Language acquisition research in autism has traditionally focused on high-level pragmatic deficits. Few studies have examined grammatical abilities in autism, with mixed findings. The present study addresses this gap in the literature by providing a detailed investigation of syntactic and higher-level discourse abilities in verbal children with autism, age 5 years. Findings indicate clear language difficulties that go beyond what would be expected based on developmental level; specifically, syntactic delays, impairments in discourse management and increased production of non-meaningful words (jargon). The present study indicates a highly specific pattern of language impairments, and importantly, syntactic delays, in a group of children with autism carefully matched on lexical level and non-verbal mental age with children with developmental delays and typical development.

In this longitudinal study, the proportion of time preschoolers directed their attention away from rewarding stimuli during a delay-of-gratification task was positively associated with efficiency (greater speed without reduced accuracy) at responding to targets in a go/no-go task more than 10 years later. The overall findings suggest that preschoolers' ability to effectively direct their attention away from tempting aspects of the rewards in a delay-of-gratification task may be a developmental precursor for the ability to perform inhibitory tasks such as the go/no-go task years later. Because performance on the go/no-go task has previously been characterized as involving activation of fronto-striatal regions, the present findings also suggest that performance in the delay-of-gratification task may serve as an early marker of individual differences in the functional integrity of this circuitry.

Despite increased attention to multiculturalism in clinical practice, clinicians frequently struggle with applying multicultural guidelines offered by the American Psychological Association and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV). The authors provide specific tools and practical methods for assessing culture during intake procedures and argue for the integration of social identity assessment into the DSM-V interview. We begin by evaluating the DSM-IV's cultural formulation guideUnes, and we provide 4 cultural principles regarding patients' and clinicians' social identities, intersectionality, and the cultural context of therapy. We encourage clinicians to consider privilege, oppression, and intersectionality in all clinical exchanges. We then evaluate the Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV) Overview to identity biases and neglected social identities, and we present the Patient Social Identity Assessment. Next, we present a dining module enabling clinicians to utilize this measure without reifying problematic trends in cultural formulation and underscore the importance of therapist self-assessment of privileged identities. We conclude with guidelines when integrating social identity assessment into intake procedures across treatment settings.

We comment on 6 clinical cases involving the application of one or more elements of Motivational interviewing (MI). First, we share our general reactions to MI and the case material. Second, we reflect briefly and specifically on each case illustration, highlighting the compelling flexibility and clinical utility of the MI spirit and its principles. Third, we offer several reflective themes across the cases, including convergences between MI and other psychotherapies, and unanswered clinical questions related to MI, its effectiveness, and its change mechanisms. Finally, we advance a context-responsive psychotherapy integration for which MI might effectively serve as the bellwether.

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