Speakers at the Meeting of Minds conference on November 29 and 30 in Copenhagen.
The hidden face of autism: Understanding the characteristics and needs of girls and women on the autism spectrum
Will Mandy, DClinPsy PhD
UCL, Department of Clinical Psychology
Autism is more commonly diagnosed in males than in females: the male-to-female ratio is three-to-one in epidemiological samples and as high as ten-to-one in clinical practice. This likely reflects an underestimation of the true prevalence of ASD in girls and women, arising from systematic biases in diagnostic criteria and clinical services. As a result, autistic females are less likely to receive an accurate and timely diagnosis, which reduces their chances of benefiting from appropriately targeted health care and educational resources.
This talk will consider the reasons for, and costs of, the under-recognition of autistic females. This will include the proposal that there is a female autism phenotype that is not well captured by current diagnostic practice. Clinical and research implications will be considered.
Why are co-occurring mental disorders so common in autism and does it matter?
Emily Simonoff, MD, FRCPsych
Professor of Child and Adolescent Psychiatry
The aim of this talk is to explore the causes for high rates of co-occurring mental health disorders and problems in people with autism and to delineate their consequences. The talk will highlight that there are likely varying reasons with different underpinning mechanisms for increased rates, and these differing mechanisms are linked to the types of co-occurring conditions. Autism is a condition in which quality of life, community participation, adaptive function and wellbeing are frequently compromised. The extent to which this is due to core features of autism, associated mental health problems and/or other co-occurring impairments will be discussed.
'Knowing me- knowing me'
The Synergy programme,
Laskaridis Foundation, Piraeus, Greece and AT-Autism, London.
'Behaviours of concern': Changing mindsets, changing narratives, changing outcomes. Does it help to switch our focus from child to teacher?
The presentation will discuss the outline of the approach which is underpinned by psychological, physiological and sociological theory allied to a mindful approach rooted in the Socratic tradition of ancient Greece. Launched in Greece in 2014, we will present findings to date of the impact on Greek schools.
The emphasis of programme is on teacher self-awareness and on building and sustaining best practice and local capacity through a system of mentors.
“You don’t look Autistic”: an autistic adult’s response
Ms Helen J. Ellis
Autistic advocate and consultant
Employee of NAS and member of Westminster Autism Commission
A look at how autistic people hide their natural reactions during everyday life and the impact this has on the individual and their support networks.
From diagnosis to functioning and quality of life – the use of the ICF core sets for autism
Professor of Child & Adolescent Psychiatric Science, PhD.
Head of Neuropsychiatry Division, Director of the Center for Neurodevelopmental Disorders at Karolinska Institutet (KIND)
Dept. of Women's & Children's Health, Karolinska Institutet.
In the past, autism has mostly been looked at from a perspective of symptomatology, while aspects of functioning and quality of life are equally needed to understand the phenomenon and to get a balanced view of well-being and strengths and weakness in each individual. The International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO) provides a comprehensive and universally accepted framework to describe health-related functioning.
To report the results of the ICF core set consensus conference for Autism Spectrum Disorder (ASD). Preparatory studies had yielded 168 ICF candidate categories for ASD. This evidence was used as a starting point to generate a Comprehensive, a Common Brief, and three age-specific WHO ICF ASD core sets. Twenty ASD experts, representing all six WHO-regions and various disciplines, were invited to participate in the 3-day consensus conference. The experts followed a three-stage decision-making and consensus process to decide on the ICF categories that should be included in the ICF Core Sets for ASD. Finally, 111 categories were included in the Comprehensive ICF Core Set, and 46 categories in the common brief set. When defining the ICF core sets for ASD, a large number of categories were selected across all of the ICF components, supporting the notion that ASD impacts wide ranges of functions and contextual factors in life. From these core sets, assessment tools will be derived for future usage in clinical and research setting as well as health care administration.
Mind the gap: increasing global representation in autism research
Dr. Rosa Hoekstra
Senior Lecturer in Psychology
Department of Psychology
Institute of Psychiatry, Psychology and Neuroscience (IoPPN)
King's College London
Most autism research is conducted in high income western countries, and within these countries ethnic minority and low socioeconomic status groups tend to be underrepresented in autism research. This lack of global representation means our current knowledge and understanding of autism is incomplete and possibly biased. The gap also leads to a growing inequity in services across the globe. Most interventions are developed in high income settings and use specialist facilitators and high intensity intervention models, making these programmes unsuitable for sustainable implementation in low resource contexts. In recent years the research gap is increasingly acknowledged, resulting in a steady increase in autism studies worldwide.
This talk will draw on previous global autism research as well as a wider literature to map out how culture and context may affect the expression, recognition, interpretation and reporting of autism symptoms. Moreover, current initiatives to test interventions suitable for low resource contexts will be discussed. Through concrete examples it will be demonstrated why collaboration with local stakeholders and researchers is crucial if we want to increase global representation in autism research and make a long-term difference in the lives of autistic people worldwide.
Aging and being autistic: Lessons (not) learned
Prof Dr. Hilde M. Geurts
University of Amsterdam, Department of Psychology
In this short presentation an overview will be given regarding what we do (not) know regarding the role of aging in autistic adults. There will be a specific focus on (mental) health issues and information processing. Apparently contrasting findings will be addressed as well as why should be careful in (over) interpreting what is known so far.
Sex differences in boys and girls with ASD: Diagnostic criteria, stress, anxiety and depression
Christopher F. Sharpley
Brain-Behaviour Research Group,
University of New England, Armidale, New South Wales, Australia
Due to the relatively lower prevalence of diagnosed ASD in girls compared to boys, there has been some discussion regarding the applicability of the diagnostic criteria for ASD to girls, with some suggestions that girls exhibit those criteria differently to boys. However, only limited direct evidence of those suggested differences has emerged to date, leaving this issue open to debate.
This presentation reports on the comparative data for (a) ASD diagnostic criteria based upon the ADOS-2, (b) standardised test results for those criteria, (c) a physiological measure of overall stress, and standardised indices of (d) anxiety and (e) depression across an age- and IQ-matched sample of 51 boys and 51 girls who had received a diagnosis of ASD. Results will be described in terms of absolute values observed on these measures, plus the clinical implications they represent. Discussion will focus upon the contribution that these data make to the issue of “What is ASD”.
Cluster Analysis of Autism Spectrum Disorder Symptomatology: Qualitatively Distinct Subtypes or Quantitative Degrees of Severity of a Single Disorder?
Centre for Autism Spectrum Disorder, Bond University, Gold Coast, Queensland, Australia
The decision to collapse several related disorders into a single diagnosis of Autism Spectrum Disorder (ASD) generated significant controversy and debate. There has been mixed evidence as to whether various ASD subtypes are qualitatively distinct or if they exist on a spectrum of symptom severity.
The present study conducted a two-step cluster analysis of major ASD symptoms in a sample of 147 young males with ASD aged between 6yr and 18yr with IQ > 70. Results indicated that that a two-cluster solution (high and low severity of ASD symptomatology) was reliable and valid. Further, the construct of challenging behaviour was not a necessary component of the two-cluster solution, verifying the new conceptualisation of ASD. Further replication of these findings with other subsets of individuals with ASD is needed.