Examining the Impact of Group-Based Social Skills Intervention in Autistic Children Aged Eight to 15 Years.

Introduction Autism spectrum disorder (ASD) is a neurological and developmental disorder, which poses challenges to social communication and behavior, particularly affecting social functioning. Individuals with ASD face significant social challenges, including difficulty understanding social cues and body language, limited ability to engage in reciprocal social interactions, and challenges with establishing empathy. A preference for routines and repetitive behaviors limits their ability to adapt to new or unexpected social situations. These problems tend to escalate during adolescence. These often cause distress to the individual as well as the caregivers. Group-based social skills interventions (GSSIs) are a widely used and effective modality for addressing core social impairments in children with autism. This study aims to assess the impact of GSSI on the broad age group of eight to 15 years, involving parents to enhance the transferability of children's social skills. Methods This was a single-arm interventional study where 30 verbal autistic children, aged eight to 15 years, with intelligence quotient (IQ) > 70 were enrolled after utilizing the Binet Kamat Test of Intelligence (BKT) to assess IQ and the Indian Scale for Assessment of Autism (ISAA) to grade severity of autism. The children received GSSI from interdisciplinary therapists for 12 sessions, on a weekly basis, lasting 90 minutes each for a period of three months. After each therapy session, parents received summaries of each session and were delegated reinforcing homework assignments to enable generalization and maintenance of the skills taught. Outcome measures were taken at three points in time by utilizing the Social Communication Questionnaire (SCQ) and the parent-rated Social Responsiveness Scale 2 (p-SRS-2): T1: pre-therapy at the time of enrolment; T2: immediately post-therapy at the end of three months of training; and T3: long-term follow-up, three months after the end of training. Results Mean SCQ scores were as follows: T1 = 21.87, T2 = 18.57, and T3 = 18.57 (p = 0.000). This progressive decline at T1, T2, and T3 indicated a decreasing trend in the severity of difficulties in the social communication domain. Mean p-SRS-2 scores were as follows: T1 = 73.00, T2 = 64.57, and T3 = 64.30 (p < 0.0001). This declining trend at T1, T2, and T3 suggested a statistically significant decrease in the severity of difficulties faced in various social aspects tested by the p-SRS-2, i.e., social awareness, social cognition, social communication, and social motivation, along with a reduction in restricted interests and repetitive behaviors (RRBs). Very strong correlation coefficients were obtained for SCQ scores (T1-T2 = 0.921, T1-T3 = 0.921, and T2-T3 = 1.000), as well as for p-SRS-2 scores (T1-T2 = 0.743, T1-T3 = 0.746, and T2-T3 = 0.989), which reinforced the statistical significance of the data. Conclusion GSSI is an effective parent-assisted intervention for adolescents with ASD, with effects lasting up to three months post-intervention.

Short-term Outcome of Social Skills Group Therapy Intervention in School Aged Children With Autism.

OBJECTIVE: To study the impact of social skills group training (SSGT) in children with autism aged 8-12 years. To compare baseline (T1), post-intervention immediate (T2) and 3 months post-intervention (T3) scores. METHODS: Single-arm interventional study in 30 children with autism, aged 8-12 years with intelligence quotient >70. Interdisciplinary therapists conducted a 90-minute weekly SSGT (10 sessions) for 3 months (August-October, 2019). Outcomes were evaluated with standardized tests- Vineland Social Maturity Scale (VSMS), Vineland Social Maturity Scale- Social Quotient (VSMS-SQ), Social Communication Questionnaire (SCQ), Parent Rated Social Responsiveness Scale-2 (pSRS-2) done at baseline and at T2 and T3. RESULTS: The mean (SD) scores at T1 and T3 were as follows: VSMS score at T1 was 66.63 (5.05), T3 was 71.03 (5.84) (P<0.001); SQ at T1 = 75.99 (6.399), T3 = 79.83 (8.94) (P=0.016), respectively.  The mean (SD) SCQ score at T1 was 27.3 (12.28), T2 was 25.8 (6.36), T3 = 27.1 (7.16) (P>0.05 for T1- T2, T2-T3, P=0.013 for T1-T3). The mean (SD) pSRS-2 score at T1 = 83.5 (6.68), T2 = 80.1 (7.87), T3 = 76.9 (8.07) (P<0.001), showing decline in severity after SSGT. CONCLUSIONS: Weekly SSGT done over 3 months showed significant improvement in social skills, which were sustained up to 3 months post-intervention.

Dietary Sugar Exposure and Oral Health Status in Children with Autism Spectrum Disorder: A Case-control Study.

This case-control study compared dietary sugar exposure and oral health status between children with and without Autism Spectrum Disorder (ASD), aged 5-12 years (n = 136, each). Data regarding socio-demographics, child's oral hygiene practices and behavior, diet-related behavior, oral habits and dental trauma were obtained. Child's diet on the previous day was recorded using 24-h recall method and sugar exposure was calculated using Dental Diet Diary (D3) mobile application. Oral Hygiene Index-Simplified (OHI-S), deft and DMFT were recorded. Results showed no significant differences in sugar exposure, deft and DMFT between the groups. Although oral hygiene practices were significantly better in children with ASD, their OHI-S was significantly worse. Significantly more children with ASD reported mouth-breathing, bruxism and self-injurious habits.

Interprofessional education and practice in an Indian setting.

With current global healthcare trends, there is a growing need for interprofessional education (IPE) and interprofessional practice (IPP) in collaborative care of persons with chronic medical conditions. Tools and models for IPE and IPP are now available, but they are not yet in widespread use. Developmental-behavioural paediatrics is a medical discipline that is characterized by IPP with an encouraging emergence of this speciality in India and other developing countries. This article provides an overview of IPE and IPP, followed by a precise account of an Indian institution, which provides services to children suffering from neurodevelopmental disorders utilizing an IPP approach and implementing IPE to its trainees.

West syndrome: clinic etiological profile, and response to treatment in Western India

Background: Information on the profile of infants with West syndrome in developing countries is limited. This study was done to determine clinico-etiological profile and clinical response of infantile spasms to various medications in children with west syndrome in a developing country.Methods: It was a retrospective cohort study from January 2017-january 2020 done in a tertiary care hospital in western India. Records of 39 children with west syndrome who visited this pediatric neurology division during study period were analysed. 6 were excluded in view of incomplete data. Detailed history, examination, investigations and medications given were noted. Follow up records were assessed to look for long term control of spasms, relapse rates after cessation, or progression to other seizure types.Results: Mean age at onset of infantile spasms was found to be 8.12 months (1 - 36 months).' Mean lag time to treatment was 5.35 months. Etiology was found in 69.7% children with perinatal causes being most common. With oral prednisolone, 54.5% had complete cessation of spasms, and with ACTH also 54.5% had complete spasm cessation. Favourable clinical response at 6 months follow up was found in 8 (47.05%) of the 17 children. Surprisingly, lag time (p=0.381) and symptomatic etiology (p=1.00) did not have any significant impact on outcome.Conclusions: This study highlights the developing country perspective of west syndrome. Increased lag time, different etiological profile and poor outcome are the challenges. High dose prednisolone is a good first line alternative treatment option in resource poor settings.

Accidental haloperidol poisoning in children.

Haloperidol, a butyrophenone neuroleptic drug, is an antipsychotic used in the treatment of adult schizophrenia and mania. It is used in children with neurological disorders like chorea and developmental disorders such as hyperactivity. With the advent of newer selective neuroleptics use of haloperidol is now on decline. However, in adults it is still the preferred drug especially in resource challenged settings. Extrapyramidal reactions occur frequently with haloperidol predominantly as parkinsonian symptoms. There are few case reports of accidental haloperidol poisoning in children and this one of them.