scholarly journals Exploring the Impact of Challenging Behaviors on Treatment Efficacy in Autism Spectrum Disorder

2019 ◽  
Author(s):  
Juliana Hoag
Author(s):  
Robin L. Gabriels ◽  
Julia Barnes

There are well-documented gaps between evidence-based interventions (EBIs) developed and tested in controlled research settings and those delivered in routine, community-based care. The field of implementation science has developed in response to identified gaps to study methods to promote the uptake and sustainment of EBIs in community care. Community mental health (MH) services play an important role in caring for individuals with autism spectrum disorder (ASD) across the lifespan who have co-occurring psychiatric conditions. This chapter summarizes over a decade of community-engaged research aimed to (a) characterize MH services for children with ASD, including the training needs of therapists and clinical needs of children with ASD receiving care; (b) develop the AIM HI (An Individualized Mental Health Intervention for ASD) intervention, a package of well-established, evidence-based behavioral strategies designed to reduce challenging behaviors in children served in MH service settings; (c) test the impact of training therapists to deliver AIM HI on child outcomes; (d) identify potential influences on implementation; and (e) test the impact of different implementation strategies to enhance therapist delivery of AIM HI. The chapter includes directions for future research including applying the AIM HI development model to older individuals with ASD and other community service systems and integrating implementation science approaches earlier in the pipeline of research-to-practice translation.


2021 ◽  
Author(s):  
Julie Gardner-Hoag ◽  
Marlena Novack ◽  
Chelsea Parlett-Pelleriti ◽  
Elizabeth Stevens ◽  
Dennis Dixon ◽  
...  

BACKGROUND Challenging behaviors are prevalent among individuals with autism spectrum disorder (ASD); however, research exploring the impact of challenging behaviors on treatment response is lacking. OBJECTIVE The purpose of the current study was to identify subtypes of ASD based on engagement in different challenging behaviors and evaluate differences in treatment response between subgroups. METHODS Retrospective data on challenging behaviors and treatment progress for 854 children with ASD were analyzed. First, participants were clustered based on eight observed challenging behaviors using k-means. Next, a multiple linear regression analysis was performed to find significant interactions between skill mastery and treatment hours, cluster assignment, and gender. RESULTS Seven diverse clusters were identified, which demonstrated a single dominant challenging behavior. For some clusters, significant differences in treatment response were found. Specifically, a cluster characterized by stereotypy was found to have significantly higher levels of skill mastery than clusters characterized by self-injurious behavior and aggression. CONCLUSIONS These findings have implications on the treatment of individuals with ASD. First, self-injurious behavior and aggression were prevalent among participants with the poorest treatment response, thus interventions targeting these challenging behaviors may be worth prioritizing. Furthermore, the use of unsupervised machine learning models to identify subtypes of ASD shows promise.


Author(s):  
Connor M. Kerns ◽  
Chandler Puhy ◽  
Chelsea M. Day ◽  
Steven J. Berkowitz

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition characterizes oppositional defiant disorder (ODD) as reflecting pervasive patterns of irritable mood, defiant behavior, and/or vindictiveness. Youth with autism spectrum disorder (ASD) exhibit high rates of disruptive behaviors commonly associated with ODD, such as noncompliance, irritability, temper tantrums, and mood dysregulation. This chapter reviews the presentation of ODD in individuals with ASD, including current prevalence estimates, proposed etiology, validated assessment methods, and emerging best practices designed to treat challenging behaviors. Although there is a robust literature describing assessment and treatment procedures for disruptive behaviors in individuals with ASD, conceptualizing these hallmark behaviors within the framework of ODD is relatively novel and not without controversy. Discussion thus includes challenges around the applicability of the diagnostic criteria in this population and future research directions that may provide clarity on this issue.


2021 ◽  
pp. 004005992110220
Author(s):  
Gretchen Scheibel ◽  
Zijie Ma ◽  
Jason C. Travers

Students with Autism Spectrum Disorder are likely to demonstrate social impairments that contribute to challenging behaviors and academic difficulties. As a result, the task of improving social communication skills is a critical component to any educational program for this population. Scripting provides an evidence-based and versatile option for improving social communication, yielding valuable results while requiring limited time and resource preparation from educators. In this article, we present step by step guidance to support practitioners in using scripting interventions. Considerations are discussed for adapting this intervention to meet the needs of students across the autism spectrum and links to resources for strengthening implementation and including other evidence-based practices.


2021 ◽  
Vol 10 (8) ◽  
pp. 1726
Author(s):  
Leonardo Zoccante ◽  
Michele Marconi ◽  
Marco Luigi Ciceri ◽  
Silvia Gagliardoni ◽  
Luigi Alberto Gozzi ◽  
...  

Equine-assisted activities and therapies (EAAT) have been suggested to improve adaptive behavior, and possibly motor function, in autism spectrum disorder (ASD). This study investigated the effects of EAAT on adaptive behavior and motor function in 15 children with ASD (13 males) aged 7–15 years as well as the impact of EAAT on the magnitude of stress in the parent–child system and the evolution in the child interaction with both the trained therapist and the therapeutic animal through the 20 weekly sessions of EAAT. EAAT were associated with greater adaptive behavior and coordination (all p ≤ 0.01) as well as a progressive improvement in the child’s abilities to respond to the increasing complexity of such form of positive behavioral support (all p < 0.001). However, EAAT did not prove to be effective in reducing parental distress. Collectively, preliminary evidence presented here may have important public health implications and gives reason to hope that EAAT could possibly be an effective option in ASD, warranting further investigation of its potential benefits in clinical trials among larger samples.


Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 96
Author(s):  
Martina Siracusano ◽  
Eugenia Segatori ◽  
Assia Riccioni ◽  
Leonardo Emberti Gialloreti ◽  
Paolo Curatolo ◽  
...  

Children with autism spectrum disorder (ASD) and their families have represented a fragile population on which the extreme circumstances of the COVID-19 outbreak may have doubly impaired. Interruption of therapeutical interventions delivered in-person and routine disruption constituted some of the main challenges they had to face. This study investigated the impact of the COVID-19 lockdown on adaptive functioning, behavioral problems, and repetitive behaviors of children with ASD. In a sample of 85 Italian ASD children (mean age 7 years old; 68 males, 17 females), through a comparison with a baseline evaluation performed during the months preceding COVID-19, we evaluated whether after the compulsory home confinement any improvement or worsening was reported by parents of ASD individuals using standardized instruments (Adaptive Behavior Assessment System (Second Edition), Achenbach Child Behavior Checklist, Repetitive Behavior Scale-Revised). No significant worsening in the adaptive functioning, problematic, and repetitive behaviors emerged after the compulsory home confinement. Within the schooler children, clinical stability was found in reference to both adaptive skills and behavioral aspects, whereas within preschoolers, a significant improvement in adaptive skills emerged and was related to the subsistence of web-delivered intervention, parental work continuance, and online support during the lockdown.


Author(s):  
Mizuho Takayanagi ◽  
Yoko Kawasaki ◽  
Mieko Shinomiya ◽  
Hoshino Hiroshi ◽  
Satoshi Okada ◽  
...  

AbstractThis study was a systematic review of research using the Wechsler Intelligence Scale for Children (WISC) with Autism Spectrum Disorder (ASD) to examine cognitive characteristics of children with ASD beyond the impact of revisions based on WISC and diagnostic criteria changes. The classic “islets of ability” was found in individuals with full-scale IQs < 100. The “right-descending profiles” were observed among high IQ score individuals. High levels on the Block Design and low Coding levels were consistently found regardless of the variation in intellectual functioning or diagnosis. This review identified patterns of cognitive characteristics in ASD individuals using empirical data that researchers may have previously been aware of, based on their experiences, owing to the increased prevalence of ASD.


Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 898-906 ◽  
Author(s):  
Brenna B Maddox ◽  
Patrick Cleary ◽  
Emily S Kuschner ◽  
Judith S Miller ◽  
Anna Chelsea Armour ◽  
...  

Many children with autism spectrum disorder display challenging behaviors. These behaviors are not limited to those with cognitive and/or language impairments. The Collaborative and Proactive Solutions framework proposes that challenging behaviors result from an incompatibility between environmental demands and a child’s “lagging skills.” The primary Collaborative and Proactive Solutions lagging skills—executive function, emotion regulation, language, and social skills—are often areas of weakness for individuals with autism spectrum disorder. The purpose of this study was to evaluate whether these lagging skills are associated with challenging behaviors in youth with autism spectrum disorder without intellectual disability. Parents of 182 youth with autism spectrum disorder (6–15 years) completed measures of their children’s challenging behaviors, executive function, language, emotion regulation, and social skills. We tested whether the Collaborative and Proactive Solutions lagging skills predicted challenging behaviors using multiple linear regression. The Collaborative and Proactive Solutions lagging skills explained significant variance in participants’ challenging behaviors. The Depression (emotion regulation), Inhibit (executive function), and Sameness (executive function) scales emerged as significant predictors. Impairments in emotion regulation and executive function may contribute substantially to aggressive and oppositional behaviors in school-age youth with autism spectrum disorder without intellectual disability. Treatment for challenging behaviors in this group may consider targeting the incompatibility between environmental demands and a child’s lagging skills.


2016 ◽  
pp. 397-418 ◽  
Author(s):  
Zhi Zheng ◽  
Esubalew Bekele ◽  
Amy Swanson ◽  
Amy Weitlauf ◽  
Zachary Warren ◽  
...  

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