The hallmark social deficits of ASD are:

1. 1. Poor eye contact

2. 2. Limited emotional, facial and voice expression

3. 3. Deficits in joint attention including deficits in showing and seeking recognition

4. 4. Deficits in mutual enjoyment

5. 5. Deficits in reading body language

These social deficits can be difficult to identify and to define even by trained clinicians, especially when there are multiple diagnoses, and other psychiatric disorders may have/mimic these social deficits.

Some of the social deficits characteristic of an ASD are found in conditions that are not ASD. The social deficits found in some children with ADHD are amplfied when the ADHD is co-morbid with Social Anxiety disorders, Language disorders, OCD and/or Global Developmental Delay, making these children look “almost autistic”.

To demonstrate the difficulty in trying to differentiate the “almost autistic” child from a child with ASD.

To stimulate discussion over the difficulty of diagnosing ASD and differentiating ASD from other childhood psychiatric disorders.

A Poster presentation with a video has been developed demonstrating “difficult to diagnose” children, and raising the alternative diagnoses.

The distinction between ADHD, ASD, and other disorders and not clear

The prevalence of ASD has mushroomed in the last 20 years, partly because of greater awareness, but also because of criteria have been diffused to include other diagnostic groups. Until better diagnostic approaches occur, the clinician is dependent on observational strategies to make the diagnosis of ASD. Given the importance of the diagnosis, better techniques for diagnosis is required.

External causes have been responsible for increased morbidity and mortality rates in Brazil. The most affected age range includes adolescent and young people, indicating the need for investments in public policies with a focus on health promotion. Violence, as one of these causes, has become treated as a public health problem, influenced by social determinants of health.

Describe health promotion practices involving adolescent participants in a health promotion and education group.

Enhance the understanding of adolescent's health promotion.

A qualitative and descriptive experience report was carried out at the Child and Adolescent Care Center in the interior of São Paulo State - Brazil. The programmed activities involved 15 adolescents and took place on sports courts, streets and sidewalks near the Center and in a room for group discussions.

The themes drugs, sexual and reproductive health, interpersonal violence at school and in the neighborhood emerged from the adolescents’ inquiries while accomplishing the proposed tasks in the different study environments. Group discussions were perceived as spaces for reflection and relaxation, and also as facilitators of bonding and, at the same time, of group adherence.

For the study subjects, making good friends, participating in sports and leisure, and talking about themes that are in line with their needs represented an important facilitator for health promotion and social inclusion.

Adolescent violence represents a severe public health problem. Adolescents between 10 and 19 years old can get involved in violent acts as victims as well as perpetrators.

Get to know the senses and meanings attributed to violence from the perspective of adolescent participants in a health promotion and education group.

Enhance the understanding of the adolescent violence phenomenon.

A qualitative and descriptive experience report was carried out at the Child and Adolescent Care Center in the interior of São Paulo State – Brazil. The 15 study subjects participated in weekly group meetings taking between one and two hours, during which the brainstorming creativity technique was used.

According to the adolescent participants, violence means everything that causes pain, suffering and is related with physical aggressions, discussions, rape, scolding and humiliation, pedophilia and violent movies on television. They denoted special concern with physical violence between couples and siblings and with songs that defile mainly the feminine image.

Group activities that allow adolescents to reflect can enhance a more critical awareness of themes like violence. They can also stimulate the search for actions to improve the reality these subjects are inserted in.

Previous studies on the impact of cannabis use disorders (CU) on outcome in psychosis were mostly based on non-representative samples, have often not controlled for confounders and rarely focused on adolescents. Thus, the aims of the present study were to assess;

• (i) prevalence of CU;

• (ii) pre-treatment and baseline differences between CU and those without CU (NCU); and

• (iii) the impact of baseline and course of CU on 18-month outcomes in a representative cohort of adolescents with early onset first episode psychosis (EOP).

The sample comprised 99 adolescents (age 14 to 18) with EOP (onset age 14 to 17), admitted to the Early Psychosis Prevention and Intervention Centre in Australia. Data were collected from medical files using a standardized questionnaire.

Prevalence of lifetime CU was 65.7%, baseline CU 53.5%, and persistent CU 26.3%. Baseline CU compared to NCU was associated with higher illness-severity, lower functioning, less insight, lower premorbid functioning and longer duration of untreated psychosis. Compared to both NCU and those who decreased or stopped CU during treatment, only persistent CU was linked to worse outcomes and more service disengagement. Effect sizes were medium controlling for relevant confounders. Medication non-adherence did not explain the link between persistent CU and worse outcome.

The prevalence of CU in adolescents with EOP is high, while only persistent CU use was associated with worse outcome with medium effect sizes. Specific needs of adolescent patients with respect to cannabis interventions within integrated care settings should be addressed in future studies.

The primary objective of this study was to assess the gander specific cognitive function of primary school children in Pakistan.

Prospective observational study conducted in 4 schools in a small district of Pakistan.

Two hundred children (90 male,110 female), age 7–12 years class 3, 4 and 5 were assessed using McCarthy scale of child cognition. Verbal and linguistic skills, mathematical skills, reasoning in conversation, memory (word, number, picture, past) and Gross fine movements were assessed.

Verbal and linguistic skills: Better skills demonstrated in girls mean score 3.99 SD(0.84), 95% CI (3.81,4.17) when compared to boys mean score 3.81 SD(0.91),95% CI (3.64,3.98).Comparison of two groups did not reach to the statistical significance T = 2.05, P = 0.15.

Girls mean score 2.66 SD (0.52), 95% CI (2.55,2.77) whereas boys mean score 2.40 SD (0.69),95% CI (2.27,2.53).It was statistically significant T = 8.3,P = 0.004. Reasoning in conversation: Better reasoning among girls demonstrated with mean score 3.90 SD (2.17), 95% CI (3.44,4.36) whereas boys scored 3.47 SD(1.89), 95% CI(3.11,3.83).It was not statistically significant T = 2.19,P = 0.14.

Girls mean score 3.52 SD(0.60),95% CI (3.40,3.65) whereas boys scoring 3.22 SD (0.87) 95% CI(3.05,3.38).It was statistically significant with T = 7.8,P = 0.006.

Girls scored 4.29SD(0.75),95% CI (4.13,4.45) whereas boys scoring 4.08 SD(0.91), 95% CI (3.91,4.25).Though better gross movements demonstrated by girls they did not reach to statistical significance T = 2.98,P = 0.08.

Girls demonstrate better cognitive function in general and there mathematical ability and memory in particle are better than there age and background matched male classmates.

Adolescents health needs are unique. An understanding of these needs will assist in the development of services, risk-reduction strategies and preventive health activities.

This qualitative study was a part of a mixed method study about female adolescents health needs and conducted in Mazandaran province, a province in the north of Iran. 67 female adolescents between 12–19 years of age participated in 8 focus group discussion. Inaddittion, semi structured interviews were done with 11 key informants including:5 parents,3 teachers and school counselors, 2 obstetricians and one midwife. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done.

Findngs of this research around the role of family in adolescents health needs emphasized on 4 overarching themes including :supportive family relationships, needs for responsible parents, well-informed parents and parental monitoring.

In attention to the critical role of family relationships in adolescents health needs, Parents education in order to help them to improve their relationships with their adolescents is necessary.

Although much has been written about the health status of adolescents, little is known about adolescents’ perception of their own educational health needs. The purpose of this article is to describe the educational health needs of female adolescents to plan support services.

This qualitative study was conducted in Mazandaran province, a province in the north of Iran. 67 female adolescents between 12–19 years of age participated in 8 focus group discussion. Inaddittion, semi structured interviews were done with 11 key informants including:5 parents,3 teachers and school counselors,2 obstetricians and one midwife. Participants were selected based on purposeful sampling and with maximum variety. All tape-recorded data was fully transcribed and thematic analysis was done.

Findngs of this research around the adolescents’ health-information needs emphasized on 5 overarching themes including necessary for education, need for appropriate content, need for suitable methods, need for suitable sources and appropriate age for education.

The results show that promotion of female adolescents’ knowledges about reproductive health and life skills is one of the most important health needs of them. Education of this issues via parents, schools and health care providers could promote the health status of adolescents.

Study of specificity of emotional - personal features of parents and children-parental relations in families, bringing up the child with speech impairment. 95 parents of children with deviations in speech development were examined by tests. Contradictory style of the relation of parents to the child is revealed. High parameters on scales “Acceptance - Rejection” (64, 3%), “Cooperation” (64, 3%), “Symbiosis” (56%) are diagnosed. As prevailing leading style of the relation “parent - child” is allocated “Symbiosis” (48%) as aspiration for satisfying all child necessities, protecting him from difficulties and troubles, constant alarm for the child. The second on frequency of occurrence is the relation of rejection, (mistrust and disrespect for the child, perception his as unadapted and unlucky person). Discrepancy in perception of the child and in the relation to him, shown as a combination of high parameters on different of direction scales (meeting in 50% of cases) and reflecting simultaneous rejection, symbiotic attachment and trust, are indicate unsolved interpersonal conflict of the parent and demand specially organized treatment. Research of features of parents emotional - personal sphere allow to establish a presence of heightened reactive and personal anxiety which isn’t resulting in depression, however breaking adequate interaction with society. Results of research allow to assume a presence of the certain not realized parents attitudes (non-acceptance personality of diseased child, non-constructive forms of interaction with him; fear of the responsibility; refusal of understanding of existing problems, their partial or full denying).

Prader-Willi Syndrome (PWS) is a genetically determined neurodevelopmental disorder which occurs in approximately 1 in 22000 births.

Parents of subjects with genetically confirmed PWS (participating in the First National Irish PWS study) were asked to fill in a demographic questionnaire, The Child Behaviour Checklist 6–18 (CBCL/6–18), Brief Symptom Inventory (BSI). The age, gender and IQ matched control group was collected through Special Schools.

Both groups (PWS and Controls) were comprised of 24 children. Internalizing problems score was higher in children with PWS than controls (T mean score (62.02 (SD = 10.17) vs. 58.13 (SD = 7.53) p < . 05). The comparison of PWS and control group along CBCL/6–18 syndromes profiles indicated that children with PWS had more sever somatic problems (mean T 63.50 SD = 8.41 vs. 56.13 SD = 6.31, p< .05), social problems (mean T 64.71 SD = 8.95 vs. 58.79 SD = 9.41, p < .05), thoughts problems (mean T 67.71 SD = 9.71 vs. 58.04 SD = 7.17, p < .05) and were more withdrawn/depressed (mean T 64.04 SD = 9.11 vs. 55.46 SD = 6.48, p < .05). Borderline difficulties were detected for the affective, somatic and ADHD CBCL DSM orientated subscales in PWS group with PWS children having significantly more somatic (mean T 63.05 SD = 8.33 vs. 52.00 SD = 6.48, P < .05) and affective (mean T 66.22 SD = 8.51, vs. 60.08 SD = 6.829 P < .05) problems than controls. The analysis of BSI scales revealed that parents of PSW children in comparison to controls had more somatization, phobic anxiety, obsessive compulsion, and anxiety problems.

PWS represents a complex psychological disorder with multiple areas of disturbances.

Several approaches have been presented for treatment of children with ASD. The aim of the present study was to compare the efficacy of Holistic Multidimensional Treatment Model (HMTM) with Applied Behavioral Analysis (ABA) in the improvement of clinical symptoms of children with ASD.

The present study was an experimental pre and post test research. The statistical population included the 3 to 8 year old children with ASD who were referred to the child psychiatry clinics in two academic Hospitals- Mashhad,Iran. The sample included 20 children who were selected with convenience sampling and randomly divided to 2 groups of ABA (8 boys and 2 girls) and HMTM (7 boys and 3 girls).The diagnosis was made by a child psychiatrist based on DSM-IV-TR criteria and using Autism Diagnostic Interview-Revised (ADIR) and Autism Diagnostic Observation Schedule (ADOS).Then the children were referred to Noore Hedayat center for the treatment. Childhood Autism Rating Scale (CARS), Bender Gestalt Test, Draw-A-Man Test Good enough, Raven's Colored Progressive Matrices Test for children, Vineland Social Maturity Scale (VSMS) and performance charts of children based on their videotaped behaviors. Data analysis was done using ANCOVA test.

Findings showed that in spite of more efficacy of HMTM compared to ABA, the differences of standard tests except Bender Gestalt Test and performance charts did not reach to the significant level(p > 0.05).

In conclusion, HMTM at least had the equal efficacy to ABA in the treatment of children with Autism Spectrum Disorder. Further researches are needed to compare the efficacy of these 2 methods.

The tripartite model of emotions (TME) specifies a general factor, negative affect (NA), which represents a shared influence on anxiety and depression, and two specific factors, physiological hyperarousal (PH) common to anxiety, and (low) positive affect (PA) common to depression (Clark & Watson, 1991).

To examine the relationships between TME and anxiety and depressive symptoms in children and adolescents.

In the study participated 126 non-referred children and adolescents, aged 10–18 years. TME was assessed by the Affect and Arousal Scale (AFARS). Anxiety symptoms were identified using the Screen for Child Anxiety Related Emotional Disorders questionnaire (SCARED). This questionnaire reports five types of anxiety disorders: panic/somatic, generalized, separation, social, and school phobia. Finally, depressive symptoms were identified using the Short Mood and Feeling Questionnaire (SMFQ). Zero-order correlations between all measures were presented.

PA negatively correlated with the depression scale only, −0.2 (p = 0.012), while NA significantly correlated with the depression and all anxiety scale, except the separation anxiety scale (p < 0.05). PH significantly correlated with the depression, panic-somatic and separation anxiety and school avoidance scale. The highest correlations were between the depression (0.39) and panic scale (0.33).

The results indicate that the relationships between TME and symptoms of anxiety and depression in children and adolescents could be partially supported. However, they are consistent with the previous findings that reported that low PA correlate with depression and PH with panic disorder (Chorpita, 2000; Jacques & Mash, 2004; De Bolle, 2010).

Cognitive impairments are partly associated with DSM-IV criteria for Autism. Cognitive studies in Autism posit domain-specific and domain-general deficits including Theory of Mind (ToM), Executive Function (EF), and Central Coherence (CC).

Research indicates that early interventions for children with High Functioning Autism (HFA) predicate crucial cognitive gains.

The purpose of this study was to evaluate the effectiveness of a group cognitive training in increasing cognitive skills in children with HFA.

Four HFA children (2 girls, 2 boys) with mean age of 6.5 who had received intensive Applied Behavioral Analysis (ABA) participated in 18 group training sessions per week. Each session lasted 75 minutes, targeted ToM, EF, and CC using Art Therapy techniques. Picture Exchange Communication System (PECS), positive reinforcement, Token system and homework were used as well. All sessions were recorded. Session by session evaluation and parental attitudes were used to evaluate cognitive skills in this single subject design. ToM was tested by some stories and puppet shows. Problem solving tasks which were comprised of mental flexibility and planning assessed EF. visuospatial-constructional coherence and verbal-semantic coherence were explored by using pattern constructions and questions about the concepts of stories.

All children improved significantly in cognitive skills especially in predicting emotional reactions in stories, EF, and visuospatial-constructional coherence; however some individual differences were considerable.

Group art-based cognitive training would be helpful for children with HFA to enhance their cognitive skills.

One of the most significant stressors for families is extent of behaviour problems exhibited by children with developmental disabilities. These affects parental efficacy and parent-child relationship which are important variables for optimal parenting (Hastig and Brow, 2002).

The aim of the present study was to examine the effectiveness of parent management training to increase child-parent relationship and parental self-efficacy of mothers with autistic children.

30 mothers of children with autism (17 in experimental group and 13 in control group) were included. The experimental group participate in parent management training sessions includes behaviour modification techniques for 6 weeks. The scales of this research were Parenting Self-Agency Measure (Dumka, Storerzinge, Jackson and Koosa, 1996) and Parent _Child Relationship test (Pianta, 1994). t test were used to compare the meanings of pre-tests and post-tests.

The results indicate that there was significant differences between parenting self-efficacy (p < ./05) and parent-child relationship (p < ./001) scores. The experimental group's parental self-efficacy and positive parent-child relationship were significantly higher than control group and parent management trainings increase those important variables in mothers of children with autism.

Parent management training programmes can enhance parental self-efficacy and parent-child relationship and prevent many problems in families with autistic children.

Obsessive compulsive disorder (OCD) in childhood was first described by Legrand du Saulle in late XIX century, however, a systematic study in pediatric population was not made until 1986, by Rapoport. It is has been documented in scientific literature that younger patients usually hide their symptoms because of shame or that they do not find their obsessions and compulsions excessive, so that they feel them in an egosyntonic way, delaying diagnosis until several years after their first symptoms.

To highlight the specific symptoms in Pediatric OCD and review its treatment and approach through the study of a case report.

A 11-year-old boy was referred by his paediatrician to a child mental outpatient service for behavioural disturbances in the last few months. For the last three years, he had been performing rituals of cleaning, order and checking, increasingly complex and with a significant impact on his life, to the point of not being able to go to school and have other members of his family involved. He also had religious and catastrophic obsessions that generated him important distress. He was treated with high doses of sertraline and low doses of risperidone, and cognitive-behavioral psychotherapy with exposure response prevention and training in relaxation techniques were associated to the treatment. The patient improved partially.

This case illustrates the delay in the diagnosis of Pediatric OCD itself as well as the complexity when treating this disorder.

Impaired cardiac autonomic regulation is likely important contributor to a potential cardiac complications in major depression. The knowledge regarding the depression effect on cardiac regulation in adolescent age is limited. Aim was to study short-term heart rate variability (HRV) as an index of cardiac autonomic control in never-treated major depressive disorder (MDD) adolescent patients using linear and nonlinear methods related to depressive symptoms severity.

We have examined 20 MDD girls and 20 healthy age-matched girls at the age from 15 to 18 years. The ECG was recorded in three positions: supine - orthostasis - supine. The HRV was analyzed using linear (time and frequency analysis) and novel nonlinear (symbolic dynamics, time assymetry) methods. The severity of depressive symptoms was evaluated using the scales Montgomery-Asberg Depression Rating Scale (MADRS) and Children’s Depression Inventory (CDI).

Several HRV linear and nonlinear parameters were significantly reduced in MDD group compared to controls in supine rest and during orthostasis. The HRV nonlinear analysis indices significantly correlated with depressive symptoms severity.

Linear and nonlinear analyses revealed reduced magnitude and complexity of the HRV indicating impaired neurocardiac regulation in adolescent major depression. In addition, new approach of HRV analysis using nonlinear methods provided important information about depressive symptoms severity and cardiac autonomic regulation relations.

Autism is a disorder of the overall development and early onset before the age of 3 years, characterized by a deviant functioning and / or delayed in three areas: social interaction, verbal and nonverbal behavior.

The child may be aggressive, either to himself or to others. Communication difficulties hamper the social control of the aggression that is often disproportionate and can frighten the family.

In this work we are interested in the management of aggression for the autistic children.

identify ways of managing aggressive behavior for autistic children

self-administered questionnaires provided to educators, psychologists, psychomotor therapists, working at Mohamed VI national center for handicapped people.

43.3% of our sample exhibits behavioral problems which are « auto ou hétéroagressifs. We noted a male predominance. Precipitating factors were identified in 30% of cases and are mainly represented by the situations of failure and the changes in the environment of the autistic child. The management of aggressive behavior is based on several methods including the use of medications and behavioral approach.

The behavioral disorders are common among autistic children and are a major problem that families face. The aggressive management of the crisis is often difficult, and management remains uncodified.

From the viewpoint of society, adolescence can be considered a transition phase into adulthood. For many psychoanalysts, the changes originating from the puberty process are accompanied with an “anguish of growth”. The crisis installed due to this process can be marked by something peculiar in the life of each one.

To discuss the clinical practice, looking towards an understanding of the peculiarities that mark the psychotherapy of an adolescent who lives through a cultural transition.

Case report referring to a clinically listening to a 15 years old adolescent who was born and raised in Japan, then moved to Brazil with her family when was 12 years old.

Adaptation to a different culture was what motivated the patient's mother to seek attention for her daughter. The family brings the image of an idealized Japan. The change did not only bring consequences to the daughter, but to the family that went through reorganization in the face of customs and material conditions. The new conditions ended up accentuating conflictive questions by the married couple and the difficulty of organizing the positions of the parents and children in family dynamics, interfering in the process of separation/ individualization of the adolescent. The patient found within a typical Japanese music group an outlet in which she could confront other discussions that stamp her identity.

Psychocultural transition has marked this phase in the life of this adolescent. Within a referential group of oriental culture, the patient has found support for these changes.