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Parental reports on the use of treatments and therapies for children with autism spectrum disorder

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Abstract

Parents of children with autism spectrum disorders (ASD; N = 479) reported via web-based survey what pharmacological (drug), diet, and behavioral/educational/alternative therapies they had tried and were using now in the treatment of their children with ASD. Depending on type of ASD, children had tried, on average, between seven and nine therapies and were now using between four and six. Children with Asperger's syndrome had tried significantly more drug treatments than had those with autism or PDD-NOS, while those in these latter two groups had tried more behavioral/educational/alternative therapies. Adolescents had a higher prevalence of drug-treatment use compared with those in middle childhood, who, in turn, had a higher frequency of use relative to those in early childhood. For most behavioral/educational/alternative treatments, more children in early and middle childhood had tried them compared with adolescents. Likewise, children in both early and middle childhood were currently using a higher number of behavioral/educational/alternative treatments than were those in the adolescent group. Findings are discussed relative to both the extant literature on treatment use among ASD families and how parents choose among the plethora of available therapies.

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... Poremećaji iz spektra autizma (u daljem tekstu PSA) pripadaju grupi neurorazvojnih poremećaja čiji se prvi znaci pojavljuju u detinjstvu (American Psychiatric Association, 2013). Pravovremena detekcija, tačna dijagnoza i odgovarajući, efikasan i naučno zasnovan tretman pozitivno utiču na razvoj, uključenost i kvalitet života osoba sa PSA (Glumbić, 2009). Roditelji, kao zastupnici svog deteta, predstavljaju okosnicu u tretmanu PSA, jer učestvuju u donošenju odluke oko izbora tretmana, izdvajaju resurse, evaluiraju tretman, a često ga i sprovode. ...
... Goin- Kochel, Myers, & Mackintosh, 2007). U velikoj grupi potencijalnih faktora(Wilson, Hamilton, Whelan, & Pilkington, 2018) koji utiču na donošenje odluke o tretmanu izdvajaju se i percepcije, odnosno ubeđenja roditelja, kako o uzroku PSA, tako i o razumevanju stanja njihovog deteta i njegovom uticaju na celokupnu porodicu(Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). ...
... Tabela 8. Deskriptivne mere odnosa između personalne kontrole kod roditelja i KAMTable 8. Descriptive measures of the relationship between personal control of parents and KAM nego u sadašnjosti. Lista tretmana formirana je na osnovu tretmana o kojima se priča u Srbiji, koji su popularni na sajtovima udruženja za PSA i drugih organizacija koje pružaju podršku osobama sa PSA, ali i po uzoru na druga istraživanja(Goin-Kochel et al., 2007; National Autism Center, 2009;Schreck & Mazur, 2008). Ostalo je nepoznato da li roditelji znaju šta koji tretman predstavlja i na čemu se zasniva. ...
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Problems of practice, in order to make business as optimal as possible, often require us to determine a location that is connected to three or four given destinations by communications of the total minimum length. That there is an answer to this challenge, we owe gratitude to the remarkable book: “What is Mathematics” ?, (An Elementary Approach to Ideas and Methods) – “What is Mathematics” (Elementary Approach to Ideas and Methods), by Richard Courant and Herbert Robbins - Richard Courant and Herbert Robins, which in one part actualizes the work of Jakob Steiner, a Swiss mathematician. We owe a special momentum and new contributions to the solutions to this problem to the emergence of Informatics, which, thanks to the unprecedented development of its hardware and software components, easily and accurately solves the challenge for more than four destinations. The aim of this paper is to solve complex problems with a better approach and ways of solving tasks so that students can improve their quality through development.
... Poremećaji iz spektra autizma (u daljem tekstu PSA) pripadaju grupi neurorazvojnih poremećaja čiji se prvi znaci pojavljuju u detinjstvu (American Psychiatric Association, 2013). Pravovremena detekcija, tačna dijagnoza i odgovarajući, efikasan i naučno zasnovan tretman pozitivno utiču na razvoj, uključenost i kvalitet života osoba sa PSA (Glumbić, 2009). Roditelji, kao zastupnici svog deteta, predstavljaju okosnicu u tretmanu PSA, jer učestvuju u donošenju odluke oko izbora tretmana, izdvajaju resurse, evaluiraju tretman, a često ga i sprovode. ...
... Goin- Kochel, Myers, & Mackintosh, 2007). U velikoj grupi potencijalnih faktora(Wilson, Hamilton, Whelan, & Pilkington, 2018) koji utiču na donošenje odluke o tretmanu izdvajaju se i percepcije, odnosno ubeđenja roditelja, kako o uzroku PSA, tako i o razumevanju stanja njihovog deteta i njegovom uticaju na celokupnu porodicu(Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). ...
... Tabela 8. Deskriptivne mere odnosa između personalne kontrole kod roditelja i KAMTable 8. Descriptive measures of the relationship between personal control of parents and KAM nego u sadašnjosti. Lista tretmana formirana je na osnovu tretmana o kojima se priča u Srbiji, koji su popularni na sajtovima udruženja za PSA i drugih organizacija koje pružaju podršku osobama sa PSA, ali i po uzoru na druga istraživanja(Goin-Kochel et al., 2007; National Autism Center, 2009;Schreck & Mazur, 2008). Ostalo je nepoznato da li roditelji znaju šta koji tretman predstavlja i na čemu se zasniva. ...
Conference Paper
The family as a natural support provider is an indispensable factor in a child's development. The birth of a child brings happiness to every family, but also a certain amount of stress. Special attention should be paid to the families of children with disabilities who are exposed to additional levels of stress. However, it often happens that the families of children with disabilities are left to fend for themselves in a system that does not allow them to meet their own needs and the needs of their own child and ultimately exercise basic human rights. The aim of this research was to examine the self-confidence in parenting abilities of parents of children with disabilities in the city of Mostar and the surrounding area. The study involved 25 parents of children with disabilities. Descriptive statistics methods and appropriate nonparametric statistical methods were used for data processing. The obtained results indicate that there is no statistically significant difference in the level of self-confidence of parents of children with disabilities about their age. The obtained results indicate that there is no statistically significant difference in the level of self-confidence in parenting abilities of parents of children with disabilities with regard to the age and working status of parents. Knowledge of parents' self-confidence is important not only for science, but also for the development and selection of appropriate intervention support programs for children with disabilities and their families. Due to the fact that the adverb was used in the research, the generalization of the obtained results is limited and there is a need for further research on this issue.
... Many treatments and interventions have focused on methods to reduce the abnormalities of sensory processing in autism. Sensory integration P R O O F xi intervention is the most commonly implemented therapy by occupational therapists for children with ASD and is one of the most commonly requested types of occupational therapy treatments in general (Goin-Kochel et al., 2007). In a chapter by Schoen et al. the authors describe their approaches to sensory integration in children with ASD. ...
... Advocacy about the effects of sensory issues in autism led to the inclusion of sensory features in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association. Parents of children with autism often seek sensory-based intervention (Goin-Kochel, Myers, & Mackintosh, 2007;Green et al., 2006;Mandell, Novak, & Levy, 2005) as a method to remediate the challenges their children face. Sensory integration intervention is the most commonly implemented therapy by occupational therapists for children with autism spectrum disorder (ASD; Case- Smith & Miller, 1999) and is one of the most commonly requested types of occupational therapy treatments in general (Goin-Kochel et al., 2007). ...
... Parents of children with autism often seek sensory-based intervention (Goin-Kochel, Myers, & Mackintosh, 2007;Green et al., 2006;Mandell, Novak, & Levy, 2005) as a method to remediate the challenges their children face. Sensory integration intervention is the most commonly implemented therapy by occupational therapists for children with autism spectrum disorder (ASD; Case- Smith & Miller, 1999) and is one of the most commonly requested types of occupational therapy treatments in general (Goin-Kochel et al., 2007). ...
... In fact, polytherapy is the norm in ASD, with families seeking between 4 and 9 services simultaneously for their child with ASD (Goin-Kochel et al., 2007;Kohler, 1999;Ruble & McGrew, 2007;Thomas et al., 2007). For example, children with ASD and their families frequently receive four different types of services outside the school system, such as SLT, social skills therapy, OT, behavior intervention, medical services, biomedical treatments, respite care, family counseling, and case management (Thomas et al., 2007). ...
... For example, children with ASD and their families frequently receive four different types of services outside the school system, such as SLT, social skills therapy, OT, behavior intervention, medical services, biomedical treatments, respite care, family counseling, and case management (Thomas et al., 2007). Similarly, a large, internet-based, international study suggested that children on an average had previously tried 7-9 therapies and were presently receiving 4-6 therapies simultaneously; in fact children with autistic disorder or Pervasive Developmental Disorder -Not Otherwise Specified (PDD-NOS) received more behavioral/educational/alternative treatments compared to children with Asperger's syndrome and younger children were more likely to receive behavioral treatments compared to adolescents who were more likely to receive medications (Goin-Kochel et al., 2007). Most commonly employed therapies in ASD include evidence-based approaches such as SLT and behavioral interventions including Applied Behavioral Analysis (Le Grice & McMenamin, 2002;Politte et al., 2015). ...
... Most commonly employed therapies in ASD include evidence-based approaches such as SLT and behavioral interventions including Applied Behavioral Analysis (Le Grice & McMenamin, 2002;Politte et al., 2015). However, caregivers frequently also turn towards non-empirically validated behavioral therapies and complementary and alternative medicine-based approaches that lack scientific efficacy data, with the hope of finding beneficial interventions that can address their child's complex needs (Goin-Kochel et al., 2007;Green et al., 2006;Politte et al., 2015). Overall, parents of children with ASD utilize a plethora of services for their children and are in fact always on the lookout for newer interventions to address the multiple needs of their children. ...
Article
The study aimed to collect data from families of children and youth with Autism Spectrum Disorder (ASD) in the state of Delaware, USA to understand their ongoing needs and challenges in accessing child healthcare and family support services. We analyzed responses from 263 caregivers of children and youth with ASD from 3 to 24 years using a statewide needs assessment survey. Over 50% caregivers indicated having unmet needs relative to both child/youth healthcare services and family support services. Between 24 and 38% caregivers expressed unmet needs for healthcare services such as social skills training, speech‐language therapy, behavioral intervention, and occupational therapy for their child and 20–24% expressed needs for family support services such as respite care, parent/sibling support groups, counseling, and babysitting support. Additionally, number of prior early interventions received, limitations in accessing healthcare services, and unmet needs for family support services significantly predicted child/youth unmet healthcare needs. Greater ASD severity and difficulties accessing child/youth healthcare services predicted participant's functional dependence on caregivers for activities of daily living. Together, these findings call for designing holistic, family‐centered interventions that address needs of both children and youth with ASD and their families. Lay summary A statewide needs assessment survey of caregivers of children and youth with ASD revealed that 50% responders had unmet needs relative to both child/youth healthcare services and family support services. Number of prior services received, limitations in accessing healthcare, and unmet needs for family support are linked to child/youth unmet healthcare needs. Severity of autism and difficulties accessing child/youth healthcare are associated with participant's functional dependence. Together, these findings call for placing the family at the heart of the service system in ASD.
... Although Salomone at al. (Salomone et al., 2015) reported that the use of the CAM interventions examined in their study were not associated with the child's age, relationships have been found in other studies. Bowker, D'Angelo, Hicks, and Wells (2011), Denne et al. (2018), Goin-Kochel, Myers, and Mackintosh (2007), Mire, Raff, Brewton, and Goin-Kochel (2015), and Salomone et al. (2016) all reported associations between the age of children and some variations in types of interventions used. Furthermore, Green et al. (2006) found that more interventions were used with younger children and when the child was described as having 'severe autism' and fewer when the child was described as having Asperger syndrome. ...
... In summary, a modest number of factors have been implicated as associated with parental decisionmaking with regard to interventions used with children with ASD, but findings have not always been consistent across studies. No studies have been conducted with an Australian sample (although some included a small number of Australian participants within mainly North American samples; e.g., Goin-Kochel et al., 2007;Green et al., 2006). Investigation of implicit factors that predict selection of interventions by parents of children with ASD may assist in both understanding factors that affect decision-making and in providing guidance to parents in this process. ...
... Initially, descriptive statistics were calculated and interventions were collapsed into six overarching groups to facilitate further analyses (as shown in Table 2). There is no generally agreed upon classification system for ASD interventions, and interventions have been grouped in several different ways by researchers in previous survey studies (e.g., Carter et al., 2011;Goin-Kochel et al., 2007;Green et al., 2006;Patten et al., 2013;Salomone et al., 2015). In the present study, the classification system used by Green et al. (2006) was used as a general framework. ...
Article
Extant research addressing implicit factors related to intervention decisions made by parents of children with autism spectrum disorder (ASD) is limited and findings have been inconsistent. In the present study, 74 parents of preschoolers with ASD were surveyed regarding intervention use. The possible relationships between implicit parent factors (education level, age, causal beliefs about ASD, complementary and alternative medicine [CAM] use, and family income) and child factors (time since diagnosis, and perceived severity of ASD), and the number and type of interventions used were examined. Consistent with previous research, only a small number of significant relationships were found, including that family income, parent use of CAM, mother’s education, parent belief in an unknown aetiology of ASD, and time since child’s diagnosis were all related to the number of interventions used. Some specific findings of previous research were not replicated in the present study (e.g., neither beliefs in environmental aetiology of ASD nor parent education levels were related to the use of specific CAM interventions), indicating that factors affecting decision-making may not be consistent across samples. Nevertheless, future research including an expanded range of possible implicit factors with more diverse samples may provide a more accurate predictive model of parent decision-making.
... Poremećaji iz spektra autizma (u daljem tekstu PSA) pripadaju grupi neurorazvojnih poremećaja čiji se prvi znaci pojavljuju u detinjstvu (American Psychiatric Association, 2013). Pravovremena detekcija, tačna dijagnoza i odgovarajući, efikasan i naučno zasnovan tretman pozitivno utiču na razvoj, uključenost i kvalitet života osoba sa PSA (Glumbić, 2009). Roditelji, kao zastupnici svog deteta, predstavljaju okosnicu u tretmanu PSA, jer učestvuju u donošenju odluke oko izbora tretmana, izdvajaju resurse, evaluiraju tretman, a često ga i sprovode. ...
... Goin- Kochel, Myers, & Mackintosh, 2007). U velikoj grupi potencijalnih faktora(Wilson, Hamilton, Whelan, & Pilkington, 2018) koji utiču na donošenje odluke o tretmanu izdvajaju se i percepcije, odnosno ubeđenja roditelja, kako o uzroku PSA, tako i o razumevanju stanja njihovog deteta i njegovom uticaju na celokupnu porodicu(Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). ...
... Tabela 8. Deskriptivne mere odnosa između personalne kontrole kod roditelja i KAMTable 8. Descriptive measures of the relationship between personal control of parents and KAM nego u sadašnjosti. Lista tretmana formirana je na osnovu tretmana o kojima se priča u Srbiji, koji su popularni na sajtovima udruženja za PSA i drugih organizacija koje pružaju podršku osobama sa PSA, ali i po uzoru na druga istraživanja(Goin-Kochel et al., 2007; National Autism Center, 2009;Schreck & Mazur, 2008). Ostalo je nepoznato da li roditelji znaju šta koji tretman predstavlja i na čemu se zasniva. ...
Conference Paper
The World Health Organization declared the COVID-19 pandemic in March 2020. Soon, the classic way of attending schools, including Bosnia and Herzegovina, was interrupted all over the world. With the interruption of the classic way of attending school, distance learning began. So school, parents, and pupils were forced to a more intensive cooperation and coordination. The aim of this study was to determine whether there are differences in the frequency of contact between parents and professionals in regular primary schools and primary schools for children with disabilities. The sample consisted of two groups of respondents. The first group of respondents was 23 parents of children with disabilities attending regular primary schools and primary schools for children with disabilities. The second group of respondents was 34 educational staff. Parents of children attending regular primary schools and parents of children attending school for children with disabilities were found to be equally satisfied with the online support received given the frequency of support and the availability of professionals outside working hours. In addition, the results showed that parents of children with disabilities attending regular schools and parents of children attending schools for children with disabilities had equally frequent contact with professionals and the school in general.
... Treatment approaches for ASD focus on behavioural interventions, speech therapy, occupational therapy and educational interventions. There has been increasing evidence over the past decade to suggest that complementary and alternative medicine (CAM) is widely used by parents with children who have ASD [4][5][6][7][8]. However, little is known about how parents perceive and negotiate information on CAM as part of their decision making regarding its use with children. ...
... Further, complementary medicine decision-making was often complex given the frequently uncertain and limited evidence available to parents. Many parents who use CAM with their children are likely to lack adequate information to assist them in minimising risk and enable safe and effective CAM use [4,25]. In addition, parents are often managing a complex array of treatments and therapies for their child's ASD, including pharmacological, dietary, behavioral, and educational interventions [26]. ...
... In addition, parents are often managing a complex array of treatments and therapies for their child's ASD, including pharmacological, dietary, behavioral, and educational interventions [26]. Furthermore, perceived benefits from CAM treatments for ASD can be based on personal values, beliefs and expectations [26], and individuals are known to make decisions based on limited anecdotal information [4,25]. ...
Article
Full-text available
Background: Complementary and alternative medicine and therapies (CAM) are widely used by parents of children with autism spectrum disorder (ASD). However, there is a gap in our understanding of how and why parents of children with ASD make decisions about CAM treatment, and how "evidence" influences their decision-making. The aim of this study was to explore views and perspectives on CAM decision-making among parents of children with ASD in Australia. Methods: Semi-structured interviews were conducted with parents of children with ASD (18 years and under) who were living in Australia. The interviews were digitally recorded, transcribed and then analysed using thematic analysis. Results: Twenty-one parents were interviewed (20 women and one man). The mean age of participants was 43 years, (SD = 5.12 years), the majority of whom were born in Australia (71%), and almost half (43%) had a bachelor degree or higher. Three main themes were identifiedin the thematic analysis. First theme was 'Parents' experiences of researching CAM treatments, the second theme was, "Navigating CAM information and practices", which comprises of the subthemes: Assessing information on CAM treatments' What counts as 'evidence'? and Assessing the impact of CAM treatments on the child - What counts as effective?, and the final theme was, "Creating a central and trustworthy source about CAM". Across themes parents' CAM decision-making was described as pragmatic, influenced by time, cost, and feasibility. Parents also reported that information on CAM was complex and often conflicting, and the creation of a centralised and reliable source of information on CAM was identified as a potential solution to these challenges. Conclusion: The development of evidence-based information resources for parents and supporting CAM health literacy may assist with navigating CAM decision-making for children's with ASD.
... Poremećaji iz spektra autizma (u daljem tekstu PSA) pripadaju grupi neurorazvojnih poremećaja čiji se prvi znaci pojavljuju u detinjstvu (American Psychiatric Association, 2013). Pravovremena detekcija, tačna dijagnoza i odgovarajući, efikasan i naučno zasnovan tretman pozitivno utiču na razvoj, uključenost i kvalitet života osoba sa PSA (Glumbić, 2009). Roditelji, kao zastupnici svog deteta, predstavljaju okosnicu u tretmanu PSA, jer učestvuju u donošenju odluke oko izbora tretmana, izdvajaju resurse, evaluiraju tretman, a često ga i sprovode. ...
... Goin- Kochel, Myers, & Mackintosh, 2007). U velikoj grupi potencijalnih faktora(Wilson, Hamilton, Whelan, & Pilkington, 2018) koji utiču na donošenje odluke o tretmanu izdvajaju se i percepcije, odnosno ubeđenja roditelja, kako o uzroku PSA, tako i o razumevanju stanja njihovog deteta i njegovom uticaju na celokupnu porodicu(Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). ...
... Tabela 8. Deskriptivne mere odnosa između personalne kontrole kod roditelja i KAMTable 8. Descriptive measures of the relationship between personal control of parents and KAM nego u sadašnjosti. Lista tretmana formirana je na osnovu tretmana o kojima se priča u Srbiji, koji su popularni na sajtovima udruženja za PSA i drugih organizacija koje pružaju podršku osobama sa PSA, ali i po uzoru na druga istraživanja(Goin-Kochel et al., 2007; National Autism Center, 2009;Schreck & Mazur, 2008). Ostalo je nepoznato da li roditelji znaju šta koji tretman predstavlja i na čemu se zasniva. ...
Article
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INTRODUCTION TO THE EMOTIONOLOGY OF CHILDHOOD (WITH AN APPENDIX TO CHILDREN'S LITERATURE) The paper provides an overview recent literature of the emotionology of childhood in historiography and in the history of children's literature, in reviewing the history of childhood emotionology in the Middle Ages and parents' feelings towards children to Stearns' reading of modern children's emotions, problematized by the notion , , Happy Children” as a product of popular American emotional culture. Correlated with the historical overview, emotiology will be explored as a modern method of approaching the literary text of children's literature. Since the field of children's literature has not been researched in Croatian literary studies by using emotionology as a methodological framework, the aim of this paper is to increase interest in literary emotionology, expand the overview of research methodology in the scientific community and thus popularize the field, especially in terms of new emotional research of children's literature in Croatia, which are given a guide by this introduction. Following the example of the history of emotions in historiography, the aim is to encourage literary emotionology to write a systematic emotionological study of literary-historical periodization of (dominant) emotions in various periods of children's literature, from the beginning of children's literature to the present day (emotionology has evidently been lacking so far). The possibility of scientific resistance is expected due to the introduction of the literary theoretical discipline of emotion, as a modern research paradigm, in the study of children's literature (as advocated by the author of this paper), just as resistance arose due to several different works of children's literature. , no longer just a moral component, but also a child’s psyche, like Pippi Longstocking (1945) by Astrid Lindgren, although it was clear that a whole new and very successful genre was emerging. Always, when it comes to newspapers, there is resistance to the new and different (Piskač, 2018), and in the world of the Internet Y and Z generation (children of the 21st century) and the growing insistence on artificial intelligence - emotional literacy, emotional intelligence, ultimately , emotional science, is also important as a predilection for maintaining a healthy childhood. The conclusion is that neither methodological, terminological or interdisciplinary and transdisciplinary problems in the study of feelings should distract us from the continuous research of emotionology at various social levels, a topic that is important in itself (Stearns and Stearns, 1985) and which - if we look at emotionology as a valent anti-essentialist feature of identity (whether real or literary) - begins its development in early childhood, which gives the topic a specific merit.
... Poremećaji iz spektra autizma (u daljem tekstu PSA) pripadaju grupi neurorazvojnih poremećaja čiji se prvi znaci pojavljuju u detinjstvu (American Psychiatric Association, 2013). Pravovremena detekcija, tačna dijagnoza i odgovarajući, efikasan i naučno zasnovan tretman pozitivno utiču na razvoj, uključenost i kvalitet života osoba sa PSA (Glumbić, 2009). Roditelji, kao zastupnici svog deteta, predstavljaju okosnicu u tretmanu PSA, jer učestvuju u donošenju odluke oko izbora tretmana, izdvajaju resurse, evaluiraju tretman, a često ga i sprovode. ...
... Goin- Kochel, Myers, & Mackintosh, 2007). U velikoj grupi potencijalnih faktora(Wilson, Hamilton, Whelan, & Pilkington, 2018) koji utiču na donošenje odluke o tretmanu izdvajaju se i percepcije, odnosno ubeđenja roditelja, kako o uzroku PSA, tako i o razumevanju stanja njihovog deteta i njegovom uticaju na celokupnu porodicu(Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). ...
... Tabela 8. Deskriptivne mere odnosa između personalne kontrole kod roditelja i KAMTable 8. Descriptive measures of the relationship between personal control of parents and KAM nego u sadašnjosti. Lista tretmana formirana je na osnovu tretmana o kojima se priča u Srbiji, koji su popularni na sajtovima udruženja za PSA i drugih organizacija koje pružaju podršku osobama sa PSA, ali i po uzoru na druga istraživanja(Goin-Kochel et al., 2007; National Autism Center, 2009;Schreck & Mazur, 2008). Ostalo je nepoznato da li roditelji znaju šta koji tretman predstavlja i na čemu se zasniva. ...
Article
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Društvene mreže kao snažan medij omogućavaju dvosmjernu komunikaciju ipojavu influencera sa značajnim utjecajem na druge ljude, posebice djecu i mlade u vrijeme njihovog intenzivnog razvoja. Influenceri svoje djelovanje ostvaruju konceptima parasocijalne povezanosti i identifikacije želja kao i influence marketingom. Medijske ličnosti danas preuzimaju jednu od socijalizacijskih uloga u odgoju te je iz tog razloga jedna od važnih uloga roditelja pomoći djeci u „odgoju za medije“ kako bi minimizirali manipulaciju djecom i njihovo uvođenje u neki iluzorni svijet koji im se prezentira kao „suvremena neminovnost“. Jedan od ciljeva istraživanja bio je problemu utjecaja influencera pristupiti s pedagoškog stajališta budući ovakav način ispitivanja na nacionalnom i širem planu izostaje. Putem posebno kreiranog anketnog upitnika ispitalo se mišljenje učenika 7. i 8. razreda (N = 51) osnovnih škola i njihovih roditelja (N = 26) o spoznajama influencerskog utjecaja i mogućih posljedica na djecu. Istraživanje je provedeno u 5 riječkih osnovnih škola. Rezultati pokazuju snažan influencerski utjecaj među učeničkom populacijom koji se ostvaruje kroz fenomene parasocijalne povezanosti, identifikacije želja i influence marketinga. Istovremeno roditelji pokazuju neinformiranost o problemu, nepoznavanje utjecaja influencera na djecu, dok neki ne uviđaju negativne utjecaje ili su prema problemu indiferentni. Istraživanje ukazuje na potrebu poticanja intenzivne komunikacije roditelja i djece o medijskom sadržaju i medijskim ličnostima kako bi se djecu osposobilo za kritički odnos prema njima. Istraživanje otvara i niz drugih istraživačkih pitanja na koje bi pedagogijska znanost trebala odgovoriti, a prvenstveno kreirati suvremene načine educiranja i osnaživanja roditeljskih odgojnih kompetencija posebice iz područja medijske pismenosti.
... Unsurprisingly, there is general consensus in the literature that children who demonstrate more severe symptoms of ASD received more services (Goin-Kochel et al. 2007;Irvin et al. 2012;Magaña et al. 2016;Zuckerman et al. 2017a); however, these results should be interpreted with caution given that ASD severity is often measured differently across studies. The most common indicator for severity of ASD symptoms is parent-report. ...
... One study (Goin-Kochel et al. 2007) investigated the use of therapies within different diagnoses across the spectrum (i.e. autism, Asperger syndrome, and pervasive developmental disorder-not otherwise specified [PDD-NOS]), consistent with earlier diagnostic systems for ASD and found that children with autism or PDD-NOS were more likely to use ABA, OT, PT, and SLP than children with Asperger syndrome. ...
... Given that families of children with ASD frequently desire more services (Dymond et al. 2007), it is important to identify factors that may put some groups at risk for utilizing fewer services than their peers. Child age is one of the most consistently identified factors associated with treatment use for individuals with ASD (Goin-Kochel et al. 2007). It has been shown to influence services offered in schools (i.e. ...
Article
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Individuals with autism spectrum disorder (ASD) often benefit from allied health services such as occupational therapy, speech and language pathology, and applied behavioral analysis. While there is consistent evidence of disparities in access and use of medical services (e.g. dentistry), no such systematic review has examined disparities and differences in allied health use amongst children with ASD. In this systematic review, we examine disparities and differences in service access and use for children with ASD. Our findings suggest that children who are older, have less severe ASD symptoms, are from minority groups, and those from particular geographic regions are less likely to receive allied health services. Limitations and future directions are discussed.
... Keywords: choice, autism spectrum disorder, parents, treatment UVOD Poremećaji iz spektra autizma (u daljem tekstu PSA) pripadaju grupi neurorazvojnih poremećaja čiji se prvi znaci pojavljuju u detinjstvu (American Psychiatric Association, 2013). Pravovremena detekcija, tačna dijagnoza i odgovarajući, efikasan i naučno zasnovan tretman pozitivno utiču na razvoj, uključenost i kvalitet života osoba sa PSA (Glumbić, 2009). Roditelji, kao zastupnici svog deteta, predstavljaju okosnicu u tretmanu PSA, jer učestvuju u donošenju odluke oko izbora tretmana, izdvajaju resurse, evaluiraju tretman, a često ga i sprovode. ...
... Traganje za bilo čime što bi moglo pomoći i odsustvo brzih i lakih rešenja čini roditelje dece sa PSA lakom metom, a mnogi ljudi vide način kako da profitiraju nudeći im bolje ishode, za njih i njihovo dete. Deca sa PSA i njihove porodice su u proseku u svakom trenutku uključeni u četiri, pet ili šest tretmana, a u prošlosti su isprobali između sedam i devet tretmanskih pristupa (Goin-Kochel, Myers, & Mackintosh, 2007). U velikoj grupi potencijalnih faktora (Wilson, Hamilton, Whelan, & Pilkington, 2018) koji utiču na donošenje odluke o tretmanu izdvajaju se i percepcije, odnosno ubeđenja roditelja, kako o uzroku PSA, tako i o razumevanju stanja njihovog deteta i njegovom uticaju na celokupnu porodicu (Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). ...
Conference Paper
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Nakon uočavanja prvih simptoma i postavljanja dijagnoze poremećaja iz spektra autizma (u daljem tekstu PSA), roditelji donose odluku o tretmanu za svoje dete, kako bi obezbedili kvalitetniji život detetu i porodici. Prilikom donošenja odluke o tretmanu, na roditelje može uticati čitav dijapazon faktora. Ubeđenja roditelja o PSA takođe mogu uticati na izbor tretmana. Cilj rada je da se utvrdi da li su roditeljska ubeđenja o PSA povezana sa odabirom tretmana. U istraživanju je učestvovao 41 roditelj dece sa PSA starosti od šest do 35 godina, na području Sombora, Beograda i Pančeva. Za potrebe istraživanja korišćeni su sledeći instrumenti: Opšti upitnik i Upitnik percepcije bolesti – Revidiran za PSA (Revised Illness Perception Questionnaire for Autism Spectrum Disorder, IPQ-R-ASD, Mire, Gealy, Kubiszyn, Burridge, & Goin-Kochel, 2017). Dobijeni rezultati pokazuju da najveći broj roditelja uključuje dete u logopedski tretman (65.8%), Primenjenu bihevioralnu analizu i tretmane zasnovane na njoj (63.5%), medikamentoznu terapiju (43.9%), defektološki tretman (34.1%) i senzornu integrativnu terapiju (31.7%). Dalje, način na koji roditelji percipiraju autizam ne utiče na to da li će oni izabrati farmakološke, komplementarne i alternativne metode ili logopedske tretmane. Međutim, ispostavilo se da percepcija kontrole ima veze sa odabirom bihevioralnih tretmana, odnosno da su roditelji koji smatraju da na neki način vladaju situacijom nad simptomima PSA skloniji uključivanju deteta u bihevioralne tretmane. Smatramo da bi bilo poželjno ponoviti ovo istraživanje na većem uzorku, sa ciljem boljeg razumevanja roditelja i njihovog doživljaja autizma. Ključne reči: izbor, poremećaji iz spektra autizma, roditelji, tretman
... Over 100 treatments (i.e., interventions, therapies) are available for children with autism spectrum disorder (ASD), some of which are evidence based and others that are not [Green et al., 2006]. Given the myriad of treatments available, it is not surprising that many families use multiple treatments [Bowker, D'Angelo, Hicks, & Wells, 2011;Green et al., 2006], implement them simultaneously [Goin-Kochel, Myers, & Mackintosh, 2007], and start and stop various treatments throughout their child's life [Bowker et al., 2011]. Factors associated with parents' treatment selection include symptom presentation and child's age [Goin-Kochel et al., 2007;Mire, Raff, Brewton, & Goin-Kochel, 2015], parental education level and income [Patten, Baranek, Watson, & Schultz, 2013], geographic location [Murphy & Ruble, 2012;Mire, Hughes, Manis, & Goin-Kochel, 2018], and parents' perceptions of treatment and ASD [Dardennes et al., 2011;Mire, Gealy, Kubiszyn, Backscheider-Burridge, & Goin-Kochel, 2017]. ...
... Given the myriad of treatments available, it is not surprising that many families use multiple treatments [Bowker, D'Angelo, Hicks, & Wells, 2011;Green et al., 2006], implement them simultaneously [Goin-Kochel, Myers, & Mackintosh, 2007], and start and stop various treatments throughout their child's life [Bowker et al., 2011]. Factors associated with parents' treatment selection include symptom presentation and child's age [Goin-Kochel et al., 2007;Mire, Raff, Brewton, & Goin-Kochel, 2015], parental education level and income [Patten, Baranek, Watson, & Schultz, 2013], geographic location [Murphy & Ruble, 2012;Mire, Hughes, Manis, & Goin-Kochel, 2018], and parents' perceptions of treatment and ASD [Dardennes et al., 2011;Mire, Gealy, Kubiszyn, Backscheider-Burridge, & Goin-Kochel, 2017]. However, there are many unknowns about factors that influence parents' decisions to employ some treatments over others [Matson & Williams, 2015]. ...
Article
Among parents of 2,582 children (ages 4–17 years old) with autism spectrum disorder (ASD), we used latent class analysis to identify subgroups and profiles of treatment users and included annual household income in the specification of the models, then described characteristics of each subgroup. Based on three indicators of fit (Akaike's Information Criterion, Bayesian Information Criterion, and Lo–Mendell–Rubin), six latent classes of treatment users emerged. Subgroups included users of: (a) mostly private and school speech and occupational therapies; (b) nearly all treatment types; (c) mostly speech and occupational therapies, plus intensive behavioral and “other” treatments, but little medication use; (d) private therapies almost exclusively; (e) primarily psychotropic medications; and (f) mostly school‐based therapies. Income significantly predicted class differences for all but one latent class. Probabilities of families' lifetime use of nine treatment types varied depending on latent classification. Proportions of families reporting having observed children's developmental regression were largest in those with the highest overall treatment use, and these children also had the lowest cognitive and adaptive‐functioning scores and the highest ASD symptom scores. Understanding patterns of treatment use among families of children with ASD is an important first step in enhancing treatment‐related selection and implementation. Autism Res 2019. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary We identified six different groups of treatment users to help explain patterns in treatment implementation among parents of children and adolescents with autism. These included families who used: (a) mostly used private and school speech and occupational therapies; (b) nearly all treatment types (private and school therapies, intensive behavioral, biomedical, psychotropic medications, and other treatments); (c) mostly speech and occupational therapies, plus intensive behavioral and “other” treatments, but little medication use; (d) private therapies almost exclusively; (e) primarily psychotropic medications; and (f) mostly school‐based therapies.
... Additionally, they found changes in daily living and socialization skills increased more during the second year of enrollment in the ABA class than in the first year (Grindle et al., 2012). Goin-Kochel et al. (2007) created a parent questionnaire to identify pharmacological drugs, diets, and therapies they had tried and were currently using as treatment for their children with ASD. Participants were divided into three groups: parents of children with autism, parents of children with Asperger Syndrome (AS), and parents of children with Pervasive Developmental Disorders not otherwise specified (PDD-NOS). ...
... Participants were divided into three groups: parents of children with autism, parents of children with Asperger Syndrome (AS), and parents of children with Pervasive Developmental Disorders not otherwise specified (PDD-NOS). Results indicated that children receive a wide range of different treatments and that most are receiving more than one treatment simultaneously (Goin-Kochel et al., 2007). ...
Article
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We evaluated the effectiveness of a statewide Medicaid program providing in-home Early Intensive Behavioral Intervention services to young children with Autism Spectrum Disorder living in a rural southern state. Program effectiveness was assessed via the Assessment of Basic Language and Learning Skills-Revised (ABLLS-R). A multi-level growth model was used to show significant variation among children’s initial ABLLS-R scores and their growth trajectories. Hispanic children tended to have lower initial scores but demonstrated similar growth compared to their non-Hispanic peers. Children who were older at initial start in the program appeared to have higher initial composite scores and higher growth trajectories. Children in more populous counties had higher initial scores but grew at similar rates to children in more rural counties.
... DTT consists of three main components: (a) an instruction from the interventionist; (b) the response from the learner; and (c) feedback from the interventionist. There have been numerous recommendations of how to implement DTT; some of which may contradict each other (e.g., Ghezzi 2007;Gongola and Sweeney 2012;Green 2001;Grow and LeBlanc 2013;Leaf et al. 2016a, b;Smith 2001 Grow and LeBlanc (2013), and Leaf et al. (2016a, b) provide three representative samples of recommendations of differing ways DTT can be implemented. Green (2001) was to use a different sample stimulus on each trial while ensuring the same comparisons are used on every trial across a trial block. ...
... There continues to be an increase in the number of interventions and/or treatments claiming effectiveness, and, in some cases, a cure (Goin-Kochel et al. 2007;Jacobson et al. 2005) for individuals diagnosed with ASD. While some interventions have a plethora of research (e.g., Early Start Denver Model), many interventions are unsubstantiated, lack empirical support for their effectiveness (Schreck and Miller 2010), and would be considered non-evidence based, pseudoscientific, and/or antiscientific (Green 1996). ...
Article
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There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.
... Studies that examined the association of ASD severity with school services have used varying informants and methods. For example, Goin-Kochel et al. (2007) measured ASD severity by obtaining parent-reported diagnoses (e.g., autism, Asperger's, PDD-NOS) via a questionnaire. Results suggested that children with a diagnosis of autism or PDD-NOS utilized more total services including occupational therapy, physical therapy, and speech therapy. ...
... Receipt of common school services refers to whether or not (yes/no) the youth was receiving at least one of three school services that are most commonly provided for youth with ASD: speech/language therapy, occupational therapy and/or social skills training (e.g., Goin-Kochel et al., 2007;Thomas, Ellis, McLaurin, Daniels, & Morrissey, 2007). Total school services includes both common school services and any other school services (e.g., adaptive physical education, counseling, etc.). ...
Article
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Supportive school services are a primary service modality for youth with autism spectrum disorder. Autism spectrum disorder, as well as co-occurring psychiatric symptoms and low intellectual abilities, interfere with academic achievement and therefore influence decisions about school services. Therefore, we examined the association of parent, teacher, and clinician ratings of autism spectrum disorder and co-occurring psychiatric symptom severity and intellectual functioning with school services. In total, 283 youth with autism spectrum disorder were assessed with clinical evaluation via the Autism Diagnostic Observation Schedule and parent and teacher versions of the CASI-4R (Child and Adolescent Symptom Inventory). Full Scale Intelligence Quotient scores were obtained from case records. Clinical and teacher evaluations of autism spectrum disorder severity predicted services and were more strongly associated with school services than parent ratings. Teacher ratings were only associated with common school services (e.g. speech/language therapy, occupational therapy, and/or social skills training) frequency at medium and high levels of clinician-rated autism spectrum disorder severity. Higher IQ and parent-rated externalizing symptoms predicted lower likelihood of receiving school services, whereas internalizing symptoms were not predictive of school services. Autism spectrum disorder symptoms may overshadow externalizing and internalizing symptoms when considering school service supports. Results highlight the importance of evaluating autism spectrum disorder severity via multiple sources, especially in cases of unclear symptom presentation, when examining correlates of school services for youth with autism spectrum disorder.
... At present, there does not appear to be research examining the ways in which early intervention services are delivered to children with ASD. A number of studies have, however, investigated the types and/or amounts of intervention services that children were receiving (Bowker et al. 2011;Carlon et al. 2015;Denne et al. 2018;Goin-Kochel et al. 2007;Green et al. 2006;Hume et al. 2005;Kasilingam et al. 2019;Patten et al. 2013;Salomone et al. 2016). A number of these studies found that speech and language therapy was the most commonly accessed intervention service for a child with ASD (Kasilingam et al. 2019;Green et al. 2006;Patten et al. 2013;Salomone et al. 2016;Shepherd et al. 2018). ...
... A number of these studies found that speech and language therapy was the most commonly accessed intervention service for a child with ASD (Kasilingam et al. 2019;Green et al. 2006;Patten et al. 2013;Salomone et al. 2016;Shepherd et al. 2018). Children were, on average, receiving at least one type of intervention service (Bowker et al. 2011), with many receiving two (Denne et al. 2018;Kasilingam et al. 2019) or more (Goin-Kochel et al. 2007;Green et al. 2006;Patten et al. 2013) concurrently. The amount of intervention received varied from 8.7 h per month (Kasilingam et al. 2019) to 40 h per week (Hume et al. 2005). ...
Article
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Little is known about parent preferences regarding delivery methods of early interventions. This research examined, through parent report, the current and preferred delivery methods of seven common educational early interventions accessed by New Zealand children with autism spectrum disorder. Responses from 63 eligible participants were collected via an online questionnaire. Results suggested that four of the seven early intervention services were predominantly delivered through some form of professional advice to parents. Participants who were receiving at least one privately funded service were more likely to have at least one service delivered directly to their child. Parents’ most preferred delivery method for all early intervention services, except parent education programs, involved a professional working directly with their child.
... Majority of the common interventions designed to enhance specific executive functions (e.g., self-control) have been primarily behavioral based [3][4][5][6][7], some interests have been developed to explore potential alternative interventions for improving executive function and reducing the behavioral problems of individuals with ASD. The alternative interventions that have been studied include massage [8], acupuncture [9], music therapy [10], and dietary/nutritional interventions [11][12]. ...
... The potential benefits of the Chan-based lifestyle intervention are consistent with the treatment effects of some conventional behavioral-based interventions and alternative mind-body interventions for enhancing executive functions and related behavioral and emotional problems in ASD [3][4][5][6][8][9][10][11]. It should be noted that about 10 minutes of daily Nei Gong practice and a once a month follow-up for monitoring the children's progress and providing guidance to their parents was sufficient to reveal some cognitive and behavioral improvement in ASD children. ...
... Consistent with previous research on service use in children with autism, associations were observed between accessing psychosocial services alone and predisposing variables, such as age. Other studies have suggested that psychosocial services are more available for younger, school-aged children compared to adolescents and adults Goin-Kochel, Myers, & Mackintosh, 2007;Green et al., 2006;Khanna et al., 2013). As children age, the cost of services increases Wang et al., 2013), and there tends to be greater psychotropic medication use (Esbensen et al., 2009). ...
Article
Background Clinical guidelines recommend that psychosocial interventions be used before medication to manage aggressive behavior in individuals with autism. However, the extent to which a multidisciplinary approach is implemented and the factors that influence service use in this complex population are not well understood. Methods In this study, parents of 182 adolescents and adults with autism and a history of aggression were asked to report on their child’s health service use every two months for a year. Individuals that used services in this time period (N = 158) were classified into three groups: users of psychotropic medication alone (n = 28, 17.7%); psychosocial services alone (n = 33, 20.9%); or users of both (n = 97, 61.4%). Results Although the majority of the sample (82.3%) received guideline recommended treatment (i.e., psychosocial services or a combination of psychosocial services and psychotropic medication), 17.7% were using psychotropic medication alone. Several enabling variables, including visiting a family physician in the two-months prior to baseline, having higher parental education, and having parents who reported being able to effectively access services predicted using psychosocial services alone or in combination with medication. Predisposing and need variables (i.e., being younger and having no psychiatric disorders) also predicted using psychosocial services compared to medication alone. Conclusions Understanding predictors of service use can help to identify and address barriers that may prevent adults with autism and aggression from accessing guideline recommended care.
... Parents in our study stressed the importance of speech therapy for their children's language skills acquisition. However, inaccessibility of treatment due to long waiting lists, dissatisfaction with the quality of services, and continual rejections of applications for personal assistance for their children had led some parents to seek out private services or pursue other treatment choices, such as complementary and alternative treatments-a finding consistent with previous studies [99][100][101]. For instance, parents mentioned nutritional supplements and gluten-and dairy-free diets as the most frequently used complementary treatments. Some of the complementary and alternative treatments for ASD have been described in the literature as either emerging or unestablished, i.e. lacking sufficient evidence to be considered as evidence-based practices [102]. ...
Article
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Background Research suggests that families’ knowledge and cultural perceptions of autism spectrum disorder (ASD), and beliefs about its etiology and prognosis, can affect parents’ recognition of the first signs of autism in their children and influence help seeking and treatment decisions. Objective This study investigated explanatory models of autism among parents of young children with ASD in the multicultural context of Sweden. Method Seventeen parents from diverse cultural, ethnic and linguistic backgrounds participated in semi-structured interviews. A deductive approach to qualitative content analysis was used to analyze data. Five domains of the Explanatory Model supplementary module of the Cultural Formulation Interview (CFI) were used as coding categories, operationalized as ‘Parents’ understanding of autism’; ‘Autism prototypes’; ‘Causal explanations’; ‘Course of autism’, and ‘Help seeking and treatment expectations’ Results The results showed that parents’ prior knowledge of autism and experience of young children’s typical developmental trajectories, as well as the opinions of children’s grandparents and preschool teachers, affected symptom recognition and help seeking. There were differences in parents’ explanatory models before and after ASD diagnosis. Initial interpretations of the disorder included medical conditions and reaction to environmental influences, while genetic, supernatural/religious factors, and vaccinations were mentioned as definite causes after obtaining a clinical diagnosis. Parents also held multiple explanatory models, influenced by the views of family members and information obtained from media or from health care professionals. Parents’ treatment decisions included use of available state-funded support services, and complementary and alternative treatments. Conclusion The results demonstrate the utility of the CFI’s Explanatory Model supplementary module in autism research. Implications for clinical practice are discussed.
... A. Miller, Schreck, Mulick, & Butter, 2012). Lastly, caregivers of children with complex disorders, such as autism, regularly participate in multiple treatments simultaneously (Goin-Kochel, Myers, & Mackintosh, 2007). Future experimental research evaluating parental decision-making should account for the influence of other complementary, or even competing, options for behavioral treatments pursued by caregivers. ...
Article
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Evidence-based behavioral therapies for children with disruptive and challenging behavior rarely yield immediate improvements in behavior. For caregivers participating in behavioral therapies, the benefits from these efforts are seldom visible until after substantial time commitments. Delays associated with relief from challenging behavior (i.e., improved behavior) can influence how caregivers decide to respond to instances of problem behavior, and in turn, their continued commitment (i.e., integrity, adherence) to treatments that require long-term implementation to produce improvements in child behavior. This study applied delay discounting methods to evaluate how delays affected caregiver preferences related to options for managing their child’s behavior. Specifically, methods were designed to evaluate the degree to which caregiver preferences for a more efficacious, recommended approach was affected by delays (i.e., numbers of weeks in treatment). That is, methods evaluated at which point caregivers opted to disregard the optimal, delayed strategy and instead elected to pursue suboptimal, immediate strategies. Results indicated that caregivers regularly discounted the value of the more efficacious treatment, electing to pursue suboptimal approaches when delays associated with the optimal approach grew larger. Caregivers demonstrated similar patterns of suboptimal choice across both clinical (i.e., intervention) and non-clinical (i.e., monetary) types of decisions. These findings are consistent with research that has highlighted temporal preferences as an individual factor that may be relevant to caregiver adherence to long-term evidence-based treatments and encourage the incorporation of behavioral economic methods to better understand caregiver decision-making.
... Le processus pour recevoir un diagnostic et des services est souvent long et complexe pour les enfants autistes. Souvent, leurs parents sont confrontés à une panoplie d'informations provenant de diverses sources concernant les possibilités d'intervention (Goin-Kochel, Myers et Mackintosh, 2007). Une gamme de services est suggérée aux parents, lesquels sont cependant seuls à décider des traitements souhaitables pour l'enfant (Myers et Plauché Johnson, 2007;Johnson et collab., 2016). ...
... The first line intervention for severe problem behavior typically involves the prescription of psychoactive medications (30-70% of children with autism spectrum disorder [ASD] receive psychoactive medications and approximately 30% receive two or more medications; Goin-Kochel, Myers, & Mackintosh, 2007;Mandell et al., 2008;Oswald & Sonenklar, 2007;Rosenberg et al., 2010). One effective alternative or adjunct to medication is function-based intervention in which a behavior analyst conducts a functional analysis (FA) and then uses the results to prescribe a treatment that matches the function of the individual's problem behavior (Beavers, Iwata, & Lerman, 2013;Hanley, Iwata, & McCord, 2003). ...
Article
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Recent research suggests that combining putative reinforcers for problem behavior into a single, synthesized contingency may increase efficiency in identifying behavioral function relative to traditional functional analysis (FA). Other research suggests potential shortcomings of synthesized contingency analysis (SCA), such as the potential for false-positive outcomes. In prior comparisons of traditional FAs and SCAs, investigators could not ascertain with certainty the true function(s) of the participants' problem behavior for use as the criterion variable. We conducted a translational study to circumvent this limitation by training a specific function for a surrogate destructive behavior prior to conducting a traditional FA and SCA. The traditional FA correctly identified the previously established function of the target response in all six cases and produced no iatrogenic effects. The SCA produced differentiated results in all cases and iatrogenic effects (i.e., an additional function) in three of six cases. We discuss these findings in terms of the mechanisms that may promote iatrogenic effects.
... Long working hours may be associated with low parent-child relationship quality because parental employment restricts parents' available time and attention for young children (Roeters, Van Der Lippe, & Kluwer, 2010). In addition, parents of children with ASD often choose a variety of interventions to use with their child concurrently (Goin-Kochel, Myers, & Mackintosh, 2007); their time spent in home-based interventions may be constrained. ...
Article
Previous research has shown that parent-training programs derived from the developmental individual-difference relationship-based model (DIR) can improve the communicative development of children with autism spectrum disorder (ASD). However, the empirical evidence is weak. This study aimed to investigate the efficacy of two home-based parent-training programs on children’s developmental abilities, adaptive functioning, and parents’ parenting skills. A rigorous randomized controlled trial (RCT) design with a dose-matched control group was used. Twenty-four preschool children with ASD and their parents were randomly assigned to the intervention group or the control group at the pre-test phase and received a 14-week intervention program. The children’s development levels were assessed using the Functional Emotional Assessment Scale (FEAS) and the Chinese version of Psychoeducational Profile-Third edition (CPEP-3). Adaptive functioning were assessed using the CPEP-3 and the Vineland Adaptive Behavior Scales. Parenting skills were assessed using the FEAS. Children and caregivers in the intervention group showed significantly greater improvements in emotional development and parenting skills than those in the control group after the 14-week period. However, no treatment efficacy emerged for other developmental areas and adaptive functioning on two standardized measures. The results suggest that the home-based parent-training program based on the DIR model may benefit children with ASD for the emotional development and the parents for parenting skills.
... For many of them, this has meant to reorganize the family routines to adapt them to the needs and to the social, health and educational resources attended by their child. The children of the interviewed women attend different rehabilitation services, in line with some studies which indicate that, for example, the parents of children with autism use an average of four to seven therapies at the same time [38]. Participation in several therapies (such as speech and language, or occupational therapy) implies greater time demand, so parents spend much time both taking their children from their rural towns to the urban locations of rehabilitation centers [36], and waiting while their children receive their specialist sessions. ...
Article
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The purpose of this research is to describe how the mothers of children with disabilities in rural areas of Extremadura perceive care tasks and the subjective impact that these tasks have on their daily life and health, as well as the subjective assessment that these mothers make of the benefits and services of the Spanish welfare policy. An interpretative paradigm was selected, using a qualitative approach and a phenomenological design. Twelve mothers were included. Data were collected through semi-structured interviews. A discourse analysis of the narrative information was performed using open, axial, and selective coding processes and the constant comparative method. Three topics have been extracted from the findings of the analysis: (1) extensive care responsibilities, (2) impacts upon well-being and daily life, and (3) resources that "barely" help. The care tasks performed by mothers of children with disabilities in rural areas have an enormous impact on their daily life and health. This involvement in caregiving generates a significant occupational imbalance which has an impact on their mental health, and which causes economic and social problems.
... The clinical application of music to mediate the developmental and therapeutic processes in autism has a long history (for review, see Reschke-Hernandez, 2011) and is one of the most frequently used treatment strategies for autism within clinical and educational settings 1 Henceforth also referred to as "autism". (Goin-Kochel, Mackintosh, & Myers, 2009;Goin-Kochel et al., 2007;Green et al., 2006;Hess et al., 2007). In this chapter, we discuss the current state of clinical research in the area. ...
Chapter
From neuroimaging and behavioral research investigating the unique relation between music and preserved cognitive skills to the clinical use of music to mediate the developmental and therapeutic processes, music has played a prominent role in clinical and research literature on autism spectrum disorder. In this chapter, we discuss the current state of clinical research in the area of music-based intervention for autism. We start outlining recent neuroimaging and behavioral research investigating the unique relation between music and preserved cognitive skills in autism. The next sections discuss key concepts underlying Neurologic Music Therapy and the impact of the neuroscience model for clinical and research practices. The discussion of the current state of clinical research is centered on results from controlled clinical studies investigating the effects of music-based interventions to address core features of autism, such as communication, social, and emotional skills. To conclude, we discuss new directions to expand the clinical scope of music-based interventions, including under-researched functions such as motor and attention control. ** This publication is available online at https://link.springer.com/chapter/10.1007/978-3-030-13027-5_20 and https://nmtacademy.files.wordpress.com/2019/05/thaut-braunjanzen2019_chapter_neurologicmusictherapy.pdf?fbclid=IwAR1cUOcS5lMRPlFvSHDM_djbKnf2Rw9jzEYr8weVqH6lrKmjdJUVKmOUSt8
... One of the most frequently employed strategies to promote social functioning for individuals with ASD is social skills teaching (SST; Goin-Kochel et al. 2007). SST can be defined as "instruction designed to improve or facilitate the acquisition or performance of social skills" (Bellini and Peters 2008, p. 858) and encompasses a wide variety of strategies such as behavioral skills training (e.g., Granpeesheh et al. 2015) and video modeling (e.g., Bellini and Akullian 2007). ...
Article
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Objectives Social skills teaching (SST) is a commonly implemented intervention strategy with individuals with autism spectrum disorder (ASD). Given the myriad of strategies that may be utilized within SST, a systematic review was conducted to identify the state of research with respect to SST.Methods Social skills teaching intervention studies published between 1998 and 2018 were reviewed. Inclusion criteria included use of a single case research design, participants between 3 and 17 years of age, inclusion of a dependent variable that targeted a discrete social skill, and data collection and are presented on the targeted discrete social skill.ResultsA total of 201 articles were identified for inclusion and coded according to intervention type, participant age, outcomes assessed, and adherence to single case design standards. A total of 12 intervention categories were identified. Video modeling represented the most frequently researched intervention between 1998 and 2018, with didactic instruction and the provision of rules representing the least frequently studied procedure.Conclusions Recent literature in SST is generally well-designed and scientifically rigorous. Researchers and practitioners are encouraged to consider these strategies as frontline intervention options when designing future research or service delivery programs for youth with ASD.
... The uncertain effectiveness of specific treatments for specific children compounds the disadvantage. Many parents of children with autism report trying multiple treatments before identifying one that addresses their child's symptoms (Goin-Kochel, Myers, and Mackintosh 2007). Parents with limited resources may be less able to experiment with treatment alternatives, leaving their children with more severe limitations. ...
Article
We used data from the 2011 Survey of Pathways to Diagnosis and Services (N = 1,420) to evaluate a conceptual model linking social background (race-ethnicity, socioeconomic status [SES]) to parental distress through children’s clinical profiles and parental beliefs about the nature and causes of their child’s autism. Children’s clinical profiles varied by social background; white children and children of more highly educated and affluent parents were less likely to experience comorbid conditions and were more likely to be diagnosed with Asperger’s. Parental beliefs also varied such that parents of racial-ethnic minority children and parents of lower SES perceived their child’s condition as more uncertain and were less likely to attribute it to genetic causes. Parents of Hispanic children and with lower incomes were more likely to be upset by the child’s condition. Although parental beliefs had independent associations with distress, children’s clinical profiles contributed more to explaining variation in distress.
... Mevcut tedavilerin etkililiğine dair kanıtlar kısıtlı olduğundan, ailelerin karar vermesi zor olmaktadır. Eğitsel tedaviler en etkili tedaviler olarak görünmekle birlikte, birçok aile ilaç ve ilaç-dışı tedavileri de kullanmaktadır 10 otizmli çocuğa sahip ebeveyn ile yapılan bir araştırmada da benzer sonuçlara rastlanmaktaydı. ...
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tarafından 08.04.2020 tarihinde 2020/55 karar numarası ile onaylanmıştır. Öz Amaç: Kompleks etiyolojisi ve çekirdek semptomlarına etkili bir tedavinin henüz olmaması nedeniyle birçok kültürde OSB'nin oluşum nedenlerine dair farklı görüşler bulunmaktadır.Bu çalışmada ailelerin OSB'nin nedenlerine ait görüşleri, tedavi seçimleri ve beklentilerinin araştırması amaçlanmıştır. Materyal ve Metot: Çalışmaya 2015-2019 yılları arasında Ondokuz Mayıs Üniversitesi Çocuk Psikiyatri kliniğine başvuran ve OSB tanısı olan çocukların aileleri dahil edilmiş olup veriler geriye dönük olarak taranmıştır. Kliniğimize başvuran her hasta için ailelere görüşme öncesinde "Ön Görüşme Formu" doldurtulmuş, bilgileri tam olan hastalar çalışmaya alınmıştır. Ön görüşme formunda çocuğun yaşı, cinsiyeti, daha önce aldığı tedavi, hastalığın ya da bozukluğun neden kaynaklandığı ve tedavi beklentisine dair sorular bulunmaktadır. Klinik global izlem-hastalık şiddeti çocuk psikiyatri uzmanı tarafından doldurulmuştur. Bulgular: Çalışma grubunda 241 çocuk ve bakım vereninin verisi incelenmiştir. Erkek ve kız hastaların klinik özellikleri, aile görüşleri ve çocuk psikiyatri uzmanı tarafından belirlenen hastalık şiddeti karşılaştırıldığında kız hastaların klinik global izlem puanlarının daha yüksek olduğu (p=0.022) ve "Çocuğun kendinden" şıkkının daha yüksek oranda işaretlendiği (p=0.014) gözlenmiştir. İki Adımlı Kümeleme Analizi sonrasında iki küme oluşmuş ve kümeler için en belirleyici özellik "Çocuğa ait nedenler" olmuştur. İki küme arasında "daha önce psikiyatrik muayene", "ilaç tedavisi" ve "yaş" özelliklerinin belirleyici olduğu gözlenmiştir. Sonuç: Ailenin tedavi seçiminde, otizmin oluşum nedenlerine ait görüşleri, bozukluğun süresi ve daha önce çocuğun görmüş olduğu psikiyatrik muayeneler etkili olmaktadır. Bu bulgular OSB ile ilgilenen klinisyenlerin ailelere rehberlik etme ve kararlarına yardımcı olması açısından önem taşımaktadır. Anahtar Kelimeler: Aile özellikleri, aşı reddi, gelişimsel bozukluk, tedavi. Abstract Aim: Due to the complex etiology and the lack of effective treatment for core symptoms, there are different views on the causes of ASD in many cultures. In this study, it was aimed to investigate the opinions, treatment choices, and expectations of families about the causes of ASD. Materials and Methods: Children diagnosed with ASD who applied to the Ondokuz Mayıs University Child Psychiatry Clinic between 2015 and 2019 were retrospectively included in the study. Patients who filled the information in the "preliminary interview forms" filled by the families before the interview for each patient who applied to our clinic were included in the study. The preliminary interview form contains questions about the child's age, gender, previous treatment, why the disease or disorder originated, and the prospect of treatment. Results: The data of 241 children and caregivers were examined in the study group. Comparing the clinical features and family views of the families of male and female patients, it was observed that the caregivers of the female patients had higher clinical global follow-up scores (p=0.022) and marked the "child's self" option (p=0.014). After a two-step clustering analysis, two clusters formed, and the most determining feature for the clusters was "Child-related causes". It was observed that "psychiatric examination", "drug treatment "and "age" were determinative between the two clusters. Conclusion: Opinions of caregivers about the causes of autism, duration of the disease, and previous psychiatric examinations affect the choice of treatment. These findings are essential for understanding the family's treatment choices and helping families and clinicians interested in ASD to guide and make decisions.
... Additional evidence-based interventions are commonly implemented in educational settings, including speech therapy, occupational therapy, cognitive therapies, social skills groups, and physical therapy. Others have less empirical support, but are commonly-reported by parents as complementary therapies used to augment their child's educational or medical intervention plan (e.g., music therapy, sensory integration therapy; Goin-Kochel et al., 2007). ...
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Children with complex behavioral profiles (e.g., ASD + ADHD) may experience delays in obtaining a final diagnosis. Low-resource or underrepresented groups may be at even greater risk for delayed diagnosis. We assessed the effect of sociodemographic factors, symptom complexity and co-occurring conditions, and identifier of first symptoms on diagnostic trajectories among children aged 3–17 years diagnosed with ASD (n = 52) or ASD + ADHD (n = 352) from a nationally-representative sample. Race/ethnicity and gender disparities were evident in both groups. Race, symptom complexity, and co-occuring conditions predicted age of final diagnosis and wait time between first concern and final diagnosis, both of which were staggeringly high. Results suggest a complex influence of sociodemographic factors on the diagnostic pathway, and risk of health disparities as a function of intersectionality.
... The survey presented parents with a comprehensive list of treatment options including open-ended questions. In generating the list, we reviewed lists of CAM treatments used in existing studies (Christon et al., 2010;Gibbard, 2005;Goin-Kochel et al., 2007;Green et al., 2006;Konuk-Sener & Karaca, 2020;Levy & Hyman, 2002;Lindly et al., 2018;Salomone et al., 2015). Next, we identified additional treatments through databases search (Google Scholar and Web of Science) using a combination of autis*, treatment, intervention, parent, and famil*. ...
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We investigated parent reports of use of special education and support services, use of evidence-based practices (EBPs), use of past and current complementary and alternative medicine (CAM) treatments, non-use of CAM treatments, willingness, and unwillingness to use CAM treatments, reasons for use and non-use of CAM treatments, and perceptions of EBPs and CAM treatments in their children’s functioning. We collected data from a total of 166 parents of children with autism spectrum disorder (ASD) through a web-based survey. 94% of the parents reported lifetime use of at least one CAM treatment. Parents weighed on a wide variety of factors in decision-making. CAM treatments use was positively associated with parental educational level, length of time since ASD diagnosis, and child’s ASD severity.
... As prevalence rates increase and diagnosis is made earlier, the demand for ASD treatments increases (Volkmar & Klin, 2005;Fombonne, 2005;Tidmarsh, 2003;Lord & Schopler, 1988). Intensive Behavioral Intervention (IBI) is the most effective treatment for autism, however, families who use behavioral treatments for autism commonly use other treatments as well (Goin-Kochel, Myers, & Mackintosh, 2007;Green, et. al., 2006). ...
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The present research is based on studies in the areas of psychology, pedagogy and design. It was investigated the reading process and reading education strategies of individuals with autism spectrum disorders (ASD) with the purpose of developing a typographic system to assist pedagogues and to develop educational aids appropriate for child's reading problems. It was used interdisciplinary research methodology in this thesis with literature study, interviews with experts and a survey study. The survey was based on the opinions and experiences of special education teachers and the following findings were presented:  The student with autism may have difficulties learning to read.
... Telehealth also opens opportunities for various care providers to collaborate and coordinate care across service systems. This is important, as caregivers of autistic youth typically are required to juggle multiple appointments across fragmented systems of care, noting that an autistic individual undergoes an average of four to seven treatments at any one time, with greater symptom severity resulting in even greater service use [9,10]. ...
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When it comes to service accessibility for autistic individuals, there exists a pipeline problem [...]
... Often, several treatments are combined to treat ASD (Bowker et al., 2011). In a study by Goin-Kochel et al. (2007), parents reported their children were enrolled in an average of 7 different interventions, including physical therapy, occupational therapy, and behavioral treatments, to address symptoms associated with ASD. This can be very overwhelming and daunting to parents trying to choose effective treatments (Mackintosh et al., 2012). ...
... When identifying potential interventions, parents are faced with an overwhelming amount of information (Miller et al., 2012;National Autism Center, 2015). For example, hundreds of different interventions exist for children with ASD with varying proof of effectiveness (Goin-Kochel et al., 2007;Miller et al., 2012;National Autism Center, 2015). These can range from drug treatments and diet therapies to behavioral, educational, and alternative interventions. ...
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Applied behavior analysis (ABA), which is often used as the basis for designing interventions for people with autism spectrum disorder (ASD), is highly misrepresented and underutilized in many countries. One country where ABA remains particularly difficult to access is France. One potential problem is that parents often rely on online resources such as social media to identify interventions for their children. Many of these sources of information do not accurately portray ABA, or even openly disapprove of the science. To examine this issue, we used a data-mining methodology to extract, categorize, and analyze 897 messages on ABA published in a popular French internet forum based on their type, tone, and accuracy. Although messages were generally accurate and approving of ABA, our results showed that one in three messages fully or partially disapproved of the science, and one in four messages contained some inaccurate information. Our analyses also indicated that parents were more likely to approve of ABA than individuals with ASD. Finally, we found that the number of approving messages published in the internet forum decreased with time, especially over the last five years. Together, these results support the relevance of developing systems-level approaches to dispel misconceptions about ABA in languages other than English.
... Of those children, it is estimated that 20% or more have disabilities (Davis, 2014). On average, military families of children with disabilities use six disability services (ranging from 4-7) per week (Goin-Kochel et al., 2007). Such services include speech, occupational, and physical therapies, social skills groups, medical specialists, and parent training. ...
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When children with disabilities receive appropriate services, they experience long-term developmental benefits. Yet, military families of children with disabilities in the United States report lacking access to needed services and having difficulty navigating service delivery systems. Unlike civilian families, military families face added stressors such as deployment and relocation. Parent advocacy may be critical for military families of children with disabilities to access needed services. However, little research has explored advocacy among military families. The purpose of this exploratory study was to examine the advocacy experiences of military families of children with disabilities. Using a snowballing sampling, we conducted individual interviews with 11 military parents of children with disabilities from five states. Participants reported unique military experiences (e.g., satisfaction with the coverage of their healthcare program but had difficulty navigating healthcare policies), barriers to advocacy (e.g., limited school resources), and facilitators to advocacy (e.g., perseverance and resilience). Based on the findings, implications for practice and research are discussed.
... For instance, consider the treatment programming for a young child diagnosed with ASD. Caregivers of children diagnosed with this disorder typically report consuming a wide range of different behavior therapies, concurrently, each to varying degrees (Goin-Kochel et al., 2007;Green et al., 2006). In a survey of caregiver treatment choices, Green et al. (2006) found that caregivers of children with ASD, on average, endorsed the use of up to eight behavior therapies at a time. ...
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Various treatment approaches have been determined efficacious for improving child behavior outcomes. Despite a variety of evidence-based options, consumers often disregard empirically supported treatments to pursue alternatives that lack empirical support, e.g. fad therapies. The choice to pursue therapies lacking empirical support has been considered as a 'gamble' on therapeutic outcomes and this form of risky choice has historically been explained using various cognitive heuristics and biases. This report translates quantitative analyses from the Operant Demand Framework to characterize how caregivers of children with behavioral issues consume treatment services. The operant demand framework is presented, its utility for characterizing patterns of treatment consumption is discussed, and a preliminary application of cross-price analyses of demand is performed to illustrate how various factors jointly influence treatment-related choice. Results indicated that caregivers endorsing interest in receiving behavioral parent training regularly pursued pseudoscientific alternatives as a functional substitute for an established therapy, despite explicit language stating a lack of evidence. These findings question the presumption of rationality in models of treatment choice as well as the degree to which scientific evidence influences the consumption of therapies. This report concludes with a discussion of Consumer Behavior Analysis and how quantitative analyses of behavior can be used to better understand factors that enhance or detract from the dissemination of evidence-based practices.
... Green et al. [47] showed that parents report the current use of an average of seven different treatment modalities (including CAM) for their children. This high number of different treatment options used is substantiated by some [49,50] but not all [51] studies and should be assessed more thoroughly on different national as well as socio-demographic levels. There are indications that higher levels of parental education, more severe symptoms, comorbid disorders and younger age of children with ASD are associated with CAM treatment use (see Table 2). ...
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Autism spectrum disorder (ASD) comprises a group of heterogeneous constellations characterized by deficits in cognitive, communicative, and social skills. ASD has no established etiology and the search for reliable biomarkers has proved to be difficult, giving rise to alternative theoretical accounts, including those related to nutrition. One such account posits that the proteins gluten and casein, derived from wheat and milk respectively, are causally involved in the symptomatic expression of the disorder. As a consequence, a diet devoid of such proteins has been hypothesized to ameliorate the behavioral symptoms of children with ASD. The scope of the present review is to analyze the effects of gluten-free and casein-free (GFCF) diets on children with autism. It has been shown that 8‒32% of parents of affected children report the current use of a GFCF diet regimen in their children. The majority of identified dietary intervention studies failed to meet basic methodological standards of interventional science. A comparison of studies conducted with adequate scientific rigor did not show any clear-cut results. In addition to the inconsistent pattern of results, findings of challenge studies largely failed to find behavioral effects after applying gluten/casein challenges to children with ASD. Studies of potential side effects suggest that it is important to monitor both aspects of nutritional adequacy and healthy physical development in children with ASD on a GFCF dietary regimen. In conclusion, evidence for the effectiveness of the GFCF diet in the treatment of autism is sparse. Rigorous scientific evaluations found no convincing evidence of therapeutic effects of the GFCF diet. Nevertheless, more sophisticated investigations should be conducted in order to identify possible benefits and harms of such a dietary approach, particularly in subgroups of individuals with ASD yet to be identified.
... En Chile existe poca información específica acerca de la ubicación escolar de NNA con Necesidades Educativas Especiales (NEE) Permanentes y en particular EA. Sin duda en los últimos años el Ministerio de Educación (MINEDUC) ha realizado grandes esfuerzos en pro de avanzar hacia un Sistema Escolar Inclusivo, que se refleja en el aumento progresivo del acceso a Proyecto de Integración Escolar particularmente a la enseñanza básica 26,27 . ...
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Introducción: Las personas del Espectro Autista (EA) enfrentan múltiples necesidades de salud, educación, proble mas sociales y económicos. La información disponible en Chile es insuficiente. Objetivo: Conocer el acceso y satisfacción con servicios de salud y educación, el impacto familiar y económico, estigma y calidad de vida de personas EA y sus familias en Chile. Sujetos y Método: Padres/cuidadores de perso nas EA respondieron la Encuesta de Necesidades de Cuidadores, desarrollada por Autism Speaks, que comprende: información demográfica, características de las personas EA (publicado previamente), utilización de servicios de salud y educación, percepciones de padres/cuidadores en satisfacción, im pacto, estigma y calidad de vida (que presenta esta publicación). Resultados: Participaron 291 cuida dores (86% madres), de 291 personas EA, 89% varones, de 1-40 años (X:10,4 DE:6,1). Se reporta un acceso insuficiente y poco específico a servicios de salud. Un 77% asiste regularmente a algún sistema escolar regular o especial. Las familias financian sobre 60% de terapias/atención médica y sobre 40% de apoyos educacionales específicos; un 25% refiere dificultades de acceso a servicios. La economía familiar se afecta por renuncia (35%) o reducción de jornadas laborales de los cuidadores (46%). El estigma se asocia a posible discriminación y sentimientos de impotencia. Las principales prioridades mencionadas para una mejor calidad de vida son apoyos para escolaridad inclusiva, mejor adaptación en el hogar y mejorar la socialización. Conclusiones: Esta encuesta aporta información relevante acerca de las necesidades, barreras y desafíos de las personas EA en Chile. Destacan las dificultades de acceso a servicios de salud y el severo impacto sobre el ingreso económico familiar. Existe estigma, discriminación e impotencia. Se requiere elaborar estrategias colaborativas para mejorar la calidad y acceso a servicios y reducir la carga económica y de salud mental familiar.
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Background: Autism spectrum disorder is a neurodevelopmental disorder characterised by social communication difficulties, restricted interests and repetitive behaviours. The clinical pathway for children with a diagnosis of autism spectrum disorder is varied, and current research suggests some children may not continue to meet diagnostic criteria over time. Objectives: The primary objective of this review was to synthesise the available evidence on the proportion of preschool children who have a diagnosis of autism spectrum disorder at baseline (diagnosed before six years of age) who continue to meet diagnostic criteria at follow-up one or more years later (up to 19 years of age). Search methods: We searched MEDLINE, Embase, PsycINFO, and eight other databases in October 2017 and ran top-up searches up to July 2021. We also searched reference lists of relevant systematic reviews. Selection criteria: Two review authors independently assessed prospective and retrospective follow-up studies that used the same measure and process within studies to diagnose autism spectrum disorder at baseline and follow-up. Studies were required to have at least one year of follow-up and contain at least 10 participants. Participants were all aged less than six years at baseline assessment and followed up before 19 years of age. Data collection and analysis: We extracted data on study characteristics and the proportion of children diagnosed with autism spectrum disorder at baseline and follow-up. We also collected information on change in scores on measures that assess the dimensions of autism spectrum disorder (i.e. social communication and restricted interests and repetitive behaviours). Two review authors independently extracted data on study characteristics and assessed risk of bias using a modified quality in prognosis studies (QUIPS) tool. We conducted a random-effects meta-analysis or narrative synthesis, depending on the type of data available. We also conducted prognostic factor analyses to explore factors that may predict diagnostic outcome. Main results: In total, 49 studies met our inclusion criteria and 42 of these (11,740 participants) had data that could be extracted. Of the 42 studies, 25 (60%) were conducted in North America, 13 (31%) were conducted in Europe and the UK, and four (10%) in Asia. Most (52%) studies were published before 2014. The mean age of the participants was 3.19 years (range 1.13 to 5.0 years) at baseline and 6.12 years (range 3.0 to 12.14 years) at follow-up. The mean length of follow-up was 2.86 years (range 1.0 to 12.41 years). The majority of the children were boys (81%), and just over half (60%) of the studies primarily included participants with intellectual disability (intelligence quotient < 70). The mean sample size was 272 (range 10 to 8564). Sixty-nine per cent of studies used one diagnostic assessment tool, 24% used two tools and 7% used three or more tools. Diagnosis was decided by a multidisciplinary team in 41% of studies. No data were available for the outcomes of social communication and restricted and repetitive behaviours and interests. Of the 42 studies with available data, we were able to synthesise data from 34 studies (69% of all included studies; n = 11,129) in a meta-analysis. In summary, 92% (95% confidence interval 89% to 95%) of participants continued to meet diagnostic criteria for autism spectrum disorder from baseline to follow-up one or more years later; however, the quality of the evidence was judged as low due to study limitations and inconsistency. The majority of the included studies (95%) were rated at high risk of bias. We were unable to explore the outcomes of change in social communication and restricted and repetitive behaviour and interests between baseline and follow-up as none of the included studies provided separate domain scores at baseline and follow-up. Details on conflict of interest were reported in 24 studies. Funding support was reported by 30 studies, 12 studies omitted details on funding sources and two studies reported no funding support. Declared funding sources were categorised as government, university or non-government organisation or charity groups. We considered it unlikely funding sources would have significantly influenced the outcomes, given the nature of prognosis studies. Authors' conclusions: Overall, we found that nine out of 10 children who were diagnosed with autism spectrum disorder before six years of age continued to meet diagnostic criteria for autism spectrum disorder a year or more later, however the evidence was uncertain. Confidence in the evidence was rated low using GRADE, due to heterogeneity and risk of bias, and there were few studies that included children diagnosed using a current classification system, such as the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the eleventh revision of the International Classification of Diseases (ICD-11). Future studies that are well-designed, prospective and specifically assess prognosis of autism spectrum disorder diagnoses are needed. These studies should also include contemporary diagnostic assessment methods across a broad range of participants and investigate a range of relevant prognostic factors.
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Individuals with autism spectrum disorder (ASD) engage in less physical activity than typically-developing peers. This can result in serious negative consequences for individual well-being and may contribute to the physical, behavioral, and emotional challenges associated with ASD. This study explored the potential benefits of trainer-led, individualized, physical fitness sessions specialized for ASD. Eleven individuals (ages 7–24 years) with ASD were assessed at baseline and following 15 fitness sessions. Participants demonstrated improvements in core and lower-body strength and reductions in restricted and repetitive patterns of behavior, along with non-significant but marked reductions in issues with daytime sleepiness. Results suggest the merit of specialized fitness programs and emphasize the need for larger and more rigorous research studies on this topic.
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Each year, millions of children in the United States are exposed to intimate partner violence. Although the body of research on these children and factors that enhance their resiliency is growing, little is known about children with intellectual and developmental disabilities who have also been exposed to intimate partner violence. This knowledge gap is notable given the prevalence of intellectual and development disabilities among children, as well as the numerous challenges facing these children and their families (e.g., medical and behavioral challenges, parenting stress, and financial burden). Informed by prior research and our practice experience, this commentary highlights information for service providers working with families experiencing both intimate partner violence and intellectual and developmental disabilities. In addition to providing an overview of children’s exposure to intimate partner violence and an overview of intellectual and developmental disabilities, the commentary summarizes the limited research exploring the intersection between these two issues and offers recommendations for enhancing research and practice. Recommendations center on the importance of training, wrap-around and tailored services, community partnerships, and intervention research focused on survivors and their children with intellectual and developmental disabilities.
Article
Research suggests that access to early intervention can improve a range of outcomes for children with autism spectrum disorder (ASD). However, little is known about the type and amount of intervention that is typically available to young children with ASD in the New Zealand community. There is also limited information about parent demand for types or amounts of early intervention services in New Zealand. Therefore, this study aimed to evaluate parent reported use of, and demand for, early intervention services for young children with ASD in New Zealand. This information was gained from an online questionnaire which was completed by 64 parents/caregivers of preschool aged children with ASD living in New Zealand. It was reported that, on average, children were receiving 2 types of intervention and parents would like them to receive an additional 5 types. On average, children were reportedly receiving 8.7 hours of intervention per month and parents would like them to receive an additional 37 hours per month. The most common intervention that children were receiving was speech and language therapy. These findings suggest that parents would like a wider variety and more hours of educational early interventions than they are currently able to access.
Article
Purpose: The aim is to understand what therapies and interventions families in a low and middle income (LMIC) country, such as Vietnam resort to in their attempts to seek care for their children with ASD and why they choose these therapies. Methods: We undertook semi-structured qualitative interviews with 27 parents of children with autism and an online survey of 112 parents as part of a broader ethnographic study over one year augmented with recent interactional observations and a review of social media. Results: There is limited access to formal interventions for families with children with ASD in Vietnam. Rather, families resort to syncretic care using an average of 6.8 different interventions per child. These included: speech therapy; physical therapy; prescribed medicines; and ABA as well as geomancy, special dietary regimes, biochemical testing, stem cell therapies and religious and cultural practices. Despite having low incomes, the families surveyed spent an average USD 345 per month on interventions, many of which are not evidence-based. Desire to care and potentially "cure" their children within a context of stigma associated with ASD drives parents to seek all possible interventions for their children. Conclusions: There remains a large gap in access to appropriate evidence-based interventions or trained therapists for families. Further information for parents, culturally appropriate guidelines for effective interventions, more trained rehabilitation professionals and regulation is required.IMPLICATIONS FOR REHABILITATIONWithin low and middle income countries (LMIC), such as Vietnam there is a lack of intervention services, difficulties in accessing appropriate specialists, poor quality care and the costs of care.Families seek a range of formal interventions and costly informal therapies as well as culturally specific practices to care for their child/ren and require information on effective therapies.In LMIC training programs to build capacity for allied health professionals need to be implemented on the latest evidence-based therapies.It is important to develop culturally appropriate Vietnamese guidelines to support interventions for children with ASD.
Article
Objective Despite limited evidence, children with neurodevelopmental and psychological disorders may be having dietary interventions incorporated into treatment. Little is known about psychologists’ role in influencing these decisions. Method Australian psychologists working with children (N=60) completed the Nutritional Competence Tool, and questions exploring psychologist attitudes, self-reported competence and practices associated with the use of dietary interventions for children presenting for psychological treatment of psychological disorders. Results Most respondents reported positive attitudes towards dietary interventions. Incorporating dietary interventions into clinical practice was common, with 56.7% reporting they would be likely to recommend one or more dietary interventions pre-specified for one of the conditions explored. Participants were most likely to endorse the use of dietary interventions for children presenting with oppositional defiant disorder, conduct disorder or other behavioural problems. Conclusion Despite training in evidence-based practice, some registered psychologists have positive attitudes towards dietary modifications in the treatment of children with psychological conditions, and may be susceptible to recommending dietary interventions, regardless of the limited evidence base. The conditions for which recommendations were most likely, as well as diets most commonly recommended had hallmark features of “fads”, raising several ethical concerns. Further research should determine how widespread this practise is. Key Points What is already known about this topic: • Dietary interventions do not have a robust evidence-base in treating psychological and neurodevelopmental disorders. • Children often receive dietary modification to aid the amelioration of symptoms of psychological and neurodevelopmental disorders. • Limited research suggests that psychologists may be contributing to the use of complementary and alternative treatments. What this paper adds: • Some psychologists have positive attitudes towards dietary interventions for a range of psychological disorders in childhood. • Some psychologists report that they are likely to recommend dietary interventions for children presenting for psychological treatment. • Oppositional defiant disorder and conduct disorder were the conditions most likely elicit information about dietary interventions or recommendations to consider a dietary interventions.
Article
Little is known about differences in the allocation of special education services to students with autism compared with students with other primary learning differences (e.g., intellectual disability [ID], specific learning disability [SLD]) and the comparative impact of sociodemographic factors on special education service receipt. The present study aimed to compare allocation of services (i.e., quantity and types) between students eligible for special education services under autism, SLD and ID, and to identify differences in sociodemographic predictors (e.g., race, neighborhood income) of service allocation. Data were culled from special education administrative records from a large urban, primarily Hispanic, Latino, or Spanish‐serving school district from academic years 2011–2012 to 2016–2017. Participants included N = 76,428 students (Nautism = 18,151, NSLD = 54,001, NID = 4,276) ages 2–18. Results showed that autistic students received, on average, more services than students with SLD. Services received by students served under autism and SLD eligibility were more congruent with areas of need (e.g., language, occupational therapy) relative to students served under ID. Student‐level socioeconomic status (free and reduced lunch) was more positively predictive of the number of special education services received than the neighborhood income of the school the student attended. Finally, the most significant racial disparities in service allocation were observed among students served under autism eligibility. The present study demonstrates the critical role of economic resources in the quantity and types of services received, and the desirability of a public education for well‐resourced families who are possibly best situated to navigate special education services. Lay Summary An eligibility of autism in special education confers a significant advantage in the number of services a student receives. Disparity in the quantity of special education services exists among autistic students across many sociodemographic factors. Most notably, greater allocation of services to non‐Hispanic, Latino, or Spanish, White American, European American, or Middle Eastern American students and students who do not receive free and reduced lunch.
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Animal-Assisted Therapy (AAT) is an intervention for children with Autism Spectrum Disorder (ASD). This study explores parent perspectives of the impact of five AAT sessions involving trained dogs with their children with ASD. A phenomenological qualitative approach was used to explore first-hand perspectives of parents. In-depth, semi-structured interviews were conducted. Data were analyzed using thematic analysis. Seventeen parents reported that the presence of the dogs facilitated their children’s engagement, enjoyment, and motivation. Parents also reported that this contributed to gains in the child’s communication with others and the dog (n = 11, 64.7%), behavioral regulation (n = 12, 70.6%), and community participation (n = 14, 82.3%). These findings indicate that parents supported the use of AAT and that dogs facilitated therapeutic gains.
Article
Background: Although Medicaid coverage of treatment for children with autism spectrum disorder (ASD) is expanding, we know little about when children receive speech‐language, occupational, and/or physical therapy. The objective of this study was to examine the relationships between predisposing, enabling and need characteristics and utilization of speech‐language, occupational, and physical therapy by diagnosis of autism spectrum disorder (ASD). Methods: We integrated administrative, Medicaid, and Census data using a large sample of children with ASD who enrolled in a 1915(c) Home and Community Based Medicaid waiver in a Southeastern state (N=1968) to explore: 1) the percent of treatment utilization by ASD diagnosis; 2) the type of therapy utilized; and 3) the predisposing, enabling, and need characteristics associated with utilization. Results: The percent of utilization was 71%; 65.8% utilized SLT, 33.4% utilized OT, and 18.4% utilized PT. Enabling (i.e., urbanicity, age of diagnosis, early intervention program enrollment) and need (i.e., Intellectual Disability) characteristics were associated with utilization while predisposing social characteristics (i.e., sex and child race‐ethnicity, and neighborhood racial composition, poverty, and affluence) were not associated with utilization. Conclusions: Findings highlight the value in monitoring when children begin treatment. As governments in the U.S. and globally work to maximize children’s potential, additional research that can inform efforts to facilitate earlier utilization will be key to promoting optimal outcomes.
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Social deficits remain one of the most difficult areas for individuals with autism spectrum disorders (‘ASD’), especially for those with average or above average cognitive skills. An intervention often used to treat social deficits for these individuals is social skills groups. This review synthesized the results of five randomized controlled trials of social skills groups including 196 individuals with autism spectrum disorders (aged 6 to 21 years). We found individuals receiving treatment showed some indications of improved social competence and better friendships when compared with those not receiving treatment. Participants receiving treatment also showed indications of less loneliness. The ability to recognize different emotions was measured in two studies and there was no evidence that it was improved by taking part in a social skills group. Social communication as it relates to idiomatic expressions was only reported in one study and no significant differences between treatment and control group were found. Nor was there evidence of a beneficial effect of social skills groups on parental or child depression. No adverse effects were reported in the studies. Limitations of this review include a small number of studies and participants, and a high risk of bias due to parents knowing whether their child was in the intervention group or not. The studies focused mainly on children with ASD aged 7 to 12 with average or above average intelligence, and they were all carried out in the US. Abstract BACKGROUND Since autism was first described, major difficulties in social interaction have been a defining feature of individuals with autism spectrum disorders (ASD). Social skills groups are a common intervention for individuals with ASD. Although a frequently recommended practice, the few studies that have addressed the efficacy of social skills groups have shown mixed results. OBJECTIVES To determine the effectiveness of social skills groups for improving social competence, social communication, and quality of life for people with ASD who are six to 21 years of age. SEARCH STRATEGY We searched the following databases in December 2011: CENTRAL (2011 Issue 4), MEDLINE (1948 to November Week 3, 2011), EMBASE (1980 to Week 50, 2011), PsycINFO (1887 to December Week 2, 2011), CINAHL (1937 to current), ERIC (1966 to current), Sociological Abstracts (1952 to current), OCLC WorldCat (12 December 2011), Social Science Citation Index (1970 to 16 December 2011), and the metaRegister of Controlled Trials (20 December 2011). We also searched the reference lists of published papers. SELECTION CRITERIA Randomized control trials (RCTs) comparing treatment (social skills groups) with a control group who were not receiving the treatment for participants aged six to 21 years with ASD. The control group could be no intervention, wait list, or treatment as usual. Outcomes sought were standardized measures of social competence, social communication, quality of life, emotion recognition, and any other specific behaviors. DATA COLLECTION AND ANALYSIS Two review authors independently selected and appraised studies for inclusion and assessed the risk of bias in each included study. All outcome data were continuous and standardized mean difference effect sizes (ES) with small sample correction were calculated. We conducted random‐effects meta‐analysis where possible. RESULTS We included five RCTs evaluating the effects of social skills groups in 196 participants with ASD aged 6 to 21 years old. The results show there is some evidence that social skills groups improve overall social competence (ES = 0.47, 95% confidence interval (CI) 0.16 to 0.78, P = 0.003) and friendship quality (ES = 0.41, 95% CI 0.02 to 0.81, P = 0.04) for this population. No differences were found between treatment and control groups in relation to emotional recognition (ES = 0.34, 95% CI ‐0.20 to 0.88, P = 0.21) assessed in two studies or social communication as related to the understanding of idioms (ES = 0.05, 95% CI ‐0.63 to 0.72, P = 0.89), which was assessed in only one study. Two additional quality of life outcomes were evaluated, with results of single studies suggesting decreases in loneliness (ES = ‐0.66, 95% CI ‐1.15 to ‐0.17) but no effect on child or parental depression. No adverse events were reported. Given the nature of the intervention and the selected outcome measures, the risk of performance and detection bias are high. There is limited generalizability from the studies as they were all conducted in the US; they focused mainly on children aged 7 to 12, and the participants were all of average or above average intelligence. AUTHORS' CONCLUSIONS There is some evidence that social skills groups can improve social competence for some children and adolescents with ASD. More research is needed to draw more robust conclusions, especially with respect to improvements in quality of life. Plain language summary Social deficits remain one of the most difficult areas for individuals with autism spectrum disorders, especially for those with average or above average cognitive skills. An intervention often used to treat social deficits for these individuals is social skills groups. This review synthesized the results of five randomized controlled trials of social skills groups including 196 individuals with autism spectrum disorders (aged 6 to 21 years). We found individuals receiving treatment showed some indications of improved social competence and better friendships when compared with those not receiving treatment. Participants receiving treatment also showed indications of less loneliness. The ability to recognize different emotions was measured in two studies and there was no evidence that it was improved by taking part in a social skills group. Social communication as it relates to idiomatic expressions was only reported in one study and no significant differences between treatment and control group were found. Nor was there evidence of a beneficial effect of social skills groups on parental or child depression. No adverse effects were reported in the studies. Limitations of this review include a small number of studies and participants, and a high risk of bias due to parents knowing whether their child was in the intervention group or not. The studies focused mainly on children with ASD aged 7 to 12 with average or above average intelligence, and they were all carried out in the US.
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This article discusses intervention and treatment options being used with the population of children and youth who have autism spectrum disorders. The discussion includes interventions based on relationship formation, skill-based treatments, physiologically oriented interventions, and comprehensive educational and treatment programs. In a follow-up article, court decisions related to intervention options for students with autism are discussed, along with recommendations for choosing interventions and treatments that have the best chance of producing desired outcomes.
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reviews scientific studies on interventions other than behavioral treatment / nonbehavioral special education classes, which are the main service-providers for most children with autism are discussed first, followed by descriptions of individual therapies, which often supplement classroom instruction / 3 kinds of individual therapies, each having several variants, are considered: (a) speech and language therapies, (b) sensory-motor therapies, and (c) psychotherapies / biological interventions, such as medications and special diets, are examined special education [project TEACCH, other public school classes, the Higashi school] / sensory-motor therapies [sensory integration therapy, auditory integration training, facilitated communication] / psychotherapies [psychoanalysis] / biological treatments [megavitamins, prevention and treatment of infections] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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We now know that professionals can diagnose children with autism when they are as young as 2 years of age (Lord, 1995). Screening and the role of the pediatrician have become even more critical as we have recognized the stability of early diagnosis over time and the importance of early intervention. At this point, experts working with children with autism agree that early intervention is critical. There is professional consensus about certain crucial aspects of treatment (intensity, family involvement, focus on generalization) and empirical evidence for certain intervention strategies. However, there are many programs developed for children with autism that differ in philosophy and a lack of research comparing the various intervention programs. Most of the programs for children with autism that exist are designed for children of preschool age, and not all are widely known or available. While outcome data are published for some of these programs, empirical studies comparing intervention programs are lacking. In this review, existing intervention programs and empirical studies on these programs will be reviewed, with a particular emphasis on the birth to 3 age group.
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The plasma amino acid profiles of 36 children with autism spectrum disorders were reviewed to determine the impact of diet on amino acid patterns. Ten of the children were on gluten and casein restricted diets administered by parents, while the other 26 consumed unrestricted diets. No amino acid profile specific to autism was identified. However, children with autism had more essential amino acid deficiencies consistent with poor protein nutrition than an age/gender matched control group. There was a trend for children with autism who were on restricted diets to have an increased prevalence of essential amino acid deficiencies and lower plasma levels of essential acids including the neurotransmitter precursors tyrosine and tryptophan than both controls and children with autism on unrestricted diets. These data indicate that larger, more focused studies of protein nutrition in children with autism are needed in order to determine the extent to which restricted diets might place the developing brains of children with autism at risk from protein malnutrition. The high rate of tryptophan and tyrosine deficiency in this group is also of concern given their role as neurotransmitter precursors.
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Our understanding and treatment of children with autism have changed dramatically since Leo Kanner first formally documented the disorder in 1943. With reference to the historical context, this paper reviews recent research addressing 4 major issues: early detection, intervention, education, and psychopharmacological management of children with autism and related (autistic) spectrum disorders (hereafter, “autism”). We conclude from our review of the evidence that, in the absence of additional, more compelling data, the clinical usefulness of existing screening instruments remains questionable. However, the potential importance of such research is underscored by the clear benefits of early behavioural intervention: despite differences in orientation, outcomes for children with autism can be significantly enhanced with early intensive intervention. Although many questions remain (notably, What are the critical therapeutic components? For whom? For what domains of development? For what level of intensity and duration?), interventions shown to be effective are all carefully planned, engineered, monitored, and designed to target specific skill domains. Including children with autism in regular classes within the public school system poses several challenges, the most pressing of which is the large number of school personnel who need to be trained in evidence-based teaching and behavioural management practices. Finally, psychotropic drugs may help to reduce some symptoms, but they are neither curative nor a substitute for other forms of support and intervention.
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To date, there have been few surveys of psychotropic and antiepileptic drug (AED) prevalence in individuals with autism-spectrum conditions. We surveyed 747 families in the Autism Society of Ohio regarding the use of psychotropic drugs, AEDs, and over-the-counter (OTC) preparations for autism. In all, 417 families (55.8%) replied. A total of 45.6% were taking some form of psychotropic agent (including St. John's wort and melatonin), whereas 11.5% were taking AEDs, and 10.3% took OTC autism preparations. The most common psychotropic agents included antidepressants (21.6%), antipsychotics (14.9%), antihypertensives (12.5%), and stimulants (11.3%). Some 51.6% were prescribed psychotropic drugs or AEDs, and 55.4% took psychotropic drugs, AEDs, or autism supplements. Demographic variables frequently found to be associated with medication use included greater age, more severe autism, more severe intellectual handicap, and housing outside the family home. Whereas there is empirical support for the use of some of these psychotropic agents in autism, others are being prescribed with minimal research support. OTC autism preparations were used in substantial numbers of individuals, despite limited research support and the possibility of toxic effects.
Article
Interventions considered to be CAM are in constant flux. New treatments emerge, older treatments become less popular, and the cycle recurs. Data supporting new treatments should be scrutinized for scientific study design, clinical safety, and scientific validity. Many families approach the clinician armed with brochures, handouts, and printouts from Web sites that are dedicated to the care and support of parents and children with ASD. A recent web search using "autism and detoxification" resulted in almost 8,000 sites. The Defeat Autism Now! (DAN!) Project arose in 1995 from collaboration of members of the Autism Research Institute. The DAN! Project advocates a specific and extensive protocol for diagnosis and treatment and can be viewed at http://www.autism.com/ari/#dan. The scientific validation and support for many interventions is incomplete and disparate from the recommendation in the American Academy of Pediatrics Policy Statement. Families should be encouraged to discuss all proposed investigations or treatments they wish to try with their primary care provider so the practitioner can serve as the medical home (Sidebar, page 688). The clinician should communicate and collaborate with the family and educational professionals to encourage objective identification of what works. With increasing access to health information and societal pressure for families to actively participate in their health management, continued growth of interest in CAM can be anticipated. Clinicians must remember that parents may have different beliefs regarding the effectiveness of treatment and different tolerance for treatment risks. Practitioners must keep avenues of communication open, remain open-minded, and not assume a "don't ask, don't tell" posture in the context of providing a medical home to the increasing number of children diagnosed with autism.
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This study examined the prevalence and correlates of use of different types of complementary and alternative medicine (CAM) among a sample of children with suspected or recently diagnosed autism. The authors' review of 284 charts of children seen at the Regional Autism Center of The Children's Hospital of Philadelphia, Pennsylvania, found that more than 30% of children were using some CAM, and that 9% were using potentially harmful CAM. Having an additional diagnosis was protective against CAM use and being Latino was associated with CAM use. Having seen a prior provider regarding the child's health condition was predictive of potentially harmful CAM use. Further research is required on cultural differences in treatment decisions about CAM, as well as the reasons for the association between the use of prior providers and CAM. The high prevalence of CAM use among a recently diagnosed sample indicates that clinicians should discuss CAM early in the assessment process.
Article
We developed an Internet survey to identify treatments used by parents of children with autism. The survey listed 111 treatments and was distributed via colleagues and through chapters of the Autism Society of America and Autism Organizations Worldwide. A total of 552 parents submitted usable returns during the 3-month survey period. On average the parents reported using seven different treatments. The number of treatments used varied as a function of the child's age and type/severity of disability within the autism spectrum. Speech therapy was the most commonly reported intervention, followed by visual schedules, sensory integration, and applied behavior analysis. In addition, 52% of parents were currently using at least one medication to treat their child, 27% were implementing special diets, and 43% were using vitamin supplements. Because parents were using a large number of treatments, many of which lack empirical support, future research should focus on understanding the decision-making processes that underlie treatment selection by parents of children with autism.
Article
In no area of developmental pediatric practice is there more controversy regarding the choice of treatment than related to children with autistic spectrum disorders (ASD). Complementary and alternative medical therapies (CAM) are often elected because they are perceived as treating the cause of symptoms rather than the symptoms themselves. CAM used for autism can be divided by proposed mechanism: immune modulation, gastrointestinal, supplements that affect neurotransmitter function, and nonbiologic intervention. Secretin as a therapy for autism is discussed as an example of how a clinical observation rapidly grew to a widespread treatment before well-designed studies demonstrated absence of effect. The plausibility for behavioral effect was not substantiated by clinical studies. CAM used for treatment of autism is examined in terms of rationale, evidence of efficacy, side effects, and additional commentary. Families and clinicians need access to well-designed clinical evidence to assist them in choice of therapies.
Article
This study examined the treatment rates and patterns in children and adolescents with autism spectrum disorders (ASDs). Data were collected on 353 nonreferred children and adolescents (mean age 9.5 +/- 3.9 years; range 3-21 years) with ASDs from public schools across Ohio. Parents provided information on the use of psychotropic medicines, vitamins, supplements, and modified diets. They also completed measures of social competence, problem behavior, and adaptive behavior. Results indicated that 46.7% of subjects had taken at least one psychotropic medication in the past year. In addition, 17.3% of subjects had taken some type of specially formulated vitamin or supplement, 15.5% were on a modified diet, 11.9% had some combination of psychotropic medication and an alternative treatment, and 4.8% had taken an anticonvulsant. Logistic regressions indicated that greater age, lower adaptive skills and social competence, and higher levels of problem behavior were associated with greater medication use. This was the first study to focus exclusively on a younger population, to survey patterns of modified diets, and to obtain standardized ratings of social competence, problem behaviors, and adaptive behavior in relation to medication use. The results of this study highlight the need for more research on psychotropic medication in children and adolescents with ASDs.
Article
One of the areas receiving the greatest attention from researchers studying autism spectrum disorders in recent years involves psychologically based early intervention programs. Various claims of cure, marked improvement in social and communication skills, and improved I.Q. are among the conclusions that have been drawn by various researchers. However, little has been done to analyze the dependent variables used in these studies and their impact on the conclusions reached regarding treatment effectiveness. Obviously, this set of measures is crucial since these methods define which behaviors "improved" and to what extent. The present review analyzes the current status, strengths, and weaknesses of these measurements.
Frequency and correlates of treatment use among a community sample of children with autism. Paper presented at the International Meeting for Autism Research
  • D S Mandell
  • M M Novak
  • S E Levy
Mandell, D. S., Novak, M. M., & Levy, S. E. (May 2005). Frequency and correlates of treatment use among a community sample of children with autism. Paper presented at the International Meeting for Autism Research. Boston, Massachusetts.
Psychopharmacology Handbook of autism and pervasive developmental disorders Are other treatments effective Behavioral intervention for children with autism: A manual for parents and professionals
  • L Scahill
  • A Martin
Scahill, L., & Martin, A. (2005). Psychopharmacology. In F. R. Volmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (3rd ed., pp. 1102–1117). Hoboken, NJ: John Wiley & Sons, Inc. Smith, T. (1996). Are other treatments effective? In C. Maurice, G. Green, & S. C. Luce (Eds.), Behavioral intervention for children with autism: A manual for parents and professionals (pp. 45–59). Austin, TX: Pro-Ed.
Early intervention for ASD spectrum disorders: A critical analysis
  • J L Matson
  • N F Minshawi
Matson, J. L., & Minshawi, N. F. (2006). Early intervention for ASD spectrum disorders: A critical analysis. Oxford, England: Elsevier Science Inc.
And then what happened? A survey of parent use, perceptions, and evaluations of therapies for children with autism in Canterbury
  • Le Grice
  • B Mcmenamin
Le Grice, B., & McMenamin, T. (March 2002). And then what happened? A survey of parent use, perceptions, and evaluations of therapies for children with autism in Canterbury. Paper Session Presented at the Autism New Zealand Conference. Auckland, New Zealand.
Bolded items denote significance. a Early childhood = 1
  • Note
Note. Bolded items denote significance. a Early childhood = 1.7–5.9 years, middle childhood = 6.0–11.9 years, adolescence = 12.0–21.9 years.
Are other treatments effective Behavioral intervention for children with autism: A manual for parents and professionals
  • T Smith
Smith, T. (1996). Are other treatments effective? In C. Maurice, G. Green, & S. C. Luce (Eds.), Behavioral intervention for children with autism: A manual for parents and professionals (pp. 45-59). Austin, TX: Pro-Ed.
Internet survey of treatments used by parents of children with autism
  • V A Green
  • K A Pituch
  • J Itchon
  • A Choi
  • M O 'reilly
  • J Sigafoos
Green, V. A., Pituch, K. A., Itchon, J., Choi, A., O'Reilly, M., & Sigafoos, J. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities, 27, 70-84.
Autism spectrum disorders: Early detection, intervention, education, and pharmacological management
  • S E Bryson
  • S J Rogers
  • E Fombonne
Bryson, S. E., Rogers, S. J., & Fombonne, E. (2003). Autism spectrum disorders: Early detection, intervention, education, and pharmacological management. Canadian Journal of Psychiatry, 48(8), 506-516.
Are other treatments effective
  • L Scahill
  • A Martin
Scahill, L., & Martin, A. (2005). Psychopharmacology. In F. R. Volmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (3rd ed., pp. 1102-1117). Hoboken, NJ: John Wiley & Sons, Inc. Smith, T. (1996). Are other treatments effective? In C. Maurice, G. Green, & S. C. Luce (Eds.), Behavioral intervention for children with autism: A manual for parents and professionals (pp. 45-59). Austin, TX: Pro-Ed.
Autism spectrum disorders: Early detection, intervention, education, and pharmacological management
  • Bryson
Internet survey of treatments used by parents of children with autism
  • Green