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Recent studies have reported that strengths-based programs, leveraging autistic adolescents' abilities and interests, could improve their skills and facilitate social engagement. However, little is known about the long-term impact of strengths-based approaches. This study aimed to explore the long-term outcomes of community strengths-based programs designed to support autistic adolescents in developing interests and skills in Science, Technology, Engineering, Arts, and Mathematics (STEAM) and the factors influencing their participation in these programs. A repeated cross-sectional survey study over three years recruited 52 parents in 2018, 52 parents in 2019, and 38 parents in 2020. Results highlighted the positive impact of these programs on autistic adolescents' health and well-being, social relationships and interactions, self-confidence and self-esteem, sense of belonging, and activities and participation. Five key elements influencing participation included the enthusiasm of the participants, their self-perception, the approach of the programs, the learning environment, and the attitudes of the mentors. This study implies that strengths-based approaches to intervention and support for autistic adolescents in a supported environment are a social model solution that could potentially have positive participant outcomes. Findings from this study could provide a framework underpinning future strengths-based interventions., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Competing Interests: "Les auteurs déclarent n’avoir aucun lien d’intérêts."

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.

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., (Copyright © 2019 Elsevier B.V. All rights reserved.)

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., (Copyright © 2019 Cleveland Clinic.)

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.

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., (© 2018 Wiley Periodicals, Inc.)

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.

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., (© 2018 Society for the Experimental Analysis of Behavior.)

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.

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.

Social information processing (SIP) skills are critical for developing and maintaining peer relationships. Building on existing assessment techniques, Virtual Environment for SIP (VESIP TM ), 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., (© 2017 International Society for Autism Research, Wiley Periodicals, Inc.)

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.

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.

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 spectrum disorder is characterized by difficulty with social communication and restricted, repetitive patterns of behavior, interest, or activities. The Diagnostic and Statistical Manual of Mental Disorders, 5th ed., created an umbrella diagnosis that includes several previously separate conditions: autistic disorder, Asperger syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified. There is insufficient evidence to recommend screening for autism spectrum disorder in children 18 to 30 months of age in whom the disorder is not suspected; however, there is a growing body of evidence that early intensive behavioral intervention based on applied behavior analysis improves cognitive ability, language, and adaptive skills. Therefore, early identification of autism spectrum disorder is important, and experts recommend the use of a validated screening tool at 18- and 24-month well-child visits. Medications can be used as adjunctive treatment for maladaptive behaviors and comorbid psychiatric conditions, but there is no single medical therapy that is effective for all symptoms of autism spectrum disorder. Prognosis is heavily affected by the severity of diagnosis and the presence of intellectual disability. Children with optimal outcomes receive earlier, more intensive behavioral interventions and less pharmacologic treatment.

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., (Copyright © 2016 Institute of Psychoanalysis.)

At a time when brain-based explanations of behaviour are proliferating, how will law respond to the badly behaved child? In Australia, children and youth with challenging behaviours such as aggression, swearing, or impulsivity are increasingly understood as having a behavioural disability and so may be afforded the protections of discrimination law. A brain-based approach to challenging behaviour also offers a seemingly neutral framework that de-stigmatises a child's 'bad' behaviour, making it a biological or medical issue rather than a failure of discipline or temperament. Yet this 'brain-based' framework is not as neutral as it appears. How law regulates the brain-based subject in the form of the badly behaved child depends on how law conceptualises the brain. This article examines two competing approaches to the brain in law: a structural, deterministic model and a 'plastic', flexible model. Each of these impacts differently on disabled and abled identity and consequently on discrimination law and equality rights. Using examples from Australian discrimination law, this article argues that as new brain-based models of identity develop, existing inequalities based on race, gender, and disability are imported, and new forms of stigma emerge. In the neurological age, not all brains are created equal., (© The Author 2016. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: Children with Autism spectrum disorders (ASD) frequently present a deficit in interpersonal and social problem solving skills. The Interpersonal Problem-Solving Skills Programme for Children (SCI-Children) comprises 10 weekly, one hour sessions working on interpersonal abilities from a mediation strategy for training purposes., Method: The first study explores the effectiveness of training through pre- and post-treatment evaluations of a sample of 22 children with ASD (7-13 years of age). The second study replicates the programme with 15 children who were assessed three times (three months before the programme starts, at the beginning of the training and at the end of it)., Results: In the first study, significant differences were found in outcome measures (a parent-report subscale of a socialisation measure and child performance on one subscale and total scores of an interpersonal problem-solving skills task). Results in the second study showed no significant changes in absence of the treatment during the waiting period and significant changes after the treatment in the socialisation measure., Conclusions: These findings suggest that the SCI-Children program causes positive impact on the participants. Further evaluation is warranted.

Background and Objective: This paper seeks to describe the experience of youth with autism spectrum disorder (ASD) in making the health care transition (HCT) to adult care., Methods: We surveyed 183 parents and guardians of youth with ASD, assessing the extent to which youth and families experienced and desired HCT services, their satisfaction with services, and obstacles to transition. Descriptive statistics were used to examine HCT measures and Fisher's exact and t tests assessed whether demographic or health measures were associated with service receipt. Any measures with a P value <.05 were included in a logistic regression model, with service receipt as the dependent variable., Results: The receipt of transition services was low overall, with rates for individual services ranging from 3% to 33% and only 60% of the sample receiving any transition service. Despite these low rates, a majority of respondents reported wanting services (73.3%-91.6%), and satisfaction for received services was high (89%-100%). Regression analyses showed depression to be the only variable significantly associated with service receipt. Youth who were identified by their caregivers as having depression experienced a higher rate of transition service receipt than those not identified as having depression., Conclusions: Findings suggest that there is a great need to address the provision of HCT services for youth with ASD. Although families who received HCT services were generally satisfied, overall rates of service receipt were quite low, and those who were not provided with services generally desired them., (Copyright © 2016 by the American Academy of Pediatrics.)

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.

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.

Unlabelled: A growing number of studies have highlighted impairments in the ability of individuals with autism spectrum disorders to recall specific, personally experienced material. These difficulties have been related to underlying problems with autonoetic consciousness, namely the subjective awareness of one's own existence in subjective time. The current paper describes the manifestation of these difficulties in three individuals diagnosed with Asperger syndrome. For the people described, lifelong collecting and hoarding behaviours appeared to serve the function of constituting and maintaining aspects of their sense of self, particularly the sense of continuity and agency over time. On the basis of this clinical information and previous research into self-related processes in people with autism spectrum disorders, an initial model of collecting and hoarding behaviours amongst individuals with Asperger syndrome was formulated. The implications of this formulation for both clinical practice and future research are discussed., Key Practitioner Message: People with Asperger syndrome can have problems in developing a functional sense of self. Collecting and hoarding behaviour by people with Asperger syndrome may reflect such underlying difficulties in their sense of self rather than being symptoms of comorbid mental illness. Interventions need to take account of the function of such behaviours rather than solely regarding them as discrete pathological signs., (Copyright © 2014 John Wiley & Sons, Ltd.)

Problem: Working with clients who present with multiple conditions and comorbidities, including mental health difficulties, neurodevelopmental disorders, and physical health conditions, requires the therapist to go beyond the existing evidence base to make decisions about which specific cognitive behavior therapy (CBT) models and resultant treatment approaches to draw on in therapy. Routine outcome monitoring across a number of parameters, including goal progress, symptom improvement, and changes in functioning, are core to maintaining accountability through monitoring the ongoing impact of idiosyncratic interventions., Method: The case of a young person (age 17 years) who presented with mixed anxiety and depression in the context of autism spectrum disorder (ASD) and chronic pain are presented. In addition to evidence-based adaptations to CBT for clients with ASDs, the therapist selected a cognitive model of low self-esteem as a means of collaboratively conceptualizing the client's difficulties., Findings and Conclusion: Routine outcome measurement demonstrated the effectiveness of the intervention., (© 2015 Wiley Periodicals, Inc.)

Background: Over the past few years, our knowledge about Asperger syndrome (AS) has increased enormously. Although it used to be a syndrome mainly encountered in childhood and adolescent psychiatry, it is now increasingly recognized in adult psychiatry. Nevertheless, little is known about psychiatric comorbidities and life course of adults with AS. The current study aimed to gain an insight into comorbidities and the development of the social situation of adults with AS., Subjects and Methods: We investigated psychiatric comorbidities, psychiatric history, professional background, partnerships, and children in 50 adults with AS (34 men and 16 women) over a broad age range (20-62 years)., Results: Seventy percent of adults with AS had at least one psychiatric comorbiditiy. Most frequent comorbidities were depression and anxiety disorders. Obsessive-compulsive disorder and alcohol abuse/dependence were also observed. Many adults had previously been treated with psychopharmacological or psychotherapeutic interventions. Although most adults had a high-level school leaving certificate and had gone on to complete training/university studies, less than half were currently in employment. Fourteen adults were living in a partnership and 10 had children., Conclusions: Adults with AS often have psychiatric comorbidities, indicating lower levels of mental health. Additionally, they seem to have severe limitations concerning professional success, despite having a good school education. Their family situation is also impaired with regard to starting a family. These considerable limitations in the life of adults with AS may help to understand their specific problems, and emphasize the importance of developing specific treatments for improving their mental health and social integration.

Introduction: The category of pervasive developmental disorders (PDD) without intellectual disability (including Asperger syndrome and high-functioning autism) has increased steadily among individuals since the 1980s. Although some symptoms may decrease with age, functional disability persists and is largely related to abnormalities in social interaction. Within the framework of PDD without intellectual disability, improving social skills appears to be a primary target for intervention programs. Despite a recent increase in the number of studies on this topic, few validated programs are yet available for clinical settings., Background: We have developed an intervention targeting the improvement of social skills from the analysis of video sequences. The goal of this intervention is to promote communication within the group through sharing their interests and emotions, and to enhance the understanding of social situations. In order to assess the efficiency of this intervention, we have conducted a prospective, open, and uncontrolled study. First, it aimed at assessing the immediate effect of our intervention on a single social skill (communication) in an experimental situation (in the group) and in an ecological situations (family and school). Second, this study aimed at assessing the effects of this intervention on the subjects' social adjustment., Method: This study included 16 individuals with high-functioning autism/Asperger syndrome. Participants were evaluated before and after a 6-month video-based training using measures of socio-communicative and adaptive skills., Results: Results revealed a statistically significant increase in the communication skills not only in the group (15.5%), but also at home (13.7%) and at school (8.7%). The evaluation of socio-adaptive behavior indicates a statistically significant increase in communication (12%), family (7%) and social autonomy (8%), and leisure activities (8%)., Discussion: The communication and social adjustment scores obtained upon inclusion were low, despite low autistic intensity scores. However, the improvement at six months was significant for most studied variables. These results are consistent with our clinical findings and seem partly explained by the use of video supports as the mediator of exchanges within the group. However, because of some methodological limitations, the conclusions on the effects of the intervention should be nuanced., Conclusions: This type of intervention seems to be an interesting therapeutic indication for individuals with high-functioning autism/Asperger syndrome. The first results are encouraging, and all participants enjoyed attending the meetings. These conclusion elements encourage us to continue this intervention and to pursue further research by studying the impact on the individuals' quality of life., (Copyright © 2014. Published by Elsevier Masson SAS.)

Within the new DSM-5, the currently differentiated subgroups of "Autistic Disorder" (299.0), "Asperger's Disorder" (299.80) and "Pervasive Developmental Disorder" (299.80) are replaced by the more general "Autism Spectrum Disorder". With regard to a patient-oriented and expedient advising therapy planning, however, the issue of an empirically reproducible and clinically feasible differentiation into subgroups must still be raised. Based on two Autism-rating-scales (ASDS and FSK), an exploratory two-step cluster analysis was conducted with N=103 children (age: 5-18) seen in our social-pediatric health care centre to examine potentially autistic symptoms. In the two-cluster solution of both rating scales, mainly the problems in social communication grouped the children into a cluster "with communication problems" (51 % and 41 %), and a cluster "without communication problems". Within the three-cluster solution of the ASDS, sensory hypersensitivity, cleaving to routines and social-communicative problems generated an "autistic" subgroup (22%). The children of the second cluster ("communication problems", 35%) were only described by social-communicative problems, and the third group did not show any problems (38%). In the three-cluster solution of the FSK, the "autistic cluster" of the two-cluster solution differentiated in a subgroup with mainly social-communicative problems (cluster 1) and a second subgroup described by restrictive, repetitive behavior. The different cluster solutions will be discussed with a view to the new DSM-5 diagnostic criteria, for following studies a further specification of some of the ASDS and FSK items could be helpful.

Autism spectrum disorder describes a behaviourally defined impairment in social interaction and communication, along with the presence of restricted interests and repetitive behaviours. Although the etiology is mostly unknown, it is evident that biological factors affect the brain and result in the autistic clinical presentation. Assessment for diagnosing autism spectrum disorder should be comprehensive in order to cover all sorts of problems related to the disorder. Knowledge and experience from working with neurological and psychiatric disorders are a prerequisite for quality in the examination. Up to now, there is no cure for autism spectrum disorder, but support and adaptations in education are nevertheless important for obtaining sufficient life quality for the patients and the family.

Although adults with autism spectrum disorder are an increasingly identified patient population, few treatment options are available. This preliminary randomized controlled open trial with a parallel design developed two group interventions for adults with autism spectrum disorders and intelligence within the normal range: cognitive behavioural therapy and recreational activity. Both interventions comprised 36 weekly 3-h sessions led by two therapists in groups of 6-8 patients. A total of 68 psychiatric patients with autism spectrum disorders participated in the study. Outcome measures were Quality of Life Inventory, Sense of Coherence Scale, Rosenberg Self-Esteem Scale and an exploratory analysis on measures of psychiatric health. Participants in both treatment conditions reported an increased quality of life at post-treatment (d = 0.39, p < 0.001), with no difference between interventions. No amelioration of psychiatric symptoms was observed. The dropout rate was lower with cognitive behavioural therapy than with recreational activity, and participants in cognitive behavioural therapy rated themselves as more generally improved, as well as more improved regarding expression of needs and understanding of difficulties. Both interventions appear to be promising treatment options for adults with autism spectrum disorder. The interventions' similar efficacy may be due to the common elements, structure and group setting. Cognitive behavioural therapy may be additionally beneficial in terms of increasing specific skills and minimizing dropout., (© The Author(s) 2013.)

We examined the efficacy of cognitive behavioural therapy (CBT) delivered in groups on the reduction of symptoms of depression, anxiety and stress in young people on the autism spectrum. Utilising a quasi-experimental design, comparisons were made between individuals allocated to a group intervention program and individuals allocated to a waitlist. Following the intervention program, participants who were initially symptomatic reported significantly lower depression and stress scores on the Depression Anxiety Stress Scales in comparison to individuals on the waitlist. There was no significant change in anxiety related symptoms. The benefits were maintained at 3 and 9 month follow-up. Our findings demonstrate the potential of CBT in a small group setting for assisting young people with ASD who have symptoms of depression and stress.

Autism Spectrum Disorder (ASD) in DSM-5 comprises the former DSM-IV-TR diagnoses of Autistic Disorder, Asperger's Disorder and PDD-nos. The criteria for ASD in DSM-5 were considerably revised from those of ICD-10 and DSM-IV-TR. The present article compares the diagnostic criteria, presents studies on the validity and reliability of ASD, and discusses open questions. It ends with a clinical and research perspective.

Background: Biomedical treatment options for autism spectrum disorder (ASD) are extremely limited. Repetitive transcranial magnetic stimulation (rTMS) is a safe and efficacious technique when targeting specific areas of cortical dysfunction in major depressive disorder, and a similar approach could yield therapeutic benefits in ASD, if applied to relevant cortical regions., Objective: The aim of this study was to examine whether deep rTMS to bilateral dorsomedial prefrontal cortex improves social relating in ASD., Methods: 28 adults diagnosed with either autistic disorder (high-functioning) or Asperger's disorder completed a prospective, double-blind, randomized, placebo-controlled design with 2 weeks of daily weekday treatment. This involved deep rTMS to bilateral dorsomedial prefrontal cortex (5 Hz, 10-s train duration, 20-s inter-train interval) for 15 min (1500 pulses per session) using a HAUT-Coil. The sham rTMS coil was encased in the same helmet of the active deep rTMS coil, but no effective field was delivered into the brain. Assessments were conducted before, after, and one month following treatment., Results: Participants in the active condition showed a near significant reduction in self-reported social relating symptoms from pre-treatment to one month follow-up, and a significant reduction in social relating symptoms (relative to sham participants) for both post-treatment assessments. Those in the active condition also showed a reduction in self-oriented anxiety during difficult and emotional social situations from pre-treatment to one month follow-up. There were no changes for those in the sham condition., Conclusion: Deep rTMS to bilateral dorsomedial prefrontal cortex yielded a reduction in social relating impairment and socially-related anxiety. Further research in this area should employ extended rTMS protocols that approximate those used in depression in an attempt to replicate and amplify the clinical response., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Objective: The incidence of Asperger's syndrome is reported as above average in young people presenting with gender dysphoria. Patients with Asperger's syndrome, however, are prone to obsessive preoccupations. This paper points out that the apparent dysphoria may in some cases prove to be a transient obsession., Method: Cases from the author's clinical practice were reviewed., Results: Two young men with histories suggesting Asperger's syndrome presented with strong convictions of gender dysphoria, asking for hormonal and surgical treatment. Treatment was withheld and after several years both came to repudiate their 'transgender phase'., Conclusions: Patients asking for sex reassignment should be assessed for indications of Asperger's syndrome. Irreversible treatments should be withheld until it is clear there is a genuine issue of transsexualism.

In many children and adolescents with gender dysphoria only minor or no psychopathology is found. 43% of patients seen in the Frankfurt University Gender Identity Clinic for children and adolescents suffer from major psychopathology. To demonstrate difficulties in treatment of these patients courses of treatment in four such patients are presented. In two natal females major psychopathology made decision for reassignment very difficult. Two natal males were in addition not able to follow recommended treatment steps, in these patients diagnostic doubts arose.

Systemic therapy (ST) is one of the most widely applied psychotherapeutic approaches in the treatment of children and adolescents, yet few systematic reviews exist on the efficacy of ST with this age group. Parallel to a similar study on adults, a systematic review was performed to analyze the efficacy of ST in the treatment of children and adolescents. All randomized or matched controlled trials (RCT) evaluating ST in any setting with child and adolescent index patients were identified by database searches and cross-references, as well as in existing meta-analyses and reviews. Inclusion criteria were: index patient diagnosed with a DSM-IV or ICD-10 listed psychological disorder, or suffering from other clinically relevant conditions, and trial published by December 2011. Studies were analyzed according to their sample, research methodology, interventions applied, and results at end-of-treatment and at follow-up. This article presents findings for internalizing and mixed disorders. Thirty-eight trials were identified, with 33 showing ST to be efficacious for the treatment of internalizing disorders (including mood disorders, eating disorders, and psychological factors in somatic illness). There is some evidence for ST being also efficacious in mixed disorders, anxiety disorders, Asperger disorder, and in cases of child neglect. Results were stable across follow-up periods of up to 5 years. Trials on the efficacy of ST for externalizing disorders are presented in a second article. There is a sound evidence base for the efficacy of ST as a treatment for internalizing disorders of child and adolescent patients., (© FPI, Inc.)

We evaluated functional communication training (FCT) combined with a chained schedule of reinforcement procedure for the treatment of challenging behavior exhibited by two individuals diagnosed with Asperger syndrome and autism. Following functional analyses that suggested that challenging behavior served multiple functions for both participants, we implemented FCT in which mands for a discriminative stimulus (S(D); wristband) were reinforced with access to the S(D) and all three functional reinforcers. Next, we modified the procedure by incorporating delays to increase ease of implementation and promote toleration of delays to reinforcement. Last, we made additional modifications to the procedure by incorporating a chained schedule of reinforcement such that (a) mands for the wristband were reinforced with access to the wristband and (b) specific mands for respective functional reinforcers were reinforced in the presence of the wristband. The results showed that the procedure successfully treated challenging behavior with multiple functions. Future directions in the evaluation and development of treatments that simultaneously address multiple functions are discussed.

Caring for offspring with autism spectrum disorders entails high levels of stress for a long period of time and is associated with several types of health complaints. Few studies have focused on specific effects of particular disorders in the spectrum. This study was carried out with the aim of evaluating the global health of parents of people with Asperger syndrome (N = 53) compared to those of typically developing children (N = 54) through self-reported measures (medication consumption and somatic symptoms) and biological markers (cortisol awakening response [CAR]). Additionally, we analysed various psychological variables as potential predictors of caregiver health. We found that caregivers take more medication and have worse self-reported health than controls, but there were no significant differences in CAR between the groups. However, after controlling for negative affect, differences between groups in CAR reached significance. With regards to predictor variables, anxiety trait, cognitive-coping style, burden and anger temperament were significantly associated with caregiver's self-reported health. These findings underline the need to develop interventions that foster improvements in the health of caregivers, reduce their burden and enhance their quality of life.

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.

This article reports the results of two case studies. Two middle school-aged participants with high-functioning autism spectrum disorders were taught to self-monitor behaviors impacting their social acceptance by peers in their general education settings: oral self-stimulatory behaviors and conversation skills. Results indicate that the intervention was effective to some degree with both participants. As a result of the self-monitoring intervention, one participant decreased self-stimulatory behaviors; however, his data were highly variable throughout the study though lower on average during intervention than in baseline. The other participant's targeted skills in communication were only slightly improved. Self-monitoring using a vibrating reminder appears to be a low-cost intervention with high levels of social acceptability, low training requirements for teachers or students, and no social stigma.

Unlabelled: The purpose of this research was to begin to characterize and compare the school and home language environments of 10 preschool-aged children with Autism Spectrum Disorders (ASD). Naturalistic language samples were collected from each child, utilizing Language ENvironment Analysis (LENA) digital voice recorder technology, at 3-month intervals over the course of one year. LENA software was used to identify 15-min segments of each sample that represented the highest number of adult words used during interactions with each child for all school and home language samples. Selected segments were transcribed and analyzed using Systematic Analysis of Language Transcripts (SALT). LENA data was utilized to evaluate quantitative characteristics of the school and home language environments and SALT data was utilized to evaluate quantitative and qualitative characteristics of language environment. Results revealed many similarities in home and school language environments including the degree of semantic richness, and complexity of adult language, types of utterances, and pragmatic functions of utterances used by adults during interactions with child participants. Study implications and recommendations for future research are discussed., Learning Outcomes: The reader will be able to, (1) describe how two language sampling technologies can be utilized together to collect and analyze language samples, (2) describe characteristics of the school and home language environments of young children with ASD, and (3) identify environmental factors that may lead to more positive expressive language outcomes of young children with ASD., (Copyright © 2013 Elsevier Inc. All rights reserved.)

This study examines the social validity of a family-centred collaborative approach to developing Social Stories™ to support the behavioural and communicative functioning of children with autism spectrum disorder (ASD). Twenty children with Pervasive Developmental Disorder (PDD)/Autism, PDD-Not Otherwise Specified, or Asperger's Disorder (aged 4-12 years) participated in a multiple baseline design across behaviours with a 6-week follow-up. The effects of behaviour stories (to reduce problem behaviours) and communication stories (to facilitate communication) as assessed by parental subjective perceptions of child functioning were evaluated and compared. Using daily parental ratings, behaviour stories were deemed effective for 11 of 17 stories (64.7%), whereas communication stories were deemed effective for 10 of 19 stories (52.6%), with great variability in effect size for both. Results also indicated variability in performance across specific story targets, although parents' perceived effects of Social Stories™ were not linked to any known child characteristics. This study argues that intervention using Social Stories™ to address behavioural and communicative functioning can yield socially valid outcomes across a range of child characteristics and intervention targets. Implications for clinical practice and how present methodological limitations can be addressed in future research are considered.

Background: This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance., Methods: A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood Behaviour Checklist - CBCL) and autistic traits (using the Social Communication Questionnaire - SCQ) during adolescence and were followed up 6 years later (at a mean age of 22 years) using the World Health Organization Disability Assessment Schedule II (WHO-DAS II) to assess functional outcome., Results: A significant positive relationship was found between CBCL score and WHO-DAS II score (β = 0.511, P = 0.001). IQ score showed a negative relationship with total WHO-DAS II score (β = -0.247, P = 0.04). SCQ score was not found to significantly influence total WHO-DAS II score (β = -0.028, P = 0.84)., Conclusions: Although the role of global intellectual ability is important, these results stress the highly predictive value of adolescent behaviours on functional outcomes in adult life among young adults receiving special educational assistance., (© 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.)

The purpose of this pilot study was to evaluate whether a modified version of the Coping Cat program could be effective in reducing anxiety in children with autism spectrum disorder (ASD). Twenty-two children (ages 8-14; IQ ≥ 70) with ASD and clinically significant anxiety were randomly assigned to 16 sessions of the Coping Cat program (cognitive-behavioral therapy; CBT) or a 16-week waitlist. Children in the CBT condition evidenced significantly larger reductions in anxiety than those in the waitlist. Treatment gains were largely maintained at two-month follow-up. Results provide preliminary evidence that a modified version of the Coping Cat program may be a feasible and effective program for reducing clinically significant levels of anxiety in children with high-functioning ASD.