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Atypical behaviors in children with autism and children with a history of language impairment

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Abstract

The frequency, course, and inter-relationships of atypical eating, sleeping, self-injurious behavior, aggression and temper tantrums in children with autism and children with a history of language impairment (HLI), was investigated using a parent interview that was created to examine these problem behaviors. The relationships between these behaviors and language, IQ, severity of autistic symptoms and depression were also assessed. Atypical eating behavior, abnormal sleep patterns, temper tantrums, and self-injurious behavior were significantly more common in the children with autism than those with HLI. Within the autism group, children who exhibited more atypical behaviors tended to have a lower nonverbal IQ, lower levels of expressive language, more severe social deficits and more repetitive behaviors. No relationship between the number of atypical behaviors and measures of cognitive or language ability was noted in the HLI group. However, having more atypical behaviors was related to increased restricted, repetitive behaviors in children with HLI. The atypical behaviors could be divided into two groups: abnormal eating and sleeping, which were independent and tended to begin early in life; and self-injury, tantrums and aggression, which began later and were inter-related. Sleep abnormalities were more common in children (groups combined) diagnosed with major depression.

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... Estimates of prevalence increase with age. By conservative estimates, nearly a third of school-age children with ASD display aggressive behavior (32.8%; Dominick et al. 2007), with some estimates as high as 53-68% (Kanne and Mazurek 2011;Mazurek et al. 2013;McTiernan et al. 2011). Accordingly, 26% of parents and 31% of teachers identify externalizing behaviors as their primary behavioral concern among elementary school-aged children with ASD (Azad and Mandell 2016). ...
... Overall, rates of aggression were similar in verbal male and female youth with ASD in this sample, with approximately one quarter of the participants reported as having aggression that fell within the clinical or borderline clinical ranges of the CBCL. These rates are comparable to those reported in some samples of school-age children and adolescents with ASD (32.8%, Dominick et al. 2007), although lower than that of other reports (53-68%, Kanne and Mazurek 2011;Mazurek et al. 2013;McTiernan et al. 2011). Considering externalizing behaviors more broadly, over a third of our sample experienced heightened rates of behavioral concerns by parent report. ...
... Considering externalizing behaviors more broadly, over a third of our sample experienced heightened rates of behavioral concerns by parent report. Thus, although problem behaviors have often been inversely associated with cognitive skill (e.g., Dominick et al. 2007;Hartley et al. 2008), a substantial proportion of our sample-verbally-fluent youth with ASD without co-occurring intellectual disability-had marked parent-reported difficulties with externalizing behaviors. Overall, results provide preliminary evidence that externalizing behaviors among children and adolescents with ASD may be linked with factors at multiple levels. ...
Article
Aggressive behaviors are common among youth with autism spectrum disorder (ASD) and correlate with pervasive social-emotional difficulties. Communication skill is an important correlate of disruptive behavior in typical development, and clarification of links between communication and aggression in ASD may inform intervention methods. We investigate child/family factors and communication in relation to aggression among 145 individuals with ASD (65 female; ages 8–17 years). Overall, more severe aggression was associated with younger age, lower family income, and difficulties with communication skills. However, this pattern of results was driven by males, and aggression was unrelated to child or family characteristics for females. Future work should incorporate these predictors in conjunction with broader contextual factors to understand aggressive behavior in females with ASD.
... ÓËÙÈ΋ ·Ú·Í›·, ηıÒ˜ Î·È ÙÔ ÂÚ-¿ÙËÌ· ÛÙËÓ ¿ÎÚË ÙˆÓ ‰·ÎÙ ‡ÏˆÓ ΢ڛˆ˜ Û ÌÈÎÚ‹ ËÏÈΛ· (Bodfish et al., 2000. Green et al., 2002. Ming, Brimacombe & Wagner, 2007. ¶¤Ú· ·fi ·˘-Ù¿, ·Ó·Ê¤ÚÔÓÙ·È ÔÈ ÂÎÚ‹ÍÂȘ ı˘ÌÔ ‡ ("tantrums") Î·È ÔÈ ·˘ÙÔÙÚ·˘Ì·ÙÈΤ˜ ("self-injurious") Û˘ÌÂÚÈ-ÊÔÚ¤˜, ηıÒ˜ Â›Û˘ Ù· ¿Ù˘· ÚfiÙ˘· Ê·ÁËÙÔ ‡ Î·È ‡ÓÔ˘ (Allik et al., 2006. Dominick et al., 2007. Goodlin-Jones et al., 2008 (Wechsler, 1989), Mullen Scales of Early Learning (Mullen, 1997) Î·È LIPS [Leiter International Performance Scale] (Leiter, 1980 (Sparrow, Balla & Cicchetti, 1985) Î·È ComFor (Noens et al., 2006). °È· ÙËÓ ÈηÓfiÙËÙ· ÙÔ˘ ÏfiÁÔ˘ ‰È·Ù›ıÂÓÙ·È Ù· PPVT [Peabody Picture Vocabulary Test -Revised] (Dunn & Dunn, 1981) ...
... ÁÁÈÛË Ù˘ ·Ó-ıÚÒÈÓ˘ ÓfiËÛ˘ (Adolphs, 2006. Cozolino, 2006. Westermann et al., 2007. Barsalou, 2008 (Stahmer, Collins & Palinkas, 2006. Shattuck & Grosse, 2007. Howlin, 2008. (Bonnel et al., 2003. Mottron et al., 2006. O' Riordan & Passetti, 2006. ªing et al., 2007 Î·È Èı·ÓÒÓ ‰È·ÎÚÈÙÈÎÒÓ Î·ÏÏÈÙ¯ÓÈÎÒÓ Î·È ·Î·‰ËÌ·˚ÎÒÓ ÈηÓÔÙ‹ÙˆÓ ÙÔ˘˜ (Frith, 2003. Dominick et al., 2007. Baron-Cohen, 2008b . Frith, 2003. Baron-Cohen, 2008a (Frith, 2003. Baron-Cohen, 2003a, 2008a. ∂ÛÙÈ¿˙ÔÓÙ·˜, Â›Û˘, ÛÙËÓ ÈηÓfiÙËÙ· ÁÈ· £Ù¡, ÙÔ ÌÔÓÙ¤ÏÔ ·-Ú·‚ϤÂÈ, ·ÊÂÓfi˜ ÙË ÛËÌ·Û›· ¿ÏÏˆÓ Úfi‰ÚÔÌˆÓ ÎÔÈÓˆÓÈÎÒÓ ÈηÓÔÙ‹ÙˆÓ ÁÈ· ÙËÓ ·Ó¿Ù˘Í‹ ÙË ( Kaplan & Hafner, 2006. Mundy & Newell, 2007 Î·È ·ÊÂÙ¤ÚÔ˘, ÙË Û˘Ì‚ÔÏ‹ ¿ÏÏˆÓ ÓÔËÙÈÎÒÓ ÏÂÈ-ÙÔ˘ÚÁ ...
... on-Cohen, 2003a, 2008a. ∂ÛÙÈ¿˙ÔÓÙ·˜, Â›Û˘, ÛÙËÓ ÈηÓfiÙËÙ· ÁÈ· £Ù¡, ÙÔ ÌÔÓÙ¤ÏÔ ·-Ú·‚ϤÂÈ, ·ÊÂÓfi˜ ÙË ÛËÌ·Û›· ¿ÏÏˆÓ Úfi‰ÚÔÌˆÓ ÎÔÈÓˆÓÈÎÒÓ ÈηÓÔÙ‹ÙˆÓ ÁÈ· ÙËÓ ·Ó¿Ù˘Í‹ ÙË ( Kaplan & Hafner, 2006. Mundy & Newell, 2007 Î·È ·ÊÂÙ¤ÚÔ˘, ÙË Û˘Ì‚ÔÏ‹ ¿ÏÏˆÓ ÓÔËÙÈÎÒÓ ÏÂÈ-ÙÔ˘ÚÁÈÒÓ Û ·˘Ù‹ (Bonnel et al., 2003. Mottron et al., 2006. O' Riordan & Passetti, 2006. Dominick et al., 2007. ∆¤ÏÔ˜, ÙÔ ÌÔÓÙ¤ÏÔ ·˘Ùfi ‰ÂÓ Ï·Ì‚¿ÓÂÈ fi"Ë ÙÔ˘ ÙȘ ˘"ËϤ˜ ‰È·ÎÚÈÙÈΤ˜ ÂȉfiÛÂȘ ÙˆÓ ·ÙfiÌˆÓ Ì ˘"ËÏ¿ ÏÂÈÙÔ˘ÚÁÈÎfi ·˘ÙÈÛÌfi ‹ Û˘Óı‹-ÎË Asperger ÛÙ· Ì·ıËÌ·ÙÈο, ÙËÓ ÏËÚÔÊÔÚÈ΋, ÙË ˙ˆÁÚ·ÊÈ΋ Î·È ÙË ÌÔ˘ÛÈ΋ (Frith, 2003. Hill & Frith, 2003. Baron-Cohen, 2006, 2008b (Happé, 1999a, 1999b. Happé & Frith, 2006. OEÙÛÈ, ÂÚÌËÓ ‡ÔÓÙ·È ÔÈ ‰È·-ÎÚ ...
... In addition, atypical behavioral patterns and reactions are the most common sources of parental stress [47] and one of the most staggering obstacles in an autistic child's education [48]. Aggression towards oneself [49] and others [50], insistence on nonfunctional rituals and activities, noncompliance to behavior rules, and tantrums [50] are common among patients with ASD and cause more psychological familial distress than core autistic symptoms [47]. The level of intellectual development in children with ASD is a strong predictor of social and adaptive functioning in adult life [51] and is associated with restricted interests and repetitive behavior [52], sensory processing [53], language growth [54], atypical behavior and expressive language [50]. ...
... In addition, atypical behavioral patterns and reactions are the most common sources of parental stress [47] and one of the most staggering obstacles in an autistic child's education [48]. Aggression towards oneself [49] and others [50], insistence on nonfunctional rituals and activities, noncompliance to behavior rules, and tantrums [50] are common among patients with ASD and cause more psychological familial distress than core autistic symptoms [47]. The level of intellectual development in children with ASD is a strong predictor of social and adaptive functioning in adult life [51] and is associated with restricted interests and repetitive behavior [52], sensory processing [53], language growth [54], atypical behavior and expressive language [50]. ...
... Aggression towards oneself [49] and others [50], insistence on nonfunctional rituals and activities, noncompliance to behavior rules, and tantrums [50] are common among patients with ASD and cause more psychological familial distress than core autistic symptoms [47]. The level of intellectual development in children with ASD is a strong predictor of social and adaptive functioning in adult life [51] and is associated with restricted interests and repetitive behavior [52], sensory processing [53], language growth [54], atypical behavior and expressive language [50]. Sensory symptoms in infancy are associated with a higher risk of developing ASD [55]. ...
Article
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Background: Autistic spectrum disorder (ASD) is a significant socio-biological problem due to its wide prevalence and negative outcomes. In the current study, we aimed to develop an autism scale for early and accurate differentiation of 3- to 4-year-olds at risk for ASD since there is no systematic monitoring of young children in Russia yet. Methods: The total sample (N = 324) included 116 children with ASD, 131 children without ASD (healthy controls), and 77 children with developmental delay (DD). An online survey of specialists working with children was conducted based on a specially designed autism questionnaire consisting of 85 multiple-choice tasks distributed across 12 domains. Initially, each child was assessed by 434 items using a dichotomous scale (0 = no, 1 = yes). Factor and discriminant analyses were performed to identify a compact set of subscales that most accurately and with sufficient reliability predicted whether a child belongs to the ASD group. Results: As a result, four subscales were obtained: Sensorics, Emotions, Hyperactivity, and Communication. The high discriminability of the subscales in distinguishing the ASD group from the non-ASD group was revealed (accuracy 85.5–87.0%). Overall, the obtained subscales meet psychometric requirements and allow for creating an online screening system for wide application.
... In this sense, behavioral difficulties, such as tantrums, sleep disorders, and atypical eating behaviors, associated with comorbidities with other psychiatric disorders are often present in children with ASD, and the daily management of these problems is difficult for children. class of professionals and family members, in general [16]. It is known, however, that the practice of a limited diet for long periods may imply health risks for subjects in the development phase, considering the parameters of a new class of diagnosis, proposed by the DSM-V, referring to the eating disorder preventive/restrictive food [15]. ...
... Also, taking into account that limited food intake can trigger nutritional deficiencies of adequate development, as well as provoke gastrointestinal symptoms, it is expected that children with food selectivity represent significantly higher degrees of these deficiencies compared to children without food selectivity [16]. ...
Article
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Autism Spectrum Disorder (ASD) refers to an alteration in neurological development typified by deficits in social communication, as well as in restricted and repetitive patterns of behavior, interests, or activities, varying in a continuum demarcated by the severity levels of their symptomatic pictures. It is estimated that about 45 to 90% of children with ASD have deficiencies in their eating habits, which may include atypical eating patterns and persistent practices of food selectivity, thus limiting the diet of these subjects. Given this context, the present study has the central objective of discussing, through the bibliographic review, the implications resulting from selectivity and eating behaviors in children with an autism spectrum disorder. It is, therefore, a descriptive study with a qualitative approach, organized from a natural perspective, emphasizing in a contextualized and judicious way the analyzed theme. Literary findings suggest that the conduct of food selectivity is significant for both family members, through high levels of stress; as, and above all, for children with ASD, since they will be more likely to develop gastrointestinal disorders, low quality of life, reduced levels of nutrients necessary for their proper development and scurvy when compared to those with typical neurodevelopment. In this sense, it appears that recognition of the different clinical and behavioral patterns manifested in children with ASD through food selectivity, is an important issue for family members and professionals in their diverse clinical practices, considering that the recognition of these patterns will be immeasurable utility in the development of adequate and early treatment strategies.
... Pediatric feeding disorders affect around 25% of all children and up to 80% of children with developmental disabilities (Manikam & Perman, 2000). In children with Autism Spectrum Disorder (ASD) (American Psychiatric Association, 2013), feeding difficulties occur more frequently and with greater diversity than in children who are typically developing and those with other developmental disabilities (Schreck et al., 2004;Dominick et al., 2007). Up to 90% of children with ASD present with some feeding difficulties (Kodak & Piazza, 2008), with food selectivity (up to 70%) being the most common (Twachtman-Reilly et al., 2008). ...
... Food avoidance 36 *** 0.29 ** 0.49 *** 0.40 *** 0.51 *** Vissoker et al., 2015). Given these problems are frequent and diverse in this population (Schreck et al., 2004;Dominick et al., 2007), the availability of psychometrically valid and reliable instruments that can be used to assess eating behaviors is essential to both clinical management and the development of appropriate interventions. Although instruments such as the BAMBI/BAMBIC (Lukens & Linscheid, 2008;Hendy et al., 2013) have been critical in advancing the assessment of eating problems among children with ASD, newer instruments specific to ASD are required that expand upon the scope of behaviors assessed and address limitations of these existing measures. ...
Article
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The Aut-Eat Questionnaire (AEQ) provides a novel and comprehensive assessment of eating problems and patterns in children with ASD. To establish the internal consistency and discriminant validity of the AEQ, parents of children with ASD (n = 105, Mage = 40.85, SD = 15.67 months) or typical development (TD; n = 98, Mage = 50.33, SD = 16.50 months) completed the AEQ. Questionnaire construction, content validity, factor analysis, internal consistency and discriminant validity are reported. The AEQ was reliable with high internal consistency in most domains. Significant differences were found between groups in all domains. The AEQ is a reliable and valid tool and may help to characterize eating difficulties in this population.
... Early intensive behavioral intervention (EIBI) is an ABA-based treatment approach that targets the core and associated symptoms of ASD in young children (Howlin et al., 2009;Reichow et al., 2012;Roane et al., 2016). Early intensive behavioral intervention aims to reduce problem behavior (e.g., aggression, self-injury), which children with ASD often display (Dominick et al., 2007), and to increase prosocial, adaptive behavior (e.g., communication, social skills). Behavior analysts generally accomplish this through a combination of structured (e.g., discrete-trial training) and naturalistic or play-based training approaches (Klintwall & Eikeseth, 2014;Roane et al., 2016). ...
Article
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Parents play an important role in the treatment of their children's symptoms of autism spectrum disorder (ASD); thus, developing effective, efficient, socially acceptable, and accessible procedures for training parents to implement applied-behavior-analysis (ABA) interventions is critically important. One potential approach involves delivering training via a virtual private network (VPN) over the internet (Fisher et al., 2014). In this study, we conducted a randomized clinical trial to evaluate a virtual parent-training program with e-learning modules and scripted role-play via a VPN. We evaluated parent implementation of ABA skills using direct-observation measures in structured-work and play-based training contexts. Parents in the treatment group showed large, statistically significant improvements on all dependent measures; those in the waitlist-control group did not. Parents rated the training as highly socially acceptable. Results add to the growing literature on the efficacy and acceptability of virtually delivered training in ABA.
... They have a habit of choosing food because they are obsessed. [22] The research by Fombonne [23] showed that autism is more common in men. The ratio of men to women is 4,3 to 1. Therefore, men are in the high-risk group compared to women. ...
Article
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Autism spectrum disorder (ASD) is a disorder that develops as a result of some neuronal abnormalities. It may be caused especially during pregnancy, or genetic factors. In addition, communication problems and repetitive behaviors are characteristic symptoms. However, does not really have a specific treatment. Cholesterol, a crucial molecule for cells, has recently attracted attention for its impact on neurons and ASD. The function of cholesterol in brain development and its impact on inflammation should help researchers understand better how cholesterol affects ASD. Children with ASD have also been observed to have complications with cholesterol and lipid metabolism. These factors show that cholesterol may play a key role in ASD.
... Moreover, the ESDM group showed more improvement in the area of maladaptive behaviors as measured by the ESDM Curriculum Checklist in comparison to the control group. This observation finds support in several studies that have described [43,44] how problem behaviors (aggressive, disruptive, self-injurious) are significantly more common in children with autism than in other neurodevelopmental disorders, and how they are strongly correlated with the severity of receptive language difficulties and more severe socio-communicative deficits [45]. ...
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The Early Start Denver Model (ESDM) is an evidence-based early intervention model for young children with autism spectrum disorder (ASD). It is crucial to investigate the feasibility of the ESDM in community settings in contexts that are culturally different from American universities in which the model was originally developed. The aim was to further evaluate the effectiveness of the ESDM delivered within the Italian community setting at low intensity. We compared a group aged 19 to 43 months receiving the ESDM for 2 h per week over the course of 1 year with a concurrent, comparable, non-randomized control group receiving treatment as usual (TAU). Children were evaluated at baseline (T0) and after 6 months (T1) and 12 months (T2) of intervention. Feasibility was evaluated by parent and therapist questionnaires, retention rate, and therapist treatment fidelity. Both groups made similar gains in cognition and language abilities. The ESDM group made larger improvement in domains measured by the ESDM Curriculum Checklist, including communication, social skills, and maladaptive behaviors. Feasibility seemed well supported by retentions, therapists and parent satisfaction, and treatment fidelity. Our study further supports the feasibility of the ESDM implemented within the Italian public health system and suggests a better response in the ESDM-treated group than in the control group.
... It affects the functioning of the brain, disrupting normal growth, and often results in impaired verbal and non-verbal communication in social and emotional interaction in their ability to communicate with others and interact with their social environment. This developmental disability remains a long-lasting formative incapacity, and this is a daunting challenge faced by parents in respect of their child's behavioural difficulties (Dominick, Davis, Lainhart, Tager-Flusberg, & Folstein, 2007). Therefore, ASD is a neural health issue in children, especially if the child with ASD still does not receive the early intervention (Al-Farsi et al., 2011). ...
Conference Paper
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ABSTRAK Background: Children with Autism usually are hard to differentiate from normal children. Consequently, society in general still has little understanding of Autism and, as a result, many among the general public view in children with ASD as spoilt kids. The parents of these children are perceived as being incapable of controlling these special children, while some of these parents are considered as too young to deal with children 'who are annoying and troublesome. These situations are evident and repeated in our life as in the public space and in family meetings. Therefore, the lack of awareness is the biggest challenge facing parents with this kind of child. The purpose of this paper was to obtain a preliminary insight into the awareness of the general population toward a child with Autism in Yemen. Methodology: This study used Google survey questionnaire forms, which were randomly distributed through social media such as Facebook and WhatsApp groups among the general public in Yemen. The total responses numbered 342. Results: The results of this study revealed that although quite a lot of the Yemeni population are familiar with the term autism, the majority of the general public has no understanding of the attributes of children with Autism. Calculations: There is an urgent need to educate the general public in several ways on Autism and help them to understand precisely what it is.
... Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and interaction, and restricted, repetitive patterns of behavior (American Psychiatric Association, 2013). While challenging behaviors such as aggression, disruption (e.g., extreme tantrums), and noncompliance are not part of the diagnostic criteria, these types of behavior problems are common in children diagnosed with ASD (e.g., Bradley et al., 2004;Brereton et al., 2006;Hartley et al., 2008;Kaat & Lecavalier, 2013) and are more common than in typically developing children (Bauminger et al., 2010;Nicholas et al., 2008) or children with other developmental disabilities (Dominick et al., 2007;Matson et al., 2008). These types of challenging behaviors commonly occur in the home and are a great source of family stress and dissonance (Baker et al., 2003;Lecavalier et al., 2006). ...
Article
Children with autism spectrum disorder (ASD) often present with challenging behaviors such as aggression, tantrums, or noncompliance. Behavior analytic interventions are considered evidence‐based for decreasing challenging behaviors and may include a combination of strategies to teach replacement behaviors and prevent and respond to challenging behaviors. However, multi‐component interventions are often implemented in treatment settings by professionals and effects may not generalize to the home. Little research has explored the levels of treatment integrity with which multi‐component interventions are implemented by parents. This study evaluated the use of behavior skills training (BST) with ongoing coaching to train parents of two children with ASD to implement multi‐component behavioral interventions in the home to decrease challenging behaviors. Treatment integrity was monitored for each treatment component, and attempts were made to minimize barriers to treatment integrity. Results support the use of BST with ongoing coaching. Implications for practice and future research are discussed.
... Beberapa penelitian secara konsisten telah membuktikan bahwa hal menonjol yang menjadi kesulitan orang tua hingga berujung pada stres pengasuhan dalam merawat anak dengan gangguan perkembangan adalah perilaku maladaptive anak (Hall & Graff, 2012). Intensnya perilaku maladaptive yang muncul, meliputi: agresivitas, tantrum, menyakiti diri sendiri, dan perilaku berulang (Dominick et al., 2007;Konst et al., 2013). Demikian juga Samson et al. (2015) menegaskan bahwa rendahnya strategi pengaturan emosi pada anak dapat meningkatkan emosi negatif, hingga akhirnya memunculkan perilaku maladaptive. ...
Article
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Tujuan dari artikel ini adalah berupaya memahami perilaku maladaptive anak dan pengukurannya. Perilaku maladaptive anak merupakan perilaku anak yang tidak mampu menyesuaikan diri atau beradaptasi dengan keadaan sekelilingnya secara wajar, dan tidak mampu beradaptasi sesuai dengan tahapan perkembangan usianya. Permasalahan-permasalahan yang ditimbulkan dari perilaku maladaptive anak dapat menghambat tercapainya perkembangan anak secara optimal. Memahami perilaku maladaptive anak sangat penting untuk meminimalisasi dampak dan tingkat keparahan perilaku. Tulisan ini merupakan reviu literatur. Hasil reviu dalam tulisan ini merupakan bahan rujukan untuk menambah pemahaman terkait konsep perilaku maladaptive anak dan pengukurannya. Perilaku maladaptive anak terbagi dua, yaitu: 1) perilaku maladaptive internalizing, digambarkan seperti ketergantungan, sikap acuh tak acuh, kesulitan makan dan tidur, cemas, perasaan penolakan, perubahan suasana hati, rendahnya kontak mata, kurangnya interaksi sosial; 2) perilaku maladaptive externalizing, dikarakteristikkan seperti perilaku impulsif, tantrum, ketidakpatuhan, tidak peka terhadap orang lain, agresif, keras kepala. Pengukuran untuk menguji perilaku maladaptive anak yang umum digunakan dalam penelitian, diantaranya: 1) Maladaptive Behavior Index-Vineland Adaptive Behavior Scales (MBI-VABS, Sparrow, et al.); 2) Strengths and Difficulties Questionnaire (SDQ, Goodman); dan 3) Child Behavior Checklist (CBCL, Achenbach).
... Caring for an autistic child can be more stressful than caring for a child with normal development (12,21). Autistic children's problems like not articulating words, exhibiting disruptive behaviours (22) and not eating well can all affect the parents adversely (23). ...
Article
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SPARISK Support Group is a WhatsApp support group which offers parents of children with Autism Spectrum Disorder (ASD) who enrol their children in a water therapy programme a platform to discuss various issues regarding caring for their autistic children. Advanced growth in technology has improved the prospect for these parents to share information and provide support. A qualitative phenomenological design was used in this study to explore the support these parents offered each other through the use of WhatsApp as a social media support group. Convenience sampling was used to select four participants who had either a child or children diagnosed with ASD who were between the ages of 7 and 16 years old, had been involved in the support group for 6 months, and lived in Penang, Malaysia. Data analysis discovered five emergent themes: (a) types of supplement and food suitable for autistic children, (b)positive experiences, (c) feeling glad, (d) informational support and (e) emotional support. Findings indicate giving the right supplement and food to autistic children and relating autistic children's positive experiences while undergoing the water therapy programme were the main functions of the group, and having water therapy coaches answering their doubts as a valuable resource. It is suggested that the use of a social media support group on WhatsApp may provide continuous support to parents of autistic children, suggesting that the formation of similar groups on other social media platforms.
... Communication is both a basic need and the right of all human beings (Brady et al., 2016), and better expressive communication is associated with fewer maladaptive behaviors in ASD (Baghdadli et al., 2003;Dominick et al., 2007;Hartley et al., 2008). Developing effective communication treatments for minimally verbal children is therefore an area of high clinical importance. ...
Article
Purpose Understanding what limits speech development in minimally verbal (MV) children with autism spectrum disorder (ASD) is important for providing highly effective targeted therapies. This preliminary investigation explores the extent to which developmental speech deficits predicted by Directions Into Velocities of Articulators (DIVA), a computational model of speech production, exemplify real phenotypes. Method Implementing a motor speech disorder in DIVA predicted that speech would become highly variable within and between tokens, while implementing a motor speech plus an auditory processing disorder predicted that DIVA's speech would become highly centralized (schwa-like). Acoustic analyses of DIVA's output predicted that acoustically measured phoneme distortion would be similar between the two cases, but that in the former case, speech would show more within- and between-token variability than in the latter case. We tested these predictions quantitatively on the speech of children with MV ASD. In Study 1, we tested the qualitative predictions using perceptual analysis methods. Speech pathologists blinded to the purpose of the study tallied the signs of childhood apraxia of speech that appeared in the speech of 38 MV children with ASD. K-means clustering was used to create two clusters from the group of 38, and analysis of variance was used to determine whether the clusters differed according to perceptual features corresponding to within- and between-token variability. In Study 2, we employed acoustic analyses on the speech of the child from each cluster who produced the largest number of analyzable tokens to test the predictions of differences in within-token variability, between-token variability, and vowel space area. Results Clusters produced by k-means analysis differed by perceptual features that corresponded to within-token variability. Nonsignificant differences between clusters were found for features corresponding to between-token variability. Subsequent acoustic analyses of the selected cases revealed that the speech of the child from the high-variability cluster showed significantly more quantitative within- and between-token variability than the speech of the child from the low-variability cluster. The vowel space of the child from the low-variability cluster was more centralized than that of typical children and that of the child from the high-variability cluster. Conclusions Results provide preliminary evidence that subphenotypes of children with MV ASD may exist, characterized by (a) comorbid motor speech disorder and (b) comorbid motor speech plus auditory processing disorder. The results motivate testable predictions about how these comorbidities affect speech. Supplemental Material https://doi.org/10.23641/asha.14384432
... In that study, the association between repetitive behaviours and aggression in children with ASD was explained by citing those children's attempts to avoid demands that may interrupt their repetitive behaviour, and / or their reactions to being prevented from reaching something that is used in a repetitive routine (Reese et al. 2005;Kanne & Mazurek, 2011). In a previous smaller study with 67 children with ASD, the presence of aggression was associated with lower IQ, with poorer language comprehension and expression, and with restricted and repetitive behaviours (Dominick et al. 2007;Kanne & Mazurek, 2011). In a French observational study (Bronsard, Botbol, Tordjman, 2010) with 74 low functioning children and adolescents with ASD, Other-Injurious Behaviours (OIB) were assessed with parents at home, with caregivers at day-care, and with a nurse and a child psychiatrist during a blood drawing. ...
Presentation
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Aggression in adolescents with autism spectrum disorder (ASD) can force parents either to medicate them or to place them in residential care programs. Here, some key issues related to adolescents' behavioural problems are summarized both for typical populations and for people with ASD, the aim being to provide parents and caregivers with a social perspective that goes beyond purely clinical approaches. Despite the challenges they face, autistic adolescents usually overcome them by early adulthood, though aggressive behaviour seems to be more a function of the autistic condition itself (e.g. repetitive behaviours) than of the passage through adolescence. Inter-parental conflicts and parenting styles may influence ASD children's mental health and even autistic symptoms. Provisions and education for the whole family are advocated.
... Some children with ASD experience less enjoyment, have poor efficiency in using adaptive emotion regulation strategies, and experience more anger and anxiety (Samson, Wells, Phillips, Hardan, & Gross, 2015). Some of them may exhibit behavioral problems, such as atypical eating behaviors, abnormal sleep patterns, self-injurious behaviors, aggression, and repetitive behavior (Dominick, Davis, Lainhart, Tager-Flusberg, & Folstein, 2007). Parents of children with ASD need more perceived social support in the face of stress related to their children's emotional/behavioral problems (Zaidman-Zait et al., 2017). ...
Article
Background Parental psychosocial factors are associated with emotional/behavioral problems in children with Autism Spectrum Disorder (ASD), but studies investigating their relationships are limited. Aims To explore the relationships between parents’ perceived social support, parental resilience, parenting self-efficacy, and emotional/behavioral problems in children with ASD, and the mechanism underlying these relationships. Method The participants were 289 parents of children with ASD (including fathers and mothers) in China. A survey comprising the Multidimensional Scale of Perceived Social Support, Resilience Scale, Parenting Sense of Competence Scale, and Strengths and Difficulties Questionnaire was administered. Results (1) Parents’ perceived social support, parental resilience, and parenting self-efficacy were significantly associated with emotional/behavioral problems in children with ASD; (2) parental resilience and parenting self-efficacy were found to play a chain-mediating role in the association between perceived social support of parents and emotional/behavioral problems in children with ASD. Conclusion It is crucial to improve parents’ perceived social support, parental resilience, and parenting self-efficacy to reduce emotional/behavioral problems in children with ASD.
... Maladaptive behavior is prevalent in children with ASD [27]. It is common for young children with ASD to have selfinjurious, aggressive, disruptive, and destructive behaviors. ...
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Objectives: Among the many intervention programs for children with autism spectrum disorder (ASD), the Early Start Denver Model (ESDM) is one of the few approaches that has succeeded in demonstrating clinical efficacy in randomized control trials. Here, we inves-tigate the clinical efficacy of ESDM intervention in young children with ASD in a community setting within Japan. Methods: All subjects were children with ASD who received ESDM intervention during the study period. Each ESDM session lasted 75 min and occurred once per week for at least 12 weeks. The outcome measures consisted of the Kyoto Scale of Psychological Develop-ment (K-test), Aberrant Behavior Checklist-Japanese version (ABC-J), and the Clinical Global Impression-Severity scale (CGI-S). Results: Twenty-seven subjects (29.4±6.4 months old) received ESDM intervention that lasted for 8.0±2.6 months on average. The score on Language and Social developmental quotient on the K-test increased significantly after the intervention. The total scores on the ABC-J and CGI-S significantly decreased after completion of the ESDM intervention. Conclusion: Our results suggest that ESDM intervention could reduce the severity of distinct clinical features of ASD, such as impair-ments in social interaction and communication assessed by the K-test, and maladaptive behavior rated by the ABC-J and CGI-S. We be-lieve that the ESDM adapted to each institution might become one of the standard options for children with ASD in Japan.
... The Kumasi Children's Home, the main facility for orphaned, neglected and abandoned children in Kumasi, also houses approximately 25 PwIDs, with two housemothers. Purposive sampling techniques were used to collect data from all housemothers (8) in both schools, as well as the two house mothers at the children's home. In addition to the housemothers, 5 teachers, 2 from CSVS and 3 from GCSS were selected. ...
... Studies 6, [99][100][101] show that ASD patients are more likely to refuse food on the basis of several of their sensorial features, but, contrary to expectations, not based on color, although literature on this aspect is still discordant. 99,[102][103][104] Studies have consistently shown that eating disturbances in the ASD population are associated with higher SP scores. Thus, eating difficulties could be considered a consequence of sensory hypersensitivity, since the act of eating involves multiple senses as vision, touch, taste, and smell. ...
Article
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social and communication skills and repetitive and restrictive behaviors. Children and adolescents with ASD are more likely to present feeding problems than their typically developing peers are. The present narrative review of literature aims to highlight the most recent evidence about epidemiology and presentations of eating and mealtime behavioral abnormalities in ASD from infancy to adolescence. Abnormalities in breastfeeding and acceptance of complementary foods have been described by most of the studies evaluating ASD early feeding history. Among the various eating and mealtime behaviors identified in ASD children and adolescents, the most common was food selectivity. The present review also provides brief overviews of the various aspects of food that may influence food acceptance by ASD patients and of the correlation between eating problems and ASD core symptoms, as well as with cognitive level, language skills, and family environment. However, studies evaluating eating problems in ASD children and adolescents are very heterogeneous and they show methodological differences. Moreover, the absence of unique definitions of eating and mealtime behaviors in ASD further limits the comparability of studies.
... In pooled data, people with ASD had 2.26-times higher odds of self-harm than those without ASD (pooled OR, 3.26; 95% CI, 2.74-3.89; I 2 = 92.56%).Seventeen studies9,18,[46][47][48]50,[54][55][56][57]62,63,65,67,69,70,72 assessed the association between ASD and selfinjurious behavior and reported ORs that ranged from 1.21 to 18.76. Sixteen studies16,17,48,49,[51][52][53][58][59][60][61]64,66,68,71,72 assessed the association between ASD and suicidality andFigure 1. Study SelectionTable 1. Characteristics of the Studies Included in the Meta-analysis (continued) ...
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Importance: Multiple studies have reported that people with autism spectrum disorder (ASD) are at a higher risk for self-injurious behavior and suicide. However, the magnitude of this association varies between studies. Objective: To appraise the available epidemiologic studies on the risk of self-injurious behavior and suicidality among children and adults with ASD. Data sources: PubMed, Embase, CINAHL, PsycINFO, and Web of Science were systematically searched for epidemiologic studies on the association between ASD and self-injurious behavior and suicidality. Databases were searched from year of inception to April through June 2020. No language, age, or date restrictions were applied. Study selection: This systematic review and meta-analysis included studies with an observational design and compared self-injurious behavior (defined as nonaccidental behavior resulting in self-inflicted physical injury but without intent of suicide or sexual arousal) and/or suicidality (defined as suicidal ideation, suicide attempt, or suicide) in children (aged <20 years) or adults (aged ≥20 years) with ASD. Data extraction and synthesis: Information on study design, study population, ASD and self-harm definitions, and outcomes were extracted by independent investigators. Study quality was assessed using the Newcastle-Ottawa Scale. Overall summary odds ratios (ORs) and 95% CIs were estimated using DerSimonian-Laird random-effects models. Main outcomes and measures: The ORs for the associations of ASD with self-injurious behavior and suicidality were calculated. Analyses were stratified by study setting and age groups as planned a priori. Results: The search identified 31 eligible studies, which were of moderate to high quality. Of these studies, 16 (52%) were conducted in children, 13 (42%) in adults, and 2 (6%) in both children and adults. Seventeen studies assessed the association between ASD and self-injurious behavior and reported ORs that ranged from 1.21 to 18.76, resulting in a pooled OR of 3.18 (95% CI, 2.45-4.12). Sixteen studies assessed the association between ASD and suicidality and reported ORs that ranged from 0.86 to 11.10, resulting in a pooled OR of 3.32 (95% CI, 2.60-4.24). In stratified analyses, results were consistent between clinical and nonclinical settings and between children and adults. Conclusions and relevance: This study found that ASD was associated with a substantial increase in odds of self-injurious behavior and suicidality in children and adults. Further research is needed to examine the role of primary care screenings, increased access to preventive mental health services, and lethal means counseling in reducing self-harm in this population.
... Households with children can be stressful; families of children with ASD may represent an especially stressful home environment. Approximately 70% of children with ASD are reported by their parents to have had severe temper tantrums at some point and 60% of those within the severe tantrum group were reported to continue to have tantrums on a daily basis (7). Loud sounds accompanying tantrums could present a challenge for cats exposed to this noise. ...
Article
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Background: Cats are a common companion animal (CA) in US households, and many live in families of children with autism spectrum disorder (ASD). The prevalence of ASD is one in 54, and many children have behavior challenges as well as their diagnostic communication disorders. Objective: Benefits of CAs for children with ASD have been identified, but little is known about the welfare of CAs in these homes. This study explored the welfare of cats ( N = 10) screened for ideal social and calm temperament using the Feline Temperament Profile (FTP) and adopted by families of children with ASD. Methods: Cat stress was measured using fecal cortisol, weight, and a behavior stress measure (cat stress score). Measures were taken at baseline in the shelter, 2–3 days after adoption, and at weeks 6, 12, and 18. Result: Outcome measures suggested the adopted cats' stress levels did not increase postadoption; however, the small sample size limited analytical power and generalizability. Conclusion: This study provides preliminary evidence for the success of cat adoption by families of children with ASD, when cats have been temperament screened and cat behavior educational information is provided. Further research is warranted to confirm these findings.
... Moreover, children may also have sensory symptoms including hypo-and hyper-sensitivity to sensory input and unusual responses to sensory stimuli in multiple domains including auditory, tactile-proprioceptive, vestibular, olfactory, and visual senses (9)(10)(11)(12). In addition, children may also demonstrate disruptive behaviors such as aggression, tantrums, defiance, and self-injurious behaviors, as well as increased levels of negative affect (10,11,13,14). Moreover, children with ASD also demonstrate cognitive difficulties such as attentional deficits, impaired decisionmaking, and impaired executive functioning (i.e., working memory, cognitive flexibility, self-control, generativity, and planning), with deficits being more pronounced during open-ended compared to structured settings (15)(16)(17). ...
Article
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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder affecting multiple developmental domains including social communication, behavioral-affective, sensorimotor, and cognitive systems. There is growing evidence for the use of holistic, whole-body, Creative Movement Therapies (CMT) such as music, dance, yoga, theater, and martial arts in addressing the multisystem impairments in ASD. We conducted a comprehensive quantitative and qualitative review of the evidence to date on the effects of CMT on multiple systems in individuals with ASD. The strongest evidence, both in terms of quantity and quality, exists for music and martial arts-based interventions followed by yoga and theater, with very limited research on dance-based approaches. Our review of 72 studies ( N = 1,939 participants) across participants with ASD ranging from 3 to 65 years of age suggests that at present there is consistent evidence from high quality studies for small-to-large sized improvements in social communication skills following music and martial arts therapies and medium-to-large improvements in motor and cognitive skills following yoga and martial arts training, with insufficient evidence to date for gains in affective, sensory, and functional participation domains following CMT. Although promising, our review serves as a call for more rigorous high-quality research to assess the multisystem effects of CMT in ASD. Based on the existing literature, we discuss implications of our findings for autism researchers and also provide evidence-based guidelines for clinicians to incorporate CMT approaches in their plan of care for individuals with ASD.
... In addition to behaviors typically associated with aggression, children with ASD can present with other maladaptive behaviors such as self-injury, tantrums, and irritability (Erickson et al., 2016). Dominick et al. (2007) reported that 32.8% of schoolage children with ASD display aggressive behaviors. On the other hand, a large-scale study of 1380 children and adolescents with ASD found that 56% were engaging in some form of aggressive action(s) at the time of assessment (Kanne & Mazurek, 2010). ...
Article
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We used parent report data to investigate video game playing, aggression, and social impairment in adolescents with autism spectrum disorder. Parents of autistic adolescents were more likely to report that their child plays video games as a hobby compared to parents of adolescents with typical development and also reported that their children spent more time playing video games. For autistic participants, we found no differences in aggression levels or social impairment when comparing players versus non-players. However, playing video games “more than average,” as compared to “average” was associated with greater aggression and greater social impairment on “awareness” and “mannerisms” subscales. Future studies should focus on how type of video game(s) played is associated with these clinically important variables.
... Especially difficulties in social communication continueacross the lifespan-to cause parental distress, including anxiety and confusion about their child's behavior and parental feelings of inefficacy (20). Furthermore, higher rates of aggressive and self-injurious behaviors have been reported in children with severe social communication deficits (21). The link between challenging behaviors and increased parental stress is well-established (22). ...
Article
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Children with autism spectrum disorder (ASD) show difficulties in social communication behaviors, emotion regulation and daily living skills, and they frequently present with challenging behaviors. In parents of children with ASD, higher rates of stress and mental health problems have been reported than in parents of either typically developing children or children with other conditions. In this study, we tested whether maternal well-being changes with improved social communicative behaviors of children with ASD receiving early intervention. We examined developmental changes in 72 pre-schoolers and stress levels in their mothers (measured by the Parental Stress Inventory) before and after a 12-month community-based intervention program based on the Early Start Denver Model, a naturalistic developmental behavioral intervention targeting social communication. Multiple regression analyses showed that maternal child-related stress was predicted by changes in children's social communication behaviors (measured with the Pervasive Developmental Disorder Behavior Inventory). Gains in the early social communication behavior domain were the strongest predictor of post-intervention child-related maternal stress, surpassing adaptive behavior, language and non-verbal cognitive gains, and reduction in challenging behavior. These findings support the hypothesis that, in children with ASD, the acquisition of social communication behaviors contribute to improvements in maternal well-being.
... Of the approximately 1 in 44 U.S. children each year who receive diagnoses of autism spectrum disorder 1 (ASD), roughly one-quarter will remain minimally verbal past age 5. 2 These children use a limited vocabulary of single words or fixed phrases to communicate, and they experience high rates of challenging behaviors, such as aggression and self-injury. [3][4][5][6] Until recently, these children were not included in research studies because they are challenging to assess, especially with standardized tests. However, in the past decade or so, assessment techniques have been refined and more studies investigating the effects of communication treatment for these severely affected children have been conducted. ...
Article
We tested an intonation‐based speech treatment for minimally verbal children with autism (auditory‐motor mapping training, AMMT) against a nonintonation–based control treatment (speech repetition therapy, SRT). AMMT involves singing, rather than speaking, two‐syllable words or phrases. In time with each sung syllable, therapist and child tap together on electronic drums tuned to the same pitches, thus coactivating shared auditory and motor neural representations of manual and vocal actions, and mimicking the “babbling and banging” stage of typical development. Fourteen children (three females), aged 5.0–10.8, with a mean Autism Diagnostic Observation Schedule‐2 score of 22.9 (SD = 2.5) and a mean Kaufman Speech Praxis Test raw score of 12.9 (SD = 13.0) participated in this trial. The main outcome measure was percent syllables approximately correct. Four weeks post‐treatment, AMMT resulted in a mean improvement of +12.1 (SE = 3.8) percentage points, compared to +2.8 (SE = 5.7) percentage points for SRT. This between‐group difference was associated with a large effect size (Cohen's d = 0.82). Results suggest that simultaneous intonation and bimanual movements presented in a socially engaging milieu are effective factors in AMMT and can create an individualized, interactive music‐making environment for spoken‐language learning in minimally verbal children with autism. We tested an intonation‐based speech treatment for minimally verbal children with autism (Auditory‐Motor Mapping Training, AMMT) against a non‐intonation–based control treatment (Speech Repetition Therapy, SRT). AMMT involves singing, rather than speaking, two‐syllable words or phrases. In time with each sung syllable, therapist and child tap together on electronic drums tuned to the same pitches, thus co‐activating shared auditory and motor neural representations of manual and vocal actions, and mimicking the “babbling and banging” stage of typical development.
... Compared to the children with ASD-only, those diagnosed with ASD+DD often exhibit obvious clinical features, including low maternal serotonin levels, low paternal IQ, and increased challenging behaviors (8,9). Moreover, the children with ASD+DD diagnosis and relatively low IQ scores often exhibit higher levels of stereotypical behavior, self-harming, and sleep problems than individuals with ASD-only (10)(11)(12). Large-scale genome sequencing studies also suggest that the disruption rate of ASD-related genes is significantly higher in the presence of comorbid DD/ID (5,13). ...
Article
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Background and Objective: Autism spectrum disorder (ASD) refers to a heterogeneous set of neurodevelopmental disorders with diverse symptom severity and comorbidities. Although alterations in gut microbiota have been reported in individuals with ASD, it remains unclear whether certain microbial pattern is linked to specific symptom or comorbidity in ASD. We aimed to investigate the associations between gut microbiota and the severity of social impairment and cognitive functioning in children with ASD. Methods: A total of 261 age-matched children, including 138 children diagnosed with ASD, 63 with developmental delay or intellectual disability (DD/ID), and 60 typically developing (TD) children, were enrolled from the Shanghai Xinhua Registry. The children with ASD were further classified into two subgroups: 76 children diagnosed with ASD and developmental disorder (ASD+DD) and 62 with ASD only (ASD-only). The gut microbiome of all children was profiled and evaluated by 16S ribosomal RNA sequencing. Results: The gut microbial analyses demonstrated an altered microbial community structure in children with ASD. The alpha diversity indices of the ASD+DD and ASD-only subgroups were significantly lower than the DD/ID or TD groups. At the genus level, we observed a decrease in the relative abundance of Prevotella . Simultaneously, Bacteroides and Faecalibacterium were significantly increased in ASD compared with DD/ID and TD participants. There was a clear correlation between alpha diversity and the Childhood Autism Rating Scale (CARS) total score for all participants, and this correlation was independent of IQ performance. Similar correlations with the CARS total score were observed for genera Bacteroides, Faecalibacterium , and Oscillospira . However, there was no single genus significantly associated with IQ in all participants. Conclusions: Specific alterations in bacterial taxonomic composition and associations with the severity of social impairment and IQ performance were observed in children with ASD or ASD subgroups, when compared with DD/ID or TD groups. These results illustrate that gut microbiota may serve as a promising biomarker for ASD symptoms. Nevertheless, further investigations are warranted.
... Keywords Telehealth · Brief functional analysis · Functional communication training · Challenging behaviour Many children with autism spectrum disorder (ASD) engage in challenging behaviours such as self-injury, aggression, and disruption (Dominick et al., 2007). Challenging behaviour in children with ASD, if left untreated, can lead to a poor quality * Katerina Dounavi ...
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This study evaluates the effectiveness of a brief functional analysis and functional communication training conducted via telehealth. Three interventionist-child dyads took part in the study including one speech and language pathologist and two school teaching assistants, each working with one child with autism spectrum disorder. Interventionists were trained using didactic training to implement a brief functional analysis as well as synchronous coaching from a BCBA ® to implement functional communication training. A multiple baseline across participants design was utilised to evaluate if interventionists could implement functional communication training to decrease challenging behaviours that included aggression, elopement and disruption. Sessions concluded earlier than planned due to school closures mandated by the COVID-19 outbreak for two of the three participants; however, existing data provide evidence that telehealth is a valid model for enabling clinicians to work in collaboration with school personnel to effectively deliver assessment and intervention procedures remotely via telehealth.
... or self-injury. In addition, they tend to act aggressively such as biting, hitting, and kicking others or themselves (Dominick et al. 2007). PK 4 concurred, stating: ...
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One in a hundred children in Malaysia are diagnosed with autism and their numbers are increasing. In general, autism refers to the imbalance that occurs in the brain and nervous system resulting in impaired language, behaviour and social interactions. Usually autistic children need clinical treatment. This study explores alternative treatment modalities, such as the practice of reading ruqyah syariyyah to autistic children based on specific procedures involving self-reading or being read to. The objectives of this study were to identify the emotional and behavioural issues faced by autistic children, understand the extent of the practice and implementation of ruqyah syariyyah reading exercises, the challenges faced in conducting this treatment, and the impact of ruqyah reading in regulating the emotions and behaviour of such children. This case study is based on interviews with five teachers and observations of four students with autism. Two students each were identified in the low and high functioning categories. The study was conducted at the Quran Education Center for Children with Special Needs (Faqeh Foundation). The study found that the practice of reading ruqyah syariyyah using certain modalities helps children with autism regulate their emotions and thus their behaviour. Accordingly, the alternative treatment involving the use of ruqyah syariyyah reading practices for children with autism is highly recommended.
... ASD is characterized by significant difficulties with social communication skills and restricted repetitive behavior patterns and interests (American Psychiatric Association, 2013). Repetitive behaviors of children with ASD negatively affect their interactions with their parents (Wilke et al., 2012), while the temper tantrums, self-harming behaviors (Dominick et al., 2007), and problem behaviors of these children that make it difficult for them to adapt to their surroundings, which may negatively affect parents. Children with ASD often experience difficulties in being understood by their parents because of their sensory sensitivities (Leekam et al., 2007;Stewart et al., 2009), repetitive behaviors and interests (American Psychiatric Association, 2013;Losh et al., 2009) and serious deficiencies in verbal and nonverbal communication as well as social interaction skills (Baron-Cohen, 2008;Dodd, 2005;Lubetsky et al., 2011;Whitaker et al., 1998;Wing, 2012). ...
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Parental emotion regulation plays a vital role in the parent–child relationship. This study examines the mediating role of mindful parenting in the relationship between parental emotion regulation difficulties and problem behaviors of children with autism spectrum disorder (ASD). The study was conducted with 273 parents of children with ASD in Istanbul. The study findings revealed a significant yet negative correlation between mindful parenting and emotion regulation difficulty and problem behaviors. The study model highlighted that emotion regulation difficulties significantly predicted mindful parenting and the child’s problem behavior, whereas mindful parenting significantly predicted the child’s problem behavior. Additionally, the study findings indicated that mindful parenting was a partial mediator.
... The definition of 'minimally verbal' varies depending on the study, but generally refers to children using fewer than 20 words and not yet at phrase level expressive language (Chenausky et al., 2019;Thurm et al., 2015;Yoder et al., 2015). Given that a child's functional expressive language ability is associated with fewer maladaptive behaviors (Dominick et al., 2007;Hartley et al., 2008) and better social outcomes (Billstedt et al., 2005;Howlin et al., 2000), identifying predictors of expressive language outcomes is important. In the most recent study of this kind, Saul and Norbury (2020) aimed to expand previous findings by Yoder et al. (2015) that parental responsiveness, child response to joint attention, child communicative intent and consonant inventory were unique predictors of expressive language growth. ...
Article
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Subgroups of children with different speech profiles have been described however, little is known about the trajectories of speech development or stability of subgroups over time. This longitudinal study described both speech trajectories and subgroup stability of 22 autistic children, aged 2;0–6;11 years, over 12 months. Independent and relational speech analyses, vocabulary size and nonverbal communication were used in clustering. Results suggest varied speech trajectories, particularly for children with ‘low language and low speech’ at Time 1. Receptive vocabulary and consonant inventory at Time 1 may predict speech outcomes after 12 months. A small subgroup of children (n = 3) present with low expressive vocabulary and speech but higher receptive vocabulary and use of gestures. This unique profile remained stable.
Article
Background Risperidone and methylphenidate are commonly used drugs to manage problem behaviors in individuals with autism spectrum disorder (ASD). Studies report that these 2 drugs may be helpful in improving core symptoms of ASD as well. Aim To assess and compare the efficacy and safety profile of risperidone and methylphenidate for problem behaviors and core symptoms in children and adolescents with ASD. Setting and Design An 8-week, prospective, interventional, randomized, and open-label trial carried out in a tertiary care hospital of northern India. Materials and Methods Forty subjects with a diagnosis of ASD according to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition were randomized to risperidone and methylphenidate groups. Childhood Autism Rating Scale, Second Edition, Indian Scale for Assessment of Autism, and Nisonger Child Behavior Rating Form were used for assessments. Adverse effects, physical, and laboratory parameters were monitored regularly. Statistical Analysis Tests applied include chi-square test, repeated measures Analysis of Variance, and Student t test, and nonparametric tests for skewed data. Data was analyzed using SPSS Version 22.0. Level of significance was set at 0.05. Results Both drugs improved inattention, hyperactivity, and stereotypies. Methylphenidate reduced self-isolation, and risperidone improved emotional dysregulation, aggression, and self-injury. Adverse effects were seen in 55% of methylphenidate group (commonly decreased appetite and irritability) and 40% of risperidone group (commonly sedation and increased appetite). Improvement in stereotypy with both drugs and self-isolated behavior with methylphenidate indicates a possible role in improving core symptoms of ASD. Conclusion Both drugs were beneficial in the management of behaviors associated with ASD. Further research to establish their role in reducing core symptoms and long-term safety is warranted.
Article
Purpose Autism spectrum disorder is a kind of neurodevelopmental disorder characterized by persistent deficits in social communication and interaction across multiple contexts, and restricted, repetitive patterns of behavior, interests or activities. The purpose of this paper is to determine the effectiveness of sensory integration intervention on emotional-behavioral problems in children with autism spectrum disorder. Design/methodology/approach This research was conducted in a pretest-posttest design with control group. The participants were 30 children with autism spectrum disorder (6–11 years old) who were selected through convenience sampling from among children with autism spectrum disorder in Zeinab center of Isfahan and were randomly divided into two groups of 15 subjects. The children of the experimental group received 14 sessions of sensory integration intervention while the control group did not receive this intervention. To measure emotional-behavioral problems, the Behavior Assessment System for Children-Second Edition was used. To analyze the data, ANCOVA and MANCOVA tests were used. Findings The results showed that sensory integration intervention improves emotional-behavioral problems and its subscales (hyperactivity, aggression, behavioral problems, anxiety, depression, somatization, attention problems, learning difficulties, atypicality and withdrawal) in children with autism spectrum disorder. Research limitations/implications Therefore, it can be concluded that sensory integration intervention can be a suitable treatment for reducing sensory problems and improving emotional-behavioral problems in children with autism spectrum disorder. Originality/value The study of the effect of sensory integration on emotional-behavioral problems in children with autism spectrum disorder is necessary as a simple and non-side-effect educational and therapeutic method, both as a step to fill the research gap in this field, besides being a cheap and affordable way for improving the various skills of children with autism spectrum disorder for professionals, teachers, parents and educators.
Article
ZET Otizm, günümüzde sadece bireyler ile sınırlı özel sorunlara yol açmamış aynı zamanda dünyanın her tarafında görülen, toplumların her kesimini etkileyen ve giderek yaygınlaşan sosyal bir olgu haline gelmiştir. Böylece sosyolojik çalışmalara davetiye çıkartmış ve bu araştırmaya da konu olmuştur. Bu araştırma, Türkiye'deki otizmli bireyleri ve ailelerini kapsayan bir alan çalışması şeklinde yapılmıştır. Çalışma, Türkiye'nin 7 bölgesi ve 14 ilinde, otizmle mücadele amaçlı, otizmli bireylerin aileleri tarafından kurulmuş bulunan 2 vakıf, 15 dernek vasıtasıyla, otizmli çocuğu olan ve çoğu bu kuruluşların yönetim kurulunda görev yapan toplam 42 katılımcıyla görüşmelere dayalı nitel bir araştırma mahiyetinde olmuştur. Bu çalışmayla, otizmin bireysel, ailevi, toplumsal alandaki yansımalarına ilişkin sosyolojik boyutlarının ortaya çıkartılması amaçlanmıştır. Bu amaç doğrultusunda, otizmli çocuğu olan katılımcıların bilgi, görgü, yaşantı, temel algı veya yaklaşımlarına başvurulmuştur. Katılımcılardan elde edilen veriler deşifre edilerek betimsel analize tabi tutulmuştur. Bu analizler sonucunda, otizmli bireylerin ve ailelerinin günlük yaşamlarında ya da toplumsal alanlarda karşılaştıkları güçlükleri veya toplumla sorunlu alanları belirlenmeye çalışılmıştır. Başka bir ifadeyle, otizmin, dar veya geniş alanda bireyleri nasıl etkilediğine, aileleri psikolojik, ekonomik, kültürel, sosyal olarak nasıl kuşattığına, birey ve aile ile toplum arasına nasıl mesafe koyduğuna açıklık getirilmiştir. Ayrıca, bunların, etiketlenme, dışlanma, sosyal izolasyon ve yabancılaşma durumlarına ilişkin veya sosyal yaşamlarına dair pozisyonları etraflı bir şekilde irdelenmiştir. Bu çalışma, çok işlenmemiş bir konuyu ele alması, ilk elden verilerin sahadan toplanması, analiz ve değerlendirme sürecinde ortaya koyduğu bakış açısı, otizmin bireylere ve ailelere ilişkin yansımaları veya toplumsal sonuçları hakkında son derece çarpıcı bulgu ve sonuçlara ulaşılması hususunda tamamıyla özgün bir çalışma olmuştur. Bu çalışma, otizme ilişkin literatürdeki önemli bir eksikliğin giderilmesi, otizm ile sosyoloji arasındaki derin bir bağın varlığına işaret * Bu çalışmada Fırat Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi, FÜBAP tarafından İSBF.11.13. numaralı proje olarak desteklenen "Sosyolojik Boyutlarıyla Otizm" başlıklı Doktora tezinin ilgili verilerinden faydalanılmıştır. Bu makale Crosscheck sistemi tarafından taranmış ve bu sistem sonuçlarına göre orijinal bir makale olduğu tespit edilmiştir.
Chapter
In dit hoofdstuk wordt uitgebreid ingegaan op de mogelijke problemen rondom eetgedrag bij Attention Deficit Hyperactivity Disorder (ADHD) en autismespectrumstoornissen (ASS). Hierbij valt te denken aan de mogelijke problemen rondom sensorische informatieverwerking (verwerking van prikkels vanuit de zintuigen) en de cognitieve theorieën zoals de theory of mind, executieve functies en centrale coherentie, die voor een groot deel de gedragingen verklaren bij ASS. Tevens komen de oorzaken en de mogelijke rol van voeding bij het ontstaan van ADHD en ASS aan bod, evenals de huidige stand van de wetenschap over diverse diëten die mogelijk een rol spelen bij de behandeling van deze gedragsstoornissen, en welke taak de (kinder)diëtist hierbij heeft. Voeding kan gedragsstoornissen zoals ADHD en ASS niet genezen, maar mogelijk wel een aantal klachten verminderen. Vooralsnog wordt het gebruik van een normale, gezonde voeding geadviseerd. De (kinder)diëtist kan onder andere een rol spelen bij een afbuigende groeicurve, overgewicht, selectief of restrictief eetgedrag, bij het creëren van structuur in het voedingspatroon en het bieden van ondersteuning en geruststelling aan ouders door kennisvergroting.
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Individuals diagnosed with autism spectrum disorder, developmental disabilities, and/or intellectual disabilities commonly display aberrant behavior (e.g., self-injurious behavior, aggression, stereotypy), which can interfere with learning and decrease their overall quality of life. Effectively decreasing this aberrant behavior often requires interventionists to conduct a functional behavior assessment to determine the reason why the aberrant behavior is occurring. Part of this functional behavior assessment could be implementing a functional analysis. A functional analysis is a systematic procedure used to determine the function of behavior. In this chapter, we will provide an overview, brief history, and the evolution of functional analysis.
Article
Background Studies on parenting behaviours among parents of adolescents with ASD either used parenting behaviours that were supported in the general population, or specific ASD related parenting behaviours. This study aimed to identify which parenting components underlie parenting behaviours among parents of adolescents with ASD, and how these components relate to adolescent and mother characteristics. Method 35 children with ASD and 38 children without ASD (aged 12–16 years old) participated with their mother in this cross-sectional study. Parenting behaviour was measured based on observations. Principal components analyses (PCA) were carried out to construct parenting components. Pearson correlations were calculated for the ASD and General Population Control (GPC) group separately to investigate the relationship between the parenting components and adolescent and mother characteristics. Results In both groups, PCAs on observed parenting behaviours yielded the components Parental Support and Behavioural Control. However, in the ASD group, Negativity was generated as a third cluster. Results indicated that only verbal IQ was significantly correlated with parenting behaviour components. Conclusions This study suggests that the framework of parenting behaviours in the general literature is applicable to parents of children with ASD. Furthermore, associations between parenting behaviours and adolescent characteristics were rather modest in the ASD group.
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Epidemiology refers to the systematic study of disease or disability at the level of a population and its spatial and temporal distribution. Epidemiology can be useful in understanding the extent and cost of a problem and may contribute to the understanding of its causes. Aggression and violence are widespread in humans with around half a million murders occurring per year globally, mostly involving young men killing one another. About one third of women also experience aggression and violence, including sexual violence, often during interpersonal relationships during their lifetime. About half of all children worldwide experience various forms of aggression and violence often from family members and in educational settings. Risk factors for aggression and violence include interpersonal disputes, alcohol, illegal drugs, crowding, high temperature, at risk times and places, availability of weapons, poverty and inequality, ethnicity, and medical conditions.KeywordsAggressionViolenceEpidemiologyPrevalenceIncidenceRisk factorsHomicideIntimate partner violenceAlcoholIllicit drugsCrowdingTemperatureWeaponsPovertyInequalityEthnicityMedical conditions
Article
The present study aims to examine the effects of the MindfulTEA program, an Mindfulness-based Interventions (MBIs) specifically designed for adults with Autism Spectrum Disorder (ASD) and Intellectual Disability, to reduce behavioural problems. MBIs are effective in improving well-being in people with high-functioning ASD, but little is known about the impact of the MBIs on people with ASD and intellectual disability associated. Fourteen adults (age 18 to 44) with ASD and intellectual disability participated in the program. Results showed a significant decrease in self-injurious and aggressive/destructive behaviours after the MBI. Stereotyped behaviour did not show significant change. Results suggest that the MindfulTEA program could effectively reduce some types of behaviour problems in people with ASD and intellectual disability. MBIs could be a useful alternative to traditional behaviour management interventions for reducing behaviour problems in this population.
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Individuals with ASD frequently suffer from an eating pathology. Both disordered eating and eating problems have each been reported in the literature to be more prevalent in individuals with ASD than in those with typical development and repetitive behaviors are often featured in these conditions. Food selectivity, the most prevalent eating problem among children with ASD, has been found to be strongly related to sensory processing disorders, part of the ASD diagnostic criteria for restricted, and repetitive patterns of behavior, interests, or activities (RRBI). Other manifestations of RRBI in the eating setting include insistence on specific methods of food preparation, food types, and mealtime rules. This chapter reviews the literature on the relation between eating pathologies, including eating disorders and eating problems, and RRBI, in individuals with ASD. A growing body of evidence supports the relation between the higher and lower order RRBI and a range of eating problems seen in ASD, with a clear role of sensory impairment as well as cognitive and motor delays on food selectivity, all of which may represent underlying mechanisms. Since limited studies have explored the range of eating problems and RRBI, research is required to understand the role of higher and lower order RRBI in eating problems to gain further insight into understudied areas such as over and compulsive eating. Future research should explore the different domains of RRBI and eating problem types and their relationships, with the goal of deepening knowledge and supporting clinicians in tailoring interventions for children with ASD.
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Individuals with a diagnosis of Autism Spectrum Disorder (ASD) and individuals with Intellectual Disabilities (ID) are at a higher risk of developing challenging behavior as compared to other populations. In this chapter, we discuss the nature, prevalence, and characteristics of challenging behaviors in individuals with ASD and ID. Aggressive behavior, self-injurious behavior, and stereotypic behavior are addressed separately. Each of these behaviors is discussed in terms of nature and characteristics, definition, topography, prevalence, and risk factors. Clearly, addressing these behaviors is pivotal to improving outcomes for affected individuals, and interventions informed by functional analysis provide an effective technology for achieving this.
Article
Self-injurious behavior (SIB) by individuals with intellectual and developmental disabilities including autism (I/DD) is among the most clinically disturbing, socially costly, and scientifically challenging behavior disorders. Forty years of clinical research has produced a knowledge base supporting idiographic behavioral assessment and treatment approaches. Despite the treatment progress, from a public health and population perspective, we argue it is less clear that we have reduced the disorder's burden. The developmental course of the disorder is mostly unknown and empirically informed population-level models of risk are absent. In this review, we systematically examined the published scientific literature specific to risk for SIB in the I/DD population. We reviewed study methodology in detail intentionally informed by an epidemiological perspective with a set of questions intended to test the quality of the inferences about risk. Results are discussed in terms of conceptual, methodological, and translational issues with respect to what needs to be done to create credible and useful clinical models for SIB risk in the I/DD population.
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Objectives The study aims to investigate attention deficit hyperactivity disorder (ADHD) symptoms, gastrointestinal (GI) symptoms, comorbid psychopathology and behaviour problems in children and adolescents with autism spectrum disorder (ASD). Methods Parents of 147 children and adolescents with ASD aged 6–18 years completed the Conners 3 Parent-Short Form, Gastrointestinal Symptom Inventory, Behavior Problems Inventory-Short Form and Autism Spectrum Disorder-Comorbid for Children. Results Fifty-six per cent of children and adolescents had a comorbid diagnosis of ADHD, yet over 70% presented with clinically significant ADHD symptoms. Forty per cent of participants received a diagnosis of ADHD before ASD and 25.6% received a diagnosis of ASD first. Relationships were found between ADHD symptoms and comorbid psychopathology, GI symptoms, and behaviour problems. Conclusions The outcomes suggest that ADHD is being underestimated as a comorbid disorder of ASD. This may have implications on treatment and interventions for children and adolescents who have a diagnosis of both ASD and ADHD.
Article
Atypical sensory processing occurs in up to 97% of children on the autism spectrum. Children who are on the autism spectrum also commonly demonstrate challenging behaviors, and their caregivers report increased levels of strain in daily life. The aim of this study was to explore four sensory processing features; seeking, avoiding, sensitivity, and registration, and their relationships with maladaptive behaviors in children with autism, as well as with caregiver strain. Participants comprised 75 children with autism aged 7–12 years (M = 7.81). Caregivers completed three questionnaire measures examining child sensory processing, maladaptive behaviors, and perceptions of caregiver strain. We found avoiding significantly associated with irritability. Avoiding also displayed the strongest relationship with global caregiver strain. Avoiding and seeking were strongly related to hyperactivity/noncompliance (components of maladaptive behavior). A multiple regression was performed to explore how atypical sensory processing features and maladaptive behaviors together predicted caregiver strain. Together, maladaptive behaviors and sensory features accounted for 58% of the variance in total caregiver strain. The only significant individual predictor of total caregiver strain was sensory avoiding, which uniquely accounted for 5.76% of the variation. The findings suggest that atypical sensory processing is associated with overall caregiver strain, above that explained by maladaptive behaviors. Implications for targeted support for the benefit of the child, parents and family unit are discussed. Children who are on the autism spectrum often have differences in sensory processing. These children also tend to show challenging behaviors, and their caregivers can experience increased stress. This study looked at how sensory processing difficulties relate to such behaviors and caregiver stress. We found that both sensory processing and challenging behaviors were related to the amount of stress caregivers felt. This suggests that interventions may benefit from looking at sensory processing features when considering how to help reduce challenging behaviors and caregiver stress.
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Despite several criticisms surrounding the DSM classification in psychiatry, a significant bulk of research on mental conditions still operates according to two core assumptions: a) homogeneity, that is the idea that mental conditions are sufficiently homogeneous to justify generalization; b) additive comorbidity, that is the idea that the coexistence of multiple conditions in the same individual can be interpreted as additive. In this paper we take autism research as a case study to show that, despite a plethora of criticism, psychiatric research often continues to operate in accordance with this model. Then we argue that such a model runs into problems once facts about comorbidity are taken into account. Finally, we offer some suggestions on how to tackle the challenge raised by comorbidity and its impact on heterogeneity. To do so, we explore transdiagnostic stratification accounts and network models to show that combining these approaches can move us in the right direction.
Article
Multisystemic Therapy (MST) is an intervention offered to young people presenting with antisocial and aggressive behaviour and is currently being adapted for use with the autism spectrum disorder (ASD) population. This qualitative study aimed to provide the first consideration of the experiences of MST therapists and supervisors of delivering standard MST to young people with suspected or diagnosed Level 1 ASD. Semi‐structured interviews were carried out with 11 MST therapists and supervisors with experience of working with the client group. Thematic analysis identified three major themes: (1) nuanced delivery of MST for Level 1 ASD, (2) need for knowledge and resources, and (3) positive experiences with delivering the intervention. Findings suggested the need for an increased focus on understanding the individual needs of a young person in assessment and intervention, the increased importance of structure and consistency, and psychoeducation for all systems around the young person in order to meet the developmental needs of young people with Level 1 ASD.
Article
Purpose: This study aimed to identify the aggressive characteristics of children and adolescents with ASD through an integrated literature review.Methods: Data collection was conducted for papers published in Korean or English language from December 2018 to February 2019. Literature search was conducted through keywords, such as 'autism', 'ASD', 'autistic', 'asperger', 'agress', 'violence', 'SIB', 'child', and 'adolescent', and 19 papers were finally selected. In order to identify the aggressive behavior characteristics and influencing factors of children and adolescents with ASD, the contents of the core results were analyzed through repeated review of research results.Results: Characteristics related to aggression in children and adolescents with ASD were classified into biological factors, cognitive factors, social factors, and affective-emotional factors, and related variables affecting aggression were identified with each topic.Conclusion: Based on the results of this study, it is suggested that the basis for the development of accessible interventions for children and adolescents with ASD and their caregivers can be prepared.
Article
Background Comorbidity is the co-occurrence of two or more disorders in the same person. Aim This study investigated the frequency of comorbid conditions, in children and adolescents, with autism spectrum disorder (ASD), cerebral palsy (CP), and a comorbid diagnosis of ASD and CP. Method Ninety-six children and adolescents with ASD, CP, and both ASD and CP aged between 4 and 18 years participated in this study. Parents completed the Gastrointestinal Symptom Inventory, Children’s Sleep Habits Questionnaire, Child Behavior Checklist, Social Communication Questionnaire, and the Vineland Adaptive Behavior Scales. Results Results of ANOVA analyses revealed significant group differences in sleep problems, social communication difficulties, and adaptive behavior. Regression analysis found that the presence of an intellectual disability significantly predicted levels of adaptive behavior. Conclusion This research demonstrated the importance of studying comorbidities in children and adolescents with CP alone, ASD alone, and combined ASD and CP.
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Differentiation of self is a multidimensional construct that refers to the capacity of emotional self-regulation, which allows a person to function individually and to be emotionally connected with others. Attachment is the emotional bond we create with the people of our close environment, which looks for our needs of feeling near and secure during our life, promoting our survival and providing the necessary stimulation in children for their correct development. The objective of the present study is to understand the relation that exist between differentiation of self and adult attachment. For the making of the present study, a bibliographic review was carried out with the following metasearch engines: Jabega UMA, Google Academics and APA PsycNET. The studies appear to agree in the existence of a negative association between Differentiation of Self and anxiety and avoidance in relationships of adult attachment, and positive association between emotional cutoff and avoidance, and among emotional reactivity and anxiety in attachment.
Article
Aggressive behaviors could be considered as a dynamic of communication, in which aggression is a language to be understood, to be deciphered by two protagonists : the aggressor coping with a stressful and threatening situation and the aggressed individual coping with an aggressive acting out. The following questions are addressed: (a) What does aggression mean to the aggressor, what does it mean to the aggressed individual? (b) What does the aggressor want or try to express, and why does he or she use this mode of expression and action over another? (c) How does the aggressed individual react, and what is the impact of his or her response on the aggressor? This article reviews studies on the definition of aggression, its measurement, its developmental role and its associated risk factors in children and adolescents. First, aggression in children and adolescents with typical and atypical development is examined based on a developmental psychology approach, clinical case studies in child and adolescent psychiatry, and an empirical study on aggression in autism. Then, in light of these studies, the problem of violence among younger and younger children and adolescents, is discussed. Finally, taking together these studies and discussion, a model is proposed that accounts for factors involved in aggressive behaviors and for different possible levels of intervention. Physical and/or psychic threats generate stress and may therefore lead to offensive or defensive aggression. Stress has to be considered in its physiological dimension (biological stress responses) and psychological dimension (perceived stress). This model reveals a vicious circle: when the main response to aggression is repression, it may reinforce physical/psychic threats and stress perceived by the aggressor, and in turn aggressive behaviors. Intervention can occur at three levels: the stressful situation, the aggressor (perception of the stressful situation and his or her response), and the aggressed individual (perception of the aggression and his or her response). This model, like all models, is limited but it offers a discussion and perspectives to understand the different links that form the “chain of aggressive behavior” and the relationships between exposure to violence and expression of violence. The article concludes on the interest of a muldisciplinary approach to aggression integrating physiological, psychological and sociological dimensions.
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The Autism Diagnostic Observation Schedule—Generic (ADOS-G) is a semistructured, standardized assessment of social interaction, communication, play, and imaginative use of materials for individuals suspected of having autism spectrum disorders. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language. Psychometric data are presented for 223 children and adults with Autistic Disorder (autism), Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) or nonspectrum diagnoses. Within each module, diagnostic groups were equivalent on expressive language level. Results indicate substantial interrater and test—retest reliability for individual items, excellent interrater reliability within domains and excellent internal consistency. Comparisons of means indicated consistent differentiation of autism and PDDNOS from nonspectrum individuals, with some, but less consistent, differentiation of autism from PDDNOS. A priori operationalization of DSM-IV/ICD-10 criteria, factor analyses, and ROC curves were used to generate diagnostic algorithms with thresholds set for autism and broader autism spectrum/PDD. Algorithm sensitivities and specificities for autism and PDDNOS relative to nonspectrum disorders were excellent, with moderate differentiation of autism from PDDNOS.
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Some children with autism and pervasive developmental disorder-not otherwise specified (PDD-NOS) have been reported to have atypical feeding behavior, such as sensitivity to food texture and selective preferences for particular foods. No systematic studies of feeding behavior in this population have been published. Munk and Repp (1994) developed methods for assessing feeding problems in individuals with cognitive and physical disabilities that allow categorization of individual feeding patterns based on responses to repeated presentations of food. In this study, we systematically replicated the Munk and Repp procedures with children with autism and PDD-NOS. Thirty children, ages 3 to 14 years, were exposed to 12 food items across 6 sessions. Food acceptance, food expulsion, and disruptive behavior were recorded on a trial-by-trial basis. Approximately half of the participants exhibited patterns of food acceptance, indicating selectivity by food category or food texture. Others consistently accepted or rejected items across food categories. Whether these patterns of food acceptance are atypical remains to be determined by comparison with the feeding patterns of typically developing children and other children with developmental delays.
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This patient illustrates a number of features typical of adults with autistic syndrome - the clumsiness, pursuit of circumscribed and unsocial interests, and lack of grasp of social situations. Perhaps more importantly, he showed marked impairment of non-verbal expression in social interactions. The deficits consequent upon his disorder have an immediate bearing on his potential for dangerous behaviour. The authors submit the speculation that this association between Asperger's syndrome and violent behaviour is more common than has been recognised and that more such individuals are to be found in long-term care institutions of various sorts.
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Data on sleep behavior were gathered on 100 children with pervasive developmental disorders (PDD), ages 2-11 years, using sleep diaries, the Children's Sleep Habits Questionnaire (CSHQ), and the Parenting Events Questionnaire. Two time periods were sampled to assess short-term stability of sleep-wake patterns. Before data collection, slightly more than half of the parents, when queried, reported a sleep problem in their child. Subsequent diary and CSHQ reports confirmed more fragmented sleep in those children who were described by their parents as having a sleep problem compared to those without a designated problem. Interestingly, regardless of parental perception of problematic sleep, all children with PDD exhibited longer sleep onset times and greater fragmentation of sleep than that reported for age-matched community norms. The results demonstrate that sleep problems identified by the parent, as well as fragmentation of sleep patterns obtained from sleep diary and CSHQ data, exist in a significant proportion of children with PDD.
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A meta-analysis of prevalence and cohort studies conducted over the last 30 years was carried out to identify risk markers for challenging behaviour shown by individuals with intellectual disabilities (IDs). A total of 86 potential studies was identified from the review, with 22 (25.6%) containing sufficient data to enable a statistical analysis to be conducted. Results indicated that males were significantly more likely to show aggression than females, and that individuals with a severe/profound degree of ID were significantly more likely to show self-injury and stereotypy than individuals with a mild/moderate degree of ID. Individuals with a diagnosis of autism were significantly more likely to show self-injury, aggression and disruption to the environment whilst individuals with deficits in receptive and expressive communication were significantly more likely to show self-injury. In most cases, tests for heterogeneity were statistically significant, as expected. The meta-analysis highlighted the paucity of methodologically robust studies of risk markers for challenging behaviours and the lack of data on incidence, prevalence and chronicity of challenging behaviour in this population.
Article
Temper tantrums are a normal response to anger and occur commonly in the child between one and four years of age. They arise from the child's thwarted efforts to exercise mastery and autonomy. Tantrums occur more frequently in the active, determined child who has abundant energy. Parenting practices that may encourage tantrums include inconsistency, unreasonable expectations, excessive strictness, overprotectiveness and overindulgence. Boredom, fatigue, hunger or illness may reduce the child's tolerance for frustration. Management consists of teaching the parents to understand the underlying meaning of tantrums and to modify parental behaviors that may perpetuate or accentuate the problem. Temper tantrums are best handled by ignoring the outburst, offering nurturance to the child after the tantrum has subsided and helping the child learn to express negative feelings in more acceptable ways.
Article
In this study, we examined three maladaptive behaviors, self-injurious behavior (SIB), stereotypies, and aggression in adults with autism, pervasive developmental disorder, not otherwise specified (PDD-NOS), and mental retardation. We used a brief functional analysis rating scale, The Questions About Behavioral Functions (QABF), to examine the function of each behavior. Across the three groups, our results indicated that aggression was primarily maintained for attentional reasons and stereotypies for nonsocial reasons. No specific function(s) were found to maintain SIB. These results suggest that the function of a maladaptive behavior may be associated more with the particular maladaptive behavior displayed rather than inclusion in a certain diagnostic group. Implications of findings for assessment and treatment issues are discussed.
Article
What is meant by the term adaptive behavior? What are the typical domains of adaptive behavior scales? How is adaptive behavior different from other constructs such as personality or intelligence? What are some of the most popular adaptive behavior scales? The adaptive behavior construct traces its roots to early work in mental retardation, which, in turn, is linked to the roots of intellectual assessment (Kamphaus, 2001). Although intelligence tests contributed mightily to the recognition of the mental retardation syndrome, Doll (1940) noted that intelligence measures lacked sufficient breadth for assessing all of the relevant domains of behavior that needed to be considered in treatment of individuals with mental retardation.
Article
We examined the functions of five severe problem behaviors in a sample of 417 institutionalized persons with mental retardation by using the Questions About Behavior Function Scale. The behaviors we examined included self-injurious behavior, aggression, stereotypies, pica, and rumination. The most common function for all behaviors except aggression was nonsocial. Aggression, however, was maintained by external environmental contingencies. Particular items of the Questions About Behavior Function Scale were identified as more frequently occurring and critical in ascertaining behavioral function. Implications of these results for developing more effective treatment plans are discussed.
Article
Sleep problems are common in children with an intellectual disability, and occur more frequently than in typically developing children. Problems usually include settling difficulties, long sleep latencies, night waking, and early morning waking. Sleep problems are also likely to be stressful for other family members, particularly parents. This paper reports a study of children’s sleep problems, and their relationship with parent stress and coping, and child behaviour problems. Fifty-two children (age 2-19 years) with an intellectual disability (ID) and their families, and a comparison group of 25 typically developing children (age 2-17 years) and their families, participated in the study. Parents completed a sleep questionnaire, the Developmental Behaviour Checklist (DBC), the Parenting Hassles Scale (PHS). Analysis showed that the presence of sleep problems was significantly associated with both the intensity and frequency of hassles, and the presence of behaviour problems. Implications for children with an ID and their families, and for intervention are discussed.
Article
Abstract Asperger's Syndrome is assumed to be closely related to autism. A case of a 21-yr-old man with Asperger's Syndrome who is frequently violent to his 71-yr-old girlfriend is presented. According to a social-cognitive model of autism, this man is predicted to be markedly impoverished in his appreciation of his victim's thoughts and feelings. Interview-based assessments confirm this deficit, and this is discussed as an important factor in the maintenance of his violence.
Article
Autistic children with an IQ below 70 and with an IQ above 70 were systematically compared. The two groups differed somewhat in the pattern of symptoms, but were closely similar in terms of the main phenomena specifically associated with autism. However, the low IQ and high IQ autistic children differed more substantially in terms of other symptoms such as self-injury and stereotypies and there were major differences in outcome. The possibility that the nature of the autistic disorder may differ according to the presence or absence of associated mental retardation needs to be taken into account in planning studies of etiology.
Article
A combined informant questionnaire and interview survey of self-injurious behavior (SIB) at a large state facility for the retarded was conducted independently three times over a 3-year period. Prevalence consistently was about 10% of the population. SIB cases tended to be younger and institutionalized longer than the rest of the population. Severe cases had a longer history of chronic SIB. SIB cases had more seizure disorders, severe language handicaps, visual impairments, and severe or profound retardation than the rest of the population. They appeared to fulfill most of the Rutter (1966) criteria for autism. But unlike the severely autistic, there was little relation of sex to incidence of SIB. Over 90% of SIB cases changed status over 3 years, suggesting that SIB was amenable to behavior modification in most cases (94%). Psychotropic behavior control medications helped in some intervention programs (52%). SIB remitted spontaneously in 27% of SIB cases where there had been no behavioral or drug intervention.
Article
We compared sleep parameters in mentally retarded infantile autism (MRIA) and mentally retarded Down's syndrome (MRDS) by means of polysomnography, evaluating traditional analysis with particular attention to the phasic components in each disorder. Data were compared with those obtained in normal subjects matched for age and sex. Mental age, Intellectual Quotient and the Childhood Autism Rating Scale were performed to obtain an estimation of the neuropsychological deficit. Abnormalities of phasic components of sleep and the presence of REM sleep components into non-REM sleep were observed in both MRIA and MRDS even if in different ways. In fact, MRDS subjects presented a reduction of REM sleep percentage and R index (number of high frequency REMs against number of low frequency REMs) and this was positively correlated to a low IQ. Unlike MRDS subjects, MRIA subjects did not show any parallelism between intellectual abilities and REM sleep deficit. In addition, the presence of undifferentiated sleep in autistic subjects implies a maturational deficit that is still present in adulthood. Finally, a high R index in MRIA was observed. This finding, which is not present in MRDS, could represent an estimation of the disorganized arrival of information caused by a dyscontrol or a reduction of inhibitor pathway. With reference to sleep mechanisms, our results suggest that the cognitive deficit in MRIA may differ from that of MRDS subjects. A maturational deficit of CNS with a dysfunction of brainstem monoaminergic neurons could represent the underlying mechanism.
Article
This study investigated the effect of age on communication and maladaptive behavior in autistic and mentally retarded children. Forty-seven autistic and 128 mentally retarded children in a special school served as subjects. The cross-sectional method was used to compare junior and senior groups, and ratings on communication skills and maladaptive behaviors were obtained from teachers. We found that the skills of comprehension and conversation in autistic children improved significantly with age, and speech improved somewhat. In spite of this improvement in communication skills, maladaptive behaviors in the autistic children other than hyperactivity did not change significantly with age. Withdrawal improved significantly with age in the mentally retarded children but not in the autistic children.
Article
Forty-seven autistic and 128 mentally retarded children, ages 6 to 14, from a special school were assessed in terms of nine maladaptive behaviors and speech skill levels. The results indicated that the group of the mentally retarded children with withdrawal had significantly lower speech skill levels than the group of those without withdrawal, and the group of the autistic children with self-injury had significantly lower speech skill levels than the group of those without self-injury.
Article
One hundred and twenty-eight mentally retarded children, ages 6 to 14, from a special school were assessed by teachers in terms of nine maladaptive behaviors. The results indicated that the prevalence of some maladaptive behaviors changed as a function of IQ and age, and that there were splits of such changes as IQ-dependent and as age-dependent by maladaptive behavior.
Autistic children with an IQ below 70 and with an IQ above 70 were systematically compared. The two groups differed somewhat in the pattern of symptoms, but were closely similar in terms of the main phenomena specifically associated with autism. However, the low IQ and high IQ autistic children differed more substantially in terms of other symptoms such as self-injury and stereotypies and there were major differences in outcome. The possibility that the nature of the autistic disorder may differ according to the presence or absence of associated mental retardation needs to be taken into account in planning studies of etiology.
Article
Of a total of 800 children (aged 3-12 years) attending a pediatric outpatient department, 182 (22.8%) were found to be having temper tantrums (mean age, 4.7 years). Temper tantrums were found to be most common at 3-5 years (75.3%), less common at 6-8 years (20.8%), and least common at 9-12 years (3.9%). Children aged 3-5 years were more likely to be of a lower social class (p < 0.01), whereas in other age groups (6-8 years and 9-12 years) children were more likely to be of an upper social class. Boys dominated the study significantly: the ratio of boys to girls was 3.1:1. Boys having temper tantrums were more likely to be of an upper social class (p < 0.001) compared with girls, who tended to be of a lower social class (p < .01). Children showed a higher incidence of history of postnatal trauma and seizure disorder compared with the control group (p < 0.05). Parental overprotection and marital discord were found to be stress factors in a significantly higher number of boys than girls (p < 0.01); parental negligence was a significant stress factor for girls (p < 0.01). Associated behavioral problems, such as thumb sucking, enuresis, tics, head banging, sleep disturbances, and hyperkinesis were found to be significantly higher among children with tantrums.
Article
Temper tantrums are a normal response to anger and occur commonly in the child between one and four years of age. They arise from the child's thwarted efforts to exercise mastery and autonomy. Tantrums occur more frequently in the active, determined child who has abundant energy. Parenting practices that may encourage tantrums include inconsistency, unreasonable expectations, excessive strictness, overprotectiveness and overindulgence. Boredom, fatigue, hunger or illness may reduce the child's tolerance for frustration. Management consists of teaching the parents to understand the underlying meaning of tantrums and to modify parental behaviors that may perpetuate or accentuate the problem. Temper tantrums are best handled by ignoring the outburst, offering nurturance to the child after the tantrum has subsided and helping the child learn to express negative feelings in more acceptable ways.
Article
Dietary intake was assessed in a sample population of 40 autistic and 34 control children with a 7-day diet record kept by the parent or primary caregiver. A questionnaire was completed by each participant to obtain descriptive data on nutrition and health issues, attitudes and beliefs about nutrition, and nutrition knowledge. The autistic children had significantly greater intake of all nutrients with the exception of vitamins A and C, and fat; overall adequacy of diets was similar for both groups. Parent/primary caregivers of autistic children reported a more positive belief in the relationship between diet and behavior, and a more positive attitude about the importance of nutrition. A higher incidence of food cravings, pica, and perceived eating problems were reported by the parent/caregivers of autistic children.
Article
Abstract— Data are reported from an exploratory study looking at the prevalence of sleep problems (broken sleep and limited hours of sleep) in a population of handicapped children. Some degree of difficulty occurred in over a third of the population. There were strong associations with age, a range of serious daytime behavioural difficulties and indices of family stress. Some support for distinct subgroups (night waking, limited hours) was obtained. The implications of these findings are discussed.
For the purpose of clarifying the pathophysiological meaning of sleep disturbance in autistic children, the sleep pattern of 75 such children was examined by a questionnaire method. Forty-nine of them showed sleep disturbance in their early life with an incidence of 65%. The poorly-developed group showed a high rate of sleep disturbance as compared with the relatively well-developed group. There was a negative correlation between the developmental level and duration period of sleep disturbance. The investigation of circumstances in which autistic children often exhibited sleep disturbance proved that abrupt changes in life environment or various problems in the way of bringing up children brought about their sleep disturbance. These findings suggest that sleep disturbance might be one of the main symptoms and related to the pathophysiology of infantile autism.
Article
314 autistic adults were identified as part of an over-all state-wide needs assessment of developmentally disabled persons. Most of the adults were mentally retarded, but generally free from physical or sensory disabilities. Manifold language and adaptive skill deficits were noted. Some 59% resided in an institutional setting; the balance were at home or in a community-care setting. Comments underscored difficulties in case finding and the need to anticipate the adult needs of autistic children.
Article
Describes the Autism Diagnostic Interview-Revised (ADI-R), a revision of the Autism Diagnostic Interview, a semistructured, investigator-based interview for caregivers of children and adults for whom autism or pervasive developmental disorders is a possible diagnosis. The revised interview has been reorganized, shortened, modified to be appropriate for children with mental ages from about 18 months into adulthood and linked to ICD-10 and DSM-IV criteria. Psychometric data are presented for a sample of preschool children.
Article
In order to find out if self-injury is associated with the autistic syndrome or at least to specific autistic behaviour patterns, 69 probands were examined and assessed according to the criteria of the Autism Diagnostic Interview according to IQ. We found a high prevalence of self-injurious behaviour among autistic individuals at age 4-5 but no positive correlation between self-injury and the different areas of autistic behaviour. Possible aetiological factors are discussed.
Article
Sleep problems are common in children with severe learning difficulties. Children with sleep problems are reported to have more behaviour problems, but daytime challenging behaviour has not been examined specifically. The current study was concerned with associations between sleep problems and challenging behaviour, as well as describing other clinical features of the childrens' sleep, as reported by parents. All children in the series showed some form of sleep disturbance, with settling problems, night waking and early waking in 44% of the sample. Children with sleep problems showed significantly more types of challenging behaviour and challenging behaviour of a greater severity than children without sleep problems, resulting in management difficulties for carers throughout the 24-h period. Reasons for this association and suggestions for intervention are discussed.
Article
Eighty-eight children with autism, living in a suburb of Tokyo, were examined by questionnaire from 21 July to 31 August. Experienced sleep disorders were observed in 56 children; 44 of whom had sleep disorders before 3 years old. The average age when sleep disorders were seen to have stopped was 5 years old. The most common problem was difficulty falling sleep (n=23), followed by frequent awakening during sleep time (n=19), then early morning awakening (n=11). Bed-wetting was observed in 22 children.
Article
In this study, we examined three maladaptive behaviors, self-injurious behavior (SIB), stereotypies, and aggression in adults with autism, pervasive developmental disorder, not otherwise specified (PDD-NOS), and mental retardation. We used a brief functional analysis rating scale. The Questions About Behavioral Functions (QABF), to examine the function of each behavior. Across the three groups, our results indicated that aggression was primarily maintained for attentional reasons and stereotypies for nonsocial reasons. No specific function(s) were found to maintain SIB. These results suggest that the function of a maladaptive behavior may be associated more with the particular maladaptive behavior displayed rather than inclusion in a certain diagnostic group. Implications of findings for assessment and treatment issues are discussed.
Article
We examined aggression and psychopathology in persons with severe or profound mental retardation. Most aggressive episodes were directed toward other clients, and ratings of aggression were positively correlated with self-injury, stereotypic behavior, and being ambulatory. In a linear regression analysis of psychopathological correlates, aggression was most consistently predicted by dependent personality and psychosis. To better describe the construct of aggression, we also developed an Aggression-psychopathology scale. Persons with mental retardation and aggression were more likely to be impulsive, attention-seeking, dependent, socially inadequate, and anxious. Intensive efforts to modify the psychopathological correlates of aggression may improve treatment planning and outcome.
Article
There have been few epidemiological studies of the disabling and poorly understood disorder self-injurious behaviour among adults with learning disabilities. Interviews were undertaken with the carers of adults known to the Leicestershire Learning Disabilities Register (n = 2277). The Disability Assessment Schedule was used and information was also collected on demographic characteristics, developmental and physical status. Self-injurious behaviour was present in 17.4% of the population. In 1.7% self-injurious behaviour occurred frequently and was severe. There was no gender difference between those with and without self-injurious behaviour. Both the chronological age and developmental quotient of individuals with self-injurious behaviour were lower than those of individuals without self-injurious behaviour. Autistic symptoms were more common among those with self-injurious behaviour. The association of self-injurious behaviour with a wide range of other maladaptive behaviours was highly significant. Logistic regression analysis retained age, developmental quotient, hearing status, immobility and number of autistic symptoms as explanatory variables for self-injurious behaviour. Self-injurious behaviour is a prevalent and disabling disorder among adults with learning disabilities.
Article
Asperger's Syndrome is one of the diagnostic subcategories of pervasive developmental disorders. It is characterized by a defect in reciprocal social interaction, lack of empathy for others and poor non-verbal communication. Antisocial acts, including aggression and sexual offense, are not considered to be common in this disorder. We describe an adolescent with Asperger's Syndrome whose main problems are his violence and sexual offenses. We assume that these symptoms are secondary to his diagnosis of Asperger's as a manifestation of his difficulties with the "theory of mind" of others. This atypical case report is in contrast with the low prevalence of aggression and sexual offense in Asperger's, as reported in the literature. We discuss the reasons for this low prevalence. Our conclusions are based on one case history and a literature review. We call for further research in this field.