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Bertilsson I, Melin J, Brogårdh C, Opheim A, Gyllensten AL, Björksell E, Sjödahl Hammarlund C. Measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in persons on the autism spectrum: A preliminary Rasch analysis. J Bodyw Mov Ther 2024; 38:464-473. [PMID: 38763594 DOI: 10.1016/j.jbmt.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/21/2023] [Accepted: 01/08/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Persons on the autism spectrum exhibit poorer body awareness than neurotypical persons. Since movement quality may be regarded as an expression of body awareness, assessment of movement quality is important. Sound assessments of measurement properties are essential if reliable decisions about body awareness interventions for persons on the autism spectrum are to be made, but there is insufficient research. OBJECTIVE To assess measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in an autism and a neurotypical reference group. METHODS Persons on the autism spectrum (n=108) and neurotypical references (n=32) were included. All were assessed with BAS MQ. Data were analyzed according to the Rasch model. RESULTS BAS MQ was found to have acceptable unidimensionality, supported by the fit statistics. The hierarchical ordering showed that coordination ability was the most difficult, followed by stability and relating. Response category functioning worked as intended for 19 out of 23 items. There were few difficult items, which decreased targeting. Reliability measures were good. BAS MQ discriminated between the autism and the reference groups, with the autism group exhibiting poorer movement quality, reflecting clinical observations and previous research. CONCLUSIONS BAS MQ was found to have acceptable measurement properties, though suffering from problems with targeting item difficulty to person ability for persons on the autism spectrum. The BAS MQ may, along with experienced movement quality, contribute to clinically relevant information of persons on the autism spectrum, although we encourage refinements and further analyses to improve its measurement properties.
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Affiliation(s)
- I Bertilsson
- Habilitation & Health, Region Västra Götaland, Lövängsvägen 3, 549 49, Skövde, Sweden; Department of Health Sciences, Lund University, Box 117, 221 00, Lund, Sweden.
| | - J Melin
- RISE Research Institutes of Sweden AB, Sven Hultins Plats 5, 412 58, Gothenburg, Sweden
| | - C Brogårdh
- Department of Health Sciences, Lund University, Box 117, 221 00, Lund, Sweden
| | - A Opheim
- Habilitation & Health, Region Västra Götaland, Bergslagsgatan 2, 411 04, Gothenburg, Sweden; Department of Rehabilitation Medicine, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 413 46, Gothenburg, Sweden
| | - A L Gyllensten
- Department of Health Sciences, Lund University, Box 117, 221 00, Lund, Sweden
| | - E Björksell
- Habilitation, Region Kronoberg, 351 88, Växjö, Sweden
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Longhurst P, Aspell J, Todd J, Swami V. "There's No Separating My View of My Body from My Autism": A qualitative study of positive body image in autistic individuals. Body Image 2024; 48:101655. [PMID: 38042087 DOI: 10.1016/j.bodyim.2023.101655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
While scholars have investigated positive body image across diverse populations, extant theory largely excludes those with differing socio-cognitive experiences, such as autistic individuals. Using constructivist grounded theory, this study sought to develop a grounded theory of positive body image in autistic individuals. One-to-one interviews with photo-elicitation were conducted with 20 autistic adults (7 women, 8 men, 5 non-binary/agender; aged 18-53 years) from the United Kingdom. Through a process of open, axial, and focused coding, a grounded theory was developed around a core category of positive body image in autistic adults and was found to comprise six themes: body connection, body acceptance, appreciating body functionality and neurodivergent strengths, having a body-positive protective filter, taking care of the body, and body and appearance neutrality. Our findings suggest that some aspects of positive body image in autistic individuals are consistent with those found in neurotypical adults. However, positive body image in autistic individuals further encompasses both the sensory (i.e., how the body is felt) and aesthetic (i.e., how the body is seen) body. These findings may stimulate research aimed at improving positive body image in autistic populations.
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Affiliation(s)
- Phaedra Longhurst
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Jane Aspell
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jennifer Todd
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
| | - Viren Swami
- School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom; Centre for Psychological Medicine, Perdana University, Kuala Lumpur, Malaysia
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Gowen E, Earley L, Waheed A, Poliakoff E. From "one big clumsy mess" to "a fundamental part of my character." Autistic adults' experiences of motor coordination. PLoS One 2023; 18:e0286753. [PMID: 37267374 DOI: 10.1371/journal.pone.0286753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
Altered motor coordination is common in autistic individuals affecting a range of movements such as manual dexterity, eye-hand coordination, balance and gait. However, motor coordination is not routinely assessed leading to undiagnosed and untreated motor coordination difficulties, particularly in adults. Few studies have investigated motor coordination difficulties and their impact from the viewpoint of autistic people. Therefore, the current study used FGs and thematic analysis to document the experience of motor coordination difficulties from the viewpoint of 17 autistic adults. Four main themes were identified. First, motor coordination difficulties were pervasive and variable, being present life-long and within multiple movements and affecting many aspects of life. Furthermore, the nature of the difficulties was variable within and between participants along with differing awareness of coordination ability. Second, participants described motor coordination as an active process, requiring concentration for most actions and at a level seemingly greater than other people. Third, motor coordination difficulties impacted upon social and emotional wellbeing by placing strain on relationships, prompting bullying and exclusion, putting safety at risk and causing a range of negative emotions. Fourth, in the absence of any support, participants described multiple learning and coping strategies. Findings highlight how it is essential to address the current lack of support for motor coordination considering the significant social and emotional consequences described by our participants. Further investigation of motor learning and interactions between sensory and motor performance in autistic adults is also warranted.
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Affiliation(s)
- Emma Gowen
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Louis Earley
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Adeeba Waheed
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Ellen Poliakoff
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Holt A, Bounekhla K, Welch C, Polatajko H. "Unheard minds, again and again": autistic insider perspectives and theory of mind. Disabil Rehabil 2021; 44:5887-5897. [PMID: 34256672 DOI: 10.1080/09638288.2021.1949052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE The Theory of Mind (ToM) deficit hypothesis is a dominant construct used to explain the social and communication difficulties observed in autistic individuals. This hypothesis was based on an interpretation of autistic individuals' observable behavior, not based on insider accounts. Insider perspectives still remain mostly absent in research on ToM. We aimed to gain an understanding of the relevance and applicability of ToM by examining writings of autistic bloggers. METHODS As part of a series of studies examining insider autistic perspectives, we used a descriptive qualitative approach and conducted a thematic analysis of content scraped from 40 blogs written by autistic authors. RESULTS The blogs offered important perspectives on the applicability of ToM to autistic individuals. The primary themes reflected empirical contradictions to ToM, explicit critiques of ToM, and pointed to ToM as a source of harm. CONCLUSION The insider perspectives call into question the ways clinicians, researchers, and society use ToM to understand autistic individuals and point to the harmful effects of ToM on autistic lived experience. These findings emphasize the importance of attending to autistic people in building a body of knowledge that better reflects autistic experiences and promotes more effective and ethical clinical practices.Implications for RehabilitationOur paper indicates the need for a timely and thorough re-evaluation of the ToM deficit hypothesis of autism.Autistic insider perspectives not only empirically demonstrate and explicitly critique the ToM deficit hypothesis, but reveal the hypothesis as harmful to autistic experience by reinforcing negative stereotypes, prompting acts of discrimination, and perpetuating autistic insider's exclusion from the research concerning them.Given the varied experiences of autistic people and the harmful impacts of the ToM deficit hypothesis, it is safer for clinicians and researchers to presume a presence of ToM and empathy, before they presume a deficit in autistic individuals.Autistic insiders are able, eager, and deserve to be included in the research and practices that concern them.
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Affiliation(s)
- Abigail Holt
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Khadija Bounekhla
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Christie Welch
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Helene Polatajko
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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Buckle KL, Leadbitter K, Poliakoff E, Gowen E. "No Way Out Except From External Intervention": First-Hand Accounts of Autistic Inertia. Front Psychol 2021; 12:631596. [PMID: 34326790 PMCID: PMC8314008 DOI: 10.3389/fpsyg.2021.631596] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 04/12/2021] [Indexed: 12/20/2022] Open
Abstract
This study, called for by autistic people and led by an autistic researcher, is the first to explore ‘autistic inertia,’ a widespread and often debilitating difficulty acting on their intentions. Previous research has considered initiation only in the context of social interaction or experimental conditions. This study is unique in considering difficulty initiating tasks of any type in real life settings, and by gathering qualitative data directly from autistic people. Four face-to-face and 2 online (text) focus groups were conducted with 32 autistic adults (19 female, 8 male, and 5 other), aged 23–64 who were able to express their internal experiences in words. They articulate in detail the actions they have difficulty with, what makes it easier or harder to act, and the impact on their lives. Thematic analysis of the transcripts found four overarching themes: descriptions of inertia, scaffolding to support action, the influence of wellbeing, and the impact on day-to-day activities. Participants described difficulty starting, stopping and changing activities that was not within their conscious control. While difficulty with planning was common, a subset of participants described a profound impairment in initiating even simple actions more suggestive of a movement disorder. Prompting and compatible activity in the environment promoted action, while mental health difficulties and stress exacerbated difficulties. Inertia had pervasive effects on participants’ day-to-day activities and wellbeing. This overdue research opens the door to many areas of further investigation to better understand autistic inertia and effective support strategies.
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Affiliation(s)
- Karen Leneh Buckle
- Body, Eye and Movement Lab, Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Kathy Leadbitter
- Social Development Research Group, Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Ellen Poliakoff
- Body, Eye and Movement Lab, Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Emma Gowen
- Body, Eye and Movement Lab, Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
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Bertilsson I, Gard G, Sjödahl Hammarlund C. Physiotherapists ' experiences of the meaning of movement quality in autism: a descriptive phenomenological study. Physiother Theory Pract 2020; 38:299-308. [PMID: 32351158 DOI: 10.1080/09593985.2020.1759166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Movement quality, represented in unrestricted movements, flow and pleasure, is often lacking in people with autism. One aspect is the non-verbal expression of the present emotional and psychological state of an individual.Purpose: To describe the meaning of movement quality in autism, as experienced by specialized physiotherapists.Method: Ten physiotherapists were interviewed. The data were recorded, transcribed verbatim, and analyzed using Giorgi᾽s descriptive phenomenological method.Findings: The general structure of movement quality in people with autism included eight key constituents: 1) reduced postural control; 2) deviant muscle tone and tension; 3) deviant sensory processing; 4) a lack of conscious awareness; 5) difficulties with body boundaries; 6) coordinating movements (including breathing); 7) lack of anticipatory preparations of movements; and 8) need of cognitive thoughts to control movements.Conclusions: This study provide an understanding of how movement quality in people with autism is expressed. Their lived bodies constantly need to protect themselves from sensory impressions from within or the surroundings, causing emotional distress and obscuring the meaning of their movements. Their bodily expression becomes restrained, fragmented, and hesitant. Understanding movement patterns and emotional reactions following their struggle with movements may facilitate constructive interaction and communication, which give important implications when designing physiotherapy interventions.
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Affiliation(s)
- Ingrid Bertilsson
- Department of Health Sciences, Lund University, Lund, Sweden.,Habilitation, Habilitation & Health, Skövde, Sweden
| | - Gunvor Gard
- Department of Health Sciences, Lund University, Lund, Sweden
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Welch C, Cameron D, Fitch M, Polatajko H. Living in autistic bodies: bloggers discuss movement control and arousal regulation. Disabil Rehabil 2020; 43:3159-3167. [DOI: 10.1080/09638288.2020.1729872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Christie Welch
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Deb Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Margaret Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Helene Polatajko
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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Perrykkad K, Hohwy J. Modelling Me, Modelling You: the Autistic Self. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2019. [DOI: 10.1007/s40489-019-00173-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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