This review describes the effects of intervention for young children with autism spectrum disorder (ASD) on parents. Like all children, children with ASD bring both negative and positive experiences for parents and families-from increased resource needs, to higher levels of parenting-related stress, to positive personal growth for family members. It is increasingly recognized that, although children with ASD are the primary targets of early ASD intervention, ASD intervention also impacts parents. From the time emerging developmental concerns begin to be identified, through the process of obtaining a diagnosis and initiating services, parents play a central role in addressing the needs of young children with ASD, including implementing and supporting early intervention. Parents experience the impact of intervention directly, through interaction with providers within the health care and educational systems. Parents also experience indirect impacts of ASD intervention due to accelerated developmental progress of children who are benefitting from services and when children make slower progress than expected or have challenging behaviors. Parental stress and psychological well-being are legitimate targets of intervention and compelling research objectives, needing no additional justification. However, parents are also the major contributors to family adaptive functioning-the activities families employ to support positive outcomes for children with ASD (e.g., family-orchestrated child experiences, parent-child interaction, child health and safety functions; Guralnick, 1997). A parent's ability to carry out adaptive functions is, in part, related to their levels of stress and psychological well-being. Thus, there is a transactional process in which parents are both impacted by and have an impact on ASD interventions for their child. Evaluating the effect of ASD intervention on parents is needed to develop new strategies for helping parents and children with ASD reach their full potential. This review will provide an overview of research on the impact of early ASD intervention on parents. Evidence regarding the impact of three types of intervention (i.e., early intensive behavioral intervention, parent-implemented intervention, and programs directly targeting parent stress) on parent well-being and family adaptive functioning will be reviewed. Potential moderators of the impact of ASD intervention on parents and family adaptive functioning will be discussed. We conclude that research on the impact of ASD intervention on parents of young children with ASD is a promising avenue for improving the lives of children with ASD and their families.
Novelty detection, a critical computation within the medial temporal lobe (MTL) memory system, necessarily depends on prior experience. The current study used functional magnetic resonance imaging (fMRI) in humans to investigate dynamic changes in MTL activation and functional connectivity as experience with novelty accumulates. fMRI data were collected during a target detection task: Participants monitored a series of trial-unique novel and familiar scene images to detect a repeating target scene. Even though novel images themselves did not repeat, we found that fMRI activations in the hippocampus and surrounding cortical MTL showed a specific, decrementing response with accumulating exposure to novelty. The significant linear decrement occurred for the novel but not the familiar images, and behavioral measures ruled out a corresponding decline in vigilance. Additionally, early in the series, the hippocampus was inversely coupled with the dorsal striatum, lateral and medial prefrontal cortex, and posterior visual processing regions; this inverse coupling also habituated as novelty accumulated. This novel demonstration of a dynamic adjustment in neural responses to novelty suggests a similarly dynamic allocation of neural resources based on recent experience.A fundamental task for organisms is to detect, learn about, and respond to change in the environment. Novelty responses in the brain signal environmental change and predict neural and behavioral adjustments to it; neural responses to novelty are thus a proxy for the salience of environmental change. Evidence from humans, nonhuman primates, and rodents points to a specialized brain system for the detection of novelty, centered around the hippocampus (HPC) and medial temporal lobe (MTL) memory system (Ranganath and Rainer 2003). It is now well documented that the HPC and MTL respond robustly to novel stimuli (Gabrieli et al. 1997;Jessen et al. 2002;Kohler et al. 2005;Bunzeck and Duzel 2006;Yassa and Stark 2008;Blackford et al. 2010;Howard et al. 2011). However, relatively little is known about how these responses are modulated by prior experience. In particular, how does a recent history rich with novel information influence MTL networks specialized for novelty processing?Other literature has described how prior exposure to biologically salient stimuli (or to a repeated feature) changes neural responses to future processing of those stimuli. Throughout the ventral visual stream, neural responses to repeated presentations of visually identical stimuli progressively decrease (Henson et al. 2003). Similarly, the amygdala and other structures implicated in fear processing habituate to cumulative exposure to trialunique stimuli that depict fear (Breiter et al. 1996;Wright et al. 2001;Fischer et al. 2003) or signal threat (Buchel et al. 1998;LaBar et al. 1998). Habituation has been proposed to be biologically adaptive: As a stimulus or feature is repeated, it provides less information about the environment, and demands fewer processing resources (Sokolov 1963;Rankin...
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