| 1. |
- Linnsand, Petra, et al.
(författare)
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A High Prevalence of Autism Spectrum Disorder in Preschool Children in an Immigrant, Multiethnic Population in Sweden: Challenges for Health Care
- 2021
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Ingår i: Journal of Autism and Developmental Disorders. - : Springer Science and Business Media LLC. - 0162-3257 .- 1573-3432. ; 51, s. 538-549
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Tidskriftsartikel (refereegranskat)abstract
- This study examines the prevalence of autism spectrum disorder (ASD) in preschool children in an immigrant population. Possible risk factors for ASD and individual needs for the children and their families are described, as well as implications for health care. The estimated minimum prevalence for ASD in the area was 3.66% for children aged 2-5 years. Multiple risk factors and extensive individual needs for the children and their families were observed. The high prevalence of ASD and the plethora of needs in immigrant communities pose challenges for health care. A coordinated health care system is necessary to meet the many and individual needs.
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| 2. |
- Linnsand, Petra, et al.
(författare)
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Intervention in autism based on Early Start Denver Model in a multiethnic immigrant setting—experiences of preschool staff involved in its implementation
- 2024
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Ingår i: Frontiers in Child and Adolescent Psychiatry. - 2813-4540. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Background: Early interventions for young children with autism have been shown to enhance developmental outcomes. However, opportunities for targeted interventions in autism, both in care and preschool, are often lacking, particularly in immigrant communities. The early start denver model (ESDM) stands as one of the most well-established intervention models, including improvement in core developmental domains and reduction of maladaptive behaviours, also delivered in preschool settings. An intervention program based on the ESDM was implemented in collaboration with parents, preschool staff, and health care professionals locally in a multiethnic immigrant and socioeconomically disadvantaged area in Gothenburg, Sweden. Purpose: The present study aimed to describe a low intensity intervention program based on the ESDM for young children with autism in a multiethnic immigrant setting and capture the experiences of the preschool staff involved in implementing the program. Method: Fifteen preschool professionals were interviewed through focus group interviews. Data were analyzed using content analysis. The interviews focused on capturing the crucial factors in the intervention program and to get more in-depth information about the intervention program's influence on the children with autism, their parents, the preschool staff, and preschool activities. Results: Central components of the intervention program were emphasized by the preschool staff. These encompassed contextual prerequisites, such as the preschool staff's participation in intervention program fostered by the local environment and features linked to the ESDM methodology. The preschool staff emphasized that shared objectives and regular network meetings as fundamental components of the model. They also underscored the seamless alignment between the ESDM and the preschool curriculum emphasizing how ESDM strategies could be easily integrated into the preschool's daily routines. The staff's experience indicated that the implementation of ESDM enriched the learning experiences of children with autism and yielded benefits to their parents, fellow peers in the preschool, and the preschool staff. Conclusions: The intervention program based on the ESDM presents a promising model for young children with autism in a multiethnic immigrant setting. Several critical factors based on the preschool staff's experiences were essential for implementation: contextual prerequisites such as organizational support, close collaboration with healthcare professionals, good competence among preschool staff, and the ESDM itself.
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| 3. |
- Linnsand, Petra
(författare)
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Young Children with Autism in a Multiethnic Immigrant Population. Prevalence, Feeding Disorders, Early Detection, and Intervention
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Autism is a neurodevelopmental condition characterized by a pattern of major impairments in social communication and behavioural/sensory problems, with high rates of coexisting neurodevelopmental and medical conditions. Over the past decade, there has been a documented rise in the registered prevalence of autism worldwide. Children born to immigrant parents may face an increased risk of autism. Several studies tend to suggest that they are often diagnosed with autism relativity late, potentially depriving them of important early interventions. Aims: The studies in this thesis were performed in a multiethnic immigrant area in Gothenburg, Sweden, and had the following primary objectives (1) examine autism prevalence and risk factors, (2) describe clinical characteristics of autism, including feeding problems, (3) explore psychometric properties of the instrument Joint Attention Observation Schedule Preschool (JA-OBS preschool) in children with suspected autism, and (4) describe an intervention program based on the Early Start Denver Model (ESDM) for young children with autism in a preschool setting and capture the experiences and perspectives of the preschool staff involved in the implementation of this program. Methods: Data were collected from a prospective longitudinal study of 46 preschool-aged children diagnosed with DSM-5 autism living in a multiethnic immigrant population area. Within this community, a local multidisciplinary team was established, focusing on diagnosis and treatment of early neurodevelopmental problems in children. All 46 children underwent thorough assessments and interventions from this team. Medical records from the Child Health Centre and comprehensive neuropsychiatric assessments were used. Data encompassed the period from pre- and perinatal stages up to the child’s sixth year of age. Semi-structured interviews were conducted with 15 preschool staff members working within the area. Results: The registered prevalence for autism in the area was 3.7%. Notably, a range of risk factors, including both genetic and non-genetic factors, were identified. A significant proportion of the children with autism experienced feeding problems (76.1%), with Avoidant/Restrictive Food Intake Disorder (ARFID) noted in 28.3% of cases. Early onset age and heterogeneity of feeding problems were highlighted. The internal consistency reliability of the JA-OBS Preschool was estimated at 0.8 (Cronbach’s alpha) and percent agreement across raters ranged from 76.9% to 100%. Central components of the intervention program, grounded in the ESDM framework, were emphasised by the preschool staff. These encompassed contextual prerequisites, such as the preschool staff’s participation in intervention program fostered by the local environment and features linked to the ESDM methodology. The preschool staff’s experiences indicated that the implementation of ESDM significantly enriched the learning experiences of children with autism, their parents, fellow peers within the preschool, as well as the staff members themselves. Conclusions: A high prevalence of autism among children within this immigrant population was found. Multiple associated factors for autism were documented, along with substantial individual needs of both the children and their families. This encompassed very high rates of early feeding problems and ARFID. The results underscore the imperative to develop multidisciplinary models in healthcare that increase accessibility to services for children with autism in immigrant communities. In that effort, the multidisciplinary team exemplifies how multi-faceted approaches can address immigrant families’ many needs and support health equity. Preschools may hold significant potential for the early identification of autism indicators. The intervention program based on the ESDM presents a promising model for young children with autism in the multiethnic immigrant setting.
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| 4. |
- Nilses, A., et al.
(författare)
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Experiences Of Immigrant Parents In Sweden Participating In A Community Assessment And Intervention Program For Preschool Children With Autism
- 2019
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Ingår i: Neuropsychiatric Disease and Treatment. ; 15, s. 3397-3410
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Tidskriftsartikel (refereegranskat)abstract
- Background: Barriers inherent in service systems for autism can hinder parents from getting help for their children, and this is probably especially true for immigrant parents. In order to provide accessible assessment and interventions for preschool children with autism, a multidisciplinary team was established in one district of a Swedish city, with a majority population of immigrants. Aim: The aim of the present study was to gain knowledge of the parents' experiences of participating in the community assessment and intervention program. Methods and procedures: A qualitative study with semi-structured interviews was conducted with parents of 11 children aged 3-5, who had been diagnosed with autism and participated in the community intervention program for at least 1 year. The interviews were recorded and transcribed verbatim, and data were analyzed following a phenomenological hermeneutical method. Results: The overall meaning of the parents' narratives was interpreted as "A new way of understanding my child made life more hopeful and more challenging than before". Their experience was interpreted as a process, captured in the three main themes: "An overwhelming diagnosis", "Cooperating with the team", and "Growing as a parent". Conclusion: As lacking knowledge of available resources and support seems to be an important barrier to access services, the results underscore the importance of providing individually tailored services including comprehensive societal support to immigrant families with young children suffering from autism. The study also highlights the importance of addressing the parents' previous awareness and knowledge of autism early in the assessment process, as well as continually involving parents in the intervention program, and this may enhance parental growth.
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| 5. |
- Nygren, Gudrun, 1957, et al.
(författare)
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Feeding Problems Including Avoidant Restrictive Food Intake Disorder in Young Children With Autism Spectrum Disorder in a Multiethnic Population
- 2021
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Ingår i: Frontiers in Pediatrics. - : Frontiers Media SA. - 2296-2360. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- We examined feeding problems, including Avoidant Restrictive Food Intake Disorder (ARFID), in preschool children with Autism Spectrum Disorder (ASD). Data were collected from a prospective longitudinal study of 46 children with ASD in a multiethnic, low resource area in Gothenburg, Sweden. Feeding problems were found in 76% of the children with ASD, and in 28%, the criteria for ARFID were met. The study highlights early onset age, the heterogeneity of feeding problems, and the need for multidisciplinary assessments in ASD as well as in feeding problems, and also the need for further elaboration of feeding disorder classifications in children. Copyright © 2021 Nygren, Linnsand, Hermansson, Dinkler, Johansson and Gillberg.
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