Digitally mediated service provision for children's social, emotional and mental health: key indicators for evaluation.

INTRODUCTION: Remote delivery of assessment, consultation and therapy via digital communication technologies in mental health services is important in rural locations, and has rapidly increased due to the COVID-19 pandemic. METHODS: This UK-based research investigated what factors should be considered in the development and evaluation of digitally mediated service provision for children and young people with social, emotional and mental health (SEMH) needs using two approaches: (1) a focus group with five young people (aged 16-19 years) and (2) an online survey with 18 parents/carers of primary-age children with SEMH difficulties. RESULTS: Getting help quickly was most important to both young people and parents/carers when accessing services, with having a say in their care of equal importance to young people but not parents/carers. Analysis identified participants' preferences and perceived positives and negatives of digitally mediated service provision. CONCLUSION: Digitally mediated service provision should be timely and patient-centred to be considered acceptable by young people with SEMH needs and their parents/carers. Evaluations should include comprehensive measures of service efficiency and service user experience to better understand the benefits of digital mediation.

Self-reported motivations for offending by autistic sexual offenders.

Autism spectrum disorder is a neurodevelopmental disorder estimated to have elevated prevalence in forensic populations (approximately 4.5%). It has been suggested that offenders with autism spectrum disorder engage more frequently in crimes against the person and sexual offences than other types of offences such as property, driving and drug offences. To date little is empirically known about the reasons why autistic individuals engage in sexual offences, yet understanding the motivation(s) for offending are key to developing and implementing effective interventions to help reduce both initial offending and also re-offending. In this study, semi-structured interviews were conducted with nine autistic sexual offenders in prisons and probation services across England and Wales. Thematic analyses revealed five main themes (social difficulties, misunderstanding, sex and relationship deficits, inadequate control and disequilibrium). Analyses indicated that social skills difficulties, lack of perspective/weak central coherence, misunderstanding the seriousness of their behaviours and a lack of appropriate relationships were the main reasons for offending reported by this group of autistic sexual offenders. Findings highlight a need to develop sex and relationship education interventions which are tailored to the needs of autistic individuals, to address both their reported reasons for offending and their reported lack of sexual knowledge and awareness.

Brief report: the relationship between visual acuity, the embedded figures test and systemizing in autism spectrum disorders.

Enhanced performance upon the Embedded Figures Test (EFT) in individuals with autism spectrum disorder (ASD) has informed psychological theories of the non-social aspects that characterise ASD. The Extreme Male Brain theory of autism proposes that enhanced visual acuity underpins greater attention to detail (assessed by the EFT) which is a prerequisite for Systemizing. To date, however, no study has empirically examined these relationships. 13 males with ASD and 13 male controls were assessed upon tasks argued to reflect these levels of processing. The ASD group were found to have significantly greater visual acuity, EFT performance and Systemizing ability than the control group. However, regression analysis revealed that the strongest relationship was between visual acuity and EFT performance.

Perceptual grouping abilities in individuals with autism spectrum disorder; exploring patterns of ability in relation to grouping type and levels of development.

This study further investigates findings of impairment in Gestalt, but not global processing in Autism Spectrum Disorder (ASD) [Brosnan, Scott, Fox, & Pye, 2004]. Nineteen males with ASD and nineteen typically developing (TD) males matched by nonverbal ability, took part in five Gestalt perceptual grouping tasks. Results showed that performance differed according to grouping type. The ASD group showed typical performance for grouping by proximity and by alignment, impairment on low difficulty trials for orientation and luminance similarity, and general impairment for grouping by shape similarity. Group differences were also observed developmentally; for the ASD group, with the exception of grouping by shape similarity, perceptual grouping performance was poorer at lower than higher levels of nonverbal ability. In contrast, no developmental progression was observed in the TD controls.

Digit ratio as an indicator of numeracy relative to literacy in 7-year-old British schoolchildren.

A great deal of recent research has focused upon the relationship between a hypothesized index of prenatal testosterone exposure, digit ratio and health, social and cognitive functioning. Many inconsistencies within the pattern of findings have been identified in the relationship between digit ratio and absolute levels of cognitive ability. Recent research has identified a relationship between digit ratio and basic numeric competency. This basic numerical competency has been argued to be influenced by biological factors. The present study extended this finding to academic assessment, namely the Standardized Assessment Tests undertaken in numeracy and literacy by children in the UK at the age of 7. The present study hypothesized that digit ratio would correlate with the relative difference between numeracy and literacy abilities. Digit ratios were calculated for 75 (mainly Caucasian) children aged between 6 and 7 attending a state funded infant school. The digit ratios were then correlated with the results from their National Standard Assessment Tests (SATs). A significant correlation was found as hypothesized. Additionally, there was a negative correlation between digit ratio and numeracy for males (indicating higher prenatal testosterone exposure related to higher numeracy SAT scores) and a positive correlation between digit ratio and literacy for females (indicating lower prenatal testosterone exposure related to higher literacy SAT scores). These effects were small and the implications for using digit ratio to facilitate understanding of hormonal influences upon academic attainment are discussed.

Digit ratio and faculty membership: implications for the relationship between prenatal testosterone and academia.

Digit ratio (length of index finger divided by length of ring finger) is an index of exposure to prenatal testosterone. Prenatal testosterone slows the growth rate of the left side of the brain while enhancing growth of the right side. Right hemisphere processing is associated with better visual-spatial and mathematical abilities, as is digit ratio. Thus, traditional sex differences in visual-spatial and mathematical abilities can be attributed to differences in exposure to prenatal testosterone, indexed by a sex dimorphic pattern in digit ratio (female=1.00, male=0.98 for UK samples). Additionally, the digit ratio is a marker for within-sex variance in visual-spatial ability. This study examines the digit ratio of an academic sample. No sex differences are found and there is a significant difference between the Science Faculty and Social Science Faculty. Social Scientists of both sexes have a ratio consistent with the male norm (0.98) whilst Scientists have a digit ratio consistent with the female norm (1.00). These results are discussed in terms of the lower normal range of male testosterone being associated with highest visual spatial abilities. Relationships with fertility and Dyslexia are also identified.

Gestalt processing in autism: failure to process perceptual relationships and the implications for contextual understanding.

BACKGROUND: Deficits in autism have been characterised as a bias towards local over global processing. This paper examines whether there is a deficit in gestalt grouping in autism. METHOD: Twenty-five low-functioning children with autism and 25 controls who were matched for chronological age and verbal mental age took part in the study. RESULTS: The autism group utilised gestalt grouping principles (proximity, similarity, closure) significantly less than the controls. Calculating an overall index of gestalt grouping, the autism group performed at chance level. There was also a deficit in identifying certain impossible figures. This pattern was not reflected in a drawing task, in which the autism sample conformed more to gestalt grouping principles than controls (non-significantly). CONCLUSIONS: The results are discussed in terms of a failure in autism to process inter-element relationships that would allow for the appreciation of larger perceptually coherent units that comprise of multiple elements and, consequently, context. The processes are argued to be preattentive.