We live in a world where we increasingly depend on information technology, as much of our work and education occurs online, often from home. An average user has an increasing amount of accounts for all kinds of online services, making authentication more and more important. As people authenticate several times a day, it is important that everyone is able to use online services and authenticate themselves, including minorities such as individuals with neurodevelopmental disorders. This thesis explores the challenges people with neurodevelopmental disorders have with authentication as well as authentication methods that can help them. This was achieved by doing a systematic literature review on collected bibliography with the help of thematic analysis. 18 studies were analyzed and helped us answer the research questions and give us an overview of the research field. The analysis showed that text-based authentication was a big issue for individuals with neurodevelopmental disorders, where passwords were often highlighted as the culprit. Alternative authentication methods were identified but showed us that there was no easy fix to the issue at hand, and that more had to be done to make authentication more accessible. / Vi lever i en värld där vi är alltmer beroende av informationsteknologi, eftersom mycket av vårt arbete och utbildning nu istället sker online, ofta även hemifrån. En genomsnittlig användare har ett ökande antal konton för alla sorters onlinetjänster, vilket gör autentisering allt viktigare. Då människor autentiserar flera gånger om dagen är det viktigt att alla kan använda onlinetjänster och auntentisera sig, inklusive minoriteter som individer med neuropsykiatriska funktionsnedsättningar. Detta examensarbete utforskar de utmaningar som personer medneuropsykiatriska funktionsnedsättningar har med autentisering samt autentiseringsmetoder som kan hjälpa dem. Detta uppnåddes genom att göra en systematisk litteraturöversikt med insamlad bibliografi med hjälp av tematisk analys. 18 studier analyserades och hjälpte oss att svara på forskningsfrågorna samt ge oss en överblick över forskningsfältet. Analysen visade att textbaserad autentisering var ett stort problem för individer med neuropsykiatriska funktionsnedsättningar, där lösenord ofta lyfts fram som boven. Alternativa autentiseringsmetoder som identifierades visade oss att det inte fanns någon enkel lösning på problemet och att mer behöver göras för att göra autentisering tillgänglig för alla.

Bakgrund: Antalet barn som diagnostiseras med neuropsykiatrisk funktionsnedsättning ökar i Sverige. Föräldrar till barn med neuropsykiatrisk funktionsnedsättning har i tidigare studier beskrivit negativa upplevelser associerat till sjukhusinläggningar för sitt barns somatiska besvär. Sjuksköterskor har även uttryckt osäkerhet kring hur de ska bemöta barnen på ett optimalt sätt. Syfte: Att belysa barnsjuksköterskors erfarenheter av att vårda barn med neuropsykiatriska funktionsnedsättningar på barnavdelningar.  Metod: Studien genomfördes som en kvalitativ intervjustudie med induktiv ansats. Nio sjuksköterskor och specialistsjuksköterskor intervjuades. Dataanalysen genomfördes med manifest innehållsanalys enligt Graneheim och Lundman (2004).   Resultat: Intervjuerna genererade kategorin Gynnsamma strategier som underlättar för barnet i vårdmötet med underkategorierna Att skapa en relation till barnet, Att samverka med föräldrarna, Att ge tid till förberedelse och planering samt Att vara flexibel i vårdmötet. Nästa kategori som framkom var Utmaningar i omvårdnaden som påverkar barnet negativt med tillhörande underkategorier Att uppleva osäkerhet och kunskapsbrist, Att uppleva stressade och tidspressade situationer, Att behöva genomföra procedurer mot barnets vilja i större utsträckning samt Att samarbetet mellan läkare och barnsjuksköterskor brister. Slutsatser: Det är av vikt att sjuksköterskan individanpassar vården utifrån barnets behov och förutsättningar. Genom att utgå från Swansons omvårdnadsteori kan sjuksköterskor finna förståelse kring hur god omvårdnad kan uppfyllas. / Background: The number of children diagnosed with a neuropsychiatric disability is increasing in Sweden. In previous studies, parents of children with neuropsychiatric disabilities have described negative experiences associated with hospitalization for their child's somatic illness. Nurses also describe flaws in meeting the children as well as uncertainty in how the nurses can optimize the encounter. Aim:  Was to highlight pediatric nurses experiences of caring for children with neuropsychiatric disabilities in children's wards. Method: The study was conducted as a qualitative interview study with an inductive approach. Nine nurses and specialist nurses were interviewed. Data analysis was carried out with manifest content analysis according to Graneheim and Lundman (2004). Results: Interviews generated the category of Favorable strategies that makes the care meeting easier for the child with the subcategories of Creating a relationship with the child, Collaborating with the parents, Giving time for preparation and planning and Being a flexible benefitted the care meeting. The next category that emerged was Challenges in nursing care that affectet the child negatively with the associated subcategories of Experiencing uncertainty and lack of knowledge, Experiencing stressful and time pressure situations, Having to carry out procedures against the child's will to a greater extent and Lack of cooperation between the doctor and nurse.  Conclusions: It is important that the nurse adjust the care based on the child's needs and conditions. By practicing Swanson's Theory of Caring, nurses can find an understanding of how good nursing care can be fulfilled.

The study proposes an ecosystemic approach as an intervention for attentional difficulties and heightened motor activity, traditionally known as AD/HD. A literature study of AD/HD is presented first as a psycho-educational frame of reference. The focus then shifts to the symtoms of AD/DH to move closer to the possible underlying causes of these symptoms. In doing so, the focus changes from AD/HD as a diagnosis to attentional difficulties and heightened motor activity as presenting symptoms. Attention and motor activity as constructs are investigated in terms of their neuro-anatomical, neuro-chemical and neuro-physiological aspects. Furthermore, neurodevelopment, physiological stress, neurodevelopmental delay, information processing systems, sensory-motor subsystems and integration as constructs are investigated to understand their role in attention and modulation of motor activity. The study of attention and motor activity and their associated neurological factors motivates an alternative, ecosystemic method of intervention. The proposed approach includes an investigation into internal and external biochemical ecosystems such as environmental pollutants, deficiencies of essential nutrients and genetic deficiencies of the immune system. Other aspects such as time, maturation and neurodevelopment are also considered as well as the gentle interplay between these aspects. The therapeutic intervention includes sound therapy, neurodevelopmental movement activities, EEG neurofeedback and nutrition. Experimental research with a sample population of 12 diagnosed grade 4 and 5 AD/HD learners over a 11 week period was conducted. Statistically significant improvements in aspects of attention were noted using 2 standardised instruments and verification through parent interviews in the first and second experimental groups. Statistically significant improvements were noted in aspects of motor activity (a decline in hyperactive behaviour) in the second experimental group with verification from teacher interviews. Additionally, children in the first experimental group improved significantly more than children in the control group with regards to mathematic skills. The second experimental group showed significant improvement with large effect sizes on reading, mathematic skills and spelling. In conclusion, the statistically significant results obtained with the proposed approach motivates implementation, with improvements in attention, motor activity control and academic performance as a prospect. / Psychology of Education / D. Ed.(Psychology of Education)

Thesis (MA)--Stellenbosch University, 2015 / ENGLISH ABSTRACT : It has been suggested that the complex needs of children with neurodevelopmental disorders are best addressed with a family-centred approach. As this approach has been increasingly incorporated into healthcare systems over recent years, most children with disabilities are now able to remain at home as opposed to living in institutions or group homes. Many parents have thus been forced to adopt the role of a primary caregiver for their child that has been diagnosed with a disability or chronic condition. This study aimed to investigate the experiences of caregivers for children with cerebral palsy in rural communities of the Western Cape, with a specific focus on the barriers and facilitators that they encounter. An exploratory qualitative design was employed and 15 individuals (aged 27-62), who were identified as caregivers for a child with cerebral palsy through purposive sampling were interviewed. Thematic analysis was used to analyse and generate themes from the semi-structured interviews that were conducted with participants. A number of barriers to caring emerged including the personal consequences of caregiving, difficulty adjusting to caregiving duties, environmental conditions, lack of access to healthcare services, lack of respite services, and negative perceptions towards disability. Various facilitators to caring were also identified, namely personal coping methods, personal transformation, social support, relationship with one’s child, community resources, child’s crèche, and financial assistance. The five levels of the Social Ecological Model were used to conceptualise the discussion of these findings and links were made to the existing literature on the caregiver experience in the developing context. In this process it was found that participants often encountered similar barriers and facilitators to caregivers for individuals with other types of conditions, such as HIV/AIDS, autism, mental illness, cancer, and neurological disorders. This could suggest that caregivers residing in developing countries share similar experiences, regardless of the condition of the care receiver. Although participants received support from a number of sources that aided them with their caregiving duties, it is evident that they still encountered gaps in the provision of a number of important services, including lack of information from healthcare professionals, lack of community programs to reduce stress and promote empowerment, and lack of disability-friendly facilities. It is vital that caregivers have access to these services to ensure their child’s well-being as well as their own. There is thus a need to explore how these services can be made more accessible to caregivers in rural communities. / AFRIKAANSE OPSOMMING : Daar word voorgestel dat die komplekse behoeftes van kinders met neuro-ontwikkelingsversteurings die beste aangespreek word deur ‘n familie-gefokusde benadering. Aangesien hierdie benadering meer geredelik geïnkorporeer is in die gesondheidsorg sisteem oor die afgelope paar jaar is meeste kinders met gestremdhede nou in staat om by die huis te kan bly in plaas daarvan om in inrigtings of groepshuise te woon. Baie ouers is dus geforseer om die rol as primêre versorger aan te neem vir hulle kind wat gediagnoseer is met ‘n gestremdheid of kroniese toestand. Hierdie studie se doel was om die ervarings van versorgers van kinders met serebrale gestremdheid in landelike gemeenskappe van die Wes-Kaap, te ondersoek, met ‘n spesifieke fokus op die hindernisse en fasiliteerders wat hulle ondervind. ‘n Ondersoekende kwalitatiewe ontwerp is gebruik en onderhoude is gevoer met 15 individue (ouderdomme 27-62) wat deur doelgerigte steekproefneming geïdentifiseer is as versorgers van ‘n kind met serebrale gestremdheid. Tematiese analise is gebruik om die semi-gestruktureerde onderhoude wat met die deelnemers gevoer is te analiseer en temas te genereer. ‘n Aantal van die hindernisse tot versorging het na vore gekom en sluit die persoonlike gevolge van versorging, probleme om aan te pas by die versorgingspligte, omgewingstoestande, tekort aan toegang tot gesondheidsorg dienste, tekort aan verligting dienste en negatiewe persepsies teenoor gestremdhede in. Verskeie fasiliteerders tot versorging is ook geïdentifiseer, naamlik persoonlike hanteringsmetodes, persoonlike transformasie, sosiale ondersteuning, verhouding met hulle kind, gemeenskapsfasiliteerders, kind se speelskool en finansiële hulp. Die vyf vlakke van die Sosiale Ekologiese Model is gebruik om die bespreking van hierdie bevindinge te konseptualiseer en verbintenisse is gemaak met bestaande literatuur wat handel oor die versorger se ervaring in die ontwikkellende konteks. In hierdie proses is gevind dat deelnemers dikwels dieselfde hindernisse en fasiliteerders ondervind as versorgers van individue met ander tipe toestande, soos MIV/VIGS, outisme, geestesiektes, kanker en neurologiese versteurings. Dit kan moontlik beteken dat versorgers wat in ontwikkellende lande woord dieselfde ervarings deel, ten spyte van die toestand van die persoon wat die versorging ontvang. Alhoewel deelnemers ondersteuning van ʼn aantal bronne ontvang het wat hulle help met hulle versorgingspligte, is dit duidelik dat hulle steeds gapings ervaar in die voorsiening van ʼn aantal belangrike dienste, insluitende ʼn tekort aan inligting van gesondheidsorg werkers, ʼn tekort aan gemeenskapsprogramme om stres verligting en bemagtiging te bevorder en ʼn tekort aan gestremdheid-vriendelike fasiliteite. Dit is baie belangrik dat versorgers toegang het tot hierdie dienste om die welstand van hulle kind en hulself te verseker. Daar is dus ʼn behoefte om te ondersoek hoe hierdie dienste meer toegangklik gemaak kan word vir versorgers in landelike gemeenskappe.

The purpose of the study was to examine the relationship between sleep patterns, motor proficiency and commonly co-occurring neurodevelopmental disorders in children, attitude to physical activity, mental health, and age. The study also looked at differences in sleep efficiency, as well as, perceived adequacy in physical activity between typically developing children and children with low motor proficiency. The sample consisted of 127 participants, 6-12 years old living in Perth, Western Australia. 51% participants were considered typically developing and 49% to have low motor proficiency. Motor proficiency, indications of Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder and anxiety/depression, adequacy in, or predilection for physical activity did not show a relationship to sleep efficiency. Significant differences between groups in sleep efficiency or adequacy in physical activity were not found. No interaction effect of neurodevelopmental disorders were identified. Sleep in children with movement impairments caused by neurodevelopmental disorders is an area where continued studies are of great importance. Although no relationship was identified in the current study, previous research has suggested sleep may play an important role for development and optimal everyday functioning. A better understanding of physical and psychological consequences and possible contributing factors of low motor proficiency in childhood is important as the risk of long-term dysfunction in emotional, cognitive and physical areas may be reduced in an optimal environment.

There is concern about the recently increasing number of infants born with Neonatal Abstinence Syndrome (NAS), yet little is known about its long-term neurodevelopmental effects. School-based speech-language pathologists (SLPs) are in a unique position to comment on potential long-term consequences of NAS because their caseloads include children with a variety of communication disorders and comorbidities. School-based SLPs across the United States (N = 258) responded to a survey about the presence of children with NAS on their caseloads and their perceptions of the children’s communication disorders and comorbidities. Results revealed that children with NAS currently are being treated by SLPs. They primarily present with receptive/expressive language and literacy disorders, and comorbid Broad Developmental Delay, ADD, and ADHD. Furthermore, documentation of NAS is often not available to SLPs, hindering creation of protocols for identification and treatment. The results of this study indicate that investment in future research is warranted.

This theoretical thesis covers the issues of Autism Spectrum Disorders (ASD) in relation to the brain connectome research. ASD belong to the group of neurodevelopmental syndromes and are characterized by deficits in communication skills, social interaction and stereotypic behaviors. The prevalence of ASD increases, its etiopathogenesis is very likely multifactorial. Within the ASD syndrome, precise differential diagnostic algorithms are difficult to implement in the absence of objective biomarkers. Extensive neuroscientific research, including the connectome projects, might improve the diagnostic and therapeutic procedures in the field of Psychiatry, including ASD. The individual's connectome profile might well serve as a new biomarker in psychiatric diagnostic and therapeutic approaches. The brain connectome represents the net of all neuronal connections in the brain. Mapping of the connectome across all ages, in health and in disease, is the main goal of the Human Connectome Project (HCP). The first HCP data show great interindividual variability with the environmental factors playing a crucial role. Extensive neurobiology research data on mechanisms of memory support the vital role of environmental stimulation in compensating for behavioral symptoms in ASD. Applied behavior analysis (ABA) is an...

I den här studien intervjuas fem personer som är yrkesverksamma inom verksamheter med konstnärligt skapande som inriktning för personer med neuropsykiatriska funktionsvariationer (NPF) och/eller utvecklingsstörning. Syftet med studien är att belysa konstnärligt skapande som verktyg kopplat till ökade krav på evidensbaserad praktik i gruppverksamheter riktade till personer med NPF och/eller utvecklingsstörning. Forskningsfrågorna avser därför att ge svar på vilka funktioner metoden konstnärligt skapande fyller som verktyg i gruppverksamheter riktade till personer med NPF och/eller utvecklingsstörning, hur dessa funktioner kan förstås samt om de kan/bör leva upp till krav på evidensbaserad praktik. Resultatet bygger på fem semistrukturerade intervjuer som har kodats och analyserats med fenomenologisk tematisk analys. Det teoretiska ramverket består av den salutogena modellen med fokus på ”en känsla av sammanhang” och Jonna Bornemarks perspektiv om ”att mäta det omätbara”.   Metoden konstnärligt skapande används frekvent i verksamheter riktade till målgruppen men samtidigt finns brister när det kommer till kvantitativ forskning för att stödja metodens effekter. Informanterna menade att den subjektiva upplevelsen av metoden är svår att mäta men att de själva upplever att konstnärligt skapande har många fördelar för den specifika målgruppen. Under studiens gång beskrev informanterna aspekter som väl stämde överens med vad som ryms inom den salutogena modellen. De gav uttryck för att det konstnärliga skapandet som metod bidrog till inkludering, kognitiv förstärkning, ökad självkänsla samt att det kunde fungera som ett alternativt kommunikation- och samtalsverktyg. / In this study, five people are interviewed who work professionally in activity groups with creative arts as a focus for people with neurodevelopmental disorders (DSM-5) and / or developmental disorder. The purpose of the study is to investigate the professionals' view of creative arts as a method in the work with the target group, and also their view of creative arts linked to the increased requirement for evidence-based practice. The questions of this research therefore intend to provide answers to what functions creative arts as a tool can have in group activities for people with DSM-5 and / or developmental disorder. We also intend to research how we can understand creative arts as a method and if/how the method should be mesured in relation to an increased requirement for evidence-based practice. The result is based on five semi-structured interviews that have been coded and analyzed with phenomenological thematic analysis. The theoretical framework is based on the salutogenic model and Jonna Bornemarks perspective on "measuring the immeasurable". The method of creative arts is frequently used in group activities for the target group, but at the same time there are deficiencies in the quantitative research bass to support the effects of the method. The respondents argued that the subjective experience of the method is difficult to measure, but that they themselves feel that creative arts has many advantages for the specific target group. During the study, the respondents described aspects that were well in line with what is included in the salutogenic model. The practitioners expressed that creative arts as a method contributed to community, cognitive reinforcement, increased self-esteem and that it could function as an alternative means of expression.

Dans le cadre du programme commun d’études pharmaco-épidémiologiques de la caisse nationale de l'assurance maladie et de l’agence nationale de sécurité du médicament, visant à évaluer l'impact sanitaire en France de l'exposition in utero à l’acide valproïque à partir des bases de données médico-administratives (BDMA) françaises, l’objectif de cette thèse était d’étudier l’utilisation des antiépileptiques pendant la grossesse et les risques de malformations congénitales et de troubles neuro-développementaux associés chez l’enfant. Le premier volet de cette thèse a consisté à formaliser et publier un algorithme d’identification des grossesses spécifiquement adapté aux BDMA françaises. L’application de cet algorithme à la description de l’utilisation des antiépileptiques pendant la grossesse a permis d’estimer à 6,7‰ la prévalence de l’utilisation des antiépileptiques pendant la grossesse et de montrer une baisse de l’utilisation des antiépileptiques de première génération, en particulier de l’acide valproïque, au bénéfice des antiépileptiques de deuxième génération entre 2007 et 2014. Dans le deuxième volet de cette thèse, l’exposition in utero à l’acide valproïque a été retrouvée associée à une augmentation du risque d’un grand nombre des malformations congénitales majeures (MCM) étudiées, avec une relation dose-effet pour les MCM les plus fréquentes, et l’exposition in utero au topiramate à une augmentation du risque de fentes oro-faciales. Des signaux relatifs à la prégabaline, au clonazépam et au phénobarbital ont aussi été identifiés. Dans le troisième volet de cette thèse, l’exposition in utero à l’acide valproïque a été retrouvée associée à une augmentation du risque de chacun des événements neuro-développementaux précoces étudiés versus lamotrigine, avec une relation dose-effet, à l’inverse des autres antiépileptiques. La réalisation d’études pharmaco-épidémiologiques à partir des BDMA françaises a permis aux autorités sanitaires de fournir rapidement des données sur l’utilisation des antiépileptiques pendant la grossesse en France. La réalisation de ces études a aussi permis de participer à l’enrichissement de la littérature observationnelle internationale sur les conséquences de l’exposition in utero aux antiépileptiques pour l’enfant à naitre. / The works of this thesis have been carried out within a programme of pharmacoepidemiological studies initiated by the National Agency of Medicine and Health Product Safety (ANSM) and the National Health Insurance fund (Cnam) in order to evaluate the public health situation in relation to prenatal exposure to valproic acid in France on the basis of the French health care databases. The objective of this thesis was to study antiepileptic drug (AED) use during pregnancy and the risks of congenital malformations and neurodevelopmental disorders associated with prenatal exposure to these drugs. In a first study, we developed an algorithm to identify pregnancy episodes and related outcomes using the French health care claims databases and applied it to study AED use during pregnancy between 2007 and 2014. Over the study period, 6.7 per 1000 pregnancies were exposed to an AED. The use of newer AEDs increased concomitantly with the decreased use of valproic acid and the other older AEDs. In a second study, prenatal exposure to valproic acid was found to be associated with a wide range of malformations among those investigated, with a dose-response relationship for half of them, and prenatal exposure to topiramate with an increased risk of cleft lip with or without cleft palate. Signals concerning pregabalin, clonazepam and phenobarbital have also been identified. In a third study, prenatal exposure to valproic acid was found to be associated with increased risks of all early neurodevelopmental outcomes investigated compared with lamotrigine, with a dose-response relationship. Prenatal exposure to the other AEDs was not associated with an increased risk of any of these neurodevelopmental outcomes versus lamotrigine. Conducting pharmacoepidemiological studies based on the French health care databases enabled the health authorities to rapidly provide data on the use of AED during pregnancy in France. It also brought additional evidence to the international observational literature on the consequences of prenatal exposure to AEDs for the unborn child.

Many people would argue that New Zealand has had a poor reputation for providing support services for the families of people with an Autistic Spectrum Disorder (ASD). The limited support services available for families in this country were highlighted during the trial and the manslaughter conviction of Janine Albury-Thomson. Albury-Thomson was found guilty of the manslaughter of her autistic daughter, Casey (MOH, 1999). The sentencing judge called for an independent inquiry to be held to examine the extent of support services that were available for families affected by the disorder with a view to identifying any gaps that may exist and ascertaining whether or not government policy could be blamed (Norris, 1998). More than twelve years have now elapsed since the Albury-Thomson trial and research was needed to ascertain the experiences of families raising a child with ASD. This research examines the experiences of families who have a child who has an ASD diagnosis. Research participants were families of people with Autism Spectrum Disorder who reside in the Canterbury/West Coast area. The research explored the support needs of families and the informal and formal supports that are available to them in this region. This research was conducted in three parts, with each part having a distinct method of data collection allowing triangulation of research findings. Part one was a survey questionnaire distributed via a range of mediums using a snowball sampling method. The second data set was made up of two case studies that were undertaken with a semi-structured interview approach. The third set of data was elicited via a semi-structured interview process from five local service providers that provide services to those with ASD and their families. A qualitative methodology was adopted to analyse research findings. This methodological approach was selected because it gave participants the opportunity to tell their stories about the diagnostic pathway they travelled and their experiences using available services. This research has social policy relevance as it was designed to examine the participant’s experiences while using services and resources available for the families of people with ASD in the Canterbury/West Coast area. Participants told of various social, emotional, and practical impacts and of the experiences they encountered while using the various services available. While the level of awareness of ASD has increased, the diagnosis process proved to be problematic for some when using the public health system. Consistent with a 2001 study commissioned on behalf of the Autistic Association of New Zealand, participants in this study who sought a diagnosis through the public health system found it to be a protracted process. Participants attributed delays to a lack of resources or staff that had a limited knowledge of ASD and saw these factors as barriers to obtaining a diagnosis within an acceptable time frame. A more timely diagnosis was reportedly received when the private health system was used. With regards to support offered by the agencies involved with ‘day to day’ contact with families it was found that overall, competent, experienced people worked for the existing agencies and they were capable of offering support where needed. However specific issues were identified by participants including a perception that case managers failed to understand their situation because they were unfamiliar with the implications of having a family member with ASD. Significantly, family members and service providers both identified a concern about a lack of suitable accommodation that can be utilised by a person with ASD. Because there is limited research into the support needs of families of a child with ASD this research provides an important insight into the needs of a fairly marginalised, and sometimes socially isolated, group. Implications for ongoing service provision and support of families are discussed in the thesis.