Treatment of Preschool Children With Autism Spectrum Disorder: A Trial to Evaluate a Learning Style Profile Intervention Program in China

Ma, Chenhuan; Chen, Lingyan; Li, Mengfan; Wu, Dan; Wang, Shasha; Zhao, Yongjie; Shi, Jianzhong; Rydell, Patrick J.; Chen, Jinjin; Wang, Yu

doi:10.3389/fped.2022.831621

Cited by 3 publications

(3 citation statements)

References 32 publications

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“…In China, children are enrolled in school at the age of 7 years ( 14 , 15 ), which is the threshold for BAA. Thus, three different methods have been studied in the sample of children aged 3.01–year–old to 6.99–year–old.…”

Section: Methodsmentioning

confidence: 99%

“…The two main reasons for assuming this span of age are as follows: (i) the age span predicted using the GP method is in intervals of approximately 6 months (e.g., 3 years, 3 years and 6 months, 4 years and 2 months) (7); (ii) age ± 3 months is regarded as the smallest range for BAA, as assessed by left hand-wrist X-rays (13). In China, children are enrolled in school at the age of 7 years (14,15), which is the threshold for BAA. Thus, three different methods have been studied in the sample of children aged 3.01year-old to 6.99-year-old.…”

Section: Data Acquisitionmentioning

confidence: 99%

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A comparative study of three bone age assessment methods on Chinese preschool-aged children

Gao

et al. 2022

Front. Pediatr.

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BackgroundBone age assessment (BAA) is an essential tool utilized in outpatient pediatric clinics. Three major BAA methods, Greulich–Pyle (GP), Tanner–Whitehouse 3 (TW3), and China 05 RUS–CHN (RUS–CHN), were applied to comprehensively compare bone age (BA) and chronological age (CA) in a Chinese sample of preschool children. This study was designed to determine the most reliable method.MethodsThe BAA sample consisted of 207 females and 183 males aged 3–6 years from the Zhejiang Province in China. The radiographs were estimated according to the GP, TW3, and RUS–CHN methods by two pediatric radiologists. The data was analyzed statistically using boxplots, the Wilcoxon rank test, and Student’s t-test to explore the difference (D) between BA and CA.ResultsAccording to the distributions of D, the boxplots showed that the median D of the TW3 method was close to zero for both male and female subjects. The TW3 and RUS–CHN methods overestimated the age of both genders. The TW3 method had the highest correct classification rate for males but a similar rate for females. The GP method did not show any significant difference between the BA and CA when applied to 3-year-old males and 4-year-old females while the TW3 method showed similar results when applied to 6-year-old females. The RUS–CHN method showed the least consistent results among the three methods.ConclusionThe TW3 method was superior to the GP and RUS–CHN methods but not reliable on its own. It should be noted that a precise age diagnosis for preschool children cannot be easily made if only one of the methods is utilized. Therefore, it is advantageous to combine multiple methods when assessing bone age.

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Section: Methodsmentioning

confidence: 99%

Section: Data Acquisitionmentioning

confidence: 99%

A comparative study of three bone age assessment methods on Chinese preschool-aged children

Gao

et al. 2022

Front. Pediatr.

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“…Instead of trying to teach children with ASD all they need to know, the LSP intervention tries to illustrate different patterns, tactics, and preferences to show how they learn and acquire knowledge from their surroundings [23]. The effectiveness of LSP has been demonstrated in our previous research [24,25]. In this study, we aimed to assess the adjunctive function of VR-CBT on preschool children with ASD by comparing the effect of VR-CBT plus LSP intervention versus LSP intervention alone.…”

Section: Introductionmentioning

confidence: 99%

Effects of a Nonwearable Digital Therapeutic Intervention on Preschoolers With Autism Spectrum Disorder in China: Open-Label Randomized Controlled Trial

Chu¹,

Shen²,

Ma³

et al. 2023

J Med Internet Res

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Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause difficulty with communication and social interactions as well as complicated family dynamics. Digital health interventions can reduce treatment costs and promote healthy lifestyle changes. These therapies can be adjunctive or replace traditional treatments. However, issues with cooperation and compliance prevent preschool patients with ASD from applying these tools. In this open-label, randomized controlled trial, we developed a nonwearable digital therapy called virtual reality–incorporated cognitive behavioral therapy (VR-CBT). Objective The aim of this study was to assess the adjunctive function of VR-CBT by comparing the effects of VR-CBT plus learning style profile (LSP) intervention with those of LSP-only intervention in preschool children with ASD. Methods This trial was performed in China on 78 preschool children (age 3-6 years, IQ>70) diagnosed with ASD who were randomized to receive a 20-week VR-CBT plus LSP intervention (intervention group, 39/78, 50%) or LSP intervention only (control group, 39/78, 50%). The primary outcome was the change of scores from baseline to week 20, assessed by using the parent-rated Autism Behavior Checklist (ABC). Secondary outcomes included the Childhood Autism Rating Scale (CARS), Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), and behavioral performance data (accuracy and reaction time) in go/no-go tasks. All primary and secondary outcomes were analyzed in the intention-to-treat population. Results After the intervention, there was an intervention effect on total ABC (β=–5.528; P<.001) and CARS scores (β=–1.365; P=.02). A similar trend was observed in the ABC subscales: sensory (β=–1.133; P=.047), relating (β=–1.512; P=.03), body and object use (β=–1.211; P=.03), and social and self-help (β=–1.593; P=.03). The intervention also showed statistically significant effects in improving behavioral performance (go/no-go task, accuracy, β=2.923; P=.04). Moreover, a significant improvement of ADHD hyperactivity-impulsivity symptoms was observed in 53 children with comorbid ADHD based on ADHD-RS-IV (β=–1.269; P=.02). No statistically significant intervention effect was detected in the language subscale of ABC (β=–.080; P=.83). Intervention group girls had larger improvements in ABC subscales, that is, sensory and body and object use and in the CARS score and accuracy of go/no-go task (all P<.05) than the control group girls. Statistically significant intervention effects could be observed in hyperactivity-impulsivity symptoms in the intervention group boys with comorbid ADHD compared with those in the control group boys (β=–1.333; P=.03). Conclusions We found potentially positive effects of nonwearable digital therapy plus LSP on core symptoms associated with ASD, leading to a modest improvement in the function of sensory, motor, and response inhibition, while reducing impulsivity and hyperactivity in preschoolers with both ASD and ADHD. VR-CBT was found to be an effective and feasible adjunctive digital tool. Trial Registration Chinese Clinical Trial Registry ChiCTR2100053165; http://www.chictr.org.cn/showproj.aspx?proj=137016

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Effects of a Nonwearable Digital Therapeutic Intervention on Preschoolers With Autism Spectrum Disorder in China: Open-Label Randomized Controlled Trial (Preprint)

Chu¹,

Shen²,

Ma³

et al. 2023

Preprint

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BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting patients of a variety of ages that can cause difficulty with communication and social interactions as well as complicated family dynamics. Digital health interventions, especially wearable digital therapies, can reduce treatment costs and promote healthy lifestyle changes for patients, and while these therapies can be adjunctive or they can even replace traditional treatments. However, issues with cooperation and compliance prevent preschool ASD patients from applying these tools. In this open-label, randomized controlled trial, we developed a non-wearable digital therapy, named Virtual Reality incorporated Cognitive Behavioral Therapy (VR-CBT). OBJECTIVE The aim of this study is to assess the adjunctive function of VR-CBT on preschool children with ASD through comparing the effect of receiving VR-CBT plus Learning Style Profile (LSP) intervention with LSP intervention alone. METHODS This randomized, controlled trial was done in Shanghai, China. A total of 78 children (aged 3–6 years, IQ over 70) diagnosed with ASD were randomized to receive a twenty-week VR-CBT plus LSP intervention (intervention group, 39/78, 50.0%) or LSP intervention only (control group, 39/78, 50.0%). The primary outcome was the change of scores from baseline to week 20, assessed by using the parent rating Autism Behavior Checklist (ABC). Secondary outcomes included the Childhood Autism Rating Scale (CARS), ADHD Rating Scale-IV (ADHD-RS-IV), and behavioral performance data (accuracy and reaction time) in Go/No-Go task. All primary and secondary outcomes were analyzed in the intention-to-treat population. RESULTS After a 20-week intervention, there was an intervention effect on total ABC (β=-5.528, P<.001) and CARS score (β=-1.365, P=.02); a similar trend was observed in ABC subscales: Sensory (β=-1.133, P=.047), Relating (β=-1.512, P=.03), Body and object use (β=-1.211, P=.03), Social and self-help (β=-1.593, P=.03). The intervention also showed statistically significant effects in improving behavioral performance (Go/No-Go task, Accuracy, β=2.923, P=.04). Moreover, a significant improvement of ADHD hyperactivity-impulsivity symptoms was observed in 53 children with comorbid ADHD based on ADHD-RS-IV (β=-1.269, P =.02). However, no statistically significant intervention effect was detec The findings show potentially positive effects of non-wearable digital therapy plus LSP on core symptoms associated with ASD, and lead to a modest improvement in function of sensory, motor and response inhibition, while reducing impulsivity and hyperactivity in those preschool autistics with comorbid ADHD. VR-CBT was found to be an effective and feasible adjunctive digital tool.ted in language subscale of ABC (β=-.080, P=.83). CONCLUSIONS The findings show potentially positive effects of non-wearable digital therapy plus LSP on core symptoms associated with ASD, and lead to a modest improvement in function of sensory, motor and response inhibition, while reducing impulsivity and hyperactivity in those preschool autistics with comorbid ADHD. VR-CBT was found to be an effective and feasible adjunctive digital tool. CLINICALTRIAL ChiCTR2100053165

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Treatment of Preschool Children With Autism Spectrum Disorder: A Trial to Evaluate a Learning Style Profile Intervention Program in China

Cited by 3 publications

References 32 publications

A comparative study of three bone age assessment methods on Chinese preschool-aged children

A comparative study of three bone age assessment methods on Chinese preschool-aged children

Effects of a Nonwearable Digital Therapeutic Intervention on Preschoolers With Autism Spectrum Disorder in China: Open-Label Randomized Controlled Trial

Effects of a Nonwearable Digital Therapeutic Intervention on Preschoolers With Autism Spectrum Disorder in China: Open-Label Randomized Controlled Trial (Preprint)

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