In this issue there are a number of papers that signal the need for greater clarity in the way in which the basic psychopathology for autism is framed. The paper by Russell et al. raises the question of the extent to which the problems faced by such children arise purely from the lack of a theory of mind. Performance on the false belief task—first used by Wimmer and Perner in 1983—is frequently treated as an indicator of whether a child has or does not have a theory of mind. In autism research it is indeed common to separate children into those with a theory of mind and those without. While not questioning that children with autism find it difficult to think about their own and other people's thoughts, the paper by Russell et al. encourages scepticism about whether this task is an index of theory of mind and of nothing more. They demonstrate that whatever else the task requires in the way of mentalising ability, it also makes substantial executive demands. This ambiguity over precisely what is required in order to complete this task successfully should lead clinicians to be cautious about claiming that failure on such a task demonstrates the lack of a theory of mind.

Reappraisal of another aspect of the autistic child's disabilities is suggested by the paper by Buitelaar et al. It is usually expected that social and emotional understanding is associated with verbal cognitive skills. In this paper this belief is challenged in a study of mentalising an emotional recognition ability in children with autistic spectrum disorders. It was found that verbal memory rather than other aspects of verbal competence was relevant and that, in addition, visuospatial skills emerged as an important predictor of social and emotional understanding. The authors suggest that this result may explain why children with poor visuospatial skills often have serious problems in social and emotional adaptation.

Repetitive behaviour is widely known to be one of three core and defining features of autism (ICD-10, World Health Organisation, 1990; DSM-IV, American Psychiatric Association, 1994). Any clinician who is told that a child repetitively flaps his arms, spends hours lining up Lego bricks, will not tolerate changes in routine, and has a peculiar fascination with the many varieties of electric fan available on the market will, before hearing anything about the social functioning or communicative abilities of that child, be deeply suspicious that the child is autistic. However, the literature on repetitive behaviour in autism reveals several paradoxes and inconsistencies. First, given the significant challenge that this class of behaviour can pose, the literature devoted to the study of this behaviour in autism is relatively small in comparison with the extensive literature on other aspects of autistic symptomatology. Whilst certain classes of repetitive behaviour have been described as nonspecific to autism (e.g. Prior & Macmillan, 1973), others have been suggested to be of particular significance to the disorder (e.g. U. Frith, 1989; Kanner, 1943; Wing & Gould, 1979). Finally, although repetitive behaviour is commonly defined as behaviour with no obvious goal or function (e.g. Hutt & Hutt, 1970), much of the literature concerning repetitive behaviour in autism has sought to explore what function this behaviour serves.

The aim of this Annotation is to provide a review of what is known about repetitive behaviour in autism, its specificity to the syndrome, and the functions or mechanisms that might underlie this behaviour at the psychological level.

Pseudoseizures or their possibility remain a troublesome clinical issue with serious implications as, particularly in older children and adolescents, they can take various forms so that their differential diagnosis is wide. Many of the traditional criteria do not, in fact, discriminate well between pseudoseizures and other episodic disorders, especially those involving dramatic behavioural manifestations. These include certain forms of epilepsy (notably mesial frontal seizures) and some other organic and psychiatric conditions. A number of more reliable diagnostic criteria remain. These include selective clinical criteria and certain findings from carefully conducted EEG monitoring with informed analysis of the results.

As children with autism have pervasive executive difficulties it is necessary to determine whether these contribute to their often-reported failure on the false belief task. Failure on this task is frequently taken to diagnose the lack of a “theory of mind”. We report two studies using two tasks that make similar executive demands to the false belief task. The first experiment showed that children with autism are significantly challenged by a “conflicting desire” task, which suggests that their difficulty with the false belief task is not rooted in difficulty with grasping the representational nature of belief. In the second study children with autism were also found to be impaired on a novel version of the “false photograph task”. A parsimonious reading of these data is that their difficulty with all three tasks is due to commonalities in the tasks' executive structure.

This study was designed to examine the developmental and cognitive correlates of theory of mind (ToM) and emotion recognition ability in children with autism (N=20), with pervasive developmental disorder-not otherwise specified (PDD-NOS) (N=20), and in psychiatric control children (N=20). The diagnostic groups were person-to-person matched on age and verbal IQ. The age of the children was between 8 and 18 years; their Full Scale IQ was at least 65. The test battery included tasks for the matching and the context recognition of emotional expressions, and a set of first- and second-order ToM tasks. The relationships between composite domain scores and the subjects' age, Verbal IQ, Performance IQ, verbal memory, visual memory, and gender were examined in bivariate and multivariate analyses. Further, the subjects who reliably and consistently passed the tasks of a domain and those who could not were compared on developmental and cognitive characteristics. Overall, the results of the various analyses converged and indicated that verbal memory, Performance IQ, age and gender were the best predictors of social cognitive ability.

The ability to distinguish serious from playful fighting by two groups of children with learning disabilities (LD) (mean age = 9.3 and 11.8 years) and non-LD children (mean age = 10.1 years) was examined. Children with LD were generally able to make this distinction, with older children being more accurate. However, the performance of children with LD was not as high as that of non-LD children: they used a smaller range of criteria; some criteria were used significantly less; and they were much more likely not to give any reason for the judgements made. On the other hand, the order in frequency of those criteria cited was similar for both non-LD children and children with LD. Physical actions of the participants, and inference about actions and/or intent were the most frequently cited criteria. These findings indicate that although children with LD use fewer social cues, and are less accurate in making judgements about the nature of behavioural episodes, the acquisition of the meaning of particular cues may follow the same sequence as for non-LD children. Possible delays in the social cognitive development of children with LD, and their implications for the social adjustment of these children, are discussed.

The purpose of the present study was to explore patterns of mother–child interaction, children's private speech use, and behavioral self-regulation among a sample of preschool children identified by their preschool teachers as evidencing behavior problems. Forty preschoolers were classified into two groups (behaviorally at-risk and a matched comparison group) on the basis of teacher ratings of impulsivity, inattention, and hyperactivity. Children completed a magnet board puzzle task once in collaboration with their mother and once individually, and maternal and child speech and behavior were coded from videotapes. Although there were no group differences in children's behavior or speech during the collaborative session, nor were there differences in children's individual task performance or on-task attention, mother–child interaction involving behaviorally at-risk children was characterized by more other-regulation, negative control, less praise, and less physical withdrawal over time, compared to interactions involving comparison children. Behaviorally at-risk children, compared to controls, used more overt, task-relevant private speech during individual problem solving. Partially internalized private speech use among at-risk preschoolers was positively associated with task performance. Group differences rather than similarities prevailed in terms of the relations between maternal behavior, child speech, and child performance.

We tested a model of prosocial development, which predicted that prosocial action might decline, not increase, throughout childhood, becoming increasingly selective, individual, gender-related, and linked to emotional dysregulation. Sixty-six focal children at 18, 24, or 30 months of age were observed at home with familiar peers and then again 6 months later. Episodes of peer interaction were analysed for instances of sharing. The predicted decline in sharing with age was qualified by cohort differences and many associations with gender. Most children shared less as they grew older, but the oldest girls slightly increased their rate of sharing over time. As peer relationships developed, girls were more likely to share with other girls; boys were more likely to show reciprocity in sharing. Individual differences in sharing were moderately stable over time and linked to another form of prosocial action, sensitivity to the peer's distress. As predicted, children who shared at higher rates were rated more negatively by their mothers. The positive relationship between prosocial action and mothers' ratings of negative personality traits was especially strong for boys.

This study examined whether the link between marital conflict management style and child conduct problems with peers and parents is direct or mediated by mothers' and fathers' parenting style (critical parenting and low emotional responsivity). One hundred and twenty children, aged 4 to 7 years, were observed interacting in our laboratory playroom solving a problem with their best friend as well as at home with their parents. In addition, all the children's parents were observed in our laboratory trying to solve two family problems as well as at home interacting under more natural conditions with each other and with their children. Mothers and fathers completed questionnaires assessing marital problem solving as well as reports of their children's behavior problems. Results indicated that a negative marital conflict management style had direct links with children's conduct problems. In addition, the linkage between negative marital conflict management and children's interactions with parents and peers was found to be mediated by both mothers' and fathers' critical parenting and low emotional responsivity, thereby supporting the indirect as well as the direct model of negative family interactions. The findings are discussed in relation to the implications for treatment.

Attachment has generally been examined from the infant's perspective. We focused on mothers' post-partum thoughts and behaviors. Guided by an ethological approach, maternal bonding was examined under conditions of proximity, separation, and potential loss. Ninety-one mothers were interviewed: mothers of full-term infants who maintained continuous proximity to the infant, mothers of healthy premature infants who were separated from the infant, and mothers of very low birthweight infants who experienced potential loss and prolonged separation. Mothers of term infants reported medium-to-high levels of preoccupations with thoughts of infant safety and well-being. Preoccupations increased with separation (Group 2) and significantly decreased with impending loss (Group 3). Attachment behaviors and representations were the highest among mothers of term infants and declined linearly with the duration of mother–infant separation. Maternal trait anxiety and depression were related respectively to higher levels of preoccupations and reduced attachment behaviors and representations, independent of the infant medical condition and mother–child separation. Discussion focused on the comparability of maternal and infant attachment in relation to the neurobiological system underlying bond formation.

The discriminant validity of children's and parents' ratings of the child's fear on the Revised Fear Survey Schedule for Children (FSSC-R; Ollendick, 1983) was examined using a clinic sample of children who met DSM criteria for phobic disorders (N=120). Discriminant function analyses and item analyses were conducted to determine if children meeting diagnostic criteria for a primary disorder of social phobia, simple phobia of the dark/sleeping alone, simple phobia of animals, or a simple phobia of shots/doctors could be differentiated on the basis of FSSC-R subscale scores and items. Results of the discriminant function analyses indicated that the child-completed as well as the parent-completed FSSC-Rs were similarly useful in differentiating the specific types of phobias. Results of the item analyses indicated that child-completed FSSC-R items could discriminate among the different simple phobias but not social phobia and that parent-completed FSSC-R items could discriminate not only the different simple phobias but also social phobia. Results are discussed in terms of the utility of the FSSC-R in the assessment of clinically significant fears in children with phobic disorders and the relative utility of child and parent ratings in the assessment of childhood fears.

Little research has addressed the relative influence of genetic and environmental factors on subclinical levels of anxiety in children. Of the two twin studies to date, one concluded that measures of adolescents' self-reported trait anxiety were best explained by shared environmental factors (Thapar & McGuffin, 1995), while the second determined that approximately half the variance was attributable to genetic effects (Topolski et al., 1997). The present study, using a sample of 547 twin pairs, reached conclusions similar to those of Topolski et al. Heritability was estimated at 45%. Measures of state anxiety conformed more closely to Thapar and McGuffin's findings, with environmental factors accounting for the variance.

Teasdale's (1988) differential activation hypothesis proposes that a tendency for negative mood to activate latent negative self-schemas characterises people at risk for depression. The current study tested predictions from this hypothesis in a community sample of 102 adolescents who were free from history of psychiatric illness, and who were subdivided according to level of emotionality, a temperamental style as assessed by parental questionnaire. Amusical mood induction task was used to induce temporary mild dysphoria, and the effect of mood induction on self-schemas was assessed. There was no difference between high and low emotionality groups in the liability to sad mood induction. However, adolescents with high emotionality endorsed significantly more negative self-descriptors after dysphoric, but not after neutral, mood induction. This was not accounted for by level of self-reported depressive symptoms over the previous week. This suggests that a “dysphoric mood induction challenge” may provide important information about vulnerability to depression that is not identified by routine self-report of mood or cognitions.

Recently a type of growth failure (Hyperphagic Short Stature) has been described, in which there is potentially reversible severe impairment of growth hormone secretion, in association with excessively high levels of psychosocial stress. This condition is a variant of the disorder formerly known as Psychosocial Dwarfism. In the present study we compared children with Hyperphagic Short Stature (N=25, aged 9.04 years±3.78, 72% male) and a closely matched sample with normal height, drawn from comparably stressful family circumstances (N=25, aged 10.61±3.04, 60% male). Measures of the psychosocial environment, anthropometry, and developmental history from infancy were obtained. Many symptoms thought previously to be characteristics of psychosocial dwarfism were found to be nonspecific stress responses. Hypotonia (p<.05), enuresis/encopresis (p<.01), and sleep cycle disruption (p<.05) did differentiate the groups. Growth, appetite, and sleep are all influenced by hypothalamic nuclei, suggesting hypothalamic pathology could account for most of the clinical features of Hyperphagic Short Stature.