Educating Children with Autism

Handbook of Autism and Pervasive Developmental Disorders

Objective This study tested the effect of beginning treatment with a speech-generating device (SGD) in the context of a blended, adaptive treatment design for improving spontaneous, communicative utterances in school-aged, minimally verbal children with autism. Method A total of 61 minimally verbal children with autism, aged 5 to 8 years, were randomized to a blended developmental/behavioral intervention (JASP+EMT) with or without the augmentation of a SGD for 6 months with a 3-month follow-up. The intervention consisted of 2 stages. In stage 1, all children received 2 sessions per week for 3 months. Stage 2 intervention was adapted (by increased sessions or adding the SGD) based on the child's early response. The primary outcome was the total number of spontaneous communicative utterances; secondary measures were the total number of novel words and total comments from a natural language sample. Results Primary aim results found improvements in spontaneous communicative utterances, novel words, and comments that all favored the blended behavioral intervention that began by including an SGD (JASP+EMT+SGD) as opposed to spoken words alone (JASP+EMT). Secondary aim results suggest that the adaptive intervention beginning with JASP+EMT+SGD and intensifying JASP+EMT+SGD for children who were slow responders led to better posttreatment outcomes. Conclusion Minimally verbal school-aged children can make significant and rapid gains in spoken spontaneous language with a novel, blended intervention that focuses on joint engagement and play skills and incorporates an SGD. Future studies should further explore the tailoring design used in this study to better understand children's response to treatment. Clinical trial registration information—Developmental and Augmented Intervention for Facilitating Expressive Language (CCNIA); http://clinicaltrials.gov/; NCT01013545.

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Communication interventions for minimally verbal children with autism: a sequential multiple assignment randomized trial.

Circadian rhythms are physiological and behavioural cycles generated by an endogenous biological clock, the suprachiasmatic nucleus. The circadian system influences the majority of physiological processes, including sleep-wake homeostasis. Impaired sleep and alertness are common symptoms of neurodegenerative disorders, and circadian dysfunction might exacerbate the disease process. The pathophysiology of sleep-wake disturbances in these disorders remains largely unknown, and is presumably multifactorial. Circadian rhythm dysfunction is often observed in patients with Alzheimer disease, in whom it has a major impact on quality of life and represents one of the most important factors leading to institutionalization of patients. Similarly, sleep and circadian problems represent common nonmotor features of Parkinson disease and Huntington disease. Clinical studies and experiments in animal models of neurodegenerative disorders have revealed the progressive nature of circadian dysfunction throughout the course of neurodegeneration, and suggest strategies for the restoration of circadian rhythmicity involving behavioural and pharmacological interventions that target the sleep-wake cycle. In this Review, we discuss the role of the circadian system in the regulation of the sleep-wake cycle, and outline the implications of disrupted circadian timekeeping in neurodegenerative diseases.

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'The clocks that time us'--circadian rhythms in neurodegenerative disorders.

In this comprehensive systematic review and meta-analysis of group design studies of nonpharmacological early interventions designed for young children with autism spectrum disorder (ASD), we report summary effects across 7 early intervention types (behavioral, developmental, naturalistic developmental behavioral intervention [NDBI], TEACCH, sensory-based, animal-assisted, and technology-based), and 15 outcome categories indexing core and related ASD symptoms. A total of 1,615 effect sizes were gathered from 130 independent participant samples. A total of 6,240 participants, who ranged in age from 0-8 years, are represented across the studies. We synthesized effects within intervention and outcome type using a robust variance estimation approach to account for the nesting of effect sizes within studies. We also tracked study quality indicators, and report an additional set of summary effect sizes that restrict included studies to those meeting prespecified quality indicators. Finally, we conducted moderator analyses to evaluate whether summary effects across intervention types were larger for proximal as compared with distal effects, and for context-bound as compared to generalized effects. We found that when study quality indicators were not taken into account, significant positive effects were found for behavioral, developmental, and NDBI intervention types. When effect size estimation was limited to studies with randomized controlled trial (RCT) designs, evidence of positive summary effects existed only for developmental and NDBI intervention types. This was also the case when outcomes measured by parent report were excluded. Finally, when effect estimation was limited to RCT designs and to outcomes for which there was no risk of detection bias, no intervention types showed significant effects on any outcome. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Project AIM: Autism intervention meta-analysis for studies of young children

Preschoolers with severe autism and minimal speech were assigned either a discrete trial or a naturalistic language treatment, and parents of all participants also received parent responsiveness training. After 12 weeks, both groups showed comparable improvement in number of spoken words produced, on average. Approximately half the children in each group achieved benchmarks for the first stage of functional spoken language development, as defined by Tager-Flusberg et al. (J Speech Lang Hear Res, 52: 643–652, 2009). Analyses of moderators of treatment suggest that joint attention moderates response to both treatments, and children with better receptive language pre-treatment do better with the naturalistic method, while those with lower receptive language show better response to the discrete trial treatment. The implications of these findings are discussed.

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Comparing Spoken Language Treatments for Minimally Verbal Preschoolers with Autism Spectrum Disorders

Results of a randomized controlled trial of speech interventions for nonverbal preschoolers with ASD

Although cheating on tests and other forms of academic dishonesty are considered rampant, no standard definition of academic dishonesty exists. The current study was conducted to investigate the perceptions of academic dishonesty in high school students, utilizing an innovative methodology, multidimensional scaling (MDS). Two methods were used to gather data: a sorting task, which was used to indirectly assess the students' perceptions, and a rating scale task, which was used to externally validate the results of the sorting task. Two dimensions emerged: Seriousness and Papers versus Exams. Implications for future research regarding high school students' perceptions of academic dishonesty are discussed.

Multidimensional Scaling of High School Students' Perceptions of Academic Dishonesty.

Quick and effective screening measures are needed for detecting Autism Spectrum Disorder (ASD). Thirty typically developing children and 30 children with ASD aged 24–68 months were used. This study explored if the ASD group would exhibit less object exploration, diversity of play, and turn-taking than the typically developing group. Older children with ASD performed less turn-taking. On all other measures, IQ accounted for more of the difference between groups than diagnosis. Implications of these results for future research are discussed.

Efficacy of Brief Quantitative Measures of Play for Screening for Autism Spectrum Disorders

Milieu communication training (MCT), an intervention designed to elicit early communication and language behaviors in young children with a variety of developmental disabilities, has a lar...

Kimberly Gilbert

Papers

Comparing Spoken Language Treatments for Minimally Verbal Preschoolers with Autism Spectrum Disorders

Results of a randomized controlled trial of speech interventions for nonverbal preschoolers with ASD

Multidimensional Scaling of High School Students' Perceptions of Academic Dishonesty.

Efficacy of Brief Quantitative Measures of Play for Screening for Autism Spectrum Disorders

Milieu Communication Training for Late Talkers