An examination of social typologies in autism

A system proposed by Wing and coworkers for subtyping autistic individuals on the basis of social interaction is examined in 78 autistic, 39 atypical, and 32 nonautistic, developmentally disordered individuals. Clinical ratings and questionnaire data based on the proposed subtypology were employed. Clinicians were able to reliably group both autistic and nonautistic cases into the three subtypes; these subtypes were strongly related to IQ. Issues relating to the validity and utility of this subtypology are discussed.     

Social cognition and impaired social interaction in people with severe learning difficulties*

ABSTRACT. Social skills training has focused on ‘performance’ or overt behaviour, rather than on the other components of successful social functioning: motivation and goals, analysis of social information, and performance feedback, Some basic aspects of this ‘analysis’ or ‘social cognition’ component were compared in a preliminary study of 25 teenagers and young adults with severe learning difficulties, whose social interaction was categorized as either ‘impaired’ or ‘appropriate’. As predicted from the literature on autistic children, there were no differences between the groups on tasks involving recognition of the visual aspects of the concept of self or perceptual role-taking. It is suggested thai social impairments do not reflect social cognitive abilities which are‘lower level’(i.e. can be solved on the basis of information available to the senses). Contrary to expectations, on the four individual tasks of affective role-taking, which is ‘higher level’, since it requires inferences to be made about the inner emotional state of another person, the differences between the groups were not significant. However, the results were in the predicted direction, and when scores on the tasks were combined, the overall performance of the socially impaired group was significantly poorer (P<0.05). It is suggested that the results from this aspect of social cognition might be attributed either to methodological difficulties or to differences between autistic children and the present sample. The clinical implications of the findings of the study are discussed.     

Autism in tuberous sclerosis complex is related to both cortical and subcortical dysfunction

OBJECTIVE: To examine the relationship between autism and epilepsy in relation to structural and functional brain abnormalities in children with tuberous sclerosis complex (TSC). METHODS: Children with TSC and intractable epilepsy underwent MRI as well as PET scans with 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) and alpha-[(11)C]methyl-L-tryptophan (AMT). Based on the results of Autism Diagnostic Interview-Revised, Gilliam Autism Rating Scale, and overall adaptive behavioral composite (OABC) from Vineland Adaptive Behavior Scale, subjects were divided into three groups: autistic (OABC < 70; n = 9), mentally-retarded nonautistic (OABC < 70; n = 9), and relatively normal intelligence (OABC > or = 70; n = 8). RESULTS: PET studies showed that the autistic group had decreased glucose metabolism in the lateral temporal gyri bilaterally, increased glucose metabolism in the deep cerebellar nuclei bilaterally, and increased AMT uptake in the caudate nuclei bilaterally, compared to the mentally-retarded nonautistic group. In addition, a history of infantile spasms and glucose hypometabolism in the lateral temporal gyri were both significantly associated with communication disturbance. Glucose hypermetabolism in the deep cerebellar nuclei and increased AMT uptake in the caudate nuclei were both related to stereotypical behaviors and impaired social interaction, as well as communication disturbance. CONCLUSIONS: These results suggest that generalized epilepsy in early life and functional deficits in the temporal neocortices may be associated with communication delays, and that functional imbalance in subcortical circuits may be associated with stereotypical behaviors and impaired social interaction in children with TSC.     

Comparisons between autistic and nonautistic children on the Test for Auditory Comprehension of Language

Expressive language differences between autistic and nonautistic populations have been a topic of research in the past decade, yet little information is available in regard to the receptive language performances based on standardized tests. Questions as to the existence of sex differences in language have also been raised. The study examines the performance of 19 matched pairs of autistic and nonautistic children on the Test for Auditory Comprehension of Language. As well, the data were analyzed according to sex for each group. The results indicated that there were no significant differences between groups or between the sexes in either group. Questions for further research are raised.     

Lateralized brain dysfunction in autism: Evidence from the Halstead-Reitan neuropsychological battery

Selected tests from the Halstead-Reitan neuropsychological battery were administered to 10 male individuals who had been diagnosed as autistic in early childhood. Results from the battery obtained from the autistic group were compared with a group of retarded persons matched for IQ and with a group of patients with demonstrable diffuse brain damage. As a group, the autistic subjects showed a pattern of deficits indicative of a significantly greater degree of left hemisphere dysfunction than either comparison group. Furthermore, within-subject comparisons revealed that the autistic group had a significantly greater left than right hemisphere dysfunction, while neither comparison group showed this lateralized pattern.     

Predictors and Correlates of Adaptive Functioning in Children with Developmental Disorders

Autism is a developmental disorder marked by impairments in socialization, communication, and perseverative behavior and is associated with cognitive impairment and deficits in adaptive functioning. Research has consistently demonstrated that children with autism have deficits in adaptive functioning more severe than their cognitive deficits. This study investigates the correlates and predictors of adaptive functioning as measured by the Vineland Adaptive Behavior Scales in high- and low-functioning children with autism and their age and nonverbal IQ matched controls. Thirty-five 9-year-old children with high-functioning autism (HAD) were compared with 31 age-matched children with developmental language disorder (DLD), and 40 9-year-old children with low-functioning autism (LAD) were compared with 17 age-matched children with low IQ on adaptive functioning, IQ, autistic symptomology, and tests of language and verbal memory. Results indicate that both groups with autism were significantly impaired compared to their matched controls on Socialization and Daily Living, but not Communication and that these impairments were more pronounced in the HAD group than in the LAD group. Adaptive behavior was strongly correlated with autistic symptomology only in the HAD group. Regression analyses indicated that IQ was strongly predictive of adaptive behavior in both low-functioning groups, but tests of language and verbal memory predicted adaptive behavior in the higher functioning groups. Results suggest that IQ may act as a limiting factor for lower functioning children but higher functioning children are impaired by specific deficits, including autistic symptomology and impaired language and verbal memory.     

A Normed Study of Face Recognition in Autism and Related Disorders

Although the interpretation of studies of face recognition in older children, adolescents, and adults with autism is complicated by the fact that participating samples and adopted methodologies vary significantly, there is nevertheless strong evidence indicating processing peculiarities even when task performance is not deficient. Much less is known about face recognition abilities in younger children with autism. This study employed a well-normed task of face recognition to measure this ability in 102 young children with autism, pervasive developmental disorder not otherwise specified (PDDNOS), and non-PDD disorders (mental retardation and language disorders) matched on chronological age and nonverbal mental age, and in a subsample of 51 children divided equally in the same three groups matched on chronological age and verbal mental age. There were pronounced deficits of face recognition in the autistic group relative to the other nonverbally matched and verbally matched groups. Performance on two comparison tasks did not reveal significant differences when verbal ability was adequately controlled. We concluded that young children with autism have face recognition deficits that cannot be attributed to overall cognitive abilities or task demands. In contrast to controls, there was a lower correlation between performance on face recognition and nonverbal intelligence, suggesting that in autism face recognition is less correlated with general cognitive capacity. Contrary to our expectation, children with PDDNOS did not show face recognition deficits.     

Comparison and item analysis of the MESSY for autistic and normal children

Seventeen autistic children were matched for age, race, and sex with 17 nonautistic children, and group differences in social skills were assessed. Appropriate social skills and levels of inappropriate assertiveness/impulsiveness were assessed and evaluated using the Matson Evaluation of Social Skills with Youngsters (MESSY). Significant differences in both the appropriate and inappropriate social behaviors displayed by the two groups were found. The implications of these results are discussed.     

Unawareness of Cognitive Deficits and Daily Functioning Among Persons With Traumatic Brain Injuries

This study examines levels of unawareness of cognitive deficits and their relationship to functional outcome among persons with traumatic brain injury (TBI). Data from 61 persons with TBI and 34 family members consisting of various measures were used. The results suggest that awareness of cognitive deficits is not differentially distributed along a concrete- continuum of cognitive domains. Awareness in this sample was significantly related to psychiatric symptomatology and partially associated with behavior disturbances and daily functioning, but not with vocational outcomes. Persons with TBI who over-estimated their cognitive abilities were found to function worse on most outcome measures, except vocation, than persons who did not overestimate their abilities.     

Hello and Goodbye: A Study of Social Engagement in Autism

We videotaped 24 children, adolescents, and young adults with autism, individually matched for chronological age and verbal mental age with 24 nonautistic persons with mental retardation, for their spontaneous and prompted greetings and farewells towards an unfamiliar adult. Compared with control subjects, those with autism were less likely to offer spontaneous verbal and nonverbal gestures of greeting and farewell, and were less likely to establish eye contact even when they were offered a greeting. There were also fewer autistic subjects who smiled, or who waved goodbye. Results corresponded with raters' subjective judgments of participants' interpersonal engagement with the stranger. One interpretation of the findings is that they reflect a relative lack of intersubjective engagement by autistic individuals.     

Unawareness of cognitive deficits and daily functioning among persons with traumatic brain injuries

This study examines levels of unawareness of cognitive deficits and their relationship to functional outcome among persons with traumatic brain injury (TBI). Data from 61 persons with TBI and 34 family members consisting of various measures were used. The results suggest that awareness of cognitive deficits is not differentially distributed along a concrete-abstract continuum of cognitive domains. Awareness in this sample was significantly related to psychiatric symptomatology and partially associated with behavior disturbances and daily functioning, but not with vocational outcomes. Persons with TBI who over-estimated their cognitive abilities were found to function worse on most outcome measures, except vocation, than persons who did not overestimate their abilities.     

A comparative study of attachment behavior in young children with autism or other psychiatric disorders

The present study examined attachment behavior in children with autism and children with other developmental or psychiatric disorders. The groups were matched on chronological and mental age, IQ, and socioeconomic status. When a modified Strange Situation paradigm was used, no group differences were found in proximity seeking, contact maintenance, proximity avoidance, or contact resistance; the groups also did not differ in their overall security ratings. Attachment security was related to several developmental variables in the autistic group but not in the nonautistic comparison group. This suggests that attachment formation may involve different processes in autistic children than in nonautistic children of equivalent intellectual level.     

Correlates of social competence in retarded children.

The relationship of role-taking and referential-communication skills with social competence was assessed in 32 retarded children (mean IQ = 56.4; mean CA = 13 years, 7 months). Significant associations were found between two types of teacher measures of children's social competence, between measures made by teachers and children themselves, and among scores of social competence and the skills of role-taking and referential communication. The findings suggest ways of assessing social adaptation more directly, which may be extended into specific interventions.     

Adaptive and intellectual functioning in autistic and nonautistic retarded children

This study examined the relationship between adaptive functioning on the Vineland Adaptive Behavior Scale (VABS) and intellectual functioning on the Stanford-Binet Intelligence Scale, 4th edition (SB-IV) in autistic children and nonautistic retarded children of comparable CA and SB-IV composite score (IQ). The autistic group had lower scores than the retarded group in VABS adaptive composite, Socialization domain, and Communication domain, and SB-IV Verbal Reasoning area. VABS domain scores yielded higher classification rates than the SB-IV area scores in discriminating the two groups. Correlations between the two measures were much higher for the autistic group than for the retarded group. Results support the conclusion that the cognitive impairment in autism is reflected in greater impairment in adaptive behaviors than in mental retardation without autism.This project was partially supported by a Center of Excellence grant from the State of Tennessee to the Department of Psychology, The University of Memphis. Appreciation is extended to the University of Tennessee Boling Center for Developmental Disabilities and to the children and parents who participated in this study.     

Deviant children grown up

A 9-year-old non-autistic boy revealed marked deficits in visuo-spatial and visuo-motor skills, in planning and organizational capacities and in impulse inhibition. Particular strengths were his verbal comprehension and reasoning abilities. This neuropsychological pattern of assets and deficits fitted the nonverbal learning disability syndrome as described by Rourke (1989). On a battery of Theory of Mind (TOM) and emotion recognition tests he performed rather poor on several first-order TOM tasks and on all second-order TOM and emotion-matching tasks, compared to samples of autistic and normal subjects. it is suggested that his visuo-spatial and cognitive shifting deficits account for his social cognitive failures, while his superior verbal skills protect him from severe social handicaps.     

Social class distribution of fathers of children enrolled in the Iowa Autism program

The social class distribution of fathers with autistic children attending a locally well-known and state-supported modern autism program was examined and was compared to the social class distributions observed in a nonautistic, mentally retarded population, in children with other psychiatric disorders, and in the general population from which the present autistic sample was drawn. No significant differences were found among the groups. The findings supported the view that if studies are not biased by certain selection factors outside the autistic child's clinical picture and diagnosis, and if services become better known and readily available, then no differences in social class distribution between autistic and nonautistic groups occur. The results suggest that social class is not an important factor in the origin of autistic syndrome.     

Principal component analysis study of visual and verbal metaphoric comprehension in children with autism and learning disabilities

This research extends previous studies regarding the metaphoric competence of autistic and learning disable children on different measures of visual and verbal non-literal language comprehension, as well as cognitive abilities that include semantic knowledge, executive functions, similarities, and reading fluency. Thirty seven children with autism (ASD), 20 children with learning disabilities (LD), and 21 typically developed (TD) children participated in the study. Principal components analysis was used to examine the interrelationship among the various tests in each group. Results showed different patterns in the data according to group. In particular, the results revealed that there is no dichotomy between visual and verbal metaphors in TD children but rather metaphor are classified according to their familiarity level. In the LD group visual metaphors were classified independently of the verbal metaphors. Verbal metaphoric understanding in the ASD group resembled the LD group. In addition, our results revealed the relative weakness of the ASD and LD children in suppressing irrelevant information.     

Cognitive and social development in infants and toddlers with a bipolar parent

This research was designed to compare early patterns of cognitive and social development in young children from families with and without a bipolar parent. 27 children (seven probands and 20 controls) were followed longitudinally during the second and third years of life. They were administered normed infant tests to assess physical object permanence, self-recognition, social role-taking, and attachment to the caregiver. There were no deficits in the performance of children from bipolar families on the cognitive tests. In contrast, on assessments that involved social relations, either with other persons or with symbolic representations of others, there were significant disturbances. Children with a bipolar parent showed developmental deficits in taking another's perspective and they displayed insecure patterns of attachment.National Institute of Mental HealthWe would like to thank Geri Cooperman, Rita Dettmers, Christine Grewell, Anne Mayfield, and Jean Welsh for their assistance on this project.     

Concentration and Memory Deficits in Patients with Fibromyalgia Syndrome

The present study compared 30 patients with Fibromyalgia Syndrome (FS) to 30 healthy control subjects matched for age, sex, and estimated intellectual level on standardized measures of attention, concentration, and memory as well as subjective ratings of memory abilities and sleep quality. In addition, in order to investigate the relationship between cognitive functioning and other physical and psychological symptoms, subjects with FS completed psychological measures of pain severity, trait anxiety, and depression. Results indicated that patients with FS performed more poorly on tests of immediate and delayed recall, and sustained auditory concentration, and their ratings of both their memory abilities and sleep quality were lower than those of controls. Furthermore, perceived memory deficits of the FS subjects were disproportionately greater than their objective deficits. Results indicated significant correlations between performance on memory and concentration measures and scores on questionnaires of pain severity and trait anxiety. Implications of these results for multidisciplinary treatment programs are discussed.     

Competence to consent to research among long-stay inpatients with chronic schizophrenia

OBJECTIVE: Questions have been posed about the competence of persons with serious mental illness to consent to participate in clinical research. This study compared competence-related abilities of hospitalized persons with schizophrenia with those of a comparison sample of persons from the community who had never had a psychiatric hospitalization. METHODS: The study participants were administered the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), a structured instrument designed to aid in the assessment of competence to consent to clinical research. The scores of 27 persons who met DSM-IV criteria for schizophrenia who were long-stay patients on a state hospital research ward were compared with those of 24 individuals from the community who were of similar age, gender, race, and socioeconomic status. RESULTS: Significant differences were found between the patients and the community sample on three measures of competence-related abilities: understanding, reasoning, and appreciation. Degree of psychopathology and cognitive functioning were significantly negatively correlated with understanding and appreciation among the patients with schizophrenia. Length of hospitalization was significantly negatively correlated with all measures of decision-making capacities. CONCLUSIONS: The generally poor performance of the long-stay patients with chronic schizophrenia highlights the difficulties this group is likely to encounter in providing consent to research. However, variation across the sample points to the need for individualized assessment and for validated techniques for facilitating decision making in the face of decisional impairments.