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Pham LNH, Lee AK, Estes A, Dager S, Hemingway SJA, Thorne JC, Lau BK. Comparing narrative storytelling ability in individuals with autism and fetal alcohol spectrum disorders. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2024; 59:779-797. [PMID: 37850612 DOI: 10.1111/1460-6984.12964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Narrative discourse, or storytelling, is used in daily conversation and requires higher-level language and social communication skills that are not always captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) have difficulties with both social communication and language skills, and narrative discourse analysis offers an ecologically relevant approach to assessing those challenges. AIMS This study investigated narrative discourse in individuals with autism and FASD, as well as an age- and sex-matched comparison group. METHODS AND PROCEDURES Narratives from 45 adolescents and adults, 11 with autism, 11 with FASD and 23 age- and sex-matched comparison participants were elicited using a wordless storybook. They were then transcribed orthographically, formatted to the Systematic Analyses of Language Transcript (SALT) convention and scored based on the SALT Narrative Scoring Scheme (NSS), a standardised language analysis protocol. In addition to the NSS total score, which assesses the overall structure and cohesion of the narratives produced, local and global measures of language ability were also employed. The local language measures included the number of mental state and temporal relation terms produced, while the global language measures included mean length of utterance, total different words, total words, total utterances, rate of speech, the number of mazes (e.g., repetitions, 'um', 'uh' or self-corrections) per total word and the NSS total score. OUTCOMES AND RESULTS Using the SALT Language Sample Analysis tool, our results revealed that on global language measures, group differences were found on rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. The autism group produced significantly more mazes per total word and scored higher on the NSS conflict/resolution category score compared to the FASD and comparison groups. Both the autism and FASD groups spoke at a lower rate than the comparison group. On local language measures of narrative production, all groups were comparable, on average. CONCLUSIONS AND IMPLICATIONS While many aspects of narrative discourse in the autism and FASD groups were similar to each other and to the comparison group, we observed group differences on global measures of narrative production and significant individual variability within groups, suggesting that narrative abilities considered at an individual level may provide important clinical information for intervention planning. Future research should also consider additional variables that influence narrative discourse, such as motivation, distractibility or decision-making of individual participants. WHAT THIS PAPER ADDS What is already known on the subject Narrative discourse, or storytelling, is used in daily conversational interactions and reveals higher-level language skills that may not be well captured by standardised assessments of language. Many autistic individuals and individuals with fetal alcohol spectrum disorders (FASD) show difficulty with pragmatic and expressive language skills. What this paper adds to existing knowledge We found that many aspects of the narratives produced by the adolescents/young adults in the autism and FASD groups were comparable to each other and to the neurotypical group. However, the groups differed on three global measures of narrative production: rate of speech, number of mazes per total words and the description of conflict/resolution in the narratives produced. Also, significant variability was observed within groups, suggesting that narrative abilities should be considered at an individual level as opposed to their clinical groups. What are the potential or actual clinical implications of this work? This study showed that narrative discourse is an appropriate task that can be added to routine clinical assessments of language abilities in autistic adolescents/young adults as well as those with FASD or typical development and has the potential to reveal higher-level, real-world language skills. An important clinical implication of this study is that narrative language abilities should be considered at an individual level and individual-tailored interventions based on ability level due to the variability observed across individuals.
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Affiliation(s)
- Linh N H Pham
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Adrian Kc Lee
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
- Institute for Learning and Brain Sciences, University of Washington, Seattle, Washington, USA
| | - Annette Estes
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
- UW Autism Center, University of Washington, Seattle, Washington, USA
| | - Stephen Dager
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Susan J Astley Hemingway
- Department of Epidemiology and Pediatrics, University of Washington, Seattle, Washington, USA
- Fetal Alcohol Syndrome Diagnostic and Prevention Network, University of Washington, Seattle, Washington, USA
| | - John C Thorne
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
- Fetal Alcohol Syndrome Diagnostic and Prevention Network, University of Washington, Seattle, Washington, USA
| | - Bonnie K Lau
- Department of Otolaryngology - Head and Neck Surgery, University of Washington, Seattle, Washington, USA
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Wei X, Zhang S, Zhang J, Yu J. Mathematics performance, response time, and enjoyment of eighth-grade autistic students and their general education peers. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2518-2529. [PMID: 37131296 DOI: 10.1177/13623613231168241] [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: 05/04/2023]
Abstract
For autistic students receiving special education services, little is known about their relative strengths, weaknesses, and enjoyment across different math content areas; their overall math interest and persistence are also not well-studied. Using the 2017 eighth-grade National Assessment of Education Progress data, this study finds, relative to general education peers with the same math proficiency level, autistic students scored higher and exhibited faster speed in solving visuospatial problems (e.g. identifying figures), but scored lower on math word problems with complex language or social context. Autistic students reported a higher level of enjoyment in solving math problems related to finding areas of shapes or figures but a lower level of persistence than their non-autistic, general education peers. Our work points out the need to help autistic students overcome their weaknesses in word problems and develop their mathematical persistence.
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Affiliation(s)
| | - Susu Zhang
- University of Illinois Urbana-Champaign, USA
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3
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Leung FYN, Stojanovik V, Micai M, Jiang C, Liu F. Emotion recognition in autism spectrum disorder across age groups: A cross-sectional investigation of various visual and auditory communicative domains. Autism Res 2023; 16:783-801. [PMID: 36727629 DOI: 10.1002/aur.2896] [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: 10/07/2022] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
Previous research on emotion processing in autism spectrum disorder (ASD) has predominantly focused on human faces and speech prosody, with little attention paid to other domains such as nonhuman faces and music. In addition, emotion processing in different domains was often examined in separate studies, making it challenging to evaluate whether emotion recognition difficulties in ASD generalize across domains and age cohorts. The present study investigated: (i) the recognition of basic emotions (angry, scared, happy, and sad) across four domains (human faces, face-like objects, speech prosody, and song) in 38 autistic and 38 neurotypical (NT) children, adolescents, and adults in a forced-choice labeling task, and (ii) the impact of pitch and visual processing profiles on this ability. Results showed similar recognition accuracy between the ASD and NT groups across age groups for all domains and emotion types, although processing speed was slower in the ASD compared to the NT group. Age-related differences were seen in both groups, which varied by emotion, domain, and performance index. Visual processing style was associated with facial emotion recognition speed and pitch perception ability with auditory emotion recognition in the NT group but not in the ASD group. These findings suggest that autistic individuals may employ different emotion processing strategies compared to NT individuals, and that emotion recognition difficulties as manifested by slower response times may result from a generalized, rather than a domain-specific underlying mechanism that governs emotion recognition processes across domains in ASD.
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Affiliation(s)
- Florence Y N Leung
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK.,Department of Psychology, University of Bath, Bath, UK
| | - Vesna Stojanovik
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Martina Micai
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Cunmei Jiang
- Music College, Shanghai Normal University, Shanghai, China
| | - Fang Liu
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
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Pepi C, De Benedictis A, Rossi-Espagnet MC, Cappelletti S, Da Rold M, Falcicchio G, Vigevano F, Marras CE, Specchio N, De Palma L. Hemispherotomy in Infants with Hemimegalencephaly: Long-Term Seizure and Developmental Outcome in Early Treated Patients. Brain Sci 2022; 13:brainsci13010073. [PMID: 36672056 PMCID: PMC9856354 DOI: 10.3390/brainsci13010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023] Open
Abstract
Hemimegalencephaly (HME) is a rare brain congenital malformation, consisting in altered neuronal migration and proliferation within one hemisphere, which is responsible for early onset drug-resistant epilepsy. Hemispherotomy is an effective treatment option for patients with HME and drug-resistant epilepsy. Surgical outcome may be variable among different surgical series, and the long-term neuropsychological trajectory has been rarely defined using a standardized neurocognitive test. We report the epileptological and neuropsychological long-term outcomes of four consecutive HME patients, operated on before the age of three years. All patients were seizure-free and drug-free, and the minimum follow-up duration was of five years. Despite the excellent post-surgical seizure outcome, the long-term developmental outcome is quite variable between patients, ranging from mild to severe intellectual disabilities. Patients showed improvement mainly in communication skills, while visuo-perceptive and coordination abilities were more impaired. Epileptological outcome seems to be improved in early treated patients; however, neuropsychological outcome in HME patients may be highly variable despite early surgery.
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Affiliation(s)
- Chiara Pepi
- Rare and Complex Epilepsies Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165 Rome, Italy
| | | | | | - Simona Cappelletti
- Unit of Clinical Psychology, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Martina Da Rold
- Scientific Institute, IRCCS “E. Medea”, Association “La Nostra Famiglia”, 31015 Conegliano, Italy
| | - Giovanni Falcicchio
- Department of Basic Medical Sciences, Neurosciences and Sense Organs—University of Bari Aldo Moro, 70121 Bari, Italy
| | - Federico Vigevano
- Rare and Complex Epilepsies Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165 Rome, Italy
| | - Carlo Efisio Marras
- Neurosurgery Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Nicola Specchio
- Rare and Complex Epilepsies Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165 Rome, Italy
- Correspondence: ; Tel.: +39-06-68592645; Fax: +39-06-68592463
| | - Luca De Palma
- Rare and Complex Epilepsies Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Full Member of European Reference Network EpiCARE, 00165 Rome, Italy
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Cruz S, Cruz R, Alcón A, Sampaio A, Merchan-Naranjo J, Rodríguez E, Parellada M, Carracedo Á, Fernández-Prieto M. How Executive Functions Correlate with Intelligence in Children and Adolescents in Autism Spectrum Disorders. JOURNAL OF COGNITION AND DEVELOPMENT 2022. [DOI: 10.1080/15248372.2022.2104283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Sara Cruz
- The Psychology for Positive Development Research Cente], Lusíada University Porto, Porto, Portugal
| | - Raquel Cruz
- Centro Nacional de Genotipado (CEGEN), Universidade de Santiago de Compostela, 15706 Santiago de Compostela, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Santiago (IDIS), 15706 Santiago de Compostela, Spain
- Centro Singular de Investigacion en Medicina Molecular y Enfermedades Crónicas (CIMUS), Universidade de Santiago de Compostela, 15782 Santiago de Compostela, Spain
| | - Alicia Alcón
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Jessica Merchan-Naranjo
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
- Network Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Elisa Rodríguez
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
- Experimental Psychology Department, School of Psychology, Universidad Complutense, Madrid, Spain
| | - Mara Parellada
- Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Ángel Carracedo
- Fundación Pública Galega de Medicina Xenómica - IDIS, SERGAS, Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, CIMUS, CIBERER, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Montse Fernández-Prieto
- Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
- Grupo de Gené tica, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
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Dakwar-Kawar O, Berger I, Barzilay S, Grossman ES, Cohen Kadosh R, Nahum M. Examining the Effect of Transcranial Electrical Stimulation and Cognitive Training on Processing Speed in Pediatric Attention Deficit Hyperactivity Disorder: A Pilot Study. Front Hum Neurosci 2022; 16:791478. [PMID: 35966992 PMCID: PMC9363890 DOI: 10.3389/fnhum.2022.791478] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveProcessing Speed (PS), the ability to perceive and react fast to stimuli in the environment, has been shown to be impaired in children with attention deficit hyperactivity disorder (ADHD). However, it is unclear whether PS can be improved following targeted treatments for ADHD. Here we examined potential changes in PS following application of transcranial electric stimulation (tES) combined with cognitive training (CT) in children with ADHD. Specifically, we examined changes in PS in the presence of different conditions of mental fatigue.MethodsWe used a randomized double-blind active-controlled crossover study of 19 unmedicated children with ADHD. Participants received either anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (dlPFC) or transcranial random noise stimulation (tRNS), while completing CT, and the administration order was counterbalanced. PS was assessed before and after treatment using the MOXO-CPT, which measures PS in the presence of various conditions of mental fatigue and cognitive load.ResultstRNS combined with CT yielded larger improvements in PS compared to tDCS combined with CT, mainly under condition of increased mental fatigue. Further improvements in PS were also seen in a 1-week follow up testing.ConclusionThis study provides initial support for the efficacy of tRNS combined with CT in improving PS in the presence of mental fatigue in pediatric ADHD.
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Affiliation(s)
- Ornella Dakwar-Kawar
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Itai Berger
- Pediatric Neurology, Assuta-Ashdod University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be’er Sheva, Israel
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University, Jerusalem, Israel
| | - Snir Barzilay
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ephraim S. Grossman
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- *Correspondence: Mor Nahum,
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Leung FYN, Sin J, Dawson C, Ong JH, Zhao C, Veić A, Liu F. Emotion recognition across visual and auditory modalities in autism spectrum disorder: A systematic review and meta-analysis. DEVELOPMENTAL REVIEW 2022. [DOI: 10.1016/j.dr.2021.101000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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8
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Takayanagi M, Kawasaki Y, Shinomiya M, Hiroshi H, Okada S, Ino T, Sakai K, Murakami K, Ishida R, Mizuno K, Niwa SI. Review of Cognitive Characteristics of Autism Spectrum Disorder Using Performance on Six Subtests on Four Versions of the Wechsler Intelligence Scale for Children. J Autism Dev Disord 2022; 52:240-253. [PMID: 33677730 PMCID: PMC8732936 DOI: 10.1007/s10803-021-04932-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Mizuho Takayanagi
- Department of Child and Adolescent Psychiatry, Arisawabashi Hospital, 5 Fuchu-machi Haneshin, Toyama, Toyama, 9392704, Japan.
| | | | | | | | | | - Tamiko Ino
- Musashino Child Development Clinic, Tokyo, Japan
| | - Kazuko Sakai
- Musashino Child Development Clinic, Tokyo, Japan
| | | | - Rie Ishida
- Musashino Child Development Clinic, Tokyo, Japan
| | - Kaoru Mizuno
- Musashino Child Development Clinic, Tokyo, Japan
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Bathelt J, Koolschijn PCM, Geurts HM. Atypically slow processing of faces and non-faces in older autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1737-1751. [PMID: 34961340 PMCID: PMC9483195 DOI: 10.1177/13623613211065297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Face recognition is a fundamental function that requires holistic processing. Differences in face processing have been consistently identified in autistic children, but it is unknown whether these differences persist across the adult lifespan. Using event-related functional magnetic resonance imaging, we measured holistic face processing with a rapid Mooney faces task in 50 autistic and 49 non-autistic participants (30–74 years). Behavioral tasks included a self-paced version of the same paradigm and a global–local processing task (Navon). Reduced detection rates for faces, but not non-faces, were found in autistic adults, including slower responses on all conditions. Without time constraints, differences in accuracy disappeared between groups, although reaction times in correctly identifying faces remained higher in autistic adults. The functional magnetic resonance imaging results showed lower activation in the left and right superior frontal gyrus in the autism group but no age-related differences. Overall, our findings point toward slower information processing speed rather than a face recognition deficit in autistic adults. This suggests that face-processing differences are not a core feature of autism across the adult lifespan.
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Affiliation(s)
- Joe Bathelt
- University of Amsterdam, The Netherlands.,Royal Holloway, University of London, UK
| | | | - Hilde M Geurts
- University of Amsterdam, The Netherlands.,Leo Kannerhuis, Youz/Parnassiagroup, The Netherlands
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Oprandi MC, Oldrati V, delle Fave M, Panzeri D, Gandola L, Massimino M, Bardoni A, Poggi G. Processing Speed and Time since Diagnosis Predict Adaptive Functioning Measured with WeeFIM in Pediatric Brain Tumor Survivors. Cancers (Basel) 2021; 13:cancers13194776. [PMID: 34638261 PMCID: PMC8508451 DOI: 10.3390/cancers13194776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/31/2022] Open
Abstract
Simple Summary Brain tumor (BT) survivors show difficulties in adaptive functioning (AF) and in acquiring independence (e.g., graduating, finding employment, building strong relationships, and being independent). The aim of our observational retrospective study is to explore the contribution of different clinical and cognitive variables in explaining and predicting the AF outcomes of BT survivors, measured with the Functional Independence Measure for Children (WeeFIM). The analysis demonstrated that processing speed and time since diagnosis are the main explanatory variables. Other clinical factors, such as age at diagnosis and hydrocephalus, differentially influence functional skills according to distinct domains (i.e., self-care, mobility, and cognition). The identification of the clinical factors influencing AF could suggest targets on which to focus attention. By successfully assessing, understanding, and managing AF, it will be possible to improve its management in pediatric BT survivors. Abstract (1) Background: Brain tumor (BT) survivors show difficulties in the acquisition of developmental milestones, related to academic achievement, vocational employment, social relationships, and autonomy. The skills underlying adaptive functioning (AF) are usually damaged in BT survivors due to the presence of the brain tumor, treatment-related factors, and other neurological sequelae. In this study, we aimed to explore the contribution of different cognitive factors in children with BT to AF, considering diagnosis-related variables. (2) Methods: Standardized cognitive assessment was undertaken and clinical information was collected from a retrospective cohort of 78 children with a BT, aged between 6 and 18 year old at the time of the assessment. Regression models were computed to investigate the influence of the selected variables on daily functional skills as measured by the Functional Independence Measure for Children (WeeFIM). (3) Results: The analyses showed that the main explanatory variables are processing speed and time since diagnosis. Other clinical variables, such as age at diagnosis and hydrocephalus, differentially influence functional skills according to distinct domains (i.e., self-care, mobility, and cognition). (4) Conclusions: The main explanatory variables of AF that emerged in our models point to a potential target of improving AF management in pediatric BT survivors.
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Affiliation(s)
- Maria Chiara Oprandi
- Neuro-Oncological and Neuropsychological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (V.O.); (M.d.F.); (D.P.); (A.B.); (G.P.)
- Correspondence:
| | - Viola Oldrati
- Neuro-Oncological and Neuropsychological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (V.O.); (M.d.F.); (D.P.); (A.B.); (G.P.)
| | - Morena delle Fave
- Neuro-Oncological and Neuropsychological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (V.O.); (M.d.F.); (D.P.); (A.B.); (G.P.)
| | - Daniele Panzeri
- Neuro-Oncological and Neuropsychological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (V.O.); (M.d.F.); (D.P.); (A.B.); (G.P.)
| | - Lorenza Gandola
- Department of Medical Oncology and Hematology, Pediatrics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (L.G.); (M.M.)
| | - Maura Massimino
- Department of Medical Oncology and Hematology, Pediatrics Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (L.G.); (M.M.)
| | - Alessandra Bardoni
- Neuro-Oncological and Neuropsychological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (V.O.); (M.d.F.); (D.P.); (A.B.); (G.P.)
| | - Geraldina Poggi
- Neuro-Oncological and Neuropsychological Rehabilitation Unit, Scientific Institute, IRCCS E. Medea, Bosisio Parini, 23842 Lecco, Italy; (V.O.); (M.d.F.); (D.P.); (A.B.); (G.P.)
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Hosozawa M, Mandy W, Cable N, Flouri E. The Role of Decision-Making in Psychological Wellbeing and Risky Behaviours in Autistic Adolescents Without ADHD: Longitudinal Evidence from the UK Millennium Cohort Study. J Autism Dev Disord 2021; 51:3212-3223. [PMID: 33196916 PMCID: PMC8349343 DOI: 10.1007/s10803-020-04783-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 01/22/2023]
Abstract
This study examined the development of decision-making and its association with psychological wellbeing and risky behaviours in adolescents with and without autism. Participants included 270 autistic and 9,713 typically developing adolescents. In both samples, those with a diagnosis of attention-deficit/hyperactivity disorder (ADHD) were excluded. Data came from the Millennium Cohort Study, a nationally representative population-based birth cohort. Decision-making was assessed using the Cambridge Gambling Task at ages 11 and 14. Psychological wellbeing (happiness, self-esteem, depressive symptoms and self-harm) and risky/antisocial behaviours were self-reported at age 14. After adjusting for sex, cognitive ability, spatial working memory, socioeconomic status and pubertal status, autistic adolescents showed comparable quality of decision-making to that of their peers at both ages but also a more deliberative decision-making style as they aged. Only in autistic adolescents was this decision-making style associated with positive outcomes.
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Affiliation(s)
- Mariko Hosozawa
- Department of Epidemiology and Public Health, University College London, London, UK
- Department of Paediatrics and Adolescent Medicine, Juntendo University, Tokyo, Japan
| | - William Mandy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Noriko Cable
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, London, UK
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Children with Autism Spectrum Disorder of All Ages, Levels of Symptom Severity and General Cognitive Ability Display Low Processing Speed Index Scores Warranting Special Educational Assistance. J Autism Dev Disord 2021; 52:3668-3675. [PMID: 34453226 PMCID: PMC9296421 DOI: 10.1007/s10803-021-05249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
The processing speed index (PSI) of the Wechsler intelligence scale for children (WISC-IV) has been found to predict a child's level of academic functioning. The consistently reported PSI weakness in children with autism spectrum disorder (ASD) therefore warrants special assistance and attempts at compensation for the disadvantages associated with these children's low PSI. We investigated the association of PSI scores with age, general cognitive ability [as measured by full-scale IQ (FSIQ)], symptom severity and discrepancy between the WISC-IV indices verbal comprehension (VCI) and perceptual reasoning (PRI) in 101 school children with ASD. The PSI weakness in children with ASD was not related to age, FSIQ, VCI-PRI discrepancy or any of the symptom measures. These findings suggest that school children with ASD independent of their age, level of cognitive ability, VCI-PRI profile and most notably independent of their symptom severity should be entitled to special assistance and compensation in educational settings.
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Focusing on Autism Spectrum Disorder in Xia-Gibbs Syndrome: Description of a Female with High Functioning Autism and Literature Review. CHILDREN-BASEL 2021; 8:children8060450. [PMID: 34073322 PMCID: PMC8227570 DOI: 10.3390/children8060450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 12/28/2022]
Abstract
Background: Xia–Gibbs syndrome (XGS) is a rare disorder caused by de novo mutations in the AT-Hook DNA binding motif Containing 1 (AHDC1) gene, which is characterised by a wide spectrum of clinical manifestations, including global developmental delay, intellectual disability, structural abnormalities of the brain, global hypotonia, feeding problems, sleep difficulties and apnoea, facial dysmorphisms, and short stature. Methods: Here, we report on a girl patient who shows a peculiar cognitive and behavioural profile including high-functioning autism spectrum disorder (ASD) without intellectual disability and provide information on her developmental trajectory with the aim of expanding knowledge of the XGS clinical spectrum. On the basis of the current clinical case and the literature review, we also attempt to deepen understanding of behavioural and psychiatric manifestations associated with XGS. Results: In addition to the patient we described, a considerable rate of individuals with XGS display autistic symptoms or have been diagnosed with an autistic spectrum disorder. Moreover, the analysis of the few psychopathological profiles of patients with XGS described in the literature shows a frequent presence of aggressive and self-injurious behaviours that could be either an expression of autistic functioning or an additional symptom of the ASD evolution. A careful investigation of the abovementioned symptoms is therefore required, since they could represent a “red flag” for ASD.
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14
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Lebreton K, Malvy J, Bon L, Hamel-Desbruères A, Marcaggi G, Clochon P, Guénolé F, Moussaoui E, Bowler DM, Bonnet-Brilhault F, Eustache F, Baleyte JM, Guillery-Girard B. Local Processing Bias Impacts Implicit and Explicit Memory in Autism. Front Psychol 2021; 12:622462. [PMID: 33967890 PMCID: PMC8104079 DOI: 10.3389/fpsyg.2021.622462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/15/2021] [Indexed: 11/23/2022] Open
Abstract
Autism spectrum disorder (ASD) is characterized by atypical perception, including processing that is biased toward local details rather than global configurations. This bias may impact on memory. The present study examined the effect of this perception on both implicit (Experiment 1) and explicit (Experiment 2) memory in conditions that promote either local or global processing. The first experiment consisted of an object identification priming task using two distinct encoding conditions: one favoring local processing (Local condition) and the other favoring global processing (Global condition) of drawings. The second experiment focused on episodic (explicit) memory with two different cartoon recognition tasks that favored either local (i.e., processing specific details) or a global processing (i.e., processing each cartoon as a whole). In addition, all the participants underwent a general clinical cognitive assessment aimed at documenting their cognitive profile and enabling correlational analyses with experimental memory tasks. Seventeen participants with ASD and 17 typically developing (TD) controls aged from 10 to 16 years participated to the first experiment and 13 ASD matched with 13 TD participants were included for the second experiment. Experiment 1 confirmed the preservation of priming effects in ASD but, unlike the Comparison group, the ASD group did not increase his performance as controls after a globally oriented processing. Experiment 2 revealed that local processing led to difficulties in discriminating lures from targets in a recognition task when both lures and targets shared common details. The correlation analysis revealed that these difficulties were associated with processing speed and inhibition. These preliminary results suggest that natural perceptual processes oriented toward local information in ASD may impact upon their implicit memory by preventing globally oriented processing in time-limited conditions and induce confusion between explicit memories that share common details.
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Affiliation(s)
- Karine Lebreton
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Joëlle Malvy
- UMR 1253, iBrain, INSERM, Université de Tours, Tours, France
| | - Laetitia Bon
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Caen, Caen, France
| | - Alice Hamel-Desbruères
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Caen, Caen, France
| | - Geoffrey Marcaggi
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Caen, Caen, France
| | - Patrice Clochon
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Fabian Guénolé
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Caen, Caen, France
| | - Edgar Moussaoui
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Caen, Caen, France
| | - Dermot M Bowler
- Autism Research Group, City, University of London, London, United Kingdom
| | | | - Francis Eustache
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
| | - Jean-Marc Baleyte
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France.,Service de Psychiatrie de l'Enfant et de l'Adolescent, Hôpital Intercommunal de Créteil, Créteil, France
| | - Bérengère Guillery-Girard
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, Caen, France
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15
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Audras-Torrent L, Miniarikova E, Couty F, Dellapiazza F, Berard M, Michelon C, Picot MC, Baghdadli A. WISC-V Profiles and Their Correlates in Children with Autism Spectrum Disorder without Intellectual Developmental Disorder: Report from the ELENA Cohort. Autism Res 2020; 14:997-1006. [PMID: 33247546 DOI: 10.1002/aur.2444] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/16/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022]
Abstract
The intellectual functioning of people with autism spectrum disorder (ASD) without intellectual developmental disorder (IDD) has not been widely studied. However, marked heterogeneity in assessment measures, samples, and results has been an obstacle for the generalization of findings. We aimed to (a) describe WISC-V intellectual functioning in a sample of children with autism spectrum disorder without intellectual developmental disorder, (b) identify WISC-V profiles, and (c) explore whether WISC-V intellectual functioning is related to ASD symptom severity and adaptive skills. Our sample consisted of 121 children from 6 to 16 years of age with ascertained ASD without an intellectual developmental disorder (IDD). The intellectual functioning of the participants was within the average range. Intra-individual analysis showed that children with ASD performed better on visual than auditory working-memory tasks. Moreover, the intellectual functioning of the participants correlated negatively with ASD symptom severity but positively with adaptive communication skills. Overall, we identified six intellectual profiles according to verbal and reasoning skills. These findings highlight the relevance of WISC-V assessment for children with ASD without an IDD to individualize intervention, especially remediation. LAY SUMMARY: This study examined WISC-V intellectual functioning in 121 children with autism spectrum disorder (ASD) without an intellectual developmental disorder (IDD). We found their intellectual functioning to be within the average, as was that of their peers with typical development (TD), and their verbal and reasoning skills were the most discriminant. In addition, the better their intellectual functioning was, the better their adaptive communication skills and the less severe their ASD symptoms. These findings highlight the relevance of WISC-V assessment in ASD to individualize early psychological remediation. Autism Res 2021, 14: 997-1006. © 2020 International Society for Autism Research, Wiley Periodicals, LLC.
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Affiliation(s)
- Lee Audras-Torrent
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France
| | - Ela Miniarikova
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France
| | - Flore Couty
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France
| | - Florine Dellapiazza
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France
| | - Mathilde Berard
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France
| | - Cécile Michelon
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France
| | - Marie-Christine Picot
- Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Department of Medical Information, University Hospital, Montpellier, France
| | - Amaria Baghdadli
- Centre de Ressource Autisme Languedoc-Roussillon, Centre d'Excellence sur l'Autisme et les Troubles Neurodéveloppementaux (CeAND), Montpellier, France.,Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, Villejuif, France.,Faculté de Médecine, Université de Montpellier, Montpellier, France
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16
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Billstedt E, Nilsson G, Leffler L, Carlsson L, Olsson I, Fernell E, Gillberg C. Cognitive functioning in a representative cohort of preschool children with febrile seizures. Acta Paediatr 2020; 109:989-994. [PMID: 31618476 DOI: 10.1111/apa.15059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/25/2019] [Accepted: 10/15/2019] [Indexed: 02/06/2023]
Abstract
AIM To analyse cognitive functioning in 4-5-year-old children who had experienced febrile seizures (FS) and to assess the importance of complex, recurrent and early vs late onset FS. METHODS The sample consisted of 73 children, screen positive for FS, drawn from the general child population of 4-year-old children attending their health check-up at child healthcare centres in Gothenburg, Sweden. They were assessed as regards general cognitive ability, visual memory and attention and were contrasted with age norms and with results obtained in 20 children without FS from the same healthcare centres. RESULTS Of the 73 children, two had a previously diagnosed intellectual disability (ID) (one mild, one moderate) and two further children tested within the study had results corresponding to mild ID. Children with early onset of FS (before age 12 months)-who often had recurrent FS-had lower full-scale, verbal and processing speed IQ than those who had later onset of FS. CONCLUSION Children with early onset of FS and particularly those with recurrent FS may be at increased risk for poorer verbal and processing speed functioning and therefore at risk of developing cognitive, executive dysfunctions. They would probably benefit from neuropaediatric and neuropsychological follow-up.
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Affiliation(s)
- Eva Billstedt
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Child Neuropsychiatry Clinic Sahlgrenska University Hospital Gothenburg Sweden
| | - Gill Nilsson
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Child Neuropsychiatry Clinic Sahlgrenska University Hospital Gothenburg Sweden
| | - Lotta Leffler
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Children and Young Persons Medical Centre Mölnlycke Sweden
| | - Lisa Carlsson
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Maternity and Paediatric Healthcare Fyrbodal Sotenäs Sweden
| | - Ingrid Olsson
- Department of Pediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Child Neuropsychiatry Clinic Sahlgrenska University Hospital Gothenburg Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Child Neuropsychiatry Clinic Sahlgrenska University Hospital Gothenburg Sweden
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17
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Peled J, Cassuto H, Berger I. Processing speed as a marker to stimulant effect in clinical sample of children with high functioning autism spectrum disorder. Nord J Psychiatry 2020; 74:163-167. [PMID: 31686565 DOI: 10.1080/08039488.2019.1686063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Patients with co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) and ASD might benefit from stimulants. There is a progressive increase in prescribing ADHD aimed medications for children diagnosed with Autism Spectrum Disorder (ASD), despite scarce knowledge and no distinct clinical guidelines for that matter.Aim: This study aims to analyze the effect of stimulant on processing speed performance and attention indices in children with ASD and ADHD.Methods: Forty children aged 6-18 years diagnosed with ASD who also met the criteria for ADHD were recruited. All children performed a computerized performance test for the assessment of cognitive attention performance three times: twice while they are drug naïve and once an hour after taking a single dose of 10 mg. methylphenidate (MPH). This performance was compared to a group of children diagnosed with 'ADHD only' without ASD.Results: A significant difference (p < 0.001) was found only in the parameter of measuring cognitive processing speed. This effect is significantly different from the response of the 'ADHD only' group.Conclusions: The reaction to MPH among ASD children is different than among ADHD children. In ASD, MPH significantly improved cognitive processing speed without changing other measured attention parameters. Improving processing speed, might improve every day functioning in children with ASD who also met the criteria for ADHD, in other means than expected. This unique response suggests new research targets for treatment with stimulants in ASD and ADHD children and its influence on cognitive parameters.
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Affiliation(s)
- Julia Peled
- The Hebrew University-Hadassah Medical School, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,Kaplan Medical Center, Rehovot, Israel
| | - Hanoch Cassuto
- Pediatric Neurology Clinics, Leumit HMO, Jerusalem, Israel
| | - Itai Berger
- Pediatric Neurology, Assuta-Ashdod University Medical Center, The Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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18
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Patrick KE, Schultheis MT, Agate FT, McCurdy MD, Daly BP, Tarazi RA, Chute DL, Hurewitz F. Executive function “drives” differences in simulated driving performance between young adults with and without autism spectrum disorder. Child Neuropsychol 2020; 26:649-665. [DOI: 10.1080/09297049.2020.1713311] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Kristina E. Patrick
- Department of Psychology, Drexel University, Philadelphia, USA
- Division of Pediatric Neurology, Department of Neurology, University of Washington, Seattle, USA
| | | | - F. Taylor Agate
- Department of Psychology, Drexel University, Philadelphia, USA
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Mark D. McCurdy
- Department of Psychology, Drexel University, Philadelphia, USA
| | - Brian P. Daly
- Department of Psychology, Drexel University, Philadelphia, USA
| | - Reem A. Tarazi
- Department of Psychiatry/Division of Neuropsychology, Drexel University, Philadelphia, USA
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19
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Yuk V, Urbain C, Anagnostou E, Taylor MJ. Frontoparietal Network Connectivity During an N-Back Task in Adults With Autism Spectrum Disorder. Front Psychiatry 2020; 11:551808. [PMID: 33033481 PMCID: PMC7509600 DOI: 10.3389/fpsyt.2020.551808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 08/13/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Short-term and working memory (STM and WM) deficits have been demonstrated in individuals with autism spectrum disorder (ASD) and may emerge through atypical functional activity and connectivity of the frontoparietal network, which exerts top-down control necessary for successful STM and WM processes. Little is known regarding the spectral properties of the frontoparietal network during STM or WM processes in ASD, although certain neural frequencies have been linked to specific neural mechanisms. METHODS We analysed magnetoencephalographic data from 39 control adults (26 males; 27.15 ± 5.91 years old) and 40 adults with ASD (26 males; 27.17 ± 6.27 years old) during a 1-back condition (STM) of an n-back task, and from a subset of this sample during a 2-back condition (WM). We performed seed-based connectivity analyses using regions of the frontoparietal network. Interregional synchrony in theta, alpha, and beta bands was assessed with the phase difference derivative and compared between groups during periods of maintenance and recognition. RESULTS During maintenance of newly presented vs. repeated stimuli, the two groups did not differ significantly in theta, alpha, or beta phase synchrony for either condition. Adults with ASD showed alpha-band synchrony in a network containing the right dorsolateral prefrontal cortex, bilateral inferior parietal lobules (IPL), and precuneus in both 1- and 2-back tasks, whereas controls demonstrated alpha-band synchrony in a sparser set of regions, including the left insula and IPL, in only the 1-back task. During recognition of repeated vs. newly presented stimuli, adults with ASD exhibited decreased theta-band connectivity compared to controls in a network with hubs in the right inferior frontal gyrus and left IPL in the 1-back condition. Whilst there were no group differences in connectivity in the 2-back condition, adults with ASD showed no frontoparietal network recruitment during recognition, whilst controls activated networks in the theta and beta bands. CONCLUSIONS Our findings suggest that since adults with ASD performed well on the n-back task, their appropriate, but effortful recruitment of alpha-band mechanisms in the frontoparietal network to maintain items in STM and WM may compensate for atypical modulation of this network in the theta band to recognise previously presented items in STM.
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Affiliation(s)
- Veronica Yuk
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences & Mental Health Program, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Charline Urbain
- Neuropsychology and Functional Neuroimaging Research Group, Center for Research in Cognition & Neurosciences and ULB Neuroscience Institute, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Laboratoire de Cartographie Fonctionnelle du Cerveau, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Evdokia Anagnostou
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.,Department of Neurology, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Margot J Taylor
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada.,Neurosciences & Mental Health Program, SickKids Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada.,Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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20
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Haigh SM, Walsh JA, Mazefsky CA, Minshew NJ, Eack SM. Processing Speed is Impaired in Adults with Autism Spectrum Disorder, and Relates to Social Communication Abilities. J Autism Dev Disord 2019; 48:2653-2662. [PMID: 29500756 DOI: 10.1007/s10803-018-3515-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by a variety of social and non-social behavioral deficits. One potential mechanism that could unify this diverse profile of behaviors is slower processing speed. Seventy-six high-functioning adults with ASD were compared to 64 matched controls on standardized measures of processing speed. Participants with ASD were significantly slower on all measures, and on the composite score from the three tests (d's > .65). ASD participants with slower processing speeds scored higher on the ADOS Communication and Reciprocal Social Interaction scale (r = .34). These findings provide evidence of slower processing speeds in adults with ASD, and that this may be contributing to impairments in social communication skills. Interventions that improve processing speed might improve social communication abilities in ASD.
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Affiliation(s)
- Sarah M Haigh
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA, 15222, USA.
| | - Jennifer A Walsh
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
| | - Carla A Mazefsky
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA, 15222, USA
| | - Nancy J Minshew
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA, 15222, USA.,Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shaun M Eack
- Department of Psychiatry, University of Pittsburgh, Suite 420, 3501 Forbes Avenue, Pittsburgh, PA, 15222, USA.,School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA
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21
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Urbano MR, Teal Raffaele C, Kreiser NL, Flaherty JM, Hartmann K. Clinical considerations for the inclusion of individuals with autism spectrum disorder in clinical trials. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:295-302. [PMID: 30290207 DOI: 10.1016/j.pnpbp.2018.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/21/2018] [Accepted: 09/30/2018] [Indexed: 10/28/2022]
Abstract
Diagnoses of autism spectrum disorder (ASD) have increased considerably over the past 20 years. Because of this rise and the inherent complexity of ASD, there is a need for an increased number of scientifically valid basic and clinical research studies addressing this disorder. This manuscript serves as an introduction to the clinical presentation of ASD as well as the unique challenges and modifications required to conduct clinical research with this population. This includes detailing the current diagnostic criteria, process of receiving an ASD diagnosis, information on assessment measures, and special considerations when developing research. It is the hope that this information will provide researchers interested in conducting clinical trials with those with ASD with baseline information and considerations when developing their research topics and methodology.
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Affiliation(s)
- Maria R Urbano
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States.
| | - C Teal Raffaele
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Nicole L Kreiser
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Jennifer M Flaherty
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
| | - Kathrin Hartmann
- Eastern Virginia Medical School, Psychiatry and Behavioral Sciences, 825 Fairfax Avenue, Suite 710, Norfolk, VA 23507-1912, United States
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22
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He Y, Su Q, Wang L, He W, Tan C, Zhang H, Ng ML, Yan N, Chen Y. The Characteristics of Intelligence Profile and Eye Gaze in Facial Emotion Recognition in Mild and Moderate Preschoolers With Autism Spectrum Disorder. Front Psychiatry 2019; 10:402. [PMID: 31281268 PMCID: PMC6596453 DOI: 10.3389/fpsyt.2019.00402] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 05/21/2019] [Indexed: 12/27/2022] Open
Abstract
Childhood autism spectrum disorder (ASD) can easily be misdiagnosed, due to the nonspecific social and communicational deficits associated with the disorder. The present study attempted to profile the mental development and visual attention toward emotion among preschool children with mild or moderate ASD who were attending mainstream kindergartens. A total of 21 children (17 boys and 4 girls) diagnosed with mild or moderate ASD selected from 5,178 kindergarteners from the Xi'an city were recruited. Another group of 21 typically developing (TD) children who were matched with age, gender, and class served as controls. All children were assessed using the Griffiths Mental Development Scales-Chinese (GDS-C), and their social visual attention was assessed during watching 20 ecologically valid film scenes by using eye tracking technique. The results showed that ASD children had lower mental development scores in the Locomotor, Personal-Social, Language, Performance, and Practical Reasoning subscales than the TD peers. Moreover, deficits in recognizing emotions from facial expressions based on naturalistic scene stimuli with voice were found for ASD children. The deficits were significantly correlated with their ability in social interaction and development quotient in ASD group. ASD children showed atypical eye-gaze pattern when compared to TD children during facial emotion expression task. Children with ASD had reduced visual attention to facial emotion expression, especially for the eye region. The findings confirmed the deficits of ASD children in real life multimodal of emotion recognition, and their atypical eye-gaze pattern for emotion recognition. Parents and teachers of children with mild or moderate ASD should make informed educational decisions according to their level of mental development. In addition, eye tracking technique might clinically help provide evidence diagnosing children with mild or moderate ASD.
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Affiliation(s)
- Yuying He
- Department of Pediatrics, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Child Healthcare Department, Xi'an Maternal and Child Health Hospital, Xi'an, China
| | - Qi Su
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lan Wang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Guangdong Provincial Key Laboratory of Robotics and Intelligent System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Wenxiang He
- Department of Pediatrics, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Chuanxue Tan
- Child Healthcare Department, Xi'an Children's Hospital, Xi'an, China
| | - Haiqing Zhang
- Department of Pediatrics, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Manwa L Ng
- Speech Science Laboratory, Division of Speech and Hearing Sciences, University of Hong Kong, Hong Kong, China
| | - Nan Yan
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Guangdong Provincial Key Laboratory of Robotics and Intelligent System, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Yanni Chen
- Department of Pediatrics, Xi'an Jiaotong University Health Science Center, Xi'an, China.,Department of Pediatrics, Shaanxi University of Chinese Medicine, Xianyang, China.,Child Healthcare Department, Xi'an Children's Hospital, Xi'an, China
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23
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Ocak E, Eshraghi RS, Danesh A, Mittal R, Eshraghi AA. Central Auditory Processing Disorders in Individuals with Autism Spectrum Disorders. Balkan Med J 2018; 35:367-372. [PMID: 29952312 PMCID: PMC6158468 DOI: 10.4274/balkanmedj.2018.0853] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The etiology and the underlying pathogenetic mechanisms of autism spectrum disorders are still largely unknown. This article provides a comprehensive review of the studies that are relevant to autism spectrum disorders and central auditory processing disorders and also discusses the relationship between autism spectrum disorders and central auditory processing disorders in the light of recent studies on this subject, which may provide new pathways in a therapeutic perspective. Several studies confirm that most of the individuals with an autism spectrum disorder have some degree of sensory dysfunction related to disorders of processing auditory, visual, vestibular, and/or tactile stimuli. Among these studies, some have addressed central auditory processing disorders. There is an increasing amount of effort for studies regarding the link between autism spectrum disorders and central auditory processing disorders. Most of the studies investigating central auditory processing disorders in patients with autism spectrum disorders have used electrophysiological measurements such as mismatch negativity and P300 event-related potentials. In addition to these, several studies have reported deterioration in speech perception and expression in patients with autism spectrum disorders, which may also be related to central auditory processing disorders in this unique group of individuals.
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Affiliation(s)
- Emre Ocak
- Department of Otolaryngology and Neurological Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Rebecca S. Eshraghi
- Department of Gastroenterology, University of Miami Miller School of Medicine, Miami USA
| | - Ali Danesh
- Department of Audiology, Florida Atlantic University School of Medicine, Miami, USA
| | - Rahul Mittal
- Department of Otolaryngology and Neurological Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Adrien A. Eshraghi
- Department of Otolaryngology and Neurological Surgery, University of Miami Miller School of Medicine, Miami, USA
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24
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Ferman S, Bar-On A. Morpho-Orthographic Processing in Children with Autism Spectrum Disorder: The Case of Hebrew Orthography. Folia Phoniatr Logop 2017; 69:54-66. [PMID: 29248925 DOI: 10.1159/000479062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/24/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Most studies on word reading in children with autism spectrum disorder (ASD) focus on graphemic-phonemic decoding and the direct orthographic route. To extend the scope, we investigated morpho-orthographic identification beyond graphemic-phonemic abilities. PATIENTS AND METHODS The original study included 31 sixth-grade children with ASD and comparison groups of typically developing (TD) children: 23 age-matched children, 15 third-graders, and 17 second-graders. The groups were compared regarding reading of morphologically based Hebrew pointed pseudowords to examine graphemic-phonemic decoding, and unpointed pseudowords to test morpho-orthographic identification. To better focus on morpho-orthographic identification processes, we eventually included only children with a minimum threshold of ≥65% correct in reading pointed pseudowords, thereby excluding 11 children with ASD, 1 TD age-matched child, and 1 TD third-grader. RESULTS About half of the children with ASD eventually included were as accurate as the TD second-graders in reading unpointed pseudowords, and slow in reading both pointed and unpointed pseudowords. The other half were as accurate as their typical peers in reading unpointed pseudowords, but slightly slower. CONCLUSION The results highlight the difficulties many Hebrew-reading children with ASD experience in using morpho-orthographic processes beyond their difficulties in using graphemic-phonemic processes, demonstrating effortful (slow) reading. While this study can be considered a pilot investigation, further studies are needed.
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Affiliation(s)
- Sara Ferman
- Department of Communication Disorders, School of Health Sciences, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Center for Academic Studies, Or Yehuda, Israel
| | - Amalia Bar-On
- Department of Communication Disorders, School of Health Sciences, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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25
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Demopoulos C, Yu N, Tripp J, Mota N, Brandes-Aitken AN, Desai SS, Hill SS, Antovich AD, Harris J, Honma S, Mizuiri D, Nagarajan SS, Marco EJ. Magnetoencephalographic Imaging of Auditory and Somatosensory Cortical Responses in Children with Autism and Sensory Processing Dysfunction. Front Hum Neurosci 2017; 11:259. [PMID: 28603492 PMCID: PMC5445128 DOI: 10.3389/fnhum.2017.00259] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Accepted: 05/01/2017] [Indexed: 11/25/2022] Open
Abstract
This study compared magnetoencephalographic (MEG) imaging-derived indices of auditory and somatosensory cortical processing in children aged 8–12 years with autism spectrum disorder (ASD; N = 18), those with sensory processing dysfunction (SPD; N = 13) who do not meet ASD criteria, and typically developing control (TDC; N = 19) participants. The magnitude of responses to both auditory and tactile stimulation was comparable across all three groups; however, the M200 latency response from the left auditory cortex was significantly delayed in the ASD group relative to both the TDC and SPD groups, whereas the somatosensory response of the ASD group was only delayed relative to TDC participants. The SPD group did not significantly differ from either group in terms of somatosensory latency, suggesting that participants with SPD may have an intermediate phenotype between ASD and TDC with regard to somatosensory processing. For the ASD group, correlation analyses indicated that the left M200 latency delay was significantly associated with performance on the WISC-IV Verbal Comprehension Index as well as the DSTP Acoustic-Linguistic index. Further, these cortical auditory response delays were not associated with somatosensory cortical response delays or cognitive processing speed in the ASD group, suggesting that auditory delays in ASD are domain specific rather than associated with generalized processing delays. The specificity of these auditory delays to the ASD group, in addition to their correlation with verbal abilities, suggests that auditory sensory dysfunction may be implicated in communication symptoms in ASD, motivating further research aimed at understanding the impact of sensory dysfunction on the developing brain.
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Affiliation(s)
- Carly Demopoulos
- Department of Radiology, University of California, San FranciscoSan Francisco, CA, United States
| | - Nina Yu
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Jennifer Tripp
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Nayara Mota
- Department of Radiology, University of California, San FranciscoSan Francisco, CA, United States
| | - Anne N Brandes-Aitken
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Shivani S Desai
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Susanna S Hill
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Ashley D Antovich
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Julia Harris
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States
| | - Susanne Honma
- Department of Radiology, University of California, San FranciscoSan Francisco, CA, United States
| | - Danielle Mizuiri
- Department of Radiology, University of California, San FranciscoSan Francisco, CA, United States
| | - Srikantan S Nagarajan
- Department of Radiology, University of California, San FranciscoSan Francisco, CA, United States
| | - Elysa J Marco
- Department of Neurology, University of California, San FranciscoSan Francisco, CA, United States.,Department of Pediatrics, University of California, San FranciscoSan Francisco, CA, United States.,Department of Psychiatry, University of California, San FranciscoSan Francisco, CA, United States
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26
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Jalbrzikowski M, Ahmed KH, Patel A, Jonas R, Kushan L, Chow C, Bearden CE. Categorical versus dimensional approaches to autism-associated intermediate phenotypes in 22q11.2 microdeletion syndrome. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017; 2:53-65. [PMID: 28367513 PMCID: PMC5373800 DOI: 10.1016/j.bpsc.2016.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND 22q11.2 Microdeletion syndrome (22q11DS) is associated with elevated rates of autism spectrum disorders (ASDs), although the diagnosis is controversial. In order to determine whether there is a biological substrate of ASD in 22q11DS, we examined neurocognitive and structural neuroanatomic differences between those with 22q11DS and an ASD diagnosis (22q11DS-ASD+) and those with 22q11DS without ASD (22q11DS-ASD-); we then determined whether these differences were better characterized within a categorical or dimensional framework. METHODS We collected multiple neurocognitive measures and high-resolution T1-weighted scans on 116 individuals (29 22q11DS-ASD+, 32 22q11DS-ASD-, 55 typically developing controls) between 6 and 26 years of age. Measures of subcortical volume, cortical thickness (CT), and surface area were extracted using the FreeSurfer image analysis suite. Group differences in neurocognitive and neuroanatomic measures were assessed; regression analyses were then performed to determine whether a categorical or dimensional measure of ASD was a better predictor of neurocognitive impairment and/or neuroanatomic abnormalities observed in 22q11DS-ASD+. RESULTS In comparison to 22q11DS-ASD-, 22q11DS-ASD+ participants exhibited decreased bilateral hippocampal CT and decreased right amygdala volumes. Those with 22q11DS-ASD+ also showed slowed processing speed and impairments in visuospatial and facial memory. Neurocognitive impairments fit a dimensional model of ASD, whereas reductions in parahippocampal CT were best explained by a categorical measure of ASD. CONCLUSIONS A combination of categorical and dimensional measures of ASD may provide the most comprehensive understanding of ASDs in 22q11DS.
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Affiliation(s)
| | - Khwaja Hamzah Ahmed
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Arati Patel
- University of Southern California, Keck School of Medicine
| | - Rachel Jonas
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
- University of California, Los Angeles, Interdepartmental Neuroscience Program
| | - Leila Kushan
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Carolyn Chow
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
| | - Carrie E. Bearden
- University of California, Los Angeles, Department of Psychiatry and Biobehavioral Sciences
- University of California, Los Angeles, Department of Psychology
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27
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Lehnhardt FG, Falter CM, Gawronski A, Pfeiffer K, Tepest R, Franklin J, Vogeley K. Sex-Related Cognitive Profile in Autism Spectrum Disorders Diagnosed Late in Life: Implications for the Female Autistic Phenotype. J Autism Dev Disord 2016; 46:139-154. [PMID: 26319250 DOI: 10.1007/s10803-015-2558-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Females with high-functioning ASD are known to camouflage their autistic symptoms better than their male counterparts, making them prone to being under-ascertained and delayed in diagnostic assessment. Thus far the underlying cognitive processes that enable such successful socio-communicative adaptation are not well understood. The current results show sex-related differences in the cognitive profile of ASD individuals, which were diagnosed late in life exclusively. Higher verbal abilities were found in males (n = 69) as opposed to higher processing speed and better executive functions in females with ASD (n = 38). Since both sexes remained unidentified during childhood and adolescence, these results are suggestive for sex-distinctive cognitive strategies as an alternative to typically-developed reciprocal social behavior and social mimicry in high functioning ASD.
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Affiliation(s)
- Fritz-Georg Lehnhardt
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
| | - Christine Michaela Falter
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Astrid Gawronski
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kathleen Pfeiffer
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Ralf Tepest
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Jeremy Franklin
- Institute of Medical Statistics, Computer Science and Epidemiology (IMSIE), University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kai Vogeley
- Department of Psychiatry and Psychotherapy, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.,Institute of Neuroscience and Medicine - Cognitive Neurosciences (INM-3), Research Center Juelich, 52425, Juelich, Germany
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28
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Hedvall Å, Westerlund J, Fernell E, Norrelgen F, Kjellmer L, Olsson MB, Carlsson LH, Eriksson MA, Billstedt E, Gillberg C. Preschoolers with Autism Spectrum Disorder Followed for 2 Years: Those Who Gained and Those Who Lost the Most in Terms of Adaptive Functioning Outcome. J Autism Dev Disord 2016; 45:3624-33. [PMID: 26123008 DOI: 10.1007/s10803-015-2509-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Clinical predictors of 2-year outcome in preschoolers with ASD were studied in a population-based group of very young children with ASD (n = 208). Children who gained the most (n = 30) and lost the most (n = 23), i.e., increased or decreased their adaptive functioning outcome according to the Vineland Composite Score between study entry (T1) and follow-up (T2), 2 years later were compared. Individual factors that differed significantly between the two outcome groups were cognitive level, age at referral, not passing expected milestones at 18 months, autistic type behavior problems and regression. However, logistic regression analysis showed that only cognitive level at T1 (dichotomized into IQ < 70 and IQ ≥ 70) made a unique statistically significant contribution to outcome prediction (p = <.001) with an odds ratio of 18.01. The findings have significant clinical implications in terms of information at diagnosis regarding clinical prognosis in ASD.
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Affiliation(s)
- Åsa Hedvall
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden.
- Department of Psychology, Karolinska University Hospital, Stockholm, Sweden.
| | | | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
- Research and Development Centre, Skaraborgs´s Hospital, Skövde, Sweden
| | - Fritjof Norrelgen
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
- Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Liselotte Kjellmer
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
- Department of Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
- CLINTEC, Division of Speech and Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Martina Barnevik Olsson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
- PRIMA Child and Adolescent Psychiatry, Stockholm, Sweden
| | - Lotta Höglund Carlsson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
- Department of Pediatrics, Astrid Lindgren Children's Hospital, Liljeholmen, Stockholm, Sweden
| | - Mats A Eriksson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
- Department of Pediatric Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden.
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, 411 19, Gothenburg, Sweden
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29
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Treble-Barna A, Zang H, Zhang N, Taylor HG, Yeates KO, Wade S. Long-Term Neuropsychological Profiles and Their Role as Mediators of Adaptive Functioning after Traumatic Brain Injury in Early Childhood. J Neurotrauma 2016; 34:353-362. [PMID: 27080734 DOI: 10.1089/neu.2016.4476] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objectives of the study were to characterize long-term neuropsychological outcomes following traumatic brain injury (TBI) sustained during early childhood, and determine whether identified neuropsychological impairments mediated the effect of TBI on long-term adaptive functioning. Participants included 16 children with severe TBI, 42 children with moderate TBI, and 72 children with orthopedic injuries (OI) sustained between ages 3 and 7 years. Children completed neuropsychological tests and caregivers completed a structured interview of child adaptive functioning at 6.9 (±1.10) years post-injury. Profile analysis and multiple mediator modeling were employed. Children with severe TBI demonstrated poorer fluid reasoning and inhibitory control than both children with moderate TBI and OI, as well as slower processing speed than the OI group. Both fluid reasoning and processing speed were significant independent mediators of the effect of severe TBI on adaptive functioning. No neuropsychological measure significantly mediated the effect of moderate TBI on adaptive functioning. Children sustaining early severe TBI demonstrate persisting neuropsychological impairments into adolescence and young adulthood. The impact of severe TBI on children's long-term adaptive functioning is mediated in part by its effects on fluid reasoning and processing speed.
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Affiliation(s)
- Amery Treble-Barna
- 1 Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - Huaiyu Zang
- 2 Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - Nanhua Zhang
- 2 Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
| | - H Gerry Taylor
- 3 Division of Developmental and Behavioral Pediatrics and Psychology, Department of Pediatrics, Case Western Reserve University and Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center , Rainbow Child Development Center, Cleveland, Ohio
| | - Keith Owen Yeates
- 4 Department of Psychology, Alberta Children's Hospital Research Institute, Hotchkiss Brain Institute, University of Calgary , Calgary, Alberta, Canada
| | - Shari Wade
- 1 Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine , Cincinnati, Ohio
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30
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Postorino V, Fatta LM, Sanges V, Giovagnoli G, De Peppo L, Vicari S, Mazzone L. Intellectual disability in Autism Spectrum Disorder: Investigation of prevalence in an Italian sample of children and adolescents. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 48:193-201. [PMID: 26619372 DOI: 10.1016/j.ridd.2015.10.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 10/19/2015] [Accepted: 10/23/2015] [Indexed: 05/07/2023]
Affiliation(s)
- Valentina Postorino
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy; The Marcus Autism Center, Emory University School of Medicine, 1920 Briarcliff Road, NE, Atlanta, GA 30329, USA.
| | - Laura Maria Fatta
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Veronica Sanges
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Giulia Giovagnoli
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy; L.U.M.S.A., Libera Università Maria SS. Assunta, Dipartimento di Scienze Umane, Piazza delle Vaschette 101, 00193 Rome, Italy
| | - Lavinia De Peppo
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy; L.U.M.S.A., Libera Università Maria SS. Assunta, Dipartimento di Scienze Umane, Piazza delle Vaschette 101, 00193 Rome, Italy
| | - Stefano Vicari
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
| | - Luigi Mazzone
- I.R.C.C.S. Children's Hospital Bambino Gesù, Department of Neuroscience, Child Neuropsychiatry Unit, Piazza S. Onofrio 4, 00165 Rome, Italy
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31
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Rommelse N, Langerak I, van der Meer J, de Bruijn Y, Staal W, Oerlemans A, Buitelaar J. Intelligence May Moderate the Cognitive Profile of Patients with ASD. PLoS One 2015; 10:e0138698. [PMID: 26444877 PMCID: PMC4596821 DOI: 10.1371/journal.pone.0138698] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/02/2015] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The intelligence of individuals with Autism Spectrum Disorder (ASD) varies considerably. The pattern of cognitive deficits associated with ASD may differ depending on intelligence. We aimed to study the absolute and relative severity of cognitive deficits in participants with ASD in relation to IQ. METHODS A total of 274 children (M age = 12.1, 68.6% boys) participated: 30 ASD and 22 controls in the below average Intelligence Quotient (IQ) group (IQ<85), 57 ASD and 54 controls in the average IQ group (85<IQ<115) and 41 ASD and 70 controls in the above average IQ group (IQ>115). Matching for age, sex, Full Scale IQ (FSIQ), Verbal IQ (VIQ), Performance IQ (PIQ) and VIQ-PIQ difference was performed. Speed and accuracy of social cognition, executive functioning, visual pattern recognition and basic processing speed were examined per domain and as a composite score. RESULTS The composite score revealed a trend significant IQ by ASD interaction (significant when excluding the average IQ group). In absolute terms, participants with below average IQs performed poorest (regardless of diagnosis). However, in relative terms, above average intelligent participants with ASD showed the most substantial cognitive problems (particularly for social cognition, visual pattern recognition and verbal working memory) since this group differed significantly from the IQ-matched control group (p < .001), whereas this was not the case for below-average intelligence participants with ASD (p = .57). CONCLUSIONS In relative terms, cognitive deficits appear somewhat more severe in individuals with ASD and above average IQs compared to the below average IQ patients with ASD. Even though high IQ ASD individuals enjoy a certain protection from their higher IQ, they clearly demonstrate cognitive impairments that may be targeted in clinical assessment and treatment. Conversely, even though in absolute terms ASD patients with below average IQs were clearly more impaired than ASD patients with average to above average IQs, the differences in cognitive functioning between participants with and without ASD on the lower end of the IQ spectrum were less pronounced. Clinically this may imply that cognitive assessment and training of cognitive skills in below average intelligent children with ASD may be a less fruitful endeavour. These findings tentatively suggest that intelligence may act as a moderator in the cognitive presentation of ASD, with qualitatively different cognitive processes affected in patients at the high and low end of the IQ spectrum.
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Affiliation(s)
- Nanda Rommelse
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands
- Karakter, Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, the Netherlands
- * E-mail:
| | - Ilse Langerak
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands
| | - Jolanda van der Meer
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Yvette de Bruijn
- Karakter, Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, the Netherlands
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Wouter Staal
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands
- Karakter, Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, the Netherlands
| | - Anoek Oerlemans
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Psychiatry, Nijmegen, The Netherlands
- Karakter, Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, the Netherlands
| | - Jan Buitelaar
- Karakter, Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, the Netherlands
- Radboud University Nijmegen Medical Centre, Nijmegen, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
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32
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McConachie H, Parr JR, Glod M, Hanratty J, Livingstone N, Oono IP, Robalino S, Baird G, Beresford B, Charman T, Garland D, Green J, Gringras P, Jones G, Law J, Le Couteur AS, Macdonald G, McColl EM, Morris C, Rodgers J, Simonoff E, Terwee CB, Williams K. Systematic review of tools to measure outcomes for young children with autism spectrum disorder. Health Technol Assess 2015; 19:1-506. [PMID: 26065374 PMCID: PMC4781156 DOI: 10.3310/hta19410] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The needs of children with autism spectrum disorder (ASD) are complex and this is reflected in the number and diversity of outcomes assessed and measurement tools used to collect evidence about children's progress. Relevant outcomes include improvement in core ASD impairments, such as communication, social awareness, sensory sensitivities and repetitiveness; skills such as social functioning and play; participation outcomes such as social inclusion; and parent and family impact. OBJECTIVES To examine the measurement properties of tools used to measure progress and outcomes in children with ASD up to the age of 6 years. To identify outcome areas regarded as important by people with ASD and parents. METHODS The MeASURe (Measurement in Autism Spectrum disorder Under Review) research collaboration included ASD experts and review methodologists. We undertook systematic review of tools used in ASD early intervention and observational studies from 1992 to 2013; systematic review, using the COSMIN checklist (Consensus-based Standards for the selection of health Measurement Instruments) of papers addressing the measurement properties of identified tools in children with ASD; and synthesis of evidence and gaps. The review design and process was informed throughout by consultation with stakeholders including parents, young people with ASD, clinicians and researchers. RESULTS The conceptual framework developed for the review was drawn from the International Classification of Functioning, Disability and Health, including the domains 'Impairments', 'Activity Level Indicators', 'Participation', and 'Family Measures'. In review 1, 10,154 papers were sifted - 3091 by full text - and data extracted from 184; in total, 131 tools were identified, excluding observational coding, study-specific measures and those not in English. In review 2, 2665 papers were sifted and data concerning measurement properties of 57 (43%) tools were extracted from 128 papers. Evidence for the measurement properties of the reviewed tools was combined with information about their accessibility and presentation. Twelve tools were identified as having the strongest supporting evidence, the majority measuring autism characteristics and problem behaviour. The patchy evidence and limited scope of outcomes measured mean these tools do not constitute a 'recommended battery' for use. In particular, there is little evidence that the identified tools would be good at detecting change in intervention studies. The obvious gaps in available outcome measurement include well-being and participation outcomes for children, and family quality-of-life outcomes, domains particularly valued by our informants (young people with ASD and parents). CONCLUSIONS This is the first systematic review of the quality and appropriateness of tools designed to monitor progress and outcomes of young children with ASD. Although it was not possible to recommend fully robust tools at this stage, the review consolidates what is known about the field and will act as a benchmark for future developments. With input from parents and other stakeholders, recommendations are made about priority targets for research. FUTURE WORK Priorities include development of a tool to measure child quality of life in ASD, and validation of a potential primary outcome tool for trials of early social communication intervention. STUDY REGISTRATION This study is registered as PROSPERO CRD42012002223. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Helen McConachie
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jeremy R Parr
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Magdalena Glod
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer Hanratty
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Nuala Livingstone
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Inalegwu P Oono
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Shannon Robalino
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian Baird
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Tony Charman
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Deborah Garland
- National Autistic Society North East Autism Resource Centre, Newcastle upon Tyne, UK
| | - Jonathan Green
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Paul Gringras
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Glenys Jones
- School of Education, University of Birmingham, Birmingham, UK
| | - James Law
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ann S Le Couteur
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Geraldine Macdonald
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Elaine M McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Christopher Morris
- PenCRU, Child Health Group, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Jacqueline Rodgers
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Emily Simonoff
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Katrina Williams
- University of Melbourne, Royal Children's Hospital and Murdoch Childrens Research Institute, Melbourne, Australia
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Bebko JM, Rhee T, McMorris CA, Ncube BL. Spontaneous strategy use in children with autism spectrum disorder: the roles of metamemory and language skills. Front Psychol 2015; 6:182. [PMID: 25788890 PMCID: PMC4349056 DOI: 10.3389/fpsyg.2015.00182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 02/04/2015] [Indexed: 11/23/2022] Open
Abstract
Metamemory, or beliefs about one’s own memory capabilities, knowing what you know, and knowing what you don’t know, has frequently been linked to the spontaneous use of rehearsal strategies in typically developing children. However, limited research has investigated mnemonic strategy use, metamemory, or the relationship between these two cognitive processes in children with autism spectrum disorders (ASDs). The current study examined the relative strength of metamemory knowledge and language skills as predictors of rehearsal use and memory performance in individuals with ASD. Twenty-one children with ASD and 21 children in a combined comparison group were matched on chronological and verbal mental age. Over two sessions, participants completed a serial recall task, a language measure, and a metamemory questionnaire. Children were classified as rehearsers/non-rehearsers based on behavioral observations and/or verbal reports of strategy use. As expected from previous research, the comparison group had a significantly higher proportion of rehearsers than the ASD group. However, spontaneous rehearsers performed significantly better on the serial recall task than non-rehearsers, regardless of group membership. Children in the comparison group had a higher mean total score on the metamemory questionnaire than the ASD group. However, when examined by rehearsal use, participants classified as rehearsers, regardless of diagnostic group, scored significantly higher on the metamemory questionnaire than non-rehearsers. Finally, across groups, hierarchical regression analyses identified both metamemory and language proficiency as significant predictors of rehearsal strategy use. The fact that the predictors showed the same relationship across the comparison group and the ASD group implies that metamemory and language proficiency, while separate entities, are both fundamental underlying skills contributing to the emergence of rehearsal strategies, and that the results are likely generalizable to other populations with developmental challenges.
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Affiliation(s)
- James M Bebko
- Children's Learning Projects, Department of Psychology, York University Toronto, ON, Canada
| | - Thomas Rhee
- Holland Bloorview Kids Rehabilitation Hospital Toronto, ON, Canada
| | - Carly A McMorris
- Children's Learning Projects, Department of Psychology, York University Toronto, ON, Canada
| | - Busisiwe L Ncube
- Children's Learning Projects, Department of Psychology, York University Toronto, ON, Canada
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Lazar M, Miles LM, Babb JS, Donaldson JB. Axonal deficits in young adults with High Functioning Autism and their impact on processing speed. NEUROIMAGE-CLINICAL 2014; 4:417-25. [PMID: 24624327 PMCID: PMC3950557 DOI: 10.1016/j.nicl.2014.01.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 01/28/2014] [Accepted: 01/28/2014] [Indexed: 11/27/2022]
Abstract
Microstructural white matter deficits in Autism Spectrum Disorders (ASD) have been suggested by both histological findings and Diffusion Tensor Imaging (DTI) studies, which show reduced fractional anisotropy (FA) and increased mean diffusivity (MD). However, imaging reports are generally not consistent across studies and the underlying physiological causes of the reported differences in FA and MD remain poorly understood. In this study, we sought to further characterize white matter deficits in ASD by employing an advanced diffusion imaging method, the Diffusional Kurtosis Imaging (DKI), and a two-compartment diffusion model of white matter. This model differentially describes intra- and extra-axonal white matter compartments using Axonal Water Fraction (faxon) a measure reflecting axonal caliber and density, and compartment-specific diffusivity measures. Diagnostic utility of these measures and associations with processing speed performance were also examined. Comparative studies were conducted in 16 young male adults with High Functioning Autism (HFA) and 17 typically developing control participants (TDC). Significantly decreased faxon was observed in HFA compared to the control group in most of the major white matter tracts, including the corpus callosum, cortico-spinal tracts, and superior longitudinal, inferior longitudinal and inferior fronto-occipital fasciculi. Intra-axonal diffusivity (Daxon) was also found to be reduced in some of these regions. Decreased axial extra-axonal diffusivity (ADextra) was noted in the genu of the corpus callosum. Reduced processing speed significantly correlated with decreased faxon and Daxon in several tracts. faxon of the left cortico-spinal tract and superior longitudinal fasciculi showed good accuracy in discriminating the HFA and TDC groups. In conclusion, these findings suggest altered axonal microstructure in young adults with HFA which is associated with reduced processing speed. Compartment-specific diffusion metrics appear to improve specificity and sensitivity to white matter deficits in this population. White matter microstructure is altered in young adults with High Functioning Autism. We report decreased Axonal Water Fraction and intra-axonal diffusivity. Changes in these DKI metrics are consistent with axonal deficits. Alterations in axonal diffusion metrics correlate with reduced processing speed. DKI may yield promising biomarkers for autism diagnosis and characterization.
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Key Words
- AD, Axial diffusivity
- ADextra, Axial extra-axonal diffusivity
- ASD, Autism Spectrum Disorders
- Autism Spectrum Disorders
- Axonal integrity
- DKI, Diffusional Kurtosis Imaging
- DTI, Diffusion Tensor Imaging
- Daxon, Intra-axonal diffusivity
- Diffusional Kurtosis Imaging
- DigitSC, Digit Symbol-Coding
- FA, Fractional anisotropy
- HFA, High Functioning Autism
- Information processing capacity
- MD, Mean diffusivity
- Processing speed
- RD, Radial diffusivity
- RDextra, Radial extra-axonal diffusivity
- TDC, Typically developing control
- White matter
- faxon, Axonal Water Fraction
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Affiliation(s)
- Mariana Lazar
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, United States
| | - Laura M Miles
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, United States
| | - James S Babb
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, United States
| | - Jeffrey B Donaldson
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, United States
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