This study was done to investigate the effectiveness of dialectical behavior therapy in patients with autism spectrum disorder and emotion-regulation problems. Many people with autism spectrum...Show moreThis study was done to investigate the effectiveness of dialectical behavior therapy in patients with autism spectrum disorder and emotion-regulation problems. Many people with autism spectrum disorder have difficulty regulating their emotions and often participate in harmful and suicidal behaviors to cope with these emotions. To date, there is not a form of therapy that fully addresses these problems in people with autism spectrum disorder. Dialectical behavior therapy does address this difficulty with emotion regulation and suicidal behavior, but is not yet implemented as an official intervention for people with autism spectrum disorder. In this study, nine participants received 42 weeks of inpatient dialectical behavior therapy. All participants have a history of suicidal thoughts and/or attempts and suffer from comorbid disorders, such as attention deficit hyperactivity disorder, post-traumatic stress disorder and depression. Assessments were done at baseline, start of pretreatment, start of inpatient treatment, end of inpatient treatment and at follow-up. The primary measured outcome was problem behavior, which was measured with daily diary cards. Primary problem behavior consisted of suicidal urges; secondary problem behavior consisted of self-harm, substance abuse or rumination. The secondary measured outcomes were coping styles, emotion regulation and quality of life, and these were measured with multiple questionnaires. At follow-up, four out of nine participants saw a significant reduction in suicidal urges (p < .001). Seven participants saw a significant reduction in secondary problem behavior (p < .001). The secondary measured outcomes were more variable with some significant improvement seen in coping styles, emotion-regulation and quality of life, but not for all participants (RCI > 1.96/RCI > -1.96). One participant dropped out after the end of inpatient treatment. In short, this study has found that dialectical behavioral therapy has potential as an effective treatment for people with autism spectrum disorder and emotion-regulation problems, but more studies are needed to fully substantiate this claim before it can be implemented as standard treatment.Show less
The behavioural overlap observed between developmental dyslexia and other neurodevelopmental disorders (NDDs) such as ADHD and ASD is an ongoing topic of research. The complexity of these...Show moreThe behavioural overlap observed between developmental dyslexia and other neurodevelopmental disorders (NDDs) such as ADHD and ASD is an ongoing topic of research. The complexity of these conditions, coupled with the overlap in behavioural characteristics, contributes to the challenge of accurately diagnosing dyslexia. Consequently, there is a prevalent tendency for learning disabilities such as dyslexia to be underdiagnosed. This study aims to examine whether there are specific cognitive impairments attributable to dyslexia, that are not observed in NDDs in general. The answer to this question was examined by comparing the cognitive profile of children diagnosed with a NDD and dyslexia to children diagnosed with a NDD but not dyslexia. The WISC-V was administered to 57 children aged between 7 and 16 years. The findings of this study showed no differences in the frequency of a deviant IQ profile between children with a NDD, with or without (suspected) dyslexia. In addition, the results showed no stronger relative weakness on the indexes of working memory, verbal comprehension, and processing speed for children with dyslexia compared to children with a NDD but not dyslexia. To conclude, the current study found no evidence for specific cognitive impairments attributable to dyslexia. Due to the small sample size in this study, further conclusions cannot be drawn from these results. Since the obtained results contradict the results of previous studies, a follow-up study to gain more knowledge about the cognitive profile of dyslexia in co-occurrence with other NDDs is advised.Show less
Abstract Autism Spectrum Disorder (ASD) is a neurological condition that impacts 1 % of the population and can be detected as early on as infancy. ASD in children is important to be examined as...Show moreAbstract Autism Spectrum Disorder (ASD) is a neurological condition that impacts 1 % of the population and can be detected as early on as infancy. ASD in children is important to be examined as more autistic pupils are attending mainstream education. One part of the routine at school that can be especially challenging for autistic pupils is recess time due to the lack of structured activities. The current thesis aims to examine to what extent the reconstruction of a school’s playground increases enjoyment, peer acceptance, interaction time and physical activity. We also explore to what extent changes in peer acceptance, interaction time and physical activity can predict changes in enjoyment levels in autistic children. In the study 41 autistic children between the ages 8 to 12 years (M = 10.12, SD = 1.01) participated. The children were pupils of a Dutch special education primary school. Data collection occurred on two occasions: firstly, right before the renovation of the playground, and then six months after the renovation. Children wore sensor belts with which peer interactions and physical activity were measured. Enjoyment and peer acceptance were assessed through self-report questionnaires and peer reports, respectively. The results from the study indicate that interaction time during recess did increase post-renovation for the autistic children. There was no statistically significant increase in enjoyment, peer acceptance and physical activity. Furthermore, changes in peer acceptance, interaction time and physical activity were not found to be statistically significant predictors of change in enjoyment. Our findings show that the physical environment at school can be an important determinant for the social inclusion of autistic pupils.Show less
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social functioning, as well as repetitive and restrictive interests and behaviors. It is...Show moreBackground: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social functioning, as well as repetitive and restrictive interests and behaviors. It is diagnosed based on symptom expression. An ASD diagnosis can influence different aspects of the life of an individual, such as eating and sleeping habits. It may also influence the lives of the people close to the diagnosed individual, especially when diagnosed in children. So far, little is known about how ASD symptom expression influences eating and sleeping patterns in five- year-old children as well as their parent’s parental stress levels. Aim: The purpose of this thesis is to investigate the relationship between ASD symptoms, eating and sleeping problems in five-year-old children, and parental stress. Methods: This thesis used online questionnaires filled out by parents of five-year-old children (n = 4588, Mean age = 5.1, SD = .46) to conduct three multiple regression models. Results: The findings supported the hypotheses (H1) that ASD symptom severity is associated with more problematic eating habits in five-year-old children; (H2) that ASD symptom severity is associated with more sleep problems in five-year-old children; (H3) that ASD symptom severity is associated with more parental stress in parents of five-year- old children. All results were reported with small effect sizes. Conclusion: ASD symptoms in five-year-old children had a small negative effect on eating and sleeping habits in children, and increased parental stress in their parents.Show less
Well-developed executive functions (EF) are important for a proper development of children. Verbal working memory and cognitive flexibility are used on daily basis in social situations, by...Show moreWell-developed executive functions (EF) are important for a proper development of children. Verbal working memory and cognitive flexibility are used on daily basis in social situations, by processing complex cognitive information and in understanding language. Children with an autism spectrum disorder (ASD) have deficits in these EF, which could explain the symptoms of their ASD, such as restricted and repetitive behaviors and difficulties in social interaction and communication. Girls show their ASD symptoms differently than boys, which could partly mean that their EF work differently. This cross-sectional study researched the relationship between verbal working memory and cognitive flexibility on the one hand and ASD symptoms on the other hand. Furthermore, it has been researched whether EF mediate the relationship between gender and ASD symptoms. In this study 38 children and adolescents, 20 boys and 18 girls, between 6 and 16 years took part. The sample contained 6 children with a DSM classification of ASD. To measure the cognitive flexibility, verbal working memory and ASD symptoms, the following instruments were used respectively: Trail Making Test, Digit Span Test and the Social Responsiveness Scale. None of the results were significant, which indicates that in this study verbal working memory and cognitive flexibility had no relationship with ASD symptoms. In addition, the mediations were also non-significant, which suggests that in this study boys and girls show comparable ASD symptoms as well as similar skills in verbal working memory and cognitive flexibility. Practically that would mean that the support boys and girls need for their EF deficits and ASD, should be similar as well. However, the results should be considered with the limitations of this study. This study contributes to the first steps into understanding and supporting girls with ASD better.Show less
Children with autism spectrum disorder (ASD) are often not included in social interactions. This is mainly because non-autistic people frequently misunderstand them and because of this do not...Show moreChildren with autism spectrum disorder (ASD) are often not included in social interactions. This is mainly because non-autistic people frequently misunderstand them and because of this do not accept, or even reject and dismiss them (Cage et al., 2018). This can make social participation for children with ASD unpleasant and stressful, even though social participation is vital for their development (Eisenberg et al., 1998; Kawachi & Berkman, 2001). To date, only a few studies have examined the impact of limited access to school participation on the psychosocial development of school-aged children with ASD. Furthermore, one may wonder whether certain factors, e.g., individual, family, or school factors, could influence the relation between social participation and psychosocial functioning in children with ASD. To address this gap of knowledge, this study examined the relation between social participation and psychosocial functioning of Dutch children with ASD aged between 4 and 16 years. Furthermore, this study explored whether and to what extent children’s individual characteristics such as IQ, their family characteristics such as parent self-efficacy, and the school characteristics, such as the social environment of the school, could moderate this relation. Two hundred parents of children with ASD from different areas of the Netherlands filled in questionnaires to report about their children’s socioemotional development through the online platform NAR (Dutch Autism Register). The results showed that the more children with ASD participated in social interactions, the fewer psychosocial problems they had. Higher parent self-efficacy predicted fewer psychosocial problems in children with ASD. However, no moderating effects were found. The current study highlights the importance of promoting social participation at school for children with ASD. It also highlights the importance of providing support to the parents of children with ASD and increasing these parents’ self-confidence in supporting their child with ASD.Show less
Sense of belonging at school is an important factor in the school context. Especially for pupils with Autism Spectrum Disorder (ASD) a sense of belonging is important in order to have positive...Show moreSense of belonging at school is an important factor in the school context. Especially for pupils with Autism Spectrum Disorder (ASD) a sense of belonging is important in order to have positive experiences at school. The most important contributor to a sense of belonging at school is the staff-pupil interaction. The purpose of the current research is to investigate the relationship between a sense of belonging at school and staff-pupil interaction for pupils with ASD. The relationship will be investigated for boys and girls at primary school and secondary school. Participants are parents of 200 children with ASD between the age of three and seventeen years old. The parents filled in questionnaires about the well-being of their children in the school context. The current research showed that there is a strong positive relationship between sense of belonging at school and staff-pupil interaction for pupils with ASD. No differences were found in the levels of sense of belonging at school and staff-pupil interaction between boys and girls and between primary and secondary school.Show less
Introduction: Tuberous sclerosis complex (TSC) is a rare genetic multisystem disorder characterized by the widespread growth of benign hamartomas in multiple organ systems, leading to very diverse ...Show moreIntroduction: Tuberous sclerosis complex (TSC) is a rare genetic multisystem disorder characterized by the widespread growth of benign hamartomas in multiple organ systems, leading to very diverse (neuropsychiatric) manifestations, including autism spectrum disorder (ASD). This study aimed to examine the prevalence of clinically assessed ASD in children with TSC visiting a specialized TSC outpatient clinic. The influence of gender, age, intellectual functioning, and mutation type on a clinical ASD diagnosis was investigated. Secondly, the predictive value of using both a screening instrument and an observational assessment in relation to a clinical DSM-IV/-V ASD diagnosis in the group of children with TSC was examined. Methods: The data sample consisted of 110 children (50% male) between 1 and 17 years old (mean age = 9.65, SD = 4.61) diagnosed with a genetically and/or clinically confirmed diagnosis of TSC and a filled out ADOS and/or SRS. They were assessed as part of standard (mental) health care and longitudinal follow-up. The independent variables were gender, age, IQ/DQ, and mutation type, which associations with clinical ASD diagnoses were examined with Chi-Square Tests of Association or independent sample t-tests. The dependent variables were ASD classifications according to the Social Responsiveness Scale (SRS/SRS-2) scores, Autism Diagnostic Observation Schedule-second edition (ADOS-2) scores, and DSM-IV/-V diagnoses. Results: A clinical ASD prevalence rate of 52.7% was found, substantially higher than in the general population. Children with a clinical ASD diagnosis had significantly lower intelligence scores (p = .01). No gender, age, or mutation type effects were found. The combined use of screening and observational- based classifications showed the highest positive predictive value for DSM-IV/-V ASD diagnosis. Discussion: The results showed a substantially higher ASD prevalence rate compared to the general population, underlining the importance of ASD assessment in children with TSC. Furthermore, these results highlighted the relevance of using both a screening instrument and an observational assessment to accurately classify children with TSC as having ASD. A better ASD prediction and classification may lead to earlier diagnosis and appropriate, personalized interventions, potentially alleviating some of the burden for both patients and their families or caregivers.Show less
Sense of belonging at school is an important factor in the school context. Especially for pupils with Autism Spectrum Disorder (ASD) a sense of belonging is important in order to have positive...Show moreSense of belonging at school is an important factor in the school context. Especially for pupils with Autism Spectrum Disorder (ASD) a sense of belonging is important in order to have positive experiences at school. The most important contributor to a sense of belonging at school is the staff-pupil interaction. The purpose of the current research is to investigate the relationship between a sense of belonging at school and staff-pupil interaction for pupils with ASD. The relationship will be investigated for boys and girls at primary school and secondary school. Participants are parents of 200 children with ASD between the age of three and seventeen years old. The parents filled in questionnaires about the well-being of their children in the school context. The current research showed that there is a strong positive relationship between sense of belonging at school and staff-pupil interaction for pupils with ASD. No differences were found in the levels of sense of belonging at school and staff-pupil interaction between boys and girls and between primary and secondary school.Show less
Background. Sensory processing problems and impaired social skills are often seen in children with Autism Spectrum Disorder (ASD). Moreover, understanding the gender gap in ASD prevalence and...Show moreBackground. Sensory processing problems and impaired social skills are often seen in children with Autism Spectrum Disorder (ASD). Moreover, understanding the gender gap in ASD prevalence and symptomatology is still not achieved. Studies are inconsistent in findings regarding gender specific ASD symptomatology and possible underlying mechanisms of gender differences. This study investigated the relationship between sensory processing and impaired social skills, and whether a mean difference exists in sensory processing symptoms between ASD boys and girls with similar social skills. Method. In this cross-sectional study 169 children (aged 7-12) participated, of which 96 typically developing (TD) and 58 ASD children. All were tested on social skills, measured through the Social Responsiveness Scale and on sensory processing problems, which was mapped out by measures of tapping accuracy, using the DrumPad 2.0 as a rhythmic measurement device. The relationship between sensory processing and social skills was investigated with the use of a Spearman’s Rho test. Mean differences in sensory processing between ASD boys and girls with similar social skills were investigated with the use of a 2x2 ANCOVA. Results. After performing Spearman's Rho test, a significant positive relationship was found in the overall sample between social skills and tapping accuracy. The 2x2 ANCOVA did not prove a significant effect of gender on mean tapping accuracy, but a significant main effect of social skills on the mean tapping accuracy was found. No significant interaction effect of gender and social skills was found. Discussion. Results indicated that social skills and tapping accuracy are associated, and that – after correction for age – social skills have an effect on tapping accuracy, irrespective of gender. To our knowledge, this is the first time that sensory processing was measured through a rhythmic device. This study contributes to the existing literature regarding gender-specific symptomology in ASD.Show less
In dit onderzoek waren 22 kinderen met ASS en 26 kinderen met een taalstoornis (gemiddelde leeftijd in maanden: 24,5, SD = 6,66) betrokken. De proefpersonen namen deel aan het Screening Onderzoek...Show moreIn dit onderzoek waren 22 kinderen met ASS en 26 kinderen met een taalstoornis (gemiddelde leeftijd in maanden: 24,5, SD = 6,66) betrokken. De proefpersonen namen deel aan het Screening Onderzoek Sociale Ontwikkeling (SOSO) in het UMC in Utrecht. Bij alle kinderen werd daar een screening naar de vroege kenmerken van autisme afgenomen en kinderen met een hoge score werden geïncludeerd (ESAT; Dietz, Swinkels, Van Daalen, Van Engeland & Buitelaar, 2006). Dit onderzoek was gericht op het onderzoeken van mogelijke verschillen in spelgedrag tussen kinderen met ASS en kinderen met een taalstoornis. Spelgedrag werd hiervoor gedefinieerd als de duur van het spelen, het soort speelgoed waarmee gespeeld werd en het spelniveau (manipulatief, relationeel, functioneel en symbolisch spelniveau). Spelobservaties zijn gedaan met een observatieschaal van Baranek et al. (2005). Uit dit onderzoek bleek dat kinderen met autisme meer met de bal en de auto (motorisch stimulerend speelgoed) speelden en kinderen met een taalstoornis meer een voorkeur hadden voor een boek en een puzzel. Uit deze resultaten blijkt dat verschillen al op jonge leeftijd te vinden zijn. Interventie zou dus al vroeg gestart kunnen worden om zo, de uit eerder onderzoeken gevonden achterstanden op spelniveau op latere leeftijd, te kunnen voorkomen.Show less
Volgens de huidige literatuur wordt verondersteld dat kinderen met stoornissen uit het Autistisch Spectrum (ASS) en verstoorde ontwikkeling van taal en Theory of Mind hebben (ToM). In dit onderzoek...Show moreVolgens de huidige literatuur wordt verondersteld dat kinderen met stoornissen uit het Autistisch Spectrum (ASS) en verstoorde ontwikkeling van taal en Theory of Mind hebben (ToM). In dit onderzoek is gekeken of taal en ToM samenhangen met een gebrekkige sociaal (wederkerig) gedrag, een criteria van ASS (DSM-IV-TR). Er is weinig informatie beschikbaar over hoe de criteria gedefinieerd in de DSM in relatie staan tot factoren als ToM en taal. ToM is in dit onderzoek gemeten met de SCVT, de taalvaardigheden met de CELF “Complexe Taalproductie”, CELF “Woordassociaties” en WISC “Woordassociaties”. Het sociaal gedrag is gemeten met de ADI-R. Er participeerden 35 kinderen tussen de 8 en 15 jaar gediagnosticeerd met ASS. De controle groep bestond uit 85 kinderen tussen de 9 en 14 jaar. De resultaten van dit onderzoek toonden aan dat kinderen met ASS een gestoorde ontwikkeling van ToM en taal hebben. Tegen de verwachtingen in hadden ToM en taal geen samenhang met het sociaal gedrag. Een mogelijke verklaring hiervoor is dat ToM gemeten met de SCVT niet altijd generaliseerbaar is naar het dagelijks leven. Daarnaast kunnen de taalvaardigheden van kinderen zich anders uiten in een testsetting in vergelijking met de alledaagse praktijk. Als laatste dient er ook rekening gehouden te worden met de psychometrische eigenschappen van de ADI-R, die wellicht een verband aantonen bemoeilijken.Show less
