Odour detection in children and young people with profound intellectual and multiple disabilities.

BACKGROUND: Olfaction provides information on very important dimensions of the environment; however the olfactory abilities of children and young people with profound intellectual and multiple disabilities (PIMD) remain largely unknown. This within-subjects study explores olfactory detection abilities in children with PIMD. METHOD: Twenty-two children and young people with PIMD (7-18 years) were presented with 18 medium intensity odours and an odourless control stimulus. Odorants were presented one by one in a randomised order. The neutral stimulus was presented prior to each odorant. Participants' responses were measured using 21 behavioural indicators. RESULTS: Results show that participants make a clear distinction between odorous and neutral conditions, between food and non-food, and between pleasant and unpleasant odours. The detection abilities are manifested by several behaviours, in particular by the duration of the head alignment on the odorant. CONCLUSIONS: This study shows that participants detect the stimuli and act differently depending on the category.

Looking back, looking forward: Methodological challenges and future directions in research on persons with profound intellectual and multiple disabilities.

BACKGROUND: Within the context of the Special Interest Research Group (SIRG) on Persons with Profound Intellectual and Multiple Disabilities (PIMD), researchers often discuss the methodological problems and challenges they are confronted with. The aim of the current article was to give an overview of these challenges. METHODS: The challenges are centred on six topics. These reflect the main components of a study's design: (a) participant demarcation, (b) participant recruitment, (c) data collection and instruments, (d) data analysis, (e) ethics/including the "voice" of persons with PIMD and (f) theoretical models. RESULTS: Next, to describing the specific challenges, possible solutions and pathways to address them are discussed. These are illustrated by recent studies by the authors and other researchers in the field. CONCLUSIONS: The current contribution wants to stimulate further discussion and exchange of ideas, and the development of creative research techniques.

Visual and Hedonic Perception of Food Stimuli in Children with Autism Spectrum Disorders and their Relationship to Food Neophobia.

The present study examined whether children with autism spectrum disorder (ASD) and typically developing (TD) children differed in visual perception of food stimuli at both sensorimotor and affective levels. A potential link between visual perception and food neophobia was also investigated. To these aims, 11 children with ASD and 11 TD children were tested. Visual pictures of food were used, and food neophobia was assessed by the parents. Results revealed that children with ASD explored visually longer food stimuli than TD children. Complementary analyses revealed that whereas TD children explored more multiple-item dishes (vs. simple-item dishes), children with ASD explored all the dishes in a similar way. In addition, children with ASD gave more negative appreciation in general. Moreover, hedonic rating was negatively correlated with food neophobia scores in children with ASD, but not in TD children. In sum, we show here that children with ASD have more difficulty than TD children in liking a food when presented visually. Our findings also suggest that a prominent factor that needs to be considered is time management during the food choice process. They also provide new ways of measuring and understanding food neophobia in children with ASD.

Olfactive short-term habituation in children and young people with profound intellectual and multiple disabilities.

BACKGROUND: Despite its importance for learning, the existence of the habituation process and its characteristics in people with profound intellectual and multiple disabilities (PIMD) remains understudied. Habituation is, however, considered the simplest form of learning, and a significant neuroadaptive mechanism. Even though habituation occurs in all sensory modalities, the olfactory system is where it manifests itself very visibly. AIM: This study explores the olfactory short-term habituation abilities of children and young people with PIMD. METHOD: Twenty children and young people with PIMD (7-18 years) were presented six times successively with a 30-second habituating olfactory stimulus. The interstimulus interval was 15 s. A new odour was presented on the seventh trial. The scenario was carried out two times with two pairs of stimuli. The participants' head alignment duration on the odour was measured. RESULTS: Seventeen participants out of 20 manifested a decline in response, which reached about 50 % between the first and sixth presentation of the habituation odour. All habituators also showed a distinctive response when exposed to a novel odour. The participants who did not habituate showed a strong, non-fluctuating response to the stimulus throughout the presentations. Three participants only habituated to one of the two habituation stimuli. CONCLUSION AND IMPLICATIONS: The results raise theoretical, scientific, and practical issues. They question the factors explaining olfactory habituation mechanisms, namely the stimulus properties and the severity of impairment, reveal the need for points of comparison for interpreting this population's responses, and point to the consequences of stimuli repetition and or variety in therapeutic or educational settings for these individuals' learning and cognitive functioning.

Odor hedonic responses in children and young people with profound intellectual and multiple disabilities.

Introduction: Odors are closely linked to emotions, play an important role in the well-being of individuals and can influence mood. Despite these crucial properties, the hedonic responses to odors of people with profound intellectual and multiple disabilities (PIMD) remain little explored. Aim: This within-subjects study aims to examine whether children and young people with PIMD react in a differentiated way to odors evaluated as pleasant or unpleasant by neurotypical adults and, if so, with which behaviors. The influence of their global mood on their emotional responses to odors is also examined. Method: Twenty children and young people (7-18 years old) with PIMD were exposed to four pairs of hedonically contrasted odors. A control stimulus was presented before each odorant. Five emotional responses, one physiological reaction (nausea reactions), and three responses reflecting approach toward or avoidance of the stimulus were recorded throughout the duration of the stimulus exposure. The participants' global mood status was measured before the start of the research with the French version of the Mood, Interest and Pleasure Questionnaire (Ross and Oliver, 2003). Results: The results show that when exposed to pleasant odorants, participants kept their heads aligned with the odorant source longer, smiled longer, and produced more positive vocalizations. In contrast, unpleasant odorants elicit more pouts and grimaces. Nausea reactions occurred in the presence of unpleasant odorants. The hedonic responses were more marked during the second presentation of the stimuli. Participants with a higher MIPQ score showed significantly more emotional reactions to odors. Conclusion: The results confirm the presence of olfactory preferences in participants with PIMD and the existence of a link between their mood, emotions and olfactory hedonic processing. They prompt the use of odors to support not only the cognitive development of this population, but also their mood and their emotional regulation abilities.

Development and preliminary validation of the Self-Awareness Situation-Based Observation Lists for children with Profound Intellectual and Multiple Disabilities.

BACKGROUND: A primary, pre-reflective form of self-awareness develops during the first two years of life, through sensory perceptions and bodily and social experiences. Although this is a central dimension in the development of children with PIMD, no tools are available to guide caregivers' observations. AIMS: To present the development procedure and the results of the first validation step of a battery aimed at direct observation of primary self-awareness behaviors in children with PIMD. METHODS AND PROCEDURE: We built a criterion-referenced tool composed of five scales proposed in two complementary lists. The first list comprises inducing standardized tasks; the second natural observation situations. The battery was administered three times to 18 children with PIMD. OUTCOMES AND RESULTS: The inducing tasks list was shown to be reliable, with good internal consistency, inter- and intra-rater reliability, high procedural reliability and high test-retest reliability. The natural observation situations list has a lower internal consistency, but high test-retest reliability. The social validity of both lists is deemed to be excellent. CONCLUSION AND IMPLICATIONS: The tool looks promising. Even if these first results need to be confirmed by further research, it opens up perspectives for assessment and intervention on a key dimension of human functioning.

Evaluating implementation outcomes of a measure of social vulnerability in adults with intellectual disabilities.

BACKGROUND: A test identified as valid and accurate in research will not automatically be considered appropriate by those involved in its use, or even be used in the first place. The Social Vulnerability Test-22 items [TV-22] is a measure specially designed for adults with intellectual disabilities (ID). This study aims to evaluate the implementation outcomes of the TV-22; more precisely its acceptability (e.g., complexity), appropriateness (e.g., perceived relevance) and the assessment fidelity (i.e., adherence to assessment guidelines) by special education practitioners. PROCEDURES: Thirty-one practitioners (8 psychologists, 11 educators, 12 special education center managers) administered the TV-22 during an interview with an adult with ID. Semi-structured interviews were conducted to collect practitioners' opinions on the acceptability and the appropriateness of the TV-22 for their clinical practice. Quantitative analyses were performed to assess the fidelity of the assessments and the influence of some personal factors. RESULTS: The results indicate a good appropriateness, a reasonable acceptability, - but a low assessment fidelity of the TV-22 by some practitioners. Psychologists stand out for a more rigorous use of the test. IMPLICATIONS: Results highlight the importance of evaluating implementation outcomes when a new measure is developed to ensure its appropriateness and correct use by stakeholders.

Effects of familiarization on odor hedonic responses and food choices in children with autism spectrum disorders.

This study assessed whether olfactory familiarization can render food odors more pleasant, and consequently food more attractive, to children with autism spectrum disorder. Participants were first presented with a series of food odors (session 1). Then, they were familiarized on four occasions (time window: 5 weeks) with one of the two most neutral odors (the other neutral odor was used as control) (session 2). In session 3, participants smelled the entire series of odors again. Both verbal and facial responses were compared from session 1 to session 3. After session 3, the children were presented with two identical foods (one containing the familiarized odor and one the control odor) and were asked to choose between these foods. Results revealed (1) a specific increase in positive emotions for the familiarized odor and (2) that 68% of the children chose the food associated with the "familiarized odor" (children who chose the "familiarized odor" food exhibited significantly more sensory particularities). These findings suggest that it is possible to modulate olfactory emotions and expand the dietary repertoire of children with autism spectrum disorder. Application of this paradigm may enable innovative prospects for food education in autism.

Odor Perception in Children with Autism Spectrum Disorder and its Relationship to Food Neophobia.

Atypical sensory functioning in Autism Spectrum Disorder (ASD) has been well documented in the last decade for the visual, tactile and auditory systems, but olfaction in ASD is still understudied. The aim of the present study was to examine whether children with ASD and neuro-typically (NT) developed children differed in odor perception, at the cognitive (familiarity and identification ability), sensorimotor (olfactory exploration) and affective levels (hedonic evaluation). Because an important function of the sense of smell is its involvement in eating, from food selection to appreciation and recognition, a potential link between odor perception and food neophobia was also investigated. To these ends, 10 children between 6 and 13 years old diagnosed with ASD and 10 NT control children were tested. To compare performance, 16 stimuli were used and food neophobia was assessed by the parents on a short food neophobia scale. Results revealed that (i) significant hedonic discrimination between attractive and aversive odors was observed in NT (p = 0.005; d = 2.378) and ASD children (p = 0.042; d = 0.941), and (ii) hedonic discrimination level was negatively correlated with food neophobia scores in ASD (p = 0.007) but not NT children. In conclusion, this study offers new insights into odor perception in ASD children, highlighting a relationship between odor hedonic reactivity and eating behavior. This opens up new perspectives on both (i) the role of olfaction in the construction of eating behavior in ASD children, and (ii) the measurement and meaning of food neophobia in this population.