مقاله انگلیسی رایگان در مورد درمان تعاملی پیلین در کودکان مبتلا به اوتیسم و لکنت – الزویر 2022

Abstract

     Introduction: It is estimated that 8% of children who stutter (CWS) have autism spectrum disorder (ASD) Briley & Ellis (2018). There is evidence that interventions for CWS and interventions for children with ASD can be effective, but there is little evidence to guide clinical decision making when working with CWS with a co-existing diagnosis of ASD. Palin Parent–Child Interaction (PCI) therapy Kelman & Nicholas (2020) is an evidence-based intervention for CWS, with the authors suggesting that the approach may be beneficial for CWS with ASD. The aim of this study was to examine outcomes for three CWS with ASD who received Palin PCI at a specialist centre for stuttering in London. Method: The participants were three CWS with ASD aged 4;5, 6;7 and 7;7. Assessments were administered before therapy, and then at three, six and twelve months after therapy began. Outcome measures included stuttering frequency, child’s communication attitude, parents’ perception of the impact of stuttering on the child, the severity of stuttering and its impact on the parents, and parents’ knowledge and confidence in managing stuttering. Results: All three children showed improvement in three or more variables. Four out of five parents reported reduced impact of stuttering on the child and themselves following therapy, and change was maintained one year post-therapy. All five parents reported increased knowledge of stuttering and confidence in managing it after therapy, and four parents maintained these changes for a year. Conclusions: Over a one year period, these CWS with ASD who received Palin PCI showed change across multiple variables. The observed increases in parent knowledge and confidence were comparable to previously published data. These preliminary findings suggest that CWS with ASD and their parents can benefit from Palin PCI therapy and that further experimental evaluation of this approach with this client group is indicated.

Introduction

Stuttering and autism spectrum disorder

     Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterised by early onset difficulties in social communication and unusually restricted, repetitive behaviour and interests (American Psychiatric Association, 2013). It may present with or without intellectual disability, and with or without language impairment (Lai et al., 2014). Shriberg et al. (2001) first identified that stuttering and other forms of dysfluency may occur within adults with ASD. A strong genetic component is evident for both ASD and stuttering (Tick et al., 2016; Yairi & Ambrose, 2013). Subsequent studies have identified stuttering in preschoolers with ASD (Plexico et al., 2010), school-aged children with ASD (Scott et al., 2014; Sisskin, 2006; Sisskin & Wasilus, 2014), and adolescents with ASD (Sisskin, 2006).

Conclusions

     The findings indicate that CWS with ASD and their parents can benefit from Palin PCI. All three children showed improvement in three or more variables. Four out of five parents reported reduced impact of stuttering on the child and on themselves after therapy and change was maintained one year after therapy. All five parents reported increased knowledge of stuttering and confidence in managing it after therapy and change was maintained one year after therapy for four parents. The findings indicate that further investigations of Palin PCI therapy with CWS with ASD are merited, and outcome measurement tools need to be validated with this clinical subpopulation.