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Stasolla F, Passaro A, Di Gioia M, Curcio E, Zullo A. Combined extended reality and reinforcement learning to promote healthcare and reduce social anxiety in fragile X syndrome: a new assessment tool and a rehabilitative strategy. Front Psychol 2023; 14:1273117. [PMID: 38179497 PMCID: PMC10765535 DOI: 10.3389/fpsyg.2023.1273117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
| | - Anna Passaro
- University “Giustino Fortunato” of Benevento, Benevento, Italy
| | | | - Enza Curcio
- University “Giustino Fortunato” of Benevento, Benevento, Italy
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Shelley L, Waite J, Tarver J, Oliver C, Crawford H, Richards C, Bissell S. Behaviours that Challenge in SATB2-associated Syndrome: Correlates of Self-injury, Aggression and Property Destruction. J Autism Dev Disord 2023:10.1007/s10803-023-06123-2. [PMID: 37751087 DOI: 10.1007/s10803-023-06123-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/27/2023]
Abstract
SATB2-associated syndrome (SAS) is a genetic syndrome characterised by intellectual disability, severe speech delay, and palatal and dental problems. Behaviours that challenge (BtC) are reported frequently; however, there is limited research on specific forms of BtC and the correlates of these behaviours. The current study explores correlates of well-defined BtC, self-injury, aggression, and property destruction, in SAS. Eighty-one parents/caregivers of individuals with SAS (53.1% male, Mage 10.12 years) completed questionnaire measures of health, behavioural, emotional, and autism characteristics. Individuals with SAS were grouped based on caregiver responses to the presence or absence of self-injury, aggression, and property destruction on the Challenging Behaviour Questionnaire. Rates of self-injury, aggression and property destruction were 42%, 77% and 49%, respectively. Between-group comparisons were conducted to compare characteristics between behaviour groups. Significantly differing characteristics were entered into separate hierarchical logistic regressions for each form of BtC. Behavioural comparisons indicated variation in the characteristics associated with each behaviour. All hierarchical logistic regression models were significant (p < .001): self-injury (χ2(5) = 38.46, R2 = 0.571), aggression (χ2(4) = 25.12, R2 = 0.414), property destruction (χ2(4) = 23.70, R2 = 0.346), explaining between 34.6% and 57.1% of the variance in behaviour presence. This is the first study to identify correlates of self-injury, aggression, and property destruction in SAS. Variability in the characteristics associated with each behaviour highlights the importance of specificity when examining BtC. Understanding correlates of specific forms of BtC has important implications for informing SAS-associated pathways to behavioural outcomes and the implementation of tailored behavioural interventions.
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Affiliation(s)
- Lauren Shelley
- College of Health and Life Sciences, Aston University, Birmingham, UK.
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK.
| | - Jane Waite
- College of Health and Life Sciences, Aston University, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
| | - Joanne Tarver
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Hayley Crawford
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, Coventry, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
| | - Stacey Bissell
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
- Cerebra Network for Neurodevelopmental Disorders, University of Birmingham, Birmingham, UK
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Fynn G, Porter M, Pellicano E. 'Playing a guessing game': Recognising and responding to anxiety in children with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2023; 36:1150-1161. [PMID: 37381992 DOI: 10.1111/jar.13136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 04/21/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Children with intellectual disability are at greater risk of developing anxiety than the general population. Limited research has examined the challenges associated with recognising and responding to anxiety in children with intellectual disability, and its perceived impact. AIM This study aimed to explore anxiety in children with intellectual disability, from the child and parent perspective to better understand how parents and children recognise and respond to anxiety. METHOD AND PROCEDURES Six children with an intellectual disability (age range: 12-17, four boys) and their mothers participated in a semi-structured interview online. Interviews were transcribed verbatim and interpreted using thematic analysis. OUTCOME AND RESULTS Mothers elaborated on the difficulties with recognising signs of anxiety due to the impact of the child's primary diagnosis and the overlap of symptoms with co-occurring conditions. Mothers and children discussed the 'contagious' effect of anxiety within the household and how this influenced mothers' approaches to managing their child's anxiety. They reported that anxiety limited the meaningful activities in which children and families could engage. CONCLUSIONS AND IMPLICATIONS These findings highlight the importance of supporting mothers to recognise their children's anxiety and to assist them with strategies on how best to respond and cope. These findings have implications for future research, and practitioners working in this field.
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Affiliation(s)
- Gabrielle Fynn
- Macquarie School of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Melanie Porter
- Macquarie School of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
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Al-Jabri B, Alnuwaiser S, Abdulghaffar H, Almuhanna R, Salaam S, Brika R, Addas A, Bedaiwi H. Healthcare Experience of Pediatric Patients with Autism Spectrum Disorders in Saudi Arabia: A Cross-Sectional Study. Pediatr Rep 2023; 15:452-461. [PMID: 37606446 PMCID: PMC10443268 DOI: 10.3390/pediatric15030042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/23/2023] Open
Abstract
Children with autism spectrum disorder (ASD) face several challenges in the healthcare setting. This study defines the challenges experienced by children with autism in hospitals in Saudi Arabia. A cross-sectional study was conducted using a questionnaire for guardians of autistic children in outpatient clinics, autism support groups, and rehabilitation centers. A total of 199 participants were included. The medical procedures causing the most anxiety to children were injections and getting their blood drawn (68.3%), vital sign measurement (41.6%), and height and weight measurement (37.8%). Long waiting hours (44.1%), increased sensory stimuli (33.2%), and overcrowding of hospital staff (27.9%) were stress-inducing in the healthcare environment. The guardians recommended that loud noises (44.7%), crowdedness (41.2%), and long waiting hours (42.1%) be avoided. The nonverbal children experienced significantly higher levels (p < 0.001) of agitation, irritability, and outbursts during doctor visits than their verbal counterparts. The children with intellectual disabilities were more tense and unresponsive during doctor visits (33.3%) than their intellectually able counterparts, who more frequently were calm and responsive (44.9%) during visits. Most patients with ASD face hardships during hospital visits. Nonverbal patients and those with intellectual disabilities have a higher tendency for hospital setting anxiety-induced outbursts, which may be eased by avoiding loud noise and overcrowding.
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Affiliation(s)
- Basma Al-Jabri
- Pediatric Department, Faculty of Medicine, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah 21589, Saudi Arabia;
| | - Sara Alnuwaiser
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Haifa Abdulghaffar
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rahaf Almuhanna
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Shaimaa Salaam
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Raval Brika
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Alia Addas
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hala Bedaiwi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Lewis LF, Stevens K. The lived experience of meltdowns for autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023:13623613221145783. [PMID: 36632658 DOI: 10.1177/13623613221145783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
LAY ABSTRACT There is not a lot known about what it feels like for autistic people to have a meltdown. Past research has focused on what meltdowns are like for parents and what meltdowns look like from the outside without understanding what it is like for the person having the meltdown. We asked 32 autistic adults about what it is like for them to have a meltdown. We asked them to tell us about their thoughts and feelings about having a meltdown. Then, we looked for themes in their responses that summarized the meltdown experience. Our findings showed that meltdowns hold different meaning to different people. During a meltdown, we found that most autistics described feeling overwhelmed by information, senses, and social and emotional stress. They often felt extreme emotions, such as anger, sadness, and fear, and had trouble with thinking and memory during the meltdown. Participants described trying to stay in control of themselves, often feeling like they were not themselves during meltdowns. They described the meltdown as a way of letting go of or releasing the extreme emotions they felt. Participants tried to stay away from things or people that might trigger a meltdown or tried to make sure they were alone if they felt a meltdown may be coming as a way of avoiding harm-including harm to their bodies, their emotions, and their relationships. These findings offer an important look into what it is like for autistic adults to have meltdowns from their own point of view.
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Palmer M, Tarver J, Carter Leno V, Paris Perez J, Frayne M, Slonims V, Pickles A, Scott S, Charman T, Simonoff E. Parent, Teacher and Observational Reports of Emotional and Behavioral Problems in Young Autistic Children. J Autism Dev Disord 2023; 53:296-309. [PMID: 35028809 PMCID: PMC9889526 DOI: 10.1007/s10803-021-05421-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
Emotional and behavioral problems (EBPs) frequently occur in young autistic children. Discrepancies between parents and other informants are common but can lead to uncertainty in formulation, diagnosis and care planning. This study aimed to explore child and informant characteristics are associated with reported child EBPs across settings. Participants were 83 4-8-year-old autistic children and their parents and teachers in the Autism Spectrum Treatment and Resilience (ASTAR) study. Questionnaires of child EBPs were completed by parents and teachers, and self-reported parenting stress and wellbeing measures were obtained. An observation of parent-child/researcher-child interaction was also completed. Parents reported more EBPs than teachers and parent-teacher agreement was low, particularly for emotional problems. Greater parenting stress and being verbal was associated with more parent- but not teacher-reported EBPs. More observed behaviors that challenge were displayed by minimally verbal children. More parenting stress could be associated with the presence of more EBPs in the home; alternatively, parenting stress may confound reports. It is essential for assessments of EBPs in autistic children to take a multi-informant approach. Better understanding of the associations between informant characteristics and informant discrepancies of EBPs is needed.
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Affiliation(s)
- Melanie Palmer
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Joanne Tarver
- grid.7273.10000 0004 0376 4727Department of Psychology, School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Virginia Carter Leno
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Juan Paris Perez
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Margot Frayne
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Vicky Slonims
- grid.420545.20000 0004 0489 3985Newcomen Neurodevelopmental Centre, Evelina Children’s Hospital, Guy’s and St Thomas NHS Foundation Trust, London, UK
| | - Andrew Pickles
- grid.13097.3c0000 0001 2322 6764Department of Biostatistics and Health Informatics, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Stephen Scott
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Tony Charman
- grid.37640.360000 0000 9439 0839Service for Complex Autism & Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Psychology, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Emily Simonoff
- grid.13097.3c0000 0001 2322 6764Department of Child and Adolescent Psychiatry, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK ,grid.37640.360000 0000 9439 0839Service for Complex Autism & Associated Neurodevelopmental Disorders, South London and Maudsley NHS Foundation Trust, London, UK
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Utilising Interview Methodology to Inform the Development of New Clinical Assessment Tools for Anxiety in Autistic Individuals Who Speak Few or no Words. J Autism Dev Disord 2022; 53:2328-2348. [PMID: 35304663 PMCID: PMC10229722 DOI: 10.1007/s10803-022-05509-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2022] [Indexed: 10/18/2022]
Abstract
Autistic individuals with intellectual disability who speak few or no words are at high risk of anxiety but are underrepresented in research. This study aimed to describe the presentation of anxiety in this population and discuss implications for the development of assessments. Interviews were conducted with 21 parents/carers of autistic individuals and nine clinicians. Data were analysed using content analysis and interpretative phenomenological analysis. Anxiety behaviours described by parents/carers included increased vocalisation, avoidance and behaviours that challenge. Changes to routine were highlighted as triggering anxiety. Clinicians discussed the importance of identifying an individual's baseline of behaviour, knowing an individual well and ruling out other forms of distress. This study raises considerations for early identification of anxiety and for subsequent support.
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