Inledning: Personer med Aspergers syndrom har svårigheter med tidshantering och tidsuppfattning vilket påverkar vardagsstrukturen negativt. De är i behov av en förutsägbar och strukturerad vardag och behöver hjälp att konkretisera tiden vilket kan ske med hjälp av tidshjälpmedel. Syfte: Syftet med denna studie är att undersöka vilka problem i vardagen, relaterat till tidsuppfattning, som finns hos personer med AS, i vilken omfattning tidshjälpmedel används samt vilken nytta det gör. Metod: En empirisk studie gjordes då tre arbetsterapeuter i semi-strukturerade intervjuer berättade deras uppfattning av tidshjälpmedel för barn och ungdomar med AS, både generellt och med specifika exempel. Kvalitativ innehållsanalys användes. Kategorierna delades upp i teman inre faktorer; då egenskaper hos personen själv påverkar tidsuppfattningen och hur problemen hanteras, och yttre faktorer; då faktorer utanför personen påverkar. Resultat: P.g.a. den bristande tidskänslan kan de inte förutse hur lång tid något kommer att ta och får därför svårt att planera. De vet inte när de ska göra vad, inte heller hur länge de bör fortsätta vilket leder till att de fastnar i aktivitet.  Många har insiktsproblem, vilket gör det svårt att få rätt hjälp. För att vardagen ska fungera är rutin och struktur viktiga byggstenar, då det är grunden för att hantera tid. Vilka tidshjälpmedel som barn och ungdomar med AS är i behov av och använder är väldigt individuellt. Vanligt är dock scheman, 20 minuters- och timstock, handi/handifon och Sigvart dygnstavla. Ett hjälpmedel ska lösa ett problem och hjälpa personen förbi en begränsning i vardagen. Målet är ofta att skapa självkontroll och självständighet. Eftersom tidshjälpmedel aldrig är statiskt krävs uppföljning kontinuerligt. Det är viktigt att omgivningen, skola och föräldrar, hjälper till då barnen ofta inte har förmågan till att ta till sig hjälpmedlet och få det att fungera på en gång. Även omgivningen har nytta av att barnen fått ett hjälpmedel då det blir mindre tjat från båda hållen. Diskussion: En förbättrad tidsuppfattning, t.ex. med hjälp av hjälpmedel, påverkar positivt den självskattade autonomin och förenklar för personerna att leva det liv de vill.

This study aimed to determine what the effect of participation in a Tomatis Programme (TP) would be on the psychological well-being and communication ability of a 14 year old, white adolescent boy with Asperger Disorder (AD). A mixed method design in the form of a single casestudy was used. Qualitative data were obtained via semi-s!mctured interviews, spontaneous sketches and observation. Quantitative data were gathered by means of projective drawings and the Profile of Mood States (POMS). Seven main categories with twenty-one sub-categories emerged eom the qualitative data, and were supported by the quantitative data. Results indicated improvement in Interpersonal Communication and all six domains of psychological well-being as defined by RyfT (1995) with most significant areas being: Environmental Mastery, Personal Growth, Autonomy and Positive Relations. The Tomatis Method (TM) proved to be a successful form of treatment to enhance psychological well-being and interpersonal communication skills in an AD patient More effective communication and better family relationships can be achieved and therefore youth with AD can be empowered to adjust their behaviour accordingly. The TM prepared the participant for a next phase in therapy where he specifically can focus on more effective social skills with peers. Further research involving more participants and a control group is needed. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2005.

Research shows that there is a gap between interest and experience in the area of sexuality for individuals with autism. Also, although these individuals have unique learning requirements pertaining to their sexuality, there is no consensus on the provision and content of such education. Using a socially inclusive theoretical lens founded on existing models of disability and competence, this bilingual study (a) developed a conceptual framework of sexuality education, as understood by adolescents living in Ontario with a diagnosis of high-functioning autism and their caregivers; (b) used extant texts to support the conceptualization provided by youth and caregivers; and (c) identified personal strengths and barriers, as well as societal supports and barriers that impact sexuality education for these youth. Using a qualitative orientation, this study employed in-depth interviews, surveys, and a literature review to better understand the topic under investigation. Twenty participants from 8 families took part in these interviews, including 9 adolescents and 11 caregivers. Survey and extant textual-analysis data were used to support the findings. Sexuality education content was conceptualized as a combination of facts and sociosexual norms, with emphasis on outcomes. Additionally, safety and pleasure were identified as important content areas, including the historically absent aspect of shared enjoyment. Some content areas were part of a greater discourse of normalization. Sexuality education was seen as a combination of formal and informal activities that are developmentally appropriate, proactive, and take place across various settings and groupings. Caregivers were cited as the primary providers of informal education, whereas schools and other community partners were seen as formal providers of education. Various supports and barriers were identified, some of which were viewed as both. Themes related to media and technology pervaded all findings. This study provides further emic and etic understanding of the subject with implications for practice, policy, and theory.

Abstract Co-morbid emotional disturbances are not uncommon in individuals with Asperger syndrome (AS) especially during the tumultuous period of adolescence. The few empirical studies that exist have only examined treatment outcomes for anxiety and anger in individuals with AS during childhood but there are no available treatment studies for adolescents or adults. Therefore, this research project aimed to examine the efficacy of a modified cognitive-behaviour therapy (CBT) program for emotional disturbance in young people with a diagnosis of AS. Firstly, it was important to establish the need for treatment by examining the prevalence and presentation of emotional disturbance in this population. Secondly, an investigation of the role of pessimistic attributional style, negative problem orientation and social competence as risk factors for emotional disturbance helped to determine the suitability of CBT. It was also essential that an existing CBT program was modified to suit the cognitive profile of young people with AS. Finally, the efficacy of a modified CBT program was evaluated in a pilot study and randomised controlled trial. In the first study, 68 young people with existing diagnosis of AS between the ages of 11 and 23 years completed a battery of measures that assessed for AS characteristics, emotional disturbances, risk factors, and cognitive ability. The results of this study indicated that approximately 21%, 20% and 40% of young people reported elevated levels of depression, anxiety, and anger symptoms respectively. Furthermore, approximately 60% of young people reported elevated levels on at least one of the emotional disturbance measures (i.e., depression, anxiety or anger symptoms), while 40% of adolescents reported elevated levels on at least two. Therefore, the study suggests that there is a need to develop evidence-based treatment for young people with AS. In addition, significant associations were found between pessimistic attributional style, negative problem orientation and social competence, and emotional disturbance. Multiple regressions suggested that these risk factors account for approximately 54%, 39% and 25% of variance in depression, anxiety and anger respectively. These results are consistent with the literature for typically developing young people, and thus, cognitive-behaviour therapy typically used to treat mood and anxiety disorders in the general population should be efficacious for the AS population. Furthermore, CBT has been shown to be efficacious in treating anxiety and anger problems in children with AS. Although there are no existing CBT programs targeting depression in young people with AS, there are numerous CBT programs for typically developing young people. One example is the Aussie Optimism Program (AOP), an Australian adaptation of the Penn Prevention program which has a strong evidence-base for treating depression. Based on the AS literature, the program was modified to suit the cognitive profile of young people with AS. These modifications include providing affective education, using visual materials, small groups with high therapist to adolescent ratio, and other modifications to assist learning. Study Two piloted the modified program with three young people with AS. The pilot study provided some evidence that the modified Aussie Optimism reduced symptoms of emotional disturbance, but the sample size was too small to obtain clear results. In addition, observations from the pilot study were used to further modify the CBT program, which enhanced the structure and delivery of the program. The final modified CBT program consisted of six 2-hour sessions teaching young people to identify emotions and discriminate between different levels of emotional intensity; to cope with emotions; to identify and challenge negative thoughts; and to solve problems. Finally, a randomised controlled trial was used in Study Three to examine the efficacy of the modified CBT in treating depression in young people with AS. Given the high co-morbidity of emotional disturbance, the study also tested the efficacy of CBT program in reducing symptoms of anxiety and anger. Forty-four young people with AS were randomly allocated to the intervention (n = 21) or the waitlist control (n = 23). The results of Study Three demonstrated that young people with high levels of depression and anger symptoms initially showed a significant reduction after the intervention, compared with the waitlist control group. Although anxiety levels reduced from time 1 to time 2 for the intervention group, the pattern of results was not statistically significant. Reliable change index (RCI) indicated that young people with high levels of symptoms at Time 1 showed meaningful clinical changes across measures of depression, anxiety and anger (parent and adolescent report) only in the intervention group (42-83%), but not in the waitlist control group (8-12%). Results in Study Three suggest that CBT modified to suit the cognitive profile of AS is efficacious in reducing depression and anger symptoms. Some of the methodological limitations of this study include a small sample size, attrition, participant variability, and a lack of longer-term follow-up. Despite these methodological limitations, these three studies provided strong evidence for the efficacy of CBT in treating emotional disturbance in young people with AS by establishing the need for an intervention, identifying the importance of the risk factors targeted by CBT, and demonstrating the efficacy of a modified CBT in reducing symptoms of emotional disturbance, specifically depression and anger, using a randomised controlled trial.

Background: There is presently a lack of consistency in research designed to measure executive functioning (EF) in autism that may be attributable to lack of homogeneity or comorbid conditions (i.e. learning disability or additional diagnosis) in test samples. Aim: A systematic review focused on a subset of EF (verbal fluency: VF) was conducted, using only studies of high-functioning individuals with autism (HFA) without an additional diagnosis or learning disability. An empirical study was conducted comparing the executive functioning profile of individuals with HFA and typically developed (TD) individuals. Method: For the systematic review, 16 studies met the specified inclusion criteria, depicting 15 semantic (category), 14 phonological (letter), and 6 switching (categories) VF tasks. In order to assess potential bias, the available VF information of the included papers was scrutinised by the author and an independent clinical practitioner. For the empirical paper, 22 HFA and 22 TD participants (mean age = 28, range = 17-73, 52% male) without a comorbid condition, learning disability or brain injury completed three subtests from the WAIS-IV (vocabulary, block design and digit span) and all subtests of the Delis–Kaplan Executive Functioning System (D-KEFS). Results: For the systematic review, a minority of semantic and phonological VF studies reported a significant difference between typically developed and HFA populations. Five of the six semantic switching studies reported a significant difference between groups. All papers included were of good or adequate quality and inter-rater reliability was high. For the empirical paper, the HFA group performed significantly poorer on the switching condition of the design fluency task, semantic conditions of the verbal fluency task and on the word context task overall. No other significant differences were observed. Summary: Although the systematic review concluded that there was insufficient evidence to support that disfluency can be attributed to autistic symptomology, the empirical study found that the HFA group performed poorer than TD in semantic VF and other subtests designed to measure generating novel ‘imaginative’ ideas, without visual cues to aid performance. The deficit on these subtests was increased when there was the added condition requiring the participant to switch between newly formed concepts. Conclusions: Although in VF, results are mixed, the empirical study demonstrates that even in a group of high-functioning individuals there are still measurable differences in EF between TD and HFA samples that may not be apparent through more general cognitive testing. Implications for using a neuropsychological profile for adults with HFA are discussed.

Las madres de hijos con síndrome de Asperger suelen vivenciar elevados niveles de estrés parental, incluso más que la mayoría de madres. Además, la percepción sobre sus propias competencias parentales tiende a ser disminuida. La literatura muestra una relación inversa entre dichos procesos, los cuales no han sido investigados en este grupo de madres en nuestro medio. Por ello, el presente estudio buscó identificar si existe tal relación y cuál era su naturaleza. Las 33 madres que conformaron la muestra respondieron al Índice de Estrés Parental y a la Escala de Competencia Parental Percibida. Se hallaron tres correlaciones significativas; una inversa y dos directas, respectivamente. Las madres que sentían la relación con su hijo como una escasa fuente de refuerzo positivo, se percibían menos competentes para brindarle estructura y guía. De otro lado, las madres de hijos con menor habilidad adaptativa, brindaban mayor tiempo y espacio para conversar y aclarar dudas. Por otra parte, las madres de hijos con escasa expresión de afectos positivos, percibían estar más adaptadas al hecho de tener un hijo. Respecto a variables sociodemográficas, las madres divorciadas o separadas reportaron menor capacidad para la crianza, mayor aislamiento, más síntomas depresivos, menor apoyo del padre, y menor competencia parental general. Similarmente, las madres de hijos únicos reportaron mayor aislamiento, mayor restricción debido al rol materno, más síntomas depresivos, menor apoyo del padre, y menor adaptación al hecho de ser madre. Los resultados se discuten e interpretan reconociendo la baja confiabilidad de ciertas sub-escalas de los instrumentos. / Mothers of children with Asperger’s syndrome tend to experience high levels of parenting stress, even more than most mothers. In addition, their perception of their own parenting competence is usually diminished. Literature review shows an inverse correlation between these processes, which have not been studied in this group of mothers in our society. Taking that into consideration, the current investigation intended to identify if such relation existed and what its nature was. The sample consisted of 33 mothers who answered the Parental Stress Index and the Perceived Parenting Competence Scale (Escala de Competencia Parental Percibida).The results indicated three significant correlations; one inverse and two direct, respectively. First, mothers who felt their relationship with their child was a scarce source of positive reinforcement, felt less competent in offering structure and guidance. Second, mothers of children with less adaptive skills, offered more time and space to talk and solve doubts. Third, mothers of children who presented low expression of positive affects, felt more adapted to the fact of raising a child. Regarding sociodemographic variables, mothers who were divorced or separated reported less parenting ability, more isolation, more depressive symptoms, less support from the father, and less overall parenting competence. Similarly, mothers of an only child reported more isolation, more restriction related to the maternal role, more depressive symptoms, less support from the father, and less adaptation to the fact of being a mother. Results are discussed and interpreted in the light of the low reliability of some sub-scales of the instruments. / Tesis

El tema de investigación de la presente tesis es la influencia de la acción docente de un aula regular, en el aprendizaje de habilidades sociales de los niños con Síndrome de Asperger y Síndrome de Down. / Tesis

A través de la metodología del Análisis de la Conversación, este documento ofrece un acercamiento minucioso de cómo dos niños diagnosticados con Síndrome de Asperger (SA), uno de los Trastornos del Espectro Autista, manejan un tema o tópico durante una conversación con la investigadora. El fenómeno que se analiza en esta investigación ha sido denominado “tópico perseverante” por Pizant y Rydell (1996) e implica que el discurso de ambos niños presente recurrencia de un mismo tópico cuando se trata de uno que les interesa mucho. De lo contrario, cuando este no es de su interés, no suelen cooperar en el desarrollo del mismo, y sus respuestas son, en su mayoría, no preferidas. Así, si están conversando sobre el tema que les gusta, no suelen colaborar para la transición gradual hacia otro, sino que perseveran en él. Se han hallado los siguientes fenómenos en la interacciones verbales registradas: respuestas no preferidas ante generador inicial de tópico, respuestas no-preferidas ante ofrecimiento de tópico a través de preguntas sí/no interrogativas (PSNI), respuestas maximizadas ante ofrecimiento de tópico a través de preguntas sí/no declarativas (PSND): casos de tópico favorito, retorno abrupto a tópico favorito, y unidades incoherentes que retornan abruptamente al tópico favorito. La manera en qué los niños diagnosticados con SA interactúan en una conversación (específicamente, manejan el tópico) es reflejo de las particularidades sociales que presentan los autistas. / Tesis

The thesis is dedicated to the life stories of adolescents with the Asperg syndrome and their problems in particular periods of development. The theoretical part describes every period of development from the prenatal period to the adolescence. In the next part the pervasive development and autistic spectrum defects are described, main focus is aimed to the Asperg syndrome. Subsequently problems of the family where the individual with the autism is involved, leisure time of the members of the family and their socialization are described. Practical chapter consists from the description, analysis and comparison of the problems of three chosen adolescents with Asperg syndrome.

Made available in DSpace on 2015-07-22T20:49:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-25 / Introdução: Autismo Infantil e síndrome de Asperger são entidades diagnósticas em uma família de transtornos de neurodesenvolvimento, chamada de Transtornos Invasivos do Desenvolvimento. Esse grupo é caracterizado por alterações qualitativas das interações sociais recíprocas e modalidades de comunicação e por um repertório de interesses e atividades restrito, estereotipado e repetitivo. Embora já reconhecido que estes pacientes apresentam prejuízo no mínimo das três áreas citadas acima, estudos que avaliam o desempenho funcional global , ainda não foram realizados para a identificação e compreensão das peculiaridades de cada condição. Objetivos: Quantificar o desempenho funcional global e a necessidade de assistência do cuidador no autismo infantil (AI) e na síndrome de Asperger (SA); compará-los com os dados normativos de crianças brasileiras e entre os dois grupos; verificar se o teste utilizado (PEDI) pode ser utilizado como um método auxiliar no diagnóstico do AI e SA. Métodos: Estudo transversal, composto por 52 crianças na faixa etária de 3 a 8 anos, diagnosticadas com AI (n=26) e SA (n=26). Utilizado o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) – versão brasileira, através de entrevista estruturada com o cuidador e observação direta. Resultados: Crianças com AI e SA obtiveram escores significativamente menores do que o esperado para a normalidade. Crianças com SA apresentaram função social significativamente melhor do que crianças com AI. No entanto, no AI os escores foram significativamente melhores do que na SA em atividades relacionadas ao autocuidado e mobilidade, necessitando de menor nível de assistência. Conclusão: Crianças com AI e SA possuem déficits em toda a esfera do desenvolvimento comparado a crianças normais. Embora pacientes com SA sejam melhores na interação social que autistas típicos, estes apresentam déficits mais acentuados em tarefas básicas como autocuidado e mobilidade, recebendo maior auxílio nestas áreas do que crianças com AI. As particularidades observadas devem auxiliar na construção do diagnóstico, além de sugerirem foco diferenciado no processo de reabilitação. / Introduction: Childhood autism and Asperger’s syndrome belong to a family of neurodevelopmental disorders called Pervasive Development Disorders. This group is characterized by qualitative abnormalities in reciprocal social interactions and modes of communication as well as a restricted repertoire of stereotyped, repetitive interests and activities. While it is recognized that such patients exhibit impairment in at least three of the aforementioned areas, studies assessing overall functional performance have not been carried out for the identification and comprehension of the peculiarities of each condition. Objectives: The aims of the present study were to 1) quantify the overall functional performance and need for caregiver assistance in childhood autism (CA) and Asperger’s syndrome (AS), 2) compare the findings between groups and to normative data from Brazilian children and 3) determine whether the PEDI test can be used as an auxiliary method for the diagnosis of CA and AS. Methods: A cross-sectional study was carried out involving 52 children between three and eight years of age diagnosed with either CA (n=26) or SA (n=26). The Brazilian version of the Pediatric Evaluation of Disability Inventory (PEDI) was administered in the form of a structured interview with the caregiver and direct observation. Results: The children with CA and AS achieved significantly lower scores than that expected for normality. The children with AS had a significantly better social function than those with CA. However, those with CA achieved significantly better scores than those with AS on activities related to self-care and mobility, requiring less assistance. Conclusion: Children with CA and AS exhibit deficits in all aspects of development in comparison to normal children. While patients with AS are better at social interaction than typical autistic children, they exhibit greater deficits with regard to basic tasks, such as self-care and mobility, requiring greater assistance than children with CA. The particularities observed may assist in the determination of the diagnosis and suggest a differentiated approach in the rehabilitation process. / TEDE / BV UNIFESP: Teses e dissertações