Effects of Exercise Interventions on Stereotypic Behaviours in Children with Autism Spectrum Disorder

Purpose:

The purpose of this systematic review was to synthesize evidence from studies examining the effect of exercise interventions on stereotypic behaviours in children with autism spectrum disorder (ASD).

Methods:

Only exercise-related physical therapy (PT) interventions were included. A multifaceted search strategy identified studies published between 1980 and 2007. Quality was assessed using the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) Study Quality Scale, the Clinical Relevance Tool for Case Studies, and the Quality, Rigour or Evaluative Criteria tool.

Results:

Seven studies (1982–2003) met our inclusion criteria; four of these used single-subject research designs, two were group studies, and one was a case study. Ages and behavioural characteristics of the children (N = 25) varied among the studies. Levels of evidence ranged from II to V (of a possible I–V). Study quality scores ranged from 2 to 5 (range: 0 to 7); mean = 3.9, mode = 5. Few studies in this area of PT practice have been published, and those identified scored low levels of rigour on the AACPDM criteria.

Conclusions:

Research suggests that exercise provides short-term reductions of stereotypic behaviours in children with ASD. Future research with stronger evidence levels, greater rigour, and longer-term outcome assessment is required to determine specific exercise parameters.     

The Experiences of Parents During Diagnosis and Forward Planning for Children with Autism Spectrum Disorder

Background For families of children diagnosed with autism spectrum disorder (ASD) getting a diagnosis is a traumatic experience on which future care and education plans for the child depend. In this paper parental experiences of diagnosis and forward planning for children with ASD are reported. Method This paper is part of a large cross‐sectional study conducted in Northern Ireland and the Republic of Ireland that assessed the needs and experiences of parents of children diagnosed with ASD. Questionnaires were designed and completed by 95 parents, reporting on 100 children, as well as 67 multi‐disciplinary professionals. Results Findings confirm that diagnostic and planning processes are extremely stressful for parents, that statutory diagnosis takes a long time, that care and education plans do not include full parental participation, and that reviews of plans do not consistently include intervention data. Conclusion Policy and practice implications of these findings are important for future revisions of diagnostic tools and manuals.     

中医推拿干预孤独症谱系障碍患儿的临床观察

目的:观察中医推拿结合行为干预对孤独症谱系障碍(Autism Spectrum Disorder,ASD)患儿干预的临床疗效。方法:选择长沙市星学园教育发展中心符合入选标准的孤独症谱系障碍患儿44例,随机分为观察组(22例),对照组(22例),对照组予以行为干预,观察组在行为干预的基础上采用中医推拿。以30次为1个周期,共进行1个周期干预,以儿童孤独症评定量表(Childhood Autism Rating Scale,CARS)和儿童孤独症行为量表(Autism Behavior Checklist,ABC)进行疗效判定。结果:干预后,观察组与对照组的CARS、ABC均较干预前下降(P<0.05),观察组优于对照组(P<0.05),观察组总有效率95.45%,对照组总有效率72.72%。结论:推拿干预孤独症谱系障碍或仅进行行为干预均能改善ASD患儿的临床症状,但是中医推拿结合行为干预的临床疗效优于单纯的行为干预。     

Siblings and Family Environments of Persons With Autism Spectrum Disorder: A Review of the Literature

OBJECTIVES: The purpose of this literature review is to summarize studies on siblings of individuals with autism spectrum disorders (ASD) in four major areas, to identify gaps in the literature, and to propose future directions for research of siblings of persons with ASD. DESIGN AND METHODS: A systematic review of research published within the past 10 years in peer review journals includes investigations on siblings' and parental characteristics, as well as sibling behaviors, relationships, and adaptation. Twelve studies are synthesized to include purpose, findings, and discussion relating it to previous work. RESULTS: Siblings are influenced by the context of their families that are impacted by biological, psychological, sociological, and ecological factors. Research studies are primarily exploratory and no intervention studies are identified. CONCLUSION: The literature review of parental and sibling characteristics, relationships, and adaptation support intervention measures for siblings and family members of persons with autism. Assessment of siblings is necessary to identify those who may be at risk for future adjustment problems and maladaptive behaviors.     

Caring for the Child With an Autism Spectrum Disorder in the Acute Care Setting

PURPOSE. This article explores the challenges that patients with autistic spectrum disorders (ASDs) face when hospitalized and provides assessment strategies and plan-of-care suggestions for nursing caregivers. CONCLUSIONS. With a high prevalence rate of medical comorbidities among this population, such as gastrointestinal complaints and seizures, nurses are likely to care for hospitalized patients with an ASD. PRACTICE IMPLICATIONS. For a child with an ASD, hospitalization can be an overwhelming sensory and cognitive experience. Nurses equipped with an understanding of the unique needs of a child with ASD can tailor the plan of care to reduce patient and family anxiety, optimize treatment goals, and reduce the stress of hospitalization.     

Toileting Problems in Children and Adolescents with Parent-Reported Diagnoses of Autism Spectrum Disorder

The current study investigated toileting problems in one hundred and twenty-seven children and adolescents with parent-reported diagnoses of autism spectrum disorder. Toileting refers to the accomplishment of various unprompted behaviors, including recognising the need to go to the toilet, and waiting before eliminating. The relationship between toileting problems and age, gender, intellectual disability, gastrointestinal symptoms, sleep problems, comorbid psychopathology, quality of life, and adaptive functioning were examined using parent-report questionnaires. The most common toileting problems were, “Does not independently perform most self-help tasks”, “Has toilet accidents during the day”, and “Parent/caregiver notices smears in underwear”. Gender, presence of intellectual disability, gastrointestinal symptoms, and comorbid psychopathology were significant predictors of toileting problems in this study. The gastrointestinal symptoms of constipation and bloating were found to be significant predictors of toileting difficulties. Specifically, constipation predicted accidents and physical problems associated with toileting, and bloating predicted social/emotional factors and physical problems. A small negative correlation was observed between total toileting problems and total health related quality of life. An increase in physical toileting difficulties was associated with lower quality of life.     

2006年中国孤独症儿童相关残疾状况分析

目的了解中国儿童孤独症相关的残疾流行病学数据,为相关工作者提供参考。方法抽取2006年第二次全国残疾人抽样调查中0～17岁孤独症残疾儿童的资料进行数据分析。结果 2006年中国0～17岁儿童中孤独症残疾率为0.212‰,男童孤独症残疾率(0.282‰)显著高于女童(0.132‰)(χ2=16.119,P=0.000),低年龄组儿童孤独症残疾率显著高于高年龄组(Linear-by-Linear As-sociation=30.101,P=0.000),城乡儿童孤独症残疾率无显著性差异(χ2=0.093,P=0.760);孤独症儿童残疾程度排列依次为:重度(32.8%),极重度(26.0%),轻度(22.1%),中度(19.1%);孤独症残疾儿童中接受过康复训练与服务的占73.3%,未接受过的占26.7%。结论孤独症残疾儿童是个较大群体,他们的康复、教育问题,特别是成年后的养护问题等都亟待社会的关注。     

Children on the Autism Spectrum: Grandmother Involvement and Family Functioning

Background This study investigated associations between the presence of a child with autism or Asperger’s disorder in the family, family functioning and grandmother experiences with the goal of better understanding grandparent involvement in the lives of grandchildren on the autism spectrum and their families. Methods Mothers and grandmothers of children who were either typically developing or on the autism spectrum completed parallel forms of a grandparent involvement measure. Mothers reported on the functioning of the immediate family. Data were analysed via multilevel modelling with mother–grandmother dyads as the unit of observation. Results Autism spectrum disorders in children were associated with more flexible family functioning, lower levels of family satisfaction, greater grandmother difficulties and more grandmother information needs. Conclusions Participation of grandparents in diagnostic and treatment meetings and increased communication among family members may facilitate grandparent support and involvement in families with a child on the autism spectrum.     

A Two Time Point Study of Imitative Abilities in Children with Autism Spectrum Disorders

Background Researchers have used various paradigms to explore the universality and specificity of imitation deficits in children with autism spectrum disorders (ASDs). However, some issues still need to be investigated, especially for children with ASDs under the age of 4. Method Two studies were conducted to examine the imitative abilities of children with autism spectrum disorders. Study 1 examined immediate and deferred imitation abilities in 18 children with ASDs, 18 children with developmental delay (DD), and 19 typically developing children (mean ages of all groups were below 4 years). Four tasks were used to evaluate immediate imitation abilities: meaningful actions on objects, non‐meaningful actions on objects, manual movements, and oral‐facial movements. Eighteen months after study 1 was completed, study 2 examined advanced imitative abilities in 11 children with ASDs and 11 children with DD from study 1. Results The results of study 1 indicated that, compared to the two control groups, children with ASDs experienced significant difficulty in imitating non‐meaningful actions only. The findings of study 2 suggested that children with ASDs were still significantly impaired on the imitation of single non‐meaningful actions compared to children with DD. Conclusions The relationships between specific imitation deficits, executive functioning, and shared intentionality in children with ASDs are further discussed.     

Unmet Needs of Families of School‐Aged Children with an Autism Spectrum Disorder

Background To aid decision making regarding the allocation of limited resources, information is needed on the perceived unmet needs of parents of school‐aged children with an autism spectrum disorder. Materials and Methods A cross‐sectional survey was conducted of 101 Canadian families of school‐aged children with an autism spectrum disorder. Results Commonly reported unmet needs were for social activities for the child (78.2%), information about services (77.2%) and continuous service provision (74.3%). Conclusions This study provides insight into needs which have not been met by the service system. Information about the unmet needs of children with an autism spectrum disorder and their families may help policy makers and service providers to develop resources and services that are responsive to their client group.