Diagnosing autism spectrum disorders in elderly people

Item does not contain fulltextBackground: As autism spectrum disorders (ASD) have largely been neglected in old-age psychiatry, the objective of the present paper is to describe the diagnostic process in elderly patients. Methods: A systematic review of the literature on ASD in older age was undertaken and illustrated by a case series of three elderly patients first diagnosed with ASD in later life by a tertiary mental health clinic. Results: The search of the literature only yielded three papers on late-life ASD, while the review of the available diagnostic procedures among adults suggests some relevance for screening instruments (Autism Questionnaire), diagnostic instruments (Module 4, Autism Diagnostic Observation Schedule), and neuropsychological examination to profile impairments. Nonetheless, the case reports clearly showed that taking a thorough history with the patient, corroborated and supplemented by a close relative or caregiver who has known the patient for at least ten years, still remains the most important diagnostic tool. Conclusion: The three case studies show that in clinical practice ASD can easily be missed in elderly individuals presenting with comorbid psychiatric disorders, potentially causing iatrogenic damage. Although further research on phenotyping and diagnosing ASD in older people is warranted, the most important step at this point is to create a greater awareness of the possibility of ASD in old age among health-care professionals working with people in this age group.11 p

Can monitoring in language comprehension in Autism Spectrum Disorder be modulated? Evidence from event-related potentials

Item does not contain fulltextThe present study examined language comprehension in Autism Spectrum Disorder (ASD) in light of monitoring. It was studied whether individuals with ASD monitor their language perception, and whether monitoring during language perception could be modulated with instructions. We presented higher-level (semantic) linguistic violations and lower-level (orthographic) linguistic violations in a free reading condition and in an instructed condition, recording event-related potentials. For control participants, a monitoring response as tapped by the P600 effect was found to semantically and orthographically incorrect input in both conditions. For participants with ASD, however, a monitoring response to semantically implausible input, tapped by the P600, was found only in the instructed condition. For orthographic errors monitoring was observed both in the free reading and in the instructed condition. This suggests that people with ASD are less inclined than typical individuals to monitor their perception of higher-level linguistic input, but that this can be enhanced with instructions