Children with Asperger syndrome

In 1994 Hans Asperger (1906-80), an Austrian physician, described a group of children with impaired social interaction and communication abilities. The name of this disorder today is Asperger's syndrome, and it is currently defined under the category of pervasive developmental disorder in DSM-IV and ICD-10. In this article the following aspects of Asperger's syndrome are focused on: personality, epidemiology, etiology, examination, differential diagnosis, management and prognosis. The article is based on a literature study. Asperger's syndrome seems to be considerably more common than "classic" autism. The syndrome is much more common in boys than in girls. The clinical characteristics of Asperger's syndrome are probably influenced by many factors, including organic and genetic factors. Asperger's syndrome is the term applied to the highest functioning end of the autism scale. There are several commonalities between Asperger's syndrome and autism, namely impairment of social interaction and communication abilities, and range of interests and activities. Differences exist primarily in the degree of impairment in language and cognitive development. Differential diagnosis, examination and management are discussed. There is a need for further research. It is important that the diagnostic criteria for Asperger's syndrome are as uniform as possible, and that they do not overlap with infantile autism.     

Diagnostic criteria of autism and Asperger's syndrome: similarities and differences

The American Psychiatric Association's last version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994) identifies within pervasive developmental disorders five subgroups: (a) autistic disorder; (b) Rett's disorder; (c) childhood disintegrative disorder; (d) Asperger's disorder's and (e) pervasive developmental disorder not otherwise specified. However, the diagnosis of the different sub-groups is difficult to establish, particularly between autistic disorder and Asperger's disorder. This article exposes the diagnostic criteria of autism and Asperger's syndrome in order to illustrate the similarities and differences between the two disorders.     

Catamnesis of patients with Kanner's early infantile autism syndrome

By means of a follow-up study the author studied 28 patients who at the age of 3-6 years were diagnosed as suffering from early infantile autism. In 6 cases the mental state of patients was characterized by traits of dissociated oligophrenic-like defect with preserved autistic forms of contacts, residual disorders of the syndrome of Kanners early autism, simbiotical dependency from the parents. In 15 cases there was a personality distortion, with traits of autism, emotional poorness, motor insufficiency, indifferent negativistic forms of contacts, mental retardation of the pseudooligophrenic type. In 7 cases there was a formation of a psychopathic state of a schizoid type.     

Psychodynamic play therapy with a high-functioning autistic child.

The increasingly dominant and sound view of autism as a developmental disorder has led to adoption of highly structured behavioral interventions and abandonment of psychoanalytic approaches. This article intends to reaffirm the relevance of traditional psychodynamic play therapy to the milder variants of the autistic syndrome. The therapy process with one high-functioning autistic child is examined and discussed in the context of autistic pathology and psychodynamic theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A male with fetal valproate syndrome and autism

Fetal valproate syndrome (FVS) is characterized by minor craniofacial anomalies, major organ malformations, and developmental delay. We report on a patient who has a clinical phenotype compatible with both FVS and autism. The presence of an autistic disorder in a previously reported case of FVS and similar findings in our patient suggest that a relation between this known teratogen and autism may exist.     

WISC–III index score profiles of 520 Swedish children with pervasive developmental disorders.

WISC–III (Wechsler, 1991) index score profiles and their characteristics were examined with traditional statistics in a large Swedish sample consisting of children with autistic disorder (n = 85), Asperger's disorder (n = 341), or pervasive developmental disorders not otherwise specified (PDD-NOS; n = 94). There was a clear and significant difference in level between children with Asperger's disorder, who performed in the average range according to the Swedish standardization, and children with either autistic disorder or PDD-NOS, who performed below the average range (almost 2 standard deviations below the mean), but few other differences between the diagnostic groups were found. The variation in this sample, compared with the Swedish standardization, was generally larger in regard to the size of standard deviations and to the proportion of individuals who exhibited significant differences between indices. The result implied that a WISC–III profile could not be used to discriminate between the different PDDs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The question of left hemisphere dysfunction in infantile autism.

Examines the hypothesis that dysfunction in the left hemisphere accounts for some of the primary behavioral and cognitive symptoms of autism. A particular variant of this theory is that language deficits, which are assumed to be attributable to left-hemisphere dysfunction, constitute the core deficit of the syndrome. The structure of these arguments and the empirical evidence are critically reviewed. It is concluded that the left-hemisphere hypothesis is inadequate to account for many of the cardinal features of autism, that it is based to some extent on flawed reasoning and weak evidence, and that it overestimates the importance of linguistic dysfunction in autistic children. Some of the questionable assumptions of this hypothesis include the following: (1) Language is always selectively impaired in autism; and (2) language reflects left hemisphere function. Nonlanguage evidence for left-hemisphere dysfunction is reviewed. Several alternative hypotheses are proposed to explain the possible link between left-hemisphere signs and infantile autism. (115 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluation of methods for the quantitation of cysteines in proteins

Rett syndrome (RS) is a clinically defined disorder characterized by autistic behavior, and cognitive and motor skill loss early in life. We performed 1H-MRS of the brain in 3 cases of RS in comparison with in autism and controls. The older patient with RS demonstrated decreased N-acetylaspartate (NAA)/choline (Cho) and NAA/creatine (Cr) ratios when compared with the autism and control groups, whereas the younger patients did not demonstrate these decreased metabolite ratios. The Cho/Cr ratio did not differ among Rett syndrome, autism and controls. Since the clinical stage did not differ among the 3 cases of RS, it was suggested that NAA was decreased with increasing age and was not related with the clinical stage of RS. The NAA/Cho, NAA/Cr and Cho/Cr ratios did not differ between autism and controls. The present data suggest that there may be a secondary degenerative process of late onset in RS, which pathophysiologically differs from autism.     

"Memory illusions: False recall and recognition in adults with Asperger's syndrome": Correction to Bowler et al. (2000).

Reports an error in "Memory illusions: False recall and recognition in adults with Asperger's syndrome" by Dermot M. Bowler, John M. Gardiner, Sarah Grice and Pia Saavalainen (Journal of Abnormal Psychology, 2000[Nov], Vol 109[4], 663-672). On page 665, Figure 1, the figure caption incorrectly reads, "Serial position effects for the Asperger and control groups of participants. Gray boxes = Asperger; black boxes = controls." The correct Figure 1 caption appears in the correction. (The following abstract of the original article appeared in record 2000-12687-011.) As persons on the autistic spectrum are known not to use semantic features of word lists to aid recall, they might show diminished susceptibility to illusory memories that typically occur with lists of associated items. Alternatively, since such individuals also have poor source monitoring, they might show greater susceptibility. The authors found that adults with Asperger's syndrome (n?=?10) recalled similar proportions of a nonpresented strong associate of the study list items, compared with controls (n?=?15). In Exp 2, rates of true and false recognition of study list associates did not differ significantly between Asperger (n?=?10) and control (n?=?10) participants. Moreover, the Asperger participants made fewer remember and more know judgments than controls for veridical but not for false recognitions. Thus, deficits found in some aspects of memory in people with Asperger's syndrome do not affect their susceptibility to memory illusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive deficits in parents from multiple-incidence autism families

This study compares parents of two autistic children with parents of a Down syndrome (DS) proband, on tests of intelligence, reading and spelling, and executive function. Autism parents performed significantly worse than DS parents on performance IQ, a test of executive function, and some reading measures (e.g. passage comprehension and rapid automatized naming). These results suggest that cognitive deficits may be an expression of the underlying genetic liability for autism and that these characteristics may contribute to a more broadly defined autism phenotype.     

Gangliosides in cerebrospinal fluid in children with autism spectrum disorders

Gangliosides are sialic acid-containing glycolipids found in all cells, especially abundant in nerve cells and mainly situated on outer-membrane surfaces. The aim of this study was to provide data on the concentration of gangliosides in the CSF of children and adolescents with autism spectrum disorders (ASD) - 66 with autistic disorder, and 19 with other autism spectrum disorders. The comparison group consisted of 29 children and adolescents, whose CSF had been sampled to exclude acute infectious CNS disorder. The concentrations of the gangliosides GM1, GD1a, GD1b, and GT1b were determined using a microimmunoaffinity technique. The ASD group had a significantly higher concentration of ganglioside GM1 compared with the comparison group. The GM1 increase could not be explained as secondary to other clinical factors. Mean ganglioside levels did not differentiate subgroups with autistic disorder and those with a more atypical clinical picture, nor subgroups with known medical disorders and those with idiopathic autism. Altered patterns of gangliosides in the CNS might reflect important correlates of pathogenesis in autism.     

Antibodies to myelin basic protein in children with autistic behavior

Based on a possible pathological relationship of autoimmunity to autism, antibodies reactive with myelin basic protein (anti-MBP) were investigated in the sera of autistic children. Using a screening serum dilution of 1:400 in the protein-immunoblotting technique, approximately 58% (19 of 33) sera of autistic children (< or = 10 years of age) were found to be positive for anti-MBP. This result in autistics was significantly (p < or = .0001) different from the controls (8 of 88 or only 9% positive), which included age-matched children with normal health, idiopathic mental retardation (MR) and Down syndrome (DS), and normal adults of 20 to 40 years of age. Since autism is a syndrome of unknown etiology, it is possible that anti-MBP antibodies are associated with the development of autistic behavior.     

Neuropsychological correlates of early symptoms of autism

Both the medial temporal lobe and dorsolateral prefrontal cortex have been implicated in autism. In the present study, performance on two neuropsychological tasks--one tapping the medial temporal lobe and related limbic structures, and another tapping the dorsolateral prefrontal cortex--was examined in relation to performance on tasks assessing autistic symptoms in young children with autism, and developmentally matched groups of children with Down syndrome or typical development. Autistic symptoms included orienting to social stimuli, immediate and deferred motor imitation, shared attention, responses to emotional stimuli, and symbolic play. Compared with children with Down syndrome and typically developing children, children with autism performed significantly worse on both the medial temporal lobe and dorsolateral prefrontal tasks, and on tasks assessing symptoms domains. For children with autism, the severity of autistic symptoms was strongly and consistently correlated with performance on the medial temporal lobe task, but not the dorsolateral prefrontal task. The hypothesis that autism is related to dysfunction of the medial temporal lobe and related limbic structures, such as the orbital prefrontal cortex, is discussed.     

Experimental studies on the infectivity of Anguillicola crassus third-stage larvae (Nematoda) from paratenic hosts

Speech, language, and communication disorders are prominent reasons for referrals to a child development center. From 1984 to 1988, 1,090 preschool children were referred to our child development center, which serves the Tel Aviv metropolitan area. Of all referrals, 432 (41%) were primarily due to speech, language, and communication problems. After exclusion of those with IQ < 50 and those with non-language-related disabilities, 323 children remained. The children were classified into different subtypes of developmental language disorders and autistic spectrum disorders. The main developmental language disorder subtypes were combined expressive-receptive (49%) and expressive (44%). Central processing deficits were less common, occurring in 20 (7%) of the children. Parents of children with developmental language disorders had educational levels similar to those of parents of children referred to the child development center for other causes. However, parents of children with infantile autism had higher educational levels than parents of children with developmental language disorder or parents of children referred for other causes (P < .001). Our results reflect the distribution of language and related problems in an unselected population of preschool children referred to a child development center.     

Review of Infantile Autism: a clinical and phenomenological-anthropological investigation taking language as a a guide and Children without Childhood: a study of childhood schizophrenia.

Reviews the books, Infantile Autism: a clinical and phenomenological-anthropological investigation taking language as a a guide by Gerhard Bosch (see record 1971-10363-000); and Children without Childhood: a study of childhood schizophrenia by Benjamin B. Wolman (see record 1970-21272-000). The continuing saga of debate on the etiology of so-called early infantile autism continues, the major workers having gradually polarized around dynamic-sociological-interpersonal causation, neurological-metabolic and genetic etiology and of course learning theory based explanations of origins. These two books stress inter-personal and communication variables. The Bosch book concentrates on the language of the autistic child in order to infer thought process and clues to causations. It is a scholarly and balanced work with a unique and potentially useful viewpoint. Benjamin B. Wolman in his "Children without Childhood" offers still another "personality" view of childhood schizophrenia. The subject matter of the book is broad however, with "childhood schizophrenia" including what Wolman calls pseudo-amentive schizophrenia, autistic schizophrenia, symbiotic schizophrenia and others (including apparently early infantile autism). The unique feature of the book is Wolman's introduction of a fresh classification system for childhood psychosis based on his clinical experience over 30 years. The book would make a useful secondary reference for undergraduates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Test rig and software for recording force and muscle activity

A standardized assessment of autistic symptomatology was completed for 29 children and young adults with a supernumerary isodicentric chromosome 15 (formerly known as inverted duplication 15). Although there was variability in severity, 20 individuals with an isodicentric chromosome 15 [idic(15)] had a high probability of being autistic. Eight of the 9 remaining children were under age 5 years and were more sociable than the rest of the cohort. Group characteristics such as gender and seizure presence could not explain the observed difference between older and younger individuals in our study. The natural history of isodicentric 15 syndrome remains to be shown through longitudinal work and may include an age-related risk for developing autism.     

Memory illusions: False recall and recognition in adults with Asperger's syndrome.

[Correction Notice: An erratum for this article was reported in Vol 110(2) of Journal of Abnormal Psychology (see record 2007-17065-001). On page 665, Figure 1, the figure caption incorrectly reads, "Serial position effects for the Asperger and control groups of participants. Gray boxes = Asperger; black boxes = controls." The correct Figure 1 caption appears in the correction.] As persons on the autistic spectrum are known not to use semantic features of word lists to aid recall, they might show diminished susceptibility to illusory memories that typically occur with lists of associated items. Alternatively, since such individuals also have poor source monitoring, they might show greater susceptibility. The authors found that adults with Asperger's syndrome (n?=?10) recalled similar proportions of a nonpresented strong associate of the study list items, compared with controls (n?=?15). In Exp 2, rates of true and false recognition of study list associates did not differ significantly between Asperger (n?=?10) and control (n?=?10) participants. Moreover, the Asperger participants made fewer remember and more know judgments than controls for veridical but not for false recognitions. Thus, deficits found in some aspects of memory in people with Asperger's syndrome do not affect their susceptibility to memory illusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autism in thalidomide embryopathy: a population study

Of a population of 100 Swedish thalidomide embryopathy cases, at least four met full criteria for DSM-III-R autistic disorder and ICD-10 childhood autism. Thalidomide embryopathy of the kind encountered in these cases affects fetal development early in pregnancy, probably on days 20 to 24 after conception. It is argued that the possible association of thalidomide embryopathy with autism may shed some light on the issue of which neural circuitries may be involved in autism pathogenesis.