Cognitive Indicators of Different Levels of Special Educational Support Needs in Autism.
TL;DR: In this article, the role of theory of mind in relation to social-behavioral difficulties in autism and suggest its value as an indicator of SEN in making timely decisions about the type of support required by children with this diagnosis.
About: This article is published in Research in Autism Spectrum Disorders.The article was published on 2011-01-01. It has received 19 citations till now. The article focuses on the topics: Special education & Mainstreaming.
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12 Sep 2014
TL;DR: A prior systematic review of interventions for children (0-12 years) with autism spectrum disorder (ASD) focusing on recent studies of behavioral interventions was published in 2013.
Abstract: Objective We updated a prior systematic review of interventions for children (0–12 years) with autism spectrum disorder (ASD), focusing on recent studies of behavioral interventions. Data sources We searched the MEDLINE® (PubMed®), PsycInfo, and Educational Resources Information Clearinghouse (ERIC) databases as well as the reference lists of included studies and recent systematic reviews. We conducted the search in December 2013. Methods We included comparative studies (with treatment and comparison groups) of behavioral interventions with at least 10 participants with ASD in the update, and made our conclusions based on the cumulative comparative evidence across the original report and update. Two investigators independently screened studies against predetermined inclusion criteria and independently rated the quality of included studies. Results We included 65 unique studies comprising 48 randomized trials and 17 nonrandomized comparative studies (19 good, 39 fair, and 7 poor quality) published since the prior review. The quality of studies improved compared with that reported in the earlier review; however, our assessment of the strength of evidence (SOE), our confidence in the stability of effects of interventions in the face of future research, remains low for many intervention/outcome pairs. Early intervention based on high-intensity applied behavior analysis over extended timeframes was associated with improvement in cognitive functioning and language skills (moderate SOE for improvements in both outcomes) relative to community controls in some groups of young children. The magnitude of these effects varied across studies, potentially reflecting poorly understood modifying characteristics related to subgroups of children. Early intensive parent training programs modified parenting behaviors during interactions; however, data were more limited about their ability to improve developmental skills beyond language gains for some children (low SOE for positive effects on language). Social skills interventions varied in scope and intensity and showed some positive effects on social behaviors for older children in small studies (low SOE for positive effects on social skills). Studies of play/interaction-based approaches reported that joint attention interventions may demonstrate positive outcomes in preschool-age children with ASD when targeting joint attention skills (moderate SOE); data on the effects of such interventions in other areas were limited (low SOE for positive effects on play skills, language, social skills). Studies examining the effects of cognitive behavioral therapy on anxiety reported positive results in older children with IQs ≥70 (high SOE for improvements in anxiety in this population). Smaller short-term studies of other interventions reported some improvements in areas such as sleep and communication, but data were too sparse to assess their overall effectiveness. Conclusions A growing evidence base suggests that behavioral interventions can be associated with positive outcomes for children with ASD. Despite improvements in the quality of the included literature, a need remains for studies of interventions across settings and continued improvements in methodologic rigor. Substantial scientific advances are needed to enhance our understanding of which interventions are most effective for specific children with ASD and to isolate elements or components of interventions most associated with effects.
130 citations
TL;DR: These MCID estimates enable users of Vineland‐II to assess both the statistical and clinical significance of any observed change, and enable use of the Vineland Adaptive Behavior Scales for further studies of ASD.
Abstract: Autism Spectrum Disorder (ASD) is associated with persistent impairments in adaptive abilities across multiple domains These social, personal, and communicative impairments become increasingly pronounced with development, and are present regardless of IQ The Vineland Adaptive Behavior Scales, Second Edition (Vineland-II) is the most commonly used instrument for quantifying these impairments, but minimal clinically important differences (MCIDs) on Vineland-II scores have not been rigorously established in ASD We pooled data from several consortia/registries (EU-AIMS LEAP study, ABIDE-I, ABIDE-II, INFOR, Simons Simplex Collection and Autism Treatment Network [ATN]) and clinical investigations and trials (Stanford, Yale, Roche) resulting in a data set of over 9,000 individuals with ASD Two approaches were used to estimate MCIDs: distribution-based methods and anchor-based methods Distribution-based MCID [d-MCID] estimates included the standard error of the measurement, as well as one-fifth and one-half of the covariate-adjusted standard deviation (both cross-sectionally and longitudinally) Anchor-based MCID [a-MCID] estimates include the slope of linear regression of clinician ratings of severity on the Vineland-II score, the slope of linear regression of clinician ratings of longitudinal improvement category on Vineland-II change, the Vineland-II change score maximally differentiating clinical impressions of minimal versus no improvement, and equipercentile equating Across strata, the Vineland-II Adaptive Behavior Composite standardized score MCID estimates range from 201 to 32 for distribution-based methods, and from 242 to 375 for sample-size-weighted anchor-based methods Lower Vineland-II standardized score MCID estimates were observed for younger and more cognitively impaired populations These MCID estimates enable users of Vineland-II to assess both the statistical and clinical significance of any observed change Autism Res 2017 © 2017 International Society for Autism Research, Wiley Periodicals, Inc
Lay Summary
The Vineland Adaptive Behavior Scales (2nd edition; Vineland-II) is the most widely used scale for assessing day-to-day “adaptive” skills Yet, it is unknown how much Vineland-II scores must change for those changes to be regarded as clinically significant We pooled data from over 9,000 individuals with ASD to show that changes of 2–375 points on the Vineland-II Composite score represent the “minimal clinically-important difference” These estimates will help evaluate the benefits of potential new treatments for ASD
90 citations
Cites background from "Cognitive Indicators of Different L..."
...…larger if substantive improvements in adaptive behavior are required before real-world functioning undergoes a meaningful change; or perhaps smaller, given the already significant special support provided to individuals with ASD and comorbid IQ deficits [e.g., Aljunied & Frederickson, 2011]....
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Journal Article•
TL;DR: This article examined relationships among behavior problems, social skills, and educational placement within a sample of children with autism spectrum disorder or ASD in public and non-public (mean age 7) school settings.
Abstract: This study examined relationships among behavior problems, social skills, and educational placement within a sample of children with autism spectrum disorder or ASD in public (mean age 7) and non-public (mean age 8) school settings (n 56). Parent and teacher agreement on child characteristics ratings tended to be similar while differences between parent ratings of students in public and non-public school settings found more behavior problems and poorer social skills for students in non-public school placements compared to public school settings. Furthermore, logistic regression analyses indicated that child age, family income, and social skills were predictive of educational placement, with overall prediction success at 87.5%. Current eligibility and diagnosis of ASD, in both clinical and educational settings, is also discussed.
45 citations
Cites background from "Cognitive Indicators of Different L..."
...What child specific characteristics predict concurrent educational placement in public and non-public school settings?...
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...Supporting the social and cognitive aspects of the previous studies, Aljunied and Frederickson (2011) found that both theory of mind and IQ were determining factors in level of special education need....
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TL;DR: Assessing theory of mind skills can reliably discriminate severity levels within autism spectrum disorder, and level of support needed as indicators of severity level.
Abstract: We investigated whether theory of mind skills can indicate autism spectrum disorder severity. In all, 62 children with autism spectrum disorder completed a developmentally sensitive theory of mind battery. We used intelligence quotient, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis and level of support needed as indicators of severity level. Using hierarchical cluster analysis, we found three distinct clusters of theory of mind ability: early-developing theory of mind (Cluster 1), false-belief reasoning (Cluster 2) and sophisticated theory of mind understanding (Cluster 3). The clusters corresponded to severe, moderate and mild autism spectrum disorder. As an indicator of level of support needed, cluster grouping predicted the type of school children attended. All Cluster 1 children attended autism-specific schools; Cluster 2 was divided between autism-specific and special needs schools and nearly all Cluster 3 children attended general special needs and mainstream schools. Ass...
40 citations
Cites background from "Cognitive Indicators of Different L..."
...…predicted school placement and was the only cognitive indicator (out of intelligence quotient (IQ), cognitive modifiability, executive functioning and central coherence) to discriminate between children requiring no support and children who required some support (Aljunied and Frederickson, 2011)....
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...The variability across ToM and IQ skills seems particularly pertinent for higher functioning children (e.g. Aljunied and Frederickson, 2011), and assessment of both may assist in decisions regarding best individualised placement and education/intervention planning....
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...In a study investigating potential cognitive indicators of level of special needs support in ASD, ToM significantly predicted school placement and was the only cognitive indicator (out of intelligence quotient (IQ), cognitive modifiability, executive functioning and central coherence) to discriminate between children requiring no support and children who required some support (Aljunied and Frederickson, 2011)....
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01 Jan 2018
TL;DR: In this paper, the authors describe executive functions (EFs) as higher-level cognitive processes that allow us to respond in an adaptive manner to the environment: to break out of habits, make decisions and evaluate risks, plan for the future, prioritize and sequence actions, and cope with novel situations.
Abstract: Executive functions (EFs) are higher-level cognitive processes that allow us to respond in an adaptive manner to the environment: to break out of habits, make decisions and evaluate risks, plan for the future, prioritize and sequence actions, and cope with novel situations. EFs consist of several processes: (1) anticipation and deployment of attention, (2) impulse control and self-regulation, (3) initiation of action, (4) working memory (WM), (5) mental flexibility and utilization of feedback, (6) planning ability and organization, (7) selection of efficient problem-solving strategies, and (8) monitoring of performance. EFs are essential for dealing successfully with daily activities. Impairments in EFs have serious consequences, which may be as important to quality of life and functional outcomes as affective symptoms.
28 citations
References
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TL;DR: A new model of metarepresentational development is used to predict a cognitive deficit which could explain a crucial component of the social impairment in childhood autism.
6,017 citations
01 Jan 1985
TL;DR: In this paper, a new model of metarepresentational development was used to predict a cognitive deficit in children with autism, which could explain a crucial component of the social impairment in childhood autism.
Abstract: Abstract We use a new model of metarepresentational development to predict a cognitive deficit which could explain a crucial component of the social impairment in childhood autism. One of the manifestations of a basic metarepresentational capacity is a ‘theory of mind’. We have reason to believe that autistic children lack such a ‘theory’. If this were so, then they would be unable to impute beliefs to others and to predict their behaviour. This hypothesis was tested using Wimmer and Perner's puppet play paradigm. Normal children and those with Down's syndrome were used as controls for a group of autistic children. Even though the mental age of the autistic children was higher than that of the controls, they alone failed to impute beliefs to others. Thus the dysfunction we have postulated and demonstrated is independent of mental retardation and specific to autism.
6,007 citations
TL;DR: An information-processing model is outlined that predicts that performance on non-routine tasks can be impaired independently of performance on routine tasks, related to views on frontal lobe functions, particularly those of Luria.
Abstract: An information-processing model is outlined that predicts that performance on non-routine tasks can be impaired independently of performance on routine tasks. The model is related to views on frontal lobe functions, particularly those of Luria. Two methods of obtaining more rigorous tests of the model are discussed. One makes use of ideas from artificial intelligence to derive a task heavily loaded on planning abilities. A group of patients with left anterior lesions has a specific deficit on the task. Subsidiary investigations support the inference that this is a planning impairment.
3,591 citations
1,817 citations
TL;DR: A group of high-functioning autistic individuals was compared to a clinical control group matched on VIQ, age, sex and SES, and the relationship of executive function and theory of mind deficits to each other, and their primacy to autism are discussed.
Abstract: A group of high-functioning autistic individuals was compared to a clinical control group matched on VIQ, age, sex and SES. Significant group differences were found on executive function, theory of mind, emotion perception and verbal memory tests, but not on spatial or other control measures. Second-order theory of mind and executive function deficits were widespread among the autistic group, while first-order theory of mind deficits were found in only a subset of the sample. The relationship of executive function and theory of mind deficits to each other, and their primacy to autism, are discussed.
1,708 citations