Dissertations / Theses on the topic 'Disorders of the autic spectrum'

Rationale: Autism is a neurodevelopmental disorder with onset prior to the age of three years characterized by qualitative impairments in social interaction and communication skill, along with a restricted repetitive and stereotyped pattern of behavior, interests, and activities. In addition to these core diagnostic features, aberrant sensory responding has also been widely reported in the literature describing children and adolescents with autism spectrum disorders (ASD). Aberrant sensory processing has, however, been infrequently studied compared to communication and cognition in autism and existing studies have had multiple methodological deficiencies, especially with sampling procedures. Purpose. The purpose of this study is to describe patterns of sensory processing found in children with an ASD to test the relationship(s) of these patterns to diagnostic and developmental variables. Method. Retrospective data collection was used to collect developmental and sensory processing variables of 400 children with an ASD. Sensory processing abilities were measured by the SSP. Results. The majority of the sample (80.5%) had a diagnosis of autism. The average age of the sample was 49.58 months. The adaptive, social, language, and motor developmental variables were consistent with diagnostic patterns in that the children with Asperger Disorder demonstrated higher developmental levels than the children with autism and PDD-NOS. Eighty-nine percent of the sample demonstrated some degree of sensory processing dysfunction on the SSP Total Score with the greatest difficulties reported on the Underresponsive/Seeks Sensation, Auditory Filtering, and Tactile Sensitivity sections. Exploratory factor analysis identified 6 parsimonious factors: Low Energy/Weak, Tactile and Movement Sensitivity, Taste/Smell Sensitivity, Auditory and Visual Sensitivity, Sensory Seeking/Distractibility, and Hypo-responsivity. These factor variables contributed to explaining the differences in five of six developmental variables of the sample that are associated with the diagnosis of autism. Receptive language, adaptive and expressive language performance were significantly correlated with sensory processing factor scores. Conclusions. Together, the sensory processing findings noted in this study describe a pattern of dysfunctional sensory modulation. These findings have significant implications for intervention programs involving individuals with an ASD, given the potential impact of these findings on a childs ability to maintain active engagement.

Questions have been raised as to whether the patterns of thoughts and behaviours experienced by individuals with autistic spectrum disorders (ASD) can be indicative of comorbid obsessive compulsive disorder (OCD). The current study aimed to compare the experiences of adults with ASD or OCD and healthy controls (HC) in terms of the symptoms experienced and the associated emotions and responses. Associations between autistic traits and OCD severity were explored. A cross-sectional design utilising MANOVA, ANOVA and correlation was employed. Methods: Eighteen participants with ASD, 20 with OCD and 19 healthy controls completed self-report measures and interviews assessing IQ, comorbid diagnoses, OCD symptoms, autistic traits and emotions and responses associated with obsessional thoughts. Participants with ASD scored significantly higher than healthy controls in terms of OCD severity and also number of obsessions and compulsions and associated distress. While the OCD and ASD groups did not differ significantly on OCD severity, the OCD group reported significantly higher levels of sadness, worry, shame, guilt and disapproval triggered by obsessions. The ASD and healthy control groups were largely comparable on these factors. Associations were found between OCD severity and particular domains which are typically impaired in ASD, including social skills, attention switching, communication and imagination. Findings suggest that OCD symptoms may be common and a source of distress in individuals with ASD, thus perhaps warranting psychological intervention. Further research into the exact nature of this distress and how this can be assessed is required.

Noonan spectrum disorders belong to the RASopathies, a group of clinically related developmental disorders caused by dysregulation of the RAS-MAPK pathway. This thesis describes genetic and clinical investigations of six families with Noonan spectrum disorders. In the first family, the index patient presented with severe Noonan syndrome (NS) and multiple café-au-lait (CAL) spots, while four additional family members displayed multiple CAL spots only. Genetic analysis of four RAS-MAPK genes revealed a de novo PTPN11 mutation and a paternally inherited NF1 mutation, which could explain the atypically severe NS, but not the CAL spots trait in the family. The co-occurrence of two mutations was also present in another patient with a severe/complex NS-like phenotype. Genetic analysis of nine RASopathy-associated genes identified a de novo SHOC2 mutation and a maternally inherited PTPN11 mutation. The latter was also identified in her brother. Both the mother and the brother displayed mild phenotypes of NS. The results from these studies suggest that an additive effect of co-occurring mutations contributes to severe/complex NS phenotypes. The inherent difficulty in diagnosing Noonan spectrum disorders is evident in families with neurofibromatosis-Noonan syndrome (NFNS). An analysis of nine RASopathy-associated genes in a five-generation family with NFNS revealed a novel NF1 mutation in all affected family members. Notably, this family was initially diagnosed with NS and CAL spots. The clinical overlap between NS and NFNS was further demonstrated in three additional NFNS families. An analysis of twelve RASopathy-associated genes revealed three different NF1 mutations, all segregating with the disorder in each family. These mutations have been reported in patients with NF1, but have, to our knowledge, not been associated with NFNS previously. Together, these findings support the notion that NFNS is a variant of NF1. Due to the clinical overlap between NS and NFNS, we propose screening for NF1 mutations in NS patients negative for mutations in NS-associated genes, preferentially when CAL spots are present. In conclusion, this thesis suggests that co-occurrence of mutations or modifying loci in the RAS-MAPK pathway contributes to the clinical variability observed within Noonan spectrum disorders and further demonstrates the importance of accurate genetic diagnosis.

The present dissertation on autism spectrum disorders (ASD) addressed several questions. First, the behavioral symptoms of speaking and mute individuals with ASD were compared on the Autism Behavior Checklist (ABC), a commonly used diagnostic instrument. In addition, questions about the construction of the ABC were investigated. In Study I it was found that although the two groups did not significantly differ on the total ABC score, the mute group demonstrated significantly more pathology on 21 of 57 items and 3 of 5 subscales. The speaking group obtained significantly higher scores on only 8 items and 1 subscale (Language). The appropriateness of providing greater pathology scores to speaking, rather than mute, individuals with ASD was called into question. In addition, it was speculated that the expressive language items are weighted too heavily, on both the Language subscale and the total score. Second, because the 57 items of the ABC were categorized into 5 subscales on a subjective basis, an empirical investigation of the factor structure of the ABC was performed. In Study II, a 5-factor model that contained 39 of the items accounted for 80% of the total variance in the checklist. No support was found for classifying the 57 items into the existing 5 subscales. Finally, the two most common forms of instruction to teach children with ASD, discrete-trial teaching and incidental teaching, were assessed. In Study III it was ascertained that discrete-trial teaching was more efficient and produced faster acquisition and initially, greater generalization. However, by follow-up, the incidental teaching methods resulted in equal retention, greater generalization, and equal or greater spontaneous usage. The findings indicate that although it takes a longer time for children with autism to learn with incidental teaching procedures, once they have acquired an ability, it may be more permanent.

This thesis examined whether individuals with Autism Spectrum Disorders are sensitive to traits. The ability of individuals with Autism Spectrum Disorders to infer traits from descriptions of behaviour was investigated by asking participants to read trait implying sentences and then to chose one of two words that best related to the sentence. In experiment 1, individuals with Autism Spectrum Disorders performed similarly to matched controls in being faster at choosing the trait in comparison to the semantic associate of one of the words in the sentence. The results from experiments 1 and 2 provided converging evidence in suggesting that inferring traits from textual descriptions of behaviour occurs with relatively little effort. The results of experiment 3 suggested that making trait inferences took priority over inferring actions or making semantic connections between words. Experiment 4 investigated whether individuals with Autism Spectrum Disorders associated the inferred trait with the person carrying out the behaviour (actor). Participants were presented with a pair of faces and sentences followed by the same pair of faces being presented with a single word. Participants had to choose which actor is best described by the word. The results provided evidence that participants with Autism Spectrum Disorders were able to associate inferred traits with the actor easily, even when the actor was represented by his face. The experiments described in this thesis provide evidence for the possibility of trait inference as relating to behaviour being a spared socio-cognitive function in autism.

Attentional abnormalities are one of the earliest signs of Autism Spectrum Disorders (ASD). Despite flourishing attention studies in autism, relatively little is known about attentional performance among young children with high-functioning autism (HFA). The present study compared 23 preschool children with HFA and 28 typically-developing children on attention network efficiencies, selective attention to social or non-social information and attention switching, with age, cognitive and language abilities matched or controlled. Compared with typically-developing children, young children with HFA showed comparative attention network efficiencies, slower orienting to face and better attention switching. Alternative explanations for their strength in attention switching are given based on superior focused attention to visual details and hyper-systemizing skills. Implications on future research and practice are discussed.
published_or_final_version
Educational Psychology
Master
Master of Social Sciences

Section A: A review of current research literature relating to the impact of child ASD upon non-affected siblings and the utility of sibling group interventions. The first section summarises and critiques studies relating to the social, emotional and behavioural adjustment of siblings, including consideration of potential mediating factors and discussion of methodological issues. The second section considers evidence for one intervention for this group, ASD-specific sibling support groups. The review suggests that inconsistencies remain within the sibling research literature and that there is a clear need for UK-based outcome research. Section B: Background: Having a brother or sister with an ASD can be challenging for non-affected siblings. These children may experience reduced parental attention, isolation from peers and difficult sibling behaviours. This pilot study aimed to investigate the utility of support groups for siblings of children with ASDs. Methods: A within group, mixed methods design was used with a pre-intervention baseline. Participants were 35 children, aged 7-15 years, with an ASD sibling. All were attending ASD-specific sibling group interventions across the South East of England. Sibling rated self-concept, anxiety and anger and parent-rated emotional difficulties were collected at pre group, post group and follow up. One group also participated in a focus group. Results: Results indicated significant improvements in self concept and significant decreases in anger and anxiety following participation in an ASD-specific sibling group. Anxiety continued to decrease at 3 month follow up. Parent-rated sibling emotional difficulties did not change. All siblings valued the groups. Four main themes were identified from qualitative data: Siblings valued the opportunity to meet similar others, have fun, learn new information about ASD and apply this knowledge to their own situation. Conclusions: The present pilot study extends existing literature on ASD-specific sibling groups. This is one of the first studies to combine qualitative data with standardised outcome measures. Participation in an ASD-specific support group may be associated with more positive self concept and decreased anger and anxiety. Given inherent study limitations, further, controlled research studies are warranted. Section C: A critical appraisal of the study conducted in section B and a reflective account of the process. This includes consideration of research skills learnt, future adaptations, clinical implications and ideas for future research.

Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2009.
Title from electronic title page (viewed Sep. 3, 2009). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Speech and Hearing Sciences in the Department of Allied Health Sciences." Discipline: Allied Health Sciences; Speech and Hearing Sciences; Department/School: Medicine.

Schizophrenie ist eine komplexe Störung, die sich in einer Vielzahl von Symptomen manifestiert. Diese schließen Änderungen in der subjektiven Wahrnehmung von sich als ein Selbst in der Welt ein, die als Selbststörungen bezeichnet werden. Der erste Artikel ist eine theoretische Beurteilung der experimentellen Paradigmen, die zur Messung von Agency verwendet werden. Es setzt sich auch mit dem Verständnis von scheinbar widersprüchlichen empirischen Befunden bezüglich Störungen von Agency in der Schizophrenie auseinander. Der zweite Artikel beschreibt eine Verhaltensstudie, in der 50 Probanden an einem semistrukturiertes Gespräch teilnahmen. Dieses Gespräch wurde mit einem eigens entwickelten Fragebogen zur Selbststörung durchgeführt, welches auf einer phenomänologischen Auffassung der Selbststörung basiert. Das Ziel dieser Studie war, zu untersuchen, ob Selbststörungssymptome, welche bei der Schizophrenie auftreten, ebenfalls in einer nicht-klinischen Population mit erhöhter Schizotypie zu finden sind. Außerdem sollte bestimmt werden, ob der neue Fragebogen Selbststörungssymptome verlässlich misst. In der Tat zeigte die Messung anhand dieses Fragebogens eine hohe Übereinstimmung zwischen verschiedenen Bewertern. In der im dritten Artikel beschriebenen Studie wurde bei 26 Probanden Eyetracking verwendet, um zu untersuchen, ob die bei der Schizophrenie zu beobachtenden Defizite bei willentlichen Sakkaden auch bei Personen mit nicht-klinisch erhöhter Schizotypie auftreten. Der Vergleich zwischen willentlichen und visuell geführten Sakkaden ermöglicht die experimentelle Manipulation des Grades an empfundener Agency über die Augenbewegungen. Es ergab eine starke negative Korrelation zwischen der Reaktionszeit bei visuell geführten Sakkaden und dem Grad der Selbststörung. Mit dieser Studie wird zum ersten Mal ein Zusammenhang zwischen Selbststörungssymptomen und Verhalten in einer Augenbewegungsaufgabe nachgewiesen.
Schizophrenia is a complex condition which manifests in a broad variety of symptoms, including alterations in the subjective experience of one as a self within the world, which are termed self disorders. The first paper is a theoretical examination of the experimental paradigms which are used for measuring agency. It also discusses how apparently contradictory empirical findings regarding disorders of agency in schizophrenia can be understood. The second paper refers to a behavioural study of 50 participants using a novel semi-structured interview, based upon a phenomenological conception of self disorder. It addresses whether self disorder symptoms typically found in schizophrenia are also found in a non-clinical high-schizotypy population and whether these symptoms can be measured reliably with this technique. The measurement of self disorders in this format was found to have good inter-rater reliability. The third paper used eye tracking to examine whether the deficits in volitional saccades found in schizophrenia would also be found in 26 non-clinical high-schizotypy subjects. Comparing volitional to visually-guided saccade allows experimental manipulation of the degree of agency over the eye movement that a subject experiences. A strong negative correlation between visually guided saccade latency and self disorder score was found. This is the first time that a link from self disorder symptoms to performance in eye movement tasks has been made.

Les troubles du spectre de l’autisme (TSA) sont caractérisés par des difficultés persistantes dans les domaines de la communication et des interactions sociales. Les individus atteints de TSA ont notamment des difficultés à décoder les émotions d’autrui et il est souvent suggéré qu’un déficit général du traitement des visages émotionnels est à l’origine de ces difficultés. Cependant, les résultats de la littérature sont incohérents et soulignent l'importance de facteurs méthodologiques qui pourraient influencer la performance des personnes TSA. Deux théories actuelles sont pertinentes au regard de ces difficultés rencontrées dans les interactions sociales : 1) la théorie de la régulation comportementale propose que ces difficultés résultent de dysfonctionnements du traitement des émotions et/ou des mécanismes permettant de répondre de façon appropriée à ces émotions; et 2) la théorie de la motivation sociale propose au contraire que ces mécanismes sont intacts et que les difficultés rencontrées sont le résultat d’un déficit de motivation sociale. Cette thèse avait pour but de départager ces deux théories, tout en contrôlant de nombreux facteurs méthodologiques qui pourraient influencer la performance des personnes TSA. L’expérience 1 visait à étudier l’impact de la direction du regard sur le traitement de la peur et de la colère. L’expérience 2 étudiait les choix d’actions spontanées en présence de visages de peur ou de colère et la catégorisation de ces émotions présentées en vision périphérique. Ces deux études révèlent des résultats similaires chez des adolescents neuro-typiques et TSA. Ces deux groupes sont capables de décoder des expressions de peur et de colère, présentées au centre de l’écran ou en périphérie, ils sont aussi sensibles aux variations d’intensité de ces émotions et aux variations de contexte (ici étudié sous la forme de la direction du regard). D’autre part, les deux groupes répondent de façon similaire à ces émotions, notamment en choisissant des actions qui leur permettent d’éviter des individus menaçants. Pris dans leur ensemble, ces résultats indiquent que les mécanismes impliqués dans le traitement des émotions, l’intégration des facteurs contextuels, et dans l’adaptation de son comportement en réponses à ces signaux sociaux sont intacts chez des adolescents atteints de TSA. Ces résultats sont discutés au regard des théories de la motivation sociale et de la régulation comportementale
Autism spectrum disorders (ASD) are neurodevelopmental conditions characterised by persistent deficits in social reciprocity. Deficits in emotion perception are common in ASD and suggested to stem from a generalised deficit in the processing of facial affect. The literature however is inconsistent, stressing the importance of methodological factors that might bring individuals with ASD to a disadvantage. Two relevant theoretical frameworks are considered: 1) the behavioural self-regulation account proposes that affective atypicalities stem from deficits in the processing of the emotional signals and/or the regulation of appropriate responses to these signals; and 2) the social motivation account proposes that the mechanisms behind either of these two stages of emotion understanding are intact and that behavioural deficits stem from reduced weighting of social information. This Ph.D. aimed to disentangle between the two theories in the context of social threats by taking into account the necessary methodological factors. Experiment 1 investigated the contextual impact of gaze direction on the categorisation of facial expressions of anger and fear. Experiment 2 investigated both free action choice in response to implicit social threats –facial expressions of anger and fear- and their emotion categorisation accuracy in visual periphery. Across both studies ASD and typically developing (TD) adolescents demonstrated intact processing of both anger and fear in direct view and in visual periphery and were sensitive to the changes in emotional intensity of the stimuli. In Experiment 1, although the control group was overall more accurate than the ASD group in emotion decoding, gaze direction impacted the processing of threat similarly in both groups. Specifically, gaze direction raised the saliency of the threat for the observer and enhanced their sensitivity to the most salient ones. In Experiment 2, both groups demonstrated an overall tendency to avoid emotional agents, which was particularly evident in the case of anger. Taken together, the mechanisms behind the processing of facial social threats appear relatively spared in ASD adolescents and the impact of contextual factors are similar ASD and typical development. Adolescents with ASD are able to use social threats to adapt their behaviour by avoiding the emotional agent, which is not surprising during a developmental period characterised by enhanced reactivity to threat. These findings are discussed in terms of the social motivation and behavioural self-regulation frameworks and future directions are proposed

Dental anxiety is a common and disabling problem for individuals with autism spectrum disorders (ASD). Little is known about the causes of dental anxiety in ASD but the literature suggests it may be related to sensory sensitivity (Stein et al., 2011) and having high rates of anxiety in general (White et al., 2009). The purpose of this research is to examine the factors that predict dental anxiety in children with ASD. The first two qualitative studies were designed to identify relevant factors in dental anxiety using a bottom-up approach. Interviews were carried out with parents of children with ASD and individuals with ASD. The second study interviewed dentists with varying expertise in ASD. Both sets of interviews were analysed using content analysis. Findings from the qualitative studies suggest that dental anxiety is related to parental anxiety, sensory sensitivity, worries about pain, and negative experiences. In the third study 45 children with ASD aged (11 to 17) and their parents, and a comparison group of 50 Typically Developing (TD) children and their parents, completed measures examining dental anxiety and associated factors. The results demonstrate that children with ASD have higher rates of dental anxiety related to their higher overall anxiety level. Correlations show that dental anxiety is related to other forms of anxiety: unusual sensory processing, cognition, past experiences at the dentist, parents’ dental anxiety, and the number of visits that a child has had to the dentist. Regression analysis shows that dental anxiety in children with ASD is determined by their worries about treatment and the number of dental visits. In TD children, dental anxiety was only predicted by their worries about treatment. Nevertheless, despite the aforementioned small differences, this third study showed that children with ASD and TD children are more alike than different, which is an interesting finding that requires further investigation. Overall, this research helps us understand the underlying causes of dental fear in children with ASD and gives insight into interventions to support them with oral care.

The aim of the present thesis was to examine imitation of biological motion in adults with autism spectrum disorders. Using a novel behavioural protocol, adults with autism and matched neurotypical control adults imitated models that displayed distinctly different, but biological believable kinematics. In Chapter Two it was observed that adults with autism exhibited low-fidelity imitation of atypical biological motion. In Chapter Three it was observed that when selective-attention instructions were provided, although eye movements recorded during action- observation was similar to controls, imitation of atypical biological motion was still impaired. In Chapter Four across three experiments it was shown that adults with autism exhibit reasonably high-fidelity imitation of atypical biological motion. This was achieved by presenting the to-be-imitated biological models in a fixed presentation structure which is known to facilitate greater integration and consolidation of sensorimotor information. This suggestion was supported by a further study where firstly participants were required to complete a secondary motor task during the inter-trial delay, and when the presentation structure was randomised (similar to Chapters Two and Three) resulting in low-fidelity imitation of atypical biological motion. These findings across the present thesis will be discussed in light of a critical evaluation with respect to current literature on imitation in autism, as well as implications for theoretical accounts of impaired imitation in autism and related sensorimotor control processes. Future considerations and translational research will be discussed, with the intention of offering prospective social rehabilitation protocols in autism.

In order to understand and interact with the world, our brains must integrate information from multiple sensory modalities to create coherent representations of scenes and events. The integration of visual, tactile and proprioceptive inputs underpins the subjective sense of self and body ownership. This, in turn, underlies the development of social processes including self-awareness, imitation and empathising, which are impaired in autism spectrum disorders (ASD). Evidence suggests that the social functioning deficits characterising ASD could contribute to atypical sensory integration underlying body representation. However, the exact mechanisms underlying sensory integration difficulties have not been specified. Moreover, it is not clear when, and how, visual, tactile and proprioceptive integration matures in typical development. This is important to establish, in order to compare how and why this integration may differ in ASD populations. This thesis firstly aimed to investigate the typical development of multisensory integration underlying body representation. Experiment One found that the ability to optimally integrate visual and proprioceptive inputs during hand localisation increases with age from very little integration in 4-year-olds to almost adult-like in typically developing 10- to 11-year-olds. Experiments Two and Three showed that sensitivity to the spatial constraints of visuo-proprioceptive integration, and sensitivity to the temporal constraints of visuo-tactile integration, develops with age in 4 to 11-year-olds. Together these studies suggest that the maturation of adult-like multisensory integration for body representation follows a protracted time course over childhood. The second aim of this thesis was to investigate the evidence for two prominent theories of atypical sensory integration underlying body representation in ASD. These are 1) an over-reliance on proprioception and 2) temporally extended sensory binding. Experiment Four examined whether trypically developing (TD) adults with a high number of autistic traits exhibit an over-reliance on proprioception. No evidence was found for this, which could indicate that atypical sensory integration is only present in individuals with a clinical diagnosis of ASD. Experiments Five and Six found evidence for temporally extended visuo-tactile integration in children with ASD, compared to TD control participants. Though no evidence was found for a fundamental over-reliance on proprioception, extended binding may have led to reduced processing of temporal synchrony over modality-specific information (i.e. proprioception). Experiment Seven and Eight found no evidence of proprioceptive over-reliance or temporally extended sensory binding in adults with ASD, relative to a TD control group. I conclude that children with ASD demonstrate temporally extended visuo-tactile binding. This represents a developmental delay rather than a life-long deficit; however, it could have a life-long impact on sensory sensitivities and social processing.

Learning and memory seem to be particularly vulnerable to the effects of heavy prenatal alcohol exposure. Previous research has, however, been limited to the study of retrospective memory (i.e., episodic or declarative memory) in children with a history of prenatal alcohol exposure. Recently, memory researchers have turned their attention to the study of prospective memory (PM), or the ability to realize and act on delayed intentions, in clinical populations. There are no published studies exploring PM in FASD, however. Prospective remembering is reliant on declarative memory as well as intact executive functioning, both of which are known to be impaired in FASD. The current study aimed, therefore, to investigate event-based PM functioning in a longitudinal cohort of children with heavy prenatal alcohol exposure. It also aimed to investigate whether the relation between prenatal alcohol exposure and prospective memory was influenced by IQ, executive functioning, or retrospective memory.

Includes bibliographical references.
Behavioral studies of fetal alcohol spectrum disorders (FASD) have indicated that aggression is common amongst alcohol-exposed adolescents, and that it appears to become more prevalent with age in that population. Such studies have documented the presence of aggression as a behavioral outcome, but have not provided detailed information regarding its presentation, including whether it is proactive or reactive in nature and under which circumstances it arises. Consequently, there is a lack of a theoretical framework within which to understand aggression in FASD. The current research comprised two studies. In Study 1, comorbid developmental disorders that are typically associated with aggression were examined in alcohol-exposed and non-exposed boys and girls. The results indicated a higher prevalence of disruptive behavior disorders, and conduct disorder in particular, amongst the alcohol-exposed boys, and highlighted a significant association between prenatal alcohol exposure and an aggressive subtype of conduct disorder. Based on these findings, Study 2, a multiple-case study, examined the aggressive behaviors of 6 alcohol-exposed and nonexposed adolescents and their classmates.

Cultural beliefs and practices affect factors associated with early diagnosis of developmental disorders, parents' understanding of the disorder, beliefs about causes, and choice of treatment procedures. Currently, most research regarding autism emanates from Western cultural perspectives. However, the notion that treatment methods are universal and that they can simply be developed in the West and exported elsewhere is inherently flawed. The purpose of this qualitative study was to examine the experience of parents from India now living in the US or other countries outside India who have a child with an autism spectrum disorder, and explore the unique contributions of the Indian culture in parents' understanding and acceptance of a childhood disability like autism. Specific cross-cultural variables measured in the study included what symptoms the parents first recognized in their child, parents' beliefs about causes, choice of treatment procedures, roles of grandparents in the child's life, availability of community resources, parent-professional interactions, and acculturation. Twenty seven parents of children with autism (24 mothers, 3 fathers) participated in the study; all but 3 of them now lived outside India. All 27 participants and their spouses were Indian in ethnicity and were born and raised in India. Most parents endorsed the western beliefs in a combination of genetics, environmental toxins, and biological factors; a substantial number also endorsed a belief that immunizations were a direct cause. A significant minority of our parents also called upon traditional Indian beliefs in karma, destiny or fate, and parental mistakes in present or past life. Most of these parents were far from their own parents and in-laws and thus removed from the high level of grandparental involvement that would be typical if they had stayed at home; however, despite the long distance separating them, a majority of the families consider their parents and in-laws as important sources of emotional support. Although a majority of parents reported that they currently do not use any treatment that came from their Indian culture, about half reported that they would prefer to use a combination of both western and Indian medicine and educational practices, if it is made available. A majority of parents in the study appear to be well integrated with their host culture. These parents have become bicultural by maintaining characteristics of their own natal culture, while selectively acquiring those of their host culture.

Overview This thesis reviewed forensic aspects of Intellectual Disabilities (ID) and Autism Spectrum Disorder (ASD). Chapter two was a case study where an individual with ID and ASD who exhibited forensic/Challenging Behaviour (CB) was assessed and intervention offered. Chapter three then focussed on the assessment of people with ID and ASD by critiquing the Wechsler Adult Intelligence Scale (WAIS), version 3 and 4 (WAIS-III & WAIS-IV) (Wechsler, 1997; Wechsler, 2008a, 2008b, 2008c) and discussed application issues for people with ID and ASD. Chapter 4 and 5 examined intervention in more depth. Chapter 4 applied Weiner’s (1985, 1993) theory of achievement, motivation and emotion as a way of understanding contextual intervention and Chapter 5 examined the effect of psychotherapeutic interventions on CB. Chapter Two The case study discussed in chapter two examined explanations of violence and diagnoses. ASD and an ID were identified as useful neurodevelopmental diagnoses that could be used as a framework to understand the individual’s needs. Some explanations of violence were related to features of these diagnoses. Social factors were also identified as increasing risk. Violence was modelled by a key male figure during childhood development which appeared to have been retained as a template of acceptable behaviour, supporting the work of Bandura on social learning (1973). This, and the experience of being a victim of this violence, also supported the work of Douglas, Hart, Webster and Belfrage (2013) who indicated that social factors can increase the risk of violence. In turn this affected attachment supporting the work of Bowlby (1980). The behavioural approach (Cipani & Schock, 2010) was also applied to identify functions of violence. A psychotherapeutic intervention was offered to improve one aspect of emotional recognition, face perception, with the aim of enabling him to comprehend visual feedback from the environment, make interpretations about the emotions experienced by others, and modify his behaviour accordingly. There was little difference to his level of skills following the intervention. It was concluded that particular skills development may be difficult for someone with a neurodevelopmental difficulty if the biological structures are not there to support that skill, or skills may take a long time to develop. In this case it was concluded that the best intervention was to consider a placement for him in an appropriate environment that would cater for his ASD and ID related needs. Comments were made about the quality of assessments and for improvements to be considered to formulation and intervention. Chapter Three Chapter three was a critique of the WAIS, a tool widely used as part of the process to identify whether someone has an ID. This may determine if an individual may be unfit to plead in court or to determine the services appropriate for that individual’s needs. The review focussed on the most recent version, WAIS-IV (Wechsler, 2008a, 2008b, 2008c) but also referred to other versions in particular the WAIS-III (Wechsler, 1997). The conclusion was there were some flaws to the assessments that required further research and also some omissions in the epistemology. The critique examined different aspects of validity and reliability. The examination of convergent validity yielded mixed results with some positive correlations with other tests and some weak correlations. This difference could be caused by some tests measuring different aspects of ‘g’. The consequences of differences can be significant, for example the scores of the Wechsler Intelligence Scale for Children, version 4 (WISC-IV) (Wechsler, 2003) and the WAIS-IV scores could differ by up to 10 points and could mean individuals moving from a children’s to an adult service could become ineligible for the same levels of support. The results for test-retest reliability were good in the short term but more research was recommended to determine if the latest version of the WAIS would be reliable in the long term. The ‘Flynn effect’ (Flynn, 2007) indicated that levels of intelligence were rising so the WAIS-IV compensated for this and currently measures intelligence at around 3 points lower than the WAIS-III. The stability of this effect was unclear. The results for internal reliability were good although more research independent of the WAIS was recommended. The application of the WAIS for individuals with an ASD and ID was considered with the WAIS being found to be a limited tool for discriminating between categories of ASD, although what can be expected is an uneven profile. It was also unclear how useful the WAIS was to discriminate between individuals with a substance misuse/abuse disorder and normal controls. There were also difficulties with the application of the WAIS to individuals with ID. Difficulties measuring intelligence at lower levels were identified as scores can be unstable. Research was also recommended to provide a comprehensive view of the effect upon results of variables such as nationality, gender and age. Chapter Four Chapter four was an empirical research project investigating Weiner’s (1985, 1993) theory of achievement, motivation and emotion as a means of understanding the responses of unqualified nursing staff to clients with ASD exhibiting CB. One hundred and twenty seven unqualified nursing staff responded to an Attributional Style Questionnaire (ASQ) (Dagnan & Cairns, 2004) and questions based on a vignette. The quantitative results found weak support for Weiner’s model. There was weak evidence for the effect of demographic variables and the type of client (ASD or ID) and the type of service (ASD or Mental Health/ID) did not affect the results. Qualitative data was themed and coded according to Braun and Clarke (2006) and Boyatzis (1998) and provided an insight into the psychological processes influencing staff responses to CB. The results suggested that intervention was influenced by staff, patient and contextual variables. A recommendation was made for a contemporary exploration of the topic and to improve the validity and reliability of the ASQ. Chapter Five Chapter five was a systematic review of psychotherapeutic interventions aimed at reducing the CB exhibited by people with ID only due to a paucity of research using people with ASD as participants. A systematic literature search was conducted using 5 databases, a search of relevant journals and contact made with experts. From this 8 papers met the inclusion/exclusion criteria and these were analysed qualitatively. Three types of psychotherapeutic intervention were used within the ten papers, Cognitive Behavioural Therapy (CBT), “Soles of the Feet” meditation and Solution-Focussed Brief Therapy. All types of psychotherapeutic intervention reduced CB although the results of studies using CBT were mixed. There were shortcomings to these conclusions; these were methodological issues such as a need to ensure the consistency of outcome measures and the types of CB used to measure change. The effect of intervention may have been modified by variables such as length of treatment, the context and intrapersonal variables. Conclusions The chapters of this research thesis indicated that neurodevelopmental factors influenced forensic/CB, although social role models, attachment and trauma were also significant. Assessments were important as they may affect fitness to plead and services/treatment offered. Assessments such as the WAIS are supported by research although further research has been recommended. The use of the WAIS with people with ASD and ID was limited as people with ASD appear to exhibit uneven profiles when completing the WAIS and there were inaccuracies when using the WAIS with people with lower levels of intelligence. The difficulties people with ASD have with social communication skills can also affect performance and support is needed when administering assessments. Intervention for people with a neurodevelopmental difficulty can also be successful. Consideration is needed regarding appropriate intervention for each individual, how long before the intervention is effective, the context including the type of support offered and how that affects outcomes, intrapersonal variables such as intelligence, and whether the treatment includes one to one support. More research of an improved quality is required to determine the effectiveness of both assessment and treatment including contextual based treatment such as the interaction between staff and patients within an institutional setting. Considering these further would improve the service for this client group and contribute to a reduction of risk.

Abstract The primary aim of the current study was to examine social anxiety symptoms in high-functioning children and adolescents, ages eight to 17 years old with autism (HFA) or Asperger syndrome (AS). The second aim was to study emotion recognition skills in children and adolescents with HFA/AS. In addition, two internationally used social anxiety questionnaires (The Social Phobia and Anxiety Inventory for Children and; The Social Anxiety Scale for Children -revised) were translated into Finnish, and psychometric analyses were performed in order assess the research and clinical utility of these measures as novel tools for the study of child social anxiety in Finland. Results suggest that adolescents, in particular, with HFA/AS experience a greater number of social anxiety symptoms and have increased rates of clinically relevant social anxiety disorder (SAD) than do their control counterparts. Parents reported higher levels of anxiety symptoms in their children with HFA/AS regardless of the child’s age; however, individuals with HFA/AS self-reported anxiety symptoms increased later in their development (i.e., adolescence). In addition, overall facial emotion recognition increased with age in the HFA/AS group. Despite this, the HFA/AS group did not reach the higher ability level attained by the typically developing adolescents regardless of age. Specifically, when the facial emotion expressed a combination of both surprise and fear, participants with HFA/AS labelled the facial expression as “fear” statistically significantly more often than did controls. Moreover, control participants interpreted faces which blended sadness and neutral emotions as neutral more often than HFA/AS participants. Results suggest that social anxiety is clinically important to assess in children and adolescents with HFA/AS. Clinical interventions which enhance emotion recognition skills and reduce social anxiety symptoms in individuals with HFA/AS may be warranted
Tiivistelmä Tutkimuksen päätarkoituksena oli selvittää sosiaalista ahdistuneisuutta 8–17-vuotiailla hyvätasoisilla lapsilla ja nuorilla, joilla on autismi (HFA) tai Aspergerin oireyhtymä (AS). Tutkimuksen toinen tarkoitus oli selvittää, miten HFA- ja AS-lapset ja nuoret kykenevät tunnistamaan tunteita kasvonilmeistä. Tutkimus arvioi myös kahden kansainvälisesti tunnetun, sosiaalista ahdistuneisuutta mittaavan kyselylomakkeen (The Social Phobia and Anxiety Inventory for Children ja The Social Anxiety Scale for Children -revised) toimivuutta suomalaisessa väestössä. Tavoitteena oli antaa uusia työvälineitä suomalaiselle lastenpsykiatrialle tutkimus- ja kliiniseen työhön. Tutkimustulokset osoittivat HFA- ja AS-nuorten kokevan muita nuoria useammin sosiaalista ahdistuneisuutta. Vanhemmat havaitsevat HFA- ja AS-lastensa sosiaalisen ahdistuneisuuden oireet lapsen iästä riippumatta, kun lapset itse kertoivat oireistaan vasta nuoruusiässä. Tutkimus osoitti myös, että HFA:ta tai AS:ää sairastavien kyky tunnistaa tunteita paranee iän myötä. Se ei kuitenkaan saavuta tavalliseen tapaan kehittyvien lasten taitotasoa nuoruusikään mennessä. HFA- ja AS-lapset ja nuoret tulkitsevat ikätovereitaan useammin kasvojen ilmeen peloksi silloin, kun kasvojenilme on sekoitus pelko-yllättyneisyyttä. Tavalliseen tapaan kehittyneet lapset ja nuoret tulkitsevat kasvojenilmeen useammin neutraaliksi kuin HFA tai AS diagnoosin saaneet, jos kasvojenilme on sekoitus surullinen-neutraalia. Tutkimustulosten perusteella tulee HFA:ta tai AS:ää sairastavia lapsia ja nuoria hoidettaessa ottaa huomioon sosiaalinen ahdistuneisuus. Heille tulisi nykyistä useammin tarjota tilaisuus myös kuntouttaa kykyä tunnistaa toisten ihmisten tunteita

Unusual Sensory Experiences (USEs) are a significant and common issue in Autism Spectrum Disorders (ASDs). People may be over- or under-sensitive to sensory information in any of the sensory domains. These expenences can seriously affect people's lives, causing distress and correlating with impairments in a number of areas of functioning. These experiences have received relatively little attention in research into ASDs. The first paper reviews the literature from the last ten years for treatments for USEs and their sequelae. Results indicate that risperidone and massage therapy can be validly shown to reduce the severity of the USEs and their effects in other areas of functioning. The other treatments have equivocal or inconclusive results and so require more research. In the second paper nine adults with Asperger Syndrome (AS) were interviewed about how their USEs have affected their lives. Results indicated that these experiences had powerful effects in many areas of their internal and social worlds. The experiences could be distressing often leading to escape and subsequent avoidance of certain situations. They could cause rejection from other people. These experiences could therefore often lead to the person with AS becoming extremely isolated. Other experiences could be fascinating and lead to specific sensory abilities which if nurtured could be utilised in jobs or pursuits. These results give evidence for the central role USEs can have in many areas of functioning for people with ASD. Implications for services and future research are discussed.

Master of Science
Department of Architectural Engineering and Construction Science
Raphael A. Yunk
Autism Spectrum Disorders, (ASD) are being diagnosed at an alarming rate. Students with ASD face many challenges in educational environments and struggle to overcome daily distractions. Students with ASD have variances in neuron connections that cause them to receive and understand their environment differently than a student without special needs. In the educational classrooms, fluorescent lighting is a significant source of extraneous stimuli that not only a source of annoyance but can also trigger common symptoms of ASD. Fluorescent fixtures economically provide an acceptable uniformity and quality of illumination, but also have disadvantages that can aggravate symptoms in students with ASD. Ballasts are required for the operation of fluorescent fixtures. These ballasts, especially if not replaced at the end of their usable life, can generate an audible hum and cyclical flickering of light. Alternative light sources, such as incandescent lamps and fixtures should be evaluated and installed not only in special needs classrooms but standard group classrooms as well. Providing additional sources or quality sources of light may help students with ASD focus on the information presented in the classroom. Traditional classroom design needs to be re-evaluated to accommodate the needs of those students with ASD to better provide a comfortable and less distracting learning environment. It is difficult to establish rigid standards for lighting designs sensitive to individuals and special needs occupants'. By understanding the symptoms of ASD and taking into account the occupants needs lighting designers will be better able to design an environment that is both comfortable and educational. This report will address the classroom environment and student considerations in order to develop parameters and design practices that will assist new lighting designers.

This thesis contains a systematic literature review, and an exploratory research study. Studies exploring how parents had experienced the process of seeking an autism spectrum disorder (ASD) diagnosis for their child were reviewed (N=28). These indicated that many parents have dissatisfying experiences due to delays, disrespectful interactions with professionals, and a paucity of information. There are issues surrounding clear clinical pathways and communication between services which cause delays in diagnosis and accessing subsequent services. The research study explored the heterogeneity of behavioural presentations in ASD. Participants were 42 children aged 5 to 17 (25 with ASD and 17 typically developing). Participants contributed demographic, behavioural, cognitive, and neurological data which were explored through cluster and descriptive statistical analyses. The three emergent clusters were strongly influenced by cognitive ability, but also demonstrated a continuum of behavioural presentations and physical and developmental health, with one cluster representing a typically developing group, one representing high-functioning ASD, and one representing low functioning ASD. In contrast to previous research, there were no associations with alpha frontal power recorded with EEG. The social subtypes of ASD identified by Wing and Gould (1979) were strongly correlated with cognitive ability and severity of symptoms. Overall this research indicates the need to continue improving the diagnosis of ASD. The heterogeneity in symptoms of ASD could be one reason why the diagnostic process is long and complex, and should be explored further. Future research should consider cognitive and behavioural

The accurate integration of audio-visual emotion cues is critical for social interactions and requires efficient processing of facial cues. Gaze behavior of typically developing (TD) individuals and individuals with autism spectrum disorders (ASD) was measured via eye-tracking during the perception of dynamic audio-visual emotion (DAVE) stimuli. This study provides information about the regions of the face sampled during an emotion perception task that is relatively more complex than those used in previous studies, providing both bimodal (auditory and visual) and dynamic (biological motion) cues. Results indicated that the ASD group was less accurate at emotion detection and demonstrated less of a visual-affective bias than TD individuals. Both groups displayed similar fixation patterns across regions during the perception of congruent audio-visual stimuli. However, between-group analyses revealed that fixation patterns differed significantly by facial regions during the perception of both congruent and incongruent movies together. In addition, fixation duration to critical regions (i.e., face, core, eyes) was negatively correlated with measures of ASD symptomatology and social impairment. Findings suggest weaknesses in the early integration of audio-visual information, automatic perception of emotion, and efficient detection of affective conflict in individuals with ASD. Implications for future research and social skills intervention programs are discussed.