Farokh lagha Akafi broujeny; Masoumeh Behboodi; Farideh dokaneifard
Abstract
The present study was conducted with the aim of comparing the effectiveness of acceptance and commitment therapy and cognitive behavioral therapy on the personality traits of mothers having children with autism spectrum disorder. This study was semi-experimental with a pre-test-post-test design and a ...
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The present study was conducted with the aim of comparing the effectiveness of acceptance and commitment therapy and cognitive behavioral therapy on the personality traits of mothers having children with autism spectrum disorder. This study was semi-experimental with a pre-test-post-test design and a control group. 45 mothers having children with autism spectrum disorder were selected by available sampling method and were equally and randomly placed in two experimental groups and one control group (15 people in each group). The experimental groups received separate training in acceptance and commitment therapy and cognitive behavioral therapy, while the members of the control group did not participate in these programs. Subjects were evaluated using the five major personality factors questionnaire (1987). The data was analyzed using univariate and multivariate analysis of covariance. The research findings indicated that acceptance and commitment therapy was effective on extroversion and cognitive-behavioral therapy was effective on the responsibility of this group of people (P<0.01). Also, examining the difference between the effectiveness of acceptance and commitment therapy and cognitive-behavioral therapy showed that there was a significant difference between the effectiveness of these two treatment methods on extroversion and responsibility (P<0.05). From this research, it can be concluded that acceptance and commitment therapy and cognitive behavioral therapy can play an important role in modulating the personality traits of mothers having children with autism spectrum disorder.
maryam shkoohirad
Abstract
Abstract
The aim of this study was to investigate the effectiveness of biomedical treatments on the symptoms and satisfaction of families with autism spectrum disorder. The present research method was a semi-experimental pre-test-post-test type with a control group. The statistical population of this ...
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Abstract
The aim of this study was to investigate the effectiveness of biomedical treatments on the symptoms and satisfaction of families with autism spectrum disorder. The present research method was a semi-experimental pre-test-post-test type with a control group. The statistical population of this research was the autistic children of the autism group in virtual space, from which thirty autistic children aged four to twelve with autism, fifteen in the experimental group and fifteen in the control group were randomly assigned. The Autism Treatment Evaluation Checklist (ATEC) was used to collect research data. The program was conducted in three months by parents and the supervision of the researcher, and the research data was analyzed using the covariance analysis method. The results of covariance analysis showed that biomedical treatments in reducing the symptoms in the Autism Treatment Evaluation Checklist (ATEC) have caused families to be satisfied. It seems that with the continuation of this method and reaching higher stages of treatment, more changes can be made in reducing the symptoms of autism and following it, reducing the challenges of the families, leading to the families' satisfaction with the treatment.
Keywords: Biomedical Treatments, Family Satisfaction, Autism Spectrum Disorder.
Extended Abstract
Introduction
Autism is a complex neurodevelopmental genetics that is caused by a combination of environmental factors. In all areas of the child's development, it is affected and behaviorally, it is limited by social damage, indirect social connection and definition (Chast and Leboer, 2022). The personal and financial cost of an autistic person in families is very high (Hoffer et al., 2022). So far, only behavioral therapies have been the mainstay of managing this disorder (Pitson et al., 2020). The absence of effective treatments for the neurodevelopmental disorder of autism is significant (Aishwarya et al., 2022). The fact that autism treatment is unproven is itself a source of family dissatisfaction and requires an urgent need to focus on the mental health of the family and create consistency in the care of the autistic individual (Lerner, White and McPartland, 2022). Psychiatrically, there are still no approved medications for the main symptoms of the disorder, such as social and communication problems, repetitive behaviors, and secondary symptoms, such as irritability and aggression (Nirenius et al., 2022). Parents reported that supplements and diet were the most helpful treatments in reducing symptoms compared to other treatments they had used to treat autism (Adams et al., 2018). Since environmental chemicals and toxins are also associated with an increased risk of neurodevelopmental disorders and certain conditions such as autism. Research examines diet between environmental exposures and neurodevelopmental outcomes (Granro, 2022). Therefore, this research intends to determine the effectiveness of diet and supplements due to the types of severity of autism spectrum disorders and the lack of evidence of effectiveness (that drug treatments, behavioral therapies, and rehabilitation therapies have not led to treatment except for control and slight improvement). Natural biomedicals, with the help of their families, take a step towards knowing the solutions to reduce and improve the symptoms of autism. Therefore, due to the increase in the prevalence of autism all over the world in recent years, the need for various researches and more and more investigations in the field of discovering treatments that will guide us to the causes of autism is necessary.
Research Questions
Does diet affect neurodevelopmental outcomes? Is it possible to see a change in the symptoms of autism with diet and natural remedies and biomedicals?
Literature Review
Regarding biomedical treatments: in the meantime, biomedical treatments are related to the activation of the immune system and anti-inflammatory effects (Ostadkarmpour and Patnins, 2021). In a research, it was shown that there is a positive correlation between modulating glutamate in the basal ganglia and the balance of the excitatory-inhibitory system, with the reduction of autism symptoms (Pertzesh et al., 2019). Research has shown that early detection of the ratios of several mitochondrial biomarkers can predict autism and distinguish between high and low-functioning spectrums (Al-Ansari and others, 2018). In a research, it was shown that insufficient levels of vitamin D play a role in the severity of autism symptoms (Al-Ansari and others, 2018). Research has shown that digestive problems are highly associated with behavioral symptoms of autism (Magoid et al., 2022). In recent studies, the role of neuroinflammation in autism behaviors has been confirmed (Cristiano et al., 2022).
Methodology
This research was practical in terms of purpose and in terms of sampling method, it was a semi-experimental pre-test-post-test type with a control group. The statistical population of this research was made up of children with autism disorder aged 4 to 12 from the virtual autism group in Tehran. The inclusion criteria were having a diagnosis of autism from a psychiatrist and age 4 to 12 years. To obtain the required sample of participants with autism disorder in the virtual space group, 15 people were randomly selected. And 15 people were selected as the control group. Both groups first responded to the autism treatment evaluation checklist, and the evaluation score of their autism level in the pre-test was determined. The experimental group, with the full cooperation of their families, was subjected to a diet of complete elimination of sugar and sweets along with the use of biomedical methods for three months. The control group did not receive any intervention during this period. At the end of the three-month intervention period, the subjects of both groups responded to the autism treatment evaluation checklist, and their autism level evaluation score was determined in the post-test.
Results
In order to analyze the data, SPSS25 software and multivariate analysis of covariance were used. The presuppositions of using multivariate covariance analysis and homogeneity of variances were checked in Levine's test. The findings showed that the scores of the subjects of the experimental group in the post-test phase in the components of speech and communication, sociability, sensory-cognitive and physical health showed a decrease, but not much change was observed in the control group.
Table of the results of covariance analysis (MANCOVA) to investigate the significant difference between the two experimental and control groups in the components of speech and communication, sociability, sensory perception and physical health.
The dependent variable
sum of squares
DF
mean square
F
Sig
Ita
speech and communication
0.860
1
0.860
0.409
0.528
0.17
Sociability
0.009
1
0.009
0.005
0.944
0.001
sensory
0.197
1
0.197
0.414
0.526
0.017
physical health
0.991
1
0.991
0.210
0.651
0.009
speech and communication
91.980
1
91.980
43.803
0.001
0.65
Sociability
77.987
1
77.987
45.094
0.001
0.65
sensory
72.398
1
72.398
151.882
0.001
0.86
physical health
367.249
1
367.249
77.646
0.001
0.76
The results of the covariance analysis in the table show that after controlling for the pre-test effects, there is a statistically significant difference between the average scores of the two experimental and control groups in the total score of speech and communication (F=43.803). There were sociability (F=45.094), sensory (F=151.882), and physical health variables (F=77.646). According to the calculated effect size, 0.65, 0.65, 0.86 and 0.76 percent of the total variances of the experimental and control groups are due to the effect of the independent variable.
Fatemeh Hosseinjani; Mehdi Zemestani
Abstract
Abstract
Autism spectrum disorder (ASD) is one of the important neurodevelopmental disorders that always has a high comorbidity with other psychiatric disorders. One of the ways to investigate this comorbidity is to identify the underlying mechanisms involved in this association. The aim of the present ...
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Abstract
Autism spectrum disorder (ASD) is one of the important neurodevelopmental disorders that always has a high comorbidity with other psychiatric disorders. One of the ways to investigate this comorbidity is to identify the underlying mechanisms involved in this association. The aim of the present study was to explore the mediating role of emotion regulation and intolerance of uncertainty in the development of externalizing disorders in children with ASD. The current research was a correlational study using structural equation modeling (pathway analysis). The statistical population included all children and adolescents with ASD in the age range of 8 to 18 years from autism schools and the autism society in Tehran, Tabriz, and Mianeh province. Using a convenience sampling method, a sample of 117 children was selected and the data were collected online from parents. Pearson correlation coefficient and pathway analysis were used for the statistical analysis of data by SPSS and AMOS software. The results of the present study showed that the symptoms of autism directly and significantly explain the symptoms of externalizing spectrum disorders. Also, emotion dysregulation and intolerance of uncertainty as mediating factors explain the severity of externalizing spectrum disorders impairments in children with autism disorder. According to these findings, it can be concluded that emotion dysregulation and intolerance of uncertainty as pathological transdiagnostic factors play an important mediating role in the exacerbation of the symptoms of externalizing disorders in children with ASD.
Keywords: Autism spectrum disorder, Transdiagnostic factors, Emotion regulation, Intolerance of uncertainty, Externalizing disorders.
Extended Abstract
Introduction
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by marked social and communication deficits, fixed interests, and repetitive behaviors (American Psychiatric Association, 2022). Children with ASD often have comorbid psychiatric disorders, including internalizing and externalizing disorders (Kaplan, Sadock, & Ruiz, 2019). Co-occurring externalizing problems (e.g. aggression, outburst behaviors, hyperactivity, and irritability) are very common in ASD across the lifespan and are often associated with poorer quality of life over and above the impact of ASD itself (Vaillancourt et al., 2017; Miller et al., 2019).
Considering the high prevalence of comorbid externalizing problems with ASD, the negative consequences of this comorbidity, identifying the underlying mechanisms involved in this comorbidity have important implications. Identifying and understanding the possible role of transdiagnostic mechanisms in the development and maintenance of externalizing pathologies in children with ASD have implications in the better explanation of the nature of comorbid disorders with ASD as well as in the modeling and developing effective treatment protocols for these children (Ozsivadjian et al., 2020).
Various transdiagnostic factors may play a mediating/moderating role in the development or maintenance of the symptoms of comorbid externalizing problems in children with ASD. Limited research has been conducted on transdiagnostic factors underlying the comorbidity of externalizing disorders in children with ASD. There is emerging empirical support for a number of cognitive-emotional mechanisms being implicated in the development and maintenance of high rates of externalizing problems in ASD (Mazefsky et al, 2013).
Among the important transdiagnostic factors that have been highly emphasized in recent studies on the externalizing problems in ASD, we can mention emotion regulation (Mazefsky et al, 2013; Morie et al., 2015) and intolerance of uncertainty (Neil, Olsson, & Pellicano, 2016; Vasa et al., 2018). These two constructs are among the important underlying transdiagnostic factors that have been emphasized in recent research on their influential and mediating role in the creation and continuation of comorbid disorders with autism spectrum disorder (Say et al., 2017; Saiz-Souanes et al., 2020).
The present study was conducted to explain the mediating role of emotion dysregulation and intolerance of uncertainty as transdiagnostic mechanisms in the development and maintenance of externalizing problems in children with ASD. The main question of the research was to what extent the two underlying and transdiagnostic constructs of emotion dysregulation and intolerance of uncertainty as mediating variables can explain the symptoms of externalizing symptoms in children with ASD?
Literature Review
Limited studies have been conducted on the role of emotion dysregulation and intolerance of uncertainty in the development of internalizing and externalizing problems in children with ASD. In this regard, Mazefsky et al. (2011) showed that children with ASD have problems in using adaptive emotion regulation strategies and they use maladaptive strategies to deal with negative daily tensions, which makes them prone to a wide range of internalizing psychopathologies including depression and anxiety. Morie et al. (2015) also showed that defect in emotion regulation plays an important role as a mediator in the development and exacerbation of anxiety and depressive symptoms in youth with ASD. Neil et al. (2016) and Vasa et al. (2018) showed that the high level of intolerance of uncertainty in children with ASD increases the level of tension and anxiety in them, and this tension in turn leads to the possibility of disruptive behaviors in them. Therefore, previous evidence shows that intolerance of uncertainty is an important element in the development and maintenance of internalizing pathologies in them. Therefore, previous pieces of evidence show that emotion dysregulation and intolerance of uncertainty in youth with ASD are among the important mediating risk factors for the development and maintenance of comorbid psychopathologies in them.
Methodology
A descriptive correlation research approach (structural equation model) is adopted in this study. The statistical population included all children and adolescents with ASD who were referred to exceptional children schools and autistic centers in Tehran, Tabriz, and Mianeh cities in 2019-2020. A convenience sampling method was used to select 117 children and adolescents with ASD as the study sample. The inclusion criteria were receiving ASD diagnosis based on the pediatric psychiatrics interview, ability to write and read, having ages between 8 and 18 years, and willingness to participate in the study. All participants were assessed by the Gilliam Autism Rating Scale-second edition (GARS-2), Strengths and Difficulties Questionnaire (SDQ), and Intolerance of Uncertainty Scale for Children (IUSC). To analyze the data, descriptive statistical metrics such as mean, standard deviation, and Pearson correlation and pathway analysis were employed using the SPSS-22 and Amos-24 software.
Results
The results of the matrix correlation showed a significant relationship between ASD symptoms, externalizing problems, emotion regulation strategies, and intolerance of uncertainty dimensions. The standardized direct effect of ASD symptoms on externalizing problems, emotion regulation strategies, and intolerance of uncertainty dimensions was significant (p> 0.05). Moreover, evaluation of indirect effects using the bootstrap method showed that the indirect effects of ASD symptoms on conduct problems, hyperactivity, emotion regulation strategies (i.e., suppression, reappraisal), and intolerance of uncertainty dimensions (prospective and inhibitory) were significant. Therefore, the indirect relationship between ASD symptoms and externalizing problems through emotion regulation and intolerance of uncertainty is significant (p> 0.05).
Conclusion
This study aimed to investigate the mediating role of transdiagnostic factors of emotion dysregulation and intolerance of uncertainty in the association between ASD symptoms and externalizing problems. The results of the present study showed that the symptoms of autism directly explain the externalizing problems in children with ASD. Also, emotion regulation and intolerance of uncertainty as mediating factors explain the severity of externalizing problems in children with ASD.
According to these findings, it can be said that emotion dysregulation and intolerance of uncertainty as pathologic transdiagnostic mechanisms probably play an important mediating role in explaining the development and maintenance of externalizing problems in children with ASD. Based on the results of this research, it can be said that the defect in emotional regulation and also the inability to tolerate ambiguous situations in autistic children and adolescents probably lead to the development of externalizing symptoms (conduct problems, hyperactivity) in them.
This study has limitations that should be considered in future research. Limitations related to the cross-sectional nature of the study, geographical region, small sample size, sampling method, and using self-reporting questionnaires as a data collection tool.
Farhad Ghadiri Sourman Abadi; khoshdavi ebrahimzade; Roya Zare; Mehrnoush Javaezi Shishavan,
Abstract
The present study was conducted with the aim of evaluating the psychometric properties of the anxiety scale of children with autism spectrum disorder (parent form). The method of the current research was a correlational description. The statistical population of the present study was all children with ...
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The present study was conducted with the aim of evaluating the psychometric properties of the anxiety scale of children with autism spectrum disorder (parent form). The method of the current research was a correlational description. The statistical population of the present study was all children with autism spectrum disorder in Tehran city who were referred to autism education and rehabilitation centers in 2022. 315 children (193 boys and 122 girls) were selected using available sampling method. After translating and obtaining the opinions of experts and subjects, the face validity of the scale was confirmed. AMOS and SPSS software were used for statistical analysis. The results of confirmatory factor analysis showed that in the sample of Iranian children with autism spectrum disorder, the four-factor structure of the scale including performance anxiety, anxiety arousal, separation anxiety and uncertainty had a good fit with the data. The results related to the correlation between this scale and the Spence anxiety scale experimentally supported the convergent validity of the anxiety scale of children with autism spectrum disorder. The internal consistency coefficients of the whole scale and subscales of functional anxiety, anxiety arousal, separation anxiety and uncertainty were obtained as 0.79, 0.78, 0.81, 0.76 and 0.82, respectively. Overall, the results of the present study showed that the anxiety scale of children with autism spectrum disorder is a valid and reliable tool for measuring anxiety in Iranian children with autism spectrum disorder. This tool can be used to measure anxiety in Research and treatment sections.
Saeed Rezayi; Asgar Choobdari
Abstract
The aim of this study was to develop and validate a package of empowerment of pre-verbal (communication) skills for children with neurodevelopmental disorders, especially children with autism. This research was done descriptively-analytically. This research method had two parts: qualitative research ...
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The aim of this study was to develop and validate a package of empowerment of pre-verbal (communication) skills for children with neurodevelopmental disorders, especially children with autism. This research was done descriptively-analytically. This research method had two parts: qualitative research and quantitative research. In the qualitative research section, the inductive qualitative content analysis method has been used. To analyze the qualitative content, a systematic search of articles, dissertations, and books related to the field of pre-verbal skills of children with autism spectrum disorder was used. Also, the face and content validity methods were used to check the validity of the developed package. Finally, the results of all content analyses performed on sources and components derived from them were presented in the form of a pre-verbal skills empowerment package. The results of content validity based on the opinions of 12 experts in this field showed that the designed package has good content validity (0.83). Therefore, it can be concluded that the pre-communication (verbal) skills empowerment package designed has the necessary formal and content validity and can be used in educational and clinical contexts.
zahra zarekhalili; Mehran Soleymani; Qorban HemmatiAlamdarlou,; hassan yaghoubi
Abstract
The aim of this study was to investigate the effect of Snoezelen method on the symptoms of children with autism spectrum disorder. The research method was quasi-experimental with pre-test and post-test design with control group. The statistical population of the present study was all children with autism ...
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The aim of this study was to investigate the effect of Snoezelen method on the symptoms of children with autism spectrum disorder. The research method was quasi-experimental with pre-test and post-test design with control group. The statistical population of the present study was all children with autism spectrum disorder, from which a sample of 30 people was selected by convenience sampling method and randomly assigned to the experimental and control groups. So that each group was 15 people and from both groups pre-test was performed and the experimental group received the Snoezelen method in 40 sessions while the control group was not presented with this intervention and at the end for both groups the post-test was performed. The instrument used in this study was the Gilliam (Garz) survival rating scale. Data analysis using univariate analysis of covariance and multivariate covariance showed that the mean scores of autism syndrome and its sub-comparisons (social interaction and communication) increased significantly and stereotyped behavior decreased P (<0/05). The findings indicate that the Snoezelen method improves autism in children with autism spectrum disorder. Therefore, it is recommended to design and implement Snoezelen program to improve autism.
Hoda Faramarzi; marzieh ghanei
Abstract
The aim of this study was to determine the effectiveness of play therapy based on cognitive-behavioral therapy on challenging behaviors of high-functioning autistic children. The research method was semi-experimental with pre-test and post-test design with control group. The statistical population of ...
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The aim of this study was to determine the effectiveness of play therapy based on cognitive-behavioral therapy on challenging behaviors of high-functioning autistic children. The research method was semi-experimental with pre-test and post-test design with control group. The statistical population of this study was all children aged 8 to 12 years old with autism spectrum disorder in health care centers of Arak in 2018. In this study, 16 high-functioning autistic children were selected by available sampling method using a questionnaire for measuring the range of autism spectrum disorder. They were randomly assigned to two groups of experimental (8 subjects) and control (8 subjects) groups. The Revised Scale of Challenging Behaviours of Bodfish, Symons, Parker & Lewis (2000), was used to assess challenging behaviors. The experimental group received 10 cognitive-behavioral treatments in a 10-minute session during a one-month period, while the control group did not receive such an intervention. At the end, the two groups were evaluated again. Data were analyzed using covariance analysis. The findings of this study showed that play therapy based on cognitive-behavioral therapy has a significant role in reducing the challenging behaviors of high-functioning autistic children.
Farzaneh Ghanimi; Asghar Dadkhah; Esmat Danesh; Sagegh Taghiloo
Abstract
Autism spectrum disorder is a type of neurodevelopmental disorder characterized by persistent impairment in social interactions and communication as well as repetitive and specific behaviors. The purpose of this study was to compare of the effectiveness of stress management and social support perception ...
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Autism spectrum disorder is a type of neurodevelopmental disorder characterized by persistent impairment in social interactions and communication as well as repetitive and specific behaviors. The purpose of this study was to compare of the effectiveness of stress management and social support perception training based on cognitive-behavioral manner on quality of life of mothers of children with autism spectrum disorder. The research method was experimental with pretest, posttest and follow up design. First, the subjects were screened for inclusion criteria, then 30 mothers with children with autism spectrum disorder were selected and after being matched, they were randomly assigned to experimental and control groups (10 person in each group). Mothers in the two groups, stress management and social support perception management, received 8 sessions of 90 minutes of intervention and the control group received no intervention. The research instrument, including WHO Quality of Life Questionnaire (1996), was administered to the subjects in all three stages. Data analysis using statistical method of repeated measures analysis of variance, showed that training of social support perception, improves component of social relations (P<0.001), and training of stress management, improves component of physical health (P<0.001), more than other components of quality of life of mothers. Based on the findings, it is suggested that support programs be implemented in community mental health organizations to develop training packages and implement guidelines related to empowering parents with children with autism spectrum disorder.
Sedigheh Annabestani; Alimohammad Naemi
Abstract
The aim of this study was to determine the effects of positive thinking traning on self-compassion and life expectancy in mothers of children with autism spectrum disorder of Sabzevar, Iran. This study was semi -experimental and pretest-posttest with control group was used. The statistical population ...
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The aim of this study was to determine the effects of positive thinking traning on self-compassion and life expectancy in mothers of children with autism spectrum disorder of Sabzevar, Iran. This study was semi -experimental and pretest-posttest with control group was used. The statistical population of the study consisted of all mothers of children with autism spectrum disorder of Sabzevar in the academic year 2017-18 that were selected according to eligibility criteria and were assigned to experimental (n = 18) and control (n = 18) groups through simple random sampling. After conducting the pre-test using the self-compassion scale and life expectancy scale, the experimental group received positive thinking traning during 10 sessions of 75 minutes, while the control group received no intervention. After the end of the program, the two groups were given a post-test. The collected data was analyzed using descriptive statistics methods (mean and standard deviation) and inferential statistics (analysis of covariance) with the help of version 23 of SPSS. The results showed that positive thinking traning have a significant effect on the self-Compassion and life expectancy with components of the mothers of children with autism spectrum disorder of Sabzevar. Accordingly, positive thinking training is an effective intervention program for helping mothers of children with autism spectrum disorder.
Maryam Bakhshi; Zekallah Morovati; Tahereh Elahi; Sara Shahmohamadian
Abstract
The purpose of this study was to determine the effectiveness of art therapy on social-communication skills, emotional regulation and behavioral flexibility in children with autism spectrum disorder. This research was quasi-experimental and it's plan was pre-test, post-test and follow-up two months with ...
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The purpose of this study was to determine the effectiveness of art therapy on social-communication skills, emotional regulation and behavioral flexibility in children with autism spectrum disorder. This research was quasi-experimental and it's plan was pre-test, post-test and follow-up two months with the control group. The statistical population included 6-12 years old children with autism spectrum disorder in Zanjan. The sample consisted of 26 children who were selected by the available sampling method and then randomly assigned into two experimental and control groups (each group was 13). The instrument of research was questionnaire of Autism Social Skills Profile_ Scott Bellini's, the Emotion Regulation Checklist- Shields & Cicchetti, and the Gilliam Autism Rating Scale-Second Edition rating scale. The experimental group perch on art therapy interventation during 44 session for 4 months that extracted from art therapy program for children and adolescents with autism by Jennifer Beth Silvers (2008). In addition to descriptive statistics, inferential statistics, the repeated measure anova were used to analyze the data. Data analysis showed that art therapy had a good effect on social-communication skills and it's components, the components of emotional regulation and instability/negativity and also behavioral flexibility, means that the intervention program improved social communication, emotion regulation and behavioral flexibility. So according to the findings of this research, art therapy as a complementary therapeutic approach can be used to improve social-communication skills, emotion regulation and behavioral flexibility in children with autism spectrum disorder.