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Bozhilova N, Welham A, Adams D, Bissell S, Bruining H, Crawford H, Eden K, Nelson L, Oliver C, Powis L, Richards C, Waite J, Watson P, Rhys H, Wilde L, Woodcock K, Moss J. Profiles of autism characteristics in thirteen genetic syndromes: a machine learning approach. Mol Autism 2023; 14:3. [PMID: 36639821 PMCID: PMC9837969 DOI: 10.1186/s13229-022-00530-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/07/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Phenotypic studies have identified distinct patterns of autistic characteristics in genetic syndromes associated with intellectual disability (ID), leading to diagnostic uncertainty and compromised access to autism-related support. Previous research has tended to include small samples and diverse measures, which limits the generalisability of findings. In this study, we generated detailed profiles of autistic characteristics in a large sample of > 1500 individuals with rare genetic syndromes. METHODS Profiles of autistic characteristics based on the Social Communication Questionnaire (SCQ) scores were generated for thirteen genetic syndrome groups (Angelman n = 154, Cri du Chat n = 75, Cornelia de Lange n = 199, fragile X n = 297, Prader-Willi n = 278, Lowe n = 89, Smith-Magenis n = 54, Down n = 135, Sotos n = 40, Rubinstein-Taybi n = 102, 1p36 deletion n = 41, tuberous sclerosis complex n = 83 and Phelan-McDermid n = 35 syndromes). It was hypothesised that each syndrome group would evidence a degree of specificity in autistic characteristics. To test this hypothesis, a classification algorithm via support vector machine (SVM) learning was applied to scores from over 1500 individuals diagnosed with one of the thirteen genetic syndromes and autistic individuals who did not have a known genetic syndrome (ASD; n = 254). Self-help skills were included as an additional predictor. RESULTS Genetic syndromes were associated with different but overlapping autism-related profiles, indicated by the substantial accuracy of the entire, multiclass SVM model (55% correctly classified individuals). Syndrome groups such as Angelman, fragile X, Prader-Willi, Rubinstein-Taybi and Cornelia de Lange showed greater phenotypic specificity than groups such as Cri du Chat, Lowe, Smith-Magenis, tuberous sclerosis complex, Sotos and Phelan-McDermid. The inclusion of the ASD reference group and self-help skills did not change the model accuracy. LIMITATIONS The key limitations of our study include a cross-sectional design, reliance on a screening tool which focuses primarily on social communication skills and imbalanced sample size across syndrome groups. CONCLUSIONS These findings replicate and extend previous work, demonstrating syndrome-specific profiles of autistic characteristics in people with genetic syndromes compared to autistic individuals without a genetic syndrome. This work calls for greater precision of assessment of autistic characteristics in individuals with genetic syndromes associated with ID.
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Affiliation(s)
- Natali Bozhilova
- grid.5475.30000 0004 0407 4824School of Psychology, University of Surrey, Guilford, UK
| | - Alice Welham
- grid.9918.90000 0004 1936 8411School of Psychology, University of Leicester, Leicester, UK
| | - Dawn Adams
- grid.1022.10000 0004 0437 5432Autism Centre of Excellence, Griffith University, Brisbane, Australia
| | - Stacey Bissell
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Hilgo Bruining
- grid.7177.60000000084992262Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Hayley Crawford
- grid.7372.10000 0000 8809 1613Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Kate Eden
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Lisa Nelson
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Christopher Oliver
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Laurie Powis
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Caroline Richards
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Jane Waite
- grid.7273.10000 0004 0376 4727School of Psychology, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Peter Watson
- grid.5335.00000000121885934MRC Brain and Cognition Unit, University of Cambridge, Cambridge, UK
| | - Hefin Rhys
- grid.451388.30000 0004 1795 1830Francis Crick Institute, London, UK
| | - Lucy Wilde
- grid.10837.3d0000 0000 9606 9301School of Psychology, Open University, Milton Keynes, UK
| | - Kate Woodcock
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Edgbaston, UK
| | - Joanna Moss
- grid.5475.30000 0004 0407 4824School of Psychology, University of Surrey, Guilford, UK
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2
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Oztan O, Zyga O, Stafford DEJ, Parker KJ. Linking oxytocin and arginine vasopressin signaling abnormalities to social behavior impairments in Prader-Willi syndrome. Neurosci Biobehav Rev 2022; 142:104870. [PMID: 36113782 PMCID: PMC11024898 DOI: 10.1016/j.neubiorev.2022.104870] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 11/19/2022]
Abstract
Prader-Willi syndrome (PWS) is a genetic neurodevelopmental disorder. Global hypothalamic dysfunction is a core feature of PWS and has been implicated as a driver of many of PWS's phenotypic characteristics (e.g., hyperphagia-induced obesity, hypogonadism, short stature). Although the two neuropeptides (i.e., oxytocin [OXT] and arginine vasopressin [AVP]) most implicated in mammalian prosocial functioning are of hypothalamic origin, and social functioning is markedly impaired in PWS, there has been little consideration of how dysregulation of these neuropeptide signaling pathways may contribute to PWS's social behavior impairments. The present article addresses this gap in knowledge by providing a comprehensive review of the preclinical and clinical PWS literature-spanning endogenous neuropeptide measurement to exogenous neuropeptide administration studies-to better understand the roles of OXT and AVP signaling in this population. The preponderance of evidence indicates that OXT and AVP signaling are indeed dysregulated in PWS, and that these neuropeptide pathways may provide promising targets for therapeutic intervention in a patient population that currently lacks a pharmacological strategy for its debilitating social behavior symptoms.
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Affiliation(s)
- Ozge Oztan
- 1201 Welch Road, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Olena Zyga
- 1201 Welch Road, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Diane E J Stafford
- Center for Academic Medicine, 453 Quarry Road, Department of Pediatrics, Division of Pediatric Endocrinology, Stanford University, Palo Alto, CA 94304, USA
| | - Karen J Parker
- 1201 Welch Road, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA; 300 Pasteur Drive, Department of Comparative Medicine, Stanford University, Stanford, CA 94305, USA.
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3
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Dimitropoulos A, Doernberg EA, Russ SW, Zyga O. Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training. J Autism Dev Disord 2022; 52:5191-5206. [PMID: 35932366 PMCID: PMC9361891 DOI: 10.1007/s10803-022-05695-9] [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: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.
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Affiliation(s)
| | | | | | - Olena Zyga
- Cleveland Clinic Center for Autism, Rocky River, OH, USA
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4
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Dimitropoulos A, Zyga O, Doernberg E, Russ SW. Show me what happens next: Preliminary efficacy of a remote play-based intervention for children with Prader-Willi syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 108:103820. [PMID: 33307337 DOI: 10.1016/j.ridd.2020.103820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/05/2020] [Accepted: 11/21/2020] [Indexed: 06/12/2023]
Abstract
Prader-Willi Syndrome (PWS) is characterized by decreased social and emotional functioning. Due to the low base-rate of children with PWS, developing behavioral interventions for individuals with PWS is faced with the challenge of enrolling enough local participants for adequate study of behavioral intervention efficacy. However, these types of studies are greatly needed in PWS and telehealth methodology may be useful in addressing this challenge. This article is a follow-up to a previous feasibility study (Dimitropoulos et al., 2017) and reports on the preliminary efficacy of a telehealth intervention delivered to 15 children, ages 6-12, with PWS. Overall, children demonstrated significantly improved cognitive and affective processes in pretend play and general cognitive flexibility following the 6-week remote intervention. These findings are limited by the lack of control group and small sample size which should be considered when interpreting results. Overall, these preliminary findings point to the potential role pretend play can serve as a means of enacting cognitive and behavioral change via telehealth.
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Affiliation(s)
| | - Olena Zyga
- Case Westerm Reserve University, Department of Psychological Sciences, United States
| | - Ellen Doernberg
- Case Westerm Reserve University, Department of Psychological Sciences, United States.
| | - Sandra W Russ
- Case Westerm Reserve University, Department of Psychological Sciences, United States
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5
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Marcelo AK, Yates TM. Prospective relations of preschoolers’ prosocial and aggressive affect themes in pretend play with prosocial and aggressive behaviors across contexts. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ana K. Marcelo
- Department of Psychology Clark University Worcester MA USA
| | - Tuppett M. Yates
- Department of Psychology University of California Riverside CA USA
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6
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Doernberg EA, Russ SW, Dimitropoulos A. Believing in Make-Believe: Efficacy of a Pretend Play Intervention for School-Aged Children with High-Functioning Autism Spectrum Disorder. J Autism Dev Disord 2020; 51:576-588. [PMID: 32556834 DOI: 10.1007/s10803-020-04547-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder marked by socio-emotional deficits, and difficulties with pretend play skills. Play skills are related to processes of adaptive functioning and emotion understanding. The present pilot study implemented an in-person pretend play intervention to school-aged children (ages 6 to 9 years, intervention group = 18, control group = 7) diagnosed with high-functioning ASD (HF-ASD), to increase children's cognitive and affective play skills, and emotional understanding abilities. The intervention consisted of 5 weekly sessions, 15-20 minutes each. The intervention group significantly increased in imagination and cognitive play skills, which generalized to increased skills in emotional understanding. Findings demonstrate the positive impact of a short, easily facilitated, accessible play intervention for school-aged children with HF-ASD.
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Affiliation(s)
- Ellen A Doernberg
- Case Western Reserve University, Cleveland, OH, USA. .,Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road, Mather Memorial Building, Rm 109, Cleveland, OH, 44106-7123, USA.
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7
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Zyga O, Dimitropoulos A. Preliminary Characterization of Parent-Child Interaction in Preschoolers With Prader-Willi Syndrome: The Relationship Between Engagement and Parental Stress. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:76-84. [PMID: 31877257 DOI: 10.1352/1944-7558-125.1.76] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Early parent-child interactions (PCI) impact social cognitive development. Relatedly, children with various developmental disorders exhibit abnormal parental attachment relationships. Parental characteristics and behaviors can impact PCI and socioemotional development as well. No research has examined the parent-child dynamic in Prader-Willi syndrome (PWS), a neurodevelopmental disorder that presents with social cognitive deficits. This article provides a preliminary characterization of PCI quality and parenting stress in 17 PWS parent-child dyads, children ages 3-5 years, in comparison to 20 typically developing children and their parent. Results suggest early PCI disruption in preschoolers with PWS and their parents report increased levels of stress in various domains. These findings have important implications not only on parent well-being in PWS but its impact on child development.
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Affiliation(s)
- Olena Zyga
- Olena Zyga and Anastasia Dimitropoulos, Case Western Reserve University
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8
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Kong X, Zhu J, Tian R, Liu S, Sherman HT, Zhang X, Lin X, Han Y, Xiang Z, Koh M, Hobbie C, Wang B, Liu K, Liu J, Yin Y, Wan G. Early Screening and Risk Factors of Autism Spectrum Disorder in a Large Cohort of Chinese Patients With Prader-Willi Syndrome. Front Psychiatry 2020; 11:594934. [PMID: 33329146 PMCID: PMC7735061 DOI: 10.3389/fpsyt.2020.594934] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
Previous studies regarding the prevalence of Autism Spectrum Disorder (ASD) in patients with Prader-Willi Syndrome (PWS) have implicated heterogenous findings. Additionally, the early screening of ASD high-risk population for ASD and identifying ASD risk factors in PWS patients have not been explored. This study included 218 Chinese PWS patients aged 3 months to 18 years old. 78% of subjects were identified as high risk for ASD by ASQ-3 Communication domain score for those younger than 3 years of age and 84% of subjects were classified as high risk for ASD by the GARS-3 for those aged 3 years and older. Among PWS clinical measurements, under-height (P = 0.0186), overweight (P = 0.0248), and obstructive sleep apnea (P = 0.0259) were each significantly correlated with ASD risk. These risk factors and their internal relationship with ASD or ASD traits warrant further studies.
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Affiliation(s)
- Xuejun Kong
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Junli Zhu
- Fisher College, Boston, MA, United States
| | - Ruiyi Tian
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Siyu Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Hannah T Sherman
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | | | - Xiaojing Lin
- Prader-Willi Syndrome Care and Support Center, Hangzhou, China
| | - Yan Han
- Institute of Dermatology and Hospital for Skin Disease, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China
| | - Zhi Xiang
- Institute of Dermatology and Hospital for Skin Disease, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China
| | - Madelyn Koh
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | | | - Bryan Wang
- Brandeis University, Waltham, MA, United States
| | - Kevin Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Jun Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, United States
| | - Yueping Yin
- Institute of Dermatology and Hospital for Skin Disease, Chinese Academy of Medical Science and Peking Union Medical College, Nanjing, China
| | - Guobin Wan
- Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China
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9
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Frygner-Holm S, Russ S, Quitmann J, Ring L, Zyga O, Hansson M, Ljungman G, Höglund AT. Pretend Play as an Intervention for Children With Cancer: A Feasibility Study. J Pediatr Oncol Nurs 2019; 37:65-75. [PMID: 31540566 DOI: 10.1177/1043454219874695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Children with cancer suffer from symptoms and burdensome treatments that often cause distress to children and their families. Mortality is one aspect of cancer diagnosis, while another is the quality of life and well-being during and after the treatment. By supporting children's communication, self-efficacy and coping ability in the care situation, children are given the possibilities for increased independence and participation and are allowed to develop an influence over their care. The aim of this study was to develop and evaluate the feasibility and acceptability of an adult-facilitated pretend play intervention for children with cancer. Five children with ongoing treatment for cancer were invited to a play intervention that consisted of six to eight sessions of structured pretend play aimed at increasing participation, independence, and well-being. A mixed method design was used to evaluate the feasibility and acceptability of the play intervention. Measures were collected before and after interventions, and in conjunction with every play session. Results suggest that the children enjoyed the play intervention. Findings indicate small improvements regarding self-efficacy in care situations and equal or increased quality of life for participants. A main finding was that no adverse events or increased worrying was reported in conjunction with play sessions. Therefore, the intervention is regarded as safe, feasible, and acceptable as reported by participants and their primary caregivers and a possible means of increasing participation and independence in children with a cancer diagnosis.
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Affiliation(s)
| | - Sandra Russ
- Case Western Reserve University, Cleveland, OH, USA
| | - Julia Quitmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Olena Zyga
- Case Western Reserve University, Cleveland, OH, USA
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10
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Dimitropoulos A, Zyga O, Russ SW. Early Social Cognitive Ability in Preschoolers with Prader–Willi Syndrome and Autism Spectrum Disorder. J Autism Dev Disord 2019; 49:4441-4454. [DOI: 10.1007/s10803-019-04152-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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11
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Chukwurah E, Osmundsen A, Davis SW, Lizarraga SB. All Together Now: Modeling the Interaction of Neural With Non-neural Systems Using Organoid Models. Front Neurosci 2019; 13:582. [PMID: 31293366 PMCID: PMC6598414 DOI: 10.3389/fnins.2019.00582] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/22/2019] [Indexed: 12/27/2022] Open
Abstract
The complex development of the human nervous system has been traditionally studied using a combination of animal models, human post-mortem brain tissue, and human genetics studies. However, there has been a lack of experimental human cellular models that would allow for a more precise elucidation of the intricate dynamics of early human brain development. The development of stem cell technologies, both embryonic and induced pluripotent stem cells (iPSCs), has given neuroscientists access to the previously inaccessible early stages of human brain development. In particular, the recent development of three-dimensional culturing methodologies provides a platform to study the differentiation of stem cells in both normal development and disease states in a more in vivo like context. Three-dimensional neural models or cerebral organoids possess an innate advantage over two-dimensional neural cultures as they can recapitulate tissue organization and cell type diversity that resemble the developing brain. Brain organoids also provide the exciting opportunity to model the integration of different brain regions in vitro. Furthermore, recent advances in the differentiation of non-neuronal tissue from stem cells provides the opportunity to study the interaction between the developing nervous system and other non-neuronal systems that impact neuronal function. In this review, we discuss the potential and limitations of the organoid system to study in vitro neurological diseases that arise in the neuroendocrine and the enteric nervous system or from interactions with the immune system.
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Affiliation(s)
- Evelyn Chukwurah
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
- Center for Childhood Neurotherapeutics, University of South Carolina, Columbia, SC, United States
| | - Allison Osmundsen
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
- Center for Childhood Neurotherapeutics, University of South Carolina, Columbia, SC, United States
| | - Shannon W. Davis
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
- Center for Childhood Neurotherapeutics, University of South Carolina, Columbia, SC, United States
| | - Sofia B. Lizarraga
- Department of Biological Sciences, University of South Carolina, Columbia, SC, United States
- Center for Childhood Neurotherapeutics, University of South Carolina, Columbia, SC, United States
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Whittington J, Holland A. A review of psychiatric conceptions of mental and behavioural disorders in Prader-Willi syndrome. Neurosci Biobehav Rev 2018; 95:396-405. [DOI: 10.1016/j.neubiorev.2018.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/15/2018] [Accepted: 10/15/2018] [Indexed: 12/21/2022]
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13
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Zyga O, Russ SW, Dimitropoulos A. The PRETEND Program: Evaluating the Feasibility of a Remote Parent-Training Intervention for Children With Prader-Willi Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:574-584. [PMID: 30421972 DOI: 10.1352/1944-7558-123.6.574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Research has shown that children with Prader-Willi syndrome (PWS) have social-cognitive challenges and decreased quality parent-child interactions. However, given the low prevalence rate, developing interventions for children with PWS is faced with the significant challenge of enrolling enough participants for local studies. To better understand the feasibility and acceptability of telehealth, the current study delivered a 6-week remote parent training intervention to 15 primary caregivers of a child with PWS (ages 3-6). Behavioral Intervention Rating Scale results indicate good acceptability (5.64/6.00) and satisfaction (4.75/5.00) with the intervention. These results are one of the first to support the use of telehealth in conducting parent training in rare disorders, such as PWS.
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Affiliation(s)
- Olena Zyga
- Olena Zyga, Sandra W. Russ, and Anastasia Dimitropoulos, Case Western Reserve University
| | - Sandra W Russ
- Olena Zyga, Sandra W. Russ, and Anastasia Dimitropoulos, Case Western Reserve University
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Evaluating the Feasibility of a Play-Based Telehealth Intervention Program for Children with Prader-Willi Syndrome. J Autism Dev Disord 2018; 47:2814-2825. [PMID: 28612246 DOI: 10.1007/s10803-017-3196-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Here we report the feasibility and acceptability of telehealth for direct intervention in children with Prader-Willi syndrome (PWS). Children with PWS have social-cognitive challenges that are similar to children with ASD. However, developing behavioral interventions for individuals with PWS is faced with the significant challenge of enrolling enough participants for local studies where multiple visits per week are indicated for effective intervention. This study delivered a 6-week play-based intervention via telehealth directly to eight children with PWS (6-12 years). Participants completed the program with minimal behavioral or technological difficulty (#sessions M = 11.875/12). Behavioral Intervention Rating Scale results indicate good acceptability (M = 5.54/6.00). These findings support using telehealth in rare disorders and delivering intervention directly to children with developmental delays through this modality.
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Bennett JA, Hodgetts S, Mackenzie ML, Haqq AM, Zwaigenbaum L. Investigating Autism-Related Symptoms in Children with Prader-Willi Syndrome: A Case Study. Int J Mol Sci 2017; 18:ijms18030517. [PMID: 28264487 PMCID: PMC5372533 DOI: 10.3390/ijms18030517] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 02/13/2017] [Accepted: 02/23/2017] [Indexed: 12/27/2022] Open
Abstract
Prader-Willi syndrome (PWS), a rare genetic disorder caused by the lack of expression of paternal genes from chromosome 15q11-13, has been investigated for autism spectrum disorder (ASD) symptomatology in various studies. However, previous findings have been variable, and no studies investigating ASD symptomatology in PWS have exclusively studied children. We aimed to characterize social communication functioning and other ASD-related symptoms in children with PWS, and assessed agreement across measures and rates of ASD diagnosis. Measures included the Autism Diagnostic Observation Schedule-2 (ADOS-2), the Social Communication Questionnaire (SCQ), Social Responsiveness Scale-2 (SRS-2), Social Skills Improvement System-Rating Scales (SSIS-RS), and the Vineland Adaptive Behavioral Scales-II (VABS-II). General adaptive and intellectual skills were also assessed. Clinical best estimate (CBE) diagnosis was determined by an experienced developmental pediatrician, based on history and review of all available study measures, and taking into account overall developmental level. Participants included 10 children with PWS, aged 3 to 12 years. Three of the 10 children were male and genetic subtypes were two deletion (DEL) and eight uniparental disomy (UPD) (with a total of 6 female UPD cases). Although 8 of the 10 children exceeded cut-offs on at least one of the ASD assessments, agreement between parent questionnaires (SCQ, SRS-2, SSIS-RS) and observational assessment (ADOS-2) was very poor. None of the children were assigned a CBE diagnosis of ASD, with the caveat that the risk may have been lower because of the predominance of girls in the sample. The lack of agreement between the assessments emphasizes the complexity of interpreting ASD symptom measures in children with PWS.
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Affiliation(s)
- Jeffrey A Bennett
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G1C9, Canada.
- Autism Research Centre-E209, Glenrose Rehabilitation Hospital, 10230 111 Avenue, Edmonton, AB T5G 0B7, Canada.
| | - Sandra Hodgetts
- Faculty of Rehabilitation Medicine, University of Alberta, 8205 114 Street, Edmonton, AB T6G 2G4, Canada.
| | - Michelle L Mackenzie
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G1C9, Canada.
| | - Andrea M Haqq
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G1C9, Canada.
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, 11405 87 Avenue, Edmonton, AB T6G1C9, Canada.
- Autism Research Centre-E209, Glenrose Rehabilitation Hospital, 10230 111 Avenue, Edmonton, AB T5G 0B7, Canada.
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16
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Bennett JA, Germani T, Haqq AM, Zwaigenbaum L. Autism spectrum disorder in Prader-Willi syndrome: A systematic review. Am J Med Genet A 2015; 167A:2936-44. [DOI: 10.1002/ajmg.a.37286] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/26/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Jeffrey A. Bennett
- Autism Research Centre, Alberta Health Services; Glenrose Rehabilitation Hospital; Edmonton Alberta Canada
- Department of Pediatrics; University of Alberta; Edmonton Alberta Canada
| | - Tamara Germani
- Autism Research Centre, Alberta Health Services; Glenrose Rehabilitation Hospital; Edmonton Alberta Canada
- Department of Pediatrics; University of Alberta; Edmonton Alberta Canada
| | - Andrea M. Haqq
- Department of Pediatrics; University of Alberta; Edmonton Alberta Canada
| | - Lonnie Zwaigenbaum
- Autism Research Centre, Alberta Health Services; Glenrose Rehabilitation Hospital; Edmonton Alberta Canada
- Department of Pediatrics; University of Alberta; Edmonton Alberta Canada
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Fountain MD, Schaaf CP. MAGEL2 and Oxytocin-Implications in Prader-Willi Syndrome and Beyond. Biol Psychiatry 2015; 78:78-80. [PMID: 26092431 DOI: 10.1016/j.biopsych.2015.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/05/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Michael D Fountain
- Translational Biology and Molecular Medicine, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.; Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas
| | - Christian P Schaaf
- Translational Biology and Molecular Medicine, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas.; Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas..
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