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Recent studies have reported that strengths-based programs, leveraging autistic adolescents' abilities and interests, could improve their skills and facilitate social engagement. However, little is known about the long-term impact of strengths-based approaches. This study aimed to explore the long-term outcomes of community strengths-based programs designed to support autistic adolescents in developing interests and skills in Science, Technology, Engineering, Arts, and Mathematics (STEAM) and the factors influencing their participation in these programs. A repeated cross-sectional survey study over three years recruited 52 parents in 2018, 52 parents in 2019, and 38 parents in 2020. Results highlighted the positive impact of these programs on autistic adolescents' health and well-being, social relationships and interactions, self-confidence and self-esteem, sense of belonging, and activities and participation. Five key elements influencing participation included the enthusiasm of the participants, their self-perception, the approach of the programs, the learning environment, and the attitudes of the mentors. This study implies that strengths-based approaches to intervention and support for autistic adolescents in a supported environment are a social model solution that could potentially have positive participant outcomes. Findings from this study could provide a framework underpinning future strengths-based interventions., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: Goal: to evaluate changes in the grey matter volume using the VBM method in a group of adolescents with ASD, who met the criteria for Asperger's Syndrome., Methods: Material and methods: Morphometric evaluations based on Voxel Based Morphometry (VBM) were performed on 37 male adolescents aged 12 to 19 (M = 14.3 ± 2.0), with autism spectrum disorders, who met the DSM-IV-TR criteria for Asperger's Syndrome and 15 neurotypical adolescents matched by age. Significance was set at p<0.007 without FWE correction and p<0.05 with FWE correction., Results: Results: the decrease in the volume of the grey matter was observed in ASD group including the pre- and postcentral gyrus, the superior and middle frontal gyrus, the inferior and superior parietal lobule, the praecuneus, the anterior and posterior cingulate cortex, the fusiform gyrus, the parahippocampal gyrus, the lingual gyrus, the middle occipital region, the cuneus and the angular gyrus, the regions of calcarine sulcus and the cerebellum. The majority of changes was localized bilaterally., Conclusions: Conclusions: the decrease in the volume of grey matter observed in ASD group can be related functionally with the characteristics of deficits observed in autism spectrum disorders which highlights the role of abnormal organization of numerous CNS structures in the genesis of symptoms observed in cognitive and behavioural domains.

It is recognised that a high proportion of adults on the autism spectrum experience depressive symptoms. However, limited research has explored autistic peoples' experiences of low mood and depression. The aim of this study was to explore the lived experiences of low mood and depression for adults on the autism spectrum. The study employed Interpretive Phenomenological Analysis to investigate the experiences of 8 adults (7 males and 1 female), aged between 19 and 51, who had a diagnosis of autism without co-occurring learning disabilities, and experienced low mood or depression. All participants recorded their thoughts and feelings in a mood diary for 1 week and participated in a semi-structured interview. Three superordinate themes emerged from the data: 'Autism has made me the person I am', 'I can't function in the world' and 'It's like trying to do accounts on the futures market': Making sense of emotions. Findings highlight a need for specialist mental health provision for adults who are on the autism spectrum. Limitations of this study and implications for future research are discussed.

The early recognition of ASD in adults is challenging, in particular due to the lack of appropriate and robust diagnostic tools. We performed a psychometric validation and diagnostic accuracy study of the French version of the RAADS-R on a sample of 305 adults: 105 with ASD without ID, 99 with psychiatric disorders, and 103 non-psychiatric control groups. The French version of the RAADS-R demonstrates good reliability and diagnostic validity, suggesting that it can help clinicians during the diagnostic process in adults with ASD without ID. However, the finding that a two-factor structure better fits the results requires further validation. This study point out the need of further study of RAADS in psychiatric disorders group due to the relatively high false positive rate (55.6%) of ASD.

Biomarkers for autism spectrum disorder (ASD) are lacking but would facilitate drug development for the core deficits of the disorder. We evaluated markers proposed for characterization of differences in social communication and interaction in adults with ASD versus healthy controls (HC) for utility as biomarkers. Data pooled from an observational study and baseline data from a placebo-controlled study were analyzed. Between-group differences were observed in eye-tracking tasks for activity monitoring, biomotion, human activity preference, composite score (p = 0.0001-0.037) and pupillometry (various tasks, p = 0.017-0.05). Impaired olfaction was more common in the ASD sample versus HC (p = 0.018). Our preliminary results suggest the potential use for stratification and response sub-analyses outcome-prediction of specific eye-tracking tasks, pupillometry and olfaction tests in ASD trials.

This study examined the perception of an ASD label compared to Asperger's syndrome or no diagnosis. Seventy-one undergraduates read an adapted vignette (Ohan et al. J Autism Dev Disord 45:3384-3389, 2015) about an undergraduate with ASD, Asperger's Syndrome, or No Diagnosis. Participants also completed questionnaires. More positive ratings emerged for the Asperger's and ASD labels than No Diagnosis in low contact scenarios, particularly when involving greater social versus professional interaction. In contrast, more positive ratings emerged for the Asperger's compared to the ASD and No Diagnosis on high contact items. Ratings between low and high contact items differed only for ASD. Results demonstrate the impact of diagnostic labels across social contexts and support the need for education surrounding changes in nosology.

Purpose: This pilot study describes the socio-professional development and quality of life of young adults with Asperger syndrome in France. Methods: Those young adults, between 18 and 30 years old, receiving care in a child psychiatry department for autistic spectrum disorder, were requested to respond to the Ad Hoc, World Health Organization Quality Of Life - Bref and Copenhagen psychosocial questionnaires regarding their socio-professional background and feelings about their future. Results: Of the 79 eligible subjects, 24 were selected to participate in our study. Their average age at the time of the pilot study was 22.2 years (standard deviation 3.4 years), and their average age when they were diagnosed was 17.5 years (standard deviation 3.7 years.). There were 54% who reported a psychiatric comorbidity anxiety disorder. Half stated they had completed secondary school and benefitted from being professionally employed. During this study, only six were employed, while the others remained financially dependent on their parents. The group's quality of life self-assessment scores were significantly lower compared to the French general population in overall psychology (43.6 versus 68.7) and social relationships (48.9 versus 76.5). However, the study's participants perceived work as an important means to their personal development. Hence, in order to cope with their difficulties, they hoped to benefit from customized support adapted to their autistic disorder and for their workplace colleagues to be better informed about Asperger syndrome. Conclusions : Our results are in line with international data. Additional studies need to be done in order to determine socio-professional integration factors and, in particular, the integration of potential contributions by occupational health departments with those social and medical teams supporting these young adults.Implications for rehabilitationYoung adults with Asperger syndrome benefit from the support of their family in determining their professional goals.Support may be required to enhance social and communicative abilities to help integration.Employees would benefit from information on the syndrome and how best to support.

Background: Synesthesia is a sensory phenomenon where certain domain-specific stimuli trigger additional sensations of e.g. color or texture. The condition occurs in about 4% of the general population, but is overrepresented in individuals with Autism Spectrum Disorder (ASD), where it might also be associated with the presence of prodigious talents., Case Presentation: Here we describe the case of a young transsexual man with Asperger Syndrome, synesthesia and a prodigious talent for foreign language acquisition. In our case, not only letters, numbers, spoken words, music, noises, weekdays and months lead to highly consistent, vivid color sensations but also his own and others' emotions, geometric shapes, any mathematical symbol, and letters from an unfamiliar alphabet (Hebrew). These color associations seem to aid categorization, differentiation and storage of information and might thereby contribute to the young man's language acquisition ability. We investigated the young man's structural brain connectivity in comparison to adults with or without ASD, applying global fiber tracking to diffusion-weighted Magnetic Resonance Imaging (MRI) data. The case presented with increased connectivity, especially between regions involved in visual and emotion processing, memory, and higher order associative binding regions. An electroencephalography experiment investigating synesthetic color and shape sensations while listening to music showed a negligible occipital alpha suppression, indicating that these internally generated synesthetic sensations derive from a different brain mechanism than when processing external visual information., Conclusions: Taken together, this case study endorses the notion of a link between synesthesia, prodigious talent and autism, adding to the currently still sparse literature in this field. It provides new insights into the possible manifestations of synesthesia in individuals with ASD and its potential contribution to prodigious talents in people with an otherwise unexceptional cognitive profile. Additionally, this case impressively illustrates how synesthesia can be a key element not only of sensory perception but also social and emotional processing and contributes to existing evidence of increased brain connectivity in association with synesthesia.

We explored subjective well-being in two groups of young adult participants diagnosed with either schizotypal disorder (Sd) (n = 29) or Asperger syndrome/autism spectrum disorder (As/ASD) (n = 22). Well-being was impaired in both groups and was lower in the Sd group than in the As/ASD group. Furthermore, there was a negative correlation between well-being and the presence of self-disorders. The negative effect of self-disorders on well-being was still significant when adjusted for diagnosis, age and gender, and level of function. The present findings point toward clinically important disorder-specific differences in the nature of impaired well-being between the Sd group and the As/ASD group, as there seems to be a self-disorder-driven additional contribution to impaired subjective well-being within the schizophrenia spectrum. These findings further nuance the understanding of fundamental and clinically important qualitative differences between the schizophrenia spectrum and the autism spectrum.

Asperger's Syndrome was introduced as a separate diagnostic category in the DSM-4 (1994). Its subsequent absorption into autism spectrum disorder in the DSM-5 (2013) led to vigorous debate and concerns about the loss of the unique Asperger's identity. Existing research has identified that adults previously diagnosed with Asperger's have expressed a diverse range of opinions regarding the DSM-5 changes. This Australian study explored the role of disability identity development in responses to the change through semi-structured interviews with 12 adults diagnosed with Asperger's under the DSM-4. Their different views did not appear to be a function of demographic variables; a connection was identified between participants' views of the change and differing stages of integration with the Asperger's and/or autism identities.

Investigated internal consistency reliability and criterion validity of the Asperger Syndrome Diagnostic Scale (ASDS) in a well-characterized sample of 120 children ([Formula: see text] = 9.91; autism [AUT] n = 54; non-autism [NOT] n = 66) who completed comprehensive outpatient evaluations with a gold-standard measure, the Autism Diagnostic Observation Schedule-2. With the exception of a low Cognitive alpha in the AUT group, internal consistency reliabilities ranged from moderate to high. Significant between-group mean differences were observed for all scores. Receiver operating characteristic analyses indicated Area Under the Curve in the fair range (.71). Cutoff points and interpretation are discussed. The ASDS appears most useful in cases of either low or high scores or as an adjuvant to gold-standard measures.

Better conversational skills correspond to a higher quality of life for adults diagnosed with autism spectrum disorder (ASD). In this study, we taught vocal-verbal responses discriminated by compound arrangements of concealed conversation partner mands to two college students with ASD. Participants learned to engage in self-questioning about their conversation partner's behavior and to reinforce three concealed mands for termination of an aversive conversation scenario. We assessed generalization to conversation probes with trained confederates and to interactions with untrained conversational partners (e.g., peers, professors). Finally, we collected peer ratings of the social validity of changes in conversational behavior as well as participants' ratings of study goals, procedures, and outcomes., (© 2019 Society for the Experimental Analysis of Behavior.)

Available reviews have shown potential effects of probiotics on neurobehavioral outcomes through 'gut-brain axis' mechanism in adults. However, reviews on cognitive function in children and adolescents are lacking. Therefore, we conducted a systematic review of randomised controlled trials (RCTs) of the effect of probiotic supplementation on cognitive function in children and adolescents. A search of four databases (Cochrane Central Register of Controlled Trials, PsycARTICLES, Scopus, PubMed) was conducted to identify RCTs published from January 1990 to December 2018. Seven studies met the inclusion criteria and their cognitive outcomes were analysed. Only one study found a positive result with Lactobacillus rhamnosus GG (LGG) 1×10 10 cfu supplementation with outcomes on attention deficit hyperactivity disorder (ADHD) or Asperger syndrome (AS) manifestations as diagnosed using the International Classification of Diseases-10 criteria. The supplementations were administered to Finnish mothers for 4 weeks before delivery and continuously given for 6 months after delivery if they breastfed, or to the children. ADHD or AS was diagnosed at the age of 13 years in 17.1% children in the placebo and none in the probiotic group (P=0.008). This study found significant differences in species composition and number of cells belonging to the genus Bifidobacterium between healthy children and children who later developed ADHD or AS at different time points. Six remaining studies with varying strains, durations of intervention, start-time of administration, and outcomes demonstrated no difference in cognition after probiotic supplementation. Metagenomic analyses on gut microbiota composition were not performed in any of these studies. In conclusion, the favourable effect of probiotic supplementation on cognitive function in children and adolescents was observed in one study with LGG supplementation by a risk reduction of developing ADHD or AS (i.e. autism). More long-term and follow-up trials using probiotics identifying the effect on cognition are warranted before routine use.

Observations about peculiarities in the autistic population concerning type and frequency of references to subjective states, and lack of perspective taking, have been on the whole referred to as the paradox of the autistic self, i.e. a co-presence of ego-centeredness and weak self-referentiality (Lombardo & Baron Cohen 2010). Prevalent approaches in autism ascribe these peculiarities to high order disfunctions caused by neurological factors, such as defective self-encoding processes. Two narratives told by an adult man with Asperger during counselling are examined with Conversation Analysis; the analysis identifies features that may lead to descriptions like the paradox of autistic self, but also reveals competences related to perspective-taking and narrative construction. Drawing on Bruner's narrative theory, as well on recent interactional research on autism and the psychology of self, it is suggested that a relatively limited practice with narrative co-construction might be at the origin of the peculiarities observed. A socio-developmental approach to the understanding of autism not only can provide explanations compatible with first and second person accounts of life with autism, but can also open new paths for researching ways of self-construction that are less reliant on social interaction. The article finally challenges assumptions in psychological research about the ability of humans to access their internal states, and discusses how such assumptions can deter understanding of atypical populations.

We examined the emotional and psychophysiological underpinnings of social interaction in the context of autism spectrum disorder, more specifically, involving participants diagnosed with Asperger syndrome (AS). We recorded participants' autonomic nervous system (ANS) activation (electrodermal activity, heart rate, and heart rate variability) and facial muscle activation during conversations in two different types of male dyads: (1) ten dyads where one participant has been diagnosed with AS (AS/NT dyads) and (2) nine dyads where both participants are neurotypical (NT/NT dyads). Afterwards, three independent raters assessed continuously each participant's affiliative and dominant behaviors during the first and last 10 minutes of the conversations. The relationship between the assessed data and ANS responses was examined. We found that, in the NT/NT dyads, a high level of affiliation displayed by the conversational partner calms down the participant when they are actively dominating the interaction. In contrast, when the participants themselves expressed affiliation, their psychophysiological responses indicated increase in arousal, which suggests that the giving of affiliation is physiologically "hard work." The affiliation-related ANS responses were similar in those NT participants whose conversational partner had AS, while some differences in facial muscle activation did occur in comparison to NT/NT dyads. In the AS participants, in contrast, a high level of affiliation provided by the conversational partner was associated with increase in arousal, suggesting heightened alertness and stress. As for their own affiliative behavior, the AS participants exhibited similar indicators of alertness and stress as the NT participants, but only when their own level of dominance was low. Our results increase understanding of how individuals with AS experience social interaction at the physiological level, and how this experience differs from that in NT individuals. Moreover, our results confirm and further specify our earlier results, where we proposed that affiliation involves the type of "sharing of the burden" that also reverberates in the participants' bodies., Competing Interests: The authors have declared that no competing interests exist.

This systematic review of randomized controlled trials (RCTs) aims at evaluating the efficacy of Occupational therapy (OT) interventions in Asperger's syndrome (AS) pediatric patients. We conducted a systematic review according to PRISMA guidelines. The screening of the literature was carried out on PUBMED, SCOPUS, WEB OF SCIENCE and OT SEEKER databases, TO December 2018. We selected three RCTs having the common objective to evaluate whether children with AS can improve their social skills thanks to OT treatments. The interventions targeted by the three selected studies were: LEGO therapy, Social Use of Language Programme, Let's Face It! software and Parent Training combined with the administration of risperidone. All the studies showed that the intervention groups improved their overall social ability.This review shows that OT interventions can help concretely AS children in overcoming their social issues. Nevertheless, more RCTs are needed to better understand the OT's benefits and limitations in AS patients.

In this study, three hundred and sixty-eight participants answered a questionnaire consisting of three vignettes describing a person with depression, severe Autism Spectrum Disorder (ASD), and high-functioning Autism Spectrum Disorder/Asperger's Syndrome (AS). Each vignette was followed by thirteen questions concerning the participant's knowledge about diagnosis, treatment, and prognosis. Participants demonstrated good mental health literacy (MHL) for depression, but were poor at diagnosing ASD. Drug therapy was rated as the least effective treatment and 'talking to a family member of friend' was rated as the most effective for each disorder. The highest prognosis ratings were given to depression, and the lowest given to ASD. Participants demonstrated better MHL than expected, possibly due to the availability of information on the Internet and the increase in prevalence of mental illnesses such as depression and ASD among the general population., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Purpose The goal of this study was to expand the field's understanding of autism through the analysis of 1st-person perspectives from autistic video webloggers (vloggers). Method This study analyzed the representation of autism in 39 YouTube videos authored by self-identified autistic individuals and published between 2007 and 2015. Consistent with the cross-disciplinary tradition of narrative inquiry, thematic analyses of the video transcripts were conducted. Findings Vloggers were predominantly, but not exclusively, White male adults who spoke mainstream American English and self-identified as experiencing Asperger's syndrome. Key findings included (a) the predominance of a narrative about autism that incorporated features of both the medical model of disability and the neurodiversity paradigm to varying degrees, (b) a trend toward more medical model features across most content areas, and (c) a relatively high prevalence of neurodiversity paradigm features related specifically to language use and the description of autistic traits. Conclusions Implications include the need for clinicians to (a) familiarize themselves with the varying views of autism held within the autistic community, (b) reflect on the language used to talk about autism and listen to how clients and/or their caregivers talk about it, and (c) consider the exploration of potential positive dimensions of autistic traits.

Asperger's syndrome is a neurodevelopmental disorder which is part of the large family of autism spectrum disorders. People with Asperger's syndrome have difficulties in social interactions, verbal and non-verbal communication, and may display behavioural oddities, with stereotypies and limited interests. They show no language delay and their cognitive development is not marked by an overall delay but by specific impairments in certain areas such as the executive functions. The clinical presentations are very heterogeneous, varying according to age and psychiatric comorbidities. Screening, diagnosis and specialized treatment are not made any easier by the diversity of the clinical manifestations. Asperger's syndrome is often diagnosed belatedly, at 11years of age on average and even in adulthood in some cases. This late diagnosis has a significant impact on the risks of depression and a poor quality of life. However, in adulthood or in adolescence, certain situations, personality traits and cognitive profiles or certain comorbidities should suggest the hypothesis of an Asperger-type autism spectrum disorder. We propose here a review of the clinical situations at different ages of life that could help with the screening and the referral of patients to specialized clinicians for diagnosis and appropriate treatment., (Copyright © 2019 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.)

Asperger's syndrome is a disorder that involves a qualitative impairment in social interactions. While most treatments are aimed at children or adolescents, in this paper we present the development of a virtual reality training application in which adults with Asperger's syndrome can train in an autonomous and controlled way how to present in public.

Since Hans Asperger's first description (Arch Psych Nervenkrankh 117:76-136, 1944), through Lorna Wing's translation and definition (Psychol Med 11:115-129, 1981), to its introduction in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM, 1994), Asperger Syndrome has always aroused huge interest and debate, until vanishing in the DSM fifth edition (2013). The debate regarded its diagnostic validity and its differentiation from high functioning autism (HFA). The present study aimed to examine whether AS differed from HFA in clinical profiles and to analyze the impact of DSM-5's innovation. Differences in cognitive, language, school functioning and comorbidities, were revealed when 80 AS and 70 HFA patients (3-18 years) were compared. Results suggested that an AS empirical distinction within autism spectrum disorder should be clinically useful.

Background: Internet technology offers psychiatrists new opportunities for remote interaction with patients. It also raises issues regarding therapeutic effectiveness, safety, technical problems and possibilities for overcoming them, and matters related to specific mental health problems such as autism. The case presented concerns an adolescent male with severe social impairment and isolation as manifestations of Aspergers syndrome., Methods: The patient was accepted contact with psychiatric services through telepsychiatry, which enabled initial assessment and the development of a therapeutic relationship., Results: In due course the patient was able to attend the clinic in person. He became somewhat reconciled to his family. With appropriate adaptations he was able to resume his education and career., Conclusions: Telepsychiatry shows promise in engaging with patients with autism spectrum disorders. As experience accrues, there is some evidence that it is safe and effective. Adaptations to traditional clinical psychotherapy may be required.

Head banging is a commonly observed movement disorder which is typically self-limited. Complications secondary to this behavior are rare. In this report, the authors present the case of a 15-year-old patient who was treated for a forehead mass which developed secondary to chronic head banging. Surgical excision was performed for treatment of the lesion. Results from surgical pathology were notable for fibrosis consistent with history of chronic head banging. Preoperative magnetic resonance imaging and physical examination were also consistent with this diagnosis. This is a rare clinical entity that should be considered in patients presenting with a forehead mass and a history of head banging.

Objectives: Emotion goals lie at the heart of emotion regulation, as people have to first decide what emotions they want to feel before engaging in emotion regulation. Given that children with Asperger's syndrome (AS) are characterized by exhibiting difficulties in emotion regulation, studying whether they display similar or different emotion goals compared to typically developing (TD) children may provide insightful information., Methods: Thirty AS and 30 TD children (10-12 years) reported about their general (i.e., how they want to feel in general) and contextualized (i.e., how they want to feel when confronting vs. collaborating with someone) emotion goals, and about their difficulties in emotion regulation through questionnaires., Results: Results showed that both groups did not differ in their general emotional goals and in their contextualized emotion goals for happiness for collaboration and anger for confrontation. AS children only differed from TD children in a higher preference for sadness for collaboration and happiness for confrontation. These emotion goals predicted their difficulties to engage in goal-directed behaviour., Conclusions: The obtained results support the need to further study emotion goals as an aspect of emotion dysregulation, namely the difficulties to engage in goal-directed behaviour when experiencing different emotions., Practitioner Points: AS and TD children did not differ in their general emotion goals. AS and TD children did not vary in their preferences for happiness for collaboration and anger for confrontation. AS children only differed in a higher preference for sadness for collaboration and happiness for confrontation. Understanding emotion goals might help practitioners to develop better interventions., (© 2018 The British Psychological Society.)

Objectives: The study aims to define the differences in clinical manifestation among adolescent girls and boys with autism spectrum disorder (ASD)., Methods: The study group consisted of 15 adolescent girls and 16 adolescent boys with diagnosis of autismor Asperger syndrome and their parents. Adolescents were assessed with ADOS (Autism Diagnostic Observation Schedule, Polish adaptation of the assessment), algorithms of ADOS and ADOS-2 (revised version) were compared. Structured interview was conducted with parents, they fulfilled AQ (Autism Quotient), ASAS (Australian Scale for Asperger Syndrome), GQ-ASC (Girls' Questionnaire for Autism Spectrum Conditions). Medical records were analyzed. Results were analyzed using statistical methods., Results: Patients were assessed with ADOS Module 4. Results indicated statistically significant differences between ASD girls and ASD boys in communication section, both verbal and gestures. The mean scores of AQ for ASD girls and ASD boys were M = 33.0 and M=30.9, and of ASAS M =57% and M =61% respectively. ASD girls had more psychiatric hospitalisations than ASD boys (60% vs. 31%), and they were more often treated with antidepressants (67% vs. 31%), anxiolytics (20% vs. 6%), mood stabilizers (40% vs. 19%). ASD boys were more often treated with psychotropic medications (50% vs. 47%) and stimulants (44% vs. 20%) than ASD girls., Conclusions: ASD girls are at risk of receiving non-spectrum classification in ADOS or ADOS-2 while their developmental history and clinical manifestation confirm ASD. Clinical data suggests that ASD girls present more abnormalities in sensory profile. ASD girls are at greater risk for developing anxiety, depression, suicidal ideation, and for psychiatric hospitalization. ASD boys appear to be at greater risk for co-occurring ADHD, OCD and tics.

Background: Behavioral, cognitive and functional particularities in autism differ according to autism subgroups and might be associated with domain-specific cognitive strengths. It is unknown whether structural changes support this specialization. We investigated the link between cortical folding, its maturation and cognitive strengths in autism subgroups presenting verbal or visuo-spatial peaks of abilities., Methods: We measured gyrification, a structural index related to function, in 55 autistic participants with (AS-SOD, N  = 27) or without (AS-NoSOD, N  = 28) a speech onset delay (SOD) with similar symptom severity but respectively perceptual and verbal cognitive strengths, and 37 typical adolescents and young adults matched for intelligence and age. We calculated the local Gyrification Index ( l GI) throughout an occipito-temporal region of interest and independently modeled age and peak of ability effects for each group., Results: Unique gyrification features in both autistic groups were detected in localized clusters. When comparing the three groups, gyrification was found lower in AS-SOD in a fusiform visual area, whereas it was higher in AS-NoSOD in a temporal language-related region. These particular areas presented age-related gyrification differences reflecting contrasting local maturation pathways in AS. As expected, peaks of ability were found in a verbal subtest for the AS-NoSOD group and in the Block Design IQ subtest for the AS-SOD group., Conclusions: Irrespective of their direction, regional gyrification differences in visual and language processing areas respectively reflect AS-SOD perceptual and AS-NoSOD language-oriented peaks. Unique regional maturation trajectories in the autistic brain may underline specific cognitive strengths, which are key variables for understanding heterogeneity in autism.

Response efficiency plays an important role in the initial success of functional communication training (FCT). Although low-effort functional communication responses (FCRs) have been shown to be most effective in replacing problem behavior; more developmentally advanced FCRs are favored later in the treatment process. Attempts to teach these more complex FCRs, however, often lead to the resurgence of problem behavior. In this study, we provide a detailed description of an effective shaping process applied within a changing criterion design to develop complex FCRs from simple FCRs without resurgence of problem behavior. Four children with various language and intellectual abilities participated in this study. A practical shaping procedure, suitable for typical teaching contexts, is described for two participants in Experiment 1. The necessity and efficacy of the shaping process are demonstrated with the participants in Experiment 2. Implications for practice and research are discussed., (© 2018 Society for the Experimental Analysis of Behavior.)

In a sample of 37 adolescents and young adults with autism spectrum disorder (ASD) and 35 typically-developing controls (TDC), we investigated sensory symptoms by clinical measures, and Mismatch Negativity and P3a component at Fz with the frequency and duration oddball paradigms of event-related potentials. Results showed that compared to TDC, ASD participants reported more sensory symptoms, and presented a shorter P3a peak latency in the duration paradigm, which was correlated with more social awareness deficits. In the frequency paradigm, P3a parameters were correlated with sensation avoiding and attention characteristics of ASD. Our findings suggest that sensory abnormality in ASD may extend into adolescence and young adulthood. P3a latency might be a potential neurophysiological marker for ASD.

Individuals with autism spectrum disorders (ASD) are increasingly entering institutions of higher education. However, many are not prepared for the academic and social demands of postsecondary environments. Although studies have evaluated academic and social interventions for children and adolescents with ASD, little research exists on the college population. The current study utilized a multiple baseline across participants design to evaluate the effectiveness of a writing learning strategy on the writing performance of three college students with ASD. Results indicated that the quality of writing performance improved following strategy instruction. In addition, participants were able to generalize strategy use to content specific writing tasks.

Asperger Syndrome and/or Clinical High Risk of Psychosis? A Differential Diagnostic Challenge This case-study deals with the often difficult differential diagnosis of Asperger syndrome and a clinical high risk state of psychosis, in particular as indicated by attenuated psychotic symptoms, as well as with its therapeutic implications. The presented case is a 10-year old girl, who has not been diagnosed with an autism spectrum disorder before being referred to a specialized center for early detection of psychosis due to possible hallucinatory experiences and delusional ideas. We demonstrate how to perform a context-sensitive differential diagnosis to distinguish between specific interests as well as related behaviors and unusual thought content as well as perceptive abnormalities, between paranoid ideas and biased interpretations of the behaviors of others typical for autism, and between disorganized symptoms and autistic unusual communication and social behavior. The resulting dual diagnoses in our case-study formed the basis for a complex differential indication, which considered both the increased stress vulnerability associated with an increased risk for the development of psychosis as well as the rigid thinking style associated with autism. Our case-report shows that such a precise differential indication can lead to stabilization over the long-term, even in patients with dual diagnoses.

Social information processing (SIP) skills are critical for developing and maintaining peer relationships. Building on existing assessment techniques, Virtual Environment for SIP (VESIP TM ), a simulation-based assessment that immerses children in social decision-making scenarios, was developed. This study presents preliminary evidence of VESIP's usefulness for measuring SIP skills in children with and without autism spectrum disorders (ASD). Twenty-one children with ASD and 29 control children participated. It was hypothesized that (a) children (8-12 years old), with and without ASD, would understand and interact effectively with VESIP; (b) VESIP scores would be reliable in both populations; and (c) children with ASD would score lower on SIP domains than typically developing peers. Results supported these hypotheses. Finally, response bias was also evaluated, showing that children with ASD have different problem-solving strategies than their peers. VESIP has great potential as a scalable assessment of SIP strengths and challenges in children with and without ASD. Autism Res 2018, 11: 305-317. © 2017 International Society for Autism Research, Wiley Periodicals, Inc., Lay Summary: Children with autism spectrum disorders (ASDs) often struggle interpreting and responding to social situations. The present study suggests that an animated, simulation-based assessment approach is an effective way to measure how children with or without ASDs problem-solve challenging social situations. VESIP is an easy-to-use assessment tool that can help practitioners understand a child's particular strengths and weaknesses., (© 2017 International Society for Autism Research, Wiley Periodicals, Inc.)

Background: During observation of the Necker cube perception becomes unstable and alternates repeatedly between a from-above-perspective ("fap") and a from-below-perspective ("fbp") interpretation. Both interpretations are physically equally plausible, however, observers usually show an a priori top-down bias in favor of the fap interpretation. Patients with Autism spectrum disorder are known to show an altered pattern of perception with a focus on sensory details. In the present study we tested whether this altered perceptual processing affects their reversal dynamics and reduces the perceptual bias during Necker cube observation., Methods: 19 participants with Asperger syndrome and 16 healthy controls observed a Necker cube stimulus continuously for 5 minutes and indicated perceptual reversals by key press. We compared reversal rates (number of reversals per minute) and the distributions of dwell times for the two interpretations between observer groups., Results: Asperger participants showed less perceptual reversal than controls. Six Asperger participants did not perceive any reversal at all, whereas all observers from the control group perceived at least five reversals within the five minutes observation time. Further, control participants showed the typical perceptual bias with significant longer median dwell times for the fap compared to the fbp interpretation. No such perceptual bias was found in the Asperger group., Discussion: The perceptual system weights the incomplete and ambiguous sensory input with memorized concepts in order to construct stable and reliable percepts. In the case of the Necker cube stimulus, two perceptual interpretations are equally compatible with the sensory information and internal fluctuations may cause perceptual alternations between them-with a slightly larger probability value for the fap interpretation (perceptual bias). Smaller reversal rates in Asperger observers may result from the dominance of bottom-up sensory input over endogenous top-down factors. The latter may also explain the absence of a fap bias.

Objective: Many studies report on the usefulness of the evaluation of Executive Functions (EF) in the assessment of participants with ADHD, while others underline how deficits of EF in these participants are not consistent and that the same executive deficits are present in many other disorders, particularly in Asperger's disorder. Using the Planning Attention Simultaneous Successive (PASS) theory, the present study explores the cognitive profiles of participants with ADHD or Asperger's disorder and compares the cognitive functioning of these two diagnostic groups., Method: Forty-four children, 24 with a diagnosis of ADHD and 20 with a diagnosis of Asperger's disorder, participated and their cognitive processes were evaluated with the Cognitive Assessment System., Results: Results underline specific cognitive profiles in ADHD and Asperger's disorder characterized by weaknesses in planning and attention, but with a diverse level of severity., Conclusion: Implications of the different cognitive profiles of these diagnostic groups are discussed.

Background: Research shows that adolescents with Autism Spectrum Disorder (ASD) experience difficulties developing friendships, and that loneliness is a significant factor contributing to higher incidence of anxiety and depression within this population., Aims: This study aimed to provide an in-depth analysis of relationships as described by adolescents with ASD, and, from these descriptions, to explore what can be inferred about the development of successful interpersonal relationships for these individuals., Methods and Procedure: Eight adolescents with ASD participated in semi-structured interviews using established personal construct theory (PCT) techniques., Outcomes and Results: PCT was found to be a helpful approach to elicit rich, qualitative data. A thematic analysis identified four themes: relationships as a source of support, perceptions of similarity and difference, valued qualities in self and others, and the development and maintenance of relationships., Conclusions and Implications: Whilst this exploratory study highlighted some commonality in terms of perceptions of family support and friendships as protective and desirable, participants differed in their ability to establish and maintain peer relationships. Participants valued personal qualities such as intelligence, humour and trust within relationships, and recognised the important role of peers and siblings in the development of social skills, a finding which has implications for the delivery of social skills training and other interventions. The study provides empirical support for the application of personal construct methodologies in ASD research and offers a potentially useful approach to therapeutic intervention., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

The aim of the study was to investigate the perception of the family functioning in parents of children with autism spectrum disorders (ASD) with normal-range intelligence and the relationships between family functioning, parenting stress and quality of life. Dyads of parents of children with ASD without intellectual disability and parents of typically developing children (controls) completed a set of self-report questionnaires. Parents of children with ASD reported lower functioning of the family as a whole and their own functioning as family members; they exhibited higher levels of parenting stress and lower quality of life. Mothers of children with ASD experienced more stress in personal domain than fathers. Relationships between family functioning, parenting stress and quality of life have been established. There were also moderate to strong correlations in mother-father dyads between their assessments of family functioning, parenting stress and QoL in social relationships and environmental domains.

Deficits in specific executive domains are highly prevalent in autism spectrum disorder; however, age-related improvements in executive functions (reflecting prefrontal maturational changes) have been reported even in individuals diagnosed with autism. The current study examined two components of cognitive flexibility (inhibition of prepotent responses and memory monitoring/updating) by using a random-motor-generation task (MPT) in a group of 23 boys with Asperger syndrome (AS) and 23 matched healthy controls. We found poorer inhibition and more repetitive responses in younger AS children solely, but comparable memory monitoring/updating skills across groups. Overall, our findings correspond well with previous studies and reveal that even in AS specific EFs may improve with age and, thus, call for a more differentiated view of executive (dys) function profiles in children diagnosed with AS. Tests such as the random-motor-generation task may help to disentangle more specific processes of executive deficits in autism spectrum disorder as compared to the more classical tests.

Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Ten women with autism spectrum disorder participated in oral interviews in order to share their experiences since their diagnosis and to discuss the factors that had enabled them to achieve success in different aspects of their life. Participants were encouraged to share their perspectives on their success and to discuss the challenges they encountered in their daily lives and how they overcame these. Interviews were analysed using a narrative-themed approach. Participants indicated that both internal and external factors enabled them to achieve success in different aspects of their lives. These included being an agent of change, a changed identity after diagnosis, experiencing the belief of others in their capability and seeing themselves as a mentor to others. Their experiences with overcoming obstacles in their lives enabled them to develop self-efficacy and to shape their own success.

Background: Perioperative care for children with autism spectrum disorder may be challenging. Previous investigators recommend development of an individualized perioperative management plan with caregiver involvement., Aim: The primary goal was to determine the usefulness of an individualized plan based on the decision to provide preoperative sedation stratified by autism spectrum severity level. Secondary goals were to assess the effectiveness of the plan based on subjective assessment of patient behavior at induction of anesthesia and caregiver satisfaction., Methods: We developed an individualized plan for each child with autism spectrum disorder scheduled for anesthesia. Children were categorized by autism spectrum disorder severity level. With institutional ethics approval, we conducted a retrospective chart review to document need for preoperative sedation, sedation stratified by autism spectrum disorder severity level, behavior at induction, and caregiver satisfaction., Results: Between 2012 and 2014, we successfully prepared a plan for 246 (98%) of 251 surgical or diagnostic procedures in 224 patients. Severity level was distributed as 45% Severity Level 1 and Asperger's, 25% Severity Level 2, and 30% Severity Level 3. The majority (90%) of cases were scheduled as day surgery. Preoperative sedation increased with increasing severity level: Severity Level 1 (21%) or Asperger's (31%), Severity Level 2 (44%), and Severity Level 3 (56%). The odds ratio for sedation use was 5.5 [CI: 2.6-11.5, P<.001] with Severity Level 3 vs Severity Level 1 patients. Cooperation at induction of anesthesia was 90% overall with preoperative sedation administered to 94 (38%) of the entire cohort. Cooperation was greatest in Severity Level 1 (98%) and Asperger's patients (93%) and somewhat less (85%) in patients in Severity Levels 2 and 3. The plan was helpful to guide sedation choices as cooperation did not differ between sedated and unsedated children at any severity level (overall χ 2 =2.87 P=.09). Satisfaction among caregivers contacted was 98%., Conclusion: The results suggest that an individualized plan is helpful in the perioperative management of children with autism spectrum disorder and that knowledge of autism spectrum disorder severity level may be helpful in determining the need for preoperative sedation., (© 2017 John Wiley & Sons Ltd.)

Background: The distinction between autism and Asperger syndrome has been abandoned in the DSM-5. However, this clinical categorization largely overlaps with the presence or absence of a speech onset delay which is associated with clinical, cognitive, and neural differences. It is unknown whether these different speech development pathways and associated cognitive differences are involved in the heterogeneity of the restricted interests that characterize autistic adults., Method: This study tested the hypothesis that speech onset delay, or conversely, early mastery of speech, orients the nature and verbal reporting of adult autistic interests. The occurrence of a priori defined descriptors for perceptual and thematic dimensions were determined, as well as the perceived function and benefits, in the response of autistic people to a semi-structured interview on their intense interests. The number of words, grammatical categories, and proportion of perceptual / thematic descriptors were computed and compared between groups by variance analyses. The participants comprised 40 autistic adults grouped according to the presence ( N  = 20) or absence ( N  = 20) of speech onset delay, as well as 20 non-autistic adults, also with intense interests, matched for non-verbal intelligence using Raven's Progressive Matrices., Results: The overall nature, function, and benefit of intense interests were similar across autistic subgroups, and between autistic and non-autistic groups. However, autistic participants with a history of speech onset delay used more perceptual than thematic descriptors when talking about their interests, whereas the opposite was true for autistic individuals without speech onset delay. This finding remained significant after controlling for linguistic differences observed between the two groups., Conclusions: Verbal reporting, but not the nature or positive function, of intense interests differed between adult autistic individuals depending on their speech acquisition history: oral reporting of intense interests was characterized by perceptual dominance for autistic individuals with delayed speech onset and thematic dominance for those without. This may contribute to the heterogeneous presentation observed among autistic adults of normal intelligence.

Predictability of dangerousness in association with mental disorders remains elusive, outside of a few relatively well-established risk factors for the prognostication of violence, such as male sex, the presence of a psychotic disorder, and comorbid substance abuse. In clinical practice, inquiry into the presence of aggressive or violent ideation, in the form of ideas of homicide or suicide, is part of a standard mental status examination. Nonetheless, fantasy life, when it concerns harm toward others, may not be as reliable an indicator of imminent danger as it may be in the case of self-harm. Five cases of young Italian men with Asperger syndrome and recurrent and extremely violent femicide fantasies are presented. While there is no direct correlation between autism spectrum conditions and violence, as other humans, persons with an autistic condition are capable of committing crimes, including homicide. All five had in common a number of characteristics and behaviors felt to be pathoplastic: All had been bullied, all had been romantically rejected, all were long-standing First Person Shooter (FPS) game players, and all were avid violent pornography consumers. The potential for an actual neurocognitive impact of violent video games, well documented in the literature, and its combination with personal life history and chronic habituation following long-standing violent pornography use is discussed in the context of social and emotional vulnerabilities. While aggressive fantasies cannot and should not be underestimated, in countries where duty to protect legislation does not exist, a clinical approach is imperative, as, incidentally, should be anywhere.

We report reduced repetitive behaviors similar to obsessive compulsive disorder and improved emotional recognition and cognitive abilities in two young patients diagnosed with high-functioning Autism as a result of deep transcranial magnetic stimulation (dTMS). The patients received daily high-frequency (5 Hz) dTMS with HAUT-coil over the medial prefrontal cortex for a period of 5-6 weeks. A computerized cognitive battery, tasks for testing emotional recognition, and clinical questionnaires were used to measure the effects of treatment. TMS might have modulated networks related to metalizing abilities and self-referential processes since both patients reported improved sociability and communication skills.

This study examined objective quality of life (work, academic success, living situation, relationships, support system) and subjective quality of life (Sense of Coherence and Short-Form Health Survey-36) in an adult sample of males ( n = 50, mean age: 30 years) with Asperger syndrome diagnosed in childhood and followed prospectively over two decades. The association between long-term diagnostic stability of an autism spectrum disorder and/or comorbid psychiatric disorders with quality of life was also examined. The results showed great variability as regards quality of life. The subsample that no longer fulfilled an autism spectrum disorder had full-time jobs or studies (10/11), independent living (100%), and reported having two or more friends (100%). In the stable autism spectrum disorder group, 41% had full-time job or studies, 51% lived independently, and 33% reported two or more friends, and a significant minority had specialized employments, lived with support from the government, or had no friends. Academic success was positively correlated with IQ. A majority of the total group scored average Sense of Coherence scores, and the mean for Short-Form Health Survey-36 was above average regarding psychical health and below average regarding mental health. Stability of autism spectrum disorder diagnosis was associated with objective but not subjective quality of life, while psychiatric comorbidity was associated with subjective but not objective quality of life.

This article is an overview of the literature on Asperger's syndrome and schizophrenia and aim to discuss their similarities and differences. Eugen Bleuler who associated the terms "schizophrenia" and "autism" a century ago, viewed autism as a form of solitude of schizophrenic patients representing withdrawal from reality. Ever since, there has been confusion as to the boundaries between these conditions. Nowadays recent research, from a variety of perspectives-genomics, neurodevelopment, psychiatry, etc. has given new information on these conditions. It is easier to demarcate these two disorders at the extremes, but it is extremely difficult dissociating milder forms of both disorders. Asperger's syndrome (AS), is considered to be a continuous and lifelong disorder with strong heritability, present from early childhood. It is included within the category of autism spectrum disorders and it is usually diagnosed in childhood. Patients with Asperger syndrome are often diagnosed late or they are considered as having schizophrenia. Misdiagnosing Asperger syndrome creates severe problems by preventing effective therapy. A lot of clinical characteristics of Asperger's syndrome are also present in schizophrenia, such as impaired social interaction, disabilities in communication and restricted interests. On the other side some clinical features may facilitate the differential diagnosis, such as the younger age at onset, family history of pervasive developmental disorders, pragmatic aspects of language use, lack of imagination, ect. It is known that symptoms of Asperger's syndrome have some overlap with those of schizophrenia, but less is known about comorbidity between these two syndromes. It is still a question whether autism spectrum disorders in young children can increase the risk for the development of schizophrenia and other psychotic disorders, later in life. Both disorders are of neurodevelopmental origin and genetic factors are prominent. In both neurocognitive deficits as well as deficits in social cognition and social functioning are marked. The boundaries between AS and schizophrenia are still not clear even if this distinction is necessary for the appropriate treatment of the patient and his family. For the writing of the literature review, the following electronic databases were used: PubMed, Scopus, Psycinfo, Cochrane Library, Web of Science and Google Scholar. The key words used were: Asperger's syndrome, schizophrenia, children and adolescents, differential diagnosis, autism spectrum disorders.

The aim was to describe the occupational transition process to upper secondary school, further education and/or work, and to discover what support influences the process from the perspectives of young adults with Asperger syndrome or attention deficit/hyperactivity disorder. This qualitative study was performed in Sweden and comprised interviews with 15 young adults recruited from community based day centres. Support influencing the process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. The overall understanding shows that the occupational transition process was a longitudinal one starting as early as in middle school, and continuing until the young adults obtained and were able to remain in employment or further education.

Objectives: Interpersonal emotion regulation (ER) plays a significant role in how individuals meet others' emotional needs and shape social interactions, as it is key to initiating and maintaining high-quality social relationships. Given that individuals with borderline personality disorder (BPD) or Asperger's syndrome (AS) exhibit problems in social interactions, the aim of this study was to examine their use of different interpersonal ER strategies compared to normative control participants., Methods: Thirty individuals with AS, 30 with BPD, and 60 age-, gender-, and education-matched control participants completed a battery of measures to assess interpersonal ER, which assessed to what extent participants tended to engage in interpersonal affect improvement and worsening and to what extent they used different strategies. Before completing those measures, all groups were screened for disorders of Axis I and Axis II with the Structured Clinical Interview for DSM-IV Axis I and Axis II Disorders., Results: Compared to controls, individuals with AS and with BPD engaged less in affect improvement. No differences were found for affect worsening. Individuals with AS reported to use less adaptive (attention deployment, cognitive change) and more maladaptive (expressive suppression) interpersonal ER strategies, compared to individuals with BPD and control participants who did not differ from each other., Conclusions: The obtained results suggest the need to develop tailored ER interventions for each of the clinical groups studied. Furthermore, they highlight the need to study further potential differences in intrapersonal and interpersonal ER in clinical populations., Practitioner Points: Individuals with Asperger's syndrome (AS) and borderline personality disorder (BPD) engaged significantly less than healthy controls in interpersonal affect improvement. Individuals with BPD did not differ from healthy controls in the use of interpersonal strategies. Individuals with AS reported to use more maladaptive and less adaptive strategies than BPD individuals and healthy controls. Understanding differences in interpersonal emotion regulation in individuals with AS and with BPD and normative controls might help practitioners develop better interventions., (© 2016 The British Psychological Society.)

Individuals with Autism Spectrum Disorder (ASD) are characterized by severe deficits in social communication, whereby the nature of their impairments in emotional prosody processing have yet to be specified. Here, we investigated emotional prosody processing in individuals with ASD and controls with novel, lifelike behavioral and neuroimaging paradigms. Compared to controls, individuals with ASD showed reduced emotional prosody recognition accuracy on a behavioral task. On the neural level, individuals with ASD displayed reduced activity of the STS, insula and amygdala for complex vs basic emotions compared to controls. Moreover, the coupling between the STS and amygdala for complex vs basic emotions was reduced in the ASD group. Finally, groups differed with respect to the relationship between brain activity and behavioral performance. Brain activity during emotional prosody processing was more strongly related to prosody recognition accuracy in ASD participants. In contrast, the coupling between STS and anterior cingulate cortex (ACC) activity predicted behavioral task performance more strongly in the control group. These results provide evidence for aberrant emotional prosody processing of individuals with ASD. They suggest that the differences in the relationship between the neural and behavioral level of individuals with ASD may account for their observed deficits in social communication., (© The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.)