1
|
Wilmot A, Hasking P, Leitão S, Hill E, Boyes M. Understanding mental health in developmental dyslexia through a neurodiversity lens: The mediating effect of school-connectedness on anxiety, depression and conduct problems. DYSLEXIA (CHICHESTER, ENGLAND) 2024; 30:e1775. [PMID: 38837597 DOI: 10.1002/dys.1775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/19/2023] [Accepted: 03/05/2024] [Indexed: 06/07/2024]
Abstract
Dyslexia, a neurocognitive difference characterised by poor word-reading, is associated with elevated risk for internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns, the reasons are largely unknown. We took a neurodiversity perspective and explored whether school-connectedness mediated these associations. A total of 283 primary school children (87 with dyslexia) and their caregivers (95.4% mothers) completed a battery of well-validated connectedness and mental health measures. Two mediation models (one for child-report and one for caregiver-report) tested direct and indirect effects of dyslexia on anxiety, depression and conduct problems via several domains of school-connectedness. After controlling for gender and neurodevelopmental conditions other than dyslexia, there were no direct effects of dyslexia on child- or caregiver-reported internalising symptoms or child-reported conduct problems. Dyslexia was associated with child and caregiver reported anxiety, depression and conduct problems via low levels of school (but not teacher, friend or peer) connectedness. Findings highlight school-connectedness as an important intervention target for the mental health of children with dyslexia. Future research is needed to test associations between dyslexia, school-connectedness and mental health over time.
Collapse
Affiliation(s)
- Adrienne Wilmot
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Penelope Hasking
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Suze Leitão
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Elizabeth Hill
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Mark Boyes
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
2
|
Rebecchi K. 'Early childhood autism, Asperger type', by H. Asperger (1982). HISTORY OF PSYCHIATRY 2024:957154X241248261. [PMID: 38679954 DOI: 10.1177/0957154x241248261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
After his 1944 thesis, Asperger continued to write about autism, but none of these texts have been translated. At a time when autism spectrum disorder faces many challenges (e.g. the nature and measurement of autism), this text tells us more about the particular population that Asperger worked with. He describes sensitive, intelligent, creative and rational children, a far cry from the Wing triad. Moreover, 'Asperger's Syndrome' was introduced after he had died, was included in the DSM-IV in 1994 and was omitted from the DSM-5 in 2013. The question posed by this last text, written before his death, is whether Asperger's descriptions of autistic children are really part of the autism spectrum disorder or whether they are outside the pathological field.
Collapse
|
3
|
Cheng Y, Bololia L. The Effects of Augmented Reality on Social Skills in Children with an Autism Diagnosis: A Preliminary Systematic Review. J Autism Dev Disord 2024; 54:1317-1331. [PMID: 36633722 DOI: 10.1007/s10803-022-05878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2022] [Indexed: 01/13/2023]
Abstract
Today, the global prevalence of autism is high and continues to increase dramatically. Effective support and interventions are therefore warranted. Augmented reality (AR), one of the recent modalities of immersive technology, is gaining traction in autism interventions. However, there is currently a lack of reviews on the use of AR in children with autism, and what is more, to the authors' knowledge, no systematic review to date has been carried out to exclusively examine the effects of AR on basic social skills in children with autism. Therefore, an evidence-based systematic review was conducted to fill the gap and answer the specific research question: Can AR support children with an autism diagnosis towards developing or promoting social skills, such as greetings? The initial search yielded a total of 416 records. After excluding duplicate articles and screening the abstract and full text, 13 studies were included for analysis. A narrative approach was employed to synthesise and evaluate the research findings to substantially explore the effects of AR-based social interventions. The favourable role of AR technology in fostering social skills in children diagnosed with autism was widely recognised in the included studies although multiple methodological limitations were identified in relation to the quality of the included studies. Overall, the promising findings may suggest the effectiveness of AR in improving social skills in children with autism. Nonetheless, this field of research still calls for more high-quality studies relying on rigorous methodologies.
Collapse
|
4
|
David AS, Deeley Q. Dangers of self-diagnosis in neuropsychiatry. Psychol Med 2024; 54:1057-1060. [PMID: 38379196 DOI: 10.1017/s0033291724000308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Affiliation(s)
- Anthony S David
- UCL Institute of Mental Health, University College London, London, UK
| | - Quinton Deeley
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| |
Collapse
|
5
|
Polidori L, Sarli G, Berardelli I, Pompili M, Baldessarini RJ. Risk of suicide attempt with gender diversity and neurodiversity. Psychiatry Res 2024; 333:115632. [PMID: 38320410 DOI: 10.1016/j.psychres.2023.115632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/25/2023] [Accepted: 11/25/2023] [Indexed: 02/08/2024]
Abstract
There is growing concern about psychiatric illness co-occurring with gender-diversity and neurodiversity, including risk of suicidal behavior. We carried out systematic reviews of research literature pertaining to suicide attempt rates in association with gender- and neurodiversity, with meta-analysis of findings. Rates of suicidal acts ranked: gender-diverse versus controls (20.1% vs. 1.90%; highly significant) > autism spectrum disorder (4.51% vs. 1.00%; highly significant) > attention deficit-hyperactivity disorder (7.52% vs. 4.09%; not significant). Attempt rates also were greater among controls who included sexual minorities (5.35% vs. 1.41%). The rate among male-to-female transgender subjects (29.1%) was slightly lower than in female-to-male subjects (30.7%), who also were encountered 24.3% more often. In sum, suicidal risk was much greater with gender-diversity than neurodiversity. Suicide attempts rate was somewhat greater among female-to-male transgender subjects. Available information was insufficient to test whether suicidal risk would be even greater among persons with both gender- and neurodiversity.
Collapse
Affiliation(s)
- Lorenzo Polidori
- Psychiatry Residency Training Program, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Giuseppe Sarli
- Psychiatry Residency Training Program, Sant'Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy; International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA
| | - Ross J Baldessarini
- International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
6
|
Jones EK, Orchard V. Neurodiversity and disability: what is at stake? MEDICAL HUMANITIES 2024:medhum-2023-012808. [PMID: 38360797 DOI: 10.1136/medhum-2023-012808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 02/17/2024]
Abstract
Neurodiversity has come hugely to the fore in recent years in a variety of contexts, and is now subject to academic debate, activist discussion, and increasingly embedded in a range of institutional and corporate settings in the Global North, from workplaces to early years education, from psychotherapy to mainstream political discourses. The term has gained traction in Medical Humanities, as well as debate within bioethics, philosophy of psychology, and of law. Institutionally, it is now relied on in therapeutic practice, autism service provision, as well as in higher education, in particular. In this conceptual article we examine what is at stake in these usages and the implications in need of scrutiny. We resituate neurodiversity in relation to questions of disability by examining the deployment of neurology as the basis for identity, rights and benefits. The emergence of the term and the understandings to which it gives rise, we argue, leave out urgent questions of what is at stake for disabled people in a political climate of increasing harshness and ableism.
Collapse
Affiliation(s)
- Eleanor K Jones
- Languages, Cultures and Linguistics, University of Southampton, Southampton, UK
| | - Vivienne Orchard
- Languages, Cultures and Linguistics, University of Southampton, Southampton, UK
| |
Collapse
|
7
|
Neubauer J, Kaiser A, Hohmann S. [Gut Microbiota and Autism Spectrum Disorders: An Overview of Correlations and Potential Implications for Therapeutic Interventions]. ZEITSCHRIFT FUR KINDER- UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2023; 52:151-165. [PMID: 38098430 DOI: 10.1024/1422-4917/a000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Gut Microbiota and Autism Spectrum Disorders: An Overview of Correlations and Potential Implications for Therapeutic Interventions Abstract: At the beginning of research on microbiota, researchers focused mainly on the role of microbiota dysbiosis in the development of gastrointestinal diseases. However, over the last years, researchers have also identified correlations with other physical processes and neuropsychiatric diseases such as autism spectrum disorder. These correlations are believed to be at least partly mediated through the brain-gut-microbiome axis. An altered composition of microbiota in patients with autism spectrum disorder was detected compared to healthy controls. Today, the discussion centers around a possible systemic impact of the metabolites of some microbiota or microbiota-induced chronic inflammatory processes on the brain (mediated through the brain-gut-microbiome axis) as an underlying mechanism. Still, the specific underlying mechanisms remain largely unknown, so conclusions on therapeutic implications are difficult to determine. Here, we describe some promising approaches to improving autistic behavior through dietary changes, the use of prebiotics and probiotics, stool transplantation from healthy controls, and restricted absorbance of certain metabolites. We need further clinical studies of high quality to fully understand the pathophysiology of autism spectrum disorder and to improve diagnostic and therapeutic strategies.
Collapse
Affiliation(s)
- Johanna Neubauer
- Klinik für Kinder- und Jugendpsychiatrie, -psychiotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Anna Kaiser
- Klinik für Kinder- und Jugendpsychiatrie, -psychiotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland
| | - Sarah Hohmann
- Klinik für Kinder- und Jugendpsychiatrie, -psychiotherapie und -psychosomatik, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- AG Neurophysiologie des Kindes- und Jugendalters, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Deutschland
| |
Collapse
|
8
|
Pettersson E. Opportunities of measuring hierarchical models of psychopathology. JCPP ADVANCES 2023; 3:e12187. [PMID: 38054064 PMCID: PMC10694532 DOI: 10.1002/jcv2.12187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/15/2023] [Indexed: 12/07/2023] Open
Abstract
All psychiatric phenomena are positively associated, and several different models can account for this observation. These include the correlated factors, network, general psychopathology as outcome, and hierarchical models. Advantages of hierarchical models, which consist of one general and several (general factor-residualized) specific factors, is that the general factor provides an opportunity to reliably measure global distress and impairment, while the specific factors might improve the ability to discriminate between individuals with different kinds of problems. Nevertheless, other models also have their respective advantages, and it remains challenging to empirically determine which model best accounts for the positive manifold in psychiatry. Instead, I present two non-empirical arguments in favor of hierarchical models. First, by measuring the general factor in isolation, the specific factors tend to include both favorable and unfavorable correlates, which might reduce stigma compared to psychiatric diagnoses that by and large are associated with only unfavorable outcomes. Second, the general psychopathology factor displays an unusual psychometric property in that it includes symptoms of opposite meaning if they have similar valence (e.g., self-reported symptoms such as gullible and paranoid, lazy and workaholic, and terrified and apathetic load in the same direction), which one might want to measure in isolation from variance capturing the content of symptoms. I conclude by speculating that tests designed based on hierarchical models might help clinical assessment.
Collapse
Affiliation(s)
- Erik Pettersson
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| |
Collapse
|
9
|
Fountain C, Winter AS, Cheslack-Postava K, Bearman PS. Developmental Trajectories of Autism. Pediatrics 2023; 152:e2022058674. [PMID: 37615073 PMCID: PMC10551845 DOI: 10.1542/peds.2022-058674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVES The goal of this study was to describe the typical, longitudinal, developmental trajectories of communication and social functioning in individuals with autism spectrum disorder from childhood through adulthood and to determine the correlates of these trajectories. METHODS Children with autism spectrum disorder who were born in California from 1992 through 2016 and enrolled with the California Department of Developmental Services were identified. Subjects with <4 evaluations in the database were excluded, resulting in a sample of 71 285 individuals. Score sequences were constructed based on evaluative items for communication and social functioning. Typical trajectories were identified using group-based latent trajectory modeling, and logistic regression was used to determine the odds of classification into a social adolescent decline trajectory by individual-, family-, and zip code-level factors. RESULTS Six typical patterns of communication functioning and 7 typical patterns of social functioning were identified. Whereas the majority of autistic individuals exhibit improved communication functioning as they age, the majority of individuals exhibit steady social functioning. A small group of individuals (5.0%) exhibits high social functioning in childhood that declines in adolescence. Membership in this adolescent decline group is associated with maternal non-Hispanic white race and ethnicity, female sex, moderate levels of maternal education, lower zip code-level median home values and population density, and higher zip code-level inequality. CONCLUSIONS Most autistic individuals show improved communication and social functioning as they age, but not all do. Trajectory group membership is correlated with socioeconomic status. Future research should investigate what drives these correlations.
Collapse
Affiliation(s)
- Christine Fountain
- Department of Anthropology & Sociology, Fordham
University, New York, NY
| | - Alix S. Winter
- Interdisciplinary Center for Innovative Theory and
Empirics, Columbia University, New York, NY
| | | | - Peter S. Bearman
- Interdisciplinary Center for Innovative Theory and
Empirics, Columbia University, New York, NY
| |
Collapse
|
10
|
Clark T, Jung JY, Roberts J, Robinson A, Howlin P. The identification of exceptional skills in school-age autistic children: Prevalence, misconceptions and the alignment of informant perspectives. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1034-1045. [PMID: 37157995 DOI: 10.1111/jar.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/30/2023] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Although autism is commonly described in terms of deficits, many autistic individuals have been found to demonstrate exceptional skills. The shift to a strengths-based approach in the field of autism necessitates increased understanding of these skills. AIMS This study examined (1) rates of exceptional skills in autistic school-age children as reported by parents and teachers, (2) associations between exceptional skills, autism severity and intellectual disability and (3) correlations between parent and teacher reports of exceptional skills. METHOD Parents and teachers of 76 children attending autism-specific schools in Australia completed online questionnaires. Thereafter, 35 parents and teachers who identified their child as having one or more exceptional skills were interviewed by a clinical psychologist. RESULTS Forty parents (53%) and 16 (21%) teachers reported that their child had at least one exceptional skill (agreement between the parent and teacher reports was low; κ = .03, p = .74). In comparison, clinical psychologist assessments identified 22 children (29%) as having at least one such skill. No statistically significant relationships were identified between exceptional skills, autism severity and intellectual disability. CONCLUSION While different exceptional skills were identified, regardless of children's intellectual functioning or autism severity, parents and teachers varied substantially in their evaluations of these skills. Furthermore, the identified prevalence rates of exceptional skills did not always align with the rates identified in previous studies. The study findings highlight the need for definitional consensus on different types of exceptional skills, and the importance of multiple criteria/multi-instrument approaches in the identification of exceptional skills in autistic children.
Collapse
Affiliation(s)
- Trevor Clark
- Aspect Research Centre for Autism Practice, Sydney, Australia
- Griffith Institute for Educational Research, Brisbane, Australia
| | - Jae Yup Jung
- School of Education, The University of New South Wales, Sydney, Australia
| | - Jacqueline Roberts
- Autism Centre of Excellence (ACE), Griffith Institute for Educational Research, Brisbane, Australia
| | | | - Patricia Howlin
- The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
11
|
Shaw SCK, Fossi A, Carravallah LA, Rabenstein K, Ross W, Doherty M. The experiences of autistic doctors: a cross-sectional study. Front Psychiatry 2023; 14:1160994. [PMID: 37533891 PMCID: PMC10393275 DOI: 10.3389/fpsyt.2023.1160994] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/13/2023] [Indexed: 08/04/2023] Open
Abstract
Introduction Medicine may select for autistic characteristics. As awareness and diagnosis of autism are growing, more medical students and doctors may be discovering they are autistic. No studies have explored the experiences of autistic doctors. This study aimed to fill that gap. Methods This is a cross-sectional study. A participatory approach was used to identify the need for the project and to modify a pre-existing survey for use exploring the experiences of autistic doctors. Results We received 225 responses. 64% had a formal diagnosis of autism. The mean age of receiving a formal diagnosis was 36 (range 3-61). Most were currently working as doctors (82%). The most common specialties were general practice / family medicine (31%), psychiatry (18%), and anesthesia (11%). Almost half of those working had completed specialty training (46%) and 40% were current trainees. 29% had not disclosed being autistic to anyone at work. 46% had requested adjustments in the workplace but of these, only half had them implemented.Three quarters had considered suicide (77%), one quarter had attempted suicide (24%) and half had engaged in self-harm (49%). 80% reported having worked with another doctor they suspected was autistic, but only 22% reported having worked with another doctor they knew was autistic. Having never worked with a potentially autistic colleague was associated with having considered suicide.Most preferred to be called "autistic doctors" (64%). Most considered autism to be a difference (83%). Considering autism to be a disorder was associated with preference for the term "doctors with autism," and with having attempted suicide. Conclusion Autistic doctors reported many challenges in the workplace. This may have contributed to a culture of nondisclosure. Mental health was poor with high rates of suicidal ideation, self-harm, and prior suicide attempts. Despite inhospitable environments, most were persevering and working successfully. Viewing autism as a disorder was associated with prior suicide attempts and a preference for person-first language. A neurodiversity-affirmative approach to autism may lead to a more positive self-identity and improved mental health. Furthermore, providing adequate supports and improving awareness of autistic medical professionals may promote inclusion in the medical workforce.
Collapse
Affiliation(s)
- Sebastian C. K. Shaw
- Department of Medical Education, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Alexander Fossi
- Centre for Autism and Neurodiversity, Thomas Jefferson University, Philadelphia, PA, United States
| | - Laura A. Carravallah
- Department of Pediatrics and Human Development and Department of Medicine, Michigan State University, East Lansing, MI, United States
| | - Kai Rabenstein
- East Sussex Healthcare NHS Trust, St. Leonards, United Kingdom
| | - Wendy Ross
- Centre for Autism and Neurodiversity, Thomas Jefferson University, Philadelphia, PA, United States
| | - Mary Doherty
- Department of Neuroscience, Brighton and Sussex Medical School, Brighton, United Kingdom
| |
Collapse
|
12
|
Pluck G. The Misguided Veneration of Averageness in Clinical Neuroscience: A Call to Value Diversity over Typicality. Brain Sci 2023; 13:860. [PMID: 37371340 DOI: 10.3390/brainsci13060860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Research and practice in clinical neurosciences often involve cognitive assessment. However, this has traditionally used a nomothetic approach, comparing the performance of patients to normative samples. This method of defining abnormality places the average test performance of neurologically healthy individuals at its center. However, evidence suggests that neurological 'abnormalities' are very common, as is the diversity of cognitive abilities. The veneration of central tendency in cognitive assessment, i.e., equating typicality with healthy or ideal, is, I argue, misguided on neurodiversity, bio-evolutionary, and cognitive neuroscientific grounds. Furthermore, the use of average performance as an anchor point for normal performance is unreliable in practice and frequently leads to the mischaracterization of cognitive impairments. Examples are explored of how individuals who are already vulnerable for socioeconomic reasons can easily be over-pathologized. At a practical level, by valuing diversity rather than typicality, cognitive assessments can become more idiographic and focused on change at the level of the individual. The use of existing methods that approach cognitive assessment ideographically is briefly discussed, including premorbid estimation methods and informant reports. Moving the focus away from averageness to valuing diversity for both clinical cognitive assessments and inclusion of diverse groups in research is, I argue, a more just and effective way forward for clinical neurosciences.
Collapse
Affiliation(s)
- Graham Pluck
- Clinical Cognitive Sciences Laboratory, Faculty of Psychology, Chulalongkorn University, Borommaratchachonnani Srisattaphat Building, 254 Phayathai Road, Bangkok 10330, Thailand
| |
Collapse
|
13
|
Jenner L, Richards C, Howard R, Moss J. Heterogeneity of Autism Characteristics in Genetic Syndromes: Key Considerations for Assessment and Support. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023; 10:132-146. [PMID: 37193200 PMCID: PMC10169182 DOI: 10.1007/s40474-023-00276-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/18/2023]
Abstract
Purpose of Review Elevated prevalence of autism characteristics is reported in genetic syndromes associated with intellectual disability. This review summarises recent evidence on the behavioural heterogeneity of autism in the following syndromes: Fragile X, Cornelia de Lange, Williams, Prader-Willi, Angelman, Down, Smith-Magenis, and tuberous sclerosis complex. Key considerations for assessment and support are discussed. Recent Findings The profile and developmental trajectory of autism-related behaviour in these syndromes indicate some degree of syndrome specificity which may interact with broader behavioural phenotypes (e.g. hypersociability), intellectual disability, and mental health (e.g. anxiety). Genetic subtype and co-occurring epilepsy within syndromes contribute to increased significance of autism characteristics. Autism-related strengths and challenges are likely to be overlooked or misunderstood using existing screening/diagnostic tools and criteria, which lack sensitivity and specificity within these populations. Summary Autism characteristics are highly heterogeneous across genetic syndromes and often distinguishable from non-syndromic autism. Autism diagnostic assessment practices in this population should be tailored to specific syndromes. Service provisions must begin to prioritise needs-led support.
Collapse
Affiliation(s)
- Lauren Jenner
- School of Psychology, University of Surrey, Guildford, England
| | | | - Rachel Howard
- School of Psychology, University of Surrey, Guildford, England
| | - Joanna Moss
- School of Psychology, University of Surrey, Guildford, England
| |
Collapse
|
14
|
Wilmot A, Pizzey H, Leitão S, Hasking P, Boyes M. "I struggle at times to see her struggle": Mothers' perspectives on dyslexia-related school struggles and the inter-connected nature of mother and child well-being. DYSLEXIA (CHICHESTER, ENGLAND) 2023; 29:136-150. [PMID: 36755469 PMCID: PMC10946717 DOI: 10.1002/dys.1733] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Parents of children with dyslexia may be at elevated risk for parenting stress and mental health concerns. Our aim was to explore the emotional experience of growing up with dyslexia in Australia from parents' perspectives. In so doing, we also developed an understanding of parents' own mental health and support needs informed by their lived experience. METHODOLOGY Seventeen interviews with mothers of children (9-14 years; 16 with a diagnosis of dyslexia) were analysed using Braun and Clarke's reflexive thematic analysis approach. ANALYSIS Five themes were developed to address our aim: Theme 1: Years in the wilderness: Life before diagnosis; 2: "I struggle at times to see her struggle"; 3. School struggles: Advocating for our children and managing distress; 4. "It's a full-time job" and a "long slog"; 5: Care for the carer: Social support and coping strategies. CONCLUSIONS Our analysis suggests that mothers of children with dyslexia may be at elevated risk for mental health concerns. Specifically, chronic worry and stress, secondary distress, challenges to parenting self-efficacy, and lack of support and understanding (feeling isolated) were highlighted as plausible risk factors. Mothers described coping strategies at the community level (e.g., school connectedness) and at the individual level (e.g., "acceptance") as protective.
Collapse
Affiliation(s)
- Adrienne Wilmot
- Faculty of Health SciencesCurtin School of Population HealthBentleyAustralia
| | - Hannah Pizzey
- Faculty of Health SciencesCurtin School of Population HealthBentleyAustralia
| | - Suze Leitão
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Allied HealthBentleyAustralia
| | - Penelope Hasking
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Population HealthBentleyAustralia
| | - Mark Boyes
- Faculty of Health SciencesCurtin enAble Institute & Curtin School of Population HealthBentleyAustralia
| |
Collapse
|
15
|
Hong SJ, Mottron L, Park BY, Benkarim O, Valk SL, Paquola C, Larivière S, Vos de Wael R, Degré-Pelletier J, Soulieres I, Ramphal B, Margolis A, Milham M, Di Martino A, Bernhardt BC. A convergent structure-function substrate of cognitive imbalances in autism. Cereb Cortex 2023; 33:1566-1580. [PMID: 35552620 PMCID: PMC9977381 DOI: 10.1093/cercor/bhac156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a common neurodevelopmental diagnosis showing substantial phenotypic heterogeneity. A leading example can be found in verbal and nonverbal cognitive skills, which vary from elevated to impaired compared with neurotypical individuals. Moreover, deficits in verbal profiles often coexist with normal or superior performance in the nonverbal domain. METHODS To study brain substrates underlying cognitive imbalance in ASD, we capitalized categorical and dimensional IQ profiling as well as multimodal neuroimaging. RESULTS IQ analyses revealed a marked verbal to nonverbal IQ imbalance in ASD across 2 datasets (Dataset-1: 155 ASD, 151 controls; Dataset-2: 270 ASD, 490 controls). Neuroimaging analysis in Dataset-1 revealed a structure-function substrate of cognitive imbalance, characterized by atypical cortical thickening and altered functional integration of language networks alongside sensory and higher cognitive areas. CONCLUSION Although verbal and nonverbal intelligence have been considered as specifiers unrelated to autism diagnosis, our results indicate that intelligence disparities are accentuated in ASD and reflected by a consistent structure-function substrate affecting multiple brain networks. Our findings motivate the incorporation of cognitive imbalances in future autism research, which may help to parse the phenotypic heterogeneity and inform intervention-oriented subtyping in ASD.
Collapse
Affiliation(s)
- Seok-Jun Hong
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Center for Neuroscience Imaging Research, Institute for Basic Science, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon 16419, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon 16419, South Korea.,Center for the Developing Brain, Child Mind Institute, 101 East 56th Street, New York, NY 10022, United States
| | - Laurent Mottron
- Centre de Recherche du CIUSSSNIM and Department of Psychiatry and Addictology, Université de Montréal, 7070 boulevard Perras, Montréal, Quebec H1E 1A4, Canada
| | - Bo-Yong Park
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Center for Neuroscience Imaging Research, Institute for Basic Science, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon 16419, South Korea.,Department of Data Science, Inha Univerisity, Incheon 22212, South Korea
| | - Oualid Benkarim
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| | - Sofie L Valk
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Otto Hahn group Cognitive neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraβe 1A. Leipzig D-04103, Germany.,Institute of Neuroscience and Medicine, Research Centre Wilhelm-Johnen-Strasse, Jülich 52425, Germany.,Institute of Systems Neuroscience, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Institute of Neuroscience and Medicine, Research Centre Wilhelm-Johnen-Strasse, Jülich 52425, Germany
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| | - Reinder Vos de Wael
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| | - Janie Degré-Pelletier
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Department of Psychology, Université du Québec à Montréal, 100 rue Sherbrooke Ouest, Montréal, Québec H2X 3P2, Canada
| | - Isabelle Soulieres
- Department of Psychology, Université du Québec à Montréal, 100 rue Sherbrooke Ouest, Montréal, Québec H2X 3P2, Canada
| | - Bruce Ramphal
- Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
| | - Amy Margolis
- Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
| | - Michael Milham
- Center for the Developing Brain, Child Mind Institute, 101 East 56th Street, New York, NY 10022, United States.,Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Adriana Di Martino
- Autism Center, Child Mind Institute, 101 East 56th Street, New York, NY 10022, United States
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| |
Collapse
|
16
|
Wilmot A, Pizzey H, Leitão S, Hasking P, Boyes M. Growing up with dyslexia: Child and parent perspectives on school struggles, self-esteem, and mental health. DYSLEXIA (CHICHESTER, ENGLAND) 2023; 29:40-54. [PMID: 36349866 PMCID: PMC10946500 DOI: 10.1002/dys.1729] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/08/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
Children with dyslexia, compared with typically reading peers, are at increased risk of internalising (e.g., anxiety) and externalising (e.g., aggression) mental health concerns; why this is the case is largely unknown. Our aim was to explore the socio-emotional experience of growing up with dyslexia from both child and parent perspectives. In so doing, we aimed to gain a better understanding of self-esteem and mental health in the context of dyslexia. One-to-one semi-structured interviews with 17 children with reading difficulties (aged 9-14 years; 16 with a diagnosis of dyslexia) and their mothers (interviewed separately) were analysed using Braun and Clarke's reflexive thematic analysis approach with a neurodiversity lens. We developed three themes to address the research aim: (1) Different in a good/bad way; (2) Exhausted and overwhelmed; and (3) It takes a community: Family school connections. Children discussed having "worries" and experiencing school-related stress and embarrassment. Mothers perceived children's internalising and externalising behaviour (meltdowns), school refusal, and homework resistance as emotional responses to children's school struggles due to poor "person-environment fit." Our analysis highlights the particular importance of parent support, friendship, and school-connectedness for the wellbeing of children with dyslexia.
Collapse
Affiliation(s)
- Adrienne Wilmot
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Hannah Pizzey
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Suze Leitão
- Faculty of Health SciencesSchool of Allied Health, Curtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Health SciencesCurtin enAble Institute, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Penelope Hasking
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Health SciencesCurtin enAble Institute, Curtin UniversityBentleyWestern AustraliaAustralia
| | - Mark Boyes
- Faculty of Health SciencesSchool of Population Health, Curtin UniversityBentleyWestern AustraliaAustralia
- Faculty of Health SciencesCurtin enAble Institute, Curtin UniversityBentleyWestern AustraliaAustralia
| |
Collapse
|
17
|
Anderson-Chavarria M, Turner J. Searching for the 'Trigger': An ethnographic analysis of parental beliefs regarding autism causation and vaccination in Puerto Rico. Vaccine 2023; 41:540-546. [PMID: 36496281 DOI: 10.1016/j.vaccine.2022.11.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
This study examines the personal beliefs held by parents of autistic children in Puerto Rico regarding the cause of their child's autism and how these beliefs may influence parental vaccination decision-making. This study seeks to contribute towards diversifying the autism literature by focusing on an autism community living in a relatively lower income, resource-deficit context. These findings expand our understandings of how parents of autistic children may perceive vaccines and how these perceptions are informed by various sources of knowledge. This ethnographic research study was conducted between May 2017 and August 2019. Methods included 350+ hours of participant-observation and semi-structured interviewing of 35 Puerto Rican parents of autistic children. 32 of these 35 parents interviewed believed autism to be the result of genetic risks that are 'triggered' by an unknown environmental factor. Suggested 'triggers' included various environmental contaminants and vaccinations. The subject of vaccination came up in every interview; 18 interviewed parents did not believe vaccines 'triggered' autism, 3 parents attributed their child's autism entirely to vaccines, while 14 considered vaccines to be one of several possible 'triggers'. It is important to note that no parents interviewed perceived vaccinations to be inherently or universally harmful. Rather, they perceived vaccinations to be one of many possible 'triggers' for a child predisposed to develop autism. In some cases, this perception prompted parents to oppose mandatory vaccination policies on the island. Parents shared nuanced, complex understandings of autism causation that may carry implications for COVID-19 vaccine uptake within the Puerto Rican autistic community.
Collapse
Affiliation(s)
- Melissa Anderson-Chavarria
- DO-PhD Program, Michigan State University College of Osteopathic Medicine and the Department of Anthropology, 909 Wilson Road, West Fee Hall, Rm 317, East Lansing, MI 48824, United States.
| | - Jane Turner
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Life Sciences Bldg, 1355 Bogue St., B240, East Lansing, MI 48824, United States.
| |
Collapse
|
18
|
Ferenc K, Byrka K, Król ME. The spectrum of attitudes towards the spectrum of autism and its relationship to psychological distress in mothers of children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:54-64. [PMID: 35296156 DOI: 10.1177/13623613221081185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
LAY ABSTRACT Mothers of children on the autism spectrum experience high levels of emotional distress. Mothers cope with stress by having their own thoughts and opinions about their children. In this study, we tested whether the way mothers perceive autism may contribute to the level of distress they feel. Some mothers see autism as a developmental disorder that needs to be cured, but some see autism as a type of mind that needs to be accepted. Our findings showed that mothers who see autism more as a type of mind are generally less stressed. But we also showed that it matters how severe are the child's symptoms, and how heavy was the perceived burden of caring for the child. These results imply that it is worth working on attitudes towards autism to help mothers cope better. But at the same time, we argue that mothers should not be judged for their perceptions of autism, as there is a huge spectrum of a child's characteristics and family's life circumstances.
Collapse
Affiliation(s)
- Kinga Ferenc
- SWPS University of Social Sciences and Humanities, Poland
| | | | | |
Collapse
|
19
|
Zakirova-Engstrand R, Roll-Pettersson L, Andersson K, Larsson H, Allodi Westling M, Hirvikoski T. Group Psychoeducational Intervention for Grandparents of Young Children with ASD: An Open Feasibility Study. J Autism Dev Disord 2023; 53:808-824. [PMID: 34247300 PMCID: PMC8272608 DOI: 10.1007/s10803-021-05189-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
This initial open feasibility trial reports on feasibility and preliminary effectiveness of the manualized, group-based psychoeducational intervention for grandparents of preschool-aged children with ASD provided by the outpatient habilitation services in Stockholm, Sweden. One hundred and twenty non-custodial grandparents participated in a 6-h intervention program. The study demonstrated good feasibility: 114 (95%) grandparents completed both pre- and post-intervention measures and evaluations and reported high intervention acceptability. The results also indicated that grandparents increased their knowledge about ASD from pre-intervention to post-intervention, gained skills about strategies of supporting their grandchildren and adult children, and appreciated the opportunity to meet and share experiences with other grandparents. Follow-up with a randomized controlled trial design is needed to firmly establish efficacy of this intervention.
Collapse
Affiliation(s)
| | | | | | - Helena Larsson
- Habilitation & Health, Stockholm County Council, Stockholm, Sweden
| | | | - Tatja Hirvikoski
- Habilitation & Health, Stockholm County Council, Stockholm, Sweden ,Department of Women’s and Children’s Health, Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND), Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden ,Center for Psychiatry Research, Region Stockholm, Stockholm, Sweden
| |
Collapse
|
20
|
Chan DV, Doran JD, Galobardi OD. Beyond Friendship: The Spectrum of Social Participation of Autistic Adults. J Autism Dev Disord 2023; 53:424-437. [PMID: 35079929 PMCID: PMC8788910 DOI: 10.1007/s10803-022-05441-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2022] [Indexed: 02/04/2023]
Abstract
Difficulties with social interactions and communication that characterize autism persist in adulthood. While social participation in adulthood is often marked by social isolation and limited close friendships, this qualitative study describes the range of social participation activities and community contacts, from acquaintances to close relationships, that contributed to connection from the perspective of 40 autistic adults. Qualitative data from interviews around social and community involvement were analyzed and revealed five main contexts where social participation occurred: vocational contexts, neighborhoods, common interest groups, support services and inclusive environments, and online networks and apps. Implications for practice to support a range of social participation include engaging in newer social networking avenues, as well as traditional paths through employment and support services.
Collapse
Affiliation(s)
- Dara V Chan
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health, The University of North Carolina at Chapel Hill and The University of North Carolina TEACCH Autism Program, Chapel Hill, USA.
- , Campus Box 7250, Chapel Hill, NC, 27599, USA.
| | - Julie D Doran
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health, The University of North Carolina at Chapel Hill and The University of North Carolina TEACCH Autism Program, Chapel Hill, USA
| | - Osly D Galobardi
- Division of Clinical Rehabilitation and Mental Health Counseling, Department of Allied Health, The University of North Carolina at Chapel Hill and The University of North Carolina TEACCH Autism Program, Chapel Hill, USA
- Essential Counseling and Therapeutic Services, PLLC, Chapel Hill, NC, USA
| |
Collapse
|
21
|
Heselton GA, Rempel GR, Nicholas DB. “Realizing the problem wasn’t necessarily me”: the meaning of childhood adversity and resilience in the lives of autistic adults. Int J Qual Stud Health Well-being 2022; 17:2051237. [PMID: 35297725 PMCID: PMC8933012 DOI: 10.1080/17482631.2022.2051237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Purpose Methods Results Conclusion
Collapse
Affiliation(s)
- Gabrielle A. Heselton
- Faculty of Health Disciplines (FHD), Athabasca University, Athabasca, Alberta, Canada
| | - Gwen R. Rempel
- Faculty of Health Disciplines (FHD), Athabasca University, Athabasca, Alberta, Canada
| | - David B. Nicholas
- Faculty of Social Work, Central and Northern Alberta Region, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
22
|
Ferenc K, Płatos M, Byrka K, Król ME. Looking through rainbow-rimmed glasses: Taking neurodiversity perspective is related to subjective well-being of autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221135818. [DOI: 10.1177/13623613221135818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Finding new ways of supporting the well-being of autistic adults is an essential goal for research and practice. We tested the predictive value of attitudes towards autism (as neurodiversity or as a disorder) and identification with other autistic people, on the psychological distress and self-esteem of autistic adults ( n = 109). Adopting a neurodiversity attitude not only predicted higher self-esteem but also served as a protective factor against the negative impact of identification with other autistic people on psychological distress. These findings show that clinicians should be sensitive to the way autistic people understand autism and the extent to which they identify with the autism community, as these factors relate to their well-being. Lay abstract Autistic adults experience a high level of distress. Finding new ways to support their well-being is an important goal for researchers and clinicians. We assessed the way autistic adults view their autism, as a disorder or as a type of mind (neurodiversity), and the level they integrate with other autistic people, and we checked how those factors contribute to their well-being. People who see autism rather as a type of mind than as a disorder had higher self-esteem. People who view themselves as more similar to other autistic people felt more stressed, but this result was not accurate for people who view autism as a type of mind. Clinicians should be sensitive to the way autistic people understand autism and to what extent they identify with the autism community, because it may relate to their well-being.
Collapse
Affiliation(s)
- Kinga Ferenc
- SWPS University of Social Sciences and Humanities, Poland
| | - Mateusz Płatos
- University of Warsaw, Poland
- Association for Social Innovation ‘Mary and Max’, Poland
| | | | | |
Collapse
|
23
|
Filippova YY, Devyatova EV, Alekseeva AS, Burmistrova AL. Cytokines and neurotrophic factors in the severity assessment of children autism. Klin Lab Diagn 2022; 67:647-651. [PMID: 36398773 DOI: 10.51620/0869-2084-2022-67-11-647-651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Due to the steady increase in the number of children with autism and the high heterogeneity of clinical groups, the diagnosis of these disorders and their severity is an urgent problem in modern medicine. In the course of the work, 126 children from 3 to 13 years old with typical neurodevelopment and with severe and mild autism spectrum disorders (ASD) were examined. Disease severity was determined according to the Childhood Autism Rating Scale (CARS). The levels of pro-/anti-inflammatory cytokines and neurotrophic factors (nerve growth factor beta and brain-derived neurotrophic factor) in blood plasma were assessed by enzyme immunoassay. Associations between indicators in each group of patients were assessed using the Spearman test and visualized as a heatmap of correlations. Statistical data processing was carried out in the R software. Significantly high levels of IL-4 in blood plasma and a decrease in the number of significant correlations within/between systems were revealed in children with mild autism compared with children with typical neurodevelopment. Such data can probably reflect the theory that some children with ASD are characterized by slow brain development, as a variant of the evolutionary norm. On the contrary, in children with severe ASD, high systemic levels of IL-6 and IFNg are shown against the background of low values of IL-10, IL-1β, TNFα and NGFβ, supported by the almost complete absence of intra/ and intersystem interactions. This may act as an indicator of maladaptation of the immune and nervous systems in severe autism, which contributes to the pathogenesis of the disease. Thus, a set of indicators: high levels of key pro-inflammatory cytokines - IL-6 and IFNg, low levels of IL-10, NGFβ and disintegration of the cytokine and nervous systems in the periphery can be proposed as an approach to indicate the severity of the condition in children with ASD.
Collapse
|
24
|
Kelvington BA, Nickl-Jockschat T, Abel T. Neurobiological insights into twice-exceptionality: Circuits, cells, and molecules. Neurobiol Learn Mem 2022; 195:107684. [PMID: 36174887 PMCID: PMC9888516 DOI: 10.1016/j.nlm.2022.107684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 09/20/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
Twice-exceptional learners face a unique set of challenges arising from the intersection of extraordinary talent and disability. Neurobiology research has the capacity to complement pedagogical research and provide support for twice-exceptional learners. Very few studies have attempted to specifically address the neurobiological underpinnings of twice-exceptionality. However, neurobiologists have built a broad base of knowledge in nervous system function spanning from the level of neural circuits to the molecular basis of behavior. It is known that distinct neural circuits mediate different neural functions, which suggests that 2e learning may result from enhancement in one circuit and disruption in another. Neural circuits are known to adapt and change in response to experience, a cellular process known as neuroplasticity. Plasticity is controlled by a bidirectional connection between the synapse, where neural signals are received, and the nucleus, where regulated gene expression can return to alter synaptic function. Complex molecular mechanisms compose this connection in distinct neural circuits, and genetic alterations in these mechanisms are associated with both memory enhancements and psychiatric disorder. Understanding the consequences of these changes at the molecular, cellular, and circuit levels will provide critical insights into the neurobiological bases of twice-exceptionality.
Collapse
Affiliation(s)
- Benjamin A Kelvington
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Thomas Nickl-Jockschat
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Ted Abel
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, USA; Department of Neuroscience and Pharmacology, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
| |
Collapse
|
25
|
Israelstam K. Neuroscience and a Countertransference Impasse in a Neurotypical‐Neurodiverse Analytic Couples Therapy. BRITISH JOURNAL OF PSYCHOTHERAPY 2022. [DOI: 10.1111/bjp.12775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
26
|
Rajendran G, McKenna PE, Corley M. Characterising developmental disorders: Towards better group comparisons in developmental research. METHODS IN PSYCHOLOGY 2022. [DOI: 10.1016/j.metip.2022.100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
27
|
Riccioni A, Siracusano M, Arturi L, Marcovecchio C, Postorino V, Gialloreti LE, Mazzone L. Developmental and Intelligence Quotient in Autism: A Brief Report on the Possible Long-Term Relation. Behav Sci (Basel) 2022; 12:bs12090304. [PMID: 36135108 PMCID: PMC9495707 DOI: 10.3390/bs12090304] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Developmental level and cognitive skills assessment represents a crucial aspect in the delineation of the clinical phenotype and long-term outcomes of individuals with autism spectrum disorder (ASD). Nevertheless, the evaluation of cognitive development trajectory across a lifespan ranging from birth to school age appears challenging for clinicians and researchers, because of the lack of measures that coherently cover this timeframe. Thus, the main goal of this community-based study was to investigate within a sample of ASD children if the developmental quotient (DQ), evaluated through the Griffiths Mental Development Scales Extended Revised (GMDS-ER) scale, predicts the non-verbal brief intelligence quotient (IQ), measured through the Leiter-R at follow-up. The main observation of our study was a positive correlation between the level of DQ and nonverbal IQ at follow-up evaluations, highlighting that ASD children characterized by a greater developmental profile will later present higher non-verbal IQ.
Collapse
Affiliation(s)
- Assia Riccioni
- Systems Medicine Department, University of Rome Tor Vergata, 00133 Rome, Italy
- Child Neurology and Psychiatry Unit, Department of Neurosciences, Policlinico Tor Vergata Foundation Hospital, 00133 Rome, Italy
| | - Martina Siracusano
- Child Neurology and Psychiatry Unit, Department of Neurosciences, Policlinico Tor Vergata Foundation Hospital, 00133 Rome, Italy
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence: or ; Tel.: +39-06-2090-0249
| | - Lucrezia Arturi
- Systems Medicine Department, University of Rome Tor Vergata, 00133 Rome, Italy
- Child Neurology and Psychiatry Unit, Department of Neurosciences, Policlinico Tor Vergata Foundation Hospital, 00133 Rome, Italy
| | - Claudia Marcovecchio
- Systems Medicine Department, University of Rome Tor Vergata, 00133 Rome, Italy
- Child Neurology and Psychiatry Unit, Department of Neurosciences, Policlinico Tor Vergata Foundation Hospital, 00133 Rome, Italy
| | - Valentina Postorino
- JFK Partners, Department of Pediatrics, School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA
| | | | - Luigi Mazzone
- Systems Medicine Department, University of Rome Tor Vergata, 00133 Rome, Italy
- Child Neurology and Psychiatry Unit, Department of Neurosciences, Policlinico Tor Vergata Foundation Hospital, 00133 Rome, Italy
| |
Collapse
|
28
|
Dwyer S, Rogan A. Seeing the unseen: Neurodiversity in the emergency department. Emerg Med Australas 2022; 34:609-612. [PMID: 35785441 DOI: 10.1111/1742-6723.14038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Sophie Dwyer
- Australasian Faculty of Public Health Medicine Specialist Training Program, Sydney, New South Wales, Australia
| | - Alice Rogan
- Te Pae Tiaki/Emergency Department, Wellington Regional Hospital, Wellington, New Zealand.,Department of Surgery and Anaesthesia, University of Otago, Wellington, New Zealand
| |
Collapse
|
29
|
Förster J, López I. Neurodesarrollo humano: un proceso de cambio continuo de un sistema abierto y sensible al contexto. REVISTA MÉDICA CLÍNICA LAS CONDES 2022. [DOI: 10.1016/j.rmclc.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
30
|
Vega S, Rojas V. Aspectos éticos en el diagnóstico y tratamiento del espectro del autismo. REVISTA MÉDICA CLÍNICA LAS CONDES 2022. [DOI: 10.1016/j.rmclc.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
31
|
Ratnayake S. 'I will never love anyone like that again': cognitive behavioural therapy and the pathologisation and medicalisation of ordinary experiences. MEDICAL HUMANITIES 2022; 48:e7. [PMID: 34845097 DOI: 10.1136/medhum-2021-012210] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 06/13/2023]
Abstract
Psychiatry has a long history of being criticised for the pathologisation and medicalisation of ordinary experiences. One of the most prominent of these critiques is advanced by Allan Horwitz and Jerome Wakefield who argue that instances of ordinary sadness in response to events such as bereavement, heartbreak and misfortune, are being mistakenly diagnosed as depression due to an increasing lack of consideration for aetiology and contextual factors. Critiques concerning pathologisation and medicalisation have not been forthcoming for psychiatry's close cousin, psychotherapy. Using Cognitive Behavioural Therapy, one of the most prominent schools of contemporary psychotherapy as a case study, I demonstrate that psychotherapy also contributes to medicalising and pathologising bereavement, heartbreak and misfortune.
Collapse
|
32
|
Global, regional and national burden of autism spectrum disorder from 1990 to 2019: results from the Global Burden of Disease Study 2019. Epidemiol Psychiatr Sci 2022; 31:e33. [PMID: 35535764 PMCID: PMC9121847 DOI: 10.1017/s2045796022000178] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
AIMS Autism spectrum disorder (ASD) is a neurodevelopmental condition, with symptoms appearing in the early developmental period. Little is known about its current burden at the global, regional and national levels. This systematic analysis aims to summarise the latest magnitudes and temporal trends of ASD burden, which is essential to facilitate more detailed development of prevention and intervention strategies. METHODS The data on ASD incidence, prevalence, disability-adjusted life years (DALYs) in 204 countries and territories between 1990 and 2019 came from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardised rates (ASRs) of ASD burden by region, sex and age. RESULTS In 2019, there were an estimated 60.38 × 104 [95% uncertainty interval (UI) 50.17-72.01] incident cases of ASD, 283.25 × 105 (95% UI 235.01-338.11) prevalent cases and 43.07 × 105 (95% UI 28.22-62.32) DALYs globally. The ASR of incidence slightly increased by around 0.06% annually over the past three decades, while the ASRs of prevalence and DALYs both remained stable over the past three decades. In 2019, the highest burden of ASD was observed in high-income regions, especially in high-income North America, high-income Asia Pacific and Western Europe, where a significant growth in ASRs was also observed. The ASR of ASD burden in males was around three times that of females, but the gender difference was shrunk with the pronounced increase among females. Of note, among the population aged over 65 years, the burden of ASD presented increasing trends globally. CONCLUSIONS The global burden of ASD continues to increase and remains a major mental health concern. These substantial heterogeneities in ASD burden worldwide highlight the need for making suitable mental-related policies and providing special social and health services.
Collapse
|
33
|
Dramatherapy for Children and Adolescents with Autism Spectrum Disorder: A Systematic Integrative Review. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
34
|
Sissons JH, Blakemore E, Shafi H, Skotny N, Lloyd DM. Calm with horses? A systematic review of animal-assisted interventions for improving social functioning in children with autism. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1320-1340. [PMID: 35403450 PMCID: PMC9344573 DOI: 10.1177/13623613221085338] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
LAY ABSTRACT Children with autism typically experience difficulties interacting socially with others when compared to their non-autistic peers. Establishing how effective interventions are for improving social functioning is important to help inform what should be offered to children with autism. This study reviewed how effective interventions that involved interaction with a live animal, known as animal-assisted interventions, are in improving social functioning in children with autism. A systematic search of the evidence on this topic found nine studies, which were explored for the effectiveness of animal-assisted interventions and the quality of methods used. Overall, these studies showed improvements in social functioning following equine-assisted or therapeutic horse-riding interventions, with initial evidence showing improvements are sustained in the short and medium term. However, several issues were identified, which limit the strength of any conclusions that can be drawn from this evidence. For example, in many studies people assessing the children were aware that they received the intervention or were in a control group. There was also not enough evidence available to draw conclusions on the effectiveness of other animal-assisted interventions. Future research should address the limitations that were common in the designs of these studies and investigate the potential benefit of other animal populations, such as dogs and cats.
Collapse
Affiliation(s)
| | | | | | | | - Donna M Lloyd
- University of Leeds, UK.,University of Manchester, UK
| |
Collapse
|
35
|
Miranda Ojeda R, San-Juan D. Letter to the Editor Concerning "Evolution and Medical Implications of Neurodiversity: Where Must We Go?". J Autism Dev Disord 2022; 53:2529-2530. [PMID: 35403926 DOI: 10.1007/s10803-022-05556-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Raul Miranda Ojeda
- Faculty of Medicine, Autonomous University of Mexico State, Av. Paseo Tollocan, C. Jesús Carranza, Moderna de la Cruz, Toluca de Lerdo, State of Mexico, 50180, Mexico.
| | - Daniel San-Juan
- Epilepsy Clinic, National Institute of Neurology and Neurosurgery, Av. Insurgentes Sur 3877, Col. La Fama, Mexico City, D.F., 14269, Mexico
| |
Collapse
|
36
|
Davies H. ‘Autism is a way of being’: An ‘insider perspective’ on neurodiversity, music therapy and social justice. BRITISH JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1177/13594575221090182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Neurodiversity (the idea that autism is a natural part of human diversity) is a concept that is only just beginning to be explored in music therapy research. The idea of neurodiversity can be viewed as an important part of the emerging discourse around diversity and social justice in British music therapy, with a potentially radical influence on both music therapy practice and the way in which autistic clients and colleagues are viewed. This article, written from the ‘insider perspective’ of an autistic Music Therapist, explores the origins of the concept of neurodiversity, the emerging strand of music therapy research concerning neurodiversity, the re-framing of autistic characteristics such as stimming within the concept of autistic culture, and the potential influence on music therapy practice and discourse of a wider paradigm shift towards the neurodiversity paradigm. These topics are considered within a social justice context, situating autistic / neurodivergent people as a minoritized identity within society and examining the potential influence of power dynamics, unconscious bias and privilege within the therapeutic relationship. The characteristics of a neurodiversity-affirmative style of music therapy are considered, and a need is identified for more music therapy research in order to elucidate this way of working.
Collapse
|
37
|
Zajic MC, Brown HM. Measuring Autistic Writing Skills: Combining Perspectives from Neurodiversity Advocates, Autism Researchers, and Writing Theories. Hum Dev 2022. [DOI: 10.1159/000524015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Autism and writing are commonly discussed independently as complex, multifaceted entities. However, studies examining their intersections are limited and often oversimplify the nuances innate to both topics. This paper focuses on the complexities involved in studying autistic individuals’ foundational writing skills (i.e., transcription and text generation skills) by drawing on theories of writing and autism grounded in perspectives from the neurodiversity movement. We frame our discussion around the complex sociocultural and cognitive factors important to writing by drawing on the Writer(s)-within-Community model. Our discussion highlights findings and trends among observational and intervention research studies as well as offers suggestions for future research guided by the ongoing reconceptualization and understanding of autistic development. In doing so, we argue that future research must look beyond written products as the only measure of writing development and beyond a diagnosis of autism as the indicator of atypical written language development.
Collapse
|
38
|
Hu B. The Analysis of Art Therapy for Children with Autism by Using the Implemented Artificial Intelligence System. INT J HUM ROBOT 2022. [DOI: 10.1142/s0219843622400023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
39
|
Harmens M, Sedgewick F, Hobson H. The Quest for Acceptance: A Blog-Based Study of Autistic Women's Experiences and Well-Being During Autism Identification and Diagnosis. AUTISM IN ADULTHOOD 2022; 4:42-51. [PMID: 36605564 PMCID: PMC8992923 DOI: 10.1089/aut.2021.0016] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background Although studies have found that autism is underdiagnosed in women and that autistic women have poorer well-being outcomes than men, less is known about autistic women's experiences with self-identification or diagnosis or how they feel such experiences affect their mental health. Methods We explored autistic women's experiences of coming to recognize and understand themselves as autistic. We used data collected from blogs written by autistic women about their diagnostic or self-identification experiences. We were particularly interested in well-being, and how this contributed to, was affected by, and interacted with the identification and diagnostic process. We used thematic analysis to explore and document experiences described in blogs from 20 blogsites (representing the views of 23 autistic women). Results Acceptance was a central issue. We developed themes of self-understanding and self-acceptance, being understood and accepted by others (including peers, clinicians, and others in the autism community), and the exhaustion resulting from trying to be accepted and be understood. These issues arose both when going through the diagnostic process, and after receiving a formal diagnosis. Conclusions Diagnosis and identification may have both positive and negative effects on autistic women's well-being, with women often describing difficulties after diagnosis as stemming from facing male stereotypes of autism. We consider the implications of our findings for clinicians, researchers, and those who work with autistic women.
Collapse
Affiliation(s)
- Miriam Harmens
- Department of Psychology, University of York, Heslington, York, United Kingdom
| | | | - Hannah Hobson
- Department of Psychology, University of York, Heslington, York, United Kingdom.,Address correspondence to: Hannah Hobson, DPhil, Department of Psychology, University of York, YO10 5DD York, United Kingdom
| |
Collapse
|
40
|
Muratori F, Apicella F. Being Born Autistic and the Forming of the Interpersonal World. PSYCHOANALYTIC INQUIRY 2022. [DOI: 10.1080/07351690.2022.2007019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
41
|
Savickaite S, McNaughton K, Gaillard E, Amaya J, McDonnell N, Millington E, Simmons DR. Exploratory study on the use of HMD virtual reality to investigate individual differences in visual processing styles. JOURNAL OF ENABLING TECHNOLOGIES 2022. [DOI: 10.1108/jet-06-2021-0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PurposeGlobal and local processing is part of human perceptual organisation, where global processing helps extract the “gist” of the visual information and local processing helps perceive the details. Individual differences in these two types of visual processing have been found in autism and ADHD (Attention-Deficit Hyperactivity Disorder). Virtual reality (VR) has become a more available method of research in the last few decades. No previous research has investigated perceptual differences using this technology.Design/methodology/approachThe objective of the research is to threefold: (1) identify if there is association between ADHD and autistic traits and the performance on the Rey-Osterrieth complex figure (ROCF) task, (2) investigate practical effects of using VR drawing tools for research on perceptual experiences and (3) explore any perceptual differences brought out by the three-dimensional nature of the VR. The standard ROCF test was used as a baseline task to investigate the practical utility of using VR as an experimental platform. A total of 94 participants were tested.FindingsAttention-to-detail, attention switching and imagination subscales of autism quotient (AQ) questionnaire were found to be predictors of organisational ROCF scores, whereas only the attention-to-detail subscale was predictive of perceptual ROCF scores.Originality/valueThe current study is an example of how classic psychological paradigms can be transferred into the virtual world. Further investigation of the distinct individual preferences in drawing tasks in VR could lead to a better understanding of individual differences in the processing of visuospatial information.
Collapse
|
42
|
Richter D, Dixon J. Models of mental health problems: a quasi-systematic review of theoretical approaches. J Ment Health 2022; 32:396-406. [PMID: 35014924 DOI: 10.1080/09638237.2021.2022638] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Mental health and mental illness have been contested concepts for decades, with a wide variety of models being proposed. To date, there has been no exhaustive review that provides an overview of existing models. AIM To conduct a quasi-systematic review of theoretical models of mental health problems. METHODS We searched academic databases, reference lists, and an electronic bookshop for literature that proposed, endorsed, reviewed, or critiqued such models. Papers, book chapters, and books were included with material by researchers, clinicians, non-medical professions, and service users writing between 2000 to June 2020 being considered. The study was registered with the Open Science Framework (No. osf.io/r3tjx). RESULTS Based on 110 publications, we identified 34 different models which were grouped into five broader categories. Many models bridged two or more categories. Biological and psychological approaches had the largest number of models while social, consumer and cultural models were less diversified. Due to the non-empirical nature of the publications, several limitations in terms of search and quality appraisal apply. CONCLUSIONS We conclude that mental health care needs to acknowledge the diversity of theoretical models on mental health problems.
Collapse
Affiliation(s)
- Dirk Richter
- Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.,Center for Psychiatric Rehabilitation, Bern University Hospital for Mental Health, Bern, Switzerland
| | - Jeremy Dixon
- Department of Social and Policy Sciences, University of Bath, Bath, UK
| |
Collapse
|
43
|
Lemos CD, Kranios A, Beauchamp-Whitworth R, Chandwani A, Gilbert N, Holmes A, Pender A, Whitehouse C, Botting N. Awareness of developmental language disorder amongst workplace managers. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106165. [PMID: 34800812 DOI: 10.1016/j.jcomdis.2021.106165] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 10/07/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Developmental Language Disorder (DLD) is one of the most prevalent developmental disorders and affects expressive and receptive language with no clear cause (Bishop et al., 2017). Awareness of DLD is currently much lower than other (sometimes less prevalent) disorders such as Autism or Attention Deficit Hyperactivity Disorder (ADHD) (Bishop, 2010). Despite this, it has now been established that the implications of DLD reach well into adulthood (Botting, 2020; Botting et al., 2016; Clegg et al., 2005; Johnson et al., 2010). Thus, DLD may affect not only school progress but also employment. Whilst recent research indicates that the rate of employment in this group was similar to peers (Conti-Ramsden et al., 2018), it also reported lower levels of employment in terms of hours, contracts and employment type. However, there is virtually no research examining why this might be the case. In contrast there is already a growing evidence base surrounding Autism Spectrum Disorder (ASD) and Dyslexia in the workplace. Systematic reviews of factors affecting employment in ASD and Dyslexia (de Beer et al., 2014; Scott et al., 2019) have revealed barriers including the job application process itself. AIMS & METHODS In this study we aimed to explore managers' awareness of DLD and their views on training, adjustments and feasibility when considering employing an individual with DLD. Specifically, we asked: 1) What awareness do managers have of DLD and how does this compare to awareness of ASD and other developmental disorders? 2) What is the extent of training on DLD and other developmental disorders in the workplace? 3) What barriers to employment are perceived to be most significant by managers? 4) What strategies do managers report as currently in place to help support people with DLD? 5) What are perceived strengths of people with DLD according to managers? RESULTS In total, 77 managers completed an anonymous online survey which was accessed via a social media link. Managers came from a wide variety of backgrounds with an equal split between public and private organisations, and across gender. The number of managers who had heard of DLD was lower than for the other disorders (ADHD, ASD, Dyslexia). This pattern was partly mirrored in the proportion of managers who felt they had received adequate training on communication difficulties. However, training on developmental disorders generally was reported as very scarce. A qualitative examination of barriers identified by managers included interviewing and CV submission, reading and following instructions, lack of clear guidelines around support needed, and financial restrictions in providing support. CONCLUSIONS These findings support existing literature and have implications for policy and practice - namely that young people with DLD may need to be proactive about disclosing their language needs, and that workplaces need increased basic training in DLD.
Collapse
Affiliation(s)
- Carmen de Lemos
- Language and Communication Science, City University of London United Kingdom
| | - Ariadne Kranios
- Language and Communication Science, City University of London United Kingdom
| | | | - Anna Chandwani
- Language and Communication Science, City University of London United Kingdom
| | - Nick Gilbert
- Language and Communication Science, City University of London United Kingdom
| | - Amy Holmes
- Language and Communication Science, City University of London United Kingdom
| | - Abby Pender
- Language and Communication Science, City University of London United Kingdom
| | - Ciara Whitehouse
- Language and Communication Science, City University of London United Kingdom
| | - Nicola Botting
- Language and Communication Science, City University of London United Kingdom.
| |
Collapse
|
44
|
Lin XB, Lim CG, Lee TS. Social Deficits or Interactional Differences? Interrogating Perspectives on Social Functioning in Autism. Front Psychiatry 2022; 13:823736. [PMID: 35546922 PMCID: PMC9084456 DOI: 10.3389/fpsyt.2022.823736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Social dysfunction is a key characteristic of autism. Determining and treating autism-related social deficits have been challenging. The medical model views interpersonal difficulties in autism as a localized set of deficits to be managed, whereas the neurodiversity movement calls for the accommodation of differences by the larger community. One common assumption underlying these perspectives is a misalignment in social behaviors between autistic individuals and neurotypicals. This paper reviews and interrogates current perspectives on social functioning in autism to uncover the intricacies of such a notion. Even though extant literature has alluded to a misalignment in social behaviors between autistic and neurotypical individuals, it is uncertain where this disparity lies. Implications for future research and practice are discussed.
Collapse
Affiliation(s)
- Xiangting Bernice Lin
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Choon Guan Lim
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,School of Social Sciences, Nanyang Technological University, Singapore, Singapore.,Department of Child and Adolescent Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Tih-Shih Lee
- Neuroscience and Behavioral Disorders Program, Duke-NUS Medical School, Singapore, Singapore.,Department of Psychiatry, Singapore General Hospital, Singapore, Singapore
| |
Collapse
|
45
|
Abstract
Many individuals on the autism spectrum are hypersensitive to certain sensory stimuli. For this group, as well as for non-autistic individuals with sensory processing disorders, being exposed to e.g. fluorescent lights, perfume odours, and various sounds and noises can be real torment. In this article, I consider the normative implications of such offence for the design of office spaces, which is a topic that has not received any attention from philosophers. After identifying different ways in which the senses of hypersensitive workers might be protected within these spaces, I show that many of such accommodations can be made at reasonable cost, before arguing that doing so ought to be a legal requirement.
Collapse
|
46
|
Miller D, Rees J, Pearson A. "Masking Is Life": Experiences of Masking in Autistic and Nonautistic Adults. AUTISM IN ADULTHOOD 2021; 3:330-338. [PMID: 36601640 PMCID: PMC8992921 DOI: 10.1089/aut.2020.0083] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background Autistic masking is an emerging research area, and so far, research has suggested that masking has a negative effect on autistic people. Masking relates to general social practices (such as identity management) and is often driven by stigma avoidance. Many nonautistic people also experience stigma that might drive them to suppress aspects of their identity. In this study, we investigate similarities and differences in experiences of masking in autistic and nonautistic people. Methods We conducted an online survey about experiences and views of masking in autistic people (n = 144), neurodivergent people without an autism diagnosis (n = 49), and neurotypical people (n = 45) recruited via social media. We used thematic analysis to analyze responses to open-ended items about masking, using an inductive approach, at a semantic level, with a critical realist paradigm. Results Thematic analysis revealed that some aspects of masking are shared across autistic and nonautistic people, such as utilizing mimicry of others as a social strategy or feeling exhausted from masking. All groups reported that masking made them feel disconnected from their true sense of identity and had a negative effect on them. Other aspects of masking seemed more specific to autistic people, such as sensory suppression, and masking leading to suicidal ideation. Conclusions Our findings suggest that many aspects of masking are experienced across different neurotypes and are likely related to outside perceptions of difference and stigma. It is likely that what we call "autistic masking" is similar to other forms of stigma management previously theorized. Some aspects of masking do seem more specific to the autistic neurotype (e.g., suppression of stimming) and should be explored further to provide support for autistic people recovering from the negative impact of masking. Lay summary Why was this study done?: Masking is the process of intentionally, or unintentionally, hiding aspects of yourself to avoid harm. Recent research has suggested that autistic people might mask a lot and that this can lead to long-term problems in mental health. At the moment, we do not know which parts of masking are specific to autistic people, and which parts might be experienced by others, especially other neurodivergent people who are not autistic, for example, people with attention-deficit hyperactivity disorder (ADHD).What was the purpose of this study?: The purpose of this study was to find out about masking in autistic and nonautistic people, to find out whether some parts of masking are specific to autistic people, or experienced by others.What did the researchers do?: We conducted an online survey about masking with three groups of people: autistic people, nonautistic people who have another neurodevelopmental or mental health diagnosis, such as dyslexia, ADHD, or depression, and nonautistic people who do not have any neurodevelopmental or mental health diagnoses. The survey included an open text box for people to write about their experiences of masking and their opinions about masking. We analyzed these responses using a method called "thematic analysis." This method helps us look for ideas that people commonly talk about in their answers.What were the results of this study?: We found out that autistic and nonautistic people think masking is very complicated and has a negative effect on them. Both autistic and nonautistic people said that masking made them exhausted and really unhappy and that it made them feel like people did not know the "real them." Only autistic people mentioned that masking sometimes makes them feel suicidal and that masking includes things that other groups did not mention (such as trying to hide being upset by sensory things such as loud noise).What do these findings add to what was already known?: Our findings suggest that some aspects of masking do not just affect autistic people (such as feeling like people do not know the real you), but other parts might be more unique to autistic people (such as hiding stims from other people).What are potential weaknesses in this study?: More women than men and nonbinary people took part, which means that we know more about women than other people. We also do not really know whether everyone in the nonautistic groups were really "not autistic." They could be autistic people who do not have a diagnosis, which might affect our results.How will these findings help autistic people now or in the future?: We hope our findings will help people to understand how masking affects autistic and nonautistic people. We also hope that people designing new studies will look at important things such as whether someone is autistic and nonbinary, or autistic and ADHD as these things might affect their experiences.
Collapse
Affiliation(s)
- Danielle Miller
- School of Psychology, Faculty of Health and Wellbeing, University of Sunderland, Sunderland, United Kingdom
| | - Jon Rees
- School of Psychology, Faculty of Health and Wellbeing, University of Sunderland, Sunderland, United Kingdom
| | - Amy Pearson
- School of Psychology, Faculty of Health and Wellbeing, University of Sunderland, Sunderland, United Kingdom.,Address correspondence to: Amy Pearson, PhD, Faculty of Health Sciences and Wellbeing, School of Psychology, University of Sunderland, Helen McArdle House, City Campus, Sunderland SR1 3SD, United Kingdom
| |
Collapse
|
47
|
Tan KS. Art and psychiatry in the 21st century: here's to more messy - and magical - entanglements. BJPsych Bull 2021; 46:1-4. [PMID: 34789347 PMCID: PMC9074159 DOI: 10.1192/bjb.2021.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 11/23/2022] Open
Abstract
In a volatile world, during a time of multiple crises and amid a projected upsurge in mental illnesses as an aftermath of the COVID-19 pandemic, now is a critical time to consider how art and psychiatry can entangle with each other. Submissions like that of Lily Aston can create new spaces for conversation, reflection and constructive collisions. This can help disrupt and extend the state of psychiatry, management of psychiatric services, and education and training in mental healthcare, and advance how we understand other bodies and minds around us, and how knowledge can be created.
Collapse
|
48
|
Aithal S, Moula Z, Karkou V, Karaminis T, Powell J, Makris S. A Systematic Review of the Contribution of Dance Movement Psychotherapy Towards the Well-Being of Children With Autism Spectrum Disorders. Front Psychol 2021; 12:719673. [PMID: 34744883 PMCID: PMC8564751 DOI: 10.3389/fpsyg.2021.719673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/31/2021] [Indexed: 12/05/2022] Open
Abstract
Background: The present review provides an original examination of published literature on the use of Dance Movement Psychotherapy (DMP) as an intervention for children with an Autism Spectrum Disorder (ASD). Method: The review was systematically conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A protocol consisting of four phases: identification; screening and selection; data extraction and synthesis; quality assurance was developed and registered with the PROSPERO. A search strategy was developed using population and intervention as the key concepts and ten databases were searched between 6.1.2018 to 4.4.2018 and 10.07.2021 to 20.07.2021. The intervention characteristics were extracted based on the TIDieR template for intervention description and replication checklist. Quality assessment and level of evidence of all the included studies were evaluated using the Mixed Methods Appraisal Tool (MMAT) and the Centre for Evidence-Based Medicine (CEBM) for treatment criteria. Results: Nine research studies with a total of 133 participants were identified through a systematic search process. There was only one mixed-methods study with the component of randomisation found during the literature search. Collected information was synthesised in relation to (a) ways in which dance movement psychotherapists work with children; (b) data collection methods and findings. Results from the reviewed literature suggest that DMP can potentially promote various aspects of well-being in children with ASD. Eight out of nine studies mentioned the effects of DMP on improving different social and communication skills. However, results from quality assessments and synthesised outcomes indicate that research in DMP is still in its infancy. Conclusions: We conclude that further large-scale, high-quality studies are required to generate further evidence that explains the processes involved in DMP, the effectiveness of DMP, the relationship between therapeutic factors of DMP, and research findings for children on the autism spectrum. Systematic Review Protocol Registration: PROSPERO, identifier: CRD42018087912.
Collapse
Affiliation(s)
- Supritha Aithal
- Research Center for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom.,Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Zoe Moula
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Vicky Karkou
- Research Center for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom.,Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Themis Karaminis
- Research Center for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom.,Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Joanne Powell
- Research Center for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom.,Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Stergios Makris
- Research Center for Arts and Wellbeing, Edge Hill University, Ormskirk, United Kingdom.,Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| |
Collapse
|
49
|
Koi P. Genetics on the neurodiversity spectrum: Genetic, phenotypic and endophenotypic continua in autism and ADHD. STUDIES IN HISTORY AND PHILOSOPHY OF SCIENCE 2021; 89:52-62. [PMID: 34365317 DOI: 10.1016/j.shpsa.2021.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
How we ought to diagnose, categorise and respond to spectrum disabilities such as autism and Attention Deficit/Hyperactivity Disorder (ADHD) is a topic of lively debate. The heterogeneity associated with ADHD and autism is described as falling on various continua of behavioural, neural, and genetic difference. These continua are varyingly described either as extending into the general population, or as being continua within a given disorder demarcation. Moreover, the interrelationships of these continua are likewise often vague and subject to diverse interpretations. In this paper, I explore geneticists' and self-advocates' perspectives concerning autism and ADHD as continua. These diagnoses are overwhelmingly analysed as falling on a continuum or continua of underlying traits, which supports the notion of "the neurodiversity spectrum", i.e., a broader swath of human neural and behavioural diversity on which some concentrations of different functioning are diagnosed. I offer a taxonomy of conceptions of the genetic, phenotypic, and endophenotypic dimensionality within and beyond these diagnostic categories, and suggest that the spectrum of neurodiversity is characteristically endophenotypic.
Collapse
Affiliation(s)
- Polaris Koi
- Philosophy Unit, University of Turku, FI-20014 Turun Yliopisto, Finland.
| |
Collapse
|
50
|
Rickson D. Family members’ and other experts’ perceptions of music therapy with children on the autism spectrum in New Zealand: Findings from multiple case studies. ARTS IN PSYCHOTHERAPY 2021. [DOI: 10.1016/j.aip.2021.101833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|