1. Marcu I, Oppenheim D, Koren-Karie N, Dolev S, Yirmiya N. {{Attachment and Symbolic Play in Preschoolers with Autism Spectrum Disorders}}. {J Autism Dev Disord};2009 (May 7)
The association between attachment and symbolic play was examined in a sample of 45 preschool age boys with autism spectrum disorders. Attachment was assessed using the strange situation procedure, and the frequency, duration, diversity and complexity of child-initiated symbolic play was assessed from observations of mother-child interactions during free play and doll play. We hypothesized that children with secure attachments will score higher on measures of symbolic play compared to children with insecure attachments, and that children with organized attachments will also score higher on measures of symbolic play compared to children with disorganized attachments. Only the second hypothesis received support, and the reasons for this, as well as the implications of the findings for attachment theory, are discussed.
2. Mori K, Ujiie T, Smith A, Howlin P. {{Parental stress associated with caring for children with Asperger’s syndrome or autism}}. {Pediatr Int};2008 (Oct 9)
Background: The levels of parental stress among parents of children with Asperger’s syndrome in comparison with parents of children with autism are unknown in the Japanese population. Methods: The stress levels in Japanese parents caring for children with Asperger’s syndrome were compared with the stress levels found in Japanese parents caring for children with autism using the Parenting Stress Index/Short Form. Results: In a sample of 193 families, both groups had a significant increase in parental stress levels. In addition, strong evidence was obtained for the presence of higher levels of parental stress in the Asperger’s group compared with the parents of the autism group after controlling for the impact of confounders, F(5,187) = 9.11, P = 0.003. The elevated levels of parental stress found in the Asperger’s group appeared to be attributable to characteristics associated with the child’s basic behavior. The potential mechanism, implications and strategies for further research are discussed. Conclusion: There are significantly elevated parental stress levels in Japanese parents of children with Asperger’s syndrome or autism. In addition, the total parental stress levels were significantly higher in parents of children with Asperger’s syndrome than in parents of children with autism.
3. van Daalen E, Kemner C, Dietz C, Swinkels SH, Buitelaar JK, van Engeland H. {{Inter-rater reliability and stability of diagnoses of autism spectrum disorder in children identified through screening at a very young age}}. {Eur Child Adolesc Psychiatry};2009 (May 7)
To examine the inter-rater reliability and stability of autism spectrum disorder (ASD) diagnoses made at a very early age in children identified through a screening procedure around 14 months of age. In a prospective design, preschoolers were recruited from a screening study for ASD. The inter-rater reliability of the diagnosis of ASD was measured through an independent assessment of a randomly selected subsample of 38 patients by two other psychiatrists. The diagnoses at 23 months and 42 months of 131 patients, based on the clinical assessment and the diagnostic classifications of standardised instruments, were compared to evaluate stability of the diagnosis of ASD. Inter-rater reliability on a diagnosis of ASD versus non-ASD at 23 months was 87% with a weighted kappa of 0.74 (SE 0.11). The stability of the different diagnoses in the autism spectrum was 63% for autistic disorder, 54% for pervasive developmental disorder, not otherwise specified (PDD-NOS), and 91% for the whole category of ASD. Most diagnostic changes at 42 months were within the autism spectrum from autistic disorder to PDD-NOS and were mainly due to diminished symptom severity. Children who moved outside the ASD category at 42 months made significantly larger gains in cognitive and language skills than children with a stable ASD diagnosis. In conclusion, the inter-rater reliability and stability of the diagnoses of ASD established at 23 months in this population-based sample of very young children are good.
