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This study examined whether teachers' professional development of their relational competence with students with attention deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) modifies teachers' and students' perceptions of their teacher-student relationships (TSR). Participants comprised teachers (n = 33) and students (n = 232) from two elementary schools: one intervention school (InS) and one control school (CoS). InS teachers reported significant TSR improvements, regardless of student group or gender (p =.03). Among InS students, significant results were driven by female neurodiverse (ND) students and neurotypical (NT) male students (p =.03). Nevertheless, positive effects were solely observed among ND female students, while NT male students, conversely, reported decreased TSR during follow-up tests. No significant effects were found at the CoS irrespective of teacher or student ratings. The findings suggest that enhancing teachers' understanding of relational competence concerning ND students will not only improve their own perceptions of their TSR but also those of ND female students. Nonetheless, directing teachers' focus towards one student group (ND students) risks diminishing teachers' attention towards other student groups, potentially explaining the poorer follow-up results among NT boys. The finding warrants further investigation, as it indicates a challenge for teachers to establish sufficient relational engagement with all students. [ABSTRACT FROM AUTHOR]

Children on the autism spectrum may receive Early Intensive Behavioural Intervention (EIBI) in Sweden to support development by providing learning opportunities. However, research suggests a need to improve the quality of their learning environment. This pre-registered study (#NCT03634761) aimed to evaluate the Swedish Autism Program Environment Rating Scale (APERS-P-SE) as a means to promote the quality of the pre-school learning environment for children on the autism spectrum, along with outcomes for these children, and their pre-school staff. In a quasi-experimental study, pre-school staff (n = 35) conducted either EIBI supported by in-service training and on-site coaching based on APERS-P-SE assessment (at k = 9 preschools) or EIBI only (k = 8), during an 8-months period. The quality of the immediate learning environment (primary outcome) increased significantly in the EIBI/APERS-P-SE preschools. However, changes in child and pre-school staff measures were not significant. In-service training and on-site coaching based on APERS-P-SE assessments can increase the quality of the learning environment in Swedish pre-school. Studies of longer duration and larger sample size are required to determine if using the APERS-P-SE can also achieve desired behavioural change for children-, and impact pre-school staff applying EIBI. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a highly impairing condition with varying clinical presentations. Psychological treatments for ADHD are often similar, irrespective of predominant symptomatology. However, because inattention and hyperactivity/impulsivity are associated with different challenges in daily life more presentation-specific treatments are warranted. The purpose of the present study was to evaluate the feasibility and explore the preliminary effects of a novel group-based cognitive-behavioral therapy (CBT) protocol for ADHD predominantly inattentive presentation (ADHD-I), with the aim to reduce symptoms of inattention and associated problems. Materials and Methods. Using an open trial design, 39 adult patients with ADHD-I were included. Participants underwent 14 sessions of the new CBT for ADHD-I (CADDI) protocol, which includes skills training in organizing and initiating activity and coping with procrastination and passivity. In addition, mindfulness meditation is practiced throughout treatment. Results. The CADDI protocol proved feasible in terms of session completion and treatment acceptability. However, home assignment completion was moderate and attrition was high. Inattentive symptoms, assessed by clinicians and self-report, were reduced of a medium effect size, (Cohen's d = 0.65 and d = 0.55, respectively) and symptoms of depression of a small effect size (d = 0.48). An increase of a large effect size was observed for mindfulness meditation (d = 0.91). No effects were seen in functional impairment, nor in quality of life. Conclusions. The CADDI protocol is a potentially valuable new psychological treatment for adults with ADHD-I, although treatment effects need to be further evaluated and participant retention secured in randomized controlled trials. [ABSTRACT FROM AUTHOR]

Methods to enhance the quality of delivered Early Intensive Behavioral Intervention (EIBI) for children with autism spectrum disorder (ASD) have received surprisingly little attention in previous research. In a pragmatic randomized controlled pilot study, we studied the feasibility and effects of enriched supervision (using detailed video feedback) on EIBI quality compared to regular supervision only, over a period of 4–6 months. EIBI was conducted in 30 children with ASD by preschool staff, where 18 received enriched, and 12 regular supervisions. EIBI quality was evaluated using the York Measure of Quality of Intensive Behavioural Intervention. The enriched supervision was deemed feasible and compared to staff receiving regular supervision. Preschool staff who received enriched supervision improved on overall quality of EIBI delivery, as well as specifically regarding goal-directedness, organization and efficiency of the EIBI. Findings support the significance of adequate education and supervision of EIBI providers for intervention quality assurance. [ABSTRACT FROM AUTHOR]

This study aimed to define the active ingredients of a participation-focused physical activity intervention for children and youth with disabilities. An ethnographic approach was employed, triangulating participant observation, interviews and focus groups. Participant recruitment occurred through purposive sampling of staff employed at Beitostolen Healthsports Centre (BHC), and paediatric service providers visiting the centre. Interviews were transcribed verbatim and coded together with observation data. Secondary coding linked data to corresponding categories of the International Classification of Functioning, Disability and Health: Child and Youth version. Thirteen staff from BHC and 7 paediatric service providers participated in the study. Fourteen active ingredients were identified and were characterised at the level of the intervention (k = 8), the organisation (k = 4), and the individual (k = 2). Within the ingredients, 53 unique ICF-CY categories were identified. Twenty-six categories belonged to the ICF-CY component of "environment," and 26 categories to "activities and participation." No categories related to "body functions" or "body structures." The role of the environment, and specifically support and relationships, may be an essential consideration for enabling physical activity participation. Outcomes may guide program design and implementation to promote and sustain physical activity behaviours for children and youth with disabilities. The active ingredients identified in this study may guide the design and implementation of programs to promote and sustain physical activity behaviours of children and youth with disabilities. Leadership qualities and strength-based attitudes may be key characteristics of organisational practice that optimise outcomes for children and families. A "relationship-centred" approach, i.e., a network of children, families, health professionals, peers, mentors, and services in the community, may support children and young people with disabilities to achieve their physical activity participation goals. [ABSTRACT FROM AUTHOR]

Background: The 2030 Agenda for Sustainable Development adapted by the United Nations envisions inclusive and equitable quality education. While there is a growing body of research on interventions designed to help children on the autism spectrum adapt to the school environment, accommodations to children needs have been given less attention. Objective: To synthesize the literature on accommodations in the learning environment for children on the autism spectrum (ages 5-19 years) in mainstream school, with a specific focus on the effects on functioning, educational outcomes and well-being. Methods: A systematic search was conducted. The study selection and data extraction were performed by two independent reviewers. Eligible studies were assessed according to the (WWC) standards. Results: The search yielded 6102 citations. Only 37 eligible studies were identified, of which 14 met the WWC standards. This inconclusive and heterogeneous body of research tentatively suggest that accommodations in the pedagogical and psychosocial leaning environment can improve performance and function in school. Conclusion and significance: Accommodations in the learning environment is a promising but understudied approach. Creative research and innovation will be needed to support policy makers and school personnel in their quest to ensure inclusive and equitable education. [ABSTRACT FROM AUTHOR]

Background: Strength-based technology clubs for adolescents with autism spectrum disorder (ASD) have become increasingly popular; however, they remain poorly described in the literature. Before the impact and benefit of strength-based technology clubs can be measured, consistency in their design and delivery must be established. This study aimed to identify the essential components of strength-based technology clubs by exploring context, mechanisms, and outcomes of existing strength-based technology clubs. Method: Twenty-three adolescents with ASD (mean age 12.96 years, SD = 1.86, range = 10–18 years), 25 parents (mean age 46.08 years, SD = 8.27, range = 33–69 years), and 20 facilitators (mean age 27.93 years, SD = 6.55, range = 20–46 years) were purposively sampled from three established strength-based technology clubs. Data were obtained via ethnographic methods, including participant observations, interviews, and focus groups. Data analysis was underpinned by a realist evaluation, which provided the context-mechanism-outcome framework. Results: Data analysis revealed that strength-based technology clubs had four context themes (personal factors of adolescents, personal factors of facilitators, personal factors of parents, institution), three mechanism themes (activity design, strengths and abilities, environment), and three outcome themes (skill building, connection with others, emotion). Conclusion: The results highlighted the importance of understanding the personal context of adolescents, providing an individualized approach, leveraging individual interests, and modifying the environment to suit the individual. The findings contributed to defining a strength-based approach within ASD, and have demonstrated that positive outcomes can be achieved by focusing on strengths rather than deficits. Future ASD services can use the results as a framework for applying a strength-based approach. The efficacy of newly designed strength-based programs can then be tested. [ABSTRACT FROM AUTHOR]

The support needs of people with neurodevelopmental disorders are not sufficiently met during the initial years of adulthood. To evaluate feasibility and preliminary effects of a novel programme designed to empower young adults with autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD) to make progress within significant life domains (i.e. work, education, finance, housing/household management, health, leisure/participation in society, and relationships/social network). TRANSITION is a 24-week programme that combines group-based workshops with personalised support based on goal attainment scaling. The study enrolled 26 young adults (50% females; age 17–24 years) in the normative intellectual range, diagnosed with ASD (n = 8), ADHD (n = 4), or both (n = 14). The intervention was delivered by the regular staff of publicly funded psychiatric services in Stockholm, Sweden. The programme was possible to implement with minor deviations from the manual. Participants and staff generally viewed the intervention positively, but also provided feedback to guide further improvement. There was a high degree of attendance throughout, with 21 participants (81%) completing the programme. All completers exceeded their predefined goal expectations within at least one domain. The TRANSITION-programme is a promising concept that deserves further evaluation. [ABSTRACT FROM AUTHOR]

Background: Despite recognition of the challenges faced by students with autism spectrum disorders (ASD) there is limited understanding of the barriers and facilitators to participation in major life areas, such as being a university student. Aim/Objective: This research aimed to examine viewpoints on what affects the success of Australian university students with ASD. Material and Method: Q-methodology was used to describe the viewpoints of university students with ASD, their parents and their mentors, on success at university for students with ASD. A total of 57 participants completed the Q-sort. Results/Findings: Three viewpoints emerged; Individualised Support, Contextual Support and Social Support. Conclusions: This study highlighted that supports need to be individualized to the barriers and facilitators faced by Australian students with ASD. Supports also need to be contextualized to the built and social environments of universities. Significance: This study supports the premise that environmental interventions can be effective in facilitating participation in major life areas, such as university education. Peer mentoring for students with ASD may have utility for this group, but should be extended to include social, emotional and psychological support. [ABSTRACT FROM AUTHOR]

Purpose: The Conners Rating Scales are widely used in research and clinical practice for measuring attention deficit/hyperactivity disorder (ADHD) and associated problem behaviors, but country-specific norms are seldom collected. The current study presents the standardization of the Swedish Conners 3VR Rating Scales. In addition, we compared the Swedish norms to those collected in the U.S. and Germany. Material and methods: The study included altogether 3496 ratings of children and adolescents aged 6-18 years from population-based samples. Results: The scores obtained for the Swedish Conners 3VR showed satisfactory to excellent internal consistency for most subscales and excellent test-retest reliability. Across-informant correlations were modest. Cross-country comparisons revealed that aggression symptoms rated by teachers and ADHD symptoms rated by parents differed between Sweden, Germany and the U.S. Executive functioning deficits also varied as a function of rater and country, with German and Swedish teachers reporting increasing behavior problems with age, whereas a decrease was observed in the U.S. For some subscales, the observed cross-cultural differences were large enough for a child to be classified as being within the normal range (t-score <60) in one country and within the clinical range (t-score>70) in another country. Conclusion: The present study shows that the Swedish adaptation of the Conners 3VR provides consistent and reproducible scores. However, across-informant ratings were only modest and significant cross-cultural differences in scoring were observed. This emphasizes the need for multi-informant assessment as well as for national norms for rating instruments commonly used within child and adolescent psychiatry research and clinical settings. [ABSTRACT FROM AUTHOR]

Purpose: To assess the generalizability of findings from randomized controlled trials (RCTs) evaluating emotion recognition (ER) training for children and adolescents with autism spectrum disorder (ASD). Methods: We present a systematic review and narrative synthesis of the determinants of external validity in RCTs on ER training. Generalizability of the findings across situations, populations, settings, treatment delivery, and intervention formats was considered. Results: We identified 13 eligible studies. Participants were predominantly boys with ASD in the normative IQ range (IQ > 70), with an age span from 4 to 18 years across studies. Interventions and outcome measures were highly variable. Several studies indicated that training may improve ER, but it is still largely unknown to what extent training effects are translated to daily social life. Conclusion: The generalizability of findings from currently available RCTs remains unclear. This underscores the importance of involving children with ASD and their caregivers in informed treatment decisions. [ABSTRACT FROM AUTHOR]

Purposes: Typically, early (pre-diagnostic) development in individuals later diagnosed with Rett syndrome (RTT) has been investigated retrospectively using parent reports, medical records and analysis of home videos. In recent years, prospective research designs have been increasingly applied to the investigation of early development in individuals with late phenotypical onset disorders, for example, autism spectrum disorder. Methods: In this study, data collected by the Danish National Birth Cohort lent itself to prospective exploration of the early development of RTT, in particular early motor-, speech-language, and sociocommunicative behaviors, mood, and sleep. Results and Conclusions: Despite limitations, this quasi prospective methodology proved promising. In order to add substantially to the body of knowledge, however, specific questions relating to peculiarites in early development could usefully be added to future cohort studies. As this involves considerable work, itmay bemore realistic to consider a set of indicators which point to a number of developmental disorders rather than to one. [ABSTRACT FROM AUTHOR]

Introduction: Autism spectrum disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) have been associated with facial affect recognition (FAR) alterations.Methods: This study examined accuracy and response times for general and specific FAR in whole face and eye-region stimuli. FAR was assessed in matched samples of children and adolescents with ASD (n = 35), ADHD (n = 32), and typical development (TD) (n = 32) aged 8.6–15.9 years (M = 11.6; SD = 2.0).Results: Compared to TD, the ASD group performed less accurate and showed longer response times for general and specific FAR, mostly driven by problems in neutral and happy face identification. The ADHD group responded faster than the ASD group for global FAR. No differences between ADHD and TD were found. Attentional distractibility had a significant effect on FAR performance in ASD and ADHD.Conclusions: Findings confirm FAR alterations in ASD, but not ADHD, and endorse effects of attentional distractibility on FAR in ASD and ADHD. FAR and attention function training is clinically meaningful in ASD. Future studies should include control for visual attention and facial configuration skills, use naturalistic FAR material and also investigate implicit FAR. [ABSTRACT FROM PUBLISHER]

Today, the treatment for children and adolescents with attention-deficit/hyperactivity disorder (ADHD) is predominantly pharmacological. However, not all individuals respond to medication or some may experience problematic side effects. In addition, the compliance and treatment fidelity to medication is sometimes limited; thus, effective non-pharmacological treatment options are desirable. Neurocognitive training (NCT) methods such neurofeedback (NF) and working memory (WMt) have shown efficacy treating the primary symptoms of ADHD in non-blinded trials. Still, larger, comparative, blinded, pragmatic randomized controlled trials (RCTs) are needed to ensure the efficacy and effectiveness of these methods, and to identify an optimal training variant. Furthermore, little is known about predictors of treatment response to NCTs, such as genetic variants. In this article, we present the protocol of a pragmatic RCT for three NCT methods: slow cortical potential (SCP) training and live z-score (LZS) training (two NF variants), and working memory training (WMt). These are evaluated against each other and a waiting list control/treatment as usual group. In a clinical outpatient setting, 200 children and adolescents with ADHD aged 9-17 years with common comorbidities are randomized to either one of the treatment groups or the waiting list control group (n=50/ group). The treatment groups (SCP/LZS/WMt) receive a total of 25 highly frequent training sessions (5/week for 5 weeks). A comprehensive assessment comprising ADHD core symptoms, psychopathology, neuropsychology, neurophysiology, quality of life, and health-related measures are collected pre-and post-treatment and at a 6-month follow-up. Primary outcomes are blinded teacher and unblinded parent ratings and selfratings on the Conners 3 for ADHD. We expect that participants receiving NCT will exhibit improved core ADHD symptomatology compared with waiting list controls. Moreover, we hypothesize that the type of NCT (i.e. SCP, LZS, WMt) and participant characteristics (e.g. genetic predisposition, age, IQ, gender, verbal skills, and comorbidity) will predict patterns of treatment effects on the various outcomes. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder characterized by impairments in social communication and interaction, and the presence of stereotyped, repetitive and restricted behavior, interests, and activities. Despite prior studies showing moderate efficacy of social skills group training (SSGT) for children and adolescents with ASD, its effectiveness remains unclear. To investigate the efficacy and effectiveness of SSGT, we have initiated a large randomized controlled multicenter trial of the manualized SSGT program ‘KONTAKT’ in N=288 children and adolescents with high functioning ASD and psychiatric comorbidities (attention deficit hyperactivity disorder, anxiety, and depression) recruited from 14 clinical units. Based on stratification for age group (children vs. adolescents) and lengths of intervention (short vs. long), the participants are randomly assigned to SSGT KONTAKT training (n=144) or to treatment as usual (n=144). Outcomes are assessed by blinded teachers and unblinded parents on the Social Responsiveness Scale (primary outcomes), participant's self-reports, and clinician ratings using well-established instruments for adaptive skills, general psychopathology, and experienced stress (secondary outcomes). We expect that participants receiving SSGT KONTAKT will show improved social responsiveness and everyday functioning, decreased general symptom severity, and perceived stress compared to standard care. Moreover, we predict that participant characteristics such as genetic predisposition, age, IQ, sex, verbal skills, and comorbidity moderate treatment effects. [ABSTRACT FROM AUTHOR]

AbstractAdditional language learners are at risk of presenting lower language skills in the majority language compared to peers. These differences in language skills have been observed at an early stage of education and may impact academic achievement later on. A randomized trial with a switching replications design was performed in Swedish preschools to examine the effectiveness of small group dialogic reading, aiming to promote oral language skills. The sample comprised 85 children with diverse language, socioeconomic, and cultural backgrounds attending nine preschools in three school districts. Dialogic reading was conducted by ten teachers, trained in dialogic reading and coached by three special education teachers. The dialogic reading intervention was feasible in preschool context and children progressed in their oral language skills during the intervention. [ABSTRACT FROM AUTHOR]

The author looks at the challenge of seeking behavioral biomarkers that detect signs of developmental disorders. Topic discussed include diseases that have unrecognized origins like single-gene mutations, diseases with genetic heterogeneity and genetically complex disorders, and the importance of combining methods from various fields in evaluating progression of developmental disorders through biomarkers.