A comparative study of the spontaneous social interactions of children with high-functioning autism and children with Asperger's disorder

Feelings of loneliness and meaning in life in subjects with Asperger's syndrome: a pilot study

Subjects with Asperger's syndrome without intellectual disabilities have significant difficulties in establishing social relationships despite their IQ being within the normal range. One of the effects of social deficit is depression. The question arises whether loneliness and dimensions of meaning in life correlate with the severity of depression and whether the average severity of depression, loneliness and dimensions of meaning in life differentiate the following groups: people with Asperger's syndrome and depression, people with Asperger's syndrome without depression, people with depression without Asperger's syndrome and healthy subjects. The study was conducted on a total of 170 people, including: 43 people with Asperger's syndrome and depression, 41 people with Asperger's syndrome without depression, 40 people with depression without Asperger's syndrome and 46 healthy people (without Asperger's syndrome and without depression). All were administered a demographic survey, Beck Depression Inventory II (BDI-II), De Jong Gierveld Loneliness Scale, Life Attitude Profile-Revised. Asperger's syndrome and depressive episodes were diagnosed on the basis of ICD-10 research criteria still applicable in Poland. In the group with Asperger's syndrome and depression the highest levels of loneliness and the lowest values of the dimensions of the sense of meaning in life, except for the acceptance of death, were observed. This result was significantly different from the results obtained in the other study groups. Both in people with Asperger's syndrome without depression and in people with depression without Asperger's syndrome, the values of the dimensions of the sense of meaning in life and the level of loneliness differ significantly from the results obtained in the control group. The BDI-II scores correlated positively with the loneliness values and negatively with the sense of meaning in life values in all groups. The results indicate that both suffering from depression and having Asperger's syndrome are associated with an increased sense of loneliness and a reduced sense of meaning in life. People with Asperger's syndrome and depression have the highest values of loneliness and the lowest values of dimensions of the sense of meaning of life compared to the other groups studied. The limitation of the work is the deliberate selection of groups, because it would be interesting to answer the question whether Asperger's syndrome is a risk factor for depression in the population.

Seeking contexts that promote neurodiverse social success: Patterns of behavior during minimally-structured interaction settings in autistic and non-autistic youth

While peer interaction differences are considered a central feature of autism, little is known regarding the nature of these interactions via directly-observed measurement of naturalistic (i.e., minimally-structured) groups of autistic and non-autistic adolescent peers. 148 autistic and non-autistic adolescents (111 male, Mage = 14.22, SDage = 1.90; MIQ = 103.22, SDIQ = 15.80) participated in a 50-minute, minimally-structured, naturalistic peer interaction paradigm with activities of varying social demands: an incidental social demand (eating in a room with peers), a physical social demand (playing a physically-interactive game), and a verbal social demand (playing a verbal game). While autistic youth exhibited fewer overall interaction behaviors than non-autistic youth, the two groups did not differ in amount of positive, negative, and low-level interaction behaviors. Within activities, autistic and non-autistic youth only differed in positive interaction behaviors during the context of a verbal social demand. Youth who displayed more positive interaction behaviors during this same activity had less autism spectrum disorder symptomatology, controlling for nested group effects and relevant covariates. These results point toward subtle differences in social demands across naturalistic settings that can either support or impede prosocial interaction for autistic youth, providing a guidepost for identifying settings that best promote social success for neurodiverse populations.

Psychometric validation of concerning behavior scale in Iranian children and young people with autism spectrum disorder

Introduction

Assessment of Concerning Behavior (ACB) was introduced by Tarver et al. (2021) to evaluate mental health and problematic/risky behaviors in children and young people with autism spectrum disorder (ASD).

Methods

This study examined the psychometric validation of the Assessment of Concerning Behavior (ACB) in an Iranian sample of parents of children and young people with ASD. Confirmatory factor analysis was conducted to examine the structure of ACB in a sample of 303 parents.

Results

The data supported the two factor structure, all factor loadings were significant and scale structure was confirmed similar to the original scale. The results supported the two-factor structure for ACB that included internalizing and externalizing problems scales. The two factors of ACB are positively correlated with Aberrant Behavior Checklist scores which showed that the validity of two factors is satisfactory. The reliability of the two subscales was reasonable as well.

Conclusion

The study suggests that the ACB could be an operational tool to assess the mental health and problematic/risky behaviors in Iranian children and young people with ASD.

Social communication problems, social anxiety, and mood problems: kindergarten and primary school teachers' perspective among students with autism spectrum disorder

This study examined the level of social communication problems (SCP), social anxiety (SA), and mood problems (MP) among children with ASD (age 4-13 years) enrolled in special classes (n = 74) and regular classes (n = 73) and grade level (kindergarten, 1st-3rd, 4th-6th) from teachers' perspective in schools of Palestinian Arabs in Israel. Teachers responded to three questionnaires about (1) SCP, (2) SA and (3) MP; the teachers' responses to the questionnaires were used to answer the research questions. Results: SCP, SA and MP were of medium rates for students with ASD enrolled in regular and special classes. No significant differences in the level of SCP could be attributed to class type (Regular, Special) or the grade level (kindergarten, 1st-3rd, 4th-6th). There were significant differences in SA levels that could be attributed to grade level in favor of the 4th-6th grades but there were no significant differences according to class type (Regular, Special). There were statistically significant differences in MP levels that could be attributed to the class type in favor of special classes, and the effect of grade level was not significant. There was a direct significant relationship between SCP, SA, and MP. Conclusion: SCP may be an important risk factor for the development of SA and MP among students with ASD, which lead us to incorporating social skills interventions by educational staff to alleviate or even prevent symptoms of SA and MP among students with ASD, which supports the view of inclusion.

Impact of the COVID-19 pandemic on risk of burn-out syndrome and recovery need among secondary school teachers in Flanders: A prospective study

Background

Due to the COVID-19 pandemic, schools were closed, teachers had to teach from home and after a while, they had to return to the classroom while the pandemic was still on-going. Even before the pandemic, teachers were already more at risk for burn-out syndrome compared to the general population. Furthermore, not much research pertaining to this population has been carried out during the pandemic and so the impact of the pandemic on teachers' risk of burn-out syndrome and recovery need remains unclear. The aim of the current study was to fill this knowledge gap and map out the impact on risk of burn-out syndrome and recovery need at different time points during the pandemic.

Methods and findings

At baseline, 2,167 secondary school teachers in Flanders were included in this prospective study. Questionnaire data were obtained at ten different time points between September 2019 and August 2021. To assess risk of burn-out syndrome and its dimensions, the Utrecht Burn-out Scale for Teachers was administered. Need for recovery was assessed using questions adopted from the Short Inventory to Monitor Psychosocial Hazards. The results revealed an initial positive effect of the first lockdown (Mar/Apr 2020) with a decrease in risk of burn-out syndrome [Odds ratio (OR) Jan/Feb 2020-Mar/Apr 2020 = 0.33, p < 0.001], emotional exhaustion (EMM Jan/Feb 2020-Mar/Apr 2020 = -0.51, p < 0.001), depersonalization (EMM Jan/Feb 2020-Mar/Apr 2020 = -0.13, p < 0.001) and recovery need [Estimated marginal mean (EMM) Jan/Feb 2020-Mar/Apr 2020 = -0.79, p < 0.001]. No significant effect on personal accomplishment was found (p = 0.410). However, as the pandemic went on, higher risk of burn-out syndrome, emotional exhaustion, depersonalization and recovery need, and lower personal accomplishment were observed.

Conclusions

Despite the initial positive impact on risk of burn-out syndrome, its dimensions and recovery need, a negative long-term impact of the COVID-19 pandemic became visible. This study highlights once again the importance for interventions to reduce teachers' risk of burn-out syndrome, especially in such difficult times as a pandemic.

Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder

In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.

Developmental outcomes in adolescence of children with autism spectrum disorder without intellectual disability: A systematic review of prospective studies

Individuals with Autism Spectrum Disorder (ASD) without intellectual disability (ID) represent approximately two-thirds of the ASD population. Here we focused on prospective research assessing different areas of functioning of children with ASD, without ID, until adolescence. Based on a pre-registered protocol (PROSPERO CRD42020189029), a systematic review of prospective studies (published between 01.01.2010 and 01.01.2020) was conducted. Twenty-eight studies met eligibility criteria. Findings indicated that ASD diagnosis and the Intelligence Quotient were highly stable over time across studies. Executive Functioning, Theory of Mind and Central Coherence processes tended to improve, although deficits remained when compared to typically developed controls. Adaptive difficulties and psychiatric comorbidity were relatively stable over time. We discuss potential implications of the findings for clinicians and educators and suggest recommendations for future research.

It's Messy but Real: A Pilot Study of the Implementation a Social Engagement Intervention for Children with Autism in Schools

Social impairment represents one of the most challenging core deficits of autism spectrum disorder (ASD) and greatly affects children's school experiences; however, few evidence-based social engagement programs have been implemented and sustained in schools. This pilot study examined the implementation and sustainment of a social engagement intervention, Remaking Recess, for four elementary-aged children with ASD and four school personnel in two urban public schools. The improved peer engagement and social network inclusion outcomes suggest that Remaking Recess can be feasibly implemented in under resourced public schools with fidelity and has the potential to improve child outcomes for children with ASD.

The games they play: Observations of children with autism spectrum disorder on the school playground

The playground may be an important context to examine the social functioning of children with autism spectrum disorder. Previous literature on playground peer engagement has used quantitative methods, but there is limited research using qualitative observations to understand the nuances of playground behavior. Using a mixed-methods approach, 55 elementary school-aged children with autism spectrum disorder who are primarily included in general education settings were observed on the school playground using the Playground Observation of Peer Engagement. Quantitative and qualitative data were examined using a mixed-methods approach. The results showed that children with autism spectrum disorder: engage in solitary and peripheral activities; demonstrate appropriate initiations and responses to peers; display self-stimulatory, motoric behaviors most frequently during solitary activities; and often have neutral affect on the playground. These findings suggest that intervention and supports for children with autism spectrum disorder may be important to deliver at recess to address peer engagement.

The play skills of children with high-functioning autism spectrum disorder in peer-to-peer interactions with their classmates: A multiple case study design

BACKGROUND/AIM

Children with ASD are known to have lower play skills than their typically developing peers. However, the play skills of children with ASD are rarely investigated using observational measures in the context of their everyday peer-to-peer play interactions. To explore the play skills of children with ASD and their aged matched classmates during a peer-to-peer play interaction.

METHODS

Using convenience sampling, four children with ASD (5-11 years) attending mainstream schools were recruited for this multiple case design study. Each child with ASD was paired with one of their aged matched typically developing classmates. Children's play skills were measured using the Test of Playfulness (ToP). Additional case data were collected through teacher-reported social skills and behaviours. Rasch analysis was utilised to convert raw ToP scores into an interval level overall score for each child. Children's individual ToP item scores, social skills and behaviours are presented by case.

RESULTS

The two children with ASD who had the highest ToP scores, also had the highest teacher-reported social skills. All children with ASD had greatest difficulty on ToP items reflecting suspension of reality and framing. Two children with ASD had higher ToP scores than their classmate. In these two cases, the classmates had similar play skills of children with ASD.

CONCLUSION

The play skills of children with ASD varied by case. Across the cases, teacher-reported social skills, classmate age and existence of friendship between children were all factors observed to influence play. These findings require replication and investigation in larger scale studies.

Autistic people's perspectives on stereotypes: An interpretative phenomenological analysis

Autism stereotypes can often portray autistic people in a negative way. However, few studies have looked at how autistic people think they are perceived by others, and none have specifically asked autistic people what they think the autistic stereotypes are. Semi-structured interviews with 12 autistic adults (aged between 20 and 63 years) were conducted. Using interpretative phenomenological analysis, three main themes emerged from the data. These were as follows: (1) the primary stereotype is that autistic people are 'weird'; (2) autistic stereotypes have negative effects and consequences; and (3) autistic people are heterogeneous. This study makes an important and novel contribution to understanding the experience of being autistic by exploring how autistic people feel they are perceived by others and identifying some of the ways in which negative stereotypes are believed to have negative consequences for autistic people.

Individual characteristics of students with autism spectrum disorders and school refusal behavior

This study compared social, executive, emotional, and behavioral characteristics of students with autism spectrum disorder who did and did not display school refusal behavior. The participants were 62 students with autism spectrum disorder without intellectual disability aged 9-16 years attending inclusive schools. Parents first completed questionnaires assessing social and executive functioning as well as emotional and behavioral problems. They then documented their child's school refusal behavior for a period of 20 days. Compared to students without school refusal behavior (n = 29), students with school refusal behavior (n = 33) were significantly less socially motivated; displayed more deficits in initiating tasks or activities, in generating ideas, responses, or problem-solving strategies; and displayed more withdrawn and depressive symptoms. Assessing social and executive functioning, as well as emotional problems, may help professionals provide tailored interventions for students with autism spectrum disorder and school refusal behavior, which will further be valuable in recognizing characteristics associated with school refusal behavior.

Evaluating the quality of peer interactions in children and adolescents with autism with the Penn Interactive Peer Play Scale (PIPPS)

Background

A core difficulty for individuals with autism is making friends and successfully engaging and interacting with peers. The majority of measures to assess peer interactions are observations in a school setting or self-report. The present study examined the convergent validity of using a teacher rating scale, the Penn Interactive Peer Play Scale (PIPPS), for collecting information about the quality of peer interactions at school.

Methods

Teachers completed the PIPPS for 107 children with ASD when the child was 9 and 13 years of age. Clinicians completed diagnostic and cognitive assessments and caregivers completed the Autism Diagnostic Interview-Revised (ADI-R) when the child was 9.

Results

Parent report of reciprocal friendships from the ADI-R was associated with teacher report about how socially connected the child was at school on the PIPPS, indicating strong convergence between teachers and parents. Children with more severe restricted and repetitive behaviors and lower verbal abilities were less connected with peers. Children with access to typical peers had more connections with peers compared to those who were in a special education classroom.

Conclusions

The findings suggest that teacher ratings from the PIPPS can accurately capture the quality of peer interactions in children and adolescents with ASD and may be useful for clinicians and researchers to evaluate peer engagement in the classroom.

Characteristics of socially successful elementary school-aged children with autism

BACKGROUND

The extant literature demonstrates that children with autism spectrum disorder (ASD) often have difficulty interacting and socially connecting with typically developing classmates. However, some children with ASD have social outcomes that are consistent with their typically developing counterparts. Little is known about this subgroup of children with ASD. This study examined the stable (unlikely to change) and malleable (changeable) characteristics of socially successful children with ASD.

METHODS

This study used baseline data from three intervention studies performed in public schools in the Southwestern United States. A total of 148 elementary-aged children with ASD in 130 classrooms in 47 public schools participated. Measures of playground peer engagement and social network salience (inclusion in informal peer groups) were obtained.

RESULTS

The results demonstrated that a number of malleable factors significantly predicted playground peer engagement (class size, autism symptom severity, peer connections) and social network salience (autism symptom severity, peer connections, received friendships). In addition, age was the only stable factor that significantly predicted social network salience. Interestingly, two malleable (i.e., peer connections and received friendships) and no stable factors (i.e., age, IQ, sex) predicted overall social success (e.g., high playground peer engagement and social network salience) in children with ASD.

CONCLUSIONS

School-based interventions should address malleable factors such as the number of peer connections and received friendships that predict the best social outcomes for children with ASD.

Investigating mobile emotional learning for children with autistic spectrum disorders

Realizing facial expression is likely to be one of the earliest facilitators of social engagement, and it is a core deficit for individuals with autism spectrum disorder (ASD) to build social relationship. Mobile learning creates the possibility of a learning environment and visual stimuli that can adapt its informal learning contexts to improve recognizing emotions for people with ASD. This study adopted features of mobile learning to help the realization of facial expression for the ASD. The proposed 3D Complex Facial Expression Recognition (3CFER) system was developed to help the deficit in facial expressions for this population. This study therefore, explored how children with ASD performed realizing facial expression using the 3CFER system; and how the phenomena of using the learning system for people with ASD performs. Participants (n = 24, 16 males and 8 females, m = 11.3 years old) were randomly assigned to either a control or an experimental group, and were involved with the pre-and post-test sessions. The control was not engaged in the system-treatment; and the experimental undertook the system-operation. The result showed that the experimental had great improvement in realizing facial expression compared with control, and surprise and shyness were mostly easy to be identified for them. The performance of using mobile learning system was promising well. However, the informal experience of recognizing facial expression in different social contexts was meaningful learning for this population.

Examining playground engagement between elementary school children with and without autism spectrum disorder

Little is known about the social behavior of children with and without autism spectrum disorder during recess. This study documented the naturally occurring recess engagement and peer interaction behaviors of children with and without autism spectrum disorder in inclusive school settings. Participants included 51 children with autism spectrum disorder and 51 classmates without autism spectrum disorder who served as peer models matched on gender, classroom, grade, age, and ethnicity. Using a timed-interval behavior-coding system, children with autism spectrum disorder spent approximately 30% of their recess time engaged in solitary activities, whereas their classmates only spent approximately 9% of recess unengaged. In addition, children with autism spectrum disorder spent about 40% of the recess period jointly engaged with peers in a reciprocal activity, conversation, or game as compared to 70% for matched classmates. These findings provide a context for which to interpret intervention outcomes and gains for children with autism spectrum disorder in inclusive settings.

Can you see it too? Observed and self-rated participation in mainstream schools in students with and without autism spectrum disorders

OBJECTIVES

To examine the degree to which observations can capture perception of participation, observed and self-rated levels of interactions for students with and without autism spectrum disorders (ASD) were explored.

METHODS

Frequencies and levels of involvement in interactions with classmates were observed and compared in 22 students with ASD and 84 of their classmates in mainstream schools, using a standardized protocol. Self-reported participation measurements regarding interactions with classmates and teachers from five questionnaire items were correlated with the observations. In total, 51,516 data points were coded and entered into the analyses, and correlated with 530 questionnaire ratings.

RESULTS

Only one weak correlation was found in each group. Compared with classmates, students with ASD participated less frequently, but were not less involved when they actually did.

CONCLUSIONS

Observations alone do not capture the individuals' perception of participation and are not sufficient if the subjective aspect of participation is to be measured.

A systematic review of peer-mediated interventions for children with autism spectrum disorder

BACKGROUND

Peer mediated intervention (PMI) is a promising practice used to increase social skills in children with autism spectrum disorder (ASD). PMIs engage typically developing peers as social models to improve social initiations, responses, and interactions.

METHOD

The current study is a systematic review examining PMIs for children and adolescents with ASD conducted using group designs. Five studies met the pre-specified review inclusion criteria: four randomized controlled trials and one pre- and post-test design.

RESULTS

Four of the studies were conducted in school settings, whereas one study was conducted in a camp setting. The studies all reported that participants improved in social skills (e.g., social initiations, social responses, social communication) post intervention. Additionally, sustainment, generalization, and fidelity of implementation were examined.

CONCLUSION

PMI is a promising approach to address social skills in children with ASD, and this approach can be conducted in meaningful real-word contexts, such as schools. Limitations of the studies as well as future directions are discussed.

Social Interaction Style of Children and Adolescents with High-Functioning Autism Spectrum Disorder

Qualitative differences in social interaction style exist within the autism spectrum. In this study we examined whether these differences are associated with (1) the severity of autistic symptoms and comorbid disruptive behavior problems, (2) the child's psycho-social health, and (3) executive functioning and perspective taking skills. The social interaction style of 156 children and adolescents (6-19 years) with high-functioning autism spectrum disorder (HFASD) was determined with the Wing Subgroups Questionnaire. An active-but-odd social interaction style was positively associated with symptoms of autism, attention deficit and hyperactivity. Furthermore, an active-but-odd social interaction style was negatively associated with children's psycho-social health and positively with executive functioning problems. Social interaction style explains part of the heterogeneity among children with HFASD.

Typical and atypical pragmatic functioning of ASD children and their partners: a study of oppositional episodes in everyday interactions

Pragmatic functioning of autism spectrum disorder (ASD) children is rarely examined in socially-meaningful contexts. This study investigates the way oppositional episodes are handled in such contexts by 25 families, 10 with ASD and 15 with typically-developing children. Oppositions occur whenever someone protests, refuses or denies someone else's action, request or statement. The analysis focuses on justifications accounting for the opposition and on their immediate persuasive effect. Analyses of 1,065 oppositional episodes show no differences in justifications among partners and children, except for ASD children with a verbal age 3-4 years, who justify less than their matched controls. The persuasive effect of justifications on children and on partners differs according to their group and verbal age. Implications of the study and future perspectives are discussed.

Neural and cortisol responses during play with human and computer partners in children with autism

Children with autism spectrum disorder (ASD) exhibit impairment in reciprocal social interactions, including play, which can manifest as failure to show social preference or discrimination between social and nonsocial stimuli. To explore mechanisms underlying these deficits, we collected salivary cortisol from 42 children 8-12 years with ASD or typical development during a playground interaction with a confederate child. Participants underwent functional MRI during a prisoner's dilemma game requiring cooperation or defection with a human (confederate) or computer partner. Search region of interest analyses were based on previous research (e.g. insula, amygdala, temporal parietal junction-TPJ). There were significant group differences in neural activation based on partner and response pattern. When playing with a human partner, children with ASD showed limited engagement of a social salience brain circuit during defection. Reduced insula activation during defection in the ASD children relative to TD children, regardless of partner type, was also a prominent finding. Insula and TPJ BOLD during defection was also associated with stress responsivity and behavior in the ASD group under playground conditions. Children with ASD engage social salience networks less than TD children during conditions of social salience, supporting a fundamental disturbance of social engagement.

Asperger's disorder will be back

This review focuses on identifying up-to-date number of publications that compared DSM-IV/ICD-10 Asperger's disorder (AspD) to Autistic Disorder/High-functioning Autism (AD/HFA). One hundred and twenty-eight publications were identified through an extensive search of major electronic databases and journals. Based on more than 90 clinical variables been investigated, 94 publications concluded that there were statistically significant or near significant level of quantitative and/or qualitative differences between AspD and AD/HFA groups; 4 publications found both similarities and differences between the two groups; 30 publications concluded with no differences between the two groups. Although DSM-5 ASD will eliminate Asperger's disorder. However, it is plausible to predict that the field of ASD would run full circle during the next decade or two and that AspD will be back in the next edition of DSM.

Ethological Approach to Autism Spectrum Disorders

The purpose of the study was to develop a new ethogram for the assessment of children and adolescents with autism spectrum disorders (ASD) and intellectual developmental disorder (IDD) and to test whether this instrument accurately distinguishes ASD participants ( n = 61) from IDD participants ( n = 61). An ethogram with 88 behavior elements was generated, including body postures, verbalizations, facial expressions, motor stereotypies, head postures, gaze behavior, gestures, and interpersonal distance. Significant differences were detected between both groups in classic ASD behaviors; in behaviors that are deficient in ASD according to established theoretical models, such as symbolic play, gaze direction, gaze following, and use of mental state language; in atypical behaviors that have also been described previously in ethological studies with ASD; and in the nonspecific behaviors of ASD, such as walk, look own body, explore, and cry. The predictive success of a diagnosis of ASD in the logistic regression model with the ethogram's factors was 98.4%. The results suggest that this ethogram is a powerful and useful tool for both the detailed study of the social behaviors of autistic children and adolescents, and for discriminating ASD and IDD.

A comparison of social cognitive profiles in children with autism spectrum disorders and attention-deficit/hyperactivity disorder: a matter of quantitative but not qualitative difference?

The aim of this study was to compare social cognitive profiles of children and adolescents with Autism Spectrum Disorders (ASD) and ADHD. Participants diagnosed with an ASD (n = 137) were compared to participants with ADHD (n = 436) on tests of facial and vocal affect recognition, social judgment and problem-solving, and parent- and teacher-report of social functioning. Both groups performed significantly worse than the normative sample on all measures. Although the ASD group had more severe deficits, the pattern of deficits was surprisingly similar between groups, suggesting that social cognitive deficit patterns may be more similar in ASD and ADHD than previously thought. Thus, like those with ASDs, individuals with ADHD may also need to be routinely considered for treatments targeting social skills.

Empathic responsiveness of children and adolescents with high-functioning autism spectrum disorder

Previous studies have shown reduced empathic responsiveness to others' emotions in preschoolers with autism spectrum disorder (ASD) and an intellectual disability. However, age and intelligence may promote children's empathic responsiveness. Therefore, we examined the empathic responsiveness in normally intelligent school-aged children and adolescents with a clinical diagnosis of ASD (n = 151) and in a typically developing comparison group (n = 50), using structured observations and parent reports. Based on the observations, participants' responses to the emotional displays of an interviewer were surprisingly similar. However, compared with parents from the comparison group, parents of a child with ASD reported significantly fewer empathic responses, particularly when the child received a high score on the Autism Diagnostic Observation Schedule. Even though parents report a reduced empathic responsiveness in school-aged children and adolescents with ASD, it may be difficult to find these empathic limitations during brief observations in a structured setting.

Recreational participation of children with High Functioning Autism

The recreation of children with High Functioning Autism (HFA) is not well understood. The objective of this cross-sectional study was to compare the recreational engagement of children with HFA and their typically developing peers. Children with HFA (n = 30) and peers (n = 31) were similar on key characteristics that may impact recreation except those related to the HFA attributes. Children with HFA differed from peers in terms of diversity (p = .002), social aspects (p = .006) and locations (p < .001) of recreation. The two groups were not statistically different in personal intensity (p = .684), enjoyment (p = .239) or preferences (p = .788) of recreation. A recreational profile was developed to benefit parents and clinicians in supporting the recreation of these children.

Increasing social engagement in children with high-functioning autism spectrum disorder using collaborative technologies in the school environment

This study examined the effectiveness of a school-based, collaborative technology intervention combined with cognitive behavioral therapy to teach the concepts of social collaboration and social conversation to children with high-functioning autism spectrum disorders (n = 22) as well as to enhance their actual social engagement behaviors (collaboration and social conversation) with peers. Two computer programs were included in the intervention: "Join-In" to teach collaboration and "No-Problem" to teach conversation. Assessment in the socio-cognitive area included concept perception measures, problem solving, Theory of Mind, and a dyadic drawing collaborative task to examine change in children's social engagement. Results demonstrated improvement in the socio-cognitive area with children providing more active social solutions to social problems and revealing more appropriate understanding of collaboration and social conversation after intervention, with some improvement in Theory of Mind. Improvement in actual social engagement was more scattered.

Competência social e autismo: o papel do contexto da brincadeira com pares

Observa-se o esforço dos pesquisadores em delinear e avaliar intervenções para facilitar o desenvolvimento da interação social em crianças com autismo e seus pares, em situações de inclusão escolar. Entre os resultados controversos dos estudos estão os que se referem ao papel do contexto das brincadeiras, isto é, se livre ou dirigida, na promoção da competência social dessas crianças. O objetivo deste estudo foi revisar criticamente a literatura sobre o tema, buscando-se evidências sobre que tipo de contexto de brincadeira tende a promover as interações entre pares, examinando-se as questões metodológicas que cercam esse debate. A conclusão foi de que ambos os contextos promovem o desenvolvimento da competência social, mas o livre tende a ser mais duradouro e espontâneo.

Facial emotion recognition in children with high functioning autism and children with social phobia

Recognizing facial affect is essential for effective social functioning. This study examines emotion recognition abilities in children aged 7-13 years with High Functioning Autism (HFA = 19), Social Phobia (SP = 17), or typical development (TD = 21). Findings indicate that all children identified certain emotions more quickly (e.g., happy < anger, disgust, sad < fear) and more accurately (happy) than other emotions (disgust). No evidence was found for negative interpretation biases in children with HFA or SP (i.e., all groups showed similar ability to discriminate neutral from non-neutral facial expressions). However, distinct between-group differences emerged when considering facial expression intensity. Specifically, children with HFA detected mild affective expressions less accurately than TD peers. Behavioral ratings of social effectiveness or social anxiety were uncorrelated with facial affect recognition abilities across children. Findings have implications for social skills treatment programs targeting youth with skill deficits.

Multirater congruence on the social skills assessment of children with asperger syndrome: self, mother, father, and teacher ratings

Children with Asperger Syndrome (AS) who attend mainstream settings face social skills deficits that have not been adequately explored. This study aims to examine social skills through self-reports of children with AS (N = 21) and a matched group of typically developing peers, as well as reports from their mothers, fathers, and teachers. Results showed that children with AS had more social skills deficits according to all raters and that they reported more aggressiveness/antisocial behavior, more conceit/haughtiness, more loneliness/social anxiety, and less assertiveness than controls. The level of agreement between raters varied significantly, suggesting that social skills are best studied with multiple informants.

Elevated cortisol during play is associated with age and social engagement in children with autism

BACKGROUND

The hallmark characteristic of autism is impaired reciprocal social interaction. While children find social interaction stress-reducing, many children with autism may find social interaction stress-inducing. The current study was designed to examine stress responsivity as measured by cortisol by comparing children with autism to neurotypical peers during an ecologically valid 20-minute playground paradigm.

METHODS

The experiment involved sets of three children: a child with autism, a neurotypical child, and a confederate. Participants included 45 prepubescent males between 8 and 12 years of age (21 with autism and 24 neurotypical children).

RESULTS

Children with autism showed fewer initiations (χ²(1) = 4.03, P = 0.044), rejected initiations from others more (χ²(1) = 7.10, P = 0.008) and spent less time interacting during motor (F(1,43) = 16.7, P = 0.0002) and cooperative (F(1,43) = 14.78, P = 0.0004) play. Repeated measures analysis of the cortisol values revealed a significant model (χ²(4) = 22.76, P < 0.0005) that included time of measurement, diagnosis and age as main effects and an interaction between diagnosis and age. Thus, as age increased among children with autism, they experienced enhanced cortisol levels while age did not modify expected cortisol levels for typical children. Stress responsivity was associated with more peripheral equipment play for motor (χ²(3) = 12.3, P = 0.006) and cooperative (χ²(3) = 8.24, P = 0.04) play as well as reduced nonverbal social skills during motor (χ²(1) = 5.52, P = 0.018) and cooperative play (χ²(1) = 4.53, P = 0.033).

CONCLUSIONS

Overall, children with autism engaged in fewer social overtures and spent less time interacting than typically developing peers during play. The peer interaction paradigm resulted in significantly higher levels of cortisol in many children with autism. Distinct patterns emerged within the autism group based on developmental (older), biological (cortisol responder) and behavioral patterns (peripheral group interaction). The enhanced cortisol response was observed in children who voluntarily engaged in interaction; thus, it does not support the notion of a response to social threat. Rather, it appears to reflect attendant metabolic preparedness and enhanced arousal from engaging socially. The data suggest that many children with autism activate hypothalamic-pituitary-adrenal responses in relatively benign social situations, which appears to be a function of age and level of social engagement. The findings support the need to teach coping strategies in addition to fundamental social skills to youth with autism.

Predictive value of subclinical autistic traits at age 14-15 months for behavioural and cognitive problems at age 3-5 years

It is unclear whether subclinical autistic traits at very young age are transient or stable, and have clinical relevance. This study investigated the relationship between early subclinical autistic traits and the occurrence of later developmental and behavioural problems as well as problems in cognitive and language functioning. Parents of infants aged 14-15 months from the general population completed the Early Screening of Autistic Traits Questionnaire (ESAT). Three groups of children with high, moderate, and low ESAT-scores (total n = 103) were selected. Follow-up assessments included the CBCL 1(1/2)-5 at age 3 years, and the SCQ, the ADI-R, the ADOS-G, an on-verbal intelligence test, and language tests for comprehension and production at age 4-5 years. None of the children met criteria for autism spectrum disorder at follow-up. Children with high ESAT-scores at 14-15 months showed significantly more internalizing and externalizing problems at age 3 years and scored significantly lower on language tests at age 4-5 years than children with moderate or low ESAT-scores. Further, significantly more children with high ESAT-scores (14/26, 53.8%) than with moderate and low ESAT-scores (5/36, 13.9% and 1/41, 2.4%, respectively) were in the high-risk/clinical range on one or more outcome domains (autistic symptoms, behavioural problems, cognitive and language abilities). Subclinical autistic traits at 14-15 months predict later behavioural problems and delays in cognitive and language functioning rather than later ASD-diagnoses. The theoretical implications of the findings lie in the pivotal role of early social and communication skills for the development of self-regulation of emotions and impulses. The practical implications bear on the early recognition of children at risk for behavioural problems and for language and cognitive problems.

Qualitative or quantitative differences between Asperger's disorder and autism? Historical considerations

The histories of autism and Asperger's Disorder (AD), based on original contributions by Kanner and Asperger, are reviewed in relation to DSM-IV diagnostic criteria. Their original articles appear to have influenced the distinction between AD and autism made in the DSM-IV. Based on up-to-date empirical research, however, it appears that AD and autism are not qualitatively distinct disorders, but are different quantitative manifestations of the same disorder. The differences between AD and autism may be a function of individual variability in these areas, not the manifestation of qualitatively distinct disorders. The DSM-IV criteria for AD and autism need to be considered with their historical developments, and based on empirical evidence, the DSM-IV diagnostic criteria may be subject to critical review.

Reduced language processing asymmetry in non-autistic individuals with high levels of autism traits

In the normal population the left hemisphere's predominance for language processing is well established. However, in disorders such as autism atypical patterns of hemispheric lateralisation are common. Given increasing recognition of the idea that autism represents a continuum, we investigated whether the reduced/absent hemispheric asymmetry for language processing extended into the normal population at the upper end of the autism spectrum. A total of 51 participants completed the AQ questionnaire (Baron-Cohen et al., 2001), and a lateralised lexical decision task assessing identification of concrete and abstract words. Based on the clinical finding of decreased hemispheric asymmetry in people with autism, we anticipated reduced hemispheric lateralisation in non-autistic people with higher levels of autism traits. Consistent with prediction, whereas people with lower AQ scores showed a clear right visual field (left hemisphere) advantage for word/nonword discrimination, people with higher AQ scores showed equivalent performance for the left and right visual fields. Our data indicate reduced left hemisphere language dominance in people with higher levels of autism traits, just as people with a clinical diagnosis of autism show atypical lateralisation. Moreover, the data offer further support for the notion that autism is a continuum, rather than a categorical diagnosis, with atypical patterns of hemispheric asymmetry being characteristic of people at the upper end of the spectrum.

Fusiform function in children with an autism spectrum disorder is a matter of "who"

BACKGROUND

Despite the importance of face processing for normal social development, no functional magnetic resonance imaging studies of face processing in autism have focused exclusively on the childhood years. To fill this gap, 45 children aged 6-12 participated in practice scans. After exclusion due to motion, 11 children with an ASD and 11 age-matched normal control subjects were included in final analyses.

METHODS

Stimuli consisted of pictures of a familiar adult, familiar child, stranger adult, stranger child, and objects. During the scan, children pressed a button in response to an identical face shown on two consecutive trials. On the basis of our prior research, masks of four anatomic regions of interest (ROIs) including the fusiform gyrus, amygdala, and anterior and posterior cingulate were created for each subject and manually edited for anatomic precision. Following deconvolution analyses, the number of voxels significantly active and percent signal change values that fell within each ROI mask were calculated for each subject.

RESULTS

Analyses revealed normal fusiform activity in children with autism when viewing a face of their mother or other children. In contrast, looking at stranger adult faces initiated profound deficits in that the mean number of significantly active voxels in the fusiform bilaterally was approximately 25% of that shown in typically developing children.

CONCLUSIONS

A selective fusiform deficit in response only to the faces of adult strangers may be the result of reduced attention and interest during those conditions. Face processing abnormalities found in autism beyond the fusiform likely exist.

Conversational behaviors in youth with high-functioning ASD and Asperger syndrome

Twenty-nine youth with autism spectrum disorders and 26 with typical development between 12 and 18 years of age were engaged in structured interviews (ADOS). The interviews were videotaped and rated for atypical conversational behaviors by trained raters, using the Pragmatic Rating Scale (Landa et al. Psychol Med 22:245-254, 1992). The ASD group was divided into AS and HFA/PDD-NOS subgroups. Significant differences were found among groups on approximately one-third of the PRS items. These items involved primarily the management of topics and information, reciprocity, intonation, and gaze management. The only differences to reach significance between the AS and HFA/PDD-NOS group were a greater tendency for overly formal speech on the part of the AS group, and more difficulty with gaze management on the part of the group with HFA/PDD-NOS. The implications of these findings for understanding and treating conversational deficits in ASD are discussed.

Social skills and problem behaviours in school aged children with high-functioning autism and Asperger's Disorder

The social skills and problem behaviours of children with high-functioning autism and Asperger's Disorder were compared using parent and teacher reports on the Social Skills Rating System. The participants were 20 children with high-functioning autism, 19 children with Asperger's Disorder, and 17 typically developing children, matched on chronological and overall mental age. The children with autism and Asperger's Disorder were not differentiated on any social skill or problem behaviour based either on teacher or parent report. However, both clinical groups demonstrated significant social skill deficits and problem behaviours relative to the typically developing children, and the original standardization sample. The findings were compatible with the view that autism and Asperger's Disorder belong on a single spectrum of disorder.

A Comparative Study of the Use and Understanding of Self-Presentational Display Rules in Children with High Functioning Autism and Asperger’s Disorder

The use and understanding of self-presentational display rules (SPDRs) was investigated in 21 children with high-functioning autism (HFA), 18 children with Asperger's disorder (AspD) and 20 typically developing (TD) children (all male, aged 4- to 11-years, matched on mental age). Their behaviour was coded during a deception scenario to assess use of SPDRs; understanding of SPDRs was assessed via three real/apparent emotion-understanding vignettes. The children with HFA and AspD used less effective SPDRs than the TD children, but there were no group differences in understanding SPDRs. The children with HFA and AspD did not differ on their use or understanding of SPDRs, and the results are discussed in relation to the similarities and differences between these diagnostic conditions.