Showing papers on "Autism published in 1993"

Long-term outcome for children with autism who received early intensive behavioral treatment.

Abstract: After a very intensive behavioral intervention, an experimental group of 19 preschool-age children with autism achieved less restrictive school placements and higher IQs than did a control group of 19 similar children by age (Lovaas, 1987). The present study followed-up this finding by assessing subjects at a mean age of 11.5 years. Results showed that the experimental group preserved its gains over the control group. The 9 experimental subjects who had achieved the best outcomes at age 7 received particularly extensive evaluations indicating that 8 of them were indistinguishable from average children on tests of intelligence and adaptive behavior. Thus, behavioral treatment may produce long-lasting and significant gains for many young children with autism.

The epidemiology of Asperger syndrome. A total population study

Abstract: This paper describes a total population study of Asperger syndrome using a two-stage procedure. All school children in an outer Goteborg borough were screened. Final case selection based on clinical work-up showed a minimum prevalence of 3.6 per 1.000 children (7-16 years of age) using Gillberg and Gillberg's criteria and a male to female ratio of 4:1. Including suspected and possible Asperger syndrome cases, the prevalence rose to 7.1 per 1.000 children and the male:female ratio dropped to 2.3:1. These findings are discussed as they relate to previously published results in the field and to findings obtained using Szatmari et al.'s and ICD-10 draft criteria for the disorder.

Social Stories: Improving Responses of Students with Autism with Accurate Social Information:

Abstract: Cincinnati, Ohio A student with autism was asked what makes his teacher laugh. He responded, &dquo;Boy, I don’t even know that. I guess I’ll never know about that.&dquo; The social impairment associated with autism is reflected in his answer, as it is in the many behaviors associated with this complex disorder. To further understand the social behavior of persons with autism, researchers have focused on social cognition -the cognitive skills required for social interaction. This area of research has dismissed some longheld beliefs, while piecing together a new understanding of the social and behavioral challenges facing persons with autism. Social cognition research helps to explain the effectiveness of a new approach to teaching social behavior that centers around social stories. Social stories are short stories that describe social situations in terms of relevant social cues and often define

Autistic children's difficulty with mental disengagement from an object: Its implications for theories of autism.

Abstract: Experiment 1 demonstrated that autistic Ss continue to fail a task originally designed as one of strategic deception when there is no opponent present: They perseveratively indicate the target object. We argue that this behavior is better explained in terms of failing to disengage from an object than in terms of a theory-of-mind deficit. To ensure that their difficulties were not due to failure to construe the task in a competitive manner, we ran a 2nd study, on detour reaching. Compared with control Ss, the autistic Ss had great difficulty with the task. We discuss autistic children's difficulties with these 2 tasks in the light of recent evidence that autism is associated with failing executive tasks and argue that viewing the syndrome as an executive deficit has clear advantages

Executive function and social communication deficits in young autistic children.

Abstract: Preschool-aged, autistic children were compared with both developmentally delayed children of similar non-verbal mental age and normally developing children of similar verbal skill on measures of executive function and social communication skills. Autistic children exhibited significantly more perseverative responses on a test of executive function when compared to both comparison groups. Autistic children also exhibited significantly fewer joint attention and social interaction behaviors. Moreover, a significant relationship was found between executive function skill and the two social communication skills, which was independent of group membership or verbal ability. Competing hypotheses to account for the relationship between executive function deficits and social communication deficits in autism are discussed.

The impact of young children with externalizing behaviors on their families.

Abstract: Compared the impact on families of young children with externalizing behaviors (e.g., hyperactive, aggressive; n = 22), autism (n = 20), or no significant problem behaviors (n = 22) on several measures of family functioning. Previous studies have found heightened stress and parental maladjustment in families with externalizing children. The present study expanded upon that literature by (1) including a clinical control group to determine the specific impact of externalizing problems, (2) focusing on preschool aged children, and (3) using a new measure to directly ascertain parents' perception of impact. Compared to parents with normally developing children, parents with externalizing children reported more negative impact on social life, more negative and less positive feelings about parenting, and higher child-related stress. Moreover, parents of externalizing children reported levels of impact and stress as high as those reported by parents of children with autism. On broader measures of parental and marital well-being, however, the three groups of families of preschoolers did not differ. The implications of these findings for intervention are discussed.

Adapted Physical Activity, Recreation and Sport: Crossdisciplinary and Lifespan

Abstract: Part 1 Foundations: active, healthy lifestyle for all celebrating individual differences and appreciating disability sport teamwork, communication, adaptation, and creativity advocacy, the law, and IEP philosophy, planning, and curriculum design assessing, prescribing, and writing the IEP teaching, evaluating, and consulting Part 2 Assessment and pedagogy for specific goals: self-concept and attitudes towards disabilities social competency, inclusion, and attitude change sensorimotor intergration and severe disability motor skills and patterns perceptual-motor learning fitness and healthy lifestyles postures and appearance play and game competence, active leisure, and relaxation adapted aquatics Part 3 Individual differences with emphasis on sport: infants, toddlers, and young children - the new emphasis other health impaired conditions learning disabilities, attention deficit hyperactivity disorder, and DCD mental retardation and special Olympics serious emotional disturbances and autism wheelchair sports and orthopaedic impairments les autres and amputations cerebral palsy, stroke and traumatic brain injury deaf and hard of hearing conditions blindness and visual impairments

Blind Ratings of Early Symptoms of Autism Based upon Family Home Movies

Abstract: Ratings of family home movies of 12 infants (0 to 2 years old) who were later diagnosed as autistic and 12 normal infants were performed by two diagnosis-blind psychiatrists with Infant Behavior Summarized Evaluation scale. The objective was to identify early symptoms of autism and their intensity and frequency before and after 1 year of age. Several pathological types of behavior related to socialization, communication, motility, and attention were noted during the first year of infant life and differentiated autistic and normal groups. These same differentiating behaviors, observed again in the second year, were more intense and associated with other pathological types of behavior, in particular, gaze avoidance, hypoactivity, and absence of emotional expressions. Analysis of the evolution of behavioral pathology in autistic children as a group during the 2 first years of life confirms the persistence of and the increase in some types of abnormality related to socialization, communication, motility, and attention functions. The limitations and values of this study concerning the early identification of autistic symptoms and functional impairments from home movies for diagnosis and establishing individualized treatment program are discussed. J. Am. Acad. Child Adolesc. Psychiatry , 1993, 32, 3:617–626.

Perceptions of stigma: the parents of autistic children

Abstract: This paper reports the findings of a qualitative study of courtesy stigma among 32 parents of autistic children. The results indicate that autism has uniquely stigmatising aspects because of the extremely disruptive nature of autistic symptoms, the normal physical appearance of autistic children, and the lack of public knowledge and understanding regarding the nature of autism. Most parents perceived themselves to be stigmatised by their child's disorder. There was a strong tendency for mothers to feel more stigmatised than fathers. Parents with more severely disabled children and children who were under the age of twelve were also somewhat more likely to perceive themselves to be stigmatised.

Sex differences in pervasive developmental disorders.

Abstract: Assessed differences in sex ratio, severity of associated mental retardation, and various metrics of severity of autism in autistic, PDD-NOS, and developmentally disordered (non-PDD) cases. Males with autism were more frequent than females, particular at higher IQ levels. The three clinical groups differed, in expected ways, in the various measures of severity of autism with the PDD-NOS cases being intermediate between the strictly diagnosed autistic group and the non-PDD developmental disordered group. Sex differences were primarily confined to IQ; sex differences in other metrics of severity of autism were not prominent. Implications for future research are discussed.

The Murdoch Early Intervention Program after 2 years.

Abstract: The goal of the Murdoch Early Intervention Program was to replicate the intensive early intervention program designed by O. I. Lovaas for 24 to 48 mo old children with severe developmental disability and autism. This paper describes the objectives, methods, and the results as of 24 mo. Four of 9 experimental children with autism have shown signs of approaching normal levels of functioning whereas 1 of 5 control children without autism has made significant progress. Improvements in the other Ss are rated as moderate to minimal.

Antibodies to myelin basic protein in children with autistic behavior.

Abstract: Based on a possible pathological relationship of autoimmunity to autism, antibodies reactive with myelin basic protein (anti-MBP) were investigated in the sera of autistic children. Using a screening serum dilution of 1:400 in the protein-immunoblotting technique, approximately 58% (19 of 33) sera of autistic children (≤10 years of age) were found to be positive for anti-MBP. This result in autistics was significantly (p ≤ .0001) different from the controls (8 of 88 or only 9% positive), which included age-matched children with normal health, idiopathic mental retardation (MR) and Down syndrome (DS), and normal adults of 20 to 40 years of age. Since autism is a syndrome of unknown etiology, it is possible that anti-MBP antibodies are associated with the development of autistic behavior.

The definition and prevalence of autism: A review.

Abstract: Sixteen studies of the prevalence of autism in childhood, using epidemiological methods in defined populations in Europe, the USA and Japan, in English or with English summaries, were found in the published literature. Age specific rates varied from 3.3 to 16.0 per 10,000. Eight studies gave rates for a sub-group of ‘typical’ autism varying from 1.2 to 8.4. Reasons for variations were sought by examining geographic and demographic details of the populations screened, methods for initial screening and final examination of possibly autistic children, demographic and clinical details of children identified as autistic, and criteria used for diagnosis. There was evidence, independent of diagnostic criteria, of a higher prevalence among children of first generation immigrants to Europe from ‘exotic’ countries. Apart from this, all differences could be due to variations in diagnostic practice and increasing awareness of the manifestations of autistic conditions throughout the range of intelligence, from severely retarded to average and above. However, it remains possible, though not proven, that rates do vary over place and/or time. The problems of defining a sub-group with ‘typical’ autism among the wide spectrum of children with the triad of impairments of social interaction, communication and imagination are discussed and the value of such a sub-grouping questioned.

Treatment of social behavior in autism through the modification of pivotal social skills

Abstract: We examined acquisition of individual social communicative behaviors and generalization across other social behaviors in 2 children with autism. The results of a multiple baseline design showed that the children's treated social behaviors improved rapidly and that there were generalized changes in untreated social behaviors. These improvements were accompanied by increases in subjective ratings of the overall appropriateness of the children's social interactions. The results suggest the possibility of identifying pivotal response classes of social communicative behavior that may facilitate the understanding of social behavior in autism as well as improve peer interactions, social integration, and social development.

Sex differences in higher functioning people with autism.

Abstract: Though a sex difference in the incidence of autism has frequently been reported, few studies have considered sex differences in the severity of features associated with autism. The Autism Diagnostic Interview was used to assess the difference between a group of 21 females and 21 males with autism with equivalent chronological nonverbal IQ greater than 60. Males were rated to be more severely autistic than females on several measures of early social development, but not in any other areas. Results are discussed in relationship to hypotheses based on sex differences in other populations.

Do children with autism recognise surprise? A research note

Abstract: We take a fresh look at emotion recognition in autistic children, by testing their recognition of three different emotions (happy, sad, and surprise). The interest in selecting these is that whereas the first two are typical “simple” emotions (caused by situations), the third is typically a “cognitive” emotion (caused by beliefs). Because subjects with autism have clear difficulties in understanding beliefs, we predicted they would show more difficulty in recognising surprise. In contrast, as they have no difficulty in understanding situations as causes of emotion, we predicted they would not show deficits in recognising happy and sad. These predictions were borne out, in a comparison with a group of normal children and in a group of subjects with mental handicap. This result shows the importance of fine-grain analysis in emotion-recognition tasks, and is discussed in relation to affective and theory of mind models of autism.

Visual orienting deficits in high-functioning people with autism

Abstract: There has been renewed interest in the idea that attentional dysfunction may underlie autistic symptomatology (e.g., Bryson, Wainwright-Sharp, & Smith, 1990; Dawson & Lewy, 1989a, 1989b). Existing research indicates problems with overfocused attention (Lovaas et al., 1971; Rincover & Ducharme, 1987), and with shifting attention between sensory modalities (Courchesne et al., 1990). These phenomena were examined further by using Posner's (1978) visual orienting task with a group of high-functioning autistic adolescents and adults, and matched normal controls. Our results indicate that autistic people have difficulty processing briefly presented cue information. Evidence of problems disengaging and shifting attention within the visual modality was also provided. The findings can be seen as consistent with previous behavioral, autonomic, and electrophysiological research which has revealed impairments in the registration, processing, and response to external stimuli.

Symbolic Play in Autism: A Review.

Abstract: Experimental research into the symbolic play of autistic children is reviewed in an attempt to outline the nature of their deficit in this area. While many studies can be criticized on methodological grounds, there is good evidence for an impairment in the spontaneous symbolic play of autistic children, an impairment that appears to extend to cover spontaneous functional play also. However studies that have investigated elicited and instructed play have indicated that autistic children may have a capacity for symbolic play that they do not spontaneously exhibit. The implications of these findings for various hypotheses concerning a symbolic play deficit in autism are considered and directions for future research are outlined.

Parietal lobe abnormalities detected with MR in patients with infantile autism

Abstract: Infantile autism is a neurologic disorder that severely disrupts the development of many higher cognitive functions. The most consistent abnormal neuroanatomic findings in autism are loss of Purkinje neurons in the posterior cerebellum as detected by autopsy studies and hypoplasia of the posterior cerebellar vermis and hemispheres as detected by in vivo neuroimaging. Evidence of developmental arrest has also been detected in limbic structures in autopsy studies of autistic patients with mental retardation. Neither in vivo neuroimaging nor autopsy studies of autistic persons have reported abnormalities in the cerebrum. Because the cerebrum mediates many higher cognitive functions, such as social communication, language, abstract reasoning, planning, and organization, that are known to be deficient in patients with autism, a closer examination of the neuroanatomy of the cerebrum in infantile autism is warranted.MR images of 21 healthy autistic patients (6-32 years old) were mixed with MR images of control s...

Using the ADI-R to diagnose autism in preschool children

Abstract: The use of an investigator-based interview (Autism Diagnostic Interview—Revised; ADI-R) in the diagnosis of 51 autistic and 43 nonautistic mentally handicapped preschool children of equivalent mental and chronological age is described. Significant differences occurred between the groups on every diagnostic subdomain from the DSM-IV/ICD-10 draft criteria, except specific aspects of stereotyped language, still relatively rare in these young children. All but one of the 51 children judged to be autistic by clinical observation and only two of the 30 nonautistic mentally handicapped children with mental ages of 18 months or higher met criteria for autism on an algorithm to DSM-IV/ICD-10 draft criteria. However, discrimination using domain totals between autistic and the 13 nonautistic, nonverbal mentally handicapped children with mental ages under 18 months was poor. Quality of social overtures to adults and peers, play, and unusual sensory behaviors and mannerisms continued to differentiate these two groups. The relevance of these findings to the diagnosis of autism in preschool children is discussed.

Programming participation in family activities for children with autism: parents' use of photographic activity schedules.

Abstract: The parents of 3 boys with autism were taught to help their children follow photographic activity schedules depicting a variety of home-living tasks. A multiple baseline across participants showed that the home-based intervention produced increases in children's engagement and social initiations and decreases in disruptive behavior, which were maintained for as long as 10 months.

Depression and social adjustment in siblings of boys with autism.

Abstract: Compared 22 siblings of autistic boys and 34 other siblings on measures of depression, social adjustment, and the amount of child care and domestic responsibility the siblings carry within the family. The relationship between sibling gender, age, birth order, qualities of the boy with autism, and family characteristics, and siblings' scores on the above measures were examined. Results of this research showed that siblings of autistic boys scored significantly higher on depression than the comparison group, but not on problems of social adjustment. There were no statistically significant gender differences; however, different gender-related patterns emerged on the correlates which may be of theoretical significance for future studies.

Locomotion of Autistic Adults

Abstract: Objective: To assess gait in patients with autism. Design: Clinical and physiologic assessment. Setting: Research hospital Patients and Subjects: Five adults with autism and five healthy, age-matched control subjects. Main Outcome Measure(s): Clinical and biomechanical assessment. Results: Clinical assessment showed mild clumsiness in four patients and upper limb posturing during gait in three patients. The velocity of gait, step length, cadence, step width, stance time, and vertical ground reaction forces were normal in all patients. The only significant abnormality was decreased range of motion of the ankle. Some patients exhibited slightly decreased knee flexion in early stance. Clinically, the gait appeared to be irregular in three patients, but the variability was not significantly increased. Conclusions: The findings in patients with autism indicate a nonspecific, neurological disturbance involving the motor system. The normal velocity of gait and the normal step length argue against a parkinsonian-type disturbance, whereas the clinical picture suggests a disturbance of the cerebellum.

Parental perception of emotional expressiveness in children with autism.

Abstract: Parents' perceptions of their children's emotional expressiveness, and possible bases for these perceptions, were investigated in a study comparing older, nonretarded autistic and normal children and in another study comparing young autistic, mentally retarded, and normal children. Both groups of autistic children were perceived as showing more negative emotion and less positive emotion than comparison children. In the younger sample, parental perceptions correlated with the children's attention and responsiveness to others' displays of emotion in 2 laboratory situations. Findings contradict the view that autism involves the "absence of emotional reaction" (American Psychiatric Association, 1987, p. 35).

Comparison of personal and computer-assisted instruction for children with autism

Abstract: The potential of computer-assisted instruction in working with individuals who have autism has been a controversial topic for both teachers and parents since its introduction 2 decades ago. In the present study computer-assisted instruction was compared with personal instruction. Four children with autism participated. Although 3 of them showed better motivation and fewer behavior problems in computer-assisted instruction compared to personal instruction, this did not affect their learning-rate. Future directions of computer-assisted instruction research for individuals with autism were discussed.