Health risks from extreme heat in China: Evidence from health insurance

Global warming has accentuated the effects of extreme heat on health. Health insurance, functioning as a risk management tool, has the potential to alleviate these impacts. Consequently, this paper investigates the correlation between extreme heat events and the demand for health insurance in China. Using data from the China Health and Nutrition Survey, we have observed a substantial increase in the likelihood of residents purchasing health insurance during extreme heat events. To be specific, for every extra day of extreme heat events annually, there is a 0.3% increase in the probability of purchasing health insurance. This effect is not uniform across different demographic groups. It is particularly pronounced among middle-aged and elderly individuals, rural residents, those with lower educational levels, higher income brackets, and individuals residing in underprivileged areas with limited access to green spaces and healthcare facilities. Furthermore, our study indicates that the increased frequency of extreme heat events not only impacts individuals' physical health but also triggers negative emotions, which in turn drive risk-averse behavior related to health insurance purchases. These findings carry substantial policy implications for mitigating the economic consequences of climate change.

What's in a sample? Epistemic uncertainty and metacognitive awareness in risk taking

In a fundamentally uncertain world, sound information processing is a prerequisite for effective behavior. Given that information processing is subject to inevitable cognitive imprecision, decision makers should adapt to this imprecision and to the resulting epistemic uncertainty when taking risks. We tested this metacognitive ability in two experiments in which participants estimated the expected value of different number distributions from sequential samples and then bet on their own estimation accuracy. Results show that estimates were imprecise, and this imprecision increased with higher distributional standard deviations. Importantly, participants adapted their risk-taking behavior to this imprecision and hence deviated from the predictions of Bayesian models of uncertainty that assume perfect integration of information. To explain these results, we developed a computational model that combines Bayesian updating with a metacognitive awareness of cognitive imprecision in the integration of information. Modeling results were robust to the inclusion of an empirical measure of participants' perceived variability. In sum, we show that cognitive imprecision is crucial to understanding risk taking in decisions from experience. The results further demonstrate the importance of metacognitive awareness as a cognitive building block for adaptive behavior under (partial) uncertainty.

Influence of parental education on the intelligence quotient profiles and socially adaptive behavior of school-age children with autism spectrum disorder in eastern China

Intelligence quotient (IQ) and adaptive behavior are the influencing factors of autism spectrum disorder (ASD) in children entering mainstream schools. This study explored the association between parental education level, IQ, and adaptive behavior in ASD groups. A total of 257 school-age ASD children were enrolled in our study from January 2017 to June 2021. Their parents completed a standard demographic form, including age at autism diagnosis, gender, school placement, and parents' educational background. The Chinese version of the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV) was completed by a certified assessor for each enrolled child. Parents were interviewed on adaptive behavior using the Chinese version of the Adaptive Behavior Assessment System, Second Edition (ABAS-II). The average IQ of school-age ASD children was 76.88 (standard deviation (SD)=22.62) and boys had higher IQ levels than girls. The IQ was positively correlated with age. The General Adaptive Composite (GAC) score was 82.47 (SD=15.86) and adaptive behavior did not increase with age. ASD children who attended mainstream schools had better adaptive behavior profiles than other children. The mother's education level showed a significant correlation with the IQ and adaptive behavior of autistic children, while the father's education level did not. Consequently, better training and support for parents may help autistic children enter mainstream schools, with adaptive training being the most urgently required skill for parents.

Factors that Influence the Daily Living Skills of Autistic Adults: The Importance of Opportunity

While existing literature has demonstrated that Daily Living Skills (DLS) performance of autistic individuals is lower than what is expected of their age and cognitive abilities, limited studies have examined DLS in autistic adults. This study aimed to understand the influence of intellectual function (IQ) and contextual factors (i.e., provision of opportunities) on autistic individuals' DLS performance. Participants included 33 autistic individuals ranging in age from 16 to 35 years. Their caregivers were administered the Vineland Adaptive Behavior Scales, 3rd edition's (Vineland-3) caregiver interview form. A novel coding system was developed to capture the frequency of reasons for participants' non-performance of DLS tasks, based on caregiver's report. "Target" scores reflecting expected possible score if reasons for nonperformance could be addressed were computed. Qualitative analysis of parental responses indicated that, for adults with average or higher IQ, lack of opportunity to learn and/or implement the skill was the most frequent reason for not performing DLS. Lack of opportunity was also the second most common reason provided for adults with NVIQ below 85, following cognitive ability. Taking into account reasons for nonperformance, "Target" scores were, on average, 7.65 points higher for the NVIQ ≥ 85 group. These findings highlight a need for multi-dimensional assessment to go beyond individual strengths and difficulties to also include contextual factors that may influence adults' skill acquisition and performance. It is essential that clinicians ensure that adequate opportunities for learning and performance are available to promote acquisition of important DLS.

Hybrid learning mechanisms under a neural control network for various walking speed generation of a quadruped robot

Legged robots that can instantly change motor patterns at different walking speeds are useful and can accomplish various tasks efficiently. However, state-of-the-art control methods either are difficult to develop or require long training times. In this study, we present a comprehensible neural control framework to integrate probability-based black-box optimization (PIBB) and supervised learning for robot motor pattern generation at various walking speeds. The control framework structure is based on a combination of a central pattern generator (CPG), a radial basis function (RBF) -based premotor network and a hypernetwork, resulting in a so-called neural CPG-RBF-hyper control network. First, the CPG-driven RBF network, acting as a complex motor pattern generator, was trained to learn policies (multiple motor patterns) for different speeds using PIBB. We also introduce an incremental learning strategy to avoid local optima. Second, the hypernetwork, which acts as a task/behavior to control parameter mapping, was trained using supervised learning. It creates a mapping between the internal CPG frequency (reflecting the walking speed) and motor behavior. This map represents the prior knowledge of the robot, which contains the optimal motor joint patterns at various CPG frequencies. Finally, when a user-defined robot walking frequency or speed is provided, the hypernetwork generates the corresponding policy for the CPG-RBF network. The result is a versatile locomotion controller which enables a quadruped robot to perform stable and robust walking at different speeds without sensory feedback. The policy of the controller was trained in the simulation (less than 1 h) and capable of transferring to a real robot. The generalization ability of the controller was demonstrated by testing the CPG frequencies that were not encountered during training.

Impact of an augmented intervention on self-regulatory, dietary and physical activity outcomes in a diabetes prevention trial among adults with prediabetes

Self-regulation can facilitate modifications in lifestyle to promote behavioral change. However, little is known about whether adaptive interventions promote improvement in self-regulatory, dietary, and physical activity outcomes among slow treatment responders. A stratified design with an adaptive intervention for slow responders was implemented and evaluated. Adults ≥ 21 years old with prediabetes were stratified to the standard Group Lifestyle Balance intervention (GLB; n = 79) or the adaptive GLB Plus intervention (GLB + ; n = 105) based on first-month treatment response. Intake of total fat was the only study measure that significantly differed between groups at baseline (P = 0.0071). GLB reported greater improvement in self-efficacy for lifestyle behaviors, goal satisfaction with weight loss, and very active minutes of activity than GLB + (all P < 0.01) at 4-months. Both groups reported significant improvement in self-regulatory outcomes and reduction in energy and fat intake (all P < 0.01). An adaptive intervention can improve self-regulation and dietary intake when tailored to early slow treatment responders.

A nonlinear relapse model with disaggregated contact rates: Analysis of a forward-backward bifurcation

Throughout the progress of epidemic scenarios, individuals in different health classes are expected to have different average daily contact behavior. This contact heterogeneity has been studied in recent adaptive models and allows us to capture the inherent differences across health statuses better. Diseases with reinfection bring out more complex scenarios and offer an important application to consider contact disaggregation. Therefore, we developed a nonlinear differential equation model to explore the dynamics of relapse phenomena and contact differences across health statuses. Our incidence rate function is formulated, taking inspiration from recent adaptive algorithms. It incorporates contact behavior for individuals in each health class. We use constant contact rates at each health status for our analytical results and prove conditions for different forward-backward bifurcation scenarios. The relationship between the different contact rates heavily influences these conditions. Numerical examples highlight the effect of temporarily recovered individuals and initial conditions on infected population persistence.

Optimizing Parent Training to Improve Oral Health Behavior and Outcomes in Underserved Children with Autism Spectrum Disorder

A randomized controlled trial established initial efficacy of a novel parent training (PT) intervention for improving oral hygiene and oral health in underserved children with ASD (Fenning et al., 2022), a population at risk for unmet dental needs. The present study describes our emic approach to PT development alongside treatment outcome data examining feasibility, acceptability, and engagement. Families with Medicaid-eligible children with ASD ages 3 to 13 years (85% male, 62% with intellectual disability) were assigned to receive PT (n = 60) or a psychoeducational toolkit (n = 59). Results indicate strong retention, fidelity, and adherence, with quantitative and qualitative metrics revealing high treatment satisfaction and utilization. Discussion focuses on implications for individualizing treatment to optimize engagement of underrepresented families.

Why are only some children with autism spectrum disorder misclassified by the social communication questionnaire? An empirical investigation of individual differences in sensitivity and specificity in a clinic-referred sample

BACKGROUND

The Social Communication Questionnaire (SCQ) is a checklist for autism spectrum disorder (ASD) commonly used in research and clinical practice. While the original validation study suggested that the SCQ was an accurate ASD screener with satisfactory sensitivity and specificity, subsequent studies have yielded mixed results, with some revealing low sensitivity, low specificity, and low utility in some settings.

METHOD

The present study examined the psychometric properties of the SCQ as well as the individual difference characteristics of 187 individuals with and without autism spectrum disorder (ASD) who were misclassified or accurately classified by the SCQ in a clinic-referred sample.

RESULTS

The SCQ showed suboptimal sensitivity and specificity, regardless of age and sex. Compared to true positives, individuals classified as false positives displayed greater externalizing and internalizing problems, whereas individuals classified as false negatives displayed better social communication and adaptive skills.

CONCLUSIONS

The findings suggest that non-autistic developmental and behavioral individual difference characteristics may explain high rates of misclassification using the SCQ. Clinicians and researchers could consider using the SCQ in combination with other tools for young children with internalizing and externalizing symptoms and other more complex clinical presentations.

A biologically inspired decision-making system for the autonomous adaptive behavior of social robots

The decisions made by social robots while they fulfill their tasks have a strong influence on their performance. In these contexts, autonomous social robots must exhibit adaptive and social-based behavior to make appropriate decisions and operate correctly in complex and dynamic scenarios. This paper presents a Decision-Making System for social robots working on long-term interactions like cognitive stimulation or entertainment. The Decision-making System employs the robot's sensors, user information, and a biologically inspired module to replicate how human behavior emerges in the robot. Besides, the system personalizes the interaction to maintain the users' engagement while adapting to their features and preferences, overcoming possible interaction limitations. The system evaluation was in terms of usability, performance metrics, and user perceptions. We used the Mini social robot as the device where we integrated the architecture and carried out the experimentation. The usability evaluation consisted of 30 participants interacting with the autonomous robot in 30 min sessions. Then, 19 participants evaluated their perceptions of robot attributes of the Godspeed questionnaire by playing with the robot in 30 min sessions. The participants rated the Decision-making System with excellent usability (81.08 out of 100 points), perceiving the robot as intelligent (4.28 out of 5), animated (4.07 out of 5), and likable (4.16 out of 5). However, they also rated Mini as unsafe (security perceived as 3.15 out of 5), probably because users could not influence the robot's decisions.

Developmental Profiles in Children and Young Adults with Alexander Disease

PURPOSE

The study aims to describe the developmental profile of children and young adults with Alexander disease [AxD] infantile form, analyzing their clinical features, adaptive behavior and neuropsychological skills.

METHODS

Participants were eight children or young adults (Mean age = 11 years; SD = 6.86; range = 5-23) and their parents. A multi-method approach was adopted to assess participant competencies: (1) an online parent survey, (2) a semi-structured interview with parents, and (3) a direct assessment of the participant's neuropsychological skills.

RESULTS

Only four parents and their children completed all measures, and a common developmental profile could not be identified. The participants experienced substantial impairment in gross-motor skills, memory and narrative macrostructure. Most parents reported a regressive trend in at least one area.

CONCLUSIONS

The high individual variability and the regressive trend highlight the need for an accurate and periodic assessment of each individual's developmental profile.

Effect of improvement measures in reducing interruptions in a Japanese hospital pharmacy using a synthetic approach based on resilience engineering and systems thinking

BACKGROUND

Workflow interruptions in pharmacies contribute to dispensing errors, a high-priority issue in patient safety, but have rarely been studied from a systemic perspective partly because of the limitations of the conventional reductionistic approach. This study aims to identify a mechanism for the occurrence of interruptions in a hospital pharmacy and find interventional points using a synthetic approach based on resilience engineering and systems thinking, and assess implemented measures for reducing them.

METHODS

At a Japanese university hospital, we gathered information about performance adjustments of pharmacists in the inpatient medication dispensing unit for oral and topical medicines (IMDU-OT) and nurses in the inpatient wards (IPWs) in the medication dispensing and delivery process. Data about the workload and workforce of pharmacists were collected from hospital information systems. Telephone inquiries and counter services in the IMDU-OT, the primary sources of interruptions to pharmacists' work, were documented. The feedback structure between the IMDU-OT and the IPWs was analyzed using a causal loop diagram to identify interventional points. The numbers of telephone calls and counter services were measured cross-sectionally before (February 2017) and four months after implementing measures (July 2020).

RESULTS

This study found that interruptions are a systemic problem emerging from the adaptive behavior of pharmacists and nurses to their work constraints, such as short staffing of pharmacists, which limited the frequency of medication deliveries to IPWs, and lack of information about the medication dispensing status for nurses. Measures for mitigating cross-system performance adjustments-a medication dispensing tracking system for nurses, request-based extra medication delivery, and pass boxes for earlier pick-up of medicines-were introduced. Following their implementation, the daily median number of telephone calls and counter services was significantly reduced (43 to 18 and 55 to 15, respectively), resulting in a 60% reduction in the total number of interruptions.

CONCLUSION

This study found interruptions in the hospital pharmacy as a systemic problem that can be reduced by mitigating difficulties being compensated for by clinicians' cross-system performance adjustments. Our findings suggest that a synthetic approach can be effective for solving complex problems and have implications for methodological guidance for Safety-II in practice.

Neurophysiological measures of auditory sensory processing are associated with adaptive behavior in children with Autism Spectrum Disorder

BACKGROUND

Atypical auditory cortical processing is consistently found in scalp electrophysiological and magnetoencephalographic studies of Autism Spectrum Disorder (ASD), and may provide a marker of neuropathological brain development. However, the relationship between atypical cortical processing of auditory information and adaptive behavior in ASD is not yet well understood.

METHODS

We sought to test the hypothesis that early (100-175 ms) auditory processing in ASD is related to everyday adaptive behavior through the examination of auditory event-related potentials (AEPs) in response to simple tones and Vineland Adaptive Behavior Scales in a large cohort of children with ASD (N = 84), aged 6-17, and in age- and IQ- matched neurotypically (NT) developing controls (N = 132).

RESULTS

Statistical analyses revealed significant group differences in early AEPs over temporal scalp regions (150-175 ms), and the expected rightward lateralization of the AEP (100-125 ms and 150-175 ms) to tonal stimuli in both groups. Lateralization of the AEP (150-175 ms) was significantly associated with adaptive functioning in the socialization domain.

CONCLUSIONS

These results lend support to the hypothesis that atypical processing of sensory information is related to everyday adaptive behavior in autism.

Effects of a small-baby protocol on early and long-term outcomes in extremely preterm infants: A quality improvement study

BACKGROUND

Extremely preterm (EPT) infants (≤28 weeks) remain at risk for poor outcomes. Small baby protocols (SBPs) may improve outcomes, but optimal strategies are unknown.

METHODS

This study evaluated whether EPT infants managed using an SBP would have better outcomes compared to a historical control (HC) group. The study compared a HC group of EPT infants 23 0/7 weeks to 28 0/7 weeks GA (2006-2007), to a similar SBP group (2007-2008). Survivors were followed until 13 years of life. The SBP emphasized antenatal steroids, delayed cord clamping, respiratory and hemodynamic minimalism, prophylactic indomethacin, early empiric caffeine, and control of sound and light.

RESULTS

There were 35 HC subjects and 35 SBP subjects. The SBP group had less severe IVH-PVH (9 % vs. 40 %, risk ratio 0.7, 95 % CI 0.5-0.9, P = 0.002) mortality (17 % vs. 46 %, risk ratio 0.6, 95 % CI 0.5-0.9, P = 0.004), and acute pulmonary hemorrhage (6 % vs. 23 %, risk ratio 0.8, 95 % CI 0.7-1.0, P = 0.04). Compliance with the SBP protocol was excellent. For the SBP group in the first 72 h, no subjects received inotropes, hydrocortisone, or sodium bicarbonate. Intubation, mechanical ventilation, fluid boluses, sedation, red blood cell transfusions, and insulin use decreased. At 10-13 years, more SBP subjects had survived without NDI (51 % vs. 23 %, risk ratio = 1.6, 95 % CI = 1.1-2.4, P = 0.01). More SBP subjects also survived without NDI and with a Vineland Adaptive Behavior Composite score > 85 (44 % vs. 11 %, risk ratio = 2.0, 95 % CI = 1.2-3.2, P ≤0.001). The SBP group had less visual impairment.

CONCLUSION

An SBP was associated with improved outcomes, including normal neurologic survival after 10 years.

Adaptive behavior and mastery motivation in children with physical disabilities

BACKGROUND

Adaptive behavior consists of conceptual, social, and practical skills and describes the ability of individuals to manage environmental demands, interact with others, and engage in activities to meet ones needs. Mastery motivation is an intrinsic characteristic that enables persistence when attempting to master a skill. Children with physical disabilities often demonstrate less effective adaptive behaviors and lower mastery motivation than their peers without disabilities, which may subsequently impact development and participation in daily activities. Therefore, it may be beneficial for pediatric rehabilitation practitioners to focus intentionally on facilitating effective adaptive behaviors in children with physical disabilities as they aim to support child development and function.

OBJECTIVE

This perspective paper highlights the importance of adaptive behavior for children with physical disabilities, discusses methods of assessment, and illustrates intervention principles and strategies to support the development of appropriate adaptive behaviors across childhood. Key intervention principles include: 1) engage children and address motivation; 2) collaborate with others; 3) support real-life meaningful experiences; 4) scaffold the just-right challenge; and 5) guide children in discovering solutions.

Adaptive behaviors and vaccination on curbing COVID-19 transmission: Modeling simulations in eight countries

Current persistent outbreak of COVID-19 is triggering a series of collective responses to avoid infection. To further clarify the impact mechanism of adaptive protection behavior and vaccination, we developed a new transmission model via a delay differential system, which parameterized the roles of adaptive behaviors and vaccination, and allowed to simulate the dynamic infection process among people. By validating the model with surveillance data during March 2020 and October 2021 in America, India, South Africa, Philippines, Brazil, UK, Spain and Germany, we quantified the protection effect of adaptive behaviors by different forms of activity function. The modeling results indicated that (1) the adaptive activity function can be used as a good indicator for fitting the intervention outcome, which exhibited short-term awareness in these countries, and it could reduce the total human infections by 3.68, 26.16, 15.23, 4.23, 7.26, 1.65, 5.51 and 7.07 times, compared with the reporting; (2) for complete prevention, the average proportions of people with immunity should be larger than 90%, 92%, 86%, 71%, 92%, 84%, 82% and 76% with adaptive protection behaviors, or 91%, 97%, 94%, 77%, 92%, 88%, 85% and 90% without protection behaviors; and (3) the required proportion of humans being vaccinated is a sub-linear decreasing function of vaccine efficiency, with small heterogeneity in different countries. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".

Developmental and behavioral groupings can predict changes in adaptive behavior over time in young children with neurodevelopmental disorders

The heterogeneity within, and the overlap between, diagnostic categories for neurodevelopmental disorders (NDDs) remain poorly understood. Developmental trajectories may diverge among children with the same diagnosis, who may also respond very differently to treatment. In a previous study, we used statistical clustering methods in a sample of 194 preschoolers who were referred for NDD assessment. We identified three distinct subgroups based on multiple developmental and behavioral variables. The present study aimed to identify: (1) early developmental markers at the surveillance and screening period that are predictive of subgroup membership at the diagnostic period (i.e., around age 5), (2) associations between subgroups and the evolution of adaptive behavior over the course of two years, and (3) predictors of adaptive behavior change. Subgroup membership was the only significant predictor of adaptive behavior change over time, which suggests that a clustering method based on developmental and behavioral profiles may be useful in treatment planning.

Importance of Path Planning Variability: A Simulation Study

Individuals vary in the way they navigate through space. Some take novel shortcuts, while others rely on known routes to find their way around. We wondered how and why there is so much variation in the population. To address this, we first compared the trajectories of 368 human subjects navigating a virtual maze with simulated trajectories. The simulated trajectories were generated by strategy-based path planning algorithms from robotics. Based on the similarities between human trajectories and different strategy-based simulated trajectories, we found that there is a variation in the type of strategy individuals apply to navigate space, as well as variation within individuals on a trial-by-trial basis. Moreover, we observed variation within a trial when subjects occasionally switched the navigation strategies halfway through a trajectory. In these cases, subjects started with a route strategy, in which they followed a familiar path, and then switched to a survey strategy, in which they took shortcuts by considering the layout of the environment. Then we simulated a second set of trajectories using five different but comparable artificial maps. These trajectories produced the similar pattern of strategy variation within and between trials. Furthermore, we varied the relative cost, that is, the assumed mental effort or required timesteps to choose a learned route over alternative paths. When the learned route was relatively costly, the simulated agents tended to take shortcuts. Conversely, when the learned route was less costly, the simulated agents showed preference toward a route strategy. We suggest that cost or assumed mental effort may be the reason why in previous studies, subjects used survey knowledge when instructed to take the shortest path. We suggest that this variation we observe in humans may be beneficial for robotic swarms or collections of autonomous agents during information gathering.

Adaptive behavior, sleep, and physical activity in adolescents with fetal alcohol spectrum disorder

BACKGROUND

Fetal alcohol spectrum disorder (FASD) is broadly associated with impairments to adaptive behavior and dysfunctional sleep. Associations between sleep, adaptive behavior, and physical activity are frequently drawn in discussions of typical development and other clinical conditions.

AIMS

In this study, we sought to characterize patterns of sleep, adaptive behavior, and physical activity in adolescents with FASD. We also investigated the associations between sleep, adaptive behavior, and physical activity within this population.

METHODS AND PROCEDURES

Twenty-seven adolescents aged 11- to 17-years with a diagnosis of FASD and their caregivers participated in this study. All participants completed parent and youth questionnaires on adaptive behavior, sleep, and physical activity.

OUTCOMES AND RESULTS

Adolescents with FASD displayed significant impairments to all domains of adaptive behavior and considerable sleep disturbance. Worse sleep was associated with older age and sleep-related breathing disturbances were associated with poorer social adaptive behavior. Participation in physical activity, particularly organized sport, was strongly associated with better adaptive behavior.

CONCLUSIONS AND IMPLICATIONS

Adolescents with FASD experience considerable challenges with regards to sleep and adaptive behavior. Physical activity, particularly organized sport, may provide opportunities for the improvement of adaptive behavior in this population.

Adaptive Behavior Profiles in Autism Spectrum Disorder

PURPOSE OF REVIEW

The goal of this paper is to provide an overview of profiles of adaptive behavior in autism spectrum disorder and highlight the importance of these everyday skills in optimizing self-sufficiency throughout life.

RECENT FINDINGS

Research has clearly confirmed that adaptive deficits exist in ASD, particularly in social skills. These impairments are highly associated with co-occurring conditions such as executive functioning impairments, psychiatric conditions, and even psychosis. There tends to be a discrepancy between intellectual capacity and adaptive functioning, particularly in autistic individuals without cognitive and language delays, with this gap widening between childhood and adulthood. Although cognition and language skills are associated with good outcome in ASD, they are insufficient in the absence of intact adaptive behavior. There is a critical need to emphasize the importance of adaptive functioning in diagnostic evaluations and treatment/intervention programs to ensure that every autistic individual has the potential for success.

Adaptive behavior and psychiatric symptoms in university students with ASD: One-year longitudinal study

In recent years, more young adults with ASD are attending post-secondary education, and several support programs have been proposed for this population. However, research regarding the long-term effects of university enrollment on outcomes among students with ASD is scarce. This study examined adaptive behavior and psychiatric symptoms during the first semester of two consecutive academic years (T1, T2) among 39 students with ASD, 29 students without ASD and high levels of social anxiety symptoms (High SA), and 32 students without ASD and low levels of SA symptoms (Low SA). Students with ASD participated in a university support program and resided with a peer mentor student without ASD, which encouraged social interaction. At T1, students with ASD reported lower levels of adaptive behavior and higher levels of social anxiety and obsessive-compulsive symptoms compared to the other groups. However, at follow-up (T2), significantly higher conceptual adaptive skill levels (specifically communication skills) and significantly lower depression symptom levels from T1 were reported only among students with ASD. The levels of social anxiety and obsessive-compulsive symptoms at T1 were negatively associated with adaptive functioning a year later (T2). Implications regarding adults with ASD attending university are discussed.

Emotional and behavioral problems in children with autism spectrum disorder and psychological distress in their parents in Saudi Arabia: The moderating effect of marital relationship satisfaction

BACKGROUND

There is a well-established association between emotional and behavioral problems in children with Autism Spectrum Disorder (ASD), unmet family support needs, and psychological distress in their parents. However, no studies hypothesized a buffering effect of marital relationship satisfaction.

AIM

The aim of this research was to investigate the moderating effect of marital relationship satisfaction in the associations among emotional and behavioral problems in children with ASD, unmet family support needs, and anxiety and depression of their parents in the context of Saudi Arabia.

DESIGN AND METHODS

This cross-sectional study recruited parents from five rehabilitation centers for children with ASD in Saudi Arabia. Data were collected with surveys completed online. A sample of 93 parents (84% female, 4.3% were 24 or younger, 36.2% between 25 and 34 years old, 40.5% between 35 and 44, and 14.7% between 45 and 54) of children with ASD was obtained. Two models of multiple regression analysis were performed to determine the relationships.

RESULTS

About 56% of the parents had anxiety symptoms and 60% had depressive symptoms. Emotional and behavioral problems of children and higher levels of unmet family support needs were associated with higher levels of anxiety in parents, and adaptive behavior of children was associated with reduced levels of depression in parents. Relationship satisfaction moderated the impact of children's emotional and behavioral problems on parental anxiety.

CONCLUSION AND IMPLICATIONS

The study highlighted the importance of marital relationship satisfaction in buffering the negative effects of ASD-related factors of children on the psychological well-being of their parents.

Quantifying medical manifestations in Hurler syndrome with the infant physical symptom score: associations with long-term physical and adaptive outcomes

BACKGROUND

A physical symptom score (PSS) for the mucopolysaccharidosis (MPS) disorders has been developed to quantitate the somatic burden of disease across multiple organ systems. Studies have demonstrated the sensitivity and its relationship to age, IQ and adaptive functioning of the PSS in older children. With the onset of newborn screening, there is an increased need to characterize the somatic symptoms in the earliest stages of life, especially for young children under 36 months of age. Consequently, a new scale, Infant Physical Symptom Score (IPSS), was developed to score physical symptoms in infants and toddlers.

OBJECTIVE

Part I. To create a measure to quantify somatic burden in patients with MPS disorders under 36 months of age. The IPSS assess outcomes and changes in somatic disease in individuals with MPS disorders diagnosed very early in life. Part II. To determine the relationship between IPSS and other measures to evaluate its validity and utility, a) we evaluated the relationship between the IPSS and PSS in the same patients with MPS I over time to determine if the two scales are measuring the same concepts, and b) we evaluated the association between IPSS and a functional adaptive measure over time with a focus on the age at first treatment (under 36 months) to determine if the IPSS has predictive value.

METHODS

Part I. The Infant Physical Symptom Score (IPSS) for the infant population in MPS disorders was established using data from 39 patients enrolled in the Lysosomal Disease Network longitudinal MPS I study (U54NS065768). All of these patients had Hurler syndrome (MPS IH) and underwent hematopoietic stem cell transplant (HSCT) at the University of Minnesota. Items for the IPSS were selected by reviewing CRFs prepared for the MPS I longitudinal study and examining medical records of these patients prior to HSCT based on the knowledge gained from the development of the PSS. Part II. Of those 39 patients, a subset of 19 were all seen 9 to 12 years post HSCT. Having retrospectively calculated their IPSS prior to HSCT, we categorized them by age at HSCT, and examined their most recent PSS along with Composite and Daily Living Skills scores on the Vineland Adaptive Behavior Scales - Second Edition (VABS-II).

RESULTS AND CONCLUSION

The total score on the IPSS collected prior to transplant differed by patient's age at transplant, as expected in this progressive condition. Those transplanted at ≤12 months of age had a mean score of 7.4, which was significantly lower, suggesting less somatic disease burden, compared to those transplanted at >12 to ≤24 months (mean 11.8) and > 24 to ≤36 months (mean 13.6). Higher IPSS reflects more evidence of somatic disease burden and lower IPSS reflects less evidence of disease burden. Nine to 12 years later, the severity level as measured by the PSS was comparable to severity on the IPSS suggesting that the two scales are measuring similar concepts. Retrospectively calculated pre-transplant IPSS were negatively associated with higher VABS-II Composite scores 9-12 years later (p value-0.015) and to a lesser extent Daily Living Skills scores (p value-0.081). We conclude that the IPSS appears to be a useful approach to quantifying the somatic disease burden of MPS IH patients under 36 months of age.

An Evaluation of Parent and Teacher Discrepancies on an Adaptive Behavior Measure for Youth with Autism Spectrum Disorder, Intellectual Disability, and Global Developmental Delay

Comprehensive evaluations include data from multiple informants, but discrepancies occur on adaptive skill measures of youth with autism spectrum disorder (ASD) and intellectual disabilities (ID). This study investigated discrepancies between parent-teacher ratings on a measure of adaptive behavior [Adaptive Behavior Assessment System, Third Edition (ABAS-3)] in a clinical sample of 115 youth. Agreement between informants was determined and then discrepancies were identified using paired-sample t-tests for the whole sample and subsamples. Factors associated with parent-teacher discrepancies were investigated including age, diagnoses, IQ, autism symptomology, and parent education. Parent-teacher scores were moderately correlated for the ABAS-3 composite and domains. Teachers rated youth with ASD and ID as having higher adaptive skills. Autism symptomology significantly predicted discrepancies between informants on the ABAS-3.

Differences in daily life executive functioning between people with autism and people with schizophrenia

This is a comparative analysis of everyday executive functioning between individuals with Autism Spectrum Disorder (ASD), Schizophrenia Spectrum Disorders (SSD) and controls using Dysexecutive Questionnaire-Spanish (DEX-Sp), to identify patterns of difficulties. Also we assessed the relationship between EF and adaptive behavior as measured by the Vineland Adaptive Behavioral Scale-II. Common areas of everyday executive functions were established as problematic in individuals with ASD and SSD related to Disinhibition and Apathy, while Disorganization and Impulsivity was gravely affected in ASD group only. The degree of Dysexecutive Syndrome was predictive of adaptive behavior in ASD group only. These suggest that DEX-Sp could be a useful tool in differentiating areas of strength and weaknesses in clinical groups such as ASD and SDD.

Microanalysis of Daily Living Skills in adolescents with Autism Spectrum Disorder without an intellectual disability

Adolescents with autism spectrum disorder (ASD) without an intellectual disability (ID) have daily living skills (DLS) that fall below their chronological age and affect their ability to achieve successful adult outcomes, but little is known about their specific DLS challenges. Utilizing the Vineland Adaptive Behavior Scales, 3rd Edition (VABS-3) in a sample of 151 adolescents with ASD without an ID, we explored the VABS-3 DLS domain, subdomains, interview topics, and individual items. Results indicated that Community DLS was a relative strength, followed by Domestic DLS, and then Personal DLS. Adolescents with ASD demonstrated significant challenges in many age appropriate DLS subdomain interview topics and individual items, indicating a need for interventions to increase acquisition of DLS to improve adult outcomes.

Italian Diagnostic Adaptive Behavior Scale: Reliability and diagnostic accuracy compared with the Vineland-II

BACKGROUND

The Diagnostic Adaptive Behavior Scale (DABS) is a short scale with excellent properties to assess the conceptual, social, and practical adaptive behavior domains for the diagnosis of intellectual disability (ID) in individuals aged 4-21 years.

AIMS

Investigate the test-retest and inter-respondent reliability of the Italian adaptation of the DABS, verify its diagnostic accuracy in identifying individuals with ID and excluding individuals with typical development (TD), and compare its psychometric properties to those of the Vineland-II.

METHODS

Test-retest reliability: The same respondent completed the Italian DABS for the same assessed person at two separate times (n = 71). Inter-respondent reliability: Two respondents for the same assessed person completed the Italian DABS independently (n = 57). Diagnostic accuracy: The same respondent completed the Italian DABS and Vineland-II for the same assessed person (n = 378; 50 % ID, 50 % TD).

RESULTS

Italian DABS test-retest and inter-respondent correlation coefficients were excellent. Italian DABS sensitivity was 86 % and specificity was 99 %, Italian DABS Areas Under the ROC Curves were excellent (or good, practical skill domain), and comparable to the results reported for the Vineland-II.

CONCLUSIONS

The Italian DABS is an excellent measure to evaluate the adaptive behavior for ID diagnosis; it is comparable to the Vineland-II but being shorter, the Italian DABS requires less time to administer.

Sensory processing and adaptive behavior in Phelan-McDermid syndrome: a cross-sectional study

Phelan-McDermid syndrome (PMS) is a genetic disorder caused by a mutation or deletion of the SHANK3 gene (chromosome 22q13.3), characterized by different sensory processing anomalies. The objective of this study is to expand and provide a detailed definition of the sensory profile of patients with PMS. The secondary objective was to examine the relationship between sensory patterns and adaptive behavior. A cross-sectional study was carried out among 51 Spanish patients with a confirmed genetic diagnosis of PMS. All the participants' parents completed the Short Sensory Profile-Spanish (SSP-S) and the Adaptive Behavior Assessment System II (ABAS-II). Correlational, multiple regression and hierarchical cluster analyses were performed. An atypical sensory profile was identified in almost 75% of PMS patients. Definite differences were found among scores; nonetheless, sub-threshold values were observed in tactile sensitivity, underresponsive/seeks sensation, auditory filtering, and low energy/weak sensory categories. Conceptual, social, and practical domains, as well as the General Adaptive Composite (GAC) of the ABAS-II showed extremely low scores (i.e., <70). Significant correlations were found (p<0.005) between SSP-S scores and the conceptual, social, practical, and GAC index of the ABAS-II, whereby higher SSP-S scores were associated with better skills and higher adaptive performance. The cluster analysis indicated that the group with the largest mutation size (7.23 Mb) showed the greatest sensory processing difficulties and very low adaptive skills.

CONCLUSIONS

Patients with PMS show an atypical sensory profile, which correlates with limitations in general adaptive behaviors.

WHAT IS KNOWN

• PMS sensory processing difficulties were associated with a pattern of underresponsive/seeks sensation, low energy/weak, and tactile hyporeactivity. • Sensory processing difficulties have been associated with limitations in the development of appropriate adaptive communication and interaction behaviors.

WHAT IS NEW

• Sensory definite differences associated with tactile hyperreactivity, as well as significant effects of underresponsiveness/seeks sensation and auditory filtering categories on the adaptive abilities were found in SHANK3_deletion patients. • Cluster analysis suggests that smaller mutation sizes were related to better sensory processing and higher adaptive skills, while patients with larger deletion sizes have greater adaptive difficulties and worse sensory processing skills.

Adaptive behavior and psychiatric comorbidities in KCNB1 encephalopathy

AIM

KCNB1 encephalopathy encompasses a broad phenotypic spectrum associating intellectual disability, behavioral disturbances, and epilepsies of various severity. Using standardized parental questionnaires, we aimed to capture the heterogeneity of the adaptive and behavioral features in a series of patients with KCNB1 pathogenic variants.

METHODS

We included 25 patients with a KCNB1 encephalopathy, aged from 3.2 to 34.1 years (median = 10 years). Adaptive functioning was assessed in all patients using the French version of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) questionnaire. We screened global behavior with the Childhood Behavioral Check-List (CBCL, Achenbach) and autism spectrum disorder (ASD) with the Social Communication Questionnaire (SCQ). We used a cluster analysis to identify subgroups of adaptive profiles.

RESULTS

VABS-II questionnaire showed pathological adaptive behavior in all participants with a severity of adaptive deficiency ranging from mild in 8/20 to severe in 7/20. Eight out of 16 were at risk of Attention Problems at the CBCL and 13/18 were at risk of autism spectrum disorder (ASD). The adaptive behavior composite score significantly decreased with age (Spearman's Rho=-0.72, p<0.001) but not the equivalent ages, suggesting stagnation and slowing but no regression over time. The clustering analysis identified two subgroups of patients, one showing more severe adaptive behavior. The severity of the epilepsy phenotype predicted the severity of the behavioral profile with a sensitivity of 70% and a specificity of 90.9%.

CONCLUSION

This study confirms the deleterious consequences of early-onset epilepsy in addition to the impact of the gene dysfunction in patients with KCNB1 encephalopathy. ASD and attention disorders are frequent. Parental questionnaires should be considered as useful tools for early screening and care adaptation.

Analysis of cognitive ability and adaptive behavior assessment tools used in an observational study of patients with mucopolysaccharidosis II

Background

Mucopolysaccharidosis II (MPS II) is a rare lysosomal storage disease characterized by cognitive impairment in most patients. This post hoc analysis evaluated changes in cognitive function, adaptive behavior and functional outcomes in patients with neuronopathic MPS II over time. Fifty-five children with MPS II were enrolled in a 24-month observational study (NCT01822184). The Differential Ability Scales, second edition (DAS-II; early years battery for ages 2 years 6 months to 6 years 11 months, school age battery for ages 7 years to 17 years 11 months), Vineland Adaptive Behavior Scales, second edition (VABS-II) and the Hunter Syndrome-Functional Outcomes for Clinical Understanding Scale (HS-FOCUS) were performed at baseline and 3-month intervals over 2 years. A subgroup of 38 children with a DAS-II General Conceptual Ability (GCA) score of 55–85 (below average–very low abilities) at any time during the study were included in this analysis.

Results

Mean (standard deviation [SD]) early years DAS-II GCA score decreased from 73.4 (15.7, n = 22) at baseline to 62.7 (34.9, n = 6) at month 24. For the six patients with early years GCA assessments at baseline and month 24, mean (SD) GCA scores decreased from 72.3 (21.3) at baseline to 62.7 (34.9) at month 24. School age GCA scores were stable over 2 years: mean (SD) 72.4 (11.8, n = 10) at baseline; 74.3 (12.3, n = 8) at month 24. Mean (SD) VABS-II Adaptive Behavior Composite (ABC) scores were stable throughout the study (baseline, 81.8 [11.8, n = 36]; month 24, 81.0 [10.2, n = 13]). Some associations between items and domains of HS-FOCUS (p < 0.05) and DAS-II GCA and VABS-II ABC scores were shown, but there was no clear pattern of changes in HS-FOCUS over 2 years.

Conclusions

The DAS-II measured changes in cognitive function over 2 years in younger patients with MPS II, whereas cognitive function in older patients remained stable. Further research is required to confirm the content validity of the DAS-II in different patient populations with MPS II. The VABS-II and HS-FOCUS were not sensitive tools for measuring behavioral and functional changes over 2 years. These findings may inform selection of appropriate cognitive and behavioral assessment tools for future studies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13023-021-02118-3.

The Floor Effect on the ABAS-II in Adolescents with Autism Spectrum Disorder

The present study aimed at enhancing the assessment of adaptive behavior in adolescents with Autism Spectrum Disorder trough the Adaptive Behavior Assessment System-Second Edition. To overcome the limits underpinning floor effect, which are commonly observed with the traditional methods, the statistical Hessl method and its revision by Orsini, Pezzuti and Hulbert was adopted. The results showed a more variation using the former method compared to the latter: a greater impairment in Social versus Leisure skills emerged. Regarding the Conceptual domain, a greater deficit in Functional Academics was observed. In the Practical domain, we found a greater impairment in Self-Care skills. Conversely, Home Living skills appeared as a strength compared to other skills. The results are discussed in reference to literature.

What to do when there is nothing to do? Toward a better understanding of idle time at work

Idle time at work is a phase of involuntary downtime during which employees experience that they cannot carry out their work tasks. In contrast to breaks, interruptions, procrastination, or withdrawal behavior, employees cannot work because of the absence of work-related tasks. Based on action regulation theory, we develop an integrative conceptual model on the antecedents and consequences of the subjective experience of idle time. We propose that work constraints (i.e., regulation problems) have negative effects on occupational well-being and task performance, and that these effects are mediated by subjective idle time. The strength of these effects is further assumed to be influenced by individuals' use of proactive (i.e., prevention) and adaptive (i.e., coping) strategies. Results of a supplemental qualitative study, for which we interviewed 20 employees from different occupations, provided preliminary support for the propositions. Finally, we develop theory on how individual, situational, and organizational characteristics may influence the proposed effects on and of idle time. Overall, this conceptual development paper contributes to a better theoretical understanding of idle time at work by extending its definition and applying action regulation theory to this practically important phenomenon.

Metacognition Mediates the Effect of Social Communication and Internalizing Behaviors on Self-management of Daily Life Tasks for Diploma-Track Autistic Youth

Social communication and executive functioning challenges as well as co-occurring anxiety/depression may make acquiring the skills needed to manage daily life tasks difficult for diploma-track autistic youth, thus limiting their participation in adult roles. This study describes the associations between executive function, social communication skills, and internalizing behaviors on task management in academically capable autistic adolescents (n = 46) using multiple regression with mediator analysis. The three predictors and youth age explained a moderate amount of variance in task management. Metacognition mediated the effect of social communication skills and internalizing behaviors on task management. Relations between underlying factors that influence self-management of daily life tasks are complex, supporting the need for multifaceted assessment and intervention approaches for academically capable autistic youth.

Metastable attunement and real-life skilled behavior

In everyday situations, and particularly in some sport and working contexts, humans face an inherently unpredictable and uncertain environment. All sorts of unpredictable and unexpected things happen but typically people are able to skillfully adapt. In this paper, we address two key questions in cognitive science. First, how is an agent able to bring its previously learned skill to bear on a novel situation? Second, how can an agent be both sensitive to the particularity of a given situation, while remaining flexibly poised for many other possibilities for action? We will argue that both the sensitivity to novel situations and the sensitivity to a multiplicity of action possibilities are enabled by the property of skilled agency that we will call metastable attunement. We characterize a skilled agent's flexible interactions with a dynamically changing environment in terms of metastable dynamics in agent-environment systems. What we find in metastability is the realization of two competing tendencies: the tendency of the agent to express their intrinsic dynamics and the tendency to search for new possibilities. Metastably attuned agents are ready to engage with a multiplicity of affordances, allowing for a balance between stability and flexibility. On the one hand, agents are able to exploit affordances they are attuned to, while at the same time being ready to flexibly explore for other affordances. Metastable attunement allows agents to smoothly transition between these possible configurations so as to adapt their behaviour to what the particular situation requires. We go on to describe the role metastability plays in learning of new skills, and in skilful behaviour more generally. Finally, drawing upon work in art, architecture and sports science, we develop a number of perspectives on how to investigate metastable attunement in real life situations.

Iterative Development of a Daily Living Skills Intervention for Adolescents with Autism Without an Intellectual Disability

Daily living skill deficits commonly co-occur in individuals with autism spectrum disorder (ASD). These deficits in adolescence are associated with poor outcomes, in both employment and independent living skills as adults. Currently, there are no interventions that directly target daily living skill acquisition in adolescents with ASD without an intellectual disability to facilitate a successful transition to adulthood. In this paper, we discuss the development, refinement, and initial efficacy studies of Surviving and Thriving in the Real World (STRW), a 14-session group treatment for both adolescents with ASD and their parent/caregiver that promotes attainment of critical daily living skills. We summarize initial feasibility studies that have been instrumental in the iterative development of STRW. The structure, core treatment elements, and content of STRW are described in detail. Lastly, we discuss the transition of the in-person STRW intervention to STRW-telehealth, which allows for adolescents with ASD to work on daily living skills in their own home with support from a therapist.

Two functions of the primate amygdala in social gaze

Appropriate gaze interaction is essential for primate social life. Prior studies have suggested the involvement of the amygdala in processing eye cues but its role in gaze behavior during live social exchanges remains unknown. We recorded the activity of neurons in the amygdala of two monkeys as they engaged in spontaneous visual interactions. We showed that monkeys adjust their oculomotor behavior and actively seek to interact with each other through mutual gaze. During fixations on the eye region, some amygdala neurons responded with short latency and more strongly to mutual than non-reciprocal gaze (averted gaze). Other neurons responded with long latency and were more strongly modulated by active, self-terminated mutual gaze fixations than by passively terminated ones. These results suggest that the amygdala not only participates to the evaluation of eye contact, but also plays a role in the timing of fixations which is crucial for adaptive social interactions through gaze.

Fragile X syndrome in young females: Influence of executive function on the neurocognitive profile and adaptive behavior

INTRODUCTION

The aim of this study is to describe the relationship between executive function (EF) and performance in different areas of the neurocognitive profile in young girls with Fragile-X-Syndrome (FXS).

METHOD

A neuropsychological assessment was carried out to 40 female participants aged 7-16 years (26 FXS, 14 control group).

RESULTS

Regarding intellectual ability, in the group of girls with FXS 3.84 % of the participants obtained IQ scores in the range of moderate ID (IQ 35-40 to 49), 46.15 % in the range of mild ID (IQ 50-70), 38.46 % in the borderline range (IQ 70-85), and 11.53 % within the average range (IQ > 85). EF was found to have a greater influence on adaptive behavior, arithmetic ability, theory of mind, leadership, social integration, social competence, and anxiety/shyness in the group with FXS.

CONCLUSIONS

In girls with FXS, EF showed a greater influence on adaptive behavior, arithmetic ability, and social domain.

Clinical Profiles of Black and White Children Referred for Autism Diagnosis

Black children with autism are diagnosed at an older age. Whether or not late detection is paralleled by differing clinical presentation is not known. We evaluated symptom profiles of 245 Black and 488 sex- and age-matched White non-Hispanic participants (82.8% male; mean age: 4.2 years) referred for ASD diagnosis. Both groups showed similar overall levels of autistic symptoms. Black children had significantly but slightly lower scores on cognitive tests and on the Vineland communication domain than White children. Groups were comparable on internalizing and externalizing co-occurring problems. Given the largely similar clinical profiles, clinical differences in initial presentation may not be a primary reason for Black/White disparities in diagnostic and services use. Limitations of a cross-sectional referred sample are acknowledged.

Capturing cognitive and behavioral variability among individuals with Down syndrome: a latent profile analysis

Background

There is a high degree of inter- and intra-individual variability observed within the phenotype of Down syndrome. The Down Syndrome Cognition Project was formed to capture this variability by developing a large nationwide database of cognitive, behavioral, health, and genetic information on individuals with Down syndrome, ages 6–25 years. The current study used the Down Syndrome Cognition Project database to characterize cognitive and behavioral variability among individuals with Down syndrome.

Methods

Latent profile analysis was used to identify classes across a sample of 314 participants based on their cognition (IQ and executive functioning), adaptive and maladaptive behavior, and autism spectrum disorder symptomatology. A multivariate multinomial regression model simultaneously examined demographic correlates of class.

Results

Results supported a 3-class model. Each class demonstrated a unique profile across the subdomains of cognition and behavior. The “normative” class was the largest (n = 153, 48%) and displayed a relatively consistent profile of cognition and adaptive behavior, with low rates of maladaptive behavior and autism symptomatology. The “cognitive” class (n = 109, 35%) displayed low cognitive scores and adaptive behavior and more autism symptomatology, but with low rates of maladaptive behavior. The “behavioral” class, the smallest group (n = 52, 17%), demonstrated higher rates of maladaptive behavior and autism symptomatology, but with cognition levels similar to the “normative” class; their adaptive behavior scores fell in between the other two classes. Household income and sex were the only demographic variables to differ among classes.

Conclusions

These findings highlight the importance of subtyping the cognitive and behavioral phenotype among individuals with Down syndrome to identify more homogeneous classes for future intervention and etiologic studies. Results also demonstrate the feasibility of using latent profile analysis to distinguish subtypes in this population. Limitations and future directions are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s11689-021-09365-2.

Policymakers as safe havens: The relationship between adult attachment style, COVID-19 fear, and regulation compliance

The COVID-19 crisis has caused severe psychological distress. Governments have been trying to fight the outbreak, inter alia, by enacting various restrictions to maintain social distancing. However, compliance with restrictions depends upon different interpersonal variables. The present study focused on the relationship between attachment patterns, fear of COVID-19, and adherence to COVID-19 guidelines. Participants completed the ECR measure to assess their adult attachment style, in addition to a COVID-19 fear and guidelines compliance questionnaire. We suggest that anxious attachment patterns may be related to heightened fear of COVID-19. Although fear and guideline adherence were positively correlated, secure attachment patterns were correlated to higher adherence than insecure attachment patterns.

Learning in single cell organisms

The survival of all species requires appropriate behavioral responses to environmental challenges. Learning is one of the key processes to acquire information about the environment and adapt to changing and uncertain conditions. Learning has long been acknowledged in animals from invertebrates to vertebrates but remains a subject of debate in non-animal systems such a plants and single cell organisms. In this review I will attempt to answer the following question: are single cell organisms capable of learning? I will first briefly discuss the concept of learning and argue that the ability to acquire and store information through learning is pervasive and may be found in single cell organisms. Second, by focusing on habituation, the simplest form of learning, I will review a series of experiments showing that single cell organisms such as slime molds and ciliates display habituation and follow most of the criteria adopted by neuroscientists to define habituation. Then I will discuss disputed evidence suggesting that single cell organisms might also undergo more sophisticated forms of learning such as associative learning. Finally, I will stress out that the challenge for the future is less about whether or not to single cell organisms fulfill the definition of learning established from extensive studies in animal systems and more about acknowledging and understanding the range of behavioral plasticity exhibited by such fascinating organisms.

Postoperative improvement of executive function and adaptive behavior in children with intractable epilepsy

INTRODUCTION

An alteration in postoperative cognitive function varies according to the patients' background characteristics, such as etiology, focus, and seizure duration. Accurate prediction and assessment of postoperative cognitive function is difficult in each patient. Adaptive behavior could describe the typical performance of daily activities and represents the ability to translate cognitive potential into real-world skills. We examined the relationship between alterations of executive function (EF) and adaptive behavior in school children undergoing surgery for intractable epilepsy.

METHODOLOGY

We enrolled 31 children with focal resection or corpus callosotomy for intractable epilepsy [mean age at surgery, 12.5 years; 16 boys; mean intellectual quotient, 73.3]. We surveyed answered questionnaires on attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and adaptive behavior using the Vineland Adaptive Behavior Scale, 2nd edition (VABS-II), and performed continuous performance tests (CPTs) on children pre- and postoperatively.

RESULT

ADHD and ASD symptoms improved after epilepsy surgery. The omission error (OE) in the CPT variable improved after epilepsy surgery, especially in children with a shorter preoperative period. Improved ASD symptoms led to an increased score of the coping skills subdomain. The reduced OE observed after surgery also increased the score of the community skills subdomain.

CONCLUSION

Improvement in EF and ASD symptoms resulted in better adaptive behavior postoperatively. These results were important for the pre- and postoperative evaluation and re-evaluation of children with epilepsy requiring special education and related services.

Adaptive Behavioral, Social-Emotional, and Neurodevelopmental Outcomes at 2 Years of Age in Hungarian Preterm Infants Based on Bayley III

AIM

 This study aimed to assess cognitive, language, and motor development as well as social-emotional and adaptive behavior skills of low birthweight (LBW) children.

METHODS

Our cohort contained 305 two-year-old LBW children. Developmental functioning was assessed by the Bayley Scales of Infant and Toddler Development, 3^rd Edition.

RESULTS

Performance in language, particularly in expressive communication was the poorest. Extremely low birthweight (ELBW) children were found to be at increased risk of developmental delay: 12.73 times in motor (95%CI = 2.8-57.5), 9.81 times in cognitive (95%CI = 3.2-29.6) and 3.91 times in language (95%CI = 1.6-9.4), and social-emotional skills (95%CI = 1.6-9.5). Parents of children with lower birthweight reported poorer social and practical adaptive skills. Self-care domain seemed to be the least developed.

CONCLUSION

Additionally, the screening for developmental delays, monitoring the adaptive behavior skills may also be useful - especially among ELBW children - in order to identify the specific areas, situations, and functions that are most in need of interventions.

ABBREVIATIONS

AB: Adaptive Behavior; ABAS-II: Adaptive Behavior Assessment System-II; BPD: Bronchopulmonary Dysplasia; BSID-III: Bayley Scales of Infant Development 3^rd Edition; BW: Birthweight; CI: Confidence Interval; CS: Composite Score; ELBW: Extremely Low Birthweight; GA: Gestational Age; IVF: In Vitro Fertilization; IVH: Intraventricular Hemorrhage; LBW: Low Birthweight; NEC: Necrotizing Enterocolitis; OR: Odds Ratio; ROP: Retinopathy of Prematurity; SE: Social-Emotional Development; VLBW: Very Low Birthweight.

The effect of adaptive behavior on risk propagation in industrial symbiosis networks

The complex symbiotic relationship in the industrial symbiosis network (ISN) may cause new risks for firms. In view of this problem, previous studies mainly regard the ISN as a static system, without considering the adaptive behavior of firms. This paper establishes a risk propagation model of the ISN based on the change of firm state, proposes four kinds of reconnection strategies to model the adaptive behavior, and uses numerical simulation to investigate the effect of adaptive behavior on risk propagation. The results demonstrate that all the reconnection strategies play an inhibitory role in the risk propagation. Therein, the effectiveness of PP strategy is the best, followed by RR strategy, and DP (SP) strategy. In any case, the effect of reconnection strategies on risk propagation will improve with the increase of the disconnection probability and network resilience. Additionally, the more decentralized weight distribution will weaken the inhibition of adaptive behavior on risk propagation.

Individual and Environmental Factors Affecting Adaptive Behavior of Toddlers with Autism Spectrum Disorder: Role of Parents' Socio-cultural Level

The effects of environmental factors [including Socio-Economic Status, Cultural Capital, and Social Capital (Socio-Cultural Level) of both parents] on the Vineland-II adaptive behavior dimensions of toddlers with autism spectrum disorder (ASD), in addition to individual factors, was investigated in 148 Italian toddlers (82% males), aged 18 to 37 months with ASD. Toddlers’ age and Griffiths Mental Development Scales general development affected all of the adaptive behavior dimensions, with negative and positive associations, respectively. The Child Behavior Checklist comorbid conditions were negatively associated with some adaptive behavior dimensions while the ADOS-2 Social affect only with the communication dimension. Mothers’ and fathers’ specific Socio-Cultural Level dimensions were positively associated with toddlers’ specific adaptive behavior dimensions with the same magnitude as comorbid conditions.

A Bayesian brain model of adaptive behavior: an application to the Wisconsin Card Sorting Task

Adaptive behavior emerges through a dynamic interaction between cognitive agents and changing environmental demands. The investigation of information processing underlying adaptive behavior relies on controlled experimental settings in which individuals are asked to accomplish demanding tasks whereby a hidden regularity or an abstract rule has to be learned dynamically. Although performance in such tasks is considered as a proxy for measuring high-level cognitive processes, the standard approach consists in summarizing observed response patterns by simple heuristic scoring measures. With this work, we propose and validate a new computational Bayesian model accounting for individual performance in the Wisconsin Card Sorting Test (WCST), a renowned clinical tool to measure set-shifting and deficient inhibitory processes on the basis of environmental feedback. We formalize the interaction between the task's structure, the received feedback, and the agent's behavior by building a model of the information processing mechanisms used to infer the hidden rules of the task environment. Furthermore, we embed the new model within the mathematical framework of the Bayesian Brain Theory (BBT), according to which beliefs about hidden environmental states are dynamically updated following the logic of Bayesian inference. Our computational model maps distinct cognitive processes into separable, neurobiologically plausible, information-theoretic constructs underlying observed response patterns. We assess model identification and expressiveness in accounting for meaningful human performance through extensive simulation studies. We then validate the model on real behavioral data in order to highlight the utility of the proposed model in recovering cognitive dynamics at an individual level. We highlight the potentials of our model in decomposing adaptive behavior in the WCST into several information-theoretic metrics revealing the trial-by-trial unfolding of information processing by focusing on two exemplary individuals whose behavior is examined in depth. Finally, we focus on the theoretical implications of our computational model by discussing the mapping between BBT constructs and functional neuroanatomical correlates of task performance. We further discuss the empirical benefit of recovering the assumed dynamics of information processing for both clinical and research practices, such as neurological assessment and model-based neuroscience.

Early Brain Injury and Adaptive Functioning in Middle Childhood: The Mediating Role of Pragmatic Language

OBJECTIVE

Traumatic brain injuries (TBIs) often adversely affect adaptive functioning (AF). However, the cognitive mechanisms by which AF is disrupted are not well understood in young children who sustain TBI. This study examined pragmatic language (PL) and executive functioning (EF) as potential mechanisms for AF disruption in children with early, predominantly mild-complicated, TBI.

METHOD

The sample consisted of 76 children between the ages of 6 and 10 years old who sustained a TBI (n = 36) or orthopedic injury (OI; n = 40) before 6 years of age and at least 1 year prior to testing (M = 4.86 years, SD = 1.59). Children's performance on a PL and an expressive vocabulary task (which served as a control task), and parent report of child's EF and AF were examined at two time points 1 year apart (i.e., at age 8 and at age 9 years).

RESULTS

Injury type (TBI vs. OI) significantly predicted child's social and conceptual, but not practical, AF. Results indicated that PL, and not expressive vocabulary or EF at time 1, mediated the relationship between injury type and both social and conceptual AF at time 2.

CONCLUSIONS

A TBI during early childhood appears to subtly, but uniquely, disrupt complex language skills (i.e., PL), which in turn may disrupt subsequent social and conceptual AF in middle childhood. Additional longitudinal research that examines different aspects of PL and adaptive outcomes into adolescence is warranted.

Factors affecting the relationship between adaptive behavior and challenging behaviors in individuals with intellectual disability and co-occurring disorders

Previous studies have reported an inverse relationship between adaptive behavior and challenging behaviors in individuals with ID. However, it is unclear which characteristics might influence this relationship in individuals with ID and co-occurring conditions. We found a positive correlation between adaptive behavior (Vineland-II) and challenging behaviors (Nisonger Child Behavior Rating Form) in a study of 105 individuals who presented with mostly severe to profound ID and comorbid physical and mental health conditions. These results might be the consequence of the individual participant characteristics. Therefore, participants were separated out into two groups representing the top (n = 24) and bottom quartiles (n = 28) for presence of challenging behaviors. The participants with the highest levels of challenging behaviors had higher levels of adaptive behavior, higher frequency of intermittent explosive/conduct disorder, but lower frequency of epilepsy and cerebral palsy. All participants with the highest levels of challenging behaviors lived in an institutional setting; whereas, those with the lowest level of challenging behaviors lived in either an institutional setting or with their family. In participants with severe/profound ID and multiple co-occurring disorders, a minimum level of adaptive behavior seems to be necessary for the expression of challenging behaviors.

The Gap Between Cognition and Adaptive Behavior in Students with Autism Spectrum Disorder: Implications for Social Anxiety and the Moderating Effect of Autism Traits

The gap between cognitive ability and adaptive behavior has been thought to enhance psychopathology among people with autism, particularly among those without intellectual disability. We examined this association by exploring the gap between cognitive understanding of social behavior and socially adaptive behavior, and its impact on social anxiety symptoms, obsessive-compulsive symptoms, and depressive symptoms, among 53 university students with autism (without intellectual disability). A higher cognition-social adaptation discrepancy was associated with more social anxiety, but this effect was moderated by autistic trait (AT) levels; a greater gap was associated with more avoidance symptoms of social anxiety only among students with high AT. Cognitive flexibility and prosocial behavior may mitigate the effects of AT. Potential implications and interventions are discussed.

Effects of sleep restriction during pregnancy on postpartum maternal behavior in female rats

Preclinical studies evaluating the effects of gestational sleep restriction on maternal behavior are needed in order to provide information on the background mechanisms underlying this relationship. In this study, 32 female 90 days-old Wistar-Hannover rats were distributed in two groups: Control group (CTRL - n = 13), not subjected to any manipulation during pregnancy; and sleep restriction group (SR - n = 19) - subjected to sleep restriction during the whole pregnancy (21 days). Maternal behavioral analysis was conducted from postpartum day 1 (PPD1) to PPD7, based on observational ethograms. On PPD11 the animals were subjected to the grooming analysis algorithm, followed by the elevated plus maze. Results from an ethogram-based analysis indicated a decrease in self-grooming among sleep-deprived rats (denoting reduced anxiety-like behavior), but no significant differences were found in maternal behavior (except for a slight increase in high arched-back nursing). Controlled analysis detected an impairment in high-arched back nursing in sleep-deprived animals. The grooming microstructure analysis showed an increased frequency of incorrect transitions among sleep restricted animals, indicating increased anxiety-like behavior. No significant differences were observed in the elevated-plus maze. In conclusion, sleep-restricted pregnant rats display an equivalent or slightly increased maternal behavior during the postpartum period, when compared to control animals.