Initial Efficacy of Project ImPACT: A Parent-Mediated Social Communication Intervention for Young Children with ASD

Project ImPACT is a parent-mediated social communication intervention for young children with ASD that was developed in community settings to encourage dissemination. A single-subject, multiple-baseline design was conducted across 8 preschoolers with ASD and their mothers to examine the efficacy of the model for improving parent intervention fidelity and child spontaneous language. Multilevel modeling was used to examine the relationship between parent fidelity and child language within session. All parents increased their use of the intervention techniques. Improvements in spontaneous use of language targets were observed for 6 of the 8 children. There was a significant association between parents’ use of the intervention strategies and their child’s spontaneous language use.     

Analysis of a Statewide Early Intervention Program for Young Children with ASD

Journal of Autism and Developmental Disorders - We evaluated the effectiveness of a statewide Medicaid program providing in-home Early Intensive Behavioral Intervention services to young children...     

A Parent-Mediated Intervention to Increase Responsive Parental Behaviors and Child Communication in Children with ASD: A Randomized Clinical Trial

Longitudinal research has demonstrated that responsive parental behaviors reliably predict subsequent language gains in children with autism spectrum disorder. To investigate the underlying causal mechanisms, we conducted a randomized clinical trial of an experimental intervention (Focused Playtime Intervention, FPI) that aims to enhance responsive parental communication (N = 70). Results showed a significant treatment effect of FPI on responsive parental behaviors. Findings also revealed a conditional effect of FPI on children’s expressive language outcomes at 12-month follow up, suggesting that children with baseline language skills below 12 months (n = 24) are most likely to benefit from FPI. Parents of children with more advanced language skills may require intervention strategies that go beyond FPI’s focus on responsive communication.     

Preschool Children with and without Developmental Delay: Risk, Parenting, and Child Demandingess

Although past literature has established relations between early child risk factors, negative parenting, and problematic child behavior, the nature of these interrelations and pathways of influence over time remains largely unknown, especially in children with developmental delays or disabilities. In the current study data were drawn from the longitudinal Collaborative Family Study and included a sample of 260 families with preschool children with and without developmental delays. Child-related risk was assessed at child age 36 months, maternal intrusiveness and negative affect at 48 months, and child demandingness at 60 months. Results indicated significant relations between early risk, negative parenting, and subsequent child demandingness. Sickliness as an infant was the most salient predictive risk factor of later child demandingness. Developmental delay was the most significant predictor of subsequent negative parenting. Results are discussed as being more indicative of additive rather than mediational processes given that early child risk and negative maternal parenting both contributed uniquely to the subsequent development of child demandingness.     

Prediction of Outcomes in Mini-Basketball Training Program for Preschool Children with Autism Using Machine Learning Models

In recent years evidence has emerged suggesting that Mini-basketball training program (MBTP) can be an effective intervention method to improve social communication (SC) impairments and restricted and repetitive behaviors (RRBs) in preschool children suffering from autism spectrum disorder (ASD). However, there is a considerable degree if interindividual variability concerning these social outcomes and thus not all preschool children with ASD profit from a MBTP intervention to the same extent. In order to make more accurate predictions which preschool children with ASD can benefit from an MBTP intervention or which preschool children with ASD need additional interventions to achieve behavioral improvements, further research is required. This study aimed to investigate which individual factors of preschool children with ASD can predict MBTP intervention outcomes concerning SC impairments and RRBs. Then, test the performance of machine learning models in predicting intervention outcomes based on these factors. Participants were 26 preschool children with ASD who enrolled in a quasi-experiment and received MBTP intervention. Baseline demographic variables (e.g., age, body, mass index [BMI]), indicators of physical fitness (e.g., handgrip strength, balance performance), performance in executive function, severity of ASD symptoms, level of SC impairments, and severity of RRBs were obtained to predict treatment outcomes after MBTP intervention. Machine learning models were established based on support vector machine algorithm were implemented. For comparison, we also employed multiple linear regression models in statistics. Our findings suggest that in preschool children with ASD symptomatic severity (r = 0.712, p < 0.001) and baseline SC impairments (r = 0.713, p < 0.001) are predictors for intervention outcomes of SC impairments. Furthermore, BMI (r = −0.430, p = 0.028), symptomatic severity (r = 0.656, p < 0.001), baseline SC impairments (r = 0.504, p = 0.009) and baseline RRBs (r = 0.647, p < 0.001) can predict intervention outcomes of RRBs. Statistical models predicted 59.6% of variance in post-treatment SC impairments (MSE = 0.455, RMSE = 0.675, R2 = 0.596) and 58.9% of variance in post-treatment RRBs (MSE = 0.464, RMSE = 0.681, R2 = 0.589). Machine learning models predicted 83% of variance in post-treatment SC impairments (MSE = 0.188, RMSE = 0.434, R2 = 0.83) and 85.9% of variance in post-treatment RRBs (MSE = 0.051, RMSE = 0.226, R2 = 0.859), which were better than statistical models. Our findings suggest that baseline characteristics such as symptomatic severity of ASD symptoms and SC impairments are important predictors determining MBTP intervention-induced improvements concerning SC impairments and RBBs. Furthermore, the current study revealed that machine learning models can successfully be applied to predict the MBTP intervention-related outcomes in preschool children with ASD, and performed better than statistical models. Our findings can help to inform which preschool children with ASD are most likely to benefit from an MBTP intervention, and they might provide a reference for the development of personalized intervention programs for preschool children with ASD.     

Coparenting Competence in Parents of Children with ASD: A Marker of Coparenting Quality

The coparenting relationship has been linked to parenting stress, parenting self-efficacy and many other concerns associated with the development of children with ASD. Parents of children with ASD (N?=?22) were interviewed to explore three domains of their coparenting relationship; (1) adaptation to the emergence of their child’s autism, (2) parenting their child with ASD, (3) expectations for their child’s developmental outcomes. The concept of coparenting competence, developed during analysis, describes collective perceptions of parenting efficacy. Parents linked perceptions of coparenting competence to their, ability to cope with diagnosis and parenting, motivation to do what they could for their child, and hopes for their child’s development. The concept of coparenting competence could play an important role in future research and intervention.     

Preliminary Effectiveness of Project ImPACT: A Parent-Mediated Intervention for Children with Autism Spectrum Disorder Delivered in a Community Program

Journal of Autism and Developmental Disorders - This is a pilot study of the effectiveness of Project ImPACT, a parent-mediated intervention for ASD delivered in a community program. The primary...     

Working Memory Training for Children with Attention Problems or Hyperactivity: A School-Based Pilot Study

We piloted a computer program to train working memory for children with attention problems or hyperactivity who attended an urban public school serving economically disadvantaged neighborhoods. Training was conducted daily for 5 weeks during school hours. Teachers rated children’s behaviors before and after the intervention, and standardized assessments of verbal and visuo-spatial working memory were also conducted. No attrition occurred due to an inability or unwillingness on the part of children to complete the training. Overall, children’s behavior and working memory improved following training, compared to baseline. Our findings suggest that school-based working memory training may be a viable means for treating children with attention problems or hyperactivity that warrants further investigation. This approach may also overcome barriers to care delivery for economically disadvantaged children who are known to be at higher risk for poor school outcomes.     

The Little Hulton Project: A Pilot Child Clinical Psychology Service for Pre-School Children and their Families

A community-based early intervention psychology service for pre-school children with emotional and behavioural problems is described. The intervention included parent training groups, a weekly open clinic, and multi-agency training, liaison and consultancy. The aims were to provide successful intervention to families, to maximise liaison with community staff and to provide a seamless service to and from the main hospital department. Evidence indicated improvements in parental coping and children's behavioural difficulties using standardised measures and gains were maintained at 6- and 12-month follow-up. This article outlines a framework for service delivery in a small community with high socio-economic deprivation.     

A Retrospective Quasi-Experimental Study of a Transitional Housing Program for Patients with Severe and Persistent Mental Illness

Transitional housing programs aim to improve living skills and housing stability for tenuously housed patients with mental illness. 113 consecutive Transitional Housing Team (THT) patients were matched to 139 controls on diagnosis, time of presentation, gender and prior psychiatric hospitalisation and compared using a difference-in-difference analysis for illness acuity and service use outcomes measured 1 year before and after THT entry/exit. There was a statistically significant difference-in-difference favouring THT participants for bed days (mean difference in difference ?20.76 days, SE 9.59, p = 0.031) and living conditions (HoNOS Q11 mean difference in difference ?0.93, SE 0.23, p < 0.001). THT cost less per participant (I$14,024) than the bed-days averted (I$17,348). The findings of reductions in bed days and improved living conditions suggest that transitional housing programs can have a significant positive impact for tenuously housed patients with high inpatient service usage, as well as saving costs for mental health services.     

Follow-up of Children Diagnosed with Pervasive Developmental Disorders: Stability and Change During the Preschool Years

Forty-one children with pervasive developmental disorders (PDDs) receiving eclectic services were assessed twice during their preschool years. Measures were compared over time for the whole group and for diagnostic subgroups: Childhood autism (CA group) and Other PDDs group. The mean intelligence quotient/developmental quotient (IQ/DQ) of the whole group was stable (P = 0.209) and scores on the Childhood Autism Rating Scale (CARS) decreased (P = 0.001). At time 2, the CA group was more impaired than the other PDDs group: autistic symptoms were more severe (P = 0.01), adaptive behavior scores were lower (P = 0.014), and a trend for lower IQ/DQs (P = 0.06). Children in this study seemed to fare better than reported in previous follow-up studies on children with autism.     

The Relation Between Change in Symptoms and Functioning in Children with ADHD Receiving School-Based Mental Health Services

This study examined the relation between reliable change in symptoms and reliable change in functioning in children with attention deficit hyperactivity disorder (ADHD; N = 64) who were enrolled in a school-based mental health program that included a daily report card intervention, teacher consultation, and behavioral parenting sessions. Parents and teachers completed the disruptive behavior disorders rating scale and the impairment rating scale at pre- and post-treatment. Group-level analyses indicated that symptom improvers demonstrated significant improvement in multiple domains of functioning, whereas symptom no-changers and deteriorators did not. However, individual-level analyses revealed that up to 40% (depending on the domain and the informant) of children achieved reliable symptom change without reliable improvement in functioning, and up to 16% achieved reliable change in functioning without reliable change in symptoms. The results have implications for measurement of treatment outcome.     

Executive Functioning in Children with ASD: An Analysis of the BRIEF

The Behavior Rating Inventory of Executive Functions (BRIEF) screens for executive function deficits in 5- to 18-year-olds. Data of three autism subgroups, according to DSM-IV-TR criteria (N = 35 Autistic Disorder, N = 27 Asperger’s Disorder and N = 65 PDD-NOS), were analyzed. The total group has elevated scores on almost all BRIEF scales. The Shift scale is clinically elevated, reflecting a deficit in cognitive flexibility. The BRIEF scales are not found to discriminate among the autism spectrum disorder (ASD) subgroups. The relation between BRIEF and IQ is complex. Possible influencing factors are discussed. Finally, it is recommended to omit the Negativity scale as a validity index in children with ASD and to consider a high score on this index as a unique characteristic of their BRIEF profile, reflecting rigidity problems.     

Brief Report: The Benefits of an Employer-Based Work-Experience Program for Participants with ASD

Journal of Autism and Developmental Disorders - An employer-based work-experience program run by a multinational organization temporarily employs people with an autism spectrum disorder (ASD) to...     

A Preliminary Neuroimaging Study of Preschool Children with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder that, by current definition, has onset prior to age 7 years. MRI studies have provided some insight into brain differences associated with ADHD, but thus far have almost exclusively focused on children ages 7 years and older. To better understand the neurobiological development of ADHD, cortical and subcortical brain development should be systematically examined in younger children presenting with symptoms of the disorder. High-resolution anatomical (MPRAGE) images, acquired on a 3.0T scanner, were analyzed in a total of 26 preschoolers, ages 4–5 years (13 with ADHD, 13 controls, matched on age and sex). The ADHD sample was diagnosed using DSM-IV criteria, and screened for language disorders. Cortical regions were delineated and measured using automated methods in Freesurfer; basal ganglia structures were manually delineated. Children with ADHD showed significantly reduced caudate volumes bilaterally; in contrast there were no significant group differences in cortical volume or thickness in this age range. After controlling for age and total cerebral volume, left caudate volume was a significant predictor of hyperactive/impulsive, but not inattentive symptom severity. Anomalous basal ganglia, particularly caudate, development appears to play an important role among children presenting with early onset symptoms of ADHD.     

Brief Report: Emotional and Behavioral Problems Among Young Children with ASD: An Exploratory Study of ADOS E-Codes and Child Characteristics

Journal of Autism and Developmental Disorders - Emotional and behavioral problems (EBPs), such as anxiety, overactivity, and aggression, can influence the diagnosis of autism spectrum disorder...