A Review of Behavioral Strategies and Support Considerations for Assisting Persons with Difficulties Transitioning from Activity to Activity

Tübinger Training for Autism Spectrum Disorders (TüTASS): a structured group intervention on self-perception and social skills of children with autism spectrum disorder (ASD)

In autism spectrum disorders (ASD), social communication and stereotypical behaviour patterns affect all areas of life, and can result in a decrease of its quality. Previous research has shown promising results for the social skills of groups of children with ASD. Furthermore, a pilot study of the Tübingen Group Training for Autism Spectrum Disorders (TüTASS) has demonstrated that mindfulness-based elements achieve additional positive effects. To build on these findings, the TüTASS training was adapted and expanded. Indeed, the TüTASS currently includes 20 90-min appointments starting with the basic skills of emotions, body, and communication, which are then transferred to personal, family, peer, and school spheres. The appointments have a fixed, consistent structure and each includes a body awareness exercise. In this study, we evaluated the TÜTASS with 27 children with ASD. The results showed improvements in pre-post comparison in behaviours associated with autism, as well as in externalising and internalising behaviours as assessed by parent reports, participant self-reports, and independent raters in participating children. Furthermore, the perceived parent burden in relation to their children decreased, whereas the participants' self-rated quality of life increased. Overall, both the participants and their parents rated the TüTASS very positively in rating sheets and in free feedback. If replicated in larger controlled trials, TÜTASS training might be a useful treatment tool for groups of children with ASD.

Adapting Drug and Alcohol Therapies for Autistic Adults

Background

Autistic people may be at a higher risk of drug and alcohol misuse than the general population. Autistic people, however, are under-represented within drug and alcohol support services. This is the first survey of drug and alcohol therapists' perceptions of current service provision for autistic clients and recommendations for reasonable adjustments that therapists can make to enhance successful outcomes.

Methods

We conducted an online survey of 122 drug and alcohol therapists, exploring therapists' demographics, training and experience with autistic clients, approaches and adaptations used with autistic clients, and therapists' confidence with autistic clients. Within two focus groups, 11 members of the autistic and broader autism (e.g., family members, professionals) communities reflected on the reasonable adjustments reported by therapists.

Results

Most therapists had autistic clients and most therapists had received no autism-specific training. Alcohol misuse was the most common presenting issue, and most therapists reported that treatment outcomes were less favorable for autistic clients than for other groups. Therapists perceived that barriers to successful outcomes were (1) a lack of autism-specific training, (2) a need to adapt therapy for autistic clients, and (3) a lack of shared perspective between the therapist and the autistic client. Previous research has identified a range of reasonable adaptations and, when asked, therapists were moderately confident in their ability to deliver these. Members of the autistic and broader autism communities coproduced guidance detailing how therapists can best adapt their practice for autistic clients including how to structure sessions and the language to use within sessions.

Conclusion

This study highlights a need for practical and theoretical training for drug and alcohol therapists to support successful adaptation to current service provision for autistic clients and to develop a shared perspective on the desired aims and outcomes of the therapeutic process.

A Long-Term Engagement with a Social Robot for Autism Therapy

Social robots are increasingly being used as a mediator between a therapist and a child in autism therapy studies. In this context, most behavioural interventions are typically short-term in nature. This paper describes a long-term study that was conducted with 11 children diagnosed with either Autism Spectrum Disorder (ASD) or ASD in co-occurrence with Attention Deficit Hyperactivity Disorder (ADHD). It uses a quantitative analysis based on behavioural measures, including engagement, valence, and eye gaze duration. Each child interacted with a robot on several occasions in which each therapy session was customized to a child's reaction to robot behaviours. This paper presents a set of robot behaviours that were implemented with the goal to offer a variety of activities to be suitable for diverse forms of autism. Therefore, each child experienced an individualized robot-assisted therapy that was tailored according to the therapist's knowledge and judgement. The statistical analyses showed that the proposed therapy managed to sustain children's engagement. In addition, sessions containing familiar activities kept children more engaged compared to those sessions containing unfamiliar activities. The results of the interviews with parents and therapists are discussed in terms of therapy recommendations. The paper concludes with some reflections on the current study as well as suggestions for future studies.

Effects of Online Training on Educators' Knowledge and Use of System of Least Prompts to Support Augmentative and Alternative Communication

The present study evaluated the effects of online training on educators' knowledge and use of system of least prompts (SLP) to support the communication of individuals with autism (ASD) who use augmentative and alternative communication (AAC). A pre/posttest group design with switching replications was utilized. Three dependent variables: (a) knowledge of SLP, (b) planning for SLP, and (c) performance of SLP implementation during teleconference role-plays, were analyzed using a two-way mixed analysis of variance (ANOVA). Results indicate that training was effective in increasing educators' knowledge as well as the ability to plan for SLP. Implementation of SLP also increased over time, however, data analysis did not support the conclusion that this result was directly related to the online training. Additional results suggest that the participants viewed online instruction, with teleconference role-play assessments and case study vignettes, as a socially valid activity. Participants reported learning a valuable skill and as a result of the training were more confident working with individuals who use AAC. Implications, limitations, and directions for future research are also discussed.

Safety and Lack of Negative Effects of Wearable Augmented-Reality Social Communication Aid for Children and Adults with Autism

There is a growing interest in the use of augmented reality (AR) to assist children and adults with autism spectrum disorders (ASD); however, little investigation has been conducted into the safety of AR devices, such as smartglasses. The objective of this report was to assess the safety and potential negative effects of the Empowered Brain system, a novel AR smartglasses-based social communication aid for people with ASD. The version of the Empowered Brain in this report utilized Google Glass (Google, Mountain View, CA, USA) as its hardware platform. A sequential series of 18 children and adults, aged 4.4 to 21.5 years (mean 12.2 years), with clinically diagnosed ASD of varying severity used the system. Users and caregivers were interviewed about the perceived negative effects and design concerns. Most users were able to wear and use the Empowered Brain (n = 16/18, 89%), with most of them reporting no negative effects (n = 14/16, 87.5%). Caregivers observed no negative effects in users (n = 16/16, 100%). Most users (77.8%) and caregivers (88.9%) had no design concerns. This report found no major negative effects in using an AR smartglasses-based social communication aid across a wide age and severity range of people with ASD. Further research is needed to explore longer-term effects of using AR smartglasses in this population.