Manualized social skills group training for children and adolescents with higher functioning autism spectrum disorder: protocol of a naturalistic multicenter, randomized controlled trial

Comparative study of the relationship between pregnancy and childbirth factors and autism in healthy children and children with autism

BACKGROUND

Autism is a group of developmental disorders of the nervous system, the main manifestations of which are defects in social interactions and communication, as well as repetitive behaviors and limited interests. The etiology of autism is not limited to a single factor. Therefore, the aim of this study was to compare the relationship between pregnancy and childbirth factors and autism in healthy children and children with autism.

MATERIALS AND METHODS

The present study was a cross-sectional study that was performed on 200 children in Isfahan in 2021. The instrument in this study was a researcher-made questionnaire. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22 software.

RESULTS

The results of data analysis between the two groups with Mann-Whitney U test showed that there was a significant relationship between maternal age at delivery, father's age at delivery, gestational age at delivery, interval between pregnancies, and the length of hospital stay (P ≤ 0.05). Also, the results of data analysis with Chi-squared test showed that there is a significant relationship between the two groups in terms of economic status, place of residence, multiple pregnancies, neonatal sex, and disease in infancy (P ≤ 0.05).

CONCLUSION

The results of this study showed that economic status, place of residence, multiple pregnancies, sex of the baby, and disease in infancy can be effective factors for this disease. According to the results of the study, by considering the factors related to autism, many cases can be adjusted and corrected as much as possible before attempting to conceive.

KONTAKT® social skills group training for Australian adolescents with autism spectrum disorder: a randomized controlled trial

While there is a large body of evidence drawn from randomised controlled trials supporting the efficacy of SSGT in autistic adolescents, the control arms of these studies are almost exclusively treated either as usual or waitlist. Addressing this limitation, 90 verbal autistic adolescents (70% male) aged 12-17 years (M = 13.77, SD = 1.6) with IQ > 70 participated in this pragmatic two-armed randomised controlled trial design study evaluating the efficacy of sixteen 90-min sessions of SSGT KONTAKT® (n = 46) in comparison to a manualised interactive group cooking programme (n = 44) of equal dosage controlling for the potentially confounding effects of exposure to a social group context. The primary outcome was the adolescents' progress towards achieving their personally meaningful social goals at follow-up. Secondary outcomes were changes in autistic traits, quality of life, facial emotion recognition skills, social anxiety, and loneliness. Assessments were conducted at baseline, post intervention and 12-week follow-up. The interaction between time point and group allocation was investigated through a random-effects regression model (linear mixed model) to examine changes in the dependent outcomes. While intention-to-treat analysis (N = 90) demonstrated that both SSGT (ES = 1.36, p < .001) and active control (ES = 1.10, p < .001) groups made progress towards their personally meaningful social goals at follow-up, KONTAKT® participants demonstrated greater progress in social goal attainment than their peers in the active control group (ES = 0.35, p = .04). Findings suggest that KONTAKT® is efficacious in supporting autistic adolescents to achieve their personally meaningful social goals compared to other prosocial group activities.Trial registration: (1) Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12617001117303, registered 31 July 2017, anzctr.org.au; (2) ClinicalTrials.gov: NCT03294668 registered 22 September 2017, https://clinicaltrials.gov .

"I don't want to be a patient": Peer mentoring partnership fosters communication for autistic university students

Background: Despite recognition of the benefits of post-school education in improving life outcomes for autistic adults their university completion rates remain low.Aim: To explore the experiences of undergraduate autistic university students participating in specialist peer mentoring (SPM) to identify active ingredients in the peer mentoring process and to examine the impact of SPM on social communication.Material and method: A total of 30 (8 female; M age = 22.3; SD = 6.7) undergraduate autistic university students engaged in SPM participated in this study. A quantitative pre-test post-test design examined changes in autistic traits. In parallel, the experiences of participating in SPM were explored through semi-structured interviews.Results: Improvements were noted at post-test on the Social Responsiveness Scale-2 total score p = 0.02), and its Social Communication, (p = 0.03) and Social Motivation (p = 0.03) sub-scales. Four themes emerged from the interviews: Developing Partnership and Understanding, Modelling and Practising Communication, Psychological Support and Grading and Planning Skills.Conclusions: These results indicated that the mentor-mentee partnership was a crucial active ingredient of SPM. This partnership appeared to modify social cognition and motivation for autistic university students through modelling and practising communication.Significance: These results demonstrate that SPM can support participation at university for autistic university students.

KONTAKT© for Australian adolescents on the autism spectrum: protocol of a randomized control trial

BACKGROUND

Individuals diagnosed with autism spectrum disorder (ASD) experience impairing challenges in social communication and interaction across multiple contexts. While social skills group training (SSGT) has shown moderate effects on various sociability outcomes in ASD, there is a need for (1) replication of effects in additional clinical and cultural contexts, (2) designs that employ active control groups, (3) calculation of health economic benefits, (4) identification of the optimal training duration, and (5) measurement of individual goals and quality of life outcomes.

METHOD/DESIGN

With the aim of investigating the efficacy and cost-effectiveness of a SSGT, KONTAKT©, a two-armed randomized control trial with adolescents aged 12-17 years (N = 90) with ASD and an intelligence quotient (IQ) of over 70 will be undertaken. Following stratification for centre and gender, participants will be randomly assigned to either KONTAKT© or to an active control group, a group-based cooking programme. Participants will attend both programmes in groups of 6-8 adolescents, over 16 one-and-a-half-hour sessions. The primary outcome examined is adolescent self-rated achievement of personally meaningful social goals as assessed via the Goal Attainment Scaling during an interview with a blinded clinician. Secondary outcomes include adolescent self-reported interpersonal efficacy, quality of life, social anxiety, loneliness, face emotion recognition performance and associated gaze behaviour, and parent proxy reports of autistic traits, quality of life, social functioning, and emotion recognition and expression. Cost-effectiveness will be investigated in relation to direct and indirect societal and healthcare costs.

DISCUSSION

The primary outcomes of this study will be evidenced in the anticipated achievement of adolescents' personally meaningful social goals following participation in KONTAKT© as compared to the active control group. This design will enable rigorous evaluation of the efficacy of KONTAKT©, exercising control over the possibly confounding effect of exposure to a social context of peers with a diagnosis of ASD.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12617001117303. Registered on 31 July 2017. anzctr.org.au ClinicalTrials.gov, NCT03294668. Registered on 22 September 2017. https://clinicaltrials.gov.

Association between Copy Number Variation and Response to Social Skills Training in Autism Spectrum Disorder

Challenges in social communication and interaction are core features of autism spectrum disorder (ASD) for which social skills group training (SSGT) is a commonly used intervention. SSGT has shown modest and heterogeneous effects. One of the major genetic risk factors in ASD is rare copy number variation (CNV). However, limited information exists whether CNV profiles could be used to aid intervention decisions. Here, we analyzed the rare genic CNV carrier status for 207 children, of which 105 received SSGT and 102 standard care as part of a randomized clinical trial for SSGT. We found that being a carrier of rare genic CNV did not have an impact on the SSGT outcome measured by the parent-report Social Responsiveness Scale (SRS). However, when stratifying by pathogenicity and size of the CNVs, we identified that carriers of clinically significant and large genic CNVs (>500 kb) showed inferior SRS outcomes at post-intervention (P = 0.047 and P = 0.036, respectively) and follow-up (P = 0.008 and P = 0.072, respectively) when adjusting for standard care effects. Our study provides preliminary evidence that carriers of clinically significant and large genic CNVs might not benefit as much from SSGT as non-carriers. Our results indicate that genetic information might help guide the modifications of interventions in ASD.

Social Skills Training for Children and Adolescents With Autism Spectrum Disorder: A Randomized Controlled Trial

OBJECTIVE

Social skills group training (SSGT) for children and adolescents with autism spectrum disorder (ASD) is widely applied, but effectiveness in real-world practice has not yet been properly evaluated. This study sought to bridge this gap.

METHOD

This 12-week pragmatic randomized controlled trial of SSGT compared to standard care alone was conducted at 13 child and adolescent psychiatry outpatient units in Sweden. Twelve sessions of manualized SSGT ("KONTAKT") were delivered by regular clinical staff. Participants (N = 296; 88 females and 208 males) were children (n = 172) and adolescents (n = 124) aged 8 to 17 years with ASD without intellectual disability. The primary outcome was the Social Responsiveness Scale rating by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and 3-month follow-up. Moderator analyses were conducted for age and gender.

RESULTS

Significant treatment effects on the primary outcome were limited to parent ratings for the adolescent subgroup (posttreatment: -8.3; 95% CI = -14.2 to -1.9; p = .012, effect size [ES] = 0.32; follow-up: -8.6; 95% CI = -15.4 to -1.8; p = .015, ES = 0.33) and females (posttreatment: -8.9; 95% CI = -16.2 to -1.6; p = .019, ES = 0.40). Secondary outcomes indicated moderate effects on adaptive functioning and clinical severity.

CONCLUSION

SSGT for children and adolescents with ASD in regular mental health services is feasible and safe. However, the modest and inconsistent effects underscore the importance of continued efforts to improve SSGT beyond current standards.

CLINICAL TRIAL REGISTRATION INFORMATION

Social Skills Group Training ("KONTAKT") for Children and Adolescent With High-functioning Autism Spectrum Disorders; https://clinicaltrials.gov/; NCT01854346.