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Autism is associated with a range of costs. This paper reviews the literature on estimating the economic costs of autism spectrum disorder (ASD). More or less 50 papers covering multiple countries (US, UK, Australia, Canada, Sweden, the Netherlands, etc.) were analysed. Six types of costs are discussed in depth: (i) medical and healthcare service costs, (ii) therapeutic costs, (iii) (special) education costs, (iv) costs of production loss for adults with ASD, (v) costs of informal care and lost productivity for family/caregivers, and (vi) costs of accommodation, respite care, and out-of-pocket expenses. A general finding is that individuals with ASD and families with children with ASD have higher costs. Education costs appear to be a major cost component for parents with children with ASD.

We examined the role of social motivation and motor execution factors in object-directed imitation difficulties in autism spectrum disorder. A series of to-be-imitated actions was presented to 35 children with autism spectrum disorder and 20 typically developing children on an Apple® iPad® by a "socially responsive" or "aloof" model, under conditions of "low" and "high motor demand." There were no differences in imitation performance (i.e. the number of actions reproduced within a fixed sequence), for either group, in response to a model who acted socially responsive or aloof. Children with autism spectrum disorder imitated the high motor demand task more poorly than the low motor demand task, while imitation performance for typically developing children was equivalent across the low and high motor demand conditions. Furthermore, imitative performance in the autism spectrum disorder group was unrelated to social reciprocity, though positively associated with fine motor coordination. These results suggest that difficulties in object-directed imitation in autism spectrum disorder are the result of motor execution difficulties, not reduced social motivation. [This paper was presented at the 2016 International Meeting for Autism Research.]

The provision of new opportunities to maximize learning is a fundamental right for all students. This paper explores the role of digital technology in the provision of educational opportunities for secondary age students who have been diagnosed with an intellectual disability and/or autism spectrum disorder. We describe a learning environment in which a range of technologies have been introduced to enable students' access to the national curriculum, and acquire skills that improve their ability to navigate the world outside the classroom. Through a qualitative study, we describe promising experiences of emerging technologies used to assist learning at the Inclusive Education Centre of a public secondary school located in regional South Australia. Our results suggest that emerging technologies can provide guidance to groups of students, encourage them to express their ideas, motivate physical activity, and improve general social interaction skills. In particular, we explore the impact, limitations and future opportunities of immersive virtual reality and social robots.

Socialization difficulties in children with an Autism Spectrum Disorder (ASD) are often associated with peer rejection and impaired academic achievement. Schools might appear to offer an ideal setting for social-emotional skills (SES) instruction. However, common challenges to successful implementation of school-based programs include inadequate staffing and resourcing, and a lack of ASD-specific staff training. This paper describes how barriers to program implementation were overcome in a project evaluating the Secret Agent Society (SAS) SES training intervention within Autism Spectrum Australia (Aspect) specialist classes. Questionnaire data was collected from school staff over a one-year period. Findings supported the effectiveness of the adoption process used, and suggest that SAS was feasible and acceptable to school staff.

This paper proposes that play therapy can be an appropriate intervention in working with children with autism in schools especially when working with children who have little in the way of social skills and poor communication. It proposes that play therapy may offer school counsellors opportunities that the more cognitive therapies do not. Through the use of case study research, the paper discusses and illustrates an intervention with a seven year old boy with autism across 12 sessions of sandplay in a school in Queensland, Australia. This paper draws our attention to the legitimate use of case study research in counselling. It also advocates for the use of sandplay, (an expressive therapy intervention) with a child who is autistic and who at first plays chaotically. This paper draws the counsellor's attention to the developmental stages that will follow when the child feels secure enough to proceed. The lack of well researched longitudinal quantitative or mixed method research in play therapy is also noted. (Contains 7 figures.)

There is limited research examining the inclusion of autistic people in their local communities. This paper reports on two Australian studies which explored this gap, focusing on both autistic people's experiences and non-autistic people's attitudes towards autistic individuals. Study One was conducted with primarily non-autistic people (n = 2,383), and Study Two with primarily parents and carers of autistic people (n = 1,297 people). The majority of non-autistic adults perceived discrimination against autistic people in the community; consistent with the experiences of autistic people and their carers. Of particular concern was more negative attitudes towards, and experiences of, autistic adults. There is an urgent need to improve society's acceptance and inclusion of autistic people of all ages.

This paper presents two studies that explored community attitudes to autism in Australia; and autistic people and their families' perspectives of community attitudes. In Study One 2424 (primarily non-autistic) people completed a survey on autism-related knowledge and attitudes; identifying a number of misperceptions and knowledge gaps in the general community. In Study Two 1353 people (primarily parents and carers of autistic people) completed a survey on autism-related experiences; identifying that the community's awareness of autism does not appear to extend to understanding how to support autistic people. There is a need for more research which integrates the perspectives of both autistic people and the broader community; and the development of communication and education interventions, "with" rather than "about" autistic people.

The experiences of regional and rural teachers supporting students on the autism spectrum in their classrooms often differ from those of their metropolitan counterparts. Interventions designed for metropolitan settings may not work the same way in regional and rural classrooms, and teachers outside major centres may encounter challenges in accessing appropriate resources and professional development. Research focussed on teaching students on the spectrum is largely conducted in metropolitan areas and does not address the contextual factors impacting regional and rural educators. Using data collected as part of a larger study, this paper examines the experiences of regional and rural teachers who were introduced to models of practice designed to support their decision making with respect to supporting students on the autism spectrum. Through interviews and survey responses, these teachers have described challenges and opportunities related to the unique and diverse settings in which they work. Their perceptions of the benefits of the models and accompanying professional support in these settings reinforce the need to embed inclusive support for students on the spectrum in foundational teaching practices that can be adapted to diverse classrooms.

Students with an autism spectrum disorder (ASD) often cannot access reliable mainstream inclusive practice that maximises their progress over time. In response to this, some parents have chosen to home educate their children. Limited research indicates that while parents find the experience beneficial for their child, there is a need for considerably more educational, social, financial support and respite. In relation to gaining appropriate support, a small number of families have managed to combine the home education of their children with an ASD with access to the services of the Schools of Isolated and Distance Education (SIDE). Little is known about this experience in the research literature. To address this deficit, the first part of this paper traces the establishment of a distance education provider in the State of Western Australia (WA). It outlines subsequent developments and describes the variety of students now catered for by SIDE inclusive of students at educational risk. The second part of the paper reports on the findings of a recent constructivist grounded theory study conducted in a metropolitan WA context that examined how parents from two families dealt with the home education of their children with an ASD with the support of SIDE.

Background: Traditional treatment for the behavioural symptoms in autism spectrum disorder (ASD) remains unsatisfactory. There is an urgent need for new, biologically relevant therapies that target both the core and comorbid symptoms that children may experience. This article builds on research previously published by the authors. Method: We report a mixed-methods analysis from a 24-week double-blind randomised controlled trial of adjunctive "N"-acetylcysteine (NAC) for the treatment of behavioural symptoms in ASD. Ninety-eight children between the ages of 3 and 9 years, diagnosed with ASD, participated in the study. Outcome measures included parents' assessment reports (obtained before, during, and after the trial), clinicians' observations, and the researchers' detailed case notes. Thematic analysis of textual data (n = 85) was carried out, followed by an evaluation of differences in the frequency with which changes in behaviour were qualitatively reported. Results: Compared with placebo, the parents of the group that received NAC reported improved calmness, decreased aggression and agitation, and greater improvements in verbal communication. Conclusions: These results support the usefulness of NAC for treating potentially disruptive behaviour (e.g., aggression and hyperactivity) in children with ASD and provide a novel finding: potentially improved verbal communication following NAC treatment. This paper supports the utility of a mixed-methods analysis for detecting latent signals in clinical trials.

Background: This descriptive single-case study reports upon a four-decade history of health care and support provided to one male with life-long intellectual disability and significant comorbidities. Methods: All available paper and electronic documentation from the past 40 years was reviewed, with relevant health and medication information collated and summarised. Results: The collated information notes radical movement in mental health diagnoses and significant emerging physical health issues. There are disparate and sometimes contradictory mental and physical health diagnoses from age 2 years and significant changes in treatment. Conclusions: This case outlines a number of important issues for medical and health care practitioners to consider when supporting individuals with intellectual disability. Clear differentiation between an existing intellectual disability, autism, and emerging mental health concerns has remained problematic over many decades. The lack of effective pain management, when contrasted against comprehensive medication regimes for health issues, is particularly concerning.

The mass media provides a frame for discourse around important health issues, and it has been widely demonstrated that the development and reinforcement of stereotypes of minority groups are strongly influenced by the news and entertainment media. An extensive search of academic databases failed to locate any studies which examined the representation of autism in the news media, although there were a number of articles on the media role in the autism and MMR debate. This paper reports on an examination of the extent, and nature, of coverage of "autism spectrum disorders" in the Australian print media between 1996 and 2005. Key findings include a relatively limited amount of factual information and a dual stereotype of people labeled as having autism as either dangerous and uncontrollable or unloved and poorly treated. The paper concludes with a discussion of the implications of the nature and tone of this coverage of autism and its potential impact on individuals described as "autistic", their families and carers and the community in general. (Contains 1 figure and 5 notes.)

Accumulating evidence suggests that the prevalence of bullying is significantly higher for students with Autism Spectrum Disorder (ASD) than for typically developing students. Additionally, the prominence and growth of social networking and resultant focus on cyberbullying in the last 10 years has added a new dimension to the traditional definitions, environments and experiences of bullying. This paper describes current anti-bullying strategies and the legal climate in regard to bullying in Australia. It then reports on interviews with 10 students with ASD and their parents, and discusses recommendations based on their perceptions for dealing with bullying in schools. Data analysis indicated that both students and parents made a range of recommendations to increase awareness of bullying; improve policies and procedures that can be more clearly communicated to students, teachers and parents; and support programmes that develop communication and relationship building within families and in schools to both prevent bullying and provide coping strategies to deal with bullying if it occurs. Parents also called for schools to give harsher penalties for offenders, particularly repeat offenders. These student and parent recommendations may contribute to the development of school and government policy and practice to help reduce the incidence of all forms of bullying in schools.

Extant research on sources of information about interventions used by parents of children with autism spectrum disorder (ASD) has provided a general overview of sources used. However, it has provided little insight into why parents view certain sources as reliable or trustworthy, or how useful parents found the information provided to them by the sources and why. This paper provides a qualitative analysis of interviews conducted with 12 Australian parents of preschool-age children with ASD. Participants discussed the factors related to their perceptions of the reliability and trustworthiness of sources used, as well as the usefulness of the information provided. Parent ratings of the reliability of sources were influenced by factors including the firsthand experience of other parents, the parent's relationship with the source, and their beliefs about the sources' intentions. A number of parents reported that sources provided either information of limited use or an overwhelming amount of information. Considerable variation was reported in the usefulness of information provided to parents. Recommendations regarding research and practice are offered.

The contemporary need for older workers to participate in education and training programs to increase their employability has exposed many of them to learning opportunities involving online learning in higher education. This paper reports research into the issues and experiences of an adult learner with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) engaging in undergraduate online learning. The issues and experiences were identified through the use of inductive, in-depth interpretive phenomenological analysis (IPA), as part of a larger study. The profile of the target student was very different from the other nine participants in the study, and was interpreted as principally related to disorientation within his online learning environment. Three types of disorientation were identified--navigational, contextual, and procedural--each of which presented strategies for its mitigation. The research revealed a significant disjunction between the characteristics of the learner's online learning environment and his learning needs and preferences, which has implications for the design and development of inclusive online learning environments in higher education.

Evaluation of the Get REAL programme in an inclusive primary school setting has indicated its effectiveness in promoting pro-social behaviour for children with high functioning Autism. However, two children with co-morbid diagnoses and complex personal circumstances showed less consistent improvements. In order to explain their unique trajectories, not readily derived from quantitative studies, an exploratory case study approach was used to examine contextual influences on patterns of progress. Multiple data sources included coded video footage from the Get REAL programme, school reports on conduct, and parents and classroom teacher reports using the Strengths and Difficulties Questionnaire. While results provide support for the efficacy of the Get REAL programme for the two children, they also highlight the value of co-ordinated strategies and collaborative individualised approaches in more complex cases. This paper outlines the Get REAL intervention and a range of other school and support agency strategies impacting progress. (Contains 2 tables and 9 figures.)

A significant gap exists in the Australian research literature on the disproportionate over-representation of minority groups in special education. The aim of this paper is to make a contribution to the research evidence-base by sketching an outline of the issue as it presents in Australia's largest education system in the state of New South Wales. Findings from this research show that Indigenous students are equally represented in special schools enrolling students with autism, physical, sensory, and intellectual disabilities, but significantly over-represented in special schools enrolling students under the categories of emotional disturbance, behaviour disorder and juvenile detention. Factors that might influence the disproportionate over-representation of Indigenous children and young people are discussed, and based on these observations, some practical implications for policy and practice are provided. (Contains 5 notes and 4 tables.)

School psychologists who contribute to the assessment of children with an autism spectrum disorder (ASD) are required by various Australian state government authorities to use standardised testing of cognitive skills, adaptive behaviour and some autism-based symptomatology to demonstrate the eligibility of those children for support funding in the school environment. However, this process does not always address the needs of parents and teachers for detailed and particular analysis of the reasons for the pervasive behavioural difficulties often shown by children with an ASD. Such difficult behaviour has been shown to contribute to high levels of stress among caregivers and often prevents the child with an ASD from successful school inclusion. Therefore, it would be advantageous for parents and teachers to have access to information obtained from an analysis of the child's behavioural difficulties as one outcome of the formal testing process that is conducted to examine the possible presence of an ASD. This paper presents a brief example of how a basic behavioural investigation might be incorporated into the assessment of children with a suspected ASD.

This paper describes a process of assisting parents of young children with Autistic Spectrum Disorder (ASD) to identify and prioritise their goals for their children's early intervention. A modified version of the Canadian Occupational Performance Measure (M-COPM) was used to facilitate this process. Twenty-two child-parent dyads involved in a home-based early intervention program participated in this study. Parents were able to identify and prioritise three to six early intervention goals for their children. Consistent with the core impairments of ASD, identified goals related to the domains of communication, behaviour, play and social interaction. The M-COPM was found to be a useful tool for enabling parents to identify goals for their children, when used and understood from a strong client and family-centred philosophical perspective. Pre- and post-intervention parent ratings of goal performance and satisfaction are presented to demonstrate the use of the M-COPM as an outcome measure. Implications for practitioners in early childhood and special education settings, and areas for further research, are also discussed. (Contains 2 figures and 1 table.)

Background: Bridging the research–practice gap in autism communication services is an identified priority for improving services. Limited research has investigated the views of practitioners regarding this research–practice gap. Investigation of the barriers experienced and facilitators used in clinical practice may assist to identify scalable and sustainable strategies to increase use of evidence‐based practices (EBPs) in the delivery of communication services to children with autism. Aims: To elucidate how Australian speech pathologists engage with external evidence and how communication outcomes are measured to demonstrate the effectiveness of service provision to children with autism. Methods & Procedures: A total of 15 Australian speech pathologists, with experience ranging from less than 1 to more than 16 years, participated in three focus groups. Data from focus groups were analysed using reflexive thematic analysis within an interpretive phenomenological paradigm. Outcomes & Results: Seven themes were identified. Participants reported on the diversity of individuals with autism, their experiences of resource constraints, seeking collegial advice and accessing a diverse range of evidence sources, the role of clinical expertise in translating evidence to practice, the barriers experienced in outcome measurement and use of stakeholders to facilitate data collection to demonstrate outcomes. Conclusions & Implications: Individual practitioner skill and beliefs are facilitators to translating research to practice. Interventions to improve clinician use of EBP should address the skill and belief barriers, aiming to increase a clinician's EBP self‐efficacy and increasing their expectation that investing in EBP activities will result in improved services for children with autism. Modelling and reflective practice are two strategies that may have an application as interventions to improve EBP use in clinical practice. What this paper adds: What is already known on the subject: Constrained resources, especially lack of time, is a barrier to routine uptake of best available evidence in clinical services for children with autism. What this paper adds to existing knowledge: In this study, the perception that speech pathologists lacked time to engage in EBP activities was linked with the speech pathologist's research skill and their beliefs about the benefits of engaging in EBP. Speech Pathologists reported using a range of information sources, as "evidence" but also reported feeling uneasy when using evidence of disputable, or unknown quality. Accessibility and relevance to their individual client were highly prioritised in selecting evidence. Clinical expertise was an essential skill for research translation. What are the potential or actual clinical implications of this work?: Interventions which target professional beliefs and research translation capability are requisite for motivating speech pathologists to improve their use of EBP.Modelling of EBP use, individual reflective practice and collegial active listening to facilitate reflective practice, might be useful strategies which target beliefs and capability of individual speech pathologists; thereby changing their EBP use. [ABSTRACT FROM AUTHOR]

This critique of facilitated communication as an aid for individuals with autism reviews its use in Australia and discusses such issues as the high degree of physical intervention provided by the assistant and the unlikely language content exhibited. An editorial comment deplores the media hype promoting facilitated communication but admits its potential for helping some individuals. (JDD)

Background and aims: Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences – and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home–school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home–school partnerships study over time and (2) understand their experiences of being community partners on the home–school partnerships project. Methods: Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home–school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home–school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. Results: We found that parents' input fundamentally shaped the broader home–school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home–school partnership study – although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home–school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. Conclusions: These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. Implications: This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities. [ABSTRACT FROM AUTHOR]

The complexities of including students with autism in schools throughout Australia has resulted in the increased necessity for collaboration between stakeholders. For included students with autism, secondary school presents a variety of subjects, teachers and peers that have the potential to increase anxiety levels compared to their primary experience. Communication between important stakeholders is critical in alleviating issues for students with autism before they escalate. In this paper, researchers report and reflect on the implementation of a co-design process as a rigorous practice-based research methodology that provided an empathy focussed platform to explore possibilities in designing a prototype digital solution to support students with autism. The project was designed to identify communication issues associated with the secondary experience of students with autism and to create solutions via the development of a rapid prototype communication app. Findings from this project suggest that involving diverse stakeholders in co-designing and exploring possibilities in complex school environments had two benefits: stakeholders had the opportunity to see the challenge from other parties' perspectives, and the process promoted creativity and flexibility in generating people-based solutions. [ABSTRACT FROM AUTHOR]

Limited studies exist exploring employers' capacity in hiring and supporting employees on the autism spectrum, and even fewer have considered interventions targeting employers' skills and knowledge in enhancing employment opportunities. In response to this need, the Integrated Employment Success Tool (IESTTM) was developed and its effectiveness established in a randomized controlled trial (RCT). Furthermore, a process evaluation was conducted to determine the usability and implementation of the IESTTM. The process evaluation was conducted to determine employers' perceived usability, implementation, and perceived barriers and facilitators in using the IESTTM. Employers (N = 29) provided their feedback via an online questionnaire. Of these, 11 participants were interviewed, further exploring their experiences. Data were analysed via descriptive statistics and thematic analysis. While employers' frequency and usage of the IESTTM varied across workplaces, it was predominantly used to increase employers' knowledge of autism and implement workplace strategies. A major barrier was the paper-based format of the intervention, with more than 60% of employers indicating the need for an online version. The process evaluation was a critical step in understanding why the IESTTM was effective, and how it could be further optimized for prospective employers. [ABSTRACT FROM AUTHOR]

The increasing number of children on the autism spectrum entering mainstream schools requires classroom teachers with the knowledge and skills to create supportive and inclusive environments in which these students can thrive. This paper reports the perspectives offered by 33 teachers who volunteered to trial an Early Years Model of Practice (EY-MoP) designed to provide information and guidance on foundational practices supportive of students on the spectrum. All teachers worked in Australian primary schools and had at least one student on the spectrum in their early years classrooms. In pre-and post-trial interviews, teachers shared their impressions of, and experiences with, the EY-MoP. In general, they endorsed the model as a resource outlining foundational practices for working with students on the spectrum. Insights shared pointed to the positive impact that this kind of comprehensive, foundational resource can have on teaching practice both in everyday planning and as a reflective tool. Responses also indicated that the model enhanced teachers' knowledge and confidence in supporting students on the spectrum. Taken together, these teacher data provide preliminary evidence for the viability of the EY-MoP as a resource to support both beginning and experienced teachers in their work with young children on the spectrum. [ABSTRACT FROM AUTHOR]

The rising number of students in schools identified as being on the autism spectrum has placed pressure on school leaders and staff to gain knowledge and take on new practice. A school-wide autism competency (SAC) approach utilises the research on elements of effective practice to build the capacity of school leaders and staff to create inclusive school cultures, implement evidence-based strategies, and improve outcomes for students on the autism spectrum. This paper reports on the experiences of three schools as they implemented the SAC approach in Queensland, Australia. A multiple case study design was utilised to examine the factors that influenced the implementation process and outcomes achieved at each school. Factors that influenced each school's ability to transform their practice for students on the autism spectrum included engagement of leaders, support from an external coach, involvement of parents, realignment of resources and staff, and the ability to manage change and competing priorities. Findings revealed that although all three schools increased staff's knowledge of students on the autism spectrum, the engagement and actions of leaders and the underlying culture of the school influenced the degree to which changes were implemented and outcomes were realised for students on the autism spectrum. [ABSTRACT FROM AUTHOR]

Media sources can influence and shape attitudes and beliefs towards others. This study explored newspapers depictions of autism. All articles which included keywords relating to autism published in 2016–18 in Australian newspapers were read, coded, and categorised. In 2016, 428 articles relating to autism were published, 532 in 2017, and 391 in 2018. Only 7% of all articles demonstrated a high content focus on autism; most (59%) were heavily focused on opinion and less than 1% included first-hand perspectives from individuals on the spectrum. Over half the articles focussed upon health and medical issues (33%) and profiles of people on the autism spectrum (25%). To minimise the spread of misinformation around autism, the paper concludes with advice for those writing media articles related to autism. Newspapers provide a public account of autism and those with autism, therefore, media portrayals and what aspects of the condition are reported, inform public perceptions. Newspaper articles predominantly focus on the health and medical aspects of the condition, emphasising a 'cure' or treatments for autism. Articles tend to single out individuals with a diagnosis on the autism spectrum, through media depictions or characterisations. Media articles reviewed often only mentioned autism but did not explain or discuss the details related to the syndrome and rarely included the expertise of qualified practitioners. Only 1% of all news stories included first-hand perspectives from individuals on the autism spectrum. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability face a number of barriers to participation in physical activity. This paper aimed to determine rates of sport and physical activity participation in an Australian sample of adults with intellectual disability, compared with rates of participation in the general Australian population. A secondary aim was to investigate factors that may contribute to participation of adults with intellectual disability. Method: Participants were part of the Australian Child to Adult Development (ACAD) study, consisting of a community sample with intellectual disability (n = 305), groups of adults with autism (n = 94), Down syndrome (n = 64), fragile X syndrome (n = 52), Williams syndrome (n = 45), and Prader–Willi syndrome (n = 30). Participation in sport/physical activity was reported over the past 3 months. Rates of participation were reported for adults with intellectual disability and compared with rates in a general Australian population sample. The relationship between participation in physical activity and age, degree of intellectual disability, physical mobility, living situation, socio‐economic disadvantage, and behaviour and emotional problems were also conducted. Results: Participants in the ACAD community sample with intellectual disability participated in sport/physical activity at lower rates than the general Australian population (42% compared with 71%). Having no physical mobility impairment was significantly associated with higher rates of participation. Those with Down syndrome participated in sport/physical activity at higher rates than the community sample with intellectual disability, while no difference in sport/physical activity participation was observed in the groups with autism or other syndromes. Conclusion: Australian adults with intellectual disability participate in sport and physical activity at lower rates than the general population. Having a physical mobility impairment was associated with lower rates of participation. However, people living in supported accommodation were more likely to participate than those in other living situations. Having Down syndrome was associated with a higher participation rate than the community sample. [ABSTRACT FROM AUTHOR]

Recruiting adults with autism spectrum disorders (ASD) into research poses particular difficulties; longitudinal studies face additional challenges. This paper reports on a mixed methods study to identify factors influencing the participation in longitudinal autism research of adults with ASD, including those with an intellectual disability, and their carers. Common and differentiating factors influencing the research participation of participants are identified and discussed. Factors influencing participation were found to differ both between and within participant categories. We propose a dichotomy whereby factors influencing research participation can be classified as those arising from a participant's values, which act as either a motivator or a deterrent; and those based on convenience, which act as either an enabler or inhibitor. These findings are applicable to research studies that seek to recruit adults with ASD as participants. [ABSTRACT FROM AUTHOR]

With the increasing number of treatment and intervention options for parents of children with autism spectrum disorders (ASD) in recent years, the number and types of interventions that parents are choosing to use has become of interest. In the present paper, the authors review 41 articles (describing 42 studies) presenting quantitative data on intervention choices of parents of children with ASD. Speech therapy was the most commonly reported intervention for both current and lifetime use. Across the studies, parents were reported to be using a variety of interventions, from those with strong empirical support, such as applied behaviour analysis (ABA), to others that lacked such support, such as dietary interventions. Some differences in the data presented across studies may be attributed to the range of different methodologies used to collect the data. Recommendations for future research, including those related to collecting treatment usage data more consistently, are discussed. [ABSTRACT FROM PUBLISHER]

The social difficulties of autism spectrum disorder (ASD) are typically explained as a disruption in the Shared Attention Mechanism (SAM) sub-component of the theory of mind (ToM) system. In the current paper, we explore the hypothesis that SAM's capacity to construct the self-other-object relations necessary for shared-attention arises from a self-categorization process, which is weaker among those with more autistic-like traits. We present participants with self-categorization and shared-attention tasks, and measure their autism-spectrum quotient (AQ). Results reveal a negative relationship between AQ and shared-attention, via self-categorization, suggesting a role for self-categorization in the disruption in SAM seen in ASD. Implications for intervention, and for a ToM model in which weak central coherence plays a role are discussed. [ABSTRACT FROM AUTHOR]

This paper charted the cognitive and behavioural profiles from toddlerhood to middle childhood in 48 children diagnosed with ASD at 24-months. The Mullen Scales of Early Learning (MSEL) was administered at 24- and 48-months and the Wechsler Abbreviated Scale of Intelligence (WASI) at school age. Autism severity was derived using The Autism Diagnostic Observation Schedule (ADOS) Results: Developmental Disability/Intellectual Disability (DD/ID; Developmental Quotient <70) reduced from 64% at 24-months to 8% at outcome. Seventy-three percent of children continued to meet ADOS cut-off at school age. Conclusion: Diagnoses at 24-months, appear to be reliable and stable. Further research is needed to investigate whether early identification, which provides more opportunity to access early intervention, may in turn facilitate cognitive development over time. [ABSTRACT FROM AUTHOR]

Many autistic adults are likely to experience poor financial wellbeing and hardship due to unemployment and under-employment. Research in the general population demonstrates that subjective financial wellbeing—how people perceive their financial situation—influences quality of life. There is no research, however, examining the subjective financial wellbeing of autistic people. This study therefore aimed to (1) understand the subjective financial wellbeing of a sample of autistic adults living in Australia compared to a general Australian population sample and (2) identify the predictors of subjective financial wellbeing in this sample of autistic adults. To this end, 191 autistic adults aged 18–83 years (mean = 39.28, standard deviation = 11.74) completed an online survey about their economic status, financial wellbeing, financial behaviors, confidence in money management skills, and anxiety and depression symptoms. Almost half of our sample felt it was a struggle to make ends meet, whereas only one-third of the general Australian population felt this way. Similar to the general population, autistic people's income and their financial behaviors (specifically, saving and not borrowing for everyday expenses) predicted their sense of financial wellbeing. Our findings have implications for both research and practice. Researchers have found the way people feel about their financial situation is related to their quality of life. We know that many autistic people find it hard to find a job. And for those autistic people who have a job, they are often underpaid. Not having a job or being underpaid often means having low income. Having low income is likely to influence how autistic people feel about their financial situation. However, no research has looked at these issues for autistic people. This is the first study that helps us learn more about what autistic adults think about their financial situation. We looked at autistic people's thoughts on this issue compared to people from the general Australian population. We also looked at what things might impact how autistic people feel about their financial situation—which might be how much money they earn, what they do with that money, and their mental health. Many autistic adults felt they were struggling with financial wellbeing and this was connected both to the level of their income and how they said they managed their money. Those who were able to save and not borrow for everyday expenses reported feeling a greater sense of financial wellbeing. Concrete changes might help to improve autistic people's financial wellbeing. We need to investigate how we can help autistic people find and keep well-paying jobs. And we need to work out the best ways of equipping autistic people with the skills they need in financial matters. [ABSTRACT FROM AUTHOR]

Background: Despite awareness of the need to support autistic students in transitions, great variability is found in transition supports provided across different school environments and staff within schools. Moreover, strategies implemented may not provide autistic students with the supports they need to reduce their anxiety and build their sense of self-determination during transitions.Aim: The current paper aimed to determine what types of transition supports are employed in Australian schools to support autistic students and to consider these supports through the lens of self-determination theory.Methods: Surveys were conducted with 422 parents, educators and education specialists who provided information on transition supports employed in schools in open-ended questions. Transition supports were explored in more depth through interviews with a subset of 30 participants.Results: Findings indicate that schools provided a range of strategies, programmes and planning processes to support students in transitions. However, students were often passive recipients of supports who were rarely involved in the planning and implementation of strategies.Conclusion: The results of this study suggest that current transition supports implemented in schools may support autistic students in some transitions, but are not likely to develop their self-determination to successfully navigate transitions over the long-term. WHAT THIS PAPER ADDS?: Drawing on self-determination theory, this study provides a unique and much needed examination of the types of strategies employed in schools and offers a critical reflection as to whether these strategies are likely to support autistic students to develop a sense of autonomy, competence and relatedness to successfully manage future transitions. [ABSTRACT FROM AUTHOR]

Barriers to healthcare experienced by Australian autistic adults have not been previously explored. We conducted a cross-sectional investigation of barriers to healthcare and associated factors from a subtle realism perspective. Perceived barriers to healthcare were obtained from the Barriers to Healthcare Checklist Short-Form (BHC). A total of 263 autistic and 70 non-autistic individuals completed the BHC. On average, autistic adults reported more barriers to healthcare (4.58) than non-autistic adults (0.76). Gender diversity, higher levels of generalised anxiety, greater global disability and less satisfaction with social support contributed to the experience of barriers to healthcare in autistic participants in regression modelling. Australian autistic adults face substantial barriers to healthcare. Understanding these barriers provides an opportunity to develop approaches to improve access; such as co-designing a healthcare access roadmap for autistic adults, with co-designed policies and practices which advocate for the needs of autistic adults. This study looked at how Australian autistic and non-autistic adults experience barriers to healthcare. We asked autistic and non-autistic adults to complete the Barriers to Healthcare Checklist Short-Form (BHC). We analysed data from 263 autistic adults and 70 non-autistic adults. We found that autistic adults experienced more barriers to healthcare than non-autistic adults. Gender diversity, feeling more anxious, having greater disability and feeling unsatisfied with social support contributed to barriers to healthcare in autistic participants. We recommend interventions such as developing and implementing a national action plan, similar to the National Roadmap for Improving the Health of People with Intellectual Disability (2021) to reduce barriers and address unmet healthcare needs of Australian autistic adults. We also recommend working with autistic adults to develop new policies and strategies, implementing environmental adaptations to health care facilities, and increasing Autism education opportunities for health professionals to address gaps in knowledge. [ABSTRACT FROM AUTHOR]

Effective parent-teacher partnerships improve outcomes for autistic students. Yet, we know little about what effective partnerships look like for parents of autistic children from different backgrounds. We conducted interviews with 17 Chinese parents of autistic children attending Australian kindergartens/schools to understand their experiences. Parents appreciated the acceptance, opportunities and supports they received in Australia. They had high expectations of children; expectations not often shared by educators. Parents were respectful of teachers' expertise and polite and undemanding in interactions. Nevertheless, parents were frustrated by inconsistent teaching quality and inadequate communication. Navigating systems was also challenging and parents faced discrimination from teachers and their community. Recommendations include fostering open home-school communication, proactively seeking parents' expertise about children and explicitly scaffolding parents' self-advocacy. [ABSTRACT FROM AUTHOR]

Describing neural connectivity between pre-frontal and parietal brain regions and anxiety in children and adolescents with Autism Spectrum Disorder (ASD) has the potential to inform diagnosis and treatment decisions. This study aimed to identify the neural connectivity patterns between the prefrontal cortex (PFC) and parietal regions in young autistic males, and to determine if Generalised Anxiety Disorder (GAD) was associated with these communication patterns. Forty-one males with ASD aged between 6 and 18 yr (M age = 10.76 yr, SD = 3.14 yr) and their mothers were recruited as volunteer participants from the Gold Coast region, Australia. After assessments, participants received 3 min of eyes-closed and 3 min of eyes-opened EEG data-collection under resting conditions. EEG data from the frontal and parietal regions were investigated for their connectivity via Granger Causality (GC). There were significant correlations between the PFC-to-parietal region GC connectivity indices and total GAD scores, and also for the core components of GAD, but these were restricted to the alpha-wave frequency with only minimal beta-wave significant results. No significant correlations between parietal-to-PFC regions and GAD were present. Communication from the decision-making region (PFC) to the spatial reasoning (parietal) regions appeared to be aimed at instigating increased motor activity associated with GAD. [ABSTRACT FROM AUTHOR]

This paper examines the upper-limb movement kinematics of young children (3-7 years) with high-functioning autism using a point-to-point movement paradigm. Consistent with prior findings in older children, a difference in movement preparation was found in the autism group (n = 11) relative to typically developing children. In contrast to typically developing children, the presence of a visual distractor in the movement task did not appear to impact on early movement planning or execution in children with autism, suggesting that this group were not considering all available environmental cues to modulate movement. The findings from this study are consistent with the possibility that autism is associated with a difficulty using visual information to prime alternative movements in a responsive way to environmental demands. [ABSTRACT FROM AUTHOR]

The construction of public problems has a lasting influence on implementation in a given policy subsystem. National and sociopolitical contexts influence issue definition differently across nations. However, the degree to which nation-specific issue definition takes place has been insufficiently explored. In recent years, the growing incidence of autism has led to a quest for causal factors. One hypothesis posits that the use of mercury in vaccines may be a culprit. This paper examines the definition of the mercury and autism issue in Australia, Canada, the United Kingdom, and the United States. Insights into the comparative elements of issue definition are suggested by the case. These insights are of particular importance to administrators, as agencies are deeply involved as objects and actors in the process of issue definition and are often responsible for implementing new and redefined policies. [ABSTRACT FROM AUTHOR]

Autistic children experience a high rate of sleep problems, which have been associated with maternal mental health difficulties. However, the directionality of these relationships has received little attention. The extent to which children's sleep problems influence maternal mental health difficulties and vice versa remains unclear. The aim of this study was to examine the bidirectional relationships between the sleep problems of autistic children and maternal mental health difficulties over 12 years. Six biennial waves of longitudinal data from when children were 4 to 5 years old were drawn from the Longitudinal Study of Australian Children. The sample comprised 397 child–mother dyads. Maternal mental health was assessed with the Kessler-6, while sleep problems were assessed through a series of questions relating to common sleep problems in children. The results demonstrated significant bidirectional effects between maternal mental health and child sleep problems at key developmental transition time points. Specifically, when children transitioned from preschool to primary school and again when the children transitioned from primary school to high school. These findings highlight the need for increased support for both the child and mother at these critical time points to reduce the negative impact of maternal psychological distress on child sleep problems and vice versa. Autistic children experience increased the rates of sleep problems. These sleep problems have been associated with mother's mental health symptoms. However, the direction of these relationships is not well understood. This study investigated the relationships between autistic children's sleep problems and mothers' mental health over a 12-year period using data collected as part of the Longitudinal Study of Australian Children. Data from 397 autistic children and their mothers were included in this study. Mothers completed a questionnaire about their own mental health and common childhood sleep problems at four time points from 4–5 years to 14–15 years. The results showed important relationships between mothers' mental health symptoms and child sleep problems at two time points. Specifically, (1) mothers' mental health symptoms when the child was aged 4 to 5 years predicted child sleep problems at age 6 to 7 years; and (2) child sleep problems at age 12–13 years predicted mothers' mental health symptoms when the child was aged 14 to 15 years. Interestingly, these significant relationships also coincide with key developmental transition time points, when the child is transitioning in and out of primary school. These findings highlight the need for increased support for both the child and mother at these times to optimise outcomes for both. [ABSTRACT FROM AUTHOR]

Aim: This study explored caregiver‐reported first signs of autism and caregiver experiences of reporting these signs to health professionals using a multiple methods approach. Background: Within the Australian context, children who have been diagnosed with autism represent a significant proportion of individuals requiring access to disability services. Due to the importance of accessing early intervention services to support future outcomes, it is vital that first signs are noticed, reported, and the diagnosis process begun as soon as possible. Method: Phase 1 of the study included a secondary analysis of a survey of caregivers, while phase 2 consisted of focus groups of caregivers of children on the autism spectrum. Results: Survey data indicated that most children were aged 12–18 months when first signs were noticed, with first signs noticed earlier in females than males. Children were age 2–6 years when caregivers sought advice and received a diagnosis. Uncertainty and a lack of information often left caregivers feeling frustrated and under‐supported when seeking advice and diagnosis. Despite first signs being recognised early by caregivers, barriers to information and seeking help and support resulted in significant delays in receiving a diagnosis. Conclusions: The study provides valuable consideration of the caregiver perspective regarding reported first signs of autism and the additional challenges faced by caregivers living in regional and rural areas. By being more informed of what caregivers first notice, health professionals may also be able to provide better support and advice to caregivers in regard to access to diagnosis and early intervention services. [ABSTRACT FROM AUTHOR]

Background: Continuing professional development (CPD) is perceived as a pivotal component of building and maintaining nursing skill and capacity. Exploring motivators for CPD engagement can aid program adaptation and improvement. The goal of this study was to survey the barriers, enablers, and changes of Australian RNs' engagement with CPD in general during the coronavirus disease 2019 (COVID-19) pandemic. An additional goal was to understand factors influencing the interest of participants to engage with programs focused on care for people with intellectual disability and/or autism. Method: This study was a cross-sectional exploratory survey. Results: Most of the sample had engaged with CPD in the previous 12 months, and the most reported topics were related to COVID-19. Sixty percent of nurses saw a change in volume of CPD. Younger nurses, with fewer years of experience, and practicing in major cities, were significantly more likely to report less CPD. Conclusion: It is pivotal that the design and promotion of CPD curricula consider the motivators and barriers for nurses' engagement with them. [J Contin Educ Nurs. 2023;54(9):405–412.] [ABSTRACT FROM AUTHOR]

Background: The age at which parents or caregivers first develop concerns about their child's development has significant implications on formal diagnosis and intervention. This study aims to determine the sociocultural factors that are associated with the age and type of first concern reported by parents of autistic children among culturally and linguistically diverse (CALD) communities in Australia. We also assessed whether sociocultural factors predict autism traits measured in terms of social affect (SA), restricted and repetitive behaviours (RRB), and calibrated severity scores (CSS). Methods: This study is a secondary data analysis of the data collected from six Autism Specific Early Learning and Care Centres (ASELCCs) as part of the Autism Co-operative Research Centre (CRC) program between 2015 and 2019. Data analysed in this study included a family history questionnaire with sociodemographic and sociocultural information, parent-reported age and type of first concern, and clinician/researcher administered Autism Diagnostic Observation Schedule - Second Edition (ADOS-2) which includes standardised domain-wise scores of social affect (SA) and restricted and repetitive behaviours (RRB) as well as calibrated severity scores (CSS), a measure of severity of autism. Primary analysis included multivariable linear regression models to examine the predictive influence of sociodemographic and sociocultural factors on the dependant variables of age of concern (AOC) and the autism traits (SA, RRB, and CSS). Results: The mean AOC in the sample was 18.18 months and the most common concerns were speech/language delay, limited social interaction, and hyperactivity/behavioural changes. The multivariable linear regression models showed factors such as increase in age of child, those from a CALD background, annual family income, sibling's autism diagnosis, and developmental concerns to be significantly associated with parental AOC. Additionally, we also found that increase in child's age and CALD status to be significant predictors of autism trait (RRB) and severity measured in terms of the CSS score. Further, females (compared to males) were associated with higher difficulties with social communication and interaction skills. Conclusion: Understanding key factors that contribute to early identification of autism can help tailor awareness programs for parents and caregivers, whilst also informing the development of services focused on serving all CALD communities. [ABSTRACT FROM AUTHOR]