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The purpose of this study was to learn what interventions have been effective in alleviating sleep problems among children with autism spectrum disorders (ASD) according to parent report. This study also investigated resources from which parents received information regarding possible interventions and to what degree these resources were helpful. The participants in this study were 48 parents and caregivers of children with ASD from both the United States and Canada. Background information was attained from participants regarding themselves and their child with ASD. Participants then answered likert-type and open-ended questions regarding their child's sleep problem(s) and the resources they have turned to for help. Eighty five different interventions were reported to treat 25 types of sleep problems. Participants also reported an overall reduction in the severity of sleep problems experienced by their child after intervention.

Joint attention behaviours play a central role in natural and believable human-robot interactions. This research presents the design decisions of a semi-autonomous joint attention robotic system, together with the evaluation of its effectiveness and perceived social presence across different cognitive ability groups. For this purpose, two different studies were carried out: first with adults, and then with children between 10 and 12 years-old. The overall results for both studies reflect a system that is perceived as socially present and engaging which can successfully establish joint attention with the participants. When comparing the performance results between the two groups, children achieved higher joint attention scores and reported a higher level of enjoyment and helpfulness in the interaction. Furthermore, a detailed literature review on robot-assisted therapies for children with autism spectrum disorders is presented, focusing on the development of joint attention skills. The children’s positive interaction results from the studies, together with state-of-the-art research therapies and the input from an autism therapist, guided the author to elaborate some design guidelines for a robotic system to assist in joint attention focused autism therapies. / Gemensam uppmärksamhet (joint attention) spelar en central roll i naturliga och trovärdiga interaktioner mellan människor och robotar. Denna rapport presenterar designbesluten av ett semi-autonomt joint attentionsystem för sociala robotar, samt en utvärdering av dess effektivitet och hur grupper med olika kognitiv förmåga upplever dess sociala närvaro. För detta ändamål genomfördes två olika studier: förstmed vuxna, och sedan med barn mellan 10 och 12 år gamla. De övergripande resultaten för båda studierna visar att vi byggt ett system som uppfattas som socialt närvarande och engagerande, och som framgångsrikt kan skapa gemensam uppmärksamhet med deltagarna. När man jämför resultaten mellan de två grupperna, finner man att barn gav högre gemensam uppmärksamhetsresultat de rapporterade att de fick mer hjälp av och tyckte bättre om roboten som använda det utvecklade systemet för joint attention. Vidare presenteras en detaljerad litteraturstudie om robotassisterade terapier för barn med autismspektrumsjukdomar, med fokus på utveckling av gemensamma uppmärksamhetsförmågor. Barnens positiva interaktioner med en robot som hade det utvecklade joint attentionsystemet, tillsammans med litteraturstudier om forskningsterapier och en intervju med en autismterapeut, vägledde författaren attutarbeta riktlinjer för hur man ska designa sociala robotar som har till syfte att användas vid terapi som syftar till att förbättra autistiska barns förmåga att kommunicera icke-verbalt och förstå vad den de talar med fokuserar på.

This study is about education of students with profound intellectual disabilities, in Sweden the training school (Sw. Träningsskola), where one or more of the students also have autism spectrum disorders. The training school is characterized by individualized forms of teaching. The study is looking into what triggers is affecting the supportive networks decisions, during sessions. In the study all staff in the team, teachers as well as assistants is titled supporters. The national framework for research is showing that teachers in special schools are facing new challenges for improvements. Knowledge-orientation and caretaking are of equal importance for improved learning. Research shows that variation might be useful for enlightenment for students with ASD. All teaching, especially in the training schools, the close encounter, as well as perspectives of relationship, is pointed out. International research emphasizes knowledge in methodology, personal treatment and evaluation of methods for improved communication, as well as the students influence in the pedagogical planning. Focus of this study is to investigate what triggers the actions of the supporter in the training session. The theoretical framework is drawn out of a socio-cultural perspective. The use of artefacts and the relational perspective is tested against respondent’s testimonies. Methodology in use is a mixed method with results from questionnaires and interviews locked together, to create both depth and breadth, in a step by step exploration of supporter’s actions. Analysis of results shows that the supporters actions to some extent is guided by authorization and competence, but that “one to one” sessions outward boundaries, which both pose a danger and an opportunity for the students improvements of knowledge. The use of artefacts is comprehensive. Results show an example of a widening of the approach to tools / aids and even nature is described as significant for the teaching environment. The criticism for passivity that training school receives can be reduced by the compassion of the supporter since the supporter´s attention gives the student variations and possibilities for choice. The discussion in this study points out a possibility to see the importance of both using and setting out markers for the supporters efforts, which could improve mediation for the student when using a relationship between student and supporter. In further studies, observations in combination with focus groups can be made for greater depth, strength and validity, for the improvement of the practice in training school.

This purpose of this study was to investigate the effectiveness of an intervention package that combined Skillstreaming procedures for the development of social skills with the use of video modeling for middle school students identified with ASD. Specifically, the purpose of this study was to determine if the video modeling intervention package has an impact on social skill performance of three middle school-aged students with ASD. A multiple probe design across participants was employed to assess the effects of the video modeling intervention package on two beginning social skills (i.e., initiate greetings and initiate a conversation). The participants were three middle school-aged students with ASD enrolled in a self-contained classroom. The dependent variable was the percentage of correct social skills components performed when greeting the teacher and initiating a conversation within in the first 10 minutes of class each morning. The independent variable was an intervention package that included video modeling and direct instruction for each social skill component with Skillstreaming procedures (i.e., modeling, role playing, feedback). The results of this research indicated that all three students improved their social skills performance following the implementation of the video modeling intervention package. Furthermore, during the maintenance phase, the social skills performance of each student was maintained. Recommendations for further study and for teachers of students with ASD are presented.

Given the behavioral expectations of students by teachers and peers in middle school inclusive classrooms and characteristics inherent to students with ASD, the purpose of this study was to explore the impact of video modeling and peer mentoring of five critical social skills for inclusion on middle school students with ASD. Specifically, the extent to which the combination of video modeling and peer mentoring of five critical social skills would increase the level of demonstration of these skills in the general education inclusion setting was investigated. Because individuals with ASD exhibit limited social communication skills, those skills necessary especially at the middle school level to understand the "hidden curriculum", social skills instruction has been deemed important (APA, 2004; Smith-Myles & Simpson). The current multiple baseline across subjects study was grounded in the research on video modeling (Bellini & Akullian, 2007) and peer mentoring (Fuchs & Fuchs, 2005; Maheady, Harper, & Mallette, 2001) as methods of providing social skills instruction for middle school students with ASD (Goldstein & McGinnis, 1997; Smith-Myles & Simpson, 2001). The impact of the video models and peer mentors was measured using the level of demonstration of five critical social skills on three middle school aged students with ASD. All three students with ASD were included in at least one general education classroom. The results of this investigation indicated that the combination of video modeling and peer mentoring of critical social skills positively impacted the levels of demonstration of the skills of students with ASD. While results varied, all three students with ASD increased their levels of demonstration of the targeted critical social skills.

Autism spectrum disorder is a diagnosis that involves difficulties with sensory sensitivity, communication, and social interaction. This condition means that the physical and psychosocial care environment can be experienced as difficult to manage. This literature review aims to explore adult patients with autism spectrum disorders' experiences of being in a care environment. A literature review was conducted where eight articles of qualitative, quantitative, and mixed methods were analyzed. Systematic searches were made in the databases Cinahl, PubMed, and PsycInfo. The results from the analysis were then written down into two main themes and seven sub-themes. The patients testified about experiences in the care environment where needs for adaptations in the physical-, sensory- and psychosocial environment had not been catered for. The patients requested individual adaptations, private spaces, and alternative communication methods. Stress was mainly caused by noise, lack of communication and short care meetings. Several of the deficiencies that emerged could lead to anxiety in the patients. Understanding the specific needs of adults with autism spectrum disorders in the care setting is critical. The care environment needs to become more accommodating when it comes to adaptations and design. Even adaptations to reduce the sensory stimulation can be part of alleviating the often stressful care environment but also to increase the well-being of the patient.

Group social skills training (GSST) is an important intervention approach to help children and adolescents with autism spectrum disorder (ASD) to find more success in social engagement and inclusion. However, there is a lack of research using direct behavioral observations, especially in generalization of acquired skills to settings other than the treatment setting. We provided social skills training to 25 adolescents with ASD using a curriculum shown to have positive effects (the UCLA PEERS® curriculum). We also administered the Autism Social Skills Profile (ASSP) and Social Communication Questionnaire – Current (SCQ-Current) to the parents of participants before and after the GSST to ensure it had the intended effect, which showed minor improvements in some areas of social engagement, though not statistically significant. We then provided seven participants and their peers in their community groups with a brief intervention that taught principles of including those with disabilities. We analyzed each of these seven participants’ level of social engagement in their community groups before and after the intervention using a multiple baseline design. Peer inclusion instruction produced mixed results across participants. We discuss the feasibility and future directions for the generalization of acquired social skills.

<p><strong>Background and objectives:</strong> Recently, more attention has been placed on contributing factors for different prevalence rates of ASDs/PDDs in geographical areas. This study examines the association between diagnosis of ASDs and distance to regional intervention centres using a population-based dataset of children attending Senior Kindergarten classes in Ontario. Demographic and socioeconomic variables were also examined to find significant predictors for diagnosis of ASDs.</p> <p><strong>Methods:</strong> Data from all sites of Ontario with completed Early Development Instrument (EDI) in school years 2009/10 and 2010/11 were included. Individual-level variables were derived based on the data provided by EDI. Neighbourhood-level variables on socioeconomic factors of children’s place of residence were obtained through census data.</p> <p><strong>Results:</strong> 708 out of 66,284 children were reported by teachers to have diagnosis of ASDs, which results in a prevalence rate of 1.0% for ASDs. Children living near regional centres were less likely to be in the diagnosed group (OR=0.77). Moreover, children living in neighborhoods with high proportion of adults with high school diplomas and high proportion of single-parent families were more at risk of being reported as diagnosed (OR=1.27 & 0.73; respectively). MCYS region that a child lives in was found to be another significant predictor for teacher-reported diagnosis of ASDs.</p> <p><strong>Conclusion:</strong> Regional centres were not the only centres providing interventions to children with ASDs in Ontario. Therefore, having in-detailed information about the exact place of receiving intervention for each child would be beneficial. Furthermore, having single-parent family structure as a significant predictor necessitates specific policies for these families to obtain appropriate services, reduce caregiver’s stress, and improve family functioning.</p> / Thesis / Master of Science (MS)

Background. Autism spectrum disorder (ASD) is characterized by persistent difficulties with social communication (American Psychiatric Association, 2013). Due to the high prevalence of ASD there’s a significant demand for services to support these individuals and the involvement of caregivers is considered a crucial element of effective early intervention for young children with developmental disabilities (Siller & Morgan, 2018). The Incredible Years ® is an evidence-based behavioral parent training program with a large body of research demonstrating its efficacy with enhancing positive parenting practices during parent-child interactions for children with behavior problems (Menting et al., 2013). The program is built on the foundational concept of child-led free play. Recently, the program has been adapted for families with young children with developmental disabilities, Incredible Years Program for Autism Spectrum Disorder and Language Delays Ages 2-5® (IY-ASLD). IY-ASLD aims to help parents learn developmentally-attuned language and play strategies to effectively engage with toddlers with ASD or social communication delays. There are few published evaluations of IY-ASLD currently. However, the findings from pilot studies are promising in terms of the feasibility of implementation, with high levels parent satisfaction and attendance. The present study uses data from a pilot study of the IY-ASLD program (N=17), which was adapted to telehealth during COVID-19 pandemic with the assistance of program developer. This dissertation contributes to an emerging body of research by evaluating the IY-ASLD program in a community setting. By examining IY’s group treatment model in a telehealth format, we also gain valuable insight about virtual parenting interventions, which have the potential to significantly expand treatment to more families. Methods. Families were recruited from a specialized early intervention and preschool program that utilizes an Applied Behavior Analysis approach to education. Seventeen (N=17) parent-child dyads from the school enrolled in the program. All or virtually all children referred to this school by their school district are at-risk for or have been diagnosed with ASD. All of the children had an IEP or IFSP with mandated speech services, 71% of the children met criteria for ASD (N = 12) on the Childhood Autism Rating Scale-2-SF, and 2/3 of the sample had adaptive behavior composites below a standard score of 70 on the Vineland Adaptive Behavior Scales- Third Edition Comprehensive Teacher Form (Sparrow et al., 2016) at baseline. The parent participants, all mothers, began and completed a 12-week IY-ASLD telehealth intervention delivered over HIPAA protected Zoom. Mothers were from diverse backgrounds (41% non US born), well-educated (94% college graduate) and had a high median household income. Data from participants was gathered through questionnaires administered to parents, child-functioning measures completed prior to treatment by school personnel, and parent-child interactions videos recorded in the home at pre-, mid-, and post-treatment across a 12-week IY-ASLD intervention. Primary outcome variables were parent verbal behaviors during 5-minute parent-child free play sessions recorded at each time point. Each vocal utterance during free play sessions was coded for function, consistent with the parenting skills that were targeted in the IY-ASLD program (e.g., reducing commands, questions, and corrections, increasing descriptive narration and praise, following the child’s lead). The independent variables were time and dosage (minutes spent in treatment) and the moderators were child’s functioning levels (special education teacher/clinician ratings on the Vineland Adaptive Behavioral Scales- Third Edition (Vineland-3, Sparrow et al., 2016) and Childhood Autism Rating Scale, Second Edition- Standard Form (CARS2= ST, Schloper et al., 2010). Results. Mothers in the IY-ASLD program significantly decreased the ratio of parent-directed language and increased the ratio of child-directed language they used during the free play sessions with large effect sizes and most of the change occurring in the mid-to-post interval. Descriptive statements (tacts) also increased significantly for all participants with large effect sizes; the number of directive or question statements (mands) decreased with medium effect sizes, though the results were not significant. Dosage was not a significant predictor of outcomes at post-treatment when pre-treatment parenting behaviors were taken into consideration, possibly due to low variability in attendance. When child level was analyzed as a moderator, there were large effect sizes for the observed changes in tacts, mands, and overall ratio of child-directed language when children were divided into ASD vs No ASD groups, but small effect sizes when looking at low vs high adaptative behavior groups. There was a significant interaction effect between change in parent language over time and ASD severity of the child; parents of children with ASD did not significantly reduce the number of mands over time, while parents of children without ASD significantly reduced their number of mands over time. This research provides support for a full-RCT of IY-ASLD in this setting, suggesting that the intervention promotes maternal use of child-directed language, particularly for children with language delays as opposed to those with more severe symptoms of ASD. Interventions such as IY-ASLD may help empower parents of preschoolers with disabilities with strategies to facilitate more rewarding free play interactions at home.