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'Natural Conduit' between two atria associated with atrial septal defect.

Herein, we present a case of 46 years old woman with an extracardiac venous connection between two atria associated with secundum type atrial septal defect (ASD). This interatrial tunnel was not recognized by both transthoracic and transesophageal echocardiographic examinations. Computed tomography suspected a blood flow from right inferior pulmonary vein to inferior caval vein. Consequently, the patient underwent cardiac catheterization. Angiography revealed a tunnel between left and right atrium. To our knowledge, this is the first report of a case with venous tunnel between two atria associated with secundum type ASD in the literature.

Cardiac Catheterization↗

Perception and production of prosody by speakers with autism spectrum disorders.

Speakers with autism spectrum disorders (ASD) show difficulties in suprasegmental aspects of speech production, or prosody, those aspects of speech that accompany words and sentences and create what is commonly called "tone of voice." However, little is known about the perception of prosody, or about the specific aspects of prosodic production that result in the perception of "oddness." The present study examined the perception and production of a range of specific prosodic elements in an experimental protocol involving natural speech among speakers with ASD between 14 and 21 years of age, in comparison with a typical control group. Results revealed ceiling effects limiting interpretation of findings for some aspects of prosody. However, there were significant between-group differences in aspects of stress perception and production. The implications of these findings for understanding prosodic deficits is speakers with autism spectrum disorders, and for future research in this area, are discussed.

Adolescent↗

Factor analysis of the Nisonger Child Behavior Rating Form in children with autism spectrum disorders.

The Nisonger Child Behavior Rating Form (NCBRF) is a behavior rating scale designed for children and adolescents with mental retardation. The purpose of this study was to explore the psychometric properties of the NCBRF in a sample of 330 children and adolescents with autism spectrum disorders (ASDs). Parent and teacher ratings were independently submitted to both exploratory and confirmatory factor analysis. As reported with the original validation study, parent and teacher versions shared similar but somewhat different factor structures. Social competence items showed more similarity with the original solutions than did problem behavior items. Problem behavior items were distributed into a somewhat simpler five-factor solution for both rating forms. Self-injurious and stereotypic items loaded on two distinct subscales for the teacher form, but not on the parent form. Factor loadings and internal consistencies were generally lower than those reported for the original versions but still within the acceptable range. Confirmatory factor analyses indicated good fits for the social competence items and acceptable fits for the problem behavior items. Overall, results supported the construct validity of the NCBRF in children and adolescents with ASDs.

Adolescent↗

Brief report: assessment of sensory abnormalities in people with autistic spectrum disorders.

Sensory functioning has long been considered crucial in the life of people with autistic spectrum disorders (ASD) (Gillberg, C., & Coleman, M. (1992). The Biology of Autistic Syndromes (2nd ed.). London: Mac Keith press.) However, much of the research is methodologically flawed and based on child populations and adults' retrospective accounts (O'Neill, M.C 1995). Sensory-perceptual abnormalities in autism. Psychological Perspectives in Autism-Conference Proceedings 1995 (pp. 55-61). Autism Research Unit, University of Sundarland). Such sensory dysfunction may contribute to poor person/environment fit and subsequent challenging behaviour. This paper presents an assessment tool developed to explore the sensory functioning of adults with ASD.

Adult↗

The weak coherence account: detail-focused cognitive style in autism spectrum disorders.

"Weak central coherence" refers to the detail-focused processing style proposed to characterise autism spectrum disorders (ASD). The original suggestion of a core deficit in central processing resulting in failure to extract global form/meaning, has been challenged in three ways. First, it may represent an outcome of superiority in local processing. Second, it may be a processing bias, rather than deficit. Third, weak coherence may occur alongside, rather than explain, deficits in social cognition. A review of over 50 empirical studies of coherence suggests robust findings of local bias in ASD, with mixed findings regarding weak global processing. Local bias appears not to be a mere side-effect of executive dysfunction, and may be independent of theory of mind deficits. Possible computational and neural models are discussed.

Autistic Disorder↗

Familial autoimmune thyroid disease as a risk factor for regression in children with Autism Spectrum Disorder: a CPEA Study.

A multicenter study of 308 children with Autism Spectrum Disorder (ASD) was conducted through the Collaborative Programs of Excellence in Autism (CPEA), sponsored by the National Institute of Child Health and Human Development, to compare the family history of autoimmune disorders in children with ASD with and without a history of regression. A history of regression was determined from the results of the Autism Diagnostic Interview-Revised (ADI-R). Family history of autoimmune disorders was obtained by telephone interview. Regression was significantly associated with a family history of autoimmune disorders (adjusted OR=1.89; 95% CI: 1.17, 3.10). The only specific autoimmune disorder found to be associated with regression was autoimmune thyroid disease (adjusted OR=2.09; 95% CI: 1.28, 3.41).

Autistic Disorder↗

Variation in early developmental course in autism and its relation with behavioral outcome at 3-4 years of age.

The aims of the present study were to describe variations in the early course of development in autism by utilizing an in-depth parent interview that incorporated techniques to improve accuracy of parent recall, and to examine the relation between variations in early developmental course in autism and behavioral outcome at 3-4 years of age. The Early Development Interview, which consisted of questions about child's behavior in several domains from birth through 2 years of age, was created and administered to parents of 72 3-4-year-old children with autism spectrum disorder and 34 3-4-year-old children with developmental delay, who were matched on mental and chronological age, and 39 1-4-year-old typically developing children, who were matched to the clinical groups on mental age. At 3-4 years of age, children were administered standardized measures (some clinician administered and some parent report); these included verbal and nonverbal IQ, autism symptom severity, and adaptive and aberrant behavior. Based on the Early Development Interview, children with autism spectrum disorder (ASD) were reported to have elevated symptoms in the social and regulatory domains by 3-6 months. By 12-15 months, parents of children with ASD reported significantly higher levels of social symptoms than parents of children with developmental delay. At 3-4 years of age, children with autism with early vs. late onset of symptoms, and with vs. without a history of loss of skills (regression) were not found to differ on standardized tests of verbal and nonverbal IQ and observational measures of autism symptom severity.

Age Factors↗

Physical activity patterns in youth with autism spectrum disorders.

The purpose of this study was to examine age-related physical activity patterns in youth with autism spectrum disorders (ASD). Thirty youth, aged 10-19 years, were divided into three groups: elementary (n=9), middle (n=9) and high (n=12) school. Participants wore an accelerometer and completed an activity questionnaire for seven consecutive days. The main findings were that (a) elementary youth are more active than the other groups, regardless type of day or time period, and (b) there are no consistent patterns in physical activity of youth with ASD according to day or time period. Findings emphasize that interventions for this population should address increasing extracurricular physical activity options during adolescence.

Adolescent↗

Focused stimulation for a child with autism spectrum disorder: a treatment study.

This study explored the use of focused stimulation as an intervention technique for a three-year-old boy diagnosed with autism spectrum disorder (ASD). His parents were trained to use focused stimulation to facilitate comprehension of what is x doing question forms. Responses to question probes were collected at both pre- and post-treatment intervals. At the beginning of the study, the child did not respond correctly to any of the target questions. Following intervention, the child made significant gains towards the target goal, but little change towards a control goal used for comparison. These findings provide preliminary support for the usefulness of focused stimulation as an intervention strategy for at least some children with ASD.

Attention↗

Early predictors of communication development in young children with autism spectrum disorder: joint attention, imitation, and toy play.

This study investigated the unique contributions of joint attention, imitation, and toy play to language ability and rate of development of communication skills in young children with autism spectrum disorder (ASD). Sixty preschool-aged children with ASD were assessed using measures of joint attention, imitation, toy play, language, and communication ability. Two skills, initiating protodeclarative joint attention and immediate imitation, were most strongly associated with language ability at age 3-4 years, whereas toy play and deferred imitation were the best predictors of rate of communication development from age 4 to 6.5 years. The implications of these results for understanding the nature and course of language development in autism and for the development of targeted early interventions are discussed.

Attention↗

Developmental correlates of different types of motor imitation in young children with autism spectrum disorders.

This study used a concurrent correlational design to examine associations between three types of motor imitation with objects and three proposed correlates in 32 two- and three-year-old children diagnosed with ASD. Attention-following and fine motor ability were significant, unique correlates of imitation in an observational learning context. Attention-following was a significant correlate of imitation in a direct elicitation context. Social reciprocity was a significant correlate of imitation in an interactive play context. These associations were observed after controlling for general developmental level. Results support previous findings that motor imitation may not reflect a unitary construct for children with ASD and that different skills may underlie the performance of different types of motor imitation. Implications for interventions targeting motor imitation are discussed.

Attention↗

Temporal coordination of joint attention behavior in preschoolers with autism spectrum disorder.

The current study investigated initiating and following declarative joint attention, and initiating requesting joint attention in a group of preschool children with autism spectrum disorder (ASD) and an age-matched control group. Different forms of joint attention were elicited while children interacted with their mothers. Temporal coordination of the children's joint attention behavior was examined using three levels of coding. Children with ASD showed less but similar requesting abilities and slower point following combined with an abnormal behavioral pattern of looking at the other person's pointing finger instead of the object pointed at. Initiating declarative behavior was qualitatively and quantitatively different, characterized by isolated instances of communication instead of a fluent shift of attention between object and person.

Attention↗

Autism spectrum phenotype in males and females with fragile X full mutation and premutation.

The behavioural phenotype of autism was assessed in individuals with full mutation and premutation fragile X syndrome (FXS) using the Autism Diagnostic Observation Scale-Generic (ADOS-G) and the Autism Diagnostic Interview (ADI-R). The participants, aged 5-80 years, comprised 33 males and 31 females with full mutation, 7 males and 43 females with premutation, and 38 non-fragile X relatives (29 males, 9 females). In the full mutation group, a total of 67% males and 23% females met either the Autism Disorder (AD) or the Autism Spectrum Disorder (ASD) criteria on at least one of the diagnostic tests. In the premutation group, 14% males and 5% females met the ADOS-G criteria for ASD. The presence of autism manifestations in males and females with full mutation and premutation provide support for a spectrum view.

Activities of Daily Living↗

Brief report: designing a playground for children with autistic spectrum disorders--effects on playful peer interactions.

This study investigated possible changes in social play and initiations in eight boys (5 to 7-years-old) with autistic spectrum disorders (ASD) who were moving from an old to a new school playground that was designed specifically to enhance playful peer interaction. Each boy was observed for half an hour over three occasions in the old, then the new setting. The playgrounds differed in design, spatial density and identity of potential play partners. As hypothesised, frequency of group play and overall social initiations increased significantly in the new setting. We discuss how playgrounds with appropriate levels of physical challenge and support for both structured, imaginative play and solitary observation may support peer interactions in children with ASD.

Autistic Disorder↗

Brief report: group social-multimodal intervention for HFASD.

Current study is the second part of a 2-year cognitive-behavioral-ecological (CB-E) intervention for high-functioning (HF) children with autism spectrum disorder (ASD). We examined the utility of a group-centered intervention on children's ability to interact cooperatively with peers during structured and non-structured social situations. Direct (e.g., social problem solving) and indirect (theory of mind; executive function) treatment effects on social cognitive capabilities were also examined. Participants were 26 preadolescent HF children with ASD. Study results demonstrated direct and indirect treatment effects on social cognition and mixed results regarding children's social interaction capabilities. Although children's cooperative capabilities within the intervention group improved, dyadic, and group social interactions during school recess did not. Discussion focused on the utility of such group-intervention in increasing social functioning.

Asperger Syndrome↗

Repetitive behaviour and play in typically developing children and children with autism spectrum disorders.

The view of a triad of impairments [(Wing and Gould (1979). Journal of Autism and Developmental Disorders, 9, 11-30] in which impaired imagination is linked with repetitive behaviour is widely accepted. However this categorisation differs from the international classification systems, which link imagination to communication impairments rather than to repetitive behaviours. To investigate this relationship, the Activities and Play Questionnaire-Revised was completed by 196 parents of 2-8-year-old children with autism spectrum disorders (ASD) and typical development. Results showed that repetitive behaviours were associated with play in ASD but not in typical development, supporting Wing and Gould's triad. However there was also an association between play, repetitive behaviour and language, confirming the international classification systems description of imagination as a component of language and communication difficulties.

Autistic Disorder↗

Varying language register according to listener needs in speakers with autism spectrum disorder.

The ability to adjust language register, or style, according to listener needs was assessed in 38 high-functioning children and adolescents with ASD. Participants were asked to explain the process of going to a restaurant to a series of listeners who varied in linguistic competence. Results showed that participants with ASD spontaneously simplified their language based on a listener's appearance and a brief introduction, but were not as adept at that adjustment as matched controls. Further stylistic adjustments were produced following increasingly specific prompts.

Age Factors↗

Effects of circumscribed interests on the social behaviors of children with autism spectrum disorders.

This study compared the effects of circumscribed interests (CI) to less preferred (LP) tangible stimuli on the social behaviors of three children with autism spectrum disorders (ASD). Based on single subject design methodology, the CI experimental sessions resulted in longer durations of target-child initiated social interactions in comparison to LP sessions. In addition, latency of participant's initial social bids to peers was decreased when CI were present. The results suggest that embedding CI into dyadic play situations with typical peers can be used to increase the social behavior children with ASD direct toward typical peers. Future research should examine the specific environmental conditions that must be present in naturalistic settings to facilitate generalization of social behavior.

Attention↗