Aim This study attempts to study the relationship between severity of autism and communication and interaction skills
Objectives-
1 To screen patients using Indian Scale for assessment of Autism (ISAA)
2. To administer ACIS (Assessment of communication and interaction skills) scale in mild, moderate and severe group of children with autism spectrum disorder.
3. To study the various domains of communication and interaction skills within mild, moderate and severe group of participants with autism spectrum disorder.
4. To study relationship between the various domains of assessment of communication and interaction skills according to the severity of autism spectrum disorder.
Study Design : Quantitative, cross sectional observational study
Study Duration: 18 months
Study Setting: Study will be conducted in a tertiary care hospital.
Sampling Technique: Stratified Sampling
Sample Size: 60 (mild-20, moderate-20 , severe20)
Extensive literature review and existing research on the outcome of children with autism revealed limited references articles.
Conducting both pilot and final study is unfeasible due to several constraints such as absence of multicenter participation, time limitations and limited number of cases meeting the inclusion criteria . It is planned to enrol a total number of 60 participants (mild-20, moderate- 20 , severe20) over the course by including all the patients who meet inclusion criteria.
INCLUSION CRITERIA
Patients with ASD, ASD with ADHD
Male and female gender
Age 2 years to 8 years
Parents who give consent for the study
EXCLUSION CRITERIA
Selective mutism
Intellectual disability without ASD
Stereotypic movement disorder
Social (pragmatic) disorder
PROCEDURE
Approval taken from EIC.
Permission for use of ACIS (Assessment of communication
and interaction skills) scale taken.
Child with autism spectrum disorder referred in
occupational therapy department would be enrolled in
study with the consent.
Demographic details would be noted. Demographics will be
discussed in discussion .
ISAA (Indian scale for assessment of autism) scale would be
administered in an area other than the sensory integration
unit. i.e, Occupational therapy mental health OPD unit.
Depending on ISAA score participants would be grouped as
mild, moderate and severe.
ACIS scale would be administered in the sensory integration
unit.
Open, simulated life role situation (sensory integration unit)
would be used for assessment of ACISAccording to ASICS, ‘Simulated life role situation’ is defined as - the therapist attempts to simulate communication and interaction situations that reflects the clients life role.
According to ACIS is defined as client is in an
unstructured situation.
Relationship between the severity of autism spectrum
disorder and communication and interaction skills will be
studied.
Session 1- Demographics would be taken, ISAA would be
administered
Session 2- ACIS would be done in open, simulated life role
situation, SI unit.
Study toolsIndian scale for assessment of autism (ISAA)
ISAA is an objective assessment tool for persons with autism which uses observation, clinical evaluation of behavior, testing by interaction with the subject and also information supplemented by parents or caretakers in order to diagnose autism. ISAA consists of 40 items rated on a 5-point scale ranging from 1 (never) to 5 (always).
The 40 items of ISAA are divided under six domains as given
Domain-I Social Relationship and Reciprocity
Domain-II Emotional Responsiveness
Domain-III Speech - Language and Communication
Domain-IV Behaviour Patterns
Domain-V Sensory Aspects
Domain-IV Cognitive Component
Interpretation:
1. <70 -no autism
2. 70“ 106 - mild autism
3. 107-153 -moderate autism
4. >153 -severe autism
Total time taken for administration of ISAA is 20-30 minutes.19
Assessment of communication and interaction skills (ACIS)
The ACIS is an observational assessment that gathers data on the skill that persons demonstrate when communicating and interacting with others in an occupation. The ACIS gathers data on skill as it is exhibited during performance of an occupational form and/or within a social group of which the person is a part.
The scale will be administered on participants in open setting. The settings were open, parallel group, cooperative group and one-onone.
The scale has three domains namely physicality, information
exchange and relations. Each domain is further divided into
subdomains which are;
Physicality- Contacts, Gazes, Gestures, Maneuvres, Orients,
Posture.
Information Exchange - Articulates, Asserts, Asks, Engages,
Expresses, Modulates, Shares, Speaks, Sustains.
Relations - Collaborates, Confirms, Focuses, Relates, Respects.
Each of the above can be rated between 1 to 4;
4 = skill supports ongoing social action
3 = questionable skill, however there is no disruption in ongoing
social action
2 = ineffective skill which impacts ongoing social action
1 = deficit skill which causes an unacceptable delay or break down in social action
The total administration time varies from 20-60 minutes.
Observation time ranges from 15-45 minutes.
Rating time ranges from 5-20 minutes depending on
experience using the ACIS.