Using the ADI-R to diagnose autism in preschool children

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.     

When the social mirror breaks: deficits in automatic, but not voluntary, mimicry of emotional facial expressions in autism

Humans, infants and adults alike, automatically mimic a variety of behaviors. Such mimicry facilitates social functioning, including establishment of interpersonal rapport and understanding of other minds. This fundamental social process may thus be impaired in disorders such as autism characterized by socio-emotional and communicative deficits. We examined automatic and voluntary mimicry of emotional facial expression among adolescents and adults with autistic spectrum disorders (ASD) and a typical sample matched on age, gender and verbal intelligence. Participants viewed pictures of happy and angry expressions while the activity over their cheek and brow muscle region was monitored with electromyography (EMG). ASD participants did not automatically mimic facial expressions whereas the typically developing participants did. However, both groups showed evidence of successful voluntary mimicry. The data suggest that autism is associated with an impairment of a basic automatic social-emotion process. Results have implications for understanding typical and atypical social cognition.     

Impaired categorical perception of facial expressions in high-functioning adolescents with autism.

Categorical perception of facial expressions is studied in high-functioning adolescents with autism, using three continua of facial expressions obtained by morphing. In contrast to the results of normal adults, the performance on the identification task in autistic subjects did not predict performance on the discrimination task, an indication that autistic individuals do not perceive facial expressions categorically. Performance of autistic subjects with low social intelligence was more impaired than that of subjects with higher social IQ scores on the expression recognition of unmanipulated photographs. It is suggested that autistic subjects with higher social intelligence may use compensatory strategies that they have acquired in social training programs This may camouflage the deficits of this subgroup in the perception of facial expressions.     

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。     

‘An Association for All’—Notions of the Meaning of Autistic Self‐Advocacy Politics within a Parent‐Dominated Autistic Movement

In this paper, we seek to explore the tensions between advocacy and self advocacy autistic movements in a Swedish context with a special focus on the meanings that enable the production of particular understandings of autism and the autistic subject. Drawing on articles written for the Swedish advocacy magazine Empowerment written for and by people with autism, the discourse analysis explores two competing discourses: a reformist and a radical. The reformist discourse underlines a goal of (political) representation expressed in Empowerment. It may be understood as an important part of producing a legitimate autistic political subject–positioned as a full member, with a full membership–within a parent‐dominated autistic advocacy movement. The reformist discourse can be viewed as a result of a negotiation, where full membership is conditioned on the parents' terms and granted on specific terms. These include working together (neuro‐inclusively), advocacy based on interest rather than identity/position as a specific target/member group, agreement upon a definition of autism as a disability (a deficit) a person has rather than an identity. In relation to this, an alternative legitimate autistic subject is produced through invoking the counter‐hegemonic radical discourse. Such a narrative produces the ‘Asperger’ or ‘Aspie’. Here, the ‘full membership’ refers to a sense of identification with sense of belonging to and being at home with other people with autism. It contains a certain amount of autistic solidarity within the group of adults with autism. Copyright © 2014 John Wiley & Sons, Ltd.     

Autism as a Form of Life: Wittgenstein and the Psychological Coherence of Autism

Autism is often taken to be a specific kind of mind. The dominant neuro‐cognitivist approach explains this via static processing traits framed in terms of hyper‐systemising and hypo‐empathising. By contrast, Wittgenstein‐inspired commentators argue that the coherence of autism arises relationally, from intersubjective disruption that hinders access to a shared world of linguistic meaning. This paper argues that both camps are unduly reductionistic and conflict with emerging evidence, due in part to unjustifiably assuming a deficit‐based framing of autism. It then develops a new Wittgensteinian account—autism as a different form of life—which avoids these issues. Rather than autistic systemising being the basis of autistic cognition, it is taken to be a reaction to pre‐epistemic and semantic anxieties that come with developing as a minority within a different form of life. This re‐framing can provide a coherent account of the autistic mind, and has significant conceptual, practical, and ethical implications.     

Autism and 15q11-q13 disorders: behavioral, genetic, and pathophysiological issues

New insights into biological factors that underlie autism may be gained by comparing autism to other neurodevelopmental disorders that have autistic features and relatively well-delineated genetic etiologies or neurobiological findings. This review moves beyond global diagnoses of autism and instead uses an endophenotypic approach to compare specific clusters of autistic symptomatology to features of chromosome 15q11-q13 disorders. Paternally or maternally derived deficiencies of 15q11-q13 result in Prader-Willi or Angelman syndromes, and we first use a global approach to review potential autism susceptibility genes in the 15q11-q13 region. We then use a more trait-based approach to suggest possible ties between specific phenotypic characteristics of autism and Prader-Willi syndrome, namely savant-like skills. We conclude with insights from pathophysiological studies that implicate altered development of specific neuron types and circuits in the cerebral cortex as part of the pathophysiological processes associated with autism and mental retardation.     

Detail-oriented cognitive style and social communicative deficits,within and beyond the autism spectrum: Independent traits that grow into developmental interdependence

At the heart of debates over underlying causes of autism is the “Kanner hypothesis” that autistic deficits in social reciprocity, and a cognitive/perceptual ‘style’ favouring detail-oriented cognition, co-vary in autistic individuals. A separate line of work indicates these two domains are normally distributed throughout the population, with autism representing an extremity. This realisation brings the Kanner debate into the realm of normative co-variation, providing more ways to test the hypothesis, and insights into typical development; for instance, in the context of normative functioning, the Kanner hypothesis implies social costs to spatial/numerical prowess. In light of this growing body of research, we review relevant factor analytic and correlational, behavioural studies. Findings are then synthesised into three themes: an alternative triad of primary autistic trait categories – Social Interaction Deficits, Cognitive Inflexibility, and Sensory Abnormalities – that more accurately reflects the factor structure of autistic traits; continuity between clinical and non-clinical autism-spectrum trait presentation; and indications that although social and non-social autistic traits may be initially independent, Kanner-like co-variance emerges behaviourally from dynamic trait interactions over the course of development. A dynamic developmental model subsuming these patterns is offered, and its advantages demonstrated in a novel account of ritualistic behaviours: as developmentally emergent, compensatory mechanisms for interactions between cognitive inflexibility and sensory abnormalities. We conclude with the broader imperative that behavioural scientists appealing for directly and exclusively genetic links may instead benefit from a developmental framing within their own discipline.     

Trapped Children: Popular Images of Children with Autism in the 1960s and 2000s

The lay public inherits much of its information about disability and mental illness through the media, which often relies on information from popular scientific works. Autism, as it was defined during the dominance of psychogenic paradigms of mental illness, generated certain tropes surrounding it, many of which have been popularized through media representations. Often inaccurate, these tropes have persisted into contemporary times despite a paradigmatic shift from psychogenic to biological explanations and treatments for mental illness. The current article examines images and articles of children with autism from the 1960s and the early 2000s in major news media and scientific literature to highlight the persistence of themes of fragmentation and the imprisonment of children with autism. While these themes have persisted in psychological and media literature, narratives of people with autism and their families often present a different perspective. This results in two divergent 'realities' of autism being disseminated into the general public.     

自闭症谱系障碍个体的焦虑：发生机制、评估与治疗

自闭症谱系障碍是一种神经发育性障碍, 主要表现为社会交往互动障碍和重复刻板性行为。焦虑或焦虑障碍常被认为是自闭症个体最普遍的共病之一。焦虑与自闭症之间的关系尚不明确, 自闭症个体的焦虑与无法忍受不确定性、杏仁核功能和体积、情绪调节策略、消极思维存在一定关联; 目前已经开发出专门用于自闭症个体焦虑的评估工具; 修订版认知行为疗法对自闭症个体焦虑的治疗取得了良好效果。未来的研究应着重探索自闭症个体焦虑的认知与神经机制, 检验专用评估工具的有效性, 继续关注现代技术(如虚拟现实技术)对自闭症个体焦虑的治疗效果。     

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.     

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.     

自闭症儿童行为评定与社会认知发展的研究

本研究用自闭症儿童发展评定量表,自闭症儿童基本社会认知问卷以及“ＴｏＭ”实验,对４９名自闭症儿童及３０名弱智儿童进行了行为评定与社会认知的研究。研究结果为目前国内自闭症的诊断和治疗提供了新的有效工具及进一步明确化的理论依据,并为其教育训练提供了标准的新的启示。     

Comparison of choose-a-movie and approach–avoidance paradigms to measure social motivation

Social motivation is a subjective state which is rather difficult to quantify. It has sometimes been conceptualised as “behavioural effort” to seek social contact. Two paradigms: approach–avoidance (AA) and choose a movie (CAM), based on the same conceptualisation, have been used to measure social motivation in people with and without autism. However, in absence of a direct comparison, it is hard to know which of these paradigms has higher sensitivity in estimating preference for social over non-social stimuli. Here we compare these two tasks for their utility in (1) evaluating social seeking in typical people and (2) identifying the influence of autistic traits on social motivation. Our results suggest that CAM reveals a clear preference for social stimuli over non-social in typical adults but AA fails to do so. Also, social seeking measured with CAM but not AA has a negative relationship between autistic traits.     

Expressive drawing ability in children with autism

The autistic impairments in emotional and social competence, imagination and generating ideas predict qualitative differences in expressive drawings by children with autism beyond that accounted by any general learning difficulties. In a sample of 60 5–19‐year‐olds, happy and sad drawings were requested from 15 participants with non‐savant autism and compared with those drawn by three control groups matched on either degree of learning difficulty (MLD), mental age (MA) or chronological age (CA). All drawings were rated by two artists on a 7‐point quality of expression scale. Contrary to our predictions, the drawings from the autistic group were rated similar to those of the MA and MLD groups. Analysis of the people and social content of the drawings revealed that although children with autism did not draw fewer people, they did draw more immature forms than mental age controls. Furthermore, there was tentative evidence that fewer social scenes were produced by the autism sample. We conclude that the overall merit of expressive drawing in autism is commensurate with their general learning difficulties, but the social/emotional impairment in autism affects their drawings of people and social scenes.     

Representing Inner Worlds: Theory of Mind in Autistic, Deaf, and Normal Hearing Children

The purpose of the study reported here was to examine the degree to which delays or deficits in developing a theory of mind are specific to children with autism or extend to other groups of atypical children with varying conversational experience and awareness. The performance of deaf children from a variety of conversational backgrounds was compared with that of autistic and normal hearing children on a range of tasks requiring representation of others' mental states. Native signers, oral deaf children, and normal hearing children scored similarly, and their performance exceeded that shown by signing deaf children from hearing families and children with autism. The latter two groups did not differ significantly from each other. These results point to an interplay among biology, conversation, and culture in the development of a theory of mind.     

Understanding Autism Implications for Psychoanalysis

Several lines of evidence inform current psychoanalytic thinking about infantile autism. Although early psychoanalytic interest in autism centered around the notion that experience might play a role in pathogenesis a large body of data suggest this is not the case; rather the condition appears to be the result of genetic and other neurobiological factors. Studies of children with autism do, however, suggest basic problems in capacities for object relations and other aspects of ego development which must be understood in the context of autistic social dysfunction. The study of normally developing infants raises considerable questions about the validity of notions such as a normal autistic phase; rather than for the normally developing child interest in the social world appears to be an innate capacity and one which has considerable importance for our understanding of the nature of early ego development and capacities for self-object differentiation.     

Autism and receptive dysphasia: Evaluation of comparative studies

Ten different studies comparing children with autism and receptive dysphasia are reviewed. Most of the studies aimed to characterize autism as a language disorder. The representativity of the samples are discussed according to heterogeneity of the autistic and dysphatic populations, and sex and social class distributions. Group differences and similarities are listed and discussed according to sample selection and matching procedures, age and sex distribution, social class membership, and the defining criteria of the two illnesses. It is concluded that the studies do not fullfill their aim, and that the project of comparing dysphatic and autistic children seems unfruitful. Group differences which seem unconnected with methodological difficulties, selection procedure, or group defining criteria, were found in parental background, use of gestures, articulation, and reading.     

Animal Faux Pas: Two Legs Good Four Legs Bad for Theory of Mind,but Not in the Broad Autism Spectrum

Research shows that the general population varies with regard to both autistic traits and theory of mind (ToM) ability. Other work has shown that autistic individuals may not underperform on ToM tests when the agent of evaluation is anthropomorphic rather than typically human. Two studies examined the relation between ToM and autistic trait profiles in over 650 adults using either the standard Faux Pas Recognition Test (FPT) or an anthropomorphized version of the FPT (FPTa). Results showed that autistic trait profiles were related to faux pas detection ability in the FPT but not the FPTa. Furthermore, while those with the broad autism phenotype scored significantly worse than those who were typically developed on the FPT, scores did not significantly differ on the FPTa. These findings add to a growing body of work suggesting that ToM ability is not at a global deficit in those on the autistic spectrum, but may relate to the mindreading of specifically human agents.