Social Communication Problems Research Articles

Association of behavioural and social-communicative profiles in children with 16p11.2 copy number variants: a multi-site study.

Despite the established knowledge that recurrent copy number variants (CNVs) at the 16p11.2 locus BP4-BP5 confer risk for behavioural and language difficulties, limited research has been conducted on the association between behavioural and social-communicative profiles. The current study aims to further delineate the prevalence, nature and severity of, and the association between, behavioural and social-communicative features of school-aged children with 16p11.2 deletion syndrome (16p11.2DS) and 16p11.2 duplication (16p11.2Dup). A total of 68 individuals (n=47 16p11.2DS and n=21 16p11.2Dup) aged 6-17years participated. Standardised intelligence tests were administered, and behavioural and social-communicative skills were assessed by standardised questionnaires. Scores of both groups were compared with population norms and across CNVs. The influence of confounding factors was investigated, and correlation analyses were performed. Compared with the normative sample, children with 16p11.2DS showed high rates of social responsiveness (67%) and communicative problems (69%), while approximately half (52%) of the patients displayed behavioural problems. Children with 16p11.2Dup demonstrated even higher rates of social-communicative problems (80-90%) with statistically significantly more externalising and overall behavioural challenges (89%). In both CNV groups, there was a strong positive correlation between behavioural and social-communicative skills. School-aged children with 16p11.2 CNVs show high rates of behavioural, social responsiveness and communicative problems compared with the normative sample. These findings point to the high prevalence of autistic traits and diagnoses in these CNV populations. Moreover, there is a high comorbidity between behavioural and social-communicative problems. Patients with difficulties in both domains are vulnerable and need closer clinical follow-up and care.

School Readiness in Preschool-Age Children with Critical Congenital Heart Disease.

This study examined the nature, variability, and predictors of school readiness difficulties in young children with critical congenital heart disease (CCHD). We hypothesized that, compared to a community control (CC) group, children with CCHD would score less well on measures of readiness and that readiness would be associated with CCHD-related risk factors. Children (60 CCHD and 60 CC) were 4 to 5 years of age and not yet attending kindergarten. Readiness measures included tests of cognition, executive function, motor ability, and pre-academic skills. Caregivers provided child behavior ratings. Analyses examined group differences in readiness, readiness profiles, and associations of readiness with CCHD-related medical risk factors. The CCHD group had lower scores than the CC group on testing and higher caregiver ratings of problems in social communication, as well as higher rates of deficits on several of the measures. Latent class analysis provided evidence for different readiness profiles, with more children with CCHD displaying profiles characterized by weaknesses in readiness. CCHD-related medical risk factors associated with readiness problems in the CCHD group included a co-morbid genetic disorder, postnatal diagnosis of CCHD, major perioperative complication, and longer periods of hospitalizations, cardiopulmonary bypass, and aortic cross-clamp placements. Findings document multiple problems in school readiness in young children with CCHD. Deficits vary across individuals and are associated with higher medical risk. Results confirm the importance of screening for school readiness in these children and suggest areas to target in designing screening measures and providing early childhood interventions.

Social Communication Problems, Social Anxiety, and Mood Problems among Students with Autism Spectrum Disorder from Teachers' Point of View

This study examined the level of social communication problems, social anxiety, and mood problems among children with ASD (age 6-13 years) enrolled in special classes (n=46) and regular classes (n=36) from teachers' point of view in the schools of a part of Palestine. Teachers responded to three questionnaires - social communication problems, social anxiety and mood problems- that were used to answer the research questions. Results: social communication problems, social anxiety and mood problems were of medium rates for students with ASD enrolled in reguler and special classes. No significant differences in the level of social communication problems could be attributed to class type (Regular, Special) or the grade level-(1st – 3rd, 4th - 6th). There were significant differences in social anxiety levels that could be attributed to grade level in favor of the 4th - 6th grades but there were no significant differences according to class type (Regular, Special). There were statistically significant differences in mood problems levels that could be attributed to the class type in favor of special classes, but no differences were found according to grade level. There was a direct significant relationship between communication problems, social anxiety, and mood problems. Conclusion: social communication problems may be an important risk factor for the development of social anxiety and mood problems among students with ASD.

Children's and Parents' Factors That Affect Parenting Stress in Preschool Children With Developmental Disabilities or Typical Development.

This study compared parenting stress in preschool children with developmental disabilities (DD) or typical development (TD). We also investigated children's factors that affect parenting stress. A total of 196 preschool children participated in the study (aged 54.8±9.2 months). There were 79 children with DD (59 with autism spectrum disorder, 61 with intellectual disability, 12 with language disorder) and 117 with TD. The high parenting stress and the low parenting stress groups were divided based on the Total Stress of Korean Parenting Stress Index Fourth Edition (K-PSI-4) with an 85-percentile cutoff score. Pearson's correlation analysis was conducted to calculate the correlation between K-PSI-4 and the children's or parents' measures. The difference in parenting stress between DD and TD was significant in the Total Stress of K-PSI-4 (p<0.001). The Total Stress scale of K-PSI-4 represented a modest to strong correlation with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Our results showed that caregivers of children with DD reported higher parenting stress than those with TD. Parenting stress was strongly associated with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Among the children's factors, especially social communication, attention problems, and aggressive behavior had association with caregivers' higher parenting stress. These findings suggest the need for early intervention for parenting stress in caregivers by assessing child characteristics, including social cognition, awareness, communication, and inattention and hyperactivity, in the evaluation of children with DD.

E-LEARNING APPLICATION FOR AUTISM CHILDREN

‘Auticore’ is a e-learning mobile application that will particularly help all the autism children to learn communication skills and to become a productive child from the childhood. All the features and interfaces are designed for children with autism spectrum disorder and Important features which may improve the quality of their learning abilities. The Sustainable Development Goals (SDGs) are a global plan to reduce inequality both inside and between countries. Autism is one of the challenging factors nowadays. Autism spectrum disorder, the name adopted in 2013, is a developmental disorder characterized by persistent problems in social communication and interaction, along with restricted and repetitive patterns of behavior, interests, or activities. The following project is specified the implementation process of E-learning application for students with autism spectrum disorder. The main goal of the project is to develop a mobile application to create a better and smartest way to learn social communication skills for children with Autism Spectrum Disorder (ASD).

EFEK BULLYING TERHADAP KETERAMPILAN KOMUNIKASI PADA REMAJA AWAL DI KOTA SURAKARTA: REGRESI LOGISTIC MULTILEVEL DARI SURAKARTA JAWA TENGAH

Background. Human interaction requires communication as a transmission of information, ideas, emotions, skills, and so on. Communication occurs when a source conveys a message to the recipient with a conscious intention to influence the recipient's behavior. One of the problems in social communication is bullying. Bullying or harassment can be through words or through actions that aim to make the opponent's mental fall and pressure. The purpose of this study was to analyze the factors that influence bullying against depression with the Health Belief Model and Social Cognitive Theory. Subjects and Method. This was a cross-sectional study conducted in junior high schools in Surakarta, in September 2023. A total sample of 250 adolescents was selected by simple random sampling. The dependent variable was bullying. The independent variables were perceived susceptibility, perceived severity, cues to action, perceived threat, perceived benefit, perceived barrier, self-efficacy, and communication. The data were collected by questionnaire and analyzed by a multiplemultilevel logistic regression run on Stata 13. Results. Bullying increased poorcommunication (b= 4.95; 95% CI= 2.24 to 10.89; p &lt;0.001). Conclusion. Bullying increases poor communication.

Camouflage, self-esteem and gratitude in young adults with varying degrees of autistic traits in Poland

Autistic spectrum conditions (ASC) imply functioning difficulties in adulthood due to the fact that they are caused by early-onset problems in social communication, unusually restricted repetitive behavior, and narrow interests. Living with ASC might be difficult for young adults who face specific developmental tasks, such as undertaking a professional career and engaging in social and civic responsibilities. Because of the need to hide their dysfunctions and to conform to social norms and conventions, affected people use camouflage strategies. In order to improve their well-being and functioning, they may also use the regulatory function of self-esteem and gratitude. The presented research carried out in Poland aimed to determine the relations between the intensity of camouflage, self-esteem, and gratitude and to test for differences in the levels of these variables, taking into consideration the intensity of the autism spectrum conditions (ASC). The study comprised a total of 104 young adults (68 women = 65.38%, and 36 men = 34.62%) who graduated from secondary or tertiary education aged between 19 and 35 years. The entire group was divided into two subgroups based on the screening questionnaire Autism Spectrum Quotient (AQ10), a ten-item abridged version. One subgroup consisted of 52 adults with a high intensity of autistic traits, and the other consisted of individuals with a low intensity of autistic traits. The results showed a correlation between the level of autism spectrum conditions and camouflage. The level of camouflage was significantly higher in the subgroup with an increased severity of autistic traits compared with the subgroup with a low severity. In contrast, no significant differences were detected between the subgroups in the levels of self-esteem and gratitude, nor were any linear correlations between spectrum conditions and self-esteem and gratitude found.

Vasopressin as Possible Treatment Option in Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is rather common, presenting with prevalent early problems in social communication and accompanied by repetitive behavior. As vasopressin was implicated not only in salt-water homeostasis and stress-axis regulation, but also in social behavior, its role in the development of ASD might be suggested. In this review, we summarized a wide range of problems associated with ASD to which vasopressin might contribute, from social skills to communication, motor function problems, autonomous nervous system alterations as well as sleep disturbances, and altered sensory information processing. Beside functional connections between vasopressin and ASD, we draw attention to the anatomical background, highlighting several brain areas, including the paraventricular nucleus of the hypothalamus, medial preoptic area, lateral septum, bed nucleus of stria terminalis, amygdala, hippocampus, olfactory bulb and even the cerebellum, either producing vasopressin or containing vasopressinergic receptors (presumably V1a). Sex differences in the vasopressinergic system might underline the male prevalence of ASD. Moreover, vasopressin might contribute to the effectiveness of available off-label therapies as well as serve as a possible target for intervention. In this sense, vasopressin, but paradoxically also V1a receptor antagonist, were found to be effective in some clinical trials. We concluded that although vasopressin might be an effective candidate for ASD treatment, we might assume that only a subgroup (e.g., with stress-axis disturbances), a certain sex (most probably males) and a certain brain area (targeting by means of virus vectors) would benefit from this therapy.

Understand ASD differences in women for accurate referral, diagnosis, accommodations

Leo Kanner (1943) and Hans Asperger (1944), whose studies included only boys, initially and independently identified autism, noting three basic characteristics: (1) social difficulties, (2) communication problems, and (3) repetitive and restrictive activities. But it wasn’t until 1980 that the term “autism” appeared in the Diagnostic and Statistical Manual of Mental Disorders‐III. Not until 1994 did Asperger's syndrome, or high‐functioning autism, appear in the DSM‐IV. And in the 2013 DSM‐5, Asperger's syndrome disappeared, merging into the integrated category of autism spectrum disorder.

Associations of age, anxiety, cognitive functioning, and social impairment with aggression in youth with autism

BackgroundPrevious research has indicated that aggression in children with autism is associated with cognitive functioning, age, anxiety, and social functioning, although most samples only include parent-report measures and participants without intellectual disability. Furthermore, there is a lack of research investigating how different aspects of social impairment are associated with aggressive behaviour in youth with autism while anxiety is included in the analyses. The aim of this study was to clarify the relationships of these variables with aggression in a large sample, diverse in age and cognitive level, using both parent- and teacher-report measures. MethodParticipants were 1179 youth (age 4–18) with a diagnosis of autism spectrum disorder, from the SFARI database. Parent- and teacher-report measures were obtained for aggression, anxiety, and social impairment. Univariate statistics were calculated to determine how each variable was associated with aggression and hierarchical regressions were conducted with all variables together. ResultsAge and intellectual disability presence/severity had small positive relationships with teacher-measured aggression while anxiety and social impairment severity had strong relationships with aggression when rated by both parents and teachers. In a regression analysis, anxiety and social communication problems had the strongest positive relationships with aggression while social motivation problems had a negative relationship with aggression. ConclusionThese results indicate the importance of anxiety and social problems, particularly in social communication and motivation, when studying and treating aggression in youth with autism.

A scoping review of oral language and social communication abilities in children with Tourette syndrome.

Children with Tourette syndrome (TS) have historically experienced problems in academic and social settings, yet their language and communication abilities have not been extensively researched. This scoping review maps the literature on the oral language and social communication abilities of children with TS in order to describe the nature of the current literature, present a summary of major findings and identify where gaps exist. A scoping review was completed to identify studies measuring the oral language or social communication abilities of children with TS. A systematic search of six electronic databases was conducted to obtain published and unpublished literature. All English studies measuring the oral language or social communication abilities of children with TS were included. Information was extracted from records and knowledge was synthesised in a narrative summary. We identified 56 records for inclusion. Almost all records were located in journals within the fields of psychology and psychiatry. Skills most often studied were verbal IQ and verbal fluency. The literature suggests an increased prevalence of language disorders and social communication problems in children with TS; however, literature comprehensively detailing these challenges was scarce. Language strengths were identified in verbal intelligence, story/sentence recall, categorisation and performance on tasks at the single-word level. Oral language and social communication skills are important for academic and social success. This review brings scattered literature together to provide up-to-date information about language in children with TS and highlights that there are considerable gaps in our knowledge about language and communication in this population. This scoping review can inform future research and support speech language pathologists in the assessment of young people with TS. What is already known on the subject Speech-language pathologists (SLPs) working in various contexts (e.g., schools, mental health teams) are likely to encounter children with Tourette syndrome (TS); however, the description of this population and potential communication characteristics is not well represented in the SLP literature. Previous literature reviews have reported strengths in verbal fluency and morphological processing. Challenges in expressive language, higher order language, social cognitionand a propensity towards autistic traits have also been identified. What this paper adds to existing knowledge This review differs from previous narrative reviews by employing a systematic approach to searching for literature. As a result, we identified 25 additional studies that had not been cited in previous reviews and additional relevant findings in 23 previously reviewed studies. This review confirms several previous conclusions about language in children with TS and extends or clarifies several others, thereby providing the most current information on oral language and social communication abilities. The use of current taxonomies of language and social communication helps to organise this literature for clinicians and researchers in speech-language pathology and identifies a need for further research from the SLP perspective. What are the potential or actual clinical implications of this work? These results imply that SLPs should screen children with TS for language disorders and investigate social communication and social interaction development. Clinicians can expect greater challenges in language and communication development for children with complex forms of TS (i.e., those who exhibit co-occurring conditions such as attention-deficit/hyperactivity disorder). The multidisciplinary nature of the current literature implies that clinical collaboration with other disciplines will be of particular benefit to serving this group of children.

Emotion dysregulation and social communication problems but not ToM properties may predict obsessive-compulsive disorder symptom severity

Objective Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with obsessive-compulsive disorder (OCD). We aimed to investigate theory of mind (ToM) abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD and to compare them to healthy controls. Methods This study was designed as a single-center, cross-sectional, case-control study. ToM abilities were evaluated via “Reading the Mind in the Eyes Test” (RMET), “Faces Test”, “Faux-Pas Test”, “Comprehension Test” and “Unexpected Outcomes Test”. Social responsiveness, pragmatic language and emotion regulation were evaluated by Social Responsiveness Scale (SRS), Children’s Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls). Results The OCD group performed significantly lower than healthy controls in the Faux Pass and Comprehension tests (p = 0.003 for both). We found a statistically significant difference between groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) as well as the total DERS score (p < 0.001). CY-BOCS total scores correlated significantly and negatively with Comprehension, Faux Pas and Unexpected Outcomes tests, and positively with CCC total, SRS total and DERS total scores. In regression analysis the DERS, SRS and CCC tests emerged as significant predictors of CY-BOCS total score. Conclusion Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may contribute to positive outcomes.

Understand ASD differences in women for accurate referral, diagnosis, and accommodation

Leo Kanner (1943) and Hans Asperger (1944), whose studies included only boys, initially and independently identified autism, noting three basic characteristics: (1) social difficulties, (2) communication problems, and (3) repetitive and restrictive activities. (see Leo Kanner, Autistic disturbances of affective contact, 2 Nervous Child 217 (1943); Hans Asperger, ‘Autistic psychopathy’ in childhood (U. Frith, trans. 1991)). But it was not until 1980 that the term “autism” appeared in the Diagnostic and Statistical Manual of Mental Disorders‐III. Not until 1994 did Asperger's syndrome, or high‐functioning autism, appear in the DSM‐IV. And in the 2013 DSM‐5, Asperger's syndrome disappeared, merging into the integrated category of autism spectrum disorder.

Abnormal Brain Structure Is Associated with Social and Communication Deficits in Children with Autism Spectrum Disorder: A Voxel-Based Morphometry Analysis.

Structural magnetic resonance imaging (sMRI) studies have shown abnormalities in the brain structure of ASD patients, but the relationship between structural changes and social communication problems is still unclear. This study aims to explore the structural mechanisms of clinical dysfunction in the brain of ASD children through voxel-based morphometry (VBM). After screening T1 structural images from the Autism Brain Imaging Data Exchange (ABIDE) database, 98 children aged 8-12 years old with ASD were matched with 105 children aged 8-12 years old with typical development (TD). Firstly, this study compared the differences in gray matter volume (GMV) between the two groups. Then, this study evaluated the relationship between GMV and the subtotal score of communications and social interaction on the Autism Diagnostic Observation Schedule (ADOS) in ASD children. Research has found that abnormal brain structures in ASD include the midbrain, pontine, bilateral hippocampus, left parahippocampal gyrus, left superior temporal gyrus, left temporal pole, left middle temporal gyrus and left superior occipital gyrus. In addition, in ASD children, the subtotal score of communications and social interaction on the ADOS were only significantly positively correlated with GMV in the left hippocampus, left superior temporal gyrus and left middle temporal gyrus. In summary, the gray matter structure of ASD children is abnormal, and different clinical dysfunction in ASD children is related to structural abnormalities in specific regions.

Autism spectrum disorder classification using Adam war strategy optimization enabled deep belief network

Autism spectrum disorder (ASD) is a brain disorder caused by dysfunction in the brain. ASD patients have social interaction and communication problems that are determined by numerous deep learning (DL) methods. The existing ASD detection methods are complex and inaccurate in ASD classification. In this investigation, the patient with ASD is determined by the Adam war strategy optimization (AWSO) based Deep Belief Network (DBN). The developed AWSO algorithm is modelled by assimilating the Adam optimizer with the War Strategy Optimization (WAO). The Adam war strategy optimization technique is a simple process and it overcomes the issue of the existing method with outstanding performance. The pre-processing is finished using anisotropic diffusion and Region of Interest (ROI) extraction to remove the noise in the input images. testing Moreover, the pivotal region extraction is completed by the Box Neighbourhood Search Algorithm based on Functional Connectivity to progress the performance of ASD classification. Then, the ASD classification is completed by the DBN, and the AWSO algorithm establishes the learning of DBN. Here, the analysis of AWSO-DBN is done using ABIDE-I and ABIDE-II, and the AWSO-DBN attained outstanding performance with the ABIDE-I dataset by varying the training set. The experimental outcome reveals that the AWSO-DBN algorithm achieved a better specificity of 0.935, an accuracy of 0.924, and a sensitivity of 0.930.

Parents’ Perceptions of the Problems in Children With Autism Spectrum Disorders: A Qualitative Study

Objectives: Parents of children with autism spectrum disorder (ASD) have valuable experiences of the possible developmental problems and other issues of their children as the primary caregivers. The present study aimed to obtain proper information by considering these experiences using a qualitative approach to explain the parents’ perception of problems in their children with ASD. Methods: This study with a qualitative design was performed on 35 parents of children with ASD (33 mothers and 2 fathers) who were selected via purposive sampling. The study data were collected using semi-structured interviews, and all sessions were recorded and immediately transcribed verbatim. We followed the Graneheim and Lundman (2003) content analysis approach (a step-by-step extraction of meaning unit, initial codes, subtheme, and theme). Results: We extracted 5 main themes of developmental, language comprehension and expression, social communication, behavioral, and general health problems. Each of these mentioned themes has several subthemes. Discussion: According to the results, the parents’ perceptions and experiences of their ASD children’s problems were similar to the findings reported by experts in a few related studies. Given the lived experiences of the parents of children with ASD, they could help enrich the references regarding the problems of children with ASD. Such data should be considered during the assessment and intervention for this group of children.

Shielding Effect of Ryanodine Receptor Modulator in Rat Model of Autism.

A neurodevelopmental disorder, autism is typically identified with three primary behavioral consequences, such as social impairment, communication problems, and limited or stereotypical behavior. Because of its co-morbidity and lack of therapeutic options, autism is a global economic burden. A short chain of fatty acid, propionic acid is formed biologically by the gut microbiome. Propionic acid levels that are too high can cause leaky intestines, which can lead to autism-like symptoms. To induce autism, male Albino Wistar rats were given propionic acid (250 mg/kg/po on the 21st, 22nd, and 23rd postnatal days). Rats also received a ryanodine receptor antagonist (Ruthenium red: 3 mg/kg/po; postnatal 21st to 50th day) to see what influence it had on propionic acid-induced autism. Anxiety, social behavior, and repeated behaviors were all assessed, as well as oxidative stress, inflammatory indicators, neuro signaling proteins, and blood-brain barrier permeability. Ruthenium red was found to counter the propionic acid-induced increases in anxiety, repetitive behavior prefrontal cortex levels of IL-6, TNF-α, TBARS, Evans blue leakage, and water content along with decreases in social behavior, IL-10, and GSH followed by hippocampus CREB and BDNF levels. Ryanodine receptor antagonists presented a neuroprotective effect in propionic acid-induced conditions like autism by modulatory effects on social and repetitive behavior, oxidative stress, neuroinflammation, and neuroprotein changes. Ryanodine receptors can be further explored in depth to manage autism as a condition. Ruthenium red can reduce the propionic acid-induced anxiety of rats with autism.Ruthenium red can improve the propionic acid-induced changes in repetitive behavior of rats with autism.Ruthenium red can reduce the propionic acid-induced social behavior dysfunction in rats with autism. Autism is a complex heterogeneous neurodevelopmental disorder mainly diagnosed with social behavior dysfunction, communication problems, and repetitive behavior. Due to high comorbidity and multiple unknown factors involvement, its exact etiology remains unclear, and so no successful treatment is available. Among the environmentally produced models of autism in rats, the most common is created by propionic acid (PPA). With short-chain type fatty acid, PPA is one of the mediators for the cycle of cell metabolism. This study attempted to study the effect of a ryano-dine receptor antagonist (Ruthenium red) on PPA-induced Anxiety, social behavior dysfunction, and repeated behaviors in rats with autism. The results showed the modulatory effects of Ruthenium red PPA-induced conditions including social and repetitive behavior, oxidative stress, neuroinflammation, and neuroprotein changes in rats with autism.

Measurement properties of the Brain Balance® multidomain developmental survey: validated factor structure, internal reliability, and measurement invariance

This study aimed to refine and validate a multidomain developmental survey (MDS) used by the Brain Balance® (BB) program. Data were analyzed on 47,571 participants (68.5% male; 4–18 years) whose parents completed the survey before/after 3 months of in-center BB participation. Exploratory Factor Analysis was applied to a training sample (n = 28,254), reducing the original item pool from 98 to 31 items and suggesting a six-factor solution. The six factors were labeled as negative emotionality, reading/writing difficulties, hyperactive-disruptive, academic disengagement, motor/coordination problems, and social communication problems. Exploratory Structural Equation Modeling was applied to two validation samples (n = 9394 and 9923), and the factor structure demonstrated strong goodness-of-fit. Test–retest reliability coefficients (per Pearson correlations) were high for each of the subscales. Finally, the survey’s factor structure appeared equivalent across four groups stratified by reported gender and adolescent status. Overall, the BB-MDS demonstrated strong measurement properties, including validated factor structure, internal reliability, test–retest reliability, and measurement invariance.

Reliable change in developmental outcomes of Brain Balance® participants stratified by baseline severity.

The effects of comprehensive multimodal programs on developmental outcomes have not been well-studied. Emerging evidence suggests a possible role for the Brain Balance® (BB) program, a multimodal training program, in serving as a nonpharmacologic approach to addressing cognitive, attentional, and emotional issues in youth. In this analysis, we examined the effects of 3 months of participation in the BB program on the outcomes of children and adolescents with developmental difficulties (N = 4,041; aged 4-18 years; 69.7% male). Parent-rated scores on the Brain Balance-Multidomain Developmental Survey (BB-MDS) were used to assess six areas at baseline and post-program: (1) negative emotionality; (2) reading/writing difficulties; (3) hyperactive/disruptive behavior; (4) academic disengagement; (5) motor/coordination problems; and (6) social communication problems. To estimate change from pre- to post-program, we calculated effect size (Cohen's d) and the Reliable Change Index (RCI) for groups stratified by baseline severity. There was a very large effect size for the moderate/high severity (d = 1.63) and extreme severity (d = 2.08) groups, and a large effect size for the mild severity group (d = 0.87). The average percentage of participants who observed reliable change over all BB-MDS domains was 60.1% (RCICTT) for extreme severity, 46.6% (RCICTT) for moderate/high severity, and 21.1% (RCICTT) for baseline mild severity. In additional assessments of primitive reflexes and sensory motor activity, students demonstrated significantly diminished primitive reflexes from pre- to post-participation and significant improvements in sensory motor skills including fine motor skills, gait and aerobic ability, proprioception, rhythm and timing, and eye-gaze stability. Overall, these results demonstrate improvements in primitive reflex integration and sensory motor skills, as well as statistically significant reliable change in emotionality, reading/writing, behavior, academic engagement, motor skills, and social communication in BB participants from pre- to post-program, with the probability and degree of change increasing as the participants' baseline severity increases. These results contribute to the growing literature on the need for evidence-based nonpharmacologic approaches to addressing developmental issues. Future research with well-controlled designs, longitudinal follow-up, implementation across settings, and participant groups in which diagnoses are known, will help to more fully characterize the effects of the BB program.

Social communication problems, social anxiety, and mood problems: kindergarten and primary school teachers’ perspective among students with autism spectrum disorder

This study examined the level of social communication problems (SCP), social anxiety (SA), and mood problems (MP) among children with ASD (age 4–13 years) enrolled in special classes (n = 74) and regular classes (n = 73) and grade level (kindergarten, 1st–3rd, 4th–6th) from teachers’ perspective in schools of Palestinian Arabs in Israel. Teachers responded to three questionnaires about (1) SCP, (2) SA and (3) MP; the teachers’ responses to the questionnaires were used to answer the research questions. Results: SCP, SA and MP were of medium rates for students with ASD enrolled in regular and special classes. No significant differences in the level of SCP could be attributed to class type (Regular, Special) or the grade level (kindergarten, 1st–3rd, 4th–6th). There were significant differences in SA levels that could be attributed to grade level in favor of the 4th–6th grades but there were no significant differences according to class type (Regular, Special). There were statistically significant differences in MP levels that could be attributed to the class type in favor of special classes, and the effect of grade level was not significant. There was a direct significant relationship between SCP, SA, and MP. Conclusion: SCP may be an important risk factor for the development of SA and MP among students with ASD, which lead us to incorporating social skills interventions by educational staff to alleviate or even prevent symptoms of SA and MP among students with ASD, which supports the view of inclusion