Telehealth for expanding the reach of early autism training to parents.

Although there is consensus that parents should be involved in interventions designed for young children with autism spectrum disorder (ASD), parent participation alone does not ensure consistent, generalized gains in children's development. Barriers such as costly intervention, time-intensive sessions, and family life may prevent parents from using the intervention at home. Telehealth integrates communication technologies to provide health-related services at a distance. A 12 one-hour per week parent intervention program was tested using telehealth delivery with nine families with ASD. The goal was to examine its feasibility and acceptance for promoting child learning throughout families' daily play and caretaking interactions at home. Parents became skilled at using teachable moments to promote children's spontaneous language and imitation skills and were pleased with the support and ease of telehealth learning. Preliminary results suggest the potential of technology for helping parents understand and use early intervention practices more often in their daily interactions with children

Fidelity Assessment in Community Programs: An Approach to Validating Simplified Methodology.

Fidelity to intervention protocol is linked to best outcomes for individuals with autism spectrum disorder (ASD; see Boyd & Corley [Autism 5(4):430-441, 2001]; Pellecchia et al. [J Autism Dev Disord 45(9):2917-2927, 2015]); however, fidelity measurement tools that are both accurate and feasible for community use are often not available. In this paper we explore methods for validated simplification of fidelity assessment procedures toward the goal of increased use in clinical practice. Video recordings (n = 36) of therapists working with children with ASD were coded using three variations of fidelity assessment methodology (trial-by-trial, 5-point Likert Scale, and 3-point Likert Scale), and the results were compared for exact agreement, mastery criterion agreement, and overall reliability. The results indicated overall a very high percentage of exact agreement (mean 99.44%, range 94.4-100%) and excellent reliability (mean Krippendorff's alpha [Kα] 1.0) between the trial-by-trial and 5-point Likert Scale across all components; however, the 3-point method may be viewed as being the more feasible strategy within community programs

A Randomized Controlled Trial of a Play-Based, Peer-Mediated Pragmatic Language Intervention for Children With Autism

Purpose: This randomized controlled trial evaluated the effectiveness of a play-based pragmatic language intervention for children with autism. Methods: A sample of 71 children with autism were randomized to an intervention-first group (n = 28 analyzed) or waitlist-first (n = 34 analyzed) group. Children attended 10, weekly clinic play-sessions with a typically developing peer, and parents mediated practice components at home. The Pragmatics Observational Measure (POM-2) and the Social Emotional Evaluation (SEE) evaluated pragmatics before, after and 3-months following the intervention. Results: POM-2 gains were greatest for intervention-first participants (p = 0.031, d = 0.57). Treatment effects were maintained at 3-month follow-up (p < 0.001–0.05, d = 0.49–0.64). POM-2 scores were not significantly different in the clinic and home settings at follow-up. Conclusion: Findings support the combination of play, peer-mediation, video-feedback and parent training to enhance pragmatic language in children with autism

Parents’ experiences in using mobile tablets with their child with autism to encourage the development of social communication skills: the development of a parents’ guide

Autism is a lifelong condition that affects how individuals interact with others and make sense of the world around them. The two core difficulties associated with autism are difficulties in social communication and interaction, and the manifestation of restricted, repetitive patterns of behaviour. However, children with autism may also have many talents and special interests among which is their affinity with digital technologies. Despite the increasing use of mobile tablets in schools and homes, and the children’s motivation in using them, there is limited guidance on how to use the tablets to teach children with autism specific skills. This study aims to fill this gap in knowledge by providing guidelines about the ways in which iPads and other tablets can be used by parents/carers and their child at home to support the development of social communication skills. Semi-structured interviews with 10 parents of primary school aged children (4-11 years old) with autism were conducted with the aim to explore their experiences in using mobile devices, such as iPads and android tablets, and social activities with their children to create opportunities for social communication development. The interview involved questions about the parents’ knowledge and experience in autism, their understanding of social communication skills, the use of technology at home, and their links with the child’s school. Qualitative analysis of the interviews showed that parents used a variety of strategies to boost their child’s social communication skills. Among these strategies were: a) the use of communication symbols, b) the use of the child’s special interest as motivator to gain their attention, and c) allowing time to their child to respond. It was also found that parents engaged their child in joint activities such as cooking, role play and creating social stories together on the device. Seven out of ten parents mentioned that the tablet is a motivating tool that can be used to teach social communication skills, nonetheless all parents raised concerns over screen time and their child’s sharing difficulties. The need for training and advice as well as building stronger links with their child’s school was highlighted. In particular, it was mentioned that recommendations would be welcomed about how parents can address their child’s difficulties in initiating or sustaining a conversation, taking turns and sharing, understanding other people’s feelings and facial expressions, and showing interest to other people. This is the first study to date that resulted in the development of a parents’ guide informed by evidence-based practice and the participants’ experiences and concerns. The proposed guidelines aim to urge parents to feel more confident in using the tablet with their child in more collaborative ways. In particular, the guide offers recommendations about how to develop verbal and non-verbal communication, gives examples of tablet based activities to interact and create things together, as well as it offers suggestions on how to provide a worry free tablet experience and how to connect with the school

Increasing appropriate social communication and pragmatic language skills in young adults with autism spectrum disorders

This report seeks to explore intervention methodologies that can be adapted for use with young transitional adults with Autism Spectrum Disorders (ASD) to increase appropriate social communication. No interventions have been developed explicitly for use in speech-language therapy with young adults with ASD. As a result, existing interventions have to be adapted to use with this population. The interventions that were adapted were Behavioral Interventions, Developmental Social Pragmatic Interventions, and Enhanced Milieu Teaching. The adaptations of the reviewed interventions were illustrated by creating an instructional video to highlight how to use the interventions and their adaptations with an adult with ASD. The author and participant consider the video development and final product to be a success; however, until peer-reviewed efficacy studies that explore the effects of these intervention adaptations with young-adults with ASD are conducted, the author cannot assert that the intervention adaptations discussed will be effective therapy strategies for young adults with ASD.Communication Sciences and Disorder

Social, Emotional, and Behavioral Functioning for Transitional-Aged Youth with Autism

There is mounting evidence to suggest that higher numbers of individuals with Autism Spectrum Disorder (ASD) are being identified, including a wide range of severity and outcome (Eaves & Ho, 2008). As identification of ASD has improved, there is a larger proportion of identified young adults with ASD (YA-ASD) in the transition to adulthood (Centers for Disease Control and Prevention, 2010). Though exceptionally talented in many cases, a large proportion YA-ASD have difficulty establishing independence and navigating the complex social nuances of a workplace, many end up “homebound” with difficulty finding employment (Daley, Weisner, & Singhal, 2014; Shattuck, Wagner, Narendorf, Sterzing, & Hensley, 2011; Taylor & Seltzer, 2011). It is quite likely that remaining homebound has far-reaching effects on the development of self-efficacy and mood functioning. In response to this challenge parents, advocates, and individuals with ASD have developed a technology-training program to help teach skills that will allow individuals with ASD to be independent: increasing skills and kindling hope for the future. The current study sought to explore the impact of the training program components on anxiety, depression, and friendships, specific to YA-ASD in the transition to adulthood. YA-ASD (n = 23) from vocational training program were given Achenbach System of Empirically Based Assessment - Adult Self-Report (ASR) before and after an 8-week period in a vocational program. Group and individual difference were measured for significant change. Few group significance was observed across the scales of the ASR. Some individual significance was observed, however no patterns of individual significance was found

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