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Course of behavioral change in autism: a retrospective study of high-IQ adolescents and adults.

OBJECTIVE: The course of behavioral change in autistic behaviors has received little attention in previous research but is a potentially important parameter for study in autism. METHOD: Autistic behaviors were systematically examined in 38 high-IQ adolescent and adult autistic individuals at their current age (13 through 28 years) and retrospectively at age 5 years using a standardized interview for autism. RESULTS: Significant change over time in autistic behaviors, generally in the direction of improvement, was detected. The proportion of subjects showing improvement in communication and social behaviors was found to be significantly higher than the proportion showing improvement in ritualistic/repetitive behaviors. Five of 38 subjects who met DSM-IV criteria for autistic disorder at age 5 years no longer met criteria at their current age, although all five continued to have substantial impairment. CONCLUSIONS: The study of patterns of behavioral change over time in autism has practical implications for both diagnosis and prognosis as well as potential importance in defining biologically meaningful subgroups and clarifying fundamental mechanisms underlying this disorder.

Adolescent↗

Spouse adjustment to stroke: aphasic versus nonaphasic partners.

A survey of spouses of stroke patients examined the impact of stroke with and without aphasia on spouse role change, emotional problems, social adjustment, and the partner's perceived communication abilities. The results of this study support earlier findings that stroke with aphasia has a greater negative impact on the patient's spouse than does stroke without aphasia. For the spouses of aphasic patients sampled in this study, role changes represented the major adjustment made to a partner's stroke. These adjustments were greater than those experienced by the spouses of nonaphasic patients. The inability of aphasic patients to communicate well with their spouses served to make necessary role adjustments more difficult. Both spouse groups were affected to some degree by the communication problems associated with stroke, with the spouses of aphasic partners being affected the most.

Aphasia↗

Anxiety in cancer patients.

Anxiety is common in cancer patient populations, and must often initially be recognized and managed by cancer care professionals. This article reviews the recent oncology and mental health literature on anxiety. The aim is to help those involved in cancer patient care who are not specialists in mental health to understand the nature of anxiety, and discriminate morbid from normal anxiety. We review recent research into the association of anxiety with events during diagnosis and management of cancer, highlighting the importance of the meaning of events to an individual as an important factor in making people anxious. Lastly we review management strategies which might be used by cancer care professionals, in particular the importance of an awareness of specific patterns of communication which may alleviate or maintain anxiety for some cancer patients.

Anti-Anxiety Agents↗

The auxiliary treatment of psychotic women; group therapy for their husbands.

Group therapy for the husbands of hospitalized psychotic women relieved the anxiety and feeling of guilt of the husbands and led to better communication between husband and wife. It was particularly helpful just before and after the wife came home from the hospital. The group meetings saved various members of the hospital staff considerable time which they otherwise would have had to devote to the husbands individually.

Anxiety↗

Correlates of change in student reported parent involvement in schooling: a new look at the National Education Longitudinal Study of 1988.

Using a subsample (2174 students, 174 schools) from the National Education Longitudinal Study of 1988 (NELS), this study drew on Eccles and Harold's (1996) framework of parent involvement in schooling to estimate the relative influence of key child, family, and school characteristics on change in three types of student-reported parent involvement in schooling between eighth and tenth grades: home communication about school, monitoring, and direct interactions with schools. It also examines relationships between changes in involvement, change in grade point average (GPA), and dropout. Overall, measured school effects accounted for a small proportion of the variation in changes in home communication and direct parent interactions with schools. Sustained home communication related to higher grades and lower likelihood of dropout, although the size of effects was small.

Adolescent↗

Deficiency of tumor necrosis factor alpha in a subclass of menstrual migraineurs.

OBJECTIVE: The objective of this study was to determine whether differences in urinary proinflammatory cytokines, interleukin-1beta (IL-1beta), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-alpha), exist between migraineurs and nonheadache control subjects, and between nonhormonal migraine and menstrual migraine. Any differences noted would expand and clarify a neuroimmune hypothesis of migraine pathogenesis and lead to future diagnostic markers or therapeutic options or both for the disorder. BACKGROUND: Current theories of migraine pathogenesis focus on biochemical abnormalities in the central nervous system resulting in sterile inflammation of meningeal blood vessels. Vasoactive substances involved in this process may include substance P, calcitonin gene-related peptide, neurokinin A, serotonin, and nitric oxide. Immune cell products, such as histamine, leukotrienes, and cytokines, also have vascular inflammatory properties. METHODS: A study of proinflammatory cytokines, IL-1beta, IL-6, and TNF-alpha, was undertaken in menstrual migraineurs. During and outside of menses, 24-hour urine samples of 19 women with migraine were taken during a menstrual migraine, a nonmenstrual migraine, and a headache-free day, and compared with 24-hour urine samples taken of 10 nonheadache controls during and outside of menses. RESULTS: A neuroimmune mechanism for migraine was tested with expected increases in proinflammatory cytokines tested during a migraine. This hypothesis was not validated. Mean IL-6 levels were increased in all three samples of migraineurs versus controls, but did not achieve statistical significance. No differences were found in IL-1beta levels between samples. Interestingly, marked differences were found in TNF-alpha values in menstrual migraineurs. Twelve (63%) of 19 migraineurs had at least one urine sample with undetectable TNF-alpha levels, whereas none of the 20 samples given by the 10 nonheadache controls in this study had undetectable levels. Thirty-two samples from men with cluster headache and nonheadache control subjects in prior studies had detectable levels. CONCLUSIONS: This deficiency of TNF-alpha levels in women with migraine may signal a disordered neuroimmune communication network and predisposition to migraine.

Female↗

Behavior management and communication strategies for dental professionals when caring for patients with dementia.

The impact of dementia and associated behavioral problems on the oral health of long-term-care-facility residents is increasing. The provision of oral hygiene care for these cognitively impaired residents is difficult and complex. Dental professionals and carers need good communication skills with cognitively impaired residents, and specific strategies for the management and prevention of their behavioral problems. Newer philosophies of dementia care enable dental professionals and carers to use more individualized and non-pharmacological approaches for dental treatment and preventive oral care provision. This paper reviews behavior management and communication strategies from the dental literature, and newer techniques and interventions from dementia research and literature.

Behavior Therapy↗

Communication patterns of individuals with moderate or severe cognitive disabilities: interactions with unfamiliar partners.

Interactions between youth with cognitive disabilities and unfamiliar adult partners were observed during a "standard partner" condition to discern the effects of the use of an augmentative and alternative communication system on communication patterns. Thirteen individuals who used the System for Augmenting Language (SAL) were compared to individuals who do not speak and who do not have SAL experience and individuals who speak. In general, the SAL users fell in the middle of the range, communicating better than the symbol-naive nonspeakers, yet not quite as well as the natural speakers with cognitive disabilities. These findings highlight the distinct contributions symbol experience makes to communication interactions with unfamiliar partners.

Activities of Daily Living↗

Effective communication and counseling with older adults.

Age-sensitive communication skills must be developed to achieve greater effectiveness in assisting older adults. These skills should be guided by research findings on the development changes related to normal aging. A listening-responding technique is presented outlining six principles that can be applied in a wide variety of situations. These principles are governed by the intention to preserve self-esteem and to clarify the needs of elderly clients. By using this approach with the older adult, the practitioner will achieve an effective communication process that generates accurate information, supports self-determination, and achieves a therapeutic process.

Adult↗

The effect of war on children.

The objective of this paper is to provide an overview of the effects of war on children during the 20th century. It is argued that wars have both direct and indirect effects on the population. It also is noted that wars have changed from being "conventional" to being of "low intensity". Under these latter circumstances civilians, including children, as well as the infrastructure of the society become targets whereas in the past, the targets were usually only military ones. The effects of the strategy used in "low intensity" conflicts is the disruption of the medical, social, educational, and public services of a country and the terrorization of the population. Under these circumstances children suffer inordinately. Their homes are destroyed, their families disrupted, and their chances of becoming mature productive members of society are compromised.

Adolescent↗

Pauses in the narratives produced by autistic, mentally retarded, and normal children as an index of cognitive demand.

This study investigated the production of different types of speech pauses and repairs in the story narratives produced by autistic, mentally retarded, and normal children, matched on verbal mental age. Ten children in each group were asked to tell the story depicted in a wordless picture book. The narratives were analyzed for frequency of grammatical (between phrase) and nongrammatical (within phrase) pauses, and for several measures of story length and complexity. The main results were that children with autism produced significantly fewer nongrammatical pauses, and that their nongrammatical pausing was correlated with measures of story length and complexity. These findings suggest that the stories told by the autistic children reflect reduced cognitive and communicative demand. The implications of this study for future research on the use of a variety of prosodic characteristics as measures of social cognitive deficit in autism are discussed.

Attention↗

Adaptive behavior of 4- through 8-year-old children with Williams syndrome.

The adaptive behavior of forty-one 4- through 8-year-olds with Williams syndrome was assessed using the Vineland Adaptive Behavior Scales-Interview Edition. Based on the cognitive and personality profiles characteristic of children with this syndrome, we predicted that the domains of Socialization and Communication would be relative strengths, whereas Daily Living Skills and Motor Skills would be relative weaknesses. We also expected that Socialization Skills would be more advanced than Communication skills, and that within the Socialization domain, interpersonal skills would be stronger than play/leisure or coping skills. All predictions were confirmed. Adaptive behavior standard score was not related to CA. The children earned similar overall standard scores on the Vineland and the Differential Ability Scales. Interrelations among adaptive behavior, cognitive abilities, and personality characteristics are discussed.

Activities of Daily Living↗