Autism

The development of imitation during the second year of life plays an important role in domains of socio-cognitive development such as language and social learning. Deficits in imitation ability in persons with autism spectrum disorder (ASD) have also been repeatedly documented from toddlerhood into adulthood, raising the possibility that early disruptions in imitation contribute to the onset of ASD and the deficits in language and social interaction that define the disorder. This study prospectively examined the development of imitation between 12 and 24 months of age in 154 infants at familial risk for ASD and 78 typically developing infants who were all later assessed at 36 months for ASD or other developmental delays. The study established a developmental measure of imitation ability, and examined group differences over time, using an analytic Rasch measurement model. Results revealed a unidimensional latent construct of imitation and verified a reliable sequence of imitation skills that was invariant over time for all outcome groups. Results also showed that all groups displayed similar significant linear increases in imitation ability between 12 and 24 months and that these increases were related to individual growth in both expressive language and ratings of social engagement, but not fine motor development. The group of children who developed ASD by age 3 years exhibited delayed imitation development compared to the low-risk typical outcome group across all time-points, but were indistinguishable from other high-risk infants who showed other cognitive delays not related to ASD.

The present paper describes a pilot and follow-up study of the preliminary development of a new tool to screen for Asperger Syndrome (AS) and related social and communication conditions (the CAST: Childhood Asperger Syndrome Test) in children aged 4-11 years, in a non-clinical setting. Pilot Study: Parents of 13 children with AS and 37 typically developing children completed the CAST. There were significant differences in mean scores, with the AS sample mean of 21.08 (range 15 -31) and the typical sample mean of 4.73 (range 0 -13). The Pilot was used to establish preliminary cut-off scores for the CAST. Main Study: Parents of 1150 primary-school-age children were sent the CAST, with 199 responders and 174 taking part in the full data analysis. Results suggest that compared to other tools currently available, the CAST may be useful for identifying children at risk for AS and related conditions, in a mainstream non-clinical sample.

Executive functioning deficits characterize the neuropsychological profiles of the childhood neurodevelopmental disorders of attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorder (ASD). This study sought to determine whether similar impairments exist in adults with ADHD (N = 53) and ASD (N = 45) in comparison with a healthy control group (N = 31), whether the two disorders can be distinguished on the basis of their executive functioning features, and whether these impairments are related to symptom severity. Both clinical groups were found to exhibit executive functioning deficits. The ADHD group had difficulty withholding a response, with relative preservation of initiation and planning abilities. In contrast, the ASD group exhibited significant impairments in initiation, planning and strategy formation. The specific executive functioning deficits were related to severity of response inhibition impairments in ADHD and stereotyped, repetitive behaviours in ASD. These findings suggest the autism

In this talk, I presented the finding of my MEd dissertation on autistic women diagnosed in adulthood. The project consisted of an international sample of more that 50 women and I conducted online focus groups based on the participants' suggestions for discussion.

This presentation took place at the study weekend organised by the Autism Centre of Education and Research in the School of Education, University of Birmingham in April 2015.

Poor handwriting has been shown to be associated with developmental disorders such as Developmental Coordination Disorder, Attention Deficit Hyperactivity Disorder, autism, and learning disorders. Handwriting difficulties could lead to academic underachievement and poor self-esteem. Therapeutic intervention has been shown to be effective in treating children with poor handwriting, making early identification critical. The SOS test (Systematic Screening for Handwriting Difficulties) has been developed for this purpose. A child copies a sample of writing within 5 min. Handwriting quality is evaluated using six criteria and writing speed is measured. The Dutch SOS test was administered to 860 Flemish children (7-12 years). Inter-and intrarater reliability was excellent. Test-retest reliability was moderate. A correlation coefficient of 0.70 between SOS and "Concise Assessment Methods of Children Handwriting" test (Dutch version) confirmed convergent validity. The SOS allowed discrimination between typically developing children and children in special education, males and females, and different age groups.

Autism Diagnostic Observation Schedule (ADOS) Modules 1-3 item and domain total distributions were reviewed for 1,630 assessments of children aged 14 months to 16 years with an autism spectrum disorder (ASD) or with heterogeneous nonspectrum disorders. Children were divided by language level and age to yield more homogeneous cells. Items were chosen that best differentiated between diagnoses and were arranged into domains on the basis of multifactor item-response analysis. Reflecting recent research, the revised algorithm now consists of two new domains, Social Affect and Restricted, Repetitive Behaviors (RRB), combined to one score to which thresholds are applied, resulting in generally improved predictive value.

Architecture, as a science, deals with the manipulation of the physical environment to facilitate certain functions and elicit intended behavior. This environment is comprised primarily of sensory elements-textures, colors, patterns, acoustics etc. In accordance to the sensory definition of autism, these elements play an important role in autistic behavior and their cognition and integration are at the core of the disorder. This definition is the basis of the Autism ASPECTSS™ Design Index as discussed here. The objective of this paper is to illustrate the use of this index and its seven principles-Acoustics, Spatial sequencing, Escape, Compartmentalization, Transition spaces, Sensory zoning and Safety-as a design development tool. The paper summarizes the impact of these principles on the development of spatial design criteria for the Advance Center for Special Needs in Qattameya, Cairo, designed by Progressive Architects, and presents a possible prototype for schools for autism which would follow the ASPECTSS™ principles.

Independent toileting is an important developmental skill which individuals with developmental disabilities often ®nd a challenge to master. Effective toilet training interventions have been designed which rely on a combination of basic operant principles of positive reinforcement and punishment. In the present study, the effectiveness of a reinforcement-based toilet training intervention was investigated with three children with a diagnosis of autism. Procedures included a combination of positive reinforcement, graduated guidance, scheduled practice trials and forward prompting. Results indicated that all procedures were implemented in response to urination accidents. A three participants reduced urination accidents to zero and learned to spontaneously request use of the bathroom within 7±11 days of training. Gains were maintained over 6-month and 1-year follow-ups. Findings suggest that the proposed procedure is an effective and rapid method of toilet training, which can be implemented within a structured school setting with generalization to the home environment.

Two studies were conducted to investigate the correlates of hyperlexia in Brazilian Portuguese-speaking children with the diagnosis of autism spectrum disorder (ASD). Study 1 involved 3 groups of school age children individually matched for word reading ability: 6 ASD hyperlexic children, 6 ASD non-hyperlexic children, and 6 typically developing children. Study 2 involved 2 ASD preschool hyperlexic boys, and a group of 21 typical children of similar word reading ability. In both studies, participants were administered several reading measures as well as measures of cognitive and linguistic abilities that have been associated with variations in typical and dyslexic reading, namely, vocabulary, phonological processes, and rapid naming. Results suggest that ASD hyperlexic reading differs from both typical and ASD non-hyperlexic reading. In particular, they suggest that hyperlexics learn to compute letter-sound relations implicitly, on the basis of statistical learning. Although the hyp...

An estimated 1.5% of the world’s population, approximately 120 million individuals, exist somewhere on the broad spectrum of autism. For far too long this spectrum, despite its diversity and nuance, was viewed as a monolithic, pathologized condition, to be cured or treated, rather than better understood or even celebrated as an identity and an alternative, but equally valid perceptual model of the world around us. This position has since shifted to a more strength based identity first position, and as the peak cohort of individuals first diagnosed when awareness was growing in the early 2000s are now reaching adulthood, self-advocacy has become an important and increasingly heard voice in the community. But architecture must listen.
I believe no one has the right to exist more comfortably, safely or effectively in space than anyone else, and it is our responsibility as architects to create the built landscape that affords this comfort, safety and efficacy to everyone- the entire spectrum of the human condition. The small collection of works included here strive to present design pathways to achieving that goal, and hopefully shift that perspective to stretch our understanding of the human condition- to be more inclusive, honest and reflective of the reality of our diverse and rich humanity.
#IQDMagazine https://iqd.it/en/

We compared the reading-related skills of children with Autism Spectrum Disorders who have hyperlexia (ASD + HPL) with age-matched children with ASD without HPL (ASD -HPL) and with singleword reading-matched typically developing children (TYP). Children with ASD + HPL performed (1) better than did children with ASD -HPL on tasks of single-word reading and pseudoword decoding and equivalently well compared to word-reading-matched TYP children on all reading-related tasks except reading comprehension. It appears that the general underlying model of single-word reading is the same in principle for ''typical'' and hyperlexic reading. Yet, the study revealed some dissimilarities between these two types of reading when more fine-grained cognitive and linguistic abilities were considered; these dissimilarities warrant further investigations.

This study examined whether language deficits persist even in children with optimal outcomes. We examined a group of children with prior diagnoses on the autism spectrum who had IQs in the normal range, were in age-appropriate mainstream classes, and had improved to such an extent that they were considered to be functioning at the level of their typically developing peers. Fourteen such children between the ages of five and nine were matched on age and sex with typically developing children, and were given a battery of 10 language tests to investigate their language abilities. Results indicated that while these children's grammatical capabilities are mostly indistinguishable from their peers, they are still experiencing difficulties in pragmatic and semantic language.

The literature suggests that the complexity of Autism Spectrum (AS) and the multidimensional care needs of Autistic individuals, often require the involvement of family and caregivers to help with providing support and advocating for an improved quality of life for the person on the spectrum and their family. This involvement in the life of the autistic person can be an enriching and at times challenging and stressful experiences for families and caregivers. To this end, this thesis explores the perception, knowledge and experience of caregivers supporting Autistic individuals or persons that may be Autistic in Grenada. To date, most of the research on autism has been conducted in developed and English speaking countries where there is extensive professional support and services. There is a dearth of research on the prevalence, identification and experiences of people living with autism and their caregivers in non-Western, less affluent and developing countries like Grenada. A sampl...

Background Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that wi...

The purpose of this qualitative study was to explore the lived experience of how sensory-related behaviors of children with autism affected family routines. In-depth semi-structured interviews were conducted with four primary caregivers regarding the meaning and impact of their child’s sensory-related behaviors on family routines that occurred inside and outside the home. Findings indicated that sensory behaviors are one factor that limited family participation in work, family and leisure activities; and that parents employed specific strategies to manage individual and family routines in light of the child’s sensory-related behaviors. This information has important implications for professionals who work with families of children with autism to decrease caregiver stress and to increase life satisfaction for the child and family.

Aim: To investigate whether children with autistic spectrum disorder (ASD) have bowel symptoms consistent with underlying enterocolitis. Methods: Information on children's stool patterns and gut symptoms collected by questionnaire at 4 weeks and at 6, 18, 30 and 42 months of age were available for

This is the first qualitative study to investigate experiences of, and attitudes towards, autism in Aboriginal and Torres Strait Islander communities in Australia. Understanding the complexity of these attitudes is crucial because they influence the recognition of autism as well as the ways in which individuals and families are supported. Twelve families with 16 autistic children living in diverse regions of Australia participated in a semi-structured interview. The interviews were thematically analysed using the six-step process outlined by Braun and Clarke. The analysis identified a marked tension in participants’ accounts. On the one hand, participants described negative feelings, including shame associated with atypical behaviour, stigmatisation and the social isolation of families, which potentially point towards under-identification or misdiagnosis. On the other hand, they also described inclusive attitudes, including ‘looking after each other’ and a growing acceptance of auti...

Purpose: The importance of coordination of educational services has been well documented in the literature. For students with disabilities, coordinated programs result in more rapid acquisition of targeted behaviors and the increased likelihood of long-term maintenance of gains. The purpose of this study was to assess whether "priming" or exposing students with autism and disruptive behaviors to school assignments before their presentation in class would affect academic performance and problem behaviors. Method: Two students diagnosed with autism who attended general education classrooms, both of whom exhibited numerous disruptive behaviors and low academic performance, participated in this study. A repeated reversals design was used to monitor student progress. Results: The results demonstrated decreases in problem behavior and increases in academic responding when priming sessions occurred. Clinical Implications: Application is discussed in terms of a mechanism for speec...

When we observe the actions performed by others, our motor system "resonates" along with that of the observed agent. Is a similar visuomotor resonant response observed in autism spectrum disorders (ASD)? Studies investigating action observation in ASD have yielded inconsistent findings. In this perspective article we examine behavioral and neuroscientific evidence in favor of visuomotor resonance in ASD, and consider the possible role of action-perception coupling in social cognition. We distinguish between different aspects of visuomotor resonance and conclude that while some aspects may be preserved in ASD, abnormalities exist in the way individuals with ASD convert visual information from observed actions into a program for motor execution. Such abnormalities, we surmise, may contribute to but also depend on the difficulties that individuals with ASD encounter during social interaction.

Perspective-taking skills and eye-gaze processing are reported to be impaired in individuals with autism spectrum disorder. This paper presents the structure and the theory behind a learning game for perspective-taking skills and eye-gaze following. The game is for lower functioning children with autism spectrum disorder, and it was developed in the CASCATE project. It has the potential to improve autism research and educational settings. It can also offer new avenues for creating teaching and intervention methods.

Relatively little is known about the effect of adult interactive style on children's communication. The aim of this study, written by Lila Kossyvaki, Glenys Jones and Karen Guldberg, all from the University of Birmingham, was to explore the effects of adult interactive style on children's spontaneous communication. The study used an action research methodology. Six children aged between four and five years with autism and three members of staff participated. Each child was video recorded for a total of two hours across four activities. The staff, in collaboration with the researcher, developed and put into practice an Adult Interactive Style Intervention (AISI) intended to promote spontaneous communication. Two months later each child was recorded for two hours across the same activities with staff using AISI. Cohen's d effect size was calculated to measure the differences pre-and post-intervention. The increase in total initiations post-intervention for all six children was significant. The findings suggest that attention should be paid to adult style when developing communication in children with autism.

Little research has been conducted on behavioral characteristics of children with autism spectrum disorder (ASD) from diverse cultures within the US, or from countries outside of the US or Europe, with little reliable information yet reported from developing countries. We describe the process used to engage diverse communities in ASD research in two community-based research projects-an epidemiologic investigation of 7-to 12-year olds in South Korea and the Early Autism Project, an ASD detection program for 18-to 36-month-old Zulu-speaking children in South Africa. Despite the differences in wealth between these communities, ASD is underdiagnosed in both settings, and generally not reported in clinical or educational records. Moreover, in both countries, there is low availability of services. In both cases, local knowledge helped researchers to address both ethnographic as well as practical problems. Researchers identified the ways in which these communities generate and negotiate the cultural meanings of developmental disorders. Researchers incorporated that knowledge, as they engaged communities in a research protocol, adapted and translated screening and diagnostic tools, and developed methods for screening, evaluating, and diagnosing children with ASD.

The relationship between theory of mind (ToM) and autobiographical memory (AM) in high-functioning autism (HFA) and Asperger syndrome (AS) has never been investigated. Here, we show that ToM abilities could be predicted by levels of AM in HFA and AS as compared to controls, suggesting that difficulties in AM are closely related to ToM impairments in HFA and AS.

Objective: The purpose of this study was to design and determine the effectiveness of educational package of executive functions on improving the levels of theory of Mind in children with high Performance autism spectrum disorder. Method: The research method is semi-experimental with post-test pre-test with control group. The statistical population of the present study was children with autism disorder aged 6 to 12 years in Urmia (274 people) in the academic year of 2019-20 were from the exceptional school for children with autism, out of the target population, Out of the total target population 40 high-performance autism were selected using Gilliam Autism Rating Scale(Gilliam,1995) and randomly assigned to two experimental (20) and control (20) groups, and the Hutchins Mind Theory Questionnaire(Hutchins et al., 2012) was completed by parents of both groups. After performing the pre-test, the experimental group was trained in the executive functions program. The program was designed by researchers and consisted of 24 sessions in which 4 skills (working memory, inhibition, flexibility and attention training) were taught, At this stage, the children in the control group did not receive any training. The post-test was performed again and the data obtained from the pre-test and post-test were analyzed using analysis of covariance.Results: The data showed a significant difference(p < 01) between the control and test groups in the post-test of variable theory of Mind scores after adjusting the effect of pre-test of theory of Mind .Conclusion: Based on this study, it can be suggested that improving the executive functions can increase the levels of theory of Mind.

هدف از پژوهش حاضر، تعیین اثربخشی آموزش بازی های اجتماعی بر علائم اضطراب کودکان مبتلا به اختلال اتیسم با عملکرد بالا بود. روش پژوهش از نوع نیمه آزمایشی با طرح پیش آزمون-پس آزمون با گروه کنترل بود. جامعه آماری این پژوهش را کلیه کودکان پسر 10 تا 12 سال مبتلا به اختلال اتیسم که درسال 1396 درحال دریافت خدماتتوانبخشی از مراکز درمانی شهر تهران بودند، تشکیل دادند. در این پژوهش 16 کودک پسر مبتلا به اختلال اتیسم با عملکرد بالا (درج شده در پرونده روانپزشکی) با استفاده از روش نمونه گیری در دسترس به عنوان حجم نمونه انتخاب و 8 نفر از آنها در گروه آزمایش و 8 نفر دیگر در گروه کنترل به شیوه تصادفی گمارش شدند. در ابتدا هردو گروهتوسط پرسشنامه اضطراب اسپنس مورد ارزیابی قرار گرفتند. گروه آزمایش در 10 جلسه 30 دقیقه ای به مدت 6 هفته بازی های اجتماعی دریافت کردند در حالی که گروه کنترل چنین مداخله ای را دریافت نکردند. در پایان مجددا هردوگروه توسط پرسشنامه اضطراب اسپنس مورد ارزیابی قرار گرفتند. داده ها با استفاده از تحلیل کوواریانس مورد تجزیه و تحلیل قرار گرفت. یافته های این پژوهش نشان داد که آموزش بازی های اجتماعی سبب کاهش اضطراب کودکان مبتلا به اختلال اتیسم با عملکرد بالا می شود. از این رو میتوان بازی های اجتماعی به عنوان یه یک روش سودمند موثر در آموزش کودکان مبتلا به اختلال اتیسم با عملکرد بالا سود جست.

The Collaborative Model for Promoting Competence and Success (COMPASS) is an evidence-based, student-centered consultation and coaching intervention developed specifically for students with ASD.

What is COMPASS? It starts with parent-teacher consultation with a COMPASS trained consultant resulting in individualized goals and teaching plans using an Evidence Based Practice in Psychology (EBPP) framework. After the consultation, teachers receive evidence-based coaching with performance feedback and progress monitoring towards IEP progress.

What are the theoretical frameworks that inform COMPASS? COMPASS is an implementation strategy influenced by the framework  of Dunst, Trivette, and Raab (2013) (Figure 3) that considers the relationships between what the COMPASS consultant does (implementation practice) to impact what the teacher does (intervention practice) to improve child educational outcomes (practice outcomes).

What has the previous research on COMPASS found? Three previous randomized controlled trials found that COMPASS results in better IEP quality and goal attainment progress over the course of an academic year compared to control groups.

What is this study about? All previous studies have been delivered by the original developers. This study sought to train local, school-based consultants to implement COMPASS with high fidelity and satisfaction.

In this talk I talked about the experiences of autistic women, drawing both from my own personal experiences as well as research that I have conducted. I also touch on how feminist discourses and actions might fail to recognise autistic women and what impact that may have on them.

This presentation took place at the study weekend organised by the Autism Centre of Education and Research in the School of Education, University of Birmingham in April 2016.

A concurrent-operants design was used to analyze the repetitive behavior of observing reflective surfaces while simultaneously engaging in erratic gross-motor body movements (EBMs) exhibited by a young boy diagnosed with autism. The assessment involved an evaluation of preference for controlled (i.e., the participant controlled the visual activity on a TV screen) versus uncontrolled (i.e., the participant viewed a previously recorded tape from the controlled condition) TV footage of his EBMs. The analysis indicated that both observing and EBMs were maintained by the direct correspondence between the body movements and the visual stimulation they produced when controlled by the participant. Thus, the EBMs appeared to be maintained on a conjugate schedule of reinforcement.

The purpose of the study was to assess the association of obstetric complications with risk for mental disorders resulting in hospitalization before the age of 15. Records from all births in Denmark from 1973 through 1993 were linked to records of all psychiatric hospitalizations. Diagnoses were grouped into seven broad categories. A reference population of 10% of births in Denmark from 1973 to 1990 was used for comparison. Obstetric complications were associated with the range of mental disorders occurring in childhood. The strongest predictors were a variable indicating the interaction of birth weight with speed of growth and the 5-minute Apgar score. There was no diagnostic group that stood out as different with respect to obstetric complications. These results are consistent with the hypothesis of the continuum of reproductive casualty.

Central coherence refers to an in-built propensity to form meaningful links over a wide range of stimuli and to generalize over as wide a range of contexts as possible. In children with autism this ability is diminished, and the impact of central coherence deficits in children with autism have previously been observed using static measures of learning, such as reading comprehension test performance. In this study, the relationship between central coherence and more dynamic indicators of learning are investigated. The responses of 52 children with autism (mean age 9:10 years) on a test of central coherence and a dynamic assessment task were analysed. All the children showed significant improvements in dynamic assessment test scores after mediation; however, among those with below average nonverbal intelligence scores, weak central coherence was significantly associated with smaller gains in performance after teaching. Implications for the validity of dynamic assessments for children ...

Although no Canadian studies have been conducted, studies suggest parents of children with autism experience difficulties obtaining a diagnosis for their child. Fifty-six parents of children with autism completed three questionnaires providing information on the families' demographics, parents' experiences throughout the diagnostic process, and their child's autistic symptomatology. These parents experienced significant difficulties obtaining a diagnosis for their child. Parents saw an average of 4.5 professionals, and waited almost 3 years to receive a diagnosis following their first visit to a professional regarding their child's development. The impact of autistic symptomatology on the diagnostic process is discussed.

Commentators tended to focus on the conceptual framework of our article, the contrast between genetic and associative accounts of mirror neurons, and to challenge it with additional possibilities rather than empirical data. This made the empirically-focused comments especially valuable. The mirror neuron debate is replete with ideas; what it needs now are system-level theories and careful experiments – tests and testability.

Social interaction with peers and the understanding and feelings of loneliness were examined in 18 high-functioning children with autism and 17 typically developing children matched for IQ, chronological age, gender, and maternal education. Observations were conducted on children&#39;s spontaneous social initiations and responses to their peers in natural settings such as recess and snack time, and children reported on their

Objective: Studies involving the use of telepractice in the delivery of services to individuals with autism spectrum disorders (ASD) were reviewed with the intent to inform practice and identify areas for future research. Methods: Systematic searches of electronic databases, reference lists and journals identified eight studies that met predetermined inclusion criteria. These studies were analysed and summarized in terms of the: (a) characteristics of the participants, (b) technology utilized, (c) services delivered via telepractice, (d) research methodology and (e) results of the study. Results: Telepractice was used by university-based researchers, behaviour analysts, psychiatrists and psychologists to assist caretakers and educators in the delivery of services to 46 participants with ASD. The services delivered included behavioural and diagnostic assessments, educational consulting, guidance and supervision of behavioural interventions and coaching/ training in the implementation of a comprehensive early intervention programme. Conclusions: Results suggests telepractice is a promising service delivery approach in the treatment of individuals with ASD that warrants additional research. Guidelines for practitioners and potential directions for future research are discussed.

Early detection of developmental delay and childhood disorders are important for early intervention. This study aimed to describe the distribution of responses in a large population-based survey, identify cutoff points for the parent concern checklist (PCC) suitable for the Chinese language and culture, and explore how many children were identified as having evidence of problems at age 18 mo different from those at age 6 mo. Using a national randomly selected sample, the overall development of 21,248 children was investigated using the Taiwan Birth Cohort study instrument, and the PCC, a problem-oriented screening instrument. The Newton-Raphson iteration showed that the PCC should be separated into three groups, those scoring 1-2 in the first group, 3-6 in the second group, and 7-8 in the third group. Structural equation models showed that 6-mo development was predictive of 18-mo development; additionally, 18-mo development and the PCC showed good concurrent validity. This study identified three groups with distinct developmental trajectories and two cutoff points of 2/3 and 6/7. Thus, the PCC can be used as a first-stage screening instrument in a two-stage window screening procedure. Further studies are needed to investigate the factors, which contribute to the differences among these groups; follow-up on the typical and atypical development of these children is necessary.