Functional analysis of tardive dyskinesia: implications for assessment and treatment

We conducted an analogue functional analysis contrasting motor tasks with varying types of social consequences for movements associated with tardive dyskinesia (TD) in 2 men who had been diagnosed with developmental disabilities and TD. Our findings suggest that TD-related movements were not a function of social reinforcement contingencies. However, motor-activation tasks decreased TD-related movements, suggesting a possible novel intervention.     

Moving to Directly Cued Locations Abolishes Spatial Interference During Bimanual Actions

Interference is frequently observed during bimanual movements if the two hands perform nonsymmetric actions. We examined the source of bimanual interference in two experiments in which we compared conditions involving symmetric movements with conditions in which the movements were of different amplitudes or different directions. The target movements were cued either symbolically by letters or directly by the onset of the target locations. With symbolic cues, reaction times were longer when the movements of the two hands were not symmetric. With direct cues, reaction times were the same for symmetric and nonsymmetric movements. These results indicate that directly cued actions can be programmed in parallel for the two hands. Our results challenge the hypothesis that the cost to initiate nonsymmetric movements is due to spatial interference in a motor-programming stage. Rather, the cost appears to be caused by stimulus identification, response-selection processes connected to the processing of symbolic cues, or both.     

Emotion regulation in Asperger's syndrome and high-functioning autism

It is generally thought that individuals with Asperger's syndrome and high-functioning autism (AS/HFA) have deficits in theory of mind. These deficits have been previously linked to problems with social cognition. However, we reasoned that AS/HFA individuals' Theory of Mind deficits also might lead to problems with emotion regulation. To assess emotional functioning in AS/HFA, 27 AS/HFA adults (16 women) and 27 age-, gender-, and education-matched typically developing (TD) participants completed a battery of measures of emotion experience, labeling, and regulation. With respect to emotion experience, individuals with AS/HFA reported higher levels of negative emotions, but similar levels of positive emotions, compared with TD individuals. With respect to emotion labeling, individuals with AS/HFA had greater difficulties identifying and describing their emotions, with approximately two-thirds exceeding the cutoff for alexithymia. With respect to emotion regulation, individuals with AS/HFA used reappraisal less frequently than TD individuals and reported lower levels of reappraisal self-efficacy. Although AS/HFA individuals used suppression more frequently than TD individuals, no difference in suppression self-efficacy was found. It is important to note that these differences in emotion regulation were evident even when controlling for emotion experience and labeling. Implications of these deficits are discussed, and future research directions are proposed.     

场景的年龄特征会影响自闭症谱系障碍儿童的注视模式

为了探讨场景年龄特征对ASD儿童场景注视模式的影响,选取14名自闭症谱系障碍（ASD）儿童和19名与其智力年龄匹配的正常发育（TD）儿童为被试,在被试对儿童场景和成人场景图片进行自由观看的同时记录其眼动。结果发现,ASD儿童对全图、面部、眼部和嘴部的访问均显著少于TD儿童,对背景区域的访问显著大于TD儿童;ASD和TD儿童对面部和身体的访问时间比都显著大于前景与背景兴趣区;ASD儿童对儿童场景中面部、眼部和嘴部兴趣区的访问时间比大于成人场景,而TD儿童则相反;两组儿童都表现出对儿童场景中背景的偏好。结果表明,在场景注视中,ASD与TD儿童具有相似的社会性注意倾向,对社会性信息给予更多注视,但ASD儿童表现更弱;场景的年龄特征会影响ASD儿童与TD儿童的场景注视模式,相对于成人场景,ASD儿童更偏向于注视儿童场景中的面孔和背景。     

The effects of movement direction and hemispace on estimates of distance traveled

BACKGROUND/HYPOTHESIS: The degree of attention directed to a stimulus and the presence of anisometric representations can alter the perception of the magnitude of a stimulus. We wanted to learn if normal right-handed subjects' estimates of distance traveled are influenced by the right-left direction or hemispace of movements. METHODS: We had blindfolded participants estimate the distance their arm was moved in a rightward or leftward direction, in right and left hemispace. Since we wanted subjects to estimate the distance traveled rather than compute the distance between the start and finish points, the subjects' arms were passively moved in sinusoidal trajectories at a constant speed. RESULTS: Subjects estimated leftward movements as longer than rightward movements, but there was no effect of hemispace. COMMENTS/CONCLUSIONS: People often attend more to novel than routine conditions and therefore participants might have overestimated the distance associated with leftward versus rightward movement because right-handed people more frequently move their right hand in a rightward direction and learn to read and write using rightward movements. Thus, leftward movements might be more novel and more attended than rightward movements and this enhanced directional attention might have influenced estimates of magnitude (distance).     

The effects of paired kinesthetic movements on literacy skills acquisition with preschoolers

Students who fail to acquire foundational literacy skills during preschool are more likely to read below grade level average in elementary school and are at a heightened risk for future school failure, poverty, early mortality, and crime. The purpose of this study was to compare the effects and maintenance of and preference for paired kinesthetic movements (KM) to a traditional drill (TD) procedure on letter–sound correspondence and word recognition with 6 preschool children. In 6 of 11 evaluations, participants mastered the KM set in substantially fewer intervention sessions than the TD set. In 5 of 11 evaluations, participants mastered the KM and TD sets with little differentiation between the number of intervention sessions. No participant mastered the control set. Maintenance data demonstrate a higher number of correct responses for the KM condition across all weeks. Preference varied across participants and was not always consistent with the more effective intervention.     

Do children with autism use inner speech and visuospatial resources for the service of executive control? Evidence from suppression in dual tasks

Three experiments used dual‐task suppression methodology to study the use of inner speech and visuospatial resources for mediating central executive performance by children with autism (CWA) and group‐matched typically developing (TD) controls. Expt 1 revealed that CWA did not recruit inner speech to facilitate arithmetic task‐switching performance: there was no effect of articulatory suppression (AS) on completion time for CWA compared to the TD group. Expt 2 revealed that suppression of visuospatial resources disrupted the task‐switching performance of both CWA and TD groups. It also confirmed that the task‐switching performance of CWA was significantly slowed by visuospatial compared to AS. Expt 3 showed that CWA also did not employ inner speech, compared to visuospatial resources, for implementing planning movements. Overall, compared to the mixture of representations used by the TD group for problem solving, CWA seemed to use visuospatial working memory resources but not inner speech to service executive control.     

Out of mind,out of sight? Investigating abnormal face scanning in autism spectrum disorder using gaze‐contingent paradigm

Diminished social motivation is hypothesized to explain abnormal face scanning pattern in individuals with autism spectrum disorder (ASD), especially reduced eye‐looking time in ASDs than typically developing (TD) people. Here, we tested an alternative explanation that children with ASD may use a compensatory strategy to avoid direct eye contact by processing the eyes through peripheral vision. We compared the face scanning patterns of children with and without ASD in two conditions: in the clear condition, the face was completely visible; in the blur condition, by using the gaze‐contingent paradigm, the whole face was blurred except for a small region being fixated at, thus children could not rely on the peripheral information to process the eyes. We found that children with ASD fixated less on the eyes than TD children in both conditions. Temporal‐course analyses further revealed the possible motivation‐based guidance of attention to process the eyes in the TD group but not in the ASD group. Additionally, we found that children with ASD scanned faces more randomly and less strategically than TD children. These results have ruled out the alternative hypothesis that the abnormal face scanning pattern in ASDs was due to their compensatory strategy to process eyes through peripheral vision, furthering our understanding of the mechanisms underlying their abnormal face scanning.     

Drawing the line: Drawing and construction strategies for simple and complex figures in Williams syndrome and typical development

In the typical population, a series of drawing strategies have been outlined, which progressively emerge during childhood. Individuals with Williams syndrome (WS), a rare genetic disorder, produce drawings that lack cohesion, yet drawing strategies in this group have hitherto not been investigated. In this study, WS and typically developing (TD) groups drew and constructed (from pre‐drawn lines and shapes) a series of intersecting and embedded figures. Participants with WS made use of the same strategies as the TD group for simple intersecting figures, though were less likely to use a typical strategy for more complex figures that contained many spatial relations. When replicating embedded shapes, the WS group used typical drawing strategies less frequently than the TD group, despite attempting to initiate a strategy that is observed in TD children. Results suggested that individuals with WS show a particular difficulty with replicating figures that include multiple spatial relations. The impact of figure complexity and task demands on performance are discussed.     

Training children aged 5–10 years in manual compliance control to improve drawing and handwriting

A large proportion of school-aged children exhibit poor drawing and handwriting. This prevalence limits the availability of therapy. We developed an automated method for training improved manual compliance control and relatedly, prospective control of a stylus. The approach included a difficult training task, while providing parametrically modifiable support that enables the children to perform successfully while developing good compliance control. The task was to use a stylus to push a bead along a 3D wire path. Support was provided by making the wire magnetically attractive to the stylus. Support was progressively reduced as 3D tracing performance improved. We report studies that (1) compared performance of Typically Developing (TD) children and children with Developmental Coordination Disorder (DCD), (2) tested training with active versus passive movement, (3) tested progressively reduced versus constant or no support during training, (4) tested children of different ages, (5) tested the transfer of training to a drawing task, (6) tested the specificity of training in respect to the size, shape and dimensionality of figures, and (7) investigated the relevance of the training task to the Beery VMI, an inventory used to diagnose DCD. The findings were as follows. (1) Pre-training performance of TD and DCD children was the same and good with high support but distinct and poor with low support. Support yielded good self-efficacy that motivated training. Post training performance with no support was improved and the same for TD and DCD children. (2) Actively controlled movements were required for improved performance. (3) Progressively reduced support was required for good performance during and after training. (4) Age differences in performance during pre-training were eliminated post-training. (5) Improvements transferred to drawing. (6) There was no evidence of specificity of training in transfer. (7) Disparate Beery scores were reflected in pre-training but not post-training performance. We conclude that the method improves manual compliance control, and more generally, prospective control of movements used in drawing performance.     

A trial-by-trial analysis reveals more intense physical activity is associated with better cognitive control performance in attention-deficit/hyperactivity disorder

Hyperactivity is a key symptom and the most observable manifestation of attention-deficit/hyperactivity disorder (ADHD). The over-activity associated with ADHD can cause specific challenges in academic settings, extracurricular activities and social relationships. Cognitive control challenges are also well established in ADHD. The current study included 44 children between the ages of 10 and 17 diagnosed with ADHD or who were typically developing (TD), all of whom had no psychiatric co-morbidity or significant learning disorders. Participants wore an actometer on their ankle while performing a flanker paradigm in order to objectively measure their rates of activity in association with cognitive control. Analyses assessed the relationship between frequency and intensity of activity to task accuracy on a trial-by-trial basis. A significant interaction effect between group and performance revealed that more intense movement was associated with better performance in the ADHD group but not in the TD group. The ADHD group demonstrated more intense activity than the TD group during correct (but not error) trials. Within-group, children with ADHD generated higher intensity movements in their correct trials compared to their error trials, whereas the TD group did not demonstrate any within-group differences. These findings suggest that excessive motoric activity associated with clinically significant ADHD symptoms may reflect compensatory efforts to modulate attention and alertness. Future research should systematically explore the relationship between motion in ADHD and how it might be used to improve cognitive performance.     

A Comparison of Two Flashcard Drill Methods Targeting Word Recognition

Traditional drill and practice (TD) and incremental rehearsal (IR) are two flashcard drill instructional methods previously noted to improve word recognition. The current study sought to compare the effectiveness and efficiency of these two methods, as assessed by next day retention assessments, under 2 conditions (i.e., opportunities to respond held constant across methods, length of instructional session held constant across methods) with 4 first-grade students identified by their teachers as struggling readers. Social validity of the two intervention methods also was evaluated. Results suggested important differences in response to instruction across students. Differences in effectiveness between TD and IR were minimal both when holding opportunities to respond and length of instructional session constant across methods. Minimal differences in efficiency were noted between TD and IR when holding instructional time constant across conditions. However, TD was clearly more efficient than IR for all students when holding opportunities to respond constant across conditions. Social validity data indicated that half of the students preferred the TD method and half preferred the IR method. Limitations and implications of the current study for school-based professionals are discussed.     

I Think We’re Alone Now: Solitary Social Behaviors in Adolescents with Autism Spectrum Disorder

Research into emotional responsiveness in Autism Spectrum Disorder (ASD) has yielded mixed findings. Some studies report uniform, flat and emotionless expressions in ASD; others describe highly variable expressions that are as or even more intense than those of typically developing (TD) individuals. Variability in findings is likely due to differences in study design: some studies have examined posed (i.e., not spontaneous expressions) and others have examined spontaneous expressions in social contexts, during which individuals with ASD—by nature of the disorder—are likely to behave differently than their TD peers. To determine whether (and how) spontaneous facial expressions and other emotional responses are different from TD individuals, we video-recorded the spontaneous responses of children and adolescents with and without ASD (between the ages of 10 and 17 years) as they watched emotionally evocative videos in a non-social context. Researchers coded facial expressions for intensity, and noted the presence of laughter and other responsive vocalizations. Adolescents with ASD displayed more intense, frequent and varied spontaneous facial expressions than their TD peers. They also produced significantly more emotional vocalizations, including laughter. Individuals with ASD may display their emotions more frequently and more intensely than TD individuals when they are unencumbered by social pressure. Differences in the interpretation of the social setting and/or understanding of emotional display rules may also contribute to differences in emotional behaviors between groups.     

Representing intentions in self and other: studies of autism and typical development

Two experiments were conducted to explore the extent to which individuals with Autism Spectrum Disorder (ASD), as well as young typically developing (TD) children, are explicitly aware of their own and others’ intentions. In Experiment 1, participants with ASD were significantly less likely than age‐ and ability‐matched comparison participants to correctly recognize their own knee‐jerk reflex movements as unintentional. Performance on this knee‐jerk task was associated with performance on measures of false belief understanding, independent of age and verbal ability, in both participants with ASD and TD children. In Experiment 2, participants with ASD were significantly less able than comparison participants to correctly recognize their own or another person’s mistaken actions as unintended, in a ‘Transparent Intentions’ task ( Russell & Hill, 2001 ; Russell, Hill & Franco, 2001 ). Performance on aspects of the Transparent Intentions task was associated with performance on measures of false belief understanding, independent of age and verbal ability, in both participants with ASD and TD children. This study suggests that individuals with ASD have a diminished awareness of their own and others’ intentions and that this diminution is associated with other impairments in theory of mind.     

Spatial-simultaneous working memory and selective interference in Down syndrome

Several studies have suggested that individuals with Down syndrome (DS) have impairments in some aspects of the visuospatial domain. It has been reported that they are particularly impaired in the spatial-simultaneous working memory (WM) even in advantageous conditions such as when information is grouped to form a configuration. This study aimed to assess the performance of individuals with DS carrying out a spatial-simultaneous WM task in single and dual selective interference conditions in order to better explore the characteristics of their impairment in this area.

Groups of individuals with DS and mentally age-matched typically developing (TD) children were asked to carry out a spatial-simultaneous WM task in a single- and in two dual-task conditions. In the single condition, the participants were required to recall an increasing number of positions of red squares presented simultaneously in a matrix. In the dual-task conditions, together with the spatial-simultaneous WM task, the participants were asked to carry out an articulatory suppression task or a tapping task.

As has already been shown in other studies, individuals with DS were found to be impaired in carrying out a spatial-simultaneous WM task and showed a worse performance with respect to the TD group in both the conditions.

These findings indicate that individuals with DS use the same coding modality as TD children of the same mental age. Just as the TD children, they performed lower in the dual- than in the single-task condition and there was no difference between the verbal and visuospatial conditions.     

Experimental finger dyspraxia

Subjects were required to perform discrete finger movements in accordance with a pre-arranged sequence of instructions. In all cases, any movement made by any finger was recorded by means of a constant-speed kymograph equipped with levers designed to record separately the movements of the individual fingers. This experiment was carried out under three conditions: (a) with no vision of the hand; (b) with direct vision of the hand; and (c) with the hand presented in mirror-image. It was found that, whereas deprivation of visual control was without effect on the efficiency of finger movements, presentation of the hand in mirror-image gave rise to significant increases in reaction time of three fingers and to an increase in the percentages of prior and substitute movements of other digits. Phenomena akin to depersonalisation were reported in some cases. It was also found that the rank order of mean reaction times of the five digits was approximately constant under all conditions and that the two fingers with the shortest reaction times were preceded by the fewest movements of other digits. These two digits were also the most frequently moved in advance when movements of other digits were requested and it is suggested that they have a certain “signpost function” in guiding identification of the remaining fingers. Some implications of these results for an understanding of “finger agnosia” are briefly indicated in an Appendix.     

Dynamical structure of center-of-pressure trajectories with and without functional taping in children with cerebral palsy level I and II of GMFCS

Postural control during quiet standing was examined in typical children (TD) and children with cerebral palsy (CP) level I and II of GMFCS. The immediate effect on postural control of functional taping on the thighs was analyzed. We evaluated 43 TD, 17 CP children level I, and 10 CP children level II. Participants were evaluated in two conditions (with and without taping). The trajectories of the center of pressure (COP) were analyzed by means of conventional posturography (sway amplitude, sway-path-length) and dynamic posturography (degree of twisting-and-turning, sway regularity). Both CP groups showed larger sway amplitude than the TD while only the CP level II showed more regular COP trajectories with less twisting-and-turning. Functional taping didn’t affect sway amplitude or sway-path-length. TD children exhibited more twisting-and-turning with functional taping, whereas no effects on postural sway dynamics were observed in CP children. Functional taping doesn’t result in immediate changes in quiet stance in CP children, whereas in TD it resulted in faster sway corrections. Children level II invest more attention in postural control than level I, and TD. While quiet standing was more automatized in children level I than in level II, both CP groups showed a less stable balance than TD.     

Deficits in volitional oculomotor control align with language status in autism spectrum disorders

Eye‐tracking paradigms are increasingly used to investigate higher‐level social and cognitive processing in autism spectrum disorder (ASD). However, the integrity of the oculomotor system within ASD is unclear, with contradictory reports of aberrant eye‐movements on basic oculomotor tasks. The purpose of the current study was to determine whether reducing population heterogeneity and distinguishing neurocognitive phenotypes can clarify discrepancies in oculomotor behaviour evident in previous reports. Reflexive and volitional eye‐movement control was assessed in 73 children aged 8–14 years from four distinct groups: Autism Language Normal (ALN), Autism Language Impaired (ALI), non‐autistic Language Impaired (LI) and Typically Developing (TD). Eye‐movement control was measured using pro‐ and antisaccade tasks and a novel ‘search distracter’ task to measure distractibility. Reflexive eye‐movements were equivalent across groups, but deficits in volitional eye‐movement control were found that aligned with language status, and were not specific to ASD. More than 80% of ALI and LI children presented error rates at least 1.5 SDs below the TD mean in an antisaccade task. In the search distracter task, 35.29% of ALI children and 43.75% of LI children had error rates greater than 1.5 SDs compared with 17.64% of ALN children. A significant proportion of children with neurodevelopmental disorders involving language function have pronounced difficulties suppressing reflexive saccades and maintaining fixations in the presence of competing stimuli. We extend the putative link between ALI and LI populations to non‐language tasks, and highlight the need to account for co‐morbidity in understanding the ontogenesis of ASD.     

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.     

自闭症谱系障碍儿童在多重线索下习得词语的眼动研究

本文利用眼动追踪技术在基线、一致和矛盾3种实验条件下考察感知觉线索和社会性线索在自闭症谱系障碍儿童词语习得中的相对作用。行为数据结果表明, 此类儿童在矛盾条件下选择枯燥物体作为新异词语的所指对象, 这说明社会性线索较之于感知觉线索具有优势作用; 而他们在基线和一致条件下选择有趣物体作为新异词语的所指对象, 且一致条件的词语习得成绩优于基线条件, 这说明社会性线索较之于感知觉线索具有促进作用。眼动数据结果表明, 此类儿童在脸部注视模式和视线追随行为上与普通儿童存在差异。这说明, 虽然社会性线索在此类儿童与普通儿童的词语习得中具有相同的相对作用, 但他们获取社会性信息的方式与普通儿童存在差异。