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McNair ML, Keenan EG, Houck AP, Lerner MD. Seeking contexts that promote neurodiverse social success: Patterns of behavior during minimally-structured interaction settings in autistic and non-autistic youth. Dev Psychopathol 2023:1-16. [PMID: 37593821 PMCID: PMC10874463 DOI: 10.1017/s0954579423000950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
While peer interaction differences are considered a central feature of autism, little is known regarding the nature of these interactions via directly-observed measurement of naturalistic (i.e., minimally-structured) groups of autistic and non-autistic adolescent peers. 148 autistic and non-autistic adolescents (111 male, Mage = 14.22, SDage = 1.90; MIQ = 103.22, SDIQ = 15.80) participated in a 50-minute, minimally-structured, naturalistic peer interaction paradigm with activities of varying social demands: an incidental social demand (eating in a room with peers), a physical social demand (playing a physically-interactive game), and a verbal social demand (playing a verbal game). While autistic youth exhibited fewer overall interaction behaviors than non-autistic youth, the two groups did not differ in amount of positive, negative, and low-level interaction behaviors. Within activities, autistic and non-autistic youth only differed in positive interaction behaviors during the context of a verbal social demand. Youth who displayed more positive interaction behaviors during this same activity had less autism spectrum disorder symptomatology, controlling for nested group effects and relevant covariates. These results point toward subtle differences in social demands across naturalistic settings that can either support or impede prosocial interaction for autistic youth, providing a guidepost for identifying settings that best promote social success for neurodiverse populations.
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Affiliation(s)
- Morgan L McNair
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Elliot Gavin Keenan
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
- Department of Human Development & Psychology, University of California, Los Angeles, CA, USA
| | - Abigail P Houck
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
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2
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Spackman E, Smillie LD, Frazier TW, Hardan AY, Alvares GA, Whitehouse A, Uljarević M. Profiles of circumscribed interests in autistic youth. Front Behav Neurosci 2023; 17:1037967. [PMID: 36844650 PMCID: PMC9947294 DOI: 10.3389/fnbeh.2023.1037967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Circumscribed interests (CI) encompass a range of different interests and related behaviors that can be characterized by either a high intensity but otherwise usual topic [referred to as restricted interests (RI)] or by a focus on topics that are not salient outside of autism [referred to as unusual interests (UI)]. Previous research has suggested that there is pronounced variability across individuals in terms of the endorsement of different interests, however, this variability has not been quantified using formal subtyping approaches. Therefore, using Latent Profile Analysis in a sample of 1,892 autistic youth (Mage = 10.82, SDage = 4.14; 420 females), this study aimed to identify subgroups based on the RU and UI profiles. Three profiles of autistic individuals were identified. They were characterized as Low CI, Predominantly RI, and Predominantly UI. Importantly, profiles differed on several key demographic and clinical variables, including age, sex composition, IQ, language level, social and communication abilities, anxiety, and obsessive-compulsive behaviors. Although replication across other samples is needed, the profiles identified in this study are potentially promising for future research given their distinct profiles of RI and UI and unique patterns of associations with key cognitive and clinical variables. Therefore, this study represents an important initial step towards more individualized assessment and support for diverse presentations of CI in autistic youth.
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Affiliation(s)
- Emily Spackman
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia,*Correspondence: Emily Spackman
| | - Luke D. Smillie
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | | | - Antonio Y. Hardan
- Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford University, Stanford, CA, United States
| | - Gail A. Alvares
- UWA Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Andrew Whitehouse
- UWA Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Mirko Uljarević
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia,Psychiatry and Behavioral Sciences, Stanford Medicine, Stanford University, Stanford, CA, United States
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3
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Kang E, Lerner MD, Gadow KD. The Importance of Parent-Teacher Informant Discrepancy in Characterizing Autistic Youth: A Replication Latent Profile Analysis. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:108-118. [PMID: 36548459 PMCID: PMC9921175 DOI: 10.1080/15374416.2022.2154217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Research about autism spectrum disorder (ASD) supports variation in symptom presentations across settings, and there is a growing literature that explicates how this variability may improve characterization of the autism phenotype. Capitalizing on a well-established literature on informant discrepancy as an index of contextual variability, research suggests that differing parent and teacher perceptions may impact treatment or education-related outcomes. A prior investigation by Lerner and colleagues suggests that parent-teacher discrepancies in ASD symptom ratings define discrete and clinically meaningful subgroups. However, replication in a larger sample is important to support the validity and utility of the subgroups for use in research and practice. METHOD The present paper used latent profile analysis (LPA) to (1) replicate the previous study by Lerner and colleagues in a larger sample of 514 clinic-referred autistic youth (aged 6-18, 83.2% male, 90.4% White, IQ 19-140) and (2) determine if parent-teacher informant discrepancies relate to clinical and functional correlates. We hypothesized that parent-teacher discrepancies in ASD symptom severity ratings would validly characterize ASD subgroups and predict clinical and functional correlates. RESULTS The results of the LPA supported a 4-profile solution made up of two parent-teacher agreement groups (high parent-teacher, 21.2%, and low parent-teacher, 34.2%) and two parent-teacher discrepancy groups (high parent-low teacher, 18.1%, and moderate parent-high teacher, 26.5%), replicating findings from Lerner and colleagues. Latent profile membership differentially predicted IQ, age, and educational outcomes of participants. CONCLUSIONS Unique, clinically useful information about the taxonomy and impact of ASD is obtained by considering informant discrepancies in symptom severity ratings, which underscores the importance of considering contextual variability assessed through multiple informants.
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Affiliation(s)
- Erin Kang
- Psychology Department, Montclair State University
| | | | - Kenneth D Gadow
- Department of Psychiatry, Stony Brook University School of Medicine
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Naples A, Tenenbaum EJ, Jones RN, Righi G, Sheinkopf SJ, Eigsti IM. Exploring communicative competence in autistic children who are minimally verbal: The Low Verbal Investigatory Survey for Autism (LVIS). AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022:13623613221136657. [PMID: 36373838 PMCID: PMC10183057 DOI: 10.1177/13623613221136657] [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: 11/16/2022]
Abstract
LAY ABSTRACT Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of "minimally verbal." Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1-8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child's communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children.
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Affiliation(s)
| | - Elena J Tenenbaum
- Women & Infants Hospital, USA.,Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Duke University Medical Center, USA
| | | | - Giulia Righi
- Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Brown University, USA
| | - Stephen J Sheinkopf
- Women & Infants Hospital, USA.,Warren Alpert Medical School of Brown University, USA.,Rhode Island Consortium for Autism Research & Treatment, USA.,Brown University, USA.,University of Missouri, USA
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McDonald RG, Khawar S, Yacoub N, Cargill MI, Lerner MD, Kang E. Performance- and Theater-Based Interventions for Supporting Social Cognition and Social Communication in Autistic Youth: A Review and Theoretical Synthesis. Semin Speech Lang 2022; 43:255-276. [PMID: 35896405 DOI: 10.1055/s-0042-1750763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Social skills interventions (SSIs) are commonly used to improve social functioning in youth with autism spectrum disorder (ASD), which is a condition characterized by differences in social cognition and social communication. Although more traditional SSIs have used knowledge-based, didactic instruction, recent research has explored the utility of performance-based SSIs, which use various activities to support implicit learning of social skills in supportive, enriched environments. This article reviews the extant literature evaluating the effectiveness or efficacy of five performance-based SSIs using theater-based approaches on social cognition and social communication. Overall, this body of literature suggests social communication gains that include increased peer interactions, peer liking, and reciprocal friendships, as well as social cognitive gains in theory of mind and affect recognition. This review also discusses theoretical models that may help explain the emerging strengths of performance- and theater-based SSIs with underlying hypotheses related to the social communication and social cognitive differences in ASD. Limitations of performance-based SSIs in the evidence-base include several approaches in initial stages of research with small sample sizes and limited maintenance of effects. Future research should aim to bridge the research-to-practice gap and use more rigorous designs and more diverse samples, including those with cooccurring intellectual disability.
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Affiliation(s)
- Rachel G McDonald
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Sadaf Khawar
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Nardin Yacoub
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Mary Isaac Cargill
- Psychology Department, Montclair State University, Montclair, New Jersey
| | - Matthew D Lerner
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - Erin Kang
- Psychology Department, Montclair State University, Montclair, New Jersey
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Wang Y, Fu Y, Luo X. Identification of Pathogenetic Brain Regions via Neuroimaging Data for Diagnosis of Autism Spectrum Disorders. Front Neurosci 2022; 16:900330. [PMID: 35655751 PMCID: PMC9152096 DOI: 10.3389/fnins.2022.900330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Autism spectrum disorder (ASD) is a kind of neurodevelopmental disorder that often occurs in children and has a hidden onset. Patients usually have lagged development of communication ability and social behavior and thus suffer an unhealthy physical and mental state. Evidence has indicated that diseases related to ASD have commonalities in brain imaging characteristics. This study aims to study the pathogenesis of ASD based on brain imaging data to locate the ASD-related brain regions. Specifically, we collected the functional magnetic resonance image data of 479 patients with ASD and 478 normal subjects matched in age and gender and used a machine-learning framework named random support vector machine cluster to extract distinctive brain regions from the preprocessed data. According to the experimental results, compared with other existing approaches, the method used in this study can more accurately distinguish patients from normal individuals based on brain imaging data. At the same time, this study found that the development of ASD was highly correlated with certain brain regions, e.g., lingual gyrus, superior frontal gyrus, medial gyrus, insular lobe, and olfactory cortex. This study explores the effectiveness of a novel machine-learning approach in the study of ASD brain imaging and provides a reference brain area for the medical research and clinical treatment of ASD.
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Affiliation(s)
- Yu Wang
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, China
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
- Hunan Xiangjiang Artificial Intelligence Academy, Changsha, China
| | - Yu Fu
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, China
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
- Hunan Xiangjiang Artificial Intelligence Academy, Changsha, China
- *Correspondence: Yu Fu
| | - Xun Luo
- Hunan Provincial Key Laboratory of Intelligent Computing and Language Information Processing, Hunan Normal University, Changsha, China
- College of Information Science and Engineering, Hunan Normal University, Changsha, China
- Hunan Xiangjiang Artificial Intelligence Academy, Changsha, China
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7
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Agelink van Rentergem JA, Deserno MK, Geurts HM. Validation strategies for subtypes in psychiatry: A systematic review of research on autism spectrum disorder. Clin Psychol Rev 2021; 87:102033. [PMID: 33962352 DOI: 10.1016/j.cpr.2021.102033] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 02/14/2021] [Accepted: 04/14/2021] [Indexed: 12/11/2022]
Abstract
Heterogeneity within autism spectrum disorder (ASD) is recognized as a challenge to both biological and psychological research, as well as clinical practice. To reduce unexplained heterogeneity, subtyping techniques are often used to establish more homogeneous subtypes based on metrics of similarity and dissimilarity between people. We review the ASD literature to create a systematic overview of the subtyping procedures and subtype validation techniques that are used in this field. We conducted a systematic review of 156 articles (2001-June 2020) that subtyped participants (range N of studies = 17-20,658), of which some or all had an ASD diagnosis. We found a large diversity in (parametric and non-parametric) methods and (biological, psychological, demographic) variables used to establish subtypes. The majority of studies validated their subtype results using variables that were measured concurrently, but were not included in the subtyping procedure. Other investigations into subtypes' validity were rarer. In order to advance clinical research and the theoretical and clinical usefulness of identified subtypes, we propose a structured approach and present the SUbtyping VAlidation Checklist (SUVAC), a checklist for validating subtyping results.
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Affiliation(s)
- Joost A Agelink van Rentergem
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Dutch Autism & ADHD Research Center, the Netherlands.
| | - Marie K Deserno
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Dutch Autism & ADHD Research Center, the Netherlands
| | - Hilde M Geurts
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands; Dutch Autism & ADHD Research Center, the Netherlands; Dr. Leo Kannerhuis, the Netherlands
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8
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Harris HK, Lee C, Sideridis GD, Barbaresi WJ, Harstad E. Identifying Subgroups of Toddlers with DSM-5 Autism Spectrum Disorder Based on Core Symptoms. J Autism Dev Disord 2021; 51:4471-4485. [PMID: 33507459 DOI: 10.1007/s10803-021-04879-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 12/01/2022]
Abstract
The objective of this study was to identify subgroups of toddlers with DSM-5 ASD based on core ASD symptoms using a person-based analytical framework. This is a retrospective study of 500 toddlers (mean age 26 months, 79% male) with DSM-5 ASD. Data were analyzed using latent class analyses in which profiles were formed based on ASD symptomatology. Social communication (SC) symptoms favored a three-class solution, while restricted/repetitive behaviors (RRBs) favored a two-class solution. Classes with higher consistency of SC deficits were younger, with lower developmental functioning. The class with more RRBs was older, with higher functioning. If confirmed in other populations, these classes may more precisely characterize subgroups within the heterogeneous group of toddlers at time of ASD diagnosis.
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Affiliation(s)
- Holly K Harris
- Division of Developmental Medicine, Massachusetts and Harvard Medical School, Boston Children's Hospital, Fegan 10, 300 Longwood Avenue, Boston, MA, 02115, USA.,Department of Pediatrics, Baylor College of Medicine and Meyer Center for Developmental Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - Collin Lee
- Division of Developmental Medicine, Massachusetts and Harvard Medical School, Boston Children's Hospital, Fegan 10, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Georgios D Sideridis
- Division of Developmental Medicine, Massachusetts and Harvard Medical School, Boston Children's Hospital, Fegan 10, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - William J Barbaresi
- Division of Developmental Medicine, Massachusetts and Harvard Medical School, Boston Children's Hospital, Fegan 10, 300 Longwood Avenue, Boston, MA, 02115, USA
| | - Elizabeth Harstad
- Division of Developmental Medicine, Massachusetts and Harvard Medical School, Boston Children's Hospital, Fegan 10, 300 Longwood Avenue, Boston, MA, 02115, USA.
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9
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Atypical communication characteristics among clinic-referred youth with and without autism spectrum disorder: Stability and associations with clinical correlates. Dev Psychopathol 2020; 32:1240-1253. [PMID: 32938518 DOI: 10.1017/s095457942000070x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Atypical communication characteristics (ACCs), such as speech delay, odd pitch, and pragmatic difficulties, are common features of autism spectrum disorder (ASD) as are the symptoms of a wide range of psychiatric disorders. Using a simple retrospective method, this study aimed to better understand the relation and stability of ACCs with a broad range of psychiatric symptoms among large, well-characterized samples of clinic-referred children and adolescents with and without ASD. Youth with ASD had higher rates and a more variable pattern of developmental change in ACCs than the non-ASD diagnostic group. Latent class analysis yielded three ACC stability subgroups within ASD: Stable ACCs, Mostly Current-Only ACCs, and Little Professors. Subgroups exhibited differences in severity of ASD symptomatology, co-occurring psychiatric symptoms, and other correlates. Our findings provide support for the clinical utility of characterizing caregiver-perceived changes in ACCs in identifying children at risk for co-occurring psychopathology and other clinically relevant variables.
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Uljarević M, Phillips JM, Schuck RK, Schapp S, Solomon EM, Salzman E, Allerhand L, Libove RA, Frazier TW, Hardan AY. Exploring Social Subtypes in Autism Spectrum Disorder: A Preliminary Study. Autism Res 2020; 13:1335-1342. [DOI: 10.1002/aur.2294] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 03/03/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
- Melbourne School of Psychological Sciences Faculty of Medicine, Dentistry, and Health SciencesThe University of Melbourne Victoria Australia
| | - Jennifer M. Phillips
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Rachel K. Schuck
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Salena Schapp
- Department of PsychiatryKaiser Permanente Redwood City California USA
| | - Elizabeth M. Solomon
- Department of Psychiatry and Behavioral Sciences, Davis Medical CenterUniversity of California Sacramento California USA
| | - Emma Salzman
- Department of PsychiatryUniversity of California San Francisco San Francisco California USA
| | - Lauren Allerhand
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Robin A. Libove
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
| | - Thomas W. Frazier
- Autism Speaks New York USA
- Department of PsychologyJohn Carroll University, University Heights Ohio USA
| | - Antonio Y. Hardan
- Department of Psychiatry and Behavioral SciencesStanford University Stanford California USA
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