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November 7, 2001        News Morgue Search  www.feat.org/search/news.asp

New Papers From The International Meeting for Autism Research - 1

** PUBLISHING NOTE TO READERS:  There will be a temporary

increase in publication postings to cover these proceedings in addition to regular news coverage, for the next two days only.

The International Meeting for Autism Research (IMFAR) is a satellite event taking place on November 9-10, 2001 in conjunction with the Society for Neuroscience meeting in San Diego, California.

It is a two-day scientific meeting comprised of all types of autism research - from molecular biology to neuropsychology to treatment will be represented at the meeting. Funding for this meeting is underwritten collaboratively by Cure Autism Now, the M.I.N.D Institute and the National Alliance for Autism Research.

The abstracts below are of the scientific papers being presented

Friday morning by the researchers.  Friday afternoon and Saturday’s reports

will be reproduced here in subsequent postings of the FEAT Newsletter.  All

of the information is from the IMFAR website:

http://www.imfar.org/index2.html

Turning Treatment Nonresponders Into Treatment Responders: Development Of Individualized Treatment Protocols For Children With Autism.

L. Schreibman*, A. C. Stahmer, and V. Cestone. Autism Research Laboratory, Univ. of CA., San Diego, Dept. of Psy., La Jolla, CA. 92093-0109.

The heterogeneity in treatment outcome for children with autism argues strongly for the development of a strategy for individualizing treatment.  While behavioral treatments enjoy the widest support as effective for these children, no single behavioral treatment has proven to be truly effective for a majority of the children. Preliminary studies in our laboratory have suggested two distinct behavioral profiles that seem to be predictive of outcomes to a specific naturalistic treatment.

Thus we have developed a preliminary ‘responder and a nonresponder” profile that has allowed us to begin to predict which children will benefit substantially from a specific naturalistic behavioral intervention (Pivotal Response Training) and which children will show little benefit. The current project was designed to refine the profile, and to determine if another well-substantiated behavioral strategy, Discrete Trial Training, will prove to be effective for children who do not respond to Pivotal Response Training.

Results to date indicate that specific behavioral indicators may be used to determine the most appropriate intervention type for young children with autism. Children with a particular profile responded differentially to the different treatments. This is the first demonstration that a pretreatment behavioral profile may allow for clinicians and teachers to design a treatment protocol specifically designed for an individual child.  Tailoring treatment to individual children should have the overall effect of reducing the heterogeneity of treatment outcome in this population. Funding:

ASA Foundation.

* * *

Long Term Follow-Up Of Children With Autism Receiving Early Intensive Behavioral Interventions (Eibi): Plastic Or Pre-Determined Responses?

Bryna Siegel, Adriana Schuler, Cynthia Arnold, Pervasive Developmental Disorders Laboratory, Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA 94143-0984 Scm Francisco State University, Pacific Graduate School of Psychology.

Thirty-three children with autistic spectrum disorders were followed from time of diagnosis in early childhood through early to mid-adolescence to determine if there was differential benefits for the 17 who had received substantial EIBI versus the 16 receiving high quality school based intervention (581) during the same early period.

Measures included initial diagnosis and IQ; outcome measures included DSM and ADI-R diagnosis, IQ and Vineland Adaptive Behavior Scale scores, and type of educational placement and educational supports. There were no significant group differences on numbers meeting ‘normalization’ criteria (29% vs. 19% for EIBI vs. SBI, respectively).

Initial diagnosis and IQ were the strongest predictors of outcome irrespective of treatment group. Those with initially more normal lQs and PDD,NOS versus autistic disorder were most likely to meet normalization criteria defined as no autistic spectrum disorder per DSM or ADI-R criteria, normal IQ, and regular education placement with no or minimal supports.

Implications for understanding the relation between intensive treatment and brain plasticity will be discussed in light of there results.

* * *

Evaluation Of Autistic Children After Three Years Of Intensive Behavioral Treatment.

G. 0. Sallows and T. 0. Graupner. Wisconsin Farly Autism Project, Madison, WI 53719.

Twenty-four children recruited from birth to three special education classes began treatment in 1996 and 1997. Selection criteria were age 2-0 to 3-6, diagnosis of autism by unaffiliated child psychiatrists and by the ADI-R, Bayley IQ of 35 or higher, and no other easily detected neurological disorders. No chromosome studies, metabolic screens, LEGs, or imaging procedures were done.

Children were randomly assigned by matched pairs (on IQ) to Clinic Directed (replicating Lovaas - 40 hrs/wk and heavy supervision) or Parent Directed (parents determined hours, 6 hrs/mo consultant supervision) treatment groups. A non-treated control group matched by age was obtained from local public schools. Pre-post measures included cognitive ability, language, and adaptive skills.

Treatment results showed a mean 22 point increase in IQ, over 90% of which occurred in the first year. Nine children showed a mean 47 point increase to the average range. Prior to treatment 46% were mute. After three years, 92% spoke, with over 70% speaking in phrases or full sentences. For the 9 “best outcome” children, representing 450/o of treated children who met Lovaas’ 1987 intake criteria, mean Vineland ABC increased to the average range. Non-treated children showed no change in IQ after four-plus years in special education.

There was little difference between Clinic and Parent Directed groups, an unanticipated finding. Pre-treatment predictors of outcome included imitation, IQ, Vineland ABC and speech. Non predictors included severity of autistic symptoms and whether or not children received supplemental treatments such as special education services.

* * *

Assessing The Outcome Of Toddlers With Autistic Spectrum Disorder In

Inclusive Programming: Standardized And Functional Measures

A. C. Stahmer and B. Ingersoll. Autism Intervention Center, Children’s Hospital, San Diego, CA 92123 and Univ. of Calif Son Diego, CA 92093.

With the passage of IDEA ‘97, intervention for young children with autistic spectrum disorder (ASD) is now provided for children under three.  While research suggests that children with autism benefit from inclusive programming, inclusive early intervention programs are rare (Strain, McGee, & Kohler, in press). The current study used a quasi-experimental design to analyze the outcomes of 20 young children with ASD in an inclusive program for children under three.

Both functional outcomes, as well as outcomes on standardized assessments such as the Bayley Scales of Infant Development, 2^nd Ed. and the Vineland Adaptive Behavior Scales were compared at entry into the program and exit from the program. Significant improvements were seen in performance on standardized assessments and functional measures. At intake, fifty percent of the subjects had no functional communication skills.

At exit (approximately six months later), ninety percent of the children utilized a functional communication system. Communication systems were individually determined for each subject based on child preference and included verbal, sign, and PECS. Eighty percent of the children used functional phrases with their chosen communication system and verbal language at program exit. In addition, social and play behaviors increased substantially.

These data suggest that inclusive programming for children under three is a successful method for increasing children’s communication, play, and social skills. Use of augmentative communication systems and a combination of research based programming is discussed.

* * *

The Facilitation Of Social-Emotional Understanding And Social Interaction In High-Functioning Children With Autism: Intervention Outcomes.

N. Baurninger. Bar-I/an University, Ramat-Gan, Israel 52900.

This study evaluated the effectiveness of a 7-month cognitive behavioral intervention for the facilitation of the social emotional understanding and social interaction of 15 high functioning children (8-16 years old) with autism. Intervention focused on teaching interpersonal problem-solving, affective knowledge, and social interaction. Pre- and post-intervention measures included: observations of social interaction, measures of problem solving and of emotion understanding, and teacher-rated social skills.

Results demonstrated progress in three areas of intervention. Children were more likely to initiate positive social interaction with peers after treatment; in particular, they improved eye contact and their ability to share experiences with peers and to show interest in peers. In problem solving after treatment, children provided more relevant solutions and more social solutions to different social situations.

In emotional knowledge after treatment, children provided more examples of basic as well as complex emotions, supplied more specific rather then general examples, and included an audience more often in complex emotions (e.g., embarrassment). Children also obtained higher teacher-rated social skills scores in cooperation, assertion, and self-control after treatment.

The implications of these findings are discussed in terms of the effectiveness of the current model of intervention for high functioning children with autism. This research was supported by agrantfroni the Israel Foundation Trustees.

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* * *

Targeting Fathers As Treatment Providers: Designing Parent Training Interventions For Fathers Of Children With Autism.

M. Winter and L. Schreibman. Autism Research Laboratory, University of California, San Diego, Department of Psychology, La Jolla, CA 92093-0109.

Previous studies indicate that training parents to implement behavioral treatment is an effective means to increase skills of children with autism (e.g. Koegel, Bimbela & Schreibman, 1996), the benefits of which include maximizing treatment time, minimizing cost and enhancing generalization.

Researchers have noted a lack of father involvement in parent training, and increasing evidence has supported the importance of the father ’s participation in parent training programs (Budd & O’Brien, 1982; Horton, 1984).

In spite of these findings, actual father participation in parent training programs has not increased. In order to assess the factors that influence father participation in parent training, a survey in questionnaire format was designed to assess mothers and fathers’ reasons for non-participation, as well as preferences regarding parent training content and format.

Results indicated that fathers and mothers differ in their reasons for not participating, preferred content, and preferred format of parent training. This provides preliminary evidence that existing methods of parent training may not be adequate in meeting the needs of fathers, suggesting that it may be possible to increase the rate of father participation in parent training programs by developing alternative types of interventions more suited to fathers.

Preliminary data suggest that a father-focused parent training program would include elements such as flexible scheduling and tailoring topics to participants’ specific areas of interest. Source of support: NIMH.

* * *

Effectiveness Of Training Parents To Target Joint Attention In Children With

Autism

M. Rocha* & Laura Schreibman Autism Research Laboratory, University of California, San Diego, San Diego, CA 92122.

Specific to children with autism are deficits in initiating and responding to joint attention initiations. The present study was designed to examine a parent-implemented (rather than therapist-implemented) autism intervention targeting joint attention responding in children with autism.

Parents were trained to increase their joint attention bids and use naturalistic behavior modification techniques to reinforce appropriate responding.

This research suggests that parents of children with autism can be effectively trained to employ joint attention training techniques and this training can be linked to increases in target behaviors. Additionally, results suggest that changes in both parent and child behavior generalize to the home environment.

Although not directly targeted, increased joint attention initiations

were also observed. Results are discussed in terms of treatment implications

and future investigations. Funding: National Institute of lslental Health

* * *

Training Spontaneous Imitation In Children With Autism Using Naturalistic Teaching Strategies.

Ingersoll and L. Schreibman. Univ. of Calif, San Diego, CA 92093.

Children with autism exhibit syndrome-specific deficits in imitation.  These deficits are a barrier to the acquisition of new skills and to socialization, and thus a focus of many early intervention programs for young children with autism. Traditional imitation training procedures are typically adult-directed and are implemented in a highly structured environment.

A multiple-baseline design was used to investigate the effectiveness of a more naturalistic, child-directed imitation intervention incorporating contingent imitation, time delay, and direct response-reinforcer relationships. Results indicate that imitation can be taught effectively in an unstructured, play environment and that these skills maintain in the absence of reinforcement.

Additional results suggest that this procedure produces collateral changes in social and language behaviors.

* * *

A Scale For Rating Conversational Impairment

DeVilliers,J. Fine and P. Szatmari. McMaster University, Faculty of Health Sciences, Hamilton, ON L8S 4L8.

Social communication impairments have a substantial impact on quality of life for individuals with Pervasive Developmental Disorder (PDD), but there are few well-standardized, reliable and valid measures of conversational breakdown that provide sufficient variation to be useful in a variety of circumstances.

The objective of this study was to develop such a scale. Forty-seven ten-minute semistructured conversations of children and adolescents with high functioning autism and Asperger’s syndrome were audiotaped, transcribed and analyzed using a functional linguistic paradigm (Halliday, 1994).

After analyzing the tapes, a sub-sample of nine pragmatic features was developed: 1)Formal Intonation; 2)Topic Switching; 3)Terseness; 4)Pedantic Speech; 5)Perseveration; 6)Pausing; 7)Distractibility; 8)Attention to Outside Environment; and 9)Atypical Stress Selection. The scale shows good interrater reliability and is not simply a reflection of IQ or language competence.

The scale represents an initial construct for characterizing language use in PDD and an initial step towards developing a treatment program for social reciprocity impairments in conversation. Sources of funding: Ontario Mental Health Foundation Social Sciences and Humanities Research Council.

* * *

Relationship Of Age And Viq To Neuropsychological And Social-Cognitive Task Performance In Autism .

F. Nagy*, K.A. Loveland, D.A. Pearson, & 3. Bachevalier. Dept. Psych.& Beh.

Sci., and Dept. Neurobiol. & Anat., Univ. TX Med. Sch., Houston, TX 77030.

Primary social-emotional deficits of autism may be related to dysfunction of a brain circuit including orbito-prefrontal cortex and amygdala, and intellectual deficits to dysfunction of dorsolateral prefrontal cortex and hippocampus. As part of a larger study to test these hypotheses, 43 children and adolescents with autism (6 f, 37 as, VIQ: 40 - 154, m=83.79 (29.50); age 86 - 225 mos m=132.16 (28.55) were tested for dysfunction of orhitofrontal cortex (object discrim. reversal), amygdala (emotion recognition: preferential looking), dorsolateral prefrontal cortex (spatial delayed alternation and attention set shift), and hippocampus (spatial span); along with sociocognitive skills (theory of mind, empathy, joint attention behavior, following point and gaze).

Relationship of age and Verbal IQ to measures was examined using multiple regression. All except preferential looking to novel emotions were significantly related to VIQ, while age was related only to preferential looking (8=0.36, p=O.Ol6) and socio-cognitive skills (joint attention 8=0.43 p=O.002; theory of mind 8=0.37, peO.OOl; pointing 8=0.53, p<O.OO1; gaze following 11=0.46, p=O.OOl).

No prefrontal or hippocampal tasks showed age-related development when VIQ was controlled, suggesting that development of prefrontal and hippocampal functions is delayed in children and adolescents with autism.

However, unexpectedly, emotion recognition showed age-related development

but was not related to verbal level. Results support the developmental

involvement of a prefrontal-limbic system in autistic symptoms. Research

Supported by NICHD: P01 HD35471

* * *

The Social Reciprocity Scale: Validation Of A Quantitative Genetic Measure Of Autistic Traits .

Constantino, R. Todd. Dept. of Psychiatry, Washington Univ. Sch. of Med., St. Louis, MO, 63110.

Objective: To validate Ihe Social Reciprocity Scale (SRS), a new 65-item questionnaire which measures autism spectrum symptomatology as a continuous variable.

Methods: The SRS was completed by parents and/or teachers of over 1800 children (age 4-17), including normal school children, child psychiatric patients with and without PDD’s, and 557 epidemiologically ascertained twin pairs. The Child Behavior Checklist (CBCL) was also obtained on all of the male twin pairs (n=232 pairs), and the Autism Diagnostic Interview-Revised (ADI-R) was obtained on 50 of the clinical subjects.

Results: The SRS takes 15-20 minutes to complete. SRS scores are normally distributed in the population, unrelated to IQ in non-retarded individuals, differentiate children with autism spectrum conditions from those with other psychiatric diagnoses, and correlate strongly (r~.80) with scores on the social deficit scale of the ADI-R. SRS scores are strongly influenced by genetic factors (on the order of .76 in males), some of which (.25-30) appear to be gender specific. Multivariate analyses of male twins confirmed that the SRS measures aspects of psychopathology that are largely distinct from those ascertained by the CBCL.

Conclusion: The SRS is a valid measure of social deficits across the entire autism spectrum from mild to severe. Assuming that the genetic factors influencing SRS scores are the same as those which confer susceptibility to autism, the SRS will be useful for identifying discordant sib pairs for population-based quantitative genetic studies of autism, as well as for large scale clinical, epidemiologic, and treatment studies.  Funding: NAAR, NICHD, CF. Dana Fdn.

* * *

Measuring Early Language Development In Preschool Children With Autism Spectrum Disorder Using The Macarthur Communicative Development Inventory (Infant Form)

I.    Charman, A. Drew, C. Baird, G. Baird. Institute of Child Health, University College London, London, WC1N IEH, UK.

Parent report data on early language development measured using the MacArthur Communicative Development Inventory (CDI - Infant Form) was collected on 134 pre-school children with autism spectrum disorder. The pattern of development of understanding of phrases, word comprehension and expression, and production of gestures, was compared to the typical pattern.

In addition to the expected pattern of considerably delayed language acquisition, atypical patterns were identified in the emergence of language skills in the sample. Comprehension of words was delayed in comparison to word and gesture production, and production of early gestures (involving sharing reference) was delayed relative to production of later gestures (involving use of objects).

However, other aspects of language development were similar to that found in typically developing infants, including gesture production acting as a “bridge” between word comprehension and word production and the pattern of acquisition across word categories and word forms.

The implications for assessment and intervention with pre-school children with autism spectrum disorder are discussed.

IMFAR website: http://www.imfar.org/index2.html

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