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Autism is diagnosed according to atypical social-communication and repetitive behaviors. However, autistic individuals are also distinctive in the high variability of specific abilities such as learning. Having been characterized as experiencing great difficulty with learning, autistics have also been reported to learn spontaneously in exceptional ways. These contrasting accounts suggest that some situations may be better than others for learning in autism. We tested this possibility using a probabilistic category learning task with four learning situations differing either in feedback intensity or information presentation. Two learning situations compared high- versus low-intensity feedback, while two other learning situations without external feedback compared isolated sequentially presented information versus arrays of simultaneously presented information. We assessed the categorization and generalization performance of 54 autistic and 52 age-matched typical school-age children after they learned in different situations. We found that children in both groups were able to learn and generalize novel probabilistic categories in all four learning situations. However, across and within groups, autistic children were advantaged by simultaneously presented information while typical children were advantaged by high-intensity feedback when learning. These findings question some common aspects of autism interventions (e.g., frequent intense feedback, minimized simplified information), and underline the importance of improving our current understanding of how and when autistics learn optimally. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Teamwork skills are widely recognized as important, but are these skills being taught effectively within business courses? Two studies utilizing survey research explore how faculty are currently us...

Starting early in life, autistics are characterized as having atypical facial expressions, as well as decreased positive and increased negative affect. The literature on autistic facial expressions remains small, however, with disparate methods and results suggesting limited understanding of common autistic emotions. Furthermore, unlike non-autistics’ emotions, autistics’ emotions have been assessed without considering this population’s characteristics. In this study, the valence of young children’s facial expressions was thus rated as positive, negative, neutral, or “unknown”—a term for perceived emotions observers do not understand. Facial expressions were assessed using the Montreal Stimulating Play Situation, a context incorporating potential autistic interests. Comparing 37 autistic and 39 typical young (27–56 months) age-matched children, we found no group differences in expressed positive, negative, and neutral emotions. We did find differences in unknown emotions, which were unique to the autistic group. Preliminary data also showed that autistic children’s repetitive behaviors co-occurred with positive, neutral, and unknown emotions, but not with negative emotions. In a novel context that considers their characteristics, we did not find decreased positive or increased negative emotions in young autistic children. Instead, they uniquely expressed emotions perceived as unknown, showing the need to improve our understanding of their full emotional repertoire. Lay abstract Autistic people are believed to have emotions that are too negative and not positive enough, starting early in life. Their facial expressions are also persistently judged to be unusual, as reflected in criteria used to identify autism. But it is possible that common autistic facial expressions are poorly understood by observers, as suggested by a range of findings from research. Another issue is that autistic emotions have always been assessed in contexts suited to non-autistics. In our study, the facial expressions of young autistic and typical children were rated as positive, negative, neutral, or “unknown”—a category we created for emotions that observers notice but do not understand. These emotions were assessed using a context suited to autistic children, including objects of potential interest to them. We found that in this context, autistic and typical children did not differ in positive, negative, or neutral facial emotions. They did differ in unknown emotions, which were found only in autistic children. We also found that repetitive behaviors in autistic children co-occurred with positive, neutral, and unknown emotions, but not with negative emotions. In a context which suits their characteristics, autistic children do not show emotions that are too negative or not positive enough. They do show emotions perceived as unknown, which means we need to improve our understanding of their full emotional repertoire.

BACKGROUND: The presence, types, disclosure rates, and effects of conflicts of interest (COIs) on autism early intervention research have not previously been studied. The purpose of this study was to examine these issues. METHODS: This study is a secondary analysis of a comprehensive meta-analysis of all group-design, non-pharmacological early intervention autism research conducted between 1970 and 2018. We coded reports for the presence/absence of COI statements, the types of COIs that were disclosed, and for 8 types of COIs, including: (a) the author developed the intervention, (b) the author is affiliated with a clinical provider, (c) the author is employed by a clinical provider, (d) the author is affiliated with an institution that trains others to use the intervention, (e) the author receives payment or royalties related to the intervention, (f) the study was funded by an intervention provider, (g) the study used a commercially available measure developed by the author, and (h) proceeds of the intervention fund the author’s research. Frequencies and proportions were calculated to determine prevalence of COIs and COI disclosures. Meta-analysis was used to estimate summary effects by COI type, and to determine if they were larger than for reports with no coded COIs. RESULTS: Seventy percent of reports were coded for ≥ 1 COI, but only ~6% of reports contained COI statements fully accounting for all coded COIs. Meta-regressions did not detect significant influences of any COI type on summary effects, however point estimates for each COI type were larger than for reports with no coded COIs. CONCLUSIONS: COIs are prevalent but under-reported in autism early intervention research. Improved reporting practices are necessary for researcher transparency, and would enable more robust examination of the effects of COIs on research outcomes.

Introduction Patients with spontaneous intracranial hemorrhage (sICH) have high mortality and morbidity, which are associated with blood pressure variability. Additionally, blood pressure variability is associated with acute kidney injury (AKI) in critically ill patients, but its association with sICH patients in emergency departments (ED) is unclear. Our study investigated the association between blood pressure variability in the ED and the risk of developing AKI during sICH patients' hospital stay. Methods We retrospectively analyzed patients with sICH, including those with subarachnoid and intraparenchymal hemorrhage, who were admitted from any ED and who received an external ventricular drain at our academic center. Patients were identified by the International Classification of Diseases, Ninth Revision (ICD-9). Outcomes were the development of AKI, mortality, and being discharged home. We performed multivariable logistic regressions to measure the association of clinical factors and interventions with outcomes. Results We analyzed the records of 259 patients: 71 (27%) patients developed AKI, and 59 (23%) patients died. Mean age (± standard deviation [SD]) was 58 (14) years, and 150 (58%) were female. Patients with AKI had significantly higher blood pressure variability than patients without AKI. Each millimeter of mercury increment in one component of blood pressure variability, SD in systolic blood pressure (SBPSD), was significantly associated with 2% increased likelihood of developing AKI (odds ratio [OR] 1.02, 95% confidence interval [CI], 1.005-1.03, p = 0.007). Initiating nicardipine infusion in the ED (OR 0.35, 95% CI, 0.15-0.77, p = 0.01) was associated with lower odds of in-hospital mortality. No ED interventions or blood pressure variability components were associated with patients' likelihood to be discharged home. Conclusion Our study suggests that greater SBPSD during patients' ED stay is associated with higher likelihood of AKI, while starting nicardipine infusion is associated with lower odds of in-hospital mortality. Further studies about interventions and outcomes of patients with sICH in the ED are needed to confirm our observations.

Background Interleukin-1 receptor 1 (IL-1R1) inhibition is a potential strategy for treating patients with chronic obstructive pulmonary disease (COPD). MEDI8968, a fully human monoclonal antibody, binds selectively to IL-1R1, inhibiting activation by IL-1α and IL-1β. We studied the efficacy and safety/tolerability of MEDI8968 in adults with symptomatic, moderate-to-very severe COPD. Methods This was a phase II, randomised, double-blind, placebo-controlled, multicentre, parallel-group study. Subjects aged 45–75 years and receiving standard maintenance therapy with ≥2 exacerbations in the past year were randomised 1:1 to receive placebo or MEDI8968 300 mg (600 mg intravenous loading dose) subcutaneously every 4 weeks, for 52 weeks. The primary endpoint was the moderate/severe acute exacerbations of COPD (AECOPD) rate (week 56 post-randomisation). Secondary endpoints were severe AECOPD rate and St George’s Respiratory Questionnaire-COPD (SGRQ-C) score (week 56 post-randomisation). Results Of subjects randomised to placebo (n = 164) and MEDI8968 (n = 160), 79.3% and 75.0%, respectively, completed the study. There were neither statistically significant differences between treatment groups in moderate/severe AECOPD rate ([90% confidence interval]: 0.78 [0.63, 0.96], placebo; 0.71 [0.57, 0.90], MEDI8968), nor in severe AECOPD rate or SGRQ-C scores. Post-hoc analysis of subject subgroups (by baseline neutrophil count or tertiles of circulating neutrophil counts) did not alter the study outcome. The incidence of treatment-emergent adverse events (TEAEs) with placebo and MEDI8968 treatment was similar. The most common TEAE was worsening of COPD. Conclusions In this phase II study, MEDI8968 did not produce statistically significant improvements in AECOPD rate, lung function or quality of life. Trial registration ClinicalTrials.gov, NCT01448850, date of registration: 06 October 2011. Electronic supplementary material The online version of this article (doi:10.1186/s12931-017-0633-7) contains supplementary material, which is available to authorized users.

We agree that autistics’ unusual overt behaviors don't necessarily mean reduced social motivation. But Jaswal & Akhtar maintain that, while autistics may appear socially uninterested, their social interest is in fact typical and indeed must be to avoid multiple poor outcomes. This problematic idealization of social typicality deflects attention from important differences in autistic cognition and interests, which should be valued.

Behaviors characterized as restricted and repetitive (RRBs) in autism manifest in diverse ways, from motor mannerisms to intense interests, and are diagnostically defined as interfering with functioning. A variety of early autism interventions target RRBs as preoccupying young autistic children to the detriment of exploration and learning opportunities. In an exploratory study, we developed a novel stimulating play situation including objects of potential interest to autistic children, then investigated repetitive behaviors and object explorations in 49 autistic and 43 age-matched typical young children (20-69 months). Autistic children displayed significantly increased overall frequency and duration of repetitive behaviors, as well as increased specific repetitive behaviors. However, groups did not significantly differ in frequency and duration of overall object explorations, in number of different objects explored, or in explorations of specific objects. Exploratory analyses found similar or greater exploration of literacy-related objects in autistic compared to typical children. Correlations between repetitive behaviors and object explorations (their frequency and duration) revealed positive, not negative, associations in both groups. Our findings, from a novel situation incorporating potential autistic interests, suggest that RRBs do not necessarily displace exploration and its possibilities for learning in autism.

Background: Mantle cell lymphoma (MCL) is a heterogeneous and often aggressive malignancy characterized by a varied median overall survival ranging from 2 years to under 10 years based on risk criteria (Hoster E, et al. JCO, 2016). While response rates to front-line chemoimmunotherapy strategies can exceed 90%, patients inevitably relapse. Novel therapies, including Bruton tyrosine kinase inhibitors and immunomodulatory agents, have been approved in the relapsed/refractory settings, yet the impact of these agents on outcomes and costs in real world populations are unknown. In an era of rapidly rising costs of therapies for hematologic malignancies, it is important to understand not only treatment patterns with the integration of novel therapies into MCL algorithms but also value, defined as incremental costs per improvement in health outcomes. Accordingly, we have designed a national prospective study of MCL patients who are initiating novel therapy. Methods: This study (NCT03816683) is an observational, prospective cohort study of patients with MCL treated in clinical practice. Eligibility includes persons ages 18 and older who have initiated standard or novel therapy within 3 months of the index enrollment date. 250 patients will be recruited from 50 academic (60%) and community (40%) settings in the United States. Recruitment will occur over 3 years, with a maximum follow-up of 60 months. The primary measures of the registry are to understand treatment patterns and value with novel therapies in MCL. The secondary measures include toxicity and efficacy of these agents when administered outside of a clinical trial and their impact on health-related quality of life and healthcare resource use. The study employs a novel patient portal that will collect patient outcomes and resource utilization over time. Analyses will be conducted from the patient, physician, and payer perspectives. Our hypothesis is that novel agents are cost-effective - as measured by costs per quality-adjusted year of life (QALY) - when used in clinical practice. Outcome measures include health state utilities (EQ-5D), (QLC-C30), survival, and healthcare resource use (HCRU), treatment modification based on adverse events, and grade 3-5 treatment-related adverse events. Uniform price weights (e.g., Medicare reimbursements) will be applied to HCRU to estimate costs. Incremental cost-utility estimates will be calculated both for the within-study period and over a lifetime, the latter using modeling. Conclusions: As the first observational study specifically designed to evaluate the clinical and economic outcomes of novel therapies for MCL in clinical practice, the findings will have high relevance for clinicians, payers, and patients. Disclosures Ujjani: AstraZeneca: Consultancy; Genentech: Consultancy; Rigel: Consultancy; Gilead: Consultancy; Abbvie: Research Funding; Pharmacyclics: Research Funding. Mato:Celgene: Consultancy; Johnson & Johnson: Consultancy, Research Funding; AstraZeneca: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Sunesis: Consultancy, Research Funding; TG Therapeutics: Consultancy, Other: DSMB member , Research Funding; LOXO: Consultancy, Research Funding; DTRM Biopharma: Research Funding; Genentech: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; Gilead: Research Funding; Acerta: Consultancy; Janssen: Consultancy. Cohen:Bristol-Meyers Squibb Company: Research Funding; Takeda Pharmaceuticals North America, Inc.: Research Funding; Gilead/Kite: Consultancy; LAM Therapeutics: Research Funding; UNUM: Research Funding; Hutchison: Research Funding; Astra Zeneca: Research Funding; Lymphoma Research Foundation: Research Funding; ASH: Research Funding; Genentech, Inc.: Consultancy, Research Funding; Janssen Pharmaceuticals: Consultancy; Seattle Genetics, Inc.: Consultancy, Research Funding. Svoboda:Kite: Consultancy; Pharmacyclics: Consultancy, Research Funding; AstraZeneca: Consultancy; Celgene: Research Funding; Kyowa: Consultancy; Seattle Genetics: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Merck: Research Funding; Incyte: Research Funding. Andorsky:AstraZeneca: Consultancy; Genetech: Research Funding; Gilead: Research Funding; CTI: Research Funding; Celgene: Research Funding. Goy:Takeda: Other: Grants outside of the submitted work; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; University of Nebraska: Research Funding; Hakensackumc: Research Funding; Acerta: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Grants outside of the submitted work, Research Funding; Hackensack University Medical Center, RCCA: Employment; Kite, a Gilead Company: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Grants outside of the submitted work; Pharmacyclics/Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Grants outside of the submitted work, Research Funding; Astrazenca: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Genentech: Other: Grants outside of the submitted work, Research Funding; COTA: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Other: leadership role for profit healthcare company. Wang:Juno Therapeutics: Research Funding; MoreHealth: Consultancy, Equity Ownership; Guidepoint Global: Consultancy; Kite Pharma: Consultancy, Research Funding; Loxo Oncology: Research Funding; Celgene: Honoraria, Research Funding; BioInvent: Consultancy, Research Funding; VelosBio: Research Funding; Aviara: Research Funding; Dava Oncology: Honoraria; Acerta Pharma: Consultancy, Research Funding; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Pharmacyclics: Honoraria, Research Funding; AstraZeneca: Consultancy, Honoraria, Research Funding, Speakers Bureau. Kumar:Pharmacyclics: Research Funding; Celgene: Research Funding, Speakers Bureau; Astra Zeneca: Other: Steering Committee for MCL Registry ; Adaptive Biotechnologies: Research Funding; Seattle Genetics: Research Funding; Abbvie Pharmaceuticals: Research Funding. Dawson:AstraZeneca: Employment, Equity Ownership. Elesinmogun:AstraZeneca: Employment, Equity Ownership. Kabadi:AstraZeneca: Employment, Equity Ownership. Seal:AstraZeneca: Employment, Equity Ownership. Pagel:Pharmacyclics: Consultancy; AstraZeneca: Consultancy; Gilead Sciences: Consultancy. Ramsey:ASCO Quality: Other: $1500 honorarium that he will receive as a speaker at.

Across the autism spectrum, level of intelligence is highly dependent on the psychometric instrument used for assessment, and there are conflicting views concerning which measures best estimate autistic cognitive abilities. Inspection time is a processing speed measure associated with general intelligence in typical individuals. We therefore investigated autism spectrum performance on inspection time in relation to two different general intelligence tests. Autism spectrum individuals were divided into autistic and Asperger subgroups according to speech development history. Compared to a typical control group, mean inspection time for the autistic subgroup but not the Asperger subgroup was significantly shorter (by 31%). However, the shorter mean autistic inspection time was evident only when groups were matched on Wechsler IQ and disappeared when they were matched using Raven's Progressive Matrices. When autism spectrum abilities are compared to typical abilities, results may be influenced by speech development history as well as by the instrument used for intelligence matching.

Superior perception, peaks of ability, and savant skills are often observed in the autistic phenotype. The enhanced perceptual functioning model (Mottron et al., 2006a) emphasizes the increased role and autonomy of perceptual information processing in autistic cognition. Autistic abilities also involve enhanced pattern detection, which may develop through veridical mapping across isomorphic perceptual and non-perceptual structures (Mottron et al., 2009). In this paper, we elaborate veridical mapping as a specific mechanism which can explain the higher incidence of savant abilities, as well as other related phenomena, in autism. We contend that savant abilities such as hyperlexia, but also absolute pitch and synaesthesia, involve similar neurocognitive components, share the same structure and developmental course, and represent related ways by which the perceptual brain deals with objective structures under different conditions. Plausibly, these apparently different phenomena develop through a veridical mapping mechanism whereby perceptual information is coupled with homological data drawn from within or across isomorphic structures. The atypical neural connectivity characteristic of autism is consistent with a developmental predisposition to veridical mapping and the resulting high prevalence of savant abilities, absolute pitch, and synaesthesia in autism.

not available. Disclosures: Study sponsored by LEO Pharma Copyright 2018 SKIN

Recent behavioral investigations have revealed that autistics perform more proficiently on Raven's Standard Progressive Matrices (RSPM) than would be predicted by their Wechsler intelligence scores. A widely-used test of fluid reasoning and intelligence, the RSPM assays abilities to flexibly infer rules, manage goal hierarchies, and perform high-level abstractions. The neural substrates for these abilities are known to encompass a large frontoparietal network, with different processing models placing variable emphasis on the specific roles of the prefrontal or posterior regions. We used functional magnetic resonance imaging to explore the neural bases of autistics' RSPM problem solving. Fifteen autistic and eighteen non-autistic participants, matched on age, sex, manual preference and Wechsler IQ, completed 60 self-paced randomly-ordered RSPM items along with a visually similar 60-item pattern matching comparison task. Accuracy and response times did not differ between groups in the pattern matching task. In the RSPM task, autistics performed with similar accuracy, but with shorter response times, compared to their non-autistic controls. In both the entire sample and a subsample of participants additionally matched on RSPM performance to control for potential response time confounds, neural activity was similar in both groups for the pattern matching task. However, for the RSPM task, autistics displayed relatively increased task-related activity in extrastriate areas (BA18), and decreased activity in the lateral prefrontal cortex (BA9) and the medial posterior parietal cortex (BA7). Visual processing mechanisms may therefore play a more prominent role in reasoning in autistics.

According to the enhanced perceptual functioning (EPF) model, autistic perception is characterized by: enhanced low-level operations; locally oriented processing as a default setting; greater activation of perceptual areas during a range of visuospatial, language, working memory or reasoning tasks; autonomy towards higher processes; and superior involvement in intelligence. EPF has been useful in accounting for autistic relative peaks of ability in the visual and auditory modalities. However, the role played by atypical perceptual mechanisms in the emergence and character of savant abilities remains underdeveloped. We now propose that enhanced detection of patterns, including similarity within and among patterns, is one of the mechanisms responsible for operations on human codes, a type of material with which savants show particular facility. This mechanism would favour an orientation towards material possessing the highest level of internal structure, through the implicit detection of within- and between-code isomorphisms. A second mechanism, related to but exceeding the existing concept of redintegration, involves completion, or filling-in, of missing information in memorized or perceived units or structures. In the context of autistics' enhanced perception, the nature and extent of these two mechanisms, and their possible contribution to the creativity evident in savant performance, are explored.

Factorial laboratory germination experiments were carried out on fruits from 10 British species of Potamogeton (Potamogetonaceae). Fruits had all been placed in a dry-room maintained at 15% RH and 15 °C for 3–6 months from the time of collection. Maximum levels of germination ranged from 13% ( P. polygonifolius ) to 90% ( P. berchtoldii ). Whilst for some species, there was some germination across all the conditions tested, for others germination was significantly increased under specific conditions. The single most important factor for promoting germination was cold stratification prior to placing at the germination temperature. Logistic regression analysis indicated that there was a positive effect of applying a cold stratification treatment in P. filiformis , P. gramineus , and P. natans . Scarification (removal of some of the fruit) also resulted in increases in the number of seeds that germinated for all species. It is suggested that the initial conditions which should be tried for germinating seeds from temperate Potamogeton species are 15–20 °C with a 12 h photoperiod, anaerobic conditions, following a cold stratification treatment. If high levels of germination are not observed, the fruits should be scarified to remove the mechanical restriction of the fruit coat.

Autistics are presumed to be characterized by cognitive impairment, and their cognitive strengths (e.g., in Block Design performance) are frequently interpreted as low-level by-products of high-level deficits, not as direct manifestations of intelligence. Recent attempts to identify the neuroanatomical and neurofunctional signature of autism have been positioned on this universal, but untested, assumption. We therefore assessed a broad sample of 38 autistic children on the preeminent test of fluid intelligence, Raven's Progressive Matrices. Their scores were, on average, 30 percentile points, and in some cases more than 70 percentile points, higher than their scores on the Wechsler scales of intelligence. Typically developing control children showed no such discrepancy, and a similar contrast was observed when a sample of autistic adults was compared with a sample of nonautistic adults. We conclude that intelligence has been underestimated in autistics.

Background An important minority of school-aged autistic children, often characterized as ‘nonverbal’ or ‘minimally verbal,’ displays little or no spoken language. These children are at risk of being judged ‘low-functioning’ or ‘untestable’ via conventional cognitive testing practices. One neglected avenue for assessing autistic children so situated is to engage current knowledge of autistic cognitive strengths. Our aim was thus to pilot a strength-informed assessment of autistic children whose poor performance on conventional instruments suggests their cognitive potential is very limited. Methods Thirty autistic children (6 to 12 years) with little or no spoken language, attending specialized schools for autistic children with the highest levels of impairment, were assessed using Wechsler Intelligence Scale for Children (WISC-IV), Raven’s Colored Progressive Matrices board form (RCPM), Children’s Embedded Figures Test (CEFT), and a visual search task. An age-matched control group of 27 typical children was also assessed. Results None of the autistic children could complete WISC-IV; only six completed any subtest. In contrast, 26 autistic children could complete RCPM, with 17 scoring between the 5th and 90th percentile. Twenty-seven autistic children completed the visual search task, while 26 completed CEFT, on which autistic children were faster than RCPM-matched typical children. Autistic performance on RCPM, CEFT, and visual search were correlated. Conclusion These results indicate that ‘minimally verbal’ or ‘nonverbal’ school-aged autistic children may be at risk of being underestimated: they may be wrongly regarded as having little cognitive potential. Our findings support the usefulness of strength-informed approaches to autism and have important implications for the assessment and education of autistic children.

In order to explain the cognitive and cerebral mechanisms responsible for the visuospatial peak in autism, and to document its specificity to this condition, a group of eight high-functioning individuals with autism and a visuospatial peak (HFA-P) performed a modified block-design task (BDT; subtest from Wechsler scales) at various levels of perceptual cohesiveness, as well as tasks tapping visuomotor speed, global perception, visual memory, visual search and speed of visual encoding. Their performance was compared with that of 8 autistics without a visuospatial peak (HFA-NP), 10 typically developing individuals (TD) and 8 gifted comparison participants with a visuospatial peak (TD-P). Both HFA-P and HFA-NP groups presented with diminished detrimental influence of increasing perceptual coherence compared with their BDT-matched comparison groups. Neither autistic group displayed a deficit in construction of global representations. The HFA-P group showed no differences in performance level or profile in comparison with the gifted BDT-matched [i.e. higher full-scale IQ (FSIQ)] group, apart from locally oriented perception. Diminished detrimental influence of perceptual coherence on BDT performance is both sensitive and specific to autism, and superior low-level processing interacts with locally oriented bias to produce outstanding BDT performance in a subgroup of autistic individuals. Locally oriented processing, enhanced performance in multiple tasks relying on detection of simple visual material and enhanced discrimination of first-order gratings converge towards an enhanced functioning and role of the primary visual cortex (V1) in autism. In contrast, superior or typical performance of autistics in tasks requiring global processing is inconsistent with the global-deficit-driven Weak Central Coherence hypothesis and its neurobiological magnocellular deficit counterpart.

Within the last 10 years, there has been an upsurge of interest in face processing abilities in autism which has generated a proliferation of new empirical demonstrations employing a variety of measuring techniques. Observably atypical social behaviors early in the development of children with autism have led to the contention that autism is a condition where the processing of social information, particularly faces, is impaired. While several empirical sources of evidence lend support to this hypothesis, others suggest that there are conditions under which autistic individuals do not differ from typically developing persons. The present paper reviews this bulk of empirical evidence, and concludes that the versatility and abilities of face processing in persons with autism have been underestimated.

Karl H. Kraus, Steven M. Fox, Fredrick S. Pike and Emily C. Salzer 170 pages, hardback, £59.99 CRC Press. 2016. ISBN 978 1 4987 3242 0 This book has proved popular in a busy first-opinion clinic. The case-based approach is easily accessible and provides a wealth of information without being too taxing. The pictures are large, frequent and good quality. I found it easy to dip into this book and read one or two cases at random. The book is in two parts: ‘Basic concepts’ and ‘Clinical cases’. The first section is devoted to the fundamentals of fracture repair and starts by discussing classification …

According to some lay groups, the nation is experiencing an autism epidemic—a rapid escalation in the prevalence of autism for unknown reasons. However, no sound scientific evidence indicates that the increasing number of diagnosed cases of autism arises from anything other than purposely broadened diagnostic criteria, cou- pled with deliberately greater public awareness and in- tentionally improved case finding. Why is the public perception so disconnected from the scientific evidence? In this article we review three primary sources of misun- derstanding: lack of awareness about the changing diag- nostic criteria, uncritical acceptance of a conclusion illogically drawn in a California-based study, and inat- tention to a crucial feature of the ''child count'' data re- ported annually by the U.S. Department of Education. KEYWORDS—autism; epidemiology; epidemic

Wechsler Intelligence Scale for Children (WISC) is widely used to estimate autistic intelligence (Joseph in The neuropsychology of autism. Oxford University Press, Oxford, 2011; Goldstein et al. in Assessment of autism spectrum disorders. Guilford Press, New York, 2008; Mottron in J Autism Dev Disord 34(1):19–27, 2004). However, previous studies suggest that while WISC-III and Raven’s Progressive Matrices (RPM) provide similar estimates of non-autistic intelligence, autistic children perform significantly better on RPM (Dawson et al. in Psychol Sci 18(8):657–662, doi: 10.1111/j.1467-9280.2007.01954.x , 2007). The latest WISC version introduces substantial changes in subtests and index scores; thus, we asked whether WISC-IV still underestimates autistic intelligence. Twenty-five autistic and 22 typical children completed WISC-IV and RPM. Autistic children’s RPM scores were significantly higher than their WISC-IV FSIQ, but there was no significant difference in typical children. Further, autistic children showed a distinctively uneven WISC-IV index profile, with a “peak” in the new Perceptual Reasoning Index. In spite of major changes, WISC-IV FSIQ continues to underestimate autistic intelligence.

Objective To establish reliability and ease of use of the Cambridge Neuropsychological Test Automated Battery (CANTAB) in assessing changes in cognitive function induced by antihypertensive drugs. Design and methods Standard neuropsychological testing was combined with CANTAB in a double-blind 18-week cross-over study in elderly hypertensives taking perindopril or hydrocholorothiazide/triamterene (HT). Cognitive effects were assessed by employing tests of attention, visuospatial and verbal memory, learning, reasoning, planning, problem solving, speed and coordination. Affect was assessed using two different depression-rating scales. Results Perindopril and the diuretic had no adverse effects on the various aspects of cognitive function. Mood, as assessed by the Hamilton Depression Rating Scale and the Beck Depression Inventory, was improved on Perindopril, and the error rate in the motor screening test was lower. Ambulatory blood pressure monitoring showed both drugs achieved effective 24-h control. Conclusions The ease of use and the ability to adjust the level of testing to the requirements of individual patients, together with the reliability of longitudinal test/re-test results, indicates that CANTAB is an important addition to the methods available to quantitate adverse central nervous system drug effects. The other purpose of the study was to assess any adverse cognitive effects of perindopril against a drug HT believed to have no adverse central nervous system effects. In this context, perindopril was free of adverse effects in all the objective tests employed. In addition, there was a benefit seen in two independent assessments of depression (the Hamilton and the Beck rating scales).

In Wang, Mottron, Peng, Berthiaume, and Dawson (2007 this issue), we conclude that autistics display a robust local bias under various experimental conditions, without evidence of a global deficit....

Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease with a wide range of clinical phenotypes that vary from predominantly airway disease (chronic bronchitis) to predominantly parenchymal disease (emphysema). Current advances for the treatment of COPD are increasingly focused on targeted treatments and development of novel biomarker-based diagnostics (Dx)'s to select the patients most likely to benefit. Clinical trial planning and design with biomarkers includes additional considerations beyond those for conventional trials in un-selected populations, e.g., the heterogeneity of COPD phenotypes in the population, the ability of a biomarker to predict clinically meaningful phenotypes that are differentially associated with the response to a targeted treatment, and the data needed to make Go/No Go decisions during clinical development. We developed the Clinical Trial Object Oriented Research Application (CTOORA), a computer-aided clinical trial simulator of COPD patient outcomes, to inform COPD trial planning with biomarkers. CTOORA provides serial projections of trial success for a range of hypothetical and plausible scenarios of interest. In the absence of data, CTOORA can identify characteristics of a biomarker-based Dx needed to provide a meaningful advantage when used in a clinical trial. We present a case study in which CTOORA is used to identify the scenarios for which a biomarker may be used successfully in clinical development. CTOORA is a tool for robust clinical trial planning with biomarkers, to guide early-to-late stage development that is positioned for success.

Throughout our lifespan we face many challenges which are often referred to as transitions. The move to university is one such transition which may place individuals at risk of suffering ongoing significant life stress, anxiety and uncertainty. Optimism, promotion of independent functioning (PIF), promotion of volitional functioning (PVF) and perceived social support (PSS) appear to be beneficial in coping with university transition and positive adaptation to adversity as well as being associated both directly and indirectly with resilience. This study was conducted in two stages which examined the mechanisms of optimism, PIF, PVF and PSS and their predictive relationship with resilience in first year university students during two semesters. The results indicated that students with higher levels of optimism, PIF, PVF and PSS experienced higher levels of resilience. In Stage One (N = 95), the multiple regression analysis (MRA) indicated optimism (ps

The autistic spectrum currently encompasses common precocious behaviourally identified constellations of social and communication atypicalities associated with restricted interests and repetitive behavior, together with uneven ability profiles. It is associated with multiple but heterogeneous genetic, functional, and structural variations whose established links with an autistic behavioral phenotype are as yet minimal. Strong evidence of high heritability contrasts with limited determination of genes and modes of transmission involved. Adaptation and outcomes vary widely according to opportunities, accommodation, and co-occurring conditions. With current diagnostic practices, multiple genetic conditions overlap with the autistic spectrum, with potential for confusion arising from phenocopies. Recent advances question the often presumed association between autism and intellectual disability and/or epilepsy. Autism is currently understood as a final common phenotypical pathway resulting from an indefinite number of genetic variations, possibly involving the same information processing pathways, and producing a variant in the way humans perceive, memorize, manipulate, and attribute emotional value to available information. Findings plausibly converge on more optional, rather than typically mandatory, hierarchies of information processing as fundamental to autism. Adaptation of education and employment according to individual strengths and needs, as well as attention to co-occurring conditions as necessary, remains today the best way to assist autistic individuals.