The current study follows a recent paper reporting that individuals with autism were just as susceptible to visual illusions as those without autism (Ropar & Mitchell, 1999). The possibility that individual differences may account for the failure to replicate Happé's (1996) findings is explored by presenting a battery of visuospatial tasks thought to measure weak central coherence (embedded figures, block design, Rey complex figure test). Participants with autism were distinguished by relatively good performance on visuospatial tasks, though there was no superiority effect in those with Asperger's syndrome. Performance on the visuospatial battery did not significantly predict susceptibility to illusions in various participant groups, including those with autism and Asperger's syndrome. This suggests that perception of illusions and performance on visuospatial tasks may rely on different mechanisms. The implications for the theory of weak central coherence are discussed.

The aims of this study were to estimate the rate of post-traumatic stress reactions in Palestinian children who experienced war traumas, and to investigate the relationship between trauma-related factors and PTSD reactions. The sample consisted of 239 children of 6 to 11 years of age. Measures included the Rutter A2 (parent) and B2 (teacher) scales, the Gaza Traumatic Event Checklist, and the Child Post-Traumatic Stress Reaction Index. Of the sample, 174 children (72.8%) reported PTSD reactions of at least mild intensity, while 98 (41%) reported moderate/severe PTSD reactions. Caseness on the Rutter A2 scale was detected in 64 children (26.8%), which correlated well with detection of PTSD reactions, but not with teacher-detected caseness. The total number of experienced traumas was the best predictor of presence and severity of PTSD. Intervention programmes for post-war children need to be evaluated, taking into account developmental and cultural aspects, as well as characteristics of the communities involved.

This study examined social-emotional functioning in children with Gilles de la Tourette's syndrome (TS) alone and children with TS and Attention Deficit Hyperactivity Disorder (ADHD). In addition, the contribution of family functioning to social competence was examined. Children with a clinical diagnosis of TS were recruited from the Yale Child Study Center TS specialty clinic. Unaffected control children were recruited through newspaper advertisements and announcements within the university and at area schools. The final sample consisted of 72 children (45 boys and 27 girls) between the ages of 8 and 14. Sixteen children met DMS-III-R criteria for TS, 33 children met criteria for TS and ADHD, and 23 children had no psychiatric diagnoses. Children with TS and ADHD evidenced more externalizing and internalizing behavior problems and poorer social adaptation than children with TS only or unaffected controls. Children with TS only were not significantly different from unaffected controls on most measures of externalizing behaviors and social adaptation but did exhibit more internalizing symptoms. Tic symptom severity was not associated with social, behavioral, or emotional functioning among children with TS, even after stratifying by medication status. However, ADHD diagnosis, obsessional symptom severity, and family functioning were significantly associated with social and emotional adjustment among TS children. Moreover, family functioning was associated with social and emotional adjustment even after controlling for TS and ADHD diagnostic status. These findings demonstrate that much of the social and behavioral dysfunction in children with TS is ADHD-specific and children with TS alone have a very different social-emotional profile than do those with TS plus ADHD. Finally, social-emotional adjustment in children with TS is best understood within the family context.

Adolescents with Asperger syndrome (AS: without delay in speech development, diagnosed according to ICD-10 clinical criteria) were compared with a group with high-functioning autism (HFA: all with delayed speech development), and a group with conduct disorder (CD). Family and genetic studies suggest that Asperger syndrome and autism form part of the same spectrum, whereas the social impairments in conduct disorder are assumed to have different origins. The aims were to explore the relationships between early speech development and other aspects of functioning in autistic disorders, and to compare autistic and nonautistic social impairments. Early and current behaviour and IQ profiles were investigated.The CD group were clearly different from both the AS and HFA groups. The AS group tended to have less severe early behavioural abnormalities than the HFA group, and were unlikely to have speech abnormalities, but other communicative, social, and restricted/stereotyped behavioural difficulties were largely of a similar pattern to the abnormalities in the HFA group. Eighty per cent of the AS group met criteria for autism on the diagnostic algorithm associated with the Autism Diagnostic Interview-Revised. By adolescence, the AS group were reported to be as abnormal as the HFA group but in structured 1:1 interaction their conversation was better. IQ profile in the AS group showed relative strength on verbal measures, unlike the HFA group, but relatively good performance on the Block Design subtest of the WISC/WAIS was a feature of both the AS and HFA groups. The results indicate closely similar behavioural manifestations may arise by adolescence despite differences in speech development. Follow-up studies and further family investigations will be required to clarify the origins of these and other patterns of autistic development.

Worldwide, more than one million children are infected with human immunodeficiency virus (HIV) and in the United States it has become the sixth leading cause of death among 15–24-year-olds. Despite the trend of increasing rates of infection, advances in therapies have led to survival past 5 years of age for more than 65% of infected children. This global health threat will therefore continue to have a significant impact on child and adolescent psychiatry and psychology. This paper reviews current studies and reports on the consequences of the acquired immunodeficiency syndrome (AIDS) epidemic in the psychiatric care and development of children and adolescents infected by HIV. From a search of all the English-language-based literature on pediatric AIDS, 140 studies are reviewed which address HIV infection and its psychological and social implications. Several topics of mental health significance are examined: (1) the epidemiology of HIV, (2) neurocognitive development among those infected, (3) psychological impact of infection, and (4) the family and social context of HIV. The transition of HIV from an acute, lethal disease to a subacute, chronic disease has enormous implications for the neurocognitive and psychosocial development of children and families. As children and adolescents infected with HIV continue to live longer, normal developmental milestones and educational needs will take on new significance. Many children will continue to be adversely impacted by non-HIV factors such as poverty, inadequate medical services, and a lack of social support. This review outlines recent developments that hold promise to effectively reduce the treatment burden on the infected, their families, and health care providers and to decrease the incidence of transmission to the uninfected.

A conceptual model has recently been hypothesized in which parallel but correlated developmental pathways exist for attention deficit behaviors and conduct problems. An important component of this model suggests that attention deficit behaviors are related to later scholastic underachievement, whereas conduct problems are unrelated to scholastic underachievement except by their common correlation with attention deficit and intelligence. The present study replicated the general model using a cross-sectional sample of 325 children, and examined whether hypothesized dual pathways (behavioral and cognitive) better account for the relationship between attention deficit, intelligence, and later scholastic achievement. Results of the structural equation modeling analysis were consistent with the hypothesized dual pathway model and suggest that school behavior and select cognitive abilities serve as important mediators between attention deficit, intelligence, and later scholastic achievement. Implications of these results for understanding the developmental trajectory of children with attention deficit and general theoretical models of ADHD are discussed.

In the present study, copying tasks were used to assess hierarchical aspects of visual perception in a group of 10 nonsavant autistic individuals with normal intelligence. In Experiment 1, the hierarchical order of graphic construction and the constancy of this order were measured for the copying of objects and nonobjects. In comparison to control participants, autistic individuals produced more local features at the start of the copying. However, they did not differ from controls with respect to graphic constancy. Experiment 2 measured the effect of geometrical impossibility on the copying of figures. Results revealed that autistic individuals were less affected by figure impossibility than were controls. Therefore, these experiments seem to support the notion of a local bias for visual information processing in individuals with autism. Two interpretations are proposed to account for this effect. According to the hierarchical deficit hypothesis, individuals with autism do not manifest the normal global bias in perceiving scenes and objects. Alternatively, the executive function hypothesis suggests that autism brings about limitations in the complexity of information that can be manipulated in short-term visual memory during graphic planning.

Comprehensive data on the developmental history and current behaviours of a large sample of high-functioning individuals with diagnoses of autism, Asperger's syndrome, or other related disorder were collected via parent interviews. This provided the basis for a taxonomic analysis to search for subgroups. Most participants also completed theory of mind tasks. Three clusters or subgroups were obtained; these differed on theory of mind performance and on verbal abilities. Although subgroups were identified which bore some relationship to clinical differentiation of autistic, Asperger syndrome, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) cases, the nature of the differences between them appeared strongly related to ability variables. Examination of the kinds of behaviours that differentiated the groups suggested that a spectrum of autistic disorders on which children differ primarily in term of degrees of social and cognitive impairments could explain the findings.

The review discusses various interventions that have been used in the treatment of children with autism. It concludes that no single mode of treatment is ever likely to be effective for all children and all families. Instead, intervention will need to be adapted to individual needs and the value of approaches that involve a functional analysis of problems is explored. It is suggested that many so called “challenging” behaviours result from the child's fundamental difficulties in communication and social understanding, or from the ritualistic and obsessional tendencies that are also characteristic of autism. Possible ways in which parents and teachers might deal with problems in these areas are discussed. The importance of early diagnosis, and with it early, practical advice for families is stressed.

The placement movements of 235 children entering foster care over a 12-month period were followed up 4 months after referral into care. Baseline and follow-up measures of the 170 children who were still in care at follow-up were also compared. Results indicated that adolescents with mental health or behavioural problems were the least likely to achieve placement stability or to display improved psychological adjustment in care. In fact, unsatisfactory transition to foster care was found to be so prevalent among these children that conventional foster family care should be considered unsuitable for them. The paper concludes that there is an urgent need for a wider range of alternative care options for the adolescent population.

This study examined the role of ADHD in the association between physical aggression and two types of executive functions. Boys received a cognitive-neuropsychological test battery over the ages of 13, 14, and 15 years. Diagnostic Interview Schedule for Children (DISC 2.25) data were collected from the boys and one parent between ages 14 and 16, and an IQ estimate was obtained at age 15. Three groups, differing in stability and level of physical aggression since kindergarten, were formed: Stable Aggressive, Unstable Aggressive, and Non-aggressive. Composite scores of validated executive function tests of working memory representing subjective ordering and conditional association learning were formed. A MANCOVA (N=149) using ADHD status, teacher-rated negative emotionality, general memory abilities, and IQ as covariates was performed on the two composite scores. ADHD and teacher-rated emotionality did not provide significant adjustment to the dependent variables. Number of ADHD symptoms was negatively associated only with general memory and IQ. General memory contributed significantly to adjusting for conditional association test scores. Group differences indicated lower conditional association scores for Unstable Aggressive boys relative to the other groups. Both IQ and general memory abilities interacted with subjective ordering within the groups. Specifically, Stable Aggressive boys performed poorly on this measure and did not benefit from increases in IQ whereas Nonaggressive boys performed best and were not disadvantaged by lower general memory abilities. This suggests a relationship exists between aspects of working memory and a history of physical aggression regardless of ADHD and IQ.

The adjustment and prosocial behaviour of 4-year-old children and their older siblings growing up in step-parent or single-parent families, or with two biological parents, was investigated within a longitudinal community study, the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC). Mean differences in mothers' perception of adjustment were found for children in different family settings, with higher levels of problems and lower prosocial scores reported for those in single- and step-parent families than those in non-stepfamilies. Individual differences within each family setting were marked. With the exception of single parenthood, which remained a risk indicator for the 4-year-olds, the contribution of family type to differences in adjustment and prosocial behaviour largely disappeared when account was also taken of negativity in family relationships, maternal age, education level, depressive symptomatology, and history of previous live-in relationships, mothers' support networks, and the family's current financial and housing circumstances. Boys remained more at risk for adjustment difficulties than girls when this range of factors was taken into account. The limitations and implications of these findings on a community sample, a first step in a programme of research into family processes in children's adjustment, are discussed.

Objective: To identify similarities and differences in neuropsychiatric correlates in children with Tourette's syndrome (TS) and those with ADHD. Method: The sample consisted of children with Tourette's syndrome with ADHD(N=79), children with Tourette's syndrome without ADHD (N=18), children with ADHD (N=563), psychiatrically referred children (N=212), and healthy controls (N=140). Results: Disorders specifically associated with Tourette's syndrome were obsessive compulsive disorder (OCD) and simple phobias. Rates of other disorders, including other disruptive behavioral, mood, and anxiety disorders, neuropsychologic correlates, and social and school functioning were indistinguishable in children with Tourette's and ADHD. However, children with Tourette's syndrome plus ADHD had more additional comorbid disorders overall and lower psychosocial function than children with ADHD. Conclusions: These findings confirm previously noted associations between Tourette's syndrome and OCDbut suggest that disruptive behavioral, mood, and anxiety disorders as well as cognitive dysfunctions may be accounted for by comorbidity with ADHD. However, Tourette's syndrome plus ADHD appears to be a more severe condition than ADHD alone.

Whereas many young children show initial wariness on meeting a stranger, shyness that lasts into middle childhood may be indicative of concurrent problems and subsequent disorder. Adjustment problems of an internalising nature, such as low self-esteem, loneliness, and anxiety may occur. Special significance has, however, been ascribed to preadolescent friendships as a means of validating self-worth and buffering against loneliness and anxiety. The main aim of the present study is to examine associations between shyness, perceptions of friendship quality, and indices of adjustment related to internalising problems.

The study involves a sample of 8.4–10.6-year-olds (N=50), preselected at 4.5 years to include a high proportion of shy children. Ratings of shyness to an unfamiliar adult had been made by different observers at 4.5 and 7 years, and at the present ages by another observer, mothers, and teachers. Observer-rated shyness was highly consistent over time and was significantly correlated with mothers' and teachers' ratings, although both significantly underestimated children's shyness relative to observer ratings. Compared with the younger children (mean age of 9 years), observed shyness (a composite over all three age points) increased in salience for the older children (mean age of 10 years), becoming significantly correlated with trait anxiety as well as low global self-worth. Indeed, global self-worth took on a central role for the older children, showing significant correlations not only with observed shyness and internalising problems (loneliness and anxiety), but also with perceptions of social acceptance and classmate support as well as friendship quality, with a named “best friend”. Thus by 10 years of age, aspects of peer relationships may influence and be influenced by global self-worth, with a possible buffering effect on any potential detrimental effects of shyness.

Children and adolescents exposed to trauma can suffer major adverse psychological effects including not only post-traumatic stress but also other psychological disorders. This study investigates the long-term course of general psychopathology following trauma in adolescence using a standardised diagnostic interview and comparisons with a matched control group. Young people (N = 216) who as teenagers had survived a shipping disaster—the sinking of the “Jupiter” in Greek waters—between 5 and 8 years previously and 87 young people as matched controls were interviewed. The survivors showed raised rates of diagnosis in a range of anxiety and affective disorders during the follow-up period. The highest rates were among the survivors who had developed Post-Traumatic Stress Disorder (PTSD), and those survivors who had not were generally similar to the controls. Onset of anxiety and affective disorders varied between being indefinitely close to the disaster to years later. Differences in rates of disorder between the survivor and control groups had lessened by the time of follow-up but were still apparent, due to continuing distress among the survivors still suffering from PTSD, and to a lesser extent among those who had recovered from PTSD. Generalisability of the findings are discussed.

This paper reports the results of a high-risk study of children under age 18 of parents who served as probands in a family study of comorbidity of substance abuse and anxiety disorders. There was a strong degree of specificity of familial aggregation of both the anxiety disorders and substance disorders. Rates of conduct disorder and depression were elevated among offspring of all affected parents. Inclusion of co-parent disorders in the evaluation of familial transmission in the present study strengthened the findings regarding the specificity of transmission of the anxiety disorders and the links between both parental substance abuse and antisocial personality with child conduct disorder.

The relationship between child- and parent-reported quality of life (QOL) and the effects of parental mental health, illness stressors, and child vulnerability was explored using two measures of QOL: the Pediatric Cancer Quality Life-32 (Varni et al., 1998a) and the Disquol (Eiser, Cotter, Oades, Seamark, & Smith, 1999). Thirty-two children with acute lymphoblastic leukaemia (mean age = 8·92 years) and 36 parents completed measures of QOL when attending routine clinic. In addition, parents also completed the General Health Questionnaire (GHQ-28), perception of the child's vulnerability, and illness-related stressors. Significant correlations were found between the overall scores on the two child-completed QOL measures, with a range of poor, moderate to good correlations found between the individual subscales. Poor to moderate concordance was found between child and parent reports. Children who self-reported poorer QOL had mothers who were more depressed. Parents who reported poorer QOL for their child reported more illness stressors and perceived their child as being more vulnerable. Assumptions that concordance between child and parent ratings of QOL is a necessary requirement for new measures of QOL are challenged.

Self-reported anxiety and depression symptoms in children and adolescents have been shown to be heritable, and are also highly correlated. Furthermore, there have been indications in the literature of sex and age differences in the aetiologies of these two types of symptoms. This study set out to ascertain to what extent the genetic and environmental factors that influence anxiety symptoms also influence depression symptoms, and whether these are the same in children and adolescents, and males and females. Four hundred and ninety pairs of twins aged 8 to 16 years completed the Children's Depression Inventory and the Trait scale of the State-Trait Anxiety Inventory for Children. There were significant effects of age and sex on the variance in and covariance between these two types of symptom. Bivariate genetic analyses of the measures indicated that the genetic influences on anxiety and depression were shared for all four groups, a finding that has been consistently demonstrated for adults.

Relatively able children with autism were compared with age- and language-matched controls on assessments of (1) familiar voice–face identity matching, (2) familiar face recognition, and (3) familiar voice recognition. The faces and voices of individuals at the children's schools were used as stimuli. The experimental group were impaired relative to the controls on all three tasks. Face recognition and voice recognition correlated significantly with voice–face identity matching, but not with each other, suggesting that the recognition impairments jointly cause the matching impairment. Neither chronological age nor verbal mental age were consistently related to the recognition and matching impairments.

Abbreviations: APT-I: Action Picture Test Information Scale; CA: chronological age; MLD: moderate learning disability; SLI: specific language impairments

This paper examines the impact of a 12-episode television series, “Families”, on disruptive child behavior and family adjustment. This media intervention comprises the first of a five-level early intervention parenting and family support strategy, known as Triple P (Positive Parenting Program). Fifty-six parents of children aged between 2 and 8 years were randomly assigned to either watching the television series or to a waitlist control group. Compared to the control group, parents in the television viewing (TV) condition reported significantly lower levels of disruptive child behavior and higher levels of perceived parenting competence, immediately following intervention. Prior to intervention approximately 42.9% of the children in the TV condition were in the clinically elevated range for disruptive child behavioral problems. This had reduced to 14.3% following intervention. In addition, a high level of consumer acceptability was reported by parents in the TV condition. All post-intervention effects were maintained at 6-month follow-up. Implications for public health approaches to family mental health are discussed.