Massimiliano Petrillo

Bio: Massimiliano Petrillo is an academic researcher. The author has contributed to research in topics: Autism spectrum disorder & Autism. The author has an hindex of 7, co-authored 14 publications receiving 95 citations.

Parent-Reported Behavioural Changes in Children With Autism Spectrum Disorder During the COVID-19 Lockdown in Italy

Abstract: Autism Spectrum Disorders (ASD) are characterized by impairments in social interaction and reciprocal communication. During a pandemic, when social distancing becomes mandatory for all, both parents and children are not supported in-person by their therapists and cannot participate in usual therapies. This study reports the main clinical changes experienced by parents of children with during the first month of lockdown during the COVID-19 pandemic in Italy. Using standardized questionnaires, the families of 63 ASD children were interviewed in February and April 2020. Findings showed an increase in restricted and repetitive behaviours in about 30% of the sample; also, motor restlessness and sleep disturbances increased, with greater irritability and mood dysregulation. On the other hand, no changes emerged in personal self-care autonomies, in taste/smell sensitivity, and in auto or other-directed aggression. Despite the undeniable negative impact that lockdown can have on the psychosocial well-being of children, having maintained a continuity in supporting families, parental counselling (even if online and not in-person) helped families to redefine the meanings of behavioural changes of their children and to understand their adaptive functionality.

Assessment of a Long-Term Developmental Relationship-Based Approach in Children with Autism Spectrum Disorder:

Abstract: 90 Italian children (72 boys, 18 girls) with a diagnosis of infantile autism (age range = 2.5-16.5 yr.) were assessed with a non-verbal intelligence test (Leiter-R). The test was repeated 3 times in four years. The measures used were IQ and Fluid Reasoning (FR), as evaluation of inductive and deductive reasoning, and the Autism Diagnostic Observation Schedule (ADOS), indicative of the severity of autistic symptoms at the beginning and at the end of therapy. The increase in the average IQ and FR scores at retests demonstrates the effectiveness of a treatment that emphasizes the centrality of the relationship-based approach. Moreover, the FR score at intake was predictive of a significant decrease of ADOS scores after four years of treatment, and of the increase in IQ observed in later evaluations. The data support the hypothesis that a relationship-based intervention allows cognitive improvement regardless of the autism severity expressed in the ADOS score.

From the Emotional Integration to the Cognitive Construction: The Developmental Approach of Turtle Project in Children with Autism Spectrum Disorder

Abstract: Background: Children with autism spectrum disorder show a deficit in neurobiological processes. This deficit hinders the development of intentional behavior and appropriate problem-solving, leading the child to implement repetitive and stereotyped behaviors and to have difficulties in reciprocal interactions, empathy and in the development of a theory of mind. The objective of this research is to verify the effectiveness of a relationship-based approach on the positive evolution of autistic symptoms. Method: A sample of 80 children with autism spectrum disorder was monitored during the first four years of therapy, through a clinical diagnostic assessment at the time of intake and then in two follow-up. Results: The results showed that through the Autism Diagnostic Observation Schedule it is possible to assess the socio-relational key elements on which the therapy is based. There was evidence, in fact, of significant improvements after two and four years of therapy, both for children with severe autistic symptoms and for those in autistic spectrum. Conclusions: Socio-relational aspects represent the primary element on which work in therapy with autistic children and can be considered as indicators of a positive evolution and prognosis that will produce improvements even in the cognitive area.

Parental Attunement, Insightfulness, and Acceptance of Child Diagnosis in Parents of Children With Autism: Clinical Implications

Abstract: Early parent-child relationships are an important factor influencing many domains of child development, even in the presence of autism. In this study, we investigated the associations between parent-child attunement during play, parental insightfulness, and parental acceptance of their child's diagnosis of an autism spectrum disorder. A sample of 50 parents (26 mothers and 24 fathers) of 26 children aged between 24 and 58 months were videotaped during parent-child play interactions and then interviewed about what they thought had gone through their child's head during the play interaction, and about their feelings and thoughts about their child's diagnosis. Play interactions were evaluated using a coding protocol to assess parental attunement. The results showed that parents who were more able to accept their child's diagnosis and to see things from their child's perspective were more likely to also be attuned during play interactions with their children. These findings highlight the importance of studying the parental ability of insightfulness and acceptance of their child diagnosis of ASD for the implementation of intervention programs for supporting parental attunement and improving the interactions between the parents and the children with autism spectrum disorders.

Sensory Processing and Repetitive Behaviors in Clinical Assessment ofPreschool Children with Autism Spectrum Disorder

Abstract: Autism is a neurodevelopmental disorder characterized by impairments in social communication and presence of restricted and repetitive patterns of behavior and interests, including abnormal reactions to sensory stimuli. Atypical responses to sensory input are increasingly recognized as a common feature of ASDs. In addition to repetitive patterns of behavior, the inclusion of sensory aspects in the diagnosis of autism in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is evidence of the prevalence of sensory dysfunctions in this population. There are several tools investigating these areas, mostly rating scales that, far from wishing to replace other methods, allow a better understanding of the alterations presents and help in defining clinical picture and individual trajectory so improving diagnosis and intervention. The purpose of this study was to investigate the relation between sensory and repetitive behavioral characteristics of a sample of 50 preschool children with ASD measured with the Short Sensory Profile and the Repetitive Behavior Scales-Revised. Results are consistent with previous researches describing the co-occurrence of repetitive behaviors and sensory response abnormalities in the ASD population. We found evidence to support that the most frequently dysfunctional sensory areas in ASD children regard tactile hypersensitivity, auditory filtering, hyporeactivity and low energy/weak; while among repetitive behaviors the most common are those stereotyped. Furthermore it emerged that direct assessment with ADOS-2, a gold standard test for ASDs, and indirect assessment with questionnaires converged on the same profiles, so suggesting the usefulness to hold together both ecological and structured observations.

Affect Dysregulation and Disorders of the Self

Abstract: Allan Schore has for some 15 years written about the processes underlying affect regulation in normal and abnormal self-development and attachment His best known book entitled Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, published in 1994, was the first coherent attempt to integrate the then recent findings of neurobiology with clinical observations in children and adults and brought down barriers that had impeded the understanding of the self and its disorders In the present volume, Schore incorporates the vast amount of data from neurosciences since 1994 and presents the reader with a truly compelling theoretical synthesis of this literature In part I, there are 4 chapters on developmental affective neuroscience They deal with the contribution experience expectant vs experience dependent phenomena make to the development of affect regulation The former are primarily gene dependent (eg, the CNS of a newborn is equipped to function well in infants who live within a reasonably safe environment and are exposed to gradual rather than violent changes) while the latter are dependent on the care taking practices the child is exposed to One example cited is the affective transmissions in mutual gaze transactions between infants and their mothers These affective parental responses are the first means by which mothers can provide a model of affect modulation to their infants (eg, mother senses when her baby is becoming overstimulated and will respond by decreasing her own stimulation, leading to calming the infant) Such soothing behaviors will secondarily effect the maturation of the orbitofrontal cortex and strengthen its regulatory abilities Attachment behavior is likewise based on the reciprocal activation of the couple’s endogenous opiate systems but also regulates the dopamine levels in the infant’s brain Schore brings these and other interdisciplinary findings together by citing the available evidence and at times even presenting colored PET or fMRI scans to make his point In part II, 5 chapters deal with developmental neuropsychiatric data and their relevance on development of the right brain, secure attachment relationships and on symptoms of PTSD, borderline and antisocial personality disorders Here again, Schore cites studies that explain important psychological processes through neuropsychiatric data For example, he cites evidence that in the context of face-to-face interactions, mothers trigger production of corticotropin releasing factor (CRF) in their infants The CRF, in turn raises the concentration of noradrenaline, increasing general energy metabolism but also controls endorphin and ACTH production, leading to an elated state in the infant When it comes to PTSD and other well-defined psychiatric disorders, the overall picture becomes more complicated For example, Schore claims that PTSD is related to the inability of the right prefrontal cortex to sufficiently modulate amygdala (ie, aggressive) functions The fact that this also occurs in children with a disorganized disoriented insecure attachment pattern is then seen as proof that this particular early maternal caretaking pattern contributes to later dissociative psychopathology One could counter that proposition by pointing out that elevated cortisol levels are important for overall stress management – but that prenatally elevated levels, especially in the third trimester of pregnancy, have been found to be especially pathogenic as they effect the developing brain at its most critical time However, high cortisol levels can be caused by a variety of conditions Intra-uterine growth retardation (IUGR) is a common condition associated in children born with ‘small gestational age’ (SGA) It is innately stressful for the infant, hence associated with elevated prenatal cortisol levels that are not associated to later maternal attachment patterns Aggressive behavior disorders are also described as a consequence of a right brain system impaired for regulating aggressive affective states Here it is said to be the low arousal state characteristic for antisocial and aggressive individuals that such individuals try to increase back to optimal or normal levels by seeking stimulation While this may be one pathway leading to aggressive behavior disorders, there are authors such as Tremblay and colleagues in Montreal who claim that all young children are highly aggressive and must “unlearn” this behavior in the process of development Those who do not or cannot do so will make up our clinical population In summary, the present volume of Allan Schore provides the reader with a provocative and stimulating theoretical synthesis of multi-disciplinary work that relates affect regulation to the development of the self and its deviations Schore’s writing style is almost poetic and transforms potentially dry data into an exciting story of discovery and multidisciplinary dependency He also suggests, at least indirectly, preventive measures that can address the problem of violence and other dysfunctions of the developing self in children through optimal early social-emotional experiences I highly recommend this volume to researchers and clinicians

The neurobiology of autism.

Abstract: Although the primary cause of autism has not yet been unravelled, a number of genetic conditions have been strongly associated with the behavioural triad of autism. We briefly review the underlying neuropathological, biological and genetic evidence of the possible mechanisms involved in autism. This knowledge should guide accurate investigation of the autistic individual and genetic counselling of parents and family members.

Normality and pathology in childhood—assessments of development

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