Raising a child with an autism spectrum disorder (ASD) can be an overwhelming experience for parents and families. The pervasive and severe deficits often present in children with ASD are associated with a plethora of difficulties in caregivers, including decreased parenting efficacy, increased parenting stress, and an increase in mental and physical health problems compared with parents of both typically developing children and children with other developmental disorders. In addition to significant financial strain and time pressures, high rates of divorce and lower overall family well-being highlight the burden that having a child with an ASD can place on families. These parent and family effects reciprocally and negatively impact the diagnosed child and can even serve to diminish the positive effects of intervention. However, most interventions for ASD are evaluated only in terms of child outcomes, ignoring parent and family factors that may have an influence on both the immediate and long-term effects of therapy. It cannot be assumed that even significant improvements in the diagnosed child will ameliorate the parent and family distress already present, especially as the time and expense of intervention can add further family disruption. Thus, a new model of intervention evaluation is proposed, which incorporates these factors and better captures the transactional nature of these relationships.

This study examined the development of joint attention in 95 infants assessed between 9 and 18 months of age. Infants displayed significant test -retest reliability on measures of following gaze and gestures (responding to joint attention, RJA) and in their use of eye contact to establish social attention coordination (initiating joint attention, IJA). Infants displayed a linear, increasing pattern of age-related growth on most joint attention measures. However, IJA was characterized by a significant cubic developmental pattern. Infants with different rates of cognitive development exhibited different frequencies of joint attention acts at each age, but did not exhibit different agerelated patterns of development. Finally, 12-month RJA and 18-month IJA predicted 24-month language after controlling for general aspects of cognitive development.The human capacity for social attention coordination has been referred to as joint attention (Bakeman & Adamson, 1984;Bruner & Sherwood, 1983). Different behavioral manifestations of joint attention begin to emerge in the first 6 months of life (D'Entremont, Hains, & Muir, 1997;Farroni, Massaccesi, & Francesca, 2002;Morales, Mundy, & Rojas, 1998) and continue to develop at least through 3 years of age (Adamson, Bakeman, & Dekner, 2004;Carpenter, Nagell, & Tomasello, 1998). These different infant joint attention behaviors may be used for declarative and instrumental-imperative functions (Bates, Benigni, Bretherton, Camaioni, & Volterra, 1979), as well as to initiate or respond to bids in interactions with social partners (Seibert, Hogan, & Mundy, 1982).Various labels have been used to refer to these behavioral dimensions of infant joint attention (Carpenter et al., 1998). Here we adopt the nomenclature initially suggested by Seibert et al. (1982) that is currently widely used in the research literature as well as in multidimensional assessments of early social communication development (e.g., Fidler, Philofsky, Hepburn, & Correspondence concerning this article should be addressed to Peter Mundy, University of Miami, 5665 Ponce De Leon Blvd., Coral Gables, FL 33146. Electronic mail may be sent to pmundy@miami.edu. NIH Public Access Author ManuscriptChild Dev. Author manuscript; available in PMC 2009 March 11. Published in final edited form as:Child Dev. 2007 ; 78(3): 938-954. doi:10.1111/j.1467-8624.2007.01042.x. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript Rogers, 2005;Henderson, Yoder, Yale, & McDuffie, 2002;Laing et al., 2002; Lord et al., 2002;Mundy, Sigman, Kasari, & Yirmiya, 1988;Smith & Ulvund, 2003;Wetherby, Allen, Cleary, Kublin, & Goldstein, 2002). Accordingly, responding to joint attention (RJA) refers to the ability to follow the direction of gaze and gestures of others, initiating joint attention (IJA) refers to the ability to use direction of gaze and gestures to direct the attention of others to spontaneously share experiences, initiating behavior regulation/requests (IBR) refers to the ability to use gaze and gestures to...

Respiratory Sinus Arrhythmia (RSA), heart rate, and accuracy and latency of emotion recognition were evaluated in children with autism spectrum disorders (ASD) and typically developing children while viewing videos of faces slowly transitioning from a neutral expression to one of six basic emotions (e.g., anger, disgust, fear, happiness, sadness, and surprise). Children with ASD were slower in emotion recognition and selectively made more errors in detecting anger. ASD children had lower amplitude RSA and faster heart rate. Within the ASD group, children with higher amplitude RSA recognized emotions faster. Less severe ASD symptoms and increased gaze to the eye region in children with ASD were related to more accurate emotion recognition.

This study aimed to evaluate the Program for the Education and Enrichment of Relational Skills (PEERS: Laugeson et al. in J Autism Dev Disord 39(4):596-606, 2009). PEERS focuses on improving friendship quality and social skills among adolescents with higher-functioning ASD. 58 participants aged 11-16 years-old were randomly assigned to either an immediate treatment or waitlist comparison group. Results revealed, in comparison to the waitlist group, that the experimental treatment group significantly improved their knowledge of PEERS concepts and friendship skills, increased in their amount of get-togethers, and decreased in their levels of social anxiety, core autistic symptoms, and problem behaviors from pre-to post-PEERS. This study provides the first independent replication and extension of the empirically-supported PEERS social skills intervention for adolescents with ASD.

Few studies have examined whether familiarity of partner affects social responses in children with autism. This study investigated heart rate regulation (respiratory sinus arrhythmia [RSA]: The myelinated vagus nerve's regulation of heart rate) and temporal-parietal electroencephalogram (EEG) activity while nineteen 8- to 12-year-old children with autism and 14 controls viewed videos of a familiar and an unfamiliar person reading a story. Children with autism had lower overall RSA levels and exhibited decreased RSA to the unfamiliar person, versus control children. Both groups decreased temporal-parietal EEG activity to the unfamiliar person. Higher RSA was related to higher social skill ratings and fewer problem behaviors. Thus, the social difficulties of children with autism may be characterized by specific mobilization to unfamiliar people.

The factors that place children with Asperger syndrome at risk for comorbid psychiatric symptoms, such as anxiety and depression, remain poorly understood. We investigated the possibility that the children's emotional and behavioral difficulties are associated with social information and attribution processing. Participants were children with either Asperger syndrome (n = 31) or typical development (n = 33).To assess social information and attribution processing, children responded to hypothetical social vignettes.They also completed self-report measures of social difficulties and psychological functioning. Their parents provided information on social competence and clinical presentation. Children with Asperger syndrome showed poor psychosocial adjustment, which was related to their social information and attribution processing patterns. Cognitive and social-cognitive abilities were associated with aspects of social information processing tendencies, but not with emotional and behavioral difficulties. Results suggest that the comorbid symptoms of children with Asperger syndrome may be associated with their social perception, understanding, and experience. KeywordsAsperger syndrome; comorbid symptoms; social information processing In his original case descriptions, Asperger (1944) highlighted pervasive deficits in the children's capacity to understand social interaction, awareness of their social difficulties, and emotional symptoms, including anxiety and depression (Wing, 1981). Since then, emotional symptoms in adolescents and young adults with Asperger syndrome have been emphasized in a number of reports (Volkmar et al., 2000;Wolff and Chick, 1980;Wolff and McGuire, 1995;Wing, 1981). Recently, several empirical studies have documented comorbid psychiatric symptoms, such as anxiety and depression, in individuals with high-functioning autism (HFA) and Asperger syndrome (Ghaziuddin et al., 1998;Green et al., 2000;Hill et al., 2004;Howlin, 2000;Kim et al., 2000;Rinehart et al., 2002;Rumsey et al., 1985;Tonge et al., 1999). Disruptive and aggressive behavior has also been reported (Eaves et al., 1994;Muris and Correspondence should be addressed to: JESSICA A. MEYER, PhD, Tavistock Clinic and Institute of Child Health, UCL, Developmental Psychopathology Research Unit, 120 Belsize Lane, London NW3 5BA, UK. e-mail: Jessica.Meyer@ucl.ac.uk. Steerneman, 1998;Pomeroy, 1998;Rinehart et al., 2002;Tantam, 2000;Tonge et al., 1999). However, the factors giving rise to these comorbid psychiatric symptoms remain unclear. NIH Public AccessDespite the often intense desire to do so, many individuals with Asperger syndrome find it extremely difficult to establish reciprocal relationships with others (Barnard et al., 2000;Green et al., 2000;Sigman and Ruskin, 1999). Limitations in the capacity for intersubjective contact with others (Hobson, 1992;Mundy and Sigman, 1989), coupled with repeated experiences of negative, unsuccessful social interactions (Bauminger, 2002;Frith, 1996;2004;Tantam, 2000;2003) may place children wit...

Infant joint attention has been observed to be related to social-emotional outcomes in at-risk children. To address whether this relation is also evident in typically developing children, 52 children were tested at 12, 15, 24, and 30 months to examine associations between infant joint attention and social outcomes. Twelve-month initiating and responding to joint attention were related to 30-month social competence and externalizing behavior, even when accounting for 15-month temperament ratings, 24-month cognition and language, and demographic variables. These results suggest that, in addition to associations with language and cognition, infant joint attention reflects robust aspects of development that are related to individual differences in the emergence of social and behavioral competence in childhood.

Young adults with ASD experience difficulties with social skills, empathy, loneliness, and social anxiety. One intervention, PEERS®for Young Adults, shows promise in addressing these challenges. The present study replicated and extended the original study by recruiting a larger sample (N = 56), employing a gold standard ASD assessment tool, and examining changes in social anxiety utilizing a randomized controlled trial design. Results indicated improvements in social responsiveness (SSIS-RS SS, p = .006 and CPB, p = .005; SRS, p = .004), PEERS® knowledge (TYASSK, p = .001), empathy (EQ, p = .044), direct interactions (QSQ-YA, p = .059), and social anxiety (LSAS-SR, p = .019). Results have important implications for the utility of the intervention for individuals with ASD.