Self-injurious behaviour in individuals with autism spectrum disorder

Background: Autism spectrum disorder (ASD) has been identified as a risk marker for self-injurious behaviour. In this study we aimed to describe the prevalence, topography and correlates of self-injury in individuals with ASD in contrast to individuals with Fragile X and Down syndromes and examine person characteristics associated with self-injury across and within these groups.\ud \ud Method: Carers of individuals with ASD (N=149; mean age=9.98, SD=4.86), Fragile X syndrome (N=123; mean age=15.32, SD=8.74) and Down syndrome (N=49; mean age=15.84, SD=12.59) completed questionnaires relating to the presence and topography of self-injury Information was also gathered regarding demographic characteristics, affect, autistic behaviour, hyperactivity, impulsivity and repetitive behaviour.\ud \ud Results: Self-injurious behaviour was displayed by 50% of the ASD sample; a significantly higher prevalence than in the Down syndrome group (18.4%) but broadly similar to the prevalence in Fragile X syndrome (54.5%). Self-injury was associated with significantly higher levels of autistic behaviour within the Down and Fragile X syndrome groups. Within the ASD group, the presence of self-injury was associated with significantly higher levels of impulsivity and hyperactivity, negative affect and significantly lower levels of ability and speech.\ud \ud Conclusions: Self-injurious behaviour is prevalent in individuals with ASD and the presence of ASD phenomenology increases the risk of self-injury in individuals with known genetic disorders but without a diagnosis of idiopathic autism. Person characteristics associated with self-injury in ASD indicate a role for impaired behavioural inhibition, low levels of ability and negative affect in the development of self-injurious behaviour

Manifesting the Imagined Homeless Body: A Case Study of the Men's Social Services Centre, Newcastle-upon-Tyne, UK

In this article, we explore the changing ways in which the homeless body has been conceptualised by architects and providers of accommodation for single homeless individuals. Tracing developments from the post-war period to the present, we focus on the needs and characteristics of single homeless individuals as they are variously imagined and constructed through the architectural design process. Through detailed examination of the life course of the Ryder & Yates-designed Salvation Army Men's Social Services Centre, Newcastle-upon-Tyne, UK, we explore how conceptions of the homeless body - shaped by, inter alia, architectural references, professional orthodoxies, and prevailing ideologies of homelessness - influenced the lived experience of the building. In so doing, we bring renewed attention to the capacity of architectural design to generate and shape the affective responses of the single homeless body, and thus the architectural profession's vital role in tackling the homelessness problem

The importance of understanding the behavioural phenotypes of genetic syndromes associated with intellectual disability

Behavioural phenotype research is of benefit to a large number of children with genetic syndromes and associated developmental delay. This article presents an overview of this research area and demonstrates how understanding pathways between gene disorders and behaviour can inform our understanding of the difficulties individuals with genetic syndromes and developmental delay experience, including self-injurious behaviour, social exploitation, social anxiety, social skills deficits, sensory differences, temper outbursts and repetitive behaviours. In addition, physical health difficulties and their interaction with behaviour are considered. The article demonstrates the complexity involved in assessing a child with a rare genetic syndrome

Visual preference for social stimuli in individuals with autism or neurodevelopmental disorders : an eye-tracking study

Background Recent research has identified differences in relative attention to competing social versus non-social video stimuli in individuals with autism spectrum disorder (ASD). Whether attentional allocation is influenced by the potential threat of stimuli has yet to be investigated. This is manipulated in the current study by the extent to which the stimuli are moving towards or moving past the viewer. Furthermore, little is known about whether such differences exist across other neurodevelopmental disorders. This study aims to determine if adolescents with ASD demonstrate differences in attentional allocation to competing pairs of social and non-social video stimuli, where the actor or object either moves towards or moves past the viewer, in comparison to individuals without ASD, and to determine if individuals with three genetic syndromes associated with differing social phenotypes demonstrate differences in attentional allocation to the same stimuli. Methods In study 1, adolescents with ASD and control participants were presented with social and non-social video stimuli in two formats (moving towards or moving past the viewer) whilst their eye movements were recorded. This paradigm was then employed with groups of individuals with fragile X, Cornelia de Lange, and Rubinstein-Taybi syndromes who were matched with one another on chronological age, global adaptive behaviour, and verbal adaptive behaviour (study 2). Results Adolescents with ASD demonstrated reduced looking-time to social versus non-social videos only when stimuli were moving towards them. Individuals in the three genetic syndrome groups showed similar looking-time but differences in fixation latency for social stimuli moving towards them. Across both studies, we observed within- and between-group differences in attention to social stimuli that were moving towards versus moving past the viewer. Conclusions Taken together, these results provide strong evidence to suggest differential visual attention to competing social versus non-social video stimuli in populations with clinically relevant, genetically mediated differences in socio-behavioural phenotypes

The assessment of presentation of Autism Spectrum Disorder and associated characteristics in individuals with severe intellectual disability and genetic syndromes

© Oxford University Press, Inc. 2012. All rights reserved. This chapter considers the prevalence and nature of Autism Spectrum Disorders (ASD) and associated symptomatology in the intellectual disability population, with particular focus on three genetically determined syndromes-Fragile X syndrome, Tuberous Sclerosis Complex, and Rett syndrome- that have received particular attention with respect to their association with ASD. It then considers the importance of accurate assessment and diagnosis of ASD in individuals with genetically determined syndromes. It describes the methods and tools available for assessing ASD in individuals with intellectual disability, and explores the appropriateness of these assessments for identifying ASD in individuals with genetically determined syndromes associated with intellectual disability

Characteristics of Autism Spectrum Disorder in Cornelia de Lange Syndrome

Background: The prevalence of Autism Spectrum Disorder (ASD) symptomatology is comparatively high in Cornelia de Lange Syndrome (CdLS). However, the profile and developmental trajectories of these ASD characteristics are potentially different to those observed in individuals with idiopathic ASD. In this study we examine the ASD profile in CdLS in comparison to a matched group of individuals with ASD.\ud \ud Method: The Autism Diagnostic Observation Schedule (ADOS) was administered to 20 individuals with CdLS (mean age = 11.34; range = 6yrs to 13yrs) and 20 individuals with idiopathic ASD (mean age = 10.42; range = 8yrs to 11yrs). Participants were matched according to adaptive behaviour skills and receptive language.\ud \ud Results: Sixty-five per cent (N= 13) of individuals with CdLS met the cut off score for autism on the total ADOS score. Further analysis at domain and item level indicated that individuals with CdLS showed significantly less repetitive behaviour, (specifically sensory interests); more eye contact, more gestures and less stereotyped speech than the ASD group. The CdLS group also showed higher levels of anxiety.\ud \ud Conclusions: The comparison between CdLS and idiopathic ASD indicates subtle group differences in the profile of ASD symptomatology that are not accounted for by degree of intellectual disability or receptive language skills. These differences may not be evident when relying solely upon clinical and domain level scores, but may be distinguishing features of the ASD presentations in the two disorders. The findings have implications for the conceptualisation and assessment of ASD in individuals with genetic syndromes

Persistence of self-injurious behaviour in autism spectrum disorder over 3 years: a prospective cohort study of risk markers

BACKGROUND: There are few studies documenting the persistence of self-injury in individuals with autism spectrum disorder (ASD) and consequently limited data on behavioural and demographic characteristics associated with persistence. In this longitudinal study, we investigated self-injury in a cohort of individuals with ASD over 3 years to identify behavioural and demographic characteristics associated with persistence. METHODS: Carers of 67 individuals with ASD (Median age of individuals with ASD in years = 13.5, Interquartile Range = 10.00–17.00), completed questionnaires relating to the presence and topography of self-injury at T(1) and three years later at T(2). Analyses were conducted to evaluate the persistence of self-injury and to evaluate the behavioural and demographic characteristics associated with persistence of self-injury. RESULTS: At T(2) self-injurious behaviour had persisted in 77.8 % of individuals. Behavioural correlates of being non-verbal, having lower ability and higher levels of overactivity, impulsivity and repetitive behaviour, were associated with self-injury at both time points. Risk markers of impulsivity (p = 0.021) and deficits in social interaction (p = 0.026) at T(1) were associated with the persistence of self-injury over 3 years. CONCLUSIONS: Impulsivity and deficits in social interaction are associated with persistent self-injury in ASD and thus may act as behavioural risk markers. The identification of these risk markers evidences a role for behaviour dysregulation in the development and maintenance of self-injury. The findings have clinical implications for proactive intervention; these behavioural characteristics may be utilised to identify ‘at risk’ individuals for whom self-injury is likely to be persistent and therefore those individuals for whom early intervention may be most warranted