Editorial

Welcome to the second edition of 2017. This issue features papers from clinical policy and parent’s perspectives.

The first paper from Marshall-Tate and colleagues examines the government response to Winterbourne View – a scandal affecting care and treatment of adults with intellectual disabilities (ID) and/or autism in the UK. So far the general view of the response to Transforming Care (TC) has predominantly focussed on people with ID or had little regard for the heterogeneity of the needs of those with autism. This paper highlights a need for TC and policies in general to make a clear distinction of the needs of individuals and specific groups when considering implementation. Although figures would suggest that in-patient provision is decreasing in line with the objective of TC, significant numbers of people are remaining in assessment and treatment units inappropriately. The reverse of this that in some areas there has been a devastating effect on local service provision. This has been characterised by a loss of hospital services catering for those requiring in-patient care for poor mental health. As a result, a wealth of clinical knowledge and skills has been lost. However, the decrease in in-patient beds has not extended to autism who appear to have been overlooked as do those people who often find themselves readmitted or moved to services not designed to meet their needs.

The second paper from Spain and colleagues reports on a pilot of a cognitive behaviour therapy (CBT) group intervention designed to improve self-esteem in adults with autism. People with autism have high rates of psychiatric co-morbidity and a number of psychological and social considerations make them vulnerable to experiencing poor self-esteem. In general, psychiatric practice CBT has been proved to benefit those with low self-esteem (LSE). However, there is not only little evidence of its effectiveness in adults with autism, it may often not be considered to be significant clinically. The paper describes the intervention and adaptations to standard protocols sensitive to a range of socio-communication deficits and neurocognitive impairments. Although, a small study, the paper offers a valuable insight into the intervention and direction of future research and is one of the first CBT group interventions designed to address LSE in adults with ASD to be reported.

The following paper from Sharma and colleagues is an investigation into the face processing responses of children with autism using skin conductance response (SCR). The paper reports on the use of two experiments relating to typically developed chidren vs children with autism. The first, learned non-face (objects) vs unknown face stimuli and familiar vs unfamiliar face. The paper compares the responses of children with autism to typically developed children. In the first experiment children with autism could differentiate faces out of learned non-face stimuli and their SCR patterns were similar to controls. However, in the second experiment SCR patterns suggest children with autism were unable to recognise familiar faces like the controls.

The next two papers come from the viewpoint of parents. The first of these is from Cremin and colleagues, and offers an insight into parental perceptions on the transition to secondary school in Ireland. Although from an Irish perspective issues identified in the paper will be recognised by people across a number of countries as students and parents experience challenges and obstacles beyond those experienced by parents of children who do not have autism, so that this anxiety may be alleviated. The paper shares a number of strategies, devised by parents, who often find secondary schools to lack awareness and knowledge of autism and the impact that this has to the person and their family. As a result, schools can be poor communicators and fail to address needs of individuals.

The final paper in this edition from Carol Potter reports on the management of sleep problems in children with autism and explores the role of fathers and the impact of these difficulties on family life. The paper reports on the results of semi-structured interviews with 25 fathers. In total, around two-thirds of fathers reported that their children experienced severe sleeping problems in the areas of bed-time resistance, sleep onset and night-time waking. Although this is a small study and not representative of all fathers it reports on what is a familiar experience for many and the resulting negative effects on paternal and maternal health, father employment and family relationships. This is an issue that families have difficulty in getting support for, with the authors putting the issue forward as a significant public health concern.

I hope you enjoy this edition of the journal and wish to thank you for your continuing support of Advances in Autism. We invite contributions from our readers to the journal and welcome a variety of papers on areas including innovative and evidence-based practice, research, case studies, service and policy-related issues and literature reviews. We welcome submissions from the range of health and social care professionals, but additionally those who use services and people who care for them. If you would like to know more about how to submit your work for publication, please contact Eddie Chaplin at the London South Bank University (mail to: chapline@lsbu.ac.uk).