The Journal of Child Psychology and Psychiatry

Ozonoff, Sally

doi: 10.1111/j.1469-7610.2010.02297.xpmid: 20698912

Ashton, Rebecca

doi: 10.1111/j.1469-7610.2010.02272.xpmid: 20524940

Background: Traumatic brain injury (TBI) in infancy is relatively common, and is likely to lead to poorer outcomes than injuries sustained later in childhood. While the headlines have been grabbed by infant TBI caused by abuse, often known as shaken baby syndrome, the evidence base for how to support children following TBI in infancy is thin. These children are likely to benefit from ongoing assessment and intervention, because brain injuries sustained in the first year of life can influence development in different ways over many years. Methods: A literature search was conducted and drawn together into a review aimed at informing practitioners working with children who had a brain injury in infancy. As there are so few evidence‐based studies specifically looking at children who have sustained a TBI in infancy, ideas are drawn from a range of studies, including different age ranges and difficulties other than traumatic brain injury. Results: This paper outlines the issues around measuring outcomes for children following TBI in the first year of life. An explanation of outcomes which are more likely for children following TBI in infancy is provided, in the areas of mortality; convulsions; endocrine problems; sensory and motor skills; cognitive processing; language; academic attainments; executive functions; and psychosocial difficulties. The key factors influencing these outcomes are then set out, including severity of injury; pre‐morbid situation; genetics; family factors and interventions. Conclusions: Practitioners need to take a long‐term, developmental view when assessing, understanding and supporting children who have sustained a TBI in their first year of life. The literature suggests some interventions which may be useful in prevention, acute care and longer‐term rehabilitation, and further research is needed to assess their effectiveness.

Fan, Yang‐Teng; Decety, Jean; Yang, Chia‐Yen; Liu, Ji‐Lin; Cheng, Yawei

doi: 10.1111/j.1469-7610.2010.02269.xpmid: 20524939

Background: The ‘broken mirror’ theory of autism, which proposes that a dysfunction of the human mirror neuron system (MNS) is responsible for the core social and cognitive deficits in individuals with autism spectrum disorders (ASD), has received considerable attention despite weak empirical evidence. Methods: In this electroencephalographic study, we examined mu suppression, as an indicator of sensorimotor resonance, concurrent with oculomotor performance while individuals (n = 20) with ASD and control participants (n = 20) either executed hand actions or observed hand actions or a moving dot. No difference in visual attention between groups was found as indicated by fixation duration and normalized fixation number on the presented stimuli. Results: The mu suppression over the sensorimotor cortex was significantly affected by experimental conditions, but not by group membership, nor by the interaction between groups and conditions. Individuals with ASD, similar to the controls, exhibited stronger mu suppression when watching hand actions relative to a moving dot. Notably, participants with ASD failed to imitate the observed actions while their mu suppression indicating the MNS activity was intact. In addition, the mu suppression during the observation of hand actions was positively associated with the communication competence of individuals with ASD. Conclusion: Our study clearly challenges the broken mirror theory of autism. The functioning of the mirror neuron system might be preserved in individuals with ASD to a certain degree. Less mu suppression to action observation coupled with more communicational severity can reflect the symptom heterogeneity of ASD. Additional research needs to be done, and more caution should be used when reaching out to the media.

Bhat, A.N.; Galloway, J.C.; Landa, R.J.

doi: 10.1111/j.1469-7610.2010.02262.xpmid: 20456532

Background: Social inattention is common in children with autism whereas associative learning capabilities are considered a relative strength. Identifying early precursors of impairment associated with autism could lead to earlier identification of this disorder. The present study compared social and non‐social visual attention patterns as well as associative learning in infant siblings of children with autism (AU sibs) and low‐risk (LR) infants at 6 months of age. Methods: Twenty‐five AU sibs and 25 LR infants were observed in a novel social‐object learning task, within which attention to social and non‐social cues was contrasted. Video recorded data were coded for percent duration of gaze to objects or caregiver. Movement rates to activate the toy within the associative learning task were also quantified. Results: Both groups learned the association between moving a switch and activating a cause–effect toy. AU sibs spent less time looking at caregivers and more time looking at the toy or joystick when their caregivers made no attempts to engage their attention. However, response to caregiver‐initiated social bids was comparable for both groups. Conclusions: Infrequent self‐initiated socially directed gaze may be an early marker of later social and communication delays.

Kochanska, Grazyna; Woodard, Jarilyn; Kim, Sanghag; Koenig, Jamie L.; Yoon, Jeung Eun; Barry, Robin A.

doi: 10.1111/j.1469-7610.2010.02238.xpmid: 20406336

Background: Implications of early attachment have been extensively studied, but little is known about its long‐term indirect sequelae, where early security organization moderates future parent–child relationships, serving as a catalyst for adaptive and maladaptive processes. Two longitudinal multi‐trait multi‐method studies examined whether early security amplified beneficial effects of children’s willing, receptive stance toward the parent on socialization outcomes. Methods: We examined parent–child early attachment organization, assessed in the Strange Situation at 14–15 months, as moderating links between children’s willing stance toward parents and socialization outcomes in Study 1 (108 mothers and children, followed to 73 months) and Study 2 (101 mothers, fathers, and children, followed to 80 months). Children’s willing stance was observed as committed compliance at 14 and 22 months in Study 1, and as responsiveness to the parent in naturalistic interactions and teaching contexts at 25 and 67 months in Study 2. Socialization outcomes included children’s internalization of maternal prohibition, observed at 33, 45, and 56 months, and maternal ratings of children’s externalizing problems at 73 months in Study 1, and mothers’ and fathers’ ratings of children’s oppositional defiant disorder and conduct disorder symptoms at 80 months in Study 2. Results: Indirect effects of attachment were replicated across both studies and diverse measures: Attachment security significantly amplified the links between children’s willing stance to mothers and all outcomes. Secure children’s willing, cooperative stance to mothers predicted future successful socialization outcomes. Insecure children’s willing stance conferred no beneficial effects. Conclusions: Implications of early attachment extend to long‐term, indirect developmental sequelae. Security in the first year serves as a catalyst for future positive socialization processes.

Hutman, Ted; Rozga, Agata; DeLaurentis, Angeline D.; Barnwell, Jenna M.; Sugar, Catherine A.; Sigman, Marian

doi: 10.1111/j.1469-7610.2010.02270.xpmid: 20546081

Background: Infants and preschoolers with ASD show impairment in their responses to other people’s distress relative to children with other developmental delays and typically developing children. This deficit is expected to disrupt social interactions, social learning, and the formation of close relationships. Response to distress has not been evaluated previously in infants with ASD earlier than 18 months of age. Methods: Participants were 103 infant siblings of children with autism and 55 low‐risk controls. All children were screened for ASD at 36 months and 14 were diagnosed with ASD. Infants’ responsiveness to distress was evaluated at 12, 18, 24, and 36 months. An examiner pretended to hit her finger with a toy mallet and infants’ responses were video‐recorded. Attention to the examiner and congruent changes in affect were coded on four‐point Likert scales. Results: Cross‐sectional and longitudinal analyses confirm that the ASD group paid less attention and demonstrated less change in affect in response to the examiner’s distress relative to the high‐risk and low‐risk participants who were not subsequently diagnosed with ASD. Group differences remained when verbal skills and general social responsiveness were included in the analytic models. Conclusions: Diagnostic groups differ on distress response from 12 to 36 months of age. Distress‐response measures are predictive of later ASD diagnosis above and beyond verbal impairments. Distress response is a worthwhile target for early intervention programs.

Schwichtenberg, A.J.; Young, G.S.; Sigman, M.; Hutman, T.; Ozonoff, S.

doi: 10.1111/j.1469-7610.2010.02267.xpmid: 20546079

Background: Difficulties in communication and reciprocal social behavior are core features of autism spectrum disorders (ASD) and are often present, to varying degrees, in other family members. This prospective longitudinal infant sibling study examines whether social‐communicative features of family members may inform which infants are at increased risk for ASD and other developmental concerns. Method: Two hundred and seventeen families participated in this study. Infant siblings were recruited from families with at least one older child diagnosed with an ASD (n = 135) or at least one typically developing older child (n = 82). Families completed the Social Responsiveness Scale to assess social and communication features of the broader autism phenotype (BAP), sometimes called quantitative autistic traits (QAT). Family affectedness was assessed in two ways: categorically, based on number of affected older siblings (i.e., typical, simplex, multiplex risk groups) and dimensionally, by assessing varying degrees of QAT in all family members. Infant siblings were assessed at 36 months of age and completed the Autism Diagnostic Observation Schedule and the Mullen Scales of Early Learning. Results: In structural equation models, comparisons between multiplex, simplex and typical groups revealed the highest rates of QAT in the multiplex group followed by the simplex and typical groups. Infant sibling outcomes were predicted by gender, family risk group, proband QAT, and additional sibling QAT. Conclusions: Replicating previous cross‐sectional and family history findings, the present study found elevated social and communication features of the BAP in siblings and fathers of ASD families, but not in mothers. While social and communication features of the BAP in mothers, fathers, and undiagnosed siblings did not predict infant sibling outcomes, having more than one affected older sibling did. Infant siblings from multiplex families were at significantly higher risk for ASD than infant siblings from simplex families in this sample.

Nation, Kate; Cocksey, Joanne; Taylor, Jo S.H.; Bishop, Dorothy V.M.

doi: 10.1111/j.1469-7610.2010.02254.xpmid: 20456536

Background: Poor comprehenders have difficulty comprehending connected text, despite having age‐appropriate levels of reading accuracy and fluency. We used a longitudinal design to examine earlier reading and language skills in children identified as poor comprehenders in mid‐childhood. Method: Two hundred and forty‐two children began the study at age 5. Further assessments of language and reading skill were made at 5.5, 6, 7 and 8 years. At age 8, fifteen children met criteria for being a poor comprehender and were compared to 15 control children both concurrently and prospectively. Results: Poor comprehenders showed normal reading accuracy and fluency at all ages. Reading comprehension was poor at each time point and, notably, showed minimal increases in raw score between 6 and 8 years. Phonological skills were generally normal throughout, but mild impairments in expressive and receptive language, listening comprehension and grammatical understanding were seen at all ages. Conclusions: Children identified as poor comprehenders at 8 years showed the same reading profile throughout earlier development. Their difficulties with the non‐phonological aspects of oral language were present at school entry and persisted through childhood, showing that the oral language weaknesses seen in poor comprehenders in mid‐childhood are not a simple consequence of their reading comprehension impairment.

Dirks, Melanie A.; Boyle, Michael H.

doi: 10.1111/j.1469-7610.2010.02244.xpmid: 20406337

Background: Although structured interviews are assumed to be scientifically superior to checklists for measuring youth psychopathology, few studies have tested this hypothesis. Interviews place a much greater burden on respondents, making it critical to determine their added value when quantifying psychiatric symptoms. Methods: Confirmatory factor analysis was used to compare interviews and checklists in community (N = 251) and clinically referred (N = 406) samples of youth aged 5 to 17 years. We examined the associations between mother‐reported externalizing symptoms assessed by interview versus checklist against (a) teacher‐reported externalizing symptoms, and (b) child’s gender, academic performance, single‐ versus two‐parent family, and family income. Models in which associations were estimated freely were contrasted to models in which the interview and the checklist were constrained to have equal associations with the variables. Finding these models fit comparably would suggest no difference between interviews and checklists. Results: In the community sample, both the constrained and unconstrained models provided comparable fit to the data, suggesting no marked differences between interviews and checklists. In the clinical sample, associations with the interview were generally stronger. Reducing the number of items on the interview to match those on the 6‐item checklist eliminated these differences, suggesting that the increased reliability of the interview scales, afforded by additional items, enhanced their quantification of psychopathology. Conclusions: Consistent with previous studies, interviews were not notably superior to checklists for the measurement of externalizing symptoms. When only a few items are used, small performance differences between checklists and interviews may be due to scale length.

Cho, Soo‐Churl; Kim, Boong‐Nyun; Hong, Yun‐Chul; Shin, Min‐Sup; Yoo, Hee Jeong; Kim, Jae‐Won; Bhang, Soo‐Young; Cho, In Hee; Kim, Hyo‐Won

doi: 10.1111/j.1469-7610.2010.02250.xpmid: 20406335