Functional analysis and generalized treatment of disruptive behavior during dental exams

Patient disruption during dental visits can impede treatment and may result in invasive approaches to care. The current study evaluated the efficacy of graduated exposure with and without extinction to decrease disruption during dental treatment for 4 young men with autism spectrum disorder (ASD). Modified functional analyses confirmed that disruption was maintained by escape from dental demands for all four young men. Initial treatment consisted of graduated exposure, whereby exam steps were initially removed and then gradually reintroduced as disruption remained low; throughout this phase, disruption resulted in a break from the exam. During the subsequent treatment phase, graduated exposure procedures continued and extinction for disruption was added. Graduated exposure alone did not result in sufficient treatment effects; however, the addition of extinction resulted in greater reductions in disruption and increases in exam completion for all 4 young men, and treatment effects generalized to a dental clinic setting.     

Evaluating the function of social interaction using time allocation as a dependent measure: A replication and extension

Call et al. (2013) described a method of assessing the function of social interactions that used time allocation as a dependent measure. The current study replicated the method described by Call et al. and evaluated several extensions aimed at increasing the feasibility and efficiency of the assessment and the utility of its results. Seven children diagnosed with Autism Spectrum Disorder (ASD) participated. Social interactions were concluded to be reinforcing for 5 participants and aversive for 2 partcipants. Time allocation data for all participants are presented as well as additional analyses related to patterns of switching toward or away from social contact and session duration. Implications of this study and its methodology as well as future directions in this line of research are discussed.     

Temporal regulation of children with autism spectrum disorder exposed to a differential-reinforcement-of low-rates schedule

This study investigated temporal adjustment of children with autism spectrum disorder under a differential-reinforcement-of-low-rates (DRL) schedule. Sixteen participants, aged 3.2 to 7 years, were exposed to two conditions, DRL 5 s and DRL 20 s. Children participated in 7 sessions in each condition, except for 1 participant who attained the adjustment criteria in the DRL 5-s schedule. Temporal adjustment was measured with the proportion of reinforced interresponse times (IRTs) and the mean IRT. The operant response was a press on a touch screen and the reinforcers were cartoons. IQ and receptive language were measured prior to the DRL sessions. Results showed that the mean proportion of reinforced IRTs was slightly higher in the DRL 5-s schedule. The mean IRT was above the IRT requirement in both conditions. However, substantial individual variability was observed. Children with higher IQ and receptive language scores presented a greater proportion of reinforced IRTs in both conditions. Moreover, participants who adjusted their responses to the DRL 5-s schedule were more likely to adjust responding to the DRL 20-s schedule. This suggests that some children might be more sensitive to reinforcement contingencies than others. This study points at future research in the field of timing in children.     

Autistic traits in mentalization-based treatment for concurrent borderline personality disorder and substance use disorder: Secondary analyses of a randomized controlled feasibility study

Autism is suggested to be a dimensional construct and often represents a comorbid state. However, research on the clinical implications of the presence of autistic traits is scarce. This study aimed to investigate the impact of subclinical autistic traits in mentalization-based treatment (MBT) for concurrent borderline personality disorder (BPD) and substance use disorder (SUD). Based on the data of a randomized controlled feasibility study by Philips, Wennberg, Konradsson, and Franck (2018), secondary analyses were conducted. It was tested, if patients’ (N = 46) levels of autistic traits were associated with treatment outcome measured in the course of and after treatment using interviews and self-report measures. Participants’ autistic traits were not associated with the change in the severity of BPD throughout and at the end of the treatment. However, results showed associations between autistic traits and the change in patients’ consumption of alcohol in the course of MBT. Furthermore, there was an association between autistic traits and the change in mentalizing capacity at the end of MBT, indicating that elevated autistic traits were associated with an improvement in mentalizing capacity. Autistic traits on a subclinical level do not appear to be a complicating factor in MBT for concurrent BPD and SUD. On the contrary, in terms of mentalizing capacity autistic traits might be associated with a larger potential for improvement or facilitate treatment outcome. Further research is needed to explore the role of higher autistic traits in treatment of this special patient group.     

母亲依恋风格与孤独症谱系障碍儿童母子依恋:母亲教养方式的中介作用

早期依恋对孤独症谱系障碍（Autism Spectrum Disorders,简称ASD）儿童的心理健康、人际关系以及未来的社会融合有重要影响。本研究采用问卷调查法,对从北京、青岛、郑州、武汉、无锡和赤峰市等地28所融合幼儿园中筛选出来的210名ASD儿童及其母亲进行施测,考察母亲的依恋风格对ASD儿童母子依恋的影响,以及母亲教养方式在其中的中介作用。研究发现：（1）总体而言,ASD儿童与母亲之间的依恋关系总体状况良好;轻度ASD儿童的母子依恋水平显著高于中度、重度ASD儿童;（2）母亲依恋回避、依恋焦虑与ASD儿童母子依恋均呈显著负相关;母亲关爱、鼓励自主与ASD儿童母子依恋均呈显著正相关,母亲控制与ASD儿童母子依恋呈显著负相关;母亲依恋回避、依恋焦虑与母亲关爱均呈显著负相关,与母亲控制均呈显著正相关;（3）母亲关爱在母亲依恋回避与ASD儿童母子依恋之间起部分中介作用,母亲关爱、母亲控制在母亲依恋焦虑与ASD儿童母子依恋之间起完全中介作用。     

A blueprint for general‐case procedures illustrated by teaching adolescents with autism spectrum disorder to use a chip‐debit card

Individuals diagnosed with autism spectrum disorder (ASD) often respond poorly to novel stimulus combinations and may have difficulty discriminating across critical and noncritical stimulus dimensions without direct teaching. General‐case procedures and multiple‐exemplar training have been effectively used to address this deficit. In the current study, the experimenters outlined general‐case procedures with video modeling, prompting and reinforcement to teach three adolescents with ASD a generalized repertoire of using a chip‐debit card. A multiple‐probe across participants design demonstrated the effectiveness of these procedures. All participants acquired the skill, responding generalized from simulated teaching materials to four novel automatic payment machines, and maintained 4 weeks following teaching. Implications of using these general‐case procedures as a blueprint for future researchers to reference when teaching individuals with ASD a generalized repertoire of any skill are discussed.     

Atypicalities in sleep and semantic consolidation in autism

Sleep is known to support the neocortical consolidation of declarative memory, including the acquisition of new language. Autism spectrum disorder (ASD) is often characterized by both sleep and language learning difficulties, but few studies have explored a potential connection between the two. Here, 54 children with and without ASD (matched on age, nonverbal ability and vocabulary) were taught nine rare animal names (e.g., pipa). Memory was assessed via definitions, naming and speeded semantic decision tasks immediately after learning (pre‐sleep), the next day (post‐sleep, with a night of polysomnography between pre‐ and post‐sleep tests) and roughly 1 month later (follow‐up). Both groups showed comparable performance at pre‐test and similar levels of overnight change on all tasks; but at follow‐up children with ASD showed significantly greater forgetting of the unique features of the new animals (e.g., pipa is a flat frog). Children with ASD had significantly lower central non‐rapid eye movement (NREM) sigma power. Associations between spindle properties and overnight changes in speeded semantic decisions differed by group. For the TD group, spindle duration predicted overnight changes in responses to novel animals but not familiar animals, reinforcing a role for sleep in the stabilization of new semantic knowledge. For the ASD group, sigma power and spindle duration were associated with improvements in responses to novel and particularly familiar animals, perhaps reflecting more general sleep‐associated improvements in task performance. Plausibly, microstructural sleep atypicalities in children with ASD and differences in how information is prioritized for consolidation may lead to cumulative consolidation difficulties, compromising the quality of newly formed semantic representations in long‐term memory.     

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。     

利用绘画区分自闭症谱系障碍儿童功能的探索

根据儿童绘画发展理论,通过对160名3.2～14岁自闭症谱系障碍儿童的“自由画”、“绘人”和“家庭成员画”的赋值编码以及与普通儿童绘画的对比,从量与质的角度,分析和探索了绘画在区分自闭症谱系障碍儿童功能的可行性。