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Scholarly Works (5 results)

  • Thesis
  • Peer Reviewed
UCLA Electronic Theses and Dissertations (2021)

Most social communication tests used to measure change in young children with autism spectrum disorder have not undergone rigorous psychometric evaluation. Notably, and most relevant to the early intervention literature, there is little information on the sensitivity of these measures to change over time, despite their frequent use. Further, most syntheses of intervention studies combine data based on constructs (e.g. language) without accounting for the potential error introduced when different measures are combined together. While this may be appropriate, more information is needed on whether there is substantial heterogeneity across commonly used social communication outcomes. The aims of this study were to examine the sensitivity to change and expected change over time of social communication measures in ASD clinical trial and longitudinal research studies. A systematic review and meta analyses was conducted to generate pooled effect sizes within each identified outcome measure, rather than pooling multiple measures together. Meta regression was used to determine whether the length of the measurement period was related to the magnitude of change over time and whether this relationship was influenced by factors such as cognitive ability, children’s age and year of publication. The average length of the included studies ranged from 3 months to 20 months. Overall, the expected change over time, measured using standardized mean differences, was small to medium, although there was considerable variability. For example, ADOS Severity scores had an expected change of 0.114 standardized mean units and an average measurement period length of 16 months whereas Vineland socialization scores had an expected change of 0.3581 standardized mean units over a shorter average measurement period of 10 months. Most outcomes were not sensitive to change over time; the expected change over time was independent of the length of the study in 9 of the 42 measures. Further, change in some measures was influenced by factors like cognitive ability, chronological age, whether children were receiving behavioral interventions and how the outcome was reported (e.g. age equivalent versus standard score). These data suggest that careful consideration is needed when selecting an appropriate outcome measure and tests that measure similar constructs can vary considerably in their expected change over time. Some recommendations based on these data include: use caution when reporting standard scores to measure change over time, use both parent report measures and clinician administered measures to track progress in behavioral interventions, and use caution when combining different outcome measures to synthesize intervention data.

    Cover page: Sensitivity and Expected Change of Commonly Used Social Communication Measures in Longitudinal Research of Children with Autism
    • Article
    • Peer Reviewed
    UCLA Previously Published Works (2021)
    Young adults with autism spectrum disorder (ASD) experience limited social connectedness, difficulty living independently, and other poor outcomes at high rates. Vocational activities, including employment and postsecondary education, are associated with increased positive outcomes and subjective well-being in typical adults. This study identified vocational activity trajectory groups in adults with ASD, examined change in these trajectories from ages 18 to 28, and compared levels of parent- and self-report subjective well-being across trajectory groups. One hundred fifty-one adults with ASD were drawn from an ongoing longitudinal study. Data on psychosocial outcomes and vocational activities were compiled from parent-report demographic forms. Vocational activities were scored using the vocational index (VDI). There was no significant effect of age on the slope of vocational trajectories (p = 0.787). Participants in the Independent Activities group had significantly higher parent-report happiness factor scores than participants in the No Activities group (F [3, 107] = 3.56, p = 0.017) and significantly higher self-report happiness factor scores than participants in the Volunteer Activities group (F [2, 35] = 6.46, p = 0.004). The Independent Activities group was also significantly more likely to have at least one social contact (X2 [3, 118] = 10.54, p = 0.014), however, there was no difference in trajectories groups in the likelihood of living independently (X2 [3, 120] = 1.71, p = 0.634). The results of this study indicate vocational activities in young adults with ASD are stable across time. In the current sample, participation in independent vocational activities was associated with increased levels of subjective well-being.
      Cover page: Work and well‐being: Vocational activity trajectories in young adults with autism spectrum disorder
      • Article
      • Peer Reviewed
      UCLA Previously Published Works (2023)
      The use of speech-generating devices (SGD) in early interventions for children with autism spectrum disorder (ASD) can improve communication and spoken language outcomes. The purpose of this study was to describe childrens responsiveness to SGD input modeled by a social partner during adult-child play interactions over a 24-week intervention trial and explore the effect of that responsiveness on spoken language growth. This secondary analysis consisted of 31 children with less than 20 functional words at study entry who received a blended behavioral intervention (JASPER + EMT) as part of a randomized controlled trial. Significant improvements were seen in rate of responsiveness to both adult SGD models and adult natural speech models; only rate of responsiveness to SGD models at entry was a significant predictor of frequency of commenting and was a more robust predictor of number of different words post-intervention. Lastly, at entry, children with more joint attention and language responded to SGD models at significantly higher rates. Attention and responsiveness to SGD output may be important mechanisms of language growth and children who have more joint attention skills may particularly benefit from use of an SGD.
        Cover page: The effect of responsiveness to speech-generating device input on spoken language in children with autism spectrum disorder who are minimally verbal†.
        • Article
        • Peer Reviewed
        UCLA Previously Published Works (2021)

        Lay abstract

        Children with autism spectrum disorder sometimes have challenges with regulating their negative emotions. These difficulties can impact children's social outcomes and how well they respond to intervention. We know that caregivers of children with autism spectrum disorder can help their children regulate negative emotions in a process known as co-regulation, but not much is known about how child and caregiver strategy use impacts children's negativity in real time. In this study, 71 caregivers of toddlers with autism spectrum disorder were asked to encourage their child to unlock a locked toy box, a task which is designed to elicit frustration. Video observations of the participants completing the task were used to examine whether specific child and caregiver behaviors increased or decreased the likelihood that the child will become upset. No child strategies were predictive of a decreased likelihood of a child becoming upset, but when children used high-energy behaviors that did not serve a purpose, such as running back and forth, they were more likely to then show signs of being upset a few seconds later. The way that caregivers responded to their child was a potent caregiver predictor of the likelihood of children's negativity, with caregivers' unresponsiveness and proactiveness both emerging as salient predictor of increased likelihood of the child being upset a few moments later. These findings give insight into how children with autism spectrum disorder and their caregiver navigate challenging and frustrating tasks, and have the potential to influence clinical practice by giving an indication off which parent and child behaviors are most effective in reducing children's negativity while interacting with parents and caregivers.
          Cover page: What are the odds? Predicting the likelihood of a negative episode in a sample of toddlers with autism spectrum disorder
          • Article
          • Peer Reviewed
          UCLA Previously Published Works (2024)
          The current study investigated the utility of the Brief Observation of Social Communication Change-Phrase Speech Young Fluent (BOSCC-PSYF) as an outcome measure of treatment response by analyzing the measures psychometric properties and initial validity. The BOSCC coding scheme was applied to 345 administrations from 160 participants diagnosed with autism. Participants included individuals of any age with phrase speech, or individuals under the age of 8 years with complex sentences. All were receiving behavioral intervention throughout the study. Test-retest and inter-rater reliability were good for the Early Communication and Social Reciprocity/Language domains, and fair for the Restricted and Repetitive Behavior domain. Significant changes occurred over time in the Early Communication and Social Reciprocity/Language domains, and Core Total scores. The BOSCC-PSYF may provide a low-cost, flexible, and user-friendly outcome measure that reliably measures changes in broad social communicative behaviors in a short period of time.
            Cover page: Extending the Usefulness of the Brief Observation of Social Communication Change (BOSCC): Validating the Phrase Speech and Young Fluent Version.
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