Joyce Magill-Evans

Social and Language Skills in Adolescent Boys with Asperger Syndrome

Twenty-one adolescent boys with Asperger syndrome and 21 boys matched on age and an estimate of IQ were assessed using standardized measures of social perception (Child and Adolescent Social Perception Measure, CASP), social skills (parent, teacher, and student forms of the Social Skills Rating System, SSRS), number of close friends and frequency of contact (Child Behavior Checklist) and expressive and receptive language (Clinical Evaluation of Language Fundamentals-Revised). There were significant differences between groups on CASP scores, SSRS scores, number of friends, frequency of contact and social competence. There was also a significant difference on receptive language. The clinically and statistically significant differences between the groups on the measures of social skills help us understand the nature of the social deficits in Asperger syndrome and suggest the need to focus on specific deficits. These findings are discussed in relation to diagnostic criteria and intervention.

The quality of life of young men with Asperger syndrome: A brief report

Factors influencing quality of life for persons with Asperger syndrome are not yet understood. Men, ages 18 to 21, completed the World Health Organization Quality Of Life measure, the Perceived Support Network Inventory, and a semi-structured interview. Asperger syndrome affects quality of life beyond the obvious social impact. The 12 men with Asperger syndrome reported a significantly lower social and physical quality of life than did the 13 men in the control group. Education, living arrangements, and number of friends were remarkably similar between groups. Those with Asperger syndrome had less positive employment experiences and showed more preference for solitary activities. Interventions need to be based on a holistic model.

Key components of early intervention programs for preterm infants and their parents: a systematic review and meta-analysis

BackgroundPreterm infants are at greater risk for neurodevelopmental disabilities than full term infants. Interventions supporting parents to improve the quality of the infant’s environment should improve developmental outcomes for preterm infants. Many interventions that involve parents do not measure parental change, nor is it clear which intervention components are associated with improved parental outcomes. The aim of this review was to categorize the key components of early intervention programs and determine the direct effects of components on parents, as well as their preterm infants.MethodsMEDLINE, EMBASE, CINAHL, ERIC, and Cochrane Database of Systematic Reviews were searched between 1990 and December 2011. Eligible randomized controlled trials (RCTs) included an early intervention for preterm infants, involved parents, and had a community component. Of 2465 titles and abstracts identified, 254 full text articles were screened, and 18 met inclusion criteria. Eleven of these studies reported maternal outcomes of stress, anxiety, depressive symptoms, self-efficacy, and sensitivity/responsiveness in interactions with the infant. Meta-analyses using a random effects model were conducted with these 11 studies.ResultsInterventions employed multiple components categorized as (a) psychosocial support, (b) parent education, and/or (c) therapeutic developmental interventions targeting the infant. All interventions used some form of parenting education. The reporting quality of most trials was adequate, and the risk of bias was low based on the Cochrane Collaboration tool. Meta-analyses demonstrated limited effects of interventions on maternal stress (Z = 0.40, p = 0.69) and sensitivity/responsiveness (Z = 1.84, p = 0.07). There were positive pooled effects of interventions on maternal anxiety (Z = 2.54, p = 0.01), depressive symptoms (Z = 4.04, p <.0001), and self-efficacy (Z = 2.05, p = 0.04).ConclusionsPositive and clinically meaningful effects of early interventions were seen in some psychosocial aspects of mothers of preterm infants. This review was limited by the heterogeneity of outcome measures and inadequate reporting of statistics.Implications of key findingsInterventions for preterm infants and their mothers should consider including psychosocial support for mothers. If the intervention involves mothers, outcomes for both mothers and preterm infants should be measured to better understand the mechanisms for change.

Parent-Child Interactions, Parenting Stress, and Developmental Outcomes at 4 Years

This study examined the relationship of father-child and mother-child interactions, perceptions of parenting stress, socioeconomic status, and prematurity to development of 44 healthy preterm and 49 full-term Canadian children at 4 years of age. Preterm or full-term birth, infant sex, and parental age accounted for 30-32% of the variance in cognitive and motor scores, respectively, on the McCarthy Scales of Childrens Abilities. Parenting stress, father-child interactions at 12 months, and preterm and full-term birth accounted for 19% of the variance for expressive language on the Clinical Evaluation of Language Fundamentals-Preschool (CELF-P). For receptive language on the CELF-P, mother-child interaction at 12 months, mothers spousal relationship, and preterm and full-term birth accounted for 13% of the variance. Addressing early parent-child interaction and perceptions of parenting stress may improve child language development.

Parent-Child Interactions and Development of Toddlers Born Preterm:

Fathers and mothers of 49 healthy preterm and 54 full-term infants were observed interacting with their child at 3 and 12 months using the Nursing Child Assessment Teaching Scale. Each parent completed the Parenting Stress Index at both times. At 18 months adjusted age, the children were assessed using the Bayley Scales of Infant Development, Sequenced Inventory of Communication Development-Revised, and MacArthur Communicative Development Inventory. Preterm children scored significantly lower on the Bayley Mental scale and on the number of words produced. Early parent-child interactions contributed to the child’s development. Mother’s interactions with the child, child gender, and family socioeconomic status predicted 17% of the variance in the Bayley Mental score. Mother’s and father’s interactions with the child, child gender, and the child’s behavior with his or her mother predicted 22% of the variance in receptive communication skills.

Stability of serial assessments of motor and communication abilities in typically developing infants-implications for screening

BACKGROUND Neuromaturational theory and dynamic systems theory make different assumptions about the rate of development of motor and communication skills. AIMS The stability of fine motor, gross motor, and communication scores of infants was evaluated to test these assumptions. STUDY DESIGN This longitudinal descriptive study evaluated infants in their homes at 9, 11, 13, 16, and 21 months of age. PARTICIPANTS One hundred and two Canadian children of English-speaking parents classified as typically developing at 23 months of age using the Diagnostic Inventory for Screening Children Preschool Screen were included. OUTCOME MEASURES The Peabody Developmental Motor Scales and the Communication Symbolic Behavior Scales-Developmental Profile were used to assess development at each time. Scores were stable if the 95% confidence intervals around the scores overlapped across all assessments. Correlations evaluated the relationship of scores in a domain over time (normative stability) as well as the relationship of scores between domains (ipsative stability). RESULTS There was large variability in scores within an infant, among infants and across developmental domains. Typical development is nonlinear rather than occurring at a constant rate. Fine motor, gross motor, and communication skills appear to develop independently. CONCLUSIONS These results have implications both for developmental screening policies and for early intervention programs. Screening should include multiple domains and multiple time points before referrals are made to early intervention programs.

Peer interactions of autistic children and adolescents

Two observational studies of verbal, high-functioning children and adolescents with autism; nonautistic, behaviorally disordered youngsters of equivalent verbal skills and chronological age; and verbal age-matched normally developing students during integrated summer day camps are reported. In the first study, observations were made of spontaneous peer interaction and play over the course of 2 weeks of day camp. The eight autistic subjects were consistently more likely to not be interacting and less likely to be engaged in any purposeful activity than the 16 other children. During the 2 weeks, time interacting and purposeful activity increased overall. In the second study, the quality of spontaneous peer-directed initiations was observed during free time in similar day camps the following summer. The 11 autistic children and adolescents produced fewer initiations than did the 20 other children and were less likely to smile or coordinate several behaviors with eye contact during an initiation. Autistic subjects were consistently more likely not to receive a response to their initiation than the other groups, although there was no identifiable relationship between the quality of the initiation and the likelihood of it receiving a response.

Are families with adolescents and young adults with cerebral palsy the same as other families

This study compared adolescents with cerebral palsy (CP) and their families to adolescents without physical disabilities and their families as the child enters and leaves adolescence (age ranges 13 to 15 years and 19 to 23 years). Families of 90 individuals with CP (42 females, 48 males) and 75 individuals without physical disabilities (34 females, 41 males) participated. They completed the Family Assessment Device, Life Situation Survey, Multidimensional Scale of Perceived Social Support, and Future Questionnaire. There were few differences in family functioning, life satisfaction, or perceived social support between the groups. Expectations of young adults with CP and parents of both adolescents and young adults regarding future independence and success were lower than the expectations of the control group. While the group results emphasize similarities between families during the two stages of adolescence, individual families and individual family members report specific challenges.

Using the berg balance scale to distinguish balance abilities in children with cerebral palsy.

Purpose: This study was designed to evaluate the use of the Berg Balance Scale (BBS) to assess the balance abilities of children with cerebral palsy. Methods: Thirty‐six ambulatory children with cerebral palsy and 14 children with no motor impairment (ages eight to 12 years) were assessed on the BBS and the Gross Motor Function Measure (GMFM). Participants with cerebral palsy comprised three groups based on diagnosis (spastic hemiplegia, spastic diplegia who ambulated without aids, and spastic diplegia who ambulated with aids). A fourth group consisted of control subjects with no motor impairment. It was hypothesized that these four groups demonstrated a hierarchy of balance abilities. A one‐way ANOVA was used to detect significant differences in test scores among the four groups. The analysis was repeated categorizing children on the Gross Motor Function Classification System (GMFCS) instead of diagnosis. Results: The ability to use scores on the GMFM was slightly better than using BBS scores to distinguish among the groups when children were classified using diagnosis. Significant pair‐wise differences among the groups were present on both the BBS and the GMFM when the children were grouped on the GMFCS. Conclusions: The results suggest that the BBS can be considered as a clinical measure of balance for children with cerebral palsy, and a functional classification system can be used to group children more homogeneously than traditional classification by diagnosis. (Pediatr Phys Ther 2002;14:92‐99)

Healthcare transition for youth with heart disease: a clinical trial

Objectives Adolescents with heart disease have complex health needs and require lifelong cardiology follow-up. Interventions to facilitate paediatric to adult healthcare transition are recommended, although outcomes are unknown. We sought to determine the impact of a transition intervention on improving knowledge and self-management skills among this population. Methods We conducted a clinical trial of 15–17 year olds with moderate or complex congenital heart disease (CHD) or cardiomyopathy. Participants were systematically allocated to either usual care (controls) or a 1 h nurse-led one-on-one teaching session about their heart. Allocation was determined by week of attendance in the cardiology clinic. The primary outcome was change in Transition Readiness Assessment Questionnaire (TRAQ) score at 6 months, possible scores ranging from 1 (low) to 5 (optimal). Cardiac knowledge (MyHeart score, range 0–100) was a secondary outcome. Analysis was intention to treat. Results Of 58 participants (48% female), 52 had CHD and 6 had cardiomyopathy. 27 were allocated to the intervention group; 3 declined the intervention and received usual care. When comparing the intervention group with the usual care group at 6 months postintervention, the mean self-management TRAQ score was 3.59 (±0.83) vs 3.16 (±1.05), respectively (p=0.048, adjusted for baseline score); the mean self-advocacy TRAQ score was 4.38 (±0.56) vs 4.01 (±0.95) (p=0.18) and the mean MyHeart score was 75% (±15) vs 61% (±25) (p=0.019). Conclusions A 1 h nurse-led transition intervention resulted in a significant improvement in self-management and cardiac knowledge scores. An educational intervention should be routine for youth with congenital or acquired heart disease. Trial registration number NCT01286480