Amanda K. Ludlow

Challenges faced by parents of children diagnosed with autism spectrum disorder

Few studies address the daily challenges faced by parents of children diagnosed with autism spectrum disorder. This article reports on a qualitative interview study with 20 parents exploring their experiences, challenges faced, and what has helped them to cope. A thematic analysis of the data identified five core categories: Dealing with challenging behaviour; dealing with judgements from others; lack of support; impact upon the family; coping and the importance of appropriate support. The findings emphasize where the parents themselves believe they still require additional support. It raises key strategies and resources that parents have found helpful.

Superior discrimination of speech pitch and its relationship to verbal ability in autism spectrum disorders

Whilst hypersensitivity to pitch information appears to be characteristic of many individuals with autism spectrum disorders little is known about the implications of such a tendency for language acquisition and development. Discrimination of systematically varied pitch differences between pairs of words, nonwords, and nonspeech pitch contour analogues was assessed in children with autism spectrum disorders (ASD) and matched controls. The findings revealed superior performance in ASD, although, like controls, discrimination of pitch in speech stimuli was poorer in this group than for nonspeech stimuli. Whilst it was hypothesized that enhanced processing of speech pitch would correlate negatively with receptive language skills in ASD, the findings did not fully support this, and enhanced discrimination skills were observed in individuals without significant language impairment. The implications of these findings for understanding heterogeneity of language ability in ASD are discussed.

Auditory processing and sensory behaviours in children with autism spectrum disorders as revealed by mismatch negativity

Sensory dysfunctions may underlie key characteristics in children with Autism Spectrum Disorders (ASD). The current study aimed to investigate auditory change detection in children with ASD in order to determine event-related potentials to meaningless and meaningful speech stimuli. 11 high functioning boys with a diagnosis of autism spectrum disorders (mean age=13.0; SD=1.08) and 11 typically developing boys (mean age=13.7; SD=1.5) participated in a mismatch negativity (MMN) paradigm. Results revealed that compared to TD controls, the children with ASD showed significantly reduced MMN responses to both words and pseudowords in the frontal regions of the brain and also a significant reduction in their activation for words in the Central Parietal regions. In order to test the relationship between sensory processing and auditory processing, children completed the Adult and Adolescent Sensory Profile. As predicted, the children with ASD showed more extreme sensory behaviours and were significantly higher than their typically developing controls across three of the sensory quadrants (sensory sensitivity, low registration and sensory avoidance). Importantly, only auditory sensory sensitivity was able to account for the differences displayed for words in the frontal and central parietal regions when controlling for the effect of group, revealing an inverse relationship of the higher sensory sensitivity scores the less activation in response for words. We discuss how the expression of sensory behaviours in ASD may result in deficient neurophysiological mechanisms underlying automatic language processing.

Emotion recognition in children with profound and severe deafness : do they have a deficit in perceptual processing?

Findings from several studies have suggested that deaf children have difficulties with emotion identification and that these may impact upon social skills. The authors of these studies have typically attributed such problems to delayed language acquisition and/or opportunity to converse about personal experiences with other people (Peterson & Siegal, 1995, 1998). The current study aimed to investigate emotion identification in children with varying levels of deafness by specifically testing their ability to recognize perceptual aspects of emotions depicted in upright or inverted human and cartoon faces. The findings from the study showed that, in comparison with both chronological- and mental-age-matched controls, the deaf children were significantly worse at identifying emotions. However, like controls, their performance decreased when emotions were presented on the inverted faces, thus indexing a typical configural processing style. No differences were found across individuals with different levels of deafness or in those with and without signing family members. The results are supportive of poor emotional identification in hearing-impaired children and are discussed in relation to delays in language acquisition and intergroup differences in perceptual processing.

Coloured Filters Enhance the Visual Perception of Social Cues in Children with Autism Spectrum Disorders

Coloured filters have been found to reduce visual distortion of text in children with autism spectrum disorders (ASD). We investigated the effect of the overlays on the “mind in the eye” task in children with ASD and controls matched for age, gender, and nonverbal IQ. Children were shown photographs of the periocular region of various faces and were asked to judge which emotion was being expressed in the eyes. In children with ASD, the perception of the emotion was significantly improved when the photograph was covered by a coloured overlay. The improvement was significantly greater than in the controls, who showed no significant effect of the overlay. A perceptual impairment may contribute to the social difficulties shown in ASD.

Color obsessions and phobias in autism spectrum disorders: The case of J.G.

The current study is the first investigation of color ‘obsessions’ and ‘phobias’ in ASD. We investigate the color perception and cognition of J.G., a boy with ASD who has a strong obsession with blue, and a strong phobia of other colors. J.G.’s performance on a series of color tasks (color-entity association; chromatic discrimination; color classification) is compared to 13 children with and without autism who do not have color obsessions or phobias. The findings lead to the formalization of two hypotheses: (i) color obsessions and phobias in individuals with ASD are related to an unusually strong ability to associate colors with entities; (ii) color obsessions are related to hyposensitivity, and color phobias to hypersensitivity, in the affected regions of color space.

Confronting the language barrier: Theory of mind in deaf children

UNLABELLED The current study addressed deaf childrens Theory of Mind (ToM) development as measured by a battery of first- and second-order belief tasks. Both a chronological age-matched control group and a younger group of pre-school aged hearing children were compared to a group of deaf children born to hearing parents. A hearing native signer enacted each of the tasks, which were pre-recorded in video clips in English (SSE), British Sign Language (BSL) and spoken English, in order to consider all communication preferences of the deaf children. Results revealed no differences in performance between the deaf and the young hearing children. However, despite the inclusion of ToM tasks based on their preferred mode of communication, the deaf children performed significantly worse at the unexpected-content and second-order belief task compared with their age-matched controls. These findings imply a delay rather than a deficit in ToM in deaf children that could be attributed to limited opportunities to converse and overhear conversations about mental states. LEARNING OUTCOMES None.

Visual performance and ocular abnormalities in deaf children and young adults: a literature review

Visual defects are common in deaf individuals. Refractive error and ocular motor abnormalities are frequently reported, with hyperopia, myopia, astigmatism and anomalies of binocular vision, all showing a greater prevalence in deaf individuals compared with the general population. Near visual function in deaf individuals has been relatively neglected in the literature to date. Comparisons between studies are problematic due to differences in methodology and population characteristics. Any untreated visual defect has the potential to impair the development of language, with consequences for education more generally, and there is a need to improve screening and treatments of deaf children.

Case Report: Color as a Therapeutic Intervention

J.G. is a 13-year-old boy diagnosed in February 1999 when he was 4 years 6 months with ‘‘high functioning autism’’ (HFA) at an Autism Spectrum Disorders Clinic of a Child and Family Mental Health Service, by a consultant and senior lecture in child and adolescent psychiatry. The assessment was conducted by a pediatrician and an educational psychologist. In addition J.G. had ‘‘four out of nine features of inattention, five of five features of hyperactivity, and four of four features of impulsivity on the diagnostic checklist. He therefore had Attention and Hyperactivity Disorder (ADHD) according to the US criteria, but not according to the more stringent British criteria. At diagnosis, medication for ADHD was deemed inappropriate for his age and his mother has since refused for him to commence medication. When examined in 2005 at age 10 his receptive vocabulary (Dunn et al. 1997) was 96 and his nonverbal IQ (Raven et al. 1992) 106. Despite his average IQ J.G. is not able to function in a mainstream school. From the age of four he reported ‘‘hot eyes’’ in response to bright colors in his environment. He disliked artificial lights and his room at home remains unlit. He suffered headache and nausea in response to colors of walls, food or other people’s clothing. He was also unable to tolerate strobe lighting, and light from reflective surfaces such as mirrors, plates and glass, and when doors were opened. He suffered from projectile vomiting on leaving the house, which interrupted his schooling. From the age of two, J.G. exhibited strong obsessions for blue and purple, and refused to travel in cars or to wear clothes that were not blue. J.G. opted for white foods, and between the ages of 1–9 years the majority of meals were given to him between two slices of bread. J.G. continually walked into doors, failed to locate the chair when sitting, tripped over and had difficulties placing objects on a table. He felt nauseated when exposed to light reflected from water. Strong smells were a source of discomfort, particularly those of food. His mother recalls taking him to the doctor in both July and November 1995 over concerns about his erratic sleeping patterns, which she refers to as ‘burn out’ periods. He would sleep 4–5 days at a time and wake with a high temperature. The episodes would occur at regular intervals every 4–6 months. In addition to the ‘burn out’ periods, J.G. appeared to have fretful and violent dreams and often fell out of bed. When J.G. was aged 10 years 6 months, he took part in a research study. The study included color naming, color discrimination and color memory (in preparation) and an assessment using the Intuitive Colour Overlays (version with 14pt typeface, Wilkins 1994; ioo Sales Ltd), the Rate of Reading Test (Wilkins et al. 1996; ioo Sales Ltd), and the Speed and Capacity of Language Processing Test (SCOLP; Baddeley et al. 1992). The Wechsler Intelligence Scale for Children (Revised) was also administered. The overlay selection procedure was the same as that used previously (Ludlow et al. 2006; Wilkins 2003). Symptoms of visual stress (movement or blurring of the letters, glare and discomfort) were assessed at the outset and after overlay selection. For the overlay selection two identical passages of text, each with the typeface and spacing used for the Rate of Reading or SCOLP, were positioned side by side and one of the overlays was placed over one of the passages. If the overlay improved the clarity of the text, it A. K. Ludlow (&) Department of Psychology, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK e-mail: amanda.ludlow@anglia.ac.uk

Understanding the impact of diet and nutrition on symptoms of Tourette syndrome: A scoping review

Anecdotal reports frequently suggest some dietary involvement in the maintenance of tics in children with Tourette syndrome (TS). This scoping review aimed to (1) understand the possible influence of diet as a trigger of tics and (2) map out the existing studies documenting dietary interventions in children with TS. Current evidence suggests no single diet to benefit individuals with TS. However, reports from parents of children with TS suggest that certain allergens in food may exacerbate tic-related symptoms. For example, an increase in tics has been related to the consumption of caffeine and refined sugar. Moreover, oligoantigenic diets and sugar-free diets have been identified as significantly reducing tics. More research is urgently needed to develop more accurate guidance for parents and children with TS, as many have reported using dietary and nutritional supplements, despite the lack of evidence detailing any benefits, side effects and recommended doses.