Affichage des articles dont le libellé est intervention médiée par les parents. Afficher tous les articles
Affichage des articles dont le libellé est intervention médiée par les parents. Afficher tous les articles

28 mai 2021

Évaluation par les parents des effets généralisés et indirects de la formation en communication fonctionnelle pour les enfants avec un diagnostic de "trouble du spectre de l'autisme"

Aperçu: G.M.

L'entraînement à la communication fonctionnelle (ECT) est un traitement comportemental qui réduit les problèmes de comportement et augmente la communication appropriée chez les jeunes enfants avec un diagnostic de "trouble du spectre de l'autisme (dTSA). 

Dans cette étude, nous avons évalué les effets de l'ECT sur les comportements problématiques ciblés et non ciblés en dehors du contexte de formation, ainsi que le stress des parents, pour 30 jeunes enfants avec un dTSA et leurs parents. Des mesures indirectes des effets du traitement de généralisation ont été administrées avant et après le traitement ECT administré par télésanté. 

Les enfants ont démontré une amélioration significative des comportements problématiques ciblés (mesurés par observation) et non ciblés (mesurés via une liste de contrôle), à ​​la fois à l'intérieur et à l'extérieur du contexte de formation, et le stress des parents a été considérablement réduit après le traitement. 

Ces résultats suggèrent que l'impact de l'ECT peut s'étendre au-delà du contexte de la formation tant pour les enfants traités que pour les parents délivrant le traitement, même lorsque la généralisation n'est pas spécifiquement programmée pendant le traitement.

. 2021 May 27;1454455211018815.  doi: 10.1177/01454455211018815. 

Parent Ratings of Generalized and Indirect Effects of Functional Communication Training for Children with Autism Spectrum Disorder

Affiliations

Abstract

Functional communication training (FCT) is a behavioral treatment that has been shown to reduce problem behavior and increase appropriate communication in young children with autism spectrum disorder (ASD). In this study, we assessed the effects of FCT on targeted and nontargeted problem behaviors outside of the training context, as well as parent stress, for 30 young children with ASD and their parents. Indirect measures of generalization treatment effects were administered prior to and following FCT treatment delivered via telehealth. Children demonstrated significant improvement on both targeted (measured via observation) and nontargeted (measured via checklist) problem behaviors, both within and outside of the training context, and parent stress was significantly reduced following treatment. These results suggest that the impact of FCT may extend beyond the training context for both the children being treated and the parents delivering treatment, even when generalization is not specifically programmed for during treatment.

Keywords: autism spectrum disorder; functional communication training; generalization; problem behavior; telehealth.

 

24 mai 2021

Caractéristiques cliniques et individuelles associées au stress maternel chez les jeunes adolescents avec un diagnostic de "trouble du spectre de l'autisme"

Aperçu: G.M.

Les parents de personnes avec un diagnostic de "trouble du spectre de l'autismeé vivent à la fois des événements stressants négatifs et positifs. Plusieurs caractéristiques cliniques et sociodémographiques des enfants autistes ont été associées au stress parental dans leur famille. Cependant, peu d'études se sont concentrées sur les adolescents et le rôle de la déficience cognitive a rarement été abordé.
L'objectif principal de la présente recherche est d'explorer les associations entre les symptômes de l'autisme, les troubles cognitifs, les problèmes émotionnels et comportementaux, les caractéristiques sociodémographiques et le stress maternel chez un échantillon de jeunes adolescents avec un
diagnostic de "trouble du spectre de l'autisme" avec et sans troubles cognitifs.
La déficience cognitive et les problèmes émotionnels et comportementaux sont associés au stress maternel, tandis que les symptômes de l'autisme semblent jouer un rôle mineur.
L'éducation et la profession de la mère ne sont associées au stress maternel que dans le groupe ayant une déficience cognitive, tandis que l'âge maternel est associé au stress dans le groupe d'adolescentes sans déficience cognitive. 

Les implications liées à l'âge pour l'intervention et les orientations futures de la recherche sont discutées.

. 2021 May 20.  doi: 10.1002/aur.2539. 

Clinical and individual features associated with maternal stress in young adolescents with autism spectrum disorder

Affiliations

Abstract

Parents of people with autism spectrum disorder experience both negative stressful and positive events. Several clinical and socio-demographic features of children on the autism spectrum have been associated with parenting stress in their families. However, there have been few studies that focus on adolescents and the role of cognitive impairment has rarely been addressed. The main aim of the present research is to explore associations between autism symptoms, cognitive impairment, emotional and behavioral problems, socio-demographic features, and maternal stress in a sample of young adolescents with Autism Spectrum Disorder with and without cognitive impairment. Cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Maternal education and occupation are only associated with maternal stress in the group with cognitive impairment, while maternal age is stress-associated in the group of adolescents without cognitive impairment. Age-related implications for intervention and future research directions are discussed. LAY SUMMARY: Parents of individuals on the autism spectrum are exposed to both negative stressful and enriching experiences during their parenthood. While the influence of several child characteristics and socio-demographic features on parental stress during childhood has been widely explored in past studies, studies on teenagers are limited. The aim of the present research is to explore the influence of several characteristics on maternal stress levels in families with teenagers on the autism spectrum. We found that cognitive impairment and emotional and behavioral problems are associated with maternal stress, while autism symptoms seem to play a minor role. Socio-demographic features are not associated with maternal stress. Broadly speaking, the subjective perception of parental distress in both groups is less related to teenagers' characteristics then the perception of having a difficult interaction with the teenagers. We divided our participants into two groups (one group with cognitive impairment and the other group without). We found that mothers of teenagers with cognitive impairment are generally more stressed compared to the other group. Furthermore, we confirm that emotional and behavioral problems seem to play a major role in maternal stress (especially in the group without cognitive impairment), while autism symptoms seem to play a minor role. Furthermore, we found that maternal education/occupation and maternal age are associated with maternal stress in the group with and the group without cognitive impairment respectively. This research highlights the association between several variables and stress in mothers of adolescents on the spectrum. Results are discussed in the framework of previous findings highlighting the lack of adequate care and support services for families, especially for those of adolescents on the spectrum with cognitive impairment.

Keywords: adolescence; autism symptoms; cognitive; emotional and behavioral problems; maternal stress; parent mediated therapy; socio-demographic features.

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03 août 2019

Intervention précoce auprès des parents chez les jeunes enfants avec un diagnostic de "trouble du spectre de l'autisme"

Aperçu: G.M.
ARTICLE DE 2013
CONTEXTE:
Les jeunes enfants avec un diagnostic de "troubles du spectre de l'autisme" (dTSA) ont des déficiences dans les domaines de la communication et des interactions sociales et affichent souvent des comportements répétitifs ou non conformes. Ce schéma précoce de difficultés est un défi pour les parents. Par conséquent, les approches qui aident les parents à développer des stratégies d’interaction et de gestion du comportement constituent une voie évidente pour une intervention précoce dans le traitement des TSA. Cette revue met à jour une revue Cochrane publiée pour la première fois en 2002, mais repose sur un nouveau protocole.
OBJECTIFS:
Évaluer l'efficacité des interventions précoces menées par les parents en termes d'avantages pour les enfants avec un dTSA et leurs parents, et explorer certains modérateurs potentiels de l'effet du traitement.
METHODES DE RECHERCHE:
Nous avons effectué des recherches dans diverses bases de données psychologiques, éducatives et biomédicales, notamment CENTRAL, MEDLINE, Embase, PsycINFO et ERIC, en août 2012. S'agissant d'une mise à jour d'un précédent examen, nous avons limité la recherche à la période qui a suivi les recherches initiales effectuées en 2002. Les bibliographies et les listes de référence des articles clés ont été consultées, des experts sur le terrain ont été contactés et des revues clés ont été recherchées manuellement.
LES CRITÈRES DE SÉLECTION:
Nous avons inclus uniquement les essais contrôlés randomisés d'interventions précoces chez les enfants avec un dTSA. Les interventions dans les conditions expérimentales ont été médiées par les parents; les conditions de contrôle comprenaient l'absence de traitement, le traitement comme d'habitude, la liste d'attente, une autre intervention centrée sur l'enfant non médiatisée par les parents ou une autre intervention médiée par les parents d'un effet moindre présumé que la condition expérimentale.
COLLECTE DE DONNÉES ET ANALYSE:
Deux auteurs de la revue (HM et IPO) ont indépendamment sélectionné les articles identifiés dans la recherche et décidé quels articles devaient être récupérés dans leur intégralité. Pour chaque étude incluse, deux auteurs de la revue (IPO et EH) ont extrait et enregistré des données à l'aide d'un formulaire de collecte de données piloté. Deux auteurs de la revue (IPO et HM) ont évalué le risque de biais dans chaque étude. Nous avons effectué la synthèse et l'analyse des données à l'aide du logiciel Review Manager 5.1 de The Cochrane Collaboration.
PRINCIPAUX RÉSULTATS:
La revue comprend 17 études de six pays (États-Unis, Royaume-Uni, Australie, Canada, Thaïlande et Chine), qui ont recruté 919 enfants avec un dTSA. Les 17 études ne pouvaient pas toutes être comparées directement ou combinées dans des méta-analyses en raison des différences dans la base théorique des interventions, leur durée et leur intensité, ainsi que des outils de mesure des résultats utilisés. Les méta-analyses ont inclus des données provenant de sous-ensembles de 10 études évaluant les interventions visant à améliorer le style d'interaction des parents et à faciliter ainsi la communication des enfants. La méta-analyse la plus importante combinait les données de 316 participants à six études et la plus petite des données combinées à partir de 55 participants de deux études. 
Les résultats des sept études restantes ont été rapportés de manière narrative. Un risque élevé de biais était évident dans les études en ce qui concerne la dissimulation d'allocation et des données de résultat incomplètes; L'absence de visibilité des participants n’était pas possible. En général, nous n'avons trouvé aucune preuve statistique des avantages tirés d'approches médiées par les parents dans la plupart des principaux résultats évalués (la plupart des aspects du langage et de la communication - qu'ils soient évalués ou rapportés directement; la fréquence des initiations d'interaction avec l'enfant observée chez les parents, le comportement adaptatif de l’enfant, le stress des parents), avec des résultats peu concluants et incohérents d’une étude à l’autre 
Cependant, la preuve d'un changement positif dans les modèles d'interaction parent-enfant était forte et statistiquement significative (attention partagée: différence moyenne standardisée (SMD) 0,41; intervalle de confiance à 95% (IC) 0,14 à 0,68, valeur P <0,05; synchronie parentale: SMD 0,90; IC 95% 0,56 à 1,23, valeur de p <0,05). De plus, certaines données suggérant une amélioration de la compréhension du langage chez l'enfant, rapportées par les parents (compréhension du vocabulaire: différence moyenne (DM 36,26; IC 95%: 1,31 à 71,20, valeur de p <0,05). la gravité des caractéristiques de l'autisme chez les enfants (SMD -0,30, IC à 95% de -0,52 à -0,08, valeur de p <0,05). 
Cependant, cette preuve du changement des compétences et des difficultés des enfants à la suite d'une intervention à médiation parentale est incertaine, effets et IC étendus, et les conclusions sont susceptibles de changer avec la publication future d’ECR de haute qualité.
CONCLUSIONS DES AUTEURS:
L’examen a mis en évidence des preuves de l’efficacité des interventions menées par les parents, plus particulièrement en ce qui concerne les indicateurs proximaux de l’interaction parent-enfant, mais également les indicateurs plus distaux de la compréhension du langage chez l’enfant et de la réduction de la gravité de l’autisme. 
La preuve que de telles interventions peuvent réduire le stress des parents n'est pas concluante
 
2013 Apr 30;(4):CD009774. doi: 10.1002/14651858.CD009774.pub2.

Parent-mediated early intervention for young children with autism spectrum disorders (ASD)

Author information

1
Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.

Abstract

BACKGROUND:

Young children with autism spectrum disorders (ASD) have impairments in the areas of communication and social interaction and often display repetitive or non-compliant behaviour. This early pattern of difficulties is a challenge for parents. Therefore, approaches that help parents develop strategies for interaction and management of behaviour are an obvious route for early intervention in ASD. This review updates a Cochrane review first published in 2002 but is based on a new protocol.

OBJECTIVES:

To assess the effectiveness of parent-mediated early interventions in terms of the benefits for both children with ASD and their parents and to explore some potential moderators of treatment effect.

SEARCH METHODS:

We searched a range of psychological, educational and biomedical databases including CENTRAL, MEDLINE, Embase, PsycINFO and ERIC in August 2012. As this is an update of a previous review, we limited the search to the period following the original searches in 2002. Bibliographies and reference lists of key articles were searched, field experts were contacted and key journals were handsearched.

SELECTION CRITERIA:

We included only randomised controlled trials of early intervention for children with ASD. The interventions in the experimental condition were mediated by parents; the control conditions included no treatment, treatment as usual, waiting list, alternative child-centred intervention not mediated by parents, or alternative parent-mediated intervention of hypothesised lesser effect than the experimental condition.

DATA COLLECTION AND ANALYSIS:

Two review authors (HM and IPO) independently screened articles identified in the search and decided which articles should be retrieved in full. For each included study, two review authors (IPO and EH) extracted and recorded data, using a piloted data collection form. Two review authors (IPO and HM) assessed the risk of bias in each study. We performed data synthesis and analysis using The Cochrane Collaboration's Review Manager 5.1 software.

MAIN RESULTS:

The review includes 17 studies from six countries (USA, UK, Australia, Canada, Thailand and China), which recruited 919 children with ASD. Not all 17 studies could be compared directly or combined in meta-analyses due to differences in the theoretical basis underpinning interventions, the duration and intensity of interventions, and the outcome measurement tools used. Data from subsets of 10 studies that evaluated interventions to enhance parent interaction style and thereby facilitate children's communication were included in meta-analyses. The largest meta-analysis combined data from 316 participants in six studies and the smallest combined data from 55 participants in two studies. Findings from the remaining seven studies were reported narratively.High risk of bias was evident in the studies in relation to allocation concealment and incomplete outcome data; Oono, I. P., Honey, E. J., & McConachie, H. (2013). Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd009774.pub2 of participants was not possible.Overall, we did not find statistical evidence of gains from parent-mediated approaches in most of the primary outcomes assessed (most aspects of language and communication - whether directly assessed or reported; frequency of child initiations in observed parent-child interaction; child adaptive behaviour; parents' stress), with findings largely inconclusive and inconsistent across studies. However, the evidence for positive change in patterns of parent-child interaction was strong and statistically significant (shared attention: standardised mean difference (SMD) 0.41; 95% confidence interval (CI) 0.14 to 0.68, P value < 0.05; parent synchrony: SMD 0.90; 95% CI 0.56 to 1.23, P value < 0.05). Furthermore, there is some evidence suggestive of improvement in child language comprehension, reported by parents (vocabulary comprehension: mean difference (MD 36.26; 95% CI 1.31 to 71.20, P value < 0.05). In addition, there was evidence suggesting a reduction in the severity of children's autism characteristics (SMD -0.30, 95% CI -0.52 to -0.08, P value < 0.05). However, this evidence of change in children's skills and difficulties as a consequence of parent-mediated intervention is uncertain, with small effect sizes and wide CIs, and the conclusions are likely to change with future publication of high-quality RCTs.

AUTHORS' CONCLUSIONS:

The review finds some evidence for the effectiveness of parent-mediated interventions, most particularly in proximal indicators within parent-child interaction, but also in more distal indicators of child language comprehension and reduction in autism severity. Evidence of whether such interventions may reduce parent stress is inconclusive. The review reinforces the need for attention to be given to early intervention service models that enable parents to contribute skilfully to the treatment of their child with autism. However, practitioners supporting parent-mediated intervention require to monitor levels of parent stress. The ability to draw conclusions from studies would be improved by researchers adopting a common set of outcome measures as the quality of the current evidence is low.
PMID:23633377
DOI:10.1002/14651858.CD009774.pub2

26 novembre 2017

* Formation parentale à la médiation pour promouvoir la communication sociale pour les tout-petits autistes: effets d'un essai contrôlé randomisé

Aperçu: G.M.
Un essai contrôlé randomisé a été mené pour évaluer les effets d'une intervention de formation à l' attention conjointe médiée (JAML) auprès de très jeunes enfants avec un diagnostic de troubles du spectre de l'autisme (TSA) âgés de 16 à 30 mois (n = 144).
Les parents, qui ont participé à 32 séances hebdomadaires à domicile, ont suivi un processus d'apprentissage médié pour cibler les résultats de la communication sociale préverbale (synchronie visuelle sociale, réciprocité et réponse et initiation des formes d'attention conjointe) tout au long des interactions quotidiennes.
Les résultats soutiennent l'intérêt d'une intervention très précoce ciblant explicitement les fonctions sociales de la communication préverbale et la promotion d'un engagement actif dans le processus d'apprentissage pour les tout-petits et les parents.  

J Autism Dev Disord. 2017 Nov 22. doi: 10.1007/s10803-017-3386-8.

Mediating Parent Learning to Promote Social Communication for Toddlers with Autism: Effects from a Randomized Controlled Trial

Author information

1
Department of Curriculum & Instruction, Indiana University, 201 N Rose Ave., Bloomington, IN, 47405, USA. hschertz@indiana.edu.
2
Frank Porter Graham Child Development Institute, University of North Carolina, 105 Smith Level Road, Chapel Hill, NC, 27599, USA.
3
Mark Chaffin Center for Healthy Development, School of Public Health Georgia State University, 14 Marietta, Room 135, Atlanta, GA, 30303, USA.
4
Juniper Gardens Children's Project, University of Kansas, 444 Minnesota Ave., Kansas, KS, USA.

Abstract

A randomized controlled trial was conducted to evaluate effects of the Joint Attention Mediated Learning (JAML) intervention. Toddlers with autism spectrum disorders (ASD) aged 16-30 months (n = 144) were randomized to intervention and community control conditions. Parents, who participated in 32 weekly home-based sessions, followed a mediated learning process to target preverbal social communication outcomes (social visual synchrony, reciprocity, and responding and initiating forms of joint attention) throughout daily interactions. The analysis found post-intervention effects for all outcomes, with all except initiating joint attention sustaining 6 months post-intervention. Findings support the value of very early intervention targeting explicitly social functions of preverbal communication and of promoting active engagement in the learning process for both toddlers and parents.
PMID:29168087
DOI:10.1007/s10803-017-3386-8

22 avril 2017

Programme enfants calmes

Traduction: G.M.

J Intellect Disabil. 2017 Jan 1:1744629517704536. doi: 10.1177/1744629517704536.

Calm child programme

Author information

1
Zagazig University, Egypt.
2
De Montfort University, UK.

Abstract

Les enfants avec un diagnostic de trouble du spectre de l'autisme (TSA) et une déficience intellectuelle (DI) sont plus vulnérables aux troubles anxieux. La participation des parents à l'intervention est cruciale pour une gestion réussie des interventions dans la population des personnes avec un diagnostic de TSA. Cet article décrit la conception et l'évaluation du programme de parentalité pour les troubles anxieux chez les enfants et les jeunes avec TSA et DI

Dans la phase 1, des entrevues semi-structurées ont été menées pour explorer les stratégies de gestion de l'anxiété à la maison et dans les établissements scolaires. Au total, 34 participants (14 parents, 20 enseignants) ont participé aux entretiens. Un processus de Delphi a été mené avec des professionnels de la santé pour développer un consensus sur les interventions d'anxiété appropriées. En phase 2, le programme d'intervention a été mis en œuvre par sept parents qui ont également participé à un groupe de discussion pour évaluer le programme développé. Un programme parental, un programme enfant calme (CCP), a été développé, mis en œuvre et évalué. Les évaluations montrent une diminution significative de l'anxiété des enfants en raison de la mise en œuvre du programme. Cette étude apporte des preuves supplémentaires à la participation des parents dans les interventions pour les enfants et les jeunes avec TSA et d'ID. 
Le CCP est une approche utile et rentable pour permettre aux parents de fournir des interventions d'anxiété dans un cadre familial.  
Children with autism spectrum disorder (ASD) and intellectual disabilities (IDs) are more vulnerable to experiencing anxiety disorders. Parental involvement in intervention is crucial for successful management of the interventions in the population of people with ASDs. This article describes the design and evaluation of parenting programme for anxiety disorders in children and young people with ASD and ID. In phase 1 semi-structured interviews were conducted to explore management strategies for anxiety at home and in school settings. A total of 34 participants (14 parents, 20 teachers) participated in the interviews. A Delphi process was conducted with health professionals to develop consensus on appropriate anxiety interventions. In phase 2 the intervention programme was implemented by seven parents who also participated in focus group to evaluate the developed programme. A parental programme, calm child programme (CCP), was developed, implemented and evaluated. The evaluations show significant decrease in children's anxiety as a result of implementing the programme. This study contributes further evidence to parental involvement in interventions for children and young people with ASD and IDs. The CCP is a useful and cost-effective approach in enabling parents to provide anxiety interventions in a home setting.

PMID: 28425373
DOI: 10.1177/1744629517704536