45.3 RECOGNIZING COMORBID PEDIATRIC BIPOLAR DISORDERS IN YOUTH WITH AUTISM SPECTRUM DISORDER

Recent evidence suggests that individuals with autism spectrum disorder (ASD) experience depression at rates approximately four times greater than the general population. Co-occurring mood problems, including depressive and bipolar disorders, are associated with negative outcomes such as lower quality of life, increased adaptive behavior impairments, and greater service use. This chapter discusses what is known about the presentation of unipolar and bipolar depression in people with ASD and describes challenges to establishing sound prevalence estimates of mood disorders in ASD as they relate to methodological design issues and diagnostic assessment practices. It also provides an overview of potential vulnerability factors in the development of depression in this population; these areas of vulnerability include characteristics such as chronological age, cognitive ability, and ASD symptom severity, as well as those individual differences that may represent more direct mechanisms, for example, maladaptive coping styles, attentional biases, social reward profiles, and predisposition to rumination. The current research on interventions specifically designed to treat mood in people with ASD is very limited. However, promising treatments include adapted cognitive behavioral therapy and mindfulness-based approaches. Though most of this chapter focuses on unipolar depression in ASD as the more well-studied mood disorder, the chapter also summarizes the small research base on bipolar disorder in the context of ASD. It ends with a call for improved screening, assessment, and evidence-based treatment options to address this significant public health problem in this special population.

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Komorbiditas anak gangguan spektrum autisme

e-CliniC ◽

10.35790/ecl.4.2.2016.14497 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Seriven Y. Warouw ◽

Christoffel Elim ◽

Herdy Munayang ◽

Neni Ekawardani

Keyword(s):

Autism Spectrum Disorder ◽

Bipolar Disorders ◽

Children With Autism ◽

Gastrointestinal Disorder ◽

Allergic Diseases ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Cross Sectional ◽

Physical Diseases ◽

Cross Sectional Design

Abstract: Autism spectrum disorder is a developmental disruption. Its early condition is characterized by delay and deviance in the development of social, communication, and other skills. Someone who has been diagnosed with autism spectrum disorder is easily to encounter other health problems which occur simultaneously, the comorbidity. Comorbidities that usually occur in children with autism spectrum disorder are mental disorders and physical diseases. This study was aimed to identify the comorbidities of children with autism spectrum disorder at autism schools, exceptional schools and disabled children therapy sites in Manado and Tomohon. This was a quantitative study with a cross-sectional design. The results showed that there were 31 parents of children with autism spectrum disorder as respondents. There were 30 children (96.77%) that had comorbidities. Of the 30 children with comorbidities, 7 children had generalized anxiety disorder (22.6%), 9 children had specific phobias (29%), 6 children had bipolar disorders (25.8%), 7 children had ADHD (22.6%), 22 children had allergic diseases (71%), 23 children had gastrointestinal disorders (74.2%), and 4 children had epilepsy (12.9%). Conclusion: In this study, most children with autism spectrum disorder had comorbidities and gastrointestinal disorder was the most frequent comorbidity.Keywords: comorbidity, children, autism spectrum disorder. Abstrak: Gangguan spektrum autisme adalah suatu gangguan perkembangan yang mana kondisi awalnya ditandai dengan keterlambatan dan penyimpangan dalam perkembangan sosial, komunikasi dan keterampilan lainnya. Orang yang didiagnosis dengan gangguan spektrum autisme sangat rentan mengalami masalah kesehatan lain yang terjadi secara bersamaan atau dikenal dengan istilah komorbiditas. Komorbiditas yang sering muncul pada anak gangguan spektrum autisme berupa gangguan mental dan penyakit fisik. Penelitian ini bertujuan untuk mengetahui komorbiditas pada anak gangguan spektrum autisme di sekolah khusus autisme, sekolah luar biasa dan tempat terapi anak berkebutuhan khusus di Kota Manado dan Tomohon. Jenis penelitian ialah kuantitatif dengan desain potong lintang terhadap 31 responden yaitu orangtua yang mempunyai anak gangguan spektrum autisme. Dari 31 responden ini didapatkan 30 anak gangguan spektrum autisme (96,77%) mengalami komorbiditas. Dari 30 anak gangguan spektrum autisme yang mengalami komorbiditas didapatkan 7 anak mengalami gangguan cemas menyeluruh (22,6%), 9 anak mengalami fobia spesifik (29%), 6 anak mengalami gangguan obsesif kompulsif (19,4%), 5 anak mengalami gangguan depresif mayor (16,1%), 8 anak mengalami gangguan bipolar (25,8), 7 anak mengalami GPPH (22,6%), 22 anak mengalami alergi (71%), 23 anak mengalami gangguan gastrointestinal (74,2%), dan 4 anak mengalami epilepsi (12,9%). Simpulan: Hampir semua anak gangguan spektrum autisme mengalami komorbiditas dan gangguan gastrointestinal merupakan komorbiditas yang paling sering ditemukan. Kata kunci: komorbiditas, anak, gangguan spektrum autisme.

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Development of Neural Structure and Function in Autism Spectrum Disorder: Potential Implications for Learning Language

American Journal of Speech-Language Pathology ◽

10.1044/2020_ajslp-19-00209 ◽

2020 ◽

Vol 29 (4) ◽

pp. 1783-1797

Author(s):

Kelly L. Coburn ◽

Diane L. Williams

Keyword(s):

Autism Spectrum Disorder ◽

Language Development ◽

Diffusion Tensor ◽

Autism Spectrum ◽

Language Intervention ◽

Spectrum Disorder ◽

Autistic Children ◽

Neural Structure ◽

Complex Information ◽

And Function

Purpose Neurodevelopmental processes that begin during gestation and continue throughout childhood typically support language development. Understanding these processes can help us to understand the disruptions to language that occur in neurodevelopmental conditions, such as autism spectrum disorder (ASD). Method For this tutorial, we conducted a focused literature review on typical postnatal brain development and structural and functional magnetic resonance imaging, diffusion tensor imaging, magnetoencephalography, and electroencephalography studies of the neurodevelopmental differences that occur in ASD. We then integrated this knowledge with the literature on evidence-based speech-language intervention practices for autistic children. Results In ASD, structural differences include altered patterns of cortical growth and myelination. Functional differences occur at all brain levels, from lateralization of cortical functions to the rhythmic activations of single neurons. Neuronal oscillations, in particular, could help explain disrupted language development by elucidating the timing differences that contribute to altered functional connectivity, complex information processing, and speech parsing. Findings related to implicit statistical learning, explicit task learning, multisensory integration, and reinforcement in ASD are also discussed. Conclusions Consideration of the neural differences in autistic children provides additional scientific support for current recommended language intervention practices. Recommendations consistent with these neurological findings include the use of short, simple utterances; repetition of syntactic structures using varied vocabulary; pause time; visual supports; and individualized sensory modifications.

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Parent Education in Studies With Nonverbal and Minimally Verbal Participants With Autism Spectrum Disorder: A Systematic Review

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00007 ◽

2020 ◽

Vol 29 (2) ◽

pp. 890-902

Author(s):

Lynn Kern Koegel ◽

Katherine M. Bryan ◽

Pumpki Lei Su ◽

Mohini Vaidya ◽

Stephen Camarata

Keyword(s):

Systematic Review ◽

Autism Spectrum Disorder ◽

Parent Education ◽

Autism Spectrum ◽

Verbal Communication ◽

Fidelity Of Implementation ◽

Spectrum Disorder ◽

Education Programs ◽

Minimally Verbal ◽

Parent Education Programs

Purpose The purpose of this systematic review was to identify parent education procedures implemented in intervention studies focused on expressive verbal communication for nonverbal (NV) or minimally verbal (MV) children with autism spectrum disorder (ASD). Parent education has been shown to be an essential component in the habilitation of individuals with ASD. Parents of individuals with ASD who are NV or MV may particularly benefit from parent education in order to provide opportunities for communication and to support their children across the life span. Method ProQuest databases were searched between the years of 1960 and 2018 to identify articles that targeted verbal communication in MV and NV individuals with ASD. A total of 1,231 were evaluated to assess whether parent education was implemented. We found 36 studies that included a parent education component. These were reviewed with regard to (a) the number of participants and participants' ages, (b) the parent education program provided, (c) the format of the parent education, (d) the duration of the parent education, (e) the measurement of parent education, and (f) the parent fidelity of implementation scores. Results The results of this analysis showed that very few studies have included a parent education component, descriptions of the parent education programs are unclear in most studies, and few studies have scored the parents' implementation of the intervention. Conclusions Currently, there is great variability in parent education programs in regard to participant age, hours provided, fidelity of implementation, format of parent education, and type of treatment used. Suggestions are made to provide both a more comprehensive description and consistent measurement of parent education programs.

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The Influence of Language Context on Repetitive Speech Use in Children With Autism Spectrum Disorder

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00003 ◽

2020 ◽

Vol 29 (1) ◽

pp. 327-334 ◽

Cited By ~ 1

Author(s):

Allison Gladfelter ◽

Cassidy VanZuiden

Keyword(s):

Autism Spectrum Disorder ◽

Autism Spectrum ◽

Individual Characteristics ◽

Receptive Vocabulary ◽

Spectrum Disorder ◽

School Age Children ◽

Social Responsiveness ◽

Contributing Factors ◽

Children With Asd ◽

Language Context

Purpose Although repetitive speech is a hallmark characteristic of autism spectrum disorder (ASD), the contributing factors that influence repetitive speech use remain unknown. The purpose of this exploratory study was to determine if the language context impacts the amount and type of repetitive speech produced by children with ASD. Method As part of a broader word-learning study, 11 school-age children with ASD participated in two different language contexts: storytelling and play. Previously collected language samples were transcribed and coded for four types of repetitive speech: immediate echolalia, delayed echolalia, verbal stereotypy, and vocal stereotypy. The rates and proportions of repetitive speech were compared across the two language contexts using Wilcoxon signed-ranks tests. Individual characteristics were further explored using Spearman correlations. Results The children produced lower rates of repetitive speech during the storytelling context than the play-based context. Only immediate echolalia differed between the two contexts based on rate and approached significance based on proportion, with more immediate echolalia produced in the play-based context than in the storytelling context. There were no significant correlations between repetitive speech and measures of social responsiveness, expressive or receptive vocabulary, or nonverbal intelligence. Conclusions The children with ASD produced less immediate echolalia in the storytelling context than in the play-based context. Immediate echolalia use was not related to social skills, vocabulary, or nonverbal IQ scores. These findings offer valuable insights into better understanding repetitive speech use in children with ASD.

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Instruction Using Augmentative and Alternative Communication Supports: Description of Current Practices by Speech-Language Pathologists Who Work With Children With Autism Spectrum Disorder

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00045 ◽

2020 ◽

Vol 29 (2) ◽

pp. 586-596 ◽

Cited By ~ 1

Author(s):

Kaitlyn A. Clarke ◽

Diane L. Williams

Keyword(s):

Autism Spectrum Disorder ◽

Augmentative And Alternative Communication ◽

Communication Systems ◽

Diagnostic Category ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Alternative Communication ◽

Speech Language Pathologists ◽

Processing Differences

Purpose The aim of this research study was to examine common practices of speech-language pathologists (SLPs) who work with children with autism spectrum disorder (ASD) with respect to whether or not SLPs consider processing differences in ASD or the effects of input during their instruction. Method Following a qualitative research method, how SLPs instruct and present augmentative and alternative communication systems to individuals with ASD, their rationale for method selection, and their perception of the efficacy of selected interventions were probed. Semistructured interviews were conducted as part of an in-depth case report with content analysis. Results Based on completed interviews, 4 primary themes were identified: (a) instructional method , (b) input provided , (c) decision-making process , and (d) perceived efficacy of treatment . Additionally, one secondary theme, training and education received , was identified . Conclusions Clinicians reported making decisions based on the needs of the child; however, they also reported making decisions based on the diagnostic category that characterized the child (i.e., ASD). The use of modeling when teaching augmentative and alternative communication to individuals with ASD emerged as a theme, but variations in the method of modeling were noted. SLPs did not report regularly considering processing differences in ASD, nor did they consider the effects of input during instruction.

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A Case Study: Unique Challenges of an Adolescent Female With Autism Spectrum Disorder

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00132 ◽

2020 ◽

Vol 5 (1) ◽

pp. 314-325

Author(s):

Kimberly F. Frazier ◽

Jessica Collier ◽

Rachel Glade

Keyword(s):

Autism Spectrum Disorder ◽

Cognitive Abilities ◽

Social Cognitive ◽

Social Performance ◽

Management Strategies ◽

Autism Spectrum ◽

Spectrum Disorder ◽

Self Management ◽

Adolescent Female ◽

Social Thinking

Background The aim of this study was to determine the clinical efficacy of combining self-management strategies and a social thinking approach to address the social performance and executive function of an adolescent female with autism spectrum disorder. Method This research examined the effects of a social knowledge training program, “Think Social,” as well as strategies to improve higher order cognitive abilities. Results and Conclusion Although quantitative improvement was not found, several qualitative gains in behavior were noted for the participants of this study, suggesting a benefit from using structured environmental cues of self-management strategies, as well as improved social understanding through social cognitive training.

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