An intervention for fears and phobias in young people with autism spectrum disorders using flat screen computer-delivered virtual reality and cognitive behaviour therapy / Morag MASKEY in Research in Autism Spectrum Disorders, 59 (March 2019)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 59 (March 2019) . - p.58-67 Titre : An intervention for fears and phobias in young people with autism spectrum disorders using flat screen computer-delivered virtual reality and cognitive behaviour therapy Type de document : Texte imprimé et/ou numérique Auteurs : Morag MASKEY, Auteur ; Helen MCCONACHIE, Auteur ; Jacqui RODGERS, Auteur ; Victoria GRAHAME, Auteur ; Jessica MAXWELL, Auteur ; Laura TAVERNOR, Auteur ; Jeremy R. PARR, Auteur Article en page(s) : p.58-67 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Virtual reality  Cognitive behavioural therapy  Anxiety  Phobia  Fear Index. décimale : PER Périodiques Résumé : Background Specific fears and phobias are common in young people with autism spectrum disorder (ASD) and can impact greatly on daily functioning. Traditional treatment methods, such as real-life or imaginal exposure, may not be suitable for this population without adaptation and alternative interventions are needed. In previous studies, we established that delivering graded exposure through computer generated scenes in a fully immersive virtual reality environment (the Blue Room) is an effective intervention for some young people with ASD and specific fears/phobias. In this study, we explored the same intervention delivered using flat screen, computer-delivered virtual reality graded exposure with cognitive behavioural therapy. Methods Eight young people with ASD received one psychoeducation session followed by four 20?minute sessions of flat screen, computer–delivered virtual reality graded exposure with cognitive behaviour therapy (CBT) sessions with a psychologist. Follow up measures, including Target Behaviour change ratings, were taken at 6 weeks, 6 months and 12 months after intervention. Results Four of the participants were classed as responders to the intervention and were able to function without the fear/phobia impacting their life. These improvements were maintained 12 months post-intervention. One participant was lost to follow-up and three participants were classed as non-responders to the intervention. Conclusions Findings show that flat screen computer-delivered virtual reality with cognitive behaviour therapy can be an effective intervention for specific fears and phobias for some young people with ASD. En ligne : https://doi.org/10.1016/j.rasd.2018.11.005 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=379 [article] An intervention for fears and phobias in young people with autism spectrum disorders using flat screen computer-delivered virtual reality and cognitive behaviour therapy [Texte imprimé et/ou numérique] / Morag MASKEY, Auteur ; Helen MCCONACHIE, Auteur ; Jacqui RODGERS, Auteur ; Victoria GRAHAME, Auteur ; Jessica MAXWELL, Auteur ; Laura TAVERNOR, Auteur ; Jeremy R. PARR, Auteur . - p.58-67. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 59 (March 2019) . - p.58-67 Mots-clés : Autism spectrum disorder  Virtual reality  Cognitive behavioural therapy  Anxiety  Phobia  Fear Index. décimale : PER Périodiques Résumé : Background Specific fears and phobias are common in young people with autism spectrum disorder (ASD) and can impact greatly on daily functioning. Traditional treatment methods, such as real-life or imaginal exposure, may not be suitable for this population without adaptation and alternative interventions are needed. In previous studies, we established that delivering graded exposure through computer generated scenes in a fully immersive virtual reality environment (the Blue Room) is an effective intervention for some young people with ASD and specific fears/phobias. In this study, we explored the same intervention delivered using flat screen, computer-delivered virtual reality graded exposure with cognitive behavioural therapy. Methods Eight young people with ASD received one psychoeducation session followed by four 20?minute sessions of flat screen, computer–delivered virtual reality graded exposure with cognitive behaviour therapy (CBT) sessions with a psychologist. Follow up measures, including Target Behaviour change ratings, were taken at 6 weeks, 6 months and 12 months after intervention. Results Four of the participants were classed as responders to the intervention and were able to function without the fear/phobia impacting their life. These improvements were maintained 12 months post-intervention. One participant was lost to follow-up and three participants were classed as non-responders to the intervention. Conclusions Findings show that flat screen computer-delivered virtual reality with cognitive behaviour therapy can be an effective intervention for specific fears and phobias for some young people with ASD. En ligne : https://doi.org/10.1016/j.rasd.2018.11.005 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=379

Mediation of 6-year mid-childhood follow-up outcomes after pre-school social communication (PACT) therapy for autistic children: randomised controlled trial / Andrew PICKLES ; Tony CHARMAN ; Helen MCCONACHIE ; Ann LE COUTEUR ; Vicky SLONIMS ; Patricia HOWLIN ; Rachel COLLUM ; Erica SALOMONE ; Hannah TOBIN ; Isobel GAMMER ; Jessica MAXWELL ; Catherine ALDRED ; Jeremy PARR ; Kathy LEADBITTER ; Jonathan GREEN in Journal of Child Psychology and Psychiatry, 65-2 (February 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-2 (February 2024) . - p.233-244 Titre : Mediation of 6-year mid-childhood follow-up outcomes after pre-school social communication (PACT) therapy for autistic children: randomised controlled trial Type de document : Texte imprimé et/ou numérique Auteurs : Andrew PICKLES, Auteur ; Tony CHARMAN, Auteur ; Helen MCCONACHIE, Auteur ; Ann LE COUTEUR, Auteur ; Vicky SLONIMS, Auteur ; Patricia HOWLIN, Auteur ; Rachel COLLUM, Auteur ; Erica SALOMONE, Auteur ; Hannah TOBIN, Auteur ; Isobel GAMMER, Auteur ; Jessica MAXWELL, Auteur ; Catherine ALDRED, Auteur ; Jeremy PARR, Auteur ; Kathy LEADBITTER, Auteur ; Jonathan GREEN, Auteur Article en page(s) : p.233-244 Index. décimale : PER Périodiques Résumé : Background There are very few mechanistic studies of the long-term impact of psychosocial interventions in childhood. The parent-mediated Paediatric Autism Communication Therapy (PACT) RCT showed sustained effects on autistic child outcomes from pre-school to mid-childhood. We investigated the mechanism by which the PACT intervention achieved these effects. Methods Of 152 children randomised to receive PACT or treatment as usual between 2 and 5?years of age, 121 (79.6%) were followed 5?6?years after the endpoint at a mean age of 10.5?years. Assessors, blind to the intervention group, measured Autism Diagnostic Observation Scale Calibrated Severity Score (ADOS CSS) for child autistic behaviours and Teacher Vineland (TVABS) for adaptive behaviour in school. Hypothesised mediators were child communication initiations with caregivers in a standard play observation (Dyadic Communication Measure for Autism, DCMA). Hypothesised moderators of mediation were baseline child non-verbal age equivalent scores (AE), communication and symbolic development (CSBS) and ?insistence on sameness? (IS). Structural equation modelling was used in a repeated measures mediation design. Results Good model fits were obtained. The treatment effect on child dyadic initiation with the caregiver was sustained through the follow-up period. Increased child initiation at treatment midpoint mediated the majority (73%) of the treatment effect on follow-up ADOS CSS. A combination of partial mediation from midpoint child initiations and the direct effect of treatment also contributed to a near-significant total effect on follow-up TVABS. No moderation of this mediation was found for AE, CSBS or IS. Conclusions Early sustained increase in an autistic child's communication initiation with their caregiver is largely responsible for the long-term effects from PACT therapy on autistic and adaptive behaviour outcomes. This supports the theoretical logic model of PACT therapy but also illuminates fundamental causal processes of social and adaptive development in autism over time: early social engagement in autism can be improved and this can have long-term generalised outcome effects. En ligne : https://doi.org/10.1111/jcpp.13798 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=520 [article] Mediation of 6-year mid-childhood follow-up outcomes after pre-school social communication (PACT) therapy for autistic children: randomised controlled trial [Texte imprimé et/ou numérique] / Andrew PICKLES, Auteur ; Tony CHARMAN, Auteur ; Helen MCCONACHIE, Auteur ; Ann LE COUTEUR, Auteur ; Vicky SLONIMS, Auteur ; Patricia HOWLIN, Auteur ; Rachel COLLUM, Auteur ; Erica SALOMONE, Auteur ; Hannah TOBIN, Auteur ; Isobel GAMMER, Auteur ; Jessica MAXWELL, Auteur ; Catherine ALDRED, Auteur ; Jeremy PARR, Auteur ; Kathy LEADBITTER, Auteur ; Jonathan GREEN, Auteur . - p.233-244. in Journal of Child Psychology and Psychiatry > 65-2 (February 2024) . - p.233-244 Index. décimale : PER Périodiques Résumé : Background There are very few mechanistic studies of the long-term impact of psychosocial interventions in childhood. The parent-mediated Paediatric Autism Communication Therapy (PACT) RCT showed sustained effects on autistic child outcomes from pre-school to mid-childhood. We investigated the mechanism by which the PACT intervention achieved these effects. Methods Of 152 children randomised to receive PACT or treatment as usual between 2 and 5?years of age, 121 (79.6%) were followed 5?6?years after the endpoint at a mean age of 10.5?years. Assessors, blind to the intervention group, measured Autism Diagnostic Observation Scale Calibrated Severity Score (ADOS CSS) for child autistic behaviours and Teacher Vineland (TVABS) for adaptive behaviour in school. Hypothesised mediators were child communication initiations with caregivers in a standard play observation (Dyadic Communication Measure for Autism, DCMA). Hypothesised moderators of mediation were baseline child non-verbal age equivalent scores (AE), communication and symbolic development (CSBS) and ?insistence on sameness? (IS). Structural equation modelling was used in a repeated measures mediation design. Results Good model fits were obtained. The treatment effect on child dyadic initiation with the caregiver was sustained through the follow-up period. Increased child initiation at treatment midpoint mediated the majority (73%) of the treatment effect on follow-up ADOS CSS. A combination of partial mediation from midpoint child initiations and the direct effect of treatment also contributed to a near-significant total effect on follow-up TVABS. No moderation of this mediation was found for AE, CSBS or IS. Conclusions Early sustained increase in an autistic child's communication initiation with their caregiver is largely responsible for the long-term effects from PACT therapy on autistic and adaptive behaviour outcomes. This supports the theoretical logic model of PACT therapy but also illuminates fundamental causal processes of social and adaptive development in autism over time: early social engagement in autism can be improved and this can have long-term generalised outcome effects. En ligne : https://doi.org/10.1111/jcpp.13798 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=520

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