Systematic review of factors affecting driving and motor vehicle transportation among people with autism spectrum disorder

Purpose: This systematic review is to critically appraise the literature on factors affecting driving and motor vehicle transportation experiences of people with autism spectrum disorders (ASD) and to provide insight into future directions for research. Methods: Systematic searches of eight databases identified 22 studies meeting our inclusion criteria. These studies were analysed in terms of the characteristics of the participants, methodology, results of the study and quality of the evidence. Results: Among the 22 studies, 2919 participants (364 individuals with ASD; 2555 parents of youth with ASD; mean age of person with ASD?=?17.3) were represented, across six countries. Studies (n?=?13) focused on factors affecting driving, including challenges in obtaining a licence, driving confidence, driving behaviours and strategies to improve driving skills. In regards to factors related to public and/or school transportation, nine studies explored rates of transportation use, access, cost and safety. Conclusion: Our findings highlight several gaps in the research and an urgent need for further transportation-related training and supports for people with ASD.

• Implications for rehabilitation

• Many people with ASD encounter challenges in obtaining a driver’s licence, driving confidence and driving performance compared to those without ASD.

• Several strategies can be useful when teaching people with ASD to drive including direct communication, encouraging coping mechanisms, breaking down tasks and providing regular and consistent driving lessons.

• Clinicians and educators should advocate for further transportation-related training and supports for people with ASD.

• More research is needed from the perspective of people with ASD to understand their experiences and the particular challenges that they encounter in obtaining a licence and navigating public transportation.

     

学龄前孤独症谱系障碍儿童健康体适能水平及影响因素

摘要目的：初步研究学龄前孤独症谱系障碍（autism spectrum disorder, ASD）儿童健康体适能水平,探讨ASD儿童健康体适能的影响因素,为其全面康复治疗和家庭运动指导提供参考。方法：选取ASD组儿童50例和正常组儿童50例,健康体适能水平采用身体质量指数、20m往返跑距离、网球掷远距离、立定跳远距离、等长俯卧撑时长、单脚站时长平均值、坐位体前屈距离7个指标,收集整理ASD儿童的影响因素情况。分析学龄前ASD儿童与正常儿童之间的健康体适能水平差异,采用多元线性回归模型分析性别、BMI、平均每天睡眠时间、平均每天久坐时间、平均每天TPA时间、平均每天MVPA时间、母亲文化水平、父亲文化水平、家庭收入、儿童主要看护人年龄对学龄前ASD儿童健康体适能影响。结果：组间对比分析结果显示ASD组网球掷远距离低于正常组（P<0.05）,20m往返跑距离、等长俯卧撑时长和单脚站时长平均值显著低于正常组儿童（P<0.001）,差异存在显著性意义。两组BMI、立定跳远距离和坐位体前屈距离成绩差异无显著性意义（P>0.05）。多元线性回归模型分析显示平均每天睡眠、总体力活动（total physical activity, TPA）、中高强度体力活动（moderate to vigorous intensity physical activity, MVPA）时间对20m往返跑距离有良好拟合作用（20m往返跑距离=﹣9.561+1.048×平均每天睡眠时间+0.076×均每天TPA时间+0.066×平均每天MVPA时间）;平均每天TPA时间对等长俯卧撑时长有良好拟合作用（等长俯卧撑时长=﹣87.625+0.428×平均每天TPA时间）;平均每天TPA、MVPA时间对单脚站时长平均值有良好拟合作用（单脚站时长平均值=6.627+0.094×平均每天总身体活动时间+0.071×平均每天中高强度活动时间）。结论：学龄前ASD儿童的心肺适能、运动适能、上肢肌肉适能低于正常儿童,综合康复干预方案应适当加入体适能训练。学龄前ASD儿童睡眠时间越长、TPA时间越长、MVPA时间越长可能心肺适能、运动适能越好,应增强学龄前ASD儿童睡眠时间和中高强度体力活动的有效时长。     

不同气质类型孤独症谱系障碍儿童的行为问题与其家庭环境的研究

目的:比较不同气质类型孤独症谱系障碍(autism spectrum disorders,ASD)儿童的行为问题及家庭环境差异,深入探讨ASD儿童气质类型及家庭环境对其行为问题的影响,为ASD儿童临床诊断和早期家庭干预提供新思路.方法:选取2018年12月-2019年11月在佳木斯大学附属第三医院住院及门诊明确诊断的3...     

广西柳州市机动车驾驶人酒后驾驶知识、态度、信念和行为调查

目的了解广西柳州市机动车驾驶人酒后驾驶的知识、态度、信念和行为（knowledge, attitude, belief and practice, KABP）。方法采用横断面调查,随机抽取的有代表性的路口,对被随机拦截的机动车驾驶人进行问卷调查。结果共调查5592名,有效问卷5569份,其中84.26%的驾驶人不了解国家有酒后驾驶的BAC值法律限制;2年内,仅有24.70%的驾驶人被警察拦截检查酒后驾驶行为,0.45%的人受到警告或处罚,15.68%的人认为若有酒后驾驶行为将有可能被警察发现;与被调查驾驶人有关系的社会成员中,仅有22.06%的人会劝告饮酒后的驾驶人不要驾车;有32.57%的人每周会饮酒1次以上。结论柳州市机动车驾驶人、社会公众对酒后驾驶相关法律、法规和执法以及对酒后驾驶引发的风险认知程度还很不足,必须采取广泛而有效的干预措施来降低酒后驾驶的发生率。     

Designing augmentative and alternative communication applications: the results of focus groups with speech-language pathologists and parents of children with autism spectrum disorder

Purpose: The purpose of this study was to gain insight from speech-language pathologists (SLPs) and parents of children with autism spectrum disorder (ASD) regarding appealing features of augmentative and alternative communication (AAC) applications.

Method: Two separate 1-hour focus groups were conducted with 8 SLPs and 5 parents of children with ASD to identify appealing design features of AAC Apps, their benefits and potential concerns. Participants were shown novel interface designs for communication mode, play mode and incentive systems. Participants responded to poll questions and provided benefits and drawbacks of the features as part of structured discussion.

Results: SLPs and parents identified a range of appealing features in communication mode (customization, animation and colour-coding) as well as in play mode (games and videos). SLPs preferred interfaces that supported motor planning and instruction while parents preferred those features such as character assistants that would appeal to their child. Overall SLPs and parents agreed on features for future AAC Apps.

Conclusion: SLPs and parents have valuable input in regards to future AAC app design informed by their experiences with children with ASD. Both groups are key stakeholders in the design process and should be included in future design and research endeavors.

• Implications for Rehabilitation

• AAC applications for the iPad are often designed based on previous devices without consideration of new features.

• Ensuring the design of new interfaces are appealing and beneficial for children with ASD can potentially further support their communication.

• This study demonstrates how key stakeholders in AAC including speech language pathologists and parents can provide information to support the development of future AAC interface designs.

• Key stakeholders may be an untapped resource in the development of future AAC interfaces for children with ASD.

     

Influence of physical activity on the health-related quality of life of young adults with and without autism spectrum disorder

Background: Health-related quality of life constructs has been used to understand the multiple dimensions (i.e., physical health, psychological, environment and social relationships) that affect a person’s health status. In order to improve health-related quality of life for young adults, it is important to understand the factors that influence each dimension. The purpose of this paper was to examine the influence of the presence of autism spectrum disorder and physical activity on the multiple domains of health-related quality of life for young adults.

Methods: Three-hundred and twenty participants, including young adults with ASD, completed a questionnaire about their physical activity and health-related quality of life.

Results: Five multiple regressions revealed that the presence of autism spectrum disorder significantly predicted overall health-related quality of life, the physical health domain, psychological domain, and the environment domain. Additionally, physical activity significantly predicted each domain and overall health-related quality of life regardless of the presence of autism spectrum disorder.

Conclusion: Practitioners should recognize the limitations that individuals with autism spectrum disorder may experience regarding their health-related quality of life, and utilize physical activity as a tool for improving health-related quality of life.

• Implications for Rehabilitation

• In order to address an individual’s overall health, practitioners must consider multiple dimensions of health-related quality of life.

• Autism spectrum disorders influence how people perceive multiple dimensions of their health.

• Physical activity is a tool for improving perceptions of the multiple dimensions of health for individuals with and without autism spectrum disorders.

     

Preparing for the future: a review of tools and strategies to support autonomous goal setting for children and youth with autism spectrum disorders

Purpose: Despite recognized benefits, current clinical practice rarely includes direct input from children and youth with autism spectrum disorder (ASD) in setting rehabilitation goals. This study reviews tools and evidence-based strategies to assist with autonomous goal settings for children and youth with ASD. Method: This study included two components: (1) A scoping review of existing tools and strategies to assist with autonomous goal setting in individuals with ASD and (2) a chart review of inter-disciplinary service plan goals for children and youth with ASD. Results: Eleven data sources, evaluating five different tools to assist with autonomous goal setting for children and youth with ASD, were found. Three themes emerged from the integration of the scoping review and chart review, which are discussed in the paper: (1) generalizability of findings, (2) adaptations to support participation and (3) practice implications. Conclusions: Children and youth with ASD can participate in setting rehabilitation goals, but few tools to support their participation have been evaluated, and those tools that do exist do not align well with current services foci. Visual aids appear to be one effective support, but further research on effective strategies for meaningful engagement in autonomous goal setting for children and youth with ASD is warranted.

• Implications for rehabilitation

• Persons with ASD are less self-determined than their peers.

• Input into one’s own rehabilitation goals and priorities is an important component of self-determination.

• Few tools exist to help engage children and youth with ASD in setting their own rehabilitation goals.

• An increased focus on identifying, developing and evaluating effective tools and strategies to facilitate engagement of children and youth with ASD in setting their own rehabilitation goals is warranted.

     

The clinical and biological role of CD20 membrane antigen modulation under immunotherapy with anti-CD20 monoclonal antibody rituximab in lymphoprolipherative neoplastic disorders

Immunotherapy using an antibody (rituximab) targeting CD20 antigen in combination with chemotherapy has been recently associated with significantly improved response rate and survival in patients with various types of CD20-positive B-cell lymphoproliferative disorders. This treatment may induce the disappearance of CD20 surface expression on neoplastic B-cells. Several mechanisms have been proposed to explain CD20 loss after rituximab therapy, while the clinical significance (if any) of this phenomenon is still not clear. We have produced a brief overview of the biological aspects of CD20 modulation after rituximab treatment and its possible clinical implications.