Mind and autism spectrum disorders: A Theory-of-Mind continuum model and typology developed from Theory-of Mind as subjectively experienced and objectively understood

This study defines Theory-of-Mind as the ability to experience one’s own mind and understand the minds of others to the extent necessary to make sense of human behaviour and the world. Since the concept of Theory-of-Mind was first applied to people with ASD (Baron-Cohen, Leslie & Frith, 1985), lack of Theory-of-Mind has been used to explain their cognitive difficulties (National Research Council, 2003), along with social, communicative and imaginative impairments (Frith, Happé & Siddons, 1994). Previous studies have tended to think of Theory-of-Mind in terms of a simple binary of deficit or credit; to exclude the voices of people with ASD; to emphasise the cognitive aspects of Theory-of-Mind over its affective aspects; and to emphasise understanding the minds of others over experiencing one’s own mind. This study aims to address these issues by investigating Theory-of-Mind as subjectively experienced by students with ASD and objectively understood by their teachers. It is the first attempt in the study of Theory-of-Mind to include the voices of individuals with ASD along with the professional views of their teachers. This study takes an interdisciplinary approach, supported by philosophy of mind and special education. A grounded theory approach and a mixed methods research design combine to build and strengthen a theory of Theory-of-Mind. For Theory-of-Mind as subjectively experienced, 20 senior secondary and post secondary school students with ASD from Republic of Korea were interviewed and student-produced documents were reviewed to draw out their inner experiences. The Korean Wechsler Adult Intelligence Scale and the Korean Vineland Social Maturity Scale were employed to assess IQ and social competence. For Theory-of-Mind as objectively understood, their teachers’ beliefs regarding their students with ASD were sought through in-depth interviews, a review of teacher-produced documents and administration of a newly developed Teacher Questionnaire. This study reports differences between Theory-of-Mind as subjectively experienced and objectively observed, and variations within the components of Theory-of-Mind. The role of imagination in Theory-of-Mind and the relationships between Theory-of-Mind components, IQ and social competence are discussed. As a result, a Theory-of-Mind continuum model and Theory-of-Mind Typology is proposed

A systematic review of mindfulness-based school interventions with early adolescents

Recent research on mindfulness-based interventions (MBIs) in schools have reported effect differences across age groups of students, with early adolescent students reporting the least effect. Existing reviews, however, include students across all age ranges and largely concern intervention effects and their contributors. The exclusion of qualitative data exploring students’ experiences of learning and practising mindfulness omits valuable information that could be used to better inform implementation of MBIs. The lack of quality critique employed in the existing reviews necessitates a new review. A search carried out in nine electronic databases resulted in an initial selection of 1571 records, from which 13 papers emerged that met all inclusion criteria. The review found positive improvements reported in well-being measures in 11 of the 13 papers examined across both quantitative and qualitative data that provide support for mindfulness as a well-being school preventative program with this age group. A quality analysis critique of each paper demonstrated methodological strengths and limitations of existing MBI studies for early adolescent students, which inform ongoing conversations about whether and how MBIs meet the criteria of evidence-based practice (EBP) as an effective educational program. Findings are discussed for future research and education considerations are reviewed for educational professionals who aim to support early adolescents through the implementation of MBIs at school

Using Mindfulness to Improve Quality of Life in Caregivers of Individuals with Intellectual Disabilities and Autism Spectrum Disorder: Agency Outcomes for Caregivers and Clients

Objectives: Research suggests that the quality of life of professional caregivers of individuals with intellectual disabilities and autism spectrum disorder can be enhanced through mindfulness-based training. The effects of such training have been evidenced in terms of perceived psychological stress, compassion satisfaction, compassion fatigue (i.e., burnout, secondary traumatic stress), and symptoms of depression. In addition to changes in caregiver personal outcomes, mindfulness-based training may have effects on the quality assurance variables of the agency that employs these caregivers. The aim of the present study was to examine the changes from a systems perspective in terms of quality assurance variables related to caregivers and clients in community-based group homes. Methods: Professional caregivers (n = 216) were randomized into three experimental conditions based on the training they received: mindfulness, psychoeducation, or inservice training-as-usual (control). The effects of the training were assessed in terms of quality assurance indices pertaining to caregivers (progressive discipline, call-ins, days absent, medical referrals, hospitalizations, and caregiver turnover) and clients (learning objectives, behavioral episodes, use of physical restraints, emergency medications [stat], medical emergencies, hospitalizations, aggression to staff, aggression to peers, and level of supervision). Results: Overall, caregivers in the mindfulness group exhibited significantly fewer progressive discipline and call-ins when compared to the psychoeducation and control groups. Caregivers in both the mindfulness and psychoeducation groups exhibited significantly fewer days of absence from work, medical referrals, and caregiver turnover when compared to the control group. There was no difference across the three groups in terms of hospitalizations. Clients under the care of mindfulness-trained caregivers showed significantly greater improvement in completing learning objectives, fewer behavioral episodes, reduced need for physical restraints and stat medication for behavioral episodes, fewer episodes of aggression to peers, and lower levels of supervision when compared to those in the psychoeducation and control groups. Clients did equally well in terms of medical emergencies, hospitalizations, and aggression to staff in the mindfulness and psychoeducation groups when compared to those in the control group. Conclusions: Differential effects of mindfulness training, psychoeducation, and inservice training-as-usual were evident in quality assurance variables related to caregivers and clients. The results suggest that training caregivers in different approaches to self-care may differentially affect not only their clinical status but also at a systems level in terms of quality assurance indices

Percutaneous radiofrequency ablation for hepatic tumors: factors affecting baseline impedance

PurposeWe aimed to evaluate factors that affect baseline impedance of percutaneous radiofrequency ablation.MethodsIn this retrospective study, we analyzed 51 patients with 55 hepatic tumors from November 2015 until April 2018. We measured the baseline impedance nine times with three adjustable tip sizes (2 cm, 2.5 cm, 3 cm) and three different pad locations (two pads attached on the thigh, four on the thigh, two on the back). The first roll-off time was measured with two grounding pads attached on the back. Body mass index, cirrhotic or non-cirrhotic liver parenchyma, previous procedure, tumor location, artificial ascites, active tip size, and the pad location were evaluated as potential factors affecting baseline impedance using the Mann–Whitney U test, t-test and analysis of variance test.ResultsComplete radiofrequency ablation was achieved in 51 patients. Body mass index (p = 0.897), cirrhotic or non-cirrhotic liver parenchyma (p = 0.767), previous procedure (p = 0.957), tumor location (p = 0.906), and artificial ascites (p = 0.882) did not significantly affect baseline impedance. Grounding pads located on the back showed the lowest baseline impedance (p < 0.001). Increase in active tip size showed gradual decrease in baseline impedance (p = 0.016).ConclusionThe factors affecting baseline impedance were the pad location and the tip size. Positioning pads on the back lowers the baseline impedance and can shorten the first roll-off time, ultimately resulting in reduced total ablation time

Effects of Mindfulness-Based Positive Behavior Support (MBPBS) Training Are Equally Beneficial for Mothers and Their Children With Autism Spectrum Disorder or With Intellectual Disabilities

Parenting a child with autism spectrum disorder (ASD) or intellectual disabilities (IDs) can be stressful for many parents. Mindfulness-Based Positive Behavior Support (MBPBS) is a customized mindfulness program that enables parents and other caregivers to reduce their perceived psychological stress to normative levels through mindfulness procedures and to support children with ASD or ID to self-manage their challenging behaviors through positive behavior support (PBS). In this study, we evaluated whether MBPBS would have differential effects on the stress levels of mothers of adolescents with ASD (n = 47) or with ID (n = 45) and the effects of the program on the aggressive, disruptive, and compliance behaviors of their children. Both groups of mothers participated in the 40-week study (10 weeks control and 30 weeks MBPBS program), rated their own stress levels, and collected daily observational data on the adolescents’ behavior. Results showed significant reductions in the level of stress in both groups of mothers, but no differential effects on mothers of children with ASD or with ID. In addition, significant reductions in aggression and disruptive behavior and increases in compliance behaviors were observed in the adolescents in both groups. The results suggest that MBPBS is equally beneficial for mothers of adolescents with ASD or ID. In the present study, although the mothers of children with ID had slightly higher levels of stress at baseline and mothers of children with ASD had lower levels of stress following the MBPBS program, the program can be considered equally effective in reducing the stress levels of both groups of mothers. This suggests that the program may be effective regardless of baseline levels of mothers’ stress

Effects of Mindful Engagement and Attention on Reciprocal Caregiver and Client Interactions: A Behavioral Analysis of Moment-to-Moment Changes During Mindfulness Practice

Objectives: The objective of this study was to examine the effects of Mindfulness-Based Positive Behavior Support (MBPBS) training on the nature of caregiver and client reciprocal interactions at a moment-by-moment level using behavior analytic methodology. Specifically, we compared the behavior of caregivers and clients before and after MBPBS training for the caregivers in terms of caregiver-client engagement, percent of learning and leisure interactions during caregiver-client engagement, and percent of the clients’ challenging behaviors and socially acceptable behaviors during learning and leisure interactions. In addition, we examined the effects of specific conditionality of attentional responses of the caregivers to the clients’ challenging or socially acceptable behavior in terms of frequency, latency, duration, and quality. Method: Caregiver and client engagements were videotaped before and after MBPBS training for the caregivers. The percent of caregiver-client engagement was analyzed using partial-interval recording for overall engagement and the clients’ challenging behaviors and socially acceptable behaviors during learning and leisure interactions. The effects of the caregivers’ attentional responses to the clients’ challenging behaviors and socially acceptable behaviors were analyzed using whole-interval recording. Results: Training caregivers in MBPBS significantly increased caregiver-client engagement during learning and leisure activities, which resulted in the clients exhibiting fewer challenging behaviors and more socially appropriate behaviors. Furthermore, an analysis of the effects of different types of caregiver attention showed differential effects on the clients’ challenging behaviors and socially acceptable behaviors. Conclusions: The results indicated that behavior analytic methods can be used as an objective and reliable way of capturing the nature of changes in predefined behaviors of both caregivers and clients at a moment-by-moment level following training of the caregivers in a mindfulness-based program. Using such an analytic method may provide an effective way of objectively measuring some experiential processes involved in mindfulness training

The Clinical Usefulness of the SD Bioline Influenza Antigen Test® for Detecting the 2009 Influenza A (H1N1) Virus

Though the 2009 worldwide influenza A (H1N1) pandemic has been declared to have ended, the influenza virus is expected to continue to circulate from some years as a seasonal influenza. A rapid antigen test (RAT) can aid in rapid diagnosis and allow for early antiviral treatment. We evaluated the clinical usefulness of RAT using SD Bioline Influenza Antigen Test® kit to detect the influenza virus, considering various factors. From August 1, 2009 to October 10, 2009, a total of 938 patients who visited the outpatient clinic at Korea University Guro Hospital with influenza-like illnesses were enrolled in the study. Throat or nasopharyngeal swab specimens were obtained from each of the patients. Using these specimens, we evaluated the influenza detection rate by rapid antigen test based on the real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) method. In comparison with rRT-PCR, the sensitivity and specificity of the RAT were 44.0% and 99.9%, respectively. The cyclic threshold values of RAT negative specimens were higher than RAT positive specimens (30.1±3.1 vs. 28.3±3.9, p=0.031). The sensitivity of the RAT kit was higher in patients who visited clinics within two days of symptom onset (60.4% vs. 11.1%, p=0.026). The results of this study show that the RAT cannot be recommended for general use in all patients with influenza-like illness because of its low sensitivity. The RAT may be used, only in the settings with limited diagnostic resources, for patients who visit a clinic within two days of symptom onset