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Blessing or curse? The World Wide Web as information source for autism and Asperger Syndrome Abstract. Objective: The World Wide Web is today one of the most common methods used for obtaining health-related information, though the quality of the information is sometimes questionable. The present study addresses the quality of the information source internet and the resulting implications and discusses examples related to autism spectrum disorder. Method: We systematically evaluated 96 German websites, with the aim of estimating specific characteristic features, reliability of publications, presentation of information as well as overall website quality. We also analyzed the clinical implications of the presentations. Results: Only 39 % of the websites provided references to scientifically well-founded information, whereas advertisements were found on 53 % of websites. The greatest percentage of false information (17 %) was disseminated concerning therapy. 75 % of the websites provided incomplete information. Only 10 % of websites discussed the impairment or familial burden. The quality of information was insufficient on 30 %, poor on 41 %, and good on only 6 % of the websites. Conclusions: Similar to results available for English-language websites, the quality of German websites providing health-related information can be considered low. Implications concerning confirmation bias, stigma, overidentification, in-group/outgroup, contrast and snowball effects are discussed.

Objective: Various different questionnaires are available for the screening of autism spectrum disorders (ASD). These screening instruments show high sensitivity and are able to identify a large number of individuals with ASD, but they lack the specificity to differentiate individuals with ASD from those children and adolescents with other complex neurobehavioural disorders (such as attention-deficit/hyperactivity disorder, emotional disorders, and others), especially for those without intellectual disabilities., Method: The present study evaluates the data of 309 individuals (153 with high-functioning ASD, 156 with other psychiatric disorders, IQ > 70) to find out whether selected items of the ADI-R can be used for an economic and sensitive screening of high-functioning ASD., Results: The results show that 8 items of the ADI-R can be used to discriminate high-functioning ASD and other psychiatric disorders. A cutoff of 5 led to a sensitivity of 0.93 and a cutoff of 6 to a specificity of 0.74., Conclusion: The combination of early onset, serious abnormalities in social contact with stereotyped or compulsive-ritualized behaviour or interests can be detected with few interview questions for screening of ASD. Nevertheless, a more detailed and specific assessment in an expert setting should follow the screening process.

The affective responses to another person's condition depend on the ability to reflect about another's thoughts and intentions. This is relevant also for high-functioning individuals with ASD who have considerable difficulties in reading the intentions of others. With the present study we introduce a novel paradigm to induce vicarious embarrassment as a form of social pain. We predicted that the vicarious embarrassment experiences of high-functioning individuals with ASD should specifically decline in social contexts that require reflecting on another's intentions. Thirty-two young adults with high-functioning ASD were matched with regards to age, gender, and verbal IQ to a control group. Vicarious embarrassment was examined with previously validated stimuli describing 30 situations that elicit vicarious embarrassment in the observer. The situations manipulated whether the displayed protagonist either accidentally or intentionally transgressed a social norm in public and participants rated their vicarious embarrassment from the observer's perspective. The ASD group showed comparable vicarious embarrassment experience in response to observing another's accidental norm transgressions but significantly reduced vicarious embarrassment when observing another who intentionally violated socials norms. Vicarious embarrassment was significantly correlated with trait empathy in the ASD group. In complex social scenarios individuals with ASD are impaired in reporting experience of vicarious embarrassment, primarily when it is required to reflect on another's intentions. The present study thus contributes to a better understanding of how persons with ASD are affected in the diversity of empathic processes in the social, everyday life environment they are embedded in., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

This study was designed to identify items of the ADI-R that allow an early and sensitive identification of children with possible Asperger syndrome (AS). The aim was to obtain an economic short interview suitable for screening purposes. The study was based on data from a clinical sample of 5-18-year-old children and adolescents (mean age 10.9 years) with either Attention-Deficit Hyperactivity Disorder (ADHD; n = 43) or AS (n = 62). The introductory questions and 36 items, which contribute to the diagnostic algorithm of the ADI-R, were subjected to content analysis and stepwise discriminant function analysis. Eight meaningful items were found, which were shown to be good predictors of AS and to discriminate between the children with AS and those with ADHD. The short interview was especially useful for the assessment and screening of children up to 11 years in our sample, because in this subgroup, sensitivity was even higher (.92) and specificity was also excellent (.90). Eight items with high discriminatory power allowed sensitive and economic screening for young children with suspected AS., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The central question of the present study was whether there are differences between children with Asperger Syndrome (AS), children with attention deficit hyperactivity disorder (ADHD) and healthy controls (HC) with respect to the organization of narratives and their verbalization of internal states. Oral narrations of a wordless picture book produced by 31 children (11 with AS, 9 with ADHD, 11 HC, aged 8-12) were analyzed regarding the following linguistic variables: story length, sentence structure and sentence complexity, coherence and cohesion of the stories, verbalization of the narrator's perspective, as well as internal state language (verbal reference to mental states). Considerable similarities were noted between the two clinical groups, which deviate from HC children. Narratives of the children with AS and ADHD were shorter than the narratives produced by the HC children. The children of both clinical groups failed to point out the main aspects of the story. In particular, children with AS did not refer to cognitive states as often as the other groups. With respect to narrative coherence, they produced fewer pronominal references than HC children and children with ADHD. In conclusion, the two clinical groups differed from the HC group on a number of features, and a less frequent reference to cognitive states was identified for the children with AS., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: This study evaluates self- and proxy-reported health-related quality of life (HRQOL) in children and adolescents with autism spectrum disorders (ASD). The study also compares HRQOL in ASD patients with a healthy control sample and a psychiatric reference sample., Method: 42 children and adolescents (39 male, mean age: 12.7 ± 2.6 years, mean IQ: 100.5 ± 20.7) with the diagnosis of autism spectrum disorder (ASD) and their parents completed the Inventory for the Assessment of Quality of Life in Children and Adolescents (ILK)., Results: Mean ILK LQ 0-28 scores were 20.6 (± 4.6) (self-report version) and 18.2 (± 4.0) (proxy version). Compared to a reference sample, mean ILK scores from the ASD sample were at the 47th percentile (self-report) and the 33rd percentile (proxy). Compared to children and adolescents with psychiatric disorders, self-reported ILK scores correlated with the 69th percentile, and proxy-reported ILK scores correlated with the 67th percentile. Self-reported HRQOL was significantly higher than proxy-reported HRQOL. No significant correlation was found between HRQOL and age, IQ, or autistic symptoms., Conclusions: HRQOL in children and adolescents with ASD seems to be better than in other psychiatric disorders, but lower than in healthy controls.

Objective: A deficit in empathy has repeatedly been described as a central feature of autistic disorders. However, little is known about how adolescents with autism evaluate their own empathic abilities, and how their parents judge these skills. The present study assesses affective components of empathy via both self-report and parental report., Method: 18 boys with autism and 18 typically developing boys participated in the study. A German translation of the Bryant Index of Empathy was used for the self-assessment of empathy. Parents rated the empathic abilities of their sons using a German version of the Griffith Empathy Measure. Both questionnaires are comparable with regards to content and mainly tap into affective components of empathy., Results: Self-reports of empathy in adolescents with autism did not differ from controls. In contrast, parents of adolescents with autism judged their sons to be less empathic compared to parents of typically developing adolescents., Conclusions: The discrepancy between unimpaired self-reported empathy and parental report of impaired empathy in adolescents with autism might result from their difficulties in effectively conveying empathic feelings to other people. Alternatively, the results may be explained by impaired introspection on inner experiences in individuals with autism.

There is an ongoing debate whether a differentiation of autistic subtypes, especially between Asperger Syndrome (AS) and high-functioning-autism (HFA) is possible and if so, whether it is a categorical or dimensional one. The aim of this study was to examine the possible clustering of responses in different symptom domains without making any assumption concerning diagnostic appreciation. About 140 children and adolescents, incorporating 52 with a diagnosis of AS, 44 with HFA, 8 with atypical autism and 36 with other diagnoses, were examined. Our study does not support the thesis that autistic disorders are discrete phenotypes. On the contrary, it provides evidence that e.g. AS and autism are not qualitatively distinct disorders, but rather different quantitative manifestations of the same disorder.

An increasing number of animal studies advert to a substantial role of the neuropeptide oxytocin in the regulation of social attachment and affiliation. Furthermore, animal studies showed anxiety and stress-reduced effects of oxytocin. First human studies confirm these findings in animal studies and implicate a crucial role of oxytocin in human social attachment behavior and in social interactions. Thus, the oxytocin system might be involved in the impairment of social interaction and attachment in autism spectrum disorders (ASD). The human oxytocin receptor gene (OXTR) represents a plausible candidate gene for the etiology of ASD. To analyze whether genetic variants in the OXTR gene are associated with ASD we performed family-based single-marker and haplotype association analyses with 22 single nucleotide polymorphisms (SNPs) in the OXTR and its 5' region in 100 families with autistic disorders on high-functioning level (Asperger syndrome (AS), high-functioning autism (HFA), and atypical autism (AA)). Single-marker and haplotype association analyses revealed nominally significant associations of one single SNP and one haplotype with autism, respectively. Furthermore, employing a "reverse phenotyping" approach, patients carrying the haplotype associated with autism showed nominally significant impairments in comparison to noncarriers of the haplotype in items of the Autism Diagnostic Interview-Revised algorithm describing aspects of social interaction and communication. In conclusion, our results implicate that genetic variation in the OXTR gene might be relevant in the etiology of autism on high-functioning level., ((c) 2009 Wiley-Liss, Inc.)

Objectives: Asperger's Syndrome is a disorder of uncertain nosological validity, which is difficult to differentiate from high-functioning autism. Even today these disorders are unfortunately diagnosed very late, often in the wake of earlier, different diagnoses. The purpose of this study is to present a screening instrument (MBAS), which is sensitive to these disorders., Methods: The instrument was tested among a total of 91 probands (44 of whom had been diagnosed as autistic, and 47 of whom had been diagnosed with a non-autistic disorder)., Results: The items on the MBAS were of average difficulty; generally, the all item-total correlation was good. The total scale has an internal consistency of Cronbach's alpha = .91 and the convergent validity of the MBAS and the ADI-R reached r = .61 (p = .001). The total score of the questionnaire discriminated highly significantly between the group with autism and that without. At a sensitivity of 95.5% and a specificity of 95.7% the number of misclassifications is low. False negative classifications occurred only in the case of very young children., Conclusions: The MBAS is a reliable and valid instrument for screening and generating tentative diagnoses of high-functioning autism. The questionnaire is well suited for the selection and generation of tentative diagnoses of autism on a high-functioning level.

The Asperger-Syndrom is a pervasive developmental disorder, characterized by impairments in primarily social and communicative competence, empathy, associated with motor awkwardness and/or clumsiness and highly circumscribed interests. The diagnostic criteria and the diagnostic methods are in detail exemplified. While the validity of autism (Kanner-syndrom) has been shown through multiple different levels of evidence, the validity of Asperger-Syndrom is still unestablished. The few literature is extremely difficult to summarize (Volkmar u. Klin 2000), given that a range of important methodological issues render comparability of findings across studies virtually impossible: these include differences in definition and circularity in definition relative to validating measures. In terms of causes of Asperger-Syndrom the following factors are discussed: genetic reasons, neurobiological disturbances and neuropsychological deficits.