The participants in this thesis were school-aged children with ASD and autistic fea-tures, 6 of whom appear in the original articles. The participants were chosen using convenience sampling. The EvTech project was advertised to families who were taking part in various therapeutic or occupational services provided by a therapy foundation in Eastern Finland, and their participation in the project was voluntary. The CASCATE project took place at two schools in Eastern Finland that provide education for children with special needs. The headmasters of the schools approved the project and, together with the teachers, special needs assistants, and parents, chose the children that they felt would benefit from participating. This meant that the children were a
heterogene-ous group in which not all had a ‘pure’ diagnosis of ASD. Some of them had a variety of diagnoses combined with ‘features of ASD’, and could thus be described as ‘autism plus’ (Gillberg & Fernell, 2014). The teachers and special needs assistants, however, considered them as having ASD, which is an important notion as some of the original articles explicitly focus on how they interact with the children.
Participants also included adults as co-participants. The children were interacting with their parents and club tutors (original article I) or teachers, special needs assis-tants, and researchers (original articles II-IV). Teachers and special needs assistants are referred to as educators. All the participants were native Finnish speakers, except for a parent of a child with ASD in original article I. However, this original article did not examine interactions between the child and his co-participants in the same level of detail as original articles II-IV.
The original articles included varying numbers of children with ASD or autistic features as participants: original article I had one participant (Veeti, referred to as
‘child’ in the original article), original article III had two participants (Antti and Otto), and original articles II (Antti, Veli, and Matti) and IV (Veli, Matti, and Roope) had three participants each. All the names are pseudonyms. The number of children in each original article was narrowed down in order to conduct more in-depth analyses that would better consider the individuality of the children. Crucially, this also afforded the scope to analyse the children’s conduct in context, making it possible to re-examine behaviours that the biomedical paradigm has often taken as being symptomatic of the children’s underlying pathology.
The participating children were chosen so that they would represent the diversity of the autism spectrum, including different ages. One specific aim was to include minimally verbal children as participants. All the participating children were boys, reflecting the imbalanced gender ratio of 4:1 in ASD (Presmanes Hill, Zuckerman, &
Fombonne, 2016; Werling & Geschwind, 2013). In original articles I-III, the participat-ing children were chosen primarily due to their limited verbal communication and reported attentional difficulties. On the other hand, original article IV focused on children who seemed particularly interested in the Kinect game-playing activity dur-ing which the data collection took place. This original article involved eye trackdur-ing and as these children were comfortable with using the eye tracking glasses for longer periods of time than some of the other children, their playing activities were chosen for more detailed analysis.
The children had been assessed earlier for diagnostic and educational purposes, which is a common practice in Finland to secure necessary support and services (e.g.
school placement, interventions, and rehabilitation). These clinical documents were available for my research, and Table 2 presents participant descriptions based on these documents. It is important to note that the documents have been produced to guide decisions around treatment and support by healthcare and education profes-sionals, and thus tend to focus on difficulties and challenges instead of the children’s competencies. It represents a common practice in the field of (biomedical) ASD re-search and such documents can provide background information on the participants using psychometric tests. As this research began with the categorisation approach inherent to the biomedical paradigm, additional psychometric tests were deemed crucial. This allowed for the production of participant descriptions similar to those in other ASD studies and, thus, provided the possibility of comparing the participants between the studies. While an extensive assessment procedure was seen as unneces-sarily distressing for the children, a few selected tests were conducted; namely the
‘Comprehension of Instructions’ test to evaluate the understanding of oral instructions (NEPSY-II) and the ‘Spatial Span’ test to evaluate visual working memory (Wechsler Memory Scale, WMS-III). Also, the Sally-Anne false-belief task was administered to evaluate the children’s theory of mind skills (Baron-Cohen et al., 1985). Furthermore, the teachers completed the Autism Spectrum Screening Questionnaire (ASSQ), while the children’s parents completed the Social Communication Questionnaire (SCQ) and the Strengths and Difficulties Questionnaire (SDQ). Table 3 presents the information from the children’s test performances.
The findings of this thesis will, however, challenge any taken-for-granted reading of these test performances and enable their critical examination in the light of inter-actional research (in sections 7 and 7.3).
table 2: information on children based on their clinical reports
Note. PT=physiotherapy, MT=music therapy, ST=speech therapy, PRT=pivotal response training, OT=occupational therapy
1 13 years, 2 months in original article III; 14 years, 9 months in original article II
2 In original articles II and III, Antti’s diagnosis is described as ‘severe intellectual disability (F79.1)’ due to a misunderstanding from his clinical reports
roope otto veeti veli matti antti Rehabilitation Pt, mt, st mt, PRt, ot,
st mt, ot, PRt st, ot ot, Pt, mt, st Pt, mt, ot,
Table 3: Children scores on NEPSY-II, WMS-III, Sally-Anne task, SCQ, and SDQ, respec-tively
measurement roope otto veeti veli matti antti
nePsY-ii (‘comprehension of
instruc-tions’)a
1 1 1 1 0 0
Wms-iii (‘spatial span’)b 0 0 0 10 4 0
Sally-Anne task Did not
pass Did not
pass Did not
pass Passed Passed Did not
pass ASSQ (teacher ratings
used)c 21 23 36 38 24 41
SCQ (lifetime version, parent
ratings used)d 8 21 15e No
informati-on available 21 24
subcategories
social interaction 1 7f 6 - 7 6
communication 3 9 3 - 5 10
stereotypical behaviour 4 4 6 - 8 7
other 0 1 0 - 1 1
SDQ (parent ratings used)g 12 24 18h 20 27 20
a Raw points out of 20
b Raw points out of 32
c Cut-off score: 22
d Cut-off score: 15
e 6 questions left unanswered
f 1 question left unanswered
g Cut-off score for ‘abnormal’: 16
h 1 question left unanswered