Abstract
While advances in intensive neonatal care have greatly improved survival rates among preterm infants, incidence of neurodevelopmental disorders in this group is still high, with autism spectrum disorder (ASD) being one of the most frequent. To this end, we conducted a social-communication intervention aimed at investigating efficacy in social-communicative skills. Eighteen children (preterm and full-term with ASD and preterm children) aged 18 through 20 months participated in the study. Our findings indicate that most participants in the intervention groups registered significant improvements in terms of socio-communicative skills, cognitive development, and language. Accordingly, these pilot data underscore the need for further research and implementation of early interventions in young preterm children with ASD.
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10 June 2021
A Correction to this paper has been published: https://doi.org/10.1007/s10803-021-05109-2
References
Adamson, L. B., Bakeman, R., Suma, K., & Robins, D. L. (2019). An expanded view of joint attention: Skill, engagement, and language in typical development and autism. Child Development, 90(1), e1–e18. https://doi.org/10.1111/cdev.12973
Agrawal, S., Rao, S. C., Bulsara, M. K., & Patole, S. K. (2018). Prevalence of autism spectrum disorder in preterm infants: A meta-analysis. Pediatrics. https://doi.org/10.1542/peds.2018-0134
Allotey, J., Zamora, J., Cheong-See, F., Kalidindi, M., Arroyo-Manzano, D., Asztalos, E., van der Post, J., Mol, B. W., Moore, D., Birtles, D., Khan, K. S., & Thangaratinam, S. (2018). Cognitive, motor, behavioural and academic performances of children born preterm: A meta-analysis and systematic review involving 64 061 children. BJOG an International Journal of Obstetrics and Gynaecology, 125(1), 16–25. https://doi.org/10.1111/1471-0528.14832
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Anderson, J. G., Baer, R. J., Partridge, J. C., Kuppermann, M., Franck, L. S., Rand, L., Jelliffe-Pawlowski, L. L., & Rogers, E. E. (2016). Survival and major morbidity of extremely preterm infants: A population-based study. Pediatrics. https://doi.org/10.1542/peds.2015-4434
Bagner, D. M., Pettit, J. W., Lewinsohn, P. M., & Seeley, J. R. (2010). Effect of maternal depression on child behavior: A sensitive period? Journal of the American Academy of Child and Adolescent Psychiatry, 49(7), 699–707. https://doi.org/10.1016/j.jaac.2010.03.012
Bayley, N. (2006). Bayley scales of infant and toddler development: Bayley-III. Harcourt Assessment, Psych. Corporation
Bejarano-Martín, Á., Canal-Bedia, R., Magán-Maganto, M., Fernández-Álvarez, C., Cilleros-Martín, M. V., Sánchez-Gómez, M. C., García-Primo, P., Rose-Sweeney, M., Boilson, A., Linertová, R., Roeyers, H., Van der Paelt, S., Schendel, D., Warberg, C., Cramer, S., Narzisi, A., Muratori, F., Scattoni, M. L., Moilanen, I., & Posada de la Paz, M. (2020a). Early detection, diagnosis and intervention services for young children with autism spectrum disorder in the European union (ASDEU): Family and professional perspectives. Journal of Autism and Developmental Disorders, 50(9), 3380–3394. https://doi.org/10.1007/s10803-019-04253-0
Bejarano-Martín, Á., Canal-Bedia, R., Magán-Maganto, M., Fernández-Álvarez, C., Lóa-Jónsdóttir, S., Saemundsen, E., Vicente, A., Café, C., Rasga, C., García-Primo, P., & Posada, M. (2020b). Efficacy of focused social and communication intervention practices for young children with autism spectrum disorder: A meta-analysis. Early Childhood Research Quarterly, 51, 430–445. https://doi.org/10.1016/j.ecresq.2020.01.004
Benassi, E., Savini, S., Iverson, J. M., Guarini, A., Caselli, M. C., Alessandroni, R., Faldella, G., & Sansavini, A. (2016). Early communicative behaviors and their relationship to motor skills in extremely preterm infants. Research in Developmental Disabilities, 48, 132–144. https://doi.org/10.1016/j.ridd.2015.10.017
Blencowe, H., Cousens, S., Chou, D., Oestergaard, M., Say, L., Moller, A.-B., et al. (2013). Born Too Soon: The global epidemiology of 15 million preterm births. Reproductive Health, 10(Suppl 1), S2. https://doi.org/10.1186/1742-4755-10-S1-S2
Chen, L.-W., Wang, S.-T., Wang, L.-W., Kao, Y.-C., Chu, C.-L., Wu, C.-C., Chiang, C.-H., & Huang, C.-C. (2020). Early neurodevelopmental trajectories for autism spectrum disorder in children born very preterm. Pediatrics. https://doi.org/10.1542/peds.2020-0297
Cheong, J. L. Y., Anderson, P. J., Burnett, A. C., Roberts, G., Davis, N., Hickey, L., Carse, E., Doyle, L. W., & for the Victorian Infant Collaborative Study Group. (2017). Changing neurodevelopment at 8 years in children born extremely preterm since the 1990s. Pediatrics. https://doi.org/10.1542/peds.2016-4086
Chernego, D. I., McCall, R. B., Wanless, S. B., Groark, C. J., Vasilyeva, M. J., Palmov, O. I., Nikiforova, N. V., & Muhamedrahimov, R. J. (2018). The Effect of a social-emotional intervention on the development of preterm infants in institutions. Infants and Young Children, 31(1), 37–52. https://doi.org/10.1097/IYC.0000000000000108
Christensen, L., & Mendoza, J. L. (1986). A method of assessing change in a single subject: An alteration of the RC index. Behavior Therapy. https://doi.org/10.1016/S0005-7894(86)80060-0
Daszykowski, M., Kaczmarek, K., Vander Heyden, Y., & Walczak, B. (2007). Robust statistics in data analysis — A review: Basic concepts. Chemometrics and Intelligent Laboratory Systems, 85(2), 203–219. https://doi.org/10.1016/j.chemolab.2006.06.016
De Groote, I., Roeyers, H., & Warreyn, P. (2006). Social-communicative abilities in young high-risk preterm children. Journal of Developmental and Physical Disabilities, 18(2), 183–200. https://doi.org/10.1007/s10882-006-9011-y
Dohmen, A., Bishop, D. V., Chiat, S., & Roy, P. (2016). Body movement imitation and early language as predictors of later social communication and language outcomes: A longitudinal study. Autism and Developmental Language Impairments, 1, 2396941516656636. https://doi.org/10.1177/2396941516656636
Estrada, E., Ferrer, E., & Pardo, A. (2019). Statistics for evaluating pre-post change: Relation between change in the distribution center and change in the individual scores. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2018.02696
Ferrer, R., & Pardo, A. (2014). Clinically meaningful change: False positives in the estimation of individual change. Psychological Assessment, 26(2), 370–383. https://doi.org/10.1037/a0035419
Fletcher-Watson, S., Apicella, F., Auyeung, B., Beranova, S., Bonnet-Brilhault, F., Canal-Bedia, R., Charman, T., Chericoni, N., Conceição, I. C., Davies, K., Farroni, T., Gomot, M., Jones, E., Kaale, A., Kapica, K., Kawa, R., Kylliäinen, A., Larsen, K., Lefort-Besnard, J., & Yirmiya, N. (2017). Attitudes of the autism community to early autism research. Autism: the International Journal of Research and Practice, 21(1), 61–74. https://doi.org/10.1177/1362361315626577
Gates, J. A., Kang, E., & Lerner, M. D. (2017). Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis. Clinical Psychology Review, 52, 164–181. https://doi.org/10.1016/j.cpr.2017.01.006
Ingersoll, B. (2010). Pilot randomized controlled trial of reciprocal imitation training for teaching elicited and spontaneous imitation to children with autism. Journal of Autism and Developmental Disorders, 40(9), 1154–1160. https://doi.org/10.1007/s10803-010-0966-2
Ingersoll, B. (2012). Brief report: Effect of a focused imitation intervention on social functioning in children with autism. Journal of Autism and Developmental Disorders, 42(8), 1768–1773. https://doi.org/10.1007/s10803-011-1423-6
Ingersoll, B., & Dvortcsak, A. (2009). Teaching social communication to children with autism: A practitioner’s guide to parent training and a manual for parents. Guilford Press.
Ingersoll, B., & Dvortcsak, A. (2019). Teaching social communication to children with autism and other developmental delays (2-book set). (2nd ed.). Guilford Press.
Jacobson, N. S., Follette, W. C., & Revenstorf, D. (1984). Psychotherapy outcome research: Methods for reporting variability and evaluating clinical significance. Behavior Therapy, 15(4), 336–352. https://doi.org/10.1016/S0005-7894(84)80002-7
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. https://doi.org/10.1037//0022-006x.59.1.12
Johnson, S., Hollis, C., Kochhar, P., Hennessy, E., Wolke, D., & Marlow, N. (2010). Autism spectrum disorders in extremely preterm children. The Journal of Pediatrics, 156(4), 525-531.e2. https://doi.org/10.1016/j.jpeds.2009.10.041
Joseph, R. M., O’Shea, T. M., Allred, E. N., Heeren, T., Hirtz, D., Paneth, N., Leviton, A., & Kuban, K. C. K. (2017). Prevalence and associated features of autism spectrum disorder in extremely low gestational age newborns at age 10 years. Autism Research, 10(2), 224–232. https://doi.org/10.1002/aur.1644
Kasari, C., Gulsrud, A., Paparella, T., Hellemann, G., & Berry, K. (2015). Randomized comparative efficacy study of parent-mediated interventions for toddlers with autism. Journal of Consulting and Clinical Psychology, 83(3), 554–563. https://doi.org/10.1037/a0039080
Kim, Y. (2019). Are gain scores really a “treacherous quicksand”? An empirical comparison between gain score methods and ANCOVA. PsyArXiv. https://doi.org/10.31234/osf.io/8p7nf
Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155–163. https://doi.org/10.1016/j.jcm.2016.02.012
Landa, R. J. (2018). Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders. International Review of Psychiatry (abingdon, England), 30(1), 25–39. https://doi.org/10.1080/09540261.2018.1432574
Lord, C., Brugha, T. S., Charman, T., Cusack, J., Dumas, G., Frazier, T., Jones, E. J. H., Jones, R. M., Pickles, A., State, M. W., Taylor, J. L., & Veenstra-VanderWeele, J. (2020). Autism spectrum disorder. Nature Reviews Disease Primers, 6(1), 1–23. https://doi.org/10.1038/s41572-019-0138-4
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule—generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223. https://doi.org/10.1023/A:1005592401947
Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule: ADOS-2 (Los Angeles, CA). Los Angeles, CA. WesternPsychological Services.
Maassen, G. H. (2004). The standard error in the jacobson and truax reliable change index: The classical approach to the assessment of reliable change. Journal of the International Neuropsychological Society: JINS, 10(6), 888–893. https://doi.org/10.1017/s1355617704106097
Marsden, E., & Torgerson, C. J. (2012). Single group, pre- and post-test research designs: Some methodological concerns. Oxford Review of Education, 38(5), 583–616. https://doi.org/10.1080/03054985.2012.731208
Mateus, V., & VieiraMartinsPachiOsório, E. D. C. P. R. A. (2020). Joint attention abilities in Brazilian preterm and full-term infants. Infant Behavior and Development, 60, 101451. https://doi.org/10.1016/j.infbeh.2020.101451
Matheis, M., Matson, J. L., & Burns, C. O. (2018). Premature birth, low birth weight, and positive screening for autism spectrum disorder in an early intervention sample. Journal of Developmental and Physical Disabilities, 30(5), 689–705. https://doi.org/10.1007/s10882-018-9613-1
Nguyen, T.-N.-N., Spencer-Smith, M., Haebich, K. M., Burnett, A., Scratch, S. E., Cheong, J. L. Y., Doyle, L. W., Wiley, J. F., & Anderson, P. J. (2018). Language trajectories of children born very preterm and full term from early to late childhood. The Journal of Pediatrics, 202, 86-91.e1. https://doi.org/10.1016/j.jpeds.2018.06.036
Nowell, S. W., Watson, L. R., Faldowski, R. A., & Baranek, G. T. (2018). An initial psychometric evaluation of the joint attention protocol. Journal of Autism and Developmental Disorders, 48(6), 1932–1944. https://doi.org/10.1007/s10803-017-3458-9
Pickard, K. E., & Ingersoll, B. R. (2015). Brief report: High and low level initiations of joint attention, and response to joint attention: Differential relationships with language and imitation. Journal of Autism and Developmental Disorders, 45(1), 262–268. https://doi.org/10.1007/s10803-014-2193-8
Robins, D. L., Casagrande, K., Barton, M., Chen, C.-M.A., Dumont-Mathieu, T., & Fein, D. (2014). Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 133(1), 37–45. https://doi.org/10.1542/peds.2013-1813
Rogers, S. J., & Vismara, L. (2014). Interventions for infants and toddlers at risk for autism spectrum disorder. In Handbook of autism and pervasive developmental disorders, fourth edition. American Cancer Society. https://doi.org/10.1002/9781118911389.hautc29
Salomone, E., Beranová, Š., Bonnet-Brilhault, F., Briciet Lauritsen, M., Budisteanu, M., Buitelaar, J., et al. (2016). Use of early intervention for young children with autism spectrum disorder across Europe. Autism: The International Journal of Research and Practice, 20(2), 233–249. https://doi.org/10.1177/1362361315577218
Sansavini, A., Zavagli, V., Guarini, A., Savini, S., Alessandroni, R., & Faldella, G. (2015). Dyadic co-regulation, affective intensity and infant’s development at 12 months: A comparison among extremely preterm and full-term dyads. Infant Behavior and Development, 40, 29–40. https://doi.org/10.1016/j.infbeh.2015.03.005
Sparrow, S., Cicchetti, D., & Saulnier, C. (2016). Vineland adaptive behavior scales–Third Edition (Vineland-3).
Ungerer, J. A., & Sigman, M. (1981). Symbolic play and language comprehension in autistic children. Journal of the American Academy of Child Psychiatry, 20(2), 318–337. https://doi.org/10.1016/S0002-7138(09)60992-4
van Breukelen, G. J. P. (2013). ANCOVA versus CHANGE from baseline in nonrandomized studies: The difference. Multivariate Behavioral Research, 48(6), 895–922. https://doi.org/10.1080/00273171.2013.831743
Zwaigenbaum, L., Bauman, M. L., Choueiri, R., Kasari, C., Carter, A., Granpeesheh, D., Mailloux, Z., Smith Roley, S., Wagner, S., Fein, D., Pierce, K., Buie, T., Davis, P. A., Newschaffer, C., Robins, D., Wetherby, A., Stone, W. L., Yirmiya, N., Estes, A., & Natowicz, M. R. (2015). Early intervention for children with autism spectrum disorder under 3 years of age: Recommendations for practice and research. Pediatrics, 136(Suppl 1), S60-81. https://doi.org/10.1542/peds.2014-3667E
Acknowledgments
The authors would like to thank and express their gratitude to the families who participated in this study.
Funding
This study was funded by the Spanish Ministry of Economy and Competitiveness [Grant PSI2016-80575-R], and the Spanish Ministry of Education, Culture and Sport [Ref.: BOE-B-2017-2646]. These funders had no role in the study design, the collection, analysis or interpretation of the data, the writing of the manuscript, or the decision to submit the paper for publication.
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ABM, RCB, and MMM designed the study; ABM and RCB wrote the manuscript; ABM, conducted the intervention program; ABM, MMM, AHF, SMD, PMG assessed families and children; ABM, MMM and EDV carried out statistical analyses and interpreted the results; MMM, AHF, EDV, CJR and MP collaborated in writing the manuscript. All authors have read and approved the final manuscript.
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Ethical approval was given by the Research Ethics Committee of the University of Salamanca, Spain (201700031949), and the Clinic Hospital of Salamanca, Spain (PI9910/2017).
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Bejarano-Martín, Á., Canal-Bedia, R., Magán-Maganto, M. et al. Effect of a Focused Social and Communication Intervention on Preterm Children with ASD: A Pilot Study. J Autism Dev Disord 52, 1725–1740 (2022). https://doi.org/10.1007/s10803-021-05068-8
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DOI: https://doi.org/10.1007/s10803-021-05068-8