The thesis presents a series of papers exploring catatonic symptoms and circadian rest-activity levels in autistic spectrum disorders (ASD). The thesis is presented in paper-based format and encompasses a literature review, an empirical paper and a critical appraisal. Paper 1 is a systematic review of available treatments for autistic catatonia. Catatonic symptoms are thought to occur in around 8% of young people with ASD, and it has been suggested that biological timing abnormalities may play a key role in the development of these difficulties. Twenty two papers were included in the final review, detailing treatment of a total of 28 cases of autistic catatonia. Both adult and paediatric cases were included. The range of treatments described encompassed electroconvulsive therapy, various psychotropic medications, behavioural and sensory therapies. The review highlights limitations in the available literature and suggests avenues for future research. Paper 2 explores circadian patterns in activity using actigraphy. A case series of 8 young people with an ASD diagnosis were recruited from specialist schools and asked to wear an actigraph for one week. Parents completed questionnaire measures of ASD traits and symptoms of autistic catatonia. Findings indicated a high degree of variability in circadian rest-activity cycles, both between participants and across the week. The study findings have implications for future research into circadian rest-activity levels in this population, as well as possible therapeutic applications. The final paper in the thesis presents a critical appraisal of the research, including discussion of strengths and limitations of the work, theoretical and clinical implications and directions for future research. Some personal reflections on the process of conducting the research are also included.

Autism is a behaviourally defined disorder. The impairments in social communication and repetitive behaviours are individually non-specific. The disorder has indistinct boundaries both with other psychiatric disorders and with normal personality types. At the cognitive level, groups of people with autistic disorder can be differentiated from people without the disorder by their ability to reason about beliefs and knowledge (Theory of Mind) and by tests of visual disembedding (central coherence). This study examined whether young people with some of the behavioural features of autism but not necessarily a diagnosis, would show this distinctive cognitive profile. In a sample of 60 young people with additional learning support needs, we found that those with high levels of autistic traits (n=40) showed the same cognitive profile as has been found in people diagnosed with autistic disorder. This supports the view that autism is an extreme on a continuum of cognitive traits. Given the highly heritable nature of autism, we hypothesised that the parents of the young people with autistic traits will also display these cognitive features. The results indicated that there was no difference between the groups of parents on an advanced test of social cognition. Parents of people with high autistic traits were more resistant to one of the visual illusions and saw fewer reversals of an ambiguous figure when IQ was statistically controlled. These results in a sample with a low genetic load suggest ambiguous figures will be important in delineating the broader cognitive phenotype of autism.

Peut-on dissocier perception et mémoire auditives ? Intuitivement, il paraît impossible de mémoriser quelque chose que l’on n’a pas perçu. Pourtant, il existe des phénomènes auditifs pour lesquels la mémoire influence la perception. L’objectif de ce travail de thèse est de déterminer si la perception auditive et la mémoire auditive sont deux fonctions dissociables, sous-tendues par deux mécanismes différents. Deux études utilisant des stimuli auditifs différents (des bruits périodiques, et du rehaussement) ont été réalisées. Une population d’enfants et d’adultes autistes de haut niveau a été inclue aux participants. En effet, ces derniers présentent des particularités dans le traitement auditif. Ces particularités peuvent être interprétées à la lumière de capacités perceptives et/ou mnésiques, sans que rien ne permette de déterminer si l’une, l’autre ou les deux fonctions cognitives que sont la perception et la mémoire, sont impliquées. Les résultats conjugués de ces deux études indiquent que les participants porteurs d’autisme présentent un déficit développemental dans le traitement de la complexité temporelle quand leur mémoire auditive est préservée. Deux mécanismes différents semblent régir les deux grandes fonctions cognitives que sont la perception auditive et la mémoire auditive, qui seraient donc dissociées. / Can we separate auditory perception and auditory memory ? Intuitively, it seems impossible to remember something that was not perceived. However, there are auditory phenomena for which memory influences perception. The objective of this work is to determine whether the auditory perception and auditory memory are two separable functions, underpinned by two different mechanisms. Two studies using different auditory stimuli (periodic noise, and enhancement) were performed. A population of children and adults with high functioning autism was included. Indeed, they have features in auditory processing. These features can be interpreted in the light of perceptual and / or memory capacity without anything possible to determine whether one or the other or both cognitive functions such as perception and memory, are involved. The combined results of these two studies indicate that the participants with autism have a developmental deficit in processing temporal complexity when their auditory memory is preserved. Two different mechanisms seem to govern the two major cognitive functions such as auditory perception and auditory memory, which would therefore be separated.

Syftet med denna studie är att utifrån några pedagogers beskrivningar bidra med kunskap om undervisning i läsförståelse för elever med intellektuell funktionsnedsättning och autismspektrumtillstånd i grundsärskolans årskurser 7-9 och på gymnasiesärskolans nationella program. Studien bygger på kvalitativa, semistrukturerade intervjuer med sex pedagoger verksamma inom grundsärskolan och gymnasiesärskolan och som undervisar i ämnet svenska. Resultaten analyseras utifrån begrepp hämtade från sociokulturell teori, nämligen fysiska och intellektuella redskap, den proximala utvecklingszonen samt scaffolding/ kommunikativa stöttor. Resultatet visar att pedagogerna ser läsförståelseförmågan som en grund för elevernas möjligheter till självständighet och delaktighet i samhället. Undervisning i läsförståelse ses som avgörande för elevernas läsförståelseutveckling. Skolans ansvar att tillgodose undervisning utifrån elevernas individuella behov och förutsättningar betonas. Organiseringen av undervisning utifrån elevernas individuella behov innebär att olika undervisningsmetoder, hjälpmedel och elevgrupperingsmetoder används. Lärarens aktiva roll, engagemang och förtrogenhet med olika metoder ses som grundläggande för framgångsrik undervisning. En gemensam uppfattning är att fortlöpande, intensiv och repetitiv undervisning ger bäst resultat. Pedagogerna i grundsärskolan och på gymnasiesärskolans individuella program uttrycker att tillgängliga tids- och personalresurser möjliggör en sådan undervisning, medan pedagogerna på gymnasiesärskolans nationella program menar att den schemalagda undervisningen i svenska är otillräcklig för att tillgodose fortlöpande undervisning. Baserat på det beskrivna behovet av fortlöpande, intensiv och repetitiv undervisning i läsförståelse, diskuteras i resultatdiskussionen om tidsresurserna är tillräckliga i aktuella elevgrupper på gymnasiesärskolans nationella program för en hållbar läsutveckling. Om man vidhåller att god läsförståelse är en grundläggande förutsättning för fullt deltagande i det moderna svenska samhället och att syftet med utbildning är att förbereda eleverna för ett ansvarsfullt liv i samhället, så är min mening att undervisning i läsförståelse i hög grad bör prioriteras inom såväl grundsärskolan som gymnasiesärskolan. / The purpose of this study – based on the accounts of qualified teachers – is to add to our understanding of teaching reading comprehension to pupils with intellectual disabilities and autistic spectrum disorders in Compulsory Schools for children with learning impairments grades 7-9 and those undergoing the Upper Secondary School national curriculum for pupils with learning disabilities. The study builds on qualitative, semi-structured interviews with six educators, all active within either Compulsory Schools for children with learning impairments or Upper Secondary Schools for pupils with learning disabilities, and all of  them Swedish language teachers. The results are analyzed on the basis of terms used in socio-cultural theory, namely physical and intellectual tools, the proximal development zone and ‘scaffolding’ (communicative supports). Results show that teachers see the ability of children to read and understand as fundamental to their prospects of becoming free individuals able to participate in society. Teaching pupils reading comprehension is viewed as pivotal to their ability to progressively understand what they read. Emphasis is laid on the responsibility of schools to provide education based on assessing the needs of each individual child. The organization of teaching structured around pupils’ individual needs means that a range of methods, aids and pupil groups is used.  The active role and personal involvement of the teacher along with his/her familiarity with a broad range of methods is seen as fundamental to successful teaching. The prevailing view is that on-going, thorough and repetitive teaching produces the best results. Teachers in Compulsory Schools for children with learning impairments along with those in Upper Secondary Schools running individual programs for pupils with learning disabilities assert that available resources in the form of time and staff make this kind of teaching achievable, while teachers in Upper Secondary Schools running national programs maintain that timetabled lessons in Swedish are insufficient to provide progressive teaching. Based on the need for on-going and repetitive teaching in reading comprehension as described above, I discuss if the time allotted to present pupil groups in Upper Secondary Schools’ national programmes is adequate for tenable reading comprehension teaching. If we maintain that good reading comprehension is a fundamental requisite for full participation in modern Swedish society and that the goal of this education is to prepare pupils for a responsible life in society, it is my opinion that teaching in reading comprehension should be given high priority in both Compulsory Schools for children with learning impairments and Upper Secondary Schools for pupils with learning disabilities.

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

O autismo é um transtorno do desenvolvimento com características que prejudicam o funcionamento diário da pessoa que recebe esse diagnóstico. As alterações sociais e de linguagem representam um dos seus distúrbios mais importantes. Considerando os estudos sobre Transtorno do Espectro Autista e a correlação entre linguagem oral e o domínio da leitura e escrita, a interação entre fonoaudiólogo e psicopedagogo é de suma importância, pontuando um elemento indispensável para obtenção de melhores resultados. A maneira de ensinar alunos com Transtorno do Espectro Autista é particularmente específica sendo importante o trabalho interdisciplinar entre escola e terapia. Tendo em vista o exposto, o objetivo desta pesquisa foi descrever o processo de adaptação escolar de gêmeos autistas do ensino infantil ao fundamental, em equipe interdisciplinar. Trata-se de um estudo de caso retrospectivo instrumental e fizeram parte da pesquisa duas crianças gemelares monozigóticas do sexo masculino que, na ocasião do início da coleta de dados, tinham 5 anos e cursavam salas de educação infantil de uma escola privada de ensino regular. Parte da pesquisa foi desenvolvida na escola privada de ensino regular, sendo três fontes de obtenção de dados 1) dados psicopedagógicos; 2) dados fonoaudiológicos; 3) dados da escola. A coleta e análise de dados foram realizadas a partir das avaliações psicopedagógicas, avaliações fonoaudiológicas e dos relatos dos professores com o propósito de intervir quanto à necessidade de adaptações de estratégias pedagógicas realizadas pela pesquisadora durante todo o período. Os resultados foram separados ano a ano e mostram que o trabalho interdisciplinar entre escola, fonoaudióloga e psicopedagoga atuando em conjunto e compartilhando conhecimentos teóricos e práticos resultou no melhor aproveitamento e desenvolvimento dos participantes. Dessa maneira, o trabalho interdisciplinar e a inclusão escolar não são tarefas fáceis, mas são absolutamente possíveis e importantes para que a criança com Transtorno do Espectro Autista esteja inserida no âmbito escolar e social, melhorando em todos os aspectos do desenvolvimento. / Autism is a disorder with features that interfere in autistic people\'s lives. Social and verbal communication changes are the most important disorders. Considering previous researches about autism and the correlation between verbal communication and reading and writing skills, the importance of the interaction between a phonoaudiologist and an educational psychologist is showed. Teaching autistic students demands a specific approach that considers school and therapy interaction as essential. The objective of this study was to describe the adaptation process of twin boys from kindergarten to elementary school through an interdisciplinary team work. It is an instrumental retrospective case study about monozygotic male twins. They were three years old and they were studying at a private regular education school in the beginning of this study. Part of the research was developed at the private regular education school using three data sources: 1) educational psychological data; 2) phonoaudiological data; 3) data from school. All the data was obtained and analyzed from educational psychological and phonoaudiological evaluations and teachers opinions aiming to adapt teaching strategies used by the researcher during the whole period. The results were separated year by year and showed that interdisciplinary work was better to the participants in terms of development. In conclusion, interdisciplinary work and school inclusion are not easy tasks but they are achievable and important, so that autistic children can be part of society and for their global development.

Studiens syfte var att få en ökad förståelse av pedagogers arbete med barn med svårigheter inom autismspektrat. I studien redogörs och analyseras pedagogernas erfarenheter utifrån olika aspekter med koppling till betydelsen av kunskap och kompetens gällande uppdraget att kunna möta dessa barn. Data samlades in från öppna intervjuer som sedan tolkades och analyserades. De sammanfattande resultaten visade bland annat att kunskap och erfarenheter gav betydande effekter i arbetet med dessa barn. Stimulerande arbetsmetoder och rutiner gav också positiva effekter där lyhördhet, trygghet och stabilitet främjades. Vi hoppas att studien ska kunna gynna framtida pedagoger.

Darbe atlikta teorinė vaikų, pasižyminčių autizmo spektro sutrikimais, pažinimo ir ugdymo, aplinkos vaidmens jų ugdyme, pagalbos tėvams, specialistų pasirengimo dirbti bei specialistų ir šeimų bendradarbiavimo analizė, kuri leido susisteminti duomenis ir išskirti pagrindinius aspektus, lemiančius šių vaikų ikimokyklinį ugdymą. Magistro darbo tyrimo objektas – ikimokyklinio amžiaus vaikų, pasižyminčių autizmu, pažinimas, remiantis specialistų ir tėvų vertinimais; tyrimo tikslas – atskleisti ikimokyklinio amžiaus vaikų, turinčių autizmo sutrikimą, pažinimo galimybes, remiantis specialistų ir tėvų vertinimais bei specialistų profesiniu pasirengimu. Tyrimas atliktas kokybinio tyrimo metodu, taikant trianguliacijos principą – duomenys apie tyrimo objektą buvo renkami iš įvairių informacijos šaltinių. Anketinės apklausos tikslas – remiantis tėvų ir specialistų vertinimais išsiaiškinti vaikų, pasižyminčių autizmu, funkcionavimo ypatumus. Interviu metu, apklausiant specialistus-ekspertus, siekta išsiaiškinti esminius aspektus, susijusius su šių vaikų ugdymo ikimokykliniame amžiuje. Autizmu pasižyminčių vaikų elgesio vertinimas atliktas, taikant Funkcinio elgesio vertinimo skalę. Siekiant išsiaiškinti specialistų pasirengimą dirbti su ikimokyklinio amžiaus autizmu pasižyminčiais vaikais, atlikta antrinių duomenų analizė. Taikyti teoriniai (mokslinės literatūros, tyrimų, dokumentų analizė) ir empiriniai (klausimynai, lyginamoji duomenų analizė, antrinių duomenų analizė) metodai. Tyrime... [toliau žr. visą tekstą] / The paper performs a theoretical analysis of cognition and education of children with autistic spectrum disorders, role of environment in their education, assistance for parents, preparation of specialists for the work and collaboration between specialists and families, which allowed systematizing the data and highlighting the main aspects that determine education of such pre-school children. The subject of the Master Thesis - cognition of autistic pre-school children based on assessment of specialists and parents; the aim of the research - to reveal the possibilities of cognition of the autistic pre-school children based on assessment of specialists and parents and vocational preparation of the specialists. The research was performed by the method of qualitative research by applying the principle of triangulation - the data about the research subject were collected from various information sources. The aim of a questionnaire survey - to ascertain functional peculiarities of autistic children based on the assessments of parents and specialists. During the interview, when interviewing specialists-experts, we sought to clarify the essential aspects related to the education of such children in the preschool age. The assessment of autistic children behaviour was performed by applying a scale of functional behaviour. An analysis of secondary data was performed in pursuance of the ascertainment of the specialists' preparation for the work with autistic pre-school children. We... [to full text]

Orientador: Kester Carrara / Banca: Sadao Omote / Banca: Ana Cláudia Moreira Almeida Verdu / Resumo: A literatura ilustra que alguns aspectos da linguagem são essenciais no desenvolvimento e aprendizagem de indivíduos com Transtornos do Espectro Austístico (TEA). Entre tais aspectos destaca-se o uso funcional da linguagem, como principal dificuldade de comunicação nessa população, sendo fundamental sua consideração em contexto acadêmico. Nessa perspectiva, esta pesquisa investigou o perfil comunicativo, com ênfase nos aspectos funcionais da linguagem, de alunos com TEA durante a interação com suas professoras, em salas comuns de instituições públicas. Participaram 14 alunos com TEA, de ambos os sexos, com idades entre três e oito anos, que frequentavam do maternal à 2ª série e suas respectivas professoras. Como parte do procedimento foram realizadas duas filmagens, cada qual com 30 minutos, em situações de sala de aula, que tinham entre seus objetivos promover o desenvolvimento da linguagem oral dos alunos. Para análise das filmagens, foi utilizado o protocolo de pragmática, que verificou a ocorrência de iniciativas de comunicação e o espaço comunicativo ocupado pelos alunos e professoras, as funções e meios comunicativos utilizados pelos alunos. Os resultados evidenciaram que de modo geral as professoras iniciaram mais a comunicação, ocupando maior espaço comunicativo durante a interação do que os alunos. Quanto aos meios comunicativos, todos os alunos utilizaram preferencialmente gestos e apresentaram individualidades referentes à utilização dos meios vocais e verbais. No que se refere às funções comunicativas houve ocorrência significativamente superior das funções menos interativas em relação às funções mais interativas, ou seja, em sua maioria... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The literature illustrates that some language aspects are essential to the development and learning of individuals with Autistic Spectrum Disorders (ASD). Among such aspects they point out the functional usage of language as the mainly difficult of communication in this population, being fundamental its consideration in academic context. From this outlook, this research delved into the communicative profile, with emphasis in the functional aspects of language of students with ASD during the interaction with their teachers, in regular classrooms of public institutions. Fourteen students with ASD, male and female, with ages between theree and eight, which attended from kindengarten to second grade, and their teachers took part in the experiment. As part of the procedure, two films were made, each one with 30 minutes, in classroom situations, which had as goal to promote the development of the students'oral language. To analyze the films, it was used the protocol of pragmatic, which verified the occurence of initiatives of communication and the communicative space taken by the students and teachers, the communicative means and functions used by students. The results showed in general terms the teachers often started the communication, taken more communicative space than their students with ASD during the interaction. Concerning to the communicative means, all the students preferable used gestures and presented individualities in using vocal and verbal means. Concerning the communicative space than... (Complete abstract click electronic access below) / Mestre