Addressing Challenging Behavior During Hospitalizations for Children with Autism: A Pilot Applied Behavior Analysis Randomized Controlled Trial / Kevin SANDERS in Autism Research, 13-7 (July 2020)  

Public ISBD [article]  inAutism Research > 13-7 (July 2020) . - p.1072-1078 Titre : Addressing Challenging Behavior During Hospitalizations for Children with Autism: A Pilot Applied Behavior Analysis Randomized Controlled Trial Type de document : Texte imprimé et/ou numérique Auteurs : Kevin SANDERS, Auteur ; John STAUBITZ, Auteur ; A Pablo JUAREZ, Auteur ; Sarah MARLER, Auteur ; Whitney BROWNING, Auteur ; Erin MCDONNELL, Auteur ; Lily L. ALTSTEIN, Auteur ; Eric A. MACKLIN, Auteur ; Zachary WARREN, Auteur Article en page(s) : p.1072-1078 Langues : Anglais (eng) Mots-clés : Aba  autism spectrum disorder  hospitalization Index. décimale : PER Périodiques Résumé : This study evaluated the feasibility, acceptance, and potential clinical benefit of brief applied behavior analysis (ABA)-based interventions for children and adolescents with autism spectrum disorder (ASD) displaying challenging behaviors during hospitalizations. Participants included 36 children diagnosed with ASD, 6-17?years of age, who were medically or psychiatrically hospitalized. Children in the intervention group received a brief ABA intervention and were compared to children in the evaluation and monitoring-only group. Families and staff recommended the intervention, children receiving the intervention demonstrated significantly more improvement in unblinded ratings of clinical severity, data from physicians indicated a positive effect of the intervention on levels of staffing and restraints and attending medical providers universally reported satisfaction and benefit of the intervention. Improvements in challenging behaviors were not significantly different as reported by parents, and the length of hospitalization did not differ between the groups. Ultimately, the outcomes of this pilot study suggest incorporating specialized ABA-based assessment and intervention during hospitalization may be feasible and well accepted by clinicians and families. However, future research must address potent methodological challenges related to capturing meaningful data during hospitalizations in order to answer questions of ultimate pragmatic, clinical, and system-level benefits. Trial Registration ClinicalTrials.gov Identifier NCT02339935, Registered 16 January 2015, First participant consented 23 February 2015. Autism Res 2020, 13: 1072-1078. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Inpatient hospitalizations for children with autism spectrum disorder (ASD) and severe behavior are common, challenging, and costly in terms of human experience. This study evaluated the benefit of brief applied behavior analysis-based interventions to children and adolescents with ASD displaying challenging behaviors during hospitalizations. Families and staff evaluating the procedures noted perceived potential benefits of the intervention, but this initial pilot study did not document changes in hospitalization length or blinded rating of improvement. En ligne : http://dx.doi.org/10.1002/aur.2308 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=429 [article] Addressing Challenging Behavior During Hospitalizations for Children with Autism: A Pilot Applied Behavior Analysis Randomized Controlled Trial [Texte imprimé et/ou numérique] / Kevin SANDERS, Auteur ; John STAUBITZ, Auteur ; A Pablo JUAREZ, Auteur ; Sarah MARLER, Auteur ; Whitney BROWNING, Auteur ; Erin MCDONNELL, Auteur ; Lily L. ALTSTEIN, Auteur ; Eric A. MACKLIN, Auteur ; Zachary WARREN, Auteur . - p.1072-1078. Langues : Anglais (eng) in Autism Research > 13-7 (July 2020) . - p.1072-1078 Mots-clés : Aba  autism spectrum disorder  hospitalization Index. décimale : PER Périodiques Résumé : This study evaluated the feasibility, acceptance, and potential clinical benefit of brief applied behavior analysis (ABA)-based interventions for children and adolescents with autism spectrum disorder (ASD) displaying challenging behaviors during hospitalizations. Participants included 36 children diagnosed with ASD, 6-17?years of age, who were medically or psychiatrically hospitalized. Children in the intervention group received a brief ABA intervention and were compared to children in the evaluation and monitoring-only group. Families and staff recommended the intervention, children receiving the intervention demonstrated significantly more improvement in unblinded ratings of clinical severity, data from physicians indicated a positive effect of the intervention on levels of staffing and restraints and attending medical providers universally reported satisfaction and benefit of the intervention. Improvements in challenging behaviors were not significantly different as reported by parents, and the length of hospitalization did not differ between the groups. Ultimately, the outcomes of this pilot study suggest incorporating specialized ABA-based assessment and intervention during hospitalization may be feasible and well accepted by clinicians and families. However, future research must address potent methodological challenges related to capturing meaningful data during hospitalizations in order to answer questions of ultimate pragmatic, clinical, and system-level benefits. Trial Registration ClinicalTrials.gov Identifier NCT02339935, Registered 16 January 2015, First participant consented 23 February 2015. Autism Res 2020, 13: 1072-1078. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Inpatient hospitalizations for children with autism spectrum disorder (ASD) and severe behavior are common, challenging, and costly in terms of human experience. This study evaluated the benefit of brief applied behavior analysis-based interventions to children and adolescents with ASD displaying challenging behaviors during hospitalizations. Families and staff evaluating the procedures noted perceived potential benefits of the intervention, but this initial pilot study did not document changes in hospitalization length or blinded rating of improvement. En ligne : http://dx.doi.org/10.1002/aur.2308 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=429

Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder / Bradley J. FERGUSON in Autism Research, 10-2 (February 2017)  

Public ISBD [article]  inAutism Research > 10-2 (February 2017) . - p.276-288 Titre : Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder Type de document : Texte imprimé et/ou numérique Auteurs : Bradley J. FERGUSON, Auteur ; Sarah MARLER, Auteur ; Lily L. ALTSTEIN, Auteur ; Evon BATEY LEE, Auteur ; Jill AKERS, Auteur ; Kristin SOHL, Auteur ; Aaron MCLAUGHLIN, Auteur ; Kaitlyn HARTNETT, Auteur ; Briana KILLE, Auteur ; Micah MAZUREK, Auteur ; Eric A. MACKLIN, Auteur ; Erin MCDONNELL, Auteur ; Mariah BARSTOW, Auteur ; Margaret L. BAUMAN, Auteur ; Kara Gross MARGOLIS, Auteur ; Jeremy VEENSTRA-VANDERWEELE, Auteur ; David Q. BEVERSDORF, Auteur Article en page(s) : p.276-288 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  gastrointestinal  autonomic nervous system  sympathetic  parasympathetic  anxiety  constipation Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) is often accompanied by gastrointestinal disturbances, which also may impact behavior. Alterations in autonomic nervous system functioning are also frequently observed in ASD. The relationship between these findings in ASD is not known. We examined the relationship between gastrointestinal symptomatology, examining upper and lower gastrointestinal tract symptomatology separately, and autonomic nervous system functioning, as assessed by heart rate variability and skin conductance level, in a sample of 120 individuals with ASD. Relationships with co-occurring medical and psychiatric symptoms were also examined. While the number of participants with significant upper gastrointestinal tract problems was small in this sample, 42.5% of participants met criteria for functional constipation, a disorder of the lower gastrointestinal tract. Heart rate variability, a measure of parasympathetic modulation of cardiac activity, was found to be positively associated with lower gastrointestinal tract symptomatology at baseline. This relationship was particularly strong for participants with co-occurring diagnoses of anxiety disorder and for those with a history of regressive ASD or loss of previously acquired skills. These findings suggest that autonomic function and gastrointestinal problems are intertwined in children with ASD; although it is not possible to assess causality in this data set. Future work should examine the impact of treatment of gastrointestinal problems on autonomic function and anxiety, as well as the impact of anxiety treatment on gastrointestinal problems. Clinicians should be aware that gastrointestinal problems, anxiety, and autonomic dysfunction may cluster in children with ASD and should be addressed in a multidisciplinary treatment plan. En ligne : http://dx.doi.org/10.1002/aur.1646 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=303 [article] Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder [Texte imprimé et/ou numérique] / Bradley J. FERGUSON, Auteur ; Sarah MARLER, Auteur ; Lily L. ALTSTEIN, Auteur ; Evon BATEY LEE, Auteur ; Jill AKERS, Auteur ; Kristin SOHL, Auteur ; Aaron MCLAUGHLIN, Auteur ; Kaitlyn HARTNETT, Auteur ; Briana KILLE, Auteur ; Micah MAZUREK, Auteur ; Eric A. MACKLIN, Auteur ; Erin MCDONNELL, Auteur ; Mariah BARSTOW, Auteur ; Margaret L. BAUMAN, Auteur ; Kara Gross MARGOLIS, Auteur ; Jeremy VEENSTRA-VANDERWEELE, Auteur ; David Q. BEVERSDORF, Auteur . - p.276-288. Langues : Anglais (eng) in Autism Research > 10-2 (February 2017) . - p.276-288 Mots-clés : autism spectrum disorder  gastrointestinal  autonomic nervous system  sympathetic  parasympathetic  anxiety  constipation Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) is often accompanied by gastrointestinal disturbances, which also may impact behavior. Alterations in autonomic nervous system functioning are also frequently observed in ASD. The relationship between these findings in ASD is not known. We examined the relationship between gastrointestinal symptomatology, examining upper and lower gastrointestinal tract symptomatology separately, and autonomic nervous system functioning, as assessed by heart rate variability and skin conductance level, in a sample of 120 individuals with ASD. Relationships with co-occurring medical and psychiatric symptoms were also examined. While the number of participants with significant upper gastrointestinal tract problems was small in this sample, 42.5% of participants met criteria for functional constipation, a disorder of the lower gastrointestinal tract. Heart rate variability, a measure of parasympathetic modulation of cardiac activity, was found to be positively associated with lower gastrointestinal tract symptomatology at baseline. This relationship was particularly strong for participants with co-occurring diagnoses of anxiety disorder and for those with a history of regressive ASD or loss of previously acquired skills. These findings suggest that autonomic function and gastrointestinal problems are intertwined in children with ASD; although it is not possible to assess causality in this data set. Future work should examine the impact of treatment of gastrointestinal problems on autonomic function and anxiety, as well as the impact of anxiety treatment on gastrointestinal problems. Clinicians should be aware that gastrointestinal problems, anxiety, and autonomic dysfunction may cluster in children with ASD and should be addressed in a multidisciplinary treatment plan. En ligne : http://dx.doi.org/10.1002/aur.1646 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=303

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