Preparing Students with ASD for Inclusive Classrooms: A Case Study of Giant Steps

Giant Steps is a therapeutic school for children with Autism Spectrum Disorder (ASD) founded in 1995 by a group of parents who felt that the public school system was not fully able to meet the needs of their children. While the education system has progressed through the years to offer all students with access to public education, many educators still are not adequately prepared to provide inclusive learning environments for students with ASD. Given the prevalence of ASD in southern Ontario (1 in every 42 boys and 1 in every 189 girls), research on ASD and inclusive practices is both vital and timely. The purpose of this qualitative case study is to understand how the Giant Steps program prepares and transitions students with ASD for inclusive classrooms. Data was collected through two rounds of in-depth interviews, and was subsequently analyzed and interpreted into research findings that are presented through three major themes (i.e., unique program aspects, holistic approach, inclusion not integration). Collectively, the themes provide insights about how students at Giant Steps are prepared for inclusion, as well as how different stakeholders within the Giant Steps program perceive inclusion and their role in preparing students for inclusive classrooms.

Living with ASD: how do children and their parents assess their difficulties with social interaction and understanding?

Social interaction and understanding in autistic spectrum disorder (ASD) are key areas of concern to practitioners and researchers alike. However, there is a relative lack of information about the skills and competencies of children and young people with ASD who access ordinary community facilities including mainstream education. In particular, contributions by parents and their children have been under-utilized. Using two structured questionnaires, 19 children with ASD reported difficulties with social skills including social engagement and temper management and also reported difficulties with social competence, affecting both friendships and peer relationships. Parents rated the children's social skill and competence as significantly worse than did the children themselves, but there was considerable agreement about the areas that were problematic. Using an informal measure to highlight their children's difficulties, parents raised issues relating to conversation skills, social emotional reciprocity and peer relationships. The implications for assessment and intervention are discussed.

Speech perception and phonological short-term memory capacity in language impairment: preliminary evidence from adolescents with specific language impairment (SLI) and autism spectrum disorders (ASD)

Background: The cognitive bases of language impairment in specific language impairment (SLI) and autism spectrum disorders (ASD) were investigated in a novel non-word comparison task which manipulated phonological short-term memory (PSTM) and speech perception, both implicated in poor non-word repetition. Aims: This study aimed to investigate the contributions of PSTM and speech perception in non-word processing and whether individuals with SLI and ASD plus language impairment (ALI) show similar or different patterns of deficit in these cognitive processes. Method & Procedures: Three groups of adolescents (aged 14–17 years), 14 with SLI, 16 with ALI, and 17 age and non-verbal IQ matched typically developing (TD) controls, made speeded discriminations between non-word pairs. Stimuli varied in PSTM load (two- or four-syllables) and speech perception load (mismatches on a word-initial or word-medial segment). Outcomes & Results: Reaction times showed effects of both non-word length and mismatch position and these factors interacted: four-syllable and word-initial mismatch stimuli resulted in the slowest decisions. Individuals with language impairment showed the same pattern of performance as those with typical development in the reaction time data. A marginal interaction between group and item length was driven by the SLI and ALI groups being less accurate with long items than short ones, a difference not found in the TD group. Conclusions & Implications: Non-word discrimination suggests that there are similarities and differences between adolescents with SLI and ALI and their TD peers. Reaction times appear to be affected by increasing PSTM and speech perception loads in a similar way. However, there was some, albeit weaker, evidence that adolescents with SLI and ALI are less accurate than TD individuals, with both showing an effect of PSTM load. This may indicate, at some level, the processing substrate supporting both PSTM and speech perception is intact in adolescents with SLI and ALI, but also in both there may be impaired access to PSTM resources.

Perseveration in ASD; the role of negative feedback and social interaction

This thesis tested several explanations for the underlying mechanisms of perseveration in populations with ASD. Explanations considered the role of executive dysfunction with particular emphasis on negative feedback, social interaction, and variations in autistic symptomology. The thesis found that negative feedback had the most infiuence on perseveration in ASD populations.

TOBY play-pad application to teach children with ASD – a pilot trial

 Purpose: To investigate use patterns and learning outcomes associated with the use of Therapy Outcomes By You (TOBY. Playpad, an early intervention iPad application. Methods: Participants were 33 families with a child with an autism spectrum disorder (ASD) aged 16 years or less, and with a diagnosis of autism or pervasive developmental disorder - not otherwise specified, and no secondary diagnoses. Families were provided with TOBY and asked to use it for 4-6 weeks, without further prompting or coaching. Dependent variables included participant use patterns and initial indicators of child progress. Results: Twenty-three participants engaged extensively with TOBY, being exposed to at least 100 complete learn units and completing between 17% and 100% of the curriculum. Conclusions: TOBY may make a useful contribution to early intervention programming for children with ASD delivering high rates of appropriate learning opportunities. Further research evaluating the efficacy of TOBY in relation to independent indicators of functioning is warranted.

Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD

We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

Physical functioning, emotional, and behavioral problems in children with ADHD and comorbid ASD : a cross-sectional study

OBJECTIVE: To examine (a) physical and daily functioning in children with ADHD and autism spectrum disorder (ASD) compared with ADHD alone and (b) whether decreased physical quality of life (QoL) is associated with increased emotional and behavioral problems in children with ADHD-ASD. METHOD: Cross-sectional study comprising 392 children with confirmed ADHD (ADHD-ASD, n = 93; ADHD alone, n = 299) recruited from 21 pediatric practices in Victoria, Australia. Data were collected via parent and teacher surveys. Key measures included the Strengths and Difficulties Questionnaire (SDQ) and Pediatric Quality of Life Inventory (PedsQL). RESULTS: Children with ADHD-ASD had poorer QoL across both psychosocial and physical health domains, and also had greater parent-reported behavioral, emotional, and peer problems, compared with children with ADHD alone. Poorer physical QoL partially mediated the relationship between comorbid ASD status and poorer emotional and behavioral functioning. CONCLUSION: The comorbid overlay of ASD in ADHD appears to influence not only problems in physical functioning but also the severity of problems relating to areas of emotional and behavioral functioning.

Inzidenz von atrialen Herzrhythmusstörungen nach katheterinterventionellem ASD-II-Verschluss

In einer retrospektiven Analyse wurden Daten von 161 pädiatrischen Patienten ausgewertet, denen im Zeitraum von Oktober 1997 bis Dezember 2008 ein Vorhofseptumdefekt vom sekundum Typ in der Kinderkardiologie des Zentrums für Kinder- und Jugendmedizin der Universitätsmedizin Mainz interventionell mittels Amplatzer Septal Occluder erfolgreich verschlossen wurde. In diesem Kollektiv wurden Alter, Shuntvolumen und IAS/Occluder Ratio als mögliche Einflussfaktoren auf die Ausbildung von prae-, peri- und postinterventionell dokumentierten atrialen Arrhythmien untersucht und unter dem Aspekt aufgetretener Arrhythmien auch die Anzahl an Langzeit-EKGs und die Dauer des Follow Up analysiert.rnIm untersuchten Kollektiv war die Anzahl der Kinder mit prae- (2,5%), peri- (2,5%) und postinterventionell (3,7%) Arrhythmien gering.rnIm untersuchten Kollektiv konnte kein Zusammenhang zwischen den dokumentierten Arrhythmien und dem Alter ermittelt werden. Allerdings war die Anzahl an L-EKGs bei den 6 Patienten mit postinterventionellen Arrhythmien in der Tendenz höher als bei den Patienten mit normalem Sinusrhythmus, ein Ergebnis, das sich in der Dauer des Follow Up nicht zeigte.rnAls Hauptergebnis der vorliegenden Arbeit zeigte sich eine Assoziation zwischen dem Shuntvolumen und auch der IAS/Occluder Ratio mit den aufgetretenen prae-, peri- und postinterventionellen Arrhythmien im untersuchten Patientenkollektiv und zwar in der Form, dass ein großer Defekt und eine niedrige IAS/Occluder Ratio die Ausbildung von atrialen Arrhythmien zu begünstigen scheinen. Festzuhalten bleibt, dass selbst bei Kindern mit großen Shuntvolumina Rhythmusstörungen früher auftreten und deshalb auch ein früherer Verschluss indiziert ist. Ebenso ist die Wahrscheinlichkeit, dass bei großen Defekten die atrialen Arrhythmien verschwinden geringer als bei kleinen Defekten. Aus diesem Ergebnis kann zumindest in der Tendenz eine Prädiktorfunktion dieser beiden Parameter für supraventrikuläre Arrhythmien abgeleitet werden.rnOffen bleibt in der vorliegenden Untersuchung die Frage nach der Ursache und Wirkung dieser Faktoren hinsichtlich der Pathogenese der Arrhythmien. Offen bleibt ebenfalls, ob eine Kombination mehrer unterschiedlicher Faktoren für die Pathogenese entscheidend ist. Ein tieferes Verständnis der Pathogenese der prae-, peri- und postinterventionellen Arrhythmien beim ASD II könnte Grundlage für eine bessere Prognose im Hinblick auf ihre Vermeidung bedeuten.

Port-a-Cath perforation of the right atrium closed with an amplatzer ASD occluder

Right atrial perforation can lead to tamponade and death. Closure devices are used for sealing of shunts in the heart. We describe an indwelling catheter that caused perforation of the right atrium and was treated with a percutaneous closure device.

Brief Report: How Adolescents with ASD Process Social Information in Complex Scenes. Combining Evidence from Eye Movements and Verbal Descriptions

We investigated attention, encoding and processing of social aspects of complex photographic scenes. Twenty-four high-functioning adolescents (aged 11–16) with ASD and 24 typically developing matched control participants viewed and then described a series of scenes, each containing a person. Analyses of eye movements and verbal descriptions provided converging evidence that both groups displayed general interest in the person in each scene but the salience of the person was reduced for the ASD participants. Nevertheless, the verbal descriptions revealed that participants with ASD frequently processed the observed person’s emotion or mental state without prompting. They also often mentioned eye-gaze direction, and there was evidence from eye movements and verbal descriptions that gaze was followed accurately. The combination of evidence from eye movements and verbal descriptions provides a rich insight into the way stimuli are processed overall. The merits of using these methods within the same paradigm are discussed.