Working Memory Training in Youth With Autism, Fragile X, and Intellectual Disability: A Pilot Study.

This pilot study sought to identify potential markers of improvement from pre-post treatment in response to computerized working memory (WM) training for youth (ages 8-18) with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) in a single arm, pre-post design. Participants included 26 children with ASD and 18 with comorbid ASD and fragile X syndrome (ASD+FXS). Analyses were adjusted for age and IQ. The ASD group demonstrated greater improvement on WM training relative to the ASD+FXS group. Participants improved on WM and far transfer outcomes, however, there were no significant group differences in improvement except for repetitive behavior. Higher hyperactivity/impulsivity ratings predicted lower performance on visuospatial WM. Findings suggest cognitive training may be beneficial for youth with ASD and ID, warranting further exploration.

Psychosocial resilience among left-behind adolescents in rural Thailand: A qualitative exploration.

When parents migrate, they often leave children behind with relatives. Despite being at higher risk of socio-emotional problems, many left-behind children have good health and social outcomes, suggesting their resilience. We sought to understand how adolescents with internal and international migrant parents build resilience in Thailand. We conducted qualitative interviews with 24 adolescents aged 10-19, and six caregivers, parents and community leaders. Interviews were transcribed, translated and analysed, drawing on techniques from grounded theory. We found that resilience was built in a context where for many families, migration was a financial necessity and the parent-child relationship was mainly phone-based. Adolescents built resilience using three key 'resources': warmth (love and understanding), financial support and guidance. Adolescents with insecure parent or caregiver relationships, or with caring responsibilities for relatives, were less likely to have access to these resources. These adolescents sought emotional and financial independence, prioritised friendships and identified role models to obtain key resources and build resilience. The findings indicate practical and psychosocial barriers to building resilience among left-behind adolescents in Thailand. Further work could explore pathways to mental illness in this population, interventions that build peer networks and caregiver-child relationships and the use of technology to support remote parenting.

Computerized Cognitive Training in Children With Autism and Intellectual Disabilities: Feasibility and Satisfaction Study.

BACKGROUND: Researchers are increasingly interested in testing and developing computerized cognitive training interventions for individuals with autism spectrum disorder due to the limited accessibility of treatments for this disorder. Understanding the feasibility of testing cognitive interventions for this population is critical, especially for individuals with ASD who have low to moderate intellectual ability. OBJECTIVE: The aim of the study was to evaluate the feasibility of computerized cognitive training as measured by attrition rate and a parent satisfaction survey. METHODS: A total of 26 participants aged 8-17 years with an autism spectrum disorder diagnosis and significant intellectual impairment were enrolled (mean age 11.1 years). They were instructed to complete 25 sessions of Cogmed Working Memory Training in 5 to 6 weeks with coach assistance. Attrition rate and parent satisfaction surveys were measured after the completion of training. RESULTS: Most participants (96%, 25/26) completed the training and indicated high satisfaction (>88%). However, among the participants who completed the training, 5 participants (19%) were unable to finish in 6 weeks, the recommended training period by Cogmed. Parents noted various positive (eg, voice-overs) and negative (eg, particular graphic and sounds associated with a stimulus) features of the game that they thought affected their child's response. CONCLUSIONS: Children with autism spectrum disorder and intellectual impairments can successfully participate in computerized cognitive training interventions but may require additional weeks to complete the training beyond the time needed for children without intellectual impairments. The overall completion rate, with extended time to complete the training, was high. Developers of cognitive training programs for this population should take into account potential issues regarding the noise level of stimuli and characteristics of the visual graphics.

Current State and Model for Development of Technology-Based Care for Attention Deficit Hyperactivity Disorder.

INTRODUCTION: Care (i.e., evaluation and intervention) delivered through technology is used in many areas of mental health services, including for persons with attention deficit hyperactivity disorder (ADHD). Technology can facilitate care for individuals with ADHD, their parents, and their care providers. The adoption of technological tools for ADHD care requires evidence-based studies to support the transition from development to integration into use in the home, school, or work for persons with the disorder. The initial phase, which is development of technological tools, has begun in earnest; however, the evidence base for many of these tools is lacking. In some instances, the uptake of a piece of technology into home use or clinical practice may be further along than the research to support its use. METHODS: In this study, we review the current evidence regarding technology for ADHD and also propose a model to evaluate the support for other tools that have yet to be tested. RESULTS: We propose using the Research Domain Criteria as a framework for evaluating the tools' relationships to dimensions related to ADHD. CONCLUSION: This article concludes with recommendations for testing new tools that may have promise in improving the evaluation or treatment of persons with ADHD.

Implementing Telepsychiatry in Thailand Benefits and Challenges.

In many developed countries, telepsychiatry has become facilitating technology in mental health care system especially in underserved areas. In a developing country like Thailand, telepsychiatry is a novel technology in which mental health care personnel should understand both administrative and clinical issues. In this article, the author has reviewed benefits and challenges of implementing telepsychiatry in Thailand. Benefits of telepsychiatry include reducing costs, improving accessibility and reducing psychiatric stigmas while challenges can be classified as man, machine and environment challenges. The author concludes that telepsychiatry in Thailand needs further studies, especially in feasibility and cost-efficiency domains in the hope that this technology will improve quality of mental health care in near future.