Toward an integrative socio-cognitive approach in autism spectrum disorder: NEAR method adaptation—study protocol

Background The cognitive impairments exhibited by people with ASD, threaten the development of social skills that are essential for establishing and maintaining harmonious social relationships. Cognitive remediation and social skills training are now considered as crucial therapeutic approaches in the management of these disorders. Several programs have already been validated and have shown improvements in social skills or cognitive performance. However, the effects of these training methods seem to be difficult to generalize to other everyday life. The aim of our study is to alleviate cognitive and social deficiencies by using a socio-cognitive framework to adapt the Neuropsychological Educational Approach to Remediation (NEAR) method for adolescents with ASD. Methods/design Adolescents meeting the DSM-5 criteria for ASD, older than 13 years, and following a regular school curriculum will be recruited from clinical population at the Child and Adolescent Psychiatry in Razi University Hospital-Manouba- Tunisia. Our study is an open and non-randomized controlled trial including 30 patients: NEAR group / control group. The NEAR method combines computerized cognitive exercises and bridging groups inspired from cognitive behavioral therapy. NEAR group will be divided into three groups of five patients each. The duration of the sessions will vary according to the capacities of the participants and the exchanges between them (about 60–120 min). In our study, bridging groups will be amended by adding other tasks including planning role plays and scenarios of problematic social situations in autism, taking into account cultural particularities in order to promote social skills. Computerized exercises will be enriched by adding other tasks aiming to improve the recognition and expression of facial emotions by using digital videos and photographs expressing the six basic emotions. The duration of the program will be about 6 months. All selected patients will have an assessment of cognitive function: social cognition, neurocognition and pragmatic skills, social skills, self-esteem and global functioning at baseline, 1 week after the end of the NEAR program and 6 months later. Conclusion This adaptive program is a promising socio-cognitive intervention that create new perspectives for adolescents with autism spectrum disorder.

[1]  Francisco González-Sala,et al.  Symbolic Play among Children with Autism Spectrum Disorder: A Scoping Review , 2021, Children.

[2]  E. Fombonne,et al.  Epidemiological surveys of ASD: advances and remaining challenges , 2021, Journal of Autism and Developmental Disorders.

[3]  A. Bouden,et al.  Validation of the Tunisian Social Situation Instrument in the General Pediatric Population , 2020, Frontiers in Psychology.

[4]  A. Miranda,et al.  Theory of Mind Profiles in Children With Autism Spectrum Disorder: Adaptive/Social Skills and Pragmatic Competence , 2020, Frontiers in Psychology.

[5]  N. Soares,et al.  Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation , 2020, Translational pediatrics.

[6]  A. Guastella,et al.  Executive Function in Autism Spectrum Disorder: History, Theoretical Models, Empirical Findings, and Potential as an Endophenotype , 2019, Front. Psychiatry.

[7]  C. Doyen,et al.  Programme de Remédiation cognitive NEAR (Neuropsychological Educational Approach to Cognitive Remediation) chez des adolescents présentant un Trouble Déficit de l’Attention/Hyperactivité et/ou un Trouble du spectre Autistique , 2019, Annales Médico-psychologiques, revue psychiatrique.

[8]  A. Fett,et al.  Patterns of Nonsocial and Social Cognitive Functioning in Adults With Autism Spectrum Disorder: A Systematic Review and Meta-analysis , 2019, JAMA psychiatry.

[9]  C. K. Frank,et al.  Reviving pragmatic theory of theory of mind , 2018, AIMS neuroscience.

[10]  N. Minshew,et al.  Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18‐month randomized clinical trial , 2018, Autism research : official journal of the International Society for Autism Research.

[11]  O. Andreassen,et al.  Metacognitive Aspects of Executive Function Are Highly Associated with Social Functioning on Parent-Rated Measures in Children with Autism Spectrum Disorder , 2018, Front. Behav. Neurosci..

[12]  Federica Scarpina,et al.  The Stroop Color and Word Test , 2017, Front. Psychol..

[13]  D. Le Gall,et al.  Development of executive functioning in school-age Tunisian children , 2016, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[14]  C. Büchel,et al.  Disentangling the autism−anxiety overlap: fMRI of reward processing in a community-based longitudinal study , 2016, Translational Psychiatry.

[15]  M. Matsui,et al.  The effects of cognitive remediation therapy using the frontal/executive program for autism spectrum disorder , 2016, International journal of psychiatry in medicine.

[16]  E. Moussaoui,et al.  Cognition sociale et autisme : bénéfices de l’entraînement aux habiletés sociales chez des adolescents présentant un trouble du spectre de l’autisme , 2016, Revue de neuropsychologie.

[17]  M. Kurtz Cognitive Remediation for Psychological Disorders , 2016 .

[18]  Mandy Rispoli,et al.  A Systematic Review and Evaluation of Video Modeling, Role-Play and Computer-Based Instruction as Social Skills Interventions for Children and Adolescents with High-Functioning Autism , 2016, Review Journal of Autism and Developmental Disorders.

[19]  F. Aboitiz,et al.  Development of social skills in children: neural and behavioral evidence for the elaboration of cognitive models , 2015, Front. Neurosci..

[20]  Tricia Z. King,et al.  The role of emotion perception in adaptive functioning of people with autism spectrum disorders , 2015, Autism : the international journal of research and practice.

[21]  I. Tanet-Mory Troubles de la théorie de l'esprit et de l'intersubjectivité dans l'autisme sans déficit intellectuel : description et perspectives thérapeutiques , 2014 .

[22]  Yael Kimhi Theory of Mind Abilities and Deficits in Autism Spectrum Disorders , 2014 .

[23]  A. Meyer,et al.  What do verbal fluency tasks measure? Predictors of verbal fluency performance in older adults , 2014, Front. Psychol..

[24]  Nicolas Franck,et al.  RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders , 2014, Front. Hum. Neurosci..

[25]  K. Gray,et al.  The relationship between emotion recognition ability and social skills in young children with autism , 2013, Autism : the international journal of research and practice.

[26]  Michael V. Lombardo,et al.  Understanding Other Minds: Perspectives from developmental social neuroscience , 2013 .

[27]  Vihang N. Vahia,et al.  Diagnostic and statistical manual of mental disorders 5: A quick glance , 2013, Indian journal of psychiatry.

[28]  Egon L. van den Broek,et al.  Motor, Emotional, and Cognitive Empathy in Children and Adolescents with Autism Spectrum Disorder and Conduct Disorder , 2013, Journal of abnormal child psychology.

[29]  F. Volkmar,et al.  Social skills groups for people aged 6 to 21 with autism spectrum disorders (ASD). , 2012, The Cochrane database of systematic reviews.

[30]  Y. S. Kim,et al.  Global Prevalence of Autism and Other Pervasive Developmental Disorders , 2012, Autism research : official journal of the International Society for Autism Research.

[31]  R. Schultz,et al.  The social motivation theory of autism , 2012, Trends in Cognitive Sciences.

[32]  K. Nakagome,et al.  The pilot study of a Neuropsychological Educational Approach to Cognitive Remediation for patients with schizophrenia in Japan , 2012, Psychiatry Research.

[33]  B. Dubois,et al.  Severe traumatic brain injury, frontal lesions, and social aspects of language use: a study of French-speaking adults. , 2011, Journal of communication disorders.

[34]  Vyv Huddy,et al.  A Meta-Analysis of Cognitive Remediation for Schizophrenia: Methodology and Effect Sizes , 2012 .

[35]  Catherine Schreiber Social Skills Interventions for Children With High-Functioning Autism Spectrum Disorders , 2011 .

[36]  S. Tordjman,et al.  Aggression in Low Functioning Children and Adolescents with Autistic Disorder , 2010, PloS one.

[37]  Alex Martin,et al.  Facial Emotion Recognition in Autism Spectrum Disorders: A Review of Behavioral and Neuroimaging Studies , 2010, Neuropsychology Review.

[38]  N. Revheim,et al.  Cognitive Remediation for Psychological Disorders: Therapist Guide , 2009 .

[39]  Adam Smith The Empathy Imbalance Hypothesis of Autism: A Theoretical Approach to Cognitive and Emotional Empathy in Autistic Development , 2009 .

[40]  Tiffany L. Hutchins,et al.  Supporting Theory of Mind Development Considerations and Recommendations for Professionals Providing Services to Individuals With Autism Spectrum Disorder , 2008 .

[41]  Lisa Ruble,et al.  Social Skills Group Therapy for Autism Spectrum Disorders , 2008 .

[42]  C. Ludwig,et al.  L’Empan de lecture comme épreuve mesurant la capacité de mémoire de travail : normes basées sur une population francophone de 775 adultes jeunes et âgés , 2008 .

[43]  Bryan M Freilich,et al.  The Neuropsychological Educational Approach to Cognitive Remediation (NEAR) Model: Practice Principles and Outcome Studies , 2008 .

[44]  D. Penn,et al.  Brief Report: Feasibility of Social Cognition and Interaction Training for Adults with High Functioning Autism , 2008, Journal of autism and developmental disorders.

[45]  Deborah C. Beidel,et al.  Social Skills Interventions for Children with Asperger’s Syndrome or High-Functioning Autism: A Review and Recommendations , 2008, Journal of autism and developmental disorders.

[46]  Christie L. Gilson,et al.  Services for Children With Autism Spectrum Disorders , 2007 .

[47]  E. Twamley,et al.  A meta-analysis of cognitive remediation in schizophrenia. , 2007, The American journal of psychiatry.

[48]  M. B. Jurado,et al.  The Elusive Nature of Executive Functions: A Review of our Current Understanding , 2007, Neuropsychology Review.

[49]  F. Volkmar,et al.  Circumscribed Interests in Higher Functioning Individuals with Autism Spectrum Disorders: An Exploratory Study , 2007 .

[50]  J. Dartigues,et al.  Test de rappel libre/rappel indicé à 16 items : normes en population générale chez des sujets âgés issues de l’étude des 3 Cités , 2007 .

[51]  J. Hallmayer,et al.  Characteristics of the broader phenotype in autism: A study of siblings using the children's communication checklist‐2 , 2006, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[52]  R. Young,et al.  Social comparison processes and depressive symptoms in children and adolescents with Asperger syndrome , 2006, Autism : the international journal of research and practice.

[53]  U. Frith,et al.  The Weak Coherence Account: Detail-focused Cognitive Style in Autism Spectrum Disorders , 2006, Journal of autism and developmental disorders.

[54]  J. Hattori,et al.  The Rey–Osterrieth Complex Figure as a measure of executive function in childhood , 2005, Brain and Development.

[55]  M. Weiss Asperger Syndrome in Adolescence: Living with the Ups, the Downs, and Things in Between. , 2005 .

[56]  Dorothy Bishop,et al.  Using a parental checklist to identify diagnostic groups in children with communication impairment: a validation of the Children's Communication Checklist--2. , 2004, International journal of language & communication disorders.

[57]  E. Hill Evaluating the theory of executive dysfunction in autism , 2004 .

[58]  T. Tombaugh Trail Making Test A and B: normative data stratified by age and education. , 2004, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[59]  E. Hill Executive dysfunction in autism , 2004, Trends in Cognitive Sciences.

[60]  J. Constantino,et al.  Validation of a Brief Quantitative Measure of Autistic Traits: Comparison of the Social Responsiveness Scale with the Autism Diagnostic Interview-Revised , 2003, Journal of autism and developmental disorders.

[61]  G. Gioia,et al.  TEST REVIEW Behavior Rating Inventory of Executive Function , 2000 .

[62]  S. Bryson,et al.  The Prevalence of Anxiety and Mood Problems among Children with Autism and Asperger Syndrome , 2000 .

[63]  J. Constantino,et al.  Reciprocal Social Behavior in Children With and Without Pervasive Developmental Disorders , 2000, Journal of developmental and behavioral pediatrics : JDBP.

[64]  S. Amanullah,et al.  The Social, Behavioral, and Academic Experiences of Children with Asperger Syndrome , 2000 .

[65]  R. Jones,et al.  Recognition of Faux Pas by Normally Developing Children and Children with Asperger Syndrome or High-Functioning Autism , 1999, Journal of autism and developmental disorders.

[66]  B. Hood,et al.  Two Intact Executive Capacities in Children with Autism: Implications for the Core Executive Dysfunctions in the Disorder , 1999, Journal of autism and developmental disorders.

[67]  S. Ozonoff,et al.  Brief Report: Specific Executive Function Profiles in Three Neurodevelopmental Disorders , 1999, Journal of autism and developmental disorders.

[68]  A. Baddeley,et al.  Dual-task performance in dysexecutive and nondysexecutive patients with a frontal lesion. , 1997, Neuropsychology.

[69]  M. Coffey,et al.  A Brief Mental Health Outcome Scale , 1995, British Journal of Psychiatry.

[70]  A. Couteur,et al.  Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders , 1994, Journal of autism and developmental disorders.

[71]  G. Dawson,et al.  Early recognition of children with autism: A study of first birthday home videotapes , 1994, Journal of autism and developmental disorders.

[72]  F. Happé An advanced test of theory of mind: Understanding of story characters' thoughts and feelings by able autistic, mentally handicapped, and normal children and adults , 1994, Journal of autism and developmental disorders.

[73]  U. Frith,et al.  Autism and Asperger Syndrome , 1992 .

[74]  S. Baron-Cohen The autistic child's theory of mind: a case of specific developmental delay. , 1989, Journal of child psychology and psychiatry, and allied disciplines.

[75]  S. Baron-Cohen,et al.  Does the autistic child have a “theory of mind” ? , 1985, Cognition.

[76]  L. Wing,et al.  Severe impairments of social interaction and associated abnormalities in children: Epidemiology and classification , 1979, Journal of autism and developmental disorders.

[77]  H. Werner,et al.  Interference effects of Stroop color-word test in childhood, adulthood, and aging. , 1962, The Journal of genetic psychology.

[78]  D. Bishop Children’s Communication Checklist (CCC-2) , 2021, Encyclopedia of Autism Spectrum Disorders.

[79]  Perrine Cheval Feelings: Un jeu créé par Vincent Bidault et Jean-Louis Roubira , 2017 .

[80]  Kie Yin Teng,et al.  Social Skills Deficits in Autism: A Study among Students with Austim Spectrum Disorder in Inclusive Classrooms. , 2015 .

[81]  Adam Waytz,et al.  Mind Attribution is for Morality , 2013 .

[82]  Selda Özdemir Social stories: an intervention technique for children with Autism , 2010 .

[83]  James Lani,et al.  Rosenberg Self-Esteem Scale (SES) , 2010 .

[84]  D. Tekin,et al.  Investigating false belief levels of typically developed children and children with autism , 2010 .

[85]  Adam Smith The Empathy Imbalance Hypothesis of Autism: A Theoretical Approach to Cognitive and Emotional Empathy in Autistic Development , 2009 .

[86]  Marie-Hélène Prud'homme L'autisme: une autre intelligence. Diagnostic, cognition et support des personnes autistes sans déficience intellectuelle. , 2005 .

[87]  J. Russell,et al.  The automated windows task: the performance of preschool children, children with autism, and children with moderate learning difficulties , 2003 .

[88]  E. Deci,et al.  Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. , 2000, The American psychologist.

[89]  N. Minshew,et al.  Autism as a disorder of complex information processing , 1998 .

[90]  C. Gray,et al.  Social Stories and Comic Strip Conversations with Students with Asperger Syndrome and High-Functioning Autism , 1998 .

[91]  S. Baron-Cohen,et al.  Understanding other minds : perspectives from autism , 1994 .

[92]  Simon Baron-Cohen,et al.  Autism: A specific cognitive disorder of "mind-blindness." , 1990 .

[93]  U. Frrrh Autism: explaining the enigma , 1989 .