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"Autistic Disorder - psychology"
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Development and brain systems in autism
This volume covers several perspectives on autism which bring together the most recent scientific views of the nature of this disorder. A number of themes organize major developments and emerging areas in autism: cognitive and neural systems development-how autism arises in the behavior and thought of very young children; discovering brain mechanisms underlying social and cognitive deficits in autism-how we can explain \"social awkwardness\" and poor language comprehension in terms of malfunctions of brain mechanisms, revealed by MRI studies of people with autism; integrating information about genes, brain, and biological mechanisms with behavioral evidence; and linking the science of autism with lives lived-how the new information about autism impacts people with autism and real-world considerations-- Source other than Library of Congress.
Book
Reduction in social anxiety after MDMA-assisted psychotherapy with autistic adults: a randomized, double-blind, placebo-controlled pilot study
Rationale
Standard therapeutic approaches to reduce social anxiety in autistic adults have limited effectiveness. Since 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy shows promise as a treatment for other anxiety disorders, a blinded, placebo-controlled pilot study was conducted.
Objectives
To explore feasibility and safety of MDMA-assisted psychotherapy for reduction of social fear and avoidance that are common in the autistic population.
Methods
Autistic adults with marked to very severe social anxiety were randomized to receive MDMA (75 to 125 mg,
n
= 8) or inactive placebo (0 mg,
n
= 4) during two 8-h psychotherapy sessions (experimental sessions) in a controlled clinical setting. Double-blinded experimental sessions were spaced approximately 1 month apart with 3 non-drug psychotherapy sessions following each. The primary outcome was change in Leibowitz Social Anxiety Scale (LSAS) Total scores from Baseline to one month after the second experimental session. Outcomes were measured again six months after the last experimental session.
Results
Improvement in LSAS scores from baseline to the primary endpoint was significantly greater for MDMA group compared to the placebo group (
P
= 0.037), and placebo-subtracted Cohen’s
d
effect size was very large (
d
= 1.4, CI − 0.074, 2.874). Change in LSAS scores from baseline to 6-month follow-up showed similar positive results (
P
= 0.036), with a Cohen’s
d
effect size of 1.1 (CI − 0.307, 2.527). Social anxiety remained the same or continued to improve slightly for most participants in the MDMA group after completing the active treatment phase.
Conclusions
This pilot trial demonstrated rapid and durable improvement in social anxiety symptoms in autistic adults following MDMA-assisted psychotherapy. Initial safety and efficacy outcomes support expansion of research into larger samples to further investigate this novel treatment for social anxiety.
Trial registration
clinicaltrials.gov
identifier, NCT02008396
Journal Article
Program for the Education and Enrichment of Relational Skills (PEERS®) for Italy: A Randomized Controlled Trial of a Social Skills Intervention for Autistic Adolescents
The
Program for the Education and Enrichment of Relational Skills
(PEERS
®
) is an intervention targeting social skills for autistic adolescents and those with other social challenges. The efficacy of the PEERS
®
on adolescents has been extensively explored but the program has not been validated in Italy. In the present study, we adapted PEERS
®
to Italian culture and evaluated its efficacy in an Italian sample. A Randomized Controlled Trial was conducted, analyzing the results of 37 autistic adolescents who were randomly assigned to two groups: experimental group (TG) and waitlist group (WL). The primary outcomes (social abilities) and secondary outcomes (co-occurring conditions, executive functions) were assessed at four time points. No differences were found at pre-treatment between groups on baseline measures and primary outcomes. At post-treatment, significant group differences emerged in primary outcomes (social knowledge and social performance) and secondary outcomes (emotion regulation). The groups’ results pooled together (TG + WL) confirmed the findings at post-treatment and showed further changes in primary outcomes (global social competence and social cognition) and secondary outcomes (externalizing problems, emotive and behavioral total problems, functional problems related to depressive symptoms). The improvements were maintained at a 3-month follow-up, except for global social competence and social cognition. Additionally, new results emerged regarding internalizing problems and global executive functioning. The efficacy of the Italian version of PEERS
®
was ascertained on primary and secondary outcomes. Innovative findings on emotion regulation, behavioral problems, and depression symptoms also emerged.
Clinical trial registration information
Program for the Education and Enrichment of Relational Skills (PEERS
®
) for Italy. An RCT’s Study on Social Skills Intervention for Adolescents with Autism Spectrum Disorder (ASD). URL:
http://clinicaltrials.gov
. TRN: NCT05473104. Release Date: July 21, 2022.
Journal Article
Relative Efficacy of Self-directed and Therapist-assisted Telehealth Models of a Parent-mediated Intervention for Autism: Examining Effects on Parent Intervention Fidelity, Well-being, and Program Engagement
Purpose
Although there is growing interest in telehealth to deliver parent-mediated intervention for autistic children, empirical evaluations are limited, and little is known regarding the relative benefits of self-directed and therapist-assisted telehealth interventions. This study examined the effect of self-directed and therapist-assisted ImPACT Online on parent learning and well-being, moderators of treatment, and predictors of program engagement.
Method
Sixty-four young autistic children and their primary caregiver participated. Children were matched on age and developmental quotient and randomly assigned to a therapist-assisted, self-directed, or resource support control group. Participants were assessed at intake, after 6 months (post), and at a 3-month follow-up.
Results
There was a significant treatment effect for parent learning for the therapist-assisted but not self-directed program; when analysis was limited to parents who completed the program, treatment effects were observed for both groups. There were no treatment effects for parent self-efficacy or parenting stress; however, there was an effect on parents’ perception of their child’s positive impact. Parenting stress did not moderate the effect of group on parent outcomes. Parent age, program satisfaction, and therapist assistance were all significant predictors of parent program engagement.
Conclusion
This study supports the efficacy of therapist-assisted telehealth parent-mediated intervention for teaching parents intervention strategies to support their child’s social communication and improving their perceptions of their child’s positive impact, and suggests that self-directed programs may be beneficial for parents who fully engage with the program.
Journal Article
The autistic stage : how cognitive disability changed 20th-century performance
This is a book for those who have a stake in and curiosity about the relationship between autism and the stage. Performance here covers theater to therapy, film to biography, art and beyond. If you are a theater or film critic, a speech or drama therapist, a higher education specialist or special education instructor, a parent of a child on the autism spectrum or an individual with ASD interested in theatre, this book may hold unique value for you. This work is meant to cover a range of issues and reach out to audiences, critics, professionals and parents who want to know more about performance representations of autism. One message reverberates throughout the book: each autistic person illustrates different approaches to and perspectives on life. We become richer each time we come to understand these new perspectives and performance powerfully enhances our understanding of them. Autism Spectrum Disorders include alternative modes of processing information, recording images, discoursing with others, and interpreting social scenes. In this conversation, performance can function as an analytical lens, a representational space, a means of perceptual innovation, and a therapeutic tool. The definition of autism as a disorder has evolved from its first diagnosis in the 1940s to our current frame of reference with several key revisions. These three categories-interaction, communication, and perseveration-underlie any published study of those on the autism spectrum. What has shifted in recent years is an approach to disability that positions autism as a social construction rather than a medical problem. -- Amazon.com.
Book
Parent-mediated communication-focused treatment in children with autism (PACT): a randomised controlled trial
Results of small trials suggest that early interventions for social communication are effective for the treatment of autism in children. We therefore investigated the efficacy of such an intervention in a larger trial.
Children with core autism (aged 2 years to 4 years and 11 months) were randomly assigned in a one-to-one ratio to a parent-mediated communication-focused (Preschool Autism Communication Trial [PACT]) intervention or treatment as usual at three specialist centres in the UK. Those assigned to PACT were also given treatment as usual. Randomisation was by use of minimisation of probability in the marginal distribution of treatment centre, age (≤42 months or >42 months), and autism severity (Autism Diagnostic Observation Schedule-Generic [ADOS-G] algorithm score 12–17 or 18–24). Primary outcome was severity of autism symptoms (a total score of social communication algorithm items from ADOS-G, higher score indicating greater severity) at 13 months. Complementary secondary outcomes were measures of parent-child interaction, child language, and adaptive functioning in school. Analysis was by intention to treat. This study is registered as an
International Standard Randomised Controlled Trial, number
ISRCTN58133827.
152 children were recruited. 77 were assigned to PACT (London [n=26], Manchester [n=26], and Newcastle [n=25]); and 75 to treatment as usual (London [n=26], Manchester [n=26], and Newcastle [n=23]). At the 13-month endpoint, the severity of symptoms was reduced by 3·9 points (SD 4·7) on the ADOS-G algorithm in the group assigned to PACT, and 2·9 (3·9) in the group assigned to treatment as usual, representing a between-group effect size of −0·24 (95% CI −0·59 to 0·11), after adjustment for centre, sex, socioeconomic status, age, and verbal and non-verbal abilities. Treatment effect was positive for parental synchronous response to child (1·22, 0·85 to 1·59), child initiations with parent (0·41, 0·08 to 0·74), and for parent-child shared attention (0·33, −0·02 to 0·68). Effects on directly assessed language and adaptive functioning in school were small.
On the basis of our findings, we cannot recommend the addition of the PACT intervention to treatment as usual for the reduction of autism symptoms; however, a clear benefit was noted for parent-child dyadic social communication.
UK Medical Research Council, and UK Department for Children, Schools and Families.
Journal Article
Nasal Oxytocin for Social Deficits in Childhood Autism: A Randomized Controlled Trial
The last two decades have witnessed a surge in research investigating the application of oxytocin as a method of enhancing social behaviour in humans. Preliminary evidence suggests oxytocin may have potential as an intervention for autism. We evaluated a 5-day ‘live-in’ intervention using a double-blind randomized control trial. 38 male youths (7–16 years old) with autism spectrum disorders were administered 24 or 12 international units (depending on weight) intranasal placebo or oxytocin once daily over four consecutive days. The oxytocin or placebo was administered during parent–child interaction training sessions. Parent and child behaviours were assessed using parent reports, clinician ratings, and independent observations, at multiple time points to measure side-effects; social interaction skills; repetitive behaviours; emotion recognition and diagnostic status. Compared to placebo, intranasal oxytocin did not significantly improve emotion recognition, social interaction skills, or general behavioral adjustment in male youths with autism spectrum disorders. The results show that the benefits of nasal oxytocin for young individuals with autism spectrum disorders may be more circumscribed than suggested by previous studies, and suggest caution in recommending it as an intervention that is broadly effective.
Journal Article