Much research has been carried out on the subject diagnoses. More and more pupils have in recent years been diagnosed with autism spectrum disorder and therefore teachers need more information about how we can help these pupils, so that they can reach the skill requirements in school. Our purpose with this research is to find out if and how important routines are for pupils with autism spectrum disorder. Furthermore, we want to ascertain which tools and methods can be used to help these pupils. The empiricism was collected through interviews and observations. Based on these we have found out that routines are extra relevant for pupils that are diagnosed with autism spectrum disorder and also that there are some methods and facilities that are very helpful for these certain pupils.

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This purpose of this study was to investigate the effectiveness of an intervention package that combined Skillstreaming procedures for the development of social skills with the use of video modeling for middle school students identified with ASD. Specifically, the purpose of this study was to determine if the video modeling intervention package has an impact on social skill performance of three middle school-aged students with ASD. A multiple probe design across participants was employed to assess the effects of the video modeling intervention package on two beginning social skills (i.e., initiate greetings and initiate a conversation). The participants were three middle school-aged students with ASD enrolled in a self-contained classroom. The dependent variable was the percentage of correct social skills components performed when greeting the teacher and initiating a conversation within in the first 10 minutes of class each morning. The independent variable was an intervention package that included video modeling and direct instruction for each social skill component with Skillstreaming procedures (i.e., modeling, role playing, feedback). The results of this research indicated that all three students improved their social skills performance following the implementation of the video modeling intervention package. Furthermore, during the maintenance phase, the social skills performance of each student was maintained. Recommendations for further study and for teachers of students with ASD are presented.

Given the behavioral expectations of students by teachers and peers in middle school inclusive classrooms and characteristics inherent to students with ASD, the purpose of this study was to explore the impact of video modeling and peer mentoring of five critical social skills for inclusion on middle school students with ASD. Specifically, the extent to which the combination of video modeling and peer mentoring of five critical social skills would increase the level of demonstration of these skills in the general education inclusion setting was investigated. Because individuals with ASD exhibit limited social communication skills, those skills necessary especially at the middle school level to understand the "hidden curriculum", social skills instruction has been deemed important (APA, 2004; Smith-Myles & Simpson). The current multiple baseline across subjects study was grounded in the research on video modeling (Bellini & Akullian, 2007) and peer mentoring (Fuchs & Fuchs, 2005; Maheady, Harper, & Mallette, 2001) as methods of providing social skills instruction for middle school students with ASD (Goldstein & McGinnis, 1997; Smith-Myles & Simpson, 2001). The impact of the video models and peer mentors was measured using the level of demonstration of five critical social skills on three middle school aged students with ASD. All three students with ASD were included in at least one general education classroom. The results of this investigation indicated that the combination of video modeling and peer mentoring of critical social skills positively impacted the levels of demonstration of the skills of students with ASD. While results varied, all three students with ASD increased their levels of demonstration of the targeted critical social skills.

Syfte: Studiens syfte var att beskriva arbetsterapeuters erfarenheter av arbete kopplat till skolrelaterade aktiviteter tillsammans med barn med autismspektrumtillstånd. Metod: Studien antog en kvalitativ ansats för att beskriva arbetsterapeuternas subjektiva upplevelser. Sju arbetsterapeuter intervjuades för att samla erfarenheter av att arbeta med barn med autismspektrumtillstånd (AST) kopplat till skolrelaterade aktiviteter. Insamlat material analyserades genom en kvalitativ innehållsanalys. Resultat: Arbetsterapeuternas beskrivningar presenterades i resultatet under kategorierna; Förutsägbarhet underlättar utförandet av aktiviteter, Både fysisk och social miljö påverkar aktiviteter, Återhämtning, viktigt både hemma och i skolan samt Vuxenstöd och vikten av kunskap. Slutsats: Resultatet visade att arbetsterapeuterna arbetade tillsammans med barnen för att skapa struktur, förutsägbarhet, möjlighet till återhämtning samt en miljö som gynnade skolrelaterade aktiviteter. Resultatet visade även vikten av att informera, utbilda och ge tips till vuxna i barnens närhet, vuxenstödet är en viktig del i arbetet med barn med AST. / Aim: The aim of this study was to describe occupational therapists experience of work with children with autism spectrum disorder (ASD) and how they support them around school activities. Method: This study had a qualitative design. Seven interviews were conducted with occupational therapists with experience that could give answers to the aim of the study. The material was then analyzed. Results: The occupational therapists’ descriptions of their experiences were presented in four different categories; Predictability supports activity performance, Physical and social environment affects activities, Recovery is important at home and in school and Support from adults and the important of knowledge. Conclusion: The results showed that occupational therapists worked together with children with ASD to create structure, predictability and an environment that supported school activities. The results also showed how important it is to educate, inform and give advice to adults in the child’s life, support from adults is an important part of the work with children with ASD.

Suicide continues to be a critical concern for society as one of the leading causes of death in the United States, increasing from 10.4 to 13.5 per 100,000 from 2000 to 2016. This risk is further increased up to 8 times for individuals with Autism Spectrum Disorder. Suicidal thoughts and behaviors have been difficult to predict on a moment-by-moment basis, in part due to technological challenges. Suicidal ideation has been identified as an important indicator of suicidal behavior and an important measurement for predicting suicide in both neurotypical individuals and individuals with autism spectrum disorder. In particular, sleep disturbances are one risk factor for suicidal behavior. Important aims of this study include identifying personalized predictors of leading up to suicidal ideation, including how sleep activity patterns affect suicidal ideation, and how these risk factors differ between those with autism spectrum, socially anxious groups. This will give further insight into predictors of suicidal ideation, providing a better understanding for predicting changes in suicidal ideation, with aims to bring more clarity in this at-risk population and improve treatment options. To observe predictors of both long-term and short-term changes in suicidal ideation, I will analyze longitudinal data. The data includes daily phone questionnaires and actigraphy data tracking using GENEActiv wearable devices that includes sleep from individuals with autism spectrum and social anxiety with a history of suicidal ideation, and neurotypical individuals who are tracked over 24-36 weeks. Results of analysis indicate that sleep duration is not a significant predictor of suicidal ideation intensity, and that there is no difference between the autism spectrum and social anxiety groups in the predictive ability of sleep. Limitations of this study include local convenience sampling which includes a large majority of white participants, part of the study and data collected occurring during the COVID-19 pandemic, and potential response bias for such a sensitive topic. This study shows overall that there is a working model for this type of analysis, however many more features of sleep including movement during sleep and waking during sleep need to be analyzed to see if there is any predictive power in information from actigraphy, which would be a low invasive method for detecting increases in suicidal ideation risk.

Behavioral symptoms of autism spectrum disorder (ASD) begin to emerge around 12 months of age and are preceded by subtle differences in how infants process and interact with the world (Elsabbagh & Johnson, 2010). Similar atypical behavioral patterns and markers of brain organization (`endophenotypes') are present in infants at risk for ASD (HRA) due to their family history, regardless of whether they ultimately develop the disorder. Possible endophenotypes of ASD were investigated through four studies that examined event-related potentials (ERPs) to speech and language in HRA and low-risk control (LRC) infants as part of a larger, longitudinal project. Chapter 2 examined ERPs to language-specific phonemes at 6, 9, and 12 months (n=59 at 6mo, 77 at 9mo, and 70 at 12mo) and found that HRA infants were not delayed in phonemic perceptual narrowing yet exhibited atypical hemispheric lateralization of ERPs at 9 and 12 months. Chapter 3 explored these findings further in a sample with known developmental outcome (n=60 at 6mo, 75 at 9mo, and 72 at 12mo) in order to understand how these ERPs differ between infants who ultimately develop ASD and infants who do not. Chapter 4 examined responses to repeated speech stimuli at 9 months (n=95). HRA infants exhibited atypically large ERPs to repeated speech, and this pattern was associated with better later language ability. Finally, Chapter 5 examined ERPs to words at 18 and 24 months (n=41 at 18mo, 52 at 24mo) and found evidence for atypical topography of responses to known versus unknown words, particularly at 18 months. These findings provide evidence that in HRA infants, even those who do not develop ASD, neural processing of linguistic stimuli is altered during infancy and toddlerhood. The results from Chapter 4 suggest that at least some of the differences seen in HRA infants who do not develop ASD may reflect beneficial, rather than disordered, processing. Overall, these results contribute to growing evidence that familial risk for ASD is associated with atypical processing of speech and language during infancy. Future work should continue to investigate more closely the implications of atypical neural processing for infants' later development.

The Centers for Disease Control (CDC) reported that approximately 1 in 54 children in the U.S. is diagnosed with an Autism Spectrum Disorder (ASD) (CDC, 2020). The prevalence of individuals diagnosed with or at-risk for ASD has increased over the past two decades (Baio et al., 2018). Impairments in social functioning, a central feature of ASD, have widespread effects on the lives and opportunities of individuals with this disorder (American Psychiatric Association, 2013). As a result, individuals with ASD are less satisfied with opportunities for social inclusion, physical well-being, and interpersonal relationships compared to individuals with intellectual disabilities (Arias et al., 2018). Technology-aided intervention may be used to reduce some of the barriers limiting access to social skills intervention. In particular, the technology-aided intervention can provide a highly motivating medium for the rehearsal of skills in a safe, controlled, and self-paced manner (Parsons & Beardon, 2000), allow for treatment programs to be implemented with high precision and fidelity with less variability, and reduce the cost of the intervention and other accessibility barriers (Ploog et al., 2013). VR has been studied extensively in training social skills for individuals diagnosed with ASD. With the flexibility and projected effectiveness that VR offers, it can provide more opportunities to learn and practice strategies for recognizing daily challenges that involve forming social relationships and related reasoning with more flexibility. VR provides a safer platform for people with ASD rather than practicing the social skill with actual people in a class or a group, it can be an excellent precursor for teaching these skills. There exists sufficient literature to provide evidence regarding the effectiveness of VR-based SST relevant for OT practice. However, the gap between the existing literature and method to integrate it in OT practice restrains OT practitioners to adopt and integrate VR in practice. Lack of comprehensive training designed specifically for OT practitioners to educate about the methods to implement, VR system selection for the priority population, and the theoretical base for implementation and use are some common barriers to using VR. To this end, this program is designed to empower OT practitioners to become efficient and confident in using this technology for addressing social skills deficits related to ASD. This is a professional development program to be delivered based on theory-driven approaches. The program is comprised of a training workshop accompanied by a hands-on practice element to provide OT practitioners with the avenue to learn, practice, and evaluate their current practices and knowledge regarding VR. Acquiring this training in using VR-based approaches will not only prepare therapists to confidently provide just the right challenge to the clients with autism according to their needs but also enhance the scope of individual OT practice.

Autism spectrum disorder is a diagnosis that involves difficulties with sensory sensitivity, communication, and social interaction. This condition means that the physical and psychosocial care environment can be experienced as difficult to manage. This literature review aims to explore adult patients with autism spectrum disorders' experiences of being in a care environment. A literature review was conducted where eight articles of qualitative, quantitative, and mixed methods were analyzed. Systematic searches were made in the databases Cinahl, PubMed, and PsycInfo. The results from the analysis were then written down into two main themes and seven sub-themes. The patients testified about experiences in the care environment where needs for adaptations in the physical-, sensory- and psychosocial environment had not been catered for. The patients requested individual adaptations, private spaces, and alternative communication methods. Stress was mainly caused by noise, lack of communication and short care meetings. Several of the deficiencies that emerged could lead to anxiety in the patients. Understanding the specific needs of adults with autism spectrum disorders in the care setting is critical. The care environment needs to become more accommodating when it comes to adaptations and design. Even adaptations to reduce the sensory stimulation can be part of alleviating the often stressful care environment but also to increase the well-being of the patient.

Group social skills training (GSST) is an important intervention approach to help children and adolescents with autism spectrum disorder (ASD) to find more success in social engagement and inclusion. However, there is a lack of research using direct behavioral observations, especially in generalization of acquired skills to settings other than the treatment setting. We provided social skills training to 25 adolescents with ASD using a curriculum shown to have positive effects (the UCLA PEERS® curriculum). We also administered the Autism Social Skills Profile (ASSP) and Social Communication Questionnaire – Current (SCQ-Current) to the parents of participants before and after the GSST to ensure it had the intended effect, which showed minor improvements in some areas of social engagement, though not statistically significant. We then provided seven participants and their peers in their community groups with a brief intervention that taught principles of including those with disabilities. We analyzed each of these seven participants’ level of social engagement in their community groups before and after the intervention using a multiple baseline design. Peer inclusion instruction produced mixed results across participants. We discuss the feasibility and future directions for the generalization of acquired social skills.