Title: Conflict adaptation and congruency sequence effects to social–emotional stimuli in individuals with autism spectrum disorders
Authors: Worsham, Gray, Larson and South
DOI: 10.1177/1362361314553280
Lay abstract: Conflict adaptation is a term that describes how the brain redistributes resources to effectively cope with conflict in the environment, such as when a change in usual schedules or rules is necessary. While previous studies have suggested that people with autism spectrum disorder (ASD) process information differently during tasks that create conflict in non-social situations, this has not been studied in ASD for social–emotional conflicts. A total of 32 children and teenagers diagnosed with ASD and 27 typically developing children and adolescents completed a task that required them to identify the emotional expression on a face while simultaneously ignoring an overlaid emotional word (for example a happy face that has the word ‘sad’ overlaid). The accuracy of their responses was measured, as well as how long it took them to respond on the task. Both groups showed evidence for conflict adaptation on this social–emotional task, based on their response times and how accurate their responses were (i.e. they were slower and less accurate on trials where a happy face had the word ‘sad’ laid over it). However, the ASD group used a different strategy when they had to deal with conflict: this group was significantly faster but also less accurate. We suggest that the ASD group avoided directing their attention towards the socially relevant information (i.e. facial expressions) on this task. Thus they did not experience the same interference or delay from social or emotional information that was observed in the typical children and adolescents. This may bias individuals with ASD towards making decisions and responding more rapidly, even when conflict is present – that is, they do not slow down to process the conflict appropriately. Nonetheless, the loss of important information from the faces reduced the accuracy of their responses, which meant they did not adapt (both cognitively and emotionally) as successfully as the typical group when conflict arose.
Title: MYmind: Mindfulness training for Youngsters with autism spectrum disorders and their parents
Authors: De Bruin, Blom, Smit, van Steensel and Bögels
DOI: 10.1177/1362361314553279
Lay abstract: Despite the dramatic increase in ASD in youth and the extremely high costs associated with ASD, hardly any interventions are available. This study examined the effects of mindfulness training for teenagers with ASD, combined with Mindful Parenting training for their parents. Mindfulness means living in the present moment, with full awareness, being non-judgmental and non-reactive towards oneself and others. After mindfulness training it was found that teenagers reported a better quality of life, and a decrease in rumination (repeatedly thinking about bad feelings and experiences from the past). However, no changes in worry, the core symptoms of ASD, or mindful awareness were found. Parents noticed improvements in their child’s social skills (e.g. in how responsive they were, how they communicated, and how motivated they were to interact socially) and in the number of preoccupations they showed. Parents further found themselves to be more mindful in everyday life, but also specifically with respect towards their teens. They felt they were more competent in their parenting, showed a less lax parenting style, and were less verbose in parenting their teens. Further, parents reported their own quality of life improved after the training. In summary, mindfulness training for teenagers with ASD combined with Mindful Parenting is feasible and although this study only covered a small group, these initial findings seem promising.
Title: Social engagement with parents in 11-month-old siblings at high and low genetic risk for autism spectrum disorder
Authors: Campbell, Leezenbaum, Mahoney, Day and Schmidt
DOI: 10.1177/1362361314555146
Lay abstract: Because autism spectrum disorder (ASD) runs in families, younger siblings of children with ASD are at higher risk to develop ASD themselves than are children in the general population. We observed 11-month-old infant siblings of children with ASD (referred to as a ‘high risk’ or ‘HR’ group) and infants with typically developing older siblings (referred to as a ‘low risk’ or ‘LR’ group) during free play with a parent. This was to identify possible early signs of ASD prior to the age at which a reliable diagnosis could be made. To avoid bias, observers did not know which infants were HR and which were LR. All participating infants were assessed for ASD in toddlerhood, most at 36 months, using the Autism Diagnostic Observation Schedule (ADOS, a standard observational assessment for autism symptoms administered by a trained clinician) and clinical judgment. HR infants who later received a diagnosis of ASD were less likely to show or give toys to their parent and were also rated as showing less social reciprocity (i.e. mutual positive social interaction) than were LR infants. HR infants who did not receive a diagnosis of ASD fell between the LR and ASD infants in their social behavior. Parent behavior during play did not differ by group and parents were generally sensitive and responsive to their infants’ play activities. Within the HR group, ratings of social reciprocity at 11 months were associated with severity of ASD symptoms (as assessed using the ADOS) at follow-up. Results suggest that standard observations of parent–infant play may be a useful addition to early assessments of emerging ASD, as they provide an opportunity to capture aspects of spontaneous social interaction with a familiar social partner.
Title: Interest level in 2-year-olds with autism spectrum disorder predicts rate of verbal, nonverbal, and adaptive skill acquisition
Authors: Klintwall, Macari, Eikeseth and Chawarska
DOI: 10.1177/1362361314555376
Lay abstract: Pedagogical interventions (typically based on applied behavior analysis; ABA) have been shown to be beneficial for young children with autism, increasing both language and social skills. Interventions are helpful for many children, but not all. One possible explanation for why children benefit differently from interventions is their motivation. Pedagogical interventions use rewards to motivate children to learn new skills. Rewards differ from child to child: soap-bubbles, candy, videos or playing peekaboo. This study recruited 70 children with autism, around the age of 2 years, who were about to start different pedagogical interventions. The children were videotaped while engaged in an organized play session with an adult, which included various toys and activities. The amount of interest or enjoyment the child showed towards these items and activities were then scored on a checklist, based on the video recordings. The children were also given psychological tests to evaluate their level of functioning. The children came back after 1.5 years of intervention and were retested with the same psychological tests. As expected, some children had benefited greatly from their interventions, whereas others had benefited less. Interestingly, those who have shown most interest and motivation during our videotaped play sessions were also those who had benefited the most from their interventions. This suggests that child motivation is a good predictor of how much that child will benefit from pedagogical interventions.
Title: Children with autism spectrum disorders who do not develop phrase speech in the preschool years
Authors: Norrelgen, Fernell, Eriksson, Hedvall, Persson, Sjölin, Gillberg and Kjellmer
DOI: 10.1177/1362361314556782
Lay abstract: There is uncertainty about the numbers of children with autism spectrum disorders (ASD) who do not develop the ability to speak in two-word phrases during their preschool years. The purpose of this study was to address this issue by assessing 165 children (141 boys, 24 girls) with ASD, who were aged 4–6 years. This group was followed over a period of 2 years, during which they received therapy at a specialized autism center. In the study, information about speech and language was collected at end of the 2-year period. Expressive language refers to the ability to use words, sentences and phrases to communicate effectively with others. We defined three categories of expressive language: nonverbal (using less than three words and having the expressive language of a toddler below the age of 15 months), minimally verbal (using at least three words but rarely/never using two-word phrases, and having the expressive language of a child under the age of two), and phrase speech (using two-word phrases or longer and having an expressive age equivalent to that of a child older than two years). Information about expressive language level was collected by interviewing the parents using a structured interview tool called the Vineland Adaptive Behavior Scales-II. A secondary purpose of the study was to examine factors that might be linked to the child’s verbal ability. These included: the child’s age; the child’s cognitive level (i.e. their level of general ability or intelligence); the type of autism the child had (e.g. classic autism, Asperger syndrome) and how severe the child’s symptoms were; whether the child’s development had stopped at some point; if the child had epilepsy or other medical conditions; and the intensity of the therapy given at the autism center. The percentage of children who fulfilled the criteria for being nonverbal, minimally verbal, or using phrase speech were 15%, 10%, and 75%, respectively. We found that the most important factor linked to the child’s expressive language ability was their cognitive level, and all children classified as being nonverbal or minimally verbal were diagnosed with an intellectual disability.
Title: Referential gaze and word learning in adults with autism
Authors: Aldaqre, Paulus and Sodian
DOI: 10.1177/1362361314556784
Lay abstract: When typically developing people hear a novel word, they often try to benefit from social signals (e.g. where the speaker is looking) to determine the correct reference of that word. Due to their impairments in social interaction, people with autism usually experience problems in consulting these social signals. This can lead to errors in their learning of words. However, not all people with autism display such errors. This has led some researchers to assume that the ability to rely on social signals to guide word learning can develop in autism, but it might be delayed compared with typically developing individuals. To test this assumption, a group of adults with autism and a group of typically developing adults were presented with two unfamiliar objects (typically an unfamiliar tool or an imaginary object). A person looked at one of the objects (the target) and labelled it with a novel name. Afterwards, participants were asked to select the target among other unfamiliar objects. In such a situation, it is only possible to choose the correct referent of the novel word by relying on the speaker’s direction of gaze. Results showed that the autism group chose the target correctly, but less so when the other object attracted their attention (by jiggling in place). In contrast, the typically developing adults chose the target consistently despite any distraction. These findings support the assumption that the ability to consult social signals during word learning develops in autism, however not to the same level as in typically developing individuals.
Title: The development of co-speech gesture and its semantic integration with speech in 6- to 12-year-old children with autism spectrum disorders
Authors: So, Wong, Lui and Yip
DOI: 10.1177/1362361314556783
Lay abstract: Children gesture when they talk. Co-speech gestures are spontaneous hand movements accompanying speech. For example, hand waving while saying, “You should not do this!” signifies disagreement. This gesture is a marker, which carries culture-specific meaning. Typically developing (TD) children gesture while talking as early as age two. They also gesture to clarify information that is ambiguous or even not mentioned in speech (supplementary gesture, e.g. pointing to a cookie while saying, “I eat”). Children with autism spectrum disorders (ASD) show delay in their understanding and development of gestures. In particular, 2- to 5-year-old children with ASD gesture less often than both TD and developmentally delayed (DD) children and have difficulty in producing certain types of gestures. However, it is not clear whether school-aged children (6 to 12 years old) still have a gesture deficit. This study examined the production of gestures among school-aged children while they were interacting with their caregivers. We found that, compared with their TD counterparts, children with ASD gestured less often and used fewer types of gestures, particularly markers. In addition, they failed to integrate speech with gesture: in particular, supplementary gestures were absent in children with ASD. In general, children with ASD who had more severe autism symptoms (related to communication and social function) tended to produce fewer gestures than those with less severe symptoms. The findings extend our understanding of gestural production in school-aged children with ASD during spontaneous interaction. The results can help guide new therapies for gestural production for children with ASD in middle and late childhood.
Title: Brief measures of anxiety in non-treatment-seeking youth with autism spectrum disorder
Authors: Kerns, Maddox, Kendall, Rump, Berry, Schultz, Souders, Bennett, Herrington and Miller
DOI: 10.1177/1362361314558465
Lay abstract: This study investigated how accurately parent, self and clinician-rated measures of anxiety detected the presence of anxiety disorders in youth with autism spectrum disorder (ASD). A total of 54 verbally proficient youth (aged 7–17 years) with ASD and their parents took part in the study. The participants took part in comprehensive interviews to determine whether or not they had an anxiety disorder and they also completed a number of brief anxiety questionnaires. The results indicated that brief anxiety questionnaires frequently misidentified anxiety difficulties in youth with ASD: they both misattributed anxiety problems to some youth (when they, in fact, did not have an anxiety problem) and missed the presence of clinically significant anxiety in others (i.e. in those who did have an anxiety problem). Attempts to revise cut-scores on these brief questionnaires (i.e. increasing/reducing the score needed for an individual to be correctly classified as having/not having an anxiety problem) did not adequately resolves these inaccuracies, suggesting that different tools may be needed.
Title: Effectiveness of a fundamental motor skill intervention for 4-year-old children with autism spectrum disorder: A pilot study
Authors: Bremer, Balogh and Lloyd
DOI: 10.1177/1362361314557548
Lay abstract: Fundamental motor skills are the basic movements (such as jumping, kicking, and catching) that are required to participate in games and play. Our study looked at the impact of a fundamental motor skill intervention on the motor skills, behaviour, and social skills of 4-year-old children with autism spectrum disorder. The fundamental motor skill programme consisted of 12, 1-hour sessions led by student volunteers and focused on teaching skills, such as running, hopping, and throwing, through simple instructions and visuals. We found that the group of children who received the intervention significantly improved their object control (e.g. catching, throwing, and kicking) and overall motor scores following the intervention when compared with the group who did not receive the intervention. There were no significant group changes in behaviour or social skills following the intervention; however, improvements were found in individual children. The intensity of the motor skill programme (i.e. receiving the intervention 1 vs. 2 times per week) did not have a significant impact on any of our outcomes. The findings from this pilot study suggest that a fundamental motor skill intervention can improve the motor skills of young children with autism spectrum disorder, and may have an impact on behaviour and social skills in some children. Future research with larger samples is needed.
Title: “You think it’s hard now … It gets much harder for our children”: Youth with autism and their caregiver’s perspectives of health care transition services
Authors: Cheak-Zamora and Teti
DOI: 10.1177/1362361314558279
Lay abstract: Children with a diagnosis of autism spectrum disorder (ASD) often have many other complex physical and mental health conditions. These youth rely heavily on their medical providers and struggle through the often-rocky transition out of pediatric care into adulthood and adult-centered care, also known as their health care transition. This study is one of the first to examine health care transition experiences of youth with ASD and their caregivers in such an in-depth way. We conducted four focus groups (groups gathered together to talk about a related issue) for a total of 13 youth participants with ASD and 19 of their caregivers. Youth and caregiver focus groups were conducted separately. Analyzing the conversations that occurred during the focus groups, we found several key themes. Parents’ discussions emphasized: (a) loss of relationship with provider and lack of support transitioning from child to adult care; (b) providers’ lack of knowledge about ASD; and (c) concerns about losing guardianship over their child. Youth emphasized their confusion and anxiety around: (a) medical providers’ roles, especially in the transition to adulthood; and (b) managing their medical lives independently from their caregivers. Our findings are important because they improve our understanding of health care transition needs among youth with ASD and their caregivers and also demonstrate a comprehensive procedure to gather input from youth with ASD.
Title: Appearance-based trust behaviour is reduced in children with autism spectrum disorder
Authors: Ewing, Caulfield, Read and Rhodes
DOI: 10.1177/1362361314559431
Lay abstract: Typically developing individuals make fast and reliable evaluations of trustworthiness based on peoples’ faces. In this study, we asked whether the same is true for children with autism spectrum disorder (ASD) and investigated how these cues might influence behaviour during a trust game. We found that typically developing children and children with ASD judge facial trustworthiness similarly, i.e. they agreed upon the faces that looked trustworthy and untrustworthy. Critically, however, we saw differences between the groups in how these cues affected behaviour. In our trust game, called Token Quest, children could share a set of tokens with a series of pretend partners (who all looked either very trustworthy or very untrustworthy). They were told that these partners would be given three times as many tokens as the child chose to share, and would then get to choose how many (if any) of their tokens they would like to return to the child. Results revealed that that token ‘investments’ by the typical children were strongly influenced by the appearance of their partners. Children with ASD, however, were no more likely to trust partners with faces that look trustworthy to them, than those that looked untrustworthy. These results cannot be accounted for by any differences between the groups in the children’s general understanding of trustworthiness, ability to read trustworthiness from faces, or understanding of the trust game. Instead, there may be a selective failure to spontaneously use facial trustworthiness information to guide behaviour in a ‘real-world’ context.
Title: Validation of existing diagnosis of autism in mainland China using standardized diagnostic instruments
Authors: Sun, Allison, Auyeung, Zhang, Matthews, Baron-Cohen and Brayne
DOI: 10.1177/1362361314556785
Lay abstract: There has been an increase in the number of children and adults reported to have autism spectrum conditions (ASC) in developed countries. However, basic estimates of the number of people diagnosed with ASC outside the West are still sparse, China included. To date, research in mainland China has mainly focused on children with ‘classic autism’ rather than the broader autism spectrum. Further, diagnosis is largely dependent on clinical judgment, without the use of widely-used and validated diagnostic instruments to aid clinicians in making their decisions. It is not known whether children in China who have been previously diagnosed with ASC meet the criteria for a diagnosis of ASC using such diagnostic instruments. In this study, children with a known diagnosis of autism (given in mainland China) were assessed using two widely used ASC diagnostic instruments: the Autism Diagnostic Observation Scale (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). Out of 50 children with an existing diagnosis of autism, 47 children met the criteria for a diagnosis of autism (classic autism) using the ADOS and 44 children met the criteria for a diagnosis of autism (classic autism) using the ADI-R. Overall, the level of agreement between the Chinese diagnosis and scores on the ADOS and ADI-R were very good.
