Children diagnosed with autism spectrum disorder (ASD) often face unique challenges when navigating the social landscape of the primary school environment, which impacts their ability to develop...Show moreChildren diagnosed with autism spectrum disorder (ASD) often face unique challenges when navigating the social landscape of the primary school environment, which impacts their ability to develop and maintain friendships. This study therefore investigated the relationship between the social interactions of children with ASD and their friendships by examining the total time spent in social contact during school breaks and its association with the number of incoming friendship nominations at school. A sample of 100 children aged 6 – 14 years (Mage = 10.75), which consisted of 48 children with ASD and 52 children without ASD from two special education schools participated in the study. The total time spent in social contact during school breaks was measured using Radio Frequency Identification (RFID) on the playground. The number of incoming friendship nominations was recorded via peer nominations. Contrary to expectations, the results showed no significant relationship between total time of social contact and incoming friendship nominations, regardless of the ASD status. Notably, although children with ASD spent less time in social contact on average, they received a similar amount of incoming friendship nominations compared to children without ASD. These findings indicate that the link between social behavior and friendship formation in children with ASD may be more complex than assumed, and suggest that children with ASD may achieve friendships without pursuing typical patterns of social contact. Furthermore, these results suggest that quantity of social contact may not be the only determinant of friendships. Instead, factors such as the quality of this contact may further influence friendships, highlighting the need for future qualitative research.Show less
This thesis explores the influence of the portrayal of Autism Spectrum Disorder (ASD) in the K-drama Extraordinary Attorney Woo on public perception and attitudes toward ASD in South Korean society...Show moreThis thesis explores the influence of the portrayal of Autism Spectrum Disorder (ASD) in the K-drama Extraordinary Attorney Woo on public perception and attitudes toward ASD in South Korean society. The study begins by examining the ASD portrayal in Extraordinary Attorney Woo, aiming to comprehend its positioning and characteristics in relation to general criticisms of ASD portrayals. Subsequently, interview videos featuring Korean individuals with ASD are analyzed to identify similarities and differences between their lived experiences and the drama's portrayal. An online survey is then conducted among South Koreans to investigate the impact of the ASD portrayal in Extraordinary Attorney Woo on public perceptions and attitudes toward individuals with ASD. The findings reveal that the drama presents an authentic character with ASD, fostering understanding and awareness of ASD as a spectrum disorder. However, certain aspects of the portrayal, such as romantic relationships and savant skills, do not accurately reflect the realities of individuals with ASD. Nonetheless, the portrayal of ASD in Extraordinary Attorney Woo positively influences public perception and promotes improved understanding and knowledge of ASD in South Korean society.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
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
Introduction: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and has a major genetic heterogeneity. Comparing monogenetic causes of ASD can contribute to...Show moreIntroduction: Autism spectrum disorder (ASD) is one of the most prevalent neurodevelopmental disorders and has a major genetic heterogeneity. Comparing monogenetic causes of ASD can contribute to understanding its genetic aetiology. This study compares patients with fragile X syndrome (FXS) to patients with tuberous sclerosis complex (TSC) in terms of ASD severity and symptomatology to create an image of their ASD symptom profiles. This could lead to more focused diagnoses and specialized treatment for these patient groups. Methods: This study included children and adolescents (ages 1–18, mean age = 9.01 years) with FXS (n = 57, 80.7% males) or TSC (n = 105, 49.5% males). The second editions of the Autism Diagnostic Observation Scale and the Social Responsiveness Scale were used to assess ASD symptomatology. First, the prevalence of official ASD diagnoses among FXS and TSC patients was compared. Next, patients with an official diagnosis were compared in terms of (1) overall autism severity, (2) severity of problems within the restricted and repetitive behaviour (RRB) and social affect domains, and (3) more specific ASD symptoms such as ‘reciprocal communication’. Intelligence quotient (IQ; mean IQ = 58.08) was included as a predictor in the logistic regression and as a covariate in both between-group analyses of covariance and all multivariate analyses of covariance. Results: FXS patients are more likely to receive an official ASD diagnosis (χ2 = 4.081, p = .043). Higher IQ is related to less autism symptomatology (χ2 = 8.592, p = .003). Overall, ASD severity of patients with an official ASD diagnosis does not differ between the patient groups. The FXS patients with ASD exhibited more severe RRB (F = 8.21, p = .005). No significant difference was found for social affect or any specific symptoms. Conclusion: ASD prevalence is higher in children with FXS than in children with TSC, with FXS patients exhibiting more severe RRB. This study illustrates the relevance of comparing symptomatology in monogenetic causes of ASD, indicating that syndrome-symptom relationships can be found. This could lead to earlier intervention and focused treatment for these patients and contributes to research on the genetic aetiology of ASD.Show less
Background: University students with autism are more likely to experience mental health issues during their studies than their neurotypical peers. The exact role of loneliness and meaning in life...Show moreBackground: University students with autism are more likely to experience mental health issues during their studies than their neurotypical peers. The exact role of loneliness and meaning in life in the mental health of students with autism is unknown. Aim: To investigate the impact that loneliness and meaning in life have on different mental health outcomes for university students with and without a diagnosis of autism. The examined mental health outcomes were depression, anxiety, and suicidal ideation. Methods: Online survey. The sample consisted of 59 students with autism and 163 neurotypical university students in the Netherlands. Results: Students with autism reported lower levels of meaning in life and higher levels of loneliness, depression, anxiety, and suicidal ideation than their neurotypical peers. Both loneliness and low meaning in life could significantly predict all the mental outcomes. Loneliness was also predictor of low meaning in life. For participants with autism, there was no evidence of meaning in life mediating the relationship of loneliness with depression and anxiety. However, meaning in life fully mediated the effect that loneliness has on suicidal ideation. Regarding the neurotypical sample, there was evidence of a partial mediation of meaning in life for all three mental health outcomes. Conclusion: Students with autism are at greater risk of depression, anxiety, and suicidal ideation. Both loneliness and low meaning in life may contribute to this. If replicated, universities may be advised to offer social support, as well as interventions targeting meaning in life to their students with autism.Show less
Autistic children tend to experience difficulties in interaction with peers, which makes them vulnerable to experience feelings of loneliness. This study investigates quantitative and qualitative...Show moreAutistic children tend to experience difficulties in interaction with peers, which makes them vulnerable to experience feelings of loneliness. This study investigates quantitative and qualitative variables related to friendship in relation to self-evaluated feelings of loneliness in both autistic and non-autistic children. Questionnaires and sensor data were used to examine the differences in quantity of friendships (network size, time spent in interaction, number of interaction partners and network centrality) and quality of friendship (reciprocal nominations and acceptance) between autistic and non-autistic children in special education as well as how the variables related to self-evaluated feelings of loneliness. No differences were found between feelings of loneliness in autistic and non-autistic children. Autistic children had fewer interaction partners and spent less time in interaction, but did not have a less central position in their networks or a smaller network size. Besides, autistic children might not have had a lower quality of friendships, as they did not have fewer reciprocal nominations than non-autistic children. Concerning the relationship between feelings of loneliness and quantitative variables, only a significant relationship was found between feelings of loneliness and network size for autistic children. No relationship was found for feelings of loneliness and quantitative variables for non-autistic children. No relationships were found between feelings of loneliness and qualitative variables for both autistic and non-autistic children. Further research should involve examining the differences in feelings of loneliness between autistic children in special and mainstream education.Show less
Social anxiety (SA) is found to be highly co-prevalent for individuals with autism spectrum disorder (ASD). Both are characterized by attentional abnormalities in emotional processing. Previous...Show moreSocial anxiety (SA) is found to be highly co-prevalent for individuals with autism spectrum disorder (ASD). Both are characterized by attentional abnormalities in emotional processing. Previous research has shown a significant bias towards angry faces for individuals in both groups. This study aims to investigate the co-prevalence between SA and ASD traits in a non-clinical sample, and how these trait dimensions relate to an attentional bias (AB) towards angry faces. We want to investigate whether SA traits moderate the relationship between ASD traits and the AB towards threatening stimuli. A dot-probe paradigm and self-report questionnaires were used. The results suggest an overlap of characteristics of SA and ASD on trait levels in a non-clinical population. There was significant bias towards angry faces independent of SA and ASD traits. No significant link between the SA and ASD traits and the attentional bias was found and the relationship between ASD traits and the AB towards angry faces was independent of SA trait scores. These results could indicate that in comparison to clinical groups, individuals at lower levels of SA are able to regulate the attentional bias more easily or that the emotional processing for individuals with ASD traits does not reach the hypo- or hyper-arousal. We suggest further exploration of the AB at various points of the spectrum for SA, as well as for clinical groups with ASD. We recommend further investigation on the difference between the AB and disengagement index, in line with recent literature on SA.Show less
Eye contact is crucial for interpersonal communication and bonding between humans. In adults, eye contact can improve feelings of connectedness to and liking for another person, as well as mood....Show moreEye contact is crucial for interpersonal communication and bonding between humans. In adults, eye contact can improve feelings of connectedness to and liking for another person, as well as mood. The present study examined whether eye contact could improve connectedness to and liking for other people in adolescents. Additionally, the influence of perceived levels of closeness (to parents, unknown adults and unknown adolescents) and inter-individual variation in autism spectrum symptoms was assessed. Participants (n = 61; 26.1% female) watched videos of themselves, an unknown adolescent, a parent, or an unknown adult of similar age as their parent either holding eye contact or averting their gaze. After each video, participants reported on their subjective feelings of connectedness to and liking for the person in the video, and their mood. Eye contact significantly improved all three aspects: connectedness, liking and mood. Participants felt most connected to their parents, liked them more and were in a better mood after looking at them, compared to unknown adolescents or adults. There was no evidence for the moderation of subclinical autism spectrum traits on the relationship between eye contact, connectedness, liking and mood. These findings highlight the importance of eye contact for connectedness to and liking for another person, as well as mood. They, therefore, have implications for interpersonal relationships and mental health. The present study points to a therapeutic potential of interventions enhancing eye contact: increased eye contact may contribute to an improved parent-child relationship, which is associated with better mental health.Show less
Research on the treatment of school refusal is mainly confined to efficacy studies conducted under controlled and ideal conditions. Efficacy studies often do not match the requirements of real...Show moreResearch on the treatment of school refusal is mainly confined to efficacy studies conducted under controlled and ideal conditions. Efficacy studies often do not match the requirements of real-world settings. In order to bridge the gap between research-based studies (i.e., efficacy studies) and everyday clinical work in education or community settings, this study was conducted under real-world conditions outside of the more constrained university environment. The aim of the current study was to: (1) gain knowledge about characteristics of youth and their families seeking treatment for school refusal in a real-world setting; and (2) to preliminarily evaluate the effectiveness of a CBT based treatment protocol delivered in an educational setting. Characteristics of ten young people were explored, and treatment effectiveness was assessed using Wilcoxon signed-rank tests. Results suggested that the prevalence of autism spectrum disorder (ASD) is highly prevalent in youth participating in treatment for school refusal in a practice-based setting. Furthermore, increases in school attendance and decreases in symptoms of anxiety and depression were observed after treatment. The promising preliminary findings of the study indicate that treatment of school refusal may be effective even for more complex cases with comorbid ASD, and when delivered with limited training and supervision. Thereby, the implementation of treatment for school refusal may become more likely in real-world practice.Show less
Since its inception, many changes to the concept of ‘autism’ have been suggested, by both autistic people and researchers. Recently, the number of people diagnosed with a form of autism has...Show moreSince its inception, many changes to the concept of ‘autism’ have been suggested, by both autistic people and researchers. Recently, the number of people diagnosed with a form of autism has increased, and a contemporary topic of discussion is whether it should be defined as a disorder, a mere human variation, or something else. As society is inclined to stigmatise eccentricity, it is important that the definition used does not harm autistic people, or misrepresent the large variety of their experiences. This thesis argues that the fifth Diagnostic and Statistical Manual for Mental Disorders’ (DSM-5) current conceptualisation of autism as ‘Autism Spectrum Disorder’ is both inaccurate and dangerous. Definitions from all DSMs are described, and the motivations behind the changes between DSMs are considered, alongside arguments from a collection of philosophers. The conclusion is that the components ‘Spectrum’ and ‘Disorder’ in ‘ASD’ risk inciting stigmatisation and suggest a more uniform expression than autism actually has. Thus, an alternative definition much be found. This alternative, which could be pursued through further research, should give autistic people a way to think about their identity, and non-autistic people a way to accurately understand and describe the diverse autistic experiences, both negative and positive.Show less
An Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder that is characterized by impairments in social interaction and communication. Lacks of Theory of Mind, empathy and...Show moreAn Autism Spectrum Disorder (ASD) is a pervasive neurodevelopmental disorder that is characterized by impairments in social interaction and communication. Lacks of Theory of Mind, empathy and emotion recognition have been invoked as an explanatory mechanism for the impairments in the social cognition in an ASD. There is a need for a better understanding of the underlying mechanisms for a better diagnosis and treatment of women with an ASD, because they are good in hiding the characteristics of an ASD. The current study compares different aspects of social cognition between women with a high functioning ASD and typical developed (TD) women through a comparison between women with and without an ASD. This comparison is based on their performance of social cognition tasks and through a comparison between women with an ASD mutually based on their reflectivity. A total of 31 women with an ASD and 30 TD women participated in this study. The prosody task of the ANT was used for recognition of basic emotions. For the visual emotion recognition the Facial Expression Recognition task was used. The informant list of the Interpersonal Reactivity Index was used to get the various aspects of empathy in daily life. The Dewey Social Story test was used for an impression of perspective taking and understanding of usual and unusual social situations. Results show that women with an ASD have more difficulty with perspective taking and in understanding of other people’s mental states. Although women with an ASD perform similar to TD women in recognizing the basic emotions, women with an ASD perform worse when these emotions are showed with low intensity. Women with an ASD are also slower in recognizing all basic emotions. The results of the comparison within the ASD-group based on their reflectivity shows that women with a good reflectivity are better in recognizing basic emotions when emotions are showed with high intensity. Furthermore, there are no noticeable differences in the comparison between women with good and poor reflectivity within the ASD-group. The two components, in which women with an ASD perform worse compared to women without ASD, can possibly play an important role in the social interactions, which are often based on high speed unconscious activities. More research is needed for a better understanding of the relationship between the Theory of Mind and the reflectivity and of the relationship between the different explanatory models of the impairments in social interaction and communication.Show less
Research master thesis | Developmental Psychopathology in Education and Child Studies (research) (MSc)
open access
2017-08-28T00:00:00Z
This study was conducted to assess subjective quality of life and to distinguish predictors of quality of life in young adults with autism spectrum disorder (ASD). Young adults with ASD enrolled in...Show moreThis study was conducted to assess subjective quality of life and to distinguish predictors of quality of life in young adults with autism spectrum disorder (ASD). Young adults with ASD enrolled in higher education were compared to control students without ASD with respect to quality of life, executive functioning, motivation performance, social anxiety, emotion regulation, stress coping abilities, ASD symptoms, adaptive functioning, and self-reflection. Young adults with ASD reported lower subjective quality of life than control peers and showed higher impairment in all of the above-mentioned areas. Within the ASD group, low initiative taking, high internalizing problems, and high negative tension in social situations predict lower quality of life. Together, these findings indicate that deficits in the stress regulation system lead to lower subjective quality of life in young adults with ASD, despite their high functioning.Show less
This study examined the influence of the level of intelligence on the level and form of social anxiety (SA) in boys and girls with and without autism spectrum disorder (ASD). Children (n = 160),...Show moreThis study examined the influence of the level of intelligence on the level and form of social anxiety (SA) in boys and girls with and without autism spectrum disorder (ASD). Children (n = 160), between eight and eighteen years old with a mean age of 11.0 years (SD = 1.7), with ASD (n = 50) and without ASD (n = 110) completed the subtests Vocabulary and Block Patterns from the Wechsler Intelligence Scale of Children-III (WISC-III-NL) and the Social Anxiety Scale for Children (SAS-k). Also other factors are taken into account, namely difference between several types of ASD, verbal and performance intelligence, forms of SA and gender in relation to SA. Children with ASD reported more SA than children without ASD, and SA is linked to the level of intelligence, in the sense that the higher the level of intelligence, the lower the level of SA. Children experienced more SA in situations which demand their intellectual skills and their outward appearance in social situations. Furthermore, children with a higher level of verbal intelligence reported a lower level of SA compared with children with a lower level of verbal intelligence. At last, children with autism reported a higher level of SA compared with children with Asperger's Syndrome or children without ASD. These findings demonstrate the relationship between children with ASD and the level of SA and the influence of intelligence. Also the importance of intelligence tests in the initiation of clinical treatment.Show less
Research master thesis | Developmental Psychopathology in Education and Child Studies (research) (MSc)
open access
2016-10-29T00:00:00Z
Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder associated with multiple cutaneous, physical and neurological symptoms. The aim of this study was to validate current NF1...Show moreNeurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder associated with multiple cutaneous, physical and neurological symptoms. The aim of this study was to validate current NF1 severity scales using PCA, and relating the NF1 severity scale and components to cognitive and behavioural outcomes. Participants were 18 children diagnosed with NF1 aged 8 to 16 years. The PCA showed that NF1 symptoms could be divided into neurological and appearance symptoms. The presence of more neurological symptoms was associated with a lower score on the task Comprehension. More symptoms in the appearance were associated with less assertiveness. A higher total number of NF1 symptoms was negatively related to the scale meta-cognition of the BRIEF, indicating poorer executive functioning in daily life for children with more NF1 symptoms. Also, elevated autistic traits were observed using the SRS, and poorer emotion recognition as measured with the ANT. Together, these results might indicate that children with NF1 share a neuropsychological profile commonly seen in children with ASD, which might be related to neurological symptoms.Show less
