Systematic review: emotion dysregulation and challenging behavior interventions for children and adolescents on the autism spectrum with graded key evidence-based strategy recommendations.

Autor: Nuske HJ; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA. heather.nuske@pennmedicine.upenn.edu., Young AV; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA.; Mayo Clinic, Mayo Eugenio Litta Children's Hospital, Rochester, USA., Khan FY; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA.; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA., Palermo EH; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA., Ajanaku B; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA., Pellecchia M; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA., Vivanti G; A. J. Drexel Autism Institute, Drexel University, Philadelphia, USA., Mazefsky CA; Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA., Brookman-Frazee L; Department of Psychiatry, University of California San Diego, San Diego, USA., McPartland JC; Yale Child Study Center, Yale University, New Haven, USA., Goodwin MS; Department of Health Sciences, Northeastern University, Boston, USA., Mandell DS; Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Floor 3, Philadelphia, PA, 19104, USA.
Jazyk: angličtina
Zdroj: European child & adolescent psychiatry [Eur Child Adolesc Psychiatry] 2024 Jun; Vol. 33 (6), pp. 1963-1976. Date of Electronic Publication: 2023 Sep 22.
DOI: 10.1007/s00787-023-02298-2
Abstrakt: Challenging behavior, such as aggression, is highly prevalent in children and adolescents on the autism spectrum and can have a devastating impact. Previous reviews of challenging behavior interventions did not include interventions targeting emotion dysregulation, a common cause of challenging behavior. We reviewed emotion dysregulation and challenging behavior interventions for preschoolers to adolescents to determine which evidence-based strategies have the most empirical support for reducing/preventing emotion dysregulation/challenging behavior. We reviewed 95 studies, including 29 group and 66 single case designs. We excluded non-behavioral/psychosocial interventions and those targeting internalizing symptoms only. We applied a coding system to identify discrete strategies based on autism practice guidelines with the addition of strategies common in childhood mental health disorders, and an evidence grading system. Strategies with the highest quality evidence (multiple randomized controlled trials with low bias risk) were Parent-Implemented Intervention, Emotion Regulation Training, Reinforcement, Visual Supports, Cognitive Behavioral/Instructional Strategies and Antecedent-Based Interventions. Regarding outcomes, most studies included challenging behavior measures, while few included emotion dysregulation measures. This review highlights the importance of teaching emotion regulation skills explicitly, positively reinforcing replacement/alternative behaviors, using visuals and metacognition, addressing stressors proactively, and involving parents. It also calls for more rigorously designed studies and for including emotion dysregulation as an outcome/mediator in future trials.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje