Dimensions of Autistic Traits Rated by Parents of Children and Adolescents with Suspected Autism Spectrum Disorders.

To examine the factor structure of autism spectrum disorder (ASD) and the psychometric properties of the German Symptom Checklist for Autism Spectrum Disorders (SCL-ASD). Data were collected from 312 clinical referrals with suspected ASD (2-18 years). Confirmatory factor analyses and analyses of reliability, convergent and divergent validity were performed. A bifactor model with one general ASD factor and two specific factors (interaction-communication; restricted, repetitive behaviors) provided an adequate data fit. Internal consistencies of the SCL-ASD subscales and the total scale were > .70. Correlations with measures of ASD traits were higher than correlations with measures of externalizing and internalizing symptoms. The results support a factor structure consistent with DSM-5/ICD-11 criteria. The SCL-ASD has sound psychometric properties.

Inhibition, flexibility, working memory and planning in autism spectrum disorders with and without comorbid ADHD-symptoms.

BACKGROUND: Recent studies have not paid a great deal of attention to comorbid attention-deficit/hyperactivity disorder (ADHD) symptoms in autistic children even though it is well known that almost half of children with autism spectrum disorder (ASD) suffer from hyperactivity, inattention and impulsivity. The goal of this study was to evaluate and compare executive functioning (EF) profiles in children with ADHD and in children with ASD with and without comorbid ADHD. METHODS: Children aged 6 to 18 years old with ADHD (n = 20) or ASD (High-Functioning autism or Asperger syndrome) with (n = 20) and without (n = 20) comorbid ADHD and a typically developing group (n = 20) were compared on a battery of EF tasks comprising inhibition, flexibility, working memory and planning tasks. A MANOVA, effect sizes as well as correlations between ADHD-symptomatology and EF performance were calculated. Age- and IQ-corrected z scores were used. RESULTS: There was a significant effect for the factor group (F = 1.55; dF = 42; p = .02). Post-hoc analysis revealed significant differences between the ADHD and the TD group on the inhibition task for false alarms (p = .01) and between the ADHD group, the ASD+ group (p = .03), the ASD- group (p = .02) and the TD group (p = .01) for omissions. Effect sizes showed clear deficits of ADHD children in inhibition and working memory tasks. Participants with ASD were impaired in planning and flexibility abilities. The ASD+ group showed compared to the ASD- group more problems in inhibitory performance but not in the working memory task. CONCLUSION: Our findings replicate previous results reporting impairment of ADHD children in inhibition and working memory tasks and of ASD children in planning and flexibility abilities. The ASD + group showed similarities to the ADHD group with regard to inhibitory but not to working memory deficits. Nevertheless the heterogeneity of these and previous results shows that EF assessment is not useful for differential diagnosis between ADHD and ASD. It might be useful for evaluating strengths and weaknesses in individual children.

Attention profiles in autistic children with and without comorbid hyperactivity and attention problems.

OBJECTIVE: Psychopathological, neuropsychological and genetic findings indicate an association between ASD Spectrum Disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). The goal of this study was to compare the neuropsychological profiles of attention functions in children with ADHD and with ASD and without comorbid ADHD. The hypothesis was that either ADHD and autistic children with comorbid ADHD symptoms were more impaired in inhibition and sustained attention performance and that all individuals with ASD show more deficits in divided attention. METHOD: Children aged 6 to 18 years old with ADHD (n = 30) or ASD with (n = 21) and without comorbid ADHD (n = 20) and 30 healthy children were included consecutively. Psychopathology was evaluated using the KIDDIE-SADS and symptom checklists for ADHD and ASD according to DSM-IV. Assessed neuropsychological functioning included inhibition, sustained as well as divided attention and alertness tasks. RESULTS: Age and IQ-corrected z-scores were used. Statistically significant group effects were found for the variables sustained attention median (F = 3.2, = .02), hits (F = 3.3, p = .02) and false alarms (F = 3.9, p = .01), divided attention hits (F = 3.3, p = .02), errors (F = 3.1, p = .03) and false alarms (F = 3.3, p = .03) and alertness false alarms (F = 2.9, p = .04). Pearson Correlations revealed associations between ADHD symptoms and sustained attention in the ADHD group and between ADHD symptoms and inhibition in the ASD+ group. CONCLUSION: Our hypothesis was partly confirmed as ADHD children showed more deficits in sustained attention and ASD children in divided attention tasks. However there was no evidence that children with ASD and comorbid ADHD symptoms have a specific profile in comparison to pure ASD children.

Structural brain abnormalities in adolescents with autism spectrum disorder and patients with attention deficit/hyperactivity disorder.

BACKGROUND: Although autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are two distinct neurodevelopmental diseases, they share behavioural, neuropsychological and neurobiological characteristics. For the identification of endophenotypes across diagnostic categories, further investigations of phenotypic overlap between ADHD and autism at the behavioural, neurocognitive, and brain levels are needed. METHODS: We examined regional grey matter differences and similarities in children and adolescents with ASD and ADHD in comparison to healthy controls using structural magnetic resonance imaging (MRI) and voxel-based morphometry. RESULTS: With regard to clinical criteria, the clinical groups did not differ with respect to ADHD symptoms; however, only patients with ASD showed deficits in social communication and interaction, according to parental rating. Structural abnormalities across both clinical groups compared to controls became evident as grey matter reductions in the left medial temporal lobe and as higher grey matter volumes in the left inferior parietal cortex. In addition, autism-specific brain abnormalities were found as increased grey matter volume in the right supramarginal gyrus. CONCLUSIONS: While the shared structural deviations in the medial temporal lobe might be attributed to an unspecific delay in brain development and might be associated with memory deficits, the structural abnormalities in the inferior parietal lobe may correspond to attentional deficits observed in both ASD and ADHD. By contrast, the autism-specific grey matter abnormalities near the right temporo-parietal junction may be associated with impaired 'theory of mind' abilities. These findings shed some light on both similarities and differences in the neurocognitive profiles of ADHD and ASD patients.

[Age-dependent differences in neuropsychological performance profiles in ADHD and autism]. / Altersabhängige Unterschiede in neuropsychologischen Leistungsprofilen bei ADHS und Autismus.

OBJECTIVES: Children and adolescents with autism or with attention deficit-hyperactivity disorder (ADHD) are compared in this study to three different age groups of healthy children and adolescents normally developed in terms of the severity of neuropsychological variables. METHODS: 42 children with autism and 31 children with ADHD according to DSM-IV as well as 30 healthy controls were assessed consecutively. Neuropsychological attention tasks (sustained attention, inhibition and setshifting) and executive functioning tasks (working memory and planning) were performed. Facial affect recognition ws assessed with a computer-based program to teach emotion processing using full faces and selected eye-pairs. RESULTS: Our data provide evidence that the attention functions we studied seem to improve with age. Differences between the two clinical groups are found particularly among the 11- to 14-year-olds in the domains of sustained attention and inhibition. We detected no statistically significant differences among the three age groups in either the domain of executive functions or in the domain of facial affect recognition. CONCLUSIONS: Although our results can only be interpreted with caution because of the descriptive character of the study and the small sample size, it nonetheless seems to be reasonable to take into account age as a relevant aspect in the utilisation of neuropsychological test procedures to better master the individual performance of different patient groups.

Neurophysiological correlates of relatively enhanced local visual search in autistic adolescents.

Previous studies found normal or even superior performance of autistic patients on visuospatial tasks requiring local search, like the Embedded Figures Task (EFT). A well-known interpretation of this is "weak central coherence", i.e. autistic patients may show a reduced general ability to process information in its context and may therefore have a tendency to favour local over global aspects of information processing. An alternative view is that the local processing advantage in the EFT may result from a relative amplification of early perceptual processes which boosts processing of local stimulus properties but does not affect processing of global context. This study used functional magnetic resonance imaging (fMRI) in 12 autistic adolescents (9 Asperger and 3 high-functioning autistic patients) and 12 matched controls to help distinguish, on neurophysiological grounds, between these two accounts of EFT performance in autistic patients. Behaviourally, we found autistic individuals to be unimpaired during the EFT while they were significantly worse at performing a closely matched control task with minimal local search requirements. The fMRI results showed that activations specific for the local search aspects of the EFT were left-lateralised in parietal and premotor areas for the control group (as previously demonstrated for adults), whereas for the patients these activations were found in right primary visual cortex and bilateral extrastriate areas. These results suggest that enhanced local processing in early visual areas, as opposed to impaired processing of global context, is characteristic for performance of the EFT by autistic patients.

[Relevance and results of Theory of Mind research for autism and other psychiatric disorders]. / Bedeutung und Ergebnisse der Theory of Mind-Forschung für den Autismus und andere psychiatrische Erkrankungen.

OBJECTIVES: Disorders of the autistic spectrum are basically characterised by a triad of symptoms: dysfunction of social interaction, communication deficits, and stereotyped behaviour patterns and interests. One of the most prominent approaches to explaining these abnormalities is the "Theory of Mind" (Baron-Cohen et al., 1885). METHODS: The present review discusses and critically examines the ongoing research and recapitulates the essential findings of the last ten years, focussing on their methodological quality and utility to explain other psychiatric disorders. RESULTS: Despite considerable research efforts in this field, the existing concepts do not constitute a consistent framework for analysing the development of autism spectrum disorders. CONCLUSIONS: Future research should aim to verify the impact of the existing theoretical models and to emphasise the similarities of the different concepts in order to gain specific information about potential causal factors of autism.

Prevalence of obesity, binge eating, and night eating in a cross-sectional field survey of 6-year-old children and their parents in a German urban population.

BACKGROUND: To assess the prevalence of obesity, obesity-related binge eating, non-obesity-related binge eating, and night eating in five- to six-year-old children and to examine the impact of parental eating disturbances. METHODS: When 2020 children attended their obligatory health exam prior to school entry in the city of Aachen, Germany, 1979 parents (97.9%) filled out a questionnaire on their child's eating habits and weight development in a cross-sectional survey. Anthropometric measurements were collected for all children in a standardized form. RESULTS: Episodes of binge eating were found in 2.0% of the children surveyed and night eating in 1.1%. There was a significant relationship between binge eating and obesity but not between night eating and the child's weight. Children's binge eating and night eating were strongly associated with eating disturbances on the part of their mothers (adjusted odds ratios [95% confidence intervals]: 6.1 [2.7-13.5] and 7.8 [2.1-29.4], respectively) and with a non-German native language (adjusted odds ratios [95% confidence intervals]: 2.6 [1.2-5.5] and 11.6 [3.5-38.7], respectively). CONCLUSIONS: In concurrence with studies on adulthood, binge eating is linked to obesity already in early childhood. Children of mothers with eating disorders and children of mothers with a non-German native language are at increased risk of developing eating disorders themselves. Future studies should focus on obesity and eating disorders in early childhood; prevention programs should seek to target young children at risk as early as possible.