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Koegel LK, Abrams DA, Tran TN, Koegel RL. Improving Social Communication in Autistic Adolescents Through a Clinic-Home-School Collaboration. J Autism Dev Disord 2024:10.1007/s10803-024-06545-6. [PMID: 39425843 DOI: 10.1007/s10803-024-06545-6] [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: 08/26/2024] [Indexed: 10/21/2024]
Abstract
Differences in social communication are common in highly verbal autistic adolescents and can interfere with development of friendships as well as lead to other co-occurring challenges. The purpose of this initial study was to assess whether targeted areas of social communication would improve following the implementation of a manualized social communication package with parent participation and school coordination. Autistic adolescents who demonstrated challenges with social communication participated in this study in the context of a rigorous concurrent multiple baseline experimental design. Weekly intervention targeting social communication was implemented over a period of six to seven weeks (depending on preintervention scores). Additionally, parents and participants completed standardized assessments of anxiety and depression and a post-intervention questionnaire was administered to assess their satisfaction with the intervention. This study demonstrated that social communication could be improved with a short-term intervention program with parent and school participation. All participants showed improvements in social communication, which was maintained at follow-up. Also, all participants and their parents reported high satisfaction with the program. These findings corroborate a growing literature base suggesting that support in the area of social communication is needed and can benefit autistic adolescents.
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Affiliation(s)
- Lynn Kern Koegel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Daniel A Abrams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Thuan N Tran
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert L Koegel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
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Chang JC, Lai MC, Chang SS, Gau SSF. Factors mediating pre-existing autism diagnosis and later suicidal thoughts and behaviors: A follow-up cohort study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2218-2231. [PMID: 38288700 DOI: 10.1177/13623613231223626] [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] [Indexed: 09/14/2024]
Abstract
LAY ABSTRACT Autistic people are more likely to experience suicidal thoughts and behaviors. The underlying relationships between potential risk factors and suicidal thoughts and behaviors in autistic individuals remain unclear. To understand this, we investigated whether specific factors in childhood/youth explain the effects of pre-existing autism spectrum disorder (ASD) diagnoses on later suicidal thoughts and behaviors in adolescence/adulthood. We assessed internalizing and externalizing problems, bullying experiences, and executive functions (including cognitive flexibility, sustained attention, and spatial working memory) at an average baseline age of 13.4 years and suicidal thoughts and behaviors at an average follow-up age of 19.2 years among 129 autistic and 121 typically developing (TD) individuals. During the follow-up period in adolescence/adulthood, autistic individuals were more likely to report suicidal thoughts than TD individuals. Being bullied partially accounted for the relationship between a pre-existing ASD diagnosis and later-reported higher suicidal thoughts. Contrary to our hypothesis, higher (instead of lower) cognitive flexibility in some autistic young people appeared to partially explain their higher rates of suicidal thoughts compared with typically developing young people. The findings imply that school bullying prevention and tailored intervention programs for autistic people, especially those with higher cognitive flexibility, are warranted to reduce their risks of experiencing suicidal thoughts.
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Affiliation(s)
- Jung-Chi Chang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Meng-Chuan Lai
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Azrieli Adult Neurodevelopmental Centre, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Hsiao MN, Chien YL, Tai YM, Chen HM, Shih HH, Chen LW, Chen YY, Soong WT, Chiu YN, Tsai WC, Laugeson E, Tseng MH, Gau SSF. A preliminary randomized controlled study of the PEERS® program for Taiwanese autistic adolescents: The effectiveness on reducing school bullying and enhancing social function. Autism Res 2024; 17:1705-1720. [PMID: 39169699 DOI: 10.1002/aur.3213] [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: 04/08/2024] [Accepted: 07/28/2024] [Indexed: 08/23/2024]
Abstract
Individuals with autism spectrum disorder (ASD) often experience lifelong social communication challenges and are more vulnerable to school bullying. Addressing their social difficulties and school bullying requires evidence-based interventions. PEERS® (Program for the Education and Enrichment of Relational Skills) was adapted and translated for Taiwanese adolescents. This randomized controlled study aimed to examine the effectiveness of the Taiwanese version of PEERS® in reducing school bullying and enhancing social function among autistic adolescents. Twenty-one autistic adolescents (mean age 14.29 ± 1.67 years; female n = 733.33%) were randomized to a treatment group (TG, n = 10) or a delayed treatment control group (DTG, n = 11). The outcome measures (school bullying, social challenges, social skills knowledge, and social skills performance) were assessed at baseline, post-treatment, and follow-up. The group and time interaction analyses revealed greater magnitudes of reduction in general school bullying (p < 0.001), victimization (p < 0.001), perpetration (p = 0.012), social challenges (p = 0.001), and peer conflicts (p < 0.001), and improvement in social knowledge (p < 0.001) in the TG group than the DTG group. The findings suggest that the PEERS® program tailored for Taiwanese adolescents is effective in reducing school bullying, decreasing social challenges, and enhancing social skills among autistic adolescents, with very large effect sizes (Cohen's d ranging from 1.19 to 2.88). Consequently, participation in the PEERS® program is recommended for adolescents with social difficulties to improve their social communication and interactions to offset school bullying and other social challenges related to adverse outcomes.
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Affiliation(s)
- Mei-Ni Hsiao
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yueh-Ming Tai
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, Taipei, Taiwan
| | - Heng-Man Chen
- Foundation for Autistic Children and Adults in Taiwan, Taipei, Taiwan
| | - Hsien-Hsueh Shih
- Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - Li-Wei Chen
- Taiwan Proactive Early Intervention Association, Taipei, Taiwan
| | - Yu-Ying Chen
- Foundation for Autistic Children and Adults in Taiwan, Taipei, Taiwan
| | - Wei-Tsuen Soong
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wen-Che Tsai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Elizabeth Laugeson
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA), Los Angeles, California, USA
| | - Mei-Hui Tseng
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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Lin HT, Tai YM, Gau SSF. Autistic Traits and Cyberbullying Involvement Mediated by Psychopathologies and School Functions in a Nationally Representative Child Sample. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:706-716. [PMID: 37477877 DOI: 10.1089/cyber.2022.0309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Cyberbullying has become an international concern among youth with autistic traits in the digital age. It draws the attention of professionals in mental health and education due to its potentially severe psychosocial and academic impacts. However, there is limited knowledge about the mediators for these associations. This study investigated whether school dysfunction and comorbid psychopathologies mediated the link between autistic traits and cyberbullying. We used a nationally representative sample of 9,483 students (9-14 years of age). The instruments included the Social Responsiveness Scale for autistic traits; the Cyberbullying Experiences Questionnaire for cyberbullying victimization and perpetration; the Swanson, Nolan, and Pelham, version IV for inattention, hyperactivity/impulsivity, and oppositional behaviors; the Child Behavior Checklist for anxiety/depression; and the Social Adjustment Inventory for Children and Adolescents for impaired school functions. Multiple mediation models were used for statistical analyses. The results showed that the 1-year prevalence rates of pure victims, pure perpetrators, and bully-victims of cyberbullying were 7.9 percent, 2.4 percent, and 5.7 percent, respectively. Cyberbullying victimization and perpetration were positively associated with autistic traits, school dysfunction, and comorbid psychopathologies. The associations between autistic traits and cyberbullying victims and bully-victims were significantly mediated by school dysfunction and hyperactivity/impulsivity (only for bully-victims), independent of sex and age. Our results suggest that early identification and intervention of these difficulties may mitigate the risks of cyberbullying. ClinicalTrials.gov ID: NCT02707848.
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Affiliation(s)
- Hai-Ti Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yueh-Ming Tai
- Department of Psychiatry, Beitou Branch, Tri-Service Hospital, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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Adams D, Dargue N, Paynter J. Longitudinal studies of challenging behaviours in autistic children and adults: A systematic review and meta-analysis. Clin Psychol Rev 2023; 104:102320. [PMID: 37515997 DOI: 10.1016/j.cpr.2023.102320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 02/23/2023] [Accepted: 07/12/2023] [Indexed: 07/31/2023]
Abstract
Autistic children and adults are at increased risk of showing behaviours that may be described as challenging, however, little is known about whether or how these behaviours may change over time. Given the profound impact that challenging behaviour can have on both the autistic individual and their support network, it is critical that the trajectory of challenging behaviours be better understood. This systematic review and meta-analysis identified and synthesised observational longitudinal studies of challenging behaviour in autistic individuals. Fifty-six studies were included in the systematic review, and the effect sizes of 37 independent samples arising from 34 of these reports were examined through meta-analysis. Crucially, across the 37 samples, scores on the measures of challenging behaviour reduced by a small, yet significant, extent over time. Although age of the sample at baseline assessment did not moderate the effect, the time between the baseline assessment and final follow-up and age at final follow-up both moderated the magnitude of the effect, with challenging behaviour scores reducing to a larger extent in (a) studies with longer intervals between baseline and final follow-up and (b) studies with older samples at follow-up. The results from the current systematic review and meta-analysis have both theoretical and practical implications for understanding challenging behaviour over time in autistic individuals. Avenues for future research are also highlighted that may allow better understanding, and therefore support of, challenging behaviour in autistic individuals.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia.
| | - Nicole Dargue
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia
| | - Jessica Paynter
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; School of Applied Psychology and Hopkins Centre, Griffith University, Gold Coast, QLD 4222, Australia
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Highlights. J Formos Med Assoc 2022. [DOI: 10.1016/j.jfma.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bullying experiences and mothers’ responses to bullying of children with autism spectrum disorder. DISCOVER PSYCHOLOGY 2022. [PMCID: PMC9376894 DOI: 10.1007/s44202-022-00045-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the fact that children with disabilities generally have been shown to be at a greater risk of bullying, which include physical attacks and threats, being picked on and teased and verbal abuse, there is still a need to understand bullying of children with autism spectrum disorder (ASD) and the strategies used by parents to support them in tackling this issue. This study aims to investigate the type and level of occurrence of bullying and parental support for children aged five with ASD who suffer from bullying. This study used both quantitative and qualitative analysis; a questionnaire, distributed to mothers of children with ASD, adopted from the Bullying for ASD Survey developed by Chen and Schwartz (Focus Autism Other Dev Disabil 27(4):200–212, 2012) measured types and frequency of bullying and parental support. An open-ended question was added to the survey to enable parents to write about the ways in which their child was bullied and the ways in which they supported their child. The results showed that while children suffered from all types of bullying, especially being picked on, being excluded and called names. Parental support showed a higher prevalence of involving peers and teachers for the prevention of bullying as well as avoiding strategies which included avoiding bullies and none of the mothers encouraged their children to stand up to bullies.
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