Understanding the Use of the Term "Weaponized Autism" in An Alt-Right Social Media Platform.

BACKGROUND: The term "weaponized autism" is frequently used on extremist platforms. To better understand this, we conducted a discourse analysis of posts on Gab, an alt-right social media platform. METHODS: We analyzed 711 posts spanning 2018-2019 and filtered for variations on the term "weaponized autism". RESULTS: This term is used mainly by non-autistic Gab users. It refers to exploitation of perceived talents and vulnerabilities of "Weaponized autists", described as all-powerful masters-of-technology who are devoid of social skills. CONCLUSIONS: The term "weaponized autism" is simultaneously glorified and derogatory. For some autistic people, the partial acceptance offered within this community may be preferable to lack of acceptance offered in society, which speaks to improving societal acceptance as a prevention effort.

Premature mortality in a population-based cohort of autistic adults in Canada.

Research from different countries suggests that autistic adults are more likely to die prematurely than non-autistic adults, but these studies do not always investigate male and female individuals separately and do not consider whether this pattern is unique to autistic people or is also an issue for people with other developmental disabilities. We examined premature mortality in autistic males and females (assigned at birth) in a population-based cohort, compared to males and females with and without other developmental disabilities. Using linked administrative health and social services population data from Ontario, Canada, age-matched males and females aged 19-65 years were followed between 2010 and 2016, and causes of death were determined. Over the 6-year observation period, 330 of 42,607 persons (0.77%) in the group without developmental disabilities had died compared to 259 of 10,646 persons (2.43%) in the autism group and 419 of 10,615 persons (3.95%) in the other developmental disabilities group. Autistic males and females were more likely to die than non-autistic males (adjusted risk ratio, RR 3.13, 95%CI 2.58-3.79) and non-autistic females (adjusted RR 3.12, 95%CI 2.35-4.13) without developmental disabilities, but were less likely to die than adults with other developmental disabilities (males: adjusted RR 0.66, 95%CI 0.55-0.79; females: adjusted RR 0.55, 95%CI 0.43-0.71). Most common causes of death varied depending on a person's sex and diagnosis. Given the greater likelihood of premature mortality in adults with developmental disabilities including autism, greater attention and resources directed toward their health and social care are needed, tailored to their sex and diagnosis-informed needs. LAY SUMMARY: This study looked at how many autistic men and women died over 6 years (2010-2016), along with how they died, and compared this to adults who did not have autism living in Ontario, Canada. It found that autistic men and women were more than three times as likely to die as people of the same age who did not have a developmental disability. However, adults with other developmental disabilities besides autism were even more likely to die than autistic adults. This means that we have to pay more attention and invest in better social and health care for autistic people, along with people who have other types of developmental disabilities.

Understanding disability in healthcare: exploring the perceptions of parents of young people with autism spectrum disorder.

Purpose: How autism spectrum disorder (ASD) is understood (i.e., as a medical problem or natural human variation) has profound implications for how healthcare services are designed and delivered. As the recipients of these services, children and families are highly invested in these debates, yet little research has sought to investigate their views. The purpose of this study was to explore parents' conceptualizations of ASD in relation to disability, and how they align with, or diverge from, conceptualizations they encounter within healthcare.Materials and methods: Nine semi-structured qualitative interviews were conducted with parents of children with ASD and thematically analyzed.Results: The accounts suggested that participants integrated multiple and sometimes contradictory conceptualizations of disability that reflected both "medical" and "social" models and sources of disablement. While the participants often advocated for acceptance and inclusion of their child, the label of "neurodiversity" was commonly rejected due to the concern for potential loss of funding for services.Conclusions: Study findings highlight the relationship between how parents conceptualize ASD and their experiences accessing supportive services within current delivery structures. Implications for ASD service providers emphasize accommodating parents' unique and evolving values and priorities for healthcare and their relation to current service systems.Implications for RehabilitationParents conceptualizations of ASD both inform and are influenced by their experiences of accessing supportive services.This study highlights that parents' perspectives are fluid, context-dependent, and do not exclusively represent a single model or perspective of disability.To meet family needs, service providers including healthcare professionals must recognize parents' unique understandings of their child's ASD and appreciate how healthcare shapes these perceptions.

Suicidal Thoughts and Behaviours Among Autistic Adults Presenting to the Psychiatric Emergency Department: An Exploratory Chart Review.

Despite increasing attention on suicidality in autistic people, we know little about suicidal presentations when autistic individuals present to hospital emergency departments (ED). We conducted an exploratory retrospective chart review of suicidal thoughts and behaviours (STB) of autistic adults who presented to a psychiatric ED. The analysis included 16 charts over a 10-week period. Findings highlight that reported STB were not always the presenting issue. Life transitions and interpersonal conflicts were common antecedents, and active rumination about STB was distressing and fatiguing. Findings imply that ED visits serve as important opportunities for suicidal risk reduction for autistic individuals, through implementation of strategies for identification of STB such as active screening, and the provision of suicide resources tailored to autistic people.

Physical activity participation among adolescents with autism spectrum disorder.

LAY ABSTRACT: Adolescents with autism spectrum disorder are less likely to be physically active compared to their age-related peers. Despite the lower levels of physical activity observed among adolescents with autism spectrum disorder, it is unknown why they are predominantly inactive. Much of the research so far has focused on understanding how biological aspects influence physical activity participation. But there is little research that has examined how social and cultural components influence their physical activity participation. There is also little research that has sought the perspectives and experiences of adolescents with autism spectrum disorder. In this study, 10 adolescent boys with autism spectrum disorder created a digital story, and also participated in two face-to-face interviews. The purpose of the study was to examine how individual, social, and cultural forces influenced physical activity participation. Analysis of the data highlight that bullying, challenges in community programs, and the prioritization of therapeutic interventions limited participation. On the contrary, participants were more likely to be active when physical activity generated meaning, purpose, a sense of identity, and affective pleasures. The findings add new knowledge suggesting that adolescents with autism spectrum disorder are not simply unmotivated. Rather, physical activity participation was shaped by wider social experiences, norms, values, and practices in which they were immersed. The findings suggest a need for directed efforts to create policies and practices which are individualized and reflective of the needs and abilities of adolescents with autism spectrum disorder to promote physical activity participation and potentially enhance physical health and wellbeing.

Exploring the Role of Physiotherapists in the Care of Children with Autism Spectrum Disorder.

Aims: Children with autism spectrum disorder (ASD) are less likely to participate in physical activity than their age related peers, and it has been suggested that physiotherapists (PT) could potentially facilitate their participation. Currently, no research has examined PTs' potential role in enhancing physical activity (PA) participation. The purpose of this qualitative study was to examine PTs experiences and perspectives of working with children with ASD, and to explore potential directions for PTs to potentially increase PA. Methods: Ten pediatric PTs in Canada were interviewed, and data were analyzed using thematic analysis. Results: Three themes were identified: the role of PT, perceived lack of expertise, confidence and training, and structural and systemic barriers. The accounts highlight the social and institutional complexity and constraints in PTs potential promotion of PA for children with ASD. Participants supported a primarily consultative role whereby PTs could educate and partner with parents, teachers, and community service providers to enhance gross motor development and individualize PA needs. Conclusions: These findings indicate how PTs might be involved in enhancing PA among children with ASD.

"Girls don't have big tummies": The experiences of weight-related discussions for children with autism spectrum disorders.

Children with autism spectrum disorders appear to be at a higher risk of having obesity than their typically developing peers. Although it has been recommended that healthcare providers speak to children with autism spectrum disorders about the potential health risks of unhealthy weight, no previous research has explored how healthcare providers communicate with them about this topic. The purpose of this study was to explore children's perspectives and experiences of discussing weight-related topics in healthcare consultations. Eight children were interviewed, and an interpretive phenomenological analysis informed the research approach and analysis of the data. Results indicated that weight-related discussions with healthcare providers were often met with trepidation, anxiety, anger, and frustration. Children also expressed that they experienced weight stigma in clinical visits and everyday interactions. Weight stigma was often (unwittingly) projected by healthcare providers during appointments and had debilitating effects on children. Finally, higher weights emerged as a repetitive/restricted interest, and children reported body image challenges regarding their higher weights. Frameworks and tools that are specific to the needs and abilities of children with autism spectrum disorders are needed for healthcare providers to foster positive conversations about weight-related topics in an effort to promote lifelong wellness.

Weighty Conversations: Caregivers', Children's, and Clinicians' Perspectives and Experiences of Discussing Weight-Related Topics in Healthcare Consultations.

Children with autism spectrum disorder (ASD) are at a higher risk of having obesity than their typically developing peers. Although it has been recommended that health care providers (HCPs) speak to caregivers and children about the risk of higher weights, no research has examined how HCPs communicate weight-related information. Furthermore, there is a dearth of evidence regarding how to approach and deliver optimal weight-related discussions among children with ASD and their caregivers. Given these knowledge gaps, 21 in-depth interviews were conducted with children with ASD, their caregivers, and HCPs. Using a qualitative analytic approach, data from interviews were analyzed thematically. Results suggest that HCPs at times projected weight stigma during clinical encounters, which did not motivate children and caregivers to work toward work loss or wellness. HCPs also described reticence in engaging families in weight-related conversations due to limited training, and lack of clinical tools to guide these conversations. All stakeholders identified a need to work together to establish a therapeutic partnership to discuss weight-related issues without blame or shame. The combination of strength-based communication approaches, establishing a strong therapeutic partnership, and development of clinical tools facilitating weight-related discussions for HCPs outlined in this article are potential vehicles to foster successful weight-related discussions while promoting lifelong wellness. Autism Research 2018, 11: 1500-1510. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Children with autism spectrum disorder (ASD) are at a higher risk of having obesity. Yet, it is unknown how healthcare providers (HCPs) should deliver weight-related information. Findings suggest children and caregivers experienced weight stigma and were uncomfortable discussing weight-related issues. HCPs identified that they did not have sufficient training, and did not feel confident identifying/addressing weight issues. Tools are needed to facilitate weight-related discussions among children, caregivers and HCPs.

Patients' Perspectives on and Experiences of Home Exercise Programmes Delivered with a Mobile Application.

Purpose: We explored patients' perspectives on home exercise programmes (HEPs) and their experiences using a mobile application designed to facilitate home exercise. Method: Data were generated using qualitative, semi-structured, face-to-face interviews with 10 participants who were receiving outpatient physiotherapy. Results: Establishing a therapeutic partnership between physiotherapists and patients enabled therapists to customize the HEPs to the patients' lifestyles and preferences. Analysis suggests that using the mobile application improved participants' ability to integrate the HEP into their daily life and was overwhelmingly preferred to traditional paper handouts. Conclusions: The results suggest that efforts to engage patients in HEPs need to take their daily lives into account. To move in this direction, sample exercise prescription questions are offered. Mobile applications do not replace the clinical encounter, but they can be an effective tool and an extension of delivering personalized HEPs in an existing therapeutic partnership.

Objectif : explorer les points de vue des patients sur les programmes d'exercices à la maison (PEM) et leurs expériences à l'égard d'une application mobile conçue pour faciliter ce type d'exercices. Méthodologie : les chercheurs ont obtenu des données qualitatives semi-structurées en interviewant dix participants qui recevaient des soins ambulatoires en physiothérapie. Résultats : en formant un partenariat thérapeutiques avec leurs patients, les physiothérapeutes pouvaient personnaliser les PEM en fonction du mode de vie et des préférences de leurs patients. Selon l'analyse, une application mobile aidait les participants à intégrer les PEM à leur quotidien. Ceux-ci la préféraient massivement aux feuilles de renseignements habituels. Conclusions : d'après les résultats, les mesures pour que les patients s'investissent dans leur PEM doivent tenir compte du quotidien. Pour aller en ce sens, des questions sur les modèles de prescription d'exercices sont proposées. Les applications mobiles ne remplacent pas la rencontre clinique, mais peuvent constituer un outil efficace et compléter le PEM personnalisé dans le cadre d'un partenariat thérapeutique établi.

Exploring the teaching and learning of clinical reasoning, risks, and benefits of cervical spine manipulation.

The aim of this study was to examine how risks and benefits of cervical spine manipulation (CSM) were framed and discussed in the context of mentorship and their impact on the perception of safe practice of CSM in clinical physiotherapy settings. A multi-method qualitative approach was employed, including a document analysis of established educational guidelines, observations of mentoring sessions, and individual face-to-face interviews with five mentees in the process of learning CSM, and four mentors with Orthopedic Manual Physical Therapy (OMPT) certification. Results demonstrated that participants' clinical decision-making processes to perform CSM were primarily oriented to the mitigation of risk. Achieving proficiency in the "science" of clinical reasoning and the "art" of "feel" related to mastering technical skills were viewed as means to mitigating risk and enhancing confidence to use CSM safely in clinical practice. While the "art" of technical skill mastery was of high importance to mentees and considered important to developing competency in performing CSM, it was discussed as distinct from their clinical reasoning processes. Thus, promoting a more balanced and integrated use of the "art" and "science" of safe practice for CSM in OMPT training may result in greater confidence and judicious use of CSM by physiotherapists.

Boys, Transitions, and Physical (In)activity: Exploring the Socio-Behavioural Mediators of Participation.

PURPOSE: To explore the socio-behavioural mechanisms that motivate or dissuade boys' participation in physical activity (PA) as they transition into adolescence and their implications for physical therapy. METHODS: This critical qualitative study involved in-depth interviews using active interviewing techniques with 15 adolescent boys. Data generation and analysis were driven by techniques of grounded theory and Bourdieu's sociology of practice. RESULTS: The analysis identified intersectional relationships among emotions, the inherent pleasures of movement, and a sense of connectedness to PA, each of which acted as a mediating mechanism in motivating participation in PA. Analogously, body dissatisfaction, negative self-perceptions, and repeated instances of explicit and symbolic bullying intersected to dissuade boys from participating and created apathy toward PA. CONCLUSION: Identifying socio-behavioural mechanisms that motivate or dissuade physically active behaviour contributes new knowledge toward understanding PA attrition among boys transitioning to adolescence. As health advocates and movement experts, physiotherapists have an important role in helping adolescents of all abilities to participate in activities that provide them with meaning, inclusivity, and a sense of connectedness to PA.

Objet: Explorer les mécanismes sociocomportementaux qui poussent les garçons à faire de l'activité physique (AP) ou les en dissuade à l'aube de l'adolescence et les répercussions sur le plan de la physiothérapie. Méthodes: Cette étude qualitative critique comportait des entrevues en profondeur basées sur des techniques de « l'entrevue active ¼ de 15 garçons adolescents. La génération et l'analyse des données ont été propulsées par les techniques de la théorie à base empirique et la sociologie de la pratique de Bourdieu. Résultats: L'analyse a dégagé des relations intersectionnelles entre les émotions, les plaisirs inhérents au mouvement et un sentiment de lien avec l'AP, dont chacune a agi comme facteur de motivation incitant à faire de l'AP. De façon analogue, l'insatisfaction à l'égard de leur corps, des perceptions de soi négatives et des cas répétés d'intimidation explicite et symbolique ont convergé pour dissuader de faire de l'AP et susciter de l'apathie à cet égard. Conclusion: La détermination de mécanismes sociocomportementaux qui motivent et découragent l'activité physique aide à produire de nouvelles connaissances qui aident à comprendre l'attrition de l'AP chez les garçons à l'aube de l'adolescence. En tant que promoteurs de la santé et experts du mouvement, les physiothérapeutes ont un rôle important à jouer en aidant les adolescents, sans égard à leurs aptitudes, à participer à des activités qui leur donnent un sens, de l'inclusivité et un sentiment de lien avec l'AP.

Are you ready? Exploring readiness to engage in exercise among people living with HIV and multimorbidity in Toronto, Canada: a qualitative study.

OBJECTIVES: Our aim was to explore readiness to engage in exercise among people living with HIV and multimorbidity. DESIGN: We conducted a descriptive qualitative study using face-to-face semistructured interviews with adults living with HIV. SETTING: We recruited adults (18 years or older) who self-identified as living with HIV and 2 or more additional health-related conditions from a specialty hospital in Toronto, Canada. PARTICIPANTS: 14 participants with a median age of 50 years and median number of 9 concurrent health-related conditions participated in the study. The majority of participants were men (64%) with an undetectable viral load (71%). OUTCOME MEASURES: We asked participants to describe their readiness to engage in exercise and explored how contextual factors influenced their readiness. We analysed interview transcripts using thematic analysis. RESULTS: We developed a framework to describe readiness to engage in exercise and the interplay of factors and their influence on readiness among adults with HIV and multimorbidity. Readiness was described as a diverse, dynamic and fluctuating spectrum ranging from not thinking about exercise to routinely engaging in daily exercise. Readiness was influenced by the complex and episodic nature of HIV and multimorbidity comprised of physical impairments, mental health challenges and uncertainty from HIV and concurrent health conditions. This key factor created a context within which 4 additional subfactors (social supports, perceptions and beliefs, past experience with exercise, and accessibility) may further hinder or facilitate an individual's position along the spectrum of readiness to exercise. CONCLUSIONS: Readiness to engage in exercise among people living with HIV is a dynamic and fluctuating construct that may be influenced by the episodic nature of HIV and multimorbidity and 4 subfactors. Strategies to facilitate readiness to exercise should consider the interplay of these factors in order to enhance physical activity and subsequently improve health outcomes of people with HIV and multimorbidity.