Promotion de l'accès à la communication, du choix et de l'agence pour les élèves autistes

Aperçu: G.M.

Objectif
Les familles et les professionnels considèrent souvent la communication améliorée et alternative (CAA) comme un « dernier recours » pour les personnes ayant des problèmes de communication ; cependant, des adultes autistes verbaux ont déclaré qu'ils auraient tiré profit de l'accès à la CAA dans leur enfance. Ce tutoriel revient sur l'histoire de cette pratique de "dernier recours" et sa pérennisation au sein du modèle médical du handicap. Le tutoriel se concentre sur l'accès à la communication, le choix et l'agence pour les étudiants autistes.

Méthode

Nous donnons un bref aperçu de la communauté de la CAA et de sa terminologie préférée, passons en revue l'historique des approches traditionnelles de la recherche sur la CAA et l'autisme, puis examinons la relation entre les modèles de handicap et le capacitisme (attitudes sociétales qui dévalorisent et limitent le potentiel des personnes handicapées)  et la vision du langage parlé comme une priorité d'intervention. Les études sur ce sujet sont rares, et résister au capacitisme nécessite de reconnaître et d'honorer les expériences et l'expertise des personnes handicapées.
Par conséquent, nous promouvons l'expertise autistique dans le cadre d'une pratique fondée sur des preuves et discutons des expériences des personnes autistes et du langage parlé.
Enfin, nous considérons le rôle de l'orthophoniste (orthophoniste) dans l'évaluation et proposons des stratégies et des recommandations basées sur l'autisme pour le soutien à la communication. 

Conclusions
Les élèves autistes verbaux qui pourraient bénéficier de la CAA peuvent ne pas avoir accès à la CAA en raison de la priorisation du langage parlé et du manque de sensibilisation aux avantages de la CAA.
Nous recommandons que les orthophonistes et les professionnels en milieu scolaire soutiennent et facilitent l'accès, le choix communicatif et l'agence en mettant en œuvre des stratégies de communication multimodales pour inclure l'utilisation de la CAA pour les élèves autistes, quel que soit leur statut de langue parlée.
La promotion de tous les types de communication et la garantie d'opportunités de communication à travers de multiples modalités sont primordiales pour l'agence et l'autodétermination d'un enfant, tout comme la normalisation de la CAA.

. 2022 Nov 4;1-16.

doi: 10.1044/2022_LSHSS-22-00031. Online ahead of print.

Promotion of Communication Access, Choice, and Agency for Autistic Students

Amy L Donaldson  ¹ , Endever Corbin  ² , Alyssa Hillary Zisk  ³ , Brandon Eddy  ¹

Affiliations

• PMID: 36332142
• DOI: 10.1044/2022_LSHSS-22-00031

Abstract

Purpose: Families and professionals often consider augmentative and alternative communication (AAC) a "last resort" for persons with communication challenges; however, speaking autistic adults have reported that they would have benefited from access to AAC as children. This tutorial discusses the history of this "last resort" practice and its perpetuation within the medical model of disability. The tutorial focuses on communication access, choice, and agency for autistic students.

Method: We provide a brief overview of the AAC community and their preferred terminology, review the history of traditional approaches to research on AAC and autism, and then examine the relationship between disability models and ableism to views of spoken language as a priority of intervention. Studies on this topic are rare, and resisting ableism requires acknowledging and honoring disabled people's experiences and expertise. Therefore, we promote autistic expertise within the framework of evidence-based practice and discuss the experiences of autistic people and spoken language. Finally, we consider the role of the speech-language pathologist (SLP) in assessment and offer autistic-based strategies and recommendations for communication support.

Conclusions: Speaking autistic students who could benefit from AAC may not have access to AAC due to the prioritization of spoken language and lack of awareness of the benefit of AAC. We recommend that SLPs and school-based professionals support and facilitate access, communicative choice, and agency by implementing multimodal communication strategies to include AAC use for autistic students regardless of their spoken language status. Promoting all types of communication and ensuring opportunities for communication across multiple modalities are paramount to a child's agency and self-determination, as is normalization of AAC.

Les éducateurs décrivent les "meilleures choses" à propos des élèves autistes à l'école

 Aperçu: G.M.

Cette étude a examiné les descriptions par les éducateurs des traits de caractère positifs des élèves avec un diagnostic de troubles du spectre de l'autisme âgés de 7 à 8 ans et de 10 à 11 ans, en utilisant une version adaptée de la classification des forces des valeurs en action (VIA).
Les forces les plus couramment reconnues aux deux tranches d'âge étaient la gentillesse, les compétences spécifiques, l'autorégulation et la persévérance. Des scores plus élevés pour les comportements difficiles étaient associés à une probabilité plus faible d'approbation des traits de bonheur et de courage. Des scores plus élevés de sévérité des symptômes de l'autisme étaient associés à une probabilité plus faible d'approbation des traits de courage. Peu de différences significatives ont été trouvées pour l'approbation des catégories de traits par le placement scolaire des étudiants ou le type de programme qu'ils ont suivi. Les résultats peuvent avoir des implications pour les relations élèves-enseignants, les évaluations pédagogiques et les interventions en milieu scolaire qui mettent l'accent sur les forces et la résilience. 

. 2022 Oct 31.

doi: 10.1007/s10803-022-05761-2. Online ahead of print.

Educators Describe the "Best Things" About Students with Autism at School

Pat Mirenda  ¹ , Anat Zaidman-Zait  ² , Katherine Tombeau Cost  ³ , Isabel M Smith  ⁴ , Lonnie Zwaigenbaum  ⁵ , Eric Duku  ⁶ , Connor Kerns  ⁷ , Stelios Georgiades  ⁶ , Tracy Vaillancourt  ⁸ , Mayada Elsabbagh  ⁹ , Teresa Bennett  ⁶ , Peter Szatmari  ¹⁰

Affiliations

• PMID: 36315320
• DOI: 10.1007/s10803-022-05761-2

Abstract

This study examined educators' descriptions of the positive character traits of students with autism spectrum disorder at ages 7-8 and 10-11, using an adapted version of the Values in Action (VIA) Classification of Strengths. The most commonly endorsed strengths at both age intervals were kindness, specific skills, self-regulation, and perseverance. Higher scores for challenging behavior were associated with a lower likelihood of endorsement for Happiness and Courage traits. Higher autism symptom severity scores were associated with a lower likelihood of endorsement for Courage traits. Few significant differences were found for endorsement of trait categories by students' educational placement or the type of curriculum they received. Results may have implications for student-teacher relationships, educational assessments, and school-based interventions that emphasize strengths and resilience.

Keywords: autism spectrum disorder; character traits; children; positive psychology; strengths; teachers.

Théories cognitives de l'autisme basées sur les interactions entre les réseaux fonctionnels cérébraux

Aperçu: G.M.

Résumé 

Les fonctions cognitives sont directement liées aux interactions entre les réseaux fonctionnels du cerveau. Cette organisation fonctionnelle change dans le trouble du spectre de l'autisme (TSA). Cependant, la nature hétérogène de l'autisme apporte des incohérences dans les résultats, et le modèle spécifique de changements basé sur les théories cognitives des TSA doit encore être bien compris.
Dans cette étude, nous avons émis l'hypothèse que la théorie de l'esprit (ToM) et la théorie de la cohérence centrale faible doivent suivre un modèle d'altération au niveau du réseau des interactions fonctionnelles. L'objectif principal est de comprendre ce schéma en évaluant les interactions entre tous les réseaux fonctionnels cérébraux. De plus, l'association entre les interactions significativement modifiées et les dysfonctionnements cognitifs dans l'autisme est également étudiée.
 Nous avons utilisé les données d'IRMf à l'état de repos de 106 sujets (5-14 ans, 46 TSA : cinq femmes, 60 HC : 18 femmes) pour définir les réseaux fonctionnels cérébraux. Les réseaux fonctionnels ont été calculés en appliquant quatre masques de parcellisation et leurs interactions ont été estimées à l'aide de la corrélation de Pearson entre leurs paires.
Par la suite, pour chaque masque, un graphique a été formé en fonction du connectome des interactions. Ensuite, les paramètres locaux et globaux du graphe ont été calculés. Enfin, une analyse statistique a été réalisée à l'aide d'un test t à deux échantillons pour mettre en évidence les différences significatives entre les groupes témoins autistes et sains.
Nos résultats corrigés montrent des changements significatifs dans l'interaction du mode par défaut, des réseaux sensori-moteurs, visuo-spatiaux, visuels et langagiers avec d'autres réseaux fonctionnels qui peuvent soutenir les principales théories cognitives de l'autisme.
Nous espérons que cette découverte éclairera une meilleure compréhension des fondements neuronaux de l'autisme.

. 2022 Oct 6;16:828985.

doi: 10.3389/fnhum.2022.828985. eCollection 2022.

Cognitive theories of autism based on the interactions between brain functional networks

Sarah Barzegari Alamdari  ¹ , Masoumeh Sadeghi Damavandi  ¹ , Mojtaba Zarei  ^{2   3} , Reza Khosrowabadi  ¹

Affiliations

• PMID: 36310850
• PMCID: PMC9614840
• DOI: 10.3389/fnhum.2022.828985

Abstract

Cognitive functions are directly related to interactions between the brain's functional networks. This functional organization changes in the autism spectrum disorder (ASD). However, the heterogeneous nature of autism brings inconsistency in the findings, and specific pattern of changes based on the cognitive theories of ASD still requires to be well-understood. In this study, we hypothesized that the theory of mind (ToM), and the weak central coherence theory must follow an alteration pattern in the network level of functional interactions. The main aim is to understand this pattern by evaluating interactions between all the brain functional networks. Moreover, the association between the significantly altered interactions and cognitive dysfunctions in autism is also investigated. We used resting-state fMRI data of 106 subjects (5-14 years, 46 ASD: five female, 60 HC: 18 female) to define the brain functional networks. Functional networks were calculated by applying four parcellation masks and their interactions were estimated using Pearson's correlation between pairs of them. Subsequently, for each mask, a graph was formed based on the connectome of interactions. Then, the local and global parameters of the graph were calculated. Finally, statistical analysis was performed using a two-sample t-test to highlight the significant differences between autistic and healthy control groups. Our corrected results show significant changes in the interaction of default mode, sensorimotor, visuospatial, visual, and language networks with other functional networks that can support the main cognitive theories of autism. We hope this finding sheds light on a better understanding of the neural underpinning of autism.

Keywords: autism spectrum disorder; cognitive theories; graph theory; intrinsic connectivity networks; resting-state fMRI.

L'effet du spray nasal d'ocytocine sur l'interaction sociale chez les jeunes enfants autistes : un essai clinique randomisé

Aperçu: G.M.

Résumé
Les soutiens précoces pour améliorer le développement social des enfants autistes sont largement promus. Bien que l'ocytocine joue un rôle crucial dans le développement social des mammifères, son rôle potentiel en tant que médicament pour améliorer le développement social chez l'homme reste incertain.
Nous avons étudié l'efficacité, la tolérabilité et l'innocuité de l'ocytocine intranasale chez les jeunes enfants autistes à l'aide d'un essai clinique en double aveugle, randomisé, contrôlé par placebo, après une phase préliminaire avec placebo. Au total, 87 enfants (âgés de 3 à 12 ans) autistes ont reçu 16 Unités Internationales (UI) d'ocytocine (n = 45) ou un placebo (n = 42) en spray nasal, matin et soir (32 UI par jour) pendant douze semaines, après une phase préliminaire de 3 semaines avec placebo.
Dans l'ensemble, il n'y avait aucun effet du traitement à l'ocytocine au fil du temps sur l'échelle de réactivité sociale évaluée par le soignant (SRS-2) (p = 0,686).
Cependant, une interaction significative avec l'âge (p = 0,028) a montré que pour les enfants plus jeunes, âgés de 3 à 5 ans, il y avait une certaine indication d'un effet du traitement. Les enfants plus jeunes qui ont reçu de l'ocytocine ont montré une amélioration de la réactivité sociale évaluée par le soignant (SRS-2).
Il n'y avait aucune autre preuve de bénéfice dans l'échantillon dans son ensemble, ou dans le groupe d'âge plus jeune, sur l'échelle d'amélioration clinique globale (CGI-S) évaluée par le clinicien, ou sur toute autre mesure secondaire. Il est important de noter que les effets placebo dans la phase initiale étaient évidents et qu'il y avait un soutien pour l'élimination de la réponse placebo dans la phase randomisée.
L'ocytocine a été bien tolérée, avec plus d'effets secondaires indésirables signalés dans le groupe placebo. Cette étude suggère la nécessité d'autres essais cliniques pour tester les avantages du traitement à l'ocytocine chez les populations autistes plus jeunes. 

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Enregistrement de l'essai www.anzctr.org.au (ACTRN12617000441314).

. 2022 Oct 27;1-9.

doi: 10.1038/s41380-022-01845-8. Online ahead of print.

The effect of oxytocin nasal spray on social interaction in young children with autism: a randomized clinical trial

Adam J Guastella  ¹ , Kelsie A Boulton  ² , Andrew J O Whitehouse  ³ , Yun Ju Song  ² , Rinku Thapa  ² , Simon G Gregory  ⁴ , Izabella Pokorski  ² , Joanna Granich  ³ , Marilena M DeMayo  ² , Zahava Ambarchi  ² , John Wray  ⁵ , Emma E Thomas  ² , Ian B Hickie  ²

Affiliations

• PMID: 36302965
• PMCID: PMC9607840
• DOI: 10.1038/s41380-022-01845-8

Free PMC article

Abstract

Early supports to enhance social development in children with autism are widely promoted. While oxytocin has a crucial role in mammalian social development, its potential role as a medication to enhance social development in humans remains unclear. We investigated the efficacy, tolerability, and safety of intranasal oxytocin in young children with autism using a double-blind, randomized, placebo-controlled, clinical trial, following a placebo lead-in phase. A total of 87 children (aged between 3 and 12 years) with autism received 16 International Units (IU) of oxytocin (n = 45) or placebo (n = 42) nasal spray, morning and night (32 IU per day) for twelve weeks, following a 3-week placebo lead-in phase. Overall, there was no effect of oxytocin treatment over time on the caregiver-rated Social Responsiveness Scale (SRS-2) (p = 0.686). However, a significant interaction with age (p = 0.028) showed that for younger children, aged 3-5 years, there was some indication of a treatment effect. Younger children who received oxytocin showed improvement on caregiver-rated social responsiveness ( SRS-2). There was no other evidence of benefit in the sample as a whole, or in the younger age group, on the clinician-rated Clinical Global Improvement Scale (CGI-S), or any secondary measure. Importantly, placebo effects in the lead-in phase were evident and there was support for washout of the placebo response in the randomised phase. Oxytocin was well tolerated, with more adverse side effects reported in the placebo group. This study suggests the need for further clinical trials to test the benefits of oxytocin treatment in younger populations with autism.Trial registration www.anzctr.org.au (ACTRN12617000441314).

Insomnie chez les enfants avec un diagnostic de trouble du spectre de l'autisme: une étude transversale sur les corrélats cliniques et le stress parental

Aperçu: G.M.

Résumé
L'insomnie est l'un des troubles concomitants les plus courants chez les enfants avec un diagnostic de troubles du spectre de l'autisme (dTSA). Le but de cette étude de cohorte transversale de 270 enfants avec un dTSA était d'évaluer la prévalence de l'insomnie à l'aide de l'échelle d'impression globale clinique du sommeil pédiatrique et de corréler les problèmes de sommeil avec le niveau cognitif, le comportement adaptatif, le stress parental, les problèmes comportementaux et émotionnels, et sévérité des principaux symptômes. 

Nos résultats ont révélé qu'un tiers des enfants souffraient d'insomnie et étaient liés à des comportements adaptatifs réduits et à des niveaux plus élevés de stress parental et de problèmes comportementaux et émotionnels. L'insomnie doit être évaluée chez les enfants avec un dTSA afin de définir une intervention appropriée pour potentiellement atténuer la gravité des corrélats cliniques et le fardeau parental.

. 2022 Oct 30.

doi: 10.1007/s10803-022-05793-8. Online ahead of print.

Insomnia in Children with Autism Spectrum Disorder: A Cross-Sectional Study on Clinical Correlates and Parental Stress

Berloco Bianca  ^{1   2} , Guerrera Silvia  ¹ , Fucà Elisa  ¹ , Menghini Deny  ³ , Valeri Giovanni  ¹ , Nobili Lino  ^{2   4} , Vicari Stefano  ^{1   5}

Affiliations

• PMID: 36310306
• DOI: 10.1007/s10803-022-05793-8

Abstract

Insomnia is one of the most common co-occurring disorders in children with autism spectrum disorder (ASD). The purpose of this cross-sectional cohort study of 270 children with ASD was to assess the prevalence of insomnia using the Pediatric Sleep Clinical Global Impression Scale and to correlate sleep problems with cognitive level, adaptive behavior, parental stress, behavioral and emotional problems, and severity of core symptoms. Our findings revealed that one-third of children had insomnia and were related to reduced adaptive behaviors and higher levels of parental stress and behavioral and emotional problems. Insomnia must be evaluated in children with ASD to define an appropriate intervention to potentially alleviate the severity of clinical correlates and parental burden.

Keywords: Adaptive behaviors; Externalizing symptoms; Internalizing symptoms; Sleep.

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

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