Children with autism spectrum disorder (ASD) are shaped and in turn shape the people in their environment especially those closest to them, their parents and their siblings. When the sibling relationships between children with ASD and their typically developing siblings are considered, challenges and opportunities present themselves for both siblings. This study assessed the effectiveness of a sibling intervention that aimed to meet the needs of both siblings involved. It was initially hypothesised that teaching the typically developing children responsive strategy use would enhance their interactions between the children leading to increases in the quality of the sibling relationship and in the well-being of both siblings. In addition, the typically developing children were given developmentally appropriate information on their sibling’s difficulties, information on emotions, and the opportunity to play mutually enjoyable games with their sibling with ASD to enhance their motivation to persist in attempts at interacting with their sibling with ASD. Initial findings suggested that the planned intervention was not necessarily benefitting the typically developing children. The focus of the intervention changed to include a more explicit focus on the influence of the intervention on the typically developing children. Changes were made, by de-emphasising the strategy component and emphasising the other components, to enable both siblings to benefit from the intervention. Findings indicated that the typically developing children had existing skills for interacting with their siblings with ASD. Increases in the quality of the sibling interactions and the well-being of both children seemed to be most strongly related to aspects of the intervention that increased the warmth of the children’s feelings towards each other and the typically developing children’s understanding and tolerance of their sibling with ASD. Overall, the findings from this project emphasised the importance of supporting family members of children with ASD for the benefit of both the family members and the benefit of the children with ASD.

Current diagnostic criteria for autism are guided by the 'Triad of Impairments' (Wing & Gould, 1979), of which 'social impairment' forms an individual category. Social difficulties have been observed in children with autism under the age of two years and the difficulties continue throughout adulthood. Few studies have used computer-based training packages (CBTP's) to facilitate social competency in individuals with autistic spectrum disorder (ASD). The present study was completed in two phases: Phase I -compared 14 individuals with ASD (IQ ý: 70), ten individuals with no disabilities (ND) and eight individuals with mild mental retardation (MR; IQ 50-70) on their ability to identify appropriate and inappropriate social interactions using 12 scenarios on a tailor-made DVD. Phase H- the ASD group was divided into two groups. Eight individuals were trained using six of the scenarios from Phase I and eight new scenarios. Following training, both groups with ASD re-viewed the 12 scenarios shown in Phase I. The results showed that individuals with ASD were less able_to identify appropriate and inappropriate social skills than individuals with MR (t (18) = 4.9, p<00 1) or ND (t (13) = 7.5, p<00 1). The severity of the autistic symptoms negatively impacted on performance (r (14) =- . 83, p<. 001). The training group significantly improved their performance (z = -2.52, p= . 05) on both trained (z = -2.207, p= . 027) and untrained scenarios (z = -2.032, p . 042). The untrained group scores showed no significant difference between Phase I and Phase II. The current study identified that individuals with autism have more difficulty understanding inappropriate and appropriate behaviour than their MR and ND peers. However the DVD was an effective method of training a component of social competency for this population. Within the trained group, ability improved on untrained as well as trained scenarios, this suggests a generalisation of skills rather than rote learning or practice effects. Future studies would benefit from addressing how to generalise this skill from computers to 'real-life' situations.

In the last twenty years, governments around the world have signed policies and enacted legislation concerning the right of every child to be provided with education. The United Nations Convention on the Rights of Persons with Disabilities (2006), which states that every child with SEN should receive education in a mainstream setting, whenever possible stimulated, at least partly, the enactment of such policies. To some extent, the Mexican government has responded to the UN initiative by reporting a gradual increase in the number of children with SEN being placed in mainstream schools over the last ten years. However, despite the efforts of some parents and teaching assistants, there is an increasing concern that many children with ASD are not educated in mainstream schools or they have been included but without the support of a qualified teaching assistant or teacher, which has a negative effect on the quality of education. This situation has emphasized the need to improve strategies in order to overcome the barriers to effective inclusion for these children. Thus, the main aim of this study was to explore the extent to which children identified as having Autistic Spectrum Disorder are included within in mainstream schools in Mexico with the support from DOMUS a non-profit parent led organisation. This is done by examining the facilitators and barriers that affect the success of inclusion of children with ASD in Mexico. Multiple case studies of children with autistic spectrum disorders were conducted. The data on the perceptions about inclusion was gathered from interviews with head teachers, teachers, teaching assistants, and parents of children with ASD. In addition, observations of the children with ASD both in class and in the playground were carried out along with focus groups conducted with secondary age classmates, sociometric data, and a review of DOMUS’ records. Participants offered many perspectives on the facilitators and barriers that should be overcome in order to include a child with autism in mainstream schools in Mexico. Seven key themes and related subthemes that can act as facilitators or barriers emerged from the analysis. These included family factors, children with ASD’s social and academic abilities, school ethos, role of teaching assistant and DOMUS, and the influence of stakeholders’ experience in overcoming anxieties about inclusion, teachers’ competence, and stakeholders’ attitudes towards children with ASD. The findings are discussed in relation to the literature review. It was concluded that the Mexican government’s inclusive education policies should be taken further, although the teachers involved should initially receive further training in order to help them feel more confident. An ASD friendly school ethos, positive attitudes from stakeholders, and financial resources can also support inclusion. Stakeholders need to overcome their anxieties, and they can achieve this by embracing the opportunity to experience inclusion. This study provides a starting-point in by identifying the facilitators that should be strengthened and the barriers that should be reduced in order to enhance the inclusion of children with ASD in Mexico.

This research explores experiences and perceptions of mothers of adolescents and young adults (13-22yrs) with Additional Support Needs (ASN) in relation to stress, service provision and family and individual Quality of Life (QoL). A particular focus is the effect of having a family member with ASN who also has a diagnosis of Autistic Spectrum Disorder (ASD) or where the young person with ASN may have an ASD which has not been diagnosed. Mothers of young people from 4 groups were recruited: i) those with ASN and no ASD (n=41), ii) those with ASN and a diagnosis of ASD (n=18), iii) those with ASN, no diagnosis of ASD but with a positive score on an ASD screening measure (n=17) and iv) typically developing controls (n=17). The mothers of young people with ASN (n=76) completed standardised questionnaires about family and individual QoL, stress, service provision, child behaviour and presence and severity of ASD traits. Twenty two of these mothers also took part in a semi-structured interview about coping with issues identified as most stressful by them in the stress questionnaire. The mothers of typically developing young people (n=17) completed standardised questionnaires on individual and family quality of life and on the behaviour of their similarly aged son or daughter. Data collected via these questionnaires showed that increased severity of ASD was associated with increased maternal stress, which in turn was associated with decreased family and maternal QoL. Mothers of typically developing young people had significantly higher individual and family QoL scores than each of the three other groups. The findings from the interviews supported the questionnaire results and gave further insight into mothers’ life experiences. Mothers identified many perceived barriers to their child’s progress including: lack of support and lack of co-ordinated service provision. The results suggest that mothers of young people with ASN experience lower individual and family quality of life than mothers of typically developing young people. Parenting an adolescent or young adult with ASN is perceived as stressful and that the presence of behaviour associated with ASD is additionally stressful. Possible reasons for differences in quality of life outcomes amongst the study groups are discussed. Implications for adequate services and recommendations for future research are suggested.

abstract: This thesis is a qualitative research study that focuses on siblings of children with Autistic Spectrum Disorder (ASD). Even though it is expected that having a child with ASD in the family will influence the whole family including siblings of the child with ASD, the sibling population is rarely included in research related to children with ASD, and there is only limited services available for them. This exploratory study (n=6) is aimed at better understanding the siblings' lives in their family settings in order to identify the siblings' unmet needs and determine how they have been influenced by the child with ASD. This study is also aimed at identifying the most appropriate support for the siblings to help them cope better. The study followed the Resiliency Model of Family Stress, Adjustment, and Adaptation and a narrative theory approach. An in-depth interview with the parents was conducted for the study, so the findings reflect the parents' perception of the siblings. All the themes emerged into two categories: life in the family setting and supports. The findings indicate that the families are striving for balance between the siblings and the children with ASD, but still tend to focus more on the children with ASD. Also, the families tend to have autonomous personal support systems. The parents tend to perceive that these personal support systems are good enough for the siblings; therefore, the parents do not feel that formal support for the siblings was necessary. As a result of the findings, recommendations are made for the organizations that work with individuals with ASD to provide more appropriate services for the families of children with ASD, including siblings. Also, recommendations are made for future studies to clarify more factors related to the siblings due to the limitation of this study; the siblings' lives were reflected vicariously via the parents. / Dissertation/Thesis / M.S.W. Social Work 2013

O transtorno do espectro do autismo (TEA) é caracterizado por déficits significativos na comunicação social e interação social. A alteração na comunicação e suas manifestações apresentam uma grande variabilidade, mesmo as crianças com boa fluência verbal apresentam prejuízos com a linguagem pragmática, sendo esta uma manifestação constante nos TEA. A linguagem pragmática é de difícil avaliação, pois é um comportamento dependente do contexto e há poucos instrumentos de avaliação. Objetivo: Comparar o perfil comunicativo de crianças com TEA com crianças que apresentam desenvolvimento normotípico e verificar a capacidade discriminativa diagnóstica do instrumento Children\'s Communication Checklist - CCC- 2. Métodos: Pais de crianças e adolescentes com diagnóstico de transtorno do espectro do autismo, provenientes do Serviço de Psiquiatria da Infância e Adolescência (SPQIA - TEA) e com desenvolvimento normotípico foram convidados a responderem o formulário de resposta do cuidador CCC-2 em sua versão para o português brasileiro. Resultados: Este estudo mostrou que as médias de todas as subescalas do grupo comparativo são maiores que as do grupo com TEA, principalmente as que verificam a pragmática e interesses. As médias das subescalas estão altamente relacionadas, apresentando alta consistência interna. O escore do Composto da Comunicação Geral (GCC) indicou pontos fracos na comunicação geral das crianças do grupo com TEA, diferenciando das crianças do grupo comparativo, apresentando sensibilidade de 85% e especificidade de 90%. E o Composto da Comunicação Social (SIDI) mostrou sensibilidade de 50% e especificidade de 95%. Conclusão: O instrumento CCC-2 apresentou boa capacidade de discriminar crianças com deficiências de comunicação, principalmente a pragmática, de uma população com desenvolvimento típico, porém, é necessário mais estudo utilizando este instrumento com outros grupos de alterações de linguagem / Autism spectrum disorder (ASD) is characterized by persistent impairment in social communication and social interaction, which is its main defining characteristic, presenting repetitive and restricted patterns of behaviors, interest and activity. The impairment of communication presents a great variability, even children with good verbal fluency present losses with the pragmatic language, it is a constant manifestation in the ASD. The pragmatic language is difficult to evaluate because it is context dependent behavior and there are few evaluation tools. Objective: This study is compared the communicative profile of children with ASD with children with typical development, and to verify the discriminative capacity of Children\'s Communication Checklist - CCC-2. Methods: Parents of children and adolescents diagnosed with Autism Spectrum Disorder from the Childhood and Adolescence Psychiatry Service (SPQIA - TEA) and with typical development were invited to respond to the CCC-2 caregiver response version Brazilian Portuguese. Results: This study showed that the means of all the subscales of the comparative group are larger than those of the group with ASD, especially those that verify the pragmatics and interests. The averages of the subscales are highly related, presenting high internal consistency. The general communication composite score (GCC) indicated weaknesses in the general communication of children in the ASD group, differing from the children in the comparative group, presenting sensitivity of 85% and specificity of 90%. And the social interaction difference index (SIDI) showed sensitivity of 50% and specificity of 95%. Conclusion: The CCC-2 instrument presented a good ability to discriminate children with communication deficits, mainly pragmatic, from a population with typical development, but more study is needed using this instrument with other groups of language disorders

This diploma thesis is focused on Snoezelen as special educational support for children with autistic spectrum disorder. Snoezelen can be understood as a way of relaxation, spending free time, pedagogical action or comprehensive therapy. It can be practiced in different facilities and it brings profit to general public with different impairment. Autistic spectrum disorder is one of diagnoses in which therapists decide to use the effect of Snoezelen. There are some researches focusing on quantitative detection of the circumstances associated with Snoezelen. This is why this thesis is dedicated to a qualitative study of the use of Snoezelen in a special pedagogical institution. This Thesis aims to analyse literary sources to comprehensively characterize problems of autistic spectrum disorders and to outline the principles, benefits and requirements of Snoezelen. Subsequently, using a qualitative survey, describe coherently the way in which Snoezelen is practiced to children with autistic spectrum in a particular special pedagogical institution, evaluate this way and recommend possible improvements. KEYWORDS Autistic spectrum disorder, autism, Snoezelen, sensory stimulation, multisensory room

Orientador: Adriana Lia Friszman de Laplane / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T04:57:03Z (GMT). No. of bitstreams: 1 Teixeira_DanielleElisaParadella_M.pdf: 1290712 bytes, checksum: 7be16f8216fe1ab4848f9be8d44337a5 (MD5) Previous issue date: 2014 / Resumo: O transtorno do espectro autista envolve déficits sociais e de comunicação e interesses fixados e comportamentos repetitivos. A família da criança com autismo vivencia um processo de adaptação no qual, planos e expectativas devem ser revistos e adequados às condições de desenvolvimento da criança. O presente estudo teve como o objetivo conhecer a forma como as mães de crianças com autismo percebem o desenvolvimento da criança nos aspectos de interação, comunicação, comportamento e educação e o que esperam desse processo. As participantes foram mães das crianças com diagnóstico de autismo que são atendidas em grupo por equipe interdisciplinar semanalmente. Os dados foram coletados no período de setembro de 2012 a março de 2013, através da realização de entrevistas individuais com cada mãe, no momento em que a criança estava em atendimento numa instituição de reabilitação pertencente à Unicamp, Campinas. As entrevistas foram gravadas em um aparelho de áudio. As informações obtidas foram transcritas, analisadas utilizando-se a técnica de Análise de Conteúdo e categorizadas da seguinte forma: Dinâmica familiar; Sentimentos maternos; Percepções e expectativas maternas. Os depoimentos revelaram que as mães apresentam variadas expectativas para a criança, que vão sendo adaptadas conforme a percepção sobre o desenvolvimento. A similaridade encontrada entre as vivências, percepções e expectativas das mães entrevistadas e as referidas na literatura em relação a crianças com outras dificuldades ou com desenvolvimento típico permitem relativizar e colocar em questão a presunção de que as famílias com filhos com autismo apresentam características especiais ou específicas. Ao mesmo tempo, os relatos evidenciam a necessidade de suporte e apoio à família para que esta enfrente o desafio de promover e acompanhar o desenvolvimento da criança / Abstract: The autistic spectrum disorder involves social, communication and repetitive behaviors and interests set deficits. The autistic child's family experiences a process of adaptation in which, plans and expectations must be reviewed and adequate to the child's developmental conditions. The purpose of this study was to understand how mothers of children with autism perceive the child's development in concerning aspects as interaction, communication, behavior and education and what are their expectations towards these processes. Participants were mothers of children diagnosed with autism who attend a weekly group in a institution of rehabilitation at Unicamp, Campinas. Data were collected from September 2012 to march 2013, by means of individual interviews conducted with each mother at the time the child was in attendance at the institution. The interviews were recorded on an audio device. The information obtained was transcribed and analyzed using the technique of content analysis and categorized as follows: Family dynamics; Maternal feelings, perceptions and maternal expectations. The statements revealed that mothers have varied expectations for the child, which will be tailored according to their perception of development. The similarity found between the experiences, perceptions and expectations of the interviewed mothers and those in the literature in relation to children with other difficulties or with typical development permit to relativize and to question the assumption that families with children with autism have special or specific features. At the same time, the reports highlight the need for family support so that it faces the challenge of promoting and monitoring the child's development / Mestrado / Interdisciplinaridade e Reabilitação / Mestra em Saúde, Interdisciplinaridade e Reabilitação

Title: Combat sport modifications for pupils with autistic spectrum disorder in elementary school curriculum. Objective: The goal of this thesis is to summarize and analyze available information regarding combat sports, role of combat sports in physical education on elementary school and autistic spectrum disorder. Knowledge from these areas should then be used for compiling a set of exercises that would modify the schooling of combat sports for pupils with autistic spectrum disorder in elementary school. Methods: Analysis method and critical research were used to compile information needed to explain the given phenomena. In the final part of the thesis, compiled data were summarized via the synthesis method. Results: After thorough research of available literature, author proposes basic principles and recommendation for the education of combat sport for pupils with ASD. Then a set of exercises was created, which contains specific modifications for each given exercise. These exercises are meant to be used in inclusive education of combat sports for pupils with ASD on elementary school. Keywords: combat sports, physical education, autistic spectrum disorder

Dans la littérature actuelle, il existe peu d’études portant sur l’évolution des adultes présentant un Trouble du Spectre Autistique (TSA) associé à une Déficience Intellectuelle (DI). Toutefois, de manière générale, les données disponibles suggèrent que se sont les personnes les plus déficientes qui connaissent les changements les moins significatifs.Cette étude exploratoire et rétrospective concerne 7 sujets atteints d’autisme associé à une DI sévère. Sont retracés sur une période de trente ans leurs parcours de vie, leurs évolutions cliniques, leurs niveaux d’adaptation au quotidien, et ceci depuis l’âge de leurs 20 ans. Le recueil de données a été réalisé sur la base d’études des dossiers médico-éducatifs ainsi qu’à partir d’entretiens semi structurés menés auprès du personnel encadrant. Bien que nous n’ayons pas pu mettre en évidence de changement significatif concernant les profils cliniques, comportementaux et adaptatifs de ces sujets, certains d’entre eux ont connu des évolutions qualitatives comme une diminution de l’intensité de la symptomatologie ou de l’importance des troubles du comportement. Les résultats ont été discutés à la lumière des travaux actuels et critiqués au regard des limites méthodologiques. Des propositions de recherches sont formulées : suivi de la population actuelle ; mise en place d’un plan longitudinal prospectif concernant une cohorte représentative de personnes adultes autistes avec DI sur une longue période ; proposition de protocoles spécifiques d’apprentissage avec évaluation des effets de ce type de prise en charge. / So far few studies have focused on the evolution of adults with Autism Spectrum Disorder associated with Intellectual Disability. In existing literature the available data show that the persons with the severest intellectual disabilities present the least significant changes. The present study - both exploratory and retrospective - deals with 7 patients with autism associated with a severe intellectual disability. Over a 30-year period - after the age of 20 - their life course, their clinical evolutions, their adaptive daily skills were described. The data collection was based on the study of their medical and educational records as well as on semidirective interviews with the staff. Although no significant change concerning their clinical, behavioural and adaptive profile could be pointed out, some patients presented qualitative evolutions such as a decrease in the intensity of their symptomatology or in the importance of their behavioral disorders. The results were discussed taking into account recent studies; they were criticized considering the methodological limits of our study. Suggestions for future research are: the follow-up of the patients of our study; the setting up of a prospective longitudinal study concerning a representative cohort of adults with autism with intellectual disability over a long period of time; suggestions of specific learning protocols together with assessments of that type of interventions.