FEAT DAILY NEWSLETTER
Sacramento, California http://www.feat.org
January 9, 2002
News Morgue Search www.feat.org/search/news.asp
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A Shot In The Arm
·
Outcome Of Early Intensive ABA For ASD Kids In A
·
Predictors of Treatment Outcome In ASD Kids:
·
Increasing Joint Attention, Play & Language
·
The Scottish Centre for Autism Preschool Treatment
·
Predicting Spoken Language Level In ASD Children
·
Classical Eyeblink Conditioning: Clinical Models
·
Use of Multimedia & Therapist-Instructed Training
For
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Use of Multimedia & Therapist-Instructed Training
For ASD Kids
A Shot In The Arm
Sarah Boseley
There are likely to be outbreaks of measles because the MMR
scare means fewer children are being vaccinated. But does that really matter?
[By Sarah Boseley in The Guardian .]
http://www.guardian.co.uk/analysis/story/0,3604,629666,00.html
Outbreaks of measles are once again possible because
parental anxiety about MMR means more and more children are not being
vaccinated. Does it really matter? Measles was once a fact of life, as much a
part of childhood as rocking horses and climbing trees.
Many people will have had it when they were less than five
years old. Measles parties are part of
our folk lore. Some parents used to take their small children to houses where
there was measles, or for that matter chicken pox, with the idea of catching
hopefully a mild dose and becoming immune for life.
What few remember is that measles is a killer - because
the death rate in the UK was always low, so the chances of knowing a family
that had lost a child to measles were small. In 1980, 18 children under the age
of four died of measles and five over that age. It was a bad year. In most of
that decade, the total number of deaths per year did not exceed 10. Yet this
was after the introduction of the single measles vaccination which was introduced
in 1968. Before there was any immunisation available, there were between
160,000 and 800,000 cases of measles annually in the UK. In an epidemic year -
because measles, left to itself, tends to be cyclical - it would cause more
than 100 deaths.
The virus, which is incredibly infectious, kept children
in bed for about five days with fever, rash, a cough, red and painful eyes,
swollen glands and a loss of appetite. One in 100 had to be admitted to
hospital, one in 20 got an ear infection, one in 200 went into convulsions and
one in a thousand ended up with meningitis or encephalitis. The most
unfortunate - one in 8,000 - got SSPE (subacute sclerosing panencephalitis)
which would set in about eight years after their measles bout, causing brain
damage and eventually early death. There are still deaths from measles in the
UK - but they are all due to SSPE in children who contracted measles as a child
before the MMR came in.
In spite of the unpleasant and sometimes tragic
consequences of measles, the take-up of the single vaccine after 1968 was low -
perhaps because the disease was so common and such a predictable childhood
event which in the majority passed with no ill-effects. But the low take-up troubled
public health officials who were aware as most of the general public would not
have been at that time that children in the UK were unnecessarily dying. It was
one of the reasons why the combined measles, mumps and rubella (MMR)
vaccination was introduced two decades later, in 1988.
Mumps is not a killer although it can have damaging
consequences such as deafness and can lead to meningitis. However, rubella,
also known as German measles, is a disaster for pregnant women, whose babies
can be born deaf, blind, brain damaged or with heart or other serious problems.
Adolesce nt girls used to be vaccinated in schools. The decision was taken to
put the vaccines together and work for the immunity of the entire population
from all three diseases. The population was at first persuaded. Take-up of the first
dose of MMR at around 15 months (to be followed by a pre-school booster) hit a
high of 92% in the mid-1990s. But the controversial work of Andrew Wakefield
and colleagues of the Royal Free Hospital Inflammatory Bowel Disease Study
Group, published in the Lancet in 1998, has undermined public confidence.
Coverage has now dropped to 84.2% nationally, according to the latest figures
from the Public Health Laboratory Service from April-June last year. There are
patches of the country which are far worse.
North Cheshire made headlines a few days ago by publishing a figure of
77%, but in London, take-up has hit an all-time low of 72.3%.
The World Health Organisation says only 95% coverage will
ensure there are no outbreaks. The UK is not facing a major epidemic of the
pre-1968 scale because most parts have above 80% coverage, but it is more than possible
that there will be localised outbreaks. The belief that measles is a minor
ailment which children are better off catching and getting over never quite
went away and tends now to be aired again by many who are frightened that the
MMR may damage their child. Dr Wakefield, who led the research into a possible
link between the vaccination, bowel disease and autism (in fact the Lancet
paper conceded that no link had been found) has recently left the Royal Free.
Scientific institutions on both sides of the Atlantic have
produced vast numbers of safety studies of the vaccines and analyses of
Wakefield’s work and invariably concluded that the measles vaccine - whether
live or in attenuated form in an injection - is not responsible for the sharp
rise in autism which has undoubtedly and worryingly occurred in the UK and the
US.
Nobody has managed to prove to the satisfaction of the
scientific community that the measles virus has been found in the gut of
children with either bowel disease or autism. But in spite of the mountain of
scientific data and opinion backing the safety of the MMR - the latest being a
paper in the prestigious American journal, Paediatrics, which says a child’s
immune system could cope with 10,000 vaccines at one time if it had to - the figures
show a continuing loss of confidence on the part of parents.
Public health officials fear we could see sudden deaths
once more from measles. Their assessment is categorically that the risk of the
deaths of even a few children outweighs any risk from the MMR. It may not be
until deaths start to occur once more - and these days they would soon be
common knowledge - that the pendulum will swing back and vaccination rates rise
once more.
·
Sarah Boseley is the Guardian’s health editor.
* * *
Outcome Of Early Intensive ABA For ASD Kids In A Community
Set
Outcome survey of early intensive behavioral intervention
for young children
with autism in a community setting
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11777258&dopt=Abstract <- - address ends here.
Boyd RD, Corley MJ.
Golden Gate Regional Center, San Francisco, CA, USA.
This article presents findings from an outcome survey of
the effects of early intensive behavioral intervention (EIBI) for young
children with autism in a community setting. Results from both individual case
reviews and parent questionnaires are presented, with the data failing to
support any instances of’recovery’ while still yielding a high degree of
parental satisfaction with the treatment.
Moreover, a follow-up inquiry into the type of services
each child was receiving in his or her post-EIBI setting documents continued
dependence on extensive educational and related developmental services,
suggesting that the promise of future treatment sparing did not materialize.
Limitations of the survey in evaluating community-based EIBI services are
discussed along with the need for further research designed to document the
effectiveness of services provided to young children with ASD in the community.
PMID: 11777258 [PubMed - in process]
* * *
Predictors of Treatment Outcome In ASD Kids: Retrospective
Study
Predictors of treatment outcome in young children with
autism: a
retrospective study
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11777257&dopt=Abstract <- - address ends here.
Gabriels RL, Hill DE, Pierce RA, Rogers SJ, Wehner B.
University of Colorado Health Sciences, Denver 80262, USA.
This study examined predictors of developmental outcomes
in 17 children diagnosed with autism or PDD-NOS, who received generic treatment
over a mean period of 37 months. Pre-treatment evaluations occurred at a mean
age of 31 months with follow-up evaluations at a mean age of 69 months. Significantly different developmental
trajectories were observed among the participants at follow-up, separating the
participants into two distinct groups (high and low outcome).
However, groups did not differ significantly in treatment
intensity or other outcome prediction measures. Pre-treatment developmental
intelligence levels between the two groups approached significance. The results
raise questions regarding the effect of treatment intensity and type, family stress
factors, and intelligence ability in very early childhood on, outcome.
PMID: 11777257 [PubMed - in process]
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* * *
Increasing Joint Attention, Play & Language Via Peer
Play
Increasing joint attention, play and language through peer
supported play
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11777255&dopt=Abstract <- - address ends here.
Zercher C, Hunt P, Schuler A, Webster J.
San Francisco State University, CA, USA. craig.zercher@sri.com
The purpose of the present study was to examine the
effects of participation in an integrated play group on the joint attention,
symbolic play and language behavior of two young boys with autism. Two
6-year-old twin brothers participated in this study, along with three typically
developing girls, ages 5, 9 and 11. A multiple baseline design was used with three
phases: no intervention, intervention with adult coaching, and intervention
without adult coaching.
After being trained, the three typically developing
children implemented the integrated play group techniques in 30 minute weekly
play group sessions for over 16 weeks. Results indicate that participation in
the integrated play group produced dramatic increases in shared attention to objects,
symbolic play acts, and verbal utterances on the part of the participants with
autism. These increases were maintained when adult support was withdrawn.
Implications of these findings for inclusion of children with autism are
discussed.
PMID: 11777255 [PubMed - in process]
* * *
The Scottish Centre for Autism Preschool Treatment
Programme I:
A developmental approach to early intervention. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11777254&dopt=Abstract <- - address ends here.
<- - address ends here.
Salt J, Sellars V, Shemilt J, Boyd S, Coulson T,
McCool S.
Scottish Centre for Autism, Department of Child and
Family Psychiatry,
Early intervention is an area of intense current interest
for parents and professionals. This article describes a mainstream National
Health Service (NHS) approach to early intervention, developed at the Scottish Centre
for Autism. The aims of treatment are to improve the child’s early social
communication and social interaction skills, leading to the potential development
of play and flexibility of behaviour. This is achieved by 1:1 intensive
treatment by trained therapists, and a schedule of parent training. The
treatment protocol incorporates a child led approach; the use of imitation as a
therapeutic strategy; using language contingent on activities; and the
introduction of flexibility into play and social exchanges.
PMID: 11777254 [PubMed - in process]
* * *
Predicting spoken language level in children with autism
spectrum disorders http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11777253&dopt=Abstract <- - address ends here.
Stone WL, Yoder PJ.
Vanderbilt University, Nashville, TN, USA. Wendy.Stone@mcmail.vanderbilt.edu
Thirty-five children who received an autism spectrum
diagnosis at the age of 2 years (24 with autism, 11 with PDD-NOS) were
re-evaluated 2 years later to examine factors related to the development of
spoken language. Child variables (play
level, motor imitation ability and joint attention) and environmental variables
(socioeconomic status and hours of speech/language therapy between ages 2 and
3) were used to predict an aggregate measure of language outcome at age 4.
After controlling for age 2 language skills, the only
significant predictors were motor imitation and number of hours of
speech/language therapy. Implications of these results for understanding the
early developmental course of autism spectrum disorders and the effects of intervention
are discussed.
PMID: 11777253 [PubMed - in process]
* * *
Classical Eyeblink Conditioning: Clinical Models And
Applications http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11777017&dopt=Abstract <- - address ends here.
.
Steinmetz JE, Tracy JA, Green JT.
Department of Psychology, Indiana University,
Bloomington 47405, USA.
In this paper, we argue that the main reason that classical
eyeblink conditioning has proven so useful when applied to clinical situations,
is that a great deal of information is known about the behavioral and neural correlates
of this form of associative learning. Presented here is a summary of three
lines of research that have used classical eyeblink conditioning to study three
different clinical conditions; autism, fetal alcohol syndrome, and
obsessive-compulsive disorder.
While seemingly very different clinical conditions,
classical eyeblink conditioning has proven very useful for advancing our
understanding of these clinical pathologies and the neural conditions that may
underlie them.
PMID: 11777017 [PubMed - in process]
* * *
Use of Multimedia & Therapist-Instructed Training For
ASD Kids Effectiveness of a multimedia programme and therapist-instructed
training for children with autism. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui
ds=11775031&dopt=Abstract <- - address ends here.
Wong SK, Tam SF.
Department of Rehabilitation Sciences, The Hong Kong
Polytechnic University, Hung Hom, Kowloon.
The present study aimed to evaluate the effectiveness of
an interactive multimedia training programme and a conventional therapist-instructed
training in improving the learning behaviours of children with autism. A
multiple-subject, single case-study time-series research design was adopted in
the study. Six children with autism, aged 2 years 4 months to 2 years 10
months, were recruited by convenience sampling. They attended a 12-session training programme on basic concepts
(e.g. colours, shapes) that was
presented as an interactive multimedia training programme and also as a
conventional, therapist-led training programme.
The attending behaviours and appropriate responses of the
subjects were videotaped for further analysis. Participants who attended the conventional
therapist-instructed training programme generally showed improvement in
attending behaviours and response rates; participants attending the multimedia
programme also showed improvement in their attending behaviours and response
rates.
The results support the hypothesis that both training programmes
are effective in improving the attending behaviours and appropriate responses
of children with autism. The authors suggest that, because children with autism
respond differently to different training approaches, customized training programmes
should be considered for individual children. The implications of the
methodology and the potential impact of the present study on the training of
children with autism are discussed.
PMID: 11775031 [PubMed - in process]
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