Mental health difficulties among young people on the autistic spectrum in mainstream secondary schools: A comparative study

Young people on the autistic spectrum (AS) may be at an increased risk of developing mental health difficulties, but to date research evidence has been equivocal and/or inadequate. The aim of the current study was to document the mental health profiles of adolescents on the AS, and to identify factors that contribute to difficulties in this area. Mental health profiles of a group of adolescents on the AS (N=22) were compared to age, gender and SEN-provision-matched control groups of adolescents with dyslexia (N=21) and with no special educational needs (N=23) using the Beck Youth Inventories. Additionally, five participants on the AS participated in semi-structured interviews about their experience of school. Quantitative analysis demonstrated that adolescents on the AS experienced significantly greater anxiety, depression, anger and lower self-concept than those with no special educational needs. They also experienced significantly greater anxiety and anger than those with dyslexia. Qualitative analysis revealed that problems in social relationships, understanding the nature of the AS, and disruptions to routine were common contributory factors to the mental health difficulties of participants. However, interview data also revealed key coping strategies implemented by participants to help them overcome their difficulties. The implications of these findings are discussed, and methodological limitations are noted

Comparing online and face-to-face student counselling: what therapeutic goals are identified and what are the implications for educational providers?

Online counselling is increasingly being used as an alternative to face-to-face student counselling. Using an exploratory mixed methods design, this project investigates the practice by examining the types of therapeutic goals that 11 to 25 year olds identify online in routine practice. These goals are then compared to goals identified in equivalent school and community-based counselling services. 1,137 online goals (expressed by 504 young people) and 221 face-to-face goals (expressed by 220 young people) were analysed for key themes using grounded theory techniques. This analysis identified three core categories (1) Intrapersonal Goals, (2) Interpersonal Goals, and (3) Intrapersonal Goals directly related to others. Further statistical analysis of these themes indicated that online and face-to-face services appear to be being used in different ways by students. These differences are discussed alongside the implications for professionals working in educational settings

Perceptions of Friendship among Adolescents with Autism Spectrum Conditions in a Mainstream High School Resource Provision

Establishing and maintaining friendships is frequently challenging for young people with autism spectrum conditions (ASC). However, few studies have explored influences on friendship development, meaning that knowledge of friendship formation processes remains limited at a critical point in social development. As friendship can impact on well-being and the success of educational inclusion, addressing this issue is important and timely. This study explores friendship among adolescents with ASC, and in particular the meaning and nature of friendship, including perceived influences on its development. Semi-structured interviews were conducted with nine participants: three adolescent students with ASC, a parent of each student, and key teachers. Students were found to have an understanding of friendship, although parents often felt it was theoretical and did not correlate with their own experiences. All of the students expressed a desire for friendship and reported having experienced loneliness. Friendships tended to centre on structured activities such as computer games, which provided both support and obstacles for friendship development. Further individual and contextual influences included levels of maturity, understanding of social rules, school environment, and peer acceptance. The implications of these findings are discussed in relation to research and practice in educational settings

What do we know about home education and autism? A thematic synthesis review

Background Mainstream education can be difficult for autistic children given the social communication difficulties, highly focused interests and sensory sensitives associated with autism. Educators can still find providing a safe, inclusive and supportive environment for autistic students challenging. Subsequently some parents decide to remove their children from school and home educate. The purpose of this thematic review is to synthesise reported findings on home educating autistic children who have previously attended formal education. Method PRISMA guidelines informed the review process. Articles included were published in the last 10 years and specific to autistic children being educated at home. Of the 22 articles meeting eligibility for full text review, 10 matched the final inclusion criteria. Results Findings related to four main themes emerging from the synthesis: the motivations and reasons that led parents to home educate their autistic children; parents’ experiences of home educating; practices and pedagogical approaches used by parents; and the impact of home education on the outcomes for autistic students. Findings revealed that home education can be a positive experience for families with good academic and social outcomes for autistic children and young people. Limitations of the evidence base are considered. Conclusion Although not all parents may be in a position to home educate their children, this review indicates that parents with appropriate educational, financial and social supports have found home educating their autistic child empowering. They report being able to provide flexible, balanced and individualised education leading to positive outcomes

Educational interventions for children with ASD: A systematic literature review 2008–2013

Systematic literature reviews can play a key role in underpinning evidence-based practice. To date, large-scale reviews of interventions for individuals with Autism Spectrum Disorder (ASD) have focused primarily on research quality. To assist practitioners, the current review adopted a broader framework which allowed for greater consideration of educational utility. Between July and August 2013, 20 databases were searched, alongside web searches and hand searches, to identify ASD intervention studies published between 2008 and 2013. This search yielded 6,232 articles and the subsequent screening and evaluation process identified 85 best evidence studies. Studies were grouped into categories and individual interventions were assessed and classified as providing most; moderate; some; or a small amount of evidence. Interventions with most evidence tended to focus on younger children and core difficulties associated with ASD. Emerging trends, such as increasing evidence for technology-based interventions and peer-mediated interventions, were identified. An encouraging finding for practitioners is that in 59% of the studies, interventions were undertaken with or by school staff. Implications for school psychology practice as well as factors to consider when selecting educational interventions are discussed

Developing mainstream resource provision for pupils with autism spectrum disorder: staff perceptions and satisfaction

Supporting pupils with autism spectrum disorder (ASD) in mainstream schools is a challenging task. This paper proposes a professional development framework for EPs to consider when supporting the development of specialist ASD staff. The framework focuses on training content, educator characteristics and organisational elements. Nine mainstream schools developing additional provision to support children with ASD and Specific Language Impairment (SLI) participated in the research. Specialist staff were provided with training and took part in follow up interviews about their developing practice. A pre-post questionnaire of participants (N = 30) attending the specialist training is supplemented with longitudinal interview data from specialist staff (N = 20). A paired sample t-test of questionnaire data showed that staff self-efficacy significantly increased pre to post training with a large effect size(0.61) and thematic analysis of interviews provided evidence of sustained professional development over time underpinned by supportive organisational factors

The use of aortic balloon occlusion in traumatic shock : first report from the ABO trauma registry

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes. REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported. Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 +/- 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion. This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.Peer reviewe

Bullying of children and adolescents with autism spectrum conditions: a 'state of the field' review

A ‘state of the field’ review of what is currently known about bullying of children and adolescents with autism spectrum conditions (ASC) is presented. We highlight compelling evidence that they are considerably more likely to be bullied than those with other or no special educational needs and disabilities (SEND). Although prevalence estimates vary from study to study, they are always worryingly high, with the highest rate reported as 94%. Those most at risk include (but are not limited to) individuals with Asperger syndrome and/or with milder deficits in social understanding, early adolescents, those attending mainstream school, and those with concurrent behavioural difficulties. Research on anti-bullying interventions for ASC is in its relative infancy. Currently available evidence suggests that a multi-level, comprehensive approach to intervention that offers parallel foci on children and young people with ASC, their peers, teaching and support staff, and the broader school ethos and climate is warranted. A crucial component of the above is the acknowledgement of the elevated risk experienced by those with ASC and the requirement to tailor interventions to their specific needs