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Mavroeidi N, Sifnaios C, Ntinou A, Iatrou G, Konstantakopoulou O, Merino Martínez M, Nucifora M, Tanrikulu I, Vadolas A. Exploring the Potential Impact of Training on Short-Term Quality of Life and Stress of Parents of Children with Autism: The Integrative Parents' Autism Training Module. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:474. [PMID: 38673385 PMCID: PMC11050325 DOI: 10.3390/ijerph21040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/04/2024] [Accepted: 04/07/2024] [Indexed: 04/28/2024]
Abstract
Parents of autistic children experience high levels of parental stress and low quality of life related to the demanding child caring burden they experience. Parent education and training programs are acknowledged to improve parental well-being and reduce parenting stress. In the framework of the Erasmus+ Integrative Autism Parents Training Project (IPAT), we developed the IPAT Training Module based on parents' expressed needs, in order to improve parental quality of life (QoL) and decrease their perceived stress. Sixty-two parents from four countries participated in the IPAT Module Training activity. We used WHOQOL-BREF and Perceived Stress Scale (PSS-10 version) for QoL and stress, respectively, before and after training and a study-specific questionnaire to assess participants' satisfaction. Parents' QoL improved significantly in the environment domain and specific items, while stress levels remained unmodified. Training appeared more advantageous for parents with lower initial QoL and those whose child had been enrolled in a special education program for an extended duration. Parents were quite satisfied, in particular those with lower initial social relationships QoL. Larger studies including a control group are necessary to support preliminary evidence provided by this study, identify additional effect moderators, and disentangle the contribution of different components of the training.
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Affiliation(s)
- Nikoletta Mavroeidi
- Department of Scientific Documentation and Education, Child and Adolescent Center, 12123 Peristeri, Greece; (C.S.); (G.I.); (A.V.)
| | - Christos Sifnaios
- Department of Scientific Documentation and Education, Child and Adolescent Center, 12123 Peristeri, Greece; (C.S.); (G.I.); (A.V.)
| | | | - Giorgos Iatrou
- Department of Scientific Documentation and Education, Child and Adolescent Center, 12123 Peristeri, Greece; (C.S.); (G.I.); (A.V.)
- Department of Psychology, University of West Macedonia, 53100 Florina, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Department of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | | | - Ibrahim Tanrikulu
- Department of Psychological Counseling & Guidance, Faculty of Education Gaziantep University, Şehitkamil-Gaziantep 27310, Turkey;
| | - Antonios Vadolas
- Department of Scientific Documentation and Education, Child and Adolescent Center, 12123 Peristeri, Greece; (C.S.); (G.I.); (A.V.)
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Anixt JS, Ehrhardt J, Duncan A. Evidence-Based Interventions in Autism. Pediatr Clin North Am 2024; 71:199-221. [PMID: 38423716 DOI: 10.1016/j.pcl.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Pediatricians have a critically important role in the care of children with autism, including conducting developmental screening to support early diagnosis and intervention, advising families about evidence-based treatments for autism spectrum disorder, and supporting families' emotional health as they care for a child with a developmental disability. The purpose of this article is to provide pediatricians with information about evidence-based autism treatments and how to determine which interventions are appropriate for children across the autism spectrum at different ages and developmental stages.
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Affiliation(s)
- Julia S Anixt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA.
| | - Jennifer Ehrhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
| | - Amie Duncan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
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Neece CL, Fenning RM, Morrell HER, Benjamin LR. Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:985-998. [PMID: 37555286 PMCID: PMC10853488 DOI: 10.1177/13623613231191558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
LAY ABSTRACT Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.
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Affiliation(s)
- Cameron L. Neece
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Rachel M. Fenning
- Department of Psychological Science and The Claremont Autism Center, Claremont McKenna College; 850 Columbia Avenue, Claremont, CA 91711, United States
| | - Holly E. R. Morrell
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
| | - Laurel R. Benjamin
- Department of Psychology, Loma Linda University; 11130 Anderson Street, Suite 119, Loma Linda, CA 92354, United States
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Backman E, Åsberg Johnels J, Thunberg G. Parental perceptions of social life before and after attending a parent training program for children with complex communication needs: the ComAlong example. Augment Altern Commun 2024; 40:46-56. [PMID: 37768212 DOI: 10.1080/07434618.2023.2262036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Parent training programs aimed at improving language outcomes for children with complex communication needs have predominantly been evaluated on child-centered outcomes and less often on the impact on social life or parental well-being. This study examined parent perceptions of social life before and after ComAlong, a group intervention providing parents with knowledge and training in responsive communication, environmental-milieu teaching strategies and augmentative and alternative communication (AAC). Parents (N = 467) completed questionnaires during the first and last sessions of ComAlong groups held in Sweden 2012 to 2018. Main outcome measure was change in the Social Life Scale from the Family Impact Questionnaire. Associations between this measure and demographic factors of parents and children were analyzed, along with reported change in parents' use of AAC. Pre-post comparisons revealed small significant positive changes in perceived impact of social life following intervention. The magnitude of the positive change was larger among parents of children with non-syndromic diagnoses and parents of children with autism spectrum disorder or attention deficit hyper activity disorder (ADHD). Differences in social life impact was not associated with parents' gender, language proficiency, age, or educational background. In conclusion, communication-focused parent training programs can have a positive impact on social family life and may thereby influence children's participation.
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Affiliation(s)
- Ellen Backman
- Regional habilitation center, Region Halland, Sweden
- Department of Social Sciences, Marie Cederschiöld University College, Sweden
| | - Jakob Åsberg Johnels
- Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Gunilla Thunberg
- DART centre for AAC and AT, Sahlgrenska University Hospital, Gothenburg, Sweden
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Breda C, Santero S, Conti MV, Cena H. Programmes to manage food selectivity in individuals with autism spectrum disorder. Nutr Res Rev 2024:1-14. [PMID: 38385245 DOI: 10.1017/s0954422424000052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders characterised by impaired social communication and restricted interests/repetitive behaviours. In this regard, sensory processing difficulties and delayed oral motor skills often predispose individuals with ASD to food selectivity (FS). It is usually associated with repetitive eating patterns that can lead to multiple malnutrition conditions. The objective of this narrative review is to present an overview about the existing nutritional interventions aiming at promoting a healthy eating pattern and addressing food selectivity among individuals with ASD. Regarding the interventions targeting nutrition education, the majority of the analysed studies failed to demonstrate their effectiveness. On the other hand, many educational interventions involving taste or cooking sessions, as well as behavioural interventions for FS, demonstrated effective results. Moreover, multidisciplinary in tailoring such programmes, including psychology speech therapy and nutritional skills, is acknowledged as a key approach.
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Affiliation(s)
- Chiara Breda
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Sara Santero
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Maria Vittoria Conti
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Bassi 21, Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, ICS Maugeri IRCCS, University of Pavia, Pavia, Italy
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Choi H, Kim JH, Yang HS, Kim JY, Cortese S, Smith L, Koyanagi A, Dragioti E, Radua J, Fusar-Poli P, Shin JI, Cheon KA, Solmi M. Pharmacological and non-pharmacological interventions for irritability in autism spectrum disorder: a systematic review and meta-analysis with the GRADE assessment. Mol Autism 2024; 15:7. [PMID: 38263251 PMCID: PMC10807060 DOI: 10.1186/s13229-024-00585-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Numerous interventions for irritability in autism spectrum disorder (ASD) have been investigated. We aimed to appraise the magnitude of pharmacological and non-pharmacological interventions for irritability in ASD without any restrictions in terms of eligible interventions. METHODS We systematically searched PubMed/MEDLINE, Scopus, and Web of Science until April 15, 2023. We included randomized controlled trials (RCTs) with a parallel design that examined the efficacy of interventions for the treatment of irritability in patients of any age with ASD without any restrictions in terms of eligible interventions. We performed a random-effects meta-analysis by pooling effect sizes as Hedges' g. We classified assessed interventions as follows: pharmacological monotherapy, risperidone plus adjuvant therapy versus risperidone monotherapy, non-pharmacological intervention, and dietary intervention. We utilized the Cochrane tool to evaluate the risk of bias in each study and the GRADE approach to assess the certainty of evidence for each meta-analyzed intervention. RESULTS Out of 5640 references, we identified 60 eligible articles with 45 different kinds of interventions, including 3531 participants, of which 80.9% were males (mean age [SD] = 8.79 [3.85]). For pharmacological monotherapy, risperidone (Hedges' g - 0.857, 95% CI - 1.263 to - 0.451, certainty of evidence: high) and aripiprazole (Hedges' g - 0.559, 95% CI - 0.767 to - 0.351, certainty of evidence: high) outperformed placebo. Among the non-pharmacological interventions, parent training (Hedges' g - 0.893, 95% CI - 1.184 to - 0.602, certainty of evidence: moderate) showed a significant result. None of the meta-analyzed interventions yielded significant effects among risperidone + adjuvant therapy and dietary supplementation. However, several novel molecules in augmentation to risperidone outperformed risperidone monotherapy, yet from one RCT each. LIMITATIONS First, various tools have been utilized to measure the irritability in ASD, which may contribute to the heterogeneity of the outcomes. Second, meta-analyses for each intervention included only a small number of studies and participants. CONCLUSIONS Only risperidone, aripiprazole among pharmacological interventions, and parent training among non-pharmacological interventions can be recommended for irritability in ASD. As an augmentation to risperidone, several novel treatments show promising effects, but further RCTs are needed to replicate findings. Trial registration PROSPERO, CRD42021243965.
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Affiliation(s)
- Hangnyoung Choi
- Department of Child and Adolescent Psychiatry, Severance Hospital, Yonsei University College of Medicine, Yonsei-Ro 50, Seodaemun-Gu, Seoul, 03722, Republic of Korea
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea
| | - Jae Han Kim
- Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Hee Sang Yang
- Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
| | - Jong Yeob Kim
- Yonsei University College of Medicine, Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA
- DiMePRe-J-Department of Precision and Rigenerative Medicine-Jonic Area, University of Bari "Aldo Moro", Bari, Italy
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu, Sant Boi de Llobregat ES, Barcelona, Spain
| | - Elena Dragioti
- Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University SE, Linköping, Sweden
| | - Joaquim Radua
- Imaging Mood- and Anxiety-Related Disorders (IMARD) Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Mental Health Research Networking Center (CIBERSAM), University of Barcelona, Barcelona, Spain
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Outreach and Support in South-London (OASIS) Service, South London and Maudlsey (SLaM) NHS Foundation Trust, London, UK
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Yonsei-Ro 50, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Severance Children's Hospital, Yonsei University Health System, Seoul, Republic of Korea.
- Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea.
| | - Keun-Ah Cheon
- Department of Child and Adolescent Psychiatry, Severance Hospital, Yonsei University College of Medicine, Yonsei-Ro 50, Seodaemun-Gu, Seoul, 03722, Republic of Korea.
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Republic of Korea.
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
- Regional Centre for the Treatment of Eating Disorders and On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada
- Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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Denusik L, Glista D, Servais M, Friesen J, Oram J, Cunningham BJ. "We were the best people to do the job": Caregivers' reported outcomes of a virtual caregiver-delivered program for autistic preschoolers. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2024; 9:23969415241244767. [PMID: 38694817 PMCID: PMC11062079 DOI: 10.1177/23969415241244767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Background and aims Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them. This study explored caregivers' perceived outcomes following one virtual caregiver-delivered program, The Hanen Centre's More Than Words® (MTW) program. Methods This study was a secondary analysis of data from individual interviews conducted with 21 caregivers who had recently participated in a virtual MTW program. A hybrid codebook thematic analysis approach was taken to analyze the interview data. Program outcomes were coded and analyzed within the International Classification Functioning, Disability, and Health (ICF) framework. Additionally, caregivers completed an online survey and rated Likert Scale items about perceived program outcomes, which were analyzed descriptively. Results Five themes were identified: (1) caregivers learned new strategies to facilitate their child's development, (2) caregivers developed a new mindset, (3) children gained functional communication skills, (4) caregiver-child relationships improved, and (5) caregivers gained a social and professional support network. These themes fell within four of five ICF framework components (activities, participation, personal factors, and environmental factors). No themes were identified under Body Structures and Functions. Survey results indicated most caregivers reported learning new communication strategies (n = 20, 95%), and identifying new teaching opportunities with their child (n = 21, 100%). Conclusions Some reported outcomes, related to Activities and Participation, were consistent with previous reports in the literature on the MTW program. In line with previous research, caregivers learned strategies to support their child's communication development. Contrary to previous quantitative studies, caregivers in this study rarely commented on gains in vocabulary and instead focused on gains in skills that positively impacted their child's ability to engage in meaningful social interaction. Novel outcomes were identified within the Participation, Personal Factors, and Environmental Factors components of the ICF framework. Implications Caregivers in this study identified important outcomes for themselves and their child that have not been the focus of prior research, suggesting it is important to integrate their perspectives in the development and evaluation of caregiver-delivered programs. Clinicians should include goals that address outcomes identified as important by caregivers, including those that address children's Participation, and those that target caregivers' Personal and Environmental Factors. Developers of caregiver-delivered programs could integrate identified goals to ensure they are meeting families' needs.
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Affiliation(s)
- Lauren Denusik
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Danielle Glista
- University of Western Ontario, London, ON, Canada
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | | | - Jodi Friesen
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Janis Oram
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
| | - Barbara Jane Cunningham
- School of Communication Sciences and Disorders, University of Western Ontario, London, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
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Chung KM, Chung E, Lee H. Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis. Soa Chongsonyon Chongsin Uihak 2024; 35:29-38. [PMID: 38204739 PMCID: PMC10774556 DOI: 10.5765/jkacap.230019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/21/2023] [Accepted: 12/03/2023] [Indexed: 01/12/2024] Open
Abstract
We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.
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Affiliation(s)
- Kyong-Mee Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Eunsun Chung
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
| | - Hoomyung Lee
- Department of Psychology, College of Arts and Science, Yonsei University, Seoul, Korea
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Cheng WM, Smith TB, Butler M, Taylor TM, Clayton D. Effects of Parent-Implemented Interventions on Outcomes of Children with Autism: A Meta-Analysis. J Autism Dev Disord 2023; 53:4147-4163. [PMID: 35996037 PMCID: PMC10539413 DOI: 10.1007/s10803-022-05688-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/11/2022]
Abstract
Children with autism spectrum disorder (ASD) have been shown to benefit from parent-implemented interventions (PIIs). This meta-analysis improved on prior reviews of PIIs by evaluating RCTs and multiple potential moderators, including indicators of research quality. Fifty-one effect sizes averaged moderately strong overall benefits of PIIs (g = 0.553), with studies having lower risk of research bias yielding lower estimates (g = 0.47). Parent and observer ratings yielded similar averaged estimates for positive behavior/social skills (g = 0.603), language/communication (g = 0.545), maladaptive behavior (g = 0.519), and to a lesser extent, adaptive behavior/life skills (g = 0.239). No other study, intervention, or participant characteristic moderated outcomes. PIIs with children with ASD tend to be effective across a variety of circumstances.
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Affiliation(s)
- Wai Man Cheng
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA.
| | - Timothy B Smith
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA.
| | - Marshall Butler
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| | - Tina M Taylor
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
| | - Devan Clayton
- Department of Counseling Psychology and Special Education, Brigham Young University Provo, 340 McKay Building, Provo, UT, 84602, USA
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Ros-DeMarize R, Klein J, Carpenter LA. Behavioral Parent Training Engagement Among Young Children With Autism Spectrum Disorder. Behav Ther 2023; 54:892-901. [PMID: 37597965 DOI: 10.1016/j.beth.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/29/2022] [Accepted: 03/23/2023] [Indexed: 08/21/2023]
Abstract
The purpose of the current study was to examine engagement with Behavioral Parent Training (BPT) for families of children with Autism Spectrum Disorder (ASD) and assess openness to novel delivery formats for BPT (e.g., telehealth, group). Participants were caregivers of 501 children with ASD (ages 2-6) enrolled in the SPARK (Simons Foundation Powering Autism Research for Knowledge) online national registry. The study assessed: (1) rates of child disruptive behavior diagnoses, (2) engagement and satisfaction with BPT, (3) parent and child factors (e.g., diagnostic history), and (4) openness to novel delivery formats. Almost 25% of young children with ASD in this sample had disruptive behavior problems rising to the level of a diagnosis of ADHD or ODD and thus would benefit from BPT. However, only one third of these families had actually been referred to BPT. Families indicated high level of interest in participating in BPT, with a particular interest in Parent Child Interaction Therapy (PCIT) as well as novel delivery formats such as telehealth and group. Specific components of the therapy and delivery formats were indicative of parent satisfaction (e.g. groups, longer treatment sessions, longer treatment length). Specific parent and child characteristics were predictive of openness to novel formats (e.g. parental depression, more severe behavioral challenges, lower verbal skills). Results underscore the need for increased referrals and access to BPT programs the ASD population. Both parent and child characteristics are important for determining appropriate delivery formats.
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Burrell TL, Sharp WG, Gillespie S, Pickard K, Brasher S, Buckley D, Scahill L. A Survey of Community Providers on Feeding Problems in Autism Spectrum Disorder. J Autism Dev Disord 2023:10.1007/s10803-023-06013-7. [PMID: 37256479 DOI: 10.1007/s10803-023-06013-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE Feeding problems, ranging from mild to severe, are common in children with autism spectrum disorder. We conducted a 15-item online survey of community providers to gather information on service demand and current treatment approaches for this clinical population. METHODS Respondents, speech-language pathologists, occupational therapists, registered dietitians, and Board-Certified Behavior Analysts, were recruited via e-mail listservs, professional conferences, continuing education programs, social media and electronic newsletters. The survey included questions about professional discipline, years in practice, patient population served, feeding problem types, therapeutic approaches, and level of interest in parent-mediated interventions. RESULTS A total of 541 community practitioners responded to the survey; 419 provided usable data. Across all providers, 97% (n = 406) reported seeing children with ASD and feeding problems. Of these, 90% (n = 367) offered treatment. Providers (n = 23) who did not treat feeding problems cited "insufficient training." Most common presenting problems included limited dietary variety, texture sensitivity, and disruptive mealtime behavior. Although treatment approaches varied across disciplines, 89.3% indicated openness to parent-mediated treatment. CONCLUSIONS These results indicate a high demand for treatment of children with ASD and feeding problems across disciplines. Food selectivity was the most common problem. Treatment approaches varied across disciplines. Dissemination and implementation of evidence-based, parent-mediated intervention is warranted.
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Affiliation(s)
- Teresa Lindsey Burrell
- Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA, USA
- Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, USA
- Children?s Healthcare of Atlanta, Atlanta, GA, USA
| | - William G Sharp
- Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA, USA
- Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, USA
- Children?s Healthcare of Atlanta, Atlanta, GA, USA
| | - Scott Gillespie
- Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA, USA
| | - Katherine Pickard
- Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA, USA
- Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, USA
| | - Susan Brasher
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, NE, Atlanta, GA, USA
| | - Derianne Buckley
- Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, USA
- Children?s Healthcare of Atlanta, Atlanta, GA, USA
| | - Lawrence Scahill
- Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA, USA.
- Marcus Autism Center, 1920 Briarcliff Rd NE, Atlanta, GA, USA.
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12
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Ros-DeMarize R, Boan A, Bradley C, Klein J, Carpenter L. Tele-PCIT: Initial Examination of Internet Delivered PCIT for Young Children with Autism. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01539-4. [PMID: 37171780 DOI: 10.1007/s10578-023-01539-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE Parent-Child Interaction Therapy (PCIT) is an empirically supported behavioral parenting program for disruptive behavior and has been shown to also be effective for children with autism spectrum disorder (ASD). Telehealth delivery of PCIT (Tele-PCIT) is also supported, but no trials have focused on children with ASD. The purpose of the study was to examine the initial efficacy of a time limited version of Tele-PCIT within an ASD sample. METHODS Participants included parents of 20 children (ages 2-6) with ASD who received 10 sessions of Tele-PCIT. Parents reported on their parenting stress, parenting practices, and child behavior. A play observation was coded for parent use of treatment skills and for child compliance. RESULTS 80% of participants completed treatment (n = 16) and results revealed significant improvements across parenting and child outcomes. Parents reported decreases in parenting stress from pre-to-post-treatment, which were maintained at a 3-month follow-up, along with decreases in negative parenting practices (i.e., Laxness and Overactivity) from pre-to-post treatment that were also maintained at follow-up. Significant increases in parent use of positive parenting skills (i.e., "Do" Skills) during child-led play and decreases in negative parenting skills (i.e., "Don't" Skills) were observed. Results also revealed significant reductions in parent rated child externalizing behavior problems from pre-to-post-treatment that were also maintained at follow-up. CONCLUSIONS Results of the current study support the initial efficacy of Tele-PCIT for treating disruptive behavior in young children with ASD. Findings from this pilot will inform larger examinations of Tele-PCIT for youth with ASD.
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Affiliation(s)
- Rosmary Ros-DeMarize
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA.
| | - Andrea Boan
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Catherine Bradley
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Jordan Klein
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Laura Carpenter
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
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13
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Gur A, Reich A. Psychological flexibility of parents of children with disabilities: A systematic literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 136:104490. [PMID: 36966545 DOI: 10.1016/j.ridd.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE Psychological flexibility, a popular concept in clinical psychology, is still evolving in the context of studying parents of children with disabilities. This study systematically reviewed the literature on the psychological flexibility of parents of children with disabilities to identify contributions of the literature and make recommendations for practice and future study. MATERIALS AND METHODS The systematic review was conducted according to the PRISMA guidelines and identified studies on the psychological flexibility of parents of children with disabilities using five electronic databases: PsychNet, PubMed, ERIC, Social Services Abstracts, and EBSCO. Twenty-six articles met the criteria and were included. A thematic analysis was conducted to extract major themes. RESULTS Three major themes emerged from the data: (1) psychological flexibility is associated with various aspects of mental health; (2) psychological flexibility is associated with parental functioning in caring for children with a disability; (3) acceptance and commitment therapy (ACT) based interventions effectively enhance the psychological flexibility of parents of children with disabilities. CONCLUSIONS The study concludes that psychological flexibility is extremely relevant to disability studies and should be further explored in relation to different parental well-being and functioning aspects. Professionals are encouraged to incorporate principles of acceptance and commitment therapy into their work with parents of children with disabilities.
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Affiliation(s)
- Ayelet Gur
- Social Work Department, Tel-Hai College, Upper Galilee, Israel.
| | - Ari Reich
- Faculty of Education, Bar Ilan University, Ramat Gan, Israel
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14
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Kenworthy L, Childress D, Armour AC, Verbalis A, Zhang A, Troxel M, Handsman R, Kocher K, Myrick Y, Werner M, Alexander KC, Cannon L, Anthony LG. Leveraging technology to make parent training more accessible: Randomized trial of in-person versus online executive function training for parents of autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:616-628. [PMID: 35916246 PMCID: PMC9892365 DOI: 10.1177/13623613221111212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
LAY ABSTRACT This study compared the first online parent training program for executive function intervention for autism to in-person parent training on the same content. Participants were parents of autistic children, who were between 8 and 12 years of age and did not have intellectual disability. Parents were randomized to the in-person (n = 51) or online (n = 46) training conditions. Both trainings were developed with stakeholder (parents and autistic people) guidance. In this trial, most parents reported that they liked both trainings and that they were able to implement what they learned with their children. Parents in both groups spent equivalent amounts of time (about 8 hours) with the training materials, but while 94% of parents in the in-person training attended both parent trainings, only 59% of parents in the online group completed all 10 online modules. Parents reported that it was difficult to stay motivated to complete the online trainings over the 10-week trial. Parent and child outcomes did not differ significantly between the groups. Overall, parents reported that the trainings resulted in a reduction in their own parenting strain and improvements in their child's flexibility, emotional control, and global executive function, but not planning and organization. These findings indicated brief in-person and online training can help parents learn to support and improve their autistic children's executive function abilities, reducing their own experience of parenting strain. The finding that the online training was equivalent to the in-person trainings is important because it is accessible to parents who encounter barriers to in-person care.
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Affiliation(s)
| | | | | | | | | | - Mary Troxel
- University of Colorado School of Medicine, USA
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15
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Kulasinghe K, Whittingham K, Mitchell AE, Boyd RN. Psychological interventions targeting mental health and the mother-child relationship in autism: Systematic review and meta-analysis. Dev Med Child Neurol 2023; 65:329-345. [PMID: 36208472 PMCID: PMC10953452 DOI: 10.1111/dmcn.15432] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 08/28/2022] [Accepted: 09/02/2022] [Indexed: 01/18/2023]
Abstract
AIM To investigate the efficacy of psychological interventions delivered to mothers of young children with autism spectrum disorder (ASD) in improving maternal mental health and the parent-child relationship. METHOD Electronic databases were searched from inception to December 2021. Studies were included if they were randomized controlled trials (RCTs) of psychological interventions that targeted maternal mental health (primary outcome) and/or the parent-child relationship (secondary outcome), delivered to mothers of children (mean age < 60 months) with ASD. Meta-analyses of three parent mental health outcomes (stress, depressive symptomatology, and general mental health) and seven parent-child relationship outcomes (parent responsiveness, affect, directiveness, non-directiveness, child initiation, infant positive affect, and infant attentiveness) were conducted using both mean and standardized mean differences. RESULTS Thirty-two RCTs met the inclusion criteria (2336 participants). Six RCTs showed improved maternal mental health (Cohen's d = 0.41-1.15), with moderate certainty of evidence for improvement in parental stress. There was low and high certainty of evidence of treatment effect on parental depressive symptoms and general mental health respectively, which did not show significant treatment effects post-intervention. Seventeen RCTs showed improved parent-child relationship (d = 0.33-2.28; low certainty of evidence). INTERPRETATION Results demonstrated that parenting interventions promoting responsiveness had the largest positive effect on the parent-child relationship and a moderate effect on overall parenting stress; however, the studies were heterogeneous, making it difficult to identify the intervention components that were responsible for the positive treatment effects. There was no significant treatment effect for studies targeting depression or general mental health, likely due to the lack of an interventional component directly targeting mental health.
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Affiliation(s)
- Kavindri Kulasinghe
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Faculty of MedicineUniversity of QueenslandBrisbaneQLDAustralia
| | - Koa Whittingham
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Faculty of MedicineUniversity of QueenslandBrisbaneQLDAustralia
| | - Amy E. Mitchell
- School of Nursing and MidwiferyGriffith UniversityBrisbaneQLDAustralia
- Menzies Health Institute QueenslandGriffith UniversityBrisbaneQLDAustralia
- Parenting and Family Support Centre, School of PsychologyUniversity of QueenslandBrisbaneQLDAustralia
| | - Roslyn N. Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, Faculty of MedicineUniversity of QueenslandBrisbaneQLDAustralia
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16
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McCrossin J, Lach L, McGrath P. Content analysis of parent training programs for children with neurodisabilities and mental health or behavioral problems: a scoping review. Disabil Rehabil 2023; 45:154-169. [PMID: 34990567 DOI: 10.1080/09638288.2021.2017493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Several systematic reviews have examined parent training programs for families of children with autism spectrum disorder (ASD). The present review expands on this literature by describing the components, delivery methods, and level of parent involvement in parent training programs that target families of children with any neurodisability and comorbid disruptive behavior or other mental health problem. MATERIALS AND METHODS Following a scoping review protocol, the search strategy included randomized controlled trials of parent training programs conducted with families of children with neurodisabilities and comorbid disruptive behavior or mental health problems. Study characteristics, program content, delivery methods, and theoretical frameworks were extracted from eligible studies. RESULTS A total of 22 articles were included from the 453 full-text articles initially screened. Thirteen different programs fell into two general categories based on whether they targeted child disruptive behavior or anxiety. Analysis of the content yielded five themes: child skill enhancement, parenting as enacted, parenting as experienced, disability-related parenting, and parent-child relationships. The theoretical underpinnings were identified, when possible, from each study. CONCLUSIONS Parent training programs for parents of children with neurodisabilities targeting child anxiety involved parents in a complementary role in treatment while those targeting disruptive behavior involved parents in a primary role in creating behavior change. We suggest that the extent of parent involvement in interventions be guided by theory rather than diagnosis of the child.Implications for rehabilitationParents of children living with neurodisabilities play a key role in delivering interventions to address comorbid mental health or behavioral problems.Parent training programs for families of children with neurodisabilities vary in relation to their aims, involvement of parents in delivering interventions, disability-specific content, and delivery methods.When referring families, rehabilitation professionals should be aware of aspects of child, parent, and family relational well-being targeted by parent training programs and, when feasible, give families a choice of the style of program to meet their needs.
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Affiliation(s)
| | - Lucyna Lach
- School of Social Work, McGill University, Montreal, Canada
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17
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Hodges AK, Hathaway KL, McMahon MXH, Volkert VM, Sharp WG. Treatment of Feeding Concerns in Children With Autism Spectrum Disorder: A Systematic Review of Behavioral Interventions With Caregiver Training. Behav Modif 2022:1454455221137328. [DOI: 10.1177/01454455221137328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Successful feeding intervention ultimately requires generalization and adoption of treatment into the home. Treatment models, however, differ regarding how and when caregivers are integrated into care delivery process. Some treatments involve a primary model of parent training with caregivers serving as co-therapist at the onset of intervention, while others involve a complimentary model where a therapist delivers the intervention and caregiver training occurs once the child’s behavior is stable. This review systematically evaluates the evidence-base regarding behavioral feeding intervention for children with autism spectrum disorder (ASD), with a specific focus on interventions involving parent training. Results provide further evidence regarding the potential benefits of behavioral intervention to improve feeding concerns in ASD, while also highlighting growing attention to documenting and/or evaluating parent training within the treatment literature. Important questions remain regarding factors guiding the use of a primary or complimentary model of parent training.
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Affiliation(s)
- Abby K. Hodges
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta’s Multidisciplinary Feeding Program, Atlanta, GA, USA
| | - Kristin L. Hathaway
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta’s Multidisciplinary Feeding Program, Atlanta, GA, USA
| | - Meara X. H. McMahon
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta’s Multidisciplinary Feeding Program, Atlanta, GA, USA
| | - Valerie M. Volkert
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta’s Multidisciplinary Feeding Program, Atlanta, GA, USA
| | - William G. Sharp
- Emory University School of Medicine, Atlanta, GA, USA
- Children’s Healthcare of Atlanta’s Multidisciplinary Feeding Program, Atlanta, GA, USA
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18
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Inoue M, Tatsumi A, Fukuzaki T. Effectiveness of the internet based parent education program on applied behavior analysis for parents of children with autism spectrum disorder. Brain Dev 2022; 44:655-663. [PMID: 35989127 DOI: 10.1016/j.braindev.2022.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/23/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Parent education (PE) in autism spectrum disorder (ASD) is recognized as an important component of support for families living with ASD. Specifically, the knowledge of how to interact with children based on applied behavior analysis (ABA) is useful for parents. In this study, a short-term, internet based on-demand PE program was conducted for parents of children with ASD to acquire knowledge of ABA and basic teaching techniques. METHODS Parents of children with ASD were recruited as study participants. They attended on-demand lectures from their homes, performed homework tasks based on lecture content and emailed them to our team. The General Health Questionnaire 30 (GHQ) and Knowledge of Behavioral Principle as Applied to Children (KBPAC) were assessed before and after the program. RESULTS Of the 25 participants, 21 attended all programs and completed all homework tasks and pre- and post-assessments. However, communication among participants via the bulletin board was low. KBPAC scores increased significantly from pre- to post-program scores, and GHQ subscales regarding anxiety and mood modulation decreased significantly from pre- to post-program scores. Positive results were obtained in the post-questionnaires as well. CONCLUSION These findings suggest the practical applicability of an online PE program for parents of children with ASD based on ABA.
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Affiliation(s)
- Masahiko Inoue
- Tottori University Graduate School of Medical Sciences, Japan.
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19
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Bradshaw J, Wolfe K, Hock R, Scopano L. Advances in Supporting Parents in Interventions for Autism Spectrum Disorder. Pediatr Clin North Am 2022; 69:645-656. [PMID: 35934491 PMCID: PMC11017782 DOI: 10.1016/j.pcl.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The rising prevalence of autism spectrum disorder (ASD) calls for clear referral and treatment guidelines for children with ASD and their caregivers. Caregiver involvement in intervention is a standard practice of care and research suggests that teaching intervention strategies to caregivers can improve child outcomes and increase caregiver efficacy. Caregiver-mediated interventions that are naturalistic, developmental, and behavioral are effective in improving social and communication skills for children with ASD. Caregiver training models that use behavioral strategies are effective in reducing challenging behaviors. Finally, reducing caregiver barriers to treatment implementation, including stress and strain, are becoming critical components for improving the well-being and care of children with ASD and their families.
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Affiliation(s)
- Jessica Bradshaw
- University of South Carolina, 1800 Gervais Street, Columbia, SC 29201, USA.
| | - Katie Wolfe
- University of South Carolina, 820 Main Street, Columbia, SC 29208, USA
| | - Robert Hock
- University of South Carolina, 1512 Pendleton Street, Columbia, SC 29208, USA
| | - Layne Scopano
- University of South Carolina, 1800 Gervais Street, Columbia, SC 29201, USA
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20
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Qu L, Chen H, Miller H, Miller A, Colombi C, Chen W, Ulrich DA. Assessing the Satisfaction and Acceptability of an Online Parent Coaching Intervention: A Mixed-Methods Approach. Front Psychol 2022; 13:859145. [PMID: 35967644 PMCID: PMC9367480 DOI: 10.3389/fpsyg.2022.859145] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/26/2022] [Indexed: 11/15/2022] Open
Abstract
Background Parent-mediated intervention (PMI) has been studied in promoting skill acquisition or behavior change in the children with autism spectrum disorder. Most studies emphasize on the improvement of child's core symptoms or maladaptive behaviors, making parental perceived competence and self-efficacy secondary. Yet, the evaluations of intervention implementation are under-reported, especially when translating such interventions into a new population or context. This research investigated the intervention implementation of a 12-week parent coaching intervention which was delivered through telehealth and tailored to Chinese population. The intervention was based on the Parent-mediated Early Start Denver Model with culturally adapted lectures, manuals, and demonstration and commentary videos. This study aimed to evaluate the intervention implementation by assessing parents' satisfaction, acceptability, appropriateness, and feasibility. Method A randomized controlled trial was conducted with two telehealth conditions: self-directed and web+group therapy. Parents in the self-directed condition received intervention individually through the online learning platform. The web+group therapy condition navigated the same program with weekly 1.5-h group coaching sessions via videoconferencing. This mixed-methods study used a concurrent convergent design to evaluate the intervention implementation at post-intervention. The quantitative data was collected from the Program Evaluation Survey and the qualitative data was collected from five focus groups. Results Parents in self-directed group reported significantly lower scores in total perceived competence than parents in web+group therapy condition, while there was no group difference on the total self-efficacy. Tailored feedback, demonstration and commentary videos, peer commenting, live coaching, and guided reflection were the top-five acceptable telehealth strategies that were strongly endorsed by parents. Family centered care, home-based intervention, strategies relative to daily activities, the remote learning platform, and the program-based community were elements that parents considered when evaluating the program's appropriateness. Parent modeling, step-by-step instructions, and tailored feedback were key components in making intervention strategies feasible for parents to implement at home. Conclusion Findings indicate the application of telehealth was acceptable, appropriate, and feasible for Chinese parents. Group-based parent coaching intervention via videoconferencing could be a promising home-based service model to increase parental perceived competence. A large-scale RCT is needed to investigate the effectiveness of group-based PMI via telehealth.
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Affiliation(s)
- Lu Qu
- Institute of AI for Education, East China Normal University, Shanghai, China
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Huiying Chen
- College of Physical Education, Yangzhou University, Yangzhou, China
| | - Haylie Miller
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Alison Miller
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | | | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Dale A. Ulrich
- School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
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21
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Jurek L, Leadbitter K, Falissard B, Colin C, Touzet S, Geoffray MM. Parental experience of parent-mediated intervention for children with ASD: A systematic review and qualitative evidence synthesis. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 27:647-666. [PMID: 35899918 DOI: 10.1177/13623613221112204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT The effectiveness of parent-mediated interventions in the field of autism spectrum disorder is well documented but information on the experience of parents involved in parent-mediated interventions is limited.This study is the first synthesis of evidence concerning the experience of parents involved in parent-mediated interventions. It synthesizes the voice of 345 parents across the world into four general themes: barriers to implementation and logistical issues, feeling overwhelmed and stressed (a need for support), facilitators of implementation, and empowerment in the parent and improvement in the child.The findings of our study provide evidence that parent-mediated interventions should be adapted to the needs of each family. Specific care and support should be offered to parents in addition to parent-mediated interventions. Our study, however, highlights which outcomes are important to parents and should be considered in future studies.
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Affiliation(s)
- Lucie Jurek
- Centre Hospitalier Le Vinatier, France.,RESHAPE, Research on Healthcare Performance, U1290, Claude Bernard Lyon 1 University (CBL1), France
| | | | - Bruno Falissard
- Centre de Recherche en Epidémiologie et en Santé des Populations, INSERM U1018, Université Paris-Saclay, France
| | - Cyrille Colin
- RESHAPE, Research on Healthcare Performance, U1290, Claude Bernard Lyon 1 University (CBL1), France.,Hospices Civils de Lyon, France
| | - Sandrine Touzet
- Hospices Civils de Lyon, France.,Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE) UMR T9405, Université Claude Bernard Lyon 1, France
| | - Marie-Maude Geoffray
- Centre Hospitalier Le Vinatier, France.,RESHAPE, Research on Healthcare Performance, U1290, Claude Bernard Lyon 1 University (CBL1), France
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22
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Agazzi H, Hayford H, Thomas N, Dickinson S, Ortiz C, Salinas-Miranda A. Pandemic parenting: A pilot study of in-person versus internet-DOCS K-5 for caregivers of school-age children with disruptive behaviors. Clin Child Psychol Psychiatry 2022; 27:569-585. [PMID: 35485248 DOI: 10.1177/13591045221096313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Behavioral parent training (BPT) programs are needed to address disruptive behavior disorders among school-aged children. Given the prolonged COVID-19 pandemic and associated mental health consequences, adapting BPTs to telehealth modalities is necessary to ensure continued services to children and families. This pilot study evaluated the use of a telehealth vs in-person modality to deliver the Developing Our Children's Skills K-5 (DOCS K-5) BPT. Participants were caregivers of children enrolled in elementary school exhibiting disruptive behaviors who participated in either in-person DOCS K-5 (n = 21) or internet-DOCS K-5 (i-DOCS K-5; n = 34). Pre- and post-intervention outcome measures were collected for child disruptive behavior, parenting stress, and caregiver symptoms of depression while consumer satisfaction was assessed at post-test only. Multiple linear and Poisson regression models were performed to assess the effect of session modality on the outcomes. Child disruptive behavior, parenting stress and depression, and consumer satisfaction scores were not significantly different across groups, even after adjusting for baseline characteristics. The results of this study provide preliminary evidence that the i-DOCS K-5 modality is as effective as the in-person program. Study findings may be beneficial to practitioners treating school-age children and utilizing telehealth interventions during the COVID-19 pandemic and onward.
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Affiliation(s)
- Heather Agazzi
- Departments of Pediatrics & Psychiatry, 33697University of South Florida, USA
| | - Holland Hayford
- Department of Pediatrics, 33697University of South Florida, USA
| | - Nicholas Thomas
- Harrell Center for the Study of Family Violence, College of Public Health, 27117University of South Florida, USA
| | - Sarah Dickinson
- Department of Pediatrics, 33697University of South Florida, USA
| | - Cristina Ortiz
- Department of Pediatrics, 33697University of South Florida, USA
| | - Abraham Salinas-Miranda
- Harrell Center for the Study of Family Violence & USF Center of Excellence in Maternal and Child Health Education, Science and Practice, 27117University of South Florida, USA
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23
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Graucher T, Sinai-Gavrilov Y, Mor Y, Netzer S, Cohen EY, Levi L, Avtalion TB, Koller J. From Clinic Room to Zoom: Delivery of an Evidence-Based, Parent-mediated Intervention in the Community Before and During the Pandemic. J Autism Dev Disord 2022; 52:5222-5231. [PMID: 35764769 PMCID: PMC9244456 DOI: 10.1007/s10803-022-05592-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/04/2022]
Abstract
Disruptive behaviors (DBs) are common in children with autism, affecting child and family quality of life. Parent-mediated interventions (PMIs) are a cost-effective and accessible way to decrease DBs. COVID-19 increased need for telehealth interventions. This study explored a group delivery of an evidence-based PMI (RUBI), delivered face-to-face and virtually in Israel, before and during the pandemic. Fifty-five families of children with autism and DB participated, 24 receiving face-to-face intervention and 31 receiving virtual. Outcome measures included the Aberrant Behavior Checklist and Home Situations Questionnaires. Results indicate reduction of DBs across groups, with > 50% of treatment-responders showing reliable change. This study is the first to assess RUBI outside the US among a sociodemographically diverse population, in both in-person and virtual contexts.
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Affiliation(s)
- Tobi Graucher
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yana Sinai-Gavrilov
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yaniv Mor
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel.,The Open University, Ra'anana, Israel
| | - Shay Netzer
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eyal Y Cohen
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Linoy Levi
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Judah Koller
- Seymour Fox School of Education, Hebrew University of Jerusalem, Jerusalem, Israel.
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24
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Fang Z, Lachman JM, Qiao D, Barlow J. Controlled Trial of a Short-term Intensive Parent Training Program within the Context of Routine Services for Autistic Children in China. PSYCHOSOCIAL INTERVENTION 2022; 31:121-131. [PMID: 37360058 PMCID: PMC10268554 DOI: 10.5093/pi2022a9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/18/2022] [Indexed: 06/28/2023]
Abstract
Recent systematic reviews found limited rigorous research conducted to date of the effectiveness of parent training programs in reducing behavioral problems for autistic children in low- and middle-income countries. This study is aimed at evaluating the effectiveness of a short-term intensive parent training program for autistic children aged three to six in the context of routine service provision in China. A quasi-experiment was conducted involving the local implementing organization and using a waitlist control. Data were collected at baseline and immediate post-intervention. The primary outcome was child behavioral problems measured using the Child Behavior Checklist Externalizing scale. Between-group comparisons used a difference-in-differences design with propensity score weighting to reduce sources of bias. A process evaluation was undertaken in parallel to assess participant involvement, program acceptability, and delivery. The protocol was prospectively registered with ClinicalTrials.gov (NCT04257331). The final sample size was 111 (treatment: 63; comparison: 48). Results suggest that the program was associated with improvements in child externalizing behaviors (b = -2.71, 95% CI [-5.23, -0.18]), parental mental health symptoms (b = -5.96, 95% CI [-11.74, -0.17]), over-reactive parenting (b = -0.63, 95% CI [-0.98, -0.27]), and parental knowledge (b = 2.08, 95% CI [2.07, 2.17]). Exploratory analysis of factors related to implementation indicated that baseline parental mental health was related to participant engagement, and that satisfaction and engagement levels were potentially linked to positive treatment effects. Findings suggest that short-term intensive parent training programs that are provided by trained non-specialists, could potentially be used as an alternative to traditional prohibitively costly services that are delivered intensively for consecutive years in low-resource contexts. Follow-ups are needed to investigate its long-term benefits.
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Affiliation(s)
- Zuyi Fang
- Beijing Normal UniversitySchool of Social Development and Public PolicyRepublic of ChinaSchool of Social Development and Public Policy, Beijing Normal University, People’s Republic of China;
| | - Jamie M. Lachman
- University of OxfordDepartment of Social Policy and InterventionUnited KingdomDepartment of Social Policy and Intervention, University of Oxford, United Kingdom
| | - Dongping Qiao
- Beijing Normal UniversitySchool of Social Development and Public PolicyRepublic of ChinaSchool of Social Development and Public Policy, Beijing Normal University, People’s Republic of China;
| | - Jane Barlow
- University of OxfordDepartment of Social Policy and InterventionUnited KingdomDepartment of Social Policy and Intervention, University of Oxford, United Kingdom
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Colombet C, Alcaraz C, de la Tribonnière X, Morsa M, Rattaz C, Baghdadli A. Self-reported needs of caregivers of people with Autism Spectrum Disorder. J Autism Dev Disord 2022:10.1007/s10803-022-05499-x. [PMID: 35441919 DOI: 10.1007/s10803-022-05499-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Autism spectrum disorder (ASD) has a major impact on caregivers. We aimed to describe caregivers' perceptions concerning their level of knowledge about ASD and their needs to better adapt education and training programs. METHODS This was a descriptive cross-sectional study conducted through a declarative and self-administered survey in France. RESULTS 1,013 individuals answered the questionnaire in 2020. If most caregivers felt they had sufficient knowledge about ASD, they still expressed a high level of needs regarding acquiring knowledge, identifying available resources, and finding social/emotional support. CONCLUSIONS This study highlights the high level of needs of caregivers and their expectations of improving their knowledge and skills to help the person with ASD.
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Affiliation(s)
- Claire Colombet
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France.
| | - Céline Alcaraz
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Xavier de la Tribonnière
- Unité transversale d'éducation du patient (UTEP), CHU Montpellier, Montpellier, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
| | - Maxime Morsa
- Laboratoire Education et Pratiques de Santé (UR3412), Université Paris Sorbonne Paris Nord, Bobigny, France
| | - Cécile Rattaz
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'excellence sur l'autisme et les troubles neuro-développementaux, CHU Montpellier, Montpellier, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807, Villejuif, France
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Jang SJ, Han JS, Bang MH, Ahn JW. Effects of a sociodrama-based communication enhancement program on mothers of children with neurodevelopmental disorders: a pilot study. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:114-123. [PMID: 35390540 DOI: 10.1016/j.anr.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/18/2022] [Accepted: 03/27/2022] [Indexed: 11/02/2022] Open
Abstract
PURPOSE The incidence and prevalence of neurodevelopmental disorders have rapidly increased, indicating an urgent need for assistance through parenting interventions. This study aimed to evaluate the effects of a sociodrama-based communication enhancement program on mothers of children with neurodevelopmental disorders. METHOD A non-randomized controlled experimental study design was employed. The experimental and control groups had 16 and 18 participants, respectively. The once-a-week six-session intervention was conducted from September to November, 2017, in South Korea. The effects of group, time, and group-by-time interactions among the groups were verified using generalized estimating equations with an autoregressive correlation structure. RESULTS There was a significant decrease in the parenting burden, alongside a significant improvement in parent-child communication and parenting competence in the experimental group compared to the control group. CONCLUSION The sociodrama-based communication enhancement program was found to positively influence the parenting burden, communication, and parenting competence of mothers of children with neurodevelopmental disorders. These findings suggest that sociodrama-based programs may be an effective intervention strategy for parents of children with neurodevelopmental disorders. The sociodrama-based communication enhancement program can be applied to decrease parenting burden and improve parent-child communication and parenting competence. Through continuous parenting interventions, an improvement in expressive language and an increase in the attachment behaviors of children with neurodevelopmental disabilities could be expected.
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Affiliation(s)
- Sun Joo Jang
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul 06974, Korea
| | - Jong-Sook Han
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul 06974, Korea.
| | - Myoung Hee Bang
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul 06974, Korea.
| | - Jung-Won Ahn
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul 06974, Korea.
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Yakubova G, Chen BB. Parent-Implemented Video-Based Intervention to Teach Autistic Children: an Evidence-Based Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00316-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Self-Directed Web-Based Parent-Mediated Interventions for Autistic Children: A systematic review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00307-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gardiner E, Wong V, Lin G, Miller AR. Terminology and descriptions of navigation and related practices for children with neurodisability and their families: a scoping review. BMC Health Serv Res 2022; 22:214. [PMID: 35177039 PMCID: PMC8851781 DOI: 10.1186/s12913-022-07617-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 02/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with neurodisability (ND) represent a significant population with a demonstrated need for coordinated support. Patient navigation has a primary focus on: facilitating access to and connection amongst fragmented systems; as well as the provision of educational and emotional support. Given the distinct needs of children with ND and their families, programs built upon such core concepts could be of great benefit. The diversity of terminology encompassing navigation-related concepts and activities (e.g., care coordination, case management, family support), however, presents challenges to both practice and research. This scoping review examined the terminology and descriptions provided within published articles on navigation-type models for children with ND and their families. METHODS The scoping review was conducted according to the Joanna Briggs Institute methodology. A preliminary search was completed on PubMed (NCBI), MEDLINE (Ovid) and CINAHL (EBSCO) to identify initial search terms, upon which a full search strategy was developed and executed in MEDLINE (Ovid) and CINAHL (EBSCO). After screening records according to our inclusion and exclusion criteria, a full-text review of relevant articles was conducted and data extracted using a researcher-developed tool. Under close supervision by the research team, study selection was primarily performed by one author. RESULTS Of the 2597 papers identified, 33 were included in the final review. From the included papers, a total of 49 terms were extracted, 20 of which were unique. Across the diversity of terminology observed, articles provided detailed and rich descriptions characterized by four central domains, namely: (i) what navigation-related resources, supports and services aim to facilitate and (ii) provide; (iii) descriptions of their intended outcomes; as well as (iv) guiding principles. CONCLUSIONS This scoping review addresses a gap in our knowledge related to the specification of patient navigation and related supports as applied to the specific context of children with ND and their families. Given the particular needs of this population, we propose an empirically-informed integrative model that synthesizes the findings from this scoping review. We suggest that this framework can be used as a guide to the mindful characterization of how supports aiming to connect children and families to needed service are termed and described within future research and in practice.
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Affiliation(s)
- Emily Gardiner
- BC Children's Hospital Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada. .,Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.
| | - Vivian Wong
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.,Sunny Hill Health Centre at BC Children's Hospital, 4500 Oak Street, Vancouver, BC, V6H 3N1, Canada
| | - Grace Lin
- School of Medicine, Queen's University, 15 Arch Street, Kingston, ON, K7L 3N6, Canada
| | - Anton R Miller
- BC Children's Hospital Research Institute, 950 West 28th Avenue, Vancouver, BC, V5Z 4H4, Canada.,Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
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Factor RS, Rea HM, Dahiya AV, Albright J, Ollendick TH, Laugeson EA, Scarpa A. An Initial Pilot Study Examining Child Social Skills, Caregiver Styles, and Family Functioning in the PEERS® for Preschoolers Program for Young Autistic Children and their Caregivers. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 121:104152. [PMID: 34942441 DOI: 10.1016/j.ridd.2021.104152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Social impairments characteristic of autism spectrum disorder (ASD) are evident in early childhood and worsen as the child matures. Though many interventions for young children exist, few specifically target social skills and involve caregivers. AIMS This pilot study examined PEERS® for Preschoolers, focusing on temporal change in child social skills, caregiver style, and family functioning in the context of a caregiver-assisted social skills intervention. This extension of the PEERS® program builds on the success of the intervention for older children, presenting skills in a developmentally appropriate manner to young autistic children and their caregivers. METHODS AND PROCEDURES The present pilot study used a non-concurrent multiple baseline design to examine the above variables with 15 autistic children (Mage = 4.87, SD = 1.25; 11 boys). Children and caregivers participated in PEERS® for Preschoolers groups, with each group randomly assigned three different baseline periods (1.5, 2, or 2.5 weeks) before beginning. OUTCOMES AND RESULTS Simulation Modeling Analysis (SMA) revealed concurrent improvements in social and caregiving skills, with subsequent changes in family functioning occurring over the course of this 16-session intervention. CONCLUSIONS AND IMPLICATIONS Future research will need to examine mechanisms of change in PEERS® for Preschoolers for children and caregivers. WHAT THIS PAPER ADDS There is a dearth of research that specifically examines social skills interventions for young autistic children that incorporates caregivers and examines family functioning as well. This paper is one of the first to evaluate the PEERS® for Preschoolers (P4P) intervention by: 1) exploring changes in child social skills, caregiver efficacy, and family functioning, and 2) analyzing the sequence of improvements in the aforementioned variables to measure systematic change. This pilot study presents results using appropriate methodology for a small sample size of children and caregivers. Results suggested concurrent improvements in social and caregiving skills and subsequent changes in family functioning. These can be built upon for further research on the PEERS® for Preschoolers intervention. This study supports PEERS® for Preschoolers as a feasible intervention that likely contributes to improvements for the child, caregiver in their relationship with their child and parenting styles in general, as well as functioning of the entire family. In sum, this work is essential to furthering the provision of a much needed service of social skills interventions for young autistic children.
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Affiliation(s)
- Reina S Factor
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States; Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States.
| | - Hannah M Rea
- Research in Autism and the Brain Lab, University of Washington, CHDD Box 357920, Seattle, WA 98195, United States
| | - Angela V Dahiya
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Jordan Albright
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Thomas H Ollendick
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
| | - Elizabeth A Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 300 Medical Plaza, Los Angeles, CA 90095, United States
| | - Angela Scarpa
- Department of Psychology, Virginia Tech, 109 Williams Hall, 890 Drillfield, Drive, Blacksburg, VA 24061, United States; Virginia Tech Autism Clinic & Center for Autism Research, 3110 Prices Fork Road, Blacksburg, VA 24061, United States
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Zeng W, Magaña S, Lopez K, Xu Y, Marroquín JM. Revisiting an RCT study of a parent education program for Latinx parents in the United States: Are treatment effects maintained over time? AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:499-512. [PMID: 34320853 PMCID: PMC8795242 DOI: 10.1177/13623613211033108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
LAY ABSTRACT Background: We conducted a follow-up investigation of a two-site randomized controlled trial in the United States. We examined whether the treatment effects in a culturally tailored parent education program for Latinx families of children with autism spectrum disorder were maintained over time.Methods: Using linear mixed models, we compared differences in parent and child outcomes across three timepoints: baseline, 4 months after baseline (Time 2), and 8 months after baseline (T3). Parent outcomes included family empowerment, self-reported confidence in, and frequency of using evidence-based strategies. Child outcomes included parent-reported challenging behaviors, social communication impairments, and the number of services received. Participants were 109 Latina mothers (intervention = 54, control = 55) of children with autism spectrum disorder.Results: After intervention at both Time 2 and Time 3 in both sites, mothers in the intervention groups reported significantly greater confidence in and frequency of using evidence-based strategies, and that their child received significantly more services. We also found that there were treatment differences across the two study sites in several outcomes.Implications: The intervention for Latinx parents of children with autism spectrum disorder was efficacious and could be maintained, and that site-specific policy and service differences may need to be examined in future research to inform dissemination and implementation.
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Affiliation(s)
- Weiwen Zeng
- Steve Hicks School of Social Work, University of Texas at Austin, TX, USA
| | - Sandy Magaña
- Steve Hicks School of Social Work, University of Texas at Austin, TX, USA
| | - Kristina Lopez
- School of Social Work, Arizona State University, AZ, USA
| | - Yue Xu
- Department of Disability and Human Development, University of Illinois at Chicago, IL, USA
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Pivotal Response Treatment (PRT) - Parent Group Training for Young Children with Autism Spectrum Disorder: A Qualitative Study on Perspectives of Parents. J Autism Dev Disord 2022; 52:5414-5427. [PMID: 35083605 PMCID: PMC8791680 DOI: 10.1007/s10803-021-05397-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2021] [Indexed: 01/31/2023]
Abstract
Pivotal Response Treatment (PRT) is considered to be an empirically supported parent-mediated treatment for children with autism spectrum disorder (ASD), but research on parental experiences is lacking. This qualitative study examined the perspectives of parents of young children with ASD who participated in a 14-week PRT with parent group training (PRT-PG). Semi-structured interviews (n = 12) were carried out, based on Grounded Theory principles. Results indicated that facilitators and barriers were related to timing and expectations, training setting and characteristics, and participant characteristics. Perceived effects were related to improved child’s social-communication skills and well-being, parental insights into their child’s needs and own habitual patterns in communication and behavior, and positive changes in family cohesion. The findings indicate that in general parents value PRT-PG as feasible and effective.
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Vess SF, Campbell JM. Parent-child interaction therapy (PCIT) with families of children with autism spectrum disorder. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2022; 7:23969415221140707. [PMID: 36506281 PMCID: PMC9726853 DOI: 10.1177/23969415221140707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIMS Parent-child interaction therapy (PCIT) is an evidence-based behavioral parent training program designed for preschool-age children that emphasizes supporting parent-child interaction patterns to improve child behavior and enhance the quality of parent-child relationships. PCIT has been deemed efficacious in treating children with disruptive behavior disorders, and recent studies have shown promising results utilizing aspects of PCIT with children with autism spectrum disorder (ASD), but none of these studies applied the entire PCIT intervention per manual protocol. The present study is the first to test the efficacy of PCIT, without modification, with families of preschool-age children with ASD without comorbid behavioral difficulties. METHODS This study employed a single-subject multiple-probe design to evaluate the efficacy of PCIT with four families with children with ASD between the ages of 2 and 4 years old (M = 40 months) over a 4-month period. RESULTS PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands. Parents reported greater confidence in parenting abilities post-treatment and significant improvement in the core areas of autism symptomatology. Parents endorsed significant improvement in aspects of the parent-child relationship, such as attachment and involvement. CONCLUSIONS Parents of children with ASD demonstrated more positive and effective parenting behavior and reported enhancements in the parent-child relationship after participating in PCIT. Children were more compliant to parental commands and exhibited improvements in social and behavioral functioning. Increases in positive parenting behaviors and child compliance to parental requests were maintained 1 month after treatment and outside the clinic setting during generalization sessions. Parents of children with ASD reported a high degree of satisfaction with PCIT. IMPLICATIONS The present study provides initial evidence of the efficacy of utilizing PCIT with families of preschool-age children with ASD and supports the continued investigation of the efficacy of PCIT with this population.
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Affiliation(s)
- Sarah F. Vess
- Sarah F. Vess, Developmental Behavioral Pediatrics, Brenner Children's Hospital, Atrium Health Wake Forest Baptist, Wake Forest School of Medicine, 3325 Silas Creek Parkway, Winston Salem, NC 27103, USA.
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Alfieri P, Scibelli F, Casula L, Piga S, Napoli E, Valeri G, Vicari S. Cooperative Parent-Mediated Therapy in Children with Fragile X Syndrome and Williams Beuren Syndrome: A Pilot RCT Study of a Transdiagnostic Intervention-Preliminary Data. Brain Sci 2021; 12:8. [PMID: 35053752 PMCID: PMC8773548 DOI: 10.3390/brainsci12010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/05/2021] [Accepted: 12/17/2021] [Indexed: 02/04/2023] Open
Abstract
Children with fragile X syndrome and William Beuren syndrome share several socio-communicative deficits. In both populations, around 30/35% of individuals meets criteria for autism spectrum disorder on gold standard instruments. Notwithstanding, few studies have explored feasibility and validity of therapy for socio-communicative deficits in individuals with these genetic conditions. In this study, we present preliminary data on a pilot RCT aimed to verify the effectiveness of cooperative parent-mediated therapy for socio-communicative deficits in a transdiagnostic perspective in a small sample of 12 participants. Our preliminary data showed that the experimental group had significant improvement in one socio-communicative skill (responsivity) and in clinical global impression, while the control group in an adaptive measure of socialization and word production. Implications of these results are then discussed.
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Affiliation(s)
- Paolo Alfieri
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children′s Hospital, IRCCS, 00165 Rome, Italy; (F.S.); (L.C.); (E.N.); (G.V.); (S.V.)
| | - Francesco Scibelli
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children′s Hospital, IRCCS, 00165 Rome, Italy; (F.S.); (L.C.); (E.N.); (G.V.); (S.V.)
| | - Laura Casula
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children′s Hospital, IRCCS, 00165 Rome, Italy; (F.S.); (L.C.); (E.N.); (G.V.); (S.V.)
| | - Simone Piga
- Clinical Epidemiology, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Eleonora Napoli
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children′s Hospital, IRCCS, 00165 Rome, Italy; (F.S.); (L.C.); (E.N.); (G.V.); (S.V.)
| | - Giovanni Valeri
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children′s Hospital, IRCCS, 00165 Rome, Italy; (F.S.); (L.C.); (E.N.); (G.V.); (S.V.)
| | - Stefano Vicari
- Child and Adolescent Psychiatry Unit, Department of Neuroscience, Bambino Gesù Children′s Hospital, IRCCS, 00165 Rome, Italy; (F.S.); (L.C.); (E.N.); (G.V.); (S.V.)
- Department of Life Sciences and Public Health, Catholic University, 00168 Rome, Italy
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Robinson A, Yong E. Emotion transformation: a grounded theory for uncovering painful triggers and repairing relational connection for parents of autistic children. ADVANCES IN AUTISM 2021. [DOI: 10.1108/aia-12-2020-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
It is often voiced that parents of autistic children are the expert of their child, whereas parenting programmes target them as effective mediators for change. This paper aims to explore this unchallenged heuristic to develop an understanding of both emotional and relational needs of parents through trainers’ experiences of delivering emotion-focused and autism parent training.
Design/methodology/approach
This qualitative study used a constructivist approach of grounded theory to gain an in-depth understanding of trainers’ experiences from their encounters when delivering parent training. Six expert trainers were interviewed, and a two-phased coding of ground theory and an adapted thematic analysis was used.
Findings
An overarching theme emerged: emotion transformation from painful triggers, to enhanced attunement and relational repair. Four main themes containing 13 subthemes were identified. The interaction of these themes and subthemes are presented in a three-phase process model. Phase 1: uncovering painful emotions from a shared journey contained one theme: parent painful triggers. Phase 2: uncovering interpersonal rupture cycle contained one theme: relational rupture cycle within non-synchrony of attunement. Phase 3: parent–child relational repair contained two themes: repairing attachment bonds and therapist’s prizing stance.
Social implications
The authors challenge the parent as expert heuristic and propose that not all parents feel expert in neurotypical-neurodivergent intersubjectivity. The authors are curious to see whether trainers/therapists can guide parents through unprocessed emotions and non-synchrony of attunement to promote healing and relational repair, which requires further investigation.
Originality/value
To the best of the authors’ knowledge, this is the first emotion-transformation process model grounded in humanistic principles of relational acceptance and emotion theory. The authors propose that a focus on process rather than outcome is more likely to result in higher parenting self-efficacy.
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Mazon C, Etchegoyhen K, Saint-Supery I, Amestoy A, Bouvard M, Consel C, Sauzéon H. Fostering parents-professional collaboration for facilitating the school inclusion of students with ASD: design of the " ToGather" web-based prototype. EDUCATIONAL TECHNOLOGY RESEARCH AND DEVELOPMENT : ETR & D 2021; 70:231-262. [PMID: 34876798 PMCID: PMC8638642 DOI: 10.1007/s11423-021-10073-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
UNLABELLED In recent years, many psycho-educational technologies were studied to address the school-related difficulties encountered by students with autism spectrum disorder (ASD). However, most of them remain individual-centered and do not consider the social environment. To fill this gap, this study reports on the user-centered design of a web-based support tool, which aims to support communication and coordination between parents, school staff and health professionals of middle and high school students with ASD, in the context of elaborating, implementing, and following an Individualized Education Plan. The study followed a two-step design process: (1) a need analysis for identifying information domains deemed important by the stakeholders; (2) through a participative iterative design process, a panel of professionals and parents provided ideas and feedbacks on the design, which was integrated in subsequent prototype versions of the "ToGather" app. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s11423-021-10073-w.
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Affiliation(s)
- Cécile Mazon
- Équipe Handicap, Activité, Cognition, Santé (HACS), Université de Bordeaux, Inserm, BPH, U1219. Site Carreire, zone Nord, bat. 1B. 146 rue Léo Saignat, 33076 Bordeaux, Gironde, Nouvelle-Aquitaine France
- Équipe-Projet Flowers, Inria Bordeaux Sud-Ouest, 200 Avenue de la Vieille Tour, 33405 Talence Cedex, Gironde, Nouvelle-Aquitaine France
| | - Kattalin Etchegoyhen
- Centre Ressources Autisme Aquitaine, Centre hospitalier Charles Perrens, 121 rue de la Béchade, CS81285, 33076 Bordeaux Cedex, Gironde, Nouvelle-Aquitaine France
| | - Isabeau Saint-Supery
- Équipe Handicap, Activité, Cognition, Santé (HACS), Université de Bordeaux, Inserm, BPH, U1219. Site Carreire, zone Nord, bat. 1B. 146 rue Léo Saignat, 33076 Bordeaux, Gironde, Nouvelle-Aquitaine France
- Équipe-Projet Flowers, Inria Bordeaux Sud-Ouest, 200 Avenue de la Vieille Tour, 33405 Talence Cedex, Gironde, Nouvelle-Aquitaine France
| | - Anouck Amestoy
- Centre Ressources Autisme Aquitaine, Centre hospitalier Charles Perrens, 121 rue de la Béchade, CS81285, 33076 Bordeaux Cedex, Gironde, Nouvelle-Aquitaine France
| | - Manuel Bouvard
- Centre Ressources Autisme Aquitaine, Centre hospitalier Charles Perrens, 121 rue de la Béchade, CS81285, 33076 Bordeaux Cedex, Gironde, Nouvelle-Aquitaine France
| | - Charles Consel
- Bordeaux INP/Enseirb-Matmeca, Avenue des Facultés, 33405 Talence Cedex, Gironde, Nouvelle-Aquitaine France
| | - Hélène Sauzéon
- Équipe Handicap, Activité, Cognition, Santé (HACS), Université de Bordeaux, Inserm, BPH, U1219. Site Carreire, zone Nord, bat. 1B. 146 rue Léo Saignat, 33076 Bordeaux, Gironde, Nouvelle-Aquitaine France
- Équipe-Projet Flowers, Inria Bordeaux Sud-Ouest, 200 Avenue de la Vieille Tour, 33405 Talence Cedex, Gironde, Nouvelle-Aquitaine France
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Andrews ML, Garcia YA, Catagnus RM, Gould ER. Effects of Acceptance and Commitment Training Plus Behavior Parent Training on Parental Implementation of Autism Treatment. PSYCHOLOGICAL RECORD 2021; 72:601-617. [PMID: 34866659 PMCID: PMC8628834 DOI: 10.1007/s40732-021-00496-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/27/2022]
Abstract
The objective of this study was to examine the effects of acceptance and commitment training (ACT) plus behavior parent training (BPT), when delivered via telehealth, on parental implementation of behavioral strategies, experiential avoidance (EA), and stress. The study also examined the subsequent effects on the parents’ autistic children’s behaviors. A multiple baseline design was implemented across four parent-child dyads who participated in the online training. The findings showed that ACT+BPT resulted in parental implementation reaching and maintaining high levels. The training also decreased EA and stress in three parents. Moreover, the parents’ ratings of their children’s challenging behaviors decreased. However, such a trend was not as clearly depicted by direct measures of the children’s behaviors. A social validity interview revealed parents found ACT beneficial in assisting them to learn and use the BPT strategies. Implications and suggestions for future research are discussed.
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Affiliation(s)
- Meredith L. Andrews
- Applied Behavior Analysis Online Program, The Chicago School of Professional Psychology, 325 North Wells Street, Chicago, IL USA
| | | | - Robyn M. Catagnus
- Applied Behavior Analysis Online Program, The Chicago School of Professional Psychology, 325 North Wells Street, Chicago, IL USA
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38
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Manohar H, Kandasamy P. Clinical outcomes of children with ASD - Preliminary findings from a 18 month follow up study. Asian J Psychiatr 2021; 64:102816. [PMID: 34461368 DOI: 10.1016/j.ajp.2021.102816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/27/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Parent-mediated intervention for children with Autism Spectrum Disorder (ASD) is a critical component to deliver evidence-based interventions in resource-limited settings. There is a need for methodologically rigorous longitudinal and follow-up studies of children with ASD to understand clinical outcome and developmental trajectories. METHODS We report the clinical outcome at 18-month follow-up of children diagnosed with ASD who received parent-mediated intervention for a 3-month period as part of a feasibility study. The study participants were followed up for 18 months as part of Treatment As Usual (TAU). Symptom severity and adaptive functioning were assessed on Childhood Autism Rating Scale (CARS) and Vineland Social Maturity Scale (VSMS) respectively. RESULTS All the study participants(n = 42), continued to show improvement between baseline and the two follow-up evaluations at 3 months and 18 months respectively, with reduction in symptom severity, improvement in core features of ASD and adaptive functioning. The maximum gains were attained during the first three months. Three subgroups were identified based on the trajectory of improvement: 1) Children with best possible outcomes, 2) Child with maintenance of gains, and 3) Children with minimal improvement. Seven participants (16.7 %) had the 'best possible' outcome at 18-month follow-up with CARS scores in the non-autistic range and they no longer qualified for a DSM-5 diagnosis of ASD. CONCLUSION The intensity of early intervention is pivotal to positively alter the developmental trajectories in children with ASD. Parent-mediated intervention is the best possible mode of intervention delivery to initiate early intervention and address the prevailing challenges in resource-limited settings.
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Affiliation(s)
- Harshini Manohar
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hembegowda Nagar, Hosur Road, Bangalore, 560029, India.
| | - Preeti Kandasamy
- Department of Child and Adolescent Psychiatry, Neuro Foundation, Salem, India.
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39
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Provenzi L, Grumi S, Rinaldi E, Giusti L. The porridge-like framework: A multidimensional guidance to support parents of children with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 117:104048. [PMID: 34375793 DOI: 10.1016/j.ridd.2021.104048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
Parents of children with developmental disabilities face many daily challenges that can lead to emotional and affective problems, difficulties in caregiving, and partial mental representations about themselves and their children. The multi-faceted nature of these parents' needs requires a multi-component approach that should include the analysis of priority support goals and the planning of tailored therapeutic actions. Despite different types of validated interventions are available, the choice of the most appropriate strategy to pursue a family-centered approach to support parents of infants with developmental disabilities is not obvious. In this scenario, we propose a multi-dimensional model, the porridge-like framework of parenting. It considers three interrelated domains in parents' experience - affective (A), behavioral (B), and cognitive (C) aspects - that are intertwined with the specific degree of the child's impairment (D). This ABCD model may provide professionals with pragmatically valid guidance to plan and deliver family-centered healthcare interventions. By covering the multi-dimensional nature of parenting challenges, it provides clinicians with conceptual categories to recognize the specific needs and to choose the most suitable therapeutic action to address them. In addition, it aims to promote an ethical approach to family-centered rehabilitation for children with developmental disabilities, maximizing the potentials of a collaborative assessment approach.
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Affiliation(s)
- Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.
| | - Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Elisa Rinaldi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Lorenzo Giusti
- Faculty of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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40
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Lestari NE, Anindya I. Does Online Counseling Reduce Anxiety in Parents of Children with Autism Spectrum Disorders During Coronavirus Disease 2019 Pandemic? Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has made governments in a number of countries to issue and implement a regulation of social and physical restriction. It leaves a serious impact, one of which is anxiety experienced by parents of children with autism spectrum disorder (ASD) as the only access to therapy and education for their children has to be done online.
AIM: The purpose of this study was to determine the optimization of online counseling on the anxiety in parents of children with ASD during COVID-19 pandemic.
MATERIALS AND METHODS: The design of this study used pre-test-post-test design without control. The sampling technique used purposive sampling with 46 respondents. The instrument used online counseling design and Generalized Anxiety Disorders-7 which has been tested for validity and reliability. This study used marginal homogeneity test.
RESULTS: The result showed that the majority of respondents’ anxiety before and after online counseling had severe and minimal anxiety (16 respondents, 34.8% and 15 respondents, 32.6%, respectively) with p = 0.012.
CONCLUSIONS: There was an effect of online counseling on anxiety in parents of children with ASD during COVID-19 pandemic. This can serve as a recommendation in providing online counseling to reduce anxiety in parents of children with ASD during COVID-19 pandemic.
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41
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Wei Q, Machalicek W, Zhu J. Treatment Acceptability for Interventions Addressing Challenging Behavior Among Chinese Caregivers of Children with Autism Spectrum Disorder. J Autism Dev Disord 2021; 53:1483-1494. [PMID: 34287734 DOI: 10.1007/s10803-021-05196-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2021] [Indexed: 11/29/2022]
Abstract
The present study evaluated treatment acceptability for behavioral interventions addressing challenging behaviors with Chinese caregivers of children with autism spectrum disorder. Factors influencing treatment acceptability (i.e., severity of challenging behavior and Chinese child-rearing values) were investigated. Caregivers of children aged 2-12 years (N = 216) participated in this survey study. Results suggest that caregivers found positive strategies including noncontingent reinforcement and positive reinforcement the most acceptable; punishment-based strategies were rated as the least acceptable. Furthermore, positive punishment was perceived as more acceptable for severe challenging behavior. Caregivers who endorsed training were more likely to find positive strategies acceptable, whereas those who endorsed shaming were more likely to rate punishment-based strategies as more acceptable. Implications for future research and culturally competent behavioral treatments in Chinese context are provided.
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Affiliation(s)
- Qi Wei
- Department of Special Education and Clinical Sciences, University of Oregon, HEDCO Education Building, Eugene, OR, 97403, USA.
| | - Wendy Machalicek
- Department of Special Education and Clinical Sciences, University of Oregon, HEDCO Education Building, Eugene, OR, 97403, USA
| | - Jinlan Zhu
- Department of Special Education and Clinical Sciences, University of Oregon, HEDCO Education Building, Eugene, OR, 97403, USA
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42
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Nuta R, Koudys J, O'Neill P. Parent treatment integrity across multiple components of a behavioral intervention. BEHAVIORAL INTERVENTIONS 2021. [DOI: 10.1002/bin.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Raluca Nuta
- Department of Applied Disability Studies Brock University St. Catharines Ontario Canada
| | - Julie Koudys
- Department of Applied Disability Studies Brock University St. Catharines Ontario Canada
| | - Paige O'Neill
- Department of Applied Disability Studies Brock University St. Catharines Ontario Canada
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43
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MacKenzie KT, Eack SM. Interventions to Improve Outcomes for Parents of Children with Autism Spectrum Disorder: A Meta-Analysis. J Autism Dev Disord 2021; 52:2859-2883. [PMID: 34189683 DOI: 10.1007/s10803-021-05164-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/27/2022]
Abstract
This meta-analysis examines the impact of parent interventions on outcomes for parents of children with ASD. A systematic review of the literature produced 37 studies that met inclusion criteria. Random-effects models revealed small but significant impacts of intervention on parental outcomes, primarily in parenting confidence and mental health. No improvements were observed in caregiving burden, family adjustment, physical health, or stress. Significant heterogeneity was observed; however, no moderation effects were detected for intervention or sample characteristics. These findings suggest parent interventions improve parenting confidence and, to a lesser degree, mental health. More work is needed to develop interventions that address a wider range of outcomes for parents of children with ASD. Limitations and implications for future research are discussed.
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Affiliation(s)
- Kristen T MacKenzie
- School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.
| | - Shaun M Eack
- School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, 4200 Fifth Ave, Pittsburgh, PA, 15260, USA.,Department of Psychiatry, School of Medicine, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA
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44
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Milgramm A, Corona LL, Janicki-Menzie C, Christodulu KV. Community-based Parent Education for Caregivers of Children Newly Diagnosed with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:1200-1210. [PMID: 33893937 DOI: 10.1007/s10803-021-05025-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/28/2022]
Abstract
Parents of children with autism spectrum disorder (ASD) frequently report high levels of stress related to the process of receiving an ASD diagnosis and navigating the intervention landscape. Parent education programs offer one approach to providing families with support, information, and resources following a child's diagnosis. Given the heterogeneity of such programs, there have been calls within the literature for increased characterization and systematic evaluation of this type of parent-focused intervention. The present study describes the structure and content of a community-based, group-format parent education program for families of children newly diagnosed with ASD. Following program participation, parents reported reductions in parenting stress, increases in knowledge and empowerment, and high levels of satisfaction. Implications and future research directions are discussed.
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Affiliation(s)
- Anna Milgramm
- Center for Autism and Related Disabilities, University at Albany, State University of New York, 1535 Western Avenue, Albany, NY, USA.
| | - Laura L Corona
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cortney Janicki-Menzie
- Center for Autism and Related Disabilities, University at Albany, State University of New York, 1535 Western Avenue, Albany, NY, USA
| | - Kristin V Christodulu
- Center for Autism and Related Disabilities, University at Albany, State University of New York, 1535 Western Avenue, Albany, NY, USA
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45
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Tan-MacNeill KM, Smith IM, Johnson SA, Chorney J, Corkum P. A systematic review of online parent-implemented interventions for children with neurodevelopmental disorders. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1886934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kim M. Tan-MacNeill
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Isabel M. Smith
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Shannon A. Johnson
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jill Chorney
- Paediatric Anaesthesia, IWK Health Centre, Halifax, New Brunswick, Canada
- Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, Nova Scotia, Halifax, Canada
| | - Penny Corkum
- Department of Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
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46
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Frost KM, Russell K, Ingersoll B. Using qualitative content analysis to understand the active ingredients of a parent-mediated naturalistic developmental behavioral intervention. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 25:1935-1945. [PMID: 33840219 DOI: 10.1177/13623613211003747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Although naturalistic developmental behavioral interventions are supported by research for supporting the development of children on the autism spectrum, how they work is not well understood. This study reviewed parent reflection comments in a systematic way to better how one such treatment worked, when delivered by caregivers. Caregivers completed weekly written reflection responses as they learned how to use the treatment techniques. We studied these responses to understand caregiver perspectives on how their children responded to the techniques. The responses were then compared to a theory of how the treatment works. Many responses were consistent with the treatment theory; however, others were not. We found that individual techniques were associated with different child responses, suggesting that general measures of social communication may not measure these specific short-term changes. Our findings point to specific behaviors that may be useful to measure in future research, or useful as indicators of treatment response in clinical practice settings. Overall, qualitative methods may be useful for understanding complex treatment processes.
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47
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Keluskar J, Reicher D, Gorecki A, Mazefsky C, Crowell JA. Understanding, Assessing, and Intervening with Emotion Dysregulation in Autism Spectrum Disorder: A Developmental Perspective. Child Adolesc Psychiatr Clin N Am 2021; 30:335-348. [PMID: 33743942 DOI: 10.1016/j.chc.2020.10.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article provides a comprehensive review of emotion dysregulation (ED) in individuals with autism spectrum disorder (ASD). The authors describe ED from a developmental perspective, and highlight how aberrations in social development and a restricted-repetitive repertoire of behaviors, render individuals with ASD more vulnerable to ED. The article also summarizes how ED in children and adolescents with ASD has been measured and conceptualized in research and clinic settings. Evidence-based pharmacologic and cognitive behavioral interventions targeting ED in ASD are summarized, with a focus on how such approaches are tailored to the developmental needs of individuals with ASD.
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Affiliation(s)
- Jennifer Keluskar
- Stony Brook Outpatient, Department of Psychiatry, Renaissance School of Medicine, Stony Brook Hospital, Putnam Hall-South Campus, Stony Brook, NY 11794-8790, USA.
| | - Debra Reicher
- Stony Brook Outpatient, Department of Psychiatry, Renaissance School of Medicine, Stony Brook Hospital, Putnam Hall-South Campus, Stony Brook, NY 11794-8790, USA
| | - Amanda Gorecki
- Stony Brook Outpatient, Department of Psychiatry, Renaissance School of Medicine, Stony Brook Hospital, Putnam Hall-South Campus, Stony Brook, NY 11794-8790, USA
| | - Carla Mazefsky
- Department of Psychiatry, University of Pittsburgh, University of Pittsburgh School of Medicine, 3811 O'hara Street, Webster Hall Suite 300, Pittsburgh, PA 15213, USA
| | - Judith A Crowell
- Child and Adolescent Psychiatry, Stony Brook Outpatient, Department of Psychiatry, Stony Brook Hospital, Putnam Hall-South Campus, Stony Brook, NY 11794-8790, USA
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48
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Parent-mediated intervention delivered through telehealth for children with autism spectrum disorder. Hippokratia 2021. [DOI: 10.1002/14651858.cd014793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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49
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Brookman-Frazee L, Chlebowski C, Villodas M, Roesch S, Martinez K. Training Community Therapists to Deliver an Individualized Mental Health Intervention for Autism Spectrum Disorder: Changes in Caregiver Outcomes and Mediating Role on Child Outcomes. J Am Acad Child Adolesc Psychiatry 2021; 60:355-366. [PMID: 32755632 DOI: 10.1016/j.jaac.2020.07.896] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 06/26/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study examines the impact of training therapists to deliver "An Individualized Mental Health Intervention for Autism Spectrum Disorder (ASD)" (AIM HI) for children with autism spectrum disorder on caregiver outcomes and the mediating role of changes in caregiver outcomes on child outcomes. METHOD Data were drawn from a cluster randomized trial conducted in 29 publicly funded mental health programs randomized to receive AIM HI training or usual care. Therapists were recruited from enrolled programs and child/caregiver participants enrolled from therapists' caseloads. Participants included 202 caregivers of children 5 to 13 years of age with autism spectrum disorder. Caregiver strain and sense of competence were assessed at baseline and 6 month postbaseline. Child behaviors were assessed at baseline and 6, 12, and 18 months postbaseline. Therapist delivery of evidence-based intervention strategies were assessed between baseline and 6 months. RESULTS A significant training effect was observed for caregiver sense of competence, with AIM HI caregivers reporting significantly greater improvement relative to usual care. There was no significant training effect for caregiver strain. Observer-rated therapist delivery of evidence-based interventions strategies over 6 months mediated training effects for sense of competence at 6 months. Changes in sense of competence from baseline to 6 months was associated with reduced child challenging behaviors at 6 months and mediated child outcomes at 12 and 18 months. CONCLUSION Combined with research demonstrating effectiveness of therapist AIM HI training on child outcomes, this study provides further evidence of the positive impact of training community therapists in the AIM HI intervention. CLINICAL TRIAL REGISTRATION INFORMATION Effectiveness and Implementation of a Mental Health Intervention for ASD (AIM HI); https://clinicaltrials.gov/; NCT02416323.
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Affiliation(s)
- Lauren Brookman-Frazee
- Child and Adolescent Services Research Center, San Diego, California; University of California, San Diego; Rady Children's Hospital, San Diego, California
| | - Colby Chlebowski
- Child and Adolescent Services Research Center, San Diego, California; University of California, San Diego.
| | - Miguel Villodas
- Child and Adolescent Services Research Center, San Diego, California; San Diego State University, California
| | | | - Kassandra Martinez
- Child and Adolescent Services Research Center, San Diego, California; University of California, San Diego; San Diego State University, California
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50
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Medda JE, Kitzerow J, Schlitt S, Berndt K, Schwenck C, Uhlmann L, Freitag CM. Pre-Post Effects of the Psychoeducational, Autism-Specific Parent Training FAUT-E. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2021; 49:134-143. [PMID: 33428461 DOI: 10.1024/1422-4917/a000781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective: Psychoeducational parent training is an economic way to provide care for parents of children newly diagnosed with an autism spectrum disorder (ASD). This study explores pre-post effect sizes of the manualized autism-specific parent training FAUT-E (Frankfurter Autismus-Elterntraining). Method: Two behaviorally trained therapists worked with 6-10 parents in eight group sessions. Twenty-four parents of 24 children with ASD participated in the study. Outcomes were child- and parent-related measures obtained at T0 (first measurement), T1 (second measurement), T2 (postintervention), and T3 (3 months after intervention). Results: Children showed improved behavior in the parent-rated Aberrant Behavior Checklist (ABC) total score after therapy (p = .001; ES T1T2 = .73) and at T3 (p = .018; ES T1-T3 = -.51), and a lower intensity of parent-rated problem behavior at T3 (p = .031; ES T1-T3 = -.46). Parental measures did not change. Conclusions: This study found medium pre-post effects on the child's behavior by FAUT-E between T1 and T2/T3; these were not observed between the measurements T0-T1. FAUT-E was easy to implement and did not increase parental stress. This is in line with results of studies on other training programs to teach parents to use effective behavioral strategies with ASD.
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Affiliation(s)
- Juliane E Medda
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, University of Frankfurt/Main.,Shared first authors
| | - Janina Kitzerow
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, University of Frankfurt/Main.,Shared first authors
| | - Sabine Schlitt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, University of Frankfurt/Main
| | - Kerstin Berndt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, University of Frankfurt/Main
| | - Christina Schwenck
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, University of Frankfurt/Main.,Department of Clinical Child and Adolescent Psychology, University of Giessen
| | - Lorenz Uhlmann
- Institute of Medical Biometry and Informatics, University of Heidelberg
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Autism Research and Intervention Centre of Excellence, University Hospital Frankfurt, University of Frankfurt/Main
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