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The aim of this study was to examine the relation between symbolic play and communicative engagement among children with and without autism. Our predictions were firstly, that in moment-by-moment interactions during semi-structured interactive play with an adult, children with and without autism would tend to show shifts in meanings in symbolic play when engaged in coordinated states of joint engagement (events involving "sharing-of-meaning"); secondly, that across atypically developing participants, sharing-of-meaning would (a) correlate with scores on a standardized test of pretend play, and (b) be inversely correlated with scores on the Autism Diagnostic Observation Schedule; and finally, that participants with autism would contrast with matched developmentally delayed participants in manifesting lower levels of joint engagement, lower levels of symbolic play, and fewer shifts in symbolic meaning. Each of these predictions was borne out. The intimate developmental relation between social engagement and symbolic play appears to be important for explaining the developmental psychopathology of autism.

There is a growing body of opinion that we should view autism as fractionable into different, largely independent sets of clinical features. The alternative view is that autism is a coherent syndrome in which principal features of the disorder stand in intimate developmental relationship with each other. Studies of congenitally blind children offer support for the latter position and suggest that a source of coherence in autism is restriction in certain forms of perceptually dependent social experience.

The focus of this study is the nature and concomitants of pretend play among young children with autism. Age- and language-matched children with autism ("n"= 27), autism spectrum disorder ("n"= 14), and developmental disorders without autism ("n"= 16) were administered the Test of Pretend Play (ToPP; Lewis & Boucher, 1997), with an additional rating of "playful pretence". As predicted, children with autism showed less playful pretend than participants with developmental disorders who did not have autism. Across the groups, playful pretence was correlated with individual differences in communication and social interaction, even when scores on the ToPP were taken into account. Limitations in creative, playful pretend among children with autism relate to their restricted interpersonal communication and engagement. (Contains 2 tables and 2 figures.)

The aim of this study was to examine how severity of autism affects children's interactions (relatedness) and relationships with their parents. Participants were 25 parent-child dyads that included offspring who were children with autism aged from 4 to 14 years. The severity of the children's autism was assessed using the calibrated severity metric of the Autism Diagnostic Observation Schedule (Gotham et al. in "J Autism Dev Disord: 39:693-705, 2009). Parent-child dyads were videotaped in 10-min semi-structured play interactions, and qualities of interpersonal relatedness were rated with the Dyadic Coding Scales (Humber and Moss in "Am J Orthopsychiatr" 75(1):128-141, 2005). Quality of relationships between parents and children were evaluated with a parent self-report measure, the Parent Child Relationship Inventory (Gerard in "Parent-Child Relationship Inventory (PCRI) manual." WPS, Los Angeles, 1994). Multivariate regression analysis revealed that severity of autism was inversely related to patterns of parent-child interaction but not to reported quality of parent-child relationship. We consider the implications for thinking about relatedness and relationships among children with autism, and opportunities for intervention.

We evaluated how children with autism make linguistic adjustments when talking with someone else. We devised two novel measures to assess (a) overall conversational linkage and (b) utterance-by-utterance resonance within dialogue between an adult and matched participants with and without autism (n = 12 per group). Participants with autism were less able to establish "cognitive linkage" with an interlocutor. As predicted, only among children with autism was there a positive correlation between the ability to link in with "speaker's meanings" and ratings of emotional connectedness with the conversational partner. Participants with autism were "not" less likely to show a basic form of dialogic resonance across successive utterances (the "frame grab"), but more often elaborated their responses in an atypical manner. (Contains 3 tables and 1 figure.)

Background: Atypical forms of autism may yield insights into the development and nature of the syndrome. Methods: We conducted a follow-up study of nine congenitally blind and seven sighted children who, eight years earlier, had satisfied formal diagnostic criteria for autism and had been included in groups matched for chronological age and verbal ability. In keeping with the original study, we met with teachers to discuss a DSM-based checklist of clinical features of autism, and conducted direct observations of the children to complete assessments on the Childhood Autism Rating Scale (CARS; Schopler, Reichler, and Renner, 1986) and the Behavior Checklist for Disordered Preschoolers (BCDP; Sherman, Shapiro, & Glassman, 1983). Results: As predicted, a substantially higher proportion of blind (eight out of nine) than sighted (none out of seven) children now "failed" to meet formal DSM criteria for autism, and in keeping with BCDP ratings, they had significantly lower CARS scores. Conclusions: Follow-up of nine congenitally blind children with autism revealed that, in adolescence, only one still satisfied diagnostic criteria for the syndrome. We consider the implications for theoretical perspectives on the development of autism.

My aim in this paper is to present reasons for adopting a focus on the development of self/other-awareness when characterizing the developmental psychopathology of autism. The strengths of such a position include an emphasis on children's emotional relations with embodied persons as foundational for their growing understanding of minds. I give special attention to the process of identifying with the attitudes of others, and experience of other-person-centred emotions, for the development of communication and thinking. The study of limitations in these aspects of self-other relatedness among individuals with autism is pivotal for understanding the pathogenesis of the syndrome.

In three experimental conditions, we tested matched children with and without autism (n = 15 per group) for their comprehension and use of first person plural ("we") and third person singular ("he") pronouns, and examined whether such linguistic functioning related to their social interaction. The groups were indistinguishable in their comprehension and use of "we" pronouns, although within each group, such usage was correlated with ratings of interpersonal connectedness with the collaborator. On the other hand, participants with autism were less likely to use third person pronouns or to show patterns of eye gaze reflecting engagement with an interlocutor's stance vis-a-vis a third person. In these settings, atypical third person pronoun usage seemed to reflect limited communicative engagement, but first person pronouns were relatively spared.

We employed semi-structured tests to determine whether children with autism produce and comprehend deictic (person-centred) expressions such as "this"/"tilde" "here"/"there" and "come"/"go", and whether they understand atypical non-verbal gestural deixis in the form of directed head-nods to indicate location. In Study 1, most participants spontaneously produced deictic terms, often in conjunction with pointing. Yet only among children with autism were there participants who referred to a location that was distal to themselves with the terms "this" or "here", or made atypical points with unusual precision, often lining-up with an eye. In Study 2, participants with autism were less accurate in responding to instructions involving contrastive deictic terms, and fewer responded accurately to indicative head nods.

We hypothesized that the qualities of play shown by children with autism reflect their impoverished experience of identifying with other people's attitudes and moving among person-anchored perspectives. On this basis, we predicted their play should manifest a relative lack of the social-developmental hallmarks that typify creative symbolic functioning. We videotaped the spontaneous and modelled symbolic play of matched groups of children with and without autism. The two groups were similar in the mechanics of play, for example in making one thing stand for another and using materials flexibly. By contrast, and as predicted, children with autism were rated as showing less playful pretend involving self-conscious awareness of pretending, investment in the symbolic meanings given to play materials, creativity, and fun.

What does it mean for a child to imitate someone else? We tested matched groups of children with and without autism (n = 16 for each group, with a mean chronological age of 11 years and a mean verbal mental age of 6 years) to investigate two potentially dissociable aspects of imitation: copying goal-directed actions, on the one hand, and imitating the "style" with which a person demonstrates those actions, on the other. Our hypothesis was that the latter, but not necessarily the former, kind of imitation reflects a special quality of interpersonal engagement in which one person identifies with another, and that the propensity to identify with others is specifically weak in autism. As predicted, participants with and without autism were similar in their ability to copy six relatively complex goal-directed actions but were significantly different in imitating the style with which six simpler goal-directed actions were executed, especially when style was incidental to accomplishing a goal. We interpret the findings in terms of a link among children's capacities for intersubjective engagement, imitation, and learning new ways to relate to objects. (Contains 3 tables and 2 figures.)

Are children with autism able to adopt, and shift among, the psychological perspectives of different people? Fifteen children with autism and 15 without autism, matched for chronological age and verbal ability, were given Feffer's (1970) role-taking task in which they were asked to tell and then re-tell stories from different protagonists' perspectives. The children with autism understood the task, adjusted narratives according to alternative viewpoints, and were similar to control participants in their use of mental state terms. Despite this, the children with autism achieved significantly lower scores for adopting different figures' perspectives, and for shifting among complementary viewpoints. The results illustrate aspects of social-cognitive impairment that extend beyond the children's limitations in "theory of mind" understanding.

Does autism involve a deficit in intersubjective engagement with other persons? We studied nonverbal communication in children and adolescents with and without autism (n = 12 per group), group-matched for chronological age and verbal mental age, during 3 min of a videotaped interview. In keeping with previous studies, there were only subtle but potentially revealing group differences on behavioral ratings. Participants with autism made fewer head-shakes/nods (but not smiles) when the interviewer was talking, and the interviewer made fewer head-shakes/nods when participants were talking. Yet there were marked group differences on reliable "subjective" ratings of (a) affective engagement and (b) the smoothness of reciprocal interaction. We interpret the findings in terms of a group difference in "identification" between conversational partners.

In this commentary, I consider several strengths of the position adopted by Racine and Carpendale (2007), but suggest that the authors are in danger of overstating their case. In doing so, they appear to sideline an issue that should be pivotal for accounts of joint attention: how does a child come to arrive at an understanding that people, both themselves and others, have "subjective perspectives" upon a shared world? I conclude with few comments on the authors' criticisms of my approach to such issues.

We studied the association between an adult's behavior and episodes of social engagement (ESEs) in young children with autism during play-based assessment. ESEs were defined as events in which a child looked toward the adult's face and simultaneously showed an additional form of communicative behavior. The adult's behavior before each ESE, and before time-sampled control periods, was rated using Coding Active Sociability in Preschoolers with Autism (CASPA). As predicted, adult musical/motoric activity, communications that followed the child's focus of attention, scaffolding through social routines, imitations of the child, and adult repetitions were significantly more prevalent before ESEs, but cognitive assessment activities, adult inactivity, and "ignoring" were significantly less prevalent. We consider the implications for understanding the developmental psychopathology of autism.

When children draw pictures of human beings, they reveal things not only about their general intellectual and artistic abilities, but also about their awareness and conception of themselves and others. What might the human figure drawings of children with autism reveal about their images of self and other--and what might they disclose about social factors that shape the drawings of children who do not have autism? On the basis of an hypothesis about the restricted social awareness of children and adolescents with autism, we predicted that there would be little differentiation between their drawings of themselves and other people. To test this prediction, we investigated a group of children and adolescents with autism and a group with learning difficulties but not autism (N=14 per group) who were individually matched for both chronological age and verbal mental age. Participants with autism mostly drew human figures that were little distinguished from one another, but introduced clear contrasts among their houses, whereas most of those with learning difficulties drew distinctive human figures as well as houses. These different profiles of performance occurred despite similarities in the numbers and kinds of feature included in the drawings, and the individuality of participants' drawing styles. Although the results were in keeping with our hypothesis that human figure drawings might reflect abnormalities in the way that children with autism mentally represent themselves and others, we conclude by stressing our tentativeness over this interpretation of the findings.

There is controversy over the basis for young children's experience of themselves and other people as separate yet related individuals, each with a mental perspective on the world--and over the nature of corresponding deficits in autism. Here we tested a form of self-other connectedness (identification) in children with and without autism, who were group-matched according to CA (approximately 6 to 16 years) and verbal MA (approximately 2 1/2 to 14 years), and therefore IQ. We gave two forms of a novel "sticker test" in which children needed to communicate to another person where on her body she should place her sticker-badge. Across the trials of Study 1, all of the non-autistic children pointed to their own bodies at least once, but over half the children with autism failed to point to themselves at all, even though they communicated successfully in other ways. In Study 2, where a screen was introduced to hide the tester's body, group differences in the children's communicative self-orientated gestures were most marked after the tester had "modelled" a point-to-herself gesture in communicating to the child. Our interpretation is that autism involves a relative failure to adopt the bodily-anchored psychological and communicative stance of another person. We suggest that this process of identification is essential to self-other relations and grounds young children's developing understanding of minds.