Identifying predictive features of autism spectrum disorders in a clinical sample of adolescents and adults using machine learning

Diagnosing autism spectrum disorders (ASD) is a complicated, time-consuming process which is particularly challenging in older individuals. One of the most widely used behavioral diagnostic tools is the Autism Diagnostic Observation Schedule (ADOS). Previous work using machine learning techniques suggested that ASD detection in children can be achieved with substantially fewer items than the original ADOS. Here, we expand on this work with a specific focus on adolescents and adults as assessed with the ADOS Module 4. We used a machine learning algorithm (support vector machine) to examine whether ASD detection can be improved by identifying a subset of behavioral features from the ADOS Module 4 in a routine clinical sample of N = 673 high-functioning adolescents and adults with ASD (n = 385) and individuals with suspected ASD but other best-estimate or no psychiatric diagnoses (n = 288). We identified reduced subsets of 5 behavioral features for the whole sample as well as age subgroups (adolescents vs. adults) that showed good specificity and sensitivity and reached performance close to that of the existing ADOS algorithm and the full ADOS, with no significant differences in overall performance. These results may help to improve the complicated diagnostic process of ASD by encouraging future efforts to develop novel diagnostic instruments for ASD detection based on the identified constructs as well as aiding clinicians in the difficult question of differential diagnosis

Exploring parental behavior and child interactive engagement : a study on children with a significant cognitive and motor developmental delay

Background and aims: Parenting factors are one of the most striking gaps in the current scientific literature on the development of young children with significant cognitive and motor disabilities. We aim to explore the characteristics of, and the association between, parental behavior and children's interactive engagement within this target group. Methods and procedures: Twenty-five parent-child dyads (with children aged 6-59 months) were video-taped during a 15-min unstructured play situation. Parents were also asked to complete the Parental Behavior Scale for toddlers. The video-taped observations were scored using the Child and Maternal Behavior Rating Scales. Outcomes and results: Low levels of parental discipline and child initiation were found. Parental responsivity was positively related to child attention and initiation. Conclusions and implications: Compared to children with no or other levels of disabilities, this target group exhibits large differences in frequency levels and, to a lesser extent, the concrete operationalization of parenting domains Further, this study confirms the importance of sensitive responsivity as the primary variable in parenting research

The prodrome of autism: early behavioral and biological signs, regression, peri- and post-natal development and genetics

Autism is one of the most heritable neurodevelopmental conditions and has an early onset, with symptoms being required to be present in the first 3 years of life in order to meet criteria for the ‘core’ disorder in the classification systems. As such, the focus on identifying a prodrome over the past 20 years has been on pre-clinical signs or indicators that will be present very early in life, certainly in infancy. A number of novel lines of investigation have been used to this end, including retrospective coding of home videos, prospective population screening and ‘high risk’ sibling studies; as well as the investigation of pre- and peri-natal, brain developmental and other biological factors. Whilst no single prodromal sign is expected to be present in all cases, a picture is emerging of indicative prodromal signs in infancy and initial studies are being undertaken to attempt to ameliorate the early presentation and even ‘prevent’ emergence of the full syndrome

Generalized effects of video modeling on establishing instructional stimulus control in children with autism: Results of a preliminary study

Video modeling has been suggested as a powerful treatment tool that has concentrated on increasing a variety of skills in children with autism. However, it has rarely been examined as a behavioral procedure for eliminating kinds of behaviors (e.g., noncompliance), a target that is often included in children’s support plans. The present study provides preliminary effects of video modeling on establishing instructional stimulus control over a simple behavior (cleaning up a toy) that required the termination of an ongoing activity. Three children with autism participated, and experimental control was accomplished using a multiple-baseline-across-subjects design. The results showed that this procedure can be effective for children with lower baseline levels of disruptive behaviors and more developed imitation skills. Successful responding generalized across stimuli and subjects and was maintained at a 1-month follow-up assessment. Specific guidelines for building video modeling into real teaching situations are also discussed

Teaching complex social skills to children with autism; advances of video modeling

Although there has been a corresponding explosion of literature regarding the treatment of the social deficits in autism, the establishment of more complex social behaviors still remains a challenge. Video modeling appears as one approach to have the potential to successfully address this challenge. Following an introduction to modeling that constitutes the basis of this procedure, the current paper explores those video modeling studies that have targeted the promotion of complex social skills. It is suggested that this approach could be an effective addition to peer-mediated treatment procedures, especially for children with autism who cannot always be in environments where peers are present. Further, the likely success of video modeling seems to be dependent upon the prior elimination of behaviors that interfere with the development of imitation skills

A service evaluation of parent adherence with dysphagia management therapy guidelines: Reports from family carers supporting children with complex needs in Greece

Purpose: Many children with complex needs exhibit eating, drinking and/or swallowing disorders (dysphagia). These children often have associated learning needs, and require assistance from carers for daily tasks such as eating and drinking. The aim of this study was to identify which strategies to manage dysphagia were challenging for family carers, and reasons for any non-adherence. Method: In this service evaluation researchers observed carers during mealtimes, and investigated carer opinions of strategies used to minimise the risks of dysphagia. Eight children with complex needs aged 3.4 - 7.5 years and their primary family caregiver participated. Results: Adherence with speech and language pathologists’ dysphagia recommendations overall was over 50% in all but one case. For specific strategies, the highest adherence was observed for diet modifications of foods (89%), communication during the mealtime (83%), amount of food to present (81%) and the pacing of fluids and foods (81%). Lower levels of adherence were identified in relation to postural management (58%), environmental changes (58%), utensils (56%) and preparatory strategies (49%). Conclusion: Adherence with use of strategies to support mealtimes was over 50% in all but one case. Findings suggest that support is essential in order to promote safe mealtimes, reduce family carers’ stress and increase knowledge, confidence and adherence in implementing dysphagia guidelines in the family home

The role of telehealth technology in the remediation of pediatric feeding disorders

Teletherapy, the use of video conferencing technology to deliver therapy services, has the potential to provide ongoing services to children that might not otherwise be able to receive traditional intervention that it essential for them to thrive. Among children who are diagnosed with developmental disorders, as well as those who are typically developing, feeding related concerns are highly prevalent. The current report discusses the nature of feeding disorders in children across the continuum of development and diagnoses, synthesizes the current literature of feeding and non-feeding related intervention programs for children in various settings, and discusses their value for future clinical use and research.Communication Sciences and Disorder

A proposal for a brief-term post-adoption intervention in the attachment-perspective. A single case study with a late-adopted child and his adoptive mother

A growing body of attachment literature has focused on bridging the gap between research and clinical applications, even in clinical work with adoptive families. A brief-term clinical intervention focused on a multi-method assessment of attachment relationships and representations was performed in the first year after placement. This single case study aimed at analysing the attachment outcomes, through a long-term follow-up, both for the adoptive mother and her late-adopted son. We assumed that this five-session attachment oriented intervention could help the mother enhance her sensitivity skills and her ability to understand both her own past attachment experiences and her child’s insecure attachment as a consequence of the failures of his previous experiences of care, supporting her six year old child in acquiring a positive image of himself and of others and the security of the caregiver’s availability up to adolescence