Autism prevalence continues to grow, yet a universally agreed upon etiology is lacking despite manifold evidence of abnormalities especially in terms of genetics and epigenetics. The authors ...postulate that the broad definition of an omnibus 'spectrum disorder' may inhibit delineation of meaningful clinical correlations. This paper presents evidence that an objectively defined, EEG based brain measure may be helpful in illuminating the autism spectrum versus subgroups (clusters) question.
Forty objectively defined EEG coherence factors created in prior studies demonstrated reliable separation of neuro-typical controls from subjects with autism, and reliable separation of subjects with Asperger's syndrome from all other subjects within the autism spectrum and from neurotypical controls. In the current study, these forty previously defined EEG coherence factors were used prospectively within a large (N = 430) population of subjects with autism in order to determine quantitatively the potential existence of separate clusters within this population.
By use of a recently published software package, NbClust, the current investigation determined that the 40 EEG coherence factors reliably identified two distinct clusters within the larger population of subjects with autism. These two clusters demonstrated highly significant differences. Of interest, many more subjects with Asperger's syndrome fell into one rather than the other cluster.
EEG coherence factors provide evidence of two highly significant separate clusters within the subject population with autism. The establishment of a unitary "Autism Spectrum Disorder" does a disservice to patients and clinicians, hinders much needed scientific exploration, and likely leads to less than optimal educational and/or interventional efforts.
Coming Out Asperger explores the complexity of diagnosis for Asperger Syndrome, the drawbacks and benefits of disclosing a diagnosis of a 'hidden disability,' and how this impinges on self-esteem. ...The contributors include some of the best-known and most exciting writers in the field of Asperger Syndrome (AS) today, and include individuals on the autism spectrum, parents and professionals. The broad range of the chapters, which draw on anecdotal, professional and research-based evidence, make this book a comprehensive and highly original consideration of the implications of an AS diagnosis. The ever-difficult question of who to tell and when once a diagnosis has been confirmed is discussed in great depth. Liane Holliday Willey and Stephen Shore examine the dynamics of disclosure, its risks and the possible effect on self- confidence. Jacqui Jackson looks at how a diagnosis impacts upon family life. Tony Attwood provides a clinician's view of diagnosing adults, and Lynne Moxon, Wendy Lawson, Dora Georgiou and Jane Meyerding discuss adult issues surrounding disclosure, including how to deal with relationships and sexuality, and disclosure in the workplace, as well as social and disability issues. A unique and fascinating insight into the important issue of diagnosis disclosure, this book is an essential guide for people with AS, parents, teachers, professionals and all those who have ever felt confused about revealing a personal issue.
Autism Spectrum Disorder (ASD) refers to a group of neurodevelopmental disorders including autism, Asperger's syndrome (AS) and pervasive developmental disorder-not otherwise specified (PDD-NOS). The ...new diagnostic criteria of ASD focuses on two core domains: social communication impairment and restricted interests/repetitive behaviors. The prevalence of ASD has been steadily increasing over the past two decades, with current estimates reaching up to 1 in 36 children. Hereditary factors, parental history of psychiatric disorders, pre-term births, and fetal exposure to psychotropic drugs or insecticides have all been linked to higher risk of ASD. Several scales such as the Childhood Autism Rating Scale (CARS), The Autism Spectrum Disorder–Observation for Children (ASD-OC), The Developmental, Dimensional, and Diagnostic Interview (3di), are available to aid in better assessing the behaviors and symptoms associated with ASD. Nearly 75% of ASD patients suffer from comorbid psychiatric illnesses or conditions, which may include attention-deficit hyperactivity disorder (ADHD), anxiety, bipolar disorder, depression, Tourette syndrome, and others. Both pharmacological and non-pharmacological interventions are available for ASD. Pharmacological treatments include psychostimulants, atypical antipsychotics, antidepressants, and alpha-2 adrenergic receptor agonists. These medications provide partial symptomatic relief of core symptoms of ASD or manage the symptoms of comorbid conditions. Non-pharmacological interventions, which show promising evidence in improving social interaction and verbal communication of ASD patients, include music therapy, cognitive behavioral therapy and social behavioral therapy. Hormonal therapies with oxytocyin or vasopressin receptor antagonists have also shown some promise in improving core ASD symptoms. The use of vitamins, herbal remedies and nutritional supplements in conjunction with pharmacological and behavioral treatment appear to have some effect in symptomatic improvement in ASD, though additional studies are needed to confirm these benefits. Developing novel disease-modifying therapies may prove to be the ultimate intervention for sustained improvement of symptoms in ASD.
In Open Book in Ways of Water, poet and artist Adam Wolfond explores the synaesthetic quality of autistic perception, the way in which water in its different materializations shapes and channels ...language. Building on notions such as “wetness,” “streams,” and “currents,” Wolfond constructs a linguistic universe in which writing and perception merge, move, and “pace to gether” – echoing both the togetherness of the senses and the gathering rhythms of water. Open Book in Ways of Water is as much a book of poetry and a book about poetry, a self-reflection in an endlessly moving and transforming element. As the author himself explains: Language is a way to understand each other but it is also reductive in the ways that it is abstracted and non-sensuous, and open writing as movement tends to be ignored as autistics are forced into neurotypical ways of seeing, and the thinking around artistic practices feels of a pace that intensifies the use of forms forming, and similarities with open processes are languaging the way of water, making language about artful relations with the more than human. Water is a game of ways and patterns that wave and ripple and can pull us under, the talk is about surfacing but languaging is about feeling, moving the ways that it makes are having variances moving the thresholds in thinking feeling of a rally that comes from cutting the grammars out and that is the way of perception that is cut by grammar and people need art to dance this dance of relation. A man of autism answers the ways of the body much of the time and that means my body rallies the artful atmospheres that are dancing me and the real feeling can dance the atmospheres as my body presence and pace shifts other bodies to be free. Having a ticcing body is making the dance about disorder but really it is about a different and diverse way of languaging with many feelings and bathing and immersing and I don’t have any other way.
Background: Motor impairment in children with Asperger Syndrome (AS) or High functioning autism (HFA) has been reported previously. This study presents results of a quantitative assessment of ...neuromotor skills in 14-22 year old HFA/AS. Methods: 16 HFA/AS and 16 IQ-matched controls were assessed by the Zurich Neuromotor Assessment (ZNA). Results: The HFA/AS group showed strongest impairments of dynamic balance skills and diadochokinesis. Motor abilities were associated with degree of social withdrawal in the full sample and severity of current autistic symptoms in the HFA/AS group. Conclusion: Similar motor patterns as in younger children were found in the older adolescents. The association of autistic symptoms with motor performance points towards an essential role of motor impairment in autism spectrum disorders.
One day, according to the Ancient Greek author Xenophon, the hero Hercules “went out to a quiet place and sat, pondering”. This book explores what happened here and how and why it can resonate with ...autistic young people. The book presents a set of ten lessons, each dealing with an aspect of what happened when Hercules entered the quiet place, met two women (or goddesses, or personifications…) and was tasked to make a choice between two paths, literal and metaphorical. The lessons deal, too, with particular dimensions of autism, including: communicating, emotions, decision-making, sensory experiences, planning and interests. This pathbreaking book should be of particular interest to professionals and practitioners looking to utilize the appeal of mythology in their work with autistic children and academics in areas such as education, Classics and literature interested in the experiential application of their subject.
To provide the first longitudinal characterization of mood and psychosocial functioning in youth with comorbid bipolar (BD) and autism spectrum (ASD) disorders.
The Course and Outcome of Bipolar ...Youth study followed 368 youth (aged 7-17 years) with DSM-IV bipolar I (BP-I), BP-II, or Not Otherwise Specified (NOS) for, on average, 9 years using the Longitudinal Interval Follow-up Evaluation. This subgroup analysis compared youth with and without ASD on clinical presentation, percentage of time with mood symptomatology, and psychosocial functioning.
Thirty youth (∼8%) met DSM-IV criteria for Asperger's disorder or pervasive developmental disorder-NOS (referred to here as ASD). Lifetime worst episode severity was similar in both groups, but youth with both BD and ASD (BD+ASD) had elevated rates of comorbid attention-deficit/hyperactivity and obsessive-compulsive disorders, were younger at intake, and had an earlier onset of mood symptoms. Over time, in both groups, the proportion of predominantly euthymic youth increased, and episode recurrence decreased. Compared to youth with BD, the clinical presentation of youth with BD+ASD more frequently involved distractibility, racing thoughts, depressed mood, social withdrawal, and low reactivity of negative mood states. ASD-related symptomatic differences were generally strongest early and decreased over time. Youth with BD+ASD had significantly greater impairment in friendships throughout follow-up.
Youth with BD+ASD exhibit typical BD mood symptoms but with earlier onset, mixed symptom presentation, and additive functional impairments. Significant amelioration of clinical symptoms occurred over time, suggesting that early recognition and treatment of mood disorders in youth with ASD may improve clinical outcomes.
Purpose: The aim of this study was to investigate the driving performance of drivers with autism spectrum disorders under complex driving conditions.
Method: Seventeen drivers with autism spectrum ...disorders and 18 typically developed drivers participated in a driving simulator trial. Prior to the assessment, participants completed the Driving Behaviour Questionnaire and measurements of cognitive and visual-motor ability. The driving simulation involved driving in an urban area with dense traffic and unpredictable events.
Results: In comparison with the typically developed group, drivers with autism spectrum disorders reported significantly more lapses in driving, committed more mistakes on the driving simulator, and were slower to react in challenging situations, such as driving through intersections with abrupt changes in traffic lights. However, they were also less likely to tailgate other vehicles, as measured by time-to-collision between vehicles, on the driving simulator.
Conclusions: The performances of licensed drivers with autism spectrum disorders appeared to be safer in respect to car-following distance but were poorer in their response to challenging traffic situations. Driver education for individuals with autism spectrum disorders should focus on quick identification of hazards, prompt execution of responses, and effective allocation of attention to reduce lapses in driving.
Implications for rehabilitation
Drivers with autism spectrum disorders reported significantly more lapses during driving.
Drivers with autism spectrum disorders were observed to be poorer in traffic scenarios requiring critical response.
Driver education for individuals with autism spectrum disorders should focus on managing anxiety and effective attention allocation while driving.
Driving simulators can be used as a safe means for training critical response to challenging traffic scenarios.
`The ideas are excellent and well laid out… This is an innovative approach to social skills training for students with Asperger's Syndrome who will tolerate acting, and for a group leader with energy ...and commitment to drama.' -Speech and Language Therapy in Practice `Schneider's enthusiasm for the subject and her passion to improve life skills of young people is very evident and encourages the reader to progress…As a catalogue of practical ideas with built-in resources, this is a useful book for support groups and families wishing to create a theatre group. Acting Antics has an easy-to-read format and includes activities that can be initiated with minimum preparation and resources.' -Children Now Magazine, 2007 This fun and inspiring step-by-step program provides the full set of tools for developing social understanding in children with Asperger Syndrome (AS) through drama. Cindy B. Schneider explains how the central processes in acting - including making and interpreting inferences from non-verbal cues, taking another's perspective, and formulating language - can be highly effective ways of addressing social cognition deficits in children with AS. Acting Antics contains a wide repertoire of activities and ideas for immediate application at home, in the classroom, in therapy workshops or social groups, ranging from initial warm up techniques, through paired activities, to larger group scenes and staging a show. Helpful appendices provide questionnaire forms to enable both the child and the program leader to assess and monitor the child's understanding of their roles, along with reproducible scripts and suitable scene designs. This complete, practical program provides a wealth of enjoyable educational ideas for parents, teachers, and therapists of children with Asperger Syndrome.
Autistic spectrum disorder (ASD) is characterized by stereotyped/obsessional behaviours and social and communicative deficits. However, there is significant variability in the clinical phenotype; for ...example, people with autism exhibit language delay whereas those with Asperger syndrome do not. It remains unclear whether localized differences in brain anatomy are associated with variation in the clinical phenotype.
We used voxel-based morphometry (VBM) to investigate brain anatomy in adults with ASD. We included 65 adults diagnosed with ASD (39 with Asperger syndrome and 26 with autism) and 33 controls who did not differ significantly in age or gender.
VBM revealed that subjects with ASD had a significant reduction in grey-matter volume of medial temporal, fusiform and cerebellar regions, and in white matter of the brainstem and cerebellar regions. Furthermore, within the subjects with ASD, brain anatomy varied with clinical phenotype. Those with autism demonstrated an increase in grey matter in frontal and temporal lobe regions that was not present in those with Asperger syndrome.
Adults with ASD have significant differences from controls in the anatomy of brain regions implicated in behaviours characterizing the disorder, and this differs according to clinical subtype.
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