Multisensory environments (MSEs) are rooms designed to provide a range of sensory stimulation through light, sound, aromas, and tactile experiences, which are delivered by electrical and other devices. They were originally developed as a leisure option for people with severe disabilities but are now promoted as having beneficial effects, such as reducing challenging behavior and increasing engagement. This chapter provides a systematic review of studies reporting the use of MSEs with people with autism spectrum disorder (ASD), although most of the research was with individuals who also had intellectual disability. Studies were generally of poor quality and measured a wide range of variables. There is little evidence that MSEs would be of benefit as an intervention option for people with ASD. Research is needed that is more carefully designed, uses clearly defined outcome measures, and compares the effects of MSEs with established interventions.

Multi-sensory rooms were originally intended as a leisure option for people with severe disabilities living in institutions. Their use has extended far beyond this and proponents, particularly equipment suppliers, continue to claim a range of benefits beyond provision of a leisure experience. We review the literature on the effects of MSEs on people with developmental disabilities other than autism spectrum disorders. The research examined was predominately of very poor quality, limiting conclusions that can be drawn. MSEs were used in a variety of ways with the wide range of outcomes measured addressing reduction of challenging behaviours and promoting more desirable behaviours. The majority of reported results were mixed or negative, with better quality studies more likely to report no effects. Overall, based on the available evidence, the use of MSEs cannot be recommended as an intervention option for individuals with developmental disabilities, but they may have a limited role as a leisure option.

Many former university students on the autism spectrum have poor employment outcomes despite strengths, qualifications, and ability. This article presents findings from a qualitative study of 11 former university students on the spectrum (self-identified: 2 males, 7 females, 2 non-binary, 18-50+ years), and five significant others (2 mothers, 3 spouses), from Australia and New Zealand. We identified issues associated with better and poorer transition to employment experiences (poor mental health, lack of support, poor interview skills). The former students also indicated a belief that it was not the role of a university education to prepare students for employment. This belief may have influenced their discipline choices and attitude towards using career supports and university employability components. The participants who studied non-vocationally specific qualifications described more difficulty with conceptualising their transition to employment, developing an employment goal, and finding work. It was suggested that universities may need to provide comprehensive transition to employment programs that develop the 'soft skills' required for employment and offer work placements for both vocationally and non-vocationally oriented courses to help students build skills that increase their employability.

The aim of this pilot study was to explore the feasibility and language outcomes of coaching parents to implement an aided language stimulation intervention using Pragmatic Organisation Dynamic Display (PODD) communication books. Two parent-child dyads, with children aged 4 years 6 months and 4 years 8 months participated in a home-based intervention. An AB design was used. Data were collected in mealtime and play activities. Dependent variables were frequency of parent use of AAC symbols and speech and frequency of child symbol use (speech, signs or graphic symbols). The intervention was feasible as parents reported they were confident in implementing it and the timeframes were appropriate for single-case research designs. An increase in parent AAC symbol use was associated with PODD book use in mealtime and for one parent in play. Both children increased their symbol use, with the clearest association in the mealtime activity. Overall, the encouraging results suggest that this approach warrants further research using stronger designs.

A synthesis and analysis of findings from a large-scale systematic review of adjustments provided to children with special educational needs in general education classrooms is presented in this chapter. Alignment of existing practices to inclusive frameworks is considered. In addition, the role of implementation science in promoting change is addressed. Implications for school leaders, policy-makers and educational authorities, teachers, and researchers are considered in relation to the findings from the systematic review. Key messages for each of these groups are clearly highlighted.

Background The majority of children referred to Child and Adolescent Mental Health Services (CAMHS) in the UK will present with mixed emotional and behavioural difficulties, but most mental health treatments are developed for single disorders. There is a need for research on treatments that are helpful for these mixed difficulties, especially for school-age children. Emotion Regulation (ER) difficulties present across a wide range of mental health disorders and mentalizing may help with regulation. The ability to mentalize one's own experiences and those of others plays a key role in coping with stress, regulation of emotions, and the formation of stable relationships. Mentalization Based Therapy (MBT) is a well-evidenced therapy that aims to promote mentalization, which in turn increases ER capacities, leading to decreased emotional and behavioural difficulties. The aim of this study is to test the clinical- and cost-effectiveness of MBT compared to treatment as usual for school age children with emotional and behavioural difficulties. If effective, we hope this approach can become available to the growing number of children presenting to mental health services with a mix of emotional and behavioural difficulties. Materials and methods Children referred to CAMHS aged 6-12 with mixed mental health problems (emotional and behavioural) as primary problem can take part with their parent/carers. Children will be randomly allocated to receive either MBT or treatment as usual (TAU) within the CAMHS clinic they have been referred to. MBT will be 6-8 sessions offered fortnightly and can flexibly include different family members. TAU is likely to include CBT, parenting groups, and/or children's social skills groups. Parent/carers and children will be asked to complete outcome assessments (questionnaires and tasks) online at the start of treatment, mid treatment (8 weeks), end of treatment (16 weeks) and at follow up (40 weeks). Trial registration Clinical trial registration: ISRCTN 11620914.

This chapter provides the results from a large-scale systematic review of adjustments provided to children with special educational needs in general education classrooms. Initially, demographic characteristics of the research will be examined, including geographic region, types of school examined, diagnostic features and characteristics of participants contributing data. This is followed by a consideration of methodology and research quality. Subsequently, the nature of adjustments will be examined across the areas of assessment; instruction; curriculum; classroom environment; organisation and management; human resource use; and technology. Key findings in these areas will be contextualized and discussed. Finally, an analysis of the key themes identified across the research will be offered and some limitations of the review acknowledged.

People with autism spectrum disorder (ASD) may have difficulties with pragmatic behaviors in conversation such as staying on topic, taking the perspective of others, and repairing misunderstandings. Many social skill interventions teach conversation skills to assist the development of friendships and avoid social isolation, but few studies have examined whether conversation partners find the reported pragmatic behaviors problematic. We examined the effect of relationship type, regularity of contact, and age of the person with ASD on conversation partner perceptions. For problem scores, multiple regressions indicated an effect for relationship type such that friends tended to report lower problem scores than siblings/other relatives, parents, or life partners. Difficulties understanding humor was reported to be more problematic by friends, whereas for life partners it was the failure to keep conversations going and inappropriate terminations. Further research is needed to confirm and extend these results to better inform interventions into social communication.

There are various models for supporting students with disability and their teachers in mainstream schools. In New South Wales, each school has a learning and support teacher allocation and the New South Wales Department of Education recommends each school have a learning support team. This paper draws on in-depth interviews with school staff from 22 schools, including 16 learning and support teachers, 20 class teachers, 25 school executives and other stakeholders. We report here on the role of learning and support teachers and learning support teams in planning, implementing and evaluating adjustments and on the operation of learning support teams. Qualitative analysis of the interview transcripts revealed two kinds of learning support teams: those that focus on a particular student and those that oversee the education and resource provision for all students with disability in a school. Some teams had more of a focus on administration and resourcing, while others dealt more with educational adjustments. Similarly, some learning and support teachers were more involved in administrative and liaison roles, while others were more active in supporting teachers and providing services directly to students. The most detailed descriptions of support were provided by learning and support teachers with special education qualifications.

The current study was conducted to examine the types of adjustments used to support students with special educational needs in mainstream classrooms and how schools monitored the effectiveness of the adjustments they use. A range of stakeholders were interviewed in 22 mainstream schools across New South Wales, Australia, and the interviews were analysed for key themes. Some schools had a narrow focus on a few key areas, with teaching assistants being the most commonly reported adjustment. Few schools used formal formative monitoring to evaluate the effectiveness of adjustments. Options for improvement schools could consider include examining the breadth of adjustments, establishing clear measurable goals, considering alternative strategies for use of teaching assistants, and ensuring adjustments are monitored.

Engagement has been identified as an important predictor of student outcomes; therefore, teachers' ability to accurately and objectively measure student engagement is essential and can assist teachers to make instructional decisions based on data rather than perception. The efficacy of training preservice teachers to observe engagement, using a previously validated observational tool that was digitised for this research, was investigated. Twenty-eight preservice teachers (PSTs) completed workshops on the use of this digitised momentary time sampling measure of child engagement as part of their teacher education program. Video clips of children in a range of activities were used to provide practice in using the measure. The correlation between PST estimation of engaged time and PST momentary time sampling data was near zero, indicating their informal estimates were inconsistent with their systematic observations. When using the engagement measure, PSTs demonstrated a mean agreement of 91.9% with reference coding for child engaged and nonengaged behaviour. PSTs rated the workshops and the utility of the measure highly. More importantly, findings indicate that the workshops were successful in training PSTs to use the engagement measure accurately, a necessary skill for data-informed practice in special and general education.

Autistic children, adolescents and their younger siblings are less likely to be fully vaccinated compared to their peers in the general population. A focus on the influence of the unfounded link between the measles, mumps and rubella (MMR) vaccine and autism has distracted from consideration of unique family experiences and autistic-child related factors, such as emotional and behavioural differences, that may influence caregivers’ vaccination decisions. Without an understanding of the unique challenges and experiences of families with autistic children along the vaccination journey, the scope for appropriate, targeted interventions to support them is limited. To address this gap, in this qualitative research study we explored factors that impact the vaccination journey for autistic children and their families in an Australian context. Participants included 16 caregivers (15 mothers; 1 father) of 25 children who had a diagnosis of autism. Seven families had multiple autistic children. Participants shared their perceptions, experiences, and anticipation related to childhood vaccinations and vaccinating their autistic child and their siblings. Conducting thematic analysis, we identified four themes, comprising eight subthemes. The primary themes were 1) caregiver upskilling and self-assurance, 2) acknowledging unique differences amongst autistic children, 3) trouble behind and trouble ahead, and 4) managing sensory overload. Through these themes, we describe the unique needs of autistic children and their families with regard to emotional and sensory aspects of the vaccination visit across settings. We conclude by making recommendations for adaptation of vaccination services to incorporate the autistic perspective and lived experiences of families of autistic children.

AbstractParents whose autistic1 child’s needs are not met within mainstream schooling may seek alternative modes of education, such as home or distance education. There is a paucity of research on the delivery of home or distance education programs for autistic students. This study reports on the experiences of parents, students and teachers in the inaugural year of Australia’s first hybrid distance education program (distance education with parent/carers as supervisors) specifically designed for autistic students. Interviews with eight parents, four students and two teachers gathered their perceptions of the program’s benefits, challenges and suggestions for improvements. All parents, students and teachers reported positive overall perceptions of and experiences in the program, and a range of outcomes for students and parents. Flexibility was identified as a key benefit of the program. Challenges identified included a lack of opportunities for students’ social interactions and the effort required of parents to support their child’s participation. Additional longitudinal research is needed to determine the long-term impact of programs of this type and to evaluate strategies for increasing student independence.

Self-determination skills, including competencies such as decision-making, are regarded by parents and teachers as important for students with special needs. Although not necessarily regarded as appropriate, teaching assistants often take substantial responsibility for delivering educational programs to students and little is known about their perspectives on self-determination. Perspectives of teaching assistants may impact on their support of programs to enhance self-determination that are developed by teachers. Teaching assistants in New South Wales mainstream schools (N = 320) were surveyed regarding their views on the importance and frequency of instruction of seven competencies related to self-determination of students with special needs. Consistent with previous research, assistants rated all the competencies highly in terms of importance, but frequency of implementation was more variable. Moderate correlations were found between ratings of importance and frequency of implementation, suggesting that greater instructional time was devoted to competencies viewed as more important. Limited differences were found between assistants working at primary and secondary levels. Although features of the interactions of teaching assistants that can inhibit self-determination have been often identified in previous research, it is argued that, paradoxically, assistants may be well positioned to facilitate the development of self-determination with appropriate training and supervision. Directions for future research are identified.

The aim of the current study was to examine how decisions are made and who is involved in decision-making regarding provision of adjustments for students with special educational needs in Australian mainstream schools. A total of 107 stakeholders were interviewed across 22 schools. Participation in decision-making varied, with students the least likely to be involved. There was variation in the degree and nature of collaboration and the degree to which decisions were subject to review. The focus of decision-making processes also varied, with some schools focusing on funding and resource allocation and others on broader support considerations. Schools used a range of formal and informal levels of decision-making but the degree to which they agreed on factors that underpinned decisions (values, legal considerations, etc.) was variable and sometimes limited. Possible explanations for the observed patterns of decision-making are offered, practical implications considered and directions for future research outlined.

A multiple probe across participants design was used to examine the effects of intervention on reality-based fictional narratives. Four boys with autism spectrum disorder (ASD) and language disorder, aged 9–10, participated in a 1:1 intervention targeting the narrative macrostructure elements of character, setting, problem, feelings, and fix. Intervention involved clinician modelling, participants saying the entire narrative, narrative stimulus pictures, and macrostructure icons. An intervention effect, maintenance, and generalization to fantasy-based fictional narratives were demonstrated for three participants. Social validity measures indicated that a naive observer-rated post-intervention narratives as better than pre-intervention narratives. This study adds to the limited research into narrative intervention with children with ASD and co-occurring language disorder. The highly structured and semi-scripted intervention could be adapted to be delivered by teachers in small groups in the classroom. Areas for future research include implementing the intervention with small groups and targeting more complex narrative macrostructure.