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Nijhof D, Melville C, Rydzewska E, Pavlopoulou G, Meehan L, Gardani M. Experiences of and treatment preferences for insomnia in autistic adults: An Interpretative Phenomenological Analysis. Sleep Med 2024; 122:163-170. [PMID: 39178754 DOI: 10.1016/j.sleep.2024.08.011] [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: 02/06/2024] [Revised: 07/24/2024] [Accepted: 08/11/2024] [Indexed: 08/26/2024]
Abstract
Insomnia and insomnia symptoms are frequent experiences of autistic people resulting in pronounced daytime effects and poor quality of life. This study employed an Interpretive Phenomenological Analysis approach to explore lived experiences of autistic adults with insomnia, perspectives on current available interventions and future treatment preferences. Twelve participants (aged 21-48 years old) were interviewed following screening for insomnia, using the Sleep Condition Indicator (scores ranged from 1 to 12; cut off >16). Each interview was analysed individually developing Personal Experiential Themes for each case, which were then mapped across cases based on identified patterns and connections. Results yielded rich personal accounts and identified two Group Experiential Themes: "The Night is Friendlier" and "It Doesn't Really Work for Me". Participants described experiences with sleeplessness throughout their adult lives and often since childhood. They discussed how the night time offers them a more relaxed and safe space to freely behave as they wish. Advice and interventions were viewed by participants via the prism of underlying social issues, such as autism acceptance and trust, and how these structures can affect participants' experiences with insomnia, help seeking and effectiveness of current interventions. Our results highlight the need for inclusion of autistic people in insomnia research through co-production and co-creation as well as clinical practice and delivery. This is the first study to integrate perspectives and experiences of autistic people towards insomnia and sleep-related advice by health care professionals. Findings are discussed in relation to theoretical and practical implications, as well as directions for future research.
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Affiliation(s)
- Dewy Nijhof
- School of Health and Wellbeing, University of Glasgow, UK
| | - Craig Melville
- School of Health and Wellbeing, University of Glasgow, UK
| | | | - Georgia Pavlopoulou
- Group for Research in Relationships And NeuroDiversity (GRRAND), Research Department of Clinical, Education & Health Psychology, University College London, UK; Anna Freud Centre, London, UK
| | - Lily Meehan
- School of Health and Wellbeing, University of Glasgow, UK
| | - Maria Gardani
- School of Health in Social Science, University of Edinburgh, UK.
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Stogiannos N, Pavlopoulou G, Papadopoulos C, Walsh G, Potts B, Moqbel S, Gkaravella A, McNulty J, Simcock C, Gaigg S, Bowler D, Marais K, Cleaver K, Lloyd JH, Dos Reis CS, Malamateniou C. Strategies to improve the magnetic resonance imaging experience for autistic individuals: a cross-sectional study exploring parents and carers' experiences. BMC Health Serv Res 2023; 23:1375. [PMID: 38062422 PMCID: PMC10704820 DOI: 10.1186/s12913-023-10333-w] [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: 08/29/2023] [Accepted: 11/15/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Autistic individuals encounter numerous barriers in accessing healthcare, including communication difficulties, sensory sensitivities, and a lack of appropriate adjustments. These issues are particularly acute during MRI scans, which involve confined spaces, loud noises, and the necessity to remain still. There remains no unified approach to preparing autistic individuals for MRI procedures. METHODS A cross-sectional online survey was conducted with parents and carers of autistic individuals in the UK to explore their experiences, barriers, and recommendations concerning MRI scans. The survey collected demographic information and experiential accounts of previous MRI procedures. Quantitative data were analysed descriptively, while key themes were identified within the qualitative data through inductive thematic analysis. RESULTS Sixteen parents/carers participated. The majority reported difficulties with communication, inadequate pre-scan preparation, and insufficient adjustments during MRI scans for their autistic children. Key barriers included an overwhelming sensory environment, radiographers' limited understanding of autism, and anxiety stemming from uncertainties about the procedure. Recommended improvements encompassed accessible communication, pre-visit familiarisation, noise-reduction and sensory adaptations, staff training on autism, and greater flexibility to meet individual needs. CONCLUSIONS There is an urgent need to enhance MRI experiences for autistic individuals. This can be achieved through improved staff knowledge, effective communication strategies, thorough pre-scan preparation, and tailored reasonable adjustments. Co-producing clear MRI guidelines with the autism community could standardise sensitive practices. An individualised approach is crucial for reducing anxiety and facilitating participation. Empowering radiographers through autism-specific education and incorporating insights from autistic individuals and their families could transform MRI experiences and outcomes.
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Affiliation(s)
- Nikolaos Stogiannos
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
- Medical Imaging Department, Corfu General Hospital, Corfu, Greece
| | - Georgia Pavlopoulou
- Department of Psychology and Human Development, University College London, Institute of Education Group for Research in Relationships in NeuroDiversity-GRRAND, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - Chris Papadopoulos
- Institute for Health Research, University of Bedfordshire, Putteridge Bury Campus, Luton, UK.
| | - Gemma Walsh
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Ben Potts
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
- Southampton General Hospital, University Hospitals Southampton Foundation Trust, Southampton, UK
| | - Sarah Moqbel
- Anna Freud National Centre for Children and Families, London, UK
| | | | - Jonathan McNulty
- School of Medicine, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Clare Simcock
- Institute of Child Health, Great Ormond Street Hospital for Children NHS Foundation Trust, University College London, London, UK
| | - Sebastian Gaigg
- Department of Psychology, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Dermot Bowler
- Department of Psychology, School of Health and Psychological Sciences, City, University of London, London, UK
| | - Keith Marais
- Community Involvement, University of London, London, UK
| | - Karen Cleaver
- Faculty of Education, Health & Human Sciences, University of Greenwich, London, UK
| | - Jane Harvey Lloyd
- Department of Specialist Science Education, University of Leeds, Leeds, UK
| | - Cláudia Sá Dos Reis
- School of Health Sciences (HESAV), University of Applied Sciences Western Switzerland (HES- SO), Lausanne, CH, Switzerland
| | - Christina Malamateniou
- Department of Midwifery & Radiography, School of Health and Psychological Sciences, City, University of London, London, UK
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Filgueira LMDA, Brilhante AVM, Sá ARD, Colares MSF. Development of a participatory research strategy involving autistic people with different levels of support needs. CIENCIA & SAUDE COLETIVA 2023; 28:1501-1512. [PMID: 37194882 DOI: 10.1590/1413-81232023285.15282022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/24/2022] [Indexed: 05/18/2023] Open
Abstract
This article describes the development of a participatory methodological study involving autistic people with varying levels of support needs in the design and validation of an instrument devised to assess the effects of social isolation during the COVID-19 pandemic and the strategies used to cope with the crisis. The development of the instrument involved the following stages: Definition of the domains to be assessed (researchers in consultation with experts and autistic people); Design of the instrument (researchers with the co-participation of autistic people); Validation of the instrument (by experts and autistic people, led by the researchers); and Final approval of the instrument (co-participation between researchers and autistic people). In addition to making the instrument more robust, the participation of autistic people in the design and application of the instrument reinforced the importance of strategies to include autistic people in research as both study participants and co-researchers.
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Affiliation(s)
- Leila Maria de Andrade Filgueira
- Faculdade de Psicologia, Universidade de Fortaleza (Unifor). Av. Washington Soares 1321, Edson Queiroz. 60811-905 Fortaleza CE Brasil.
| | | | - Adrianna Reis de Sá
- Programa de Pós-Graduação em Saúde Coletiva e Bioética, Universidade de Brasília. Brasília DF Brasil
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Pavlopoulou G, Usher C, Pearson A. 'I can actually do it without any help or someone watching over me all the time and giving me constant instruction': Autistic adolescent boys' perspectives on engagement in online video gaming. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2022; 40:557-571. [PMID: 35633283 DOI: 10.1111/bjdp.12424] [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: 07/30/2021] [Accepted: 05/06/2022] [Indexed: 11/02/2022]
Abstract
Research into autistic adolescents' engagement in online gaming has so far focused on time spent gaming, or characterizing problematic gaming behaviour and has relied mostly on caregiver report. In the current study, we interviewed 12 autistic adolescent boys, asking about their perspectives on their engagement in online gaming, and their motivations. We analysed the interview data using thematic analysis and identified three key themes in the data, which focused on agency and a sense of belonging, emotion regulation, and acknowledgement of the differing perceptions that the young people and their caregivers had of gaming. Our findings show the need to include the viewpoints of autistic young people in research about their interests and well-being, and provide insights that can help caregivers and professionals to support autistic young people in flourishing.
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Affiliation(s)
- Georgia Pavlopoulou
- Group for Research in Relationships and NeuroDiversity-GRRAND, Department of Psychology and Human Development, Institute of Education, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
| | - Claire Usher
- Group for Research in Relationships and NeuroDiversity-GRRAND, Department of Psychology and Human Development, Institute of Education, University College London, London, UK
| | - Amy Pearson
- School of Psychology, Faculty of Health and Wellbeing, University of Sunderland, Sunderland, UK
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Phung J, Penner M, Pirlot C, Welch C. What I Wish You Knew: Insights on Burnout, Inertia, Meltdown, and Shutdown From Autistic Youth. Front Psychol 2021; 12:741421. [PMID: 34803822 PMCID: PMC8595127 DOI: 10.3389/fpsyg.2021.741421] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 10/06/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: Burnout, inertia, meltdown, and shutdown (BIMS) have been identified as important parts of some autistic people's lives. This study builds on our previous work that offered early academic descriptions of these phenomena, based on the perspectives of autistic adults. Objectives: This study aimed to explore the unique knowledge and insights of eight autistic children and youth to extend and refine our earlier description of burnout, inertia, and meltdown, with additional exploration of shutdown. We also aimed to explore how these youth cope with these phenomena and what others around them do that make things better or worse, with a hope to glean knowledge to design better supports. Methods: One-to-one interviews were conducted with eight children and youth, who shared their experience with BIMS. To match individual communication strengths of children and youth, we took a flexible approach to interviews, allowing for augmentative communication systems and use of visual images to support verbal interviews, as needed. We conducted a reflexive, inductive thematic analysis, using an iterative process of coding, collating, reviewing, and mapping themes. Findings: Our analysis has identified that these youth describe BIMS as a multi-faceted experience involving emotional, cognitive and physical components. Moreover, these multifaceted experiences are often misunderstood by neurotypical adults, which contributes to inadequate support in managing BIMS. Of the four experiences, these youth identified meltdowns as most common. Conclusion: By gaining first-hand perspectives, we have identified novel insights into BIMS and developed a more holistic understanding of these phenomena. These youths' descriptions of supportive strategies for BIMS stress the importance of compassion and collaboration from trusted adults. This new knowledge will provide a foundation for how to better support autistic children and youth. Further research is required to develop an understanding of BIMS, especially with respect to how it is experienced by children and youth. Future research should leverage the insights and experiential knowledge of autistic children and youth to co-design support tool(s) for BIMS.
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Affiliation(s)
- Jasmine Phung
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Melanie Penner
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Clémentine Pirlot
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Christie Welch
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
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