scholarly journals Improvement of Autism Symptoms After Comprehensive Intensive Early Interventions in Community Settings

2020 ◽  
pp. 107839032091525
Author(s):  
Nils Haglund ◽  
SvenOlof Dahlgren ◽  
Maria Råstam ◽  
Peik Gustafsson ◽  
Karin Källén
Keyword(s):  
Comparison Group ◽  
Group Versus ◽  
Children With Autism ◽  
Autism Diagnostic Observation Schedule ◽  
Analysis Of Covariance ◽  
Community Treatment ◽  
Autism Symptoms ◽  
Treatment As Usual ◽  
Severity Scores ◽  
Intensive Programs

BACKGROUND: Preschool children with autism in southern Sweden participated in a comprehensive Naturalistic Developmental Behavioral Intervention (NDBI) program. AIMS: To evaluate the ongoing NDBI program by comparing the pre- and postintervention outcomes in terms of improved autism symptom severity. METHOD: The improvement of Autism Diagnostic Observation Schedule (ADOS-R) test results between baseline and evaluation among children participating in the NDBI program ( n = 67) was compared with the results among children receiving community treatment as usual ( n = 27) using analysis of covariance. RESULTS: The study showed that children in the NDBI group improved their ADOS-R total scores between baseline and evaluation (−0.8 scores per year; 95% CI [−1.2, −0.4]), whereas no improvement was detected in the comparison group (+0.1 scores per year; 95% CI [−0.7, +0.9]). The change in the NDBI group versus the change in the comparison group was statistically significant after adjusting for possible confounders as well. Children in the NDBI group also significantly improved their ADOS severity scores, but the scores were not significantly different from those of the comparison group. CONCLUSIONS: The results from the current naturalistic study must be interpreted cautiously, but they do support earlier studies reporting on improvement of autism symptoms after early intensive interventions. Results from observational studies are difficult to interpret, but it is nevertheless of uttermost importance to evaluate costly autism intervention programs. The results do indicate that children with autism benefit from participating in early comprehensive intensive programs.

Improvement of Autism Symptoms After Comprehensive Intensive Early Interventions in a Clinical Setting

2017 ◽  
Vol 41 (S1) ◽  
pp. S127-S128 ◽  
Author(s):  
N. Haglund ◽  
S. Dahlgren ◽  
M. Råstam ◽  
P. Gustafsson ◽  
K. Källén
Keyword(s):  
Developmental Delay ◽  
Comparison Group ◽  
Intervention Group ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Symptom Improvement ◽  
Similar Degree ◽  
Natural Setting ◽  
Autism Symptoms ◽  
Severity Scores

IntroductionThe last two decades increase in early detection and diagnosing children with autism spectrum disorders (ASD) has challenged child and youth habilitation centers to offer the best and most appropriate treatment and support.Objectives and aimsTo evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with ASD based on principles of behaviour learning and developmental science, implemented in the child's natural setting.MethodThe change in autism symptoms among children participating in CIEI (intervention group, n = 67) was compared with children who received traditional habilitation services only (comparison group, n = 27). Symptom changes were measured as evaluation-ADOS-R-scores, total-, severity-, and module-adjusted-scores (ADOS-MAS), minus the corresponding baseline-scores, divided by the time between baseline and evaluation, and estimated using ANOVA adjusting for confounders. The ADOS-MAS were developed to allow improved communicative functions to be counted in the overall symptom improvement.ResultsChildren in both study groups improved their autism symptoms as measured with the ADOS-MAS, and the improvement was statistically significantly larger among children without any developmental delay (P < .001). When adjustments were made for developmental delay, there was a statistically significant larger improvement of ADOS-MAS among children in the intervention group than in the comparison group (P = 0.047). Similar results were found for ADOS-R-total and ADOS-severity scores (P = 0.023 and P = 0.060. respectively).ConclusionThe results of the current study indicate that the CIEI program significantly improve social and communicative skills among children with autism, and that children with developmental delay could benefit to a similar degree as other children.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Profiles of Receptive and Expressive Language Abilities in Boys With Comorbid Fragile X Syndrome and Autism

2012 ◽  
Vol 117 (1) ◽  
pp. 18-32 ◽  
Author(s):  
Andrea McDuffie ◽  
Sara Kover ◽  
Leonard Abbeduto ◽  
Pamela Lewis ◽  
Ted Brown
Keyword(s):  
Fragile X Syndrome ◽  
Test Performance ◽  
Symptom Severity ◽  
Fragile X ◽  
Expressive Language ◽  
Negative Relationship ◽  
Autism Diagnostic Observation Schedule ◽  
Diagnostic Interview ◽  
Autism Symptoms ◽  
Severity Scores

Abstract The authors examined receptive and expressive language profiles for a group of verbal male children and adolescents who had fragile X syndrome along with varying degrees of autism symptoms. A categorical approach for assigning autism diagnostic classification, based on the combined use of the Autism Diagnostic Interview—Revised and the Autism Diagnostic Observation Schedule (ADOS), and a continuous approach for representing autism symptom severity, based on ADOS severity scores, were used in 2 separate sets of analyses. All analyses controlled for nonverbal IQ and chronological age. Nonverbal IQ accounted for significant variance in all language outcomes with large effect sizes. Results of the categorical analyses failed to reveal an effect of diagnostic group (fragile X syndrome–autism, fragile X syndrome–no autism) on standardized language test performance. Results of the continuous analyses revealed a negative relationship between autism symptom severity and all of the standardized language measures. Implications for representing autism symptoms in fragile X syndrome research are considered.

scholarly journals Differences in subcortico-cortical interactions identified from connectome and microcircuit models in autism

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Bo-yong Park ◽  
Seok-Jun Hong ◽  
Sofie L. Valk ◽  
Casey Paquola ◽  
Oualid Benkarim ◽  
...  
Keyword(s):  
Data Exchange ◽  
Computational Models ◽  
Simulation Models ◽  
Autism Diagnostic Observation Schedule ◽  
Supervised Machine Learning ◽  
Global Network ◽  
Imaging Data ◽  
Phenotypic Data ◽  
Severity Scores ◽  
High Level

AbstractThe pathophysiology of autism has been suggested to involve a combination of both macroscale connectome miswiring and microcircuit anomalies. Here, we combine connectome-wide manifold learning with biophysical simulation models to understand associations between global network perturbations and microcircuit dysfunctions in autism. We studied neuroimaging and phenotypic data in 47 individuals with autism and 37 typically developing controls obtained from the Autism Brain Imaging Data Exchange initiative. Our analysis establishes significant differences in structural connectome organization in individuals with autism relative to controls, with strong between-group effects in low-level somatosensory regions and moderate effects in high-level association cortices. Computational models reveal that the degree of macroscale anomalies is related to atypical increases of recurrent excitation/inhibition, as well as subcortical inputs into cortical microcircuits, especially in sensory and motor areas. Transcriptomic association analysis based on postmortem datasets identifies genes expressed in cortical and thalamic areas from childhood to young adulthood. Finally, supervised machine learning finds that the macroscale perturbations are associated with symptom severity scores on the Autism Diagnostic Observation Schedule. Together, our analyses suggest that atypical subcortico-cortical interactions are associated with both microcircuit and macroscale connectome differences in autism.

435 Single Session CBT to Improve PAP Initiation and Adherence among Veterans with OSA

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A172-A172
Author(s):  
Todd Bishop ◽  
Patrick Walsh ◽  
Tracy Stecker ◽  
Katrina Speed ◽  
Lisham Ashrafioun ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Comparison Group ◽  
Behavioral Therapy ◽  
Subsequent Treatment ◽  
Single Session ◽  
Post Intervention ◽  
Chi Square ◽  
Treatment As Usual ◽  
Obstructive Sleep

Abstract Introduction Obstructive sleep apnea (OSA) is a condition that is prevalent, pernicious, and linked to the development and exacerbation of several disease processes. Positive airway pressure (PAP) is a highly efficacious intervention; however, initiation and adherence rates are poor. This represents a critical gap in care and a missed opportunity to reduce morbidity and mortality associated with OSA. The present study piloted a single session of cognitive behavioral therapy for treatment seeking (CBT-TS) among veterans diagnosed with obstructive sleep apnea and newly prescribed PAP. Methods Participants were asked to complete assessments at baseline and at two- and four-weeks post-intervention. A sample of 40 Veterans were enrolled in the study and completed a baseline interview, 27 completed CBT-TS. A matched comparison group of 64 veterans who did not receive the intervention was constructed using electronic medical record and PAP adherence data. Mann Whitney U and Chi Square tests were used to examine group differences in initiation and adherence. Results Participants who completed the CBT-TS session were more likely to initiate PAP (at least 3 consecutive nights of use) as compared to those receiving treatment as usual (TAU) [(CBT-TS; 96.3%; 26/27) versus (TAU; 64.1%; 41/64); X2(1, N = 91) = 10.16, p = .001]. Participants in the CBT-TS group also used their PAP devices for a greater number of nights over the first month than the comparison group [(CBT-TS; M = 21.7 (SD = 8.9), Mdn = 26.0) versus (TAU; M = 14.4 (SD = 12.6), Mdn = 15.5); U = 555.0, p = .007] and were more likely to use the device in an adherent manner (i.e., ≥4 hours use in an evening); [(CBT-TS; M = 15.1 (SD = 11.2); Mdn = 15.0) versus (TAU; M = 10.3 (SD = 11.2), Mdn = 6.5); U =630.0, p = .038]. Conclusion These preliminary data suggest that CBT-TS may have utility in increasing initiation of PAP and subsequent treatment adherence among Veterans diagnosed with OSA and newly prescribed PAP. Support (if any) This work was supported by the VA Center of Excellence for Suicide Prevention in the Finger Lakes Healthcare System.

Before School Exercise Effects on Fitness and Academic Performance in Schoolchildren: A Retrospective Case-Controlled Study

2021 ◽  
pp. 1-6
Author(s):  
Austin J. Kulp ◽  
Xihe Zhu
Keyword(s):  
Academic Performance ◽  
Cardiorespiratory Fitness ◽  
Comparison Group ◽  
Fifth Graders ◽  
Reading Test ◽  
Analysis Of Covariance ◽  
Controlled Study ◽  
Retrospective Case ◽  
Significant Difference ◽  
Before School

Background/Purpose: Before school exercise programs (BSEPs) give students time for breakfast and add time to their daily physical activity. However, the effects of BSEP on physical fitness and academic achievement in the classroom remain unclear. The purpose of this study is to examine the effects of BSEP on cardiorespiratory fitness and academic performance among fourth- and fifth-grade students. Method: A retrospective case-controlled design was used in this study. Fourth and fifth graders (N = 84) were participants, half signed up for BSEP that met once a week for 10 weeks. A retrospectively case-controlled comparison group was generated from the classmates of those in BSEP in the same school. All students took PACER and statewide academic performance assessments. Multivariate analysis of covariance for student cardiorespiratory fitness, and mathematics and reading, were conducted, adjusting for pretest performances. Analysis/Results: There were improvements for both groups in academic performances and cardiorespiratory fitness. The cardiorespiratory fitness and reading test improvements were greater in the BSEP group than those in the comparison group, controlling for their pretests. However, there was no significant difference in student mathematics test performances. Conclusion: Students in BSEP group benefited from participating in the program with greater improvement in cardiorespiratory and reading test performances than the comparison group. These findings suggested that providing a BSEP once a week for 45 min may be beneficial to fourth and fifth graders.

Cognitive Therapy for Major Depressive Disorder in Primary Care

1984 ◽  
Vol 144 (4) ◽  
pp. 400-406 ◽  
Author(s):  
John D. Teasdale ◽  
Melanie J. V. Fennell ◽  
George A. Hibbert ◽  
Peter L Amies
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Cognitive Therapy ◽  
Comparison Group ◽  
Psychological Treatment ◽  
Antidepressant Medication ◽  
Self Report ◽  
Major Depressive ◽  
Treatment As Usual ◽  
Severity Of Depression

SummaryCognitive therapy for depression is a psychological treatment designed to train patients to identify and correct the negative depressive thinking which, it has been hypothesised, contributes to the maintenance of depression. General practice patients meeting Research Diagnostic Criteria for primary major depressive disorder were randomly allocated either to continue with the treatment they would normally receive (which in the majority of cases included antidepressant medication) or to receive, in addition, sessions of cognitive therapy. At completion of treatment, patients receiving cognitive therapy were significantly less depressed than the comparison group, both on blind ratings of symptom severity made by psychiatric assessors and on a self-report measure of severity of depression. At three-month follow-up cognitive therapy patients no longer differed from patients receiving treatment-as-usual, but this was mainly as a result of continuing improvement in the comparison group.

scholarly journals A randomized, prospective pilot study of patient expectancy and antidepressant outcome

2012 ◽  
Vol 43 (5) ◽  
pp. 975-982 ◽  
Author(s):  
B. R. Rutherford ◽  
S. M. Marcus ◽  
P. Wang ◽  
J. R. Sneed ◽  
G. Pelton ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Antidepressant Medication ◽  
Clinical Trial Design ◽  
Study Groups ◽  
Medication Administration ◽  
Analysis Of Covariance ◽  
Major Depressive ◽  
Active Medication ◽  
Severity Scores ◽  
Prospective Investigation

BackgroundThis study is a randomized, prospective, investigation of the relationships between clinical trial design, patient expectancy and the outcome of treatment with antidepressant medication.MethodAdult out-patients with major depressive disorder (MDD) were randomized to either placebo-controlled (PC, 50% probability of receiving active medication) or comparator (COMP, 100% probability of receiving active medication) administration of antidepressant medication. Independent-samples t tests and analysis of covariance (ANCOVA) were used to determine whether the probability of receiving active medication influenced patient expectancy and to compare medication response in the PC v. COMP conditions. We also tested the correlations between baseline expectancy score and final improvement in depressive symptoms across study groups.ResultsSubjects randomized to the COMP condition reported greater expectancy of improvement compared to subjects in the PC condition (t = 2.60, df = 27, p = 0.015). There were no statistically significant differences in the analyses comparing antidepressant outcomes between subjects receiving medication in the COMP condition and those receiving medication in the PC condition. Higher baseline expectancy of improvement was correlated with lower final depression severity scores (r = 0.53, p = 0.021) and greater improvement in depressive symptoms over the course of the study (r = 0.44, p = 0.058).ConclusionsThe methods described represent a promising way of subjecting patient expectancy to scientific study. Expectancy of improvement is affected by the probability of receiving active antidepressant medication and seems to influence antidepressant response.

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