scholarly journals FASTER and SCOTT&EVA Trainings for Adults with High-Functioning Autism Spectrum Disorder (ASD): Study Protocol for a Randomized Controlled Trial.

2021 ◽  
Author(s):  
Ludger Tebartz van Elst ◽  
Thomas Fangmeier ◽  
Ulrich Max Schaller ◽  
Oliver Hennig ◽  
Meinhard Kieser ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Cognition ◽  
Social Communication ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Responsiveness ◽  
Evidence Based ◽  
Computer Based Training ◽  
Randomized Controlled ◽  
Computer Based

Abstract Background: Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition with a prevalence rate above 1%, characterized by deficits in social communication and interaction, restrictive, repetitive patterns of behavior, interests or activities as well as a preference for sameness and routines. The majority of adult ASD patients suffer from comorbid conditions such as depression and anxiety. Therapy options for adult ASD patients are lacking, with presently no available evidence-based interventions in Germany. Recently, two interventions to improve social responsiveness have been published. FASTER (“Freiburger Asperger-Spezifische Therapie für ERwachsene” = Freiburg Asperger specific therapy for adults) is a manualized group psychotherapy program including three modules on psychoeducation, stress regulation management as well as non-verbal and verbal social communication training with videotaped tasks. SCOTT&EVA (“Social Cognition Training Tool”, and its enhancement “Emotionen Verstehen und Ausdruecken” = understanding and expressing emotions) is a computer-based training program to enhance social cognition including video and audio material of emotional expressions and complex real-life social situations. Initial studies for both programs have shown good feasibility and efficacy. Methods: 360 adult participants with an autism spectrum disorder (ASD) will take part in a randomized controlled three-armed multicenter trial to prove the efficacy of manualized group psychotherapy and a manualized computer-based training program. Both interventions will be compared with a treatment as usual (TAU) group, aiming to establish evidence-based psychotherapy approaches for adult individuals with ASD. The primary outcome is evaluated by parents, spouses, or others who have sufficient insight into the respective participant’s social communication and interaction, and will be measured with the Social Responsiveness Scale. First, the differences between both interventions in comparison to TAU will be analyzed. If there are significant differences both interventions will be tested confirmatorily.Discussion: The trial is the first to validate psychiatric therapeutic options for adult ASD patients in Germany. A trial is needed because the prevalence of ASD in adulthood without intellectual disability is high, and no evidence-based intervention can be offered in Germany.Trial Registration: DRKS00017817, German Clinical Trial Register, Registered 20 April 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017817

scholarly journals FASTER and SCOTT&EVA trainings for adults with high-functioning autism spectrum disorder (ASD): study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ludger Tebartz van Elst ◽  
Thomas Fangmeier ◽  
Ulrich Max Schaller ◽  
Oliver Hennig ◽  
Meinhard Kieser ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Communication ◽  
Primary Outcome ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Responsiveness ◽  
Evidence Based ◽  
Computer Based Training ◽  
Randomized Controlled ◽  
Computer Based

Abstract Background Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition with a prevalence rate above 1%, characterized by deficits in social communication and interaction; restrictive, repetitive patterns of behavior, interests, or activities; and a preference for sameness and routines. The majority of adult ASD patients suffer from comorbid conditions such as depression and anxiety. Therapy options for adult ASD patients are lacking, with presently no available evidence-based interventions in Germany. Recently, two interventions to improve social responsiveness have been published. FASTER (“Freiburger Asperger-Spezifische Therapie für ERwachsene” = Freiburg Asperger-specific therapy for adults) is a manualized group psychotherapy program including three modules on psychoeducation, stress regulation management, and non-verbal and verbal social communication training with videotaped tasks. SCOTT&EVA (“Social Cognition Training Tool”, and its enhancement “Emotionen Verstehen und Ausdruecken” = understanding and expressing emotions) is a computer-based training program to enhance social cognition including video and audio material of emotional expressions and complex real-life social situations. Initial studies for both programs have shown good feasibility and efficacy. Methods Three hundred sixty adult participants with an autism spectrum disorder (ASD) will take part in a randomized controlled three-armed multi-center trial to prove the efficacy of manualized group psychotherapy and a manualized computer-based training program. Both interventions will be compared with a treatment as usual (TAU) group, aiming to establish evidence-based psychotherapy approaches for adult individuals with ASD. The primary outcome is evaluated by parents, spouses, or others who have sufficient insight into the respective participant’s social communication and interaction, and will be measured with the Social Responsiveness Scale. First, each of both interventions will be compared to TAU. If at least one of the differences is significant, both interventions will be compared against each other. The primary outcome will be measured at baseline (T0) and 4 months after baseline (T1). Discussion The trial is the first to validate psychiatric therapeutic and training interventions for adult ASD patients in Germany. A trial is needed because the prevalence of ASD in adulthood without intellectual disability is high, and no evidence-based intervention can be offered in Germany. Trial registration German Clinical Trial Register DRKS00017817. Registered on 20 April 2020.

Teaching Social Scripts to Improve Social Communication for Students With Autism Spectrum Disorder

2021 ◽  
pp. 004005992110220
Author(s):  
Gretchen Scheibel ◽  
Zijie Ma ◽  
Jason C. Travers
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Communication ◽  
Challenging Behaviors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Academic Difficulties ◽  
Evidence Based Practices ◽  
Social Scripts ◽  
Students With Autism

Students with Autism Spectrum Disorder are likely to demonstrate social impairments that contribute to challenging behaviors and academic difficulties. As a result, the task of improving social communication skills is a critical component to any educational program for this population. Scripting provides an evidence-based and versatile option for improving social communication, yielding valuable results while requiring limited time and resource preparation from educators. In this article, we present step by step guidance to support practitioners in using scripting interventions. Considerations are discussed for adapting this intervention to meet the needs of students across the autism spectrum and links to resources for strengthening implementation and including other evidence-based practices.

scholarly journals SMARTer Approach to Personalizing Intervention for Children With Autism Spectrum Disorder

2018 ◽  
Vol 61 (11) ◽  
pp. 2629-2640 ◽  
Author(s):  
Connie Kasari ◽  
Alexandra Sturm ◽  
Wendy Shih
Keyword(s):  
Autism Spectrum Disorder ◽  
Research Methods ◽  
Social Communication ◽  
Empirical Studies ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Current Status ◽  
Evidence Based ◽  
Targeted Interventions

Purpose This review article introduces research methods for personalization of intervention. Our goals are to review evidence-based practices for improving social communication impairment in children with autism spectrum disorder generally and then how these practices can be systematized in ways that personalize intervention, especially for children who respond slowly to an initial evidence-based practice. Method The narrative reflects on the current status of modular and targeted interventions on social communication outcomes in the field of autism research. Questions are introduced regarding personalization of interventions that can be addressed through research methods. These research methods include adaptive treatment designs and the Sequential Multiple Assignment Randomized Trial. Examples of empirical studies using research designs are presented to answer questions of personalization. Conclusion Bridging the gap between research studies and clinical practice can be advanced by research that attempts to answer questions pertinent to the broad heterogeneity in children with autism spectrum disorder, their response to interventions, and the fact that a single intervention is not effective for all children. Presentation Video https://doi.org/10.23641/asha.7298021

Effectiveness of N-acetylcysteine in autism spectrum disorders: A meta-analysis of randomized controlled trials

2020 ◽  
pp. 000486742095254
Author(s):  
Tsung-Min Lee ◽  
Kuan-Min Lee ◽  
Chuan-Ya Lee ◽  
Hsin-Chien Lee ◽  
Ka-Wai Tam ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Repetitive Behavior ◽  
Autism Spectrum ◽  
Mean Difference ◽  
Spectrum Disorder ◽  
Controlled Trials ◽  
Social Responsiveness ◽  
Randomized Controlled

Objective: Currently, pharmaceutical treatment options for autism spectrum disorder are limited. Brain glutaminergic dysregulation is observed in autism spectrum disorder. N-acetylcysteine, which can be converted to glutathione and subsequently release glutamate into the extracellular space, and thus reduce glutamatergic neurotransmission at synapses, is considered a potential drug for autism spectrum disorder treatment. Here, we analyzed the treatment effects of N-acetylcysteine on autism spectrum disorder in randomized controlled trials. Study design: Updated systematic review and meta-analysis. Data sources: By systematically searching the PubMed, Embase and Cochrane Library, we obtained five randomized controlled trials. Study selection: Meta-analyses were performed to examine the improvement in autistic behaviors as measured by the Aberrant Behavior Checklist, Social Responsiveness Scale and Repetitive Behavior Scale–Revised, using mean difference with a 95% confidence interval and a random-effects model. Data Synthesis: After 8–12 weeks of N-acetylcysteine supplementation, the pooled result of four trials revealed an improvement in Aberrant Behavior Checklist total score (mean difference = 1.31, 95% confidence interval = [0.42, 2.20]). When one trial was excluded, the sensitivity test result was stronger (mean difference = 1.88, 95% confidence interval = [0.92, 2.83]). The pooled results of three trials revealed significant improvements in hyperactivity (mean difference = 4.80, 95% confidence interval = [1.20, 8.40]) and irritability (mean difference = 4.07, 95% confidence interval = [1.13, 7.04]). Regarding Social Responsiveness Scale, the pooled result of two trials showed significant improvement in social awareness after 8–12 weeks of N-acetylcysteine supplementation (mean difference = 1.34, 95% confidence interval = [0.09, 2.59]). No differences were observed in the pooled results of two trials using Repetitive Behavior Scale, either in the total or the subscales. Conclusion: We concluded that N-acetylcysteine is safe and tolerable, reduces hyperactivity and irritability and enhances social awareness in children with autism spectrum disorder. However, further evidence should be sought before a general recommendation.

scholarly journals Naturalistic evaluation of preschoolers’ spontaneous interactions: The Autism Peer Interaction Observation Scale

Autism ◽  
2021 ◽  
pp. 136236132198991
Author(s):  
Nirit Bauminger-Zviely ◽  
Analia Shefer
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Communication ◽  
Intelligence Quotient ◽  
Peer Interaction ◽  
Autism Diagnostic Observation Schedule ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Responsiveness ◽  
Observation Scale ◽  
Autism Diagnostic Observation

Peer interaction can be challenging in autism spectrum disorder, but naturalistic peer-observation scales for preschoolers are scarce. This study examined psychometric qualities of the newly developed Autism Peer Interaction Observation Scale. We tested the Autism Peer Interaction Observation Scale to (a) characterize peer interactions of preschoolers with autism spectrum disorder who were cognitively able versus typical age-mates, (b) explore each group’s hierarchical pattern of peer interaction behaviors, and (c) identify Autism Peer Interaction Observation Scale’s links with standard reports for assessing social-communication functioning (Vineland Behavior Scales, 2nd ed.), social impairment (Social Responsiveness Scale, 2nd ed.), autism severity (Autism Diagnostic Observation Schedule, 2nd ed.), and intelligence quotient (Mullen) in the cognitively able preschoolers with autism spectrum disorder group. Participants comprised 85 preschoolers (50 cognitively able preschoolers with autism spectrum disorder, intelligence quotient > 75; 35 typical). Groups were matched for age, intelligence quotient, and maternal education. Significant group differences emerged on all Autism Peer Interaction Observation Scale categories, in favor of typical. In cognitively able preschoolers with autism spectrum disorder, correlation analyses indicated that more typical peer relations on Autism Peer Interaction Observation Scale were linked with better adaptive and socialization skills (Vineland Behavior Scales, 2nd ed.) and fewer social atypicalities (Social Responsiveness Scale, 2nd ed.). Higher intelligence quotient scores were linked with better Autism Peer Interaction Observation Scale social-communication functioning. Only a few Autism Peer Interaction Observation Scale social-communication categories significantly correlated with the Autism Diagnostic Observation Schedule, 2nd ed. Findings highlight the Autism Peer Interaction Observation Scale as differentiating between groups and providing knowledge about peer interaction in natural settings. This new tool can help personalize social-communication programs and evaluations of early intervention outcomes. Lay abstract Peer interaction can be challenging in autism spectrum disorder, but naturalistic peer-observation scales for preschoolers are limited. This study examined the newly developed Autism Peer Interaction Observation Scale, with 17 subcategories, which evaluate naturalistic peer interaction processes in preschoolers with autism spectrum disorder and typical development. We tested the Autism Peer Interaction Observation Scale to (a) characterize peer interactions of preschoolers with autism spectrum disorder who were cognitively able versus typical age-mates, (b) explore each group’s hierarchical pattern of peer interaction behaviors, and (c) identify Autism Peer Interaction Observation Scale’s links with standard reports for assessing social-communication functioning (Vineland Behavior Scales, 2nd ed.), social impairment (Social Responsiveness Scale, 2nd ed.), autism severity (Autism Diagnostic Observation Schedule, 2nd ed.), and intelligence quotient (Mullen) in the cognitively able preschoolers with autism spectrum disorder group. Participants comprised 85 preschoolers (50 cognitively able preschoolers with autism spectrum disorder, intelligence quotient > 75; 35 typical). Groups were matched according to age, intelligence quotient, and maternal education. Significant group differences emerged on all Autism Peer Interaction Observation Scale categories, with the typical group showing better social-communication functioning as compared to the cognitively able preschoolers with autism spectrum disorder group. Also, in cognitively able preschoolers with autism spectrum disorder that observed as demonstrating more typical peer relations on the Autism Peer Interaction Observation Scale showed better adaptive and socialization skills on the Vineland (Vineland Behavior Scales, 2nd ed.) and fewer social atypicalities on the Social Responsiveness Scale, 2nd ed. Higher intelligence quotient scores were linked with better observed social-communication functioning (on Autism Peer Interaction Observation Scale). Few Autism Peer Interaction Observation Scale social-communicative categories significantly correlated with the Autism Diagnostic Observation Schedule, 2nd ed. Findings highlight the Autism Peer Interaction Observation Scale as differentiating the two preschooler groups and providing additional knowledge about socially communicative peer interaction in natural settings. This new tool can help personalize social-communication programs and evaluations of early intervention outcomes, thereby leading to a fuller picture of these young children’s functioning.

Evidence-Based Social Communication Interventions for Children with Autism Spectrum Disorder

2015 ◽  
Vol 84 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Laci Watkins ◽  
Michelle Kuhn ◽  
Katherine Ledbetter-Cho ◽  
Cindy Gevarter ◽  
Mark O’Reilly
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Communication ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Evidence Based ◽  
Communication Interventions

scholarly journals Prediction of social behavior in autism spectrum disorders: Explicit versus implicit social cognition

Autism ◽  
2020 ◽  
Vol 24 (7) ◽  
pp. 1758-1772
Author(s):  
Cara M Keifer ◽  
Amori Yee Mikami ◽  
James P Morris ◽  
Erin J Libsack ◽  
Matthew D Lerner
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Cognition ◽  
Social Behavior ◽  
Social Communication ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Deficits ◽  
Implicit Social Cognition ◽  
Implicit And Explicit ◽  
Interaction Behaviors

Deficient social communication and interaction behaviors are a hallmark feature of individuals with autism spectrum disorder. These social communication and interaction deficits potentially stem from problems with explicit social cognition (i.e. processes that are controlled and largely conscious) as well as with implicit social cognition (i.e. processes that are fast, spontaneous, and primarily unconscious). This study aimed to investigate the relative contributions of implicit and explicit social cognition factors as predictors of multi-informant measures of social communication and interaction behaviors in a sample of 34 youth with clinical diagnoses of autism spectrum disorder. Behavioral, cognitive, and electrophysiological indices of implicit and explicit social cognition were entered into partial least squares regression models designed to identify latent factors that optimally predict parent-report, observer-coded, and clinician-rated social communication, and interaction outcomes. Results indicated that while both implicit and explicit social cognition factors optimally predicted outcomes, implicit social cognition factors were relatively more predictive. Findings have important implications for the conceptualization and measurement of social functioning as well as the development of targeted social interventions in autism spectrum disorder populations. Lay abstract Difficulties with social communication and interaction are a hallmark feature of autism spectrum disorder. These difficulties may be the result of problems with explicit social cognition (effortful and largely conscious processes) such as learning and recalling social norms or rules. Alternatively, social deficits may stem from problems with implicit social cognition (rapid and largely unconscious processes) such as the efficient integration of social information. The goal of this study was to determine how problems in explicit and implicit social cognition relate to social behavior in 34 youth with autism spectrum disorder. We measured aspects of implicit and explicit social cognition abilities in the laboratory using behavioral, cognitive, and brain (electrophysiological) measures. We then used those measures to predict “real-world” social behavior as reported by parents, clinicians, and independent observers. Results showed that overall better aspects of implicit and explicit social cognition predicted more competent social behavior. In addition, the ability to fluidly integrate social information (implicit social cognition) was more frequently related to competent social behavior that merely knowing what to do in social situations (explicit social cognition). These findings may help with the development of interventions focusing on improving social deficits.

Familial confounding on the ability to read minds: A co-twin control study

Autism ◽  
2019 ◽  
Vol 23 (8) ◽  
pp. 1948-1956 ◽  
Author(s):  
Johan Isaksson ◽  
Mark J Taylor ◽  
Karl Lundin ◽  
Janina Neufeld ◽  
Sven Bölte
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Cognition ◽  
Autistic Traits ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Shared Environment ◽  
Social Responsiveness ◽  
Communication Challenges ◽  
The Mind ◽  
The Impact

Alterations in social cognition are hypothesized to underlie social communication challenges in autism spectrum disorder. However, the etiologic underpinnings driving this association, as well as the impact of other psychiatric conditions on the association, remain unclear. Using a co-twin control design, we examined n = 308 twins (mean age = 16.63; 46% females) with autism spectrum disorder, attention-deficit/hyperactivity disorder, affective disorders, or typical development using the Reading the Mind in the Eyes Test to operationalize social cognition ability. Clinical diagnosis of autism spectrum disorder, as well as the extent of quantitative autistic traits, as measured by parental reports using the Social Responsiveness Scale-2, predicted fewer expected responses on the Reading the Mind in the Eyes Test across the pairs. The association remained when adjusting for other diagnoses and IQ. In addition, male sex, lower age, and lower IQ predicted poorer performance on the Reading the Mind in the Eyes Test. The associations between autism and social cognition ability were lost within pairs in both the full sample and the monozygotic subsample. We conclude that the association between autism and social cognition across the sample highlights the importance of social cognition alterations in autism spectrum disorder when compared with other conditions. The attenuation of the association in the within-pair models indicate familial confounding, such as genes and shared environment, influencing both autism and social cognition.

The utility of parent-report screening tools in differentiating autism versus attention-deficit/hyperactivity disorder in school-age children

Autism ◽  
2021 ◽  
pp. 136236132110300
Author(s):  
Sara Guttentag ◽  
Somer Bishop ◽  
Rebecca Doggett ◽  
Rebecca Shalev ◽  
Megan Kaplan ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Social Communication ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Social Responsiveness ◽  
School Age ◽  
Social Communication Questionnaire ◽  
Hyperactivity Disorder ◽  
The Social

Symptoms of autism spectrum disorder and attention-deficit/hyperactivity disorder often co-occur, challenging timely, and accurate diagnosis. We assessed the performance of three parent-report measures in discriminating autism spectrum disorder from attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD) in school-age verbally fluent children. We examined the Autism Symptom Interview – School-Age and two widely used parent questionnaires: Social Responsiveness Scale – 2nd Edition and Social Communication Questionnaire – Lifetime. Receiver operating characteristic curves assessed each instrument’s performance against the best-estimate clinician Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnosis of autism spectrum disorder or of ADHDw/oASD ( n = 74, n = 102, respectively; 6–11 years). These yielded moderate accuracies: area under the curve = 0.85, 0.79, and 0.78 for Social Communication Questionnaire – Lifetime, Autism Symptom Interview, and Social Responsiveness Scale – 2nd Edition, respectively. Area under the curve pairwise comparisons reached our statistical significance ( p < 0.01) for the Social Communication Questionnaire – Lifetime versus the Social Responsiveness Scale – 2nd Edition. Within instruments, sensitivity and specificity varied across autism spectrum disorder cutoffs. Along with the between-instrument variability, this indicates that clinicians and researchers have valid options, depending on the settings and their goals. Comparing children correctly and incorrectly classified as autism spectrum disorder showed no differences in demographics, intellectual abilities, or in any specific clinical profile(s), except for the degree of parent concerns across autism spectrum disorder and comorbid psychopathology-related symptoms. Together, results suggest that complementing parent screeners with multiple sources may be needed to best differentiate school-age verbally fluent children with autism spectrum disorder versus ADHDw/oASD. Lay abstract We tested the ability of a short, recently developed parent interview and two widely used parent-report questionnaires to discriminate school-age verbal children with autism spectrum disorder from those with attention-deficit/hyperactivity disorder without autism spectrum disorder (ADHDw/oASD). These measures included the Autism Symptom Interview – School-Age, the Social Responsiveness Scale – 2nd Edition, and the Social Communication Questionnaire – Lifetime. The classification accuracy of all three parent screeners fell in the moderate range. Accuracy varied by instrument, and the Social Communication Questionnaire – Lifetime questionniare showed the highest accuracy. Children with autism spectrum disorder who were incorrectly classified by all parent screeners did not differ from those correctly classified in regard to demographics, intellectual abilities, nor in any specific clinical area beyond general parent concerns. These findings showed that there are valid screening options for assessing school-age verbal children with autism spectrum disorder versus ADHDw/oASD. They also underscore the need to assess multiple sources of information for increased accuracy.

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