Frances Tustin's classic text _Autistic States in Children_ put forward convincing clinical evidence that some forms of childhood autism are psychogenic and respond to methods of treatment very different from the behavioural techniques often adopted without success. Her pioneering work with such children has gained ground since the book was first published and she herself has revised her understanding of the aetiology of psychogenic autism. This revised edition of the book incorporates her new thinking based on recent (...) infant observational studies and her own clinical experience. (shrink)

Interactive robots are used increasingly not only in entertainment and service robotics, but also in rehabilitation, therapy and education. The work presented in this paper is part of the Aurora project, rooted in assistive technology and robot-human interaction research. Our primary aim is to study if robots can potentially be used as therapeutically or educationally useful ‘toys’. In this paper we outline the aims of the project that this study belongs to, as well as the specific qualitative contextual perspective that (...) is being used. We then provide an in-depth evaluation, in part using Conversation Analysis, of segments of trials where three children with autism interacted with a robot as well as an adult. We focus our analysis primarily on joint attention which plays a fundamental role in human development and social understanding. Joint attention skills of children with autism have been studied extensively in autism research and therefore this behaviour provides a relevant focus for our study. In the setting used, joint attention emerges from natural and spontaneous interactions between a child and an adult. We present the data in the form of transcripts and photo stills. The examples were selected from extensive video footage for illustrative purposes, i.e. demonstrating how children with autism can respond to the changing behaviour of their co-participant, i.e. the experimenter. Furthermore, our data shows that the robot provides a salient object, or mediator for joint attention. The paper concludes with a discussion of implications of this work in the context of further studies with robots and children with autism within the Aurora project, as well as the potential contribution of robots to research into the nature of autism. (shrink)

Theory of Mind (ToM) is one of the most relevant concepts in the field of social cognition, particularly in the case of Autism Spectrum Disorders (ASD). Literature showing that individuals with ASD display deficits in ToM is extensive and robust. However, some related issues deserve more research: the heterogeneous profile of ToM abilities in children with ASD and the association between different levels of ToM development and social, pragmatic, and adaptive behaviors in everyday life. The first objective of (...) this study was to identify profiles of children with ASD without intellectual disability (ID), based on explicit and applied ToM knowledge, and compare these profiles with a group of children with typical development (TD). A second objective was to determine differences in symptom severity, adaptive/social behavior, and pragmatic abilities between the profiles identified. Fifty-two children with a clinical diagnosis of ASD without ID and 37 children with TD performed neuropsychological ToM tasks and two vocabulary and memory tests. In addition, all of their mothers completed different questionnaires about applied ToM abilities, severity of ASD symptoms, adaptive/social skills, and pragmatic competence. Two subgroups were identified in the cluster analysis carried out with explicit and applied ToM indicators. The “Lower ToM abilities” profile obtained significantly lower scores than the “Higher ToM abilities” profile on all the ToM measures. Furthermore, the analysis of covariance, controlling for vocabulary and working memory (ANCOVAs), showed statistically significant differences in applied ToM abilities between the two groups of children with ASD without ID and the group with TD. However, only the group with “Higher ToM abilities” achieved similar performance to the TD group on the verbal task of explicit ToM knowledge. Finally, the “Lower ToM abilities” cluster obtained significantly higher scores on autism symptoms (social and communication domains) and lower scores on adaptive behavior and pragmatic skills than the cluster with “Higher ToM abilities”. Taken together, these findings have implications for understanding the heterogeneity in ToM skills in children with ASD without ID, and their differential impact on social, communicative, and adaptive behaviors. (shrink)

Restricted and repetitive behavior is a core symptom of autism spectrum disorder characterized by features of restrictedness, repetition, rigidity, and invariance. Few studies have investigated how restrictedness is manifested in motor behavior. This study aimed to address this question by instructing participants to perform the utmost complex movement. Twenty children with ASD and 23 children with typical development performed one-dimensional, left-right arm oscillations by demonstrating varying amplitudes and frequencies. The entropy of amplitude and velocity was calculated as (...) an index of kinematic complexity. Results showed that the velocity entropy, but not the amplitude entropy, was significantly lower in ASD than in TD, suggesting restricted kinematics. Further analysis demonstrated that a significantly higher proportion of the velocity values was allocated at a low-speed level in the children with ASD. A qualitative comparison of the complex movement with movement at preferred frequency suggested that the children with ASD might be less likely to shift away from the preferred movement. However, our study can be improved in terms of recruiting a larger sample of participants, measuring the level of motivation, and collecting both complex and preferred movements of the same participant. (shrink)

There is controversy as to whether children with developmental language disorder (DLD) and those with high-functioning autism plus language impairment (HFA-LI) share similar language profiles. This study investigated the similarities and differences in the production of Chinese negative sentences by children with DLD and children with HFA-LI to provide evidence relevant to this controversy. The results reflect a general resemblance between the two groups in their lower-than-TDA (typically developing age-matched) performance. Both groups encountered difficulties in using (...) negative markers, which suggests that they might be impaired in feature agreement. Slight differences were detected between the two groups. Specifically, children with DLD experienced difficulties with the agreement on the feature [+telic] and that on the feature [+dynamic], while children with HFA-LI had difficulties with the agreement on the feature [+dynamic] and that on the feature [−dynamic]. This study supports the idea of a common symptomatology for the two disorders. More importantly, it suggests that these two disorders, DLD and HFA-LI, are not altogether the same in terms of language impairment. This paper concludes that general labels should not be simply attached to any children with language disorders. Instead, atypical language is very worthy of further analysis in the categorization of language disorders. (shrink)

Children and adults with autism do worse on tests of inferences than controls. This fact has been attributed to poor language skills, a tendency to focus on detail, and poor social understanding. This study examines whether children with autism with age-appropriate language and cognitive skills have difficulties drawing inferences from academic, expository texts. Sixteen children with autism and a control group of twenty-four children were matched on language skills, nonverbal cognitive ability, and auditory (...) and nonverbal working memory and compared on their responses to questions that require inferences. The children with autism scored significantly lower on inference questions than the controls. Although language skills explain much of the variance in inference scores, diagnostic background also made a contribution. The results are discussed in the light of theories of suppression of irrelevant information and recognition of text writers’ communicative intention. (shrink)

Processing and recognizing facial expressions are key factors in human social interaction. Past research suggests that individuals with autism spectrum disorder present difficulties to decode facial expressions. Those difficulties are notably attributed to altered strategies in the visual scanning of expressive faces. Numerous studies have demonstrated the multiple benefits of exposure to pet dogs and service dogs on the interaction skills and psychosocial development of children with ASD. However, no study has investigated if those benefits also extend to (...) the processing of facial expressions. The aim of this study was to investigate if having a service dog had an influence on facial expression processing skills of children with ASD. Two groups of 15 children with ASD, with and without a service dog, were compared using a facial expression recognition computer task while their ocular movements were measured using an eye-tracker. While the two groups did not differ in their accuracy and reaction time, results highlighted that children with ASD owning a service dog directed less attention toward areas that were not relevant to facial expression processing. They also displayed a more differentiated scanning of relevant facial features according to the displayed emotion. Results from the present study suggest that having a service dog and interacting with it on a daily basis may promote the development of specific visual exploration strategies for the processing of human faces. (shrink)

There is emerging evidence to demonstrate the efficacy of music based interventions for improving social functioning in children with Autism Spectrum Disorders (ASD). While this evidence lends some support in favour of using song over spoken directives in facilitating engagement and receptive intervention in ASD, there has been little research that has investigated the efficacy of such stimuli on socio-communicative responsiveness measures. Here, we present preliminary results from a pilot study which tested whether sung instruction, as compared to (...) spoken directives, could elicit greater number of socio-communicative behaviours in young children with ASD. Using an adapted single-subject design, three children between the ages of 3 and 4 years, participated in a programme consisting of 18 sessions, of which 9 were delivered with spoken directives and 9 with sung. Sessions were counterbalanced and randomized for three play activities - block matching, picture matching and clay play. All sessions were video-recorded for post-hoc observational coding of three behavioural metrics which included performance, frequency of social gesture and eye contact. Analysis of the videos by two independent raters indicated increased socio-communicative responsiveness in terms of frequency of social gesture as well as eye contact during sung compared to spoken conditions across all participants. Our findings suggest that sung directives may play a useful role in engaging children with ASD and also serve as an effective interventional medium to enhance socio-communicative responsiveness. (shrink)

This study analyzed the relation between mental time travel (MTT) and the ability to produce a storytelling focusing on global coherence, which is one of the most notable characteristics of narrative discourse. As global coherence is strictly tied to the temporal sequence of the events narrated in a story, we hypothesized that the construction of coherent narratives would rely on the ability to mentally navigate in time. To test such a hypothesis, we investigated the relation between one component of MTT—namely, (...) episodic future thinking (EFT)—and narrative production skills by comparing the narratives uttered by 66 children with high-functioning autism spectrum disorder (ASD) with those produced by 66 children with typical development. EFT was assessed by administering a task with minimal narrative demands, whereas storytelling production skills were assessed by administering two narrative production tasks that required children to generate future or past episodes with respect to the target stimuli. The results showed that EFT skills were impaired only in a subgroup of children with ASD and that such subgroup performed significantly worse on the narrative production task than ASD participants with high EFT skills and participants with typical development. The practical and theoretical implications of these findings are discussed. (shrink)

We provide support from attachment research to the argument that children with autism only appear to lack social motivation. This research has shown that the attachment system of children with autism is intact, and one-half form secure attachments. This is illustrated with an observation of a young child with autism during a separation and reunion observation with his mother.

Eye-tracking studies have revealed a specific visual exploration style characterizing individuals with Autism Spectrum Disorder (ASD). The aim of this study is to investigate the impact of stimulus type (static vs. dynamic) on visual exploration in children with ASD. Twenty-eight children with ASD, 28 children matched for developmental communication age and 28 children matched for chronological age watched a video and a series of photos involving the same joint attention scene. For each stimulus, Areas of (...) Interest (AOI) were determined based on Voronoi diagrams, which were defined around participants’ fixation densities, defined by the mean shift algorithm. To analyze the eye-tracking data on visual exploration, we used a method for creat-ing AOI a posteriori, based on participants’ actual fixations. The results showed the value of both kinds of stimuli. The photos allowed for the identification of more precise AOI, and show similarities in exploration between ASD and typical children. On the other hand, in video, among ASD children only, there are few differences in the way they look at the target depend-ing on the deictic cue used. This raises questions regarding their understanding of a joint atten-tion bid recorded on a video. Finally, whatever the stimulus, pointing seems to be the most im-portant element for children to look at the target. (shrink)

Individuals with Autism spectrum disorders (ASD) have difficulties in the recollection of past experiences (Episodic Memory). Accumulating evidence suggests that they might have also difficulties in the ability to imagine potential future scenarios (Episodic Future Thinking, EFT) and in narrative generation skills. This investigation aimed to determine 1) whether impairments of EFT can be identified in a large cohort of children with high functioning ASD using a task with minimal narrative demands; and 2) if such impairments are related (...) to the ability to generate a narrative's scenario. 77 children with high-functioning ASD and 77 children with typical development were recruited for the study. The two groups were balanced for age, level of formal education, and IQ. EFT was assessed by administering a task with minimal narrative demands, whereas narrative generation skills were assessed with three tasks requiring children to generate past, middle or future episodes in a narrative discourse. With respect to control participants, a subgroup of children with ASD had impaired EFT skills and also showed significant impairments in the ability to generate adequate narratives. On the contrary, participants with spared EFT had normal performance on the narrative generation task. Interestingly, EFT skills predicted narrative generation abilities in both groups. The results of this study support the hypothesis that EFT may be impaired in some but not all children with ASD and of a relation between difficulties with EFT and impairments in the process of narrative generation. The assessment of EFT should employ tasks that do not require narrative production, as children with impaired EFT may also have reduced narrative skills. (shrink)

This study investigated the understanding of underinformative sentences like “Some elephants have trunks” by children with autism spectrum disorder (ASD). The scalar term ‘some’ can be interpreted pragmatically, ‘Not all elephants have trunks’, or logically, ‘Some and possibly all elephants have trunks’. Literature indicates that adults with ASD show no real difficulty in interpreting scalar implicatures, i.e., they often interpret them pragmatically, as controls do. This contrasts with the traditional claim of difficulties of people with ASD in other (...) pragmatic domains, and is more in line with the idea that pragmatic problems are not universal. The aim of this study was to: a) gain insight in the ability of children with ASD to derive scalar implicatures, and b) do this by assessing not only sensitivity to underinformativeness, but also different degrees of tolerance to violations of informativeness. We employed a classic statement-evaluation task, presenting optimal, logical false, and underinformative utterances. In Experiment 1, children had to express their judgment on a binary option ‘I agree’ vs ‘I disagree’. In Experiment 2, a ternary middle answer option ‘I agree a bit’ was also available. Sixty-six Flemish-speaking 10-year-old children were tested: 22 children with ASD, an IQ-matched group, and an age-matched group. In the binary judgment task, the ASD-group gave more pragmatic answers than the other groups, which was significant in the mixed effects logistic regression analysis, although not in the non-parametric analysis. In the ternary judgment task, the children with ASD showed a dichotomized attitude towards the speaker’s meaning, by tending to either fully agree or fully disagree with underinformative statements, in contrast with TD children, who preferred the middle option. Remarkably, the IQ-matched group exhibited the same pattern of results as the ASD group. Thanks to a fine-grained measure such as the ternary judgment task, this study highlighted a neglected aspect of the pragmatic profile of ASD, whose struggle with social communication seems to affect also the domain of informativeness. We discuss the implications of the dichotomized reaction towards violations of informativeness of these two groups in terms of the potential role of ASD and of cognitive and verbal abilities. (shrink)

The well-known impairments in the social use of eye-gaze by children with autism have been chiefly explored through experimental methods. The present study aims to contribute to the naturalistic analysis of social eye-gaze by applying Conversation Analysis to video recordings of three Finnish children with a diagnosis of autism, each interacting with familiar others in ordinary settings . The analysis identifies two interactional environments where some children with autism show eye-gaze related competence with respect (...) to gazing at their co-participants: these are when the child carries out an initiating action or a responsive action . We discuss how this qualitative analysis of interactional structure could be extended using quantitative methods and eye-tracking technology in order to develop a better understanding of the disorder. Keywords: Autism; eye-gaze; conversation analysis; social interaction; interactional competence. (shrink)

The well-known impairments in the social use of eye-gaze by children with autism have been chiefly explored through experimental methods. The present study aims to contribute to the naturalistic analysis of social eye-gaze by applying Conversation Analysis to video recordings of three Finnish children with a diagnosis of autism, each interacting with familiar others in ordinary settings. The analysis identifies two interactional environments where some children with autism show eye-gaze related competence with respect to (...) gazing at their co-participants: these are when the child carries out an initiating action or a responsive action. We discuss how this qualitative analysis of interactional structure could be extended using quantitative methods and eye-tracking technology in order to develop a better understanding of the disorder. Keywords: Autism; eye-gaze; conversation analysis; social interaction; interactional competence. (shrink)

This article examines three films made during the 1950s by Elwyn James Anthony at the psychotic clinic for children at the Maudsley Hospital that marked an important transition in the purpose and practice of visual documentation in a clinical setting: film as a research tool was transitioning from the recording of external signs as indicators of internal subjective states, to the capture of the visual flow of communication between subjects. It is a shift that had a particular impact on (...) the emergent classification of autism, a modality not yet properly separated from the broader term of psychosis, as a non-relational condition whose visual capture demonstrated a void of inter-human communicational exchange. Film was significant not only as a recording apparatus, but as a method of cutting and crafting sequences of movements into brief repetitive motifs. The filmed behaviour of children remained opaque to interpretation, a ‘finding’ that facilitated the modelling of an emergent autism as subjects who were isolated, alienated and automaton-like, inhabiting a separate temporality. The article situates this ‘second’, affectless autism, within a broader context of post-war research into gestures as a language of the body, developed largely through an intellectual network of German émigré psychoanalysts who had fled to the US and UK in the 1930s. (shrink)

This study explored spatial navigation alongside several other cognitive abilities that are thought to share common underlying neurocognitive mechanisms (e.g., the capacity for self-projection, scene construction, or mental simulation), and which we hypothesised may be impaired in autism spectrum disorder (ASD). Twenty intellectually high-functioning children with ASD (with a mean age of ~8 years) were compared to 20 sex, age, IQ, and language ability matched typically developing children on a series of tasks to assess spatial navigation, episodic (...) memory, episodic future thinking (also known as episodic foresight or prospection), theory of mind, relational memory, and central coherence. This is the first study to explore these abilities concurrently within the same sample. Spatial navigation was assessed using the “memory island” task, which involves finding objects within a realistic, computer simulated, three-dimensional environment. Episodic memory and episodic future thinking were assessed using a past and future event description task. Theory of mind was assessed using the “animations” task, in which children were asked to describe the interactions between two animated triangles. Relational memory was assessed using a recognition task involving memory for items (line drawings), patterned backgrounds, or combinations of items and backgrounds. Central coherence was assessed by exploring differences in performance across segmented and unsegmented versions of block design. Children with ASD were found to show impairments in spatial navigation, episodic memory, episodic future thinking, and central coherence, but not theory of mind or relational memory. Among children with ASD, spatial navigation was found to be significantly negatively related to number of repetitive behaviours. In other words, children who showed more repetitive behaviours showed poorer spatial navigation. The theoretical and practical implications of the results are discussed. (shrink)

Sensory processing problems and related dysfunctions are among the most common conditions in children with autism spectrum disorder. This study examined the effect of sensory integration therapy on different aspects of occupational performance in children with ASD. The study was conducted on an intervention group receiving SIT and a control group with 3- to 8-year-old children with ASD. The Short Child Occupational Profile was used to compare the two groups in terms of the changes in their (...) occupational performance and the Sensory Profile was used to assess sensory problems. The intervention group showed significantly greater improvement in all the SCOPE domains, as well as in all the SP domains, except for the “emotional reactions” and “emotional/social responses” domains,. The effectiveness of SIT in improving occupational performance in children with ASD as a health-related factor is supported by our findings. (shrink)

Introduction: There is significant overlap in the type of structural language impairments exhibited by children with autism spectrum disorder and children with attention deficit hyperactivity disorder. This similarity suggests that the cognitive impairment contributing to the structural language deficits in ASD and ADHD may be shared. Previous studies have speculated that procedural memory deficits may be the shared cognitive impairment. The procedural deficit hypothesis argues that language deficits can be explained by differences in the neural structures underlying (...) the procedural memory network. This hypothesis is based on the premise that the neural structures comprising the procedural network support language learning. In this study, we aimed to test the PDH in children with ASD, ADHD, and typical development.Methods: One hundred and sixty-three participants : 91 with ASD, 26 with ADHD, and 46 with TD, completed standardized measures of cognitive and language ability as well as structural magnetic resonance imaging. We compared the structural language abilities, the neural structures underlying the procedural memory network, and the relationship between structural language and neural structure across diagnostic groups.Results: Our analyses revealed that while the structural language abilities differed across ASD, ADHD, and TD groups, the thickness, area, and volume of the structures supporting the procedural memory network were not significantly different between diagnostic groups. Also, several neural structures were associated with structural language abilities across diagnostic groups. Only two of these structures, the inferior frontal gyrus, and the left superior parietal gyrus, are known to be linked to the procedural memory network.Conclusions: The inferior frontal gyrus and the left superior parietal gyrus, have well-established roles in language learning independent of their role as part of the procedural memory system. Other structures such as the caudate and cerebellum, with critical roles in the procedural memory network, were not associated with structural language abilities across diagnostic groups. It is unclear whether the procedural memory network plays a fundamental role in language learning in ASD, ADHD, and TD. (shrink)