Critical issues in the residential care of people with autism

Autism

International school psychologists play an important professional role in providing early diagnostic, consultative and treatment-planning services for autistic children and their families. Recent advances in our understanding of this complex disorder necessitates updating professionals in the etiology and treatment of autism. The article describes components of making a differential diagnosis of autism from developmental language/speech disorders, mental retardation and schizophrenia. Etiological theories based on recent neurobiological data are outlined and the psychometric properties of cognitive ability and behavioral rating instruments frequently used with this population are delineated. Specific innovative educational and pharmacological treatment approaches are reviewed.

Comparing residential programmes for adults with autism spectrum disorders and intellectual disability: outcomes of challenging behaviour and quality of life

BACKGROUND

Owing to methodological issues, little research has been conducted to examine quality of life (QoL) as a treatment outcome in autism spectrum disorders (ASD) and intellectual disabilities (ID). This study was conducted to combine QoL measures and objective observations of challenging behaviours (CB) in order to evaluate changes over time in adults with ASD and ID who were treated in two different residential programmes; we hypothesised that a decrease in CB would be related to an improved QoL.

METHOD

In a longitudinal study (45 months), we followed 31 adults with ASD and ID who had been integrated into two residential programmes [Autism Programme with a Structured Method (PAMS) vs. traditional programme for ID (No-PAMS)] for 2-19 years. QoL [Quality of Life Inventory in a Residential Environment (IQVMR)] and severity of autistic features (Childhood Autism Rating Scales) were evaluated annually. CB, as measured by the Aberrant Behaviour Checklist (ABC), including stereotypic behaviour and inappropriate speech, were repeatedly assessed every 3 months.

RESULTS

Observed separately, the groups' results were different. In the PAMS programme, stereotypic behaviour and inappropriate speech (ABC scores) significantly decreased, and the IQVMR total score increased; in contrast, in the comparison group, ABC scores did not change and the IQVMR total score decreased. In all, three mixed-effect ANCOVAs partially confirmed that the PAMS programme had an effect on CB and that QoL improvement did not directly depend on the type of programme but on reducing CB as measured by the ABC.

CONCLUSION

The PAMS programme has a positive and indirect influence on QoL by reducing CB.

Quality of life of adults with pervasive developmental disorders and intellectual disabilities

The purpose of this study was to observe quality of life (QoL) and global evolution of persons with Pervasive Developmental Disorders (PDD) in three different groups. Individualized programs for PDD were compared to traditional programs for intellectual disabilities. Behavioural disorders were repeatedly evaluated using the Aberrant Behaviour Checklist (ABC) and QoL once a year. Little research has investigated this domain due to methodological problems with a non-verbal population. Two preliminary studies of individualized programs showed a significant reduction in behaviour disorders over the course of the study. The recent inclusion of a control group indicates that a traditional program reduces lethargy/social withdrawal (ABC factor 2). A good QoL was measured for the three groups.