intervention for social skills deficits in children with 22q11.2 deletion syndrome
DESCRIPTION
Intervention for Social Skills Deficits in Children With 22q11.2 Deletion SyndromeTRANSCRIPT
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Carrie E. Bearden, Ph.D.*, Maria Jalbrzikowski, Jennifer Ho, Carolyn Chow, and Chelsea Anderson
Departments of Psychiatry and Biobehavioral Sciences and Psychology
Semel Institute for Neuroscience and Human Behavior University of California, Los Angeles
[email protected] Phone: 310-206-2983
18th International Scientific Meeting of the VCFS Educational Foundation
Newark, NJ July 15-17 2011
Intervention for Social Skills Deficits in Children with 22q11.2 Deletion Syndrome
(VCFS)
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Presentation Outline
Characterization of social deficits in children nad adolescents with 22qDS Treatment approaches for social deficits
Exercise-induced brain plasticity Neuroplasticity as a pre-requisite for treatment response?
Development of a possible intervention
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ADHD
Autism
22q11.2
microdeletion
OCD
Anxiety Disorders
Psychosis
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ADHD
Autism
22q11.2
microdeletion
OCD
Anxiety Disorders
Psychosis
Neural Features
-Anomalous myelination
- Dopamine Neurotransmission
Social Problems
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Psychosocial Profile of Children with 22q11DS: Child Behavior Checklist
At-
risk
Norm
al
Range Philadelphia
(CHOP)
UCLA
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Characteristic Social Deficits
Autistic Spectrum
Poor regulation of social interaction through eye contact, facial expression, gesture, posture, intonation
Failure to develop age-appropriate peer relationships
Limited social-emotional reciprocity
Preoccupations/ restricted interests
Theory of mind/perspective-taking
Schizotypal Spectrum
Social anhedonia
Poor recognition of emotional expression
Excessive social anxiety
Cycle of bullying/teasing
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Bearden et al. Cer Cortex 2009 Gray Matter Thinning in : -anterior cingulate and medial frontal cortex (social cognition network) -occipito-parietal cortex (visuospatial navigation)
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Publications on Brain Imaging, Genetics and Cognition in VCFS
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We need more/better psychosocial treatments for children and teens
with VCFS!!
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Interventions for Social Deficits in ASD Using Peer Group
-Peer-mediated practice to improve social interactions for children with autism during recess activities -Peers are taught Pivotal Response Training (PRT) strategies: gaining attention, varying activities, narrating play, reinforcing attempts, and turn-taking
Number of independent appropriate attempts for social initiations/ gaining attention directed at peers
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-Link between hippocampal neurogenesis, stress-induced behavioral changes, and beneficial effects of enriched environment. -Social stress in mice can cause behavior resembling human depression -Behaviors can be ameliorated if mice are in an environment that promotes exercise and exploration. -Beneficial effect of activity depended on the growth of new neurons in the adult brain.
Treatment Rationale: Restorative Power of Exercise
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Additive effects of exercise and environmental enrichment on adult
neurogenesis
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Exercise also increases hippocampal volume in patients with schizophrenia
Pajonk et al Arch Gen Psych 2010
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Social Exercise Remediation Program
Exercise may provide the optimal platform in which remediation effects can occur
New treatment will integrate social activities with physical exercise program
While physical exercise can boost brain development, social element may differentially improve social function and self-esteem
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Summary and Implications
Children with 22qDS are at increased risk for a variety of psychiatric symptoms, and social deficits are a component of many disorders
Poor social function very common in 22qDS- developmental trajectory not clear
Early intervention can help!
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Importance of Early Intervention
Screening of at risk groups for early signs of illness E.g., mammography, liver function tests, EKG
Invasiveness of intervention scales with stage of illness
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Longitudinal Study at UCLA : Cognition and Brain Structure in
22q11.2DS
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Acknowledgements
NIH/NICHD grant # P50-HD-055784 (CART Pilot Project Grant to CEB), Consortium for Neuropsychiatric Phenomics (RB), ARRA Award 1R01HD065280-01 (SB), RO1 MH085953 (CEB)
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Department of Psychology Theo van Erp
Katie Karlsgodt
Ty Cannon
Laboratory of NeuroImaging
Rebecca Dutton
Christina Boyle
Paul Thompson
Arthur Toga
Angela Matevoysan
Pegeen Cronin
Dan Geschwind
Mirella Dapretto
Susan Bookheimer
Lab Members: Laurie Brenner
Maria Jarlbrkowski
Peter Bachman
Danielle Schlosser
Shauna Mc Manus
Sarah Jacobson
Jennifer Ho
Carolyn Chow
Jessica Hopkins
Nicole Enrique
Ivana Poste
Neurobehavioral
Genetics Nelson Freimer
Giovanni Coppola
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And most importantly.. THANK YOU!!
and HAPPY BIRTHDAY BOB!!