The nature of sense making in parenting a child with Asperger syndrome

The present study examined the nature of sense making in 218 parents who have a child with Asperger syndrome (AS) by developing and validating a multi-item sense making scale for parents of children with AS (SMS-PCAS) and examined the relationships between sense making dimensions and both positive and negative adjustment outcomes. Two hundred and eighteen parents of children with AS completed questionnaires at Time 1 and 12 months later (Time 2). Exploratory factor analyses identified six sense making factors: spiritual perspective, causal attributions, changed perspective, identification, reframing, and luck/fate. All of the factors were psychometrically sound. Cross-sectional regression analyses indicated that the SMS-PCAS factors accounted for significant portions of variance in Time 1 depression, anxiety and positive affect. Sense making factors did not account for significant portions of variance in Time 2 adjustment variables after controlling for Time 1 adjustment and relevant demographics. Results provide support for the multi-dimensional nature of sense making and the differential relationships between sense making dimensions and adjustment outcomes.     

The nature of benefit finding in parents of a child with Asperger syndrome

The present study examined the nature of benefit finding in 220 parents of a child with Asperger syndrome (AS) by developing and validating a multi-item Benefit Finding Scale for Parents of Children with AS (BFS-PCAS) and examining the relationships of benefit finding dimensions with positive and negative indicators of adjustment. Parents of children with AS completed questionnaires at Time 1 and 12 months later (Time 2). Exploratory factor analyses identified six benefit finding factors that were moderately inter-correlated: New Possibilities, Growth in Character, Appreciation, Spiritual Growth, Positive Effects of the Child, and Greater Understanding. Cross-sectional analyses showed that benefit finding was associated with higher levels of anxiety and positive affect. Results provide support for the use of a multi-item scale to measure benefit finding and for the differential relationships of benefit finding dimensions with positive and negative indicators of adjustment.     

Prosopagnosia in a preschool child with Asperger syndrome

We investigated a male, aged 4 years 11 months, who fulfilled the criteria of Asperger syndrome). In addition to the typical pattern of autistic symptoms, psychological testing revealed prosopagnosia in tasks for face recognition and matching. Prosopagnosia was also present when he tried to identify the faces of his parents and himself in photographs whenever these were presented with photographs of other persons. Although impairment in reciprocal social interaction in individuals with Asperger syndrome is closely correlated to their impaired perceptional abilities in non-verbal communication, especially facial expression, overt prosopagnosia seems to be a rare neuropsychological symptom in persons with autistic disorders.     

Insomnia is a frequent finding in adults with Asperger syndrome

Background  

Asperger syndrome (AS) is a neurodevelopmental disorder belonging to autism spectrum disorders with prevalence rate of 0,35% in school-age children. It has been most extensively studied in childhood while there is scarcity of reports concerning adulthood of AS subjects despite the lifelong nature of this syndrome. In children with Asperger syndrome the initiation and continuity of sleep is disturbed because of the neuropsychiatric deficits inherent of AS. It is probable that sleep difficulties are present in adulthood as well. Our hypothesis was that adults with AS suffer from difficulty in initiating and maintaining sleep and nonrestorative sleep (insomnia).     

Parenting a child with cancer: promotion and prevention-focused parenting

Applying regulatory focus theory (RFT), it was predicted that, among survivors of childhood cancer, quality of life (QoL) may be compromised by prevention-focused parenting (the focus on avoiding negative outcomes), rather than promotion-focused parenting (the focus on approaching positive outcomes). Interviews with mothers of survivors of Acute Lymphoblastic Leukaemia (ALL) and tumours of the Central Nervous System (CNS) were coded for reports of parenting and related to child QoL. Parents reported overall more promotion than prevention; however, mothers of children with tumours of the CNS reported more prevention-focus than mothers of children with ALL. Furthermore, prevention focus was related to child QoL, regardless of diagnosis. The study points toward the value of further development of RFT in clinical contexts.     

Identity and role in parenting a child with cancer

In this paper we suggest that the needs and roles of parents of children with cancer have been inadequately conceptualized by traditional approaches to investigating the psychosocial aspects of chronic childhood illnesses such as cancer. Conducted mainly within discourses of psychopathology, traditional approaches have tended to characterize parents' experience of their child's illness in terms of 'maladjustment' and 'coping', but have done little to illuminate the processes involved in how parents live with their child's illness. In other areas, the research literature treats parents solely as proxy sources of their children's views, and the complexity of their roles as caregivers and individuals in their own right has been ignored. We attempt to re-characterize parenting a child with cancer, drawing attention to how the roles, identities and social obligations of parents position them in relation to the medical world, and highlight the emotional work carried out by parents, including protection of their own and their child's identity. Drawing on various bodies of empirical and theoretical work, including the developing field of childhood studies and the literature on informal carers, we suggest ways of rethinking our understanding of the experience of parenting a child with cancer. In doing so, we consider how the narratives of parents can inform the development of measures to assess the impact of the childhood cancer on the quality of parents' lives, and the role that social and organizational aspects of services can play in ameliorating some of the difficulties involved in parenting a child with cancer.     

Eastern sandplay as a safe container for a combined intervention for a child with Asperger syndrome: A case study

The present study reports on using an Eastern sandplay intervention to develop the psychological well-being and interpersonal communication skills of a preschool boy with Asperger syndrome (AS) in China. Fifty intervention sessions were provided over a 1-year treatment period. Eastern sandplay proved to be a successful container for the combined intervention of AS, making use of expressive treatment, situational drama, and peers involvement. The mechanism of the treatment efficiency was also explored.     

Comorbidity of Asperger syndrome: a preliminary report

Asperger syndrome (AS) is a pervasive developmental disorder characterized by autistic social dysfunction and idiosyncratic interests in the presence of normal intelligence. There is no history of language delay. Although people with AS are known to suffer from comorbid psychiatric conditions, few studies have systematically addressed this topic. This preliminary report describes the occurrence of psychiatric disorders in a series of patients with AS diagnosed according to the ICD-10/DSM-IV criteria. Out of 35 patients (29 males and six females; mean age 15.1 years; mean verbal IQ 105.9; mean performance IQ 97.5; mean full-scale IQ 102.7), 23 patients (65%) presented with symptoms of an additional psychiatric disorder at the time of evaluation or during the 2-year follow-up. Children were most likely to suffer from attention deficit hyperactivity disorder, while depression was the most common diagnosis in adolescents and adults. The implications of these findings are discussed.     

Restless legs syndrome is a common finding in multiple sclerosis and correlates with cervical cord damage

In this prospective study, we estimated the prevalence of restless legs syndrome (RLS) in multiple sclerosis (MS) patients, and compared the extent of brain and cervical cord damage between patients with and without RLS using conventional and diffusion tensor magnetic resonance imaging (MRI). Eighty-two consecutive MS patients were evaluated. Each patient underwent a medical history interview, a neurological examination and brain/cervical cord MRI. Global and regional dual-echo lesion load (LL), number of cervical cord lesions, mean diffusivity (MD) and fractional anisotropy (FA) histograms metrics of the normal-appearing tissues of the brain and cervical cord were assessed. Thirty subjects had RLS; they showed a higher Expanded Disability Status Scale score than patients without. No difference between the two groups was found in whole brain, cerebellar and brainstem T(2)-LLs; MD and FA histograms derived metrics of the normal appearing brain tissues; basal ganglia MD; number of cervical cord lesions and cord MD histograms derived metrics. Cervical cord average FA was significantly reduced in MS patients with RLS compared to those without. RLS symptoms are very common in MS. This form of RLS should be considered as symptomatic. Higher disability and cervical cord damage represent a significant risk factor for RLS in MS patients.     

Clumsiness in autism and Asperger syndrome: a further report

Clumsiness has been proposed as a diagnostic feature of Asperger syndrome (AS), a type of pervasive developmental disorder recently introduced in the ICD-10 and DSM-IV. However, the extent to which this symptom is specific to AS is not clear. To investigate this issue, we compared a sample of AS children with age- and sex-matched groups of children with autistic disorder and pervasive developmental disorder not otherwise specified (PDDNOS). Twelve subjects with AS (ICD-10/DSM-IV; 11 males; average age 11.4 years; mean full-scale IQ 104.9) were compared with 12 subjects with autistic disorder (DSM-III-R; 11 males; average age 10.3 years; mean full-scale IQ 78.4) and 12 subjects with PDDNOS (DSM-III-R; 10 males; average age 10.1 years; mean full-scale IQ 78.2). The BruininksOseretsky test, a standardized test of motor coordination, was administered blind by the same investigator to all the three groups. While coordination deficits were found in all three groups, children with AS were found to be less impaired than those with autistic disorder and PDDNOS. However, no significant relationship was found between coordination scores and diagnosis after adjusting for the level of intelligence. These findings suggest that some patients with AS may be less clumsy than those with autistic disorder and that this difference may be the result of their higher level of intelligence. Studies based on larger samples using multiple measures of coordination are needed to further clarify the role of clumsiness in the classification of pervasive developmental disorders.     

Theory of mind, severity of autistic symptoms and parental correlates in children and adolescents with Asperger syndrome

This study addresses the theory of mind (ToM) ability of Asperger's syndrome/high-functioning autism (AS/HFA) children and their parents and the severity of the autistic symptoms. Fifty-three families, each consisting of a mother, father and a child, participated in this study (N=159). The 53 children in the sample included 25 children diagnosed with AS/HFA and 28 typically developing (TD) children. The Social Attribution Task (SAT) and tests assessing autistic symptoms were used. AS/HFA children had lower scores than TD children on three of the SAT indices (Person, ToM Affective, and Salience). Fathers of AS/HFA children did not have lower scores than fathers of TD children on the SAT task, whereas mothers of AS/HFA children had lower scores on the Person index, a pattern similar to seen in their children, suggesting a possible genetic contribution of mothers to ToM deficit in AS/HFA children.     

Empathy deficits in Asperger syndrome: a cognitive profile

Although lack of empathy has been considered a central characteristic of Asperger syndrome, quantitative and qualitative assessments of empathy in this syndrome are lacking. We present two cases of adolescents with Asperger syndrome who show extreme deficits on measures of both cognitive and affective empathy. Analysis of their performance on tasks assessing cognitive and affective processing did not reveal significant impairment in executive functions, nor in their ability to recognize emotions or the ability to create a mental representation of another person's knowledge. However, both patients were unable to integrate the emotional content with mental representations and deduce the other person's emotional state. These results suggest that impaired empathy in individuals with Asperger syndrome may be due to impaired integration of the cognitive and affective facets of the other person's mental state.     

Life course impacts of parenting a child with a disability

We contrasted parents who had a child with a developmental disability, a serious mental health problem, and a normative comparison group with respect to parental attainment and well-being at mid-life. Data are from the Wisconsin Longitudinal Study, collected when the respondents were 18, 36, and 53 or 54, on average. Although similar at age 18, group patterns of attainment and well-being diverged thereafter. Parents of a child with a developmental disability had lower rates of employment, larger families, and lower rates of social participation but were similar to parents without a child with a disability in educational and marital status, physical health, and psychological well-being. Parents whose child had a serious mental health problem had normative patterns of educational and occupational attainment and marriage, but elevated levels of physical symptoms, depression, and alcohol symptoms at mid-life.     

A model of resilience and meaning after military deployment: Personal resources in making sense of war and peacekeeping experiences

The aim of the present study was to examine whether the specific personal resources of self-esteem, optimism and perceived control, combined in the latent variable called ‘resilience’, were associated with cognitive processing of war-zone experiences. Data were collected by questionnaires from a sample of 1.561 veterans who had participated in various war or peacekeeping operations. Structural equation modelling was performed to assess the expected relationships between the observed and latent variables. The construct of resilience was well-defined and proved to be strongly associated with both construals of meaning, comprehensibility versus personal significance, after military deployment. According to our model, higher resilience predicted less distrust in others and the world, more personal growth and less intrusions and avoidance after military deployment.     

Group Therapy for Boys with Features of Asperger Syndrome and Concurrent Learning Disabilities: Finding a Peer Group

In this paper, we present a pilot group therapy model with modifications, for boys who meet the criteria of Asperger Syndrome as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994), and who have concurrent learning disabilities. It is recognized that learning disabilities are often a feature of Asperger Syndrome. Children and adolescents with learning disabilities are vulnerable to experiencing social and emotional problems, in particular difficulties with peers. The social functioning of children and adolescents who have Asperger Syndrome is greatly impeded, although they are motivated to have social contact and to make friends. This paper describes how elements of interpersonal group therapy were combined with modifications, which address the unique social and cognitive profiles of the boys in this group. Case examples are provided to illustrate the group model. The group members and their parents were interviewed after the group and two years later, to obtain their views of the group. Their responses are presented.     

Obstetric factors in Asperger syndrome: comparison with high-functioning autism

Asperger syndrome (AS) is a pervasive developmental disorder widely regarded as a mild variant of autism. To investigate if AS is associated with a history of fewer obstetric insults compared to autism, we examined the developmental history and obstetric records of 10 males with AS (mean full scale IQ 95.3), and compared them with 10 autistic males with a full scale IQ of 70 or above (so-called high-functioning autism; mean full scale IQ 82.6). Males with AS showed a trend toward lower Apgar scores at one minute (chi-square=4; df=l; P=0.04) and were more likely to have been born to mothers outside the optimal age group of 20–30 years (chi-square=5; df= 1; P=0.02). They were also less likely to have been irritable and floppy as infants (chi-square=3.8; df= I; P=0.05). However, the total optimality scores did not differ significantly between the two groups.     

Autism and Asperger syndrome: coexistence with other clinical disorders

OBJECTIVE:: To provide a clinically useful analysis of the extent to which autism and Asperger syndrome coexist with other disorders. METHOD: Selective review of the literature detailing data pertaining to symptoms and disorders sometimes encountered in connection with autism or Asperger syndrome. RESULTS: A large number of medical conditions, psychiatric disorders and behavioural and motor dyscontrol symptoms are associated with autism and Asperger syndrome. CONCLUSION: Comorbidity is to be expected in autism spectrum disorders -directly or indirectly. Comorbid conditions may be markers for underlying pathophysiology and suggest a more varied treatment approach. There is a great need for in-depth research into this area, meaning that the exclusion criteria of current diagnostic manuals, i.e. those that rule out a diagnosis of autism in some disorders, and a diagnosis of certain other disorders in autism may have to be revised.     

Left occipital hypoperfusion in a case with the Asperger syndrome.

The Asperger syndrome, a less severe variant of autism, has drawn increasing interest among child psychiatrists. Cerebral blood flow studies with autistic subjects have failed to reveal consistent findings. We are reporting a case with the Asperger syndrome, whose single photon emission computed tomography showed left occipital hypoperfusion.     

Anxiety and social worries in children with Asperger syndrome

OBJECTIVE: The current study examined anxiety and social worries in a group of children with Asperger syndrome (AS). METHOD: Sixty-five children with AS were compared with a clinically anxious sample and a normative sample using parent and child reports. RESULTS: Comparisons between clinically anxious children and children with AS showed similar scores on overall anxiety and on six anxiety subscales using child reports. Parent reports revealed higher ratings of overall anxiety and described children with AS experiencing more obsessive-compulsive symptoms and physical injury fears than clinically anxious children. CONCLUSIONS: Children with AS without a diagnosis of anxiety, present with more anxiety symptoms than a normal population and with a different profile than a clinically anxious population. Study limitations are identified and considerations for future research presented.