Social Skills Training for Adolescents with Asperger Syndrome and High-Functioning Autism

The effectiveness of a social skills training group for adolescents with Asperger syndrome and high-functioning autism (AS/HFA) was evaluated. Parents of six groups of adolescents (n = 46, 61% male, mean age 14.6) completed questionnaires immediately before and after the 12-week group. Parents and adolescents were surveyed regarding their experience with the group. Significant pre- to post-treatment gains were found on measures of both social competence and problem behaviors associated with AS/HFA. Effect sizes ranged from .34 to .72. Adolescents reported more perceived skill improvements than did parents. Parent-reported improvement suggests that social skills learned in group sessions generalize to settings outside the treatment group. Larger, controlled studies of social skills training groups would be valuable.     

Sleep Patterns of School-Age Children with Asperger Syndrome or High-Functioning Autism

Sleep patterns of 32 school-age children with Asperger syndrome (AS) and high-functioning autism (HFA) were compared to those of 32 typically developing age- and gender-matched children, using parent survey and one week of diary and actigraphic monitoring. Parents of children with AS/HFA more commonly reported that their children had difficulty falling asleep. One week of sleep recording with diary and actigraphy confirmed that children in the AS/HFA group spent a longer time awake in bed before falling asleep than children in the control group, possibly because the children in the AS/HFA group had earlier bedtimes. Other essential aspects of sleep patterns coincided between the groups. The sleep patterns of children with AS and HFA did not differ.     

Sleep Patterns in School-age Children with Asperger Syndrome or High-functioning Autism: A Follow-up Study

The course of sleep patterns over 2–3 years was compared between 16 school-age children with Asperger syndrome (AS) or high-functioning autism (HFA) and 16 age- and gender-matched typically developing children, using 1-week actigraphy at baseline and follow-up. At baseline (mean age 11.1 years), children with AS/HFA had longer sleep latency and lower sleep efficiency during school days, but earlier sleep start and sleep end during weekends. At follow-up (mean age 13.7 years), children with AS/HFA had longer night wakings and lower sleep efficiency during weekends than the controls. The overall change of sleep patterns, however, is similar in children with AS/HFA and typically developing controls over a 2 to 3-year period. There is one change in affiliation since the time of the study, namely, Hiie Allik has defended her thesis, and obtained a doctoral degree at the Karolinska Institutet, Stockholm, Sweden. Dr. Allik conducted this study in partial fulfilment of the requirements for a doctoral degree at the Karolinska Institutet, Stockholm, Sweden.     

Recognition of Faux Pas by Normally Developing Children and Children with Asperger Syndrome or High-Functioning Autism

Most theory of mind (ToM) tests are designed for subjects with a mental age of 4–6 years. There are very few ToM tests for subjects who are older or more able than this. We report a new test of ToM, designed for children 7–11 years old. The task involves recognizing faux pas. Study 1 tested 7–9, and 11-year-old normal children. Results showed that the ability to detect faux pas developed with age and that there was a differential developmental profile between the two sexes (female superiority). Study 2 tested children with Asperger syndrome (AS) or high-functioning autism (HFA), selected for being able to pass traditional 4- to 6-year level (first- and second-order) false belief tests. Results showed that whereas normal 9- to 11-year-old children were skilled at detecting faux pas, children with AS or HFA were impaired on this task. Study 3 reports a refinement in the test, employing control stimuli. This replicated the results from Study 2. Some patients with AS or HFA were able to recognize faux pas but still produced them. Future research should assess faux pas production.     

Social Anxiety in High-functioning Children and Adolescents with Autism and Asperger Syndrome

We examined social anxiety and internalizing symptoms using the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Social Anxiety Scale for Children -Revised (SASC-R), and the Child Behavior Checklist (CBCL) in a sample of fifty-four high-functioning subjects with autism or Asperger syndrome (HFA/AS) (M = 11.2 ± 1.7 years) and 305 community subjects (M = 12.2 ± 2.2 years). Children and adolescents completed the SPAI-C and SASC-R, and their parents completed the CBCL Internalizing scale. Adolescents with HFA/AS scored higher than the community sample on all measures. Behavioural avoidance and evaluative social anxiety increased by age within the HFA/AS group, whereas behavioural avoidance decreased by age in control participants. Data support that HFA/AS in adolescents may be associated with clinically relevant social anxiety symptoms.     

A Screening Questionnaire for Asperger Syndrome and Other High-Functioning Autism Spectrum Disorders in School Age Children

The high-functioning Autism Spectrum Screening Questionnaire (ASSQ) is a 27-item checklist for completion by lay informants when assessing symptoms characteristic of Asperger syndrome and other high-functioning autism spectrum disorders in children and adolescents with normal intelligence or mild mental retardation. Data for parent and teacher ratings in a clinical sample are presented along with various measures of reliability and validity. Optimal cutoff scores were estimated, using Receiver Operating Characteristic analysis. Findings indicate that the ASSQ is a useful brief screening device for the identification of autism spectrum disorders in clinical settings.     

Pragmatic inference abilities in individuals with Asperger syndrome or high-functioning autism. A review

This review summarizes studies involving pragmatic language comprehension and inference abilities in individuals with Asperger syndrome or high-functioning autism. Systematic searches of three electronic databases, selected journals, and reference lists identified 20 studies meeting the inclusion criteria. These studies were evaluated in terms of: (a) purpose of study, (b) participant characteristics and (c) procedures. Across the studies, the ages of participants varied between 6 and 57 years. The pragmatic comprehension and inference abilities measured varied from homograph comprehension to ability to understand non-literal statements. Pragmatic inference weaknesses, but not inabilities, were found throughout the studies. However, researchers did not wholly agree on the reasons and the extent of processing difficulties. The most commonly suggested explanations for pragmatic inference deficits were theory of mind and central coherence.     

Pragmatic Inferences in High-Functioning Adults with Autism and Asperger Syndrome

Although people with autism spectrum disorders (ASD) often have severe problems with pragmatic aspects of language, little is known about their pragmatic reasoning. We carried out a behavioral study on high-functioning adults with autistic disorder (n = 11) and Asperger syndrome (n = 17) and matched controls (n = 28) to investigate whether they are capable of deriving scalar implicatures, which are generally considered to be pragmatic inferences. Participants were presented with underinformative sentences like “Some sparrows are birds”. This sentence is logically true, but pragmatically inappropriate if the scalar implicature “Not all sparrows are birds” is derived. The present findings indicate that the combined ASD group was just as likely as controls to derive scalar implicatures, yet there was a difference between participants with autistic disorder and Asperger syndrome, suggesting a potential differentiation between these disorders in pragmatic reasoning. Moreover, our results suggest that verbal intelligence is a constraint for task performance in autistic disorder but not in Asperger syndrome.

The Strange Stories Test: A Replication with High-Functioning Adults with Autism or Asperger Syndrome

Two groups of individuals, one with high-functioning autism and the other with Asperger syndrome were tested using Happé's Strange Stories Test of a more advanced theory of mind (Happé, 1994). This assesses the ability to interpret a nonliteral statement. Relative to normal controls who were IQ and age-matched, individuals with autism or Asperger syndrome performed less well on the task, while performing normally on a non-mentalistic control task. Individuals with autism or Asperger syndrome could provide mental state answers, but had difficulty in providing contextually appropriate mental state answers. Rather, their answers tended to concentrate on the utterance in isolation. This replicates Happé's result. Although the majority of both clinical groups provided context-inappropriate interpretations, the autism group had the greater difficulty. Results are discussed in relation to both weak central coherence and theory of mind.     

Brief Report: Cognitive Flexibility and Focused Attention in Children and Adolescents with Asperger Syndrome or High-Functioning Autism as Measured on the Computerized Version of the Wisconsin Card Sorting Test

The aim of the present study was to assess mental flexibility and set maintenance of a group of individuals with Asperger syndrome (AS) or high-functioning autism (HFA) (N = 13; mean age 16,4), as compared with a matched group of typically developing children and adolescents (N = 13; mean age 15,6) on the computerized version of the Wisconsin Card Sorting Test (WCST). The participants in the AS/HFA group performed less well than the controls on all categories of the WCST, but the differences did not reach conventional statistical significance on most categories of the WCST. On the category failure to maintain set, however, the AS/HFA participants performed significantly less well than the controls, suggesting a deficit of focused attention.     

Cognitive Differences in Pictorial Reasoning Between High-Functioning Autism and Asperger’s Syndrome

We investigated linguistic and visuospatial processing during pictorial reasoning in high-functioning autism (HFA), Asperger’s syndrome (ASP), and age and IQ-matched typically developing participants (CTRL), using three conditions designed to differentially engage linguistic mediation or visuospatial processing (visuospatial, V; semantic, S; visuospatial + semantic, V + S). The three groups did not differ in accuracy, but showed different response time profiles. ASP and CTRL participants were fastest on V + S, amenable to both linguistic and nonlinguistic mediation, whereas HFA participants were equally fast on V and V + S, where visuospatial strategies were available, and slowest on S. HFA participants appeared to favor visuospatial over linguistic mediation. The results support the use of linguistic versus visuospatial tasks for characterizing subtypes on the autism spectrum.     

Language Abilities of Children with Asperger Syndrome

Current diagnostic taxonomies (ICD-10, DSM-IV) emphasize normal acquisition of language in Asperger syndrome (AS). Although many linguistic sub-skills may be fairly normal in AS there are also contradictory findings. There are only few studies examining language skills of children with AS in detail. The aim of this study was to study language performance in children with AS and their age, sex and IQ matched controls. Children with AS had significantly lower scores in the subtest of Comprehension of Instructions. Results showed that although many linguistic skills may develop normally, comprehension of language may be affected in children with AS. The results suggest that receptive language processes should be studied in detail in children with AS.     

Quantitative Assessment of Neuromotor Function in Adolescents with High Functioning Autism and Asperger Syndrome

Background: Motor impairment in children with Asperger Syndrome (AS) or High functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of neuromotor skills in 14–22 year old HFA/AS. Methods: 16 HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). Results: The HFA/AS group showed strongest impairments of dynamic balance skills and diadochokinesis. Motor abilities were associated with degree of social withdrawal in the full sample and severity of current autistic symptoms in the HFA/AS group. Conclusion: Similar motor patterns as in younger children were found in the older adolescents. The association of autistic symptoms with motor performance points towards an essential role of motor impairment in autism spectrum disorders.     

Emotion Recognition in Children and Adolescents with Autism Spectrum Disorders

We examined upper facial basic emotion recognition in 57 subjects with autism spectrum disorders (ASD) (M = 13.5 years) and 33 typically developing controls (M = 14.3 years) by using a standardized computer-aided measure (The Frankfurt Test and Training of Facial Affect Recognition, FEFA). The ASD group scored lower than controls on the total scores of FEFA and perceived ambiguous stimuli more often as a negative emotion. The older ASD group (≥12 years) performed better than the younger ASD group (<12 years) on the blended emotions of FEFA. The results support the findings that individuals with ASD have difficulties in emotion recognition. However, older subjects with ASD seem to have better skills than younger subjects with ASD.     

The Friendship Questionnaire: An Investigation of Adults with Asperger Syndrome or High-Functioning Autism, and Normal Sex Differences

Friendship is an important part of normal social functioning, yet there are precious few instruments for measuring individual differences in this domain. In this article, we report a new selfreport questionnaire, the Friendship Questionnaire (FQ), for use with adults of normal intelligence. A high score on the FQ is achieved by the respondent reporting that they enjoy close, empathic, supportive, caring friendships that are important to them; that they like and are interested in people; and that they enjoy interacting with others for its own sake. The FQ has a maximum score of 135 and a minimum of zero. In Study 1, we carried out a study of n = 76 (27 males and 49 females) adults from a general population, to test for previously reported sex differences in friendships. This confirmed that women scored significantly higher than men. In Study 2, we employed the FQ with n = 68 adults (51 males, 17 females) with Asperger Syndrome or high-functioning autism to test the theory that autism is an extreme form of the male brain. The adults with Asperger Syndrome or high-functioning autism scored significantly lower on the FQ than both the male and female controls from Study 1. The FQ thus reveals both a sex difference in the style of friendship in the general population, and provides support for the extreme male brain theory of autism.     

Differentiating Autism and Asperger Syndrome on the Basis of Language Delay or Impairment

Asperger syndrome (AS) is differentiated from high-functioning autism (HFA) largely on a history of “language delay.” This study examined “specific language impairment” as a predictor of outcome. Language skills of 19 children with AS and 45 with HFA were assessed at 4–6 years of age (Time 1) and 2 years later (Time 2). Children’s symptoms and functional outcome scores were assessed every 2 years (Times 3, 4, and 5) until ages 15–17 years old. Regression analysis revealed that specific language impairment at time 2 more often accounted for the greatest variation in outcome scores in adolescence than the standard diagnosis of AS versus HFA based on history of language delay. Diagnostic implications are discussed.     

Performance of Children and Adolescents with Asperger Syndrome or High-functioning Autism on Advanced Theory of Mind Tasks

Although a number of advanced theory of mind tasks have been developed, there is a dearth of information on whether performances on different tasks are associated. The present study examined the performance of 21 children and adolescents with diagnoses of Asperger syndrome (AS) and 20 typically developing controls on three advanced theory of mind tasks: The Eyes Task, the Strange Stories, and the Stories from Everyday Life. The participants in the clinical group demonstrated lower performance than the controls on all the three tasks. The pattern of findings, however, indicates that these tasks may share different information-processing requirements in addition to tapping different mentalizing abilities.     

Spatial Frequency and Face Processing in Children with Autism and Asperger Syndrome

Two experiments were designed to investigate possible abnormal face processing strategies in children with autistic spectrum disorders. A group of 11 children with autism was compared to two groups of normally developing children matched on verbal mental age and on chronological age. In the first experiment, participants had to recognize faces on the basis of identity, emotion, gaze direction, gender, and lip reading. All aspects of face processing, except for identity matching, were deficient in the autistic population compared with controls. In the second study, children had to match faces on either high-(i.e., local facial features) or low-spatial frequency information (i.e., global configuration of faces). Contrary to the control subjects, children with autism showed better performance when using high rather than low spatial frequency, confirming face-processing peculiarities in this population.     

Verbal Marking of Affect by Children with Asperger Syndrome and High Functioning Autism during Spontaneous Interactions with Family Members

Verbal marking of affect by older children with Asperger Syndrome (AS) and high functioning autism (HFA) during spontaneous interactions is described. Discourse analysis of AS and HFA and typically developing children included frequency of affective utterances, affective initiations, affective labels and affective explanations, attribution of affective responses to self and others, and positive and negative markers of affect. Findings indicate that children with AS and HFA engaged in a higher proportion of affect marking and provided a higher proportion of affective explanations than typically developing children, yet were less likely to initiate affect marking sequences or talk about the affective responses of others. No significant differences were found between groups in terms of the marking of positive and negative affect.     

Brief Report: The Use of WAIS-III in Adults with HFA and Asperger Syndrome

The WAIS III was administered to 16 adults with high functioning autism (HFA) and 27 adults with Asperger syndrome. Differences between Verbal Intelligence (VIQ) and Performance Intelligence (PIQ) were not found. Processing Speed problems in people with HFA appeared. At the subtest level, the Asperger syndrome group performed weak on Digit Span. Comprehension and Block Design were relative strengths. In the HFA group, performance on Digit-Symbol Coding and Symbol Search was relatively poor. Strengths were found on Information and Matrix Reasoning. The results suggest that the VIQ-PIQ difference cannot distinguish between HFA and Asperger syndrome. WAIS III Factor Scale and Subtest patterning provides a more valid indicator.