学龄高功能孤独障碍患儿脑白质结构的对照研究

目的分析比较学龄高功能孤独障碍患儿大脑白质结构的异常。方法对17例高功能(IQ≥70)孤独障碍患儿(患者组)以及15名年龄、性别、智商与之相匹配的正常儿童(对照组)进行T1加权三维MRI成像,应用基于像素的形态测量法(VBM)等分析比较两组脑白质体积的差异。结果与正常对照组相比,患者组大脑左侧半球白质的总体积减少(P=0.050),右前扣带回以及左顶上小叶区域脑白质体积显著减少(P<0.001)。结论学龄高功能孤独障碍患儿脑白质体积异常明显,脑白质的异常可能是学龄孤独障碍的重要病理机制之一。     

Linguistic characteristics of individuals with high functioning autism and Asperger syndrome

This study examined the linguistic characteristics of high functioning individuals with autism and Asperger syndrome. Each group consisted of 10 participants who were matched on sex, chronological age, and intelligence scores. Participants generated a narrative after watching a brief video segment of the Social Attribution Task video. Each participant was then asked 10 questions related to the stimulus video. The narrative samples and responses to the questions were analysed linguistically. Individuals with high functioning autism and Asperger syndrome performed similarly on most measures of language function; however, results suggest there may be pragmatically‐based differences between the groups in the use of verb tense markers.     

Group swimming and aquatic exercise programme for children with autism spectrum disorders: A pilot study

Objective: To evaluate the effectiveness of a 14-week aquatic exercise programme for children with autism spectrum disorders (ASD).

Design: Non-randomized control trial.

Methods: Twelve children participated in this pilot study with seven participants in the aquatic exercise group and five in the control group. The programme was held twice per week for 40 minutes per session. Swimming skills, cardiorespiratory endurance, muscular endurance, mobility skills and participant and parent satisfaction were measured before and after the intervention.

Results: No significant between-group changes were found. Within-group improvements for swimming skills were found for the intervention group. Programme attendance was high. Parents and children were very satisfied with the programme activities and instructors.

Conclusions: This pilot programme was feasible and showed potential for improving swimming ability in children with ASD. Exercise intensity was low for some participants, most likely contributing to a lack of significant findings on fitness outcomes.     

高功能孤独症患儿胼胝体及额叶体积的磁共振研究

目的探讨高功能孤独症(high functioning autism,HFA)患儿的胼胝体以及额叶体积是否异常。方法对17例6~14岁的HFA患儿(智商≥70)以及16名年龄、性别、智商等与患者组相匹配的健康学龄儿童进行T1加权三维容积磁共振成像。根据改良的Witelson范式将胼胝体划分为五个亚区,采用自编软件计算和比较两组被试胼胝体区及各个亚区的体积,应用个体脑结构地图集(Individual brain atlases using SPM,IBASPM)工具箱计算额叶体积。结果 HFA组与正常对照组相比额叶总体积及左侧额叶体积增大[(193.91±23.23)cm3vs(177.86±18.2)cm3,P=0.04;(96.08±11.89)cm3vs(87.52±9.14)cm3,P=0.03],而右侧额叶、胼胝体总体积及各亚区的体积差异均无统计学意义(P>0.05);HFA组胼胝体前三分之一部的体积与额叶总体积、右侧额叶体积呈正相关(r=0.51,P=0.04;r=0.50,P=0.04);未见HFA组中儿童孤独症评定量表评分与胼胝体及额叶的体积存在相关(P>0.05)。结论 HFA患儿的额叶体积增...     

Verbal fluency in adults with high functioning autism or Asperger syndrome

The semantic and phonemic fluency performance of adults with high functioning autism (HFA), Asperger syndrome and a neurotypical control group were compared. All participants were matched for age and verbal ability. Results showed that the participants with HFA were significantly impaired in their performance of both semantic fluency tasks and the phonemic fluency task using the letter M. The Asperger group was only impaired in their performance of the semantic fluency task ‘professions’. The social components of the ‘professions’ task may have influenced the performance of the two disorder groups for this subtest negatively. The fluency deficits could not be attributed to a lack of the use of strategies or to difficulties in switching between strategies. The impairment in two of the three verbal fluency subtests in the HFA group can be attributed to the relatively low processing speed found in this group.     

Sex differences in cognitive and symptom profiles in children with high functioning autism spectrum disorders

Although a small number of studies have investigated sex differences in the associated features of high-functioning autism spectrum disorders (HFASDs), they have failed to provide consistent findings. We sought to examine sex differences in 5–9-year-old females and males with HFASDs within a narrow range of ages before adolescence in order to identify the noticeable autistic profile of females compared to males. Using the Japanese version of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) and the Childhood Autism Rating Scale-Tokyo Version (CARS-TV), 20 females with HFASDs were compared with 26 males with HFASDs. Although females and males with HFASDs share similar cognitive profiles in WISC-III, females demonstrated a different symptom profile from males in CARS-TV. Although the female subjects scored significantly lower than the male subjects on “Body Use,” “Object Use,” and “Activity Level,” female subjects scored significantly higher than males on “Taste, Smell, and Touch Response and Use” in the CARS-TV. This finding can be useful for the early identification of females with HFASDs who have typically been underdiagnosed. Future research should focus on elucidating the possible behavioral, neurological, and genetic links to these sex differences.     

Social competence with an unfamiliar peer in children and adolescents with high functioning autism: Measurement and individual differences

Children and adolescents with high functioning autism (HFA) display heterogeneity in social competence, which may be particularly evident during interactions with unfamiliar peers. The goal of this study was to examine predictors of social competence variability during an unfamiliar peer interaction. Thirty-nine participants with HFA and 39 age-, gender- and IQ-matched comparison participants were observed during dyadic laboratory interactions and detailed behavioral coding revealed three social competence dimensions: social initiative, social reciprocity, and social self-monitoring. Participants with HFA displayed higher social initiative but lower reciprocity than comparison participants. For participants with HFA, theory of mind was positively associated with observed initiative. For COM participants, social anxiety was negatively associated with reciprocity. However, for HFA participants, there was a quadratic relation between parent-reported social anxiety and observed reciprocity, demonstrating that low and high levels of anxiety were associated with low reciprocity. Results demonstrated the utility of our behavioral coding scheme as a valid assessment of social competence for children and adolescents with and without HFA. The curvilinear association between social anxiety and reciprocity highlights the importance of examining nonlinear relations in individuals with HFA, and emphasizes that discrete profiles of social anxiety in individuals with HFA may necessitate different treatment options.     

Working memory network alterations in high‐functioning adolescents with an autism spectrum disorder

Aim

People with autism spectrum disorder (ASD) typically have deficits in the working memory (WM) system. WM is found to be an essential chain in successfully navigating in the social world. We hypothesize that brain networks for WM have an altered network integrity in ASD compared to controls.

Methods

Thirteen adolescents (one female) with autistic disorder (n = 1), Asperger's disorder (n = 7), or pervasive developmental disorder not otherwise specified (n = 5), and 13 typically developing healthy control adolescents (one female) participated in this study. Functional magnetic resonance imaging (MRI) was performed using an n‐back task and in resting state.

Results

The analysis of the behavioral data revealed deficits in WM performance in ASD, but only when tested to the limit. Adolescents with ASD showed lower binary global efficiency in the WM network than the healthy control group with n‐back and resting‐state data. This correlated with diagnostic scores for total problems, reciprocity, and language.

Conclusion

Adolescents with higher‐functioning autism have difficulty with the WM system, which is typically compensated. Functional MRI markers of brain network organization in ASD are related to characteristics of autism as represented in diagnostic scores. Therefore, functional MRI provides neuronal correlates for memory difficulties in adolescents with ASD.     

Hand preference and motor functioning in children with autism

This study examined three theories that have been proposed to explain the high rates of ambiguous hand preference in young children with autism. Twenty children with autism were matched with 20 children with developmental delays and 20 normally developing children. The groups were compared on measures of hand preference and motor skills. Results indicated that the lack of development of a hand preference in children with autism was not a direct function of their cognitive delay, as the children with developmental delays showed a dissimilar pattern of hand preference. The lack of a definite hand preference in the children with autism was also not due to a lack of motor skill development, as the children with developmental delays displayed similar levels of gross and fine motor skills without the accompanying lack of a definite hand preference. The finding that children with autism with a definite hand preference displayed better performance on motor, language, and cognitive tasks than children with autism who did not display a definite hand preference, however, provided support for the bilateral brain dysfunction hypothesis.     

Deficits in the initiation of eye movements in the absence of a visual target in adolescents with high functioning autism

BACKGROUND: We used ocular motor paradigms to examine whether or not saccades are impaired in individuals with high functioning autism (HFA). METHODS: We recorded eye movements in patients with HFA (n=11), and in normal adolescents (n=11) on anti-saccade, memory-guided saccade (MGS), predictive saccade and gap/overlap tasks. RESULTS: Compared with the normal subjects, patients with HFA had (1) a significantly higher percentage of directional errors on the anti-saccade task (63.2% versus 26.6%), (2) a significantly higher percentage of response suppression errors on a MGS task (60.3% versus 29.5%) and (3) a significantly lower percentage of predictive eye movements on a predictive saccade task. They also showed longer latencies on a MGS task and for all conditions tested on a gap/null/overlap task (fixation target extinguished before, simultaneously, or after the new peripheral target appeared). When the latencies during the gap condition were subtracted from the latencies in the overlap condition, there was no difference between patients and normals. CONCLUSIONS: Abnormalities in ocular motor function in patients with HFA provide preliminary evidence for involvement of a number of brain regions in HFA including the dorsolateral prefrontal cortex (dlPFC) and the frontal eye fields (FEFs) and possibly the basal ganglia and parietal lobes.     

The neural correlates of mindfulness-induced depression reduction in adults with autism spectrum disorder: A pilot study

Adults with autism spectrum disorder (ASD) experience high rates of depression and anxiety, and some evidence suggests mindfulness-based stress reduction (MBSR) is effective in reducing these symptoms. However, the neural mechanisms of symptom alleviation, and benefit of MBSR beyond education/support groups are unknown. Maladaptive forms of self-reflection are linked to ASD, depression, and anxiety. In this pilot study, we hypothesized (a) MBSR would reduce depression and anxiety in adults with ASD and (b) a mechanism of symptom alleviation would be increased blood oxygen level-dependent signal in neural self-reflection hubs. Twenty-eight adults were randomly assigned to an 8-week MBSR group (n = 15) or a support group (n = 13) that met for the same amount of time with relaxation education materials. Based on previous self-reflection literature in ASD, regions of interest (ROIs) were middle cingulate cortex (MCC) and ventromedial prefrontal cortex (vmPFC). Only the MBSR group demonstrated significant reductions in depression, and neither group significantly changed in anxiety. Only the MBSR group increased activity of right MCC during self-reflection, and the increase correlated with depression alleviation. There were no changes in vmPFC for the MBSR group or either ROI for the support/education group. Seed-to-voxel connectivity analysis revealed that only the MBSR group increased functional connectivity between right MCC and pre/postcentral gyrus, suggesting MBSR may increase primary sensorimotor input to higher order cognitive brain regions. Taken together, MBSR may be effective for reducing depression in adults with ASD, and the neural mechanism may be increasing frontal circuit involvement during self-directed thought.     

High-functioning autism spectrum disorder in adulthood: A systematic review of factors related to psychosocial outcomes

ABSTRACT

Background This systematic review aimed to identify the factors related to psychosocial outcomes for adults with high-functioning autism spectrum disorder (HFASD). A further aim was to appraise the research methodology and provide recommendations for future research.

Method Systematic review methodology was used to comprehensively search for peer-reviewed articles, assess methodological rigor, and summarise the results. Twenty-seven studies published between 1989 and December 2015 met inclusion criteria and included 1,398 individuals (M age?=?28.54 years) with HFASD (IQ?≥?70).

Results Factors most consistently found to be related to poor psychological, social, and adaptive outcomes included greater symptom severity, lower childhood IQ, impaired nonverbal learning, cognitive shifting deficits, negative thinking styles, and perceptions of low social support.

Conclusions Overall, key risk factors for poor psychosocial outcomes of adults with HFASD were identified. However, further prospective longitudinal research with large samples is needed to examine the complex and potentially bidirectional relationships among these factors.     

A metacognitive training pilot study for adolescents with autism spectrum disorder: Lessons learned from the preliminary stages of intervention development

Background Cognitive differences, including deficits in self-awareness, are common in high-functioning individuals with autism spectrum disorder (ASD) and represent a fruitful target for intervention. The current project presents the preliminary research undertaken in the development of metacognitive training (MCT), an intervention designed to increase knowledge about personal strengths and challenges in adolescents with ASD.

Method Two groups of 4 adolescents with ASD completed MCT, as well as measures to assess satisfaction and adverse effects. Visual inspection and thematic analysis were used to interpret the data.

Results Overall, both participants and their parents rated MCT favourably; the youth most enjoyed the interactive activities, whereas parents appreciated the opportunity for socialising and psychoeducation. There were no systematic changes on quantitative measures of adverse effects (i.e. self-esteem or depression).

Conclusion Although the results suggest further investigation of MCT may be warranted, certain modifications to the MCT protocol and research methodology are needed.     

A pilot study of social inclusion and quality of life for parents of children with autism spectrum disorder

ABSTRACT

Background Access to both childcare and early intervention for pre-school children with autism spectrum disorder (ASD) can be difficult for parents or carers and may impact on parental social inclusion and wellbeing. There is limited research investigating how specialist centres offering both services may impact on parental outcomes.

Method Parents whose children were attending such a specialised childcare setting in two states in Australia (Tasmania and South Australia) were invited to participate in a mixed-methods study investigating quality of life (Qol), social inclusion and perceptions of the centres.

Results Parents had typically low levels of QoL but reported a range of benefits from receiving services, including increased levels of community participation and increased competence and confidence in themselves as parents.

Conclusions Childcare centres offering specialist multi-disciplinary early intervention and parental support are valued by parents and assist with social inclusion.     

Language and communication skills in preschool children with autism spectrum disorders: contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability

This study examined the contribution of cognitive function, severity of autism, and adaptive functioning to the variability in language and communication skills in 129 preschool children (aged 24-63 months) with autism spectrum disorder (ASD). Participants were selected from a representative research cohort of 208 preschool children on the basis of caregiver completion of the MacArthur-Bates Communicative Development Inventories (CDI). The children were classified into three cognitive groups: (a) Normal intelligence; (b) Developmental delay; and (c) Intellectual disability. Autism symptom severity was measured by the Autistic Behavior Checklist (ABC), and adaptive functioning by the Daily Living Skills (DLS) and Socialization (Soc) subscales from the Vineland Adaptive Behavior Scales. For each of five CDI variables (Phrases understood, Words understood, Words produced, Gestures and actions, and Language use), the contribution of cognition, severity of autism symptoms, and adaptive functioning to the variability was examined. Cognition and age explained about half or more of the variance in the four verbal language CDI variables, but only about one fourth of the variance in the non-verbal communication variable Gestures and actions. Severity of autism symptoms and the two adaptive measures (DLS and Soc) each only accounted for a few percent more of the variance in the four CDI language variables; however, for Gestures and actions, an additional 11-21% of the variance was accounted for. In conclusion, for children with ASD, receptive and expressive language is mainly related to cognitive level, whereas non-verbal communication skills seem to also be related to severity of autism symptoms and adaptive functioning.     

Biographical disruption: Experiences of mothers of adults assessed for autism spectrum disorder

ABSTRACT

Background Little is known about the experiences of parents whose sons or daughters are diagnosed with autism spectrum disorder (ASD) during adulthood.

Method In this exploratory study, 6 mothers of adults recently diagnosed with ASD were interviewed about the ASD assessment process. Thematic analysis was used to analyse the interviews.

Results Two superordinate themes are described: (1) biographical continuity, and (2) biographical disruption. Mothers did not experience significant disruption around the ASD assessment itself, as they had sought an explanation for their son’s/daughter’s behaviour since childhood. Therefore, being referred for an ASD assessment was simply another assessment for their son or daughter and was thus a biographical continuity. Mothers experienced biographical disruption once an ASD diagnosis was received, as they realised that an ASD diagnosis did not result in any additional support, and found this greatly frustrating.

Conclusions There is an unmet need for postdiagnostic support among adults diagnosed with ASD, and for their parents.     

Parent perceptions of the potential communicative acts of young children with autism spectrum disorder

Background The aim of this project was to examine parent perceptions of potential communicative acts (PCAs) of children with, or at risk for, autism spectrum disorder (ASD).

Methods Participants were 6 males ranging from 17 to 30 months of age. Behaviours of interest were compared using parent report taken from the Inventory of Potential Communication Acts (IPCA) and videotaped observation collected during the Autism Diagnostic Observation Schedule – Second Edition (ADOS-2 Toddler Module). PCA verification categories included facial expression, eye gaze, vocalisation, challenging behaviour, body movement, stereotypic movement, imitation, or symbolic forms.

Results On average, 83% of PCA categories coded from the ADOS-2 videotapes were also reported by parents using the IPCA questionnaire. For half of the participants, parent report added PCA information beyond what was collected during standard observation.

Conclusions Results suggest that parent report questionnaires are viewed as a complement to information obtained from standard observation.     

Investigating a reading comprehension intervention for high school students with autism spectrum disorder: A pilot study

We adapted and piloted Collaborative Strategic Reading–High School, a reading comprehension intervention, with three high school students with autism spectrum disorder to investigate its effects on their reading comprehension. Using a nonconcurrent, multiple-baseline design, participants with autism spectrum disorder were paired with a neurologically typical (neurotypical) reading partner to learn and use reading strategies with informational text two to three times per week. Daily comprehension checks were collected and visually inspected for trends along with data on the number of challenging behaviors and social interactions displayed during intervention. Fidelity of implementation was also measured. Though exploratory, increases in comprehension and interactions were noted along with decreases in challenging behaviors. Implications for practice and research are discussed.