Managing Repetitive Behaviours in Young Children with Autism Spectrum Disorder (ASD): Pilot Randomised Controlled Trial of a New Parent Group Intervention The Social Communication Intervention Project: a randomized controlled trial of the effectiveness of speech and language therapy for school-age children who have pragmatic and social communication problems with or without autism spectrum disorder. A Randomized Controlled Trial of the Korean Version of the PEERS® Parent‐Assisted Social Skills Training Program for Teens With ASD Randomized comparative trial of a social cognitive skills group for children with autism spectrum disorder. Effects and Moderators of a Short Theory of Mind Intervention for Children with Autism Spectrum Disorder: A Randomized Controlled Trial Effectiveness of sensory integration interventions in children with autism spectrum disorders: a pilot study. Clinical assessment of autism in high-risk 18-month-olds Intervention targeting development of socially synchronous engagement in toddlers with autism spectrum disorder: a randomized controlled trial. Randomized Controlled Trial: Multimodal Anxiety and Social Skill Intervention for Adolescents with Autism Spectrum Disorder Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder Theory of Mind Training in Children with Autism: A Randomized Controlled Trial ‘Everyday Memory’ Impairments in Autism Spectrum Disorders Use of Social Stories to Improve Self-Regulation in Children with Autism Spectrum Disorders A systematic review of peer-mediated interventions for children with autism spectrum disorder. Effects of a brief Early Start Denver model (ESDM)-based parent intervention on toddlers at risk for autism spectrum disorders: a randomized controlled trial. A Randomized Controlled Trial of the Social Tools And Rules for Teens (START) Program: An Immersive Socialization Intervention for Adolescents with Autism Spectrum Disorder. Autism spectrum disorders in extremely preterm children. Working memory and cognitive flexibility-training for children with an autism spectrum disorder: a randomized controlled trial. Social involvement of children with autism spectrum disorders in elementary school classrooms. Imitation from 12 to 24 months in autism and typical development: a longitudinal Rasch analysis. Enhancing interactions during daily routines: A randomized controlled trial of a web‐based tutorial for parents of young children with ASD Group-based cognitive behavioural psychotherapy for children and adolescents with ASD: the randomized, multicentre, controlled SOSTA-net trial. A randomized, placebo controlled trial of omega-3 fatty acids in the treatment of young children with autism
Early intervention for autism spectrum disorder ( ASD ) tends to focus on enhancing social-communication skills . We report the acceptability , feasibility and impact on child functioning of a new 8 weeks parent-group intervention to manage restricted and repetitive behaviours ( RRB ) in young children with ASD aged 3–7 years . Forty-five families took part in the pilot RCT . A range of primary and secondary outcome measures were collected on four occasions ( baseline , 10 , 18 and 24 weeks ) to capture both independent ratings and parent-reported changes in RRB . This pilot established that parents were willing to be recruited and r and omised , and the format and content of the intervention was feasible . Fidelity of delivery was high , and attendance was 90 % . A fully powered trial is now planned BACKGROUND Children who show disproportionate difficulty with the pragmatic as compared with the structural aspects of language are described as having pragmatic language impairment ( PLI ) or social communication disorder ( SCD ) . Some children who have PLI also show mild social impairments associated with high-functioning autism or autism spectrum disorder ( ASD ) . There is little robust evidence of effectiveness of speech- language interventions which target the language , pragmatic or social communication needs of these children . AIMS To evaluate the effectiveness of an intensive manualized social communication intervention ( SCIP ) for children who have PLI with or without features of ASD . METHODS & PROCEDURES In a single-blind RCT design , 88 children with pragmatic and social communication needs aged 5;11 - 10;8 , recruited from UK speech and language therapy services , were r and omly assigned in a 2:1 ratio to SCIP or to treatment-as-usual . Children in the  SCIP  condition received up to 20 sessions of direct intervention from a specialist research speech and language therapist working with supervised assistants . All therapy content and methodology was derived from an intervention manual . A primary outcome measure of structural language and secondary outcome measures of narrative , parent-reported pragmatic functioning and social communication , blind-rated perceptions of conversational competence and teacher-reported ratings of classroom learning skills were taken pre-intervention , immediately post-intervention and at 6-month follow-up . Analysis was by intention to treat . OUTCOMES & RESULTS No significant treatment effect was found for the primary outcome measure of structural language ability or for a measure of narrative ability . Significant treatment effects were found for blind-rated perceptions of conversational competence , for parent-reported measures of pragmatic functioning and social communication , and for teacher-reported ratings of classroom learning skills . CONCLUSIONS & IMPLICATION S There is some evidence of an intervention effect on blind and parent/teacher-reported communication outcomes , but not st and ardized language assessment outcomes , for 6 - 11-year-old children who have pragmatic and social communication needs . These findings are discussed in the context of the increasingly central role of service user outcomes in providing evidence for an intervention . The substantial overlap between the presence of PLI and ASD ( 75 % ) across the whole cohort suggests that the intervention may also be applicable to some verbally able children with ASD who have pragmatic communication needs Impaired social functioning is a hallmark feature of autism spectrum disorder ( ASD ) , often requiring treatment throughout the life span . PEERS ® ( Program for the Education and Enrichment of Relational Skills ) is a parent‐assisted  social skills training for teens with ASD . Although PEERS ® has an established evidence base in improving the social skills of adolescents and young adults with ASD in North America , the efficacy of this treatment has yet to be established in cross‐cultural validation trials . The objective of this study is to examine the feasibility and treatment efficacy of a Korean version of PEERS ® for enhancing social skills through a r and omized controlled trial ( RCT ) .The English version of the PEERS ® Treatment Manual ( Laugeson & Frankel , 2010 ) was translated into Korean and review ed by 21 child mental health professionals . Items identified as culturally sensitive were surveyed by 447 middle school students , and material was modified accordingly . Participants included 47 teens between 12 and 18 years of age with a diagnosis of ASD and a verbal intelligence quotient ( IQ ) ≥ 65 . Eligible teens were r and omly assigned to a treatment group ( TG ) or delayed treatment control group ( CG ) . Primary outcome measures included question naires and direct observations quantifying social ability and problems directly related to ASD . Secondary outcome measures included scales for depressive symptoms , anxiety , and other behavioral problems . Rating scales for parental depressive symptoms and anxiety were examined to detect changes in parental psychosocial functioning throughout the PEERS ® treatment . Independent sample s t‐tests revealed no significant differences at baseline across the TG and CG conditions with regard to age ( 14.04 ± 1.64 and 13.54 ± 1.50 years ) , IQ ( 99.39 ± 18.09 & 100.67 ± 16.97 ) , parental education , socioeconomic status , or ASD symptoms ( p < 0.05 ) , respectively . Results for treatment outcome suggest that the TG showed significant improvement in communication and social interaction domain scores on the Autism Diagnostic Observation Schedule , interpersonal relationship and play/leisure time on the subdomain scores of the Korean version of the Vinel and Adaptive Behavior Scale ( p 's < 0.01 ) , social skills knowledge total scores on the Test of Adolescent Social Skills Knowledge — Revised ( p < 0.01 ) , and decreased depressive symptoms on the Child Depression Inventory following treatment ( p < 0.05 ) . Analyses of parental outcome reveal a significant decrease in maternal state anxiety in the TG after controlling for potential confounding variables ( p < 0.05 ) . Despite cultural and linguistic differences , the PEERS ® social skills intervention appears to be efficacious for teens with ASD in Korea with modest cultural adjustment . In an RCT , participants receiving the PEERS ® treatment showed significant improvement in social skills knowledge , interpersonal skills , and play/leisure skills , as well as a decrease in depressive symptoms and ASD symptoms . This study represents one of only a few cross‐cultural validation trials of an established evidence ‐based treatment for adolescents with ASD . Autism Res 2014 , 7 : 145–161 . © 2014 International Society for Autism Research , Wiley Periodicals , OBJECTIVE This study evaluated the efficacy of a targeted social skills training group in school-aged children with autism spectrum disorder ( ASD ) . The intervention , Seaver-NETT ( Nonverbal communication , Emotion recognition , and Theory of mind Training ) , is a 12-session cognitive-behavioral intervention ( CBI ) for verbal , school-aged children targeting ASD-specific social behavioral impairments . METHOD Sixty-nine children with ASD , 8 to 11 years of age , with verbal IQs greater than 70 , participated in a r and omized comparative trial to examine the efficacy of NETT relative to a facilitated play group . Treatment outcomes included caregiver reports of social behavior and neuropsychological assessment s of social cognition conducted by blinded raters . Outcomes were collected at baseline , endpoint , and 3 months posttreatment . RESULTS Significant improvements were found on social behavior outcomes such as nonverbal communication , empathic responding , and social relations in the NETT condition relative to the active control at endpoint . Verbal IQ moderated the interaction effect on social behavior , with higher verbal IQ associated with improvements in the CBI condition . No significant improvements were found on social cognitive outcomes . No significant group differences were found at 3-month follow-up conducted with approximately half the sample ( n = 34 ) . CONCLUSION These data indicate that targeted CBI social skills groups such as NETT improve social communication deficits in verbal , school-aged children with ASD . The moderating effects of high verbal IQ suggest a need to consider participant and treatment characteristics associated with outcomes in future studies . Clinical trial registration information-Neural and Behavioral Outcomes of Social Skills Groups in Children With Autism Spectrum Disorder ; https:// clinical trials.gov ; NCT01190917 Limited perspective taking or “ Theory of Mind ” ( ToM ) abilities are a core deficit of autism , and many interventions are aim ed to improve ToM abilities . In this study , we investigated the effectiveness of a ToM treatment for children with autism spectrum disorders ( ASD ) and , for the first time , the moderating roles of social interaction style ( SIS ) and disruptive behavior ( DB ) , to determine which children are most likely to respond to this intervention . The trial protocol is registered at www.trialregister.nl , trial number 2327 and published before the data collection was finished ( www.trialsjournal.com ) . Children with autism aged 7–12 years ( n = 97 ) were r and omized over a waitlist control or a treatment condition . Outcome measures included ToM and emotion underst and ing , parent and teacher question naires on children 's social skills , ToM‐related social behavior , and autistic traits . Six‐month follow‐up parent reported data were collected for the treatment group . The treatment had a positive effect on ToM underst and ing , parent‐reported ToM behavior , and autistic traits , but not on parent or teacher‐reported social behavior . Passive SIS was associated with diminished treatment effects on autistic traits , but DB was unrelated to outcomes . The ToM intervention  improved conceptual social underst and ing and ToM‐related behavior of children with ASD . However , broader application of learned skills to other domains of functioning was limited . Individual differences with regard to treatment response are discussed . Autism Res 2015 , 8 : 738–748 . © 2015 International Society for Autism Research , Wiley Periodicals , The purpose of this pilot study was to establish a model for r and omized controlled trial research , identify appropriate outcome measures , and address the effectiveness of sensory integration ( SI ) interventions in children with autism spectrum disorders ( ASD ) . Children ages 6 - 12 with ASD were r and omly assigned to a fine motor or SI treatment group . Pretests and posttests measured social responsiveness , sensory processing , functional motor skills , and social-emotional factors . Results identified significant positive changes in Goal Attainment Scaling scores for both groups ; more significant changes occurred in the SI group , and a significant decrease in autistic mannerisms occurred in the SI group . No other results were significant . The study discusses considerations for design ing future outcome studies for children with ASD Earlier intervention improves outcomes for children with autism spectrum disorders ( ASDs ) , but existing identification tools are at the limits of st and ardization with 18-month-olds . We assessed potential behavioural markers of ASD at 18 months in a high-risk cohort of infant siblings of children with ASD . Prospect i ve data were collected using the Autism Diagnostic Observation Schedule ( ADOS ) and Autism Observation Scale for Infants ( AOSI ) on 155 infant siblings and 73 low-risk controls at 18 months . Infants were classified into three groups ( ASD sibs , non-ASD sibs , controls ) based on blind best-estimate diagnosis at age 3 . Fisher 's exact tests , followed by discriminant function analyses , revealed that the majority of informative ADOS items came from the social and behavioural domains , and AOSI items measuring behavioural reactivity and motor control contributed additional information . Findings highlight the importance of considering not only social-communication deficits , but also basic dimensions of temperament including state regulation and motor control when assessing toddlers with suspected ASD BACKGROUND Social and communication impairments are core deficits and prognostic indicators of autism . We evaluated the impact of supplementing a comprehensive intervention with a curriculum targeting socially synchronous behavior on social outcomes of toddlers with autism spectrum disorders ( ASD ) . METHODS Fifty toddlers with ASD , ages 21 to 33 months , were r and omized to one of two six-month interventions : Interpersonal Synchrony or Non-Interpersonal Synchrony . The interventions provided identical intensity ( 10 hours per week in classroom ) , student-to-teacher ratio , schedule , home-based parent training ( 1.5 hours per month ) , parent education ( 38 hours ) , and instructional strategies , except the Interpersonal Synchrony condition provided a supplementary curriculum targeting socially engaged imitation , joint attention , and affect sharing ; measures of these were primary outcomes . Assessment s were conducted pre-intervention , immediately post-intervention , and , to assess maintenance , at six-month follow-up . R and om effects models were used to examine differences between groups over time . Secondary analyses examined gains in expressive language and nonverbal cognition , and time effects during the intervention and follow-up periods . RESULTS A significant treatment effect was found for socially engaged imitation ( p = .02 ) , with more than doubling ( 17 % to 42 % ) of imitated acts paired with eye contact in the Interpersonal Synchrony group after the intervention . This skill was generalized to unfamiliar context s and maintained through follow-up . Similar gains were observed for initiation of joint attention and shared positive affect , but between-group differences did not reach statistical significance . A significant time effect was found for all outcomes ( p < .001 ) ; greatest change occurred during the intervention period , particularly in the Interpersonal Synchrony group . CONCLUSIONS This is the first ASD r and omized trial involving toddlers to identify an active ingredient for enhancing socially engaged imitation . Adding social engagement targets to intervention improves short-term outcome at no additional cost to the intervention . The social , language , and cognitive gains in our participants provide evidence for plasticity of these developmental systems in toddlers with ASD . http://www . clinical trials.gov/ct2/show/NCT00106210?term = l and a&rank = 3 Anxiety is common among adolescents with autism spectrum disorders ( ASD ) and may amplify the core social disability , thus necessitating combined treatment approaches . This pilot , r and omized controlled trial evaluated the feasibility and preliminary outcomes of the Multimodal Anxiety and Social Skills Intervention ( MASSI ) program in a sample of 30 adolescents with ASD and anxiety symptoms of moderate or greater severity . The treatment was acceptable to families , subject adherence was high , and therapist fidelity was high . A 16 % improvement in ASD social impairment ( within-group effect size = 1.18 ) was observed on a parent-reported scale . Although anxiety symptoms declined by 26 % , the change was not statistically significant . These findings suggest MASSI is a feasible treatment program and further evaluation is warranted BACKGROUND Autism spectrum disorder ( ASD ) is a frequent developmental disorder characterized by pervasive deficits in social interaction , impairment in verbal and nonverbal communication , and stereotyped patterns of interests and activities . It has been previously reported that there is vitamin D deficiency in autistic children ; however , there is a lack of r and omized controlled trials of vitamin D supplementation in ASD children . METHODS This study is a double-blinded , r and omized clinical trial ( RCT ) that was conducted on 109 children with ASD ( 85 boys and 24 girls ; aged 3 - 10 years ) . The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children . ASD patients were r and omized to receive vitamin D3 or placebo for 4 months . The serum levels of 25-hydroxycholecalciferol ( 25 (OH)D ) were measured at the beginning and at the end of the study . The autism severity and social maturity of the children were assessed by the Childhood Autism Rating Scale ( CARS ) , Aberrant Behavior Checklist ( ABC ) , Social Responsiveness Scale ( SRS ) , and the Autism Treatment Evaluation Checklist ( ATEC ) . TRIAL REGISTRATION NUMBER UMIN-CTR Study Design : trial number : UMIN000020281 . RESULTS Supplementation of vitamin D was well tolerated by the ASD children . The daily doses used in the therapy group was 300 IU vitamin D3/kg/day , not to exceed 5,000 IU/day . The autism symptoms of the children improved significantly , following 4-month vitamin D3 supplementation , but not in the placebo group . This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD . CONCLUSIONS This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients . Depending on the parameters measured in the study , oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD . At this stage , this study is a single RCT with a small number of patients , and a great deal of additional wide-scale studies are needed to critically vali date the efficacy of vitamin D in ASD Many children with Autism Spectrum Disorders ( ASD ) participate in social skills or Theory of Mind ( ToM ) treatments . However , few studies have shown evidence for their effectiveness . The current study used a r and omized controlled design to test the effectiveness of a 16-week ToM treatment in 8–13 year old children with ASD and normal IQs ( n = 40 ) . The results showed that , compared to controls , the treated children with ASD improved in their conceptual ToM skills , but their elementary underst and ing , self reported empathic skills or parent reported social behaviour did not improve . Despite the effects on conceptual underst and ing , the current study does not indicate strong evidence for the effectiveness of a ToM treatment on the daily life mindreading skills Abstract ‘ Everyday memory ’ is conceptualised as memory within the context of day-to-day life and , despite its functional relevance , has been little studied in individuals with autism spectrum disorders ( ASDs ) . In the first study of its kind , 94 adolescents with an ASD and 55 without an ASD completed measures of everyday memory  from the Rivermead Behavioural Memory Test ( RBMT ) and a st and ard word recall task ( Children ’s Auditory Verbal Learning Test-2 : CAVLT-2 ) . The ASD group showed significant impairments on the RBMT  , including in prospect i ve memory , alongside impaired performance on the CAVLT-2 . Social and communication ability was significantly associated with prospect i ve remembering in an everyday memory context but not with the CAVLT-2 . The complex nature of everyday memory and its relevance to ASD is discussed ABSTRACT A multiple baseline across participants design was used to evaluate the effects of Social Stories to help preschool-aged children with characteristics of Autism Spectrum Disorders ( ASD ) increase their engagement in functional behaviors and use sensory integrative-based strategies to promote self-regulation . Three children , 3–5 years old , from a self-contained preschool classroom were selected to participate in the study . The intervention package included reading individualized Social Stories that discussed desired behaviors and self-regulation strategies . The research ers measured the percentage of intervals in which participants engaged in desired behaviors . The frequency of desired behaviors increased for all participants . The use of self-regulation strategies varied across participants . These findings suggest that the intervention was successful in increasing desired behaviors of the three children . Further research is recommended on the effectiveness of embedding sensory integrative strategies into Social Stories . Practitioners may consider the use of Social Stories as a tool to increase independence and encourage self-regulated behaviors in children with characteristics of ASD BACKGROUND Peer mediated intervention ( PMI ) is a promising practice used to increase social skills in children with autism spectrum disorder ( ASD ) .  PMIs engage typically developing peers as social models to improve social initiations , responses , and interactions . METHOD The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group design s. Five studies met the pre-specified review inclusion criteria : four r and omized controlled trials and one pre- and post-test design . RESULTS Four of the studies were conducted in school setting s , whereas one study was conducted in a camp setting . The studies all reported that participants improved in social skills ( e.g. , social initiations , social responses , social communication ) post intervention . Additionally , sustainment , generalization , and fidelity of implementation were examined . CONCLUSION PMI is a promising approach to address social skills in children with ASD , and this approach can be conducted in meaningful real-word context s , such as schools . Limitations of the studies as well as future directions are discussed OBJECTIVE This study was carried out to examine the efficacy of a 12-week , low-intensity ( 1-hour/wk of therapist contact ) , parent-delivered intervention for  toddlers at risk for autism spectrum disorders ( ASD ) aged 14 to 24 months and their families . METHOD A r and omized controlled trial involving 98 children and families was carried out in three different sites investigating the efficacy of a parent delivery of the Early Start Denver model ( P-ESDM ) , which fosters parental use of a child-centered responsive interaction style that embeds many teaching opportunities into play , compared to community treatment as usual . Assessment s were completed at baseline and 12 weeks later , immediately after the end of parent coaching sessions . RESULTS There was no effect of group assignment on parent-child interaction characteristics or on any child outcomes . Both groups of parents improved interaction skills , and both groups of children demonstrated progress . Parents receiving P-ESDM demonstrated significantly stronger working alliances with their therapists than did the community group . Children in the community group received significantly more intervention hours than those in the P-ESDM group . For the group as a whole , both younger child age at the start of intervention and a greater number of intervention hours were positively related to the degree of improvement in children 's behavior for most variables . CONCLUSIONS Parent-implemented intervention studies for early ASD thus far have not demonstrated the large effects seen in intensive-treatment studies . Evidence that both younger age and more intervention hours positively affect developmental rates has implication s for clinical practice , service delivery , and public policy Adolescents with ASD face numerous personal and context ual barriers that impede the development of social motivation and core competencies , warranting the need for targeted intervention . A r and omized controlled trial was conducted with 40 adolescents to evaluate the merits of a multi-component socialization intervention that places emphasis on experiential learning . This investigation evaluated the impact of the 20-week START program on the social functioning of adolescents with ASD . Significant Group × Time differences between START and waitlist control groups were found across multiple measures . Secondary analyses of the entire program cohort also yielded significant improvement trends across all measures . These findings may be an important step in identifying optimal strategies to target the complex factors limiting optimal social development in ASD OBJECTIVES To investigate the prevalence , correlates , and antecedents of autism spectrum disorders ( ASD ) in extremely preterm children . STUDY DESIGN We conducted a prospect i ve study of all births < 26 weeks gestation in the United Kingdom and Irel and in 1995 . Of 307 survivors at 11 years , 219 ( 71 % ) were assessed and compared with 153 term-born classmates . Parents completed the  Social Communication Question naire ( SCQ )  to assess autism spectrum symptoms , and ASD were diagnosed by using a psychiatric evaluation . An IQ test and clinical evaluation were also administered . Longitudinal outcome data were available for extremely preterm children . RESULTS Extremely preterm children had significantly higher SCQ scores than classmates ( mean difference , 4.6 points ; 95 % CI , 3.4 - 5.8 ) . Sixteen extremely preterm children ( 8 % ) were assigned an ASD diagnosis , compared with none of the classmates . By hospital discharge , male sex , lower gestation , vaginal breech delivery , abnormal cerebral ultrasound scanning results , and not having had breast milk were independently associated with autism spectrum symptoms . By 6 years , independent associates were cognitive impairment , inattention and peer problems , withdrawn behavior at 2.5 years , and not having had breast milk . CONCLUSIONS Extremely preterm children are at increased risk for autism spectrum symptoms and ASD in middle childhood . These symptoms and disorders were associated with neurocognitive outcomes , suggesting that ASD may result from abnormal brain development in this population BACKGROUND People with autism spectrum disorders ( ASDs ) experience executive function ( EF ) deficits . There is an urgent need for effective interventions , but in spite of the increasing research focus on computerized cognitive training , this has not been studied in ASD . Hence , we investigated two EF training conditions in children with ASD . METHODS In a r and omized controlled trial , children with ASD ( n = 121 , 8 - 12 years , IQ > 80 ) were r and omly assigned to an adaptive working memory ( WM ) training , an adaptive cognitive flexibility-training , or a non-adaptive control training ( mock-training ) . Braingame Brian , a computerized EF-training with game-elements , was used . Outcome measures ( pretraining , post-training , and 6-week-follow-up ) were near-transfer to trained EFs , far-transfer to other EFs ( sustained attention and inhibition ) , and parent 's ratings of daily life EFs , social behavior , attention deficit hyperactivity disorder (ADHD)-behavior , and quality of life . RESULTS Attrition-rate was 26 % . Children in all conditions who completed the training improved in WM , cognitive flexibility , attention , and on parent 's ratings , but not in inhibition . There were no significant differential intervention effects , although children in the WM condition showed a trend toward improvement on near-transfer WM and ADHD-behavior , and children in the cognitive flexibility condition showed a trend toward improvement on near-transfer flexibility . CONCLUSION Although children in the WM condition tended to improve more in WM and ADHD-behavior , the lack of differential improvement on most outcome measures , the absence of a clear effect of the adaptive training compared to the mock-training , and the high attrition rate suggest that the training in its present form is probably not suitable for children with ASD BACKGROUND Children with autism spectrum disorders ( ASD ) are increasingly included in general education classrooms in an effort to improve their social involvement . METHODS Seventy-nine children with ASD and 79 r and omly selected , gender-matched peers ( 88.6 % male ) in 75 early ( K-1 ) , middle ( 2nd-3rd ) , and late ( 4th-5th ) elementary classrooms across 30 schools completed social network surveys  examining each child 's reciprocal friendships , peer rejection , acceptance , and social involvement . RESULTS Across grade levels , peers less frequently reciprocated friendships with children with ASD than students in the matched sample . While children with ASD were not more likely to be rejected by peers , they were less accepted and had fewer reciprocal friendships than matched peers at each grade level . Although 48.1 % of children with ASD were involved in the social networks of their classrooms , children with ASD were more likely to be isolated or peripheral to social relationships within the classroom across all grade levels , and this difference is even more dramatic in later elementary grade s. CONCLUSIONS In inclusive classrooms , children with ASD are only involved in peers ' social relationships about half of the time , and appear to be even less connected with increasing grade level . Promoting children with ASD 's skills in popular activities to share with peers in early childhood may be a key preventive intervention to protect social relationships in late elementary school grade The development of imitation during the second year of life plays an important role in domains of sociocognitive development such as language and social learning . Deficits in imitation ability in persons with autism spectrum disorder ( ASD ) from toddlerhood into adulthood have also been repeatedly documented , raising the possibility that early disruptions in imitation contribute to the onset of ASD and the deficits in language and social interaction that define the disorder . This study prospect ively examined the development of imitation between 12 and 24 months of age in 154 infants at familial risk for ASD and 78 typically developing infants who were all later assessed at 36 months for ASD or other developmental delays . The study established a developmental measure of  imitation ability  and examined group differences over time , using an analytic Rasch measurement model . Results revealed a unidimensional latent construct of imitation and verified a reliable sequence of imitation skills that was invariant over time for all outcome groups . Results also showed that all groups displayed similar significant linear increases in imitation ability between 12 and 24 months and that these increases were related to individual growth in both expressive language and ratings of social engagement but not in fine motor development . The group of children who developed ASD by age 3 years exhibited delayed imitation development compared with the low-risk typical outcome group across all time-points , but were indistinguishable from other high-risk infants who showed other cognitive delays not related to ASD Children with Autism Spectrum Disorder ( ASD ) often experience difficulty participating in everyday home routines , such as bed time or bath time . This r and omized controlled trial examined the efficacy of an interactive , web‐based parenting tutorial for improving children 's engagement in daily routines ( i.e. , proximal outcomes ) as well improving children 's social communication and parenting efficacy and stress ( i.e. , broad outcomes ) . Parents of children with ASD between 18 and 60 months were r and omly assigned to the  Tutorial  group ( n = 52 ) or the  Control group ( n = 52 ) . All parents completed question naires at baseline ( T1 ) , 1 month after T1 ( T2 ; post‐tutorial completion ) , and 2 months after T1 ( T3 ) . Relative to the Control group , parents in the Tutorial group reported significantly higher use of evidence ‐based instructional strategies and higher levels of child engagement during routines at T2 and T3 . In addition , parents in the Tutorial group reported significantly lower parenting stress and higher parenting efficacy at T3 , as well as higher ratings of child social communication at T2 and T3 , compared to the Control group . Parents reported being highly satisfied with both the clinical content and technical aspects of the tutorial . These improvements in both proximal and broad parent‐child outcomes suggest that this tutorial may be a promising and accessible way for empowering some parents and improving parent‐child interactions . Autism Res 2018 , 11 : 667–678 . © 2018 International Society for Autism Research , Wiley Periodicals , BACKGROUND Group-based psychotherapy in Autism Spectrum Disorder ( ASD ) has predominantly been studied in the United States by small studies in school-aged children without long-term follow-up . We report results of a large , confirmatory , multicentre r and omized-controlled phase-III trial in children and adolescents study ing the ASD specific , manualized group-based cognitive behavioural SOSTA-FRA approach . METHODS High-functioning ASD individuals aged 8 - 19 years old were r and omized to 12 sessions SOSTA-FRA or treatment as usual . Primary outcomes were change in total raw score of the parent-rated Social Responsiveness Scale ( pSRS ) between baseline ( T2 ) and end of intervention ( T4 ) , and between T2 and 3 months after end of intervention ( T5 ) . TRIAL REGISTRATION IS RCT N94863788 . RESULTS Between 20/5/2010 and 14/2/2013 , n = 320 ASD patients were screened , n = 228 patients were r and omized , and N = 209 analysed .  Mean pSRS difference between groups at T4 was -6.5 ( 95 % CI -11.6 to - 1.4 ; p = .013 ) , and at T5 -6.4 ( -11.5 to -1.3 , p = .015 ) . Pre-treatment SRS and IQ were positively associated with stronger improvement at T4 and T5 . CONCLUSIONS Short-term ASD-specific add-on group-based psychotherapy has shown postintervention efficacy with regard to parent-rated social responsiveness predominantly in male high-functioning children and adolescents with ASD . Future studies should implement blinded st and ardized observational measures of peer-related social interaction Background Autism spectrum disorder ( ASD ) is a neurodevelopmental disorder affecting more than 1 % of children . It is characterized by social communication deficits and repetitive behaviors/restricted interests . In the absence of any medications known to improve core symptom domains , parents often use complementary alternative treatments , including omega-3 fatty acid supplements . Methods We conducted a 6-month , r and omized , placebo controlled trial of omega-3 fatty acid supplements ( 1.5 g ) vs placebo in children 2 to 5 years of age with ASD . Primary outcome measures included the autism composite score of the Pervasive Developmental Disorders Behavioral Inventory ( PDDBI ) and the externalizing problems score of the Behavior Assessment System for Children ( BASC-2 ) . Secondary outcome measures included clinical global improvement ( Clinical Global Impression-Improvement ( CGI-I ) ) , adaptive function ( Vinel and Adaptive Behavior Scale ( VABS-II ) ) , and language gains ( Preschool Language Scale ( PLS-4 ) ) , as well as safety . Exploratory analysis investigated potential correlations between changes in cytokine profiles and treatment response . Results Thirty-eight participants were r and omized in a 1:1 fashion . There was no significant difference between groups on the 0- to 24-week change in PDDBI autism composite scores ( p = 0.5 ) . There was a significant group by week interaction on the BASC-2 externalizing problem score , with participants r and omized to the treatment group demonstrating worsening scores ( p = 0.02 ) . There was no statistically significant week by group effect on either adaptive function ( p = 0.09 ) or language ( p = 0.6 ) . Omega-3s were relatively well tolerated . Changes in cytokines during the study did not significantly correlate with treatment response . Conclusions This study does not support high dose supplementation of omega-3 fatty acids in young children with ASD.Trial registration Clinical trials.gov NCT01248728 . Registered 22 November 2010
In particular , there is little evidence that the identified tools would be good at detecting change in intervention studies .
The obvious gaps in available outcome measurement include well-being and participation outcomes for children , and family quality -of-life outcomes , domains particularly valued by our informants ( young people with ASD and parents ) .
This is the first systematic review of the quality and appropriateness of tools design ed to monitor progress and outcomes of young children with ASD .
BACKGROUND The needs of children with autism spectrum disorder ( ASD ) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children 's progress .
Relevant outcomes include improvement in core ASD impairments , such as communication , social awareness , sensory sensitivities and repetitiveness ; skills such as social functioning and play ; participation outcomes such as social inclusion ; and parent and family impact .
OBJECTIVES To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years .
To identify outcome areas regarded as important by people with ASD and parents .