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

Effects of a Brief Early Start Denver Model (ESDM)–Based Parent Intervention on Toddlers at Risk for Autism Spectrum Disorders: A Randomized Controlled Trial

This study was carried out to examine the efficacy of a 12-week, low intensity (one-hour-per-week of therapist contact), parent-delivered intervention for toddlers at risk for autism spectrum disorders (ASD) ages 14–24 months and their families

A Descriptive, Multiyear Examination of Positive Behavior Support

A major goal of positive behavior support (PBS) is to produce broad-based, long-term improvements in adaptive behavior; however, the empirical base, at present, is mainly composed of relatively short-term studies carried out in circumscribed contexts. Therefore, a need exists for reliable data that can inform the field regarding the comprehensive lifestyle effects of PBS implementation in natural community contexts over extended periods of time. The current investigation was conducted to provide a descriptive analysis of PBS with diverse participants and broad measurement strategies over multiple years. Using extensive data portfolios for 21 participants, we employed rating scales to quantify changes in key variables from baseline through 2 years of intervention. The data revealed variable levels of intervention integrity, generalized reductions in problem behavior with occasional relapses, and encouraging enhancements across six domains of quality of life. This study represents an initial attempt to understand the processes and outcomes of behavioral support by documenting behavioral patterns across full days, entire years, and all environments. We discuss the need to consider new conceptual and methodological frameworks for further study of efficacious and sustainable behavior support

Methods for acquiring MRI data in children with autism spectrum disorder and intellectual impairment without the use of sedation.

BackgroundMagnetic resonance imaging (MRI) has been widely used in studies evaluating the neuropathology of autism spectrum disorder (ASD). Studies are often limited, however, to higher functioning individuals with ASD. MRI studies of individuals with ASD and comorbid intellectual disability (ID) are lacking, due in part to the challenges of acquiring images without the use of sedation.MethodsUtilizing principles of applied behavior analysis (ABA), we developed a protocol for acquiring structural MRI scans in school-aged children with ASD and intellectual impairment. Board certified behavior analysts worked closely with each child and their parent(s), utilizing behavior change techniques such as pairing, shaping, desensitization, and positive reinforcement, through a series of mock scanner visits to prepare the child for the MRI scan. An objective, quantitative assessment of motion artifact in T1- and diffusion-weighted scans was implemented to ensure that high-quality images were acquired.ResultsThe sample consisted of 17 children with ASD who are participants in the UC Davis Autism Phenome Project, a longitudinal MRI study aimed at evaluating brain developmental trajectories from early to middle childhood. At the time of their initial scan (2-3.5 years), all 17 children had a diagnosis of ASD and development quotient (DQ) <70. At the time of the current scan (9-13 years), 13 participants continued to have IQs in the range of ID (mean IQ = 54.1, sd = 12.1), and four participants had IQs in the normal range (mean = 102.2, sd = 7.5). The success rate in acquiring T1-weighted images that met quality assurance for acceptable motion artifact was 100 %. The success rate for acquiring high-quality diffusion-weighted images was 94 %.ConclusionsBy using principles of ABA in a research MRI setting, it is feasible to acquire high-quality images in school-aged children with ASD and intellectual impairment without the use of sedation. This is especially critical to ensure that ongoing longitudinal studies of brain development can extend from infancy and early childhood into middle childhood in children with ASD at all levels of functioning, including those with comorbid ID

Effects of a Brief Early Start Denver Model (ESDM)–Based Parent Intervention on Toddlers at Risk for Autism Spectrum Disorders: A Randomized Controlled Trial

OBJECTIVE: This study was carried out to examine the efficacy of a 12-week, low intensity (one-hour-per-week of therapist contact), parent-delivered intervention for toddlers at risk for autism spectrum disorders (ASD) ages 14–24 months and their families. METHOD: A randomized controlled trial involving 98 children and families was carried out in three different sites investigating the efficacy of a parent delivery of the Early Start Denver Model (P-ESDM) (which fosters parental use of a child-centered responsive interaction style that embeds many teaching opportunities into play) compared to community treatment as usual. Assessments were completed at baseline and 12 weeks later, immediately after the end of parent coaching sessions. RESULTS: There was no effect of group assignment on parent-child interaction characteristics or on any child outcomes. Both groups of parents improved interaction skills and both groups of children demonstrated progress. Parents receiving P-ESDM demonstrated significantly stronger working alliances with their therapists than did the community group. Children in the community group received significantly more intervention hours than those in the P-ESDM group. For the group as a whole, both younger child age at the start of intervention, and a greater number of intervention hours, were positively related to degree of improvement in children’s behavior for most variables. CONCLUSIONS: Parent-implemented intervention studies for early ASD have thus far not demonstrated the large effects seen in intensive treatment studies. Evidence that both younger age and more intervention hours positively affect developmental rates has implications for clinical practice, service delivery, and public policy

Additional file 3: of Methods for acquiring MRI data in children with autism spectrum disorder and intellectual impairment without the use of sedation

MRI Video Scanning—Parent Handout. (PDF 33.6 kb