Affective exchanges between young autistic children and their mothers

Social behaviors increase more when children with ASD are imitated by their mother vs. an unfamiliar adult

Previous research suggests that being imitated by an adult increases the social behaviors of children with an autism spectrum disorder (ASD). In the current study, we examined whether familiarity with the imitating social partner modulates this effect. Ten children with ASD and their mothers participated. The children's social behaviors were observed prior to and following a 3-min period in which an adult social partner imitated everything they did. In one condition the partner was the child's mother, and in the other condition the partner was an unfamiliar experimenter. The results revealed significant increases in distal social behaviors (gazes toward the adult, vocalizing) following imitation by both partners. There was a significantly greater increase in proximal social behaviors (including approach, being physically close, and touching) and a greater decrease in playing alone when the imitator was the child's mother as opposed to the experimenter. The findings suggest that the experience of being imitated creates an atmosphere of mutuality and rapport between children with ASD and their social partners, which increases their sociability even in interactions with already familiar adults.

Joint attention initiation with and without positive affect: risk group differences and associations with ASD symptoms

Infants at risk for autism spectrum disorders (ASD) may have difficulty integrating smiles into initiating joint attention (IJA) bids. A specific IJA pattern, anticipatory smiling, may communicate preexisting positive affect when an infant smiles at an object and then turns the smile toward the social partner. We compared the development of anticipatory smiling at 8, 10, and 12 months in infant siblings of children with ASD (high-risk siblings) and without ASD (low-risk siblings). High-risk siblings produced less anticipatory smiling than low-risk siblings, suggesting early differences in communicating preexisting positive affect. While early anticipatory smiling distinguished the risk groups, IJA not accompanied by smiling best predicted later severity of ASD-related behavioral characteristics among high-risk siblings. High-risk infants appear to show lower levels of motivation to share positive affect with others. However, facility with initiating joint attention in the absence of a clear index of positive affective motivation appears to be central to the prediction of ASD symptoms.

The motivation for very early intervention for infants at high risk for autism spectrum disorders

The first Autism Research Matrix (IACC, 2003) listed the identification of behavioural and biological markers of risk for autism as a top priority. This emphasis was based on the hypothesis that intervention with infants at-risk, at an early age when the brain is developing and before core autism symptoms have emerged, could significantly alter the developmental trajectory of children at risk for the disorder and impact long-range outcome. Research has provided support for specific models of early autism intervention (e.g., Early Start Denver Model) for improving outcomes in young children with autism, based on both behavioural and brain activity measures. Although great strides have been made in ability to identify risk markers for autism in younger infant/toddler samples, how and when to intervene during the prodromal state remains a critical question. Emerging evidence suggests that abnormal brain circuitry in autism precedes altered social behaviours; thus, an intervention designed to promote early social engagement and reciprocity potentially could steer brain development back toward the normal trajectory and remit or reduce the expression of symptoms.

Neural and behavioural responses to face-likeness of objects in adolescents with autism spectrum disorder

Numerous studies have revealed atypical face processing in autism spectrum disorders (ASD) characterized by social interaction and communication difficulties. This study investigated sensitivity to face-likeness in ASD. In Experiment 1, we found a strong positive correlation between the face-likeness ratings of non-face objects in the ASD (11–19 years old) and the typically developing (TD) group (9–21 years old). In Experiment 2 (the scalp-recorded event-related potential experiment), the participants of both groups (ASD, 12–19 years old; TD, 12–18 years old) exhibited an enhanced face-sensitive N170 amplitude to a face-like object. Whereas the TD adolescents showed an enhanced N170 during the face-likeness judgements, adolescents with ASD did not. Thus, both individuals with ASD and TD individuals have a perceptual and neural sensitivity to face-like features in objects. When required to process face-like features, a face-related brain system reacts more strongly in TD individuals but not in individuals with ASD.

Does facial expressivity count? How typically developing children respond initially to children with autism

Research investigating expressivity in children with autism spectrum disorder has reported flat affect or bizarre facial expressivity within this population; however, the impact expressivity may have on first impression formation has received little research input. We examined how videos of children with autism spectrum disorder were rated for expressivity by adults blind to the condition. We further investigated the friendship ratings given by 44 typically developing children to the same videos. These ratings were compared to friendship ratings given to video clips of typically developing children. Results demonstrated that adult raters, blind to the diagnosis of the children in the videos, rated children with autism spectrum disorder as being less expressive than typically developing children. These autism spectrum disorder children were also rated lower than typically developing children on all aspects of our friendship measures by the 44 child raters. Results suggest that impression formation is less positive towards children with autism spectrum disorder than towards typically developing children even when exposure time is brief.

Emotional facial and vocal expressions during story retelling by children and adolescents with high-functioning autism

PURPOSE

People with high-functioning autism (HFA) have qualitative differences in facial expression and prosody production, which are rarely systematically quantified. The authors' goals were to qualitatively and quantitatively analyze prosody and facial expression productions in children and adolescents with HFA.

METHOD

Participants were 22 male children and adolescents with HFA and 18 typically developing (TD) controls (17 males, 1 female). The authors used a story retelling task to elicit emotionally laden narratives, which were analyzed through the use of acoustic measures and perceptual codes. Naïve listeners coded all productions for emotion type, degree of expressiveness, and awkwardness.

RESULTS

The group with HFA was not significantly different in accuracy or expressiveness of facial productions, but was significantly more awkward than the TD group. Participants with HFA were significantly more expressive in their vocal productions, with a trend for greater awkwardness. Severity of social communication impairment, as captured by the Autism Diagnostic Observation Schedule (ADOS; Lord, Rutter, DiLavore, & Risi, 1999), was correlated with greater vocal and facial awkwardness.

CONCLUSIONS

Facial and vocal expressions of participants with HFA were as recognizable as those of their TD peers but were qualitatively different, particularly when listeners coded samples with intact dynamic properties. These preliminary data show qualitative differences in nonverbal communication that may have significant negative impact on the social communication success of children and adolescents with HFA.

The Interplay between Emotion and Cognition in Autism Spectrum Disorder: Implications for Developmental Theory

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is clinically defined by abnormalities in reciprocal social and communicative behaviors and an inflexible adherence to routinised patterns of thought and behavior. Laboratory studies repeatedly demonstrate that autistic individuals experience difficulties in recognizing and understanding the emotional expressions of others and naturalistic observations show that they use such expressions infrequently and inappropriately to regulate social exchanges. Dominant theories attribute this facet of the ASD phenotype to abnormalities in a social brain network that mediates social-motivational and social-cognitive processes such as face processing, mental state understanding, and empathy. Such theories imply that only emotion related processes relevant to social cognition are compromised in ASD but accumulating evidence suggests that the disorder may be characterized by more widespread anomalies in the domain of emotions. In this review I summarize the relevant literature and argue that the social-emotional characteristics of ASD may be better understood in terms of a disruption in the domain-general interplay between emotion and cognition. More specifically I will suggest that ASD is the developmental consequence of early emerging anomalies in how emotional responses to the environment modulate a wide range of cognitive processes including those that are relevant to navigating the social world.

To enforce or not to enforce? The use of collaborative interfaces to promote social skills in children with high functioning autism spectrum disorder

The goal of this stud was to examine whether a technological touch activated Collaborative Puzzle Game (CPG) increased positive social behaviors in children with high functioning autism spectrum disorder (HFASD). The CPG involved construction of a virtual puzzle by selecting and dragging pieces into the solution area on a touch screen table. The target picture was presented on the top of the screen. Six dyads of children with HFASD (aged 8-11 years) engaged in the CPG in a Free Play (FP) mode in which partners could independently move puzzle pieces versus in an Enforced Collaboration (EC) mode in which partners could only move puzzle pieces together. Videos of the dames were coded for the frequencies of positive and negative social interaction, affect, play, and autistic behaviors. Parents completed the Social Responsiveness Scale (SRS). Wilcoxon Signed-ranks tests indicated that children with HFASD showed significantly higher frequencies of positive social interaction and collaborative play in the EC versus FP modes but there were no differences in negative social behaviors. Differences in social behaviors between partners during the puzzle games were not significant; however there were differences within pair in the severity of social deficits as assessed by the SRS questionnaire. The CPG in an EC mode was effective in promoting positive social interaction by requiring children to work together towards a mutual goal. However, the increased challenge in this mode, particularly for children with lower social-communication skills, suggests the need for establishing selection criteria and mediation steps for such interventions.

Brief report: longitudinal improvements in the quality of joint attention in preschool children with autism

Children with autism exhibit deficits in their quantity and quality of joint attention. Early autism intervention studies rarely document improvement in joint attention quality. The purpose of this study was to determine whether there was a change in joint attention quality for preschoolers with autism who were randomized to a joint attention intervention, symbolic play intervention, or a control group. Quality was defined as shared positive affect during joint attention as well as shared positive affect and utterances during joint attention. Interactions of group and time were found for both types of joint attention quality. During the follow up visits, the joint attention and symbolic play intervention groups produced more of these two types of joint attention quality than the control group.

Social attention: a possible early indicator of efficacy in autism clinical trials

For decades, researchers have sought to clarify the nature of the social communication impairments in autism, highlighting impaired or atypical 'social attention' as a key measurable construct that helps to define the core impairment of social communication. In this paper, we provide an overview of research on social attention impairments in autism and their relation to deficiencies in neural circuitry related to social reward. We offer a framework for considering social attention as a potential moderator or mediator of response to early behavioral intervention, and as an early indicator of efficacy of behavioral and/or pharmacological treatments aimed at addressing the social impairments in autism.

Inter-hemispheric competition relieved in both: hypotheses for autism and schizophrenia from problem theory

A logical relationship exists among six general problems that people face in life. Using hope about something for its subjective probability, its expected likelihood, the problems form a series where the method of assessing hope changes in a simple manner from one problem to the next. The central hypothesis is that human beings exploit this. Brain structures and predispositions have evolved accordingly, leading to the hemispheres having different predispositions. The hemispheres are effectively joined at 5 months. Infants will then find that they engage in two unrelated activities. Typical infants label the activities in detail, using visual images, as part of gaining control over them. Hypotheses are: (a) autistic children fail labelling at the start, and hence they encounter uncontrolled competition between the hemispheres; (b) with some, serotonin abnormality impairs sensory information processing and hence the labelling; (c) with some, a delay in myelination from autoimmune effects disrupts labelling; (d) the likelihood of this 'delay autism' is reduced by long chain omega oils; (e) self-pressuring, which underlies taking on challenges and play like Hide and Seek, brings relief from the competition by raising the influence of one side; (f) the same left-right competition occurs in confused episodes and schizophrenia in vulnerable people who encounter pressures to use both hemispheres at the same time; (g) some symptoms raise the influence on one side ideationally. This leads to coherent theories of autism and schizophrenia. In both competition between the hemispheres is relieved primarily by self-pressuring, which raises influence on one side.

The autism diagnosis in translation: shared affect in children and mouse models of ASD

In the absence of molecular biomarkers that can be used to diagnose ASD, current diagnostic tools depend upon clinical assessments of behavior. Research efforts with human subjects have successfully utilized standardized diagnostic instruments, which include clinician interviews with parents and direct observation of the children themselves [Risi et al., 2006]. However, because clinical instruments are semi-structured and rely heavily on dynamic social processes and clinical skill, scores from these measures do not necessarily lend themselves directly to experimental investigations into the causes of ASD. Studies of the neurobiology of autism require experimental animal models. Mice are particularly useful for elucidating genetic and toxicological contributions to impairments in social function [Halladay et al., 2009]. Behavioral tests have been developed that are relevant to autism [Crawley, 2004, 2007], including measures of repetitive behaviors [Lewis, Tanimura, Lee, & Bodfish, 2007; Moy et al., 2008], social behavior [Brodkin, 2007; Lijam et al., 1997; Moretti, Bouwknecht, Teague, Paylor, & Zoghbi, 2005], and vocal communication [D'Amato et al., 2005; Panksepp et al., 2007; Scattoni et al., 2008]. Advances also include development of high-throughput measures of mouse sociability that can be used to reliably compare inbred mouse strains [Moy et al., 2008; Nadler et al., 2004], as well as measures of social reward [Panksepp & Lahvis, 2007] and empathy [Chen, Panksepp, & Lahvis, 2009; Langford et al., 2006]. With continued generation of mouse gene-targeted mice that are directly relevant to genetic linkages in ASD, there remains an urgent need to utilize a full suite of mouse behavioral tests that allows for a comprehensive assessment of the spectrum of social difficulties relevant to ASD. Using impairments in shared affect as an example, this paper explores potential avenues for collaboration between clinical and basic scientists, within an amply considered translational framework.

Listeners prefer the laughs of children with autism to those of typically developing children

The purpose of this study was to investigate the impact of laugh sounds produced by 8- to 10-year-old children with and without autism on naïve listeners, and to evaluate if listeners could distinguish between the laughs of the two groups. Results showed that listeners rated the laughs of children with autism more positively than the laughs of typically developing children, and that they were slightly above chance levels at judging which group produced the laugh. A subset of participants who reported listening for “uncontrolled” or “longer” laughs were significantly better at discriminating between the laughs of the two groups. Our results suggest that the laughs of children with autism have the potential to promote the formation of relationships.

Behavioral profiles of affected and unaffected siblings of children with autism: contribution of measures of mother-infant interaction and nonverbal communication

We investigated whether deficits in social gaze and affect and in joint attention behaviors are evident within the first year of life among siblings of children with autism who go on to be diagnosed with autism or ASD (ASD) and siblings who are non-diagnosed (NoASD-sib) compared to low-risk controls. The ASD group did not differ from the other two groups at 6 months of age in the frequency of gaze, smiles, and vocalizations directed toward the caregiver, nor in their sensitivity to her withdrawal from interaction. However, by 12 months, infants in the ASD group exhibited lower rates of joint attention and requesting behaviors. In contrast, NoASD-sibs did not differ from comparison infants on any variables of interest at 6 and 12 months.

Iniciativas de comunicação na interação entre crianças com distúrbios do espectro autístico e suas mães: análise pragmática

OBJETIVOS: investigar as iniciativas de comunicação na interação entre crianças com distúrbios do espectro autístico (DEA) e suas mães, por meio de uma análise pragmática. MÉTODO: cinco crianças com DEA, de ambos os gêneros, idades entre cinco e 12 anos juntamente com suas mães. O grupo controle constou de cinco crianças com desenvolvimento normal, pareadas com as crianças com DEA de acordo com gênero e idade e suas respectivas mães, totalizando 20 participantes. Para a caracterização da amostra foram utilizadas uma Ficha informativa e a Escala de Avaliação de Traços Autísticos. Cada díade foi filmada por 30 minutos durante as interações lúdicas, analisadas a partir do Protocolo de Pragmática. Este instrumento avalia as iniciativas de comunicação, meios e funções comunicativas expressas. Os dados foram tratados estatisticamente (p < 0,05; foram utilizados os testes não-paramétricos de Wilcoxon e de Mann-Whitney). RESULTADOS: foram observadas diferenças estatisticamente significantes entre as iniciativas comunicativas das crianças com DEA e suas mães, quando comparadas ao grupo controle. As díades que envolveram crianças com DEA iniciaram menos a comunicação e utilizaram predominantemente gestos e vocalizações menos interativas. CONCLUSÕES: estes dados possibilitaram descrever aspectos fundamentais para compreensão das manifestações clínicas da população estudada e para a elaboração de programas de intervenção que visem melhorar a qualidade de vida da criança e sua família.

Emotions in action through the looking glass

The paper aims at highlighting how our primary understanding of others' actions is rooted in the mirror mechanism. To this end, the anatomical architecture of the mirror neuron system for action will be outlined as well as its role in grasping goals and intentions in others' motor behaviour. One further step through the looking glass of social cognition will be referring to the ubiquitous emotional colouring of actions and considering its links with the motor domain. This will allow a clearer perspective on the mechanism underlying our abilities for emotional understanding and on cases in which these abilities are amiss, as in autistic spectrum disorders.

Second person intentional relations and the evolution of social understanding

Second person intentional relations, involving intentional activities directed at the perceptor, are qualitatively different from first and third person relations. They generate a peculiar, bidirectional kind of intentionality, especially in the realm of visual perception. Systems specialized in dealing with this have been selected by evolution. These systems can be considered to be the evolutionary precursors to the human theory of mind.

Four-year-old humans are different: Why?

The intentionality schema is an abstraction that relates phylogenetic and ontogenetic sequences of social understanding, but it also obscures the differences between humans and other primates. In particular, it ignores human social developmental and communicative history and the important roles that language plays in human understanding of others' intentional states.

Omitting the second person in social understanding

Barresi & Moore do not consider information about intentional relations available within emotional engagement with others and do not see that others are perceived in the second as well as the third person. Recognising second person information forces recognition of similarities and connections not otherwise available. A developmental framework built on the assumption of the complete separateness of self and other is inevitably flawed.

Rhesus monkeys are radical behaviorists

The data reviewed in Barresi & Moore's treatment of social understanding is recast in terms of a model of social intelligence that was advanced some time ago (Gallup 1982). When it comes to their analysis of the behavior of other individuals, most primates (and humans younger than 18 months of age) appear to function as radical behaviorists, whereas chimpanzees and older infants show evidence of becoming primitive cognitive psychologists.

Ontogeny, evolution, and folk psychology

Barresi & Moore assume an equivalence between ontogenetic and evolutionaiy transformations of social understanding. The mechanisms of evolution allow for novel structures to arise, both through terminal addition and through the onset of novel pathways at time points that precede the end points of ancestral pathways. Terminal addition may not be the appropriate model for the evolution of human object-directed imitation, intermodal equivalence, or joint attention.

Are blind babies delayed in achieving social understanding?

Barresi & Moore's account predicts that infants deprived of visual input will be delayed in achieving social understanding, a hypothesis that receives some support from studies of language use. by blind children. It is proposed that recently developed false belief and appearance/reality tasks be used to explore this issue further. Three possibly distracting conceptual issues are also discussed.

Intentional relations and social understanding

Organisms engage in various activities that are directed at objects, whether real or imagined. Such activities may be termed “intentional relations.” We present a four-level framework of social understanding that organizes the ways in which social organisms represent the intentional relations of themselves and other agents. We presuppose that the information available to an organism about its own intentional relations (or first person information) is qualitatively different from the information available to that organism about other agents’ intentional relations (or third person information). However, through the integration of these two sources of information, it is possible to generate representations of intentional relations that are uniformly applicable to the activities of both self and other. The four levels of the framework differ in the extent to which such integration occurs and in the degree to which imagination is involved in generating these representations. Most animals exist at the lowest level, at which integration of first and third person sources of information does not occur. Of nonhuman species, only great apes exhibit social understanding at intermediate levels, at which integration of these sources of information provides uniform representations of intentional relations. Only humans attain the highest level, at which it is possible to represent intentional relations with mental objects. We propose that with the development of the imagination, children progress through three stages, equivalent to the later three levels of the framework. The abnormalities in social understanding of autistic individuals are hypothesized to result from a failure to develop integrated representations of intentional relations.

Understanding self and other

We consider the various criticisms and requests for clarification made by the commentators of our framework for understanding intentional relations. Our response is organized according to the main themes in the target article: general theory, phylogeny, development, and autism. We also add some discussion of further issues, such as simulation and moral theory, that were not addressed in the target article.

Faces do not capture special attention in children with autism spectrum disorder: a change blindness study

Two experiments investigated attention of children with autism spectrum disorder (ASD) to faces and objects. In both experiments, children (7- to 15-year-olds) detected the difference between 2 visual scenes. Results in Experiment 1 revealed that typically developing children (n = 16) detected the change in faces faster than in objects, whereas children with ASD (n = 16) were equally fast in detecting changes in faces and objects. These results were replicated in Experiment 2 (n = 16 in children with ASD and 22 in typically developing children), which does not require face recognition skill. Results suggest that children with ASD lack an attentional bias toward others' faces, which could contribute to their atypical social orienting.

A prospective study of toddlers with ASD: short-term diagnostic and cognitive outcomes

BACKGROUND

Despite recent increases in the number of toddlers referred for a differential diagnosis of autism spectrum disorders (ASD), knowledge of short-term stability of the early diagnosis as well as cognitive outcomes in this cohort is still limited.

METHOD

Cognitive, social, and communication skills of 89 clinic-referred toddlers were assessed at the average age of 21.5 (SD = 4.9) months, and reassessed at 46.9 (SD = 7.7) months. Groups with stable and unstable diagnostic presentation were identified and compared on their profile of cognitive and social-communicative skills obtained at the time of initial diagnosis.

RESULTS

Stability of the ASD diagnosis was 100%; diagnosis of autism was stable in 74% of cases as compared to 83% and 81% in PDD-NOS and Non-ASD groups, respectively. Worsening of social disability symptoms resulting in autism diagnosis was noted in 17% of toddlers initially diagnosed with PDD-NOS and in 19% of toddlers with initial diagnosis of non-ASD disorder. However, marked improvement was noted in approximately 1/4 of children initially presenting with autism, warranting diagnostic reassignment to PDD-NOS at follow-up. An analysis of developmental skills profiles suggests particular relevance of the assessment of verbal and nonverbal communication skills to diagnostic differentiation between subtypes within ASD in the second year of life.

CONCLUSIONS

Stability of ASD diagnosis in toddlers is high, though marked changes in severity of symptoms is to be expected in a minority of cases. Simultaneous consideration of cognitive, social, and communication skills profiles enhances accuracy of diagnostic classification and prediction of outcome.

Dynamic fearful gaze does not enhance attention orienting in individuals with Asperger's disorder

Although impaired joint attention is one of the core clinical features of pervasive developmental disorder including autistic disorder and Asperger's disorder, experimental studies failed to report its impairment. This discrepancy might be the result of differences between real-life and experimental situations. The present study examined joint attention in 11 individuals with Asperger's disorder and 11 age-matched controls under naturalistic conditions using a target detection paradigm with dynamic emotional gaze cues. Although both groups showed gaze-triggered attention orienting as assessed by the differences in reaction time for invalid minus valid cues, enhancement of joint attention by fearful (vs. neutral) gaze was observed in the control, but not in the Asperger group. This suggests that the integration of emotion and gaze direction that elicits strong joint attention is impaired in individuals with Asperger's disorder.

Emotional, motivational and interpersonal responsiveness of children with autism in improvisational music therapy

Through behavioural analysis, this study investigated the social-motivational aspects of musical interaction between the child and the therapist in improvisational music therapy by measuring emotional, motivational and interpersonal responsiveness in children with autism during joint engagement episodes. The randomized controlled study (n = 10) employed a single subject comparison design in two different conditions, improvisational music therapy and toy play sessions, and DVD analysis of sessions. Improvisational music therapy produced markedly more and longer events of 'joy', 'emotional synchronicity' and 'initiation of engagement' behaviours in the children than toy play sessions. In response to the therapist's interpersonal demands, 'compliant (positive) responses' were observed more in music therapy than in toy play sessions, and 'no responses' were twice as frequent in toy play sessions as in music therapy. The results of this exploratory study found significant evidence supporting the value of music therapy in promoting social, emotional and motivational development in children with autism.

Joint attention and social-emotional approach behavior in children with autism

Autism is a development disorder that is characterized by a significant disturbance of social development. Research strongly suggests that this disorder results from neurological anomalies or deficits. However, both the specific neural systems involved in autism, and the most pertinent behavioral functions of those systems remains unclear. One current topic of debate concerns the degree to which the social disturbance of autism may result from developmental anomalies in neurological systems that subserve cognitive, or affective processes. In this paper a model of the neurological, cognitive, and affective processes involved in the pathogenesis of autism will be described in the context of an attempt to understand dissociations in the early social-skill development of these children. Young children with autism are better able to use social-communication gestures to request objects or events than they are able to use similar gesture simply to initiate joint or socially shared attention relative to an object or event. An integration of recent research suggests that joint attention skill development differs from requesting skill development with regard to affective and cognitive processes that may be associated with frontal and midbrain neurological systems. In particular, this integration of the literature suggests the following: (a) there is a specific neurological subsystem that regulates and promotes what are called social-emotional approach behaviors; (b) the tendency to initiate joint attention bids is prototypical of a social-emotional approach behavior; and (c) attenuation of social-approach behaviors in children with autism leads to a specific impoverishment of social information processing opportunities. This impoverishment has a lifelong negative effect on the social cognitive development of these children.

A theoretical approach to the deficits in infantile autism

Deficits specific to the syndrome of infantile autism appear in imitation, emotion sharing, theory of mind, pragmatics of communication, and symbolic play. Current competing theories of Hobson and of Baron-Cohen, Frith, and associates account for some, but not all, of these specific deficits. The present article suggests that early social capacities involving imitation, emotion sharing, and theory of mind are primarily and specifically deficient in autism. Further, these three capacities involve forming and coordinating social representations of self and other at increasingly complex levels via representational processes that extract patterns of similarity between self and other. Stern's theory of interpersonal development is offered as a continuous model for understanding the development and deficits of the autistic child and as a means for integrating competing theories about the primary deficits in autism. Finally, the article suggests a neuropsychological model of interpersonal coordination involving prefrontal cortex and executive function capacities that is consistent with the social deficits observed in autism.

Focused and social attention of autistic children in interactions with familiar and unfamiliar adults: A comparison of autistic, mentally retarded, and normal children

This study involved observations of children's behaviors in interactive situations with both familiar and unfamiliar partners. The greatest differences between the autistic and nonautistic children were in an unstructured situation where caregivers did not initiate interactions. In this situation, autistic children rarely looked to the partner or initiated social bids to the partner. They also were less focused on the toys available for play compared to nonautistic children. However, the autistic children were similar in their interactive responses to the partner in an adult-initiated social situation. Individual differences confirmed that more able autistic children in terms of cognitive and language abilities also engaged in greater social and communicative behavior with the partner. These findings suggest that the ways in which social deficits are manifested by autistic children are variable with respect to the context in which they are measured.

Imitation and expression of facial affect in autism

This study examined elicited (posed) affective expressions in children, adolescents, and young adults with autism (N = 18) or Down's syndrome (N = 24). Subjects were asked to (a) imitate five modeled expressions (Imitation task) and (b) produce five labeled expressions (Expression task). Subjects with autism produced recognizable expressions in both tasks, but they produced fewer than did subjects with Down's syndrome when target emotions were labeled but not modeled (Expression). Imitation and Expression tasks were equally difficult for subjects with autism, but subjects with Down's syndrome performed better in Expression than in Imitation. In both tasks, the responses of subjects with autism contained many unusual behaviors, such as bizarre expressions and those that looked “mechanical.” Results suggest that producing elicited affective expressions is more difficult for persons with autism than for persons with Down's syndrome of similar chronological age, mental age, and IQ.

Subjective experience and causes of affect in high-functioning children and adolescents with autism

The ability to use language to identify causes for emotion and to describe the subjective experience of various emotions was examined in 28 male and female children and adolescents with autism compared to 28 normally developing and mentally handicapped subjects of equivalent chronological age and mean length of utterance. Mentally handicapped and lower functioning autistic subjects were also similar in verbal IQ. Individuals with autism did not grossly differ from other participants in their descriptions of emotion but were less likely to relate emotions to either reaching a goal or social interaction and more likely to attribute positive emotions to concrete events (e.g., going on a trip). Results are discussed in terms of current cognitive and affective theories of autism.

Mothers' use of imitative play for facilitating social responsiveness and toy play in young autistic children

The effectiveness of imitating an autistic child's actions as a means for promoting social responsiveness and creative toy play was explored. Fifteen autistic children between the ages of 2 and 6 years and their mothers were assessed before and after a 2-week period during which they engaged in imitative play for 20 minutes per day. At the pre-intervention assessment, autistic children's gaze at mother's face was of longer duration, and their toy play was more creative during imitative play than during a free play session. At the post-intervention assessment, significant cumulative increases in duration of gaze at mother's face and creative toy play were found. Children's positive behavior changes were not found to be a function of developmental level of imitative ability, play skills, Vineland social age, IQ, or severity of autistic symptoms. Instead, the majority of children showed positive responses to this interactive strategy, regardless of these individual characteristics.

Interventions to improve communication in autism

Children with autism benefit from intensive, early intervention that focuses on increasing the frequency, form, and function of communicative acts. Available evidence shows that highly structured behavioral methods have important positive consequences for these children, particularly in eliciting first words. However, the limitation of these methods in maintenance and generalization of skills suggests that many children with autism will need to have these methods supplemented with less adult-directed activities to increase communicative initiation and carry over learned skills to new settings and communication partners. Providing opportunities for mediated peer interactions with trained peers in natural settings seems to be especially important in maximizing the effects of this intervention.