Autism occupies an extreme position among childhood pathologies due to its severity, duration and impact on the family. In this qualitative study, four primary caregivers of autistic children were interviewed regarding their experiences of the diagnostic process, their post-diagnostic adjustment, and how helping professionals can improve their service rendering to these families. This study utilised a phenomenological approach to look at primary caregivers as the best-informed authority to explore and describe their lived realities and experiences of raising their autistic children in South Africa. The rationale for a phenomenological approach in this study is that such an interpretative inquiry enables material to be collected and analysed within the specific context of the subjective realities of primary caregivers of autistic children in South Africa. The researcher utilised semi-structured, in-depth, face-to-face interviews as method of data collection. Each participant was interviewed over the course of three separate interviews. The themes and categories that resulted from a content analysis of the material were grouped into two broad fields of experience, namely: (1) experiences surrounding the diagnostic process; and (2) the pervasive influence of autism on different areas of family life. In terms of experiences surrounding children’s diagnosis, four themes were identified: (1) Being a new parent and making sense out of chaos; (2) Responsibility and blame; (3) Confusion and disillusionment during early experiences with helping professionals; and (4) Feelings about the diagnosis. The pervasive influence of autism on different areas of family life includes: (5) Strained family relationships; (6) Challenges of behaviour management and disciplining the autistic child; (7) Challenges of finding suitable resources for education and day-care; and (8) Maintaining the family unit and doing things as a family.

A significant rise in the number of students with autism spectrum disorders (ASD) served in today's schools requires special education administrators to possess knowledge in this area. The purpose of this study was to determine the general knowledge of special education administrators concerning ASD and knowledge of educational programming, to explore their educational training and professional development experiences in ASD, to identify the training needs of special education administrators in ASD, and to determine if knowledge, training and experience in ASD predict litigation. Using survey methods, data were collected from a sample of 106 special education administrators in Texas. Data revealed special education administrators were most knowledgeable of general characteristics, common myths, and instructional strategies, and less knowledgeable of eligibility criteria. Knowledge regarding educational programming for learners with ASD produced mixed results. Logistic regression analysis revealed general autism knowledge, knowledge of educational programming, training, and experience in ASD were not factors predicting litigation. Although results indicated none of the factors explored in this study were predictors of litigation, areas of need regarding professional development were identified. Implications for future research are also discussed.

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It is becoming more apparent in recent years that many females with autism spectrum disorder (autism) have not been identified, sometimes until adulthood. Most of what is known about early signs of autism is based on predominantly male symptomatic presentations or data gathered from females with autism who are severely affected by autism and co-morbid conditions such as intellectual developmental disorder. One of the issues contributing to the under diagnosis of females is that the presentation of symptoms or traits and developmental histories of females with autism may not be the same as those of males. There is a gap in the research literature regarding the early presentations of autism in females, particularly for females with age-appropriate language and cognitive abilities. We interviewed parents of adolescent and adult females with significant autism symptoms or traits (but without intellectual developmental disorder). Interviews asked about developmental histories and parent recollections of differences they may have noticed in their daughters' early years. We also interviewed a group of parents whose daughters were not showing significant signs of autism but had similar social isolation and anxiety. Interpretative phenomenological analysis methods were used to analyze conversations with parents as a way to determine what seemed most salient to them about their daughters' early years without being influenced by symptom checklists. We found communication differences, restricted or repetitive interest and social communication differences to be recurring themes in the reports from parents interviewed. Learning about what early development in females with autism might look like can help us to reformulate our identification and assessment procedures for young children, particularly females who show developmental differences that have not previously been associated with autism.

Children’s self-regulation has shown to be related to the trajectories across various domains of adaptive functioning and school success. Delay in self-regulation development represents an area of major challenge for children with autism spectrum disorder (ASD) (e.g., Jahromi, 2017), a neurodevelopmental disorder characterized by persistent deficits in social communication and interaction as well as restricted and repetitive behaviors (American Psychiatric Association, 2013). Children with ASD are often reported academic difficulties and underachievement compared to their typically developing peers (e.g., Nation et al., 2006). It has been well-documented that typically developing children with greater self-regulation had better academic achievement (e.g., Blair & Razza, 2007). However, few studies have extended the examination of the association between self-regulation and academic learning to the populations with special needs, especially to those with ASD. Moreover, the majority of previous studies solely relied on standardized assessments to reflect children’s temporary learning outcomes rather than their dynamic learning process. Little is known about how children’s self-regulatory skills are related to the way they learn and how various child characteristics moderate this association. Therefore, the goal of this study was to examine how the self-regulatory capacities of children with ASD, including executive function and effortful control, were linked to their dynamic academic learning process and to investigate the moderating effects of various child characteristics on this association, including ASD-related symptoms severity, school engagement, reward sensitivity, and adaptive behavior, all of which represent areas of challenge for children with ASD. Additionally, children with ASD often receive many different types of reinforcement at school. Their ability to wait for delayed reinforcement and their responsiveness to different reinforcers seem crucial for how successful they could adapt to school lives. Thus, another goal of this study was to investigate children with ASD’s responses to delayed reinforcement as well as token and social reinforcers in the natural classroom environment and to identify strategies that can facilitate their tolerance to delayed reinforcement and responsiveness to different types of reinforcers. Thirty-two preschoolers aged 36 to 68 months from two specialized applied behavior analysis schools in the greater New York City area participated in the study. Each participant had an Individualized Education Program with a classification of Preschooler with Disability and had a current diagnosis of autism confirmed with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2; Lord et al., 2012). Children with ASD received direct measures on their executive function in a laboratory setting and assessments on their responses to delayed reinforcement as well as token and social reinforcers in the natural classroom environment. Parents filled out reports regarding children with ASD’s executive function, effortful control, and reward sensitivity. Teachers completed scales on these children’s school engagement and adaptive behavior. Regarding the participants’ academic learning, instead of using one-time standardized assessments, this study derived school data of multiple literacy and mathematics programs over a period of time to investigate the number of learning opportunities and additional one-to-one educational interventions a child required to achieve an academic objective in the learning process. Findings in this study showed that children with ASD with better self-regulation engaged in school activities to a greater extent, demonstrated better adaptive behavior at school, and were reported to have stronger social communication skills. Children with ASD with better emotional control, attention, and inhibitory control achieved academic objectives in literacy faster, especially in the domains of word recognition and reading comprehension. Also, children with ASD with a better overall EF level learned math concepts and problem-solving skills faster in both trial-based and script-based mathematics curricula, and those with better working memory demonstrated a higher learning rate in the trial-based mathematics programs. Further analyses showed that the relationship between self-regulation and academic learning in children with ASD was influenced by their behavior school engagement and reward sensitivity. These results inform future interventions to focus on the school engagement behaviors and sensitivity to reward in children with ASD when developing their self-regulation and academic learning skills. Moreover, three socially-oriented strategies, including using language, gestures, and eye contact, were found to help children with ASD respond better to delayed reinforcement, above and beyond their self-regulation level. Also, these children responded better in a task that they already mastered under a situation in which tokens could be earned for exchanging preferred items or activities contingent on their performance rather than in a situation where only social attention was available. Overall, self-regulation emerged as a potential protective factor for young children with ASD in their school success in terms of engagement and adaptive level as well as academic learning rates. Self-regulation development is recommended to be included as an essential component in future academic and social-emotional interventions for children with ASD. Meanwhile, developing the ability to use language, gestures, or eye contact to communicate needs and emotions may help children with ASD have a better response to delayed reinforcement in the natural classroom environment. Considering the majority of them demonstrated altered reward sensitivity characterized by nonsocial stimuli hypersensitivity and social rewards hyposensitivity, it is important to enhance their responsiveness and sensitivity to social reinforcers to promote their school adjustment and success.

BACKGROUND: Autism Spectrum Disorder is a range of neurodevelopmental disorders that typical manifest as social deficits, delayed or impaired communication skills, and repetitive behaviors in day-to-day life. Patients with Autism Spectrum Disorder (ASD) often present with other concurrent clinical disorders. Sleep disorders (SD) and sleep issues are highly prevalent in ASD children and rank as one of the most common concurrent clinical disorders. Prevalence rates vary widely, ranging from 40 to 80 percent, as compared with that of typically developing children in which prevalence rates are approximately 30 percent. Sleep problems can have an impact on daytime health and may result in neurocognitive dysfunction and behavioral disruptions. A cyclical pattern arises: individuals with autism are observed to have sleep difficulties, which may exacerbate autistic traits, which can in turn further worsen their quality of sleep. Therefore, sleep disorders may have wide ranging effects on daytime functioning, developmental progress, and quality of life for children with ASD. OBJECTIVES: The purpose of this thesis is to provide a review of the research status of ASD, SD, the interplay between these two disorders, and therapeutic interventions that have been researched or are currently being investigated. A goal of this thesis is also to recommend areas of future investigation based on the current state of autism research. METHODS: A literature review of studies, abstracts, and clinical trial data relating to ASD, SD, and other comorbidities observed in ASD was performed. CONCLUSION: Current models and theories on the relationship between ASD and SD suggest that the underlying etiology of autism itself may contribute to sleep troubles, and might even have wide-reaching impacts on other unrelated aspects of ASD. Gastrointestinal, otolaryngologic, and psychiatric comorbidities are observed in autism and may affect sleep in these patients, but the mechanism by which this occurs is unclear. There are many treatments for sleep troubles in ASD such as melatonin and behavioral interventions, with varying success. Much work is required to understand the underlying mechanism between both autism and sleep disorders. There is also a need for more efficacious therapeutic interventions, but there are multiple clinical trials underway which may have promising results. Future studies should also incorporate robust data-collection instruments such as polysomnography to validate findings. / 2021-06-14T00:00:00Z

The demand for effective social skills interventions for children with autism spectrum disorders is a pertinent issue for school-based professionals. One approach to increase appropriate social skills is to involve peer support by training a few socially competent children to positively interact with a student with an ASD. Potentially, training larger groups of children could result in increasing the number of different peers who would actively support positive interactions with their classmates with ASD. Thus, the present study investigated the effect of a class-wide peer-training strategy on the percentage of positive social interaction and number of peer contacts for three elementary students with autism spectrum disorders. All peers in the three different classrooms received a brief lesson on respecting differences in others and how to support all classmates during classroom and recess activities. Next, each class was taught how to support other students in the class by modeling, role playing, and didactic instruction. This training specifically targeted preferred recess activities and social skills goals of the student with an ASD. After training, peers received a verbal prompt to use skills before a recess period, implemented the procedures in the absence of direct supervision during recess, and participated for a chance to earn points towards a class-wide reward for participating in positive interactions with the student with an ASD. A multiple baseline across the three classrooms showed replicated positive effects of the intervention relative to a prior baseline condition. Results showed that the class-wide respect and social support skills training paired with a contingent reward contingency increased the level of positive social interactions as well as the number of peer contacts for all three students with autism spectrum disorders.

The dominant approach to treating social dysfunction in individuals with autism views that dysfunction as a skill deficit. However, another plausible interpretation is that social dysfunction in some individuals arises from motivational deficits. The proposed study presents a method to assess motivational deficits for social attention in individuals with autism. By borrowing methods from behavioral economics, we assessed the essential value for social attention and compared it to the essential value for food. Five individuals diagnosed with autism were included in the project. First, we assessed preference for food by using paired-preference assessment. To identify preference hierarchy for attention, we used a modified version of the paired-preference assessment. After establishing the preference hierarchies for food and attention, the top items from each category were delivered on a fixed-ratio schedule. During this reinforcement assessment the participants received one reinforcer every time they emitted the target response. The final stage of the study included the assessment of the essential value for each of the two commodities (food and attention). During this stage, we increased the number of responses participants were required to emit to earn a reinforcer across each daily session. All of the participants showed a decrease in reinforcers earned as the work requirement increased, and for three of the participants the essential value of food appeared noticeably higher than that of attention. Using the methods from behavior economics allowed the comparison of two commodities that differed in nature, and assisted capturing the important qualities of these potential reinforcers. These results suggest that behavioral economic-based assessments of reinforcer value may have clinical utility.