Autistic behavior, FMR1 protein, and developmental trajectories in young males with fragile X syndrome.

In the context of a longitudinal study, we assessed the relationship between ratings of autistic behavior, FMR1 protein expression (FMRP), and the developmental trajectories of 55 young males with fragile X syndrome. Autistic behavior, as measured by the Childhood Autism Rating Scale, was not related to FMRP expression. However, autistic behavior was a significant predictor of both developmental status and developmental change. Boys with both autistic behavior and fragile X syndrome functioned at significantly lower levels of development and grew at significantly slower rates than those without autistic behavior. FMRP expression accounted for less variance in developmental level than did autistic behavior, and was not significantly related to slope (developmental change over time). No autistic behavior x FMRP interaction was found.

Early development, temperament, and functional impairment in autism and fragile X syndrome.

We compared the developmental status, functional abilities, and temperament of 31 young boys with fragile X syndrome (FXS) who did not have autism, matched on chronological age, gender, and race, with 31 boys with autism but no FXS. Children with autism exhibited a more variable profile of development in comparison with a relatively flat profile for children with FXS. Children with autism were significantly more delayed in social skills and were rated by observers as exhibiting a greater degree of impairment in cognitive, communication, and social skills. On temperament ratings, both groups were slower to adapt, less persistent, and more withdrawing than the reference group. Boys with FXS were rated as more active than the referent group, whereas boys with autism were rated as less intense, more distractible, having a higher threshold for response, and less rhythmic than the reference group. A smaller three-group analysis compared boys with FXS, boys with autism, and boys with both FXS and autism. Children with both autism and FXS were substantially more delayed than children with autism or FXS alone.

The Environmental Rating Scale (ERS): a measure of the quality of the residential environment for adults with autism.

This study used classical test theory to assess the psychometric properties of the Environmental Rating Scale (ERS), a measure specifically designed to assess the treatment programs in residential settings that serve individuals with autism. Results of the confirmatory factor analysis support the presence of a single factor represented by the total score. The reliability of the measure was demonstrated by assessments of the internal consistency, stability, and interrater reliability. Preliminary analysis of the validity of the ERS indicates that this measure discriminates between treatment settings designed specifically for individuals with autism and those designed for other populations of developmentally handicapped clients and family homes. The ERS was also significantly positively correlated with a measure of the caregiver's knowledge about autism and a visitor's global impression of the desirability of the setting as a place to live.

The Vineland Adaptive Behavior Scales: supplementary norms for individuals with autism.

Vineland Adaptive Behavior Scales Special Population norms are presented for four groups of individuals with autism: (a) mute children under 10 years of age; (b) children with at least some verbal skills under 10 years of age; (c) mute individuals who are 10 years of age or older; and (d) individuals with at least some verbal skills who are 10 years of age or older. The sample included 684 autistic individuals ascertained from cases referred for the DSM-IV autism/PDD field trial collaborative study and five university sites with expertise in autism. Young children had higher standard scores than older individuals across all Vineland domains. In the Communication domain, younger verbal children were least impaired, older mute individuals most impaired, and younger mute and older verbal individuals in the midrange. Verbal individuals achieved higher scores in Daily Living Skills than mute individuals. The expected profile of a relative weakness in Socialization and relative strength in Daily Living Skills was obtained with age-equivalent but not standard scores. Results high-light the importance of employing Vineland special population norms as well as national norms when evaluating individuals with autism.

Autistic behavior in young boys with fragile X syndrome.

A sample of 57 boys with fragile X syndrome (fraX) between the ages of 24 and 133 months was rated using the Childhood Autism Rating Scale (CARS) to assess the extent to which autism and autistic features were evident in a young population. Fourteen subjects (approximately 25% of the sample) scored above the cutoff for autism, suggesting a relatively high incidence of autistic behavior. All but 2 of these 14 were in the mildly or moderately autistic range, however, and only a few items received severe ratings, suggesting that severe autism is relatively rare in fraX, at least during the early years. The CARS resulted in a continuum of autistic ratings in the fraX population, but no particular items on the CARS contributed disproportionately to autism ratings. A visual comparison of ratings on an autistic, non-fraX sample revealed similar profiles of ratings, suggesting that differentiating fraX and autism on the basis of CARS ratings is not likely. Within the fraX group, chronological age and socioeconomic status did not correlate with CARS ratings, but severity of delay was strongly related, such that more severely delayed children scored higher (more autistic) on the CARS.

TEACCH-supported employment program.

Division TEACCH has served over 100 persons with autism through its supported employment program. Three models of supported employment are utilized: individual placement model, dispersed enclave model, and mobile crew model. Within each of these models there is an emphasis on utilizing individual strengths and interests, identifying appropriate jobs, and providing extensive long-term support. A retention rate of 89% demonstrates the success of the program which is due in large part to the broad array of long-term support services that are provided.

Brief report: two case studies using virtual reality as a learning tool for autistic children.

The children complied with most requests. Some of our teaching goals were limited by technology or space while others were limited by the difficulty of presenting a task to the children in a way that was understandable within their environment. However, the opportunity to introduce this technology to children was an important first step in exploring the potential VR offers to understanding the perceptual processes involved in autism. Our results indicate that the will accept a VR helmet and wear it, identify familiar objects and qualities of these objects in their environment while using the helmet, and locate and move toward objects in their environment while wearing the helmet. More research is necessary to verify the potential in this area, especially to discover if learning experiences through VR generalize to other environments, but it appears virtual reality may provide a useful tool for furthering our understanding of autism and guiding efforts at treatment and intervention.

Full inclusion and students with autism.

The concept of "full inclusion" is that students with special needs can and should be educated in the same settings as their normally developing peers with appropriate support services, rather than being placed in special education classrooms or schools. According to advocates the benefits of full inclusion are increased expectations by teachers, behavioral modeling of normally developing peers, more learning, and greater self-esteem. Although the notion of full inclusion has appeal, especially for parents concerned about their children's rights, there is very little empirical evidence for this approach, especially as it relates to children with autism. This manuscript addresses the literature on full inclusion and its applicability for students with autism. Although the goals and values underlying full inclusion are laudable, neither the research literature nor thoughtful analysis of the nature of autism supports elimination of smaller, highly structured learning environments for some students with autism.

Sexual attitudes and knowledge of high-functioning adolescents and adults with autism.

Interviewed 21 high-functioning adults with autism and 20 mildly to moderately mentally retarded adults without autism about sexuality and dating. Sexual knowledge and interest were assessed by a sexuality vocabulary checklist and a multiple-choice questionnaire. Group differences were found in experience, with more sexual experiences among the mentally retarded adults, but not in knowledge or interest. In both groups IQ was positively correlated with knowledge scores and males had significantly greater interest in sexuality than females. Implications of sex and group differences are discussed.

Normalization and its relevance today.

Historically, the normalization principle has been influential in promoting a comprehensive community-based service delivery system for people with developmental handicaps. However, its effects were more positive a decade ago when the issues were simply inhumane institutions or more individualized community-based alternatives. Issues in community-based programs for developmentally handicapped people have become more diverse and the choices more complex. In the current climate, the effects of the normalization principle have polarized issues for several reasons: The theory works better than current practice, the criteria are vague and the goals unattainable, normalization takes the focus away from individual client needs, the theory discourages diversity, normalization has become a rallying point for inappropriate practices, overzealousness of normalization advocates has polarized issues, normalization promotes an undesirable value system, and normalization ignores handicapped clients' deficits. What is needed to replace the normalization principle today are guiding concepts that are clearer, more responsive to client needs, and more reflective of value systems that are in the best interests of handicapped people.

Perceptions of popularity among a group of high-functioning adults with autism.

The purpose of this study was to determine how a group of adults with autism perceived one another's interpersonal attributes and popularity. Five female and 11 male high-functioning autistic adults, 18-45 years old, participated in a social skills group together for several years. A sociogram and a questionnaire designed to determine perceptions of best looking, most athletic, and most humorous group members were administered to group members and nonhandicapped group leaders. Independent assessments of intelligence and empathy also were taken. Results indicated that perceived attractiveness and sense of humor were correlated with popularity, but group members' assessments of these attributes differed from those of the nonhandicapped group leaders. Differences between group members and group leaders responses and the implications of the results of the study for social skills training with high-functioning autistic adolescents and adults are discussed.