scholarly journals Preliminary feasibility testing of a planning focused CBT for adolescents with an ASD diagnosis: Suggestions for intervention adaptations to meet needs of autistic teens

2020 ◽  
Author(s):  
Anouck I. Staff ◽  
Hilde Geurts ◽  
Marije Kuin ◽  
saskia van der oord ◽  
Bianca Boyer
Keyword(s):  
Secondary School ◽  
Autism Spectrum ◽  
Pharmacological Interventions ◽  
Post Intervention ◽  
Current Form ◽  
Adhd Diagnosis ◽  
Autism Spectrum Disorder Diagnosis ◽  
Reported Data ◽  
Planning Problems ◽  
Adolescents With Asd

Adolescents with an Autism Spectrum Disorder diagnosis (ASD) show executive functioning (EF) difficulties that are crucial to succeed in secondary school, but evidence-based EF interventions are lacking. However, for adolescents with an ADHD diagnosis such an intervention was developed, called Plan My Life (PML), which focused on enhancement of planning skills and in which motivational interviewing was integrated. We explored the applicability of PML in a sample of 12 adolescents with ASD (12-17 years). Pre- to post intervention parent-reported data were collected on EF problems, planning problems, and ASD characteristics. Also, qualitative analyses were conducted on therapist evaluations to investigate whether PML in its present form is suitable for adolescents with ASD and how the PML should be adjusted to better serve their needs. Reliable Change Indices showed that in general adolescents with ASD did not improve, suggesting that in its current form PML is not suitable for adolescents with ASD. However, attrition was low (N = 1), adolescents and parents evaluated PML positively, and a feasible list of therapist recommendations was formulated for adjustment of PML to the needs of this particular group. These recommendations seem specific to autistic teens and may be applicable to other non-pharmacological interventions that will be developed for teens with ASD to improve their care and outcomes.

scholarly journals Determinants of an autism spectrum disorder diagnosis in childhood and adolescence: Evidence from the UK Millennium Cohort Study

Autism ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1557-1565
Author(s):  
Mariko Hosozawa ◽  
Amanda Sacker ◽  
William Mandy ◽  
Emily Midouhas ◽  
Eirini Flouri ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
United Kingdom ◽  
Secondary School ◽  
Primary School ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
School Entry ◽  
Autism Spectrum Disorder Diagnosis ◽  
The United Kingdom

This study aimed to identify determinants of a late autism spectrum disorder diagnosis, including diagnoses made ‘very late’ (i.e., in adolescence), using the Millennium Cohort Study, a nationally representative population-based cohort in the United Kingdom. Children diagnosed with autism spectrum disorder by age 14 (N = 581) were included and grouped by the parent-reported timing of diagnosis: before school (up to age 5), during primary school (age 5–11) and during secondary school (age 11–14). Predictors of diagnostic timing, at the child, family and school levels, were investigated using multinomial logistic regression. Most (79%) children with autism spectrum disorder were diagnosed after school entry, and 28% were not diagnosed until secondary school. Among those not diagnosed until secondary school, 75% had been identified at age 5 years by a parent and/or teacher as having socio-behavioural difficulties. Being diagnosed after starting school was predicted by living in poverty (adjusted relative risk ratio: primary = 1.90, 95% confidence interval: 1.03–3.53; secondary = 2.15, 1.05–4.42) and/or having no initial parental concerns (primary = 0.32, 0.15–0.70; secondary = 0.19, 0.09–0.43). Having typical-range intelligence also predicted diagnosis during secondary school. The result indicates that those without cognitive delays and poorer children were at risk of ‘very late’ (i.e. adolescent) diagnosis. Strategies to promote earlier identification, targeting age at primary school entry, could help those more likely to be diagnosed late. Lay abstract Despite policy emphasis on early identification, many children with autism spectrum disorder are diagnosed late, with some being diagnosed as late as in adolescence. However, evidence on what determines the timing of autism spectrum disorder diagnosis including children diagnosed in adolescence is lacking. Understanding these determinants, particularly in those diagnosed later than is ideal, can inform the development of effective strategies to improve earlier identification of autism spectrum disorder. This study used a nationally representative population-based cohort in the United Kingdom to explore child, family and school level predictors of timing of autism spectrum disorder diagnosis. In the United Kingdom, 79% of the children with autism spectrum disorder were diagnosed after entering primary school and 28% during secondary school. Among those not diagnosed until secondary school, 75% had shown social difficulties noticed by parents and/or teachers at age 5 years. The results suggest that healthcare providers should be aware that, even for universal systems of care, those living in poverty and having higher intelligence are most likely to miss out on a timely diagnosis. Strategies to promote earlier identification among school-aged children, including targeting primary school entry age (i.e. around age 5) and that encouraging referrals for a formal assessment at the first report of concerns over the child’s social development may benefit those children who would otherwise be diagnosed later.

scholarly journals Sleeping without Prescription: Management of Sleep Disorders in Children with Autism with Non-Pharmacological Interventions and Over-the-Counter Treatments

2020 ◽  
Vol 10 (7) ◽  
pp. 441
Author(s):  
Dario Esposito ◽  
Arianna Belli ◽  
Raffaele Ferri ◽  
Oliviero Bruni
Keyword(s):  
Children And Adolescents ◽  
Behavioral Interventions ◽  
Sleep Disturbances ◽  
Challenging Behaviors ◽  
Autism Spectrum ◽  
Herbal Remedies ◽  
Lifestyle Modifications ◽  
Pharmacological Interventions ◽  
Over The Counter ◽  
Adolescents With Asd

Autism Spectrum Disorders (ASD) are lifelong neurodevelopmental conditions characterized by abnormal social interaction, communication, and behavior. Sleep disturbances represent a common comorbidity in children and adolescents with ASD, with prevalence ranging from 50 to 80%. It has been proved that sleep disruption worsens the symptoms of autism and results in challenging behaviors. Improving sleep should therefore be a primary therapeutic goal. Treatment options range from lifestyle modifications to pharmacological therapy. Several reviews have been written on pharmacological treatments, but very few on the beneficial effects of non-pharmacological interventions, over-the-counter drugs, and nutritional supplements. This study consists of a narrative review of the literature, presenting the available evidence on the following treatments: sleep education, behavioral interventions, complementary and alternative medicine (special mattresses and blankets, massage, aromatherapy, yoga, physical activity), and commonly used over-the-counter medications and supplements (antihistamines, melatonin, tryptophan, carnosine, iron, vitamins, and herbal remedies). For some treatments—such as melatonin and behavioral interventions—effectiveness in ASD is well established in the literature, while other interventions appear of benefit in clinical practice, even if specific studies in children and adolescents with ASD are lacking. Conversely, other treatments only seem to show anecdotal evidence supporting their use.

scholarly journals Feasibility of a Virtual Nutrition Intervention for Adolescents With Autism Spectrum Disorder

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 109-109
Author(s):  
Acadia Buro ◽  
Mikaela Strange ◽  
Tiantian Pang ◽  
Syed Hasan ◽  
Heewon Gray
Keyword(s):  
Autism Spectrum Disorder ◽  
Dietary Intake ◽  
Outcome Measures ◽  
Response Rate ◽  
Autism Spectrum ◽  
Nutrition Intervention ◽  
Post Intervention ◽  
Anthropometric Measures ◽  
Adolescents With Autism ◽  
Adolescents With Asd

Abstract Objectives Adolescents with autism spectrum disorder (ASD) are at an increased risk of obesity and unhealthy eating behaviors. This study examined the feasibility of a virtual implementation of a nutrition intervention for adolescents with ASD, as well as feasibility of virtually assessing outcome measures, including anthropometric measures, dietary intake, and psychosocial determinants of dietary intake. Methods BALANCE (Bringing Adolescent Learners with Autism Nutrition and Culinary Education) is an 8-week theory-driven nutrition intervention for adolescents with ASD. The intervention is based on Social Cognitive Theory. Six groups of adolescents (n = 27; group size ranged 2–7) participated in the intervention and pre-/post-intervention assessments. Fidelity checklists included measures on attendance, participation, homework, fidelity, and technical difficulties. Feasibility of assessing outcome measures, including the Block Kids Food Frequency Questionnaire (FFQ), a validated psychosocial survey, and height and weight, was evaluated on response rate, completion, and data quality. Results Mean lesson attendance was 88%, participation was 3.5 of 4, homework completion was 51.9%, fidelity was 98.9%, and prevalence of technical difficulties was 0.4 of 2 (no technical difficulties or minor difficulties for all lessons). Baseline response rate was 100% for all outcome measures, with 100% completion for the FFQ and 98.9% for the psychosocial survey. Post-intervention response rate was 92.6% for the FFQ and 96.3% for the psychosocial survey and anthropometric measures, with 100% completion for the FFQ and 99.5% for the psychosocial survey. Data quality was high for 88% of the matched FFQs and 100% of the psychosocial surveys. Conclusions Findings of the study suggest that a virtual implementation and evaluation of BALANCE was feasible, indicating that BALANCE may be implemented in virtual settings to reach diverse populations of adolescents with ASD. Future research is warranted to examine the impact of BALANCE on dietary behavior changes and obesity outcomes. Funding Sources This work was funded by the University of South Florida College of Public Health Internal Grant & Student Research Scholarship.

Exercise-Based Interventions Aimed at Improving Balance in Children with Autism Spectrum Disorder: A Meta-Analysis

2021 ◽  
pp. 003151252110602
Author(s):  
Mirjana Djordjević ◽  
Haris Memisevic ◽  
Srecko Potic ◽  
Uros Djuric
Keyword(s):  
Autism Spectrum Disorder ◽  
Children And Adolescents ◽  
Intervention Studies ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Mean Difference ◽  
Spectrum Disorder ◽  
Post Intervention ◽  
Standardized Mean Difference ◽  
Adolescents With Asd

Children with Autism Spectrum Disorder (ASD) often have deficits in motor skills, especially balance. This article presents a meta-analytic review of 15 intervention studies that aimed to improve balance in children and adolescents with ASD. Across these studies, there were 195 participants with ASD for whom pre-intervention and post-intervention balance scores were available. We measured the standardized mean difference (Hedges’ g) between their pre-intervention and post-intervention balance scores and found a large, positive effect from these balance interventions (standardized mean difference—1.82 (95% CI [1.34, 2.29])). Various balance intervention procedures were shown to be very efficacious for children and adolescents with ASD. Clearly, balance is a motor skill that is very susceptible to intervention efforts. We also provided recommendations to researchers regarding what information to include when conducting intervention studies.

Sleep problems and daytime functioning in adolescents with ASD

2021 ◽  
Author(s):  
Ilona Schouwenaars ◽  
Maurice Magnée ◽  
Hilde Geurts ◽  
Coen van Bennekom ◽  
Sigrid Pillen ◽  
...  
Keyword(s):  
Reference Lists ◽  
Sleep Problems ◽  
Original Data ◽  
Autism Spectrum ◽  
Daytime Functioning ◽  
Hand Search ◽  
Autism Spectrum Disorder Diagnosis ◽  
Sleep Parameters ◽  
The Relationship ◽  
Adolescents With Asd

Sleep problems commonly occur in adolescents with an autism spectrum disorder diagnosis (ASD). However, the knowledge of how sleep problems affect those adolescents’ lives is fragmentised. This review focuses on the question: What is the relationship between sleep and daytime functioning in adolescents with ASD. An electronic database (PsycINFO, Cochrane, ERIC, PubMed, WOS) and hand search (INSAR congress archive and included studies reference lists) was performed in September 2020 resulting in 2561 studies. Studies were included if they contained autistic participants aged between 10 and 19 without intellectual disability, related sleep to daytime functioning, were available in English, and used original data. Nine studies were included (Nparticipants = 674). The most prominent finding was the association of all sleep parameters with internalizing problems. Furthermore, most significant associations with daytime functioning were found for sleep problems in general and for sleep efficiency. The results provide input for tailored sleep interventions. However, more research is needed to get a clearer picture of the relationship between specific sleep parameters and daytime functioning to ensure that this knowledge will provide better input for sleep interventions. It is important to focus on limited age ranges, larger samples sizes, multiple measurement methods, and longitudinal approaches.

scholarly journals Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Emily R. Bemmer ◽  
Kelsie A. Boulton ◽  
Emma E. Thomas ◽  
Ben Larke ◽  
Suncica Lah ◽  
...  
Keyword(s):  
Young Adults ◽  
Social Anxiety ◽  
Social Functioning ◽  
Autism Spectrum ◽  
Self Report ◽  
Post Intervention ◽  
Adults With Autism ◽  
Adolescents And Adults ◽  
Adults With Asd ◽  
Young Adults With Asd

Abstract Background There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. Method Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). Results Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program. Limitations The absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study. Conclusions These findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.

scholarly journals A role-play assessment tool and drama-based social skills intervention for adults with autism or related social communication difficulties

Dramatherapy ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 41-60
Author(s):  
Céliane Trudel ◽  
Aparna Nadig
Keyword(s):  
Social Skills ◽  
Social Communication ◽  
Assessment Tool ◽  
Role Play ◽  
Autism Spectrum ◽  
Social Skills Intervention ◽  
Post Intervention ◽  
Adults With Autism ◽  
Play Assessment ◽  
Communication Difficulties

This study adds to a small literature on social skills measures and interventions for adults with autism spectrum disorder (ASD) or related social communication difficulties (SCD) without intellectual disability (ID). In study 1, a new multimodal assessment tool, the role-play assessment of social skills (R-PASS), was used to measure real-time application of social skills. The scores of adults with ASD/SCD were marginally lower than those of neurotypical adults, with a large effect size, suggesting that the measure can identify differences between the two groups. Therefore, the R-PASS shows potential as an objective tool to assess dynamic and naturalistic social skills. In Study 2, a pre–post single-group design study, we measured the effectiveness of a drama-based social skills intervention for seven participants who self-identified as having ASD/SCD. The R-PASS was used by external raters blind to diagnosis and intervention status to compare the performance of intervention participants to that of neurotypical adults. R-PASS scores suggested substantial improvement of social skills in the majority of participants post-intervention. Furthermore, relatives’ and participants’ perception of their social communication and self-regulation skills improved from pre- to post-intervention. These results suggest that the intervention may have helped the participants improve their social skills.

scholarly journals Nutritional Intervention with Dried Bonito Broth for the Amelioration of Aggressive Behaviors in Children with Prenatal Exposure to Dioxins in Vietnam: A Pilot Study

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1455
Author(s):  
Muneko Nishijo ◽  
Tai The Pham ◽  
Ngoc Thao Pham ◽  
Hai Thai Thu Duong ◽  
Ngoc Nghi Tran ◽  
...  
Keyword(s):  
Aggressive Behavior ◽  
Prenatal Exposure ◽  
Intervention Group ◽  
Experimental Period ◽  
Nutritional Intervention ◽  
Autism Spectrum ◽  
Aggressive Behaviors ◽  
Post Intervention ◽  
Dioxin Exposure ◽  
Covert Aggression

Dioxins have been suggested to induce inflammation in the intestine and brain and to induce neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), partly due to deficits in parvalbumin-positive neurons in the brain that are sensitive to inflammatory stress. Previously, we reported ADHD traits with increased aggressiveness in children with prenatal exposure to dioxins in Vietnam, whereas dried bonito broth (DBB) has been reported to suppress inflammation and inhibit aggressive behavior in animal and human studies. In the present study, we investigated the association between dioxin exposure and the prevalence of children with highly aggressive behaviors (Study 1), as well as the effects of DBB on the prevalence of children with highly aggressive behaviors (Study 2). Methods: In Study 1, we investigated the effects of dioxin exposure on the prevalence of children with high aggression scores, which were assessed using the Children’s Scale of Hostility and Aggression: Reactive/Proactive (C-SHARP) in dioxin-contaminated areas. The data were analyzed using a logistic regression model after adjusting for confounding factors. In Study 2, we performed nutritional intervention by administering DBB for 60 days to ameliorate the aggressiveness of children with high scores on the C-SHARP aggression scale. The effects of DBB were assessed by comparing the prevalence of children with high C-SHARP scores between the pre- and post-intervention examinations. Results: In Study 1, only the prevalence of children with high covert aggression was significantly increased with an increase in dioxin exposure. In Study 2, in the full ingestion (>80% of goal ingestion volume) group, the prevalence of children with high covert aggression associated with dioxin exposure was significantly lower in the post-ingestion examination compared with in the pre-ingestion examination. However, in other ingestion (<20% and 20–79%) groups and a reference (no intervention) group, no difference in the prevalence of children with high covert aggression was found between the examinations before and after the same experimental period. Conclusions: The findings suggest that DBB ingestion may ameliorate children’s aggressive behavior, which is associated with perinatal dioxin exposure.

scholarly journals Resources, Problems and Challenges of Autism Spectrum Disorder Diagnosis and Support System in Poland

2021 ◽  
Author(s):  
Anna Lenart ◽  
Jacek Pasternak
Keyword(s):  
Autism Spectrum Disorder ◽  
Support System ◽  
Autism Spectrum ◽  
Diagnostic Tools ◽  
Diagnostic Process ◽  
Autism Diagnosis ◽  
Autism Spectrum Disorder Diagnosis ◽  
Effective System ◽  
Diagnostic Standards ◽  
And Control

AbstractThe article refers to resources, problems and challenges of autism diagnosis and support system in Poland. The resources include: the increasing number of specialists, diagnostic and therapeutic centres, well-established course of education for people working with youths, standardised and normalised diagnostic tools. The diagnostic process is not without some areas in need of our focus: the tendency of some specialists to make unauthorised diagnosis, overshadowing; underestimation of comorbidity of ASD with other disorders. The challenges refer to introducing an effective system of monitoring the services provided in form of certification and control in order to prevent their abuse, initiating category of temporary diagnosis; paying more attention on individual’s resources, better cooperation among specialists, teachers and families, developing and unifying diagnostic standards.

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