Six Flags Parks Receive Autism Certification

The main aim of this thesis was to evaluate the efficacy of an emotion training intervention for young children with autism. Further aims were to investigate the relationship between emotion recognition ability, autism symptom severity and social skills in young children with autism. The first chapter of this thesis provides a review of the literature on emotion recognition skills of children with autism. It has been suggested that difficulties in recognising and responding to emotions may underlie the social deficits that are a core feature of autism (Baron-Cohen, Golan, & Ashwin, 2009). However research varies regarding the exact nature of emotion recognition skills of children with autism. Review of the literature suggests that children with autism and comorbid ID have some difficulty matching and labelling basic facial expressions of emotion, for both human and non-human faces, across static and dynamic conditions, when compared with typically developing children and those with other clinical disorders matched for mental age, VIQ or PIQ. For children with high-functioning Autism Spectrum Disorders (ASD), results vary due to large differences between studies. In general, research suggests that children with high-functioning autism have emotion recognition difficulties relative to typically developing children matched for chronological age and cognitive ability, and that these difficulties may be specific to the recognition of complex, but not basic, emotional expressions. These findings highlight the importance of emotion training programmes for young children with autism. Chapter 1 also discusses research in to the relationship between emotion recognition ability and social skills for individuals with autism. Some research has reported a specific association between reduced accuracy in the recognition of expressions of sadness and reduced social skills for adolescents and adults with ASD (Boraston, Blakemore, Chilvers & Skuse, 2007; Wallace et al., 2011) but no research has investigated this association for children with autism. It was suggested that future research might benefit from the investigation of the relationship between emotion recognition skills and social skills in young children with autism. Chapter 2 of this thesis provides a review of research evaluating emotion recognition interventions for children with autism, with the aim of identifying areas of research requiring further investigation. Review of the literature suggested that most emotion training programmes designed for children with autism have been evaluated with older, high-functioning children. Few of these programmes have been evaluated with young children with autism and none have been trialled with young children with autism and comorbid intellectual disability. One of the intervention programmes reviewed in Chapter 2 (the Transporters; Changing Media Development, 2006) was designed for use with young children with autism but had only been evaluated with high-functioning children with ASD. Further research was needed to evaluate its efficacy with young children with autism with a lower range of cognitive ability. The main focus of the current study was to investigate the efficacy of an emotion training programme (the Transporters) for use with a group of 55 young children with autism of a lower range of intellectual ability. To address limitations in previous research the current study also investigated the relationship between emotion recognition ability, autism symptom severity and social skills for young children with autism, with analyses based on the intervention study’s baseline assessment data. Three research papers were developed from this data and are presented in Chapters 4 to 6 as submitted journal articles. Paper 1 was a randomised controlled trial evaluating the efficacy of the Transporters emotion recognition training programme for use with a group of 55 young children with autism, aged four to seven years (FSIQ 42-107). Previous research evaluating the use of the Transporters programme suggested that it was effective in teaching emotion recognition skills to high-functioning children with ASD (e.g., Golan et al., 2010). However in the current study the Transporters programme showed limited efficacy in teaching basic emotion recognition skills to young children with autism of a lower range of cognitive ability. Improvements were limited to the recognition of expressions of anger, with poor maintenance of these skills at follow-up, and with no generalisation of skills to Theory of Mind or social skills. These findings provide limited support for the efficacy of the Transporters programme for young children with autism of a lower cognitive ability, with results suggesting that the Transporters may be more efficacious for older, higher-functioning children with autism. Paper 2 assessed the relationship between degree of autism symptom severity and emotion recognition ability for 55 young children with autism. Only two previous studies had been published on this topic, with findings suggesting that increased autism symptom severity was related to reduced accuracy in emotion recognition in older children and adolescents with ASD. More research was needed to investigate the relationship between autism symptom severity and emotion recognition skills in young children with autism. In support of previous findings, the current study showed that higher autism severity scores were associated with reduced accuracy in the recognition of facial expressions of fear and anger, as well as decreased accuracy in the identification of desire-based but not situation-based emotions. These findings suggest that emotion recognition difficulties may be more pronounced for children with more severe levels of autism symtomatology. Paper 3 investigated the relationship between emotion recognition ability and social skills for a sub-group of 42 young children with autism. Three previous studies had been published on this topic, but further research was needed into the association between accuracy in the recognition of specific emotions (happiness, sadness, anger and fear) and social skills in young children with autism. In the current study, analyses indicated that accuracy in the recognition of expressions of sadness (but not happiness, anger or fear) was associated with better social skills. These findings extend previous research with adults with ASD, suggesting that accuracy in the recognition of sadness is also related to better social skills in children with autism. The discussion chapter comments on the limitations of the current study, as well as the clinical implications and future research directions generated by this research. The main limitation of the current study was that outcome measures were limited the use of four basic facial expressions of emotion. This was due to the young developmental age of the participants, the cognitive demands of the emotion recognition tasks, and difficulty obtaining standardised measures of emotion recognition ability that could be reliably used with children with autism of a young developmental age. As a result, it is unknown whether children improved in their recognition of the more complex emotions that were also targeted in the Transporters programme. Further research is needed to develop and evaluate emotion recognition stimuli for use with young children with autism of a young developmental age. These materials would assist in the evaluation of emotion training programmes for young children with autism. The main conclusion of the current study was that the Transporters emotion training programme showed limited efficacy for use with young children with autism of a lower range of cognitive ability. The Transporters programme may instead be more efficacious for older, higher-functioning, children with autism. Collectively the current findings suggest that there is a need to identify more effective interventions to help teach emotion recognition skills to children with autism of a young developmental age, including those with comorbid ID.

BackgroundThere is increasing public and professional awareness of autism spectrum disorders with early recognition, diagnosis and interventions that are known to improve prognosis. Poor knowledge about childhood autism among paediatric and psychiatric nurses who are members of multidisciplinary teams that care for such children may be a major barrier to early interventions that could improve quality of life and prognosis in childhood autism. Factors that influence knowledge about childhood autism among these nurses are not known. This study assessed knowledge about childhood autism among paediatric and psychiatric nurses in Ebonyi state, Nigeria and determined the factors that could be influencing such knowledge.MethodsForty specialist paediatric and forty psychiatric nurses, making a total sample of eighty, were randomly selected from all the health care facilities in Ebonyi state, Nigeria. A socio-demographic questionnaire and knowledge about childhood autism among health workers (KCAHW) questionnaire were administered to them and the study was a point survey.ResultsThe total mean score on the KCAHW questionnaire among the nurses that participated in the study was 12.56 ± 3.23 out of a total of 19 possible. The mean score for the paediatric nurses was 11.78 ± 3.64 while psychiatric nurses had mean score of 13.35 ± 2.58. The mean scores in Domain 1 were 6.17 ± 1.75 for the paediatric nurses and 6.52 ± 1.43 for the psychiatric nurses. The mean scores in Domain 2 were 0.65 ± 0.48 for the paediatric nurses and 0.80 ± 0.41 for the psychiatric nurses. Domain 3 showed mean scores of 1.97 ± 1.25 for the paediatric nurses while psychiatric nurses scored 2.62 ± 1.23. Domain 4 yielded the mean scores of 2.97 ± 1.54 and 3.42 ± 0.98 for the paediatric and psychiatric nurses respectively.There was significant relationship between the total mean score on the KCAHW questionnaire for the two groups and the area of specialisation of the nurses (t = -2.23, df = 78, p = 0.03) and there was also significant relationship between previous involvement in managing children with childhood autism as a specialist paediatric or psychiatric nurse and the total mean score on the KCAHW questionnaire (t = 6.90, df = 78, p = 0.00).ConclusionThe scores reflect deficits in knowledge about childhood autism among the study cohorts. Paediatric and psychiatric nurses as members of multidisciplinary teams that care for children with childhood autism are expected to provide holistic care and adequate counselling to the families of these children. Unfortunately in this environment, they are not fully equipped with enough knowledge about childhood autism. Education on childhood autism is therefore needed and can be provided through continuing medical education and emphasizing childhood autism in their training curriculum. This will enhance early identification and diagnosis of childhood autism with early interventions that are known to improve prognosis.

Motor dysfunction represents a prevalent neurological feature of autism that may provide an indication of neurobiological underpinnings, clinical diagnosis, prognosis and treatment, particularly early in the disorder. A number of studies have set out to characterise motor dysfunction in autism, however, a majority of this research has focused on older children (above 7 years) and those who demonstrate average range intellectual functioning (IQ>80). The aim of the current thesis was to examine and characterise motor function in young children with autism (3 to 7 years), across the spectrum of cognitive ability. This was undertaken using innovative methodologies that may provide a new approach to characterising motor dysfunction in children with autism. Chapter 3 examined coordinated, whole-body movement in a rise-to-stand task (commenced from the supine position) in young children with autism, including children with an intellectual disability (low-functioning) and without (high-functioning). Observational and temporal analysis revealed that only blind-rated balance and stability distinguished the children with high-functioning autism, who otherwise demonstrated grossly intact form and timing of movement relative to intellectually-matched children. Children with low-functioning autism were not found to perform the rise-to-stand movement differently from intellectually-matched children. Chapter 4 examined upper-limb motor kinematics in children with high-functioning autism using a point-to-point movement paradigm presented on a touch screen. Children with autism demonstrated increased variability in movement planning time, relative to typically developing children. No differences in the temporal execution of movement were found. When a visual distractor was introduced nearby the target of the point-to-point movement, it was found that the children with autism did not change their movement to adjust for this distractor. In contrast, typically developing children made several temporal adjustments in their movement planning when a distractor was present. Together, the findings from Chapters 3 and 4 illustrate the subtlety of the motor profile exhibited by children with autism. Chapter 5 examined the association between motor function as measured on a standardised clinical motor assessment battery, and anxiety, another associated feature of autism. The findings revealed that dynamic balance dysfunction was associated with increased anxiety in children with high-functioning autism, indicating an inter-relationship between motor dysfunction and psychological features of autism. The close relationship between motor and perceptual function in autism formed the basis for Chapter 6, which examined the suggestion that an overlap in behavioural definitions underlies the relationship between sensory defensiveness and anxiety in autism. The study found support for the behavioural overlap hypothesis. The findings from Chapters 5 and 6 highlighted the importance of multidisciplinary management for children with autism, and also the need to consider motor and sensory dysfunction in autism in the context of the social and behavioural features of the disorder. The findings from this thesis are discussed in terms of the motor trajectory of autism, the clinical conceptualisation of the disorder, and the confounding variables associated with the measurement of motor and perceptual function in autism.

- Autism is a disorder in children who have speech and a different way of communicating with other children his age were caused by developmental abnormalities of the nervous system. The term autism was first introduced by Leo Kanner in 1943. It used to autism is considered to be a lifelong disorder that can not be handled, but today many are aware that the handling of the symptoms of autism as early as possible can bring remarkable changes impact on children's development who have it. To check whether a child has autism or not, to use international standards on autism. ICD-10 (International Classification of Diseases) in 1993 and DSM-IV (Diagnostic and Statistical Manual) in 1994 to formulate criteria for the diagnosis of Autism Infantil with the same content, which is currently used throughout the world. Fuzzy logic can be used in diagnosing autis early childhood. Fuzzy Inference System (FIS) is a model Mamdani Mamdani fuzzy reasoning system that can be applied in the process of diagnosing autis in children of various criteria for patient characteristics. Using a data processing application logic while Mamdani FIS decision support systems using MATLAB toolbox R2011b. The result of this study is to diagnose autis decision support early childhood Mamdani FIS approach is more precise and efficient. Keywords : Diagnoses Of Autism, Fuzzy Inference System MethodMamdani. ABSTRACT - Autism is a disorder in children who have speech and a different way of developmental abnormalities of the nervous system. The term autism was first introduced by Leo Kanner in 1943. It used to be autonomous as it is possible to bring a remarkable change impact on children's development who have it. To check whether a child has autism or not, to use international standards on autism. ICD-10 (International Classification of Diseases) in 1993 and DSM-IV (Diagnostic and Statistical Manual) in 1994 to formulate criteria for the diagnosis of Autism Infantil with the same content, which is currently used throughout the world. Fuzzy logic can be used in diagnosis autis early childhood. Fuzzy Inference System (FIS) is a model Mamdani Mamdani fuzzy reasoning system that can be applied in the process of diagnosing autism in children of various criteria for patient characteristics. Using a data processing application logic while MIS FIS decision support systems using MATLAB toolbox R2011b. The result of this study is to diagnose autism decision support early childhood Mamdani FIS approach is more precise and efficient. Keywords: Diagnoses Of Autism, Fuzzy Inference System MethodMamdani.

BackgroundIn designing programs to raise the community level of awareness about childhood autism in sub-Saharan Africa, it is logical to use the primary healthcare workers as contact point for education of the general public. Tertiary healthcare workers could play the role of trainers on childhood autism at primary healthcare level. Assessing their baseline knowledge about childhood autism to detect areas of knowledge gap is an essential ingredient in starting off such programs that would be aimed at early diagnosis and interventions. Knowledge of the healthcare workers on availability of facilities and law that would promote the required interventions is also important. This study assessed the baseline knowledge about childhood autism and opinion among Nigerian healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders.MethodA total of one hundred and thirty four (134) consented healthcare workers working in tertiary healthcare facilities located in south east and south-south regions of Nigeria were interviewed with Socio-demographic, Knowledge about Childhood Autism among Health Workers (KCAHW) and Opinion on availability of Facilities and Law caring for the needs and rights of children with Childhood Autism and other developmental disorders (OFLCA) questionnaires.ResultsThe total mean score of participated healthcare workers on KCAHW questionnaire was 12.35 ± 4.40 out of a total score of 19 possible. Knowledge gap was found to be higher in domain 3 (symptoms of obsessive and repetitive pattern of behavior), followed by domains 1 (symptoms of impairments in social interaction), 4 (type of disorder autism is and associated co-morbidity) and 2 (symptoms of communication impairments) of KCAHW respectively among the healthcare workers. Knowledge about childhood autism (KCA) as measured by scores on KCAHW questionnaire was significantly associated with age group distribution of the healthcare workers, with those age group of fourth decades and above more likely to have higher mean score (p = 0.004) and previous experience of managing children with autism spectrum disorders (ASD) (p = 0.000). KCA showed near significant association with area of specialty, with those healthcare workers in psychiatry compared to pediatrics having higher mean score (p = 0.071) and also with years of working experience of the healthcare workers (p = 0.056). More than half of the healthcare workers subscribed to the opinion that facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders are lacking in Nigeria.ConclusionThe correlates of KCA may help in selection of those tertiary healthcare workers that would best fit the role of trainers. It is important to update the knowledge gaps of those healthcare workers who scored low in different domains of KCAHW questionnaire. It is imperative for policy makers in Nigeria to advocate and implement multidisciplinary healthcare service system that would ensure early diagnosis and interventions. Nationally representative baseline epidemiological data that would guide policy and planning are also desirable.

In this thesis, we explore the density of the microglia in the cerebral and cerebellar cortices of individuals with autism to investigate the hypothesis that neuroinflammation is involved in autism. We describe in our findings an increase in microglial density in two disparate cortical regions, frontal insular cortex and visual cortex, in individuals with autism (Tetreault et al., 2012). Our results imply that there is a global increase in the microglial density and neuroinflammation in the cerebral cortex of individuals with autism. We expanded our cerebellar study to additional neurodevelopmental disorders that exhibit similar behaviors to autism spectrum disorder and have known cerebellar pathology. We subsequently found a more than threefold increase in the microglial density specific to the molecular layer of the cerebellum, which is the region of the Purkinje and parallel fiber synapses, in individuals with autism and Rett syndrome. Moreover, we report that not only is there an increase in microglia density in the molecular layer, the microglial cell bodies are significantly larger in perimeter and area in individuals with autism spectrum disorder and Rett syndrome compared to controls that implies that the microglia are activated. Additionally, an individual with Angelman syndrome and the sibling of an individual with autism have microglial densities similar to the individuals with autism and Rett syndrome. By contrast, an individual with Joubert syndrome, which is a developmental hypoplasia of the cerebellar vermis, had a normal density of microglia, indicating the specific pathology in the cerebellum does not necessarily result in increased microglial densities. We found a significant decrease in Purkinje cells specific to the cerebellar vermis in individuals with autism. These findings indicate the importance for investigation of the Purkinje synapses in autism and that the relationship between the microglia and the synapses is of great utility in understanding the pathology in autism. Together, these data provide further evidence for the neuroinflammation hypothesis in autism and a basis for future investigation of neuroinflammation in autism. In particular, investigating the function of microglia in modifying synaptic connectivity in the cerebellum may provide key insights into developing therapeutics in autism spectrum disorder.

The basis for folinic acid treatment in neuro-psychiatric disorders

Assessment of serum trace elements and electrolytes in children with childhood and atypical autism

Repetitive behaviors are a core symptom domain in autism that has been linked to alterations in the serotonin system. While the selective serotonin-receptive inhibitor fluvoxamine has been shown to be effective in adults with autism, as yet no published placebo controlled trials with these agents document safety and efficacy in children with autism. This study examines the selective serotonin reuptake inhibitor liquid fluoxetine in the treatment of repetitive behaviors in childhood and adolescent autism spectrum disorders (ASDs). In total, 45 child or adolescent patients with ASD were randomized into two acute 8-week phases in a double-blind placebo-controlled crossover study of liquid fluoxetine. Study design included two randomized 8-week fluoxetine and placebo phases separated by a 4-week washout phase. Outcome measures included measures of repetitive behaviors and global improvement. Low-dose liquid fluoxetine (mean final dose: 9.9+/-4.35 mg/day) was superior to placebo in the treatment of repetitive behaviors by CY-BOCS compulsion scale. The effect size was in the moderate to large range, and the doses used were low. Liquid fluoxetine was only slightly, and not significantly, superior to placebo on CGI autism score partially due to a phase order effect. However, fluoxetine was marginally superior to placebo on a composite measure of global effectiveness. Liquid fluoxetine did not significantly differ from placebo on treatment emergent side effects. Liquid fluoxetine in low doses is more effective than placebo in the treatment of repetitive behaviors in childhood autism. Limitations include small sample size and the crossover design of the study. Further replication and long-term maintenance trials are needed.

Intellectual disability (ID) is a condition with a myriad of aetiologies. Given the aetiological heterogeneity, it is logical that researchers are beginning to find syndrome specific cognitive strengths and weaknesses within the ID population. Knowledge regarding such strengths and weaknesses has important implications for education strategies and interventions. In the context of education research, the three frontally mediated functions of sustained attention, response inhibition and working memory can be grouped under the umbrella term cognitive control. There has been very little research examining sustained attention and response inhibition in Down syndrome and autism and ID, and also negligible research into working memory in autism and co-morbid ID. The only pocket of research in this field seems to be in the area of working memory in DS. A thorough literature search identified a clear lack of investigation of cognitive function for those with autism and ID, and also studies that systematically vary the modality of stimulus presentation. With both DS and autism and ID, most research has compared performances on task involving predominately visual or auditory processing, with few using multiple versions of the same task that differ only in the modality of presentation. Accordingly, the main aims of this study were, to firstly investigate the three aspects of cognitive control in adolescents with DS, autism and ID and a comparison group with non-specific intellectual disability (NSID). Secondly, performances were compared using identical versions of tasks that had either a visual or auditory mode of presentation. The final aim of this research was to consider the results in the context of classroom performance, and provide recommendations for the education sector. Participants were recruited from schools and support organisations throughout metropolitan and regional areas of Victoria, Australia. Participants were administered a two-hour test battery of clinical and experimental neuropsychological tasks at either their school or at Monash University. Data from 15 males with DS, 12 males with autism and co-morbid and 12 males with non specific intellectual disability (NSID) were utilised for this research. With regard to sustained attention, the groups were compared on omission errors from visual and auditory versions of the child friendly version of the sustained attention to response task (SART). The group with DS had more difficulty sustaining their attention than both the groups with autism and ID and NSID. The males with autism and ID performed similarly to those with NSID on sustained attention tasks. Modality differences were not observed in any of the groups. For response inhibition, the groups were compared on commission errors from the SART. While no group differences were evident overall, a double dissociation arose between the group with DS and the group with autism and ID. The group with DS were stronger in the visual condition than the group with autism and ID, while the reverse was evident in the auditory condition. For working memory, a novel task was developed for the purposes of this research, which also had visual and auditory versions. On this task, the group with DS performed similarly to the group with autism and ID, with both groups demonstrating poorer performances than the group with NSID. Results from this research suggest that individuals with DS may benefit from more support than their peers in maintaining attention, with targeted strategies capitalising on visual strengths in the classroom. The results with regard to response inhibition also support this approach, and also suggest the converse for those with autism, i.e. presenting material verbally, provided it is kept concise. Both the group with DS and the group with autism and ID had weaknesses in working memory when compared to NSID, with broad recommendations involving reducing the amount of information to be processed at any one point in time as well as providing visual or verbal (as appropriate) prompts and cues to reduce the need to hold information in working memory. This study highlights the need for an individual approach to supporting those with an ID, both within the classroom and beyond. It provides suggestions for future education and intervention strategies that are well informed by the growing body of evidence supporting unique patterns of cognitive strengths and weaknesses within both DS and autism and ID.

Persons with autism can experience severe issues during the puberty and adolescence resulting from the changes that occur in their body. People with autism are sexual beings. They have sexual needs and desires as other people. Sexual development is part of the overall development of their personality. The main objective of this research was to present sexual development, sexual behavior, and sexual identity among persons with autism. Furthermore, we determined the views and opinions of the parents and students, special educators and rehabilitators, about children with autism. Basic tasks of this research were: to determine whether persons with autism have a clear picture and concept of their sexuality, whether the parents discuss this topic with their children, whether and how persons with autism know what sex is, what is contraception, unwanted pregnancy, sexually transmitted diseases or intimate parts of the body, whether they show some kind of sexual behavior, and whether the parents and students should be educated regarding the sexual development, behavior, and sexual identity of persons with autism. The survey was conducted over a period of almost 3 months, which included 94 respondents. Obtained data was collected, grouped, tabled, and processed with the standard statistical program Microsoft Office Excel 2003, applying χ2 tests and Fisher's Exact test. Statistical important difference was at the level of p Key words: persons with autism, sexuality, sexual behavior, sexual needs, sexual development, sexual education. (ProQuest: ... denotes formulae omitted.) Introduction For the normal teenager, adolescence is the period of development starting with puberty, and continuing until the individual has become capable of functioning independently in society, taking full responsibility for his or her own actions (1). From the beginning of puberty, the normal adolescent has to learn to deal with increasingly strong sexual impulses (2,3). The uniqueness of sexual behavior for persons with autism is conditional inter alia, by their inability to appropriately understand the biological changes that occur during the period of puberty and adolescence. During this period the definite sexual orientation has been determined. Girls begin to have growth spurts, develop breasts, pubic and underarm hair, and have vaginal discharge, and boys have: growth spurts, bigger hands and feet, increased muscle mass, deepened voice, facial and underarm hair, and more hair in the pubic area. Their penis and testicles also develop (2). Good hygiene by taking a shower or bath each day, washing your hair, underarms, and vaginal area is increasingly important. Many young people with autism find the physical changes associated with puberty distressing or confusing (3, 4). The individual with autism spectrum disorder will need to be prepared for the changes that are normal during puberty. Many of the individuals have problems and difficulties because of these changes and therefore there is an even greater importance in the adequate preparation for physical and hormonal changes (4). Autism as a developmental disorder leads to serious problems in sexual development and behavior. Sexuality develops through social contacts and communication, through physical contact, through the game, and in that assimilates social rules and norms (5). Persons with autism are like other people in terms of sexual development, and they have: * The right to receive training in socialsexual behavior that will open doors for social contact with people in the community. …

PARENTAL REPORTS OF THE DEVELOPMENT OF AUTISM IN THEIR CHILDREN: THE RELEVANCE OF REGRESSION, COMORBIDITY, AND GENETICS IN THE DETECTION OF EARLY CHARACTERISTICS By Robin P. Goin, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2003 Major Director: Barbara J. Myers, Ph.D., Department of Psychology Early detection of autism plays an important role in enhancing developmental outcomes for affected children. Identifying potential characteristics of the disorder evident during infancy and toddlerhood aids efforts to screen for such symptoms, which may lead to earlier and more accurate diagnoses; however, it is unclear to what extent certain factors encourage or impede early detection. Because parents are responsible for making decisions on behalf of their children based upon their perceptions of children’s developmental progression, caregivers were queried in terms of their beliefs about the development of autism characteristics in their children. Participants included 393 caregivers of children with autism, Asperger’s syndrome, and PDD-NOS from the U.S. and 5 other English-speaking countries who completed an online questionnaire containing both closedand open-ended questions. Rich, descriptive information on children was provided in terms of demographic variables, comorbid diagnoses outside of the autism spectrum, the type of autism onset (congenital or regressive) children experienced, the presence of a family history of autism or other mental-health disorders, and the ages at which behavioral difference were detected for 11 early symptoms indicative of autism. Analyses were conducted with the last 4 variables within this list and with an additional variable reflecting parents’ beliefs about the etiology of autism (genetic versus some external mechanism). Significant relationships existed between a variety of these variables with the exception of a family history of autism or other mental-health disorders. About half of the sample reported that their children developed autism in a congenital fashion while the remaining half, a regressive fashion. Those indicating a congenital onset reported noticing all 11 early characteristics at younger ages relative to those indicating a regressive onset; however, significant differences between groups existed for only 4 of these 11 early symptoms. Parents who indicated a congenital onset were also more likely to espouse a genetic etiology for autism relative to parents indicating a regressive onset who were more likely to attribute the disorder to some external mechanism. Type of autism onset and presence versus absence of child comorbidity independently predicted the ages at which parents detected anomalies in 7 of the 11 early characteristics. Interpretations of the findings are discussed in detail, followed by suggestions for future directions of research in this area.

"The Reason I Jump" by Naoki Higashida: A Reconsideration of Autism, Empathy, and “Mind-Blindness”

BACKGROUND: Autism is a complex developmental disability that typically appears during the first three years of life and is the result of a neurological disorder that affects the normal functioning of the brain, impacting development in the areas of social interaction and communication skills. The growing prevalence and incidence rate reported for autism spectrum disorders increases medical health care costs in many countries, and has become a global concern regarding health care service provision. In terms of policy decisions, it must be acknowledged that the families of autism patients have unmet service needs and are often forced to finance much of this care out of pocket. This present study aims to identify medical utilization by patients with autism in Taiwan and compare medical utilization between patients with and without autism in the 7-12 group age in 2007 and follow up to 2009. METHODS: The study used data from the Taiwan National Health Research Institute (NHRI), from 2007 and a follow-up in 2009. Target populations were selected, with 176 cases of autistic disorders and 880 non-autism cases in the 7-12 age group, for a ratio of 1:5. Statistical analysis was carried out using SAS version 9.2 to analyze the data. RESULTS: This study found that patients with autism were significantly more likely to utilize both ambulatory care and hospitalization. Those of younger age were less likely to utilize ambulatory care (p<.0001). For the number of hospitalizations, males were significantly less likely to be hospitalized compared to females (p<.008). In term of expenditure on ambulatory visits, patients with autism were more likely incur greater expenditure on these services with a strongly significant (p<.0001). Also, adjusting for age – younger ages of autism are likely to spend less on ambulatory visits. For expenditure on hospitalizations, age was significant, which means those of younger age with autism are likely spend more on these services. With regard to different geographical areas, Central Taiwan shows a particularly strong tendency to spend less on hospitalizations (p<.002). Lastly, comparing medical utilization, autistic patients were much more like to use ambulatory care services, with a remarkable mean (56.35 ± 38.64), than non-autistic patients (26.01±20.60), which is related to the higher mean for expenditure on ambulatory care for patients with autism (65873.90 ± 62887.43) compared to those without autism (13401.26±11329.58). CONCLUSION: The present study confirms that patients with autism had higher utilization of ambulatory care and also that there are many factors associated with autism patients, who are more likely to use the medical utilization by related to its greater cost. As medical utilizations and cost are still the main issue for both families with autism and the country, then, from the macro view, policy makers would need to pay more attention on the findings from such an inquiry. The data provide a guide to the principal implications to consider when devising appropriate prevention and intervention approaches that take these children’s unique needs into account.

Autism Spectrum Disorders: Phenotype and Diagnosis, C. Lord and S. Spence Past and Future Perspectives on Autism Epidemiology, E. Fombonne Genetic Basis of Autism, E. Bonora, J.A. Lamb, G. Barnby, A.J. Bailey, and A.P. Monaco Finding Genes in Spite of Heterogeneity: Endophenotypes, QTL Mapping, and Expression Profiling in Autism, D.H Geschwind and M. Alarcon A Mixed Epigenetic and Genetic and Mixed De Novo and Inherited Model for Autism, A.L. Beaudet and H.Y. Zoghbi Neurobiology of Related Disorders: Fragile X Syndrome, U. Narayanan and S.T. Warren Fear and Anxiety Pathways, K.S. LaBar and J.E. LeDoux Cerebellar Networks and Autism: An Anatomical Hypothesis, R.P. Dum and P.L. Strick Language in Autism, M. Walenski, H. Tager-Flusberg, and M.T. Ullman Prefrontal Cortex, J.L. Price The Social Brain, Amygdala, and Autism, C.M. Schumann, M.D. Bauman, C.J. Machado, and D.G. Amaral The Thalamus and Neuromodulatory Systems, M. Steriade Modeling Features of Autism in Animals, P.H. Patterson Neuroanatomical and Neurochemical Studies of the Autistic Brain: Current Thought and Future Directions, M.L. Bauman, G. Anderson, E. Perry, and M. Ray The Social Brain in Autism: Perspectives from Neuropsychology and Neuroimaging, R.T. Schultz, K. Chawarska, and F.R. Volkmar Structural Neuroimaging, R.A. Carper, G.M. Wideman, and E. Courchesne Neuropsychology and Neurophysiology of Autism Spectrum Disorders, N. Minshew, S.J. Webb, D.L. Williams, and G. Dawson Pharmacological Treatments, C.J. McDougle, D.J. Posey, and K.A. Stigler Behavioral, Educational, and Developmental Treatments for Autism, S.J. Rogers and S. Ozonoff The Costs of Autism, M.L Ganz Index