The Mullen scales of early learning: ceiling effects among preschool children

Two cognitive tests were administered to typically developing children (36–67 months): the Mullen Scales of Early Learning (MSEL), which is appropriate for very young children and thus often used in research with atypical samples (e.g., children with Autism Spectrum Disorder), and the Kaufman Assessment Battery for Children (K-ABC). This was done in order to re-examine possible MSEL ceiling effects in a new sample and achieve a more in-depth understanding of these ceiling effects, if indeed present. Results indicated that among children ranging in age from 51 to 68 months, MSEL scores were significantly lower than K-ABC scores, and that with increasing age the number of children who completed the MSEL without establishing a ceiling level increased. Our results indicated that the MSEL scores are affected by ceiling effects and, therefore, the test underestimates cognitive abilities among older and more cognitively able children.     

Early and persistent motor difficulties in infants at-risk of developing autism spectrum disorder: A prospective study

Analyses were conducted in order to investigate motor development in younger siblings of children diagnosed with autism spectrum disorder (ASD). Infants at familial risk and low risk of developing ASD were tested longitudinally between the ages of 7 and 36 months. Data were analysed from motor scales on the Mullen Scales of Early Learning and the Vineland Adaptive Behaviour Scales at each age point. Significantly lower motor scores in at-risk infants were evident from the age of 7 months compared to the low-risk group. Infants who were later diagnosed with ASD demonstrated significantly poorer Fine Motor skills at 36 months than at-risk infants without any developmental difficulties. In addition, Gross Motor scores were highly correlated across the two measures for low-risk infants and infants who later developed ASD. Early motor difficulties may be an early indicator of a number of neurodevelopmental disorders, including ASD.     

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。     

Performance on the dimensional change card sort and backward digit span by young children with autism without intellectual disability

The early development of executive function (EF) and its relation to autism symptom expression is of considerable theoretical interest, particularly in children without general cognitive delay. Executive function was tested in 23 children with autism spectrum disorders (ASD) without intellectual disability and 20 age- and IQ-matched typically developing children. Even though performance was equivalent between the two groups on tests of general intelligence, flexibility in card sorting was lower for children with ASD. Verbal working memory during the backward digit span did not differ between groups. Among children with ASD, poorer performance on card sorting distinguished a subgroup with worse social-communication functioning above and beyond IQ. Controlling for IQ social and repetitive symptoms of ASD did not differ based on card sorting ability.     

Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder

To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II). Detailed developmental and medical history was obtained from all participants. Diagnosis was based on clinical consensus of at least two expert clinicians, using test results, clinical observations, and parent report. 23% of participants with a reported community diagnosis of ASD were classified as non-spectrum based on our consensus diagnosis. ASD and non-spectrum participants did not differ on age at evaluation and age of first community diagnosis. Non-verbal IQ scores and Adaptive Behavior Composite scores were significantly higher in the non-spectrum group compared to the ASD group (104.5?±?21.7 vs. 80.1?±?21.6, p?<?.01; 71.1?±?15 versus 79.5?±?17.6, p?<?.05, respectively). Participants enrolled with community diagnosis of PDD-NOS were significantly more likely to be classified as non-spectrum on the study consensus diagnosis than Participants with Autism or Asperger (36% versus 9.5%, Odds Ratio?=?5.4, p?<?.05). This study shows suboptimal agreement between community diagnoses of ASD and consensus diagnosis using standardized instruments. These findings are based on limited data, and should be further studied, taking into consideration the influence of DSM 5 diagnostic criteria on ASD prevalence.     

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.     

Metacognitive monitoring and control processes in children with autism spectrum disorder: Diminished judgement of confidence accuracy

Metacognition consists of monitoring processes (the ability to accurately represent one’s own mental states) and control processes (the ability to control one’s cognitive processes effectively). Both processes play vital roles in self-regulated learning. However, currently it is unclear whether these processes are impaired in individuals with autism spectrum disorders (ASDs). This study aimed to assess metacognition in thirty-two children with ASD, and 30 IQ-/age-matched neurotypical children, using a judgment of confidence task. It was found that children with ASD showed diminished accuracy in their judgments of confidence, indicating metacognitive monitoring impairments in ASD. Children with ASD also used monitoring to influence control processes significantly less than neurotypical children, despite little evidence of impairments in overall control ability.     

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.     

自闭谱系障碍:一种主动性的社会认知控制缺陷

认知控制是一项高级的认知能力,是个体执行功能的一部分。包括认知控制在内的执行功能缺陷被认为是自闭谱系障碍的主要原因之一。本研究基于双重认知控制模型,通过非社会性和社会性两个领域的任务比较了自闭谱系障碍儿童（ASD）与正常发展儿童（TD）的认知控制能力的差异。结果发现：（1）ASD儿童在非社会性领域的认知控制上不存在缺陷,ASD儿童在社会性领域的认知控制上仅表现出了主动性认知控制缺陷,不存在反应性认知控制缺陷;(２)ASD儿童的主动性控制并不像TD儿童一样出现两个领域的加工分化,他们没有像TD儿童一样,表现出社会性领域的主动性控制的优势;（３）社会性领域的主动性控制和反应性控制可以显著从负正两个方向上预测自闭症状的严重程度。本研究认为,可以把ASD看成是一种主动性的社会认知控制缺陷。社会性领域的认知控制指标可为ASD的诊断与训练提供重要参考。     

High cognitive sensitivity to activational effects of testosterone in parents of offspring with autism spectrum disorders

The existence of mild forms of autistic-like characteristics in parents of children with autism spectrum disorders (ASDs) has been defined as a broader autistic phenotype (BAP). Excessive prenatal exposure to testosterone (T) seems to play a role in its development. The aims of this study were to characterize whether ASD parents show masculinized brains or high T prenatal exposure compared to a normative population, using cognitive questionnaires, and also to examine the T level changes in response to different cognitive tasks. ASD parents were found to present higher autistic and lower empathic trait scores than controls. They also have higher T levels and magnitude of T response to cognitive tasks. Specific correlation patterns between masculinized brain types and T levels were observed only in ASD parents. Thus, it seems that first-degree relatives of people with ASD have high T levels during task performance, which, in turn, produce slight cognitive masculinization. Our findings should be considered for understanding the role of androgens in the etiology of ASD. Nevertheless, the masculinization parameters described throughout the study are subtle and require further analysis.     

Developmental Changes in Pretend Play from 22- to 34-Months in Younger Siblings of Children with Autism Spectrum Disorder

Developmental trajectories of children’s pretend play and social engagement, as well as parent sensitivity and stimulation, were examined in toddlers with an older sibling with autism spectrum disorder (ASD, high risk; HR) and toddlers with typically-developing older siblings (low risk; LR). Children (N = 168, 97 boys, 71 girls) were observed at 22, 28, and 34 months during free play with a parent and elicited pretend play with an examiner. At 28 and 34 months, children were asked to imagine the consequences of actions pantomimed by the examiner on a pretend transformation task. At 36 months children were assessed for ASD, yielding 3 groups for comparison: HR children with ASD, HR children without ASD (HR-noASD), and LR children. Children in all 3 groups showed developmental changes, engaging in more bouts of pretend play and obtaining higher scores on the elicited pretend and transformation tasks with age, but children with ASD lagged behind the other 2 groups on most measures. Children with ASD were also less engaged with their parents or the examiner during play interactions than either LR or HR-noASD children, with minimal developmental change evident. Parents, regardless of group, were highly engaged with their children, but parents of HR-noASD children received somewhat higher ratings on stimulation than parents of LR children. Most group differences were not accounted for by cognitive functioning. Instead, lower social engagement appears to be an important correlate of less advanced pretend skills, with implications for understanding the early development of children with ASD and for early intervention.     

A Preliminary Study of Activation,Stress, and Self-Management of Parents of Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) and developmental disabilities are high users of services, yet very little is known about how parents of these children interact with the health care system. Further, compared to parents of children with other developmental disabilities, parents of children with ASD experience more stress and dissatisfaction with services. Current efforts for improving services point to a need for understanding caregivers’ perceptions of their own health-care related beliefs and actions. Activation is a construct that measures the belief, knowledge, action, and persistence of managing one’s health care needs. The objective of this preliminary study was to evaluate the activation of parents of children with ASD using an adapted parent activation measure (PAM) for children with developmental disabilities called the PAM-DD. Data were collected from parents who received treatment as usual from a community-based outpatient treatment planning service for children with ASD. PAM-DD scores were compared with parent ratings of stress, self-management, and service satisfaction. Results indicated that increased activation correlated positively with parent report of satisfaction and ability to self-manage child issues such as eating, sleeping, and behavior and correlated negatively with parenting stress. The study of activation shows promise as a feature of quality of care for parents of children with developmental disabilities.     

MMPI-2 personality profiles of high-functioning adults with autism spectrum disorders

The Minnesota Multiphasic Personality Inventory-Second Edition was administered to 20 adults with autism spectrum disorders (ASD) who fell in the average to above average range of intelligence and 24 age-, intelligence-, and gender-matched college students. Large group differences, with the ASD group scoring higher, were found on the L validity scale, Clinical Scales 2 (D) and 0 (Si), Content scale Social Discomfort (SOD), Supplementary scale Repression (R), and Personality Psychopathology Five (PSY-5) scale INTR (Introversion). The proportion of ASD adults scoring in the clinical range on these scales was between 25% and 35%. High scores on these scales are consistent with the clinical picture of Asperger syndrome and high-functioning autism in adulthood. Future directions and implications for identifying adults in need of a specialized autism assessment are discussed.     

Relative preferences for edible and leisure stimuli in children with autism

Prior researchers have reported a tendency for individuals with developmental disabilities to select edible items more often than leisure items when those items are presented together in stimulus preference assessments. However, children with autism spectrum disorders (ASD), with whom many behavior analysts currently practice, are underrepresented in this body of literature. We conducted a replication of prior research with 26 children with ASD. Results indicated that edible items were more likely than leisure items to rank highly in our preference assessments, in concurrence with prior research. However, leisure items were also selected more often overall than in prior research, and significant individual variation was observed. These results suggest that preference assessments containing both edible and leisure stimuli can yield useful information for behavior analysts providing services to children with ASD, and the degree of preference for edible items noted in prior work may not be reflected in this contemporary population.     

Development of a Unified Protocol for the Treatment of Emotional Disorders in Youth

This study evaluated the efficacy of the Mind Reading interactive computer software to remediate emotion recognition deficits in children with autism spectrum disorders (ASD). Six unmedicated children with ASD and 11 unmedicated non-clinical control subjects participated in the study. The clinical sample used the software for five sessions. The control sample was evaluated only on pre- and post-test performance to assess practice effects. Results showed that participants with ASD scored significantly higher on the posttest than on the pretest. As level of emotion difficulty increased, mean scores on the pretest decreased, indicating that difficulty level had a valid effect. The Mind Reading computer software appears to significantly improve the emotion recognition abilities in children with ASD.     

Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.     

Developmental neuropsychological assessment of 4- to 5-year-old children born following Preimplantation Genetic Diagnosis (PGD): A pilot study

The purpose of this pilot study was to evaluate developmental neuropsychological profiles of 4- to 5-year-old children born after Preimplantation Genetic Diagnosis (PGD). Twenty-seven participants received a neurological examination and a battery of neuropsychological assessments including Wechsler Preschool & Primary Scale of Intelligence - Third Edition (WPPSI-III; cognitive development), Preschool Language Scale, Fourth Edition (PLS-4; language development), Wide Range Assessment of Visual Motor Abilities (visual motor abilities), Childhood Autism Rating Scales II (a screening test for autistic spectrum disorders), and the Miles ABC Test (ocular dominance). Parental questionnaires included the Behavior Rating Inventory of Executive Function Preschool Version (BRIEF-P; executive function), Child Behavior Checklist (CBCL) and the Carey Temperament Scales Behavioral Style Questionnaire (socioemotional development and temperament), and the Vineland Adaptive Behavior Scales, Interview Edition, Second Edition (general adaptive behavior). Subjects’ tests results were compared to each test’s norms. Children born after PGD demonstrated scores within the normal or above-normal ranges for all developmental outcomes (mean ± SD): WPPSI-III-VIQ 107.4 ± 14.4 (p = .013), PLS-4-Total 113.2 ± 12.4, p < .001), CBCL-Total 41.1 ± 8.6 (p < .001), BRIEF-P-Global Executive Composite 44.8 ± 9.5 (p = .009). Twelve (44%) of the PGD children had a significant difference between their VIQ and PIQ scores (compared to 27% in the general population). One subject was found to show possible signs of autistic spectrum disorder, although a family history of autism was noted. In conclusion, in this pilot study, children assessed at age 4–5 years and conceived after PGD displayed developmental neuropsychological outcomes within normal limits as compared to their chronologic peers. A larger study is needed to evaluate and follow the neuropsychological development of children born after PGD.     

运用沙箱游戏区分自闭症谱系障碍儿童功能的可行性探索

摘 要： 通过沙箱作品来解读研究对象的内心世界是为常见,然根据其作品来区分自闭症谱系障碍（ASD）儿童功能的研究尚少,本研究力图为此进行探索。通过对126名已有医院诊断书的3.2~14岁ASD儿童的沙箱游戏行为、微缩玩具摆放过程观察及作品分析发现,ASD儿童功能越高,其沙箱游戏总分和沙箱游戏各观察维度的得分也越高,差异显著性均达到p<.001。ASD儿童功能越高,其沙箱作品的整合性、空间布局和想象力水平也越高。运用沙箱游戏或可区分ASD儿童的功能。     

Comparison of the Vineland Adaptive Behavior Scales, Second Edition, and the Bayley Scales of Infant and Toddler Development, Third Edition

The Vineland Adaptive Behavior Scales, Second Edition (Vineland-II), and Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) were administered to 65 children between the ages of 12 and 42 months referred for developmental delays. Standard scores and age equivalents were compared across instruments. Analyses showed no statistical difference between Vineland-II ABC standard scores and cognitive levels obtained from the Bayley-III. However, Vineland-II Communication and Motor domain standard scores were significantly higher than corresponding scores on the Bayley-III. In addition, age equivalent scores were significantly higher on the Vineland-II for the fine motor subdomain. Implications for early intervention are discussed.     

Effects of enthusiastic and non-enthusiastic voice in praise on the behavior of children with autism and typically developing children

Behavioral intervention manuals for children with autism spectrum disorder (ASD) commonly recommend that praise should be delivered in an enthusiastic tone of voice. Only a few studies, however, have explicitly tested this assumption, and results have been mixed. This study therefore compared the effects of enthusiastic and non-enthusiastic tone of voice in praise on the behavior of children with ASD. We also examined how typically developing (TD) children responded to enthusiastic and non-enthusiastic praise. Participants were 21 children with ASD matched on developmental age with the chronological age of 20 TD children. The effects of enthusiastic and non-enthusiastic praise were assessed using an application on a tablet computer designed to isolate tone of voice as a variable in vocally delivered praise. Two buttons produced the same six praise statements, one with an enthusiastic tone of voice and one with a neutral tone of voice. Results showed that the children with ASD, on average, allocated more responding to the square on the tablet computer producing enthusiastic praise as compared to the square producing non-enthusiastic praise. In addition, higher rates of responding to non-enthusiastic praise correlated positively with higher IQ, suggesting that non-enthusiastic praise was more effective for children with ASD with higher cognitive scores. The TD children, in contrast, did not allocate more responding to either the squares, suggesting that tone of voice in praise was not an important variable for the behavior of TD children.