OPENING CONFERENCE
Improving mental health clinicians’ capacity to support autistic mental health

Speaker: Jonathan A. Weiss, PhD, C.Psych., Associate Professor, Dept. of Psychology, York University Research Chair in Autism and Neurodevelopmental Disability Mental Health, Director, LaMarsh Centre for Child and Youth Research, York University, Toronto, Ontario, Canada

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CONFERENCE SUMMARY
It is well known that autistic children and adolescents are more likely to experience mental health problems, such as anxiety, depression, and behavioural issues, compared to peers without autism. Though evidence-based psychotherapy that addresses mental health problems in youth without autism has been shown to be effective for autistic youth (e.g., cognitive behaviour therapy), autistic youth are less likely to receive these interventions. Autistic people also report challenges in accessing and using mental health care services and dissatisfaction with therapy. For their part, clinicians often report low levels of confidence, knowledge and self-efficacy in treating mental health problems in autistic clients, and also report concerns about youth with other neurodevelopmental conditions. If we are to develop informed policies and capacity building plans, we need Canadian information on clinicians' training, experience, attitudes and knowledge about addressing mental health challenges in autistic clients. In working with the Youth Services Bureau of Ottawa and the Ottawa Coordinated Access and Referral case resolution program, we co-produced an online mental health clinician survey designed to tap these clinician variables. The tool also assesses the most common presenting problems of these clients, the kinds of adaptations to treatment that are employed, and clinician training needs. The current talk will present results of this research, including the readiness of clinicians to treat autistic clients and the kinds of adaptations they employ when doing so. It will also discuss how it informed the next steps for tailored capacity building for publicly funded children’s mental health care.

ABOUT THE SPEAKER
Jonathan A. Weiss, PhD (York University), is an Associate Professor in the Department of Psychology, and a Clinical Psychologist. Dr. Jonathan Weiss’s research focuses on mental health in autistic people or with intellectual disabilities across the lifespan. He conducts studies into how people with developmental disabilities access mental health care, and is interested in their service needs, use, and experiences. His work is also focused on understanding and supporting family wellness when at least one family member has a developmental disability. He is interested in program development and evaluation, and in particular on the impact of Special Olympics on the psychological well-being of participants, and of psychosocial interventions to promote resilience and improve the mental health of children and adults with developmental disabilities. Dr. Weiss’s research is funded by the Canadian Institutes of Health Research and the Social Sciences and Humanities Research Council, as well as from non-Tri-Agency sources, including the Ontario Mental Health Foundation, Kids Brain Health Network, and the Public Health Agency of Canada. He currently holds the York Research Chair in Autism and Neurodevelopmental Disability Mental Health.

Communication 1
Understanding the Relationship between Autism Spectrum Disorder and Substance Use among Adults and Adolescents

Speaker: Helandri Haasbroek, Bs.A. Student at University of Johannesburg, Johannesburg, Gauteng, South Africa

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CONFERENCE SUMMARY
Autism spectrum disorder has often been assumed to be a protective factor against substance use, yet the extent of substance use in this population has been difficult to determine as limited research has been done on these interacting variables. 26 studies published between 2009 and 2019 were used to uncover the relationship between autism spectrum disorder and substance use. A significant indication that this population is more susceptible to substance use and related disorders was found, yet this may only remain true for adults and not for adolescents. Various interacting environmental and genetic/neurological factors combine with one another and may contribute towards this vulnerability such as feelings of isolation, deficits in executive functioning and genetic heritability. High comorbidity rates of depression, anxiety disorders and attention deficit/hyperactivity disorder may further strengthen this vulnerability. Screening for substance use in these patients is not a common practice and the treatment of substance use disorder remains a challenge suggesting that many individuals may remain underdiagnosed. These findings demonstrate the need for more primary research to be done and for greater awareness of this vulnerability within mental health settings.

ABOUT THE SPEAKER
Helandri Haasbroek is currently doing her masters degree in research psychology at the University of Johannesburg in South Africa. Her research focuses on qualitative accounts on the motivation and experiences of Autistic people who use psychoactive substances.

Communication 2
Substance use, mental health and autism

Speaker: Jean-Sébastien Fallu, PhD, Associate Professor, School of Psychoeducation, University of Montreal, Montreal, Québec, Canada. Editor of Drogues, santé et société journal

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CONFERENCE SUMMARY
The conference will first address several basic but little-known concepts related to psychoactive substance use, including reasons for use, types of use, dangerousness of drugs, policies and stigma. The general limitations of substance use studies and those specific to the relationship between substance use and mental health will be described. The conference will then take a more specific look at the links between autism, drugs and addiction, particularly level 1 autism. A discussion will then follow on the question of case management, the need for linkage and integration in light of needs related to the dual problem, syndemia, and the potentially structuring and synergetic character of this linkage or better integration. Finally, special attention will be given to the harm reduction and intervention approach with this population.

ABOUT THE SPEAKER
Jean-Sébastien Fallu has been an associate professor at the School of Psychoeducation of the Université de Montréal. His research interests include the etiology and the prevention of problematic substance use and related policies. He is a regular researcher with the Institut Universitaire sur les Dépendances [University Research Institute on Addictions] with the Groupe de Recherche et d'Intervention sur les substances psychoactives [Psychoactive Drug Research and Intervention Group] - Québec (RISQ) and with the Centre de recherche en santé publique [Public Health Research Centre] (CReSP).

Communication 3
Collaborating with autistic people in research and practice

Speaker: Ariel Cascio, PhD, Assistant Professor, Medicine & Society, Central Michigan University College of Medicine, Mount Pleasant, Michigan, United States

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CONFERENCE SUMMARY
Researchers and practitioners working with autistic people who seek specialized services need to collaborate with autistic people as stakeholders, participants, clients, and colleagues. In this workshop, I will describe the work of the autism research ethics task force organized by the Pragmatic Health Ethics Research Unit of the Institut de recherches cliniques de Montréal. This Task Force was charged with generating suggested best practices for research ethics in studies involving people on the autism spectrum, based on personal experience and a review of the literature, and using the framework of person-oriented research ethics. The Task Force included researchers, autistic self-advocates, parents, professionals, and advocacy organization representatives. I will present an overview of key research ethics issues impacting research and practice in specialized services, including respect, empowerment, power dynamics, and participatory collaboration. I will describe strategies for increasing accessibility for autistic people, including minimizing sensory burden and maximizing clarity of communication. I will also address the diversity of people and perspectives in autism and autistic communities, cautioning against a one-size-fits-all approach. I will speak from my perspective as a non-autistic researcher, and invite dialogue and reflection on positionality.

ABOUT THE SPEAKER
Ariel Cascio, Assistant Professor at the Central Michigan University College of Medicine. Dr. Cascio received a Ph.D. in anthropology from Case Western Reserve University, undertook postdoctoral work at the Pragmatic Health Ethics Research Unit of the Institut de recherches cliniques de Montréal and conducts research on social and ethical issues related to autism, autistic people, and autism research. This research has been funded, in part, by the U.S-Italy Binational Fulbright Commission and the SSHRC Banting Postdoctoral Fellowship Program.

Communication 4
Problematic use of alcohol, drugs, internet and video games in autistic young adults in Quebec

Speakers: Myriam Laventure, Full Professor, Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke and Claude L. Normand, Associate Professor, Department of Psychoeducation and Psychology, Université du Québec en Outaouais

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CONFERENCE SUMMARY
Various studies suggest that autistic individuals are more vulnerable to substance abuse and problematic use of the internet and video games. The presence of social isolation among these young adults, and restricted interests, for example in computers, could be linked to this problematic use.

Two parts of a study conducted in Quebec on substance and non-substance addictions in autistic young adults will be presented. The objective of the first part was to describe and compare the alcohol and drug use of these young people, and the second, the problematic use of the internet and video games, taking into account gender, age, occupation and co-occurring diagnoses. The sample consisted of 65 adults with autism, 50.7% of whom were women (mean age = 23.77, SD = 4.3).

The results of the first study indicate that 15% of autistic young adults showed at risk or problematic substance use, while 9.3% of the participants had problematic internet use and 3% had a score above the gaming disorder threshold. While drug and alcohol use in males and females is comparable, the being older and having depressive symptoms is associated with more severe substance use.

These findings will be discussed in relation to issues of screening and intervention for alcohol, drug, internet and video game use in young adults with autism.

ABOUT THE SPEAKERS
Myriam Laventure is full professor in the Department of Community Health Sciences of the Faculty of Medicine and Health Sciences at the Université de Sherbrooke. Regular researcher at the Groupe de Recherche et d'Intervention sur les substances psychoactives [Psychoactive Drug Research and Intervention Group] - Québec (RISQ) and at the Institut Universitaire sur les Dépendances [University Research Institute on Addictions] of the CIUSS [Integrated Health and Social Services Centre] du Centre-Sud-de-l'Île-de-Montréal. Her research focuses on prevention among young people at risk of early initiation to alcohol and drugs and at risk of developing problematic use.

Claude L. Normand is an associate professor in the Department of Psychoeducation and Psychology at the Université du Québec en Outaouais (UQO). Her research focuses on the social participation of young people and adults with autism or an intellectual disability (ID) in digital society. She studied the factors that facilitate access to information and communication technologies, and collaborated in the development of the TUT (training in the use of technologies) program subsidized by the OPHQ. Her most recent work focuses on the risks associated with the use of the Internet and social media, including the development of an addiction or problematic use of video games.

Communication 5
Autism and problematic video game use

Speaker: Micah Mazurek, Associate Professor, School of Education & Human Development, Director, Supporting Transformative Autism Research (STAR), University of Virginia, Charlottesville, United States

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CONFERENCE SUMMARY
Individuals with autism experience difficulties with social and community engagement, yet often have strong interests in screen-based technology. Video games appear to be particularly motivating and engaging; however, preoccupation with video games and excessive video game use can be clinically significant issues for many children and adults with autism. Problematic game use can interfere with participation in daily activities and responsibilities and may have detrimental effects on mental health and well-being. Given that individuals with autism are already at risk for health and psychosocial difficulties, a better understanding of these issues is imperative for promoting positive outcomes. This presentation will provide an overview of a series of studies conducted to examine video game use among individuals with autism. Themes and findings across studies of both children and adults with autism will be examined, including patterns, preferences, correlates, and potential consequences of problematic video game use. Both quantitative and qualitative findings will be explored to provide broader perspectives on important aspects of game use and motivations among individuals with autism. Clinical implications and avenues for future research will also be discussed.

ABOUT THE SPEAKER
Micah Mazurek, PhD, is an Associate Professor at the University of Virginia, Director of the Supporting Transformative Autism Research (STAR) initiative, and a licensed clinical psychologist with expertise in autism. Dr. Mazurek has an active program of federally-funded research focused on understanding and improving outcomes for individuals on the autism spectrum and their families. Her current projects focus on developing new tools, techniques, and technologies for improving diagnosis, treatment, and access to care. Her work also focuses on examining positive and negative aspects of screen-based technology use, and on improving health and mental health outcomes for children and adults on the autism spectrum.

Communication 6
Video games, autism behaviour and parents: an often problematic quartet

Speakers: Line Desjardins, psychoeducator in private clinic and doctoral student in psychoeducation at Université Laval, Quebec, QC, Canada and Jonathan Deschênes-Casey, Specialised Addiction Practitioner, Le Grand Chemin, Quebec, QC, Canada

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CONFERENCE SUMMARY
For several years now, the problematic use of video games among young people has been the subject of research, a growing number of which focuses on autistic individuals. However, to this day, there have been few studies on the relationship between parental practices and the problematic use of video games.

This presentation focuses on evidence-based parenting practices for supervising autistic children and teenagers with regard to the problematic use of video games. First, we will outline the results of a systematic review on this subject. Next, we will examine the variables that contribute to the emergence of this problem. We will discuss the nature of video games and their presence in the family environment, the characteristics or vulnerabilities related to autism that may promote the problematic use of video games, behaviour functional, and finally, the choice of parental strategies and their context of use.

We will discuss the strategies used by parents of non-autistic youth in a similar context and compare the results. We will present available screening and assessment tools as well as current services available offered by Le Grand Chemin to youth and their families. Practitioners as well as parents who are dealing with this reality will find some ideas for reflection and intervention.

ABOUT THE SPEAKERS
Line Desjardins is a psychoeducator in a private clinic. She is enrolled in a doctoral program in psychoeducation and psychopedagogy at Université Laval and her project is being carried out under the direction of professors Francine Julien-Gauthier and Marie-Hélène Poulin. Her professional interests are in educational strategies in families with an autistic child. Thus, it seems natural to her that her doctoral project should focus on parental practices related to the problematic use of video games.

Jonathan Deschênes-Casey is a specialised addiction practitioner who has been working with adolescents for 16 years at the Grand Chemin Centre. Since 2013, he has also worked with the families of teenagers and has developed an expertise in working with young people with a problematic use of the Internet. His dedication to youth, his ability to listen and his capacity to build trust make Mr. Deschênes-Casey a counsellor who embodies the values advocated by Le Grand Chemin.

Communication 7
Integration of services and addiction screening

Speaker: Karine Gaudreau, Social worker, Masters in addiction intervention, Doctoral student in clinical sciences, specialized in addiction, Department of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada

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CONFERENCE SUMMARY
Among people with a mental health disorder, between 20% and 50% will develop a Substance Use Disorder (SUD). This co-morbidity leads to a poorer prognosis because of lower compliance with treatment and more erratic use of services. Several factors enhance the effectiveness of treatment, including early screening, working on the two disorders in an integrated manner, and promoting follow-ups adapted to needs. This presentation will focus on general screening and addiction assessment tools as well as advice on how to use them and pass a questionnaire. The different types of treatment available for co-occurring disorders will be presented. Best practices in integrated collaborative treatment will be discussed. Potential treatment objectives for follow-up workers, gradually applied according to the person's stage of motivation will also be shared.

ABOUT THE SPEAKER
Karine Gaudreau has been a social worker for 20 years. She has worked in a psychiatric hospital with people with serious mental health problems and several associated disorders including substance use disorder and coordinated a training course enabling more than 100 practitioners per year to receive training co-occurring mental health problems. Currently working on her doctorate in clinical sciences with a specialisation in addictions, she is interested in the use of family and friends to help motivate people with concomitant disorders.

Communication 8
Telepractice : A modality to be considered for an adapted service offer

Speaker: Priscilla Ménard, B Sc., Planning, Programming and Research Officer, Centre intégré universitaire de santé et de services sociaux [Integrated Health and Social Services Centre] -- Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), QC, Canada

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CONFERENCE SUMMARY
The COVID-19 pandemic required exceptional measures to reduce the spread of the virus. The requirement to limit travel and social contact created a challenge for the delivery of services to autistic people and their families. Yet the need for support and learning remains, and for some, may even be increasing. The implementation of new modalities of intervention, such as telepractice, is proving to be an option in addition to the usual provision of services. In the spring of 2020, an inter-institutional committee, led by the Institut universitaire en DI-TSA [University Research Institute on ID and ASD], was set up to support practitioners in the implementation of telepractice for people with intellectual disability or autism and their families. Telepractice is now considered as a modality to be maintained in the post-pandemic service offer.

The aim of this presentation is to share documentation and tools available to support the implementation of telepractice activities as well as the work of the committee.

ABOUT THE SPEAKER
Priscilla Ménard has worked in the field of autism and intellectual disability as special educator for nearly 10 years. After completing various mandates as a planning, programming and research officer in clinical services, she joined the University Research Institute's psychosocial research team in 2017. She acts mainly as a professional supporting the development of evidence-based practices, in collaboration with clinical teams and the research community. Since the beginning of the pandemic, she has been actively involved in the development of telepractice, and coordinates the Telepractice Committee in ID-ASD.

Communication 10
Cross-training to support the integration of services in the field of co-occurring conditions: evolution and evaluation of the Montreal program

Speakers: Michel Perreault, Researcher, Douglas Mental Health University Institute; Associate Professor, Department of Psychiatry, McGill University, Montreal, QC and Léonie Archambault, Research Coordinator, Douglas Mental Health University Institute, Montreal, QC; Doctoral Student in Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada

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CONFERENCE SUMMARY
The prevalence of co-occurring mental health and substance use disorders is high in Western countries. However, the services offered are generally fragmented. In order to support the integration of services, a cross-training programme was initiated in Montreal in 2002.

Between 2002 and 2020, the Cross-training Program organised 19 days of exchanges and six cycles of observation traineeships, for a total of more than 6,000 participants. The evaluation of the activities allowed documenting the satisfaction and the acquisition of knowledge. For example, for the 2010-2016 period, the majority of participants in the exchange sessions report having obtained useful information on the service offer to orient the people with whom they work (71%), having learned more about how other resources work (73%) and having identified practitioners from other networks who could orient them as needed (71%).

Since March 2020, the social distancing measures related to COVID-19 have forced the transition of the program's activities to a digital format. Online training and virtual meetings with program representatives have been developed. The evaluation of the impacts of the digital shift is underway, and preliminary results show a very high level of satisfaction among the participants reached. For example, 95% of those who evaluated the online training report that they have learned something, and 92% of those who evaluated the virtual meetings report that they have obtained useful information on various resources so that they can refer the people with whom they work.

Co-authors:

• Kristelle Alunni-Menichini, Douglas Hospital Research Centre and McGill University
• Diana Milton, Douglas Hospital Research Centre
• Nicole Perreault, Public Health Regional Branch, CIUSSS Centre-Sud de Montréal
• Karine Bertrand, University of Sherbrooke and University Institute on Addictions