Sleep problems are common in children with ASD. Despite this, evidence for interventions, particularly alternative approaches such as weighted blankets is limited. Aims. The aims of the study were to examine weighted blankets for: (1) their effectiveness as an intervention for sleep problems; (2) their impact on sleep state organisation; (3) their impact on night-time movement; (4) the sensory characteristics of children responding to the intervention; (5) parent’s perceptions of the intervention; (6) behavioural interventions as a second intervention if required. Method. Using a non-concurrent multiple baseline design, five children with autism aged between 7 to 13 years received a weighted blanket intervention with the option of a secondary behavioural intervention. Results. One participant rejected the weighted blanket outright. Four participants showed no substantial improvements in sleep problems or changes in sleep state organisational. Despite this, parents of four participants still perceived the weighted blanket to be moderately effective. The sensory profiles of participants were not related to their response to the intervention. Participants’ night-time movements were not found to be suppressed by the weighted blankets. Two participants went on to receive a behavioural intervention, one was successful and the other withdrew from the study before implementing the strategies. One other participant’s sleep difficulties resolved over time without further intervention. Implications. The current study neither supported weighted blankets as an intervention for sleep problems in children with autism nor supported contentions of its effectiveness for children with sensation seeking behaviours.

Bakgrund: En familj som lever med ett barn som har autismspektrumtillstånd påverkar dem och hela deras livssituation. Barnet behöver särskilt stöd av föräldrarna under hela deras levnadsår. Barn med autismspektrumtillstånd är personer som har individuella behov och dessa kan variera stort. Enligt tidigare studier som inkluderats i denna litteraturstudie framkom det att dessa individuella behov kan ha negativ påverkan på föräldrarna. Autismspektrumtillstånd är en neuropsykiatrisk funktionsnedsättning där personen har ett annorlunda sätt att ta in, bearbeta och tolka information. Det beskrivs som en livslång funktionsnedsättning utan botemedel. Forskning visar att det är 20 % vanligare att barn med autismspektrumtillstånd behöver mer sjukhusvård, jämfört med barn som har en normal kognitiv utveckling. Vetenskapliga studier har även visat att genom en djupare förståelse hos vårdpersonal för hur föräldrarnas välmående påverkas kan man senare gå vidare med att undersöka vilken insats från vården som familjen är i behov av. Syfte: Syftet med denna litteraturstudie var att beskriva föräldrars upplevelser av att leva i en familj där ett barn har autismspektrumtillstånd. Metod: Datainsamling till litteraturstudien utfördes i databaserna Pubmed, Cinahl och PsycINFO. Till resultatdelen analyserades och sammanställdes 10 kvalitativa empiriska studier med inspiration av Fribergs analysmetod och beskrivande syntes. Resultat: Upplevelserna av att leva i en familj där ett barn har autismspektrumtillstånd påverkar hela familjen och deras sociala nätverk. Resultatet i litteraturstudien innefattade svårigheter att finna en balans i föräldrarollen samt hur denna roll kunde balanseras för att tillgodose barnets behov. Många föräldrar upplevde en åsidosatthet från både familj, vänner och samhället. Genom att föräldrarna godtog barnets funktionsnedsättning kunde de se livet ur ett nytt perspektiv vilket hjälpte dem att finna hopp och en inre styrka. Slutsats: Att vara förälder till ett barn med autismspektrumtillstånd kan innebära många olika känslor som innefattar både emotionella och sociala påfrestningar i vardagen. Föräldrarnas upplevelser av sin livssituation var individuella men gemensamt för samtliga föräldrar var att de alltid försökte göra det bästa de kunde utifrån den nya riktningen livet hade tagit. / Background: Living in a family where a child has autism spectrum disorder affects their whole life situation. Usually a child with autism spectrum disorder requires support from their parents during their entire life. According to recent studies that are included in this literature study identifies that these individual needs may have negative effects on parents. Autism spectrum disorder is a neuropsychiatric disability where the person has a different way to take in, process and interpret information. ASD is a lifelong disability with no cure. Studies have shown that 20 % of children with autism spectrum disorder need more hospital treatment, compared with children with normal cognitive development. Scientific studies have also shown that through a deeper understanding of health professionals on how parents' well-being is affected you can later go on to examine the contribution of the care that the family is in need of. Aim: The aim of this study was to describe parent’s experiences of living in a family where a child has autism spectrum disorder. Methods: Collecting data for the study was performed in PubMed, Cinahl and PsycINFO. In this literature study 10 qualitative empirical studies were analysed and compiled with Friberg’s method of analysis, inspired by descriptive synthesis. Results: The experience of living in a family where a child has autism spectrum disorder affects the entire family and their social networks. The results of this literature study included the difficulty of finding a balance in their parental role and how this role can be balanced to meet the child's needs. Many parents felt omitted from family, friends and society. By accepting their child's disability parents could see life from a new perspective which helped them find hope and inner strength. Conclusion: Being a parent to a child with autism spectrum disorder may involve many different emotions which includes both emotional and social stresses of everyday life. The experiences were individual but the most common things for these parents was that they all tried to do everything they could for their children based on the new direction their life had taken.

Since the passing of the Education Act (1989) special education policies and documents have promoted partnership as a key component of establishing relevant and inclusive school practices. Professionals and families have been encouraged to work together to resolve issues for children with disabilities. However, little information is available to families and professionals about how to negotiate and achieve authentic partnerships. This thesis makes an important contribution to current knowledge about partnerships by investigating how a group of people (a parent, teacher, paraprofessional and teacher/researcher) make sense of working together to support the inclusion of a student with ASD in his regular school. It is hoped that our descriptions of how we have worked together may help other professionals and families in similar situations. In saying this, the lessons we have learned are ours and are peculiar to the context in which we worked. In New Zealand partnership between professionals and families of children with disabilities is usually enacted through the Individual Education Plan (IEP) process. This study utilises an alternative partnership model, the Quality Learning Circle (QLC). The participants’ learning journeys are described and the experience of partnership for the participants is discussed. Data are drawn from a range of sources to identify those strategies that support, and barriers that hinder, the development of authentic partnerships. Findings identify those conditions that were essential for the partnership in this study to work effectively. Within this research I contrast the key dimensions of the IEP and QLC, showing the IEP process to be wanting. I suggest a partnership model that embraces a dual focus on both the student and those supporting him/her is a more effective tool for supporting the inclusion of children with disabilities. It is argued that there is a lack of recognition in current funding criteria for the difference an effective partnership can make in supporting the inclusion of students ii with severe behavioural challenges. Consideration needs to be given to the costs and issues of ineffective partnerships, with a particular focus on current Ministry of Education practices.

The autistic child typically displays few appropriate behaviors and a host of inappropriate behaviors. The attention span of these children is extremely short and does not permit the child to fixate to any one activity for a significant period of time. Further, Ferster, et al. (1961) have established that autistic children respond to very few reinforcing stimuli. However, some research has indicated that most autistic children respond positively to music and rhythmic sounds. This study assessed the effects of an operant conditioning program using contingent music as a reinforcing stimulus for appropriate block proximity. The subject was an 11-year-old male, one of twins, who was diagnosed autistic. The study utilized a four-phase ABAB design, where A phases were baseline periods, B phases were conditioning periods. In the baseline condition, the subject was observed for six sessions without earphones and six sessions with earphones but no music. In the treatment phase, music was presented contingent upon instances of block proximity. Instances of appropriate block activity significantly increased when the child was wearing the earphones and receiving music contingent upon block activity. Appropriate behavior decreased during a reversal probe. Additionally, self-stimulatory behaviors dropped to near zero during the conditioning phase of the study.

The purpose of this study was to examine the experiences of parents of children with autism during the transition from preschool to school within an Early Intensive Behavioural Intervention (EIBI) program. Qualitative interviews within grounded theory framework were conducted to gain a better understanding about parents’ perceptions of the social supports they received during the transition period. Data collection involved semi-structural interviews with six families whose children completed EIBI program at St.Amant and were enrolled in school. Due to the small sample size, a metasynthesis of five qualitative studies about the transition experiences of families with children with autism was added. This metasynthesis provided additional information to the data collected from interviews in order to strengthen the trustworthiness of the current study. All data collected from the interviews were coded, categorized and analysed using a constant comparative method. Findings from both data collection components emphasize the importance of parents’ involvement in the transition process and suggest that an effective partnership between the home, the EIBI program and the school is a significant factor to a successful transition. The findings also highlight the need for strategic planning of the transition process that is family-focused and involves an active role of a facilitator, who can offer practical guidance and support to children and their families. Practical implications and recommendations for future research are discussed.

Heightened levels of stress are observed in mothers of children with autism spectrum disorders (ASD), yet little is known about the relationship between stress and coping in mothers of children recently diagnosed with an ASD. The objectives of this study were to determine the levels of maternal stress, identify coping strategies used by mothers, examine the relationship between stress and coping, and ascertain whether coping mediated the relationship between ASD symptom severity and subsequent maternal stress. Data on 128 mothers of children who had received a diagnosis of ASD in the last four months were examined. Results indicated that mothers presented with elevated levels of stress. With regards to coping, escape-avoidance and confrontive coping were positively correlated with stress, while seeking social support was negatively correlated with stress. Confrontive coping did not mediate the relationship between ASD symptom severity and maternal stress. Results confirm previous findings, while underscoring the importance of helping mothers understand the relationship between the coping strategies they adopt and the subsequent stress they experience.

In general terms a mand is a requesting response. Typically, children learn basic mands (e.g., “I want drink”) before learning to mand for information. Across three experiments I taught children with autism to mand for information using the mands “What is it?,” “Where?,” and/or “Which?”. In Experiment 1, a modified multiple-baseline design across situations was used to evaluate a teaching procedure that consisted of contrived motivating operations, prompt fading and prompt delay, natural consequences, error correction, and a brief preference assessment for teaching “What is it?” The results demonstrated strong internal validity with each of the three participants, with each showing generalization to situations, activities, scripts, the natural environment, and over time. In Experiment 2, a modified multiple-baseline design across three participants was used to evaluate approximately the same teaching procedure for teaching “Where?” The results demonstrated strong internal validity with each of the three participants, with generalization by all three participants to novel situations, activities, location the natural environment, and over time. In Experiment 3, a modified multiple-baseline design across three participants was used to evaluate approximately the same teaching procedure for teaching “Which?” The results demonstrated strong internal validity with generalization by all three participants to novel situations, activities, scripts, the natural environment, and over time. These findings are discussed in terms of its contributions to applied behaviour analysis research on teaching mand to children with autism.

Autism prevalence has dramatically increased over the last 10 years, currently affecting 1 in 88 individuals. Individuals with autism face impairments in communication, with one-third to one-half of children with autism not developing natural speech and remaining non-verbal. Individuals with autism are increasingly being integrated into the educational system, within general and self-contained classrooms. A lack of research is apparent regarding the communicative techniques of individuals with non-verbal autism; thus, posing the question: how do children with non-verbal autism communicate? This study set out to examine the communicative techniques of five individuals with non-verbal autism, in their self-contained classrooms. Participants were videotaped during three or four observational periods. Videotaped observations were analyzed using the Modified-Classroom Observation for Measuring Intentional Communication tool (M-COSMIC), which identified the communicative partner, function, role, and form used by each participant. Results showed that all participants shared the same main communicative partner: an educational assistant; and the communicative forms of eye contact and action. Differences amongst participants appeared in the utilization of communicative categories. Three participants utilized functions from the behaviour regulation category; the remaining two participants communicated using functions from the dyadic social interaction and joint attention categories. The results of this study indicate that classroom professionals may need increased education regarding main communication techniques and communicative complexity used by individuals with non-verbal autism. As well, this study shows a gap in collaboration between educational assistants and classroom teachers, with no recognition of examining communication holistically. These findings suggest the need for further open-ended research allowing for the inclusion of all communicative forms, and accounting for the extensive factors impacting communication competence. / Graduate / 0515 / 0621

Autism is characterized by qualitative impairments in communication and reciprocal social interaction. About 3 in 10,000 in the general population suffer from this neurodevelopmental disorder. The majority of patients also manifest mental retardation and about 20-45% epilepsy. Multiple exostoses is the commonest form of all skeletal dysplasias, affecting 1 in 50,000 live births. The condition, characterized by cartilaginous protuberances at the ends of the diaphyses, affects the extremities causing skeletal deformities and short stature. Autism and multiple exostoses are considered to be inherited disorders, but the underlying biochemical defects of the disorders are unknown. Both of these conditions allow for survival but considerably diminish the quality of life. An X;8 translocation was identified in a female patient, ML, with autism and multiple exostoses. Her phenotypic manifestations are likely due to the chromosomal abnormality. A positional candidate cloning strategy was used to investigate the genes involved in the translocation. The translocation breakpoint was first isolated in Yeast Artificial Chromosomes (YACs), then in cosmid and plasmid clones. The translocation was reciprocal within a 5'-GGCA-3' sequence found on both X and 8 chromosomes without gain or loss of a single nucleotide. The translocation breakpoint on the X chromosome occurred in the first intron of the gastrin releasing peptide receptor (GRPR) gene and on chromosome 8 approximately 30 kb distal to the 3' end of the Syndecan-2 gene (SDC2), also known as human heparan sulfate proteoglycan or fibroglycan. Although the GRPR gene was shown to escape X-inactivation and the coding region of the SDC2 gene was not disrupted, a dosage effect of the GRPR gene and a position effect of the SDC2 gene may, however, have contributed to the phenotype observed in this patient. The orientation of these genes with respect to the translocation was incompatible with the formation of a fusion gene. The GRPR and SDC2 genes may provide insight into the biochemical nature of autism and multiple exostoses. Investigation of mutations in these two genes in unrelated patients with either autism or multiple exostoses as well as linkage and association studies are needed to validate them as candidate genes.

Objectives: 1) to determine if children and adolescents with autism spectrum disorder (ASD) encounter difficulties accessing dental, 2) to identify barriers that diminish access to dental care for this population. Methods: This descriptive study is based on a web-survey conducted at the Geneva Centre for Autism in Toronto between November 2008 and March 2009. Forty-nine multiple choice questions including open-ended fields were developed. Parents of children with ASD (ages 5–18) completed the survey. Results: The majority of participants visited a dentist regularly (71%) and had private dental insurance (64%). Parents/caregivers were more likely to have difficulties finding a dentist as unmarried parents (OR=3.7, P=0.075) or when their level of education was high school/less (OR=10.4, P=0.043). Conclusions: The majority of children/adolescents with ASD had access to dental care. Difficulties accessing dental care were related to family structure, parents’ education and their perception of dentists’ knowledge of ASD.