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Case 8: - To dopamine or not to dopamine, that is the question
- Edited by Nevena V. Radonjić, State University of New York Upstate Medical University, Thomas L. Schwartz, State University of New York Upstate Medical University, Stephen M. Stahl, University of California, San Diego
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- Case Studies: Stahl's Essential Psychopharmacology
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- 03 April 2024
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- 18 April 2024, pp 133-148
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Summary
What neurotransmitter system is routinely influenced by both antipsychotics and stimulants?
Programmes to manage food selectivity in individuals with autism spectrum disorder
- Chiara Breda, Sara Santero, Maria Vittoria Conti, Hellas Cena
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- Nutrition Research Reviews , First View
- Published online by Cambridge University Press:
- 22 February 2024, pp. 1-14
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Autism spectrum disorder (ASD) is a complex group of neurodevelopmental disorders characterised by impaired social communication and restricted interests/repetitive behaviours. In this regard, sensory processing difficulties and delayed oral motor skills often predispose individuals with ASD to food selectivity (FS). It is usually associated with repetitive eating patterns that can lead to multiple malnutrition conditions. The objective of this narrative review is to present an overview about the existing nutritional interventions aiming at promoting a healthy eating pattern and addressing food selectivity among individuals with ASD. Regarding the interventions targeting nutrition education, the majority of the analysed studies failed to demonstrate their effectiveness. On the other hand, many educational interventions involving taste or cooking sessions, as well as behavioural interventions for FS, demonstrated effective results. Moreover, multidisciplinary in tailoring such programmes, including psychology speech therapy and nutritional skills, is acknowledged as a key approach.
Are prosocial tendencies relevant for developmental psychopathology? The relations of prosocial behavior and empathy-related responding to externalizing problems, internalizing problems, and autism spectrum disorder
- Nancy Eisenberg, Antonio Zuffianò, Tracy L. Spinrad
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- Development and Psychopathology , First View
- Published online by Cambridge University Press:
- 13 February 2024, pp. 1-11
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The field of developmental psychopathology tends to focus on the negative aspects of functioning. However, prosocial behavior and empathy-related responding – positive aspects of functioning– might relate to some aspects of psychopathology in meaningful ways. In this article, we review research on the relations of three types of developmental psychopathology– externalizing problems (EPs), internalizing problems (IPs), and Autism Spectrum Disorder (ASD) – to empathy-related responding (e.g., affective and cognitive empathy, sympathy, personal distress) and prosocial behavior. Empathy-related responding and prosocial behavior generally have been inversely related to EPs, although findings are sometimes reversed for young children and, for empathy, weak for reactive aggression. Some research indicates that children’s empathy (often measured as emotional contagion) and personal distress are positively related to IPs, suggesting that strong sensitivity to others’ emotions is harmful to some children. In contrast, prosocial behaviors are more consistently negatively related to IPs, although findings likely vary depending on the motivation for prosocial behavior and the recipient. Children with ASD are capable of prosocially and empathy-related responding, although parents report somewhat lower levels of these characteristics for ASD children compared to neurotypical peers. Issues in regard to measurement, motivation for prosociality, causal relations, and moderating and mediating factors are discussed.
Chapter 8 - Diagnosis of Co-occurrent Mental Health Problems in Persons with Intellectual Disability, Major Communication and Insight Difficulties, and Stressor-Related Disorders
- Edited by Andrea Fiorillo, University of Campania “L. Vanvitelli”, Naples, Peter Falkai, Ludwig-Maximilians-Universität München, Philip Gorwood, Sainte-Anne Hospital, Paris
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- Mental Health Research and Practice
- Published online:
- 01 February 2024
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- 08 February 2024, pp 122-134
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Summary
The prevalence of psychiatric disorders among patients with intellectual disability (ID) and low-functioning autism spectrum disorder (ASD) is higher than in the general population. The available reports on this comorbidity vary depending on the adopted methodologies, the size of the examined ID population, and the criteria used to diagnose mental disorders. Multiple factors contribute to the significantly different presentation of psychopathological symptoms and syndromes in people with ID and ASD compared to the general population, including cognitive and communicative impairments, developmental peculiarities, and neuro-autonomic vulnerability. Because they have a hard time conceptualizing and articulating their mental states, the diagnosis of their psychopathology must rely on firsthand observation of behaviors in the context of daily life as well as third-party accounts. As a result, diagnostic criteria designed for the general population are ineffective when used in these groups, so for them specific diagnostic procedures and instruments should be a significant determinant of psychiatric diagnosis validity.
Current practices of Portuguese speech-language pathologists with preschool-age children with pragmatic impairment: A cross-sectional survey
- Tatiana PEREIRA, Ana Margarida RAMALHO, Marisa LOUSADA
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- Journal of Child Language , First View
- Published online by Cambridge University Press:
- 30 January 2024, pp. 1-18
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This study aims to investigate the practice patterns used by Portuguese speech-language pathologists (SLPs) with preschool-age children with pragmatic impairment and to identify the actual need(s) perceived by SLPs in this field. A total of 351 SLPs responded. The results reveal that 81.5 per cent of the respondents (n=286) reported working or had previously worked with preschool-age children with pragmatic impairment arising from autism spectrum disorder, developmental language disorder, or both. Considering the clinical practice, similarities and differences were found, many of which are due not to the inherent characteristics of each disorder but to the scarcity of research in clinical pragmatics. These results are also reflected in the needs perceived by SLPs and the degree of confidence with which they work with these children. Implications for clinical practice and directions for future research are discussed.
Rumination and altered reactivity to sensory input as vulnerability factors for developing post-traumatic stress symptoms among adults with autistic traits
- Liliana Dell’Osso, Giulia Amatori, Federico Giovannoni, Enrico Massimetti, Ivan Mirko Cremone, Barbara Carpita
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 15 January 2024, pp. 119-125
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Objective
Recent literature has suggested that individuals with autism spectrum disorder (ASD) or autistic traits (ATs) would be more likely to encounter traumatic events in their lifetime and to develop post-traumatic stress disorder (PTSD). However, the nature of this relationship has not yet been fully elucidated. The aims of this study were to evaluate the relationship between AT and PTSD and to investigate which specific autistic dimension was more associated with trauma and stress-related symptoms.
MethodsA total of 68 subjects with ASD and 64 healthy controls (HCs) were assessed with the Adult Autism Subthreshold Spectrum (AdAS Spectrum) and the Trauma and Loss Spectrum (TALS) questionnaires. Statistical analyses included Mann–Whitney U test, chi-square test, calculation of Spearman’s coefficients, and logistic regression analysis.
ResultsPatients with significant AT reported a 30% rate of PTSD and higher TALS total and domain scores than HCs, among whom no PTSD was found instead. Significant positive correlations were reported between AdAS Spectrum and TALS-SR scores in the whole sample. AdAS Spectrum total scores were statistically predictive of the presence of PTSD. High scores at AdAS Spectrum Inflexibility and adherence to routine and Restrictive interest and rumination domains were identified as positive predictors of a probable PTSD.
ConclusionCompared to HCs, subjects with significant AT are more likely to present symptoms of PTSD. In particular, AT related to ruminative thinking, narrow interests, and sensorial reactivity would seem to predict the presence of post-traumatic stress symptomatology.
4 Language Development in Infants and Toddlers (12 to 24 months) with Agenesis of the Corpus Callosum
- Ella Bohlman, Jasmin Turner, Lauren D Haisley, Lana Hantzch, Kelly N Botteron, Stephen Dager, Annette M Estes, Lisa Flake, Heather C Hazlett, Robert Schultz, Joseph Piven, Jed Elison, Lynn Paul
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 404-405
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Objective:
It is unclear how agenesis of the corpus callosum (ACC), a congenital brain malformation defined by complete or partial absence of the corpus callosum, impacts language development. fMRI studies of middle childhood suggest that the corpus callosum plays a role in the interhemispheric language network (Bartha-Doering et al., 2020), and that reduced interhemispheric functional connectivity is correlated with worse language abilities in children with ACC (Bartha-Doering et al., 2021). Additionally, accumulating evidence suggests structural abnormalities of the corpus callosum play a role in neurodevelopmental disorders. While children who go on to receive an autism spectrum disorder (ASD) diagnosis may show early signs of altered word and gesture acquisition (Iverson et al., 2018), the same is not known about ACC. This study examined language development during the second year of life in children with ACC in comparison to neurotypical control participants, as well as other children at elevated risk of ASD.
Participants and Methods:The MacArthur-Bates Communicative Development Inventories (MCDI): Words and Gestures scales were administered to parents of 74 children with isolated ACC at 12, 18 and 24 months of age. Children whose first language was not English and children who were bilingual were excluded. Comparison groups consisted of individuals with a low familial likelihood of ASD (LL- n=140) and individuals with high familial likelihood of ASD who do and do not have a confirmed ASD diagnosis (HL+ n=68, HL- n=256).
Results:Compared to LL controls, the ACC group produced fewer words at 18 and 24 months of age, and demonstrated fewer words understood at all three timepoints. Similarly, compared to the HL- group, the ACC group demonstrated fewer words produced and understood at 18 months of age, and fewer words produced at 24 months of age. The ACC and HL+ groups did not differ in words produced or words understood at any timepoint.
Conclusions:Overall, infants with ACC demonstrated delayed vocabulary expansion from 12 to 24 months of age. These findings illustrate the role of callosal connectivity in the development of language across the first 2 years of life, and highlight the need for support and interventions that target vocabulary production and comprehension.
80 Implications of Body Mass Index on Executive Functioning in Clinically Diagnosed Neurodiverse Children
- Laura A Campos, Sri Vaishnavi Konagalla, Jessica Smith, Jordan Linde, Madison Berl, Chandan Vaidya, Lauren Kenworthy
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 72-73
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Childhood obesity is a serious health epidemic affecting the world today. Children who are obese earlier in life are more likely to stay obese and have an increased risk of poorer health outcomes later in life, such as diabetes and cardiovascular diseases. Obesity is also associated with deficits in executive function. Executive function (EF) is comprised of several distinct but interrelated abilities including working memory, planning, inhibition, and flexibility. Prior research suggests that obesity drives brain changes which implicate executive function structures. Our aim is to examine the relationship between childhood obesity and executive function in children with neurodevelopmental disorders.
Participants and Methods:These data are from an ongoing study on neural and behavioral phenotypes of executive functioning in children with developmental disabilities, primarily Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Only study participants with complete BMI and BRIEF data were included in these analyses (n = 184). 134 representing (72.8%) of the participants were Male, 49 representing (26.6%) were Female, and 1 representing (.5%) were Gender nonconforming. 50 representing (27.2%) of the participants were between 8-9 years, 55 representing (29.9%) were between 10-11 years, and 80 representing (43.0%) were between 12-13 years. Average age was 11 years. 11 representing (6.0%) of the participants were underweight, 115 representing (62.5%) were healthy, 29 representing (15.8%) were overweight, and 29 representing (15.8%) were obese. Average BMI was 19.0, ranging from 13.2 to 36.3. 106 representing (57.6%) of the participants identified as White, 65 representing (35.3%) identified as BIPOC (2 Asian, 31 Hispanic/Latinx, 32 Black) and 13 representing (4.4%) identified as other/unspecified. 114 representing (61.9%) of the participants had a diagnosis of ADHD, ASD, or comorbid ASD and ADHD, 70 representing (38.1%) had a diagnosis of other. Average FSIQ-2 score was 106.98. Parents were asked to complete the Behavior Rating Inventory of Executive Function (BRIEF-2) and the Inhibit, Shift, Working Memory (WM), Planning, and Global Executive Composite (GEC) scales were used as the dependent measure in analyses. BMI (kg/mA2) was calculated based on CDC 2000 growth charts and classified into 4 mutually exclusive categories—underweight, healthy, overweight, and obese. There was a prediction that higher BMI would be associated with lower executive function.
Results:A one-way ANOVA revealed a statistically significant difference between groups (F(3,180) = 3.649, p = .014). A Tukey post hoc test revealed more Shift problems in the obese group (74.55 ± 11.7) compared to the overweight group (65.79 ± 11.6, p = .026). There was no statistically significant difference between the underweight/healthy and obese groups (p = .999/p = .054). There was no statistically significant difference in mean T-scores for the Inhibit, WM, Planning, or GEC scales.
Conclusions:Childhood obesity and executive function deficits are significant risk factors for adult health outcomes. Obesity and elevated executive function T-scores for flexibility are related in a group of children with neurodevelopmental disorders. Future investigation will explore the role of cortical thickness and medication in these data.
15 An Investigation of Non-Evidence Based Autism Intervention Representations in the Media
- Daniel Q Earixson
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 624-625
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This study seeks to describe the context and contents of YouTube videos featuring non-evidence-based practices (NEBPs) for autism spectrum disorder, including recent fad usage of transcranial magnetic stimulation.
Participants and Methods:A sample search of autism intervention-related YouTube videos was conducted to reflect the experience of caregivers researching autism intervention information on the internet. Exclusion criteria was applied to create a preliminary dataset. The videos were categorized into general evidence-based practice (EBP), non-evidence-based practice (NEBP), and both EBP and NEBP. The NEBP-related videos were then qualitatively described using a priori codes based on the literature regarding signs of pseudoscience, as well as an iteratively developed codebook through a constant comparative method between two independent coders.
Results:Total videos from the YouTube search using the query "Autism Treatment" were capped at 150 videos. Total videos in English were 138. Total discrete videos (non-repeated) were 134. Total NEBP-related discrete videos were 62 (46% of final dataset); Total EBP-related videos were 38 (28.3% of final dataset); and total videos containing both EBP and NEBP as subject matter were 25 (18.6% of final dataset). Of the NEBP-related in the final dataset, the most frequent NEBP which occurred was stem cell therapy (n=26), followed by the Son-Rise program (n=13), Cannabis/marijuana (n=5), transcranial magnetic stimulation/magnetic e-resonance therapy (n=5), neurofeedback (n=1), brain rehabilitation (n=1), suramin (n=2), fecal transplants (n=2), Hyperbaric Oxygen therapy (n=1), Ayurvedic medicine (n=1), virtual reality (n=1), and others. The constant comparative method of coding yielded results specific to videos about NEBPs in autism, including: statements declaring a treatment will be effective, a banner on the YouTube page indicating if the channel is from a reputable source, a parent testimonial, a parent or caregiver display of emotion with respect to treatment efficacy, statements regarding pre-intervention repetitive or challenging behaviors, statements regarding demonstrated effects of the treatment, statements of a definitive cause of autism, statements regarding the severity of the autism in the treatment subject, specific words in reference to autism, including "disease", "toxin", or "inflammation", discussion of the financial aspect of the treatment, and videos with both high and low production values.
Conclusions:The likelihood of a caregiver encountering and watching videos containing NEBP-related material when using a general query to search the internet for information on autism intervention is high. Additionally, videos regarding NEBPs have more engagements (e.g., likes, comments, shares) than videos regarding EBPs, oftentimes by multitudes. The information contained within videos in which an NEBP is the subject aligns with pre-established warning signs for pseudoscience for autism interventions, however this study also contributes new warning signs through the construction of the iterative codebook. Specifically, statements about treatment efficacy in the absence of cited research, an emotional parent testimony about the individual with autism's experience with the NEBP therapy, statements regarding behavioral improvements linked to participation in the therapy oftentimes in the context of inflated claims, and clear and confident statements regarding the cause of autism with no cited research.
2 Effects of Early Exposure to More Than One Language in the Home on Language Skills and Brain Functional Network Organization in Young Children with Autism Spectrum Disorder
- Bosi Chen, Adriana Rios, Lindsay Olson, Madison Salmina, Stephanie Peña, Annika Linke, Inna Fishman
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 210-211
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Concerns that exposure to more than one language in the home might negatively impact language development in young children with autism spectrum disorder (ASD) are common among caregivers. Although research directly examining the impact of a multilingual home environment in ASD is scarce, emerging evidence shows that language outcomes might be equivalent or better in children with ASD exposed to more than one language (Romero & Uddin, 2021). However, no evidence to date exists on whether exposure to more than one language affects early brain functional development in children with ASD. The current study aims to examine the (1) cross-sectional and (2) longitudinal associations between home language environment (exposure to one v. multiple languages at home, H1l vs. H>1l) and receptive and expressive language skills in young children with and without ASD, and (3) to investigate links between home language environment and brain functional network organization.
Participants and Methods:Participants included young children with ASD (n=67, mean age: 35±13 months, H>1l n=43) and typically developing (TD) children (n=39, mean age: 32±16 months, H>1l n=17) enrolled in a longitudinal study of early brain markers of autism. A subset of children with ASD for whom longitudinal behavioral data from two study visits were available (n=21, H>1l n=11) were used for exploratory analysis. Receptive language (RL) and expressive language (EL) skills were assessed by the Mullen Scales of Early Learning at each study visit. Data from 42 children with ASD (H>1l n=27) and 38 TD children (H>1l n= 15) for whom functional MRI data were acquired during natural sleep were included in functional connectivity (FC) analysis. ANCOVAs were employed to examine the effect of diagnosis, home language environment (H1l vs. H>1l) and its interaction on RL and EL skills while controlling for socioeconomic variables (i.e., maternal education level, income-to-needs ratio) and gestational age at birth. Linear mixed models were applied to explore the longitudinal effect of home language environment on RL and EL skills across two study visits in the ASD group. Lastly, FC analysis was conducted to compare functional connectivity across 7 canonical brain networks in children with and without ASD who were raised in H1l and H>1l.
Results:We found significant diagnosis by home language environment interaction effect on EL skills, with children with ASD and H1l exhibiting the lowest EL skills. Longitudinal analysis identified a significant home language environment by study visit interaction effect on EL skills in children with ASD. Specifically, children with ASD and H1l showed lower EL skills at study visit 1 but equivalent EL skills at study visit 2 compared to children with ASD and H>1l. FC analysis revealed that children with ASD and H>1l displayed more typical brain network organization (similar to TD children) compared to those with H1l, specifically for FC between language, frontoparietal, and default mode networks.
Conclusions:These results suggest that early exposure to more than one language in the home may be linked with better expressive language skills in young children with ASD. Results of functional connectivity analysis also suggest that exposure to more than one language may be associated with more neurotypical functional network organization, particularly involving language and high-order networks.
18 Improving Job Interview Skills in Autistic Youth Using a Combined Intervention Approach Inspired by Positive Psychology
- Helen M Genova, Mikayla Haas, Heba Elsayed, Michael Dacanay, Lauren Hendrix, John DeLuca
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 627-628
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Nearly 85% of adults on the autism spectrum are unemployed, although nearly 70% of those who are unemployed express a desire and willingness to work. The job interview has been identified as a significant obstacle to obtaining employment by young adults on the spectrum. A growing field of research has been focused on evaluating innovative training tools to improve interview skills. Our previous work shows that a virtual reality job interview training (VR-JIT) tool improves certain job interview skills (such as sounding professional, establishing rapport), but does not improve the ability to speak about personal strengths and abilities. The current study combined VR-JIT with a new training tool: Kessler Foundation Strength Identification and Expression (KF-STRIDE), an intervention grounded in principles of positive psychology. KF-STRIDE targets identification of personal character strengths and expressing those strengths to employers in a socially appropriate way.
Participants and Methods:The current study evaluated data from 20 autistic youth, randomized to an experimental group (n=10) and a services-as-usual (SAU) control group (n=10). Those in the experimental group participated in a 12 session intervention (9 sessions using VR-JIT and 3 sessions in KF-STRIDE). Each session was roughly one hour. Job interview performance was assessed by video-recorded mock job interviews rated by blinded assessors pre- and post- the intervention. Paired samples t-tests were conducted to examine differences in job interview skills from baseline to follow up in both groups.
Results:The intervention group showed a significant improvement from baseline to follow-up in job interview skills in general (p = .004), and specifically sharing strengths about themselves to a future employer (p = .004). No significant differences were seen from baseline to follow-up in the SAU group. Conclusions: Individuals on the autism spectrum are significantly underemployed, which negatively impacts one’s ability to lead an independent life. Two innovative tools: VR-JIT and KF-STRIDE successfully improved job interview skills, including the ability to identify and express personal strengths. These findings indicate that these combined tools may help to improve employment skills for individuals on the autism spectrum.
2 Infant Imitation: Detecting Risk in the First Year with PediaTrac™
- Samantha Levick, Michelle Lobermeier, Angela D. Staples, Jennifer C. G. Larson, Renee Lajiness-O’Neill
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 510-511
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Objective:
Imitation has pervasive associations with social and communicative development. However, few methods have been developed to measure this construct in typically developing infants, and even less is available for at-risk populations, such as infants born preterm. Autism spectrum disorder (ASD), a particular risk of premature birth, is associated with atypical imitation and social communication. Although imitation emerges in infancy, most current screening and diagnostic tools for ASD cannot be utilized prior to 12 months. The present study aimed to develop and validate a caregiver-report measure of infant imitation, characterize imitation profiles at 4, 6, and 9 months in term and preterm infants, and explore the relationship between imitation and scores on an ASD screening questionnaire at 18 months.
Participants and Methods:Participants (N = 571) were recruited from a larger multi-site study of PediaTrac™ v3.0, a web-based tool for monitoring and tracking infant development, and were surveyed longitudinally at birth, 2, 4, 6, 9, 12, 15, and 18 months. Participants completed the online PediaTrac™ survey and several reliable and validated questionnaires via pen-and-paper format. For the purposes of this study, only the Ages and Stages Questionnaire (3rd ed.; ASQ-3), Communication and Symbolic Behavior Scales-Developmental Profile (CSBS-DP), Brief Infant Sleep Questionnaire (BISQ), and the Modified Checklist for Autism in Toddlers - Revised with Follow-Up (M-CHAT-R/F) were examined. The following hypotheses were tested: (1) proposed imitation items will represent a unitary latent construct, for which convergent and discriminant validity will be demonstrated, (2) there will be measurement invariance between term status groups at each assessment period, (3) preterm infants will obtain lower caregiver-reported imitation scores compared to term infants, and (4) imitation abilities at the assessment period with the most robust imitation factor will predict M-CHAT-R/F scores at 18 months.
Results:Distinct imitation factors at 4, 6, and 9 months were modeled with confirmatory and exploratory factor analyses. Relationships between the factors and established measures of infant communication (CSBS; ASQ) and sleep (BISQ) revealed convergent and discriminant validity, respectively. Strict measurement invariance was demonstrated for the 4- and 9-month factors, and metric invariance for the 6-month measure. Full term infants scored higher on imitation at 9 months, though variance in this outcome was related to term status differences in sensorimotor skills. Lastly, the 9-month imitation factor, coupled with 6-month sensorimotor skills, predicted 18-month ASD risk over and above gestational age.
Conclusions:This study provides support for the assessment of infant imitation, utilizing imitation to detect risk in preterm infants, and extending the age of identification for ASD risk into the first year. PediaTrac™ imitation, in combination with the PediaTrac™ sensorimotor domain, may be useful in detecting developmental risk, and specifically risk for ASD, within the first year, leading to earlier initiation of intervention. Further, with its minimal completion time and ease of dissemination through digital platforms, this measure can expand access to care and improve long-term outcomes for children and families.
11 Language Development of Primary-School-Aged Children with Autism Spectrum Disorder.
- Elizaveta Davydova, Denis Davydov, Darya Pereverzeva, Uliana Mamokhina, Ksenia Salimova
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 803-804
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Delayed speech and language development is one of the main diagnostic criteria for autism spectrum disorders (ASD) and is found almost in all children with ASD. Language development in children with ASD may differ from the norm both quantitatively (delayed speech development, reduced vocabulary, scarcity of speech and limitation in its use) and qualitatively (echolalias, violation of speech grammatical structure, difficulties in the communicative use of speech). Studying different aspects of language development in ASD is very important as it provides opportunities for finer diagnostics, as well as for targeted correction of communication disorders.
Participants and Methods:The study included 34 primary-school-aged children, who were diagnosed ASD using ADOS-2, diagnostic groups included “autism” (24 children) and “autism spectrum” (8 children). Speech development was assessed using the “Korablik” test on 9 parameters: distinguishing sounds; understanding and generating nouns, verbs and syntax; text understanding; sentences repetition. Kaufman test battery (KABC-II) and the Wechsler test (WISC-III) were used to assess non-verbal intelligence. The sample was divided into two subgroups according to an educational program recommended by PMPC (Psychological, Medical and Pedagogical Commission). Group 1 included 15 children, attending program 8.1, which is recommended for children with ASD who reach developmental milestones before starting study. Group 2 included 19 children attending program 8.2, which is recommended for children with ASD who do not reach developmental milestones before starting study.
Results:In general, all children were the best successful in understanding and generating nouns, understanding verbs, and the least successful in understanding text and searching for sound in the word. Comparing subgroups using Mann-Whitney test revealed significant differences in all measured speech parameters, except for word repetition and noun generation. Group 2 demonstrated uneven results for separate subtests - minimum scores in some subtests coexisted with maximum in others. The group also showed uneven scores distribution inside the subtests, for example, half of the children did not cope with the task to determine a sound in a word, while the rest successfully completed at least 83% of the task. A significant positive correlation between all speech subtests was found in the group. Correlation analysis for parameters of speech development, severity of autistic manifestations and non-verbal intelligence revealed a significant direct relationship between the total scores of impressive and expressive speech and IQ and an inverse relationship with the severity of autistic manifestations and disorders of social and communicative behavior. No relationships like described above were found for group 1.
Conclusions:Obtained results indicate variability of reasons for delayed development of various language aspects in children with ASD.
81 Autism Symptoms Reported and Observed During Neuropsychological Assessment of Children with Congenital Heart Disorder
- Lauren D Haisley, Lauren Miller, Danielle DeFrancisco, Sarah Nigro, Christy Casnar, Michelle Loman
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 73-74
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Objective:
Children with congenital heart disease (CHD) have increased likelihood for Autism Spectrum Disorder (AuSD; Sigmon, Kelleman, Susi, Nylung & Oster, 2020). Even those not meeting full criteria remain at greater risk for problems with social processing/communication (Cassidy et al, 2018). The current study examined what symptoms indicative of potential AuSD were qualitatively reported by parents, and what symptoms were noted behaviorally by clinicians. These behaviors may be targets for both further clinical inquiry and intervention.
Participants and Methods:A retrospective chart review of CHD patients seen for neuropsychological assessment between the ages of 6-18 years and between 2016-2021 was conducted. The final sample included 88 patients (Ethnicity: 14% Hispanic; Race: 76% White, 17% Black/African American, 5% Asian, 1% Native American, 1% Unknown). A coding system for AuSD symptoms was derived by the authors, who are experienced in AuSD diagnosis and assessment, based on DSM-5 criteria. A comprehensive list of behaviors consistent with each symptom category was generated, and assessment reports were subsequently reviewed noting the presence, absence or “no mention” of each symptom. A second coding system was derived to assess for AuSD symptoms documented in each report’s behavioral observations. Three pediatric neuropsychologists, one post-doctoral fellow, and one psychometrist were coders, with very good reliability (k=.854 (95% CI, .827 to .881), p < .0001).
Results:Twelve patients (14%) were diagnosed with AuSD. Age of diagnosis ranged from 3-14 years (M=7.82, SD=3.92). Main concerns parents expressed included difficulty with reciprocal conversation (75%), making friends (75%), initiating and maintaining social interactions (67%), and restrictive/intense interests (58%). During testing, providers noted variable eye contact (67%), appropriate responses to questions but minimal social conversation (67%), and exaggerated prosody (42%). Of those who did not have an AuSD diagnosis, the most frequent parent concerns included difficulty making friends (38%), difficulty initiating or maintaining social interactions (33%), atypical affect (25%), and restrictive/intense interests (18%). In this sample, providers noted concerns with answering questions but not maintaining conversation (26%), flat affect (16%), loud (17%) or soft (21%) speech volume, and socially immature behaviors (10%). Within this No Diagnosis group, general social concerns were highly correlated (point biserial) with more specific autism symptoms (e.g., intense interests, difficulty with transitions, sensory sensitivities r = .986 - .784), although most often the presence or absence of these concerns were not documented.
Conclusions:We examined qualitative parent-reported and provider-observed behaviors indicative of potential AuSD as detailed in a comprehensive neuropsychological evaluation report. Behaviors in children with formal AuSD diagnoses were consistent with that diagnosis, based on both parent and provider description. Of note, in children without AuSD, though, both parents and providers reported AuSD-like concerns (e.g., social communication/interaction problems, atypical interests, atypical affect, atypical speech volume) in a large minority of children. It is important that if general social concerns are present, that providers follow-up on, and document, a broader constellation of AuSD symptoms. These behaviors deserve further exploration and study within the CHD population and are important areas of inquiry in any clinical evaluation, as they should directly inform intervention.
20 Using Automated Sentiment Analysis to Examine Self-Evaluation in Youth with Autism Spectrum Disorder
- Jacob D Gronemeyer, Mikayla Haas, Heba Elsayed, Michael Dacanay, Helen Genova
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 629
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Objective:
Individuals diagnosed with autism spectrum disorder (ASD) experience negative self-evaluation, indicated by low levels of self-esteem and describing themselves more negatively to others. Variations in reading comprehension, difficulty identifying emotions, and masking (camouflaging of autistic traits) make it difficult to accurately measure self-evaluation of individuals with ASD using subjective self-report scales such as the Rosenburg Self-Esteem Scale. Therefore, it is important to explore more objective methods of measuring self-evaluation in ASD. Sentiment analysis is a popular Natural Language Processing (NLP) technique used to quantify the emotional content of language programmatically by automatically transforming text into a data frame of words represented as individual values or tokens. Each token can then be categorized as positive or negative with a sentiment dictionary. The current study aims to investigate an automated sentiment analysis approach to evaluate self-evaluation by quantifying implicit linguistic affective valence of ASD participants' verbal self-describing statements in a naturalistic setting. Specifically, we evaluated the frequency of positive or negative words used during a mock job interview in which individuals with ASD were asked to describe themselves. We then examined the relationship between positive and negative word usage and standard self-report measures of self-evaluation.
Participants and Methods:Twenty-four young adults with ASD were included in this study with an age range of 15-24 and a mean age of 19.2 years. Participants completed a battery of assessments including a mock job interview in which they were asked to describe themselves as a measure of implicit self-esteem. Self-esteem and knowledge of personal strengths was assessed using the Rosenberg Self-Esteem Scale and Strengths Knowledge Scale, respectively. Interview transcripts were automatically transformed into word token data frames using the tidytext package in Rstudio. Frequencies of positive and negative words were calculated and their ratio to total word count was used to measure the implicit positivity and negativity of transcripts.
Results:There was a significant negative correlation between the frequency of negative sentiment in transcripts and measure on the Rosenburg Self-Esteem Scale (r = -.376, p = .035) and the Strengths Knowledge Scale (r = -.387, p = .031) indicating that individuals with higher self-esteem and knowledge of their strengths used fewer negative words when talking during a mock interview.
Conclusions:While our results are preliminary, this pilot study represents the first to use automated sentiment analysis to study self-evaluation in individuals with ASD. The use of this technique on natural linguistic data collected through a mock job interview allows researchers to quantitatively analyze the emotionality of transcriptions and create insights that would otherwise be unavailable using more subjective qualitative techniques. Limited research into self-evaluation in this population has yielded inconsistent results, relying too heavily upon qualitative or self-report measures. The ability to programmatically quantify affective valence in transcripts is a time and cost-effective technique for improving validity of future measures of self-evaluation.
2 Early Presentation of Autistic Features in Infants with Agenesis of the Corpus Callosum
- Lana Hantzsch, Lauren D Haisley, Jasmin Turner, Lynn K Paul, Jed T Elison
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 402-403
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Objective:
Agenesis of the Corpus Callosum (ACC), a congenital disorder in which the corpus callosum partially or completely fails to develop properly, occurs in ∼1 in 4,000 live births. ACC has been identified as a major risk factor for receiving an Autism Spectrum Disorder (ASD) diagnosis (∼10% diagnosis rate, as compared to 2.3% in the general population), but little is currently known about behavioral and social development during infancy and early childhood in this disorder. In this study we aim to 1) characterize the manifestation of autistic features in 24-month-old children (a common age for early diagnosis of ASD) with ACC and a convenience sample of age matched comparison children from the community, and 2) determine if parent reports of autistic features during the first year of life are associated with reciprocal social behavior and autistic traits at 24-months of age in children with ACC.
Participants and Methods:Parents of infants who had received a diagnosis of ACC completed the Parent Rating of Communication, Emotion, and Social Skills (PROCESS) for their child at 6, 12, and 24-months of age, and the video-referenced rating of reciprocal social behavior (vrRSB) at 24-months of age. Comparison data were obtained from a convenience community sample in Minnesota. Aim 1). The distributions of PROCESS total scores at 24-months were compared between the ACC group (n=43) and control group (n=1058) via a 2-tailed t-test. Likewise, distributions of reciprocal social behavior (RSB) scores at 24 months were compared between ACC (n=72) and controls (n=1438) via a 2-tailed t-test. Aim 2). A partial Pearson Correlation was conducted between ACC participants’ 6-month PROCESS scores and 24-month RSB (n=18) scores, as well as between their 12-month PROCESS and 24-month vrRSB (n=37) scores, controlling for child sex.
Results:Aim 1). At 24 months of age, children with ACC are reported to have significantly higher PROCESS scores (t = 3.73, df = 42.67, p < .001), and RSB (t = 4.89, df = 88.38, p < .001) scores than comparison toddlers, indicating an elevated presentation of behaviors associated with autistic features. Aim 2). No correlation was found between participants’ 6-month PROCESS and 24-month RSB scores (r(16) = .39, p = .12). A relatively strong correlation (r(35) = .60, p < .001) was found between participants’ 12-month PROCESS and 24-month RSB scores.
Conclusions:As early as two years of age, children with ACC display a heightened presentation of autistic features compared to typically developing controls. Additionally, reports of social behaviors related to ASD at 24-months are correlated with reports of autistic features at 12-months of age. This evidence indicates that children with ACC who are at a higher likelihood for being diagnosed with ASD may be identified as early as 12-months old. Formulating and leveraging an early identification methodology is imperative for this population with an already elevated risk for ASD, as providing early interventions leads to improved outcomes later in life.
50 Therapy and Medication Use Moderating Neural Alterations Underlying Social Cognition Performance in Youth with Autism and Psychosis
- Niharika Verma, Rhideeta Jalal, Hector Gutierrez, Deanna Aghbashian, Nicholas Rockwood, Aarti Nair
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 459-460
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Objective:
Individuals with Autism Spectrum Disorder (ASD) or Early-Onset Psychosis (EOP) both experience substantial difficulties with social cognition (Spek et al. 2012; Lanillos et al. 2020); however, the impact of therapy and medication use on their social cognition has not yet been examined (Lai et al. 2014; Schiffman et al. 2018). This project will explore the effects of the history of therapy and medication use as moderating variables between neural architecture and social cognition performance.
Participants and Methods:T1-weighted imaging data were acquired on a 3T Siemens scanner for 51 ASD and EOP participants (Mean Age = 16.33), with 41 individuals endorsing history of therapy and 23 endorsing history of medication use across groups. Cortical thickness was calculated using FreeSurfer imaging analysis software (v5.3; Fischel et al., 2002) for social brain regions including inferior parietal lobe (IPL), middle temporal lobe (MPL), caudal anterior cingulate cortex (cACC), rostral anterior cingulate cortex (rACC), fusiform gyrus, precuneus cortex, and insular cortex. The Awareness of Social Inference Test (TASIT; McDonald et al., 2006) was administered to assess social cognition performance. After controlling for individuals that had a history of both therapy and medication use, Pearson's correlations were utilized to examine the relationship between cortical thickness and social cognition performance in ASD and EOP patients. The PROCESS Procedure moderation analysis in SPSS was utilized to determine if history of therapy or medication use moderated the relationship between cortical thickness and social cognition performance (Hayes, 2018).
Results:Across groups, there was a negative association between an individual's cACC thickness and TASIT Do score (r = -.415, p = .005) as well as the total TASIT score (r = -.325, p = .031). Additionally, there was a positive association between an individual's precuneus cortical thickness and their TASIT Say score (r = .440, p = .003). Results of the moderation analyses revealed that lack of medication use was associated with greater rACC thickness and higher TASIT Say score (R2 Change = .1281 mm, p = .0191). Additionally, lack of past therapy experience was associated with greater insular thickness and higher TASIT Think scores (R2 Change = .1957 mm, p = .0033). Conversely, past therapy history was associated with greater fusiform gyrus thickness and higher TASIT Say score (R2 Change = .1115 mm, p =.0262).
Conclusions:Our results suggest that for individuals without a history of therapy or medication use, higher cortical thickness of the rACC and insula support better social cognition performance; whereas for individuals with past therapy experience, higher cortical thickness of the fusiform cortex underlies better social cognition performance. Collectively, these findings suggest that an individual's history of therapy or medication use may be relevant variables to consider when examining the relationship between neural cortical thickness and social cognition performance in these neuropsychiatric conditions.
44 Functional Connectivity In The Default Mode Network Of ASD and ADHD
- Amritha Harikumar, Chao Zhang, Chase C. Dougherty, Jessica A. Turner, Andrew M. Michael
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 454-455
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Objective:
Autism Spectrum Disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are neurodevelopmental disorders with overlapping symptomatology and shared genetic makeup. Numerous previous studies have investigated ASD and ADHD using resting state functional networks. One functional network of particular interest is the Default Mode Network (DMN), as it has been shown to be abnormal in several mental disorders. Previous studies have investigated the DMN in ASD and ADHD separately but reported mixed trends of increased and decreased functional connectivity (FC) in the DMN in ASD and increased FC in ADHD. Additionally, little studies have investigated executive and attentional network dysfunction in the DMN for ASD and ADHD populations. To better understand the shared characteristics between ASD and ADHD, this study analyzed the DMN FC in children with ASD and ADHD.
Participants and Methods:Archival datasets from Autism Brain Imaging Data Exchange (ABIDE)-I and ADHD-200 datasets were used, with 33 ADHD, 35 ASD, and 32 typically developing (TD) males (ages = 7-17 years). After applying a standard pre-processing pipeline, 11 regions of interest (ROIs) from the Dosenbach-160 atlas were examined with 55 ROI pairs generated for the 100 subjects.
Results:Significant differences were noted between ASD-ADHD groups in attentional networks and executive functioning networks. Specifically, significant Group x VIQ interactions were noted for FC between the following pairs of regions: medial prefrontal cortex - ventromedial prefrontal cortex, anterior cingulate cortex -ventromedial prefrontal cortex, inferior temporal lobe - ventromedial prefrontal cortex, angular -ventromedial prefrontal cortex, angular -anterior cingulate cortex, inferior temporal lobe -ventrolateral prefrontal cortex, angular -superior frontal lobe, and intraparietal sulcus -superior frontal lobe. In the above FC pairs, FC in ADHD was negatively correlated with VIQ, with no correlation for ASD and positive correlation for TD. Previous literature has indicated that ADHD individuals demonstrate increased executive functioning deficits compared to ASD individuals. This study provides evidence at a neural level for these findings by demonstrating decreased FC trends in ADHD in attentional and executive functioning networks compared to ASD individuals. Group and VIQ main effects demonstrated mixed patterns across the three groups, as well as shared decreased FC in attention/executive networks for both ASD and ADHD groups.
Conclusions:In summary, this study found similar findings from previous studies regarding mixed connectivity patterns, as well as shared dysfunction between ASD and ADHD groups. These results help in solidifying the theory that ASD and ADHD share clinical and neural patterns which need to be examined further. Future directions include utilizing more ASD+ADHD comorbid individuals in studies comparing ASD and ADHD FC trends as well as seeking to further understand the neuropsychological and neuroimaging profiles in ASD and ADHD.
12 Does Executive Functioning Predict Diagnostic Timing of Autism?
- Alexis Khuu, Lauren Kenworthy, Allison Ratto
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 622-623
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Objective:
Executive functioning (EF) is impaired in autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), and EF challenges are exacerbated in youth with ASD and ADHD (ASD+ADHD), which may impact diagnostic timing. We hypothesized youth with ASD+ADHD would be more impaired in EF (as opposed to other functional domains) compared to autistic youth without ADHD (ASD-only), with particular deficits in metacognition and inhibition. We also predicted youth with ASD+ADHD would be at significant risk for delayed ASD diagnosis and that greater EF challenges would predict earlier age of ASD diagnosis across groups.
Participants and Methods:Data from a clinical database was extracted for 400 youth who received a new diagnosis of ASD after age 5, either with a co-occurring diagnosis of ADHD (ASD+ADHD group: n=297; Mage of ASD diagnosis=10.49; 25.9% female; 48.1% white) or without a co-occurring ADHD diagnosis (ASD-only group: n=100; Mage of ASD diagnosis=12.02; 34.0% female; 44.7% white). EF was measured with the BRIEF-2 parent-report, and ASD symptom strength was measured with the SRS-2 School Age form. Independent samples t-tests investigated whether a) the ASD+ADHD group was uniquely impaired in EF compared to the ASD-only group, b) parents of ASD+ADHD report elevated EF problems, and c) the ASD+ADHD group was at significant risk for delayed ASD diagnosis. Pearson correlations examined the association between age of ASD diagnosis and EF for each diagnostic group. Hierarchical linear regressions further analyzed whether specific EF domains concurrently predicted age of ASD diagnosis, after controlling for the known predictors of assigned sex at birth, FSIQ, and ASD symptom strength.
Results:The ASD+ADHD group had greater challenges in overall EF (t=-6.42, p<.001), metacognitive skills (t=-6.47, p <.001), and inhibition skills (t=-7.06, p<.001). There was no significant difference in parent-reported autism symptoms between the ASD and ASD+ADHD groups (t=0.973, p=.331). The ASD+ADHD group received ASD diagnoses earlier than the ASD-only group (t=4.194, p<.001). In the ASD-only group, age of ASD diagnosis was not significantly correlated to overall EF, metacognitive skills, nor inhibition skills (ps>.05). In the ASD+ADHD group, ASD diagnosis was significantly related to overall EF (r(297)=.128, p=.027) and metacognitive skills (r(297)=.329, p<.001) but not inhibition skills (r(297)=.078, p=.180). Hierarchical linear regressions controlling for assigned sex at birth, FSIQ, and SRS-2 T-scores were used to determine whether these EF components significantly predicted age of ASD diagnosis. Overall EF did not predict age of ASD diagnosis in the ASD+ADHD group (ß=.034, t=1.417, p=.157), but metacognitive skills did (ß=.123, t=5.582, p<.001).
Conclusions:Our findings suggest youth with ASD+ADHD have greater impairment in overall EF, metacognition, and inhibition compared to ASD-only youth, despite similar levels of ASD traits, consistent with hypotheses. Contrary to our hypothesis, youth with ASD+ADHD in this sample were diagnosed with ASD earlier. However, results also suggest EF problems, specifically metacognitive deficits, predict later age of ASD diagnosis. Future research is needed to replicate findings and better understand how EF and other functional domains predict ASD diagnostic timing.
17 Studying the Use of Politeness in Employment Specific Scenarios in Youth with Autism Spectrum Disorder.
- Heba E Elsayed, Peter Meulenbroek, Zuzanna Myszko, Jacob Gronemeyer, Helen M Genova
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 626-627
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Objective:
Employment is crucial in the lives of adults with Autism Spectrum Disorder (ASD) as gainful occupational activity creates opportunities to form meaningful social relationships, participate in community life, and become financially independent. Impairments in pragmatic language skills (i.e., use of language to achieve social goals) negatively impact the ability to make and maintain cooperative work relationships with employers and coworkers, which are critical aspects of employment. A specific pragmatic skill key to workplace communication includes using a suitable degree of politeness, loosely defined as demonstrating the appreciation of the thoughts and feelings of your listener. Politeness can be measured with politeness markers (PMs). Appropriate PM use promotes positive, cooperative relationships. There are two main categories of PMs: positive and negative PMs. Positive PMs express appreciation or praise to the listener. Negative PMs avoid conflict and marks consideration of the thoughts and feelings of the listener. Crucially, negative PMs require more monitoring of social boundaries as they require consideration of the conversational partner’s potential reactions to statements and their emotional states. This makes PMs a novel new approach to evaluating speech in persons with ASD. Because PMs serve a purely social function in language, they include non-tangible words, such as would, could, may, or might. The current study explores the utility of an employment-specific social communication assessment tool, the Voicemail Elicitation Task (VET), in persons with ASD. The VET has proven sensitive to identifying social communication deficits in persons with traumatic brain injury.
Participants and Methods:The current cohort comparative study included a sample of young adults with ASD (n=22) and neurotypical controls (NTC; n=10). All participants were given the VET, which utilizes a standardized computerized language sampling procedure that assesses politeness markers (PMs) in work-related role-play scenarios. The outcome measure of the VET is PMs per minute (PMpM) which is obtained by dividing the sum of PMs by the speaking time (in minutes). Higher PMpM indicates higher PM use (more politeness), while lower PMpM indicates lower PM use (less politeness).
Results:The preliminary results indicated a significantly lower total PMpM in ASD participants (mean: 13.68 SD: 6.28) compared to NTCs (mean 18.72, SD: 3.65), p = 0.026. Post hoc analysis indicated that the differences in groups were driven by significantly lower negative PMs rates used by the ASD group (mean 9.18, SD: 5.77) compared to NTCs (mean: 16.30, SD: 7.78), p = 0.002, while both groups were similar in their mean level of positive PMs use, p = 0.442.
Conclusions:This study represents an important step toward validating the VET for use in ASD, which will improve the capacity of the field to address unemployment in this population. The results of the current study indicate that individuals with ASD show deficits in PM use which could impact their interpersonal relationships within the workplace environment. Designing interventions to target these deficits could help provide better employment outcomes for this population.