A Study of Ladder Model Conversation Training Strategy to Improve the Conversation Ability of Children with Autism / 听力学及言语疾病杂志

Objective To study the intervention effect of Ladder Model conversation training strategy on im-proving the conversation skills of children with autism.Methods A multi-probe design across participants was a-dopted to examine the intervention effectiveness of the strategy on two 7～8 year old autistic children.Intervention lasted for 4 weeks for subjuct A and 3 weeks for subject B.Thirty-five minutes each time,three times a week.The number and type of conversation initiation,maintenance and interruption were evaluated in the baseline period,in-tervention period,maintenance period and generalization period.The overlap rate and simplified time-series analysis were used to evaluate the outcome.Results The number of conversation initiation of subject A(overlap rate 8.33％,C=0.89,P＜0.01)and subject B(overlap rate 20％,C=0.83,P＜0.01)was significantly higher in in-tervention periods than that in baseline,but no significant difference was observed between the other adjacent peri-ods.The number of conversation maintenance of subject A(overlap rate 0％,C=0.89,P＜0.01)and subject B(o-verlap rate 10％,C=0.91,P＜0.01)was significantly higher in intervention periods than that in baseline,but no significant difference was found between the other adjacent periods.The type of conversation initiation and mainte-nance that subjects improved were mainly in verbal forms.The main type of interruption was"unexplained re-sponse",the proportion of interruption decreased obviously after intervention.Conclusion The strategy has posi-tive effect on improving conversation initiation and maintenance of children with autism,and reducing the proportion of interruption.

Burden of care perceived by the principal caregivers of autistic children and adolescents visiting health facilities in Lucknow City

Background: Autism is extraordinarily difficult for families to cope with for various reasons. Perceived burden and care for the child with autism, available forms of social support, and the interactions between the autistic child and other family members are areas of significant concern for families. Objective: The objective of this study was to determine the burden of care perceived by the principal caregivers of autistic children or adolescent visiting health facilities in Lucknow city. Methods: The cross-sectional study was conducted from October 2016 to September 2017 with a sample of 90 principal caregivers (aged <60 years) of autistic children and adolescents aged 3–19 years and diagnosed with autism, attending government and private health facilities providing treatment for autism in Lucknow, Uttar Pradesh, India. Validated tools were used to assess the burden of care and disability level of autistic children. Data were analyzed using the software SPSS version 16. Results: The caregivers of autistic children and adolescents perceived the burden of care in different domains in varying extent with “caregiver's routine” and “taking responsibility” domains affected the most. The burden perceived was found to be affected by the permanent residence of caregiver, rural/urban dwelling, type of family, socioeconomic status, age at which diagnosis was made, knowledge about autism and the severity of autism. Conclusions: Availability and easy accessibility of autism treatment facilities must be the most probable reason for less burden perceived in three domains, by caregivers of urban settings and those belonging to Lucknow. Furthermore, better knowledge on autism and family and friends' support led to decrease in the burden perceived by the caregivers in various domains. Thus, it was found that the burden perceived can be reduced by universal availability of evidence-based early diagnosis and treatment of autism and improving the knowledge of caregivers about autism.

Evaluation of Early Start and One to One Based Intervention for Preschool Autistic Children

Background: There is an increasing recognition ofeffectiveness of one to one intervention for autistic childrenbefore age of 6 years old. Our objective was to explore theimportance of early detection and early intervention by one toone maneuver.Methods: We studied 100 children aged divided into twogroups of children, each group composed of 50 autisticchildren. The first group aged 22months- 6years old and hadreceived 15-20 hours a week of the intervention – one to onesessions of comprehensive early intervention program, whilethat of the second group aged 6 – 12 years old and werealready receiving group -based programs of intervention.Autism spectrum disorder was diagnosed clinically by DSM-Vthen participants were assessed before and after interventionby CARS-2-ST and by Vineland Adaptive Behaviours Scales–Second Edition (VABS-II) that was conducted by a licensedpsychologist.Results: As regard the first group Statistically significant postintervention improvements were found in children’sperformance on their overall intellectual functioning andsignificant increases in their child’s communication,socialization, daily living skills and motor skills on the VABS-II,and a significant decrease in autism-specific features on theCARS scale. Nonetheless, these results are different from thesecond group as showed mild improvement statistically nonsignificant.Conclusion: Our results in children indicated a significantrelationship between early intervention of one to one sessionsand prominent improvement. However, the late intervention bygroup based session’s revealed unapparent improvement.

Impacts of having Children with Autism in Malay Family of Indonesia

Background: Having an autistic child and living together may not be easy for the affected families. The families may experience and face various effects when caring for their autistic children, both physically and psychologically. This study aimed to describe the impacts of having children with autism experienced by Malay family in West Kalimantan Indonesia.Methods: This ethnography study employed participant observations, focus group discussions, and in-depth interviews to gather the data from 20 Malay families who have autistic children who were selected using a purposive sampling technique. The families served as the key informants comprising fathers, mothers, siblings, grandmothers, and grandfathers. The data collected through the three techniques were then analyzed using thematic analysis.Results: The findings of this study generated five impacts categorized into themes consisting of (1) stress on main caregivers; (2) financial problem; (3) impact on employment; (4) impact on family or marital relationship; and (5) positive impact of having autistic children.Conclusions: Families with autistic children have a high risk of experiencing physical, psychological, and social problems. Thus, to improve the quality of family health, nurses, and health workers need to teach the family how to manage stress properly. They may also need to provide counseling to primary caregivers by making a deep hearing of their concerns

Study on the relationship between serum oxytocin levels and social competence in children with autism / 重庆医学

Objective To explore the difference of serum oxytocin levels between autistic children and healthy children at the age of 3-5,and the relationship between serum oxytocin levels and social competence in children with autism.Methods Twenty-five autistic children and twenty healthy children were tested by an enzyme-linked immunosorbent assay to evaluate the oxytocin levels;the SRS was used to evaluate social competence of children with autism.Results Mann-Whitney test showed there were significantly differences in oxytocin level between autistic children and healthy children(P<0.05).The social competence of autistic children was negatively correlated to oxytocin levels(r=-0.735,P<0.01).Multiple liner regression analyses showed that oxytocin level was an impact factor of the social competence of autistic children(F=11.931,P<0.01).Conclusion This study indicates that the serum oxytocin level maybe a factor which influence the social competence of autistic children.

Um estudo sobre o brincar de crianças autistas na perspectiva histórico-cultural / A study about play behavior of autistic children from the historical-cultural perspective / Un estudio sobre la actividad de jugar de niños autistas en perspectiva histórico-cultural

O brincar de crianças autistas é descrito como muito restrito e peculiar. Com a preocupação pela busca de práticas educativas promissoras, a presente pesquisa tomou como referência a teoria histórico-cultural e teve o objetivo de analisar os modos como crianças autistas se orientam para o outro e para o objeto durante a atividade lúdica. O estudo focalizou três sujeitos, com idade de seis a doze anos, durante sessões de brincadeira coordenadas pela primeira autora, que interagia com as crianças atribuindo significado às suas ações e ao uso de brinquedos, e encorajava a emergência de jogos imaginativos. Os dados foram organizados sob dois temas: modos de brincar das crianças e modos de atuação do adulto. Os achados indicam que a mediação da pesquisadora propiciou a ocorrência de muitos momentos de orientação para o outro e de uso contextualizado de objetos, incluindo ações do jogo de papéis.

Play behavior of autistic children is described as very restricted and peculiar. Concerned with the search for promising educational practices, we use historical-cultural theory to analyze the ways through which autistic children orient themselves towards others and objects in situations of play. The study focuses on three subjects, aged between six and twelve years, during play sessions. These sessions were coordinated by the first author, who ascribed meaning to the children's actions and use of toys, and encouraged the emergence of imaginative play. Data were organized under two topics: children's modes of playing and adult's modes of participation. The findings suggest that the researcher's mediation allowed for the occurrence of many instances of orientation towards the other as well as moments of contextualized use of objects, including actions of role play.

La actividad de jugar de niños autistas se describe como muy restricta y peculiar. A partir de la preocupación con la busca de prácticas educativas promisoras la presente investigación tomó como referencia la teoría histórico-cultural y tuvo el objetivo de analizar los modos como niños autistas se orientan para el otro y para el objeto durante la actividad lúdica. El estudio se realizó con tres sujetos con edades entre seis a doce años, durante sesiones de juego coordinadas por la primera autora que interactuaba con los niños atribuyendo significado a sus acciones y al uso de juguetes, incentivando juegos imaginativos. Se organizaron los datos en dos temas: modos de jugar de los niños y modos de actuar del adulto. Los resultados indican que la mediación de la investigadora permitió acontecer muchos momentos de orientación para el otro y el uso contextualizado de objetos, incluyendo acciones del juego de roles.

Molecular Genetic Study for FMR-1 Gene in Autistic Children / 신경정신의학

OBJECTIVES: To elucidate an association of the fragile X syndrome with autism, Southern blot analysis was performed in 66 autistic children aged from 2 years to 11 years. METHODS: Subjects were 66 autistic children with of autistic disorder diagnosed by DSM-IV criteria and Childhood Autism Rating Scale-Korean version. Genomic DNA was extracted from peripheral blood and DNA was used to detect a FMR (Fragile Mental Retardation)-1 gene. Xho/PstI probes and two restriction enzymes (EcoRI, EagI)were used for Southern blot analysis. RESULTS: There were one boy with a methylated mosaic pattern and 3 boys and 2 girls with an unmethylated premutation band. But there was no full mutation pattern. CONCLUSION: Although the possibility of the relationship between autistic disorder and FMR-1 gene has been suggested, the results from this study do not provide any definite association of FMR-1 gene with autism in autistic children.