The Effectiveness of Equine-Based Therapy in the Treatment of Social and Behavioural Aspects of Children with Autism Spectrum Disorder: A Systematic Review

Introduction: Individuals with Autism spectrum disorder (ASD) present with impairments in social interactions, communication, restricted, repetitive and stereotyped patterns of behaviour, interests or activities. Equine-based therapy is used as a treatment with children with disabilities. There have been no systematic reviews conducted on the effectiveness of equine-based therapy in children with ASD. Purpose: To examine the effectiveness of equine-based therapy on behavioural and social interactions in the treatment of children with ASD. Methods: A systematic search of Cochrane, OT Seeker, MEDLINE, Embase, CINAHL, PsychINFO, Informit health databases and Proquest central were conducted. Studies of participants, aged 4-16 years, with professional diagnosed ASDs were included if they utilised outcome measures assessing behaviours and social interactions through questionnaire or observation. A critical appraisal, using the McMaster Critical Review Form for Quantitative Studies, was performed to assess methodological quality. NHMRC body of evidence framework was used to provide the study with an overall grade of recommendation in assessing quality of evidence. Results: Eight studies of varying research designs and methodological quality met the inclusion criteria. The participants in these studies were aged between 4-16 years of age. The duration of the inventions ranged from 6-12 weeks, and each study used varied measures of outcome. Overall, studies showed some improvements in behaviours and social interactions following an equine-based therapy intervention. Conclusions: Few studies have investigated the effect of equine therapy on behaviour and social interactions of children with ASD. The current body of evidence is constrained by small sample size, lack of comparator, crude sampling methods, and the lack of standardised outcome measures. Equine-based therapy shows potential as a treatment method for behaviours and social interactions in children with ASD.

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Exploratory Study of Fecal Cortisol, Weight, and Behavior as Measures of Stress and Welfare in Shelter Cats During Assimilation Into Families of Children With Autism Spectrum Disorder

Frontiers in Veterinary Science ◽

10.3389/fvets.2021.643803 ◽

2021 ◽

Vol 8 ◽

Author(s):

Gretchen K. Carlisle ◽

Rebecca A. Johnson ◽

Colleen S. Koch ◽

Leslie A. Lyons ◽

Ze Wang ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Small Sample Size ◽

Children With Autism ◽

Communication Disorders ◽

Preliminary Evidence ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Fecal Cortisol ◽

Children With Asd

Background: Cats are a common companion animal (CA) in US households, and many live in families of children with autism spectrum disorder (ASD). The prevalence of ASD is one in 54, and many children have behavior challenges as well as their diagnostic communication disorders.Objective: Benefits of CAs for children with ASD have been identified, but little is known about the welfare of CAs in these homes. This study explored the welfare of cats (N = 10) screened for ideal social and calm temperament using the Feline Temperament Profile (FTP) and adopted by families of children with ASD.Methods: Cat stress was measured using fecal cortisol, weight, and a behavior stress measure (cat stress score). Measures were taken at baseline in the shelter, 2–3 days after adoption, and at weeks 6, 12, and 18.Result: Outcome measures suggested the adopted cats' stress levels did not increase postadoption; however, the small sample size limited analytical power and generalizability.Conclusion: This study provides preliminary evidence for the success of cat adoption by families of children with ASD, when cats have been temperament screened and cat behavior educational information is provided. Further research is warranted to confirm these findings.

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The Feasibility and Acceptability of Delivering Pivotal Response Treatment for Autism Spectrum Disorder via Telehealth: A Pilot Study (Preprint)

10.2196/preprints.32520 ◽

2021 ◽

Author(s):

Krista Nicole Drapalik ◽

David Grodberg ◽

Pamela Ventola

Keyword(s):

Autism Spectrum Disorder ◽

Parent Training ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Training Condition ◽

Stepped Care ◽

Pivotal Response Treatment ◽

Clinical Effects ◽

Children With Asd

BACKGROUND Pivotal Response Treatment (PRT), an evidence-based and parent-delivered intervention, is designed to improve social communication in individuals with autism spectrum disorder (ASD). OBJECTIVE To assess the feasibility, acceptability, and clinical effects of an online model of PRT delivered via MindNest Health that aims to provide self-directed and engaging online modules, real-time coaching and feedback, and accessible stepped-care to large populations of parents seeking resources for their children with ASD. METHODS Male and female children, ages 2-7 years old with single-word to phrase-level speech, were eligible to participate in the study. Families were randomized to the online parent training condition or control condition. The online component of the intervention consisted of eight 20-minute online courses of content describing parent training principles in PRT. Four 1-hour videoconferences were held after course 1, course 3, course 5, and course 8. Parents were given 1-2 weeks to complete each course. Parents completed the Client Expectancies Questionnaire (CCQ) at Week 2 and endpoint, as well as the Behavioral Intervention Rating Scale (BIRS) at endpoint to assess parental expectancies and treatment acceptability and effectiveness. RESULTS 9 of 14 subjects completed the study curriculum in the online parent training condition, and 6 of 12 subjects completed the control condition. A total of 58% subjects completed study curriculum by study closure. Within the online parent training condition, there was a significant increase in mean CCQ Total Scores from 25.38 ± 3.25 at baseline to 27.5 ± 3.74 at endpoint (P = .04), mean CCQ Confidence Scores from 6.0 ± 1.07 at baseline to 6.75 ± 0.89 at endpoint (P = .02), and mean CCQ Other Improvement Scores 5.25 ± 0.89 at baseline to 6.25 ± 1.28 at endpoint (P = .009). Within the control condition, a modest increase in CCQ scores existed (Confidence △M = +.25; Recommend △M = +.25; Total Score △M = +.50), but no significant results were found (Confidence P = .38; Recommend P = .36; Total Score P = .43). Out of the eleven parents that completed the BIRS at endpoint, 83% parents endorsed they slightly agree or agree with over 93% of the Acceptability factor items on the BIRS. CONCLUSIONS The feasibility of this online treatment is endorsed by the high rate of online module completion and attendance to videoconferences within the online parent training group. Acceptability of treatment is supported by strong ratings on the CCQ and significant improvements in scores as well as strong ratings on the BIRS. This study’s small sample size limits the conclusions that can be drawn, however, the PRT MindNest Health platform holds promise to support parents of children with ASD who are unable to access traditional, in-person parent-mediated intervention for their child.

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Herbal Medicine Treatment for Children with Autism Spectrum Disorder: A Systematic Review

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2017/8614680 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 9

Author(s):

Miran Bang ◽

Sun Haeng Lee ◽

Seung-Hun Cho ◽

Sun-Ae Yu ◽

Kibong Kim ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Herbal Medicine ◽

Rating Scale ◽

Small Sample Size ◽

Herbal Medicines ◽

Effective Rate ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Qualitative Synthesis

Objective. To summarize and evaluate the efficacy and safety of herbal medicines used for the treatment of autism spectrum disorder (ASD) in children. Methods. Thirteen electronic databases were searched from their inception to November 2016. Randomized controlled trials (RCTs) that assessed the efficacy of herbal medicines alone or in combination with other Traditional Chinese Medicine treatments for ASD in children were included. The Cochrane Risk of Bias Tool was used and other data analyses were performed using RevMan (Version 5.3). Results. Ten RCTs involving 567 patients with ASD were included for qualitative synthesis. In conjunction with conventional therapy, herbal medicines significantly improved the Childhood Autism Rating Scale (CARS) score, but the results of effects on total effective rate (TER) were different between the included studies. The use of herbal medicines with integrative therapy improved the CARS score and TER. In the studies that documented adverse events, no serious events were associated with herbal medicines. Conclusions. The efficacy of herbal medicines for the treatment of ASD appears to be encouraging but was inconclusive owing to low methodological quality, herbal medicine diversity, and small sample size of the examined studies.

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IL-38 inhibits microglial inflammatory mediators and is decreased in amygdala of children with autism spectrum disorder

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2004666117 ◽

2020 ◽

Vol 117 (28) ◽

pp. 16475-16480 ◽

Cited By ~ 1

Author(s):

Irene Tsilioni ◽

Harry Pantazopoulos ◽

Pio Conti ◽

Susan E. Leeman ◽

Theoharis C. Theoharides

Keyword(s):

Autism Spectrum Disorder ◽

Social Interactions ◽

Children With Autism ◽

Autism Spectrum ◽

Spectrum Disorder ◽

University Of Maryland ◽

Human Microglia ◽

Adult Human ◽

Children With Asd ◽

The University

Autism spectrum disorder (ASD) is characterized by impaired social interactions and communication. The pathogenesis of ASD is not known, but it involves activation of microglia. We had shown that the peptide neurotensin (NT) is increased in the serum of children with ASD and stimulates cultured adult human microglia to secrete the proinflammatory molecules IL-1β and CXCL8. This process is inhibited by the cytokine IL-37. Another cytokine, IL-38, has been reported to have antiinflammatory actions. In this report, we show that pretreatment of cultured adult human microglia with recombinant IL-38 (aa3-152, 1–100 ng/mL) inhibits (P< 0.0001) NT-stimulated (10 nM) secretion of IL-1β (at 1 ng/mL) and CXCL8 (at 100 ng/mL). In fact, IL-38 (aa3-152, 1 ng/mL) is more potent than IL-37 (100 ng/mL). Here, we report that pretreatment with IL-38 (100 ng/mL) of embryonic microglia (HMC3), in which secretion of IL-1β was undetectable, inhibits secretion of CXCL8 (P= 0.004). Gene expression of IL-38 and its receptor IL-36R are decreased (P= 0.001 andP= 0.04, respectively) in amygdala from patients with ASD (n= 8) compared to non-ASD controls (n= 8), obtained from the University of Maryland NeuroBioBank. IL-38 is increased (P= 0.03) in the serum of children with ASD. These findings indicate an important role for IL-38 in the inhibition of activation of human microglia, thus supporting its development as a treatment approach for ASD.

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The Roots of Autism and ADHD Twin Study in Sweden (RATSS)

Twin Research and Human Genetics ◽

10.1017/thg.2014.12 ◽

2014 ◽

Vol 17 (3) ◽

pp. 164-176 ◽

Cited By ~ 37

Author(s):

Sven Bölte ◽

Charlotte Willfors ◽

Steve Berggren ◽

Joakim Norberg ◽

Lina Poltrago ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Neurodevelopmental Disorders ◽

Twin Study ◽

Cognitive Skills ◽

Small Sample Size ◽

Monozygotic Twins ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Narrow Scope

Neurodevelopmental disorders affect a substantial minority of the general population. Their origins are still largely unknown, but a complex interplay of genetic and environmental factors causing disturbances of the central nervous system's maturation and a variety of higher cognitive skills is presumed. Only limited research of rather small sample size and narrow scope has been conducted in neurodevelopmental disorders using a twin-differences design. The Roots of Autism and ADHD Twin Study in Sweden (RATSS) is an ongoing project targeting monozygotic twins discordant for categorical or dimensional autistic and inattentive/hyperactive-impulsive phenotypes as well as other neurodevelopmental disorders, and typically developing twin controls. Included pairs are 9 years of age or older, and comprehensively assessed for psychopathology, medical history, neuropsychology, and dysmorphology, as well as structural, functional, and molecular brain imaging. Specimens are collected for induced pluripotent (iPS) and neuroepithelial stem cells, genetic, gut bacteria, protein-/monoamine, and electron microscopy analyses. RATSS's objective is to generate a launch pad for novel surveys to understand the complexity of genotype-environment-phenotype interactions in autism spectrum disorder and attention-deficit hyperactivity disorder (ADHD). By October 2013, RATSS had collected data from 55 twin pairs, among them 10 monozygotic pairs discordant for autism spectrum disorder, seven for ADHD, and four for other neurodevelopmental disorders. This article describes the design, recruitment, data collection, measures, collected pairs’ characteristics, as well as ongoing and planned analyses in RATSS. Potential gains of the study comprise the identification of environmentally mediated biomarkers, the emergence of candidates for drug development, translational modeling, and new leads for prevention of incapacitating outcomes.

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Employment programmes and interventions targeting adults with autism spectrum disorder: A systematic review of the literature

Autism ◽

10.1177/1362361316661855 ◽

2016 ◽

Vol 21 (8) ◽

pp. 929-941 ◽

Cited By ~ 56

Author(s):

Darren Hedley ◽

Mirko Uljarević ◽

Lauren Cameron ◽

Santoshi Halder ◽

Amanda Richdale ◽

...

Keyword(s):

Systematic Review ◽

Autism Spectrum Disorder ◽

Family System ◽

Small Sample Size ◽

Empirical Studies ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Future Research ◽

The Impact

Individuals with autism spectrum disorder face significant challenges entering the workforce; yet research in this area is limited and the issues are poorly understood. In this systematic review, empirical peer-reviewed studies on employment programmes, interventions and employment-related outcomes in individuals with autism spectrum disorder over 18 years with and without intellectual disability were identified and evaluated. The review was prefaced by a summary of previous systematic reviews in the area. Web of Science, Medline, PsychINFO, ERIC and Scopus databases were systematically searched through to October 2015. From 32,829 records identified in the initial search, 10 review and 50 empirical articles, comprising N = 58,134 individuals with autism spectrum disorder, were included in the review. Selected articles were organised into the following themes: employment experiences, employment as a primary outcome, development of workplace skills, non-employment-related outcomes, assessment instruments, employer-focused and economic impact. Empirical studies were limited by poor participant characterisation, small sample size and/or a lack of randomisation and use of appropriate controls. Poor conceptualisation and measurement of outcomes significantly limited study quality and interpretation. Future research will require a multidisciplinary and multifaceted approach to explore employment outcomes on the individual, the family system, co-workers and the employer, along with the impact of individual differences on outcome.

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Interactive video-player to improve social smile in individuals with autism spectrum disorder

Advances in Autism ◽

10.1108/aia-05-2019-0014 ◽

2019 ◽

Vol 6 (2) ◽

pp. 109-119

Author(s):

Vikas Khullar ◽

Manju Bala ◽

Harjit Pal Singh

Keyword(s):

Autism Spectrum Disorder ◽

Interactive Video ◽

Small Sample Size ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Content Type ◽

The Social ◽

Video Player ◽

Live Interaction

Purpose The purpose of this paper is to propose and develop a live interaction-based video player system named LIV4Smile for the improvement of the social smile in individuals with autism spectrum disorder (ASD). Design/methodology/approach The proposed LIV4Smile intervention was a video player that operated by detecting smile using a convolutional neural network (CNN)-based algorithm. To maintain a live interaction, a CNN-based smile detector was configured and used in this system. The statistical test was also conducted to validate the performance of the system. Findings The significant improvement was observed in smile responses of individuals with ASD with the utilization of the proposed LIV4Smile system in a real-time environment. Research limitations/implications A small sample size and clinical utilizing for validation and initial training of ASD individuals for LIV4Smile could be considered under implications. Originality/value The main aim of this study was to address the inclusive practices for children with autism. The proposed CNN algorithm-based LIV4Smile intervention resulted in high accuracy in facial smile detection.

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THE EFFECT OF A GREEK TRADITIONAL DANCE PROGRAM ON THE MOTOR COMPETENCE OF CHILDREN WITH AUTISM SPECTRUM DISORDER

European Journal of Physical Education and Sport Science ◽

10.46827/ejpe.v7i3.3885 ◽

2021 ◽

Vol 7 (3) ◽

Author(s):

Evaggelia-Anna Marouli ◽

Vasiliki Kaioglou ◽

Vasilios Karfis ◽

Antonios Kambas ◽

Maria Koutsouba ◽

...

Keyword(s):

Autism Spectrum Disorder ◽

Motor Behavior ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Motor Competence ◽

Children With Asd ◽

Traditional Dance ◽

Group A ◽

Group B

It is usual for individuals with autism spectrum disorder (ASD) to demonstrate deficits in motor behavior. Participation in movement programs has been suggested to elicit improvements in their motor competence (MC) level. The aim of the present study was to examine the effect of a Greek traditional dance (GTD) program on the MC of 6-14-year-old children with ASD. The study design included eight participants (two girls, six boys), who were randomly allocated into two equal-sized groups, group A (its members participated only in the regular Physical Education lessons provided by their school) and group B (its members additionally followed an 8-week GTD program of two 40-min sessions per week). Children’s MC was assessed prior and immediately after the completion of the GTD program by the Bruininks- Oseretsky Test of Motor Proficiency (BOT-2 SF). Due to study’s small sample size and participants’ heterogenous ASD characteristics, the results will be interpreted as outcomes of multiple single case studies. Overall, it was observed that the MC of all participants was considerably poor; however, members of group B made greater improvements in both the total BOT-2 point score and most item raw scores compared to those of group A, with balance and body coordination skills presenting the greater improvements. Even though the results of this study stress the positive effect of GTD on the MC of children with ASD, future studies employing wider sample sizes and/or implementing longer programs are required to further confirm its merit. Article visualizations:<img src="/-counters-/edu_01/0874/a.php" alt="Hit counter" />

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Examining the effect of a wearable, anxiety detection technology on improving the awareness of anxiety signs in autism spectrum disorder: a pilot randomized controlled trial

Molecular Autism ◽

10.1186/s13229-021-00477-z ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Jenny Nguyen ◽

Robyn E. Cardy ◽

Evdokia Anagnostou ◽

Jessica Brian ◽

Azadeh Kushki

Keyword(s):

Autism Spectrum Disorder ◽

Randomized Controlled Trial ◽

Small Sample Size ◽

Controlled Trial ◽

Autism Spectrum ◽

Small Sample ◽

Deep Breathing ◽

Randomized Controlled ◽

Children With Asd ◽

Detection Technology

Abstract Background Anxiety is prevalent in autism spectrum disorder (ASD) and can negatively impact physical and mental health. Self-awareness of anxiety signs is a key barrier to success of anxiety interventions for many children. Methods To address this, we conducted a randomized controlled trial to assess whether the Anxiety Meter, a wearable, real-time anxiety detection technology, can improve awareness of anxiety symptoms and the initiation of relaxation techniques in children with ASD. Twenty-eight children with ASD were trained on the use of the Anxiety Meter and taught a diaphragmatic breathing relaxation technique over three visits. On the fourth visit, participants were randomized to either receive feedback of their anxiety level or no feedback from the Anxiety Meter while completing a stress-eliciting task (public speaking) and asked to engage in deep breathing if anxious. Results Feedback from the Anxiety Meter was associated with increased likelihood of initiating deep breathing in response to anxiety. Limitations Limitations include the small sample size, imbalanced group matching for IQ and sex, and the controlled-laboratory settings which limit the statistical power and generalizability of the results to real-world settings. Conclusions Although these results are limited by the relatively small sample size, they support the feasibility of using a wearable device and real-time feedback to improve anxiety symptom awareness. Trial Registration ClinicalTrials.gov Identifier: NCT02160691, registration date: 06/05/2014.

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Can probiotics benefit young people with autism spectrum disorders?

BJPsych Open ◽

10.1192/bjo.2021.752 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S282-S282

Author(s):

Pooja Ramani ◽

Regina Sala

Keyword(s):

Autism Spectrum Disorder ◽

Young People ◽

Statistical Significance ◽

Gastrointestinal Symptoms ◽

Autism Spectrum ◽

Small Sample ◽

Spectrum Disorder ◽

Sample Sizes ◽

Autism Symptoms ◽

Children With Asd

AimsThe aims are to evaluate the effectiveness of Probiotics on young people with Autism Spectrum Disorder.We hypothesized that there will be an improvement of the comorbid gastrointestinal symptoms that can accompany Autism Spectrum Disorder.We believe that the use of probiotics can exert bidirectional effects on the gut-brain axis which may result in improvements in core Autism symptoms.MethodA literature search was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We used databases including OVID MEDLINE, Pubmed, EMBASE, AMED and the Cochrane register of controlled trials. Studies using Probiotics as a treatment for children with ASD were identified by key search terms; Child*, young person*, adoles*, teenagers, ASD, Autism Spectrum Disorder, Autism, Pervasive developmental disorder, PDD, Probiotics, Supplements, Lactobacillus, and Bifidobacterium. Inclusion criteria: Children of age range 2-18 with a diagnosis of ASD and having at least one gastrointestinal symptom were included. Exclusion criteria: The following were excluded: studies looking at Autism with interventions aside from Probiotics; studies where Probiotics were tested in conjunction with other interventions; studies where there were additional neurodevelopmental disorders.ResultTwelve studies identified all utilized probiotics. This included 7 Randomised Control Trials, 2 Open-Label studies, 1 pre and post-intervention design and 1 Case study. All RCTs gave probiotics or placebo to children.Ten studies showed an improvement in gastrointestinal symptoms. Six studies showed improvements in various behavioral measures. Four studies showed improvements in core autism symptoms. However, the sample sizes in these studies were not large enough to prove statistical significance.ConclusionNo studies showed an adverse reaction which indicates probiotics can be considered a safe treatment.The improvements in a variety of parameters imply probiotics a suitable adjunctive intervention that may help improve ASD core symptoms in young people as well as improving physical and behavioural comorbidities which in some cases was noted by parents.However, due to high dropout rates and generally small sample sizes, larger-scale trials are needed to critically confirm the efficacy of probiotics for children with ASD.

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