Children with autism spectrum disorder (ASD) often face barriers when establishing peer connections at school. This aim of this study is to explore how social network inclusion in the classroom is associated with playground peer engagement. Independent observers administered friendship surveys to determine social network inclusion in the classroom and recorded the playground engagement states of 55 children with ASD from 42 general education classrooms in 16 public elementary schools in the northeastern United States. Linear regression models were used to examine associations between social network inclusion and playground engagement. Results indicated an association between social network inclusion and playground engagement. Children who were included to a greater degree in their classrooms’ social network spent more time engaged with peers on the playground. These findings highlight the importance of supporting social interactions in multiple contexts in schools.
Purpose: Previous research has identified termination of interruptions to repetitive behaviour as a reinforcer capable of maintaining problem behaviour. Effective treatments have included functional communication training and multiple schedules of reinforcement.
Methods: In the present study, a functional analysis determined that the aggression of an eight-year-old boy with autism spectrum disorder was maintained by termination of interruptions of repetitive behaviour. An intervention was implemented consisting of differential reinforcement of other behaviour and response cost.
Results: The intervention produced and maintained a reduction in aggression and increased tolerance for interruptions of systematically increasing durations.
Conclusions: This case study demonstrates an alternative approach to the treatment of problem behaviours such as aggression maintained by termination of repetitive behaviour that includes teaching the individual to tolerate interruption of repetitive behavior.
Keywords: Avoidance; differential reinforcement of other behaviour; interruption; repetitive behaviour.
We report the feasibility and preliminary efficacy of a structured behavioral intervention with a sample of minimally verbal girls with autism spectrum disorder between the ages of 2 and 6 years old. Ten participants with no functional vocal behavior were randomized to a 4-week behavioral intervention or waitlist control group. Caregivers reported child communicative repertoires at pre- and post-randomization assessments. Social communication was also assessed at these time points using the Early Social Communication Scales. All feasibility benchmarks were met and findings of preliminary efficacy showed large effect sizes within groups. The current findings suggest the feasibility of recruiting and retaining samples of young, minimally verbal girls with autism spectrum disorder in randomized clinical trials.
Keywords: Feasibility; Female; Intervention; Minimally verbal; Sex differences.
Computational linguistics holds promise for improving scientific integrity in clinical psychology, and for reducing longstanding inequities in healthcare access and quality. This paper describes how computational linguistics approaches could address the “reproducibility crisis” facing social science, particularly with regards to reliable diagnosis of neurodevelopmental and psychiatric conditions including autism spectrum disorder (ASD). It is argued that these improvements in scientific integrity are poised to naturally reduce persistent healthcare inequities in neglected subpopulations, such as verbally fluent girls and women with ASD, but that concerted attention to this issue is necessary to avoid reproducing biases built into training data. Finally, it is suggested that computational linguistics is just one component of an emergent digital phenotyping toolkit that could ultimately be used for clinical decision support, to improve clinical care via precision medicine (i.e., personalized intervention planning), granular treatment response monitoring (including remotely), and for gene-brain-behavior studies aiming to pinpoint the underlying biological etiology of otherwise behaviorally-defined conditions like ASD.
Altered gamma-band electrophysiological activity in individuals with autism spectrum disorder (ASD) is well documented, and analogous gamma-band alterations are recapitulated in several preclinical murine models relevant to ASD. Such gamma-band activity is hypothesized to underlie local circuit processes. Gamma-band cross-frequency coupling (CFC), a related though distinct metric, interrogates local neural circuit signal integration. Several recent studies have observed perturbed gamma-band CFC in individuals with ASD, although the direction of change remains unresolved. It also remains unclear whether murine models relevant to ASD recapitulate this altered gamma-band CFC. As such, this study examined whether mice with parvalbumin (PV) cell-specific ablation of NMDA-R1 (PVcre/NR1fl/fl) demonstrated altered gamma-band CFC as compared with their control littermates (PVcre/NR1+/+-mice that do not have the PV cell-specific ablation of NMDA-R1). Ten mice of each genotype had 4 min of “resting” electroencephalography recorded and analyzed. First, resting electrophysiological power was parsed into the canonical frequency bands and genotype-related differences were subsequently explored so as to provide context for the subsequent CFC analyses. PVcre/NR1fl/fl mice exhibited an increase in resting power specific to the high gamma-band, but not other frequency bands, as compared with PVcre/NR1+/+. CFC analyses then examined both the standard magnitude (strength) of CFC and the novel metric PhaseMax-which denotes the phase of the lower frequency signal at which the peak higher frequency signal power occurred. PVcre/NR1fl/fl mice exhibited altered PhaseMax, but not strength, of gamma-band CFC as compared with PVcre/NR1+/+ mice. As such, this study suggests a potential novel metric to explore when studying neuropsychiatric disorders.
Keywords: ASD; cross-frequency coupling; gamma; phase; phase-amplitude coupling.
While genes with an excess of de novo mutations (DNMs) have been identified in children with neurodevelopmental disorders (NDDs), few studies focus on DNM patterns where the sex of affected children is examined separately. We considered ∼8,825 sequenced parent-child trios (n ∼26,475 individuals) and identify 54 genes with a DNM enrichment in males (n = 18), females (n = 17), or overlapping in both the male and female subsets (n = 19). A replication cohort of 18,778 sequenced parent-child trios (n = 56,334 individuals) confirms 25 genes (n = 3 in males, n = 7 in females, n = 15 in both male and female subsets). As expected, we observe significant enrichment on the X chromosome for females but also find autosomal genes with potential sex bias (females, CDK13, ITPR1; males, CHD8, MBD5, SYNGAP1); 6.5% of females harbor a DNM in a female-enriched gene, whereas 2.7% of males have a DNM in a male-enriched gene. Sex-biased genes are enriched in transcriptional processes and chromatin binding, primarily reside in the nucleus of cells, and have brain expression. By downsampling, we find that DNM gene discovery is greatest when studying affected females. Finally, directly comparing de novo allele counts in NDD-affected males and females identifies one replicated genome-wide significant gene (DDX3X) with locus-specific enrichment in females. Our sex-based DNM enrichment analysis identifies candidate NDD genes differentially affecting males and females and indicates that the study of females with NDDs leads to greater gene discovery consistent with the female-protective effect.
Keywords: X chromosome; autism; female protective effect; intellectual disability; neurodevelopmental disorder; sex bias
Autism spectrum disorders (ASDs) are increasingly prevalent neurodevelopmental disorders characterized by sociocommunicative impairments. Growing consensus indicates that neurobehavioral abnormalities require explanation in terms of interconnected networks. Despite theoretical speculations about increased local and reduced distal connectivity, links between local and distal functional connectivity have not been systematically investigated in ASDs. Specifically, it remains open whether hypothesized local overconnectivity may reflect isolated versus overly integrative processing. Resting state functional MRI data from 57 children and adolescents with ASDs and 51 typically developing (TD) participants were included. In regional homogeneity (ReHo) analyses, pericalcarine visual cortex was found be locally overconnected (ASD > TD). Using this region as seed in whole-brain analyses, we observed overconnectivity in distal regions, specifically middle frontal gyri, for an ASD subgroup identified through k-means clustering. While in this subgroup local occipital to distal frontal overconnectivity was associated with greater symptom severity, a second subgroup showed the opposite pattern of connectivity and symptom severity correlations. Our findings suggest that increased local connectivity in ASDs is region-specific and may be partially associated with more integrative long-distance connectivity. Results also highlight the need to test for subtypes, as differential patterns of brain-behavior links were observed in two distinct subgroups of our ASD cohort.
Keywords: autism; frontal cortex; functional connectivity MRI; local connectivity; visual cortex.
There are two established electroencephalogram (EEG) indices that putatively relate to anxiety symptoms: a) the error-related negativity (ERN), which reflects endogenous threat sensitivity, and b) resting-state EEG relative right frontal activity (rRFA), which relates to approach/withdrawal motivation. We examined these indices conjointly to better elucidate differential mechanisms underlying the common anxiety phenotype in youth with autism spectrum disorder (ASD), in relation to subjective reports of symptomatology and treatment response. EEG was recorded from 53 youth with ASD who participated in a 10-week social skills intervention (SSI). More negative ERN related to higher self-reported social anxiety symptoms at baseline, and predicted improvements in self-reported social anxiety symptoms following SSI. Although rRFA did not relate to anxiety symptoms at baseline, more rRFA predicted improvement in parent-reported anxiety domains but worsening in self-reported anxiety symptoms. This study provides evidence for unique neural mechanisms of anxiety symptoms and changes in anxiety after SSI in youth with ASD.
Keywords: Anxiety; Autism spectrum disorder; Electroencephalogram (EEG); Error-related negativity (ERN); Hemispheric asymmetry.
Autistic self-advocates, family members, and community organizations have called for greater emphasis on enhancing quality of life (QoL) for people with autism. Doing this is critical to understand how QoL unfolds across the life course and to clarify whether gender affects QoL, health, and functioning for people with autism. The purpose of this study was to curate and test a lifespan QoL measurement tool using freely available and well-constructed National Institutes of Health Parent-Reported Outcomes Measurement Information System (PROMIS). To develop the PROMIS Autism Battery-Lifespan (PAB-L), we identified PROMIS scales relevant for autism, reviewed each item, consulted with a panel of autism experts, and elicited feedback from autistic people and family members. This battery provides a comprehensive portrait of QoL for children ages 5-13 (through parent proxy), teens 14-17 (parent proxy and self-report), and adults 18-65 (self-report) with autism compared to the general population. Participants and parent informants (N = 912) recruited through a children’s hospital and nationwide U.S. autism research registry completed the PAB-L online. Results indicate that compared to general population norms, people with autism of all ages (or their proxies) reported less desirable outcomes and lower QoL across all domains. Women and girls experienced greater challenges in some areas compared to men and boys with autism. The PAB-L appears to be a feasible and acceptable method for assessing patient-reported outcomes and QoL for autistic people across the life course. Autism Res 2020, 13: 970-987. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We developed a survey to measure the quality of life of children, teens, and adults with autism using free National Institutes of Health PROMIS questionnaires. People with autism and family members rated the PROMIS Autism Battery-Lifespan as useful and important. Some reported a good quality of life, while many reported that their lives were not going as well as they wanted. Women and girls reported more challenges in some areas of life than men and boys.
Keywords: adults; life course; life span/lifespan; patient-reported outcomes; quality of life; sex/gender; women with autism.