Older adults with autism spectrum disorders in Sweden: a register study of diagnoses, psychiatric care utilization and psychotropic medication of 601 individuals

In a Swedish sample of persons eligible for disability services and aged 55 years or older in 2012, persons (n = 601) with autism spectrum disorder diagnoses registered in specialist care were identified. Register data concerning diagnoses of other psychiatric disorders, psychiatric care, and psychiatric medication were reviewed. More than 60% had been in contact with psychiatric care. The majority had no intellectual disability (ID) diagnosis recorded during the study period. Apart from ID, affective disorders, anxiety and psychotic disorders were most commonly registered; alcohol/substance abuse disorders were uncommon. Psychotropic drug prescriptions were very common, especially in the ID group. Professionals need awareness of this vulnerable group; studies concerning their life circumstances and service requirements should be conducted

Exploring new ways of thinking about and developing staff practice: the role of modes of thinking

Purpose: Nobel Prize winner Daniel Kahneman’s work on modes of “thinking” provides a comprehensive text which is little explored in respect of work with people who have an intellectual or developmental disability. This paper aims to explore the potential of this work to change staff development and practice. Design/Methodology: Key themes from Thinking Fast, and Slow (Kahneman, 2011) are described and applied to current staff practice. Findings: Modes of thinking are relevant and important to understanding and improving manager and staff practice. Originality: To our knowledge this is the first attempt to describe and understand staff thinking and practice using Kahneman’s ideas

Organisational impact on the use of restrictive measures: The perspective of Swedish front‐line managers

Background: Restrictive measures (RM) are prevalent in services for people with intellectual disabilities. This study investigates managerial awareness of RM and the nature of organisational supports required to reduce their use. Method: A survey asked front‐line managers and staff what (RM) were used, their purpose, impact and importance (10‐item Likert scales) and what organisational changes were required (free text). Responses were analysed using descriptive methods and content analysis. Results: Managers reported a lower use of RM, compared with staff. According to managers, RM were mainly used to keep service users from harm, their use having a significant impact. Opportunities to change practices were limited by a lack of resources and organisational support. Conclusion: Front‐line managers seem to lack the capacity to address the use of RM due to organisational drift; limited manager time and opportunity to allocate resources; inadequate environments; and lack of skilled staff, knowledge and relevant professional input

As if living like others : An idealisation of life in group homes for people with intellectual disability

Background: People with Intellectual Disability (ID) in Sweden should be enabled to live like others. This life like others is realised in group homes that have little in common with the typical home. Method: A reading of Appiah’s As if is used to discuss how people with ID are supported in Sweden. Current national data are presented within the framework of idealisation, the use of (useful) untruths to navigate a complex context. Results: Small group homes should allow people with ID to communicate their preferences and exert real influence over how support is provided. Instead, times of budget austerity require the efficient use of resources in ever larger settings, where normalisation of deviance is prevalent. Conclusions: Although the stated aim is that people with ID live like others, the idealisation is rather that they live as if they live like others. This is generally not discussed, possibly due to de-differentiation

A Possible World: Autism from Practice to Theory

Persons with autism develop along trajectories that differ from the typical. Therefore, development itself gives important clues for understanding the behavioral profile characteristic of autism. Developing autism means being different, not necessarily being deficient. The infant and her environment coevolve, and therefore experience of a dynamic world is important in shaping both brain and behavior. Early development of sensory and motor skills is highly linked to cognitive abilities Exploration of the environment helps educate the perceptual system and intimately links perception with action in an interactive loop. The action?perception loop continues to play an important role in cognitive development and later cognitive processing, such as categorization and concept formation. Sensorimotor disturbances are ubiquitously found in the autism spectrum. This thesis traces sensorimotor development in autism, and the possible consequences a disturbance in the coupling of action and perception can have on cognitive processes, which are situated and embodied. The thesis also includes a chapter on pedagogical implications. The cues offered to further learning and behavior must be adapted to the different experiences of living on the autism spectrum. The cues must be salient, target the appropriate memories of similar contexts. provide sufficient feedback, etc

The role of context and inhibition in ADHD.

We have shown in a computational model that a poor memory for context could result in some of the behaviors associated with ADHD, which is well in line with the dynamic developmental theory. Given the important role of context in extinction, a weaker context due to a steeper delay-of-reinforcement gradient would result in impaired inhibition

A model of attentional impairments in autism: first steps toward a computational theory

A computational model with three interacting components for context sensitive reinforcement learning, context processing and automation can autonomously learn a focus attention and a shift attention task. The performance of the model is similar to that of normal children, and when a single parameter is changed, the performance on the two tasks approaches that of autistic children