A review of embodiment in autism spectrum disorders

Figurative language processing in autism spectrum disorders: A review

Impairments in the broader domain of pragmatics are considered to be a defining feature of Autism Spectrum Disorders (ASD). A challenging aspect of pragmatic competence is the ability to process nonliteral language. Interestingly, previous studies in figurative language comprehension in ASD have demonstrated conflicting results regarding participants' performance. The main scientific debate focuses on the underlying skills which facilitate processing of nonliteral speech in ASD. Namely, Theory of Mind (ToM), language abilities and Executive functions (EFs) are regarded as factors affecting autistic individuals' performance. This review addresses figurative language comprehension in ASD in light of the above three interpretive accounts. We reviewed data from recent studies in this field concluding that autistic children indeed encounter systematic difficulties in the processing of non-literal language. Moreover, only ToM and verbal skills were found to correlate the most with figurative language comprehension in ASD. Notably, we found that differences related to research methodology and tasks' properties may have led to discrepancies between studies' results. Finally, we argue that future studies should encompass in their experimental design figurative comprehension tasks with minimal linguistic demands and also measures of ToM, verbal ability and EFs in order to shed more light in the independent contribution of those skills to the processing of nonliteral language in ASD.

Measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in persons on the autism spectrum: A preliminary Rasch analysis

BACKGROUND

Persons on the autism spectrum exhibit poorer body awareness than neurotypical persons. Since movement quality may be regarded as an expression of body awareness, assessment of movement quality is important. Sound assessments of measurement properties are essential if reliable decisions about body awareness interventions for persons on the autism spectrum are to be made, but there is insufficient research.

OBJECTIVE

To assess measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in an autism and a neurotypical reference group.

METHODS

Persons on the autism spectrum (n=108) and neurotypical references (n=32) were included. All were assessed with BAS MQ. Data were analyzed according to the Rasch model.

RESULTS

BAS MQ was found to have acceptable unidimensionality, supported by the fit statistics. The hierarchical ordering showed that coordination ability was the most difficult, followed by stability and relating. Response category functioning worked as intended for 19 out of 23 items. There were few difficult items, which decreased targeting. Reliability measures were good. BAS MQ discriminated between the autism and the reference groups, with the autism group exhibiting poorer movement quality, reflecting clinical observations and previous research.

CONCLUSIONS

BAS MQ was found to have acceptable measurement properties, though suffering from problems with targeting item difficulty to person ability for persons on the autism spectrum. The BAS MQ may, along with experienced movement quality, contribute to clinically relevant information of persons on the autism spectrum, although we encourage refinements and further analyses to improve its measurement properties.

"There's No Separating My View of My Body from My Autism": A qualitative study of positive body image in autistic individuals

While scholars have investigated positive body image across diverse populations, extant theory largely excludes those with differing socio-cognitive experiences, such as autistic individuals. Using constructivist grounded theory, this study sought to develop a grounded theory of positive body image in autistic individuals. One-to-one interviews with photo-elicitation were conducted with 20 autistic adults (7 women, 8 men, 5 non-binary/agender; aged 18-53 years) from the United Kingdom. Through a process of open, axial, and focused coding, a grounded theory was developed around a core category of positive body image in autistic adults and was found to comprise six themes: body connection, body acceptance, appreciating body functionality and neurodivergent strengths, having a body-positive protective filter, taking care of the body, and body and appearance neutrality. Our findings suggest that some aspects of positive body image in autistic individuals are consistent with those found in neurotypical adults. However, positive body image in autistic individuals further encompasses both the sensory (i.e., how the body is felt) and aesthetic (i.e., how the body is seen) body. These findings may stimulate research aimed at improving positive body image in autistic populations.

Theoretical-Methodological Foundations for the Global Integration Method (Método de Integração Global-MIG) in the Treatment of Autism Spectrum Disorder

Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention has been paid to motor and environmental reactivity aspects (behavior/interest restriction and sensory reactivity). The evidence rationale for the Global Integration Method (MIG, "Método de Integração Global"), a model addressing sensorimotor reactivity in addition to socio-communication, is presented. MIG is an integrative, interdisciplinary, family-oriented intervention and naturalistic program that addresses all levels and moderating factors of ASD's impact. MIG's theoretical rationale is based on the predictive coding impairment and embodied cognition hypotheses. MIG incorporates both bottom-up (flexible therapeutic suit, social-motor synchronization) and top-down (schematic social information processing, narratives, imagery) strategies to promote the building and use of accurate, flexible and context-sensitive internal predictive models. MIG is based on the premises that predictive coding improves both socio-communication and environmental reactivity, and that the postural stabilization provided by the flexible therapeutic suit frees information processing resources for socio-cognitive learning. MIG builds on interdisciplinary, professionally and parentally mediated work based on behavioral principles of intensive training in a situated environment.

Word learning in ASD: the sensorimotor, the perceptual and the symbolic

Word learning requires successful pairing of form and meaning. A common hypothesis about the process of word learning is that initially, infants work on identifying the phonological segments corresponding to words (speech analysis), and subsequently map those segments onto meaning. A range of theories have been proposed to account for the underlying mechanisms and factors in this remarkable achievement. While some are mainly concerned with the sensorimotor affordances and perceptual properties of referents out in the world, other theories emphasize the importance of language as a system, and the relations among language units (other words or syntax). Recent approaches inspired by neuro-science suggest that the storage and processing of word meanings is supported by neural systems subserving both the representation of conceptual knowledge and its access and use (Lambon Ralph et al., Nature Reviews Neuroscience 18:42–55, 2017). Developmental disorders have been attested to impact on different aspects of word learning. While impaired word knowledge is not a hallmark of Autism Spectrum Disorder (ASD), and remains largely understudied in this population, there is evidence that there are, sometimes subtle, problems in that domain, reflected in both how such knowledge is acquired and how words are used (Vulchanova et al., Word knowledge and word usage: A cross-disciplinary guide to the mental lexicon, Mouton De Gruyter, 2020). In addition, experimental evidence suggests that children with autism present with specific problems in categorizing the referents of linguistic labels leading to subsequent problems with using those labels (Hartley and Allen, Autism 19:570–579, 2015). Furthermore, deficits have been reported in some of the underlying mechanisms, biases and use of cues in word learning, such as e.g., object shape (Field et al., Journal of Autism and Developmental Disorders 46:1210–1219, 2016; Tek et al., Autism Research 1:208–222, 2008). Finally, it is likely that symbol use might be impaired in ASD, however, the direction of the causal relationship between social and communication impairment in autism and symbolic skills is still an open question (Allen and Lewis, Journal of Autism and Developmental Disorders 45:1–3, 2015; Allen and Butler, British Journal of Developmental Psychology 38:345–362, 2020; Wainwright et al., Journal of Autism and Developmental Disorders 50:2941–2956, 2020). Further support for impaired symbol formation in autism comes from the well-attested problems with figurative, non-literal language use (e.g., metaphors, idioms, hyperbole, irony) (Vulchanova et al., Frontiers in Human Neuroscience 9:24, 2015). Here we propose that embodied theories of cognition which link perceptual experience with conceptual knowledge (see Eigsti, Frontiers in Psychology 4:224, 2013; Klin et al., Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 358:345–360, 2003) might be useful in explaining the difficulty in symbolic understanding that individuals with autism face during the word learning process.

The multimodal facilitation effect in human communication

During face-to-face communication, recipients need to rapidly integrate a plethora of auditory and visual signals. This integration of signals from many different bodily articulators, all offset in time, with the information in the speech stream may either tax the cognitive system, thus slowing down language processing, or may result in multimodal facilitation. Using the classical shadowing paradigm, participants shadowed speech from face-to-face, naturalistic dyadic conversations in an audiovisual context, an audiovisual context without visual speech (e.g., lips), and an audio-only context. Our results provide evidence of a multimodal facilitation effect in human communication: participants were faster in shadowing words when seeing multimodal messages compared with when hearing only audio. Also, the more visual context was present, the fewer shadowing errors were made, and the earlier in time participants shadowed predicted lexical items. We propose that the multimodal facilitation effect may contribute to the ease of fast face-to-face conversational interaction.

EEG resting-state functional connectivity: evidence for an imbalance of external/internal information integration in autism

Background

Autism spectrum disorder (ASD) is associated with atypical neural activity in resting state. Most of the studies have focused on abnormalities in alpha frequency as a marker of ASD dysfunctions. However, few have explored alpha synchronization within a specific interest in resting-state networks, namely the default mode network (DMN), the sensorimotor network (SMN), and the dorsal attention network (DAN). These functional connectivity analyses provide relevant insight into the neurophysiological correlates of multimodal integration in ASD.

Methods

Using high temporal resolution EEG, the present study investigates the functional connectivity in the alpha band within and between the DMN, SMN, and the DAN. We examined eyes-closed EEG alpha lagged phase synchronization, using standardized low-resolution brain electromagnetic tomography (sLORETA) in 29 participants with ASD and 38 developing (TD) controls (age, sex, and IQ matched).

Results

We observed reduced functional connectivity in the ASD group relative to TD controls, within and between the DMN, the SMN, and the DAN. We identified three hubs of dysconnectivity in ASD: the posterior cingulate cortex, the precuneus, and the medial frontal gyrus. These three regions also presented decreased current source density in the alpha band.

Conclusion

These results shed light on possible multimodal integration impairments affecting the communication between bottom-up and top-down information. The observed hypoconnectivity between the DMN, SMN, and DAN could also be related to difficulties in switching between externally oriented attention and internally oriented thoughts.

Supplementary Information

The online version contains supplementary material available at 10.1186/s11689-022-09456-8.

Auditory perceptual learning in autistic adults

The automatic retuning of phoneme categories to better adapt to the speech of a novel talker has been extensively documented across various (neurotypical) populations, including both adults and children. However, no studies have examined auditory perceptual learning effects in populations atypical in perceptual, social, and language processing for communication, such as populations with autism. Employing a classic lexically-guided perceptual learning paradigm, the present study investigated perceptual learning effects in Australian English autistic and non-autistic adults. The findings revealed that automatic attunement to existing phoneme categories was not activated in the autistic group in the same manner as for non-autistic control subjects. Specifically, autistic adults were able to both successfully discern lexical items and to categorize speech sounds; however, they did not show effects of perceptual retuning to talkers. These findings may have implications for the application of current sensory theories (e.g., Bayesian decision theory) to speech and language processing by autistic individuals. LAY SUMMARY: Lexically guided perceptual learning assists in the disambiguation of speech from a novel talker. The present study established that while Australian English autistic adult listeners were able to successfully discern lexical items and categorize speech sounds in their native language, perceptual flexibility in updating speaker-specific phonemic knowledge when exposed to a novel talker was not available. Implications for speech and language processing by autistic individuals as well as current sensory theories are discussed.

Autism and the Sensory Disruption of Social Experience

Autism research has recently witnessed an embodied turn. In response to the cognitivist approaches dominating the field, phenomenological scholars have suggested a reconceptualization of autism as a disorder of embodied intersubjectivity. Part of this interest in autistic embodiment concerns the role of sensory differences, which have recently been added to the diagnostic criteria of autism. While research suggests that sensory differences are implicated in a wide array of autistic social difficulties, it has not yet been explored how sensory and social experience in autism relate on a phenomenological level. Given the importance of the sensory dimension of social encounters in phenomenological analyses of autism, this question must be considered crucial. This article investigates the role played by sensory differences in autistic social experience. Through a phenomenological analysis informed primarily by the philosophy of Maurice Merleau-Ponty with particular emphasis on the relation between intersubjectivity and perception, I argue that sensory differences affect the way other people appear in autistic experience on a pre-reflective level. By drawing on autistic young adults’ experiential descriptions of social encounters, this article identifies three aspects of how sensory differences affect social experiences in autism. First, social encounters manifested as sensorially disturbing, chaotic, and unpredictable events. Second, the embodied expressions of others appeared unfamiliar, threatening, and promoted a sense of detachment from the social world. Third, deliberate practices were employed to actively seek perceptual and social meaning in these disorienting social encounters. This analysis stresses the importance of understanding embodied intersubjectivity through its sensory dimensions. In addition, it indicates an important avenue for future research in exploring the potential role of practice in maintaining an intuitive grip on social meaning. By approaching social encounters as sensory and perceptual events, I emphasize how social difficulties in autism are inherently world-involving phenomena rather than a cognitive deficit reducible to the autistic person.

'They ask no questions and pass no criticism': A mixed-methods study exploring pet ownership in autism

Many autistic people cite a strong attachment to animals, and some studies suggest they may even show a bias towards animals over people. This mixed-methods study explored companion animal attachment in the adult autistic community. In a quantitative study with 735 people, we found that autistic adults were equally attached to their pets as neurotypicals but were less likely to own them, even though pet ownership corresponded with better mental health outcomes. Substituting pets for people also served as a compensatory mechanism for social contact in the autistic sample. In a second qualitative study, we explored the lived experiences of 16 autistic pet owners. The interpretive phenomenological analysis highlighted the benefits and the barriers to animal companionship. Together these mixed methods findings underline how pets improve the lives of their autistic owners. We conclude with specific recommendations for increasing animal companionship opportunities for autistic adults.

The development and psychometric assessment of communication skills checklist for 6- to 24-month-old Persian children

Prelinguistic skills play an important role in children's communication development. These skills are considered as significant bases for language acquisition and function conductive to later social development. Means of communication, communicative functions, skills with cognitive bases, and language comprehension are important prelinguistic skills. There is a critical period for acquiring prelinguistic skills and early identification of communication deficits is an important issue to be considered. The present study aimed to develop a communication skills checklist for Persian children aged 6- to 24-month-old and evaluate its psychometric properties. Parents of 277 Persian children aged 6- to 24-month-old participated in the current study. A checklist was first developed after an extensive literature review and various psychometric analyses in addition to regression analyses were carried out to determine its validity and reliability. The final checklist contained 36 items with high face validity and content validity (CVI > 0.62, CVR > 0.79). Also, the checklist demonstrated a high association with the CNCS (Pearson's correlation coefficient = 0.85, p < 0.001), and the construct validity showed significant differences between the four age groups (F-test = 197.881, p < 0.001). The results of the internal consistency measurement (Cronbach's alpha coefficient = 0.952) and the test-retest reliability test (ICC = 0.933, p < 0.001) revealed excellent reliability of the checklist. In conclusion, based on the psychometric assessment, this checklist is a promising tool for assessing communication skills in Persian children aged 6 to 24 months.

Content validity of an instrument for motor assessment of youth with autism

Abstract Introduction Children and adolescents with autism spectrum disorder (ASD) present motor disorders that have been the focus of physical therapy interventions. However, the standardized motor assessments available in the literature have important gaps, among them the complexity of the tasks evaluated and the absence of qualitative information about the subjects' performance. Objective To develop and evaluate the content validity of the Gross Motor Assessment of Children and Adolescents with ASD checklist (GMA-AUT checklist). Methods The GMA-AUT checklist was sent to a committee of experts for content validation. The content validity index (CVI) was used to assess the degree of agreement between the experts. To verify the content validity of the checklist, the minimal acceptable CVI was 0.80. Results Based on the suggestions made, the GMA-AUT was reformulated and submitted to the same panel of experts for reassessment. In the second and final draft of the checklist, only two items had a CVI of 0.88, while all others reached a CVI of 1.00. Conclusion The GMA-AUT checklist presents adequate content validity for assessing gross motor in children and adolescents with ASD according to experts in the field.

Feelings first? Sex differences in affective and cognitive processes in emotion recognition

The recognition of emotional expressions is important for social understanding and interaction, but findings on the relationship between emotion recognition, empathy, and theory of mind, as well as sex differences in these relationships, have been inconsistent. This may reflect the relative involvement of affective and cognitive processes at different stages of emotion recognition and in different experimental paradigms. In this study, images of faces were morphed from neutral to full expression of five basic emotions (anger, disgust, fear, happiness, and sadness), which participants were asked to identify as quickly and accurately as possible. Accuracy and response times from healthy males (n = 46) and females (n = 43) were analysed in relation to self-reported empathy (Empathy Quotient; EQ) and mentalising/theory of mind (Reading the Mind in the Eyes Test). Females were faster and more accurate than males in recognising dynamic emotions. Linear mixed-effects modelling showed that response times were inversely related to the emotional empathy subscale of the EQ, but this was accounted for by a female advantage on both measures. Accuracy was unrelated to EQ scores but was predicted independently by sex and Eyes Test scores. These findings suggest that rapid processing of dynamic emotional expressions is strongly influenced by sex, which may reflect the greater involvement of affective processes at earlier stages of emotion recognition.

Brief Report: Preferred Processing of Social Stimuli in Autism: A Perception Task

In this study we investigate whether persons with autism spectrum disorder (ASD) perceive social images differently than control participants (CON) in a graded perception task in which stimuli emerged from noise before dissipating into noise again. We presented either social stimuli (humans) or non-social stimuli (objects or animals). ASD were slower to recognize images during their emergence, but as fast as CON when indicating the dissipation of the image irrespective of its content. Social stimuli were recognized faster and remained discernable longer in both diagnostic groups. Thus, ASD participants show a largely intact preference for the processing of social images. An exploratory analysis of response subsets reveals subtle differences between groups that could be investigated in future studies.

Motor Skill Differences in Autism Spectrum Disorder: a Clinically Focused Review

PURPOSE OF REVIEW

This review synthesizes recent, clinically relevant findings on the scope, significance, and centrality of motor skill differences in autism spectrum disorder (ASD).

RECENT FINDINGS

Motor challenges in ASD are pervasive, clinically meaningful, and highly underrecognized, with up to 87% of the autistic population affected but only a small percentage receiving motor-focused clinical care. Across development, motor differences are associated with both core autism symptoms and broader functioning, though the precise nature of those associations and the specificity of motor profiles to ASD remain unestablished. Findings suggest that motor difficulties in ASD are quantifiable and treatable, and that detection and intervention efforts targeting motor function may also positively influence social communication. Recent evidence supports a need for explicit recognition of motor impairment within the diagnostic framework of ASD as a clinical specifier. Motor differences in ASD warrant greater clinical attention and routine incorporation into screening, evaluation, and treatment planning.

Patterns of Contagious Yawning and Itching Differ Amongst Adults With Autistic Traits vs. Psychopathic Traits

Both individuals with diagnosed with Autism Spectrum Disorder (ASD) and individuals high in psychopathic traits show reduced susceptibility to contagious yawning; that is, yawning after seeing or hearing another person yawn. Yet it is unclear whether the same underlying processes (e.g., reduced eye gaze) are responsible for the relationship between reduced contagion and these very different types of clinical traits. College Students (n = 97) watched videos of individuals yawning or scratching (a form of contagion not reliant on eye gaze for transmission) while their eye movements were tracked. They completed the Interpersonal Reactivity Index (IRI), the Autism-Spectrum Quotient (AQ), the Psychopathy Personality Inventory-Revised (PPI-R), and the Adolescent and Adult Sensory Processing Disorder Checklist. Both psychopathic traits and autistic traits showed an inverse relationship to contagious yawning, consistent with previous research. However, the relationship between autistic (but not psychopathic) traits and contagious yawning was moderated by eye gaze. Furthermore, participants high in autistic traits showed typical levels of contagious itching whereas adults high in psychopathic traits showed diminished itch contagion. Finally, only psychopathic traits were associated with lower overall levels of empathy. The findings imply that the underlying processes contributing to the disruptions in contagious yawning amongst individuals high in autistic vs. psychopathic traits are distinct. In contrast to adults high in psychopathic traits, diminished contagion may appear amongst people with high levels of autistic traits secondary to diminished attention to the faces of others, and in the absence of a background deficit in emotional empathy.

The Autism-Competency-Group (AutCom). A promising approach to promote social skills in adults with autism spectrum disorder and intellectual disability

Autism spectrum disorders (ASD) are often associated with intellectual disability (ID). ASD-specific group concepts usually focus on people on a high functioning level. The Autism-Competence-Group (AutCom) combines a psycho-educative approach with music and dance/movement interventions in adults with ASD and ID. AutCom includes 16 structured 90-minute sessions to foster social and emotional competencies. This study investigates the acceptability and effectiveness of AutCom. Practicability and acceptability were measured based on participation frequency and patient satisfaction (CSQ-8). Efficacy was assessed in a pre-post design (N = 12) based on self- and third-party assessment with a control group matched by gender and level of ID. Primary outcome variables were social and emotional competence, and secondary outcomes were challenging behavior and quality of life. A participation rate of 86% indicated practicability; high CSQ-8 scores (M = 30 of max. 32) indicated acceptability. Significant improvement was found in social competence compared to the control group and emotional competence in the pre-post self-assessment on the AutCom questionnaire. No significant improvement was found in challenging behavior and quality of life. AutCom is shown to be a promising and highly accepted group concept in fostering social and emotional skills in adults with ASD and ID.

Interactional Synchrony and Its Association with Social and Communication Ability in Children With and Without Autism Spectrum Disorder

Social partners tend to coordinate their behaviors in time. This "interactional synchrony" is associated with a host of positive social outcomes, making it ripe for study in autism spectrum disorder (ASD). Twenty children with ASD and 17 typically developing (TD) children participated in conversations with familiar and unfamiliar adults. Conversations were rated for movement synchrony and verbal synchrony, and mothers completed measures regarding children's everyday social and communication skills. Children with ASD exhibited less interactional synchrony, with familiar and unfamiliar partners, than TD peers. Beyond group-level differences, interactional synchrony negatively correlated with autism symptom severity, and predicted dimensional scores on established social and communication measures. Results suggest that disrupted interactional synchrony may be associated with impaired social functioning in ASD.

Emotional prosody recognition in children with high-functioning autism under the influence of emotional intensity: Based on the perspective of emotional dimension theory

This paper investigated the ability of Mandarin-speaking children with high-functioning autism (HFA) to recognize the four categories of emotional prosody, namely, happiness, anger, sadness and fear, in moderate- and high-intensity emotional conditions using auditory discrimination tasks. Thirty-four children with HFA between 5 and 7 years of age and 34 typically developing (TD) controls participated in this study. In moderate-intensity conditions, children with HFA scored lower than TD children in the recognition of the four categories of emotional prosody, indicating an overall impairment. With an increase in the intensity of emotion, children with HFA showed improved accuracy for anger, decreased accuracy for happiness, but no change in accuracy for either sadness or fear. An analysis of error patterns demonstrated that unlike TD children, children with HFA were inclined to mistake happiness for anger, with the two categories differing in valence, and this inclination deepened as the intensity increased. In discriminating between sadness and fear, which have a slight arousal difference, both groups showed difficulty in moderate-intensity conditions. In high-intensity conditions, TD children were inclined to perceive stimuli as exhibiting fear, which demonstrates comparatively high arousal; thus, they were more accurate for fear, while HFA children were not sensitive to increases in arousal, showing no noticeable effect. These findings indicated that children with HFA have a mechanism distinct from that of TD children in emotional prosody recognition, exhibiting various degrees of impairment in this regard.

Scaling of Early Social Cognitive Skills in Typically Developing Infants and Children with Autism Spectrum Disorder

We delineate the sequence that typically developing infants pass tasks that assess different early social cognitive skills considered precursors to theory-of-mind abilities. We compared this normative sequence to performance on these tasks in a group of autistic (AUT) children. 86 infants were administered seven tasks assessing intention reading and shared intentionality (Study 1). Infants responses followed a consistent developmental sequence, forming a four-stage scale. These tasks were administered to 21 AUT children (Study 2), who passed tasks in the same sequence. However, performance on tasks that required following others' eye gaze and cooperating with others was delayed. Findings indicate that earlier-developing skills provide a foundation for later-developing skills, and difficulties in acquiring some early social cognitive skills in AUT children.

Visual-Tactile Spatial Multisensory Interaction in Adults With Autism and Schizophrenia

Background: Individuals with autism spectrum disorder (ASD) and schizophrenia (SZ) exhibit multisensory processing difficulties and social impairments, with growing evidence that the former contributes to the latter. However, this work has largely reported on separate cohorts, introducing method variance as a barrier to drawing broad conclusions across studies. Further, very few studies have addressed touch, resulting in sparse knowledge about how these two clinical groups may integrate somatic information with other senses. Methods: In this study, we compared adults with ASD (n = 29), SZ (n = 24), and typical developmental histories (TD, n = 37) on two tasks requiring visual-tactile spatial multisensory processing. In the first task (crossmodal congruency), participants judged the location of a tactile stimulus in the presence or absence of simultaneous visual input that was either spatially congruent or incongruent, with poorer performance for incongruence an index of spatial multisensory interaction. In the second task, participants reacted to touch in the presence or absence of dynamic visual stimuli that appeared to approach or recede from the body. Within a certain radius around the body, defined as peripersonal space (PPS), an approaching visual or auditory stimulus reliably speeds reaction times (RT) to touch; outside of this radius, in extrapersonal space (EPS), there is no multisensory effect. PPS can be defined both by its size (radius) and slope (sharpness of the PPS-EPS boundary). Clinical measures were administered to explore relations with visual-tactile processing. Results: Neither clinical group differed from controls on the crossmodal congruency task. The ASD group had significantly smaller and more sharply-defined PPSs compared to the other two groups. Small PPS size was related to social symptom severity across groups, but was largely driven by the TD group, without significant effects in either clinical group. Conclusions: These results suggest that: (1) spatially static visual-tactile facilitation is intact in adults with ASD and SZ, (2) spatially dynamic visual-tactile facilitation impacting perception of the body boundary is affected in ASD but not SZ, and (3) body boundary perception is related to social-emotional function, but not in a way that maps on to clinical status.

Focusing: A new challenger for improving the empathy skills of medical students

OBJECTIVES

Studies of empathy among medical students reported an alarming significant decline during medical education. Some authors identified the third year of education as the most problematic one: empathy decreased significantly when the curriculum was shifting to patient-care activities. Scientists have tried to address the means and methods for improving empathy skills (e.g., by improving communication abilities), but investigations on this topic are missing. Based on the Damasio's hypothesis and scientific studies, we assume that Focusing (i.e., an embodied practice where one attends to a bodily felt sense and uses it to understand the self and situations) would be significantly and positively linked to empathy.

METHOD

After their clinical internships, we selected third-year medical students (N = 121) and asked them to complete three questionnaires assessing empathy, Focusing, and social desirability.

RESULTS

By controlling social desirability, findings confirmed that Focusing (especially the "having access to the felt body" component) was significantly and positively linked with empathy (i.e., Fantasy & Perspective-Taking), and positively predicted Fantasy, Perspective-Taking, and Empathic Concern.

CONCLUSIONS

These preliminary results suggest that the felt body plays a role in increasing empathy (mainly on cognitive empathy). Few scientific studies have described constructs that significantly promote cognitive empathy and empathic concern (a deeply anchored trait of empathy), which suggests new avenues of investigation.

Motor atypicalities in infancy are associated with general developmental level at 2 years, but not autistic symptoms

LAY ABSTRACT

Atypicalities in motor functioning are often observed in later born infant siblings of children with autism spectrum disorder. The goal of our study was to investigate motor functioning in infants with and without familial history of autism spectrum disorder. Specifically, we investigated how infants catch a ball that is rolling toward them following a non-straight path, a task that requires both efficient planning and execution. Their performance was measured using detailed three-dimensional motion capture technology. We found that several early motor functioning measures were different in infants with an older autistic sibling compared to controls. However, these early motor measures were not related to autistic symptoms at the age of 2 years. Instead, we found that some of the early motor measures were related to their subsequent non-social, general development. The findings of our study help us understand motor functioning early in life and how motor functioning is related to other aspects of development.

The Right Temporoparietal Junction Is Causally Associated with Embodied Perspective-taking

A prominent theory claims that the right temporoparietal junction (rTPJ) is especially associated with embodied processes relevant to perspective-taking. In the present study, we use high-definition transcranial direct current stimulation to provide evidence that the rTPJ is causally associated with the embodied processes underpinning perspective-taking. Eighty-eight young human adults were stratified to receive either rTPJ or dorsomedial PFC anodal high-definition transcranial direct current stimulation in a sham-controlled, double-blind, repeated-measures design. Perspective-tracking (line-of-sight) and perspective-taking (embodied rotation) were assessed using a visuo-spatial perspective-taking task that required understanding what another person could see or how they see it, respectively. Embodied processing was manipulated by positioning the participant in a manner congruent or incongruent with the orientation of an avatar on the screen. As perspective-taking, but not perspective-tracking, is influenced by bodily position, this allows the investigation of the specific causal role for the rTPJ in embodied processing. Crucially, anodal stimulation to the rTPJ increased the effect of bodily position during perspective-taking, whereas no such effects were identified during perspective-tracking, thereby providing evidence for a causal role for the rTPJ in the embodied component of perspective-taking. Stimulation to the dorsomedial PFC had no effect on perspective-tracking or taking. Therefore, the present study provides support for theories postulating that the rTPJ is causally involved in embodied cognitive processing relevant to social functioning.SIGNIFICANCE STATEMENT The ability to understand another's perspective is a fundamental component of social functioning. Adopting another perspective is thought to involve both embodied and nonembodied processes. The present study used high-definition transcranial direct current stimulation (HD-tDCS) and provided causal evidence that the right temporoparietal junction is involved specifically in the embodied component of perspective-taking. Specifically, HD-tDCS to the right temporoparietal junction, but not another hub of the social brain (dorsomedial PFC), increased the effect of body position during perspective-taking, but not tracking. This is the first causal evidence that HD-tDCS can modulate social embodied processing in a site-specific and task-specific manner.

Complementary and Alternative Treatments for Autism Spectrum Disorders: A Review for Parents and Clinicians

Complementary and alternative therapy (CAT) methods for children with autism spectrum disorders (ASD) are widespread in European countries and the Russian Federation; however, their efficacy and safety is not routinely considered by parents and clinicians when recommended or used. The current narrative review presents the most widely known CAT interventions for children with ASD synthesizing data from meta-analyses, systematic reviews, and randomized controlled trials obtained from the PubMed database based on the safety-efficacy model. We have found that, of the reviewed CATs, only the melatonin intervention can be considered safe and effective for children with ASD with comorbid sleep problems. The methods that were classified as safe but had inconclusive efficacy are recommended to be implemented only when they do not interfere with front line treatment for ASD, Applied Behavior Analysis (ABA). Methods with the lack of current evidence for the efficacy such as auditory integration therapies, bioacoustic correction, sensory integration therapy, micropolarization, animal assisted therapy, and dietary interventions should not be recommended as alternative treatments and can only be used as complimentary to ABA-based interventions. We advise against the use of chelation, hyperbaric oxygen therapy, and holding therapy due their documented harmful psychological and physical effects. When considering CAT for ASD we recommend parents and clinicians use the criteria suggested by Lofthouse and colleagues [59]: only the therapies that are safe, easy, cheap, and sensible can be recommended and used, as opposed to therapies that are risky, unrealistic, difficult, or expensive that should not be recommended or utilized.

Degree and not type of iconicity affects sign language vocabulary acquisition

Lexical iconicity-signs or words that resemble their meaning-is overrepresented in children's early vocabularies. Embodied theories of language acquisition predict that symbols are more learnable when they are grounded in a child's firsthand experiences. As such, pantomimic iconic signs, which use the signer's body to represent a body, might be more readily learned than other types of iconic signs. Alternatively, the structure mapping theory of iconicity predicts that learners are sensitive to the amount of overlap between form and meaning. In this exploratory study of early vocabulary development in American Sign Language (ASL), we asked whether type of iconicity predicts sign acquisition above and beyond degree of iconicity. We also controlled for concreteness and relevance to babies, two possible confounding factors. Highly concrete referents and concepts that are germane to babies may be amenable to iconic mappings. We reanalyzed a previously published set of ASL Communicative Development Inventory (CDI) reports from 58 deaf children learning ASL from their deaf parents (Anderson & Reilly, 2002). Pantomimic signs were more iconic than other types of iconic signs (perceptual, both pantomimic and perceptual, or arbitrary), but type of iconicity had no effect on acquisition. Children may not make use of the special status of pantomimic elements of signs. Their vocabularies are, however, shaped by degree of iconicity, which aligns with a structure mapping theory of iconicity, though other explanations are also compatible (e.g., iconicity in child-directed signing). Previously demonstrated effects of type of iconicity may be an artifact of the increased degree of iconicity among pantomimic signs. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Evaluating the interplay between subclinical levels of mental health symptoms and coordination dynamics

Viewed under the broad theoretical umbrella of an embodied-embedded approach to psychological activity, body movements can be seen to play an essential role in shaping social interaction. Of note, research concerning the embodiment of social cognition has documented key differences in non-verbal behaviour during social interaction for individuals diagnosed with a range of disorders, including social anxiety disorder and autism spectrum disorder. The present work sets out to extend these findings by better understanding the interplay between subclinical variation in psychopathology and social-motor coordination, a key component of effective interaction. We asked participants, in pairs, to swing hand-held pendula that varied in their intrinsic movement characteristics. Extending previous clinically oriented work (Varlet et al., 2014, Frontiers in Behavioral Neuroscience, 8, 29), our results indicated that subclinical variation in mental health status was predictive of disruption to the patterns of coordination dynamics that characterize effective social exchange. This work provides further evidence for the utility of theorizing social interaction as a self-organizing dynamical system and strengthens support for the claim that disruption to interpersonal coordination may act as an embodied-embedded marker of variation in mental health.

Reviews of Social Embodiment for Design of Non-Player Characters in Virtual Reality-Based Social Skill Training for Autistic Children

The purpose of this paper is to review the scholarly works regarding social embodiment aligned with the design of non-player characters in virtual reality (VR)-based social skill training for autistic children. VR-based social skill training for autistic children has been a naturalistic environment, which allows autistic children themselves to shape socially-appropriate behaviors in real world. To build up the training environment for autistic children, it is necessary to identify how to simulate social components in the training. In particular, designing non-player characters (NPCs) in the training is essential to determining the quality of the simulated social interactions during the training. Through this literature review, this study proposes multiple design themes that underline the nature of social embodiment in which interactions with NPCs in VR-based social skill training take place.

Balance Performance in Autism: A Brief Overview

Children with autism not only have limited social and communicative skills but also have motor abnormalities, such as poor timing and coordination of balance. Moreover, impaired gross motor skills hamper participation with peers. Balance control is interesting from a cognitive science perspective, since it involves a complex interplay between information processing, motor planning, and timing and sequencing of muscle movements. In this paper, we discuss the background of motor problems in children with autism, focusing on how posture is informed by sensory information processing. We also discuss the neurobiological basis of balance problems, and how this is related to anxiety in this group. We then discuss possible avenues for treatment of autism spectrum disorder (ASD) symptoms, especially as regards movement-related interventions. Finally, we present a theoretical outlook and discuss whether some of the symptoms in ASD can be understood from an embodied cognition perspective.

Dissociation between executed and imagined bimanual movements in autism spectrum conditions

Autism spectrum conditions (ASC) are characterized by social-communicative deficits and repetitive stereotyped behaviors. Altered motor coordination is also observed and a dysfunction of motor imagery has been recently reported on implicit tasks. However, no information on explicit motor imagery abilities is available in ASC. Here, we employed a spatial bimanual task to concurrently assess motor coordination and explicit motor imagery in autism. A secondary objective of the study was to evaluate these abilities across two populations of ASC, namely adolescents and adults with ASC. To this aim, we took advantage of the circles-lines task in which where participants were asked to continuously draw: right hand lines (unimanual condition); right hand lines and left hand circles (bimanual condition); right hand lines while imagining to draw left hand circles (imagery condition). For each participant, an Ovalization Index (OI) was calculated as a deviation of the right hand drawing trajectory from an absolute vertical axis. Results showed a significant and similar coupling effect in the bimanual condition (i.e., a significant increase of the OI values with respect to the unimanual condition) in both controls and ASC participants. On the contrary, in the imagery condition, a significant coupling effect was found only in controls. Furthermore, adult controls showed a significantly higher imagery coupling effect in comparison to all the other groups. These results demonstrate that atypical motor imagery processes in ASC are not limited to implicit tasks and suggest that development of neural structures involved in motor imagery are immature in ASC. Autism Res 2018, 11: 376-384. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

Autism spectrum conditions (ASC) are characterized by social-communicative and motor coordination difficulties but in many cases also by an impaired capability to imagine movements. In this study we found that while two handed coordination in ASC can be developed as well as in typically developed persons, the development of motor imagery could still be immature in ASC, leading to difficulties in imagining, understanding as well as programming and coordinating complex movements.

Can You Play with Fire and Not Hurt Yourself? A Comparative Study in Figurative Language Comprehension between Individuals with and without Autism Spectrum Disorder

Individuals with High functioning autism (HFA) are distinguished by relative preservation of linguistic and cognitive skills. However, problems with pragmatic language skills have been consistently reported across the autistic spectrum, even when structural language is intact. Our main goal was to investigate how highly verbal individuals with autism process figurative language and whether manipulation of the stimuli presentation modality had an impact on the processing. We were interested in the extent to which visual context, e.g., an image corresponding either to the literal meaning or the figurative meaning of the expression may facilitate responses to such expressions. Participants with HFA and their typically developing peers (matched on intelligence and language level) completed a cross-modal sentence-picture matching task for figurative expressions and their target figurative meaning represented in images. We expected that the individuals with autism would have difficulties in appreciating the non-literal nature of idioms and metaphors, despite intact structural language skills. Analyses of accuracy and reaction times showed clearly that the participants with autism performed at a lower level than their typically developing peers. Moreover, the modality in which the stimuli were presented was an important variable in task performance for the more transparent expressions. The individuals with autism displayed higher error rates and greater reaction latencies in the auditory modality compared to the visual stimulus presentation modality, implying more difficulty. Performance differed depending on type of expression. Participants had more difficulty understanding the culturally-based expressions, but not expressions grounded in human experience (biological idioms). This research highlights the importance of stimulus presentation modality and that this can lead to differences in figurative language comprehension between typically and atypically developing individuals. The current study also contributes to current debates on the role of structural language in figurative language comprehension in autism.

"We Dance and Find Each Other"1: Effects of Dance/Movement Therapy on Negative Symptoms in Autism Spectrum Disorder

The treatment of deficits in social interaction, a shared symptom cluster in persons with schizophrenia (negative symptoms) and autism spectrum disorder (DSM-5 A-criterion), has so far remained widely unsuccessful in common approaches of psychotherapy. The alternative approach of embodiment brings to focus body-oriented intervention methods based on a theoretic framework that explains the disorders on a more basic level than common theory of mind approaches. The randomized controlled trial at hand investigated the effects of a 10-week manualized dance and movement therapy intervention on negative symptoms in participants with autism spectrum disorder. Although the observed effects failed to reach significance at the conventional 0.05 threshold, possibly due to an undersized sample, an encouraging trend towards stronger symptom reduction in the treatment group for overall negative symptoms and for almost all subtypes was found at the 0.10-level. Effect sizes were small but clinically meaningful, and the resulting patterns were in accordance with theoretical expectations. The study at hand contributes to finding an effective treatment approach for autism spectrum disorder in accordance with the notion of embodiment.

Body Constraints on Motor Simulation in Autism Spectrum Disorders

Developmental data suggested that mental simulation skills become progressively dissociated from overt motor activity across development. Thus, efficient simulation is rather independent from current sensorimotor information. Here, we tested the impact of bodily (sensorimotor) information on simulation skills of adolescents with Autism Spectrum Disorders (ASD). Typically-developing (TD) and ASD participants judged laterality of hand images while keeping one arm flexed on chest or while holding both arms extended. Both groups were able to mentally simulate actions, but this ability was constrained by body posture more in ASD than in TD adolescents. The strong impact of actual body information on motor simulation implies that simulative skills are not fully effective in ASD individuals.

Facial Feedback and Social Input: Effects on Laughter and Enjoyment in Children with Autism Spectrum Disorders

Both social input and facial feedback appear to be processed differently by individuals with autism spectrum disorder (ASD). We tested the effects of both of these types of input on laughter in children with ASD. Sensitivity to facial feedback was tested in 43 children with ASD, aged 8-14 years, and 43 typically developing children matched for mental age (6-14), in order to examine whether children with ASD use bodily feedback as an implicit source of information. Specifically, children were asked to view cartoons as they normally would (control condition), and while holding a pencil in their mouth forcing their smiling muscles into activation (feedback condition) while rating their enjoyment of the cartoons. The authors also explored the effects of social input in children with ASD by investigating whether the presence of a caregiver or friend (companion condition), or the presence of a laugh track superimposed upon the cartoon (laugh track condition) increased the children's self-rated enjoyment of cartoons or the amount of positive affect they displayed. Results showed that the group with ASD was less affected by all three experimental conditions, but also that group differences seemed to have been driven by one specific symptom of ASD: restricted range of affect. The strong relationship between restricted affect and insensitivity to facial feedback found in this study sheds light on the implications of restricted affect for social development in ASD.

Youth with autism spectrum disorder comprehend lexicalized and novel primary conceptual metaphors

Individuals with autism spectrum disorder (ASD) have difficulty comprehending metaphors. However, no study to date has examined whether or not they understand conceptual metaphors (i.e. mappings between conceptual structures), which could be the building blocks of metaphoric thinking and understanding. We investigated whether 13 participants with ASD (age 7;03-22;03) and 13 age-matched typically developing (TD) controls could comprehend lexicalized conceptual metaphors (e.g., Susan is a warm person) and novel ones (e.g., Susan is a toasty person). Individuals with ASD performed at greater than chance levels on both metaphor types, although their performance was lower than TD participants. We discuss the theoretical relevance of these findings and educational implications.

Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression

Depression is characterized by disturbed sleep and eating, a variety of other nonspecific somatic symptoms, and significant somatic comorbidities. Why there is such close association between cognitive and somatic dysfunction in depression is nonetheless poorly understood. An explosion of research in the area of interoception-the perception and interpretation of bodily signals-over the last decade nonetheless holds promise for illuminating what have until now been obscure links between the social, cognitive-affective, and somatic features of depression. This article reviews rapidly accumulating evidence that both somatic signaling and interoception are frequently altered in depression. This includes comparative studies showing vagus-mediated effects on depression-like behaviors in rodent models as well as studies in humans indicating both dysfunction in the neural substrates for interoception (e.g., vagus, insula, anterior cingulate cortex) and reduced sensitivity to bodily stimuli in depression. An integrative framework for organizing and interpreting this evidence is put forward which incorporates (a) multiple potential pathways to interoceptive dysfunction; (b) interaction with individual, gender, and cultural differences in interoception; and (c) a developmental psychobiological systems perspective, emphasizing likely differential susceptibility to somatic and interoceptive dysfunction across the lifespan. Combined with current theory and evidence, it is suggested that core symptoms of depression (e.g., anhedonia, social deficits) may be products of disturbed interoceptive-exteroceptive integration. More research is nonetheless needed to fully elucidate the relationship between mind, body, and social context in depression.

Figurative language processing in atypical populations: the ASD perspective

This paper is intended to provide a critical overview of experimental and clinical research documenting problems in figurative language processing in atypical populations with a focus on the Autistic Spectrum. Research in the comprehension and processing of figurative language in autism invariably documents problems in this area. The greater paradox is that even at the higher end of the spectrum or in the cases of linguistically talented individuals with Asperger syndrome, where structural language competence is intact, problems with extended language persist. If we assume that figurative and extended uses of language essentially depend on the perception and processing of more concrete core concepts and phenomena, the commonly observed failure in atypical populations to understand figurative language remains a puzzle. Various accounts have been offered to explain this issue, ranging from linking potential failure directly to overall structural language competence (Norbury, 2005; Brock et al., 2008) to right-hemispheric involvement (Gold and Faust, 2010). We argue that the dissociation between structural language and figurative language competence in autism should be sought in more general cognitive mechanisms and traits in the autistic phenotype (e.g., in terms of weak central coherence, Vulchanova et al., 2012b), as well as failure at on-line semantic integration with increased complexity and diversity of the stimuli (Coulson and Van Petten, 2002). This perspective is even more compelling in light of similar problems in a number of conditions, including both acquired (e.g., Aphasia) and developmental disorders (Williams Syndrome). This dissociation argues against a simple continuity view of language interpretation.

"Put Myself Into Your Place": Embodied Simulation and Perspective Taking in Autism Spectrum Disorders

Embodied cognition theories hold that cognitive processes are grounded in bodily states. Embodied processes in autism spectrum disorders (ASD) have classically been investigated in studies on imitation. Several observations suggested that unlike typical individuals who are able of copying the model's actions from the model's position, individuals with ASD tend to reenact the model's actions from their own egocentric perspective. Here, we performed two behavioral experiments to directly test the ability of ASD individuals to adopt another person's point of view. In Experiment 1, participants had to explicitly judge the left/right location of a target object in a scene from their own or the actor's point of view (visual perspective taking task). In Experiment 2, participants had to perform left/right judgments on front-facing or back-facing human body images (own body transformation task). Both tasks can be solved by mentally simulating one's own body motion to imagine oneself transforming into the position of another person (embodied simulation strategy), or by resorting to visual/spatial processes, such as mental object rotation (nonembodied strategy). Results of both experiments showed that individual with ASD solved the tasks mainly relying on a nonembodied strategy, whereas typical controls adopted an embodied strategy. Moreover, in the visual perspective taking task ASD participants had more difficulties than controls in inhibiting other-perspective when directed to keep one's own point of view. These findings suggested that, in social cognitive tasks, individuals with ASD do not resort to embodied simulation and have difficulties in cognitive control over self- and other-perspective.

A review of visual perspective taking in autism spectrum disorder

Impairments in social cognition are a key symptom of autism spectrum disorder (ASD). People with autism have great difficulty with understanding the beliefs and desires of other people. In recent years literature has begun to examine the link between impairments in social cognition and abilities which demand the use of spatial and social skills, such as visual perspective taking (VPT). Flavell (1977) defined two levels of perspective taking: VPT level 1 is the ability to understand that other people have a different line of sight to ourselves, whereas VPT level 2 is the understanding that two people viewing the same item from different points in space may see different things. So far, literature on whether either level of VPT is impaired or intact in autism is inconsistent. Here we review studies which have examined VPT levels 1 and 2 in people with autism with a focus on their methods. We conclude the review with an evaluation of the findings into VPT in autism and give recommendations for future research which may give a clearer insight into whether perspective taking is truly impaired in autism.