Previous studies have shown that autistic people often display atypical responses when processing sensory information, with particular prevalence within the auditory domain. Often provoked by common everyday sounds, auditory hypersensitivity can result in self-regulatory fear responses. This can be potentially harmful to autistic individuals and the people around them and is associated with greater occurrence of anxiety, depression, and poorer overall quality of life in the autistic population. Rather than a physiological causation, the literature suggests that hypersensitivity to sound is likely to be caused by how auditory stimuli are processed in the brain. This paper reports a home-based digital intervention aimed to address auditory hypersensitivity in autistic children. Developed as an interactive virtual reality game, the system integrates exposure-based therapy techniques into game mechanics and delivers target auditory stimuli to the player rendered via binaural-based spatial audio. The performance of the platform was evaluated in a 10-week feasibility study, during which children (n = 7) engaged weekly with the game during a 30 min session. Following this period, a comparison of pre- and post-study measurements showed a decrease in sensitivity for five participants, with qualitative feedback highlighting an increase in tolerance towards real-world stimuli and challenging environments. These results provide initial support for SoundFields as a home-based intervention targeting auditory hypersensitivity experienced by autistic children.

The aim was to investigate the agreement between the ADI-R Deaf adaptation and ADOS-2 Deaf adaptation overall diagnostic categorisation for autism (AUT) and a wider threshold to include autism spectrum (ASD) in a cohort of deaf children with and without ASD. We compared results of the instruments used on their own and when combined and propose standard criteria for the combined use of the ADI-R Deaf adaptation and ADOS-2 Deaf adaptation for use with deaf children. In total, 116 deaf children had a Gold standard NICE guideline assessment; 58 diagnosed with ASD and 58 without ASD, and for both groups a blinded informant based ADI-R Deaf adaptation and direct assessment using the ADOS-2 Deaf adaptation were separately completed. There was moderate agreement between the ADI-R Deaf adaptation and ADOS-2 Deaf adaptation for the wider threshold of ASD (Kappa, 0.433). To achieve the lowest number of false negatives, the most successful assessment tool approach is using the wider threshold of ASD with either ADI-R Deaf adaptation or ADOS-2-Deaf adaptation (95% sensitivity). This compares with 88% for the ADI-R Deaf adaptation alone and 74% for the ADOS-2-Deaf adaptation alone (wider threshold of ASD). To achieve a low number of false positives, the most successful assessment tool approach is a combination of ADI-R Deaf adaptation and ADOS-2- Deaf adaptation (using the narrow threshold of autism for both) (95% specificity). This compares with 83% for the ADI-R Deaf adaptation alone and 81% for the ADOS-2-Deaf adaptation (narrow threshold) alone. This combination is therefore recommended in specialist clinics for diagnostic assessment in deaf children.

Self-harming behaviours can include cutting the skin, ligaturing and taking overdoses. These actions can result in infection, blood loss, or even death. A young person's risk of dying by suicide increases if they engage in self-harm. Self-help empowers people to utilise different coping strategies and implement life changes without reliance on a clinical intervention, "helping people to help themselves". Self-help toolkits contain a variety of items that are selected by the person to help them manage the urge to self-harm. The items included sensory objects, distractions, prompts to seek help and creative prompts such as colouring books and pens and personal items that trigger positive memories. AMED, EMBASE, APA Psycinfo and MEDLINE were searched with no language restriction or date restriction. Of the 368 studies screened, 13 met the inclusion criteria. The studies were mainly small scale or case studies pertaining to the use of self-help toolkits or similar. They described the need for a flexible and/or individualised approach to self-help toolkits. Abstracts and studies were screened separately by two members of the research team for inclusion. Qualitative data was analysed using Grounded Theory. Nine themes were identified: Creativity, Hope, Social contact/help seeking, calming/relaxing, sensory items, reflection, distractions, therapeutic prompts and emotional release. Self-efficacy and self-awareness were the two main mechanisms identified. Self-help toolkits were found to be acceptable and helpful, but the limited evidence base means their efficacy for reducing self-harm episodes has not been established.