Designing emergency preparedness resources for children with autism

Emergency preparedness is a fast developing field of education driven by the numerous disasters worldwide with more recent notable examples including the terrorist attacks of 9/11 in the U.S in 2001, the 2004 Indian Ocean Tsuanmi, Hurricane Katrina in 2005, the London bombings in 2005, the earthquake in China in 2008, the Great East Japan Earthquake in 2011, Hurricane Sandy in 2012 and more recently the Paris terror attacks in 2015. Whilst there is a growing literature focusing on the psychological implications of such disasters on children, there remains a lack of focus on disability, particularly neurodevelopmental disabilities such as autism. Due to the nature of autism it is likely that this group will have specific needs during disasters and emergency situations and may find such situations more stressful than their typically developing peers, as such they can be considered a more at risk group in such events. In this paper, I consider the need for an intervention for a nearly wholly neglected group in the field of education for emergency preparedness, children with autism, and report on phase one of a project aimed at designing resources for this group.

Autistic Functioning and Language Development

This thesis is a retrospective qualitative study based on psychotherapy sessions with children presenting autistic features who use language in atypical ways. The aim was to understand, through the transferential relationship, what psychological context in terms of anxieties and defences prevents the child from using language efficiently. Hypotheses concerning children‘s use of language in the context of their emotional oscillation and evolution during the course of treatment were noted and checked against subsequent developments. They were also triangulated with the outcome of a grounded theory analysis. The grounded theory analysis led to the emergence of higher-level themes that were compared within and across cases and allowed factors surrounding the children‘s use of language to be conceptualized. The grounded theory method was used in parallel with the usual process of evaluation of the dynamics of each session and patient used by psychoanalysts a posteriori and which is part of the researcher‘s background. This procedure was enhanced by the use of Bion‘s Grid, here in a version adapted to the aims of the research. This approach is discussed in detail in the Methodology chapter. The psychoanalytic theoretical background that supported the research was mainly based on the tradition of Object-Relations Theory, particularly the evolution of Kleinian thinking represented by Bion‘s works, and as far as autism is concerned, by Frances Tustin and Donald Meltzer‘s formulations. Concerning the subject of language development, Meltzer‘s explorations on the necessary conditions for its development and the philosopher Wittgenstein‘s investigations on the social function of language were the main influences of this work. The evolution of the children‘s use of language in parallel with their emotional development in the context of their psychotherapies was analyzed and some hypotheses about the oscillations in their emotional and mental functioning were made. The oscillation in the children‘s emotional state, language use and thinking processes was also studied in terms of a general fluctuation between different mental states that was considered to be present in different degrees and quality in mental life and more strongly when there are limitations in communication skills and social interaction. A few excerpts from notes on adolescent and adult cases with autistic features were included in the Discussion Chapters to briefly illustrate this aspect.