Occupational Therapy's efficacy in children with Asperger's syndrome: a systematic review of randomized controlled trials.

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.

Adults with autism spectrum disorder: Updated considerations for healthcare providers.

Children with autism spectrum disorder (ASD) eventually grow up and need to make the transition from pediatric services to adult. This is a diverse patient population.

Mental health literacy for autism spectrum disorder and depression.

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.

A Virtual Reality Training Application for Adults With Asperger's Syndrome.

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.

Perception on family support and predictors' of satisfaction with the healthcare service among families of children and adolescents with serious mental illnesses who are in active psychiatric treatment.

PROBLEM: Little is known about the factors related to satisfaction with healthcare services among families of children with serious mental illness who were in active psychiatry treatment. METHODS: A cross-sectional study was conducted to explore perceived family support, illness beliefs, and families' satisfaction with healthcare services. Sixty-eight families of children with anxiety, depression, attention-deficit/hyperactivity disorder, eating disorders, and autism/Asperger's syndrome participated. Data were collected from March 2015 to December 2016. FINDINGS: Illness beliefs and perceived family support explained 23% of the variance in family satisfaction with the healthcare service. CONCLUSION: Family interventions need to specifically focus on the families' satisfaction with healthcare services and on utilizing the family support network, offering emotional support, and exploring illness beliefs.

Telepsychiatry in Asperger's syndrome.

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.

Caso clínico: Trastorno del Espectro Autista (TEA) / Autistic Spectrum Disorder (ASD)

Paciente, 18 años, hijo único, pololeando. Antecedentes Psiquiátricos Familiares (+). Repitió 3 veces el 1ero básico. Aislamiento social e intereses restringidos desde la infancia. Derivado de Alter joven. Historia de larga data (>1 año) de mayor descuido de higiene personal, aislamiento social e irritabilidad. Hipótesis diagnóstica: TEA. Seguimiento con controles médicos, con terapeuta ocupacional y psicoterapia. Examen mental al inicio: Con escaso contacto visual. Pseudocontactado, hipomímico. Afecto con rango de expresividad emocional disminuido. Humor depresivo. Lenguaje lacónico, aprosódico. Al examen (6 meses después) destaca buen arreglo personal, contactado, establece contacto visual, tranquilo, adecuado, cooperador, eutímico, mímica facial acorde al relato, lenguaje bien articulado, con manierismos y estereotipias, prosodia alterada, pensamiento estructurado, con rigidez cognitiva y concreto.

Patient, 18 years old, only child, in love relationship. Family Psychiatric Background (+). He repeated 3 times the 1st basic course. Social isolation and restricted interests from childhood. Derived from Young Alter. Long history (> 1 year) of greater neglect of personal hygiene, social isolation and irritability. Diagnostic hypothesis: ASD. Follow-up with medical controls, occupational therapist and psychotherapy. Mental exam at the start: With little eye contact. Pseudocontact, hypomimic. Affect with decreased emotional expressiveness. Depressive mood. Laconic language, aprosodic.

Shaping complex functional communication responses.

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.

[Asperger Syndrome and/or Clinical High Risk of Psychosis? A Differential Diagnostic Challenge]. / Asperger-Syndrom und/oder klinisch erhöhtes Psychoserisiko? Eine differenzialdiagnostische Herausforderung.

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.

Virtual Environment for Social Information Processing: Assessment of Children with and without Autism Spectrum Disorders.

Social information processing (SIP) skills are critical for developing and maintaining peer relationships. Building on existing assessment techniques, Virtual Environment for SIP (VESIPTM ), 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.

Effects of Learning Strategy Training on the Writing Performance of College Students with Asperger's Syndrome.

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.

Enhanced cognition and emotional recognition, and reduced obsessive compulsive symptoms in two adults with high-functioning autism as a result of deep Transcranial Magnetic Stimulation (dTMS): a case report.

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.

[Behavioral intervention for preschool children with autism ­ outcome of parent-based Intervention]. / Verhaltenstherapeutische Intervention für Vorschulkinder mit Autismus.

Objective: Early intensive behavioral intervention (EIBI) has proved to be an effective intervention for children with autism spectrum disorder (ASD). In this exploratory study, we evaluated the effects of a community-based service model with parents as active therapists. Method: 13 children with ASD between 2 and 5 years of age at intake participated in the study. A waiting-list control design was employed. The children received 1 year of home-based EIBI for approximately 20 hours a week, their parents functioning as primary therapists. The waiting-list control group consisted of seven children who were tested 6 months before the intervention commenced. The intervention was based on the University of California at Los Angeles Young Autism Project model (UCLA YAP; Lovaas, 1981, 1987, 2003). The Psychoeducational Profile (3rd ed., PEP-3), the Parenting Stress Index (PSI), and the Childhood Autism Rating Scale (2nd ed., CARS 2) were used to measure outcome. In addition, a mental developmental index (MDI) was calculated on the basis of the Cognitive Verbal/Preverbal subscale of the PEP-3. Results: After 1 year of EIBI, we found a significant increase in the PEP-3 scores and MDI scores as well as a significant reduction in the CARS 2 scores. No significant changes were seen when participants were on the waiting list. The stress level of the parents did not change significantly and in fact showed overall a slight decrease. Conclusion: This model of providing EIBI appears to hold some promise. Comprehensive parental involvement did not affect their stress level. The study need to be replicated with a larger sample and an improved design.

Autism and Mind-Body Therapies: A Systematic Review.

BACKGROUND: Mind-body therapies are often used by people with autism spectrum disorders (ASD). However, there has been little examination into which types of mind-body therapies have been investigated for people with ASD and for what purposes. A systematic review was conducted to evaluate the existing evidence for mind-body therapies for people with ASD, particularly to determine the types of mind-body therapies used and the outcomes that are targeted. METHODS: PubMed, PsychInfo, and Scopus were searched using terms for ASD and mind-body therapies. Sixteen studies were selected for review; these studies tested interventions using mindfulness, meditation, yoga, Nei Yang Gong, and acceptance commitment therapy. Most study outcomes targeted behavior, psychological symptoms, and quality of life for children and adults with ASD as well as their parents. RESULTS: There was little overlap between studies on the types of mind-body therapies used and associated outcomes, and only three of the studies were randomized controlled trials. Most studies were small and uncontrolled. Some studies modified the mind-body therapies to increase accessibility for people with ASD. CONCLUSION: The evidence for mind-body therapies for people with ASD is limited and would benefit from larger randomized controlled trials.

The capacity to tell a joke: Reflections from work with Asperger children.

The capacity to tell a joke is a highly complex interpersonal event that depends upon the maturation of certain developmental achievements which are absent or stunted in children with Asperger's Syndrome. These include the ability to know another's mind, a sense of interpersonal timing and, most notably, a capacity for abstract thinking. The author discusses Freud's () notion of joke-work, which is akin to dream-work, both of which are pathways to forming mental representations. Freud considered joke-work as a mental activity that operated on the verbal level and the author examines the preverbal dimensions that are rooted in the earliest mother/infant interactions. An extended case discussion of the psychoanalytic treatment of an Asperger boy is offered to illustrate these points and to demonstrate the activity of joke-work as a means of building mental representations.