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1.
Trials ; 22(1): 291, 2021 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879224

RESUMO

Having access to parenting interventions in the early years is key to improve the developmental outcomes of children with neurodevelopmental problems. The Incredible Years® (IY) Parent Program is a group intervention that has demonstrated efficacy in terms of reducing stress in parents, as well as improving behavioral, emotional, and social outcomes in children. The program has been recently adapted for families of children with autism or language delays (IY-ASLD®). This intervention has not yet been implemented in the Spanish Public Health System, where there is a scarcity of evidence-based interventions being offered to families with young children presenting neurodevelopmental problems. The main aims of this study are to determine the feasibility of implementing the IY-ASLD® program within Spanish Child Mental Health Services and to examine parents' acceptability and satisfaction with the intervention. As a secondary objective, we aim to evaluate its preliminary effectiveness in terms of reducing parental stress and behavioral difficulties in their children. The FIRST STEPS study is a multicenter, pilot randomized controlled trial comparing the IY-ASLD® program with a treatment-as-usual (TAU) condition. Approximately 70 families of children with autism spectrum disorder (ASD) and preterm children with communication and/or socialization difficulties (aged 2-5 years) will be recruited. Families will be assessed prior to randomization and after the intervention. Due to the COVID-19 pandemic, the intervention will consist of 22 weekly online sessions (approximately 6 months). The FIRST STEPS pilot trial will demonstrate the feasibility and acceptability of reliably implementing the IY-ASLD® program within the Spanish Public Health System. The results of this study could represent the first step to inform policymakers in Spain when designing evidence-based healthcare pathways for families of children presenting ASD symptoms or neurodevelopmental difficulties at early stages. TRIAL REGISTRATION: ClinicalTrials.gov NCT04358484 . Registered on 04 April 2020.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Comunicação , Socialização , Transtorno do Espectro Autista/terapia , Transtorno Autístico/terapia , Criança , Pré-Escolar , Humanos , Estudos Multicêntricos como Assunto , Poder Familiar , Pais , Projetos Piloto , Nascimento Prematuro , Ensaios Clínicos Controlados Aleatórios como Assunto , Espanha
2.
Artigo em Inglês | MEDLINE | ID: mdl-33803581

RESUMO

Autism Spectrum Disorder (ASD) is a constellation of social deficits and repetitive sensory-motor behaviours. Aquatic therapy (AT) may be effective in improving the social interactions and behaviours in children with ASD. The objective of this study was to evaluate the effects of an AT program on social competence and quality of life and to understand participant's experiences related to the intervention by obtaining qualitative data. A mixed methods intervention study was conducted among 6 children with ASD and their parents, with two research phases in a concurrent embedded design (an aquatic intervention as the quantitative design and a qualitative design in second step). The intervention and qualitative design followed international guidelines and were integrated into the method and reporting subheadings. Significant improvement was observed in the physical competence (p = 0.026) and important improvements in school functioning and aquatic skills, with no adverse events. Qualitative findings described: the meaning of AT intervention, patterns of behaviour and activities changes, social communication and social interaction. The aquatic intervention showed positive results for the social and physical competence, with elements of discordance, expansion, and confirmation between quantitative and qualitative results.


Assuntos
Transtorno do Espectro Autista , Qualidade de Vida , Transtorno do Espectro Autista/terapia , Criança , Comunicação , Humanos , Habilidades Sociais
3.
Artigo em Inglês | MEDLINE | ID: mdl-33800787

RESUMO

Various therapeutic interventions have been studied and found to be effective in reducing the stereotypical behaviors of children with autism spectrum disorder (ASD). There has been increasing interest in using animal-assisted interventions (AAIs) as an alternative approach to therapeutic rehabilitation for children with ASD, and many studies have reported that AAI has significant benefits for the cognitive, psychological, and social behavior of children with ASD. The present study was designed to examine the effects of a 16 weeks therapeutic horseback riding program on social interaction and communication skills in children with autism. Eighty-four children diagnosed with ASD, aged between 6 and 12 years old, were recruited for this study. All selected participants met the DSM-V criteria, and a total of sixty-one participants (N = 61) completed the study. A quasi-experimental design with an experimental group and control group was implemented for this study, taking measurements at pre-test, interim-test, and post-test to monitor the behavior changes in social and communication throughout the 16-week intervention. Repeated measures ANOVA and the independent sample t-test were used for data analysis, to assess the difference between the experimental group and control group. The results indicated that the THR program had positive influences on overall social skills and communication, based on the SSIS and the ABLLS-R scores, compared to the control group (p < 0.05). A notable improvement in the overall social interaction score was observed from the interim-testing point to post-test. In addition, participants in the therapeutic horseback riding (THR) group achieved significant improvements on six out of seven items in their communication evaluations. In conclusion, after 16 weeks of intervention, the THR program significantly enhanced the subdomains of social and communication skills in the areas of social interaction, communication, responsibility, and self-control, compared to the control group.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Terapia Assistida por Cavalos , Animais , Transtorno do Espectro Autista/terapia , Criança , Comunicação , Humanos
4.
Percept Mot Skills ; 128(3): 1037-1058, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33663275

RESUMO

Children with autism have displayed imbalances in responding to feedback and feedforward learning information and they have shown difficulty imitating movements. Previous research has focused on motor learning and coordination problems for these children, but little is known about their motoric responses to visual live animation feedback. Thus, we compared motor output responses to live animation biofeedback training in both 15 children with autism and 15 age- and sex-matched typically developing children (age range: 8-17 years). We collected kinematic data via Inertial Measurement Unit devices while participants performed a series of body weight squats at a pre-test, during live animation biofeedback training, and at post-test. Dependent t-tests (α = 0.05), were used to test for statistical significance between pre- and post-test values within groups, and repeated measures analyses of variance (α = 0.05) were used to test for differences among the training blocks, within each group. The Model Statistic technique (α = 0.05) was used to test for pre- and post-test differences on a single-subject level for every participant. Grouped data revealed little to no significant findings in the children with autism, as these participants showed highly individualized responses. However, typically developing children, when grouped, exhibited significant differences in their left hip position (p = 0.03) and ascent velocity (p = 0.004). Single-subject analyses showed more individualistic live animation responses of children with autism than typically developing children on every variable of interest except descent velocity. Thus, to teach children with autism new movements in optimal fashion, it is particularly important to understand their individualistic motor learning characteristics.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Adolescente , Transtorno do Espectro Autista/terapia , Transtorno Autístico/terapia , Biorretroalimentação Psicológica , Fenômenos Biomecânicos , Criança , Humanos , Aprendizagem
5.
Artigo em Inglês | MEDLINE | ID: mdl-33670846

RESUMO

YouTube is one of the most well-known and widely accessed websites worldwide, thus having a powerful pedagogical potential. Nonetheless, the quality and the veracity of some YouTube videos are questionable. Doubts regarding the trustworthiness of factual content is a controversial factor that needs to be taken into account, especially when addressing public health issues. For this reason, the main objective of this work is to analyze the content of the most viewed videos in Spanish on YouTube related to autism spectrum disorder (ASD). To carry out this research, the terms "autism AND education", "autism AND intervention", and "autism AND cure" were used (in Spanish). The analysis of these searches results indicated that videos included in the "cure" category are shorter, and less valued by internet users, obtaining the lowest ratings on the "Patient Education Materials Assessment Tool" for audiovisual materials (PEMAT-A/V), in addition to present therapies that are in fact more harmful than videos in other categories. In general, videos containing recommendations for therapies that are harmful are the ones that have received most views, along with the videos that include alternative non-harmful therapies. Practical implications of these findings and recommendations for further research are discussed.


Assuntos
Transtorno do Espectro Autista , Mídias Sociais , Transtorno do Espectro Autista/terapia , Humanos , Internet , Saúde Pública , Gravação em Vídeo , Gravação de Videoteipe
6.
Medicine (Baltimore) ; 100(11): e22269, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33725922

RESUMO

BACKGROUND: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition, which is characterized by impairment in social interaction or communication and lack of flexibility of imagination and behavior. Acupuncture is one of the most common modality of Traditional Chinese medicine (TCM) and has been used to treat various disease in clinical practice for more than 2000 years in China by correcting disharmony and dysregulation of body. It has sometimes been used as a treatment aimed at improving ASD symptoms and outcomes, but its clinical effectiveness and safety has not been rigorously reviewed. We will plan to conduct a systematic review and meta-analysis to summarize the current evidence on the effects and safety of acupuncture for ASD. METHODS: The following databases will be searched: PubMed, the Cochrane Library, Embase, Wanfang Data, China National Knowledge Infrastructure, SinoMed, and VIP. Randomised controlled trials will be included to evaluate the effect and safety of acupuncture on patients with ASD. The primary outcome will be the core features of ASD. The risk of bias will be assessed by the Cochrane risk of bias tool. We will conduct a meta-analysis and sensitivity analysis, as well as a subgroup analysis if high heterogeneity is present, using Revman 5.3. We will use funnel plots to identify potential reporting biases. The Grading of Recommendations Assessment, Development and Evaluation will be used to evaluate the quality of evidence. RESULTS: This study will be to assess the effect and safety of acupuncture for ASD. CONCLUSIONS: This study will assess the effect of acupuncture for ASD and provide reliable evidence for the choice of treatments. ETHICS AND DISSEMINATION: The protocol will not need ethical approval because no issues of participant privacy exist. The results of this systematic review will provide evidence about the effect and safety of acupuncture for ASD. The results will be disseminated through peer review.


Assuntos
Terapia por Acupuntura/métodos , Transtorno do Espectro Autista/terapia , Humanos , Metanálise como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
7.
Behav Ther ; 52(2): 324-337, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33622503

RESUMO

Although the alliance is a consistent predictor of treatment outcomes in psychosocial interventions, few studies have examined this association among youth with autism spectrum disorder (ASD). In particular, youth-therapist alliance has never been examined in social skills interventions (SSIs), a common modality for this population. In this study, thirty-four youth with ASD (Mage = 12.41; 79% male) participated in a community-delivered, group-based SSI in a summer camp format led by eight Head Therapists (Mage = 32.12; 50% male). Early alliance and change in alliance over the course of the treatment were assessed via self- and observer-reported measures. Both self- and observer-rated alliance were associated with positive treatment outcomes as reported by parents (decreased problem behaviors) and other peers in the group (reciprocated friendship and social preference). These results provide the first evidence of the role of the alliance in an SSI for youth with ASD and add to the growing body of literature that demonstrates the importance of assessing and addressing the alliance in treatment for this population.


Assuntos
Transtorno do Espectro Autista , Comportamento Problema , Adolescente , Adulto , Transtorno do Espectro Autista/terapia , Criança , Feminino , Humanos , Masculino , Pais , Grupo Associado , Habilidades Sociais
8.
Int J Lang Commun Disord ; 56(2): 415-434, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33522068

RESUMO

BACKGROUND: Many healthcare and educational services providers have undergone a rapid transition from a face-to-face to a tele-practice mode of service delivery in the context of the COVID-19 outbreak. This, in turn, has led to a need to understand better the evidence underpinning such moves. Based on a review of existing reviews, this paper critically analyses the relevant literature related to intervention with children with communication disabilities drawing on the COM-B model. METHODS & PROCEDURES: Ten reviews were identified following a systematic searching of electronic databases. These were then coded according to both PRISMA criteria and the components of the COM-B model. Based on these findings, a critical analysis of the state of the tele-practice intervention literature is discussed and fed into evidence-based advice for practitioners transitioning to this mode of service delivery. OUTCOMES & RESULTS: The COM-B mapping suggests that the existing literature has provided primary evidence for physical opportunity and reflective motivation (e.g., participants have the time to take part and the necessary materials, as well as a desire to do it). It has also focused on elements of social opportunity (e.g., having support and prompts from others to take part). However, there are significant gaps in the description and analysis of both physical and psychological capability components. CONCLUSIONS & IMPLICATIONS: Whilst the evidence for tele-practice interventions for children and young people with communication disabilities is growing, it is also lacking a comprehensive framework to support its implementation. In times of rapid transitions, researchers and practitioners alike need to understand how to evaluate comprehensively the impact of changing the mode of intervention delivery. The COM-B model provides a powerful tool to reflect on the key elements for the successful design and implementation of tele-practice interventions. What this paper adds What is already known on this subject Tele-practice has been a feature of service delivery for speech and language therapists working with children and young people with speech and language disorders for many years, as it has in other areas of practice. This came into sharp focus during 2020 during the 'lock-down' following the start of the COVID-19 pandemic when most practice went online. What this paper adds to existing knowledge This study set out to provide a framework for understanding service delivery, drawing on the COM-B behaviour change model. This is applied using a rapid review methodology to 10 systematic and narrative reviews of the existing literature published since 2005. The findings suggest that while most studies demonstrated efficacy, there was a lack of information regarding specific aspects of the model which would affect their implementation. What are the potential or actual clinical implications of this work? It is anticipated that the paper has the potential to have a direct bearing on how tele-practice services for children and young people with speech and language disorders will be delivered in the future. The paper concludes with a series of recommendations for practice and research in terms of the application of the COM-B model to tele-practice in speech and language therapy.


Assuntos
Transtornos da Comunicação/terapia , Telemedicina/métodos , Adolescente , Transtorno do Espectro Autista/terapia , Criança , Pré-Escolar , Humanos , Pandemias
9.
J Appl Behav Anal ; 54(2): 566-581, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33600614

RESUMO

Children with autism spectrum disorder often display deficits in daily living skills. Behavior analysts can use telehealth, such as videoconferencing technology, to deliver interventions to families of these children. Given the COVID-19 pandemic and the common barriers to accessing behavioral interventions, it is imperative to evaluate the effectiveness and practicality of delivering behavioral interventions via telehealth. This study evaluated the efficacy of a parent-implemented intervention with coaching via telehealth to improve daily living skills. Children ranging in age from 5 to 9 years participated in the study with 1 or 2 of their parents serving as the primary implementer(s). Parents implemented the intervention with fidelity and the intervention yielded increases in independent daily living skill completion for all 4 participants.


Assuntos
Atividades Cotidianas/psicologia , Transtorno do Espectro Autista/terapia , Educação não Profissionalizante/métodos , Tutoria/métodos , Pais/educação , Telemedicina/métodos , Transtorno do Espectro Autista/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pais/psicologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-33477719

RESUMO

Visual pedagogy has emerged as a new approach in improving dental care in children with autism spectrum disorders (ASDs). This paper aimed to evaluate and assess the scientific evidence on the use of visual pedagogy in improving oral hygiene skills and cooperation during dental care in children with ASDs. The review protocol was registered on the PROSPERO Register (CRD42020183030). Prospective clinical studies, randomized trials, interruptive case series, before and after comparison studies, and cross-sectional studies following the PRISMA guideline were searched in PubMed, Embase, Scopus, and Google Scholar using ad hoc prepared search strings. The search identified 379 papers, of which 342 were excluded after title and abstract evaluation, and 37 full-text papers were analyzed. An additional four papers were added after consulting reference lists. Eighteen papers were disregarded; 23 were finally included, and their potential bias was assessed using ROB-2 and ROBINS-I tools. The wide heterogenicity of the studies included does not allow for conclusive evidence on the effectiveness of visual pedagogy in oral hygiene skills and dental care. Nevertheless, a significant and unilateral tendency of the overall outcomes was found, suggesting that visual pedagogy supports ASD children in improving both oral hygiene skills and cooperation during dental care.


Assuntos
Transtorno do Espectro Autista , Transtorno do Espectro Autista/terapia , Criança , Estudos Transversais , Assistência Odontológica , Humanos , Higiene Bucal , Estudos Prospectivos
13.
Am J Psychiatry ; 178(1): 30-38, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33384012

RESUMO

Recent progress in the identification of genes and genomic regions contributing to autism spectrum disorder (ASD) has had a broad impact on our understanding of the nature of genetic risk for a range of psychiatric disorders, on our understanding of ASD biology, and on defining the key challenges now facing the field in efforts to translate gene discovery into an actionable understanding of pathology. While these advances have not yet had a transformative impact on clinical practice, there is nonetheless cause for real optimism: reliable lists of risk genes are large and growing rapidly; the identified encoded proteins have already begun to point to a relatively small number of areas of biology, where parallel advances in neuroscience and functional genomics are yielding profound insights; there is strong evidence pointing to mid-fetal prefrontal cortical development as one nexus of vulnerability for some of the largest-effect ASD risk genes; and there are multiple plausible paths forward toward rational therapeutics development that, while admittedly challenging, constitute fundamental departures from what was possible prior to the era of successful gene discovery.


Assuntos
Transtorno do Espectro Autista/genética , Predisposição Genética para Doença/genética , Transtorno do Espectro Autista/etiologia , Transtorno do Espectro Autista/terapia , Genes/genética , Humanos
14.
Z Kinder Jugendpsychiatr Psychother ; 49(2): 134-143, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33428461

RESUMO

Objective: Psychoeducational parent training is an economic way to provide care for parents of children newly diagnosed with an autism spectrum disorder (ASD). This study explores pre-post effect sizes of the manualized autism-specific parent training FAUT-E (Frankfurter Autismus-Elterntraining). Method: Two behaviorally trained therapists worked with 6-10 parents in eight group sessions. Twenty-four parents of 24 children with ASD participated in the study. Outcomes were child- and parent-related measures obtained at T0 (first measurement), T1 (second measurement), T2 (postintervention), and T3 (3 months after intervention). Results: Children showed improved behavior in the parent-rated Aberrant Behavior Checklist (ABC) total score after therapy (p = .001; ES T1T2 = .73) and at T3 (p = .018; ES T1-T3 = -.51), and a lower intensity of parent-rated problem behavior at T3 (p = .031; ES T1-T3 = -.46). Parental measures did not change. Conclusions: This study found medium pre-post effects on the child's behavior by FAUT-E between T1 and T2/T3; these were not observed between the measurements T0-T1. FAUT-E was easy to implement and did not increase parental stress. This is in line with results of studies on other training programs to teach parents to use effective behavioral strategies with ASD.


Assuntos
Transtorno do Espectro Autista , Educação Infantil/psicologia , Educação em Saúde , Pais/educação , Pais/psicologia , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Criança , Humanos , Comportamento Problema
15.
J Appl Behav Anal ; 54(1): 87-102, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33369729

RESUMO

Telehealth delivery of applied behavior analysis treatment has focused on supervision or staff and parent training, rather than the direct delivery of treatment to clients. The novel coronavirus (COVID-19) crisis had the potential to significantly disrupt access to direct treatment for individuals with autism. We report a sample of 17 cases that transitioned from in-person to telehealth delivery of treatment when shelter-in-place orders were issued. Of these cases, 76% of participants transitioned to technician-delivered telehealth services whereas the rest transitioned to a caregiver-implemented telehealth model. Participants continued to access a similar dosage of treatment hours per week in spite of the treatment model transition (in-person M = 12; telehealth M = 11) and maintained or improved correct independent responding across all targets from in-person treatment (M = 75%) to telehealth treatment (M = 80%). These findings provide initial evidence that some clients with autism benefit from technician-delivered telehealth services.


Assuntos
Análise do Comportamento Aplicada/métodos , Transtorno do Espectro Autista/terapia , Telemedicina/métodos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Adulto Jovem
16.
J Am Acad Child Adolesc Psychiatry ; 60(3): 338-339, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33310160

RESUMO

This is an important study for several reasons and shows a positive way forward for the design, execution, and analysis of intervention trials in the autism field. Brookman-Frazee et al.1 present a novel analysis demonstrating that their community training program, An Individualized Mental Health Intervention (AIM HI), which has been shown to improve behaviors that challenge in young children with autism,2 also leads to improvements in parental sense of competence (but not caregiver strain). This is in line with a limited number of other recent studies that have addressed the same issue.3,4 The present report adds to our knowledge in at least 2 important ways; both investigating the mechanisms of how these outcomes might come about. First, the study demonstrates that implementation of the training during the period of intervention, specifically, continuity across treatment sessions and the effectiveness with which a therapist pursued teaching a caregiver skill, mediated improvements in parental sense of competence at the end of treatment. Of note, these process or fidelity implementation ratings were blind coded by naïve raters trained to reliability on video-recorded sessions, an example of the high-quality methodology valued by expert trialists. Second, the authors not only show that changes in parental sense of competence during the intervention are associated with reductions in child behaviors that challenge at the end of the treatment period, they also conducted a formal mediation analysis that further demonstrates that changes in parental sense of competence during the treatment period are related to improvements in child outcomes at 12 and 18 months, long after the intervention period itself. There have long been calls highlighting the value of such mechanistic analysis to get "maximum value" from the precious resource of intervention trials,5 but these have only rarely been taken up in the autism intervention field.6.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Transtorno do Espectro Autista/terapia , Cuidadores , Criança , Pré-Escolar , Humanos , Saúde Mental , Pais , Reprodutibilidade dos Testes
17.
J Med Internet Res ; 22(12): e19658, 2020 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-33382381

RESUMO

BACKGROUND: Individuals with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can experience obstacles in traditional health care situations due to difficulties associated with their impairment. OBJECTIVE: This controlled study aims to investigate the feasibility of an internet-based support and coaching intervention (IBSC), including 2 weekly chat sessions and 2 complementary clinic visits with coaches over the course of 8 weeks, for adolescents and young adults with ADHD and/or ASD in 2 naturalistic routine care settings. METHODS: Individuals with ADHD and/or ASD aged 15-32 years were recruited in 2 clinical settings, where they received either IBSC (n=24) or treatment as usual (TAU; n=20). Outcome measures included self-report questionnaires assessing quality of life (Manchester Short Assessment for Quality of Life), sense of coherence (Sense Of Coherence 29), self-esteem (Rosenberg Self-Esteem Scale), and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale [HADS] and Montgomery-Åsberg Depression Rating Scale-Self-reported, respectively). RESULTS: Significant between-group effects were observed in measures of anxiety (HADS) at postintervention (P=.02) as well as at the 6-month follow-up (P=.004). Significant between-group effects were also noted for depressive symptoms (HADS) postintervention (P=.04). The between-group effects were partially explained by a deterioration in the TAU group. A significant increase in self-esteem (P=.04) as well as a decrease in anxiety (P=.003) at the 6-month follow-up was observed in the intervention group following IBSC. Findings from a qualitative study of the intervention are consistent with the results. CONCLUSIONS: The findings from this study suggest that IBSC holds promise as a feasible complement or alternative to traditional face-to-face health care meetings.


Assuntos
Assistência Ambulatorial/normas , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno do Espectro Autista/terapia , Qualidade de Vida/psicologia , Adolescente , Adulto , Estudos de Viabilidade , Feminino , Humanos , Internet , Masculino , Pesquisa Qualitativa , Apoio Social , Adulto Jovem
18.
Artigo em Inglês | MEDLINE | ID: mdl-33375475

RESUMO

Children with autism spectrum disorders (ASD) are at risk for oral health disparities. With the dramatic rise in ASD prevalence to 1 in 54 children, it is likely that an increasing number of dental practitioners will encounter or be asked to treat children with ASD. This paper reviews explanations related to the increasing prevalence of ASD, provides reasons why children with ASD are at increased risk for poor oral health, and discusses unique interprofessional collaborations between dental practitioners and occupational therapists. Occupational therapists and dentists can work together to plan modifications to the dental environment or adapt dental protocols to reduce some of the barriers encountered by those with ASD, provide desensitization strategies before the clinic visit, or help a child with emotional regulation during clinical treatments.


Assuntos
Transtorno do Espectro Autista , Odontologia , Terapia Ocupacional , Saúde Bucal , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/terapia , Criança , Odontólogos , Humanos , Comunicação Interdisciplinar , Papel Profissional
20.
Medicine (Baltimore) ; 99(45): e23128, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157993

RESUMO

INTRODUCTION: The purpose of this study is to evaluate the efficacy and safety of complementary and alternative medicine in the treatment of autism spectrum disorder. METHODS AND ANALYSIS: We will electronically search Pubmed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trial, China National Knowledge Infrastructure, China Biomedical Literature Database, China Science Journal Database, and Wan-fang Database from their inception. Also, we will manually retrieve other resources, including reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to complementary and alternative medicine treating autism spectrum disorder will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed-effect model or random-effect model depend on the heterogeneity test. The Childhood Autism Rating Scale (CARS) and Autism Behavior Checklist (ABC) scores will be the primary outcomes. The scores of the Autism Treatment Evaluation Checklist and the Ritvo-Freeman Real Life Rating Scale will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis, and the level of evidence will be assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Continuous data will be expressed in the form of weighted mean difference or standardized mean difference with 95% confidence intervals (CIs), whereas dichotomous data will be expressed in the form of relative risk with 95% CIs. ETHICS AND DISSEMINATION: The protocol of this systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION: OSF Registries, DOI: 10.17605/OSF.IO/ HA97R (https://osf.io/ha97r).


Assuntos
Transtorno do Espectro Autista/terapia , Terapias Complementares , Metanálise como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Criança , Terapias Complementares/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
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