The growing number of children diagnosed with autism and the demand for evidence-based interventions has lead to an increase in the need for well-trained behavior analysts.  There are only a small handful of programs that are accredited by ABAI and have course sequences approved by the BACB.  Even fewer of these programs have formal institutional course approval for classes in autism.  The purpose of this paper is to describe a training summit that was held in September of 2009.  The purpose of the summit was to consider and discuss a wide range of issues involved in higher education and autism intervention and to produce a special volume of the European Journal of Behavior Analysis that would explore these issues.

Previous research notes difficulties in functioning and low quality of life (QoL) among transition-age youth on the autism spectrum, and poor mental health may contribute to these difficulties. This study examined the role of autism symptom severity and mental health problems on self-reported functioning and QoL in treatment-seeking transition-age autistic youth. The study included 140 autistic youth (16–25 years, M = 20.44 (SD = 2.95); n = 91 females [65%], n = 42 males [30%], n = 7 non-binary [5%]). We assessed functioning using a structured interview and QoL through a self-report questionnaire. Factors potentially associated with functioning and QoL were assessed using standardized self-report questionnaires of autism symptom severity, symptoms of anxiety and depression, and information from medical records. Participants reported functioning on the 90th percentile compared to general population norms, indicating significant disability, and also rated low overall QoL. Regression analysis showed that autism symptom severity and anxiety symptoms, and to some extent gender and having an ADHD diagnosis, explained 46% of the variance in overall functioning. Symptoms of anxiety and depression, and to a lesser extent, active friendship, explained 43% of the variance in QoL. Sampling limitations of the study include the overrepresentation of women and newly diagnosed participants. We highlight that functioning and QoL are multifactorial, necessitating a comprehensive assessment of transition-aged autistic youth, including mental health problems, to plan tangible interventions.

In Sweden, young autistic children typically attend community-based preschool programs, which may not be adapted to their needs. In the current study, stakeholders to autistic children receiving Early Intensive Behavioral Intervention were interviewed following a quasi-randomized study (#NCT03634761) aimed at improving the preschool program quality using the Swedish version of the Autism Program Environment Rating Scale (APERS). Stakeholders provided their perceptions and experiences concerning key factors for high quality preschool programs as well as well as their experiences of the abovementioned APERS study. Applying thematic analysis, stakeholder groups differed in what they emphasized, but all highlighted staff’s competence, children’s inclusion and participation, collaboration, and the learning environment as key program areas that had been positively influenced by the APERS-based intervention.

A prerequisite for effective implementation of early intensive behavioral interventions is a high quality learning environment. However, research to date suggests that the learning environment in community based Swedish preschools is not optimal for children with ASD. A brief overview of the Swedish early intervention support system will be followed by a description of the cultural adaption of the Autism Program Environment Rating Scale (APERS-PE). Furthermore, an ongoing comparative study involving 17 preschools will be described. All participating preschools have children enrolled in EIBI preschool programs, entailing that paraprofessionals and parents obtain supervision at habilitation centers. In addition preschool staff in the study’s experimental group receive monthly on-site coaching, and in-service training on evidence based practices and autism. Outcome measures include pre-post APERS-PE assessments, child engagement and adaptive behavior, and staff knowledge and self-efficacy. Preliminary findings indicate increased learning environment quality in the study’s experimental group as rated by APERS-PE.

BACKGROUND Children on the autism spectrum may receive Early Intensive Behavioural Intervention (EIBI) in Sweden to support development by providing learning opportunities. However, research suggests a need to improve the quality of their learning environment.

AIM This pre-registered study (#NCT03634761) aimed to evaluate the Swedish Autism Program Environment Rating Scale (APERS-P-SE) as a means to promote the quality of the pre-school learning environment for children on the autism spectrum, along with outcomes for these children, and their pre-school staff.

MATERIAL AND METHODS In a quasi-experimental study, pre-school staff (n = 35) conducted either EIBI supported by in-service training and on-site coaching based on APERS-P-SE assessment (at k = 9 preschools) or EIBI only (k = 8), during an 8-months period.

RESULTS The quality of the immediate learning environment (primary outcome) increased significantly in the EIBI/APERS-P-SE preschools. However, changes in child and pre-school staff measures were not significant.

CONCLUSIONS AND SIGNIFICANCE In-service training and on-site coaching based on APERS-P-SE assessments can increase the quality of the learning environment in Swedish pre-school. Studies of longer duration and larger sample size are required to determine if using the APERS-P-SE can also achieve desired behavioural change for children-, and impact pre-school staff applying EIBI.

Increasing rates of autism spectrum disorder (ASD) and younger age at diagnosis pose a challenge to preschool intervention systems. In Sweden, most young autistic children receive intervention service in community-based preschool programs, but no tool is yet available to assess the quality of the preschool learning environment. This study adapted the Autism Program Environment Rating Scale Preschool/Elementary to Swedish community context (APERS-P-SE). Following translation and a multistep modification process, independent experts rated the content validity of the adaptation. Findings indicate high cross-cultural validity of the adapted APERS-P-SE. The cultural adaption process of the APERS-P-SE highlights similarities and differences between the American and Swedish preschool systems and their impact on early ASD intervention.

Increasing rates of autism spectrum disorder (ASD) and younger age at diagnosis pose a challenge to preschool intervention systems. In Sweden, most young autistic children receive intervention service in community-based preschool programs, but no tool is yet available to assess the quality of the preschool learning environment. This study adapted the Autism Program Environment Rating Scale Preschool/Elementary to Swedish community context (APERS-P-SE). Following translation and a multistep modification process, independent experts rated the content validity of the adaptation. Findings indicate high cross-cultural validity of the adapted APERS-P-SE. The cultural adaption process of the APERS-P-SE highlights similarities and differences between the American and Swedish preschool systems and their impact on early ASD intervention.

Introduction: Increased diagnoses rates of autism and earlier identification pose new challenges to preschools and services delivering early intervention to children on the spectrum. A prerequisite for successful implementation of support is a high quality preschool learning environment. Here, we briefly describe the process of translating, culturally adapting and validating the contents of the Autism Program Environment Rating scale (APERS), originally designed for assessing the quality of the learning environment for children and adolescents with autism in the USA, to a European language and educational context.

Methods: In an authorized step-wise procedure, the 59 item scale was translated by a PhD level clinician fluent in English with expertise in autism and psychometrics. Subsequently, following internal feedback from the research team, adaptions addressing translation and cultural adaption of the scale were made. Then, five Swedish external preschool and early intervention experts were invited to provide feedback on the cultural appropriateness of the adapted scale. Lastly, nine additional independent external experts within the field of autism, preschool and early intervention were invited to rate the content validity of the adapted scale. Relevance of subdomains and domains was assessed as well as clarity and comprehensiveness for all of the scale’s items. Experts also rated the practical relevance, need, usefulness, and feasibility of the scale as a whole, and provided anecdotal formative feedback.

Results: All items, subdomains, and domains of the scale were estimated by the raters as showing sufficient content validity (Content validity index &#8805,.79). Several Swedish experts highlighted the need for such a scale, and the usefulness of the scale as a means to assess and then support preschool staff to improve learning environment for children with autism. However, some concerns were raised about the comprehensiveness of the scale and the challenges preschools will meet in improving their learning environment. 

Discussion There seems to be a need for a rating scale to assess and improve the learning environment for children with autism in preschool settings. Although the usefulness and content validity of the translated and adapted scale was established, little is still known about other psychometric properties of the scale, and more work needs to be done to assess its usefulness as a tool for systematic improvement of preschool program quality.

The aim of this study was to investigate the longitudinal development of studentshaving difficulties with reading and their decoding ability in Swedish compulsoryschool. Another aim was to relate this to the experiences of educational activitiesexpressed by students and parents. The decoding ability was assessed by a wordchain test given at three occasions and was compared with results on a letter chaintest.  Retrospective  interviews  were  performed  with  students  and  parents.  Thedecoding ability tended to improve for most of the students over time, althoughsome of them failed to improve or even decreased their scores, indicating a lackof  environmental  adjustment.  Special  educational  support  was  according  tostudents  and  parents  organised  in  small  and  often  very  heterogeneous  groupswhere  the  students  sometimes  received  adequate  support  but  often  felt  deviantfrom friends in their regular classes. The responsibility for helping the childrenwith  their  schoolwork  was  allocated  to  the  parents.  Research  in  this  areademonstrates the necessity of a well-structured and stimulating learning situation.Yet, the development of these students’ decoding abilities, personal experiences,and  parental  involvement  indicate  that  competence  and  resources  at  schoolregarding children at risk for developing reading difficulties are often lacking in  the Swedish educational system.

The Good Behavior Game (GBG) is a classroom management strategy that consistently demonstrates its ability to promote positive behaviors and peer relations among students, with immediate and long-term benefits. This scoping review aimed to provide an overview of peer-reviewed research on the GBG specifically focused on students with special educational needs (SEN) in mainstream education settings. Following a systematic search-and-selection procedure, 30 studies were included, 26 with an experimental design and 4 with a qualitative/mixed-methods design. SEN participants were mainly subgroups of students with baseline assessments of emotional-behavioral difficulties; there was, however, substantial clinical and methodological heterogeneity across studies. Integrative findings from quantitative and qualitative studies indicate that the GBG benefits most students with SEN in mainstream settings, while results for students with severe socio-behavioral difficulties are ambiguous. We identified a paucity of research on students with neurodevelopmental diagnoses such as attention deficit hyperactivity disorder or autism spectrum disorder, as well as on the perspectives of students and teachers and challenges associated with the GBG for students with severe difficulties. Schools implementing the GBG should be aware that some students may need individual adaptations to participate in the GBG, and teachers may need support to implement these adaptations. 

Behavior analysts are not recognized or regulated as a distinct profession in Europe. For the most part, European behavior analysts adhered to the standards set by the U.S.-based Behavior Analyst Certification Board (BACB). However, the BACB certification has not been recognized officially in any European jurisdiction. The recent decision by the BACB to discontinue eligibility of non-U.S. residents to apply for the BCBA exam by the end of 2022 has brought the issue of professional regulation outside of the United States into sharp focus. This article offers a snapshot in time of professional recognition of behavior analysts in 21 European countries. It stems from the Erasmus+ funded EuroBA project and its Professional Advisory Group (PAG). The EuroBA project aims to develop common standards and competences for behavior analysts to facilitate national regulation and mutual recognition across Europe.

Prevalence estimations for Autism Spectrum Disorder have been increasing over the past few years with rates now reported to be at 1: 68. Interventions that are based on Applied Behaviour Analysis are significantly related to best outcomes and are widely considered `treatment as usual' in North America. In Europe, this is not the case, instead a rather ill-defined `eclectic' approach is widely promoted and in this paper we discuss some of the roots of this gulf between Europe and North America and correct some of the misconceptions that prevail about Applied Behaviour Analysis in Europe.

Specialized educational programs previously unavailable to many students are now accessible to students spread throughout the world. In particular, this globalization presents new opportunities and challenges for universities educating professionals in the field of autism treatment. The aim of the present case study is to analyse the experiences of students who participated in an intercultural graduate level blended learning course in applied behaviour analysis with an autism focus. Students were enrolled in universities in four Nordic-Baltic countries. Country based focus group interviews and surveys were used to explore student’s experiences and perceptions. Results indicate that access to expertise and interacting with other cultures were noted to positively affect learning experience. Risk for cultural divide due to discrepancies in technology, differing pedagogical traditions, and understanding of English were also reported. Implications regarding the potential risks and benefits inherent in intercultural blended learning courses are discussed and suggestions are offered for enhancing the success of such courses.

Denna artikel beskriver en kvalitativ intervjustudie av föräldrars erfarenheter av stödinsatsen personlig assistans till barn. Deltagare är åtta föräldrar till sex barn med autism och/eller utvecklingsstörning i Sverige. Intervjuerna analyserades med tolkande fenomenologisk analys. Resultatet visar att föräldrar ser personlig assistans som viktig men också som förknippad med problem. Organisationen av personlig assistans är inte anpassad för den enskilda familjens förutsättningar, personliga assistenter uppfattas som okunniga och barnen har lite inflytande. Med hjälp av Bronfenbrenners (1979) ekologiska modell visas hur personlig assistans kan anpassas bättre till familjer. Studien tyder också på att det behövs ett större kunskapsutbyte mellan yrkesverksamma och familjer samt en ökad förståelse för förälderns ofta komplexa roll som assistent, expert, målsättare och genomdrivare.

In the present study, a didactic perspective was used to examine collaborations and negotiations between preschools and habilitation centres concerning intensive behavioural interventions for children with autism spectrum disorders in inclusive settings in Swedish preschools. The didactic triangle was used as the theoretical tool to analyse information derived from a qualitative case-study in two preschools exemplifying ‘high quality practice’. Direct content analysis was used to analyse data with a focus on the child, the pedagogue, and the subject. Data were collected through multiple sources during a 12-month period, including observations and interviews. A model of aspects of the collaboration between preschools, habilitation centres, and families was conceptualized based on the didactic triangle: the ‘pedagogue cornerstone’ encompassed competence, attitudes, and collaborations; the ‘child cornerstone’ encompassed learning in relation to specific goals; the ‘subject cornerstone’ encompassed both subjects shared with typically developing peers and subjects related to the specific challenges. In addition, the preschool principals were described as important. Different factors in relation to tensions and collaborations between organizations concerning inclusive education were elaborated. Implications for preschools, inter-organizational collaboration, and future research are discussed.

Using semi-structured interviews this study investigated the personal experiences of parents of pre-school children with intellectual disabilities within the Swedish social support system. Thirteen parents of 10 children participated. Interview transcripts were qualitatively analysed using interpretative phenomenological analysis. Three themes emerged: orchestrating formal support; early intervention; and informal support. Parents described orchestrating different organisations within the formal support system and thinking through how they articulated their needs in order to obtain desired supports. Syndrome specific parental groups provided information which parents used to obtain support from the municipality and/or habilitation. The importance of adapting early intervention to both child and family needs is highlighted. The implications of these findings from a family-centred perspective are discussed.

PURPOSE Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) is a relatively new diagnosis characterized by an abrupt and dramatic onset of obsessive-compulsive disorder (OCD), together with neuropsychiatric symptoms. Very little research has been done to understand the experience of being a parent of a child with PANS. The current study aimed to explore aspects related to parental stress in parents of children with PANS.

METHOD The study employed in-depth semi-structured individual interviews with 13 parents of children diagnosed with PANS. Parents were recruited via an announcement on the websites of patient organizations, and in waiting rooms at child medical clinics. An inductive qualitative content analysis approach was used as a guide for analysis of data.

RESULTS The analysis of interviews identified five categories of parents’ experiences of stress related to: (1) being effected by the symptoms; (2) experiencing the symptoms over and over again; (3) having no control; (4) obtaining medical treatment is challenging; and (5) managing problems. The results are discussed in relation to the Transactional Theory of Stress and Coping.

CONCLUSIONS the study illuminates how parents’ perceptions of the child’s symptoms, parents’ strategies for managing problems, as well as experiences related to healthcare providers, may increase or decrease parental stress.

  The last decade has experienced an increase of children diagnosed with autism creating  a demand for behaviour analytic  supports. However many countries lack expertise and university based coursework in behaviour analysis. The purpose of this paper is to present two courses which utilized blended learning technologies. Blended learning has been found especially useful when expertise is geographically limited, and for culturally tailoring content. The first course was advanced level and adhered to BACB certification guidelines (BCBA), collaboration was between University of North Texas and Stockholm University. The second course introduced ABA as it relates to autism to students  in the Nordic-Baltic region. Courses were evaluated using different formats. Findings are discussed related to topics raised at higher education summit held  at the University of North Texas which focused on issues  pertaining to designing, implementing, and supervising behaviour analytic interventions in autism

Research conducted in Sweden suggests contradictory findings regarding the outcome of EIBI. Such findings could be the result of many factors, some of which include difficulties implementing EIBI across cultures. This presentation will present an exploration of considerations related to EIBI, culture, and applied behavior analysis. Aspects to be discussed include how culture may affect the perception of applied behavior analysis and implentation of EIBI. In this paper we discuss culture from a behavioral perspective that includes shared and interlocking contingencies. This includes a broad range of "cultures": organisational, higher education, preschool, as well as parental ethinic and linquistic backgrounds. Our discussion is couched in an implementation science framework Thar underscores the relevance of researchers understanding possible effects of distal variables on implementation of EIBI in preschool settings and the importance of behavior analysts being aware of these issues.

This study compared general educators' (175) perceptions regarding the envisioned inclusion of a pupil with either dyslexia or mild mental retardation. Educators filled out three questionnaires, Teacher Efficacy Scale, Teachers Response to Inclusion and a School Climate Scale. Fifty-three percent filled out the surveys based on having a pupil with dyslexia, and 4 7 % based on having a pupil with mild mental retardation. A factor analysis conducted on the Teacher Efficacy Scale revealed two factors: personal teaching efficacy and general teaching efficacy. Results indicated that educators were more negative regarding the inclusion of a pupil with mild mental retardation than with dyslexia. In addition, personal teacher efficacy was associated with teaching a pupil with mild mental retardation, while general teaching efficacy was associated with teaching a pupil with dyslexia. Findings revealed that high personal teacher efficacy was positively related to the number of credits in post graduate special education course work and active parental participation but not to experience. High personal teacher efficacy was negatively related to support from school administration.