[Developmental Speech and Language Disorders According to ICD-11]. / Entwicklungsstörungen des Sprechens oder der Sprache nach ICD-11.

Developmental Speech and Language Disorders According to ICD-11 Abstract. In ICD-11, similar to ICD-10, speech and language disorders are classified as neurodevelopmental disorders, which are part of ICD-11 Chapter 6 (Mental, Behavioural and Neurodevelopmental Disorders). The ICD-10 criteria were not well accepted by many professionals in research and clinic who work with children with speech and language disorders. Especially linguists and speech and language therapists see ICD-10 as too crude and lacking specification of individual language problems. Medical professions in turn criticize the missing aspect of organically caused speech and language problems. This paper presents the classification of speech and language problems or disorders according to ICD-11 compared to ICD-10. One essential aspect lies in the differentiation between "primary" and "secondary" neurodevelopmental disorders. In addition, we compare and discuss other recent classification approaches, such as DSM-5, CATALISE-2, and the classification "Auditory Processing Disorder" by pediatric audiologists. We present a classification approach based on ICD-11, supplemented by an additional specification of the respective impaired speech or language area in the individual child and based on a thorough speech and language assessment. We thus hope to pave the path for an interdisciplinary classification of speech and language disorders according to ICD-11, our aim being to establish a common terminology that can be used by all professions. We expect this common terminology to improve clinical care and to allow for the integration and comparability of speech- and language-related research efforts.

[Empirically based developmental and behavioral intervention programs targeting the core symptoms and language development in toddlers and preschool children with autism spectrum disorder]. / Empirisch untersuchte entwicklungsorientierte und verhaltenstherapeutisch basierte Therapieprogramme zur Verbesserung der Kernsymptome und der Sprachentwicklung bei Klein- und Vorschulkindern mit Autismus-Spektrum-Störungen.

Empirically based developmental and behavioral intervention programs targeting the core symptoms and language development in toddlers and preschool children with autism spectrum disorder Abstract. This systematic review summarizes findings of articles included in the German AWMF-S3 clinical guideline on early intervention in autism spectrum disorders (ASD). We present the current state-of the art of evidence-based interventions for toddlers and preschool-aged children with ASD, specifically targeting the core symptoms and language development. We included studies on manualized developmental and behavioral interventions for children with ASD aged <7 years according to DSM-III(R), DSM-IV(TR), DSM-5, and ICD-10. The publication dates ranged from 1 January 2011 to 31 August 2018 or as included in the NICE-children guidelines. Studies were included by an iterative hierarchy: systematic review > randomized-controlled trial > clinically controlled trial. Outcome measures were core ASD symptoms and precursor abilities, or language abilities. The interventions were collated by (1) frequency and (2) approach. The studies focused on low-intensive interventions targeting parental synchrony, the child's initiations, reciprocity, joint attention, play and imitation skills as well as comprehensive interventions. Improvement of core ASD symptoms regarding social communication was observed for low-intensive training of parental synchrony and child's reciprocity as well as for low-intensive comprehensive developmental interventions implementing natural-learning paradigms. High-frequency discrete trial interventions did not improve social communication. Language abilities improved by comprehensive interventions. In conclusion, intervention recommendations are summarized.

Study protocol of the multi-centre, randomised controlled trial of the Frankfurt Early Intervention Programme A-FFIP versus early intervention as usual for toddlers and preschool children with Autism Spectrum Disorder (A-FFIP study).

BACKGROUND: Naturalistic developmental behavioural interventions (NDBI) have been shown to improve autism-specific symptoms in young children with Autism Spectrum Disorder (ASD). NDBI approaches, such as the ASD-specific Frankfurt Early Intervention Programme for ASD (A-FFIP), are based on ASD-specific developmental and learning aspects. A-FFIP is a low-intensity intervention which can easily be implemented in the local health care/social welfare system. The aim of the present study is to establish 1-year efficacy of the manualised early intervention programme A-FFIP in toddlers and preschool children with ASD. It is hypothesised that A-FFIP will result in improved ASD-specific symptoms compared to early intervention as usual (EIAU). Child- and family-specific secondary outcomes, as well as moderators and mediators of outcome, will be explored. METHODS/DESIGN: A prospective, multi-centre, parallel-group, randomised controlled, phase-III trial comparing A-FFIP versus EIAU. A total of 134 children (A-FFIP: 67, EIAU: 67) aged 24-66 months at baseline assessment meeting the criteria for ASD (DSM-5) will be included. The primary outcome is the absolute change of the total score of the Brief Observation of Social Communication Change (BOSCC-AT) between baseline (T2) and 1-year follow-up (T6). The treatment effect will be tested, adjusted for relevant covariates applying a mixed model for repeated measures. Secondary outcomes are BOSCC social communication and repetitive-behaviour scores, single ASD symptoms, language, cognition, psychopathology, parental well-being and family quality of life. Predictors, moderators and mediating mechanisms will be explored. DISCUSSION: If efficacy of the manualised A-FFIP early intervention is established, the current study has the potential to change clinical practice strongly towards the implementation of a low-intensity, evidence-based, natural early intervention in ASD. Early intervention in ASD requires specialist training, which subsequently needs to be developed or included into current training curricula. TRIAL REGISTRATION: German Registry for Clinical Trials (Deutscher Register Klinischer Studien, DRKS); ID: 00016330. Retrospectively registered on 4 January 2019. URL: https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016330.

Case-control study of the low intensive autism-specific early behavioral intervention A-FFIP: Outcome after one year.

Abstracts: Objective: In current international research, early intervention in children with autism-spectrum disorder (ASD) focuses on naturalistic developmental behavioral interventions (NDBI). The manualized Frankfurt Early Intervention Program for preschool-aged children with ASD (A-FFIP) implements NDBI principles within a low-intensity approach of 2 h intervention/week. The present case-control study established effect sizes of change in autistic symptoms, comorbid behavioral problems as well as IQ after one year. Methodology: An intervention group (N = 20; age: 3.4-7.9 years) and a treatment-as-usual control group (N = 20; age: 3.2-7.3 years) of children with ASD were matched for developmental and chronological age. The outcome measures used were the ADOS severity score, the Child Behavior Checklist, and cognitive development. Results: After one year, the A-FFIP group showed a trend towards greater improvement in autistic symptoms (η2 = .087 [95 %-CI: .000-.159]) and significantly greater improvements in cognitive development (η2 = .206 [CI: .012-.252]) and global psychopathology (η2 = .144 [CI: .001-.205]) compared to the control group. Conclusion: The efficacy of A-FFIP should be established in a larger, sufficiently powered, randomized controlled study.

Using the brief observation of social communication change (BOSCC) to measure autism-specific development.

To date no reliable and objective, change sensitive instrument for autistic symptoms is available. The brief observation of social communication change (BOSCC) was specifically developed to measure change of core autistic symptoms, for example, for use as outcome measure in early intervention trials. This study investigated quality criteria of a preliminary research version of the BOSCC in N = 21 children with autism spectrum disorder (ASD) who had participated for 1 year in the Frankfurt early intervention program (FFIP). BOSCC rating was done on play based ADOS video scenes. Inter-rater agreement on the BOSCC average total was very high. The BOSCC showed a significant decrease of autistic symptoms after 1 year with a medium effect size. Symptom specific improvements were captured by the social communication subscale and most single items. The BOSCC showed comparable change sensitivity to other autism specific instruments. Future studies should focus on the finalized BOSCC version, and replicate findings in a larger sample. Autism Res 2016, 9: 940-950. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

The Frankfurt early intervention program FFIP for preschool aged children with autism spectrum disorder: a pilot study.

Different early intervention programs, developed predominantly in the US, for preschool aged children with autism spectrum disorders (ASD) have been published. Several systematic review articles including a German Health Technology Assessment on behavioural and skill-based early interventions in children with ASD reported insufficient evidence and a substantial problem of generalisability to the German context. In Germany, approx. 2-5 h early intervention is supported by social services. Here, we report the results of a 1 year pre-post pilot study on a developmentally based social pragmatic approach, the Frankfurt Early Intervention program FFIP. In FFIP, individual 2:1, behaviourally and developmentally based therapy with the child is combined with parent training and training of kindergarten teachers. Treatment frequency is 2 h/week. Outcome measures were the Vineland Adaptive Behaviour Scales II (VABS), mental age and the ADOS severity score. Improvements after 1 year were observed for the VABS socialisation scale and the mental age quotient/IQ (medium effect sizes). Results are comparable with several other studies with a similar or slightly higher therapeutic intensity implementing comparable or different early intervention methods or programs. Compared to most high-intensity programs (30-40 h/week), lower cognitive gains were observed. Results have to be replicated and assessed by a randomized-controlled study before any final conclusions can be drawn.