Does DSM-IV Asperger's Disorder Exist?

DSM-IV criteria for autistic and Asperger's disorders were applied to 157 children with clinical diagnoses of autism or Asperger's disorder. All children met the DSM-IV criteria for autistic disorder and none met criteria for Asperger's disorder, including those with normal intelligence and absence of early speech delay. The reason for this was that all children had social impairment and restricted and repetitive behavior and interests (required DSM-IV symptoms for both autistic and Asperger's disorders) and all had a DSM-IV communication impairment (which then qualified them for a diagnosis of autistic disorder and not Asperger's disorder). Communication problems exhibited by all children were impaired conversational speech or repetitive, stereotyped, or idiosyncratic speech (or both), which are DSM-IV criteria for autism. These findings are consistent with those of 5 other studies and indicate that a DSM-IV diagnosis of Asperger's disorder is unlikely or impossible.     

Stimulus overselectivity in autistic,trainable mentally retarded,and non-handicapped children: Comparative research controlling chronological (rather than mental) age

Much of the comparative research on stimulus overselectivity has been flawed by either failure to control for chronological age and language ability of the subjects or reliance on the controversial technique of matching on mental age. The present study investigated the prevalence of overselectivity in autistic, trainable mentally retarded, and non-handicapped children demonstrating some expressive speech. The ages of the children were between 6 years-6 months and 9 years-3 months. Thus, chronological age and language ability were controlled, rather than allowed to vary unsystematically. Results indicated no significant differences between the autistic and TMR samples, but significant differences between the handicapped samples and the non-handicapped group. Some, but not all, of the handicapped children displayed overselectivity.     

The savant syndrome and autistic disorder

Savant syndrome, characterized by remarkable islands of mental ability in otherwise mentally handicapped persons, may occur in autistic as well as nonautistic individuals. Overall, approximately 10% of autistic persons exhibit savant abilities; roughly 50% of those with savant syndrome have autism, and the remaining 50% have other forms of developmental disability. Most commonly, savant syndrome takes the form of extraordinary musical abilities, but may also include calendar-calculation, artistic, mathematical, spatial, mechanical, and memory skills. While savant syndrome was first described more than a century ago, only recently have researchers begun to employ a more uniform nomenclature and more standardized testing in an effort to compare the abilities of savants with those of normal persons. Males show signs of savant syndrome approximately four times more often than females. Along with imaging study findings, this fact suggests the presence of a developmental disorder involving left-brain damage with right-brain compensation.     

Favourite objects of autistic children

Favourite objects (FOs) of autistic children were compared with the FOs of healthy preschool and school children as well as mentally handicapped children. Three clusters of objects were obtained for normal children (comprising primary transitional objects and their forerunners, secondary transitional objects, and non-cuddly toys). When autistic children and mentally handicapped children were included, a fourth cluster of deviant objects was found. Frequency distributions of the two handicapped groups in the clusters were similar. Similarities between the two handicapped groups were also found within each cluster. The occurrence of secondary transitional objects was rare in the handicapped groups. The characteristics of "autistic" FOs reported in earlier case studies (e.g. being hard, often having an exciting effect, not being used in their adequate functions) were typical only of objects in the fourth cluster.     

自闭症幼儿的视觉性自我认知实验研究

通过对平均心理年龄为23个月的6名自闭症幼儿的实验研究．甄别他们是否能从视觉上进行自我与他人的分化认知并进一步探索自闭症幼儿对镜像自我认知与录像自我认知上的差异;以秒为单位．对实验结果和过程进行了编码分析。结果表明：这6名幼儿在看自己的录像时,比看同伴的表现出更多的关注和喜悦;对录像的自我进行认知寸表现出更大的关注和积极情绪。由此推断他们已具有初步的自我认知。     

HOW WE HAVE BEEN LEARNING TO TALK ABOUT AUTISM: A ROLE FOR STORIES

Abstract: Autism fiction has become a genre of novel-writing in its own right. Many examples are given in the essay. What does this activity do for us? There used to be no language in which autistic experience could be described. One characteristic difficulty for autistic people is understanding what other people are doing. So absence of a discourse of autistic experience is to be expected. Analyses advanced by Wolfgang Köhler and Lev Vygotsky already made plain long ago that social interaction is a precondition for a language of the inner life. One role for the wave of autism stories now being published, is to create such a language of autism. This in turn affects how autistic people think of themselves. It certainly affects how nonautistic, "neurotypical," individuals think about autism. Not all of this is a good thing, for all too many stories foster images of "the" autistic person as having special gifts that ordinary people lack.     

表情强度对自闭症儿童面部表情识别影响的实验研究

为探寻自闭症儿童在识别低强度（10%,30%）、中强度（40%,60%）和高强度（70%,90%）的愤怒和开心面部表情时,识别情绪类型的既有能力和差异。采用表情标签范式,用E-prime软件在电脑上呈现不同强度的3D合成面部表情刺激,分别对10名自闭症儿童、10名正常发育儿童和10名智障儿童进行了实验研究。结果发现,自闭症儿童在低强度表情时具有面部表情识别障碍,其对不同强度面部表情识别正确率显著低于智障儿童和正常发育儿童;自闭症儿童面部表情识别正确率与面部表情强度呈正相关,面部表情强度越大,自闭症儿童面部表情识别的正确率越高;自闭症儿童对低强度面部表情识别时,对开心表情的识别正确率高于愤怒表情,但是,在中强度和高强度面部表情识别时,存在显著的愤怒优势效应。     

Comprehension in "hyperlexic" readers

Mentally retarded children who can read aloud written words better than one would expect from their Mental Age are often called hyperlexic. The reading comprehension thought to be impaired in such children was investigated in four experiments. Mentally retarded advanced decoders, including autistic and nonautistic children, were compared with younger nonretarded children matched for Mental Age and Reading Age. Experiment 1 established that mildly mentally retarded readers could match sentences to pictures as well as could be expected from their verbal ability. This was the same whether they read the sentences or heard them. Experiment 2 demonstrated that only the more able retarded subjects, but not the less able ones, used sentence context in a normal way in order to pronounce homographs. Experiments 3 and 4 showed that these same more able children could extract meaning at both sentence and story level, and their performance was indistinguishable from that of normal controls. Hence, it is doubtful whether these advanced decoders should be called hyperlexic. In contrast, the readers of relatively low verbal ability performed much worse than their normal controls. Although they could be induced under certain conditions to read sentence-by-sentence rather than word-by-word, they did not do so spontaneously. Furthermore, they did not make use of already existing general knowledge in order to answer questions about the stories they had read. The ability to comprehend in terms of large units of meaning seems to be specifically impaired in these low verbal ability fluent readers. We suggest that it is this impairment that marks true hyperlexia. Since there were no differences between autistic and nonautistic readers on any of our tasks, we conclude that hyperlexia is not an autism-specific phenomenon.     

自闭症幼儿自主性共同注意的实验研究

为探索和发现自闭症幼儿的自主性共同注意的特征,以6名自闭症幼儿,以及在心理年龄与之匹配的弱智和正常儿童各6名作为研究对象,以实验和准实验的方法,进行此研究。同时还以秒为单位对实验过程与结果进行编码分析。结果表明,自闭症幼儿的自主性视觉方向所及目标物多于人,而人的目标中叉更多地锁定同伴而非教师。自闭症幼儿在唤起他人共同注意时多以“拉”和“抱”来替代指点行为。自主性共同注意的发生率与情绪有密切关系。     

More than the Terrible Twos: The Nature and Severity of Behavior Problems in Clinic-Referred Preschool Children

The primary goals of this study are to describe the nature and severity of disruptive behavior problems in clinic-referred preschoolers from low-income environments and to explore the validity of DSM-IV disruptive disorders for young children. We examine the relation between DSM-IV symptoms, standardized behavior checklists, and observational ratings as a means of exploring measurement validity in this age group. Seventy-nine clinic-referred preschoolers (ages 2 through 5 years) from low-income environments were assessed. To examine whether clinic-referred preschool children have symptoms that are consistent with DSM-IV disruptive behavior disorders, parents were administered a semistructured diagnostic interview, modified for developmentally appropriate usage. In addition, parents completed the Child Behavior Checklist (CBCL) and children's behavior problems were assessed with observational ratings during parent–child interaction. Nearly half of the sample met criteria for conduct disorder, and three quarters met criteria for oppositional defiant disorder. Preliminary evidence for the validity of DSM-IV disruptive disorders in preschool children was demonstrated through association with CBCL scores, behavior ratings, and significant levels of impairment. Future efforts aimed at validating these diagnoses in preschoolers and implications for prevention are discussed.     

关于自闭症的临床、实验心理学的研究

最近,国际上的临床心理学、实验心理学对自闭症的诊断、分类、发生率以及教育与治疗等,从各个角度展示了许多新的研究结果。实验心理学的调查结果表明,自闭症儿童的注意力异常,对视、听、触等感觉反应处理样式,不同于弱智儿童和正常儿童。语言障碍是自闭症儿童发展障碍中的核心症侯,这与自闭症在社会性和人际关系上存在障碍有着密切的关系。进入９０年代以后,对自闭症“心的理论”的各种实验研究,引起各国研究者的注目和争论     

A comparison of cognitive/neuropsychological impairments of nonretarded autistic and schizophrenic children

The performance of children meeting DSM-III criteria for schizophrenic disorder and infantile autism and of normal children (ages 7 years 10 months to 14 years 4 months) was compared on the Wisconsin Card Sorting Test, Rey's Tangled Line Test, Benton Judgment of Line Orientation, Digit Symbol Substitution Test, and Peabody Picture Vocabulary Test. The mean performance IQ of the schizophrenic and autistic children was equal and in the normal range. The normal children were of average intelligence as estimated by the PPVT. As compared to normal children, both autistic and schizophrenic children were impaired on the DSST and RTLT. The autistic children had significantly lower scores on the PPVT than schizophrenic and normal children. The schizophrenic children made significantly more perseverative responses on the WCST than did normal children. They significantly increased their nonperseverative errors on the second half of the WCST, after having been taught the correct sorting principles. It is argued that in schizophrenia a core deficit in momentary processing capacity underlies the above performance pattern. In contrast, in autism the core cognitive deficit involves an inability to use language to regulate and control ongoing behavior.Preparation of this article was supported in part by a John D. and Catherine T. MacArthur Foundation Grant to Robert Asarnow, and NIMH Grant MH 30897 to the UCLA Clinical Research Center for the Study of Childhood Psychoses. We gratefully acknowledge the assistance of Michael J. Goldstein, Ph.D., who acted as reseach advisor to the first author over the course of this study; Delores Adams, who assisted us in data analysis; and Sara Lerner, who enthusiastically helped us in data collection. We also acknowledge the assistance of the staff of the Clinical Research Center for the Study of Childhood Psychosis at UCLA, as well as the many children who participated in this study, and their parents.     

自闭症儿童依恋研究述评

摘要　　研究者曾一度认为自闭症儿童无法建立起依恋关系。本文系统回顾了自闭症儿童依恋研究的最新进展,将自闭症儿童是否存在依恋行为（尤其是安全型依恋行为）、依恋发展解释理论、研究方法、类型分布以及影响因素等问题进行了详细梳理,并结合研究分析,提出有关自闭症儿童依恋研究的几点启示,以供参考。     

The level and nature of autistic intelligence

Autistics are presumed to be characterized by cognitive impairment, and their cognitive strengths (e.g., in Block Design performance) are frequently interpreted as low-level by-products of high-level deficits, not as direct manifestations of intelligence. Recent attempts to identify the neuroanatomical and neurofunctional signature of autism have been positioned on this universal, but untested, assumption. We therefore assessed a broad sample of 38 autistic children on the preeminent test of fluid intelligence, Raven's Progressive Matrices. Their scores were, on average, 30 percentile points, and in some cases more than 70 percentile points, higher than their scores on the Wechsler scales of intelligence. Typically developing control children showed no such discrepancy, and a similar contrast was observed when a sample of autistic adults was compared with a sample of nonautistic adults. We conclude that intelligence has been underestimated in autistics.     

The epidemiology of autistic spectrum disorders: is the prevalence rising?

For decades after Kanner's original paper on the subject was published in 1943, autism was generally considered to be a rare condition with a prevalence of around 2-4 per 10,000 children. Then, studies carried out in the late 1990s and the present century reported annual rises in incidence of autism in pre-school children, based on age of diagnosis, and increases in the age-specific prevalence rates in children. Prevalence rates of up to 60 per 10,000 for autism and even more for the whole autistic spectrum were reported. Reasons for these increases are discussed. They include changes in diagnostic criteria, development of the concept of the wide autistic spectrum, different methods used in studies, growing awareness and knowledge among parents and professional workers and the development of specialist services, as well as the possibility of a true increase in numbers. Various environmental causes for a genuine rise in incidence have been suggested, including the triple vaccine for measles, mumps and rubella (MMR]. Not one of the possible environmental causes, including MMR, has been confirmed by independent scientific investigation, whereas there is strong evidence that complex genetic factors play a major role in etiology. The evidence suggests that the majority, if not all, of the reported rise in incidence and prevalence is due to changes in diagnostic criteria and increasing awareness and recognition of autistic spectrum disorders. Whether there is also a genuine rise in incidence remains an open question.     

Caregiver interactions with autistic children

Caregiver interactions with young autistic children were contrasted with those involving caregivers and developmentally matched mentally retarded and normal infants. Caregivers of autistic children were similar to other caregivers in their responsiveness to child nonverbal communication bids and in their engagement in mutually sustained play. Caregivers of autistic children were similar to caregivers of mentally retarded children in their greater use of control strategies. However, these two groups of caregivers differed in the particular strategies they used to shape their children's behavior. Caregivers of mentally retarded children pointed to objects while caregivers of autistic children spent more time physically holding their children on task. Individual differences within the autistic sample indicated that caregivers regulated their children's behavior less and showed more mutual play and positive feedback to more communicatively able autistic children. These findings suggest that caregivers respond differentially to the specific deficiencies shown by their children.     

Diagnostic implications of McCarthy scale general cognitive index/binet IQ discrepancies for low-socioeconomic-status preschool children

This study compared McCarthy Scale General Cognitive Index (GCI) and Stanford-Binet IQ discrepancies for both normal and handicapped preschool children of low socioeconomic status (SES). Both tests were administered in counter-balanced order to a total of 70 children. The results of these comparisons yielded a significant positive relationship between GCI and IQ, as well as a significant discrepancy between the two scores, favoring IQ, of a relatively small magnitude (3.9 points). There were significant discrepancies favoring IQ for the subgroups of learning-disabled, speech-impaired, and mentally retarded, those for all but mentally retarded being of relatively small magnitude; thus, the learning-disabled group was not uniquely characterized by a large discrepancy. In contrast to results consistently favoring IQ over GCI, when age groups were compared, the younger, 3 year olds, showed the reverse, though nonsignificant, trend.     

The prevalence of specific learning disorder in mathematics and comorbidity with other developmental disorders in primary school-age children

Mathematics difficulties are common in both children and adults, and they can have a great impact on people's lives. A specific learning disorder in mathematics (SLDM or developmental dyscalculia) is a special case of persistent mathematics difficulties, where the problems with maths cannot be attributed to environmental factors, intellectual disability, or mental, neurological or physical disorders. The aim of the current study was to estimate the prevalence rate of SLDM, any gender differences in SLDM, and the most common comorbid conditions. The DSM-5 provides details regarding these only for specific learning disorders in general, but not specifically for SLDM. We also compared the prevalence rates obtained on the basis of the DSM-IV and DSM-5 criteria. We investigated the performance of 2,421 primary school children on standardized tests of mathematics, English, and IQ, and several demographic factors over the primary school years. We applied the DSM-5 diagnostic criteria to identify children with a potential diagnosis of SLDM. Six per cent of our sample had persistent, severe difficulties with mathematics, and, after applying the exclusion criteria, 5.7% were identified as having an SLDM profile. Both persistent maths difficulties and consistently exceptionally high performance in maths were equally common in males and females. About half of the children with an SLDM profile had some form of language or communication difficulty. Some of these children also had a diagnosis of autism, social, emotional, and behavioural difficulties or attention deficit and hyperactivity disorder. Our findings have important implications for research and intervention purposes, which we discuss in the study.     

STIMULUS OVERSELECTIVITY IN LEARNING DISABLED CHILDREN

Stimulus overselectivity, a phenomenon exhibited by autistic and institutionalized retarded individuals, was examined in mildly handicapped and nonhandicapped public school children. Subjects were 16 young, educable mentally retarded, 16 learning disabled, 15 nonhandicapped first- and second-graders, and 16 older, educable retarded students. The children were trained on a 3-component visual discrimination task and then tested on individual elements to determine which element or elements were controlling subject responses. Nine of the young educable mentally retarded children and eight of the learning disabled students showed some overselectivity. The majority of overselective retarded children were controlled by only one of the three components of the training cue, whereas the majority of the overselective learning disabled children responded to the discrimination task on the basis of two of the three components. No overselectivity was exhibited by the nonhandicapped students. All three cue components were also functional in controlling the responding of 14 of the 16 older retarded students, but two children were under the control of only one cue. The research indicated that in terms of overselectivity, learning disabled children respond more like young, mildly retarded children than they do like nonhandicapped ones. The demonstration of stimulus overselectivity in a sizable portion of a learning disabled sample may have implications for a more empirically based approach to this handicapped population.