Children with an intellectual disability (ID) and/or autism spectrum disorder (ASD) are known to suffer from significantly more sleep problems, anxiety and challenging behaviour (CB) than typically developing children (TD), yet little is known about the relationship between these factors in the child ID/ASD population. The study aim was to examine these relationships. We hypothesised that there would be significant positive correlations between the three factors and that sleep problems and anxiety would predict a significant amount of the variance in levels of CB. Parental measures of sleep problems, anxiety and CB were completed by 187 parents of children with ID and/or ASD. Significant positive associations were found between the three factors. A hierarchical multiple regression showed that medication, sleep problems and anxiety accounted for 42% of the variance in CB, with a large effect size. These findings suggest that these relationships should be considered during clinical practice, particularly in the case of CB interventions where sleep problems and/or anxiety are also present.
Background: It is proposed that the classification of paediatric bowel elimination disorders is central to their effective treatment.
Method: By separating the terms soiling and encopresis and clearly defining the aetiologies behind both, a treatment pathway begins to emerge.
Results: The theoretical model described suggests that encopresis may require only psychological management, whereas soiling (caused by constipation) is more complex, and although it needs medical management, it may or may not require psychological input.
Conclusions: By using such a functional classification to define a treatment protocol, the roles of both medical and psychological services could be more clearly understood from the outset.
For many years in the field of autism, the actions, skills and responses of autistic people were often described as abnormal, maladjusted or deficient. The goal of many interventions was, and still is, to teach autistic children and adults to behave like their non-autistic peers as evidenced in approaches designed to teach (neurotypical) social skills, (neurotypical) communication and in programmes designed to modify behaviour to make autistics appear neurotypical. This approach – which sees autistic behaviour as aberrant and without purpose and thus aims to remove this behaviour – is described as normalisation. We challenge this view from a neurodiversity-affirmative perspective, querying the assumed lack of purpose in autistic behaviour as well as examining the impact on autistics of the deliberate removal of autistic behaviour. However, there are other perspectives on autism and no definitive understanding of autism. Our view is not one held by all autistic people let alone everyone else. We call this the autism worldview dilemma and make recommendations for UK autism legislation to ensure that parents and carers understand when an intervention is aimed at normalising their young person.
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