Reported quality indicators and implementation outcomes of community partnership in autism intervention research: A systematic review.

There is minimal research on the quality of community partnerships in studies of interventions for autistic children. However, building high quality community engagement in autism intervention research may improve implementation outcomes. This systematic review examined studies that report community partnership in autism intervention research. A total of 135 articles were identified and 11 of these articles were included in the final review. Community partnership data were extracted using indicators from the conceptual framework for assessing research-practice partnerships (RPP; Henrick et al., Henrick et al., Assessing research-practice partnerships: Five dimensions of effectiveness, William T. Grant Foundation, 2017) and implementation outcomes data were extracted using the taxonomy of distinct implementation outcomes (Proctor et al., Administration and Policy in Mental Health and Mental Health Services Research, 38:65-76, 2011). Quality of studies were appraised using JBIs critical appraisal tools (Munn et al., JBI Evidence Synthesis, 18:2127-2133, 2020). RPP indicators and implementation outcomes were variably reported across studies. RPP indicators and implementation outcomes more likely to be reported were related to building trust, cultivating partnership relationships, conducting rigorous research to inform action, acceptability, and feasibility. RPP indicators and implementation outcomes less likely to be reported were related to building capacity to engage in partnership work, sustainability, cost, and penetration. Together, these results may suggest the need for increased sustainability and capacity building efforts in partnerships and increased guidelines for reporting outcomes.

A mixed-methods examination of clinicians' perceived barriers to telehealth delivered applied behavior analysis.

Following the COVID-19 pandemic, clinicians relied on telehealth to ensure continuity of essential healthcare services, such as Applied Behavior Analysis (ABA). Identifying barriers and examining them in the context of other implementation outcomes is important to support appropriate adaptations and sustainability of telehealth-delivered ABA services. Convergent mixed methods design was utilized to identify barriers experienced by ABA clinicians (N = 388) when delivering ABA services over telehealth to autistic children and their families following the first six months of the COVID-19 pandemic. Additionally, barriers were examined in relation to telehealth implementation outcomes and intentions for continued adoption. Findings reveal that clinicians rated providing direct services (M = 3.52, SD = 1.14) as more difficult than conducting assessments (M = 3.29, SD = 1.06), and both as more difficult than providing parent-mediated interventions [(M = 2.47, SD = 1.11), F(2, 381) = 162.26, p < 0.001]. A principal components analysis indicated a 3-factor solution of barriers related to: (1) technology (α = 0.82), (2) administrative tasks (α = 0.88), and (3) client characteristics (α = 0.88). The most frequently endorsed barriers were related to client characteristics, including increased difficulty providing telehealth services to children who elope (M = 4.37, SD = 0.81), children who exhibit challenging behaviors (M = 4.31; SD = 0.83), and children who are in the preverbal stage or use nonverbal language to communicate (M = 4.07; SD = 1.00). Fewer barriers related to client characteristics uniquely predicted implementation variables including acceptability, appropriateness, and feasibility. Thematic analysis revealed challenges related to technology, caregiver involvement, child engagement, implementation of intervention strategies over telehealth, and administrative or logistical barriers. These findings highlight the need for targeted strategies that facilitate telehealth use to address specific client needs and support the implementation of telehealth services in usual care settings.

Brief Report: Response to Joint Attention and Object Imitation as Predictors of Expressive and Receptive Language Growth Rate in Young Children on the Autism Spectrum.

Joint attention and imitation are thought to facilitate a developmental cascade of language and social communication skills. Delays in developing these skills may affect the quality of children's social interactions and subsequent language development. We examined how responding to joint attention and object imitation skills predicted rate of expressive and receptive communication growth rate in a heterogeneous sample of autistic children. Children's baseline skills in responding to joint attention uniquely predicted expressive, but not receptive, language growth rate over time, while object imitation did not significantly predict language growth rate over and above joint attention skills. Future research should examine the potential moderating roles of child age and developmental level in explaining associations between joint attention and object imitation and later language development.

Object label and category knowledge among toddlers at risk for autism spectrum disorder: An application of the visual array task.

Individuals diagnosed with autism spectrum disorder (ASD) demonstrate atypical development of receptive language and object category knowledge. Yet, little is known about the emerging relation between these two competencies in this population. The present study utilized a gaze-based paradigm, the visual array task (VAT), to examine the relation between object label and object category knowledge in a sample of toddlers at heightened genetic risk for developing ASD. Eighty-eight toddlers with at least one typically developing older sibling (low-risk; LR) or one older sibling diagnosed with ASD (high-risk; HR) completed the VAT at 17 (LR n = 20; HR n = 27) and/or 25 months of age (LR n = 42; HR n = 22). Results indicated that the VAT was both a sensitive measure of receptive vocabulary as well as capable of reflecting gains in category knowledge for toddlers at genetic risk of developing ASD. Notably, an early emerging difference in the relation between target label knowledge and category knowledge for the groups was observed at 17 months of age but dissipated by 25 months of age. This suggests that while the link between receptive vocabulary and category knowledge may develop earlier in LR groups, HR groups may potentially catch up by the second year of life. Therefore, it is likely meaningful to consider differences in category knowledge when conceptualizing the receptive language deficits associated with HR populations. During language learning, typically developing children are sensitive to the common features of category members and use this information to generalize known object labels to newly encountered exemplars. The inability to identify similarities between category members and/or utilize this information when learning new object referents at 17 months of age may be a potential mechanism underlying the delays observed in HR populations.

A method for defining the CORE of a psychosocial intervention to guide adaptation in practice: Reciprocal imitation teaching as a case example.

LAY ABSTRACT: Interventions that support social communication include several "components," or parts (e.g. strategies for working with children and families, targeting specific skills). Some of these components may be essential for the intervention to work, while others may be recommended or viewed as helpful but not necessary for the intervention to work. "Recommended" components are often described as "adaptable" because they can be changed to improve fit in different settings where interventions are offered or with different individuals. We need to understand which parts of an intervention are essential (and which are adaptable) when translating interventions from research to community settings, but it is challenging to do this before studying an intervention in the community. This article presents the CORE (COmponents & Rationales for Effectiveness) Fidelity Method-a new method for defining the essential components of evidence-based interventions-and applies it to a case example of Reciprocal Imitation Teaching, an intervention that parents are taught to deliver with their young children with social communication delays. The CORE Fidelity Method involves three steps: (1) gathering information from multiple sources; (2) integrating information from previous research and theory; and (3) drafting a CORE model for ongoing use. The benefits of using the CORE Fidelity Method may include: (1) improving consistency in intervention and research materials to help all providers emphasize the most important skills or strategies; (2) clarifying which parts of the intervention can be adapted; and (3) supporting future research that evaluates which intervention components work and how they work.

The visual array task: A novel gaze-based measure of object label and category knowledge.

Visual attention measures of receptive vocabulary place minimal task demand on participants and produce a more accurate measure of language comprehension than parent report measures. However, current gaze-based measures employ visual comparisons limited to two simultaneous items. With this limitation, the degree of similarity of the target to the distractor can have a significant impact on the interpretation of task performance. The current study evaluates a novel gaze-based paradigm that includes an eight-item array. This visual array task (VAT) combines the theoretical frameworks of the Intermodal Preferential Looking Paradigm (IPLP) and looking-while-listening (LWL) methods of language comprehension measurement but using a larger array of simultaneously presented items. The use of a larger array of items and the inclusion of a superordinate category contrast may provide a more sensitive measure of receptive vocabulary as well as an understanding of the extent to which early word comprehension reflects knowledge of broader categories. Results indicated that the tested VAT was a sensitive measure of both object label and category knowledge. This paradigm provides researchers with a flexible and efficient task to measure language comprehension and category knowledge while reducing behavioral demands placed on participants.

Longitudinal Cognitive and Behavioral Presentation of Adult Female with Kabuki Syndrome.

BACKGROUND Kabuki syndrome (KS) is a rare disease with an estimated prevalence of approximately 1: 32 000. While the clinical presentation of KS is heterogeneous, manifestations may include: characteristic facial features, postnatal growth retardation, and skeletal abnormalities. With regards to the cognitive profile, most individuals with KS have an Intellectual Disability, but the magnitude of the impairment ranges from mild to severe, and verbal abilities are generally stronger than nonverbal abilities (i.e., visual spatial and visual perception abilities). Given the low incidence of KS, there is limited literature illustrating the longitudinal development of individuals with the condition. This report presents the cognitive and behavioral trajectory of an individual with KS. CASE REPORT The patient in this case report was a 27-year-old female with KS. Her cognitive profile had remained in the average range over time, but consistent with the limited KS literature, her verbal abilities were significantly higher than her nonverbal abilities. Specifically, our patient demonstrated significant deficits in visual motor and visual perceptual skills. With regards to her core language skills, her expressive skills were average, yet her receptive skills were below average. Throughout the majority of her schooling, her academic achievement skills were mildly delayed. Notably, her performance on cognitive and academic assessments remained stable over time. During young adulthood, she developed significant internalizing symptoms, particularly depressive symptoms. CONCLUSIONS This is the first case report to illustrate the presentation of an individual with KS from toddlerhood through young adulthood. The patient's clinical presentation across time was relatively consistent with the KS literature to date; notable patterns of language, motor, cognitive and behavioral deficits illustrate the considerable heterogeneity that exists within the syndrome. This case report, particularly, illustrates the persistence of the cognitive profile over time and also the co-occurring psychiatric symptoms that might emerge.