Social impairment in ASD: It’s not just a confusing face

A study conducted in the U.K. on adults with Autism Spectrum Disorder confirms that the social impairment experienced by adults with ASD is not due solely to problems processing facial expressions or visual cues but is also due to other types of processing of emotional cues such as processing of vocal cues and processing of body language (pragmatics). Here’s the abstract:

BACKGROUND: Previous behavioural and neuroimaging studies of emotion processing in autistic spectrum disorder (ASD) have focused on the use of facial stimuli. To date, however, no studies have examined emotion processing in autism across a broad range of social signals.

METHOD: This study addressed this issue by investigating emotion processing in a group of 23 adults with ASD and 23 age- and gender-matched controls. Recognition of basic emotions (‘happiness’, ‘sadness’, ‘anger’, disgust’ and ‘fear’) was assessed from facial, body movement and vocal stimuli. The ability to make social judgements (such as approachability) from facial stimuli was also investigated.

RESULTS: Significant deficits in emotion recognition were found in the ASD group relative to the control group across all stimulus domains (faces, body movements and voices). These deficits were seen across a range of emotions. The ASD group were also impaired in making social judgements compared to the control group and this correlated with impairments in basic emotion recognition.

CONCLUSIONS: This study demonstrates that there are significant and broad-ranging deficits in emotion processing in ASD present across a range of stimulus domains and in the auditory and visual modality; they cannot therefore be accounted for simply in terms of impairments in face processing or in the visual modality alone. These results identify a core deficit affecting the processing of a wide range of emotional information in ASD, which contributes to the impairments in social function seen in people with this condition.

The study is:

Philip RC, Whalley HC, Stanfield AC, Sprengelmeyer R, Santos IM, Young AW, Atkinson AP, Calder AJ, Johnstone EC, Lawrie SM, Hall J: Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders. Psychol Med. 2010, 27:1-11.

DSM-5: Proposed changes in Autism Spectrum Disorder

One of the many changes proposed for the DSM-V, the diagnostic manual used by mental health professionals, is a revision of the group of disorders currently subsumed under Pervasive Developmental Disorders.  In the current system in the DSM-IV-TR, there are five disorders in this group:  Rett’s Disorder, Childhood Disintegrative Disorder, Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS). Under the new proposal, however:

• The name for the grouping would change from Pervasive Developmental Disorders to Autism Spectrum Disorders.
• Rett’s Disorder would be removed completely from the DSM.  You can read their rationale for removal here.
• The diagnostic criteria for Autistic Disorder will change.  You can read the revised diagnostic criteria here.  You can also read the rationale for changing the diagnostic criteria by clicking on the “Rationale” tab on that page and see the existing diagnostic criteria by clicking on the “DSM-IV” tab on that page.
• Asperger’s Disorder will be removed as a unique or separate diagnosis; people currently diagnosed with Asperger’s Disorder would be diagnosed under the newly re-defined Autistic Disorder. You can read the rationale for this change here.
• Childhood Disintegrative Disorder will be removed as a unique or separate diagnosis;  children who meet current diagnostic criteria for Childhood Disintegrative Disorder would be diagnosed under the newly re-defined Autistic Disorder. You can read the rationale for this change here.
• PDD-NOS will also be removed as a unique diagnosis and will be subsumed under the proposed Autistic Disorder.

If you wish to send the APA feedback on their proposal, you can register on the DSM-5 web site and then submit feedback when you are logged in and looking at a particular diagnosis.

Note:  With this post, I am switching over to “DSM-5″ instead of “DSM-V,” as the APA just announced that they are changing that, too!

Court: vaccines do not cause autism

In three decisions issued today, three masters of the U.S. Federal Court of Claims found that there was insufficient evidence linking  vaccines to autism.  The decisions come one year after similar rulings in three other test cases brought before the “vaccine court” as it is sometimes referred to.   As disappointing as the rulings may be to parents who believe that there is a link, experts have consistently failed to convince the court that the combined effects of the MMR (measles, mumps and rubella) vaccine and thimerosal, a mercury-containing preservative used in vaccines,  causes autism.

The rulings can be appealed to the federal court.

Opinion:  Mead case
Opinion: King case
Opinion: Dwyer case

ADHD and ASD in OCD

Those of us who teach or treat children and teens with Autism Spectrum Disorder (ASD) are used to encountering a lot of obsessive-compulsive symptoms or full-blown Obsessive-Compulsive Disorder (OCD). Indeed, several studies have reported significant rates of OCD in individuals with ASD. Few studies, however, have turned the question around to look at ASD is in the presence of  OCD.   Now a recent Dutch study suggests sheds some light on the relationship between Attention Deficit Hyperactivity Disorder (ADHD), OCD, and ASD.  In this study,  the investigators looked at OCD, ASD, and ADHD symptoms in 109 adult outpatients with OCD and compared them to healthy controls.

Overall, the investigators found that both ADHD and ASD occurred at higher rates in the OCD patients than in the healthy controls.   The researchers also found that for patients with OCD:

• ASD scores correlated with OCD total scores. The higher the score on the autistic measures, the more severe the OCD symptoms were likely to be for patients with OCD.
• ADHD total scores correlated significantly with ASD total scores.  ASD social skills and attention-switching scores correlated with ADHD scores on inattention, and to a lesser degree, hyperactivity.
• ADHD total scores also correlated with OCD symptom severity. In particular, ADHD scores correlated with OCD scores in the domains of aggression/checking, symmetry/ordering, and contamination/washing.
• Patients who had both OCD and ADHD had more autistic symptoms than OCD-alone.

Their study is:

Anholt GE, Cath DC, van Oppen P, Eikelenboom M, Smit JH, van Megen H, van Balkom AJ. Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity? J Autism Dev Disord, 2009, Dec 29.

« Previous Page