Patterns of development in young children with autism

Objective: To determine the extent to which the developmental profile of children less than 4 years can help in distinguishing children with autism from children with developmental delay.Methods: Subjects were 32 children with autism as per the DSM IV criteria and 32 children with developmental delay matched on chronological and academic age. The Developmental Profile II was used to assess the developmental functioning in five domains including physical, social, self help, academic, and communication.Results: The two groups showed significantly different developmental profiles and these differences were accounted for mainly by significantly lower social skills and superior motor skills in the autistic group as compared to the developmentally delayed group.Conclusion: Developmental Profile II may help in distinguishing young children with autistic disorder from non-autistic children with comparable developmental delays     

SOCIAL INTERACTIONS OF AUTISTIC, MENTALLY RETARDED AND NORMAL CHILDREN AND THEIR CAREGIVERS

The social interactions of young autistic children and their caregivers were contrasted to interactions involving normal and mentally retarded controls. The autistic children displayed a much lower frequency of attention sharing behaviors, such as pointing to or showing objects. Alternatively, the autistic children directed as much looking, vocalizing and proximity behaviors toward their caregivers as did the other groups. Thus, although the autistic children did not show a clear lack of responsiveness to their caregivers, they did display a significant deficit in indicating behaviors during child-caregiver interaction.     

A descriptive hospital based study of children with autism

The clinical and neurodevelopmental profile of 51 children with Autistic disorder, from a referral population was studied. A detailed history and examination was undertaken. The development/intelligence quotient and social quotient were assessed. Standard diagnostic tests were applied in children above 2 years of age. Younger children were evaluated with a screening test and re-evaluated at 2 years. It was observed that a correct diagnosis had been made in only 5.8% of children prior to referral. The mean age of presentation was 3.28 years. Ninety-six percent of the autistic children had developmental delay. Qualitative impairment in social interaction and communication was more commonly observed than restricted interests and activities. Forty-seven (92.15%) children were severely autistic and 4 (7.84%) mildly to moderately autistic. All children less than 2 years were confirmed to have Autistic disorder later.     

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目的比较3岁前有无睡眠障碍孤独症儿童临床症状及发展特点。方法对1999—2006年在北京星星雨教育研究所接受特殊教育的275例孤独症学生进行儿童期孤独症评定量表(CARS)、克氏行为量表(CABS)测量。结果总体上3岁前有过睡眠障碍者症状严重于无睡眠障碍者。2~4岁时,有过睡眠障碍者比无睡眠障碍者病情严重,如有过睡眠障碍者情感、感觉、行为、社交问题均比无睡眠障碍者严重;5~8岁时,两者病情严重程度却比较接近,且有过睡眠障碍患儿情感反应优于无睡眠障碍患儿。结论3岁前有过睡眠障碍者与无睡眠障碍者有着不同的病情发展模式。前者起始症状严重,随后病情进展缓慢;后者起始症状虽然较轻,但病情进展迅速,以至于两类患者在学龄初期时病情严重程度基本相当。     

Memory Impairments and Communication in Relatively Able Autistic Children

Autistic people have specific memory difficulties. The effects of these difficulties on communication in relatively able autistic children and learning impaired controls were assessed in three experiments. The experiments tested the ability to: (1) carry out instructions; (2) ask questions without repetition; and (3) answer questions about past activities. When specific memory skills were required autistic children's communication was impaired relative to controls. When the need to use these skills was eliminated from the tasks the autistic children performed as well as controls. Some practical and theoretical implications of the findings are discussed.     

Play and imitation skills in the diagnosis of autism in young children

Play behaviors and motor imitation skills of 91 children between the ages of 3 and 6 years were investigated to determine their utility in distinguishing autism from mental retardation and other communication disorders. The performance of 22 autistic children was compared with that of 15 mentally retarded, 15 hearing-impaired, 19 language-impaired, and 20 non-handicapped children. Play behaviors were assessed using structured observations of free-play activities, and imitation skills were measured using a set of 12 individually administered tasks. The autistic group spent less total time interacting with toys and using toys appropriately, engaged in fewer functional play acts, and obtained lower imitation scores compared with all other groups. Discriminant function analysis revealed that the latter three variables discriminated the autistic children from the nonautistic handicapped children, with motor imitation emerging as the most important differentiating measure. These results suggest that measuring play and imitation skills may be useful in the clinical diagnosis of autism.     

Predictors of outcome among high functioning children with autism and Asperger syndrome

BACKGROUND: The objective of this paper is to assess the extent to which measures of cognitive abilities taken in an inception cohort of young high functioning children with autism and Asperger syndrome predict outcome roughly two and six years later. METHOD: Children who received a diagnosis of autism or Asperger syndrome (AS) and who had a nonverbal IQ score in the 'non-retarded' range were included in the inception cohort. Measures of language and nonverbal skills were taken when the children were 4-6 years of age and outcome assessments were completed when the children were 6-8 and 10-13 years of age. The three outcome measures consisted of scales of adaptive behaviours in socialisation and communication and a composite measure of autistic symptoms (abnormal language, abnormal body and object use, difficulties relating to others, sensory issues and social and self-help difficulties). RESULTS: The explanatory power of the predictor variables was greater for communication and social skills than for autistic symptoms. The power of prediction was stable over time but did differ by PDD subtype. In general, the association between language skills and outcome was stronger in the autism group than in the AS group. CONCLUSIONS: These results support the emphasis of early intervention programmes on language but more work needs to be done on understanding variables that influence outcome in social skills and autistic behaviours, particularly in those with AS.     

Facial Expressions of Affect in Autistic, Mentally Retarded and Normal Children

This study examined the facial affect expressions of autistic, mentally retarded and normal children. Affect was coded using the Maximally Discriminative Movement Coding System. Results indicated that the autistic children were more flat/neutral in their affect expression than the mentally retarded children. Moreover, they displayed a variety of ambiguous expressions not displayed by any of the other children. This unique pattern may be related to the difficulties that autistic children have in sharing affect, and to the difficulties that others experience in reading their affective signals.     

Imitation performance in toddlers with autism and those with other developmental disorders

BACKGROUND: The present study sought to examine the specificity, developmental correlates, nature and pervasiveness of imitation deficits very early in the development of autism. METHODS: Subjects were 24 children with autism (mean age 34 months), 18 children with fragile X syndrome, 20 children with other developmental disorders, and 15 typically-developing children. Tasks included manual, oral-facial, and object oriented imitations, developmental measures, joint attention ability, and motor abilities. RESULTS: Children with autism were found to be significantly more impaired in overall imitation abilities, oral-facial imitation, and imitations of actions on objects than children in all of the other groups. Imitation skills of young children with fragile X syndrome were strongly influenced by the absence or presence of symptoms of autism. For children with autism, imitation skills were strongly correlated with autistic symptoms and joint attention, even when controlling for developmental level. For comparison groups, imitation was related to other developmental abilities including play, language, and visual spatial skills. Neither motor functioning nor social responsivity accounted for a significant amount of variance in imitation scores, when controlling for overall developmental level, which accounted for much of the variation in imitation ability. CONCLUSIONS: Simple imitation skills were differentially impaired in young children with autism, and lack of social cooperation did not account for their poor performance. In autism, imitation skills clustered with dyadic and triadic social interactions and overall developmental level, but were not related to play or language development. For comparison children, all these areas were inter-related. Hypotheses about a specific dyspraxic deficit underlying the imitation performance in autism were not supported.     

Autistic Children''s Knowledge of Thinking and Feeling States in Other People

Autistic children, pair matched on chronological and verbal mental age with control children, were given Hobson's task of recognition of emotions and Baron-Cohen's False Belief tasks to assess the replicability of their findings of deficits in understanding of feeling and mental states in autism. There were no group differences on the emotion tasks and performance was related to chronological and verbal mental age. An autism specific deficit was shown in only one of the false belief conditions and again performance was related to verbal comprehension ability. There was some consistency within the group in responses across the two kinds of tasks. Parent reported social behaviour and experience in the autistic children was only weakly related to the ability to pass the tasks. It is argued that the results reflect developmental factors and that claims for an autism specific problem in these kinds of social/cognitive processing may need further exploration.     

COMMUNICATION BEHAVIORS IN AUTISM AND DEVELOPMENTAL LANGUAGE DELAY

The communicative behavior of autistic and developmental language delay (DLD) children matched for nonverbal mental age and mean length of utterance (MLU) was compared to that of normally-developing (ND) 2-yr-olds. Autistic children were less able than other children to respond correctly to language or gestures used to direct their attention, used attention directing (pointing, showing) less frequently, and produced more echolalic speech when making requests. DLD and ND children differed only in number of pronouns used while requesting. Attention-directing gestures were associated with receptive and expressive language abilities for autistic, DLD and normal children.     

THE BEHAVIOUR OF DOWN''S SYNDROME CHILDREN USING THE ''LOCK BOX'': A RESEARCH NOTE

A Lock Box for investigating problem-solving behaviour in pre-schoolers was used with seventeen Down's syndrome children (mean CA 37.4 months, S.D. 10.1 months) and seventeen 'normal' children (mean CA 37.4 months, S.D. 10.2 months) while their mothers were present. The behaviour was found to be different for the two groups, with the normal children showing greater competence, more organization and less perseverance. Significant associations between Lock Box measures and the mental age of the Down's syndrome children paralleled those reported by Goodman for older mentally retarded children in a test situation without the mother. The Lock Box is especially appropriate for assessing the ability of language-delayed children and it is suggested that a situation with the mother present may extend its usefulness with very young children.     

Deception and Sabotage in Autistic, Retarded and Normal Children

We investigated autistic, mentally retarded, and normal children's ability to deceive or obstruct an opponent. When required to tell a lie (saying that a box was locked) autistic children performed significantly worse than their controls, taking into account mental age. However, they readily prevented a competitor from gaining a reward by physical manipulation (locking a box). Their success on sabotage demonstrated that their failure on deception was not due to an inability to understand the task. Performance on deception was predicted by performance on a false belief attribution task. The present findings confirm that autistic children have a specific deficit in understanding and manipulating beliefs.     

Autistic spectrum disorders

Autistic spectrum disorders is a complex developmental disorder with social and communication dysfunction at its core. It has a wide clinical spectrum with a common triad of impairments — social communication, social interaction and social imagination. Even mild or subtle difficulties can have a profound and devastating impact on the child. To be able to provide suitable treatments and interventions the distinctive way of thinking and learning of autistic children has to be understood. The core areas of social, emotional, communication and language deficits have to be addressed at all levels of functioning. The important goals of assessment include a categorical diagnosis of autism that looks at differential diagnosis, a refined precise documentation of the child’s functioning in various developmental domains and ascertaining presence of co-morbid conditions. The interventions have to be adapted to the individual’s chronological age, developmental phase and level of functioning. The strategies of curriculum delivery and teaching the child with autism is distinctive and includes presence of structure to increase predictability and strategies to reduce arousal of anxiety     

Predicting IQ change in preschoolers with developmental delays.

This study examined IQ change over a 2-year period in 291 young children (mean age 39 months) referred to a pediatric developmental clinic for evaluation of developmental problems. Although correlation between initial and follow-up IQ was very high (0.78), there was also a significant increase in mean IQ score, from 67.12 to 74.06. Moreover, 26% of the subjects showed IQ increase of 16 points or more. Variables making some contribution to IQ change were initial clinical diagnosis, etiology, and intervention. Children diagnosed with a developmental language disorder made significantly greater gains than those diagnosed as mentally retarded. Sex, family status, initial age, and test interval were not significantly correlated with IQ change. We concluded that prediction for individual children is difficult, but that initial diagnosis may be useful in differentially predicting IQ change in young children with developmental delays.     

THE AUTISTIC CHILD''S APPRAISAL OF EXPRESSIONS OF EMOTION: A FURTHER STUDY

Autistic and matched non-autistic retarded children were selected for their ability to recognize the correspondence between schematic drawings and videotaped scenes involving people. The subjects of both groups were able to choose schematic drawings of gestures for a person's gestures of emotion enacted on videotape. However, the autistic children were significantly impaired in choosing which of the drawings of gestures should 'go with' videotaped vocalizations and facial expressions characteristic of four emotional states. The results were found to be consistent with results from a previous, related study in which the same subjects had chosen drawn or photographed faces to indicate their judgements of the same videotapes of emotional expression. It is suggested that these findings reflect an important aspect of autistic children's social disability.     

Characteristics of preschool children diagnosed as having an atypical pervasive developmental disorder

Pediatricians and child psychiatrists encounter preschool children who are not autistic, but who have early deficits in both interpersonal and communication skills. Confusion exists over their diagnosis. Eighteen atypical children currently diagnosed as having an atypical pervasive developmental disorder are described. Areas discussed are social relatedness, speech and language, mental status, cognition, behavior, perception, social background, and medical/neurological status. These children constitute a distinct and frequently seen group within the spectrum of pervasive developmental disorders. Their characteristics are not currently captured within a diagnostic category in the Diagnostic and Statistical Manual, Third Edition (DSM-III), of the American Psychiatric Association. A revision of DSM-III, DSM-III-R, is currently being prepared. These children may not be captured within a diagnostic category in DSM-III-R. The distinguishing characteristics are onset before the age of three, language delay with disordered communication, social relationships characterized by variable relatedness, ritualistic or manneristic behaviors, the likelihood of hyperactivity and/or a short attention span, affective disturbances, excessive anxiety, and a thinking disorder or perseverative behaviors.     

Traitement visuel et cognition sociale chez des enfants et adolescents avec traits autistiques

Autism is characterized by major difficulties in the social interaction and communication domains. Recent studies suggest that deficits in social information processing could contribute to the expression of autistic traits, as regards communication and socialization skills. The objective of our study with children and adolescents manifesting autistic traits is to examine the characteristics of visual information processing whilst viewing social scenes, in order to evaluate the relationship between autistic trait expression and deficits in processing socially salient information. Our results suggest that children and adolescents presenting autistic traits show patterns of visual processing of social information that are comparable to those observed in adults with autism. These results are discussed from the standpoint of developmental cognitive psychopathology.     

Regression in autism: prevalence and associated factors in the CHARGE Study.

OBJECTIVE: The aim of this study was to examine the prevalence of regressive autism and associated demographic, medical, and developmental factors by using 2 different definitions of regression based on the Autism Diagnostic Interview, Revised. METHODS: Subjects were aged 2 to 5 years, with autism (AU) or autism spectrum disorder (ASD) confirmed by standardized measures. Children with regression, defined as a) loss of both language and social skills or b) loss of either language or social skills, were compared with each other and to children with AU or ASD with no reported loss of skills on developmental and adaptive functioning. Parents reported on seizure, gastrointestinal, and sleep concerns. RESULTS: Fifteen percent (50/333) of the combined AU-ASD group lost both language and social skills; 41% (138/333) lost either language or social skills. No differences were found between the 2 samples of children with regression. Few developmental, demographic, or medical differences were found between the combined regression group and children without loss of skills, in both the larger AU-ASD sample and the more homogeneous AU-only sample. Children with regression had significantly lower communication scores than children without regression. CONCLUSIONS: The prevalence of regression in a large sample of young children with AU and ASD varies depending on the definition used; requiring loss of language significantly underestimates the frequency of developmental regression. Children with regression performed significantly less well than those without regression on 2 measures of communication, but the clinical meaningfulness of these differences is uncertain because of the small effect sizes.