2016Emory UniversityTom CariveauLawrence Scahill
A new treatment for minimally verbal girls with ASD
Little is known about the social behavior of children with and without autism spectrum disorder during recess. This study documented the naturally occurring recess engagement and peer interaction behaviors of children with and without autism spectrum disorder in inclusive school settings. Participants included 51 children with autism spectrum disorder and 51 classmates without autism spectrum disorder who served as peer models matched on gender, classroom, grade, age, and ethnicity. Using a timed-interval behavior-coding system, children with autism spectrum disorder spent approximately 30% of their recess time engaged in solitary activities, whereas their classmates only spent approximately 9% of recess unengaged. In addition, children with autism spectrum disorder spent about 40% of the recess period jointly engaged with peers in a reciprocal activity, conversation, or game as compared to 70% for matched classmates. These findings provide a context for which to interpret intervention outcomes and gains for children with autism spectrum disorder in inclusive settings.
Keywords: autism spectrum disorder; peers; playground engagement; social communication.
Although children with autism spectrum disorder are frequently included in mainstream classrooms, it is not known how their social networks change compared to typically developing children and whether the factors predictive of this change may be unique. This study identified and compared predictors of social connectivity of children with and without autism spectrum disorder using a social network analysis. Participants included 182 children with autism spectrum disorder and 152 children without autism spectrum disorder, aged 5-12 years in 152 general education K-5 classrooms. General linear models were used to compare how age, classroom size, gender, baseline connectivity, diagnosis, and intelligence quotient predicted changes in social connectivity (closeness). Gender and classroom size had a unique interaction in predicting final social connectivity and the change in connectivity for children with autism spectrum disorder; boys who were placed in larger classrooms showed increased social network fragmentation. This increased fragmentation for boys when placed in larger classrooms was not seen in typically developing boys. These results have implications regarding placement, intervention objectives, and ongoing school support that aimed to increase the social success of children with autism spectrum disorder in public schools.
Children with ASD show high frequency of restricted and repetitive behaviors (RRBs); however, higher-order RRBs, such as restricted interests, have remained largely resistant to treatment. This study evaluated change in severity of RRBs following a 16-weeks open trial of Pivotal Response Treatment (PRT). Participants included 15 children with ASD ages 4-7 years. RRBs, as measured by the repetitive behavioral scales-revised (RBS-R) and aberrant behaviors checklist, decreased significantly after treatment. These reductions remained significant after controlling for change in social communication skills. PRT shows promise in reducing RRBs; although PRT explicitly addresses pivotal social communication skills, there is a secondary and less direct effect on RRBs.
Keywords: Behavior therapy; Pivotal Response Treatment (PRT); Repetitive Behavior Scale-Revised (RBS-R); Restricted and repetitive behaviors.
Behavioral interventions for autism have gained prominence in recent years; however, the neural-systems-level targets of these interventions remain poorly understood. We use a novel Bayesian framework to extract network-based differences before and after a 16-week pivotal response treatment (PRT) regimen. Our results suggest that the functional changes induced by PRT localize to the posterior cingulate and are marked by a shift in connectivity from the orbitofrontal cortex to the occipital-temporal cortex. Our results illuminate a potential PRT-induced learning mechanism, whereby the neural circuits involved during social perception shift from sensory and attentional systems to higher-level object and face processing areas.
Many consensus guidelines encourage parents and teachers to openly communicate about their concerns regarding their children. These guidelines attest to the importance of achieving consensus about what issues are most critical and how to address them. The purpose of this study was to examine whether parents and teachers (1) agree about their concerns for their children with autism and (2) when given the opportunity, whether they discussed these concerns. Participants were 39 parent-teacher dyads of children with autism in kindergarten-through-fifth grade autism support classrooms. Each parent and teacher was interviewed separately about their concerns and then observed together in a discussion about the child. Parents and teachers generally agreed about their primary and secondary concerns. When given an opportunity to communicate their concerns, 49% of the parent-teacher dyads discussed problems that neither reported as their primary concern, and 31% discussed problems that neither reported as their primary or secondary concern. These findings suggest that interventions should target parent-teacher communication, rather than agreement, to facilitate home-school collaboration.
Keywords: autism; autism spectrum disorders; family–school partnerships; parent–teacher communication.
Effective parent-teacher communication involves problem-solving concerns about students. Few studies have examined problem solving interactions between parents and teachers of children with autism spectrum disorder (ASD), with a particular focus on identifying communication barriers and strategies for improving them. This study examined the problem-solving behaviors of parents and teachers of children with ASD. Participants included 18 teachers and 39 parents of children with ASD. Parent-teacher dyads were prompted to discuss and provide a solution for a problem that a student experienced at home and at school. Parents and teachers also reported on their problem-solving behaviors. Results showed that parents and teachers displayed limited use of the core elements of problem-solving. Teachers displayed more problem-solving behaviors than parents. Both groups reported engaging in more problem-solving behaviors than they were observed to display during their discussions. Our findings suggest that teacher and parent training programs should include collaborative approaches to problem-solving.
Keywords: autism; autism spectrum disorder; parent-teacher communication; problem-solving.
Background: Peer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.
Method: The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.
Results: Four of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.
Conclusion: PMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.
Keywords: Autism spectrum disorder; Peer-mediated interventions; Systematic review.
Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that would benefit from low-cost and reliable improvements to screening and diagnosis. Human language technologies (HLTs) provide one possible route to automating a series of subjective decisions that currently inform “Gold Standard” diagnosis based on clinical judgment. In this paper, we describe a new resource to support this goal, comprised of 100 20-minute semi-structured English language samples labeled with child age, sex, IQ, autism symptom severity, and diagnostic classification. We assess the feasibility of digitizing and processing sensitive clinical samples for data sharing, and identify areas of difficulty. Using the methods described here, we propose to join forces with researchers and clinicians throughout the world to establish an international repository of annotated language samples from individuals with ASD and related disorders. This project has the potential to improve the lives of individuals with ASD and their families by identifying linguistic features that could improve remote screening, inform personalized intervention, and promote advancements in clinically-oriented HLTs.
Keywords: annotation; autism spectrum disorder; collection; data distribution; language resources; quality control.