The quantity and quality of research into autism and related conditions have increased dramatically in recent years. Consequently we selectively review key accomplishments and highlight directions for future research. More consistent approaches to diagnosis and more rigorous assessment methods have significantly advanced research, although the boundaries of the 'broader phenotype' remain to be defined and the validity of Asperger's disorder as a discrete syndrome remains controversial. Recent epidemiological studies have shown that Autism Spectrum Disorders are common, but there continues to be debate about the causes of the increase in the frequency with which autism is diagnosed. Psychological research has helped to develop new developmental models for the disorder and there have also been significant advances in the molecular genetics of autism and understanding of the underlying neurobiological processes. Areas important for future research include the study of autism as it first develops, i.e., in infants and very young children, and of specific processes (psychological and neurobiological) which underlie the disorder. Significant challenges lie ahead in evaluating the growing number of treatments for autism and in integrating the results of research into treatment and educational settings.

Autism and Pervasive Developmental Disorders

This study evaluated Mind Reading, an interactive systematic guide to emotions, for its effectiveness in teaching adults with Asperger syndrome ~AS! and high-functioning autism ~HFA! to recognize complex emotions in faces and voices. Experiment 1 tested a group of adults diagnosed with AS0HFA ~n 19! who used the software at home for 10–15 weeks. Participants were tested on recognition of faces and voices at three different levels of generalization. A matched control group of adults with AS0HFA ~n 22! were assessed without any intervention. In addition, a third group of general population controls ~n 24! was tested. Experiment 2 repeated the design of Experiment 1 with a group of adults with AS0HFA who used the software at home and met in a group with a tutor on a weekly basis. They were matched to a control group of adults with AS0HFA attending social skills training and to a general population control group ~n 13 for all three groups!. In both experiments the intervention group improved significantly more than the control group on close, but not distant, generalization tasks. Verbal IQ had significant effects in Experiment 2. Using Mind Reading for a relatively short period of time allows users to learn to recognize a variety of complex emotions and mental states. However, additional methods are required to enhance generalization.

/pdf/systemizing-empathy-teaching-adults-with-asperger-syndrome-3qjc73ugt0.pdf

Systemizing empathy: Teaching adults with Asperger syndrome or high-functioning autism to recognize complex emotions using interactive multimedia

Objective: To review the current knowledge on neurobiological aspects of autism and pervasive developmental disorders, as well as to provide pediatricians with up to date information on diagnosis and treatment of autism. Sources of data: Review of MEDLINE and Internet. Summary of the findings: Autism is the 3rd developmental disorder, with an incidence of 40 to 130/100,000 individuals. Diagnosis is based on clinical findings, following DSM IV criteria. Neuroimaging, investigation of fetal neurological status, and genetic investigation contribute towards a better understanding of the neurobiology of autism. Conclusion: Pediatricians are the first health professional to come in contact with patients with autism. Thus, they should be able to diagnose and to coordinate the multidisciplinary treatment of these patients.

http://jped.com.br/conteudo/04-80-s83/ing.pdf

Autism and pervasive developmental disorders

Background: People with autism experience profound and pervasive difficulties in the social domain. Attempts to teach social behaviours tend to adopt either a behavioural or a ‘theory of mind’ (ToM) approach. The beneficial aspects and limitations of both paradigms are summarized before an examination of how virtual reality technology may offer a way to combine the strengths from both approaches. Methods: This is not an exhaustive review of the literature; rather, the papers are chosen as representative of the current understanding within each broad topic. Web of Science ISI, EMBASE and PsycInfo were searched for relevant articles. Results: Behavioural and ToM approaches to social skills training achieve some success in improving specific skills or understanding. However, the failure to generalize learned behaviours to novel environments, and the unwieldy nature of some behavioural methodologies, means that there is a need for a training package that is easy to administer and successful in promoting learning across contexts. Conclusions: Virtual reality technology may be an ideal tool for allowing participants to practise behaviours in role-play situations, whilst also providing a safe environment for rule learning and repetition of tasks. Role-play within virtual environments could promote the mental simulation of social events, potentially allowing a greater insight into minds. Practice of behaviours, both within and across contexts, could also encourage a more flexible approach to social problem solving. Virtual environments offer a new and exciting perspective on social skills training for people with autistic spectrum disorders.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2788.2002.00425.x

The potential of virtual reality in social skills training for people with autistic spectrum disorders

This article reports the results of a meta-analysis of technology-based intervention studies for children with autism spectrum disorders. We conducted a systematic review of research that used a pre-post design to assess innovative technology interventions, including computer programs, virtual reality, and robotics. The selected studies provided interventions via a desktop computer, interactive DVD, shared active surface, and virtual reality. None employed robotics. The results provide evidence for the overall effectiveness of technology-based training. The overall mean effect size for posttests of controlled studies of children with autism spectrum disorders who received technology-based interventions was significantly different from zero and approached the medium magnitude, d = 0.47 (confidence interval: 0.08-0.86). The influence of age and IQ was not significant. Differences in training procedures are discussed in the light of the negative correlation that was found between the intervention durations and the studies' effect sizes. The results of this meta-analysis provide support for the continuing development, evaluation, and clinical usage of technology-based intervention for individuals with autism spectrum disorders.

Innovative technology-based interventions for autism spectrum disorders: A meta-analysis

Children with autism have difficulty in solving social problems and in generating multiple solutions to problems. They are, however, relatively skilled in responding to visual cues such as pictures and animations. Eight distinct social problems were presented on a computer, along with a choice of possible solutions, and an option to produce alternative solutions. Eight preschool children with autism and eight matched normal children went through 10 training sessions interleaved with 6 probe sessions. Children were asked to provide solutions to animated problem scenes in all the sessions. Unlike the probe sessions, in the training sessions problem solutions were first explained thoroughly by the trainer. Subsequently these explanations were illustrated using dynamic animations of the solutions. Although children with autism produced significantly fewer alternative solutions compared to their normal peers, a steady increase across probe sessions was observed for the autistic group. The frequency of new ideas was directly predicted by the diagnostic category of autism. Results suggest young children with autism and their normal peers can be taught problem-solving strategies with the aid of computer interfaces. More research is required to establish whether such computer-assisted instruction will generalize to nontrained problem situations in real-life contexts.

/pdf/enhancing-social-problem-solving-in-children-with-autism-and-48ocujcmfu.pdf

Enhancing social problem solving in children with autism and normal children through computer-assisted instruction.

This research examined whether children with autism could be trained to improve their conversational skills and whether this led to changes in standard tests of theory of mind (ToM). Three high-functioning children with autism participated in a multiple baseline across participants design. The children were taught how to initiate a conversation, take turns during conversation, listen attentively, maintain a conversation topic, and change a conversation topic appropriately. The children were tested for ToM using False Belief tasks before and after training sessions. Results indicate that the amount of shared interest exhibited by the children with autism during conversation with their caregivers increased during training sessions. The children also made more responses that were appropriate to the context of the conversation. Performance on the False Belief tasks remained constant throughout the study. Results are discussed with respect to the implications of results of performance in standard ToM tasks.

/pdf/teaching-conversational-skills-to-children-with-autism-2ab6m7bx56.pdf

Teaching Conversational Skills to Children with Autism: Effect on the Development of a Theory of Mind.

This study compared the effect of structured play (SP) and facilitated play (FP) in promoting spontaneity and responsiveness in communication and play behaviors in children with autism. SP is characterized by the use of mass practice trials under the instruction of the experimenter while FP incorporated incidental teaching with multiple exemplars. Eight preschoolers participated in a crossover design of both play conditions. Gains in appropriate communication and play were observed across both treatments. Respondent communicative acts occurred more frequently across all participants during SP compared with FP. The preliminary results indicate an interaction between the mental age of the child and the teaching paradigm used. The need to match treatment goals and specific methods of the play intervention to the skill profile of participants is discussed.

A Comparison of the Effects of Structured Play and Facilitated Play Approaches on Preschoolers with Autism A Case Study

This experiment compared the effect of computerized visual feedback (computer assisted instruction) with traditional play interaction (personal instruction) in promoting vocal imitation in children with autism. Ten non-verbal children with autism participated in ten sessions. Each session was composed of four sections: a parent and a trainer interacted with the child on the computer or using play interactions. The study was conducted as a simultaneous treatment design and the sequence of experimental conditions was randomized across sessions. Participants showed significantly greater vocal imitations in the computer assisted instruction condition, compared with the personal instruction condition. This trend was present in nine out of ten children. Vocal imitations increased across the sessions, with greater increments in the computer assisted instruction condition. These effects were consistent across both parent and trainer.

/pdf/enhancing-vocal-imitations-in-children-with-autism-using-the-31w58s4qdr.pdf

Enhancing Vocal Imitations in Children with Autism Using the IBM Speech Viewer

The article reports the results of a pilot study comparing traditional behavioural approaches and natural play interventions for young children with autism over a 10 week period. Two matched groups of eight young children with autism participated. Using a crossover design, children in both groups showed positive gains in compliance, attending, play and communication with their therapists and parents. Improvements in attending and compliance were higher following the behavioural condition compared with the natural play condition. Seven participants had reduced autism scores after the intervention. The findings suggest that behavioural and play approaches affect behaviour in different ways and that autistic symptomatology of young children may be amenable to treatment. The discussion focuses on the active ingredients of treatments and the need to base efficacy research on well-planned treatment comparisons.

http://journals.sagepub.com/doi/pdf/10.1177/1362361304045212

Vera Bernard-Opitz

Papers

Enhancing social problem solving in children with autism and normal children through computer-assisted instruction.

Teaching Conversational Skills to Children with Autism: Effect on the Development of a Theory of Mind.

A Comparison of the Effects of Structured Play and Facilitated Play Approaches on Preschoolers with Autism A Case Study

Enhancing Vocal Imitations in Children with Autism Using the IBM Speech Viewer

Comparison of Behavioural and Natural Play Interventions for Young Children with Autism