Autistic adults' perspectives and experiences of diagnostic assessments that include play across the lifespan / Emma PRITCHARD-ROWE in Autism, 29-1 (January 2025)  

Public ISBD [article]  inAutism > 29-1 (January 2025) . - p.64-75 Titre : Autistic adults' perspectives and experiences of diagnostic assessments that include play across the lifespan Type de document : Texte imprimé et/ou numérique Auteurs : Emma PRITCHARD-ROWE, Auteur ; Carmen DE LEMOS, Auteur ; Katie HOWARD, Auteur ; Jenny GIBSON, Auteur Article en page(s) : p.64-75 Langues : Anglais (eng) Mots-clés : assessment  autism  autistic perspectives  diagnosis  neurodiversity  play Index. décimale : PER Périodiques Résumé : Play is often included in autism diagnostic assessments. These tend to focus on 'deficits' and non-autistic interpretation of observable behaviours. In contrast, a neurodiversity-affirmative assessment approach involves centring autistic perspectives and focusing on strengths, differences and needs. Accordingly, this study was designed to focus on autistic perspectives of diagnostic assessments that incorporate play. Autism community stakeholders were consulted on the design of the study. Semi-structured interviews were conducted with 22 autistic adults aged 18-57 years who live in the United Kingdom. Interpretative phenomenological analysis was used to identify themes. Autistic adults highlighted the varying ways in which play was included in their diagnostic assessments, such as via the Autism Diagnostic Observation Schedule. Our findings highlight the importance of better adapting assessment to the heterogeneity of autism. For example, our findings question the extent to which play is useful for assessing autistic women and girls who mask. Our findings also suggest that holistic, neurodiversity-affirmative assessment practices should be adopted. Our findings support the importance of adopting a personalised approach to diagnostic assessments that use play, in addition to assessing strengths and differences as well as needs.Lay abstractPlay is often included in autism diagnostic assessments. These assessments tend to focus on negatives and how people who are not autistic interpret observable behaviours. It is important to take a neurodiversity-affirmative assessment approach. This involves focusing on what autistic people say and looking at strengths and needs. We wanted to find out how autistic adults experience diagnostic assessments that include play. We asked autistic and non-autistic people to help us design our study and interview questions. We then interviewed 22 autistic adults to find out what they think about the use of play in assessments. We used a qualitative method called interpretative phenomenological analysis to analyse the data. Autistic adults told us about the different ways play was included in their diagnostic assessments. For example, some completed a diagnostic tool called the Autism Diagnostic Observation Schedule. Autistic adults also talked about the importance of considering how autistic people are different to each other. For example, we found that play may not be useful for assessing women or girls who mask. This suggests that professionals should adopt a personalised approach to diagnostic assessments that use play catering to each person?s needs. Our findings also suggested that professionals should assess strengths and differences as well as needs. En ligne : https://dx.doi.org/10.1177/13623613241257601 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=544 [article] Autistic adults' perspectives and experiences of diagnostic assessments that include play across the lifespan [Texte imprimé et/ou numérique] / Emma PRITCHARD-ROWE, Auteur ; Carmen DE LEMOS, Auteur ; Katie HOWARD, Auteur ; Jenny GIBSON, Auteur . - p.64-75. Langues : Anglais (eng) in Autism > 29-1 (January 2025) . - p.64-75 Mots-clés : assessment  autism  autistic perspectives  diagnosis  neurodiversity  play Index. décimale : PER Périodiques Résumé : Play is often included in autism diagnostic assessments. These tend to focus on 'deficits' and non-autistic interpretation of observable behaviours. In contrast, a neurodiversity-affirmative assessment approach involves centring autistic perspectives and focusing on strengths, differences and needs. Accordingly, this study was designed to focus on autistic perspectives of diagnostic assessments that incorporate play. Autism community stakeholders were consulted on the design of the study. Semi-structured interviews were conducted with 22 autistic adults aged 18-57 years who live in the United Kingdom. Interpretative phenomenological analysis was used to identify themes. Autistic adults highlighted the varying ways in which play was included in their diagnostic assessments, such as via the Autism Diagnostic Observation Schedule. Our findings highlight the importance of better adapting assessment to the heterogeneity of autism. For example, our findings question the extent to which play is useful for assessing autistic women and girls who mask. Our findings also suggest that holistic, neurodiversity-affirmative assessment practices should be adopted. Our findings support the importance of adopting a personalised approach to diagnostic assessments that use play, in addition to assessing strengths and differences as well as needs.Lay abstractPlay is often included in autism diagnostic assessments. These assessments tend to focus on negatives and how people who are not autistic interpret observable behaviours. It is important to take a neurodiversity-affirmative assessment approach. This involves focusing on what autistic people say and looking at strengths and needs. We wanted to find out how autistic adults experience diagnostic assessments that include play. We asked autistic and non-autistic people to help us design our study and interview questions. We then interviewed 22 autistic adults to find out what they think about the use of play in assessments. We used a qualitative method called interpretative phenomenological analysis to analyse the data. Autistic adults told us about the different ways play was included in their diagnostic assessments. For example, some completed a diagnostic tool called the Autism Diagnostic Observation Schedule. Autistic adults also talked about the importance of considering how autistic people are different to each other. For example, we found that play may not be useful for assessing women or girls who mask. This suggests that professionals should adopt a personalised approach to diagnostic assessments that use play catering to each person?s needs. Our findings also suggested that professionals should assess strengths and differences as well as needs. En ligne : https://dx.doi.org/10.1177/13623613241257601 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=544

Play-based interventions to support social and communication development in autistic children aged 2–8 years: A scoping review / Jenny L. GIBSON in Autism & Developmental Language Impairments, 6 (January-December 2021)  

Public ISBD [article]  inAutism & Developmental Language Impairments > 6 (January-December 2021) . - 23969415211015840 Titre : Play-based interventions to support social and communication development in autistic children aged 2–8 years: A scoping review Type de document : Texte imprimé et/ou numérique Auteurs : Jenny L. GIBSON, Auteur ; Emma PRITCHARD, Auteur ; Carmen DE LEMOS, Auteur Article en page(s) : 23969415211015840 Langues : Anglais (eng) Mots-clés : Autism  play  intervention  language & communication Index. décimale : PER Périodiques Résumé : Background and aimsPlay is used by practitioners from across disciplinary backgrounds as a natural and enjoyable context for providing intervention and support in early childhood. In the case of autism interventions, many therapies are based on the association between social play and the development of social skills, language development, and communication skills, as these are often particular areas of challenge for autistic children. However, play is a wide-ranging concept and the extant literature on play-based interventions is large and heterogeneous. This means it is challenging for practitioners and families to navigate the evidence base and make choices about differing intervention strategies. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform clinical decision-making.MethodsAn initial stakeholder consultation confirmed the relevance of the topic to practitioners and autistic people. A scoping review methodology (preregistered) was used to identify relevant literature. We systematically searched seven databases to find peer-reviewed primary intervention studies of play-based approaches targeting language, social and communication outcomes for autistic children aged 2-8?years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs). The literature was summarised according to a range of characteristics, including study design, population characteristics, agent of intervention and outcomes measured, among others. These summaries were then used to develop a framework for some key considerations for practitioners appraising play-based approaches.Results388 studies met inclusion criteria. Approximately 21% of studies were RCTs, and over 50% had ?10 participants. Over 45% of studies reported multiple relevant outcomes, with social play skills being the most common single intervention target. Girls and minority background groups are under-represented. A range of intervention types were identified, and some high-level categorisations are proposed.Main contribution: On the basis of the evidence synthesis we suggest important dimensions for appraisal of play-based interventions, including the role of play within an intervention (as a context, a key developmental mechanism, or a component of a larger approach), the underpinning philosophy (e.g. behaviourist or developmental), and the role of the practitioner (providing parent feedback, 1:1 intervention, group facilitation).ConclusionsThe wide range of approaches uncovered by this review is a testament to the wonderful diversity inherent to both play and autism. However, research could usefully focus on consolidating the evidence base for existing approaches, rather than aiming for further diversification. Implications: The conceptual framework proposed in this review can help practitioners appraise the literature and aid their advice to families when making shared intervention decisions. En ligne : http://dx.doi.org/10.1177/23969415211015840 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459 [article] Play-based interventions to support social and communication development in autistic children aged 2–8 years: A scoping review [Texte imprimé et/ou numérique] / Jenny L. GIBSON, Auteur ; Emma PRITCHARD, Auteur ; Carmen DE LEMOS, Auteur . - 23969415211015840. Langues : Anglais (eng) in Autism & Developmental Language Impairments > 6 (January-December 2021) . - 23969415211015840 Mots-clés : Autism  play  intervention  language & communication Index. décimale : PER Périodiques Résumé : Background and aimsPlay is used by practitioners from across disciplinary backgrounds as a natural and enjoyable context for providing intervention and support in early childhood. In the case of autism interventions, many therapies are based on the association between social play and the development of social skills, language development, and communication skills, as these are often particular areas of challenge for autistic children. However, play is a wide-ranging concept and the extant literature on play-based interventions is large and heterogeneous. This means it is challenging for practitioners and families to navigate the evidence base and make choices about differing intervention strategies. This review aims to provide a comprehensive map of the research on this topic and to develop a conceptual framework to inform clinical decision-making.MethodsAn initial stakeholder consultation confirmed the relevance of the topic to practitioners and autistic people. A scoping review methodology (preregistered) was used to identify relevant literature. We systematically searched seven databases to find peer-reviewed primary intervention studies of play-based approaches targeting language, social and communication outcomes for autistic children aged 2-8?years. We then summarised the literature using narrative synthesis and Evidence Gap Maps (EGMs). The literature was summarised according to a range of characteristics, including study design, population characteristics, agent of intervention and outcomes measured, among others. These summaries were then used to develop a framework for some key considerations for practitioners appraising play-based approaches.Results388 studies met inclusion criteria. Approximately 21% of studies were RCTs, and over 50% had ?10 participants. Over 45% of studies reported multiple relevant outcomes, with social play skills being the most common single intervention target. Girls and minority background groups are under-represented. A range of intervention types were identified, and some high-level categorisations are proposed.Main contribution: On the basis of the evidence synthesis we suggest important dimensions for appraisal of play-based interventions, including the role of play within an intervention (as a context, a key developmental mechanism, or a component of a larger approach), the underpinning philosophy (e.g. behaviourist or developmental), and the role of the practitioner (providing parent feedback, 1:1 intervention, group facilitation).ConclusionsThe wide range of approaches uncovered by this review is a testament to the wonderful diversity inherent to both play and autism. However, research could usefully focus on consolidating the evidence base for existing approaches, rather than aiming for further diversification. Implications: The conceptual framework proposed in this review can help practitioners appraise the literature and aid their advice to families when making shared intervention decisions. En ligne : http://dx.doi.org/10.1177/23969415211015840 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459

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