The use of Internet-based communication by people with autism

Despite having difficulties in the areas of social interaction and communication, the introduction of the Internet seems to have encouraged some high-functioning autistic people to communicate with each other via chat rooms and bulletin boards. The Internet can address the social isolation of autism by improving the potential to find others who have similar experiences. Additionally it may be that, for autistic people, the Internet also offers a comfortable space more suited to their communication style, perhaps one in which their interaction seems less odd. If so, there are possible implications for this group of people in terms of education, employment and social inclusion. However there are risks. Autistic people may be particularly vulnerable to individuals misrepresenting themselves or to the possibility of over-reliance on computer-mediated interaction resulting in an exacerbation of obsessive behaviour and withdrawal from face-to-face interaction. An initial survey, to discover the extent of Internet use among people with autism and investigate their motivations for using it, was carried out, obtaining responses from 138 people with high-functioning autism or Asperger syndrome. Results indicated a high level of computer and Internet use amongst respondents and implied that email was a popular means of communication, more so than face-to-face communication even when interacting with friends. This introductory survey raised issues and questions which were explored in more depth with a subset of the respondents who were interviewed by email about their experiences, motivations and perceptions regarding Internet-based communication. In addition to 19 email interviews, data were also collected from 4 non or reluctant users of the Internet who were sent a series of questions by post. A grounded theory analysis of the data revealed a heightened awareness of communication amongst this group of participants, who offered insights into the process of communication in terms of its component parts and how it breaks down for them. Central to the analysis is a theme of the interviewee as observer, feeling detached to some degree from mainstream interaction and like an outsider. From this perspective participants offered their analysis of the complex process of communication, online and offline as they experienced it, highlighting key aspects of the Internet in relation to their own needs, ones which made it a unique form of communication. Their insights into communication are described in four themes: control, clarity, the role of nonverbal communication and the social role of communication. Additionally the interviewees expressed a sense of liberation that could come with online communication for people with Asperger syndrome/high-functioning autism such that they may interact with others on a more equal basis. This could be empowering but with the sense of liberation there was a risk of losing control over one’s interactions. The interviewees’ perceptions of CMC are explored within a uses and gratifications framework which posits that people use particular communication channels to satisfy their individual needs and motives. By using computer-mediated communication some of the social and communication barriers which contribute to the disability of autism may be broken down

The use of Internet-based communication by people with autism

Despite having difficulties in the areas of social interaction and communication, the introduction of the Internet seems to have encouraged some high-functioning autistic people to communicate with each other via chat rooms and bulletin boards. The Internet can address the social isolation of autism by improving the potential to find others who have similar experiences. Additionally it may be that, for autistic people, the Internet also offers a comfortable space more suited to their communication style, perhaps one in which their interaction seems less odd. If so, there are possible implications for this group of people in terms of education, employment and social inclusion. However there are risks. Autistic people may be particularly vulnerable to individuals misrepresenting themselves or to the possibility of over-reliance on computer-mediated interaction resulting in an exacerbation of obsessive behaviour and withdrawal from face-to-face interaction. An initial survey, to discover the extent of Internet use among people with autism and investigate their motivations for using it, was carried out, obtaining responses from 138 people with high-functioning autism or Asperger syndrome. Results indicated a high level of computer and Internet use amongst respondents and implied that email was a popular means of communication, more so than face-to-face communication even when interacting with friends. This introductory survey raised issues and questions which were explored in more depth with a subset of the respondents who were interviewed by email about their experiences, motivations and perceptions regarding Internet-based communication. In addition to 19 email interviews, data were also collected from 4 non or reluctant users of the Internet who were sent a series of questions by post. A grounded theory analysis of the data revealed a heightened awareness of communication amongst this group of participants, who offered insights into the process of communication in terms of its component parts and how it breaks down for them. Central to the analysis is a theme of the interviewee as observer, feeling detached to some degree from mainstream interaction and like an outsider. From this perspective participants offered their analysis of the complex process of communication, online and offline as they experienced it, highlighting key aspects of the Internet in relation to their own needs, ones which made it a unique form of communication. Their insights into communication are described in four themes: control, clarity, the role of nonverbal communication and the social role of communication. Additionally the interviewees expressed a sense of liberation that could come with online communication for people with Asperger syndrome/high-functioning autism such that they may interact with others on a more equal basis. This could be empowering but with the sense of liberation there was a risk of losing control over one’s interactions. The interviewees’ perceptions of CMC are explored within a uses and gratifications framework which posits that people use particular communication channels to satisfy their individual needs and motives. By using computer-mediated communication some of the social and communication barriers which contribute to the disability of autism may be broken down

Validation of a home safety questionnaire used in a series of case-control studies

© 2014 BMJ Publishing Group. All rights reserved. Conclusions This study found that the validity of selfreports varied with safety practice. Questions with a high specificity will be useful for practitioners for identifying households who may benefit from home safety interventions and will be useful for researchers as measures of exposures or outcomes.Objective To measure the validity of safety behaviours, safety equipment use and hazards reported on a questionnaire by parents/carers with children aged under 5 years participating in a series of home safety casecontrol studies.Methods The questionnaire measured safety behaviours, safety equipment use and hazards being used as exposures in five case-control studies. Responses to questions were compared with observations made during a home visit. The researchers making observations were blind to questionnaire responses.Results In total, 162 families participated in the study. Overall agreement between reported and observed values of the safety practices ranged from 48.5% to 97.3%. Only 3 safety practices (stair gate at the top of stairs, stair gate at the bottom of stairs, stairs are carpeted) had substantial agreement based on the κ statistic (k=0.65, 0.72, 0.74, respectively). Sensitivity was high (≥70%) for 19 of the 30 safety practices, and specificity was high (≥70%) for 20 of the 30 practices. Overall for 24 safety practices, a higher proportion of respondents over-reported than under-reported safe practice (negative predictive value>positive predictive value). For six safety practices, a higher proportion of respondents under-reported than over-reported safe practice (negative predictive valu

Implementing an Injury Prevention Briefing to aid delivery of key fire safety messages in UK children’s centres: qualitative study nested within a multi-centre randomised controlled trial

Background To improve the translation of public health evidence into practice, there is a need to increase practitioner involvement in initiative development, to place greater emphasis on contextual knowledge, and to address intervention processes and outcomes. Evidence that demonstrates the need to reduce childhood fire-related injuries is compelling but its translation into practice is inconsistent and limited. With this knowledge the Keeping Children Safe programme developed an "Injury Prevention Briefing (IPB)" using a 7 step process to combine scientific evidence with practitioner contextual knowledge. The IPB was designed specifically for children’s centres (CCs) to support delivery of key fire safety messages to parents. This paper reports the findings of a nested qualitative study within a clustered randomised controlled trial of the IPB, in which staff described their experiences of IPB implementation to aid understanding of why or how the intervention worked. Methods Interviews were conducted with key staff at 24 CCs participating in the two intervention arms: 1) IPB supplemented by initial training and regular facilitation; 2) IPB sent by post with no facilitation. Framework Analysis was applied to these interview data to explore intervention adherence including; exposure or dose; quality of delivery; participant responsiveness; programme differentiation; and staff experience of IPB implementation. This included barriers, facilitators and suggested improvements. Results 83% of CCs regarded the IPB as a simple, accessible tool which raised awareness, and stimulated discussion and behaviour change. 15 CCs suggested minor modifications to format and content. Four levels of implementation were identified according to content, frequency, duration and coverage. Most CCs (75%) achieved ‘extended’ or ‘essential’ IPB implementation. Three universal factors affected all CCs: organisational change and resourcing; working with hard to engage groups; additional demands of participating in a research study. Six specific factors were associated with the implementation level achieved: staff engagement and training; staff continuity; adaptability and flexibility; other agency support; conflicting priorities; facilitation. CCs achieving high implementation levels increased from 58% (no facilitation) to 92% with facilitation. Conclusion Incorporating service provider perspectives and scientific evidence into health education initiatives enhances potential for successful implementation, particularly when supplemented by ongoing training and facilitation

Biopsychosocial Intervention for Stroke Carers (BISC): protocol for a feasibility randomized controlled trial

Introduction Reducing length of hospital stay for stroke survivors often creates a shift in the responsibility of care towards informal carers. Adjustment to the caregiving process is experienced by many carers as overwhelming, complex and demanding, and can have a detrimental impact on mental and physical health and wellbeing. National policy guidelines recommend that carers’ needs are considered and addressed; despite this, few interventions have been developed and empirically evaluated. We developed a biopsychosocial intervention in collaboration with carers of stroke survivors. Our aim is to determine whether the intervention can be delivered in a group setting and evaluated using a randomised controlled trial (RCT). Methods and Analysis Feasibility randomised controlled trial (RCT) and nested qualitative interview study. We aim to recruit up to 40 stroke carers within one year of the stroke onset. Carers are randomised to usual care or usual care plus biopsychosocial intervention. Each intervention group will consist of five stroke carers. The intervention will focus on: psychoeducation, psychological adjustment to stroke, strategies for reducing unwanted negative thoughts and emotions, and problem solving strategies. The main outcome is the feasibility of conducting an RCT. Carer outcomes at six months include: anxiety and depression, quality of life, and carer strain. Data is also collected from stroke survivors at baseline and six months including: level of disability, anxiety and depression, and quality of life. Ethics and Dissemination Favourable ethical opinion was provided by East Midlands – Nottingham2 Research Ethics Committee (14/EMI/1264). This study will determine whether delivery of the biopsychosocial intervention is feasible and acceptable to stroke carers within a group format. It will also determine whether it is feasible to evaluate the effects of the biopsychosocial intervention in an RCT. We will disseminate our findings through peer-reviewed publications and presentations at national and international conferences

Modifiable risk factors for scald injury in children under 5 years of age: a multi-centre case–control study

Objective: To determine the relationship between a range of modifiable risk factors and medically attended scalds in children under the age of 5 years. Methods: Multicentre matched case-control study in acute hospitals, minor injury units and GP practices in four study centres in England. Cases comprised 338 children under 5 presenting with a scald, and 1438 control participants matched on age, sex, date of event and study centre. Parents/caregivers completed questionnaires on safety practices, safety equipment use, home hazards and potential confounders. Odds ratios were estimated using conditional logistic regression. Results: Parents of cases were significantly more likely than parents of controls to have left hot drinks within reach of their child (adjusted odds ratio (AOR) 2.33, 95%CI 1.63, 3.31; population attributable fraction (PAF) 31%). They were more likely not to have taught children rules about climbing on kitchen objects (AOR 1.66, 95%CI 1.12, 2.47; PAF 20%); what to do or not do when parents are cooking (AOR 1.95, 95%CI 1.33, 2.85; PAF 26%); and about hot things in the kitchen (AOR 1.89, 95%CI 1.30, 2.75; PAF 26%). Conclusions: Some scald injuries may be prevented by parents keeping hot drinks out of reach of children and by teaching children rules about not climbing on objects in the kitchen, what to do or not do whilst parents are cooking using the top of the cooker and about hot objects in the kitchen. Further studies, providing a more sophisticated exploration of the immediate antecedents of scalds are required to quantify associations between other hazards and behaviours and scalds in young children

Nightingallery: theatrical framing and orchestration in participatory performance

The Nightingallery project encouraged participants to converse, sing, and perform with a musically responsive animatronic bird, playfully interacting with the character while members of the public could look on and observe. We used Nightingallery to frame an HCI investigation into how people would engage with one another when confronted with unfamiliar technologies in conspicuously public, social spaces. Structuring performances as improvisational street theatre, we styled our method of exhibiting the bird character. We cast ourselves in supporting roles as carnival barkers and minders of the bird, presenting him as if he were a fantastical creature in a fairground sideshow display, allowing him the agency to shape and maintain dialogues with participants, and positioning him as the focal character upon which the encounter was centred. We explored how the anthropomorphic nature of the bird itself, along with the cultural connotations associated with the carnival/sideshow tradition helped signpost and entice participants through the trajectory of their encounters with the exhibit. Situating ourselves as secondary characters within the narrative defining the performance/use context, our methods of mediation, observation, and evaluation were integrated into the performance frame. In this paper, we explore recent HCI theories in mixed reality performance to reflect upon how genre-based cultural connotations can be used to frame trajectories of experience, and how manipulation of roles and agency in participatory performance can facilitate HCI investigation of social encounters with playful technologies. © 2014 Springer-Verlag London

Poison prevention practices and medically attended poisoning in young children: multicentre case-control study

Introduction Childhood poisonings are common, placing a substantial burden on health services. Case-control studies have found inconsistent evidence about modifiable risk factors for poisonings amongst 0-4 year olds. This study quantifies associations between poison prevention practices and medically attended poisonings in 0-4 year olds. Methods Multicentre case-control study conducted at hospitals, minor injury units and family practices from four study centres in England between 2010 and 2013. Participants comprised 567 children presenting with unintentional poisoning occurring at home, and 2320 community control participants matched on age, sex, date of event and study centre. Parents/caregivers provided data on safety practices, safety equipment use, home hazards and potential confounders, by means of self-completion questionnaires. Data were analysed using conditional logistic regression. Results Compared with community controls, parents of poisoned children were significantly more likely not to store medicines out of reach (adjusted odds ratio (AOR) 1.59; 95%CI, 1.21, 2.09; population attributable fraction (PAF) 15%), not to store medicines safely (locked or out of reach (AOR 1.83; 95%CI 1.38, 2.42; PAF 16%) and not to have put all medicines (AOR 2.11; 95%CI 1.54, 2.90; PAF 20%) or household products (AOR 1.79, 95%CI 1.29, 2.48; PAF 11%) away immediately after use. Conclusions Not storing medicines out of reach or locked away and not putting medicines and household products away immediately after use increased the odds of secondary care attended poisonings in 0-4 year olds. If associations are causal, implementing these poison prevention practices could each prevent between 11% and 20% of poisonings

Designing location based learning experiences for people with intellectual disabilities and additional sensory impairments

The research reported here is part of a larger project which seeks to combine serious games (or games based learning) with location based services to help people with intellectual disability and additional sensory impairments to develop work based skills. Specifically this paper reports on where these approaches are combined to scaffold the learning of new routes and ultimately independent travel to new work and educational opportunities. A phased development methodology is applied in a user sensitive manner, to ensure that user feedback drives the ongoing development process. Methods to structure this include group feedback on conceptual storyboards, expert review of prototypes using usability heuristics relating to the main system goals, and finally co-discovery methods with student pairs exploring all three modes of the system in real world contexts. Aspects of developmental and cognitive psychological theories are also reviewed and it is suggested that combining games based learning approaches with location based services is an appropriate combination of technologies for an application specifically designed to scaffold route learning for this target audience