Comportements inadaptés chez les enfants autistes et désespoir parental : le rôle modérateur du fonctionnement réflexif parental

Aperçu: G.M.

Le désespoir chez les parents a des répercussions sur leur propre bien-être ainsi que sur leur capacité à répondre aux besoins de leurs enfants.
Dans la présente étude, nous avons examiné l'effet des comportements inadaptés chez les enfants autistes sur le désespoir parental, en accordant une attention particulière à la question de savoir si le fonctionnement réflexif parental modérerait l'effet des comportements inadaptés sur le désespoir parental.

Notre échantillon comprenait 68 parents d'enfants autistes âgés de 3 à 18 ans.
Les résultats ont révélé une relation positive significative entre les comportements inadaptés chez les enfants et le désespoir chez les parents. De plus, le fonctionnement réflexif parental a modéré l'effet des comportements inadaptés de l'enfant sur le désespoir parental, de sorte que les comportements inadaptés des enfants étaient positivement associés au désespoir parental chez les parents ayant un fonctionnement réflexif faible (mais pas élevé).
Les résultats suggèrent que le fonctionnement réflexif parental peut être un facteur de protection contre le désespoir parental, et donc une cible possible pour les interventions en cas de désespoir chez les parents dont les enfants autistes présentent des comportements inadaptés plus importants. 

 

. 2022 Nov 5.

doi: 10.1002/aur.2841. Online ahead of print.

Maladaptive behaviors in children with autism and parental hopelessness: The moderating role of parental reflective functioning

Yael Enav  ¹ , Marguerite V Knudtson  ² , Antonio Y Hardan  ² , James J Gross  ²

Affiliations

• PMID: 36333959
• DOI: 10.1002/aur.2841

Abstract

Hopelessness in parents has implications for parents' own well-being as well as their ability to meet the needs of their children. In the present study, we examined the effect of maladaptive behaviors in children with autism on parental hopelessness, with particular attention to whether parental reflective functioning would moderate the effect of maladaptive behaviors on parental hopelessness. Our sample included 68 parents of children with autism between the ages of 3 and 18. Findings revealed a significant positive relationship between maladaptive behaviors in the children and hopelessness in the parents. Moreover, parental reflective functioning moderated the effect of child maladaptive behaviors on parental hopelessness, such that children's maladaptive behaviors were positively associated with parental hopelessness in parents with low (but not high) reflective functioning. Findings suggest parental reflective functioning may be a protective factor against parental hopelessness, and thus a possible target for interventions for hopelessness in parents whose children with autism exhibit greater maladaptive behaviors.

Keywords: adults; affect/emotion; children; clinical psychology; restricted/repetitive behaviors.

© 2022 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.

References

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Utilisation de la désensibilisation des mouvements oculaires et du reconditionnement (EMDR) avec des personnes autistes : une étude d'entretiens qualitatifs avec des thérapeutes EMDR

Aperçu: G.M.

Objectifs
La désensibilisation des mouvements oculaires et le reconditionnement (EMDR) est une thérapie psychologique fondée sur des données probantes qui cible la détresse associée aux traumatismes et aux troubles affectifs. Peu d'études ont examiné l'EMDR pour les personnes autistes qui ont des problèmes de santé mentale concomitants, mais il existe des preuves préliminaires de son efficacité. La présente étude a exploré les expériences de travail des thérapeutes EMDR avec des personnes autistes et les adaptations incorporées dans la pratique clinique pour la rendre plus accessible et efficace. 

Conception
Une conception d'entrevue qualitative a été utilisée. Les données ont été analysées par thème. 

Méthode
Vingt-trois thérapeutes EMDR basés au Royaume-Uni ont participé à des entretiens qualitatifs semi-structurés ponctuels. 

Résultats
Quatre thèmes principaux ont émergé : (1) l'expérience d'être autiste ; (2) les facteurs liés à l'accès à l'EMDR ; (3) adapter l'EMDR ; et (4) la supervision et le soutien des thérapeutes EMDR. Les participants ont décrit l'offre d'une approche nuancée et personnalisée ; celui qui a conservé les composants intégraux des huit phases de l'EMDR, tout en étant flexible et réactif à chaque client. 

Conclusions
Les résultats renforcent l'importance d'offrir une thérapie psychologique basée sur la formulation qui s'adapte de manière fondée sur des preuves, selon les préférences et les besoins des personnes autistes. Des recherches supplémentaires devraient établir les facteurs influençant l'accessibilité et l'efficacité de l'EMDR pour les personnes autistes, ainsi que l'impact de la formation pertinente sur l'autisme sur les connaissances, les compétences et la confiance des thérapeutes EMDR et des superviseurs cliniques travaillant avec ce groupe de clients.

. 2022 Dec;95(4):1071-1089.

doi: 10.1111/papt.12419. Epub 2022 Aug 11.

Using eye movement desensitisation and reprocessing (EMDR) with autistic individuals: A qualitative interview study with EMDR therapists

Naomi Fisher  ¹ , Henna Patel  ² , Caroline van Diest  ³ , Debbie Spain  ²

Affiliations

• PMID: 36334027
• DOI: 10.1111/papt.12419

Abstract

Objectives: Eye Movement Desensitisation and Reprocessing (EMDR) is an evidence-based psychological therapy that targets distress associated with trauma and affective disturbance. Few studies have examined EMDR for autistic individuals who have co-occurring mental health conditions, but there is preliminary evidence of effectiveness. The current study explored EMDR therapists' experiences of working with autistic individuals, and adaptations incorporated into clinical practice to make this more accessible and effective.

Design: A qualitative interview design was used. Data were thematically analysed.

Method: Twenty-three UK-based EMDR therapists attended one-off semi-structured qualitative interviews.

Results: Four main themes emerged: (1) the experience of being autistic; (2) factors around accessing EMDR; (3) adapting EMDR; and (4) supervision and support for EMDR therapists. Participants described offering a nuanced and tailored approach; one that retained the integral components of the eight phases of EMDR, while also being flexible and responsive to each client.

Conclusions: Findings reinforce the importance of offering formulation-based psychological therapy that flexes in an evidence-informed way, according to the preferences and needs of autistic individuals. Further research should establish factors influencing accessibility and effectiveness of EMDR for autistic individuals, and the impact of autism-relevant training on the knowledge, skills and confidence of EMDR therapists and clinical supervisors working with this client group.

Keywords: autism; clinical supervision; eye movement desensitisation and reprocessing (EMDR); mental health; psychological therapy; trauma.

© 2022 The Authors. Psychology and Psychotherapy: Theory, Research and Practice published by John Wiley & Sons Ltd on behalf of The British Psychological Society.

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Rapport court. Un programme de formation innovant pour les familles d'enfants et d'adolescents avec un diagnostic de "troubles du spectre de l'autisme" au Qatar : les parents en tant qu'interventionnistes

Aperçu: G.M.

Introduction
Des recherches antérieures ont établi l'association des comportements inadaptés présentés par les personnes atteintes de troubles du spectre autistique (TSA) avec une augmentation de l'ampleur du fardeau des soins parmi leurs soignants. Les besoins en santé mentale des soignants et leur prise en charge efficace doivent donc être dûment pris en considération. 

Objectif
L'objectif principal de cet article est de réitérer l'importance du rôle des programmes de formation pour les soignants dans l'amélioration de leurs connaissances et leur permettant de gérer les défis comportementaux avec plus d'indépendance et de confiance. 

Méthodes
Les objectifs, la structure et le contenu du programme de formation sur les TSA pour les soignants mis en œuvre par le service spécialisé en santé mentale de l'enfant et de l'adolescent, Hamad Medical Corporation, sont décrits. Une soixantaine de familles ont bénéficié de cette initiative à ce jour. Une synthèse des retours d'expérience d'une quarantaine d'aidants, tous parents biologiques, est également résumée. 

Résultats
Le score moyen lié aux connaissances des participants avant et après la formation est passé de 3,28 à 4,41. Sur les 40 parents qui ont fourni des commentaires, 27 (67,5 %) ont signalé une amélioration de leur compréhension du sujet après la participation. 

Conclusion
Cette initiative consolide l'importance des programmes axés sur la sensibilisation et l'amélioration de l'adaptation chez les aidants d'enfants et de jeunes avec un diagnostic de TSA.

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• Add to Sear2022 Nov 1;131:104368.

doi: 10.1016/j.ridd.2022.104368. Online ahead of print.

Short Report. An innovative training programme for families of children and adolescents with Autism Spectrum Disorder in Qatar: Parents as interventionists

Manal Osman Abouelseoud  ¹ , Prerana Saini  ² , May Jasim Almuraisi  ³ , Yasser Saeed Khan  ⁴

Affiliations

• PMID: 36334402
• DOI: 10.1016/j.ridd.2022.104368

Abstract

Introduction: Previous research has established the association of maladaptive behaviours exhibited by individuals with Autism Spectrum Disorder (ASD) with an increase in the extent of care burden among their caregivers. The mental health needs of caregivers and their effective management, therefore, need to be given due consideration. The main aim of this paper is to reiterate the significance of the role of training programmes for caregivers in enhancing their knowledge and enabling them to manage behavioural challenges with more independence and confidence.

Methods: The aims, structure, and content of the ASD training programme for caregivers implemented by the specialist child and adolescent mental health service, Hamad Medical Corporation, are described. Sixty families have benefited from this initiative so far. A summary of the feedback provided by forty caregivers, all biological parents, is also summarised.

Results: The mean score related to knowledge among participants before and after attending the training increased from 3.28 to 4.41. Out of the 40 parents who provided feedback, 27 (67.5%) reported an increase in their understanding of the topic after attendance.

Conclusion: This initiative consolidates the significance of programmes focusing on enhancing awareness and improving coping among caregivers of children and young people with ASD.

Keywords: Autism Spectrum Disorder; Care burden; Parents education; Quality of life.

Que peut-on améliorer dans l'apprentissage de la prise en charge des personnes autistes ? Une étude qualitative basée sur la simulation clinique infirmière

Aperçu: G.M

But/objectif
Le but de cette étude était d'identifier les principaux schémas d'erreurs commises par les étudiants en soins infirmiers de 4e année dans la pratique clinique simulée avec des scénarios de soins pour les personnes atteintes de troubles du spectre autistique (TSA). 

Contexte
La simulation clinique joue actuellement un rôle majeur dans la formation des étudiants en soins infirmiers et offre aux participants la possibilité de pratiquer et de développer leurs seuils cliniques avec un patient pédiatrique diagnostiqué avec un TSA. 

Conception
Une étude qualitative longitudinale rétrospective a été réalisée. 

Méthodes
Une analyse de contenu des dossiers de débriefing existants sur une période de 7 années universitaires (2016-2022) a été réalisée. Le scénario a été simulé par un patient standardisé diagnostiqué avec un TSA, avec 23 groupes d'étudiants en soins infirmiers. 

Résultats
Les résultats ont montré différents schémas d'erreurs. Ces modèles ont été regroupés en 1 catégorie principale (faiblesses) et 5 sous-catégories principales : clinique, communication, connaissances sur les TSA, émotions et comportement envers les parents. Les erreurs les plus répétées étaient une utilisation excessive de la communication verbale, des stimuli abondants, une faible demande d'informations de la part des principaux aidants, une faible demande d'informations sur les émotions et les intérêts de l'enfant et une méconnaissance du profil de l'enfant avec un diagnostic de TSA. 

Conclusion
À partir des résultats de cette étude, nous pouvons souligner le manque de formation que les étudiants ont reçue sur l'approche pratique pour prodiguer des soins à ces personnes. Il a également été inféré dans cette étude que la simulation clinique est un outil favorisant la réflexion et l'apprentissage expérientiel des étudiants lorsqu'ils sont confrontés à la prise en charge de personnes avec un diagnostic de TSA. 

. 2022 Oct 29;65:103488.

doi: 10.1016/j.nepr.2022.103488. Online ahead of print.

What can be improved in learning to care for people with autism? A qualitative study based on clinical nursing simulation

José Luis Díaz-Agea  ¹ , Natalia Macías-Martínez  ² , César Leal-Costa  ³ , Gema Girón-Poves  ⁴ , Juan Antonio García-Méndez  ⁵ , Ismael Jiménez-Ruiz  ⁶

Affiliations

• PMID: 36334521
• DOI: 10.1016/j.nepr.2022.103488

Abstract

Aim/objective: The aim of this study was to identify the main patterns of errors that 4th year nursing students made in simulated clinical practice with scenarios of care for people with Autism Spectrum Disorder (ASD).

Background: Clinical simulation currently plays a major role in the training of nursing students and provides the participants with the opportunity to practice and develop their clinical sills with a pediatric patient diagnosed with ASD.

Design: A retrospective longitudinal qualitative study was performed.

Methods: Content analysis of the existing debriefing records from a period of 7 academic years (2016-2022) was carried out. The scenario was simulated by a standardized patient diagnosed with ASD, with 23 groups of nursing students.

Results: The results showed different patterns of errors. These patterns were grouped into 1 main category (weaknesses) and 5 major subcategories: clinical, communication, knowledge about ASD, emotions, and behavior towards parents. The most repeated errors were excessive use of verbal communication, abundant stimuli, low demand for information from primary caregivers, low demand for information about the child's emotions and interests, and a lack of knowledge of the profile of the child with ASD.

Conclusion: From the findings of this study, we can highlight the lack of training that students received on the practical approach for providing care to these individuals. It has also been inferred in this study that clinical simulation is a tool that favors reflection and experiential learning for students when they are faced with caring for people with ASD.

Keywords: Autism; Clinical simulation; Learning by doing; Nursing; Pediatrics.

Sommeil chez les enfants avec des troubles neurodéveloppementaux pendant la COVID-19 : une revue intégrative

Aperçu: G.M.

Introduction
Les problèmes de sommeil surviennent à des taux plus élevés chez les enfants atteints de troubles neurodéveloppementaux que dans la population typique. L'impact de la COVID-19 sur les problèmes de sommeil dans cette population est peu connu. Des recherches approfondies dans les bases de données ont été utilisées pour identifier les articles, et 31 études ont été considérées comme appropriées pour cette revue. 

Résultats
La plupart des études ont signalé une aggravation des troubles du sommeil pendant les restrictions liées à la COVID-19. Toutes les études ont été menées lorsque les cliniques étaient fermées ; seules deux études ont porté sur les options de traitement telles que la musicothérapie et l'éducation à l'hygiène du sommeil et ont constaté une amélioration des problèmes de sommeil. 

Discussion
Les recherches futures doivent se concentrer sur le développement d'interventions pour aider les familles à distance et donner aux familles une boîte à outils de préparation en temps de crise. 

. 2022 Oct 11;S0891-5245(22)00290-5.

doi: 10.1016/j.pedhc.2022.10.001. Online ahead of print.

Sleep in Children With Neurodevelopmental Disabilities During COVID-19: An Integrative Review

Rebecca Kronk  ¹ , Inah Kim  ² , David Nolfi  ³

Affiliations

• PMID: 36334949
• DOI: 10.1016/j.pedhc.2022.10.001

Abstract

Introduction: Sleep issues occur at higher rates in children with neurodevelopmental disorders than in the typical population. Little is known about the impact of COVID-19 on sleep issues in this population METHOD: This integrative review aimed to characterize studies during the COVID-19 pandemic (2020-2022) addressing the prevalence and management of sleep issues in children and youth with neurodevelopmental disorders.Comprehensive database searches were used to identify articles, and 31 studies were considered suitable for this review.

Results: Most studies reported worsening sleep disturbances during COVID-19 restrictions. All studies were conducted when clinics were closed; only two studies addressed treatment options such as music therapy and sleep hygiene education and found improvement in sleep issues.

Discussion: Future research needs to concentrate on developing interventions to assist families remotely and empower families with a toolkit of preparedness in times of crisis.

Keywords: COVID-19; Neurodevelopmental disability; attention deficit hyperactivity disorder; autism spectrum disorders; sleep quality.

Efficacité d'une intervention psychologique assistée par robot pour les enfants avec un diagnostic de troubles du spectre de l'autisme

Aperçu: G.M.

Les difficultés d'interaction sociale caractérisent les enfants avec un diagnostic de "troubles du spectre de l'autisme" (dTSA) et ont un impact négatif sur leur vie quotidienne. L'intégration d'un robot social-humanoïde dans le traitement clinique standard s'est avérée prometteuse.
L'objectif principal de cette étude contrôlée randomisée était d'évaluer l'efficacité d'une intervention psychosociale assistée par robot et l'objectif secondaire était d'étudier les différences potentielles entre un groupe d'intervention assistée par robot et un groupe témoin recevant une intervention humaine uniquement.
L'analyse des résultats a montré que l'intervention assistée par robot pouvait être bénéfique en améliorant les compétences psychosociales des enfants. Cette amélioration a été mise en évidence par les tests neuropsychologiques et les rapports des parents.
La comparaison des groupes n'a présenté que des différences statistiquement significatives minimes. L'étude souligne le potentiel des interventions assistées par robot pour augmenter les soins standard.

. 2022 Nov 4.

doi: 10.1007/s10803-022-05796-5. Online ahead of print.

Effectiveness of a Robot-Assisted Psychological Intervention for Children with Autism Spectrum Disorder

Vasiliki Holeva  ¹ , V A Nikopoulou  ² , C Lytridis  ³ , C Bazinas  ³ , P Kechayas  ² , G Sidiropoulos  ³ , M Papadopoulou  ⁴ , M D Kerasidou  ² , C Karatsioras  ⁵ , N Geronikola  ⁶ , G A Papakostas  ³ , V G Kaburlasos  ³ , A Evangeliou  ⁴

Affiliations

• PMID: 36331688
• DOI: 10.1007/s10803-022-05796-5

Abstract

Difficulties with social interaction characterise children with Autism Spectrum Disorders and have a negative impact in their everyday life. Integrating a social-humanoid robot within the standard clinical treatment has been proven promising. The main aim of this randomised controlled study was to evaluate the effectiveness of a robot-assisted psychosocial intervention and the secondary aim was to investigate potential differences between a robot-assisted intervention group and a control group receiving intervention by humans only. The analysis of the results showed that robot-assisted intervention could be beneficial by improving children's psychosocial skills. This improvement was highlighted by neuropsychological testing and parent reporting. Group comparison only presented minimal statistically significant differences. The study underpins the potential of robot-assisted interventions to augment standard care.

Keywords: Autism spectrum disorders; Human–robot interaction; Psychological intervention; Randomised controlled trial; Robot-assisted therapy.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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