Forms of resistance in people with severe and profound intellectual disabilities.

Government policy in the UK emphasises that people with intellectual disabilities should have the opportunity to make choices and exert control over their own lives as much as possible. The ability of a person to resist activities and offers is therefore important, particularly for people with severe and profound intellectual disabilities, who are likely to have language impairments and need to communicate their choices non-verbally. Video and ethnographic data were collected from two services for people with severe and profound intellectual disabilities. Examples of resistance by people with severe and profound intellectual disabilities and responses to that resistance by support workers were collected and examined using conversation analysis and ethnographic description. A range of non-verbal resistance behaviours are described, and the difficulty for support workers in identifying resistance when behaviour is ambiguous is discussed. The importance of understanding these behaviours as examples of decision-making is stressed.

Investigating eye movement patterns, language, and social ability in children with autism spectrum disorder.

Although all intellectually high-functioning children with autism spectrum disorder (ASD) display core social and communication deficits, some develop language within a normative timescale and others experience significant delays and subsequent language impairment. Early attention to social stimuli plays an important role in the emergence of language, and reduced attention to faces has been documented in infants later diagnosed with ASD. We investigated the extent to which patterns of attention to social stimuli would differentiate early and late language onset groups. Children with ASD (mean age = 10 years) differing on language onset timing (late/normal) and a typically developing comparison group completed a task in which visual attention to interacting and noninteracting human figures was mapped using eye tracking. Correlations on visual attention data and results from tests measuring current social and language ability were conducted. Patterns of visual attention did not distinguish typically developing children and ASD children with normal language onset. Children with ASD and late language onset showed significantly reduced attention to salient social stimuli. Associations between current language ability and social attention were observed. Delay in language onset is associated with current language skills as well as with specific eye-tracking patterns.

Primary school children rate children with autism negatively on looks, speech and speech content.

Adults and adolescents form negative first impressions of ASD adults and children. We examined the first impression ratings of primary school children (6-9 years) of their ASD peers. 146 school children rated either silent videos, speech or transcribe speech from 14 actors (7 ASD, 7 TD). The ASD actors were rated more negatively than the typically developing actors on all three stimulus types. Children with ASD are likely to be judged more negatively than their peers at the very start of their formal education. Contrary to previous research, for primary school children, the content of the speech was judged as negatively as the delivery of the speech.

Self-determination and co-operation in supported mealtimes involving people with severe intellectual disabilities.

PURPOSE: People with severe intellectual disabilities are often supported during mealtimes. However, little information exists about how they and care staff co-ordinate their mealtime behaviours. METHOD: Four people with severe intellectual disabilities and 12 members of care staff participated in this research. Video data were collected from two services for people with intellectual disabilities. Approximately 30 eating or drinking interactions were filmed, totalling approximately 9.5 h of footage. This footage was analysed using conversation analysis (CA). Ethnographic notes were made. CA is a fine-grained systematic approach which allows examination of how mealtimes are achieved, looking closely at verbal and non-verbal behaviours. RESULTS: Results show how people with severe intellectual disabilities can demonstrate whether they are ready, or not, for a mouthful of food or drink despite their limited language abilities. Ways in which readiness and unreadiness were demonstrated are outlined and staff responses are also considered. CONCLUSIONS: There are wider implications for self-determination among people with severe intellectual disabilities. Examples provided suggest that people with severe intellectual disabilities can, and do, make decisions about how fast they eat and when they prefer to complete other activities. Respecting these decisions, carers better support the autonomy of individuals with severe intellectual disabilities.

People with severe intellectual disabilities often need support in eating and drinking.People with severe intellectual disabilities use a variety of verbal and non-verbal resources to show when they are ready and when they are not.Decisions made by people with severe intellectual disabilities relating to mealtimes should be acknowledged and respected.Allowing people with severe intellectual disabilities to steer mealtime activities promotes agency and self-determination.

Shining a Light on a Hidden Population: Social Functioning and Mental Health in Women Reporting Autistic Traits But Lacking Diagnosis.

Female Phenotype Theory (FPT) suggests that autistic women often present with less obvious social impairments than autistic men. We examined the possibility of an exaggerated female phenotype among undiagnosed but probably autistic women. In two nationwide online surveys, we compared self-reported social functioning and mental health between diagnosed autistic women and women without diagnosis who scored ≥ 32 on the Autism Quotient. Compared to diagnosed autistic women, probably autistic women had higher empathy and general social functioning, and were more likely to have received a diagnosis of Borderline Personality Disorder. Autistic women had typically received more mental health diagnoses prior to their ASC diagnosis than autistic men. These findings shed light on the history of misdiagnosis experienced by many autistic women.

Emotion Recognition and Context in Adolescents with Autism Spectrum Disorder.

Emotion recognition research in autism has provided conflicting results and has ignored the role of context. We examined if autistic adolescents use context to identify displayed and felt emotion. Twenty adolescents with autism and 20 age-matched neurotypical adolescents identified emotions from a standardised set of images. The groups also viewed videos scenes with actors displaying a feigned emotion masking their true feelings. Participants identified the displayed and felt emotions. Both groups identified emotions from static images equally well. In the video condition, the autism group was unable to distinguish between the displayed and felt emotions. Emotion research is often divorced from context. Our findings suggest that autistic individuals have difficulty integrating contextual cues when processing emotions.

Room to read: The effect of extra-large letter spacing and coloured overlays on reading speed and accuracy in adolescents with dyslexia.

BACKGROUND: Coloured overlay and extra-large letter spacing may improve reading speed and accuracy in individuals with dyslexia; however, research has yet to identify which types of reading errors are diminished. AIM: To determine the impact of extra-large letter spacing and colour overlay on reading and assess the impact of both interventions on reading errors. SAMPLE: Thirty-two dyslexic children were matched on age, verbal and non-verbal IQ with 27 children with no diagnosis of dyslexia. The average age of each group was 13 years. METHOD: Participants read four texts with either standard or extra-large letter spacing with or without a coloured overlay. RESULTS: Extra-large letter spacing significantly improved reading speed more substantially for the dyslexia group. In addition, extra-large letters significantly reduced the number of missed word errors made by the dyslexia group. In contrast, coloured overlays did not significantly impact reading speed or the reduction of errors. CONCLUSION: Increasing letter spacing is an effective way for teachers to improve reading skills in students with dyslexia.

Autistic traits in individuals self-defining as transgender or nonbinary.

BACKGROUND: Autism spectrum traits are increasingly being reported in individuals who identify as transgender, and the presence of such traits have implications for clinical support. To-date little is known about autism traits in individuals who identify as nonbinary. AIMS: To empirically contribute to current research by examining autistic traits in a self-identifying transgender and nonbinary gender group. METHOD: One hundred and seventy-seven participants responded to a survey consisting of the Autism Spectrum Quotient (AQ), the Empathy Quotient (EQ), the Systematising Quotient (SQ) and the Reading the Mind in the Eyes Task (RME). Comparisons were made between cisgender, transgender and nonbinary groups. RESULTS: Individuals with autism spectrum disorder (ASD) or meeting the AQ cut-off score for ASD were over-represented in both the transgender and nonbinary groups. The key variables differentiating the transgender and nonbinary groups from the cisgender group were systematising and empathy. Levels of autistic traits and cases of ASD were higher in individuals assigned female at birth than those assigned male at birth. CONCLUSIONS: A proportion of individuals seeking help and advice about gender identity will also present autistic traits and in some cases undiagnosed autism. Lower levels of empathy, diminished theory of mind ability and literalness may impede the delivery of effective support. Clinicians treating transgender and nonbinary individuals, should also consider whether clients, especially those assigned female at birth, have an undiagnosed ASD.

Living with autism without knowing: receiving a diagnosis in later life.

Increasingly adults over the age of 50 are receiving a diagnosis of autism spectrum condition. Growing up in a time when autism was poorly recognised, these adults have lived unknowingly with the condition and face readjustment. This paper reports the first study to investigate this population. Nine adults over the age of 50, who had recently been diagnosed with ASC, were interviewed, and thematic analysis was used to analyse the transcripts. Results showed that the participants had received treatment for anxiety and depression. They reported ASC behaviours in their childhood and growing up they felt isolated and alien. Receiving a diagnosis was seen as a positive step and allowed for a reconfiguration of self and an appreciation of individual needs. Given the positive aspects of receiving a late diagnosis, more work is needed to identify older adults with undiagnosed ASC.

Altered bodily self-consciousness and peripersonal space in autism.

There is some evidence that disordered self-processing in autism spectrum disorders is linked to the social impairments characteristic of the condition. To investigate whether bodily self-consciousness is altered in autism spectrum disorders as a result of multisensory processing differences, we tested responses to the full body illusion and measured peripersonal space in 22 adults with autism spectrum disorders and 29 neurotypical adults. In the full body illusion set-up, participants wore a head-mounted display showing a view of their 'virtual body' being stroked synchronously or asynchronously with respect to felt stroking on their back. After stroking, we measured the drift in perceived self-location and self-identification with the virtual body. To assess the peripersonal space boundary we employed an audiotactile reaction time task. The results showed that participants with autism spectrum disorders are markedly less susceptible to the full body illusion, not demonstrating the illusory self-identification and self-location drift. Strength of self-identification was negatively correlated with severity of autistic traits and contributed positively to empathy scores. The results also demonstrated a significantly smaller peripersonal space, with a sharper (steeper) boundary, in autism spectrum disorders participants. These results suggest that bodily self-consciousness is altered in participants with autism spectrum disorders due to differences in multisensory integration, and this may be linked to deficits in social functioning.

The Feeling of Me Feeling for You: Interoception, Alexithymia and Empathy in Autism.

Following recent evidence for a link between interoception, emotion and empathy, we investigated relationships between these factors in autism spectrum disorder (ASD). 26 adults with ASD and 26 healthy participants completed tasks measuring interoception, alexithymia and empathy. ASD participants with alexithymia demonstrated lower cognitive and affective empathy than ASD participants without alexithymia. ASD participants showed reduced interoceptive sensitivity (IS), and also reduced interoceptive awareness (IA). IA was correlated with empathy and alexithymia, but IS was related to neither. Alexithymia fulfilled a mediating role between IA and empathy. Our findings are suggestive of an alexithymic subgroup in ASD, with distinct interoceptive processing abilities, and have implications for diagnosis and interventions.

Experiences of Sex Education and Sexual Awareness in Young Adults with Autism Spectrum Disorder.

The research investigated feelings towards sex education and sexual awareness in young adults with autism spectrum disorder (ASD). Data were generated from the sexual knowledge, experiences, feelings and needs questionnaire (McCabe et al. 1999), the sexual awareness questionnaire (Snell et al. 1991) and semi-structured interviews. Twenty typically developing and 20 ASD individuals participated. Feelings toward sex education did not differ between the groups, but the groups differed significantly on measures of sexual awareness. Negative experiences of sex education and issues of vulnerability, social anxiety, and confused sexuality were prominent features of the qualitative interviews. This report suggest that mainstream sex and relationship education is not sufficient for people with ASD, specific methods and curricular are necessary to match their needs.

The effects of letter spacing and coloured overlays on reading speed and accuracy in adult dyslexia.

BACKGROUND: Zorzi et al. (2012, Proc. Natl. Acad. Sci. U.S.A., 109, 11455) found evidence that extra-large letter spacing aids children with dyslexia, but the evidence for the coloured overlays is contradictory (e.g., Henderson et al., 2013, J. Res. Special Educ. Needs, 13, 57; Wilkins, 2002, Ophthalmic Physiol. Opt., 22, 448), and possible combined advantages have not been identified. AIMS: To investigate whether extra-large letter spacing or coloured overlays can alleviate reading problems in dyslexic adults. SAMPLE: The participants were 24 dyslexic and 24 non-dyslexic university students, matched for age and fluid intelligence. METHODS: The reading speed and the errors made by a dyslexic and a control group were measured in four conditions: with and without coloured overlays and with normally and largely spaced texts. RESULTS: Large letter spacing improves the reading speed in general, as well as improves the reading accuracy in dyslexic readers. CONCLUSIONS: The results support the positive effect of letter spacing on reading performance.

How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the Classroom.

Sensory processing difficulties are consistently reported amongst individuals with an autistic spectrum condition (ASC); these have a significant impact on daily functioning. Evidence in this area comes from observer reports and first-hand accounts; both have limitations. The current study used the Adolescent/Adult Sensory Profile (AASP; Brown and Dunn in The Adolescent/Adult Sensory Profile: self questionnaire. Pearson, 2002a), and a qualitative questionnaire to investigate sensory issues in school children with ASC. The AASP found that the participants' mean scores were outside normal parameters. Participants reported difficulties in at least one sensory domain, with hearing affecting them the most. Content analysis revealed sensory sensitivity to affect the participant's learning and that sensory experiences were largely negative. Results suggest that schools need to create sensory profiles for each individual with ASC.

Does facial expressivity count? How typically developing children respond initially to children with autism.

Research investigating expressivity in children with autism spectrum disorder has reported flat affect or bizarre facial expressivity within this population; however, the impact expressivity may have on first impression formation has received little research input. We examined how videos of children with autism spectrum disorder were rated for expressivity by adults blind to the condition. We further investigated the friendship ratings given by 44 typically developing children to the same videos. These ratings were compared to friendship ratings given to video clips of typically developing children. Results demonstrated that adult raters, blind to the diagnosis of the children in the videos, rated children with autism spectrum disorder as being less expressive than typically developing children. These autism spectrum disorder children were also rated lower than typically developing children on all aspects of our friendship measures by the 44 child raters. Results suggest that impression formation is less positive towards children with autism spectrum disorder than towards typically developing children even when exposure time is brief.

Associations between language development and skin conductance responses to faces and eye gaze in children with autism spectrum disorder.

Attention to social stimuli is associated with language development, and arousal is associated with the increased viewing of stimuli. We investigated whether skin conductance responses (SCRs) are associated with language development in autism spectrum disorder (ASD): a population that shows abnormalities in both attention to others and language development. A sample of 32 children with ASD (7-15 year; M = 9 year) was divided into two groups, based on language onset histories. A typically developing comparison group consisted of 18 age and IQ matched children. SCRs were taken as the participants viewed faces. SCRs differentiated the ASD group based on language onset and were associated with abnormal attention to gaze in infancy and subsequent language development.