Brian Reichow

Social Skills Interventions for Individuals with Autism: Evaluation for Evidence-Based Practices within a Best Evidence Synthesis Framework

AbstractThis paper presents a best evidence synthesis of interventions to increase social behavior for individuals with autism. Sixty-six studies published in peer-reviewed journals between 2001 and July 2008 with 513 participants were included. The results are presented by the age of the individual receiving intervention and by delivery agent of intervention. The findings suggest there is much empirical evidence supporting many different treatments for the social deficits of individuals with autism. Using the criteria of evidence-based practice proposed by Reichow et al. (Journal of Autism and Developmental Disorders, 38:1311–1318, 2008), social skills groups and video modeling have accumulated the evidence necessary for the classifications of established EBP and promising EBP, respectively. Recommendations for practice and areas of future research are provided.

Sensitivity and Specificity of Proposed DSM-5 Diagnostic Criteria for Autism Spectrum Disorder

OBJECTIVE This study evaluated the potential impact of proposed DSM-5 diagnostic criteria for autism spectrum disorder (ASD). METHOD The study focused on a sample of 933 participants evaluated during the DSM-IV field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and specificity for proposed DSM-5 diagnostic criteria were evaluated using field trial symptom checklists as follows: individual field trial checklist items (e.g., nonverbal communication); checklist items grouped together as described by a single DSM-5 symptom (e.g., nonverbal and verbal communication); individual DSM-5 criterion (e.g., social-communicative impairment); and overall diagnostic criteria. RESULTS When applying proposed DSM-5 diagnostic criteria for ASD, 60.6% (95% confidence interval: 57%-64%) of cases with a clinical diagnosis of an ASD met revised DSM-5 diagnostic criteria for ASD. Overall specificity was high, with 94.9% (95% confidence interval: 92%-97%) of individuals accurately excluded from the spectrum. Sensitivity varied by diagnostic subgroup (autistic disorder = 0.76; Aspergers disorder = 0.25; pervasive developmental disorder-not otherwise specified = 0.28) and cognitive ability (IQ < 70 = 0.70; IQ ≥ 70 = 0.46). CONCLUSIONS Proposed DSM-5 criteria could substantially alter the composition of the autism spectrum. Revised criteria improve specificity but exclude a substantial portion of cognitively able individuals and those with ASDs other than autistic disorder. A more stringent diagnostic rubric holds significant public health ramifications regarding service eligibility and compatibility of historical and future research.

Comprehensive Synthesis of Early Intensive Behavioral Interventions for Young Children with Autism Based on the UCLA Young Autism Project Model

A 3-part comprehensive synthesis of the early intensive behavioral intervention (EIBI) for young children with autism based on the University of California at Los Angeles Young Autism Project method (Lovaas in Journal of Consulting and Clinical Psychology, 55, 3–9, 1987) is presented. The three components of the synthesis were: (a) descriptive analyses, (b) effect size analyses, and (c) a meta-analysis. The findings suggest EIBI is an effective treatment, on average, for children with autism. The conditions under which this finding applies and the limitations and cautions that must be taken when interpreting the results are discussed within the contextual findings of the moderator analyses conducted in the meta-analysis.

Comparison of Overlap Methods for Quantitatively Synthesizing Single-Subject Data

Four overlap methods for quantitatively synthesizing single-subject data were compared to visual analysts’ judgments. The overlap methods were percentage of nonoverlapping data, pairwise data overlap squared, percentage of data exceeding the median, and percentage of data exceeding a median trend. Visual analysts made judgments about 160 A-B data sets selected randomly from the Journal of Applied Behavior Analysis . The four overlap methods were compared for data sets in which all visual analysts agreed a change in data occurred or a change did not occur across conditions. Each overlap method had unacceptably high levels of errors. Given the findings and weaknesses of the overlap methods, their use should be abandoned. The desirable characteristics of a quantitative synthesis method are described.

Evidence-based practices and treatments for children with autism

Evidence-based practices and treatments for children with autism , Evidence-based practices and treatments for children with autism , کتابخانه دیجیتال جندی شاپور اهواز

Cognitive-Behavioral Therapy for Anxiety in Children With High-Functioning Autism: A Meta-analysis

BACKGROUND: Anxiety is a common and impairing problem in children and adolescents with autism spectrum disorder (ASD). There is emerging evidence that cognitive-behavioral therapy (CBT) could reduce anxiety in children with high-functioning ASD. OBJECTIVE: To systematically review the evidence of using CBT to treat anxiety in children and adolescents with ASD. Methods for this review were registered with PROSPERO (CRD42012002722). METHODS: We included randomized controlled trials published in English in peer-reviewed journals comparing CBT with another treatment, no treatment control, or waitlist control. Two authors independently screened 396 records obtained from database searches and hand searched relevant journals. Two authors independently extracted and reconciled all data used in analyses from study reports. RESULTS: Eight studies involving 469 participants (252 treatment, 217 comparison) met our inclusion criteria and were included in meta-analyses. Overall effect sizes for clinician- and parent-rated outcome measures of anxiety across all studies were d = 1.19 and d = 1.21, respectively. Five studies that included child self-report yielded an average d = 0.68 across self-reported anxiety. CONCLUSIONS: Parent ratings and clinician ratings of anxiety are sensitive to detecting treatment change with CBT for anxiety relative to waitlist and treatment-as-usual control conditions in children with high-functioning ASD. Clinical studies are needed to evaluate CBT for anxiety against attention control conditions in samples of children with ASD that are well characterized with regard to ASD diagnosis and co-occurring anxiety symptoms.

Systematic Review of Articles Describing Experience and Supports of Individuals with Autism Enrolled in College and University Programs

The increase in the number of higher-functioning individuals with autism spectrum disorders (ASD) is likely to lead to an increased interest in postsecondary opportunities including degree-granting college and university programs. To provide an understanding of the current evidence-base for supporting individuals with ASD in higher education, this article reports the results of a systematic review of the literature concerning college students with ASD. Overall, 20 articles describing 69 individuals met the inclusion criteria. This small number of articles and participants indicates the scarcity of research on this topic and only two of these studies were experimental in nature. These studies described a video-self modeling intervention and a counseling intervention respectively. Eighteen “case studies” were also present in the literature that described difficulties ranging from anxiety to housing concerns. This review deliniates the limitation of our understanding of effective college programming for individuals with ASD.

Autism in DSM-5: progress and challenges

BackgroundSince Kanner’s first description of autism there have been a number of changes in approaches to diagnosis with certain key continuities . Since the Fourth edition of the Diagnostic and Statistical Manual (DSM-IV) appeared in 1994 there has been an explosion in research publications. The advent of changes in DSM-5 presents some important moves forward as well as some potential challenges.MethodsThe various relevant studies are summarized.ResultsIf research diagnostic instruments are available, many (but not all) cases with a DSM-IV diagnosis of autism continue to have this diagnosis. The overall efficiency of this system falls if only one source of information is available and, particularly, if the criteria are used outside the research context. The impact is probably greatest among the most cognitively able cases and those with less classic autism presentations.ConclusionsSignificant discontinuities in diagnostic practice raise significant problems for both research and clinical services. For DSM-5, the impact of these changes remains unclear.

Development, Procedures, and Application of the Evaluative Method for Determining Evidence-Based Practices in Autism

Recently, we sought to review the empirical evidence on interventions for children with autism spectrum disorders (ASDs) in search of interventions meeting the criteria of evidence-based practice (EBP). As outlined in Chap. 1, EBP is defined differently by different disciplines. Although many of these definitions were quite good, it quickly became apparent that locating and defining EBP for children with ASDs using the available definitions and procedures would be difficult. Therefore, we decided to create a new method for evaluating empirical evidence to determine if a practice could be considered an EBP. This decision was made only after determining that existing methods were not well suited for our specific needs; when possible, elements and standards from existing methods were adopted into the evaluative method presented in this chapter.

Effects of Weighted Vests on the Engagement of Children With Developmental Delays and Autism

The use of weighted vests for children with autism spectrum disorders and developmental disabilities is a common practice as part of sensory integration therapy programs. The purpose of the current investigation was to extend the research on the use of weighted vests for children with autism and developmental delays in a methodologically rigorous study. The study was conducted using an alternating treatment design.This allowed the comparison of three different conditions: weighted vest, vest with no weight (which served as a placebo), and no vest (which served as a baseline). The results showed no differentiation in engagement between conditions for any of the participants. Implications for practice and future research are provided.