Diehl J.J.,University of Notre Dame |
Paul R.,Yale Child Study Center
Research in Autism Spectrum Disorders | Year: 2012
In research, it has been difficult to characterize the prosodic production differences that have been observed clinically in autism spectrum disorders (ASD). Moreover, the nature of these differences has been particularly hard to identify. This study examined one possible contributor to these perceived differences: motor planning. We examined the ability of children and adolescents with ASD to imitate prosodic patterns in comparison to a group with learning disabilities (LD) and a typically developing (TD) comparison group. Overall, we found that both the ASD and LD groups were significantly worse at perceiving and imitating prosodic patterns than the TD comparison group. Similar to previous studies using non-imitative speech, participants with ASD showed a significantly longer duration of utterances than the two comparison groups when attempting to imitate an intonation pattern. The implications of differences in duration of utterances are discussed. This study also highlights the importance of using clinical comparison groups in studies of language performance in individuals with ASD. © 2011 Elsevier Ltd.
Preston J.L.,Haskins Laboratories |
Brick N.,Southern Connecticut State University |
Landi N.,Yale Child Study Center
American Journal of Speech-Language Pathology | Year: 2013
Purpose: The purpose of this study was to evaluate the efficacy of a treatment program that includes ultrasound biofeedback for children with persisting speech sound errors associated with childhood apraxia of speech (CAS). Method: Six children ages 9-15 years participated in a multiple baseline experiment for 18 treatment sessions during which treatment focused on producing sequences involving lingual sounds. Children were cued to modify their tongue movements using visual feedback from real-time ultrasound images. Probe data were collected before, during, and after treatment to assess word-level accuracy for treated and untreated sound sequences. As participants reached preestablished performance criteria, new sequences were introduced into treatment. Results: All participants met the performance criterion (80% accuracy for 2 consecutive sessions) on at least 2 treated sound sequences. Across the 6 participants, performance criterion was met for 23 of 31 treated sequences in an average of 5 sessions. Some participants showed no improvement in untreated sequences, whereas others showed generalization to untreated sequences that were phonetically similar to the treated sequences. Most gains were maintained 2 months after the end of treatment. The percentage of phonemes correct increased significantly from pretreatment to the 2-month follow-up. Conclusion: A treatment program including ultrasound biofeedback is a viable option for improving speech sound accuracy in children with persisting speech sound errors associated with CAS. © American Speech-Language-Hearing Association.
Lebowitz E.R.,Yale Child Study Center |
Omer H.,Tel Aviv University |
Leckman J.F.,Yale Child Study Center
Depression and Anxiety | Year: 2011
Background: This study explored the nature of disruptive and coercive behaviors in pediatric obsessive-compulsive disorder (OCD). Method: Thirty children with OCD and a disruptive behavior disorder (DBD) were compared to 30 children with DBD alone using the Child Behavior Checklist and a novel 18-item questionnaire focused on distinctive coercive and disruptive behaviors seen in pediatric OCD (CD-POC). Results: Although youth with DBD alone had higher ratings of Externalizing Behaviors on the CBCL compared to the youth with OCD + DBD, their ratings on the CB-POC scale were lower. For example, 83% of OCD + DBD parents reported that their child "Imposes rules or behaviors on others due to tactile or other sensitivity and reacts to disobedience with rage or violence (e.g. forbids certain sounds, demands specific temperature settings)" compared to 23% of the parents of youth with DBD alone. Other highly discriminating behaviors included: "Demands special 'cuddling' or ritualized contact without regard for the will of others" and "Forbids the use of objects in his/her vicinity because of feelings of fear or disgust (e.g. knives, scissors, creams)." Total scores on the CD-POC were also correlated with OCD severity (P<.01). Conclusion: The results suggest that the nature of DBD in pediatric OCD may be distinctive and worthy of further study. © 2011 Wiley-Liss, Inc.
McPartland J.C.,Yale Child Study Center
Current Opinion in Neurology | Year: 2016
Purpose of review Despite significant progress in recognizing the biological bases of autism spectrum disorder, diagnosis and treatment rely primarily on subjective evaluation of behavior. This review highlights the challenges unique to neurodevelopmental disorders that have limited biomarker development. Recent findings The field of neurodevelopmental disorders requires objective quantification of biological processes to enable designation of subgroups likely to benefit from specific treatments, index diagnostic status/risk, demonstrate engagement of targeted systems, and provide more rapid assessment of change than traditional clinical observation and caregiver report measures. Summary Useful biomarkers for neurodevelopmental disorders must be reliable across development, evident at the individual level, and specific to a unit of analysis, be it diagnostic status or functional process. The ultimate value of biomarkers for neurodevelopmental disorders will relate to their ease of use, cost, scalability, sensitivity, and methodological objectivity. © 2016 Wolters Kluwer Health, Inc.
Stover C.S.,Yale Child Study Center
Journal of the American Academy of Psychiatry and the Law | Year: 2013
Factors that predict custody and visitation decisions are an important area of research, especially in the context of high-conflict divorce. In these cases, youths are at significantly higher risk for exposure to ongoing conflict, violence, and triangulation in their parents' disputes. What variables courts and evaluation clinics use to make custody decisions and whether they are the most salient requires further study. The work by Raub and colleagues in this issue extends our understanding of important factors considered by the courts and custody evaluators in high-conflict divorce and points to directions for future research in this area.
Reiss D.,Yale Child Study Center
Journal of Child Psychology and Psychiatry and Allied Disciplines | Year: 2016
Eratosthenes came close to a precise estimate of the circumference of the earth around the year 240 BC. His accomplishment depended on a verifiable tenet among his contemporaries: the earth was a sphere. At Syrene, the sun cast no shadow at the summer solstice. On that day, Eratosthenes measured the angle of the sun's shadow in Alexandria over 700 kilometers to north, at 712′ or 1/50th of the circumference of a perfect sphere. Read the full article at doi: 10.1111/jcpp.12461 © 2016 Association for Child and Adolescent Mental Health.
Steiner A.M.,Yale Child Study Center
Journal of Positive Behavior Interventions | Year: 2011
Despite the ubiquitous nature of parent education in autism treatment, relatively few studies directly address how parent education should be conducted. Given that the literature on parental well-being suggests that treatments that facilitate positive parental adaptation to their child's disability may be beneficial, this study examined the impact of a strength-based approach to parent education. An alternating treatments design was used to compare the effects of therapist statements that highlighted the child's deficits versus those that emphasized strengths. These two approaches were evaluated on the following measures: parent affect, parent statements regarding child behavior, and the quality of parent-child interactions. Results indicate that parents displayed improved affect, made more positive statements about their child, and also exhibited more physical affection toward their child during the strength-based approach. Findings have implications for autism programming, parental coping, and parent-child relationships. © 2011 Hammill Institute on Disabilities.
Lebowitz E.R.,Yale Child Study Center
Journal of Obsessive-Compulsive and Related Disorders | Year: 2013
Despite the efficacy of E/RP and pharmacotherapy for OCD, many children do not respond adequately to therapy. Furthermore, many children exhibit low motivation or ability to actively participate in therapy, a requirement of E/RP. Research has underscored the importance of family accommodation for the clinical course and treatment outcomes of childhood OCD. Recent studies highlighted the potential of family involvement in treatment to enhance outcomes for challenging cases. These interventions however still require child participation. The goal of this clinical report is to describe an exclusively parent-based intervention and present preliminary indications of its acceptability, feasibility and potential efficacy. The Supportive Parenting for Anxious Childhood Emotions (SPACE) Program is a manualized treatment focused on reducing accommodation and coping supportively with the child's responses to the process. The theoretical foundation of the intervention is presented and its practical implementation is illustrated, with excerpts from the treatment manual and a clinical vignette. Preliminary results from the parents of 6 children, who refused individual therapy, are presented. Parents participated in 10 weekly sessions and reported high satisfaction and reduced child symptoms. Research is required to investigate the potential of SPACE as a complement or alternative to other evidence based interventions for childhood OCD. © 2013 Elsevier Inc.
McPartland J.C.,Yale Child Study Center |
Reichow B.,Yale Child Study Center |
Volkmar F.R.,Yale Child Study Center
Journal of the American Academy of Child and Adolescent Psychiatry | Year: 2012
Objective: This study evaluated the potential impact of proposed DSM-5 diagnostic criteria for autism spectrum disorder (ASD). Method: The study focused on a sample of 933 participants evaluated during the DSM-IV field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and specificity for proposed DSM-5 diagnostic criteria were evaluated using field trial symptom checklists as follows: individual field trial checklist items (e.g., nonverbal communication); checklist items grouped together as described by a single DSM-5 symptom (e.g., nonverbal and verbal communication); individual DSM-5 criterion (e.g., social-communicative impairment); and overall diagnostic criteria. Results: When applying proposed DSM-5 diagnostic criteria for ASD, 60.6% (95% confidence interval: 57%64%) of cases with a clinical diagnosis of an ASD met revised DSM-5 diagnostic criteria for ASD. Overall specificity was high, with 94.9% (95% confidence interval: 92%97%) of individuals accurately excluded from the spectrum. Sensitivity varied by diagnostic subgroup (autistic disorder = 0.76; Asperger's disorder = 0.25; pervasive developmental disordernot otherwise specified = 0.28) and cognitive ability (IQ < 70 = 0.70; IQ ≥ 70 = 0.46). Conclusions: Proposed DSM-5 criteria could substantially alter the composition of the autism spectrum. Revised criteria improve specificity but exclude a substantial portion of cognitively able individuals and those with ASDs other than autistic disorder. A more stringent diagnostic rubric holds significant public health ramifications regarding service eligibility and compatibility of historical and future research. © 2012 American Academy of Child and Adolescent Psychiatry.
Martin A.,Yale Child Study Center
Academic Psychiatry | Year: 2014
Objective The author reflects on lessons in becoming and being a psychiatry journal editor. Methods The author describes his transition from a writer to an editor and his development as an editor. Results Editors need to consider the originality, novelty, methodological rigor of manuscripts, as well as their prose and ethical integrity. Conclusion The author hopes that others undertake the role of editor. © 2014 Academic Psychiatry.