Selective Attention and Perceptual Load in Autism Spectrum Disorder

ABSTRACT— It has been suggested that the locus of selective attention (early vs. late in processing) is dependent on the perceptual load of the task. When perceptual load is low, irrelevant distractors are processed (late selection), whereas when perceptual load is high, distractor interference disappears (early selection). Attentional abnormalities have long been reported within autism spectrum disorder (ASD), and this study is the first to examine the effect of perceptual load on selective attention in this population. Fourteen adults with ASD and 23 adults without ASD performed a selective attention task with varying perceptual loads. Compared with the non-ASD group, the ASD group required higher levels of perceptual load to successfully ignore irrelevant distractors; moreover, the ASD group did not show any general reduction in performance speed or accuracy. These results suggest enhanced perceptual capacity in the ASD group and are consistent with previous observations regarding superior visual search abilities among individuals with ASD.     

Three Dimensions of Oppositionality in Autism Spectrum Disorder

In autism spectrum disorder (ASD), symptoms of oppositional defiant disorder (ODD) are common but poorly understood. DSM-5 has adopted a tripartite model of ODD, parsing its features into ‘angry and irritable symptoms’ (AIS), ‘argumentative and defiant behavior’ (ADB) and ‘vindictiveness’. This was based on findings in non-autistic populations that each of these dimensions of oppositionality has a distinct constellation of associations with internalising and externalising psychopathology. We applied the tripartite DSM-5 ODD model to ASD to test its generalisability beyond non-ASD populations; and to elucidate the nature of ODD symptoms in ASD. Participants were 216 verbally-fluent young people (mean age?=?9.6 years, range 3.0 to 16.2 years, 82 % male) with ASD. Cross-sectional parent-and teacher-report data were analysed using bootstrap multiple regression to test the following predictions, derived from studies of non-ASD young people: (1) AIS will be the main predictor of internalising problems; (2) ADB will be the main predictor of ADHD symptoms; (3) all ODD traits will independently predict conduct disorder symptoms; (4) vindictiveness will be the main predictor of aggressive conduct problems. Our findings using both parent and teacher data were consistent with the non-ASD ODD literature. AIS were associated with internalising but not externalising problems; ADB and vindictiveness were associated with externalising but not internalising problems; and vindictiveness was the main predictor of aggression. The DSM-5 tripartite model of ODD appears to be generalisable to ASD: for people with an autistic disorder, AIS, ADB and vindictive dimensions of oppositionality have distinct associations with concurrent psychopathology, suggesting the need to assess them as separate constructs.     

Comparing Attention to Socially-Relevant Stimuli in Autism Spectrum Disorder and Developmental Coordination Disorder

Difficulties with social interaction have been reported in both children with an autism spectrum disorder (ASD) and children with developmental coordination disorder (DCD), although these disorders have very different diagnostic characteristics. To date, assessment of social skills in a DCD population has been limited to paper-based assessment or parent report. The present study employed eye tracking methodology to examine how children attend to socially-relevant stimuli, comparing 28 children with DCD, 28 children with ASD and 26 typically-developing (TD) age-matched controls (aged 7–10). Eye movements were recorded while children viewed 30 images, half of which were classed as ‘Individual’ (one person in the scene, direct gaze) and the other half were ‘Social’ (more naturalistic scenes showing an interaction). Children with ASD spent significantly less time looking at the face/eye regions in the images than TD children, but children with DCD performed between the ASD and TD groups in this respect. Children with DCD demonstrated a reduced tendency to follow gaze, in comparison to the ASD group. Our findings confirm that social atypicalities are present in both ASD and to a lesser extent DCD, but follow a different pattern. Future research would benefit from considering the developmental nature of the observed findings and their implications for support.     

Financial Capabilities Among Youth with Autism Spectrum Disorder

Youth with Autism Spectrum Disorder (ASD) experience significant difficulties assuming adult responsibilities and achieving independence. Little is known about their desire or ability to manage their own finances. This study explored the financial circumstances, money management skills, and desires for financial independence among 27 youth with ASD. Youth took part in 30–60?min semi-structured interviews about independence. Strategies of theme analysis identified three critical themes about finances and emerging adulthood for youth with ASD. Youth (1) defined independence by being able to manage their finances, (2) worried about their lack of money management skills, and (3) cited poor financial skills as barrier to independence. Results suggest youth with ASD understand the importance of financial capability and strive for financial independence, but lack the skills and support needed to achieve their financial goals. This study provides preliminary information for clinicians, educators, and researchers to develop financial capability modules for youth with ASD.     

Community Perspectives on Adults With Autism Spectrum Disorder

Little is known about community attitudes toward adults with autism spectrum disorder (ASD) and what factors lead to more positive attitudes. Using a cross-sectional design with a quantitative correlational approach, 60 adults were surveyed regarding experiences, knowledge, and comfort with adults with ASD living in the community. Most participants reported having encountered a person with ASD. Among these participants with personal experience, knowledge about ASD was relatively high. Amount of experience was the only variable associated with comfort. Results suggest that increasing exposure to people with ASD may be more effective in improving community acceptance compared to informational campaigns.     

Selective Mutism and Its Relations to Social Anxiety Disorder and Autism Spectrum Disorder

In current classification systems, selective mutism (SM) is included in the broad anxiety disorders category. Indeed, there is abundant evidence showing that anxiety, and social anxiety in particular, is a prominent feature of SM. In this article, we point out that autism spectrum problems in addition to anxiety problems are sometimes also implicated in SM. To build our case, we summarize evidence showing that SM, social anxiety disorder (SAD), and autism spectrum disorder (ASD) are allied clinical conditions and share communalities in the realm of social difficulties. Following this, we address the role of a prototypical class of ASD symptoms, restricted and repetitive behaviors and interests (RRBIs), which are hypothesized to play a special role in the preservation and exacerbation of social difficulties. We then substantiate our point that SM is sometimes more than an anxiety disorder by addressing its special link with ASD in more detail. Finally, we close by noting that the possible involvement of ASD in SM has a number of consequences for clinical practice with regard to its classification, assessment, and treatment of children with SM and highlight a number of directions for future research.

     

Assessment and Diagnosis of Autism Spectrum Disorder in Hanoi,Vietnam

For individuals with autism spectrum disorder (ASD), early and accurate diagnosis enables early intervention, which leads to improved quality of life. The diagnostic label of ASD has only been recognized in Vietnam since 2000 and the number of children who have been diagnosed has increased dramatically. However, there is limited understanding about the condition. This article aims to describe the current assessment and diagnostic practices in Hanoi, Vietnam, a low resource setting. Data for this article came from in-depth interviews with parents of children with ASD and service providers, and observation at health clinics and early intervention centers that provide ASD assessment during field work from July 2011 to May 2012. This study reveals that although there is some improvement in assessment services, parents still face a number of challenges in accessing quality assessment and diagnosis of ASD in Vietnam. These include rushed and perfunctory assessment; a lack of clinical guidelines for assessment; limited communication among health professionals in assessment teams, and between professionals and parents of children with ASD. Public awareness-raising of the signs of autism, capacity building for professionals, development of practical and contextual appropriate assessment protocols are needed to enhance the accessibility and quality of assessment services.     

Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder

To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II). Detailed developmental and medical history was obtained from all participants. Diagnosis was based on clinical consensus of at least two expert clinicians, using test results, clinical observations, and parent report. 23% of participants with a reported community diagnosis of ASD were classified as non-spectrum based on our consensus diagnosis. ASD and non-spectrum participants did not differ on age at evaluation and age of first community diagnosis. Non-verbal IQ scores and Adaptive Behavior Composite scores were significantly higher in the non-spectrum group compared to the ASD group (104.5?±?21.7 vs. 80.1?±?21.6, p?<?.01; 71.1?±?15 versus 79.5?±?17.6, p?<?.05, respectively). Participants enrolled with community diagnosis of PDD-NOS were significantly more likely to be classified as non-spectrum on the study consensus diagnosis than Participants with Autism or Asperger (36% versus 9.5%, Odds Ratio?=?5.4, p?<?.05). This study shows suboptimal agreement between community diagnoses of ASD and consensus diagnosis using standardized instruments. These findings are based on limited data, and should be further studied, taking into consideration the influence of DSM 5 diagnostic criteria on ASD prevalence.     

A Comparison of Structural Brain Imaging Findings in Autism Spectrum Disorder and Attention-Deficit Hyperactivity Disorder

ASD and ADHD are regarded as distinct disorders in the current DSM-5. However, recent research and the RDoC initiative are recognizing considerable overlap in the clinical presentation of ASD, ADHD, and other neurodevelopmental disorders. In spite of numerous neuroimaging findings in ASD and ADHD, the extent to which either of the above views are supported remains equivocal. Here we compare structural MRI and DTI literature in ASD and ADHD. Our main findings reveal both distinct and shared neural features. Distinct expressions were in total brain volume (ASD: increased volume, ADHD: decreased volume), amygdala (ASD: overgrowth, ADHD: normal), and internal capsule (ASD: unclear, ADHD: reduced FA in DTI). Considerable overlap was noted in the corpus callosum and cerebellum (lower volume in structural MRI and decreased FA in DTI), and superior longitudinal fasciculus (reduced FA in DTI). In addition, we identify brain regions which have not been studied in depth and require more research. We discuss relationships between brain features and symptomatology. We conclude by addressing limitations of current neuroimaging research and offer approaches that account for clinical heterogeneity to better distinguish brain-behavior relationships.     

The Spectrum of Autism Spectrum Disorder: A Spectrum of Needs,Services, and Challenges

The dramatic rise in the diagnosis of autism spectrum disorders (ASDs) has resulted in a significant explosion in visibility and a substantial increase in the understanding of this complex group of disorders. Over the last decade, what was once defined only as “autism” has become a spectrum of neurodevelopmental disorders, with variable presentations and levels of impairment that requires an equally broad continuum of care. A wealth of research has not discovered a single “cause” for ASDs, but rather has found a range of genetic/genomic variations that likely play a significant role in the etiology of these disorders. Routine screening for autism is becoming more common, allowing for more timely diagnosis, and hopefully for earlier entry into appropriate and effective treatment. Although there remains no single ‘‘cure’’, there are treatments available that can improve overall functioning and decrease problematic or interfering symptoms across the full spectrum of this disorder. The wide spectrum of ASD presentations complicates treatment planning, with overall ASD severity a factor in determining type, intensity, and duration of interventions and services. This article presents a two-dimensional model of “ASD severity” that considers both the level of specific ASD symptoms/deficits and the level of cognitive resources/limitations as a framework for understanding needs, challenges, and potentially effective interventions for individuals across the ASD spectrum.     

Sympathetic Under-Arousal and Externalizing Behavior Problems in Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) commonly exhibit co-occurring externalizing behavior problems, which can impede learning opportunities and contribute significantly to caregiver stress. Substantial theory and research has linked under-arousal of the sympathetic nervous system to increased externalizing problems in children without ASD, but under-arousal has not been considered as an explanatory mechanism for individual differences among children with ASD. We tested the notion that lower electrodermal activity (EDA) would predict more externalizing problems in children with ASD, and considered the degree to which parent co-regulatory support could buffer this risk. Forty children with ASD between the ages of 4 and 11 years and their primary caregivers participated in a laboratory visit that included various play, compliance, and problem-solving regulatory tasks. EDA was measured through wireless wrist sensors, parental scaffolding was observed during a dyadic problem-solving task, and parents rated their children’s externalizing behavior problems. As predicted, low EDA during the compliance-oriented tasks directly predicted higher child externalizing problems. Parental scaffolding moderated the link between under-arousal during the problem-solving regulatory tasks and externalizing problems such that the relation was observed in the context of low, but not high, support. Implications for relevant theories (e.g., fearlessness theory, stimulation-seeking theory) are discussed, and the potential for psychophysiological patterns to inform intervention with these children is considered.     

Memory for emotionally arousing events over time in Autism Spectrum Disorder

Emotionally arousing events are typically better remembered and more resistant to forgetting than neutral events. Findings from word list paradigms suggest that this may not hold for individuals with Autism Spectrum Disorder (ASD), who also tend to be less accurate as eyewitnesses under some circumstances. To test whether attenuated effects of arousal on memory may be responsible for poorer eyewitness testimonies in ASD, we asked adults with and without the disorder to view either arousing or neutral versions of a narrated slide sequence (Experiment 1) or video clip (Experiment 2) before assessing their memory for the material. Both groups exhibited increases in psychophysiological arousal during the arousing compared with the neutral version of the narratives, and both groups also demonstrated a memory advantage for the arousing events. Contrary to predictions, these observations indicate that stimulus induced arousal modulates memory for naturalistic events relatively typically in ASD. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Electrodermal Activity Moderates Sleep-Behavior Associations in Children with Autism Spectrum Disorder

Research on Child and Adolescent Psychopathology - Relative to children without autism spectrum disorder (ASD), children with ASD experience elevated sleep problems that can contribute to...     

Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.     

Parentification of Adult Siblings of Individuals with Autism Spectrum Disorder

Many typically-developing (TD) siblings provide care for their siblings with autism spectrum disorder (ASD), both as children and as adults. Research on parentification (i.e., when children assume responsibilities typically reserved for adults) has been mixed, with some studies supporting positive outcomes for TD siblings and others indicating negative outcomes. Some of these discrepancies may be due to inconsistencies in differentiating types of parentification. The current study examined how different types of parentification during childhood (retrospectively-reported) related to distress outcomes and attitudes about sibling relationships among 41 TD adult siblings of individuals with ASD. Results indicated that parent-focused parentification was positively related with anxiety and stress among TD siblings. Sibling-focused parentification was positively related to stress but was also related to more positive sibling relationship attitudes. Accounting for demographic variables and the other form of parentification, parent-focused parentification was a unique predictor of distress, whereas sibling-focused parentification was a unique predictor of positive sibling relationship attitudes. Although parentification is often viewed negatively, sibling-focused parentification and perceived benefits of parentification may predict positive outcomes. Results suggest that parentification may prove important in understanding the complex nature of sibling relationships. Specifically, strengthening the sibling bond and reducing parent-focused parentification during childhood may curtail sibling relationship problems and general distress in TD siblings later in life.     

Children with Autism and Their Friends: A Multidimensional Study of Friendship in High-Functioning Autism Spectrum Disorder

This study of Israeli and American preadolescent children examined characteristics of friendship in 44 children with high-functioning autism spectrum disorder (HFASD) compared to 38 typically developing children (TYP), as they interacted with a close friend Participants were 8-12 years of age (HFASD: Israel, n = 24; USA, n = 20; TYP: Israel, n = 23; USA, n = 15), and were matched on SES, receptive language vocabulary, child age, and gender (each study group included one girl). Multidimensional assessments included: individual behaviors of target children and observed child-friend interactions during construction and drawing scenarios; target child's and friend's self-perceived mutual friendship qualities; and mother-reported characteristics (friendship's duration/frequency; friend's age/gender/disability status). Overall, children with HFASD displayed a number of differences on individual and dyadic friendship measures. Both age and verbal abilities affected friendship behaviors. Children with HFASD and their friends perceived friendship qualities similarly, suggesting that preadolescents with HFASD have capacities for interpersonal awareness. Between-group similarities also emerged on several complex social behaviors, suggesting that friendship follows a developmental trajectory in autism and may enhance social interaction skills in autism.     

Increasing Behavioral Variability and Social Skill Accuracy in Children with Autism Spectrum Disorder

Although social skills training for children with autism spectrum disorder (ASD) often addresses deficits in social communication, restricted and repetitive social behaviors are less frequently targeted in the literature. The present study evaluated a manualized social skills training program, modified to incorporate lag schedules of reinforcement, to promote appropriate and variable responding in three children in a school setting. Participants attended social skills once weekly, with probes of social skills taking place daily. A multiple baseline design across target skills was used to determine intervention efficacy. Results of the study indicated that the social skills curriculum incorporating lag schedules of reinforcement resulted in substantial increases in the number of appropriate and variable responses demonstrated by participants during each probe session, as well as the number of appropriate and variable responses demonstrated overall.