Podcast: Resources and Services for Adolescents and Young Adults
Previous work has demonstrated that social attention is related to early language abilities. We explored whether we can facilitate word learning among children with autism by directing attention to areas of the scene that have been demonstrated as relevant for successful word learning. We tracked eye movements to faces and objects while children watched videos of a woman teaching them new words. Test trials measured participants’ recognition of these novel word-object pairings. Results indicate that for children with autism and typically developing children, pointing to the speaker’s mouth while labeling a novel object impaired performance, likely because it distracted participants from the target object. In contrast, for children with autism, holding the object close to the speaker’s mouth improved performance.
Keywords: Attention to faces; Autism; Eye-tracking; Joint attention; Word-learning.
Up to 40% of children with Autism Spectrum Disorder (ASD) exhibit co-occurring anxiety symptoms. Despite recent success in mitigating anxiety symptoms in school-aged children with ASD (mean age >9 years) using adapted versions of Cognitive Behavioural Therapy, little is known about potential treatment outcomes for younger children. To address the gap in the literature, this open-label study evaluated change in anxiety following a 16-week open-label trial of Pivotal Response Treatment (PRT) in children with ASD aged 4-8 years. PRT is a behavioural treatment based on the principles of Applied Behaviour Analysis and has a primary aim of increasing social communication skills in children with ASD through natural reinforcements. To minimise conflation of anxiety and other co-occurring symptoms such as disruptive behaviour and attention-deficit hyperactivity disorder, we measured anxiety using the autism anxiety subscale of the Child and Adolescent Symptom Inventory (CASI) devised by Sukhodolsky et al. (2008). We observed significant anxiety reduction over 16-weeks of PRT. Furthermore, anxiety reduction was independent of changes in autism symptom severity. This study shows promising results for PRT as an intervention for reducing anxiety in young children with ASD.
Keywords: Autism Spectrum Disorder (ASD); Pivotal Response Treatment (PRT); anxiety.
Few evidence-based practices, defined as the use of empirically supported research and clinical expertise for children with autism, have been successfully implemented and sustained in schools. This study examined the perspectives of school personnel ( n = 39) on implementing a social engagement intervention for children with autism. Semi-structured interviews, informed by the Domitrovich et al. (2008) framework, were conducted. Participants were asked about (1) school factors that affect the general implementation of evidence-based practices, (2) their specific experiences implementing the social engagement intervention, and (3) barriers to and facilitators of implementing the social engagement intervention. Data were analyzed using an integrated approach. General (e.g. implementation process, leadership, support, and staff) and intervention-specific (e.g. staff, barriers, and facilitators) implementation themes were identified. These findings suggest that a variety of factors should be considered when implementing evidence-based practices in schools and that implementing social engagement interventions for children with autism may require additional specific support for implementation.
Keywords: autism; implementation; schools; social engagement intervention.
Background: We examined racial/ethnic disparities in school-based behavioral health service use for children with psychiatric disorders.
Methods: Medicaid claims data were used to compare the behavioral healthcare service use of 23,601 children aged 5-17 years by psychiatric disorder (autism, attention deficit hyperactivity disorder [ADHD], conduct/oppositional defiant disorder, and “other”) and by race/ethnicity (African-American, Hispanic, white, and other). Logistic and generalized linear regression analyses were used.
Results: Differences in service use by racial/ethnic group were identified within and across diagnostic groups, both for in-school service use and out-of-school service use. For all disorders, Hispanic children had significantly lower use of in-school services than white children. Among children with ADHD, African-American children were less likely to receive in-school services than white children; however, there were no differences in adjusted annual mean Medicaid expenditures for in-school services by race/ethnicity or psychiatric disorders. Statistically significant differences by race/ethnicity were found for out-of-school service use for children with ADHD and other psychiatric disorders. There were significant differences by race/ethnicity in out-of-school service use for each diagnostic group.
Conclusions: Differences in the use of school-based behavioral health services by racial and ethnic groups suggest the need for culturally appropriate outreach and tailoring of services to improve service utilization.
Keywords: Medicaid; behavioral health; health disparity; mental health; school-based health services.
Pivotal Response Treatment (PRT) is an evidence-based treatment for individuals with ASD that targets social communication skills, most notably social motivation. The aim of the current study was to map microanalytic changes in social communication during dyadic child-therapist interactions following a 16-week trial of PRT. We proposed that a microanalytic approach would allow us to meticulously outline the dynamics of the “building blocks” of children’s discourse, stressing certain aspect that might go unnoticed in global methods of coding. We hypothesized that PRT would improve measures of linguistic social communication in children.
We utilized continuous microanalysis of behavior to explore changes in social communication during PRT sessions in 20 high-functioning children with ASD (ages 4–7 years). For each child, two videotaped PRT sessions – at the beginning and end of these 16 weeks – were coded for vocalizations and verbalizations. This allowed us to compare the amount, fluency, adequacy and reciprocity of social communication between child and therapist at the early versus final stages of PRT.
Results
Compared to baseline, at endpoint, children increased their overall use of vocalizations as well as the congruency of their responses to those of the therapist. The amount of non-congruent responses also dropped significantly. Additionally, children improved in measures of conversational fluency and use of self-referential pronouns.
Conclusions
These results provide a mapping of microanalytic changes in social and linguistic communication that occur during PRT and point to children’s improvement in social communication behavior leading to greater social reciprocity and conversational synchrony following treatment.
Keywords
Problem solving between parents and teachers is critical to maximizing student outcomes. The current study examined the associations among the different components of problem solving, as well as the relationship between various characteristics and problem solving in parents and teachers of children with autism spectrum disorder (ASD). Participants were 18 teachers and 39 parents of children with ASD. Parents and teachers completed a demographic survey, phone interview, and dyad observation. Results indicated that parent and teacher problem solving strategies were correlated with each other. Lower-income parents and parents interacting with White teachers displayed less problem solving. Findings suggest that school-based service delivery models to improve problem solving should consider both skill development, as well as the sociodemographic characteristics that parents and teachers bring to their interactions.
Keywords: autism spectrum disorder; communication; family involvement; parent–teacher relationships; problem solving.