Alopecia Areata Prevalence in Australia: Insights From a Nationally Representative Cross-Sectional Survey Study.

Social participation, defined as a person’s involvement in activities providing interactions with others in society or the community, has positive associations with quality of life for children with disabilities; it provides the basis for creating social connections, encouraging community participation, providing social identity, and developing new or existing skills (e.g., emotional and behavioral control, physical coordination, pragmatic communication, social cooperation). Examples of social participation include participation in physical activities or group sports, outings with friends, classes or lessons (e.g., music lessons), religious organizations, volunteer work, or employment. However, studies have shown children with fragile X syndrome (FXS) and other developmental disabilities (DD) such as autism spectrum disorder (ASD), intellectual disability (ID), developmental delay, speech/language impairment, and cerebral palsy, participate in social and recreational activities at lower rates and have fewer social relationships than their typically developing peers.. Myriad factors affect social participation for individuals with ID and DD. For example, Buttimer and Tierney found that students with mild to moderate ID reported time constraints, lack of transportation, and feeling restricted by parents from engaging in activities as barriers to leisure participation. A study by Smith et al. exploring social participation experiences of families raising children with ASD found that the child’s difficulty in understanding or meeting social expectations, along with the community’s lack of sensitivity to family circumstances, and the family’s difficulty in managing their child’s behaviors served as barriers to social participation. Merrells et al. investigated social inclusion experiences from the perspective of young adults with ID and found that social participation and friendships may be negatively influenced by a lack of integrated programs providing interaction with people without DD, exclusion or rejection from employment opportunities, and lack of access to communication devices (e.g., cell phones, social media). However, some participants in this study indicated preferring isolation or not having access to these devices, suggesting social participation may also rely on the individual’s interests. Other factors potentially impacting social participation include availability and adequacy of resources such as programs, services or finances, the individual’s ability to meet activity demands, and support from friends, family, or the community. FXS is the leading single-gene cause of ID and ASD and is commonly associated with behavioral and emotional conditions such as attention problems, hyperactivity, anxiety, hyperarousal, irritability, aggression, self-injurious behaviors, and obsessive-compulsive disorder (OCD) or perseverative behaviors. FXS is also characterized by social avoidance (e.g., poor eye contact), social withdrawal, sensory integration dysfunction, and language deficits, which can interfere with appropriate social behaviors and persist into adulthood. Studies have shown that conditions such as anxiety or depression (among females with FXS), aberrant behaviors such as lethargy, irritability, or hyperactivity, and delayed social or functional skills are associated with reduced quality of life and can predict level of independence for individuals with FXS in adulthood. However, studies have shown involvement in social activities is associated with fewer depressive symptoms among adolescents with ASD and young adults with DD. Additionally, participating in group social activities provides an opportunity for children with disabilities to develop and strengthen the skills necessary for independence. Adolescents with disabilities have reported feeling more independent and self-reliant after participating in summer camp activities as they had to manage their daily living skills and explore their physical ability without the help of a caregiver.