scholarly journals A Mobile Game Platform for Improving Social Communication in Children with Autism: A Feasibility Study

2021 ◽  
Vol 12 (05) ◽  
pp. 1030-1040
Author(s):  
Yordan Penev ◽  
Kaitlyn Dunlap ◽  
Arman Husic ◽  
Cathy Hou ◽  
Peter Washington ◽  
...  
Keyword(s):  
Social Exchange ◽  
Quality Care ◽  
Children With Autism ◽  
Social Responsiveness ◽  
Vineland Adaptive Behavior Scales ◽  
Access To Treatment ◽  
Current Form ◽  
Mobile Game ◽  
Viable Approach ◽  
Game Platform

Abstract Background Many children with autism cannot receive timely in-person diagnosis and therapy, especially in situations where access is limited by geography, socioeconomics, or global health concerns such as the current COVD-19 pandemic. Mobile solutions that work outside of traditional clinical environments can safeguard against gaps in access to quality care. Objective The aim of the study is to examine the engagement level and therapeutic feasibility of a mobile game platform for children with autism. Methods We designed a mobile application, GuessWhat, which, in its current form, delivers game-based therapy to children aged 3 to 12 in home settings through a smartphone. The phone, held by a caregiver on their forehead, displays one of a range of appropriate and therapeutically relevant prompts (e.g., a surprised face) that the child must recognize and mimic sufficiently to allow the caregiver to guess what is being imitated and proceed to the next prompt. Each game runs for 90 seconds to create a robust social exchange between the child and the caregiver. Results We examined the therapeutic feasibility of GuessWhat in 72 children (75% male, average age 8 years 2 months) with autism who were asked to play the game for three 90-second sessions per day, 3 days per week, for a total of 4 weeks. The group showed significant improvements in Social Responsiveness Score-2 (SRS-2) total (3.97, p <0.001) and Vineland Adaptive Behavior Scales-II (VABS-II) socialization standard (5.27, p = 0.002) scores. Conclusion The results support that the GuessWhat mobile game is a viable approach for efficacious treatment of autism and further support the possibility that the game can be used in natural settings to increase access to treatment when barriers to care exist.

Disproportionate Negative Impact of the Radiation Oncology Alternative Payment Model on Rural Providers: A Cost Identification Analysis of Medicare Claims

2021 ◽  
pp. OP.21.00330
Author(s):  
Constantine A. Mantz ◽  
Nikhil G. Thaker ◽  
Praveen Pendyala ◽  
Anne Hubbard ◽  
Thomas J. Eichler ◽  
...  
Keyword(s):  
Radiation Oncology ◽  
Negative Impact ◽  
Quality Care ◽  
Fee For Service ◽  
Current Form ◽  
Payment Model ◽  
Physician Practices ◽  
Bundled Payments ◽  
Treatment Services ◽  
Rural And Urban

PURPOSE: The Radiation Oncology Alternative Payment Model (APM) is a Medicare demonstration project that will test whether prospective bundled payments to a randomly selected group of physician practices, hospital outpatient departments, and freestanding radiation therapy centers reduce overall expenditures while preserving or enhancing the quality of care for beneficiaries. The Model follows a complicated pricing methodology that blends historical reimbursements for a defined set of services made to professional and technical providers to create a weighted payment average for each of 16 cancer types. These averages are then adjusted by various factors to determine APM payments specific to each participating provider. METHODS: This impact study segregates APM participants into rural and urban groups and analyzes the effect of the Radiation Oncology Alternative Payment Model on their fee-for-service reimbursements. RESULTS: The main findings of this study are (1) the greater net-negative revenue impact on rural facilities versus urban facilities that would have participated in the Model this year and (2) the relative lack of high-value treatment services (ie, stereotactic radiotherapy and brachytherapy) delivered by rural facilities that exacerbates their negative impact. CONCLUSION: As such, rural providers participating in the Model in its current form may face greater risk to their economic viability and greater difficulty in funding technology improvements necessary for the achievement of high-quality care compared with their urban counterparts.

Extending Caregiver Training Via Telecommunication for Rural Icelandic Children With Autism

2018 ◽  
Vol 38 (1) ◽  
pp. 26-42 ◽  
Author(s):  
Kristín Guðmundsdóttir ◽  
Shahla Ala’i-Rosales ◽  
Zuilma Gabriela Sigurðardóttir
Keyword(s):  
Rural Families ◽  
Children With Autism ◽  
Behavioral Parent Training ◽  
Multiple Baseline ◽  
Caregiver Training ◽  
Single Subject ◽  
Training Methods ◽  
Child Behaviors ◽  
Viable Approach ◽  
Training Protocol

This study describes the development and evaluation of a behavioral parent training protocol via telecommunication for three parents of preschool children with autism, with limited access to behavioral expertise. A single-subject, multiple baseline experimental design across child behaviors, replicated across parents, was used to evaluate the effects of the training protocol. Dependent measures were collected via telecommunication for most assessments and included parent and child responses during naturalistic play. During intervention, the parents were taught methods to increase their child’s sociocommunicative behavior. All targeted skills increased during intervention. The increase was maintained with two families and some generalization to other settings occurred. The results indicate that training via telecommunication is a viable approach for rural families with low speed Internet connection. Continued development and refinement of telehealth training methods is discussed in context of technological challenges and procedures that fit telecoaching for rural families.

scholarly journals Efficacy and safety of memantine in children with autism spectrum disorder: Results from three phase 2 multicenter studies

Autism ◽  
2019 ◽  
Vol 23 (8) ◽  
pp. 2096-2111 ◽  
Author(s):  
Antonio Y Hardan ◽  
Robert L Hendren ◽  
Michael G Aman ◽  
Adelaide Robb ◽  
Raun D Melmed ◽  
...  
Keyword(s):  
Extended Release ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Social Responsiveness Scale ◽  
Social Responsiveness ◽  
Phase 2 ◽  
Open Label ◽  
Double Blind ◽  
Three Phase ◽  
Open Label Trial

Three phase 2 trials were conducted to assess the efficacy and long-term safety of weight-based memantine extended release (ER) treatment in children with autism spectrum disorder. MEM-MD-91, a 50-week open-label trial, identified memantine extended-release treatment responders for enrollment into MEM-MD-68, a 12-week randomized, double-blind, placebo-controlled withdrawal trial. MEM-MD-69 was an open-label extension trial in which participants from MEM-MD-68, MEM-MD-91, and open-label trial MEM-MD-67 were treated ⩽48 weeks with memantine extended release. In MEM-MD-91, 517 (59.6%) participants were confirmed Social Responsiveness Scale responders at week 12; mean Social Responsiveness Scale total raw scores improved two to three times a minimal clinically important difference of 10 points. In MEM-MD-68, there was no difference between memantine and placebo on the primary efficacy parameter, the proportion of patients with a loss of therapeutic response (defined as ⩾10-point increase from baseline in Social Responsiveness Scale total raw score). MEM-MD-69 exploratory analyses revealed mean standard deviation improvement in Social Responsiveness Scale total raw score of 32.4 (26.4) from baseline of the first lead-in study. No new safety concerns were evident. While the a priori–defined efficacy results of the double-blind trial were not achieved, the considerable improvements in mean Social Responsiveness Scale scores from baseline in the open-label trials were presumed to be clinically important.

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