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Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism. Thesis Proposal Presented By Peter D. Marle, B.A. Presented by Peter D. Marle, B.A. Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism.

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Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

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  1. Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism Thesis Proposal Presented By Peter D. Marle, B.A. Presented by Peter D. Marle, B.A. Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  2. Autism Spectrum Disorder – A Brief History A. Anecdotal Accounts (see Luther, 1652; Wing, 1997) 1. Changeling babies 2. Feral children (e.g., Victor “wild boy” of Aveyron) people Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  3. Autism Spectrum Disorder – A Brief History A. Anecdotal Accounts (see Luther, 1652; Wing, 1997) 1. Changeling babies 2. Feral children (e.g., Victor “wild boy” of Aveyron) B. Scientific Investigation 1. Those prior to “autism” 2. Those who defined “Autism” a. Leo Kanner b. Hans Asperger 3. Diagnostic and Statistical Manual of Mental Disorders (DSM) Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  4. Autism Spectrum Disorder – DSMHistory A. DSM (1952) and DSM-II (1968) 1. Schizophrenic reaction, childhood type 2. Autism and schizoid personality disorder? B. DSM-III (1980) 1. Infantile autism a. full presentation b. residual state 2. Autism and schizophrenia? C. DSM-III-R (1987) 1. Social impairments, communicative impairments, and restricted interests D. DSM-IV (1994) 1. Asperger’s disorder 2. Childhood disintegrative disorder 3. Pervasive developmental disorder – not otherwise specified E. DSM-IV-TR (2000) F. DSM-5(2011; Press edition due out 2013) American Psychological Association (APA) Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  5. DSM-5 Proposed Changes and Rationale A. Combine Current PDD diagnoses B. Level of Severity - see APA, 2011 Source: http://themindofanapple.blogspot.com/2011/04/autism-awareness-day.html people Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  6. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts B. Restricted, repetitive patterns of behavior, interests, or activities C.  Symptoms must be present in early childhood D.  Symptoms together limit and impair everyday functioning people -American Psychiatric Association (APA), 2011 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  7. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction 2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people -American Psychiatric Association (APA), 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  8. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction 2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people -American Psychiatric Association (APA), 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  9. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction 2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people -American Psychiatric Association (APA), 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  10. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction 2.   Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people -American Psychiatric Association (APA), 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  11. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction 2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people -American Psychiatric Association (APA), 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  12. DSM-5 Proposed Criteria for ASD A. Persistent deficits in social communication and social interaction across contexts, not accounted for by general developmental delays, and manifest by all 3 of the following: 1.     Deficits in social-emotional reciprocity; ranging from abnormal social approach and failure of normal back and forth conversation through reduced sharing of interests, emotions, and affect and response to total lack of initiation of social interaction 2.     Deficits in nonverbal communicative behaviors used for social interaction; ranging from poorly integrated- verbal and nonverbal communication, through abnormalities in eye contact and body-language, or deficits in understanding and use of nonverbal communication, to total lack of facial expression or gestures. 3.     Deficits in developing and maintaining relationships, appropriate to developmental level (beyond those with caregivers); ranging from difficulties adjusting behavior to suit different social contexts through difficulties in sharing imaginative play and  in making friends  to an apparent absence of interest in people -American Psychiatric Association (APA), 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  13. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  14. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  15. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  16. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  17. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  18. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  19. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  20. DSM-5 Proposed Criteria for ASD B. Restricted, repetitive patterns of behavior, interests, or activities as manifested by at least two of  the following: 1.     Stereotyped or repetitive speech, motor movements, or use of objects; (such as simple motor stereotypies, echolalia, repetitive use of objects, or idiosyncratic phrases).  2.     Excessive adherence to routines, ritualized patterns of verbal or nonverbal behavior, or excessive resistance to change; (such as motoric rituals, insistence on same route or food, repetitive questioning or extreme distress at small changes). 3.     Highly restricted, fixated interests that are abnormal in intensity or focus; (such as strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interests). 4.     Hyper-or hypo-reactivity to sensory input or unusual interest in sensory aspects of environment; (such as apparent indifference to pain/heat/cold, adverse response to specific sounds or textures, excessive smelling or touching of objects, fascination with lights or spinning objects). -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  21. DSM-5 Proposed Criteria for ASD C. Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities) D. Symptoms together limit and impair everyday functioning -APA, 2010 Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  22. Neurological Sequelae • General Findings from the Literature • Increased Gray Matter Density • White Matter Deficits in Left Hemisphere • Disrupted Interconnectivity of Cortical Systems • Reduced size of Corpus Callosum see Schmitz et al. (2006), Minshew and Williams (2007), and Verhoeven et al. (2010) Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  23. Neurological Sequelae Interconnectivity Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  24. Neurological Sequelae Interconnectivity Disrupted Interconnect- ivity Between Frontal and Parietal Lobes Disrupted Interconnect-ivity Between Limbic and Sensory Systems Disrupted Cortical Connectivity Increased Frontal Lobe Connectedness to Insula Disrupted Cortical Interconnectivity • Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  25. Autism – Causes and Controversies A. Bettelheim 1. Kanner 2. “Refrigerator Mothers” 3. Rimland B. Vaccinations 1. Jenny McCarthy a. Autism? C. Genetic Heritability (Hallmayer et al., 2011) 1. 37% Mz 2. 55% Dz D. In Vivo Factors (Hallmayer et al., 2011) 1. Parental age 2. Low birth weight 3. Multiple births 4. Maternal infections Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  26. The Present Study Purpose A. CASS (Coolidge Autistic Symptom Survey) 1. Current alignment 2. Age Range B. DSM-5 changes Hypotheses A. A One-Factor Solution will Best Fit the Data B. Internal Reliability will be Good C. Test-Retest Reliability will be Adequate D. The CASS will Differentiate (1) Severe, (2) Mild Autism, and (3) Group-Matched Control Group Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  27. The Present Study Participants A. Power Analysis based on Marle, Monaghan, Rhoades, and Coolidge (2011) 1. (η2 = .66 for three groups) a. seven children per group necessary (N = 21) 2. (η2 = .14; β = .80) a. twenty-two children per group necessary (N = 66) B. Participant characteristics 1. Three groups 2. Parents of children ages 5 to 17 years 3. Collecting data on children’s a. age b. age when diagnosed c. age when parents first noticed differences d. gender e. race and ethnicity f. diagnosis g. medications, h. first behavioral concern 4. Also obtaining information as to who diagnosed the child Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  28. The Present Study Materials A. Informed Consent Form B. 90-Item CASS 1. Forty-five original items a. socialization b. speech and language c. nonverbal communication d. repetitive/stereotyped behavior 2. Forty-five new items a. social communication b. restricted interests and repetitive behaviors c. twenty-one retrospective items C. Demographic Information Sheet Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  29. The Present Study Procedure A. Packets 1. Delivered to parents (via psychology classes, autism resource centers, or participating school district classes) 2. Parents return SASE envelopes B. Packets will take about 30 min to complete C. Participants from psychology classes will be offered SONA credit Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  30. The Present Study Proposed Data Analysis Hypothesis 1. A One-Factor Solution will Best Fit the Data 1. PCA with varimax rotation Hypothesis 2. Internal Reliability will be Good 1. Cronbach’sα≥ .80 Hypothesis 3. Test-Retest Reliability will be Adequate 1. Thirty parents will be asked to complete the CASS two times (1 week interval) 2. r≥ .80 Hypothesis 4. The CASS will Differentiate (1) Severe, (2) Mild Autism, and (3) Group- Matched Control Group 1. Oneway ANOVA 2. Tukey’s HSD Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

  31. References American Psychiatric Association. (2010). Autism Spectrum Disorder. Retrieved from http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=94 AdolphsR (1999) Social cognition and the human brain. Trends in Cognitive Science, 3, 469-479. Burklund, L., Eisenberger , N. I., & Lieberman, M. D. (2007) The face of rejection: rejection sensitivity moderates dorsal anterior cingulate activity to disapproving facial expressions. Social Neuroscience, 2 , 238-253. Courchesne, E., Courchesne, R. Y., Hicks, G., & Lincoln, A. J. (1985). Functioning of the brain-stem auditory pathway in non-retarded autistic individuals. Electroencephalographically Clinical Neurophysiology, 61, 491-501. Di Martino, A., Rossa, K., Uddina, L. Q., Sklara, A. B., Castellanosa, F. X., & Milhama, M. P. (2009). Functional brain correlates of social and nonsocial processes in autism spectrum disorders: An activation likelihood estimation meta-analysis. Biological Psychiatry, 65, 63-74. Dunn, M. A., Gomes, H., & Gravel, J. (2008). Mismatch negativity in children with autism and typical development. Journal of Autism Developmental Disorders, 38, 52-71. Eisenberger, N. L., Lieberman, M. D., & Williams, K. D. (2003). Does rejection hurt? An fMRI study of social exclusion. Science, 302, 290-292. Foundis, A. L., Eure, K. F., Luevano., L. F., & Weinberger, E. R. (1998). MRI Asymmetries of Broca’s area: The pars triangularis and pars percularis. Groen , W. B., Zwiers, M. P., van der Gaag, R.-J., & Buitelaar, J. K. (2007). The phenotype and neural correlates of language in autism: An integrative review. Neuroscience & Biobehavioral Reviews, 32, 1416-1425. Groen, W. B., Tesink, C., Petersson, K. M., van Berkum, J., van der Gaag, R. J., Hagoort, P., & Buitelaar, J. K. (2010). Semantic, factual, and social language comprehension in adolescents with autism: An fMRI study. Cerebral Cortex, 20, 1937-1945. Kwon, S., Kim, J., Choe, B. H., Ko, C., & Park, S. (2007). Electrophysiological assessment of central auditory processing by auditory brainstem responses in children with autism spectrum disorders. Journal of Korean Medical Science, 22, 656-659. Marco, E. J., Hinkley, L. B. N., Hill, S. S., & Nagarajan, S. S. (2011). Sensory processing in autism: A review of neurophysiologic findings. Pediatric Research, 69, 48R-54R. Mayberg, H. S. (2003). Modulating dysfunctional limbic-cortical circuits in depression: towards development of brain-based algorithms for diagnosis and optimized treatment. British Medical Bulletin,65, 193-207. Murphy, D. G., Critchley, H. D., Schmitz, N., McAlonan, G., van Amelsvoort, T., & Robertson, D. (2002) Asperger syndrome: A proton magnetic resonance spectroscopy study of brain. Archives of General Psychiatry, 59, 885-891. Northoff, G., Walter, M., Schulte, R. F., Beck, J., Dydak, U., Henning, A., Boeker, H., Grimm., S., & Boesiger, P. (2007) GABA concentrations in the human anterior cingulate cortex predict negative BOLD responses in fMRI. Nature Neuroscience, 10, 1515-1517. Raichle, M. E., MacLeod, A. M., Snyder, A. Z., Powers, W. J., Gusnard, D. A., Shulman, G. L. (2001). A default mode of brain function. Procedings of the National Academy of Sciences of the United States of America, 98, 676-682. Rizzolatti, G., & Craighero, L. (2004). Ther mirror-neuron system. Annual Review of Neuroscience, 27, 169-192. Rosenhall, U., Nordin, V., Brantberg, K., & Gillberg, C. (2003). Autism and auditory brain stem responses. Ear Hear, 24, 206-214. Sanders, J., Johnson, K. A., Garavan, H., Gill, M., & Gallagher, L. (2008). A review of neuropsychological and neuroimaging research in autistic spectrum disorders: Attention, inhibition, and cognitive flexibility. Research in Autism Spectrum Disorders, 2, 1-16. Schmitz, N., Rubia, K., Daly, E., Smith, A., Williams, S., & Murphy, D. G. M. (2006). Neural correlates of executive function in autistic spectrum disorders. Biological Psychiatry, 59, 7-16. Verhoeven, J. S., De Cock, P., Lagae, L., & Sunaert, S. (2010). Neuroimaging of autism. Neuroradiology, 52, 3-14. Psychometric Development of a New Inventory to Assess Symptoms across the Spectrum of Autism

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