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Wu D, Wolff JJ, Ravi S, Elison JT, Estes A, Paterson S, St John T, Abdi H, Moraglia LE, Piven J, Swanson MR. Infants who develop autism show smaller inventories of deictic and symbolic gestures at 12 months of age. Autism Res 2024; 17:838-851. [PMID: 38204321 PMCID: PMC11014769 DOI: 10.1002/aur.3092] [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: 12/20/2022] [Accepted: 12/19/2023] [Indexed: 01/12/2024]
Abstract
Gestures are an important social communication skill that infants and toddlers use to convey their thoughts, ideas, and intentions. Research suggests that early gesture use has important downstream impacts on developmental processes, such as language learning. However, autistic children are more likely to have challenges in their gestural development. The current study expands upon previous literature on the differences in gesture use between young autistic and non-autistic toddlers by collecting data using a parent-report questionnaire called the MCDI-Words and Gestures at three time points, 12, 18, and 24 months of age. Results (N = 467) showed that high-likelihood infants who later met diagnostic criteria for ASD (n = 73 HL-ASD) have attenuated gesture growth from 12 to 24 months for both deictic gestures and symbolic gestures when compared to high-likelihood infants who later did not meet criteria for ASD (n = 249 HL-Neg) and low-likelihood infants who did not meet criteria for ASD (n = 145 LL-Neg). Other social communicative skills, like play behaviors and imitation, were also found to be impacted in young autistic children when compared to their non-autistic peers. Understanding early differences in social communication growth before a formal autism diagnosis can provide important insights for early intervention.
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Affiliation(s)
- Dennis Wu
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, USA
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shruthi Ravi
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Sarah Paterson
- James S. McDonnell Foundation, Saint Louis, Missouri, USA
| | - Tanya St John
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Hervé Abdi
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, USA
| | - Luke E Moraglia
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, USA
| | - Joseph Piven
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meghan R Swanson
- Department of Psychology, University of Texas at Dallas, Richardson, Texas, USA
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Chang X, Sun L, Li R. Application of symbolic play test in identification of autism spectrum disorder without global developmental delay and developmental language disorder. BMC Psychiatry 2023; 23:138. [PMID: 36879230 PMCID: PMC9990336 DOI: 10.1186/s12888-023-04647-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Children with autism spectrum disorders (ASD) usually experience difficulty regarding symbolic play. However, studies on whether symbolic play test (SPT) can differentiate between ASD and other developmental disorders are inconsistent, and evaluating the application value of the SPT in the identification of ASD without global developmental delay (GDD) and developmental language disorder (DLD) is necessary. METHODS A total of 200 children were selected as the research participants. There were 100 cases of ASD without GDD and 100 cases of DLD. All children were tested by SPT and Children Neuropsychological and Behavioral Scale-Revision (CNBS-R2016). Binomial logistic regression was used for multivariate analysis. The receiver operating characteristic (ROC) curve was used to evaluate the value of SPT in identifying ASD without GDD and DLD. RESULTS SPT equivalent age was lower than chronological age in the two groups, the difference between the ASD without GDD group was greater than that in the DLD group, and the proportion of SPT equivalent age retardation was higher than that in the DLD group; the differences were statistically significant. Logistic regression analysis showed that there was a difference in SPT equivalent age between DLD and ASD without GDD. When the cut-off value of the SPT was 8.5, the largest area under the ROC curve was 0.723, and the sensitivity and specificity for the diagnosis of ASD without GDD were 0.720 and 0.620 respectively. CONCLUSIONS Symbolic play ability in ASD children is worse than that of DLD children at comparable development levels. SPT may be helpful to distinguish ASD without GDD from children with DLD.
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Affiliation(s)
- Xuening Chang
- Department of Child Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Lingli Sun
- Department of Child Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China
| | - Ruizhen Li
- Department of Child Health Care, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, 430016, China.
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Moerman F, Warreyn P, Demurie E, Boterberg S, Vermeirsch J, Roeyers H. Play in Relation to Autism Traits in Young Children at Elevated Likelihood for Autism Spectrum Disorder. J Autism Dev Disord 2021; 53:1413-1430. [PMID: 34668127 DOI: 10.1007/s10803-021-05326-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Play of younger siblings of children with autism spectrum disorder (ASD) (siblings; n = 44), very preterm children (preterms; n = 44), and children at typical likelihood for ASD (n = 36) was observed at 24 months. Children with ASD and atypical development engaged less in spontaneous (pre-)symbolic play than typically developing children. Total duration of spontaneous and elicited (pre-)symbolic play was associated with later ASD traits in siblings. However, no association between most play variables and ASD traits was found in preterms. This suggests possible different ASD-trajectories between siblings and preterms. Thus, spontaneous (pre-)symbolic play may be indicative of developmental challenges across several populations, and results highlight the need to move beyond studying only siblings in order to broaden our understanding of ASD.
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Affiliation(s)
- Floor Moerman
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium.
| | - Petra Warreyn
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Ellen Demurie
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Sofie Boterberg
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Julie Vermeirsch
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
| | - Herbert Roeyers
- Research in Developmental Disorders Lab, Department of Experimental Clinical and Health Psychology, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium
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González-Sala F, Gómez-Marí I, Tárraga-Mínguez R, Vicente-Carvajal A, Pastor-Cerezuela G. Symbolic Play among Children with Autism Spectrum Disorder: A Scoping Review. CHILDREN 2021; 8:children8090801. [PMID: 34572233 PMCID: PMC8470741 DOI: 10.3390/children8090801] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/29/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
Symbolic play is considered an early indicator in the diagnosis of autism spectrum disorder (ASD) and its assessment. The objective of this study was to analyze the difficulties in symbolic play experienced by children with ASD and to determine the existence of differences in symbolic play among children with ASD, children with other neurodevelopmental disorders and children with typical development. A scoping review was carried out in the Web of Science (WoS), Scopus, ERIC, and PsycInfo databases, following the extension for scoping reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The number of papers included in the review was 22. The results confirm that children with ASD have greater difficulties with symbolic play than children with other neurodevelopmental disorders and children with typical development, even when controlling for their verbal age. Difficulties are greater in situations of free or spontaneous play. Results evidenced that the absence or deficiency in the symbolic play can serve as an early indicator of ASD between the first and second year of life, the developmental moment in which this type of play begins.
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Affiliation(s)
- Francisco González-Sala
- Department of Developmental and Educational Psychology, University of Valencia, 46010 València, Spain;
- Correspondence: (F.G.-S.); (I.G.-M.); (R.T.-M.)
| | - Irene Gómez-Marí
- Department of Education and School Management, University of Valencia, 46010 València, Spain
- Correspondence: (F.G.-S.); (I.G.-M.); (R.T.-M.)
| | - Raúl Tárraga-Mínguez
- Department of Education and School Management, University of Valencia, 46010 València, Spain
- Correspondence: (F.G.-S.); (I.G.-M.); (R.T.-M.)
| | - Alba Vicente-Carvajal
- Department of Developmental and Educational Psychology, University of Valencia, 46010 València, Spain;
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Goetzmann L. Gamma elements as protomental representations: Suggestions for expanding W. R. Bion's theory of elements. THE INTERNATIONAL JOURNAL OF PSYCHOANALYSIS 2020; 101:1085-1105. [PMID: 33952125 DOI: 10.1080/00207578.2020.1822145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
W. R. Bion developed various models and theories to describe the formation of mental representations. This article introduces an expansion of the model of alpha and beta elements by a new category, termed "gamma elements". Despite being transformable, gamma elements are characterized by an excessive feeling of reality, such that the subject must evacuate them. We are dealing here with visions, pseudohallucinations, scenarios in nightmares that are as terrible as they are sensorily charged, flashbacks, or overwhelming physical feelings interspersed with hypochondriacal anxieties. Using the "theory of maternal semiotics" (Kristeva), the author traces how the child's projectiles, i.e. beta experiences projected into the maternal container, are transformed into alpha and gamma elements. In this respect, gamma elements are more or less precise indicators of the analytic process: they indicate the extent to which the analysand is capable of enduring and transforming frustrating experiences in the here-and-now. The expansion of Bion's model of elements, therefore, has direct clinical relevance, in that gamma elements can be understood both as imaginative creations and as indications of disorganizing processes.
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Affiliation(s)
- Lutz Goetzmann
- Institute of Philosophy, Psychoanalysis and Cultural Studies, Berlin, Germany
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Palacios P, Rodríguez C, Méndez-Sánchez C. Communicative Mediation by Adults in the Construction of Symbolic Uses by Infants. Integr Psychol Behav Sci 2018; 52:209-227. [PMID: 29502196 DOI: 10.1007/s12124-018-9422-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Adult semiotic mediation in the origin and evolution of the first symbolic uses of objects by infants in contexts of triadic interactions was investigated. Six infant-parent dyads interacting together with ten objects were observed longitudinally from 9 to 15 months of age, with an interval of three months between each observation. The communicative mediators used by adults, in the form of demonstrations and ostensive gestures, decrease as infants grow up. The orchestration of these semiotic mediators also decreases and the functions of the demonstrations change. At the beginning, the adults use them merely to demonstrate the symbolic uses of object, but later they use them to evaluate, complete or correct the symbolic uses by the infants. The semiotic mediators are first used to guide the child at the level of attention and later at the level of cultural practices of symbolic uses of objects. These changes in communicative mediators and their functions reveal the educational role of adults through adjustment in communication, always in tune with the infant's knowledge and performance.
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Affiliation(s)
- Pedro Palacios
- Departamento de Psicología, Centro de Ciencias Sociales y Humanidades, Universidad Autónoma de Aguascalientes, Av. Universidad 940, Edif, 212, Ciudad Universitaria, 20131, Aguascalientes Ags, Mexico.
| | - Cintia Rodríguez
- Departamento de Psicología Evolutiva y Educación, Facultad de Psicología, Universidad Autónoma de Madrid, Módulo I-116, Cantoblanco, 28049, Madrid, Spain
| | - Cecilia Méndez-Sánchez
- Departamento de Psicología, Centro de Ciencias Sociales y Humanidades, Universidad Autónoma de Aguascalientes, Av. Universidad 940, Edif, 212, Ciudad Universitaria, 20131, Aguascalientes Ags, Mexico
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Abstract
In 1943, Leo Kanner published the first systematic description of early infantile autism. He concluded that this was a neurodevelopmental disorder and that 'these children have come into the world with an innate inability to form the usual, biologically provided contact with people'. Moreover, his astute descriptions of parental behavior in his first publications were prescient and underlie later recognition of the importance of genetics. Our understanding has grown over the ensuing years with revisions in diagnostic classification, recognition of the broader autism phenotype in families, appreciation of the importance of developmental models, advances in genetic methodology, better understanding of the relationship to intellectual deficits, recognition of syndromic autism in neurogenetic sydromes, advances in neuroimaging, and advances in animal models, both mutant mouse models and transgenic non human primate models. Kanner recognized diagnostic heterogeneity and opined that the children had not read those diagnostic manuals and did not easily fall into clear cut categories. Such heterogeneity continues to confound our diagnostic efforts. Always an advocate for children, when reviewing the DSM III criteria in 1980, Kanner emphasized that no matter how well developed our criteria each child must be treated as a unique person.
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Affiliation(s)
- James Harris
- a Department of Psychiatry and Behavioral Sciences , The Johns Hopkins University School of Medicine , Baltimore , MD , USA
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How does restricted and repetitive behavior relate to language and cognition in typical development? Dev Psychopathol 2016; 29:863-874. [PMID: 27417193 DOI: 10.1017/s0954579416000535] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Relations between restricted and repetitive behavior at age 26 months and children's concurrent (N = 203) and later (n = 161) social cognition and language development were investigated. Restricted and repetitive behavior was assessed using two scales: sensory and motor repetitive behaviors and rigidity/routines/restricted interests. Language was assessed at ages 26 and 51 months; social cognition was assessed at ages 26 (symbolic play) and 51 and 61 months (theory of mind). Sensory and motor repetitive behavior was negatively related to children's (a) language performance at 26 and 51 months, (b) instructed symbolic play at 26 months, and (c) theory of mind performance at 51 and 61 months. Path analyses showed that children's sensory and motor repetitive behavior at age 26 months was related to lower receptive verbal ability and theory of mind at 51 months, which led to lower theory of mind at 61 months. Rigidity/routines/restricted interests at 26 months were unrelated to concurrent and later social cognition and language. These results are discussed in terms of the pathways via which sensory and motor repetitive behavior might impact negatively on development.
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Abstract
PURPOSE OF REVIEW To provide an update on recent studies concerning social cognition in autism spectrum disorders (ASDs), to compare different theoretical approaches used to interpret empirical data, and to highlight a number of conceptual issues. RECENT FINDINGS In regard to social cognition in ASDs, there is an emerging emphasis on early-onset and prolonged sensory-motor problems. Such sensory-motor problems may fit with the theories of social cognition that emphasize the importance of embodied interaction rather than deficits in mindreading, or they may reflect more general aspects of developmental disorders. SUMMARY Different theoretical frameworks offer alternative perspectives on the central characteristics in ASDs and motivate different ways of conceptualizing diagnosis and intervention. Theory-of-mind approaches continue to appeal to false-belief paradigms, and debate continues about the performance of individuals with autism. Likewise, there is continuing debate and renewed skepticism about the role of simulation and deficits in the mirror system in ASDs. Growing evidence concerning sensory-motor problems, specifically disrupted patterns in re-entrant (afferent and proprioceptive) sensory feedback across the autistic spectrum, may not only provide support for more embodied interactive approaches, but also suggests that a single approach is unlikely able to explain all social cognition problems in autism. A pluralist approach understands ASDs as involving a variant range of cascading disrupted processes.
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