Autism Behavioural Interventional Research in low–resource settings: Overcoming prevailing challenges ­ an Asian perspective

Harshini, M.; Kothiyal, Preeti

doi:10.1016/j.ajp.2016.12.004

Cited by 16 publications

(7 citation statements)

References 25 publications

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“…The impediments documented and therefore needs further research are the service delivery, graded care, health economic, awareness, misconceptions, delay in diagnosis and initiation of intervention in relationship to ASD. [13] This study thus adds data to an important area of EI research in India. [14]…”

Section: Discussionmentioning

confidence: 99%

Predictive components in the structure of an intensive, parent mediated, early intervention for children with autism spectrum disorders in India

Viswanathan

Russell

2019

J Family Med Prim Care

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Introduction: The predictive factors of parent mediated, Early Intervention (EI) for children with Autism Spectrum Disorders (ASD) have not been studied in India; we document the structural therapeutic factors, which predict the EI outcome. Methods: Data of 77 children with an ICD 10 diagnosis of Pervasive Developmental Disorder (ASD in DSM 5), and completed a 12-week EI with proven effectiveness was collected from the database of a teaching hospital. We studied the structural therapeutic factors associated with EI outcome, as measured by Psycho-Educational Profile-Revised (PEP-R), while controlling the confounders with multiple linear regression analyses. Results: The Fine-motor skills improved in residential patients (t = 2.54, P = 0.02; 15 units). As the duration of intervention decreased at home per day, there was a significant decrease in Gross-motor skills (t = -2.67, P = 0.02; -15 units). With increase in duration of intervention in hospital per day, there was a significant increase (t = 2.86, P = 0.01; 30 units) in the Eye-hand integration. Cognitive-verbal skills acquisition decreased (t = -2.90, P = 0.01; 33 units) as the duration of intervention decreased at hospital. The use of medication did not predict any of the outcome factors. Conclusion: The above mentioned predictive factors should be monitored and titrated in the family context when children with ASD undergo parent mediated, EI programme. It is important to that the multidisciplinary family medicine teams reinforce these parents, who are the main column of support in primary-care settings for children with neuro-developmental disabilities in India.

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Section: Discussionmentioning

confidence: 99%

Predictive components in the structure of an intensive, parent mediated, early intervention for children with autism spectrum disorders in India

Viswanathan

Russell

2019

J Family Med Prim Care

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“…Alternately, initiating center-based interventions in pediatric or primary care settings are a further step forward to curtail delay in treatment initiation. [14]…”

Section: Discussionmentioning

confidence: 99%

“…Alternately, initiating center-based interventions in pediatric or primary care settings are a further step forward to curtail delay in treatment initiation. [14] In this study, children with various referral diagnoses were later identified to have ASD on detailed evaluation. This raises the importance of specifically looking for comorbid neurodevelopmental disorders in children presenting with developmental concerns.…”

Section: Discussionmentioning

confidence: 99%

Early Diagnosis and Intervention for Autism Spectrum Disorder: Need for Pediatrician-Child Psychiatrist Liaison

Manohar¹,

Kothiyal²,

Chandrasekaran

et al. 2019

Indian Journal of Psychological Medicine

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Background: Early interventions in children with autism spectrum disorder (ASD) reduce progressive symptom development. Delay in diagnosis and initiation of ASD-specific interventions is observed across settings. This study aimed to assess the trends in time to diagnosis and treatment initiation in a tertiary care pediatric setting. Methodology: Families of children with ASD ( n = 50) were assessed, and details regarding age at first symptom recognition, medical consultation, receiving the diagnosis, and initiation of treatment were collected, in addition to detailed clinical assessment. Results: About 70% of families met a pediatrician for initial concerns, and 20% received a diagnosis of ASD from the first-contact pediatrician. The mean age at initial symptom recognition was 22.22 ± 9.47 months, whereas the first consultation was 27.22 ± 10.83 months. The mean age at initiation of ASD-specific interventions was 36.58 ± 10.2 months, amounting to an overall delay of 14.38 months from initial symptom recognition to treatment initiation. The time delay in our study is found to be lesser compared with similar studies across settings. Discussion: Pediatricians have a significant role to play in early diagnosis and care of children with ASD in close liaison with child psychiatry teams. Improving awareness, routine screening, and prompt referral of children “at-risk” for ASD are imperative. Initiating ASD-specific interventions in pediatric or primary care settings is an effective alternative to curtail the delay in treatment initiation.

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“…The challenges associated with providing care in someone’s native language likely compounds barriers that already exist for culturally diverse, vulnerable families. Multiple studies show that differences in cultural attitudes and approaches toward child development can impact how minority families respond to the challenges of having a child with ASD (Elder et al, 2016; Harshini and Preeti, 2017; Zuckerman et al, 2014a, 2014b). For example, Zuckerman and colleagues found that among Latina mothers of children with ASD, there was limited knowledge about ASD, and often differing views between mothers and providers about the child’s development and the importance of treatment services (Zuckerman et al, 2014a).…”

Section: Discussionmentioning

confidence: 99%

Implementing systems-based innovations to improve access to early screening, diagnosis, and treatment services for children with autism spectrum disorder: An Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services network study

Fingert

Carter

Pierce

et al. 2018

Autism

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In 2013, the National Institute of Mental Health funded five trials of unique, multicomponent, systems-based innovations designed to improve access to early screening, diagnosis, and treatment of autism spectrum disorder-collectively known as the Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services Network. As part of an ongoing effort to pool data and learn from shared experience, we collected information across all studies about innovation components and implementation strategies. First, each study group completed standardized checklists based on the Template for Intervention Description and Replication and the Expert Recommendation for Implementing Change. Then, we interviewed principal and co-investigators of each study (n = 9) to further explore innovation components and assess barriers and facilitators to implementation. Innovation strategies were diverse (five different autism spectrum disorder screeners were used, 40% included early intervention trainings, 60% involved new technology). Common implementation strategies included developing stakeholder relationships and provider trainings. Barriers included inefficient systems of care, difficulty engaging families in the innovations, provider attitudes, and organizational culture (e.g. difficulty changing clinic processes). These findings suggest that-despite diverse settings and a variety of innovation content-common facilitators and challenges exist in implementing innovations to enhance access to early autism spectrum disorder screening, diagnosis, and treatment.

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Autism Behavioural Interventional Research in low–resource settings: Overcoming prevailing challenges an Asian perspective

Cited by 16 publications

References 25 publications

Predictive components in the structure of an intensive, parent mediated, early intervention for children with autism spectrum disorders in India

Predictive components in the structure of an intensive, parent mediated, early intervention for children with autism spectrum disorders in India

Early Diagnosis and Intervention for Autism Spectrum Disorder: Need for Pediatrician-Child Psychiatrist Liaison

Implementing systems-based innovations to improve access to early screening, diagnosis, and treatment services for children with autism spectrum disorder: An Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services network study

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Autism Behavioural Interventional Research in low–resource settings: Overcoming prevailing challenges ­ an Asian perspective

Cited by 16 publications

References 25 publications

Predictive components in the structure of an intensive, parent mediated, early intervention for children with autism spectrum disorders in India

Predictive components in the structure of an intensive, parent mediated, early intervention for children with autism spectrum disorders in India

Early Diagnosis and Intervention for Autism Spectrum Disorder: Need for Pediatrician-Child Psychiatrist Liaison

Implementing systems-based innovations to improve access to early screening, diagnosis, and treatment services for children with autism spectrum disorder: An Autism Spectrum Disorder Pediatric, Early Detection, Engagement, and Services network study

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Autism Behavioural Interventional Research in low–resource settings: Overcoming prevailing challenges an Asian perspective