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Die autistischen psychopathen im kindersalter
... When defining Asperger syndrome in 1944, Hans Asperger stated that children with this syndrome are characterized by a lack of sense of humor (Asperger, 1944). This statement seems to be somewhat implicitly accepted, at least in popular culture. ...
... At first sight, these interpretations seem to imply that autistic individuals present with less interest in producing or appreciating humor, seemingly rendering the argument in favor of Asperger's (1944) also seems important to acknowledge that some individuals might not benefit from humor as much as is normatively imagined, and this should not necessarily be seen as a deficit. Indeed, if autistic individuals get less out of humorous interactions for the reasons outlined above, it seems logical that they simply engage less in humor. ...
Humor is an important component of human communication that enhances the
quality of social interactions and fosters social bonding. Moreover, humor can enrich
psychological well-being, notably through its role in emotion regulation. Indeed, humor can help people to deal with their negative emotions, either through distraction, by occupying their mind with a humorous thought, or through helping them to reinterpret a given situation differently. However, humor also presents with a darker side. When it is intentionally hurtful, it can have strong negative consequences on the well-being of victims of mockery. Similar consequences can result if humor is wrongly perceived. It is thus important to better understand humor processing in individuals with different conditions, who might develop specific positive or negative relationships with humor. The goal of this cumulative thesis was, therefore, to contribute to ongoing research regarding the understanding of humor processing in individuals with neurodevelopmental conditions, specifically autism spectrum disorder (ASD) and Williams syndrome (WS), two conditions that appear to be at two extreme poles of the social motivation spectrum. Moreover, this thesis takes on a transdiagnostic perspective, to read individual differences regarding humor processing and appreciation beyond specific developmental condition classifications.
This thesis is situated around three main components of humor: cognitive competencies, individual characteristics, and behavioral responses. These components are explained and developed in the introductory chapter (Chapter 1: Introduction). First, the cognitive foundations of humor are briefly presented, with a particular focus on incongruity- resolution theories of humor. It is argued and demonstrated that humor is a complex cognitive task to process, much more than it might initially appear. Second, this chapter addresses how humor can be differentially perceived according to the individual characteristics that influence the development of specific humor styles, how humor is appreciated, and the general temperament of people toward humoristic interactions. The third part of this introductory chapter describes the behavioral responses that are commonly related to the appreciation of humor, namely smiles and laughter. To convey the conceptual foundations of the concept of humor as it is approached in this thesis, a section on the functions of humor highlights why the study of humor in neurodevelopmental conditions is necessary and important. Next, since this thesis focuses on ASD and WS, these conditions are briefly described and presented. So too is Down syndrome (DS), a third group of investigation. This chapter also clarifies why and how ASD and WS appear as two extremes of a social motivation spectrum and addresses what research has already brought to the knowledge base on humor in these two conditions. Finally, the Introduction chapter closes with a discussion of the goals and methodological context of this thesis. This cumulative thesis is based on four articles: Articles 1 to 4. The discussion of these is presented in Chapter 2: Articles. Article 1 presents a conceptual overview of the research and knowledge base on humor processing in individuals with ASD and WS, and suggests several lines of thought for future research. Article 2 presents the results of a survey-based study on gelotophobia (i.e., the fear of being laughed at), which was distributed to the parents of young individuals (5–25 years of age) with ASD (N = 48), WS (N = 43), and DS (N = 139). The results confirmed that autistic individuals are particularly prone to developing gelotophobia and this tendency is in line with their high-level seriousness and bad mood. These results also suggest to understand these individual differences from a transdiagnostic perspective. Article 3 presents the results of a second survey-based study that investigated different humor styles; this was distributed to the parents of young verbal individuals (5–25 years old) with ASD (N = 31), WS (N = 34), and DS (N = 82). The results showed that autistic individuals seem to engage more in self-defeating humor and from a transdiagnostic
perspective, this is linked to their tendency to develop conduct problems. Finally, Article 4 presents an experimental study that investigated expressive responses to humorous and non-humorous stimuli, and a general understanding of simple types of humor, in individuals with WS (N = 8) and typically developing (TD) children (N = 9). The results revealed that individuals with WS are able to understand and appreciate simple humor in much the same way as TD children, but they tend to express more “extreme” responses in the sense that they more easily engage in laughing out loud.
The final chapter of this thesis (Chapter 3: General discussion and conclusion) presents a general overview and discussion of the main findings of all four articles and examines what they bring to the ongoing knowledge base on humor in general as well as in neurodevelopmental conditions. This chapter also resumes the strength and importance of interpreting the survey-based findings presented in Articles 2 and 3 from a transdiagnostic perspective and offers several practical implications and suggestions for future research. This final chapter also presents the main limitations and strengths of the research presented in this thesis and closes with some concluding remarks. Overall, this thesis refines our understanding and raises awareness of individual differences in relation to humor processing
... 5 ASD is characterized by 2 sets of core features: impaired social communication and social interaction, and restricted and repetitive behaviors and interests. 6,7 Developmental traits related to ASD, also known as quantitative autistic traits or simply autistic traits, are defined as the subclinical manifestation of these characteristics that can be measured on a continuous scale, forming a spectrum among both the general population and individuals with ASD. [8][9][10] There are multiple tools for screening autistic traits, such as the social responsiveness scale (SRS), which is a widely utilized and well-validated instrument for measuring the presence and severity of impaired social communication and social interaction. ...
... This finding may be attributed to unmeasured variations among the pregnant women in these 2 cohorts, such as those related to geographical differences. The overwhelmingly null associations between the metal mixture (Pb, Hg, Se, 6 Environmental Health Insights and Mn) as well as individual metals within the mixture and offspring SRS Z-scores are consistent with some of the existing studies. For example, in a cohort study of 371 mother-child pairs in New Hampshire, metals (arsenic [As], copper [Cu], Mn, Pb, Se, and zinc [Zn]) measured in maternal toenails at 27-week gestation (ie, second trimester) was not associated with the offspring SRS Z-scores at 36 months. ...
Background
Prenatal exposure to metals is hypothesized to be associated with child autism. We aim to investigate the joint and individual effects of prenatal exposure to urine metals including lead (Pb), mercury (Hg), manganese (Mn), and selenium (Se) on child Social Responsiveness Scale (SRS) scores.
Methods
We used data from 2 cohorts enriched for likelihood of autism spectrum disorder (ASD): Early Autism Risk Longitudinal Investigation (EARLI) and the Markers of Autism Risk in Babies-Learning Early Signs (MARBLES) studies. Metal concentrations were measured in urine collected during pregnancy. We used Bayesian Kernel Machine Regression and linear regression models to investigate both joint and independent associations of metals with SRS Z-scores in each cohort. We adjusted for maternal age at delivery, interpregnancy interval, maternal education, child race/ethnicity, child sex, and/or study site.
Results
The final analytic sample consisted of 251 mother-child pairs. When Pb, Hg, Se, and Mn were at their 75th percentiles, there was a 0.03 increase (95% credible interval [CI]: −0.11, 0.17) in EARLI and 0.07 decrease (95% CI: −0.29, 0.15) in MARBLES in childhood SRS Z-scores, compared to when all 4 metals were at their 50th percentiles. In both cohorts, increasing concentrations of Pb were associated with increasing values of SRS Z-scores, fixing the other metals to their 50th percentiles. However, all the 95% credible intervals contained the null.
Conclusions
There were no clear monotonic associations between the overall prenatal metal mixture in pregnancy and childhood SRS Z-scores at 36 months. There were also no clear associations between individual metals within this mixture and childhood SRS Z-scores at 36 months. The overall effects of the metal mixture and the individual effects of each metal within this mixture on offspring SRS Z-scores might be heterogeneous across child sex and cohort. Further studies with larger sample sizes are warranted.
... Autismikirjon häiriötä luonnehtivat rajoittuneet ja toistuvat käyttäytymismallit, rajoittuneet ja/tai intensiteetiltään poikkeavat kiinnostuksen kohteet, poikkeavuudet sosio-emotionaalisessa vastavuoroisuudessa ja ei-kielellisessä viestinnässä sekä vaikeudet ihmissuhteiden luomisessa, ylläpitämisessä ja ymmärtämisessä (American Psychological Association, 2013, s. 50) 1 . Näiden ydinpiirteiden lisäksi poikkeava prosodia on ollut mukana jo varhaisissa autismikirjon kuvauksissa, ja onkin jo pitkään ollut tunnettua, että autismikirjon henkilöillä on usein puheessaan poikkeavia prosodisia piirteitä (Asperger, 1944;Kanner, 1943). Toisaalta on huomionarvoista, että autismikirjon henkilöiden prosodia on myös monessa suhteessa samankaltaista kuin tyypillisesti kehittyneillä henkilöillä (esim. ...
... On tunnettua, että autismikirjon henkilöillä on usein epätyypillisiä prosodisia piirteitä puheessaan. Tällaisia piirteitä voivat olla esimerkiksi poikkeavan suppea intonaation vaihteluväli, huomattavan nopea puhe, nykivä puherytmi, laajat intonaation muutokset, hiljainen ääni, epäjohdonmukainen taukorakenne, poikkeavat painotukset ja nariseva tai nasaalinen ääni (Asghari, Farashi, Bashirian & Jenabi, 2021;Asperger, 1944;Baltaxe, 1984;Baltaxe & Simmons, 1985Fay & Schuler, 1980;Nakai, Takashima, Takiguchi & Takada, 2014;Paul, 1987;Paul, Augustyn, Klin & Volkmar, 2005a;Paul ym., 2005b;Shriberg ym., 2001;Tager-Flusberg, 2000;Thorson, Usher, Patel & Tager-Flusberg, 2016;Wiklund & Vainio, 2019). Kun poikkeavia prosodisia piirteitä esiintyy, ne voivat heikentää puheen ymmärrettävyyttä (Redford, Kapatsinski & Cornell-Fabiano, 2018), ja ne voivat myös vaikeuttaa merkittävästi yksilön tulemista sosiaalisesti hyväksytyksi (Paul ym. ...
Tämä artikkeli käsittelee autismikirjon varhaisnuorten puheen prosodian havaittua epätyypillisyyttä. Kyseessä on pilottitutkimus, jonka aineisto koostuu viiden 11-13-vuotiaan suomea äidinkielenään puhuvan autismikirjon pojan ja kuuden samanikäisen neurotyypillisen pojan puhenäytteistä. Puhenäytteet on kerätty spontaanista puheesta. Aineiston pohjalta koostettiin havaintokoe, jonka suoritti 50 neurotyypillistä yliopisto-opiskelijaa. Tulokset osoittavat, että neurotyypilliset aikuiset pitävät autismikirjon varhaisnuorten puheen prosodiaa epätyypillisempänä kuin samanikäisten neurotyypillisten verrokkien puheen prosodiaa. Epätyypillisyyden vaikutelma voi akustisten analyysien ja arvioijien kirjallisten vastausten perusteella aiheutua esimerkiksi laulunomaisesta tai poukkoilevasta sävelkulusta, katkonaisesta puherytmistä, suurista sävelkulun vaihteluista tai poikkeavan tasaisesta sävelkulusta. Epätyypillisyyden vaikutelmaa voivat korostaa mm. morfosyntaktiset ongelmat (kuten esimerkiksi väärät sijamuodot tai katkonaiset lauserakenteet), epäselvät sanat tai veltto artikulointi. Nariseva ääni, joka oli tavallinen piirre puhenäytteissä, ei sen sijaan kiinnittänyt arvioijien huomiota. Autismikirjon poikien puheen arveltiin usein olevan ei-syntyperäisen suomen puhujan tuottamaa, vaikka kaikki informantit olivat syntyperäisiä, yksikielisiä suomen puhujia. Arvioijien oli myös usein vaikeaa ymmärtää, mitä autismikirjon henkilöt sanoivat puhenäytteissä. Tutkimuksen tulokset kasvattavat tietoisuutta prosodisista erityispiirteistä suomenkielisillä autismikirjon varhaisnuorilla.
... Asperger presented a lecture "Das psychisch abnorme Kind" on a seven year old boy who exhibited behaviors that were labeled as "Autistische Psychopathen". Six years later, in 1944, Asperger reported four additional cases of children aged 6-11years, but in the following discussion he talks about hundreds of children that he had observed during the years and outlines the patterns of behaviour (see Fig1) (Asperger 1944; Translation in Uta Frith, 1991). Asperger specifically states that his aim was to report on a personality disorder already manifest in childhood, which to his knowledge has not yet been described (Asperger 1944, translation by Uta Frith, p 87, 1991). ...
... Six years later, in 1944, Asperger reported four additional cases of children aged 6-11years, but in the following discussion he talks about hundreds of children that he had observed during the years and outlines the patterns of behaviour (see Fig1) (Asperger 1944; Translation in Uta Frith, 1991). Asperger specifically states that his aim was to report on a personality disorder already manifest in childhood, which to his knowledge has not yet been described (Asperger 1944, translation by Uta Frith, p 87, 1991). Nevertheless, the clinical characteristics described by Asperger very closely resemble those of the children with "schizoid personality" reported by Sukhareva (Wolff, 1996). ...
Grunya Efimovna Sukhareva – the discoverer of Autism spectrum disorder in childhood
... Since the first reports of ASD by Kanner and Asperger [35,36], the clinical heterogeneity of motor disturbance had been continuously described and considered as one of the relevant features of ASD [27]. However, people have always focused on evaluating and intervening in the core symptoms of ASD, largely ignoring the potential mutual influence between motor development and core symptoms [9]. ...
Background
Motor disturbance, as a related symptom of autism spectrum disorders (ASD), has not received the attention it deserves. We aimed to investigate the different degrees of motor developmental delay and influencing factors in Chinese preschool children with ASD, in order to enhance people’s awareness of motor developmental delay in ASD children.
Methods
We recruited 1,256 ASD children aged 2–6 years from the China Multi-Center Preschool Autism Project (CMPAP). We investigated the overall status of neurodevelopment in preschool children with ASD through the Revised Children Neuropsychological and Behavior Scale (CNBS-R2016) and the Gesell Developmental Scale (GDS). The multivariate ordered logistic regression model was used to analyze the relationship between different degrees of motor developmental delay and demographic, core symptoms of ASD, and maternal risk factors, which were evaluated using the questionnaires, the Childhood Autism Rating Scale (CARS) and the Social Responsiveness Scale-Second Edition (SRS-2).
Results
The proportions of delayed development in various neurodevelopmental domains was significantly imbalanced in preschool children with ASD. The proportions of gross and fine motor developmental delay were as high as 39.6% and 68.4% respectively. ASD children in different age subgroups all exhibited gross and fine motor developmental delay. The CARS and SRS-2 total scores of ASD children with mild, moderate-severe gross or fine motor developmental delay were significantly higher than those with normal motor skills development (P < 0.05). ASD children aged ≥ 5 years, or higher CARS and SRS-2 total scores, or gestational age in the 28–36+ 6 weeks were more likely to suffer from gross motor developmental delay (OR values were 5.504, 1.083, 1.846 respectively) and fine motor developmental delay (OR values were 2.216, 1.074, 1.011, 1.661 respectively).
Conclusion
Gross and fine motor developmental delay were difficulties that most preschool children with ASD may face, and ASD children with motor developmental delay had greater deficits in social skills. Therefore, it is necessary to continuously monitor the gross and fine motor development progress of children with ASD for facilitating early identification and individualized intervention.
... Dentre os Transtornos do Neurodesenvolvimento pode-se localizar o Transtorno do Espectro Autista (TEA), caracterizado por déficits persistentes (atuais ou na história prévia) na díade: 1. reciprocidade socioemocional, nos padrões de comunicação verbal e/ou não verbal, nos relacionamentos interpessoais; 2. padrões restritos e/ou repetitivos de comportamentos, preferências e atividades (American Psychiatric Association* [APA] [DSM-5-TR], 2022). Desde as suas primeiras descrições, na década de 40 (Asperger, 1944;Kanner, 1943), muitos pesquisadores se dedicam a estudá-lo em suas diversas especificidades, desde os processos de triagem, acurácia diagnóstica, heterogeneidade das manifestações clínicas (em função da idade, sexo, cognição e linguagem), comorbidades, políticas públicas e eficácia de tratamentos (Hyman et al., 2019;Lord et al, 2018). ...
This study aimed to assess the validity of the Screening Scale for Identification of Signs of Autism for Teachers (TEA-PROF), which supports the systematization of teachers’ observations regarding behaviors indicative of Autism Spectrum Disorder (ASD). A total of 1,327 Elementary School 1 teachers from public and private schools participated. The scale consists of 65 items, divided into two categories: communication/social interaction impairments (CIS) and restricted and repetitive patterns (PRR). Confirmatory factor analysis revealed that the behaviors are organized into two factors, both demonstrating good fit indices and factor loadings, ranging from -.83 to .85, which were subsequently submitted to a second-order factor called “TEA.” Internal consistency was high, with ωh=.99 for the total test, α=.97 for CIS, and α=.98 for PRR. These results provide evidence that the TEA-PROF effectively groups items into the two core diagnostic domains.
... Establishing community support groups to provide peer support and resources to people with ASD. 10 ...
... Not only abnormal sensory processing, but also delays and deficits in motor behavior have been frequently described in ASD (e.g. Ming et al., 2007), ever since the initial reports by Leo Kanner (1943) and Hans Asperger (1944). Motor impairment can range from delayed motor milestones (Provost et al., 2007), to motor incoordination (Mari et al., 2003), deficits in gross and fine motor skills (Noterdaeme et al., 2002), and difficulties in postural control (Memari et al., 2014). ...
... En 1943, el psiquiatra Leo Kanner, de la Clínica Psiquiátrica Infantil Johns Hopkins, empleó el término autismo, derivado de la etimología griega autós (αὑτός) que significa sí mismo, para describir a 11 participantes (8 niños y 3 niñas) que se distinguían de sus otros pacientes por su evidente falta de contacto con el mundo que los rodeaba (Kanner, 1943;Frith, 1993). Por otra parte, el médico pediatra Hans Asperger, de la Clínica Pediátrica Universitaria de Viena, empleó el mismo término para designar a un grupo de menores que se comportaban como sabios silenciosos y con habilidades especiales para realizar tareas concretas, como la construcción de máquinas complejas (Asperger, 1944). ...
La educación inclusiva y de calidad constituye un aspecto esencial para aprendizaje de los estudiantes con capacidades diferentes. Los modelos educativos convencionales enfatizan en las dificultades que se presentan en el trastorno del espectro autista (TEA), el trastorno por déficit de atención con hiperactividad (TDAH), la dislexia y el síndrome de Down (SD). El objetivo de este artículo es abordar estas condiciones desde el paradigma de la Neurodiversidad, haciendo énfasis en el potencial más que en la alteración. Se propone un abordaje que va más allá del diagnóstico y convoca al uso de estrategias flexibles, creativas e innovadoras en el aula que facilitan la comunicación, la adquisición de nuevos saberes, así como el desarrollo de las capacidades, habilidades y potencialidades de los estudiantes que aprenden de una manera diferente.
... Altered sensory reactivities and interests were recognized in the original descriptions of autism spectrum disorder (ASD) (Kanner, 1951;Asperger, 1944) and are now considered core to its diagnosis (American Psychiatric Association, 2013). Indeed, sensory features are among the first differences reported in infants who go on to receive a diagnosis of ASD and predict the severity of other core behavioral symptoms of ASD, such as social communication deficits and repetitive behaviors (Kern et al., 2007;Boyd et al., 2009;Simmons et al., 2009). ...
Alterations in γ-aminobutyric acid (GABA) have been implicated in sensory differences in individuals with autism spectrum disorder (ASD). Visual signals are initially processed in the retina, and in this study, we explored the hypotheses that the GABA-dependent retinal response to light is altered in individuals with ASD. Light-adapted electroretinograms were recorded from 61 adults (38 males and 23 females; n = 22 ASD) in response to three stimulus protocols: (1) the standard white flash, (2) the standard 30 Hz flickering protocol, and (3) the photopic negative response protocol. Participants were administered an oral dose of placebo, 15 or 30 mg of arbaclofen (STX209, GABA B agonist) in a randomized, double-blind, crossover order before the test. At baseline (placebo), the a-wave amplitudes in response to single white flashes were more prominent in ASD, relative to typically developed (TD) participants. Arbaclofen was associated with a decrease in the a-wave amplitude in ASD, but an increase in TD, eliminating the group difference observed at baseline. The extent of this arbaclofen-elicited shift significantly correlated with the arbaclofen-elicited shift in cortical responses to auditory stimuli as measured by using an electroencephalogram in our prior study and with broader autistic traits measured with the autism quotient across the whole cohort. Hence, GABA-dependent differences in retinal light processing in ASD appear to be an accessible component of a wider autistic difference in the central processing of sensory information, which may be upstream of more complex autistic phenotypes.
... El TEA mantiene los síntomas específicos clínicos identificados por Kanner (1943) y Asperger (1944;Wing, 1981). Ambos estudiosos consideraron al autismo una entidad de por vida por la co-incidencia de problemáticas persistentes en la comunicación y, muchas veces, en el lenguaje, en la interacción social, patrones de comportamiento restrictivos y repetitivos, repertorio restringido de intereses y actividades. ...
El Trastorno del Espectro Autista (TEA) es una condición compleja que ha experimentado avances significativos en su diagnóstico y clasificación con la llegada del Manual Diagnóstico y Estadístico de los Trastornos Mentales, Quinta Edición (DSM-5). En contraposición al DSM-IV-TR, que empleaba una clasificación categórica, el DSM-5 adopta un enfoque dimensional, evaluando dos criterios clave: déficits en la comunicación y la interacción social, y patrones de comportamiento restringidos y repetitivos. Este cambio permite una mayor especificidad y reduce la incidencia de diagnósticos erróneos, aunque a expensas de la sensibilidad, especialmente en poblaciones adultas y adolescentes. Además, la gravedad del TEA se clasifica según el nivel de soporte requerido, variando desde "demasiado" hasta "algún" apoyo. Se da especial atención a comorbilidades, incluidas las discapacidades intelectuales y otras condiciones psiquiátricas como el TDAH y la esquizofrenia. Estas modificaciones hacen que el diagnóstico y la intervención sean más individualizados, beneficiando tanto al clínico como al paciente.
... Kanner beskrev videre at guttene hadde vansker med sosialt samspill, hadde manglende eller lite verbalt språk og ekkolali (gjentakelse av det andre sier eller har sagt), annerledes reaksjoner på sensoriske stimuli og gjentakende og ensidige handlingsmønster. Omtrent samtidig, i 1944, publiserte en østerriksk psykiater, Hans Asperger, en vitenskapelig artikkel knyttet til sitt forskningsarbeid der han studerte fire gutter som hadde gode intellektuelle evner, men manglet evne til å knytte vennskap (Asperger, 1944). De strevde med blikkontakt og hadde problemer med å forstå kroppsspråk og abstrakt språkbruk. ...
Mennesker som får en autismediagnose, er en heterogen gruppe med
styrker og utfordringer som kommer til uttrykk på ulike måter hos den
enkelte. Behov for hjelp er svært varierende innenfor gruppen, men
mange har langvarige behov for opplæring og tilrettelegging på de fleste
livsarenaer. Muligheter og livsvilkår til mennesker med diagnosen har
endret seg gjennom tidene, etter hvert som samfunnets kunnskap har
utviklet seg. Hensikten med kapitlet er å synliggjøre hvordan endringer
i samfunnets forståelse av og syn på diagnosen får betydning for hvilke
mulighetsrom som gis menneskene med autisme.
... Las primeras descripciones del autismo hechas por Kanner y Asperger (1943y 1944 fueron realizadas en el contexto del paradigma estructural de la psiquiatría, con fuerte influencia del psicoanálisis en el mismo. Ninguno de los dos autores describieron la presencia de alucinaciones en sus trabajos (Kanner, 1943;Asperger, 1944;Maleval, 2013) y han conceptualizado al autismo como una entidad diferenciada de la esquizofrenia. A pesar de esto en los años posteriores algunos clínicos que se dedicaron al autismo, lo han considerado como parte del campo de las psicosis infantiles (Tustin, 2011;Belaga, 2007;Kolvin et al., 1971). ...
El diagnóstico diferencial entre el autismo y la esquizofrenia en la infancia ha sido motivo de numerosas controversias. Debido a que las alucinaciones verbales podrían ser uno de los fenómenos clínicos principales al momento de establecer un diagnóstico diferencial, se propuso como objetivo indagar sobre la presencia o ausencia de alucinaciones verbales en el autismo. Para ello se realizó una revisión selectiva y asistemática de la evidencia científica actual. Sumado a esto se conceptualizó el fenómeno de la alucinación, y principalmente la alucinación verbal, desde una perspectiva histórica; se abordó la relevancia otorgada a las alucinaciones en la delimitación de los constructos nosográficos mencionados; y se analizó las alucinaciones verbales en el autismo comparando distintos paradigmas, incluyendo aportes del psicoanálisis. Observamos que desde el lado de la evidencia científica no es posible afirmar conclusiones contundentes respecto de la presencia o ausencia de alucinaciones verbales en el autismo. A su vez, la revisión histórica del concepto de alucinación verbal desde la psiquiatría clásica junto con aportes del psicoanálisis, nos invitan a pensar que una de las características diferenciales entre el autismo y la psicosis es la ausencia de alucinaciones verbales en el primer cuadro, y que de haber alucinaciones en el autismo, estas presentarían cualidades diferentes a las de la psicosis. Consideramos sumamente relevante poder establecer esta diferenciación en el fenómeno alucinatorio en el autismo, no sólo para poder establecer un diagnóstico diferencial entre ambos cuadros, sino también por las implicancias que esto podría suscitar en el tratamiento farmacológico.
... A line of research delved into another dimension of information that can be analyzed with automatized measures, namely vocal and verbal features. Indeed, atypicalities in vocal and verbal production were noted in the first descriptions of the disorder 27,28 and still are considered one of the core diagnostic features of the disorder 1 . Individuals with ASD often present language delay, which, historically, has constituted one of the principal defining features of the disorder 29 . ...
A timely diagnosis of autism is paramount to allow early therapeutic intervention in preschoolers. Deep Learning (DL) tools have been increasingly used to identify specific autistic symptoms, and offer promises for automated detection of autism at an early age. Here, we leverage a multi-modal approach by combining two neural networks trained on video and audio features of semi-standardized social interactions in a sample of 160 children aged 1 to 5 years old. Our ensemble model performs with an accuracy of 82.5\% (F1 score: 0.816, Precision: 0.775, Recall: 0.861) for ASD screening. Additional combinations of our model were developed to achieve higher specificity (92.5\%, i.e., few false negatives) or sensitivity (90\%, i.e. few false positives). Finally, we found a relationship between the neural network modalities and specific audio versus video ASD characteristics, bringing evidence that our neural network implementation was effective in taking into account different features that are currently standardized under the gold standard ASD assessment.
... Indeed, ASD, although known by other labels over time, 42) has consis tently been distinguished by a deficit in social awareness 43) and was viewed as rare by knowledgeable indi viduals in the US and independently in Europe at the time of its discovery 80 years ago. 44,45) ...
Despite worldwide acceptance of acetaminophen as a necessary medicine in the field of pediatrics, evidence that early life exposure to acetaminophen causes neurodevelopmental injury in susceptible babies and children has mounted for more than a decade. Evidence is diverse, including extensive work with laboratory animals, otherwise unexplained associations, factors associated with the metabolism of acetaminophen, and some limited studies in humans. Although evidence has reached an overwhelming level and has been reviewed in detail recently, some controversy remains. In this narrative review, some of those controversies are evaluated. Evidence from the prepartum and the postpartum period is considered, avoiding controversies raised by considering only the limited evidence pointing exclusively toward risks during the prepartum period. Among other issues, the associations through time between acetaminophen use and the prevalence of neurodevelopmental disorders are considered. A systematic review reveals that the use of acetaminophen in the pediatric population was never tracked carefully, but historical events that affected use of the drug were documented and are sufficient to establish apparent correlations with changes in the prevalence of neurodevelopmental disorders. In addition, problems with exclusive reliance on results from meta-analyses of large datasets and from studies involving small time frames of drug exposure are reviewed. Further, evidence demonstrating why some children are susceptible to acetaminophen-induced neurodevelopmental injury is examined. It is concluded that, at least among the factors considered, there is no valid rationale for controversy regarding the conclusion that early life exposure to acetaminophen causes neurodevelopmental injury in susceptible babies and small children.
... Η σύγχυση ανάμεσα στη διαταραχή της σχιζοφρένειας και το φάσμα του αυτισμού ή συγκεκριμένα του συνδρόμου Άσπεργκερ ξεκίνησε από την επιλογή κιόλας των ονομάτων τους. Πιο αναλυτικά, τόσο ο Kanner (1943), ο οποίος περιέγραψε τον τυπικό (βαρύ) αυτισμό, όσο και ο Asperger (1944) που περιέγραψε την πιο ήπια μορφή του, χρησιμοποίησαν τον όρο αυτισμός στην ονομασία των συνδρόμων που ανακάλυψαν (πρώιμος παιδικός αυτισμός και αυτιστική ψυχοπάθεια αντίστοιχα). Ο όρος αυτός, όμως, χρησιμοποιήθηκε για πρώτη φορά από τον Bleuler (1911), προκειμένου να περιγράψει την απομόνωση από την πραγματικότητα που βιώνουν τα άτομα με σχιζοφρένεια και τη δημιουργία ενός παράλληλου, ιδιωτικού κόσμου τον οποίο βιώνουν ως εξίσου σημαντικό. ...
The shared clinical characteristics of adults with schizophrenia and adults with Asperger's syndrome could lead to misdiagnoses and, consequently, to ineffective interventions. Therefore, any test that could facilitate the differential diagnosis is of utmost importance. Our aim is to examine whether the ability to decode emotional prosody could be used as an additional measurement during the procedure of the diagnostic evaluation. In the present study, we present preliminary results from administering an emotional prosody test, which examines the emotions of happiness, anger, sadness, surprise, fear, and neutrality, to 8 individuals with a recent diagnosis of schizophrenia, 8 individuals who were diagnosed with Asperger's syndrome at their adulthood, and 8 healthy adults with similar characteristics in terms of age, years of education and gender to the participants of the two clinical groups. The results demonstrated a general impairment of prosody perception in adults with schizophrenia and a specific difficulty of people with Asperger's syndrome in recognizing the emotion of surprise. Further research, however, revealed there were some individuals from both clinical groups who performed similarly. Therefore, examining the ability to decode emotional prosody can be used as an additional measure during the diagnostic process.
... Recognition began around 1981, after the publication of translations (German to English) of his works by Lorna Wing. In return for his work, the condition he described was named Asperger's Syndrome [4,[9][10][11]. ...
The article narrates a brief history about the first possible descriptions of autism spectrum disorder (ASD) until the publication of Leo Kanner and Hans Asperger, then reports the evolution of its definition and concept, contextualizing its first inclusion in the ICD (International Statistical Classification of Diseases and Health related problems) and DMS (Diagnostic and statistical Manual of mental disorders) up to its latest versions. It discusses the clinical picture characterized by heterogeneous manifestation and associated comorbidities. This article also presents the weight of the contribution of genetic and environmental factors in the etiology of the disorder, t he diagnosis based on clinical observation and absence of biomarkers, discussions th and efficacy and limitation of pharmacological treatment and pedagogical approaches, similarly exposes a possible research strand for ASD, developed from the production of biobanks as a source of investigation of symptoms, genetic alterations, physiological dysfunctions with the objective of identifying subgroups of individuals with ASD and thus enable the targeting of individualized and more effective interventions.
... Autism Spectrum Disorder (ASD), a neurodevelopmental condition is characterised by impairments in social communication and interaction, alongside a narrow range of repetitive behaviours and interests (1,2). No medications exist that alleviate the core features of ASD (3,4). ...
Autism Spectrum Disorder (ASD) is a common neurodevelopmental condition typically
diagnosed at 2-4 years of age when deficits in social interaction and communication are noted
by carers. Our knowledge of ASD is advancing with greater awareness of the needs of autistic
children and adults and a move towards improving services for these patients. The underlying
neurobiology of ASD is a unifying aetiological agent, likely altered through both genetic and
environmental influences. There is compelling evidence to suggest that abnormalities in
Excitatory (E) glutamate and inhibitory (I) Gamma-Aminobutyric Acid (GABA) signalling in the brain may underpin ‘atypical’ development. Therefore I chose to examine relationships within the glutamatergic system in the striatum.
First I looked at metabotropic glutamate receptor 5 (mGluR5) in adults with and without ASD and found higher levels of mGluR5 among autistic participants. This is consistent with other recent studies. Despite the close functional ties between mGluR5 and E/I signalling, no-one had directly examined the relationship between mGluR5 and glutamate or GABA in vivo in the human brain of autistic individuals. I found a strong negative relationship between GABA+ and mGluR5. I then looked at mGluR5 in three animal models associated with ASD to see whether
any of these models might explain the greater availability of mGluR5 in autism. CNTNAP2 KO mice had significantly higher mGlu5 receptor binding in the striatum (caudate-putamen) as compared to wild-type (WT) mice. Given that CNTNAP2 is associated with a specific striatal deficit of parvalbumin positive GABA interneurons and ‘autistic’ features, this finding suggests that an increase in mGluR5 in ASD may relate to developmental GABAergic interneuron abnormalities.
Neurodevelopment requires careful coordination of neuronal and glial processes spanning proliferation, differentiation, myelination and pruning. Disruption to this process can result in neurodevelopmental difficulties and disorders such as ASD. Therefore I conducted early life studies examining the relationship between subcortical Glx (Glutamate and Glutamine), N-acetylaspartate (a marker of neuronal health) and myo-Inositol (a marker of glial activity) at three early life time points: in utero, within 4 weeks of birth (neonatal time point) and at 4-6-months of age (‘infant’ time point). I compared these to later neurodevelopmental outcomes
finding that higher neonatal NAA concentrations corresponded to better general
neurodevelopmental scores and lower ADOS-2 scores. As NAA is a marker of neuronal health this implies that we can mark neuronal health at birth and demonstrate that this correlates with neurodevelopmental outcomes. I then went on to examine these same relationships at the 4-6-month timepoint. Higher levels of myo-Inositol (and therefore greater glial activity) corresponded to poorer general and social developmental outcomes. Higher levels of Glx and therefore excess excitation predicted greater social deficits. This is in keeping with the theory of
E/I imbalance.
... The history of research into emotion recognition deficits in individuals with autism spectrum disorders (ASD) is as long as the history of research into the functioning of this group. As early as the 1940s, the pioneers of research on the functioning of individuals with ASD-Leo Kanner (1943) and Hans Asperger (1944)-drew attention to the difficulties experienced by this group in terms of establishing emotional contact with others. Today, researchers emphasize the neurophysiological background of the deficit in the recognition of the emotional states of others that is found in individuals with ASD (Dapretto et al., 2006). ...
Current research reveals an important role of cognitive strategies in the development of the ability to recognize emotions in persons with autism spectrum disorder (ASD). Therefore, a closer look at
the relationship between emotion recognition deficits in that group and the underlying sensory integration processes may prove relevant for explaining the origins of this deficit. In order to verify the existence and scope of the relationship between emotion recognition and the level of sensory responsiveness in children with ASD, a study was carried out among a group of 63 children with an ASD diagnosis, aged between 3 years and 7 months to 9 years and 3, months using the Emotion Recognition subscale from the Theory of Mind Mechanism Scale and the Sensory Experiences Questionnaire. The obtained results revealed that only the level of sensory hyporesponsiveness was a predictor of the level of emotion recognition in the sample. Confirming the role of the level of sensory hyporesponsiveness in explaining the deficit in emotion recognition provides a better understanding of the genesis of this deficit. It also justifies the need to include sensory hyporesponsiveness therapy in the educational and rehabilitation process aimed at improving the children with ASD’s emotion recognition abilities.
... The history of the diagnostic category of "autism" is a complicated one. "Autism" was first clinically described as a discrete medical diagnosis in the 1940s by both Leo Kanner (in English) and Hans Aspergers (in German (translated into English only in the 1980s) (Kanner, 1943;Asperger, 1944). Between the 1940s and 1960s descriptions in the literature characterized autistic people as "children, who from early life showed extreme withdrawal" or "profound aloneness, " as "[having] disability in forming "usual" relationships with people, " children who displayed an "insistence on sameness, " "stereotyped movement" and that the "disturbance results in severe characteristic difficulties of social integration" (Kanner, 1943). ...
Introduction
While not all autism research is ableism, autism researchers can be ableist, including by talking about autistic people in sub-human terms (dehumanization), treating autistic people like objects (objectification), and making othering statements which set autistic people apart from non-autistic people, and below in status (stigmatization).
Method
This mixed-method study aimed to investigate how autism researchers construct autistic people and autism research, and to investigate whether including autistic people more in research relates to lower ableism in narratives about autistic people. We used a survey with autism researchers (N = 195) asking five open-ended questions about autism and autism research, as well as demographics, career length, contact with autistic people (familial and non-familial) and degree to which researchers involve autistic people in their research. We used content analysis to categorize narratives used by autism researchers and cues for ableism (dehumanization, objectification, and stigmatization). We then used binary-logistic regression to identify whether narrative or higher inclusion of autistic people predicted fewer ableist cues, controlling for career length and connections to autistic people.
Results and discussion
Using medicalized narratives of autism predicted higher odds of ableist cues compared to employing social model or neutral embodiment narratives. Greater inclusion of autistic people in research predicted significantly lower odds of ableist cues, while controlling for other contact with autistic people and career length. Next, we used reflexive thematic analysis to analyze researcher’s perceptions of autistic people and autism research. Narratives reflected core ideological disagreements of the field, such as whether researchers consider autism to be an intrinsic barrier to a good life, and whether researchers prioritize research which tackles “autism” versus barriers to societal inclusion for autistic people. Instrumentality (a form of objectification) was key to whether researchers considered a person to have social value with emphasis revolving around intellectual ability and independence. Lastly, language seemed to act as a tool of normalization of violence. Researchers relied on an amorphous idea of “autism” when talking about prevention or eradication, potentially because it sounds more palatable than talking about preventing “autistic people,” despite autism only existing within the context of autistic people.
... Autism (or Autism Spectrum Disorder/Condition; ASD/ASC) was first described clinically by Leo Kanner and Hans Asperger in the 1940s (Kanner, 1943;Asperger, 1944). It is also often referred to as high-functioning autism and Asperger Syndrome, although these classifications are no longer clinically diagnosed (Hayes, 2019). ...
Unemployment amongst the autistic population is high, yet research is emerging suggesting that Supported Employment Programmes (SEPs) can enable many Young People (YP) to make this transition successfully. However, this research overwhelmingly adopts quantitative methods to reach such conclusions, limiting our understanding of these YP’s experiences of such support. Further, eliciting their views is increasingly recognised as crucial in developing appropriate support. Additionally, this, along with the lack of literature regarding the Educational Psychologist’s (EP’s) role with this population and within such settings, restricts the development of EP practice, pertinent since the extensions to their role (now working with YP up to 25 years old; DfE, 2014). The current research sought to firstly explore the views and experiences of autistic YP’s opportunities for, and barriers to, employment, what support from an autism-specific SEP they find helpful, and what further support they feel is required to better support them into employment. Secondly, the EP’s role within SEP settings was explored, guided by these YP’s perspectives. This two-phase research study consisted of semi-structured interviews with eight autistic YP with Education Health and Care Plans (EHCPs) in their final year of a 2-year autism-specific SEP, followed by a focus group with 7 SEP staff members. Findings, analysed through thematic analysis, are presented through five themes; 1) ‘conceptualising autism: the combination and interaction of individual and environmental barriers’; 2) ‘autism identities: juxtaposed feelings’; 3) ‘the value of practical learning alongside understanding, adjustments and advocacy’; 4) ‘hopes for increased independence, understanding, acceptance and support’; and 5) ‘valuable contributions from EPs/EPSs to support SEP students learning, wellbeing, support and outcomes’. Findings have implications for a range of stakeholders with key roles in improving employment outcomes for this population, including SEPs, EPs, a range of other professionals, Local Authorities (LAs), government, and more broadly, society.
... The notion of self in SCZ, ASD and synesthesia SCZ and ASD have long been described as disorders of the self (Bleuler 1911(Bleuler /1950Kanner 1943;Asperger 1944). Bleuler (1911Bleuler ( /1950 suggests that SCZ is linked to an alteration in a person's basic sense of self-"the personality loses its unity" (p. ...
Recent research has proposed that certain aspects of psychosis, as experienced in, e.g., schizophrenia (SCZ), but also aspects of other cognitive conditions, such as autism spectrum disorders (ASD) and synesthesia, can be related to a shattered sense of the notion of self. In this paper, our goal is to show that altered processing of self can be attributed to an abnormal functioning of cortico-striatal brain networks supporting, among other, one key human distinctive cognitive ability, namely cross-modality, which plays multiple roles in human cognition and language. Specifically, our hypothesis is that this cognitive mechanism sheds light both on some basic aspects of the minimal self and on some aspects related to higher forms of self, such as the narrative self. We further link the atypical functioning in these conditions to some recent evolutionary changes in our species, specifically, an atypical presentation of human self-domestication (HSD) features. In doing so, we also lean on previous work concerning the link between cognitive disorders and language evolution under the effects of HSD. We further show that this approach can unify both linguistic and non-linguistic symptoms of these conditions through deficits in the notion of self. Our considerations provide further support for the hypothesis that SCZ and ASD are diametrically opposed cognitive conditions, as well for the hypothesis that their etiology is associated with recent human evolution, leading to a deeper understanding of the causes and symptoms of these disorders, and providing new cues, which can be used for an earlier and more accurate diagnostics.
... He also reported that the boys were not able to make sense of the words such as 'respect' and 'polite' and they displayed strange stereotypic movement and behaviours. He described the four boys as having "autistic psychopathy", which was later known as Asperger's Syndrome (Asperger, 1944). In 1943, without having the knowledge of Hans Asperger's report, Leo Kanner also used the word 'autism' to describe the behaviours of the children he observed. ...
This thesis aimed to investigate how autistic individuals are perceived by non-autistic individuals in the absence of a social context. An experimental paradigm was developed and piloted in order to test retrodictive mindreading (Chapter 2). The paradigm had a target phase, in which behavioural stimuli were created (in a non-social context), and a perceiver phase, in which judgments were made regarding the behavioural stimuli. Findings suggested that people do emit observable behavioural signals, while recalling their memories in response to cue words. The same paradigm was used in Chapter 3 to investigate differences between autistic and neurotypical targets in measures of readability, social favourability, and expressiveness from neurotypical perceivers. Findings revealed that perceivers were able to make accurate inferences about autistic behaviour and, in some cases, were better at inferring autistic behaviour when compared to the neurotypical behaviour. These findings were consistent in perceivers of different age groups. Autistic targets were also judged to be more expressive than the neurotypicals. However, in terms of social favourability ratings, autistic individuals were less liked than the neurotypical individuals by perceivers from three age groups: 10-12 years, adults and older adults. No evidence was found that autistic individuals were less liked by children aged between four to nine years. In Chapter 4, two studies were carried out to investigate a range of aspects of the written narratives of autistic and neurotypical targets while writing about emotional experiences. While the first study focused only on the numbers of words used of different types, the second study aimed to investigate more holistic differences in the quality of autistic and neurotypical writings. Findings suggested that autistic individuals’ narratives have many similarities but also some differences from neurotypical individuals' narratives in the quality and the structural aspects of writing. Autistic individuals even seemed to be better on some of the measures. In Chapter 5, the study aimed to investigate whether people can correctly guess autism diagnosis from watching brief samples of behaviour or from reading narratives that describe their emotional experiences. The study also looked at the effect of diagnostic disclosure on social favourability ratings. Findings indicated that although perceivers tended to judge that targets are neurotypical as opposed to autistic, nevertheless to some extent autistic individuals can be distinguished based on their behaviours and also from written excerpts that describe their life experiences. Furthermore, when informed that some targets were autistic, perceivers rated all targets to be less likeable compared to the condition when no diagnostic was used. This suggested that people seem to have a negative (implicit) attitude or stigma towards autistic individuals that influences their judgments. In conclusion, this work suggests people may not find it difficult to accurately perceive autistic individuals when a social context is not involved and using text as a means of communication with the non-autistic individuals may protect autistic individuals from being affected by the negative perceptions of the non-autistic individuals.
... stated Asperger (1944). However, the social withdrawal described is not identical in every patient, and thus the disorder was first described as a "spectrum" in the 2000 revised edition of the DSM-IV (Zeldovich, 2018). ...
The number of individuals diagnosed with autism spectrum disorders (ASD) has increased in recent years, and so has public awareness. However, our knowledge of the condition is still in its infancy. As a challenge to open our eyes, this study explores particular parts of the autistic world of perception: the sensory experiences of the indoors. The empirical study shows in detail how the respondents visually perceive interior spaces. The perception of different light sources, conspicuous patterns, and cluttered spaces can affect the well-being and mood of autistic individuals from Germany. The study shows that there are individually specific assessments of visual stimuli. Therefore, one solution for all is not feasible. However, design is a bridge between people whose perception is sensitive to visual perception and those responsible for interior design. Design ideas for indoor spaces such as restaurants, supermarkets, and offices are developed based on the observed challenges. The thesis aims to broaden the horizon of designers and decision-makers in designing these interior spaces by gaining insight into the existing environment from the perspective of people with disabilities. The final proposed recommendations serve as a solution approach to improve the well-being and inclusion of autistic people, thereby increasing the public's comprehension of the condition.
In this chapter, the diseases deriving from alterations of the ecological niche and regarding our holobiont are discussed. Possible alterations of the ecological niche regarding the holobiont: A: Reduced exposure to allergens; B: Elimination of intestinal parasites; C: Alterations of the microbiome at birth; D: Alterations of skin and mucosal microbiome; E: Alterations of the gut microbiome and obesity; F: The case of Helicobacter pylori.
A neurodiversity movement (NDM) has gained momentum, mainly driven by autistic self-advocates. The main argument of the NDM is that neurodivergent people experience discrimination that is on par with the historical discrimination of other minority groups. In this article, we propose a behavior analyst’s perspective on the NDM. We first explore the history and emergence of the concept of neurodiversity and its neurological as well as psychological basis. We consider its potential for generating what some consider a zero-sum game, in which one group makes all the gains potentially at the expense of another group. We finish with the suggestion that a win–win situation is possible if the focus shifts proactively to advocacy for all persons with autism, including those with very high support needs who often are not able to advocate actively for themselves and who tend to benefit greatly from evidence-based behavior-analytic interventions.
The location of the living human being in the animal world is a long-standing discussion, with recurrences from time to time. Perhaps one of the most significant for contemporary Western thought was the course that Kojeve gave between 1935 and 1939 on the phenomenology of Hegel’s spirit, not so much not only because of the teaching itself but because of the resonances on the rest of French thought and in a certain sense European in general. Bataille, Lacan, Levy-Srauss, Foucault, and Agamben, among others, refer to the turn this course represented for human interpretation.
Based on this interpretation, several unavoidable concepts can be identified, without which this discussion would be meaningless: the concept of homo has been indistinctly associated with sapiens, faber, zoon politikón, ludens, conscious, or drive. The first has had a clear expression in the anthropological tradition or non-pragmatic sociology, leaving the last two reserved for psychology and psychoanalysis.
In an approximation to the Freudian text of 1915 Drive and destinations of drive, which J. Lacan made in his Seminar 11, “The Four Fundamental Concepts of Psychoanalysis”; specifically, in the class of May 6, 1964 “Disassembly of the Drive,” he reminds us how essential one of the concepts of psychoanalysis is for the analytic experience: the drive (Trieb). This term, with a long history of clarifications and ambiguities in Freud’s work, is found throughout the entire corpus of his metapsychology, basting together the rest of the concepts and giving the body to a theory of the human psyche. Thus, the drive, rooted in psychoanalytic interpretations, which “every analyst (is) knows by existence” (Lacan, Les quatre concepts fondamentaux de la psychanalyse. Le séminaire, livre XI. Éditions du Seuil, 1964, p. 60); however, it has been “used” at will, according to what each theoretician needed for what he had to address.
At the very core of this discussion is the relationship with Pathos. The recognition or not of the living human and its type variants, pathology as a result of the non-pathological or pathos as indissoluble from the cultural essence have been some of the central questions. However, autism has appeared as an uncomfortable stone, whether one enters via “normality” toward the “pathological” or vice versa. It has even had a problematic history in the psychoanalytic tradition as well.
In this way, since the notion of autism began to be legitimised in the psychoanalytic tradition to name certain subjects—particularly infants—a diverse and challenging use was made of the Freudian notion of drive in its interpretation.
Then, to ask: how could “drive theory” explain what psychoanalysis considers “autism”? What are the difficulties in the dialogue between these two signifiers? Are these difficulties due to the misunderstanding of the word autism, as some hypothesise? Or to the different meanings of the drive in Freud, as others think? Or perhaps, are there other epistemic reasons that block these two concepts in the psychoanalytic theoretical gear?
We hypothesise that the appearance of autism came to shake up all this tradition for which the human subject was a fracture in the animal evolutionary continuity, both that of consciousness/unconscious—which exceeds the possibility of discussion in this space—and the “drive thesis,” which is the one that concerns us. In this sense, the opposition continuism-discontinuism would now be, for the phylogenetic, put into question, to be eventually replaced by an asymptotic continuism, more assimilable to the Spinozian bet.
This chapter explores the references to Sigmund Freud’s theory of drives in the interpretative approaches to child autism. Notably, it analyses the psychoanalytic thesis that proposes a constitutive failure in primordial times to understand the genesis of autism. The work explicitly presents a revelation of drive theory’s importance for the approach to autism. It also drives the exploration of the modes of appropriation and the use of said theorisation to explain the autistic phenomenon. Finally, the chapter discusses the analysis of the difficulties presented to the psychoanalytic authors when trying to accept autistic functioning and their theoretical choices to interpret it according to drive’s theory.
Almost two decades before Kanner's and Asperger's works, the original paper by child psychiatrist Grunya Efimovna Sukhareva had already been written. It was published in 1926 by Sukhareva in a German scientific journal of psychiatry and neurology, with a detailed description of children who presented clinical conditions whose characteristics and evolution closely resemble autism, according to current criteria. In the present historical note, we intend to present Sukhareva's pioneering work and retrieve the meaning of her original contribution.
Resumo
Quase duas décadas antes dos trabalhos de Kanner e Asperger, o artigo original da psiquiatra infantil Grunya Efimovna Sukhareva já havia sido escrito. Foi publicado por Sukhareva em 1926, em uma revista científica alemã de psiquiatria e neurologia, com uma descrição detalhada de crianças que apresentavam quadro clínico cujas características e evolução em muito se assemelham ao autismo, segundo os critérios atuais. Nesta nota histórica, pretende-se apresentar o trabalho pioneiro de Sukhareva e resgatar o significado da sua contribuição original.
Introduction
In vivo myeloarchitectonic mapping based on Magnetic Resonance Imaging (MRI) provides a unique view of gray matter myelin content and offers information complementary to other morphological indices commonly employed in studies of autism spectrum disorder (ASD). The current study sought to determine if intracortical myelin content (MC) and its age‐related trajectories differ between middle aged to older adults with ASD and age‐matched typical comparison participants.
Methods
Data from 30 individuals with ASD and 36 age‐matched typical comparison participants aged 40–70 years were analyzed. Given substantial heterogeneity in both etiology and outcomes in ASD, we utilized both group‐level and subject‐level analysis approaches to test for signs of atypical intracortical MC as estimated by T1w/T2w ratio.
Results
Group‐level analyses showed no significant differences in average T1w/T2w ratio or its associations with age between groups, but revealed significant positive main effects of age bilaterally, with T1w/T2w ratio increasing with age across much of the cortex. In subject‐level analyses, participants were classified into subgroups based on presence or absence of clusters of aberrant T1w/T2w ratio, and lower neuropsychological function was observed in the ASD subgroup with atypically high T1w/T2w ratio in spatially heterogeneous cortical regions. These differences were observed across several neuropsychological domains, including overall intellectual functioning, processing speed, and aspects of executive function.
Conclusions
The group‐level and subject‐level approaches employed here demonstrate the value of examining inter‐individual variability and provide important preliminary insights into relationships between brain structure and cognition in the second half of the lifespan in ASD, suggesting shared factors contributing to atypical intracortical myelin content and poorer cognitive outcomes for a subset of middle aged to older autistic adults. These atypicalities likely reflect diverse histories of neurodevelopmental deficits, and possible compensatory changes, compounded by processes of aging, and may serve as useful markers of vulnerability to further cognitive decline in older adults with ASD.
Four groups of children with autism spectrum disorders (ASD) are identified, differing in the depth and essence of the child’s environment interaction disorders. Each group is characterized by common traits: specific manifestations of autism, communication skills, and opportunities and limitations in the development of mental functions. Despite qualitative differences, these groups are formed based on the one biological deficiency with various degrees of criticality. This deficiency reduces the child’s endurance for contact with the environment and blocks the actualization of vital adaptation objectives, which require increasing activity from a child. A child is inadequate to solve self-protection tasks, form individual selectivity, organize goal-directed behavior, and process social experience. This prevents the child from developing meaningful connections with the environment, pathologically distorts the relationship between the affect and the intellect, and blocks opportunities for cognitive development. The differences between the identified groups are caused by the accentuation of problems in solving one of the highlighted vital tasks, which determines the nature of maladaptation in general and the severity and essence of mental development disorders. The groups are not considered separate clinical forms; they are used as benchmarks for identifying critical points of adaptive activity disorders in autism. Their identification is crucial for a differentiated approach to psychological diagnostics of ASD, assessment of mental development dynamics in autism, and establishing the order of remedial therapy objectives.
Autism spectrum disorder (ASD) has become a common neurodevelopmental disorder. The heterogeneity of ASD poses great challenges for its research and clinical translation. On the basis of reviewing the heterogeneity of ASD, this review systematically summarized the current status and progress of pathogenesis, diagnostic markers, and interventions for ASD. We provided an overview of the ASD molecular mechanisms identified by multi‐omics studies and convergent mechanism in different genetic backgrounds. The comorbidities, mechanisms associated with important physiological and metabolic abnormalities (i.e., inflammation, immunity, oxidative stress, and mitochondrial dysfunction), and gut microbial disorder in ASD were reviewed. The non‐targeted omics and targeting studies of diagnostic markers for ASD were also reviewed. Moreover, we summarized the progress and methods of behavioral and educational interventions, intervention methods related to technological devices, and research on medical interventions and potential drug targets. This review highlighted the application of high‐throughput omics methods in ASD research and emphasized the importance of seeking homogeneity from heterogeneity and exploring the convergence of disease mechanisms, biomarkers, and intervention approaches, and proposes that taking into account individuality and commonality may be the key to achieve accurate diagnosis and treatment of ASD.
Background
Autism has been considered a ‘male‐dominant’ condition. However, recent research suggests that autistic females are underdiagnosed, misdiagnosed, and later diagnosed. Females may also have different and more nuanced behavioral profiles. To examine diagnosis rates of females, we used 20 years of state‐wide data to characterize historical trends in the diagnosis of autism in females to determine whether the proportion of females diagnosed with autism has changed over time.
Methods
Data were drawn from 10,247 participants (males = 8,319, females = 1928) who received an autism diagnosis between 2000 and 2021 from state‐wide autism centers associated with the University of North Carolina TEACCH Autism Program.
Results
The rates of females diagnosed with autism increased at a greater rate compared with males. Age of diagnosis remained consistently higher for females. Late diagnosis (defined as 13+) increased over time across both males and females, however, was more commonly associated with females, particularly those with co‐occurring intellectual disability.
Conclusions
Our results indicate that the proportion of females diagnosed with autism has increased steadily over a 20‐year period, which likely reflects greater societal knowledge of how autism may manifest differentially in females.
Although first described in 1944 (the year the description of infantile autism), Asperger’s syndrome attracted little attention until the publication by Lorna Wing in early 1980. Over time, different views of the definition of Asperger’s syndrome developed. By the time of the Third Edition of the American Psychiatric Association’s Diagnostic and Statistical Manual and the Tenth Edition of the World Health Organization’s International Classification of Disease, enough information had accumulated to include the condition within the broader autism category. Asperger’s syndrome remained a focus of research interest and debate until its exclusion in the DSM-5 in 2013. We argue that the decision to remove Asperger’s syndrome 10 years ago as a distinct condition was premature. A discussion of the tensions around defining Asperger’s and concerns now arising due to the lack of this diagnostic category for new cases is provided.
Several measures have been developed to assess loneliness in the general population. Here, we examined if, and how accurately, widely-used measures capture the experience of loneliness in autistic adults. A total of 203 autistic participants from the UK completed an online survey, which included two widely-used loneliness questionnaires: the University of California, Los Angeles (UCLA) Loneliness Scale Version 3 and the Social and Emotional Loneliness Scale for Adults (SELSA). Participants completed the measures and provided their views on how well they captured their experiences of loneliness. A direct measure, asking participants how often they felt lonely, was also completed. Results demonstrated that scores on the UCLA and SELSA questionnaires positively correlated with the direct measure of loneliness, suggesting that these tools accurately index autistic experiences of loneliness. However, qualitative responses suggested that participants found both scales difficult to complete. Using reflexive thematic analysis, we identified three themes that encapsulated participants’ views: (1) failing to distinguish between the characteristics/experiences of loneliness and being autistic, (2) loneliness is not a static trait and (3) inappropriate wording. Given that our sample of autistic participants tended to prefer the UCLA scale to the SELSA, we provide initial recommendations around how the UCLA scale could be adapted for autistic adults.
Lay abstract
There has been increasing interest in research on loneliness in autistic adults. Much of this research has involved giving autistic adults widely-used questionnaires that are thought to measure how lonely people are. However, these questionnaires have been developed for the general public. We do not know whether these questionnaires accurately measure how lonely autistic adults are. We asked 203 autistic adults to complete an online survey that included two widely-used loneliness questionnaires: (1) the University of California, Los Angeles (UCLA) Loneliness Scale Version 3 and (2) the Social and Emotional Loneliness Scale for Adults (SELSA). We also asked participants to rate how lonely they were from 1 (often/always) to 5 (never). Participants were then asked to give their views on the questionnaires (e.g. what they thought was good, and what they thought was not so good about them). We found that the scores on the UCLA scale and the SELSA aligned with participants’ ratings of how lonely they were, which suggests that these two questionnaires accurately measure loneliness in autistic people. However, our participants also identified several ways to improve the questionnaires. This included (1) better distinguishing the characteristics/experiences of loneliness from those of being autistic; (2) better reflecting how loneliness may change at different times and in different contexts and (3) making the phrasing of the questions clearer. Overall, our autistic participants tended to prefer the UCLA scale to the SELSA. Therefore, we present some recommendations about how the UCLA scale could be changed to be more suitable for autistic people.
Autistic girls and women experience more mental health difficulties and poorer well-being than their non-autistic peers. Little emphasis has been placed on the perspectives of the girls and women within the literature. This review aims to provide an overview of the factors that impact autistic females’ emotional and social well-being and mental health, as described in self-report qualitative studies. The protocol for the present review was pre-registered on PROSPERO (CRD42020184983), and this article follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PsycInfo, Academic Search Complete and MEDLINE were systematically searched using a pre-defined search string. This yielded 877 unique records, which were systematically screened by two reviewers, resulting in 52 eligible studies. Structured data extraction and quality appraisal were completed. The present review presents the perspectives of 973 autistic females aged 13–70+. Thematic synthesis identified three themes and nine subthemes. Our findings suggest that autistic girls’ and women’s experiences can be conceptualised within a social model, where biological and psychological factors (‘The Autistic Neurotype’) are experienced through the lens of social factors (‘The Neurotypical World’ and ‘Stigma’), together shaping well-being and mental health outcomes.
Lay abstract
Difficulties with mental health and low levels of well-being are more common among autistic girls and women than non-autistic people, but we do not fully understand why. Research does not focus enough on what autistic girls and women could tell us about this. This review aims to summarise the studies where autistic girls and women explain things that affect their mental health and well-being to help us understand how to prevent these difficulties from developing. Three research databases were searched to find possibly relevant studies. There were 877 studies found, which two researchers screened according to particular criteria. They found 52 studies that could be included in this review. One researcher evaluated the quality of these studies and extracted the key information from them. This review summarises the views of 973 autistic girls and women aged between 13 and 70+. The findings from the 52 studies were analysed, and we found many factors that affect the mental health and well-being of autistic girls and women. These factors fall into two categories: (1) difficulties living in a world not designed for autistic people and (2) the impact of stigma due to being autistic.
What can we learn about the brain, mind, and education when working with autistic children and students? What insights from the brain, mind, and education can we use to support and empower autistic children and students? I’ll aim to discuss these two questions in this chapter. After a short introduction to the history of autism as a clinical entity, I’ll briefly review new insights from these three sources of knowledge.From the brain, the number of neuroimaging studies focusing on autism in infants and toddlers has risen significantly during the past two decades. This increase in literature is attributable to better collecting and sharing data techniques. Thanks to these datasets, neuroscientists found new differences in how autistic brains wire themselves compared to neurotypical ones, switching the target of their research from brain area to neural networks.From the mind, a cognitive model simulates and tries to explain mental processes. New cognitive models of autism are no longer deficit-based but perceptual, motivational, and predictive.From education, the emergence of an autistic community is a massive opportunity for all professionals to understand, act and provide adequate accommodations. Feedback from autistic students should be the core of new education policies.KeywordsAutism Spectrum disorderNeural networkEducationCognitive modelAutistic community
A timely diagnosis of autism is paramount to allow early therapeutic intervention in preschoolers. Deep Learning (DL) tools have been increasingly used to identify specific autistic symptoms, and offer promises for automated detection of autism at an early age. Here, we leverage a multi-modal approach by combining two neural networks trained on video and audio features of semi-standardized social interactions in a sample of 160 children aged 1 to 5 years old. Our ensemble model performs with an accuracy of 82.5% (F1 score: 0.816, Precision: 0.775, Recall: 0.861) for ASD screening. Additional combinations of our model were developed to achieve higher specificity (92.5%, i.e., few false negatives) or sensitivity (90%, i.e. few false positives). Finally, we found a relationship between the neural network modalities and specific audio versus video ASD characteristics, bringing evidence that our neural network implementation was effective in taking into account different features that are currently standardized under the gold standard ASD assessment.
W tej książce chciałem zawrzeć refleksje osób z autyzmem na temat edukacji, odpowiedzi na pytania, jak ją oceniają i jak chcieliby ją zorganizować. Zależało mi nie na przedstawieniu dysonansu pomiędzy rzeczywistością a nadziejami, ale próbowałem przede wszystkim się dowiedzieć, co powinniśmy zrobić i jakie wprowadzić zmiany w celu optymalizacji procesu edukacji. Zdaję sobie sprawę, że przedstawione opinie są subiektywne oraz mają charakter nieprecyzyjny, gdyż są oparte na własnych doświadczeniach. - autor ze Wstępu
Theoric and psychometric issues in the relationship between autism and visual impairments
Relationship between autism and visual impairments.
This chapter is directed towards therapists’ actions in group sessions involving French- and Finnish-speaking preadolescent boys with autism spectrum disorder (ASD). On the one hand, the focus is on how two therapists orient the group towards achieving meaningful learning outcomes with regard to the topic of conversation. The analysis concentrates on the therapists’ output or response strategies when they orient the group discussion and assess speech produced by the children, either validating it or parts of it or inviting them to provide more valid input. The results show that although a specific response category may have many functions, the aim of all of them is to maintain intersubjectivity among the participants (Wiklund & Määttä, 2021). On the other hand, the chapter discusses the therapists’ teaching orientations. The results of the analyses suggest that prosodic skills are often overlooked in group sessions and that the focus of the sessions tends, implicitly or explicitly, to be on the general norms of social interaction and embodied social interaction (Wiklund & Stevanovic, 2018).
Historically, few important writers have focused on the developmental disorders of their characters. In recent years, however, there has been a growing interest in representing the life of people diagnosed with neuro developmental conditions such as autistic spectrum disorders. In the novel Colin Fischer, Ashley Edward Miller and Zack Stentz give voice to an Aspergian named Colin Fischer. While identifying how the symptoms of the syndrome are expressed in Colin, this paper examines this complex and unique protagonist and the way in which home-based intervention plays a significant role in his personal development. Colin demonstrates how individuals diagnosed with Asperger’s face multiple challenges, but there is often something in which they excel. His extraordinary memory and his skill in accomplishing diverse tasks that most people would find boring are astonishing; they focus on Colin’s quiet dignity in the face of constant victimisation. The social message is that it is crucial to develop these skills in order to make the individual self-confident and successful.
Les unités d’enseignement maternelle autisme (UEMA) sont des dispositifs d’inclusion créées en France grâce au 3e plan autisme (Instruction interministérielle du 10 juin 2016). Elles se caractérisent par un fonctionnement d’équipe inédit et des missions pluridisciplinaires. La prise en charge des enfants en classe s’accompagne d’une guidance parentale par les professionnels. Cette dernière, pour réussir, suppose une collaboration entre les parents et les professionnels. Or, la pratique au sein d’une UEMA montre que des obstacles et des freins à la collaboration peuvent survenir. L’étude porte sur les conditions d’une collaboration réussie entre les acteurs, en observant l’accompagnement des parents par les professionnels. L’argumentation théorique se centre sur l’intersubjectivité et sur la notion de transmission identitaire. Plus précisément, la réflexion porte sur la capacité des éducateurs à transmettre les stratégies éducatives et un pouvoir d’agir aux parents d’enfant autiste, tout en accueillant leurs affects. De ce fait, les facteurs influant sur la transmission identitaire et l’élaboration d’une intersubjectivité sont observés, pour saisir leur importance dans la collaboration entre les parents et les professionnels. Méthodes – À travers une enquête quantitative et psychodynamique, les différents processus en jeu sont observés par des questionnaires: évaluation du pouvoir d’agir, du stress, du coping, du fardeau perçu et de l’alliance parentale chez les parents ; évaluation de la représentation au travail et de l’accord aux principes de soutien pour les professionnels. Des comptes rendus d’interventions et de réunions sont également étudiés. À travers des études de cas approfondies, le suivi porte sur l’intervention de trois éducatrices auprès de quatre enfants et leurs parents. Les résultats mettent en avant une influence des processus évalués dans la dynamique de transmission éducative. Ils permettent de définir une collaboration entre les parents et les professionnels réussie ou mise en défaut. Ils dégagent l’importance des facteurs de vulnérabilité et de protection chez les parents et des positionnements identitaires chez les professionnels. Il est proposé en conclusion que la collaboration entre les parents et les professionnels fasse l’objet d’une évaluation initiale du style relationnel de chaque acteur, du système dans lequel il évolue et des facteurs internes psychologiques qui peuvent l’influencer.
As the prevalence rates of autism and neurodegenerative dementia are rising, it has become a public health priority understanding the factors that might contribute to the co-occurrence of the two conditions. To date, the literature about the intersection between autism and neurodegenerative dementia is still limited although growing. In this perspective article, we summarized the evidence on this topic, describing the behavioral features shared by autism and neurodegenerative dementia, including social communication difficulties, cognitive alterations, and emotional problems. In addition, we reviewed the results from recent studies on the prevalence of dementia in autistic older individuals. Last, we focused on possible shared mechanisms and pathological underpinnings for each condition. We highlighted the importance of understanding the strengths and the needs of autistic subjects who present comorbid dementia, in order to develop long term care resources and arrange appropriate intervention programs. Furthermore, we argued that the systematic study of potentially common etiopathological mechanisms could increase our knowledge about the pathological basis of autism
and neurodegenerative dementia, to possibly develop targeted interventions.
Autism researchers can be ableist, including by talking about autistic people in sub-human terms (dehumanisation), treating autistic people like objects (objectification), and making othering statements which set autistic people apart from non-autistic people, and below in status (stigmatisation). This mixed-method study aimed to investigate how autism researchers construct autistic people and autism research, and to investigate whether including autistic people more in research relates to lower ableism in narratives about autistic people. We used a survey with autism researchers (N =195) asking five open-ended questions about autism and autism research, as well as demographics, career length, contact with autistic people (familial and non-familial) and degree to which researchers involve autistic people in their research. We used content analysis to categorize narratives used by autism researchers and cues for ableism (dehumanization, objectification, and stigmatisation). We then used binary-logistic regression to identify whether narrative or higher inclusion of autistic people predicted fewer ableist cues, controlling for career length and connections to autistic people. Using medicalised narratives of autism predicted higher odds of ableist cues compared to employing social model or neutral embodiment narratives. Greater inclusion of autistic people in research predicted significantly lower odds of ableist cues, while controlling for other contact with autistic people and career length. Next, we used reflexive thematic analysis to analyse researcher’s perceptions of autistic people and autism research. Narratives reflected core ideological disagreements of the field, such as whether researchers consider autism to be an intrinsic barrier to a good life, and whether researchers prioritise research which tackles “autism” versus barriers to societal inclusion for autistic people. Instrumentality (a form of objectification) was key to whether researchers considered a person to have social value with emphasis revolving around intellectual ability and independence. Lastly, language seemed to act as a tool of normalisation of violence. Researchers relied on an amorphous idea of “autism” when talking about prevention or eradication, potentially because it sounds more palatable than talking about preventing “autistic people”, despite autism only existing within the context of autistic people.
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