Does Quality of Life Differ for Children With Autism Spectrum Disorder and Intellectual Disability Compared to Peers Without Autism?

Saudi parents' perspectives of the factors influencing the quality of life of their children with autism spectrum disorder

BACKGROUND

Research indicates that the deficits in social communication and the repetitive, restrictive behaviour of persons with Autistic Spectrum Disorder (ASD) can pose challenges to their functioning in different Quality of Life (QoL) domains, leading to lower levels of life satisfaction. Evidence also indicates that various social and family factors, such as the support received in the community/environment and the composition of the family, could impact the QoL of persons with ASD.

AIM

To study the factors influencing the QoL of children with ASD in the Kingdom of Saudi Arabia (KSA) by investigating the perspectives of their parents.

METHOD

Questionnaires were completed by 110 parents who had a child with ASD. The questionnaire included the 96-item KidsLife-ASD scale to capture parents' perspectives regarding the difficulties experienced by their child, the ASD support received by their families, and the QoL of the child. The data obtained from the questionnaire were statistically analysed using IBM SPSS software.

RESULTS

The difficulties experienced by children with ASD and aspects of the support (services and interventions, and challenges) they receive are factors that influence the QoL of children with ASD in the KSA. Moreover, the number of children in the family, the birth order of child with ASD, and the severity of ASD symptoms are factors that influence parents' perceptions of their children's difficulties, family ASD support, and the child's QoL.

CONCLUSIONS

Saudi parents who have one child with ASD believed that the QoL of their child was high and confirmed that the difficulties experienced by the child and the support received by the family were factors which influenced the QoL of a child with ASD.

A hybrid graph network model for ASD diagnosis based on resting-state EEG signals

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder and early diagnosis is crucial for effective treatment. Stable and effective biomarkers are essential for understanding the underlying causes of the disorder and improving diagnostic accuracy. Electroencephalography (EEG) signals have proven to be reliable biomarkers for diagnosing ASD. Extracting stable connectivity patterns from EEG signals helps ensure robustness in ASD diagnostic systems. In this study, we propose a hybrid graph convolutional network framework called Rest-HGCN, which utilizes resting-state EEG signals to capture differential patterns of brain connectivity between normal children and ASD patients using graph learning strategies. The Rest-HGCN combines brain network analysis techniques and data-driven strategies to extract discriminative graph features from resting-state EEG signals. By automatically extracting differential graph patterns from these signals, the Rest-HGCN achieves reliable ASD diagnosis. To evaluate the performance of Rest-HGCN, we conducted ASD diagnosis experiments using k-fold cross-validation on the public ABC-CT resting EEG dataset. The proposed Rest-HGCN model achieved accuracies of 87.12 % and 85.32 % in single-subject and cross-experiment analyses, respectively. The results suggest that Rest-HGCN can effectively capture discriminant graph patterns from resting EEG signals and achieve robust ASD diagnosis. This may provide an effective and convenient tool for clinical ASD diagnosis.

Parent Perspectives on Assisted Communication and Autism Spectrum Disorder

IMPORTANCE

Parents of nonspeaking children with autism spectrum disorder (ASD) may present with complex challenges associated with communicating with their children.

OBJECTIVE

To explore the firsthand experiences of parents of children with ASD who use assisted communication (AC) to communicate, which has yet to be explored in the literature.

DESIGN

Semistructured interviews with ten parents of individuals with ASD, age 15 to 36 yr, who use AC to communicate.

RESULTS

Analysis of the data revealed four superordinate themes, each with two subthemes: (1) Relationship (subthemes: Involving the Child, Improved Relationship), (2) Future (subthemes: Hopes and Dreams, Planning), (3) Support (subthemes: Limited Availability of Service Providers, Underestimation), and (4) Understanding (subthemes: Communication, Understanding of the Child). The themes illustrated that using AC modalities improved the parent-child relationship (Relationship) and helped parents understand their child on a deeper level (Understanding). A positive outcome of having a new means of communication with their child was that parents could better plan for a future that reflects their child's innermost hopes and dreams (Future). Parents also reported that the lack of a consensus concerning using AC with nonspeaking children led to decreased support (Support) from professionals and educators, limiting the child's opportunities.

CONCLUSIONS AND RELEVANCE

This study provides phenomenological qualitative evidence that use of AC provides benefits to the parent-child relationship. Plain-Language Summary: This study investigated the lived experience of parents of children with autism spectrum disorder (ASD) and how the use of assisted communication (AC) affected their relationship with their child. Ten parents were interviewed. Four main topics emerged from the analysis of these interviews: (1) improved closeness in relationship, (2) improved ability to plan for the future, (3) wish for improved availability of service providers, and (4) improved understanding of who the child is as a person. Parents play a key role as team members in support of the child's performance in occupations. The results of this study suggest that AC plays an important role in supporting the parent-child relationship; therefore, AC programs should be considered when implementing and planning occupational therapy treatments for individuals who have communication impairments.

Psychological therapies for anxiety in autistic individuals with co-occurring intellectual developmental disorder: A systematic review

This systematic review aimed to evaluate the efficacy of psychological therapies for anxiety for people with autism and co-occurring intellectual developmental disorder (AUT + IDD). A systematic search identified 13 studies comprising 49 participants with AUT + IDD, aged between 5 and 41 years. Most studies were single-case experimental designs (n = 7) or case studies or case series (n = 4). Studies implemented cognitive behavioural therapy (n = 4) or exposure therapy techniques (n = 9). All studies reported a reduction in anxiety symptoms, as measured by either quantitative measures or defined as participants meeting end of treatment criterion. However, the conclusions are preliminary due to the methodological limitations of the current literature. The implications of these findings, as well as recommendations for future direction in the field, are discussed.

Examining physical activity and quality of life in adults with autism spectrum disorder and intellectual disability

Adults with autism and co-occurring intellectual disability engage in low levels of physical activity and are at increased risk of developing secondary health conditions attributed to physical inactivity compared to adults in the general population. Few studies have examined the use of objective measures to characterize physical activity levels for adults with autism and intellectual disability. The current study aimed to examine the relationship between physical activity, using an activity tracker, and quality of life in adults with autism and intellectual disability. In the current study, 38 adults with autism and intellectual disability, ages 18-55, wore a Fitbit Flex 2® activity tracker for 1 week, and completed the Quality of Life Questionnaire. The relationship between average daily step count quality of life was examined. Most adults in the sample were overweight and taking fewer daily steps than recommended guidelines. Increased average daily step count was significantly associated with quality of life.

Short Report: Outcomes for siblings associated with sub-groups of autistic children with intellectual disability identified by latent profile analysis

BACKGROUND

Recent research suggests that having a brother or sister with autism may contribute to increased positive or negative emotional or psychological impact on siblings.

AIMS

To use a novel multidimensional data analysis method to further understand outcomes for siblings of autistic children.

METHODS AND PROCEDURES

318 siblings of children with a recorded autism diagnosis and an intellectual disability were included for latent profile analysis. Five variables (DBC disruptive and anxiety; VABS II communication, daily living, and socialization skills) were used to identify sub-groups of autistic children. Primary carers reported on sibling relationship quality (items from the Sibling Relationship Questionnaire warmth/closeness and conflict scales), and siblings' behavioral and emotional problems.

OUTCOMES AND RESULTS

The profile groups differed in their levels of ID coupled with disruptive behavior, emotional problems and adaptive skills. Profiles included a severe ID, low behavior and emotional problems and low adaptive skills group; a group with mild ID coupled with high adaptive skills and low emotional and behavioral problems; and a mild ID group with high emotional and behavioral problems. Conflict in the sibling relationship differed across the profile groups (F (4304) = 15.13, p < .001).

CONCLUSIONS AND IMPLICATIONS

Siblings of autistic children with the highest support needs were reported to have the lowest conflict in their relationships. Conversely, siblings of the autistic children with the highest levels of externalizing behaviors and anxiety were reported to have the highest levels of conflict in the sibling relationship.

The Quality of Life for Children with Autism Spectrum Disorder Scale: Factor Analysis, MIMIC Modeling, and Cut-Off Score Analysis

Our purpose in this study was to further examine the psychometric properties of the Quality of Life for Children with Autism Spectrum Disorder (QOLASD-C) scale. We first investigated the factor structure and the internal consistency of the scale. The bifactor model showed good fit and strong reliability. Second, we used multiple-indicators multiple-causes (MIMIC) modeling to examine the associations between demographic variables and the QOLASD-C dimensions. Results showed differences on overall QOL based on age, race/ethnicity, and autism spectrum disorder severity, but no relationships with gender. All demographic variables were associated with one or all three subscales (i.e., interpersonal relationships, self-determination, emotional well-being) of the QOLASD-C. Third, an optimal cut-off score of 37 was identified. Implications for research and practice are discussed.

Parental perspectives on the quality of life of children with Down syndrome

Down Syndrome (DS) is the most common chromosome abnormality and the most frequent cause of developmental delay/intellectual disabilities in children. Although the investigation of the quality of life (QoL) is crucial in children with DS, relatively poor attention has been paid to this topic. The current study aimed to evaluate parent-reported QoL in a group of children with DS and identify children's individual and clinical features associated with different levels of QoL. We included in the study 73 children with DS (5-12 years) and investigated the parent-reported levels of QoL by means of the Pediatric Quality of Life Inventory. Cognitive level and the presence of behavioral difficulties were also evaluated. The overall parent-reported QoL of children with DS was high; emotional functioning was the domain with the highest level of QoL. Moreover, parents perceived low levels of QoL in children who exhibited low IQ, worse analogical reasoning, worse adaptive skills, more frequent challenging behaviors, more ritualistic/sameness behavior and more autistic symptoms. No differences emerged for family variables, namely parental education and employment, between the two groups with high and low QoL, as perceived by parents. The understanding of cognitive and behavioral factors - such as analogical reasoning, socio-communication abilities and challenging behaviors - related with different degrees of QoL in children with DS is crucial for the development of effective strategies to promote the improvement of the QoL.

A quality of life supports model: Six research-focused steps to evaluate the model and enhance research practices in the field of IDD

In the field of intellectual and developmental disabilities (IDD) the constructs of quality of life and supports have been combined into a Quality of Life Supports Model (QOLSM) that is currently used internationally for supports provision, organization transformation, and systems change. With the model's increasing and widespan use in research and practice, there is a need to evaluate the model's impact at the individual, organization, and systems levels. The purpose of this article is to outline six specific research-focused evaluation steps that allow researchers to evaluate the model and thereby enhance research practices is the field of IDD. These steps involve: (1) operationalizing components of the QOLSM; (2) relating QOLSM components to the type of research planned and intended outcome indicators; (3) gathering evidence and establishing its credibility; (4) interpreting and communicating the results; (5) implementing research outcomes at the level of the microsystem, mesosystem and macrosystem; and (6) judging the impact of the model. These steps delineate a research framework that is based on a systematic approach to evidence-based practices and enhanced research practices in the field of IDD.

Automated ASD detection using hybrid deep lightweight features extracted from EEG signals

BACKGROUND

Autism spectrum disorder is a common group of conditions affecting about one in 54 children. Electroencephalogram (EEG) signals from children with autism have a common morphological pattern which makes them distinguishable from normal EEG. We have used this type of signal to design and implement an automated autism detection model.

MATERIALS AND METHOD

We propose a hybrid lightweight deep feature extractor to obtain high classification performance. The system was designed and tested with a big EEG dataset that contained signals from autism patients and normal controls. (i) A new signal to image conversion model is presented in this paper. In this work, features are extracted from EEG signal using one-dimensional local binary pattern (1D_LBP) and the generated features are utilized as input of the short time Fourier transform (STFT) to generate spectrogram images. (ii) The deep features of the generated spectrogram images are extracted using a combination of pre-trained MobileNetV2, ShuffleNet, and SqueezeNet models. This method is named hybrid deep lightweight feature generator. (iii) A two-layered ReliefF algorithm is used for feature ranking and feature selection. (iv) The most discriminative features are fed to various shallow classifiers, developed using a 10-fold cross-validation strategy for automated autism detection.

RESULTS

A support vector machine (SVM) classifier reached 96.44% accuracy based on features from the proposed model.

CONCLUSIONS

The results strongly indicate that the proposed hybrid deep lightweight feature extractor is suitable for autism detection using EEG signals. The model is ready to serve as part of an adjunct tool that aids neurologists during autism diagnosis in medical centers.

Defining quality of life for individuals with neurodevelopmental disorders: Challenges within an inpatient population

PURPOSE

The concept of Quality of Life (QoL) for people with neurodevelopmental disorders primarily focuses on deinstitutionalisation and community inclusion. This population, however, often presents with comorbid diagnoses and is sectioned to treatment facilities under the Mental Health Act. The aim of this paper is to review the existing literature on QoL and discuss the consideration of this specialised population and the environment when measuring QoL.

METHODS

Databases were searched using specific inclusion and exclusion criteria to ensure literature reviewed was relevant to the defined population. The challenges identified from the literature were categorised into interpersonal and intrapersonal factors.

RESULTS

A total of 30 articles were retrieved and considered in this review.

CONCLUSIONS

This paper discusses how these individuals present with different behaviours and opportunities, which subsequently make it difficult to apply existing knowledge of QoL. The need to further examine the QoL in this specific population is discussed.

Addressing Quality of Life of Children With Autism Spectrum Disorder and Intellectual Disability

Despite the advances on the assessment of quality of life, this concept is barely studied and is riddled with important limitations for those with autism spectrum disorder (ASD). This article is aimed at validating a questionnaire to assess quality of life of children with ASD and intellectual disability (ID). Based on the KidsLife Scale, geared toward people with ID, the most reliable items for those with ASD were selected. Study participants were 420 persons, from 4 to 21 years old. Results indicated that the KidsLife-ASD Scale measured eight intercorrelated domains, had good reliability, and exhibited adequate evidences of validity. KidsLife-ASD emerges as a helpful tool to guide person-centered planning addressed at improving quality of life.

Measurable Indicators of CRPD for People with Intellectual and Developmental Disabilities within the Quality of Life Framework

This article proposes the quality of life (QOL) construct as a framework from which to develop useful indicators to operationalize, measure, and implement the Articles of the Convention on the Rights of Persons with Disabilities (CRPD). A systematic review of the scientific literature on people with intellectual and developmental disabilities (IDD) was carried out, with the aim of identifying personal outcomes that can be translated into specific and measurable items for each of the CRPD Articles aligned to the eight QOL domains. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the systematic review was conducted across the Web of Science Core Collection, Current Contents Connect (CCC), MEDLINE, KCI-Korean Journal Database, Russian Science Citation Index and SciELO Citation Index, for articles published between 2008 and 2020. A total of 65 articles focusing on people with IDD were selected. The results were grouped into four broad categories: conceptual frameworks used to monitor the CRPD; instruments used to assess the rights set out in the CRPD; recommendations on the use of inclusive research; and indicators or personal outcomes associated with specific rights contained in the CRPD.

Gender Differences in Social Inclusion of Youth with Autism and Intellectual Disability

The aim of this study was to delve into the role of gender differences in social inclusion of children and youth with autism spectrum disorder (ASD) and intellectual disability (ID). A sample of 420 participants with ASD and ID aged between 4 and 21 years was evaluated using the ASD-KidsLife Scale. Females obtained lower scores in most of the items of social inclusion. These differences remained when the covariables of level of ID, support needs, and age were controlled. None of the items presented differential item functioning as a function of gender. Gender differences, as were found in social inclusion, are discussed and recommendations are given in order to provide equal opportunities to girls and boys with ASD.

Adaptación transcultural para Colombia de la Escala KidsLife para personas con discapacidad intelectual y múltiple

Introducción. La calidad de vida, como constructo multidimensional, considera aspectos físicos, sociales y culturales de las personas con discapacidad intelectual; por ello, se hace necesario contar con instrumentos adaptados y validados que permitan reconocer las necesidades específicas de esta población.Objetivo. Adaptar transculturalmente para Colombia la Escala KidsLife para personas con discapacidad intelectual.Materiales y métodos. Estudio instrumental hecho por fases: se hizo una revisión preliminar de la escala por parte de los investigadores; se comprobó la validez de contenido por juicio de siete expertos, quienes valoraron importancia, influencia, observancia y adecuación gramatical, y se realizó un estudio piloto con 30 personas para determinar confiabilidad y poder discriminativo.Resultados. En cuanto a la validez de contenido, los coeficientes de concordancia ponderados para concordancia entre jueces y concordancia de las dimensiones resultaron buenos. Respecto a la confiabilidad y poder discriminativo, se halló consistencia interna muy buena para la escala total (alfa de Cronbach 0.95) y 52 ítems bajo poder discriminativo (p>0.1).Conclusiones. La adaptación y validez para Colombia de la Escala KidsLife permitirá fortalecer procesos de atención desde las diferentes dimensiones de calidad de vida centrados en las necesidades de la persona con discapacidad intelectual y múltiple, las familias y los profesionales de apoyo.