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Psychological assessment of adolescents and adults with autism.

This paper reports the results of a small follow-up study on 17 autistic adolescents and young adults who are also intellectually retarded. The aim is to examine how far scores on the Psychoeducational Profile (PEP) predicts scores on the Adolescent and Adult Psychoeducational Profile (AAPEP) 5 years later. One subscale eye-hand coordination significantly predicts the scores on three subscales of the AAPEP: Vocational Skills, Independent Functioning, and Vocational Behavior. Imitation predicts Interpersonal Behavior. Fine Motor predicts Leisure Skills and Cognitive Performance predicts Functional Communication. Results are interpreted in terms of the implications for educational intervention programs with autistic adolescents and adults.

Activities of Daily Living↗

Developmental analysis of outerdirectedness in noninstitutionalized EMR children.

Outerdirectedness has been found in nonretarded and institutionalized retarded children to be related inversely to cognitive level and directly to history of failure experiences. The developmental nature of outerdirectedness was investigated among noninstitutionalized EMR children using two independent measures of outerdirectedness. Forty subjects, comprising two MA levels, were given a block-design task that was equally difficult for both MA groups. Glancing from the task was found to be related inversely to MA. On a task in which subjects were scored for the amount of imitation of the experimenter's behavior, imitation was also found to be related inversely to MA. However, imitation and glancing were not correlated, suggesting that they may tap different aspects of outerdirectedness.

Adolescent↗

Children with autism display more social behaviors after repeated imitation sessions.

Based on earlier studies, an adult's imitations of the behaviors of children with autism lead to increased social behavior in the children. The present study explored the effects of repeated sessions of imitation. Twenty children were recruited from a school for children with autism to attend three sessions during which an adult either imitated all of the children's behaviors or simply played with the child. During the second session the children in the imitation group spent a greater proportion of time showing distal social behaviors toward the adult including: (1) looking; (2) vocalizing; (3) smiling; and (4) engaging in reciprocal play. During the third session, the children in the imitation group spent a greater proportion of time showing proximal social behaviors toward the adult including: (1) being close to the adult; (2) sitting next to the adult; and (3) touching the adult. These data suggest the potential usefulness of adult imitative behavior as an early intervention.

Attention↗

[Movement and behavioral disorders in anterior cerebral artery territory infarction].

Anterior cerebral artery territory infarction, which affects the medial frontal lobe and anterior part of the corpus callosum, may cause disinhibitory movement and behavioral disorders. The pathophysiology of disinhibitory movement and behavioral disorders was discussed in relation to the role of the frontal lobe in motor control and hemispheric asymmetry of motor functions. Instinctive grasp reaction is the prototype of disjunctive motor disinhibition syndromes, and diagnostic dyspraxia and compulsive manipulation of tools are the most illustrative forms. Diagnostic dyspraxia can be defined as uncontrolled cross-purposeful actions of the left hand triggered by voluntary activities of the left hand. In compulsive manipulation of tools, a patient, with the right hand, grasp and use tolls placed in front of them against the patient's will. The left hand often restrains the unintentional movement of the right hand in accordance with the patient's will. Utilization and imitation behaviors described by Lhermitte et al belong to disinhibitory behavioral disorders, in which volition of the patient or an individual as a whole is involved. External stimuli reflexively provoke the patient's will to act. The behaviors accordant with the will, even if inappropriate, are not compulsive, but the easily-raised volition in response to the stimuli is pathological. These disinhibitory disorders differ from disjunctive motor disinhibition syndromes because of lack of inconsistency between will and manifested behavior. Lesions in the frontal lobes has been suggested to be responsible for utilization and imitation behaviors.

Cerebral Infarction↗

Imitation in EMR boys: model competency and age.

The effects of model age and competence on the imitation behavior of 80 EMR boys were investigated. Subjects viewed a videotape in which either an adult or a peer performed a motor task with either high or low competence. In addition, the models engaged in four different kinds of off-task social behavior. The results indicated that the boys imitated the off-task social behavior emitted by high-competent and peer models more than low-competent and adult models. In addition, high-competent models were imitated more than were low-competent models on the motor-skill task, but no significant age effect was found. The efficacy of modeling as an instructional strategy was discussed, and we concluded that EMR boys should be exposed to competent models, especially peers, who emit a repertoire of adaptive behavior.

Age Factors↗

The development of imitation by reinforcing behavioral similarity to a model.

This research demonstrated some of the conditions under which retarded children can be taught to imitate the actions of adults. Before the experiment, the subjects were without spontaneous imitative behavior, either vocal or motor. Each subject was taught, with food as reinforcement, a series of responses identical to responses demonstrated by an experimenter; i.e., each response was reinforced only if it was identical to a prior demonstration by an experimenter. Initially, intensive shaping was required to establish matching responses by the subjects. In the course of acquiring a variety of such responses, the subjects' probability of immediate imitation of each new demonstration, before direct training, greatly increased. Later in the study, certain new imitations, even though perfect, were never reinforced; yet as long as some imitative responses were reinforced, all remained at high strength. This imitativeness was then used to establish initial verbal repertoires in two subjects.

Child↗

Utilization behavior: clinical manifestations and neurological mechanisms.

This paper describes a variety of motor release phenomena, including manual grasping and groping, imitation behavior, utilization behavior, and alien hand sign, their clinical manifestations. and proposed neural mechanisms. One of these specific neurobehavioral disorders, initially described by Lhermitte (Brain [1983] 106: 237-255), and termed utilization behavior, is addressed in more detail. Patients with this disorder are described as reaching out and using objects in the environment in an automatic manner. The current paper provides a comprehensive review of studies that have documented utilization behavior in individuals with a variety of pathologies, all having a specific predilection for the frontal lobes and frontal-striatal systems. Goldberg's (Behavioral and Brain Sciences [1985] 8: 567-616) theoretical framework for understanding motor release phenomena, which conceptualizes these behaviors as resulting from an imbalance between proposed medial (voluntary, goal directed, and future directed) and lateral (automatic, stimulus bound, and visually based) motor systems, is also discussed. Utilization behavior may prove to be a common underlying cause of high levels of excessive and intrusive motor behaviors within various clinical populations. A more comprehensive understanding of the neural systems underlying utilization behavior may prove highly useful for the differential diagnosis of conditions involving the mesial frontal cortex and fronto-striatal connections. Recent studies have started to investigate utilization behavior in clinical populations with known or suspected frontal system dysfunction, including adult patients with a variety of psychiatric conditions and children with ADHD.

Brain Diseases↗

[Suicide in adolescence].

With 1500 death each year, suicide does represent the second cause of death in young people (between 15 and 25 years). There is a clear increase of suicide rate during adolescence, with an higher rate of suicide attempts in females, but an higher mortality in boys. Suicidal behaviors in adolescents are clinically characterized by impulsivity, rhythmicity (during schooling) and seasonality. Risks factors are numerous. However, psychiatric disorders represent the main one, especially depressive states, conduct disorders and their association. In adolescents familial and environment events may have an important role in suicidal behaviors, especially the role of imitation behavior. These different factors interact and constitute dynamic models. The role of each factor can be involved differently considering the sex. Dangerosity of suicide in adolescents should not be under-estimated, as it has been the case in the past. It is particularly true if we consider the high rate of recidive (approximatively 50%) in this population. These data emphasized the importance of a careful evaluation of all suicidal adolescents more precisely of depressive symptoms and aggressive and/or delinquent behavior and of prevention.

Adolescent↗

[Imitation and utilization behavior in major depressive states].

Imitation and utilization behaviour (IB ; UB) have been described in lesions or deafferentations of the frontal lobes. Both reflect a loss of the patients' autonomy. IB and UB having been encountered in a case of melancholia, a systematic study has been undertaken in psychiatric departments. Sixty patients have been examined among whom 18 had a major depressive episode and 19 a dysthymic episode. IB or UB or both were present in every case of the first group, in 3 cases of the second one. Such data show first an unexpected focal specific neurological sign in a psychiatric disease. Second, they suggest a relationship with the frontal hypoactivity shown by PET studies in major depressive episodes. Such frontal hypoactivity should not be viewed as the cause of major depression but as a concomitant disorder. Its role in the awareness and expression of the thymic disturbance is discussed.

Behavior↗

Imitation in the family: a study of older parents and their adult sons.

Older parents and their adult sons (fifteen father-mother-son triads) participated in this study which investigated whether imitative behavior is prominent in these families and whether interpersonal perceptions are related to the degree of imitation. Both perceptual and moral imitation tasks were used and personality descriptions were obtained on dimensions of activity, potency, and evaluation. Adult sons were found to imitate their parents on both tasks and particularly their fathers on moral issues. Older parents also were found to imitate their sons in a possible "reversal" of the direction of identification. Differential patterns of interpersonal perceptions were related to imitation for the three groups. Potential theoretical explanations are discussed.

Adult↗

Impaired mirror-image imitation in Asperger and high-functioning autistic subjects.

Imitation is crucial for proper development of social and communicative skills. Here, we argue that, based on an error analysis of a behavioral imitation task, adult Asperger and high-functioning autistic subjects suffer from an intriguing deficit of imitation: they lack the natural preference for imitation in a mirror-image fashion. The imitation task consisted of a simple movement sequence of putting a pen with the left or right hand into a green or a blue cup using one of two possible grips. The subjects were asked to imitate the experimenter's hand movements either using the crossed hand (e.g., the subject's right hand corresponding to the experimenter's right hand) for imitation or to imitate as if looking in a mirror (e.g., the subject's left hand corresponding to the experimenter's right hand). When people normally view other persons face-to-face, they prefer to imitate as in a mirror, and observation of mirror-image-like movements speeds up performance in nonimitative tasks. However, our autistic subjects, defective in social cognition, did not profit from mirror-image movements of others. These results provide a new insight into the difficulties that autistic subjects face in viewing and understanding actions of others.

Adult↗

Imitation of a two-action sequence by pigeons.

Developmental psychologists have described imitation as a process that suggests perspective-taking abilities. However, imitative behavior has been found in animals, which are generally not considered capable of taking the perspective of another. Previous studies with birds have demonstrated the imitation of a single response (sometimes referred to as action-level imitation). In the present experiment, we examined the extent to which pigeons would imitate an unfamiliar sequence of two behaviors (sometimes referred to as program-level imitation). Our results indicate that, although there are individual differences, pigeons show a significant tendency to match a demonstrated sequence of behavior involving, first, a response to a treadle (pecking at it or stepping on it) and, second, pushing aside a screen that blocks access to food (a left-vs.-right push).

Animals↗

Comparison of nonretarded and mentally retarded children on tasks involving direct and rule-governed imitation.

The influence of intellectual level and social reinforcement on imitation learning was examined. Tasks involving direct and rule-governed imitation of a mode were presented to 20 mentally retarded and 20 nonretarded children. The children within each group were randomly assigned to either an affective ("good-fine") or an informative ("correct-right") social reinforcement condition. Reinforcement, administered on a fixed ration (FR4) schedule, was contingent on the child's imitative behavior. A multivariate analysis of variance showed that both the Population X Reinforcement Type interaction and the Reinforcement main effect were significant. Univariate follow-up tests showed that only rule-governed imitation contributed significantly to the multivariate effects. Analysis of simple effects indicated that retarded children performed optimally under affective reinforcement, while the nonretarded children performed highest under informative reinforcement.

Adolescent↗

Fictional depiction of suicide in television films and imitation effects.

Studies of imitative suicide by viewers of fictional depictions of suicide in television films have produced contradictory findings. Using a nationwide sample of cases of suicide, the author found no evidence for increased numbers of suicides after broadcast of three films. However, some support was found for an imitation effect specific to the depiction of a suicide method in one of these films (p less than 0.05). To the extent that fictional presentations of suicide may serve as stimuli for imitative behavior, the effect appears to depend on a complex interaction among characteristics of the stimulus, the observer of that stimulus, and conditions of time and geography.

Adolescent↗

Newborn infants imitate adult facial gestures.

Newborn infants ranging in age from 0.7 to 71 hours old were tested for their ability to imitate 2 adult facial gestures: mouth opening and tongue protrusion. Each subject acted as his or her own control in a repeated-measures design counterbalanced for order of stimulus presentation. The subjects were tested in low illumination using infrared-sensitive video equipment. The videotaped records were scored by an observer who was uninformed about the gesture shown to the infants. Both frequency and duration of neonatal mouth openings and tongue protrusions were tallied. The results showed that newborn infants can imitate both adult displays. 3 possible mechanisms underlying this early imitative behavior are suggested: instrumental or associative learning, innate releasing mechanisms, and active intermodal matching. It is argued that the data favor the third account.

Facial Expression↗

The temporal relationship between reduction of early imitative responses and the development of attention mechanisms.

BACKGROUND: To determine whether early imitative responses fade out following the maturation of attentional mechanisms, the relationship between primitive imitation behaviors and the development of attention was examined in 4-month-old infants. They were divided into high and low imitators, based on an index of imitation. The status of attention was assessed by studying inhibition of return (IOR). Nine-month-old infants were also tested to confirm the hypothesis. RESULTS: The IOR latency data replicate previous results that infants get faster to produce a covert shift of attention with increasing age. However, those 4-month-olds who showed less imitation had more rapid saccades to the cue before target presentation. CONCLUSION: The cortical control of saccade planning appears to be related to an apparent drop in early imitation. We interpret the results as suggesting a relationship between the status of imitation and the neural development of attention-related eye movement.

Age Factors↗

An alternative view of pronominal errors in autistic children.

Persistent pronominal errors in autistic children have been attributed either to a psychosocial deficit or to a linguistic or cognitive deficit. However, recent studies of normal children suggest that the failure to observe pronouns in speech addressed to another person is a major reason children show pronominal errors. The present study investigated if pronominal errors in autistic children can be explained by this alternative hypothesis. Children's attentiveness to the pronoun models and their imitative behaviors were examined under two modeling conditions. The nonaddressee condition provided children with systematic opportunities to observe pronoun models directed to another person as well as those directed to themselves. The addressee condition provided only systematic opportunities to observe pronoun models directed to children. Clear evidence for the alternative hypothesis was obtained for second person pronouns, suggesting that pronominal errors in autistic children can be interpreted within the framework of normal language development.

Autistic Disorder↗

[A young adult female case of Wilson's disease presenting with mental disorder and frontal lobe signs].

We report a young adult female case of Wilson's disease presenting with mental disorder and frontal lobe signs. The patient was admitted to our neurological unit on October 4, 1999 because of schizophrenia-like symptom, dysphagia, dysarthria and gait disturbance. She showed slowly progressive rigidity and dystonia. Her parents were the second cousins. Neurological examination revealed bilateral pyramidal and extrapyramidal signs, frontal lobe signs (include the imitation behavior). Tendon reflexes were slightly exaggerated in all extremities. Bilateral Babinski, Chaddock and Hoffmann signs were positive. Her verbal IQ on the Wechsler Adult Intelligence Scale-revised was 49. Biochemical examination revealed low plasma copper and ceruloplasmin concentration. Cerebrospinal fluid was normal. Cranial MRI demonstrated diffuse brain atrophy and enlargement of the lateral ventricles. T2-weighted images of the MRI demonstrated hyperintense signal in both thalamus and basal ganglia. SPECT showed hypoperfusion in the left frontal lobe, both thalamus and basal ganglia. EEG revealed diffuse theta wave. The diagnosis of Wilson's disease was made and the treatment of D-penicillamine 900 mg per day was started. This hypoperfusion of SPECT and EEG findings improved after 2 months under D-penicillamine therapy. Neurological findings showed slight improvement. A few Wilson's disease patients presenting with mental disorder have been reported. Wilson's disease should always be considered in differential diagnosis of mental disorders. We emphasize the importance of early diagnosis and treatment of Wilson's disease.

Adolescent↗