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Burack JA, Friedman S, Lessage M, Brodeur D. Re-visiting the 'mysterious myth of attention deficit': A systematic review of the recent evidence. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:271-288. [PMID: 36437709 DOI: 10.1111/jir.12994] [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: 07/15/2021] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Based on the inclusive and methodologically rigorous framework provided by Ed Zigler's developmental approach, we previously challenged what we called, 'the mysterious myth of attention deficit', the fallacy of attention as a universal deficit among persons with intellectual disability (ID). In this latest update, we conducted a systematic review of studies of essential components of attention among persons with ID published in the interim since the last iteration of the mysterious myth narrative was submitted for publication approximately a decade ago. We searched the databases PubMed and PsycINFO for English-language peer-reviewed studies published from 1 January 2011 through 5 February 2021. In keeping with the developmental approach, the two essential methodological criteria were that the groups of persons with ID were aetiologically homogeneous and that the comparisons with persons with average IQs (or with available norms) were based on an appropriate index of developmental level, or mental age. Stringent use of these criteria for inclusion served to control for bias in article selection. Articles were then categorised based on aetiological group studied and component of visual attention. Based on these criteria, 18 articles were selected for inclusion out of the 2837 that were identified. The included studies involved 547 participants: 201 participants with Down syndrome, 214 participants with Williams syndrome and 132 participants with fragile X syndrome. The findings from these articles call attention to the complexities and nuances in understanding attentional functioning across homogeneous aetiological groups and highlight that functioning must be considered in relation to aetiology; factors associated with the individual, such as developmental level, motivation, styles and biases; and factors associated with both the task, such as context, focus, social and emotional implications, and levels of environmental complexity.
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Affiliation(s)
- J A Burack
- Department of Educational & Counseling Psychology, McGill University, Montreal, Canada
| | - S Friedman
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - M Lessage
- Department of Psychology, University of Toronto, Toronto, Canada
| | - D Brodeur
- Department of Psychology, Acadia University, Wolfville, Canada
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2
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Brkić D, Ng-Cordell E, O'Brien S, Martin J, Scerif G, Astle D, Baker K. [Formula: see text]FarmApp: a new assessment of cognitive control and memory for children and young people with neurodevelopmental difficulties. Child Neuropsychol 2022; 28:1097-1115. [PMID: 35332845 DOI: 10.1080/09297049.2022.2054968] [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: 02/02/2023]
Abstract
We introduce a new touchscreen-based method measuring aspects of cognitive control and memory, in children and young people with neurodevelopmental difficulties, including intellectual disability (ID). FarmApp is a gamified, tablet-based assessment tool measuring go/no-go response speed, response inhibition, visuospatial short-term memory span, and long-term memory. Here, we assessed the feasibility, validity, and utility of the method, including the benefits of measuring change in performance over two weeks. We observed that: 1) a higher proportion of participants completed FarmApp than traditional psychometric tests; 2) this proportion increased when participants had opportunity for two weeks of self-paced testing at home; 3) ADHD-relevant behavioral difficulties were associated with average go/no-go performance across all attempts, and change in go/no-go performance over time, indicating sensitivity of the method to cognitive differences with real-world relevance. We also addressed the potential utility of the FarmApp for exploring links between ID etiology and cognitive processes. We observed differences in go/no-go task between two groups of ID participants stratified by the physiological functions of associated genetic variants (chromatin-related and synaptic-related). Moreover, the synaptic group demonstrated higher degree of improvement in go/no-go performance over time. This outcome is potentially informative of dynamic mechanisms contributing to cognitive difficulties within this group. In sum, FarmApp is a feasible, valid, and useful tool increasing access to cognitive assessment for individuals with neurodevelopmental difficulties of variable severity, with an added opportunity to monitor variation in performance over time and determine capacity to acquire task competence.
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Affiliation(s)
- Diandra Brkić
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Elise Ng-Cordell
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom.,Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Sinéad O'Brien
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Jessica Martin
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom.,Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Duncan Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Kate Baker
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
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3
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Behavior Problems and Social Competence in Fragile X Syndrome: A Systematic Review. Genes (Basel) 2022; 13:genes13020280. [PMID: 35205326 PMCID: PMC8871871 DOI: 10.3390/genes13020280] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 02/06/2023] Open
Abstract
Fragile X syndrome (FXS) causes intellectual disability and is the known leading cause of autism. Common problems in FXS include behavior and social problems. Along with syndromic characteristics and autism comorbidity, environmental factors might influence these difficulties. This systematic review focuses on the last 20 years of studies concerning behavior and social problems in FXS, considering environmental and personal variables that might influence both problems. Three databases were reviewed, leading to fifty-one studies meeting the inclusion criteria. Attention deficit hyperactivity disorder (ADHD) problems remain the greatest behavior problems, with behavioral problems and social competence being stable during the 20 years. Some developmental trajectories might have changed due to higher methodological control, such as aggressive behavior and attention problems. The socialization trajectory from childhood to adolescence remains unclear. Comorbidity with autism in individuals with FXS increased behavior problems and worsened social competence profiles. At the same time, comparisons between individuals with comorbid FXS and autism and individuals with autism might help define the comorbid phenotype. Environmental factors and parental characteristics influenced behavior problems and social competence. Higher methodological control is needed in studies including autism symptomatology and parental characteristics. More studies comparing autism in FXS with idiopathic autism are needed to discern differences between conditions.
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John Thurman A, Summers Swinehart S, Klusek J, Roberts JE, Bullard L, Marzan JCB, Ted Brown W, Abbeduto L. Daily Living Skills in Adolescent and Young Adult Males With Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:64-83. [PMID: 34979036 PMCID: PMC8740615 DOI: 10.1352/1944-7558-127.1.64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/27/2021] [Indexed: 05/04/2023]
Abstract
By adulthood, most males with fragile X syndrome (FXS) require support to navigate day-to-day settings. The present study cross-sectionally: (1) characterized the profile of daily living skills in males with FXS and (2) examined associated participant characteristics (i.e., fragile X mental retardation protein [FMRP] expression, nonverbal cognition, language, autism symptomatology, and anxiety symptomatology) using the Waisman-Activities of Daily Living questionnaire. Males with FXS (n = 57, ages 15-23 years) needed more help/support in the areas of domestic and community daily livings skills, than in the area of personal daily living skills. Significant associations were observed between reduced daily living skills and lower nonverbal cognition, receptive language, expressive language, and increased autism symptomatology. Receptive language emerged as the strongest unique predictor of daily living skill performance.
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Affiliation(s)
- Angela John Thurman
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health
- MIND Institute, University of California Davis Health
| | - Stephanie Summers Swinehart
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health
- MIND Institute, University of California Davis Health
| | - Jessica Klusek
- Department of Communication Sciences and Disorders, University of South Carolina
| | | | - Lauren Bullard
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health
- MIND Institute, University of California Davis Health
| | | | - W. Ted Brown
- Department of Psychiatry, University of Sydney
- Department of Human Genetics, NYS Institute for Basic Research
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health
- MIND Institute, University of California Davis Health
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5
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Concurrent Associations between Expressive Language Ability and Independence in Adolescents and Adults with Fragile X Syndrome. Brain Sci 2021; 11:brainsci11091179. [PMID: 34573200 PMCID: PMC8465941 DOI: 10.3390/brainsci11091179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Few individuals with fragile X syndrome (FXS) successfully meet adult normative expectations in education, employment, peer relations, and habitation, although there is within-syndrome variability in this regard. The primary goal of this study was to determine whether expressive language skills contribute to the capacity for independent functioning in adulthood even after controlling for nonverbal cognitive ability. METHODS Participants were 18- to 23-year-olds with FXS. Expressive language was assessed using the psychometrically validated Expressive Language Sampling (ELS) conversation and narration procedures. The language produced was transcribed and analyzed to yield measures of expressive vocabulary, syntax, and intelligibility. Parents concurrently completed questionnaires on the independent functioning of the participants with FXS. RESULTS All three ELS measures were significantly corelated with multiple measures of independence. The magnitudes of the correlations were reduced when nonverbal IQ was controlled through partial correlation. Nonetheless, many of the partial correlations were medium to large and several were statistically significant. CONCLUSIONS Expressive language skills appear to contribute uniquely to the capacity for independence, although longitudinal data are needed to evaluate the possibility of a bidirectional relationship between these domains. Thus, language intervention may be a prerequisite for preparing youth with FXS for an independent adult life.
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Doherty BR, Longhi E, Cole V, Karmiloff-Smith A, Cornish K, Scerif G. Disentangling autism spectrum and attention-deficit/hyperactivity symptoms over development in fragile X syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 104:103692. [PMID: 32505083 DOI: 10.1016/j.ridd.2020.103692] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 05/08/2020] [Accepted: 05/08/2020] [Indexed: 06/11/2023]
Abstract
Even genetic disorders associated with monogenic aetiologies are characterized by complex and variable risk for poor outcomes, highlighting the need to follow trajectories longitudinally. Here, we investigated the longitudinal relationships between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) symptoms in a population at high risk for both: boys with fragile X syndrome. 59 boys with fragile X syndrome aged 3-10 years old at entry participated in this study, and were followed up one and two years after their first visit. As expected, we found strong relationships over three timepoints for ADHD symptoms (as measured by the parent-rated Conners scale) and ASD symptoms (as measured by the Social Communication Questionnaire [SCQ]). In addition, using structural equation modeling (SEM) we found that ADHD symptoms at time 2 predicted ASD symptoms at time 3, suggestive of a causal relationship. Importantly, these relationships hold when including chronological age at entry to the study, as well as when including severity of impairment as measured by IQ, and their effects on both ASD and ADHD symptoms do not reach significance. This result highlights the need to study outcomes longitudinally and it informs the comorbidity of the two symptom domains in FXS as well as their potential directionality, both of which have been little researched. In addition, our findings may suggest a future need to study how ADHD symptoms and their treatment impact individuals with ASD.
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Affiliation(s)
| | - Elena Longhi
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Victoria Cole
- Department of Experimental Psychology, University of Oxford, United Kingdom
| | - Annette Karmiloff-Smith
- Department of Experimental Psychology, University of Oxford, United Kingdom; Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Kim Cornish
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Gaia Scerif
- Department of Experimental Psychology, University of Oxford, United Kingdom.
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7
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Moskowitz LJ, Will EA, Black CJ, Roberts JE. Restricted and Repetitive Behaviors in Males and Females with Fragile X Syndrome: Developmental Trajectories in Toddlers Through Young Adults. J Autism Dev Disord 2020; 50:3957-3966. [PMID: 32221748 DOI: 10.1007/s10803-020-04459-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There is limited research on the trajectory of restricted and repetitive behaviors (RRBs) in fragile X syndrome (FXS), with previous studies only examining males and/or examining RRBs as a unitary construct rather than delineating subtypes of RRBs. Thus, we described the trajectory of five subtypes of RRBs in 153 males and females with FXS (aged 1-18 years) with repeated measurement over time (445 total assessments). Multilevel modeling was used to test age-related differences in RRB subtypes between males and females with FXS, controlling for nonverbal IQ. Results showed that lower-order Sensory-Motor behaviors decreased over time for both males and females, while there was no significant change in the higher-order RRBs. The trajectory between males and females differed for Self-Injury.
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Affiliation(s)
- Lauren J Moskowitz
- Department of Psychology, St. John's University, 8000 Utopia Parkway, Queens, NY, 11439, USA.
| | - Elizabeth A Will
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Conner J Black
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Jane E Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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8
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Chernenok M, Burris JL, Owen E, Rivera SM. Impaired Attention Orienting in Young Children With Fragile X Syndrome. Front Psychol 2019; 10:1567. [PMID: 31354578 PMCID: PMC6635477 DOI: 10.3389/fpsyg.2019.01567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/20/2019] [Indexed: 11/18/2022] Open
Abstract
Fragile X syndrome (FXS) is a genetic disorder caused by a trinucleotide CGG expansion within the FMR1 gene located on the X chromosome. Children with FXS have been shown to be impaired in dynamic visual attention processing. A key component of dynamic processing is orienting—a perceptual ability that requires disengagement and engagement of attention from one stimulus to fixate on a second. Orienting, specifically the disengagement and engagement of attention, has previously not been studied in young children with FXS. Using an eye tracking gap-overlap task, the present study investigated visual disengagement and engagement in young children with FXS, compared to mental age (MA)- and chronological age (CA)-matched typically developing children. On gap trials, the central stimulus elicited fixation, but then disappeared before the peripheral target appeared, imposing a visual gap between stimuli. On overlap trials, the central stimulus elicited fixation, and remained present when the peripheral target appeared, creating visual competition. A gap effect emerges when latencies to shift to the peripheral target are longer in overlap versus gap conditions, reflecting the recruitment of cortical and subcortical disengagement and engagement mechanisms. The gap effect was measured as the latency to orient attention to the peripheral target during gap versus overlap conditions. Both MA and CA groups showed the expected gap effect, where children were slower to orient to peripheral targets on overlap trials than on gap trials. In contrast, in the FXS group, saccadic latencies between gap and overlap trials were not significantly different, indicating no significant gap effect. These findings suggest disrupted attentional engagement patterns in FXS that may be underlying impairments in attention orienting, and suggest potential targets for attention training in this population.
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Affiliation(s)
- Mariya Chernenok
- Department of Human Ecology, University of California, Davis, Davis, CA, United States.,Center for Mind and Brain, University of California, Davis, Davis, CA, United States
| | - Jessica L Burris
- Department of Psychology, Rutgers University, Newark, NJ, United States
| | - Emily Owen
- Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Susan M Rivera
- Center for Mind and Brain, University of California, Davis, Davis, CA, United States.,Department of Psychology, University of California, Davis, Davis, CA, United States.,MIND Institute, University of California Davis Medical Center, Sacramento, CA, United States
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9
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Schmitt LM, Shaffer RC, Hessl D, Erickson C. Executive Function in Fragile X Syndrome: A Systematic Review. Brain Sci 2019; 9:E15. [PMID: 30654486 PMCID: PMC6356760 DOI: 10.3390/brainsci9010015] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/17/2022] Open
Abstract
Executive function (EF) supports goal-directed behavior and includes key aspects such as working memory, inhibitory control, cognitive flexibility, attention, processing speed, and planning. Fragile X syndrome (FXS) is the leading inherited monogenic cause of intellectual disability and is phenotypically characterized by EF deficits beyond what is expected given general cognitive impairments. Yet, a systematic review of behavioral studies using performance-based measures is needed to provide a summary of EF deficits across domains in males and females with FXS, discuss clinical and biological correlates of these EF deficits, identify critical limitations in available research, and offer suggestions for future studies in this area. Ultimately, this review aims to advance our understanding of the underlying pathophysiological mechanisms contributing to EF in FXS and to inform the development of outcome measures of EF and identification of new treatment targets in FXS.
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Affiliation(s)
- Lauren M Schmitt
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
| | - Rebecca C Shaffer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
| | - David Hessl
- MIND Institute, Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA 95616, USA.
| | - Craig Erickson
- Division of Child and Adolescent Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
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10
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Crawford H, Moss J, Stinton C, Singla G, Oliver C. Overactivity, impulsivity and repetitive behaviour in males with fragile X syndrome: contrasting developmental trajectories in those with and without elevated autism symptoms. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:672-683. [PMID: 29722449 DOI: 10.1111/jir.12488] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/07/2018] [Accepted: 03/10/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Hyperactivity and repetitive behaviour are characteristic features of fragile X syndrome (FXS). However, little is known about the influence of autism symptomatology on how these characteristics develop over time. We investigate the profiles and developmental trajectories of overactivity, impulsivity and repetitive behaviour, in males with FXS over three time points spanning 8 years. METHOD Participants formed two subgroups, those who displayed elevated symptoms of autism at Time 1 (n = 37; Mage = 16.32; age range = 6.61-43.51) and those who did not (n = 32; Mage = 8.43; age range = 8.94-47.49). RESULTS Participants without elevated symptoms of autism showed a reduction in impulsivity and repetitive questioning over time, whereas those with elevated symptoms of autism did not. Differences between the two subgroups in several topographies of repetitive behaviour emerged at Time 3 only. CONCLUSIONS These results further understanding of the relationship between autistic phenomenology and behavioural characteristics in FXS.
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Affiliation(s)
- H Crawford
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - J Moss
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - C Stinton
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - G Singla
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
| | - C Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham, UK
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Robinson M, Klusek J, Poe MD, Hatton DD, Roberts JE. The Emergence of Effortful Control in Young Boys With Fragile X Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:89-102. [PMID: 29480774 PMCID: PMC6174087 DOI: 10.1352/1944-7558-123.2.89] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Effortful control, or the ability to suppress a dominant response to perform a subdominant response, is an early-emerging temperament trait that is linked with positive social-emotional development. Fragile X syndrome (FXS) is a single-gene disorder characterized by hallmark regulatory impairments, suggesting diminished effortful control. This study compared the development of effortful control in preschool boys with FXS ( n = 97) and typical development ( n = 32). Unlike their typical peers, the boys with FXS did not exhibit growth in effortful control over time, which could not be accounted for by adaptive impairments, FMR1 molecular measures, or autism symptoms. These results contribute to our understanding of the childhood phenotype of FXS that may be linked to the poor social-emotional outcomes seen in this group.
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Affiliation(s)
- Marissa Robinson
- Marissa Robinson, University of South Carolina, Department of Psychology
| | - Jessica Klusek
- Jessica Klusek, University of South Carolina, Department of Communication Sciences and Disorders
| | - Michele D Poe
- Michele D. Poe, University of Pittsburgh, Program for the Study of Neurodevelopment in Rare Disorders, Pittsburgh
| | - Deborah D Hatton
- Deborah D. Hatton, Vanderbilt University, Department of Special Education; and
| | - Jane E Roberts
- Jane E. Roberts, University of South Carolina, Department of Psychology
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12
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Garg S, Green J. Studying child development in genetic models of ASD. PROGRESS IN BRAIN RESEARCH 2018; 241:159-192. [DOI: 10.1016/bs.pbr.2018.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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13
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Ballantyne CJ, Núñez M, Manoussaki K. Visuo-spatial construction trajectories in Fragile X Syndrome (FXS) and Autism Spectrum Disorders (ASD): Evidence of cognitive heterogeneity within neurodevelopmental conditions. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 70:113-125. [PMID: 28923376 DOI: 10.1016/j.ridd.2017.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 06/26/2017] [Accepted: 08/10/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND/AIMS There have been discrepancies reported in visuo-spatial construction ability in children with Autism Spectrum Disorders (ASD), fragile X Syndrome (FXS) and those with a comorbid diagnosis of FXS and ASD (AFXS). This study aimed to provide a better understanding of the visuo-spatial processing styles in these heterogeneous neurodevelopmental disorders. METHODS AND PROCEDURE Navon-type tasks were used to assess visuo-spatial construction ability across 5 groups of children: typically developing, FXS, AFXS, ASD children who scored low-moderate (HFA) and ASD children that scored severe (LFA) on the Childhood Autism Rating Scale (CARS). Analyses of their developmental trajectories compared the performance of these groups. OUTCOMES AND RESULTS Each group produced their own distinct trajectory. HFA achieved higher scores from an earlier age than the TD group, while the LFA group's performance was driven by a bias in local processing. The FXS performance was normalised by using mental age as a predictor while neither mental nor chronological age predicted the AFXS group performance. CONCLUSIONS AND IMPLICATIONS The study showed unique processing styles. These findings highlight the importance of taking comorbidity and the severity of symptoms within each condition into account in order to understand cognitive abilities and cognitive profiles.
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Affiliation(s)
- Carrie J Ballantyne
- Department of Psychology, School of Media, Culture and Society, University of the West of Scotland, Paisley, High Street, PA1 2BE, United Kingdom.
| | - María Núñez
- Department of Psychology, School of Media, Culture and Society, University of the West of Scotland, Paisley, High Street, PA1 2BE, United Kingdom.
| | - Kallia Manoussaki
- Department of Psychology, School of Media, Culture and Society, University of the West of Scotland, Paisley, High Street, PA1 2BE, United Kingdom.
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14
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Syndromic Autism: Progressing Beyond Current Levels of Description. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2017. [DOI: 10.1007/s40489-017-0116-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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15
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Abstract
OBJECTIVES The purpose of this systematic literature review is to describe what is known about fragile X syndrome (FXS) and to identify research gaps. The results can be used to help inform future public health research and provide pediatricians with up-to-date information about the implications of the condition for individuals and their families. METHODS An electronic literature search was conducted, guided by a variety of key words. The search focused on 4 areas of both clinical and public health importance: (1) the full mutation phenotype, (2) developmental trajectories across the life span, (3) available interventions and treatments, and (4) impact on the family. A total of 661 articles were examined and 203 were included in the review. RESULTS The information is presented in the following categories: developmental profile (cognition, language, functional skills, and transition to adulthood), social-emotional profile (cooccurring psychiatric conditions and behavior problems), medical profile (physical features, seizures, sleep, health problems, and physiologic features), treatment and interventions (educational/behavioral, allied health services, and pharmacologic), and impact on the family (family environment and financial impact). Research gaps also are presented. CONCLUSIONS The identification and treatment of FXS remains an important public health and clinical concern. The information presented in this article provides a more robust understanding of FXS and the impact of this complex condition for pediatricians. Despite a wealth of information about the condition, much work remains to fully support affected individuals and their families.
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Affiliation(s)
- Melissa Raspa
- RTI International, Research Triangle Park, North Carolina; and
| | - Anne C Wheeler
- RTI International, Research Triangle Park, North Carolina; and
| | - Catharine Riley
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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16
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Doherty BR, Scerif G. Genetic Syndromes and Developmental Risk for Autism Spectrum and Attention Deficit Hyperactivity Disorders: Insights From Fragile X Syndrome. CHILD DEVELOPMENT PERSPECTIVES 2017. [DOI: 10.1111/cdep.12227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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17
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Valencia-Naranjo N, Robles-Bello MA. Learning potential and cognitive abilities in preschool boys with fragile X and Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 60:153-161. [PMID: 27984817 DOI: 10.1016/j.ridd.2016.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 12/05/2016] [Accepted: 12/05/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Enhancing cognitive abilities is relevant when devising treatment plans. AIMS This study examined the performance of preschool boys with Down syndrome and fragile X syndrome in cognitive tasks (e.g., nonverbal reasoning and short-term memory), as well as in improving cognitive functions by means of a learning potential methodology. METHODS AND PROCEDURES The basic scales corresponding to the Skills and Learning Potential Preschool Scale were administered to children with Down syndrome and others with fragile X syndrome, matched for chronological age and nonverbal cognitive development level. RESULTS The fragile X syndrome group showed stronger performance on short-term memory tasks than the Down syndrome group prior to intervention, with no differences recorded in nonverbal reasoning tasks. In addition, both groups' cognitive performance improved significantly between pre- and post-intervention. However, learning potential relative to auditory memory was limited in both groups, and for rule-based categorization in Down syndrome children. CONCLUSION The scale offered the opportunity to assess young children's abilities and identify the degree of cognitive modifiability. Furthermore, factors that may potentially affect the children's performance before and during learning potential assessment are discussed.
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Lee M, Martin GE, Berry-Kravis E, Losh M. A developmental, longitudinal investigation of autism phenotypic profiles in fragile X syndrome. J Neurodev Disord 2016; 8:47. [PMID: 28050218 PMCID: PMC5203725 DOI: 10.1186/s11689-016-9179-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Targeting overlapping behavioral phenotypes in neurogenetic disorders can help elucidate gene-behavior relationships. Fragile X syndrome (FXS) and autism spectrum disorder (ASD) have been studied as a model for this approach, and important areas of phenotypic overlap and divergence have been documented. However, few studies have examined how the manifestation of ASD-related phenotypes in FXS may change over development, a question which has important implications for conceptualizing shared etiologies of these disorders and their constituent phenotypes. The goal of this study was to characterize ASD phenotypes in boys and girls with FXS across development, as well as to compare individual component phenotypes among boys with FXS and boys with idiopathic ASD (ASD-O) over time. METHODS Sixty-five boys and girls with FXS and 19 boys with ASD-O completed a battery of diagnostic, cognitive, and language assessments at two time points (mean 2.5 years apart). Nonparametric tests assessed changes in diagnostic classification in FXS over time, and hierarchical linear modeling and repeated measures assessed changes in individual ASD symptoms in FXS over time. Additionally, ANCOVAs compared ASD symptom severity and component phenotypes in boys with FXS-O, FXS-ASD, and ASD-O at both time points. RESULTS Overall, ASD symptom manifestation for children with FXS significantly increased over time, and developmental predictors varied based on the domain of symptoms assessed. The greatest degree of overlap was observed between boys with FXS-ASD and ASD-O in the domain of reciprocal social communication across time points, whereas boys with ASD-O demonstrated greater impairment in restricted and repetitive behaviors at the later time point. CONCLUSIONS ASD symptoms increased in FXS with age, and social language impairment emerged as a potential core shared feature of FXS and ASD that may help elucidate underlying molecular genetic variation related to phenotypic variance, and aid intervention planning for subgroups of children showing distinct phenotypes. Results highlight the value of a developmental perspective, and longitudinal data in particular, in evaluating shared behavioral phenotypes across genetic conditions, lending insight into underlying cognitive, neural, and genetic mechanisms associated with key developmental phenotypes in ASD and FXS.
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Affiliation(s)
- Michelle Lee
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Gary E. Martin
- Department of Communication Sciences and Disorders, St. John’s University, Staten Island, NY USA
| | | | - Molly Losh
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL USA
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Kirk HE, Gray K, Riby DM, Taffe J, Cornish KM. Visual attention and academic performance in children with developmental disabilities and behavioural attention deficits. Dev Sci 2016; 20. [PMID: 27649816 DOI: 10.1111/desc.12468] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 05/30/2016] [Indexed: 11/29/2022]
Abstract
Despite well-documented attention deficits in children with intellectual and developmental disabilities (IDD), distinctions across types of attention problems and their association with academic attainment has not been fully explored. This study examines visual attention capacities and inattentive/hyperactive behaviours in 77 children aged 4 to 11 years with IDD and elevated behavioural attention difficulties. Children with autism spectrum disorder (ASD; n = 23), Down syndrome (DS; n = 22), and non-specific intellectual disability (NSID; n = 32) completed computerized visual search and vigilance paradigms. In addition, parents and teachers completed rating scales of inattention and hyperactivity. Concurrent associations between attention abilities and early literacy and numeracy skills were also examined. Children completed measures of receptive vocabulary, phonological abilities and cardinality skills. As expected, the results indicated that all groups had relatively comparable levels of inattentive/hyperactive behaviours as rated by parents and teachers. However, the extent of visual attention deficits varied as a result of group; namely children with DS had poorer visual search and vigilance abilities than children with ASD and NSID. Further, significant associations between visual attention difficulties and poorer literacy and numeracy skills were observed, regardless of group. Collectively the findings demonstrate that in children with IDD who present with homogenous behavioural attention difficulties, at the cognitive level, subtle profiles of attentional problems can be delineated.
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Affiliation(s)
- Hannah E Kirk
- School of Psychological Sciences, Monash University, Australia.,Monash Institute of Cognitive and Clinical Neuroscience, Australia
| | - Kylie Gray
- Centre for Developmental Psychology & Psychiatry, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia
| | | | - John Taffe
- Centre for Developmental Psychology & Psychiatry, Department of Psychiatry, School of Clinical Sciences, Monash University, Australia
| | - Kim M Cornish
- School of Psychological Sciences, Monash University, Australia.,Monash Institute of Cognitive and Clinical Neuroscience, Australia
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Ballantyne CJ, Núñez M. Developmental trajectories of hierarchical visuo-spatial processing in fragile X syndrome and ASD: Within- and cross-syndrome variability. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 51-52:103-115. [PMID: 26809150 DOI: 10.1016/j.ridd.2015.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 12/22/2015] [Accepted: 12/26/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND/AIMS Despite the advances in understanding visuo-spatial processing in developmental disorders such as ASD and fragile X syndrome (FXS), less is known about the profile of those with a comorbid diagnosis, or the role of within-disorder disparities between individuals across the ASD spectrum. METHODS AND PROCEDURES Using a developmental trajectory approach, we tested 5 groups of children: Typically developing, FXS, FXS+ASD, ASD individuals who had low-moderate symptoms (HFA) and ASD individuals who had severe symptoms (LFA). Symptoms of ASD were assessed using the Childhood Autism Rating Scale: CARS and hierarchical visuo-spatial processing was assessed using the Navon task. OUTCOMES AND RESULTS Crucially, results differed between HFA and LFA participants. Furthermore, the pattern of results differed between those who had a diagnosis of FXS only and FXS+ASD. Poorer performance within the FXS groups and the group who are low functioning on the ASD spectrum indicated a delayed developmental rate compared to typical controls. CONCLUSIONS AND IMPLICATIONS This study showed that diagnosis and severity of symptoms are indicative of differences in visuo-spatial processing styles. It is important that heterogeneity within FXS and ASD populations are considered in subsequent studies and look beyond diagnostic group differences.
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Affiliation(s)
- Carrie J Ballantyne
- Division of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK.
| | - María Núñez
- Division of Psychology, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow G4 0BA, UK.
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Abstract
BACKGROUND We sought to examine fundamental aspects of attention in children with Rett syndrome, a severely disabling neurodevelopmental disorder caused by spontaneous mutations in the X-linked MECP2 gene. To gauge their attention, we used eye tracking, which bypasses the profound impairments in expressive language and hand use in Rett syndrome. We report two aspects of attention-shifting and sustaining-basic abilities known to drive cognitive growth. METHODS Two groups were compared: those with Rett syndrome (N = 20; 3-15 years) and a typically developing comparison group (N = 14; 3-16 years), using a task in which an attractive central stimulus was followed, after a short gap, by a dynamic target presented to one side. Time to shift to the target location (reactive and anticipatory saccades) and time fixating the target were assessed. RESULTS Children with Rett syndrome were consistently slower to shift (largely because of fewer anticipations); their reactive saccades were also slower than those of typically developing children, but not significantly so. The Rett syndrome group spent considerable time looking at the target (over 75% of available time), although significantly less so than the typically developing group. CONCLUSIONS These findings indicate that children with Rett syndrome could maintain attention on a stimulus and orient relatively quickly to the appearance of a target in the visual field. However, they had difficulty in anticipating predictable events, a difficulty in endogenous attention that is likely to have deleterious implications for executive functioning.
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Grefer M, Flory K, Cornish K, Hatton D, Roberts J. The emergence and stability of attention deficit hyperactivity disorder in boys with fragile X syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2016; 60:167-78. [PMID: 26610738 PMCID: PMC4720543 DOI: 10.1111/jir.12226] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 07/13/2015] [Accepted: 08/12/2015] [Indexed: 05/18/2023]
Abstract
BACKGROUND Children with fragile X syndrome (FXS) are at high risk for developing a range of behavioural disorders, including attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD). However, very few studies have investigated the comorbid profile of FXS and ADHD and the possible dissociation from the FXS and ASD profile. The present study examined the relationship of childhood temperament characteristics of the Surgency facet (activity level, impulsivity, approach, shyness, and smiling and laughter) and the severity of ADHD and ASD features at two measurement time points in childhood, preschool (ages 3-4) and at school entry (ages 5-6). METHODS The study consisted of males with FXS measured at each time point (preschool and school entry), as well as comparison of typically developing (TD) boys at the preschool measurement time point. Parent reported measures of temperament and behavioural symptoms were collected at each time point. Multiple regression analyses were used to analyse obtained data. RESULTS Elevated activity level scores are associated with ADHD scores at preschool age and elevated shyness and decreased smiling and laughter are strongly associated with ADHD scores upon school entry. Impulsivity emerges as a strong indicator of elevated ADHD scores around school age, but even preschool impulsivity scores demonstrate some predictive value for higher ADHD scores later in school. Finally, no Surgency characteristic was significantly related to ASD scores at any age. CONCLUSIONS Impulsivity serves as an indicator of elevated ADHD symptoms across development periods in boys with FXS, while activity level is just indicative of higher ADHD scores at the preschool age. The Surgency facet of temperament at either age does not predict strong relationships of comorbid pathologies of ADHD and ASD in FXS. However, Surgency characteristics may serve as informative discriminative factors when studying behavioural outcomes in boys with FXS.
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Affiliation(s)
- M Grefer
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - K Flory
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - K Cornish
- School of Psychological Sciences, Monash University, Melbourne, Australia
| | - D Hatton
- Department of Special Education, Vanderbilt University, Nashville, TN, USA
| | - J Roberts
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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Hustyi KM, Hall SS, Quintin EM, Chromik LC, Lightbody AA, Reiss AL. The relationship between autistic symptomatology and independent living skills in adolescents and young adults with fragile X syndrome. J Autism Dev Disord 2015; 45:1836-44. [PMID: 25518824 DOI: 10.1007/s10803-014-2342-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Few studies have examined the relationship between autistic symptomatology and competence in independent living skills in adolescents and young adults with fragile X syndrome (FXS). In this study, 70 individuals with FXS, aged 15-25 years, and 35 matched controls were administered direct measures of independent living skills and autistic symptomatology. Results showed that higher levels of autistic symptomatology were associated with lower levels of competence in independent living skills in individuals with FXS, but not in controls. These data indicated that the relationship between autistic symptomatology and independent living skills was syndrome-specific. Early intervention strategies that address autistic symptomatology are sorely needed to improve functional outcomes in this population.
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Affiliation(s)
- Kristin M Hustyi
- Department of Psychiatry and Behavioral Sciences, Center for Interdisciplinary Brain Sciences Research (CIBSR), Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305, USA,
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Frolli A, Piscopo S, Conson M. Developmental changes in cognitive and behavioural functioning of adolescents with fragile-X syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:613-621. [PMID: 25160119 DOI: 10.1111/jir.12165] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Individuals with fragile-X syndrome exhibit developmental delay, hyperexcitation and social anxiety; they also show lack of attention and hyperactivity. Few studies have investigated whether levels of functioning change with increasing age. Here, we explored developmental changes across adolescence in the cognitive and behavioural profile of individuals with fragile-X syndrome. To this scope, we assessed intellectual functioning, adaptive behaviour, autistic symptomatology, behavioural problems (e.g. hyperactivity/lack of attention) and strengths (prosocial behaviours). METHOD Thirty-six participants underwent standardised outcome measures (i.e. the Wechsler Intelligence Scales-Revised, the Childhood Autism Rating Scale, the Vineland Adaptive Behavior Scales, and the Strengths and Difficulty Questionnaire) in three time points (Time 1: 9-11; Time 2: 11-13, and Time 3: 13-15 years). RESULTS Verbal IQ improved across time, whereas Nonverbal IQ declined and Full Scale IQ was quite unchanged. Autism ratings decreased; communication and social aspects of adaptive behaviour also enhanced. Finally, elevated levels of hyperactivity/lack of attention at Time 1 significantly improved across the three time points, whereas emotional symptoms, behavioural difficulties, problems with peers and prosocial behaviours remained stable over time. CONCLUSION These findings revealed specific developmental changes in cognitive and behavioural functioning of individuals with fragile-X syndrome, likely related to a progressive maturation of brain systems devoted to attentional control.
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Affiliation(s)
- A Frolli
- Department of Psychology, Second University of Naples, Naples, Italy
| | - S Piscopo
- Laboratory of Animal Physiology and Evolution, Stazione Zoologica Anton Dohrn, Naples, Italy
| | - M Conson
- Department of Psychology, Second University of Naples, Naples, Italy
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Traverso L, Viterbori P, Usai MC. Improving executive function in childhood: evaluation of a training intervention for 5-year-old children. Front Psychol 2015; 6:525. [PMID: 25983706 PMCID: PMC4415324 DOI: 10.3389/fpsyg.2015.00525] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/13/2015] [Indexed: 11/21/2022] Open
Abstract
Executive function (EF) refers to a set of higher order cognitive processes that control and modulate cognition under continuously changing and multiple task demands. EF plays a central role in early childhood, is associated and predictive of important cognitive achievements and has been recognized as a significant aspect of school readiness. This study examines the efficacy of a group based intervention for 5-year-old children that focuses on basic components of EF (working memory, inhibitory control, cognitive flexibility). The intervention included 12 sessions, lasted 1 month and used low-cost materials. Seventy-five children took part in the study. The results indicate that the children who attended the intervention outperformed controls in simple and more complex EF tasks. Specifically, these children exhibited increased abilities to delay gratification, to control on-going responses, to process and update information, and to manage high cognitive conflict. These results suggest the possibility that this intervention, which may be easily implemented in educational services, can promote EF during preschool period before the entrance in primary school.
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Affiliation(s)
- Laura Traverso
- Department of Education Sciences, University of Genoa Genoa, Italy
| | - Paola Viterbori
- Department of Education Sciences, University of Genoa Genoa, Italy
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Benjamin DP, McDuffie AS, Thurman AJ, Kover ST, Mastergeorge AM, Hagerman RJ, Abbeduto L. Effect of speaker gaze on word learning in fragile X syndrome: a comparison with nonsyndromic autism spectrum disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2015; 58:383-95. [PMID: 25629603 PMCID: PMC4675125 DOI: 10.1044/2015_jslhr-l-14-0136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 10/28/2014] [Accepted: 12/03/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE This study examined use of a speaker's direction of gaze during word learning by boys with fragile X syndrome (FXS), boys with nonsyndromic autism spectrum disorder (ASD), and typically developing (TD) boys. METHOD A fast-mapping task with follow-in and discrepant labeling conditions was administered. We expected that the use of speaker gaze would lead to participants selecting as the referent of the novel label the object to which they attended in follow-in trials and the object to which the examiner attended in the discrepant labeling trials. Participants were school-aged boys with FXS (n=18) or ASD (n=18) matched on age, intelligence quotient, and nonverbal cognition and younger TD boys (n=18) matched on nonverbal cognition. RESULTS All groups performed above chance in both conditions, although the TD boys performed closest to the expected pattern. Boys with FXS performed better during follow-in than in discrepant label trials, whereas TD boys and boys with ASD did equally well in both trial types. The type of trial administered first influenced subsequent responding. Error patterns also distinguished the groups. CONCLUSION The ability to utilize a speaker's gaze during word learning is not as well developed in boys with FXS or nonsyndromic ASD as in TD boys of the same developmental level.
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Affiliation(s)
- David P. Benjamin
- MIND Institute, University of California, Davis
- UC Davis School of Medicine
| | - Andrea S. McDuffie
- MIND Institute, University of California, Davis
- UC Davis School of Medicine
| | - Angela J. Thurman
- MIND Institute, University of California, Davis
- UC Davis School of Medicine
| | | | | | - Randi J. Hagerman
- MIND Institute, University of California, Davis
- UC Davis School of Medicine
| | - Leonard Abbeduto
- MIND Institute, University of California, Davis
- UC Davis School of Medicine
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Scerif G, Baker K. Annual research review: Rare genotypes and childhood psychopathology--uncovering diverse developmental mechanisms of ADHD risk. J Child Psychol Psychiatry 2015; 56:251-73. [PMID: 25494546 DOI: 10.1111/jcpp.12374] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/10/2014] [Indexed: 01/25/2023]
Abstract
BACKGROUND Through the increased availability and sophistication of genetic testing, it is now possible to identify causal diagnoses in a growing proportion of children with neurodevelopmental disorders. In addition to developmental delay and intellectual disability, many genetic disorders are associated with high risks of psychopathology, which curtail the wellbeing of affected individuals and their families. Beyond the identification of significant clinical needs, understanding the diverse pathways from rare genetic mutations to cognitive dysfunction and emotional-behavioural disturbance has theoretical and practical utility. METHODS We overview (based on a strategic search of the literature) the state-of-the-art on causal mechanisms leading to one of the most common childhood behavioural diagnoses - attention deficit hyperactivity disorder (ADHD) - in the context of specific genetic disorders. We focus on new insights emerging from the mapping of causal pathways from identified genetic differences to neuronal biology, brain abnormalities, cognitive processing differences and ultimately behavioural symptoms of ADHD. FINDINGS First, ADHD research in the context of rare genotypes highlights the complexity of multilevel mechanisms contributing to psychopathology risk. Second, comparisons between genetic disorders associated with similar psychopathology risks can elucidate convergent or distinct mechanisms at each level of analysis, which may inform therapeutic interventions and prognosis. Third, genetic disorders provide an unparalleled opportunity to observe dynamic developmental interactions between neurocognitive risk and behavioural symptoms. Fourth, variation in expression of psychopathology risk within each genetic disorder points to putative moderating and protective factors within the genome and the environment. CONCLUSION A common imperative emerging within psychopathology research is the need to investigate mechanistically how developmental trajectories converge or diverge between and within genotype-defined groups. Crucially, as genetic predispositions modify interaction dynamics from the outset, longitudinal research is required to understand the multi-level developmental processes that mediate symptom evolution.
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Affiliation(s)
- Gaia Scerif
- Department of Experimental Psychology, University of Oxford, Oxford, UK
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Kover ST, McCary LM, Ingram AM, Hatton DD, Roberts JE. Language development in infants and toddlers with fragile X syndrome: change over time and the role of attention. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:125-44. [PMID: 25715182 PMCID: PMC5656241 DOI: 10.1352/1944-7558-120.2.125] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Fragile X syndrome (FXS) is associated with significant language and communication delays, as well as problems with attention. This study investigated early language abilities in infants and toddlers with FXS (n = 13) and considered visual attention as a predictor of those skills. We found that language abilities increased over the study period of 9 to 24 months, with moderate correlations among language assessments. In comparison to typically developing infants (n = 11), language skills were delayed beyond chronological age and developmental-level expectations. Aspects of early visual attention predicted later language ability. Atypical visual attention is an important aspect of the FXS phenotype with implications for early language development, particularly in the domain of vocabulary.
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Freeman NC, Gray KM, Taffe JR, Cornish KM. Development of a New Attention Rating Scale for Children With Intellectual Disability: The Scale of Attention in Intellectual Disability (SAID). AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:91-109. [PMID: 25715180 DOI: 10.1352/1944-7558-120.2.91] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Difficulties with attention, impulsivity, and hyperactivity are thought to be as common among children with intellectual disability (ID) as they are in children without ID. Despite this, there is a lack of scales to specifically assess ADHD symptomatology in children and adolescents with ID. This article describes the development and evaluation of a teacher-completed measure; the Scale of Attention in Intellectual Disability (SAID). A community survey of 176 teachers of children 5-13 years of age, with ID at all levels of impairment indicated that the T-SAID is a reliable and valid measure. Integrating this scale with neuropsychological and clinical research holds exciting promise for enhancing our understanding of the nature of attention difficulties within populations with ID.
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Tonnsen BL, Grefer ML, Hatton DD, Roberts JE. Developmental trajectories of attentional control in preschool males with fragile X syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 36C:62-71. [PMID: 25462466 PMCID: PMC4397109 DOI: 10.1016/j.ridd.2014.09.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 09/22/2014] [Indexed: 05/31/2023]
Abstract
Attention problems are among the most impairing features associated with fragile X syndrome (FXS). However, few studies have examined behavioral development of inhibitory control in very young children with FXS. We examined attentional control in 3-6 year boys with FXS using both an experimental inhibitory control paradigm and parent-report of attention problems. Study 1 examined attentional control in FXS compared to comparison groups matched on chronological and mental age. To determine the stability of impairments over time in FXS, Study 2 examined patterns of developmental change in an expanded longitudinal sample. Across studies, males with FXS demonstrated persistent impairments in inhibitory control and parent-reported attention problems. Inhibitory control was related to, but not solely driven by, lower mental age. Although parent-rated attention problems remained stable across ages, inhibitory control improved with time. Children with more severe attention problems often displayed initially poorer inhibitory control. However, these trajectories also improved more rapidly with age. Our findings indicate that despite persistent deficits in attentional control in young children with FXS, multi-method assessment can be used to capture developmental growth that should be further supported through early, targeted intervention.
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Affiliation(s)
- Bridgette L Tonnsen
- University of South Carolina Department of Psychology, 1512 Pendleton Street, Columbia, SC 29208, USA(1)
| | - Marjorie L Grefer
- University of South Carolina Department of Psychology, 1512 Pendleton Street, Columbia, SC 29208, USA(1)
| | - Deborah D Hatton
- Vanderbilt University Department of Special Education, Peabody College, Nashville, TN 37203, USA(2)
| | - Jane E Roberts
- University of South Carolina Department of Psychology, 1512 Pendleton Street, Columbia, SC 29208, USA(1).
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Benjamin DP, Mastergeorge AM, McDuffie AS, Kover ST, Hagerman RJ, Abbeduto L. Effects of labeling and pointing on object gaze in boys with fragile X syndrome: an eye-tracking study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2658-72. [PMID: 25062097 PMCID: PMC4154990 DOI: 10.1016/j.ridd.2014.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 05/26/2023]
Abstract
We examined the visual processing of a social learning stimulus and the ways in which visual attention was distributed to objects as well as to the examiner's face during word learning under conditions that varied only in the presence or absence of a label. The goal of the current study, then, was to evaluate the effects of differentially providing pointing and labeling during exposure to a novel target object in males with fragile X syndrome (FXS) (n=14, ages 4.33-10.02), autism spectrum disorder (ASD) (n=17, ages 4.04-10.4), or typical development (TD) (n=18, ages 2.05-5.33). In particular, the present study examined attention to the examiner's face as well as target and distracter objects that were presented as video stimuli. An eye-tracker captured gaze to the video stimuli as they were shown in order to examine the way in which children with FXS, ASD, or TD distributed their gaze toward the examiner and the objects. Results indicated that no group showed increased gaze toward the target object compared to the distracter object. However, results revealed that participants with FXS showed significantly increased face gaze compared to the novel objects, whereas children with ASD and TD both showed similar amounts of relative gaze toward the face and objects. Furthermore, the act of pointing at the target object was found to increase gaze toward the target objects compared to when there was no pointing in all groups. Together, these findings suggest that social cues like those employed in a word-learning task, when presented with video, may relate to gaze in FXS in context- or task-dependent ways that are distinct from those expected during live interaction.
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Affiliation(s)
- David P Benjamin
- MIND Institute, University of California-Davis, United States; Department of Psychiatry and Behavioral Sciences, U.C. Davis School of Medicine, United States.
| | - Ann M Mastergeorge
- Division of Family Studies and Human Development, University of Arizona, United States.
| | - Andrea S McDuffie
- MIND Institute, University of California-Davis, United States; Department of Psychiatry and Behavioral Sciences, U.C. Davis School of Medicine, United States.
| | - Sara T Kover
- University of Washington, Seattle, WA, United States.
| | - Randi J Hagerman
- MIND Institute, University of California-Davis, United States; Department of Pediatrics, U.C. Davis School of Medicine, Sacramento, CA, United States.
| | - Leonard Abbeduto
- MIND Institute, University of California-Davis, United States; Department of Psychiatry and Behavioral Sciences, U.C. Davis School of Medicine, United States.
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Couzens D. Behavior Phenotype: A Synthesis of Research to Understand Age-Related Change in Behavior in Several Syndromes. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2014. [DOI: 10.1111/jppi.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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van der Molen MJW, Stam CJ, van der Molen MW. Resting-state EEG oscillatory dynamics in fragile X syndrome: abnormal functional connectivity and brain network organization. PLoS One 2014; 9:e88451. [PMID: 24523898 PMCID: PMC3921158 DOI: 10.1371/journal.pone.0088451] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 01/13/2014] [Indexed: 12/11/2022] Open
Abstract
Disruptions in functional connectivity and dysfunctional brain networks are considered to be a neurological hallmark of neurodevelopmental disorders. Despite the vast literature on functional brain connectivity in typical brain development, surprisingly few attempts have been made to characterize brain network integrity in neurodevelopmental disorders. Here we used resting-state EEG to characterize functional brain connectivity and brain network organization in eight males with fragile X syndrome (FXS) and 12 healthy male controls. Functional connectivity was calculated based on the phase lag index (PLI), a non-linear synchronization index that is less sensitive to the effects of volume conduction. Brain network organization was assessed with graph theoretical analysis. A decrease in global functional connectivity was observed in FXS males for upper alpha and beta frequency bands. For theta oscillations, we found increased connectivity in long-range (fronto-posterior) and short-range (frontal-frontal and posterior-posterior) clusters. Graph theoretical analysis yielded evidence of increased path length in the theta band, suggesting that information transfer between brain regions is particularly impaired for theta oscillations in FXS. These findings are discussed in terms of aberrant maturation of neuronal oscillatory dynamics, resulting in an imbalance in excitatory and inhibitory neuronal circuit activity.
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Affiliation(s)
- Melle J. W. van der Molen
- Institute of Psychology, Developmental Psychology Unit, Leiden University, Leiden, the Netherlands
- Leiden Institute for Brain and Cognition. Leiden, the Netherlands
- * E-mail:
| | - Cornelis J. Stam
- Department of Clinical Neurophysiology, VU University Medical Center, Amsterdam, the Netherlands
- Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Maurits W. van der Molen
- Department of Developmental Psychology, University of Amsterdam, Amsterdam, the Netherlands
- Cognitive Science Center Amsterdam, Amsterdam, The Netherlands
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Wass SV. Applying cognitive training to target executive functions during early development. Child Neuropsychol 2014; 21:150-66. [PMID: 24511910 PMCID: PMC4270409 DOI: 10.1080/09297049.2014.882888] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 01/08/2014] [Indexed: 12/29/2022]
Abstract
Developmental psychopathology is increasingly recognizing the importance of distinguishing causal processes (i.e., the mechanisms that cause a disease) from developmental outcomes (i.e., the symptoms of the disorder as it is eventually diagnosed). Targeting causal processes early in disordered development may be more effective than waiting until outcomes are established and then trying to reverse the pathogenic process. In this review, I evaluate evidence suggesting that neural and behavioral plasticity may be greatest at very early stages of development. I also describe correlational evidence suggesting that, across a number of conditions, early emerging individual differences in attentional control and working memory may play a role in mediating later-developing differences in academic and other forms of learning. I review the currently small number of studies that applied direct and indirect cognitive training targeted at young individuals and discuss methodological challenges associated with targeting this age group. I also discuss a number of ways in which early, targeted cognitive training may be used to help us understand the developmental mechanisms subserving typical and atypical cognitive development.
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Affiliation(s)
- Sam V. Wass
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
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The BTBR mouse model of autism spectrum disorders has learning and attentional impairments and alterations in acetylcholine and kynurenic acid in prefrontal cortex. PLoS One 2013; 8:e62189. [PMID: 23638000 PMCID: PMC3634761 DOI: 10.1371/journal.pone.0062189] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 03/19/2013] [Indexed: 02/07/2023] Open
Abstract
Autism is a complex spectrum of disorders characterized by core behavioral deficits in social interaction, communication, repetitive stereotyped behaviors and restricted interests. Autism frequently presents with additional cognitive symptoms, including attentional deficits and intellectual disability. Preclinical models are important tools for studying the behavioral domains and biological underpinnings of autism, and potential treatment targets. The inbred BTBR T+tf/J (BTBR) mouse strain has been used as an animal model of core behavioral deficits in autism. BTBR mice exhibit repetitive behaviors and deficits in sociability and communication, but other aspects of their cognitive phenotype, including attentional performance, are not well characterized. We examined the attentional abilities of BTBR mice in the 5-choice serial reaction time task (5-CSRTT) using an automated touchscreen testing apparatus. The 5-CSRTT is an analogue of the human continuous performance task of attention, and so both the task and apparatus have translational relevance to human touchscreen cognitive testing. We also measured basal extracellular levels of a panel of neurotransmitters within the medial prefrontal cortex, a brain region critically important for performing the 5-CSRTT. We found that BTBR mice have increased impulsivity, defined as an inability to withhold responding, and decreased motivation, as compared to C57Bl/6J mice. Both of these features characterize attentional deficit disorders in humans. BTBR mice also display decreased accuracy in detecting short stimuli, lower basal levels of extracellular acetylcholine and higher levels of kynurenic acid within the prefrontal cortex. Intact cholinergic transmission in prefrontal cortex is required for accurate performance of the 5-CSRTT, consequently this cholinergic deficit may underlie less accurate performance in BTBR mice. Based on our findings that BTBR mice have attentional impairments and alterations in a key neural substrate of attention, we propose that they may be valuable for studying mechanisms for treatment of cognitive dysfunction in individuals with attention deficits and autism.
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Wass SV, Smith TJ, Johnson MH. Parsing eye-tracking data of variable quality to provide accurate fixation duration estimates in infants and adults. Behav Res Methods 2013; 45:229-50. [PMID: 22956360 PMCID: PMC3578727 DOI: 10.3758/s13428-012-0245-6] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Researchers studying infants' spontaneous allocation of attention have traditionally relied on hand-coding infants' direction of gaze from videos; these techniques have low temporal and spatial resolution and are labor intensive. Eye-tracking technology potentially allows for much more precise measurement of how attention is allocated at the subsecond scale, but a number of technical and methodological issues have given rise to caution about the quality and reliability of high temporal resolution data obtained from infants. We present analyses suggesting that when standard dispersal-based fixation detection algorithms are used to parse eye-tracking data obtained from infants, the results appear to be heavily influenced by interindividual variations in data quality. We discuss the causes of these artifacts, including fragmentary fixations arising from flickery or unreliable contact with the eyetracker and variable degrees of imprecision in reported position of gaze. We also present new algorithms designed to cope with these problems by including a number of new post hoc verification checks to identify and eliminate fixations that may be artifactual. We assess the results of our algorithms by testing their reliability using a variety of methods and on several data sets. We contend that, with appropriate data analysis methods, fixation duration can be a reliable and stable measure in infants. We conclude by discussing ways in which studying fixation durations during unconstrained orienting may offer insights into the relationship between attention and learning in naturalistic settings.
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Affiliation(s)
- S V Wass
- Centre for Brain and Cognitive Development, Birkbeck College, University of London, London, WC1E 7HX, UK.
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Owen ER, Baumgartner HA, Rivera SM. Using infrared eye-tracking to explore ordinal numerical processing in toddlers with Fragile X Syndrome. J Neurodev Disord 2013; 5:1. [PMID: 23402354 PMCID: PMC3610201 DOI: 10.1186/1866-1955-5-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Accepted: 01/15/2013] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Fragile X syndrome (FXS) is the most common cause of inherited intellectual disability and non-idiopathic autism. Individuals with FXS present with a behavioral phenotype of specific and selective deficits in an array of cognitive skills. Disruption of number processing and arithmetic abilities in higher-functioning adults and female adolescents with FXS has been well established. Still, both numerical skills and developmentally antecedent cognitive processes have just begun to be investigated in toddlers with FXS. The goal of the current study was to assess how very young children with FXS respond to ordinal relationships among numerical magnitudes. METHODS Infrared eye-tracking was used to explore infants' novelty recognition during passive viewing of ordinal numerical sequences; t-tests were used to analyze group differences in looking time. RESULTS Ordinal recognition of numerical magnitudes is significantly impaired in young toddlers with FXS. CONCLUSIONS This study is the first to experimentally evaluate early number sense and ordinal recognition in toddlers with FXS, and our findings reveal that ordinal recognition of numerical magnitudes is significantly impaired in young toddlers with FXS, suggesting that later arithmetic impairments associated with FXS may have their origins in a developmental impairment of this more basic aspect of numerical cognition.
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Affiliation(s)
- Emily R Owen
- Department of Psychology, 1 Shields Avenue, University of California, Davis, CA 95616, USA
- University of California, Davis Center for Mind and Brain, 267 Cousteau Pl., Davis, CA 95618, USA
| | - Heidi A Baumgartner
- Department of Psychology, 1 Shields Avenue, University of California, Davis, CA 95616, USA
- University of California, Davis Center for Mind and Brain, 267 Cousteau Pl., Davis, CA 95618, USA
| | - Susan M Rivera
- Department of Psychology, 1 Shields Avenue, University of California, Davis, CA 95616, USA
- University of California, Davis Center for Mind and Brain, 267 Cousteau Pl., Davis, CA 95618, USA
- M.I.N.D. Institute, University of California Davis Medical Center, 2825 50th St., Sacramento, CA 95817, USA
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Keehn B, Müller RA, Townsend J. Atypical attentional networks and the emergence of autism. Neurosci Biobehav Rev 2013; 37:164-83. [PMID: 23206665 PMCID: PMC3563720 DOI: 10.1016/j.neubiorev.2012.11.014] [Citation(s) in RCA: 229] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 10/22/2012] [Accepted: 11/23/2012] [Indexed: 10/27/2022]
Abstract
The sociocommunicative impairments that define autism spectrum disorder (ASD) are not present at birth but emerge gradually over the first two years of life. In typical development, basic attentional processes may provide a critical foundation for sociocommunicative abilities. Therefore early attentional dysfunction in ASD may result in atypical development of social communication. Prior research has demonstrated that persons with ASD exhibit early and lifelong impairments in attention. The primary aim of this paper is to provide a review of the extant research on attention in ASD using a framework of functionally independent attentional networks as conceptualized by Posner and colleagues: the alerting, orienting and executive control networks (Posner and Petersen, 1990; Petersen and Posner, 2012). The neural substrates and typical development of each attentional network are briefly discussed, a review of the ASD attention literature is presented, and a hypothesis is proposed that links aberrant attentional mechanisms, specifically impaired disengagement of attention, with the emergence of core ASD symptoms.
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Affiliation(s)
- Brandon Keehn
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA.
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Wass S, Scerif G, Johnson M. Training attentional control and working memory – Is younger, better? DEVELOPMENTAL REVIEW 2012. [DOI: 10.1016/j.dr.2012.07.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cornish K, Roberts JE, Scerif G. Editorial: capturing developmental trajectories of change in persons with intellectual and developmental disability. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2012; 117:83-86. [PMID: 22515823 DOI: 10.1352/1944-7558-117.2.83] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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