Bulletin of the Menninger Clinic : Evidence-Based Treatment and Conceptualization of Autism Spectrum Disorder - Septembre 2019

mercredi 18 septembre 2019

Le numéro de septembre 2019 du Bulletin of the Menninger Clinic est consacré au TSA :

Evidence-Based Treatment and Conceptualization of Autism Spectrum Disorder

1. Patriquin MA. Evidence-based treatment and conceptualization of autism spectrum disorder : Emotion regulation, social impairment, and anxiety as targets. Bull Menninger Clin ;2019 (Summer) ;83(3):199-204.

The goal of this special issue is to highlight innovative evidence-based treatments and conceptualizations of emotion regulation difficulties, social impairment, and anxiety in autism spectrum disorder (ASD). The issue is organized into these three highly linked constructs. Targeting these constructs effectively will help to ensure positive outcomes for youth and adults with ASD. It is clear that continued research is needed that creatively addresses emotion regulation problems, social impairment, and anxiety in ASD.

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2. Reyes NM, Pickard K, Reaven J. Emotion regulation : A treatment target for autism spectrum disorder. Bull Menninger Clin ;2019 (Summer) ;83(3):205-234.

Individuals with autism spectrum disorder (ASD) tend to experience difficulties with emotion regulation (ER). Treatments designed to address ER difficulties in individuals with ASD are emerging. The authors review cognitive-behavioral therapy (CBT) and mindfulness-based treatments that have focused on ER difficulties in youth and young adults with ASD. In general, these treatments addressing ER skills have included awareness of emotions/psychoeducation about emotions, frustration tolerance, and ER skills, as well as practice and use of these skills during group therapy that sometimes includes caregivers. The results from these interventions are encouraging for individuals with high-functioning ASD because ER skills tend to improve following treatment. The inclusion of ER in other ASD treatments is discussed.

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3. Factor RS, Swain DM, Antezana L, Muskett A, Gatto AJ, Radtke SR, Scarpa A. Teaching emotion regulation to children with autism spectrum disorder : Outcomes of the Stress and Anger Management Program (STAMP). Bull Menninger Clin ;2019 (Summer) ;83(3):235-258.

Young children with autism spectrum disorder (ASD) struggle with emotion regulation (ER), which is developmentally preceded by lability/negative affect (L/N), and their parents face unique challenges to parenting and providing assistance. The Stress and Anger Management Program (STAMP) is a cognitive-behavioral treatment designed to address ER deficits in young children with ASD through child skill-building and parent training. The current study evaluated child L/N, ER, and parental confidence outcomes in 4- to 7-year-old children with ASD (N = 23 ; 19 boys) and their parents randomly assigned to a treatment (n = 12) or a waitlist control group (n = 11). Child L/N decreased, regulation was not significantly changed, and parental confidence regarding the child’s ability to manage anger and anxiety increased from pre- to posttreatment in the treatment group, but not in the waitlist group. Implications for future interventions that address ER in children with ASD and their parents are discussed.

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4. Hartmann K, Urbano MR, Raffaele CT, Kreiser NL, Williams TV, Qualls LR, Elkins DE. Outcomes of an emotion regulation intervention group in young adults with autism spectrum disorder. Bull Menninger Clin ;2019 (Summer) ;83(3):259-277.

Individuals on the autism spectrum experience difficulties in social relationships and emotion regulation. The aim of the present exploratory research study was to develop and explore the effectiveness of a manualized emotion regulation group intervention for autistic adults to improve emotion regulation and social communication. The group participants included seven young adults (age > 18 years) on the autism spectrum. Primary outcome measures were the Social Responsiveness Scale (SRS-2) and the Emotion Regulation Questionnaire (ERQ). Group participants reported significant improvements on the Social Communication and Interaction subscale (SCI ; t = 2.601, p = .041), the Social Awareness (AWR ; t = 3.163, p = .019), and the Social Cognition (COG ; t = 4.861, p = .003) subscales of the SRS-2 : Self Report. Overall, this study provides preliminary evidence of the effectiveness of a group treatment approach that focuses on emotion regulation to improve social interactions for young adults on the autism spectrum.

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5. Simmons GL, Hilton DC, Jarrett MA, Tomeny TS, White SW. Considering equifinality in treatment planning for social impairment : Divergent paths in neurodevelopmental disorders. Bull Menninger Clin ;2019 (2019/09/01) ;83(3):278-300.

Youth with autism spectrum disorder (ASD) present with deficits in both social cognition and executive functioning (EF), which contribute to social impairment. Autistic youth are also frequently diagnosed with comorbid attention-deficit/hyperactivity disorder (ADHD), a disorder that, like ASD, includes impaired EF and social functioning. The comorbidity of ASD and ADHD may result in compounded social impairment, but prior research has not sufficiently evaluated the extent to which this comorbidity profile responds to evidence-based intervention targeting social deficits. It is conceivable that dually targeting EF and social cognition impairment will be more impactful than direct social skills training alone. The authors present an integrative model for intervention programming that examines pathways to social impairment in order to more effectively improve social skills and thereby impact both proximal (e.g., emotion expression, current peer relationships) and more distal outcomes (e.g., depression, self-esteem) in youth with ASD and other neurodevelopmental disorders.

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6. Marro BM, Kang E, Hauschild KM, Normansell KM, Abu-Ramadan TM, Lerner MD. Social performance-based interventions promote gains in social knowledge in the absence of explicit training for youth with autism spectrum disorder. Bull Menninger Clin ;2019 (Summer) ;83(3):301-325.

Youth with autism spectrum disorder (ASD) experience deficits in social knowledge. It has long been theorized that these youth must learn these skills explicitly, and social skills interventions (SSIs) have followed suit. Recently, performance-based SSIs have emerged, which promote in vivo opportunities for social engagement without explicit instruction. Effects of performance-based SSIs on social knowledge have not been examined. This study employs two discrete samples (one lab-based, one community-based) of youth with ASD to examine the effects of performance-based interventions on social knowledge. Results largely support the efficacy and effectiveness of improving social knowledge by performance-based interventions without explicit teaching. This indicates that youth with ASD may be able to learn these aspects of social cognition implicitly, rather than exclusively explicitly. The results of the current study also suggest that SSI content, dosage, and intensity may relate to these outcomes, which are important considerations in clinical practice and future studies.

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7. Hunsche MC, Kerns CM. Update on the effectiveness of psychotherapy for anxiety disorders in children and adolescents with ASD. Bull Menninger Clin ;2019 (Summer) ;83(3):326-352.

A growing body of research has examined the efficacy of varying formats (individual, group, linear, modular) of cognitive-behavioral therapy (CBT) as a treatment for anxiety disorders in children and youth with autism spectrum disorders (ASD). The present review utilized Chambless and Hollon’s (1998) criteria for efficacious treatments to : (1) critically review the current evidence base for the efficacy of CBT for anxiety disorders in ASD ; and (2) provide recommendations for future research. Findings identify two probably efficacious CBT programs (one group and one individual program) and five possibly efficacious programs, but no well-established programs. Similarities and differences in the components of these programs, which range from unmodified to specifically developed for ASD populations, are highlighted. In addition, the steps required to demonstrate well-established efficacy, and ultimately effectiveness, are discussed alongside other recommendations for refined future research.

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