Thesis(MEdPsych)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Autism or Autism Spectrum Disorder (ASD) is a condition that, at present, affects approximately one out of every 100 children globally and indications are that the prevalence thereof is steadily on the rise. ASD is a complex neurological condition that impairs social interaction, communication and behaviour. Research on the wide-ranging effects of ASD and its unique characteristics in each child with ASD is widely available. Several studies refer to the fact that ASD has an impact on the family unit, but very few researchers have investigated the support that families from different cultural groups in South Africa are enjoying whilst raising a child with autism. The current situation being what it is means that professionals and families have very little data on the subject and inadequate support is available to address the specific needs of families who are raising a child with autism. The aim of this study was to investigate the support structures of three families from three different cultural groups in South Africa who were raising a child with autism. The central issue that was researched was the support structures available to parents raising a child with autism, and how parents access that support. This is a qualitative study within an interpretive research paradigm. In this case study, the methods of data collection comprised semi-structured interviews, observations and reflective journals. This design embraced qualitative research methods that could expose the uniqueness of each family’s experience and allowed participants the freedom to express this. The three families, who were purposefully selected for this study, were from different cultural backgrounds. One of the children in each family met the criteria published in the Diagnostic and statistical manual of mental disorders, fourth edition, text revision (American Psychiatric Association, 2000) for Autism or Pervasive Developmental Disorder not Otherwise Specified (PDD-NOS). The study found that the parents in the three families received support from their spouses and the neuro-typical siblings. The families also enjoyed physical support, financial support and emotional support from different sources. Parents reported feeling supported when others show acceptance and understanding of their children’s deficits and when such others are prepared to ‘go the extra mile’. The three families also perceived information and guidance as a valuable source of support. Even though they had firm support structures in place, they also reported on the lack of support available to them. All three families enjoyed these forms of support, but it was interesting to find out that the families received the support from different sources. / AFRIKAANSE OPSOMMING: Outisme of outisme spektrum versteuring (OSV) is 'n toestand wat tans ongeveer een uit elke 100 kinders wêreldwyd affekteer en daar is aanduidings dat die voorkoms daarvan steeds toeneem. OSV is 'n komplekse neurologiese toestand wat swak sosiale interaksie, kommunikasie en gedrag tot gevolg het. Navorsingsresultate oor die breë gevolge van OSV en die unieke eienskappe daarvan in elke kind met OSV is algemeen beskikbaar. Verskeie studies verwys na die feit dat OSV 'n impak het op die gesinseenheid, maar tot dusver het baie min navorsers die ondersteuning ondersoek wat gesinne uit verskillende kulturele groepe in Suid-Afrika tydens die opvoeding van 'n kind met outisme geniet . Die huidige situasie voorsien professionele mense en gesinne van baie min data oor die onderwerp en onvoldoende ondersteuning is beskikbaar om die spesifieke behoeftes van gesinne met 'n kind met outisme aan te spreek. Die doel van hierdie studie was om ondersoek in te stel na die ondersteuning wat gesinne in verskillende kultuurgroepe in Suid-Afrika tydens die opvoeding van ‘n kind met outisme geniet. Die sentrale ondersoekvraag het betrekking gehad op ondersteuningstrukture vir gesinne met ‘n kind met outisme binne hul kultuurgroep, sowel as die wyse waarop die gesinne toegang tot die ondersteuning verkry. Die studie was kwalitatief van aard binne 'n interpretatiewe navorsingsparadigma en ’n gevallestudie is as navorsingsontwerp gekies. Data is deur middel van semi-gestruktureerde onderhoude, waarnemings en reflektiewe joernale ingesamel. Die kwalitatiewe navorsingsmetodes omvat die uniekheid van elke gesin se ervaring en laat deelnemers die vryheid om uitdrukking daaraan te gee. Drie gesinne is doelbewus vir hierdie studie gekies. Die gesinne moes oor die volgende kenmerke beskik: Hulle moes uit verskillende kulturele agtergronde (Afrikaan, Wit en Indiër) kom. Hul kind moes voldoen aan die kriteria in die Diagnostiese en Statistiese Handleiding van geestesversteurings, vierde uitgawe, teks hersiening (2000) vir Outisme of pervasieve ontwikkelingsstoornis nie anders gespesifiseer nie (PDD-NOS). Verskeie etiese beginsels is vir hierdie studie nagekom om te verseker dat die navorsing eties was. Die studie het bevind dat die ouers in die drie gesinne ondersteuning van hul gades en die neurotipiese broers en susters van die kind met outisme ontvang het. Die gesinne het ook fisiese ondersteuning, finansiële steun en emosionele ondersteuning vanuit verskillende bronne geniet. Die gesinne het aangedui dat hul ondersteun voel wanneer hul kinders se afwykings aanvaar word, begrip daarvoor getoon word en andere bereid was om die ‘ekstra myl te loop’. Die drie gesinne het ook inligting en leiding as waardevolle bronne van ondersteuning ervaar. Selfs al het die families sterk ondersteuningstrukture in plek gehad, het hulle ook die gebrek aan ondersteuning uitgelig. Al drie gesinne geniet die bogenoemde vorme van ondersteuning, maar dit was interessant om uit te vind dat die families hierdie ondersteuning vanuit verskillende bronne ontvang het.

Ce mémoire présente et discute d’une problématique importante qui s’inscrit dans un contexte actuel, autant sur le plan international que local, puisqu’elle touche 1 enfant sur 68 (CDC, 2010). On parle ici du trouble du spectre de l’autisme (TSA). Plus spécifiquement, cette recherche se concentre sur les jeunes adultes autistes, qui du jour au lendemain, se retrouvent face à une interruption de services. Elle suggère qu’une adaptation adéquate de l’environnement soit davantage explorée en vue d’offrir des centres de jour adaptés à cette clientèle. La question de recherche est la suivante : Quels sont les éléments du design intérieur qui peuvent améliorer la qualité de vie des adultes autistes? Il est essentiel de s’y attarder, puisque les personnes TSA sont entre autres caractérisées par leur hypersensibilité et leur hyposensibilité face à l’environnement. Bien que le sujet de l’autisme soit richement documenté par le domaine des sciences médicales, il est apparu qu’il l’est moins par celui de l’aménagement. La stratégie méthodologique de cette recherche repose sur des analyses de précédents, des observations participantes ainsi que la tenue d’entretiens semi-dirigés auprès de parents d’enfants autistes. Cette étude vise simultanément l’amélioration de la compréhension de la pratique émergente du design comme moyen d’intervention ainsi que l’identification des facteurs (éclairages, couleurs, matériaux, division de l’espace, etc.) pouvant améliorer le bien-être des adultes autistes. Sur la base des données collectées, il a été remarqué qu’effectivement, plusieurs moyens peuvent être entrepris pour concevoir des environnements améliorant le bien-être de ces adultes. Les résultats extraits du terrain mènent à des propositions d’aménagement claires : rendre l’abstrait le plus concret possible, aménager des zones de retrait social, offrir une variété d’ambiances, et finalement, offrir un encadrement sécuritaire. / This thesis presents and discusses an important issue that is part of a current context, both international and local level, since it affects 1 child in 68 (CDC, 2010). We are talking about the Autism spectrum disorder (ASD). More specifically, this research focuses on young autistic adults who suddenly find themselves facing a lack of services. It suggests that an adequate adaptation of the environment should be explored in order to provide adapted day Centers to this clientele. The question of the research is the following: What are the elements of interior design that can improve the quality of life of autistic adults? It is essential to linger over it, since ASD people are characterized by hypersensitivity and hyposensitivity to the environment. Even if the subject of autism is richly documented by medical science, it appeared that it is less studied by the interior architecture domain. The methodological strategy of this research is based on analysis of precedents, participant observation and the conducting semi-structured interviews with parents of autistic people. This study aims simultaneously to improve the understanding of the emerging practice of design as an intervention and the identification of factors (lightings, colors, materials, spatial organization) that could improve the wellbeing of autistics adults. Based on the data collected, it was noticed that, indeed, several means can be undertaken to design environments improving the well-being of adults. The results extracted from the field study lead us to clear layout proposals: making the abstract as concrete as possible, develop areas of social withdrawal, offer a variety of atmospheres, and finally provide a safe environment.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-07-18T11:46:06Z No. of bitstreams: 1 Renata Cristina Michel.pdf: 1614274 bytes, checksum: e95f711d2385e57a6d1783ef14a0dfa6 (MD5) / Made available in DSpace on 2018-07-18T11:46:06Z (GMT). No. of bitstreams: 1 Renata Cristina Michel.pdf: 1614274 bytes, checksum: e95f711d2385e57a6d1783ef14a0dfa6 (MD5) Previous issue date: 2018-05-10 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Results from previous studies indicated that there was a reduction in the percentage of intervals with occurrence of disruptive behaviors after children with ASD were taught a verbal response relevant to the situation that evoked such behaviors; and there was an increase in the percentage of intervals with occurrence of relevant verbal responses (control). In the present study, we sought to verify the effect, on disruptive behaviors, on the emission of verbal responses and non-verbal responses, from a Functional Communication Training (FCT), plus a procedure to avoid escape of important activities by participants; it was also sought to verify if there was a generalization of the verbal response before a naive experimenter. Participants were three children between three and six years old, diagnosed with autism, who attended to school for at least one year, had verbal behavior below that expected for the age, and disruptive behaviors maintained by negative reinforcement (task escape). A functional analysis was performed composed of three experimental conditions: Demand; Attention; and Control. The results of the functional analysis showed that there was a considerably greater number of disruptive responses emitted by the three participants in the demand condition. In the Functional Communication Training (FCT) phase, each participant was taught to request a pause to perform tasks through verbal command responses. Initially, the participant was instructed to issue the verbal response, immediately after the presentation of the task, and gradually increased the time between the issuance of the experimenter's instruction ("Do ...") and the tip for verbal response by participant, until the verbal response was issued without any prompt. The results showed that the three participants presented a decrease in the emission of disruptive responses after the acquisition of the verbal response to request a pause to perform tasks. Then, in the Fading out phase for the task execution response and a gradual decrease of the prompt was implemented, from highest to lowest: DF - total physical hint, DL - light physical tip, DG - gestural tip and I - independent response. The results indicated that the three participants acquired the response for the task execution, reducing the emission of verbal pause requests for execution and maintaining a low number of disruptive responses. In the generalization test of the verbal response (mand) and the non-verbal response (do the task) to a naive experimenter, it was verified that for all the participants there was generalization of the verbal response and generalization of the nonverbal response / Resultados de estudos anteriores apontaram que houve redução da porcentagem dos intervalos com ocorrência de comportamentos disruptivos após crianças com TEA serem ensinadas a emitir resposta verbal relevante à situação que evocava tais comportamentos; e houve aumento da porcentagem dos intervalos com ocorrência de respostas verbais relevantes (mando). No presente estudo, buscou-se verificar o efeito, sobre comportamentos disruptivos, sobre a emissão de respostas verbais e de respostas não verbais, de um Treino de Comunicação Funcional (FCT), acrescido de um procedimento para evitar a esquiva de atividades importantes pelos participantes; buscou-se, também, verificar se ocorria generalização da emissão da resposta verbal diante de experimentadora ingênua. Foram participantes três crianças, entre três e seis anos de idade, diagnosticadas com autismo, que frequentavam escola há pelo menos um ano, apresentavam comportamento verbal abaixo do esperado para a idade e comportamentos disruptivos mantidos por reforçamento negativo (fuga da tarefa). Foi conduzida análise funcional composta de três condições experimentais: Condição de demanda; Condição de atenção; e Condição controle. Os resultados da análise funcional mostraram que houve um número consideravelmente maior de respostas disruptivas emitidos pelos três participantes na condição de demanda. Na fase do Treino de Comunicação Funcional (FCT), cada participante foi ensinado a solicitar pausa da execução de tarefas através de respostas verbais de mando. Inicialmente, era dada dica ao participante para emissão da resposta verbal, imediatamente após a apresentação da tarefa, e aumentava-se gradativamente o tempo entre a emissão da instrução da experimentadora (“Faça...”) e a dica para a resposta verbal pelo participante, até que a resposta verbal fosse emitida sem nenhuma dica. Os resultados mostraram que os três participantes apresentaram diminuição na emissão de respostas disruptivas após a aquisição da resposta verbal para solicitação de pausa para a execução de tarefas. Em seguida, na fase de Dica para a resposta de execução da tarefa e diminuição gradativa da dica (Fading-out), foi implementado um procedimento de alteração do nível de dica, da maior para a menor: DF - dica física total, DL – dica física leve, DG – dica gestual e I – resposta independente. Os resultados apontaram que os três participantes adquiriram a resposta de execução das tarefas, reduzindo a emissão de respostas verbais de solicitação de pausa para a sua execução e mantendo baixo número de emissão de respostas disruptivas. No teste de generalização da emissão de resposta verbal (mando) e do tempo de permanência na tarefa diante de uma experimentadora ingênua, verificou-se que, para todos os participantes, houve generalização da resposta verbal e generalização da resposta não verbal

Étant donné que le bilinguisme et le multilinguisme sont la norme plutôt que l’exception, plusieurs enfants, y inclus plusieurs enfants ayant un trouble du spectre de l’autisme (TSA) sont élevés dans des contextes bilingues. Cependant, il y a actuellement peu de recherche examinant le développement langagier d’enfants ayant été exposés à deux langues, de la petite enfance à l’âge scolaire. Cette thèse a pour objectif d’examiner l’influence du bilinguisme sur le développement d’habiletés langagières d’enfants bilingues ayant un développement neurotypique à l’âge scolaire, ainsi que chez leurs pairs ayant un TSA. Cet objectif est atteint par l’entremise de trois manuscrits. Le premier manuscrit est une revue de la littérature dans le cadre de laquelle nous avons examiné le développement langagier d’enfants bilingues ayant un DN d’enfants ayant d’autres troubles de développement et finalement d’enfants ayant un TSA. Cette revue révéla que, tout comme leurs pairs ayant un DN, les enfants ayant un TSA peuvent devenir des locuteurs bilingues, et que le bilinguisme n’est pas néfaste à leur développement langagier. Cependant, certaines limites dans la littérature existante ont aussi été révélées. Dans un premier temps, la majorité des études publiées ont examiné les habiletés langagières d’enfants bilingues d’âge préscolaire. Toutefois, peu d’études ont examiné leur développement langagier une fois qu’ils atteignent l’âge scolaire, et ce, tant chez les enfants ayant un DN que chez les enfants ayant un TSA. Par ailleurs, peu d’études ont comparé les capacités langagières d’enfants ayant un TSA à celles de leurs pairs bilingues ayant un DN et aucune étude n’a comparé leurs capacités langagières à celles de leurs pairs unilingues ayant un DN. Les résultats qui découlent de cette revue ont menés à deux études expérimentales examinant l’influence du bilinguisme sur le développement langagier chez les enfants d’âge scolaire ayant un DN, ainsi que chez leurs pairs ayant un TSA. Notre revue de littérature suggère que l’exposition langagière pourrait jouer un rôle déterminant vis-à-vis les capacités langagières d’enfants bilingues. Le second manuscrit a donc comme objectif d’examiner la relation entre le développement langagier d’enfants étant des bilingues simultanés (exposés à leurs deux langues avant l’âge de trois ans) d’âge scolaire, et la quantité d’exposition langagière reçue dans chacune de leurs langues (le français et l’anglais). Globalement, nos résultats ont démontré une interaction entre la quantité d’exposition à l’anglais et la performance sur certaines mesures de langage expressif, mais pas avec les mesures de langage réceptif en anglais. En français, aucune interaction entre la quantité d’exposition au français et les performances sur les différentes mesures langagières n’a été trouvée. Ces différences sont potentiellement dues à des différences dans les montants d’exposition au français et à l’anglais, mais d’autres explications sont aussi discutées. De plus, les résultats suggèrent qu’en ayant approximativement 20% de leur exposition à une langue, ces enfants bilingues peuvent obtenir des scores dans la tranche moyenne sur toutes les mesures langagières. Par ailleurs, les enfants qui se servent de leurs deux langues tous les jours semblent nécessiter un moins grand pourcentage d’exposition pour développer des capacités langagières dans la moyenne. Ces résultats pourraient être expliqués par le transfert positif et une amélioration des capacités métalinguistiques plus généralement. Ce type d’amélioration pourrait permettre aux enfants qui se servent de leurs deux langues tous les jours de développer de meilleures capacités d’acquisition langagière. Les résultats de la revue de littérature ont aussi démontré que peu est connu en ce qui a trait aux capacités langagières d’enfants bilingues ayant un TSA lorsqu’ils atteignent l’âge scolaire. Conséquemment, pour le troisième manuscrit j’ai complété une étude pilote ayant comme objectif d’examiner si trois enfants bilingues simultanés d’âge scolaire et ayant un TSA (sans trouble de langage ou de déficiences intellectuelles) pouvaient atteindre des niveaux d’habiletés langagières semblables à celles de leurs pairs unilingues ayant un TSA. J’ai aussi cherché à savoir si ces trois enfants bilingues ayant un TSA pouvaient atteindre des seuils langagiers semblables à ceux de 19 pairs bilingues et 12 pairs unilingues ayant tous un DN. Les résultats ont démontré que ces bilingues simultanés ayant un TSA ont eu des performances semblables à celles de leurs pairs unilingues ayant un TSA sur des mesures langagières normées. Ils ont aussi eu des performances semblables à celles de leurs pairs bilingues et unilingues ayant un DN. L’ensemble de ces résultats démontrent que les enfants bilingues simultanés d’âge scolaire avec et sans TSA peuvent atteindre des niveaux d’habiletés langagières semblables à ceux de leurs pairs unilingues, du moins, dans une de leurs langues, sinon dans les deux. Bien que les bilingues ne sont pas deux unilingues en une seule personne, les résultats de nos recherches concordent avec ceux de recherches antécédentes et démontrent que le bilinguisme n’est pas néfaste pour le développement langagier oral d’enfants d’âge scolaire ayant un DN ou ayant un TSA. / Since bilingualism and multilingualism are the norm rather than the exception, many children, including children with autism spectrum disorder (ASD), live in bilingual or minority-language households. However, little research has examined the language development of school-aged children who have been exposed to two languages since early childhood, and fewer still have examined bilingual school-aged children with ASD. In this thesis, I examine the influence of bilingualism on language development in both school-aged ND children and in their peers with ASD. This objective will be achieved through the three manuscripts making up this thesis. For the first manuscript, we completed a review of the literature in which we examined the language development of ND bilingual children, of bilingual children with various developmental disorders, and of bilingual children with ASD. This review revealed that, as with neurotypically developing (ND) children, children with ASD can become bilingual speakers, and that bilingualism is not detrimental to their language development. Our review also revealed some of the limits of the existing literature. First, the majority of existing studies had examined bilingual language development in preschool-aged children with and without ASD, but had not examined the language development of these bilingual children once they reached school age. Second, few studies had compared the language abilities of bilingual children with ASD to those of their ND bilingual peers, and at time of publication, none had compared them to those of ND monolingual children. The results from this review lead to two studies examining the influence of bilingualism on language development in school-aged ND children and in children with ASD. Our review of the literature suggested that language exposure may play an important role in determining bilingual children’s language ability. However, little was known about its influence in school-aged children. Therefore, for the second manuscript, I examined whether there was a relationship between language development and the amount of language exposure that ND simultaneous bilinguals (i.e. children having been exposed to both languages before the age of three years) received in each of their languages (French and English). I found a relationship between lifetime exposure to English and performances on some English-language expressive language measure, but not on receptive language measures. In French, no relationship between the amount of exposure to French and performances on any of the French-language measures was found. These differences in findings could be due to differences in language exposure ranges across both languages but other potential explanations are also discussed. Findings also show that when receiving 20% of their exposure to a language, most children were able to obtain scores within the average range on the language measures. Moreover, children who were exposed to both of their languages on a daily basis often had stronger performances on language measures than children who did not receive daily exposure to both of their languages. I hypothesized that positive transfer and improved metalinguistic abilities more generally may have contributed to improved language learning abilities in children who used both of their languages on a daily basis. Findings from the literature review also revealed that little was known about the language abilities of bilingual children with ASD once they reached school-age. With that in mind, the third manuscript reports on a pilot study that examined whether three simultaneous bilingual school-aged children with ASD (without a comorbid language disorder or an intellectual disability) could achieve language levels similar to those of their two French-monolingual peers with ASD. I also explored whether these bilingual children with ASD could reach language proficiency levels similar to those of their 19 ND simultaneous bilingual peers, in both of their languages (French and English), and whether they had similar abilities to those of their 12 ND French-monolingual peers. I found that the simultaneous bilingual children with ASD performed similarly on standardized language measures to their two monolingual peers with ASD, in both of their languages. They also had similar performances to those of their ND bilingual peers, as well as to those of their ND monolingual peers. Overall, these findings reveal that ND school-aged simultaneous bilinguals and their simultaneous bilingual peers with ASD (without a language disorder or intellectual disability) can achieve language proficiency levels similar to those of their monolingual peers, in at least one, if not both of their languages. While bilingual children are not two monolinguals within one child, our findings are similar to previous findings and show that bilingualism does not appear to impede the language development of school-aged ND bilingual children and bilingual children with ASD.

[ES] El Trastorno del Espectro Autista (TEA) es una afección compleja que se encuentra dentro de los llamados Trastornos del Neurodesarrollo. Está caracterizada por la presencia de disfunciones en las interacciones sociales, en la capacidad comunicativa, pensamiento simbólico, así como, conductas estereotipadas y desregulación de carácter sensorial. Actualmente, dada su elevada prevalencia, ha despertado el interés científico para poder llevar a cabo diagnósticos más tempranos que repercutan en intervenciones más eficaces. Hasta el momento el diagnóstico del TEA se ha venido realizando mediante baterías diagnósticas estandarizadas basadas en criterios cualitativos, por lo cual, la respuesta puede distar de la obtenida en un contexto real. Es por ello que herramientas como la Realidad Virtual (RV), con la potencialidad de reproducir entornos con elevado grado de realismo, pueden ser un contexto válido tanto para la evaluación como para la intervención terapéutica. Se han aplicado entornos virtuales no inmersivos, dado el rechazo de la población TEA a utilizar visores RV, aunque con resultados observacionales. Dichas limitaciones pueden superarse con el uso de los llamados Entornos Virtuales Inmersivos (EVI), ya que suponen una solución tecnológica no invasiva, con mayor capacidad de inmersión y, por tanto, de generar respuestas con mayor similitud a las obtenidas en un contexto real. Las mediciones de carácter observacional pueden superarse con mediciones fisiológicas, tales como, la actividad electrodermal (EDA), que proporciona la respuesta de la excitación corporal en forma de sudoración ante un estímulo o el eye tracking, el cual muestra el comportamiento ocular. Ambas suponen respuestas implícitas, inconscientes y cuantificables, que pueden ayudar a definir la afección. Por todo ello, la presente Tesis Doctoral, compuesta de tres estudios, tiene como objetivo unir el uso de EVI, con capacidad de estimulación visual, auditiva y olfativa con medidas fisiológicas, focalizadas en la evaluación y entrenamiento del TEA, además de estudiar las relaciones entre las mismas y las baterías diagnósticas del TEA. El Estudio nº 1 valoró la adaptación de los participantes a los dispositivos y el EVI y los niveles EDA en un contexto de respuesta al saludo. Los resultados hallaron que los sujetos TEA mostraron una tolerancia similar en el uso del EVI y del dispositivo EDA. Aumentaron sus niveles de excitación con respecto al estado de reposo previo (Ratio), cuando intervino el sentido del olfato, no habiendo relaciones significativas con las baterías diagnósticas. El Estudio nº 2 profundizó en los niveles EDA en un contexto de imitación total o parcial. Los resultados mostraros que los sujetos TEA mostraron una menor activación (Ratio), ante procesos de imitación total, con estimulación olfativa, no encontrando relaciones significativas con las baterías diagnósticas. El Estudio nº 3 estudió el EDA y el comportamiento ocular en un EVI basado en un Centro Comercial. Los resultados EDA, no proporcionaron diferencias en la sesión de evaluación, pero descendieron en los sujetos TEA tras una sesión de entrenamiento. El comportamiento ocular en la sesión de evaluación discriminó entre los grupos, pero en el entrenamiento el comportamiento fue similar. Las relaciones entre dichas medidas y las baterías diagnósticas no mostraron relaciones significativas. Tecnologías inmersivas y medidas psicofisiológicas para la evaluación y entrenamiento de niños con Trastorno del Espectro Autista Como conclusión final cabe señalar que, la medida electrodermal que contó con mayor capacidad para identificar a la población TEA fue la medida Ratio. Mientras que el EDA, tras el entrenamiento, fue indicador de una mejora de la excitación ante situaciones de señalado, respuesta al nombre y atención conjunta, en el caso del comportamiento ocular, fue capaz de diferenciar entre los grupos únicamente en la / [CA] El Trastorn de l'Espectre Autista (TEA) és una afecció complexa que es troba dins dels anomenats Trastorns del Neurodesenvolupament. Està caracteritzada per la presència de disfuncions en les interaccions socials, en la capacitat comunicativa, pensament simbòlic, així com, conductes estereotipades i desregulació del caràcter sensorial. Actualment, donada la seua elevada prevalença, ha despertat l'interés científic per poder dur a terme diagnòstics més primerencs que deriven en intervencions més eficaces. Fins al moment el diagnòstic del TEA s'ha realitzat mitjançant bateries diagnòstiques estandarditzades basades en criteris qualitatius, és per això que la resposta pot ser diferent a l'obtinguda en un context real. Per tant, eines com la Realitat Virtual, amb la capacitat de reproduir entorns amb un elevat grau de realisme, poden ser un context vàlid tant per a l'avaluació com per a la intervenció terapèutica. S'han aplicat entorns virtuals no immersius, donat el rebuig de la població TEA a utilitzar visors RV, malgrat que amb resultats observacionals. Dites limitacions poden superar-se amb l'ús dels anomenats Entorns Virtuals Immersius (EVI), ja que suposen una solució tecnològica no invasiva, amb major capacitat d'immersió i per tant, de generar respostes amb major similitud a les obtingudes en un context real. Les mesures de caràcter observacional poden superar-se amb mesures fisiològiques, tals com, l'activitat electrodermal (EDA), que proporciona la resposta de l'excitació corporal en forma de sudoració enfront d'un estímul o l'eye tracking, el qual mostra el comportament ocular. Ambdues suposen respostes implícites, inconscients i quantificables, que poden ajudar a definir l'afecció. Per tot això, la present Tesi Doctoral, composta de tres estudis, té com a objectiu unir l'ús d'EVI, amb capacitat d'estimulació visual, auditiva i olfactiva amb mesures fisiològiques, focalitzades en l'avaluació i entrenament del TEA, a més d'estudiar les relacions entre les mateixes i les bateries diagnòstiques del TEA. L'Estudi nº 1 va valorar l'adaptació dels participants als dispositius i l'EVI i els nivells EDA en un context de resposta salutació. Els resultats van trobar que els subjectes TEA van mostrar una tolerància similar en l'ús d'EVI i del dispositiu EDA. Van augmentar els seus nivells d'excitació pel que fa a l'estat de repòs prEVI (Ràtio), quan va intervenir el sentit de l'olfacte, no havent-hi relacions significatives amb les bateries diagnòstiques. L'Estudi nº 2 va aprofundir en els nivells EDA en un context d'imitació total o parcial. Els resultats mostraren que els subjectes TEA mostraren una menor activació (Ràtio), davant de processos d'imitació total, amb estimulació olfactiva, no trobant relacions significatives amb les bateries diagnòstiques. L'Estudi nº 3 va estudiar l'EDA i el comportament ocular a un EVI basat en un Centre Comercial. Els resultats EDA, no van proporcionar diferències en la sessió d'avaluació, però van baixar en els subjectes TEA després d'una sessió d'entrenament. El comportament ocular en la sessió d'avaluació va discriminar entre els grups, però en l'entrenament el comportament va ser similar. Les relacions entre aquestes mesures i les bateries diagnòstiques no van mostrar relacions significatives. Com a conclusió final es pot assenyalar que, la mesura electrodermal que va comptar amb major capacitat per a identificar a la població TEA fou la mesura Ràtio. Pel quefa a l'EDA, després de l'entrenament, va ser un indicador d'una millora de l'excitació enfront de situacions d'assenyalament, resposta al nom i atenció conjunta, en el cas del comportament ocular, va ser capaç de diferenciar entre els grups únicament en la sessió d'avaluació. Finalment, l'EDA i el comportament ocular, no van ser mesures amb capacitat correlacional amb les bateries diagnòstiques. / [EN] Autism Spectrum Disorder (ASD) is a complex condition that falls under the category of so-called Neurodevelopmental Disorders. It is characterized by the presence of dysfunctions in social interactions, in the communicative capacity, symbolic thinking, as well as, stereotypical behaviours and deregulation of sensorial character. Currently, given its high prevalence, it has awakened scientific interest in order to carry out earlier diagnoses that will have an impact on more effective interventions. Until now, the diagnosis of ASD has been carried out by means of standardized diagnostic batteries based on qualitative criteria, so that the response may be far from that obtained in a real context. Therefore, tools such as Virtual Reality (VR), with the potential to reproduce highly realistic environments, can be a valid context for both assessment and therapeutic intervention. Non-immersive virtual environments have been applied, given the refusal of the ASD population to use VR viewers, although with bservational results. These limitations can be overcome with the use of so-called Immersive Virtual Environments (IVEs), since they represent a non-invasive technological solution, with a greater capacity for immersion and, therefore, for generating responses that are more similar to those obtained in a real context. Observational measurements can be overcome with physiological measurements, such as electrodermal activity (EDA), which provides the body's response in the form of sweating to a stimulus, or eye tracking, which shows the behaviour of the eye. Both involve implicit, unconscious and quantifiable responses, which can help define the condition. Consequently, the present Doctoral Thesis, composed of three studies, aims to unite the use of IVE, with the capacity of visual, auditory and olfactory stimulation with physiological measures, focused on the evaluation and training of ASD, as well as studying the relationships between them and the diagnostic batteries of ASD. The Study nº1 evaluated the adaptation of the participants to the deviIces and the IVE and the EDA levels in a context of response to the greeting. The results found that ASD subjects showed similar tolerance in the use of the IVE and EDA dEVIce. They increased their levels of arousal with respect to the prEVIous resting state (Ratio), when the sense of smell was involved, with no significant relationship with the diagnostic batteries. Study nº2 studied in depth the EDA levels in a context of total or partial imitation. The results show that the ASD subjects showed a lower activation (Ratio), when facing total imitation processes, with olfactory stimulation, finding no significant relations with the diagnostic batteries. The Study nº3 studied the EDA and the ocular behaviour in an IVE based in a Shopping Centre. The EDA results, did not provide differences in the evaluation session, but they decreased in the ASD subjects after a training session. Eye behaviour in the assessment session discriminated between the groups, but in the training the behaviour was similar. The relationships between these measures and the diagnostic batteries did not show significant relationships. As a final conclusion, it should be pointed out that the electrodermal measure that had more capacity to identify the ASD population was the Ratio measure. While the EDA, after the training, was an indicator of an improvement of the excitement in front of situations of signalling, response to the name and joint attention, in the case of the ocular behaviour, it was one able to differentiate between the groups only in the evaluation session. Finally, the EDA and the ocular behaviour, were not measured with correlational capacity with the diagnostic batteries. / Olmos Raya, E. (2021). Tecnologías Inmersivas y medidas psicofisiológicas para la evaluación y entrenamiento de niños con Trastorno del Espectro Autista [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/165871 / TESIS

Autism Spectrum Disorder (ASD), previously known as Pervasive Development Disorder (PDD) is a developmental disorder present from early childhood. Children diagnosed with ASD commonly exhibit symptoms of ADHD resulting in increased severity of symptoms and impairment of functioning. This group of children is frequently treated with methylphenidate which has been recommended by some but criticised by others. This systematic review aims to explore the effect of methylphenidate treatment on symptoms of ASD, functioning and adverse effects  Six articles were extracted from five different databases (Medline, Psych INFO, PubMed, Scopus, and Web of Science) and chosen based on a pre-determined inclusion and exclusion criteria. The results show that MPH treatment may be successful as an intervention for some children with ASD showing ADHD symptoms while other children are very susceptible to adverse effects with some being unable to tolerate the treatment. The chosen studies provided limited acknowledgement of the effect on functioning making it an important focus for future research. It is important that professionals are aware of the negative effects MPH might cause to ensure a positive outcome and well-being for children with this disorder. There is a need for further understanding of the connection between ASD and ADHD with additional exploration of possible moderators such as IQ, dose size and level of functioning.

Background: Children and youths with neurodevelopmental disorders are less physically active and have inferior physical fitness levels than their typically developed peers. Organized activities, especially team sports, can be challenging to this group due to common socio-behavioral, linguistic, and personality characteristics and limitations in motor proficiency. Physical activity and team sports may benefit this group by improving cognition, attention, socio-emotional functioning, and motor skills. Aim: Explore the conditions for including children and youths with neurodevelopmental disorders in team sports in Sweden. Methods: A mixed-methods approach was applied. Semi-structured interviews investigated the structural and organizational practices surrounding barriers and enablers to inclusion and coach education. A nationwide web survey described the coaching population and assessed perceived knowledge and conditions for inclusion in team sports. Soccer, ice hockey, floorball, handball, and group gymnastics represented the team sports. A qualitative content analysis was applied to interview data, followed by descriptive and bivariate (chi-square and simple multinomial logistic regression) analyses and multiple multinomial logistic regressions. Results: This neurodiverse group was described as difficult to target due to its heterogeneity. Sports associations described going through an identity introspection and working on inclusion issues at large but had different ways of addressing neurodevelopmental disorders, and varying strategies to educate coaches. Most coaches reported receiving education outside of sports. 40% of coaches claimed to have knowledge of neurodevelopmental disorders, associated with personal experiences, female gender, and coaching older junior teams. 71.6% of coaches felt comfortable accommodating this group, also related to personal experience, coaching under 8 teams, knowing whom to turn to for support, and coaching older junior teams. Conclusion: While most coaches felt capable of accommodating children with neurodevelopmental disorders, coach knowledge was based on personal experiences and interests. Sports associations addressed the inclusion issue but need to develop their educational opportunities for coaches. Increased knowledge could make team sports more accessible to children with invisible disabilities. / Bakgrund: Barn och unga med neuropsykiatriska funktionsnedsättningar är mindre fysiskt aktiva och har sämre fysisk kondition än sina neurotypiska jämlikar. Organiserade aktiviteter, särskilt lagidrott, kan utgöra en utmaning för denna grupp på grund av vanliga sociala, språkliga och personliga egenskaper och beteenden, samt motoriska begränsningar. Fysisk aktivitet och lagidrott kan gagna denna grupp genom att förbättra kognition, uppmärksamhet, socio-emotionella och motoriska färdigheter. Syfte: Att utforska förutsättningarna för att inkludera barn och unga med neuropsykiatriska funktionsnedsättningar inom lagidrotten i Sverige. Metod: En blandad metod tillämpades. Semistrukturerade intervjuer användes för att undersöka strukturell och organisatorisk praxis kring hinder och möjliggörare för inkludering och ledarutbildningar. En nationell webb-baserad tvärsnittsundersökning beskrev gruppen med ledare och undersökte ledares självskattade kunskap och förutsättningar för inkludering inom lagidrotten. Fotboll, ishockey, innebandy, handboll och truppgymnastik representerade lagidrotten. En kvalitativ innehållsanalys applicerades på intervjumaterialet, följt av deskriptiva och bivariata (chi2 samt enkel multinomial logistisk regression) analyser samt multivariata logistiska regressioner. Resultat: Denna neurodiversa grupp beskrevs som en svår målgrupp på grund av sin heterogenitet. Idrottsförbunden beskrev hur de analyserar sig själva och arbetar med inkludering i bred bemärkelse men har olika sätt att adressera neuropsykiatriska funktionsnedsättningar, samt varierande strategier för att utbilda ledare. De flesta ledare rapporterade att de genomgått sin utbildning utanför idrotten. 40% av ledarna ansåg sig ha kunskap om neuropsykiatriska funktionsnedsättningar, vilket kunde associeras med personlig erfarenhet, kvinnligt kön och att träna äldre juniorer. 71,6% av ledare kände sig bekväma i att bemöta denna grupp, vilket också kunde associeras med personlig erfarenhet, att träna under 8-åringar, veta vem man kan vända sig till för hjälp, samt att träna äldre juniorer. Slutsats: Medan de flesta ledare kände sig kapabla att bemöta barn med neuropsykiatriska funktionsnedsättningar, baserades ledares kunskap på personlig erfarenhet och intresse. Idrottsförbunden adresserade inkluderingsfrågan men behöver utveckla utbildningsmöjligheterna för ledare. Ökad kunskap skulle kunna göra lagidrott mer tillgänglig för barn med osynliga funktionsnedsättningar.

This research delves into idiopathic autism spectrum disorder (ASD), investigating the role of TrkB signaling pathways and BDNF regulation in the cortex. Additionally, it explores offering insights into maternal influences on mouse models. / Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by challenges in social interactions and repetitive behaviors. Prevalence of ASD is estimated to be 1 in 54 globally and is rising recently in many countries including Canada. ASD affects individuals differently, making diagnosis challenging. At present, no molecular diagnosis of ASD is available. Further, available medications only manage some symptoms of the disease and have adverse side effects in children. Therefore, there is a need for accurate molecular diagnostic tools to aid in molecular detection and treatment of ASD. To this end, a better understanding of the underlying molecular mechanisms that link ASD etiology to ASD-related behavior is crucial. While genetic factors contribute to syndromic ASD, most cases of ASD are idiopathic with unknown causes, influenced by a combination of epigenetic and environmental factors. TrkB and its downstream signaling pathways, such as Akt and Erk, are hyper-activated in syndromic ASD and hypo-activated in idiopathic cases. Therefore, drugs like rapamycin that inhibit the mTOR pathway downstream of TrkB are beneficial for syndromic ASD but not idiopathic cases. Additionally, insulin-like growth factor 1 (IGF-1), which mitigates ASD-related synaptic disruptions via Akt and Erk signaling, shows unchanged mRNA and protein levels along with its receptor in the idiopathic ASD fusiform gyrus. In ASD with either genetic or epigenetic/environmental causes, disruptions in synaptic connectivity are observed. Synaptic function is regulated by signaling pathways involving brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), as well as their downstream signaling cascades such as MAPK and Akt. The existing literature suggests that there is an association between BDNF and TrkB signaling pathways and ASD. However, a serious gap in knowledge about the precise molecular role of TrkB in ASD pathology is that our current understanding is correlational in nature and based on observational studies that lack causal experiments. This underscores the importance of further research to understand the causative role of TrkB and its related molecular events in idiopathic ASD. The present work aims to provide a deeper understanding about the causative role of molecular mechanisms underlying TrkB signaling in ASD. ASD mouse models exhibit behaviors and molecular features resembling those observed in human ASD. Therefore, these mouse models are helpful tools for studying ASD. However, understudied physiological confounding factors, such as maternal age and parity, can introduce biases and add to data variability, thus negatively impacting the reproducibility and translational value of ASD mouse models. To achieve a reliable mouse model of ASD, we conducted our first study that examines the impact of maternal age and parity on pregnancy complications, neurodevelopment, and social behavior in mice. Results demonstrate that older maternal age and prior motherhood interact to ensure a normal, steady developmental rate and provide protective effects against anxiety, social impairment, and olfactory deficits. Given the current lack of clarity regarding the causative impact of TrkB on ASD pathology, our subsequent investigation sought to establish a causal relationship between TrkB signaling and ASD. We used the TrkB agonist, LM22A-4 treatment in a validated ASD mouse model. Our results demonstrate that treatment with LM22A-4 effectively rescues the core symptoms associated with ASD (social impairment and repetitive behavior). These findings indicate that impaired TrkB signaling is responsible for ASD-like behavior of valproic acid (VPA)-exposed mice. However, unlike TrkB-related molecular events occurring in the fusiform gyrus of idiopathic ASD, TrkB isoform protein levels, BDNF species, Akt, and Erk total protein levels and activation remained unchanged in VPA-exposed cortices compared to healthy control mice. Since our VPA mouse model does not replicate human idiopathic ASD, our study cannot draw a conclusion on how disruptions in these signaling pathways may contribute to the development and manifestation of ASD symptoms. Cortex is responsible for various aspects of social behavior that are impaired in ASD. However, regulatory mechanisms that are involved in ASD upstream of cortical TrkB and BDNF are not well known. BDNF expression is highly cell-and tissue-specific and is regulated by different sets of transcription factors in specific tissues. While NURR1, the BDNF regulator in midbrain neurons, is associated with ASD pathology, its specific role in regulation of cortical BDNF is not yet well-established. Our third study aimed to understand the role of NURR1 in regulating BDNF specifically in the cortex. We showed that in resting and depolarized neurons, when NURR1 is knocked down, BDNF mRNA levels remained unchanged, suggesting that NURR1 does not regulate BDNF in cortical neurons and highlighting the tissue-specificity of BDNF regulation. In summary, we address the understudied effects of maternal factors on mouse models, which enhances the reliability of ASD research. Further, our studies significantly enhance the understanding of ASD by elucidating the role of TrkB and its downstream signaling pathways in the behavioral aspects of the disorder. We also contribute to the knowledge of BDNF regulation in the cortex, a brain tissue with crucial roles in various aspects of social behavior. In a forward-looking approach, the results of our studies provide valuable insights into mouse modeling of idiopathic ASD and the potential role of TrkB in ASD behavioral symptoms. / Thesis / Candidate in Philosophy / Autism spectrum disorder (ASD) is a condition that is accompanied by challenges in social interaction and repetitive behaviors. ASD is a complicated condition because we do not fully understand all the details of how it works in the body. Studying ASD is important as it is the most challenging condition in children and it is becoming more common, especially in the last two decades. While scientists are developing molecular tools to improve ASD diagnosis and understand its biology, these tools are not widely used in clinics for ASD diagnosis yet. Also, the approved medications available can only help with managing some of the behavioral symptoms like self-harming behavior. Despite the pressing need to find a solution, our recent advancements have not yet brought us closer to a cure for ASD, mainly because of the complexity of the disorder. Therefore, identifying the specific ASD-related mechanisms at the molecular level that contribute to ASD-related behaviors is crucial for gaining a deeper understanding of the disease. In ASD, there are problems with how brain cells communicate with each other. This communication is controlled by certain molecules in the brain, such as brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), along with other molecules. There is evidence suggesting a link between these molecules and ASD, but we have not fully understood their precise roles because most of the current knowledge is based on observations and correlations, rather than on establishing cause-and-effect relationships. To bridge this gap, our research focused on understanding TrkB's role in ASD. We required reliable mouse models. Since we aimed to induce ASD-like behaviors in mice using an ASD-causing chemical, it was crucial to ensure they were healthy beforehand. We needed to confirm that any social deficits or repetitive behaviors were not due to other factors, such as adverse infancy experiences or impaired interactions between mother and infant. We discovered that sexually mature dams aged between 3 to 6 months, with a history of previous pregnancies and motherhood, give birth to healthier litters. These litters can serve as a more dependable source for our animal behavioral studies. Many cases of ASD in humans are caused by non-genetic factors such as environmental influences like pesticides, air pollution, and the use of certain drugs during pregnancy. In cases of human ASD triggered by non-genetic factors, there is an increase in proBDNF, the precursor of BDNF. However, this proBDNF does not efficiently convert to BDNF. With insufficient BDNF and TrkB receptors, molecules like Akt (protein kinase B, also PKB) and Erk (Extracellular Signal-Regulated Kinase), which are crucial for neuron communication, are also less active downstream. This imbalance disrupts neuron connections, leading to ASD behaviors. In our research, the ASD-causing chemical which we used is valproic acid. It is originally an anti-seizure medication. When pregnant women took valproic acid, the chance of their child having ASD increased. Scientists used this information to inject pregnant mice with valproic acid, and as a result, all the offspring showed ASD-like behaviors. We anticipated that by isolating the brains of these offspring and measuring protein levels of BDNF, TrkB, Akt, and Erk, we would observe a similar pattern to that seen in humans with non-genetic ASD cases. We focused on studying the cortex, a region of the brain responsible for regulating social behaviors in both mice and humans. Since ASD is associated with challenges in social behaviors, we isolated the cortex from mouse brains to analyze protein levels. A chemical known as LM22A-4 with a structure resembling BDNF can bind to TrkB and activate it. We expected that the offspring of pregnant dams injected with valproic acid, which led to reduced TrkB axis activation in their brains, would show improvement in ASD behavior. This anticipation stems from the understanding that LM22A-4 activates the TrkB axis, thus compensating for its reduction, which is thought to be causing ASD-like behaviors. The offspring of mothers injected with valproic acid exhibited ASD-like behaviors, unlike the control mice. Control mice were offspring of pregnant dams injected with a solution containing only the substances used to dissolve valproic acid, typically water and salt (saline). Mice prenatally exposed to valproic acid (VPA) exhibited ASD-like behaviors, but treatment with LM22A-4 helped alleviate these behaviors, promoting more typical behavior patterns. LM22A-4, by activating TrkB receptors, helped to protect the brain from harm caused by exposure to valproic acid before birth. This could mean that valproic acid-induced changes in TrkB-related molecular mechanisms are involved in social behavior difficulties and increased repetitive behaviors seen in autism. Nevertheless, the levels of TrkB, BDNF, proBDNF, Akt, and Erk in the cortex of offspring from mothers injected with valproic acid were like those in the offspring from mothers injected with the saline solution. Therefore, the BDNF and TrkB signaling pathways remained unchanged in the cortex of our valproic acid model in this study, and they differ from those observed in human idiopathic ASD. We also speculated that a protein, called NURR1 acting upstream of BDNF and TrkB might be involved in the process. NURR1 acts as a regulatory protein that binds to the BDNF, increasing the production of copies from the BDNF. We also used a small RNA that targets a specific region in the Nurr1 and inhibits its protein production We anticipated a reduction in Nurr1 levels. As NURR1 acts as an upregulator of BDNF, lower levels of Nurr1 would result in decreased BDNF production. Activating NURR1 resulted in increased BDNF mRNA levels. However, when NURR1 was reduced, BDNF mRNA levels remained unaffected. This led us to conclude that if NURR1 levels decrease, other proteins may step in to maintain BDNF mRNA levels. Therefore, in the cortex, unlike in some other brain regions, the presence of NURR1 is not essential for regulating Bdnf. In summary, before inducing ASD-like behavior in mice using valproic acid, it is crucial to ensure the health of the mice. We used sexually mature mothers with prior pregnancy experience to provide a healthy baseline. We showed valproic acid induced ASD-like behaviors in mice offspring. We also observed that LM22A-4 treatment alleviated ASD-like behaviors of offspring. In our study, we demonstrated that the levels of BDNF, TrkB, Erk, and Akt proteins in the cortex of mice exposed to valproic acid were not affected. For this reason, our mouse model does not resemble human non-genetic ASD. Finally, NURR1's role in BDNF regulation varies by brain region. Lowering NURR1 did not affect BDNF mRNA levels, suggesting compensatory mechanisms. Our findings suggest new directions for further research to better understand the roles of TrkB and BDNF in non-genetic ASD. Overall, this study provides valuable knowledge that can contribute to advancing our understanding of idiopathic ASD-related molecular mechanisms.

Certaines recherches ont investigué le traitement visuel de bas et de plus hauts niveaux chez des personnes neurotypiques et chez des personnes ayant un trouble du spectre de l’autisme (TSA). Cependant, l’interaction développementale entre chacun de ces niveaux du traitement visuel n’est toujours pas bien comprise. La présente thèse a donc deux objectifs principaux. Le premier objectif (Étude 1) est d’évaluer l’interaction développementale entre l’analyse visuelle de bas niveaux et de niveaux intermédiaires à travers différentes périodes développementales (âge scolaire, adolescence et âge adulte). Le second objectif (Étude 2) est d’évaluer la relation fonctionnelle entre le traitement visuel de bas niveaux et de niveaux intermédiaires chez des adolescents et des adultes ayant un TSA. Ces deux objectifs ont été évalué en utilisant les mêmes stimuli et procédures. Plus précisément, la sensibilité de formes circulaires complexes (Formes de Fréquences Radiales ou FFR), définies par de la luminance ou par de la texture, a été mesurée avec une procédure à choix forcés à deux alternatives. Les résultats de la première étude ont illustré que l’information locale des FFR sous-jacents aux processus visuels de niveaux intermédiaires, affecte différemment la sensibilité à travers des périodes développementales distinctes. Plus précisément, lorsque le contour est défini par de la luminance, la performance des enfants est plus faible comparativement à celle des adolescents et des adultes pour les FFR sollicitant la perception globale. Lorsque les FFR sont définies par la texture, la sensibilité des enfants est plus faible comparativement à celle des adolescents et des adultes pour les conditions locales et globales. Par conséquent, le type d’information locale, qui définit les éléments locaux de la forme globale, influence la période à laquelle la sensibilité visuelle atteint un niveau développemental similaire à celle identifiée chez les adultes. Il est possible qu’une faible intégration visuelle entre les mécanismes de bas et de niveaux intermédiaires explique la sensibilité réduite des FFR chez les enfants. Ceci peut être attribué à des connexions descendantes et horizontales immatures ainsi qu’au sous-développement de certaines aires cérébrales du système visuel. Les résultats de la deuxième étude ont démontré que la sensibilité visuelle en autisme est influencée par la manipulation de l’information locale. Plus précisément, en présence de luminance, la sensibilité est seulement affectée pour les conditions sollicitant un traitement local chez les personnes avec un TSA. Cependant, en présence de texture, la sensibilité est réduite pour le traitement visuel global et local. Ces résultats suggèrent que la perception de formes en autisme est reliée à l’efficacité à laquelle les éléments locaux (luminance versus texture) sont traités. Les connexions latérales et ascendantes / descendantes des aires visuelles primaires sont possiblement tributaires d’un déséquilibre entre les signaux excitateurs et inhibiteurs, influençant ainsi l’efficacité à laquelle l’information visuelle de luminance et de texture est traitée en autisme. Ces résultats supportent l’hypothèse selon laquelle les altérations de la perception visuelle de bas niveaux (local) sont à l’origine des atypies de plus hauts niveaux chez les personnes avec un TSA. / Most studies investigating visual perception in typically developing populations and in Autism Spectrum Disorder (ASD) have assessed lower- (local) and higher-levels (global) of processing in isolation. However, much less is known about the developmental interactions between mechanisms mediating early- and intermediate-level vision in both typically developing populations and in ASD. Based on such premise, the present thesis had two main objectives. The first objective (Study 1) was to evaluate the developmental interplay between low- and intermediate-levels of visual analysis at different periods of typical development (school-age, adolescence and adulthood). The second objective (Study 2) was to evaluate the functional relationship between low- and intermediate-levels of visual analysis in adolescents and adults diagnosed with ASD. Common methodologies were used to assess both objectives. Specifically, sensitivity to slightly curved circles (Radial Frequency Patterns or RFP), defined by luminance or texture information, was measured using a two alternative temporal forced choice procedure. Results obtained in Study 1 demonstrated that local information defining a RFP (mediated by intermediate visual mechanisms) differentially affected sensitivity at different periods of development. Specifically, when the contour was luminance-defined, children performed worse when compared to adolescents and adults only when RFPs targeted a global processing style (few deformations along the RFP’s contour). When RFPs were texture-defined, children’s sensitivity was worse compared to that of adolescents and adults for both local and global conditions. Therefore, timing of adult-like sensitivity to RFPs is dependent on the type of local physical elements defining its global shape. Poor visual integration between low and intermediate visual mechanisms, which could be attributed to immature feedback and horizontal connections as well as under-developed visual cortical areas, may account for such reduced sensitivity in children. Results obtained from Study 2 demonstrated that manipulating the local physical elements of RFPs impacts visual sensitivity in ASD. Specifically, sensitivity to RFPs is unaffected in ASD only when visual analysis is dependent on local deformations of luminance-defined contours. However, sensitivity is reduced for both local and global visual analysis when shapes are texture-defined. Such results suggest that intermediate-level, shape perception in ASD is functionally related to the efficacy with which local physical elements (luminance versus texture) are processed. It is possible that abnormal lateral or feed-forward / feedback connectivity within primary visual areas in ASD, which possibly arise from excitatory / inhibitory signalling imbalance, accounts for differential efficacy with which luminance and texture information is processed in ASD. These results support the hypothesis that atypical higher-level perception in ASD, when present, may have early (local) visual origins.

De senaste decennierna har förutsättningarna på arbetsmarknaden förändrats till följd av bland annat den tekniska utvecklingen och ökade krav på stresstolerans och social kompetens. Vi har upptäckt ett forskningsgap gällande möjligheter för individer med autismspektrumtillstånd att delta på den svenska arbetsmarknaden genom anställning. Studiens syfte var att undersöka Stockholms stads styrdokuments beskrivning av krav och ideal på medarbetare samt vilka insatser som bedrivs. Detta för att undersöka möjligheterna för individer med neuropsykiatrisk funktionsnedsättning i allmänhet och autismspektrumtillstånd i synnerhet att delta genom arbete i kommunens verksamheter. Vi har genomfört en dokumentstudie och använt induktiv tematisk analys för att söka förståelse. Vår slutsats är att kraven på medarbetarna tenderar hindra deltagande i arbete för studiens fokusgrupp särskilt gällande krav på social kompetens och utveckling av kommunens verksamheter. Kravet på individanpassning kan tyda på ökade möjligheter till deltagande. Då insatserna på daglig verksamhet har bristande incitament att nå reguljär arbetsmarknad kan fokus på insatser i verksamheterna hindra möjligheterna till deltagande i arbete för fokusgruppen / The last decades, prerequisites on the labour market have changed due to technical development and elevated demands on stress-resistance and social skills. We have distinguished a research gap in terms of examining the possibilities to attend the competitive labour market for adults with autism spectrum disorder in Sweden. The aim of this study is to examine regulatory documents from Stockholm municipality and how they describe requirements and ideals on their employees and which efforts they conduct. This to examine the possibilities for individuals with neuropsychiatric disabilities in general and autism spectrum disorder specifically to participate through employment within the municipality’s various functions. Our conclusion is that the demands on the employees tend to hinder participation in work for the focus group because of demands on social competencies and constant development of the organisations various functions. The demand on personal adaption could contribute to increase participation. Since the efforts within daily activities tend to lack incentives to reach the competitive labour market, a large focus on these efforts might hinder further participation in work for the focus group.