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Background Comorbidity is the co-occurrence of two or more disorders in the same person. Aim This study investigated the frequency of comorbid conditions, in children and adolescents, with autism spectrum disorder (ASD), cerebral palsy (CP), and a comorbid diagnosis of ASD and CP. Method Ninety-six children and adolescents with ASD, CP, and both ASD and CP aged between 4 and 18 years participated in this study. Parents completed the Gastrointestinal Symptom Inventory, Children’s Sleep Habits Questionnaire, Child Behavior Checklist, Social Communication Questionnaire, and the Vineland Adaptive Behavior Scales. Results Results of ANOVA analyses revealed significant group differences in sleep problems, social communication difficulties, and adaptive behavior. Regression analysis found that the presence of an intellectual disability significantly predicted levels of adaptive behavior. Conclusion This research demonstrated the importance of studying comorbidities in children and adolescents with CP alone, ASD alone, and combined ASD and CP. peer-reviewed

This study investigated the relationship between sleep, gastrointestinal symptoms, challenging behavior, adaptive behavior, and quality of life between children and adolescents with autism spectrum disorder (ASD), with and without attention-deficit/hyperactivity disorder (AD/HD) symptoms. Parents of 118 children and adolescents with ASD completed the Conners Early Childhood Rating Scale–Parent Short Form or the Conners 3–Parent Short Form, Children’s Sleep Habits Questionnaire, Gastrointestinal Symptom Inventory, Behavior Problems Inventory–Short Form, Pediatric Quality of Life Inventory and the Vineland Adaptive Behavior Scales, Second Edition. The ASD group and the ASD with AD/HD groups differed significantly in sleep problems, gastrointestinal symptoms, and quality of life. Regressions indicated that AD/HD symptoms accounted for a small proportion of the variance for the differences in sleep problems and quality of life. AD/HD symptoms contribute to the complex needs of individuals with ASD. Research is necessary to investigate how these symptoms exacerbate comorbidities. peer-reviewed

Objectives:Sleep problems are common among children with autism spectrum disorder (ASD) and can have a negative impact on the child’s behaviour and daytime functioning. The current pilot study examined objective measurements of child and parent sleep as factors associated with the stress, anxiety, depressive symptoms, social support and quality of life of parents of children with ASD.Methods:Participants were nine children with ASD and their parents (nine mothers and three fathers). Participants wore an actigraph for 7 consecutive days and nights. Measures of sleep habits and quality were used to ascertain child and parent sleep. Measures of parenting stress, anxiety, depressive symptoms, quality of life and social support were collated.Results:Results indicated the emergence of high parental stress, anxiety and depressive symptoms. Significant correlations were observed between parent depressive symptoms, and both subjective sleep quality and child sleep disruptions.Conclusions:The present study found that parental well-being is affected by child sleep problems.

The aim of this study was to review the existing literature on abdominal pain in children and adolescents with autism spectrum disorder. Systematic search of four databases (PsycINFO, ERIC, PubMed, MEDLINE) identified 13 studies that met the inclusion criteria. Articles were analyzed for common themes, including the prevalence of abdominal pain and gastrointestinal (GI) symptoms, associations between abdominal pain/GI symptoms and behavioral and emotional concerns, associations between abdominal pain/GI symptoms, and other comorbid disorders and treatment options based on gut bacteria, diet, and probiotics. Reasons for varying prevalence rates, persistence of symptoms over time, comorbidities, and different treatment options are discussed. Clinical implications and recommendations for future research are also discussed. Open Access funding provided by the IReL Consortium peer-reviewed

Objectives:The study aims to investigate attention deficit hyperactivity disorder (ADHD) symptoms, gastrointestinal (GI) symptoms, comorbid psychopathology and behaviour problems in children and adolescents with autism spectrum disorder (ASD).Methods:Parents of 147 children and adolescents with ASD aged 6–18 years completed the Conners 3 Parent-Short Form, Gastrointestinal Symptom Inventory, Behavior Problems Inventory-Short Form and Autism Spectrum Disorder-Comorbid for Children.Results:Fifty-six per cent of children and adolescents had a comorbid diagnosis of ADHD, yet over 70% presented with clinically significant ADHD symptoms. Forty per cent of participants received a diagnosis of ADHD before ASD and 25.6% received a diagnosis of ASD first. Relationships were found between ADHD symptoms and comorbid psychopathology, GI symptoms, and behaviour problems.Conclusions:The outcomes suggest that ADHD is being underestimated as a comorbid disorder of ASD. This may have implications on treatment and interventions for children and adolescents who have a diagnosis of both ASD and ADHD.

Aim Research is required to study the relationship between age of autism spectrum disorder (ASD) diagnosis and the presence of comorbidities. Method The Gastrointestinal Symptom Inventory, Autism Spectrum Disorder-Comorbid for Children, Behavior Problem Inventory-Short Form and Social Communication Questionnaire were completed by parents of 129 children and adolescents with a diagnosis of ASD. Results Results revealed significant relationships between the age of ASD diagnosis, the presence of comorbidities and intellectual disability. Significant correlations were found between the age of ASD diagnosis and self-injurious and stereotyped behavior. Comorbid psychopathology significantly predicted the presence of GI symptoms. In addition, the relationship between comorbid psychopathology and challenging behavior in this study was reported as bi-directional as both comorbidities predicted one another in the sample. Conclusion Future research needs to consider the role of comorbidities in relation to ASD diagnosis.

This systematic review aimed to determine what existing job transition programs are evidence-based and methodologically founded. The PRISMA method was used for the review, and the inclusion criteria were to include studies where there were a description of transition programs and functional curriculum for acquiring employment competences; internship experiences in employment context; single-case or group-design studies with youths as participants; and diagnosis of intellectual disability. Forty-six studies were initially selected, and three final articles met all the criteria set for assessing the methodology quality. Although the review results show that more research is needed to provide empirical programs for enhancing the acquisition of employment capabilities, some evidence emerged from the analysis of studies. These concern mainly four aspects: curriculum contents facilitating the development of self-determination and the acquirement of job-related skills, chance to have individualized internships, support of job coaches, and technological solutions and programs anchored in community-based settings.

The present study investigated the association between autism and problematic internet use (PIU) and gaming disorder (GD). A systematic literature search was conducted in accordance with PRISMA guidelines. A total of 2286 publications were screened, and 21 were deemed eligible for inclusion in the review. The majority of the studies found positive associations between PIU and subclinical autistic-like traits with weak and moderate effect sizes and between PIU and Autism Spectrum Disorder (ASD) with varying effect sizes. Additionally, individuals with ASD were more likely to exhibit symptoms of GD with moderate and strong effect sizes. Future research would benefit from high-quality studies examining GD and PIU at a clinical level and their relationship with both clinical and subclinical autism. Open access funding provided by Eötvös Loránd University. This study was supported by the Hungarian National Research, Development and Innovation Office (KKP126835; ELTE Thematic Excellence Programme 2020, KP2020-IKA-05). Orsolya Király and Beatrix Koronczai was supported by the János Bolyai Research Scholarship of the Hungarian Academy of Sciences and by the ÚNKP-20-5 New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund. peer-reviewed

Aim Children and adolescents diagnosed with an autism spectrum disorder (ASD) often demonstrate difficulties with feeding. The goal of the current study was to investigate co-occurring issues that often accompany feeding problems in 120 children and adolescents with ASD.Method: This study investigated the relationship between feeding problems and gastrointestinal symptoms, challenging behavior and sensory issues, quality of life, adaptive functioning and use of complementary and alternative medicine (CAM).Results: High rates of feeding problems, gastrointestinal symptoms, challenging behavior and sensory issues were endorsed by caregivers. Considerable differences were observed in the levels of gastrointestinal symptoms, challenging behavior, sensory issues, quality of life and CAM practices.Conclusion: The results of this study extend the present literature by highlighting comorbid conditions related to feeding problems and how feeding problems impact quality of life and adaptive behavior. peer-reviewed 2021-06-04

Frequency of feeding problems, gastrointestinal (GI) symptoms, challenging behavior, sensory problems and comorbid psychopathology were assessed using the following questionnaires: Screening Tool for Feeding Problems for Children, GI Symptoms Inventory, Behavior Problems Inventory Short Form, Short Sensory Profile, and Autism Spectrum Disorder-Comorbidity Child (ASD-CC) in 136 children and adolescents with ASD. Eighty-four percent had food selectivity, followed by food refusal (78.7%), rapid eating (76.5%), chewing problems (60.3%), food stealing (49.3%) and vomiting (19.1%). Higher rates of GI symptoms, challenging behavior, and sensory issues were found in those who presented with rapid eating, food refusal and food stealing than those without these problems. Comorbid psychopathology predicted rapid eating, food selectivity and food refusal. peer-reviewed 2021-01-18

Background People with autism spectrum disorder (ASD) can experience affective problems, gastrointestinal (GI) symptoms, sleep problems, and challenging behaviour. This study identified the frequency of affective problems and explored how they related to co-occurring conditions in children and adolescents with ASD. Method Participants were children and adolescents diagnosed with ASD using DSM-IV-TR criteria (n = 95), 40 % (n = 38) of whom also had a diagnosis of intellectual disability (ID). The following scales were completed by the participants’ parents or guardians: Child Behaviour Checklist (CBCL), Gastrointestinal Symptoms Inventory, Children’s Sleep Habits Questionnaire (CSHQ), and the Behaviour Problems Inventory-Short Form (BPI-S). Pearson’s correlations and independent sample t-tests were used to examine the relationships between variables. Two hierarchal multiple regressions examined predictors for affective problems in preschool and school-aged children with ASD. Results Participants scored in the clinical range (69.5 %) and borderline range (10.5 %) for affective problems. Significant positive relationships were found between affective problems and sleep problems, GI symptoms, and challenging behaviour. ID and gender predicted affective problems in preschool aged children. In school-aged children, affective problems were predicted by ID, sleep problems, and aggressive/destructive behaviour severity. However, only 25 % of the variance in affective problems was accounted for. Conclusions Future research is needed to understand how affective problems are impacted by co-occurring conditions in children and adolescents with ASD. Affective problems are prevalent in this population and the quality of life for individuals may be improved if practitioners consider co-occurring conditions during clinical practice. peer-reviewed

This systematic review aims to offer an updated understanding of the relationship between gastrointestinal symptoms (GIS) and autism spectrum disorder (ASD) in children and adolescents. The databases PsycINFO, Medline, Cinahl, and ERIC were searched using keywords, and relevant literature was hand-searched. Papers (n = 3319) were systematically screened and deemed eligible if they were empirical studies published in English since 2014 and measured the GIS of individuals with ASD who were under 18 years old. Thirty studies were included in the final review. The study findings were synthesized under eight themes, including the prevalence and nature of GIS and their relationship with developmental regression, language and communication, ASD severity, challenging behavior, comorbid psychopathology, sleep problems, and sensory issues. The review found that GIS were common and that there was contradictory evidence concerning their relationship with co-occurring conditions. It also identified evidence of some causal relationships that support the existence of the gut–immune–brain pathways. Future research needs to use large prospective designs and objective and standardized GIS measurements to provide a nuanced understanding of GIS in the context of ASD.

Over forty percent of autistic children experience poor sleep quality, and social interaction difficulties are a core characteristic of autism. However, the relationship between sleep quality and social functioning and behavior remains poorly understood. This systematic review examined the evidence concerning the impact of sleep quality on the social functioning and behavior problems in autistic children and adolescents. It also identified key related factors and evaluated how this issue has been researched to date. Seven key journals were hand-searched and five databases were systematically searched, using keywords. Titles and abstracts of 4123 items were screened against eligibility criteria by two researchers. Relevant studies were retained if they were peer-reviewed empirical papers, published in English between 2000 and 2021. Then, the full text of 97 papers was screened and if they met the eligibility criteria, their reference lists were hand-searched. Forty-six studies were included in the final review. Data were systematically extracted and two authors critically appraised the strengths and weaknesses of studies using Critical Appraisal Skills Programme tools. Key themes were identified, because a meta-analysis was not possible due to the studies’ heterogeneity. The review identified that sleep quality and social functioning are associated with one another and there is a small amount of evidence that a bi-directional causal relationship may exist. Evidence suggests that several nights of suboptimal sleep duration and a lack of deep continuous sleep negatively impact externalizing and internalizing behavior. Sleep quality is also reduced by anxiety and sensory sensitivity. However, longitudinal studies with larger samples are needed to establish causality. Future research needs to examine confounding factors and to develop consensus regarding best-practice processes for the objective measurement of sleep with autistic children. Additional research also needs to further examine the consequences of poor sleep quality on internalizing behavior, and the impact of socio-cultural practices. peer-reviewed

22q11.2 Deletion Syndrome (22q11DS) is a genetic syndrome caused by a chromosomal microdeletion. It affects approximately 1 in 850-992 pregnancies, and its clinical manifestations include congenital heart disease, gastrointestinal symptoms, and psychiatric illnesses. The study examined the relationship between adaptive behavior and functional outcomes, educational attainment, employment, and independent living, and whether age, gender, intellectual disability, presence of psychiatric disorder, and close friendships could predict levels of adaptive behavior. Parents of adults with 22q11DS (n = 101; 48 male and 54 female) completed the Waisman Activities of Daily Living Scale, demographic details, and questions elicited employment, education, and relationships status. Analysis conducted in SPSS, included descriptive statistics, measures of association, Analysis of Variance, logistic and linear regressions. Differences in levels of overall adaptive behavior were found regarding employment and living status, but not in educational attainment. Having close friendships was associated with adaptive behavior as well as the likelihood of living independently. Further research is needed, ideally using prospective designs and purposive sampling strategies. This needs to examine how social and communication deficits impact relationship building and how they are affected by the clinical manifestations of 22q11DS. It also needs to focus on how different social structures interface with levels of adaptive behavior.

Angelman syndrome (AS), is a rare genetic disorder. This study investigated the relationship between parent-reported comorbid symptoms including gastrointestinal symptoms, sleep problems, internalizing symptoms, and behavior problems in children and adolescents with AS.Parents of 98 children and adolescents with AS completed the Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Child Behavior Checklist, Social Communication Questionnaire, and the Behavior Problem Inventory-Short Form. Data were analyzed using descriptive statistics, Pearson's correlation coefficients, and hierarchical multiple regressions.There was a high frequency of GI symptoms (99%), sleep problems (95.9%), challenging behavior (98%), internalizing symptoms (38%), and 72.4% of children and adolescents presented with ASD symptoms. Self-injurious behavior (SIB), aggressive/destructive behavior, and the frequency of stereotyped behavior positively correlated with GI symptoms and sleep problems and it was moderately negatively associated with age. Internalizing symptoms and age were positively associated with SIB. Aggression was significantly related to gender, but not the presence of ASD symptoms.Findings highlight the relationships between comorbid conditions. They may lead to a deeper understanding of how comorbidities present in children and adolescents with Angelman Syndrome.

Aim: The purpose of this pilot was to evaluate the effectiveness of the E-IDEAS curriculum, specifically designed for workplace inclusion of youths with intellectual disabilities (ID) and aimed to transfer social, communication, independent living and employment skills.Method: The curriculum was attended by 5 participants, and it was provided concurrently with five different work-placements across a period of six months. Two assessment tools were used to demonstrate the acquisition of such skills and an evidence-base improvement of their quality of life. Pre and post-intervention standardized assessments were also taken for measuring the improvement in quality of life (through the San Martín Scale) and adaptive behavior (through the Vineland-II Adaptive Behavior Scale).Results: The data collected showed increases in the acquisition of such skills. Evidence of maintenance and generalization were also demonstrated.Conclusion: Implications for practice and further research are discussed. This research was supported by funding from the charity RESPECT and the People Programme (Marie Curie Actions) of the European Union’s Seventh Framework Programme [FP7/2007-2013] under REA grant agreement no. [PCOFUND-GA-2013-608728]. peer-reviewed

Aistear: The Early Childhood Curriculum Framework, was launched in Ireland in 2009. The framework is applicable in all settings where children in the 0-6-year range are present; this includes all early years settings and the first two years of primary schools, referred to as “infant classes” in the Irish context. This article shares the findings of a local research project which sought to explore the implementation of “Aistear”, by Early Years Educators (EYEs) and Primary School Teachers (PSTs) in pre-schools and infant classes. This research, based on a qualitative case-study design, was primarily focused on those educators working with children who are between three and six years of age and was based in the North East region of Ireland. The study examined the implementation of Aistear and how educators adapted their existing curriculum and daily routine. Thirteen educators participated, including six EYEs and seven PSTs. The collected data was thematically analysed with the emerging story captured through five key themes: Emergent Curriculum, Social Development, Communication, Holistic Development, and Implementation of Aistear. Overall, the benefits for children’s social interactions, language development and cognitive development through play in a child-led environment were discussed by participants. However, training, ratios and resources were a concern and a requirement for EYEs and PSTs. The recommendations from this study indicates that further research into the implementation of Aistear on a national scale would offer greater insight into the adaptation of the curriculum framework within pre-schools and infant classes in primary schools. peer-reviewed

Aim: Frequency and relationship between child comorbid psychopathology and parental stress, quality of life (QoL), anxiety, depression, and social support were examined in parents of children and adolescents with autism spectrum disorder (ASD). Method: Parents of 152 children and adolescents with ASD completed the Autism Spectrum Disorder-Comorbid for Children, Parenting Stress Index-Short Form, World Health Organization Quality of Life Abbreviated Version, Hospital Anxiety and Depression Scale, and the Multidimensional Scale of Perceived Social Support. Results: A series of one-way multivariate analysis of variance was conducted to examine the relationship between child comorbid psychopathology and parental well-being. A relationship was found between parental QoL, depression and anxiety and child comorbid psychopathology. Results showed a relationship between parental stress and the severity of child conduct, and repetitive behaviors. Conclusion: This study adds to existing literature by demonstrating the relationship between comorbid psychopathology in children and adolescents in ASD and parental well-being. peer-reviewed

Individuals diagnosed with autism spectrum disorder (ASD) have a higher probability of developing co-occurring mental or physical health conditions. However, little is known about how these health conditions develop and impact the lives of the adult ASD population. This paper reviewed existing studies concerning factors affecting the health status of adults with ASD and described their outcomes and prevalence. A systematic search of electronic databases yielded 21 studies eligible to be included. The most common physical problems affecting health were epilepsy and immune, gastrointestinal, and sleep disorders. Mental health disorders, most prominently mood and anxiety disorders and OCD, were also strong factors for determining health in adults. Future research should focus on measuring the overall health status of the adult ASD population. Open Access funding provided by the IReL Consortium. peer-reviewed

Functional assessment is a technique consisting of a set of procedures that define the relationship between events in the environment and specific target behaviors. The purpose of functional assessment is to identify maintaining contingencies for challenging behavior in an individual s environment. This chapter provides an overview of populations evaluated with functional assessment, which includes the following: Autism Spectrum Disorder, Intellectual Disability, Emotional Behavioral Disorder, Attention-Deficit/Hyperactivity Disorder, Fragile X Syndrome, Angelman Syndrome, Prader-Willi Syndrome, Smith-Magenis Syndrome, Lesch-Nyhan Syndrome, Acquired Brain Injury, Typically Developing Children, Children at Risk of Developmental Disabilities, Children with Prenatal Drug Exposure, and Children who use Wheelchairs. The subsequent part of this chapter will focus on the behaviors and problems evaluated with functional assessment, which include the following: aggression, self-injurious behavior, stereotypy, bizarre speech, skin picking, hand mouthing, feeding problems, elopement, noncompliance and disruptive behavior, multiple typographies of problem behavior, sleep problems, and happiness behaviors. An extensive review of the research will provide the reader with the range of possible uses of functional assessment. Peer reviewed 2023-03-27

Aim: Comorbid psychopathology refers to having a diagnosis of two or more co-occurring psychological disorders. The current study investigated the differences between children and adolescents with no-mild, moderate and severe comorbid psychopathology in children and adolescents with ASD.Method: Parents of 133 children completed the Autism Spectrum Disorder-Comorbid for Children, Behavior Problems Inventory-Short Form, Pediatric Quality of Life Inventory, Vineland Adaptive Behavior Scales, Social Communication Questionnaire, Short Sensory Profile, and Behavioral/Educational Interventions and Complementary/Alternative Medicine (CAM) Interventions of the Autism Treatment Network Registry Parent Baseline Assessment.Results: A significant difference was found between severity of comorbid psychopathology and all types of challenging behavior and all sensory issues except movement. A small effect size was also found between comorbid psychopathology and quality of life.Conclusion: The findings from this study show significant difficulties associated with those with comorbid psychopathology in ASD in challenging behavior, sensory issues and quality of life. peer-reviewed 2022-03-12

[No abstract available] Peer reviewed 2021-10-08

Background Comorbidity is the presence of at least two disorders in one person at one time. This study examined the frequency of gastrointestinal (GI) symptoms, sleep problems, comorbid psychopathology, challenging behaviour and autism spectrum disorder (ASD) symptoms in children and adolescents with duplication 15q syndrome (Dup15q), aged 3-17 years. This study also examined whether challenging behaviour in Dup15q is predicted by age, gender, presence of an intellectual disability, sleep problems, GI symptoms and comorbid psychopathology. Method Parental measures were completed by 101 parents of children and adolescents with Dup15q. Questionnaires were composed of the Children's Sleep Habits Questionnaire, Behavior Problems Inventory - Short Form, GI Symptom Inventory, Social Communication Questionnaire and the Child Behavior Checklist. Results Sleep problems (94%), GI symptoms (87%) and challenging behaviour (100%) were common comorbidities represented in the sample in this study. Significant relationships were found between challenging behaviour and the presence of co-occurring sleep problems, GI symptoms, comorbid psychopathology and ASD symptoms. Further analysis revealed that these comorbidities also predicted challenging behaviour. Conclusion This research demonstrated the importance of studying the relationships between GI symptoms, sleep problems, comorbid psychopathology, ASD symptoms and challenging behaviour in Dup15q and how these conditions can shape the Dup15q phenotype.

Background: Resilience is a process of adapting to stress. For people with dementia, resilience is enhanced through having positive social relationships. Social robots, such as MARIO, can facilitate social engagement. However, the effect of social robots on resilience has not yet been determined. Objective: To investigate how MARIO, a social robot, affects the resilience of people with dementia. Method: Multiple case study methodology was used to explore the resilience of people with dementia during and after they used MARIO in 12 facilitated sessions. Data collection was conducted using: dementia care mapping; semi-structured interviews with people with dementia (n=10), caregivers (n=6), and relatives (n=7); and questionnaires including the Quality of Life in Alzheimer’s disease and The Resilience Scale. During sessions, data was collected using the Observational Measure of Engagement. Data analysis was guided by framework analysis. Qualitative and quantitative data were analysed in NVIVO 12 and SPSS respectively. Then, all data was triangulated in a matrix, analysed for similarities and differences within and across cases, and themes were developed. Results: The cross-case analysis produced four themes: Resilience changes minute to minute; Initiating and maintaining readiness; Active co-creation of meaningful activity; Impact on resilience. The findings revealed that people with dementia required skilled facilitation to use MARIO. During interactions with MARIO, the resilience of eight out of ten people was supported. Sessions with MARIO increased the wellbeing of people with dementia by providing a meaningful activity that re-enforced their positive self-concept. Conclusion: Social robots need to have greater capability to interpret and respond to the emotional needs of users if they are to benefit the resilience of people with dementia without the presence of a supportive facilitator. Future research should explore how strength-based strategies can empower people with dementia to create a meaningful activity using social robots. peer-reviewed

Background The purpose of this study was to investigate the relationship between sleep problems, gastrointestinal symptoms, social functioning, autism traits, and social support on quality of life (QoL) in 107 adults with autism spectrum disorder (ASD). Method Questionnaires included the Autism Spectrum Quotient-10 (Adult), Multidimensional Scale of Perceived Social Support, Social Functioning Questionnaire, Pittsburgh Sleep Quality Index, Gastrointestinal Symptom Inventory, and World Health Organization Quality of Life-BREF. Results GI symptoms were a common comorbidity with 86 % of participants presenting with them. Sleep problems were also frequent issues with 89 % of participants being classified as poor sleepers. Greater sleep problems were correlated with poorer QoL in the physical health and environment domains. Specifically, the sleep problem of daytime dysfunction was correlated with poorer QoL in physical health. Daytime dysfunction and sleep duration were correlated with poorer QoL in the environment domain. Better social support was correlated with greater QoL in the psychological, social and environment domains. Poorer social functioning was correlated with poorer QoL in each of the four domains. Conclusion This research indicated that GI symptoms and sleep problems are common comorbid conditions in the adult ASD population. This paper expanded upon the existing literature by highlighting unexplored factors influencing QoL in adults with ASD.

Aim Frequency and relationship between gastrointestinal symptoms, sleep problems, internalizing and externalizing symptoms, behavior problems and autism spectrum disorder (ASD) symptoms, and predictors of behavior problems were examined in children and adolescents with Cerebral Palsy (CP). Method Parents of 104 children and adolescents with CP completed the Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Child Behavior Checklist, Social Communication Questionnaire and the Behavior Problem Inventory-Short Form. Results High frequency of behavior problems (88.5%), gastrointestinal symptoms (81.7%), sleep problems (81%) ASD symptoms (48%) and internalizing and externalizing symptoms (31.7%) were found. Relationships were found between gastrointestinal symptoms and sleep problems, and gastrointestinal symptoms and internalizing and externalizing symptoms. Relationships were found between sleep problems and behavior problems. Intellectual disability, sleep problems, internalizing and externalizing symptoms, and ASD symptoms predicted behavior problems. Conclusion Findings highlights the frequency of comorbidities that exist in CP and how these comorbidities affect one another. peer-reviewed 2021-06-07

Background: 22q11.2 deletion syndrome (22q) is a chromosome disorder, where a segment of chromosome 22, located at 811.2, is missing. This study aims to investigate the relationship between a number of parent-reported comorbid conditions including gastrointestinal symptoms, sleep problems, autism spectrum disorder (ASD) symptoms and behavior problems in children and adolescents with 22q deletion syndrome.Method: The Gastrointestinal Symptom Inventory, Children's Sleep Habits Questionnaire, Behavior Problem Inventory-Short Form and the Social Communication Questionnaire were completed by parents of 149 children and adolescents aged 3-18 years with a diagnosis of 22q.Results: A series of correlations and hierarchical multiple regressions were conducted to examine the relationships between GI symptoms, sleep problems and behavior problems in children and adolescents with 22q deletion syndrome. A significant moderate relationship was found between GI symptoms and sleep problems. Gender and ASD symptoms predicted GI symptoms. Significant small relationships were found between GI symptoms and self-injurious behavior. Significant small to moderate relationships were found between sleep problems and self-injurious behavior, aggressive/destructive behavior, and sterotyped behavior. Sleep problems predicted challenging behavior.Conclusions: This research demonstrated the importance of studying the relationship between comorbidities, including gastrointestinal symptoms, sleep problems, and behavior problems and how they shape the phenotype of 22q deletion syndrome. peer-reviewed 2021-05-28

Samson et al. (Journal of Autism and Developmental Disorders 41:475 483, 2011) conducted the first empirical investigation examining the fear of being laughed at (gelotophobia) and its prevalence in individuals with high functioning autism spectrum disorder (hfASD). The present research examined gelotophobia in relation to social functioning, perceived social support, life satisfaction and quality of life (QoL) in individuals with hfASD, including past experiences of bullying and the presence of comorbid psychopathology. Participants were 103 adults with a clinical diagnosis of hfASD and 137 typically developing controls. Individuals with hfASD presented with higher rates of gelotophobia symptomatology in comparison to controls (87.4 vs. 22.6% respectively). It was also found that social functioning, past experiences of bullying, anxiety and life satisfaction were predictors of gelotophobia amongst individuals with hfASD. peer-reviewed 2019-07-03

Psychosis is a set of symptoms related to mental health issues that occurs in a range of psychotic disorders. Psychosis in individuals with intellectual disabilities is an underexplored area in research. This chapter provides an overview of psychosis in intellectual disability (ID). Definitions of what psychosis is will be discussed, as well the prevalence and incidence of psychosis. The importance of studying psychosis in ID will be outlined, including a discussion of the difficulties of providing a diagnosis of psychosis in individuals with an ID. Difficulties of diagnosis will be discussed in terms of diagnostic systems and assessment tools, presence of dual diagnosis, similarities in the etiology of challenging behavior and psychiatric disorder, severity of challenging behavior, the level and degree of intellectual disability, and difficulties in self-report. Risk factors of psychosis will be examined, including baseline risks, early-life risks, childhood risks, and risks later in life. Assessment of psychosis will be outlined, including recommendations for the assessment of psychosis in individuals with intellectual disabilities. Pharmacological and psychological treatment of psychosis in ID will be discussed including recommendations for treatment. Finally, future directions for research will be outlined. Not peer reviewed 2021-09-04

MARIO is a social robot developed with and for people living with dementia (PLWD) to promote social connectivity and reduce loneliness and isolation by providing access to a number of applications that PLWD can access, via speech and/or touchscreen commands. These applications include My Calendar, which reminds the PLWD about daily schedules and appointments; My Music which provides access to the PLWD s personalised music and My Memories which gives the PLWD the opportunity to reminiscence by showing them photographs of family, friends and/or significant life events. MARIO was developed, tested and evaluated with PLWD in a long stay residential setting over a 13-month period from September 2016 to October 2017. During the first 5 months of MARIO s introduction to PLWD, researchers maintained a reflective practice diary. The aims of the study were twofold: (1) To capture the experiences of researchers of being involved in this process and (2) To help identify strategies to enhance PLWD s engagement with the robot. These reflections were analysed in NVIVO 11.4 using thematic analysis guided by a qualitative descriptive methodology. The following themes emerged from the research: (1) Level of interest in having MARIO present in long-term residential care (LTC), (2) MARIO s appearance and functionalities, (3) Engaging with MARIO, (4) Researchers Recommendations for Introducing Robots in Dementia Care and (5) Impact on researchers. From the researcher s recommendations for introducing robots in dementia care, a number of key strategies were identified which may facilitate the engagement of PLWD with social robots. These include the use of verbal and/or physical prompting by the robot, lack of distraction, and actively engaging staff members or family members when introducing the robot to PLWD. This work highlights the important contribution of reflective practice to the introduction and development of social robots in dementia care. The research leading to these findings have received funding from the European Union Horizon 2020-the Framework Programme for Research and Innovation (2014–2020) under Grant Agreement 643808 Project MARIO ‘Managing active and healthy aging with use of caring service robots’. peer-reviewed 2020-06-14

Research has recently focused on studying comorbidity in the autism spectrum but little research has been conducted on follow-up studies or conducting longitudinal research into these conditions. Mannion, Leader, and Healy (2013) examined the frequency of comorbid disorders in children and adolescents with autism spectrum disorder and the predictors of sleep problems. The current study is a follow-up study conducted two years later with 56 participants. Age, gender, level of intellectual disability, presence of epilepsy, attention deficit/hyperactivity disorder (AD/HD) and an anxiety disorder were assessed, along with administering the Autism Spectrum Disorder-Comorbid for Children (ASD-CC), the Children's Sleep Habits Questionnaire (CSHQ) and Gastrointestinal Symptom Inventory. The aim of the study was to determine if comorbid symptoms changed over time. An additional aim was to explore if there is a relationship between family medical history and history of autoimmune diseases, and child comorbid conditions. Sleep problems persisted in 91.5% of participants. Gastrointestinal symptoms persisted in 84.4% of participants. There was a significant difference between over-eating at baseline and at two-year follow-up, where over-eating became more severe over time. It was found that 92.9% of participants presented with a family history of autoimmune disease. The most common autoimmune diseases were osteoarthritis, psoriasis and hypothyroidism. The associations between familial autoimmune diseases and child comorbid conditions are discussed in the study. (C) 2015 Published by Elsevier Ltd. peer-reviewed

Gelotophobia can be defined as the fear of being laughed at or ridiculed. The aim of the current literature review is to present a synthesis of the literature on gelotophobia and the link between high-functioning autism spectrum disorder (hfASD) and gelotophobia. It will also give an overview of the literature regarding the variables hypothesised to be affected by the presence of gelotophobic symptoms in individuals with hfASD, namely social functioning, perceived social support and overall quality of life. Topics explored are defining the characteristics of gelotophobia, conceptualisation and measurement implications of gelotophobia, the aetiology and consequences of gelotophobia, analysing the social competence of gelotophobes and assessing the literature on the presence of gelotophobia in a hfASD sample. The characteristics of hfASD will be discussed. Research on hfASD and its relationship with other variables is also investigated, including comorbid psychopathology, perceived social support, social functioning, shame-bound emotions and overall quality of life. The current review will place an emphasis on research conducted on an adult population of individuals with hfASD. Given the limited research in the area, more research is needed to better understand the relationship between gelotophobia and bullying, social functioning, perceived social support, comorbid psychopathology and quality of life in individuals with hfASD. In conclusion, experts in the area of gelotophobia need to expand their research to include individuals with hfASD, and autism researchers need to be aware of gelotophobia and to incorporate gelotophobia as a potential comorbidity into their research. peer-reviewed 2019-07-19

The current study investigated toileting problems in one hundred and twenty-seven children and adolescents with parent-reported diagnoses of autism spectrum disorder. Toileting refers to the accomplishment of various unprompted behaviors, including recognising the need to go to the toilet, and waiting before eliminating. The relationship between toileting problems and age, gender, intellectual disability, gastrointestinal symptoms, sleep problems, comorbid psychopathology, quality of life, and adaptive functioning were examined using parent-report questionnaires. The most common toileting problems were, "Does not independently perform most self-help tasks", "Has toilet accidents during the day", and "Parent/caregiver notices smears in underwear". Gender, presence of intellectual disability, gastrointestinal symptoms, and comorbid psychopathology were significant predictors of toileting problems in this study. The gastrointestinal symptoms of constipation and bloating were found to be significant predictors of toileting difficulties. Specifically, constipation predicted accidents and physical problems associated with toileting, and bloating predicted social/emotional factors and physical problems. A small negative correlation was observed between total toileting problems and total health related quality of life. An increase in physical toileting difficulties was associated with lower quality of life. peer-reviewed 2019-03-22

Anxiety-related concerns are among the most common presenting problems for school-age children and adolescents with autism spectrum disorder (ASD) in clinical settings. The current study examined the relationship between anxiety and gastrointestinal (GI) symptoms, sleep problems, and challenging behavior in a sample of children and adolescents with ASD, aged 6 17 years. Parental measures were completed by 109 parents of children and adolescents with ASD. Significant positive correlations were found between anxiety and GI symptoms, and anxiety and sleep problems. A hierarchal linear regression indicated that demographic variables, GI symptoms, sleep problems, and challenging behavior accounted for 34% of the variance in anxiety, with sleep, severity of self-injurious behavior, age, and diagnosis of intellectual disability emerging as significant predictors. The findings suggest that these factors should be considered during clinical practice as they may serve as important alerts for clinicians to consider assessing for anxiety disorders. Future research should investigate these variables further by examining their associations with specific types of anxiety disorders. peer-reviewed

MARIO is a companion robot that aims to help people with dementia (PWD) to battle isolation and loneliness by enabling them to stay socially active by providing a number of applications focused on hobbies (music, movies, etc), staying engaged with communities (reading headlines, reading local twitter feeds etc.) and staying connected with family and friends (telephoning them, reading their news from twitter, etc.). This paper presents the results from the initial trials of MARIO interacting with PWD involving a limited set of applications. It confirms some of the challenges hypothesized at the outset of the study and provides guidelines for future development work.

In 2009, Kroeger and Sorensen-Burnworth published a comprehensive review of the literature on toilet training individuals with autism spectrum disorder and other developmental disabilities. Their review highlighted that the majority of toilet training programs were modelled after Azrin and Foxx s Rapid Toilet Training (RTT) method. The current study will review toilet training programs for the developmental disability population since 2009. Behaviourally based components of these programs will be described and their contribution to toilet training discussed. This study will also review the questionnaires available to assess toileting difficulties in this population, and their contribution to toilet training programs will also be reviewed. peer-reviewed

The purpose of this review is to provide an overview of the research on attention-deficit/hyperactivity disorder (AD/HD) in individuals with autism spectrum disorder (ASD). Topics explored are the prevalence of AD/HD, the importance of studying AD/HD, as well as the questionnaire measures used to measure AD/HD in individuals with ASD. Research on the relationship between AD/HD in ASD and parental stress and psychological distress, developmental regression, language and communication, adaptive behavior, social skills, autism severity, challenging behavior, comorbid psychopathology, gastrointestinal symptoms, sleep problems, epilepsy, sensory issues, motor difficulties, and quality of life are also discussed. Research on cardiac reactivity and executive functioning are also explored. Finally, recommendations for treatment are given as well as areas where future research is needed. peer-reviewed