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Auteur Vicky SLONIMS |
Documents disponibles écrits par cet auteur (17)
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Treatment mechanism in the MRC preschool autism communication trial: implications for study design and parent-focussed therapy for children / Andrew PICKLES in Journal of Child Psychology and Psychiatry, 56-2 (February 2015)
[article]
Titre : Treatment mechanism in the MRC preschool autism communication trial: implications for study design and parent-focussed therapy for children Type de document : Texte imprimé et/ou numérique Auteurs : Andrew PICKLES, Auteur ; Victoria HARRIS, Auteur ; Jonathan GREEN, Auteur ; Catherine ALDRED, Auteur ; Helen MCCONACHIE, Auteur ; Vicky SLONIMS, Auteur ; Ann LE COUTEUR, Auteur ; Kristelle HUDRY, Auteur ; Tony CHARMAN, Auteur ; THE PACT CONSORTIUM,, Auteur Article en page(s) : p.162-170 Langues : Anglais (eng) Mots-clés : Autism measurement error mediation parent–child interaction parent-focussed therapy Index. décimale : PER Périodiques Résumé : Background The PACT randomised-controlled trial evaluated a parent-mediated communication-focused treatment for children with autism, intended to reduce symptom severity as measured by a modified Autism Diagnostic Observation Schedule-Generic (ADOS-G) algorithm score. The therapy targeted parental behaviour, with no direct interaction between therapist and child. While nonsignificant group differences were found on ADOS-G score, significant group differences were found for both parent and child intermediate outcomes. This study aimed to better understand the mechanism by which the PACT treatment influenced changes in child behaviour though the targeted parent behaviour. Methods Mediation analysis was used to assess the direct and indirect effects of treatment via parent behaviour on child behaviour and via child behaviour on ADOS-G score. Alternative mediation was explored to study whether the treatment effect acted as hypothesised or via another plausible pathway. Mediation models typically assume no unobserved confounding between mediator and outcome and no measurement error in the mediator. We show how to better exploit the information often available within a trial to begin to address these issues, examining scope for instrumental variable and measurement error models. Results Estimates of mediation changed substantially when account was taken of the confounder effects of the baseline value of the mediator and of measurement error. Our best estimates that accounted for both suggested that the treatment effect on the ADOS-G score was very substantially mediated by parent synchrony and child initiations. Conclusions The results highlighted the value of repeated measurement of mediators during trials. The theoretical model underlying the PACT treatment was supported. However, the substantial fall-off in treatment effect highlighted both the need for additional data and for additional target behaviours for therapy. En ligne : http://dx.doi.org/10.1111/jcpp.12291 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=259
in Journal of Child Psychology and Psychiatry > 56-2 (February 2015) . - p.162-170[article] Treatment mechanism in the MRC preschool autism communication trial: implications for study design and parent-focussed therapy for children [Texte imprimé et/ou numérique] / Andrew PICKLES, Auteur ; Victoria HARRIS, Auteur ; Jonathan GREEN, Auteur ; Catherine ALDRED, Auteur ; Helen MCCONACHIE, Auteur ; Vicky SLONIMS, Auteur ; Ann LE COUTEUR, Auteur ; Kristelle HUDRY, Auteur ; Tony CHARMAN, Auteur ; THE PACT CONSORTIUM,, Auteur . - p.162-170.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 56-2 (February 2015) . - p.162-170
Mots-clés : Autism measurement error mediation parent–child interaction parent-focussed therapy Index. décimale : PER Périodiques Résumé : Background The PACT randomised-controlled trial evaluated a parent-mediated communication-focused treatment for children with autism, intended to reduce symptom severity as measured by a modified Autism Diagnostic Observation Schedule-Generic (ADOS-G) algorithm score. The therapy targeted parental behaviour, with no direct interaction between therapist and child. While nonsignificant group differences were found on ADOS-G score, significant group differences were found for both parent and child intermediate outcomes. This study aimed to better understand the mechanism by which the PACT treatment influenced changes in child behaviour though the targeted parent behaviour. Methods Mediation analysis was used to assess the direct and indirect effects of treatment via parent behaviour on child behaviour and via child behaviour on ADOS-G score. Alternative mediation was explored to study whether the treatment effect acted as hypothesised or via another plausible pathway. Mediation models typically assume no unobserved confounding between mediator and outcome and no measurement error in the mediator. We show how to better exploit the information often available within a trial to begin to address these issues, examining scope for instrumental variable and measurement error models. Results Estimates of mediation changed substantially when account was taken of the confounder effects of the baseline value of the mediator and of measurement error. Our best estimates that accounted for both suggested that the treatment effect on the ADOS-G score was very substantially mediated by parent synchrony and child initiations. Conclusions The results highlighted the value of repeated measurement of mediators during trials. The theoretical model underlying the PACT treatment was supported. However, the substantial fall-off in treatment effect highlighted both the need for additional data and for additional target behaviours for therapy. En ligne : http://dx.doi.org/10.1111/jcpp.12291 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=259 Using implementation science frameworks to explore barriers and facilitators for parents' use of therapeutic strategies following a parent-mediated autism intervention / Sophie CARRUTHERS in Autism, 27-4 (May 2023)
[article]
Titre : Using implementation science frameworks to explore barriers and facilitators for parents' use of therapeutic strategies following a parent-mediated autism intervention Type de document : Texte imprimé et/ou numérique Auteurs : Sophie CARRUTHERS, Auteur ; Natasha MLECZKO, Auteur ; Stephanie PAGE, Auteur ; Shalini AHUJA, Auteur ; Ceri ELLIS, Auteur ; Patricia HOWLIN, Auteur ; Kathy LEADBITTER, Auteur ; Lauren TAYLOR, Auteur ; Vicky SLONIMS, Auteur ; Tony CHARMAN, Auteur Article en page(s) : p.1011-1025 Langues : Anglais (eng) Mots-clés : autism spectrum disorders,interventions - psychosocial/behavioural,qualitative research Index. décimale : PER Périodiques Résumé : One core component of the Paediatric Autism Communication Therapy-Generalised involves supporting parents to change their interaction and communication style with their child. This behaviour change has been found to affect child outcomes. Implementation science methodologies offer a range of opportunities to investigate how interventions are delivered in practice; however, few autism intervention studies have used such designs to explore the behaviour change of parents. We interviewed 27 parents and explored their use of intervention strategies after the Paediatric Autism Communication Therapy-Generalised trial. We employed the Theoretical Domains Framework and Consolidated Framework for Implementation Research to systematically explore a range of barriers and facilitators experienced by the parents associated with parents' characteristics, their context and features of the intervention. Our analysis revealed barriers and facilitators across three themes: Motivating Factors, which was further subdivided into Compatibility and Buy-In and Alignment of Goals and Outcomes; Opportunity and Support; Parent Characteristics. Almost all parents reported continued use of the Paediatric Autism Communication Therapy-Generalised strategies. Facilitators (e.g. parental confidence in using the strategies) and barriers (e.g. child?s behaviour) were identified. Consideration of these factors can inform identification of implementation strategies to test in future studies of Paediatric Autism Communication Therapy-Generalised and other parent-mediated early autism interventions.Lay abstractMany early autism interventions teach parents therapeutic strategies to help them adjust their communication style with their children. Research has shown that this behaviour change in parents leads to improvements in child communication. It is, therefore, important to learn what factors support or hinder parents in their use of therapeutic strategies learned in such interventions. This study set out to interview parents who had participated in a research trial of the Paediatric Autism Communication Therapy-Generalised intervention. We interviewed 27 caregivers and explored their use of the strategies up to 2?years after the end of the research trial. Qualitative frameworks were used to inform interview questions and data analysis. These frameworks focused on a range of contextual factors, including parents' characteristics, their context and features of the intervention. Parents reported barriers and facilitators to using Paediatric Autism Communication Therapy-Generalised strategies across three themes: Motivating Factors; Opportunity and Support; Parent Characteristics. One of these themes, Motivating Factors, was further divided into the subthemes Compatibility and Buy-In and Alignment of Goals and Outcomes. Almost all parents reported continued use of the Paediatric Autism Communication Therapy-Generalised strategies. Facilitators included parental confidence in using the strategies and barriers included child?s behaviour. Consideration of these factors can inform ways to better support parents in future autism interventions. En ligne : https://doi.org/10.1177/13623613221125630 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499
in Autism > 27-4 (May 2023) . - p.1011-1025[article] Using implementation science frameworks to explore barriers and facilitators for parents' use of therapeutic strategies following a parent-mediated autism intervention [Texte imprimé et/ou numérique] / Sophie CARRUTHERS, Auteur ; Natasha MLECZKO, Auteur ; Stephanie PAGE, Auteur ; Shalini AHUJA, Auteur ; Ceri ELLIS, Auteur ; Patricia HOWLIN, Auteur ; Kathy LEADBITTER, Auteur ; Lauren TAYLOR, Auteur ; Vicky SLONIMS, Auteur ; Tony CHARMAN, Auteur . - p.1011-1025.
Langues : Anglais (eng)
in Autism > 27-4 (May 2023) . - p.1011-1025
Mots-clés : autism spectrum disorders,interventions - psychosocial/behavioural,qualitative research Index. décimale : PER Périodiques Résumé : One core component of the Paediatric Autism Communication Therapy-Generalised involves supporting parents to change their interaction and communication style with their child. This behaviour change has been found to affect child outcomes. Implementation science methodologies offer a range of opportunities to investigate how interventions are delivered in practice; however, few autism intervention studies have used such designs to explore the behaviour change of parents. We interviewed 27 parents and explored their use of intervention strategies after the Paediatric Autism Communication Therapy-Generalised trial. We employed the Theoretical Domains Framework and Consolidated Framework for Implementation Research to systematically explore a range of barriers and facilitators experienced by the parents associated with parents' characteristics, their context and features of the intervention. Our analysis revealed barriers and facilitators across three themes: Motivating Factors, which was further subdivided into Compatibility and Buy-In and Alignment of Goals and Outcomes; Opportunity and Support; Parent Characteristics. Almost all parents reported continued use of the Paediatric Autism Communication Therapy-Generalised strategies. Facilitators (e.g. parental confidence in using the strategies) and barriers (e.g. child?s behaviour) were identified. Consideration of these factors can inform identification of implementation strategies to test in future studies of Paediatric Autism Communication Therapy-Generalised and other parent-mediated early autism interventions.Lay abstractMany early autism interventions teach parents therapeutic strategies to help them adjust their communication style with their children. Research has shown that this behaviour change in parents leads to improvements in child communication. It is, therefore, important to learn what factors support or hinder parents in their use of therapeutic strategies learned in such interventions. This study set out to interview parents who had participated in a research trial of the Paediatric Autism Communication Therapy-Generalised intervention. We interviewed 27 caregivers and explored their use of the strategies up to 2?years after the end of the research trial. Qualitative frameworks were used to inform interview questions and data analysis. These frameworks focused on a range of contextual factors, including parents' characteristics, their context and features of the intervention. Parents reported barriers and facilitators to using Paediatric Autism Communication Therapy-Generalised strategies across three themes: Motivating Factors; Opportunity and Support; Parent Characteristics. One of these themes, Motivating Factors, was further divided into the subthemes Compatibility and Buy-In and Alignment of Goals and Outcomes. Almost all parents reported continued use of the Paediatric Autism Communication Therapy-Generalised strategies. Facilitators included parental confidence in using the strategies and barriers included child?s behaviour. Consideration of these factors can inform ways to better support parents in future autism interventions. En ligne : https://doi.org/10.1177/13623613221125630 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=499