Affective exchanges between young autistic children and their mothers

Free recall and forgetting of emotionally arousing words in autism spectrum disorder

Since the earliest descriptions of individuals with autism spectrum disorders (ASDs) abnormalities in affective behaviours have been considered a prominent feature in their clinical manifestations. What remains unclear, however, is whether these altered emotional behaviours are a mere facet of abnormalities in socio-cognitive processes or whether they constitute a primary feature of the condition. A number of studies now indicate that emotional processing atypicalities in ASD extend to domains outside the broader context of social cognition leading us to suggest that the disorder may be characterised by basic abnormalities in how psychophysiological and cognitive emotional responses modulate one another [Gaigg, S. B. & Bowler, D. M. (2007). Differential fear conditioning in Asperger's syndrome: Implications for an amygdala theory of autism. Neuropsychologia, 45, 2125-2134]. In the current study, we show that although individuals with ASD, like typical individuals, exhibit a free recall advantage for emotionally arousing and semantically related neutral as compared to unrelated neutral words, they do not show reduced forgetting rates for arousing stimuli as do typical individuals. These observations provide further support for the view that psychophysiological emotional responses do not modulate cognitive processes normally in ASD and further implicate abnormalities of amygdala connectivity (in particular with the hippocampus) in the neuropathology underlying this disorder.

Facial expression of affect in children with Cornelia de Lange syndrome

BACKGROUND

Individuals with Cornelia de Lange syndrome (CdLS) have been reported to show comparatively high levels of flat and negative affect but there have been no empirical evaluations. In this study, we use an objective measure of facial expression to compare affect in CdLS with that seen in Cri du Chat syndrome (CDC) and a group of individuals with a mixed aetiology of intellectual disabilities (ID).

METHOD

Observations of three groups of 14 children with CdLS, CDC and mixed aetiology of ID were undertaken when a one-to-one interaction was ongoing.

RESULTS

There was no significant difference between the groups in the duration of positive, negative or flat affect. However, the CdLS group displayed a significantly lower ratio of positive to negative affect than children in the other groups.

DISCUSSION

This difference partially confirms anecdotal observations and could be due to the expression of pain caused by health problems associated with CdLS or neurological expression of the CdLS gene in facial muscles related to expression of positive affect. However, further research is needed to directly test these possible associations.

Interactions of fathers and their children with autism1

The aim of the present study was to compare the activity of fathers and their children with autism with those of children with Down syndrome, and normally developing children during the father-child interaction. Participants were 14 children with autism and their fathers, 15 children with Down syndrome and their fathers, and 16 normally developing children and their fathers. The age of subjects was between 3.0 and 6.0 years old. The study consisted of one 15-minute free-play session in the father-child diad, taking place in the experiment room. Differences between the groups of fathers were found in terms of three variables under analysis: frequency of looking at the child, physical contact with the child and suggesting play. Children with autism brought objects to their fathers or pointed out objects and directed their fathers' attention by vocalising less frequently than children with Down syndrome and normally developing children. Moreover, children with autism exhibited the fewest vocalisations combined with looking at the father and exhibited many more behaviours involving running and moving about the room than normally developing children. Self-stimulating behaviours were the most frequent in children with autism, with no differences in that respect found between children with Down syndrome and normally developing children. The analysis of fathers' behaviour demonstrates that fathers of children with developmental disorders focus on observing their children and attempt to keep close contact with them to a larger extent than fathers of normally developing children. The pattern of differences in the activity of fathers of children with autism and children with Down syndrome does not paint a clear picture. In general, fathers from both groups actively sought to maintain contact with their children. Differences in the activity during play between children with autism and the other subjects in the study are consistent with the clinical features of autism.

Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder

Advances in the fields of cognitive and affective developmental neuroscience, developmental psychopathology, neurobiology, genetics, and applied behavior analysis have contributed to a more optimistic outcome for individuals with autism spectrum disorder (ASD). These advances have led to new methods for early detection and more effective treatments. For the first time, prevention of ASD is plausible. Prevention will entail detecting infants at risk before the full syndrome is present and implementing treatments designed to alter the course of early behavioral and brain development. This article describes a developmental model of risk, risk processes, symptom emergence, and adaptation in ASD that offers a framework for understanding early brain plasticity in ASD and its role in prevention of the disorder.

Developing social interaction and understanding in individuals with autism spectrum disorder: a groupwork intervention

BACKGROUND

Difficulties with social interaction and understanding lie at the heart of the communication disorder that characterises the autism spectrum. This study sought to improve social communication for individuals with autism spectrum disorder (ASD) by means of a groupwork intervention focusing on social and emotional perspective-taking, conversation skills, and friendship skills. It also aimed to address some of the limitations of previous interventions, including a lack of generalisation to other settings, so as to maximise inclusion in the community.

METHOD

A group of 46 high functioning children and adolescents with ASD (38 boys, 8 girls, age range 6-16 years) were allocated to one of 6 intervention groups. Each group met over a period of 12-16 weeks for a minimum of one 1(1/2)-hour weekly session aimed at promoting key areas of social interaction and understanding, supported by home-based practice.

RESULTS

Significant gains were achieved in comparison with a normative population, and individual parent ratings showed marked and sustained changes in the key areas targeted in the group sessions.

CONCLUSION

Social communication in children and adolescents with ASD can be enhanced through the use of a groupwork intervention addressing social interaction and understanding.

The empathic brain and its dysfunction in psychiatric populations: implications for intervention across different clinical conditions

Empathy is a concept central to psychiatry, psychotherapy and clinical psychology. The construct of empathy involves not only the affective experience of the other person's actual or inferred emotional state but also some minimal recognition and understanding of another's emotional state. It is proposed, in the light of multiple levels of analysis including social psychology, cognitive neuroscience and clinical neuropsychology, a model of empathy that involves both bottom-up and top-down information processing underpinned by parallel and distributed computational mechanisms. The predictive validity of this model is explored with reference to clinical conditions. As many psychiatric conditions are associated with deficits or even lack of empathy, we discuss a limited number of these disorders including psychopathy/antisocial personality disorders, borderline and narcissistic personality disorders, autistic spectrum disorders, and alexithymia. We argue that future clinical investigations of empathy disorders can only be informative if behavioral, dispositional and biological factors are combined.

Emotional responsivity in children with autism, children with other developmental disabilities, and children with typical development

Twenty six children with autism, 24 children with developmental disabilities, and 15 typically developing children participated in tasks in which an adult displayed emotions. Child focus of attention, change in facial tone (i.e., hedonic tone), and latency to changes in tone were measured and summary scores of emotional contagion were created. Group differences existed in the ratio of episodes that resulted in emotional contagion. Correlations existed between measures of emotional contagion, measures of joint attention, and indices of severity of autism. Children with autism demonstrated muted changes in affect, but these responses occurred much less frequently than in comparison groups. The findings suggest directions for early identification and early treatment of autism.

Identification and evaluation of children with autism spectrum disorders

Autism spectrum disorders are not rare; many primary care pediatricians care for several children with autism spectrum disorders. Pediatricians play an important role in early recognition of autism spectrum disorders, because they usually are the first point of contact for parents. Parents are now much more aware of the early signs of autism spectrum disorders because of frequent coverage in the media; if their child demonstrates any of the published signs, they will most likely raise their concerns to their child's pediatrician. It is important that pediatricians be able to recognize the signs and symptoms of autism spectrum disorders and have a strategy for assessing them systematically. Pediatricians also must be aware of local resources that can assist in making a definitive diagnosis of, and in managing, autism spectrum disorders. The pediatrician must be familiar with developmental, educational, and community resources as well as medical subspecialty clinics. This clinical report is 1 of 2 documents that replace the original American Academy of Pediatrics policy statement and technical report published in 2001. This report addresses background information, including definition, history, epidemiology, diagnostic criteria, early signs, neuropathologic aspects, and etiologic possibilities in autism spectrum disorders. In addition, this report provides an algorithm to help the pediatrician develop a strategy for early identification of children with autism spectrum disorders. The accompanying clinical report addresses the management of children with autism spectrum disorders and follows this report on page 1162 [available at www.pediatrics.org/cgi/content/full/120/5/1162]. Both clinical reports are complemented by the toolkit titled "Autism: Caring for Children With Autism Spectrum Disorders: A Resource Toolkit for Clinicians," which contains screening and surveillance tools, practical forms, tables, and parent handouts to assist the pediatrician in the identification, evaluation, and management of autism spectrum disorders in children.

Effects of object complexity and type on the gaze behavior of children with pervasive developmental disorder

The looking behavior of children with pervasive developmental disorder (PDD) and age- and IQ-matched normal control children was studied using infrared oculography. Stimuli varying in complexity and topic were presented to test whether children with PDD have specific abnormalities in looking behavior to complex stimuli and/or to faces. All children showed more and longer fixations on the complex objects than on the simple objects, especially the complex nonsense figure, but group differences were not found. The results show no evidence for specific abnormalities in looking behavior to either faces or to complex stimuli in high functioning children with PDD.

Identification: the missing link between joint attention and imitation?

In this paper we outline our hypothesis that human intersubjective engagement entails identifying with other people. We tested a prediction derived from this hypothesis that concerned the relation between a component of joint attention and a specific form of imitation. The empirical investigation involved "blind" ratings of videotapes from a recent study in which we tested matched children with and without autism for their propensity to imitate the self-/other-orientated aspects of another person's actions. The results were in keeping with three a priori predictions, as follows: (a) children with autism contrasted with control participants in spending more time looking at the objects acted upon and less time looking at the tester; (b) participants with autism showed fewer "sharing" looks toward the tester, and although they also showed fewer "checking" and "orientating" looks, they were specifically less likely to show any sharing looks; and, critically, (c) within each group, individual differences in sharing looks (only) were associated with imitation of self-other orientation. We suggest that the propensity to adopt the bodily anchored psychological stance of another person is essential to certain forms of joint attention and imitation, and that a weak tendency to identify with others is pivotal for the developmental psychopathology of autism.

Maternal sensory sensitivity, mother-infant 9-month interaction, infant attachment status: predictors of mother-toddler interaction at 24 months

At 24-months of age, toddlers (N=62) and their mothers were observed in a free-play session to determine the contribution of (a) maternal sensory sensitivity to positive and negative infant facial expressions as measured in a signal detection task at 6 months, (b) maternal behavior and affect, infant behavior and affect, and dyadic interaction at 9 months, and (c) infant attachment status at 12 months in predicting maternal, toddler, and dyadic measures at 24 months. Hierarchical regression analyses revealed that over and above early maternal behavior, which was predictive of later maternal behavior at 24 months, sensory sensitivity to the positive infant expression at 6 months predicted maternal behavior at 24 months and sensory sensitivity to both the positive and negative expression was associated with later maternal affect. Infant attachment status emerged as the variable which predicted toddler behavior and dyadic interaction at 24 months.

Verbal marking of affect by children with Asperger Syndrome and high functioning autism during spontaneous interactions with family members

Verbal marking of affect by older children with Asperger Syndrome (AS) and high functioning autism (HFA) during spontaneous interactions is described. Discourse analysis of AS and HFA and typically developing children included frequency of affective utterances, affective initiations, affective labels and affective explanations, attribution of affective responses to self and others, and positive and negative markers of affect. Findings indicate that children with AS and HFA engaged in a higher proportion of affect marking and provided a higher proportion of affective explanations than typically developing children, yet were less likely to initiate affect marking sequences or talk about the affective responses of others. No significant differences were found between groups in terms of the marking of positive and negative affect.

On intersubjective engagement in autism: a controlled study of nonverbal aspects of conversation

Does autism involve a deficit in intersubjective engagement with other persons? We studied nonverbal communication in children and adolescents with and without autism (n = 12 per group), group-matched for chronological age and verbal mental age, during 3 min of a videotaped interview. In keeping with previous studies, there were only subtle but potentially revealing group differences on behavioral ratings. Participants with autism made fewer head-shakes/nods (but not smiles) when the interviewer was talking, and the interviewer made fewer head-shakes/nods when participants were talking. Yet there were marked group differences on reliable 'subjective' ratings of (a) affective engagement and (b) the smoothness of reciprocal interaction. We interpret the findings in terms of a group difference in identification between conversational partners.

Autism and the development of face processing

Autism is a pervasive developmental condition, characterized by impairments in non-verbal communication, social relationships and stereotypical patterns of behavior. A large body of evidence suggests that several aspects of face processing are impaired in autism, including anomalies in gaze processing, memory for facial identity and recognition of facial expressions of emotion. In search of neural markers of anomalous face processing in autism, much interest has focused on a network of brain regions that are implicated in social cognition and face processing. In this review, we will focus on three such regions, namely the STS for its role in processing gaze and facial movements, the FFA in face detection and identification and the amygdala in processing facial expressions of emotion. Much evidence suggests that a better understanding of the normal development of these specialized regions is essential for discovering the neural bases of face processing anomalies in autism. Thus, we will also examine the available literature on the normal development of face processing. Key unknowns in this research area are the neuro-developmental processes, the role of experience and the interactions among components of the face processing system in shaping each of the specialized regions for processing faces during normal development and in autism.

Autism and developmental delay: a comparative clinical study in very young children using IBSE scale

OBJECTIVE

This study improves the knowledge of early autistic symptomatology and research concerning (i) the significant differences in the behaviors of children with autistic disorder (AD) and children with a developmental delay (DD), and (ii) the influence of the cognitive delay on symptomatology.

METHOD

Two groups of 20 young children (7-42 months) were compared: children with AD, and those with DD. The groups were paired by chronological and developmental age. The comparison was extended to four subgroups composed according to age (younger and older children--<24 months, >24 months) and to the global development quotient (GDQ) (the more and less delayed). Each child was evaluated with the Infant Behavior Summarized Evaluation scale (IBSE).

RESULTS

For the younger AD children, significant differences affected social communication and their adaptation to the environment (intolerance to frustration, resistance to change). For the older children (>24 months), this study showed the rapid progression of the number of distinctive signs between AD and DD children according to age and/or developmental level.

CONCLUSIONS

Cognitive delay has an important influence on the symptomatology at the moment of initial recognition of an autistic syndrome. This study is a complement for the fuller understanding of the nature and early diagnosis of disorders specific to autism at the earliest phases of development.

What Facilitates Social Engagement in Preschool Children with Autism?

We studied the association between an adult's behavior and episodes of social engagement (ESEs) in young children with autism during play-based assessment. ESEs were defined as events in which a child looked toward the adult's face and simultaneously showed an additional form of communicative behavior. The adult's behavior before each ESE, and before time-sampled control periods, was rated using Coding Active Sociability in Preschoolers with Autism (CASPA). As predicted, adult musical/motoric activity, communications that followed the child's focus of attention, scaffolding through social routines, imitations of the child, and adult repetitions were significantly more prevalent before ESEs, but cognitive assessment activities, adult inactivity, and "ignoring" were significantly less prevalent. We consider the implications for understanding the developmental psychopathology of autism.

Neurocognitive and electrophysiological evidence of altered face processing in parents of children with autism: implications for a model of abnormal development of social brain circuitry in autism

Neuroimaging and behavioral studies have shown that children and adults with autism have impaired face recognition. Individuals with autism also exhibit atypical event-related brain potentials to faces, characterized by a failure to show a negative component (N170) latency advantage to face compared to nonface stimuli and a bilateral, rather than right lateralized, pattern of N170 distribution. In this report, performance by 143 parents of children with autism on standardized verbal, visual-spatial, and face recognition tasks was examined. It was found that parents of children with autism exhibited a significant decrement in face recognition ability relative to their verbal and visual spatial abilities. Event-related brain potentials to face and nonface stimuli were examined in 21 parents of children with autism and 21 control adults. Parents of children with autism showed an atypical event-related potential response to faces, which mirrored the pattern shown by children and adults with autism. These results raise the possibility that face processing might be a functional trait marker of genetic susceptibility to autism. Discussion focuses on hypotheses regarding the neurodevelopmental and genetic basis of altered face processing in autism. A general model of the normal emergence of social brain circuitry in the first year of life is proposed, followed by a discussion of how the trajectory of normal development of social brain circuitry, including cortical specialization for face processing, is altered in individuals with autism. The hypothesis that genetic-mediated dysfunction of the dopamine reward system, especially its functioning in social contexts, might account for altered face processing in individuals with autism and their relatives is discussed.

Understanding the Nature of Face Processing Impairment in Autism: Insights From Behavioral and Electrophysiological Studies

This article reviews behavioral and electrophysiological studies of face processing and discusses hypotheses for understanding the nature of face processing impairments in autism. Based on results of behavioral studies, this study demonstrates that individuals with autism have impaired face discrimination and recognition and use atypical strategies for processing faces characterized by reduced attention to the eyes and piecemeal rather than configural strategies. Based on results of electrophysiological studies, this article concludes that face processing impairments are present early in autism, by 3 years of age. Such studies have detected abnormalities in both early (N170 reflecting structural encoding) and late (NC reflecting recognition memory) stages of face processing. Event-related potential studies of young children and adults with autism have found slower speed of processing of faces, a failure to show the expected speed advantage of processing faces versus nonface stimuli, and atypical scalp topography suggesting abnormal cortical specialization for face processing. Other electrophysiological studies have suggested that autism is associated with early and late stage processing impairments of facial expressions of emotion (fear) and decreased perceptual binding as reflected in reduced gamma during face processing. This article describes two types of hypotheses-cognitive/perceptual and motivational/affective--that offer frameworks for understanding the nature of face processing impairments in autism. This article discusses implications for intervention.

The functional architecture of human empathy

Empathy accounts for the naturally occurring subjective experience of similarity between the feelings expressed by self and others without loosing sight of whose feelings belong to whom. Empathy involves not only the affective experience of the other person's actual or inferred emotional state but also some minimal recognition and understanding of another's emotional state. In light of multiple levels of analysis ranging from developmental psychology, social psychology, cognitive neuroscience, and clinical neuropsychology, this article proposes a model of empathy that involves parallel and distributed processing in a number of dissociable computational mechanisms. Shared neural representations, self-awareness, mental flexibility, and emotion regulation constitute the basic macrocomponents of empathy, which are underpinned by specific neural systems. This functional model may be used to make specific predictions about the various empathy deficits that can be encountered in different forms of social and neurological disorders.

Early detection of core deficits in autism

The goal of this review of the research literature is to discuss approaches to the early detection of autism in infancy. Early detection would enable diagnoses to be made before 18 months of age rather than at 24-30 months, the age where diagnoses start to be made now. After summarizing the criteria for a deficit to be considered "core" to the disorder, the literature on research strategies used in early detection is examined. In order to guide the design of future studies, the review then turns to an overview of what is known about the processes of early social development in typically developing children that underlie the domains in which core deficits are manifested in young children with autism. The social domains covered in the review are those that show development in typically developing infants below 18 months of age: dyadic interaction and imitation; emotion discrimination; and attachment. The review concludes that all of these areas are worthy of investigation in young children, particularly those at higher risk of showing some of the core deficits of autism such as the infant siblings of children with autism.

Self-regulation and affective expression during play in children with autism or Down Syndrome: a short-term longitudinal study

Our study examined stability of self-regulation and affective expression in children with autism or Down syndrome over a 2 year period. A behaviorally-anchored rating scale was used to assess a self-regulation factor (attention, adaptability, object orientation, and persistence), negative affect factor (hostility, irritability, and compliance), and positive affect factor (positive affect, affective sharing, and dull affect) from videotapes of play sessions involving each child and his or her mother. The patterns of ratings within each group were similar from time 1 to time 2, with the autism group showing more deviant ratings on measures of self-regulation and affective sharing. From time 1 to time 2, children with autism showed relatively high stability for the self-regulation factor, but less stability than children with Down syndrome for all three factors.

Social and cardiac responses of young children with autism

The behavioral and heart rate responses of 22 children with autism and 22 children with other developmental disabilities were compared whilst they were watching videotapes of a baby either playing or crying. We expected both groups to show arousal as increased heart rate when watching the video of the crying baby, and the children with autism to attend less than the other children to both videos. However, the children with autism were as attentive to the videos as the other children, and both groups showed heart rate slowing compared with a baseline condition. There was no change in heart rate during interactions with a stranger or separation from mothers. The findings suggest that the lack of social attention often demonstrated by children with autism does not stem from increased arousal in social situations. An alternative explanation is considered.

Responses and sustained interactions in children with mental retardation and autism

Sustained interactions and responses to social bids made by children with autism and verbal-age-matched children with mental retardation were recorded in two naturalistic settings. Children with autism produced fewer positive responses and more "no responses" than children with mental retardation; both groups were more likely to make positive responses to adults and not to respond to other children. Furthermore, although the frequency of conversations was not different for the two groups, children with autism were significantly less likely to engage in sustained play compared to children with mental retardation. Results suggest that children with autism are able to master the more rote and need-oriented social skills, such as simple conversation, but may not develop other forms of social interactions, like play.

Attentional skills during the first 6 months of age in autism spectrum disorder

OBJECTIVE

To study the quality of early attention in autism spectrum disorder (ASD) through home movies.

METHOD

Fifteen home movies from the first 6 months of life of children who later received a diagnosis of ASD were compared with home movies of 15 normal children. The diagnosis was performed after the third year of life of children by two senior child and adolescent psychiatrists using a checklist of symptoms according to the. The films of the two groups were mixed and rated by blind observers through a Grid for the Assessment of Attentional Skills in Infants, composed of 13 items grouped into three developmental areas.

RESULTS

Using multivariate analysis of variance, the authors found significant differences between the two groups for the items in the social attention and the social behavior areas; on the contrary, there were no differences in nonsocial attention.

CONCLUSIONS

The authors pose some hypotheses about a specific early-appearing impairment of attention in ASD in which children shift their spontaneous attention mainly toward nonsocial stimuli rather than toward social stimuli. The importance of this finding for early diagnosis and treatment is underlined.

'Kiss, cuddle, squeeze': the experiences and meaning of touch among parents of children with autism attending a Touch Therapy Programme

The aim of this qualitative study was to explore the experiences and meaning of touch between parents and children with autism before and after attending a Touch Therapy Programme. The sample comprised 12 parents (1 father and 11 mothers) of children (1 female and 11 male) with autism. Parents were interviewed before and immediately after the 8-week programme. Pre-programme results suggested that children were controlling the experience of touch. Parents felt 'hurt' in response to the 'aloof nature of autism, and natural parenting instincts (e.g. spontaneous cuddles) were restricted. Post-programme results suggested that children appeared to tolerate touch. Parents reported that routine tasks (e.g. dressing) were accomplished more easily and that children appeared generally more relaxed. Parents reported feeling 'closer' to their children and felt that the touch therapy had opened a communication channel between themselves and their children.

Gaze behavior of children with pervasive developmental disorder toward human faces: a fixation time study

BACKGROUND

The abnormal gaze behavior of autistic children toward human faces, as observed in daily-life situations, are investigated in two fixation time studies. It has been argued that faces are a special kind of stimuli for normal individuals and that this might not be the case for autistic children.

METHODS

A group of high-functioning autistic children (including a group of sub-threshold PDD-NOS children) was compared with a group of normal children, with respect to their fixation behavior for photographs of human faces. Using an infrared eye-tracking device, fixation times for the whole face and for the facial elements of faces were compared between the two groups. The first study dealt with faces having an emotional expression. The second study dealt with neutral faces presented either upright or upside-down.

RESULTS

Results of the two studies showed that autistic children have the same fixation behavior as normal children for upright faces, with or without an emotional expression. Furthermore, results of the second study showed that normal children spent less time looking at upside-down faces, but that the fixation times of autistic children were not influenced by the orientation of the faces.

CONCLUSIONS

These results plead against the notion that the abnormal gaze behavior in everyday life is due to the presence of facial stimuli per se. Furthermore, the absence of a face orientation effect in autistic children might be a reflection of a lack of holistic processing of human faces in autism.

Spatial orientation adjustments in children with autism in Hong Kong

Abnormal spatial orientation and body postures in children with autism often interfere with visual abilities to attend tasks and social interactions. Twenty-four children diagnosed with autism from Kowloon, Hong Kong were assessed for spatial orientation and spatial management abilities. Positive changes in spatial orientation were evident when the children wore ambient prism lenses and included changes in posture from slanted to erect. Adjustments in spatial management were evident in improved ball catching ability, a task requiring visual tracking and eye-hand coordination. The findings suggest that alterations to the sensory systems may lead to behavioral change in some children.

Autism during infancy: a retrospective video analysis of sensory-motor and social behaviors at 9-12 months of age

This retrospective video study explored the usefulness of sensory-motor measures in addition to social behaviors as early predictors of autism during infancy. Three groups included 11 children with autism, 10 with developmental disabilities, and 11 typically developing children. Home videos were edited to obtain a 10-minute cross-section of situations at 9-12 months for each subjects. Using interval scoring, raters coded several behavioral categories (i.e., Looking, Affect, Response to Name, Anticipatory Postures, Motor/Object Stereotypies, Social Touch, Sensory Modulation). Nine items, in combination, were found to discriminate the three groups with a correct classification rate of 93.75%. These findings indicate that subtle symptoms of autism are present at 9-12 months, and suggest that early assessment procedures need to consider sensory processing/sensory-motor functions in addition to social responses during infancy. Furthermore, prior to a time that they reported autistic symptoms, caregivers used compensatory strategies to increase the saliency of stimuli in order to engage their children more successfully; these strategies may provide a window for earlier diagnosis.

Timing of social gaze behavior in children with a pervasive developmental disorder

The aim of the study was to compare social initiatives and gaze behavior in low-functioning children with a pervasive developmental disorder (PDD), high-functioning children with a PDD, children with a language disorder, and normally developing children. Behavior of the children was observed while they watched television and performed a playful task with a parent. Compared to the high-functioning children, the low-functioning children with a PDD showed fewer social initiatives. The high-functioning children with a PDD did not differ from the non-PDD control children in the number of social initiatives and gazes. However, in children with PDD, timing of social gaze proved to be different in that they had lower levels of visual checking before but not after a declarative pointing gesture. Furthermore, they had lower levels of returning gaze.

Hello and goodbye: a study of social engagement in autism

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

A dimensional classification of autism spectrum disorder by social communication domains

OBJECTIVE

To investigate whether "social communication" could be used to assess severity of symptoms in autism spectrum disorder. Social communication refers to the communication of cognitive and emotional information through facial expression, gesture, and prosody and through implicit understanding of pragmatics and of theory of mind.

METHOD

Subjects were evaluated by raters using the Autism Diagnostic interview-Revised and either the Autism Diagnostic Observation Schedule or the Pre-Linguistic Autism Diagnostic Observation Schedule. Two investigators independently diagnosed autism, Asperger's disorder, or pervasive developmental disorder-not otherwise specified in 63 subjects. Items from the Autism Diagnostic Interview-Revised that were judged to represent social communication behaviors were factor-analyzed.

RESULTS

Three factors were identified: affective reciprocity, joint attention, and theory of mind. Comparing this new classification approach to DSM-IV led to suggestions for possible changes in the latter: (1) Vocabulary and grammar deficiencies in autistic persons should be coded under developmental language disorder, (2) The diagnosis of Asperger's disorder may not be needed. (3) Requiring that all persons with autism spectrum disorder have a symptom from the "restrictive, repetitive, and stereotypic" list may need to be reconsidered.

CONCLUSIONS

The DSM-IV category of pervasive developmental disorder may be ideal for diagnosing "classic" autism, but it may be inadequate for diagnosing less severe forms of the disorder.

Following the child's lead: mothers' interactions with children with autism

This study examined the extent to which mothers of preschool children with autism use language that is related to the child's focus of attention. Fourteen mother-child dyads involving preschool children with autism participated in this study, along with 14 matched dyads involving typically developing preschool children. Both groups were observed during 15 minutes of free play. Results revealed that the mothers of children with autism directed verbalizations to something within the child's focus of attention as frequently as the mothers of typically developing children. Thus, children with autism had as many opportunities to benefit from verbal input related to their focus of attention as did typically developing children. However, mothers of children with autism directed verbalizations to something not within the child's focus of attention more frequently than mothers of typically developing children. This nonrelated input may have reflected the mothers' attempts to adapt to their children's difficulties in attention and interaction.

Abnormal saccadic eye movements in autistic children

The saccadic eye movements, generated during a visual oddball task, of autistic children, normal children, children with attention deficit disorder and hyperactivity (ADDH), and dyslexic children were examined to determine whether autistic children differed from these other groups in saccadic frequency. Autistic children made more saccades during the presentation of frequent stimuli (than normals and ADDH children), and between stimulus presentations. Also, unlike the normal and dyslexic groups, their saccadic frequency did not depend on stimulus type. This abnormal pattern of saccades may negatively influence the ability to attend to stimuli, and thereby learning processes. Suggestions are made with respect to possible abnormalities in subcortical mechanisms involved in saccade generation.

An investigation of attention and affect in children with autism and Down syndrome

Longitudinal videotape recordings of six young children with autism and six age- and language-matched children with Down syndrome in structured play with their mothers at home were coded for the focus of the child's visual attention for four bimonthly visits and for facial affect for two of the four visits. The main finding was that the children with autism showed reduced expression of positive affect in a familiar social context. The autistic group attended to the mother's face and the researchers only about half as much as the Down syndrome group, but these differences did not reach statistical significance. Compared to the Down syndrome group, the autistic group displayed a smaller proportion of their total positive affect toward the mother's face and toward the researcher, but only the latter group difference reached statistical significance. Although limited by the small sample size, these findings suggest that autistic children's known deficits in attention and affective responsiveness to others persist even in structured interactions with a familiar partner in the home.

Children with a pervasive developmental disorder, children with a language disorder and normally developing children in situations with high- and low-level involvement of the caregiver

The social behaviour of low-functioning children with a Pervasive Development Disorder (PDD), high-functioning children with a PDD, children with a Language Disorder (LD) and normally developing children (ND) was investigated in a playroom session while they were interacting with one of their parents. High-functioning children with a PDD were found to differ from the other groups in social responsivity. Low-functioning children with a PDD differed from high-functioning children with a PDD in the total number of social bids, type of social bids, number of looks at parent and social responsivity. When parents structured the behaviour of their children, this resulted in an increase in number of social bids and looks in the low-functioning children with PDD.

Linking parental perceptions to interactions in young children with autism

This study examines the relation of parental perceptions and observed parent-child interactive behaviors. Samples observed included normally developing children, children with autism, and children with mental retardation who were equivalent on mental age. Parental perceptions of children's temperament and parental feelings of parenting stress were examined. Results indicated that parental perceptions of autistic children's behavior were more often linked to actual child and parental behaviors than in the comparison samples. Parents who reported their autistic children as more difficult in temperamental style had children who were less engaged during a social game with the parent and less responsive in interaction with an experimenter. Parents who reported greater stress had autistic children who were less responsive in social interactions with others.

Long-term stability of individual differences in the emotional responsiveness of children with autism

The results of two studies designed to investigate the short- and long-term stability of autistic children's responsiveness to displays of negative emotions in others are reported here. In the first study we measured the attention and behavioural responses of 22 autistic children to another's distress about a year and a half after initial assessments in a similar situation. In the second study, the children were re-assessed in two affective contexts over 5 years after initial testing. Individual differences in early responses to affect predicted affective responsiveness at each follow-up. Emotional responsiveness was positively associated with concurrent cognitive skills at each point of assessment. Furthermore, autistic children discriminated between affective and non-affective contexts when this discrimination was tested at the second follow-up.

But what is the intentional schema?

The intentional schema may not be sufficiently characterized to make questions about its role in individual and species development intelligible. The idea of metarepresentation may perhaps give it enough content. The importance of metarepresentation itself, however, can be called into question.

Understanding minds and selves

Barresi & Moore provide a welcome focus on children's abilities to integrate first and third person information about intentional relations but they pay insufficient attention to the origins of children's understanding of the nature of subjective orientations vis-à-vis a shared world and the potential significance of such understanding as a source (rather than an outcome) of domain-general information-processing capacities.