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Descriptors:
Psychopathology; Risk; Public Health; Diagnostic Tests; Attention Deficit Hyperactivity Disorder; Genetics; Pervasive Developmental Disorders; Body Weight; Siblings; Prenatal Influences; Environmental Influences; Correlation; Attribution Theory; Molecular Structure; Autism; Hazardous Materials; Disadvantaged Environment; Intervention; Drug Therapy

Abstract:
Background: Attention deficit hyperactivity disorder (ADHD) and its possible causes still attract controversy. Genes, pre and perinatal risks, psychosocial factors and environmental toxins have all been considered as potential risk factors. Method: This review (focussing on literature published since 1997, selected from a search of PubMed) critically considers putative risk factors with a focus on genetics and selected environmental risks, examines their relationships with ADHD and discusses the likelihood that these risks are causal as well as some of the main implications. Results: No single risk factor explains ADHD. Both inherited and noninherited factors contribute and their effects are interdependent. ADHD is familial and heritable. Research into the inherited and molecular genetic contributions to ADHD suggest an important overlap with other neurodevelopmental problems, notably, autism spectrum disorders. Having a biological relative with ADHD, large, rare copy number variants, some small effect size candidate gene variants, extreme early adversity, pre and postnatal exposure to lead and low birth weight/prematurity have been most consistently found as risk factors, but none are yet known to be definitely causal. There is a large literature documenting associations between ADHD and a wide variety of putative environmental risks that can, at present, only be regarded as correlates. Findings from research designs that go beyond simply testing for association are beginning to contest the robustness of some environmental exposures previously thought to be ADHD risk factors. Conclusions: The genetic risks implicated in ADHD generally tend to have small effect sizes or be rare and often increase risk of many other types of psychopathology. Thus, they cannot be used for prediction, genetic testing or diagnostic purposes beyond what is predicted by a family history. There is a need to consider the possibility of parents and siblings being similarly affected and how this might impact on engagement with families, influence interventions and require integration with adult services. Genetic contributions to disorder do not necessarily mean that medications are the treatment of choice. We also consider how findings might influence the conceptualisation of ADHD, public health policy implications and why it is unhelpful and incorrect to dichotomise genetic/biological and environmental explanations. It is essential that practitioners can interpret genetic and aetiological research findings and impart informed explanations to families. (Contains 2 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Behavior Modification; Behavior Problems; Children; Autism; Pervasive Developmental Disorders; Comparative Analysis; Selection; Intervention; Outcomes of Treatment

Abstract:
Offering children with autism spectrum disorders (ASD) choices between activities (e.g., working on math or English), instructional materials (e.g., using a pen or pencil), or environmental arrangements (e.g., where to sit) has been shown to reduce challenging behavior maintained by escape from task demands. However, the majority of research investigating choice-based interventions for challenging behavior has examined across-activity choices (i.e., choosing between activities) and relatively few studies have examined within-activity choice (i.e., choosing between instructional materials or environmental arrangements). The purpose of this study is to replicate and extend previous research on choice-based challenging behavior interventions by comparing the effects of across-activity choices and within-activity choices on the escape-maintained challenging behavior of 4 children with ASD. An alternating treatment design was embedded within the "B" phase of an ABAB design in which the "A" phase represented a no-choice baseline condition. Both choice formats resulted in less challenging behavior than the baseline condition for all participants. Across-activity choice resulted in less challenging behavior than within-activity choice for 3 participants. Implications for research and practice are discussed. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Autism; Trainees; Technical Assistance; Educational Practices; Professional Development; Pervasive Developmental Disorders; Statewide Planning; Program Evaluation; State Programs; Pretests Posttests; Knowledge Base for Teaching; Self Efficacy; Best Practices; Mentors; Portfolio Assessment; Program Effectiveness; Improvement Programs; Teacher Improvement; Skill Development; Teaching Skills

Abstract:
Training and technical assistance programs for autism spectrum disorders (ASD) have emerged in many states as educators, administrators, and institutions of higher education attempt to address the increasing needs for enhancing the knowledge and skills of educators and disseminating the ever-growing knowledge of educational practices. This report provides data from an evaluation study of a professional development effort conducted by a state-sponsored autism spectrum disorders network. Results documented the positive impact of an 18-month, mentored professional development experience for school-based professionals throughout the state. Surveys of trainees' knowledge before and after training indicated shifts in their confidence, from basic knowledge of ASD characteristics and practices to confidence in their ability to implement ASD-related practices. In addition, mentors documented increased use of ASD practices in trainees' classrooms using a checklist of ASD evidence-based practices. (Contains 3 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Individualized Education Programs; Autism; Communication Skills; Young Children; Teaching Methods; Pervasive Developmental Disorders; Early Childhood Education; Preschool Children; Interpersonal Communication; Generalization; Maintenance; Student Behavior; Behavior Modification; Instructional Effectiveness

Abstract:
This 5-month study examined the impact of a behaviorally based naturalistic teaching strategy, milieu teaching, on the communication skills of preschool-aged children with Autism Spectrum Disorder (ASD) in an early childhood special education (ECSE) classroom. A multiple baseline across participants design was used. Communication targets were selected based on each child's Individualized Education Plan. Milieu teaching strategies were implemented in two activities per day per target. Generalization and maintenance effects were also determined. Results indicated that milieu strategies are an effective means of providing communication skills instruction for young children with ASD in an ECSE classroom. (Contains 3 figures.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Teaching Methods; Autism; Early Intervention; Workshops; Fidelity; Pervasive Developmental Disorders; Comparative Analysis; Trainers; Young Children; Feedback (Response); Scores

Abstract:
The growing number of Autism Spectrum Disorder cases exceeds the services available for these children. This increase challenges both researchers and service providers to develop systematic, effective dissemination strategies for transporting university research models to community early intervention (EI) programs. The current study developed an abbreviated training workshop to teach the Early Start Denver Model (ESDM) to 24 community EI practitioners and examined their fidelity of implementation posttraining and 4 months later. Practitioners successfully implemented and self-assessed their delivery of the ESDM teaching strategies compared with fidelity ratings by expert trainers by the end of the workshop. Those who submitted follow-up materials met fidelity in their direct delivery, whereas their self-assessment of skill delivery appeared lower compared with trainers' fidelity ratings. Findings are discussed about the immediate gains and challenges of community-based dissemination of the ESDM, and the priority for continued research in implementation science to support and sustain intervention delivery. (Contains 2 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Behavior Problems; Autism; Interaction; Mental Retardation; Pervasive Developmental Disorders; Race; Ethnicity; Comorbidity; African Americans; Adults; Institutionalized Persons; Measures (Individuals); Predictor Variables; Correlation

Abstract:
Rates of challenging behaviors were assessed in 175 adults with intellectual disability (ID) or ID and a comorbid autism spectrum disorder (ASD). The relationship between ASD diagnosis, race, and challenging behaviors was assessed using the "Autism Spectrum Disorders-Behavior Problems for Adults (ASD-BPA)." Those with ASD and ID were found to exhibit significantly more challenging behaviors than those with ID alone. No significant main effect of race was found. However, a significant interaction between ASD diagnosis and race was found: In those with ASD, Caucasian participants exhibited more challenging behaviors than African Americans, whereas the opposite held true in those without ASD. Specific subscales of the ASD-BPA were also examined, with a significant interaction found on the Stereotypy subscale. Results and their implications are discussed. (Contains 2 tables and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Identification; Evidence; Autism; Response to Intervention; Programming; Fidelity; Family Involvement; Pervasive Developmental Disorders; Eligibility; Learning Disabilities; Emotional Disturbances; Behavior Disorders; Asperger Syndrome; Mental Retardation; Special Education

Abstract:
The Response to Intervention (RTI) framework, a preventive model of universal screening, tiered interventions, and ongoing progress monitoring, poses an interesting consideration for identification and service delivery for children with autism spectrum disorders (ASD). Upon examination of the existing literature, paucity exists regarding how RTI might guide identification and service delivery for students with ASD; however, the authors consider core tenets of RTI and how they are relevant for students with ASD given what is known about this unique population. Due to the importance of early identification and interventions for individuals with ASD, the RTI framework could be problematic if used to delay education eligibility. Thus, two routes of identification are outlined by the authors, one of which expedites evaluation based on pervasive symptomatology, while the other route uses a form of universal screening to assist in moving toward evaluation for those suspected of ASD. The use of tiered interventions for prevention or service delivery could cause potential complications given the need for early identification and individualized intensive programming. However, there is a clear match for several instructional RTI components and ASD, specifically for evidence-based interventions that are implemented with fidelity and monitored frequently, and other aspects such as family involvement, which could improve programming for students with ASD. (Contains 1 table and 1 figure.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Foreign Countries; Children; Autism; Pervasive Developmental Disorders; Sentences; Suprasegmentals; Comprehension; Figurative Language; Cues; Sino Tibetan Languages; Intonation; Beliefs; Intention; Theory of Mind

Abstract:
English-speaking children with Autism Spectrum Disorders (ASD) are less capable of using prosodic cues such as intonation for irony comprehension. Prosodic cues, in particular intonation, in Cantonese are relatively restricted while sentence-final particles (SFPs) may be used for this pragmatic function. This study investigated the use of prosodic cues and SFPs in irony comprehension in Cantonese-speaking children with and without ASD. Thirteen children with ASD (8;3-12;9) were language-matched with 13 typically developing (TD) peers. By manipulating prosodic cues and SFPs, 16 stories with an ironic remark were constructed. Participants had to judge the speaker's "belief" and "intention." Both groups performed similarly well in judging the speaker's "belief." For the speaker's "intention," the TD group relied more on SFPs. The ASD group performed significantly poorer and did not rely on either cue. SFPs may play a salient role in Cantonese irony comprehension. The differences between the two groups were discussed by considering the literature on theory of mind. (Contains 1 figure and 2 tables.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Personality Traits; Resilience (Psychology); Developmental Delays; Autism; Psychotherapy; Coping; Males; Children; Symptoms (Individual Disorders); Outcomes of Treatment; Foreign Countries; Child Development

Abstract:
This article illustrates a little boy's journey from autistic-like symptoms into more adaptive ways of coping with trauma and separation. Drawing from the psychoanalytic literature on autism and trauma, it discusses how traumatic events in the first two years of life may cause a child to withdraw from social relationships and cause developmental delay. Using the case of a young child in intensive psychotherapy, the article considers his experience of separation and looming loss at an early age and also explores how the author's concomitant bereavement impacted on the countertransference. In addition, the shifts in the young boy's relationship to inanimate objects and particularly his attraction to rubber, is considered with reference to the psychoanalytic concepts of "autistic sensation" and "transitional phenomena". The author demonstrates how planning and preparing for the end of treatment was an essential part of the psychotherapy, helping the patient to develop resilience and to live through the experience of separation. (Contains 5 notes.) Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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Descriptors:
Adolescents; Autism; Psychotherapy; Interpersonal Relationship; Counseling Techniques; Coping; Counselor Client Relationship

Abstract:
Aspects are outlined of the psychotherapy of two adolescents who were starting to emerge from a previous state of chronic (though high-functioning) autism. A central theme is the difficulty these adolescents had in tolerating the separateness of others (and thus the possibility that others could be lost) and at the same time being unable to remain content with a state of autistic adhesive unity with the other. This contribution is an attempt to build on the work of a number of highly creative psychoanalytic pioneers in the understanding of autistic children and adolescents and their application to these children of ideas involving symbiotic at-one-ness and fears of psychic separateness. The influences of Frances Tustin, Anne Alvarez, Thomas Ogden and Susan Reid are particularly key. Note:The following two links are not-applicable for text-based browsers or screen-reading software. Show Hide Full Abstract

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