Journal of Health and Rehabilitation Sciences

Social Skills, Aberrant Behavior, and Quality of Life Among Autistic Students: Findings from a Longitudinal Cohort Study

2026-04-08T07:40:02+02:00

Objective: To examine the average change over time in behavior, social skills, and quality of life for autistic individuals, and to investigate any potential associations between the outcomes.

Methods: This six-year longitudinal cohort study included 50 participants (aged 7-19 years) with autism spectrum disorder (ASD) from a specialized school. Evaluations for Aberrant Behavior Checklist (ABC), Social Responsiveness Scale (SRS) and Pediatric Quality of Life (PedsQL) 4.0 were completed by parents and teachers every 3 months. Mixed-effects models were used to detect significant changes in the mean ABC, SRS and PedsQL across timepoints, and to examine any longitudinal relationships between the outcomes.

Results: There were statistically significant improvements in the mean teacher-reported ABC (p=0.002), parent-reported SRS (p=0.006), teacher-reported SRS (p=0.003), and PedsQL (p<0.001) over time for all participants, but not for parent-reported ABC (p=0.5). There were significant longitudinal associations between PedsQL and parent-reported ABC (p=0.03), and between PedsQL and SRS (parent: p=0.03; teacher: p=0.001) within an individual.

Conclusions: The significant improvement in behavior, social responsiveness, and quality of life in these autistic children and young adults suggests that the specialized learning environment may have been beneficial. It also highlights the importance of providing collaborative and personalized therapeutic care and education programs for the ASD population.

Parental bonding in individuals with autism spectrum disorder: insights through the separation individuation lens

2026-04-03T07:28:07+02:00

Introduction: This study examines how individuals with autism spectrum disorder (ASD) perceive early relationships with their parents, framing these perceptions within Mahler’s separation-individuation process and Bowlby’s attachment theory. Early parent-child interaction is conceptualized as a reciprocal developmental process shaped primarily by ASD-related communication profiles and parental responses to these developmental characteristics and other various factors that contribute to parent-child interaction.

Objectives: The study aims to investigate whether adults with and without ASD differ in their perceptions of parental bonding – specifically care and overprotection – and to explore how adults with ASD describe early relational experiences with both mothers and fathers.

Methods: A mixed‑methods design was applied to deepen understanding of both measurable and subjective relational patterns. Quantitatively, 38 adults with ASD and 100 adults without ASD completed the Parental Bonding Instrument (PBI), assessing each parent separately. Reliability was examined using Cronbach’s alpha, and group differences were tested with independent sample t‑tests. Qualitatively, semi‑structured interviews with 18 adults with ASD were analyzed using inductive thematic analysis to capture lived experiences of early relational processes and to triangulate quantitative findings.

Results: Adults with ASD reported significantly higher perceived maternal overprotection, whereas no differences emerged in perceived care. Qualitative analysis revealed heterogeneity in relational experiences, including emotional distance, misunderstandings, and limited autonomy, alongside examples of supportive parental behavior.

Conclusion: The findings indicate that perceptions of overprotection and relational challenges arise within a broader developmental and sociocultural context shaped by neurodivergent communication patterns, parental coping strategies, and prevailing intervention narratives. The results highlight the need for parent support programs that promote relational sensitivity, autonomy support, and a nuanced understanding of ASD-specific developmental characteristics, rather than attributing relational difficulties to parents.

Cognitive-Communicative Differences Between Mild Cognitive Impairment and Healthy Aging: A Comparative Study Using the SCCAN

2026-02-28T10:40:55+01:00

Aim: To examine cognitive-communicative functioning in adults with Mild Cognitive Impairment due to Alzheimer’s disease
(MCI-AD) and compare performance with cognitively healthy older adults using the Bulgarian-adapted version of the
Scales of Cognitive and Communicative Ability for Neurorehabilitation (SCCAN-BG).

Methods: This cross-sectional comparative study included 60 participants: 30 individuals with MCI-AD and 30 cognitively
healthy controls comparable in education. Cognitive-communicative functioning was assessed across SCCAN domains, including
orientation, memory, attention, oral expression, auditory and reading comprehension, writing, and problem solving.
Group differences were analysed using non-parametric statistical methods.

Results: Overall SCCAN performance was lower in the MCI-AD group. Consistent group differences were observed in
memory, attention, oral expression, and problem solving. These differences suggest reduced efficiency in tasks that require
integrated cognitive-communicative processing. Reading comprehension and writing were largely preserved. Auditory
comprehension showed a non-significant trend towards lower performance in the MCI-AD group.

Conclusion: Cognitive-communicative changes are evident at the MCI-AD stage and extend beyond memory impairment
alone. The SCCAN-BG captures early, functionally relevant vulnerability in everyday communication. This supports its use
for clinical monitoring and rehabilitation-oriented decision-making in populations at risk for Alzheimer’s disease–related
cognitive decline.

Effects of Sports Rehabilitation and Caregiver-Led Home-Based Exercise on Gross Motor Function and Therapy Engagement in Children with Developmental Disabilities

2026-03-25T06:47:38+01:00

Aim: This study aimed to compare the effectiveness of a hospital-based sports rehabilitation program (SRP) versus a home-based exercise program (HEP) on motor function, participation-related, and therapy engagement outcomes in children with developmental disabilities and to evaluate feasibility and safety.

Methods: This exploratory randomized pilot study allocated 16 children to SRP or HEP (1:1) using block randomization stratified by Gross Motor Function Classification System (GMFCS) level. Both interventions were delivered for 8 weeks. Outcomes included Gross Motor Function Measure (GMFM), Pediatric Balance Scale (PBS), Canadian Occupational Performance Measure (COPM-Performance/Satisfaction), Pediatric Volitional Questionnaire (PVQ), and Goal Attainment Scaling (GAS; T-score). A 2×2 mixed ANOVA (group × time) was used for most outcomes, and an independent t-test was used for GAS T-scores.

Results: Both groups showed significant improvements over time in GMFM and PBS (p < 0.001). Group-by-time interactions favored SRP for COPM–Performance (p = 0.038), COPM–Satisfaction (p = 0.025), and PVQ (p = 0.038). The GAS T-scores did not differ between the groups (p = 0.645). Feasibility criteria were met (≥75% adherence, fidelity, and exercise dose).

Conclusion: Both interventions were feasible and safe over 8 weeks. The SRP may confer greater benefits for participation-related outcomes. Future adequately powered trials with a longer follow-up period are warranted to confirm these findings.

Families As System Actors In Discovery: Embedding Co-Production Within The Equilibrium Systems Model Of Employment

2026-02-12T11:00:34+01:00

Background: Discovery is a core practice within Customised Employment, intended to identify the strengths, interests, and support needs of people with disability to inform meaningful employment pathways. Despite strong evidence that families influence employment outcomes, their role within Discovery remains informal, inconsistent, and largely untheorised.

Aim: This paper examines the role of families within Discovery and proposes a structured model for embedding family involvement as a core component of inclusive employment practice.

Methods: Drawing on the Equilibrium Systems Model of Employment (ESME), international literature, and applied practice experience, the paper develops the Family Discovery Model as a conceptual and practice-informed framework. The model is examined in relation to co-production theory, Customised Employment fidelity, and contemporary disability employment policy contexts.

Results: The Family Discovery Model positions families as system actors who contribute through narrative building, network mapping, and collaborative reflection. These functions strengthen employment planning, improve alignment between participant goals and service delivery, and enhance system coherence. Practice-based vignettes demonstrate how structured family involvement can support school-to-work transitions, movement from segregated employment, and pathway development for individuals with complex support needs.

Conclusion: Embedding families as co-producers within Discovery offers a practical and scalable mechanism for strengthening rehabilitation practice and advancing inclusive employment systems. By operationalising family involvement within a structured framework, the model supports improved employment outcomes, greater fidelity to Customised Employment principles, and stronger alignment with contemporary disability policy objectives.