Behavioural and cognitive-behavioural interventions for outwardly directed aggressive behaviour in people with intellectual disabilities

Using the Listening2Faces App with Three Young Adults with Autism: A Feasibility Study

Objectives

Listening2Faces (L2F) is a therapeutic, application-based training program designed to improve audiovisual speech perception for persons with communication disorders. The purpose of this research was to investigate the feasibility of using the L2F application with young adults with autism and complex communication needs.

Methods

Three young adults with autism and complex communication needs completed baseline assessments and participated in training sessions within the L2F application. Behavioral supports, including the use of cognitive picture rehearsal, were used to support engagement with the L2F application. Descriptive statistics were used to provide (1) an overview of the level of participation in L2F application with the use of behavioral supports and (2) general performance on L2F application for each participant.

Results

All three participants completed the initial auditory noise assessment (ANA) as well as 8 or more levels of the L2F application with varying accuracy levels. One participant completed the entire L2F program successfully. Several behavioral supports were used to facilitate participation; however, each individual demonstrated varied levels of engagement with the application.

Conclusions

The L2F application may be a viable intervention tool to support audiovisual speech perception in persons with complex communication needs within a school-based setting. A review of behavioral supports and possible beneficial modifications to the L2F application for persons with complex communication needs are discussed.

International consensus recommendations for the identification and treatment of tuberous sclerosis complex-associated neuropsychiatric disorders (TAND)

BACKGROUND

Tuberous sclerosis complex (TSC) is associated with a wide range of physical manifestations for which international clinical recommendations for diagnosis and management have been established. TSC is, however, also associated with a wide range of TSC-Associated Neuropsychiatric Disorders (TAND) that are typically under-identified and under-treated yet associated with a profound burden of disease. The contemporary evidence base for the identification and treatment of TAND is much more limited and, to date, consensus recommendations for the diagnosis and management of TAND have also been limited and non-specific.

METHODS

The TANDem project was launched with an international, interdisciplinary, and participatory consortium of 24 individuals, including TSC family representatives, from all World Health Organization (WHO) regions but one. One of the aims of the TANDem project was to generate consensus recommendations for the identification and treatment of TAND. At the time of this project, no internationally adopted standard methodology and methodological checklists existed for the generation of clinical practice recommendations. We therefore developed our own systematic procedure for evidence review and consensus-building to generate evidence-informed consensus recommendations of relevance to the global TSC community.

RESULTS

At the heart of the consensus recommendations are ten core principles surrounded by cluster-specific recommendations for each of the seven natural TAND clusters identified in the literature (autism-like, dysregulated behavior, eat/sleep, mood/anxiety, neuropsychological, overactive/impulsive, and scholastic) and a set of wraparound psychosocial cluster recommendations. The overarching recommendation is to "screen" for TAND at least annually, to "act" using appropriate next steps for evaluation and treatment, and to "repeat" the process to ensure early identification and early intervention with the most appropriate biological, psychological, and social evidence-informed approaches to support individuals with TSC and their families.

CONCLUSIONS

The consensus recommendations should provide a systematic framework to approach the identification and treatment of TAND for health, educational, social care teams and families who live with TSC. To ensure global dissemination and implementation of these recommendations, partnerships with the international TSC community will be important. One of these steps will include the generation of a "TAND toolkit" of "what to seek" and "what to do" when difficulties are identified in TAND clusters.