Developmental Neurorehabilitation : Advances in Autism (Avril 2018)

Numéros spéciaux

Le numéro d’avril 2018 de Developmental Neurorehabilitation est consacré à l’autisme : Advances in Autism

1. Berggren S, Fletcher-Watson S, Milenkovic N, Marschik PB, Bolte S, Jonsson U. Emotion recognition training in autism spectrum disorder : A systematic review of challenges related to generalizability. Dev Neurorehabil ;2018 (Apr) ;21(3):141-154.

PURPOSE : To assess the generalizability of findings from randomized controlled trials (RCTs) evaluating emotion recognition (ER) training for children and adolescents with autism spectrum disorder (ASD). METHODS : We present a systematic review and narrative synthesis of the determinants of external validity in RCTs on ER training. Generalizability of the findings across situations, populations, settings, treatment delivery, and intervention formats was considered. RESULTS : We identified 13 eligible studies. Participants were predominantly boys with ASD in the normative IQ range (IQ > 70), with an age span from 4 to 18 years across studies. Interventions and outcome measures were highly variable. Several studies indicated that training may improve ER, but it is still largely unknown to what extent training effects are translated to daily social life. CONCLUSION : The generalizability of findings from currently available RCTs remains unclear. This underscores the importance of involving children with ASD and their caregivers in informed treatment decisions.

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2. Sim A, Vaz S, Cordier R, Joosten A, Parsons D, Smith C, Falkmer T. Factors associated with stress in families of children with autism spectrum disorder. Dev Neurorehabil ;2018 (Apr) ;21(3):155-165.

PURPOSE : The purpose of this study was to identify key factors associated with severe stress in families raising a child with autism spectrum disorder (ASD). METHODS : Questionnaires were mailed to families with one or more children with a diagnosis of ASD. Data from 543 surveys were analyzed using univariate and multivariate logistic regression. RESULTS : Forty-four percent (n = 241) of the caregivers reported severe family stress related to raising a child with ASD. Severe family stress was associated with (1) reduced ability to socialize ; (2) not having accessed individual therapy ; (3) negative co-parent relationships ; and (4) high out of pockets costs due to the child’s ASD. The specific ASD diagnosis, comorbid conditions, socio-demographic variables, and social support were not associated with severe family stress. CONCLUSION : The findings of the current study highlight the importance of a systemic approach to family stress, whereby individual, family, and ecological factors are investigated.

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3. Silbaugh BC, Falcomata TS, Ferguson RH. Effects of a lag schedule of reinforcement with progressive time delay on topographical mand variability in children with autism. Dev Neurorehabil ;2018 (Apr) ;21(3):166-177.

OBJECTIVE : Evaluate the effects of a Lag 1 schedule of reinforcement and progressive time delay (TD) on topographical mand variability in children with autism. METHODS : Using single-subject design methodology, a multiple baseline across behaviors with embedded reversal design was employed. During Lag 0, reinforcement was delivered contingent on any independent instances of manding. During Lag 1 + TD, prompts were faded and reinforcement was delivered contingent on independent or prompted variant mand topographies. RESULTS : Higher levels of topographical mand variability were observed during Lag 1 + TD for both participants. CONCLUSIONS : A Lag 1 schedule of reinforcement with progressive TD increased variability across functionally equivalent vocal mand topographies for both participants. This finding extends prior literature by providing a novel model for studying reinforced mand variability in children, and by demonstrating how practitioners could use prompts and differential reinforcement to increase topographical mand variability in children with autism.

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4. Ninci J, Rispoli M, Neely LC, Guz S. Transferring picture exchange requests to receptive identification for children with ASD. Dev Neurorehabil ;2018 (Apr) ;21(3):178-187.

The purpose of this study was to evaluate a procedure to transfer stimulus control from picture exchange requests to receptive identification. Three children with autism spectrum disorder (ASD) and absent receptive identification repertoires participated. An adapted alternating treatment design was used. During intervention, two high-preferred and two low-preferred targets were available during picture exchange requesting sessions. Participants requested primarily for one or both high-preferred targets. During receptive identification instructional sessions, one participant acquired one high-preferred target, one participant acquired all targets, and one participant demonstrated no improvements. Generalization to novel examples of targets was assessed pre- and post-intervention and programmed if necessary. One participant generalized his acquired high-preferred target without programming. Another participant generalized a high-preferred and a low-preferred target without programming, and acquired a high-preferred target with programming. Potential benefits of this intervention and suggestions for future research are presented.

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5. Burns CO, Matson JL. An investigation of the association between seizures, autism symptomology, and developmental functioning in young children. Dev Neurorehabil ;2018 (Apr) ;21(3):188-196.

OBJECTIVE : The aim of the present study was to explore whether a history of seizures was associated with autism symptom severity and developmental functioning in young children. METHODS : Autism symptom severity and developmental functioning were compared between children with and without a history or seizures who either had atypical development or met criteria for autism spectrum disorder (ASD) based on review of records by a licensed clinical psychologist. RESULTS : Parents of children who met criteria for ASD reported lower levels of autism symptomology when the child had a history of seizures, while the opposite trend was found for children with atypical development. Participants without ASD or seizures had greater developmental functioning than the other groups. CONCLUSION : The present study emphasizes the need for early identification and diagnosis of both ASD and seizure disorders, as timely intervention for these two conditions may be related to improved outcomes for young children.

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6. Fitzgerald E, Yap HK, Ashton C, Moore DW, Furlonger B, Anderson A, Kickbush R, Donald J, Busacca M, English DL. Comparing the effectiveness of virtual reality and video modelling as an intervention strategy for individuals with Autism Spectrum Disorder : Brief report. Dev Neurorehabil ;2018 (Apr) ;21(3):197-201.

The increasing numbers of individuals diagnosed with Autism Spectrum Disorder (ASD) has foreshadowed a greater need for effective intervention procedures to aid learning. PURPOSE : This study compared the effectiveness of video modelling (VM) and virtual reality (VR) for teaching adults with ASD. METHODS : Using an alternating treatments design without baseline two participants completed paper folding projects of varying difficulty following exposure to either VM or VR task modelling. The rate of learning (ROL) determined treatment effectiveness. RESULTS : One participant reached mastery criterion for the intermediate project on the 5th trial with both VR and VM (i.e. equal ROL). The other achieved mastery by the 6th trial of VM, but did not attain mastery in VR. Both participants reported enjoying both procedures. CONCLUSIONS : The results suggest that VM was more effective than VR in facilitating learning. Implications for future research are discussed.

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7. Herman C, Healy O, Lydon S. An interview-informed synthesized contingency analysis to inform the treatment of challenging behavior in a young child with autism. Dev Neurorehabil ;2018 (Apr) ;21(3):202-207.

PURPOSE : Experimental Functional analysis (EFA) is considered the « gold standard » of behavioural assessment and its use is predictive of treatment success. However, EFA has a number of limitations including its lengthy nature, the high level of expertise required, and the reinforcement of challenging behaviour. This study aimed to further validate a novel interview-informed synthesised contingency analysis (IISCA). METHODS : An open-ended interview and brief direct observation informed an IISCA for a young boy with autism who engaged in challenging behaviour. Resulting data supported the hypothesis that the target behaviour was multiply controlled by escape from demands and access to tangible items. An intervention comprised of most-to-least prompting, escape extinction, differential reinforcement and a high-probability instruction sequence was evaluated using a reversal design. RESULTS : This intervention reduced challenging behaviour to low levels and resulted in increased compliance. CONCLUSIONS : Findings support the status of the IISCA as a valid, practical, and effective process for designing function-based interventions.

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