Examining Trajectories of Daily Living Skills over the Preschool Years for Children with Autism Spectrum Disorder.

Preschool children with autism spectrum disorder (ASD) experience slower development of daily living skills (DLS) that are essential for independent functioning compared to typically developing children. Few studies have examined the trajectories of DLS in preschoolers with ASD and the existing literature has reported conflicting results. This study examined DLS trajectories and potential covariates for preschoolers with ASD from a multi-site longitudinal study following children from diagnosis to the end of grade 1. Multi-level modeling was conducted with DLS domain scores from the Vineland Adaptive Behavior Scales-2. The results demonstrated a positive trajectory of increasing scores over time, associations of age of diagnosis, developmental level, stereotypy, and language skills with the mean score at T4 or age 6 years, whereas rate of change was only associated with ASD symptom severity, such that an improvement in DLS trajectory was associated with lower and improving ASD symptom severity.

Service utilization in a sample of preschool children with autism spectrum disorder: A Canadian snapshot.

OBJECTIVE: To describe services received by preschool children diagnosed with autism spectrum disorder (ASD) during the five-year period following their diagnosis. METHOD: An inception cohort of preschoolers diagnosed with ASD from Halifax (Nova Scotia), Montreal (Quebec), Hamilton (Ontario), Edmonton (Alberta) and Vancouver (British Columbia) were invited to participate. Parents/caregivers (n=414) described the services provided to their children at four time points: baseline (T1; within four months of diagnosis; mean age three years); six months later (T2); 12 months later (T3); and at school entry (T4). Data were first coded into 11 service types and subsequently combined into four broader categories (no services, behavioural, developmental and general) for analysis. RESULTS: More than 80% of children at T1, and almost 95% at T4 received some type of service, with a significant number receiving >1 type of service at each assessment point. At T1, the most common service was developmental (eg, speech-language therapy). Subsequently, the most common services were a combination of behavioural and developmental (eg, intensive therapy based on applied behaviour analysis and speech-language therapy). Service provision varied across provinces and over time. DISCUSSION: Although most preschool children with ASD residing in urban centres were able to access specialized services shortly after diagnosis, marked variation in services across provinces remains a concern.

OBJECTIF: Décrire les services qu'ont reçus des enfants d'âge préscolaire ayant un trouble du spectre autistique (TSA) pendant la période de cinq ans suivant leur diagnostic. MÉTHODOLOGIE: Une cohorte initiale d'enfants d'âge préscolaire ayant un TSA diagnostiqué et qui provenaient de Halifax (Nouvelle-Écosse), de Montréal (Québec), de Hamilton (Ontario), d'Edmonton (Alberta) ou de Vancouver (Colombie-Britannique) a été invitée à participer à l'étude. Les parents et les tuteurs (n=414) ont décrit les services fournis à leur enfant à quatre moments : au début (T1; dans les quatre mois suivant le diagnostic, âge moyen de trois ans); six mois plus tard (T2); 12 mois plus tard (T3) et à l'entrée à l'école (T4). Les chercheurs ont d'abord codé les données en 11 types de services, pour ensuite les regrouper en quatre catégories plus vastes (absence de services, comportementaux, développementaux et généraux) en vue de leur analyse. RÉSULTATS: Plus de 80 % des enfants ont reçu certains services à T1, et près de 95 % à T4, et un nombre significatif a reçu plus d'un type de services à chaque évaluation. À T1, le service le plus courant était de type développemental (p. ex., orthophonie). Par la suite, les services les plus courants étaient un mélange de services comportementaux et développementaux (p. ex., thérapie intensive selon l'analyse de comportement appliquée et orthophonie). La prestation des services variait selon les provinces et au fil du temps. EXPOSÉ: Même si la plupart des enfants d'âge préscolaire ayant un TSA qui habitaient dans un centre urbain avaient accès à des services spécialisés peu après le diagnostic, les variations marquées des services entre les provinces demeurent préoccupantes.

Language impairment and early social competence in preschoolers with autism spectrum disorders: a comparison of DSM-5 profiles.

Children with autism spectrum disorder (ASD) and structural language impairment (LI) may be at risk of more adverse social-developmental outcomes. We examined trajectories of early social competence (using the Vineland-II) in 330 children aged 2-4 years recently diagnosed with ASD, and compared 3 subgroups classified by: language impairment (ASD/LI); intellectual disability (ASD/ID) and ASD without LI or ID (ASD/alone). Children with ASD/LI were significantly more socially impaired at baseline than the ASD/alone subgroup, and less impaired than those with ASD/ID. Growth in social competence was significantly slower for the ASD/ID group. Many preschool-aged children with ASD/LI at time of diagnosis resembled "late talkers" who appeared to catch up linguistically. Children with ASD/ID were more severely impaired and continued to lag further behind.

Cognitive scripts in autistic children and adolescents.

People normally rely on cognitive scripts to structure social interaction. As the dysfunctional social behavior of people with autism extends to situations that are commonly scripted, one wonders whether a partial explanation might be either absent or deficient scriptal representations. Twenty-four relatively high-functioning subjects with autism were compared to typically developing children who had been selected to be similar to the autistic subjects in terms of nonverbal mental age and language level. All subjects were presented with a series of three tasks designed to assess the presence of cognitive social scripts. Results indicated that basic scriptal knowledge was intact but that reliable differences in expressive language persisted.

Neologisms and idiosyncratic language in autistic speakers.

Language samples from matched groups of 80 autistic, mentally handicapped, and normally developing children were coded for the presence of neologisms and/or idiosyncratic language use. Cognitive, social, or linguistic factors that might account for these errors were identified and assessed. More autistic subjects used neologisms and idiosyncratic language than age- and language skill-matched control groups. No single factor or combination of factors was responsible for this difference. Across diagnostic groups, similar patterns of error were noted, except that the autistic subjects were more likely to use words inappropriately that had no phonological or semantic similarity to the intended English word. For the autistic groups, the frequency of idiosyncratic language increased with language complexity. In contrast, such errors decreased with language skill in the mentally handicapped group. Theoretical implications for determining the nature and source of the language disorder associated with autism are discussed.

Flunisolide nasal spray compared to beclomethasone dipropionate in the treatment of seasonal rhinitis.

Forty-seven informed out-patients with the diagnosis seasonal rhinitis of at least two years' duration took part in a controlled single blind, double observer, parallel four-center study for the purpose to compare efficacy and tolerance of two local corticosteroid nasal sprays: flunisolide 25 micrograms/dose and beclomethasone 50 micrograms/dose. The patients received for four weeks one of the two treatments; flunisolide 50 micrograms in each nostril twice daily or beclomethasone dipropionate 50 micrograms in each nostril four times daily. The study was conducted under the Declaration of Helsinki. Patients were assessed on admission and after two and four weeks. All patients completed the trial. The results showed that both drugs are highly effective in controlling nasal rhinitis symptoms, 21 out of 24 flunisolide treated patients and 21 out of 23 beclomethasone treated stated good to total control after four weeks' treatment during the pollen season. No statistical difference between the two could be discovered in any of the parameters measured. The only side effect recorded was mild transistory stinging in connection with application of the two different sprays. This occurred in a few patients in both groups. The results from the study indicate that the new corticosteroid flunisolide in a dose of 100 micrograms X 2 is comparable to beclomethasone dipropionate 100 micrograms X 4 concerning efficacy and tolerance in prophylactic treatment of seasonal rhinitis.