封闭世界中的孩子——儿童自闭症的分析与治疗

Kanner教授于1943年最先报道了关于儿童自闭症的详细研究,自闭症作为一种症侯群,其具体症状因人而异。社会交往障碍、语言发育障碍、刻板的行为方式是自闭症的三个主要障碍。本文从儿童自闭症的表现特征、原因、治疗等方面入手,详细阐述了这一发生在婴幼儿时期的发展障碍及其治疗方法,为自闭症儿童的早期发现、训练和矫治提供参考。     

音乐干预对自闭症儿童语言障碍的影响

语言障碍是自闭症的核心症状之一,改善自闭症儿童的语言障碍对其日常生活具有重要意义。诸多研究证实音乐干预能够明显改善自闭症儿童的语言障碍。从干预材料的角度出发,音乐干预包括将音乐刺激与语言刺激严格匹配的音乐干预方法以及将音乐作为学习背景的音乐干预方法,二者均能有效促进自闭症儿童的语言表达和交流。目前最有代表性的自闭症语言障碍的音乐干预方法包括听觉动作通路训练(AMMT)、基于旋律的语言沟通治疗(MBCT)以及背景音乐干预方法。音乐干预方法的发展今后需着眼于音乐类型的选择、音乐与其他活动的结合,同时兼顾不同自闭症儿童群体的适用性以及音乐干预在生活中的推广。     

自闭症神经机制研究的新进展

“自闭症”是由美国儿童精神病医生Kanner,L．在1943年首次提出来的。其主要症状包括社会交往障碍、语言发展障碍、认知障碍以及行为刻板反复。现代实验技术手段的发展为探索自闭症病因之迷提供了重要的帮助。大量自闭症的神经机制方面的证据主要来自于运用脑成像技术(如核磁共振成像MRI、正电子发射层描术PET等)、动物脑损伤、尸     

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     

自闭症儿童的语言研究现状及构想

汉语的语言和文化独特,国外文献对自闭症儿童语言障碍特征的描述不能全面客观反映汉语自闭症儿童语言特点;基于医学量表描述的自闭症儿童语言及非语言特征较为笼统,亟需实证研究的大数据来整合自闭症儿童语言的各个范畴特征,进行康复;以往研究很少把自闭症儿童的语言和非语言结合起来,需要考察语言和非语言的跨通道特性和各自不同功能,其语言和表达性非语言可能互补。据此,我们提出自闭症儿童语言和非语言研究新构想。     

探索宗教疗法的积极作用 以自闭症救治为例北大核心CSSCISSCI

美国自闭症与发展性障碍监控（ADDM）网络的最新数据显示,每110名儿童中大约就有1名患有自闭症谱系障碍（ASD）,我国近期相关调查也显示,自闭症儿童的数量在我国呈现不断增长趋势。自闭症是由器质性病变引发的一种终身精神疾病,其典型症状为认知、语言和社会交往障碍及刻板性行为问题。目前,由于医学上对此疾病暂无有效的治疗方法,因此心理治疗就成为自闭症应对的重要手段。心理学领域利用一切心理资源来探寻应对自闭症的干预方法时,宗教因素受到研究者们极大的关注,主要聚焦于自闭症患者的宗教信仰、宗教在自闭症治疗及其家庭中的作用等方面。     

自闭症儿童话语多模态个案研究

以多模态理论为基础,从语言、非语言及其跨通道性等方面比较正常男童和两个自闭症男童叙事语言。叙事中,他们讲述一个无字书《青蛙,你在哪里?》的故事并录像。分析多模态语料发现,高功能自闭症儿童和正常儿童的叙事字数、句数,代词、语气词、心理词汇的数量和概念错误数没有显著差别,中度自闭症患儿在这些方面显著不及高功能自闭症儿童。非语言及跨通道方面,高功能自闭症儿童比中等程度患儿表现要好,中等自闭症儿童无法集中注意力,无法独自完成述说故事。针对他们的多模态特征,提出了康复建议。     

fNIRS在自闭症脑功能研究中的应用与展望

社会交往能力是人类生存的基本技能。社交能力的缺失会导致严重的行为障碍和精神疾病,如自闭症。由于自闭症儿童的特殊性,绝大多数的自闭症脑成像研究多集中在年龄较大的高功能自闭症儿童在静息态或简单的任务态下的脑激活模式或功能连接状态。自闭症的核心症状—社会交往障碍和语言交流障碍却较少有研究触及。近年来,近红外光学脑功能成像技术的发展为我们在真实的交流和互动中研究自闭症儿童的神经病理机制提供了新的工具和机遇。     

自闭症儿童的内隐学习假说：来自人工语法学习的证据

由于自闭症的症状和个体的内隐学习都主要涉及语言领域,研究者提出了内隐学习假说,认为自闭症症状可能部分来自于内隐学习缺陷。然而,目前的研究尚未得出一致的结论。该研究采用人工语法学习范式和无意义的汉字串材料,并严格控制材料的组块特征,考察了一般的自闭症儿童、年龄匹配的普通儿童以及年龄和智商匹配的智障儿童的内隐学习。结果发现：（1）普通儿童和智障儿童的内隐学习成绩都显著高于随机水平,表明他们能够内隐习得语法规则;（2）自闭症儿童的内隐学习成绩与随机水平没有显著差异,同时与两组对照组儿童的成绩也没有显著差异。这可能意味着,自闭症儿童语法规则的内隐学习既存在缺陷、又有所保留。该研究为自闭症儿童的内隐学习假说提供了新的来自语言领域的证据。     

新生儿对语音的感知、辨别和学习

新生儿自娩出起便开始利用臻于成熟的听觉系统对语音的各要素进行大脑表征和学习记忆。考察新生儿语音加工特点,不仅能揭示语言功能在人类发展最初阶段的认知神经机制,还能对自闭症等神经发育性疾病的早期预警和临床诊断提供有价值的线索。我们回顾并总结了新生儿对语音的感知、辨别和学习以及语言发展对自闭症的预测作用,发现新生儿对特定语音存在感知偏好;新生儿具备独特的音素辨别能力;婴儿期语言加工的脑功能或结构指标对自闭症具有一定的预测价值。我们建议未来研究从三个方面开展工作。在基础研究方面：第一,严格控制语音材料的韵律因素,重新审查新生儿语言加工特征及大脑偏侧化问题;第二,揭示新生儿语音学习的认知神经机制以及睡眠的记忆巩固作用。在临床转化研究方面,以高风险自闭症新生儿为追踪对象,基于纵向多模态脑观测数据,建立疾病风险评估系统,揭示出生早期语言发展脑指标对自闭症的预测价值。     

Cerebral lateralization in individuals diagnosed as autistic in early childhood

Early infantile autism was found to be associated with an atypical pattern of cerebral lateralization. Based on EEG measures of hemispheric activation during cognitive processing, it was found that 7 of the 10 autistic individuals tested showed a pattern of hemispheric specialization rarely seen in the normal population; namely, a “reversal” in lateralization reflective of a lack of left-hemisphere specialization for linguistic functions. Furthermore, the autistic individuals' pattern of cognitive strengths and weakness is suggestive of a selective impairment of the left cerebral hemisphere.     

Sub‐threshold autism traits: The role of trait emotional intelligence and cognitive flexibility

Theory and research suggests that features of autism are not restricted to individuals diagnosed with autism spectrum disorders (ASDs), and that autism‐like traits vary throughout the general population at lower severities. The present research first investigated the relationship of autism traits with trait emotional intelligence and empathy in a sample of 163 adults aged between 18 and 51 years (44% male). It then examined performance on a set of tasks assessing social cognition and cognitive flexibility in 69 participants with either high or low scores on ASD traits. Results confirm that there is pronounced variation within the general population relating to ASD traits, which reflect similar (though less severe) social‐cognitive and emotional features to those observed in ASDs.     

Cognition Without Control: When a Little Frontal Lobe Goes a Long Way

ABSTRACT— The prefrontal cortex is crucial for the ability to regulate thought and control behavior. The development of the human cerebral cortex is characterized by an extended period of maturation during which young children exhibit marked deficits in cognitive control. We contend that prolonged prefrontal immaturity is, on balance, advantageous and that the positive consequences of this developmental trajectory outweigh the negative. Particularly, we argue that cognitive control impedes convention learning and that delayed prefrontal maturation is a necessary adaptation for human learning of social and linguistic conventions. We conclude with a discussion of recent observations that are relevant to this claim of evolutionary trade-offs in a wide range of research areas, including attention-deficit hyperactivity disorder, autism spectrum disorders, creativity, and sleep.     

Neuroepileptic correlates of autistic symptomatology in tuberous sclerosis

Tuberous sclerosis is a genetic condition that is strongly associated with the development of an autism spectrum disorder. However, there is marked variability in expression, and only a subset of children with tuberous sclerosis develop autism spectrum disorder. Clarification of the mechanisms that underlie the association and variability in expression will potentially throw light on the biological processes involved in the etiology of idiopathic forms of autism spectrum disorder. Current evidence indicates that the likelihood of a child with tuberous sclerosis developing an autism spectrum disorder is greater if the child has a mutation in the TSC2 gene, although autism can and does develop in children with TSC1 mutations. The likelihood is also greater if the child has early-onset infantile spasms that are difficult to control, especially if there is an epileptiform focus in the temporal lobes. The emerging evidence is consistent with the notion that early onset electrophysiological disturbances within the temporal lobes (and perhaps other locations) has a deleterious effect on the development and establishment of key social cognitive representations concerned with processing social information, perhaps especially from faces. However, alternative mechanisms to account for the findings cannot yet be ruled out. Future research will have to employ prospective longitudinal designs and treatment trials to clarify the processes involved.     

Why we need cognitive explanations of autism

In the 70 years since autism was described and named there have been huge changes in the conceptualization of this enigmatic condition. This review takes a personal perspective on the history of autism research. The origins of the first cognitive theories of autism, theory of mind and weak central coherence, are discussed and updated to inform future developments. Selected experimental findings are interpreted in the historical context of changes that have been brought about by advances in methodology. A three-level framework graphically illustrates a causal chain between brain, mind, and behaviour to facilitate the identification of phenotypes in neurodevelopmental disorders. Cognition is placed at the centre of the diagram to reveal that it can link together brain and behaviour, when there are complex multiple mappings between the different levels.     

Performance-based measures in autism: implications for diagnosis, early detection, and identification of cognitive profiles

Provides a critical review of performance-based assessment measures in autism. Currently, performance-based measures of autism are being explored in two domains: structured play sessions and cognitive-neuropsychological assessments. Structured play sessions are designed to elicit the behavioral symptoms associated with autism to provide a consistent and valid means of early detection and diagnosis of autism across different evaluators and settings. These structured play sessions provide a supplement to diagnostic instruments based on parental report. Cognitive-neuropsychological tasks have been used to identify possible underlying cognitive impairments in autism including executive function, theory of mind, selective attention, and abstraction. Currently, cognitive tasks are useful in treatment planning but are inappropriate for diagnostic purposes. Important goals for the future will be to integrate parent-report diagnostic interviews and structured play observations and to identify a profile of cognitive impairments that are specific to pervasive developmental disorders that can be incorporated into diagnostic protocols.     

Cognitive deficits in developmental disorders

The existence of specific developmental disorders such as dyslexia and autism raises interesting issues about the structure of the normally developing mind. In these disorders distinct cognitive deficits can explain a range of behavioural impairments and have the potential to be linked to specific brain abnormalities. One possibility is that there are specific mechanisms dedicated to particular types of information processing. These mechanisms may function independently of more general information processing systems and may have a distinct anatomical basis in the brain.     

Social cognition and its neural correlates in schizophrenia and autism

The study of social cognition in psychiatric disorders has become increasingly popular in recent years. This is due to the its proposed link to social functioning and the inability of general neurocognitive skills to explain the spectrum of impairments observed in patients. This article reviews research into two of the processes thought to underlie social cognition (emotion perception and theory of mind) in schizophrenia and autism. This is followed by a look at neuroimaging studies and their efforts to localize the neural correlates of emotion perception and theory of mind in the two disorders. We concluded that while a specific impairment in emotion perception and theory of mind skills cannot be generalized to all individuals with autism and schizophrenia, there are subpopulations that have lingering deficits of social cognition tasks. Neuroimaging work consistently points to the involvement of the fusiform gyrus and amygdala in emotion processing, while the medial prefrontal and frontal cortex are implicated in tasks invoking theory of mind. We propose that deficits of social cognition may benefit from cognitive remediation therapy and pharmacological cognitive enhancers.     

Forty years on: Uta Frith's contribution to research on autism and dyslexia, 1966-2006

Uta Frith has made a major contribution to our understanding of developmental disorders, especially autism and dyslexia. She has studied the cognitive and neurobiological bases of both disorders and demonstrated distinctive impairments in social cognition and central coherence in autism, and in phonological processing in dyslexia. In this enterprise she has encouraged psychologists to work in a theoretical framework that distinguishes between observed behaviour and the underlying cognitive and neurobiological processes that mediate that behaviour.     

Patterns of language and discourse comprehension skills in school‐aged children with autism spectrum disorders

Åsberg, J. (2010). Patterns of language and discourse comprehension skills in school‐aged children with autism spectrum disorders. Scandinavian Journal of Psychology 51, 534–539. The present study examined patterns of language and discourse comprehension skills in Swedish school‐aged children with autism spectrum disorders (ASD) (n = 16) as compared to a slightly younger group of typically developing children (n = 16) matched for non‐verbal cognitive ability. Results suggested significantly lower abilities in narrative discourse comprehension for the ASD group, but not in oral receptive vocabulary or reception of grammar. This difficulty with discourse‐level comprehension appeared to be of a general nature, as no evidence was found for the hypothesis that participants with ASD would find comprehension of inferential discourse information disproportionally more difficult than stated information, or for the hypothesis that discourse processing in ASD would be characterized by an elevated processing of explicitly stated narrative details. The study has clinical and educational implications, as the findings suggest that children with ASD would benefit from being offered specific support for discourse‐level comprehension.