The use of Multi-Sensory Environments with autistic children: Exploring the effect of having control of sensory changes

Multi-Sensory Environments (also called sensory or Snoezelen® rooms) are specialised spaces that contain equipment to modify the environment. They are commonly used in special-needs schools with autistic children, but empirical investigation into how to best use Multi-Sensory Environments with autistic children has been limited. Based on converging evidence that autistic children may benefit from having control, we tested 41 autistic children (8 female) aged 4–12 years (mean = 8 years, standard deviation = 2.05 years) who used the Multi-Sensory Environment both with and without control over the sensory changes. Behavioural coding of video data showed that having control was associated with increased attention and reduced repetitive motor behaviours, sensory behaviours, activity levels, stereotyped speech and vocalisations. Social behaviour, anxiety, positive affect and arousal were not significantly affected by condition. Our findings demonstrate that how a Multi-Sensory Environment is used can affect autistic children’s behaviours. They also suggest that providing control of sensory changes to autistic children may help create better conditions for learning

A sequential mixed-methods approach to exploring the experiences of practitioners who have worked in multi-sensory environments with autistic children

Background & Aims Multi-Sensory Environments (MSEs) are common in special-needs schools and are widely used with autistic pupils. In this exploratory sequential mixed-methods study, we explored the beliefs and experiences of practitioners who regularly use MSEs with autistic pupils. Methods Qualitative interviews with ten practitioners (9 female, aged 24–62 years) identified six themes reflecting beliefs about MSE use with autistic children. To explore wider relevance of these themes, codes from the themes were converted into a 28-item online survey. Results Qualitative themes included: (1) MSEs are perceived to benefit behaviour, attention and mood, (2) MSEs have distinct properties that facilitate benefits, (3) MSE use should be centred on the child’s needs, (4) MSEs are most effective when the practitioner plays an active role, (5) MSEs can be used for teaching and learning, and (6) MSE use can present challenges. Responses to the survey (n = 102, 93 female, aged 21–68 years) generally showed good agreement with the original interviews, and there was modest evidence that MSE training affected beliefs about the benefits of MSE use. Conclusions & Implications These results provide insight into possible benefits of MSE use for autistic children and are relevant when considering the development of practitioner guidelines

Size constancy is preserved but afterimages are prolonged in typical individuals with higher degrees of self-reported autistic traits

Deficits in perceptual constancies from early infancy have been proposed to contribute to autism and exacerbate its symptoms (Hellendoorn et al., Frontiers in Psychology 6:1–16, 2015). Here, we examined size constancy in adults from the general population (N = 106) with different levels of self-reported autistic traits using an approach based on negative afterimages. The afterimage strength, as indexed by duration and vividness, was also quantified. In opposition to the Hellendoorn and colleagues’ model, we were unable to demonstrate any kind of relationship between abilities in size constancy and autistic traits. However, our results demonstrated that individuals with higher degrees of autistic traits experienced more persistent afterimages. We discuss possible retinal and post-retinal explanations for prolonged afterimages in people with higher levels of autistic traits

Evidence of initial success for China exiting COVID-19 social distancing policy after achieving containment.

Background: The COVID-19 epidemic was declared a Global Pandemic by WHO on 11 March 2020. By 24 March 2020, over 440,000 cases and almost 20,000 deaths had been reported worldwide. In response to the fast-growing epidemic, which began in the Chinese city of Wuhan, Hubei, China imposed strict social distancing in Wuhan on 23 January 2020 followed closely by similar measures in other provinces. These interventions have impacted economic productivity in China, and the ability of the Chinese economy to resume without restarting the epidemic was not clear. Methods: Using daily reported cases from mainland China and Hong Kong SAR, we estimated transmissibility over time and compared it to daily within-city movement, as a proxy for economic activity. Results: Initially, within-city movement and transmission were very strongly correlated in the five mainland provinces most affected by the epidemic and Beijing. However, that correlation decreased rapidly after the initial sharp fall in transmissibility. In general, towards the end of the study period, the correlation was no longer apparent, despite substantial increases in within-city movement. A similar analysis for Hong Kong shows that intermediate levels of local activity were maintained while avoiding a large outbreak. At the very end of the study period, when China began to experience the re-introduction of a small number of cases from Europe and the United States, there is an apparent up-tick in transmission. Conclusions: Although these results do not preclude future substantial increases in incidence, they suggest that after very intense social distancing (which resulted in containment), China successfully exited its lockdown to some degree. Elsewhere, movement data are being used as proxies for economic activity to assess the impact of interventions. The results presented here illustrate how the eventual decorrelation between transmission and movement is likely a key feature of successful COVID-19 exit strategies

Database of epidemic trends and control measures during the first wave of COVID-19 in mainland China.

OBJECTIVES: In this data collation study, we aimed to provide a comprehensive database describing the epidemic trends and responses during the first wave of coronavirus disease 2019 (COVID-19) throughout the main provinces in China. METHODS: From mid-January to March 2020, we extracted publicly available data regarding the spread and control of COVID-19 from 31 provincial health authorities and major media outlets in mainland China. Based on these data, we conducted descriptive analyses of the epidemic in the six most-affected provinces. RESULTS: School closures, travel restrictions, community-level lockdown, and contact tracing were introduced concurrently around late January but subsequent epidemic trends differed among provinces. Compared with Hubei, the other five most-affected provinces reported a lower crude case fatality ratio and proportion of critical and severe hospitalised cases. From March 2020, as the local transmission of COVID-19 declined, switching the focus of measures to the testing and quarantine of inbound travellers may have helped to sustain the control of the epidemic. CONCLUSIONS: Aggregated indicators of case notifications and severity distributions are essential for monitoring an epidemic. A publicly available database containing these indicators and information regarding control measures is a useful resource for further research and policy planning in response to the COVID-19 epidemic

The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries.

The ongoing coronavirus disease 2019 (COVID-19) pandemic poses a severe threat to public health worldwide. We combine data on demography, contact patterns, disease severity, and health care capacity and quality to understand its impact and inform strategies for its control. Younger populations in lower-income countries may reduce overall risk, but limited health system capacity coupled with closer intergenerational contact largely negates this benefit. Mitigation strategies that slow but do not interrupt transmission will still lead to COVID-19 epidemics rapidly overwhelming health systems, with substantial excess deaths in lower-income countries resulting from the poorer health care available. Of countries that have undertaken suppression to date, lower-income countries have acted earlier. However, this will need to be maintained or triggered more frequently in these settings to keep below available health capacity, with associated detrimental consequences for the wider health, well-being, and economies of these countries