Social-Emotional Issues in Autism Spectrum Disorders
Qualitative impairments in social interaction is one of the defining characteristics for the diagnosis of Autistic Disorder and for Asperger syndrome, according to the DSM-IV-TR (APA, 2000). Social impairments can include: lack of use of nonverbal behaviors such as eye gaze, gestures, body postures, and facial expressions; lack of social-emotional reciprocity; impairment in expression of pleasure in the happiness of others; and a lack of interaction with peers, including an absence of symbolic or imaginative play activities (APA, 2000). This core impairment has led some to identify social deficits as the “heart” of autism spectrum disorders (Gutstein, 2005).
Two of the factors that appear to be predictive of the diagnosis of ASD on the CHAT (Baron-Cohen, Allen, & Gillberg, 1992) screening tool for infants involve a social component: (1) lack of joint attention skills or lack of protodeclarative pointing, and (2) lack of eye gaze with a caregiver that is found in joint attention and social referencing. Research has revealed that children diagnosed with autism rarely pointed to external events, followed points, or alternated their gaze between objects and people during infancy (Wetherby & Prutting, 1984). They also were found to be impaired in their ability to direct or share attention with the experimenter compared with typical peers and those with mental retardation (Mundy, Sigman, Ungerer, & Sherman, 1986). Compared with children with Down syndrome and typical peers, children with autism displayed fewer orienting responses to stimuli, and this lack of responding was more severe for social stimuli (Dawson, Meltzoff, Osterling, Rinaldi, & Brown, 1998). Children with autism have been shown to display relatively few deictic gestures, or gestures used for social reasons such as in joint attention (Attwood, Firth, & Hermelin, 1988).
Some authors hypothesize that the basic problem for infants with ASD is one of attention (Bogdashina, 2005). Due to possible problems with overselectivity of stimuli (Schreibman & Lovaas, 1973) and an inability to select relevant stimuli, infants and young children with ASD may not attend to caregiver facial expression or consider eye gaze as important. Other researchers state that specific deficits in imitation skills may be fundamental (Rogers & Bennetto, 2000). The tendency of children with autism not to imitate others may be due to impairment with identifying with others (Carpenter, 2006). Both social-cognitive understanding and social motivations affect what infants will copy from a demonstration, and impairments in either aspect will explain a lack of imitation in children with ASD (Carpenter).
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