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.

Using Augmented Reality to Elicit Pretend Play for Children with Autism.

Children with autism spectrum condition (ASC) suffer from deficits or developmental delays in symbolic thinking. In particular, they are often found lacking in pretend play during early childhood. Researchers believe that they encounter difficulty in generating and maintaining mental representation of pretense coupled with the immediate reality. We have developed an interactive system that explores the potential of Augmented Reality (AR) technology to visually conceptualize the representation of pretense within an open-ended play environment. Results from an empirical study involving children with ASC aged 4 to 7 demonstrated a significant improvement of pretend play in terms of frequency, duration and relevance using the AR system in comparison to a non computer-assisted situation. We investigated individual differences, skill transfer, system usability and limitations of the proposed AR system. We discuss design guidelines for future AR systems for children with ASC and other pervasive developmental disorders.

A Methodology of Analysis for Monitoring Treatment Progression with 19-Channel Z-Score Neurofeedback (19ZNF) in a Single-Subject Design.

19-Channel Z-Score Neurofeedback (19ZNF) is a modality using 19-electrodes with real-time normative database z-scores, suggesting effective clinical outcomes in fewer sessions than traditional neurofeedback. Thus, monitoring treatment progression and clinical outcome is necessary. The area of focus in this study was a methodology of quantitative analysis for monitoring treatment progression and clinical outcome with 19ZNF. This methodology is noted as the Sites-of-Interest, which included repeated measures analyses of variance (rANOVA) and t-tests for z-scores; it was conducted on 10 cases in a single subject design. To avoid selection bias, the 10 sample cases were randomly selected from a pool of 17 cases that met the inclusion criteria. Available client outcome measures (including self-report) are briefly discussed. The results showed 90% of the pre-post comparisons moved in the targeted direction (z = 0) and of those, 96% (80% Bonferroni corrected) of the t-tests and 96% (91% Bonferroni corrected) of the rANOVAs were statistically significant; thus indicating a progression towards the mean in 15 or fewer 19ZNF sessions. All cases showed and reported improvement in all outcome measures (including quantitative electroencephalography assessment) at case termination.

Tratamiento de los trastornos del espectro autista: unión entre la comprensión y la práctica basada en la evidencia / Treatment of autism spectrum disorders: union between understanding and evidence-based practice

Introducción. De manera sintética se da cuenta de las características heterogéneas de funcionamiento de las personas con trastornos del espectro autista (TEA) y cómo dichas características también pueden estar en la base de la variabilidad en la respuesta al tratamiento. Se recalca la necesidad de combinar, en el tratamiento, la práctica basada en la evidencia y una comprensión profunda de los TEA. Desarrollo. Se explican algunos de los principios esenciales que deben guiar el tratamiento desde la óptica de indicadores de calidad que han de contener los programas de intervención. Se incide en las características y contenidos que forman parte de los programas que se llevan a cabo en el ámbito de la intervención temprana, explicando brevemente algunos de esos programas, y posteriormente se caracteriza la intervención, con el uso de técnicas y estrategias, que habitualmente se realiza en niños y adolescentes de alto nivel de funcionamiento. Conclusión. La investigación y conocimiento acumulados y la cada vez mayor evidencia experimental configuran las características que deben adoptar los programas de intervención y tratamiento usados en personas con TEA. Dicho tratamiento debe comenzar de manera temprana, lo antes posible y extenderse a lo largo del ciclo vital (AU)

Introduction. Synthetically realizes heterogeneous operating characteristics of people with autism spectrum disorders (ASD) and how these features can also be based on the variability in response to treatment. It emphasizes the need to combine, in treatment, evidence-based practice with a deep understanding of ASD. Development. It explains some of the key principles that should guide the treatment from the standpoint of quality indicators should include intervention programs, to then influence the features and content that are part of the programs carried out in the field early intervention, briefly explaining some of these programs and then characterize the intervention, with the use of techniques and strategies, which is usually carried out with children and adolescents in high-functioning. Conclusion. Research and accumulated knowledge and the increasing experimental evidence configure the features to be taken by intervention and treatment programs that are used with people with ASD. Such treatment should begin early, as soon as possible and spread over the life cycle (AU)

[Treatment of autism spectrum disorders: union between understanding and evidence-based practice]. / Tratamiento de los trastornos del espectro autista: unión entre la comprensión y la práctica basada en la evidencia.

INTRODUCTION: Synthetically realizes heterogeneous operating characteristics of people with autism spectrum disorders (ASD) and how these features can also be based on the variability in response to treatment. It emphasizes the need to combine, in treatment, evidence-based practice with a deep understanding of ASD. DEVELOPMENT: It explains some of the key principles that should guide the treatment from the standpoint of quality indicators should include intervention programs, to then influence the features and content that are part of the programs carried out in the field early intervention, briefly explaining some of these programs and then characterize the intervention, with the use of techniques and strategies, which is usually carried out with children and adolescents in high-functioning. CONCLUSION: Research and accumulated knowledge and the increasing experimental evidence configure the features to be taken by intervention and treatment programs that are used with people with ASD. Such treatment should begin early, as soon as possible and spread over the life cycle.

TITLE: Tratamiento de los trastornos del espectro autista: union entre la comprension y la practica basada en la evidencia.Introduccion. De manera sintetica se da cuenta de las caracteristicas heterogeneas de funcionamiento de las personas con trastornos del espectro autista (TEA) y como dichas caracteristicas tambien pueden estar en la base de la variabilidad en la respuesta al tratamiento. Se recalca la necesidad de combinar, en el tratamiento, la practica basada en la evidencia y una comprension profunda de los TEA. Desarrollo. Se explican algunos de los principios esenciales que deben guiar el tratamiento desde la optica de indicadores de calidad que han de contener los programas de intervencion. Se incide en las caracteristicas y contenidos que forman parte de los programas que se llevan a cabo en el ambito de la intervencion temprana, explicando brevemente algunos de esos programas, y posteriormente se caracteriza la intervencion, con el uso de tecnicas y estrategias, que habitualmente se realiza en niños y adolescentes de alto nivel de funcionamiento. Conclusion. La investigacion y conocimiento acumulados y la cada vez mayor evidencia experimental configuran las caracteristicas que deben adoptar los programas de intervencion y tratamiento usados en personas con TEA. Dicho tratamiento debe comenzar de manera temprana, lo antes posible y extenderse a lo largo del ciclo vital.

Neurofeedback therapy in patients with non pain syndromes of chronic and paroxysmal character-literature review and own experience.

Neurofeedback has been used in treatment of many other than pain clinical syndromes. This group includes chronic as well as paroxysmal syndromes previously treated pharmacologically. However due to non satisfactory results of this treatment introduction of non-pharmacological therapy has been examined. Observations from our 9-year experience of neurofeedback therapy used in children and adult patients with epilepsy, Asperger syndrome, depression, neurosis, personality disorders, drug addiction and other (not pain) syndromes have been presented in this paper. Positive influence of neurofeedback therapy on symptoms intensity, frequency, duration and social relations of treated patients has been confirmed by our own and other authors observations. Neurofeedback therapy has been tried by patients with other difficult life problems and has been effective in some of them. The effectiveness of the therapy has been confirmed by patients, their relatives and also by neurophysiological results. Additionally, preliminary results of neurofeedback therapy used in management of computer addiction in children and adolescents have been presented herein.

A social competence intervention for young children with high functioning autism and Asperger syndrome: a pilot study.

The key features of Asperger Syndrome (AS) and high functioning autism (HFA) include marked and sustained impairment in social interactions. A multi-session, small group program was developed to increase social perception based on the assumption perceptual or interpretive problems underlying these social difficulties. Additionally, the group format espoused a play therapy orientation and the use of sociodramatic play was the primary therapeutic modality used. Qualitative analyses of the data resulted in an explanation of the key changes in social interactions that took place through the course of the intervention. Although each participant's experience in this group was unique, all children in this program demonstrated improvements in their social interactions, as they experienced development both emotionally and behaviorally. Findings suggest that, despite their rigid interests and behavior patterns, the social limitations of these children improved when provided with the necessary environmental resources.

Socio-dramatic affective-relational intervention for adolescents with asperger syndrome & high functioning autism: pilot study.

This study examined the effectiveness of a novel intervention called 'socio-dramatic affective-relational intervention' (SDARI), intended to improve social skills among adolescents with Asperger syndrome and high functioning autism diagnoses. SDARI adapts dramatic training activities to focus on in vivo practice of areas of social skill deficit among this population. SDARI was administered as a six-week summer program in a community human service agency. Nine SDARI participants and eight age- and diagnosis-group matched adolescents not receiving SDARI were compared on child- and parent-report of social functioning at three week intervals beginning six weeks prior to intervention and ending six weeks post-intervention. Hierarchical Linear Modeling (HLM) was used to estimate growth trends between groups to assess treatment outcomes and post-treatment maintenance. Results indicated significant improvement and post-treatment maintenance among SDARI participants on several measures of child social functioning. Implications for practice and research are discussed.

Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let's Face It! program.

BACKGROUND: An emerging body of evidence indicates that relative to typically developing children, children with autism are selectively impaired in their ability to recognize facial identity. A critical question is whether face recognition skills can be enhanced through a direct training intervention. METHODS: In a randomized clinical trial, children diagnosed with autism spectrum disorder were pre-screened with a battery of subtests (the Let's Face It! Skills battery) examining face and object processing abilities. Participants who were significantly impaired in their face processing abilities were assigned to either a treatment or a waitlist group. Children in the treatment group (N = 42) received 20 hours of face training with the Let's Face It! (LFI!) computer-based intervention. The LFI! program is comprised of seven interactive computer games that target the specific face impairments associated with autism, including the recognition of identity across image changes in expression, viewpoint and features, analytic and holistic face processing strategies and attention to information in the eye region. Time 1 and Time 2 performance for the treatment and waitlist groups was assessed with the Let's Face It! Skills battery. RESULTS: The main finding was that relative to the control group (N = 37), children in the face training group demonstrated reliable improvements in their analytic recognition of mouth features and holistic recognition of a face based on its eyes features. CONCLUSION: These results indicate that a relatively short-term intervention program can produce measurable improvements in the face recognition skills of children with autism. As a treatment for face processing deficits, the Let's Face It! program has advantages of being cost-free, adaptable to the specific learning needs of the individual child and suitable for home and school applications.

Neurofeedback outcomes in clients with Asperger's syndrome.

This paper summarizes data from a review of neurofeedback (NFB) training with 150 clients with Asperger's Syndrome (AS) and 9 clients with Autistic Spectrum Disorder (ASD) seen over a 15 year period (1993-2008) in a clinical setting. The main objective was to investigate whether electroncephalographic (EEG) biofeedback, also called neurofeedback (NFB), made a significant difference in clients diagnosed with AS. An earlier paper (Thompson et al. 2009) reviews the symptoms of AS, highlights research findings and theories concerning this disorder, discusses QEEG patterns in AS (both single and 19-channel), and details a hypothesis, based on functional neuroanatomy, concerning how NFB, often paired with biofeedback (BFB), might produce a change in symptoms. A further aim of the current report is to provide practitioners with a detailed description of the method used to address some of the key symptoms of AS in order to encourage further research and clinical work to refine the use of NFB plus BFB in the treatment of AS. All charts were included for review where there was a diagnosis of AS or ASD and pre- and post-training testing results were available for one or more of the standardized tests used. Clients received 40-60 sessions of NFB, which was combined with training in metacognitive strategies and, for most older adolescent and adult clients, with BFB of respiration, electrodermal response, and, more recently, heart rate variability. For the majority of clients, feedback was contingent on decreasing slow wave activity (usually 3-7 Hz), decreasing beta spindling if it was present (usually between 23 and 35 Hz), and increasing fast wave activity termed sensorimotor rhythm (SMR) (12-15 or 13-15 Hz depending on assessment findings). The most common initial montage was referential placement at the vertex (CZ) for children and at FCz (midway between FZ and CZ) for adults, referenced to the right ear. Metacognitive strategies relevant to social understanding, spatial reasoning, reading comprehension, and math were taught when the feedback indicated that the client was relaxed, calm, and focused. Significant improvements were found on measures of attention (T.O.V.A. and IVA), core symptoms (Australian Scale for Asperger's Syndrome, Conners' Global Index, SNAP version of the DSM-IV criteria for ADHD, and the ADD-Q), achievement (Wide Range Achievement Test), and intelligence (Wechsler Intelligence Scales). The average gain for the Full Scale IQ score was 9 points. A decrease in relevant EEG ratios was also observed. The ratios measured were (4-8 Hz)(2)/(13-21 Hz)(2), (4-8 Hz)/(16-20 Hz), and (3-7 Hz)/(12-15 Hz). The positive outcomes of decreased symptoms of Asperger's and ADHD (including a decrease in difficulties with attention, anxiety, aprosodias, and social functioning) plus improved academic and intellectual functioning, provide preliminary support for the use of neurofeedback as a helpful component of effective intervention in people with AS.

Functional neuroanatomy and the rationale for using EEG biofeedback for clients with Asperger's syndrome.

This paper reviews the symptoms of Asperger's Syndrome (AS), a disorder along the autism continuum, and highlights research findings with an emphasis on brain differences. Existing theories concerning AS are described, including theory of mind (Hill and Frith in Phil Trans Royal Soc Lond, Bull 358:281-289, 2003), mirror neuron system (Ramachandran and Oberman in Sci Am 295(5):62-69, 2006), and Porges' (Ann N Y Acad Sci 1008:31-47, 2003, The neurobiology of autism, Johns Hopkins University Press, Baltimore, 2004) polyvagal theory. (A second paper, Outcomes using EEG Biofeedback Training in Clients with Asperger's Syndrome, summarizes clinical outcomes obtained with more than 150 clients.) Patterns seen with QEEG assessment are then presented. Single channel assessment at the vertex (CZ) reveals patterns similar to those found in Attention-Deficit/Hyperactivity Disorder. Using 19-channel data, significant differences (z-scores > 2) were found in the amplitude of both slow waves (excess theta and/or alpha) and fast waves (beta) at various locations. Differences from the norm were most often found in mirror neuron areas (frontal, temporal and temporal-parietal). There were also differences in coherence patterns, as compared to a normative database (Neuroguide). Low Resolution Electromagnetic Tomography Analysis (Pascual-Marqui et al. in Methods Find Exp Clin Pharmacol 24C:91-95, 2002) suggested the source of the abnormal activity was most often the anterior cingulate. Other areas involved included the amygdala, uncus, insula, hippocampal gyrus, parahippocampal gyrus, fusiform gyrus, and the orbito-frontal and/or ventromedial areas of the prefrontal cortex. Correspondence between symptoms and the functions of the areas found to have abnormalities is evident and those observations are used to develop a rationale for using EEG biofeedback, called neurofeedback (NFB), intervention. NFB training is targeted to improve symptoms that include difficulty reading and mirroring emotions, poor attention to the outside world, poor self-regulation skills, and anxiety. Porges' polyvagal theory is used to emphasize the need to integrate NFB with biofeedback (BFB), particularly heart rate variability training. We term this emerging understanding the Systems Theory of Neural Synergy. The name underscores the fact that NFB and BFB influence dynamic circuits and emphasizes that, no matter where we enter the nervous system with an intervention, it will seek its own new balance and equilibrium.

Intervención psicoeducativa basada en imágenes en niños y niñas con trastornos generalizados del desarrollo / Psycho-educative intervention based on children images with pervasive development disorder

Esta investigación consiste en el diseño, ejecución y evaluación de un programa de intervención psicoeducativa basado en imágenes, aplicado a nueve niños con Trastorno Generalizado del Desarrollo (TGD) de tipo autista, cuyas edades fluctuaban entre los 3 y 8 años de edad en Temuco. El programa se enfocó para activar el desarrollo de las dimensiones de anticipación y flexibilidad en niños con TGD. Con el propósito de determinar el perfil de desarrollo inicial de los participantes, se les aplicó el Inventario de Desarrollo de Espectro Autista IDEA. Una vez ejecutado el programa se les evaluó nuevamente con el mismo instrumento, evidenciándose diferencias significativas en las dimensiones de anticipación t = 0,039 (P<0.05), complementariamente se encontraron resultados no esperados, en la escala de trastorno de desarrollo social t = 0,040 (P<0.05). No hubo evidencias significativas en la dimensión de sentido de actividad propia, obteniéndose un resultado de t = 0, 57 (P>0, 05). Los resultados reflejan la efectividad de la aplicación del programa de intervención con imágenes cuyo propósito es aportar a la sistematización del trabajo con niños que padecen algún trastorno generalizado del desarrollo.

This investigation is about the design, execution and evaluation of a psycho-educative intervention program based on the use of images, tested on nine children with autistic type of Pervasive Developmental Disorder (PDD) from 3 to 8 years old in Temuco, Chile. This program was implemented to activate de development in the anticipation and flexibility dimensions en children with PDD. In order to determine the initial participant’s profile, the autism spectrum disorders development inventory IDEA was applied. After the program was finished, this instrument was also used, showing significant differences in the anticipation dimension with t = 0,039 (P<0.05). As a non expected result in the social development dimension there was found that t = 0,040 (P<0.05). There was no significant change in the own activity self perception dimension, obtaining a t = 0, 57 (P>0, 05). These results show the effectiveness of the image based intervention program applied which purpose is to make a contribution to systematize the work with children suffering some Pervasive Developmental Disorder.

Union and separation in the therapy of pervasive developmental disorders and ADHD.

This paper discusses the characteristics of psychotherapy for pervasive developmental disorders (PDD) in the context of the curative effects of the movement of images. The 'autistic spectrum' is widened here and includes not only PDD, but also ADHD. The main common characteristic in these two sets of disorders seems to be the lack of a subject, which manifests itself as the absence of awareness of otherness and difficulties with boundaries and language. In these cases a normal psychotherapy is ineffective as it presupposes an established subject. However a psychotherapeutic approach with these patients can contribute to the emergence of a subject. In severe cases the process of union and separation which is enacted either in the therapeutic relationship or in symbolic play leads to the birth of a subject, and of language. In milder cases, such as ADHD, the moments of separation and confrontation with the therapist suffice. I will discuss a case of my own with Asperger's syndrome in which union and separation in the play therapy occurred simultaneously. This indicates that union and separation are not a consecutive process, but are simultaneous and lead to dialectical movement. However, in neurotic cases with an established subjectivity the symbolic meaning of image plays a central role. This corresponds to Jung's understanding of image in alchemy.

Helping families find the best evidence: CAM therapies for autism spectrum disorders and Asperger's Disorder.

Family-Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family-to-family support, and confidence building.

[The use of verbal communicative abilities to increase the mean length of utterance in high-functioning autism and Asperger Syndrome]. / O uso de habilidades comunicativas verbais para aumento da extensão de enunciados no autismo de alto funcionamento e na S índrome de Asperger.

BACKGROUND: high-functioning autism (HFA) and Asperger Syndrome (AS) are pervasive developmental disorders that present alterations in the communicative and social skills. AIM: to use verbal communicative skill strategies (VCS) to increase the mean length of utterance (MLU) produced by individuals with HFA and AS. METHOD: participants were three 12-year-old males with HFA or AS. Data was collected from videotape recordings of structured verbal interaction sessions with the researcher and each participant during eight months. In order to verify the effects of the intervention, a multiple baseline research design across the participants was used, being composed by two phases: baseline (BL) and intervention (I). In the BL phase, spontaneous interaction situations occurred between the researcher and each participant. In the first phase of I, the intervention sessions occurred twice a week and gradually worked their way to once a week, but only after each participant had reached the goal of increasing the MLU. The number of sessions decreased gradually to avoid any drop in performance. The strategies which were used were divided in blocks of activities: spontaneous conversation; activities involving specific language difficulties; games with rules; story/report telling; and meta-linguistic activities. RESULTS: the application of the proposed strategies for verbal communicative abilities achieved the purpose of increasing the MLU of all three participants. CONCLUSION: suggestions are made for further researches that investigate the maintenance of the results in other environments and during the interaction with different communication partners.

O uso de habilidades comunicativas verbais para aumento da extensão de enunciados no autismo de alto funcionamento e na S índrome de Asperger / The use of verbal communicative abilities to increase the mean length of utterance in high-functioning autism and Asperger Syndrome

TEMA: o autismo de alto funcionamento (AAF) e a síndrome de Asperger (SA) são transtornos globais do desenvolvimento que apresentam alterações nas habilidades comunicativas e sociais. OBJETIVO: o objetivo desta pesquisa foi promover o aumento da extensão média dos enunciados (EME) produzidos por indivíduos com AAF e SA por meio de estratégias que utilizavam habilidades comunicativas verbais (HCV). MÉTODO: participaram deste estudo três indivíduos com AAF ou SA do gênero masculino, com doze anos. Os dados foram coletados mediante gravações em vídeo de sessões estruturadas de interação verbal entre cada participante e a pesquisadora durante oito meses. Foi utilizado um delineamento experimental de linha de base múltipla cruzando com sujeitos, composto por duas fases: linha de base (LB) e intervenção (I). Na LB, ocorreram situações espontâneas de interação adulto e cada participante. Na primeira fase da I, inicialmente foram realizadas sessões duas vezes por semana e só se passava para a realização de sessões semanais após o indivíduo alcançar o objetivo de aumentar a EME. Houve a diminuição gradual do número de sessões, para que não houvesse queda no desempenho. As estratégias aplicadas foram divididas em blocos atividades com conversa espontânea; atividades que envolvessem dificuldades específicas de linguagem; jogos de regras; solicitações de relatos de histórias ou acontecimentos e atividades metalingüísticas. RESULTADOS: os resultados demostraram que a utilização de HCV foi efetiva para promover o aumento da EME. CONCLUSÃO: ficam sugestões para outras pesquisas que investiguem a manutenção dos resultados obtidos em outros ambientes e em interação com vários interlocutores.

BACKGROUND: high-functioning autism (HFA) and Asperger Syndrome (AS) are pervasive developmental disorders that present alterations in the communicative and social skills. AIM: to use verbal communicative skill strategies (VCS) to increase the mean length of utterance (MLU) produced by individuals with HFA and AS. METHOD: participants were three 12-year-old males with HFA or AS. Data was collected from videotape recordings of structured verbal interaction sessions with the researcher and each participant during eight months. In order to verify the effects of the intervention, a multiple baseline research design across the participants was used, being composed by two phases: baseline (BL) and intervention (I). In the BL phase, spontaneous interaction situations occurred between the researcher and each participant. In the first phase of I, the intervention sessions occurred twice a week and gradually worked their way to once a week, but only after each participant had reached the goal of increasing the MLU. The number of sessions decreased gradually to avoid any drop in performance. The strategies which were used were divided in blocks of activities: spontaneous conversation; activities involving specific language difficulties; games with rules; story/report telling; and meta-linguistic activities. RESULTS: the application of the proposed strategies for verbal communicative abilities achieved the purpose of increasing the MLU of all three participants. CONCLUSION: suggestions are made for further researches that investigate the maintenance of the results in other environments and during the interaction with different communication partners.

[Asperger syndrome - a too late diagnosed disorder?]. / Asperger-Syndrom - eine zu spät diagnostizierte Störung?

Asperger syndrome is a disorder within the autistic spectrum, which was first described by Hans Asperger in 1944. It belongs to the group of pervasive developmental disorders and is particularly characterized by qualitative impairments of social interaction and communication as well as distinct special interests and stereotyped patterns of behaviour. We present a patient, showing the typical behavioural symptoms of the Asperger syndrome, which were first diagnosed at the age of sixteen.

Effects of vagus nerve stimulation in a patient with temporal lobe epilepsy and Asperger syndrome: case report and review of the literature.

Seizures are a common comorbidity of autism and occur in as many as 30% of patients. This case report describes a 23-year-old man diagnosed with both Asperger syndrome and bitemporal epilepsy. The patient had behavioral regression that correlated with worsening of his intractable seizures. He subsequently underwent implantation of a vagus nerve stimulation therapy device for his refractory epilepsy. Both his seizures and his behavior were monitored for 6 months. We describe the efficacy of vagus nerve stimulation therapy in reducing seizure severity as well as improving the behavioral components of his Asperger syndrome. We also review the current literature regarding epilepsy in autistic spectrum disorders.

Social skills training for adolescents with Asperger syndrome and high-functioning autism.

The effectiveness of a social skills training group for adolescents with Asperger syndrome and high-functioning autism (AS/HFA) was evaluated. Parents of six groups of adolescents (n = 46, 61% male, mean age 14.6) completed questionnaires immediately before and after the 12-week group. Parents and adolescents were surveyed regarding their experience with the group. Significant pre- to post-treatment gains were found on measures of both social competence and problem behaviors associated with AS/HFA. Effect sizes ranged from .34 to .72. Adolescents reported more perceived skill improvements than did parents. Parent-reported improvement suggests that social skills learned in group sessions generalize to settings outside the treatment group. Larger, controlled studies of social skills training groups would be valuable.