An Ecological Visual Exploration Tool to Support the Analysis of Visual Processing Pathways in Children with Autism Spectrum Disorders

Recent improvements in the field of assistive technologies have led to innovative solutions aiming at increasing the capabilities of people with disability, helping them in daily activities with applications that span from cognitive impairments to developmental disabilities. In particular, in the case of Autism Spectrum Disorder (ASD), the need to obtain active feedback in order to extract subsequently meaningful data becomes of fundamental importance. In this work, a study about the possibility of understanding the visual exploration in children with ASD is presented. In order to obtain an automatic evaluation, an algorithm for free (i.e., without constraints, nor using additional hardware, infrared (IR) light sources or other intrusive methods) gaze estimation is employed. Furthermore, no initial calibration is required. It allows the user to freely rotate the head in the field of view of the sensor, and it is insensitive to the presence of eyeglasses, hats or particular hairstyles. These relaxations of the constraints make this technique particularly suitable to be used in the critical context of autism, where the child is certainly not inclined to employ invasive devices, nor to collaborate during calibration procedures.The evaluation of children’s gaze trajectories through the proposed solution is presented for the purpose of an Early Start Denver Model (ESDM) program built on the child’s spontaneous interests and game choice delivered in a natural setting

The Relationship between Autism and the Multiple Intelligences Theory: Identifying Patterns in Learning for Educational Purposes

The Multiple Intelligences theory has been used to modify lessons in the traditional classroom for years. Incorporating this intelligence theory into lesson plans, teachers address students various learning abilities. However, this educational theory can also be used to improve students’ strengths in intelligence areas they are not proficient in. This is particularly beneficial for individuals with autism with social deficits due to their developmental disorder. Autism spectrum disorder can negatively impact various cognitive elements of an individual’s life, but it primarily affects an individual’s social skills and interpersonal intelligence. One of the most prominent solutions to improving social skills for students with autism is including them into general classroom environments with peers who are non-disabled. Though this can prove to be a challenge in the traditional classroom, the non-traditional classroom offers more opportunities for inclusion and success. Through the use of inclusion in environments such as the music classroom, students with autism are able to develop multiple intelligences at once, including interpersonal intelligence. Orff Shulwerk is a music education method that, after significant research, has shown to address all eight areas of intelligence at once. This method can reach out to students that excel in every intelligence category as well as benefit students with autism

A Review of “Music and Movement” Therapies for Children with Autism: Embodied Interventions for Multisystem Development

The rising incidence of Autism Spectrum Disorders (ASDs) has led to a surge in the number of children needing autism interventions. This paper is a call to clinicians to diversify autism interventions and to promote the use of embodied music-based approaches to facilitate multisystem development. Approximately 12% of all autism interventions and 45% of all alternative treatment strategies in schools involve music-based activities. Musical training impacts various forms of development including communication, social-emotional, and motor development in children with ASDs and other developmental disorders as well as typically developing children. In this review, we will highlight the multisystem impairments of ASDs, explain why music and movement therapies are a powerful clinical tool, as well as describe mechanisms and offer evidence in support of music therapies for children with ASDs. We will support our claims by reviewing results from brain imaging studies reporting on music therapy effects in children with autism. We will also discuss the critical elements and the different types of music therapy approaches commonly used in pediatric neurological populations including autism. We provide strong arguments for the use of music and movement interventions as a multisystem treatment tool for children with ASDs. Finally, we also make recommendations for assessment and treatment of children with ASDs, and provide directions for future research

Concept Mapping and the Cognitive Orientation to Daily Occupational Performance (CO-OP) Approach As An Intervention Framework for Adolescents with Autism Spectrum Disorder (ASD)

Individuals who are diagnosed with Autism Spectrum Disorder (ASD) experience a range of difficulties that impact their daily occupational performance. The current body of research identifies the importance of occupational engagement and competence as fundamental elements in facilitating an individual’s social connections, development of personal autonomy and overall wellbeing. This dissertation explores the use of concept mapping embedded within the meta-cognitive framework of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach, to engage adolescents with ASD in meaningful occupations. This thesis contains three manuscripts, an introductory and a final reflection chapter. The first manuscript is a methodological paper that outlines a qualitative concept mapping framework that can be applied within the field of occupational science. The second manuscript explores how concept mapping can be theoretically embedded with the CO-OP approach to facilitate the engagement, occupational competence, relatedness and autonomy of adolescents with ASD. The third manuscript presents the findings of a focused sensory ethnography exploration that explores the personalized and socio-cultural perceptions of adolescents with ASD while participating in a novel intervention. The third manuscript is analyzed using an occupational science framework, and highlights the themes identified by the participants through their concept maps and personal reflections. The data were analyzed using the qualitative concept mapping framework presented in the first manuscript, and through deductive thematic analysis using a theoretical codebook derived and highlighted in the third manuscript. This thesis contributes new knowledge to shaping the development and delivery of interventions focused on enhancing the occupational performance of adolescents with ASD in meaningful goals important in the transition to adulthood. It has expanded the limited research that approaches the topic from the frameworks of qualitative research, multi-modal and multi-sensory methods. It also uniquely explores the concept of human occupation as it relates to culture of ASD, and the development of meaningful life skills within a group environment. This work has implications for the future methodologies and research questions for studies exploring the lives of adolescents with ASD, the CO-OP approach, and the use of visual methods in exploring occupational meaning

Eye-tracking explorations of attention to faces for communicative cues in Autism Spectrum Disorders

Background Individuals with Autism Spectrum Disorder (ASD) have been reported to show socio-communicative impairments which are associated with impaired face perception and atypical gaze behaviour. Attending to faces and interpreting the important socio-communicative cues presented allows us to understand other’s cognitive states, emotions, wants and desires. This information enables successful social encounters and interactions to take place. Children with ASD not attending to these important social cues on the face may cause some of the socio-communicative impairments observed within this population. Examining how children with ASD attend to faces will enhance our understanding of their communicative impairments. Aim The present thesis therefore aimed to use eye-tracking methodology to examine attention allocation to faces for communicative cues in children with ASD. Method The first line of enquiry examined how children with ASD (n = 21; age = 13y7m) attended to faces presented within their picture communication systems compared to typically developing children matched on chronological age, verbal ability age and visuo-spatial ability age. The next investigation was conducted on the same group of children and examined how children with ASD attended to faces of different familiarity including, familiar, unfamiliar and the child’s own face. These faces were also presented with direct gaze or averted gaze to investigate how this would impact on the children’s allocation of attention. The final exploration highlighted how children with ASD (n = 20; age = 12y3m) attended to socially salient information (faces) and non-socially salient information (objects) presented within social scenes of varying complexity, compared to typically developing controls. Again groups were matched based on chronological age, verbal ability age, and visuo-spatial ability age. Results Children with ASD were shown to allocate attention to faces presented within their picture communication symbols similarly compared to their typically developing counterparts. All children were shown to fixate significantly longer on the face images compared to the object images. The children with ASD fixated for similar amounts of time to the eye and mouth regions regardless of familiarity and gaze direction compared to their controlled matches. All groups looked significantly longer at the eye areas compared to the mouth areas of the faces across all familiarity types. The children also fixated longer on the eye and mouth regions of direct gazing faces compared to the regions presented on the averted gazing faces. The children with ASD fixated on the faces and objects presented within social scenes similar to their typically developing counterparts across all complexity conditions. The children were shown to fixate significantly longer on the objects compared to the faces. Conclusions Children with ASD showed typical allocation of attention to faces. This suggests that faces are not aversive to them and they are able to attend to the relevant areas such as eye and mouth regions. This may have been influenced by the inclusion of high functioning children with ASD. However these results may also suggest that attention allocation and gaze behaviour are not the only factors which contribute to the socio-communicative impairments observed in ASD

Investigation Into the Physical Environmental Correlates of Aggressive Behaviour in Children with Neurodevelopmental Disorders (NDDs)

Background: Physical environmental influences on childhood aggression in children with neurodevelopmental disabilities is a severely under-researched research locus. The aim of this doctorate was to elucidate specific associations between children’s developmental environment and aggressive behaviours, using this evidence to reciprocally inform an experimental psychology project to investigate underlying mechanisms. To explore these effects, the programme of study was broadly divided into three reflexive workstreams using diverse research methodologies. Methods: In the first workstream, I conducted a systematic review of the current literature examining physical environmental influences on childhood aggressive behaviours in both typically developing children (aged 0 – 18) and those diagnosed with NDDs. The literature on children with NDDs was substantially limited in comparison to peers without NDDs. The second workstream was comprised of a large-scale secondary data analysis (multiply imputed growth curve modelling) to investigate environmental influences on conduct problems across early development. I used data from the Millennium Cohort Study (MCS) to assess how physical environmental metrics, such as neighbourhood greenspace, air pollution, household crowding, and presence of home damp influenced the development and severity of conduct problems in children with (n=8013) and without NDDs (n=155) between the ages of 3 – 11 years. Finally, building upon evidence from the previous two workstreams, I designed a proof-of-principle psychological experiment to examine the influence of urban nature exposure on children with NDDs. Specifically, simulating a real-world urban greenspace using a Person-Environment-Activity Research Laboratory (PEARL). This facilitated the ability to manipulate and isolate individual environmental aspects of urban nature exposure (light, sound, and projection). Following ethical review and approval, I recruited 3 children (100% male) with mild and moderate intellectual disability aged between 12 – 15 years (Mean age = 14) attending a local school for children with special educational needs. We examined their physiological reactions to four simulated urban green space aspects (light, sound, landscape projections, and vegetation) against a baseline control condition. I also collected demographic information on parent reported aggressive behaviours, exposure to local greenspace(s), physical and mental health history, medication, and adaptive behaviours (ABAS-3). This research lays the foundation for future large scale experimental paradigms that can disentangle the effects of nature exposure in these children, with the aim of translating these findings into real world therapeutic design interventions and relevant policy changes to improve the quality of the built environment for these children. Findings: From articles retrieved from my systematic review I found evidence for the beneficial influences of nature in both populations, and simultaneously negative effects of both noise and air pollution in typically developing children only. Evidence for other environmental aspects such as crowding, music, urbanicity, meteorology, and interior design had either insufficient or inconsistent evidence to extrapolate concreate conclusions. More evidence on the effect of these exposures on child aggression outcomes is recommended. From the analysis of the MCS cohort I found various sociodemographic factors (ethnicity, sex, poverty, family structure, maternal distress) and internal residential conditions were associated with increased childhood conduct problem trajectories in both groups of children. I also discovered potential evidence of a moderating influence effect of intellectual disability on the relationship between spatial density and conduct problems. From the final experimental project, I report preliminary evidence for the influence of urban greenspaces to reduce physiological arousal in children with complex neurodisability profiles. Initial evidence for the hierarchical nature of urban greenspace sensorial aspects was reported, for example: that urban nature soundscapes maybe a more influential environmental stimuli than lighting or landscape projections. Conclusion: Drawing together multi-disciplinary research methodologies facilitated the ability to identify disparities in research examining physical environmental determinants of aggression in neurodiverse child populations. Reciprocally, the systematic review and secondary data analysis contributed incrementally to filling this lacuna of research. Using findings from these two work streams, I identified that exploring the potentially therapeutic influences of urban nature exposure on children with neurodevelopmental disorders may provide novel indicators of its aetiological mechanisms. I reported original findings supporting these research aims, elucidating the potential hierarchical nature of urban greenspace elements. This was also the first study of its kind reporting the potential for simulated urban park spaces to reduce physiological arousal in neurodivergent children with aggressive behavioural difficulties