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Requests for pathological demand avoidance diagnoses have increased over recent years but pathological demand avoidance remains a controversial issue. We undertook a systematic review of peer-reviewed studies of pathological demand avoidance, using standardised appraisal and synthesis methods, to assess how pathological demand avoidance is identified and to explore the relationships between pathological demand avoidance, autism and other developmental/psychiatric disorders. A search of PsycINFO/PubMed/MEDLINE/Embase identified 13 studies meeting inclusion criteria. Narrative synthesis was chosen due to methodological heterogeneity of the identified studies. Autistic children/adolescents constituted the majority of participants in most studies. Most studies provided clearly defined inclusion criteria together with adequate descriptions of participants and study settings. Almost all studies relied on the parental report of pathological demand avoidance symptoms/diagnosis. Identification of pathological demand avoidance in all studies seemed to be, directly or indirectly, based on the criteria developed by Newson et al. While eight studies used objective criteria for the identification of pathological demand avoidance, the measures used have methodological limitations. Though associations with anxiety have been reported, few studies took account of possible relationships between pathological demand avoidance and other conditions, such as anxiety. Methodological limitations restrict current conclusions regarding the uniformity or stability of the constellation of behaviours associated with pathological demand avoidance or the characteristics of individuals displaying them. Clinical implications of current research are discussed.

Although many researchers have investigated emotional and behavioral difficulties in individuals with Williams syndrome, few have used standardized diagnostic assessments. We examined mental health problems in 92 adults with Williams syndrome using the Psychiatric Assessment Schedule for Adults with Developmental Disabilities--PAS-ADD (Moss, Goldberg, et al., 1996). Factors potentially associated with mental health problems were also explored. The PAS-ADD identified mental health problems in 24% of the sample. The most common were anxiety (16.5%) and specific phobias (12%). Other diagnoses included depression, agoraphobia, and social phobia. No association was found between the presence of mental health problems and either individual (e.g., age, IQ, language level) or external (life events) variables.

This study examined predictors of developmental outcomes in 17 young children diagnosed with autism or pervasive developmental disorder, who received generic treatment over an average of 37 months. Although children differed substantially in outcomes, these were not predicted by treatment intensity or other treatment variables although pre-treatment developmental intelligence levels approached significance as a predictor variable. (Contains references.) (Author/DB)

Investigates the syntactical level of spontaneous and echolalic utterances of 26 autistic boys at different stages of phrase speech development. Speech samples were collected over a 90-minute period in unstructured settings in participants' homes. Imitations were not deliberately elicited, and only unprompted, noncommunicative echoes were analyzed. (RH)

Background: In early typical language development, children understand words before they are able to use them in speech. Children with autism spectrum disorders (ASD) generally show impairments in both the comprehension and the production of language. However, the relative degree of delay or impairment in each of these sub-domains may also be atypical and remains less well-understood. Aims: Relative delay in receptive and expressive language skills was examined within a large sample of preschoolers with autism. Children's language abilities varied from pre-verbal to fluent speech. Method & Procedures: Scores on one direct clinician assessment and two parent-report measures of language were obtained for 152 preschoolers with core autism. Outcomes & Results: As expected, on average, the language ability of the children with autism was lower than typical age norms, albeit with substantial individual variability. On all three language measures, receptive ability was relatively more impaired than expressive ability. Higher non-verbal ability was associated with such an atypical language profile. Conclusions & Implications: Recognition of the marked receptive language impairment relative to expressive language, found to affect at least one-third of preschoolers with autism in this sample, has important implications for interacting with these children and for informing appropriate targets in language and communication intervention. [ABSTRACT FROM AUTHOR]

Copyright of American Journal on Intellectual & Developmental Disabilities is the property of American Association on Intellectual & Developmental Disabilities and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Recent reviews highlight limitations in the evidence base for early interventions for children with autism. We conducted a systematic review of controlled studies of early intensive behavioral interventions (EIBI) for young children with autism. Eleven studies met inclusion criteria (including two randomized controlled trials). At group level, EIBI resulted in improved outcomes (primarily measured by IQ) compared to comparison groups. At an individual level, however, there was considerable variability in outcome, with some evidence that initial IQ (but not age) was related to progress. This review provides evidence for the effectiveness of EIBI for some, but not all, preschool children with autism. [ABSTRACT FROM AUTHOR]

Background: This prospective study compared outcome for pre-school children with autism spectrum disorders (ASD) receiving autism-specific nursery provision or home-based Early Intensive Behavioural Interventions (EIBI) in a community setting. Methods: Forty-four 23- to 53-month-old children with ASD participated (28 in EIBI home-based programmes; 16 in autism-specific nurseries). Cognitive, language, play, adaptive behaviour skills and severity of autism were assessed at intake and 2 years later. Results: Both groups showed improvements in age equivalent scores but standard scores changed little over time. At follow-up, there were no significant group differences in cognitive ability, language, play or severity of autism. The only difference approaching significance ( p = .06), in favour of the EIBI group, was for Vineland Daily Living Skills standard scores. However, there were large individual differences in progress, with intake IQ and language level best predicting overall progress. Conclusions: Home-based EIBI, as implemented in the community, and autism-specific nursery provision produced comparable outcomes after two years of intervention. [ABSTRACT FROM AUTHOR]

Difficulties in social interaction are a central feature of Asperger syndrome. Effective social interaction involves the ability to solve interpersonal problems as and when they occur. Here we examined social problem-solving in a group of adults with Asperger syndrome and control group matched for age, gender and IQ. We also assessed autobiographical memory, on a cueing task and during social problem-solving, and examined the relationship between access to specific past experiences and social problem-solving ability. Results demonstrated a social problem-solving impairment in the Asperger group. Their solutions were less detailed, less effective and less extended in time. Autobiographical memory performance was also impaired with significantly longer latencies to retrieve specific memories and fewer specific memories retrieved in comparison to controls. [ABSTRACT FROM AUTHOR]

The requirement for educational provision for all children to be evidence based has been highlighted in many government policies.1 The significant additional costs of educating children with autism, and difficulties in recruiting adequately trained teachers, have placed increasing pressure on education authorities to provide more cost-effective instruction methods for pupils with autism. Computer-assisted interventions (CAI) have been suggested as a possible means of meeting the educational needs of this group, and findings from mostly small, uncontrolled studies have indicated positive improvements in areas such as academic ability, social and communication skills, and adaptive behavior.2 The present study by Pellecchia et al.3 describes an evaluation of one such program: TeachTown: Basics. This is a computer-assisted intervention that aims to increase students' vocabulary, listening skills, socio-emotional development, and academic and cognitive abilities. It is designed for children with autism or other developmental disabilities with a nonverbal mental age equivalent of 2 to 7 years. A brief (20 minutes per day for 3 months), small-scale (n = 22, children 3-6-years of age), randomized control trial (RCT) of TeachTown: Basics, previously conducted in the Los Angeles Unified School District,4 produced some positive but generally nonsignificant changes in language and cognitive measures compared with a control group. Although the authors themselves were cautious about the results, this very limited evidence from a single RCT was enough for the School District of Philadelphia (the eighth largest district in the country) to decide to roll out the program to students in all of its kindergarten to second grade autism support classrooms. [ABSTRACT FROM AUTHOR]

Abstract: This contribution presents an update on recent research into autism spectrum disorders (ASD). The areas covered include the genetic and neurological bases of ASD and the procedures required for accurate diagnostic assessment. Findings that challenge traditional views of ASD, particularly related to prevalence rates (now known to be much higher than originally believed), and levels of cognitive and linguistic ability are also discussed. The results of treatment trials are variable and the need for a much higher level of experimental sophistication in intervention research is highlighted. The necessity of providing more effective treatments and support networks for adults with ASD, rather than the focus being almost entirely on children, is stressed. [Copyright &y& Elsevier]

Few supported employment programmes have been specifically designed for people with autism, especially those who are more able. This study examines the outcome of a supported employment service (NAS Prospects) for adults with autism or Asperger syndrome (IQ 60+) over an 8 year period. Approximately 68 percent of clients found employment. Of the 192 jobs, the majority were permanent contracts and most involved administrative, technical or computing work. Assessment of current clients indicates that IQ, language skills and educational attainments are high. However, work has also been found for those of lower abilities. Individuals supported by Prospects show a rise in salaries, contribute more tax and claim fewer benefits. Satisfaction with the scheme is high among clients, employers and support workers. Although the programme continues to incur a financial deficit, this has decreased. Moreover, there are many non-financial benefits, which are difficult to quantify. The importance of specialist employment support of this kind is discussed. [ABSTRACT FROM AUTHOR]

Increasing numbers of children with autism spectrum disorder (ASD) are diagnosed in the preschool years, and their educational progress must be monitored. Parent questionnaire data can augment psychometric assessments and individual planning at low cost. One hundred and twenty-five parents of UK children who entered dedicated autism primary schools and units in two consecutive calendar years were asked to complete three questionnaires. Fifty-seven parents repeated the questionnaire measures one year later. Encouraging developmental progress was observed on the Vineland Adaptive Behavior Scales-Screener. Symptom severity as measured by the Social Communication Questionnaire did not change over time. The pattern of change scores on the Autism Treatment Evaluation Checklist was mixed, and confounding disadvantages this questionnaire. The study demonstrated that it is possible to collect useful information on the progress of children with ASD using parents as informants. Such data would assist in judging claims regarding developmental progress within particular programmes. [ABSTRACT FROM AUTHOR]

The question of whether Asperger syndrome and high-functioning autism should be considered as the same or different conditions has been a source of debate and controversy over recent years. In the present study, 34 adults with autism who had shown early delays in language were compared with 42 individuals who were reported to have had no such delays, either in their use of words or phrases. All participants were at least 18 years of age, had a nonverbal IQ of 70 or above and met ADI-R criteria for age of onset, communication and social impairments, and stereotyped behaviors. Those in the language delay group were diagnosed as having high-functioning autism. The remainder were designated as having Asperger syndrome. The groups were matched for age, nonverbal IQ and gender. No significant differences were found between the groups either in their total ADI-R algorithm scores, or in their algorithm scores on individual domains. Social outcome ratings and ADI-R scores based on current functioning also failed to differentiate between the groups. Scores on tests of language comprehension and expression were also similar, but in both groups language abilities were well below chronological age level. The implications of these results with respect to the differences between Asperger syndrome and high-functioning autism are discussed. The poor performance on language tests also challenges the assumption that early language development in Asperger syndrome is essentially normal. [ABSTRACT FROM AUTHOR]

The article discusses the diagnostic and treatment issues on autism and intellectual disability. Information about the estimates of the prevalence of autism and other related disorders is presented. Also included are the factors associated with the diagnosis and treatment of the disorder including preschool interventions and home-based behavioral programs.

Studies of parental satisfaction with the way in which diagnostic information is imparted have generally focused on conditions that are evident from birth. Diagnostic disclosure for disorders in which the onset is later, and less readily identifiable, has received less attention. The present study investigated parents' views of diagnostic procedures for children whose developmental delays only became apparent as they grew older. The degree of satisfaction was related to the type of diagnosis given but 2 weeks after the assessment 87% of parents described themselves as being very or fairly satisfied. However, levels of satisfaction were lower at a later follow-up than they had been initially. Moreover, several specific aspects of the assessment fell short of the ideal model and parents offered a number of practical and cost-effective suggestions as to how these could be remedied. These ranged from ways in which pre-assessment procedures could be made more useful, how diagnostic information should be presented and how the physical setting could be improved. [ABSTRACT FROM AUTHOR]

The article presents information on the articles that have been published in the October 2005 issue of the "Austism: The International Journal of Research and Practice." The articles from the United States deal with the important perspectives of people with autism spectrum disorders (ASD). The study on which these articles are based used a qualitative analysis of three discussion groups of adults with ASD to determine the issues of concern around the topic of social challenges. The article from Great Britain deals with ways of coping with stress by parents of children with ASD. Researchers studied 89 parents of preschoolers with ASD and 46 parents of school-aged children with ASD. The coping strategies that were found were categorized as active avoidance problem focused on religious denial. The results showed that avoidance coping was associated with more stress, anxiety and depression in both parents and religious denial. Positive coping was associated with less depression in both parents.

The article discusses various reports published within the issue, including one by Daniel B. Legof and Michael Sherman on long-term outcome of social skills intervention based on interactive LEGO play and another by Panagiotis Siaperas and Julie Beadle-Brown on the use of a structured teaching approach in adults with autism in Greece.

Comments on the articles in the September 2004 issue of the journal "Autism." Co-authorship and collaboration by academic researchers and clinicians and focus on practical intervention strategies; Study comparing the traditional behavioral approaches with more naturalistic play interventions for young children with autism; Play and social interactions of young children with autism in free play settings.

Editorial. Presents the articles on autism, published in the March 1999 issue of the periodical 'Autism.' Frequency of autism-related disorders; Mortality and causes of death in people with developmental disorders; Interventions for children with autism; Biology of autism; Effects of a dietary program for children on autism.

The author comments on a study published within the issue which focused on the association between autism and developmental language disorders. She finds that the study failed to clarify the debate about the nature of the association between autism and developmental language disorders although this remains to be an important area for future research, especially with genetics. She is urging the authors to conduct studies of adults specifically diagnosed with pragmatic language impairment (PLI) as children.

Background: There is a growing call for empirically based programming to support the success of students with autism spectrum disorder (ASD) as they transition to college.Aims: The purpose of this study was to identify the needs and challenges faced by adolescents and young adults with ASD in postsecondary education.Methods: A mixed methods approach was taken to explore the needs of college-bound and college-enrolled students with ASD. Primary stakeholders (i.e., parents, educators/support staff from secondary and postsecondary institutions, and students) participated in an online survey (n=67) and focus groups (n=15).Results: Across the stakeholder groups, commonly identified areas of difficulty included limited interpersonal competence, managing competing demands in postsecondary education, and poor emotional regulation. There was a high degree of agreement across stakeholders in the identified needs and challenges.Implications: Findings from this preliminary needs analysis will inform the development of programming to support students with ASD. [ABSTRACT FROM AUTHOR]