京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第18203号 / 人健博第20号 / 新制||人健||2(附属図書館) / 31061 / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 三谷 章, 教授 精山 明敏, 教授 髙橋 良輔 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

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Pivotal Response Training (PRT) is an intervention that was originally developed by Koegel & Koegel (2006) that teaches pivotal behaviors to children with Autism Spectrum Disorder (ASD). Research places a significant emphasis on teaching parents and other caregivers to implement these procedures with their children. However, PRT is often implemented and trained with wide variability. The purpose of this literature review was to critically review the literature on parent-implemented PRT and evaluated the issues identified within the literature. A multiple step search procedure is conducted for this literature review and eighteen articles were selected based on the inclusionary criteria. Results of the review identify trends in the current literature of how parents have been trained to implemented PRT. This review also highlights the need for future research on parent implemented PRT to assess parent’s treatment integrity once initial competency with the PRT intervention has been met, and the need for future research to focus on assessing social validity in several ways. / Applied Behavioral Analysis

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Individuals with autism spectrum disorder (ASD) have difficulties in many areas of social cognition including face perception. Decades of research examining face processing abilities in ASD populations have yielded equivocal results. The current thesis includes a series of experiments intended to clarify the nature of the face processing deficits seen in ASD. In Study 1 I examined norm-based coding of facial identity in adults with ASD. I measured identity aftereffects in adults with and without ASD and found no significant group differences. In Study 2 I examined simple (Experiment 1) and opposing (Experiment 2) figural aftereffects for male and female faces and found no significant group differences as adults with ASD. In Study 3 I examined perceptual strategies employed by adults with ASD when processing emotional facial expressions and found that adults with ASD employ a rule-based strategy. Finally, in Study 4 I examined what drives face processing deficits in adults with ASD; deficits in processing emotional information in faces or a deficit in processing socially complex information in faces. I found that adults with ASD had a deficit in discriminating basic and complex emotional facial expressions, suggesting that emotion-perception demands are associated with poor face processing in ASD. The results of the studies demonstrate that adult with ASD show typical perceptual mechanisms underlying face perception, use an atypical perceptual strategies when processing facial expressions, and have a specific deficit in processing emotional expressions. / Thesis / Doctor of Philosophy (PhD)

Bakgrund Sömn är en förutsättning för en god hälsa och välbefinnande. Flertal individer med diagnosen autismspektrumtillstånd upplever någon form av sömnstörningar. Ett av sjuksköterskans professionella ansvar är att identifiera samt erbjuda individuella omvårdnadsåtgärder för att främja sömn. Konsekvenser av en otillräcklig sömn kan vara försämrade kärnsymtom hos individer med diagnosen autismspektrumtillstånd, negativ påverkan på hälsa och livskvaliteten samt resultera i onödiga vårdkostnader. Genom att identifiera omvårdnadsåtgärder om sömn relaterad till diagnosen autismspektrumtillstånd kan sjuksköterskan minska sömnstörningar och därmed främja sömn.  Syfte Syftet var att beskriva omvårdnadsåtgärder för att främja sömn för individer med autismspektrumtillstånd. Metod Denna icke-systematiska litteraturöversikt utfördes baserad på 19 vetenskapliga artiklar med både kvantitativ och kvalitativ design. Artiklarna inhämtades från databaserna PubMed och CINAHL under september och oktober 2021. Artiklarna kvalitetsgranskades utifrån Sophiahemmet Högskolas bedömningsunderlag. En integrerad analys utfördes där ett tema framkom med tillhörande tre subteman, vilket data sorterades in under.  Resultat I resultatet framkom ett tema, sömnhygien. Under temat beskrevs omvårdnadsåtgärder som främjade sömn hos individer med diagnosen autismspektrumtillstånd. Utifrån temat skapades tre subteman, sömninterventioner, utbildning och delaktighet. Resultatet påvisade även att anhöriga spelade en viktig roll i omvårdnaden för att främja sömn hos individer med diagnosen autismspektrumtillstånd.  Slutsats Omvårdnadsåtgärder innefattande olika sorters interventioner såsom fysisk aktivitet, rutiner samt hjälpmedel och utbildning var viktiga sömnbefrämjande faktorer för individer med diagnosen autismspektrumtillstånd. Det är även väsentligt att omvårdnadsåtgärderna är anpassade för att skapa ett sammanhang för den enskilda individen. Anhöriga spelade en stor roll som stöd i utförandet av omvårdnadsåtgärder. Individers delaktighet i sin vård framhölls som en viktig faktor för att minska sömnstörningar och därmed främja sömn. Förhoppningen är att den icke-systematiska litteraturöversikten kan bidra med mer kunskap för att främja sömn för individer med diagnosen autismspektrumtillstånd. / Background Sleep is a prerequisite for good health and well-being. Most individuals diagnosed with autism spectrum disorders experience some form of sleep disorder. One of the nurse's professional responsibilities is to identify and offer individual nursing measures to promote sleep. Consequences of insufficient sleep can be worsened core symptoms, negative impact on health and quality of life and result in unnecessary care costs. By identifying nursing care measures related to the diagnosis of autism spectrum disorder, the nurse can reduce sleep disorders and thus promote sleep.  Aim The purpose was to describe nursing interventions to promote sleep for individuals with autism spectrum disorders. Method This non-systematic literature review was performed based on 19 scientific articles with both quantitative and qualitative design. The articles were obtained from the databases PubMed and CINAHL in september och october 2021. The articles were quality reviewed from Sophiahemmet University's assessment basis. An integrated analysis was performed where a theme emerged with three sub-themes, wich the data were sorted under. Results  The result revealed a theme, sleep hygiene. The theme described nursing interventions that promoted sleep in individuals with diagnosed with autism spectrum disorders. Based on the theme, three subthemes were created, sleep interventions, education and participations. The results also showed that relatives played an important role in nursing to promote sleep in individuals with autism spectrum disorders. Conclusions  Nursing measures including various types of interventions such as physical activity, routines as well as aids and education were important sleep-promoting factors for individuals diagnosed with autism spectrum disorder. It was also essential that the nursing measures were adapted to create a context for the individual. Relatives played a major role in supporting the performance of nursing care. The individual's participation in their care is emphasized as an important factor in reducing sleep disorders and thereby promoting sleep. The hope is that the non-systematic literature review can contribute more knowledge to promote sleep for individuals diagnosed with autism spectrum disorders.