abstract: Parents fulfill a pivotal role in early childhood development of social and communication skills. In children with autism, the development of these skills can be delayed. Applied behavioral analysis (ABA) techniques have been created to aid in skill acquisition. Among these, pivotal response treatment (PRT) has been empirically shown to foster improvements. Research into PRT implementation has also shown that parents can be trained to be effective interventionists for their children. The current difficulty in PRT training is how to disseminate training to parents who need it, and how to support and motivate practitioners after training. Evaluation of the parents’ fidelity to implementation is often undertaken using video probes that depict the dyadic interaction occurring between the parent and the child during PRT sessions. These videos are time consuming for clinicians to process, and often result in only minimal feedback for the parents. Current trends in technology could be utilized to alleviate the manual cost of extracting data from the videos, affording greater opportunities for providing clinician created feedback as well as automated assessments. The naturalistic context of the video probes along with the dependence on ubiquitous recording devices creates a difficult scenario for classification tasks. The domain of the PRT video probes can be expected to have high levels of both aleatory and epistemic uncertainty. Addressing these challenges requires examination of the multimodal data along with implementation and evaluation of classification algorithms. This is explored through the use of a new dataset of PRT videos. The relationship between the parent and the clinician is important. The clinician can provide support and help build self-efficacy in addition to providing knowledge and modeling of treatment procedures. Facilitating this relationship along with automated feedback not only provides the opportunity to present expert feedback to the parent, but also allows the clinician to aid in personalizing the classification models. By utilizing a human-in-the-loop framework, clinicians can aid in addressing the uncertainty in the classification models by providing additional labeled samples. This will allow the system to improve classification and provides a person-centered approach to extracting multimodal data from PRT video probes. / Dissertation/Thesis / Doctoral Dissertation Computer Science 2019

Syfte: Syftet med studien var att beskriva arbetsterapeuters erfarenhet av att använda bedömningsinstrument i arbetet tillsammans med barn med autismspektrumtillstånd i åldrarna 6–12 år. Metod: En kvalitativ datainsamlingsmetod användes där åtta yrkesverksamma arbetsterapeuter intervjuades. En semistrukturerad intervjuguide valdes för att undersöka arbetsterapeuternas erfarenheter. Urvalet av deltagare skedde genom ett strategiskt urval. Dataanalys genomfördes därefter med en kvalitativ innehållsanalys. Resultat: Resultatet presenteras i ett övergripande tema; Familjen som klient samt tre kategorier; Förberedelser inför användning av bedömningsinstrument, Bedömningsinstrument i och efter mötet tillsammans med barnet samt Den erfarenhetsbaserade kunskapen. Det framkommer tydligt att erfarenheten av att arbeta tillsammans med barn som har autismspektrumtillstånd påverkar hur arbetsterapeuter väljer att arbeta med bedömningsinstrument. Av resultatet framgår att arbetsterapeuter idag ej använder bedömningsinstrument i den utsträckning som önskas. Resurser samt tidsaspekten påverkar användningens frekvens. Slutsats: Studien har bidragit till en ökad förståelse kring arbetsterapeuters erfarenheter av att använda bedömningsinstrument i arbetet tillsammans med barn med autismspektrumtillstånd. Tidsbrist är någonting som många gånger påverkar möjligheterna att arbeta mer frekvent med bedömningsinstrument vilket i sin tur påverkar habilitering för diagnosgruppen. Det är av stor vikt att fortsatt forskning inom området sker för att kunna ta fram ett instrument som är mer anpassat till diagnosgruppen. / Abstract Aim: The aim of the study was to describe occupational therapists' experience of using assessment tools in the work together with children with autism spectrum disorders between the ages 6-12. Method: A qualitative data collection method was used where eight professional occupational therapists were interviewed. A semi-structured interview guide was chosen to examine the occupational therapists' experiences. The participants were recruited through a strategic selection. Data analysis was then conducted with a qualitative content analysis. Result: The result is presented in an overall theme; The family as a client with three categories; Preparations for the use of assessment tools, Assessment tools during and after the meeting together with the child and The experience-based knowledge. It is clear that the experience of working with children with Autism spectrum disorder affects how occupational therapists choose to work with assessment tools. The results show that occupational therapists today do not use assessment tools to the extent desired. Resources and the time aspect affect the frequency of use. Conclusion: The study has contributed to an increased understanding of occupational therapists' experiences of using assessment tools in their work with children with Autism spectrum disorder. Lack of time is something that often affects the opportunities to work more frequently with assessment tools, which in turn affects habilitation for the diagnostic group. It is of great importance that further research in this area is done to be able to develop an instrument that is more adapted to the diagnostic group.

Denna studien är en litteraturöversikt, det vill säga en överblick av befintlig forskning. Flickor/kvinnor med autismspektrumtillstånd är ett område som är relativt outforskat, vilket innebär en rad olika konsekvenser för denna grupp. Syftet med denna uppsatsen är att beskriva forskningsläget avseende att som flicka/kvinna leva med autism och därmed kunna identifiera behov av vidare forskning. Detta kommer att undersökas genom att svara på följande två frågeställningar. (1) Hur ser forskningsläget ut avseende att som flicka/kvinna leva med ett autismspektrumtillstånd? (2) Vilka kunskapsluckor kan identifieras? Resultatet visar att gruppen är utsatta på flera olika plan vilket i sin tur ger olika effekter i deras liv. En diagnos kan både främja men även motverka gruppens livsmöjligheter. Den kan leda till en bättre självkännedom och känslor av tillhörighet men kan även leda till sorg och depression. För att kunna förstå målgruppens komplexa situation krävs det mer / This report is a literature review, i.e. a review of existing research. Girls/Women with autism spectrum disorder is a relatively unexplored area. This entails a variety of different consequences for this group. The aim of this study is to describe the research area regarding living with autism spectrum disorder as a girl/woman in order to identify the need for further research. This will be reviewed by answering the following questions. (1) What does the research area regarding living with autism spectrum disorder as a girl/woman look like? (2) Which gaps of knowledge can be identified? The review shows that the group is vulnerable in many different aspects which affects their lives in different ways. A diagnosis can both help but also counteract the life chances of this group. It can lead to better self-awareness and a sense of belonging but leads to grief and depression as well. This area requires more research that can better explain the vulnerability of this group to help better understand their complex situation.

World of Aspergers Annotation In my diploma thesis, which I called the Asperger's World, I elaborate on subject of specific perception of people with autistic spectrum disorder. The aim of the thesis is to evaluate the following main aspects: how people with Asperger syndrome perceive their disability and whether they are recognized as part of society or stigmatized. In the theoretical part I define the term autism and Asperger syndrome. I describe certain aspects that exclude this syndrome from other autistic manifestations and point out differences in behavior and experience of everyday life of these individuals. Emphasis is placed above all on other sensory perceptions and ethical issues concerning children and adolescents. Their integration into common school classes, the perception of teachers, classmates and parents. The practical part contains three case studies on which I would like to show how difficult it is to deal with this disability from the perspective of the parents of the affected child. Furthermore, the expressions of children and adults themselves with Asperger syndrome, pedagogues, classmates, friends and co-workers. In the discussion, I compare my knowledge with sources used, and in the end, I evaluate the given issue. Key words Asperger syndrome, autism spectrum disorder, integration...

The master thesis copes with gender dysphoria (GD) in persons with autism spectrum disorder (ASD). The quantitative research was chosen to study this topic. The main goal was to determine whether people with mild ASD have a higher prevalence of GD or higher rate of GD compared to the general neurotypical population (NT). The main methods used in this research were: Autism Quotient Questionnaire (AQ-10) and the Gender Identity/Gender Dysphoria Questionnaire in Adolescents and Adults (GIDYQ-AA), which made it possible to determine the degree of GD and the potential co-occurrence of a diagnosis of gender incongruence (GI; according to ICD-11). In the research there were 196 subjects with the age ranging from 16 to 74 years. The ASD group was compromised 90 persons and in the NT group there were 106 people. While in the NT group no one admitted transgender identity, in the ASD group 2.2 % of subjects informed about transgender identity and 14.4 % of the autistic group were not sure about it. Based on the GIDYQ-AA results, 4.4 % of people with ASD had a low score indicating a possible presence of a diagnosis of GD (GI). Furthermore, the research found that women with autism had significantly higher rate of GD than both women in the NT group and men with ASD. Overall, subjects with ASD achieved...

I denna uppsats undersöks användningen, användbarheten, samt för- och nackdelar medäventyrsrollspel som behandlingsform vid psykisk ohälsa och autismspektrumtillstånd.För att studera detta har vi genomfört en kvalitativ intervjustudie med verksammapraktiker. Resultatet visar att behandlingens struktur är liknande för olika klientgrupperäven om behandlingsfokuset kan skilja sig beroende på klientens problematik.Återkommande teman är användandet av fantasin som verktyg vid behandling,äventyrsrollspelet som ramverk, social träning samt möjligheten till personligutveckling vilket är positiva aspekter av behandlingen. Dock är behandlingen begränsadför individer med vissa typer av problematik och skulle därmed fungera bättre som enkompletterande terapi. Den har även högt ställda kompetenskrav på behandlare som villanvända metoden. I diskussionen använder vi symbolisk interaktionism som teoretisktramverk för att tolka resultatet. / This study explores the usage, applications, as well as the pros and cons of utilizingtabletop role-playing games as a method of therapy for individuals with mental illnessand autism spectrum disorder. Qualitative interviews were conducted with practitionerswho apply the method. The result shows that the method is structured similarly fordifferent client groups while treatment focus changes according to individual diagnoses.Some recurring themes were: fantasy as a tool for therapy, the tabletop role-playinggame framework, social training, and possibility for personal growth which are allpositive aspects of the treatment. However, the treatment has limitations when used onindividuals with certain types of mental health problems and would instead work betteras a complementary treatment. However, a high level of competence is required forpractitioners who wish to utilize the method. In the discussion we seek to answer ourexplored issues through a symbolic interactionist theoretical standpoint.

<p>Touch plays a key role in facilitating social communication and is often presented in conjunction with auditory stimuli such as speech. Individuals with autism spectrum disorder (ASD) frequently show atypical behavioral responsivity to both tactile and auditory stimuli, which is associated with increased ASD symptomatology. However, as discussed throughout Chapter 1, the neural mechanisms associated with responsivity to tactile and auditory stimuli in ASD are not fully understood. For example, some have argued that differences in responding to tactile and auditory stimuli may be attributed to sensory and perceptual factors, whereas others suggest that these differences could be related to atypicalities in allocation of attention to incoming stimuli. In Chapter 2, I address these competing hypotheses by examining early and late ERP components (indicative of perceptual and attentional processing respectively) in response to tactile and auditory stimuli. Next, despite the evidence suggesting that touch plays a role in modulating attention in typical development (TD), it is unclear whether touch cues affect the response of the phasic alerting network – a subcomponent of attention – in ASD and TD, and whether the alerting response may be atypical in children with ASD. In Chapter 3, I address this gap in the literature by examining whether tactile cues presented at different intervals before auditory targets facilitate reaction times differently in children with ASD and TD. Lastly, because prior research has shown associations between sensory and attentional processes and ASD symptomatology, in Chapters 2 and 3, I examine the associations of neural and behavioral indices of tactile and auditory processing with ASD symptomatology and language skills in children with ASD and TD. </p><p>In Chapter 2, I show that children in both the ASD and TD groups do not exhibit differences in both early and later neurological responses to tactile and auditory stimuli, suggesting that under certain experimentally-controlled conditions, behavioral differences to tactile and auditory stimuli may not be attributable to atypicalities in perceiving or attending to the incoming sensory input. However, neural responsivity to tactile and auditory stimuli is linked with sensory responsivity and social skills in all children. Specifically, reduced early contralateral activation to tactile stimuli is related to increased tactile symptoms, and reduced early amplitudes to auditory oddball stimuli are associated with impairments in reciprocal social communication in children with ASD as well as when examined across all children, and greater tendency of overall sensory hyper-reactivity. Additionally, in the TD group, greater later amplitudes to touch and auditory oddball stimuli are related to differences in reciprocal social communication and sensory reactivity respectively, indicating that patterns of allocation of attention may be related to ASD-like traits in typical development. Lastly, there is an association between greater sensitivity to changes to a stream of auditory stimuli and expressive language skills in all children. These results suggest that, although there are no group differences between neurological responses to tactile and auditory stimuli in ASD and TD, individual neural differences may be related to sensory and socio-communicative skills in all children. </p><p>In Chapter 3, I show that although children with ASD responded more slowly than children with TD, both groups displayed faster reaction times as a result of tactile cues before auditory targets, suggesting equivalent phasic alerting in response to tactile stimuli. Longer intervals between cues and targets benefitted children in both groups resulting in faster reaction times. Contrary to my hypotheses, touch-related behavioral facilitation was not associated with ASD symptomatology and language skills. </p>Taken together, the results of these studies suggest that, at least in certain contexts and with certain cues, children with ASD may show typical neurological processing in response to tactile and auditory stimuli, and that touch may facilitate the response of the alerting network similarly in ASD and TD. Therefore, everyday behavioral differences in response to tactile and auditory stimuli may be related to the specific nature of the stimuli as well as social contexts in which such stimuli are more likely to be encountered. Differences between processing rich and dynamic sensory stimuli experienced in the outside world vs experimentally-controlled sensory stimuli presented in the laboratory settings are discussed in Chapter 4. Additionally, I argue that individual responses expected in social vs non-social experimental settings may affect neural and behavioral responses in individuals with ASD. Finally, future research directions are discussed.

Good prognosis for children with Autism Spectrum Disorder and their participation in everyday life situations depends on healthcare professionals’ ability to make diagnoses and provide interventions as early as possible. Thus, professionals at the primary healthcare level ought to have the knowledge and competence to identify the symptoms of ASD and make referrals where necessary. This study aims to describe healthcare professionals’ knowledge regarding ASD symptoms in children, and the factors that influence their level of knowledge.  A systematic literature review method as described by Jesson, Matheson &amp; Lacey was used to study the topic, and searches in CINAHL, PsycINFO and PubMed generated 10 relevant articles for the study. Their quality was assessed using the critical review form and content analysis was used to evaluate the findings. ‘healthcare knowledge’ by Kohn were used to explain them.  Findings showed that healthcare professionals have varied levels of knowledge regarding ASD symptoms depending on different factors like professionals’ age, years of work experience, previous encounter with children having ASD, among others. The concept, theory-practice gap and types of knowledge were used to explain the findings. Conclusion: Firstly, increase in ASD training among healthcare professionals is necessary and secondly, it needs to translate to practice for quality care towards children with ASD.

Social camouflaging is prevalent among patients with Autism spectrum disorder [ASD] and entails copying and/or masking behaviours, personality traits and adaptive functioning in order to adjust to environmental demands. The aim of this thesis was to explore clinicians’ experiences of working with adult patients with ASD who display social camouflaging. Research questions explored clinicians’ perceptions of frequency and nature of social camouflaging among males and females with ASD, as well as their competence and confidence in working with these patients. This was examined using a mixed-methods sequential explanatory design, consisting of a quantitative and a qualitative phase. Quantitative data was collected through a web-based questionnaire which was completed by clinicians [n=31] working in a specialised setting in Sweden. Four clinicians [n=4] also participated in qualitative semi-structured interviews. Paired samples t-tests indicated that females were observed to display social camouflaging more often. Clinicians’ competence and confidence did not differ to a significant degree between males and females when social camouflaging was displayed. Possible explanations for this were discussed through the main themes found in the qualitative thematic analysis. The themes consisted of clinicians’ understanding of social camouflaging, perceived obstacles when working with this group of patients and important prerequisites for clinicians in order to overcome these obstacles. The findings emphasized the need to broaden the view of ASD through future research, since it causes gaps of knowledge that clinicians seldom have the opportunities to fill. Furthermore, measures to enable support and resources for clinicians are needed to help this patient group. / Social kamouflering förekommer hos patienter med Autismspektrumtillstånd [AST] och kan yttra sig genom kopiering och/eller maskering av beteenden, personlighetsdrag och adaptiv funktion för att möjliggöra en anpassning i linje med omgivningens krav. Syftet med denna uppsats var att undersöka klinikers upplevelser av att möta vuxna patienter med AST som uppvisar social kamouflering. Frågeställningarna undersökte klinikers upplevelse av frekvens och natur av social kamouflering hos män och kvinnor med AST, samt deras kompetens och självsäkerhet i mötet med dessa patienter. Detta undersöktes genom en mixad metod med sekventiell förklarande design, innehållande en kvantitativ och en kvalitativ fas. Kvantitativa data samlades in genom ett webb-baserat formulär som fylldes i av kliniker [n=31] från specialiserade enheter i Sverige. Fyra av dessa kliniker [n=4] deltog även i kvalitativa semi-strukturerade intervjuer. Parade t-tester indikerade att kvinnor observerades uppvisa social kamouflering mer frekvent. Klinikers kompetens och självsäkerhet skilde sig inte till en betydande grad mellan män och kvinnor när social kamouflering uppvisades. Möjliga förklaringar till detta diskuterades utifrån de huvudteman som återfanns i den kvalitativa tematiska analysen. Teman inkluderade klinikers förståelse av social kamouflering, upplevda hinder i mötet med denna patientgrupp samt viktiga förutsättningar för att överkomma dessa hinder. Resultaten betonade vikten av att framtida forskning breddar bilden av AST, eftersom det tycks skapa kunskapsluckor som kliniker sällan ges möjlighet att fylla. Utöver detta framhölls behovet av åtgärder för att möjliggöra stöd och resurser för kliniker för att de skall kunna hjälpa denna patientgrupp.

The aim of this master's thesis is to describe the possibilities of interprofessional cooperation of an occupational therapist and a behavioral analyst in selected personal activities of daily living in children with autism spectrum disorder (ASD). With the help of activity analysis the view of both experts was demonstrated resulting in the description of their therapeutic intervention. The theoretical part describes the basic characteristics of ASD including selected personal activities of daily living with which children with ASD may have difficulties. The following chapters are about the basic principles of occupational therapy including the description of activity analysis, which is one of the important evaluation methods in occupational therapy. Furthermore the history and the basic characteristics of applied behavioral analysis (ABA) is described focusing on activity analysis used in the ABA program. The next chapter describes the common areas of both professions including shared elements and therapeutic approaches. The last chapter is devoted to the description of the interprofessional cooperation of an occupational therapy and a behavioral analyst. The practical part consists of 3 descriptive case studies in which an occupational therapist and a behavioral analyst performed a task analysis...