Non-directive play therapy as a means of recreating optimal infant socialization patterns

The paper proposes that non-directive play therapy recreates conditions similar to those created between a carer and infant during normal development. By the heightening in therapy of essentially normal developmental processes the child with harmful or inadequate relationship experiences is enabled to rework and reintegrate these into normal interactiv patterns. Ways are reviewed in which non-directive play therapy exemplifies important attachment properties in an individual's primary relationships, and recreates healthy carer-infant patterns of interaction such as topicsharing, face-to-face interactions, mutuality and symbolic play, in order to bring about therapeutic change. This primary corrective function is similar to other responsive therapeutic approaches, but it is argued that a particular strength of non-directive play therapy lies in its inherent flexibility and responsiveness to the individual child, which resembles normal infant socialization with a sensitive carer.     

The Process of Systemic Change in Filial Therapy: A Phenomenological Study of Parent Experience

This phenomenological study represents the first qualitative exploration of parents’ experiences of the process of filial therapy from a systemic lens. Filial therapy is a treatment approach that teaches parents how to conduct weekly thirty minute play times with their target child at home in an effort to improve the parent–child relationship. Previous research has focused almost exclusively on the impact of this model on this relationship; however, the results from this focus group study (n = 8) indicate several relational shifts that occur within the greater family and societal contexts and suggest potential reasons for treatment gain maintenance over time.     

Intensive Child-Centered Play Therapy for Children on the Autism Spectrum: A Pilot Study

To investigate the effectiveness of intensive child-centered play therapy (CCPT) for children diagnosed with autism spectrum disorder (ASD), the authors randomly assigned 23 children with diagnosed ASD and symptoms of ASD on the Social Responsiveness Scale–2nd Edition (Constantino, 2012), to an intensive CCPT condition (n = 12) or a no-intervention control group (n = 11). Children who participated in 24 sessions of CCPT showed a statistically significant decrease in ASD core symptoms and behavioral symptoms, such as externalizing problems, attention problems, and aggression, compared with children in the control group. Implications are discussed.     

Attachment security differs by later autism spectrum disorder: A prospective study

Although difficulties with social relationships are key to autism spectrum disorder (ASD), no previous study has examined infant attachment security prior to ASD diagnosis. We prospectively assessed attachment security at 15 months in high‐risk infants with later ASD (high‐risk/ASD, n = 16), high‐risk infants without later ASD (high‐risk/no‐ASD, n = 40), and low‐risk infants without later ASD (low‐risk/no‐ASD, n = 39) using the Strange Situation Procedure. High‐risk/ASD infants were disproportionately more likely to be classified as insecure (versus secure) and more likely to be classified as insecure‐resistant (versus secure or avoidant) than high‐risk/no‐ASD and low‐risk/no‐ASD infants. High‐risk infants with insecure‐resistant attachments were over nine times more likely to receive an ASD diagnosis than high‐risk infants with secure attachments. Insecure‐resistant attachment in high‐risk infants suggests a propensity toward negative affect with the parent in conditions of stress. Insecure‐resistant attachment may prove useful as a potential early index of propensity toward ASD diagnosis in high‐risk siblings, while insecure‐resistant attachment in the context of emergent autism may contribute to difficulties experienced by children with ASD and their families.     

Does culture shape face perception in autism? Cross‐cultural evidence of the own‐race advantage from the UK and Japan

Autism spectrum disorders (ASD) are associated with face perception atypicalities, and atypical experience with faces has been proposed as an underlying explanation. Studying the own‐race advantage (ORA) for face recognition can reveal the effect of experience on face perception in ASD, although the small number of studies in the area present mixed findings. This study probed the ORA in ASD by comparing two cultural groups simultaneously for the first time. Children with ASD in the UK (N = 16) and Japan (N = 26) were compared with age‐ and ability‐matched typically developing (TD) children in the UK (N = 16) and Japan (N = 26). Participants completed a two‐alternative forced‐choice task, whereby they had to recognize a just seen face from a foil which was manipulated in one of four ways (IC: identity change; EE: easy eyes; HE: hard eyes; HM: hard mouth). Face stimuli were Asian and Caucasian, and thus the same stimuli were own and other race depending on the cultural group. The ASD groups in the UK and Japan did not show impaired face recognition abilities, or impairments with recognizing faces depending on manipulations to the eye region, and importantly they showed an ORA. There was considerable heterogeneity in the presence of the ORA in ASD and TD and also across cultures. Children in Japan had higher accuracy than children in the UK, and TD children in Japan did not show an ORA. This cross‐cultural study challenges the view that atypical experiences with faces lead to a reduced/absent ORA in ASD.     

Neural bases of Theory of Mind in children with autism spectrum disorders and children with conduct problems and callous‐unemotional traits

Individuals with autism spectrum disorders (ASD) have difficulty understanding other minds (Theory of Mind; ToM), with atypical processing evident at both behavioural and neural levels. Individuals with conduct problems and high levels of callous‐unemotional (CU) traits (CP/HCU) exhibit reduced responsiveness to others' emotions and difficulties interacting with others, but nonetheless perform normally in experimental tests of ToM. The present study aimed to examine the neural underpinnings of ToM in children (aged 10–16) with ASD (N = 16), CP/HCU (N = 16) and typically developing (TD) controls (N = 16) using a non‐verbal cartoon vignette task. Whilst individuals with ASD were predicted to show reduced fMRI responses across regions involved in ToM processing, CP/HCU individuals were predicted to show no differences compared with TD controls. The analyses indicated that neural responses did not differ between TD and CP/HCU groups during ToM. TD and CP/HCU children exhibited significantly greater medial prefrontal cortex responses during ToM than did the ASD group. Within the ASD group, responses in medial prefrontal cortex and right temporoparietal junction (TPJ) correlated with symptom severity as measured by the Autism Diagnostic Observation Schedule (ADOS). Findings suggest that although both ASD and CP/HCU are characterized by social difficulties, only children with ASD display atypical neural processing associated with ToM.     

Case–contrast study about parent–infant interaction in a Brazilian sample of siblings of children with autism spectrum disorders

Siblings of children with autism spectrum disorders (ASD) present greater susceptibility to developmental problems, in comparison with siblings of typically developing children. The greater prevalence of mental health disorders among parents of children with ASD increases younger siblings’ vulnerability to emotional problems. The aim of this study is to compare the interaction between carers and babies aged 2 to 26 months (M = 11.7, SD = 6.9) who are siblings of children with ASD (ASD dyads) with the interaction of dyads of siblings of typically developing children (TD dyads). The protocol of Clinical Indicators of Risk for Child Development and the Coding Interactive Behaviour measures were used to evaluate interaction. ASD dyads presented higher scores of constriction in their interaction, P = .024, with babies presenting higher scores of withdrawal behavior, P = .003, and carers presenting higher scores of depressive mood, P = .008, when compared to TD dyads. The ASD dyads have interactive impairments more frequently than do the TD dyads.     

Psychological Well-Being and Parent-Child Relationship Quality in Relation to Child Autism: An Actor-Partner Modeling Approach

Parents of children with autism spectrum disorder (ASD) often report poor psychological well-being, including a high level of parenting stress and depressive symptoms. Little is known about the extent to which poor parent psychological well-being alters the emotional quality of the parent-child relationship in a context of child ASD. This study examined the association between actor (one's own) and partner (one's partner's) level of parenting stress and depressive symptoms and the emotional quality of the parent-child relationship using a Five Minute Speech Sample (FMSS) in 150 families of children with ASD, aged 5–12 years (85.7% male). Mothers and fathers were aged 38.69 (SD = 5.62) and 40.76 (SD = 6.19), respectively; 76% of mothers and 68% of fathers had a college degree. Structural equation modeling, using Analysis of Moment Structures software, was used to test Actor-Partner Interdependence Models. Results indicated that mother's level of parenting stress and depressive symptoms were associated with her own FMSS Warmth and Criticism toward the child with ASD 12 months later in negative and positive directions. Mother's level of parenting stress was also negatively associated with father's FMSS Warmth toward the child with ASD 12 months later. Finally, father's level of parenting stress was positively associated with his FMSS Criticism toward the child with ASD. Overall, findings indicate that the mother-child and father-child relationship are both impacted by parent psychological well-being in families of children with ASD; however, actor effects are stronger for mothers and partner effects were only found for fathers. Implications for interventions are discussed.     

Rural Chinese youth during the transition into adulthood: Family dynamics and psychological adjustment

Rural youth in China experience numerous challenges during their transition into adulthood. Yet, research on this transition and its relevant influential factors is rare. Through the lens of family systems theory, this study examined the impacts of family dynamics (i.e., interparental and parent–adolescent interactions) in adolescence on the psychological adjustment of youth as they transition into adulthood. Participants were 1330 youth and their mothers in rural Gansu. In 2004, mothers completed questionnaires of interparental and parent–adolescent interactions when youth were adolescents (M_age = 15.03, SD = 1.15). In 2009, youth completed questionnaires of depression and self-esteem when they were emerging adults (M_age = 20.03, SD = 1.15). Results of structural equation modelling suggested that while interparental interactions in adolescence were not associated with the psychological adjustment of youth in emerging adulthood, positive parent–adolescent interactions in adolescence predicted better psychological adjustment of youth in emerging adulthood. Furthermore, mediation analysis showed that although interparental interactions did not directly affect the psychological adjustment of youth, they were positively associated with parent–adolescent interactions, which in turn contributed to the psychological adjustment of youth. The results reveal an enduring influence of family dynamics on psychological adjustment among rural Chinese youth during the transition into adulthood.     

The relationship between spoken language and speech and nonspeech processing in children with autism: a magnetic event‐related field study

It has been proposed that language impairments in children with Autism Spectrum Disorders (ASD) stem from atypical neural processing of speech and/or nonspeech sounds. However, the strength of this proposal is compromised by the unreliable outcomes of previous studies of speech and nonspeech processing in ASD. The aim of this study was to determine whether there was an association between poor spoken language and atypical event‐related field (ERF) responses to speech and nonspeech sounds in children with ASD (n = 14) and controls (n = 18). Data from this developmental population (ages 6–14) were analysed using a novel combination of methods to maximize the reliability of our findings while taking into consideration the heterogeneity of the ASD population. The results showed that poor spoken language scores were associated with atypical left hemisphere brain responses (200 to 400 ms) to both speech and nonspeech in the ASD group. These data support the idea that some children with ASD may have an immature auditory cortex that affects their ability to process both speech and nonspeech sounds. Their poor speech processing may impair their ability to process the speech of other people, and hence reduce their ability to learn the phonology, syntax, and semantics of their native language.     

Longitudinal development of manual motor ability in autism spectrum disorder from childhood to mid‐adulthood relates to adaptive daily living skills

Many individuals with autism spectrum disorder (ASD) exhibit motor difficulties, but it is unknown whether manual motor skills improve, plateau, or decline in ASD in the transition from childhood into adulthood. Atypical development of manual motor skills could impact the ability to learn and perform daily activities across the life span. This study examined longitudinal grip strength and finger tapping development in individuals with ASD (n = 90) compared to individuals with typical development (n = 56), ages 5 to 40 years old. We further examined manual motor performance as a possible correlate of current and future daily living skills. The group with ASD demonstrated atypical motor development, characterized by similar performance during childhood but increasingly poorer performance from adolescence into adulthood. Grip strength was correlated with current adaptive daily living skills, and Time 1 grip strength predicted daily living skills eight years into the future. These results suggest that individuals with ASD may experience increasingly more pronounced motor difficulties from adolescence into adulthood and that manual motor performance in ASD is related to adaptive daily living skills.     

Adolescent–parent attachment as a mediator of relations between parenting and adolescent social behavior and wellbeing in China

The purpose of this study was to examine links between parenting dimensions (authoritative parenting, psychological control, and parental authority) and adolescent wellbeing (self‐esteem, autonomy, and peer attachments) as mediated by parent–teen attachment, among Chinese families. The sample included 298 Chinese adolescents, ages 15–18 years (M age = 16.36, SD = .68; 60% female). The mediation model was examined using path analyses (one model with parental authority as overprotection, and one with it as perceived behavioral control). To improve model fit a direct path was added from authoritative parenting to autonomy. Authoritative parenting was positively predictive of attachment, while psychological control and overprotection (but not behavioral control) were negative predictors. In turn, adolescent–parent attachment was positively related to the three outcomes. Lastly, the model paths did not differ by adolescent gender. These findings suggest that parenting behaviors may play a crucial role in adolescent social behaviors and wellbeing via adolescent–parent attachment.     

Word comprehension mediates the link between gesture and word production: Examining language development in infant siblings of children with autism spectrum disorder

Children's gesture production precedes and predicts language development, but the pathways linking these domains are unclear. It is possible that gesture production assists in children's developing word comprehension, which in turn supports expressive vocabulary acquisition. The present study examines this mediation pathway in a population with variability in early communicative abilities—the younger siblings of children with autism spectrum disorder (ASD; high‐risk infants, HR). Participants included 92 HR infants and 28 infants at low risk (LR) for ASD. A primary caregiver completed the MacArthur‐Bates Communicative Development Inventory (Fenson, et al., 1993) at 12, 14, and 18 months, and HR infants received a diagnostic evaluation for ASD at 36 months. Word comprehension at 14 months mediated the relationship between 12‐month gesture and 18‐month word production in LR and HR infants (ab = 0.263; p < 0.01). For LR infants and HR infants with no diagnosis or language delay, gesture was strongly associated with word comprehension (as = 0.666; 0.646; 0.561; ps < 0.01). However, this relationship did not hold for infants later diagnosed with ASD (a = 0.073; p = 0.840). This finding adds to a growing literature suggesting that children with ASD learn language differently. Furthermore, this study provides an initial step toward testing the developmental pathways by which infants transition from early actions and gestures to expressive language.     

Perceiving gaze from head and eye rotations: An integrative challenge for children and adults

Gaze is an emergent visual feature. A person's gaze direction is perceived not just based on the rotation of their eyes, but also their head. At least among adults, this integrative process appears to be flexible such that one feature can be weighted more heavily than the other depending on the circumstances. Yet it is unclear how this weighting might vary across individuals or across development. When children engage emergent gaze, do they prioritize cues from the head and eyes similarly to adults? Is the perception of gaze among individuals with autism spectrum disorder (ASD) emergent, or is it reliant on a single feature? Sixty adults (M = 29.86 years‐of‐age), thirty‐seven typically developing children and adolescents (M = 9.3 years‐of‐age; range = 7–15), and eighteen children with ASD (M = 9.72 years‐of‐age; range = 7–15) viewed faces with leftward, rightward, or direct head rotations in conjunction with leftward or rightward pupil rotations, and then indicated whether the face was looking leftward or rightward. All individuals, across development and ASD status, used head rotation to infer gaze direction, albeit with some individual differences. However, the use of pupil rotation was heavily dependent on age. Finally, children with ASD used pupil rotation significantly less than typically developing (TD) children when inferring gaze direction, even after accounting for age. Our approach provides a novel framework for understanding individual and group differences in gaze as it is actually perceived—as an emergent feature. Furthermore, this study begins to address an important gap in ASD literature, taking the first look at emergent gaze perception in this population.     

Temperament and its Relationship to Autistic Symptoms in a High-Risk Infant Sib Cohort

The present study prospectively investigated early temperamental profiles and their associations with autistic symptoms in high-risk infants (N = 138) with an older sibling with autistic spectrum disorder (ASD) and low-risk infants (N = 73) with no family history of ASD. Children who were diagnosed with ASD at 36 months were distinguished from non-ASD sibs and controls by a temperament profile marked by lower positive affect, higher negative affect and difficulty controlling attention and behavior, which we labeled Effortful Emotion Regulation. This profile also distinguished the non-ASD sib group from the control group. Children with ASD were distinguished from both of the other two groups by a temperament profile of low Behavioral Approach (lower sensitivity to “social” reward cues). Low levels of Behavioral Approach were associated with a higher number of ASD symptoms, even after taking into account IQ, sex and group membership. Finally, a cluster analysis revealed two ASD subgroups distinguished by number of ASD symptoms, IQ, age of diagnosis and scores on the Behavioral Approach profile. These findings suggest that temperament may be a useful framework for understanding the emergence of ASD early in life.     

Sexualization in Lyrics of Popular Music from 1959 to 2009: Implications for Sexuality Educators

This study analyzed sexualization in lyrics of popular music in the final year of six decades. The study sample was comprised of Billboard Hot 100 year-end songs from 1959, 1969, 1979, 1989, 1999, and 2009 (N = 600). Regression analysis was used to compare the presence of sexualized lyrics from 1959 with other study years. Male artists’ lyrics (OR = 2.163; p = .029; CI = 1.080–4.333), non-White artists’ lyrics in 1999 and 2009 (OR = 2.670; p < .001; CI = 1.554–4.586), and 2009 lyrics (OR = 3.439; p = .003; CI = 1.515–7.809), were significantly more likely to contain sexualization. Recent research associating sexual content in media with adolescent sexual activity together with findings demonstrating a connection between exposure to objectifying media and self-sexualized behavior make this study’s findings significant to sexuality educators desiring to improve sexual health outcomes and promote healthy adolescent sexual development. Sexuality educators should be cognizant of the recent significant trend toward the inclusion of sexualization in music lyrics and the probable impact such music may have on adolescent sexual behavior and attitudes.     

Follow-up of victims of one terrorist attack in Israel: ASD, PTSD and the perceived threat of Iraqi missile attacks

The first aim of the study was to examine the relationships between acute stress reactions and post-traumatic reactions following exposure to a terrorist attack. The second was to examine whether exposure to a terrorist attack increases the perceived threat and fear of renewed Iraqi missile attacks. Data were collected at two points in time: during the first month after the exposure to a terrorist attack (N = 54), and four months later (N = 44). Twenty-four percent of the exposed group had acute stress disorder (ASD), and a similar percentage had PTSD. Among participants who had ASD, the chances of developing PTSD were three times greater than among those who had never experienced ASD. Among participants who had been exposed to a terrorist attack and developed PTSD, the perceived threat of an Iraqi missile attack was greater than among those who had been exposed to a terrorist attack but did not develop PTSD, or among the participants in the control group. The discussion deals with the findings in light of the current controversy regarding ASD and the current situation in Israel.     

Open-Trial Pilot of Parent-Child Interaction Therapy for Children With Autism Spectrum Disorder

In this pilot study, the effectiveness and feasibility of Parent-Child Interaction Therapy (PCIT) for decreasing disruptive behavior was evaluated in 17 young children with Autism Spectrum Disorder (ASD). PCIT is a behaviorally based play therapy which targets the parent-child relationship through live coaching of play interactions and the implementation of consistent discipline techniques. Following an average of 19 sessions, disruptive behavior as measured by multiple indices significantly decreased. Congruently, parents increased positive parental following skills and decreased negative parental leading skills across the course of treatment. In addition, parents reported increased levels of child functional communication and prosocial behavior. High levels of parent acceptability of the intervention were also noted. Effect sizes were medium to large across measured dependent variables, including parent report and behavioral observations. Implications for the clinical use of PCIT within an ASD population and future research with controlled outcome studies are discussed.     

Resistance and outcome expectations in cognitive‐behavioural therapy for generalised anxiety disorder

Greater client resistance has been consistently found to be negatively associated with outcome in psychotherapy. However, the pathways through which resistance impacts such outcomes are underexplored. Given that client outcome expectation (OE) has been identified as an important common factor in psychotherapy, the goals of the present study were to examine: (a) the impact of resistance on subsequent client and therapist OE (COE & TOE, respectively); and (b) whether COE and/or TOE mediate the relationship between resistance and outcome. These relationships were tested among 44 clients with severe generalised anxiety disorder treated with cognitive‐behavioural therapy in the context of a randomised controlled trial (Westra, Constantino, & Antony, 2016). Resistance was measured at a mid‐treatment session, and COE and TOE were assessed at baseline and immediately after the resistance session. Treatment outcome was measured via client‐rated worry severity at post‐treatment. As predicted, higher resistance was associated with lower subsequent COE and TOE; B = ?.73, p < .001 and B = ?.46, p < .001, respectively. In turn, lower post‐resistance COE predicted higher post‐treatment worry (B = ?.5, p < .001), indicating mediation. In contrast, TOE did not mediate the relationship between resistance and outcome (B = ?.02, p = .876). These results suggest that resistance can be demoralising to both clients and therapists. However, only lower client morale may be detrimental to therapy outcome. This study contributes to understanding outcome pathways through two common therapy processes.     

Adolescents’ Social Environment and Depression: Social Networks, Extracurricular Activity, and Family Relationship Influences

The present study examined components of adolescents’ social environment (social network, extracurricular activities, and family relationships) in association with depression. A total of 332 adolescents presenting for a routine medical check-up were self-assessed for social network risk (i.e., smoking habits of best male and female friends), extracurricular activity level (i.e., participation in organized sports teams, clubs, etc.), family relationship quality (i.e., cohesion and conflict), and symptoms of depression (i.e., minimal, mild, moderate/severe). Results of a forward linear regression modeling indicate that social environment components were associated with a significant proportion of the variance in adolescent depression (Adjusted R ² = .177, p ≤ .05). Specifically, adolescent females (β = .166, p < .01) and those having more smokers in their social network (β = .107, p < .05) presented with significantly greater depression symptoms. Conversely, adolescents who engaged in more extracurricular activities (β = −.118, p < .05) and experienced higher quality family relationships (β = −.368, p < .001) presented with significantly lower depressive symptoms. These findings highlight the important role that the social environment plays in adolescent depression, as well as yields new insights into socially-based intervention targets that may ameliorate adolescent depression. These intervention targets may be gender-specific, include positive social network skills training, increase adolescents’ engagement in organized activities, and attend to the quality of their family relationships.