Dance promotes positive benefits for negative symptoms in autism spectrum disorder (ASD): A systematic review

BackgroundAutism spectrum disorder (ASD) is characterized as a neurodevelopmental disorder with stereotyped and repetitive behaviors. Dance practice can elicit esthesia to stimulate the communication process through the notion of the phenomenal body that is recognized in an expressive and symbolic space.ObjectiveTo conduct a systematic review to identify how dance promotes positive benefits for the negative symptoms in ASD.MethodWe formulated the research question based on PICO: “What is the influence of dance on negative symptoms in individuals with autism spectrum disorder?”. Databases were searched in March 2019 and included PubMed, Science Direct, Scopus, PsycInfo and Web of Science.ResultsWe identified 9,350 studies of which five were selected for our review (a total of 266 individuals). All included studies showed an influence of dance on negative symptoms, including empathy, emotional expression, body awareness, behavior, and psychological wellbeing that impact on social reciprocity, and consequently the communication process, in ASD.ConclusionsDance practice may contribute to body awareness and social involvement using techniques that provide mirroring, synchronization, rhythm, and reciprocity in adults with normal to high-functioning ASD.     

Supporting parents of children with autism spectrum disorders to become informed consumers of evidence on speech pathology practice

The aim of this pilot study was to evaluate the effectiveness of an intervention program designed to help parents of children with autism spectrum disorders (ASD) to become informed consumers of evidence for speech pathology services. The program comprised an interactive workshop and the provision of written materials aimed at increasing the participants’ knowledge of evidence-based practice (EBP) principles and confidence discussing EBP with their children's speech pathologists. Using a repeated measures within-group design (pre/post) and mixed methods of analysis, the results indicate that the participants’ knowledge and confidence increased following their participation in the program. Qualitative analysis revealed that parents differed with regard to which component (workshop or written information) was most helpful. The results provide preliminary evidence to support the further development and testing of intervention programs aimed at supporting parents of children with ASD to become informed consumers of evidence-based speech pathology services.     

Social communication intervention effects vary by dependent variable type in preschoolers with autism spectrum disorders

Abstract

Individuals with autism spectrum disorders (ASDs) have difficulty communicating in ways that are primarily for initiating and maintaining social relatedness (i.e., social communication). We hypothesized that the way researchers measured social communication would affect whether treatment effects were found. Using a best evidence review method, we found that treatments were shown to improve social communication outcomes approximately 54% of the time. The probability that a treatment affected social communication varied greatly depending on whether social communication was directly targeted (63%) or not (39%). Finally, the probability that a treatment affected social communication also varied greatly depending on whether social communication as measured in (a) contexts very similar to treatment sessions (82%) or (b) contexts that differed from treatment on at least setting, materials, and communication partner (33%). This paper also provides several methodological contributions.     

A survey of practice for clinicians working with children with autism spectrum disorders and feeding difficulties

Abstract

The aim of this study was to document information from allied health clinicians about children on their caseload with autism spectrum disorders and feeding difficulties. An electronic survey was disseminated to clinicians working with this group around Australia, where 150 responses were returned and 96 were able to be analysed. Variability in responses was observed for service delivery models, frequency of input, referral reasons, and intervention choices. The majority of respondents identified limited-to-average knowledge of feeding therapy options for this population. Clinician confidence was significantly correlated with perceived therapy success. Results of the survey suggest a need for clinical guidelines in the area to direct practice. Low levels of clinician confidence and perceived therapy success also highlight a need for ongoing research and training.     

Preparing for the future: a review of tools and strategies to support autonomous goal setting for children and youth with autism spectrum disorders

Purpose: Despite recognized benefits, current clinical practice rarely includes direct input from children and youth with autism spectrum disorder (ASD) in setting rehabilitation goals. This study reviews tools and evidence-based strategies to assist with autonomous goal settings for children and youth with ASD. Method: This study included two components: (1) A scoping review of existing tools and strategies to assist with autonomous goal setting in individuals with ASD and (2) a chart review of inter-disciplinary service plan goals for children and youth with ASD. Results: Eleven data sources, evaluating five different tools to assist with autonomous goal setting for children and youth with ASD, were found. Three themes emerged from the integration of the scoping review and chart review, which are discussed in the paper: (1) generalizability of findings, (2) adaptations to support participation and (3) practice implications. Conclusions: Children and youth with ASD can participate in setting rehabilitation goals, but few tools to support their participation have been evaluated, and those tools that do exist do not align well with current services foci. Visual aids appear to be one effective support, but further research on effective strategies for meaningful engagement in autonomous goal setting for children and youth with ASD is warranted.

• Implications for rehabilitation

• Persons with ASD are less self-determined than their peers.

• Input into one’s own rehabilitation goals and priorities is an important component of self-determination.

• Few tools exist to help engage children and youth with ASD in setting their own rehabilitation goals.

• An increased focus on identifying, developing and evaluating effective tools and strategies to facilitate engagement of children and youth with ASD in setting their own rehabilitation goals is warranted.

     

The challenges of screening pre-school children for autism spectrum disorders in Iran

Purpose: Early identification and diagnosis of children with autism spectrum disorder is recommended, but this is difficult to achieve in less developed countries due to a lack of suitable tools and personnel. This two-phase study, undertaken in Iran, aimed to develop culturally appropriate and feasible means for screening pre-school children for autism spectrum disorder (ASD). Method: The first phase involved information and training events held in four cities to alert parents and to recruit and train professionals to undertake screenings and diagnostic assessments. In phase 2, a screening tool developed in Iran was administered to over 20 000 preschool children with the Iranian version of the GARS2 scale used to assess the probability of the child having ASD. Results: Over 250 professionals were trained and assessed as competent screeners of whom a further 67 were trained and accredited to use GARS2. They included postgraduate students and practitioners from a range of disciplines. In all, 1579 children screened positive; however, only 130 parents brought their child for the diagnostic assessment of whom 22% had a high probability of having ASD. Conclusion: The feasibility of undertaking a screening programme for ASD with Iranian preschoolers has been demonstrated although further research is needed to refine the screening and diagnostic tools, monitor assessors and promote greater engagement of families.

• Implications for Rehabilitation

• Sizeable numbers of postgraduate students and practitioners were recruited to assist with the screening and assessments of preschoolers.

• The uptake of screening was highest among parents of four and five years olds but much less so for younger children and in bringing children for further assessments.

• Further research is needed into the development of more suitable screening and diagnostic tools for ASD with Iranian preschoolers and the training of assessors in their use.

     

Evidence-based assessment and autism spectrum disorders: A scoping review

Abstract

Assessment of language and communication in autism spectrum disorders (ASD) is a critical element in developing appropriate and effective interventions and supports. While there is a large literature on diagnosis of autism, the information available to guide clinical practice for communication and language specifically is sparser. In this scoping review, we sought to identify research articles and critical reviews dealing with communication assessment for individuals with autism. The first and second author each conducted an independent search of relevant scholarly databases to identify articles published between 1995 and 2013. Differences were resolved via discussion; 54 relevant articles were identified using the search terms: autism + language + assessment; autism + speech + assessment; and autism + communication + assessment. While guidelines for best practice are premature, especially given the diversity of developmental and cognitive profiles in ASD, emerging consensus was seen in the following areas: (a) formal norm- and criterion-referenced tests not designed specifically for ASD have been investigated and shown to be feasible and interpretable in use with individuals with autism; (b) language sample analysis and/or structured observational elicitations of communication in naturalistic contexts are widely advocated as a means to ensure the full profile of an individual’s strengths and challenges; (c) caregiver report measures in several studies compared favorably with formal tests, therefore many scholars support their use to supplement direct testing in clinical environments, because they can serve as probes of naturally occurring communication behaviors.     

Investigating requests for information in children with autism spectrum disorders: Static versus dynamic assessment

This study investigated the use of static assessment (SA) and dynamic assessment (DA) methodologies for examining the production of requests for information (RI) by children with autism spectrum disorders (ASD) and typically developing peers (TDP) within their school environment. Following an initial SA observation session, the effects of manipulating contextual and linguistic variables to facilitate the production of RI were systematically investigated across three DA sessions. The contextual variables included object/activity choice and physical setting (e.g., treatment room versus classroom). The linguistic variables included prompting of RI production in an attempt to enhance performance. Independent and paired t-test comparisons revealed statistically significant differences in production of RI between the TDP group and children with ASD. The environmental variables of object/activity choice and linguistic prompting appeared to influence performance for a subgroup of children with ASD. Clinical implications related to the importance of assessing performance using both static and dynamic methodologies are discussed.     

Parent implemented early intervention for young children with autism spectrum disorder: a systematic review

BACKGROUND: Recent estimates concerning the prevalence of autism spectrum disorder (ASD) suggest that at least one in 200 children is affected. This group of children and families have important service needs. The involvement of parents in implementing intervention strategies designed to help their autistic children has long been accepted as helpful. The potential benefits are increased skills and reduced stress for parents as well as children. METHODS: This research review focused on interventions for children aged 1-6 years, and was carried out using systematic methodology: a comprehensive search of psychological, educational and biomedical databases, as well as bibliographies and reference lists of key articles, contact with experts in the field, and hand search of key journals. Only studies which involved a concurrent element of control were included. RESULTS: The review found very few studies that had adequate research design from which to draw conclusions about the effectiveness of parent-implemented early intervention. Both randomized and controlled studies tended to suggest that parent training leads to improved child communicative behaviour, increased maternal knowledge of autism, enhanced maternal communication style and parent child interaction, and reduced maternal depression. CONCLUSION: It seems that parent training can successfully contribute to intervention for young children with ASD. However, the review highlights the need for improved research in this area.     

Memory-focused interventions for people with cognitive disorders: A systematic review and meta-analysis of randomized controlled studies

BackgroundA better understanding of people with cognitive disorders improves performance on memory tasks through memory-focused interventions are needed.ObjectivesThe purpose of this study was to assess the effect of memoryfocused interventions on cognitive disorders through a meta-analysis.DesignSystematic review and meta-analysis.Data sourcesThe online electronic databases PubMed, the Cochrane Library, Ovid-Medline, CINHAL, PsycINFO, Ageline, and Embase (up to May 2017) were used in this study. No language restriction was applied to the search.Review methodsObjective memory (learning and memory function, immediate recall, delayed recall, and recognition) was the primary indicator and subjective memory performance, global cognitive function, and depression were the secondary indicators. The Hedges' g of change, subgroup analyses, and meta-regression were analyzed on the basis of the characteristics of people with cognitive disorders.ResultsA total of 27 studies (2177 participants, mean age = 75.80) reporting RCTs were included in the meta-analysis. The results indicated a medium-to-large effect of memory-focused interventions on learning and memory function (Hedges' g = 0.62) and subjective memory performance (Hedges' g = 0.67), a small-to-medium effect on delayed recall and depression, and a small effect on immediate recall and global cognitive function (all p < 0.05) compared with the control. Subgroup analysis and meta-regression indicated that the effects on learning and memory function were more profound in the format of memory training, individual training, shorter treatment duration, and more than eight treatment sessions, and the effect size indicated the MMSE score was the most crucial indicator (β = −0.06, p = 0.04).ConclusionsThis is first comprehensive meta-analysis of special memory domains in people with cognitive disorders. The results revealed that memory-focused interventions effectively improved memory-related performance in people with cognitive disorders. An appropriately designed intervention can effectively improve memory function, reduce disability progression, and improve mood state in people with cognitive disorders. Additional randomized controlled trials including measures of recognition, global cognitive function, and depression should be conducted and analyzed.     

学龄前孤独症谱系障碍患儿屏幕暴露情况与睡眠问题的调查

目的 探讨学龄前孤独症谱系障碍(ASD)患儿屏幕暴露情况与睡眠问题,并对两者在该群体中的关系进行初步探讨.方法 使用自制的《屏幕使用情况问卷》和《中文版儿童睡眠习惯问卷》对101例学龄前ASD患儿屏幕暴露及睡眠状况展开评估,应用Logistic回归分析探讨两者关系.结果 学龄前ASD患儿屏幕暴露超时(>1 h/d)检出...     

Clinician-patient communication: a systematic review

Goal of Work  The goal of this work was to identify methods of clinician–patient cancer-related communication that may impact patient outcomes associated with distress at critical points in the course of cancer care. Materials and methods  A systematic review of practice guidelines, systematic reviews, or randomized trials on this topic was conducted. Guidelines for quality was evaluated using the Appraisal of Guidelines for Research and Evaluation Instrument, and the contributive value for recommendations was assessed. Systematic reviews and randomized trials were also evaluated for methodological rigor. Results  Four existing guidelines, eight systematic reviews and nine randomized trials were identified. Two of the guidelines were of high quality, and all systematic reviews reported clear search criteria and support for their conclusions; the randomized trials were of modest or low quality. For all situations and disease stages, guidelines consistently identified open, honest, and timely communication as important; specifically, there was evidence for a reduction in anxiety when discussions of life expectancy and prognosis were included in consultations. Techniques to increase patient participation in decision-making were associated with greater satisfaction but did not necessarily decrease distress. Few studies took cultural and religious diversity into account. Conclusions  There is little definitive evidence supporting the superiority of one specific method for communicating information compared to another. Evidence regarding the benefit of decision aids or other strategies to facilitate better communication is inconsistent. Since patients vary in their communication preferences and desire for active participation in decision making, there is a need to individualize communication style.     

Equine assisted activities and therapies in children with autism spectrum disorder: A systematic review and a meta-analysis

Introduction: The multifactorial nature of Autism Spectrum Disorder (ASD) is the reason why complementary and alternative methods of treatment are sought in order to support the classic approach.Objectives: The aim of the study was to assess the effectiveness of Equine-Assisted Activities and Therapies (EAAT) in ASD patients based on a review of the literature.Methods: A review of the literature and a meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PUBMED, Cochrane Library, Web of Science, ClinicalTrials.gov and PEDro databases were searched until July 20, 2017. Only articles published in English, in a journal with a review process, after 1999, with a control group or presentation of comparative pre-/post-therapy results in ASD patients, and clear inclusion/exclusion criteria were considered. The methodological quality of the included studies was assessed using the Quality Assessment Tool for Quantitative Studies (QATQS).The meta-analysis of three studies was conducted.Results: A total of 15 studies with 390 participants (aged: 3–16 years) were included. The interaction between psychosocial functioning and EAAT was investigated in most studies. Improvement was reported in the following domains: socialization, engagement, maladaptive behaviors, and shorter reaction time in problem-solving situations after EAAT. The meta-analysis revealed no statistically significant differences for the investigated effects.Conclusions: Despite the need for further, more standardized research, the results of the studies included in this review allow us to conclude that EAAT may be a useful form of therapy in children with ASD.     

Using a social robot to teach gestural recognition and production in children with autism spectrum disorders

While it has been argued that children with autism spectrum disorders are responsive to robot-like toys, very little research has examined the impact of robot-based intervention on gesture use. These children have delayed gestural development. We used a social robot in two phases to teach them to recognize and produce eight pantomime gestures that expressed feelings and needs. Compared to the children in the wait-list control group (N?=?6), those in the intervention group (N?=?7) were more likely to recognize gestures and to gesture accurately in trained and untrained scenarios. They also generalized the acquired recognition (but not production) skills to human-to-human interaction. The benefits and limitations of robot-based intervention for gestural learning were highlighted.

• Implications for Rehabilitation

• Compared to typically-developing children, children with autism spectrum disorders have delayed development of gesture comprehension and production.

• Robot-based intervention program was developed to teach children with autism spectrum disorders recognition (Phase I) and production (Phase II) of eight pantomime gestures that expressed feelings and needs.

• Children in the intervention group (but not in the wait-list control group) were able to recognize more gestures in both trained and untrained scenarios and generalize the acquired gestural recognition skills to human-to-human interaction.

• Similar findings were reported for gestural production except that there was no strong evidence showing children in the intervention group could produce gestures accurately in human-to-human interaction.

     

Early detection of autism spectrum disorders: screening between 12 and 24 months of age

PURPOSE: The purpose of this article is to present nurse practitioners (NPs) with information on screening for autism spectrum disorders (ASDs) in children between 12 and 24 months of age. Recommendations are also provided for appropriate referrals and initiation of early intervention (EI). DATA SOURCES: Review of published literature about ASD. CONCLUSIONS: Children with ASD exhibit impaired social interaction, verbal and nonverbal communication deficits, and repetitive, restricted, and stereotyped patterns of behavior or interests. Studies show that these children benefit from beginning intensive EI as soon as possible. IMPLICATIONS FOR PRACTICE: Early detection enables children with suspected ASD to be evaluated by specialists and entered into treatment programs at the earliest possible opportunity. Because of the importance of early diagnosis of ASD, it is critical that NPs use established screening instruments to maximize time and increase the reliability of the assessment.     

The psychometric properties of the mindful attention awareness scale among Arab parents of children with autism spectrum disorder

Aim

The purpose of this study was to examine the psychometric properties and the theoretical structure of the mindful attention awareness scale (MAAS) with parents of children with autism spectrum disorder (ASD) in Jordan.

The effectiveness of non-pharmacological interventions in older adults with depressive disorders: A systematic review

BackgroundIt is widely acknowledged that mental health disorders are common in older adults and that depression is one of the most serious threats to the mental health of older adults. Although best practice guidelines point out that moderate to severe depression should be approached with pharmacotherapy together with complementary therapies, the use of antidepressant drugs in older adults has various disadvantages, such as long response time, side effects, potential risk of dependency and tolerance, poor compliance rates and high probability of drug interactions. In addition, qualitative studies of depressed people with a chronic illness have indicated that both patients and healthcare professionals prefer a psychosocial treatment for depression over a pharmacological one.ObjectiveThis review aimed to identify and synthesize the best available evidence related to the effectiveness of non-pharmacological interventions for older adults with depressive disorders.DesignSystematic review of studies with any experimental design considering non-pharmacological interventions for older adults with depressive disorders.Data sourcesAn initial search of MEDLINE and CINAHL was undertaken, followed by a second search for published and unpublished studies, from January 2000 to March 2012, of major healthcare-related electronic databases. Studies in English, Spanish and Portuguese were included in the review.Review methodsThis review considered studies that included adult patients, aged over 65 years with any type of depressive disorder, regardless of comorbidities and any previous treatments, but excluded those with manic or psychotic episodes/symptoms. All studies that met the inclusion criteria were assessed for methodological quality by two independent reviewers using a standardized critical appraisal checklist for randomized and quasi-randomized controlled studies from the Joanna Briggs Institute. Data extraction was also conducted by two independent reviewers based on the Joanna Briggs Institute data extraction form for experimental studies.ResultsTwenty-three studies met the inclusion criteria. Of those, seventeen were excluded after critical appraisal of methodological quality and six were included in this review. These studies included 520 participants and described cognitive behavior therapy, competitive memory training, reminiscence group therapy, problem-adaptation therapy, and problem-solving therapy in home care. Evidence suggests that all these interventions reduce depressive symptoms.ConclusionsAccording to evidence, non-pharmacological interventions had positive effects on improving patients’ depression and may be useful in practice. However, due to the diversity of interventions and the low number of studies per intervention included in this systematic review, evidence is not strong enough to produce a best practice guideline.     

A systematic review of disability awareness interventions for children and youth

Purpose: Children’s lack of knowledge about disability can adversely impact their attitudes toward people with disabilities. The purpose of this study is to review the common elements of effective disability awareness interventions. Methods: A systematic review of disability awareness interventions for children and youth was conducted to assess the effective components of these interventions. Electronic searches were conducted using OVID, CENTRAL, PsychInfo, ERIC, Social Science Citation Index, GreyNET Scopus and Google Scholar. The inclusion criteria included (i) an intervention raising awareness about disability, (ii) school-age children with the average age between 5–19 years old, (iii) at least one measurable outcome focusing on knowledge about disability or attitudes towards and/or acceptance of people with a disability and (iv) published article or grey literature. Results: Of the 1031 articles that were identified in the search, 42 met the criteria to be included in the review. We classified the disability awareness interventions into 5 broad types including (i) social contact, (ii) simulation, (iii) curriculum, (iv) multi-media curriculum and (v) multiple components. Thirty-four studies showed an improvement in attitudes towards and/or acceptance of peers with disabilities. Eight of these studies also demonstrated an improvement in knowledge of people with disabilities. Five of the interventions found no support for improving knowledge about, or acceptance of people with disabilities. Conclusion: Disability awareness interventions can successfully improve children’s knowledge about and attitudes towards peers with a disability; they should include several different components over multiple sessions. Relevance: These findings are being used to further develop disability awareness interventions to help improve the social inclusion and participation of children with disabilities within mainstream classrooms.

Implications for Rehabilitation

• Well-designed disability awareness interventions for children and youth can help improve knowledge about disability, attitudes towards people with a disability and acceptance of peers with a disability.

• Rehabilitation health care providers and educators should be trained to recognize when children with disabilities are being socially excluded and be prepared to provide or recommend appropriate resources and interventions on how to address this issue.

• Clinicians, educators and children with disabilities should all be involved in the development of disability awareness programs.

• Educators should carefully choose an appropriate intervention to meet the needs of the children in their class while considering age appropriateness and diversity of the students. It is also important for educators to be cognizant of the broader societal influences that impact attitudes towards disability.