We examined variations in maternal sensitivity at 6 months of child age as a function of child negativity and maternal physiology. We expected maternal vagal withdrawal in response to infant negative affect to facilitate the maintenance of sensitivity, but only for mothers of securely attached children. One hundred and forty-eight infant-mother dyads were observed in multiple contexts at 6 months of child age, and associations among maternal and child variables were examined with respect to 12-month attachment quality. Mothers of later securely attached children were more sensitive than mothers of avoidant children. However, sensitivity decreased for all mothers at high levels of infant negative affect. Furthermore, for mothers of avoidant children, vagal withdrawal was associated with sensitivity to child distress. No association was found between vagal withdrawal and sensitivity for mothers of securely attached children. This suggests that mothers of avoidant children may be uniquely challenged by the affective demands of their infants.

A single dose of synthetic human secretin is not an effective treatment for autism or pervasive developmental disorder.

We evaluated the effects of a voice output communication aid (VOCA) and naturalistic teaching procedures on the communicative interactions of young children with autism. A teacher and three assistants were taught to use naturalistic teaching strategies to provide opportunities for VOCA use in the context of regularly occurring classroom routines. Naturalistic teaching procedures and VOCA use were introduced in multiple probe fashion across 4 children and two classroom routines (snack and play). As the procedures were implemented, all children showed increases in communicative interactions using VOCAs. Also, there was no apparent reductive effect of VOCA use within the naturalistic teaching paradigm on other communicative behaviors. Teachers' ratings of children's VOCA communication, as well as ratings of a person unfamiliar with the children, supported the contextual appropriateness of the VOCA. Probes likewise indicated that the children used the VOCAs for a variety of different messages including requests, yes and no responses, statements, and social comments. Results are discussed in regard to the potential benefits of a VOCA when combined with naturalistic teaching procedures. Future research needs are also discussed, focusing on more precise identification of the attributes of VOCA use for children with autism, as well as for their support personnel.

No abstract

Hierarchical linear modeling was used to describe longitudinal relations between maternal sensitivity and depressive symptomatology for mothers of children with differing attachment classifications at 36 months of child age using data from the NICHD Study of Early Child Care. Attachment during toddlerhood was assessed using a modified Strange Situation Paradigm developed by the MacArthur Working Group on Attachment. On average, maternal sensitivity increased longitudinally from 6 to 36 months for groups with children classified as secure or resistant, but not for groups classified as avoidant or disorganized. Higher maternal depressive symptoms were associated with lower levels of sensitivity for all mothers, although this effect was significantly less severe for mothers of securely attached children. In addition, higher maternal depressive symptoms were associated with decreases in sensitivity from 6 to 36 months for mothers of children who at 36 months showed disorganized attachments combined with underlying patterns of avoidant or resistant behavior.

Applied research in mental retardation has focused on skill training and education to the relative neglect of measuring and increasing happiness in the lives of people with mental retardation. Here we report the results of four preliminary studies that were conducted to develop and demonstrate methodologies for measuring happiness in people with profound mental retardation and other severe handicaps. These results suggest that: (1) facial expressions can provide a valid measure of happiness, and can be measured reliably by relatively untrained observers; (2) the rate of spontaneous smiling is highly variable across individuals; (3) some individuals’ happiness can be increased dramatically by very simple social interactions; and (4) clients’ differential emotional reactions to various caregivers may be useful in tracking the development of social relationships. Suggestions for future research include systematic replication of these preliminary findings with a larger number and variety of subjects, and demonstration of how these measures can be applied to quality assurance systems.

Accumulated evidence shows that biology and the environment can mediate self-injurious behavior (SIB) in persons with mental retardation. Whether pharmacological treatment alters the environmental mediation of self-injury is unclear. Opioid antagonist effects on sequential dependencies for self-injury were studied in the context of experimental single-subject double-blind placebo-controlled designs. Direct observational data were collected for 4 adult subjects in real time on daily rate of SIB and staff interactions. Clinically significant reductions (i.e., > or = 33%) in SIB rate were observed for 3 of the 4 subjects. For all subjects, the magnitude of the sequential dependency between staff behavior and self-injury was significantly greater during treatment with naltrexone than during treatment with a placebo. Results are discussed in relation to behavioral mechanisms of action regulating medication effects for self-injury.

B efore 2000, children <2 years of age had the highest incidence of invasive pneumococcal diseases (IPDs) such as bacteremia, meningitis, or other infection of a normally sterile site (1). Researchers estimated that, in the United States, annual IPD incidence was 165 cases/100,000 children <12 months of age and 203 cases/100,000 children 12-23 months of age (1). Until the United States began a universal 7-valent pneumococcal conjugate vaccine (PCV7) immunization program for children in 2000, Streptococcus pneumoniae was the leading cause of bacterial meningitis (1).S. pneumoniae was also the most common bacterial cause of community-acquired pneumonia and otitis media (OM) in young children. Furthermore, in the 1990s, concerns emerged regarding the growing number of pneumococcal isolates with reduced susceptibility to fi rst-and second-line antimicrobial drugs (1).PCV7 was the fi rst pneumococcal conjugate vaccine (PCV) approved for use in children <2 years of age in the United States. Pneumococcal polysaccharide vaccines, which preceded PCVs, are not immunogenic in children <2 years of age (1,2). PCV7 overcame the challenge of poor immunogenicity among infants and young children through conjugation technology; it was introduced into the US infant immunization schedule in 2000, providing direct protection against several serotypes of invasive and noninvasive pneumococcal disease (3,4). PCV7 protects against the S. pneumoniae serotypes responsible for >80% of IPD cases among children in North America (i.e., serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) (1,4). In 2010, PCV13, a vaccine providing protection against 6 additional serotypes (i.e., serotypes 1, 3, 5, 6A, 19A, and 7F), was approved in the United States, partially because of increasing incidence of serotypes not covered by PCV7 (1,4).Clinical trial data suggested that PCV7 would be effective against IPD, OM, and according to a posthoc analysis, pneumonia (5). The effi cacy of PCV7 (and later PCV13) against all forms of pneumococcal disease was greater than expected, partly because of indirect protection gained through herd immunity (6-8). The United States was the fi rst country to introduce a PCV program for infants and, during the transition to PCV13, recommended the largest catchup program for children <5 years of age who had been vaccinated with PCV7 (9). After an initially slow uptake limited by constrained supply, the United States has achieved consistently high (>80%) 3-dose