Reading comprehension improvement in autism

Introduction

A subset of autistic children excel at word decoding but have difficulty with reading comprehension (i.e., the discrepant poor comprehender reading profile). Prior research suggests the Visualizing and Verbalizing (V/V) for language comprehension and thinking intervention helps improve reading comprehension in autistic children with this reading profile. Previous studies have demonstrated the role of vocabulary, memory, and social functioning in reading comprehension; however, predictors and moderators of reading comprehension within this specific profile of autistic readers have not been thoroughly explored.

Methods

In this study, we examined the effectiveness of the V/V intervention by comparing reading comprehension scores between groups and across time. Participants included a sample of autistic children (AUT-EXP; n=22) and a waitlist control group of autistic children (AUT-WLC; n=17) with reading comprehension difficulties, as well as a sample of non-autistic children (Non-AUT; n=26) (all age 8-13 years). AUT-EXP and AUT-WLC groups completed a battery of cognitive assessments during pre and post tests. We also analyzed whether cognitive assessment scores predicted reading comprehension, and examined the moderating effects of group (AUT-EXP vs. AUT-WLC) on these relationships.

Results

The AUT-EXP group significantly improved in their pre to post reading comprehension scores (t(21)=4.19, p<.001, d=.89), whereas the AUT-WLC group did not. Verbal memory significantly predicted reading comprehension, though group did not moderate relationships between cognitive test performance and reading comprehension.

Discussion

Results suggest that the V/V intervention may help improve reading comprehension for autistic children with the discrepant poor comprehender reading profile. Additionally, strategies for improving verbal memory may indirectly enhance reading comprehension in autistic children with this reading profile.

Risky driving behavior among individuals with Autism, ADHD, and typically developing persons

INTRODUCTION

Many individuals with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) often experience difficulty with driving, including difficulty with obtaining a driver's license as well as driving safely and efficiently. Such difficulties negatively impact their ability to function independently and participate in daily activities that require driving. ASD and ADHD commonly occur co-morbidly and share many overlapping clinical features. Few studies have directly compared the nature of difficulties in driving safety outcomes between ASD and ADHD. The overarching goal of the current study was to characterize and compare self-reported driving behavior among young autistic drivers, ADHD drivers, and typically developing (TD) drivers.

METHOD

Fifty-four participants (14 ASD, 20 ADHD, 20 TD); ages 16-30) completed the Autism Spectrum Quotient and ADHD Adult Rating scale as a method of screening of symptoms. All three groups then completed the Driving Behavior Questionnaire (DBQ), which measured self-reported driving violations, driving errors, and overall risky driving behavior. The three groups of ASD, ADHD, and TD individuals were then compared regarding symptomology and driving behavior differences.

RESULTS

One-way ANOVAs indicated group differences in DBQ total scores and DBQ errors. Drivers with ADHD reported significantly greater overall risky driving behaviors and driving errors compared to ASD and TD drivers. There were no significant differences between ASD and TD drivers in reported risky driving behaviors and errors. Linear regressions indicated that among all drivers, self-reported ADHD symptoms were significantly associated with higher levels of self-reported overall risky driving and driving errors, regardless of diagnostic group.

DISCUSSION

Risky driving and driving errors may be more closely related to symptoms that are characteristic of ADHD. This has implications for individuals with ADHD and autistic individuals who often show or report higher rates of ADHD symptoms. Future studies should compare driving skills of ASD and ADHD drivers using objective measures of driving performance, such as driving simulators or on-road tests.

White and gray matter correlates of theory of mind in autism: a voxel-based morphometry study

Autism spectrum disorder (ASD) is characterized by difficulties in theory of mind (ToM) and social communication. Studying structural and functional correlates of ToM in the brain and how autistic and nonautistic groups differ in terms of these correlates can help with diagnosis and understanding the biological mechanisms of ASD. In this study, we investigated white matter volume (WMV) and gray matter volume (GMV) differences between matching autistic and nonautistic samples, and how these structural features relate to age and ToM skills, indexed by the Reading the Mind in the Eyes (RMIE) measure. The results showed widespread GMV and WMV differences between the two groups in regions crucial for social processes. The autistic group did not express the typically observed negative GMV and positive WMV correlations with age at the same level as the nonautistic group, pointing to abnormalities in developmental structural changes. In addition, we found differences between the two groups in how GMV relates to ToM, particularly in the left frontal regions, and how WMV relates to ToM, mostly in the cingulate and corpus callosum. Finally, GMV in the left insula, a region that is part of the salience network, was found to be crucial in distinguishing ToM performance between the two groups.

Pathways to Psychopathology Among Autistic Adults

PURPOSE OF REVIEW

Autistic adults frequently require treatment of mental health problems. Increased rates of suicidality and diminished quality of life among autistic people may be partially attributable to psychiatric symptoms. Some risk factors for mental health problems in autistic people are likely the same as risk factors present in neurotypical individuals, but unique factors that are specific to neurodivergent individuals, and some even more specific to autistic people, may exist. Understanding pathways from autism to mental health problems could inform intervention efforts at the individual and societal levels.

RECENT FINDINGS

We review a growing body of research identifying risk processes across the affective, cognitive, and social domains. Consistent with the principle of equifinality, different processes appear to independently and jointly lead to heightened risk for the onset of mental health problems. Autistic adults frequently utilize mental healthcare services, and experience heightened risk for chronic impairment as a result of mental health problems. Understanding causal and developmental risk processes in autism should inform personalized treatment. We synthesize extant research on these processes and offer suggestions for addressing them therapeutically and societally.

The spike-and-slab elastic net as a classification tool in Alzheimer's disease

Alzheimer's disease (AD) is the leading cause of dementia and has received considerable research attention, including using neuroimaging biomarkers to classify patients and/or predict disease progression. Generalized linear models, e.g., logistic regression, can be used as classifiers, but since the spatial measurements are correlated and often outnumber subjects, penalized and/or Bayesian models will be identifiable, while classical models often will not. Many useful models, e.g., the elastic net and spike-and-slab lasso, perform automatic variable selection, which removes extraneous predictors and reduces model variance, but neither model exploits spatial information in selecting variables. Spatial information can be incorporated into variable selection by placing intrinsic autoregressive priors on the logit probabilities of inclusion within a spike-and-slab elastic net framework. We demonstrate the ability of this framework to improve classification performance by using cortical thickness and tau-PET images from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to classify subjects as cognitively normal or having dementia, and by using a simulation study to examine model performance using finer resolution images.

Accuracy of Machine Learning Algorithms for the Diagnosis of Autism Spectrum Disorder: Systematic Review and Meta-Analysis of Brain Magnetic Resonance Imaging Studies

BACKGROUND

In the recent years, machine learning algorithms have been more widely and increasingly applied in biomedical fields. In particular, their application has been drawing more attention in the field of psychiatry, for instance, as diagnostic tests/tools for autism spectrum disorder (ASD). However, given their complexity and potential clinical implications, there is an ongoing need for further research on their accuracy.

OBJECTIVE

This study aimed to perform a systematic review and meta-analysis to summarize the available evidence for the accuracy of machine learning algorithms in diagnosing ASD.

METHODS

The following databases were searched on November 28, 2018: MEDLINE, EMBASE, CINAHL Complete (with Open Dissertations), PsycINFO, and Institute of Electrical and Electronics Engineers Xplore Digital Library. Studies that used a machine learning algorithm partially or fully for distinguishing individuals with ASD from control subjects and provided accuracy measures were included in our analysis. The bivariate random effects model was applied to the pooled data in a meta-analysis. A subgroup analysis was used to investigate and resolve the source of heterogeneity between studies. True-positive, false-positive, false-negative, and true-negative values from individual studies were used to calculate the pooled sensitivity and specificity values, draw Summary Receiver Operating Characteristics curves, and obtain the area under the curve (AUC) and partial AUC (pAUC).

RESULTS

A total of 43 studies were included for the final analysis, of which a meta-analysis was performed on 40 studies (53 samples with 12,128 participants). A structural magnetic resonance imaging (sMRI) subgroup meta-analysis (12 samples with 1776 participants) showed a sensitivity of 0.83 (95% CI 0.76-0.89), a specificity of 0.84 (95% CI 0.74-0.91), and AUC/pAUC of 0.90/0.83. A functional magnetic resonance imaging/deep neural network subgroup meta-analysis (5 samples with 1345 participants) showed a sensitivity of 0.69 (95% CI 0.62-0.75), specificity of 0.66 (95% CI 0.61-0.70), and AUC/pAUC of 0.71/0.67.

CONCLUSIONS

The accuracy of machine learning algorithms for diagnosis of ASD was considered acceptable by few accuracy measures only in cases of sMRI use; however, given the many limitations indicated in our study, further well-designed studies are warranted to extend the potential use of machine learning algorithms to clinical settings.

TRIAL REGISTRATION

PROSPERO CRD42018117779; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=117779.

A-24 Metacognition and behavioral regulation associated with distinct connectivity patterns in autism spectrum disorder

Objective

Executive function (EF) deficits are well documented in children with autism spectrum disorder (ASD)1-2 and are commonly measured clinically using parent ratings3. No studies have investigated whether parent ratings of EF predict brain connectivity in ASD.

Aim

Examine whether the Behavior Rating Inventory of Executive Function (BRIEF) predicts functional brain connectivity in ASD.

Method

Resting-state fMRI and behavioral data were obtained from the Autism Brain Imaging Data Exchange (ABIDE-II) database6 (n = 106 ASD, ages 5-13). ROI-to-ROI (Region of Interest) connectivity was computed for 132 ROIs spanning the whole brain, defined using Conn Toolbox. Multiple regression analyses examined the effect of BRIEF metacognition on connectivity while controlling for BRIEF behavioral regulation, and vice versa. Age, sex, and full-scale IQ were included as covariates. FDR correction was used (p < 0.05).

Results

More severe deficits in metacognition were associated with stronger connectivity between the left hippocampus and several ROIs, including the cerebellum and planum temporale. More severe deficits in metacognition were associated with weaker right hippocampus – right frontal pole connectivity. More severe deficits in behavioral regulation were associated with stronger connectivity between subcortical regions (i.e., thalamus, putamen, and caudate) and regions involved in motor (superior frontal gyrus) and limbic systems (cingulate gyrus). More severe behavioral regulation deficits were associated with weaker cerebellar-cerebellar connectivity.

Conclusions

Findings suggest that parent-ratings of metacognitive abilities in children with ASD are associated with hippocampal connectivity, while behavioral regulation abilities are associated with thalamic and striatum connections. These results build upon previous studies of metacognition and behavioral regulation 5,6.

[S-100 protein positivity in osteogenic tumours and tumour-like bone forming lesions]

Various osteogenic tumours and bone producing tumour-like lesions of bone were examined for S-100 protein using the immunostaining methods. The positive reaction for S-100 protein of some bone cells was detected not only in osteoblastic osteosarcomas and osteoblastomas, but also in osteoplastic reactive lesions, fibrous dysplasia, Paget's disease and in the tissue of the bony callus. The positive reaction for osteocalcin in these cells showed, that they may be of osteoblastic and osteocytic lineage. The S-100 protein positive bone cells have to be differentiated from chondrocytes persisting in new-formed bone trabecullae. On the one hand S-100 protein positive osteocytes and osteoblasts may represent transient form of osteocytes histogenetically related to chondrocytes, but we were not able to prove such suggestion. Therefore, S-100 protein positivity can be caused by polyclonal character of the used antibody, that is a mixture of three antibodies, S-100 A1, A6 and anti B2. The specificity of these three components differs depending on the histogenesis of cells and their functional status. Such explanation is supported by the results of our study, because we also observed intense positivity of bone cells in the reaction with monoclonal antibody against S-100A6. In contrast, no staining of bone cells was detected with monoclonal antibodies against S-100 A1 and B2.

Expression of actin isoforms in human auricular cartilage

The objective of this study was to determine whether human auricular chondrocytes can also express alpha-- -smooth muscle actin. Immunohistochemistry using monoclonal antibodies for alpha-smooth actin, muscle-specific actin, beta-actin, S-100 protein, CD34, and desmin was performed on samples of human ear cartilage obtained from 20 individuals during a partial resection of the ear for different reasons. Moreover, the RT-PCR analysis of actin isoforms in auricular chondrocytes was performed. Approximately 60 % of the chondrocytes of the ear cartilage expressed alpha-smooth muscle actin as demonstrated by immunohistochemistry in all the examined samples. Actin-positive chondrocytes occurred in both external subperichondrial layers of the auricular cartilage. This finding was confirmed by the RT-PCR technique. The knowledge of this fact could help us to better understand the chondrocyte changes occurring during the healing and transplantation of auricular cartilage. The question of whether it is necessary to refer to these predominating cells in ear cartilage as myochondrocytes is considered. This is the first report of an unusual immunophenotype and contractile potential for human auricular chondrocytes.

Desmin-positive and alpha-smooth muscle actin positive chondrocytes in human defective articular cartilage--preliminary report

We studied the results of immunostaining for S-100 protein, alpha-smooth muscle actin, muscle specific actin and desmin in articular cartilage specimens obtained during an arthroscopy from eight patients with different degrees of osteoarthritis of the knee joint. In all cases, most of the cartilage cells were strongly positive for S-100 protein. Actin positive chondrocytes were present in four samples showing repair cartilage changes with occurrence of fibrocartilage tissue. Moreover, in one case, we observed typical desmin-positive chondrocytes in the layer of cartilage filling the defect of the articular cartilage surface. The expression of desmin can be regarded as a reaction to trauma or the indication of an inherent abnormality. The chondrocytes probably switched on smooth muscle features during the healing process, because desmin is to a great extent a typical muscle cell marker. This fact could probably support our previous supposition that cartilage cells expressing muscle markers could be designated as myochondroblasts and myochondrocytes analogously to the terminology of myofibroblasts. It is possible that during the healing of the cartilage defects, such a transformation of the immunophenotype of the cartilage cells is quite frequent, but it could also be only transient nature only.

Laryngeal papilloma--precancerous condition?

In a group of 179 patients treated for recurrent laryngeal papillomatosis 668 surgeries were performed in the years 1982-1995 in the Department of Otorhinolaryngology, Head and Neck Surgery in Prague. The group was divided into 77 patients with a juvenile form of papillomatosis and 102 patients with an adult form. The adult form was then divided into a multiple (65 patients) and solitary form (37 patients). Three patients with a juvenile form of papillomatosis were irradiated in advance. None of these patients developed a carcinoma. There were 3 cases (1.7%) of carcinoma in the whole group of patients with histologically verified papillomas during repeated previous surgeries. All 3 patients with malignancy had an adult form of papillomatosis, two with a multiple form and one with a solitary form. The intervals between the first treatment for papilloma and the diagnosis of carcinoma was 8, 3 and 2 years.The rates of malignant transformation of papillomas vary in the literature. We suppose, that because of the generally long interval between the diagnosis of papilloma and that of carcinoma, to make a final conclusion of a certain ratio is very difficult. We envisage that in our group of patients with papillomatosis new cases of carcinoma will occur in the future.