An evaluation of the Homunculi Approach as an intervention for pupils with autism spectrum experiencing anxiety

Young people with Autism Spectrum (AS) are a population at risk of experiencing Mental Health Problems (MHPs); with anxiety being the most commonly reported internalising MHP for this population (Skokauskas & Gallagher, 2012). Schools have been identified as well placed to support pupils experiencing MHPs (DoH & DfE, 2017). The primary aim of the present research was to evaluate the Homunculi Approach (Greig & MacKay, 2013b) as an intervention for secondary aged pupils with AS experiencing anxiety. The secondary aim of the research was to explore factors affecting implementation of the Homunculi Approach. An embedded mixed methods design was utilised where the primary research aim (Phase 1) was supplemented by the secondary research aim (Phase 2). Phase 1 consisted of an A-B single case experimental design (SCED) with four participants across four different secondary schools. Anxiety was measured through: repeated behavioural observations and a weekly anxiety questionnaire (PI-ED); pre and post intervention measures, completed by the young people, parents and teachers (SCAS, SAS-TF and SDQ); and measures which occur organically within the Homunculi Approach intervention. Phase 2 of the research explored the factors which affected implementation of the intervention in schools by interviewing the school staff who delivered the Homunculi Approach. The data was collected using an activity theory framework. The findings from the research indicated the intervention was effective in reducing anxiety for two participants, and ineffective in reducing anxiety for the other two participants. Several implementation factors were identified which may have impacted on the effectiveness of the Homunculi Approach when delivered by members of school staff in secondary schools. The findings are discussed in relation to the literature. Limitations of the research, such as the small sample size and possible impact of external factors, are acknowledged. Possible implications and ideas for future research are presented

Does a child’s language ability affect the correspondence between parent and teacher ratings of ADHD symptoms?

Background: Rating scales are often used to identify children with potential Attention-Deficit/Hyperactivity Disorder (ADHD), yet there are frequently discrepancies between informants which may be moderated by child characteristics. The current study asked whether correspondence between parent and teacher ratings on the Strengths and Weakness of ADHD symptoms and Normal behaviour scale (SWAN) varied systematically with child language ability. Method: Parent and teacher SWAN questionnaires were returned for 200 children (aged 61–81 months); 106 had low language ability (LL) and 94 had typically developing language (TL). After exploring informant correspondence (using Pearson correlation) and the discrepancy between raters, we report inter-class correlation coefficients, to assess inter-rater reliability, and Cohen’s kappa, to assess agreement regarding possible ADHD caseness. Results: Correlations between informant ratings on the SWAN were moderate. Children with LL were rated as having increased inattention and hyperactivity relative to children with TL; teachers, however, rated children with LL as having more inattention than parents. Inter-rater reliability of the SWAN was good and there were no systematic differences between the LL and TL groups. Case agreement between parent and teachers was fair; this varied by language group with poorer case agreement for children with LL. Conclusion: Children’s language abilities affect the discrepancy between informant ratings of ADHD symptomatology and the agreement between parents and teachers regarding potential ADHD caseness. The assessment of children’s core language ability would be a beneficial addition to the ADHD diagnostic process.</p

An evaluation of the Homunculi Approach as an intervention for pupils with autism spectrum experiencing anxiety

Young people with Autism Spectrum (AS) are a population at risk of experiencing Mental Health Problems (MHPs); with anxiety being the most commonly reported internalising MHP for this population (Skokauskas & Gallagher, 2012). Schools have been identified as well placed to support pupils experiencing MHPs (DoH & DfE, 2017). The primary aim of the present research was to evaluate the Homunculi Approach (Greig & MacKay, 2013b) as an intervention for secondary aged pupils with AS experiencing anxiety. The secondary aim of the research was to explore factors affecting implementation of the Homunculi Approach. An embedded mixed methods design was utilised where the primary research aim (Phase 1) was supplemented by the secondary research aim (Phase 2). Phase 1 consisted of an A-B single case experimental design (SCED) with four participants across four different secondary schools. Anxiety was measured through: repeated behavioural observations and a weekly anxiety questionnaire (PI-ED); pre and post intervention measures, completed by the young people, parents and teachers (SCAS, SAS-TF and SDQ); and measures which occur organically within the Homunculi Approach intervention. Phase 2 of the research explored the factors which affected implementation of the intervention in schools by interviewing the school staff who delivered the Homunculi Approach. The data was collected using an activity theory framework. The findings from the research indicated the intervention was effective in reducing anxiety for two participants, and ineffective in reducing anxiety for the other two participants. Several implementation factors were identified which may have impacted on the effectiveness of the Homunculi Approach when delivered by members of school staff in secondary schools. The findings are discussed in relation to the literature. Limitations of the research, such as the small sample size and possible impact of external factors, are acknowledged. Possible implications and ideas for future research are presented

Additional file 1: of Does a child’s language ability affect the correspondence between parent and teacher ratings of ADHD symptoms?

Recruitment flow diagram. Table S1. Differences between children included in the current sample (i.e. those with SWAN questionnaire data available from both parents and teacher) and those who are not included in the current sample. Table S2. Mean (SD) parent and teacher ratings on the SWAN for the whole sample and by language group, Figure S2. Marginal means of SWAN total score as rated by parent (dark grey bars) and teachers (light grey bars) for typical language (TL) and low language (LL) groups; error bars are 95% CIs. Description of findings shown in Figure S2. Table S3. rates of potential ADHD subtype identification by parents vs. teachers for the whole sample and by language group. (DOCX 95 kb