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Open Access
Article
Publication date: 12 November 2019

Henny Kupferstein

The purpose of this paper is to explore why autistic people and their caregivers choose interventions other than applied behavior analysis (ABA), and how their decision impacts…

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Abstract

Purpose

The purpose of this paper is to explore why autistic people and their caregivers choose interventions other than applied behavior analysis (ABA), and how their decision impacts them over their lifespan. The focus group was divided into those who pursued augmentative and alternative communication (AAC)-based supports, received ABA, selected other interventions or received no intervention at all. The reported posttraumatic stress symptoms (PTSS) of ABA recipients were compared to non-ABA recipients in order to evaluate the long-term impacts of all intervention types. Using a mixed-method thematic analysis, optional comments submitted alongside a quantitative online survey were reviewed for emergent themes. These comments augmented the survey Likert scores with a qualitative impression of the diverse intervention-related attitudes among participants. Investigating the lived experiences of autism intervention recipients illuminated the scope of the long-term impacts of each intervention that was chosen. Overall, autistics who received no intervention fared best, based on the lowest reported PTSS. These findings may inform the potential redesign of autism interventions based on the firsthand reported experiences and opinions of autistics.

Design/methodology/approach

The aim of this study was to conduct research that is both question-driven and data-driven to aid in the analysis of existing data (Van Helden, 2013). In the research question-driven approach, the independent variables were the intervention type and duration of exposure relative to lifespan; the dependent variables were the PTSS severity score and binary indicator of meeting PTSS criteria. The analyses that were conducted included linear regression analyses of severity score on intervention type and duration, and χ2 tests for independence of the probabilities of PTSS criterion satisfaction and intervention type. This experiment was designed to test the data-driven hypothesis that the prevalence and severity of PTSS are dependent on the type of autism intervention and duration of exposure. After reviewing the primary data set, the data-driven inquiry determined that the sample for secondary analysis should be categorized by communication-based vs non-communication-based intervention type in order to best complement the limitations and strengths of the published findings from the primary analysis.

Findings

Autistics who received no intervention had a 59 percent lower likelihood of meeting the PTSS criteria when compared to their ABA peers, and they remained 99.6 percent stable in their reported symptoms throughout their lifespan (R2=0.004). ABA recipients were 1.74 times more likely to meet the PTSS criteria when compared to their AAC peers. Within the 23 percent who selected an intervention other than ABA, consisting of psychotherapy, mental health, son-rise and other varying interventions, 63 percent were asymptomatic. This suggests that the combined benefits of communication-based interventions over behaviorism-influenced ABA practices may contribute to enhanced quality of life. Although not generalizable beyond the scope of this study, it is indicated from the data that autistics who received no intervention at all fared best over their lifetimes.

Research limitations/implications

The obvious advantage of a secondary analysis is to uncover key findings that may have been overlooked in the preliminary study. Omitted variables in the preliminary data leave the researcher naive to crucially significant findings, which may be mitigated by subsequent testing in follow-up studies (Cheng and Phillips, 2014, p. 374). Frequency tables and cross-tabulations of all variables included in the primary analysis were reproduced. The secondary analysis of existing data was conducted from the design variables used in the original study and applied in the secondary analyses to generate less biased estimates (Lohr, 2010; Graubard and Korn, 1996). Inclusion criteria for each intervention group, PTSS scores and exposure duration, were inherited from the primary analysis, to allow for strategic judgment about the coding of the core variables pertaining to AAC and PTSS. The data sample from 460 respondents was reduced to a non-ABA group of n=330. An external statistician scored each respondent, and interrater reliability was assessed using Cohen’s κ coefficient (κ=1).

Practical implications

Including the autistic voice in the long-term planning of childhood interventions is essential to those attempting to meet the needs of the individuals, their families and communities. Both parents and autistic participant quotes were obtained directly from the optional comments to reveal why parents quit or persisted with an autism intervention.

Social implications

Practitioners and intervention service providers must consider this feedback from those who are directly impacted by the intervention style, frequency or intensity. The need for such work is confirmed in the recent literature as well, such as community-based participatory research (Raymaker, 2016). Autistics should be recognized as experts in their own experience (Milton, 2014). Community–academic partnerships are necessary to investigate the needs of the autistic population (Meza et al., 2016).

Originality/value

Most autistic people do not consider autism to be a mental illness nor a behavior disorder. It is imperative to recognize that when injurious behavior persists, and disturbance in mood, cognition, sleep pattern and focus are exacerbated, the symptoms are unrelated to autism and closely align to the diagnostic criteria for posttraumatic stress disorder (PTSD). When PTSD is underdiagnosed and untreated, the autistic individual may experience hyperarousal and become triggered by otherwise agreeable stimuli. Since autism interventions are typically structured around high contact, prolonged hours and 1:1 engagement, the nature of the intervention must be re-evaluated as a potentially traumatic event for an autistic person in the hyperarousal state. Any interventions which trigger more than it helps should be avoided and discontinued when PTSS emerge.

Details

Advances in Autism, vol. 6 no. 1
Type: Research Article
ISSN: 2056-3868

Keywords

Open Access
Article
Publication date: 4 July 2018

Yvonne van Zaalen, Mary McDonnell, Barbara Mikołajczyk, Sandra Buttigieg, Maria del Carmen Requena and Fred Holtkamp

The purpose of this paper is to focus on ethical and judicial themes related to technology and the older adults.

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Abstract

Purpose

The purpose of this paper is to focus on ethical and judicial themes related to technology and the older adults.

Design/methodology/approach

Different consecutive phases in technology design and allocation will be discussed from a range of perspectives.

Findings

Longevity is one of the greatest achievements of contemporary science and a result of development of social relations. Currently, various non-communicable diseases affect older adults and impose the greatest burden on global health. There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for good quality of life (QOL). The concept of assisting the older adult through the use of technology so as to access healthcare services has enormous potential. Although the potential of technology in healthcare is widely recognised, technology use can have its downsides. Professionals need to be aware of the risks, namely, those related to the privacy of the older person, which may accompany technology use.

Research limitations/implications

By 2050, there will be more people aged over 65 than there are children. This phenomenon of global ageing constitutes a massive challenge in the area of health protection.

Practical implications

Professionals need to be aware of the risks, for example, related to the privacy of the older person, that may accompany technology use.

Social implications

There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for QOL.

Originality/value

The concept of assisting the older adult through the use of technology to avail of healthcare has enormous potential. Assistive technology, social media use and augmentative and alternative communication can have a positive effect on the QOL of older people, as long as they are supported enough in use of these technologies. However, ethical and juridical considerations are at stake as well.

Details

Journal of Enabling Technologies, vol. 12 no. 2
Type: Research Article
ISSN: 2398-6263

Keywords

Open Access
Article
Publication date: 8 March 2022

Karen Bunning, Joseph Karisa Gona, Charles Richard Newton and Sally Hartley

Raising a child with learning and developmental disabilities in a low-income setting is challenged by inadequate resources, limited support and poverty. The impacts on caregivers…

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Abstract

Purpose

Raising a child with learning and developmental disabilities in a low-income setting is challenged by inadequate resources, limited support and poverty. The impacts on caregivers include fatigue, distress and isolation. The purpose of this paper is to report on a programme (2008-2021) that was set up in Kilifi County, Kenya to investigate and address these difficulties.

Methodology

The programme used mixed methods through a series of interconnected studies, starting with a situation analysis, followed by a home-based intervention where the caregiver served as agent for change using augmentative and alternative communication (AAC) methods. This was followed by two community-based inclusive development initiatives: disability awareness training to community groups and empowering self-help groups for caregivers of children growing up with disabilities.

Findings

The situation analysis revealed scarce support services for caregivers and children with learning and developmental disabilities, with report of limited resources, inadequate coverage and poor professional practice. A home-based, AAC intervention was associated with improved caregiver well-being, significant positive changes to caregiver perceptions of the child’s communication and some expansion to the child’ social activities. However, questions around sustainability persisted. Disability awareness training led by persons with lived experience of disability showed positive changes to the views, values and attitudes of established community groups. Caregiver participation in self-help groups was associated with their greater personal agency, perceptions of increased social support and reduced severity of child’s disability.

Originality

The programme narrative demonstrates a rationalised and evidence-based process for community-based inclusive development that is low cost, culturally acceptable, with potential for sustainability.

Details

Tizard Learning Disability Review, vol. 27 no. 1
Type: Research Article
ISSN: 1359-5474

Keywords

Open Access
Article
Publication date: 30 September 2015

Lucia Parisi, Teresa Di Filippo and Michele Roccella

Cornelia de Lange syndrome (CdLS) is a congenital disorder characterized by distinctive facial features, growth retardation, limb abnormalities, intellectual disability, and

Abstract

Cornelia de Lange syndrome (CdLS) is a congenital disorder characterized by distinctive facial features, growth retardation, limb abnormalities, intellectual disability, and behavioral problems. Cornelia de Lange syndrome is associated with abnormalities on chromosomes 5, 10 and X. Heterozygous point mutations in three genes (NIPBL, SMC3 and SMC1A), are responsible for approximately 50-60% of CdLS cases. CdLS is characterized by autistic features, notably excessive repetitive behaviors and expressive language deficits. The prevalence of autism spectrum disorder (ASD) symptomatology is comparatively high in CdLS. However, the profile and developmental trajectories of these ASD characteristics are potentially different to those observed in individuals with idiopathic ASD. A significantly higher prevalence of self-injury are evident in CdLS. Self-injury was associated with repetitive and impulsive behavior. This study describes the behavioral phenotype of four children with Cornelia de Lange syndrome and ASDs and rehabilitative intervention that must be implemented.

Details

Mental Illness, vol. 7 no. 2
Type: Research Article
ISSN: 2036-7465

Keywords

Open Access
Article
Publication date: 24 January 2024

Giulio Lancioni, Gloria Alberti, Francesco Pezzuoli, Juri Bruciati, Nirbhay Singh, Mark O'Reilly and Jeff Sigafoos

This study assessed two technology systems aimed at enabling a man with intellectual disability, blindness, deafness and motor and tactile discrimination problems to make verbal…

Abstract

Purpose

This study assessed two technology systems aimed at enabling a man with intellectual disability, blindness, deafness and motor and tactile discrimination problems to make verbal requests through simple one-hand signs.

Design/methodology/approach

The study was conducted according to an ABAB design. During the B (intervention) phases, the man used the two systems, which included (1) nine mini recording devices fixed on the man’s clothes or wheelchair (i.e. in positions the man touched with his sign movements) and (2) nine tags with radio frequency identification codes (fixed at approximately the same positions as the mini recording devices) and a dedicated tag reader, respectively. Making a sign (i.e. touching a recording device or reaching a tag) led to the verbalization of the request related to that sign.

Findings

During baseline, the mean frequency of signs/requests made was below 2 per session, and only some of those requests were identified/satisfied. During the intervention, the mean frequency of requests made and satisfied was about 10 per session with each of the systems.

Originality/value

The results, which are to be taken with caution given the preliminary nature of the study, seem to suggest that the systems can help translate simple signs into verbal requests.

Details

Journal of Enabling Technologies, vol. 18 no. 1
Type: Research Article
ISSN: 2398-6263

Keywords

Open Access
Article
Publication date: 15 August 2022

Ana Junça Silva, Patrícia Neves and António Caetano

This study draws on the affective events theory (AET) to understand how telework may influence workers' well-being. Hence this study aimed to (1) analyze the indirect relationship…

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Abstract

Purpose

This study draws on the affective events theory (AET) to understand how telework may influence workers' well-being. Hence this study aimed to (1) analyze the indirect relationship between telework and well-being via daily micro-events (DME), and (2) test whether procrastination would moderate this indirect effect.

Design/methodology/approach

To test the goals, data were gathered from a sample of teleworkers in the IT sector (N = 232). To analyze the data, a moderated mediation analysis was performed in SPSS with PROCESS macro.

Findings

The results showed that micro-daily events mediated the positive relationship between telework and well-being; however, this relation was conditional upon the levels of workers' levels of procrastination, that is, this link became weaker for those who were procrastinators.

Practical implications

By highlighting the importance of telework, DME and procrastination, this study offers managers distinct strategies for enhancing their employees' well-being.

Originality/value

Despite the existing research investigating the effect of telework on well-being, studies investigating the intervening mechanisms between these two constructs are scarce. Moreover, there is a lack of research investigating the moderating effect of procrastination in these relations. Hence, this study fills these gaps and advances knowledge on the process that explains how (via DME) and when (when procrastination is low) teleworking influences workers' well-being.

Details

International Journal of Manpower, vol. 45 no. 1
Type: Research Article
ISSN: 0143-7720

Keywords

Open Access
Article
Publication date: 14 May 2020

Kamilla Klefbeck

This study aim was to analyze how lesson study can enhance learning for students with intellectual disability, and how teachers' collaboration affects the design and analysis of…

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Abstract

Purpose

This study aim was to analyze how lesson study can enhance learning for students with intellectual disability, and how teachers' collaboration affects the design and analysis of the intervention.

Design/methodology/approach

Lesson study was used as a methodological framework. Ten special educational needs teachers met the researcher for three collaborative meetings. Between meetings, teachers performed and adjusted a lesson on a particular mathematical issue: quantity and size judgment. To evaluate the lesson design, students completed pre- and post-lesson examinations and attitude tests with Likert-type scales.

Findings

Students' knowledge increased during the study. The mean scores for the first group (six students) were 4.3 in the pre-test and 6.5 in the post-test (effect size 0.9). For the second group (four students), the mean score was 3.8 in the pre-test and 4.3 in the post-test (effect size 0.2). Attitude measurement showed split opinions; seven students had a positive experience and three had a predominantly negative experience. Assessment of teacher certainty using transcribed audio recordings of teachers' statements during the collaborative meetings indicated a positive relation between teacher expressions of certainty and student learning. The teacher–researcher collaboration increased teachers' focus on student learning and deepened the researcher's analysis.

Originality/value

There is an urgent need to explore collaborative development in special educational needs teaching. Lesson study is an effective way of examining teachers' collaborative processes using data on teachers' reasoning about teaching and students' learning.

Details

International Journal for Lesson & Learning Studies, vol. 9 no. 3
Type: Research Article
ISSN: 2046-8253

Keywords

Open Access
Article
Publication date: 4 October 2018

Justin Barrett Leaf, Robert K. Ross, Joseph H. Cihon and Mary Jane Weiss

Kupferstein (2018) surveyed 460 respondents and found that 46 percent of respondents met the diagnostic threshold for posttraumatic stress disorder after exposure to…

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Abstract

Purpose

Kupferstein (2018) surveyed 460 respondents and found that 46 percent of respondents met the diagnostic threshold for posttraumatic stress disorder after exposure to applied-behavior-analysis-based intervention. The purpose of this paper is to provide an evaluation a critical analysis of Kupferstein (2018) including the experimental methods and discussion of the results.

Design/methodology/approach

The authors evaluated the Kupferstein’s methodological rigor with respect to the use of hypothesis testing, use of indirect measures, selection of respondents, ambiguity in definitions, measurement system, and framing of the experimental question when conducting the correlational analysis in addition to Kupferstein’s analysis and discussion of the results.

Findings

Based upon the analysis, Kupferstein’s results should be viewed with extreme caution due to several methodological and conceptual flaws including, but not limited to, leading questions used within a non-validated survey, failure to confirm diagnosis, and incomplete description of interventions.

Originality/value

It is the authors’ hope that this analysis provides caregivers, clinicians, and service providers with a scientific lens which will useful in viewing the limitations and methodological flaws of Kupferstein.

Details

Advances in Autism, vol. 4 no. 3
Type: Research Article
ISSN: 2056-3868

Keywords

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