of an international consensus conference. Disability and Rehabilitation 34: 429-438. Fleming AR, Fairweather JS and Leahy MJ. (2013) Quality of Life As a Potential Rehabilitation Service Outcome: The Relationship Between Employment, Quality of Life, and Other Life Areas. Rehabilitation Counseling Bulletin 57: 9-22.
The first main theme we distinguished, “providing security”, is known from disability stud- ies, where quality aspects of participation are described as, “a sense of security as providing a foundation to pursue challenges and take risks in their lives” (p. 1450) [ 37 ]. The security function of parents has been widely confirmed [ 88 – 90 ], and it is often reported how the physical envi- ronment can hinder the participation of adolescents with ASD [ 91 , 92 ], whereas providing agency and control over the physical environment support it [ 93 , 94 ]. The third subtheme, that of “informational environments” is a novel one. Information affects the security perception of adolescents with ASD, as their ability to derive information from social contexts is reduced [ 95 ]. An information-sensitive environment can contribute to their sense of security by pro- viding different and more adapted information. According to the “reasonable person model” [ 30 , 31 ] people can respond more appropriately when their environments support their needs for meaningful, focused, and comprehensive information [ 39 , 40 ]. This allows cognitive map- ping, processing of information, and decision making, thus providing a sense of agency and control. This is suitable for adolescents with ASD, who require structure and predictability [ 96 , 97 ]. Used widely in the contexts of urban planning [ 98 , 99 ], this model is also used in fields like fatigue and violence reduction [ 100 ]. It might support interventions to improve the partic- ipation of adolescents with ASD like orientation and way-finding, building confidence and trust in relationships, or creating restorative places in schools and community settings. Proj- ects regarding architecture and design [ 101 ] and community services [ 102 ] offer encouraging examples in this respect.
According to the Occupational Therapy Practice Framework: Domain and Process (American Occupational Therapy Association [AOTA], 2014a), occupations are central to an individual’s identity and constitute any daily activities in which people engage. Case-Smith (2015) indicates that young children spend a considerable amount of time engaged in play, thus play is a child’s main occupation. Play is important to consider as an intervention tool to improve specific developmental skills and as an intervention goal to improve the occupation itself. Children with ASD typically show different play patterns and have difficulty with reciprocal interactions, which can have an adverse effect on occupational
The aim of this research was to compare alexithymia and personality factors in students with and without ASD. The results of the present research showed that student with ASD had higher alexithymia than student without ASD (P<0.001). The result of this study coin- cided with previous studies [16, 17]. Alexithymia is marked by the low ability to experience, name, and express emotions of anybody. Alexithymic individuals with ASD cannot express their emotions or distinguish the emotions from the face. They do not have the sym- pathy for others, and have problem in their commu- nication with others . Alexithymia is challenging for individuals with ASD as they lack of imagination and emotion . ASD individuals with high level of alexithymia needs more attention towards their physi- cal sensitivity rather than psychiatric problems .
mother (Kanner, 1943). Kanner’s theory was later popularised by Bruno Bettelheim in the 1950s who also theorised autism’s origin rested with ‘Refrigerator Mothers’ or mothers who maintained an emotional isolation from the child (Silverman & Brosco, 2007; Yazbac 2003; Marohn, 2002). At this time, ASD was interpreted in classic Freudian terms as a syndrome of ego damage that resulted from unconscious parental rejection (Silverman & Brosco, 2007). Because of the implication of the mother in the cause of ASD, it was believed that the child should be removed from the parent’s care and placed in an environment that provided the necessary warmth (Bettelheim, 1972). As Laidler (2004) pointed out, the ‘refrigerator mothers’ theory failed to take into account the fact that in the same families, there were other siblings who received the same parental treatment, who remained unaffected. Bettelheim committed suicide at the age of 86 in 1990 (Pollak, 1997). However, the impacts of his work and perspectives continued to effect families for years to come. It was later thought that autism was childhood schizophrenia because of commonalities that existed between the two.
Of importance is the approach that study authors take to the diagnosis of ASD. We intend to report on the method used for diagnosis. We recognise that some studies will diagnose subjects with ASD using a clearly defined diagnostic process or a tool administered by an appropriate person, with wide clinical acceptance. This approach recognises that while multidisciplinary clinical team assessment is the best practice for ASD diagnosis, some tools have acceptable accuracy for diagnosis for research. As such, some studies will determine the pres- ence or absence of ASD using the best practice clinical assessment and apply an appropriate classification sys- tem at the time the study was done, with DSM criteria (III/IV/V) or (ICD-9/10). In accordance with the current DSM-V recommendations, studies that have classified children as “autistic disorder”, “Asperger’s disorder” or “ pervasive developmental disorder not otherwise speci- fied ” will be given the diagnosis of autismspectrum dis- order. Other studies may use the Autism Diagnostic Observation Scale (any version) or Autism Diagnostic Interview (original or revised) to make a diagnosis.
offer additional provision to that being offered within a local authority. New School Network (2015) state that the free school programme created 2000 places in specialist provision for children with ASD. These new schools have often been established by groups of parents and charities such as the NAS and Ambitious about Autism. It is possible that this is a reflection of the negative experiences of families in maintaining a mainstream placement for these students. Whilst there have been a range of views around the efficacy of provision offered in secondary education, there also appears to be a lack of information that monitors what form of education is being accessed by pupils on the autismspectrum during the secondary phase of their schooling. Barnard et al. (2002) reported that there are discrepancies between the number of pupils diagnosed with an ASD in primary education and those in secondary education. Whilst some of these pupils could move into specialist provision, Barnard et al. (2002) propose that there could be a significant number of children who are missing out on secondary education, calling for more research to establish what is happening at this stage.
Mattila et al., 2011). This differential diagnosis has led to an expanding body of research evaluating sex differences in autism. Understanding sex differences in more detail is important for unpacking the complex aetiology of autism (Rutter et al., 2003). An evaluation of the research to date reveals a number of inconsistencies in the clinical autism phenotype across males and females. some studies have indicated that autistic females display more severe social and communication difficulties compared to autistic males (Hartley and Sikora, 2009), while others have indicated that these difficulties are less severe in autistic women (McLennan et al., 1993), or report no sex differences (Wilson et al., 2016). Some studies suggest that autistic males show more stereotyped and repetitive behaviours than females ( Hattier et al., 2011; Van Wijngaarden-Cremers et al., 2014) and that females on the spectrum display more socially acceptable special interests (Gould and Ashton-Smith, 2011). However, others argue that these interests and behaviours are similar across sex (Harrop et al., 2015). It has also been suggested that in order to receive a diagnosis, women are required to display more impairment in functioning than men (Dworzynski et al., 2012), yet other studies fail to confirm these findings when controlling for IQ (Holtmann et al., 2007; Pilowsky et al., 1998).
Stability and reliability of diagnosis. Recent studies have demonstrated that a diagnosis of ASD at the age of 2 years is stable over time and reliable across clinicians (e.g., Cox et al., 1999; Lord, 1995; Kleinman et al., 2008; Moore & Goodson, 2003; Stone et al., 1999; Turner et al., 2006). Cox et al. (1999) examined the stability of the Autism Diagnostic Interview-Revised (ADI-R; Lord, Rutter, & Le Couteur, 1994) and clinical diagnosis in a sample of 50 prospectively assessed children at 20 months and 42 months of age. Closely linked to ICD-10 and the DSM-IV criteria, the ADI-R is a clinician administered, semi-structured parent interview evaluating communication, social development, play, and restricted, repetitive, and stereotyped behaviour (Lord et al., 1994). The ADI-R provides a classification of either Autistic Disorder or non-autistic; it does not provide a classification for any other sub-type (e.g., PDD.NOS) (Pandey et al., 2008). Cox et al. (1999) found that all the children classified with Autistic Disorder using the ADI-R at 20 months of age went on to receive a diagnosis of Autistic Disorder or another Pervasive Development Disorder at 42 months (Cox et al., 1999)
what she does each year, by taking notes of what works and what doesn’t. She’s pleased with the money she’s earning as the business is growing each year and her plan is to come off tax credits etc altogether. Jenny thinks that what makes a good job is “being happy with your work. It has to something you enjoy doing. It has to be something that challenges you and stretches you but not so challenging you give up.” She gave the example of answering the phone, which she wouldn’t do previously, but now she’s beginning to. There have been 3 key aspects of support for Jenny: her family; her personal assistants funded by Direct Payments, who have been critical to what she has achieved; and the Princes Trust, who took her on “with all her baggage”, helped her start up and have continued to follow up with her to see that she can keep going. The Princes Trust was so impressed by her achievements that she won their New Business of the Year award for 2003. The best thing about having a job for Jenny is the potential for being independent and not having to rely on her family all the time, especially financially. She also likes the fact that she has learnt new skills and her job keeps her occupied. She gets out more as a result of her job: for example going to nurseries or Flower Shows. Having her PA’s to drive her places has helped a lot; a medical condition means she is not allowed to drive herself. She has got to know more people through her work. Earning money has enabled her to buy her own clothes and to make contributions to the household. Jenny’s dream job would be the head of a big garden chain with lots of money and she’d be swimming in the Caribbean! She is planning to have a house of her own and she and her family have already identified the site on part of their land. In the shorter term, her plans include thinking about getting a van or hatchback. Jenny’s path to her current position hasn’t been easy. She has clear ideas about help that other people might need. She believes employers need to be aware of people’s individual differences and to accommodate these. She sees it as an issue about attitude and awareness. Some employers would need a course in how to deal with employees with difficulties. As she said when talking about the woman she offered work experience to, “I know what it feels like. If no one will give people like me a chance, I will.”
As a neuro-developmental disorderautism is now burning issue not only for Bangladesh but also for whole world. However, very few researches had been completed about Autismspectrumdisorder (ASD) in Bangladesh till now. In this study researcher tried to find out some risk factors which might increase the level of autismspectrumdisorder. The study area was the selected areas of Sirajganj district in Bangladesh. In Sirajganj district Autismspectrumdisorder is more than other district as it is disaster prone area and people are unconscious about health problem. Cross sectional analytical study was followed for this study. In this study total 124 respondents selected through random sampling technique. Data collection was done by face to face interview to the parents of autistic child with semi-structured questionnaire. According to this study most of the autistic child age was below 10 years and mean age was 8.8 years. Among the entire autistic child 62% were male and 38% were female. Most of the autistic child family type was nuclear (90%). In this study, Most of the autistic child parents had 2 or less children. Number of children had negative association with level of autism. If, number of children increased level of autism decreased and number of children decreased then level of autism increased. Birth order also was significant factor for increased level of autism. It also had negative association with level of autism. That means level of autism increased for lower birth order or 1 st and
Abstract: Executive dysfunction has been shown to be a promising endophenotype in neurodevelopmental disorders such as autismspectrumdisorder (ASD) and attention-deficit/ hyperactivity disorder (ADHD). This article reviewed 26 studies that examined executive function comparing ASD and/or ADHD children. In light of findings from this review, the ASD + ADHD group appears to share impairment in both flexibility and planning with the ASD group, while it shares the response inhibition deficit with the ADHD group. Conversely, deficit in attention, working memory, preparatory processes, fluency, and concept formation does not appear to be distinctive in discriminating from ASD, ADHD, or ASD + ADHD group. On the basis of neurocognitive endophenotype, the common co-occurrence of executive func- tion deficits seems to reflect an additive comorbidity, rather than a separate condition with distinct impairments.
Our review suggests employment patterns may be different dependent on the phase of the disorder with rates being highest early in illness course. Damage to employment outcome appears to accumulate over time and the more episodes people have. The onset and early course of bipolar occurs most typically in youth and early adulthood, a period when work is first obtained. Bipolar episodes which prevent a job history being developed may leave a long lasting effect, which accrues over time, given that previous employment is strongly correlated to future work (39). Education is an additional predictor of future employment in bipolar disorder (42) and its disruption in youth due to illness may also compound the direct effects of mood episodes. These findings as well as the cognitive decline associated with mood episodes (37) would support the extension of the early intervention paradigm to bipolar disorder. Service configurations and stage specific treatments require further research but one particular success of early intervention in psychosis has been vocational recovery (43) and hence it is worth considering whether this success can be replicated in bipolar disorder.
Reciprocal influence is an essential aspect of social be- havior: individuals are influenced by others in their beliefs and preferences . An essential element of this influence is mimetic desire (MD), which is the tendency to pursue goals pursued by others . As an example, children often run after the same toy, even if other identical toys are available. MD is crucial for non-verbally sharing information about values (i.e., whether objects present in the environment are good or bad) without wasting time on trial-and-error learn- ing and might therefore shape preferences during development. Two lines of reasoning led us to hypothesize that MD may be dysfunctional in autismspectrumdisorder (ASD).
We also have readings of previous ATECs six months prior to homeopathic interven- tion. Some children were receiving regular traditional therapies but none of them re- ceived homeopathic medicines. When we examined the profile of some children in the previous six months, we could see that there were some children who were not doing well. Many of them showed deterio- ration in their autistic features. In some cases, special educators specifically re- quested us to examine and help these ex- tremely hyperactive children, to whom they could not give any special input. After homeopathic intervention, we could see the graph drastically changing. This was true for mild, moderate as well as severe autism. Homeopathic intervention brought about significant relief in autism and we could certainly see a reversal in scores. The study was extensive enough to include children of both sexes as well as being evenly distributed in age groups. It covered the entire range of autism – mild, moderate and severe (Fig. 3) – while from the stand- point of cognitive ability we had a sufficient number of children who were high func- tioning as well as enough with mental re- tardation (Table 3).
participants expressed emotional, financial, or social challenges navigating the complex ASD-related service system. This led many to feel they had to personally advocate for their child to receive adequate services. These efforts required extensive time and energy on the part of all the parents we interviewed. Many participants described adjusting their work schedules or leaving their jobs to accommodate the new responsibilities associated with their child’s care. Others described moving to cities or school districts that had more reliable resources. Many also conveyed difficulty in gaining effective forms of personal and medical support during this period, including childcare and individual therapy. Although our sample was not varied enough to account for differences by education or socioeconomic status, reflected in this theme are experiences that are likely to be impacted by these factors. Even after parents secured services for their children, many felt they needed to remain vigilant to keep those resources in place, especially during school and life transitions. Many of our participants described challenges navigating the systems related to autism care while juggling other responsibilities. One mother explained feeling overwhelmed after her daughter’s ASD diagnosis, stating: I have to do everything, so I have to work, I have to take care of my daughter, I have to talk to all these people to get all these assessments and appointments. Sometimes, I forget some of these appointments because there are so many appointments.
However, the research examined in this critical review provide compelling evidence for neurodegeneration as the underlying mechanism for the loss of neurological func- tion in individuals diagnosed with an ASD who have regressed and lost previously acquired skills and abilities. As with other neurodegenerative diseases, the evidence of neurodegeneration in the brain in ASD includes: (1) neu- ronal cell loss, (2) activated microglia and astrocytes, (3) proinflammatory cytokines, (4) oxidative stress, and (5) el- evated 8-oxo-guanosine levels. In addition, areas of the brain that have shown evidence of neurodegeneration cor- relate to areas known to be affected in ASD, including areas of speech and socialization.
Not unique to ASD but of interest diagnostically because it highlights special targets of treatment that further explains the features of the disorder in a particular patient are associated features (Volkmar et al. 2014). Associated features can be differen- tiated from comorbid disorders as they are aspects that are not uncommon but in and of themselves not disease states. Some associated features that have needed re- sponses from the care delivery system include poor receptive language, and uneven IQ scores. These two deficits will need to be addressed especially in educational settings. Listing them alerts the school that special services will be necessary. A dif- ferent intervention perhaps led by occupational or physical therapists may be neces- sary to work with motor deficits such as hypotonia or toe walking. Therefore, within the diagnostic language, these associated features could be mentioned. Finally, a behavior that influences quality of life, and perhaps impacts the restrictiveness of a community placement is self-injury. Listing this behavior as an associated feature should marshal the behavioral and medical resources that influence this problem.
Limitations. While addressing a number of issues in previous research, the present study has a number of its own limitations which must be addressed. First, the present study provided a relatively small sample of adults with ASD. It is also worth noting that the efforts involved in gaining this small sample meant it was unlikely a well-matched non-ASD group could also have been recruited within a suitable timeframe. A matched non-ASD group could have provided a useful comparison to establish the extent to which executive function and mental health difficulties impair everyday activities for adults with ASD and to also compare how scores would have been affected by repeated testing on these particular measures at the time scale used in the study. Also, the length of time in employment was very short for some participants. For example, one participant spent only eight days in employment and, together with the small sample size, meant it was unlikely that differences were found at the group analysis level post- compared to pre- employment. However, the study has provided a highly rich dataset for both before and after employment and the longitudinal approach allowed for a more detailed level of analysis over multiple time points. The sample size also reflects the low numbers of adults with ASD who are offered employment (Rosenblatt, 2008). Adults with ASD may need additional support to gain and maintain employment and relatively few autism and employment services exist. This meant the number of participants was low in this study in spite of the intense and extensive recruitment approach.
Autismspectrumdisorder (ASD) is characterized by impairments in social interaction, communication, and behavior as well as sensory challenges. Substantial evidence supports benefits of specific behavioral, educational, and some pharmacologic interventions for children with ASD. However, given the limits of available treatments in improving core and associated ASD symptoms, substantial resource challenges in accessing evidence- based treatment approaches, and perceptions regarding lessened risks of treatment, many families, if not a majority of families, pursue dietary and nutritional approaches as components of treatment. 1 – 11 Given