Autismspektrumtillstånd (AST) är en neuropsykiatrisk funktionsnedsättning som kan påverka individens vardagsliv. Livsområden som kan vara problematiska är bland annat arbetsliv, familjeliv, relationer och områden som kräver social interaktion. Syftet med föreliggande studie var att undersöka vardaglig kommunikation hos vuxna med AST samt att genom deltagarnas personliga berättelser undersöka hur AST kan påverka en individs liv. Denna typ av studie är viktig för att generera en bättre förståelse för behoven hos vuxna med AST och därmed ge indikationer för vilka typer av anpassningar som kan behövas i samhället. Föreliggande studie baserades på en videoinspelad fokusgruppsdiskussion med fyra deltagare som i vuxen ålder har diagnostiserats med AST. Två olika analysmetoder användes för att studera materialet, nämligen samtalsanalys och innehållsanalys. Resultaten visade att deltagarna har kompetens för social interaktion och empatisk förmåga. Ett par av deltagarna uppfattades ha annorlunda blickanvändning, och oväntade ämnesbyten och avbrottsförsök observeras under diskussionen. Flertalet av deltagarna uppgav att de har haft psykiska svårigheter under sina liv och de ser diagnostiseringen som viktig för deras livskvalitet då den möjliggör kontaktskapande med likasinnade. Detta förefaller vara betydelsefullt för dem då de har svårt att bygga relationer. Resultaten i föreliggande studie kan bidra till en ökad förståelse för hur en neuropsykiatrisk diagnos kan påverka en individs liv. / Autism Spectrum Disorders (ASD) is a neuropsychiatric impairment that may affect an individual's everyday life. Life areas that may be problematic include work, family, relationships and areas that require social interaction. The aim of the present study was to investigate communication in everyday life amongst adults with ASD as well as, by listening to the participants' personal narratives, explore how AST can affect an individual's life. The study was based on a video recorded focus group discussion with four participants who in adulthood have been diagnosed with ASD. Conversation Analysis and Content analysis were used for analysis of the material. The results showed that the participants have skills for social interaction and empathy. Some of the participants were perceived as using their gaze in a deviant way, and unexpected changes in topics and attempted interruptions were observed during the discussion. The majority of the participants described periods of psychiatric problems during their lives, and that the diagnosis has been important for their quality of life as it enables them to create relationships with people with similar difficulties. This appears to be important to them since they have difficulties building relationships. The results contribute to a better understanding of how a neuropsychiatric diagnosis can affect an individual's life.

Asthma and allergies have increased considerably during the past 40-50 years. Along with this increase, a heightened awareness regarding different neuro-developmental disorders such as autism spectrum disorder has occurred and it has been proposed that such disorders are also on the increase. It has been suggested that environmental factors, especially in the indoor environments, may be associated with the increase in these disorder, especially among children, who spend more than 90% of their time indoors. The aim of this thesis has been to investigate certain environmental factors in homes and their impact on children’s health, in terms of asthma, rhinitis, eczema as well as autism spectrum disorders, and to identify certain methodological difficulties in epidemiological investigations. We found that the mean incidence rate per year for doctor diagnosed asthma was in the range of 0.6-2.4% and for incidence of rhinitis 1.1-3.7%. The incidence rate of eczema ever was 2.7%. These results showed that when using a cohort established after birth the estimated incidence rates are strongly dependent of how the baseline population’s health and how the studied health outcome at follow up is defined. Our results showed that the associations between parental reported moisture problems in the home and asthma in children that were revealed in cross-sectional analyses decreased or disappeared when longitudinal data were used on the same data set. Our results therefore indicate that associations between parental reported moisture problems and asthma from cross-sectional questionnaire studies should be interpreted with caution due to the risk for reporting bias. Our results show that children who were living in homes with PVC-flooring in the bedroom in early childhood were more likely to develop asthma during the following 5-year period when compared with children living in homes without such flooring material. A similar association could be seen for children with autism spectrum disorder, where PVC-flooring in early childhood was associated with more reports of autism spectrum disorder five years later. These results indicate that building materials including suspected endocrine disrupting chemicals such as phthalates might be of importance for the development of these chronic diseases. Further studies are needed to explore the early life exposure and the mechanisms and contribution of phthalates for the development of chronic diseases. / Appendix A (en undersökning) och Appendix B (en undersökning)finns i den tryckta versionen av avhandlingen

Introduction: Young people with high functioning autism spectrum disorders (HFASD) are particularly vulnerable to developing comorbid depression. It has been suggested that young people with HFASD and comorbid mental health difficulties are likely to experience difficulties during the transition to adulthood. This transition involves significant changes in both services and daily routine, something which people with HFASD often find difficult. Aims: This thesis includes two distinct pieces of work. A systematic review aiming to understand the prevalence of depression in children and young people with HFASD. A qualitative study aiming to explore transition to adulthood from the perspectives of young people with HFASD, who currently attend child and adolescent mental health services (CAMHS), and their families. Methods: For the systematic review, literature reporting the prevalence of depression in children and young people with HFASD was systematically searched and reviewed. For the qualitative study, data collection and analysis followed the principles of Interpretative Phenomenological Analysis (IPA). Four dyads of a young person with HFASD and a parent were interviewed. Results: The systematic review identified 18 studies which described results from 17 independent samples. The prevalence reported varied from 0% to 83%. This variation is most likely explained by methodological differences between studies. In the qualitative study, transition to adulthood was described as a process during which the young person is developing independence, while parents continue to have a role in providing support. Current and future support needs were perceived differently by the young people with HFASD than their parents, with the young people reporting less need for support. Conclusions: Further research is needed to better understand how to assess depression in this population, as well as the impact of age, gender, setting, medication use and other comorbidities. Transition is a time of uncertainty and change for young people, during which they become more independent of their families. Services need to consider the impact of these processes and young people’s perceptions about what it means to receive support.

abstract: Over the past two decades, substantial research has documented the increase of students with disabilities enrolling in post-secondary education. The purpose of the study was to examine factors identified as significant in preparing individuals who fall on the autism spectrum for post-secondary experiences. The study was exploratory in nature and designed to identify perceived critical program elements needed to design successful post-secondary transition programs for students with an autism spectrum disorder (ASD). The study used archival research and grounded theory to look at expectations of parents with young adults with an ASD and young adults with an ASD on post-secondary transition and to discern whether expectations impact the successful post transition of young adults. More than likely, due to an overall increase in the prevalence of ASDs, many more students with an ASD will be attending a post-secondary educational setting in the near future. Understanding expectations and particular challenges faced by students with an ASD will be necessary for colleges to meet the unique needs of this population. / Dissertation/Thesis / Ph.D. Educational Leadership and Policy Studies 2011

Play is an important contributor to children’s development: it reflects, reinforces, and results in development (Johnson, Christie, Wardle, 2005). However, the tools available to support planning and measurement of play are not sufficiently detailed or focused on children with autism and severe learning difficulties (SLD). Play for children with autism is consistently identified as restrictive and repetitive. Although extensive research examines symbolic play, the content and structure of functional play, which is considered a valuable precursor of symbolic play, is rarely the subject of focused research (Williams, 2003; Lifter, Foster-Sanda, Arzamarski, Briesch, & McClure, 2011). Given the developmental potential that play presents, the aim of this study was to examine the functional play presented by children with autism and SLD, with a view to designing a play framework that enables teachers to support functional play development in the classroom. A pragmatic mixed methods approach was adopted across a three-stage study in three schools. Study 1 provides the background for creating a functional play framework, while Study 2 focuses on the creation of the framework through objective observations of the play activity of a total of 27 children with autism and SLD, as well as interviews with nine classroom teachers. Study 3 was a process of trialling the framework in two schools and collaborating with eight teachers to finalise the functional play framework, in particular by considering its usability. Data collected across the three studies provided a description of functional play that suggests it is more complex than traditionally defined. Four key areas of functional play were identified: interacting with one object; interacting with two (or more) objects; interacting with self; and interacting with the environment. Additionally, 12 subcategories were established as components related to functional play. Teachers reported that they could use the framework to baseline play, set targets and measure play progression for children with autism and SLD. The framework was also identified as a tool that supports classroom management and continuing professional development. The proposed framework facilitates the identification of small increments of progress and extends on other available play frameworks. By developing detailed descriptions of the play that children with autism and SLD present, the framework provides a greater ability to identify precise deficits and, more specifically, to target support in the area of play. Additionally, the collaborative approach with classroom teachers provides diverse viewpoints but also begins to merge the gap between researchers and practitioners in order to ensure a useful resource. Recommendations for further descriptive accounts, greater involvement of classroom professionals in the development of resources and additional trials of the framework are acknowledged.

No description available.

Introdução: O transtorno do espectro autista (TEA) atualmente é definido como um distúrbio do desenvolvimento neurológico caracterizado por déficits na comunicação e interação social e padrões restritos e repetitivos de comportamento, interesses e atividades. Estima-se que aproximadamente 1% da população mundial seja diagnosticada com esta desordem. O TEA manifesta-se por uma variedade de sintomas nas áreas cognitiva, emocional e neurocomportamental. Além dos sintomas característicos como estereotipias, ecolalia, déficits de comunicação, algumas manifestações envolvendo a alimentação podem ser observadas nesses pacientes. As desordens alimentares podem envolver aversão a determinados alimentos, insistência em comer um número limitado de alimentos e recusa de provar alimentos novos. O estado nutricional desses pacientes pode ser alterado pelo inadequado consumo alimentar e fatores relacionados ao comportamento alimentar. Objetivos: avaliar o estado nutricional [antropometria e bioimpedância elétrica (BIA)], o consumo e o comportamento alimentar em crianças e adolescentes com TEA, bem como os sentimentos e estratégias dos pais/cuidadores desses pacientes frente a esse comportamento. Métodos: Para a avaliação antropométrica foram realizadas medidas de peso (kg), altura (cm) e circunferência da cintura (CC). A composição corporal (massa magra e massa gorda) e o ângulo de fase foram verificados através da BIA. Foi calculado o Índice de Massa Corporal (IMC) e classificado o estado nutricional de cada participante. A avaliação do consumo alimentar foi realizada através do preenchimento do registro alimentar de 3 dias, posteriormente os nutrientes foram calculados no software NutriBase® e comparado com os valores das Dietary Reference Intake (DRIs) de acordo com o sexo e idade. O questionário Behavior Pediatrics Feeding Assessment Scale (BPFA) foi utilizado para avaliar o comportamento alimentar dos participantes e as estratégias e sentimentos dos pais/cuidadores referentes ao momento da alimentação das crianças e adolescentes. Resultados: De acordo com o percentual de gordura corporal obtido pela BIA e a CC um amplo percentual desta amostra apresentou adiposidade central e total elevada (49,2%). Segundo o IMC 38,9% apresentaram sobrepeso, 36,5% obesidade e 15,8% baixo peso. O grupo TEA ingeriu em média mais calorias do que o grupo controle apresentou repertório limitado de alimentos consumidos, e alta prevalência de inadequação no consumo de cálcio, sódio, ferro, vitamina B5, ácido fólico, e vitamina C. Os escores do BPFA foram maiores no grupo TEA comparados com controles para todos os domínios. Independente da frequência da manifestação de problemas alimentares estes impactam fortemente os pais/cuidadores. Conclusões: Esta dissertação fornece evidencias sobre seletividade alimentar que não parecem estar associadas com a redução da ingestão de calorias, mas sim com a qualidade da alimentação, sendo assim um potencial fator de risco para doenças nutricionais. Esses resultados contribuem para a importância da avaliação nutricional (antropométrica, da composição corporal e de problemas alimentares) dentro da rotina clínica de pacientes com TEA e seus familiares, sempre considerando as características singulares de cada paciente. / Introduction: The autism spectrum disorder (ASD) is currently defined as a neurodevelopmental disorder characterized by communication and social interaction deficits and restricted and repetitive patterns of behavior, interests and activities. Approximately 1% of the population have ASD diagnoses. ASD is manifested by a wide variety of cognitive, emotional, and neurobehavioral symptoms. In addition to the characteristic symptoms such as stereotypies, echolalia, communication deficits, some events involving nutrition aspects may be observed in these patients. Feeding problems may involve aversion to certain foods, insistence on eating only a small selection of foods and refusal to try new foods. Consequently, nutritional status can be changed by inadequate food consumption and factors related to feeding behavior. Objectives: evaluate the nutritional status [anthropometry and bioelectrical impedance (BIA)], consumption and feeding problems in children and adolescents with ASD. Methods: Anthropometric measurements - weight (kg), height (cm), waist circumference (WC) - were performed and the test of body composition (fat mass, fat free mass) and phase angle was held by BIA. The body mass index (BMI) was calculated and nutritional status of each participant was classified. The food intake evaluation was carried out by a 3-day food record, and nutrients subsequently calculated on the NutriBase® software and compared with the reference values according to sex and age in the Dietary Reference Intake (DRIs). The Behavior Pediatrics Feeding Assessment Scale (BPFA) questionnaire was used to evaluate the feeding problems of the participants and the strategies and feelings of parents / caregivers regarding the mealtime. Results: According to the body fat percentage obtained by BIA and WC, a large percentage of this sample showed a high central and total adiposity (49.2%). According to BMI 38.9% were overweight, 36.5% obesity and 15.8% underweight. The ASD group consumed on average more calories than the control group, showed limited repertoire of foods consumed, and high prevalence of inadequate calcium, sodium, iron, vitamin B5, folic acid, and vitamin C consumption. BPFA scores were higher in the ASD group when compared to controls for all domains. Independently of how often children and adolescents denote feeding problems, when they occur, it impacts strongly on their parents. Conclusions: These studies provides evidence on food selectivity that seem to be associated with the food quality, rather than the reduced calorie intake, thus being a potential risk factor for nutritional diseases. These results contribute to the importance of the nutritional assessment (anthropometric, body composition and eating problems) within the clinical setting in patients with ASD and parents/caregivers, always considering the unique characteristics of each patient.

A presença de traços de personalidade em familiares de pessoas com diagnóstico de Transtornos do Espectro do Autismo (TEA) parece corresponder a algumas das características comportamentais de indivíduos com TEA, apontando para a alta herdabilidade dessa condição. Esta área de estudos é referida como aquela que investiga o fenótipo ampliado do autismo (FAA). A presente pesquisa é composta por dois estudos: o primeiro teve como objetivo apresentar uma revisão crítica da literatura, especialmente sobre os aspectos comportamentais ligados ao FAA, abordando-se os traços de personalidade e diferenças de gênero, nos genitores. O segundo investigou a presença desses traços em genitores de crianças com o diagnóstico de TEA, através de um delineamento de estudos de casos múltiplos, utilizando instrumentos nacionais e internacionais. Os resultados apontam para a presença de traços autísticos nos genitores, especialmente em relação à área de Interação Social Recíproca e Comportamentos Repetitivos e Estereotipados. Esta pesquisa alinha-se a outras, ao identificar alguns traços de personalidade em pais e mães de crianças com autismo, que parecem corresponder, em algum nível, aos encontrados no TEA e, por isso, podem representar o fenótipo ampliado do autismo. / The presence of personality traits in relatives of people diagnosed with Autism Spectrum Disorder (ASD) seems to correspond to some of the behavioral characteristics of individuals with ASD, pointing to the high heritability of this condition. This area of study is referred to as one that investigates the Broader Autism Phenotype (BAP). This research consists of two studies: one aimed at reviewing the literature, especially on the behavioral aspects related to the BAP, approaching the personality traits and gender differences in parents of children with autism. Second, we investigated the presence of these traits in these parents through a design of multiple case studies, using national and international measures. The results indicate the presence of autistic traits in these parents, especially in relation to the area of Social Interaction and Repetitive and Stereotyped Behaviors. This research aligns to other studies of the field, to identify some personality traits in parents of children with autism, which seem to correspond to some degree, those found in ASD and therefore may represent the broader autism phenotype.

Durante muitos anos, diversas pesquisas na área de Design no Brasil, constataram limitados investimentos no desenvolvimento de produtos para auxiliar as pessoas com deficiência. Diante disso, esta tese teve por objetivo propor uma abordagem para os equipamentos de auxílio à comunicação de crianças com Transtorno do Espectro do Autismo (TEA) por meio do Design e da Realidade Aumentada (RA). Para o desenvolvimento da pesquisa foram realizadas pesquisa bibliográfica, pesquisa documental, Estudo de Caso e experimentos. Também foram realizadas observações das crianças com TEA, no ambiente da Associação de Pais e Amigos do Autista (AMA) da cidade de Florianópolis, para embasar a proposta de projeto de Prancha de Comunicação Alternativa e Aumentativa. A proposta resultante teve como base comum o produto prancha de comunicação que foi utilizada com aplicativo que utiliza Realidade Aumentada e está disponível no mercado. Nesta prancha de base o usuário aponta o dispositivo móvel para o pictograma e assim acessa e visualiza o vídeo que estabelece a comunicação transmitindo a ação que a criança realmente deseja executar. A base para a análise dos resultados foi a descrição detalhada dos casos por meio da apresentação de painéis representativos de cada criança por dia de aplicação e painéis comparativos de todas as crianças durante a realização do estudo. Evidenciam-se assim, os elementos indicadores de que a solução proposta apresenta vantagens em relação a algumas pranchas atualmente existentes e que pode contribuir para facilitar a comunicação e a interação não só das crianças com TEA, mas também de outras crianças com limitações na comunicação. / For many years, several studies in the area of Design in Brazil have founded limited investments in product development to help people with desabilities. Therefore, the aim of this thesis was to propose an approach to the equipment to aid the communication of children with Autism Spectrum Disorder (ASD) through Design and Augmented Reality (AR). For the development of the research were carried out bibliographic and documental researches, case studies and experiments. Observations were also made of the children with ASD in the Association of Parents and Friends of the Autistic (AMA) of Florianópolis to base the project proposal of the Alternative and Increasing Communication Board. The resulting proposal was based on the common product board that was developed together with an Augmented Reality mobile application available on the market. On this basis board the user points the mobile device to the pictogram and thus accesses and visualizes the video which establishes the communication and transmittes the action that the child really wants to perform. Thus, there is evidence that the proposed solution has advantages over some existing boards and can contribute to facilitate the communication and interaction not only of children with ASD, but also of other children with communication limitations.

As pessoas desenvolvem-se na interação social, a partir do uso de instrumentos e de signos, sendo o processo de comunicação essencial para tal desenvolvimento. No entanto, a comunicação, longe de ser um processo inato ou maturacional, é um processo sócio-histórico que se desenvolve ao longo da vida e por meio do qual o sistema de símbolos é adquirido em um longo processo ontológico de aprendizagem cultural. A comunicação é estruturada como um complexo e multidimensional processo de aquisição da linguagem. Assim, é impossível pensar em comunicação sem linguagem. A linguagem tem uma dupla função comunicativa, como meio de comunicação e como processo de compreensão e representação do pensamento. A aquisição da linguagem inclui, entre outras, as dimensões social, cultural, histórica e intersubjetiva. Percebe-se que, nos casos de déficits na comunicação, o processo de intersubjetividade fica comprometido, uma vez que ao menos um dos envolvidos é prejudicado, seja na construção ou na compreensão de sentidos e significados nas interações/mediações. Em pessoas com Transtorno do Espectro Autista há déficits de comunicação e de linguagem que se manifestam com alterações principalmente no uso, na forma ou no conteúdo da linguagem pragmática. Nesses casos, o uso de Comunicação Alternativa (CA) tem proporcionado subsídios para suplementar, complementar ou construir um processo de comunicação. Nessa perspectiva, essa pesquisa teve como objetivo desenvolver um sistema de comunicação alternativa, para web e dispositivos móveis, com vistas a apoiar a inclusão de sujeitos com autismo, de 3-5 anos, em diferentes contextos sociais. Essa investigação foi qualitativa, estruturada em uma pesquisaação. Iniciou-se com a proposta de uma metodologia para orientar o desenvolvimento do recurso, baseada em contextos de uso (DCC) e, especialmente, orientada para a comunicação alternativa. Assim como foi proposta uma metodologia de mediação (Ação Mediadora), para uso com sujeitos com autismo, em três contextos sociais com o instrumento, com a análise das duas metodologias. A primeira, do desenvolvimento do recurso, levou-se em consideração os contextos e as ações mediadoras em execução nos mesmos. A segunda, da Metodologia de Ação Mediadora, na perspectiva da inclusão, dos processos de comunicação e na interação social de três crianças com TEA, em três contextos estudados. Como resultado, foi disponibilizado o Sistema SCALA. Ele é um recurso disponível na web e para dispositivo móvel tablet Android, nas versões prancha e narrativas visuais e o protótipo de sistema de varredura web para módulo prancha e o comunicador livre, chat de conversação, uma Metodologia de Ação mediadora para uso do recurso. Como resultados desse trabalho foi apresentada uma metodologia inovadora para o desenvolvimento de uma tecnologia assitiva, o DCC. Disponibilizado um sistema de comunicação alternativa (SCALA) para web e disposivos móveis gratuito. A análise do desenvolvimento do Sistema Scala apontaram-no como um recurso simples, prático e objetivo, próprio para apoio da comunicação e da interação, facilitador do letramento, da inclusão e de trabalhos colaborativos. Os cursos de formação de professores capacitaram professores para inclusão de sujeitos com TEA. A elaboração da metodologia de Ações mediadoras, com uso da CA e de recursos tecnológicos mostrou-se eficaz para o uso em três contextos, com três crianças com TEA. O Uso das ações mediadoras utilizadas, no período desse estudo, levaram a ampliação da comunicação intencional e das formas de contrução e representação comunicacionais nas três crianças com TEA. Constatou-se ainda, o crescimento da interação social e inclusão das mesmas. nos processos de interação social, acréscimo da comunicação oral e gestual nas três crianças, com autismo, foco da pesquisa. / People thrive on social interaction, from the use of tools and signs, and this is the process of communication essential for such development. However, communication, far from being an innate or maturational process, is a socio-historical process that develops throughout life and through which the system of symbols is acquired in a long ontological process of cultural learning. Communication is structured as a complex and multidimensional process of language acquisition. Thus, it is impossible to think of communication without language. The language has a dual communicative function as a means of communication and as a process of understanding and representation of thought. The acquisition of language includes, among others, the social, cultural, historical and intersubjective dimensions. It is noticed, that in cases of deficits in communication, the process of intersubjectivity is compromised, since at least one of those involved is harmed, either in construction or in the understanding of meanings and signification in interactions / mediations. In people with Autism Spectrum Disorder are deficits in communication and language, which is manifested as changes in use mainly in the form, or content of pragmatic language in these cases, the use of Alternative Communication (CA) has provided grants to supplement, complement or build a communication process. In this perspective, this study aimed to develop an alternative communication system, to web and mobile devices, with the aim of supporting the inclusion of subjects with autism, 3-5 years, in different social contexts. This research was structured in a qualitative action research. Began is the proposal of a methodology to guide the development of the resource, based on contexts of use (DCC) and especially geared to alternative communication. As well as, a method was proposed mediation (Action Mediator) for use with individuals with autism in three contexts sociaI with the instrument. With the analysis of the two methodologies. The first, the development of the resource, taking into account the contexts and the mediating processes running on them. Second, the methodology of Mediator action from the perspective of inclusion, the processes of communication and social interaction of three children with ASD in three contexts studied. As a result the SCALA system is available. The feature, available on the web and mobile tablet android, the board and visual narratives and the prototype versions of web scanning module and board for free communicator, chat conversation system. The Methodology of Action for mediating resource usage. As a result of this work, a new method has been presented for the development of an Assistive technology, DCC. Provided a system for alternative communication (SCALA) to free web and mobile disposivos. The analysis of the development of the Scala system showed it as a simple, practical and objective, specifically to support the communication and interaction, facilitator of literacy, inclusion and feature collaborative works. Training courses for teachers trained teachers for inclusion of subjects with ASD. The development of the methodology of Shares mediators, using AC and technological resources proved to be effective for use in three contexts, with three children with ASD. The use of mediating processes used in the period of the study, led the expansion of intentional communication and forms of representation construction and communication in the three children with ASD. It was further observed, the growth of social interaction and inclusion. the processes of social interaction, increase the oral and gestural communication in three children with autism, the research focus.