Effect of sustained attention on Early Start Denver Model outcomes

Introduction: There is very little research on the use of sustained attention as an outcome predictor for the Early Start Denver Model (ESDM). We hypothesized that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes. Methods: 10 pre-preschool age children with a diagnosis of autism spectrum disorder received one year of ESDM therapy. A novel coding scheme was developed to evaluate each child’s pre-treatment level of sustained attention. Mullen Scales of Early Learning were evaluated prior to and after one year of ESDM. Pre-treatment levels of sustained attention were compared to pre-and post-treatment Mullen scores. Sustained attention was evaluated as an outcome predictor for ESDM. Results: Preliminary results identified a positive correlation between the duration of an episode of sustained attention and the pre- and post-treatment Mullen scores. A positive correlation was also identified between the functional use of an object during an episode of sustained attention and the pre- and post-treatment Mullen scores. Conclusion: Preliminary results support the hypothesis that a child’s level of sustained attention prior to therapy will correlate with positive ESDM outcomes. More participants are required to confirm the significance of the preliminary results

Social affiliation motives modulate spontaneous learning in Williams syndrome but not in autism

BACKGROUND: Children with autism spectrum disorder (ASD) and those with Williams syndrome (WS) have difficulties with learning, though the nature of these remains unclear. METHODS: In this study, we used novel eye-tracking and behavioral paradigms to measure how 36 preschoolers with ASD and 21 age- and IQ-matched peers with WS attend to and learn novel behaviors (1) from the outcomes of their own actions (non-social learning), (2) through imitation of others’ actions (social learning), and across situations in which imitative learning served either an instrumental function or fulfilled social affiliation motives. RESULTS: The two groups demonstrated similar abilities to learn from the consequences of their own actions and to imitate new actions that were instrumental to the achievement of a tangible goal. Children with WS, unlike those with ASD, increased their attention and imitative learning performance when the model acted in a socially engaging manner. CONCLUSIONS: Learning abnormalities in ASD appear to be linked to the social rather than instrumental dimensions of learning

Verbal labels increase the salience of novel objects for preschoolers with typical development and Williams syndrome, but not in autism

Background: Early research has documented that young children show an increased interest toward objects that are verbally labeled by an adult, compared to objects that are presented without a label. It is unclear whether the same phenomenon occurs in neurodevelopmental disorders affecting social development, such as autism spectrum disorder (ASD) and Williams syndrome (WS). Methods: The present study used a novel eye-tracking paradigm to determine whether hearing a verbal label increases the salience of novel objects in 35 preschoolers with ASD, 18 preschoolers with WS, and 20 typically developing peers. Results: We found that typically developing children and those with WS, but not those with ASD, spent significantly more time looking at objects that are verbally labeled by an adult, compared to objects that are presented without a label. Conclusions: In children without ASD, information accompanied by the speaker's verbal label is accorded a "special status," and it is more likely to be attended to. In contrast, children with ASD do not appear to attribute a special salience to labeled objects compared to non-labeled objects. This result is consistent with the notion that reduced responsivity to pedagogical cues hinders social learning in young children with ASD

Interventions for anxiety in mainstream school‐aged children with autism spectrum disorder: A systematic review

Anxiety is a common problem in school‐aged children with autism spectrum disorder (ASD). Cognitive behavioral therapy (CBT) and other psychosocial interventions have been developed as alternatives to pharmacological intervention to treat anxiety symptoms in students with ASD without co‐occurring intellectual disability. This present synthesis of evidence is a systematic review and meta‐analysis examining the efficacy of interventions for reducing anxiety among school‐aged children with ASD. The review summarizes evidence from 24 studies using an experimental or quasi‐experimental design. The authors’ conclude that there is evidence that CBT is an effective behavioral treatment for anxiety in some children and youth with ASD without co‐occurring intellectual disability. Evidence for other psychoeducational interventions is more limited, not just due to the popularity of CBT but also due to the quality of the smaller number of non‐CBT studies available

Intensive behavioural interventions based on applied behaviour analysis for young children with autism : an international collaborative individual participant data meta-analysis

This individual participant data meta-analysis is the most intensive possible evaluation of the effectiveness of early intensive applied behaviour analysis?based interventions for pre-school autistic children compared with treatment as usual/eclectic interventions. Data from 491 participants (originally collected in 10 studies) were included. Children receiving early intensive applied behaviour analysis?based interventions improved more on the Vineland adaptive behaviour scale (MD?=?7.00; 95% confidence interval?=?1.95?12.06) and cognitive ability (intelligence quotient) (MD?=?14.13; 95% confidence interval?=?9.16?19.10) relative to comparators at 2?years; though effects varied considerably across studies. Evidence for other outcomes was inconclusive due to insufficient evidence and there were few data on longer-term effects. All studies were at risk of bias across several domains, often due to the lack of randomisation or blinding of outcome assessors. Given the emerging evidence of modest, albeit short term, effects of a range of pre-school autism interventions and the limitations of the quality of evaluation studies to date, future research should investigate which supports and interventions are most effective for children and families prioritising outcomes measures that are meaningful for the autism community and longer-term follow-up. Further systematic reviews of the existing evidence are unlikely to add to the findings presented here.Lay abstractEarly intensive applied behaviour analysis?based interventions are designed to support young autistic children?s learning and development. Unfortunately, the available evidence about the effectiveness of these interventions remains unclear. Several reviews have focused on the published findings rather than contacting the authors to collect and analyse data about the individual participants in the original studies. Also, most of the studies were carried out by groups involved in delivering the interventions leading to the potential bias in interpreting the results. Our research team (supported by an international advisory group) carried out an independent individual patient data review by collecting the original participant data from the authors of the studies, to examine the effectiveness of these interventions. The results suggested that early intensive applied behaviour analysis?based interventions might lead to some changes in children?s cognitive ability (intelligence quotient) and everyday life skills after 2?years, compared with standard treatments. However, all the studies had problems with the way they were designed. Also, few of the studies looked at outcomes that have been described as most important to autistic people or followed children beyond 2?years. We think that further systematic reviews of the existing evidence are unlikely to add to the findings of our review. Furthermore, we recommend that future research should investigate which types of supports and interventions are most effective for children and families, prioritising outcomes measures that are meaningful for the autism community and include, wherever possible, longer-term follow-up

Effectiveness and Feasibility of the Early Start Denver Model Implemented in a Group-Based Community Childcare Setting

A recent study documented the efficacy of the Early Start Denver Model (ESDM) delivered in a 1:1 fashion. In the current study we investigated the effectiveness and feasibility of the ESDM in the context of a long-day care community service, with a child-staff ratio of 1:3. Outcomes of 27 preschoolers with ASD undergoing 15–25 h per week of ESDM over 12 months were compared to those of 30 peers with ASD undergoing a different intervention program delivered in a similar community long-day care service. Children in both groups made gains in cognitive, adaptive and social skills. Participants in the ESDM group showed significantly higher gains in developmental rate and receptive language.No Full Tex