Showing papers in "Journal of Autism and Developmental Disorders in 1978"

Sensorimotor functioning and communication in mute autistic children.

Abstract: There were two purposes underlying this study: to describe the sensorimotor functioning of mute autistic children and to relate their sensorimotor performance to nonverbal communication. Twelve mute children, diagnosed autistic, ranging from 4 years 9 months to 12 years of age, were administered four scales of sensorimotor development from the Uzgiris and Hunt (1975) series: object permanence, gestural imitation, means for obtaining environmental events, and causality. Subjects performed most poorly on the imitation scale with 9 of 12 performing below Piaget's fifth sensorimotor stage. In contrast, performance was highest on the object permanence scale: No child scored below Stage V. Regarding the subjects' non-verbal communication, Stage V performance on the means and causality scales and Stage III on the imitation scale appeared to form minimal prerequisites for intentional communication in a variety of situations. Finally, none of the subjects, even those with relatively complete sensorimotor development, spontaneously used what Bates (1976) has called “protodeclarative” gestures to point out or show objects to adults. The absence of protodeclarative gestures may represent a qualitatively distinct pattern of prelinguistic development in certain autistic children.

Systematic recording of behaviors and skills of retarded and psychotic children.

Abstract: The design, administration, and scoring of the first edition of the Children's Handicaps, Behavior & Skills (HBS) structured interview schedule, intended to elicit information concerning mentally retarded or psychotic children, are described. A high level of reliability was achieved with experienced interviewers and good informants. In a study of 104 such children, the levels of overall agreement between parent and professional informants on the 62 sections of the schedule were, in general, 7O% or above. Agreement was better for rating absence of skills or behavioral abnormalities than for rating their presence. This tendency was particularly marked for the behavioral abnormalities. Parents, when compared with professional workers, tended to describe their children as having higher developmental skills, more social contact but also more repetitive and difficult behavior.

Prevalence of self-injurious behaviors in a large state facility for the retarded: a three-year follow-up study.

Abstract: A combined informant questionnaire and interview survey of self-injurious behavior (SIB) at a large state facility for the retarded was conducted independently three times over a 3-year period. Prevalence consistently was about 10% of the population. SIB cases tended to be younger and institutionalized longer than the rest of the population. Severe cases had a longer history of chronic SIB. SIB cases had more seizure disorders, severe language handicaps, visual impairments, and severe or profound retardation than the rest of the population. They appeared to fulfill most of the Rutter (1966) criteria for autism. But unlike the severely autistic, there was little relation of sex to incidence of SIB. Over 90% of SIB cases changed status over 3 years, suggesting that SIB was amenable to behavior modification in most cases (94%). Psychotropic behavior control medications helped in some intervention programs (52%). SIB remitted spontaneously in 27% of SIB cases where there had been no behavioral or drug intervention.

Cerebral asymmetry and the development of early infantile autism.

Abstract: Two experiments involving listening preferences of autistic and normal subjects were conducted to test the hypothesis that the right cerebral hemisphere is more active than the left hemisphere in autistic children. Results showed that when given a choice between verbal and musical material, the autistic children preferred music, while normal children showed no preference. Secondly, autistic children listened to both types of material predominantly with the left ear. Although normal subjects showed greater variation among themselves, they tended to listen to music more often with the left ear and to listen to verbal material more often with the right. These results support the notion that some autistic children are predominantly right-hemisphere processors.

Behavior, language, and development in three-year-old children.

Abstract: An epidemiological study of 3-year-old children showed there to be a marked association between behavior problems and language delay. Behavior problems were present in 14% of a random sample of 705 children, whereas 59% of 22 children with language delay had such problems. Data obtained from a battery of developmental tests were analyzed to examine the differences between children with behavior problems, matched controls, and children with language delay. It was found that children with behavior problems scored significantly lower on these tests, particularly those concerned with language. There were no significant differences in test scores between children with language delay only and those with combined behavior problems and language delay.

Course and Prognosis of Childhood Schizophrenia.

Abstract: Follow-up data on 57 schizophrenic patients, including 25 boys and 32 girls between the ages of 7 and 13, is reported. Average length of follow-up was 15 years. Symptoms found in children under 10 and in prepubertal cases are described. Cases with acute, relapsing episodes occurred more often than chronic cases, but before age 11 acute cases were less frequent. Twenty percent of the patients recovered completely, 30% reached a relatively good social adjustment, and 50% had moderate or poor remission. Family incidence of psychiatric disorders had no influence on prognosis, nor did unfavorable family environment. Premorbid personality development was, however, found to be of prognostic value. Prodromal episodes occurred in 55% of the cases, and 65% of the patients were preoccupied by death. Additional follow-up findings are presented, and problems of diagnosis are discussed.

Evidence from auditory nerve and brainstem evoked responses for an organic brain lesion in children with autistic traits.

Abstract: In an attempt to resolve the question as to whether children with autistic traits have an organic nervous system lesion, auditory nerve and brainstem evoked responses were recorded in a group of 15 children with autistic traits. The most obvious results included a longer response latency of the auditory nerve and a longer brainstem transmission time, compared to normal children. Five of the autistic children were found to be profoundly deaf. These results strengthen the theory that an organic lesion of the nervous system can give rise to autistic traits.

Autistic symptoms in a child with congenital cytomegalovirus infection.

Abstract: A case of intrauterine cytomegalovirus infection with onset of autistic symptoms apparently after 6 months of age is reported. Physicians who find autistic symptoms in very young children might include cytomegalovirus in their differential to document the presence or absence of a correlation.

Development of communicative behavior in autistic children: a parent program using manual signs.

Abstract: Mothers of four 6- and 7-year-old autistic classmates were taught to use manual signs with verbalizations to aid development of appropriate communicative behavior and to deter undesirable behavior in their children. The experimental treatment was initiated in a daily mother-child laboratory session using a multiple-baseline design across subjects. The preschool classroom program remained unchanged. Data were recorded for each child daily over a 5-week period, in the classroom and in a mother-child session, on four types of communicative behavior and four types of inappropriate behavior. Communicative behaviors increased and inappropriate behaviors decreased in relation to baseline conditions for each child. The manual sign program facilitated generalization of communicative behavior to the child's total environment. Desirable behaviors were maintained and had improved in the classroom 3 months after initiation of the program.

A Simultaneous Comparison of Three Methods for Language Training with an Autistic Child: An Experimental Single Case Analysis.

Abstract: In a single-case, simultaneous-treatment design, three methods for experimental language acquisition in one autistic child were compared using a Latin square design and trend-line analysis. Results showed a total communication approach to be significantly superior to sign-based and verbalization approaches. The verbalization treatment resulted in decreased performance. Results indicate that use of a cross-modality inhibitory process to explain the alleged superiority of the sign-based approach is questionable. Variation among autistic children indicates a need for further research and for caution against premature acceptance of a given treatment approach or theoretical explanation.

Handedness in autistics, retardates, and normals of a wide age range

Abstract: Tests of handedness were carried out with 34 autistic children aged from 4 years 10 months to 18 years 11 months, and with sex-, age-, and IQ-matched retardates and sex- and age-matched normals. There were no significant differences between the groups on frequency of handedness, degree of righthand usage, or degree of dominant-hand usage. There was however a significant increase in the variance of dominant-hand usage from normals and retardates to autistics. These results were taken to indicate that earlier reports of handedness differences in young autistic children may reflect a developmental lag rather than a specific etiology of autism. Some support for this hypothesis was found from a comparison of age-trends between the groups. The relationship of such a developmental delay to the etiology of autism was discussed.

Using self-stimulation as reinforcement for autistic children

Abstract: This experiment examined the effects of using self-stimulatory behavior as reinforcement for spontaneous appropriate sentences in two autistic children. The children were put on a token system and always received one token for every spontaneous appropriate sentence they made. An ABABA design was employed. In condition A, the opportunity to self-stimulate was contingent on the payment of tokens (two tokens for 2 minutes of self-stimulation). In condition B, no tokens were required for self-stimulation. The results showed that both subjects exhibited a much higher rate of spontaneous appropriate sentences during the contingent self-stimulation (A) condition, demonstrating that self-stimulation functioned as an effective reinforcement. The possibility of using self-stimulation as reinforcement in the treatment of autistic children is discussed.

Pantomimic Representation in Psychotic Children.

Abstract: Previous research suggests that verbal deficits among psychotic children may be paralleled by deficits in nonverbal pantomime. However, certain questions such as the level of pantomime exhibited by psychotic children, its susceptibility to modification, and its relation to other symbolic functions have not been systematically examined. To investigate these issues, 24 psychotic children were required to represent absent objects (e.g., toothbrush) via pantomime after receiving verbal instructions or instructions accompanied by a model demonstrating the pantomime. Also, measures of receptive and expressive speech, human figure drawings, and pretend play were obtained. The findings indicated very few complete failures in pantomime; higher pantomime performance when a model was provided although even in this condition most responses consisted of low-level substitutions of a body part in place of the absent object; and significant relationships between pantomime and measures of receptive vocabulary, echolalia, drawing, and play. The relationship of the findings to symbolic functioning in normal children and their relevance to understanding symbolic deficits in psychotic children are discussed.

Disruptive behavior: a dietary approach.

Abstract: The effect of particular foods on levels of hyperactivity, uncontrolled laughter, and disruptive behaviors was studied in an 8-year-old autistic boy. The floor of the child's room was taped off into six equal-sized rectangles to measure general activity level. Frequency data were recorded on screaming, biting, scratching, and object throwing. A time-sample technique was used to record data on laughing. Data were gathered during four phases. During an initial 4-day period the child was fed a normal American diet. A 6-day fasting period followed, during which time only spring water was allowed. The third phase lasted 18 days and involved the presentation of individual foods. During the final phase of the study the child was given only foods that had not provoked a reaction in the third phase. Results showed that foods such as wheat, corn, tomatoes, sugar, mushrooms, and dairy products were instrumental in producing behavioral disorders with this child.

Plasma zinc, copper, and amino acid levels in the blood of autistic children.

Abstract: Plasma zinc, copper, and amino acid levels have been measured in a group of autistic children. All three variables were found to be normal. These findings are in disagreement with the previously reported results of some other workers but if confirmed would indicate that autism cannot simply be attributed to a disorder of zinc metabolism.

A controlled crossover study of triiodothyronine in autistic children

Abstract: A placebo-controlled crossover study of behavioral effects of triiodothyronine (T3) was conducted in 30 young clinically euthyroid autistic children. Multiple independent raters and multiple rating scales were used. Except for a few symptoms that were reduced on T3, the drug did not differ from placebo. Time itself accounted for most of the improvement in the whole sample. As a group, the lower IQ children responded to T3. The individual children who were responders could not be defined by any parameter.

Psychotic Behavior in Children Under the Institutions for the Mentally Retarded in Denmark.

Abstract: The purpose of this research project was to identify children with psychotic behavior in the Institutions for the Mentally Retarded in Denmark and to analyze psychotic behavior. The subjects for study were 392 children, partly selected as a representative sample, partly selected as a sample of children with psychotic behavior. A combined observation and interview scheme was constructed containing 17 behavioral items and 6 developmental scales. Scoring systems for psychotic behavior were constructed and their consistency analyzed by the Rasch item-analysis model. Two major behavioral dimensions, “bizarre behavior” and “psychotic withdrawal,” were used for the diagnostic grouping of the subjects. The distributions of the children in regard to developmental retardation, organic brain damage, and psychiatric diagnoses were investigated. Conclusions regarding guidelines for reorganization of present services and establishment of new services are proposed.

The Effect of Environmental Stimulation upon the Stereotyped Behavior of Autistic Children.

Abstract: Two groups of three autistic children, equated for chronological age but differing in IQ and performance MA, were observed for 20-minute sessions. Total duration of time subjects engaged in stereotyped behavior was recorded for each minute. During minutes 6--15, subjects were provided with either minimal or high environmental stimulation. High environmental stimulation was found to increase the mean duration of time the low-IQ group engaged in stereotyped behavior but to decrease the duration for the high-IQ group. The theoretical implications are discussed.

Hormonal and cardiac response of autistic children to changes in environmental stimulation.

Abstract: A study was made of physiological responses of autistic children to variations in environmental load in order to examine the under- versus over-arousal dichotomy. More specifically, measures of urinary mucoprotein excretion and mean heart rate and three measures of heart rate variability were compared with matched controls in conditions of normal, high, and low total environmental load. The results suggest that, although behaviorally unresponsive, the autistic children responded physiologically, were generally in a lower state of arousal than the control group, and were labile in response to changes in stimulation.

Suppression of repetitive self-injurious behavior by contingent inhalation of aromatic ammonia.

Abstract: Two institutionalized children who exhibited high rates of severely self-injurious behaviors were punished with aromatic ammonia inhalation on a response-contingent basis. This contingency was applied throughout all aspects of each child's institutional program which focused on teaching of self-help skills. Suppression of the self-injurious responses was both rapid and general. The contingency was maintained for 2 months, although there was no responding after the first 5 days. Follow-up sessions, conducted 4 months after the punishment contingency was removed, revealed that suppression effects were highly durable. Aromatic ammonia inhalation appears to be an effective alternative for decelerating extremely maladaptive behaviors that do not yield to more conventional nonaversive forms of therapy. However, the procedure should be used with great caution, for it may involve risk to the subject.

Paired associate learning in early infantile autism and receptive developmental aphasia.

Abstract: A comparative study of nonverbal MA matched groups of five autistic, five aphasic, five normal and five retarded children was made on an auditory-visual and a visual-visual paired-associate learning task. The results showed that, although the autistic and receptive aphasic children were both unable to associate sounds with their visual counterparts at the same rate as normal children, the aphasic children overcame this deficit at a significantly faster rate than autistic children. This study pinpoints one dysfunction that could subsume the severe verbal comprehension defect in autistic and aphasic children.

Triiodothyronine (T3) concentration and therapy in autistic children.

Abstract: The clinical and biochemical status of thyroid function of patients with an autistic syndrome was investigated. The study consisted of 13 patients between the ages of 7 and 21 years. There was no clinical evidence for hypothyroidism in any patient, and T3, T4, and TSH concentrations were within the normal range. Two patients who had retarded bone ages were treated with triiodothyronine for 6 months. Hyperthyroidism developed when T3 levels exceeded physiologic concentrations in these patients. The concept that the clinical response to triiodothyronine in autistic patients results from correction of thyroid dysfunction is not supported by these findings.

Newborn Minor Physical Anomalies and Prediction of Infant Behavior.

Abstract: The relationship between a newborn score of minor physical anomalies (MPAs) and behavior at ages 1 and 2 was examined. From an initial screening population of 933, 63 high anomaly and 78 low anomaly infants were followed until age 2 by examiners blind for the newborn anomaly score. High anomaly infants were more likely to be temperamentally difficult as rated by parent interview and direct observation. A subgroup of six infants who were considered irritable at both ages 1 and 2 were all from the high anomaly group. However, there was little agreement between behavioral ratings across situations and over time, and there were no significant predictors of behavior problems at age 2 based on any newborn or 1-year measure. These results indicate that the newborn anomaly score by itself is unlikely to prove clinically useful in predicting preschool behavior problems for an unselected population. The usefulness of this measure for other, “high-risk,” populations remains to be explored.

Effects of L-5-hydroxytryptophan in autistic children.

Abstract: Behavioral effects of L-5-Hydroxytryptophan (L-5-HTP), administered in combination with carbidopa, were evaluated in three autistic children using direct behavioral observation and parent ratings. Children were assessed under each of four experimental conditions: Baseline, Placebo I, L-5-HTP plus carbidopa, and Placebo II. During the 20-week study two children showed behavioral change that appeared to be unrelated to drug treatment. The findings did not support the hypothesis that a functional deficit in brain 5-HT underlies the autistic syndrome.

Plasma dopamine-beta-hydroxylase in childhood psychosis.

Abstract: A previous report suggested that plasma dopamine-β-hydroxylase (DBH) is elevated in childhood autism. We measured plasma DBH in 15 children with functional psychosis and in 10 psychotic children with known organic etiology. DBH activity was significantly elevated in the children with functional psychoses and showed a significant correlation with age that is not reported for this age range in normals. It is possible that children with functional psychoses show an abnormal continuation of the rise in plasma DBH activity characteristic of infancy. No differences between children with functional psychoses and children with organic psychoses were found for red blood cell catechol-O-methyl-transferase, plasma monoamine oxidase, or plasma cyclic AMP.

The development of pronoun usage in the psychotic child

Abstract: Twenty-three psychotic children ranging in age from 5 to 16 were interviewed in half-hour play sessions. The play session comprised three activities designed to elicit statements using the pronouns I, you, and he to express the concepts of possession, action, and description. It was hypothesized that psychotic children would use the third-person pronoun he more readily than the first-person pronoun I (Hypothesis I), and that possession, action, and description statements would develop in an orderly sequence as predicted by Bosch (1962/1970) (Hypothesis II). Hypothesis I was not confirmed: Some of the least advanced psychotic children used the pronoun I, and only the most advanced children used you and he. Hypothesis II was confirmed: the least advanced children used pronouns correctly in statements expressing the concept of possession, whereas the most advanced children had mastered all three contexts of pronoun use. These results have implications for language therapy, and they are concordant with the language theories of Piaget and Werner and Kaplan.

The cognitive--affective dilemma in early infantile autism: the case of Clarence.

Abstract: This case study presents long-term follow-up data on Clarence, one of Kanner's original cases of infantile autism. Clarence's attempts to establish a heterosexual relationship and his plans for marriage are described. His success is attributed in part to therapeutic intervention, which was directed at promoting affective responsiveness in the patient. The case of Clarence is seen as lending support to the thesis of DesLauriers and Carlson (1969), who maintain that the core problem in infantile autism is a disturbance of affective contact.