Advances in Autism : 2016 – Issue 1
1. Sebastian D, Tanja S. Barriers to healthcare for people on the autism spectrum. Advances in Autism ;2016 ;2(1):2-11.
Purpose – Adults on the autism spectrum experience difficulties in receiving health care, and health care providers face difficulties in offering health care to adults on the autism spectrum. The purpose of this paper is first, to assess the various difficulties and second, to provide strategies to overcome them. Design/methodology/approach – In this qualitative research project, current barriers and facilitators to health care services were sampled from a collaboration of autistic self-advocates and autism professionals in Berlin, Germany. The findings were complemented by a review of practical guidelines and research about the service accessibility of patients on the autism spectrum. Findings – A comprehensive list of barriers to health care was compiled and structured according to various aspects, such as “making appointments”, “waiting area”, “communication”, and “examination”. Strategies considering the perceptual and communicative peculiarities of autism were found to improve access to health care for autistic adults. Practical implications – Providing access to the health care system may improve the diagnosis and treatment of mental and somatic illnesses, and thereby, the health status and quality of life for people on the autism spectrum. This recognition of the needs of adults on the autism spectrum may serve as a model for other areas in society, such as education and employment. Originality/value – Data acquisition in this project is of special value because it resulted from collaboration between an autistic self-advocacy organization and professionals working in the field of intellectual developmental disabilities considering the experiences of autistic adults in the entire range of intellectual functioning.
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2. Barry C, Jessica C, Jo E, Bev C. The Engagement for Learning Framework : connecting with learning and evidencing progress for children with autism spectrum conditions. Advances in Autism ;2016 ;2(1):12-23.
Purpose – The purpose of this paper is to describe and illustrate the use of the Engagement for Learning Framework developed through the Complex Learning Difficulties and Disabilities (CLDD) Research Project (2009-2011). The resources support mainstream and special educators to extend the engagement of learners with CLDD. Design/methodology/approach – In total, 95 educational settings and 224 students took part across three phases of research (November 2009-March 2011) comprising a resource development phase and two trial phases in mainstream and special schools. The researchers used an exploratory, multiple case study approach and action research methodologies. A recent case study from Hamilton School, Birmingham, illustrates the Engagement for Learning Framework. Findings – The resulting Engagement Profile and Scale data showed increases in engagement for similar proportions of the student cohort. Across the three phases, 81-85 per cent (mean : 83 per cent) increased their levels of engagement for learning, 2-9 per cent (mean : 5.3 per cent) showed no change, while 5.5-16 per cent (mean : 11.6 per cent) showed decreased levels of engagement. Descriptive data corroborated these scores. Originality/value – This original research added value to existing work by developing resources for educators that enabled them to adapt activities to encourage students’ engagement in seven engagement areas (awareness, curiosity, investigation, discovery, anticipation, persistence and initiation). The resources enabled educators to score learner engagement over time to show progress and collected associated descriptive data.
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3. Debbie S, Lucy ON, Laura H, Eddie C. Psychological interventions for adults with ASD : clinical approaches. Advances in Autism ;2016 ;2(1):24-30.
Purpose – Empirical research indicates that adults who have autism spectrum disorders (ASD) can derive clinically and statistically meaningful benefits from individual and group-based psychological interventions, specifically those which employ skills-based, behavioural, and cognitive techniques. Given the inherent socio-communication, executive functioning, and theory of mind impairments that individuals with ASD can experience, it is deemed necessary to modify the design and delivery of interventions so as to enhance engagement and outcomes. The paper aims to discuss these issues. Design/methodology/approach – This general review provides a summary of the extant literature and clinical guidelines for the provision of psychological interventions for adults with ASD. Findings – Adaptations to the structure, process, content, and outcome measurement are outlined. It is likely that optimal treatment gains for adults with ASD are contingent on a prolonged assessment phase, pre-therapy interventions including psycho-education and skills-based interventions, thoughtful regard to the formulation of presenting difficulties, and consideration of, and methods to overcome, the difficulties that may arise when seeking to implement change, identify goals, and manage endings. Originality/value – This is one of the first reviews to condense the clinical implications for providing psychological interventions for adults with ASD.
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4. Anastasios G, Dene R, Emma W. The assessment of autism spectrum disorders in adults. Advances in Autism ;2016 ;2(1):31-40.
Purpose – The purpose of this paper is to explore and highlight the main elements of an autism spectrum disorder assessment in adults. It features significant challenges for the clinical teams responsible to undertake the assessment. This paper aims to explain the importance of the wider needs assessment in accordance to the Autism Act and Autism Strategy. Design/methodology/approach – The paper describes the main symptom domains for an ASD diagnosis, according to the two basic diagnostic manuals. It provides compendious summary of the available diagnostic tools and the significant comorbidities people with ASD present with including other neurodevelopmental disorders, mental or physical health problems, challenging behaviour and risk issues. Findings – The paper proposes that all National Health System professionals should be able to recognise possible signs of ASD and accordingly refer individuals for a comprehensive assessment to secondary services. It highlights the importance of a wider needs assessment as part of a broader approach to addressing the needs of those with suspected ASD. Practical implications – The paper aims to improve the gaps which remain in the referral and diagnostic process of people affected by ASD. Social implications – Through a comprehensive assessment the paper aims to improve the educational, social and personal functioning of people with ASD as well as the quality of life of their parents and carers. Originality/value – The paper assembles a wide range of relevant considerations in regards to potential ASD in one place, and can be used to inform a comprehensive understanding of the assessment/diagnosis process.
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5. Ashleigh S, E. WK. Distinguishing autism from co-existing conditions : a behavioural profiling investigation. Advances in Autism ;2016 ;2(1):41-54.
Purpose – Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition for which there is no known cure. The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. The paper aims to discuss this issue. Design/methodology/approach – A number of questionnaires and a computer-based task were used in the current study. The authors asked the participants about symptoms of ASD, attention deficit hyperactivity disorder (ADHD) and anxiety, as well as overall adaptive functioning. Findings – The results demonstrate that each condition, in its pure form, can be clearly differentiated from one another (and from neurotypical controls). Further analyses revealed that when ASD occurs together with anxiety, anxiety appears to be a separate condition. In contrast, there is no clear behavioural profile for when ASD and ADHD co-occur. Research limitations/implications – First, due to small sample sizes, some analyses performed were targeted to specific groups (i.e. comparing ADHD, ASD to comorbid ADHD+ASD). Larger sample sizes would have given the statistical power to perform a full scale comparative analysis of all experimental groups when split by their comorbid conditions. Second, males were over-represented in the ASD group and females were over-represented in the anxiety group, due to the uneven gender balance in the prevalence of these conditions. Lastly, the main profiling techniques used were questionnaires. Clinical interviews would have been preferable, as they give a more objective account of behavioural difficulties. Practical implications – The rate of psychiatric comorbidity in autism is extremely high, which raises questions about the nature of the co-occurring symptoms. It is unclear whether these additional conditions are true comorbid conditions, or can simply be accounted for through the ASD diagnosis. Social implications – This information will be important, not only to healthcare practitioners when administering a diagnosis, but also to therapists who need to apply evidence-based treatment to comorbid and stand-alone conditions. Originality/value – This study is the first to investigate the nature of co-existing conditions in ASD in a New Zealand population.
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6. Jane M, Eddie C. Reducing barriers to accessing services and improving engagement with interventions. Advances in Autism ;2016 ;2(1):null.
