Abstract
Children with autism struggle to remember details of events from their own lives. Autobiographical memories can help people connect socially with others, for instance, by sharing intimate details about their past, something individuals with autism have trouble doing. The new study suggests that treatments that improve their memory may also improve their social abilities. The study assessed children’s autobiographical memories by testing both semantic memory, which stores facts such as names and addresses, and episodic memory, which records events they experienced, such as a birthday party. The researchers looked at 63 children with autism who have intelligence quotients of 70 or higher, and 63 controls, all aged 8 to 16 years. Over 3 days of memory testing, the children with autism needed more prompting to remember both recent and older events, with the researchers asking, “And then what?” when a child paused for too long or became distracted. The researchers triggered memories in the participants by having them make associations with word cues such as “happy,” “angry” and “search.” They also asked them open-ended questions, including, “Tell me the first thing that ever happened to you, that you can remember, in your whole life.”
Both groups formed their first memories at around 3 years of age. However, those in the autism group retrieved fewer memories than controls did. They also tended to describe past events in general terms, such as, “my holiday with Grandma” or recall nothing at all, rather than supplying specific details. Emotion does influence recall in some ways, however. Children with autism expressed less emotion than controls did when describing older memories, but surprisingly were more emotional than controls in descriptions of recent memories. They also recalled the most intricate details from their emotion-laden memories, a fact that holds true for most people. Older children in both groups expressed more emotion and remembered more details than did the younger ones, suggesting that these skills improve over time. Although autism seems to impair the recall of both semantic and episodic memories, neither difficulty seems rooted in problems with visual memory. Instead, children in both groups who show more rigid thought patterns and poor verbal fluency, marks of a shortfall in executive function, struggle more than others to share new memories about themselves. In contrast, the recall of older memories doesn’t rely on executive function abilities, so the reason for that deficit remains puzzling. It may stem from an absence of self-awareness and reflection, functions that may be impaired in children with autism, the researchers say. Self-awareness and reflection may then be the key to committing autobiographical events to memory.—Goddard, L., Dritschel, B., & Robinson, S. (2014). Development of autobiographical memory in children with autism spectrum disorders: Deficits, gains, and predictors of performance. Development and Psychopathology, 26, 215–228.
The Early Start Denver Model for Autism
Early intervention for toddlers with autism spectrum disorder helps improve their intellectual ability and reduces autism symptoms years after originally getting treatment, a new study shows. The study is the first in more than 20 years to look at long-term outcomes after early intensive autism intervention. The therapy began when children were 18 to 30 months of age and involved therapists and parents working with the toddlers in their homes for more than 15 hr each week for 2 years.
The therapy, known as the Early Start Denver Model, or ESDM for short, was designed to promote social and communication skills and learning. The research team found that 2 years after completing the intervention, children maintained gains in overall intellectual ability and language and showed new areas of progress in reduced autism symptoms. This type of intervention has been shown to help children with autism, but it hadn’t been shown to work with very young children over a longer timescale until now. These results make the case for autism-specific, one-on-one intervention to begin as soon as autism symptoms emerge, which for many children is before 30 months of age.
The researchers studied two groups of young children with autism—the first received community intervention as usual for 2 years, which was a mix of what was available in the community such as speech therapy and developmental preschool. The second group received ESDM, which addresses a comprehensive set of goals, is delivered one-on-one in the home, and incorporates parent coaching and parent-delivered intervention with the child. This approach is designed to enhance a child’s motivation and follows each child’s interests in playing with toys and engaging in fun activities, songs, and basic daily routines. After 2 years of intensive intervention, children in the ESDM group showed a significantly greater increase in IQ, adaptive functioning, communication, and other measures than did the comparison group. Furthermore, 2 years after the early intervention ended, children who received the one-on-one care saw their autism symptoms reduce further, while children who had participated in community intervention had no overall reduction.—Estes, A., Munson, J., Rogers, S. J., Greenson, J., Winter, J., & Dawson, G. (2015). Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 580–587.
Learning to Lie
Children who are taught to reason about the mental states of others are more likely to use deception to win a reward. Developing “theory of mind” (ToM) may enable children to engage in the sophisticated thinking necessary for intentionally deceiving another person. Research suggests that children begin to tell lies somewhere around ages 2 and 3, and studies have shown a correlation between children’s ToM and their tendency to lie. Researchers conducted a hide-and-seek task to identify children who hadn’t yet started lying. The children were shown a selection of stickers and were asked to pick their favorite one—they were told that they could only keep the sticker if they successfully won 10 candies from the hide-and-seek game. In the game, the child was told to hide a candy under one of two cups while the researcher’s eyes were closed. The researcher then opened his or her eyes, asked the child where the candy was hidden, and chose whichever cup the child pointed to. Thus, the child could only win the candy by lying to the experimenter about its location.
A total of 42 children who never lied—who told the truth about the location of the candy on each of the 10 trials—were selected to continue with the study. The children, who were around 3 years old, were randomly assigned to complete either theory-of-mind training or control tasks focused on quantitative reasoning. The theory-of-mind training included the standard false-contents task, in which children were shown a pencil box and asked what they thought was inside. When it was revealed that the box didn’t actually contain pencils, they were asked to reason about what other people would think was in the box. The goal of the training was to teach kids that people can know and believe different things—that is, even though the child has learned the true contents of the box, someone else would probably believe that the box contained pencils. The children completed the training tasks or quantitative tasks every other day, for a total of six sessions. After the sessions were complete, the researchers again tested the children on the theory-of-mind tasks and the hide-and-seek tasks. As expected, children who received theory-of-mind training showed improvement on the theory-of-mind tasks over time, while the children in the control group did not. More importantly, the children who received the theory-of-mind training were also more likely to lie in the hide-and-seek task compared with those in the control group. And this difference held over a 30-day period.—Ding, X. P., Wellman, H. M., Wang, Y., Fu, G., & Lee, K. (2015). Theory-of-mind training causes honest young children to lie. Psychological Science, 26, 1812–1821. doi:10.1177/0956797615604628
Influencing Social Skill Through Theater
Children with autism can see big gains in socialization, communication, and other skills by learning to perform on stage. Children on the spectrum who participated in a 10-week, 40-hr theater program saw an increase in everyday skills like communication and the ability to recognize faces as compared with children with autism who did not attend the lessons. Researchers looked at 30 children with autism ages 8 to 14 years. Seventeen of the children were randomly assigned to participate in the theater-based intervention while the others did not. The program included theatrical games, role-playing, and other drama exercises and ultimately focused on preparing for a 45-min play, which participants performed after completing the intervention. The children with autism worked with typically-developing peers who were trained to help facilitate the activities and perform alongside them. Children with autism who attended the theater sessions were also asked to practice their new skills for 15 min daily by watching a series of web videos highlighting the target behaviors, role-playing, and songs they were working on in the intervention. At the end of the program, children who participated were more likely to engage in group play, and parents reported far greater gains in social communication as compared with children with autism who did not attend the sessions. The positive changes persisted 2 months after program completion. Children who took part in the intervention also showed greater facial recognition skills and ToM abilities as compared with those in the control group.—Corbett, B. A., Key, A. P., Qualls, L., Fecteau, S., Newsom, C., Coke, C., & Yoder, P. (2016). Improvement in social competence using a randomized trial of a theatre intervention for children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 46, 658–672.