Wechsler IQ profile and theory of mind in autism: a research note

Cognitive Profile in Autism and ADHD: A Meta-Analysis of Performance on the WAIS-IV and WISC-V

OBJECTIVE

Previous research has suggested that neurodevelopmental conditions may be associated with distinctive cognitive profiles on the Wechsler intelligence tests (of which the most recent editions are the WAIS-IV and WISC-V). However, the extent to which a cognitive profile can be reliably identified for individuals meeting criteria for autism or ADHD remains unclear. The present review investigated this issue.

METHOD

A search was conducted in PsycInfo, Embase, and Medline in October 2022 for papers reporting the performance of children or adults diagnosed with autism or ADHD on the WAIS-IV or the WISC-V. Test scores were aggregated using meta-analysis.

RESULTS

Scores were analyzed from over 1,800 neurodivergent people reported across 18 data sources. Autistic children and adults performed in the typical range for verbal and nonverbal reasoning, but scored ~1 SD below the mean for processing speed and had slightly reduced scores on working memory. This provides evidence for a "spiky" cognitive profile in autism. Performance of children and adults with ADHD was mostly at age-expected levels, with slightly reduced scores for working memory.

CONCLUSION

Although the pattern of performance on the Wechsler tests is not sufficiently sensitive or specific to use for diagnostic purposes, autism appears to be associated with a cognitive profile of relative strengths in verbal and nonverbal reasoning and a weakness in processing speed. Attention deficit hyperactivity disorder appears less associated with a particular cognitive profile. Autistic individuals may especially benefit from a cognitive assessment to identify and support with their strengths and difficulties.

Attention Allocation During Exploration of Visual Arrays in ASD: Results from the ABC-CT Feasibility Study

Visual exploration paradigms involving object arrays have been used to examine salience of social stimuli such as faces in ASD. Recent work suggests performance on these paradigms may associate with clinical features of ASD. We evaluate metrics from a visual exploration paradigm in 4-to-11-year-old children with ASD (n = 23; 18 males) and typical development (TD; n = 23; 13 males). Presented with arrays containing faces and nonsocial stimuli, children with ASD looked less at (p = 0.002) and showed fewer fixations to (p = 0.022) faces than TD children, and spent less time looking at each object on average (p = 0.004). Attention to the screen and faces correlated positively with social and cognitive skills in the ASD group (ps < .05). This work furthers our understanding of objective measures of visual exploration in ASD and its potential for quantifying features of ASD.

Different levels of visuospatial abilities linked to differential brain correlates underlying visual mental segmentation processes in autism

The neural underpinnings of enhanced locally oriented visual processing that are specific to autistics with a Wechsler's Block Design (BD) peak are largely unknown. Here, we investigated the brain correlates underlying visual segmentation associated with the well-established autistic superior visuospatial abilities in distinct subgroups using functional magnetic resonance imaging. This study included 31 male autistic adults (15 with (AUTp) and 16 without (AUTnp) a BD peak) and 28 male adults with typical development (TYP). Participants completed a computerized adapted BD task with models having low and high perceptual cohesiveness (PC). Despite similar behavioral performances, AUTp and AUTnp showed generally higher occipital activation compared with TYP participants. Compared with both AUTnp and TYP participants, the AUTp group showed enhanced task-related functional connectivity within posterior visuoperceptual regions and decreased functional connectivity between frontal and occipital-temporal regions. A diminished modulation in frontal and parietal regions in response to increased PC was also found in AUTp participants, suggesting heavier reliance on low-level processing of global figures. This study demonstrates that enhanced visual functioning is specific to a cognitive phenotypic subgroup of autistics with superior visuospatial abilities and reinforces the need to address autistic heterogeneity by good cognitive characterization of samples in future studies.

Brief Report: The Factors Associated with Social Cognition in Children with Autism Spectrum Disorder

This study examined whether school-aged autistic children without co-occurring intellectual disabilities (autisticWoID) show similar difficulty on Theory of Mind (ToM) tasks as young autisticWoID children and if these difficulties are related to problems in domain-general aspects of cognition. Eighty-one autisticWoID and 44 neurotypical (NT) children between the ages of 8-16 years participated in this study and were matched on verbal IQ. ToM performance significantly and independently differentiated many, but not all, autisticWoID and NT participants above and beyond the effects of working memory and inferential thinking. However, these cognitive variables did not fully explain difficulties with social cognition in autisticWoID children. These findings have implications for understanding autism, the factors that may impact intervention for social cognition in autism, and the factors that impact the education of autistic children who may struggle in general education classrooms.

Differential neural correlates underlying mental rotation processes in two distinct cognitive profiles in autism

Enhanced visuospatial abilities characterize the cognitive profile of a subgroup of autistics. However, the neural correlates underlying such cognitive strengths are largely unknown. Using functional magnetic resonance imaging (fMRI), we investigated the neural underpinnings of superior visuospatial functioning in different autistic subgroups. Twenty-seven autistic adults, including 13 with a Wechsler's Block Design peak (AUTp) and 14 without (AUTnp), and 23 typically developed adults (TYP) performed a classic mental rotation task. As expected, AUTp participants were faster at the task compared to TYP. At the neural level, AUTp participants showed enhanced bilateral parietal and occipital activation, stronger occipito-parietal and fronto-occipital connectivity, and diminished fronto-parietal connectivity compared to TYP. On the other hand, AUTnp participants presented greater activation in right and anterior regions compared to AUTp. In addition, reduced connectivity between occipital and parietal regions was observed in AUTnp compared to AUTp and TYP participants. A greater reliance on posterior regions is typically reported in the autism literature. Our results suggest that this commonly reported finding may be specific to a subgroup of autistic individuals with enhanced visuospatial functioning. Moreover, this study demonstrated that increased occipito-frontal synchronization was associated with superior visuospatial abilities in autism. This finding contradicts the long-range under-connectivity hypothesis in autism. Finally, given the relationship between distinct cognitive profiles in autism and our observed differences in brain functioning, future studies should provide an adequate characterization of the autistic subgroups in their research. The main limitations are small sample sizes and the inclusion of male-only participants.

Comparison of Verbal Performance of Children with Autism Spectrum Disorder on the WISC-V

Children with autism spectrum disorder (ASD) display variable verbal cognitive profiles despite a historical requirement for a language delay in autistic disorder. This study compared the Verbal Comprehension Index (VCI) to the newly created ancillary index score, the Verbal Expanded Crystallized Index (VECI) of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) in a group of children with ASD. Using the ASD sample from the standardization data of the WISC-V, results indicated the VCI and VECI were significantly different for the ASD group but not for the matched controls. Follow up analysis of the ASD group revealed the VCI and VECI were significantly different for those with language impairment but not for those without language impairment. Psychologists should consider administering all verbal subtests of the WISC-V to children with ASD given the VECI may better capture the language impairment seen in this population.

Theory of Mind Among Swedish Children with ASD, Down Syndrome and Typically Developing Group

The present study examined the role of IQ and the Theory of Mind understanding in children with an autism spectrum disorder and down syndrome. Sixty-six Swedish children with ASD (n = 26), DS (n = 18), and typically developed group (n = 22) ranged between 6 and 12 years old were compared on ToM tasks consisted of standard ToM and IQ tasks. SPSS 25 program was used to analyze data. The results indicated that individuals with ASD reach a better understanding of first-order ToM tasks than children with DS. This picture was the same in the TD group to show better ability than children with ASD and DS on first-order tasks, except one task which was not found significant differences. To employ second-order TD performed better than clinical groups, while, there was no significant difference between ASD and DS. The scores for the third-order task in children with ASD were significantly better than children with DS.

Review of Cognitive Characteristics of Autism Spectrum Disorder Using Performance on Six Subtests on Four Versions of the Wechsler Intelligence Scale for Children

This study was a systematic review of research using the Wechsler Intelligence Scale for Children (WISC) with Autism Spectrum Disorder (ASD) to examine cognitive characteristics of children with ASD beyond the impact of revisions based on WISC and diagnostic criteria changes. The classic "islets of ability" was found in individuals with full-scale IQs < 100. The "right-descending profiles" were observed among high IQ score individuals. High levels on the Block Design and low Coding levels were consistently found regardless of the variation in intellectual functioning or diagnosis. This review identified patterns of cognitive characteristics in ASD individuals using empirical data that researchers may have previously been aware of, based on their experiences, owing to the increased prevalence of ASD.

The cognitive benefits of bilingualism in autism spectrum disorder: Is theory of mind boosted and by which underlying factors?

This study examined whether bilingualism boosts Theory of Mind as measured by a non-verbal false belief (FB) task in children with autism spectrum disorder (ASD), and how this potential boost may stem from improvements in a variety of other domains, namely executive functions (EFs), language, metalinguistic awareness skills, as well as autism severity. One hundred and three children with ASD (7- to 15-year-olds) (43 bilingual and 60 age- and IQ-matched monolingual children) were tested on a nonverbal task of attentional switching, working memory and updating task, and an online, low-verbal first-order FB task. Results showed a clear FB benefit for bilingual children with ASD as compared with their monolingual peers. There were also boosts in EF, however, there is no evidence that these EF boosts drove the FB advantage. Enhanced FB was not explained either by language, metalinguistic skills, or lower autism severity. While the results do not conclusively settle the debate on what triggers the ToM advantage in bilingual children with ASD, the empirical picture of the current study suggests that the ToM component of FB understanding in bilingual children with ASD is enhanced by the bilingual experience per se. LAY SUMMARY: The current study aimed to determine if and how bilingualism may improve the ability to understand others' beliefs in children with autism spectrum disorder (ASD). We assessed their belief reasoning alongside a series of other skills hypothesized to be beneficial for such reasoning, namely understanding, producing, and thinking about language, recalling and switching between information, and the severity of their autistic symptoms. The overall findings highlight advantages for bilingual children with ASD over their monolingual peers for grasping beliefs, thus suggesting that pursuing bilingualism may be beneficial for cognition in ASD. Other boosts were also associated with bilingualism, such as recalling and switching between information, but these boosts were not directly related to belief understanding, highlighting the beneficial role of bilingualism per se.

Self-categorization and Autism: Exploring the Relationship Between Autistic Traits and Ingroup Favouritism in the Minimal Group Paradigm

The Integrated self-categorization model of autism (ISCA) argues that a self-categorization dysfunction could be the link between some of the disparate features of ASD. To the extent that this is true, any social psychological phenomena arising from self-categorization should be impaired in autistic people. Based on this premise, we investigated whether ingroup favouritism within the minimal group paradigm is reduced to the extent that individuals possess autistic traits. Results indicated that participants with a high proportion of autistic traits showed less ingroup favouritism, and that this was due to a decreased tendency for self-categorization. By providing evidence of the disruption of self-categorization in ASD, these findings lend support to ISCA and raise important issues for existing accounts of the disorder.

Theory of Mind, Executive Functions, and Syntax in Bilingual Children with Autism Spectrum Disorder

Impairments in Theory of Mind (ToM) are a core feature of Autism Spectrum Disorder (ASD). ToM may be enhanced by various factors, including bilingualism, executive functions (EF), and complex syntax. This work investigates the language-cognition interface in ASD by exploring whether ToM can be enhanced by bilingualism, whether such ToM boosts would be due to EF or syntax, and whether routes to mentalizing would differ between bilinguals and monolinguals on the spectrum. Twenty-seven monolingual Greek-speaking and twenty-nine bilingual Albanian-Greek children with ASD were tested on ToM reasoning in verbal and low-verbal ToM tasks, an executive function 2-back task, and a sentence repetition task. Results revealed that bilingual children with ASD performed better than monolinguals with ASD in the low-verbal ToM and the 2-back tasks. In the sentence repetition task, bilinguals scored higher than monolinguals in complex sentences, and specifically in adverbials and relatives. Regarding the relations between ToM, EF, and sentence repetition, the monolingual group’s performance in the verbal ToM tasks was associated with complement syntax, whereas, for the bilingual children with ASD, performance in both verbal and low-verbal ToM tasks was associated with EF and adverbial clause repetition. The overall pattern of results suggests that mentalizing may follow distinct pathways across the two groups.

Cool Executive Function and Verbal Comprehension Mediate the Relation of Hot Executive Function and Theory of Mind in Children with Autism Spectrum Disorder

Impaired executive function (EF), verbal comprehension, and theory of mind (ToM) may contribute to social difficulties in children with autism spectrum disorder (ASD). The linkage between cool (cognitive) EF and ToM has been widely investigated, but the relations between hot (affective) EF and ToM remain largely unknown. The roles of cool EF and verbal comprehension have not been previously explored together to address hot EF-ToM relations. This study applied mediation analysis to investigate the mediating effects of cool EF and verbal comprehension to further elaborate the link between hot EF and ToM in children with ASD and average intellectual abilities. A total of 97 children with ASD aged from 6 to 12 years participated in this study. Children's cool EF, hot EF, and verbal comprehension were, respectively, measured with the computerized Dimensional Change Card Sort task, Children's Gambling Task, and the verbal comprehension index of the Wechsler Intelligence Scale for Children-fourth edition. Children's ToM was assessed with the Theory of Mind Task Battery. Partial correlation coefficients indicated that hot EF was significantly related with ToM with age controlled for. The results of the mediation analysis showed that cool EF and verbal comprehension mediated the linkage between hot EF and ToM. These findings highlight not only the connections between hot EF and ToM but also the importance of cool EF and verbal comprehension on hot EF-ToM relations in clinical assessments and interventions for school-aged children with ASD and average intellectual abilities. LAY SUMMARY: Relatively few studies have investigated the hot (affective) executive function (EF)-theory of mind (ToM) relations in children with autism spectrum disorder (ASD). This study discovered that hot EF was significantly related to ToM, while cool (cognitive) EF and verbal comprehension mediated the relationship between hot EF and ToM. Therefore, the influence of cool EF and verbal comprehension on hot EF-ToM relations should be considered in studies involving children with ASD. Autism Res 2021, 14: 921-931. © 2020 International Society for Autism Research and Wiley Periodicals LLC.

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.

Different associations between intelligence and social cognition in children with and without autism spectrum disorders

Autism spectrum disorders (ASD) are characterized by impaired social cognition and communication. In addition to social impairment, individuals with ASD often have intellectual disability. Intelligence is known to influence the phenotypic presentation of ASD. Nevertheless, the relation between intelligence and social reciprocity in people with ASD remains unclear, especially in childhood. To elucidate this relation, we analyzed 56 typically developing children (35 male, 21 female, aged 60–91 months) and 46 children with ASD (35 male, 11 female, aged 60–98 months) from university and affiliated hospitals. Their cognitive function was evaluated using the Kaufman Assessment Battery for Children. Their social cognition was assessed using the Social Responsiveness Scale. We used linear regression models to ascertain whether the associations between intelligence and social cognition of typically developing children and children with ASD are significantly different. Among the children with ASD, scores on the Kaufman Assessment Battery for Children correlated significantly with social cognition, indicating that higher intelligence is associated with better social cognition. For typically developing children, however, no significant correlation was found. One explanation might be that children with ASD fully use general intelligence for successful learning in social cognition, although extensive use of intelligence might not be necessary for TD children. Alternatively, autistic impairment in social cognition can be compensated by intelligence despite a persistent deficit in social cognition. In either case, when using the SRS as a quantitative phenotype measure for ASD, the influence of intelligence must be considered.

Central coherence in adults with a high-functioning autism spectrum disorder. In a search for a non-self-reporting screening tool

BACKGROUND

Autism spectrum disorder in adults, especially high-functioning ones, is often difficult to differentiate from other mental disorders. Therefore, many adults with ASD are misdiagnosed, and their social difficulties are not adequately addressed. Moreover, frequent comorbid issues make diagnosis a challenging prospect. Most of the available screening and diagnostic tools rely on self-reporting, which can be a biased method. Weak Central Coherence is one of the main cognitive theories of ASD. According to research, individuals with ASD are slower in comparison to typically developed control on the uptake of context. The study goal was to see if the central coherence tasks could be used as a reliable screening marker that differentiates between high-functioning ASD and typically developed controls.

METHOD

Thirty males with ASD (as in DSM-5) and 30 demographically matched controls were investigated with Central Coherence Inferences Tests. Tests' scores and reaction times needed to complete the tasks in both groups were compared.

RESULTS

High-functioning participants with ASD achieved a similar score in central coherence tests as the typically developed control group, but they needed significantly more time to solve them. The ROC analysis for both central coherence tests revealed AUC values of 0.73 in differentiating ASD from typically developed controls.

CONCLUSIONS

The results are discussed in reference to the clinical application of central coherence as a possible screening marker. Further research directions are proposed in terms of differential diagnosis of adults with ASD.

"Motion or Emotion? Recognition of Emotional Bodily Expressions in Children With Autism Spectrum Disorder With and Without Intellectual Disability"

The recognition of emotional body movement (BM) is impaired in individuals with Autistic Spectrum Disorder ASD, yet it is not clear whether the difficulty is related to the encoding of body motion, emotions, or both. Besides, BM recognition has been traditionally studied using point-light displays stimuli (PLDs) and is still underexplored in individuals with ASD and intellectual disability (ID). In the present study, we investigated the recognition of happy, fearful, and neutral BM in children with ASD with and without ID. In a non-verbal recognition task, participants were asked to recognize pure-body-motion and visible-body-form stimuli (by means of point-light displays-PLDs and full-light displays-FLDs, respectively). We found that the children with ASD were less accurate than TD children in recognizing both the emotional and neutral BM, either when presented as FLDs or PLDs. These results suggest that the difficulty in understanding the observed BM may rely on atypical processing of BM information rather than emotion. Moreover, we found that the accuracy improved with age and IQ only in children with ASD without ID, suggesting that high level of cognitive resources can mediate the acquisition of compensatory mechanisms which develop with age.

La comprensión de las meteduras de pata en escolares con autismo. Su relación con variables cognitivas y de teoría de la mente

El presente estudio tiene una doble finalidad. La primera es analizar dos de las variables implicadas en la comprensión de las meteduras de pata (MP) en el autismo (Cociente Intelectual; CI, y la Falsa Creencia; FC). La segunda, examinar en detalle las dificultades encontradas en la tarea de MP, dividida la población con autismo en dos grupos según su CI (Grupo 1= rango CI 100-120, Grupo 2 = rango CI 70-85). De dicha tarea de MP, se adaptaron cuatro historias (viñetas y narración) de Baron-Cohen, O’Riordan, Stone, Jones y Plaisted (1999), y se administraron a los dos grupos de niños y pre-adolescente con autismo (N = 34) de entre 7 y 12 años (M = 9.6, DE = 1.55), que las resolvieron a partir de respuestas de elección dicotómica y de explicación verbal. Los resultados demuestran la capacidad predictiva del CI total (r = 0.53; p < 0.001; R2 = 0.28) y de la FC (r = 0.51; p < 0.001; R2 = 0.26). El 40 % de la variabilidad de la tarea de MP se vio explicada por las variables predictores FC y Vocabulario. Además, se encontraron diferencias significativas entre grupos (el Grupo 1 respondió mejor que el Grupo 2) tanto en respuestas de elección forzada personaje (ii) e ignorancia (vii) y la suma total como en su explicación verbal. Estos resultados se discuten más detalladamente debido a su posible repercusión en la vida diaria de las personas con autismo.

Simple Mindreading Abilities Predict Complex Theory of Mind: Developmental Delay in Autism Spectrum Disorders

Theory of mind (ToM) is impaired in individuals with autism spectrum disorders (ASD). The aims of this study were to: (i) examine the developmental trajectories of ToM abilities in two different mentalizing tasks in children with ASD compared to TD children; and (ii) to assess if a ToM simple test known as eyes-test could predict performance on the more advanced ToM task, i.e. comic strip test. Based on a sample of 37 children with ASD and 55 TD children, our results revealed slower development at varying rates in all ToM measures in children with ASD, with delayed onset compared to TD children. These results could stimulate new treatments for social abilities, which would lessen the social deficit in ASD.

Different brain networks underlying intelligence in autism spectrum disorders

There has been sustained clinical and cognitive neuroscience research interest in how network correlates of brain-behavior relationships might be altered in Autism Spectrum Disorders (ASD) and other neurodevelopmental disorders. As previous work has mostly focused on adults, the nature of whole-brain connectivity networks underlying intelligence in pediatric cohorts with abnormal neurodevelopment requires further investigation. We used network-based statistics (NBS) to examine the association between resting-state functional Magnetic Resonance Imaging (fMRI) connectivity and fluid intelligence ability in male children (n = 50) with Autism Spectrum Disorders (ASD; M = 10.45, SD = 1.58 years and in controls (M = 10.38, SD = 0.96 years) matched on fluid intelligence performance, age and sex. Repeat analyses were performed in independent sites for validation and replication. Despite being equivalent on fluid intelligence ability to strictly matched neurotypical controls, boys with ASD displayed a subnetwork of significantly increased associations between functional connectivity and fluid intelligence. Between-group differences remained significant at higher edge thresholding, and results were validated in independent-site replication analyses in an equivalent age and sex-matched cohort with ASD. Regions consistently implicated in atypical connectivity correlates of fluid intelligence in ASD were the angular gyrus, posterior middle temporal gyrus, occipital and temporo-occipital regions. Development of fluid intelligence neural correlates in young ASD males is aberrant, with an increased strength in intrinsic connectivity association during childhood. Alterations in whole-brain network correlates of fluid intelligence in ASD may be a compensatory mechanism that allows equal task performance to neurotypical peers.

Failing, hacking, passing: Autism, entanglement, and the ethics of transformation

One of the most notable recent changes in autism science is the belief that autism is a heterogeneous condition with no singular essence. I argue that this notion of 'autistic heterogeneity' can be conceived as an 'agential cut' and traced to uncertainty work conducted by cognitive psychologists during the early 1990s. Researchers at this time overcame uncertainty in scientific theory by locating it within autism itself: epistemological uncertainty was interwoven with ontological indeterminacy and autism became heterogeneous and chance like, a condition determined by indeterminacy. This paper considers not only the conceptual significance of this move but also the impact upon forms of subjectivity. This analysis is undertaken by integrating the agential realism of Karen Barad with the historical ontology of Michel Foucault. I argue that these two approaches are, firstly, concerned with ontologies of emergence and, secondly, foreground the inherently ethical nature of change. As such these theories can be used to articulate an 'ethics of transformation'. I argue that the agential cut which brought about autistic heterogeneity is potentially problematic within an ethics of transformation, limiting the possibility of future change in subjectivity by imagining difference and resistance as properties of autism rather than the individual.

Autistic Children Show a Surprising Relationship between Global Visual Perception, Non-Verbal Intelligence and Visual Parvocellular Function, Not Seen in Typically Developing Children

Despite much current research into the visual processing style of individuals with Autism Spectrum Disorder (ASD), understanding of the neural mechanisms is lagging, especially with respect to the contributions of the overlapping dichotomies of magnocellular/parvocellular (afferent neural pathways), global/local (perception) and dorsal/ventral (cortical streams). Here, we addressed this deficiency by measuring inspection times (ITs) for novel global/local stimuli as well as recording nonlinear visually evoked potentials (VEPs), in particular, magnocellular and parvocellular temporal efficiencies. The study was conducted on a group of male ASD children and a typically developing (TD) group matched for mean age and mean non-verbal intelligence, as measured by the Raven's Progressive Matrices. The IT results did not differ between groups, however a negative correlation between global IT and Raven's score was found in the ASD group, that was not evident in the TD group. Nonlinear VEP showed the ASD group had smaller amplitude parvocellular-generated second order responses compared to the TD group. This is a sign of improved temporal responsiveness in ASD vs. TD groups. Principal Component Analysis linked global IT, non-verbal intelligence scores and VEP parvocellular efficiency in a single factor for the ASD but not the TD group. The results are suggestive of a constraint on pathways available for cognitive response in the ASD group, with temporal processing for those with ASD becoming more reliant on the parvocellular pathway.

Vision Research Literature May Not Represent the Full Intellectual Range of Autism Spectrum Disorder

Sensory, in particular visual processing is recognized as often perturbed in individuals with Autism Spectrum Disorder (ASD). However, in terms of the literature pertaining to visual processing, individuals in the normal intelligence range (IQ = 90-110) and above, are more frequently represented in study samples than individuals who score below normal in the borderline intellectual disability (ID) (IQ = 71-85) to ID (IQ < 70) ranges. This raises concerns as to whether or not current research is generalizable to a disorder that is often co-morbid with ID. Thus, the aim of this review is to better understand to what extent the current ASD visual processing literature is representative of the entire ASD population as either diagnosed or recognized under DSM-5. Our recalculation of ASD prevalence figures, using the criteria of DSM-5, indicates approximately 40% of the ASD population are likely to be ID although searching of the visual processing literature in ASD up to July 2016 showed that only 20% of papers included the ASD with-ID population. In the published literature, the mean IQ sampled was found to be 104, with about 80% of studies sampling from the 96-115 of the IQ range, highlighting the marked under-representation of the ID and borderline ID sections of the ASD population. We conclude that current understanding of visual processing and perception in ASD is not based on the mean IQ profile of the DSM-5 defined ASD population that now appears to lie within the borderline ID to ID range. Give the importance of the role of vision for the social and cognitive processing in ASD, we recommend accurately representing ASD via greater inclusion of individuals with IQ below 80, in future ASD research.

Social-Emotional Inhibition of Return in Children with Autism Spectrum Disorder Versus Typical Development

In typical development there is a bias to orient visual attention to social information. Children with ASD do not reliably demonstrate this bias, and the role of attention orienting has not been well studied. We examined attention orienting via the inhibition of return (IOR) mechanism in a spatial cueing task using social-emotional cues; we studied 8- to 17-year-old children with ASD (n = 41) and typically developing controls (TDC) (n = 25). The ASD group exhibited a significantly stronger IOR effect than the TDC group, and the IOR effect correlated positively with social impairments but was unrelated to co-occurring ADHD or anxiety symptoms. The results provide evidence of an early altered attention mechanism that is associated with to core social deficits in ASD.

Does WISC-IV Underestimate the Intelligence of Autistic Children?

Wechsler Intelligence Scale for Children (WISC) is widely used to estimate autistic intelligence (Joseph in The neuropsychology of autism. Oxford University Press, Oxford, 2011; Goldstein et al. in Assessment of autism spectrum disorders. Guilford Press, New York, 2008; Mottron in J Autism Dev Disord 34(1):19-27, 2004). However, previous studies suggest that while WISC-III and Raven's Progressive Matrices (RPM) provide similar estimates of non-autistic intelligence, autistic children perform significantly better on RPM (Dawson et al. in Psychol Sci 18(8):657-662, doi: 10.1111/j.1467-9280.2007.01954.x , 2007). The latest WISC version introduces substantial changes in subtests and index scores; thus, we asked whether WISC-IV still underestimates autistic intelligence. Twenty-five autistic and 22 typical children completed WISC-IV and RPM. Autistic children's RPM scores were significantly higher than their WISC-IV FSIQ, but there was no significant difference in typical children. Further, autistic children showed a distinctively uneven WISC-IV index profile, with a "peak" in the new Perceptual Reasoning Index. In spite of major changes, WISC-IV FSIQ continues to underestimate autistic intelligence.

Perceptual Averaging in Individuals with Autism Spectrum Disorder

There is mounting evidence that observers rely on statistical summaries of visual information to maintain stable and coherent perception. Sensitivity to the mean (or other prototypical value) of a visual feature (e.g., mean size) appears to be a pervasive process in human visual perception. Previous studies in individuals diagnosed with Autism Spectrum Disorder (ASD) have uncovered characteristic patterns of visual processing that suggest they may rely more on enhanced local representations of individual objects instead of computing such perceptual averages. To further explore the fundamental nature of abstract statistical representation in visual perception, we investigated perceptual averaging of mean size in a group of 12 high-functioning individuals diagnosed with ASD using simplified versions of two identification and adaptation tasks that elicited characteristic perceptual averaging effects in a control group of neurotypical participants. In Experiment 1, participants performed with above chance accuracy in recalling the mean size of a set of circles (mean task) despite poor accuracy in recalling individual circle sizes (member task). In Experiment 2, their judgments of single circle size were biased by mean size adaptation. Overall, these results suggest that individuals with ASD perceptually average information about sets of objects in the surrounding environment. Our results underscore the fundamental nature of perceptual averaging in vision, and further our understanding of how autistic individuals make sense of the external environment.

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.

Native Savant Talent and Acquired Skill

The paper represents an attempt to evaluate the effect of professional art training on savant artistic ability, and focuses on the work of the artist Stephen Wiltshire. It was undertaken jointly by two of Stephen's own tutors at art school and the two principal authors. The context of the research was, by its nature, not experimental but attempted to look at possible artistic and technical developments in relation to characteristics of autistic savant abilities. Savant ability has often been regarded as a fixed entity which cannot be accounted for solely in terms of continuous practice. There have however been few reports of the effect of expert tuition. As the young savant artist investigated here had previously almost exclusively used line drawing, and had rarely employed tonal values (shading), this dimension was focused upon as giving a possible indication of the effectiveness of teaching. In addition, structured interviews concerned with a detailed analysis of Stephen's work showed that although there was considerable progress during his college attendance, autism also appeared to set limits to Stephen's artistic development in regard to artistic intentions and subject agenda.

Contrasting Styles of Drawing in Gifted Individuals with Autism

The drawings of two artistically gifted young people with autism (BX and CZ) were compared and related to their cognitive profiles. BX is more typical of other cases of autistic savants in his choice of non-human subject matter and linear style of drawing and also in his cognitive profile. CZ is unusual in drawing the human face and in concentrating on the drawing technique of tonal contrasts; her cognitive profile is also atypical. The article highlights individual differences within the autistic savant population.

How High-Functioning Children with Autism Understand Real and Deceptive Emotion

Autism is associated with problems in understanding and expressing emotion. We compared the ability of eight high- functioning children with autism (i.e. those with IQ scores ≥ 70) and eight age- and gender-matched controls with similar oral language development, to understand the facial expression of real and deceptive emotion. Children with autism had limited understanding of socially derived emotion. Although they could relate emotions to standard facial expressions, they were less able than controls to indicate the real emotions story characters feel, the deceptive emotions they express in the face, or the social reasons prompting a deceptive facial expression. For high- function children with autism, facial expressions may function as lexical codes but not as forms of social communication that modify beliefs.

Looking without Perceiving: Impaired Preattentive Perceptual Grouping in Autism Spectrum Disorder

Before becoming aware of a visual scene, our perceptual system has organized and selected elements in our environment to which attention should be allocated. Part of this process involves grouping perceptual features into a global whole. Individuals with autism spectrum disorders (ASD) rely on a more local processing strategy, which may be driven by difficulties perceptually grouping stimuli. We tested this notion using a line discrimination task in which two horizontal lines were superimposed on a background of black and white dots organized so that, on occasion, the dots induced the Ponzo illusion if perceptually grouped together. Results showed that even though neither group was aware of the illusion, the ASD group was significantly less likely than typically developing group to make perceptual judgments influenced by the illusion, revealing difficulties in preattentive grouping of visual stimuli. This may explain why individuals with ASD rely on local processing strategies, and offers new insight into the mechanism driving perceptual grouping in the typically developing human brain.

Cognition and Behaviour in Sotos Syndrome: A Systematic Review

BACKGROUND

Research investigating cognition and behaviour in Sotos syndrome has been sporadic and to date, there is no published overview of study findings.

METHOD

A systematic review of all published literature (1964-2015) presenting empirical data on cognition and behaviour in Sotos syndrome. Thirty four journal articles met inclusion criteria. Within this literature, data relating to cognition and/or behaviour in 247 individuals with a diagnosis of Sotos syndrome were reported. Ten papers reported group data on cognition and/or behaviour. The remaining papers employed a case study design.

RESULTS

Intelligence quotient (IQ) scores were reported in twenty five studies. Intellectual disability (IQ < 70) or borderline intellectual functioning (IQ 70-84) was present in the vast majority of individuals with Sotos syndrome. Seven studies reported performance on subscales of intelligence tests. Data from these studies indicate that verbal IQ scores are consistently higher than performance IQ scores. Fourteen papers provided data on behavioural features of individuals with Sotos syndrome. Key themes that emerged in the behavioural literature were overlap with ASD, ADHD, anxiety and high prevalence of aggression/tantrums.

CONCLUSION

Although a range of studies have provided insight into cognition and behaviour in Sotos syndrome, specific profiles have not yet been fully specified. Recommendations for future research are provided.

Discrepancy between WISC-III and WISC-IV Cognitive Profile in Autism Spectrum: What Does It Reveal about Autistic Cognition?

The cognitive profile and measured intellectual level vary according to assessment tools in children on the autism spectrum, much more so than in typically developing children. The recent inclusion of intellectual functioning in the diagnostic process for autism spectrum disorders leads to the crucial question on how to assess intelligence in autism, especially as some tests and subtests seem more sensitive to certain neurodevelopmental conditions. Our first aim was to examine the cognitive profile on the current version of the most widely used test, the Wechsler Intelligence Scales for Children (WISC-IV), for a homogenous subgroup of children on the autism spectrum, i.e. corresponding to DSM-IV diagnosis of “autism”. The second aim was to compare cognitive profiles obtained on the third edition versus 4^th edition of WISC, in order to verify whether the WISC-IV yields a more distinctive cognitive profile in autistic children. The third aim was to examine the impact of the WISC-IV on the cognitive profile of another subgroup, children with Asperger’s Syndrome. 51 autistic, 15 Asperger and 42 typically developing children completed the WISC-IV and were individually matched to children who completed the WISC-III. Divergent WISC-IV profiles were observed despite no significant intelligence quotient difference between groups. Autistic children scored significantly higher on the Perceptual Reasoning Index than on the Verbal Comprehension Index, a discrepancy that nearly tripled in comparison to WISC-III results. Asperger children scored higher on the VCI than on other indexes, with the lowest score found on the Processing Speed Index. WISC-IV cognitive profiles were consistent with, but more pronounced than WISC-III profiles. Cognitive profiles are a valuable diagnostic tool for differential diagnosis, keeping in mind that children on the autism spectrum might be more sensitive to the choice of subtests used to assess intelligence.

Issues related to obtaining intelligence quotient-matched controls in autism research

BACKGROUND

Intelligence Quotient (IQ) is considered to be an index of global cognitive functioning and has traditionally been used as a fulcral measure in case-control studies in neuro-developmental disorders such as autism.

AIM

The aim is to highlight the issues of "matching for IQ" with controls in autism research.

MATERIALS AND METHODS

Percentile scores on the Coloured Progressive Matrices of 20 children with autism in the age range of 5 to 12 years have been graphically compared with 21 age matched typically developing children.

RESULTS AND CONCLUSIONS

The percentile scores of the so-called high functioning children with autism from special schools were well below that of typically developing children. There are many challenges when using IQ in case-control studies of autism. Alternative approaches need to be considered.

Severity of autism is related to children's language processing

Problems in language processing have been associated with autism spectrum disorder (ASD), with some research attributing the problems to overall language skills rather than a diagnosis of ASD. Lexical access was assessed in a looking-while-listening task in three groups of 5- to 7-year-old children; two had high-functioning ASD (HFA), an ASD severe (ASD-S) group (n = 16) and an ASD moderate (ASD-M) group (n = 21). The third group were typically developing (TD) (n = 48). Participants heard sentences of the form "Where's the x?" and their eye movements to targets (e.g., train), phonological competitors (e.g., tree), and distractors were recorded. Proportions of looking time at target were analyzed within 200 ms intervals. Significant group differences were found between the ASD-S and TD groups only, at time intervals 1000-1200 and 1200-1400 ms postonset. The TD group was more likely to be fixated on target. These differences were maintained after adjusting for language, verbal and nonverbal IQ, and attention scores. An analysis using parent report of autistic-like behaviors showed higher scores to be associated with lower proportions of looking time at target, regardless of group. Further analysis showed fixation for the TD group to be significantly faster than for the ASD-S. In addition, incremental processing was found for all groups. The study findings suggest that severity of autistic behaviors will impact significantly on children's language processing in real life situations when exposed to syntactically complex material. They also show the value of using online methods for understanding how young children with ASD process language.

Cross-sectional evidence for a decrease in cognitive function with age in children with autism spectrum disorders?

Autism spectrum disorders (ASD) are associated with early disturbances in brain maturation processes and these interferences presumably have their consequences for the progressive emergence of cognitive deficits later in life, as expressed in intelligence profiles. In this study, we addressed the impact of age on cognitive functioning of 6- to 15-year-old children and adolescents with ASD. Intelligence profiles were measured by the Wechsler Intelligence Scale for Children and compared among four consecutive age cohorts (children aged 6.17-8.03 years, 8.04-9.61 years, and 9.68-11.50 years and adolescents aged 11.54-15.85 years) of 237 high-functioning boys with ASD. The results clearly demonstrated that the global intelligence level was lower in children aged 8 years and older, when compared with 6- and 7-year-old children with ASD. This is mostly due to the Freedom From Distractibility factor, suggesting that older children were less able to sustain their attention, they were more distractible, or had more graph motor difficulties. Moreover, an effect of age was also found with respect to the relatively poor performance on the subtest Comprehension when compared with other verbal comprehension subtests, indicating that specifically the impairments in verbal comprehension and social reasoning abilities were more profound in older children when compared with 6- and 7-year-old children with ASD. Findings of this cross-sectional study showed that it is relevant to take age into account when evaluating the impact of cognitive impairments on intelligence in children with ASD, because the impact of these developmental disorders might be different at different ages.

Cognitive abilities in siblings of children with autism spectrum disorders

The aim of the present study was to assess the cognitive profiles of children with autistic spectrum disorder and of their healthy siblings (Siblings). With the term cognitive profile, we indicate the relationship extant among the values of verbal and performance subtests of the Wechsler Intelligence Scale. The conducted statistical analyses indicated that, although siblings showed a normal intelligent quotient and did not differ in this aspect from typically developing group, their cognitive profile was amazingly similar to that of their relatives affected by autism. A k-means clustering analysis on the values of single subtests further confirmed this result, showing a clear separation between typically developing children on the one side, and autistics and their siblings on the other. We suggest that the common cognitive profile observed in autistic children and their siblings could represent a marker of liability to autism and, thus, a possible intermediate phenotype of this syndrome.

Interventions based on the Theory of Mind cognitive model for autism spectrum disorder (ASD)

BACKGROUND

The 'Theory of Mind' (ToM) model suggests that people with autism spectrum disorder (ASD) have a profound difficulty understanding the minds of other people - their emotions, feelings, beliefs, and thoughts. As an explanation for some of the characteristic social and communication behaviours of people with ASD, this model has had a significant influence on research and practice. It implies that successful interventions to teach ToM could, in turn, have far-reaching effects on behaviours and outcome.

OBJECTIVES

To review the efficacy of interventions based on the ToM model for individuals with ASD.

SEARCH METHODS

In August 2013 we searched CENTRAL, Ovid MEDLINE, Embase, CINAHL, PsycINFO, ERIC, Social Services Abstracts, AutismData, and two trials registers. We also searched the reference lists of relevant papers, contacted authors who work in this field, and handsearched a number of journals.

SELECTION CRITERIA

Review studies were selected on the basis that they reported on an applicable intervention (linked to ToM in one of four clearly-defined ways), presented new randomised controlled trial data, and participants had a confirmed diagnosis of an autism spectrum disorder. Studies were selected by two review authors independently and a third author arbitrated when necessary.

DATA COLLECTION AND ANALYSIS

Risk of bias was evaluated and data were extracted by two review authors independently; a third author arbitrated when necessary. Most studies were not eligible for meta-analysis, the principal reason being mis-matching methodologies and outcome measures. Three small meta-analyses were carried out.

MAIN RESULTS

Twenty-two randomised trials were included in the review (N = 695). Studies were highly variable in their country of origin, sample size, participant age, intervention delivery type, and outcome measures. Risk of bias was variable across categories. There were very few studies for which there was adequate blinding of participants and personnel, and some were also judged at high risk of bias in blinding of outcome assessors. There was also evidence of some bias in sequence generation and allocation concealment. Not all studies reported data that fell within the pre-defined primary outcome categories for the review, instead many studies reported measures which were intervention-specific (e.g. emotion recognition). The wide range of measures used within each outcome category and the mixed results from these measures introduced further complexity when interpreting results.Studies were grouped into four main categories according to intervention target/primary outcome measure. These were: emotion recognition studies, joint attention and social communication studies, imitation studies, and studies teaching ToM itself. Within the first two of these categories, a sub-set of studies were deemed suitable for meta-analysis for a limited number of key outcomes.There was very low quality evidence of a positive effect on measures of communication based on individual results from three studies. There was low quality evidence from 11 studies reporting mixed results of interventions on measures of social interaction, very low quality evidence from four studies reporting mixed results on measures of general communication, and very low quality evidence from four studies reporting mixed results on measures of ToM ability.  The meta-analysis results we were able to generate showed that interventions targeting emotion recognition across age groups and working with people within the average range of intellectual ability had a positive effect on the target skill, measured by a test using photographs of faces (mean increase of 0.75 points, 95% confidence interval (CI) 0.22 to 1.29 points, Z = 2.75, P < 0.006, four studies, N = 105). Therapist-led joint attention interventions can promote production of more joint attention behaviours within adult-child interaction (mean increase of 0.55 points, 95% CI 0.11 to 0.99 points, Z = 2.45, P value = 0.01, two studies, N = 88). Further analysis undermines this conclusion somewhat by demonstrating that there was no clear evidence that intervention can have an effect on joint attention initiations as measured using a standardised assessment tool (mean increase of 0.23 points, 95% CI -0.48 to 0.94 points, Z = 0.63, P value = 0.53, three studies, N = 92). No adverse effects were apparent.

AUTHORS' CONCLUSIONS

While there is some evidence that ToM, or a precursor skill, can be taught to people with ASD, there is little evidence of maintenance of that skill, generalisation to other settings, or developmental effects on related skills. Furthermore, inconsistency in findings and measurement means that evidence has been graded of 'very low' or 'low' quality and we cannot be confident that suggestions of positive effects will be sustained as high-quality evidence accumulates. Further longitudinal designs and larger samples are needed to help elucidate both the efficacy of ToM-linked interventions and the explanatory value of the ToM model itself. It is possible that the continuing refinement of the ToM model will lead to better interventions which have a greater impact on development than those investigated to date.

Using fiction to assess mental state understanding: a new task for assessing theory of mind in adults

Social functioning depends on the ability to attribute and reason about the mental states of others – an ability known as theory of mind (ToM). Research in this field is limited by the use of tasks in which ceiling effects are ubiquitous, rendering them insensitive to individual differences in ToM ability and instances of subtle ToM impairment. Here, we present data from a new ToM task – the Short Story Task (SST) - intended to improve upon many aspects of existing ToM measures. More specifically, the SST was designed to: (a) assess the full range of individual differences in ToM ability without suffering from ceiling effects; (b) incorporate a range of mental states of differing complexity, including epistemic states, affective states, and intentions to be inferred from a first- and second-order level; (c) use ToM stimuli representative of real-world social interactions; (d) require participants to utilize social context when making mental state inferences; (e) exhibit adequate psychometric properties; and (f) be quick and easy to administer and score. In the task, participants read a short story and were asked questions that assessed explicit mental state reasoning, spontaneous mental state inference, and comprehension of the non-mental aspects of the story. Responses were scored according to a rubric that assigned greater points for accurate mental state attributions that included multiple characters’ mental states. Results demonstrate that the SST is sensitive to variation in ToM ability, can be accurately scored by multiple raters, and exhibits concurrent validity with other social cognitive tasks. The results support the effectiveness of this new measure of ToM in the study of social cognition. The findings are also consistent with studies demonstrating significant relationships among narrative transportation, ToM, and the reading of fiction. Together, the data indicate that reading fiction may be an avenue for improving ToM ability.

Autism, processing speed, and adaptive functioning in preschool children

Objectives. To study cognitive test profiles with a focus on processing speed in a representative group of preschool children with autism spectrum disorder (ASD) and relate processing speed to adaptive functioning. Methods. Cognitive assessments were performed in 190 3.6–6.6-year-old children (164 boys and 26 girls) with ASD, using either Griffiths' developmental scales (n = 77) or the Wechsler Preschool and Primary Scale of Intelligence-Third Edition (WPPSI-III) (n = 113). Cognitive data were related to adaptive functioning as measured by Vineland Adaptive Behavior Scales (VABS). Results. Cognitive profiles were characterized by low verbal skills. Low processing speed quotients (PSQs) were found in 66 (78%) of the 85 children who were able to participate in the processing speed subtests. Except for Socialization, all VABS domains (Communication, Motor Skills, Daily Living Skills, and Adaptive Behavior Composite scores) correlated significantly with PSQ. Multiple regression analysis showed that PSQ predicted 38%, 35%, 34%, and 37% of the variance for Communication, Daily Living Skills, Motor Skills, and total Adaptive Composite scores, respectively. Conclusion. Preschool children with ASD had uneven cognitive profiles with low verbal skills, and, relatively, even lower PSQs. Except for Socialization, adaptive functioning was predicted to a considerable degree by PSQ.

Abstract spatial reasoning as an autistic strength

Autistic individuals typically excel on spatial tests that measure abstract reasoning, such as the Block Design subtest on intelligence test batteries and the Raven’s Progressive Matrices nonverbal test of intelligence. Such well-replicated findings suggest that abstract spatial processing is a relative and perhaps absolute strength of autistic individuals. However, previous studies have not systematically varied reasoning level – concrete vs. abstract – and test domain – spatial vs. numerical vs. verbal, which the current study did. Autistic participants (N = 72) and non-autistic participants (N = 72) completed a battery of 12 tests that varied by reasoning level (concrete vs. abstract) and domain (spatial vs. numerical vs. verbal). Autistic participants outperformed non-autistic participants on abstract spatial tests. Non-autistic participants did not outperform autistic participants on any of the three domains (spatial, numerical, and verbal) or at either of the two reasoning levels (concrete and abstract), suggesting similarity in abilities between autistic and non-autistic individuals, with abstract spatial reasoning as an autistic strength.