Comunicación, atención conjunta e imitación en el trastorno del espectro autista

El objetivo de este trabajo es analizar las relaciones entre el desarrollo lingüístico y comunicativo inicial en el Trastorno del espectro autista (TEA) y otros indicadores del desarrollo sociocognitivo temprano (atención conjunta y capacidad de imitación inmediata). Han participado 11 niños de entre 3 y 5 años de edad (M=37 meses; DT= 7 meses), con un diagnóstico de TEA, fundamentado en la observación conductual en diferentes contextos, la aplicación de instrumentos estandarizados (ADI-R) y el cumplimento de los criterios propuestos por el DSM-IV-TR. Los resultados obtenidos revelan una asociación significativa entre las habilidades de atención conjunta y el nivel de desarrollo comunicativo alcanzado, así como entre la capacidad de atención conjunta y de imitación. Sin embargo, no se obtuvieron correlaciones significativas entre las destrezas de imitación y la capacidad comunicativa. En el trabajo se discuten los hallazgos obtenidos y sus implicaciones para la evaluación e intervención en niños con TEA.The aim of this work is to analyze the relationships between initial linguistic and communicative development in autism spectrum disorders and other indicators of early sociocognitive development (joint attention and immediate imitation). The participants were 11 children, with an age range comprised between three and five years old (M= 37 months, SD=7 months), diagnosed with ASD, based on several measures: behavioral observation in different contexts, application of standardized instruments (ADI-R) and meeting DSM-IV criteria for ASD diagnosis. Results show a significant association between joint attention abilities and imitation. However, it was not found significant correlations between imitation skills and communicative competence. These findings are discussed considering their implications for assessment and intervention in children with ASD

Comunicación, atención conjunta e imitación en el trastorno del espectro autista

El objetivo de este trabajo es analizar las relaciones entre el desarrollo lingüístico y comunicativo inicial en el Trastorno del espectro autista (TEA) y otros indicadores del desarrollo sociocognitivo temprano (atención conjunta y capacidad de imitación inmediata). Han participado 11 niños de entre 3 y 5 años de edad (M=37 meses; DT= 7 meses), con un diagnóstico de TEA, fundamentado en la observación conductual en diferentes contextos, la aplicación de instrumentos estandarizados (ADI-R) y el cumplimento de los criterios propuestos por el DSM-IV-TR. Los resultados obtenidos revelan una asociación significativa entre las habilidades de atención conjunta y el nivel de desarrollo comunicativo alcanzado, así como entre la capacidad de atención conjunta y de imitación. Sin embargo, no se obtuvieron correlaciones significativas entre las destrezas de imitación y la capacidad comunicativa. En el trabajo se discuten los hallazgos obtenidos y sus implicaciones para la evaluación e intervención en niños con TEA.The aim of this work is to analyze the relationships between initial linguistic and communicative development in autism spectrum disorders and other indicators of early sociocognitive development (joint attention and immediate imitation). The participants were 11 children, with an age range comprised between three and five years old (M= 37 months, SD=7 months), diagnosed with ASD, based on several measures: behavioral observation in different contexts, application of standardized instruments (ADI-R) and meeting DSM-IV criteria for ASD diagnosis. Results show a significant association between joint attention abilities and imitation. However, it was not found significant correlations between imitation skills and communicative competence. These findings are discussed considering their implications for assessment and intervention in children with ASD

Social Validity Evaluation of the Hanen Program It Takes Two to Talk® in Spain

This study sought to assess the social validity of It Takes Two to Talk (ITTT)®¿The Hanen Program for parents, delivered to families of children with language delays in Valencia, Spain. Social validity was assessed using a multi-method approach¿ questionnaires (filled out by the parents) and a focus group¿at different times during the program and at follow-up. The acceptability of the procedures used in ITTT® was positive in terms of the program format and the didactic resources used, such as the video-recordings of the parent-child interactions. Parents also expressed their overall satisfaction with the results, regarding changes in their communication style and the advances observed in their child's language development. However, some suggestions were made to better meet the families' needs related to the length of the program and distribution of the contents, the time devoted to individual training, and the adaptation to the context

Profiles of families with risk factors and behavioral problems in children with attention deficit hyperactivity disorder

INTRODUCCIÓN: La literatura evidencia que las familias de niños con déficit de atención e hiperactividad (TDAH) experimentan factores de riesgo relacionados con niveles elevados de estrés, menor apoyo social, o menor capacidad de afrontamiento. Estos factores familiares contextuales pueden verse agravados por la presencia de problemas comportamentales y sociales en niños con TDAH. OBJETIVOS: El presente estudio se planteó los siguientes objetivos: 1) Identificar perfiles de familias de niños con TDAH en edad escolar de acuerdo con indicadores contextuales y variables socioemocionales como el nivel de estrés, las estrategias de afrontamiento y el apoyo social. 2) Evaluar las diferencias entre los grupos establecidos en diferentes dominios de dificultades comportamentales y emocionales. MÉTODO: Participaron en este estudio 35 niños, entre 7 y 11 años, que habían recibido un diagnóstico clínico de TDAH. Se determinó un índice de riesgo familiar a partir de la información que aportaron las familias sobre el nivel educativo de los padres, la situación laboral, la existencia de psicopatología parental y la tipología familiar. Además, se evaluó el nivel de estrés parental, el apoyo social, las habilidades de afrontamiento y los problemas comportamentales y emocionales del niño. RESULTADOS: Los análisis clúster jerárquicos realizados determinaron la existencia de dos grupos de familias; una con “riesgo severo” y otra con “riesgo moderado-bajo”. El perfil severo se asoció con mayores problemas sociales en los niños. Concretamente se apreció mayor hiperactividad y más problemas con los iguales. CONCLUSIONES: Los factores contextuales y socioemocionales de las familias deberían tenerse en cuenta en el abordaje de los problemas comportamentales que presentan los niños con TDAH.INTRODUCTION: Literature shows that families of children with attention deficit hyperactivity disorder (ADHD) experience risk factors related to high levels of stress, less social support, or less coping skills. These contextual family factors can be aggravated by the presence of behavioral and social problems in children with ADHD. AIMS: The present study set out the following objectives: 1) To identify profiles of families of children with ADHD at school age according to contextual indicators and socio-emotional variables such as stress level, coping strategies and social support. 2) To evaluate the differences between groups established in different domains of behavioral and emotional difficulties. METHOD: Thirty-five children, between 7 and 11 years old, who had received a clinical diagnosis of ADHD participated in this study. A family risk index was determined from the information provided by the families on the educational level, professional situation, parental psychopathology and parental status. In addition, the level of parental stress, social support, coping skills and behavioral and emotional problems of the child were evaluated. RESULTS: Hierarchical cluster analyses carried out determined the existence of two groups of families; one with “severe risk” and another one with “moderate-low risk”. The severe profile was associated with greater social problems in children. Specifically, more hyperactivity and problems with peers. CONCLUSIONS: Contextual and socio-emotional factors of families should be taken into account in the approach of behavioral problems that children with ADHD present.peerReviewe

Parents' Perceptions and Experiences with Their Children's Use of Augmentative/Alternative Communication: A Systematic Review and Qualitative Meta-Synthesis

Augmentative and alternative communication (AAC) consists of any method of communicating that supplements or completely substitutes oral and/or written language when it is impaired. Therefore, it enables children with complex communication needs to develop their full communicative potential. However, despite the many benefits of AAC and its widespread use, several review studies have underscored the problems faced by parents and children who use AAC in their daily lives. The general objective of this systematic review and qualitative meta-synthesis is to provide a complete overview of parents' experiences and perceptions with their children's use of AAC. Specifically, it aimed to identify common themes and subthemes of interest and to analyze the research quality of the selected studies. An exhaustive literature search was carried out using different electronic databases. Nineteen studies were included, involving 297 parents. A thematic synthesis was undertaken. Three main themes and nine subthemes were identified: service support (accessibility, providers and coordination); characteristics of AAC systems (usability and acceptability, features, cost and funding); and integration of AAC in daily life (family, school, social and community). Findings raise a need for more services that support children with complex communication deficits in different contexts, more functional use of AAC systems at school and in real-world situations, as well as service assistance over an extended time period

Inhibition, emotional self-control, working memory and monitoring. Do they predict the typical manifestations of adults with ADHD?

INTRODUCCIÓN: Los déficits en inhibición, control emocional, memoria de trabajo y supervisión se han evidenciado en numerosas investigaciones focalizadas en el trastorno por déficit de atención con hiperactividad (TDAH), pero la información sobre su posible influencia diferencial en las manifestaciones características del trastorno es escasa. OBJETIVOS: El presente estudio se propuso analizar las relaciones de las funciones ejecutivas de regulación (inhibición y control emocional) y metacognitivas (memoria de trabajo y supervisión) con manifestaciones del TDAH y determinar el poder de predicción de esas cuatro funciones ejecutivas en dichas manifestaciones. MÉTODO: Sesenta y un jóvenes adultos entre18 y 24 años con un diagnóstico clínico de subtipo combinado de TDAH en la infancia completaron la Escala Conners de síntomas de TDAH y el Inventario de Funcionamiento Ejecutivo (BRIEF). RESULTADOS: Se encontraron relaciones estadísticamente significativas entre inhibición, regulación emocional, memoria de trabajo y supervisión y las subescalas del Conners. Además, los déficits en las funciones ejecutivas fueron diferencialmente sensibles en la predicción de problemas significativos del TDAH. La memoria de trabajo y la supervisión fueron predictores de los problemas de atención, la inhibición predijo los problemas de autoconcepto y la hiperactividad/ inquietud mientras que el autocontrol emocional fue el mejor predictor de la impulsividad. CONCLUSIONES: La medida de funciones ejecutivas de regulación y metacognitivas pueden ayudar tanto en el diagnóstico como en las evaluaciones de seguimiento del tratamiento de adultos con TDAH.INTRODUCTION: Deficits in inhibition, emotional control, working memory and monitoring have been evidenced in numerous investigations focused on attention déficit hyperactivity disorder (ADHD), but information about its posible differential influence on the characteristic manifestations of the disorder is not very well known. OBJECTIVES: The purpose of this study was to analyze the relationships and the predictive power of the regulation functions (inhibition and emotional control) and metacognitive functions (working memory and supervisión) in the manifestations of ADHD. METHOD: Sixty-one Young adults between the ages of 18 and 24 with a combined clinical diagnosis of ADHD subtype in childhood completed the Conners Scale of ADHD Symptoms and the Executive Performance Inventory (BRIEF). RESULTS: Statistically significant relationships were found between inhibition, emotional regulation, working memory and monitoring and the Conners subscales. In addittion, deficits in executive functions were diferentially sensitive in predicting significant ADHD problems. Working memory and supervisión were predictors of attention problems, inhibition prediced self-concept problems and hyperactivity/restlessness while emotional self-control was the best predictor of impulsivity. CONCLUSIONS: The assessment of behavioral regulation functions and metacognitive executive functions may assist both in the diagnosis and the follow-up evaluations of treatment of adults with ADHD.peerReviewe

Social Cognition in Children with High-Functioning Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder. Associations with Executive Functions

Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders characterized by social impairments. The first objective of this study was to analyze social cognition deficits of children with ADHD, high-functioning ASD (HFASD), and typical development (TD) in their performance on explicit and applied measures of theory of mind (ToM). The second objective was to investigate the relationships between executive functions and social cognition in HFASD and ADHD. One hundred and twenty-six 7- to 11-year old children, 52 with HFASD, 35 with ADHD, and 39 with TD, performed the NEPSY-II social perception subtests. Parents estimated their children’s ToM skills using the Theory of Mind Inventory (ToMI). Teacher-reported data from the Behavior Rating Inventory of Executive Function (BRIEF) were also obtained. The HFASD and ADHD groups showed worse performance on the verbal ToM task than the TD group, and only the performance of the HFASD group was significantly lower than the TD group on the contextual ToM task. Parents also estimated that the HFASD group had more difficulties on the applied ToM than the ADHD and TD groups. Furthermore, there is a different executive function-theory of mind link in the HFASD and ADHD groups: behavioral regulation processes such as inhibition and emotional control are more associated with social cognition in children with ADHD, whereas metacognitive processes such as initiation and planning have a strong association with social cognition in children with HFASD. These findings have implications for understanding social perception deficits in neurodevelopmental disorders, highlighting the need for early intervention

Children with autism spectrum disorder and comorbid attention deficit hyperactivity disorder. Relationships between symptoms and executive function, social cognition, and behavioral problems

Numerous studies have mentioned the importance of discovering the mechanisms underlying the association between autism spectrum disorder (ASD) and comorbid attention deficit hyperactivity disorder (ADHD), with executive function (EF) deficits and theory of mind (ToM) being the most widely investigated cognitive processes. The present study proposed, first, to analyze the executive profile and social cognition processes in children with ASD, ASD+ADHD, ADHD, and typical development (TD). A second objective was to explore the relationship between ASD and ADHD symptoms and EF, ToM, and behavioral problems in children with ASD+ADHD. Participants were 124 children between 7 and 11 years old, distributed in four groups: 37 TD, 35 ADHD, 30 ASD, and 22 ASD+ADHD, matched on age and IQ. The teachers evaluated the EF with the BRIEF, and the parents assessed the application of ToM skills and the behavioral problems. In addition, a subscale of the NEPSY-II battery was administered to measure performance on emotion recognition. The results showed a similar profile of executive deficits in the ASD+ADHD and ADHD groups, whereas the difficulties in ToM skills in the group with ASD+ADHD were similar to those of the group with ASD. Finally, in children with ASD+ADHD, inattention symptoms were significantly associated with metacognitive deficits and ToM difficulties, and ASD symptoms were associated with behavioral problems. These findings support the need to take inattention symptoms into account and provide training in communication strategies when designing treatments for children with ASD

Theory of Mind Profiles in Children With Autism Spectrum Disorder: Adaptive/Social Skills and Pragmatic Competence

Theory of Mind (ToM) is one of the most relevant concepts in the field of social cognition, particularly in the case of Autism Spectrum Disorders (ASD). Literature showing that individuals with ASD display deficits in ToM is extensive and robust. However, some related issues deserve more research: the heterogeneous profile of ToM abilities in children with ASD and the association between different levels of ToM development and social, pragmatic, and adaptive behaviors in everyday life. The first objective of this study was to identify profiles of children with ASD without intellectual disability (ID), based on explicit and applied ToM knowledge, and compare these profiles with a group of children with typical development (TD). A second objective was to determine differences in symptom severity, adaptive/social behavior, and pragmatic abilities between the profiles identified. Fifty-two children with a clinical diagnosis of ASD without ID and 37 children with TD performed neuropsychological ToM tasks and two vocabulary and memory tests. In addition, all of their mothers completed different questionnaires about applied ToM abilities, severity of ASD symptoms, adaptive/social skills, and pragmatic competence. Two subgroups were identified in the cluster analysis carried out with explicit and applied ToM indicators. The “Lower ToM abilities” profile obtained significantly lower scores than the “Higher ToM abilities” profile on all the ToM measures. Furthermore, the analysis of covariance, controlling for vocabulary and working memory (ANCOVAs), showed statistically significant differences in applied ToM abilities between the two groups of children with ASD without ID and the group with TD. However, only the group with “Higher ToM abilities” achieved similar performance to the TD group on the verbal task of explicit ToM knowledge. Finally, the “Lower ToM abilities” cluster obtained significantly higher scores on autism symptoms (social and communication domains) and lower scores on adaptive behavior and pragmatic skills than the cluster with “Higher ToM abilities.” Taken together, these findings have implications for understanding the heterogeneity in ToM skills in children with ASD without ID, and their differential impact on social, communicative, and adaptive behaviors

The Impact of Inattention, Hyperactivity/Impulsivity Symptoms, and Executive Functions on Learning Behaviors of Children with ADHD

Children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at risk of experiencing lower academic achievement compared to their peers without ADHD. However, we have a limited understanding of the mechanisms underlying this association. Both the symptoms of the disorder and the executive functions can negatively influence learning behaviors, including motivation, attitude toward learning, or persistence, key aspects of the learning process. The first objective of this study was to compare different components of learning behaviors in children diagnosed with ADHD and typically developing (TD) children. The second objective was to analyze the relationships among learning behaviors, executive functioning, and symptoms of hyperactivity/impulsivity in both groups. Participants were 35 children diagnosed with ADHD and 37 with TD (7–11 years old), matched on age and IQ. The teachers filled out the Behavior Rating Inventory of Executive Function (BRIEF) and the Learning Behaviors Scale, which evaluates Competence/motivation, Attitude toward learning, Attention/persistence, and Strategy/flexibility. In addition, parents and teachers filled out the DSM-5 diagnostic criteria for ADHD. ANOVAs showed significant differences between children with ADHD and TD children on all the learning behaviors. Moreover, in both the ADHD and TD groups, the behavioral regulation index of the BRIEF predicted the search for strategies, and the metacognition index was a good predictor of motivation. However, attitude toward learning was predicted by metacognition only in the group with ADHD. Therefore, the executive functions had greater power than the typical symptoms of inattention and hyperactivity/impulsivity in predicting learning behaviors of children with ADHD. The findings are in line with other studies that support the influence of the executive functions on performance, highlighting the importance of including their development as a top priority from early ages in the school setting in order to strengthen learning behaviors.This work is supported by the Spanish State Research Agency (Agencia Española de Investigación, AEI) and the European Regional Development Fund (Fondo Europeo de Desarrollo Regional, FEDER) through the Project PSI2016-78109 (AEI/FEDER, UE) and by the University of Valencia (UV-INVPREDOC15- 265889)