Harald Martinsen

Psychiatric Disorders in People with Autism Spectrum Disorders: Phenomenology and Recognition

The prevalence and incidence rates of psychiatric disorders are higher in people with autism spectrum disorders (ASD) than in the general population (Bradley, Summers, Hayley, & Bryson, 2004; Brereton, Tonge, & Einfeld, 2006; Clarke, Baxter, Perry, & Prasher, 1999; Ghaziuddin & Greden, 1998; Ghaziuddin, 2005; Ghaziuddin, Alessi, & Greden, 1995; Ghaziuddin, Tsai, & Ghaziuddin, 1992; Glenn, Bihm, & Lammers, 2003; Howlin, 1997, 2000; Howlin, Goode, Hutton, & Rutter, 2004; Lainhart, 1999; Leyfer et al., 2006; Matson & Nebel-Schwalm, 2007; Morgan, Roy, & Chance, 2003; Simonoff et al., 2008; Tsakanikos et al., 2006).

Patterns in sleep–wakefulness in three-month old infants exposed to methadone or buprenorphine

BACKGROUND Infants exposed to opioides in-utero frequently demonstrate withdrawal symptoms in the neonatal period and have difficulties with state regulation. AIM This study examines sleep-wakefulness-distress patterns as indicators of regulatory mechanisms at 3 months of age. PARTICIPANTS A national infant cohort (N=35) born to women in high-dose maintenance treatment during pregnancy and a comparison group (N=36) of low-risk infants born in the same period. OUTCOME MEASURES Distributions and frequencies of sleep, wakefulness and distress measured in hours and episodes on sleep charts recorded by the mothers in the two groups. RESULTS Women in maintenance treatment were monitored closely during pregnancy to avoid illicit drug use and to be prepared for motherhood. They were also offered residential treatment before pregnancy and after the child was born. There were no statistical differences between the two groups in any of the 10 measures reflecting diurnal and nocturnal rhythmicity at 3 months despite of neonatal abstinence syndrome in 47% of the exposed infants and significant differences in infant characteristics with respect to birth weight, gestational age and maternal characteristics. CONCLUSIONS Follow-up procedures combining drug monitoring and counseling during pregnancy and in the first months after birth enhance the development of state regulation in terms of sleep-wakefulness patterns.

Adults with intellectual disabilities and mental illness in psychiatric inpatient units: empirical studies of patient characteristics and psychiatric diagnoses from 1996 to 2011

Abstract Background: Adults with intellectual disabilities still have limited access to psychiatric hospitalization when they experience mental illness. Knowledge about patients admitted to inpatient psychiatric units is still sparse. The objective of this review is to investigate patient characteristics and psychiatric diagnoses of adults with intellectual disabilities admitted to psychiatric inpatient units. Methods: A broad search of four electronic databases was conducted for relevant articles, which included controlled and naturalistic studies. The search was limited to articles published in English from 1996 through 2011. Results: Out of 310 hits, 72 articles were reviewed in full text and 19 were chosen for further analyses. Only empirical studies from psychiatric units admitting patients with intellectual disabilities and confirmed or suspected mental illness were considered. The included articles encompass about 4000 patients. Psychosis was the most common psychiatric diagnosis, followed by affective disorder and anxiety disorder. Behaviour problems were observed in a majority of the patients. Practical application: It appears that patients with intellectual disabilities and mental illness admitted to psychiatric inpatient units have especially complex conditions, which may include psychosis or affective disorder, challenging behaviour, often with additional physical conditions, and sparse verbal skills. More research is needed to develop suitable treatment for patients with intellectual disabilities in psychiatric inpatient settings.

Child–child interactions and positive social focus among preschool children

This study is based on video‐recorded observations of 64 children during free play at their nursery. A measure of social focus in the preschool, regarded as an indicator of social status, was constructed from the amount of positive and neutral contacts children received from their peers. Only six children often received positive or neutral contacts from their peers. The majority of the children were relatively seldom focused on by the others. A total of 16 contact categories were observed which reflected the content, manner and social function of the contacts. Twelve of the contact categories were significantly correlated with social focus. A contact score was constructed based on the child–child contacts that were significantly correlated with social focus. The contact score predicted to a large extent social status assigned to the child by other children, sharing about 60% variance with social focus. Age did not have a significant independent contribution to the prediction of social focus, when the contact score and age were tested together in a variance analysis. This is indicative of a strong relationship between social behaviour and social status among preschool children. The relation between social focus, age and social behaviour is discussed.

Observing Communication Skills in Staff Interacting with Adults Suffering from Intellectual Disability, Autism and Schizophrenia

Background: Related to nursing, co-morbidity of intellectual disability (ID), autism and mental health problems, generate a need for integrated knowledge from both intellectual disability nursing and psychiatric nursing. Aim: The aim of the current paper is to examine the reliability of an instrument designed for observing communication skills in professionals caring for patients with intellectual disability, autism and schizophrenia. Procedure: A naturalistic prospective observational design was chosen. Scoring categories were developed, staff and patient communications were video-recorded and then scored. Reliability was estimated by inter-rater agreement. Results: Across 370 sequences of interaction, all categories except one were observed. Inter-rater agreement on the observational categories was high. Conclusion: The instrument worked as expected according to both observer agreement and presence of staff communication skills.

Observation‐based descriptions of social status in the pre‐school

In this study, we showed that it is feasible to employ observational methods in description of social status; thereby allowing inclusion of children with insufficient cognitive ability to make valid judgement of social role, and evading the validity issues concerning teacher and parent report. We observed presence on social arenas and social interactions in 64 children, aged 11–61 months, during free play at their kindergarten. Activity, Centrality and Focus were used to construct a three‐dimensional, observation‐based sociogram. Results indicated that below two years of age, children gather in larger groups on social arenas, but they tend to be socially passive and are rarely addressed by other children. Older children tend to be together in smaller groups, are socially more active and are more focused upon by other children. In general, only few children are granted much positive focus from their peers in the pre‐school.

Imitation at the Onset of Speech

Imitation, or the tendency to replicate the actions of others, is regarded both as a precursor to language development and a strategy for language learning. As a precursor, imitation has traditionally been considered a means for cognitive development, and thereby a necessary condition for the onset of language. The most influential representative for such a view is Piaget, who described several stages in the development of imitative behavior, with deferred imitation as the final stage. According to Piaget, the appearance of the semiotic function depends on deferred imitation, symbolic play, drawing, mental imagery, and verbal evocation. The first four of the above are considered to be based on imitation, whereas the fifth is acquired in a context of imitation (Piaget & Inhelder, 1969; Sinclair-de-Zwart, 1974).