Autism

We hypothesized that the difficulties of the child with autism originate from disorders of organization and regulation of actions according to environmental changes. Autism impoverishes general mental representation skills, which are the basis of symbolic play and the development of communication. Twenty-one children with autism were compared with 14 children with global intellectual impairment and 15 matched typically developing children, on both regulation of play activities and communication development. Regulation of play was very disordered in children with autism, with breaking off, dissociation and instability of actions. However, in directed play their actions were more structured and corresponded to a better developmental level. In addition, dysregulation was associated with delayed, heterogeneous development of communication skills. The results of this study are in line with our hypotheses and emphasize the role of symbolic play in differential diagnosis and the value of therapies based on regulation processes and symbolic play.

The Questionnaire on Resources and Stress (Friedrich, short form: QRS-F) has been used widely with parents of children with disabilities. However, its psychometric properties in parents of young children with autism have not been established. Here, 174 mothers and 43 fathers of children under 6 years with autism spectrum disorder were studied by two independent research teams. Each parent completed a 31-item version of the QRS-F. Factor analysis of the mothers’ scores on these items failed to identify an expected two- or three-factor structure. Thus, the properties of a total stress score were explored. Analyses revealed evidence of good reliability, and expected associations with social support, coping and autism severity. These analyses lend preliminary support to the convergent validity of the scale. Overall, the data support the use of a total stress score from the 31-item version of the QRS-F in research with parents of young children with autism.

Previous trials of secretin for the treatment of autism have utilized a single or double dose administered intravenously. This is a report of a double-blind, randomized, controlled crossover trial of transdermally applied secretin in 15 children diagnosed with autism or pervasive developmental delay. Secretin or placebo was applied daily, in ointment form, to the backs of the children in randomized, successive 4 week periods with an intermediate 6 week washout period. Behavioral outcomes were measured by parents and teachers using the Autism Treatment Evaluation Checklist. Overall, there were no statistically significant differences in speech, sociability, sensory, and health scores for treatment versus placebo periods. In addition, there were no differences in such scores for children with a history of diarrhea. Severity of autism was significantly greater at baseline in children receiving concomitant medications. Improvement in speech was found during the treatment phase of the trial (p = 0.0479 for secretin versus placebo) only in children not using other medications.

Few studies have compared sexual behaviours among adolescents with high-functioning autism (HFA) and typical populations, and indicated whether specialized education is required. We hypothesized that adolescents with HFA would (1) display poorer social behaviours; (2) engage in fewer behaviours related to privacy and have poorer knowledge regarding privacy issues; (3) have less sex education; and (4) display more inappropriate sexual behaviours; and that (5) parental concerns would be greater for the HFA sample. Parents of typical adolescents (n = 50) and adolescents with HFA (n = 23) were surveyed with a Sexual Behaviour Scale (SBS) developed by the authors, with domains corresponding to the hypotheses. The HFA and typical groups were found to be significantly different on all five domains. However, following covariation with age and level of social behaviour, it was found that only parental concerns about their child distinguished between typical adolescents and those with HFA. Specialized sex education programmes with a social interaction emphasis should be considered for this group.

Excess or deficiency of natural trace elements has been implicated in the etiology of autism. This study explores whether concentration levels of toxic metals in the hair of children with autism significantly differ from those of age- and sex-matched healthy controls. In-hair concentration levels of antimony, uranium, arsenic, beryllium, mercury, cadmium, lead and aluminum from 40 boys with autism and 40 healthy boys were determined by Perkin-Elmer mass spectrometry. The children with autism had significantly (p < 0.001) higher in-hair concentration levels of lead, mercury and uranium. There was no significant difference between the two groups in the other five toxic elements. The ratio between nutritional elements and toxic metals among children with autism was within the normal range. The possible sources of the toxic metals are discussed. Such testing is informative but at present the practical implications in terms of diagnosis and clinical management are limited.

Thirty-three websites self-published on the Internet by parents of children with autism were examined using grounded theory. The process that the parents underwent closely follows an outline drawn by Catford and Ray to describe the hero’s development. Following diagnosis, parents of children with autism underwent a period of readjustment after which each of the parents described in the study prepared himself or herself for action. In the aftermath, the parents viewed themselves and their offspring in a positive light. At the close of the life narrative, all said they had come to terms with their child’s present circumstances and were prepared to help other parents in coping with their children. Our study suggests that the Internet allows stressed parents of children with autism to forge ties among themselves and extricate themselves from their isolation.

Children with autism were compared with control groups on their ability to make moral judgements. Participants were presented with pairs of vignettes in which actions were either deliberate or accidental and caused injury to a person or damage to property. Participants were asked to judge which protagonist was the naughtier and to verbally justify this judgement. Results showed that the children with autism were as likely as controls to judge culpability on the basis of motive, and to judge injury to persons as more culpable than damage to property. Children with autism also offered some appropriate verbal justifications for their judgments although most justifications were of poor quality and reiterated the story. Results are discussed in terms of theory of mind and the possible role of deficits in complex reasoning and executive functions.