The Autism-Spectrum Quotient (AQ)—Adolescent Version

The Autism Spectrum Quotient (AQ) quantifies autistic traits in adults. This paper adapted the AQ for children (age 9.8–15.4 years). Three groups of participants were assessed: Group 1: n=52 adolescents with Asperger Syndrome (AS) or high-functioning autism (HFA); Group 2: n=79 adolescents with classic autism; and Group 3, n=50 controls. The adolescents with AS/HFA did not differ significantly from the adolescents with autism but both clinical groups scored higher than controls. Approximately 90% of the adolescents with AS/HFA and autism scored 30+, vs. none of the controls. Among the controls, boys scored higher than girls. The AQ can rapidly quantify where an adolescent is situated on the continuum from autism to normality.     

Brief Report: The Impact of Subcortical Band Heterotopia and Associated Complications on the Neuropsychological Functioning of a 13-year-old Child

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. Sixteen HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). 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. 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.     

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.     

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.     

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.     

Autism Spectrum Disorder Reclassified: A Second Look at the 1980s Utah/UCLA Autism Epidemiologic Study

The purpose of the present study was to re-examine diagnostic data from a state-wide autism prevalence study (n = 489) conducted in the 1980s to investigate the impact of broader diagnostic criteria on autism spectrum disorder (ASD) case status. Sixty-four (59 %) of the 108 originally “Diagnosed Not Autistic” met the current ASD case definition. The average IQ estimate in the newly identified group (IQ = 35.58; SD = 23.01) was significantly lower than in the original group (IQ = 56.19 SD = 21.21; t = 5.75; p < .0001). Today’s diagnostic criteria applied to participants ascertained in the 1980s identified more cases of autism with intellectual disability. The current analysis puts this historic work into context and highlights differences in ascertainment between epidemiological studies performed decades ago and those of today.     

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.     

Use of Context in Pragmatic Language Comprehension by Children with Asperger Syndrome or High-Functioning Autism

Utilizing relevance theory, this study investigated the ability of children with Asperger syndrome (AS) and high-functioning autism (HFA) to use context when answering questions and when giving explanations for their correct answers. Three groups participated in this study: younger AS/HFA group (age 7–9, n = 16), older AS/HFA group (age 10–12, n = 23) and a normally functioning control group (age 7–9, n = 23). The results indicated that the younger AS/HFA group did less well when answering contextually demanding questions compared to the control group, and the performance of the older AS/HFA group fell in between the younger AS/HFA group and the control group. Both AS/HFA groups had difficulties explaining their correct answers, suggesting that they are not always aware of how they have derived answers from the context.     

Psychiatric disorders in individuals with high-functioning autism and Asperger's disorder: Similarities and differences

Abstract

Objectives. To investigate and compare the rate and type of psychiatric co-morbidity in individuals with diagnosis of high functioning autism (HFA) and Asperger's disorder (AS). Methods. This study includes 30 children and adolescents with diagnosis of HFA and 30 with diagnosis of AS. Diagnoses of HFA and AS were made using strict DSM-IV criteria. Psychiatric co-morbidity was assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL-T). Results. The rate of comorbid psychiatric disorders was very high in both groups (93.3% in HFA and 100% in AS). The most common disorder in both groups was attention deficit hyperactivity disorder. There was no statistically significant difference between groups in the rate of associated psychiatric disorders, except for major depressive disorder (P = 0.029) and ADHD-combined type (P = 0.030). The AS group displayed greater comorbidity with depressive disorders and ADHD-CT. Conclusion. From a clinical perspective, it could be concluded that both disorders involve a high risk for developing psychiatric disorders, with AS patients at greater risk for depression. From a nosological perspective, the substantial similarities in terms of psychiatric comorbidity may support the idea that both disorders are on the same spectrum and differs in some aspects.     

Repetitive Behavior Profiles in Asperger Syndrome and High-Functioning Autism

Although repetitive behaviors are a core diagnostic domain for autism spectrum disorders, research in this area has been neglected. This study had two major aims (1) to provide a detailed characterization of repetitive behaviors in individuals with Asperger Syndrome (AS), high-functioning autism (HFA), and typically developing controls (TD); and (2) to examine whether differences in repetitive behavior profiles could provide evidence for the external validity of AS separate from HFA. Specifically, it was hypothesized that circumscribed interests would be more prevalent and cause more impairment in the AS group than the HFA group, while the reverse would be true for other categories of repetitive behavior. The parent(s) of 61 children and adolescents (19 with AS, 21 with HFA, and 21 TD) completed two interviews focused specifically on lifetime and current repetitive behavior symptoms. No reliable differences in repetitive behavior between AS and HFA children were found. Results suggested that circumscribed interests differ in developmental course from the three other DSM-IV-TR categories of repetitive behavior. Internal consistency among the four DSM-IV-TR categories of repetitive behavior was high, =.84, providing evidence for a unitary repetitive behaviors factor. The importance of expanding research in the repetitive behavior domain is highlighted as part of the necessary integration of behavioral and neurobiological approaches to understanding the etiology of autism.     

Levels of emotional awareness and autism: An fMRI study

Abstract

Autism is associated with an inability to identify and distinguish one's own feelings. We assessed this inability using alexithymia and empathy questionnaires, and used fMRI to investigate brain activity while introspecting on emotion. Individuals with high functioning autism/Asperger syndrome (HFA/AS) were compared with matched controls. Participants rated stimuli from the International Affective Picture System twice, once according to the degree of un/pleasantness that the pictures induced, and once according to their color balance. The groups differed significantly on both alexithymia and empathy questionnaires. Alexithymia and lack of empathy were correlated, indicating a link between understanding one's own and others’ emotions. For both groups a strong relationship between questionnaire scores and brain activity was found in the anterior insula (AI), when participants were required to assess their feelings to unpleasant pictures. Regardless of self-reported degree of emotional awareness, individuals with HFA/AS differed from controls when required to introspect on their feelings by showing reduced activation in self-reflection/mentalizing regions. Thus, we conclude that difficulties in emotional awareness are related to hypoactivity in AI in both individuals with HFA/AS and controls, and that the particular difficulties in emotional awareness in individuals with HFA/AS are not related to their impairments in self-reflection/mentalizing.     

Differential activation of the amygdala and the 'social brain' during fearful face-processing in Asperger Syndrome

Impaired social cognition is a core feature of autism. There is much evidence showing people with autism use a different cognitive style than controls for face-processing. We tested if people with autism would show differential activation of social brain areas during a face-processing task. Thirteen adults with high-functioning autism or Asperger Syndrome (HFA/AS) and 13 matched controls. We used fMRI to investigate 'social brain' activity during perception of fearful faces. We employed stimuli known to reliably activate the amygdala and other social brain areas, and ROI analyses to investigate brain areas responding to facial threat as well as those showing a linear response to varying threat intensities. We predicted: (1) the HFA/AS group would show differential activation (as opposed to merely deficits) of the social brain compared to controls and (2) that social brain areas would respond to varied intensity of fear in the control group, but not the HFA/AS group. Both predictions were confirmed. The controls showed greater activation in the left amygdala and left orbito-frontal cortex, while the HFA/AS group showed greater activation in the anterior cingulate gyrus and superior temporal cortex. The control group also showed varying responses in social brain areas to varying intensities of fearful expression, including differential activations in the left and right amygdala. This response in the social brain was absent in the HFA/AS group. HFA/AS are associated with different patterns of activation of social brain areas during fearful emotion processing, and the absence in the HFA/AS brain of a response to varying emotional intensity.     

Asperger's syndrome and autism: neurocognitive aspects

The objectives of this study were to see: (1) whether children with Asperger's Syndrome (AS) have similar neurocognitive deficits compared to nonretarded, or high-functioning autistic (HFA) children; and (2) whether the essential cognitive deficit among these children is in language or abstract problem solving. Subjects with AS, HFA, and a control group of socially impaired child psychiatric outpatient controls (OPC) were compared on a battery of neuropsychological tests. The results indicated that the AS and HFA groups differed little but that large differences from the OPC were observed on all tests. When the AS and HFA with FSIQ above 85 were compared to the OPC, outstanding deficits on motor coordination, language comprehension, and facial recognition were observed. Finally, some evidence is presented to suggest that the pattern of deficits of AS and HFA subjects varied by developmental level. The implications of these results for a neurological theory of autism are discussed.     

孤独症和Asperger综合征儿童的心灵理论对照研究

目的探讨孤独症和Asperger综合征(AS)儿童的心理推测能力。方法应用表情识别和虚假信念课题分别对21例高功能孤独症(HFA)儿童、54例AS儿童和70名正常健康儿童进行测试。结果表情识别题中, HFA组通过率明显低于正常组(P<0．01),AS组与正常组无显著差异;虚假信念题通过率为正常儿童组>AS组> HFA组(P<0．01)。结论 HFA和AS儿童基本能识别简单表情,但存在理解虚假信念的缺陷,说明他们的心理推测能力低下。     

Social attribution in children with high functioning autism and Asperger syndrome: An exploratory study in the Chinese setting

The present study aimed to examine social attribution in children with high-functioning autism (HFA) and Asperger's syndrome (AS). A sample of 20 boys (9 with HFA and 11 with AS) and 20 age-matched controls were recruited for this study. All participated in two tasks measuring social attribution ability, the conventional Social Attribution Task (SAT) and a modified version with animals rather than shapes (mSAT). They also completed a battery of neuropsychological tests. Compared to typically developing controls, children with autism spectrum disorders were impaired on some measures in both SATs. However, group differences in ‘theory-of-mind’ indices were only significant in the mSAT, with the ASD group performing more poorly than controls. In addition, the scores in person index of both versions of the SAT correlated with executive function in children with HFA/AS. The current study found the mSAT paradigm was especially sensitive to ToM difficulties in young Chinese children with HFA/AS. Social attribution in children with HFA/AS, unlike neurotypical children, was related to executive function ability, suggesting these psychological domains are not distinct in children with autism spectrum disorders.     

Residual Difficulties with Categorical Induction in Children with a History of Autism

In two experiments, typically developing (TD) children, high-functioning children with autism (HFA) and children with a history of autism who have achieved optimal outcomes (OOs), matched on age (M = 13 years) and nonverbal IQ, were asked to extend properties of categories to new items (categorical induction). All groups demonstrated some knowledge of category structure by extending at above-chance levels; however, the TD group extended more consistently than the OO and HFA groups. More consistent extenders had higher lexical and nonverbal IQ scores (Experiment 1) or higher pragmatics scores (Experiment 2). Thus, even very high functioning individuals with autism, or with an OO, still exhibit residual difficulties with category knowledge and extension; moreover, category tasks relate to a variety of verbal and nonverbal abilities. The difficulty these groups had with categorical induction may be related to their difficulty with generalization more widely; future research should investigate this possibility.     

Brief Report: A Comparison of Statistical Learning in School-Aged Children with High Functioning Autism and Typically Developing Peers

Individuals with autism spectrum disorders have impairments in language acquisition, but the underlying mechanism of these deficits is poorly understood. Implicit learning is potentially relevant to language development, particularly in speech segmentation, which relies on sensitivity to transitional probabilities between speech sounds. This study investigated the relationship between implicit learning and current language abilities in school-aged children with high functioning autism and a history of language delay (n = 17) and in children with typical development (n = 24) using a well-studied artificial language learning task. Results suggest that high functioning children with autism (HFA) and TD groups were equally able to implicitly learn transitional probabilities from a lengthy stimulus stream. Furthermore, task performance was not strongly associated with current language abilities. Implications for implicit learning research in HFA are discussed.     

The ‘Reading the Mind in the Voice’ Test-Revised: A Study of Complex Emotion Recognition in Adults with and Without Autism Spectrum Conditions

This study reports a revised version of the ‘Reading the Mind in the Voice’ (RMV) task. The original task (Rutherford et al., (2002), Journal of Autism and Developmental Disorders, 32, 189–194) suffered from ceiling effects and limited sensitivity. To improve that, the task was shortened and two more foils were added to each of the remaining items. About 50 adults with Asperger Syndrome (AS) or High Functioning Autism (HFA) and 22 matched controls took the revised task. Results show the revised task has good reliability and validity, is harder, and more sensitive in distinguishing the AS/HFA group from controls. Verbal IQ was positively correlated with performance, and females performed worse than males in the AS/HFA group. Results are discussed with regard to multi modal empathizing deficits in autism spectrum conditions (ASC).     

Narrative Discourse in Adults with High-Functioning Autism or Asperger Syndrome

We report a study comparing the narrative abilities of 12 adults with high-functioning autism (HFA) or Asperger Syndrome (AS) versus 12 matched controls. The study focuses on the use of referential expressions (temporal expressions and anaphoric pronouns) during a story-telling task. The aim was to assess pragmatics skills in people with HFA/AS in whom linguistic impairments are more subtle than in classic autism. We predicted no significant differences in general narrative abilities between the two groups, but specific pragmatic deficits in people with AS. We predicted they use fewer personal pronouns, temporal expressions and referential expressions, which require theory of mind abilities. Results confirmed both predictions. These findings provide initial evidence of how social impairments can produce mild linguistic impairments.     

The Autism-Spectrum Quotient (AQ) Children’s Version in Japan: A Cross-Cultural Comparison

In the current study, the child AQ was administered in Japan, to examine whether the UK results for reliability and validity generalize to a different culture. Assessment groups were: Group 1: n = 81 children with Asperger Syndrome (AS) or high-functioning autism (HFA); Group 2: n = 22 children diagnosed PDD-NOS with average IQ; and Group 3: n = 372 randomly selected controls from primary and secondary schools. Both clinical groups scored significantly higher than controls (AS/HFA mean AQ = 31.9, SD = 6.93; PDD-NOS mean AQ = 28.0, SD = 6.88; controls mean AQ = 11.7, SD = 5.94). Among the controls, males scored significantly higher than females. The pattern of difference between clinical groups and controls was found to be similar in both countries.