Jessica Paynter

Autism in toddlers born very preterm

OBJECTIVE: This study aimed to determine the prevalence of autism spectrum disorder (ASD) by using the Autism Diagnostic Observation Schedule-Generic (ADOS-G) classifications in children born very preterm during their toddler years. METHODS: Two birth cohorts of toddlers (2 and 4 years old) each recruited over 12 months and born at <29 weeks’ gestation were administered the Modified Checklist of Autism in Toddlers–Follow-up Interview (M-CHAT-FI) screen, the ADOS-G, and developmental assessments. The ADOS-G was conducted on toddlers with M-CHAT-FI–positive screens. RESULTS: Data were available on 88% (169/192) of children. In total, 22 (13%) toddlers screened positive and 3 (1.8%) were confirmed diagnostically with ASD. These 3 cases reached the highest ADOS-G threshold classification of autism. All but 1 child who scored below the ADOS-G thresholds (11/12) demonstrated some difficulty with social communication. Risk was significantly increased for co-occurring neurodevelopmental problems in 21 of the 22 positive-screen ASD cases. Adaptive behavior (P < .001) was the only co-occurring factor independently predictive of ASD in toddlers. CONCLUSIONS: Children born very preterm are at increased risk of ASD. By using the ADOS-G, we found a lower incidence of ASD in children born at <29 weeks’ gestation compared with previous studies. Children who screened positive for ASD on the M-CHAT-FI had developmental delays consistent with subthreshold communication impairment.

Knowledge and Use of Intervention Practices by Community-Based Early Intervention Service Providers

This study investigated staff attitudes, knowledge and use of evidence-based practices (EBP) and links to organisational culture in a community-based autism early intervention service. An EBP questionnaire was completed by 99 metropolitan and regionally-based professional and paraprofessional staff. Participants reported greater knowledge and use of EBPs compared to emerging and unsupported practices. Knowledge and use of EBPs were linked to each other independent of significant correlations with organisational culture and attitudes. Knowledge and use of EBPs was greater in metropolitan than regional locations and paraprofessionals reported greater use of unsupported practices and lower levels of knowledge and use of EBPs than professionals. The implications of these findings for the facilitation of knowledge transfer are discussed.

A Systematic Review of the Literature on Emergent Literacy Skills of Preschool Children With Autism Spectrum Disorder

A wealth of research has been conducted into emergent literacy (i.e., precursors to formal reading) skills and development in typically developing (TD) children. However, despite research suggesting children with autism spectrum disorder (ASD) are at risk of reading challenges, limited research exists on their emergent literacy. Thus, we aimed to systematically review emergent literacy research with this population. Database searches from 1995 to 2015 yielded three articles that met inclusion criteria. Results suggested both strengths and challenges in emergent literacy skills in children with ASD. Significant links between emergent literacy skills and both oral language and nonverbal cognition were also found. The findings highlight the need for further research; future directions and implications are discussed.

The Emergent Literacy Skills of Preschool Children with Autism Spectrum Disorder

A high percentage of school-age students with autism spectrum disorder (ASD) have reading comprehension difficulties leading to academic disadvantage. These difficulties may be related to differences in children’s emergent literacy development in the preschool years. In this study, we examined the relationship between emergent literacy skills, broader cognitive and language ability, autism severity, and home literacy environment factors in 57 preschoolers with ASD. The children showed strengths in code-related emergent literacy skills such as alphabet knowledge, but significant difficulties with meaning-related emergent literacy skills. There was a significant relationship between meaning-related skills, autism severity, general oral language skills, and nonverbal cognition. Identification of these meaning-related precursors will guide the targets for early intervention to help ensure reading success for students with ASD.

Vineland Adaptive Behavior Scales: II Profile of Young Children with Autism Spectrum Disorder

AbstractAdaptive behaviour is a crucial area of assessment for individuals with Autism Spectrum Disorder (ASD). This study examined the adaptive behaviour profile of 77 young children with ASD using the Vineland-II, and analysed factors associated with adaptive functioning. Consistent with previous research with the original Vineland a distinct autism profile of Vineland-II age equivalent scores, but not standard scores, was found. Highe st scores were in motor skills and lowest scores were in socialisation. The addition of the Autism Diagnostic Observation Schedule calibrated severity score did not contribute significant variance to Vineland-II scores beyond that accounted for by age and nonverbal ability. Limitations, future directions, and implications are discussed.

A pilot study of the effects of an Australian centre-based early intervention program for children with autism

The current study sought to evaluate the effectiveness of an Australian centre-based early intervention program for children with autism. Outcomes for 10 children with autistic disorder aged between 32 and 65 months of age participating in the AEIOU early intervention program were investigated. Measures of educational, cognitive, and adaptive skills as well as autism symptoms were administered. Significant gains in educational skills in the areas of cognitive verbal/preverbal, fine motor and visual-motor imitation, motor domain score, and social reciprocity, were obtained as were decreases in autism symptoms. Limited evidence of gains was obtained for measures of cognitive or adaptive behaviour skills. This study provides promising preliminary evidence in support of the AEIOU program in terms of symptom reduction and increases in educational skills. Limitations and future research directions are discussed.

Utilisation of evidence-based practices by ASD early intervention service providers

A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and use of strategies, organisational culture, individual attitudes, sources of information and considerations informing intervention choices by early intervention providers. An online survey was completed by 72 early intervention providers from four organisations across Australia. Providers reported high levels of trust and access of information from internal professional development, therapists and external professional development. A range of considerations including child factors, family values and research were rated as important in informing intervention choices. Participants reported greater knowledge and use of evidence-based and emerging practices than unsupported. Levels of use were linked to levels of knowledge, as well as some organisational and attitudinal factors. Areas for future research and implications are discussed.

Diagnostic evaluation for autism spectrum disorder: a survey of health professionals in Australia

Objectives There is currently no agreed Australian standard for the diagnosis of autism spectrum disorder (ASD) even though there are specific diagnostic services available. We suspected inconsistency in the diagnostic practices of health professionals in Australia and aimed to assess these practices across the nation by surveying all relevant professional groups. Design In this study, we completed a survey of 173 health professionals whose clinical practice includes participating in the diagnostic process for ASD in Australia. Participants completed an online questionnaire which included questions about their diagnostic setting, diagnostic practice and diagnostic outcomes in 2014–2015. Participants Participants covered a range of disciplines including paediatrics, psychiatry, psychology, speech pathology and occupational therapy. All states and territories of Australia were represented. Setting Participants came from a range of service settings which included hospitals, non-governmental organisations, publicly funded diagnostic services and private practice. Results There was variability in diagnostic practices for ASD in Australia. While some clinicians work within a multidisciplinary assessment team, others practice independently and rarely collaborate with other clinicians to make a diagnostic decision. Only half of the respondents reported that they include a standardised objective assessment tool such as the Autism Diagnostic Observation Schedule in ASD assessments, and one-third indicated that they do not include measures of development, cognition and language in assessments where ASD is suspected. Conclusions Reported practice of some professionals in Australia may not be consistent with international best practice guidelines for ASD diagnosis. These findings highlight the need for a minimum national standard for ASD diagnosis throughout Australia that ensures best practice regardless of the type of setting in which the service is provided.

“Attention: Myth Follows!” Facilitated Communication, Parent and Professional Attitudes towards Evidence-based Practice, and the Power of Misinformation

Abstract Facilitated Communication (FC) is a non-evidence-based intervention with documented dangers that continues to be used with some children with autism spectrum disorders. In this response to Lilienfeld, Marshall, Todd, and Shane, we consider how the findings of our own research involving parents and professionals may contribute to the development of strategies aimed at countering FC and other unsupported practices. We also consider the ways in which misinformation may be contributing to the persistence of FC. We affirm Lilienfeld et al.’s recommendation that countering FC requires a comprehensive and concerted effort, which must build awareness, capacity, and resilience within parents, professionals, and organizations to adopt only evidence-based interventions.

Recognising the “forgotten man”: Fathers’ experiences in caring for a young child with autism spectrum disorder

ABSTRACT Background Despite decades of research on family adaptation in relation to caring for a child with an autism spectrum disorder (ASD), the wellbeing of fathers remains poorly understood. Method The present study sought to investigate experiences of fathers of young children with ASD aged between 2½ and 6 years attending an ASD-specific early intervention centre. Eighteen fathers initially completed a mailed questionnaire and 8 of these fathers were then interviewed by telephone. The questionnaire included standardised measures assessing constructs of the double ABCX model of family adaptation. The interview used open-ended questions to understand the experiences of fathers’ involvement in caring, sources of support, and coping strategies. Results Fathers experienced elevated levels of parental stress and elevated depressive symptoms. Interviews deepened understanding of fathers’ personal experiences of each component of the double ABCX model. Conclusions Findings from this study provide further insight into the fathering role and demonstrate the utility of the double ABCX model as a framework for exploring their experiences. The need for further research to explore practical implications to better support fathers is discussed.