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

Understanding Repetitive Behaviours: A clinical and cost-effectiveness, multi-site randomised controlled trial of a group for parents and carers of young autistic children / Victoria GRAHAME in Autism, 29-8 (August 2025)  

Public ISBD [article]  inAutism > 29-8 (August 2025) . - p.1998-2015 Titre : Understanding Repetitive Behaviours: A clinical and cost-effectiveness, multi-site randomised controlled trial of a group for parents and carers of young autistic children Type de document : Texte imprimé et/ou numérique Auteurs : Victoria GRAHAME, Auteur ; Ashleigh KERNOHAN, Auteur ; Ehsan KHARATI, Auteur ; Ayesha MATHIAS, Auteur ; Chrissie BUTCHER, Auteur ; Linda DIXON, Auteur ; Sue FLETCHER-WATSON, Auteur ; Deborah GARLAND, Auteur ; Magdalena GLOD, Auteur ; Jane GOODWIN, Auteur ; Saoirse HERON, Auteur ; Emma HONEY, Auteur ; Ann LE COUTEUR, Auteur ; Leila MACKIE, Auteur ; Jessica MAXWELL, Auteur ; Lewis MONTGOMERY, Auteur ; Emmanuel OGUNDIMU, Auteur ; Helen PROBERT, Auteur ; Deborah RIBY, Auteur ; Priyanka ROB, Auteur ; Leanne ROGAN, Auteur ; Laura TAVERNOR, Auteur ; Luke VALE, Auteur ; Elspeth Imogen WEBB, Auteur ; Christopher WEETMAN, Auteur ; Jacqui RODGERS, Auteur Article en page(s) : p.1998-2015 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  interventions - psychosocial/behavioural  pre-school children  school-age children Index. décimale : PER Périodiques Résumé : Restricted and repetitive behaviours vary greatly between autistic people. Some are a source of pleasure or create opportunities for learning; others may be detrimental in day-to-day life or cause harm. We have developed, in close collaboration with parents/carers, the Understanding Repetitive Behaviours programme, designed for families of young autistic children, to help them recognise, understand and respond sensitively to their child?s impactful restricted and repetitive behaviours. This study is a clinical and cost-effectiveness, multi-site randomised controlled trial of the Understanding Repetitive Behaviours parent programme versus a psychoeducation programme (equivalent to current best practice), learning about autism. Participants were parents/carers, with an autistic child aged between 3-9?years and 11?months. The study was delivered across three sites in England and Scotland. Analyses were completed using intention-to-treat principles. Two hundred and twenty seven families were randomised (113 in LAA; 114 in Understanding Repetitive Behaviours arm). No differences were found between the arms on the primary outcome measure (The Clinical Global Impression - Improvement scale). Analysis of secondary outcomes indicated that children in the Understanding Repetitive Behaviours arm were more likely to be rated as responders in target impactful restricted and repetitive behaviours at 24?weeks but that this effect was not maintained at 52?weeks. Improvements in parent and family functioning were apparent, with no evidence of differences between the arms. The study reconfirms that it is important that clinicians consider both restricted and repetitive behaviours and social communication needs of autistic children with parents when planning appropriate support.Lay abstract Autistic children, frequently repeat the same behaviours over and over, have specific interests or like things to stay the same. These behaviours and interests are often fun and helpful. However, sometimes they can impact negatively on day-to-day life or put the child at risk of harm. Working closely with parents of autistic children, we developed an 8-week programme (Understanding Repetitive Behaviours) to help them recognise and understand these behaviours. This study aimed to find out whether the understanding repetitive behaviour programme was helpful and good value for money. Two hundred and twenty seven families were allocated by chance to receive either Understanding Repetitive Behaviours or a learning about autism programme. When experts made judgements about whether children showed positive changes across various measures, and these were analysed, there were no differences between the programmes. However, parents who attended the Understanding Repetitive Behaviours programme reported improvement in one of their child?s specific repetitive behaviour (selected to be the main focus of the Understanding Repetitive Behaviours programme) at 24?weeks after the end of the programme. Parents who attended either programme reported more confidence, greater wellbeing and less stress up to 1?year after the end of the study. En ligne : https://journals.sagepub.com/doi/abs/10.1177/13623613251333175 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=564 [article] Understanding Repetitive Behaviours: A clinical and cost-effectiveness, multi-site randomised controlled trial of a group for parents and carers of young autistic children [Texte imprimé et/ou numérique] / Victoria GRAHAME, Auteur ; Ashleigh KERNOHAN, Auteur ; Ehsan KHARATI, Auteur ; Ayesha MATHIAS, Auteur ; Chrissie BUTCHER, Auteur ; Linda DIXON, Auteur ; Sue FLETCHER-WATSON, Auteur ; Deborah GARLAND, Auteur ; Magdalena GLOD, Auteur ; Jane GOODWIN, Auteur ; Saoirse HERON, Auteur ; Emma HONEY, Auteur ; Ann LE COUTEUR, Auteur ; Leila MACKIE, Auteur ; Jessica MAXWELL, Auteur ; Lewis MONTGOMERY, Auteur ; Emmanuel OGUNDIMU, Auteur ; Helen PROBERT, Auteur ; Deborah RIBY, Auteur ; Priyanka ROB, Auteur ; Leanne ROGAN, Auteur ; Laura TAVERNOR, Auteur ; Luke VALE, Auteur ; Elspeth Imogen WEBB, Auteur ; Christopher WEETMAN, Auteur ; Jacqui RODGERS, Auteur . - p.1998-2015. Langues : Anglais (eng) in Autism > 29-8 (August 2025) . - p.1998-2015 Mots-clés : autism spectrum disorders  interventions - psychosocial/behavioural  pre-school children  school-age children Index. décimale : PER Périodiques Résumé : Restricted and repetitive behaviours vary greatly between autistic people. Some are a source of pleasure or create opportunities for learning; others may be detrimental in day-to-day life or cause harm. We have developed, in close collaboration with parents/carers, the Understanding Repetitive Behaviours programme, designed for families of young autistic children, to help them recognise, understand and respond sensitively to their child?s impactful restricted and repetitive behaviours. This study is a clinical and cost-effectiveness, multi-site randomised controlled trial of the Understanding Repetitive Behaviours parent programme versus a psychoeducation programme (equivalent to current best practice), learning about autism. Participants were parents/carers, with an autistic child aged between 3-9?years and 11?months. The study was delivered across three sites in England and Scotland. Analyses were completed using intention-to-treat principles. Two hundred and twenty seven families were randomised (113 in LAA; 114 in Understanding Repetitive Behaviours arm). No differences were found between the arms on the primary outcome measure (The Clinical Global Impression - Improvement scale). Analysis of secondary outcomes indicated that children in the Understanding Repetitive Behaviours arm were more likely to be rated as responders in target impactful restricted and repetitive behaviours at 24?weeks but that this effect was not maintained at 52?weeks. Improvements in parent and family functioning were apparent, with no evidence of differences between the arms. The study reconfirms that it is important that clinicians consider both restricted and repetitive behaviours and social communication needs of autistic children with parents when planning appropriate support.Lay abstract Autistic children, frequently repeat the same behaviours over and over, have specific interests or like things to stay the same. These behaviours and interests are often fun and helpful. However, sometimes they can impact negatively on day-to-day life or put the child at risk of harm. Working closely with parents of autistic children, we developed an 8-week programme (Understanding Repetitive Behaviours) to help them recognise and understand these behaviours. This study aimed to find out whether the understanding repetitive behaviour programme was helpful and good value for money. Two hundred and twenty seven families were allocated by chance to receive either Understanding Repetitive Behaviours or a learning about autism programme. When experts made judgements about whether children showed positive changes across various measures, and these were analysed, there were no differences between the programmes. However, parents who attended the Understanding Repetitive Behaviours programme reported improvement in one of their child?s specific repetitive behaviour (selected to be the main focus of the Understanding Repetitive Behaviours programme) at 24?weeks after the end of the programme. Parents who attended either programme reported more confidence, greater wellbeing and less stress up to 1?year after the end of the study. En ligne : https://journals.sagepub.com/doi/abs/10.1177/13623613251333175 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=564

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