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Introduction: Implementing low-intensity interventions, such as group-based parent education and training (PET), is a cost and time effective way of providing early intervention for families and their children with autism spectrum disorder (ASD) in low- and middle-income countries (LMICs). Relatively little empirical research demonstrates the effectiveness of parent education and training in this context. Methods: The study aimed to develop and pilot a group-based parent education and training (PET) programme (COMPAS) and determine its appropriateness and acceptability. Secondly, it aimed to investigate the clinical effectiveness of the programme to improve the communication interaction skills and self-efficacy beliefs of parents of young children with autism. The study followed an exploratory sequential mixed methods research design and used the Replicating Effective Programs (REP) framework. Sixty-one participants took part in the study which consisted of 3 phases. In phase one we developed the programme and teaching materials and activities. In the pre-implementation phase, we collected qualitative and quantitative data via questionnaires from two stakeholder groups (25 parents and 5 autism experts). In the implementation phase, we used a single group pre-test post-test design with 31 parents of children with autism to determine changes in parent-child interaction and parenting self-efficacy. The primary outcome of the implementation phase, parent-child interaction, was measured using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO), and the secondary outcome, parenting self-efficacy, was measured using the Parenting Sense of Competence Scale (PSOC) and the Parenting Self-Efficacy Measuring Instrument (P-SEMI). Results: In the pre-implementation phase, a panel of experts agreed the training content was comprehensive and relevant, and that the manual was user-friendly. After the pilot study parents felt confident that they could use at least one of the strategies taught during everyday routines or play with their child. Results from the implementation phase indicated significant improvement in parenting interactions (p < .05, d = 1.26) and self-efficacy (p < .05, d = 0.35) after the training. Conclusion: We developed and piloted a training programme in a LMIC setting which resulted in increased interaction skills and self-efficacy for parents of young children with autism. This study indicates that brief, group parent education and training in a LMIC is feasible and can be effective in improving parenting skills and feelings of competence.

京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第23125号 / 人健博第87号 / 新制||人健||6(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 林 悠, 教授 稲富 宏之, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

In this survey, a number of recent studies were reviewed to assess the impact of using assistive technology in teaching students diagnosed with Autism Spectrum Disorder. The survey investigates the possible beneficial effects of such technology in terms of academic learning as well as in terms of social integration of students in the years 4-6 (ages 9 -13). The role of Autism Spectrum Disorder in limiting the learning abilities and social skills of diagnosed students is covered, explaining the factors most relevant within this context. Recent studies were chosen as they dealt with more recent technological tools that are relevant today, with the exclusion of older forms of technology that are deemed obsolete. The different forms of technology used in these studies are taken into consideration, both simple and advanced forms were reviewed, and the results were examined critically. In addition, different sample sizes were also considered, ranging from single cases to relatively bigger samples. The findings do confirm that the use of assistive technology does help improve the social and academic performance of autistic students to varying degrees and that improvements are felt by the educators as well as parents and caregivers. Attention was given to the factors influencing the choice of the technological tools used in assisting autistic students. The survey further considers the limitations and setbacks that can occur with the use of technology

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting social behaviors. ASD affects 1 in 59 children with males affected more frequently. ASD is postulated to result from excitatory and inhibitory neurotransmission imbalances. Brain-derived neurotrophic factor (BDNF) signaling affects ASD by influencing synaptogenesis, plasticity, and survival. Studying early in-utero neuropathological changes within ASD requires the use of animal models. Expression of BDNF-associated genes were analyzed within laser capture microdissected pyramidal neurons from the anterior cingulate cortex of male and female BTBR and valproic acid mouse models. No expression differences were found in any gene comparing the three groups. Gender comparisons did identify differences in NTRK2 and EFNB2. Significant correlations of gene expression were identified for male NTRK2 with EFNB2 and GRIN1 and EFNB2 with GRIN1 and female BDNF with GRIN1 expressions (p

Background: Some children with ASD have comprehension difficulties that affect their ability to follow directives that contain prepositions. Aided input has been known to facilitate improved comprehension skills when spoken language is used with graphic symbols. Aims: This study examined the effects that aided input presented at two levels (20% of aided input and 60% of aided input) has on children with ASD’s following of directives that contain prepositions. Methods: An experimental, within-subjects crossover design was utilised where all participants were exposed to each treatment condition at a different time period. Altogether 21 participants between 5.0 and 11.11 years of age were asked to follow 12 directives using aided input at two conditions. Participants first completed a pre-test task to confirm their noun knowledge, preposition knowledge and matching skills. Participants were described based on the CARS classification and their PPVT-4 scores. The effects of the aided input were measured and compared based on the accuracy of responses. Results: Descriptive statistics were used to describe the data, and multivariate analysis was used to analyse the data. Some children with ASD (n=9) who received a higher level of aided input (60%) were able to respond more accurately than those who received a lower level of aided input (20%). However, some children with ASD (n=4) responded more accurately to the lower level of aided input (20%) than the higher level of aided input (60%). Some children with ASD (n=5) responded in the same manner for both levels of aided input and some children with ASD (n=3) did not respond at all despite the level of aided input. The results showed no statistically significant difference between the higher (60%) and lower (20%) levels of aided input. Conclusion: It was concluded that the 60% aided input level yielded a higher accuracy of responses than the 20% aided input level in some children with ASD. In addition, the results suggest that augmenting spoken language was advantageous in some children with ASD. However, further research is needed to better describe the effects of aided input, using graphic symbols. Future research directions are suggested. / Dissertation (MA)--University of Pretoria, 2019. / Centre for Augmentative and Alternative Communication (CAAC) / MA / Unrestricted

Virtual learning has been used long before the COVID-19 pandemic for mental health care or acute conditions but was rarely used as a replacement for in-person visits. Additionally, virtual learning was primarily used for those earning graduate and undergraduate degrees. Virtual learning for individuals younger than eighteen is not typically researched, as it has not been a subject of importance or seen as a replacement for in-person learning. The current study worked with four male children under the age of eighteen from both the neurotypical and neurodiverse populations. Participants were paired into dyads to assess learning done both virtually and in-person when presented with a brainteaser puzzle using a multiple baseline across participants design. Two of the four participants engaged in both treatment conditions. Percent of independently completed steps of a brainteaser puzzle and percent of on-task behavior were measured across conditions. Implications of the current study suggest that individuals that are considered severely delayed may learn more proficiently when in-person, however, others with less severe developmental disabilities and those that are considered neurotypical may be able to learn across either condition.

Autism spectrum disorder (ASD) affects the lives of 1 in 54 children in the United States. By definition, these children often have social communication deficits as well as restrictive and repetitive behaviors that are socially isolating. Inclusion of participants with disabilities such as ASD in classroom or group settings with peers is a high-priority goal for building skills that lead to independent living and higher quality of life for all. Balancing an individual’s class or group participation is not always easy with different levels of social skills, however. In a classroom, this can translate to difficulty in knowing how to participate in a way that is equal to that of their peers—oftentimes children with ASD do not realize that others also need a turn to speak or that other children are not as interested in their restricted ¬interests as they are. We used differential reinforcement and self-monitoring within an existing token system to reduce excess participation in group settings for some individuals, with the goal of better balancing opportunities for all group members to participate. Called "Stack the Deck," this simple intervention allowed for more uninterrupted instruction time with fewer talk outs and meltdowns from adolescents with ASD. Our intervention occurred in a clinical setting, a once-weekly social skills group utilizing the PEERS Social Skills manualized intervention for adolescents with ASD. Groups ran for 12–14 weeks in duration and taught skills such as how to make friends, how to enter and exit conversations, as well as how to host "get-togethers." Our sample size was 33, with 26 males and 7 females. These participants met criteria for autism spectrum disorder and/or had significant social impairment, and had age-appropriate verbal and cognitive abilities by parent report (later measured within the study). Across our A-B intervention, we saw changes over time when it came to participation rates for over-responders (participants who attempted to respond far above the group average during baseline) and under-responders (participants who attempted to respond at rates far below the group average during baseline), with no changes (the desired result) for individuals who were already participating at an appropriate rate. Over-responders showed the most significant changes. A secondary finding of reduced talk-outs overall within the groups was also found. These results suggest that a fairly simple group behavioral intervention was able to produce a group environment more conducive to direct instruction that has direct application to inclusive classrooms as well as clinical environments. Further research can determine if the effects within individuals seen in one setting carry over to others.

Mutations in TSC2 cause the disorder tuberous sclerosis (TSC), which has a high incidence of autism and intellectual disability. TSC2 regulates mRNA translation required for group 1 metabotropic glutamate receptor-dependent synaptic long-term depression (mGluR-LTD), but the identity of mRNAs responsive to mGluR-LTD signaling in the normal and TSC brain is largely unknown. We generated Tsc2+/- mice to model TSC autism and performed ribosome profiling to identify differentially expressed genes following mGluR-LTD in the normal and Tsc2+/- hippocampus. Ribosome profiling reveals that in Tsc2+/-mice, RNA-binding targets of Fragile X Mental Retardation Protein (FMRP) are increased. In wild-type hippocampus, induction of mGluR-LTD caused rapid changes in the steady state levels of hundreds of mRNAs, many of which are FMRP targets. Moreover, mGluR-LTD signaling failed to promote phosphorylation of eukaryotic elongation factor 2 (eEF2) in Tsc2+/- mice, and chemically mimicking phospho-eEF2 with low cycloheximide enhances mGluR-LTD in the Tsc2+/- brain. These results suggest a molecular basis for bidirectional regulation of synaptic plasticity by TSC2 and FMRP. Furthermore, deficient mGluR-regulated translation elongation contributes to impaired synaptic plasticity in Tsc2+/- mice.

Two of the most under-researched and under-served populations in the field of autism spectrum disorder (ASD), minimally to low-verbal (MLV) individuals and children from low-resource countries, would benefit the most from engaging their parents in research and intervention. First, parents’ unique familiarity with their children could be highly advantageous for language assessment providing a more ecologically valid representation of their children’s abilities. Second, parents’ verbal input, known to predict children’s language, is an important avenue to investigate to guide the development of parent-mediated interventions. Natural language samples, which are used in all three dissertation studies, are ideal for assessing expressive language and for analyzing communicative variations in verbal input. In Study 1, I examined the feasibility of parents (N=33) collecting language samples at home from their MLV children/adolescents with ASD (6;6–19;7years) following a semi-structured elicitation protocol, ELSA-A. I predicted that because of parents’ unique familiarity with their children, they will be better at eliciting speech from them. The results supported this prediction. When with their parents, the MLV children/adolescents produced twice as much speech than when with examiners. Parents collected longer ELSA-As but administered fewer of the recommended activities. Therefore, although parents are not as good at following semi-structured assessment protocols, they elicit speech that is more representative of their children’s everyday abilities. In Studies 2 and 3, I compared the parental input to 37 Bulgarian-speaking (2;7–9;10 years) and 37 English-speaking (1;8–4;9 years) children with ASD matched on expressive language. I compared input in terms of quantity and quality, such as lexical diversity and sentence types (Study-2), and in terms of how parents addressed their children, focusing on personal pronouns, names, and kinship terms (Study-3). Based on past research, I hypothesized that input would differ in quality but not quantity. Indeed, parents’ speech differed in sentence types but not in overall amount. Bulgarian parents asked fewer questions but used more statements. As predicted, they also used significantly more ways to address their children because of the structural characteristics of Bulgarian and potentially different discourse practices. These studies lay the foundation for future cross-linguistic and cross-cultural comparisons in ASD. / 2023-08-30T00:00:00Z