Cory Shulman

Peer Interaction and Loneliness in High-Functioning Children with Autism

Social interaction with peers and the understanding and feelings of loneliness were examined in 18 high-functioning children with autism and 17 typically developing children matched for IQ, chronological age, gender, and maternal education. Observations were conducted on childrens spontaneous social initiations and responses to their peers in natural settings such as recess and snack time, and children reported on their understanding and feelings of loneliness and social interaction. Overall, children with autism revealed a good understanding of both social interaction and loneliness, and they demonstrated a high level of social initiation. However, they spent only half the time in social interactions with peers compared with their matched counterparts, and they interacted more often with a typically developing child than with another special education child. Despite the intergroup differences in frequency of interaction, a similar distribution of interactions emerged for both groups, who presented mostly positive social behaviors, fewer low-level behaviors, and very infrequent negative behaviors. Children with autism reported higher degrees of loneliness than their typical age-mates, as well as a lower association between social interaction and loneliness, suggesting their poorer understanding of the relations between loneliness and social interaction. Research and practice implications of these findings are discussed.

Patterns of growth in verbal abilities among children with autism spectrum disorder.

Verbal skills were assessed at approximately ages 2, 3, 5, and 9 years for 206 children with a clinical diagnosis of autism (n = 98), pervasive developmental disorders-not otherwise specified (PDD-NOS; n = 58), or nonspectrum developmental disabilities (n = 50). Growth curve analyses were used to analyze verbal skills trajectories over time. Nonverbal IQ and joint attention emerged as strong positive predictors of verbal outcome. The gap between the autism and other 2 groups widened with time as the latter improved at a higher rate. However, there was considerable variability within diagnostic groups. Children with autism most at risk for more serious language impairments later in life can be identified with considerable accuracy at a very young age, while improvement can range from minimal to dramatic.

The Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale: Differences Between Diagnostic Systems and Comparison Between Genders

Diagnoses for autism based on the Autism Diagnostic Interview-Revised (ADI-R) and the Childhood Autism Rating Scale (CARS) were examined for 83 individuals with suspected autism. Agreement between systems reached 85.7%. Participants receiving diagnosis of autism based on only one system were significantly younger in age than individuals receiving diagnoses according to both systems. Individuals who did not receive diagnosis of autism on the ADI-R had lower chronological and mental ages and lower CARS scores compared to individuals who received diagnosis of autism based on the ADI-R. Eighteen females and 18 males were matched to examine possible gender differences. No significant findings were revealed, suggesting that the symptoms of autism according to the ADI-R and CARS do not differ between males and females when matched for chronological and mental ages.

The Development and Maintenance of Friendship in High-Functioning Children with Autism Maternal Perceptions

The current study investigated mothers’ perceptions of the development of friendship in high-functioning children with autism and in typically developing children. Fourteen mothers in each group (autism, typical) completed the Childhood Friendship Survey regarding their children’s friendships. Main results indicated that both groups (autism and typical) tended to have same-gender and same-age friendships. However, friendships of children with autism differ compared with typical children’s friendships on number of friends, friendship duration, frequency of meetings, and type of activities. Half of the friendships in the autism group were mixed (friendship with a typically developing child). Mixed differed from non-mixed friendships in that mixed pairs met and played mostly at home, whereas non- mixed pairs met and played at school. Factors contributing to the development and formation of friendship in each group are discussed.

Immunological and autoimmune considerations of Autism Spectrum Disorders

Autism Spectrum Disorders (ASD) are a group of heterogeneous neurodevelopmental conditions presenting in early childhood with a prevalence ranging from 0.7% to 2.64%. Social interaction and communication skills are impaired and children often present with unusual repetitive behavior. The condition persists for life with major implications for the individual, the family and the entire health care system. While the etiology of ASD remains unknown, various clues suggest a possible association with altered immune responses and ASD. Inflammation in the brain and CNS has been reported by several groups with notable microglia activation and increased cytokine production in postmortem brain specimens of young and old individuals with ASD. Moreover several laboratories have isolated distinctive brain and CNS reactive antibodies from individuals with ASD. Large population based epidemiological studies have established a correlation between ASD and a family history of autoimmune diseases, associations with MHC complex haplotypes, and abnormal levels of various inflammatory cytokines and immunological markers in the blood. In addition, there is evidence that antibodies that are only present in some mothers of children with ASD bind to fetal brain proteins and may be a marker or risk factor for ASD. Studies involving the injection of these ASD specific maternal serum antibodies into pregnant mice during gestation, or gestational exposure of Rhesus monkeys to IgG subclass of these antibodies, have consistently elicited behavioral changes in offspring that have relevance to ASD. We will summarize the various types of studies associating ASD with the immune system, critically evaluate the quality of these studies, and attempt to integrate them in a way that clarifies the areas of immune and autoimmune phenomena in ASD research that will be important indicators for future research.

The Ability to Manipulate Behavior and to Understand Manipulation of Beliefs: A Comparison of Individuals with Autism, Mental Retardation, and Normal Development.

This study investigated the ability to deceive in participants with autism, mental retardation ( MR), and normal development. The authors used S. Hala, M. Chandler, and A. S. Fritzs (1991) procedures, in which children deceive by creating false trails or by erasing all trails and lying about the true location of a hidden object. Participants with autism and those with MR did not differ in their ability to use a deceptive method to manipulate the behavior of another person. Participants with autism were significantly less able than participants with MR to understand that they manipulated the beliefs of another person by predicting the outcome of their deceptive act. The normal group outperformed the group with autism but not the group with MR on both parts of the task. Different possible interpretations of the results are discussed, including a deficit in theory of mind and a deficit in executive control functions.

From categorization to classification : a comparison among individuals with autism, mental retardation, and normal development

Free-sorting, matrix, and class-inclusion tasks were administered to 16 participants with autism, 16 participants with mental retardation (MR), and 16 normal children, matched for mental age. On perceptual matrices, participants with MR performed less well than those with autism, who performed less well than normal children. On functional matrices, participants with autism and those with MR performed less well than normal children. Participants with autism performed less well than participants with MR and normal children in free-sorting representational objects and in the class-inclusion tasks, which require higher operational thought. These results suggest that individuals with autism have difficulties with tasks that necessitate internal manipulation of information. This impairment is discussed in relation to the cognitive deficit characterizing autism.

Moral and Social Reasoning in Autism Spectrum Disorders

This study compared moral and social reasoning in individuals with and without autism spectrum disorders (ASD). Ten familiar schoolyard transgressions were shown to 18 participants with and 18 participants without ASD. They judged the appropriateness of the behavior and explained their judgments. Analysis of the rationales revealed that participants with typical development used significantly more abstract rules than participants with ASD, who provided more nonspecific condemnations of the behaviors. Both groups judged social conventional transgressions to be more context-bound than moral transgressions, with this distinction more pronounced in typically developing individuals, who also provided significantly more examples of situations in which the depicted behaviors would be acceptable. The educational implications of these findings for individuals with ASD are discussed.

Ability and Disability in Autism Spectrum Disorder: A Systematic Literature Review Employing the International Classification of Functioning, Disability and Health‐Children and Youth Version

Objective: This study is the first in a series of four empirical investigations to develop International Classification of Functioning, Disability and Health (ICF) Core Sets for Autism Spectrum Disorder (ASD). The objective was to use a systematic review approach to identify, number, and link functional ability and disability concepts used in the scientific ASD literature to the nomenclature of the ICF‐CY (Children and Youth version of the ICF, covering the life span). Methods: Systematic searches on outcome studies of ASD were carried out in Medline/PubMed, PsycINFO, ERIC and Cinahl, and relevant functional ability and disability concepts extracted from the included studies. These concepts were then linked to the ICF‐CY by two independent researchers using a standardized linking procedure. New concepts were extracted from the studies until saturation of identified ICF‐CY categories was reached. Results: Seventy‐one studies were included in the final analysis and 2475 meaningful concepts contained in these studies were linked to 146 ICF‐CY categories. Of these, 99 categories were considered most relevant to ASD (i.e., identified in at least 5% of the studies), of which 63 were related to Activities and Participation, 28 were related to Body functions, and 8 were related to Environmental factors. The five most frequently identified categories were basic interpersonal interactions (51%), emotional functions (49%), complex interpersonal interactions (48%), attention functions (44%), and mental functions of language (44%). Conclusion: The broad variety of ICF‐CY categories identified in this study reflects the heterogeneity of functional differences found in ASD—both with respect to disability and exceptionality—and underlines the potential value of the ICF‐CY as a framework to capture an individuals functioning in all dimensions of life. The current results in combination with three additional preparatory studies (expert survey, focus groups, and clinical study) will provide the scientific basis for defining the ICF Core Sets for ASD for multipurpose use in basic and applied research and every day clinical practice of ASD. Autism Res 2015, 8: 782–794.

Cognitive and Behavioural Development of Israeli Males with Fragile X and Down Syndrome

Hebrew translations of the Kaufman Assessment Battery for Children (KABC) and the Vineland Adaptive Behaviour Scales (VABS) were administered to 17 Israeli males with fragile X and 17 with Down syndrome matched for chronological and mental ages. When differences in the initial baselines were considered, the pattern of findings was generally consistent with previous reports. On the K-ABC, the males with fragile X scored higher on some subtests of the Simultaneous Domain but not on any of those of the Sequential Domain. On the VABS, superior scores of the males with fragile X on the Daily Living Skills and Communication domains is consistent with prior evidence of their relative strength on the former and the specific weakness of persons with Down syndrome on the latter. These differences between the males with fragile X and Down syndrome with regard to functioning on various domains and subdomains highlight the need to carefully examine the profiles of aetiologically homogeneous groups of persons.