The Importance of Distinguishing Propensity Versus Ability to Imitate in ASD Research and Early Detection

Teaching Imitation to Young Children with Autism Spectrum Disorder Using Discrete Trial Training and Contingent Imitation

Imitation is a pivotal skill for children with and without disabilities, serving both learning and social interaction functions for young children. Children with autism spectrum disorder (ASD) frequently experience delays in acquiring this skillset, demonstrating challenges in the ability and/or propensity to imitate the actions of others. Current intervention programs frequently use discrete trial teaching (DTT) or contingent imitation to support imitation development in young children with ASD. This study combined contingent imitation with DTT to teach imitation to individuals who had previously struggled with acquiring this skill. A multiple probe design across three preschool children with ASD was conducted within participants' early learning classrooms. Response to intervention varied across participants, with participants with more advanced imitation skills at study onset demonstrating greater outcomes. Combining contingent imitation with DTT may facilitate the propensity to imitate for individuals who exhibit some appropriate object engagement and are inconsistently imitating others' actions with objects. However, further research using stronger research design is needed to improve the teaching of imitation to young children with ASD who exhibit challenges with this skillset.

The relationship between alexithymia and theory of mind: A systematic review

Theory of Mind (ToM), the ability to represent the mental states of oneself and others, is an essential social skill disrupted across many psychiatric conditions. The transdiagnostic nature of ToM impairment means it is plausible that ToM impairment is related to alexithymia (difficulties identifying and describing one's own emotions), as alexithymia is seen across psychiatric conditions. Whilst many studies have examined links between alexithymia and ToM, results are mixed. Therefore, the purpose of this systematic review is to provide a taxonomy of ToM tests and assess their relationship with alexithymia. Tests are grouped according to whether they assess propensity to engage spontaneously in ToM or accuracy of ToM inferences, with tests further subdivided into those that do, and do not, require emotion recognition. A review of 63 suitable studies suggests that alexithymia is often associated with reduced ToM, and inaccurate ToM when tasks require emotion recognition. This latter finding appears due to impaired emotion recognition, rather than ToM impairment per se. Further directions and considerations for future research are discussed.

No preference for direct versus averted gaze in autistic adults: a reinforced preferential looking paradigm

Background

With the overarching objective to gain better insights into social attention in autistic adults, the present study addresses three outstanding issues about face processing in autism. First, do autistic adults display a preference for mouths over eyes; second, do they avoid direct gaze; third, is atypical visual exploration of faces in autism mediated by gender, social anxiety or alexithymia?

Methods

We used a novel reinforced preferential looking paradigm with a group of autistic adults (n = 43, 23 women) pairwise matched on age with neurotypical participants (n = 43, 21 women). Participants watched 28 different pairs of 5 s video recordings of a speaking person: the two videos, simultaneously displayed on the screen, were identical except that gaze was directed at the camera in one video and averted in the other. After a 680 ms transition phase, a short reinforcement animation appeared on the side that had displayed the direct gaze.

Results

None of the groups showed a preference for mouths over eyes. However, neurotypical participants fixated significantly more the stimuli with direct gaze, while no such preference emerged in autistic participants. As the experiment progressed, neurotypical participants also increasingly anticipated the appearance of the reinforcement, based on the location of the stimulus with the direct gaze, while no such anticipation emerged in autistic participants.

Limitations

Our autistic participants scored higher on the social anxiety and alexithymia questionnaires than neurotypicals. Future studies should match neurotypical and autistic participants on social anxiety and alexithymia and complement questionnaires with physiological measures of anxiety.

Conclusions

The absence of preference for direct versus averted gaze in the autistic group is probably due to difficulties in distinguishing eye gaze direction, potentially linked to a reduced spontaneous exploration or avoidance of the eye region. Social attention and preference for direct versus averted gaze correlated with alexithymia and social anxiety scores, but not gender.

Imitation in Angelman syndrome: the role of social engagement

Individuals with Angelman syndrome (AS) are characterized by severe cognitive impairments alongside an enhanced drive for social engagement. As knowledge on imitation skills in this population is limited, we conducted the first controlled study of imitation in AS. We examined how 23 individuals with AS and 21 typically developing young children with similar mental age imitated novel actions in response to socially or non-socially engaging models, and in response to video-recorded versus live demonstrations of novel actions. Individuals with AS imitated as frequently and as accurately as typical young children in response to live demonstrations; but they imitated less frequently and less accurately in response to video-recorded demonstrations. Further, imitation was modulated by whether the demonstrator was socially engaging or emotionally neutral in the AS group, while this modulation was not present in the comparison group. Individuals with higher mental age imitated more frequently and more accurately across groups. Imitation performance in AS appears to be more modulated by the social context compared to typical infants and young children with similar mental age, possibly reflecting an enhanced drive for social engagement. A socially engaging instructional style might facilitate imitative learning in this population.

From Using Tools to Using Language in Infant Siblings of Children with Autism

Forty-one high-risk infants (HR) with an older sibling with autism spectrum disorder (ASD) were observed longitudinally at 10, 12, 18 and 24 months of age during a tool use task in a play-like scenario. Changes in grasp types and functional actions produced with a spoon were assessed during elicited tool use. Outcome and vocabulary measures were available at 36 months, distinguishing: 11 HR-ASD, 15 HR-language delay and 15 HR-no delay. Fewer HR-ASD infants produced grasp types facilitating spoon use at 24 months and functional actions at 10 months than HR-no delay. Production of functional actions in HR infants at 10 months predicted word comprehension at 12 months and word production at 24 and 36 months.

Object-directed imitation in autism spectrum disorder is differentially influenced by motoric task complexity, but not social contextual cues

We examined the role of social motivation and motor execution factors in object-directed imitation difficulties in autism spectrum disorder. A series of to-be-imitated actions was presented to 35 children with autism spectrum disorder and 20 typically developing children on an Apple^® iPad^® by a socially responsive or aloof model, under conditions of low and high motor demand. There were no differences in imitation performance (i.e. the number of actions reproduced within a fixed sequence), for either group, in response to a model who acted socially responsive or aloof. Children with autism spectrum disorder imitated the high motor demand task more poorly than the low motor demand task, while imitation performance for typically developing children was equivalent across the low and high motor demand conditions. Furthermore, imitative performance in the autism spectrum disorder group was unrelated to social reciprocity, though positively associated with fine motor coordination. These results suggest that difficulties in object-directed imitation in autism spectrum disorder are the result of motor execution difficulties, not reduced social motivation.

A new test of advanced theory of mind: The "Strange Stories Film Task" captures social processing differences in adults with autism spectrum disorders

Real-life social processing abilities of adults with autism spectrum disorders (ASD) can be hard to capture in lab-based experimental tasks. A novel measure of social cognition, the "Strange Stories Film task' (SSFt), was designed to overcome limitations of available measures in the field. Brief films were made based on the scenarios from the Strange Stories task (Happé) and designed to capture the subtle social-cognitive difficulties observed in ASD adults. Twenty neurotypical adults were recruited to pilot the new measure. A final test set was produced and administered to a group of 20 adults with ASD and 20 matched controls, alongside established social cognition tasks and questionnaire measures of empathy, alexithymia and ASD traits. The SSFt was more effective than existing measures at differentiating the ASD group from the control group. In the ASD group, the SSFt was associated with the Strange Stories task. The SSFt is a potentially useful tool to identify social cognitive dis/abilities in ASD, with preliminary evidence of adequate convergent validity. Future research directions are discussed. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1120-1132. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

Autism, attachment, and social learning: Three challenges and a way forward

We explore three challenges that Autism Spectrum Disorder (ASD) poses to our understanding of the processes underlying early attachment. First, while caregiver-infant attachment and later social-affiliative behavior share common biobehavioral mechanisms, individuals with ASD are able to form secure attachment relationships, despite reduced social-emotional reciprocity and motivation for social interaction. Therefore, disruptions in social affiliation mechanisms can co-exist with secure caregiver-infant bonding. Second, while early attachment quality is associated with later social outcomes in typical development, interventions targeting caregiver-child interaction in ASD often show positive effects on parental responsivity and attachment quality, but not on child social behavior. Therefore, improvements in parent-child bonding do not necessarily result in improvements in social functioning in ASD. Third, individuals with ASD show normative brain activity and selective social affiliative behaviors in response to people that they know but not to unfamiliar people. We propose a conceptual framework to reformulate and address these three theoretical impasses posed by ASD, arguing that the dissociable pathways of child-parent bonding and social development in ASD are shaped by (1) a dissociation between externally-driven and internally-driven attachment responses and (2) atypical learning dynamics occurring during child-caregiver bonding episodes, which are governed by and influence social-affiliation motives and other operant contingencies.

The Social Effect of "Being Imitated" in Children with Autism Spectrum Disorder

There is evidence that “being imitated” has social effects, and that the imitation of the child's actions may be used as a strategy to promote social engagement in children with autism spectrum disorder (ASD). The observation of someone that imitates us recruits, indeed, neural areas involved in social cognition. We reviewed studies exploring the behavioral consequences of “being imitated” in children with ASD. We aimed at assessing what are the social skills targeted by this strategy, and the factors that may improve the response. The “being imitated” strategy improves social gazes, proximal social behaviors, and play skills, particularly in children with low developmental level, and also when the strategy is implemented by children's mothers. The “being imitated” may be used as a tool in early intervention to improve social skills, helping to assess the effects of intervention at both behavioral and neural level.

The Relationship between Social and Motor Cognition in Primary School Age-Children

There is increased interest in the relationship between motor skills and social skills in child development, with evidence that the mechanisms underlying these behaviors may be linked. We took a cognitive approach to this problem, and examined the relationship between four specific cognitive domains: theory of mind, motor skill, action understanding, and imitation. Neuroimaging and adult research suggest that action understanding and imitation are closely linked, but are somewhat independent of theory of mind and low-level motor control. Here, we test if a similar pattern is shown in child development. A sample of 101 primary school aged children with a wide ability range completed tests of IQ (Raven's matrices), theory of mind, motor skill, action understanding, and imitation. Parents reported on their children's social, motor and attention performance as well as developmental concerns. The results showed that action understanding and imitation correlate, with the latter having a weak link to motor control. Theory of mind was independent of the other tasks. These results imply that independent cognitive processes for social interaction (theory of mind) and for motor control can be identified in primary school age children, and challenge approaches that link all these domains together.