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Recent research has proposed a specific female phenotype within autism spectrum disorder (ASD). It suggests females exhibit differences in social communication styles with higher levels of camouflaging and compensatory strategies, as well as variance in restrictive repetitive behaviours (RRBs); however, many existing studies have been based on either small, disproportionate or child and adolescent samples, leaving questions about the specific phenotype. This study aims to explore the sex difference and phenotype in a clinic sample of individuals diagnosed with autism.

A service evaluation of sex/ gender differences on 150 historical ASD assessment reports (75 males, 75 females) using a 103-item questionnaire developed from a quantitative review of existing literature was undertaken.

Females camouflaged more significantly than males in five different areas (thinking how to act next, preparing conversation in advance, making lists of prompts/social responses, wearing a mask/acting, less monotone voice); however, these were not maintained in post-analysis correction.

This study points the evidence towards a different phenotype of Autism that is more common in women than men rather than a unique female phenotype.

The present paper answers two significant questions: (1) What are the relative consumer and firm-level effects of marketing through metaverse compared to conventional marketing endeavors? (2) What are the current trends in utilizing the metaverse as reported in the recent literature?

This study employs a systematic literature review methodology, utilizing a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart to synthesize existing research. Thirty-five articles written in English were selected and analyzed from two databases, Web of Science and EBSCO Host.

The findings indicate that consumer-level effects of the metaverse include consumer loyalty and brand attachment. The firm-level benefits are decentralization and cost reductions. The paper proposes a framework indicating variables that could attenuate or enhance the association between immersive components of the metaverse and their resultant effects.

This study contributes to understanding the role of metaverse in marketing practices related to the marketing mix components. The study conceptualizes a novel framework for the metaverse and its resultant effects.

Although increased social time is associated with healthier lifestyles, autistic people often present in therapy with social time difficulties. Given the growing interest in digital interventions and their applicability for autistic individuals, a social time app could be beneficial to support autistic people to manage social time, but there is limited research in this field, especially that which involves people with lived experience. The purpose of this study was to use co-production to conduct consultations with expert clinicians about the relationship between autism and social time, and the future development of a smartphone app to monitor and support social time in autistic people.

A qualitative methodology investigated clinicians’ views on the relationship between autism and social time and potential development of a social time app. Clinicians (N = 8) participated in semi-structured interviews facilitated by a researcher with lived experience of autism.

Participants were psychologists and psychotherapists from a specialist autism service. Thematic analysis identified factors associated with social time, such as differences with neurotypical populations, need for balance with non-social time and gender differences. According to participants, advantages of social time were connecting with people and forming relationships, whereas challenges were limited social skills, anxiety and anger and frustration. Suggested features of an app were a user-friendly design, psychoeducational components and prompts and reminders. Potential advantages of the app were support outside of therapy, support in therapy and monitoring emotional responses, whereas challenges were task completion and personalising content.

Findings reinforce the importance of a balance between social and non-social time for autistic people, which could be monitored and supported using a social time app. Clinicians could incorporate use of this app within psychological therapies to support emotional regulation and general functioning.

The purpose of this study is to explore the support needs surrounding intimate relationships and sexuality of autistic adults accessing funded social care in England.

Semi-structured interviews with 15 autistic adults who were accessing funded social care examined their support needs surrounding intimate relationships and sexuality, with subsequent data analysis using reflexive thematic analysis.

Four themes were generated: Help at hand, but not too close for comfort, No “cookie-cutter rules”: personalised, inclusive approaches, Playing it safe, not leaving it too late, and Autism-informed education and support.

The authors produced an online learning module for social care staff in England on best practice in supporting autistic adults without learning disabilities with relationships and sexuality.

To the best of the authors' knowledge, there has been no other UK-based research published to date on the social care support needs of autistic adults without learning disabilities surrounding relationships, gender and sexuality.

At present, there is no reference to Attention Autism (AA) as a framework and therapeutic tool with autistic children in occupational therapy (OT) literature. By way of introducing AA as a potential intervention to the OT community, this study aims to investigate the extent to which participation in a two-day AA training could contribute to increasing confidence and inspire changes in practice for Irish occupational therapists (OTs) supporting autistic children.

A pilot study design with mixed qualitative and quantitative methods was used to evaluate the impact of a two-day AA training on six OTs. The OTs support autistic children throughout Ireland across public, private and voluntary sectors. They completed brief, non-standardised questionnaires 2 weeks before the training (Time 1) and again 12 weeks post (Time 2) training session. At Time 2, additional exploratory questions were answered by OTs regarding their use of AA in practice.

This explorative study’s quantitative findings presented percentage change increases within three areas of confidence for all OTs. These include establishing attention, motivating and developing functional skill goals with autistic children. One of the participants did not score any change in confidence in a fourth area, building rapport, however, the five other participants scored percentage change increases. Qualitative data provided by participants showed that they were implementing AA in practice since attending the training. Five of the participants reported positive experiences of using AA and one participant reported the programme was not suitable for her caseload because of their level of understanding and need.

This was a small, exploratory, practice-based study. As this is the first study exploring this area of practice for OTs, to the best of the authors’ knowledge, there were no standardised methods of assessment available, therefore a self-designed survey was used by the author which had a limited number of open-ended questions and four Likert scale questions. This study was also limited in that there was one main researcher who also delivered the two-day AA training. The sample data set was small which resulted in the limitation of the choice of methods used to analyse the quantitative data. Percentage changes were used as the only available and reliable method for a small data set.

Findings of this study, despite their preliminary nature, indicate that AA training may be a useful professional development consideration for OTs who provide a service for autistic children. Further AA research in OT is required including larger and more rigorous studies. An alternative training option of The Curiosity Programme may be considered for OTs supporting children who may not yet be ready to participate in AA.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

To reveal the emotions and information needs expressed by Chinese parents of children with autism spectrum disorder (ASD) in an online forum, and their relationship.

The 10,062 data were from “Yi Lin”, China’s largest online forum for ASD. Open coding identified parents’ emotions and information needs, and a chi-squared test explored the correlation.

First, parents’ emotions were categorized into four themes: emotions about coping with their child’s care, emotions about the parents’ own behavior, emotions about social support with other parents and emotions about anticipating the future. Parents’ overall emotions were negative (72.47%), while the tendency of emotions varied among the four themes. Second, five information needs topics were expressed: intervention and training of ASD, parenting experiences, schooling issues, social interaction and support and future development. Different information needs topics contained different themes of emotions. Third, the tendency of emotions and expression of information needs were significantly correlated. Negative emotions had a statistically significant correlation in expression of information needs.

This study reveals the relationship between the emotions and information needs expressed by parents of children with ASD. The ASD forum could develop emotional support modules and functions for parents and facilitate emotional communication between parents.

The prevalence of exposure to adversity is elevated in autistic populations, compared to neurotypical peers. Despite this, the frequency and nature of early adverse experiences are not well understood in autistic adults, with several underlying methodological limitations in the available literature. The purpose of this study is to systematically synthesise and analyse the prevalence of childhood adversity in this marginalised population, in accordance with the adverse childhood experiences (ACEs) framework.

Peer-reviewed empirical research articles were systematically searched for from electronic databases and screened against established inclusion criteria. Pooled prevalence rates for individual ACE types were calculated.

Four papers were included (N = 732), all of which used a predominantly or exclusively female sample. Only sexual abuse was reported in all papers, with a pooled prevalence rate of 38%. Physical abuse and emotional abuse were less frequently explored, with two papers reporting on these ACEs, though obtained comparable and higher pooled prevalence rates (39% and 49%, respectively). Pooled prevalence rates could be calculated for neither neglect nor “household” ACEs because of insufficient data. The limited state of the evidence, in conjunction with high levels of heterogeneity and poor sample representativeness found, positions the ACEs of autistic adults as a critical research priority.

To the best of the authors’ knowledge, this study is the first to systematically synthesise the prevalence of early childhood adversities, as conceptualised in accordance with the ACEs framework, in adults with autistic traits.

This study aims to synthesize the existing serious games designed to promote mental health in adolescents with chronic illnesses.

This study conducted a review following the guidelines of Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in databases PubMed, Scopus, Web of Science, Cochrane Library, cumulative index to nursing and allied health literature, PsycINFO, China national knowledge infrastructure Wanfang, VIP Database for Chinese Technical Periodicals and SinoMed from inception to February 12, 2023.

A total of 14 studies (describing 14 serious games) for improving the mental health of adolescents with chronic diseases were included. Of all the included games, 12 were not described as adopting any theoretical framework or model. The main diseases applicable to serious games are cancer, type 1 diabetes and autism spectrum disorder. For interventional studies, more than half of the study types were feasibility or pilot trials. Furthermore, the dosage of serious games also differs in each experiment. For the game elements, most game elements were in the category “reward and punishment features” (n = 50) and last was “social features” (n = 4).

Adolescence is a critical period in a person’s physical and mental development throughout life. Diagnosed with chronic diseases during this period will cause great trauma to the adolescents and their families. Serious game interventions have been developed and applied to promote the psychological health field of healthy adolescents. To the best of the authors’ knowledge, this study is the first to scope review the serious game of promoting mental health in the population of adolescents with chronically ill. At the same time, the current study also extracted and qualitatively analyzed the elements of the serious game.

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual disability and/or autism guidelines for a cohort of outpatients seen in the outpatients’ clinics in the two teams who participated in this study to review the trend of psychotropic prescribing with a prescription indication along with the utilisation of non-pharmacological interventions.

Data was retrospectively collected over a period of one year for patients sampled conveniently in the outpatient’s clinic. The data was collected from two sites from psychiatric letters to the general practitioners (GPs), with the focus being psychotropic prescription indication and their adherence to British National Formulary limits, inclusion of a wider multi-disciplinary team or MDT (including nurses, psychologists and health support workers), use of Clinical Global Impression (CGI) scale for assessing medication side effects and response to treatment.

Most of the patients had at least one review in the previous six months. Antipsychotics were the highest prescribed medications without an indication for their use (13.3%) followed by anxiolytics and other medications. CGI recording was suboptimal, with 26% of the patient population did not have medication side effects and effectiveness monitored through this method. In total, 41% of patients were open to community nurses followed by other disciplines.

To the best of the authors’ knowledge, this is an original article following the pilot study completed by the authors.