1. Aishworiya R, Kang YQ. {{Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic}}. {J Autism Dev Disord};2020 (Aug 20)
Amidst the ongoing novel Coronavirus disease pandemic, children with developmental disabilities warrant specific attention to minimise having disproportionate consequences. These children are especially vulnerable to the effects of the pandemic due to (1) Greater healthcare needs, (2) Dependency on community-based services and (3) Mental health concerns. Healthcare professionals, public health systems and the society needs to come together to advocate for these children by optimising access to healthcare and community intervention services, promoting mental well-being and caregiver welfare. The consequences of missed present-day opportunities might only be evident in the years to come in these children. Hence, despite the prolonged pandemic, with consequent limitations in availability of resources, children with developmental disabilities should continue to be supported.
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2. Beskorovainaya T, Konovalov F, Demina N, Shchagina O, Pashchenko M, Kanivets I, Pyankov D, Ryzhkova O, Polyakov A. {{Case Report: Complicated Molecular Diagnosis of MECP2 Gene Structural Rearrangement in a Proband with Rett Syndrome}}. {J Autism Dev Disord};2020 (Aug 20)
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3. Bobbette N, Ouellette-Kuntz H, Tranmer J, Lysaght R, Ufholz LA, Donnelly C. {{Adults with intellectual and developmental disabilities and interprofessional, team-based primary health care: a scoping review}}. {JBI Evid Synth};2020 (Jul);18(7):1470-1514.
OBJECTIVE: This scoping review aimed to examine the state of the evidence for interprofessional, team-based primary health care for adults with intellectual and developmental disabilities. INTRODUCTION: Adults with intellectual and developmental disabilities are a complex, vulnerable population known to experience health inequities. Interprofessional primary health care teams are recommended to improve access to comprehensive and coordinated health care for these individuals. Limited information is available regarding what services interprofessional primary health care teams provide and how services are evaluated specific to the care of this population. INCLUSION CRITERIA: This scoping review considered all studies that referenced individuals with intellectual and/or developmental disabilities who were 18 years or older. It considered all studies that referred to health care provision within a primary health care context. All studies that discussed the provision of interprofessional primary health care services were included. « Interprofessional primary health care team » was the term used to describe services provided by health providers (e.g. physicians, nurse practitioners, nurses, dietitians, social workers, mental health workers, occupational therapists, physical therapists) working in a team-based model of care. METHODS: This scoping review was conducted in accordance with JBI methodology for scoping reviews. Quantitative, qualitative, and mixed methods study designs were considered for inclusion. In addition, systematic reviews, program descriptions, clinical reviews, and opinion papers were considered. Studies published in English and French were included. The period considered was from 2000 to the date of the searches (July and August 2018 for bibliographic databases and January 2019 for the final searches of unpublished studies and selected papers from key authors). RESULTS: The search identified 2761 records. Despite the global search strategy, only 20 records were included in the final review, mainly consisting of work based in the United States and Canada. Results were heterogeneous and descriptive in nature, consisting of cross-sectional designs, program descriptions, and clinical reviews. The findings represent only a few distinct interprofessional primary health care team models of care and multiple contributions from a small pool of researchers. Roles for physicians, nurse practitioners, nurses, social workers, and mental health providers were identified. Ten studies identified either patient-reported outcomes or health-utilization outcomes. Overall, there was no consistent reporting of outcomes across studies, and outcomes specifically related to many interprofessional services were not captured. Although interprofessional, team-based approaches are supported at a policy and practice level, the concept of interprofessional primary health care for this population remains understudied and is challenged by differences in primary health care provision across the world, complexity in how the field is defined, as well as a lack of consistent reporting of the organizational attributes and processes that support interprofessional primary health care provision. CONCLUSIONS: To fully realize the potential of interprofessional primary health care teams, health services research is needed to describe organizational attributes and processes, and evaluate interventions for this population. Engaging in this work will ultimately provide a more fulsome evidence base to support high-quality, interprofessional primary health care provision for adults with intellectual and developmental disabilities.
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4. Buro AW, Gray HL, Kirby RS, Berkman K, Agazzi H, Shaffer-Hudkins E. {{Diet quality in an ethnically diverse sample of children and adolescents with autism spectrum disorder compared with nationally representative data}}. {Disabil Health J};2020 (Jul 30):100981.
BACKGROUND: Children with developmental disabilities are at an increased risk of unhealthy eating habits, which may contribute to compromised growth and development. Children with autism spectrum disorder (ASD) exhibit unique risk factors for unhealthy dietary patterns, including sensory issues and cognitive rigidity at mealtimes. OBJECTIVE: This cross-sectional study examined diet quality in a sample of children with ASD in Florida compared to nationally representative National Health and Nutrition Examination Survey (NHANES) 2009-2014/2013-2014 data using the Healthy Eating Index-2015 (HEI-2015). METHODS: A 24-h food record was completed by 41 parents of children with ASD aged 2-17 years, and food and beverage items consumed by each child were reported per standardized 24-h recall protocol. Two models were used to compare mean total and component HEI-2015 scores to NHANES means: (1) comparing means for our full sample to published NHANES means for children aged 2-18 years and (2) a matched model with subjects matched 1:1 by age, gender, race/ethnicity, and parent education level. RESULTS: HEI component scores were significantly lower (poorer) in children with ASD for whole fruit, total vegetables, dairy, total protein foods, and seafood and plant protein. Whole grains, fatty acids, added sugars, and refined grains scores were higher (better) in our sample. However, total HEI scores and HEI scores for all 13 components were similar among children with ASD and the matched cases from the NHANES data. CONCLUSIONS: There are potential discrepancies in diet quality between children with ASD and general population. Further research with a larger sample size, reporting both total and component HEI scores, is needed.
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5. Dickson KS, Chlebowski C, Haine-Schlagel R, Ganger B, Brookman-Frazee L. {{Impact of Therapist Training on Parent Attendance in Mental Health Services for Children with ASD}}. {J Clin Child Adolesc Psychol};2020 (Aug 20):1-12.
OBJECTIVE: The current study explored the impact of training therapists in a mental health intervention for children with autism spectrum disorder (ASD) on parent attendance in their children’s therapy sessions. We also examined family, therapist, and program factors as potential moderators. METHOD: Data were drawn from a cluster-randomized community effectiveness trial of « An Individualized Mental Health Intervention for ASD (AIM HI) ». Participants included 168 therapists yoked with 189 children recruited from publicly-funded mental health services. Data included family (caregiver strain, parent sense of competence, race/ethnicity), therapist (background, experience), and program (service setting) characteristics, and parent session attendance. Multilevel models were used to evaluate the effectiveness of AIM HI therapist training on caregiver attendance and identify moderators of training effects on parent attendance. RESULTS: Parents attended a higher percentage of sessions in the AIM HI training condition compared to the Usual Care condition. Program service setting moderated the effect of AIM HI training, with higher parent attendance in non-school (mostly outpatient) settings compared to school settings and a significantly smaller difference between the settings in the AIM HI condition. CONCLUSIONS: Effective strategies to promote parent engagement, especially in service settings such as schools, are warranted. Findings support the effectiveness of AIM HI training in promoting parent attendance across multiple publicly-funded mental health service settings. The larger effect in school-based programs supports the utility of training in evidence-based interventions such as AIM HI to increase the feasibility of parent attendance in such services.
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6. Fanning PAJ, Sparaci L, Dissanayake C, Hocking DR, Vivanti G. {{Functional play in young children with autism and Williams syndrome: A cross-syndrome comparison}}. {Child Neuropsychol};2020 (Aug 20):1-25.
Functional play during early childhood paves the way to symbolic play and social communicative skills. However, functional play is surprisingly understudied in children with developmental disorders affecting social and communicative domains, such as Autism Spectrum Disorder (ASD) and Williams syndrome (WS). To address this issue and to evaluate both the quantity and quality of functional play in children with ASD and WS, we examined different play types using fine grained behavioral analysis with a group of age and IQ-matched developmentally delayed children with ASD (n = 14) and WS (n = 14) in comparison with 12 age-matched typically developing (TD) children. Significant differences were found in the quantity of functional play in the ASD and WS groups compared to TD children, with a limited breadth of object exploration found in children with ASD. While TD children engaged more frequently in functional versus nonfunctional play, this was not the case for children with ASD and WS, who showed the same amount of functional and nonfunctional play. Furthermore, functional play behavior was associated with intellectual and adaptive function in children with WS, but not ASD. These results point to the importance of intervention strategies that focus on functional play in improving developmental outcomes for children with ASD and WS.
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7. Ferguson EF, Drapalik KN, Liang J, Hua K, Feerst H, Mallory AB, Vernon TW. {{Social Interaction Skill Intervention for Autistic Adults with Intellectual Disability and Limited Language: A Pilot of the SKILL Program}}. {J Autism Dev Disord};2020 (Aug 18)
There is a dearth of research that focuses on social intervention efforts for adults on the autism spectrum with intellectual disability and limited conversational language. Using a multiple baseline experimental design, this pilot investigation of the Socialization Knowledge for Individuals with Limited Language (SKILL) program evaluated a novel peer-facilitated group program specifically designed to target social interaction skills for this population. Findings from five pilot participants yielded evidence of social improvements across specific verbal skills (on-topic conversational contributions and responses) and nonverbal behaviors (eye-contact, active listening), as evidenced by coded social conversation probes and parent-report measures. These findings demonstrate the promise of a socialization intervention for a population that has historically been neglected in the social intervention research literature.
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8. Fodstad JC, Kerswill SA, Kirsch AC, Lagges A, Schmidt J. {{Assessment and Treatment of Noise Hypersensitivity in a Teenager with Autism Spectrum Disorder: A Case Study}}. {J Autism Dev Disord};2020 (Aug 20)
Noise hypersensitivity is a poorly understood symptom of Autism Spectrum Disorder (ASD). For some, problem behaviors co-occur with the aversive noise. Limited literature exists on treating noise hypersensitivity; however, noise hypersensitivity may be related to a specific phobia. This case study utilizes modified Cognitive Behavioral Therapy (CBT) to address anxiety, avoidance, and problem behaviors evoked by noise in a teen with ASD and mild Intellectual Disability (ID). Using multi-method assessment and individualized treatment, problem behaviors reduced, and independent coping strategies use occurred. Successful desensitization supports the efficacy of modified CBT as a treatment for noise-related anxiety and problem behaviors in individuals with ASD and ID. Outcomes are discussed considering intervention difficulties for noise hypersensitivity in a complex and diverse population.
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9. Gilmore R, Ziviani J, Sakzewski L. {{Efficacy of group social skills interventions on social competency and participation in adolescents with acquired and developmental disabilities: a systematic review protocol}}. {JBI Evid Synth};2020 (Jul 3)
OBJECTIVE: The objective of this review is to evaluate the efficacy of group social skills interventions in improving social knowledge, social competency, and social participation in adolescents with acquired and developmental disabilities. INTRODUCTION: Difficulties with social functioning and participation are commonly experienced by adolescents with a range of acquired and developmental disabilities. There is evidence for the use of group social skills interventions in youth with autism spectrum disorder, although less is known about their efficacy with youth with other disabilities. INCLUSION CRITERIA: This review will include studies that evaluate group social skills interventions in adolescents with an acquired or developmental disability, excluding a primary mental health disorder. Randomized control trials will be the only experimental design included and group social skills interventions must have an available intervention manual to allow use in clinical practice. Primary outcomes will include measures of social knowledge, social competence, and social participation. METHODS: PubMed, CINAHL, Embase, Cochrane Register of Controlled Trials, PsycINFO and Web of Science will be searched for eligible studies published in English. Clinical Trials Registry, Google Scholar, and ProQuest Dissertation and Theses will also be searched. Screening, study selection, critical appraisal, and data extraction will be conducted by two independent reviewers using standardized tools. Studies will be pooled, where possible, with statistical meta-analysis and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Summary of Findings presented. SYSTEMATIC REVIEW REGISTRATION NUMBER: The protocol for this systematic review has been submitted to PROSPERO.
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10. Hartwell M, Keener A, Coffey S, Chesher T, Torgerson T, Vassar M. {{Brief Report: Public Awareness of Asperger Syndrome Following Greta Thunberg Appearances}}. {J Autism Dev Disord};2020 (Aug 18)
Thunberg’s increased media attention coupled with her diagnosis-Asperger Syndrome (AS)-may foster help-seeking behaviors among those with similar psychiatric disorders. Using Google Trends data, we compared values of AS from the week of the UN Climate Summit through the end of the year compared to an ARIMA model predicting search interest had Thunberg not been in the media. The search trend for AS at peak was 254.07% higher than predicted and was on average 10.61 points above the projected model during this time. As the primary goal of AS intervention focuses on improving quality of life and preventing common comorbidities such as depression and anxiety, capitalizing on increased public interest in AS and help-seeking behaviors is imperative.
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11. Hayward BE, Steinbach PJ, Usdin K. {{A point mutation in the nuclease domain of MLH3 eliminates repeat expansions in a mouse stem cell model of the Fragile X-related disorders}}. {Nucleic Acids Res};2020 (Aug 20);48(14):7856-7863.
The Fragile X-related disorders (FXDs) are Repeat Expansion Diseases, genetic disorders that result from the expansion of a disease-specific microsatellite. In those Repeat Expansion Disease models where it has been examined, expansion is dependent on functional mismatch repair (MMR) factors, including MutLγ, a heterodimer of MLH1/MLH3, one of the three MutL complexes found in mammals and a minor player in MMR. In contrast, MutLα, a much more abundant MutL complex that is the major contributor to MMR, is either not required for expansion or plays a limited role in expansion in many model systems. How MutLγ acts to generate expansions is unclear given its normal role in protecting against microsatellite instability and while MLH3 does have an associated endonuclease activity, whether that contributes to repeat expansion is uncertain. We show here, using a gene-editing approach, that a point mutation that eliminates the endonuclease activity of MLH3 eliminates expansions in an FXD mouse embryonic stem cell model. This restricts the number of possible models for repeat expansion and supports the idea that MutLγ may be a useful druggable target to reduce somatic expansion in those disorders where it contributes to disease pathology.
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12. Konečná B, Radošinská J, Keményová P, Repiská G. {{Detection of disease-associated microRNAs -application for autism spectrum disorders}}. {Rev Neurosci};2020 (Aug 19)
Autism spectrum disorders (ASD) diagnostic procedure still lacks a uniform biological marker. This review gathers the information on microRNAs (miRNAs) specifically as a possible source of biomarkers of ASD. Extracellular vesicles, and their subset of exosomes, are believed to be a tool of cell-to-cell communication, and they are increasingly considered to be carriers of such a marker. The interest in studying miRNAs in extracellular vesicles grows in all fields of study and therefore should not be omitted in the field of neurodevelopmental disorders. The summary of miRNAs associated with brain cells and ASD either studied directly in the tissue or biofluids are gathered in this review. The heterogeneity in findings from different studies points out the fact that unified methods should be established, beginning with the determination of the accurate patient and control groups, through to sample collection, processing, and storage conditions. This review, based on the available literature, proposes the standardized approach to obtain the results that would not be affected by technical factors. Nowadays, the method of high-throughput sequencing seems to be the most optimal to analyze miRNAs. This should be followed by the uniformed bioinformatics procedure to avoid misvalidation. At the end, the proper validation of the obtained results is needed. With such an approach as is described in this review, it would be possible to obtain a reliable biomarker that would characterize the presence of ASD.
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13. Li Y, Luo ZY, Hu YY, Bi YW, Yang JM, Zou WJ, Song YL, Li S, Shen T, Li SJ, Huang L, Zhou AJ, Gao TM, Li JM. {{The gut microbiota regulates autism-like behavior by mediating vitamin B(6) homeostasis in EphB6-deficient mice}}. {Microbiome};2020 (Aug 20);8(1):120.
BACKGROUND: Autism spectrum disorder (ASD) is a developmental disorder, and the effective pharmacological treatments for the core autistic symptoms are currently limited. Increasing evidence, particularly that from clinical studies on ASD patients, suggests a functional link between the gut microbiota and the development of ASD. However, the mechanisms linking the gut microbiota with brain dysfunctions (gut-brain axis) in ASD have not yet been full elucidated. Due to its genetic mutations and downregulated expression in patients with ASD, EPHB6, which also plays important roles in gut homeostasis, is generally considered a candidate gene for ASD. Nonetheless, the role and mechanism of EPHB6 in regulating the gut microbiota and the development of ASD are unclear. RESULTS: Here, we found that the deletion of EphB6 induced autism-like behavior and disturbed the gut microbiota in mice. More importantly, transplantation of the fecal microbiota from EphB6-deficient mice resulted in autism-like behavior in antibiotic-treated C57BL/6J mice, and transplantation of the fecal microbiota from wild-type mice ameliorated the autism-like behavior in EphB6-deficient mice. At the metabolic level, the disturbed gut microbiota in EphB6-deficient mice led to vitamin B(6) and dopamine defects. At the cellular level, the excitation/inhibition (E/I) balance in the medial prefrontal cortex was regulated by gut microbiota-mediated vitamin B(6) in EphB6-deficient mice. CONCLUSIONS: Our study uncovers a key role for the gut microbiota in the regulation of autism-like social behavior by vitamin B(6), dopamine, and the E/I balance in EphB6-deficient mice, and these findings suggest new strategies for understanding and treating ASD. Video abstract.
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14. McBride GR, Stephenson KAJ, Comer G, Flanagan O. {{The Use of Oral Midazolam to Facilitate the Ophthalmic Examination of Children with Autism and Developmental Disorders}}. {J Autism Dev Disord};2020 (Aug 18)
Ophthalmic examinations of developmentally delayed/autistic children are challenging. Oral midazolam may be a viable alternative to general anaesthesia for this indication. Single-centre retrospective cohort study (January 2018-March 2020). Oral midazolam (0.5 mg/kg, max 15 mg). Metrics included: patient demographics, examination completion rate, duration of stay and adverse events. 50 oral midazolam examinations were performed (45 patients). Mean age was 79.12 months. All had developmental delay (66.67% autism). Time to ophthalmic examination was 60.31 minutes. Eye examination was successfully completed in 98%. No adverse events were reported. Mean stay was 3.35 hours. Oral midazolam (0.5 mg/kg, max 15 mg) is associated with safe, successful completion of ophthalmic examinations in children previously unexaminable in clinic.
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15. Morris SM, Acosta MT, Garg S, Green J, Legius E, North K, Payne JM, Weiss LA, Constantino JN, Gutmann DH. {{Autism in neurofibromatosis type 1: misuse of covariance to dismiss autistic trait burden}}. {Dev Med Child Neurol};2020 (Aug 20)
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16. Rivest D, Prud’homme J. {{Incertitude diagnostique et action politique : une association de parents face aux politiques de l’autisme, 1982-2017}}. {Can Bull Med Hist};2020 (Aug 20):e392102019.
The definition of diagnostic categories, such as autism, is not always consensual. It can be the cause of political struggles between various actors, including professionals, public administrations or patient associations. However, little is known about the situation of patient or parent associations in these « diagnostic politics. » We assert here that these associations are more sensitive to the politics of definition than is suggested by the current historiography. Through an analysis of discourses and strategies of the Quebec Autism Society from 1982 to 2017, we document the role that this association intends to play in the politics of autism and we show how the adoption by the state of diagnostic-based policies intensify definitional debates in civil society, including among parents.
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17. Schmitz-Abe K, Sanchez-Schmitz G, Doan RN, Hill RS, Chahrour MH, Mehta BK, Servattalab S, Ataman B, Lam AN, Morrow EM, Greenberg ME, Yu TW, Walsh CA, Markianos K. {{Homozygous deletions implicate non-coding epigenetic marks in Autism spectrum disorder}}. {Sci Rep};2020 (Aug 20);10(1):14045.
More than 98% of the human genome is made up of non-coding DNA, but techniques to ascertain its contribution to human disease have lagged far behind our understanding of protein coding variations. Autism spectrum disorder (ASD) has been mostly associated with coding variations via de novo single nucleotide variants (SNVs), recessive/homozygous SNVs, or de novo copy number variants (CNVs); however, most ASD cases continue to lack a genetic diagnosis. We analyzed 187 consanguineous ASD families for biallelic CNVs. Recessive deletions were significantly enriched in affected individuals relative to their unaffected siblings (17% versus 4%, p < 0.001). Only a small subset of biallelic deletions were predicted to result in coding exon disruption. In contrast, biallelic deletions in individuals with ASD were enriched for overlap with regulatory regions, with 23/28 CNVs disrupting histone peaks in ENCODE (p < 0.009). Overlap with regulatory regions was further demonstrated by comparisons to the 127-epigenome dataset released by the Roadmap Epigenomics project, with enrichment for enhancers found in primary brain tissue and neuronal progenitor cells. Our results suggest a novel noncoding mechanism of ASD, describe a powerful method to identify important noncoding regions in the human genome, and emphasize the potential significance of gene activation and regulation in cognitive and social function. Lien vers le texte intégral (Open Access ou abonnement)
18. Seto K, Lloyd M, Chan V, Chung H, Balogh R. {{Traumatic Brain Injury Incidence in Adults with Intellectual & Developmental Disabilities}}. {Can J Neurol Sci};2020 (Aug 20):1-23.
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19. Waddington F, Franke B, Hartman C, Buitelaar JK, Rommelse N, Mota NR. {{A polygenic risk score analysis of ASD and ADHD across emotion recognition subtypes}}. {Am J Med Genet B Neuropsychiatr Genet};2020 (Aug 20)
This study investigated the genetic components of ADHD and ASD by examining the cross-disorder trait of emotion recognition problems. The genetic burden for ADHD and ASD on previously identified emotion recognition factors (speed and accuracy of visual and auditory emotion recognition) and classes (Class 1: Average visual, impulsive auditory; Class 2: Average-strong visual & auditory; Class 3: Impulsive & imprecise visual, average auditory; Class 4: Weak visual & auditory) was assessed using ASD and ADHD polygenic risk scores (PRS). Our sample contained 552 participants: 74 with ADHD, 85 with ASD, 60 with ASD + ADHD, 177 unaffected siblings of ADHD or ASD probands, and 156 controls. ADHD- and ASD-PRS, calculated from the latest ADHD and ASD GWAS meta-analyses, were analyzed across these emotion recognition factors and classes using linear mixed models. Unexpectedly, the analysis of emotion recognition factors showed higher ASD-PRS to be associated with faster visual emotion recognition. The categorical analysis of emotion recognition classes showed ASD-PRS to be reduced in Class 3 compared to the other classes (p value threshold [pT] = 1, p = .021). A dimensional analysis identified a high ADHD-PRS reduced the probability of being assigned to the Class 1 or Class 3 (pT = .05, p = .028 and p = .044, respectively). Though these nominally significant results did not pass FDR correction, they potentially indicate different indirect causative chains from genetics via emotion recognition to ADHD and ASD, which need to be verified in future research.
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20. Whittingham K, McGlade A, Kulasinghe K, Mitchell AE, Heussler H, Boyd RN. {{ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy): a randomised controlled trial of an innovative intervention for infants at risk of autism spectrum disorder}}. {BMJ Open};2020 (Aug 20);10(8):e034315.
INTRODUCTION: Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with impacts on behaviour, cognition, communication, social interaction and family mental health. This paper reports the protocol of a randomised controlled trial (RCT) of a very early intervention, ENACT (ENvironmental enrichment for infants; parenting with Acceptance and Commitment Therapy), for families of infants at risk of ASD. METHODS AND ANALYSIS: We aim to recruit 66 mothers of infants at risk of ASD (ie, infants with a sibling or parent diagnosed with ASD) to this RCT. Families will be randomly assigned to care-as-usual or ENACT. ENACT is a very early intervention, leveraging parent-child interactions to improve early social reciprocity, while supporting parental mental health and the parent-child relationship through Acceptance and Commitment Therapy. Intervention content is delivered online (approximately 8 hours) and supported by more than 7 consultations with a clinician. Parents will perform the social reciprocity intervention with their child (30 min per day). Assessments at four time points (baseline, 3 months, 6 months, and 12 months corrected age) will assess parent-infant interaction, parental mental health, infant development and early ASD markers. Analysis will be by intention to treat using general linear models for RCTs. ETHICS AND DISSEMINATION: This protocol has been approved by the Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/19/QCHQ/50131) and the University of Queensland Human Research Ethics Committee (2019000558). If efficacy is demonstrated, the intervention has the potential for wide and accessible dissemination. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12618002046280).
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21. Yoder PJ, Stone WL, Edmunds SR. {{Parent utilization of ImPACT intervention strategies is a mediator of proximal then distal social communication outcomes in younger siblings of children with ASD}}. {Autism};2020 (Aug 18):1362361320946883.
Later born siblings of children with autism spectrum disorders (ASD) are at elevated risk for language delay or ASD. One way to manage this risk may be for parents to use techniques taught in Improving Parents as Communication Teachers (ImPACT) with the younger siblings during the period in which language delay and ASD may be too subtle to be diagnosed. ImPACT targets children’s play, imitation, and communication skills. Improvement in these skills may reduce the severity of language delays and social communication deficits associated with ASD. In this study, 97 younger siblings of children with ASD and their primary parents were randomly assigned to ImPACT or a control group. We measured whether parents used ImPACT teaching strategies and whether children used the skills that ImPACT targets. We also measured children’s later language ability and social communication skills. The results confirmed our predictions that parents’ use of ImPACT strategies improves language ability by improving children’s motor imitation and communication skills. Use of ImPACT also had a positive effect on children’s language delay and ASD symptoms, supporting the clinical value of the findings. The study’s methodological strengths make this one of the most rigorous tests of ImPACT and supports one way to manage the risk of language delay and ASD in younger siblings of children with ASD.
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22. Yoder PJ, Stone WL, Edmunds SR. {{For which younger siblings of children with autism spectrum disorder does parent-mediated intervention work?}}. {Autism};2020 (Aug 18):1362361320943373.
In this second of two primary papers, we examined two pre-intervention characteristics that might describe for whom a parent-implemented intervention, « Improving Parents As Communication Teachers, » worked. Investigators randomized 97 high-risk siblings and their primary parent to either the Improving Parents As Communication Teachers or control group, used intent-to-treat analysis, and used assessors and coders who were blinded to group assignment. We predicted that a combined risk score (incorporating young siblings’ sex, multiplex status, and behavioral risk) would describe the subgroup for whom Improving Parents As Communication Teachers affected the targeted skills related to reducing communication challenges. We also predicted that pre-intervention level of parents’ depressive symptoms would describe the parents whose parenting stress and effectiveness as parents would be improved by learning to use Improving Parents As Communication Teachers. In girls with only one older sibling with autism spectrum disorder and who scored at low risk on an autism spectrum disorder screen, parental receipt of Improving Parents As Communication Teachers training had an indirect effect on children’s expressive language ability or autism spectrum disorder diagnosis through earlier effects on high-risk siblings’ intentional communication or expressive vocabulary. We did not confirm our prediction regarding Improving Parents As Communication Teachers’ effect on parenting-related stress or sense of parenting effectiveness.
