A Meta-Analysis of Imitation Abilities in Individuals With Autism Spectrum Disorders

Higher or lower? Interpersonal behavioral and neural synchronization of movement imitation in autistic children

How well autistic children can imitate movements and how their brain activity synchronizes with the person they are imitating have been understudied. The current study adopted functional near-infrared spectroscopy (fNIRS) hyperscanning and employed a task involving real interactions involving meaningful and meaningless movement imitation to explore the fundamental nature of imitation as a dynamic and interactive process. Experiment 1 explored meaningful and meaningless gesture imitation. The results revealed that autistic children exhibited lower imitation accuracy and behavioral synchrony than non-autistic children when imitating both meaningful and meaningless gestures. Specifically, compared to non-autistic children, autistic children displayed significantly higher interpersonal neural synchronization (INS) in the right inferior parietal lobule (r-IPL) (channel 12) when imitating meaningful gestures but lower INS when imitating meaningless gestures. Experiment 2 further investigated the imitation of four types of meaningless movements (orofacial movements, transitive movements, limb movements, and gestures). The results revealed that across all four movement types, autistic children exhibited significantly lower imitation accuracy, behavioral synchrony, and INS in the r-IPL (channel 12) than non-autistic children. This study is the first to identify INS as a biomarker of movement imitation difficulties in autistic individuals. Furthermore, an intra- and interindividual imitation mechanism model was proposed to explain the underlying causes of movement imitation difficulties in autistic individuals.

Effects of transcranial direct current stimulation on brain activity and cortical functional connectivity in children with autism spectrum disorders

Introduction

Transcranial direct current stimulation (tDCS) has emerged as a therapeutic option to mitigate symptoms in individuals with autism spectrum disorder (ASD). Our study investigated the effects of a two-week regimen of tDCS targeting the left dorsolateral prefrontal cortex (DLPFC) in children with ASD, examining changes in rhythmic brain activity and alterations in functional connectivity within key neural networks: the default mode network (DMN), sensorimotor network (SMN), and dorsal attention network (DAN).

Methods

We enrolled twenty-six children with ASD and assigned them randomly to either an active stimulation group (n=13) or a sham stimulation group (n=13). The active group received tDCS at an intensity of 1mA to the left DLPFC for a combined duration of 10 days. Differences in electrical brain activity were pinpointed using standardized low-resolution brain electromagnetic tomography (sLORETA), while functional connectivity was assessed via lagged phase synchronization.

Results

Compared to the typically developing children, children with ASD exhibited lower current source density across all frequency bands. Post-treatment, the active stimulation group demonstrated a significant increase in both current source density and resting state network connectivity. Such changes were not observed in the sham stimulation group.

Conclusion

tDCS targeting the DLPFC may bolster brain functional connectivity in patients with ASD, offering a substantive groundwork for potential clinical applications.

Social-Motor Coordination Between Peers: Joint Action Developmental Trajectories in ASD and TD

Coordinating a physical movement in time and space with social and nonsocial partners to achieve a shared goal - "joint action" (JA) - characterizes many peer-engagement situations that pose challenges for individuals with autism spectrum disorder (ASD). This cross-sectional study examined development of JA capabilities comparing ASD versus typically developing (TD) groups in early childhood, preadolescence, and adolescence while performing mirroring and complementing JA tasks with social (peer) and nonsocial (computer) partners. Results indicated better motor coordination abilities on computerized tasks than in peer dyads, with larger peer-dyad deficits shown by the ASD group. Developmental growth in JA abilities emerged, but the ASD group lagged behind same-age peers with TD. Socio-motor interventions may offer new channels to facilitate peer engagement in ASD.

Differences in Praxis Errors in Autism Spectrum Disorder Compared to Developmental Coordination Disorder

This study aimed to better understand how autism spectrum disorder (ASD) and developmental coordination disorder (DCD) differ in types of praxis errors made on the Florida Apraxia Battery Modified (FAB-M) and the potential relationships between praxis errors and social deficits in ASD. The ASD group made significantly more timing sequencing errors in imitation of meaningful gestures, as well as more body-part-for-tool errors during gesture-to-command compared to the other two groups. In the ASD group, increased temporal errors in meaningful imitation were significantly correlated with poorer affect recognition and less repetitive behaviors. Thus, in ASD, aspects of imitation ability are related to socioemotional skills and repetitive behaviors.

Motor imagery in autism: a systematic review

Introduction

Motor Imagery (MI) is when an individual imagines performing an action without physically executing that action and is thought to involve similar neural processes used for execution of physical movement. As motor coordination difficulties are common in autistic individuals it is possible that these may affect MI ability. The aim of this systematic review was to assess the current knowledge around MI ability in autistic individuals.

Methods

A systematic search was conducted for articles published before September 2023, following PRISMA guidance. Search engines were PsycINFO, PubMed, Web of Science, Scopus, Wiley Online Library and PsyArXiv. Inclusion criteria included: (a) Original peer-reviewed and pre-print publications; (b) Autistic and a non-autistic group (c) Implicit or explicit imagery tasks (d) Behavioral, neurophysiological or self-rating measures, (e) Written in the English language. Exclusion criteria were (a) Articles only about MI or autism (b) Articles where the autism data is not presented separately (c) Articles on action observation, recognition or imitation only (d) Review articles. A narrative synthesis of the evidence was conducted.

Results

Sixteen studies across fourteen articles were included. Tasks were divided into implicit (unconscious) or explicit (conscious) MI. The implicit tasks used either hand (6) or body (4) rotation tasks. Explicit tasks consisted of perspective taking tasks (3), a questionnaire (1) and explicit instructions to imagine performing a movement (2). A MI strategy was apparent for the hand rotation task in autistic children, although may have been more challenging. Evidence was mixed and inconclusive for the remaining task types due to the varied range of different tasks and, measures conducted and design limitations. Further limitations included a sex bias toward males and the hand rotation task only being conducted in children.

Discussion

There is currently an incomplete understanding of MI ability in autistic individuals. The field would benefit from a battery of fully described implicit and explicit MI tasks, conducted across the same groups of autistic children and adults. Improved knowledge around MI in autistic individuals is important for understanding whether MI techniques may benefit motor coordination in some autistic people.

Brain mechanisms of social signalling in live social interactions with autistic and neurotypical adults

The simple act of watching another person can change a person's behaviour in subtle but important ways; the individual being watched is now capable of signalling to the watcher, and may use this opportunity to communicate to the watcher. Recent data shows that people will spontaneously imitate more when being watched. Here, we examine the neural and cognitive mechanisms of being watched during spontaneous social imitation in autistic and neurotypical adults using fNIRS brain imaging. Participants (n = 44) took part in a block-moving task where they were instructed only to copy the block sequence which people normally do using a straight low action trajectory. Here, the demonstrator sometimes used an atypical 'high' action trajectory, giving participants the opportunity to spontaneously copy the high trajectory even if this slowed their performance. The confederate who demonstrated each block sequence could watch the participant's actions or close her eyes, giving a factorial design with factors of trajectory (high/low) and watched (watched/unwatched). Throughout the task, brain signals were captured from bilateral temporal/parietal/occipital cortex using fNIRS. We found that all participants performed higher actions when being watched by the confederate than when not being watched, with no differences between autistic and neurotypical participants. The unwatched conditions were associated with higher activity of the right inferior parietal lobule in all participants and also engagement of left STS only in autistic participants. These findings are consistent with the claim that people engage different neural mechanisms when watched and unwatched and that participants with autism may engage additional brain mechanisms to match neurotypical behaviour and compensate for social difficulties. However, further studies will be needed to replicate these results in a larger sample of participants.

Production of Mandarin consonant aspiration and monophthongs in children with Autism Spectrum Disorder

Impaired speech sound production adds difficulties to social communication in children with Autism Spectrum Disorder (ASD), while a limited attempt has been made to figure out the speech sound production among Mandarin-speaking children with ASD. The current study conducted both auditory-perceptual scoring and quantitative acoustic analysis of speech sound imitated by 27 Mandarin-speaking children with ASD (3.33-7.00 years) and 30 chronological-age-matched typically developing (TD) children. Auditory-perceptual scoring showed significantly lower scores for aspirated/unaspirated consonants and monophthongs in children with ASD. Moreover, the correlation between the developmental age of language and production accuracy in children with ASD emphasised the importance of language assessment. The quantitative acoustic analysis further indicated that the ASD group produced a much shorter voice onset time for aspirated consonants and showed a reduced vowel space than the TD group. Early interventions focusing on these production patterns should be introduced to improve the speech sound production in Mandarin-speaking children with ASD.

Autistic adults benefit from and enjoy learning via social interaction as much as neurotypical adults do

BACKGROUND

Autistic people show poor processing of social signals (i.e. about the social world). But how do they learn via social interaction?

METHODS

68 neurotypical adults and 60 autistic adults learned about obscure items (e.g. exotic animals) over Zoom (i) in a live video-call with the teacher, (ii) from a recorded learner-teacher interaction video and (iii) from a recorded teacher-alone video. Data were analysed via analysis of variance and multi-level regression models.

RESULTS

Live teaching provided the most optimal learning condition, with no difference between groups. Enjoyment was the strongest predictor of learning: both groups enjoyed the live interaction significantly more than other condition and reported similar anxiety levels across conditions.

LIMITATIONS

Some of the autistic participants were self-diagnosed-however, further analysis where these participants were excluded showed the same results. Recruiting participants over online platforms may have introduced bias in our sample. Future work should investigate learning in social contexts via diverse sources (e.g. schools).

CONCLUSIONS

These findings advocate for a distinction between learning about the social versus learning via the social: cognitive models of autism should be revisited to consider social interaction not just as a puzzle to decode but rather a medium through which people, including neuro-diverse groups, learn about the world around them. Trial registration Part of this work has been pre-registered before data collection https://doi.org/10.17605/OSF.IO/5PGA3.

From child-peer similarity in imitative behavior to matched peer-mediated interventions in autism

Self-consciousness develops through a long process, from pre-reflexive consciousness relying on body perception, to "meta" self-awareness. It emerges from the imitative experience between children and their peers. This experience linked to the capacity to test structural similarities between oneself and others, is addressed according to the concept of interpersonal affordance. We hypothesize that the opportunity for co-actors to engage in a process of interpersonal coordination is underlined by their similarity in terms of morphological, behavioral and motor features. This experience can sustain the emergence of new affordances for objects for each co-actor, as well as new affordances in terms of joint actions. We apply this idea in the context of peer-mediated interventions (PMI) in autism spectrum disorder (ASD). We argue that, in PMI, an encounter between children with autism and similar peers would foster the opportunity to engage in a spontaneous process of interpersonal coordination. This process would enable the development of self-consciousness and the emergence of perception of interpersonal, self and other's affordances for children with autism. We conclude that metrics to assess morphological, behavioral and motor similarity should then be defined and used in future studies to test our hypothesis in children with autism versus TD children or between children with autism.

Case report: An evaluation of early motor skills in an infant later diagnosed with autism

Researchers and clinicians are increasingly interested in understanding the etiology of autism spectrum disorder (ASD) and identifying behaviors that can provide opportunities for earlier detection and therefore earlier onset of intervention activities. One promising avenue of research lies in the early development of motor skills. The present study compares the motor and object exploration behaviors of an infant later diagnosed with ASD (T.I.) with the same skills in a control infant (C.I.). There were notable difference in fine motor skills by just 3 months of age, one of the earliest fine motor differences reported in the literature. In line with previous findings, T.I. and C.I. demonstrated different patterns of visual attention as early as 2.5 months of age. At later visits to the lab, T.I. engaged in unique problem-solving behaviors not demonstrated by the experimenter (i.e., emulation). Overall, findings suggest that infants later diagnosed with ASD may show differences in fine motor skills and visual attention to objects from the first months of life.

Dancing out for a voice; a narrative review of the literature exploring autism, physical activity, and dance

Autism Spectrum Disorder is characterised by profound challenges with social communication and social interaction. Currently, there are few therapeutic interventions that successfully target some of the functionally impairing traits associated with autism. Furthermore, many of these interventions comprise a variety of limitations; including, limited accessibility, extensive durations, or the requirement of a trained professional to deliver the intervention. New research suggests that instead of targeting all traits associated with Autism Spectrum Disorder with a single solution, scientific research should focus on providing therapeutic tools that alleviate functionally impairing facets specific to the individual. Owing to the nature of physical activity, sports, and dance (coordinated movement) these activities could provide opportunities to enhance communication skills and social development in autistic children. Therefore, this paper gives a narrative overview of the literature surrounding communication and coordinated movement; outlining what is meant by communication challenges, exploring the benefits of coordinated movement for traits associated with Autism Spectrum Disorder, and delineating how coordinated movement elicits positive outcomes for autistic children.

Peer mediation in play settings for minimally verbal students with autism Spectrum disorder

Background and aims

Peer-mediated interventions (PMIs) are effective strategies to foster socialization of children with autism spectrum disorder (ASD) in natural settings. However, research examining the efficacy of peer mediation for students with ASD who have the greatest cognitive and language impairments remains limited. Additionally, previous studies essentially targeted communicative abilities of participants. To address this gap, the present study evaluated the effects of a play-based PMI on three socio-communicative skills (play, social engagement and imitation) of minimally verbal students with ASD who also have a comorbidity of intellectual disability (ID).

Methods

Seven children with ASD attending ordinary school settings and 14 typically developing (TD) preschoolers participated. Seven single-sex groups were formed, and children played together during two 30 min weekly sessions. TD children were trained according to the principles of the integrated play group model. We used a multiple-baseline design across participants to measure the effects of the intervention on play skills, social engagement and motor imitation of students with ASD.

Results

Outcomes revealed an intervention effect for most of the participants, despite some variations across children. After the peer training, four children increased their duration of functional/symbolic play, six children improved their duration of interactive play and five children increased their rates of motor imitation. Concerning maintenance gains, inter-individual differences are also important.

Conclusions and implications

These findings suggest that a play-based PMI may be a feasible option for targeting inclusive education and improving socio-communicative skills of some minimally verbal students with ASD who also have an ID. However, variations across children invite further research to clarify how individual factors can moderate the effects of PMIs in children with ASD who are the most impaired.

New Methods for Unraveling Imitation Accuracy Differences Between Children with Autism and Typically Developing Peers

This study applies methods used in sign language and gesture research to better understand reduced imitation accuracy (IA) of actions and gestures in children with autism spectrum disorder (ASD), and we addressed contrasting theories on IA in ASD and the role of objects and meanings in imitation. Eight male children with ASD with a mean chronological age (CA) of 86.76 months (SD = 10.74, range 70.5-104.4) and 22 male and female peers with typical development (TD) and a mean CA of 85.44 months (SD = 7.95, range 73.4-96.7) imitated videos of an adult performing actions with objects, representational gestures, conventional gestures and meaningless gestures. We measured accuracy as ability to effectively reproduce features (handshape, palm orientation, location, movement direction and type) and timing (speed) of observed actions/gestures, after ruling out cases of specular (i.e., mirror-like) versus anatomical imitation. Results highlighted significantly lower feature and timing accuracy in children with ASD with respect to the TD group across tasks, and these findings supported sensory-motor theories of IA in ASD. Our data also showed the different impact of objects and meanings within groups. Overall, these results suggest validity to our assessment method and suggested the importance of considering both discreet variables (i.e., variables describing action/gesture feature accuracy, e.g. handshape, movement direction) and continuous variables (i.e., kinematic variables, e.g. speed) in evaluating IA in autism.

Motor networks in children with autism spectrum disorder: a systematic review on EEG studies

Motor disturbance and altered motor networks are commonly reported in individuals with autism spectrum disorder (ASD). It has been suggested that electroencephalogram (EEG) can be used to provide exquisite temporal resolution for understanding motor control processes in ASD. However, the variability of study design and EEG approaches can impact our interpretation. Here, we conducted a systematic review on recent 11 EEG studies that involve motor observation and/or execution tasks and evaluated how these findings help us understand motor difficulties in ASD. Three behavior paradigms with different EEG analytic methods were demonstrated. The main findings were quite mixed: children with ASD did not always show disrupted neuronal activity during motor observation. Additionally, they might have intact ability for movement execution but have more difficulties in neuronal modulation during movement preparation. We would like to promote discussions on how methodological selections of behavioral tasks and data analytic approaches impact our interpretation of motor deficits in ASD. Future EEG research addressing the inconsistency across methodological approaches is necessary to help us understand neurophysiological mechanism of motor abnormalities in ASD.

Emerging signs of autism spectrum disorder in infancy: Putative neural substrate

Autism spectrum disorder (ASD) is characterized by altered development of the social brain with prominent atypical features in the fronto-temporo-parietal cortex and cerebellum. Early signs of ASD emerge between 6 and 12 months: reduced social communication, slightly less advanced motor development, and repetitive behaviour. The fronto-temporo-parietal cortex and cerebellum play a prominent role in the development of social communication, whereas fronto-parietal-cerebellar networks are involved in the planning of movements, that is, movement selection. Atypical sensory responsivity, a core feature of ASD, may result in impaired development of social communication and motor skills and/or selection of atypical repetitive behaviour. In the first postnatal year, the brain areas involved are characterized by gradual dissolution of temporary structures: the fronto-temporo-parietal cortical subplate and cerebellar external granular layer. It is hypothesized that altered dissolution of the transient structures opens the window for the expression of early signs of ASD arising in the impaired developing permanent networks. WHAT THIS PAPER ADDS: The early social and motor signs of autism spectrum disorder emerge between the ages of 6 and 12 months. Altered dissolution of transient brain structures in the fronto-temporo-parietal cortex and cerebellum may underlie the emergence of these early signs.

What affects gestural learning in children with and without Autism? The role of prior knowledge and imitation

The present study examined whether prior knowledge to the learning target and imitation during learning affected learning outcomes in preschool children with autism spectrum disorder (ASD, N = 22) compared to their typically developing (TD, N = 15) peers. Children's gestural skills in recognizing and producing the target gestures before and after the training, as well as their imitative behavior during the training were coded. Results showed that consistent prior knowledge benefited gestural learning in both groups. Besides, only children with ASD were hindered by inconsistent prior knowledge. Notably, the effect of imitation was not significant in the ASD group. In conclusion, the learning process in children with ASD may differ from those with typical development, suggesting special-designed interventions are required.

EEG resting-state functional connectivity: evidence for an imbalance of external/internal information integration in autism

Background

Autism spectrum disorder (ASD) is associated with atypical neural activity in resting state. Most of the studies have focused on abnormalities in alpha frequency as a marker of ASD dysfunctions. However, few have explored alpha synchronization within a specific interest in resting-state networks, namely the default mode network (DMN), the sensorimotor network (SMN), and the dorsal attention network (DAN). These functional connectivity analyses provide relevant insight into the neurophysiological correlates of multimodal integration in ASD.

Methods

Using high temporal resolution EEG, the present study investigates the functional connectivity in the alpha band within and between the DMN, SMN, and the DAN. We examined eyes-closed EEG alpha lagged phase synchronization, using standardized low-resolution brain electromagnetic tomography (sLORETA) in 29 participants with ASD and 38 developing (TD) controls (age, sex, and IQ matched).

Results

We observed reduced functional connectivity in the ASD group relative to TD controls, within and between the DMN, the SMN, and the DAN. We identified three hubs of dysconnectivity in ASD: the posterior cingulate cortex, the precuneus, and the medial frontal gyrus. These three regions also presented decreased current source density in the alpha band.

Conclusion

These results shed light on possible multimodal integration impairments affecting the communication between bottom-up and top-down information. The observed hypoconnectivity between the DMN, SMN, and DAN could also be related to difficulties in switching between externally oriented attention and internally oriented thoughts.

Supplementary Information

The online version contains supplementary material available at 10.1186/s11689-022-09456-8.

Motor performance, praxis, and social skills in autism spectrum disorder and developmental coordination disorder

Previous research has shown that individuals with autism spectrum disorder (ASD) and developmental coordination disorder (DCD) may have overlapping social and motor skill impairments. This study compares ASD, DCD, and typically developing (TD) youth on a range of social, praxis and motor skills, and investigates the relationship between these skills in each group. Data were collected on participants aged 8–17 (n = 33 ASD, n = 28 DCD, n = 35 TD). Overall, the clinical groups showed some similar patterns of social and motor impairments but diverged in praxis impairments, cognitive empathy, and Theory of Mind ability. When controlling for both social and motor performance impairments, the ASD group showed significantly lower accuracy on imitation of meaningful gestures and gesture to command, indicating a prominent deficit in these praxis skills in ASD.

The mirror neuron system compensates for amygdala dysfunction - associated social deficits in individuals with higher autistic traits

The amygdala is a core node in the social brain which exhibits structural and functional abnormalities in Autism spectrum disorder and there is evidence that the mirror neuron system (MNS) can functionally compensate for impaired emotion processing following amygdala lesions. In the current study, we employed an fMRI paradigm in 241 subjects investigating MNS and amygdala responses to observation, imagination and imitation of dynamic facial expressions and whether these differed in individuals with higher (n = 77) as opposed to lower (n = 79) autistic traits. Results indicated that individuals with higher compared to lower autistic traits showed worse recognition memory for fearful faces, smaller real-life social networks, and decreased left basolateral amygdala (BLA) responses to imitation. Additionally, functional connectivity between the left BLA and the left inferior frontal gyrus (IFG) as well as some other MNS regions was increased in individuals with higher autistic traits, especially during imitation of fearful expressions. The left BLA-IFG connectivity significantly moderated the autistic group differences on recognition memory for fearful faces, indicating that increased amygdala-MNS connectivity could diminish the social behavioral differences between higher and lower autistic trait groups. Overall, findings demonstrate decreased imitation-related amygdala activity in individuals with higher autistic traits in the context of increased amygdala-MNS connectivity which may functionally compensate for amygdala dysfunction and social deficits. Training targeting the MNS may capitalize on this compensatory mechanism for therapeutic benefits in Autism spectrum disorder.

Computational Measurement of Motor Imitation and Imitative Learning Differences in Autism Spectrum Disorder: Computational Motor Imitation Measurement in ASD

Motor imitation is a critical developmental skill area that has been strongly and specifically linked to autism spectrum disorder (ASD). However, methodological variability across studies has precluded a clear understanding of the extent and impact of imitation differences in ASD, underscoring a need for more automated, granular measurement approaches that offer greater precision and consistency. In this paper, we investigate the utility of a novel motor imitation measurement approach for accurately differentiating between youth with ASD and typically developing (TD) youth. Findings indicate that youth with ASD imitate body movements significantly differently from TD youth upon repeated administration of a brief, simple task, and that a classifier based on body coordination features derived from this task can differentiate between autistic and TD youth with 82% accuracy. Our method illustrates that group differences are driven not only by interpersonal coordination with the imitated video stimulus, but also by intrapersonal coordination. Comparison of 2D and 3D tracking shows that both approaches achieve the same classification accuracy of 82%, which is highly promising with regard to scalability for larger samples and a range of non-laboratory settings. This work adds to a rapidly growing literature highlighting the promise of computational behavior analysis for detecting and characterizing motor differences in ASD and identifying potential motor biomarkers.

Moving Toward Understanding Autism: Visual-Motor Integration, Imitation, and Social Skill Development

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a behavioral phenotype characterized by impaired development of social-communicative skills and excessive repetitive and stereotyped behaviors. Despite high phenotypic heterogeneity in ASD, a meaningful subpopulation of children with ASD (∼90%) show significant general motor impairment. More focused studies on the nature of motor impairment in ASD reveal that children with ASD are particularly impaired on tasks such as ball catching and motor imitation that require efficient visual-motor integration (VMI). Motor computational approaches also provide evidence for VMI impairment showing that children with ASD form internal sensorimotor representations that bias proprioceptive over visual feedback. Impaired integration of visual information to form internal representations of others' and the external world may explain observed impairments on VMI tasks and motor imitation of others. Motor imitation is crucial for acquiring both social and motor skills, and impaired imitation skill may contribute to the observed core behavioral phenotype of ASD. The current review examines evidence supporting VMI impairment as a core feature of ASD that may contribute to both impaired motor imitation and social-communicative skill development. We propose that understanding the neurobiological mechanisms underlying VMI impairment in ASD may be key to discovery of therapeutics to address disability in children and adults with ASD.

Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review

PURPOSE OF REVIEW

This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD).

RECENT FINDINGS

Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.

Movement kinematics and cortical activation in children with and without autism spectrum disorder during sway synchrony tasks: an fNIRS study

Children with Autism Spectrum Disorder (ASD) have difficulties with socially embedded movements such as imitation and interpersonal synchrony (IPS); however, related movement characteristics and underlying neural mechanisms are not well understood. This study compared the movement characteristics and cortical activation patterns of children with and without ASD during a whole-body, sway synchrony task when different levels of social information were provided. Thirty children with and without ASD (mean age: 12.6 years, SE: 0.6 years) participated. Movement kinematics and fNIRS-based cortical activation were recorded when the child observed an adult tester sway side to side, when they swayed solo, or when they swayed face to face with the tester with or without fingertips touching (i.e., IPS). Children with ASD showed reduced synchrony and smaller sway amplitude compared to typically developing children without ASD. They showed reduced cortical activation over the inferior frontal gyrus and superior temporal sulcus during IPS and did not show significant increase in cortical activation when more social information was provided. The cortical activation findings were significantly associated with IPS behaviors and social communication performance. The ASD-related neurobiomarkers identified in our study could be used as objective measures to evaluate intervention effects in children with ASD.

Individuals with autism spectrum disorder are impaired in absolute but not relative pitch and duration matching in speech and song imitation

Individuals with autism spectrum disorder (ASD) often exhibit atypical imitation. However, few studies have identified clear quantitative characteristics of vocal imitation in ASD. This study investigated imitation of speech and song in English-speaking individuals with and without ASD and its modulation by age. Participants consisted of 25 autistic children and 19 autistic adults, who were compared to 25 children and 19 adults with typical development matched on age, gender, musical training, and cognitive abilities. The task required participants to imitate speech and song stimuli with varying pitch and duration patterns. Acoustic analyses of the imitation performance suggested that individuals with ASD were worse than controls on absolute pitch and duration matching for both speech and song imitation, although they performed as well as controls on relative pitch and duration matching. Furthermore, the two groups produced similar numbers of pitch contour, pitch interval-, and time errors. Across both groups, sung pitch was imitated more accurately than spoken pitch, whereas spoken duration was imitated more accurately than sung duration. Children imitated spoken pitch more accurately than adults when it came to speech stimuli, whereas age showed no significant relationship to song imitation. These results reveal a vocal imitation deficit across speech and music domains in ASD that is specific to absolute pitch and duration matching. This finding provides evidence for shared mechanisms between speech and song imitation, which involves independent implementation of relative versus absolute features. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) often exhibit atypical imitation of actions and gestures. Characteristics of vocal imitation in ASD remain unclear. By comparing speech and song imitation, this study shows that individuals with ASD have a vocal imitative deficit that is specific to absolute pitch and duration matching, while performing as well as controls on relative pitch and duration matching, across speech and music domains.

Supporting autism spectrum disorder screening and intervention with machine learning and wearables: a systematic literature review

The number of autism spectrum disorder individuals is dramatically increasing. For them, it is difficult to get an early diagnosis or to intervene for preventing challenging behaviors, which may be the cause of social isolation and economic loss for all their family. This SLR aims at understanding and summarizing the current research work on this topic and analyze the limitations and open challenges to address future work. We consider papers published between 2015 and the beginning of 2021. The initial selection included about 2140 papers. 11 of them respected our selection criteria. The papers have been analyzed by mainly considering: (1) the kind of action taken on the autistic individual, (2) the considered wearables, (3) the machine learning approaches, and (4) the evaluation strategies. Results revealed that the topic is very relevant, but there are many limitations in the considered studies, such as reduced number of participants, absence of datasets and experimentation in real contexts, need for considering privacy issues, and the adoption of appropriate validation approaches. The issues highlighted in this analysis may be useful for improving machine learning techniques and highlighting areas of interest in which experimenting with the use of different noninvasive sensors.

The Association among Autistic Traits, Interactional Synchrony and Typical Pattern of Motor Planning and Execution in Neurotypical Individuals

Autism spectrum disorder (ASD) is characterized by deficits in interactional synchrony and motor performance, but little is known about the association between them. The current study investigated the association among aberrant interactional synchrony (as measured by interactors’ symmetry in the form of the hand at each time-point along movement’s execution), motor functioning and the level of Autistic traits. In this study, autistic traits were evaluated by the Autistic Spectrum Quotient (AQ). Two tasks were used: (1) an interactional synchrony task where participants and the research assistant were instructed to move their hands together; and (2) a motor planning task which allows for continuous monitoring of natural hand movements. Pearson correlation analysis indicated a significant association between lower communication skills (i.e., higher AQ communication scores) and lower intentional synchrony rates. In addition, lower communication skills were found associated with typical patterns of motor planning and execution characterized by shorter time to start the movement and higher value of max speed. Mediator analyses supported the notion that aberrant intentional synchrony in individuals with low communication skills is partially mediated through typical patterns of motor planning and execution. These results suggest typical patterns of motor functions may account for intentional synchrony difficulties.

PROTOCOL: Video-based interventions for promoting positive social behaviour in children with autism spectrum disorders: a systematic review and meta-analysis

This is the protocol for a Campbell review. The primary objective for this review is summarising the effectiveness of video-based interventions (VBI) in promoting prosocial behaviours in a population of young people with autism spectrum disorders (ASD). The research questions employed to fulfil this objective include: (1) Do VBI improve prosocial behaviours in children with ASD? (2) Which social skills and interactive behaviours are most successful? (3) Do VBI generally have successful rates of skill generalisation and response maintenance? (4) Do demographic characteristics (age, gender) of participants influence the effectiveness of VBI's?

Children With Autism Exhibit More Individualized Responses to Live Animation Biofeedback Than Do Typically Developing Children

Children with autism have displayed imbalances in responding to feedback and feedforward learning information and they have shown difficulty imitating movements. Previous research has focused on motor learning and coordination problems for these children, but little is known about their motoric responses to visual live animation feedback. Thus, we compared motor output responses to live animation biofeedback training in both 15 children with autism and 15 age- and sex-matched typically developing children (age range: 8-17 years). We collected kinematic data via Inertial Measurement Unit devices while participants performed a series of body weight squats at a pre-test, during live animation biofeedback training, and at post-test. Dependent t-tests (α = 0.05), were used to test for statistical significance between pre- and post-test values within groups, and repeated measures analyses of variance (α = 0.05) were used to test for differences among the training blocks, within each group. The Model Statistic technique (α = 0.05) was used to test for pre- and post-test differences on a single-subject level for every participant. Grouped data revealed little to no significant findings in the children with autism, as these participants showed highly individualized responses. However, typically developing children, when grouped, exhibited significant differences in their left hip position (p = 0.03) and ascent velocity (p = 0.004). Single-subject analyses showed more individualistic live animation responses of children with autism than typically developing children on every variable of interest except descent velocity. Thus, to teach children with autism new movements in optimal fashion, it is particularly important to understand their individualistic motor learning characteristics.

Computerized Assessment of Motor Imitation as a Scalable Method for Distinguishing Children With Autism

BACKGROUND

Imitation deficits are prevalent in autism spectrum conditions (ASCs) and are associated with core autistic traits. Imitating others' actions is central to the development of social skills in typically developing populations, as it facilitates social learning and bond formation. We present a Computerized Assessment of Motor Imitation (CAMI) using a brief (1-min), highly engaging video game task.

METHODS

Using Kinect Xbox motion tracking technology, we recorded 48 children (27 with ASCs, 21 typically developing) as they imitated a model's dance movements. We implemented an algorithm based on metric learning and dynamic time warping that automatically detects and evaluates the important joints and returns a score considering spatial position and timing differences between the child and the model. To establish construct validity and reliability, we compared imitation performance measured by the CAMI method to the more traditional human observation coding (HOC) method across repeated trials and two different movement sequences.

RESULTS

Results revealed poorer imitation in children with ASCs than in typically developing children (ps < .005), with poorer imitation being associated with increased core autism symptoms. While strong correlations between the CAMI and HOC methods (rs = .69-.87) confirmed the CAMI's construct validity, CAMI scores classified the children into diagnostic groups better than the HOC scores (accuracyCAMI = 87.2%, accuracyHOC = 74.4%). Finally, by comparing repeated movement trials, we demonstrated high test-retest reliability of CAMI (rs = .73-.86).

CONCLUSIONS

Findings support the CAMI as an objective, highly scalable, directly interpretable method for assessing motor imitation differences, providing a promising biomarker for defining biologically meaningful ASC subtypes and guiding intervention.

A Data Driven Approach Reveals That Anomalous Motor System Connectivity is Associated With the Severity of Core Autism Symptoms

This study examined whether disruptions in connectivity involving regions critical for learning, planning, and executing movements are relevant to core autism symptoms. Spatially constrained ICA was performed using resting-state fMRI from 419 children (autism spectrum disorder (ASD) = 105; typically developing (TD) = 314) to identify functional motor subdivisions. Comparing the spatial organization of each subdivision between groups, we found voxels that contributed significantly less to the right posterior cerebellar component in children with ASD versus TD (P <0.001). Next, we examined the effect of diagnosis on right posterior cerebellar connectivity with all other motor subdivisions. The model was significant (P = 0.014) revealing that right posterior cerebellar connectivity with bilateral dorsomedial primary motor cortex was, on average, stronger in children with ASD, while right posterior cerebellar connectivity with left-inferior parietal lobule (IPL), bilateral dorsolateral premotor cortex, and supplementary motor area was stronger in TD children (all P ≤0.02). We observed a diagnosis-by-connectivity interaction such that for children with ASD, elevated social-communicative and excessive repetitive-behavior symptom severity were both associated with right posterior cerebellar-left-IPL hypoconnectivity (P ≤0.001). Right posterior cerebellar and left-IPL are strongly implicated in visuomotor processing with dysfunction in this circuit possibly leading to anomalous development of skills, such as motor imitation, that are crucial for effective social-communication. LAY SUMMARY: This study examines whether communication between various brain regions involved in the control of movement are disrupted in children with autism spectrum disorder (ASD). We show communication between the right posterior cerebellum and left IPL, a circuit important for efficient visual-motor integration, is disrupted in children with ASD and associated with the severity of ASD symptoms. These results may explain observations of visual-motor integration impairments in children with ASD that are associated with ASD symptom severity.

The role of eye contact in young children's judgments of others' visibility: A comparison of preschoolers with and without autism spectrum disorder

Typically-developing (TD) children under age 5 often deny that they can see a person whose eyes are covered (e.g., Moll & Khalulyan, 2017). This has been interpreted as a manifestation of their preference for reciprocal interactions. We investigated how 3- to 4-year-old children with autism spectrum disorder (ASD, n = 12) respond in this situation. Because a lack of interpersonal connectedness and reciprocal communication are core features of this disorder, we predicted that young children with ASD will not make mutual regard a condition for seeing another person and therefore acknowledge being able to see her. Against this prediction, children with ASD gave the same negative answers as a group of TD (n = 36) age-mates. Various interpretations are discussed, including the possibility that some children with ASD are capable of relating to others as second persons.

Deficits in Prediction Ability Trigger Asymmetries in Behavior and Internal Representation

Predictive coding is an emerging theoretical framework for explaining human perception and behavior. The proposed underlying mechanism is that signals encoding sensory information are integrated with signals representing the brain's prior prediction. Imbalance or aberrant precision of the two signals has been suggested as a potential cause for developmental disorders. Computational models may help to understand how such aberrant tendencies in prediction affect development and behavior. In this study, we used a computational approach to test the hypothesis that parametric modifications of prediction ability generate a spectrum of network representations that might reflect the spectrum from typical development to potential disorders. Specifically, we trained recurrent neural networks to draw simple figure trajectories, and found that altering reliance on sensory and prior signals during learning affected the networks' performance and the emergent internal representation. Specifically, both overly strong or weak reliance on predictions impaired network representations, but drawing performance did not always reflect this impairment. Thus, aberrant predictive coding causes asymmetries in behavioral output and internal representations. We discuss the findings in the context of autism spectrum disorder, where we hypothesize that too weak or too strong a reliance on predictions may be the cause of the large diversity of symptoms associated with this disorder.

Differences in cortical activation patterns during action observation, action execution, and interpersonal synchrony between children with or without autism spectrum disorder (ASD): An fNIRS pilot study

Engaging in socially embedded actions such as imitation and interpersonal synchrony facilitates relationships with peers and caregivers. Imitation and interpersonal synchrony impairments of children with Autism Spectrum Disorder (ASD) might contribute to their difficulties in connecting and learning from others. Previous fMRI studies investigated cortical activation in children with ASD during finger/hand movement imitation; however, we do not know whether these findings generalize to naturalistic face-to-face imitation/interpersonal synchrony tasks. Using functional near infrared spectroscopy (fNIRS), the current study assessed the cortical activation of children with and without ASD during a face-to-face interpersonal synchrony task. Fourteen children with ASD and 17 typically developing (TD) children completed three conditions: a) Watch-observed an adult clean up blocks; b) Do-cleaned up the blocks on their own; and c) Together-synchronized their block clean up actions to that of an adult. Children with ASD showed lower spatial and temporal synchrony accuracies but intact motor accuracy during the Together/interpersonal synchrony condition. In terms of cortical activation, children with ASD had hypoactivation in the middle and inferior frontal gyri (MIFG) as well as middle and superior temporal gyri (MSTG) while showing hyperactivation in the inferior parietal cortices/lobule (IPL) compared to the TD children. During the Together condition, the TD children showed bilaterally symmetrical activation whereas children with ASD showed more left-lateralized activation over MIFG and right-lateralized activation over MSTG. Additionally, using ADOS scores, in children with ASD greater social affect impairment was associated with lower activation in the left MIFG and more repetitive behavior impairment was associated with greater activation over bilateral MSTG. In children with ASD better communication performance on the VABS was associated with greater MIFG and/or MSTG activation. We identified objective neural biomarkers that could be utilized as outcome predictors or treatment response indicators in future intervention studies.

Importance of body representations in social-cognitive development: New insights from infant brain science

There is significant interest in the ways the human body, both one's own and that of others, is represented in the human brain. In this chapter we focus on body representations in infancy and synthesize relevant findings from both infant cognitive neuroscience and behavioral experiments. We review six experiments in infant neuroscience that have used novel EEG and MEG methods to explore infant neural body maps. We then consider results from behavioral studies of social imitation and examine what they contribute to our understanding of infant body representations at a psychological level. Finally, we interweave both neuroscience and behavioral lines of research to ground new theoretical claims about early infant social cognition. We propose, based on the evidence, that young infants can represent the bodily acts of others and their own bodily acts in commensurate terms. Infants initially recognize correspondences between self and other-they perceive that others are "like me" in terms of bodies and bodily actions. This capacity for registering and using self-other equivalence mappings has far-reaching implications for mechanisms of developmental change. Infants can learn about the affordances and powers of their own body by watching adults' actions and their causal consequences. Reciprocally, infants can enrich their understanding of other people's internal states by taking into account the way they themselves feel when they perform similar acts. The faces, bodies, and matching actions of people are imbued with unique meaning because they can be mapped to the infant's own body and behavior.

Continuing to look in the mirror: A review of neuroscientific evidence for the broken mirror hypothesis, EP-M model and STORM model of autism spectrum conditions

The mirror neuron system has been argued to be a key brain system responsible for action understanding and imitation. Subsequently, mirror neuron system dysfunction has therefore been proposed to explain the social deficits manifested within autism spectrum condition, an approach referred to as the broken mirror hypothesis. Despite excitement surrounding this hypothesis, extensive research has produced insufficient evidence to support the broken mirror hypothesis in its pure form, and instead two alternative models have been formulated: EP-M model and the social top-down response modulation (STORM) model. All models suggest some dysfunction regarding the mirror neuron system in autism spectrum condition, be that within the mirror neuron system itself or systems that regulate the mirror neuron system. This literature review compares these three models in regard to recent neuroscientific investigations. This review concludes that there is insufficient support for the broken mirror hypothesis, but converging evidence supports an integrated EP-M and STORM model.

Body maps in the infant brain: implications for neurodevelopmental disabilities

This review and synthesis discusses recent work that has utilized brain imaging methods, such as the electroencephalogram (EEG) and magnetoencephalogram, to provide insights into the ways that the body is represented in the infant brain. One aspect of body representation concerns somatotopic maps of the body surface in somatosensory cortex. A good deal is known about the properties of these maps in adults, but there has been relatively little developmental work. Recent studies have provided new insights into the organization of infant neural body maps and have laid the foundations for examining their plasticity in relation to behavioral development. Other work has suggested that neural body maps may be involved in the registration of correspondences between self and other, with implications for early social development. Here, body representations are discussed in the context of preterm birth and autism spectrum disorder, providing novel perspectives relevant to developmental medicine and child neurology. WHAT THIS PAPER ADDS: ●Somatotopic body maps develop prenatally through intrinsic and activity-dependent mechanisms. ●There is increasing interest in understanding postnatal plasticity in body maps. ●Body representations may be involved in the registration of preverbal, interpersonal relationships.

Applying Machine Learning to Kinematic and Eye Movement Features of a Movement Imitation Task to Predict Autism Diagnosis

Autism is a developmental condition currently identified by experts using observation, interview, and questionnaire techniques and primarily assessing social and communication deficits. Motor function and movement imitation are also altered in autism and can be measured more objectively. In this study, motion and eye tracking data from a movement imitation task were combined with supervised machine learning methods to classify 22 autistic and 22 non-autistic adults. The focus was on a reliable machine learning application. We have used nested validation to develop models and further tested the models with an independent data sample. Feature selection was aimed at selection stability to assure result interpretability. Our models predicted diagnosis with 73% accuracy from kinematic features, 70% accuracy from eye movement features and 78% accuracy from combined features. We further explored features which were most important for predictions to better understand movement imitation differences in autism. Consistent with the behavioural results, most discriminative features were from the experimental condition in which non-autistic individuals tended to successfully imitate unusual movement kinematics while autistic individuals tended to fail. Machine learning results show promise that future work could aid in the diagnosis process by providing quantitative tests to supplement current qualitative ones.

Imitation in Chinese Preschool Children: Influence of Prior Self-Experience and Pedagogical Cues on the Imitation of Novel Acts in a Non-Western Culture

Both prior experience and pedagogical cues modulate Western children’s imitation. However, these factors have not been systematically explored together within a single study. This paper explored how these factors individually and together influence imitation using 4-year-old children born and reared in mainland China (N = 210)—a country that contains almost one-fifth of the world’s population, and in which childhood imitation is under-studied using experimental methodology. The behavior of children in this culture is of special interest to theory because traditional East Asian culture places high value on conformity and fitting in with the group. Thus, high-fidelity imitation is emphasized in the local culture. This value, practice, or norm may be recognized by children at a young age and influence their imitative performance. In this study, we crossed prior self-experience and pedagogical cues, yielding four demonstration groups in addition to a control group. This design allowed us to investigate the degree to which Chinese preschoolers’ imitation was modulated by the two experimental factors. High-fidelity imitation was significantly modulated by prior self-experience but not by pedagogical cues, as measured by the number of novel acts imitated and also the serial order of these acts. This study (i) expands our understanding of factors that modulate imitation of novel behaviors in preschoolers and (ii) contributes to efforts to broaden research beyond Western societies to enrich our theories, particularly regarding social learning and imitation. Imitation is a key mechanism in the acquisition of culturally appropriate behaviors, mannerisms, and norms but who, what, and when children imitate is malleable. This study points to both cross-cultural invariants and variations to provide a fuller picture of the scope and functions of childhood imitation.

Learning of skilled movements via imitation in ASD

Autism spectrum disorder (ASD) consists of altered performance of a range of skills, including social/communicative and motor skills. It is unclear whether this altered performance results from atypical acquisition or learning of the skills or from atypical "online" performance of the skills. Atypicalities of skilled actions that require both motor and cognitive resources, such as abnormal gesturing, are highly prevalent in ASD and are easier to study in a laboratory context than are social/communicative skills. Imitation has long been known to be impaired in ASD; because learning via imitation is a prime method by which humans acquire skills, we tested the hypothesis that children with ASD show alterations in learning novel gestures via imitation. Eighteen participants with ASD and IQ > 80, ages 8-12.9 years, and 19 typically developing peers performed a task in which they watched a video of a model performing a novel, meaningless arm/hand gesture and copied the gesture. Each gesture video/copy sequence was repeated 4-6 times. Eight gestures were analyzed. Examination of learning trajectories revealed that while children with ASD made nearly as much progress in learning from repetition 1 to repetition 4, the shape of the learning curves differed. Causal modeling demonstrated the shape of the learning curve influenced both the performance of overlearned gestures and autism severity, suggesting that it is in the index of learning mechanisms relevant both to motor skills and to autism core features. Autism Res 2020, 13: 777-784.. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Imitation is a route by which humans learn a wide range of skills, naturally and in therapies. Imitation is known to be altered in autism spectrum disorder (ASD), but learning via imitation has not been rigorously examined. We found that the shape of the learning curve is altered in ASD, in a way that has a significant impact both on measures of autism severity and of other motor skills.

Preliminary Test of the Potential of Contact With Dogs to Elicit Spontaneous Imitation in Children and Adults With Severe Autism Spectrum Disorder

IMPORTANCE

Finding strategies to enhance imitation skills in people with autism spectrum disorder (ASD) is of major clinical relevance.

OBJECTIVE

To evaluate whether contact with dogs may be a useful approach to elicit spontaneous imitation in people with ASD.

DESIGN

Participants completed a spontaneous imitation task under three experimental conditions: after a free-play interaction with a live dog, after a free-play interaction with a robotic dog, and after a waiting period that involved no stimuli.

PARTICIPANTS

Ten children and 15 adults diagnosed with severe ASD.

OUTCOMES AND MEASURES

Imitation ratio, imitation accuracy, and indicators of social motivation.

RESULTS

Children appeared more motivated and engaged more frequently in spontaneous imitation in the live dog condition than in the other conditions. No differences between conditions were found for adults for imitation or social motivation. However, correlations suggested a possible trend for adults in time spent engaging with the live dog before testing and in increased imitation frequency.

CONCLUSIONS AND RELEVANCE

The results are preliminary and do not indicate the utility of integrating (live) dogs into interventions aimed at promoting social motivation and enhancing imitation skills in people with ASD. However, they suggest that doing so holds promise. Larger scale studies are now needed.

WHAT THIS ARTICLE ADDS

This research calls for occupational therapy practitioners' attention to the potential benefits that may derive from using dogs to promote spontaneous imitation, and increase imitation performance, in people with ASD, particularly children.

Comparison of Imitation From Screens Between Typically Developing Preschoolers and Preschoolers With Autism Spectrum Disorder

Typically developing (TD) children exhibit a transfer deficit imitating significantly less from screen demonstrations compared to a live demonstrations. Although many interventions for children with autism spectrum disorder (ASD) include video materials, little research exists comparing the effectiveness of video demonstration over live instruction. The current study compared imitation learning from live and screen-based demonstrations of how to make a puzzle by 3- to 4.5-year-old TD children (n = 68) and children with ASD (n = 17). Children were tested on either on a three-dimensional (3D) magnet board (MB) with magnetic puzzle pieces or a 2D touch screen (TS) with virtual puzzle pieces. Neither TD nor ASD children exhibited a transfer deficit suggesting that for this task, the transfer deficit ends around 3 years of age. Children with ASD were less efficient overall than TD children on the task and performed worse than their TD counterparts when they were tested with the 3D MB puzzle. These findings suggest that children with ASD have greater difficulty acting on 3D objects than 2D TSs. Future studies should investigate if TSs can be used to teach children with ASD other tasks (184 words).

Instructions to attend to an observed action increase imitation in autistic adults

This study investigated whether reduced visual attention to an observed action might account for altered imitation in autistic adults. A total of 22 autistic and 22 non-autistic adults observed and then imitated videos of a hand producing sequences of movements that differed in vertical elevation while their hand and eye movements were recorded. Participants first performed a block of imitation trials with general instructions to imitate the action. They then performed a second block with explicit instructions to attend closely to the characteristics of the movement. Imitation was quantified according to how much participants modulated their movement between the different heights of the observed movements. In the general instruction condition, the autistic group modulated their movements significantly less compared to the non-autistic group. However, following instructions to attend to the movement, the autistic group showed equivalent imitation modulation to the non-autistic group. Eye movement recording showed that the autistic group spent significantly less time looking at the hand movement for both instruction conditions. These findings show that visual attention contributes to altered voluntary imitation in autistic individuals and have implications for therapies involving imitation as well as for autistic people's ability to understand the actions of others.

Moving Along and Beyond the Spectrum: Creative Group Therapy for Children With Autism

Group therapy for autism confronts the core of the syndrome. Non-directed dynamic approaches, in which moment-to-moment spontaneous expressions drive the content of group sessions, are even more intricate. The implementation of nonverbal creative techniques holds the key to self-expression and self-other exploration, promoting communication and play. This manuscript offers an integrative conceptual model and a case report regarding such mind-body therapeutic perspective. The creative arts intervention is presented via a small group of young minimally verbal children with autism, deprived of communicative language, offering an interdisciplinary perspective to delineate group challenges and rationale, process, and outcomes. Vignettes are provided to illustrate the group development. A thorough discussion follows, addressing three intertwining axes: firstly, the implications of nonverbal creative means are considered; secondly, the psychophysiological processes set in motion through sensory-motor experiences are deliberated; and thirdly, the emergence of "moments of meeting" and spontaneously generated playful group activities are enlightened.

Altered Connectivity Between Cerebellum, Visual, and Sensory-Motor Networks in Autism Spectrum Disorder: Results from the EU-AIMS Longitudinal European Autism Project

BACKGROUND

Resting-state functional magnetic resonance imaging-based studies on functional connectivity in autism spectrum disorder (ASD) have generated inconsistent results. Interpretation of findings is further hampered by small samples and a focus on a limited number of networks, with networks underlying sensory processing being largely underexamined. We aimed to comprehensively characterize ASD-related alterations within and between 20 well-characterized resting-state networks using baseline data from the EU-AIMS (European Autism Interventions-A Multicentre Study for Developing New Medications) Longitudinal European Autism Project.

METHODS

Resting-state functional magnetic resonance imaging data was available for 265 individuals with ASD (7.5-30.3 years; 73.2% male) and 218 typically developing individuals (6.9-29.8 years; 64.2% male), all with IQ > 70. We compared functional connectivity within 20 networks-obtained using independent component analysis-between the ASD and typically developing groups, and related functional connectivity within these networks to continuous (overall) autism trait severity scores derived from the Social Responsiveness Scale Second Edition across all participants. Furthermore, we investigated case-control differences and autism trait-related alterations in between-network connectivity.

RESULTS

Higher autism traits were associated with increased connectivity within salience, medial motor, and orbitofrontal networks. However, we did not replicate previously reported case-control differences within these networks. The between-network analysis did reveal case-control differences showing on average 1) decreased connectivity of the visual association network with somatosensory, medial, and lateral motor networks, and 2) increased connectivity of the cerebellum with these sensory and motor networks in ASD compared with typically developing subjects.

CONCLUSIONS

We demonstrate ASD-related alterations in within- and between-network connectivity. The between-network alterations broadly affect connectivity between cerebellum, visual, and sensory-motor networks, potentially underlying impairments in multisensory and visual-motor integration frequently observed in ASD.

Using mimicry of body movements by a virtual agent to increase synchronization behavior and rapport in individuals with schizophrenia

Synchronization of behavior such as gestures or postures is assumed to serve crucial functions in social interaction but has been poorly studied to date in schizophrenia. Using a virtual collaborative environment (VCS), we tested 1) whether synchronization of behavior, i.e., the spontaneous initiation of gestures that are congruent with those of an interaction partner, was impaired in individuals with schizophrenia compared with healthy participants; 2) whether mimicry of the patients' body movements by the virtual interaction partner was associated with increased behavioral synchronization and rapport. 19 patients and 19 matched controls interacted with a virtual agent who either mimicked their head and torso movements with a delay varying randomly between 0.5 s and 4 s or did not mimic, and rated feelings of rapport toward the virtual agent after each condition. Both groups exhibited a higher and similar synchronization behavior of the virtual agent forearm movements when they were in the Mimicry condition rather than in the No-mimicry condition. In addition, both groups felt more comfortable with a mimicking virtual agent rather than a virtual agent not mimicking them suggesting that mimicry is able to increase rapport in individuals with schizophrenia. Our results suggest that schizophrenia cannot be considered anymore as a disorder of imitation, particularly as regards behavioral synchronization processes in social interaction contexts.

Interpersonal Synchronization, Motor Coordination, and Control Are Impaired During a Dynamic Imitation Task in Children With Autism Spectrum Disorder

Background: Impairments in imitation abilities have been commonly described in children with autism spectrum disorder (ASD). How motricity in interpersonal coordination impacts imitation, during long lasting semi-ecological conditions, has not been carefully investigated.

Methods: Eighty-five children and adolescents (39 controls with typical development, TD; 29 patients with ASD; 17 patients with developmental coordination disorder, DCD), aged 6 to 20 years, participated to a behavioral paradigm in which participants, standing and moving, interacted with a virtual tightrope walker standing and moving as well. During the protocol, we measured automatically and continuously bodily postures and movements from RGB sensor recording to assess participants' behavioral imitation.

Results: We show that (1) interpersonal synchronization (as evidenced by the synchrony between the participant's and the tightrope walker's bars) and (2) motor coordination (as evidenced by the synchrony between the participant's bar and its own head axis) increased with age and were more impaired in patients with ASD. Also, motor control as evidenced by the movement angle standard deviations of participants' bar and head were significantly impaired in ASD compared to TD or DCD.

Conclusion: Interpersonal synchronization and motor coordination during ecological interaction show both subtle impairment in children with ASD as compared to children with TD or DCD. These results questioned how motricity mature in terms of motor control and proprioception in children with ASD.

Learning an Embodied Visual Language: Four Imitation Strategies Available to Sign Learners

The parts of the body that are used to produce and perceive signed languages (the hands, face, and visual system) differ from those used to produce and perceive spoken languages (the vocal tract and auditory system). In this paper we address two factors that have important consequences for sign language acquisition. First, there are three types of lexical signs: one-handed, two-handed symmetrical, and two-handed asymmetrical. Natural variation in hand dominance in the population leads to varied input to children learning sign. Children must learn that signs are not specified for the right or left hand but for dominant and non-dominant. Second, we posit that children have at least four imitation strategies available for imitating signs: anatomical (Activate the same muscles as the sign model), which could lead learners to inappropriately use their non-dominant hand; mirroring (Produce a mirror image of the modeled sign), which could lead learners to produce lateral movement reversal errors or to use the non-dominant hand; visual matching (Reproduce what you see from your perspective), which could lead learners to produce inward–outward movement and palm orientation reversals; and reversing (Reproduce what the sign model would see from his/her perspective). This last strategy is the only one that always yields correct phonological forms in signed languages. To test our hypotheses, we turn to evidence from typical and atypical hearing and deaf children as well as from typical adults; the data come from studies of both sign acquisition and gesture imitation. Specifically, we posit that all children initially use a visual matching strategy but typical children switch to a mirroring strategy sometime in the second year of life; typical adults tend to use a mirroring strategy in learning signs and imitating gestures. By contrast, children and adults with autism spectrum disorder (ASD) appear to use the visual matching strategy well into childhood or even adulthood. Finally, we present evidence that sign language exposure changes how adults imitate gestures, switching from a mirroring strategy to the correct reversal strategy. These four strategies for imitation do not exist in speech and as such constitute a unique problem for research in language acquisition.

Behavioral Own-Body-Transformations in Children and Adolescents With Typical Development, Autism Spectrum Disorder, and Developmental Coordination Disorder

Background: In motor imitation, taking a partner's perspective often involves a mental body transformation from an embodied, ego-centered viewpoint to a disembodied, hetero-centered viewpoint. Impairments of both own-body-transformation (OBT) and abnormalities in visual-spatial processing have been reported in patients with neurodevelopmental disorders including autism spectrum disorder (ASD). In the context of a visual-motor interactive task, studying OBT impairments while disentangling the contribution of visual-spatial impairments associated with motor coordination problems has not been investigated. Methods: 85 children and adolescents (39 controls with typical development, TD; 29 patients with ASD; 17 patients with developmental coordination disorder, DCD), aged 6-19 years, participated in a behavioral paradigm in which participants interacted with a virtual tightrope walker (TW) standing and moving with him. The protocol enables to distinguish ego-centered and hetero-centered perspectives. Results: We show that (1) OBT was possible but difficult for children with neurodevelopmental disorders, as well as for TD children, when the task required the participant to perform a mental rotation in order to adopt a hetero-centered perspective. (2) Using multivariate models, hetero-centered perspective score was significantly associated with age, TW orientation, latency, and diagnosis. ASD and TD groups' performances were close and significantly correlated with age. However, it was not the case for DCD, since this group was specifically handicapped by visual-spatial impairments. (3) ASD and DCD did not perform similarly: motor performance as shown by movement amplitude was better in DCD than ASD. ASD motor response was more ambiguous and hardly readable. Conclusion: Changing perspective in a spatial environment is possible for patients with ASD although delayed compared with TD children. In patients with DCD, their visual-spatial impairments negatively modulated their performances in the experiment.