for young children with social communication impairments' (E-PLAYS): protocol for a feasibility randomised controlled trial study. Pilot Feasibility Stud 2019; 5:75. [PMID: 31198579 PMCID: PMC6556014 DOI: 10.1186/s40814-019-0456-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 05/09/2019] [Indexed: 12/17/2022] Open
Abstract
Background A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The proposal presented in this article describes a feasibility study for a trial to test an intervention (‘E-PLAYS’) aimed at supporting children with social communication impairments. E-PLAYS harnesses technology in the form of a novel computer game in order to develop collaborative and communication skills. Preliminary studies by the authors show that when E-PLAYS was administered by the research team, children with social communication impairments showed improvements on communication test scores and on observed collaborative behaviours. The study described here is a pragmatic trial to test the application of E-PLAYS delivered by NHS speech and language therapists together with schools. Methods This protocol outlines a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with treatment as usual control arm, with randomisation at the level of the speech and language therapist. The aim of this study is to ascertain whether it will be feasible to progress to running a full-scale definitive trial to test the effectiveness of E-PLAYS in an NHS setting. Data relating to recruitment and retention, the appropriateness of outcomes and the acceptability of E-PLAYS to participants will be collected. Speech and language therapists will select suitable children (ages 4–7 years old) from their caseloads and deliver either the E-PLAYS intervention (experimental group) or treatment as usual (control group). Assessments will include blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. There will also be a qualitative process evaluation. Discussion The findings of this study will inform the decision as to whether to progress to a full-scale definitive randomised controlled trial to test the effectiveness of E-PLAYS when delivered by speech and language therapists and teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Trial registration ISRCTN 14818949 (retrospectively registered).
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Affiliation(s)
- Suzanne Murphy
- 1Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Victoria Joffe
- 2Division of Language and Communication Science, School of Health Sciences, University of London, Northampton Square, London, EC1V 0HB UK
| | - David Messer
- 3Education & Language Studies, Faculty of Wellbeing, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Sarah Crafter
- 4School of Psychology, Faculty of Arts & Social Sciences, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Jessica Radley
- 5Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX UK
| | - Sailaa Sunthararajah
- 6Research and Development Office, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford, IG3 8XJ UK
| | - Kerry Bell
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Belen Corbacho
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Caroline Fairhurst
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Sara Rodgers
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Torgerson
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Charlie Welch
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
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The Need for a Developmentally Based Measure of Social Communication Skills. J Am Acad Child Adolesc Psychiatry 2019; 58:555-560. [PMID: 31130206 PMCID: PMC6599636 DOI: 10.1016/j.jaac.2018.12.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/04/2018] [Accepted: 02/15/2019] [Indexed: 12/14/2022]
Abstract
The ability to demonstrate and quantify changes in social communication skills has been hindered by a lack of existing measures with appropriate standardization and psychometric properties. Such a measure would be helpful for research in many populations but would be particularly crucial for detecting incremental changes in youth with neurodevelopmental disorders who might gain skills but still lag substantially behind same-age peers. Although study designs and statistical methods are under development to try to account for slow and/or nonlinear, but potentially meaningful, improvements,1 there is a dearth of measures designed to capture growth and loss of social communication skills. This opinion piece outlines the argument for such a measure and the primary issues to consider in its development.
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Brenne E, Rimehaug T. Pragmatic language impairment general and specific associations to mental health symptom dimensions in a child psychiatric sample. Scand J Child Adolesc Psychiatr Psychol 2019; 7:1-10. [PMID: 33520766 PMCID: PMC7709940 DOI: 10.21307/sjcapp-2019-001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background The results of several international studies indicate a high prevalence of language and communication impairments among children who are referred to child psychiatric services. However, these impairments are likely to remain undetected unless language and communication impairments are evaluated during the psychiatric assessment. Aims The aim of the present study is to investigate the specific association between general and specific mental health problems, as expressed by the problem scales of Child Behavior Checklist (CBCL) and Teachers Report Form (TRF), and pragmatic skills and pragmatic language impairments (PLI) as defined the Pragmatic Composite of the Child Communication Checklist (CCC-PC). Methods Children aged from 8 to 13 years (n = 73) were recruited in sequence following referral to a child and adolescent psychiatry (CAMHS) outpatient clinic within 12 months. Children with possible or established autism or intellectual disability were excluded. Standardized instruments measuring language, communication and mental health symptoms were distributed to parents and teachers, an intelligence test administered for clinical purposes, and demographic information was included. Results The parent reports showed PLI among 38% of the children and revealed strong associations with the CBCL scales for emotional problems, thought problems and, especially, social and withdrawal symptoms, which mean more associations to internalized and non-externalized problems. PC-scores were at similar levels and PLI was reported by teachers at similar rates (compared to parent reports) with moderate agreement. Teacher PC-scores showed associations to only one TRF-scale, social problems. The CCC-PC subscale with the strongest associations to mental health symptoms was «Use of Context» («Social Relationships» do not contribute to the CCC-PC scores). Conclusion There was a general increase in PC-scores and increased prevalence of PLI in this clinical sample. PC-scores correlated with symptom scores for internalizing and non-externalizing problems scales. The strongest common factors appear to be related to the social aspects of mental health. Pragmatic skills should be considered as a protective factor for mental health rather than investigating pragmatic impairment as a risk or vulnerability factor.
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Affiliation(s)
- Edel Brenne
- Child psychiatry department, Nord-Trondelag Health Trust, Levanger, Norway
| | - Tormod Rimehaug
- Child psychiatry department, Nord-Trondelag Health Trust, Levanger, Norway.,Norwegian University of Science and Technology Trondheim, Norway
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21
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Hofvander B, Bering S, Tärnhäll A, Wallinius M, Billstedt E. Few Differences in the Externalizing and Criminal History of Young Violent Offenders With and Without Autism Spectrum Disorders. Front Psychiatry 2019; 10:911. [PMID: 31920758 PMCID: PMC6927936 DOI: 10.3389/fpsyt.2019.00911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/18/2019] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorders (ASDs) are known to be associated with an increased risk of aggression and challenging behavior. In this study, we have mapped the externalizing history of a nationally representative cohort of young violent offenders with ASD, compared with offenders without ASD. Two hundred and sixty-nine violent offenders were assessed for prevalence of ASD, and participated in a thorough assessment of previous externalizing problems and criminal history. Twenty-six offenders met consensus clinical DSM-IV criteria for ASD and they were compared to offenders without ASD from the same cohort. Overall, we found a very high prevalence of externalizing and antisocial behaviors in the history of these offenders and there were few differences between the groups. Placements in foster homes were overrepresented in the ASD group and the ASD-offenders had significantly more often been diagnosed with a neurodevelopmental disorder (i.e. ASD or ADHD) by a clinician before the study. At index conviction, ASD offenders were overrepresented in sex crimes with a child victim. Though offenders without ASD had more previous convictions, in particular drug crimes, we found no difference in terms of total number of prosecuted crimes. Substance use disorders were more common among offenders without ASD. The ASD offenders scored higher compared to the non-ASD offenders on the Affective facet of the Psychopathy Checklist-Revised (PCL-R) but there were no differences in terms of total PCL-R scores. Our results provide important knowledge of the developmental history of offenders with ASD. Though this is a small and atypical phenotype it poses significant challenges to the criminal justice system and we need to understand more of it to be able to prevent these individuals from committing crimes but also to provide a fair judicial treatment, to assess exculpatory factors and improve our forensic treatment models.
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Affiliation(s)
- Björn Hofvander
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Sophie Bering
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - André Tärnhäll
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - Märta Wallinius
- Child and Adolescent Psychiatry, Department of Clinical Sciences, Lund, Faculty of Medicine, Lund University, Lund, Sweden.,Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
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Ford T, Parker C, Salim J, Goodman R, Logan S, Henley W. The relationship between exclusion from school and mental health: a secondary analysis of the British Child and Adolescent Mental Health Surveys 2004 and 2007. Psychol Med 2018; 48:629-641. [PMID: 28838327 DOI: 10.1017/s003329171700215x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Children with poor mental health often struggle at school. The relationship between childhood psychiatric disorder and exclusion from school has not been frequently studied, but both are associated with poor adult outcomes. We undertook a secondary analysis of the British Child and Adolescent Mental Health Surveys from 2004 and its follow-up in 2007 to explore the relationship between exclusion from school and psychopathology. We predicted poorer mental health among those excluded. METHOD Psychopathology was measured using the Strengths and Difficulties Questionnaire, while psychiatric disorder was assessed using the Development and Well-Being Assessment and applying Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM IV) criteria. Exclusion from school and socio-demographic characteristics were reported by parents. Multi-variable regression models were used to examine the impact of individual factors on exclusion from school or psychological distress. RESULTS Exclusion from school was commoner among boys, secondary school pupils and those living in socio-economically deprived circumstances. Poor general health and learning disability among children and poor parental mental health were also associated with exclusion. There were consistently high levels of psychological distress among those who had experienced exclusion at baseline and follow-up. CONCLUSIONS We detected a bi-directional association between psychological distress and exclusion. Efforts to identify and support children who struggle with school may therefore prevent both future exclusion and future psychiatric disorder.
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Affiliation(s)
- T Ford
- University of Exeter,Exeter,UK
| | | | - J Salim
- University of Exeter,Exeter,UK
| | | | - S Logan
- University of Exeter,Exeter,UK
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23
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Eapen V, Grove R, Aylward E, Joosten AV, Miller SI, Van Der Watt G, Fordyce K, Dissanayake C, Maya J, Tucker M, DeBlasio A. Transition from early intervention program to primary school in children with autism spectrum disorder. World J Clin Pediatr 2017; 6:169-175. [PMID: 29259892 PMCID: PMC5695075 DOI: 10.5409/wjcp.v6.i4.169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/14/2017] [Accepted: 09/04/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the characteristics that are associated with successful transition to school outcomes in preschool aged children with autism.
METHODS Twenty-one participants transitioning from an early intervention program were assessed at two time points; at the end of their preschool placement and approximately 5 mo later following their transition to school. Child characteristics were assessed using the Mullen Scales of Early Learning, Vineland Adaptive Behaviour Scales, Social Communication Questionnaire and the Repetitive Behaviour Scale. Transition outcomes were assessed using Teacher Rating Scale of School Adjustment and the Social Skills Improvement System Rating Scales to provide an understanding of each child’s school adjustment. The relationship between child characteristics and school outcomes was evaluated.
RESULTS Cognitive ability and adaptive behaviour were shown to be associated with successful transition to school outcomes including participation in the classroom and being comfortable with the classroom teacher. These factors were also associated with social skills in the classroom including assertiveness and engagement.
CONCLUSION Supporting children on the spectrum in the domains of adaptive behaviour and cognitive ability, including language skills, is important for a successful transition to school. Providing the appropriate support within structured transition programs will assist children on the spectrum with this important transition, allowing them to maximise their learning and behavioural potential.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Child Psychiatry, South West Sydney (AUCS), ICAMHS, Mental Health Centre, L1, Liverpool Hospital, Liverpool 2170, Australia
- School of Psychiatry, University of New South Wales, Sydney 2052, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
| | - Rachel Grove
- School of Psychiatry, University of New South Wales, Sydney 2052, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
| | - Elizabeth Aylward
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- KU Marcia Burgess Autism Specific Early Learning and Care Centre, Liverpool 2170, Australia
| | - Annette V Joosten
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- School of Occupational Therapy and Social Work, Curtin University, Perth 6000, Australia
| | - Scott I Miller
- Western Australia Autism Specific Early Learning and Care Centre, Bedford 6052, Australia
- Autism Association of Western Australia, Perth 6000, Australia
| | - Gerdamari Van Der Watt
- Western Australia Autism Specific Early Learning and Care Centre, Bedford 6052, Australia
- Autism Association of Western Australia, Perth 6000, Australia
| | - Kathryn Fordyce
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- St Giles Society North West Tasmania Autism Specific Early Learning and Care Centre, Burnie 7320, Australia
| | - Cheryl Dissanayake
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- La Trobe University, Melbourne 3000, Australia
| | - Jacqueline Maya
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- La Trobe University, Melbourne 3000, Australia
| | - Madonna Tucker
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- AEIOU Foundation, Nathan 4111, Australia
| | - Antonia DeBlasio
- Cooperative Research Centre for Living with Autism (Autism CRC), Long Pocket 4850, Australia
- AnglicareSA Daphne St Autism Specific Early Learning and Care Centre, Prospect 5082, Australia
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Helland WA, Helland T. Emotional and behavioural needs in children with specific language impairment and in children with autism spectrum disorder: The importance of pragmatic language impairment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 70:33-39. [PMID: 28886424 DOI: 10.1016/j.ridd.2017.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Language problems may negatively affect children's behaviour and have detrimental effects on the development of peer-relations. AIMS We investigated and compared emotional and behavioural profiles in children with SLI and in children with ASD aged 6-15 years and explored to what extent pragmatic language problems contributed to the emotional and behavioural needs (EBN) in these clinical groups. METHODS AND PROCEDURES The ASD group consisted of 23 children (19 boys; 4 girls) and the SLI group consisted of 20 children (18 boys; 2 girls). In order to assess EBN and language abilities, the Strength and Difficulties Questionnaire (SDQ) and the Children's Communication Checklist -2 (CCC-2) were filled out by parents. OUTCOMES AND RESULTS Our main findings were that although EBN was common in both groups; the children in the ASD group were significantly impaired relative to the children in the SLI group. However, in both groups pragmatic language problems were found to be significantly associated with EBN. IMPLICATIONS A comprehensive assessment of EBN as well as pragmatic language abilities should be an integral part of the assessment procedure. Considering the substantial influence of pragmatic language abilities on social function and in resolving interpersonal conflicts with peers further development of therapy plans and interventions targeting pragmatics is strongly needed.
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Affiliation(s)
- Wenche Andersen Helland
- Section of Research and Innovation, Helse Fonna Health Authority, Norway; Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009 Bergen, Norway.
| | - Turid Helland
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009 Bergen, Norway
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Marsh A, Spagnol V, Grove R, Eapen V. Transition to school for children with autism spectrum disorder: A systematic review. World J Psychiatry 2017; 7:184-196. [PMID: 29043156 PMCID: PMC5632603 DOI: 10.5498/wjp.v7.i3.184] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/29/2017] [Accepted: 07/03/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To identify factors that promote a positive start to school for children with autism spectrum disorder (ASD).
METHODS Web of Science, MEDLINE, Scopus, and PsychINFO searches were conducted to identify literature published after 1991 and relevant to school transition processes in children with ASD. Twenty studies were deemed eligible for inclusion. These studies evaluated a range of factors including school readiness, parent and teacher perspectives on transition practices, characteristics of children with ASD that are associated with successful transition to school and the impact of school based intervention programs.
RESULTS A review of these studies showed that children with ASD are less school ready emotionally than their peers and those children with ASD appear to have more externalising behaviours and self-regulation difficulties that affect their school engagement and their relationships with their teachers. There was a paucity of research looking at interventions targeting school readiness. However, school-based behavioural interventions appear to improve cognitive, language and daily living skills, but have less impact on socialisation and peer inclusion.
CONCLUSION Children with ASD face more challenges transitioning to school, particularly with social interaction. Further development and implementation of specific school-based interventions is needed in order to assist children with autism to maximise their success in starting school.
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Affiliation(s)
- Annabel Marsh
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool Hospital, Liverpool NSW 2170, Australia
| | - Vanessa Spagnol
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool Hospital, Liverpool NSW 2170, Australia
| | - Rachel Grove
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool Hospital, Liverpool NSW 2170, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), St Lucia QLD 4067, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney NSW 2052, Australia
- Academic Unit of Child Psychiatry, South West Sydney Local Health District, Liverpool Hospital, Liverpool NSW 2170, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), St Lucia QLD 4067, Australia
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26
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Billstedt E, Anckarsäter H, Wallinius M, Hofvander B. Neurodevelopmental disorders in young violent offenders: Overlap and background characteristics. Psychiatry Res 2017; 252:234-241. [PMID: 28285251 DOI: 10.1016/j.psychres.2017.03.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 02/10/2017] [Accepted: 03/03/2017] [Indexed: 12/14/2022]
Abstract
Neurodevelopmental disorders (Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), tic disorder, intellectual disability (ID)), in prison populations have received increased attention but the focus has generally been on one single condition leaving out the global picture. This study assessed the prevalence and overlap of neurodevelopmental disorders (NDD) in a consecutive cohort (n=270) of young adult male offenders (age 18-25 years), sentenced for "hands-on" violent offences and serving prison time in Swedish prisons. Seventy-one percent of all who met inclusion criteria participated. Comprehensive clinical assessments were carried out including history of early antisocial behavior and maladjustment, self-report questionnaires and an intelligence test. Sixty-three percent of the study group met DSM-IV criteria for childhood ADHD, 43% for ADHD in adulthood, 10% met criteria for an ASD, 6% for Tourette syndrome, and 1% for ID. Twenty-two percent had borderline intellectual functioning. A substantial rate of overlap between the NDDs was found. The combined NDD group had an earlier onset of antisocial behavior, had more aggressive behavior and lower school achievements than the non-NDD group. The results highlight the need for prison and probation services to be attentive of and screen for neurodevelopmental disorders in young violent offenders.
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Affiliation(s)
- Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
| | - Henrik Anckarsäter
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Märta Wallinius
- Forensic Psychiatry, Department of Clinical Sciences, Lund University, Lund, Sweden; Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - Björn Hofvander
- Lund University, Faculty of Medicine, Department of Clinical Sciences, Child and Adolescent Psychiatry, Lund, Sweden; Division of Forensic Psychiatry, Region Skåne, Sweden
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27
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Cummings L. Cognitive Aspects of Pragmatic Disorders. PERSPECTIVES IN PRAGMATICS, PHILOSOPHY & PSYCHOLOGY 2017. [DOI: 10.1007/978-3-319-47489-2_22] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wieckowski AT, Coffman MC, Kim-Spoon J, White SW, Richey JA, Ollendick TH. Impaired fear recognition and social anxiety symptoms in adolescence. JOURNAL OF CHILD AND FAMILY STUDIES 2016; 25:3381-3386. [PMID: 28082827 PMCID: PMC5222562 DOI: 10.1007/s10826-016-0491-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study represents the first examination of adolescent anxiety in relation to peer emotion recognition, rather than adult emotion recognition. Additionally, we examine potential mechanisms for the development of Social Anxiety in females. Facial emotion recognition (FER) is important for accurate social cognition, which is impaired in individuals with various disorders, including anxiety disorders. Social anxiety often onsets during adolescence, is observed more commonly in females, and is often associated with FER difficulties. Given the importance of peer interaction during adolescence, and some evidence that FER may differ as a function of the stimuli (adolescent or adult faces), we sought to study FER in relation to social anxiety symptoms using stimuli portraying adolescent faces. Male and female adolescents (N=64) completed an online survey in which they rated 257 child and adolescent emotional faces and completed a self-report measure of social anxiety symptoms. We examined differences in emotion recognition (e.g., fear, anger, sadness) between individuals with high and low levels of social anxiety symptoms. Adolescents with high social anxiety symptoms were more likely to have problems correctly identifying fearful expressions (90.55% accuracy) compared to adolescents with low social anxiety symptoms (96.00% accuracy; t = 2.375, p = .021, d = 0.594), and this effect was observed exclusively in female adolescents. The observed sex difference in accurate identification of fearful faces in relation to social anxiety could suggest a potential mechanism for social anxiety development in adolescent females.
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Affiliation(s)
| | - Marika C. Coffman
- Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, Virginia, USA
| | - Jungmeen Kim-Spoon
- Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, Virginia, USA
| | - Susan W. White
- Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, Virginia, USA
| | - John A. Richey
- Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, Virginia, USA
| | - Thomas H. Ollendick
- Virginia Polytechnic Institute and State University, Department of Psychology, Blacksburg, Virginia, USA
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Cognitive and affective components of Theory of Mind in preschoolers with oppositional defiance disorder: Clinical evidence. Psychiatry Res 2016; 241:128-34. [PMID: 27173657 DOI: 10.1016/j.psychres.2016.04.082] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 04/22/2016] [Accepted: 04/22/2016] [Indexed: 11/23/2022]
Abstract
The goal of the study was to examine the affective-cognitive components of Theory of Mind (ToM), in a community sample of 538 preschoolers, and more specifically in a subsample of 40 children diagnosed with ODD. The relationship between affective and cognitive ToM and some ODD clinical characteristics was examined. Children were assessed with structured diagnostic interviews and dimensional measures of psychopathology, impairment and unemotional traits. A measure based on eye-gaze was used to assess ToM. Mixed analysis of variance compared the mean cognitive versus affective scale scores and the between-subjects factor ODD. The association between ToM-scores and clinical measures was assessed through correlation models. Execution and reaction time to emotional and cognitive components of ToM tasks are different at age 5 in normally developing children. Oppositional Defiant children had slower response time when performing the affective mentalizing condition than children without the disorder. The correlation matrix between ToM-scores and clinical measures showed specific associations depending on the impaired ToM aspect and the psychological domain. Results may have clinical implications for the prevention and management of ODD.
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Trubanova A, Kim I, Coffman MC, Bell MA, Richey JA, LaConte SM, Gracanin D, White SW. The Role of Perspective-Taking on Ability to Recognize Fear. CURRENT RESEARCH IN PSYCHOLOGY 2016; 6:22-30. [PMID: 28105290 PMCID: PMC5241087 DOI: 10.3844/crpsp.2015.22.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Impairment in the ability to detect certain emotions, such as fear, is linked to multiple disorders and follows a pattern of inter-individual variability and intra-individual stability over time. Deficits in fear recognition are often related to social and interpersonal difficulties but the mechanisms by which this processing deficit might occur are not well understood. One potential mechanism through which impaired fear detection may influence social competency is through diminished perspective-taking, the ability to perceive and consider the point of view of another individual. In the current study, we hypothesized that intra-individual variability in the accuracy of facial emotion recognition is linked to perspective-taking abilities in a well-characterized, non-clinical adult sample. Results indicated that the ability to accurately detect fear in the faces of others was positively correlated with perspective-taking, consistent with initial hypotheses. This relationship appeared to be unique to recognition of fear, as perspective-taking was not significantly associated with recognition of the other basic emotions. Results from this study represent an initial step towards establishing a potential mechanism between some processes of FER and perspective-taking difficulties. It is important to establish the relationship between these processes in a non-clinical adult sample so that we can consider the possibility of a developmental or pathological influence of impoverished perspective-taking on fear perception.
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Affiliation(s)
- Andrea Trubanova
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Inyoung Kim
- Department of Statistics, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Marika C. Coffman
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Martha Ann Bell
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - J. Anthony Richey
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Stephen M. LaConte
- Department of Biomedical Engineering and Sciences, Virginia Tech Carilion Research Institute, Roanoke, Virginia, USA
| | - Denis Gracanin
- Department of Computer Science, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Susan W. White
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
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Mandy W, Murin M, Baykaner O, Staunton S, Cobb R, Hellriegel J, Anderson S, Skuse D. Easing the transition to secondary education for children with autism spectrum disorder: An evaluation of the Systemic Transition in Education Programme for Autism Spectrum Disorder (STEP-ASD). AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:580-90. [PMID: 26304678 PMCID: PMC4887819 DOI: 10.1177/1362361315598892] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In mainstream education, the transition from primary to secondary school (‘school transition’) is difficult for children with autism spectrum disorder, being marked by high levels of emotional and behavioural difficulties. The Systemic Transition in Education Programme for Autism Spectrum Disorder (STEP-ASD) is a new, manualised school transition intervention. We investigated its feasibility and efficacy for children diagnosed with autism spectrum disorder (N = 37; mean age = 11.47 years; mean IQ = 85.24) using an unblinded, non-randomised, controlled design. Teachers found the intervention feasible and acceptable. Children receiving STEP-ASD (n = 17) showed a large (Cohen’s d = 0.88) reduction in school-reported emotional and behavioural difficulties, whereas controls (n = 20) showed a slight increase (d = −0.1) (p = 0.010). These encouraging findings suggest the value of STEP-ASD as a low-intensity intervention for reducing problem behaviours and distress in children with autism spectrum disorder as they transition to mainstream secondary school.
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Mohammadzaheri F, Koegel LK, Rezaee M, Rafiee SM. A randomized clinical trial comparison between pivotal response treatment (PRT) and structured applied behavior analysis (ABA) intervention for children with autism. J Autism Dev Disord 2015; 44:2769-77. [PMID: 24840596 DOI: 10.1007/s10803-014-2137-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Accumulating studies are documenting specific motivational variables that, when combined into a naturalistic teaching paradigm, can positively influence the effectiveness of interventions for children with autism spectrum disorder (ASD). The purpose of this study was to compare two applied behavior analysis (ABA) intervention procedures, a naturalistic approach, pivotal response treatment (PRT) with a structured ABA approach in a school setting. A randomized clinical trial design using two groups of children, matched according to age, sex and mean length of utterance was used to compare the interventions. The data showed that the PRT approach was significantly more effective in improving targeted and untargeted areas after 3 months of intervention. The results are discussed in terms of variables that produce more rapid improvements in communication for children with ASD.
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Affiliation(s)
- Fereshteh Mohammadzaheri
- Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
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33
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Moul C, Cauchi A, Hawes DJ, Brennan J, Dadds MR. Differentiating autism spectrum disorder and overlapping psychopathology with a brief version of the social responsiveness scale. Child Psychiatry Hum Dev 2015; 46:108-17. [PMID: 24604214 DOI: 10.1007/s10578-014-0456-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The Social Responsiveness Scale (SRS) is a well-established measure of autism spectrum disorder (ASD), yet it is known to suffer reduced specificity in samples of children with comorbid emotional or behavioural problems. This research examined the specificity of the SRS in children with mixed presentations of internalising and externalising psychopathology and ASD. Participants were 522 (397 male) children aged between 4 and 16 years. The associations between SRS total scores and diagnoses were determined using partial correlations and analyses of variance. A subsample of participants with a single diagnosis was used to identify a subset of questions that distinguished between ASD and all other diagnoses. These items were used to create the 16-item SRS-brief. The SRS was found to have good reliability and sensitivity but poor specificity. The SRS-brief had good psychometric properties and was found to be a more accurate tool for the screening of ASD than the original SRS.
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Affiliation(s)
- Caroline Moul
- School of Psychology, University of New South Wales, Sydney, Australia,
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Mandy W, Murin M, Baykaner O, Staunton S, Hellriegel J, Anderson S, Skuse D. The transition from primary to secondary school in mainstream education for children with autism spectrum disorder. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2015; 20:5-13. [PMID: 25576142 PMCID: PMC4702244 DOI: 10.1177/1362361314562616] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The transition from primary to secondary education (hereafter ‘school transition’) is a major ecological shift that poses considerable social, emotional, academic and organisational challenges. It is commonly assumed that this school transition is especially difficult for children with autism spectrum disorder, but that idea is mainly based on anecdotal evidence and requires systematic investigation. We describe change and continuity for children with autism spectrum disorder (N = 28, mean age = 11.29 years, mean full-scale IQ = 87.86) transitioning in mainstream education from primary to secondary school. Levels of psychopathology, adaptive functioning and peer victimisation were measured by parent, self and teacher report in the last year of primary school, and again after one term of secondary school. At follow-up, all participants were still in their secondary school, and there was no evidence for a marked escalation of difficulties during the transition. Instead, we observed high levels of psychopathology and maladaption at baseline which persisted across the transition and were in some cases under-recognised. By parent report, levels of bullying fell from primary to secondary school. Future research should investigate factors, such as school characteristics, that influence the move to secondary education in autism spectrum disorder, to inform the development of interventions to promote successful school transition.
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35
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Murphy SM, Faulkner DM, Reynolds LR. A randomised controlled trial of a computerised intervention for children with social communication difficulties to support peer collaboration. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2821-2839. [PMID: 25104223 DOI: 10.1016/j.ridd.2014.07.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 07/14/2014] [Indexed: 06/03/2023]
Abstract
An intervention aiming to support children with social communication difficulties was tested using a randomised controlled design. Children aged 5-6 years old (n=32) were tested and selected for participation on the basis of their scores on the Test of Pragmatic Skills (TPS) and were then randomly assigned to the intervention arm or to the delayed intervention control group. Following previous research which suggested that computer technology may be particularly useful for this group of children, the intervention included a collaborative computer game which the children played with an adult. Subsequently, children's performance as they played the game with a classmate was observed. Micro-analytic observational methods were used to analyse the audio-recorded interaction of the children as they played. Pre- and post-intervention measures comprised the Test of Pragmatic Skills, children's performance on the computer game and verbal communication measures that the children used during the game. This evaluation of the intervention shows promise. At post-test, the children who had received the intervention, by comparison to the control group who had not, showed significant gains in their scores on the Test of Pragmatic Skills (p=.009, effect size r=-.42), a significant improvement in their performance on the computer game (p=.03, r=-.32) and significantly greater use of high-quality questioning during collaboration (p<.001, r=-.60). Furthermore, the children who received the intervention made significantly more positive statements about the game and about their partners (p=.02, r=-.34) suggesting that the intervention increased their confidence and enjoyment.
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Affiliation(s)
- Suzanne M Murphy
- Institute for Health Research, University of Bedfordshire, Putteridge Bury, Hitchin Road, Luton, Bedfordshire LU2 8LE, United Kingdom.
| | - Dorothy M Faulkner
- Faculty of Education and Language Studies, Open University, Walton Hall, Milton Keynes MK7 6AA, United Kingdom
| | - Laura R Reynolds
- Child and Adolescent Mental Health Services, Beech Close Resource Centre, Beech Road, Dunstable, Bedfordshire LU6 3SD, United Kingdom
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White SW, Richey JA, Gracanin D, Bell MA, LaConte S, Coffman M, Trubanova A, Kim I. The Promise of Neurotechnology in Clinical Translational Science. Clin Psychol Sci 2014; 3:797-815. [PMID: 26504676 DOI: 10.1177/2167702614549801] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neurotechnology is broadly defined as a set of devices used to understand neural processes and applications that can potentially facilitate the brain's ability to repair itself. In the past decade, an increasingly explicit understanding of basic biological mechanisms of brain-related illnesses has produced applications that allow a direct yet noninvasive method to index and manipulate the functioning of the human nervous system. Clinical scientists are poised to apply this technology to assess, treat, and better understand complex socioemotional processes that underlie many forms of psychopathology. In this review, we describe the potential benefits and hurdles, both technical and methodological, of neurotechnology in the context of clinical dysfunction. We also offer a framework for developing and evaluating neurotechnologies that is intended to expedite progress at the nexus of clinical science and neural interface designs by providing a comprehensive vocabulary to describe the necessary features of neurotechnology in the clinic.
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Parker C, Whear R, Ukoumunne OC, Bethel A, Thompson-Coon J, Stein K, Ford T. School exclusion in children with psychiatric disorder or impairing psychopathology: a systematic review. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2014. [DOI: 10.1080/13632752.2014.945741] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Wright B, Marshall D, Collingridge Moore D, Ainsworth H, Hackney L, Adamson J, Ali S, Allgar V, Cook L, Dyson L, Littlewood E, Hargate R, McLaren A, McMillan D, Trépel D, Whitehead J, Williams C. Autism Spectrum Social Stories In Schools Trial (ASSSIST): study protocol for a feasibility randomised controlled trial analysing clinical and cost-effectiveness of Social Stories in mainstream schools. BMJ Open 2014; 4:e005952. [PMID: 25009139 PMCID: PMC4091400 DOI: 10.1136/bmjopen-2014-005952] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Current evidence suggests that Social Stories can be effective in tackling problem behaviours exhibited by children with autism spectrum disorder. Exploring the meaning of behaviour from a child's perspective allows stories to provide social information that is tailored to their needs. Case reports in children with autism have suggested that these stories can lead to a number of benefits including improvements in social interactions and choice making in educational settings. METHODS AND ANALYSIS The feasibility of clinical and cost-effectiveness of a Social Stories toolkit will be assessed using a randomised control framework. Participants (n=50) will be randomised to either the Social Stories intervention or a comparator group where they will be read standard stories for an equivalent amount of time. Statistics will be calculated for recruitment rates, follow-up rates and attrition. Economic analysis will determine appropriate measures of generic health and resource use categories for cost-effectiveness analysis. Qualitative analysis will ascertain information on perceptions about the feasibility and acceptability of the intervention. ETHICS AND DISSEMINATION National Health Service Ethics Approval (NHS; ref 11/YH/0340) for the trial protocol has been obtained along with NHS Research and Development permission from Leeds and York Partnership NHS Foundation Trust. All adverse events will be closely monitored, documented and reported to the study Data Monitoring Ethics Committee. At least one article in a peer reviewed journal will be published and research findings presented at relevant conferences. TRIAL REGISTRATION NUMBER ISRCTN96286707.
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Affiliation(s)
| | | | | | | | | | - Joy Adamson
- York Trials Unit, Department of Health Sciences, York, UK
| | - Shehzad Ali
- Department of Health Sciences, University of York, York, UK
| | | | - Liz Cook
- York Trials Unit, Department of Health Sciences, York, UK
| | - Lisa Dyson
- York Trials Unit, Department of Health Sciences, York, UK
| | | | | | | | - Dean McMillan
- Department of Health Sciences, University of York, York, UK
| | - Dominic Trépel
- Department of Health Sciences, University of York, York, UK
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Helland WA, Lundervold AJ, Heimann M, Posserud MB. Stable associations between behavioral problems and language impairments across childhood - the importance of pragmatic language problems. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:943-951. [PMID: 24642228 DOI: 10.1016/j.ridd.2014.02.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 02/18/2014] [Accepted: 02/21/2014] [Indexed: 06/03/2023]
Abstract
This study investigated language function associated with behavior problems, focusing on pragmatics. Scores on the Children's Communication Checklist Second Edition (CCC-2) in a group of 40 adolescents (12-15 years) identified with externalizing behavior problems (BP) in childhood was compared to the CCC-2 scores in a typically developing comparison group (n=37). Behavioral, emotional and language problems were assessed by the Strengths and Difficulties Questionnaire (SDQ) and 4 language items, when the children in the BP group were 7-9 years (T1). They were then assessed with the SDQ and the CCC-2 when they were 12-15 years (T2). The BP group obtained poorer scores on 9/10 subscales on the CCC-2, and 70% showed language impairments in the clinical range. Language, emotional and peer problems at T1 were strongly correlated with pragmatic language impairments in adolescence. The findings indicate that assessment of language, especially pragmatics, is vital for follow-up and treatment of behavioral problems in children and adolescents.
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Affiliation(s)
- Wenche Andersen Helland
- Department of Psychiatry, Helse Fonna HF, Stord Hospital, 5414 Stord, Norway; Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway; Department of Speech and Language Disorders, Statped vest, P.O. Box 6039, 5892 Bergen, Norway.
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, P.O. Box 7800, 5020 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health; Uni Research, P. O. Box 7800, 5032 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
| | - Mikael Heimann
- Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden; The Swedish Institute of Disability Research, Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden
| | - Maj-Britt Posserud
- Department of Child and Adolescent Psychiatry, Haukeland University Hospital, 5021 Bergen, Norway; Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Health; Uni Research, P. O. Box 7800, 5032 Bergen, Norway; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway
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Norbury CF. Practitioner review: Social (pragmatic) communication disorder conceptualization, evidence and clinical implications. J Child Psychol Psychiatry 2014; 55:204-16. [PMID: 24117874 DOI: 10.1111/jcpp.12154] [Citation(s) in RCA: 136] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/16/2013] [Indexed: 12/13/2022]
Abstract
BACKGROUND DSM-5 sees the introduction of Social (Pragmatic) Communication Disorder (SPCD), characterized by persistent difficulties using verbal and nonverbal communication for social purposes, in the absence of restricted and repetitive interests and behaviours. There is currently much confusion about the precise diagnostic criteria for SPCD and how this disorder relates to autism spectrum disorders (ASD), previous descriptions of pragmatic language impairment (PLI) and more specific language disorders (LD). METHOD Proposed criteria for SPCD are outlined. A selective review of the evidence considers whether these criteria form a cohesive and distinct diagnostic entity. Approaches to assessment and intervention are discussed. RESULTS Implementing the new diagnosis is currently challenged by a lack of well-validated and reliable assessment measures, and observed continuities between SPCD and other neurodevelopmental disorders. High rates of comorbidity between SPCD and other seemingly disparate disorders (including conduct disorder, ADHD and disorders of known genetic origin) raise questions about the utility of this diagnostic category. CONCLUSIONS SPCD is probably best conceptualized as a dimensional symptom profile that may be present across a range of neurodevelopmental disorders, although there is an urgent need to investigate the latent structure of SPCD using consistent diagnostic criteria. In addition, social communication and aspects of pragmatic language may be dissociated, with the latter heavily influenced by structural language attainments. Finally, there is a dearth of reliable and culturally valid assessment measures with which to make a differential diagnosis, and few rigorously tested intervention programmes. The implications for research and clinical practice are outlined.
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41
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Vloet TD, Großheinrich N, Konrad K, Freitag C, Herpertz-Dahlmann B. [Female conduct disorders]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2014; 42:95-107; quiz 107-8. [PMID: 24571815 DOI: 10.1024/1422-4917/a000276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The last few years have seen much research on girls with conduct disorder (CD). This article summarizes the gender-specific data regarding prevalence, differences with respect to symptomatology (e.g., subtypes of aggression, callous-unemotional (cu)-traits), and it presents data on the autonomic and neuroendocrine stress system as well as genetic, neurocognitive, and neuroimaging data. Differences in the impact of environmental factors on boys and girls for the development of CD are discussed. Taken together, the data indicate that there is great overlap in symptomatology, personality traits, and neurobiological aberrations in girls and boys with CD. Since fewer girls than boys exhibit CD symptomatology, further investigations on CD in girls might help to identify resilience factors that could improve future therapeutic interventions.
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Affiliation(s)
- Timo D Vloet
- Klinik für Kinder- und Jugendpsychiatrie, RWTH Aachen
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42
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de la Osa N, Granero R, Penelo E, Ezpeleta L. Usefulness of the Social and Communication Disorders Checklist (SCDC) for the Assessment of Social Cognition in Preschoolers. EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2014. [DOI: 10.1027/1015-5759/a000193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study provides data on the usefulness of the Spanish version of the Social and Communication Disorders Checklist (SCDC; Skuse et al., 1997 ), in terms of the validity and reliability of derived scores. Data were obtained from parents’ interviews and parents’ and teachers’ questionnaires that measured different psychological variables from a community sample of 579 (291 boys and 288 girls), 5-year-old children. These children were tested to assess their intellectual capacity. Confirmatory factor analyses yield a one-dimensional structure invariant across sex within each informant (parents or teachers), with negligible latent mean differences between boys and girls for both informants (parents-teachers). The internal consistency was satisfactory (alpha values ≥ .85 for teacher version and ≥ .75 for parent version). SCDC scores correlated with specific scales related to developmental problems, aggressive behavior, executive functioning, and uncaring behavior toward others. SCDC scores were unrelated to intelligence quotient, whereas SCDC scores were associated with the presence of disruptive disorders, measured with diagnostic interview. Results provide evidence on reliability and validity of SCDC scores, which is potentially a useful measure for the study of social cognition and its relationship with preschool adjustment.
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Affiliation(s)
- Nuria de la Osa
- Unitat d’Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Spain
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Roser Granero
- Unitat d’Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Spain
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Eva Penelo
- Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Lourdes Ezpeleta
- Unitat d’Epidemiologia i de Diagnòstic en Psicopatologia del Desenvolupament, Universitat Autònoma de Barcelona, Spain
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
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Schwenck C, Ciaramidaro A. Soziale Kognition bei Autismus-Spektrum-Störungen und Störungen des Sozialverhaltens. KINDHEIT UND ENTWICKLUNG 2014. [DOI: 10.1026/0942-5403/a000125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Soziale Kognition umfasst eine Reihe von impliziten und expliziten Informationsverarbeitungsprozessen, die im Rahmen der sozialen Interaktion stattfinden, wie zum Beispiel die implizite Aufmerksamkeitszuwendung, die Emotionserkennung oder die Theory of Mind. Defizite in der sozialen Kognition werden im Zusammenhang mit Störungsbildern, zu deren Kernsymptomatik eine Störung in der sozialen Interaktion zählt, angenommen, darunter Autismus-Spektrum-Störungen (ASS) und Störungen des Sozialverhaltens (SSV). Die vorliegende Übersichtsarbeit gibt einen Einblick in den derzeitigen Forschungsstand mit einem Fokus auf Verhaltens- und Bildgebungsstudien über verschiedene Prozesse der sozialen Kognition bei diesen beiden Störungsbildern.
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Affiliation(s)
- Christina Schwenck
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes und Jugendalters, Goethe-Universität Frankfurt am Main
| | - Angela Ciaramidaro
- Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes und Jugendalters, Goethe-Universität Frankfurt am Main
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Green BC, Johnson KA, Bretherton L. Pragmatic language difficulties in children with hyperactivity and attention problems: an integrated review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2014; 49:15-29. [PMID: 24372883 DOI: 10.1111/1460-6984.12056] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Diagnostic criteria for attention deficit hyperactivity disorder (ADHD) suggest a range of difficulties in the pragmatic aspects of language, including excessive talking and interrupting others. Such difficulties have been periodically reported over several decades in studies on the language abilities of children with features of ADHD, yet a comprehensive review of the literature has been lacking. AIMS This review aims to integrate evidence from several lines of research from 1979 to the present on pragmatic language difficulties in children with ADHD or symptoms of ADHD. METHODS & PROCEDURES A comprehensive search of empirical literature on pragmatic language in children with ADHD or symptoms of ADHD was conducted using PsycINFO and PubMed databases and through following up relevant references cited in articles. Literature was reviewed with respect to the nature and extent of pragmatic language difficulties in ADHD. OUTCOMES & RESULTS Thirty studies met the review inclusion criteria, including recent questionnaire studies, observational studies of children's communication patterns, and studies of higher-level language comprehension and production. The studies indicate a consistent profile of pragmatic language impairments in children with features of ADHD, particularly in the areas of excessive talking, poor conversational turn-taking, and lack of coherence and organization in elicited speech. CONCLUSIONS & IMPLICATIONS Pragmatic language difficulties are common in children with features of ADHD. These difficulties are consistent with deficits in executive function that are thought to characterize ADHD, thus providing some support for the theory that executive function contributes to pragmatic language competency. As yet there is very little empirical evidence of specific relationships between particular aspects of pragmatic language and particular domains of executive function. Given the importance of pragmatic language competency for children's social and academic functioning, pragmatic language abilities should be considered during clinical assessment for ADHD and targeted for intervention.
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Affiliation(s)
- Benita C Green
- Melbourne School of Psychological Sciences, University of Melbourne, VIC, Australia
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45
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Charlton JJ, Law J. ‘The Story in a Box’: measuring the online communication behaviours of children identified as having emotional and behavioural difficulties using LENA and Noldus Observer. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2013. [DOI: 10.1080/13632752.2013.854957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Szczepaniak D, McHenry MS, Nutakki K, Bauer NS, Downs SM. The prevalence of at-risk development in children 30 to 60 months old presenting with disruptive behaviors. Clin Pediatr (Phila) 2013; 52:942-9. [PMID: 23836809 DOI: 10.1177/0009922813493832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study assessed the prevalence of failed developmental screens in 30- to 60-month-old children who presented with a behavioral complaint of disruptive behavior to a referral clinic. METHODS A retrospective chart review was performed in a specialty behavioral pediatric clinic. Outcome measures were obtained from children referred to the clinic with parental concern of disruptive behavior. RESULTS Out of 151 patients, 66% (99/151) had been screened for developmental delays with a formal screening instrument. Of these, 71% (70/99) failed developmental screening in one or more domains. CONCLUSIONS Preschoolers referred to a behavioral clinic for parental concerns of disruptive behaviors were more than 4 times more likely to be at risk for developmental delays than the general population, with a majority of suspected delays in communication and problem-solving domains. This finding suggests that developmental screening should be a part of the initial workup for children with disruptive behaviors.
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Mandy W, Skuse D, Steer C, St Pourcain B, Oliver BR. Oppositionality and socioemotional competence: interacting risk factors in the development of childhood conduct disorder symptoms. J Am Acad Child Adolesc Psychiatry 2013; 52:718-27. [PMID: 23800485 DOI: 10.1016/j.jaac.2013.04.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 02/07/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Oppositional behavior in childhood is a probabilistic risk factor for the subsequent development of more serious conduct problems characteristic of conduct disorder (CD). The capacity to understand the subjective states of others (socioemotional competence) helps regulate antisocial behavior in typical development. We hypothesized that socioemotional competence moderates the developmental relationship between oppositionality and CD symptoms, such that oppositional defiant disorder (ODD) symptoms pose the greatest risk for subsequent CD symptoms in children with poor socioemotional competence. METHOD Parent-report data were collected for 6,218 children at 7 and 10 years of age. Bootstrap multiple regression predicting CD symptoms at age 10 was used to test for an interaction between socioemotional competence and ODD symptoms, while also accounting for direct effects and controlling for sex, maternal education, attention-deficit/hyperactivity disorder symptoms, and CD symptoms at 7 years. We further tested whether the interaction applied to both males and females, and to both aggressive and rule-breaking CD symptoms. RESULTS A significant interaction was found between ODD and socioemotional competence: the association between oppositionality at 7 years and CD traits at 10 years was strongest for children with poor socioemotional capacities. As predicted, this moderation effect was significant in a model predicting aggression, but it was not significant for rule-breaking CD symptoms. CONCLUSION Socioemotional competence moderates the developmental relationship between mid-childhood oppositionality and more serious conduct problems in later childhood. A capacity to understand the subjective states of others may buffer the risk posed by oppositionality for later CD symptoms, including aggression.
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Affiliation(s)
- William Mandy
- Department of Clinical, Education and Health Psychology, University College London, UK.
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Bons D, van den Broek E, Scheepers F, Herpers P, Rommelse N, Buitelaaar JK. Motor, Emotional, and Cognitive Empathy in Children and Adolescents with Autism Spectrum Disorder and Conduct Disorder. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 41:425-43. [DOI: 10.1007/s10802-012-9689-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Richmond NE, Tran T, Berry S. Can the Medical Home eliminate racial and ethnic disparities for transition services among Youth with Special Health Care Needs? Matern Child Health J 2012; 16:824-33. [PMID: 21505782 DOI: 10.1007/s10995-011-0785-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The Medical Home (MH) is shown to improve health outcomes for Youth with Special Health Care Needs (YSHCN). Some MH services involve Transition from pediatric to adult providers to ensure YSHCN have continuous care. Studies indicate racial/ethnic disparities for Transition, whereas the MH is shown to reduce health disparities. This study aims to (1) Determine the Transition rate for YSHCN with a MH (MH Transition) nationally, and by race/ethnicity (2) Identify which characteristics are associated with MH Transition (3) Determine if racial/ethnic disparities exist after controlling for associated characteristics, and (4) Identify which characteristics are uniquely associated with each race/ethnic group. National survey data were used. YSCHN with a MH were grouped as receiving Transition or not. Characteristics included race, ethnicity (Non-Hispanic (NH), Hispanic), sex, health condition effect, five special health care need categories, education, poverty, adequate insurance, and urban/rural residence. Frequencies, chi-square, and logistic regression were used to calculate rates and define associations. Alpha was set to 0.05. About 57.0% of YSHCN received MH Transition. Rates by race/ethnicity were 59.0, 45.5, 60.2, 41.9, and 44.6% for NH-White, NH-Black, NH-Multiple race, NH-Other, and Hispanic YSHCN, respectively. Disparities remained between NH-White and NH-Black YSHCN. All characteristics except urban/rural status were associated. Adequate insurance was associated for all race/ethnic groups, except NH-Black YSHCN. Almost 57.0% of YSHCN received MH Transition. Disparities remained. Rates and associated characteristics differed by race/ethnic group. Culturally tailored interventions incorporating universal factors to improve MH Transition outcomes are warranted.
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Affiliation(s)
- Nicole E Richmond
- Louisiana State University Health Sciences Center School of Medicine, Department of Pediatrics, New Orleans, LA 70112, USA.
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Abstract
BACKGROUND The nosology of autism spectrum disorders (ASD) is at a critical point in history as the field seeks to better define dimensions of social-communication deficits and restricted/repetitive behaviors on an individual level for both clinical and neurobiological purposes. These different dimensions also suggest an increasing need for quantitative measures that accurately map their differences, independent of developmental factors such as age, language level and IQ. METHOD Psychometric measures, clinical observation as well as genetic, neurobiological and physiological research from toddlers, children and adults with ASD are reviewed. RESULTS The question of how to conceptualize ASDs along dimensions versus categories is discussed within the nosology of autism and the proposed changes to the DSM-5 and ICD-11. Differences across development are incorporated into the new classification frameworks. CONCLUSIONS It is crucial to balance the needs of clinical practice in ASD diagnostic systems, with neurobiologically based theories that address the associations between social-communication and restricted/repetitive dimensions in individuals. Clarifying terminology, improving description of the core features of ASD and other dimensions that interact with them and providing more valid and reliable ways to quantify them, both for research and clinical purposes, will move forward both practice and science.
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Affiliation(s)
- Catherine Lord
- Center for Autism and the Developing Brain, Weill-Cornell Medical College and New York Presbyterian Hospital/Westchester Division, White Plains, NY, USA
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