Autism recent issues

Editorial

Bowler, D. — 2009-06-17

Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders?: A case control study

Smith, R.A., Farnworth, H., Wright, B., Allgar, V. — 2009-06-17

There is considerable controversy as to whether there is an association between bowel disorders and autism. Using a bowel symptom questionnaire we compared 51 children with autism spectrum disorder with control groups of 35 children from special school and 112 from mainstream school. There was a significant difference in the reporting of certain bowel symptoms (constipation, diarrhoea, flatulence) and food faddiness between the autism group and the mainstream school control group. There was no significant difference between the autism group and children in the special schools except for faddiness, which is an autism specific symptom and not a bowel symptom. This study confirms previously reported findings of an increase in bowel symptoms in children with autism. It would appear, however, that this is not specifically associated with autism as bowel symptoms were reported in similar frequency to a comparison group of children with other developmental and neurological disorders.

Developmental regression in children with an autism spectrum disorder identified by a population-based surveillance system

Wiggins, L. D., Rice, C. E., Baio, J. — 2009-06-17

This study evaluated the phenomenon of autistic regression using population-based data. The sample comprised 285 children who met the autism spectrum disorder (ASD) case definition within an ongoing surveillance program. Results indicated that children with a previously documented ASD diagnosis had higher rates of autistic regression than children who met the ASD surveillance definition but did not have a clearly documented ASD diagnosis in their records (17—26 percent of surveillance cases). Most children regressed around 24 months of age and boys were more likely to have documented regression than girls. Half of the children with regression had developmental concerns noted prior to the loss of skills. Moreover, children with autistic regression were more likely to show certain associated features, including cognitive impairment.These data indicate that some children with ASD experience a loss of skills in the first few years of life and may have a unique symptom profile.

Parenting stress and psychological functioning among mothers of preschool children with autism and developmental delay

Estes, A., Munson, J., Dawson, G., Koehler, E., Zhou, X.-H., Abbott, R. — 2009-06-17

Parents of children with developmental disabilities, particularly autism spectrum disorders (ASDs), are at risk for high levels of distress. The factors contributing to this are unclear. This study investigated how child characteristics influence maternal parenting stress and psychological distress. Participants consisted of mothers and developmental-age matched preschool-aged children with ASD (N = 51) and developmental delay without autism (DD) ( N = 22). Evidence for higher levels of parenting stress and psychological distress was found in mothers in the ASD group compared to the DD group. Children's problem behavior was associated with increased parenting stress and psychological distress in mothers in the ASD and DD groups. This relationship was stronger in the DD group. Daily living skills were not related to parenting stress or psychological distress. Results suggest clinical services aiming to support parents should include a focus on reducing problem behaviors in children with developmental disabilities.

Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy

Kim, J., Wigram, T., Gold, C. — 2009-06-17

Through behavioural analysis, this study investigated the social-motivational aspects of musical interaction between the child and the therapist in improvisational music therapy by measuring emotional, motivational and interpersonal responsiveness in children with autism during joint engagement episodes. The randomized controlled study (n = 10) employed a single subject comparison design in two different conditions, improvisational music therapy and toy play sessions, and DVD analysis of sessions. Improvisational music therapy produced markedly more and longer events of `joy', `emotional synchronicity' and `initiation of engagement' behaviours in the children than toy play sessions. In response to the therapist's interpersonal demands, `compliant (positive) responses' were observed more in music therapy than in toy play sessions, and `no responses' were twice as frequent in toy play sessions as in music therapy. The results of this exploratory study found significant evidence supporting the value of music therapy in promoting social, emotional and motivational development in children with autism.

The role of vision for online control of manual aiming movements in persons with autism spectrum disorders

Glazebrook, Cherylm., Gonzalez, D., Hansen, S., Elliott, D. — 2009-06-17

Recent studies suggest motor skills are not entirely spared in individuals with an autism spectrum disorder (ASD). Previous reports demonstrated that young adults with ASD were able to land accurately on a target despite increased temporal and spatial variability during their movement. This study explored how a group of adolescents and young adults with an ASD used vision and proprioception to land successfully on one of two targets. Participants performed eye movements and/or manual reaching movements, either with or without vision. Although eye movements were executed in a similar timeframe, participants with ASD took longer to plan and execute manual reaching movements. They also exhibited significantly greater variability during eye and hand movements, but were able to land on the target regardless of the vision condition. In general, individuals with autism used vision and proprioception. However, they took considerably more time to perform movements that required greater visual-proprioceptive integration.

Perceiving the impossible: How individuals with autism copy paradoxical figures

Sheppard, E., Ropar, D., Mitchell, P. — 2009-06-17

Mottron and colleagues found that individuals with autism were less affected by geometric impossibility than comparison participants on a copying task. The current experiment sought to determine whether a local perceptual style could account for this. Participants with and without autism copied possible and impossible geometric figures. Geometric impossibility had a larger effect on drawing time for comparison participants than for those with autism. However, participants with autism did not use more localized drawing strategies. Strength of impossibility effect was associated with a global strategy amongst comparison participants but this relationship was not found amongst participants with autism. The findings suggest that differences in high-level conceptual processing may account for group differences in effects of impossibility.

Book review: Autism: An Integrated View from Neurocognitive, Clinical, and Intervention Research edited by Evelyn McGregor, Maria Nunez, Katie Cebula and Juan Carlos Gomez. Oxford: Blackwell, 2008. ISBN--978--1--4051--5696--7. {pound}24.99 pbk. 352 pp

Crane, L. — 2009-06-17

Book Review: Asperger Syndrome and Employment by Genevieve Edmonds and Luke Beardon (eds). London: Jessica Kingsley, 2008. ISBN 978--1--84310--648--7 pbk. 176 pp

Hill, E. L., Collins, A. — 2009-06-17

Editorial

Hare, D. J., Mills, R. — 2009-04-15

Sensory processing in adults with autism spectrum disorders

Crane, L., Goddard, L., Pring, L. — 2009-04-15

Unusual sensory processing has been widely reported in autism spectrum disorders (ASDs); however, the majority of research in this area has focused on children. The present study assessed sensory processing in adults with ASD using the Adult/Adolescent Sensory Profile (AASP), a 60-item self-report questionnaire assessing levels of sensory processing in everyday life. Results demonstrated that sensory abnormalities were prevalent in ASD, with 94.4 percent of the ASD sample reporting extreme levels of sensory processing on at least one sensory quadrant of the AASP. Furthermore, analysis of the patterns of sensory processing impairments revealed striking within-group variability in the ASD group, suggesting that individuals with ASD could experience very different, yet similarly severe, sensory processing abnormalities. These results suggest that unusual sensory processing in ASD extends across the lifespan and have implications regarding both the treatment and the diagnosis of ASD in adulthood.

Divided attention capacity in adults with autism spectrum disorders and without intellectual disability

Bogte, H., Flamma, B., Van Der Meere, J., Van Engeland, H. — 2009-04-15

Earlier research showed that divided attention, an aspect of executive function, is limited in both children and adults with autism spectrum disorders (ASDs). The current study explored divided attention capacity in adults with ASD and without intellectual disability (n = 36). Divided attention was tested using a computerized variant of a well-known memory recognition test, with two levels of cognitive load. The effect of cognitive load on reaction time performance is considered to be inversely proportional to divided attention capacity. The study failed to provide a relationship between divided attention and ASD, contrary to earlier research. Findings indicated that only the adults with ASD who used medication had a divided attention deficit, and that this group had specific difficulty reaching a binary decision in a memory search task. An additional finding was that the participants with ASD were overall slow. Possible causes and implications of these findings are discussed.

Executive functioning differences between adults with attention deficit hyperactivity disorder and autistic spectrum disorder in initiation, planning and strategy formation

2009-04-15

Executive functioning deficits characterize the neuropsychological profiles of the childhood neurodevelopmental disorders of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD). This study sought to determine whether similar impairments exist in adults with ADHD (N = 53) and ASD (N = 45) in comparison with a healthy control group (N = 31), whether the two disorders can be distinguished on the basis of their executive functioning features, and whether these impairments are related to symptom severity. Both clinical groups were found to exhibit executive functioning deficits. The ADHD group had difficulty withholding a response, with relative preservation of initiation and planning abilities. In contrast, the ASD group exhibited significant impairments in initiation, planning and strategy formation. The specific executive functioning deficits were related to severity of response inhibition impairments in ADHD and stereotyped, repetitive behaviours in ASD. These findings suggest the pattern of executive functioning deficits follows a consistent trajectory into adulthood.

The `not guilty verdict': Psychological reactions to a diagnosis of Asperger syndrome in adulthood

Punshon, C., Skirrow, P., Murphy, G. — 2009-04-15

Asperger syndrome is a relatively new diagnostic classification. A number of factors make receiving a diagnosis of Asperger syndrome in adulthood a unique experience. This study used a phenomenological approach to examine the experiences of 10 adults receiving such a diagnosis. Results suggested that six major themes were associated with receiving a diagnosis of Asperger syndrome. Individuals discussed their negative life experiences and their experience of services prior to diagnosis, which led to individuals holding certain beliefs about the symptoms of Asperger syndrome. These beliefs had an effect on the formation of each individual's perceived self-identity. Participants made links between how they felt when they received the diagnosis and their current beliefs about both their `symptoms' and themselves. Finally, participants highlighted the importance of the societal view of Asperger syndrome. The implications of these findings are reappraised in the context of previous research and the wider literature on identity formation.

The costs of services and employment outcomes achieved by adults with autism in the US

Cimera, R. E., Cowan, R. J. — 2009-04-15

This article examines the cost of services and employment outcomes obtained by adults with autism within the United States vocational rehabilitation (VR) system. It found that the number of such individuals has increased by more than 121 percent from 2002 to 2006. Moreover, though adults with autism were employed at higher rates than most disability groups investigated, they tended to work far fewer hours and earn less in wages per week. The study also found that adults with autism were among the most costly individuals to serve.

Objective and subjective quality of life in adults with autism spectrum disorders in southern Spain

Saldana, D., Alvarez, R. M., Lobaton, S., Lopez, A. M., Moreno, M., Rojano, M. — 2009-04-15

Subjective and objective measures of quality of life (QoL) were obtained for adults with autism spectrum disorders (ASDs) living in Andalusia (Spain). Seventy-four families responded to questionnaires about objective QoL indicators such as employment, health, adaptive behaviour and social network, and were asked to act as proxies for subjective QoL measures. Outcome on objective QoL was extremely poor. Social networks were most frequently composed of family members. Community-oriented resources were absent in most cases. For two-thirds of the families, the ability to act as proxies for subjective QoL was seriously limited by the participants' poor social and communicative abilities. The results are indicative of the need for additional support to families of adults with ASD and increased community-based resources. Further conceptualization of indicators and measurement of subjective QoL in individuals with severe disabilities and ASD is also needed in order to include their own perspective in the evaluation of service provision.

Economic cost of autism in the UK

Knapp, M., Romeo, R., Beecham, J. — 2009-04-15

Autism has lifetime consequences, with potentially a range of impacts on the health, wellbeing, social integration and quality of life of individuals and families. Many of those impacts are economic. This study estimated the costs of autism spectrum disorders (ASDs) in the UK. Data on prevalence, level of intellectual disability and place of residence were combined with average annual costs of services and support, together with the opportunity costs of lost productivity. The costs of supporting children with ASDs were estimated to be £2.7 billion each year. For adults, these costs amount to £25 billion each year. The lifetime cost, after discounting, for someone with ASD and intellectual disability is estimated at approximately £1.23 million, and for someone with ASD without intellectual disability is approximately £0.80 million.

Editorial

Hare, D. J. — 2009-03-04

Autistic traits predict performance on the block design

Stewart, M. E., Watson, J., Allcock, A.-J., Yaqoob, T. — 2009-03-04

The Autism-Spectrum Quotient (AQ) has been developed to measure the degree to which an adult with normal intelligence has autistic traits. Although use of the AQ has resulted in a number of important findings, few studies have assessed whether scores predict cognitive aspects of ASD. This study assessed whether AQ scores predicted performance on an adapted block design. The test was adapted with a `whole' and a `segmented' task. High AQ scorers performed better than low scorers on the `whole' task in the block design but performed equivalently on the `segmented' task, as would be predicted in the autism spectrum. These findings add to the evidence showing construct validity for the AQ.

Examining correlates of cooperation in autism: Imitation, joint attention, and understanding intentions

Colombi, C., Liebal, K., Tomasello, M., Young, G., Warneken, F., Rogers, S. J. — 2009-03-04

The goal of the current study was to examine the contribution of three early social skills that may provide a foundation for cooperative performance in autism: (1) imitation, (2) joint attention, and (3) understanding of other people's intentions regarding actions on objects. Fourteen children with autistic disorder (AD) and 15 children with other developmental disabilities (DDs) matched on non-verbal developmental age (AD, mean 27.7, SD 9.8; DD, mean 33.4, SD 11.1) and verbal developmental age (AD, mean 21.5, SD 12.3; DD, mean 28.4, SD 11.0) participated in the study. Children with autism showed poorer performance on imitation and joint attention measures, but not on the intentionality task. Multiple regression analyses showed that imitation skills and joint attention contributed independently to cooperation, above and beyond the understanding of intentions of actions on objects.

Naturalistic observations of elicited expressive communication of children with autism: An analysis of teacher instructions

Chiang, H.-M. — 2009-03-04

This study observed expressive communication of 17 Australian and 15 Taiwanese children with autism who were mute or had limited spoken language during 2 hour regular school routines and analyzed teacher instructions associated with elicited expressive communication. Results indicated: (a) the frequency of occurrence of elicited expressive communication was very low; (b) the incidence of elicited expressive communication was negatively correlated with autism severity; (c) verbal prompt and a combination of verbal prompt and modeling were the most common types of teacher instruction and the use of physical prompt was a rate event; (d) modeling and verbal prompt were positively correlated with speech and unaided augmentative and alternative communication (AAC) and a combination of verbal prompt and modeling was positively associated with aided AAC; and (e) modeling, verbal prompt, and a combination of modeling and verbal prompt were positively correlated with requesting function and commenting function was positively correlated with modeling and verbal prompt.

The usefulness of the Revised Psychoeducational Profile for the assessment of preschool children with pervasive developmental disorders

2009-03-04

Data from the Psychoeducational Profile—Revised (PEP—R) were analysed in a sample of 46 children, aged from 1.7 to 5.11 years, of whom 21 had autistic disorder (AD) and 25 had pervasive developmental disorder not otherwise specified (PDD-NOS). Analysis with a t-test for independent samples revealed a significant difference (p < 0.05) between children with AD and those with PDD-NOS on both developmental and behavioural PEP—R scales, supporting the utility of the PEP—R in discriminating between two diagnostic groups. This study emphasizes the effectiveness of the PEP—R as a tool for the early assessment of children with pervasive developmental disorders.

Inverse correlation between the conceptual and perceptual processing in children with autism may be due to processing bias differences in information recall

Fei Chen, — 2009-03-04

Fragile X and autism

Lathe, R. — 2009-03-04

Editorial

Bowler, D. — 2009-01-28

Electrodermal reactivity to emotion processing in adults with autistic spectrum disorders

Hubert, B.E., Wicker, B., Monfardini, E., Deruelle, C. — 2009-01-28

Although alterations of emotion processing are recognized as a core component of autism, the level at which alterations occur is still debated. Discrepant results suggest that overt assessment of emotion processing is not appropriate. In this study, skin conductance response (SCR) was used to examine covert emotional processes. Both behavioural responses and SCRs of 16 adults with an autistic spectrum disorder (ASD) were compared to those of 16 typical matched adults. Participants had to judge emotional facial expressions, the age of faces or the direction of a moving object. Although behavioural performance was similar in the two populations, individuals with an ASD exhibited lower SCRs than controls in the emotional judgement task. This suggests that such individuals may rely on different strategies due to altered autonomic processing. Furthermore, failure to produce normal physiological reactions to emotional faces may be related to social impairments in individuals with an ASD.

`Hath charms to soothe . . .': An exploratory study of how high-functioning adults with ASD experience music

Allen, R., Hill, E., Heaton, P. — 2009-01-28

Semi-structured interviews were conducted with 12 high-functioning adults on the autism spectrum, in order to examine the nature of their personal experiences of music. Consistent with the literature on typically developing people's engagement with music, the analysis showed that most participants exploit music for a wide range of purposes in the cognitive, emotional and social domains, including mood management, personal development and social inclusion. However, in contrast to typically developing people, the ASD group's descriptions of mood states reflected a greater reliance on internally focused (arousal) rather than externally focused (emotive) language.

Similarities and differences between children and adolescents with autism spectrum disorder and those with obsessive compulsive disorder: Executive functioning and repetitive behaviour

Zandt, F., Prior, M., Kyrios, M. — 2009-01-28

In order to examine hypothesized underlying neurocognitive processes in repetitive behaviour, children and adolescents (7—16 years) with autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) were compared on a range of executive function (EF) measures. Performance on neuropsychological tests assessing executive functioning showed a trend for children with ASD to perform poorly on tasks requiring generation of multiple responses, while children with OCD tended to demonstrate impairments on a task requiring inhibition. Parental ratings on a questionnaire measure of EF indicated impairments in both groups relative to controls. Relationships between questionnaire and performance measures of EF were generally weak. There was some limited support for a relationship between EF and repetitive behaviour, but effects tended to be small and variable across groups and measures.

Siblings of individuals with an autism spectrum disorder: Sibling relationships and wellbeing in adolescence and adulthood

Orsmond, G. I., Kuo, H.-Y., Seltzer, M. M. — 2009-01-28

We investigated sibling relationships and wellbeing in adolescents and adults with a sibling with an autism spectrum disorder (ASD). Adolescents engaged in more shared activities than did adults. Adolescents reported greater social support, greater use of emotion-focused coping strategies, and less use of problem-focused coping than adults. In adulthood, females with a sister with ASD reported the most positive affect in the sibling relationship and men with a sister with ASD the least. Adolescents engaged in more shared activities and reported more positive affect in their sibling relationship when their sibling with ASD had fewer behavior problems; greater use of problem-focused coping buffered the negative effects of behavior problems on sibling engagement. For adults, more shared activities were observed when the sibling with ASD was younger in age and had fewer behavior problems; greater positive affect in sibling relationships was predicted by greater parental support.

Quality of life of family caregivers of children with autism: The mother's perspective

Shu, B.-C. — 2009-01-28

The purpose of this study was to explore the relationship between the quality of life (QOL) and feeling of mothers of a child with autism. The QOL instrument was also used. A total of 104 participants completed all questionnaires, which included the Taiwan version of the WHOQOL—BREF. A final robust parsimonious structural model showed a positive correlation between the four domains of QOL. Mother's feeling was positively related to the physical and psychological domains. History of chronic disease was negatively related to mother's feeling and the physical domain. Religion was negatively correlated with the psychological and environmental domains. The study provided evidence that the WHOQOL—BREF is an adequate and appropriate instrument in the assessment of caregivers of children with autism in Taiwan. Mother's feeling, history of chronic disease and religion were related to QOL in these mothers of children with autism.

Can one hour per week of therapy lead to lasting changes in young children with autism?

Vismara, L. A., Colombi, C., Rogers, S. J. — 2009-01-28

Deficits in attention, communication, imitation, and play skills reduce opportunities for children with autism to learn from natural interactive experiences that occur throughout the day. These developmental delays are already present by the time these children reach the toddler period. The current study provided a brief 12 week, 1 hour per week, individualized parent—child education program to eight toddlers newly diagnosed with autism. Parents learned to implement naturalistic therapeutic techniques from the Early Start Denver Model, which fuses developmental- and relationship-based approaches with Applied Behavior Analysis into their ongoing family routines and parent—child play activities. Results demonstrated that parents acquired the strategies by the fifth to sixth hour and children demonstrated sustained change and growth in social communication behaviors. Findings are discussed in relation to providing parents with the necessary tools to engage, communicate with, and teach their young children with autism beginning immediately after the diagnosis.

Book review: New Developments in Autism: the future is today edited by Juan Martos Perez, Pedro M Gonzalez, Maria Llorente Comi and Carmen Nieto. London: Jessica Kingsley, 2007. ISBN 9781843104490

Russell, A. — 2009-01-28

Book review: The Complete Guide to Asperger's Syndrome by T. Attwood, London: Jessica Kingsley, 2006. ISBN 1843104954. {pound}17.99 hbk. 397

Robinson, J. — 2009-01-28

Book review: Reflections: Me and Planet Weirdo by P. Hughes, Brentwood: Chipmunkapublishing, 2007. ISBN 978--1-84747--146--8. {pound}5 ebk. 189 pp

Brooker, A. — 2009-01-28

A Response to the article on the Association between Paracetamol/Acetaminophen: Use and Autism by Stephen T. Schultz

Cox, A. R., Mcdowell, S. — 2009-01-28

Response to the Letter by Cox and McDowell: Association of Paracetamol/Acetaminophen Use and Autism

Schultz, S. T. — 2009-01-28