IntroductionInterventions using robot-assisted therapy may be beneficial for the social skills development of children with autism spectrum disorder (ASD); however, randomised controlled trials (RCTs) are lacking. The present research aims to assess the feasibility of conducting an RCT evaluating the effectiveness of a social skills intervention using Kinesics and Synchronisation in Personal Assistant Robotics (Kaspar) with children with ASD.Methods and analysisForty children will be recruited. Inclusion criteria are the following: aged 5–10 years, confirmed ASD diagnosis, IQ over 70, English-language comprehension, a carer who can complete questionnaires in English and no current participation in a private social communication intervention. Children will be randomised to receive an intervention with a therapist and Kaspar, or with the therapist only. They will receive two familiarisation sessions and six treatment sessions for 8 weeks. They will be assessed at baseline, and at 10 and 22 weeks after baseline. The primary outcome of this study is to evaluate whether the predetermined feasibility criteria for a full-scale trial are met. The potential primary outcome measures for a full-scale trial are the Social Communication Questionnaire and the Social Skills Improvement System. We will conduct a preliminary economic analysis. After the study has ended, a sample of 20 participants and their families will be invited to participate in semistructured interviews to explore the feasibility and acceptability of the study’s methods and intervention.Ethics and disseminationParents/carers will provide informed consent, and children will give assent, where appropriate. Care will be taken to avoid pressure or coercion to participate. Aftercare is available from the recruiting NHS Trust, and a phased withdrawal protocol will be followed if children become excessively attached to the robot. The results of the study will be disseminated to academic audiences and non-academic stakeholders, for example, families of children with ASD, support groups, clinicians and charities.Trial registration numberISRCTN registry (ISRCTN14156001); Pre-results.
AimsTo determine whether adverse childhood experiences (ACE) influence child behaviour and correlation with final diagnosis of ASD in a cohort of children referred for a diagnosis of autism spectrum disorder (ASD).MethodsWe did a retrospective analysis of 156 children referred to a district level child development centre for assessment of ASD. Correlation by means of univiarate chi squared tests using SPSS of behavioural features (sensory difficulties, poor sleep, loses temper, physical aggression and sad or self-harm) in relation to potential predisposing factors including: age, sex, gestation, epilepsy, chromosomal defect, presence of developmental delay, final diagnosis of ASD and ACE in the form of maternal depression, domestic violence and child protection plan (past or present). Source of information was electronic records (SystmOne), where the evidence for domestic violence and the child protection plan was derived directly from police and social care.ResultsThe average age of the children at the time of referral was 6.5 (median 5.4, range 1–15) years, 40 (26%) were girls, only 3 had been born pre-term (<36 weeks). 115 had been through the complete ASD diagnostic process and 63 (55%) had received a diagnosis of ASD. In relation to ACE; 12 (8%) had or had had a protection plan, 19 (12%) had experienced domestic violence and 9 (6%) maternal depression.Significant associations were: domestic violence with temper (p=0.037) and aggression (p=0.030), maternal depression with aggression (p=0.049), child self-harm with temper (p=0.001) and aggression (p=0.04), sleep difficulties with aggression (p=0.002), developmental delay with temper (p=0.012). The diagnosis of ASD correlated with sensory difficulties (p<0.001) and developmental delay (p=0.014). Many aggressive children received medication (p=0.003).ConclusionThe results show exposure to domestic violence and maternal depression had an impact on behaviour but not on the diagnosis of ASD which was strongly correlated with developmental delay. Computerised medical records systems deriving information from a variety of sources can reveal the impact of ACE on child behaviour. It is important two of the three ACE were recorded independently of parental history. These relationships, using these types of information sources, deserve further systematic prospective study with larger cohorts.
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