Efficacy of a Parent-Implemented Pivotal Response Treatment for Children with Autism Spectrum Disorder.

PURPOSE: Pivotal response treatment (PRT) is a well-established intervention addressing core symptoms of autism spectrum disorder (ASD), with parent involvement as a key component. The current study aimed to examine the effects of PRT parent training on parent fidelity and provide descriptive analyses of parent-child interactions before and after parent training. It also probed parental acceptance and satisfaction with the program. METHODS: A concurrent multiple baseline design across participants was used to evaluate the effectiveness of the parent training program. Four parents (range 32-47 years old) and their children with ASD participated in the study. The intervention comprised 12 one-on-one parent training sessions over six consecutive weeks. The visual analysis and effect size calculation (Tau-U) were used to evaluate functional relationship between independent and dependent variables. The descriptive analysis was used to analyze parent-child interaction data. RESULTS: The findings reveal that all parents learned and maintained PRT with a high level of fidelity, they also enhanced awareness to create more opportunities for interactions during free play, and the parents were very satisfied with the program. The results also indicate that the six-week parent training program is effective in teaching parents to implement PRT with their children. CONCLUSION: These results suggest that the parent training program may be a promising treatment model that is effective, efficient, and cost-effective. Implications for future research and practice are then discussed.

How parents of children with autism spectrum disorder experience the COVID-19 pandemic: Perspectives and insights on the new normal.

BACKGROUND: Considering the fact that family members necessarily spend more time together during the pandemic, this study aims to reveal the perceptions of parents with children who have autism spectrum disorder of the COVID-19 pandemic in Turkey and their experiences of the difficulties during the pandemic. METHOD: A qualitative phenomenology design was used in the study. Seven mothers and one father gave their consent and participated in the study. Data were collected through semi-structured interviews and analyzed using content analysis. RESULTS: The results of the analysis were collected in two broad themes using 68 codes. The perspective of the parents, who evaluated the pandemic process positively in the beginning, became negative as lockdown lengthened. The issues and adverse effects of the pandemic that they most talked about were the increasing roles and responsibilities of parents, the deep impact on their mental health, and the problems experienced in distance education. CONCLUSIONS: During this period, parents who were psychologically depressed wanted to feel that they were not alone. Parents made many suggestions and recommendations so that others would not have the same experience.

The Efficacy of Pivotal Response Treatment in Teaching Question-Asking Initiations to Young Turkish Children with Autism Spectrum Disorder.

In the present study, a concurrent multiple baseline design across participants was used to evaluate the efficacy of pivotal response treatment (PRT) on the acquisition, maintenance, and generalization of the question-asking initiations by four children with autism spectrum disorder (ASD). The researchers also examined whether the implementation of PRT resulted in collateral changes in language development and other areas of development. The results of this study indicate that PRT is highly effective in teaching question-asking initiations. Participating children with ASD were able to generalize in natural settings and maintain long-term question-asking initiations. Furthermore, PRT resulted in positive collateral changes in language and other areas of development. Implications for future research and practice are then discussed.

The role of upper airway morphology in apnea versus hypopnea predominant obstructive sleep apnea patients: an exploratory study.

OBJECTIVE: The objective of this study was to investigate the association between upper airway morphology and apnea vs hypopnea predominance in patients with obstructive sleep apnea (OSA) syndrome. METHODS: A retrospective study on consecutively CT scans obtained from 54 OSA patients and 53 non-snoring controls. CT scans were measured to evaluate upper airway and surrounding structures' morphologic characteristics. OSA patients (matched for age, gender and body mass index) compared as two groups; apneic group: apnea ratio >50% and hypopneic group: hypopnea ratio >50%. Morphologic characteristics were analyzed using Kruskal-Wallis test and Pearson's correlation test. RESULTS: Apneic group (17 patients) showed 76.56% apnea rate and hypopneic group (37 patients) showed 78.46% hypopnea rate. Minimal lateral and anteroposterior dimensions of velopharynx in the apneic group (0.86 ± 0.73 and 0.21 ± 0.13 cm, respectively) was statistically lesser from that of the hypopneic group (1.2 ± 0.42 and 0.54 ± 0.22 cm, respectively). Minimum cross-sectional area of the velopharynx was also lesser in apneic group (0.21 ± 0.16 cm2) than that in hypopneic group (0.65 ± 0.38 cm2). Almost all upper airway parameters in both apneic and hypopneic groups were tended to be smaller than in controls. CONCLUSION: Decrease in airway volume does not signify the type of respiratory event, but significant narrowing of velopharynx in both dimensions; thus having the narrowest value below a certain level causes more apnea. Advances in knowledge: We did not find a similar study when we did a literature search, showing the relationship of apnea vs hypopnea predominance and upper airway parameters in CT in patients with OSA.

Evaluation of effects of anterior palatoplasty operation on upper airway parameters in computed tomography in patients with pure snoring and obstructive sleep apnea syndrome.

AIM: To investigate changes in upper airway volume parameters measured by computerized tomography scans in patients with surgically treated by anterior palatoplasty of whom having pure snoring and mild-moderate obstructive sleep apnea. METHOD: A prospective study on consecutively anterior palatoplasty performed pure snoring and obstructive sleep apnea patients. Computerized tomography scans were obtained preoperatively and following anterior palatoplasty procedure to measure changes in upper airway volume. Patients underwent diagnostic drug induced sleep endoscopy to assess the site of obstruction. Preoperative and postoperative measurements were compared using student's t test and Chi-square test. RESULTS: Twenty-two patients (16 men and 6 women, age 48.22 ± 9.23, body mass index 25.85 ± 2.57) completed the trial. Anterior palatoplasty was associated with an increase in total upper airway volume from 4.81 ± 1.73 cm3 before treatment to 6.57 ± 2.03 cm3 after treatment (p < 0.005). Change in soft palate thickness did not vary significantly (p < 0.039). The mean soft palate length has changed from 4.13 ± 0.41 to 3.93 ± 0.51 cm (p < 0.001). The preoperative and postoperative measurements of cross-sectional areas and volumes all showed significant difference except velopharynx minimal lateral airway dimension. The operational procedure increased the total upper airway volume much more in men than in women (p < 0.05). CONCLUSION: Results of this study indicate that anterior palatoplasty operation appears to produce significant increase in upper airway volume and cross sectional area. It does not seem to have an effect on lateral airway dimension. Computerized tomography is a quick and noninvasive imaging technique that allows for quantitative assessment of the velopharyngeal patency changes.