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Differences in the structure of social behaviour of autistic children and non-autistic retarded controls.

Social and task-oriented behaviours of autistic children were compared to those of individually age- and IQ-matched non-autistic retarded controls. Autistic children showed deficits in visual reciprocity, in indicating joint attention and referential head gestures, and in the integration of gaze and gestures when reacting to tasks. The findings confirmed the notion of social and pragmatic communicative deficits in autism. The implications of these findings for theories of social behaviour in autism (avoidance, facial perception, theory of mind) are discussed.

Autistic Disorder↗

A model of preverbal social development and its application to social dysfunctions in autism.

Studies of early face perception are used to develop a model of how face expressions might be transduced to initiate consonant internal affect, related outward expressions and other behaviours. Underlying neural mechanisms and processes are identified. The model is generalised to offer an account of aspects of typical preverbal social development. It is then used to develop aetiological hypotheses about the lack of social interest and motivation in autism and to provide a framework for evaluating other theories of autism. Although derived from existing literature, the model offers a distinctive account.

Amygdala↗

An ethological approach to autism: an analysis of visual behaviour and interpersonal contact in a child versus adult interaction.

Eighteen children classified into 4 diagnostic categories were compared based on their behaviour in a child-adult interaction. The categories consist of autistic children with full syndrome, autistic children in a residual state, hyperactive children, and mentally retarded children. An ethological analysis of the interpersonal distance, the amount of physical contact, and the direction of the look/gaze was carried out to describe some behavioural aspects of infantile autism. The autistic children with full syndrome were found to be different from the other categories by a relatively close interpersonal distance, a high frequency of physical contact, and a low frequency of "look at face".

Adolescent↗

The radial dysplasia/imperforate anus/vertebral anomalies syndrome (the VATER association): Developmental aspects and eye findings.

The developmental evaluations of four children of different age groups with radial dysplasia/imperforate anus/vertebral anomalies syndrome are presented. These show that although the gross motor behavior is significantly delayed, intelligence, language, and social development are within normal range. Therefore, the patients with this syndrome merit every effort toward rehabilitation. Three of the patients discussed have ophthalmological abnormalities, in addition to their major malformations. It may be that congenital eye defects are another component of this syndrome of morphogenesis.

Abnormalities, Multiple↗

Direct assessment of social behaviour from videotape recordings.

A number of frequency and duration measures, and also general ratings, were made to assess specified aspects of interpersonal behaviour. These were taken from videotape recordings of interviews, or informal conversations, involving psychiatric patients. The frequency and duration measures were found to have high inter-rater reliability. Pearsonian correlations were in the range of 0-88--0-99. The general ratings were less reliable (0-42--0-86). The patients were divided into two groups. The first were patients whose major difficulties were interpersonal problems. The second contained patients with other psychiatric problems. Comparisons between these groups revealed a number of significant differences in the behavioural frequency and duration measures. Significant differences were also found in the general ratings, but there were disagreements between the two raters which made the interpretation of these differences difficult. When, within the interpersonal problem group, informal conversations were compared with formal interviews, it was found that subjects spent longer looking at the other person during the conversation. No other differences were evident. The implications of the results for social skills research are discussed.

Adult↗

Interpersonal distance as a function of situationally induced anxiety.

Two experiments were conducted to investigate the effects of situationally induced anxiety on interpersonal distance in a two-person conversation. In the anxiety-arousing situation subjects were asked to discuss an interesting incident while their social competence was assessed from behind a one-way screen. The briefing and debriefing periods were used for control purposes. Analysis of speech disturbance rates showed that the anxiety manipulation was successful. A significant increase in interpersonal distance was found in the anxiety-inducing situation relative to the low stress situation. The implications for the controversy concerning the effect of anxiety on the need for affliation are discussed.

Anxiety↗

Social skills training with mentally handicapped people: a review.

Four questions are asked about the use of social skills training procedures with mentally handicapped people. The first is, 'What are social skills in the context of mental handicap?', and it is suggested that they involve a complex array of perceptual, cognitive, motor and motivational processes, all of which can be disrupted due to various problems common among mentally handicapped people. The second question, 'What changes do social skills training programmes aim to achieve?', leads to the conclusion that most programmes have concentrated on motor, and to some extent on motivational processes, at the expense of perceptuo-cognitive ones. In asking, 'Have the programmes been successful in achieving these changes?', the answer is a guarded 'yes', given the limited aims of most investigators. Generalization to the natural environment has only occasionally been established, though it is often not measured. The fourth question is, 'What is the clinical significance of the changes obtained by such programmes and how can future ones be made more clinically relevant?'. The answer to the first part of the question is that, in general, their clinical utility has not been established. Future programmes could be made more clinically relevant if they were integrated with strategies for producing more benign and stimulating environments for mentally handicapped people.

Adolescent↗

Memory without context: amnesia with confabulations after infarction of the right capsular genu.

OBJECTIVE: To explore the mechanism of an amnesia marked by confabulations and lack of insight in a patient with an infarct of the right inferior capsular genu. The confabulations could mostly be traced back to earlier events, indicating that the memory disorder ensued from an inability to store the temporal and spatial context of information acquisition rather than a failure to store new information. METHODS: To test the patient's ability to store the context of information acquisition, two experiments were composed in which she was asked to decide when or where she had learned the words from two word lists presented at different points in time or in different rooms. To test her ability to store new information, two continuous recognition tests with novel non-words and nonsense designs were used. Recognition of these stimuli was assumed to be independent of the context of acquisition because the patient could not have an a priori sense of familiarity with them. RESULTS: The patient performed at chance in the experiments probing knowledge of the context of information acquisition, although she recognised the presented words almost as well as the controls. By contrast, her performance was normal in the recognition tests with non-words and nonsense designs. CONCLUSION: These findings indicate that the patient's amnesia was based on an inability to store the context of information acquisition rather than the information itself. Based on an analysis of her lesion, which disconnected the thalamus from the orbitofrontal cortex and the amygdala, and considering the similarities between her disorder, Wernicke-Korsakoff syndrome, and the amnesia after orbitofrontal lesions, it is proposed that contextual amnesia results from interruption of the loop connecting the amygdala, the dorsomedial nucleus, and the orbitofrontal cortex.

Amnesia↗

Toward a multimodal communication theory of psychotherapy: the vicarious coprocessing of experience.

"Talking" therapy is examined as an interpersonal transaction. The personal-experience narrative is used as a vehicle through which the patient and therapist coprocess a mutual experience. Within the narrative transaction, the patient is able to vicariously re-experience and reconfigure the narrated events as he/she believes the therapist is experiencing them. Nonverbal symbolic modes of communication such as music, movement, and art also provide media through which patients and therapists can coprocess a mutual experience. The vicarious coprocessing of experience is a therapeutic factor common to talking therapy, music therapy, art therapy, movement therapy, conventional social interaction, and some healing practices in other cultures.

Adaptation, Psychological↗

Intractable seizures, compulsions, and coprolalia: a pediatric case study.

A 10-year-old girl with intractable complex partial seizures developed aphasia, coprolalia, and repetitive motor behaviors involving touching, sexual touching, and aggressive acts. Her symptoms subsided following surgical resection of a left anterior temporal lobe ganglioglioma and control of seizures. Possible neurobehavioral implications of the reversibility of this patient's symptoms are discussed.

Brain Neoplasms↗

Impact of therapeutic management on use of seclusion and restraint with disruptive adolescent inpatients.

Use of seclusion and restraint on three inpatient adolescent psychiatric units was examined during two five-month periods before and after implementation of a "therapeutic management" protocol. Under the protocol, staff classified disruptive behaviors into four stages and provided verbal and behavioral interventions to control behavior at each stage. Patients who required seclusion and restraint had significant latitude to determine the timing of their release from the interventions and met with staff one hour and 24 hours after their release to explore alternatives to aggression. The number of episodes of seclusion and restraint fell by 64 percent after the protocol was adopted, and the number of patients who required those interventions dropped by 39 percent. The mean duration of episodes of seclusion and restraint was reduced by 59 percent. Therapeutic management provides a corrective experience by addressing the developmental needs, deficient cognitive skills, and poor internalized controls of disruptive adolescents.

Adolescent↗

Developing functional requesting: acquisition, durability, and generalization of effects.

This study investigated the effects of a language program called the missing-item format, on the acquisition of requesting during snack periods. The missing-item format, an assessment and training approach, develops a child's spontaneous requesting skills in everyday tasks. Generalization and response-durability measures were also collected. The missing-item format produced effects in requests for targeted snack items, but not for the majority of generalization and durability measures. A generalization training program was then implemented, using the missing-item format. As a result, a requesting repertoire that was durable and generalized across multiple settings and stimulus conditions was established in both students.

Child↗

How should the effectiveness of Social Stories to modify the behaviour of children on the autistic spectrum be tested? Lessons from the literature.

Social Stories are an extensively used intervention to address behaviour difficulties of children on the autistic spectrum. This article summarizes what Social Stories are and sets out to determine whether there is any relevant literature demonstrating the effectiveness of this intervention. Whilst the existing literature suggests positive findings with respect to the effectiveness of Social Stories, there is considerable variability in the quality of research methodology, with no single study employing comprehensive, stringent standards. This article highlights the factors that should be considered and addressed when testing the effectiveness of Social Stories, as a means of informing future research.

Adolescent↗