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The long-term effects of auditory training on children with autism.

Eighty children, 3-17 years of age, with autism or Asperger syndrome and mild to severe distress in the presence of some sounds, were randomly allocated to two groups. The experimental group received auditory training and the control group listened to the same unmodified music under the same conditions. Significant improvements in behavior and severity of autism were maintained for 12 months by both groups. Informal data suggested that a range of abnormal responses to sound and other sensory abnormalities may also have improved. Verbal and performance IQ increased significantly 3 to 12 months after interventions. Findings suggest that some aspect of both auditory training and listening to selected unmodified music may have a beneficial effect on children with autism and sound sensitivity, and indicate a need for further research into the effects that led to these changes and the mechanisms involved in the sensory abnormalities commonly associated with autism.

Acoustic Stimulation↗

The use of the ADI-R as a diagnostic tool in the differential diagnosis of children with infantile autism and children with a receptive language disorder.

Children with infantile autism and children with a specific receptive language disorder often show similar behavioural problems, making the differentiation between these two diagnostic categories difficult. The purpose of this study is to evaluate the usefulness of parental information in the differential diagnosis of the two types of disorders mentioned above. Sixteen children with a receptive language disorder and 11 children with infantile autism participated in the study. All children had normal non-verbal IQs. The ADI-R (Autism Diagnostic Interview-Revised) was performed with all children. The results showed that the ADI-R items reflecting behavioural features at pre-school age (age range 4-5 years) were better suited to differentiate the groups than the items reflecting behavioural features at the time of the investigation (mean age: 9 years). The items on the dimension "Reciprocal social interaction" and "Communication and language" discriminated the groups better than the items of the dimension "Restricted interests". According to the ICD-10 algorithm of the ADI-R one child with autism and one child with a receptive language disorder were falsely classified. These false classifications were mainly due to a distorted parental perception of the child's behaviour. The ADI-R is a useful tool in the differential diagnosis of developmental disorders.

Algorithms↗

The fears, phobias and anxieties of children with autism spectrum disorders and Down syndrome: comparisons with developmentally and chronologically age matched children.

This study compared the fears and behavior problems of 25 children with an autism spectrum disorder (ASD), 43 children with Down syndrome (DS), 45 mental age (MA) matched children, and 37 chronologically age (CA) matched children. Children's fears, phobias, anxieties and behavioral problems were assessed using parent reports. Significant differences emerged across the diagnostic groups on a variety of fears. Children with ASD were reported to have more situation phobias and medical fears, but fewer fears of harm/injury compared to all other groups. The groups also differed in terms of the pattern of correlations between fears, phobias, anxieties and behavior problems. For children with ASD, fears, phobias and anxieties were closely related to problem behaviors, whereas fears, phobias, and anxieties were less related to behavioral symptoms for the other groups of subjects. Such findings suggest that children with ASD exhibit a distinct profile of fear and anxiety compared to other mental age and chronologically age-matched children, and these fears are related to the symptoms associated with ASD.

Anxiety Disorders↗

Emotional understanding, cooperation, and social behavior in high-functioning children with autism.

In contrast to typically developing children, children with autism rarely exhibit cooperative social behavior. To examine whether this problem reflects global developmental delays or autism-specific deficits, the present study compared cooperation, emotional understanding, personality characteristics, and social behavior of 10 children with autism who had average IQ to those of 16 children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) and 10 typically developing children. In cooperative behavior, level of emotional understanding, and aloof behavior, the autism group outperformed the ADHD/ODD group and did not differ significantly from typically developing children. However, the autism group showed worse emotion recognition and more active-but-odd behavior than the other groups. The results indicate that high-functioning children with autism can develop cooperative social behavior and advanced theory of mind abilities, but continue to show deficits in identifying emotions and displaying socially appropriate behavior.

Affect↗

Individuals with autism spectrum disorder show normal responses to a fear potential startle paradigm.

The present study utilized a fear potentiated startle paradigm to examine amygdala function in individuals with autism spectrum disorder. Two competing hypotheses regarding amygdala dysfunction in autism have been proposed: (1) The amygdala is under-responsive, in which case it would be predicted that, in a fear potentiated startle experiment, individuals with autism would exhibit decreased fear conditioning and/or potentiation, and (2) The amygdala is over responsive, in which case an exaggerated potentiation of the startle response would be predicted. Fourteen adolescents and adults diagnosed with autism spectrum disorder and 14 age, gender, IQ, and anxiety level-matched typical adolescents and adults participated. Both participants with autism and typical participants potentiated the startle response following fear conditioning and no group differences in the latency or amplitude of the potentiated startle response were found. These results suggest that this aspect of amygdala function, namely fear conditioning and potentiation of the startle response, is intact in individuals with autism.

Adolescent↗

Functional characteristics of disruptive behavior in developmentally disabled children with and without autism.

Expanding on Reese et al. [2003], functional behavioral assessment interviews [O'Neill et al., 1997] concerning disruptive behavior were conducted with parents of 23 children with autism (6 females, 17 males, chronological ages [CA] 24-60 months) and 23 controls without autism pair-matched for CA, developmental age and sex. All children exhibited frequent disruptive behavior. The interviews suggested that matched control children's disruptive behavior typically functioned to gain attention or items, or to escape demands in general. This was also true for girls with autism. For boys with autism, disruptive behavior more often functioned to (a) escape demands that interfere with repetitive behavior, (b) retain access to an item used in repetitive routines, or (c) avoid idiosyncratically aversive sensory stimuli (e.g., ordinary household noises). These results emphasize the importance of considering behavioral characteristics that are associated with sex and specific disorders or syndromes when conducting functional behavioral assessments.

Attention Deficit and Disruptive Behavior Disorder↗

Maternal recurrent mood disorders and high-functioning autism.

A quantitative examination was made of the association of parental mood and anxiety disorders with severity of disability within a large sample of young children with Pervasive Developmental Disorder (PDD). Maternal recurrent mood disorders were associated with elevated cognitive and adaptive functioning in their affected children, parent reports of increased behavior problems and teacher reports of an internalizing behavioral style. Maternal histories of anxiety disorders and paternal depression or anxiety disorders were not associated with levels of adaptive/cognitive functioning or levels of maladaptive behaviors in the children. Various genetic models are discussed. It is hypothesized that genes associated with recurrent depression in women may exert a "protective" effect on cognition and adaptive functioning in children with PDD.

Adaptation, Psychological↗

Brainstem auditory evoked potentials in receptive developmental language disorder.

It has been hypothesized that receptive developmental language disorder (RDLD) may be explained by an auditory processing deficit. The neuroanatomical locus of this deficit is unknown. Brainstem auditory evoked potentials (BAEPs) reflect the functioning of the auditory nerve and auditory brainstem pathways to high-frequency acoustical stimulation in humans and reflect the first stages of auditory processing. These were studied in 12 subjects with RDLD (four females and eight males, ages 12 to 19) and twelve control subjects (three females and nine males, ages 14 to 24). Click intensity and rate of stimulation were varied. The BAEPs for the RDLD group were comparable to the control group as well as to hospital norms across intensity levels and stimulation rates. The evidence obtained suggests that a disorder in the neurophysiological systems underlying the BAEPs and reflecting initial stages of auditory processing is not essential for RDLD.

Adolescent↗

Response monitoring, the error-related negativity, and differences in social behavior in autism.

Children with autism not only display social impairments but also significant individual differences in social development. Understanding the source of these differences, as well as the nature of social impairments, is important for improved diagnosis and treatments for these children. Current theory and research suggests that individual differences in response monitoring, a specific function of the anterior cingulate cortex (ACC), may contribute to social-emotional and social-cognitive impairments and individual differences in autism. To examine this hypothesis, we used a modified flanker task to assess an ERP index of response monitoring, the error-related negativity (ERN), in a sample of higher function children with autism (HFA) and an IQ-matched control sample. The results revealed a significant Diagnostic group by Verbal IQ interaction on ERN amplitude indicating that the most verbally capable HFA children displayed significantly larger ERN amplitudes than did the control children. Within the HFA sample, greater ERN amplitude was also related to parent reports of fewer symptoms of social interaction impairments, fewer internalizing problems, but more externalizing problems, although these associations were reduced to nonsignificance when medication status was controlled. The latter results complement previous observations from imaging studies of a significant association between ACC activity and social symptoms and impairments in autism. The implications of these results for future research on brain-behavior relations, as well as treatment related research with children with autism are discussed.

Affect↗

Central nervous changes in social dysfunction: autism, aggression, and psychopathy.

Neurodevelopmental disorders such as autism and schizophrenia involve social interaction problems and poor mentalizing abilities, associated with abnormal regional cerebral activity. Similar problems may be present in aggressive personality disorders and psychopathy. This paper reviews brain imaging data from research aiming at establishing possible central nervous correlates to aggression and psychopathy. Studies in this field are associated with a range of method problems. Differences between criminal offenders and controls may be confounded by a number of factors unrelated to personality traits or aggression per se. Phenotypical characterisation varies between studies as do the laboratory methods and their interpretation. In spite of these problems, there are some recurrent findings in the present literature. Hypoactivity or structural reduction of the prefrontal cortex is a consistent finding in violent offenders or subjects with antisocial personality disorder. When defined as a personality disorder of social interaction and empathy, psychopathy seems to be associated rather with central abnormalities in the limbic circuitry. Indications of an increased dopaminergic neurotransmission relative to the serotonergic have also been connected to such personality traits, especially to the AD/HD-related behavioural aspects. Further studies using strict phenotypical definitions or experimental models are clearly warranted to establish a pathophysiological background to destructive personality traits and the propensity to violent acting out.

Aggression↗

Delayed automatic detection of change in speech sounds in adults with autism: a magnetoencephalographic study.

OBJECTIVE: Autism is a form of pervasive developmental disorder in which dysfunction in interpersonal relationships and communication is fundamental. This study evaluated neurophysiological abnormalities at the basic level of language processing, i.e. automatic change detection of speech and non-speech sounds, using magnetoencephalographic recording of mismatch response elicited by change in vowels and tones. METHODS: The auditory magnetic mismatch field (MMF) was evaluated in 9 adults with autism and 19 control subjects using whole-head magnetoencephalography. The MMF in response to the duration change of a pure tone or vowel /a/ and that in response to across-phoneme change between vowels /a/ and /o/, were recorded. RESULTS: The groups were not significantly different in MMF power under any conditions. However, the autism group showed a left-biased latency prolongation of the MMF particularly under the across-phoneme change condition, and this latency delay was significantly associated with greater symptom severity. CONCLUSIONS: These results suggest that adults with autism are associated with delayed processing for automatic change detection of speech sounds. These electrophysiological abnormalities at the earliest level of information processing may contribute to the basis for language deficits observed in autism. SIGNIFICANCE: These results provide the first evidence for delayed latency of phonetic MMF in adults with autism.

Acoustic Stimulation↗

The relationship of working memory, inhibition, and response variability in child psychopathology.

INTRODUCTION: The aim of this study was to investigate the relationship between working memory and inhibition in children with attention deficit hyperactivity disorder (ADHD), high-functioning autism (HFA), and Tourette syndrome (TS), compared to normally developing children. Furthermore, the contribution of variation in processing speed on working memory and inhibition was investigated in these childhood psychopathologies. METHOD: Four groups of children are reported in this study: 65 children with ADHD, 66 children with HFA, 24 children with TS, and 82 normal control children. All children were in the age range of 6-13 years. RESULTS: The relationship between working memory and inhibition was similar in children with ADHD, HFA, TS, and normally developing children. The relationship between both domains did not alter significantly for any of the groups, when variation in processing speed was taken into account. More symptoms of hyperactivity/impulsivity are related to a poorer inhibitory process and greater response variability. More symptoms of autism are related to a poorer working memory process. CONCLUSION: The current study showed that working memory, inhibition, and response variability, are distinct, but related cognitive domains in children with developmental psychopathologies. Research with experimental manipulations is needed to tackle the exact relationship between these cognitive domains.

Adolescent↗

The effects of fixed-time and contingent schedules of negative reinforcement on compliance and aberrant behavior.

Prior research has suggested that fixed-time (FT) schedules of reinforcement do not necessarily preclude the acquisition of appropriate behavior (e.g., mands) when combined with differential reinforcement (DRA). These studies also note that dense FT schedules are more likely to interfere with DRA packages than lean FT schedules. In the current investigation, we examined whether similar findings would occur with FT schedules of negative reinforcement. Schedule analyses were conducted with two participants following functional analyses that identified escape from task demands as the maintaining variable for problem behavior. Differential negative reinforcement of alternative behavior (DNRA) was implemented first to establish behavioral control (decreased problem behavior and increased compliance). Breaks (negative reinforcement) were then concurrently delivered on a FT basis under either dense (at a greater rate than that obtained during DNRA alone) or lean (at a lower rate than that obtained during DNRA) reinforcement schedules. In general, results showed that FT escape did not preclude compliance when the FT schedule was lean, but treatment gains were significantly disrupted when dense FT schedules were superimposed.

Attention Deficit and Disruptive Behavior Disorder↗

A total population study of challenging behaviour in the county of Hedmark, Norway: prevalence, and risk markers.

Studies in Britain and the US indicate that 10-15% of people with mental retardation show challenging behaviour, like attacking others (aggression), self-injurious behaviour, destruction, and other difficult, disruptive or socially unacceptable acts. Most researchers indicate that challenging behaviour is more common among adolescents and young adults, among males, is associated with autism, and increases with lack of communication skills and severity of mental retardation. These factors can be understood as risk markers, and some of them can be decreased by preventive and treatment interventions, at least in principle. The present study confirmed most of the previous findings, with some exceptions: the prevalence of more demanding challenging behaviour was somewhat lower in the present study, and no association between gender and challenging behaviour was found. We also concluded that declining prevalence of challenging behaviour at older ages is not a result of a young age structure of the population.

Adolescent↗

Comorbid psychopathology with autism spectrum disorder in children: an overview.

Comorbidity, the co-occurrence of two or more disorders in the same person, has been a topic receiving considerable attention in the child psychopathology literature overall. Despite many publications in the ADHD, depression and other child literatures, autism spectrum disorder has not received such scrutiny. The purpose of this review will be to discuss the available evidence. We address specific variables in diagnosis and classification of comorbid symptoms, and propose potential avenues for research and practice with respect to differential diagnosis. A brief discussion of the implications for treatment is also provided.

Anxiety Disorders↗

A reference method for correlation of anatomic and functional brain images: validation and clinical application.

We describe a reference device that provides accurate correlation between anatomic and functional brain images. The reference device, which generates fiduciary reference points on sequential scan planes, is positioned adjacent to the canthomeatal line of the subject and held in place by a glasses-like framework anchored to the external auditory meatus. The reference system was tested on 17 subjects undergoing 99mTc hexamethylpropylene amine oxime ([99mTc]HMPAO) brain single-photon emission computed tomography (SPECT) and cranial computed tomography (CT) scans. The centers of the caudate nuclei, thalami, brain stem, and cerebellar vermis were identified independently on CT and SPECT. The average difference +/- 1 SD between structure locations (x, y, and z) on SPECT and CT were calculated as 1.86 +/- 1.5, 2.16 +/- 1.4, and 1.83 +/- 1.9 mm, respectively. The clinical application of the method is showed by coregistration of images from SPECT to MRI. An example of sequential [99mTc]HMPAO brain SPECT scan sections precisely coregistered with MRI scan sections oriented parallel to and sequentially above the canthomeatal line illustrates the correlation between regional cerebral blood flow (rCBF) tracer activity on SPECT and normal anatomic structures. Test-retest activation paradigms in brain SPECT requires precise SPECT-to-SPECT image coregistration to evaluate changes in rCBF during activation. Precisely coregistered rest, 48-hour repeat rest [99mTc]HMPAO SPECT studies are shown to illustrate the normal intrasubject variability of tracer uptake. An example of the usefulness of image coregistration for evaluation of viable residual brain tumor and its application to tumor biopsy is presented. An example of developmental abnormalities identified by [99mTc]HMPAO brain SPECT is illustrated by a case of autistic disorder. An example of image coregistration in stroke and evaluation of cerebrovascular disease with Diamox (Lederle Laboratory Division, Pearl River, NY) cerebrovasculature stress testing is presented. The usefulness in epilepsy using a protocol whereby the tracer is injected during the ictal phase of seizure is presented. We conclude that the reference system provides an accurate, rapid, and noninvasive patient-specific method for correlating brain structure with brain function.

Adolescent↗

Comorbid anxiety symptoms in children with pervasive developmental disorders.

The present study examined the prevalence of comorbid anxiety symptoms in 44 children with pervasive developmental disorders. Parents of the children were interviewed using the Anxiety Disorders section of the Diagnostic Interview Schedule for Children. Results indicated that severe anxiety symptoms are highly prevalent in children with pervasive developmental disorders: 84.1% of the children met the full criteria for at least one anxiety disorder. Furthermore, 72.7% of the children displayed ritualistic behaviors. Implications of the findings are discussed.

Adolescent↗