Robert Didden

Bullying Among Adolescents With Autism Spectrum Disorders: Prevalence and Perception

This study examined: (a) the prevalence of bullying and victimization among adolescents with ASD, (b) whether they correctly perceived bullying and victimization, and (c) whether Theory of Mind (ToM) and bullying involvement were related to this perception. Data were collected among 230 adolescents with ASD attending special education schools. We found prevalence rates of bullying and victimization between 6 and 46%, with teachers reporting significantly higher rates than peers. Furthermore, adolescents who scored high on teacher- and self-reported victimization were more likely to misinterpret non-bullying situations as bullying. The more often adolescents bullied, according to teachers and peers, and the less developed their ToM, the more they misinterpreted bullying situations as non-bullying. Implications for clinical practice are discussed.

Cyberbullying among students with intellectual and developmental disability in special education settings

Objective: To explore the types, prevalence and associated variables of cyberbullying among students with intellectual and developmental disability attending special education settings. Methods: Students (n = 114) with intellectual and developmental disability who were between 12–19 years of age completed a questionnaire containing questions related to bullying and victimization via the internet and cellphones. Other questions concerned sociodemographic characteristics (IQ, age, gender, diagnosis), self-esteem and depressive feelings. Results: Between 4–9% of students reported bullying or victimization of bullying at least once a week. Significant associations were found between cyberbullying and IQ, frequency of computer usage and self-esteem and depressive feelings. No associations were found between cyberbullying and age and gender. Conclusions: Cyberbullying is prevalent among students with intellectual and developmental disability in special education settings. Programmes should be developed to deal with this issue in which students, teachers and parents work together.

A review of the nature and treatment of sleep disorders in individuals with developmental disabilities

This paper describes research on the prevalence, correlates, and treatment of sleep disorders in individuals with developmental disabilities. A significant number of individuals with developmental disabilities have disordered sleep, although prevalence estimates vary from 13% to 86%. Constitutional variables, including age, presence of physical and sensory impairments, and certain genetic syndromes and medical conditions appear to be related to sleep disturbance, but the evidence is mainly correlational and therefore cannot be said to show a causal relation. While a number of behavioral interventions have proven effective in the treatment of sleep disturbance, and drug therapy involving melatonin appears promising, epidemiologic work on the correlates of sleep disorders appear to have had little impact on treatment. Consideration of the nature of sleep disorders may enhance treatments for individuals with developmental disabilities.

Behavioral Treatment of Challenging Behaviors in Individuals with Mild Mental Retardation: Meta-Analysis of Single-Subject Research.

A meta-analytic study on effectiveness of behavioral and psychotherapeutic treatments for challenging behaviors in individuals with mild mental retardation is reported. Eighty articles were examined. For each comparison, several study variables and two effect sizes (percentage of nonoverlapping data-PND and percentage of zero data-PZD) were evaluated (Ms = 75% and 35%, respectively). Studies in which experimental designs and methods of experimental functional analysis were used had significantly larger PNDs than those with AB designs and descriptive methods, respectively. Functional analysis, reliability of recording, generalization, and internally valid designs resulted in larger PZDs. We found that behavioral interventions for challenging behaviors are effective with people with mild mental retardation.

Effects of Speech Output on Maintenance of Requesting and Frequency of Vocalizations in Three Children with Developmental Disabilities

We evaluated the role of digitized speech output on the maintenance of requesting and frequency of vocalizations in three children with developmental disabilities. The children were taught to request access to preferred objects using an augmentative communication speech-generating device (SGD). Following acquisition, rates of requesting and vocalizations were compared across two conditions (speech output on versus speech output off) that were alternated on a session-by-session basis. There were no major or consistent differences across the two conditions for the three children, suggesting that access to preferred objects was the critical variable maintaining use of the SGDs. The results also suggest that feedback in the form of digitized speech from the SGD did not inhibit vocalizations. One child began to speak single words during the latter part of the study, suggesting that in some cases AAC intervention involving SGDs may facilitate speech.

Exogenous melatonin for sleep problems in individuals with intellectual disability: a meta-analysis.

Recent meta‐analyses on melatonin has raised doubts as to whether melatonin is effective in treating sleep problems in people without intellectual disabilities. This is in contrast to results of several trials on melatonin in treating sleep problems in individuals with intellectual disabilities. To investigate the efficacy of melatonin in treating sleep problems in individuals with intellectual disabilities, we performed a meta‐analysis of placebo‐controlled randomized trials of melatonin in individuals with intellectual disabilities and sleep problems. Data were selected from articles published on PubMed, Medline, and Embase between January 1990 and July 2008. We examined the influence of melatonin on sleep latency, total sleep time, and number of wakes per night. Quality of trials was assessed using the Downs and Black checklist. Nine studies (including a total of 183 individuals with intellectual disabilities) showed that melatonin treatment decreased sleep latency by a mean of 34 minutes (p<0.001), increased total sleep time by a mean of 50 minutes (p<0.001), and significantly decreased the number of wakes per night (p<0.05). Melatonin decreases sleep latency and number of wakes per night, and increases total sleep time in individuals with intellectual disabilities.

Low Intensity Behavioral Treatment Supplementing Preschool Services for Young Children with Autism Spectrum Disorders and Severe to Mild Intellectual disability.

This study evaluated the effectiveness of low intensity behavioral treatment (on average 6.5h per week) supplementing preschool services in 3-6-year-old children with autism spectrum disorder and severe to mild intellectual disability. Treatment was implemented in preschools (i.e., daycare centers) and a discrete trial teaching approach was used. Twelve children in the treatment group were compared to 22 children receiving regular intervention. At pre-treatment, both groups did not differ on chronological age, developmental age, diagnosis and level of adaptive skills. Eight months into treatment, children receiving behavioral treatment displayed significantly higher developmental ages and made more gains in adaptive skills than children from the control group. No significant differences between groups were found on autistic symptom severity and emotional and behavioral problems.

Cost Comparison of Early Intensive Behavioral Intervention and Treatment as Usual for Children with Autism Spectrum Disorder in the Netherlands.

Early intensive behavioral intervention (EIBI) may result in improved cognitive, adaptive and social functioning and reductions in autism severity and behavioral problems in children with Autism Spectrum Disorder (ASD). For a subset of children, normal functioning may be the result. However, due to the intensity (20-40 h per week for 3 years with a low child staff ratio) implementation costs are high and can be controversial. Estimated costs for education, (supported) work and (sheltered) living for individuals with ASD in The Netherlands are applied in a cost-offset model. A compelling argument for the provision of EIBI is long term savings which are approximately € 1,103,067 from age 3 to 65 years per individual with ASD. Extending these costs to the whole Dutch ASD population, cost savings of € 109.2-€ 182 billion have been estimated, excluding costs associated with inflation.

Promoting question-asking in school-aged children with autism spectrum disorders: Effectiveness of a robot intervention compared to a human-trainer intervention

Objective: The purpose of the present study was to investigate the effectiveness of an applied behaviour analysis (ABA)-based intervention conducted by a robot compared to an ABA-based intervention conducted by a human trainer in promoting self-initiated questions in children with autism spectrum disorder (ASD). Methods: Data were collected in a combined crossover multiple baseline design across participants. Six children were randomly assigned to two experimental groups. Results: Results revealed that the number of self-initiated questions for both experimental groups increased between baseline and the first intervention and was maintained during follow-up. The high number of self-initiated questions during follow-up indicates that both groups maintained this skill. Conclusions: The interventions conducted by a robot and a human trainer were both effective in promoting self-initiated questions in children with ASD. No conclusion with regard to the differential effectiveness of both interventions could be drawn. Implications of the results and directions for future research are discussed.

Melatonin for Chronic Insomnia in Angelman Syndrome: A Randomized Placebo-Controlled Trial

Previous studies suggested that melatonin improves sleep in insomniac patients with Angelman syndrome. To assess the efficacy of melatonin, a randomized placebo-controlled study was conducted in 8 children with Angelman syndrome with idiopathic chronic insomnia. After a 1-week baseline period, patients received, depending on age, either melatonin 5 or 2.5 mg, or placebo, followed by 4 weeks of open treatment. Parents recorded lights off time, sleep onset time, wake-up time, and epileptic seizures in a diary. Salivary melatonin levels were measured at baseline and the last evening of the fourth treatment week. Melatonin significantly advanced sleep onset by 28 minutes, decreased sleep latency by 32 minutes, increased total sleep time by 56 minutes, reduced the number of nights with wakes from 3.1 to 1.6 nights a week, and increased endogenous salivary melatonin levels. Parents were satisfied with these results. Indications that melatonin dose in Angelman syndrome patients should be low, are discussed.