A qualitative study into the experience of living with acalculia after stroke and other forms of acquired brain injury.

Acalculia, an acquired disability following a brain injury, involves difficulty processing numerical information and/or calculations. Acalculia is not routinely screened for, and as a result there is a lack of understanding about the nature and prevalence and the impact of the condition. This qualitative study was initiated by stroke survivors with a strong interest in acalculia. Sixteen stroke/brain injury survivors with acalculia and seven carers were interviewed using semi-structured online interviews. Participants ranged in age, gender, time post-onset, country of residence and numeracy level prior to brain injury. Data were analysed using thematic analysis. Three main themes were identified: Awareness and Diagnosis; Emotional and Practical Impact (independence); Support, Coping Strategies and Self-training. Participants and carers repeatedly referred to the lack of awareness and treatment for acalculia and the impact acalculia has had on their lives and independence. Practical impacts included managing money, making appointments, using timetables, organizing social activities and employment, and managing medication. Our results highlight the urgent need to develop suitable assessments and interventions for acalculia and the scope for this to be Patient, Carer and Public involvement (PCPI)-led. The data also reveal useful strategies and suggestions regarding effective timing, targets and approaches for intervention.

Time perception in autistic adults: Interval and event timing judgments do not differ from nonautistics.

It has previously been proposed that autistic people have problems with timing which underlie the behavioral and cognitive differences in the condition. However, the nature of this postulated timing issue has not been well specified and the existing experimental literature has generated mixed findings. In the current study, we attempted a systematic investigation of timing processes in autistic adults using scalar expectancy theory as a theoretical framework. Autistic (n = 58) and nonautistic (n = 91) adults matched for age, sex, and full-scale IQ completed a battery of auditory and visual timing tasks measuring basic subsecond duration perception (temporal discrimination thresholds), clock processes (verbal estimation), clock and memory processes (temporal generalization), and event timing (temporal order judgments). Participants also completed suprasecond retrospective duration estimates where the participant was not warned in advanced that they would be required to make a timing judgment, and questionnaires measuring self-reported timing behaviors in daily life. The groups reported differences on questionnaires, but measures of timing performance were comparable overall. In an exploratory analysis, we performed principal components analysis to investigate the relationship between timing judgments and participants' self-reported social-communicative, sensory, and motor traits. Measures of timing performance were not well correlated with these questionnaire scores. The current study, the largest conducted on time and autism to date, shows no clear evidence for reduced timing performance in autistic adults. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Developing a model of long-term social rehabilitation after traumatic brain injury: the case of the head forward centre.

BACKGROUND: Social isolation and inactivity are highly problematic long-term consequences of Traumatic Brain Injury. They are rarely addressed by rehabilitation programmes, which focus on early phases of recovery. Day centres, or "drop-in" peer support groups, have emerged as an informal solution to social rehabilitation needs. However, there is a lack of knowledge regarding the therapeutic ingredients of these services. METHODS: Twelve survivors of Traumatic Brain Injury that attended a social rehabilitation service (Head Forward Centre, UK; HFC), were interviewed to explore the meanings attached to the service and its activities. Thematic analysis was used to describe emerging themes and build a model of social rehabilitation. RESULTS: Four therapeutic functions were attached to HFC: (a) HFC as a safe and predictable milieu; (b) HFC as a space where identity can be reconstructed; (c) HFC as a place where survivors can remain cognitive and socially active; (d) HFC as a network of continuous support. CONCLUSION: A model of long-term social rehabilitation should consider both psychological and practical/functional ingredients. Such a model can help informal rehabilitation services reflect upon their goals and activities, as well as articulate therapeutic actions along the rehabilitation path. The conceptualization of these four therapeutic ingredients in holistic rehabilitation models is described, and contrasted with its use in long-term social rehabilitation.IMPLICATIONS FOR REHABILITATIONSocial isolation and inactivity are important problems in the long-term rehabilitation of people with TBI. Both problems can be addressed by social rehabilitation services (day centres and peer support groups).Participation in social rehabilitation can promote a sense of normality and belongingness, which contribute to the long-term process of identity reconstruction.Social rehabilitation can help maintaining people with TBI cognitive and socially active, as well as developing a network of continuous support.

Time perception and autistic spectrum condition: A systematic review.

Problems with timing and time perception have been suggested as key characteristics of autism spectrum condition (ASC). Studies and personal accounts from clinicians, parents, caregivers, and self-reports from autistic people themselves often refer to problems with time. Although a number of empirical studies have examined aspects relating to time in autistic individuals, there remains no clear consensus on whether or how timing mechanisms may be affected in autism. A key reason for this lack of clarity is the wide range of timing processes that exist and subsequently the wide range of methodologies, research paradigms, and samples that time-based studies have used with autism populations. In order to summarize and organize the available literature on this issue, a systematic review was conducted. Five electronic databases were consulted. From an initial 597 records (after duplicates were removed), 45 papers were selected and reviewed. The studies are reviewed within different sections based on the different types of timing ability that have been explored in the neurotypical (NT) population: time sensitivity, interval timing, and higher-order time perception. Within each section cognitive models, methodologies, possible clinical implications, and research results are discussed. The results show different consistency across studies between the three types of timing ability. The highest consistency of results showing atypical time perception abilities is found in high-level time perception studies. It remains unclear if autism is characterized by a fundamental time perception impairment. Suggestions for future research are discussed. Autism Res 2019, 12: 1440-1462. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This systematic review examines the different types of timing and time perception behavior that have been investigated in autism. Overall, there are a number of studies that show differences between autistic and non-autistic individuals, but some studies do not find such differences. Group differences are more consistent across studies using complex tasks rather than simpler more fundamental timing tasks. We suggest that experiments across a range of timing tasks would be fruitful to address gaps in our knowledge.

"Relating through sameness": a qualitative study of friendship and social isolation in chronic traumatic brain injury.

Social isolation has been described as a common problem among traumatic brain injury (TBI) survivors during the chronic phase. Due to physical, cognitive and behavioural changes, survivors become less socially active and experience a marked decrease in the number of friends. The goal of this investigation is to explore TBI survivors' subjective account of the challenges encountered in sustaining friendships, as well as gaining insight into their particular understanding of such difficulties. Using a thematic analysis approach, 11 survivors of TBI were interviewed in relation to their experience of social isolation and friendship during the chronic stage. Four main themes emerged from the interviews: (1) The impact of long-term cognitive and behavioural problems on relationships; (2) Loss of old friends; (3) Difficulties making new friends, and (4) Relating to other survivors in order to fight social isolation (sameness). Clinical implications of these findings, as well as their relevance in the design of long-term rehabilitation programmes, are discussed. Particular emphasis is placed on the need to acknowledge the value of relating to other survivors, as a way of resisting cultural discourses about disability, and as a source of self-cohesion in the process of identity re-construction.