The autistic dialogic style: a case of Asperger's syndrome

This paper explores the idea of possible proto-experiences of the prenatal child in the context of Bion's model of container/contained. The physical configuration of the embryo/foetus contained in the maternal uterus represents the starting point for an enquiry into the unborn child's possible experiences of its state of being contained in a container. The paper takes into consideration the sensory dimensions of auditory, tactile and kinaesthetic levels of awareness of the prenatal child in relation, respectively, to the maternal voice and the uterine environment. The author's hypothesis is that concrete prenatal experiences of containment may have their mental counterpart in the development of a proto-mental container and memory, the existence of which can be observed in the newborn infant. It is also suggested that prenatal proto-experiences of containment may prepare the child for further postnatal realisations of the pre-conception of containment and represent the experiential basis for the encounter with the breast. Observations of newborn babies in an obstetric ward, as well as the observation of a prematurely born child, seem to confirm the idea that the intrauterine experience of container/contained plays a role in the child's prenatal development. The meaning of prenatal thumb-sucking is explored in terms of the model of container/contained at a part-object level. An observation of the play of a three-year-old child offers material for further thought about the meaning and function of the introjected configuration of container/contained for the development of a sense of identity and symbolic thinking. The clinical case of an autistic child who survived a threatened miscarriage shows how the emotional containment in psychotherapy allowed the formerly inaccessible nameless dread to re-emerge and be represented and shared.     

孤独症儿童动作发展障碍的神经机制

动作发展障碍(Developmental motor disorders)是孤独症谱系障碍的常见特征。通过系统回顾孤独症儿童动作发展障碍的神经科学研究, 发现γ-氨基丁酸和5-羟色胺浓度的改变及γ-氨基丁酸相关蛋白和Shank蛋白的表达异常不仅会损害中枢神经系统的发育, 而且还能导致突触兴奋性与抑制性失衡, 进而改变孤独症儿童小脑和大脑皮层运动区的功能连接。孤独症儿童小脑、基底神经节和胼胝体结构的改变对全脑的连通性产生了负面影响。神经生化机制和脑结构的异常共同导致了脑功能的异常, 最终造成孤独症儿童的动作发展障碍。此外, 动作发展障碍与孤独症核心症状共同的神经基础主要包括镜像神经元系统紊乱, 丘脑、基底神经节和小脑异常以及SLC7A5和PTEN 基因突变。未来研究需要关注与运动密切相关的其他神经递质, 如乙酰胆碱和多巴胺; 探索动作发展障碍神经网络的动态机制及其形成; 剖析该障碍的神经机制和自闭症核心症状神经机制的相互作用。     

WISC-R Subtest But No Overall VIQ–PIQ Difference in Dutch Children with PDD-NOS

VIQ–PIQ differences have been studied in children with autism and Asperger syndrome but have not been studied in a separate group of children with PDD-NO, although, PDD-NOS has a much higher prevalence rate than autism and deficits in communication and social interaction are severe. The Wechsler Intelligence Scale for Children-Revised (WISC-R) was administered to 100 children, aged 6–12 years, with PDD-NOS (n = 76), autism (n = 13), and Asperger syndrome (n = 11). PDD-NOS was diagnosed using explicit research criteria. No overall differences between VIQ and PIQ were found in PDD-NOS and autism. Peaks in the subtest scores on Information, Similarities, Picture Arrangement, and Mazes, and troughs in the subtest scores on Comprehension, Digit Span, and Coding were demonstrated in children with PDD-NOS. Their score on the Freedom from Distractibility factor was lower than the scores on the Verbal Comprehension factor and the Perceptual Organization factor. Children with PDD-NOS seemed to have a similar VIQ–PIQ profile as children with autism, and on the subtest level children with PDD-NOS showed some similarities to children with Asperger syndrome or autism. It was not possible to distinguish PDD-NOS from autism or Asperger syndrome by using IQ scores.     

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.     

Unfamiliar face recognition in children with autistic spectrum disorders

We investigated unfamiliar face recognition in low‐functioning children with autistic spectrum disorders (ASD) using a ‘part‐of‐face’ method. This method has not previously been used for unfamiliar faces with this population. The ‘part‐of‐face’ procedure provides measures of both face recognition accuracy and of processing style. We compared the performance of the children with ASD with three control groups: children with developmental delay (DD), typically developing (TD) children matched for verbal cognitive ability and TD children matched for chronological age (CA). Compared to the DD group, the ASD group showed similar processing in recognition accuracy and processing style. Compared to the TD children, the ASD group did not show the same level of accuracy as controls of the same CA, instead showing similar performance to younger TD children. However, as both children with ASD and DD showed the same performance, no ASD‐specific deficit was found. Copyright © 2009 John Wiley & Sons, Ltd.     

自闭症谱系障碍的生物基础

自闭症谱系障碍是一组发病于生命早期, 由一系列生理、心理因素引起的神经发育障碍。遗传、脑神经结构、营养素等是自闭症谱系障碍的生物基础的重要来源。个体在孕育早期形成的大脑和机体异常可能是导致自闭症谱系障碍的关键。这种异常在出生后的发育中具体作用于神经活动、脑发育、免疫系统等生理途径。研究者们今后可以尝试横跨不同自闭症谱系障碍亚型、年龄和发育阶段, 开展横向与纵向相结合的大范围研究, 以进一步明确自闭症谱系障碍的生物基础。     

Evolution of Research on Interventions for Individuals with Autism Spectrum Disorder: Implications for Behavior Analysts

The extraordinary success of behavior-analytic interventions for individuals with autism spectrum disorder (ASD) has fueled the rapid growth of behavior analysis as a profession. One reason for this success is that for many years behavior analysts were virtually alone in conducting programmatic ASD intervention research. However, that era has ended. Many investigators from other disciplines are now carrying out large-scale intervention studies and beginning to report successes of their own. The increasing number and range of studies has the potential to improve services for individuals with ASD, and it challenges behavior analysts to intensify their research efforts.     

Union and separation in the therapy of pervasive developmental disorders and ADHD

Abstract :  This paper discusses the characteristics of psychotherapy for pervasive developmental disorders (PDD) in the context of the curative effects of the movement of images. The 'autistic spectrum' is widened here and includes not only PDD, but also ADHD. The main common characteristic in these two sets of disorders seems to be the lack of a subject, which manifests itself as the absence of awareness of otherness and difficulties with boundaries and language.
In these cases a normal psychotherapy is ineffective as it presupposes an established subject. However a psychotherapeutic approach with these patients can contribute to the emergence of a subject. In severe cases the process of union and separation which is enacted either in the therapeutic relationship or in symbolic play leads to the birth of a subject, and of language. In milder cases, such as ADHD, the moments of separation and confrontation with the therapist suffice.
I will discuss a case of my own with Asperger's syndrome in which union and separation in the play therapy occurred simultaneously. This indicates that union and separation are not a consecutive process, but are simultaneous and lead to dialectical movement. However, in neurotic cases with an established subjectivity the symbolic meaning of image plays a central role. This corresponds to Jung's understanding of image in alchemy.     

The associations between autistic and communication traits in parents and developmental outcomes in children at familial risk of autism at 6 and 24 months of age

BackgroundSeveral studies have explored relationships between parent broader autism phenotype and offspring communication, and have reported that autistic-like traits in parents are related to offspring communication difficulties and autism severity. However, past research has focused on studying such associations in childhood and we know very little about them in infancy. With accumulating evidence that interventions administered during infancy may be most effective in reducing ASD symptoms, it is imperative to examine whether relationships between parent autistic-like traits and child communication appear even earlier during this critical period of life.MethodThis longitudinal study collected data from infant siblings of autistic children (N = 32) and infants with no family history of autism (N = 45) to explore how autistic-like traits in parents related to child developmental outcomes during infancy.ResultsParental communication difficulties and autistic-like traits were found to be associated with a range of child behaviours in the first two years of life, including social-emotional difficulties at 6 and 24 months, lower communication and emerging cognition at 24 months, and increased autistic behaviours at 24 months.ConclusionsBased on the results, it appears that some of the difficulties seen in parents are relayed to children genetically. These findings contribute to ASD research concerning early communication development in children and heritability of ASD traits and may have important implications in monitoring child development. Furthermore, since the current study found a significant association between autistic traits in parents and child social-emotional behaviour as early as 6 months of age, it provides evidence of the value of assessing interventions that target infancy.     

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.     

Emotional,behavioral, and cognitive factors that differentiate obsessive-compulsive disorder and other anxiety disorders in youth

Abstract

The current study examined specific emotional, behavioral, and cognitive variables that may distinguish obsessive-compulsive disorder (OCD) from generalized anxiety disorder (GAD), social phobia (SoP), and separation anxiety disorder (SAD) in youth. Youth with OCD (n=26) and other anxiety disorders (ADs; n=31), aged 7–12 years (56.1% males), and their parents participated. The study compared the two anxious groups on levels of emotional, behavioral, and cognitive functioning, as well as impairment associated with the disorder. Results indicated that in comparison to youth with GAD, SoP, or SAD, youth with OCD were found to have poorer emotion regulation skills, as well as greater oppositionality, cognitive problems/inattention, and parent impairment associated with the disorder. The findings suggest that there are unique characteristics of OCD that may differentiate this disorder from other ADs in youth. Potential clinical implications and directions for future research are discussed.     

孤独症谱系障碍者的情绪韵律识别

情绪韵律识别是从声学线索变化中提取情绪信息,进而推断他人情绪状态的过程。情绪韵律识别缺陷是孤独症谱系障碍者的一种常见表现,此缺陷会受到情绪韵律强度、字面语义、情景语境、心理声学能力和共患疾病的影响。目前,该人群情绪韵律识别缺陷的原因探析集中于心智化能力不足、社会动机缺失和经验匮乏假说等。孤独症谱系障碍者情绪韵律识别的神经机制研究主要集中于与健康人群的比较,相关发现包括情绪韵律识别的右半球优势效应、局部脑区激活增多、大脑网络连接不足和早期注意模式异常。未来,应该进一步提高实验范式的生态效度,注重孤独症个体差异因素,整合相关理论解释,并开发有效的测评工具和干预策略。     

A comparison of the effects of providing activity and material choice to children with autism spectrum disorders

The present study compares the effects of providing choice between activities or between materials for completion of activities on the on-task behavior of 4 boys with autism spectrum disorders. Results showed that the participants displayed higher levels of on-task behavior during the choice conditions than in the no-choice condition. However, the type of choice opportunity did not seem to have a differential effect.     

Teaching multiply controlled intraverbals to children and adolescents with autism spectrum disorders

Reciprocal conversations, instructional activities, and other social interactions are replete with multiply controlled intraverbals, examples of which have been conceptualized in terms of conditional discriminations. Although the acquisition of conditional discriminations has been examined extensively in the behavior‐analytic literature, little research has evaluated procedures to establish multiply controlled intraverbals. Thus, the purpose of this investigation was to evaluate the effects of procedures based on conditional discrimination training on the acquisition of multiply controlled intraverbals with 7 participants who had been diagnosed with autism spectrum disorders. We evaluated the effects of prompt delay with error correction, a differential observing response (DOR), and a DOR plus blocked trials on the acquisition of intraverbals using a multiple baseline design. Accuracy of intraverbal performance increased for at least 1 set of stimuli for all participants under prompt delay with error correction conditions; however, 4 participants required additional teaching (i.e., DOR, modified DOR, modified prompt delay with error correction). Based on these findings, when prompt delay with error correction is not sufficient to establish multiply controlled intraverbals, prompted DORs may be an effective alternative.     

Mental health criminal defenses in persons with neuropsychiatric disorders

Persons with neuropsychiatric disorders present specific and unique challenges for forensic experts and defense attorneys in the criminal justice system. This article reviews two potential criminal defenses: legal insanity and the various legal standards or tests of criminal responsibility that are used in jurisdictions throughout the United States (i.e., the M’Naghten standard and the American Law Institute's Model Penal Code), and the partial legal defense of diminished capacity (lacking the mental state necessary to be found guilty of a specific intent crime). The process of evaluating criminal responsibility or diminished capacity is also presented with a specific emphasis on common issues that arise in evaluating defendants with Intellectual Developmental Disorder (Intellectual Disability), Parasomnias, Seizure Disorders, and Neurocognitive Disorders.