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Greaves-Lord K, Alma M, de Graaff B, Landsman J, van der Weide K, Jagersma G, Beskers T, Wubs M, Mandemaker H, van Daalen E, van der Linde J, Stapert AF, Bekius J, Piening S, Landlust A, van Balkom IDC. Clinical stance on response initiation in autistic adults: co-creating an integrative approach based on theory and lived experiences to act from language, via motor movement to wellbeing. Front Psychol 2023; 14:1229596. [PMID: 37780169 PMCID: PMC10539615 DOI: 10.3389/fpsyg.2023.1229596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/09/2023] [Indexed: 10/03/2023] Open
Abstract
Getting 'stuck', literally and figuratively, is a common experience for autistic people. Literally 'stuck' means exhibiting limited response initiation due to immobility with tense muscles and inability to move. Figuratively 'stuck' means loneliness, passivity or captivity in activities that do not offer long-term satisfaction. To further conceptualize this complex phenomenon of limited response initiation in autistic individuals, we performed qualitative interviews and focus groups with autistic people and their family members, followed by brainstorm sessions and a Delphi study with input from a larger panel of experts from multiple backgrounds. We aimed to co-create the outline of an integrative approach to support autistic people in moving away from this 'stuck state' to more flexible, limber 'supple states' in order to live freer, more meaningful, satisfying and peaceful lives. Over time, in interaction with all participants, our shared insight grew. Based on this, we here stipulate a conceptual framework, in which the described 'stuck state' at the micro-level of the muscles/behavior of one individual, probably is caused by feeling/being 'stuck' or 'cramped' at several overarching (i.e., meso and macro) levels. For instance, stuck in relationships with unhealthy dynamics, stuck at home creating short-term calm, trance-like states (e.g., gaming), stuck at an educational level that might fit the individuals' current social-emotional state rather than their potential cognitive level, stuck in a job that pays the bills but does not feel meaningful, nor contributes to a satisfying life with opportunities for personal development. Stuck in a mental/public health care system where ever ongoing changes in policies hinder sustained support to suit care-needs. Stuck in a regulated societal system making it likely to repeatedly get stuck. Is this phenomenon specific to autism? Formally we have only conducted interviews with this population, but in another smaller, related project we also spoke to people from the general population with careers that are considered successful in the general society. These people actually voiced similar experiences. Therefore, we hypothesize that this numbing state of being or feeling 'stuck' may be a prevalent phenomenon that needs to be addressed. In this article, we discuss several types of interventive approaches (i.e., language-based talking therapies, affective experiential expressive therapies, physical therapies and systemic therapies), prevention as well as intervention programs, directed at different primary stakeholders, that can complement and enrich each other in an integrative policy, that leads to tailor-made, personalized trajectories of interdisciplinary support to enable people to live satisfying, meaningful, dignified and peaceful lives.
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Affiliation(s)
- Kirstin Greaves-Lord
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, Netherlands
| | - Manna Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Benjamin de Graaff
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Jeanet Landsman
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Klaske van der Weide
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | | | | | | | | | - Emma van Daalen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia’s Children’s Hospital, Rotterdam, Netherlands
| | - Joost van der Linde
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Anne Fleur Stapert
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Jeroen Bekius
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Sigrid Piening
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychiatry, Rob Giel Research Centre, University Medical Center Groningen, Groningen, Netherlands
| | - Annemiek Landlust
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Ingrid D. C. van Balkom
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychiatry, Rob Giel Research Centre, University Medical Center Groningen, Groningen, Netherlands
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Investigating autistic traits, social phobia, fear of COVID-19, and internet use disorder variables in the context of videoconference fatigue. TELEMATICS AND INFORMATICS REPORTS 2023; 11:100067. [PMCID: PMC10202897 DOI: 10.1016/j.teler.2023.100067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/22/2023] [Accepted: 05/20/2023] [Indexed: 10/28/2023]
Abstract
In response to the coronavirus disease 2019 (COVID-19) pandemic, many individuals turned to synchronous online video communication technologies as a substitute for real-world face-to-face interactions. Evidence indicates that some users of such technologies show symptoms of exhaustion and fatigue during and after videoconferences (VCs) – this phenomenon is referred to as Videoconference Fatigue (VC fatigue). Research characterizing the possible vulnerability factors for VC fatigue is still scarce and considered to be in its early stage. Contributing to closing this gap in the existing literature is the motivation for the present study. Survey data was collected from 311 German-speaking participants to explore the relationships of VC fatigue with several psychological factors including autistic traits, social phobia, Fear of COVID-19, tendencies towards Internet Use Disorders (IUD tendencies), and Fear of Missing Out (FoMO, trait and state variables). Results showed that VC fatigue was significantly positively correlated with all of these psychological factors except state-FoMO, and corss-sectional mediation analyses provided further evidence for the positive association between autistic traits and VC fatigue. Specifically, the relationship between autistic traits and VC fatigue was mediated by Fear of COVID-19 and IUD tendencies rather than social phobia, with the latter being a preregistered hypothesis. This study adds to the literature by revealing several possible vulnerability factors associated with VC fatigue. In essence, the present work sheds light on the complex association between autistic traits and VC fatigue. We discuss the implications of our study as well as its limitations and potential avenues for future research.
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Pellicano E, Heyworth M. The Foundations of Autistic Flourishing. Curr Psychiatry Rep 2023; 25:419-427. [PMID: 37552401 PMCID: PMC10506917 DOI: 10.1007/s11920-023-01441-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE OF REVIEW All people-including Autistic people-deserve to live flourishing lives. But what does a flourishing life look like for Autistic people? We suggest that the hidden biases, methodological errors, and key assumptions of autism science have obscured answers to this question. Here, we seek to initiate a broader discussion about what the foundations for a good Autistic life might be and how this discussion might be framed. RECENT FINDINGS We identify five ways in which autism science can help us all to secure those foundations, including by (1) giving Autistic well-being prominence in research, (2) amplifying Autistic autonomy, (3) attending better to everyday experiences, (4) acknowledging context, and (5) working in partnership with Autistic people and their families and allies to ensure that they are at the heart of research decision-making. Such an approach would direct the focus of autism research to help shape good Autistic lives.
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Affiliation(s)
- Elizabeth Pellicano
- Department of Clinical, Educational and Health Psychology, University College London, 26 Bedford Way, London, WC1H 0DS, UK.
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, Australia.
| | - Melanie Heyworth
- Macquarie School of Education, Macquarie University, 29 Wally's Walk, Sydney, Australia
- Reframing Autism, Warners Bay, NSW, Australia
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104
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Chu L, Shen L, Ma C, Chen J, Tian Y, Zhang C, Gong Z, Li M, Wang C, Pan L, Zhu P, Wu D, Wang Y, Yu G. Effects of a Nonwearable Digital Therapeutic Intervention on Preschoolers With Autism Spectrum Disorder in China: Open-Label Randomized Controlled Trial. J Med Internet Res 2023; 25:e45836. [PMID: 37616029 PMCID: PMC10485722 DOI: 10.2196/45836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder that can cause difficulty with communication and social interactions as well as complicated family dynamics. Digital health interventions can reduce treatment costs and promote healthy lifestyle changes. These therapies can be adjunctive or replace traditional treatments. However, issues with cooperation and compliance prevent preschool patients with ASD from applying these tools. In this open-label, randomized controlled trial, we developed a nonwearable digital therapy called virtual reality-incorporated cognitive behavioral therapy (VR-CBT). OBJECTIVE The aim of this study was to assess the adjunctive function of VR-CBT by comparing the effects of VR-CBT plus learning style profile (LSP) intervention with those of LSP-only intervention in preschool children with ASD. METHODS This trial was performed in China on 78 preschool children (age 3-6 years, IQ>70) diagnosed with ASD who were randomized to receive a 20-week VR-CBT plus LSP intervention (intervention group, 39/78, 50%) or LSP intervention only (control group, 39/78, 50%). The primary outcome was the change of scores from baseline to week 20, assessed by using the parent-rated Autism Behavior Checklist (ABC). Secondary outcomes included the Childhood Autism Rating Scale (CARS), Attention-Deficit/Hyperactivity Disorder Rating Scale-IV (ADHD-RS-IV), and behavioral performance data (accuracy and reaction time) in go/no-go tasks. All primary and secondary outcomes were analyzed in the intention-to-treat population. RESULTS After the intervention, there was an intervention effect on total ABC (β=-5.528; P<.001) and CARS scores (β=-1.365; P=.02). A similar trend was observed in the ABC subscales: sensory (β=-1.133; P=.047), relating (β=-1.512; P=.03), body and object use (β=-1.211; P=.03), and social and self-help (β=-1.593; P=.03). The intervention also showed statistically significant effects in improving behavioral performance (go/no-go task, accuracy, β=2.923; P=.04). Moreover, a significant improvement of ADHD hyperactivity-impulsivity symptoms was observed in 53 children with comorbid ADHD based on ADHD-RS-IV (β=-1.269; P=.02). No statistically significant intervention effect was detected in the language subscale of ABC (β=-.080; P=.83). Intervention group girls had larger improvements in ABC subscales, that is, sensory and body and object use and in the CARS score and accuracy of go/no-go task (all P<.05) than the control group girls. Statistically significant intervention effects could be observed in hyperactivity-impulsivity symptoms in the intervention group boys with comorbid ADHD compared with those in the control group boys (β=-1.333; P=.03). CONCLUSIONS We found potentially positive effects of nonwearable digital therapy plus LSP on core symptoms associated with ASD, leading to a modest improvement in the function of sensory, motor, and response inhibition, while reducing impulsivity and hyperactivity in preschoolers with both ASD and ADHD. VR-CBT was found to be an effective and feasible adjunctive digital tool. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100053165; http://www.chictr.org.cn/showproj.aspx?proj=137016.
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Affiliation(s)
- Liting Chu
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Division of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Li Shen
- Clinical Research Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Chenhuan Ma
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jinjin Chen
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan Tian
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chuncao Zhang
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zilan Gong
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengfan Li
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chengjie Wang
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lizhu Pan
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peiying Zhu
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Danmai Wu
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Wang
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guangjun Yu
- Department of Child Health Care, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- School of Medicine, The Chinese University of Hong Kong, Shenzhen, China
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105
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Minor GN, Hannula DE, Gordon A, Ragland JD, Iosif AM, Solomon M. Relational memory weakness in autism despite the use of a controlled encoding task. Front Psychol 2023; 14:1210259. [PMID: 37691809 PMCID: PMC10484720 DOI: 10.3389/fpsyg.2023.1210259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Recent work challenged past findings that documented relational memory impairments in autism. Previous studies often relied solely on explicit behavioral responses to assess relational memory integrity, but successful performance on behavioral tasks may rely on other cognitive abilities (e.g., executive functioning) that are impacted in some autistic individuals. Eye-tracking tasks do not require explicit behavioral responses, and, further, eye movements provide an indirect measure of memory. The current study examined whether memory-specific viewing patterns toward scenes differ between autistic and non-autistic individuals. Methods Using a long-term memory paradigm that equated for complexity between item and relational memory tasks, participants studied a series of scenes. Following the initial study phase, scenes were re-presented, accompanied by an orienting question that directed participants to attend to either features of an item (i.e., in the item condition) or spatial relationships between items (i.e., in the relational condition) that might be subsequently modified during test. At test, participants viewed scenes that were unchanged (i.e., repeated from study), scenes that underwent an "item" modification (an exemplar switch) or a "relational" modification (a location switch), and scenes that had not been presented before. Eye movements were recorded throughout. Results During study, there were no significant group differences in viewing directed to regions of scenes that might be manipulated at test, suggesting comparable processing of scene details during encoding. However, there was a group difference in explicit recognition accuracy for scenes that underwent a relational change. Marginal group differences in the expression of memory-based viewing effects during test for relational scenes were consistent with this behavioral outcome, particularly when analyses were limited to scenes recognized correctly with high confidence. Group differences were also evident in correlational analyses that examined the association between study phase viewing and recognition accuracy and between performance on the Picture Sequence Memory Test and recognition accuracy. Discussion Together, our findings suggest differences in the integrity of relational memory representations and/or in the relationships between subcomponents of memory in autism.
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Affiliation(s)
- Greta N. Minor
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Deborah E. Hannula
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Andrew Gordon
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
| | - J. Daniel Ragland
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
| | - Ana-Maria Iosif
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
| | - Marjorie Solomon
- Department of Psychiatry & Behavioral Sciences, University of California, Davis, Davis, CA, United States
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Wilkinson E, Rinaldi ML, Christodulu KV. Predicting Self-Esteem and Depressive Symptoms from Social Skills Among Youth Referred for an Autism Evaluation. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01581-2. [PMID: 37608236 DOI: 10.1007/s10578-023-01581-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
Social skills are associated with depression and self-esteem in autistic youth. Minimal comparisons between youth and parent-reported social skills to clinically relevant samples limit existing studies. This study compared the relationships between parent and youth-reported social skills, self-esteem, and depressive symptoms between autistic youth and youth referred for but not given an autism diagnosis. Regression analyses of cross-sectional data revealed that youth-reported social skills statistically predicted self-esteem, parent-reported social skills statistically predicted depressive symptoms, and self-esteem statistically predicted depressive symptoms. All relationships were weaker in the autistic group, except parent-reported social skills and depressive symptoms, which was stronger. Results indicate that poor social skills are associated with mental health outcomes among youth referred for autism diagnosis, but that autism-related factors may influence these relationships. Implications for future research and clinical practice are discussed.
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Affiliation(s)
- Emma Wilkinson
- Center for Autism and Related Disabilities, University at Albany State University of New York, 1535 Western Avenue, Albany, NY, 12203, USA.
| | - Melissa L Rinaldi
- Center for Autism and Related Disabilities, University at Albany State University of New York, 1535 Western Avenue, Albany, NY, 12203, USA
| | - Kristin V Christodulu
- Center for Autism and Related Disabilities, University at Albany State University of New York, 1535 Western Avenue, Albany, NY, 12203, USA
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Möde L, Borgolte A, Ghaneirad E, Roy M, Sinke C, Szycik GR, Bleich S, Wiswede D. Cognitive control in adults with high-functioning autism spectrum disorder: a study with event-related potentials. Front Psychiatry 2023; 14:1180827. [PMID: 37599885 PMCID: PMC10436303 DOI: 10.3389/fpsyt.2023.1180827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Little is known about cognitive control in adults with high-functioning forms of autism spectrum disorder because previous research focused on children and adolescents. Cognitive control is crucial to monitor and readjust behavior after errors to select contextually appropriate reactions. The congruency effect and conflict adaptation are measures of cognitive control. Post-error slowing, error-related negativity and error positivity provide insight into behavioral and electrophysiological correlates of error processing. In children and adolescent with autism spectrum disorder deficits in cognitive control and error processing have been shown by changes in post-error slowing, error-related negativity and error positivity in the flanker task. Methods We performed a modified Eriksen flanker task in 17 adults with high-functioning autism spectrum disorder and 17 healthy controls. As behavioral measures of cognitive control and error processing, we included reaction times and error rates to calculate congruency effects, conflict adaptation, and post-error slowing. Event-related potentials namely error-related negativity and error positivity were measured to assess error-related brain activity. Results Both groups of participants showed the expected congruency effects demonstrated by faster and more accurate responses in congruent compared to incongruent trials. Healthy controls exhibited conflict adaptation as they obtained performance benefits after incongruent trials whereas patients with autism spectrum disorder did not. The expected slowing in reaction times after errors was observed in both groups of participants. Individuals with autism spectrum disorder demonstrated enhanced electrophysiological error-processing compared to healthy controls indicated by increased error-related negativity and error positivity difference amplitudes. Discussion Our findings show that adults with high-functioning autism spectrum disorder do not show the expected upregulation of cognitive control in response to conflicts. This finding implies that previous experiences may have a reduced influence on current behavior in these patients which possibly contributes to less flexible behavior. Nevertheless, we observed intact behavioral reactions after errors indicating that adults with high-functioning autism spectrum disorder can flexibly adjust behavior in response to changed environmental demands when necessary. The enhancement of electrophysiological error-processing indicates that adults with high-functioning autism spectrum disorder demonstrate an extraordinary reactivity toward errors reflecting increased performance monitoring in this subpopulation of autism spectrum disorder patients.
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Affiliation(s)
- Laura Möde
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Anna Borgolte
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Erfan Ghaneirad
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Mandy Roy
- Asklepios, Psychiatric Hospital Ochsenzoll, Hamburg, Germany
| | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Gregor R. Szycik
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
- Center of Systems Neuroscience, Hannover, Germany
| | - Daniel Wiswede
- Department of Neurology, University of Lübeck, Lübeck, Germany
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108
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Nicoli G, Pavon G, Grayson A, Emerson A, Mitra S. Touch may reduce cognitive load during assisted typing by individuals with developmental disabilities. Front Integr Neurosci 2023; 17:1181025. [PMID: 37600233 PMCID: PMC10434793 DOI: 10.3389/fnint.2023.1181025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/20/2023] [Indexed: 08/22/2023] Open
Abstract
Many techniques have attempted to provide physical support to ease the execution of a typing task by individuals with developmental disabilities (DD). These techniques have been controversial due to concerns that the support provider's touch can influence the typed content. The most common interpretation of assisted typing as an ideomotor phenomenon has been qualified recently by studies showing that users with DD make identifiable contributions to the process. This paper suggests a neurophysiological pathway by which touch could lower the cognitive load of seated typing by people with DD. The required sensorimotor processes (stabilizing posture and planning and executing manual reaching movements) and cognitive operations (generating and transcribing linguistic material) place concurrent demands on cognitive resources, particularly executive function (EF). A range of developmental disabilities are characterized by deficits in sensorimotor and EF capacity. As light touch has been shown to facilitate postural coordination, it is proposed that a facilitator's touch could assist the seated typist with sensorimotor and EF deficits by reducing their sensorimotor workload and thereby freeing up shared cognitive resources for the linguistic elements of the task. This is the first theoretical framework for understanding how a facilitator's touch may assist individuals with DD to contribute linguistic content during touch-assisted typing.
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Affiliation(s)
- Giovanni Nicoli
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Giulia Pavon
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Andrew Grayson
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
| | - Anne Emerson
- Faculty of Social Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Suvobrata Mitra
- School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
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109
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Davut G, Onur D, Hüseyin G. Autistic features and executive functions in first episode psychosis: Associations with functionality and quality of life. Early Interv Psychiatry 2023; 17:814-823. [PMID: 36653734 DOI: 10.1111/eip.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/15/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
AIM The present study aimed at investigating the relationships between autistic features and cognitive deficits, functionality and quality of life in first episode psychosis (FEP) patients. METHODS Sixty FEP patients [mean age (SD) = 32.53 (10.74), n = 23 female, n = 37 male] were enrolled in this cross-sectional study. Data was collected using a sociodemographic and clinical data form, the Positive and Negative Syndrome Scale (PANSS), the PANSS Autism Severity Score (PAUSS), the Personal and Social Performance Scale (PSP), the Frontal Assessment Battery (FAB), and the World Health Organization Quality of Life Scale Short Form in Turkish Version (WHOQOL-BREF TR). RESULTS Autistic symptom severity was found to be higher in males than females, and higher in patients with a family history of psychotic disorder. An inverse relationship was found between the duration of education and the severity of autistic symptoms. While there was an inverse relationship between autistic symptom severity and executive functions and functionality, no significant correlation was found with quality of life. Negative symptom severity was a predictor of executive functions and functionality. No significant difference was observed between autistic and psychotic domains which were related to executive functions. CONCLUSIONS Our study is the first to examine the relationship between autistic/psychotic symptoms and executive functions and functionality in patients with FEP. The results show that autistic symptoms are associated with worse social and personal functioning and worse executive functions in patients with FEP. Longitudinal follow-up studies with larger samples are required to determine the direction of the relations.
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Affiliation(s)
- Genç Davut
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Durmaz Onur
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Güleç Hüseyin
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
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Lupi E, Tucci F, Casula L, Novello RL, Guerrera S, Vicari S, Valeri G. Early and stable difficulties of everyday executive functions predict autism symptoms and emotional/behavioral problems in preschool age children with autism: a 2-year longitudinal study. Front Psychol 2023; 14:1092164. [PMID: 37583604 PMCID: PMC10425204 DOI: 10.3389/fpsyg.2023.1092164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/10/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Longitudinal studies of autistic children show that autism symptoms and emotional/behavioral problems vary and change over time. However, the factors that affect this variability remain far from certain and very little is known about what take place in the preschool period and the role of executive functions (EF). Methods Here, we test the influence of stable difficulties in everyday executive functioning (EEF) during early childhood across 2 years on autistic symptoms and emotional and behavioral problems. Twenty-nine autistic children (24 males and 5 females) were assessed twice within the space of 2 years. At baseline (M = 29 months, SD =5.6 months), participants were assessed for EEF, cognitive development, autistic symptoms, and emotional/behavioral problems. At follow-up, we repeated the same assessment except for cognitive development. Results The group with stable difficulties (across 2 years) in EEF during early childhood showed a worsening in the severity of autistic symptoms and emotional and behavioral problems compared with children without EEF difficulties (p < 0.05), and these effects cannot be attributable to cognitive development. Discussion Our results suggest that early and stable EEF plays the role of a modifier by interacting with the core domains of autism, in particular with the social affect domain (SA CSS), influencing social cognition and exacerbating or lessening symptom expression and emotional behavioral problems. These short-term longitudinal and preliminary findings underscore the importance of EEF as necessary target for early intervention in children with autism.
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Affiliation(s)
- Elisabetta Lupi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Federico Tucci
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Laura Casula
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Roberta Lucia Novello
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Silvia Guerrera
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giovanni Valeri
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Pavlov D, Gorlova A, Haque A, Cavalcante C, Svirin E, Burova A, Grigorieva E, Sheveleva E, Malin D, Efimochkina S, Proshin A, Umriukhin A, Morozov S, Strekalova T. Maternal Chronic Ultrasound Stress Provokes Immune Activation and Behavioral Deficits in the Offspring: A Mouse Model of Neurodevelopmental Pathology. Int J Mol Sci 2023; 24:11712. [PMID: 37511470 PMCID: PMC10380915 DOI: 10.3390/ijms241411712] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/09/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Neurodevelopmental disorders stemming from maternal immune activation can significantly affect a child's life. A major limitation in pre-clinical studies is the scarcity of valid animal models that accurately mimic these challenges. Among the available models, administration of lipopolysaccharide (LPS) to pregnant females is a widely used paradigm. Previous studies have reported that a model of 'emotional stress', involving chronic exposure of rodents to ultrasonic frequencies, induces neuroinflammation, aberrant neuroplasticity, and behavioral deficits. In this study, we explored whether this model is a suitable paradigm for maternal stress and promotes neurodevelopmental abnormalities in the offspring of stressed females. Pregnant dams were exposed to ultrasound stress for 21 days. A separate group was injected with LPS on embryonic days E11.5 and E12.5 to mimic prenatal infection. The behavior of the dams and their female offspring was assessed using the sucrose test, open field test, and elevated plus maze. Additionally, the three-chamber sociability test and Barnes maze were used in the offspring groups. ELISA and qPCR were used to examine pro-inflammatory changes in the blood and hippocampus of adult females. Ultrasound-exposed adult females developed a depressive-like syndrome, hippocampal overexpression of GSK-3β, IL-1β, and IL-6 and increased serum concentrations of IL-1β, IL-6, IL-17, RANTES, and TNFα. The female offspring also displayed depressive-like behavior, as well as cognitive deficits. These abnormalities were comparable to the behavioral changes induced by LPS. The ultrasound stress model can be a promising animal paradigm of neurodevelopmental pathology associated with prenatal 'emotional stress'.
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Affiliation(s)
- Dmitrii Pavlov
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Anna Gorlova
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Abrar Haque
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Carlos Cavalcante
- Department of Human Health and Science, MacEwan University, Edmonton, AB T5J 4S2, Canada
| | - Evgeniy Svirin
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Alisa Burova
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Elizaveta Grigorieva
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Elizaveta Sheveleva
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Dmitry Malin
- Laboratory of Psychiatric Neurobiology, Department of Normal Physiology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Sofia Efimochkina
- Laboratory of Psychiatric Neurobiology, Department of Normal Physiology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Andrey Proshin
- P.K. Anokhin Research Institute of Normal Physiology, 125315 Moscow, Russia
| | - Aleksei Umriukhin
- Laboratory of Psychiatric Neurobiology, Department of Normal Physiology, Institute of Molecular Medicine, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Sergey Morozov
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
| | - Tatyana Strekalova
- Laboratory of Cognitive Dysfunctions, Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, 125315 Moscow, Russia
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Wong OWH, Barzilay R, Lam AMW, Chan S, Calkins ME, Gur RE, Gur RC. Executive function as a generalized determinant of psychopathology and functional outcome in school-aged autism spectrum disorder: a case-control study. Psychol Med 2023; 53:4788-4798. [PMID: 35912846 PMCID: PMC10388326 DOI: 10.1017/s0033291722001787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) are challenged not only by the defining features of social-communication deficits and restricted repetitive behaviors, but also by a myriad of psychopathology varying in severity. Different cognitive deficits underpin these psychopathologies, which could be subjected to intervention to alter the course of the disorder. Understanding domain-specific mediating effects of cognition is essential for developing targeted intervention strategies. However, the high degree of inter-correlation among different cognitive functions hinders elucidation of individual effects. METHODS In the Philadelphia Neurodevelopmental Cohort, 218 individuals with ASD were matched with 872 non-ASD controls on sex, age, race, and socioeconomic status. Participants of this cohort were deeply and broadly phenotyped on neurocognitive abilities and dimensional psychopathology. Using structural equation modeling, inter-correlation among cognitive domains were adjusted before mediation analysis on outcomes of multi-domain psychopathology and functional level. RESULTS While social cognition, complex cognition, and memory each had a unique pattern of mediating effect on psychopathology domains in ASD, none had significant effects on the functional level. In contrast, executive function was the only cognitive domain that exerted a generalized negative impact on every psychopathology domain (p factor, anxious-misery, psychosis, fear, and externalizing), as well as functional level. CONCLUSIONS Executive function has a unique association with the severity of comorbid psychopathology in ASD, and could be a target of interventions. As executive dysfunction occurs variably in ASD, our result also supports the clinical utility of assessing executive function for prognostic purposes.
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Affiliation(s)
- Oscar W. H. Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Ran Barzilay
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Angela M. W. Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Sandra Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Monica E. Calkins
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Raquel E. Gur
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Ruben C. Gur
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
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113
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Corbett BA, White S, Lerner M, Preacher KJ, Klemencic ME, Simmons GL, Pilkington J, Gable P, Gioia A, Key AP. Peers, play, and performance to build social salience in autistic youth: A multisite randomized clinical trial. J Consult Clin Psychol 2023; 91:411-425. [PMID: 37199977 PMCID: PMC10330829 DOI: 10.1037/ccp0000821] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Individuals with autism spectrum disorder (ASD) have significant impairment in social competence and reduced social salience. SENSE Theatre, a peer-mediated, theater-based intervention has demonstrated posttreatment gains in face memory and social communication. The multisite randomized clinical trial compared the Experimental (EXP; SENSE Theatre) to an Active Control Condition (ACC; Tackling Teenage Training, TTT) at pretest, posttest, and follow-up. It was hypothesized that the EXP group would demonstrate greater incidental face memory (IFM) and better social behavior (interaction with novel peers) and social functioning (social engagement in daily life) than the ACC group, and posttest IFM would mediate the treatment effect on follow-up social behavior and functioning. METHOD Two hundred ninety participants were randomized to EXP (N = 144) or ACC (N = 146). Per protocol sample (≥ 7/10 sessions) resulted in 207 autistic children 10-16 years. Event-related potentials measured IFM. Naive examiners measured social behavior (Vocal Expressiveness, Quality of Rapport, Social Anxiety) and functioning (Social Communication). Structural equation modeling was used to assess treatment effects. RESULTS SENSE Theatre participants showed significantly better IFM (b = .874, p = .039) at posttest, and significant indirect effects on follow-up Vocal Expressiveness a × b = .064, with 90% CI [.014, .118] and Quality of Rapport a × b = .032, with 90% CI [.002, .087] through posttest IFM. CONCLUSIONS SENSE Theatre increases social salience as reflected by IFM, which in turn affected Vocal Expressiveness and Quality of Rapport. Results indicate that a neural mechanism supporting social cognition and driven by social salience is engaged by the treatment and has a generalized, indirect effect on clinically meaningful functional outcomes related to core symptoms of autism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Blythe A. Corbett
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center
- Vanderbilt University, Department of Psychology
| | - Susan White
- University of Alabama, Department of Psychology, Tuscaloosa
| | | | | | - Mark E. Klemencic
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | | | - Jennifer Pilkington
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
| | - Philip Gable
- University of Delaware, Department of Psychological and Brain Sciences
| | - Ayla Gioia
- Stony Brook University, Department of Psychology
| | - Alexandra P. Key
- Vanderbilt University Medical Center, Department of Psychiatry and Behavioral Sciences
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center
- Vanderbilt University Medical Center, Department of Hearing and Speech Sciences
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114
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Vegni N, D'Ardia C, Di Filippo G, Melchiori FM. The impact of Lego® Therapy on cognitive skills in Autism Spectrum Disorders: a brief discussion. AIMS Neurosci 2023; 10:190-199. [PMID: 37426776 PMCID: PMC10323259 DOI: 10.3934/neuroscience.2023016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/14/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023] Open
Abstract
Over the years, several interventions have been implemented, including Lego® Therapy, with the aim of supporting and implementing social and communication skills impairments in Autism Spectrum Disorders (ASD). Although recent studies have shown that the ability to learn implicitly is preserved in ASDs, no study related to Lego® Therapy has analyzed whether and how this training can also affect aspects not directly treated. In this study, we report a first attempt of assessment of Lego® Therapy's effect on the specific area of cognitive skills in an ASD child. Over a period of 12 months, a child with ASD had weekly meetings with an expert operator of Lego® aiming to improve the child's ability to communicate, reduce impulsiveness and hyper verbalism, and encourage pro-social behavior. The intervention resulted in positive outcomes that were assessed after 12 months.
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115
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Sadigurschi N, Scrift G, Hirrlinger J, Golan HM. Genetic impairment of folate metabolism regulates cortical interneurons and social behavior. Front Neurosci 2023; 17:1203262. [PMID: 37449270 PMCID: PMC10338116 DOI: 10.3389/fnins.2023.1203262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction The implications of folate deficiency in neuropsychiatric disorders were demonstrated in numerous studies. Genetic deficiency in a key folate metabolism enzyme, MTHFR, is an example of the interaction between genetic and environmental risk factors: the maternal MTHFR deficiency governs in-utero nutrient availability, and the embryo's Mthfr genotype influences its ability to metabolize folates. Here, we explore how the maternal and offspring Mthfr genotypes affect cortical interneuron densities and distributions, mouse social outcome, and the relation of the different interneuron patterns to cortical excitability. Methods Two experiments were conducted to examine the effects of maternal and offspring Mthfr-KO heterozygosity. Mice were tested for direct social interactions (DSIs), repetitive behavior and cortical laminar distribution of interneuron populations expressing glutamate-decarboxylase-65, parvalbumin and somatostatin. Susceptibility to seizure was tested by exposure to pentylenetetrazole (PTZ). Results Maternal Mthfr+/- genotype was associated with suppressed social activities and reduced interneuron densities in all layers of the retrosplenial cortex (RSC). Somatostatin density and the somatostatin/parvalbumin ratio in the RSC and frontal cortex positively correlated with social behavior in the mice. An interaction between maternal and offspring Mthfr genotypes resulted in higher susceptibility of wild-type offspring to PTZ induced seizure. Discussion Maternal folate metabolism was shown to be critical to interneuron ontogenesis. Our results demonstrate that interneurons have a specific susceptibility to folate deficiency that may mediate folate's involvement in neuropsychiatric disease. The relations between cortical somatostatin interneuron patterns and social behavior highlight this subpopulation of interneurons as a target for further research.
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Affiliation(s)
- Noa Sadigurschi
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Gilad Scrift
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Johannes Hirrlinger
- Carl-Ludwig-Institute for Physiology, University of Leipzig, Leipzig, Germany
- Department of Neurogenetics, Max-Planck-Institute for Multidisciplinary Sciences, Göttingen, Germany
| | - Hava M. Golan
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- Azrieli National Center for Autism and Neurodevelopment Research, Ben-Gurion University of the Negev, Beer Sheva, Israel
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116
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Cundari M, Vestberg S, Gustafsson P, Gorcenco S, Rasmussen A. Neurocognitive and cerebellar function in ADHD, autism and spinocerebellar ataxia. Front Syst Neurosci 2023; 17:1168666. [PMID: 37415926 PMCID: PMC10321758 DOI: 10.3389/fnsys.2023.1168666] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
The cerebellum plays a major role in balance, motor control and sensorimotor integration, but also in cognition, language, and emotional regulation. Several neuropsychiatric disorders such as attention deficit-hyperactivity disorder (ADHD), autism spectrum disorder (ASD), as well as neurological diseases such as spinocerebellar ataxia type 3 (SCA3) are associated with differences in cerebellar function. Morphological abnormalities in different cerebellar subregions produce distinct behavioral symptoms related to the functional disruption of specific cerebro-cerebellar circuits. The specific contribution of the cerebellum to typical development may therefore involve the optimization of the structure and function of cerebro-cerebellar circuits underlying skill acquisition in multiple domains. Here, we review cerebellar structural and functional differences between healthy and patients with ADHD, ASD, and SCA3, and explore how disruption of cerebellar networks affects the neurocognitive functions in these conditions. We discuss how cerebellar computations contribute to performance on cognitive and motor tasks and how cerebellar signals are interfaced with signals from other brain regions during normal and dysfunctional behavior. We conclude that the cerebellum plays a role in many cognitive functions. Still, more clinical studies with the support of neuroimaging are needed to clarify the cerebellum's role in normal and dysfunctional behavior and cognitive functioning.
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Affiliation(s)
- Maurizio Cundari
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
- Unit of Neuropsychiatry, Hospital of Helsingborg, Helsingborg, Sweden
- Unit of Neurology, Hospital of Helsingborg, Helsingborg, Sweden
| | - Susanna Vestberg
- Department of Psychology, Faculty of Social Science, Lund University, Lund, Sweden
| | - Peik Gustafsson
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Medical Faculty, Lund University, Lund, Sweden
| | - Sorina Gorcenco
- Department for Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Anders Rasmussen
- Department of Experimental Medical Science, Faculty of Medicine, Lund University, Lund, Sweden
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117
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Justus SA, Mirjalili S, Powell PS, Duarte A. Neural reinstatement of context memory in adults with autism spectrum disorder. Cereb Cortex 2023; 33:8546-8556. [PMID: 37106572 PMCID: PMC10321090 DOI: 10.1093/cercor/bhad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is associated with episodic memory impairment. However, episodic memories include a variety of contextual details, and it is difficult to solely rely on behavioral data to assess how specifically (i.e. event-specific reinstatement) an event is remembered. We applied encoding-retrieval representational similarity (ERS) analysis to EEG data to assess event-specific ERS for object-context associations in a sample of 34 adults (17 with, 17 without ASD). Participants studied objects presented alongside 2 contextual features: scene/color, and attention was directed toward one object-context relationship. At retrieval, memory was assessed for the object and both contexts. Behavioral results revealed no group differences in item or context memory performance. ERS results revealed group temporal differences in reinstatement. Results may indicate differences in both encoding (i.e. fewer perceptual details) and retrieval (i.e. ineffectively skipping through memory fragments) in ASD and should be further investigated in studies modulating the perceptual detail required for memory decisions. Results highlight the utility of ERS as a methodology used to evaluate episodic reinstatement even in the absence of behavioral differences in memory performance.
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Affiliation(s)
- Sidni A Justus
- Department of Psychological Science, Kennesaw State University, 402 Bartow Ave NW, Kennesaw, GA 30144, United States
| | - Soroush Mirjalili
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, United States
| | - Patrick S Powell
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta GA 30333, United States
| | - Audrey Duarte
- Department of Psychology, University of Texas at Austin, 108 E Dean Keeton St, Austin, TX 78712, United States
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118
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Hellings J. Pharmacotherapy in autism spectrum disorders, including promising older drugs warranting trials. World J Psychiatry 2023; 13:262-277. [PMID: 37383284 PMCID: PMC10294139 DOI: 10.5498/wjp.v13.i6.262] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/06/2023] [Accepted: 04/18/2023] [Indexed: 06/19/2023] Open
Abstract
Available pharmacotherapies for autism spectrum disorders (ASD) are reviewed based on clinical and research experience, highlighting some older drugs with emerging evidence. Several medications show efficacy in ASD, though controlled studies in ASD are largely lacking. Only risperidone and aripiprazole have Federal Drug Administration approval in the United States. Methylphenidate (MPH) studies showed lower efficacy and tolerability for attention deficit hyperactivity disorder (ADHD) than in the typically developing (TD) population; atomoxetine demonstrated lower efficacy but comparable tolerability to TD outcomes. Guanfacine improved hyperactivity in ASD comparably to TD. Dex-troamphetamine promises greater efficacy than MPH in ASD. ADHD medications reduce impulsive aggression in youth, and may also be key for this in adults. Controlled trials of the selective serotonin reuptake inhibitors citalopram and fluoxetine demonstrated poor tolerability and lack of efficacy for repetitive behaviors. Trials of antiseizure medications in ASD remain inconclusive, however clinical trials may be warranted in severely disabled individuals showing bizarre behaviors. No identified drugs treat ASD core symptoms; oxytocin lacked efficacy. Amitriptyline and loxapine however, show promise. Loxapine at 5-10 mg daily resembled an atypical antipsychotic in positron emission tomography studies, but may be weight-sparing. Amitriptyline at approximately 1 mg/ kg/day used cautiously, shows efficacy for sleep, anxiety, impulsivity and ADHD, repetitive behaviors, and enuresis. Both drugs have promising neurotrophic properties.
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Affiliation(s)
- Jessica Hellings
- Department of Psychiatry, University of Missouri-Kansas City, Lee's Summit, MO 64063, United States
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119
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Tonizzi I, Usai MC. Math abilities in autism spectrum disorder: A meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104559. [PMID: 37329855 DOI: 10.1016/j.ridd.2023.104559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/10/2023] [Accepted: 06/11/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Studies focusing on math abilities in autism spectrum disorder (ASD) are limited and often provide inconsistent results. AIM This meta-analysis was conducted to investigate math abilities in people with autism spectrum disorder (ASD) compared to typically developing (TD) participants. METHODS AND PROCEDURES According with PRISMA guidelines, a systematic search strategy was adopted. First, 4405 records were identified through database searching; then, the title-abstract screening led to the identification of 58 potentially relevant studies and, finally, after the full-text screening, 13 studies were included. OUTCOMES AND RESULTS Results shows that the group with ASD (n = 533) performed lower than the TD group (n = 525) with a small-to-medium effect (g=0.49). The effect size was not moderated by task-related characteristics. Instead, sample-related characteristics, specifically age, verbal intellectual functioning, and working memory, were significant moderators. CONCLUSIONS AND IMPLICATIONS This meta-analysis shows that people with ASD have poorer math skills than their TD peers, suggesting the importance of investigating math abilities in autism, taking into account the role of moderating variables.
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Affiliation(s)
- Irene Tonizzi
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy
| | - Maria Carmen Usai
- Department of Educational Sciences, University of Genoa, Corso Podestà 2, 16128 Genoa, Italy.
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120
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Yankovitz BE, Kasirer A, Mashal N. The Relationship between Semantic Joke and Idiom Comprehension in Adolescents with Autism Spectrum Disorder. Brain Sci 2023; 13:935. [PMID: 37371412 DOI: 10.3390/brainsci13060935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/30/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Semantic jokes involve resolving an incongruity emerging from wordplay or from a violation of world knowledge. The research has shown individuals with autism spectrum disorder (ASD) demonstrate a lower performance on humor tasks involving social situations; however, less is known about their semantic joke comprehension. This study examines semantic joke comprehension among adolescents with ASD and its possible relationship to vocabulary size, theory of mind (ToM), and idiom comprehension. Thirty-two adolescents with ASD and 32 typically developed (TD) peers participated. Semantic joke comprehension was assessed via a multiple-choice questionnaire and time-limited computer program. Vocabulary, ToM abilities, and idiom comprehension were also tested. The results reveal that adolescents with ASD are as fast in processing semantic jokes as their age- and vocabulary-matched TD peers, but less accurate. Age and idiom comprehension significantly contributed to semantic joke comprehension among both groups. As semantic joke comprehension is based on incongruity resolution, the greater difficulties in comprehension among the adolescents with ASD may have been due to deficits in simultaneously retaining two alternative interpretations and selecting the relevant one (and not due reduced ToM abilities). Similar to the TD group, semantic joke comprehension among the ASD group appeared to be more developed with age.
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Affiliation(s)
- Bat-El Yankovitz
- The Faculty of Education, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Anat Kasirer
- Levinsky-Wingate Academic Center, Tel-Aviv 61480, Israel
| | - Nira Mashal
- The Faculty of Education, Bar-Ilan University, Ramat Gan 5290002, Israel
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121
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de Maat DA, Van der Hallen R, de Nijs PFA, Visser K, Bastiaansen D, Truijens FL, van Rijen EHM, Ester W, Prinzie P, Jansen PW, Dekker LP. Children with Autism Spectrum Disorder in Times of COVID-19: Examining Emotional and Behavioral Problems, Parental Well-Being, and Resilience. J Autism Dev Disord 2023:10.1007/s10803-022-05846-y. [PMID: 37213037 PMCID: PMC10201036 DOI: 10.1007/s10803-022-05846-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 05/23/2023]
Abstract
This longitudinal study assessed the impact of the COVID-19 pandemic on children with autism spectrum disorder (ASD; n = 62; Mage = 13 years) by measuring emotional and behavioral problems before and during the pandemic, and by comparing this change to a matched sample of children without ASD (n = 213; Mage = 16 years). Moreover, we examined whether indicators of parental well-being promoted resilience of children with ASD. Results showed that the mean change in problems did not differ between children with and without ASD. Importantly, some children showed an increase in problems, while others showed resilience. Parental well-being indicators were not related to resilience among children with ASD. The interindividual variability in responses, particularly among children with ASD, highlights the need for personalized support.
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Affiliation(s)
- Donna A de Maat
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands.
- The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - Ruth Van der Hallen
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Pieter F A de Nijs
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kirsten Visser
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Sarr Autism Rotterdam, Youz Child and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands
| | - Dennis Bastiaansen
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Yulius Center for Child and Adolescent Psychiatry, Dordrecht, The Netherlands
| | - Femke L Truijens
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Elisabeth H M van Rijen
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
| | - Wietske Ester
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
- Sarr Autism Rotterdam, Youz Child and Adolescent Psychiatry, Parnassia Group, Rotterdam, The Netherlands
- Child and Adolescent Psychiatry, Curium-LUMC, Oegstgeest, The Netherlands
- Parnassia Bavo Group, Parnassia Bavo Academy, The Hague, The Netherlands
| | - Peter Prinzie
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands
| | - Pauline W Jansen
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands
- The Generation R Study Group, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Linda P Dekker
- Department of Psychology, Education, and Child Studies, Erasmus University Rotterdam, Burgemeester Oudlaan 50, Rotterdam, 3000 DR, The Netherlands
- Rotterdam Autism Consortium (R.A.C.), Rotterdam, The Netherlands
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O’Hora KP, Kushan-Wells L, Hoftman GD, Jalbrzikowski M, Gur RC, Gur R, Bearden CE. Distinct Neurocognitive Profiles and Clinical Phenotypes Associated with Copy Number Variation at the 22q11.2 Locus. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.12.23289905. [PMID: 37292882 PMCID: PMC10246073 DOI: 10.1101/2023.05.12.23289905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Rare genetic variants that confer large effects on neurodevelopment and behavioral phenotypes can reveal novel gene-brain-behavior relationships relevant to autism. Copy number variation at the 22q11.2 locus offer one compelling example, as both the 22q11.2 deletion (22qDel) and duplication (22qDup) confer increased likelihood of autism spectrum disorders (ASD) and cognitive deficits, but only 22qDel confers increased psychosis risk. Here, we used the Penn Computerized Neurocognitive Battery (Penn-CNB) to characterized neurocognitive profiles of 126 individuals: 55 22qDel carriers (MAge=19.2 years, 49.1% male), 30 22qDup carriers (MAge=17.3 years, 53.3 % male), and 41 typically developing (TD) subjects (MAge=17.3 years, 39.0 % male). We performed linear mixed models to assess group differences in overall neurocognitive profiles, domain scores, and individual test scores. We found all three groups exhibited distinct overall neurocognitive profiles. 22qDel and 22qDup carriers showed significant accuracy deficits across all domains relative to controls (Episodic Memory, Executive Function, Complex Cognition, Social Cognition, and Sensorimotor Speed), with 22qDel carriers exhibiting more severe accuracy deficits, particularly in Episodic Memory. However, 22qDup carriers generally showed greater slowing than 22qDel carriers. Notably, slower social cognition speed was uniquely associated with increased global psychopathology and poorer psychosocial functioning in 22qDup. Compared to TD, 22q11.2 CNV carriers failed to show age-associated improvements in multiple cognitive domains. Exploratory analyses revealed 22q11.2 CNV carriers with ASD exhibited differential neurocognitive profiles, based on 22q11.2 copy number. These results suggest that there are distinct neurocognitive profiles associated with either a loss or gain of genomic material at the 22q11.2 locus.
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Affiliation(s)
- Kathleen P. O’Hora
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Neuroscience Interdepartmental Program, University of California, Los Angeles, CA, USA
| | - Leila Kushan-Wells
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Gil D. Hoftman
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children’s Hospital, Boston, MA, USA
| | - Raquel C. Gur
- Department of Psychiatry, University of Pennsylvania and the Penn-CHOP Lifespan and Brain Institute, Philadelphia, PA, USA
| | - Ruben Gur
- Department of Psychiatry, University of Pennsylvania and the Penn-CHOP Lifespan and Brain Institute, Philadelphia, PA, USA
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Psychology, University of California, Los Angeles, CA, USA
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123
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Kiep M, Spek A, Ceulemans E, Noens I. Sensory Processing and Executive Functioning in Autistic Adults. J Autism Dev Disord 2023:10.1007/s10803-023-06008-4. [PMID: 37171766 DOI: 10.1007/s10803-023-06008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE One of the core features that can be experienced by adults on the autism spectrum is hyper- and hyporeactivity to sensory stimuli. Research suggests that executive functioning (EF) impairments are related to sensory issues. In this study the relationship between sensory processing issues and EF was investigated. We expected sensory processing issues to predict EF impairments. METHODS Thirty men and 30 women on the autism spectrum, 20 men and 24 women without autism were included and matched on intelligence and age. Group comparisons were conducted to determine if groups differed regarding self-reported sensory processing issues (GSQ-NL) and self-reports on EF (BRIEF-A). Correlational and regression analyses were carried out to investigate the relationship between self-reports on GSQ-NL and BRIEF-A. RESULTS We found significant differences between men and women on the spectrum with regard to sensory processing issues and EF. Hyporeactivity to sensory information explained most of the EF problems. CONCLUSION Clinicians should be aware of differences in sensory experiences between adults on the spectrum and non-autistic adults and differences between men and women during assessment and subsequent counselling.
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Affiliation(s)
- Michelle Kiep
- Autisme Expertise Centrum, Eemnes, Netherlands.
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium.
- Leuven Autism Research, KU Leuven, Leuven, Belgium.
| | | | - Eva Ceulemans
- Quantative Psychology and Inaffiliationidual Differences, KU Leuven, Leuven, Belgium
| | - Ilse Noens
- Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
- Leuven Autism Research, KU Leuven, Leuven, Belgium
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Fossum IN, Orm S, Andersen PN, Geurts HM, Øie MG, Skogli EW. Childhood Executive Function Predicts Internalizing and Externalizing Symptoms in Emerging Adults With and Without Autism: A 10-Year Longitudinal Study. Dev Neuropsychol 2023; 48:97-111. [PMID: 37154789 DOI: 10.1080/87565641.2023.2206663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Individuals with autism spectrum disorder (ASD) and typically developing individuals were assessed on three neuropsychological tests of executive function (EF) and on scales of autism symptoms and co-occurring internalizing and externalizing symptoms at baseline (T1; N = 88, Mage = 11.8 years, 73% males), 2-year (T2; 99% retention, Mage = 13.9 years), and 10-year follow-ups (T3; 75% retention, Mage = 21.4 years). An EF composite score from T1 significantly predicted internalizing symptoms at T2 (β = .228) and internalizing and externalizing symptoms at T3 (β = .431 and .478, respectively), when controlling for age and autism symptoms. OThe findings suggest that EF difficulties are a long-term risk factor for more co-occurring symptoms. .
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Affiliation(s)
- Ingrid Nesdal Fossum
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Stian Orm
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Per Normann Andersen
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Hilde M Geurts
- Division of Brain & Cognition, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Brumunddal, Norway
| | - Erik Winther Skogli
- Division Mental Health Care, Innlandet Hospital Trust, Brumunddal, Norway
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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125
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St. John T, Estes AM, Hazlett HC, Marrus N, Burrows CA, Donovan K, Torres Gomez S, Grzadzinski RL, Parish-Morris J, Smith R, Styner M, Garic D, Pandey J, Lee CM, Schultz RT, Botteron KN, Zwaigenbaum L, Piven J, Dager SR. Association of Sex With Neurobehavioral Markers of Executive Function in 2-Year-Olds at High and Low Likelihood of Autism. JAMA Netw Open 2023; 6:e2311543. [PMID: 37140923 PMCID: PMC10160873 DOI: 10.1001/jamanetworkopen.2023.11543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/19/2023] [Indexed: 05/05/2023] Open
Abstract
Importance Children with autism and their siblings exhibit executive function (EF) deficits early in development, but associations between EF and biological sex or early brain alterations in this population are largely unexplored. Objective To investigate the interaction of sex, autism likelihood group, and structural magnetic resonance imaging alterations on EF in 2-year-old children at high familial likelihood (HL) and low familial likelihood (LL) of autism, based on having an older sibling with autism or no family history of autism in first-degree relatives. Design, Setting, and Participants This prospective cohort study assessed 165 toddlers at HL (n = 110) and LL (n = 55) of autism at 4 university-based research centers. Data were collected from January 1, 2007, to December 31, 2013, and analyzed between August 2021 and June 2022 as part of the Infant Brain Imaging Study. Main Outcomes and Measures Direct assessments of EF and acquired structural magnetic resonance imaging were performed to determine frontal lobe, parietal lobe, and total cerebral brain volume. Results A total of 165 toddlers (mean [SD] age, 24.61 [0.95] months; 90 [54%] male, 137 [83%] White) at HL for autism (n = 110; 17 diagnosed with ASD) and LL for autism (n = 55) were studied. The toddlers at HL for autism scored lower than the toddlers at LL for autism on EF tests regardless of sex (mean [SE] B = -8.77 [4.21]; 95% CI, -17.09 to -0.45; η2p = 0.03). With the exclusion of toddlers with autism, no group (HL vs LL) difference in EF was found in boys (mean [SE] difference, -7.18 [4.26]; 95% CI, 1.24-15.59), but EF was lower in HL girls than LL girls (mean [SE] difference, -9.75 [4.34]; 95% CI, -18.32 to -1.18). Brain-behavior associations were examined, controlling for overall cerebral volume and developmental level. Sex differences in EF-frontal (B [SE] = 16.51 [7.43]; 95% CI, 1.36-31.67; η2p = 0.14) and EF-parietal (B [SE] = 17.68 [6.99]; 95% CI, 3.43-31.94; η2p = 0.17) associations were found in the LL group but not the HL group (EF-frontal: B [SE] = -1.36 [3.87]; 95% CI, -9.07 to 6.35; η2p = 0.00; EF-parietal: B [SE] = -2.81 [4.09]; 95% CI, -10.96 to 5.34; η2p = 0.01). Autism likelihood group differences in EF-frontal (B [SE] = -9.93 [4.88]; 95% CI, -19.73 to -0.12; η2p = 0.08) and EF-parietal (B [SE] = -15.44 [5.18]; 95% CI, -25.86 to -5.02; η2p = 0.16) associations were found in girls not boys (EF-frontal: B [SE] = 6.51 [5.88]; 95% CI, -5.26 to 18.27; η2p = 0.02; EF-parietal: B [SE] = 4.18 [5.48]; 95% CI, -6.78 to 15.15; η2p = 0.01). Conclusions and Relevance This cohort study of toddlers at HL and LL of autism suggests that there is an association between sex and EF and that brain-behavior associations in EF may be altered in children at HL of autism. Furthermore, EF deficits may aggregate in families, particularly in girls.
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Affiliation(s)
- Tanya St. John
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Annette M. Estes
- Department of Speech and Hearing Science, University of Washington, Seattle
- University of Washington Autism Center, University of Washington, Seattle
| | - Heather C. Hazlett
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine in St Louis, Missouri
| | | | - Kevin Donovan
- Department of Biostatistics, University of Pennsylvania, Philadelphia
| | - Santiago Torres Gomez
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Rebecca L. Grzadzinski
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Julia Parish-Morris
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Rachel Smith
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
| | - Martin Styner
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Dea Garic
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Juhi Pandey
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Chimei M. Lee
- Department of Pediatrics, University of Minnesota, Minneapolis
| | - Robert T. Schultz
- Center for Autism Research, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine in St Louis, Missouri
| | - Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Joseph Piven
- Carolina Institute for Developmental Disabilities, Carrboro, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill
| | - Stephen R. Dager
- Department of Radiology, University of Washington Medical Center, Seattle
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Nicholls LAB, Stewart ME. Autistic traits are associated with enhanced working memory capacity for abstract visual stimuli. Acta Psychol (Amst) 2023; 236:103905. [PMID: 37086664 DOI: 10.1016/j.actpsy.2023.103905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 03/03/2023] [Accepted: 04/10/2023] [Indexed: 04/24/2023] Open
Abstract
We tested whether the association between autistic traits and enhanced performance in visual-perceptual tasks extends to visual working memory capacity. We predicted that any positive effect of autistic traits on visual working memory performance would be greatest during domain-specific tasks, in which visual resources must be relied upon. We used a visual 'matrix' task, involving recall of black-and-white chequered patterns which increased in size, to establish participants' capacity (span). We assessed 144 young adults' (M = 22.0 years, SD = 2.5) performance on abstract, 'low semantic' versus 'high semantic' task versions. The latter offered multimodal coding due to the availability of long-term memory resources that could supplement visual working memory. Participants also completed measures of autistic traits and trait anxiety. Autistic traits, especially Attention to Detail, Attention Switching, and Communication, positively predicted visual working memory capacity, specifically in the low semantic task, which relies on visual working memory resources. Autistic traits are therefore associated with enhanced processing and recall of visual information. The benefit is removed, however, when multimodal coding may be incorporated, emphasising the visual nature of the benefit. Strengths in focused attention to detail therefore appear to benefit domain-specific visual working memory task performance.
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Affiliation(s)
- Louise A Brown Nicholls
- School of Psychological Sciences & Health, University of Strathclyde, 40 George Street, Glasgow, G1 1QE, UK.
| | - Mary E Stewart
- Centre for Applied Behavioural Sciences, Department of Psychology, School of Social Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
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Kourtesis P, Kouklari EC, Roussos P, Mantas V, Papanikolaou K, Skaloumbakas C, Pehlivanidis A. Virtual Reality Training of Social Skills in Adults with Autism Spectrum Disorder: An Examination of Acceptability, Usability, User Experience, Social Skills, and Executive Functions. Behav Sci (Basel) 2023; 13:bs13040336. [PMID: 37102850 PMCID: PMC10136366 DOI: 10.3390/bs13040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/14/2023] [Accepted: 04/15/2023] [Indexed: 04/28/2023] Open
Abstract
Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations similar to those in real life; however, more research is needed to elucidate aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, which incorporated five social scenarios with three difficulty levels. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports, and executive functions. Working memory and planning ability were significant predictors of the functionality level in ASD and the VR system's perceived usability, respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level. Planning ability substantially predicted performance in social scenarios, suggesting an implication in social skills. Immersive VR social skills training in individuals with ASD appears to be an appropriate service, but an errorless approach that is adaptive to the individual's needs should be preferred.
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Affiliation(s)
- Panagiotis Kourtesis
- Department of Psychology, National and Kapodistrian University of Athens, 157 84 Athens, Greece
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9AD, UK
| | - Evangelia-Chrysanthi Kouklari
- Department of Child Psychiatry, Aghia Sophia Children's Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
- 1st Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Petros Roussos
- Department of Psychology, National and Kapodistrian University of Athens, 157 84 Athens, Greece
| | - Vasileios Mantas
- 1st Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Katerina Papanikolaou
- Department of Child Psychiatry, Aghia Sophia Children's Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Christos Skaloumbakas
- Department of Child Psychiatry, P. & A. Kyriakou Children's Hospital, 115 28 Athens, Greece
- Habilis, R&D Team, 141 22 Athens, Greece
| | - Artemios Pehlivanidis
- 1st Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
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128
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Massera A, Bonaiuto JJ, Gautier-Martins M, Costa S, Rayson H, Ferrari PF. Longitudinal effects of early psychosocial deprivation on macaque executive function: Evidence from computational modelling. Proc Biol Sci 2023; 290:20221993. [PMID: 37040804 PMCID: PMC10089718 DOI: 10.1098/rspb.2022.1993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/06/2023] [Indexed: 04/13/2023] Open
Abstract
Executive function (EF) describes a group of cognitive processes underlying the organization and control of goal-directed behaviour. Environmental experience appears to play a crucial role in EF development, with early psychosocial deprivation often linked to EF impairment. However, many questions remain concerning the developmental trajectories of EF after exposure to deprivation, especially concerning specific mechanisms. Accordingly, using an 'A-not-B' paradigm and a macaque model of early psychosocial deprivation, we investigated how early deprivation influences EF development longitudinally from adolescence into early adulthood. The contribution of working memory and inhibitory control mechanisms were examined specifically via the fitting of a computational model of decision making to the choice behaviour of each individual. As predicted, peer-reared animals (i.e. those exposed to early psychosocial deprivation) performed worse than mother-reared animals across time, with the fitted model parameters yielding novel insights into the functional decomposition of group-level EF differences underlying task performance. Results indicated differential trajectories of inhibitory control and working memory development in the two groups. Such findings not only extend our knowledge of how early deprivation influences EF longitudinally, but also provide support for the utility of computational modelling to elucidate specific mechanisms linking early psychosocial deprivation to long-term poor outcomes.
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Affiliation(s)
- Alice Massera
- Institut des Sciences Cognitives – Marc Jeannerod, CNRS UMR5229, Bron 69500, France
- Université Claude Bernard Lyon 1, Université de Lyon, 69100, France
| | - James J. Bonaiuto
- Institut des Sciences Cognitives – Marc Jeannerod, CNRS UMR5229, Bron 69500, France
- Université Claude Bernard Lyon 1, Université de Lyon, 69100, France
| | - Marine Gautier-Martins
- Institut des Sciences Cognitives – Marc Jeannerod, CNRS UMR5229, Bron 69500, France
- Université Claude Bernard Lyon 1, Université de Lyon, 69100, France
| | - Sara Costa
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma 43125, Italy
| | - Holly Rayson
- Institut des Sciences Cognitives – Marc Jeannerod, CNRS UMR5229, Bron 69500, France
- Université Claude Bernard Lyon 1, Université de Lyon, 69100, France
| | - Pier Francesco Ferrari
- Institut des Sciences Cognitives – Marc Jeannerod, CNRS UMR5229, Bron 69500, France
- Université Claude Bernard Lyon 1, Université de Lyon, 69100, France
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma 43125, Italy
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129
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Kim JH, Song DY, Han HS, Yoon NH, Cho HB, Lee HB, Choi KH, Chae PK, Bong G, Ahn S, Yoo HJ. Improving adaptive behaviors for autistic adults without intellectual disability through executive function training. Asian J Psychiatr 2023; 84:103579. [PMID: 37043906 DOI: 10.1016/j.ajp.2023.103579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
Executive functioning (EF) is a cognitive process used to perform various daily activities throughout one's lifespan. Autistic adults without intellectual disabilities (ID) also experience difficulties with EF, which is closely associated with adaptive behaviors. For this reason, it is important to improve adaptive behaviors through enhanced use of EF for autistic adults to transition into adulthood successfully. This study aims to conduct a randomized controlled trial to evaluate the effectiveness of a newly developed and modified intervention program. Thirty autistic adults without ID were randomly assigned to the treatment or waitlist group. The participants and caregivers completed various assessments and self-report questionnaires to measure everyday EF and adaptive behaviors. We performed linear mixed-effect modeling to compare the two groups. Data collected at pre-, middle, post-, and follow-up based on participants who completed the program were used to explore changes across time. While there were significant differences in the EF utility-scale (F=5.46, p = .027) between the treatment and waitlist groups, no group x time interactions were detected in other measures. Everyday EF and adaptive behaviors improved when comparing measurements at different time points (p < .001). Our program is Korea's first evidence-based intervention to improve everyday EF and adaptive behaviors for autistic adults without ID.
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Affiliation(s)
- Joo Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea
| | - Da-Yea Song
- Department of Psychiatry, Seoul National University College of Medicine, South Korea
| | - Hye Sun Han
- Department of Neurology, Samsung Medical Center, South Korea
| | - Nan-He Yoon
- Division of Social Welfare & Health Administration, Wonkwang University, South Korea
| | - Hwi Bin Cho
- Department of Psychiatry, Konkuk University Medical Center, South Korea
| | - Han Bit Lee
- Center for Campus Life & Culture, Seoul National University, South Korea
| | - Kyung Hee Choi
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea
| | | | - Guiyoung Bong
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea
| | - Soyeon Ahn
- Division of Statistics, Medical Research Collaborating Center, Seoul National Unversity Bundang Hospital, South Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea; Department of Psychiatry, Seoul National University College of Medicine, South Korea.
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130
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Pirinen V, Loukusa S, Dindar K, Mäkinen L, Hurtig T, Jussila K, Mattila ML, Eggers K. A Comprehensive Analysis of Speech Disfluencies in Autistic Young Adults and Control Young Adults: Group Differences in Typical, Stuttering-Like, and Atypical Disfluencies. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:832-848. [PMID: 36763844 DOI: 10.1044/2022_jslhr-22-00265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE The purpose of this study was to examine the nature of speech disfluencies in autistic young adults and controls by using a wide-range disfluency classification of typical disfluencies (TD; i.e., filled pauses, revisions, abandoned utterances, and multisyllable word and phrase repetitions), stuttering-like disfluencies (SLD; i.e., sound and syllable repetitions, monosyllable word repetitions, prolongations, blocks, and broken words), and atypical disfluencies (AD; i.e., word-final prolongations and repetitions and atypical insertions). METHOD Thirty-two autistic young adults and 35 controls completed a narrative telling task based on socially complex events. Frequencies of total disfluencies, TD, SLD, AD and stuttering severity were compared between groups. RESULTS The overall frequency of disfluencies was significantly higher in the autistic group and significant between-group differences were found for all disfluency categories. The autistic group produced significantly more revisions, filled pauses, and abandoned utterances, and each subtype of SLD and AD than the control group. In total, approximately every fourth autistic participants scored at least a very mild severity of stuttering, and every fifth produced more than three SLD per 100 syllables. CONCLUSIONS Disfluent speech can be challenging for effective communication. This study revealed that the speech of autistic young adults was highly more disfluent than that of the controls. The findings provide information on speech disfluency characteristics in autistic young adults and highlight the importance of evaluating speech disfluency with a wide-range disfluency classification in autistic persons in order to understand their role in overall communication. The results of this study offer tools for SLPs to evaluate and understand the nature of disfluencies in autistic persons.
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Affiliation(s)
- Veera Pirinen
- Research Unit of Logopedics, University of Oulu, Finland
| | - Soile Loukusa
- Research Unit of Logopedics, University of Oulu, Finland
| | - Katja Dindar
- Research Unit of Logopedics, University of Oulu, Finland
| | - Leena Mäkinen
- Research Unit of Logopedics, University of Oulu, Finland
| | - Tuula Hurtig
- Research Unit of Clinical Medicine, Psychiatry, Child Psychiatry, University of Oulu, Finland
- Child Psychiatry, Oulu University Hospital, Finland
| | - Katja Jussila
- Child Psychiatry, Oulu University Hospital, Finland
- Division of Psychology, VISE, Faculty of Education, University of Oulu, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Finland
| | - Marja-Leena Mattila
- Child Psychiatry, Oulu University Hospital, Finland
- Research Unit of Clinical Medicine, Child Psychiatry, University of Oulu, Finland
| | - Kurt Eggers
- Department of Rehabilitation Sciences, Ghent University, Belgium
- Department of Speech-Language Pathology, Thomas More University College, Antwerp, Belgium
- Department of Psychology and Speech-Language Pathology, University of Turku, Finland
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131
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Pagni BA, Hill E, Walsh MJM, Delaney S, Ogbeama D, Monahan L, Cook JR, Guerithault N, Dixon MV, Ballard L, Braden BB. Distinct and shared therapeutic neural mechanisms of mindfulness-based and social support stress reduction groups in adults with autism spectrum disorder. J Psychiatry Neurosci 2023; 48:E102-E114. [PMID: 36990468 PMCID: PMC10065804 DOI: 10.1503/jpn.220159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/16/2022] [Accepted: 12/09/2022] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) alleviates depression and anxiety in adults with autism spectrum disorder (ASD); however, underlying therapeutic neural mechanisms and mindfulness-specific effects have yet to be elucidated. METHODS We randomly assigned adults with ASD to MBSR or social support/education (SE). They completed questionnaires that assessed depression, anxiety, mindfulness traits, autistic traits and executive functioning abilities as well as a self-reflection functional MRI task. We used repeated-measures analysis of covariance (ANCOVA) to evaluate behavioural changes. To identify task-specific connectivity changes, we performed a generalized psychophysiological interactions (gPPI) functional connectivity (FC) analysis on regions of interest (ROIs; insula, amygdala, cingulum and prefrontal cortex [PFC]). We used Pearson correlations to explore brain-behaviour relationships. RESULTS Our final sample included 78 adults with ASD - 39 who received MBSR and 39 who received SE. Mindfulness-based stress reduction uniquely improved executive functioning abilities and increased mindfulness traits, whereas both MBSR and SE groups showed reductions in depression, anxiety and autistic traits. Decreases specific to MBSR in insula-thalamus FC were associated with anxiety reduction and increased mindfulness traits, including the trait "nonjudgment;" MBSR-specific decreases in PFC-posterior cingulate connectivity correlated with improved working memory. Both groups showed decreased amygdala-sensorimotor and medial-lateral PFC connectivity, which corresponded with reduced depression. LIMITATIONS Larger sample sizes and neuropsychological evaluations are needed to replicate and extend these findings. CONCLUSION Together, our findings suggest that MBSR and SE are similarly efficacious for depression, anxiety and autistic traits, whereas MBSR produced additional salutary effects related to executive functioning and mindfulness traits. Findings from gPPI identified shared and distinct therapeutic neural mechanisms, implicating the default mode and salience networks. Our results mark an early step toward the development of personalized medicine for psychiatric symptoms in ASD and offer novel neural targets for future neurostimulation research. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT04017793.
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Affiliation(s)
- Broc A Pagni
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Ethan Hill
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Melissa J M Walsh
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Shanna Delaney
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Destiny Ogbeama
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Leanna Monahan
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - James R Cook
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | | | - Maria V Dixon
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - Lisa Ballard
- From Arizona State University, College of Health Solutions, Phoenix, AZ
| | - B Blair Braden
- From Arizona State University, College of Health Solutions, Phoenix, AZ
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132
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Heyworth M, Brett S, den Houting J, Magiati I, Steward R, Urbanowicz A, Stears M, Pellicano E. "I'm the Family Ringmaster and Juggler": Autistic Parents' Experiences of Parenting During the COVID-19 Pandemic. AUTISM IN ADULTHOOD 2023; 5:24-36. [PMID: 36941857 PMCID: PMC10024268 DOI: 10.1089/aut.2021.0097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background Little is known about autistic parenthood. The literature that exists suggests that autistic parents can find it difficult to manage the everyday demands of parenting and domestic life. While emerging research has also highlighted more positive parenting experiences, greater understanding of autistic parenthood is needed. Objective This study sought to understand autistic parents' parenting experiences during the initial phase of the COVID-19 pandemic. Methods Thirty-five Australian autistic parents (95% women) of autistic children (aged 4-25 years) took part in semi-structured interviews designed to elicit their experiences of life during lockdown. We used reflexive thematic analysis using an inductive (bottom-up) approach to identify patterned meanings within the data set. Results Autistic parents repeatedly spoke of how the lockdown brought some initial relief from the intensity of their usual lives caring for their children. Nevertheless, most autistic parents felt that the "cumulative stress" of trying to juggle everything during lockdown proved very challenging, which eventually took its toll on parents' mental health. Parents were aware that they needed support but found it difficult to reach out to their usual social supports (including autistic friends) for help, and formal supports were virtually nonexistent. Consequently, they felt "very much forgotten." Nevertheless, they described how their connections with their children grew stronger over lockdown as they focused on nurturing their children's "mental health ahead of everything else." Conclusions Our analysis shows how challenging conventional life can be for autistic parents. Parenting requires grappling with a distinctive set of demands, which are usually partially manageable through the informal supports many autistic parents draw upon. The relative absence of informal supports during the pandemic, however, left them reliant on more formal supports, which were not forthcoming. Research is urgently needed to identify the most effective formal supports for autistic parents, ideally in partnership with autistic parents themselves.
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Affiliation(s)
- Melanie Heyworth
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Reframing Autism, Sydney, Australia
| | - Simon Brett
- Macquarie School of Education, Macquarie University, Sydney, Australia
| | - Jacquiline den Houting
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
| | - Iliana Magiati
- School of Psychological Science, University of Western Australia, Perth, Australia
| | | | | | - Marc Stears
- Sydney Policy Lab, University of Sydney, Sydney, Australia
| | - Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Australia
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133
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Christoforou M, Jones EJH, White P, Charman T. Executive function profiles of preschool children with autism spectrum disorder and attention-deficit/hyperactivity disorder: A systematic review. JCPP ADVANCES 2023; 3:e12123. [PMID: 37431322 PMCID: PMC10241451 DOI: 10.1002/jcv2.12123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 10/06/2022] [Indexed: 01/09/2023] Open
Abstract
Background Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are both associated with differences in Executive Functioning (EF). There is lack of clarity around the specificity or overlap of EF differences in early childhood when both disorders are first emerging. Method This systematic review aims to delineate preschool EF profiles by examining studies comparing the EF profiles of children with and without ASD or ADHD. Five electronic databases were systematically searched (last search in May 2022) to identify published, quantitative studies of global and specific EF (Inhibition, Shifting, Working Memory (WM), Planning and Attentional Control), comparing children aged 2-6 with a diagnosis of ASD or ADHD to peers without ASD or ADHD. Results Thirty-one empirical studies (10 ADHD and 21 ASD studies) met criteria for inclusion. EF profiles in preschool ASD were characterised by consistent Shifting, and, in most cases, Inhibition impairments. ADHD studies consistently reported impairments in Inhibition and Planning, and in most cases WM. Findings with regards to sustained Attention and Shifting in ADHD and WM and Planning in ASD were mixed. Conclusions Overall, current evidence indicates overlap but also some specificity in EF impairments in preschool ASD and ADHD. There were differences in the degree to which individual domains were impaired, with Shifting more consistently impaired in ASD, and Inhibition, WM and Planning in ADHD. Methodological issues and differences in methods of outcome measurement could potentially underlie mixed findings, as informant-based measures revealed more robust EF impairments than laboratory-based tasks.
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Affiliation(s)
- Marina Christoforou
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Emily J. H. Jones
- Centre for Brain and Cognitive DevelopmentBirkbeckUniversity of LondonLondonUK
| | - Philippa White
- Department of Child PsychiatryInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Tony Charman
- Department of PsychologyInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
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134
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Greco G, Choi B, Michel K, Faja S. Here's the Story: Narrative Ability and Executive Function in Autism Spectrum Disorder. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 101:102092. [PMID: 36644329 PMCID: PMC9835513 DOI: 10.1016/j.rasd.2022.102092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background Difficulties with narrative have been reported in individuals diagnosed with autism spectrum disorder (ASD), but the role of executive function on narrative ability has not been examined in ASD. In this study, we aimed to (1) examine whether narrative abilities of ASD children differed from neurotypical (NT) children who did not differ in age, sex, and IQ; and (2) investigate relations between executive function and narrative ability in ASD children. Method Narratives were elicited from 64 ASD children and 26 NT children using a wordless picture book and coded to derive several aspects of narrative ability such as propositions, evaluative devices, and self-repairs. Executive functions (specifically, inhibition and working memory) were measured using both experimenter-administered assessment and parent-report measures. Results Compared to NT children, ASD children produced fewer propositions but did not differ in their use of evaluative devices and self-repairs during narrative production. Greater inhibitory challenges related to more self-repairs involving repetition of story elements, whereas working memory did not relate to any of the measures of narrative ability among ASD children. Conclusions This study revealed that narratives by verbally fluent ASD children were shorter and less complex than those by NT children but did not differ in the specific features of narratives. Furthermore, although ASD children did not make more self-repairs than NT children, difficulty with inhibition was related to more self-repairs, indicating more dysfluent narrative production in ASD children, which has implications for intervention.
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Affiliation(s)
- Gabriella Greco
- University of Washington, Seattle, WA, USA
- Boston Children’s Hospital, Boston, MA, USA
| | - Boin Choi
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Susan Faja
- Boston Children’s Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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135
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Conner CM, Elias R, Smith IC, White SW. Emotion Regulation and Executive Function: Associations with Depression and Anxiety in Autism. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 101:102103. [PMID: 36741741 PMCID: PMC9897310 DOI: 10.1016/j.rasd.2023.102103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Adolescents and young adults with autism spectrum disorder (ASD) are prone to experience co-occurring mental health conditions such as mood or anxiety disorders, as well as impairments in emotion regulation and executive functioning. However, little research has examined inter-relationships among these constructs, despite evidence of additional stressors and increased risk of internalizing disorders at this age, relative to non-autistic individuals. If either emotion regulation or executive functioning are shown to have patterns of association with mental health, this can inform mechanism-based intervention. Method Fifty-seven autistic adolescents and adults (16-25 years) with ASD in a transition intervention completed questionnaires and clinician-administered measures at baseline. Analyses assessed whether executive functioning impairment, above and beyond emotion regulation impairment, were associated with depression and anxiety symptoms. Results ASD characteristics, emotion regulation, anxiety, and depression were significantly correlated. ASD characteristics was a significant contributor to depression and emotion regulation impairments were significant contributors to anxiety and depression. Findings indicated that inhibition difficulties did not uniquely contribute to depression or anxiety above emotion regulation impairment. Difficulties in cognitive flexibility were associated with depression above and beyond ASD characteristics, IQ, and emotion regulation, but not associated with anxiety. Conclusions Although preliminary, findings suggest that inflexibility and regulatory impairment should be considered in depression remediation approaches. Improving ER, on the other hand, may have broader transdiagnostic impact across both mood and anxiety symptoms in ASD.
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Affiliation(s)
| | - Rebecca Elias
- University of Southern California, Los Angeles, CA
- Children’s Hospital Los Angeles, Los Angeles, CA
| | - Isaac C. Smith
- University of Connecticut School of Medicine, West Hartford, CT
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136
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Albaum CS, Vashi N, Bohr Y, Weiss JA. A Systematic Review of Therapeutic Process Factors in Mental Health Treatment for Autistic Youth. Clin Child Fam Psychol Rev 2023; 26:212-241. [PMID: 35999330 PMCID: PMC9879813 DOI: 10.1007/s10567-022-00409-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
Understanding the role of therapeutic process factors in treatment change may prove useful for discerning why some autistic youth benefit from psychosocial interventions that target emotional and psychological aspects of mental health, while others do not. The aim of the current study was to synthesize what is currently known about therapeutic process factors in mental health treatment of emotional and psychological challenges for autistic youth, regarding how process factors have been measured in past research, and the relation between process factors and treatment outcome. A systematic review of the literature was conducted to narratively synthesize all articles published up until June 2021. Methodological quality of included studies was appraised. Twenty-five studies met inclusion criteria. Process factors assessed across studies included relational factors; treatment expectations, readiness, and satisfaction; and treatment engagement from youth and their parents. Process-outcome associations were reported for a limited number of constructs. There is a limited, albeit growing, body of high-quality research evaluating the role of process factors in the treatment of mental health issues for autistic youth. Future research should continue to examine process factors in relation to treatment outcome, and validate measures to accurately capture process-related constructs in mental health treatment for this population. Greater understanding of therapy processes can lead to developing evidence-informed strategies that clinicians can implement to promote positive expectations, relationships, and engagement.
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Affiliation(s)
- Carly S Albaum
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
| | - Nisha Vashi
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Yvonne Bohr
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
| | - Jonathan A Weiss
- Department of Psychology, York University, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada
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137
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Meir N, Novogrodsky R. Referential expressions in monolingual and bilingual children with and without Autism Spectrum Disorder (ASD): A study of informativeness and definiteness. JOURNAL OF CHILD LANGUAGE 2023; 50:215-244. [PMID: 34847976 DOI: 10.1017/s0305000921000702] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The current study evaluated the separate and combined effects of bilingualism and Autism Spectrum Disorder (ASD) on informativeness and definiteness marking of referential expressions. Hebrew-speaking monolingual children (21 with ASD and 28 with typical language development) and Russian-Hebrew-speaking bilingual children (13 with ASD and 30 with typical language development) aged 4-9 years participated. Informativeness, indexed by referential contrasts, was affected by ASD, but not by bilingualism. Definiteness use was non-target-like in children with ASD and in bilingual children, and it was mainly predicted by children's morpho-syntactic abilities in Hebrew. Language-universal and language-specific properties of referential use are discussed.
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Affiliation(s)
- Natalia Meir
- Department of English Literature and Linguistics, Bar-Ilan University, Ramat Gan, Israel
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Rama Novogrodsky
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
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138
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Li K, Liang X, Xie X, Tian L, Yan J, Lin B, Liu H, Lai W, Liu X, Xi Z. Role of SHANK3 in concentrated ambient PM2. 5 exposure induced autism-like phenotype. Heliyon 2023; 9:e14328. [PMID: 36938421 PMCID: PMC10018567 DOI: 10.1016/j.heliyon.2023.e14328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/08/2023] Open
Abstract
Perinatal air pollution plays an important role in the development of autism. However, research on the pathogenic mechanism remains limited. In this study, the model of systemic inhalation of concentrated approximately 8-fold the level (mean concentration was 224 μg/m3) reported in ambient outdoor air of PM2.5 (particulate matters that are 2.5 μm or less in diameter)in early-postnatal male Sprague-Dawley (SD) rats was established. Through a series of autism-related behavioral tests, it was identified that young rats (postnatal day 1-day21, named PND1-PND21) exposed to PM2.5 exhibited typical autistic phenotypes, such as impaired language communication, abnormal repetitive and stereotyped behaviors, and impaired social skills. Moreover, synaptic abnormalities have been found in the brain tissues of young rats exposed to PM2.5. In terms of the molecular mechanism, we found that the levels of SH3 and multiple ankyrin repeat domains 3 (SHANK3) expression and key molecular proteins in the downstream signaling pathways were decreased in the brain tissues of the exposed rats. Finally, at the epigenetic level, SHANK3 methylation levels were increased in young rats exposed to PM2.5. In conclusion, the study revealed that PM2.5 exposure might induce the early postnatal autism through the SHANK3 signaling pathway by affecting the SHANK3 methylation levels and reducing the SHANK3 expression levels. The study could provide new ideas for autism etiology and a theoretical basis for the prevention and treatment of autism in children.
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Affiliation(s)
- Kang Li
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Xiaotian Liang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
- Binzhou Medical College, Yantai, 264000, China
| | - Xiaoqian Xie
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
- Binzhou Medical College, Yantai, 264000, China
| | - Lei Tian
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Jun Yan
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Bencheng Lin
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Huanliang Liu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Wenqin Lai
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
| | - Xiaohua Liu
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
- Corresponding author.
| | - Zhuge Xi
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, 300050, China
- Binzhou Medical College, Yantai, 264000, China
- Corresponding author. Tianjin Institute of Environmental and Operational Medicine, No. 1, Dali Road, Heping District, Tianjin, 300050, PR China.
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139
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Zhang R, Cheng G, Wu L. Influence of instructor's facial expressions in video lectures on motor learning in children with autism spectrum disorder. EDUCATION AND INFORMATION TECHNOLOGIES 2023; 28:1-14. [PMID: 37361809 PMCID: PMC9971683 DOI: 10.1007/s10639-023-11676-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/20/2023] [Indexed: 06/28/2023]
Abstract
During the COVID-19 pandemic, video materials have played crucial roles in supporting learning among children with autism spectrum disorder (ASD). This study aimed to explore the effects of the instructor's facial expressions in video lectures on attention and motor learning in children with ASD versus typically developing (TD) children. A total of 60 children were randomly assigned to four groups: (1) ASD-happy, (2) ASD-neutral, (3) TD-happy, and (4) TD-neutral. Both happy groups paid more attention to the video lectures. The ASD groups achieved higher accuracy and fidelity of motor learning when the instructor smiled. Results revealed that greater attention to video lectures predicted better performance in children with ASD. This study has practical implications for the design of learning materials for children with ASD: An instructor should be encouraged to show a happy expression to promote learning.
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Affiliation(s)
- Rujing Zhang
- School of Media and Technology, Liaocheng University, Liaocheng, People’s Republic of China
| | - Guifang Cheng
- School of Media and Technology, Liaocheng University, Liaocheng, People’s Republic of China
| | - Lei Wu
- Faculty of Education, Shandong Normal University, Jinan, People’s Republic of China
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140
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Field SL, Fox JRE, Jones CRG, Williams MO. "Work WITH us": a Delphi study about improving eating disorder treatment for autistic women with anorexia nervosa. J Eat Disord 2023; 11:17. [PMID: 36759874 PMCID: PMC9909870 DOI: 10.1186/s40337-023-00740-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/26/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND There is an increased prevalence of anorexia nervosa (AN) in autistic women and this group has poorer treatment outcomes compared to non-autistic women with AN. However, there is little research into improving eating disorder treatment for autistic women. This study investigated how best to support autistic women with AN within eating disorder services. METHOD A three-stage Delphi study was conducted with 49 participants with relevant expertise as a researcher, clinician, or expert by experience. RESULTS A total of 70 statements were generated, with 56 reaching consensus after the final round. Statements reaching consensus made recommendations for adaptations to treatment, staff training, and service organisation. CONCLUSIONS The results highlight the need to distinguish between autism- and AN-related difficulties, accommodate autistic traits such as sensory sensitivities and communication differences, and ensure the autistic voice is present in both the development and delivery of care. Future research should investigate the impact of these adaptations on outcomes. The applicability of these recommendations to autistic people with other eating disorders and of other genders needs to be investigated further.
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Affiliation(s)
- Sarah L Field
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, 11Th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK
| | - John R E Fox
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, 11Th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.,Doctorate in Clinical Psychology, University of Liverpool, Liverpool, L69 7ZA, UK
| | - Catherine R G Jones
- Wales Autism Research Centre, School of Psychology, Cardiff University, Cardiff, CF10 3AT, UK
| | - Marc O Williams
- South Wales Doctoral Programme in Clinical Psychology, Cardiff University, 11Th Floor, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK.
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141
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Buckle KL, Poliakoff E, Gowen E. The blind men and the elephant: The case for a transdiagnostic approach to initiation. Front Psychol 2023; 13:1113579. [PMID: 36825241 PMCID: PMC9941546 DOI: 10.3389/fpsyg.2022.1113579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 02/10/2023] Open
Abstract
Difficulty initiating voluntary action is an under-recognized and often invisible impairment in various psychiatric, neurodevelopmental, and neurological conditions. Understanding the commonalities of volition impairments across diagnoses is limited by a lack of consistent terminology, arbitrary distinctions between conditions, the habit of looking only to the prevailing definitions and theories to explain observed traits, and the covert nature of initiation. The siloed approach to research in this area evokes the parable of the blind men and the elephant, where understanding the whole picture is impeded by a limited view. There has been little effort to consider how differing terms overlap or to use objective methods to differentiate phenomena along meaningful lines. We propose a triad of interacting elements, all of which are needed for successful initiation of voluntary action: (i) executive function, (ii) volition, and (iii) movement. Failure to initiate a response may be due to impairments in any of these, which often co-occur. This paper calls for the following considerations to improve research in this area: (i) put aside preconceptions about conditions and their mechanisms to adopt a flexible transdiagnostic approach; (ii) consider executive function, movement, and volition as possible dimensional variations with related underlying mechanisms; (iii) carefully differentiate components of complex functions; (iv) look to first-hand reports for covert and previously unrecognized traits. These approaches have the potential to elucidate the cognitive and biological mechanisms underpinning voluntary action and create a foundation to develop more appropriate and informed interventions.
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Affiliation(s)
| | - Ellen Poliakoff
- Body, Eye and Movement Lab, Division of Psychology, Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Emma Gowen
- Body, Eye and Movement Lab, Division of Psychology, Communication and Human Neuroscience, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
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142
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Lee RR, Ward AR, Lane DM, Aman MG, Loveland KA, Mansour R, Pearson DA. Executive Function in Autism: Association with ADHD and ASD Symptoms. J Autism Dev Disord 2023; 53:688-700. [PMID: 33515417 PMCID: PMC8322145 DOI: 10.1007/s10803-020-04852-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/12/2022]
Abstract
There is substantial comorbidity between autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD), and there are well-documented executive functioning (EF) deficits in both populations. An important question concerns whether EF deficits in children with ASD are related to severity of ASD, ADHD, or both. We examined ADHD and ASD symptoms in relation to ratings of EF in the home and classroom. The sample comprised 64 children (55 males) diagnosed with ASD (mean age = 9.26 years; mean FSIQ = 92). Analyses indicated that parent and teacher ratings of EF (except Shift and Emotional Control) were consistently related to ADHD symptom severity, but not to ASD severity. Thus, functioning in the domains of Shift and Emotional control appear relatively spared, whereas performance in all other EF was impaired in relation to ADHD symptoms.
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Affiliation(s)
- Rachel R Lee
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Anthony R Ward
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | | | - Katherine A Loveland
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rosleen Mansour
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Deborah A Pearson
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
- Louis A. Faillace M.D. Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, 1941 East Road, Room 3.126 BBSB, Houston, TX, 77054, USA.
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143
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Likhitweerawong N, Khorana J, Boonchooduang N, Phinyo P, Patumanond J, Louthrenoo O. Associated biological and environmental factors of impaired executive function in
preschool‐aged
children: A
population‐based
study. INFANT AND CHILD DEVELOPMENT 2023. [DOI: 10.1002/icd.2404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Narueporn Likhitweerawong
- Division of Growth and Development, Department of Pediatrics, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - Jiraporn Khorana
- Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
- Center of Clinical Epidemiology and Clinical Statistics, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
- Clinical Surgical Research Center, Department of Surgery, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - Nonglak Boonchooduang
- Division of Growth and Development, Department of Pediatrics, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - Phichayut Phinyo
- Center of Clinical Epidemiology and Clinical Statistics, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
- Department of Family Medicine, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - Jayanton Patumanond
- Center of Clinical Epidemiology and Clinical Statistics, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
| | - Orawan Louthrenoo
- Division of Growth and Development, Department of Pediatrics, Faculty of Medicine Chiang Mai University Chiang Mai Thailand
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144
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Burgevin M, Lacroix A, Ollivier F, Bourdet K, Coutant R, Donadille B, Faivre L, Manouvrier-Hanu S, Petit F, Thauvin-Robinet C, Toutain A, Netchine I, Odent S. Executive functioning in adolescents and adults with Silver-Russell syndrome. PLoS One 2023; 18:e0279745. [PMID: 36662731 PMCID: PMC9858375 DOI: 10.1371/journal.pone.0279745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 12/13/2022] [Indexed: 01/21/2023] Open
Abstract
Silver-Russell syndrome (SRS) is a rare imprinting disorder characterized by prenatal and postnatal growth retardation. The two principal causes of SRS are loss of methylation on chromosome 11p15 (11p15 LOM) and maternal uniparental disomy of chromosome 7 (UPD(7)mat). Knowledge of the neuropsychological profile of SRS remains sparse and incomplete even if several difficulties related to attention and learning have been reported both in the literature and by patients with SRS. These difficulties could be the result of troubles in different cognitive domains, but also of executive dysfunction. Nevertheless, executive functioning has never been investigated, even though executive functions play an essential role in psychological development, and are extensively involved in daily life. The present study explored the executive functioning of individuals with SRS due to UPD(7)mat or 11p15 LOM. A battery of executive tasks assessing cognitive flexibility, inhibitory control, and working memory, together with a task assessing sustained attention, was administered to 19 individuals with SRS (13-39 years) and 19 healthy controls. The Behavior Rating Inventory of Executive Function was also completed by the participants' families. The results showed that participants with SRS had similar performance (z-scores) to our controls, in a context of normal intellectual efficiency. Group comparisons with Bayesian statistics showed a single difference between the 11p15 LOM and control groups: the completion time for part A of the Trail Making Test appeared to be longer in the 11p15 LOM group than in the control group. However, at the clinical level, several participants with SRS had clinically significant scores on various measures of EFs. Thus, the cognitive phenotype of SRS did not appear to be characterized by executive dysfunction, but individuals with SRS could be at high risk of developing executive dysfunction or attention-deficit/hyperactivity disorder. These results provide new insights into the neuropsychological profile of individuals with SRS.
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Affiliation(s)
- Mélissa Burgevin
- Univ Rennes, LP3C (Laboratoire de Psychologie, Cognition, Comportement et Communication)–EA 1285, FHU GenOMedS, Rennes, France
| | - Agnès Lacroix
- Univ Rennes, LP3C (Laboratoire de Psychologie, Cognition, Comportement et Communication)–EA 1285, FHU GenOMedS, Rennes, France
| | - Fanny Ollivier
- Univ Angers, Nantes Université, LPPL, SFR CONFLUENCES, Angers, France
| | | | - Régis Coutant
- Service Endocrinologie Pédiatrique, CHU Angers, Angers, France
| | - Bruno Donadille
- Endocrinologie, Service du Pr Christin-Maitre, Hôpital Saint Antoine, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Laurence Faivre
- INSERM–University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, Dijon, France
- CHU Dijon, Centre de Référence Maladies Rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, Dijon, France
| | - Sylvie Manouvrier-Hanu
- CHU Lille, Centre de Référence Maladies Rares Labellisé Pour les Anomalies du Développement Nord-Ouest, Clinique de Génétique, Lille, France
- Univ Lille, EA7364 –RADEME–Maladies Rares du Développement Embryonnaire et du Métabolisme : du Phénotype au Génotype et à la Fonction, Lille, France
| | - Florence Petit
- CHU Lille, Clinique de Génétique Guy Fontaine, Lille, France
| | - Christel Thauvin-Robinet
- INSERM–University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, Dijon, France
- CHU Dijon, Centre de Référence Maladies Rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, Dijon, France
| | - Annick Toutain
- Service de Génétique, Centre Hospitalier Universitaire, UMR 1253, iBrain, Université de Tours, Inserm, FHU GenOMedS, Tours, France
| | - Irène Netchine
- Sorbonne Université, INSERM UMR_S 938, Centre de Recherche Saint Antoine, APHP, Hôpital Armand Trousseau, Explorations Fonctionnelles Endocriniennes, Paris, France
| | - Sylvie Odent
- Service de Génétique Clinique, Centre Référence Anomalies du Développement CLAD Ouest, Univ Rennes, CNRS, INSERM, IGDR (Institut de Génétique et Développement de Rennes), UMR 6290 ERL 1305, FHU GenOMedS, Rennes, France
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145
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Yon-Hernández JA, Canal-Bedia R, Wojcik DZ, García-García L, Fernández-Álvarez C, Palacio-Duque S, Franco-Martín MA. Executive functions in daily living skills: A study in adults with autism spectrum disorder. Front Psychol 2023; 14:1109561. [PMID: 37113122 PMCID: PMC10127455 DOI: 10.3389/fpsyg.2023.1109561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Adults with autism and adults with schizophrenia show difficulties in adaptive skills, especially those related to daily functioning. Some studies suggest that adaptive skills are associated with deficits in executive functions (EF), while others indicate that intelligence quotient (IQ) might also play a role. Literature suggests that autistic symptoms further affect adaptive skills. The interest of the current study, therefore, was to explore to what extent IQ, EFs as well as core autistic symptoms predict adaptive skills. Methods To do this, 25 controls, 24 adults with autism, and 12 with schizophrenia were assessed on IQ (Wechsler Adult Intelligence Scale), and executive functioning. The EF was measured with neuropsychological tasks (inhibition, updating, and task switching) and with the Dysexecutive-Spanish Questionnaire (DEX-Sp) which assessed everyday life EF problems. Core ASD symptoms were measured using the Autism Diagnostic Observation Schedule, the Autism Spectrum Quotient-Short version (AQ-S), and the Repetitive Behavior Questionnaire - 3 (RBQ-3). Results The results indicated EF difficulties in both, autism and schizophrenia. The IQ explained a high percentage of the variance found in adaptive skills, but only in the autism group. We can conclude, therefore, that high IQ is associated with low adaptive skills levels and EFs affect adaptive functioning in people with autism; however, this does not explain the difficulties in adaptive functioning in the schizophrenia group. Core features of autism assessed with self-report questionnaires (but not the ADOS-2) predicted low scores on the adaptive skills, only in the autism group. Discussion Both EF measures predicted adaptive skills scores in autism, but not in schizophrenia. Our results suggest that different factors affect the adaptive functioning in each disorder. For instance, the EFs should be a central focus for improvement, especially for individuals with autism.
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Affiliation(s)
- Jo A. Yon-Hernández
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Ricardo Canal-Bedia
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- *Correspondence: Ricardo Canal-Bedia,
| | - Dominika Z. Wojcik
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | | | - Clara Fernández-Álvarez
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Stefanny Palacio-Duque
- Instituto Universitario de Integración en la Comunidad, InFoAutismo, Universidad de Salamanca, Salamanca, Spain
| | - Manuel A. Franco-Martín
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
- Zamora Hospital (Complejo Asistencial de Zamora), Zamora, Spain
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146
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Bladen M, Thorpe N, Ridout D, Barrie A, McGibbon E, Mance A, Watson L, Main E. Autism spectrum disorders in boys at a major UK hemophilia center: prevalence and risk factors. Res Pract Thromb Haemost 2023; 7:100013. [PMID: 36891525 PMCID: PMC9986098 DOI: 10.1016/j.rpth.2022.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 10/07/2022] [Accepted: 10/22/2022] [Indexed: 01/21/2023] Open
Abstract
Background Autism spectrum disorders (ASDs) are diagnosed by social communication difficulties strong, narrow interests, and repetitive stereotyped behavior. An apparently-elevated prevalence of ASD at a major UK hemophilia center warranted investigation. Objectives To screen boys with hemophilia for difficulties in social communication and executive function and identify the prevalence and risk factors for ASD. Methods Parents of boys with hemophilia aged 5 to 16 years completed the Social Communication Questionnaire, Children's Communication Checklist, and the Behavior Rating Inventory of executive function. Prevalence and potential risk factors for ASD were evaluated. Boys with an existing diagnosis of ASD did not complete questionnaires, but were included in the prevalence analysis. Results Negative scores on all 3 questionnaires were observed for 60 of 79 boys. Positive scores on 1, 2, and 3 questionnaires were seen in 12 of 79, 3 of 79, and 4 of 79 boys, respectively. In addition to the 11 of 214 boys with a prior ASD diagnosis, 3 further boys were diagnosed with ASD, yielding a prevalence of 14 (6.5%) of 214, greater than that of boys in the UK general population. Premature birth was linked to having ASD, but did not fully explain the increased prevalence with more boys born <37 weeks scoring positively on the Social Communications Questionnaire and Children's Communication Checklist compared with those born at term. Conclusion This study identified an increased prevalence of ASD at 1 UK hemophilia center. Prematurity was identified as a risk factor but did not fully explain the higher prevalence of ASD. Further investigation in the wider national/global hemophilia communities is warranted to determine whether this is an isolated finding.
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Affiliation(s)
- Melanie Bladen
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,UCL Great Ormond Street Institute of Child Health, London, UK
| | - Nicola Thorpe
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Deborah Ridout
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Alpha Barrie
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emma McGibbon
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Abigail Mance
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Eleanor Main
- UCL Great Ormond Street Institute of Child Health, London, UK
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147
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Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder: Shared or Unique Neurocognitive Profiles? Res Child Adolesc Psychopathol 2023; 51:17-31. [PMID: 36006496 PMCID: PMC9763138 DOI: 10.1007/s10802-022-00958-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 10/15/2022]
Abstract
Attention-deficit/hyperactivity (ADHD) and autism spectrum (ASD) disorders are commonly co-occurring conditions characterized by neurocognitive impairments. Few studies have directly compared neurocognitive profiles in ADHD and ASD and fewer still have controlled for comorbidity of ADHD and ASD. All direct comparisons have been in clinic samples, leaving the question of generalizability of results unaddressed. We compared neurocognitive performance in clinically ascertained ASD (n = 261) and ADHD (n = 423) cases and controls (n = 162), 6.0-17.9 years of age. We also compared ASD (n = 190) and ADHD (n = 926) cases ascertained in the community with controls (n = 14,842) of similar age. Using the stop-signal task (SST), we measured response inhibition (stop-signal reaction time-SSRT), sustained attention (defined as reaction time variability-RTV), and reaction time (RT). We controlled for comorbidity using ADHD and ASD trait scores and categorically-defined ADHD. Compared with controls, both clinic ADHD and ASD had significantly longer SSRT and RTV than controls and did not differ from each other. ADHD traits accounted for neurocognitive impairment in ASD, but not vice versa. There were no group differences for RT. Similar patterns of neurocognitive impairment were observed in the community sample. In the largest direct comparison of ADHD and ASD to date, we found impaired response inhibition and sustained attention in both disorders. However, neurocognitive impairment in ASD was almost completely accounted for by comorbid ADHD. Results generalized in the community sample indicating that referral bias alone did not drive results. Response inhibition and sustained attention likely play a role in ADHD and ASD.
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148
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The Use of Technology-Based Interventions in Teaching STEM Skills to Autistic Students in K-12 Settings: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2022. [DOI: 10.1007/s40489-022-00351-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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149
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Thorell LB, Fuermaier ABM, Christiansen H, Steinmayr R, Baeyens D, de la Peña AG, Groom MJ, Idrees I, van der Oord S, van den Hoofdakker BJ, Luman M, Mammarella IC, Skoglund C. Distance learning during the COVID-19 pandemic for children with ADHD and/or ASD: a European multi-center study examining the role of executive function deficits and age. Child Adolesc Psychiatry Ment Health 2022; 16:101. [PMID: 36514179 PMCID: PMC9745722 DOI: 10.1186/s13034-022-00540-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND One of the COVID-19 pandemic consequences that has affected families the most is school lockdowns. Some studies have shown that distance learning has been especially challenging for families with a child with neurodevelopmental disorders such as ADHD or ASD. However, previous studies have not taken the heterogeneity of these disorders into account. The aim of the present study was therefore to investigate differences between families with a child with ADHD, ASD, or both conditions, and to examine the role of underlying deficits in executive functioning (EF) in both children and parents in relation to negative and positive effects of distance learning. METHODS Survey data assessing both negative and positive experiences of distance learning were collected from parents with a child aged 5-19 years in seven Western European countries: the UK, Germany, Spain, Sweden, the Netherlands, Italy, and Belgium. Altogether, the study included 1010 families with a child with ADHD and/or ASD and an equally large comparison group of families with a child without mental health problems. We included measures of three different types of negative effects (i.e., effects on the child, effects on the parent, and lack of support from school) and positive effects on the family. RESULTS Results confirmed that families with a child with ADHD, ASD or a combination of ADHD and ASD showed higher levels of both negative and positive effects of distance learning than the comparison group. However, few differences were found between the clinical groups. Group differences were more pronounced for older compared to younger children. Regarding the role of both ADHD/ASD diagnosis and EF deficits, primarily children's EF deficits contributed to high levels of negative effects. Parent EF deficits did not contribute significantly beyond the influence of child EF deficits. Families of children with ADHD/ASD without EF deficits experienced the highest levels of positive effects. CONCLUSIONS School closings during COVID-19 have a major impact on children with EF problems, including children with neurodevelopmental disorders. The present study emphasizes that schools should not focus primarily on whether a student has a neurodevelopmental disorder, but rather provide support based on the student's individual profile of underlying neuropsychological deficits.
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Affiliation(s)
- Lisa B. Thorell
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Nobels Väg 9, 17177 Stockholm, Sweden
| | | | | | | | - Dieter Baeyens
- grid.5596.f0000 0001 0668 7884KU Leuven, Leuven, Belgium
| | | | | | - Iman Idrees
- grid.4563.40000 0004 1936 8868University of Nottingham, Nottingham, UK
| | | | - Barbara J. van den Hoofdakker
- grid.4494.d0000 0000 9558 4598University Medical Center Groningen, University of Groningen & Accare Child Study Center, Groningen, The Netherlands
| | - Marjolein Luman
- grid.16872.3a0000 0004 0435 165XVrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, & Levvel, Specialists in Youth and Family Care, Amsterdam, The Netherlands
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150
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Lei J, Charman T, Leigh E, Russell A, Mohamed Z, Hollocks MJ. Examining the relationship between cognitive inflexibility and internalizing and externalizing symptoms in autistic children and adolescents: A systematic review and meta-analysis. Autism Res 2022; 15:2265-2295. [PMID: 36196666 PMCID: PMC10092776 DOI: 10.1002/aur.2826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/19/2022] [Indexed: 12/15/2022]
Abstract
Compared to neurotypical peers, autistic adolescents show greater cognitive inflexibility (CI) which manifests at the behavioral and cognitive level and potentially increases vulnerability for the development of internalizing (INT) and externalizing (EXT) symptoms. This systematic review and meta-analysis explored the association between CI and INT/EXT in autistic adolescents. PubMed, EMBASE, MEDLINE, PsycINFO and Web of Science databases were searched to identify relevant studies until April 2022 (PROSPERO protocol: CRD42021277294). Systematic review included 21 studies (n = 1608) of CI and INT, and 15 studies (n = 1115) of CI and EXT. A pooled effect size using Pearson's correlation between CI and INT/EXT was calculated and the moderating effects of age, sex, IQ and study quality were investigated using meta-regressions. Sensitivity analyses were completed to investigate the impact of measure variance for CI and co-occurring ADHD on the overall effects. Greater CI is associated with increased INT (nine studies; n = 833; r = 0.39 (moderate effect), 95% confidence interval [0.32, 0.46]) and EXT (six studies; n = 295; r = 0.48 (large effect), 95% confidence interval [0.38, 0.58]). Results withheld when only using parental reports of CI and excluding autistic adolescents with co-occurring ADHD. Increased CI may be a transdiagnostic vulnerability factor that can increase autistic adolescents' rigid or perseverative patterns of unhelpful cognition and behaviors and reduce their ability to access psychological interventions. Addressing CI may improve autistic children and adolescents' engagement with psychological therapy for co-occurring mental health difficulties.
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Affiliation(s)
- Jiedi Lei
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Eleanor Leigh
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, UK
| | - Zameer Mohamed
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
| | - Matthew J Hollocks
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Trust, London, UK
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