Thesis (MScSportSc)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Autism Spectrum Disorder (ASD) has been described as a neuro-developmental disorder influencing the social interaction and communication skills of individuals. Those with ASD have been observed to experience sensory input challenges, which could result in motor delays. Descriptive research was conducted with two case studies, who were boys aged 6- and 8-years, diagnosed with ASD. The purpose of the study was to design and implement a Sensory-Motor Integration (SMI) programme for each boy and to assess the effect it had on the sensory motor skills of the boys over time. At the start of the intervention, the boys were assessed with three neuro-developmental and diagnostic evaluations (Social Communication Questionnaire, Autism Diagnostic Interview Revised and Autism Diagnostic Observation Schedule-2nd Edition) conducted by a psychiatrist to re-affirm their previous ASD diagnoses. The two boys (Subject A and Subject G) participated in individualised sessions of 30 minutes each, twice a week for seven months. The SMI programme focused on vestibular and somato-sensory (proprioceptor) variables. The Quick Neurological Screening Test-3 (QNST III) and the Sensory Input Systems Screening Test (SISST) were used to evaluate the latter at baseline. These were repeated regularly, every 4 to 5 weeks, over the 7-month period and included a retention test of 5 weeks. Based on the results from the subtests of the motor skill tests, a self-designed SMI programme was integrated into the planning of the intervention programme for each boy according to their sensory-motor needs. Subject A showed improvement in the following vestibular subtests in the QNST-III: Stand on one leg (67%) and Tandem walk (83%) and retaining his standard from the Post-test to the Retention test. For muscle tone ability and proprioception, the Arm and leg extension subtest also demonstrated improvement (67%) from the Pre-to the Post-test. The results of the subtest were not retained over the retention period and increased only slightly being 33% from the baseline score. The proprioceptive function of Subject A showed great improvement in the following QNSTIII subtests: Finger to nose (67%), Rapidly reversing repetitive hand movements (88%) and Left and right discrimination (67%). The results of vestibular-related subtests for Subject G showed improvement in the following: Stand on one leg (33%) and the Arm and leg extension task (33%). Some of the scores of Subject G started in the functional category of “severe discrepancy”; however there was improvement in the following proprioceptionrelated subtests: Finger to nose (43%), Thumb and finger circles (20%), and Reversing repetitive hand movements (86%). Although Subject G showed gradual improvement over time, his two sensory systems struggled to integrate with the more complex tasks. The outcome of the individualised SMI programmes showed that the sensory-motor skills improved by enhancing the stimulation of their vestibular and somato-sensory (proprioception) function. Regarding the SISST, Subject A progressed from a ‘fail’ to ‘pass’, in the following test items: the Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive Support Reflex (PSR) and the Ocular Alignment test items. Results from the Vestibular test for both Subject A and Subject G appeared to be ‘hypo-vestibular’ (under-stimulated) according to the Post- Rotary Nystagmus test (PRN) score at baseline. These scores were inconsistent during the intervention. The only test item to show positive improvement for Subject G was the Equilibrium Reactions. Lastly, both Subject A and Subject G remained in the ‘fail’ category for Kinaesthesis, which may indicate their ongoing poor proprioception and spatial orientation. There is a need for further research in the area of sensory-motor individualised programmes for children with ASD. Suggestions for future research interventions are to conduct the individualised programmes either over a longer period of time and more frequently at three times a week. / AFRIKAANSE OPSOMMING: Outisme Spektrum Versteuring (OSV) word beskryf as 'n neuro-ontwikkelingsversteuring wat die sosiale interaksie en kommunikasie van individue beïnvloed. Daar is waargeneem dat diegene met OSV, uitdagings met betrekking tot sensoriese insette ervaar, wat kan lei tot motoriese agterstande. Beskrywende navorsing is toegepas met twee gevalle-studies. Die ouderdom van die twee seuns wat met outisme gediagnoseer was, was 6- en 8-jaar oud. Die doel van die studie was om ʼn Sensories-Motoriese Integrasie (SMI) program te ontwikkel en te implementeer as intervensie wat op elk van die seuns spesifiek toegespits is. Die intervensie-program het voorsiening gemaak om aan die uitvoering van bepaalde motoriese vaardighede aandag te skenk en om die uitwerking daarvan oor die 7-maande tydperk te assesseer. Die twee seuns (Geval A en Geval G) het individuele sessies van 30 minute elk twee keer per week bygewoon. Die SMI program het op die vestibulêre en somato-sensoriese (proprioseptor) sisteme gefokus om hul vermoë en vordering waar te neem. Aan die begin van die studie is drie neuro-ontwikkelings- en diagnostiese meetinstrumente (SCQ, ADIR-R en ADOS) deur 'n psigiater gelei om die vorige OSV diagnose van die seuns te bevestig. Die “Quick Neurological Screening Test” (QNST III) en die “Sensory Input Systems Screening Test“ (SISST) is benut om hul aanvangsvermoë as basislyn te bepaal. Hierdie toetse was gereeld herhaal, elke 4 tot 5 weke oor ʼn tydperk van 7 maande en het ʼn retensie toets van 5 weke ingesluit. Op grond van die resultate van die sub-toetse van die vermelde motoriese vaardigheidstoetse, is die self-ontwerpte SMI intervensie-program vir elke seun, volgens sy persoonlike sensoriese-motoriese behoeftes, beplan. Geval A het verbetering getoon in die volgende QNST-III sub-toets: Staan op een been (67%) en Tandemloop (83%), en handhaaf sy standaard vanaf die na-toets tot en met die retensie toets. Vir spiertonus en propriosepsie, het die Arm- en been-ekstensie sub-toets ook ʼn verbetering (67%) van die voor-toets tot die na-toets getoon. Die resultaat van hierdie subtoets is nie oor die hele tydperk gehandhaaf nie, en het net effens verhoog (33%) van die basislyn telling. Die proprioseptiewe funksie van Geval A het 'n groot verbetering in die volgende QNST-III sub-toetse getoon: Vinger na neus (67%), Vinnige omkeer, herhalende hand bewegings (88%) en Links en regs diskriminasie (67%). Geval G se resultate vir die vestibulêre-verwante sub-toetse het verbetering in die volgende getoon: Een been staan (33%) en Arm- en Been-ekstensie (33%). Sommige van die resultate van Geval G het op 'n ernstige diskripansie begin, maar daar was verbetering in die volgende proprioseptiewe verwante sub-toetse: Vinger na neus (43%), Duim en vinger sirkels (20%) en Vinnige omkeer, herhalende hand bewegings (86%). Ten spyte daarvan dat Geval G ʼn geleidelike verbetering oor tyd getoon het, het sy twee sensoriese stelsels gesukkel om met die meer komplekse take met mekaar te integreer. Die uitkoms van die geïndividualiseerde SMI programme het getoon dat die sensoriesemotoriese vaardighede by beide seuns verbeter as gevolg van die verbeterde stimulering van hul vestibulêre en somato-sensoriese (proprioseptiewe) funksie. Die SSIST resultate toon dat Geval A van ‘druip’ na ‘slaag’ in die volgende toetsitems gevorder het: Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive Support Reflex (PSR) en die Ocular Alignment toetsitems. Resultate van die vestibulêre toets, blyk dit dat sowel Geval A as Geval G ‘hipo-vestibulêr’ (onder-gestimuleer) was volgens die “Post-Rotary Nystagmus toets” (PRN) meting wat by die basislyn toetsing behaal is. Hierdie tellings was veranderlik tydens die intervensie. Die enigste toetsitem wat ʼn positiewe verbetering by Geval G getoon het, was die Ekwilibriumsreaksie. Laastens, beide Geval A en Geval G het in die ‘druip’ kategorie vir Kinestese gebly wat daarop dui dat hul swak propriosepsie en ruimtelike oriëntasie steeds teenwoordig was. Daar is 'n behoefte aan verdere navorsing op die gebied van sensoriese-motoriese individuele programme vir kinders met OSV. Toekomstige navorsing wat individuele programme benut, moet oorweeg om die intervensie oor ʼn langer tydperk (bv. een jaar) te laat geskied met meer sessies per week (bv. drie sessies).

Early detection facilitates early intervention (EI), which optimizes outcomes in autism spectrum disorders (ASD) and other developmental delays. However, facilitating the transition between receiving a diagnosis of ASD and other delays and accessing care has received little attention. When families first receive a diagnosis, they often experience grief, confusion, heightened stress, and difficulty accessing appropriate and affordable services, further increasing the disadvantages and disparity experienced by underrepresented populations. This feasibility study will focus on ways providers can better facilitate access to EI services for families following an initial diagnosis. Forty-nine diverse parents with children (16-32 m) diagnosed with ASD and other developmental delays were recruited from a larger screening study. During feedback, all families were provided with a provider list (treatment as usual) of therapeutic services. Half of the families were randomly assigned to receive a DVD/ Youtube Link (treatment plus video) that describes the diagnosis as well as common therapeutic options for children with developmental delays. Parents were asked questions regarding their use of materials (video vs. provider list) following feedback and their ability to access EI services. Study retention, demand and satisfaction were assessed to evaluate the use of video recommendations and the provider list. Demand, satisfaction and completion rates were assessed to evaluate the use of video recommendations as a feasible intervention following diagnosis. Additionally, differences in post measures of parental sense of competence, parental stress and access to the EI system were used to assess the potential efficacy of the intervention. Seventy- five percent of parents (across both treatment groups) used the provider list, whereas only 29% of parents who were randomized to the video condition reported that they viewed the video recommendations. Qualitative reactions from parents in the current investigation suggest a need for interdisciplinary care and coordination between mothers. Challenges to delivering a brief intervention following diagnosis are explored.

The purpose of this study was to explore the impact of child-centered play therapy (CCPT) on the social competence, empathy, and self-regulation of children diagnosed with autism spectrum disorder (ASD). The constructs of social competence, empathy, and self-regulation were measured using the Social-Emotional Assets Rating Scale (SEARS). This study utilized a single-case design; the researcher collected data throughout the duration of the study, including baseline, treatment, and follow-up phases. The sample included 5 children ranging from ages 6 to 8 years old: 3 Caucasian males, 1 African-American female, and 1 Latin-American female. Mothers of the participants completed the parent form of the SEARS once per week throughout all phases of the study. During the treatment phase of the study, the children participated in CCPT approximately 2 times per week for 30 minutes each time. Visual analysis of the data indicated play therapy was beneficial for three participants, as they demonstrated improvements in social competence, empathy, and self-regulation. Two participants responded to the intervention with mixed results. Discussion includes implications for clinical practice and future research as well as limitations of the study.

Autism spectrum disorders (ASDs) are chronic and pervasive developmental disorders; children with ASDs require more multidisciplinary services than children with other developmental, behavioral, and emotional disorders (Kogan et al., 2008). Little research has been done on the practices and perspectives of the professionals providing services to children with ASDs. Evidence-based practice (combining use of evidence-based interventions [EBIs], family-centered care [FCC] respecting patient/family values, and clinical expertise) leads to the best outcomes for children with ASDs (APA Presidential Task Force on Evidence-Based Practice, 2006). The aim of this study was to assess the extent to which psychological constructs (attitudes, subjective norms, perceived behavioral control) within the Theory of Planned Behavior (Ajzen, 1991) are helpful for understanding the behavior of professionals in regards to two areas of evidence-based practice: recommending and/or providing EBIs and using a FCC approach to care with children with ASDs. Professionals (N=709) providing direct services to children with ASDs were recruited from different disciplines (Education, Medicine/Nursing, Occupational and Physical Therapy, Psychology, Social Work, Speech Language Pathology/Audiology) and were asked to fill out an Internet or paper survey including measures on TPB constructs and EBI and FCC behavior. Participants were recruited from a convenience Internet sample and a stratified random sample of online provider listings (from professional and autism-specific organizations). Professionals’ attitudes and familiarity with EBIs significantly predicted their self-reported recommendation and provision of EBIs in the positive direction. Professionals’ attitudes, perceived-behavioral control, and years in practice significantly predicted self-reported use of an FCC approach with children with ASDs in the positive direction. There was a trend for explicit training on EBI or FCC to predict professionals’ behavior, but these findings did not reach conventional levels of significance. Subjective norms did not significantly predict EBI or FCC behavior. Discipline membership did not moderate the relationship between TPB and EBI and FCC self-reported behavior measures. The TPB is a useful framework for better understanding professionals’ evidence-based practice behavior. This study sheds light on practices and perspectives of professionals working with children with ASDs and highlights areas for future research and training with this population.

Neuronal plasticity deficits underlie many of the neurobehavioral problems seen in Fetal Alcohol Spectrum Disorders (FASD). Recently, we showed that third trimester alcohol exposure lead to a persistent disruption in ocular dominance (OD) plasticity. For instance, few days of monocular deprivation results in a robust reduction of cortical regions responsive to the deprived eye in normal animals, but not in ferrets exposed early to alcohol. This plasticity deficit can be reversed if alcohol-exposed animals are treated with a phosphodiesterase type 1 (PDE1) inhibitor during the period of monocular deprivation. PDE1 inhibition can increase cAMP and cGMP levels, activating transcription factors such as the cAMP response element binding protein (CREB) and the Serum response factor (SRF). SRF is important for many plasticity processes such as LTP, LTD, spine motility and axonal pathfinding. Here we attempt to rescue OD plasticity in alcohol-treated ferrets using a Sindbis viral vector to express a constitutively active form of SRF during the period of monocular deprivation. Using optical imaging of intrinsic signals and single unit recordings we observed that overexpression of a constitutively active form of SRF (Sindbis SRF+), but neither its dominant negative (SRF-) nor GFP, restored OD plasticity in alcohol-treated animals. Surprisingly, this restoration was observed throughout the extent of the primary visual cortex and most cells infected by the virus were positive for GFAP rather than NeuN. Hence, we further tested whether overexpression of SRF exclusively in astrocytes is sufficient to restore OD plasticity in alcohol-exposed ferrets. To accomplish that, first we exposed cultured astrocytes to the SRF+, SRF- or control GFP viruses. After 24h, these astrocytes were implanted in the visual cortex of alcohol-exposed animals or saline controls one day before MD. Optical imaging of intrinsic signals showed that alcohol-exposed animals that were implanted with astrocytes expressing SRF, but not SRF- or GFP, showed robust restoration of OD plasticity in all visual cortex. These findings suggest that overexpression of SRF exclusively in astrocytes can improve neuronal plasticity in FASD.

Title: Sexuality of people with mental disability and autism spectrum disorders in residential facilities in South Bohemia Author: Bc. Veronika Beránková Supervisor: Doc. PhDr. Jan Šiška, Ph.D. ABSTRACT This thesis solves the attitude of the sexuality of people with mental disability and autism spectrum disorders in residential facilities in South Bohemia. We specifically wonder, if there is any work with sexuality and in which way. Chosen research problems were solved during an interview with the employees of the facility whoch provides residential services. Then we did an analysis of the interview by coding and categorization of answers. In the final stage, emerged from the analysis of the interviews main interests of respondents and their attitudes to the sexuality topic. We created a summary which shows how staff work with sexuality of clients with mental disability and autism spectrum disorders and which are their individual attitudes. The benefit of this thesis is effort of explanation our topic to the general public and to the facilities providing residential social services itself. KEYWORDS Mental disability, autism spectrum disorders, sexuality, residential facilities, social services.

The diploma with title Preparing the teachers for the integration of the children with autistic spektrum disorders into regular primary school aims in its theoretical part acquaint the reader with the concept of autistic spectrum disorders, the classification and individual characteristics closer disorders. It provides an overview of suitable approaches, forms and methods of work with these children, educational opportunities and further aims at integration into mainstream schools. In its research section it aims to penetrate deeper into the issue of preparing teachers to integrate pupils with autism and a description of its subsequent course. Based on qualitative research methods, namely semi-structured interviews and document research presents a collection of opinions, attitudes, experiences, recommendations and advice on how to integrate teachers and school principals, as well as opinions and attitudes of teachers who don't have experience with integration. The results of the investigation could be a base for further research of a quantitative nature.

Autism is a complex disorder with possible genetic, epigenetic and environmental components. As the etiology remains uncertain and an increase in incidence is suspected, the involvement of possible environmental risk factors has gained increasing attention. With this thesis, I aim to provide tools for assessing such risk factors. Firstly, I aim to construct a questionnaire for the analysis of an environmental component in the etiology of autism. Secondly, I aim to assess the importance of prenatal exposure to metals in certain diseases and thirdly I aim to construct a methodology enabling the analysis of the mitochondrial epigenome, which is especially interesting in relation to autism as mitochondrial diseases occur more frequently in an autistic population than in the general population. For the creation of the questionnaire the scientific literature was reviewed. The resulting questionnaire contains general, prenatal, neonatal and paternal risk factors. The metal analysis was conducted on the cord blood of patients who later developed autism, antinuclear antibodies positive rheumatoid arthritis or diabetes, which were then compared to healthy control subjects. My findings propose a link between elevated levels of cord blood cadmium or aluminum and rheumatic arthritis. In addition, elevated aluminum levels might be associated with autism. In regards to the analysis of the mitochondrial epigenome, to my knowledge, no standard protocol exists with frozen human whole blood as a source. In this thesis, I succeeded in creating the basis for such a protocol, however still needing several small modifications for an increased overall yield.

This diploma thesis deals with the issue of inclusion of children with autism in pre-school education. It describes the concept of autism and its specificities, which can be significantly manifested in the inclusion of children in joint education up to the age of six. It points to the potential pitfalls that can arise in education and training. It explains concepts related to autistic spectrum disorders and discusses in detail the triad of impairments and related issues based on expert opinions. The thesis also shows different approaches and proven procedures for working with children with autism not only in kindergarten, but also for practice in the family. It describes different cognitive styles and other specifics that may arise in connection with autistic spectrum disorders and have a major impact on the child and his surroundings. It also includes personal examples from practice that illustrate the complexity and diversity of working with children with autistic spectrum disorder in kindergarten. In the second part of this work a case study is described, which can also serve as an example of good practice. It describes the class attended by two boys with autism. Part of the case study and a description of the climate detection program in the classroom designed for preschool children. This is...

Attachment theory is concerned with the relational ‘tie’ that exists between a mother and her child, which is said to play an imperative role in a child’s mental development and future attachment relationships. Although there is extensive research on attachment theory on an international scale, there is a paucity of information with regard to this in the South African context. The object of this study is to investigate mothers’ experiences of attachment with their child who has an Autistic Spectrum Disorder (ASD). In addition this research aims to investigate whether this attachment relationship between a mother and her ASD child differs, or is the same across diverse socio-economic groups in the South African context. This research was qualitative in nature, which elicited rich, descriptive and personal accounts of mothers’ experiences of attachment with their ASD child across diverse socio-economic groups. Twelve participants from advantaged and disadvantaged communities from Johannesburg and the greater Johannesburg area were invited to participate in this study. Data was gathered through semi-structured interviews and analysed using thematic content analysis. Seven themes emerged from this study which explored mothers’ experiences of attachment with their ASD child. In addition, similarities and differences were found in mothers experiences of attachment across the diverse socio-economic groups.