Objective: To investigate mothers’ experiences in raising a child with suspected high functioning autism or Asperger’s syndrome while trying to get a diagnosis for their child, specifically focusing on stress and health-related quality of life. Mothers who already have a diagnosis for their child acted as a comparison group. Method: A cross-sectional mixed methods approach was applied. The Parenting Stress Index Short Form (PSI/SF), the 12 Item Short-Form Health Survey (SF12) and a demographic questionnaire was administered to a convenience sample of 40 mothers in the experimental group and 44 in the comparison group, all of whom resided in the UK. Qualitative semi-structured interviews with a sample of 4 mothers in each group followed to expand on those findings; data was analysed using thematic analysis. Results: Although both groups displayed clinically high mean scores for all the PSI/SF subscales and overall stress, the experimental group displayed significantly higher scores in the Parenting Stress and Difficult Child subscales and overall stress scores. The experimental group scored significantly worse in the Mental Component Summary scores of the Health Survey than the comparison group, indicating poorer mental-health related quality of life. The interviews, which discussed mother’s experiences of raising their child, the diagnostic process and its implications, also supported the quantitative findings. Implications: This study highlights the health and mental health implications on the large population of mothers seeking diagnoses of autism for their children. This population group is largely neglected in the literature. This brings into focus areas where further in-depth research and development of support systems for this population would potentially benefit these parents, specifically in terms of health related quality of life and it supports the drive by the National Autistic Society for earlier diagnoses and more efficient diagnostic processes.

Autism is diagnosed according to three core impairments; communication, socialisation and imagination. Imagination deficits have typically received less attention in the literature than communication and socialisation, with difficulties often inferred from impoverished capacities for pretence. The aim of the thesis was to investigate the nature of the imagination deficit in children with high functioning autism utilising a new methodology; storytelling. Employing a storytelling methodology, which is argued to be a naturalistic and supportive research tool, the thesis explored the ability of children with autism to engage in imaginative storytelling as compared to a verbal and chronological age individually matched control group.

Interest in the role of the gastrointestinal (GI) microbiota on host health has exponentially increased in recent years, with the microbiome now considered a major organ that can have systematic effects. This has included hypotheses and subsequent studies of possible roles of the GI micro biota in autistic spectrum disorders (ASD). Previous data demonstrated differences in the faecal microbiota of ASD and non-ASD children, particularly within the Clostridium populations (most notably Clostridium clusters I and II). The primary objective of this work was to investigate the diversity and dynamics of the anaerobic faecal spore-forming bacteria (including Clostridium) associated with ASD using a range of enrichment methods. Twenty-two faecal samples were collected from 11 subjects (5 ASD, 3 non-ASD siblings and 3 unrelated non-ASD children), yielding 2340 isolates - 1286 'biotypes' comprising 109 species (60 of which were non spore-formers) from anaerobic cultivation across 8 enrichment methods (aerobic dessication, anaerobic dessication, heat and ethanol treatments of faecal samples, each cultured on Fastidious anaerobe agar and Reinforced clostridial agar). All enrichment methods contributed to the anerobic sporeformer diversity, with temporal stability for some biotypes demonstrated whilst others fluctuated from sample to sample. Biotype specificity was also found among commonly isolated anaerobic spore-formers for the ability to utilize tryptophan and/or phenylalanine. Multiple antibiotic resistance was also common, with more than 50 % of common Clostridium biotypes showing resistance to vancomycin (both ASD and non-ASD isolates). Aerobic cultivation of 7 of the faecal samples (4 ASD and 1 non-ASD subjects; all four treatments) on Tryptone soya agar isolated 180 'biotypes' (446 isolates) including 62 spore-former species (46 Bocillioceoce species, 12 Paenibacillaceae species, 3 Clostridium species and Rummeliibacillus pycnus). Whilst heat treatment gave the greatest diversity of Bacillus, all treatments again contributed to the overall diversity recovered. This is the first study of aerobic spore-formers harboured by ASD children. The diversity of anaerobic and aerobic spore-formers described herein extends our knowledge of these populations within the GI microbiota of ASD and non-ASD children, and demonstrated that employment of multiple enrichment methods is required to maximise the recovery of sporeformer diversity within such complex microbial ecosystems. The Clostridium data corroborates previously published findings regarding distinctions in the Clostridium populations of ASD and non-ASD cohorts (particularly Clostridium clusters I and II). The extensive collection of Clostridium biotypes obtained from the anaerobic spore-former work is an invaluable resource that could be applied to develop and/or validate molecular-based techniques for future studies examining the diversity, dynamics and relative abundance of Clostridium populations at subspecies levels. The resource could also be used for phenotypic and/or functional studies (including metabolomics) of faecal bacteria. Design and method development of a statistically powered feeding study investigating the effects of L. plantarum WCFSI on GI symptoms and faecal microbiota in ASD

Five experiments investigated the importance of attentional and social cues in word learning, the relationship between word learning and theory of mind (ToM), methods that might promote performance on ToM tasks in children with autism spectrum disorders (ASD), and children's understanding of deception. The experiments included groups of typically developing children aged between 2- and 5-years, and high functioning children with ASD. Experiments 1 and 2 replicated a study by Akhtar and colleagues (1996) to investigate the role of 'object salience' and discourse novelty' in word learning. These studies showed that children tend to use saliency cues to infer word meaning in the absence of social cues, but attend to the latter when these are available. This was true for both populations, indicating that children with ASD can develop rather advanced skills in language and social cognition following interventions. Experiments 3 and 4 implemented novel ToM tasks focussing attention on the objects or the colours used within the task. Children had to infer intention through the act of choosing. They were also either taught or not taught the names for the test objects', Performance improved in both groups with knowledge of relevant labels, but especially in the ASD group when the most salient feature within the games was colour. Focusing attention on colour within learning contexts might motivate children with ASD to follow, understand and perform on a learning task. Experiment 5 was an exploratory study looking at children's understanding of deception when the contextual cues are perceptual, social, or verbal. The results are discussed in light of the relative importance of these cues in the assessment of ToM abilities in children.

No description available.

Broadening of the original concept of theory of mind has been necessary to more accurately reflect the social complexity involved in arriving at an understanding of others' minds. However, such expansion has primarily focused on developmental mechanisms, whereas the issue of what social understanding actually encompasses has been relatively neglected. In an effort to dispel the resulting ambiguity which surrounds this latter aspect, this thesis pursued clarification of the potential constituents to children's social understanding in typical development and autism. Part 1 of the thesis required methodological enterprise as a prelude to the more theoretically driven focus outlined in Part 2 in order to first verify the subsequent use of valid and comprehensive measures of social cognition. Part 2 delved into the issue of: "What are the constituents of children’s social understanding?" adopting the theoretical framework offered by Tager-Flusberg and Joseph (2005) to guide our exploration of the constituents - social cognition, social perception, social attention, and language - and the possible continuity of paths between them. Contrary to expectation, no link was found between social-perceptual and social-cognitive abilities in 4- to 6-year-olds. However, a subsequent study of a much larger group of typically developing 4- to 5-year-olds was sufficiently broad to enable structural equation modelling of relationships between these constructs and constructs of social attention and language. These analyses revealed well- differentiated constituents of social understanding and directed us to a new model of social understanding in which language abilities were integral to the relationship between social perception and social cognition. Also, this new model suggested that the continuity between these three constructs was quite distinct from a lower-level construct encompassing joint attention and orienting abilities. The final experimental chapter then examined these findings in the context of autism - findings indicated that children with autism performed significantly less well than language-matched typical children within the domain of social attention but performed comparatively well within the social-perceptual construct. However, unlike typical children, neither this lack of a significant social-perceptual impairment nor language matching was sufficient to lead to social-cognitive success for children with autism. This substantiates the view that children with autism may only arrive at social-cognitive understanding by certain aspects of language, such as syntactic comprehension. The thesis findings underline the importance for social understanding research - in an ever-expanding field - to embrace apparent important distinctions between inherently different constituents of social understanding. Implications for future research and theoretical considerations are discussed.

The rationale for this study was based on the paucity of current literature about adolescents whose siblings have autism spectrum conditions (ASCs). This sparse research has revealed mixed results, some of which appears to suggest that there may be negative psychosocial outcomes for adolescents whose siblings have ASCs, and some of which indicates that these adolescents are able to adjust relatively well. Furthermore, most of the limited literature around the adaptation of adolescents whose siblings have ASCs is quantitative in its methodology. This study proposed the use of qualitative methodology to discover what experiences adolescents could reveal about having a sibling with ASCs and how these experiences might impact on these adolescents’ psychosocial adjustment. There were four main aims of the study: (1) to explore the experiences of adolescents whose siblings have ASCs; (2) to explore how these experiences might impact on these adolescents’ psychosocial adjustment; (3) to assess for possible implications for service delivery; (4) to generate a theoretical account of the pertinent factors influencing adolescent psychosocial adjustment, with a view to identifying possible areas for future research. Photo elicitation methodology was used to help gather data alongside semi-structured interviews conducted with 11 adolescents between the ages 12-18 years whose siblings were diagnosed with ASCs. Grounded theory was employed to analyse the data. Four main themes were identified from the data: experiencing ASCs in daily life; adolescent psychological factors; social impact of ASCs on interpersonal relationships; adolescents’ perceptions of siblings with ASCs. From these themes, a theoretical model was developed to demonstrate what adolescents identify from their subjective experiences as being crucial factors for adaptive psychosocial adjustment to living with a sibling with ASCs. The initial conclusions illustrated by the theoretical model suggest that adolescents feel most able to cope with and adjust psychosocially to living with a child with ASCs when they experience open and collaborative channels of communication with parents; supportive social networks that include friends, peers, family, extended family; positive perceptions of their siblings, including realistic hopes for their siblings’ development; knowledge and understanding of ASCs and a perceived sense of self-efficacy in being able to manage their siblings in times of distress. Negative hypothesis testing was subsequently employed to assess the validity of the theoretical model. This scrutiny of the theoretical model highlighted the complexities relating to how each of the participant’s accounts fitted with the proposed model. In light of this, whilst the theoretical model derived from this study can be helpful for providing an overview for some of the factors that appear to feature in how adolescents adjust psychosocially to living with a sibling with ASCs, it is ambitious to claim anything beyond this given that there are any number of factors specific to an individual’s circumstances that will also influence how an adolescent adjusts psychosocially to living with a sibling with ASCs. This raises several clinical and research implications.

No description available.

No description available.

Cerebral Visual Impairment (CVI) is a brain-based visual processing disorder caused by abnormal development of, or damage to, the optic radiations, striate cortex, and peristriate areas (Soul & Matsuba, 2010). It is one of the leading causes of visual impairment in children. A wide spectrum of visual difficulties is described in children with CVI but there is only speculation about social behavioural outcomes, including autistic spectrum disorders. Results of a systematic review of studies of autism in children with congenital blindness suggest that a visual impairment places a child at greater risk of developing autism. The research question addressed in the present study is whether CVI (in the absence of major ocular disease) might be developmentally associated with features of autism. Using case series methodology, a cohort of nine children, age 5-15 years was selected with major risk factor for brain injury and a diagnosis of CVI, but without the presence of severe neurological disability. Parents were interviewed using the Diagnostic Interview for Social and Communication Disorders and each child participated in the Autism Diagnostic Observation Schedule. Information on visual behaviour was gathered using the CVI Question Inventory (Dutton et al 2010). All children in this case series emerged with some behavioural characteristics of autism. Using the standardised assessment protocols, 2 children reached the defined cut-off values for autism across both measures, and following adjustments for visual impairments, this was reduced to 1 child. This study suggests that children with CVI follow a range of developmental pathways, significantly influenced by their visual impairments such as abnormal face detection and poor perception of biological motion cues, the end points of which include some specific aspects of ASD (impaired gesture, face perception and imaginative play). These findings are discussed in relation to theories of social cognition and cognitive neuroscientific theories of social perception.