bluuebunny/crossref_metadata_2025 huggingface dataset:
Searching, Finding and Struggling: Psychotherapy for an Adolescent in Substitute Care
Authors: Fleming Robert W.K.
Published: November 2003

Young people who have spent much of their lives in the care system can have serious emotional and psychiatric problems. Psychoanalytic psychotherapy is rarely considered in cases where the young person has no immediate ‘ownership’ of a problem. Work is described with an adolescent who, with assistance, found and struggled to use a therapeutic space. Comments are made about how this case may suggest improvements for the referral processes for other adolescents in substitute care.
Auditing Audit
Authors: Dogra Nisha
Published: November 2003

The aims of this study were to establish the levels and quality of audit activity within a child and adolescent mental health service (CAMHS) before and after the development of a service-wide audit group. Clinical staff were surveyed using standard proformas. Between 1996 and 1999, only one project within CAMHS had completed the audit cycle although considerable activity was apparently taking place. A second cycle audit showed that since the introduction of the audit group the number of projects with clear protocols increased from five to twelve with at least three further projects under development, although staff perceive that they are undertaking less audit activity. Five projects have been completed and recommendations made by three of these. The number of completed projects making recommendations has risen through the development of the audit group and the audit profile raised within the service.
Service Use Over 18 Months among a Nationally Representative Sample of British Children with Psychiatric Disorder
Authors: Ford Tamsin , Goodman Robert , Meltzer Howard
Published: November 2003

In 1999, a representative sample of 10,438 British 5-15-year-olds was assessed psychiatrically, 929 of these had a psychiatric disorder. Five hundred and ninety- six (64.2%) of these children with psychiatric disorder were followed up 18 months later using postal questionnaires and telephone interviews with parents, in order to chart their contacts with services over that 18-month period. About half had not been in contact with any services, while only one fifth had seen specialized mental health services. Although levels of extreme dissatisfaction were low, approximately as many parents felt that intervention had made no difference as felt that intervention had been helpful. Contacts with specialized mental health services seemed brief and often involved more than one type of service or professional. These results provide an interesting snapshot of services across Britain, which we hope will stimulate a productive debate on how best to improve services for this group of children.
Use the Body and Forget the Body: Treating Anorexia Nervosa with Adapted Physical Activity
Authors: Duesund Liv , Skårderud Finn
Published: November 2003

Anorexia nervosa represents an over-concern with body shape and weight. This article describes seven female patients with severe anorexia nervosa who were given a time-limited program of Adapted Physical Activity (APA). The aim was to investigate how social interaction in activities could move negative attention from the objectified anorectic body to a more profound and subjective experience of one’s own body. APA may represent a therapeutic access to anorexia nervosa, as a supplement to psychotherapy.
Good Children with Conversion Disorder: Breaking the Silence
Authors: Kozlowska Kasia
Published: November 2003

The diagnosis of conversion disorder in childhood is shrouded in uncertainty, a lack of satisfactory explanations, doctor-parent hostility, shame and family silence. Speculations as to the aetiology of conversion symptoms have resulted in hypotheses ranging from malingering, self-deceit, unconscious processes, theories of communication, intolerable predicaments and illness behaviour to hypothesized neurophysiological processes. Of note, is the absence of patient perspectives from the literature, and a tendency for families of ‘good’ children with conversion disorder to respond to inquiries about psychological factors with unease, hostility or silence. The child’s experience of conversion symptoms and illness context are valuable sources of information. This article presents two personal accounts of conversion disorder in children with exemplary premorbid functioning. It aims to demystify the circumstances in which conversion symptoms may present, reestablish dialogue about children’s predicaments and rekindle interest in the developmental trajectories of children presenting with conversion symptoms.
Skills Training for Managing Disturbed Adolescents in a Residential Treatment Program
Authors: Pazaratz Don
Published: November 2003

An integrated approach to training youth workers includes teaching the fundamentals of psychology, child development, family relationships, sociology, ethical issues and group dynamics. However, in residential treatment, it is the quality of staff-adolescent interactions that is the most crucial component, with its impact on the structure and successful operation of group care. This article looks at how a residential treatment program integrates theoretical training with pragmatic adolescent care practice to maximize therapeutic effectiveness.
The Universal Vortex
Authors: Podolska Sue
Published: November 2003

This article is presented as a conversation between two mental health professionals in e-mail format and intends to raise the following questions: 1.Does the mental health arena rely too heavily upon the differentiation of conditions rather than seeking to make correlations between them? 2.Is obsessive compulsive disorder (OCD) screaming for closer scrutiny? If OCD were considered as existing as a ‘symptom’ of many conditions, rather than existing in its own right, how would the approach to treating it be different? Also, how would this affect the treatment of its comorbidities? 3.If OCD is a symptom of other conditions, is it possible that a common mechanism (a Universal Vortex) is responsible for the condition’s existence?
Developmental Assessment of the Internationally Adopted Child: Challenges and Rewards
Authors: Weitzman Carol Cohen
Published: November 2003

Each year approximately 17,000 children are adopted into the USA from a variety of countries around the globe. Most of these children have been reared in orphanages and have suffered varying degrees of emotional deprivation, substandard health care and nutrition, neglect, trauma and loss. Research suggests that length of institutionalization is the greatest predictor of the risk for developmental delay and mental health problems. Specialized clinics have been developed to evaluate the unique needs of the internationally adopted child. This article focuses on key elements and challenges of the developmental evaluation of the internationally adopted child including: (i) reviewing the pre-adoptive medical record and/or video, (ii) interviewing adoptive parents, and (iii) performing comprehensive assessments of newly arrived adoptees. A review of research findings is discussed and applying available and limited research to clinical assessments is considered.
Mental and Physical Health Co-Morbidity in Looked after Children
Authors: Hill Catherine , Thompson Margaret
Published: November 2003

Children living in public care are more vulnerable to mental and physical health morbidity than their peers living within birth families. The aetiology is complex but pre-care health neglect and abuse, genetic predisposition and the subsequent instability experienced within public care are key contributory factors. Conduct disorder is the commonest mental health problem described. If conduct-related behavioural problems are the defining feature of a child’s difficulties, promoting good physical health becomes particularly challenging. Equally, anxiety and affective disorders can easily be overlooked during physical health consultations. Services must work closely across specialist professional boundaries to promote health in the spirit of the Children Act (1989) as ‘a positive state of mental physical and spiritual wellbeing’. This article describes the evidence for co-morbidity of physical and mental health problems and highlights the importance of close working across mental and physical health services.
The Emotional Tasks of Moving from Fostering to Adoption: Transitions, Attachment, Separation and Loss
Authors: Lanyado Monica
Published: November 2003

The paradoxical emotional tasks involved for a child moving from fostering to adoption are discussed from two linked perspectives. Attachment theory highlights the fact that the child is being expected to form a new attachment to the adoptive family whilst often being in the grips of mourning the loss of the foster family. The author suggests that a significant amount of the anger and violence expressed by children such as these is the result of their suffering from ‘multiple traumatic loss’. Winnicott’s ideas about the potential of transitional experiences, phenomena and objects to offer a way of working with the painful paradox of simultaneous attachment and loss in as creative a way as possible, are illustrated. The three-year-old patient was referred for psychoanalytic psychotherapy to help him to cope as well as possible with his move from his loved foster home to his unknown adoptive home. The importance of facilitating a growing ability to play out in the therapy the intense feelings inevitably engendered, as opposed to acting them out in everyday life, is emphasized. It is argued that therapy offered during such difficult life transitions, if it can be thoughtfully contained by the professional network around the child can hold a significant therapeutic potential. The psychodynamics of the professional network surrounding the child are discussed in this context.
Changes in Attachment Representations Over the First Year of Adoptive Placement: Narratives of Maltreated Children
Authors: Hodges Jill , Steele Miriam , Hillman Saul , Henderson Kay , Kaniuk Jeanne
Published: November 2003

Children who develop their ‘internal working models’ of attachment in situations of neglect or abuse, carry the effects of these models into new placements if they are then adopted or fostered. This article reports on the assessment of these effects using the story stem technique, which provides children with a way of displaying their expectations and perceptions of attachment figures using both verbal and non-verbal means of representation. An outline of the story stem assessment technique is given, and the ‘Little Pig’ stems and a summary of the rating system are presented. The article then reports preliminary findings from a larger ongoing research project, comparing themes in the stories of previously maltreated children placed for adoption with those of a group of children adopted in the first year of life, and using the technique to track changes in the children’s attachment representations, and some other aspects of their ‘internal working models’, over the first year of placement in their new families.
Disorders of Attachment in Adopted and Fostered Children: Recognition and Treatment
Authors: Howe David , Fearnley Sheila
Published: November 2003

This article briefly reviews a small number of outcome studies for adopted and fostered children, concentrating particularly on the progress of older-placed children. A transactional model of children’s development is introduced to explain the different pathways taken by children post placement. In this model transactions occur between children and their social environment which co-determine their developmental progress. The model is applied to children placed for adoption and foster care who have had a pre-placement history of abuse, neglect or rejection. Many of these children are also diagnosed as suffering a disorder of attachment. These disorders are the result of early relational trauma experienced in the context of an attachment relationship. The disturbed behaviours of many of these children place great demands on the parenting capacities of adoptive parents and foster carers. The therapeutic work of the Keys Attachment Centre, which specializes in treating children with disorders of attachment, is outlined. A case example is given illustrating the types of behaviour associated with attachment-disordered children and the kinds of intervention developed by therapists specializing in this field.
Comparison of ICD-10 and Gillberg’s Criteria for Asperger Syndrome
Authors: Leekam Susan , Libby Sarah , Wing Lorna , Gould Judith , Gillberg Christopher
Published: November 2003

In this study, algorithms designed for the Diagnostic Interview for Social and Communication Disorders (DISCO) were used to compare the ICD-10 criteria for Asperger syndrome with those suggested by Gillberg. Two hundred children and adults were studied, all of whom met the ICD-10 criteria for childhood autism or atypical autism. Only three (1 percent) met criteria for ICD-10 Asperger syndrome. In contrast, 91 (45 percent) met criteria for Asperger syndrome defined by Gillberg, which more closely resemble Asperger’s own descriptions. Results showed that the discrepancy in diagnosis was due to the ICD-10 requirement for ‘normal’ development of cognitive skills, language, curiosity and self-help skills. When comparisons were based on Gillberg’s criteria only, results showed the participants diagnosed as having Asperger syndrome differed significantly from the rest on all but two of Gillberg’s criteria. However, all of these criteria could be found in some of those not diagnosed as having Asperger syndrome. The results emphasize the differences between the two diagnostic systems. They also question the value of defining a separate subgroup and suggest that a dimensional view of the autistic spectrum is more appropriate than a categorical approach.
Strategies for Improving the Social Integration of Children with Asperger Syndrome
Authors: Attwood Tony
Published: November 2003

There is general agreement that children with Asperger syndrome have difficulties in social integration with their peers. Our current understanding of the nature of these difficulties is explained and specific strategies are described that are designed to encourage greater competence in the skills that are necessary to achieve effective social integration. While we do not have any clear scientific evidence of whether and how these strategies are successful, they provide a source of ideas for future examination by academic research and provisional remedial programmes for practitioners.
Do Children with Autism have Expectancies about the Social Behaviour of Unfamiliar People?
Authors: Nadel Jacqueline , Croué Sabine , Mattlinger Marie-Jeanne , Canet Pierre , Hudelot C. , Lécuyer C. , Martini Mary
Published: November 2003

Eight low-functioning and non-verbal children with autism were presented with a modified version of the ‘still face’ paradigm (still face/imitative interaction/still face) performed by a stranger. The children’s reactions illustrate the development of expectancies concerning human social behaviour. While they ignored the stranger and did not show any concern about her odd behaviour during the first still episode, they all focused on the adult during the second still episode. In this episode, they exhibited a mixed social pattern of positive overtures and negative emotional expressions which resembles the still face effect found in normally developing infants. These findings suggest that low-functioning children with autism are able to integrate their previous experience with a partner and detect social contingency, but that they are not able to form a generalized expectancy for social contingency in human beings with whom they have not yet had contact. This may explain why they generally ignore strangers.
Attribution of Mechanical and Social Causality to Animated Displays by Children with Autism
Authors: Bowler Dermot M. , Thommen Evelyne
Published: November 2003

Two studies are reported that compare the descriptions given by children with and without autism of animated stimuli depicting mechanical launching effects, intentional reactions or sequences of mechanical and intentional reactions. Children were matched on chronological age, verbal mental age and IQ. The children with autism were as able as the control groups at differentiating mechanical launches from intentional reactions. Moreover, their descriptions of the longer action sequence were significantly different neither in length nor in their use of mental state language from those of the controls. However, finer-grained analyses of the accounts showed that the children with autism involved themselves more in the narrative than did control children. They also made less reference to episodes showing actions between animate objects, especially when the objects were not in contact. The implications of these findings for theories of autistic social dysfunction are discussed.
Imitation, Theory of Mind and Related Activities in Autism
Authors: Brown Julie , Whiten Andrew
Published: November 2003

Systematic naturalist observations of imitation, theory of mind and other related activities (play and social contact) were conducted for five groups of subjects. The groups comprised children with autism, adults with autism, children with mixed learning disabilities, and normally developing 3- to 4-year-olds and 5- to 6-year-olds. Very little imitation was observed in any group other than the 3- to 4-year- old normal children, making it difficult to draw any conclusion about the specificity and universality of a deficit in spontaneous imitation. However, autistic subjects showed less interaction with peers, more manipulative activity, less symbolic play and less evidence of understanding mental states. The quality of these behaviours, when they did occur, also differed between groups. Comparisons across school and play situations indicated no major situational differences. The implications of the results are discussed with regard to Rogers and Pennington’s intersubjectivity theory of autism.
Practical Paediatric Psychopharmacological Prescribing in Autism
Authors: Gringras Paul
Published: November 2003

Claims of ‘miracle cures’ for autism in the press and on the Internet bring new pressures to bear on parents of children with autism, and the professionals who care for them. Between a third and a half of people with autism in America are receiving some psychotropic medication. Despite recent advances in paediatric psychopharmacology, there is no proof that any medication can target the primary social impairments that characterize autism. The article discusses the evidence behind two approaches to psychopharmacological management in children with autism. The first approach selects certain target symptoms such as resistance to change, ritualistic/compulsive behaviours, hyperactivity, aggressive behaviours and sleep problems. The evidence for the effectiveness of agents including stimulants, anti- depressants, and melatonin when used to treat these symptoms is appraised. The second approach attempts to treat or cure the primary social impairment underlying autism. The evidence for the effectiveness of agents including naltrexone, fenfluramine and secretin is appraised. Early reports in this field have generated false hope, and the need for well-designed larger multicentre trials is emphasized.
Neuromotor Assessment and Autistic Disorder
Authors: Brasic James Robert , Gianutsos John G.
Published: November 2003

Autistic disorder presents in early childhood with marked deviations in social interactions and communication and with a restricted and peculiar range of interests and activities. Although probably a heterogeneous condition, autistic disorder includes a class of individuals who also have subtle neurological impediments manifested as disturbances of movement, balance, posture and gait. We review neuromotor and neurobehavioral assessments for persons with autistic disorder and related conditions to improve the classification of the impairments and to facilitate the utilization of therapies specific for each class.
Researches in Brief
Authors: Nally Brenda , Houlton Bob , Ralph Sue
Published: November 2003

Television and video play an important and positive role in the lives of most families. However, for parents of children with autism they also cause problems when the children become obsessive about video recordings and prevent family use of the main television. These problems are examined through a content analysis of the discussion of a small focus group ( n = 6) of parents of children with autism. Six substantive issues surrounding the use of video in families with children with autism are identified.
Why and why not? Factors Influencing Employment for Individuals with Asperger Syndrome
Authors: Nesbitt Sophie
Published: November 2003

The supported employment literature relating to organizational concerns has focused mostly on mild intellectual disability. The purpose of this study is to investigate the area of supported employment for individuals with Asperger syndrome using Prospects - The National Autistic Society’s Supported Employment Service. The study will focus on a comparison of employment factors that influence organizations currently employing an individual with Asperger syndrome with organizations who are not. Findings suggest that many of the items rated as important to both types of organization were related to areas that might typically be difficult for an individual with Asperger syndrome. Organizations using Prospects found items relating to support and information regarding Asperger syndrome to be significantly more important. Organizations not employing an individual with Asperger syndrome focused more on items related to the ability of the individual to behave in certain expected ways. Reasons for differences and implications for service developments and future research are discussed.
Counterfactual Reasoning and False Belief Understanding in Children with Autism
Authors: Peterson Donald M. , Bowler Dermot M.
Published: November 2003

The Sally-Anne task used to assess children’s understanding of false belief has traditionally been conceptualized as a test of mental state understanding in that it asks the child where a protagonist thinks an object is located when the protagonist has a false belief about the object’s location. However, a recent logical analysis by Peterson and Riggs identifies a strategy for such tasks involving a specific reasoning process they term subtractive reasoning. This can be assessed by asking the child a question such as, ‘If the marble had not been moved, where would it be now?’ Studies of typically developing children have shown strong associations between false belief and subtractive reasoning tasks even when verbal mental age is controlled. In the present study we replicated these experiments using children with autism and children with severe learning difficulties. Although significant correlations between the two tasks were found for all three groups, analyses of contingencies between the two tasks and comparison of their respective difficulty for each group suggested that ability in subtractive reasoning was a necessary but not sufficient component of successful performance in the false belief tasks. Our results indicate the presence of a further factor which is required in these tasks, and which is deficient in autism, and we argue that this may consist in a specific type of generativity.
A Psychosocial Study on Restricted Interests in High Functioning Persons with Pervasive Developmental Disorders
Authors: Mercier Céline , Mottron Laurent , Belleville Sylvie
Published: November 2003

To explore how restricted interests are perceived by individuals with pervasive developmental disorders (PDDs) and their relatives, 18 in-depth semi-structured interviews were conducted with six high-functioning individuals with PDD, their parents and/or siblings. Results revealed that restricted interests play a significant role in the person’s life that is acknowledged by most of their relatives. They provide a sense of well-being, a positive way of occupying one’s time, a source of personal validation, and an incentive for personal growth. However, these positive dimensions are counterbalanced by their negative consequences. Following the demands and the support from their environment, the participants in the study reported to have involved themselves in an active process to adapt, reduce or diversify their restricted interests. These findings on transformation of restricted interests under development and social pressure may have theoretical (for cognitive models of autism) and clinical consequences (in their use for rehabilitation).
Home-Based Behavioral Intervention for Young Children with Autism/Pervasive Developmental Disorder
Authors: Luiselli James K. , Cannon Barbara O’malley , Ellis James T. , Sisson Robert W.
Published: November 2003

Sixteen children with diagnoses of autism and pervasive developmental disorder who participated in home-based behavioral intervention were evaluated retrospectively to determine whether the ‘intensity’ of service delivery (hours per week, duration in months, total hours) and the age at which intervention was introduced (before and after 3 years of age) influenced developmental rating scale assessments of progress. Children who were involved in services before and after 3 years of age all demonstrated significant changes on six developmental domains when assessed before and following intervention but there were no significant differences between these groups. Overall improvement in the areas of communication, cognitive and social- emotional functioning was predicted by the duration of time (months) that a child spent in home-based intervention. These findings are discussed in light of recommendations for the ‘intensive’ behavioral treatment of young children with autism.
The Economic Impact of Autism in Britain
Authors: Järbrink Krister , Knapp Martin
Published: November 2003

Little is known about the economic impact of autism. This study estimated the economic consequences of autism in the United Kingdom, based on published evidence and on the reanalysis of data holdings at the Centre for the Economics of Mental Health (CEMH). With an assumed prevalence of 5 per 10,000, the annual societal cost for the UK was estimated to exceed £1 billion. The lifetime cost for a person with autism exceeded £2.4 million. The main costs were for living support and day activities. Family costs account for only 2.3 percent of the total cost, but a lack of relevant information limited our ability to estimate these costs. Minor improvements in life outcome for people with autism could substantially reduce costs over the lifetime.
Perceptions of School by Two Teenage Boys with Asperger Syndrome and their Mothers: A Qualitative Study
Authors: Carrington Suzanne , Graham Lorraine
Published: November 2003

This qualitative study aimed to develop an understanding of the challenges faced by teenage boys with Asperger syndrome and their mothers. A case study approach was used to collect data from two 13-year-old boys who have Asperger syndrome and their mothers in Queensland, Australia. Data were collected through the use of semi- structured interviews. The words of the boys and their mothers provide a valuable insight into the personal experiences and feelings of the participants. An inductive approach to data analysis identified four themes: (1) developmental differences; (2) problems associated with the general characteristics of Asperger syndrome (i.e. communication and social difficulties, restricted range of interests, a need for routine); (3) stress; and (4) ‘masquerading’. The first three themes relate strongly to the current literature, but the emergence of masquerading is of particular interest in developing a fuller understanding of the experiences of individuals with Asperger syndrome at school.
The Asperger Syndrome (and High-Functioning Autism) Diagnostic Interview (ASDI): A Preliminary Study of a New Structured Clinical Interview
Authors: Gillberg Christopher , Gillberg Carina , Råstam Maria , Wentz Elisabeth
Published: November 2003

The development of the Asperger Syndrome (and high- functioning autism) Diagnostic Interview (ASDI) is described. Preliminary data from a clinical study suggest that inter-rater reliability and test-retest stability may be excellent, with kappas exceeding 0.90 in both instances. The validity appears to be relatively good. No attempt was made in the present study to validate the instrument as regards the distinction between Asperger syndrome and high-functioning autism.
A Deficit in Shifting Attention Present in High-Functioning Autism but not Asperger’s Disorder
Authors: Rinehart Nicole J. , Bradshaw John L. , Moss Simon A. , Brereton Avril V. , Tonge Bruce J.
Published: November 2003

The aim of this study was to examine executive functioning, in particular, attentional set-shifting deficits in high-functioning autism (n = 12) and Asperger’s disorder (n = 12). A large or global digit composed of smaller or local digits was presented during each trial. The participants indicated the presence of 1s or 2s by pressing the appropriate button. These targets could appear globally or locally. Relative to IQ, sex and age matched controls, reaction time to global targets in individuals with autism was retarded when the previous target appeared locally. This deficiency in shifting from local to global processing, however, was not observed in individuals with Asperger’s disorder. The theoretical and neurobiological significance of this dissociation in executive functioning in these clinically related disorders was explored.
Non-Significance of Early Speech Delay in Children with Autism and Normal Intelligence and Implications for DSM-IV Asperger’s Disorder
Authors: Mayes Susan Dickerson , Calhoun Susan L.
Published: November 2003

According to the DSM-IV, children with Asperger’s disorder do not have significant cognitive or speech delays, whereas children with autistic disorder may or may not. In our study, children with normal intelligence who had clinical diagnoses of autism or Asperger syndrome were divided into two groups: those with and without a significant speech delay. The purpose was to determine if clinically meaningful differences existed between the two groups that would support absence of speech delay as a DSM-IV criterion for Asperger’s disorder. No significant differences were found between the 23 children with a speech delay and the 24 children without a speech delay on any of the 71 variables analyzed, including autistic symptoms and expressive language. Results suggest that early speech delay may be irrelevant to later functioning in children who have normal intelligence and clinical diagnoses of autism or Asperger syndrome and that speech delay as a DSM-IV distinction between Asperger’s disorder and autism may not be justified.
What Do Medical Students Know about Autism?
Authors: Shah Kalpna
Published: November 2003

Although recent research indicates the importance of early recognition and intervention for children with autism, it is clear that many families remain very dissatisfied with the diagnostic process. In order to improve this situation, it is essential that primary care practitioners, such as GPs, are fully aware of the core symptoms of autism. The present study reports on autism awareness amongst 250 medical students at different stages of their training. Differences between first-year and fourth-year students were compared with respect to their knowledge of various aspects of autism, including diagnosis, cause, symptomatology, treatment and outcome. Fourth-year students were significantly more likely to respond correctly to questions related to diagnostic criteria and core symptoms. However no significant differences were found between first-year and fourth-year students for other aspects, such as possible causes, IQ profiles, prognosis and treatment. These findings suggest that more emphasis needs to be placed on teaching medical students about autism if diagnosis and access to intervention are to be improved.
Theory of Mind, Causal Attribution and Paranoia in Asperger Syndrome
Authors: Blackshaw Alison J. , Kinderman Peter , Hare Dougal J. , Hatton Chris
Published: November 2003

Theory of mind (ToM) deficits are central to autistic spectrum disorders, including Asperger syndrome. Research in psychotic disorders has developed a cognitive model of paranoid delusions involving abnormal causal attributions for negative events. Possible aetiologies of these include deficits in social reasoning, specifically ToM. The present study investigated this attributional model of paranoia in Asperger syndrome. Participants diagnosed with Asperger syndrome scored significantly higher on a measure of paranoia and lower on a measure of ToM, compared with the control group. They did not differ in self-concept and causal attributions, contrary to the attributional model of paranoia. A regression analysis highlighted private self-consciousness as the only predictor of paranoia. The theoretical and clinical implications of these findings are discussed.
Interaction Patterns Between Children and their Teachers when Using a Specific Multimedia and Communication Strategy
Authors: Tjus Tomas , Heimann Mikael , Nelson Keith E.
Published: November 2003

This study reports on observed interaction patterns between 20 children with autism and mixed intellectual disabilities (mean chronological age = 11:4 years; language age = 4:7 years) and their nine teachers working with a specially developed multimedia program aiming to increase literacy skills. An increase in verbal expression was found over time for the total group. Children with autism also showed increased enjoyment and willingness to seek help from their teachers. Teachers for both diagnostic groups reduced their instructions on how to handle the computer during the program but the decrease was greater in the teachers for children with autism. When the total group of children was subdivided according to language age (high versus low), it appears that those with a low language age showed an increase in verbal expressiveness from start to end of training. Those with a high language age showed increased enjoyment. It is concluded that more detailed studies of the interaction patterns between teachers and children are needed, and these should be related to children’s language level as well as to diagnostic group.
The Attitudes of Teachers in Scotland to the Integration of Children with Autism into Mainstream Schools
Authors: Gregor Evelyn M C , Campbell Elaine
Published: November 2003

Around 4600 school-age children in Scotland fall within the spectrum of autistic disorders, of whom 780 have been identified in schools. This study sought the views of 23 specialist and 49 mainstream teachers, 22 with experience of autism, 27 without. They were questioned about the advantages and disadvantages of integration into mainstream for autistic children, their own ability to cope and predictors of success. Questionnaires were issued to special units and to mainstream primary and secondary schools. A minority of mainstream respondents believed children with autism should be integrated where possible. Mainstream teachers with experience of autism showed more confidence to deal with the children than those without experience. Many expressed concerns about effects on mainstream pupils but most were willing to undertake more training. Specialist teachers were more positive, although they acknowledged possible disadvantages for both groups of children and stressed that the success of integration depends on the individual child.
Pervasive Developmental Disorder and Obstetric Complications in Children and Adolescents with Tuberous Sclerosis
Authors: Park Rebecca J. , Bolton Patrick F.
Published: November 2003

Children with autism have an increased risk for obstetric complications but it is not known whether these are of primary aetiological significance. It is also unclear whether obstetric complications play a secondary role in shaping phenotypic expression in individuals at genetic risk for autism. We investigated this question by studying the role of obstetric complications in determining phenotypic manifestations in tuberous sclerosis, a single gene disorder frequently associated with autism spectrum disorders. Obstetric histories of 43 children with non-familial TS and 40 unaffected siblings were obtained using a structured parent interview. ADI-R, ADOS-G and IQ evaluations were undertaken. Children with TS experienced more obstetric complications than their unaffected siblings, but these were related to mild rather than severe adversities. No differences in obstetric complications were found in children with and without autism spectrum disorders and there was no positive correlation between obstetric adversities and severity of autism spectrum disorders or intellectual impairments.
Towards a New Functional Assessment of Autistic Dysfunction in Children with Developmental Disorders
Authors: Adrien Jean-Louis , Roux Sylvie , Couturier Guylène , Malvy Joëlle , Guerin Pascaline , Debuly Sabine , Lelord Gilbert , Barthélémy Catherine
Published: November 2003

In order to assess particular disorders of psychological development and functioning in children with developmental disorders, we have developed a new tool, the Behaviour Function Inventory (BFI), based on 11 neurophysiological functions, disorders of which are considered to contribute to the core autistic syndrome. This article reports the reliability and validity study of this new scale. Factorial analysis computed on the 55 initial items identified six main dimensions which we characterized and labelled: interaction dysfunction, praxis dysfunction, auditory dysfunction, attention dysfunction, islet of ability and emotional dysfunction. Relationships between these six new variables and diagnostic subgroups, and chronological and developmental age, are discussed. The BFI offers precise information of the functional symptomatology of autism, showing clear evidence of some disordered areas of functioning. This new approach may provide valuable information in clinical research, especially for psychopathology and physiopathology studies.
Evaluation of a New Computer Intervention to Teach People with Autism or Asperger Syndrome to Recognize and Predict Emotions in Others
Authors: Silver Miriam , Oakes Peter
Published: November 2003

This randomized controlled trial looked at the effect of a new computer program designed to teach people with autistic spectrum disorders to better recognize and predict emotional responses in others. Two groups of 11 children (age 12-18) with autism or Asperger syndrome at two special schools participated: one group used the computer program for 10 half-hour sessions over 2 weeks. Within-program data showed a significant reduction in errors made from first to last use. Students were assessed pre- and post-intervention using facial expression photographs, cartoons depicting emotion-laden situations, and non-literal stories. Scores were not related to age or verbal ability. The experimental group made gains relative to the control group on all three measures. Gains correlated significantly with the number of times the computer program was used and results suggest positive effects. Further research could assess whether these gains generalized into real life or improved performance on theory of mind measures.
Children with Autism Display more Social Behaviors after Repeated Imitation Sessions
Authors: Field Tiffany , Field Tory , Sanders Chris , Nadel Jacqueline
Published: November 2003

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.
The Scottish Centre for Autism Preschool Treatment Programme
Authors: Salt Jeff , Sellars Val , Shemilt John , Boyd Sheila , Coulson Tracey , McCool Susan
Published: November 2003

Early intervention is an area of intense current interest for parents and professionals. This article describes a mainstream National Health Service (NHS) approach to early intervention, developed at the Scottish Centre for Autism. The aims of treatment are to improve the child's early social communication and social interaction skills, leading to the potential development of play and flexibility of behaviour. This is achieved by 1:1 intensive treatment by trained therapists, and a schedule of parent training. The treatment protocol incorporates a child led approach; the use of imitation as a therapeutic strategy; using language contingent on activities; and the introduction of flexibility into play and social exchanges.
Increasing Joint Attention, Play and Language through Peer Supported Play
Authors: Zercher Craig , Hunt Pam , Schuler Adriana , Webster Janice
Published: November 2003

The purpose of the present study was to examine the effects of participation in an integrated play group on the joint attention, symbolic play and language behavior of two young boys with autism. Two 6-year-old twin brothers participated in this study, along with three typically developing girls, ages 5, 9 and 11. A multiple baseline design was used with three phases: no intervention, intervention with adult coaching, and intervention without adult coaching. After being trained, the three typically developing children implemented the integrated play group techniques in 30 minute weekly play group sessions for over 16 weeks. Results indicate that participation in the integrated play group produced dramatic increases in shared attention to objects, symbolic play acts, and verbal utterances on the part of the participants with autism. These increases were maintained when adult support was withdrawn. Implications of these findings for inclusion of children with autism are discussed.
Predictors of Treatment Outcome in Young Children with Autism
Authors: Gabriels Robin L. , Hill Dina E. , Pierce Rebecca A. , Rogers Sally J. , Wehner Beth
Published: November 2003

This study examined predictors of developmental outcomes in 17 children diagnosed with autism or PDD-NOS, who received generic treatment over a mean period of 37 months. Pre-treatment evaluations occurred at a mean age of 31 months with follow-up evaluations at a mean age of 69 months. Significantly different developmental trajectories were observed among the participants at follow-up, separating the participants into two distinct groups (high and low outcome). However, groups did not differ significantly in treatment intensity or other outcome prediction measures. Pre-treatment developmental intelligence levels between the two groups approached significance. The results raise questions regarding the effect of treatment intensity and type, family stress factors, and intelligence ability in very early childhood on, outcome.
The CAST (Childhood Asperger Syndrome Test)
Authors: Scott Fiona J. , Baron-Cohen Simon , Bolton Patrick , Brayne Carol
Published: November 2003

The article describes a pilot and follow-up study of the preliminary development of a new tool to screen for Asperger syndrome (AS) and related social and communication conditions (the Childhood Asperger Syndrome Test, CAST) in children aged 4-11 years, in a non-clinical setting. In the pilot study, parents of 13 children with AS and of 37 typically developing children completed the CAST. There were significant differences between the AS and typical sample means. The pilot was used to establish preliminary cut-off scores for the CAST. In the main study, parents of 1150 primary-school-age children were sent the CAST, and 174 took part in the full data analysis. Results suggest that compared with other tools currently available, the CAST may be useful for identifying children at risk for AS and related conditions, in a mainstream non-clinical sample. Further research is ongoing.
Iron Deficiency in Autism and Asperger Syndrome
Authors: Latif A , Heinz P. , Cook R.
Published: November 2003

This research considers the prevalence of iron deficiency in children with autism and Asperger syndrome and examines whether this will influence guidelines and treatment. Retrospective analysis of the full blood count and, as far as available, serum ferritin measurements of 96 children (52 with autism and 44 with Asperger syndrome) was undertaken. Six of the autistic group were shown to have iron deficiency anaemia and, of the 23 autistic children who had serum ferritin measured, 12 were iron deficient. Only two of the Asperger group had iron deficiency anaemia and, of the 22 children who had their serum ferritin measured, only three were iron deficient. Iron deficiency, with or without anaemia, can impair cognition and affect and is associated with developmental slowing in infants and mood changes and poor concentration in children. This study showed a very high prevalence of iron deficiency in children with autism, which could potentially compromise further their communication and behavioural impairments.
Hardiness and Social Support as Predictors of Stress in Mothers of Typical Children, Children with Autism, and Children with Mental Retardation
Authors: Weiss Mary Jane
Published: November 2003

This study assessed the effects of social support and hardiness on the level of stress in mothers of typical children and children with developmental disabilities. One hundred and twenty mothers participated (40 mothers of children with autism, 40 mothers of children with mental retardation, and 40 mothers of typically developing children). Results indicated significant group differences in ratings of depression, anxiety, somatic complaints and burnout. Regression analyses were conducted to determine the best predictors of the dependent measures. Both hardiness and social support were predictive of successful adaptation. The relationships among hardiness, support and coping are discussed.
Parent Information and Direct Observation in the Diagnosis of Pervasive and Specific Developmental Disorders
Authors: Noterdaeme Michele , Mildenberger Katrin , Sitter Stefan , Amorosa Hedwig
Published: November 2003

Children with autism and children with a severe specific receptive language disorder show clear deficits in communicative language skills and social relationships. In this study the usefulness of a standardized parent interview (ADI-R) and a standardized observation schedule (ADOS-G) for the differential diagnosis of these two groups was assessed. Eleven children with early infantile autism and 16 children with a specific receptive language disorder participated. The parent interview was conducted with all parents and the observation schedule was administered to all children. Ten out of 11 children with autism were correctly classified as having autism on the ADI-R and the ADOS-G. One child with a receptive language disorder was falsely classified as having autism on the ADI-R, and none on the ADOS-G. Parent interview provides extensive information on the developmental course of the child. Direct observation gives an overview of actual relevant behavioural problems. The two instruments are complementary in the diagnosis of developmental disorders.