Autism spectrum disorders (ASDs) are diagnosed when individuals show impairments in three behavioural domains: communication, social interactions, and repetitive, restrictive behaviours and interests (RRBIs). Recent data suggest that these three sets of behaviours are genetically heterogeneous. Early language delay is strongly associated with ASD, but the basis for this association and the relationship with individual sub-domains of ASD has not been systematically investigated. In the present study, data came from a population-based twin sample with language development data at 2-4 years, measured by the MacArthur Communicative Development Inventory (MCDI), and data at 8 years using the Childhood Asperger Syndrome Test (CAST). For the total CAST and the three subscales at 8 years, approximately 300 same-sex twin pairs were selected as showing extreme autistic-like traits (ALTs), defined here as pairs in which at least one member of the twin pair scored in the highest 5% of the distribution. Phenotypic analyses indicated that children showing extreme social and communication ALTs (but not the RRBI subscale) at 8 years were below average in language development at 2-4 years. A regression model for selected twin data suggested that genetic influences account for this overlap, but that these effects are only in part mediated by genes that are shared between language and extreme autistic traits.
Background: Effective implementation of parent training programmes for preschool Attention-Deficit/Hyperactivity Disorder type is constrained by barriers limiting take-up and effective engagement by 'hard to reach' and 'difficult to treat' families. Method: We describe an evidence-driven adaptation and piloting of an existing empirically supported preschool ADHD parenting programme to address these problems. Results: The New Forest Parenting programme was changed substantially in terms of length; content and delivery on the basis of information gathered from the literature, from parents and practitioners, further modifications were made after the pilot study. Conclusions: The adapted-NFPP is currently being assessed for efficacy in a large multicentre randomized controlled trial.
Key Practitioner Message• Parenting approaches can make a valuable contribution to the management of preschool ADHD • However barriers exist to implementation related to the extra burden of developmental delay in children and the complicating role of mental health problems and serious life events in parents and families• Parenting programmes need to be adapted and extended to improve outcomes in such families • In the New Forest Parenting Programme we have added modules for children (e.g. sleep, sensory issues, speech and language difficulties and adults (e.g. parental ADHD and learning difficulties) and increased exposure and access to difficult to reach families.
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