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Sökning: WFRF:(Berggren Steve) > (2015-2019)

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1.
  • Berggren, Steve (författare)
  • Emotion recognition and expression in autism spectrum disorder : significance, complexity, and effect of training
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The overall scientific aim of this thesis is to examine emotion recognition in children with Autism Spectrum Disorder (ASD), its specificity to ASD and connection to other cognitive functions, as well as to map the effects of previous and novel emotion recognition and emotion expression training programs in children with ASD across cultures. Emotion processing training in ASD is a potentially valuable tool to improve the lives and outcomes of children with ASD, but it has been lacking an adequate scientific preparation, content and motivational design, as well as high-end technical expertise. In study I, we review the existing randomized controlled trials on emotion recognition training for children and adolescents with ASD, focusing external validity, a largely aspect in the area. External validity is significant to evaluate for several reasons. First, emotion recognition training approaches have been diverse, and ASD forms population a heterogeneous population. Second, children and adolescents with ASD often have difficulties with generalizing knowledge from the training context to new situations, and it is not clear how this is reflected in the results of the various emotion recognition training programs. Third, emotion recognition training is often performed using computerized programs in controlled settings, raising questions about the extent to which the effects translate to everyday situations. The systematic review demonstrated few indications to presume that current emotion training programs generalize outside of the training setting into everyday life social interactions. This review highlights the need to focus on external validity in future emotion recognition training studies, and to improve reporting of these aspects. Study II examined basic facial affect recognition in well-matched samples ofchildren with ASD, Attention-Deficit Hyperactivity Disorder (ADHD) and typical development using the computer-based FEFA-2 test. We examined accuracy and response times for general and specific facial affect recognition skills in whole face and eye-region stimuli. The ASD samples performed inferior to typical developing controls. There were no difference between the ADHD sample, on one hand, and the ASD and typical sample, on the other. In the clinical samples, particularly the ADHD sample, cognitive distractibility explained a substantial proportion of variance of basic facial affect recognition performance. This research largely confirms previous findings on emotion recognition in ASD, and aspects of specificity compared to ADHD, a neurodevelopmental condition overlapping with ASD. Importantly, the study shows that performance on emotion recognition tasks is not only depending on pure emotion recognition capacities, but is also largely influenced by other cognitive functions. Study III explored cultural differences in emotion recognition in children with ASD and typically developed children. Compared to many previous studies, differences in recognizing emotion expression was tested in three modalities of basic and complex emotion processing, namely in face, voice, and body language including gestures. These expressions were also examined in integrated form using complex social scenes. The study was conducted across three countries and cultural contexts: Israel, United Kingdom and, and Sweden. Children with ASD showed impairments in both basic and complex emotions on all three modalities and their integration in context compared to typically developing matched control children. Both children with ASD and typical development performed better on basic than complex emotions. Cross-cultural differences were limited to some face and body stimuli, indicating high cross cultural comparability of emotion recognition findings. Study IV included a cross-cultural evaluation of the effects of the serious game “Emotiplay” in ASD on emotion recognition skills, and parent-reported autism symptomatology and adaptive skills in United Kingdom, Israel and Sweden. Emotion recognition tasks comprised face, voice, body, and integrative social scenes. Children used Emotiplay 8-12 weeks in a home setting. In the United Kingdom children were tested prepost, while children in Israel and Sweden were randomized to training or a waiting-list control group. Results showed improvements in emotion recognition regarding body language and integrative tasks as well as adaptive socialization in the United Kingdom site. In Israel and Sweden, the active groups improved more than controls on all emotion recognition outcomes. There was also an effect on autism related symptoms in the sample from Israel. Findings support the feasibility and usefulness of serious gaming to enhance emotion recognition and possibly reduce autism symptoms and socialization issues in autistic children. Emotiplay was found useful across three cultures. Still, future research and follow-up studies are needed to determine long-term effects and evaluate its impact on real life situations.
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2.
  • Berggren, Steve, et al. (författare)
  • Emotion recognition training in autism spectrum disorder : A systematic review of challenges related to generalizability.
  • 2018
  • Ingår i: Developmental Neurorehabilitation. - : Informa UK Limited. - 1751-8423 .- 1751-8431. ; 21:3, s. 141-154
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To assess the generalizability of findings from randomized controlled trials (RCTs) evaluating emotion recognition (ER) training for children and adolescents with autism spectrum disorder (ASD).METHODS: We present a systematic review and narrative synthesis of the determinants of external validity in RCTs on ER training. Generalizability of the findings across situations, populations, settings, treatment delivery, and intervention formats was considered.RESULTS: We identified 13 eligible studies. Participants were predominantly boys with ASD in the normative IQ range (IQ > 70), with an age span from 4 to 18 years across studies. Interventions and outcome measures were highly variable. Several studies indicated that training may improve ER, but it is still largely unknown to what extent training effects are translated to daily social life.CONCLUSION: The generalizability of findings from currently available RCTs remains unclear. This underscores the importance of involving children with ASD and their caregivers in informed treatment decisions.
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3.
  • Bolte, Sven, et al. (författare)
  • Challenges and Inequalities of Opportunities in European Psychiatry Research The Example of Psychodiagnostic Tool Availability in Research on Early Autism Identification
  • 2018
  • Ingår i: European Journal of Psychological Assessment. - : Hogrefe Publishing Group. - 1015-5759 .- 2151-2426. ; 34:4, s. 270-277
  • Tidskriftsartikel (refereegranskat)abstract
    • Europe is diverse in terms of economy, cultures, socio-demography, and languages. A crucial aspect of psychiatric research is the availability of standardized screening, diagnostic, and characterization instruments. We fine-mapped the accessibility of 14 clinical scales and cognitive tests for the assessment of early childhood Autism Spectrum Disorder (ASD; e.g., ADOS, ADI-R, SCQ, SRS, CHAT, MESL) within 21 European countries. These tools are essential for internationally competitive early ASD detection research. We identified a considerable variation not only in the availability, but also psychometric standardization, and formal distribution of the instruments between the countries, privileging English speaking, high-income, and highly populated European countries. Absence of country-specific standardization was a problem across many countries, independent of income and size. Findings demonstrate, on a concrete level, the challenges in creating equal early ASD identification research opportunities in Europe, and the need for increased funding for instrument development and validation. We discuss the reasons, implications, and consequences of this inequity and ways of reducing it.
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4.
  • Choque Olsson, Nora, et al. (författare)
  • Social Skills Training for Children and Adolescents With Autism Spectrum Disorder : A Randomized Controlled Trial
  • 2017
  • Ingår i: Journal of the American Academy of Child and Adolescent Psychiatry. - : Elsevier BV. - 0890-8567 .- 1527-5418. ; 56:7, s. 585-592
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Social skills group training (SSGT) for children and adolescents with autism spectrum disorder (ASD) is widely applied, but effectiveness in real-world practice has not yet been properly evaluated. This study sought to bridge this gap.METHOD: This 12-week pragmatic randomized controlled trial of SSGT compared to standard care alone was conducted at 13 child and adolescent psychiatry outpatient units in Sweden. Twelve sessions of manualized SSGT ("KONTAKT") were delivered by regular clinical staff. Participants (N = 296; 88 females and 208 males) were children (n = 172) and adolescents (n = 124) aged 8 to 17 years with ASD without intellectual disability. The primary outcome was the Social Responsiveness Scale rating by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and 3-month follow-up. Moderator analyses were conducted for age and gender.RESULTS: Significant treatment effects on the primary outcome were limited to parent ratings for the adolescent subgroup (posttreatment: -8.3; 95% CI = -14.2 to -1.9; p = .012, effect size [ES] = 0.32; follow-up: -8.6; 95% CI = -15.4 to -1.8; p = .015, ES = 0.33) and females (posttreatment: -8.9; 95% CI = -16.2 to -1.6; p = .019, ES = 0.40). Secondary outcomes indicated moderate effects on adaptive functioning and clinical severity.CONCLUSION: SSGT for children and adolescents with ASD in regular mental health services is feasible and safe. However, the modest and inconsistent effects underscore the importance of continued efforts to improve SSGT beyond current standards.CLINICAL TRIAL REGISTRATION INFORMATION: Social Skills Group Training ("KONTAKT") for Children and Adolescent With High-functioning Autism Spectrum Disorders; https://clinicaltrials.gov/; NCT01854346.
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5.
  • Jonsson, Ulf, 1974-, et al. (författare)
  • Long-term social skills group training for children and adolescents with autism spectrum disorder : a randomized controlled trial.
  • 2019
  • Ingår i: European Child and Adolescent Psychiatry. - : Springer Science and Business Media LLC. - 1018-8827 .- 1435-165X. ; 28:2, s. 189-201
  • Tidskriftsartikel (refereegranskat)abstract
    • Social skills group training (SSGT) is widely used for intellectually able children and adolescents with autism spectrum disorder (ASD). Previous studies indicate small to moderate effects on social communication capacities. The duration of most available programs is relatively short, and extended training might lead to further improvement. This randomized controlled trial compared an extended 24-week version of the SSGT program KONTAKT with standard care. The weekly sessions gradually shifted in content from acquisition of new skills to real-world application of the acquired skills. A total of 50 participants with ASD (15 females; 35 males) aged 8-17 years were included. The study was conducted at two child and adolescent psychiatry outpatient units in Sweden. The primary outcome was the Social Responsiveness Scale-Second Edition (SRS-2) rated by parents and blinded teachers. Secondary outcomes included parent- and teacher-rated adaptive behaviors, trainer-rated global functioning and clinical severity, and self-reported child and caregiver stress. Assessments were made at baseline, posttreatment, and at 3-months follow-up. Parent-rated SRS-2 scores indicated large effects posttreatment [- 19.2; 95% CI - 29.9 to - 8.5; p < .001, effect size (ES) = 0.76], which were maintained at follow-up (- 20.7; 95% CI - 31.7 to - 9.7; p < .0001, ES = 0.82). These estimates indicate substantially larger improvement than previously reported for shorter SSGT. However, the effects on teacher-rated SRS-2 and most secondary outcomes did not reach statistical significance. Our results suggest added benefits of extended SSGT training, implying that service providers might reach better results by optimizing the delivery of SSGT.
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6.
  • Tammimies, Kristiina, et al. (författare)
  • Association between copy number variation and response to social skills training in Autism Spectrum Disorder
  • 2019
  • Ingår i: Scientific Reports. - : Nature Publishing Group. - 2045-2322. ; 9:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Challenges in social communication and interaction are core features of autism spectrum disorder (ASD) for which social skills group training (SSGT) is a commonly used intervention. SSGT has shown modest and heterogeneous effects. One of the major genetic risk factors in ASD is rare copy number variation (CNV). However, limited information exists whether CNV profiles could be used to aid intervention decisions. Here, we analyzed the rare genic CNV carrier status for 207 children, of which 105 received SSGT and 102 standard care as part of a randomized clinical trial for SSGT. We found that being a carrier of rare genic CNV did not have an impact on the SSGT outcome measured by the parent-report Social Responsiveness Scale (SRS). However, when stratifying by pathogenicity and size of the CNVs, we identified that carriers of clinically significant and large genic CNVs (>500 kb) showed inferior SRS outcomes at post-intervention (P = 0.047 and P = 0.036, respectively) and follow-up (P = 0.008 and P = 0.072, respectively) when adjusting for standard care effects. Our study provides preliminary evidence that carriers of clinically significant and large genic CNVs might not benefit as much from SSGT as non-carriers. Our results indicate that genetic information might help guide the modifications of interventions in ASD. 
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7.
  • Tammimies, Kristiina, et al. (författare)
  • Association between rare copy number variation and response to social skills training in autism spectrum disorder
  • 2018
  • Ingår i: bioRxiv. - : Cold Spring Harbor Laboratory.
  • Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
    • Challenges in social communication and interaction are core symptoms in autism spectrum disorder (ASD) for which social skills group training (SSGT) is a commonly used intervention. SSGT has shown modest but heterogeneous effects in clinical trials, and therefore identification of effect moderators could enable more precise intervention decisions. One of the major genetic risk factors in ASD are rare copy number variation (CNV). However, limited information exists whether rare CNVs profiles can be used to aid in intervention decisions. Therefore, we conducted the first study to date analyzing rare CNVs as genetic moderators in the outcome of SSGT in ASD. For this, we analyzed rare genic CNV carrier status of 207 children of which 105 received SSGT and 102 standard care as part of a recent randomized clinical trial for 12-weeks SSGT. We used mixed linear models to assess the association of being a CNV carrier, grouped by the effect and size of the CNVs and the primary response to SSGT, the parent-report Social Responsiveness Scale (SRS) measured at post-intervention and 3-months follow-up. Additionally, we analyzed the secondary outcome assessments included parent-rated adaptive behaviors (ABAS-II) and trainer-rated clinical global impression (CGI). We show that being a carrier of any size rare genic CNV did not impact on the SSGT outcome. However, when stratifying the groups by size of the CNVs, we identified that carriers of large CNVs (>500 kb) showed inferior SRS outcomes at post-intervention (β = 15.35, 95% CI 2.86-27.84, P=0.017) and follow-up (β = 14.19, 95% CI 1.68-26.70, P=0.028). Similar results were shown for the parent-rated secondary outcome. In contrast, the carriers of small CNVs had better outcome at post-intervention (β = -1.20, 95 % CI -2.0 - -0.4 P = 0.003) but not at follow-up for the trainer-rated secondary outcome CGI. These results remained when we tested the specificity of the effect by including the standard care group and adjusting for IQ levels. While our study suggests that being a carrier of any size rare genic CNV did not impact the outcome, it provides preliminary evidence that carriers of high-risk CNVs might not benefit on SSGT as much as non-carriers. Our results indicate that genetic information eventually might help guide personalized intervention planning in ASD. We additionally highlight that more research is needed to understand the intervention needs of autistic individuals with specified molecular alterations.
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8.
  • Zander, Eric, et al. (författare)
  • The Interrater Reliability of the Autism Diagnostic Interview-Revised (ADI-R) in Clinical Settings
  • 2017
  • Ingår i: Psychopathology. - : S. Karger AG. - 0254-4962 .- 1423-033X. ; 50:3, s. 219-227
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The Autism Diagnostic Interview-Revised (ADI-R) is considered a first choice assessment tool in autism spectrum disorder. Nevertheless, despite its wide use in psychiatric practice and recommendations by various clinical guidelines, its interrater reliability has predominantly been confirmed in research settings by specially trained, research reliability interviewers. The reliability of ADI-R assessments among clinicians has not yet been established. Therefore, this study examined the spontaneous interrater reliability of the ADI-R in a naturalistic clinical multicenter setting. Sampling and Methods: Ten video-recorded ADI-R administrations were rated by 5 different raters each from a pool of 11 raters affiliated to 8 different clinical sites. Results: The interrater reliability for the 12 diagnostic criteria operationalizing autism spectrum disorders according to DSM-IV/ICD-10 in the ADI-R algorithms ranged between G(q,k) (analogous to intraclass correlations) = 0.96 and 0.99 for reciprocal social interaction, 0.96 and 1.00 for communication, and 0.91 and 0.97 for repetitive and restricted behavior. Reliability of diagnostic classification was KCohen 0.83. Conclusions: The findings endorse the psychometric properties of ADI-R in terms of interrater reliability previously reported from research settings and support their generalization to common clinical settings. Limitations of this study include an unbalanced sample composition.
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