Brief report: neuropsychological testing of autistic children through an exploration with frontal lobe tests

Comprehension of irony in autistic children: The role of theory of mind and executive function

Although previous studies have examined irony comprehension in autistic children and potential impact factors, the relationship between theory of mind (ToM), executive function (EF), symptoms of autism, and comprehension of irony in this population remains largely unknown. This study explored irony comprehension in autistic children and examined the roles of ToM and EF in linking autism symptoms to deficits in irony comprehension. Twenty autistic children were compared with 25 typically developing (TD) children in an irony story picture task, ToM task, and EF task. The results showed that autistic children had impaired comprehension of irony compared with TD children, and performance on ironic stories showed a significant moderate discriminatory effect in predicting autistic children. A ToM deficit has also been proposed for autistic children. Comprehension of irony was significantly correlated with second-order ToM (2nd ToM) but was not significantly correlated with any components of EF. Moreover, 2nd ToM can predict the level of irony comprehension and mediate the relationship between symptoms of autism and irony comprehension. Taken together, these findings suggest that irony comprehension may offer a potential cognitive marker for quantifying syndrome manifestations in autistic children, and 2nd ToM may provide insight into the theoretical mechanism underlying the deficit in irony comprehension in this population.

Combined Gait and Grasping in Autistic and Non-Autistic Youths

This study was designed to extend research on motor skill development in autism spectrum disorder using a dual-task skill. Nine autistic and 18 non-autistic youths walked without grasping or while reaching to grasp a small or large object. Step extremity ratio, percent time in double support, and normalized speed were quantified. We hypothesized that gait would differ between autistic and non-autistic youth and that differences would be moderated by the phase (approach and grasp) and the complexity of the task (walking and grasping versus walking alone). Although gait parameters were similar during the walking-only trials, the combined task resulted in slower speed and shorter steps in autistic youth, particularly during the grasp phase. These findings, while in a small sample, offer preliminary evidence that autistic youth who show typical gait during simple assessments of motor ability may have difficulties in more complex tasks that require the coordination of movements.

Do children with and without autism spectrum disorder use different visuospatial processing skills to perform the Rey-Osterrieth complex figure test?

Visuospatial organization abilities are closely related to other visuospatial processing skills, such as visuomotor coordination, perceptual abilities, mental rotation, and working memory (WM). One task that enables visuospatial organization abilities to be investigated is the Rey-Osterrieth complex figure test (ROCFT). When examining visuospatial functioning, individuals with autism spectrum disorder (ASD) have proved capable of operating both locally and globally, depending on the sub-domain embraced, with a preference for a locally-oriented processing of visuospatial information. The present research aimed to establish whether different underlying visuospatial skills might account for performance in the ROCFT in children and adolescents with ASD, compared with typically developing (TD), by considering the role of local/global visuospatial processing. The study involved 39 participants who have ASD without intellectual disability, and 57 TD aged 8-16 years. The participants were administered tasks assessing visuospatial organization abilities, manual dexterity, visual perception, mental rotation, spatial-sequential, spatial-simultaneous WM, and visuospatial processing. Our results suggest that manual dexterity and visuospatial processing similarly explain performance in both groups, while differences in visuospatial WM account for the two groups' visuospatial organization abilities. Spatial-simultaneous WM predicted performance in copy and recall conditions in the TD group but not in the ASD group, while spatial-sequential WM only did so in the latter group, reinforcing the tendency of children with ASD towards local bias in the visuospatial organization domain. The implications of these findings are discussed. LAY SUMMARY: The visuospatial organization abilities of children and adolescents with and without autism were compared, considering their underlying visuospatial skills. Visuospatial organization impairments emerged for children with autism, who differed from typically developing children in the underlying visuospatial skills involved. Given the crucial role of visuospatial organization abilities in everyday life, our results could inspire practitioners to develop training interventions that take into account the strengths and weaknesses of individuals with autism.

Measuring the Impact of Bilingualism on Executive Functioning Via Inhibitory Control Abilities in Autistic Children

One factor that may influence how executive functions develop is exposure to more than one language in childhood. This study explored the impact of bilingualism on inhibitory control in autistic (n = 38) and non-autistic children (n = 51). Bilingualism was measured on a continuum of exposure to investigate the effects of language environment on two facets of inhibitory control. Behavioural control of motor impulses was modulated positively through increased bilingual exposure, irrespective of diagnostic status, but bilingual exposure did not significantly affect inhibition involving visual attention. The results partially support the hypothesis that bilingual exposure differentially affects components of inhibitory control and provides important evidence for families that bilingualism is not detrimental to their development.

Local Processing Bias Impacts Implicit and Explicit Memory in Autism

Autism spectrum disorder (ASD) is characterized by atypical perception, including processing that is biased toward local details rather than global configurations. This bias may impact on memory. The present study examined the effect of this perception on both implicit (Experiment 1) and explicit (Experiment 2) memory in conditions that promote either local or global processing. The first experiment consisted of an object identification priming task using two distinct encoding conditions: one favoring local processing (Local condition) and the other favoring global processing (Global condition) of drawings. The second experiment focused on episodic (explicit) memory with two different cartoon recognition tasks that favored either local (i.e., processing specific details) or a global processing (i.e., processing each cartoon as a whole). In addition, all the participants underwent a general clinical cognitive assessment aimed at documenting their cognitive profile and enabling correlational analyses with experimental memory tasks. Seventeen participants with ASD and 17 typically developing (TD) controls aged from 10 to 16 years participated to the first experiment and 13 ASD matched with 13 TD participants were included for the second experiment. Experiment 1 confirmed the preservation of priming effects in ASD but, unlike the Comparison group, the ASD group did not increase his performance as controls after a globally oriented processing. Experiment 2 revealed that local processing led to difficulties in discriminating lures from targets in a recognition task when both lures and targets shared common details. The correlation analysis revealed that these difficulties were associated with processing speed and inhibition. These preliminary results suggest that natural perceptual processes oriented toward local information in ASD may impact upon their implicit memory by preventing globally oriented processing in time-limited conditions and induce confusion between explicit memories that share common details.

An examination of perseverative errors and cognitive flexibility in autism

Perseveration is a well-replicated finding in autism. The aim of this study was to examine how the context of the task influences performance with respect to this phenomenon. We randomly assigned 137 children aged 6–12 with and without autism to complete a modified card-sorting task under one of two conditions: Children were either told the sorting rules on each trial (Explicit), or were given feedback to formulate the rules themselves (Implicit). While performance was enhanced on the Explicit condition for participants without autism, the participants with autism were disadvantaged by this manipulation. In contrast, there were few differences in performance between groups on the Implicit condition. Exploratory analyses were used to examine this unexpected result; increased autism symptomology was associated with poorer performance.

How Do Children with Autism Spectrum Disorder Encode and Reproduce Visuospatial Stimuli?: Investigation into Visuospatial Processing Abilities and Styles

OBJECTIVE

The purpose of this study was to examine the visuospatial processing abilities of children with autism spectrum disorder (ASD) using the Rey Osterrieth Complex Figure (ROCF).

METHODS

One-hundred thirty-four children with ASD [mean age (MA)=113.56 months], 150 siblings of children with ASD (MA= 111.67 months), and 55 typically developing (TD) children (MA=109.02 months) were included in this study. During their one-time visit, participants completed the ROCF, various autism diagnostic assessments, and the Korean-Leiter International Performance ScaleRevised. Repeated-measures Analysis of Covariance (ANCOVA) and post-hoc Tukey-Kramer comparisons were computed to compare the ROCF scores. Partial correlations and multiple regressions were computed to examine the association between ROCF scores and the severity of autistic symptoms, as measured by the Autism Diagnostic Interview-Revised (ADI-R) among children with ASD.

RESULTS

There were significant main effects of the analysis group in Structural and Incidental Accuracy, Error, and Style. More siblings than TD children drew in a part-oriented way, but the performance of the sibling group was comparable or superior to that of the TD group in all parameters. Social Interaction scores of children with ASD were significantly associated with Organization scores in Copy condition. Whether or not a child drew in the Part-Oriented style significantly predicted his/her repetitive and restricted behavior scores.

CONCLUSION

The findings add to the evidence for altered visuospatial processing patterns of ASD as a potential inherent and genetic trait and suggest that this particular cognitive style should not be considered as a deficit. Educational and theoretical implications are discussed.

Comprehensive attention training system (CATS): A computerized executive-functioning training for school-aged children with autism spectrum disorder

OBJECTIVE

Theory suggests that impaired executive functioning (EF) might explain several symptoms of autism spectrum disorder (ASD) in children. However, only a few studies have examined the efficacy of EF training for the children using randomized control trial designs, and only two of them found significant benefits of the training.

METHOD

We designed Comprehensive Attention Training System (CATS), and tested this new EF intervention for children with ASD in a small-sampled randomized controlled trial. Twenty-five children with ASD aged six to twelve were randomly assigned to either the CATS or the control training and were assessed pre- and post-training.

RESULTS

Relative to the control group, the CATS group improved on EF as measured by the trail-making test, avoiding perseverative errors, and forming conceptual responses in the Wisconsin Card Sorting Task. There were also indications that CATS contributed to long-term communication skills as measured by the Vineland adaptive behavior scales.

CONCLUSIONS

We report preliminary evidence that the CATS intervention may improve the EF of school-aged children with ASD compared to a control intervention. We discuss the results in terms of their generalizability to other developmental disorders.

A cross-task comparison on visuospatial processing in autism spectrum disorders

This study aimed to draw a cross-task comparison on visuospatial processing in autism spectrum disorder without intellectual disability. Participants with autism spectrum disorder were matched with typically developing individuals on general intelligence and perceptual reasoning index. The two groups were subsequently compared on visuospatial processing speed, visuo-perceptual, visuo-constructive, and visuospatial working memory tasks. Our results revealed similar performances between autism spectrum disorder and typically developing individuals on measures of visuospatial processing speed and visuospatial working memory. The autism spectrum disorder group showed slower reaction times than the typically developing group in the visuo-perceptual task, when stimuli were characterized by a minimum level of perceptual cohesiveness, revealing weaker spatial integration abilities. Concerning the visuo-constructive domain, no differences between the autism spectrum disorder and the typically developing group emerged for the unsegmented condition, revealing that our participants with autism spectrum disorder were similar to the typically developing group in the local analysis of the stimuli. The discussion takes into account the role of individual differences on visuospatial intelligence, task requirements, and cognitive domains to clarify the visuospatial processing skills of individuals with autism spectrum disorder.

Allocentric Versus Egocentric Spatial Memory in Adults with Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) present difficulties in forming relations among items and context. This capacity for relational binding is also involved in spatial navigation and research on this topic in ASD is scarce and inconclusive. Using a computerised version of the Morris Water Maze task, ASD participants showed particular difficulties in performing viewpoint independent (allocentric) navigation, leaving viewpoint dependent navigation (egocentric) intact. Further analyses showed that navigation deficits were not related to poor visual short-term memory or mental rotation in the ASD group. The results further confirm the need of autistic individuals for support at retrieval and have important implications for the design of signposts and maps.

Executive Function in Autism Spectrum Disorder: History, Theoretical Models, Empirical Findings, and Potential as an Endophenotype

This review presents an outline of executive function (EF) and its application to autism spectrum disorder (ASD). The development of the EF construct, theoretical models of EF, and limitations in the study of EF are outlined. The potential of EF as a cognitive endophenotype for ASD is reviewed, and the Research Domain Criteria (RDoC) framework is discussed for researching EF in ASD given the multifaceted factors that influence EF performance. A number of executive-focused cognitive models have been proposed to explain the symptom clusters observed in ASD. Empirical studies suggest a broad impairment in EF, although there is significant inter-individual variability in EF performance. The observed heterogeneity of EF performance is considered a limiting factor in establishing EF as a cognitive endophenotype in ASD. We propose, however, that this variability in EF performance presents an opportunity for subtyping within the spectrum that can contribute to targeted diagnostic and intervention strategies. Enhanced understanding of the neurobiological basis that underpins EF performance, such as the excitation/inhibition hypothesis, will likely be important. Application of the RDoC framework could provide clarity on the nature of EF impairment in ASD with potential for greater understanding of, and improved interventions for, this disorder.

Impaired Hippocampal Synaptic Plasticity and Enhanced Excitatory Transmission in a Novel Animal Model of Autism Spectrum Disorders with Telomerase Reverse Transcriptase Overexpression

Recently, we have reported that animals with telomerase reverse transcriptase (TERT) overexpression exhibit reduced social interaction, decreased preference for novel social interaction and poor nest-building behaviors symptoms that mirror those observed in human autism spectrum disorders (ASD). Overexpression of TERT also alters the excitatory/inhibitory (E/I) ratio in the medial prefrontal cortex. However, the effects of TERT overexpression on hippocampal-dependent learning and synaptic efficacy have not been investigated. In the present study, we employed electrophysiological approaches in combination with behavioral analysis to examine hippocampal function of TERT transgenic (TERT-tg) mice and FVB controls. We found that TERT overexpression results in enhanced hippocampal excitation with no changes in inhibition and significantly impairs long-term synaptic plasticity. Interestingly, the expression levels of phosphorylated CREB and phosphory-lated CaMKIIα were significantly decreased while the expression level of CaMKIIα was slightly increased in the hippocampus of TERT-overexpressing mice. Our observations highlight the importance of TERT in normal synaptic function and behavior and provide additional information on a novel animal model of ASD associated with TERT overexpression.

Executive Functions and Prosodic Abilities in Children With High-Functioning Autism

Little is known about the relationship between prosodic abilities and executive function skills. As deficits in executive functions (EFs) and prosodic impairments are characteristics of autism, we examined how EFs are related to prosodic performance in children with high-functioning autism (HFA). Fifteen children with HFA (M = 7.4 years; SD = 1.12), matched to 15 typically developing peers on age, gender, and non-verbal intelligence participated in the study. The Profiling Elements of Prosody in Speech-Communication (PEPS-C) was used to assess prosodic performance. The Children's Color Trails Test (CCTT-1, CCTT-2, and CCTT Interference Index) was used as an indicator of executive control abilities. Our findings suggest no relation between prosodic abilities and visual search and processing speed (assessed by CCTT-1), but a significant link between prosodic skills and divided attention, working memory/sequencing, set-switching, and inhibition (assessed by CCTT-2 and CCTT Interference Index). These findings may be of clinical relevance since difficulties in EFs and prosodic deficits are characteristic of many neurodevelopmental disorders. Future studies are needed to further investigate the nature of the relationship between impaired prosody and executive (dys)function.

A theoretical approach to the deficits in infantile autism

Deficits specific to the syndrome of infantile autism appear in imitation, emotion sharing, theory of mind, pragmatics of communication, and symbolic play. Current competing theories of Hobson and of Baron-Cohen, Frith, and associates account for some, but not all, of these specific deficits. The present article suggests that early social capacities involving imitation, emotion sharing, and theory of mind are primarily and specifically deficient in autism. Further, these three capacities involve forming and coordinating social representations of self and other at increasingly complex levels via representational processes that extract patterns of similarity between self and other. Stern's theory of interpersonal development is offered as a continuous model for understanding the development and deficits of the autistic child and as a means for integrating competing theories about the primary deficits in autism. Finally, the article suggests a neuropsychological model of interpersonal coordination involving prefrontal cortex and executive function capacities that is consistent with the social deficits observed in autism.

Planning Skills in Autism Spectrum Disorder Across the Lifespan: A Meta-analysis and Meta-regression

Individuals with an autism spectrum disorder (ASD) are thought to encounter planning difficulties, but experimental research regarding the mastery of planning in ASD is inconsistent. By means of a meta-analysis of 50 planning studies with a combined sample size of 1755 individuals with and 1642 without ASD, we aim to determine whether planning difficulties do exist and which factors contribute to this. Planning problems were evident in individuals with ASD (Hedges'g = 0.52), even when taking publication bias into account (Hedges'g = 0.37). Neither age, nor task-type, nor IQ reduced the observed heterogeneity, suggesting that these were not crucial moderators within the current meta-analysis. However, while we showed that ASD individuals encounter planning difficulties, the bias towards publishing positive findings restricts strong conclusions regarding the role of potential moderators.

On Bridging the Gap Between Social-Personality Psychology and Neuropsychology

Although cognitive psychology has learned much from the study of patients with neuropsychological impairments, social and personality psychologists have been slow to do the same. In this article we argue that the domain of clinical neuropsychology holds considerable untapped potential for formulating and testing models within social and personality psychology and describe some of the ways in which questions of interest to social and personality psychologists can be addressed with neuropsychological data. Examples are drawn from a variety of neuropsychological syndromes, including amnesia, autism, anosognosia, commissurotomy, frontal lobe damage, and prosopagnosia. We conclude that consideration of the personal and social lives of patients with neuropsychological impairments ultimately will lead to a richer understanding of the person, one that bridges the gap between social and cognitive levels of analysis.

Executive functioning in men and women with an autism spectrum disorder

Executive functioning (EF) is thought to be linked to autism spectrum disorders (ASD) specific symptoms. The majority of research has focused on children and adolescents with ASD and, therefore, little is known about EF in adults. Furthermore, little is known about gender differences. Ninety-nine men and forty women with ASD were compared with and 35 neurotypical men 25 neurotypical women. Participants were matched on age, total intelligence, and verbal ability. The following instruments were used to measure executive functioning: digit span and letter and number sequencing of the WAIS-III, Tower of Hanoi, WCST, and Verbal fluency. Multiple analysis of variance was conducted to determine group differences. Women with ASD performed worse on the working memory tasks of the WAIS-III than neurotypical women. Furthermore, women with ASD had more perseverations on the WCST than neurotypical women. The gender comparison in the ASD group showed differences in performance on mental flexibility (WCST), working memory (WAIS-III), generativity and self-monitoring (Verbal fluency). However, these differences were unequivocal and no gender specific cognitive profile could be pinpointed. Individual strengths and frailties should be highlighted in clinical practice, as impairments in EF can be under influence of the overall cognitive abilities of the individual. Furthermore, gender differences were found. This could explain differences in representation of ASD symptoms in both groups. These differences show how important thorough diagnostics are. Autism Res 2017, 10: 940-948. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Neuropsychological Profiles of Children with Asperger Syndrome and Autism

This study examined the possibility that diagnostic differentiation between children with autism and Asperger syndrome may be enhanced through the use of neuropsychological profiles. Two groups of children, clinically diagnosed as having Asperger syndrome ( n35) or autism ( n21), were tested with a neuropsychological battery to assess the propositions that these groups might differ in terms of Wechsler IQ profiles, brain hemispheric strengths and weaknesses, and executive functioning. Clinically diagnosed children with Asperger syndrome and autism were not differentiated on the basis of their neuropsychological profiles. The major difference between them was the overall higher IQ in Asperger syndrome, which was largely due to superior verbal abilities. Differences were also examined using DSM-IV/ICD-10 criteria: children were grouped according to the early history of presence or absence of language delay. No differences between the groups on any neurocognitive measure were found and there was no support for current neuropsychological theories purporting to support differential diagnostic status. It appears that current diagnostic differentiation in clinical practice may be primarily influenced by the child’s estimated verbal IQ level.

Executive Functioning and Memory Strategy Use in Children with Autism

An executive functioning deficit in autism should be reflected in a low level of active strategy use on memory tasks. This study was a direct examination of memory strategy use in two problem-solving situations by children with autism. Two groups with autism were tested, one high-functioning group and one with moderate cognitive impairments. All participants took part in two memory experiments to examine the effect of changing the nature of the learning situation on strategy use: one experiment used a serial recall task, and the other a recall readiness task. In contrast to previous studies, significant spontaneous strategy use was found on both memory tasks, particularly among the high-functioning group. Similarly, changing task structure was found to have an important impact on increasing strategy use, particularly for the moderate-functioning group. However, the overall rate of strategy use for the children with autism was still lower than would be expected for non-handicapped groups. The results support an executive functioning deficit interpretation, but a deficit that is less extensive among high-functioning individuals. Practical implications of the study in terms of cognitive training are also discussed.

Executive Function/Attention Deficits in Boys with Asperger Syndrome, Attention Disorder and Reading/Writing Disorder

Executive function/attention deficits were examined in children with Asperger syndrome, attention disorder and reading/ writing disorder and in a group of normal children. Neuropsychological tests as well as cognitive tasks measuring different components in the processing of information were used. The measures were divided into Mirsky’s four components of attention, namely ‘sustain’,‘focus-execute’,‘shift’ and ‘encode’. All abnormal groups differed markedly from the normal group on measures of executive function/attention. The group diagnosed as having attention disorder showed the most consistent difficulties. However, no specific marker of ‘executive function deficits’ that could represent the three different disorders was found.

Executive function is affected in autism spectrum disorder, but does not correlate with intelligence

INTRODUCTION

Studies of executive function in autism spectrum disorder without intellectual disability (ASD-WID) patients are contradictory. We assessed a wide range of executive functioning cognitive domains in a sample of children and adolescents with ASD-WID and compared them with age-, sex-, and intelligence quotient (IQ)-matched healthy controls.

METHODS

Twenty-four ASD-WID patients (mean age 12.8±2.5 years; 23 males; mean IQ 99.20±18.81) and 32 healthy controls (mean age 12.9±2.7 years; 30 males; mean IQ 106.81±11.02) were recruited.

RESULTS

Statistically significant differences were found in all cognitive domains assessed, with better performance by the healthy control group: attention (U=185.0; P=.0005; D=0.90), working memory (T51.48=2.597; P=.006; D=0.72), mental flexibility (U=236.0; P=.007; D=0.67), inhibitory control (U=210.0; P=.002; D=0.71), and problem solving (U=261.0; P=0.021; D=0.62). These statistically significant differences were also found after controlling for IQ.

CONCLUSION

Children and adolescents with ASD-WID have difficulties transforming and mentally manipulating verbal information, longer response latency, attention problems (difficulty set shifting), trouble with automatic response inhibition and problem solving, despite having normal IQ. Considering the low executive functioning profile found in those patients, we recommend a comprehensive intervention including work on non-social problems related to executive cognitive difficulties.

Dopamine and the development of executive dysfunction in autism spectrum disorders

Persons with autism regularly exhibit executive dysfunction (ED), including problems with deliberate goal-directed behavior, planning, and flexible responding in changing environments. Indeed, this array of deficits is sufficiently prominent to have prompted a theory that executive dysfunction is at the heart of these disorders. A more detailed examination of these behaviors reveals, however, that some aspects of executive function remain developmentaly appropriate. In particular, while people with autism often have difficulty with tasks requiring cognitive flexibility, their fundamental cognitive control capabilities, such as those involved in inhibiting an inappropriate but relatively automatic response, show no significant impairment on many tasks. In this article, an existing computational model of the prefrontal cortex and its role in executive control is shown to explain this dichotomous pattern of behavior by positing abnormalities in the dopamine-based modulation of frontal systems in individuals with autism. This model offers excellent qualitative and quantitative fits to performance on standard tests of cognitive control and cognitive flexibility in this clinical population. By simulating the development of the prefrontal cortex, the computational model also offers a potential explanation for an observed lack of executive dysfunction early in life.

Exploring links between language and cognition in autism spectrum disorders: Complement sentences, false belief, and executive functioning

A growing body of work indicates a close relation between complement clause sentences and Theory of Mind (ToM) in children with autism (e.g., Tager-Flusberg, & Joseph (2005). In Astington, & Baird (Eds.), Why language matters for theory of mind (pp. 298-318). New York, NY, US: Oxford University Press, Lind, & Bowler (2009). Journal of Autism and Developmental Disorders, 39(6), 929). However, this link is based primarily on success at a specific complement clause task and a verbal false-belief (FB) task. One cannot exclude that the link found between these tasks may be a by-product of their both presupposing similar levels of language skills. It is also an open question if the role of complementation in ToM success is a privileged one as compared to that of other abilities which have been claimed to be an important factor for ToM understanding in autism, namely executive functioning (EF) (Pellicano (2007). Developmental Psychology 43, 974). Indeed the role played by complementation may be conceived of as an indirect one, mediated by some more general cognitive function related to EF. This study is the first to examine the relation between theory of mind assessed both verbally and non-verbally and various types of complement clause sentences as well as executive functions in children with autism spectrum disorder (ASD). Our participants included 17 children and adolescents with ASD (aged 6 to 16) and a younger TD control group matched on non-verbal IQ (aged 4 to 9 years). Three tasks assessing complements of verbs of cognition, verbs of communication and verbs of perception were conducted. ToM tasks involved a verbal ToM task (Sally-Anne, Baron-Cohen et al. (1985). Cognition, 21(1), 37) as well as a non-verbal one (Colle et al. (2007). Journal of Autism and Developmental Disorders, 37(4), 716). Indexes of executive functions were collected via a computerized version of the Dimensional Change Card-Sorting task (Frye et al., 1995). Standardized measures of vocabulary, morphosyntax and non-verbal IQ were also administered. Results show similar performance by children with ASD and TD controls for the understanding of complement sentences, for non-verbal ToM and for executive functions. However, children with ASD were significantly impaired for false belief when this was measured verbally. For both ASD and TD, correlations controlling for IQ were found between the verbal FB task and complement sentences of verbs of communication and cognition, but not with verbs of perception. EF indexes did not significantly correlate with either of the ToM tasks, nor did any of the general language scores. These findings provide support for the view that knowledge of certain specific types of complement clause may serve as a privileged means of 'hacking out' solutions to verbal false belief tasks for individuals on the autistic spectrum. More specifically, complements with a truth-value that is independent of that of the matrix clause (i.e. those occurring with verbs of cognition and of communication, but not of perception) may describe a false event while the whole sentence remains true, making these linguistic structures particularly well suited for representing the minds of others (de Villiers, 2007).

LEARNING OUTCOMES

Readers will be able to (1) describe and evaluate the hypothesis that complement sentences play a privileged role in false belief task success in autism; (2) describe performance on complement sentences, executive functioning and false belief tasks by children with autism as compared to IQ-matched peers; (3) explain which types of complements specifically relate to false belief task performance and why; and (4) understand that differences in performance by children with autism at different types of false-belief tasks may be related to the nature of the task conducted and the underlying mechanisms involved.

Spatial navigation, episodic memory, episodic future thinking, and theory of mind in children with autism spectrum disorder: evidence for impairments in mental simulation?

This study explored spatial navigation alongside several other cognitive abilities that are thought to share common underlying neurocognitive mechanisms (e.g., the capacity for self-projection, scene construction, or mental simulation), and which we hypothesized may be impaired in autism spectrum disorder (ASD). Twenty intellectually high-functioning children with ASD (with a mean age of ~8 years) were compared to 20 sex, age, IQ, and language ability matched typically developing children on a series of tasks to assess spatial navigation, episodic memory, episodic future thinking (also known as episodic foresight or prospection), theory of mind (ToM), relational memory, and central coherence. This is the first study to explore these abilities concurrently within the same sample. Spatial navigation was assessed using the "memory island" task, which involves finding objects within a realistic, computer simulated, three-dimensional environment. Episodic memory and episodic future thinking were assessed using a past and future event description task. ToM was assessed using the "animations" task, in which children were asked to describe the interactions between two animated triangles. Relational memory was assessed using a recognition task involving memory for items (line drawings), patterned backgrounds, or combinations of items and backgrounds. Central coherence was assessed by exploring differences in performance across segmented and unsegmented versions of block design. Children with ASD were found to show impairments in spatial navigation, episodic memory, episodic future thinking, and central coherence, but not ToM or relational memory. Among children with ASD, spatial navigation was found to be significantly negatively related to the number of repetitive behaviors. In other words, children who showed more repetitive behaviors showed poorer spatial navigation. The theoretical and practical implications of the results are discussed.

Prospective memory in adults with high-functioning autism spectrum disorders: exploring effects of implementation intentions and retrospective memory load

This study examined, for the first time, the impact of implementation intentions on prospective memory (PM) performance in adults with autism spectrum disorders (ASD) and further explored the role of retrospective memory for PM in ASD. PM was assessed with Virtual Week, a computerized game simulating upcoming everyday-life tasks. Twenty-seven adults with ASD and 27 age- and ability-matched controls were included. Half of the participants were instructed to form implementation intentions (i.e., encoding PM tasks in form of if-then statements), while the rest received simple PM instructions. Results provide first tentative evidence for beneficial effects of implementation intentions and PM tasks with low demands on retrospective memory for adults with ASD's PM. Overall, results point to the importance of planning and retrospective memory for successful prospective remembering in ASD.

Childhood Autism: What Do We Know and Where Should We Go?

The object of this paper is to provide a brief review of current knowledge of childhood autism. A sketch of the most recent knowledge concerning diagnosis, aetiology, patterns of cognitive disability, and treatment approaches is provided. In the second part of the paper, areas of research needing further development to enhance our understanding of the syndrome are identified, along with some suggested strategies for future work.

Inter-individual cognitive variability in children with Asperger's syndrome

Multiple studies have tried to establish the distinctive profile of individuals with Asperger's syndrome (AS). However, recent reports suggest that adults with AS feature heterogeneous cognitive profiles. The present study explores inter-individual variability in children with AS through group comparison and multiple case series analysis. All participants completed an extended battery including measures of fluid and crystallized intelligence, executive functions, theory of mind, and classical neuropsychological tests. Significant group differences were found in theory of mind and other domains related to global information processing. However, the AS group showed high inter-individual variability (both sub- and supra-normal performance) on most cognitive tasks. Furthermore, high fluid intelligence correlated with less general cognitive impairment, high cognitive flexibility, and speed of motor processing. In light of these findings, we propose that children with AS are characterized by a distinct, uneven pattern of cognitive strengths and weaknesses.

Spatial navigation impairments among intellectually high-functioning adults with autism spectrum disorder: exploring relations with theory of mind, episodic memory, and episodic future thinking

Research suggests that spatial navigation relies on the same neural network as episodic memory, episodic future thinking, and theory of mind (ToM). Such findings have stimulated theories (e.g., the scene construction and self-projection hypotheses) concerning possible common underlying cognitive capacities. Consistent with such theories, autism spectrum disorder (ASD) is characterized by concurrent impairments in episodic memory, episodic future thinking, and ToM. However, it is currently unclear whether spatial navigation is also impaired. Hence, ASD provides a test case for the scene construction and self-projection theories. The study of spatial navigation in ASD also provides a test of the extreme male brain theory of ASD, which predicts intact or superior navigation (purportedly a systemizing skill) performance among individuals with ASD. Thus, the aim of the current study was to establish whether spatial navigation in ASD is impaired, intact, or superior. Twenty-seven intellectually high-functioning adults with ASD and 28 sex-, age-, and IQ-matched neurotypical comparison adults completed the memory island virtual navigation task. Tests of episodic memory, episodic future thinking, and ToM were also completed. Participants with ASD showed significantly diminished performance on the memory island task, and performance was positively related to ToM and episodic memory, but not episodic future thinking. These results suggest that (contra the extreme male brain theory) individuals with ASD have impaired survey-based navigation skills—that is, difficulties generating cognitive maps of the environment—and adds weight to the idea that scene construction/self-projection are impaired in ASD. The theoretical and clinical implications of these results are discussed.

Impaired comprehension of alternating syntactic constructions in autism

Individuals on the higher-functioning end of the autism spectrum have significant impairments in communication. Language delay can occur, particularly in syntactic or structural linguistic knowledge. However, classically observed semantic deficits generally overshadow these structural deficits. This research examined the potential effects on comprehension of dative expressions that exhibited syntactic alternation versus those that were restricted, whether in syntactic construction or through marked semantic differences in construction. Children with autism and matched neurotypical control participants were presented with a sentence battery of dative statements representing these variations in construction and were asked to display basic comprehension of the sentence meaning by identifying the recipient, or indirect object, of the dative verb. Construction, restriction, and semantic differentiation variables were analyzed for potential effects on the rate of accurate comprehension. Both groups performed with greater accuracy when dative expressions used a prepositional phrase than when the dative action was expressed in the syntax. The autism group performed more poorly when the dative expression could syntactically alternate than when it was restricted. These effects improve our knowledge of how children with autism understand alternating grammatical constructions. Autism Res2014, 7: 314–321. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.

Using the virtual reality-cognitive rehabilitation approach to improve contextual processing in children with autism

BACKGROUND

This pilot study investigated the efficacy of a novel virtual reality-cognitive rehabilitation (VR-CR) intervention to improve contextual processing of objects in children with autism. Previous research supports that children with autism show deficits in contextual processing, as well as deficits in its elementary components: abstraction and cognitive flexibility.

METHODS

Four children with autism participated in a multiple-baseline, single-subject study. The children were taught how to see objects in context by reinforcing attention to pivotal contextual information.

RESULTS

All children demonstrated statistically significant improvements in contextual processing and cognitive flexibility. Mixed results were found on the control test and changes in context-related behaviours.

CONCLUSIONS

Larger-scale studies are warranted to determine the effectiveness and usability in comprehensive educational programs.

A Systematic Review of the End-State Comfort Effect in Normally Developing Children and in Children With Developmental Disorders

The end-state comfort (ESC) effect signifies the tendency to avoid uncomfortable postures at the end of goal-directed movements and can be reliably observed during object manipulation in adults, but only little is known about its development in children. The aim of the present paper is to provide a review of research on the ESC effect in normally developing children and in children with various developmental disorders, and to identify the factors constraining anticipatory planning skills. Three databases (Medline, Scopus, and PubMed) and relevant journals were scrutinized and a step-wise analysis procedure was employed to identify the relevant studies. Thirteen studies assessed the ESC effect in children, ranging from 1.5–14 years of age. Nine out of these thirteen studies reported the ESC effect to be present in normally developing children, but the results are inconsistent with regard to children’s age and the kind of ESC task used. Some evidence even suggests that these planning skills are intact in children with developmental disorders. Inconsistencies between findings are discussed in the light of moderating factors like the number of action steps, precision requirements, familiarity with the task, the task procedure, motivation, sample size, and age, as well as the cognitive and motor development of the participants. Further research is needed to investigate the onset and the developmental course of ESC planning, as well as the interdependencies with other cognitive abilities and sensory-motor skills.

Do adults with autism spectrum disorders compensate in naturalistic prospective memory tasks?

The present study is the first to directly compare event- and time-based prospective memory in Autism Spectrum Disorders (ASD) using a contextual task mirroring real life demands of prospective memory. Twenty-five individuals with ASD and 25 age- and ability-matched controls completed the Dresden Breakfast task which required participants to prepare breakfast following a set of rules and time restrictions. Overall, adults with ASD had less correct time- and event-based prospective memory responses in comparison to controls, which is consistent with previous research in children with ASD. Moreover, ASD participants completed fewer tasks, followed rules less closely, and monitored the elapsing time less closely than controls. Individuals with ASD seem not to be compensating in naturalistic prospective memory tasks.

Time-Based Prospective Memory in Children With Autism Spectrum Disorder

In this study, for the first time, prospective memory was investigated in 11 school-aged children with autism spectrum disorders and 11 matched neurotypical controls. A computerised time-based prospective memory task was embedded in a visuospatial working memory test and required participants to remember to respond to certain target times. Controls had significantly more correct prospective memory responses than the autism spectrum group. Moreover, controls checked the time more often and increased time-monitoring more steeply as the target times approached. These differences in time-checking may suggest that prospective memory in autism spectrum disorders is affected by reduced self-initiated processing as indicated by reduced task monitoring.

Managing complexity: impact of organization and processing style on nonverbal memory in autism spectrum disorders

The contributions of cognitive style and organization to processing and recalling a complex novel stimulus were examined by comparing the Rey Osterrieth Complex Figure (ROCF) test performance of children, adolescents, and adults with ASD to clinical controls (CC) and non-impaired controls (NC) using the Developmental Scoring System. The ROCF task involves a complex structure with strong organizational or integrative processing demands. The individuals with ASD relied on a predominantly part-oriented strategy to cope with the complexity of the task and did not make the typical developmental shift to a configurational approach. Both processing style and organization (whether pieces of information were perceived as connected to one another in a meaningful way) contributed to structural recall in the ASD group.

The intense world theory - a unifying theory of the neurobiology of autism

Autism covers a wide spectrum of disorders for which there are many views, hypotheses and theories. Here we propose a unifying theory of autism, the Intense World Theory. The proposed neuropathology is hyper-functioning of local neural microcircuits, best characterized by hyper-reactivity and hyper-plasticity. Such hyper-functional microcircuits are speculated to become autonomous and memory trapped leading to the core cognitive consequences of hyper-perception, hyper-attention, hyper-memory and hyper-emotionality. The theory is centered on the neocortex and the amygdala, but could potentially be applied to all brain regions. The severity on each axis depends on the severity of the molecular syndrome expressed in different brain regions, which could uniquely shape the repertoire of symptoms of an autistic child. The progression of the disorder is proposed to be driven by overly strong reactions to experiences that drive the brain to a hyper-preference and overly selective state, which becomes more extreme with each new experience and may be particularly accelerated by emotionally charged experiences and trauma. This may lead to obsessively detailed information processing of fragments of the world and an involuntarily and systematic decoupling of the autist from what becomes a painfully intense world. The autistic is proposed to become trapped in a limited, but highly secure internal world with minimal extremes and surprises. We present the key studies that support this theory of autism, show how this theory can better explain past findings, and how it could resolve apparently conflicting data and interpretations. The theory also makes further predictions from the molecular to the behavioral levels, provides a treatment strategy and presents its own falsifying hypothesis.

Dorsolateral prefrontal cortex magnetic resonance imaging measurements and cognitive performance in autism

This study examined the relationships between volumetric measurements of frontal lobe structures and performance on executive function tasks in individuals with autism. Magnetic resonance imaging (MRI) scans were obtained from 38 individuals with autism and 40 matched controls between the ages of 8 and 45 years. Executive function was assessed using neuropsychological measures including the Wisconsin Card Sorting Test and Tower of Hanoi. Differences in performance on the neuropsychological tests were found between the 2 groups. However, no differences in dorsolateral prefrontal cortex volumes were observed between groups. No correlations between volumetric measurements and performance on the neuropsychological tests were found. Findings from this study suggest that executive function deficits observed in autism are related to functional but not anatomical abnormalities of the frontal lobe. The absence of correlations suggests that executive dysfunction is not the result of focal brain alterations but, rather, is the result of a distributed neural network dysfunction.

[Does the islet of ability on visuospatial tasks in children with high-functioning autism really indicate a deficit in global processing?]

OBJECTIVE

The literature on autism reports regularly the presence of a peak of ability on the visuospatial tasks. The classic interpretation of this result refers to the theoretical model proposed by Frith (1989) who evokes a "lack of central coherence" in persons with autism that is a deficit in the mobilization of global processing. The research reported here has for objective to propose a reflection on the relevance of this model by asking the following question: is global processing impaired in autism or simply not mobilized for the benefit of the almost exclusive appeal to local treatment?

METHODS

A group of children with high-functioning autism was compared with normally developping children (n=15 per group), matched on age and global level of intelligence. The clinical group, 14 boys and a girl, had received a diagnosis of typical autism according to the criteria of the ICD-10 (F84.0) confirmed by ADI-R. These children all used a functional language at the time of inclusion within the study, however all of them initially presented a delay in language (mean age: 8 years and 6 months; mean total IQ: 98.07). The typically developping group, 12 boys and three girls, were from ordinary school (mean age: 9 years, mean total IQ: 106.2). Two tasks were employed for the collection of data: the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) was used to estimate the total-, verbal- and performance-IQ scores of every child and to match both groups. It also permitted the evaluation and comparison of the performances of the children on the following visuospatial tasks: "picture completion", "object assembly" and "block design". The NEPSY scale permitted the estimation and comparison of the levels of performance of both groups on visuospatial functions.

RESULTS

In terms of scores, the tasks of the WISC-III, requiring visiospatial processing as well as the global evaluation of the visiospatial functions with the NEPSY, showed the absence of significant differences between children with high-functioning autism and typical children of the same age. However, differences of strategies appeared both between the groups and, in children with autism, according to the tasks to resolve. The comparison of subtests, "arrows" and "picture completion" on one hand, and "object assembly" and "block design" on the other, showed that children with autism are capable of mobilizing correct configural processing in the first ones but not in the second. The only factor which differentiates these tasks is the appeal or not to a motor coordination. It is possible that the lack of motor ease, often described in this type of children, sometimes leads them towards strategies of low level, i.e., to local adjustments, unlike the typical children who mobilize a strategy supported on a global representation of the purpose to be reached.

CONCLUSION

If our results confirm the capacities of children with autism to resolve the tasks requiring a visiospatial processing, the strategies which they mobilize do not support the existence of a weakness of the central coherence. We suggest, in persons with autism, the idea of a priority granted to the local information treatment in the absence of a deficit of global or configural processing.

Event-based prospective memory performance in autism spectrum disorder

The purpose of the present study was to investigate event-based prospective memory performance in individuals with autism spectrum disorder and to explore possible relations between laboratory-based prospective memory performance and everyday performance. Nineteen children and adolescents with autism spectrum disorder and 19 matched neurotypical controls participated. The laboratory-based prospective memory test was embedded in a visuo-spatial working memory test and required participants to remember to respond to a cue-event. Everyday planning performance was assessed with proxy ratings. Although parents of the autism group rated their children's everyday performance as significantly poorer than controls' parents, no group differences were found in event-based prospective memory. Nevertheless, individual differences in laboratory-based and everyday performances were related. Clinical implications of these findings are discussed.

Local vs. global approaches to reproducing the Rey Osterrieth Complex Figure by children, adolescents, and adults with high-functioning autism

Individuals with autism have an atypical pattern of visual processing. Various studies have provided evidence that individuals with autism perceive the details of stimuli before the gestalt, the reverse of the typical pattern of visual processing. This study used the Rey Osterreith Complex Figure (ROCF) task and an objective scoring system to examine local/global processing approaches to its reproduction in 37 individuals diagnosed with high-functioning autism (HFA) compared to 49 age-, IQ-, and gender-matched typically developing controls (TD). The sample was divided into children (aged 8-14 years) and adolescents/adults (aged 15-47 years) to assess age effects. Results showed no difference in overall performance on the ROCF between HFA and TD children. TD participants displayed improved organizational and planning skills with age and a shift to global processing approaches, but there were no differences in performance between children and adolescents/adults with HFA. There was no evidence of enhanced local processing in either HFA group. These findings suggest that HFA individuals with average IQ scores do not have the clinically demonstrable evidence of the enhanced local processing thought to reflect increased local brain connectivity in more severely autistic individuals. The deficient global processing of the HFA adults reflects dependence of performance on impaired strategic problem-solving abilities, which has been demonstrated to result from under development of neural connectivity between visuo-spatial and frontal brain regions in HFA adults.

Impairments on "open-ended" executive function tests in autism

The executive function (EF) theory of autism has received much support recently from a growing number of studies. However, executive impairments have not always been easy to identify consistently and so novel "ecologically valid" tests have been designed which tap into real-life scenarios that are relevant to and representative of everyday behavior. One characteristic of many of these tasks is that they present the participant with an "ill-structured" or "open-ended" situation. Here, we investigated the possibility that tasks with greater degrees of open-endedness might prove more sensitive to detecting executive impairment in autism. Forty-five children with autism spectrum disorder (ASD) were compared to 27 age- and IQ-matched control children on a range of cognitive tests of EF. Group differences were found on half of the tasks, with the greatest degree of impairment detected on the more open-ended tasks. The ASD group also performed more poorly on a simple control condition of a task. Detailed consideration of task performance suggested that the ASD group tended to create fewer spontaneous strategies and exhibit more idiosyncratic behavior, which particularly disadvantaged them on the more open-ended tasks. These kinds of behaviors have been reported in studies of neurological patients with frontal lobe involvement, prima facie suggesting a link between the scientific fields. However, we suggest that this behavior might equally result from a poor understanding of the implicit demands made by the experimenter in open-ended test situations, due to the socio-communicative difficulties of these children.