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Lampri S, Peristeri E, Marinis T, Andreou M. Metaphor comprehension and production in verbally able children with Autism Spectrum Disorder. Autism Res 2024; 17:2292-2304. [PMID: 39126199 DOI: 10.1002/aur.3210] [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: 03/14/2024] [Accepted: 07/22/2024] [Indexed: 08/12/2024]
Abstract
Research in the field of figurative language processing in Autism Spectrum Disorders (ASD) has demonstrated that autistic individuals experience systematic difficulties in the comprehension of different types of metaphors. However, there is scarce evidence regarding metaphor production skills in ASD. Importantly, the exact source of metaphor processing difficulties in ASD remains largely controversial. The debate has mainly focused on the mediating role of structural language skills (i.e., lexical knowledge) and cognitive abilities (i.e., Theory of Mind and executive functions) in ASD individuals' ability to comprehend and generate metaphors. The present study examines metaphor comprehension and production in 18 Greek-speaking verbally able children with ASD and 31 typically-developing (TD) controls. Participants completed two tasks, namely, a low-verbal multiple-choice sentence-picture matching task that tested their ability to comprehend conventional predicate metaphors, and a sentence continuation task that assessed their ability to generate metaphors. The study also included measures of fluid intelligence, expressive vocabulary, and working memory within the sample. The results show that the ASD group had significantly lower performance than the TD group in both metaphor comprehension and production. The findings also reveal that expressive vocabulary skills were a key factor in the metaphor comprehension and production performance of the children with ASD. Working memory capacity was also found to correlate significantly with metaphor comprehension performance in the ASD group. Conversely, no correlations were found in the TD group with neither of the above factors. Of note, children with ASD generated significantly more inappropriate responses and no-responses to the metaphor production task compared with the control group. The overall results reveal that children with ASD had difficulty with both comprehending and using metaphorical language. The findings also indicate that TD children may employ diverse cognitive strategies or rely on different underlying skills when processing metaphors compared with children with ASD.
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Affiliation(s)
- Stella Lampri
- Department of Speech and Language Therapy, University of Peloponnese, Kalamata, Greece
| | - Eleni Peristeri
- Department of Theoretical and Applied Linguistics, School of English, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Theodoros Marinis
- Department of Linguistics, University of Konstanz, Konstanz, Germany
| | - Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, Kalamata, Greece
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Peristeri E, Drakoulaki K, Boznou A, Nerantzini M, Gena A, Lengeris A, Varlokosta S. What Silent Pauses Can 'Tell' Us About the Storytelling Skills of Autistic Children: Relations Between Pausing, Language Skills and Executive Functions. J Autism Dev Disord 2024:10.1007/s10803-024-06523-y. [PMID: 39207583 DOI: 10.1007/s10803-024-06523-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: 08/12/2024] [Indexed: 09/04/2024]
Abstract
Silent pauses may serve communicative purposes such as demarcating boundaries between discourse units in language production. Previous research has shown that autistic children differ in their pausing behavior from typically-developing (TD) peers, however, the factors behind this difference remain underexplored. The current study was aimed at comparing the use of silent pauses in the narrative production of autistic children and age-matched TD children, and also to identify possible relations between pausing behavior and the children's language and executive function abilities. According to the study's findings, the autistic children did not differ from their TD peers in the use of grammatical pauses, however, the former tended to produce significantly less syntactically complex narratives than the TD group, which increased the likelihood that the autistic group would pause appropriately at phrasal boundaries. Though we have found low rates of ungrammatical silent pauses and omitted pauses in obligatory discourse contexts across both groups, autistic children with lower cognitive flexibility tended to use more ungrammatical pauses than their peers with higher cognitive flexibility scores. Also, the autistic group tended to omit obligatory silent pauses more often as their narration became more complex. The results demonstrate that syntactic complexity in narrative production modulated autistic children's pausing behavior, and that structurally simple narrations boosted the autistic group's appropriate use of grammatical pauses. The overall findings also demonstrate the importance of studying silent pauses in the narrative discourse of autistic children, and also highlight the links between silent pauses and the children's syntactic and cognitive skills.
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Affiliation(s)
- Eleni Peristeri
- Department of Theoretical & Applied Linguistics, School of English, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Katerina Drakoulaki
- Department of Linguistics, Faculty of Philology, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Antonia Boznou
- Department of Linguistics, Faculty of Philology, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Michaela Nerantzini
- Department of Speech and Language Therapy, University of Ioannina, 45110, Ioannina, Greece
| | - Angeliki Gena
- Department of Philosophy, Pedagogy and Psychology, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Angelos Lengeris
- Department of Linguistics, Faculty of Philology, National and Kapodistrian University of Athens, 15772, Athens, Greece
| | - Spyridoula Varlokosta
- Department of Linguistics, Faculty of Philology, National and Kapodistrian University of Athens, 15772, Athens, Greece
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Themistocleous CK, Andreou M, Peristeri E. Autism Detection in Children: Integrating Machine Learning and Natural Language Processing in Narrative Analysis. Behav Sci (Basel) 2024; 14:459. [PMID: 38920791 PMCID: PMC11200366 DOI: 10.3390/bs14060459] [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: 03/31/2024] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 06/27/2024] Open
Abstract
Despite the consensus that early identification leads to better outcomes for individuals with autism spectrum disorder (ASD), recent research reveals that the average age of diagnosis in the Greek population is approximately six years. However, this age of diagnosis is delayed by an additional two years for families from lower-income or minority backgrounds. These disparities result in adverse impacts on intervention outcomes, which are further burdened by the often time-consuming and labor-intensive language assessments for children with ASD. There is a crucial need for tools that increase access to early assessment and diagnosis that will be rigorous and objective. The current study leverages the capabilities of artificial intelligence to develop a reliable and practical model for distinguishing children with ASD from typically-developing peers based on their narrative and vocabulary skills. We applied natural language processing-based extraction techniques to automatically acquire language features (narrative and vocabulary skills) from storytelling in 68 children with ASD and 52 typically-developing children, and then trained machine learning models on the children's combined narrative and expressive vocabulary data to generate behavioral targets that effectively differentiate ASD from typically-developing children. According to the findings, the model could distinguish ASD from typically-developing children, achieving an accuracy of 96%. Specifically, out of the models used, hist gradient boosting and XGBoost showed slightly superior performance compared to the decision trees and gradient boosting models, particularly regarding accuracy and F1 score. These results bode well for the deployment of machine learning technology for children with ASD, especially those with limited access to early identification services.
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Affiliation(s)
| | - Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, 24100 Kalamata, Greece
| | - Eleni Peristeri
- School of English, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
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Peristeri E, Frantzidis CA, Andreou M. Editorial: Neural mechanisms of language and cognitive performance in individuals with neurodevelopmental disorders. Front Psychol 2024; 15:1414354. [PMID: 38741752 PMCID: PMC11089099 DOI: 10.3389/fpsyg.2024.1414354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/15/2024] [Indexed: 05/16/2024] Open
Affiliation(s)
- Eleni Peristeri
- Department of English Studies, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, Kalamata, Greece
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Peristeri E, Frantzidis CA, Andreou M. Reading comprehension differences between children with Autism Spectrum Disorder and low cognitive abilities and children with Autism Spectrum Disorder and intact cognitive skills: the roles of decoding, fluency and morphosyntax. Front Psychol 2024; 15:1357590. [PMID: 38659686 PMCID: PMC11040691 DOI: 10.3389/fpsyg.2024.1357590] [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: 12/19/2023] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Reading comprehension is one of the most important skills learned in school and it has an important contribution to the academic success of children with Autism Spectrum Disorder (ASD). Though previous studies have investigated reading comprehension difficulties in ASD and highlighted factors that contribute to these difficulties, this evidence has mainly stemmed from children with ASD and intact cognitive skills. Also, much emphasis has been placed on the relation between reading comprehension and word recognition skills, while the role of other skills, including fluency and morphosyntax, remains underexplored. This study addresses these gaps by investigating reading comprehension in two groups of school-aged children with ASD, one with intact and one with low cognitive abilities, also exploring the roles of word decoding, fluency and morphosyntax in each group's reading comprehension performance. Methods The study recruited 16 children with ASD and low cognitive abilities, and 22 age-matched children with ASD and intact cognitive skills. The children were assessed on four reading subdomains, namely, decoding, fluency, morphosyntax, and reading comprehension. Results The children with ASD and low cognitive abilities scored significantly lower than their peers with intact cognitive abilities in all reading subdomains, except for decoding, verb production and compound word formation. Regression analyses showed that reading comprehension in the group with ASD and intact cognitive abilities was independently driven by their decoding and fluency skills, and to a lesser extent, by morphosyntax. On the other hand, the children with ASD and low cognitive abilities mainly drew on their decoding, and to a lesser extent, their morphosyntactic skills to perform in reading comprehension. Discussion The results suggest that reading comprehension was more strongly affected in the children with ASD and low cognitive abilities as compared to those with intact cognitive skills. About half of the children with ASD and intact cognitive skills also exhibited mild-to-moderate reading comprehension difficulties, further implying that ASD may influence reading comprehension regardless of cognitive functioning. Finally, strengths in decoding seemed to predominantly drive cognitively-impaired children's reading performance, while the group with ASD and intact cognitive skills mainly recruited fluency and metalinguistic lexical skills to cope with reading comprehension demands, further suggesting that metalinguistic awareness may be a viable way to enhance reading comprehension in ASD.
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Affiliation(s)
- Eleni Peristeri
- Department of English Studies, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, Kalamata, Greece
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Peristeri E, Andreou M. Intellectual development in young children with autism spectrum disorders: A longitudinal study. Autism Res 2024; 17:543-554. [PMID: 38183366 DOI: 10.1002/aur.3089] [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: 09/05/2023] [Accepted: 12/14/2023] [Indexed: 01/08/2024]
Abstract
Intelligence profiles in autism have been characterized by great variability. The questions of how autistic children's intelligence changes over time, and what factors influence these changes deserve study as part of efforts to document child autism profiles, but also because the relationship between intellectual functioning and children's background characteristics is poorly understood, particularly in a longitudinal context. A total of 39 autistic children and 39 age-matched neurotypical children (5-9 years old) completed two IQ assessments at preschool age and up to 4 years later. Repeated-measures analyses assessed longitudinal changes in the children's verbal (VIQ), performance (PIQ), and full-scale IQ (FSIQ) at group level. We further sought to identify clusters with distinct profiles in each group by adopting an unsupervised K-means clustering approach, and detect possible between-subgroup differences in terms of children's socioeconomic status and autism severity. The largest cluster in the autistic group was composed of children whose PIQ significantly dropped at follow-up, while the second largest cluster improved in all quotients; the smallest cluster, wherein children had more highly educated mothers than the rest of the clusters, was characterized by large improvement in VIQ. For the neurotypical children, there was a two-cluster division; the majority of them improved in the three quotients, while very few dropped in PIQ at follow-up. The relation between socioeconomic status and IQ changes was significant for both groups. The findings demonstrate both the complexity of intelligence changes in autism and the need to view this complexity through the lens of the children's socioeconomic diversity.
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Affiliation(s)
- Eleni Peristeri
- Department of Theoretical and Applied Linguistics, School of English, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Andreou
- Department of Speech and Language Therapy, University of Peloponnese, Kalamata, Greece
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Al-Mazidi SH. The Physiology of Cognition in Autism Spectrum Disorder: Current and Future Challenges. Cureus 2023; 15:e46581. [PMID: 37808604 PMCID: PMC10557542 DOI: 10.7759/cureus.46581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/10/2023] Open
Abstract
Cognitive impairment is among the most challenging characteristics of autism spectrum disorder (ASD). Although ASD is one of the common neurodevelopmental disorders, we are still behind in diagnosing and treating cognitive impairment in ASD. Cognitive impairment in ASD varies, meaning it could be at the sensory perception level to cognitive processing, learning, and memory. There are no diagnostic criteria for cognitive impairment that are specific to ASD. The leading causes of cognitive impairment in ASD could be neurological, immune, and gastrointestinal dysfunction. Immune dysfunction might lead to neuroinflammation, affecting neural connectivity, glutamate/gamma-aminobutyric acid (GABA) balance, and plasticity. The gut-brain axes are essential in the developing brain. Special retinal changes have recently been detected in ASD, which need clinical investigation to find their possible role in early diagnosis. Early intervention is crucial for ASD cognitive dysfunction. Due to the heterogeneity of the disease, the clinical manifestation of ASD makes it difficult for clinicians to develop gold-standard diagnostic and therapeutic criteria. We suggest a triad for diagnosis, which includes clinical tests for immune and gastrointestinal dysfunction biomarkers, clinical examination for the retina, and an objective neurocognitive evaluation for ASD, and to develop a treatment strategy involving these three aspects. Developing clear treatment criteria for cognitive impairment for ASD would improve the quality of life of ASD people and their caregivers and would delay or prevent dementia-related disorders in ASD people.
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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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