Detail and gestalt focus in individuals with optimal outcomes from autism spectrum disorders

The Autism Constellation and Neurodiversity: Long-Term and Adult Outcomes in Autism Spectrum Disorder

Research on autistic adults suggests significant heterogeneity in outcomes. A significant proportion of individuals struggle with intellectual disability and limited communication skills. Of the 67% who have age-appropriate cognitive skills, around half are expected to attain a college education, and 25% are likely to hold a full-time job. Outcomes have been improving over time, in part because of earlier diagnosis and earlier intervention. Indeed, an estimated 10% to 20% are expected to lose all symptoms of autism by adolescence.

Body social models of disability: Examining enactive and ecological approaches

Autistic philosopher and neurodiversity proponent Robert Chapman (2021) argues that disability may be best understood by utilizing an ecological functional model where the focus is on the intersection and overlaps between relational contributions to collectives and group functioning with individual functionality. This presents an alternative to both social-relational models of disability advocated by other neurodiversity proponents and the orthodox medical model of disability. While enactivists such as Michelle Maiese and Juan Toro, Julian Kiverstein and Erik Rietveld have also offered relational models of disability that challenge the orthodox medical model, I argue that unlike the ecological functional model, these enactivist models remain problematically committed to an individualist methodology. Drawing on what Miriam Kyselo has labeled the body social problem, I show that the enactivist models not only face theoretical issues, but also practical issues in terms of their recommended intervention strategies for disability. I argue that for these reasons, if enactivists want a relational model of disability, then they should adopt both a neurodiversity paradigm approach and Chapman’s ecological functional model.

Balance rehabilitation for postural control in children with Autism Spectrum Disorder: A two-case report study

OBJECTIVE

This study aimed to investigate the effect of balance rehabilitation on postural control in both low and increased cognitive load conditions in two children with Autism Spectrum Disorders (ASD).

METHODS

Two children diagnosed with ASD participated in a 4-week personalized balance rehabilitation program with two sessions per week. We assessed postural control in two single task (ST) conditions with low cognitive load: Eyes Closed (EC), Eyes Open (EO); and in five increased cognitive load conditions. Those dual task (DT) conditions consisted of presenting images representing a neutral condition, sadness, anger, happiness, and fear. Postural control parameters (surface, velocity, medio-lateral and antero-posterior sway amplitudes of the center of pressure (CoP)) were collected by a posturographic platform before and after the balance rehabilitation.

RESULTS

The rehabilitation program resulted in a 30-96% improvement of postural control parameters in the ST condition for both participants. In DT, participant 1 progressed on all conditions while participant 2 progressed on 3 of the 5 conditions (sadness, anger and fear).

CONCLUSION

This suggests that these two children with ASD improved their balance control in both low and increased cognitive load conditions. These encouraging results need to be replicated before recommending balance rehabilitation as standard health rehabilitation in children with ASD.

Conversation During a Virtual Reality Task Reveals New Structural Language Profiles of Children with ASD, ADHD, and Comorbid Symptoms of Both

Many studies have utilized standardized measures and storybook narratives to characterize language profiles of children with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD). They report that structural language of these children is on par with mental-age-matched typically developing (TD) peers. Few studies have looked at structural language profiles in conversational contexts. This study examines conversational speech produced in a virtual reality (VR) paradigm to investigate the strengths and weaknesses of structural language abilities of these children. The VR paradigm introduced varying social and cognitive demands across phases. Our results indicate that children from these diagnostic groups produced less complex structural language than TD children. Moreover, language complexity decreased in all groups across phases, suggesting a cross-etiology sensitivity to conversational contexts.

Neurodiversity and the Social Ecology of Mental Functions

In psychiatry, mental dysfunction is typically framed in relation to models that seek to be continuous with physiology or evolutionary biology and that compare individual fitness to a broader functional norm. Proponents of the neurodiversity movement, however, challenge the pathologization of minority cognitive styles and argue that we should reframe neurocognitive diversity as a normal and healthy manifestation of biodiversity. Neurodiversity proponents have thus far drawn on social-relational models of disability to challenge the medical model of disability, but they have not developed an alternative functional analysis to replace conceptions of neurological dysfunction or impairment. Here I clarify and defend the neurodiversity perspective by drawing on ecological functional models that take relational contributions to collectives, and group functioning, into account alongside individual functionality. Using the example of autism as well as recent developments in the study of cognitive diversity, I apply these models to human mental functioning and argue that what I call the ecological model has greater utility for research and practice than the leading psychiatric functional analyses of mental functioning.

Perceptual inference is impaired in individuals with ASD and intact in individuals who have lost the autism diagnosis

Beyond the symptoms which characterize their diagnoses, individuals with autism spectrum disorder (ASD) show enhanced performance in simple perceptual discrimination tasks. Often attributed to superior sensory sensitivities, enhanced performance may also reflect a weaker bias towards previously perceived stimuli. This study probes perceptual inference in a group of individuals who have lost the autism diagnosis (LAD); that is, they were diagnosed with ASD in early childhood but have no current ASD symptoms. Groups of LAD, current ASD, and typically developing (TD) participants completed an auditory discrimination task. Individuals with TD showed a bias towards previously perceived stimuli-a perceptual process called "contraction bias"; that is, their representation of a given tone was contracted towards the preceding trial stimulus in a manner that is Bayesian optimal. Similarly, individuals in the LAD group showed a contraction bias. In contrast, individuals with current ASD showed a weaker contraction bias, suggesting reduced perceptual inferencing. These findings suggest that changes that characterize LAD extend beyond the social and communicative symptoms of ASD, impacting perceptual domains. Measuring perceptual processing earlier in development in ASD will tap the causality between changes in perceptual and symptomatological domains. Further, the characterization of perceptual inference could reveal meaningful individual differences in complex high-level behaviors.

How Children with Autism Spectrum Disorder, Developmental Language Disorder, and Typical Language Learn to Produce Global and Local Semantic Features

A local processing bias, often considered a cognitive style unique to autism spectrum disorder (ASD), may influence the types of semantic features acquired by children with ASD and could contribute to weaknesses in word learning. Children with developmental language disorder (DLD) also struggle to learn semantic aspects of words, but this cognitive style has not been ascribed to children with DLD. The purpose of this study was to explore whether global–local processing differences influence the type of semantic features children with ASD, DLD, and their neurotypical peers learn to produce when learning new words. Novel word definitions produced by 36 school-aged children (12 with ASD, 12 with DLD, and 12 with typical language) who participated in an extended word-learning paradigm were used to extract newly learned semantic features. These semantic features were then coded for global and local attributes and analyzed to detect whether there were differences between groups. Results indicated that the children with ASD and DLD produced more global, rather than local, semantic features in their definitions than the children with typical language. An over-reliance on global, rather than local, features in children with ASD and DLD may reflect deficits in depth of word knowledge.

Ventral stream hierarchy underlying perceptual organization in adolescents with autism

Object recognition relies on a hierarchically organized ventral visual stream, with both bottom-up and top-down processes. Here, we aimed at investigating the neural underpinnings of perceptual organization along the ventral visual stream in Autism Spectrum Disorders (ASD), and at determining whether this would be associated with decreased top-down processing in ASD. Nineteen typically developing (TD) adolescents and sixteen adolescents with ASD participated in an fMRI study where they had to detect visual objects. Five conditions displayed Gabor patterns (defined by texture and/or contour) with increasing levels of perceptual organization. In each condition, both groups showed similar abilities. In line with the expected cortical hierarchy, brain activity patterns revealed a progressive involvement of regions, from low-level occipital regions to higher-level frontal regions, when stimuli became more and more organized. The brain patterns were generally similar in both groups, but the ASD group showed greater activation than TD participants in the middle occipital gyrus and lateral occipital complex when perceiving fully organized everyday objects. Effective connectivity analyses suggested that top-down functional connections between the lower levels of the cortical hierarchy were less influenced by the meaning carried by the stimuli in the ASD group than in the TD group. We hypothesize that adolescents with ASD may have been less influenced by top-down processing when perceiving recognizable objects.

An exploration of the association between matrix reasoning and eating disturbance behavior in girls with autism spectrum disorder

Background

Although there have been suggestions that central coherence may be associated with eating disturbances (EBD) in children with autism spectrum disorder (ASD), relatively little attention has been given to specific aspects of IQ and EDB.

Methods

The association between total IQ, perceptual and verbal composite scores and subtests was explored in a sample of 50 high-functioning girls with ASD (mean age = 9.7 years, SD = 2.4 years, range = 6 years to 14 years). Self-reports and mothers' reports were collected about the girls' EDB.

Results

There were only isolated associations between mothers' data and the girls' IQ. Selected aspects of the girls' self-reported EDB were significantly associated with matrix reasoning.

Conclusion

The role of IQ, particularly matrix reasoning, in the assessment and treatment of EDB in girls with ASD, is highlighted by these findings.

Larger Receptive Field Size as a Mechanism Underlying Atypical Motion Perception in Autism Spectrum Disorder

Atypical visual motion perception has been widely observed in individuals with autism spectrum disorder (ASD). The pattern of results, however, has been inconsistent. Emerging mechanistic hypotheses seek to explain these variable patterns of atypical motion sensitivity, each uniquely predicting specific patterns of performance across varying stimulus conditions. Here, we investigated the integrity of two such fundamental mechanisms-response gain control and receptive field size. Twenty children and adolescents with ASD and 20 typically developing (TD) age- and IQ-matched controls performed a motion discrimination task. To adequately model group differences in both mechanisms of interest, we tested a range of 23 stimulus conditions varying in size and contrast. Results revealed a motion perception impairment in ASD that was specific to the smallest sized stimuli (1°), irrespective of stimulus contrast. Model analyses provided evidence for larger receptive field size in ASD as the mechanism that explains this size-specific reduction of motion sensitivity.

Preschool predictors of school-age academic achievement in autism spectrum disorder

OBJECTIVE

Characterization of academic functioning in children with autism spectrum disorder (ASD), particularly predictors of achievement, may have important implications for intervention. The current study aimed to characterize achievement profiles, confirm associations between academic ability and concurrent intellectual and social skills, and explore preschool predictors of school-age academic achievement in a sample of children with ASD.

METHOD

Children with ASD (n = 26) were evaluated at the approximate ages of two, four, and ten. Multiple regression was used to predict school-age academic achievement in reading and mathematics from both concurrent (i.e. school-age) and preschool variables.

RESULTS

Children with ASD demonstrated a weakness in reading comprehension relative to word reading. There was a smaller difference between mathematics skills; math reasoning was lower than numerical operations, but this did not quite reach trend level significance. Concurrent IQ and social skills were associated with school-age academic achievement across domains. Preschool verbal abilities significantly predicted school-age reading comprehension, above and beyond concurrent IQ, and early motor functioning predicted later math skills.

CONCLUSIONS

Specific developmental features of early ASD predict specific aspects of school-age achievement. Early intervention targeting language and motor skills may improve later achievement in this population.

Uh, Um, and Autism: Filler Disfluencies as Pragmatic Markers in Adolescents with Optimal Outcomes from Autism Spectrum Disorder

Filler disfluencies--uh and um--are thought to serve distinct discourse functions. We examined fillers in spontaneous speech by youth with autism spectrum disorder (ASD), who struggle with pragmatic language, and by youth with ASD who have achieved an 'optimal outcome' (OO), as well as in peers with typical development (TD). While uh rates did not differ, participants with ASD produced um less frequently than OO or TD groups. Um rate was associated with autism symptom severity, but not executive function or language abilities, suggesting that um serves a pragmatic, listener-oriented function. Moreover, in contrast to minimal production in ASD, the typical OO um production substantiates the normalization of subtle social communication in this population.

Story Goodness in Adolescents With Autism Spectrum Disorder (ASD) and in Optimal Outcomes From ASD

PURPOSE

This study examined narrative quality of adolescents with autism spectrum disorder (ASD) using a well-studied "story goodness" coding system.

METHOD

Narrative samples were analyzed for distinct aspects of story goodness and rated by naïve readers on dimensions of story goodness, accuracy, cohesiveness, and oddness. Adolescents with high-functioning ASD were compared with adolescents with typical development (TD; n = 15 per group). A second study compared narratives from adolescents across three groups: ASD, TD, and youths with "optimal outcomes," who were diagnosed with ASD early in development but no longer meet criteria for ASD and have typical behavioral functioning.

RESULTS

In both studies, the ASD group's narratives had lower composite quality scores compared with peers with typical development. In Study 2, narratives from the optimal outcomes group were intermediate in scores and did not differ significantly from those of either other group. However, naïve raters were able to detect qualitative narrative differences across groups.

CONCLUSIONS

Findings indicate that pragmatic deficits in ASD are salient and could have clinical relevance. Furthermore, results indicate subtle differences in pragmatic language skills for individuals with optimal outcomes despite otherwise typical language skills in other domains. These results highlight the need for clinical interventions tailored to the specific deficits of these populations.