In this submission, five articles are presented examining one theme: diagnosis of autism spectrum disorders (ASD) in children. Three articles provides perspectives on various social and medical factors that influence the diagnosis of ASD, and the others examine social and behavioural outcomes for children diagnosed with ASD. One article provides an in depth examination of the dilemmas of diagnosis from a parental perspective. The research utilized both qualitative and quantitative methods. A secondary analysis of a longitudinal birth cohort study revealed that there were a number of children who had autistic traits equally severe as those with clinical diagnosis. Further analysis exposed a possible gender bias in diagnosis. Outcomes for children with ASD diagnoses were worse than for those without diagnoses but with comparable behaviours as preschoolers. ASD diagnosis apparently had no positive effect on the developmental trajectory of prosocial behaviour. The implications of these results are discussed. Analysis of qualitative data collected in semi-structured interviews with parents of both diagnosed and undiagnosed children exposed dilemmas faced by parents as they contemplated an ASD diagnosis and highlighted parental action to de-stigmatise the condition after diagnosis had been applied. The body of work as a whole falls at the junction of clinical and educational psychology, developmental psychology, social psychology, social psychiatry, sociology and epidemiology. It draws attention to a number of social processes that contribute to ASD diagnosis. Overall, it is argued, the work supports the conceptualisation of ASD as both a biologically and socially determined condition.

Infants with older siblings on the autism spectrum (ASD-sibs) are at risk for socio-emotional difficulties. ASD-sibs were compared to children of typically developing siblings (TD-sibs) in the Face-to-Face/Still-Face (FFSF) at 6 months and the Early Social Communication Scales (ESCS) at 8, 10, 12, 15, and 18 months. ASD-sibs exhibited non-significant trends to smile less and display more neutral affect than TD-sibs during the FFSF. There was a significant status by gender interaction such that male ASD-sibs showed less smiling and lower affective valence compared to male TD-sibs. Additionally, ASD-sibs showed a lack of emotional continuity in the FFSF. ASD-sibs displayed less initiating joint attention, initiating behavioral requesting, and responding to joint attention over time than TD-sibs. Results are discussed with respect to the social orienting model of autism.

Autism is a severe developmental disorder characterized by impairments in reciprocal social interaction and communication, coupled with repetitive stereotypic activities. Evidence from twin and family studies strongly suggest that genetic factors play a significant role in the etiology of autism. The factors involved in the development of autism are also thought to underlie related pervasive developmental disorders (PDD). The affected sib-pair method was used to screen nine autosomal candidate loci in 18 families, each of which have two or more children with autism or a related PDD. Candidate loci were selected on the basis that: (1) the locus is near genetic disorders or chromosomal abnormalities found to co-occur with autism; and/or (2) the gene encodes a protein which has been speculated to play a role in the pathophysiology of autism. Genotypes of the affected children and their parents were determined for the following microsatellite markers which are tightly linked to the candidate genes/regions: 13S118, DRD2, TH, HRAS-1, 22S343, D15S11, GABRB3, 16S291, and DBH. No significant concordance between affected siblings was observed for any of the loci tested. During the study, however, many of the families were found to be uninformative at the dopamine beta hydroxylase (DBH) microsatellite locus. A comparsion of DBH allele frequencies observed in the parents to published British values revealed a significant difference between the two groups (L2=13.16, df=5, p<0.05). Given this finding, and the knowledge that serum DBH activity is largely under the control of DNA sequences in or close to the DBH gene, serum DBH activities were measured in the parents and in an adult control group. Mean serum DBH activity was found to be significantly lower in parents with two autistic/PDD children compared to an adult control group (Student's t=-1.71, df=60, p<0.05). DBH alleles are defined by a polymorphic dinucleotide repeat and the presence or absence of a 19 bp sequence. Upon further analysis the frequency of alleles in which the 19 bp sequence is deleted was found to be significantly increased in the mothers with two autistic/PDD children, compared to both published frequencies (L2=11.99, df=1, p<0.001) and to a Canadian control group (L2=6.96, df=1, p<0.01). Subsequent investigation revealed that deletion of the 19 bp sequence is associated with lower mean serum DBH enzyme activity (nondeletion homozygotes 44.5±28.6 iu/L; heterozygotes 30.4±16.0 iu/L; and deletion homozygotes 20.5±15.3 iu/L; F=5.45, df=59, p<0.01). Based on these findings it is proposed that lowered maternal serum DBH activity provides a uterine environment which, in conjunction with genotypic susceptiblity of a fetus, results in autism or a related PDD. / Thesis / Master of Science (MS)

Este trabalho é resultado de uma pesquisa de cunho qualitativo, que teve como objetivos descrever os parâmetros que norteiam práticas em psicologia escolar frente às demandas relacionadas ao aluno com Transtornos Globais do Desenvolvimento. Apresenta a demanda, a compreensão desses transtornos dos pontos de vista médico e social, algumas possibilidades de atuação em psicologia e subsídios para a formação profissional. À luz de uma psicologia que se propõe crítica, discute-se a atuação de profissionais no trabalho junto a esses alunos, a escolas e equipes multidisciplinares. Ao final, discute um fazer do psicólogo, que espelha a diversidade, tanto da ciência psicológica, enquanto teorias e práticas, quanto da sociedade. Concluímos ser indispensável o trabalho do psicólogo nas escolas, porém nota-se a emergente necessidade de repensar as intervenções de modo que as mesmas possam contribuir coletivamente e efetivamente para a democratização do ensino e para a transformação social. / This work is the result of a qualitative research, which aimed to describe the parameters that guide the practice of school psychology to meet the demands related to the student with a Pervasive Developmental Disorder-PDD. Displays the demand, the understanding of disorders of the views medical and social, some possibilities of action in psychology, and subsidies for vocational training. In the light of a critical psychology that proposes, discuss the role of professionals in working with the student, school and multidisciplinary teams. At the end, making a show psychologist that reflects the diversity of both the psychological science as theories and practices, and the society. We concluded that the work of psychologists in schools is essential, but we can see the emerging need to rethink the interventions so that they can collectively and effectively contribute to the democratization of education and to social transformation

Even among the most high-functioning individuals with autism, there is a wide range of variation in outcome. This study examined within-child factors, such as temperament, that contribute to variation in social outcomes, the most salient area of deficit among individuals with high-functioning autism (HFA). Approach/withdrawal tendencies and effortful control were used to predict variation in symptoms and social skills. A unique multi-method approach employing self- and parent-report measures, physiological assessment, and social observation was used to determine whether temperament could be used to predict variation in social skills and symptom presentation. Results indicated that compared with an age- and gender-matched control group, the HFA group self-reported higher levels of negative affect and lower levels of surgency and were observed to exhibit higher levels of approach tendencies and lower levels of social skills. Across all participants, higher levels of effortful control were predictive of more adaptive social skills and higher levels of observed approach behavior were predictive of higher levels of anxiety. These results are discussed in relation to the variability in outcomes seen among individuals with autism and the implications for the development of interventions to enhance adaptive outcomes.

ABSTRACT THE EFFECTS OF PRIMING ON SPONTANEOUS VERBAL LANGUAGE IN CHILDREN WITH AUTISM SPECTRUM DISORDERS by Michelle L. Ivey A multi-element design was used to investigate the effect of priming on spontaneous verbal communication in children with Autism Spectrum Disorders (ASD). Three children with ASD engaged in 20-minute thematic activity sessions (ACT) with the investigator. Prior to the ACTs, they met with another trained researcher for 10-minute presessions. Half of the presessions incorporated the conventions of priming with materials to be used in the upcoming ACT (i.e., related presessions; RP). During the other half of the presessions, participants were not primed for the upcoming ACT (i.e., unrelated presesessions; UP). The researcher conducted presessions so the investigator was blind to the condition. Procedural fidelity checks of the presessions, based on a checklist of the critical components of priming, revealed 100% adherence to procedures. Participants’ utterances during ACT were recorded, transcribed, and coded based on functionality. The dependent variables were spontaneous comments, requests, topic initiations, social information seeking, and total. Once the criterion of a 30% increase from the mean of the first 3 UP was achieved for three consecutive sessions, priming was withdrawn and then reinstated to demonstrate a functional relation. Additionally, Cohen's d was calculated to determine effect size for the intervention. Reliability was assessed for transcription and coding. There were fewer than 10 word disagreements on any transcript, which did not affect coding. A line by line comparison of the coding across the dependent variables yielded an average reliability of 85%. Visual inspection of the data and statistical analysis revealed that two of the three participants reached criterion for spontaneous comments (Cohen's d = .32 and .95), one reached criterion for total utterances (Cohen's d = 2.99), the other achieved the goal during the reinstatement following the withdrawal (Cohen’s d = 1.00). None increased requesting. Topic initiation and social information seeking did not occur with sufficient frequency for meaningful analyses. Similar to most interventions with individuals with ASD, priming was effective for increasing spontaneous verbal comments for some but not all of the participants. Priming was highly effective for two of the participants. This ground-breaking study creates momentum for further investigation and examination of the variables that affect benefit.

Este trabalho é resultado de uma pesquisa de cunho qualitativo, que teve como objetivos descrever os parâmetros que norteiam práticas em psicologia escolar frente às demandas relacionadas ao aluno com Transtornos Globais do Desenvolvimento. Apresenta a demanda, a compreensão desses transtornos dos pontos de vista médico e social, algumas possibilidades de atuação em psicologia e subsídios para a formação profissional. À luz de uma psicologia que se propõe crítica, discute-se a atuação de profissionais no trabalho junto a esses alunos, a escolas e equipes multidisciplinares. Ao final, discute um fazer do psicólogo, que espelha a diversidade, tanto da ciência psicológica, enquanto teorias e práticas, quanto da sociedade. Concluímos ser indispensável o trabalho do psicólogo nas escolas, porém nota-se a emergente necessidade de repensar as intervenções de modo que as mesmas possam contribuir coletivamente e efetivamente para a democratização do ensino e para a transformação social. / This work is the result of a qualitative research, which aimed to describe the parameters that guide the practice of school psychology to meet the demands related to the student with a Pervasive Developmental Disorder-PDD. Displays the demand, the understanding of disorders of the views medical and social, some possibilities of action in psychology, and subsidies for vocational training. In the light of a critical psychology that proposes, discuss the role of professionals in working with the student, school and multidisciplinary teams. At the end, making a show psychologist that reflects the diversity of both the psychological science as theories and practices, and the society. We concluded that the work of psychologists in schools is essential, but we can see the emerging need to rethink the interventions so that they can collectively and effectively contribute to the democratization of education and to social transformation

Made available in DSpace on 2016-03-15T19:40:23Z (GMT). No. of bitstreams: 1 Rosane Lowenthal - DD2006.pdf: 382320 bytes, checksum: 6a6e97760e5bdab1aa3be863aa2c72ac (MD5) Previous issue date: 2006-09-12 / Universidade Federal de São Paulo / The literature has reported frequencies from 1% to 11% of pervasive developmental disorder (PDD) in Down s syndrome (DS). It is not clear, if the frequency of this co-occurrence is higher or lower than in other mental retardations. The aim of the study was to identify the comorbidity of autistic spectrum disorders in children and adolescents with DS from Curitiba Brasil. 205 parents of children and adolescents with DS, between 5 and 19 years-old were asked to complete the self-report Autism Screening Questionnaire (ASQ) and the family history questionnaire (provided by Prof. C. Gillberg). The frequency of PDD in the DS sample was 15.6%, with 5.58% of autism (8 males and 2 females) and 10.05% of PDD non autism (9 males and 9 females). This study showed a higher frequency of TID in SD, even though more studies are needed to answer if this frequency is higher than in other mental retardations. / Os trabalhos publicados na literatura mostram taxas de transtornos invasivos do desenvolvimento (TID) em pessoas com síndrome de Down (SD) entre 1 e 11%. Não está claro se a freqüência desta ocorrência é mais alta ou mais baixa que em outras deficiências intelectuais. O objetivo deste estudo é fazer um rastreamento de TID em crianças e adolescentes com SD que residem em Curitiba Brasil. 205 pais de crianças e adolescentes com SD, entre 5 e 19 anos, responderam o questionário para triagem de TID, Autism Screening Questionnaire (ASQ), e o questionário de histórico familiar (cedido pelo Dr. Gillberg). A freqüência de TID em SD encontrada neste trabalho foi de 15,6%, com 5,58% de autismo (8 meninos e 2 meninas) e 10,05% de TID sem autismo (9 meninos e 9 meninas). Esse trabalho encontrou uma alta freqüência de TID em SD, sendo necessários mais estudos para esclarecimento se essa freqüência é maior do que a encontrada em outras deficiências mentais.

This study examined the costs of pervasive developmental disorder (PDD) treatment in a large healthcare organization. When compared to individual therapy and mixed therapy, family therapy had significantly fewer sessions, fewer episodes of care, and better cost-effectiveness. Individual therapy had significantly shorter treatment length than mixed therapy. There were no differences in treatment length or number of episodes by license, but dropout and cost-effectiveness were significantly different. Medical doctors had the highest dropout and best cost-effectiveness, while Marriage and Family Therapists had the lowest dropout and Masters of Social Work had the poorest cost-effectiveness. Children had significantly higher dropout than other age groups. An autism diagnosis was associated with fewer sessions but additional episodes of care when compared to PDD. Having a comorbid diagnosis is associated with longer treatment length but slightly fewer episodes of care. A regression model to predict number of episodes of care by intensity of treatment, provider type, and modality, intensity of treatment explained only 6% of the variance.

This study aimed to explore the underlying basis of the communication difficulties in children (between 5.0 and 7.11 years) with high functioning pervasive developmental disorder (HFPDD) (n=26), compared to children with specific language impairment (SLI) (n=26), and children with no history of developmental difficulty (NDD) (n=26). The study looked at: whether different profiles could be obtained for the groups on comprehensive batteries of communication, cognitive processing and theory of mind; which areas measured were best correlated; and which measures best differentiated the groups. Comprehensive communication and theory of mind batteries were devised and conducted. Cognitive processing was measured using the Cognitive Assessment System (CAS) (Naglieri and Das, 1997). Data was analysed using descriptive statistics, analysis of variance, the Kruskal-Wallis test, Bonferroni t tests, frequency distributions, Pearson correlation coefficients and discriminant function analyses. Kappa coefficients and analysis of variance measures were carried out on 23% of the rated data in order to establish inter-rater agreement and acceptable levels of agreement were reached. On the communication assessment, the HFPDD group experienced the most difficulty on the measures of understanding abstract vocabulary, understanding conversation, pronoun alternation, higher level semantics, narrative ability and pragmatic ability. In contrast, the SLI group experienced the most difficulty on the measures of expressive grammar and narrative clarity. On the cognitive processing assessment, the HFPDD group experienced marked difficulty in the areas of planning and attention, while the SLI group experienced significant difficulty in the areas of successive processing and less marked but still significant difficulty in the area of planning. Within the HFPDD group, a group with simultaneous processing markedly stronger than successive processing, a group with successive processing markedly stronger than simultaneous processing, and a group with simultaneous and successive processing occurring at a similar level, were identified. The HFPDD group experienced significant difficulty on all the measures of theory of mind, although a limited number of HFPDD subjects did not experience difficulty. The SLI group experienced significant difficulty on the two theory of mind measures that were more verbally loaded. Strong correlations were found between receptive language, expressive semantics, narrative ability, pragmatic ability, planning, attention and theory of mind; and between expressive grammar and successive processing. Pragmatic ability, narrative ability, planning, and certain of the theory of mind measures best appeared to discriminate the groups. A combined model of language, cognitive and theory of mind processing is proposed to explain the differences between the HFPDD and SLI groups.