Autisme Information Science

03 avril 2017

Impact du modèle Early Start Denver sur le niveau cognitif des enfants avec un diagnostic de trouble du spectre de l'autisme: protocole d'étude pour un essai randomisé contrôlé utilisant un modèle Zelen à deux étapes

Aperçu: G.M.

L'intervention précoce pour le trouble du spectre de l'autisme (TSA) dans les pays francophones d'Europe est hétérogène et mal évaluée à ce jour. Les unités d'intervention précoce appliquant le modèle Early Start Denver (ESDM) pour les tout-petits et les jeunes enfants avec un diagnostic de TSA ont été créées en France et en Belgique pour améliorer cette situation.

Nous évaluerons l'efficacité de 12 heures par semaine d'intervention ESDM sur le niveau cognitif des enfants avec un diagnostic de TSA, sur une période de 2 ans.

Cliquer ICI pour accéder à l'intégralité de l'article en anglais

2017 Mar 27;7(3):e014730. doi: 10.1136/bmjopen-2016-014730.

Impact of the Early Start Denver Model on the cognitive level of children with autism spectrum disorder: study protocol for a randomised controlled trial using a two-stage Zelen design

Touzet S^1,², Occelli P^1,², Schröder C^3,⁴, Manificat S⁵, Gicquel L^6,⁷, Stanciu R⁸, Schaer M⁹, Oreve MJ¹⁰, Speranza M^10,¹¹, Denis A^1,², Zelmar A^1,², Falissard B^12,¹³, Georgieff N^14,¹⁵, Bahrami S^11,¹⁶, Geoffray MM^14,¹⁵; IDEA Study Group.

Author information

1: Pôle Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon F-69003, France.
2: Laboratoire Health Services and Performance Research, EA 7425 HESPER, Université de Lyon, Lyon F-69008 France.
3: Department of Child and Adolescent Psychiatry, Hopitaux universitaires de Strasbourg, Strasbourg F-67000, France.
4: CNRS UPR 3212-Team 9, Strasbourg University, Strasbourg F-67000, France.
5: Centre Hospitalier Saint Jean de Dieu, Lyon F-69008, France.
6: Pôle Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier Spécialisé Henri Laborit, Saint Benoît F-86280, France.
7: Child and Adolescent Psychiatry Department, Unité de Recherche Clinique, Université de Poitiers, Poitiers F-86000, France.
8: Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Bruxelles 1020, Belgium.
9: Office Médico-Pédagogique, University of Geneva, Geneva, Switzerland.
10: Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Centre Hospitalier de Versailles, Le Chesnay F-78150, France.
11: EA 4047 HANDIReSP, Université de Versailles Saint-Quentin-en-Yvelines, Versailles F-78000, France.
12: Université Paris-Sud, CESP, INSERM, UVSQ, Université Paris-Saclay, U1178, Maison de Solenn, Paris cedex 14, France.
13: Department of Public Health, AP-HP, Hôpital Paul Brousse, Villejuif F-94800, France.
14: Department of child and adolescent psychiatry, Centre Hospitalier le Vinatiers, Bron F-69500, France.
15: Université de Lyon, Lyon F-69008, France.
16: CIC 1429, INSERM, AP-HP, Hôpital Raymond-Poincare, Garches F-92380, France.

Abstract

INTRODUCTION:

Early intervention for autism spectrum disorder (ASD) in the European French-speaking countries is heterogeneous and poorly evaluated to date. Early intervention units applying the Early Start Denver Model (ESDM) for toddlers and young children with ASD have been created in France and Belgium to improve this situation. It is essential to evaluate this intervention for the political decision-making process regarding ASD interventions in European French-speaking countries. We will evaluate the effectiveness of 12 hours per week ESDM intervention on the cognitive level of children with ASD, over a 2-year period.

METHODS AND ANALYSIS:

The study will be a multicentre, randomised controlled trial, using a two-stage Zelen design. Children aged 15-36 months, diagnosed with ASD and with a developmental quotient (DQ) of 30 or above on the Mullen Scale of Early Learning (MSEL) will be included. We will use a stratified minimisation randomisation at a ratio 1:2 in favour of the control group. The sample size required is 180 children (120 in the control and 60 in the intervention group). The experimental group will receive 12 hours per week ESDM by trained therapists 10 hours per week in the centre and 2 hours in the toddlers' natural environment (alternatively by the therapist and the parent). The control group will receive care available in the community. The primary outcome will be the change in cognitive level measured with the DQ of the MSEL scored at 2 years. Secondary outcomes will include change in autism symptoms, behavioural adaptation, communicative and productive language level, sensory profile and parents' quality of life. The primary analysis will use the intention-to-treat principle. An economic evaluation will be performed.

DISSEMINATION:

Findings from the study will be disseminated through peer reviewed publications and meetings.

TRIAL REGISTRATION NUMBER:

NCT02608333 (clinicaltrials.gov); Pre-results.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PMID: 28348195
DOI: 10.1136/bmjopen-2016-014730

La formation en mémoire de travail chez les enfants souffrant de troubles neuropsychiatriques et le fonctionnement intellectuel léger à limité, le rôle du coaching; Un essai contrôlé randomisé en double aveugle

Aperçu: G.M.

La formation en mémoire de travail (WMT) a permis d'offrir des avantages thérapeutiques aux patients atteints de trouble déficitaire de l'attention avec déficit de l'hyperactivité (TDAH) et aux patients avec des déficiences intellectuelles légères à limitées (MBID; 60 <IQ <85). Cependant, il manque des preuves solides des effets de transfert et des avantages de traitement de la WMT par rapport à la formation placebo.

Cette étude apportera à la littérature puisque le rôle du coaching dans le WMT de Cogmed n'a pas été étudié auparavant. Elle fournira également des occasions d'enquêter sur une version alternative de WMT dans un grand groupe d'enfants vulnérables, pour lesquels peu de traitements fondés sur des preuves sont disponibles. En fin de compte, cela nous permettra de conseiller les professionnels de la santé mentale et les écoles d'éducation spéciale sur l'utilisation de ce type d'intervention pour les enfants atteints de MBID et des troubles neuropsychiatriques.

Cliquer ICI pour accéder à l'intégralité de l'article en anglais

Cliquer ICI pour télécharger l'article au format PDF

2017 Mar 28;17(1):114. doi: 10.1186/s12888-017-1274-6.

Working memory training in children with neuropsychiatric disorders and mild to borderline intellectual functioning, the role of coaching; a double-blind randomized controlled trial

Roording-Ragetlie S^1,², Klip H³, Buitelaar J^3,^4,⁵, Slaats-Willemse D^3,⁶.

Author information

1: Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands. s.roording@karakter.com
2: Karakter Child and Adolescent Psychiatry, Utrechtseweg 320, 6862 BC, Oosterbeek, The Netherlands. s.roording@karakter.com.
3: Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands.
4: Department of Cognitive Neuroscience, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.
5: Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
6: Department of Psychiatry, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.

Abstract

BACKGROUND:

Working memory training (WMT) has been shown to offer therapeutic benefits to both patients with Attention-Deficit Hyperactivity Disorder (ADHD) and patients with mild to borderline Intellectual Disabilities (MBID; 60 < IQ < 85). However, robust evidence for transfer effects and treatment benefits of WMT over placebo training are lacking. Owing to the nature of double-blind research designs in RCTs, children have received non-specific coaching not based on their actual training performance. Active coaching based on individual training results (such as in clinical practice) might enhance the efficacy of Cogmed WMT. Furthermore, clinical experience and the general treatment approach to these vulnerable children has shown that the intensity and duration of WMT is often too stressful. This study therefore investigated the efficacy of a less intensive, but more prolonged Cogmed WMT (including active personalized coaching and feedback) in reducing behavioral symptoms and improving neurocognitive functioning and academic achievements in children with MBID and neuropsychiatric disorders.

METHODS/DESIGN:

A double-blind RCT with children (age 10.0-13.11) with neuropsychiatric disorders (ADHD and/or autism spectrum disorder (ASD)) and MBID (IQ: 60 < IQ < 85). Two groups (each n = 26) will receive Cogmed WMT (version R/M) at home or at school for 8 weeks, 4 days a week, at 30 min a day. One group will receive active personalized coaching and feedback based on their actual individual performance during Cogmed training. The other group will only receive general non-personalized coaching (i.e. no receive personalized coaching and feedback). Both groups will undergo a neurocognitive assessment (working memory, executive functioning, academic achievements) before and after training and complete several questionnaires (behavioral problems, parenting style) with a 6 months follow-up.

DISCUSSION:

This study will add to the literature since the role of coaching in Cogmed WMT has not been studied before. It will also provide opportunities to investigate an alternative version of WMT in a large group of vulnerable children, for whom few evidence-based treatments are available. Ultimately, this will allow us to advise mental health care professionals and special education schools about the use of this type of intervention for children with MBID and neuropsychiatric disorders.

TRIAL REGISTRATION:

Dutch Trial Register. NTR5223 . Registration date 06-09-2015.

PMID: 28351374
DOI: 10.1186/s12888-017-1274-6

02 avril 2017

Tâche en tant que renforçateur: une alternative réactive aux formes traditionnelles d'échappement à l'extinction

Aperçu: G.M.

Les comportements inappropriés, allant de la résistance passive à l'agression physique, la destruction de biens ou les comportements d'auto-mutilation, sont souvent produits pour échapper ou éviter des activités non voulues.

Les procédures proactives ne sont que modérément efficaces sans l'échappement à l'extinction, mais cette procédure peut produire des effets secondaires négatifs et des efforts ont été faits pour trouver des alternatives.

A partir d'une ligne de base multiple, sur les excès comportementaux, les activités non voulues et les les participants, un délai d'expiration de la possibilité de travailler réduit efficacement les excès de comportement et développe une meilleure compliance aux activités non voulues.

2016 Sep 12;10(1):22-34. doi: 10.1007/s40617-016-0139-7. eCollection 2017.

Task as Reinforcer: a Reactive Alternative to Traditional Forms of Escape Extinction

Ward S¹, Parker A², Perdikaris A².

Author information

1: Whole Child Consulting, LLC, Dunnellon, FL 34434 USA.
2: Chicago Autism Behavior Specialists, Itasca, IL 60143 USA.

Abstract

Inappropriate behaviors, ranging from passive resistance to physical aggression, property destruction, or self-injurious behavior frequently function for escape from or avoidance of non-preferred activities. Proactive procedures have been shown to be only moderately effective without the use of escape extinction, but escape extinction can produce negative side effects, and efforts have been made to find alternatives. The current study tested the efficacy of a reactive procedure that may serve as an alternative to traditional forms of escape extinction. In a multiple baseline across behavioral excesses, non-preferred activities, and participants, a timeout from the opportunity to work effectively reduced behavioral excesses and increased compliance with non-preferred activities. With one participant, a multiple baseline was implemented across instructional targets, resulting in an increased rate of skill acquisition after "wait outs" were introduced to each program.

PMID: 28352504
PMCID:PMC5352626
DOI: 10.1007/s40617-016-0139-7

L'utilisation de l'évaluation dans les programmes de traitement pour les enfants avec un diagnostic d'autisme

Aperçu: G.M.

L'évaluation du programme consiste à utiliser les activités planifiées pour surveiller les processus, les résultats et l'impact d'un programme ou d'une intervention en matière de santé.

Un bref aperçu des fournisseurs d'interventions comportementales en Californie et au Texas et la recherche de la littérature comportementale suggèrent que la pratique de l'évaluation du programme est sous-utilisée parmi les fournisseurs de services comportementaux.

Les pratiques organisationnelles actuelles consistent principalement à faire un rapport sur les objectifs individuels des consommateurs. Le but de cet article est de fournir une introduction aux processus et aux procédures d'évaluation afin de promouvoir la mise en œuvre de certaines ou de toutes ces composantes. Les domaines abordés comprennent la définition de la population desservie et les intervenants du programme, décrivant le programme et l'intervention, en sélectionnant les buts et les objectifs de l'évaluation, les considérations éthiques et les rapports.

2016 Jul 18;10(1):35-44. doi: 10.1007/s40617-016-0130-3. eCollection 2017.

The Use of Evaluation in Treatment Programs for Children with Autism

Miller KL¹.

Author information

1: Ed Support Services, 1942 Embarcadero, Oakland, CA 94606 USA.

Abstract

Program evaluation is the use of planned activities to monitor process, outcomes, and impact of a health program or intervention. The application of program evaluation to behavioral analytic treatment programs for children with autism is a useful and necessary activity to inform practitioners and other stakeholders of the efficacy of these programs and to promote adherence to best-practice treatments. A brief survey of behavioral providers in California and Texas and search of the behavioral literature suggest that the practice of program evaluation is underutilized among providers of behavioral services. Current organizational practices primarily involve reporting on individualized consumer goals. The purpose of this paper is to provide an introduction to evaluation processes and procedures to promote the implementation of some or all of these components. Areas discussed include defining the population served and program stakeholders, describing the program and intervention, selecting evaluation goals and objectives, ethical considerations, and reporting.

PMID: 28352505
PMCID: PMC5352622
DOI: 10.1007/s40617-016-0130-3

Une comparaison des procédures pour enseigner l'étiquetage réceptif des mots charnière à un enfant avec un diagnostic de trouble du spectre de l'autisme

Aperçu: G.M.

Les praticiens devraient éviter d'enseigner les discriminations simples comme une stratégie pour faciliter la formation à la discrimination conditionnelle dans la pratique clinique

Évaluation du village de Dany à enseigner les compétences à deux jeunes enfants avec un diagnostic de trouble du spectre de l'autisme

Aperçu: G.M.

Le village de Dany est une émission de télévision pour enfants intégrant de nombreux éléments de modélisation vidéo, une intervention qui peut enseigner des compétences aux enfants avec un diagnostic de trouble du spectre de l'autisme (TSA)

Cette étude a évalué l'impact du visionnement des épisodes du village de Dany sur la performance rigoureuse d'essayer de nouveaux aliments et d'arrêter le jeu poliment avec deux enfants de cinq ans avec un diagnostic de TSA.

Les deux enfants ont montré une amélioration des performances des compétences uniquement après avoir vu des épisodes village de Dany, suggérant que regarder des épisodes peut aider les enfants avec un diagnostic de TSA à acquérir des compétences spécifiques.

2016 Aug 12;10(1):67-71. doi: 10.1007/s40617-016-0134-z. eCollection 2017.

Evaluating the Ability of the PBS Children's Show Daniel Tiger's Neighborhood to Teach Skills to Two Young Children with Autism Spectrum Disorder

Dotson WH¹, Rasmussen EE², Shafer A³, Colwell M⁴, Densley RL², Brewer AT⁵, Alonzo MC⁵, Martinez LA⁵.

Author information

1: 0000 0001 2186 7496grid.264784.bBurkhart Center for Autism Education and Research & Department of Educational Psychology & Leadership, Texas Tech University, 2902 18th Street, Room 207, Lubbock, TX 79409 USA.
2: 0000 0001 2186 7496grid.264784.bCollege of Media & Communication, Texas Tech University, Lubbock, TX USA.
3: 0000 0004 1936 8008grid.170202.6School of Journalism and Communication, University of Oregon, Eugene, OR USA.
4: 0000 0001 2186 7496grid.264784.bHuman Development and Family Studies, Texas Tech University, Lubbock, TX USA.
5: 0000 0001 2186 7496grid.264784.bBurkhart Center for Autism Education and Research, Texas Tech University, Lubbock, TX USA.

Abstract

Daniel Tiger's Neighborhood is a children's television show incorporating many elements of video modeling, an intervention that can teach skills to children with autism spectrum disorders (ASD). This study evaluated the impact of watching Daniel Tiger's Neighborhood episodes on the accurate performance of trying new foods and stopping play politely with two five-year-old children with ASD. Both children showed improved performance of skills only following exposure to episodes of Daniel Tiger's Neighborhood, suggesting that watching episodes can help children with ASD learn specific skills.

KEYWORDS:

Autism; Eating; Television; Transitioning; Video

PMID: 28352509
PMCID: PMC5352624
DOI: 10.1007/s40617-016-0134-z

Utilisation de la modélisation vidéo avec instruction vocale pour former le personnel des écoles publiques à mettre en œuvre une évaluation préférencielle

Aperçu: G.M.

L'identification des renforcements putatifs est un élément essentiel de la programmation pour les personnes handicapées.

Cette étude a examiné l'efficacité de l'utilisation de la modélisation vidéo avec instruction vocale (VMVO) pour former deux membres du personnel de l'école publique pour effectuer cette évaluation. Les résultats démontrent que VMVO a été efficace dans la formation, produisant une réponse généralisée, une maintenance et des notes de validité sociale élevées.

2016 Jul 27;10(1):72-76. doi: 10.1007/s40617-016-0135-y. eCollection 2017.

Using Video Modeling with Voice-over Instruction to Train Public School Staff to Implement a Preference Assessment

Bovi GM¹, Vladescu JC¹, DeBar RM¹, Carroll RA², Sarokoff RA³.

Author information

1: 0000 0004 0383 182Xgrid.448604.aDepartment of Applied Behavior Analysis, Caldwell University, 120 Bloomfield Avenue, Caldwell, NJ 07006 USA.
2: 0000 0001 2156 6140grid.268154.cWest Virginia University, Morgantown, WV USA.
3: Bernards Township Public Schools, Basking Ridge, NJ USA.

Abstract

The identification of putative reinforcers is a critical component of programming for individuals with disabilities. A multiple stimulus without replacement preference assessment is one option for identifying putative reinforcers; however, staff must be trained on the steps necessary to conduct the assessment for it to be useful in practice. This study examined the effectiveness of using video modeling with voice-over instruction (VMVO) to train two public school staff to conduct this assessment. Results demonstrate that VMVO was effective in training, producing generalized responding, maintenance, and high social validity ratings.

PMID: 28352510
PMCID: PMC5352625
DOI: 10.1007/s40617-016-0135-y

Préférence de l'apprenant entre le séquençage de l'essai massif et alternatif lors de l'apprentissage des relations de stimulation avec les enfants ayant un diagnostic d'autisme

Aperçu: G.M.

Les deux enfants ont démontré leur préférence pour la condition de séquençage de l'essai alternatif

2016 Aug 31;10(1):77-82. doi: 10.1007/s40617-016-0140-1. eCollection 2017.

Learner Preference Between Massed- and Alternating-Trial Sequencing when Teaching Stimulus Relations to Children with Autism

Guilhardi P¹, Smith J¹, Rivera C¹, Ross RK¹.

Author information

1: Beacon ABA Services, Inc, 321 Fortune Boulevard, Milford, MA 01757 USA.

Abstract

Two children with autism were assessed for preference between intersession distribution of mastered and unknown instructional trials on a computerized matching-to-sample task consisting of 12 total learning opportunities. Choice responses yielded presentation of either massed-trial sequencing (six unknown/six mastered stimuli relations or vice-versa) or alternating-trial sequencing delivery (alternation of unknown and mastered stimuli relations) followed by reinforcement for correct responses. An extinction condition served as an experimental control. Both children demonstrated a preference for the alternating-trial sequencing condition, and implications for instructional programming and possible effects to delays to higher rates of reinforcement are discussed.

PMID: 28352511
PMCID: PMC5352627
DOI: 10.1007/s40617-016-0140-1

Réduction de l'alimentation rapide chez une adolescente avec un diagnostic d'autisme

Aperçu: G.M.

La consommation rapide, un comportement potentiellement dangereux et socialement inapproprié, a reçu relativement peu d'attention dans la littérature. Cette étude a cherché à étendre la recherche dans ce domaine en évaluant davantage l'efficacité d'un téléavertisseur vibrant combiné à une règle pour augmenter le temps d'inter-réponse entre les bouchées chez une femme adolescente diagnostiquée avec un autisme.

Les résultats indiquent que le temps d'inter-réponse a augmenté de la ligne de base seulement après qu'une impulsion vocale "attendre" a été introduite dans les paramètres de la clinique et de la maison.

La nature discrète de l'intervention permet la mise en œuvre dans des contextes inclusifs. Il existe des implications pour promouvoir les habiletés sociales dans des environnements naturalistes.

2016 Aug 29;10(1):87-91. doi: 10.1007/s40617-016-0143-y. eCollection 2017.

Reduction of Rapid Eating in an Adolescent Female with Autism

Page SV¹, Griffith K¹, Penrod B¹.

Author information

1: 0000 0001 2169 6543grid.253564.3Department of Psychology, California State University, Sacramento, 6000 J Street, Sacramento, CA 95819-6007 USA.

Abstract

Rapid eating, a potentially dangerous and socially inappropriate behavior, has received relatively little attention in the literature. This study sought to extend the research in this area by further evaluating the effectiveness of a vibrating pager combined with a rule for increasing inter-response time between bites in one adolescent female diagnosed with autism. Results indicated that inter-response time increased from baseline only after a vocal prompt to "wait" was introduced across clinic and home settings. Implications for promoting autonomy in individuals with developmental disabilities are discussed.This antecedent-based intervention can easily be generalized to caregiversThe unobtrusive nature of the intervention allows for implementation in inclusive settingsThere are implications for promoting social skills in naturalistic environmentsThe intervention can promote independence through teaching self-management.

PMID: 28352513
PMCID: PMC5352629
DOI: 10.1007/s40617-016-0143-y

Qu'est-ce que les études protéomiques nous ont enseigné au sujet des nouvelles cibles médicamenteuses dans l'autisme?

Aperçu: G.M.

Bien que les TSA présentent un taux élevé d'héritabilité, la recherche génétique seule n'a pas permis de comprendre complètement les causes sous-jacentes. Les développements récents utilisant des techniques d'imagerie et des approches de profil moléculaire à base de protéomique ont maintenant commencé à générer de nouvelles idées sur les voies sous-jacentes affectées à la fois dans le cerveau et dans la périphérie chez les personnes diagnostiquées.

La découverte de profils de biomarqueurs sexospécifiques chez les patients avec TSA suggère qu'il existe des mécanismes adaptatifs distincts ou des causes étiologiques différentes chez les patients avec TSA, masculins et féminins.

2017;974:49-67. doi: 10.1007/978-3-319-52479-5_3.

What Have Proteomic Studies Taught Us About Novel Drug Targets in Autism?

Guest PC¹, Martins-de-Souza D^2,³.

Author information

1: Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Rua Monteiro Lobato 255 F/01, Cidade Universitária Zeferino Vaz, 13083-862, Campinas, Brazil. paulcguest@yahoo.com
2: Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Rua Monteiro Lobato 255 F/01, Cidade Universitária Zeferino Vaz, 13083-862, Campinas, Brazil.
3: UNICAMP's Neurobiology Center, Rua Monteiro Lobato 255, Cidade Universitária Zeferino Vaz, 13083-862, Campinas, Brazil.

Abstract

Autism spectrum disorders (ASDs) are a heterogeneous group of conditions with complex behavioural phenotypes. Although ASDs show a high rate of heritability, genetic research alone has not provided a complete understanding of the underlying causes. Recent developments using imaging techniques and proteomic-based molecular profiling approaches have now begun to generate new insights into the underlying pathways affected in both the brain and the periphery in individuals with these conditions. Of potential high importance is the constant finding of gender-specific biomarker profiles in ASD patients. This suggests that there are either distinct adaptive mechanisms or different aetiological causes in male and female ASD patients. This chapter addresses the findings using these approaches with a view to identification of novel drug targets or new treatment strategies based on personalized medicine objectives. Eventually, this will lead to a better disease understanding of ASD at the physiological and molecular levels, which may facilitate novel drug discovery efforts in this challenging area of medicine.

PMID 28353224
DOI: 10.1007/978-3-319-52479-5_3

Certains enfants avec un diagnostic d'autisme possèdent des compétences sociales latentes qui peuvent être testées

Aperçu: G.M.

L'idée des compétences sociales latentes dans l'autisme est apparue comme une interprétation possible de l'amélioration rapide (mais temporaire) des sujets autistes dans les études d'ocytocine.

Les résultats confirment l'hypothèse selon laquelle la réponse normale à l'élément ADIR-59 "Secure Base" indique la présence de compétences sociales latentes dans l'autisme qui pourraient prédire une croissance sociale plus développée chez les sujets autistes plus âgés.

2017 Mar 16;13:827-833. doi: 10.2147/NDT.S131661. eCollection 2017.

Some children with autism have latent social skills that can be tested

Hrdlicka M¹, Urbanek T², Vacova M¹, Beranova S¹, Dudova I¹.

Author information

1: Department of Child Psychiatry, Charles University Second Faculty of Medicine and University Hospital Motol, Prague.
2: Institute of Psychology, Academy of Sciences, Brno, Czech Republic.

Abstract

BACKGROUND:

The idea of latent social skills in autism emerged as a possible interpretation of the rapid (but temporary) improvement of autistic subjects in oxytocin studies. We tested a hypothesis that a normal response to Item No 59 "Secure Base" from the third version of the Autism Diagnostic Interview - Revised (ADIR-59) could indicate the presence of latent social skills in autism.

METHODS:

We examined 110 autistic children (88 boys and 22 girls) with a mean age of 6.0±2.5 years (range: 2.2-14.8 years) using the Autism Diagnostic Observation Schedule (ADOS) - Generic. A diagnosis of mental retardation was established in 68 autistic children (62%).

RESULTS:

The difference in the ADOS social domain between children aged ≤5 years on one side and children older than 5 years on the other side was significant in subjects with normal responses to ADIR-59 (9.60 vs 6.47; P=0.031) but not in those with abnormal responses to ADIR-59 (10.62 vs 9.63; P=0.537). In a predictive model, lower ADOS social domain scores were predicted by older age (P=0.001), lower scores on the ADIR-59 (P=0.01), and the absence of mental retardation (P=0.049).

CONCLUSION:

The results support the hypothesis that the normal response to item ADIR-59 "Secure Base" indicates the presence of latent social skills in autism that might foretell further social growth in older autistic subjects.

KEYWORDS:

Autism Diagnostic Interview – Revised; Autism Diagnostic Observation Schedule; autism; latent social skills; prediction

PMID: 28356742
PMCID: PMC5360407
DOI: 10.2147/NDT.S131661

La santé mentale chez les jeunes adultes en prison: l'importance des troubles du comportement au début de l'enfance

Aperçu: G.M.

Le fardeau psychiatrique pour la santé des prisonniers est important. Cependant, il existe un manque d'études de haute qualité sur les troubles psychiatriques chez les jeunes adultes présentant un risque élevé de récidive.La recherche vise à enquêter sur la prévalence des troubles psychiatriques et l'utilisation des services de santé mentale chez les jeunes délinquants violents masculins et l'impact du trouble de comportement à l'enfance (COCD).

Le groupe COCD était surreprésenté dans la plupart des catégories cliniques et avait des probabilités cinq fois plus élevées (OR = 5.1, 95% IC 2.0-12.8) de se voir diagnostiquer un trouble psychotique, trois fois plus élevées (OR = 3.2, IC 95% 1.2-8.5) d'avoir un trouble de l'usage de substances et deux fois plus élevées d'avoir un trouble de l'humeur (OR = 2,3, IC 95% 1,3-4,0) ou un trouble anxieux (OR = 2,0, IC 95% 1.1-3,5).

2017 Mar 23;3(2):78-84. doi: 10.1192/bjpo.bp.116.003889. eCollection 2017.

Mental health among young adults in prison: the importance of childhood-onset conduct disorder

Hofvander B¹, Anckarsäter H², Wallinius M³, Billstedt E⁴.

Author information

1: , PhD, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Division of Forensic Psychiatry, Region Skåne, Kristianstad, Sweden; Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK.
2: , MD, Department of Forensic Psychiatry, Centre of Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
3: , PhD, Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden; Regional Forensic Psychiatric Clinic, Växjö, Sweden.
4: , PhD, Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Abstract

BACKGROUND:

The psychiatric health burden of prisoners is substantial. However, there is a lack of high-quality studies of psychiatric disorders among young adults with a high risk of reoffending.

AIMS:

To investigate the lifetime prevalence of psychiatric disorders and use of mental health services among young male violent offenders and the impact of childhood-onset conduct disorder (COCD).

METHOD:

A nationally representative cohort (n = 270, age 18-25) of male offenders was followed back in medical records and clinically assessed by gold standard methods. Lifetime prevalences are presented together with odds ratios (ORs) as risk estimates in relation to COCD.

RESULTS:

Previous use of psychiatric services among the participants was high but their lifetime psychiatric morbidity was even higher, with 93% meeting criteria for at least one Axis I disorder. The COCD group was overrepresented in most clinical categories and carried five times higher odds (OR = 5.1, 95% CI 2.0-12.8) of a psychotic disorder, three times higher odds (OR = 3.2, 95% CI 1.2-8.5) of a substance use disorder and two times higher odds of a mood disorder (OR = 2.3, 95% CI 1.3-4.0) or anxiety disorder (OR = 2.0, 95% CI 1.1-3.5).

CONCLUSIONS:

The mental health burden is substantial among young violent offenders, and COCD is an important indicator of future mental health problems which must be a priority for public health efforts.

DECLARATION OF INTEREST:

None.

COPYRIGHT AND USAGE:

© The Royal College of Psychiatrists 2017. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license.

PMID: 28357134
PMCID: PMC5362727
DOI: 10.1192/bjpo.bp.116.003889

Hésitation vaccinale: à la recherche de la zone de confort de la communication des risques

Aperçu: G.M.

Cet article rapporte les résultats d'un sondage national en ligne auprès des parents d'enfants de 5 ans et moins. Les objectifs de l'étude étaient d'évaluer la compréhension par les parents des vaccinations chez les enfants, d'identifier les sources d'information auxquelles ils croient pour le contenu lié aux vaccins, d'évaluer où les parents avec de jeunes enfants tiennent compte des problèmes clés du débat public sur la vaccination et identifier quelle communication des risques est la plus efficace pour les comportements des parents qui hésitent à vacciner.

Les études montre qu'environ 92% des parents canadiens interrogés considèrent que les vaccins sont sûrs et efficaces et font en sorte que les médecins et les responsables de la santé publique fournissent des renseignements pertinents en matière de vaccination. Cependant, un certain nombre d'entre eux croient ou ne savent pas s'il existe un lien entre les vaccins et l'autisme (28%), craignent que les vaccins ne nuisent sérieusement à leurs enfants (27%), ou pensent que l'industrie pharmaceutique est derrière la poussée obligatoire de vaccination (33%).

2017 Mar 3;9. pii: ecurrents.outbreaks.0561a011117a1d1f9596e24949e8690b. doi: 10.1371/currents.outbreaks.0561a011117a1d1f9596e24949e8690b.

Vaccine Hesitancy: In Search of the Risk Communication Comfort Zone

Greenberg J¹, Dubé E², Driedger M³.

Author information

1: School of Journalism and Communication, Carleton University, Ottawa, Ontario, Canada.
2: Institut National de Santé Publique du Québec, Québec, Canada; Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada.
3: Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

INTRODUCTION:

This paper reports the findings of a national online survey to parents of children aged 5 and younger. The objectives of the study were to assess parental understanding of childhood immunizations, identify sources of information that they trust for vaccine-related content, assess where parents with young children stand on the key issues in the public debate about vaccination, and identify which risk communication messages are most effective for influencing the behaviours of vaccine hesitant parents. La plupart des parents comptent toujours sur les médias traditionnels et les sites officiels du gouvernement pour obtenir des informations opportunes et crédibles sur les vaccins et les maladies évitables par la vaccination.
Les résultats de l'étude sont très pertinents dans un contexte où les responsables de la santé publique dépensent des ressources importantes pour augmenter les taux de vaccination chez les enfants et lutter contre l'hésitation du vaccin.
Les données offrent un aperçu de l'endroit où les parents insistent sur le débat politique et public sur la vaccination obligatoire, quels aspects de la science des vaccins restent incertains pour eux, quels sont les médias et les sources institutionnelles qu'ils utilisent et font confiance pour naviguer dans l'environnement de l'information sur la santé, comment ils recherchent des informations et À qui ils ont confiance en période d'urgence ou de crise de santé, et quelles stratégies de communication sont considérées comme les plus efficaces pour persuader les parents hésitant des vaccinés de vacciner leurs enfants.

METHODS:

A total of 1,000 surveys (closed and open-ended questions) were administered in November 2015 using the Angus Reid Forum Panel, a key consumer panel consisting of approximately 150,000 Canadian adults aged 18 and older, spread across all geographic regions of Canada.

RESULTS:

Approximately 92% of the Canadian parents surveyed consider vaccines safe and effective, and trust doctors and public health officials to provide timely and credible vaccine-related information. However, a concerning number of them either believe or are uncertain whether there is a link between vaccines and autism (28%), worry that vaccines might seriously harm their children (27%), or believe the pharmaceutical industry is behind the push for mandatory immunization (33%). Moreover, despite the common assumption that social media are becoming the go-to source of health news and information, most parents still rely on traditional media and official government websites for timely and credible information about vaccines and vaccine preventable diseases, particularly during community-based disease outbreaks. Finally, parents reported high levels of support for pro-vaccine messaging that has been demonstrated in previous research to have little to no positive impact on behaviour change, and may even be counterproductive.

DISCUSSION:

The study's results are highly relevant in a context where public health officials are expending significant resources to increase rates of childhood immunization and combat vaccine hesitancy. The data offer insight into where parents stand on the political and public debate about mandatory vaccination, what aspects of vaccine science remain uncertain to them, which media and institutional sources they use and trust to navigate the health information environment, how they look for information and whom they trust during periods of health emergency or crisis, and which communication strategies are considered most effective in persuading vaccine hesitant parents to immunize their children.

PMID: 28357154
PMCID: PMC5346025
DOI: 10.1371/currents.outbreaks.0561a011117a1d1f9596e24949e8690b