Autism

Frequently changing conceptualizations of autism have caused widespread confusion over its precise nature and aetiology. This study aimed to investigate teachers’ views of autism, together with their training needs. The Stone Autism Questionnaire (1987) was modified and used to evaluate the level of knowledge and understanding among a sample of 72 teaching and support staff from four mainstream and four special (non-autism) schools in South London. Ten mental health professionals working in the field of autism completed the same questionnaire as a ‘control’ measure for comparison. Teachers and support staff were found to hold a number of views about autism that were significantly different from those of mental health professionals; the majority had received little or no training regarding the disorder. All three groups were unanimous in their demand for more training. The results have serious implications for the educational experiences and developmental achievements of children with autism in schools in England.

Clinical features of boys with fragile X premutations and intermediate alleles

Fragile X syndrome has a characteristic behavioural and physical phenotype. Clinical experience and case reports suggest that boys with premutations and intermediate alleles may have similar, but possibly milder, clinical features than those with the full mutation. We conducted detailed physical, psychiatric, psychological and speech and language evaluations on a clinical series of 10 boys, with either premutation or intermediate CGG triplet expansions. Wherever possible we measured the levels of FMR1 protein in participants' hair roots. Many participants demonstrated striking resemblance in their clinical picture, behavioural and physical, to individuals with the fragile X syndrome full mutation. However, protein expression was normal in all participants where it was assessed, despite large variation in CGG triplet repeats. We propose that the findings are unlikely to be attributable to ascertainment bias alone. Replication on larger independent samples is required to confirm our impression that fragile X premutations and intermediate alleles may be associated with important developmental disabilities and physical features.

Executive function and theory of mind performance of boys with fragile-X syndrome

Fragile-X syndrome is the most common genetically inherited cause of intellectual disability. People with this syndrome typically show a behavioural profile of abnormal social interactions which are similar in some ways to those seen in people with autism. The present study investigated whether cognitive processes which have been hypothesized to underlie social abnormalities associated with autism are also impaired in boys with fragile-X syndrome without autistic spectrum disorders. Eight boys with fragile-X syndrome and eight with intellectual disability of unknown aetiology, matched on receptive verbal ability, age and with no diagnosis of autism, were tested on a battery of theory of mind and executive function tasks. Significantly more boys with fragile-X syndrome failed the simplest theory of mind task. However, this could be attributed to overall level of ability rather than group membership. No differences were found between the groups on any other measures used. A proportion of both groups failed first- and second-order false belief tasks. The performance of both groups on the executive function measure was at the floor of the test. At low levels of overall ability, the performance of boys with fragile-X syndrome and boys with intellectual disability of unknown aetiology may be more similar than they are different The implication of this result for clinical interventions is discussed.

Five-year follow-up study of extremely low-birthweight infants

This study investigated whether extremely low-birthweight (ELBW) babies, who at two years had no major handicaps, were at higher risk for intellectual and socio-emotional problems at five years than a control group of children with normal birthweights. There were statistically significant differences between the two groups. The ELBW children were language-delayed, and more active and more intense in their behaviour. There was a tendency for the ELBW children to be lighter and shorter than the controls, but their mean head-circumference was significantly smaller. In general, however, if no serious neurological, neurosensory or cognitive impairment is found among ELBW children at two years, later cognitive and socio-emotional development is likely to be within the normal range.

Increasing simple toy play in profoundly mentally handicapped children: II. Designing special toys

The purpose of this study was to increase simple toy play in profoundly mentally handicapped children by presenting them with specially designed toys. Twenty children (mean chronological age 14 years, mean mental age less than 1 year) were observed while playing with the special toys, which emitted stimuli (vibration, light, or sound) when appropriately operated. They were also observed with the toys when the stimuli were unavailable. There were large individual differences, but, in general, children interacted significantly more with the experimental toys than with the control toys and engaged in significantly less stereotyped behavior when the experimental toys were available. The implications for clinical and research work are discussed.

Increasing simple toy play in profoundly mentally handicapped children. I. Training to play

The purpose of this study was to increase simple toy play in profoundly mentally handicapped children. Twenty children (mean chronological age, 14 years; mean mental age, less than 1 year) were trained to play with ordinary toys, half by a behavior modification technique and half by a control procedure. The operant training led to some increases in total toy contact but did not appear to be significantly more effective than the control technique in promoting independent constructive play. The possible reasons for the relative lack of success of the behavioral training are discussed.

Cognitive characteristics of parents of autistic children

The parents of 15 autistic boys with a nonverbal IQ of at least 80 were compared with a matched group of parents of normal boys on the Goldstein-Scheerer Object Sorting Test and the Bannister-Fransella Grid Test of Thought Disorder. It was necessary to control for social class effects as abnormal scores on the thought disorder tests were more frequent in parents of manual social class. It was found that (a) there was a lack of agreement between the two tests of thought disorder, (b) the parents of autistic children showed thought disorder scores closely comparable to those of the parents of normals, and (c) there was no consistent association between thought disorder and anxiety. The methodological and substantive implications of the findings are discussed in relation to the results of previous investigations.