Kate Simpson

Music Interventions for Children with Autism: Narrative Review of the Literature

It is widely reported that music can be beneficial to individuals with autism. This review was undertaken to determine the evidence base for the use of music as an intervention for children with autism. After searching relevant databases, 128 articles were identified of which 20 articles met the study’s inclusion criteria. Composed songs and improvisational music therapy were the predominant music techniques used. There was somewhat limited evidence to support the use of music interventions under certain conditions to facilitate social, communicative and behavioural skills in young children with autism. The implications of these findings in terms of use of music interventions, issues related to generalization and maintenance, and future research are discussed.

A review of research into stakeholder perspectives on inclusion of students with autism in mainstream schools

ABSTRACT Increasing numbers of students with autism are being educated in mainstream schools. However, outcomes for students with autism are poor when compared to typical students and students with other developmental disabilities. In order to better understand facilitators and barriers to success at school for students with autism, research into the attitudes of key stakeholders, educators, parents, people with autism, to inclusion in mainstream schools for students with autism, was reviewed. Key themes emerging included attitudes to inclusion, the characteristics of autism and social communication in particular and interaction with the school environment, and consequent student problem behaviour. Level of knowledge and understanding of school staff emerged as the primary issue with all stakeholders identifying the need for more training. Other support needs identified included the need for structural support, resources and funding. Parents, in particular, identified the need for a collaborative approach to the education process. The findings highlight the need to translate theory into practice to increase capacity in schools to provide effective educational programmes for students with autism.

Anxiety-related symptomatology in young children on the autism spectrum:

Anxiety symptomatology is frequently reported in autistic children, and the prevalence of anxiety disorder is estimated at around 40%. However, most studies have focused upon children of age 8 years or above, so little is known about early signs of anxiety in younger children with autism. This study sought to describe anxiety-related symptomatology in 95 5- to 6-year-old autistic children using the Anxiety Scale for Children with Autism Spectrum Disorder. Wide variability was found in levels of symptomatology with the most frequently reported items within the ‘uncertainty’ subscale and the least frequently reported items in the ‘anxious arousal’ subscale. Comparisons of those with scores less than or greater than 70 on adaptive behaviour suggests some influence of ability on presentation of anxiety-related symptomatology.

Teaching receptive labelling to children with autism spectrum disorder: A comparative study using infant-directed song and infant-directed speech

Abstract Background There is a growing body of literature investigating the efficacy of music interventions for children with autism spectrum disorder (ASD); however, little empirical research has been conducted into the use of musical elements to facilitate language learning. Methods This crossover-design study compared the responses of 22 children with ASD (M age = 5.88 years) to sung and spoken instructions embedded into a computer-based communication intervention designed to teach receptive labelling. Results There was no significant difference between the sung and spoken conditions. Following both conditions, there was a significant increase in receptive labelling skills; skills were generalised and were maintained at follow-up. A difference in group performance was found. Conclusion Further research is required to investigate child characteristics that may impact on childrens performance using this approach.

School-related anxiety symptomatology in a community sample of primary-school-aged children on the autism spectrum

Although it is recognized that the prevalence of anxiety is elevated in children with autism spectrum disorder, there has been very limited research exploring such anxiety in school contexts. As a result, there is limited detailed information for teachers or educators on how anxiety in autism may present in the school setting for children on the autism spectrum. The aims of this study were to (a) report the profile of results on a measure of school anxiety in a community sample of children on the autism spectrum, (b) investigate whether scores on this measure differed with child variables or enrollment into a mainstream or special school, and (c) document the level of agreement between teacher-reported and parent-reported anxiety symptoms. Teachers of 92 children aged 5-12 completed a questionnaire pack including the School Anxiety Scale-Teacher Rating (SAS-TR). Elevated levels of anxiety (above the SAS-TR total anxiety clinical cut-off) were noted in 21.7% of the sample, with a larger proportion of children scoring above the generalized anxiety cut-off (27.2%) than the social anxiety cut-off (14.1%). Older participants (U = 744, p = .02, η2 = 0.06) and those attending mainstream schools (U = 661, p = .02, η2 = 0.06) had significantly higher scores on the generalized, but not the social, anxiety subscales, with effect sizes suggesting a medium effect. The results highlight the need for further, more detailed research into the presentation and impact of school anxiety in children with autism attending both mainstream and special schools.

Parent descriptions of the presentation and management of anxiousness in children on the autism spectrum

The complex interaction between anxiety and autism has led to debate about the presentation of anxiety in individuals on the spectrum and questions about the extent to which traditional checklists assess the entire range of symptomatology. Moreover, studies to date have not explored how the presentation of anxiety may differ between settings. Through a combination of open-ended questions, closed questions and standardised measures, parents of 173 children (aged 6–13) on the autism spectrum provided (1) descriptors of their child’s anxiety at home, school and in the community and (2) strategies used to reduce their child’s anxiety in each setting. Over half (52.6%) felt their child was anxious at home, 77.6% at school and 76.2% in the community. Parents reported differing presentations of anxiety between settings, with the majority of descriptions relating to observable, behavioural changes (e.g. hides/shuts down, repetitive behaviours) rather than cognitive or physiological signs. Parents also reported using different strategies across settings. The use of open-ended questions allowed the identification of signs of anxiety not explored within traditional questionnaires and highlighted the potential for signs to vary across settings. This knowledge is critical to inform the development or adaptations of anxiety measures and interventions.

Picture Exchange Communication System (PECS) may facilitate communicative behaviors between individuals with developmental disabilities and their peers, but further replications are necessary

This review provides a summary and appraisal commentary on the treatment review by Cannella-Malone, H. I., Fant, J. L., & Tullis, C. A. (2009). Using the picture exchange communication system to increase the social communication of two individuals with severe developmental disabilities. Journal of Developmental and Physical Disabilities, 22, 149–163. Source of funding and disclosure of interest: No source of funding reported, and the original authors of this research report no conflicts of interest.

Implementing structured consultation with autism spectrum disorder early intervention practitioners

ABSTRACT Background Implementation of evidence-based practices with fidelity during early intervention is important in achieving positive outcomes for children with autism spectrum disorder. However, uptake with fidelity has been poor in community settings. Traditional professional development approaches have done little to change practice. This has stimulated interest in researching the use of structured consultation to address this challenge. Method In this study, we used a single case experimental design with multiple baselines across participants to investigate the effects of structured consultation on the use of descriptive praise. Participants were 4 early intervention professional and paraprofessional staff, 1 in the role of consultant and 3 consultees. Results All consultees learned to implement descriptive praise with fidelity and maintained improvements at follow-up. All participants rated the professional development program based on structured consultation as socially valid. Conclusions Structured consultation improved treatment fidelity and was acceptable to staff. Replication on a larger scale is recommended.

Staff views on supporting evidence based practice for children with ASD

Abstract Purpose: A variety of empirically supported interventions are available for children with autism spectrum disorder (ASD), but previous research suggests that their selection and use within an evidence-based practice (EBP) framework in clinical settings is challenging. To date, research has primarily focused on identifying individual, organisational, and contextual barriers to EBP rather than identifying collaborative solutions to these barriers through consultation with staff. The aim of our study was to explore staff views on supporting EBP in their work with children with ASD. Materials and methods: We conducted five focus groups involving 29 professional (e.g., speech pathologists, teachers), paraprofessional (e.g., childcare workers), and managerial staff to explore their views. Audio recordings were transcribed verbatim and analysed using thematic analysis. Results: Two central themes, comprising six categories, emerged to account for the participants’ views. Initiative and Effort accounted for the range of creative strategies staff had developed to support their engagement in EBP. They also expressed the need for A Better Way involving organisational-wide support such as this engagement, including peer-to-peer mentoring. Conclusions: The findings suggest that an organisational-wide model to support engagement in EBP, with peer-to-peer mentoring at its foundation, may provide a desirable, ecologically valid, and acceptable model. Implications for Rehabilitation Clinicians and educators recognise the importance of evidence-based practice. Efforts to support evidence-based practice have focused mostly on access to research evidence. Clinicians and educators in this study were developing their own strategies based on intuition. They identified a need for organisation-wide approaches to supporting evidence-based practice. Peer-to-peer mentoring appears to be an acceptable and viable strategy.

Translating Research to Practice in Prelinguistic Communication

Implementation of evidence-based intervention practices into every day settings in the community has been a serious challenge for researchers in the field of autism spectrum disorder (ASD). There is general agreement that a gap exists between research and practice and that this must be broached if we are to achieve the best possible outcomes for individuals with ASD. This gap is all too evident in the sub-group of prelinguistic communicators with ASD who may be even more likely to receive experimental approaches as they fail to respond to interventions that have proven effective for other sub-groups of children.