Alliance-Outcome Associations in a Community-Based Social Skills Intervention for Youth With Autism Spectrum Disorder

Although the alliance is a consistent predictor of treatment outcomes in psychosocial interventions, few studies have examined this association among youth with autism spectrum disorder (ASD). In particular, youth-therapist alliance has never been examined in social skills interventions (SSIs), a common modality for this population. In this study, thirty-four youth with ASD (M_age = 12.41; 79% male) participated in a community-delivered, group-based SSI in a summer camp format led by eight Head Therapists (M_age = 32.12; 50% male). Early alliance and change in alliance over the course of the treatment were assessed via self- and observer-reported measures. Both self- and observer-rated alliance were associated with positive treatment outcomes as reported by parents (decreased problem behaviors) and other peers in the group (reciprocated friendship and social preference). These results provide the first evidence of the role of the alliance in an SSI for youth with ASD and add to the growing body of literature that demonstrates the importance of assessing and addressing the alliance in treatment for this population.     

The race that precedes coactivation: development of multisensory facilitation in children

Rationale: The facilitating effect of multisensory integration on motor responses in adults is much larger than predicted by race‐models and is in accordance with the idea of coactivation. However, the development of multisensory facilitation of endogenously driven motor processes and its relationship to the development of complex cognitive skills in school‐age children is largely unexplored. Method: Twenty adults and 95 children where allocated into six age groups: 6, 7, 8, 9, 10–11 and adults. Participants’ motor reaction times (MRTs) and accuracy in response to the detection of auditory, visual and audiovisual stimuli were recorded. Children's reading accuracy and nonverbal IQ were also assessed. Results: In general, MRTs of children were significantly slower with greater variability than those of adults. Although the average level of multisensory facilitation was similar for all age groups, mean cumulative density functions (CDFs) showed that multisensory facilitation in 6 and 10–11‐year‐olds is within the predictive limits of race‐models. Where coactivation was seen in the CDF of individual children it was not as strong or as consistent as that in adults. The degree of multisensory facilitation did not correlate with age, reading accuracy or IQ. Conclusion: The average level of multisensory facilitation to endogenously driven motor responses does not change gradually with age nor is it related to intelligence or reading accuracy. In general, multisensory integration remains immature until 10–11 years of age and lies within the predicted confines of race‐models.     

Establishing arbitrary comparative relations and referential transformations of stimulus function in individuals with autism

Relational Frame Theory posits that complex language develops through arbitrarily applicable relational networks, with potential implications for individuals with autism. Responding relationally based on comparison occurs when participants respond to any number of comparative properties, such as “bigger” or “faster.” Experiment 1 established two 3-member comparative networks, in which a stimulus A was conditioned as “bigger” or “faster” than a stimulus B, and the stimulus B was conditioned as “bigger” or “faster” than a stimulus C in 2 children with autism. Both participants met the mastery criterion for the trained relations and demonstrated the emergence of the untrained combinatorially entailed A–C and C–A relations. The participants could also match the arbitrary A stimuli with larger or faster objects and the C stimuli with smaller or slower objects. The results were replicated in Experiment 2 with the same participants, where a 5-member relational network was established for the bigger/smaller relation.     

Subjective Well-Being in Adolescence: The Role of Self-Control,Social Support,Age, Gender,and Familial Crisis

Focusing on adolescents’ subjective well-being, the present study comprised three parts. The first examined the role of two coping mechanisms, self-control and social support, in predicting subjective well-being. The second related to the role of age and gender in predicting adolescents’ subjective well-being. The third raised the question of whether exposure to familial crisis would predict adolescents’ subjective well-being and whether self-control and social support would moderate the link between crisis and adolescents’ subjective well-being. Participants included 380 adolescents ages 13–17 years (M = 15.32, SD = .98; 194 boys, 176 girls, 10 unspecified), from six integrative junior-high and high schools in central Israel. All schools served a heterogeneous Jewish student population. Based on responses to a questionnaire identifying adolescents who reported experiencing a severe life crisis during the last year (e.g., severe illness in family, parent death or separation/divorce), the sample was divided into two groups: exposure to familial crisis (n = 96) and no exposure to familial crisis (n = 284). Outcomes revealed that both self-control and social support predicted adolescents’ subjective well-being. As expected, older adolescents presented lower levels of subjective well-being than younger ones. In contrast to the hypothesis, gender did not predict subjective well-being. Although exposure to crisis did not predict higher negative affect or lower positive affect, an interaction emerged between self-control and crisis in predicting positive affect. Thus, among adolescents who experienced crisis, better self-control skills predicted higher levels of positive affect.     

The degree of certainty in brain death: probability in clinical and Islamic legal discourse

The University of Michigan conference “Where Religion, Policy, and Bioethics Meet: An Interdisciplinary Conference on Islamic Bioethics and End-of-Life Care” in April 2011 addressed the issue of brain death as the prototype for a discourse that would reflect the emergence of Islamic bioethics as a formal field of study. In considering the issue of brain death, various Muslim legal experts have raised concerns over the lack of certainty in the scientific criteria as applied to the definition and diagnosis of brain death by the medical community. In contrast, the medical community at large has not required absolute certainty in its process, but has sought to eliminate doubt through cumulative diagnostic modalities and supportive scientific evidence. This has recently become a principal model, with increased interest in data analysis and evidence-based medicine with the intent to analyze and ultimately improve outcomes. Islamic law has also long employed a systematic methodology with the goal of eliminating doubt from rulings regarding the question of certainty. While ample criticism of the scientific criteria of brain death (Harvard criteria) by traditional legal sources now exists, an analysis of the legal process in assessing brain death, geared toward informing the clinician’s perspective on the issue, is lacking. In this article, we explore the role of certainty in the diagnostic modalities used to establish diagnoses of brain death in current medical practice. We further examine the Islamic jurisprudential approach vis-à-vis the concept of certainty (yaqīn). Finally, we contrast the two at times divergent philosophies and consider what each perspective may contribute to the global discourse on brain death, understanding that the interdependence that exists between the theological, juridical, ethical, and medical/scientific fields necessitates an open discussion and active collaboration between all parties. We hope that this article serves to continue the discourse that was successfully begun by this initial interdisciplinary endeavor at the University of Michigan.     

Audiovisual integration in noise by children and adults

The aim of this study was to investigate the development of multisensory facilitation in primary school-age children under conditions of auditory noise. Motor reaction times and accuracy were recorded from 8-year-olds, 10-year-olds, and adults during auditory, visual, and audiovisual detection tasks. Auditory signal-to-noise ratios (SNRs) of 30-, 22-, 12-, and 9-dB across the different age groups were compared. Multisensory facilitation was greater in adults than in children, although performance for all age groups was affected by the presence of background noise. It is posited that changes in multisensory facilitation with increased auditory noise may be due to changes in attention bias.     

Susceptibility to the flash-beep illusion is increased in children compared to adults

Audio-visual integration was studied in children aged 8-17 (N = 30) and adults (N = 22) using the 'flash-beep illusion' paradigm, where the presentation of two beeps causes a single flash to be perceived as two flashes (fission illusion), and a single beep causes two flashes to be perceived as one flash (fusion illusion). Children reported significantly more fission illusions than adults, indicating that auditory and visual information was integrated more often, and less selectively, than in adults. Within either group, illusion reports did not correlate with either age or motor coordination measures. The current results show that the form of multisensory integration indexed by the illusion is slow to mature in normally developing children.     

The relationship between multisensory integration and IQ in children

It is well accepted that multisensory integration has a facilitative effect on perceptual and motor processes, evolutionarily enhancing the chance of survival of many species, including humans. Yet, there is limited understanding of the relationship between multisensory processes, environmental noise, and children's cognitive abilities. Thus, this study investigated the relationship between multisensory integration, auditory background noise, and the general intellectual abilities of school-age children (N = 88, mean age = 9 years, 7 months) using a simple audiovisual detection paradigm. We provide evidence that children with enhanced multisensory integration in quiet and noisy conditions are likely to score above average on the Full-Scale IQ of the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV). Conversely, approximately 45% of tested children, with relatively low verbal and nonverbal intellectual abilities, showed reduced multisensory integration in either quiet or noise. Interestingly, approximately 20% of children showed improved multisensory integration abilities in the presence of auditory background noise. The findings of the present study suggest that stable and consistent multisensory integration in quiet and noisy environments is associated with the development of optimal general intellectual abilities. Further theoretical implications are discussed.