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in Communication Disorders
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Social Communication Disorders in School-Age Children
Service Delivery

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External Scientific Evidence

Evidence-Based Practice Guidelines
National Institute for Health and Clinical Excellence

Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults
National Institute for Health and Clinical Excellence. (2009).
London (UK): The British Psychological Society and The Royal College of Psychiatrists, No. CG72.
Added: October 2012

Description
This guideline provides recommendations for the diagnosis and management of attention deficit hyperactivity disorder (ADHD) in children, adolescents, and adults. The guideline is intended for clinicians and service commissioners.

Recommendations

  • “Positive effects of psychological interventions on core ADHD symptoms together with ratings of conduct, social skills or self-efficacy were found. The interventions studied were either mixed [cognitive behavioral therapy] CBT/social skills interventions delivered to groups or predominantly CBT interventions”  (p. 172).

  • "If the [school-aged] child or young person with ADHD has moderate levels of impairment, the parents or carers should be offered referral to a group parent training/education programme, either on its own or together with a group treatment programme (CBT and/or social skills training) for the child or young person” (p. 205).

  • “When using group treatment (CBT and/or social skills training) for the [school-aged] child or young person in conjunction with a parent-training/education programme, particular emphasis should be given to targeting a range of areas, including social skills with peers, problem solving, self-control, listening skills and dealing with and expressing feelings. Active learning strategies should be used, and rewards given for achieving key elements of learning” (p. 205).

  • “For older adolescents with ADHD and moderate impairment, individual psychological interventions (such as CBT or social skills training) may be considered as they may be more effective and acceptable than group parent training/education programmes or group CBT and/or social skills training” (p. 205).

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Evidence-Based Systematic Reviews
Social Skills Interventions for Children with High-Functioning Autism Spectrum Disorders
Schreiber, C. (2011).
Journal of Positive Behavior Interventions, 13(1), 49-62.
Added: October 2012

Description
This is a review of studies that investigated social skills interventions used with children with high-functioning autism spectrum disorders (HFASD).

Conclusions
"Cognitive behavioral therapy or social skills instruction in a group setting for individuals with HFASD is a potentially effective way to teach social skills, and the group setting may foster friendships. However, in order for the skills to be maintained and generalized, they must be practiced in a naturalistic environment" (p. 59).

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Social Skills Development in Children with Autism Spectrum Disorders: A Review of the Intervention Research
Williams White, S., Keonig, K., et al. (2007).
Journal of Autism and Developmental Disorders, 37(10), 1858-1868.

This review meets the criteria for a high-quality evidence-based systematic review.
Added: October 2012

Description
This is a review of published studies and unpublished dissertations exploring the state of the evidence for social skills training interventions for school-age children with autism spectrum disorders (ASD) in order to determine future research directions.

Conclusions
Although empirical support for this approach is incomplete, group-based social skills training may be a useful intervention for children with ASD. Promising teaching strategies for social skills training include teaching social scripts, modeling and role-play, differential reinforcement, peer involvement, multiple trainers, parent involvement, practice in natural environments, fostering self-awareness, errorless teaching, and defining concrete social rules.

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Knowledge Translation in ABI Rehabilitation: A Model for Consolidating and Applying the Evidence for Cognitive-Communication Interventions
MacDonald, S., & Wiseman-Hakes, C. (2010).
Brain Injury, 24(3), 486-508.
Added: October 2012

Description
This is a review of systematic reviews investigating the use of communication and cognitive interventions in adults and children with acquired brain injury (e.g., stroke and traumatic brain injury).

Conclusions
"Overall the evidence supports the use of social communication interventions; however, it indicates that more evidence is required to recommend specific forms of social communication intervention.  Evidence to date suggests that social communication interventions are most likely to be effective when they are individualized, contextualized, involve practice in real world communications, focus on self regulation or meta-cognitive approaches and incorporate provision of natural feedback, videotaping self-monitoring" (p. 499).

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A Meta-Analysis of School-Based Social Skills Interventions for Children with Autism Spectrum Disorders
Bellini, S., Peters, J. K., et al. (2007).
Remedial and Special Education, 28(3), 153-162.
Added: October 2012

Description
This is a meta-analysis of single-subject designs investigating school-based social skills interventions for children and adolescents with autism spectrum disorders (ASD).

Conclusions
"Similar treatment, maintenance, and generalization effects were observed across collateral skills, peer-mediated, child-specific, and comprehensive interventions.  Furthermore, there were no significant differences between the intervention and maintenance effects of studies that implemented group interventions and studies that implemented individual interventions" (p. 160).

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Practitioner Review: Psychosocial Interventions for Children with Selective Mutism: A Critical Evaluation of the Literature from 1990-2005
Cohan, S. L., Chavira, D. A., et al. (2006).
Journal of Child Psychology and Psychiatry, and Allied Disciplines, 47(11), 1085-1097.
Added: October 2012

Description
This is a review of peer-reviewed studies that investigated psychosocial interventions for children with selective mutism (SM) who "consistently fail to speak in one or more social settings (e.g., school) despite speaking normally in other settings (e.g., home)" (p. 1085).

Conclusions
"A potentially effective treatment approach for a typical SM child who experiences significant social anxiety and is mute at school would include individual psychotherapy focusing on communication skills and anxiety management, in addition to a behavioral program implemented concurrently in the school setting to shape appropriate verbal communication" (p. 1094).

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Evidence-Based Review of Interventions for Autism Used in or of Relevance to Occupational Therapy
Case-Smith, J., & Arbesman, M. (2008).
American Journal of Occupational Therapy, 62(4), 416-429.
Added: October 2012

Description
This is a review of Level I (i.e., randomized controlled trials, systematic reviews, meta-analyses), Level II (nonrandomized clinical trials, cohort studies), and Level III evidence (before-after studies and one group designs) that pertain to interventions conducted by occupational therapists for children and adolescents with autism. Although the intended audience is occupational therapists, the interventions target cognitive communication outcomes.

Conclusions
Social skills training in groups yielded “limited gains in social interaction of adolescents” (p. 422).

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Clinical Expertise/Expert Opinion

Consensus Guidelines
National Initiative for Autism: Screening and Assessment; National Autistic Society; Royal College of Psychiatrists; Royal College of Paediatrics and Child Health; All Party Parliamentary Group on Autism (United Kingdom)

National Autism Plan for Children (NAPC): Plan for the Identification, Assessment, Diagnosis and Access to Early Interventions for Pre-School to Primary School Aged Children with Autism Spectrum Disorders (ASD)
Le Couteur, A., Baird, G., et al. (2003).
London (United Kingdom): The National Autistic Society, 57 pages.
Added: October 2012

Description
This guideline provides good practice recommendations for the identification, assessment, diagnosis and intervention for preschool and elementary school-aged children with autism spectrum disorder (ASD). The target audience of this guideline includes speech-language pathologists and other professionals providing services to this population.

Recommendations

  • Families should be assisted with ways to foster social-communicative interactions with their child; treatment programs that have proven effective for parents and professionals include offering small group social opportunities for children and their families (p. 43).

  • It is recommended that primary school aged children with autism be provided "planned additional individual and small group social skills opportunities tailored to the needs of the child (including supported after school and leisure social clubs)" (p. 45).

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Client/Patient/Caregiver Perspectives

No information was found pertaining to client/patient/caregiver perspectives.


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