Perspectives of Former Students with ASD from Australia and New Zealand on Their University Experience.

The university experience of students with ASD was explored through a qualitative study of 11 former university students and six significant others from Australia and New Zealand. A range of key issues were identified including difficulties encountered when studying, reasons for completion and non-completion, supports used, and coping strategies used by the participants. Many switched to part-time to manage their poor mental health and/or executive function and most had slow rates of progress. Also, some felt they had made poor discipline choices. The participants offered suggestions for future students and for making universities more autism friendly, and the possible need for transition and more structured study supports was identified.

Partner Perceptions of Conversations with Individuals with Autism Spectrum Disorder.

Pragmatic difficulties resulting in problems with reciprocal conversation are widely studied in individuals with autism spectrum disorder (ASD). There is some consensus on the conversation differences between individuals with autism compared to neurotypical groups and groups with other developmental delays. There is little information on whether conversation partners (neurotypical or with ASD) of individuals with ASD find these differences problematic. The results indicate that behaviors reported to be the most problematic were not necessarily behaviors commonly addressed in research. Further, some conversational capacities that have received less research focus were perceived as more problematic. Although conversation partners who had ASD themselves reported the frequency of behaviors similarly to the neurotypical group, they did not find the behaviors as problematic.

An On-Line Survey of University Students with Autism Spectrum Disorder in Australia and New Zealand: Characteristics, Support Satisfaction, and Advocacy.

An on-line survey of 102 (51 females; undergraduate and graduate) university students with ASD across Australia and New Zealand examined student characteristics and satisfaction with academic and non-academic supports. A broad range of disciplines were studied, and the participants' reported strengths included a passion for learning, strong technology skills, and creative thoughts. The participants' greatest concerns were academic requirements and mental health, including high rates of self-harm and suicidal ideation. Despite support satisfaction ratings being high, support usage was low, possibly indicating a mismatch of supports and needs, lack of awareness of available supports, and/or poor advocacy skills.

A Systematic Literature Review of Empirical Research on Postsecondary Students with Autism Spectrum Disorder.

The findings from a systematic literature review of 24 empirical studies of interventions for post-secondary students with autism spectrum disorder (ASD) are reported in this study. A diverse range of interventions were examined, many of which appeared feasible and high rates of participant satisfaction were also reported. Differing responses within and among interventions may point to the possible need for individualized supports. Few studies analyzed a specific academic support despite many students with ASD indicating they prefer these supports and that they find them useful. This may highlight the need for participant preferences to be given more consideration when designing supports. Most studies were of poor quality, however, so any conclusions are tentative. Directions for future research were discussed.

Instruments to Evaluate Nurse Residency Programs: A Review of the Literature.

The purpose of this literature review was to explore evaluation instruments used by nurse residency programs to evaluate outcomes. The 15 studies found yielded 26 instruments, and all instruments were subjective, dated, and varied in how they were used. Nursing professional development practitioners should use a combination of reliable, valid, and current evaluation methods to appraise their nurse residency programs in order to demonstrate program quality and effectiveness.

Perspectives of University Students with Autism Spectrum Disorder.

Students with autism spectrum disorder (ASD) are at heightened risk of post-secondary educational failure and account for approximately 1% of students in post-secondary education. Findings from an on-line survey of students with ASD attending university in Australian are reported in this study. Respondents indicated high rates of academic and non-academic difficulties but low usage of supports. Ratings for supports were idiosyncratic, and some students indicated discomfort from using supports or disclosing their disability. Those students who delayed their disclosure accessed fewer supports and reported a poorer overall university experience. Recommendations were made including the need for better transition support and alternative strengths based approaches that use more flexible and individualised curriculum designs.

Friendship Satisfaction in Children with Autism Spectrum Disorder and Nominated Friends.

The current study examined the level of friendship satisfaction of children with autism spectrum disorder (ASD) and their nominated friends (with and without diagnosis of ASD). A total of 77 target children with ASD and friends from 49 nominated friendships participated in the study. Relatively high levels of friendship satisfaction were reported by both target children and their nominated friends with no overall difference between dyads involving typically developing friends and friends with ASD. Analysis at the individual dyad level showed a high level of agreement on the reported level of satisfaction across the target participants and their friends. Limitations and directions for future research are presented.

Using the Choiceboard Creator™ app on an iPad© to teach choice making to a student with severe disabilities.

This paper describes an intervention to teach the use of the Choiceboard Creator app on an iPad for choice making to a student with autism, severe intellectual disability, and challenging behavior. This app provides flexibility in the number of pictures and blank distractors displayed, produces voice output, shuffles the picture arrangement after each activation, and makes the selected picture more salient by enlarging it once it has been selected. The effectiveness of the intervention was explored using a multiple baseline across three settings. Pre- and post-assessments of the student's ability to select a picture given the spoken word or the object and to select the object given the spoken word or the picture explored the further development of picture skills. The student learned to use a display of three pictures in free play, a display of two pictures in morning circle, and a display of five pictures at morning tea.

Perceived Friendship Quality of Children with Autism Spectrum Disorder as Compared to their Peers in Mixed and Non-mixed Dyads.

There has been limited research exploring the similarity of perception of friendship quality between children with Autism Spectrum Disorder (ASD) and their friends. In this study, 45 children with ASD participated together with their friends. Two levels of friendship quality congruency were investigated: reciprocity and mutuality. A high proportion of the friendships were reciprocated for both the mixed and non-mixed friendship groups. Nevertheless, students with ASD reported substantial differences in perceptions of their friendship quality as compared to their nominated friends. The findings of the present study mirrored those of previous research with typically developing children. Further study is required to systematically investigate the differences in friendship quality perceptions within friendship dyads for both typically developing children and those with ASD diagnosis.

Systematic review of sensory integration therapy for individuals with disabilities: Single case design studies.

Sensory integration therapy (SIT) is a controversial intervention that is widely used for people with disabilities. Systematic analysis was conducted on the outcomes of 17 single case design studies on sensory integration therapy for people with, or at-risk of, a developmental or learning disability, disorder or delay. An assessment of the quality of methodology of the studies found most used weak designs and poor methodology, with a tendency for higher quality studies to produce negative results. Based on limited comparative evidence, functional analysis-based interventions for challenging behavior were more effective that SIT. Overall the studies do not provide convincing evidence for the efficacy of sensory integration therapy. Given the findings of the present review and other recent analyses it is advised that the use of SIT be limited to experimental contexts. Issues with the studies and possible improvements for future research are discussed including the need to employ designs that allow for adequate demonstration of experimental control.

A Review of the Use of Touch-Screen Mobile Devices by People with Developmental Disabilities.

This article presents a review of the research on the use of mobile touch-screen devices such as PDAs, iPod Touches, iPads and smart phones by people with developmental disabilities. Most of the research has been on very basic use of the devices as speech generating devices, as a means of providing video, pictorial and/or audio self-prompting and for leisure activities such as listening to music and watching videos. Most research studies were small-n designs that provided a preponderant level of research evidence. There is a clear need for more research with younger participants and with a much wider range of apps, including educational apps.

Modulation of intracortical inhibition in response to acute psychosocial stress is impaired among individuals with chronic neck pain.

OBJECTIVE: Psychosocial stress has been associated with a variety of chronic pain disorders although the mechanisms responsible for this relationship are unknown. The purpose of this study was to compare the excitability of intracortical and corticospinal pathways to the trapezius muscle in individuals with and without chronic neck pain during exposure to low and high levels of psychosocial stress. METHODS: Single and paired-pulse transcranial magnetic stimulation was used to assess motor evoked potentials (MEPs) and short-interval intracortical inhibition (SICI) during mental math performed in the presence and absence of social evaluative threat. RESULTS: All participants demonstrated higher amplitude MEPs in the high stress compared to the low stress condition (p < 0.01). Participants with chronic neck pain had significantly greater SICI than healthy participants in the low stress condition (p = 0.03). During exposure to the stressor, healthy participants showed an increase in SICI, whereas participants with neck pain showed no change (group difference for change in SICI, p < 0.01). CONCLUSIONS: These findings suggest that individuals with chronic neck pain inhibit motor output to the trapezius in the presence of minor stressors, and are unable to compensate for additional stress-evoked increases in corticospinal excitability through further modulation of SICI. This observation has potential implications for the management of patients who have difficulty relaxing painful muscles during times of stress.

Health-related quality of life before and after pediatric epilepsy surgery: the influence of seizure outcome on changes in physical functioning and social functioning.

Health-related quality of life (HRQOL) is an important outcome in pediatric epilepsy surgery, but there are few studies that utilize presurgical ratings to assess the effect of surgery on HRQOL. We collected parental ratings on the Quality of Life in Childhood Epilepsy (QOLCE) questionnaire for 28 children who participated in neuropsychological assessment before and after epilepsy surgery. Our results revealed significant improvements in overall HRQOL after surgery, especially in physical and social activities. These changes were apparent despite generally unchanged intellectual and psychological functioning. Children with better seizure outcome had more improvement in HRQOL; however, improvements were not statistically different among children with Engel class I, II, and III outcomes. Our results suggest that children can experience significant improvements in HRQOL following epilepsy surgery even when neuropsychological functioning remains unchanged. Moreover, improvements in HRQOL appear evident in children who experience any worthwhile improvement in seizure control (Engel class III or better).

Dependence of the paired motor unit analysis on motor unit discharge characteristics in the human tibialis anterior muscle.

The paired motor unit analysis provides in vivo estimates of the magnitude of persistent inward currents (PIC) in human motoneurons by quantifying changes in the firing rate (ΔF) of an earlier recruited (reference) motor unit at the time of recruitment and derecruitment of a later recruited (test) motor unit. This study assessed the variability of ΔF estimates, and quantified the dependence of ΔF on the discharge characteristics of the motor units selected for analysis. ΔF was calculated for 158 pairs of motor units recorded from nine healthy individuals during repeated submaximal contractions of the tibialis anterior muscle. The mean (SD) ΔF was 3.7 (2.5)pps (range -4.2 to 8.9 pps). The median absolute difference in ΔF for the same motor unit pair across trials was 1.8 pps, and the minimal detectable change in ΔF required to exceed measurement error was 4.8 pps. ΔF was positively related to the amount of discharge rate modulation in the reference motor unit (r² = 0.335; P<0.001), and inversely related to the rate of increase in discharge rate (r² = 0.125; P<0.001). A quadratic function provided the best fit for relations between ΔF and the time between recruitment of the reference and test motor units (r² = 0.229, P<0.001), the duration of test motor unit activity (r² = 0.110, P<0.001), and the recruitment threshold of the test motor unit (r² = 0.237, P<0.001). Physiological and methodological contributions to the variability in ΔF estimates of PIC magnitude are discussed, and selection criteria to reduce these sources of variability are suggested for the paired motor unit analysis.

Discharge rate modulation of trapezius motor units differs for voluntary contractions and instructed muscle rest.

This study examined discharge rate modulation at respiratory (0-0.5 Hz) and beta (16-32 Hz) frequencies in trapezius motor units active during voluntary contractions and during periods of instructed rest under conditions of low and high psychosocial stress. In separate sessions, single motor unit activity was recorded from the trapezius muscle of healthy women during low-intensity voluntary contractions and during periods of instructed muscle rest that followed voluntary contractions. The level of psychosocial stress during periods of instructed muscle rest was manipulated using a verbal math task combined with social evaluative threat which increased perceived anxiety, heart rate, and blood pressure (P ≤ 0.002). Discharge rate modulation was quantified by the mean power of motor unit discharge rate profiles within frequency bands of interest. Under low stress conditions, motor units active during instructed rest had greater power at 0-0.5 Hz (P = 0.002) and less power at 16-32 Hz (P = 0.009) compared to those active during voluntary contraction. Exposure to the stressor increased the amount of motor unit activity during instructed rest (P = 0.021) but did not alter the power of discharge rate modulation at 0-0.5 Hz (P = 0.391) or 16-32 Hz (P = 0.089). These results indicate that sustained motor unit activity during periods of instructed muscle rest has a lesser contribution from inputs at beta frequencies and a greater contribution from inputs at respiratory frequencies than present during low-intensity voluntary contractions. Furthermore, increases in motor unit activity when exposed to stressors during periods of instructed rest are not caused by changes in inputs at respiratory or beta frequencies.

Discharge behaviors of trapezius motor units during exposure to low and high levels of acute psychosocial stress.

This study investigated the effects of acute psychosocial stress on trapezius single motor unit discharge behaviors. Twenty-one healthy women performed feedback-controlled isometric contractions under conditions of low and high psychosocial stress in the same experimental session. Psychosocial stress was manipulated using a verbal math task combined with social evaluative threat that significantly increased perceived anxiety, heart rate, and blood pressure (P < 0.001). Motor unit discharge behaviors including the threshold and discharge rate at recruitment [7.7% (5.7%) maximal voluntary isometric contraction and 7.3 pulses per second (pps) (6.8 pps), P > 0.121, N = 103] and derecruitment [6.0% (4.4%) maximal voluntary isometric contraction and 6.5 pps (4.1 pps), P > 0.223, N = 99], the mean [11.3 pps (2.3 pps), P = 0.309, N = 106] and variability [2.5 pps (0.91 pps), P = 0.958, N = 106] of discharge rate, and the proportion of motor units exhibiting double discharges (21%, P = 0.446) did not change across stress conditions. Discharge rate modulation with changes in contraction intensity was highly variable and similar across stress conditions (P > 0.308, N = 89). Rate-rate modulation of concurrently active motor units was also highly variable (r = -0.84 to 1.00, N = 75). Estimates of DeltaF for motor unit pairs with rate-rate modulation >or=0.7 were positive and similar across stress conditions [4.7 pps (2.0 pps), P = 0.405, N = 16]. The results indicate that acute psychosocial stress does not alter trapezius motor unit discharge behaviors during a precisely controlled motor task in healthy women.

The effect of arm movements on the lower limb during gait after a stroke.

The purpose of this study was to examine the influence of arm movements on lower limb movement and muscle activation during treadmill walking after a stroke. Ten high functioning stroke and 10 healthy subjects walked on a treadmill while swinging their arms naturally, and while holding onto handles that were either fixed in place or allowed to slide along horizontal handrails. Full-body kinematics were recorded, along with bilateral surface electromyography from lower limb muscles. Arm movements influenced lower limb muscle activity but had little effect on movement patterns at the joints. When handrails were present a small amount of weight was borne through the upper limbs, and for stroke subjects this was reduced when the handles were free to slide. Activity of proximal leg muscles during stance was affected by the weight borne through the upper limbs, increasing when arm movements were performed. Soleus activity during stance was greatest with unsupported arm movements. In stroke subjects, early stance tibialis anterior activity in the paretic leg was greatest with no arm movements, and early swing tibialis anterior activity in both legs was greatest with unsupported arm movements. Many of the changes in muscle activation appeared to be due to changes in postural stability that occurred when performing arm movements. Overall, results support further study of the long-term changes associated with the inclusion of arm movements in gait rehabilitation protocols.

Iconicity in the development of picture skills: typical development and implications for individuals with severe intellectual disabilities.

The iconicity of graphic symbols and the iconicity hypothesis are theoretical concepts that have had an impact on the use of augmentative and alternative communication strategies for people with severe intellectual disabilities. This article reviews some of the recent literature on the impact of iconicity on symbol recognition and use by typically developing children and relates those findings to people with severe disability. It seems that although iconicity may have some impact on symbol learning, there are other variables that are likely to be much more important. It is likely that iconicity is not helpful to those learning graphic symbols who have little or no comprehension of spoken language.

Picture-book reading as an intervention to teach the use of line drawings for communication with students with severe intellectual disabilities.

Picture-book reading provides an effective intervention context for young children learning spoken language and may also be appropriate for teaching the use of augmentative and alternative communication to children with severe intellectual disabilities. This study reports on a group intervention using a semiscripted book reading routine implemented by a teacher in a classroom for students with severe intellectual disabilities. Student use of line drawings was observed over the course of the intervention. Students' abilities to match words, line drawings, book illustrations, and real objects were assessed weekly. There were differences between baseline and intervention performances for all students, and these differences were particularly noticeable for one student.

Recognition and use of line drawings by children with severe intellectual disabilities: the effects of color and outline shape.

Communication symbols for students with severe intellectual disabilities often take the form of computer-generated line drawings. This study investigated the effects of the match between color and shape of line drawings and the objects they represented on drawing recognition and use. The match or non-match between color and shape of the objects and drawings did not have an effect on participants' ability to match drawings to objects, or to use drawings to make choices.