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Predictors of treatment outcomes in toddlers with autism spectrum disorders
S128
IACAPAP 2012 – 20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S127–S139
Mo-O-04
Family structure and stability as a factor for juvenile justice contact among nigerian adolescents O. Atilola a,∗ , O.O. Omigbodun b a Department of Psychiatry, University College Hospital, Ibadan, Nigeria b College of Medicine, University of Ibadan, Ibadan, Nigeria ∗ Corresponding author. Social indicators in Nigeria abound with unfavourable indices like widespread poverty, low levels of literacy and low life expectancy. This is compounded by a poor state of social welfare serving a predominantly youthful population. This adverse social environment is known to increase the risk for child abuse and neglect and juvenile delinquency. While the long-term solution to the increasing number of vulnerable and delinquent youth in Nigeria is socio-economic emancipation, a medium term measure is to identify and address risk factors for child neglect and delinquency. We explored the family unit of adolescents in some juvenile justice facilities in Nigeria. Results showed that compared with controls, juvenile justice residents have significantly higher experiences of family transition, family instability and parental psychopathology. Family centred strategies to curb the rising cases of child neglect and juvenile delinquency in the country are discussed. http://dx.doi.org/10.1016/j.neurenf.2012.04.055
AUTISM Mo-O-05
Helping parents learning to live with autism spectrum disorders: The jumpstart learning to learn model – a workshop B. Siegel Psychiatry, University of California, San Francisco, San Francisco/CA, USA Helping Parents Learning to Live with Autism Spectrum Disorders: The JumpStart Learning to Learn (JSLTL) Model – A Workshop (ASDs) Research supports positive outcomes for parents and for children when parent training around ASDs includes component of intervention with: – autism didactics; – personal coping strategies; – dyadic counseling; – technical assistance in learning strategies to reduce the child’s negative behaviors; – strategies to foster communication; – teaching of a repertoire of leisure activities to build reciprocity. JSLTL is administered to families with newly-diagnosed children in the first weeks after ASD diagnosis in an intensive, week-long, 6 hours per day format of 1:1 parent coaching in the use of pivotal behavior methods, developmentallybased communication training, child-centric play strategies, and integrative sessions for applying these skills at home and in selecting on-going therapies. This workshop will present the methods and illustrative data on effectiveness. http://dx.doi.org/10.1016/j.neurenf.2012.04.056 Mo-O-06
Predictors of treatment outcomes in toddlers with autism spectrum disorders G. Vivanti School Of Psychological Science, La Trobe University, Melbourne, Australia Background.– Early intensive behavioural interventions have been shown to improve outcomes in autism. However, children with autism display individual differences in response to treatment. Understanding the predictors of outcomes is crucial for enabling practitioners to prospectively recommend treatment strategies in order to increase the overall rate of positives outcomes.
Objectives.– Our aim was to identify the individual differences in early emerging social and cognitive abilities which are prospectively associated with positive response to treatment. Methods: Participants were 25 2- to 4- years old children with an ASD enrolled in an early intensive behavioural treatment program. We assessed a range of social-cognitive abilities at start of treatment. Standardized measures of cognitive and social functioning 1 year after the start of treatment were used as the outcome measures. Results.– Individual differences in the ability to engage in functional actions on objects were correlated to outcomes in Non-Verbal Developmental Quotient (r = .8; P < .001) and social skills (r = .9; P < .0001), while individual differences in social attention were associated to differential outcomes in Verbal Developmental Quotient (r = .7; P < .01) Conclusions.– Individual differences in early emerging social and non-social cognitive abilities were differentially associated to gains in different developmental areas. The ability to engage in functional actions with objects appears to be a powerful predictor of both non-social and social gains in our sample. http://dx.doi.org/10.1016/j.neurenf.2012.04.057 Mo-O-07
Early as usual treatment in autism: The first italian multisite perspective cohort study A. Narzisi ∗ , F. Muratori , IDIA Consortium Stella Maris Scientific Institute, Calambrone (Pisa), Italy ∗ Corresponding author.
Objectives.– To evaluate the role of not manualized AS USUAL intervention for improving outcomes of toddlers with autism spectrum disorder (ASD). Methods.– 70 children with ASD between 18 and 47 months of age were assessed at baseline and after six months using ADOS-G; Griffiths Mental Developmental scales; and Vineland Adaptive Behavior scales (VABS). Parents filled out MacArthur inventory; Social Communication Questionnaire; CBCL and Parent Stress Index. All children were referred to community providers for intervention. Hours of treatment, school attendance and parent mediated interventions were considered. Results.– At endpoint, most children were still classified as having an ADOS-G diagnosis of autism spectrum disorder. However, 20 of 57 children had changed from core autism to autism spectrum disorder and 3 out of 13 had changed from autism spectrum disorder to non-spectrum. Treatment effects were obtained for cognitive functioning (General Quotient was higher by 15.7 points than baseline on Griffiths); language; adaptive behaviour; child behaviour and parental stress. Conclusions.– This first Italian multisite study shows that school attendance and parents involvement in child’s treatments were predictive of a best clinical outcome. We’ll discuss our results considering their similarity and differences compared to recent literature on this field. http://dx.doi.org/10.1016/j.neurenf.2012.04.058 Mo-O-08
Translational research on biomedical assessment and treatment of autism R.L. Hendren Psychiatry, University of California, San Francisco,USA Our understanding of the etiology of autism is growing rapidly, and as it grows it is changing the way we are considering interventions. Evidence is mounting that multiple genes are involved, their expression is influenced through environmental interaction, the immune system plays a role in many cases, and there are likely critical periods when the active process of epigenetic changes pushes the neuro-developmental trajectory toward the autism spectrum. Evidence-based standards of intervention, such as behavioral therapies, speech and language interventions, and medications for symptoms associated with autism are being joined with understudied nutritional and alternative “biomedical” interventions in many treatment programs. This proposed IACAPAP presentation will provide several examples of these interventions and the rationale for them, describe some of the problems encountered in trial design, and offer solutions from recently
IACAPAP 2012 – 20th World congress / Neuropsychiatrie de l’enfance et de l’adolescence 60S (2012) S127–S139
Mo-O-04
Family structure and stability as a factor for juvenile justice contact among nigerian adolescents O. Atilola a,∗ , O.O. Omigbodun b a Department of Psychiatry, University College Hospital, Ibadan, Nigeria b College of Medicine, University of Ibadan, Ibadan, Nigeria ∗ Corresponding author. Social indicators in Nigeria abound with unfavourable indices like widespread poverty, low levels of literacy and low life expectancy. This is compounded by a poor state of social welfare serving a predominantly youthful population. This adverse social environment is known to increase the risk for child abuse and neglect and juvenile delinquency. While the long-term solution to the increasing number of vulnerable and delinquent youth in Nigeria is socio-economic emancipation, a medium term measure is to identify and address risk factors for child neglect and delinquency. We explored the family unit of adolescents in some juvenile justice facilities in Nigeria. Results showed that compared with controls, juvenile justice residents have significantly higher experiences of family transition, family instability and parental psychopathology. Family centred strategies to curb the rising cases of child neglect and juvenile delinquency in the country are discussed. http://dx.doi.org/10.1016/j.neurenf.2012.04.055
AUTISM Mo-O-05
Helping parents learning to live with autism spectrum disorders: The jumpstart learning to learn model – a workshop B. Siegel Psychiatry, University of California, San Francisco, San Francisco/CA, USA Helping Parents Learning to Live with Autism Spectrum Disorders: The JumpStart Learning to Learn (JSLTL) Model – A Workshop (ASDs) Research supports positive outcomes for parents and for children when parent training around ASDs includes component of intervention with: – autism didactics; – personal coping strategies; – dyadic counseling; – technical assistance in learning strategies to reduce the child’s negative behaviors; – strategies to foster communication; – teaching of a repertoire of leisure activities to build reciprocity. JSLTL is administered to families with newly-diagnosed children in the first weeks after ASD diagnosis in an intensive, week-long, 6 hours per day format of 1:1 parent coaching in the use of pivotal behavior methods, developmentallybased communication training, child-centric play strategies, and integrative sessions for applying these skills at home and in selecting on-going therapies. This workshop will present the methods and illustrative data on effectiveness. http://dx.doi.org/10.1016/j.neurenf.2012.04.056 Mo-O-06
Predictors of treatment outcomes in toddlers with autism spectrum disorders G. Vivanti School Of Psychological Science, La Trobe University, Melbourne, Australia Background.– Early intensive behavioural interventions have been shown to improve outcomes in autism. However, children with autism display individual differences in response to treatment. Understanding the predictors of outcomes is crucial for enabling practitioners to prospectively recommend treatment strategies in order to increase the overall rate of positives outcomes.
Objectives.– Our aim was to identify the individual differences in early emerging social and cognitive abilities which are prospectively associated with positive response to treatment. Methods: Participants were 25 2- to 4- years old children with an ASD enrolled in an early intensive behavioural treatment program. We assessed a range of social-cognitive abilities at start of treatment. Standardized measures of cognitive and social functioning 1 year after the start of treatment were used as the outcome measures. Results.– Individual differences in the ability to engage in functional actions on objects were correlated to outcomes in Non-Verbal Developmental Quotient (r = .8; P < .001) and social skills (r = .9; P < .0001), while individual differences in social attention were associated to differential outcomes in Verbal Developmental Quotient (r = .7; P < .01) Conclusions.– Individual differences in early emerging social and non-social cognitive abilities were differentially associated to gains in different developmental areas. The ability to engage in functional actions with objects appears to be a powerful predictor of both non-social and social gains in our sample. http://dx.doi.org/10.1016/j.neurenf.2012.04.057 Mo-O-07
Early as usual treatment in autism: The first italian multisite perspective cohort study A. Narzisi ∗ , F. Muratori , IDIA Consortium Stella Maris Scientific Institute, Calambrone (Pisa), Italy ∗ Corresponding author.
Objectives.– To evaluate the role of not manualized AS USUAL intervention for improving outcomes of toddlers with autism spectrum disorder (ASD). Methods.– 70 children with ASD between 18 and 47 months of age were assessed at baseline and after six months using ADOS-G; Griffiths Mental Developmental scales; and Vineland Adaptive Behavior scales (VABS). Parents filled out MacArthur inventory; Social Communication Questionnaire; CBCL and Parent Stress Index. All children were referred to community providers for intervention. Hours of treatment, school attendance and parent mediated interventions were considered. Results.– At endpoint, most children were still classified as having an ADOS-G diagnosis of autism spectrum disorder. However, 20 of 57 children had changed from core autism to autism spectrum disorder and 3 out of 13 had changed from autism spectrum disorder to non-spectrum. Treatment effects were obtained for cognitive functioning (General Quotient was higher by 15.7 points than baseline on Griffiths); language; adaptive behaviour; child behaviour and parental stress. Conclusions.– This first Italian multisite study shows that school attendance and parents involvement in child’s treatments were predictive of a best clinical outcome. We’ll discuss our results considering their similarity and differences compared to recent literature on this field. http://dx.doi.org/10.1016/j.neurenf.2012.04.058 Mo-O-08
Translational research on biomedical assessment and treatment of autism R.L. Hendren Psychiatry, University of California, San Francisco,USA Our understanding of the etiology of autism is growing rapidly, and as it grows it is changing the way we are considering interventions. Evidence is mounting that multiple genes are involved, their expression is influenced through environmental interaction, the immune system plays a role in many cases, and there are likely critical periods when the active process of epigenetic changes pushes the neuro-developmental trajectory toward the autism spectrum. Evidence-based standards of intervention, such as behavioral therapies, speech and language interventions, and medications for symptoms associated with autism are being joined with understudied nutritional and alternative “biomedical” interventions in many treatment programs. This proposed IACAPAP presentation will provide several examples of these interventions and the rationale for them, describe some of the problems encountered in trial design, and offer solutions from recently