Music Therapists' Perceptions of the Therapeutic Potentials Using Music When Working With Verbal Children on the Autism Spectrum: A Qualitative Analysis.

While there are numerous descriptions of the use of music and its therapeutic potential by music therapists working with nonverbal children on the autism spectrum, only limited literature focuses on exploring how music therapists use music and perceive its therapeutic potential when working with children on the spectrum who have verbal skills. This qualitative study aimed to explore music therapists' descriptions of the use of music and its therapeutic potential in their work with children on the autism spectrum who have verbal skills. Semi-structured interviews were conducted with six qualified music therapists from Israel and then analyzed according to the principles of interpretative phenomenological analysis (IPA). Three main themes were identified: (a) musical infrastructure, which describes how the music therapists facilitated musical experiences to support the children's ability to regulate their arousal, attention and emotions; (b) the meeting point between musical and verbal playfulness, which reflects the music therapists' beliefs about how musical experiences add vitality and support the development of both verbal and nonverbal imaginative play; and (c) musical responses, which describes the different ways music therapists use their voice and songs to interact musically with verbal children. The experiences described by the participants emphasize the importance of the therapist musically attuning to the child's emotional, physiological, creative, and playful qualities, even when the child has verbal skills. These musical interactions help to create a shared experience between the child and therapist that are perceived to help the child's different forms of regulation, continuity, and vitality within the play.

Beyond diagnosis: the relevance of social interactions for participation in inclusive preschool settings.

Purpose: This study aims to explore the role of three specific factors within the child-environment interaction process - engagement, independence and social interactions - in influencing development and learning of children with disabilities in inclusive preschool settings. The main question is whether children can be categorised in homogenous groups based on engagement, independence and social interactions (proximal variables within a biopsychosocial framework of human development). The study also examined whether children with the same diagnosis would group together or separately, when trying to identify clusters of engagement, independence and social interactions, and additionally whether such clusters vary as a function of individual child characteristics, and/or as a function of structural and process characteristics of preschool environment. Methods: Data was taken from an intervention study conducted in mainstream preschools in Portugal. A person-centered cluster analysis was conducted to explore group membership of children with various diagnoses, based on their engagement, independence and social interaction profiles. Results: Results show that children clustered based on similarity of engagement, independence and social interaction patterns, rather than on diagnosis. Besides, it was found that quality of peer interaction was the only predictor of cluster membership. Conclusion: These findings support the argument that participation profiles may be more informative for intervention purposes than diagnostic categories, and that preschool process quality, namely peer interaction, is crucial for children's participation.

Forty years of referrals and outcomes to a UK Child Development Centre (CDC): Has demand plateaued?

AIMS: To explore 40 years of Child Development Centre (CDC) activity and outcomes at Northampton General Hospital 1974-2014. METHODS: The study comprises 3 data sets: a published report from 1974 to 1999, an internal audit from 2001 to 2004, and more recent data collected from 2005 to 2014. The medical notes of all children who were assessed by the CDC in 2014 were reviewed, along with referral data collected by the CDC manager from this year and the preceding 10 years. RESULTS: From January 1, 1974 to December 31, 2014, 3,786 children were assessed. The male to female ratio is 2.8:1 from 2005 to 2014. Referrals for behavioural difficulties increased from 10% (10/100 referrals) in 1999-2004 to 17.8% (18/101 referrals) in 2014. Similarly, referrals for social and communication problems, "interaction" increased two and a half fold from 10% (10/100 referrals) in 1999-2004 to 26.7% (27/101 referrals) in 2014. Between 2004 and 2014, numbers of referrals for "developmental delay" halved (22.2% to 12%). CONCLUSION: We are aware of no other comparable extant UK CDC database. Services should plan for a referral rate of 6.5 per 1,000 preschool children. Between 1974 and 2014, there has clearly been a change in recorded assessment outcomes. From the mid-1980s, this reflects the change to a preschool assessment role and a shift away from purely educational outcome to include medical conditions. Covering 1974-2014, we demonstrate a clear increase in the number of referrals together with an increasing demand for assessments for social interaction and behavioural difficulties. This reflects the increased awareness of these neurodevelopmental difficulties and the changing diagnostic criteria which will now more likely result in an Autistic Spectrum Disorder diagnosis than previously. Together, these two features are most likely to have considerable implications for service development within Child Development Centres (CDCs) and Child Development Teams (CDTs).

A Group-Administered social Skills Training for 8- to 12- Year-Old, high-Functioning Children With Autism Spectrum Disorders: An Evaluation of its Effectiveness in a Naturalistic Outpatient Treatment Setting.

A social skills training (SST) for high-functioning children with autism spectrum disorders (ASD) was evaluated in an outpatient setting using a combined between- and within-subject design in which SST and a waiting list condition were compared. According to parents and teachers, the SST produced greater improvement of social skills than the waiting list, and these effects were maintained at 3 months follow-up. No between-group effects were found for loneliness, although in general scores on this outcome measure decreased from pre- to follow-up. The effects of SST were unaffected by social anxiety, ADHD symptoms, Theory of Mind, or desire for social interaction. Altogether, SST seems an effective intervention for high-functioning children with ASD that can be applied in daily clinical practice.

A Quantitative Summary of The Listening Program (TLP) Efficacy Studies: What Areas Were Found to Improve by TLP Intervention?

A quantitative summary of existing research examining the effects of The Listening Program (TLP) on various functions in children is presented. Nine studies were used, looking at TLP intervention effects across studies, within each study and for various outcome measures. The studies looked at TLP intervention on children with autism spectrum disorder, Down syndrome, learning disabilities, auditory processing disorders, attention deficit hyperactivity disorders, Rhett syndrome, dyspraxia, cerebral palsy, fibromyalgia, arthritis and stroke. The magnitude of the TLP effect size revealed a mean value of 0.41 across all studies. For each individual study, effect size ranged from 0.23 to 1.28. Two studies yielded significantly larger effect size than the other studies. One of these studies (effect size 1.19) examined the improvement in auditory processing for children identified with autism. The other study (effect size 1.28) examined improvement in academically related skills of underachieving school children. Larger effect sizes were obtained for research that examined auditory processing/listening skills (mean effect size 0.72) than for research looking at non-auditory areas (mean effect size 0.31), although all revealed positive changes. The effect size of various outcome measures is discussed in order to identify variables that might affect the outcomes as well as what these results mean to occupational therapists who would consider TLP intervention for clients. Copyright © 2016 John Wiley & Sons, Ltd.

[Schooling of patients exhibiting Autism Spectrum Disorders without mental retardation]. / La scolarisation des patients atteints par des troubles du spectre autistique sans retard mental.

INTRODUCTION: Autism Spectrum Disorders belong to Pervasive Development Disorders. Although access to education is recommended by the French National High Authority for Health (HAS), the practice remains limited and the reasons for the low education rate of these children have still not been sufficiently explored in the literature. OBJECTIVE: The main objective of this study was to analyze the links between Autism Spectrum Disorder without mental retardation, psychiatric comorbidity and education. The secondary objective was to analyze the cognitive and contextual factors that could limit educational inclusion. METHOD: Eighty-three autistic patients (3-18years old; 73 males and 10 females) with childhood autism, atypical autism or Asperger's syndrome (criteria from the International Classification of Diseases-10) without mental retardation and in education were assessed at the Alpine Centre for Early Diagnosis of Autism. The sample included 45 subjects with childhood autism, 12 subjects with atypical autism and 26 subjects with Asperger's syndrome. The diagnosis was based on the Autism Diagnostic Interview Revised (ADI-R), in accordance with the recommendations of the HAS, the Autism Diagnostic Observation Schedule (ADOS) and the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV). RESULTS: Our results showed that childhood autism and atypical autism were mainly found in nursery and primary school, whereas Asperger's syndrome was mainly found in secondary school (Chi(2)=18.23; df=6; P<.006). Individuals with childhood autism and atypical autism were more likely to receive the support of a special educational assistant (Chi(2)=15.61; df=2; P<.000) and underwent a higher number of consultations and treatment episodes than those with Asperger's syndrome (Chi(2)=27.83; df=14; P<.015). The cognitive profiles obtained with the WISC-IV also differed: the Verbal Comprehension Index (VCI) and Working Memory Index (WMI) were higher for Asperger's syndrome than for childhood autism and atypical autism (respectively, F=23.11, P<.000; df=2; partial η(2)=.576 and F=8.06, P<.001; df=2; partial η(2)=.357). Linear regression showed that the VCI and Processing Speed Index (PSI) were inversely correlated to the number of hours spent with a special educational assistant: the lower these indexes, the greater the amount of time spent with a special educational assistant. No link was found between psychiatric comorbidity, type of psychological and psychiatric treatment, and education. DISCUSSION: The use of special educational assistants seems to be linked to the diagnosis of Autism Spectrum Disorders and neuropsychological functioning, as assessed by WISC-IV, along a continuum that ranges from childhood autism (more needs and deficits) to atypical autism to Asperger's syndrome. The Verbal Comprehension Index (VCI) and the Processing Speed Index (PSI) could be used to evaluate the number of hours of support needed by children and to better target the deficits and specific needs of children without mental retardation who are in education. A study on a larger scale could help to more closely address the question of the cognitive abilities of children with Autism Spectrum Disorder without mental retardation, so as to better help them in their education.

An Exploratory Investigation of the Role of Parenting Stress in Relationship Focused Intervention.

BACKGROUND: Mothers of young children with Pervasive Developmental Disorders (PDD) and other disabilities (DD) have been reported to experience high levels of stress. This investigation examined the effects of parental stress on mothers' participation in a Relationship Focused intervention (RFI). METHODS: Mothers and young children who had either PDD (n = 18) or DD (n = 26) received weekly RF intervention for one year. RESULTS: Pre-post comparisons indicated significant increases in mothers' responsiveness and children's development and social emotional functioning. Intervention effects were greater for mothers of children with PDD than for mothers of children with DD. There were three findings related to the role parenting stress. First, high levels of parenting stress did not interfere with mothers' ability to learn RFI strategies; second, there were non-significant decreases in parenting stress during intervention; third, parenting stress enhanced the effects of mothers' responsiveness on children. CONCLUSION: High levels of parenting stress does not appear to interfere with parent participation in RFI.

Uncovering the evidence for behavioral interventions with individuals with fragile X syndrome: a systematic review.

Fragile X syndrome (FXS) is associated with a wide range of cognitive, emotional, and behavioral difficulties. Although there is considerable research on the behavioral phenotype of FXS, few empirical studies of behavioral interventions with this population have been identified. Through a hand search of 34 behavioral journals, we examined the evidence base for behavioral interventions with individuals with FXS and in light of the current state of knowledge regarding the FXS behavioral phenotype. Systematic review procedures were used to identify behavioral intervention studies that included at least one participant with FXS, extract and summarize the data on several relevant dimensions, and rate the methodological quality of the studies. Results revealed 31 intervention studies with a small number of participants with FXS. Overall, results suggest a behavioral approach to intervention with individuals with FXS shows promise. Future research focused on individuals with FXS will be necessary to continue to examine differences in response to intervention and interventions that specifically address phenotypic characteristics.

An iPad™-based picture and video activity schedule increases community shopping skills of a young adult with autism spectrum disorder and intellectual disability.

OBJECTIVE: To evaluate the iPad 2™ with Book Creator™ software to provide visual cues and video prompting to teach shopping skills in the community to a young adult with an autism spectrum disorder and intellectual disability. METHODS: A multiple probe across settings design was used to assess effects of the intervention on the participant's independence with following a shopping list in a grocery store across three community locations. RESULTS: Visual cues and video prompting substantially increased the participant's shopping skills within two of the three community locations, skill increases maintained after the intervention was withdrawn, and shopping skills generalized to two untaught shopping items. Social validity surveys suggested that the participant's parent and staff favorably viewed the goals, procedures, and outcomes of intervention. CONCLUSIONS: The iPad 2™ with Book Creator™ software may be an effective way to teach independent shopping skills in the community; additional replications are needed.

Evaluation of a continuing education course for occupational therapy practitioners on the use of applied behavior analysis.

A three hour continuing education course combining occupational therapy practice and behavior analysis strategies related to children with autism spectrum disorders was developed and delivered to 24 occupational therapy practitioners. Participants completed evaluations pre-course, post-course, and one month follow up on their self-efficacy, knowledge, and skills in managing challenging behaviors of children with autism spectrum disorders. Overall, ratings scores showed an increase in participants' self-efficacy and knowledge and skill at post-course and one-month follow-up. Despite this increase, participants continued to implement sensory strategies to decrease challenging behaviors due to increased self-efficacy in using sensory strategies and the lack of support in implementing behavior techniques outside their session time.

A systematic review of sensory-based treatments for children with disabilities.

Sensory-based therapies are designed to address sensory processing difficulties by helping to organize and control the regulation of environmental sensory inputs. These treatments are increasingly popular, particularly with children with behavioral and developmental disabilities. However, empirical support for sensory-based treatments is limited. The purpose of this review was to conduct a comprehensive and methodologically sound evaluation of the efficacy of sensory-based treatments for children with disabilities. Methods for this review were registered with PROSPERO (CRD42012003243). Thirty studies involving 856 participants met our inclusion criteria and were included in this review. Considerable heterogeneity was noted across studies in implementation, measurement, and study rigor. The research on sensory-based treatments is limited due to insubstantial treatment outcomes, weak experimental designs, or high risk of bias. Although many people use and advocate for the use of sensory-based treatments and there is a substantial empirical literature on sensory-based treatments for children with disabilities, insufficient evidence exists to support their use.

Self-controlled technologies to support skill attainment in persons with an autism spectrum disorder and/or an intellectual disability: a systematic literature review.

Persons with an autism spectrum disorder and/or intellectual disability have difficulties in processing information, which impedes the learning of daily living skills and cognitive concepts. Technological aids support learning, and if used temporarily and in a self-controlled manner, they may contribute to independent societal participation. This systematic review examines the studies that applied self-controlled technologies. The 28 relevant studies showed that skills and concepts are learned through prompting, interaction with devices, and practicing in (realistic) virtual environments. For attaining cognitive concepts, advanced technologies such as virtual reality are effective. Five studies focussed on cognitive concepts and two on emotion concepts. More research is necessary to examine the generalization of results and effect of using technology for learning cognitive and emotional concepts. Implications for Rehabilitation Persons with a moderate to mild intellectual disability and/or with autism can use self-controlled technology to learn new activities of daily living and cognitive concepts (e.g. time perception and imagination). Specific kinds of technologies can be used to learn specific kinds of skills (e.g. videos on computers or handheld devices for daily living skills; Virtual Reality for time perception and emotions of others). For learning new cognitive concepts it is advisable to use more advanced technologies as they have the potential to offer more features to support learning.

Vocational support approaches in autism spectrum disorder: a synthesis review of the literature.

This synthesis-based analysis identifies and reviews studies evaluating vocational resources for adults with autism spectrum disorder. It is based on a larger systematic review of intervention studies in autism spectrum disorder, from which a critical interpretive synthesis was conducted on studies related to vocation and autism spectrum disorder. In total, 10 studies were found that examine employment support for youth and adults with autism spectrum disorder. Two domains of vocational intervention in the literature were found: supported employment including community placement and job coaching and media and technology-based augmentative tools. The literature is limited in volume and quality of methodology, yet emerging constructs are promising in introducing the utility of vocational resources, in particular, supported employment in community settings. These vocational approaches are examined, along with representative studies. Recommendations for advancing practice, community capacity, and research are offered.

Teacher ratings of evidence-based practices from the field of autism.

Students who have a hearing loss and a comorbid diagnosis of an autism spectrum disorder (ASD) have multiple obstacles to overcome. Using Gallaudet Research Institute data, Szymanski, Brice, Lam, and Hotto calculated 1 deaf student in 59 received services for both a hearing loss and an ASD (Szymanski, Brice, Lam, & Hotto, 2012). Teachers of the deaf (TOD) in a Midwestern state completed a survey (N = 68) to indicate familiarity with evidence-based practices (EBP) from the field of ASD in order to confirm or reject the hypothesis that they would not report familiarity with these practices. Further analyses explored use and perceived effectiveness of EBP for those TOD who had familiarity with the instructional practices. Results of the study indicated that there was wide variance in TOD familiarity, use, and perceived effectiveness of the EBP.

An intervention to improve social participation for adolescents with autism spectrum disorder: pilot study.

OBJECTIVE: To increase flexible thinking, self-regulation and empathy for adolescents with ASD. METHOD: Five adolescents (M = 13.5 years; SD = 0.84 years; four males) were assessed pre and post intervention for flexible thinking and social competence (as measured by the SSIS). Parents rated their adolescent's social competence pre and post intervention. RESULTS: A large decrease was found in parent rating of their child's level of hyperactivity (12.8, SD = 2.3; 11, SD = 2.2) (p = 0.034) (Cohen's d = 0.95). Parents increased their rating of their child's cooperation and empathy (Cohen's d = 0.71 and 0.56, respectively). A medium effect for flexible thinking was observed in three items (Cohen's d = 0.5 to 0.62) and a large effect for one item (Cohen's d = 1.35). Adolescents decreased self-scoring on the social scale post intervention. CONCLUSION: Improvements were observed in adolescents' flexible thinking and social insights, and parent's perception of their child's self-regulation.

Trastornos generalizados del desarrollo en otorrinolaringología pediátrica / Pervasive development disorders in pediatric otolaryngology / Transtornos generalizados do desenvolvimento emotorrinolaringologia pediátrica

Los pacientes con TGD, presentan un variado abanico de patologías, relacionadas con los trastornos del comportamiento, del lenguaje y del desarrollo. El comportamiento de cada uno de ellos puede ser muy diferente. Es primordial llegar al diagnóstico correcto de las patologías otorrinolaringológicas, hipoacusias de conducción, neurosensoriales, ventilatorias, deglutorias y del lenguaje. Estos pacientes requieren una mayor atención y acompañamiento en la realización de los estudios diagnósticos, en el manejo del niño y su familia en la consulta y en los procedimientos quirúrgicos. Se realizará en este trabajo, un abordaje a esta patología desde todos los aspectos que involucran al otorrinolaringólogo y al equipo multidisciplinario.

Os pacientes com TGD apresentam um variado leque de patologias relacionadas com os transtornos do comportamento, de linguagem e de desenvolvimento. O comportamento de cada um deles pode ser muito diferente. É primordial chegar ao diagnóstico correto das patologias otorrinolaringológicas, hipoacusias de condução, neurossensoriais, ventilatórias, deglutórias e de linguagem. Estes pacientes requerem uma maior atenção e acompanhamento na realização de estudos diagnósticos, na maneira como lidar com a criança e a sua família durante a consulta e nos procedimentos cirúrgicos. Neste trabalho, esta patologia será abordada a partir de todos os aspectos que envolvem o otorrinolaringologista e a equipe multidisciplinar.

Patients with PDD present with a broad spectrum of impairments associated with behavior, language, and development. These patients may behave very differently from each other. Adequate diagnosis of the otolaryngology pathologies, such as conductive or sensorineural hearing loss and ventilation, swallowing, and language disturbances is of utmost importance. These patients and their families require additional care, support, and management strategies during doctor visits, when diagnostic studies are performed, and in the preparation for surgical p Discuss in this paper an approach to this disease from every aspect involving the otolaryngologist and the multidisciplinary team.

VI. The role of physical activity in reducing barriers to learning in children with developmental disorders.

Emerging research suggests that physical activity may be an effective non-pharmaceutical intervention approach for childhood developmental disorders. Findings indicate that both single bouts of activity and chronic physical activity associate with improved mental health and classroom performance in children with attention-deficit/hyperactivity disorder and children with autism spectrum disorders. This review describes the research in this area and identifies limitations and challenges to the translation of these findings to promote physical activity in clinical practice and educational policy.

Interaction of participant characteristics and type of AAC with individuals with ASD: a meta-analysis.

Individuals with autism spectrum disorders (ASD) and complex communication needs often rely on augmentative and alternative communication (AAC) as a means of functional communication. This meta-analysis investigated how individual characteristics moderate effectiveness of three types of aided AAC: the Picture Exchange Communication System (PECS), speech-generating devices (SGDs), and other picture-based AAC. Effectiveness was measured via the Improvement Rate Difference. Results indicated that AAC has small to moderate effects on speech outcomes, and that SGDs appear to be most effective when considering any outcome measure with individuals with ASD without comorbid intellectual/developmental disorders (IDD). PECS appears to be most effective when considering any outcome measure with individuals with ASD and IDD. SGDs and PECS were the most effective type of AAC for preschoolers, when aggregating across outcome measures. No difference was found between systems for elementary-aged and older individuals.