Różne sposoby definiowania autyzmu. Przegląd stanowisk

Autyzm jest pojęciem wieloznacznym, nieostrym. W nomenklaturze medycznej kilkakrotnie już zmieniał się jego zakres semantyczny. W artykule przedstawiono sposoby występowania tego pojęcia w klasyfikacjach międzynarodowych DSM (Diagnostic and Statistical Manual of Mental Disorders) i ICD (International Statistical Classification of Diseases and Related Health Problems). Cechą wspólną tych definicji jest redukcjonistyczne podejście do pacjenta (jednostki zredukowanej do objawów chorobowych) i myślenie w kategoriach choroby bądź zaburzenia (ASD – Autism Spectrum Disorder). Obecnie istnieją również inne ujęcia autyzmu, o uznanie prawomocności których zabiegają aktorzy społeczni/grupy interesu spoza establishmentu medycznego. W opinii publicznej silnie zakorzenione jest skojarzenie autyzmu z puzzlem bądź kolorem niebieskim spopularyzowane przez fundację Autism Speaks. Ponadto w wydarzeniach medialnych, publikacjach o charakterze popularno-naukowym, naukowym, w tym w literaturze terapeutycznej, coraz częściej występuje określenie „stany ze spektrum autyzmu” (Autism Spectrum Condition). Ukazanie sporu o definicję autyzmu jest istotne, gdyż z argumentacji każdej ze stron wynikają implikacje w stosunku do zdrowia.

Investigating intra-individual variability of face scanning in autistic children

We investigated the intra-individual variability of face scanning in autistic children to represent a new avenue for understanding abnormal face scanning in autism spectrum condition. Across four studies, we used eye-tracking techniques to systematically examine the variability of face scanning patterns in autistic children when performing different tasks and scanning different types of faces. Autistic and non-autistic children were asked to complete a face judgment task (Study 1, age range: 4.9–7.2 years), a face recognition task (Study 2, age range: 4.7–7.6 years), a facial expression recognition task (Study 3, age range: 4.3–7.4 years), and a dynamic facial expression free viewing task (Study 4, age range: 2.5–5.6 years). In addition, we conducted Study 5 using houses as stimuli to test the specificity of the results to faces (age range: 4.9–7.2 years). We found that scan pattern similarity between different face presentations was lower in autistic children than non-autistic children, which was robust to variations in experimental methods. Furthermore, the decreased scan pattern similarity in autism spectrum condition was evident in both viewing faces and houses. These results suggest that the scanning patterns of autistic children are noisier and variable. It might represent a new avenue for the understanding of core symptoms in autism spectrum condition. Lay abstract Atypical face scanning is suggested to be related to social interactions and communicative deficits in autistic children. We systematically examined whether autistic and non-autistic children used consistent scanning patterns when performing different tasks and scanning different types of faces. We found that autistic children scanned faces more variably than non-autistic children: While non-autistic children used more consistent scanning patterns, autistic children’s scanning patterns changed frequently when watching different faces. Autistic children’s variable face scanning patterns might delay and impair face processing, resulting in a social interaction deficit. What’s more, variable scanning patterns may create an unstable and unpredictable perception of the environment for autistic children. Developing in such an unstable environment might motivate autistic children to retract from the environment, avoid social interaction, and focus instead on the performance of repetitive behavior. Therefore, studying face scanning variability might represent a new avenue for understanding core symptoms in autistic people.

Menstruation and menopause in autistic adults: Periods of importance?

Autism spectrum conditions were once seen as a predominantly male condition. This has caused a paucity of information on common events in the lives of women, such as menstruation and menopause. Some smaller studies indicate that autistic women might suffer from increased difficulties surrounding these events. This study aims to investigate whether autistic women experience more frequent premenstrual dysphoric disorder, and increased complaints surrounding menopause. In partly overlapping samples (premenstrual dysphoric disorder, n = 70, nASC = 28, ncomparisons = 42; menopause, n = 65, nASC = 30, ncomparisons = 35), we investigated premenstrual dysphoric disorder prevalence and menopausal complaints. In 70 individuals, we did not find an increased prevalence of premenstrual dysphoric disorder in autistic women (14.3%) compared with non-autistic women (9.5%). In 65 women aged 40 years and above, we found that autistic women did experience higher levels of menopausal complaints. In autistic women, higher menopausal complaints were associated with higher levels of depression and autistic traits. In non-autistic women, menopausal complaints were associated with increased inattention, hyperactivity/impulsivity (i.e. attention deficit hyperactivity disorder traits), and depression. With this work, we show the important role that major reproductive milestones can have in an autistic woman’s life. Lay abstract Autism spectrum conditions were once seen as a predominantly male condition, but this has caused research to have little focus on women. Therefore, little is known about menstruation and menopause in autism spectrum conditions. Some smaller studies indicate that autistic individuals might suffer from increased difficulties surrounding these events. This study aimed to investigate whether autistic women experience more frequent premenstrual dysphoric disorder, causing extreme physical, emotional, and functional impairment. In a partly overlapping sample, we also examined whether women with autism spectrum condition experience increased complaints surrounding menopause. We did not find an increased prevalence of premenstrual dysphoric disorder in autism spectrum conditions (14.3%) compared with non-autistic women (9.5%). Those with autism spectrum conditions did experience increased menopausal complaints. These menopausal complaints were associated with higher levels of depression and autistic traits. In non-autistic women, menopausal complaints were associated with increased inattention, hyperactivity/impulsivity (i.e. attention deficit hyperactivity disorder traits), and depression. With this work, we show the important role that major reproductive milestones can have in an autistic woman’s life.

An evaluation of the online post-diagnostic groups facilitated by the autism spectrum condition service at Gloucestershire Health and Care NHS

Purpose Autism spectrum condition (ASC) is a lifelong developmental condition. According to research, it is recommended that those diagnosed with ASC should be offered post-diagnosis support to explore their diagnosis (Punshow, Skirrow and Murphy, 2009). The ASC Diagnostic Assessment Service at Gloucestershire Health Care (GHC) NHS Foundation Trust offers an assessment service to adults (18+) located within Gloucestershire. All those who receive a diagnosis are then invited to a 7-week post-diagnostic group facilitated by the multidisciplinary team. This service evaluation aimed to evaluate the aforementioned group so that it can be improved upon and thus provide a better service for future clients. Design/methodology/approach In total, 14 participants (6 males, 8 females) were interviewed for the purpose of this evaluation following their attendance at these groups. Findings The interview transcripts then underwent thematic analysis with four themes identified; “Autistic Community”, “Experience of Being Part of an Online Group”, “Opportunity for Consolidation”, and “Design Considerations and Improvements”. Further sub-themes were also identified. Overall, the service evaluation identified that the group provided a platform for sharing experiences and gaining a sense of belonging. It also highlighted that individuals have different preferences for whether groups should be facilitated online or face-to-face, and also different preferences for the duration of sessions. Further analysis also revealed the suggestion that the final session, for family and friends, should be optional so that those without a support network, do not need to attend as this caused unease in some. Further findings were also identified. Originality/value To the authors’ knowledge, existing articles have only focused on the evaluation of the availability of post-diagnostic provision and autistic individuals’ general impression of it rather than an in-depth evaluation of a specific type of support.

Designing accessible visual programming tools for children with autism spectrum condition

Visual programming tools allow users to create interactive media projects such as games and animations using visual representations of programming concepts. Although these tools have been shown to have huge potential for teaching children, research has shown that they may not be accessible for children with cognitive impairments, including those with autism spectrum condition. Therefore, this study proposes a set of recommendations for the design of accessible visual programming tools for children with autism spectrum condition. Semi-structured interviews with experts ($$n=7$$ n = 7 ) were conducted and thematically analysed to identify initial recommendations. A second set of semi-structured interviews with a subset of the initial experts ($$n=3$$ n = 3 ) were then conducted to validate and produce a final set of recommendations.

‘You don’t look autistic’: A qualitative exploration of women’s experiences of being the ‘autistic other’

There is currently a paucity of literature exploring the experiences of women on the autism spectrum. It is imperative research is conducted to capture the experiences of women on the autism spectrum and ensure appropriate support is provided to this cohort. Drawing upon a social constructionist framework, this qualitative research study sought to understand how psychological and socio-cultural constructions of autism spectrum condition and gender influence the well-being of women on the autism spectrum. Eight participants engaged in a semi-structured interview, with thematic analysis conducted to demonstrate the impact of gender roles and social expectations on the women’s identity and autism spectrum condition expression. The research highlighted the changing understandings of autism spectrum condition across a woman’s lifespan and the process and impact of resisting hegemonic autism spectrum condition categorisation. The findings demonstrate that social constructions of gender and stereotypical understandings of autism spectrum condition, which prioritise a deficit, medical model, have significant consequences for women’s well-being and subjectivity. The women experienced challenging formative years, but with diagnosis and the evolution and acceptance of their identities, they were able to resist negative narratives of autism spectrum condition, embrace their strengths and develop adaptive coping strategies. It is hoped this article generates insights for societal and clinical recognition to better support women on the autism spectrum. Lay abstract Most autism spectrum condition research addresses the neurological and biological causes of autism spectrum condition, focusing upon deficits associated with autism spectrum condition and behavioural interventions designed to minimise these deficits. Little is known about the lived experiences of adult women on the autism spectrum and how they navigate social expectations around gender, autism spectrum condition and gendered understandings of autism spectrum condition. The lived experiences of eight women on the AS will be shared here, with attention to how gendered expectations influence women’s experiences of autism spectrum condition, their sense of self and well-being. Findings showed these women struggled to reconcile the expectations of others, particularly early in life. The women had difficultly conforming to stereotypical ideals of femininity, yet as they aged, they felt less need to conform, valuing their unique style and behaviours. The women also rejected deficit-oriented descriptions of autism spectrum condition generated by the medical community, preferring to focus on their strengths and unique characteristics. It is hoped this article helps psychologists and the wider community to understand and meet the needs of women on the AS.