A multimodal intervention for children and adults with autism spectrum disorders: ‘ReAttach’

Paula Weerkamp-Bartholomeus, Ph.D.1, Prof. Dr. Vladimir Trajkovski2

1ReAttach Therapy Institute, Eindhoven, The Netherlands, e-mail: info@reattach-therapy-institute.com

2Institute of Special Education and Rehabilitation, Faculty of Philosophy, University “Ss. Cyril and Methodius” Blvd. Goce Delchev 9A, 1000 Skopje, Republic of Macedonia, e-mail vladotra@fzf.ukim.edu.mk

 Abstract

Introduction: Autism spectrum disorders (ASD) are characterized by impairments in social interaction and communication and restricted and repetitive interests/behaviors, which has considerable impact on daily life functioning. ReAttach is an intervention based on attachment, arousal regulation and training multiple sensory integration processing.

Aim: investigate the effectivity of ReAttach in terms of improvement of daily life functioning.

Method: Eight therapists were trained to perform ReAttach with a group of participants (N=58). Comparison of the mean scores on the Autism Treatment Evaluation Checklist (ATEC) was conducted with a paired sample t-test.

Results: In this study we have explored the potential of 5 sessions of ReAttach to significantly improve the ATEC scores of participants diagnosed with ASD within a short period of time. The results revealed significant decreases of problems (p<0.001) in the subscales: I. Speech (t=9.96, df=57, p=0.000), II. Sociability (t=13.72, df=57, p=0.000), III. Sensory Cognitive Awareness (t=11.91, df=57, p=0.000), IV. Health / Physical / Behavior (t=11.64, df=57, p=0.000) and total scores of the ATEC (t=15.23, df=57, p=0.000).

We made comparison of mean total scores in various diagnosis within the whole ASD group: Autistic disorder (N=6, age M=18.67, SD±6.92, males were 100%) t=4.78, df=5, p=0.005; Asperger syndrome (N=24, age M=27.75, SD±12.88 males were 70.83%)  t=10.56, df=23, p=0.000; PDD-NOS (N=24, age  M=22.17, SD±11.68, males were 83.33%), t=9.26, df=23, p=0.000; ASD and Intellectual Disability (N=4, age M=26.75, SD±16.17, males were 75%) t=4.40, df=3, p=0.022.

Conclusions: This study confirms that ReAttach has a positive impact on daily life functioning. Practical research confirms the hypothesis that this intervention has a positive effect on various developmental areas described in the ATEC. The results further suggest that people within the entire range of ASD can benefit from ReAttach and the method itself might provide important clues to efficient ASD treatment.

Keywords: autism, innovation, treatment

Citation: Weerkamp Bartholomeus P, Trajkovski V. Multimodalna intervencija za decu i odrasle sa autističnim spektrom poremećaja: „Reattach“. Zbornik rezimea ‡ IV stručno-naučni skup sa međunarodnim učešćem „Aktuelnosti u edukaciji i rehabilitaciji osoba sa smetnjama u razvoju“. Beograd, 24-25 oktobar, 2015; 19.

ASSOCIATION BETWEEN CEREBRAL PALSY AND AUTISM SPECTRUM DISORDERS

VLADIMIR TRAJKOVSKI, MD, PhD, Full Professor

Macedonian Scientific Society for Autism, Institute of Special Education and Rehabilitation, Faculty of Philosophy, University “Ss. Cyril and Methodius”

Address: Blvd. “Goce Delchev 9A, 1000 Skopje, Republic of Macedonia

E-mail: vladotra@fzf.ukim.edu.mk

Abstract

Relevance: Clinical heterogeneity among children with neurodevelopmental disorders reflects diversity in strengths and needs that can have important implications for therapeutic management. Autism Spectrum Disorder (ASD) is sometimes a co-occurring associated condition of cerebral palsy. Whereas cerebral palsy affects motor functioning, autism affects certain areas of brain development. Cerebral palsy (CP) is primarily a motor disorder, caused by a cerebral lesion occurring in the developing brain.

Purpose: To explore autism spectrum symptoms in children with cerebral palsy (CP), and the association between autism spectrum symptoms and medical and psychiatric co-morbidity.

Results: Over the past two decades there has been greater recognition that risk of mental health and neurobehavioral disorders is shared across the broad continuum of developmental medicine, including cerebral palsy. The current best practice for diagnosing ASD in a child with CP is completing a thorough clinical assessment and combining this with the clinician’s

judgement. The assessment of ASD in the face of CP should entail a detailed history, examination and structured observation of the child’s social and communication skills, complemented with standardized diagnostic instruments which are validated for children with motor difficulties. Both conditions are discovered at roughly the same age, usually. Cerebral palsy is usually discovered a little earlier, at perhaps 6 months to 2 years of age. Autism is discovered a little later, usually by 5 years of age.  They are highly variable, with some symptoms present in some children but not others. Both conditions can be very severe or hardly noticeable.

Conclusions: A holistic approach is required when evaluating a child who demonstrates impairments in social communication skills in the presence of motor impairment More attention should be given to autism spectrum symptoms in the regular follow-up of children with CP in an attempt to enhance social functioning.

Key words: cerebral palsy, autism spectrum disorders, neurodevelopmental disorders.

VIII interdisciplinary congress in Moscow

The president of MSSA Prof. Dr. Vladimir Trajkovski is invited lecturer at the VIII interdisciplinary vocational scientific congress with international participation “Children’s cerebral palsy and other disorders in children’s movement”, which will be held from 1 to 2 November 2018 in Moscow, Russia. Within the 30 minute lecture he will speak on the topic: “Association between Cerebral Palsy and Autism Spectrum Disorders”. Besides the lecture, significant contacts are planned with medical institutions from Russia and across Europe.