Strategies for Conducting Research on Language in Autism

Several different methodological approaches that have been used in studying language in children with autism are outlined. In classic studies, children with autism are compared to comparison groups typically matched on age, IQ, or mental age in order to identify which aspects of language are uniquely impaired in autism. Several methodological problems are noted with this approach including (a) heterogeneity of the autism population, (b) mental retardation, (c) developmental change with age, and (d) sample size and ascertainment. An alternative strategy is suggested which focuses on identifying the complex expression of the language phenotype in autism across the full range of the syndrome. This approach explores within-group individual differences in language functioning, and recently identified distinct language phenotypic subgroups within the autism population that are relevant to understanding the underlying genetic and neurobiological etiology of autism.     

Psychotropic Medications in Autism: Practical Considerations for Parents

Medications are widely prescribed in children with autism spectrum disorders. Most commonly these medications are used to decrease symptoms that fall under three main clusters: irritability, ADHD-like symptoms, and repetitive behaviors. In this guide we introduce basic approaches to medications in children with autism and review the scientific evidence in each symptom cluster.     

Matching Children on the Autism Spectrum to Classrooms: A Guide for Parents and Professionals

Meeting the needs of a learner with an autism spectrum disorder requires specialized expertise. Assessing the extent to which a potential program or classroom meets a child’s needs is a source of serious challenge for parents and professionals alike. Indeed, identifying, prioritizing and agreeing upon the child’s needs are complex questions for which there are no clear and straightforward answers. The process of establishing a match between a student and a placement must explore several primary dimensions: child, setting, and instructor variables, treatment philosophy and strategies, assessment and evaluation, and family needs and involvement. Additionally, there is a great deal of complexity considering how to interpret, integrate and apply empirical research findings and prominent professional opinions to develop sound and practical solutions. Discussion and agreement about the importance of each of these factors and how they apply in a specific situation forms the foundation of an interactive dialogue between service providers and families to create a “best fit” between student and program.     

Teaching Parents Behavioral Strategies for Autism Spectrum Disorder (ASD): Effects on Stress,Strain, and Competence

We report on parent outcomes from a randomized clinical trial of parent training (PT) versus psychoeducation (PEP) in 180 children with autism spectrum disorder (ASD) and disruptive behavior. We compare the impact of PT and PEP on parent outcomes: Parenting Stress Index (PSI), Parent Sense of Competence (PSOC), and Caregiver Strain Questionnaire (CGSQ). Mixed-effects linear models evaluated differences at weeks 12 and 24, controlling for baseline scores. Parents in PT reported greater improvement than PEP on the PSOC (ES?=?0.34), CGSQ (ES?=?0.50), and difficult child subdomain of the PSI (ES?=?0.44). This is the largest trial assessing PT in ASD on parent outcomes. PT reduces disruptive behavior in children, and improves parental competence while reducing parental stress and parental strain.     

Pivotal Response Group Treatment Program for Parents of Children with Autism

The number of children diagnosed with autism spectrum disorders is increasing, necessitating the development of efficient treatment models. Research has demonstrated that parent-delivered behavioral interventions are a viable treatment model; however, little research has focused on teaching parents in groups. The aim of this study was to demonstrate that parents can learn Pivotal Response Training (PRT) in group therapy, resulting in correlated gains in children’s language. Baseline and post-treatment data were obtained and examined for changes in (a) parent fidelity of PRT implementation, and (b) child functional verbal utterances. Significant differences were observed for both variables. These findings suggest that parents can learn PRT in a group format, resulting in correlated child language gains, thus future controlled studies are warranted.     

Interventions to Improve Outcomes for Parents of Children with Autism Spectrum Disorder: A Meta-Analysis

Journal of Autism and Developmental Disorders - This meta-analysis examines the impact of parent interventions on outcomes for parents of children with ASD. A systematic review of the literature...     

Disseminating ASD Interventions: A Pilot Study of a Distance Learning Program for Parents and Professionals

There is a need for the adaptation of training in evidence-based interventions to non-traditional methods, particularly for individuals working with children with autism spectrum disorders (ASD). An internet-based self-directed distance learning program was created to teach reciprocal imitation training, a naturalistic behavioral intervention aimed at increasing imitation in children with ASD. A single-subject multiple-baseline design study evaluated the effect of the program on changes in therapist (sample 1) and parent (sample 2) knowledge and behavior, and changes in child behavior. Adult participants improved their knowledge and use of the intervention techniques, and child participants improved their rates of imitation. Results suggest that a self-directed distance learning program may be effective for disseminating evidence-based practices to individuals working with children with ASD.     

Differential Diagnosis of Hispanic Children Referred for Autism Spectrum Disorders: Complex Issues

This study examines the decision-making process used for differential diagnosis of a sample of Hispanic children referred for autism spectrum disorders (ASDs). Of the sample of 28 children, 18 were diagnosed with ASDs. Of the 10 children who were not diagnosed with ASDs, 80% were found to have multiple diagnostic labels or comorbidities. Mann-Whitney U analyses determined the differences between the children with the most severe social impairment, children with less severe social impairment and the non-autistic children on several domains commonly used to assess ASDs. These analyses indicated significant differences in some characteristics of the children in the sample. Based on these results, a decision-tree for the diagnosis of children with and without ASDs with comorbid disorders was developed.     

Mediating Effects of Social Support on Quality of Life for Parents of Adults with Autism

The aim of this study was to examine the mediating effect of formal and informal social support on the relationship of caregiver burden and quality of life (QOL), using a sample of 320 parents (aged 50 or older) of adult children with autism spectrum disorder (ASD). Multiple linear regression and mediation analyses indicated that caregiver burden had a negative impact on QOL and that informal social support partially mediated the relationship between caregiver burden and parents’ QOL. Formal social support did not mediate the relationship between caregiver burden and QOL. The findings underscored the need to support aging parents of adult children with ASD through enhancing their informal social support networks.     

An Early Social Engagement Intervention for Young Children with Autism and their Parents

The social vulnerabilities associated with young children with autism are recognized as important intervention targets due to their influence on subsequent development. Current research suggests that interventions that combine motivational and social components can create meaningful changes in social functioning. Simultaneously, it is hypothesized that parent delivery of such strategies can invoke increases in these core social behaviors and parent engagement. This study examined the effects of teaching parents to implement a social engagement intervention with their children. The results indicated that the use of this parent-delivered social intervention led to (a) increases in their children’s use of eye contact, directed positive affect, and verbal initiations, (b) increases in parent positive affect and synchronous engagement, and (c) generalized increases in parent and child behaviors.     

Comparative Effects of Mindfulness and Support and Information Group Interventions for Parents of Adults with Autism Spectrum Disorder and Other Developmental Disabilities

This study evaluated two community based interventions for parents of adults with autism spectrum disorder and other developmental disabilities. Parents in the mindfulness group reported significant reductions in psychological distress, while parents in the support and information group did not. Reduced levels of distress in the mindfulness group were maintained at 20 weeks follow-up. Mindfulness scores and mindful parenting scores and related constructs (e.g., self-compassion) did not differ between the two groups. Results suggest the psychological components of the mindfulness based group intervention were effective over and above the non-specific effects of group processes and informal support.     

Effective Prevention Strategies for Increasing Health Services Utilization Among Hispanic Youth

The study purpose is to address the underutilization of mental health services among Hispanic youth. This article provides professionals with strategies to increase health services utilization by utilizing a framework of the levels of prevention model, with an emphasis on primary prevention. The following questions were explored: (1) What are primary prevention strategies that can assist school professionals? (2) What are secondary prevention strategies and tertiary prevention strategies school professionals can employ to increase the utilization of health services? Implementing primary, secondary, and tertiary prevention strategies may improve Hispanic youth’s overall mental health, academic achievement, and quality of life.     

The Impact of Parent-Delivered Intervention on Parents of Very Young Children with Autism

This study investigated the impact of a parent-coaching intervention based on the Early Start Denver Model (P-ESDM) on parenting-related stress and sense of competence. This was part of a multisite, randomized trial comparing P-ESDM (n = 49) with community intervention (n = 49) for children aged 12 and 24 months. The P-ESDM group reported no increase in parenting stress, whereas the Community group experienced an increase over the same 3-month period. Parental sense of competence did not differ. Number of negative life events was a significant predictor of parenting stress and sense of competence across both groups. This suggests that a parent-coaching intervention may help maintain parental adjustment directly after a child is diagnosed with ASD.     

Adherence to Behavioral and Medical Treatment Recommendations by Parents of Children with Autism Spectrum Disorders

The extent to which parents of children with intellectual or developmental disabilities are adherent to prescribed treatments has not been investigated. In this treatment adherence study, parents (n = 220) of children with autism spectrum disorders were surveyed regarding implementation of recommended treatments to manage problem behavior of their children living at home. Overall adherence to medical treatment recommendations was significantly greater than adherence to behavioral treatment recommendations (p < .002). Of the behavioral treatment recommendations, parents reported greater adherence to reinforcement (81.7%) than punishment (68.9%). Child diagnosis (p < .002) and the diagnosis × marital status interaction (p < .05) were significantly associated with reported adherence to behavioral and medical treatment, respectively. Results are discussed in light of the need to address adherence enhancement and measurement methods. Portions of this work were presented at the Annual Gatlinburg Conference on Research and Theory in Intellectual and Developmental Disabilities, San Diego, CA, March 2008.     

Assessing Need for Social Support in Parents of Children with Autism and Down Syndrome

Parents of children with autism frequently turn to the service delivery system to access supports designed to help adapt to the challenges of having a child with a life-long impairment. Although studies have suggested various supports and coping strategies that are effective for adapting, few studies have examined parents’ own perceptions of needs, and whether parents felt their needs were being met. In the present study the Family Needs Questionnaire (FNQ; Waaland et al., 1993) was modified to address needs for children with developmental disorders. A sample of fifty-six parents of children with autism and a comparison group of thirty-two parents of children with Down syndrome completed the FNQ. The groups did not differ significantly on the number of important needs reported nor the number of important needs being met. However, the two groups differed in the types of supports they most frequently endorsed as Important or Unmet.     

Comparing the Impact of Differing Preschool Autism Interventions on Parents in Two Canadian Provinces

Journal of Autism and Developmental Disorders - Early Intensive Behavioural Intervention (EIBI) is effective for preschoolers with autism spectrum disorder (ASD). Parental measures are rarely...     

Strategies for Perceiving Facial Expressions in Adults with Autism Spectrum Disorder

Rutherford and McIntosh (J Autism Dev Disord 37:187–196, 2007) demonstrated that individuals with autism spectrum disorder (ASD) are more tolerant than controls of exaggerated schematic facial expressions, suggesting that they may use an alternative strategy when processing emotional expressions. The current study was designed to test this finding using photographs of real people. In addition, two control tasks were added to eliminate alternative explanations. We replicated the findings of Rutherford and McIntosh (J Autism Dev Disord 37:187–196, 2007) and also demonstrated that adults with ASD do not show this tolerance when evaluating how realistic the expressions are. These results suggest adults with ASD employ a rule-based strategy to a greater extent than typical adults when processing facial expressions but not when processing other aspects of faces.     

Autism and Early Years Practice. A Guide for Early Years Professionals,Teachers and Parents

Delirium is commonly encountered in the setting of paediatric consultation-liaison psychiatry. However, it is commonly misdiagnosed as current operational diagnostic criteria may be difficult to apply in children. We present a practical approach to eliciting the signs and symptoms of delirium in children and a proposed treatment algorithm which elaborates a variety of environmental management strategies and includes explicit thresholds for the use of antipsychotic medications.