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Braverman Y, Edmunds SR, Hastedt I, Faja S. Mind the Gap: Executive Function Is Associated with the Discrepancy Between Cognitive and Adaptive Functioning in Autistic Children Without Cognitive Delay. J Autism Dev Disord 2024:10.1007/s10803-024-06354-x. [PMID: 38778001 DOI: 10.1007/s10803-024-06354-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/25/2024]
Abstract
Adaptive functioning is central to autistic individuals' independence and well-being. However, autism spectrum disorder (ASD) is associated with poor adaptive functioning, even in the absence of cognitive delays or deficits. This study examined how age and executive function associate with adaptive functioning-particularly the gap between cognitive and adaptive functioning. We addressed our research questions separately for a school-age (N = 101 ages 7-12) cohort and a preschool (N = 48 ages 2 and 4) cohort of autistic children without cognitive delays. Both cohorts of parents reported on their children's adaptive and executive functioning skills. The difference between adaptive and cognitive skills was computed for each participant. For each cohort, we evaluated whether adaptive skills decline with age. Next, we measured, in each cohort, whether children's executive function corresponded with this gap between their adaptive and cognitive skills. Adaptive functioning did not decline relative to cognitive ability in the younger cohort, but the gap was present in the school-age cohort. Yet, reduced executive function consistently corresponded with a greater cognitive-adaptive gap in socialization domains for both preschool and school-age children. Targeting EF, specifically emotional control, during preschool years may support both adaptive functioning and social connectedness for autistic children without cognitive delays.
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Affiliation(s)
- Yael Braverman
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Sarah R Edmunds
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Psychology & Department of Educational Studies, University of South Carolina, Columbia, SC, USA
| | - Ingrid Hastedt
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA
- Department of Psychology, University of Massachusetts Boston, Boston, MA, USA
| | - Susan Faja
- Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
- Laboratories of Cognitive Neuroscience, Boston Children's Hospital, Two Brookline Place, Brookline, MA, 0244, USA.
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Anixt JS, Ehrhardt J, Duncan A. Evidence-Based Interventions in Autism. Pediatr Clin North Am 2024; 71:199-221. [PMID: 38423716 DOI: 10.1016/j.pcl.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Pediatricians have a critically important role in the care of children with autism, including conducting developmental screening to support early diagnosis and intervention, advising families about evidence-based treatments for autism spectrum disorder, and supporting families' emotional health as they care for a child with a developmental disability. The purpose of this article is to provide pediatricians with information about evidence-based autism treatments and how to determine which interventions are appropriate for children across the autism spectrum at different ages and developmental stages.
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Affiliation(s)
- Julia S Anixt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA.
| | - Jennifer Ehrhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
| | - Amie Duncan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
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Chien YL, Tai YM, Chiu YN, Tsai WC, Gau SSF. The mediators for the link between autism and real-world executive functions in adolescence and young adulthood. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:881-895. [PMID: 37522400 DOI: 10.1177/13623613231184733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
LAY ABSTRACT Childhood factors that predict real-world executive function in autism spectrum disorder during the transition into adulthood are largely unknown. This study aimed to identify the predictors for the behavioral and cognitive aspects of real-world executive function in late adolescent and young adult autistic populations. We followed up 289 autistic youth (mean age 11.6 years) and 203 non-autistic controls (10.7 years) to their ages of 16.9 and 15.8, respectively. The Behavior Rating Inventory of Executive Function scale was used to measure the real-world executive function at late adolescence and young adulthood at follow-up. Potential predictors such as autistic symptoms, inattention or hyperactivity symptoms, peer relationship, emotional symptoms, and parenting styles were assessed in childhood at first enrollment. The results showed that childhood inattention, withdrawn behaviors, social communication difficulties, and child-reported emotion and inattention/hyperactivity may predict real-world lower executive function in late adolescence and young adults with autism. When separating executive function into behavioral and cognitive aspects, we found that oppositional behaviors and peer problems were specific predictors for behavioral regulation and cognitive function, respectively. Our findings suggested that treating common predictors in childhood, such as inattention, may potentially improve real-world executive function in autism during the transition into adulthood.
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Affiliation(s)
| | - Yueh-Ming Tai
- Tri-Service General Hospital of National Defense Medical Center, Taiwan
| | | | | | - Susan Shur-Fen Gau
- National Taiwan University Hospital, Taiwan
- National Taiwan University, Taiwan
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van Andel DM, Sprengers JJ, Königs M, de Jonge MV, Bruining H. Effects of Bumetanide on Neurocognitive Functioning in Children with Autism Spectrum Disorder: Secondary Analysis of a Randomized Placebo-Controlled Trial. J Autism Dev Disord 2024; 54:894-904. [PMID: 36626004 PMCID: PMC10907457 DOI: 10.1007/s10803-022-05841-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 01/11/2023]
Abstract
We present the secondary-analysis of neurocognitive tests in the 'Bumetanide in Autism Medication and Biomarker' (BAMBI;EUDRA-CT-2014-001560-35) study, a randomized double-blind placebo-controlled (1:1) trial testing 3-months bumetanide treatment (≤ 1 mg twice-daily) in unmedicated children 7-15 years with ASD. Children with IQ ≥ 70 were analyzed for baseline deficits and treatment-effects on the intention-to-treat-population with generalized-linear-models, principal component analysis and network analysis. Ninety-two children were allocated to treatment and 83 eligible for analyses. Heterogeneous neurocognitive impairments were found that were unaffected by bumetanide treatment. Network analysis showed higher modularity after treatment (mean difference:-0.165, 95%CI:-0.317 to - 0.013,p = .034) and changes in the relative importance of response inhibition in the neurocognitive network (mean difference:-0.037, 95%CI:-0.073 to - 0.001,p = .042). This study offers perspectives to include neurocognitive tests in ASD trials.
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Affiliation(s)
- Dorinde M van Andel
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Jan J Sprengers
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marsh Königs
- Department of Paediatrics, Emma Neuroscience Group, Amsterdam UMC Emma Children's Hospital, Amsterdam, The Netherlands
| | - Maretha V de Jonge
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department Education and Child Studies, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands
| | - Hilgo Bruining
- Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.
- Child and Adolescent Psychiatry and Psychosocial Care, Emma Children's Hospital, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.
- N=You Neurodevelopmental Precision Center, Amsterdam Neuroscience, Amsterdam Reproduction and Development, Amsterdam UMC, Amsterdam, Netherlands.
- Levvel, Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands.
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
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Torske T, Nærland T, Quintana DS, Hypher RE, Kaale A, Høyland AL, Hope S, Johannessen J, Øie MG, Andreassen OA. Sex as a Moderator Between Parent Ratings of Executive Dysfunction and Social Difficulties in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3847-3859. [PMID: 35838825 PMCID: PMC10499744 DOI: 10.1007/s10803-022-05629-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2022] [Indexed: 11/25/2022]
Abstract
Girls and boys might differ in autistic symptoms and associated cognitive difficulties such as executive function (EF). We investigated sex differences in the relationship between parent rated EF and autistic symptoms in 116 children and adolescents (25 girls) aged 5-19 years with an intelligence quotient above 70 and an autism spectrum disorder (ASD) diagnosis. They were rated with the behavior rating inventory of executive function (BRIEF) and the autism diagnostic interview revised (ADI-R). We found a positive association between EF and the ADI-R domains of reciprocal social interaction (p < 0.001) and communication (p = 0.001) in girls, while these relationships were small and non-significant in boys. Our results provide a greater understanding of the sex-specific characteristics of children and adolescents with ASD.
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Affiliation(s)
- Tonje Torske
- Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Postboks 800, 3004, Drammen, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Terje Nærland
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Daniel S Quintana
- Department of Psychology, University of Oslo, Oslo, Norway
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ruth Elizabeth Hypher
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | - Anett Kaale
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | - Anne Lise Høyland
- Faculty of Medicine and Health Sciences, Department of Mental Health, Regional Centre for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Sigrun Hope
- NORMENT, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway
| | - Jarle Johannessen
- NevSom Department of Rare Disorders and Disabilities, Oslo University Hospital, Oslo, Norway
- Department of Medicine, University of Oslo, Oslo, Norway
| | - Merete G Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Department, Innlandet Hospital Trust, Lillehammer, Norway
| | - Ole A Andreassen
- K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
- NORMENT, University of Oslo and Oslo University Hospital, Oslo, Norway
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Davut G, Onur D, Hüseyin G. Autistic features and executive functions in first episode psychosis: Associations with functionality and quality of life. Early Interv Psychiatry 2023; 17:814-823. [PMID: 36653734 DOI: 10.1111/eip.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/15/2022] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
AIM The present study aimed at investigating the relationships between autistic features and cognitive deficits, functionality and quality of life in first episode psychosis (FEP) patients. METHODS Sixty FEP patients [mean age (SD) = 32.53 (10.74), n = 23 female, n = 37 male] were enrolled in this cross-sectional study. Data was collected using a sociodemographic and clinical data form, the Positive and Negative Syndrome Scale (PANSS), the PANSS Autism Severity Score (PAUSS), the Personal and Social Performance Scale (PSP), the Frontal Assessment Battery (FAB), and the World Health Organization Quality of Life Scale Short Form in Turkish Version (WHOQOL-BREF TR). RESULTS Autistic symptom severity was found to be higher in males than females, and higher in patients with a family history of psychotic disorder. An inverse relationship was found between the duration of education and the severity of autistic symptoms. While there was an inverse relationship between autistic symptom severity and executive functions and functionality, no significant correlation was found with quality of life. Negative symptom severity was a predictor of executive functions and functionality. No significant difference was observed between autistic and psychotic domains which were related to executive functions. CONCLUSIONS Our study is the first to examine the relationship between autistic/psychotic symptoms and executive functions and functionality in patients with FEP. The results show that autistic symptoms are associated with worse social and personal functioning and worse executive functions in patients with FEP. Longitudinal follow-up studies with larger samples are required to determine the direction of the relations.
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Affiliation(s)
- Genç Davut
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Durmaz Onur
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
| | - Güleç Hüseyin
- Erenköy Mental Health and Neurology Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey
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Lupi E, Tucci F, Casula L, Novello RL, Guerrera S, Vicari S, Valeri G. Early and stable difficulties of everyday executive functions predict autism symptoms and emotional/behavioral problems in preschool age children with autism: a 2-year longitudinal study. Front Psychol 2023; 14:1092164. [PMID: 37583604 PMCID: PMC10425204 DOI: 10.3389/fpsyg.2023.1092164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/10/2023] [Indexed: 08/17/2023] Open
Abstract
Introduction Longitudinal studies of autistic children show that autism symptoms and emotional/behavioral problems vary and change over time. However, the factors that affect this variability remain far from certain and very little is known about what take place in the preschool period and the role of executive functions (EF). Methods Here, we test the influence of stable difficulties in everyday executive functioning (EEF) during early childhood across 2 years on autistic symptoms and emotional and behavioral problems. Twenty-nine autistic children (24 males and 5 females) were assessed twice within the space of 2 years. At baseline (M = 29 months, SD =5.6 months), participants were assessed for EEF, cognitive development, autistic symptoms, and emotional/behavioral problems. At follow-up, we repeated the same assessment except for cognitive development. Results The group with stable difficulties (across 2 years) in EEF during early childhood showed a worsening in the severity of autistic symptoms and emotional and behavioral problems compared with children without EEF difficulties (p < 0.05), and these effects cannot be attributable to cognitive development. Discussion Our results suggest that early and stable EEF plays the role of a modifier by interacting with the core domains of autism, in particular with the social affect domain (SA CSS), influencing social cognition and exacerbating or lessening symptom expression and emotional behavioral problems. These short-term longitudinal and preliminary findings underscore the importance of EEF as necessary target for early intervention in children with autism.
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Affiliation(s)
- Elisabetta Lupi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Federico Tucci
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy
| | - Laura Casula
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Roberta Lucia Novello
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Silvia Guerrera
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giovanni Valeri
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Wong OWH, Barzilay R, Lam AMW, Chan S, Calkins ME, Gur RE, Gur RC. Executive function as a generalized determinant of psychopathology and functional outcome in school-aged autism spectrum disorder: a case-control study. Psychol Med 2023; 53:4788-4798. [PMID: 35912846 PMCID: PMC10388326 DOI: 10.1017/s0033291722001787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 01/30/2023]
Abstract
BACKGROUND Individuals with autism spectrum disorder (ASD) are challenged not only by the defining features of social-communication deficits and restricted repetitive behaviors, but also by a myriad of psychopathology varying in severity. Different cognitive deficits underpin these psychopathologies, which could be subjected to intervention to alter the course of the disorder. Understanding domain-specific mediating effects of cognition is essential for developing targeted intervention strategies. However, the high degree of inter-correlation among different cognitive functions hinders elucidation of individual effects. METHODS In the Philadelphia Neurodevelopmental Cohort, 218 individuals with ASD were matched with 872 non-ASD controls on sex, age, race, and socioeconomic status. Participants of this cohort were deeply and broadly phenotyped on neurocognitive abilities and dimensional psychopathology. Using structural equation modeling, inter-correlation among cognitive domains were adjusted before mediation analysis on outcomes of multi-domain psychopathology and functional level. RESULTS While social cognition, complex cognition, and memory each had a unique pattern of mediating effect on psychopathology domains in ASD, none had significant effects on the functional level. In contrast, executive function was the only cognitive domain that exerted a generalized negative impact on every psychopathology domain (p factor, anxious-misery, psychosis, fear, and externalizing), as well as functional level. CONCLUSIONS Executive function has a unique association with the severity of comorbid psychopathology in ASD, and could be a target of interventions. As executive dysfunction occurs variably in ASD, our result also supports the clinical utility of assessing executive function for prognostic purposes.
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Affiliation(s)
- Oscar W. H. Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Ran Barzilay
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Angela M. W. Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Sandra Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Monica E. Calkins
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Raquel E. Gur
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
| | - Ruben C. Gur
- Neurodevelopment and Psychosis Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, Pennsylvania, USA
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Kourtesis P, Kouklari EC, Roussos P, Mantas V, Papanikolaou K, Skaloumbakas C, Pehlivanidis A. Virtual Reality Training of Social Skills in Adults with Autism Spectrum Disorder: An Examination of Acceptability, Usability, User Experience, Social Skills, and Executive Functions. Behav Sci (Basel) 2023; 13:bs13040336. [PMID: 37102850 PMCID: PMC10136366 DOI: 10.3390/bs13040336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/14/2023] [Accepted: 04/15/2023] [Indexed: 04/28/2023] Open
Abstract
Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations similar to those in real life; however, more research is needed to elucidate aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, which incorporated five social scenarios with three difficulty levels. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports, and executive functions. Working memory and planning ability were significant predictors of the functionality level in ASD and the VR system's perceived usability, respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level. Planning ability substantially predicted performance in social scenarios, suggesting an implication in social skills. Immersive VR social skills training in individuals with ASD appears to be an appropriate service, but an errorless approach that is adaptive to the individual's needs should be preferred.
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Affiliation(s)
- Panagiotis Kourtesis
- Department of Psychology, National and Kapodistrian University of Athens, 157 84 Athens, Greece
- Department of Psychology, University of Edinburgh, Edinburgh EH8 9AD, UK
| | - Evangelia-Chrysanthi Kouklari
- Department of Child Psychiatry, Aghia Sophia Children's Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
- 1st Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Petros Roussos
- Department of Psychology, National and Kapodistrian University of Athens, 157 84 Athens, Greece
| | - Vasileios Mantas
- 1st Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
| | - Katerina Papanikolaou
- Department of Child Psychiatry, Aghia Sophia Children's Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Christos Skaloumbakas
- Department of Child Psychiatry, P. & A. Kyriakou Children's Hospital, 115 28 Athens, Greece
- Habilis, R&D Team, 141 22 Athens, Greece
| | - Artemios Pehlivanidis
- 1st Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, 115 28 Athens, Greece
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Kim JH, Song DY, Han HS, Yoon NH, Cho HB, Lee HB, Choi KH, Chae PK, Bong G, Ahn S, Yoo HJ. Improving adaptive behaviors for autistic adults without intellectual disability through executive function training. Asian J Psychiatr 2023; 84:103579. [PMID: 37043906 DOI: 10.1016/j.ajp.2023.103579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 03/09/2023] [Accepted: 04/03/2023] [Indexed: 04/14/2023]
Abstract
Executive functioning (EF) is a cognitive process used to perform various daily activities throughout one's lifespan. Autistic adults without intellectual disabilities (ID) also experience difficulties with EF, which is closely associated with adaptive behaviors. For this reason, it is important to improve adaptive behaviors through enhanced use of EF for autistic adults to transition into adulthood successfully. This study aims to conduct a randomized controlled trial to evaluate the effectiveness of a newly developed and modified intervention program. Thirty autistic adults without ID were randomly assigned to the treatment or waitlist group. The participants and caregivers completed various assessments and self-report questionnaires to measure everyday EF and adaptive behaviors. We performed linear mixed-effect modeling to compare the two groups. Data collected at pre-, middle, post-, and follow-up based on participants who completed the program were used to explore changes across time. While there were significant differences in the EF utility-scale (F=5.46, p = .027) between the treatment and waitlist groups, no group x time interactions were detected in other measures. Everyday EF and adaptive behaviors improved when comparing measurements at different time points (p < .001). Our program is Korea's first evidence-based intervention to improve everyday EF and adaptive behaviors for autistic adults without ID.
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Affiliation(s)
- Joo Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea
| | - Da-Yea Song
- Department of Psychiatry, Seoul National University College of Medicine, South Korea
| | - Hye Sun Han
- Department of Neurology, Samsung Medical Center, South Korea
| | - Nan-He Yoon
- Division of Social Welfare & Health Administration, Wonkwang University, South Korea
| | - Hwi Bin Cho
- Department of Psychiatry, Konkuk University Medical Center, South Korea
| | - Han Bit Lee
- Center for Campus Life & Culture, Seoul National University, South Korea
| | - Kyung Hee Choi
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea
| | | | - Guiyoung Bong
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea
| | - Soyeon Ahn
- Division of Statistics, Medical Research Collaborating Center, Seoul National Unversity Bundang Hospital, South Korea
| | - Hee Jeong Yoo
- Department of Psychiatry, Seoul National University Bundang Hospital, South Korea; Department of Psychiatry, Seoul National University College of Medicine, South Korea.
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Conner CM, Elias R, Smith IC, White SW. Emotion Regulation and Executive Function: Associations with Depression and Anxiety in Autism. RESEARCH IN AUTISM SPECTRUM DISORDERS 2023; 101:102103. [PMID: 36741741 PMCID: PMC9897310 DOI: 10.1016/j.rasd.2023.102103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Adolescents and young adults with autism spectrum disorder (ASD) are prone to experience co-occurring mental health conditions such as mood or anxiety disorders, as well as impairments in emotion regulation and executive functioning. However, little research has examined inter-relationships among these constructs, despite evidence of additional stressors and increased risk of internalizing disorders at this age, relative to non-autistic individuals. If either emotion regulation or executive functioning are shown to have patterns of association with mental health, this can inform mechanism-based intervention. Method Fifty-seven autistic adolescents and adults (16-25 years) with ASD in a transition intervention completed questionnaires and clinician-administered measures at baseline. Analyses assessed whether executive functioning impairment, above and beyond emotion regulation impairment, were associated with depression and anxiety symptoms. Results ASD characteristics, emotion regulation, anxiety, and depression were significantly correlated. ASD characteristics was a significant contributor to depression and emotion regulation impairments were significant contributors to anxiety and depression. Findings indicated that inhibition difficulties did not uniquely contribute to depression or anxiety above emotion regulation impairment. Difficulties in cognitive flexibility were associated with depression above and beyond ASD characteristics, IQ, and emotion regulation, but not associated with anxiety. Conclusions Although preliminary, findings suggest that inflexibility and regulatory impairment should be considered in depression remediation approaches. Improving ER, on the other hand, may have broader transdiagnostic impact across both mood and anxiety symptoms in ASD.
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Affiliation(s)
| | - Rebecca Elias
- University of Southern California, Los Angeles, CA
- Children’s Hospital Los Angeles, Los Angeles, CA
| | - Isaac C. Smith
- University of Connecticut School of Medicine, West Hartford, CT
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Rosello R, Martinez-Raga J, Tomas JM, Rosello B, Berenguer C, Cortese S. Exploring developmental trajectories throughout adolescence of children with autism spectrum disorder without intellectual disability. J Neural Transm (Vienna) 2023; 130:299-312. [PMID: 36385316 DOI: 10.1007/s00702-022-02554-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022]
Abstract
Characterizing the developmental trajectories of children with autism spectrum disorder (ASD) throughout adolescence and across different domains of functioning offers opportunities to improve long-term outcomes. This prospective study explored, for the first time, the evolution of children with ASD-without intellectual disability (ID) in terms of socio-adaptative skills, learning behaviors, executive functioning (EF), and internalizing/externalizing problems, compared to typically developing (TD) peers. Forty-five children with ASD-without ID and 37 matched TD children (aged 7-11) were assessed at baseline and after 5 years. Parents and teachers completed measures on theory of mind (ToM), socialization, daily living skills, learning style, EF, and emotional/behavioural difficulties at both time points. On all the domains assessed, the ASD group performed significantly worse than the TD group, both in childhood and adolescence. Specific changes were noted between baseline and follow-up assessment on adaptive skills, prosocial behavior, emotional control, inhibit, working memory and monitoring. Group membership (ASD/TD) was influenced by peer relationships and inhibit EF variables. These findings have implications for clinical and school settings.
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Affiliation(s)
- Rocio Rosello
- Division of Psychiatry, Imperial College London, London, UK.
- Division of Psychiatry, University of Valencia, Valencia, Spain.
| | - Jose Martinez-Raga
- Division of Psychiatry, University of Valencia, Valencia, Spain
- Doctor Peset Hospital of Valencia, Valencia, Spain
| | - Jose Manuel Tomas
- Division of Methodology and Behavioural Science, University of Valencia, Valencia, Spain
| | - Belen Rosello
- Division of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Carmen Berenguer
- Division of Developmental and Educational Psychology, University of Valencia, Valencia, Spain
| | - Samuele Cortese
- Solent NHS Trust, Southampton, UK
- Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, USA
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- Centre for Innovation in Mental Health (CIMH), University of Southampton, Southampton, UK
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13
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Ji Z, Wang L, Cai M, Lu L, Wang H. Bibliometric analysis study on cognitive function in developmental coordination disorder from 2010 to 2022. Front Psychol 2022; 13:1040208. [PMID: 36562047 PMCID: PMC9764009 DOI: 10.3389/fpsyg.2022.1040208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
Objective To identify the research hotspots on cognitive function in developmental coordination disorder (DCD) in recent years, predict the research frontier and development trend, and provide more perspectives for the study of the DCD population. Methods Using CiteSpace and VOSviewer software to draw charts, 1,082 pieces of literature about DCD and cognitive function in the Web of Science core collection database from 2010 to 2022 were visually analyzed. Results and conclusion Interest in the cognitive function of DCD has been on the rise in the past 10 years. Over 40 countries and regions, 117 institutions and 200 researchers have participated in the corresponding research, mainly in the United States, and their institutions have published more highly influential results. The hot keywords are DCD, children, attention, working memory, performance, and attention-deficit/hyperactivity disorder (ADHD), and the main research hot topics include functional performance, population, cognitive psychology. The research directions include "DCD," "Asperger syndrome," "memory," "infant," "clumsiness," "neurodevelopmental disorder," "occupational therapy," "preschool children," "motor competence," "model," and "online control." Future research should focus on motor imagery and intrinsic models and use more neurophysiological techniques to reveal the cognitive characteristics of children with DCD and develop intervention programs.
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Affiliation(s)
- Zhiguang Ji
- Department of Physical Education, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Liyan Wang
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Ming Cai
- College of Rehabilitation Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Le Lu
- Department of Physical Education, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Hongbiao Wang
- Department of Physical Education, Shanghai University of Medicine and Health Sciences, Shanghai, China,*Correspondence: Hongbiao Wang,
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14
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Assessment of Adaptive Behavior in People with Autism Spectrum Disorders through the ICAP. Behav Sci (Basel) 2022; 12:bs12090333. [PMID: 36135137 PMCID: PMC9495773 DOI: 10.3390/bs12090333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/23/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Evaluating adaptive behavior in people with Autism Spectrum Disorder (ASD) requires attending to a set of cognitive processes associated with social interaction skills and functional communication that are altered. This paper presents the analysis of an instrument to assess and diagnose adaptive behavior in people with Autism Spectrum Disorder (ASD), given the need for rigorous, standardized, and statistically reliable tools to address this dimension, incorporated into the diagnosis since 1992. The Inventory for Service Planning and Individual Programming (ICAP) was applied to n = 209 children with ASD. Its psychometric properties were studied to provide statistical criteria for its usefulness in assessing adaptive behavior. Results highlighted variations in its original structure, reducing the number of items from 77 to 60 by eliminating those with little discriminative power, and of dimensions from four to three given their greater congruence with the results of the exploratory analysis: daily life skills (α = 0.892–0.935), communication and linguistic skills (α = 0.860–0.931), and motor skills (α = 0.828–0.857). This again raises questions about the use of instruments similar in their dimensions, and about the interaction between variables and items, a frequent issue in the field of mind, social, and health sciences.
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15
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Pellicano E, Fatima U, Hall G, Heyworth M, Lawson W, Lilley R, Mahony J, Stears M. A capabilities approach to understanding and supporting autistic adulthood. NATURE REVIEWS PSYCHOLOGY 2022; 1:624-639. [PMID: 36090460 PMCID: PMC9443657 DOI: 10.1038/s44159-022-00099-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/28/2022]
Abstract
There is little comprehensive research into autistic adulthood, and even less into the services and supports that are most likely to foster flourishing adult autistic lives. This limited research is partly because autism is largely conceived as a condition of childhood, but this focus of research has also resulted from the orthodox scientific approach to autism, which conceptualizes autistic experience almost entirely as a series of biologically derived functional deficits. Approaching autism in this way severely limits what is known about this neurodevelopmental difference, how research is conducted and the services and supports available. In this Review, we adopt an alternative research strategy: we apply Martha Nussbaum’s capabilities approach, which focuses on ten core elements of a thriving human life, to research on autistic adulthood. In doing so, we identify areas where autistic adults thrive and where they often struggle, and highlight issues to which researchers, clinicians and policymakers should respond. The resulting picture is far more complex than conventional accounts of autism imply. It also reveals the importance of engaging autistic adults directly in the research process to make progress towards genuinely knowing autism and supporting flourishing autistic lives. The focus on functional deficits in conventional autism research constrains understanding of autistic lives. In this Review, Pellicano et al. appraise research on autistic adulthood through a capabilities lens to identify areas where autistic adults thrive, and where more research and services are needed to enhance their quality of life.
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16
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Barton H, McIntyre LL. Caregiver-reported executive functioning and associated adaptive and challenging behaviour in children with histories of developmental delay. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:121-132. [PMID: 34213015 DOI: 10.1111/jir.12865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 05/08/2021] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Deficits in executive functioning (EF) have been measured in individuals with developmental disabilities, such as autism spectrum disorder and attention-deficit/hyperactivity disorder, through the use of behaviour rating scales and performance-based assessment. Associations between EF and variables such as challenging and adaptive behaviour have been observed; however, limited research exists on EF profiles in children with heterogeneous developmental delay or with intellectual disability (ID) or the impact of EF on adaptive and challenging behaviour with this population. METHODS The present study sought to examine the EF profile of 93 children (75 male and 18 female) previously identified with developmental delay in early childhood. EF was assessed using the Behaviour Rating Inventory of Executive Function, Second Edition (BRIEF-2). Children were categorised into an ID group (n = 14) or no ID group (n = 79) based on scores from cognitive and adaptive behaviour assessments. EF profiles were investigated and compared by group. In addition, the impact of EF on both adaptive behaviour and challenging behaviour was measured using hierarchical linear regressions. RESULTS Statistically significant differences in caregiver-reported EF were not observed between groups; however, both the ID and the no ID group scores were elevated as reported by their caregivers. For the overall sample, caregiver-EF accounted for significant variance in both adaptive (22%) and challenging (68%) behaviour after accounting for child age and sex. CONCLUSIONS Results indicated deficits in EF for children with and without ID. The significance of EF was accounted for in both adaptive and challenging behaviour for all children in the sample. Future research could elucidate the role of adaptive and challenging behaviour in understanding EF variability among children with histories of developmental delay.
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Affiliation(s)
- H Barton
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, Oregon, USA
| | - L L McIntyre
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene, Oregon, USA
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17
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Laureys F, De Waelle S, Barendse MT, Lenoir M, Deconinck FJ. The factor structure of executive function in childhood and adolescence. INTELLIGENCE 2022. [DOI: 10.1016/j.intell.2021.101600] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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18
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Nadeem MS, Hosawi S, Alshehri S, Ghoneim MM, Imam SS, Murtaza BN, Kazmi I. Symptomatic, Genetic, and Mechanistic Overlaps between Autism and Alzheimer's Disease. Biomolecules 2021; 11:1635. [PMID: 34827633 PMCID: PMC8615882 DOI: 10.3390/biom11111635] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/26/2021] [Accepted: 11/01/2021] [Indexed: 02/02/2023] Open
Abstract
Autism spectrum disorder (ASD) and Alzheimer's disease (AD) are neurodevelopmental and neurodegenerative disorders affecting two opposite ends of life span, i.e., childhood and old age. Both disorders pose a cumulative threat to human health, with the rate of incidences increasing considerably worldwide. In the context of recent developments, we aimed to review correlated symptoms and genetics, and overlapping aspects in the mechanisms of the pathogenesis of ASD and AD. Dementia, insomnia, and weak neuromuscular interaction, as well as communicative and cognitive impairments, are shared symptoms. A number of genes and proteins linked with both disorders have been tabulated, including MECP2, ADNP, SCN2A, NLGN, SHANK, PTEN, RELN, and FMR1. Theories about the role of neuron development, processing, connectivity, and levels of neurotransmitters in both disorders have been discussed. Based on the recent literature, the roles of FMRP (Fragile X mental retardation protein), hnRNPC (heterogeneous ribonucleoprotein-C), IRP (Iron regulatory proteins), miRNAs (MicroRNAs), and α-, β0, and γ-secretases in the posttranscriptional regulation of cellular synthesis and processing of APP (amyloid-β precursor protein) have been elaborated to describe the parallel and overlapping routes and mechanisms of ASD and AD pathogenesis. However, the interactive role of genetic and environmental factors, oxidative and metal ion stress, mutations in the associated genes, and alterations in the related cellular pathways in the development of ASD and AD needs further investigation.
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Affiliation(s)
- Muhammad Shahid Nadeem
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.S.N.); (S.H.)
| | - Salman Hosawi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.S.N.); (S.H.)
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.); (S.S.I.)
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia;
| | - Syed Sarim Imam
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (S.A.); (S.S.I.)
| | - Bibi Nazia Murtaza
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad 22310, Pakistan;
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (M.S.N.); (S.H.)
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Romer AL, Pizzagalli DA. Is executive dysfunction a risk marker or consequence of psychopathology? A test of executive function as a prospective predictor and outcome of general psychopathology in the adolescent brain cognitive development study®. Dev Cogn Neurosci 2021; 51:100994. [PMID: 34332330 PMCID: PMC8340137 DOI: 10.1016/j.dcn.2021.100994] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/08/2021] [Accepted: 07/19/2021] [Indexed: 12/30/2022] Open
Abstract
A general psychopathology ('p') factor captures shared variation across mental disorders. One hypothesis is that poor executive function (EF) contributes to p. Although EF is related to p concurrently, it is unclear whether EF predicts or is a consequence of p. For the first time, we examined prospective relations between EF and p in 9845 preadolescents (aged 9-12) from the Adolescent Brain Cognitive Development Study® longitudinally over two years. We identified higher-order factor models of psychopathology at baseline and one- and two-year follow-up waves. Consistent with previous research, a cross-sectional inverse relationship between EF and p emerged. Using residualized-change models, baseline EF prospectively predicted p factor scores two years later, controlling for prior p, sex, age, race/ethnicity, parental education, and family income. Baseline p factor scores also prospectively predicted change in EF two years later. Tests of specificity revealed that bi-directional prospective relations between EF and p were largely generalizable across externalizing, internalizing, neurodevelopmental, somatization, and detachment symptoms. EF consistently predicted change in externalizing and neurodevelopmental symptoms. These novel results suggest that executive dysfunction is both a risk marker and consequence of general psychopathology. EF may be a promising transdiagnostic intervention target to prevent the onset and maintenance of psychopathology.
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Affiliation(s)
- Adrienne L Romer
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Belmont, MA, USA.
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA; Harvard Medical School, Belmont, MA, USA; McLean Imaging Center, McLean Hospital, Belmont, MA, USA
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20
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Ludyga S, Pühse U, Gerber M, Mücke M. Muscle strength and executive function in children and adolescents with autism spectrum disorder. Autism Res 2021; 14:2555-2563. [PMID: 34351051 PMCID: PMC9292567 DOI: 10.1002/aur.2587] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/14/2021] [Accepted: 07/23/2021] [Indexed: 11/25/2022]
Abstract
The development of effective (non‐pharmacological) treatment approaches for executive dysfunction in autism spectrum disorder (ASD) requires evidence that factors influencing this domain can be modified by behavioral interventions. The present cross‐sectional study investigated the relative associations of ASD, muscle strength and body mass index with executive function and information processing among the Healthy Brain Network cohort. Patients with ASD (N = 174) and healthy peers (N = 202) aged 5 to 18 years completed cognitive tasks of the NIH toolbox (Pattern Comparison, Flanker, List Sorting, Card Sorting) to assess core components of executive function and information processing. Additionally, anthropometrics and muscle strength were collected from selected items (push‐ups, curl‐ups, trunk lift, and grip strength) of the Fitnessgram battery. Based on structural equation modeling, ASD was related to impaired muscle strength and executive function, when confounders (age, sex, pubertal status, and socioeconomic status) were accounted for. Muscle strength further showed independent contributions to information processing and executive function. This association was moderated by ASD, so that higher muscle strength was related to higher executive function in ASD patients only. The present findings provide a first indication that the promotion of muscle strength may have the potential to generally enhance information processing and to reduce ASD‐related executive dysfunction in children and adolescents.
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Affiliation(s)
- Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Manuel Mücke
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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21
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Ludyga S, Tränkner S, Gerber M, Pühse U. Effects of Judo on Neurocognitive Indices of Response Inhibition in Preadolescent Children: A Randomized Controlled Trial. Med Sci Sports Exerc 2021; 53:1648-1655. [PMID: 34261995 DOI: 10.1249/mss.0000000000002626] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Although exercise is suggested to benefit inhibitory control in children and adolescents, the current evidence is limited to exercise-induced improvements for its interference control subtype. In contrast, the potential of exercise to facilitate response inhibition still remains unclear. However, the neurocognitive profile of martial arts athletes suggests that this sports category promises benefits for cognitive control processes related to response inhibition. The present randomized controlled trial therefore examined the effects of judo on behavioral and neurocognitive indices of response inhibition (N2, P3a, P3b) in preadolescent children. METHODS Participants (N = 44) were randomly allocated to a martial arts group, who completed 120-min judo per week over 3 months, and a wait-list control group. At baseline and follow-up, participants completed the Movement Assessment Battery for Children-2 and a physical work capacity test on a bicycle ergometer at 170 bpm (PWC170). In addition, a computerized Go/NoGo task with simultaneous electroencephalographic recordings was administered. RESULTS In the martial arts group, a greater decrease in NoGo error rate and a higher increase in NoGo N2 amplitude were found in comparison to the control group. These behavioral and neurocognitive changes were correlated. In contrast to N2, the P3a/b amplitude, Movement Assessment Battery for Children-2, and physical work capacity test at 170 bpm did not change differently between groups over the intervention period. CONCLUSIONS The present findings indicate that judo promises benefits for response inhibition that are independent of alterations in motor skills and cardiorespiratory fitness. A change toward more effective conflict monitoring seems to underlie this improvement in cognitive performance.
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Affiliation(s)
- Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, SWITZERLAND
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22
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Patterns of Continuity and Change in the Psychosocial Outcomes of Young Autistic People: a Mixed-Methods Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2021; 48:301-313. [PMID: 31797119 DOI: 10.1007/s10802-019-00602-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Long-term longitudinal studies have consistently demonstrated that the outcomes of autistic individuals are highly variable. Yet, these studies have typically focused on aspects of functioning deemed to be critical by non-autistic researchers, rather than autistic people themselves. Here, we uniquely examined the long-term psychosocial outcomes of a group of young autistic people (n = 27; M age = 17 years; 10 months; 2 female) followed from childhood using a combination of approaches, including (1) the standard, normative approach, which examined changes in diagnostic outcomes, autistic features and adaptive functioning over a 9-year period and (2) a qualitative approach, which involved semi-structured interviews to understand young people's own subjective experiences of their current functioning. On average, there was no significant change in young people's diagnostic outcomes and autistic features over the 9-year period, although there was much variability at the individual level. There was far less variability, however, in young people's everyday functioning, with marked declines over the same period. While these often-substantial everyday challenges aligned well with young people's subjective reports, there was no straightforward one-to-one mapping between self-reported experiences of being autistic and standard measures of severity. These findings call for concerted efforts to understand autistic outcomes through the mixing of quantitative and qualitative reports and for sustained and targeted interventions during adolescence in those areas that matter most to young people themselves.
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Nadeem MS, Murtaza BN, Al-Ghamdi MA, Ali A, Zamzami MA, Khan JA, Ahmad A, Rehman MU, Kazmi I. Autism - A Comprehensive Array of Prominent Signs and Symptoms. Curr Pharm Des 2021; 27:1418-1433. [PMID: 33494665 DOI: 10.2174/1381612827666210120095829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by multiple psychological and physiological impairments in young children. According to the recent reports, 1 out of every 58 newly-born children is suffering from autism. The aetiology of the disorder is complex and poorly understood, hindering the adaptation of targeted and effective therapies. There are no well- established diagnostic biomarkers for autism. Hence the analysis of symptoms by the pediatricians plays a critical role in the early intervention. METHODS In the present report, we have emphasized 24 behavioral, psychological and clinical symptoms of autism. RESULTS Impaired social interaction, restrictive and narrow interests, anxiety, depression; aggressive, repetitive, rigid and self-injurious behavior, lack of consistency, short attention span, fear, shyness and phobias, hypersensitivity and rapid mood alterations, high level of food and toy selectivity; inability to establish friendships or follow the instructions; fascination by round spinning objects and eating non-food materials are common psychological characteristics of autism. Speech or hearing impairments, poor cognitive function, gastrointestinal problems, weak immunity, disturbed sleep and circadian rhythms, weak motor neuromuscular interaction, lower level of serotonin and neurotransmitters, headache and body pain are common physiological symptoms. CONCLUSION A variable qualitative and quantitative impact of this wide range of symptoms is perceived in each autistic individual, making him/her distinct, incomparable and exceptional. Selection and application of highly personalized medical and psychological therapies are therefore recommended for the management and treatment of autism.
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Affiliation(s)
- Muhammad Shahid Nadeem
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Bibi Nazia Murtaza
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad, Pakistan
| | - Maryam A Al-Ghamdi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Akbar Ali
- College of Pharmacy, Northern Border University Rafha 1321, Saudi Arabia
| | - Mazin A Zamzami
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Jalaluddin A Khan
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Aftab Ahmad
- College of Pharmacy, Northern Border University Rafha 1321, Saudi Arabia
| | - Mujaddad Ur Rehman
- Department of Zoology, Abbottabad University of Science and Technology (AUST), Abbottabad, Pakistan
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Brief Report: An Exploration of Cognitive Flexibility of Autistic Adolescents with Low Intelligence Using the Wisconsin Card Sorting Task. J Autism Dev Disord 2021; 53:1726-1732. [PMID: 34114127 DOI: 10.1007/s10803-021-05134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2021] [Indexed: 10/21/2022]
Abstract
Cognitive flexibility (CF) is the ability to shift between concepts or rules. Difficulty with CF is associated with autism (i.e., ASD) as it contributes to repetitive behaviours. However, little is known about CF skills of autistic adolescents with low intelligence. This study uses the Wisconsin Card Sorting Task (WCST) to assess the CF of 36 adolescents, all with a Weschler full-scale IQ between 50 and 85, 14 of whom had an ASD diagnosis. The results indicated no statistically significant differences in WCST performance between those with and without ASD. It was also found that performance IQ significantly contributed to the WCST performance in the ASD group only, suggesting an autism-specific role of non-verbal cognitive functioning in CF.
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How children with neurodevelopmental disorders can benefit from the neurocognitive effects of exercise. Neurosci Biobehav Rev 2021; 127:514-519. [PMID: 33991545 DOI: 10.1016/j.neubiorev.2021.04.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/01/2021] [Indexed: 11/22/2022]
Abstract
Exercise is an integral part of children's lives, and research in educational settings has found that regular engagement promises improvements in executive function (i.e. top-down control of goal-directed behavior). Based on recent advances in understanding the moderators and the neurocognitive mechanisms of these effects, we highlight a potential application of exercise in the treatment of executive dysfunction. Even though different neurodevelopmental disorders are characterized by a heterogeneity in core symptoms, children affected by these disorders often face common executive function deficits. So far, exercise has not been recognized as an alternative or additional treatment for this specific cognitive impairment. The limited experimental evidence in children with neurodevelopmental disorders provides a first indication that regular exercise engagement benefits executive function. However, we identified key research questions that need to be answered before a prescription of exercise to children with executive dysfunction can be encouraged in clinical practice.
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Halder S, Bruyere SM. Self-reported impediments at home, school, and community: autistic adults' first-person accounts of their life trajectories and derived pathways. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:900-912. [PMID: 37113660 PMCID: PMC10127941 DOI: 10.1080/20473869.2021.1917111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 06/19/2023]
Abstract
Objectives: Despite suggestions of strengths and abilities of autistic people, it has been an underexplored area in autism research, the primary focus of which has been on examining differences and atypicalities as deficits rather than strengths. Understanding the self-reported impediments via first-person accounts of autistic adults for facilitating the strengths is an important prerequisite for an in-depth comprehension of the unique diversities and potentialities of autistic people, and roadmap development. Methods: The study is based on qualitative phenomenological inductive thematic analysis through in-depth interviews with 10 verbally- and cognitively-able autistic adults, following purposive and snowball sampling. Results: The impediments at home, school, and communities are presented through the five inductively extracted themes. Additionally, the study proposes future pathways for fostering an effective environment to nurture the innate potentialities of autistic people via a strength-focused lens. Conclusion: The study endorses the paradox of strength and atypicalities and advocates a shift from a deficit-focused approach to a strength-focused approach of support, and promotes the neurodiverse model of acceptance and embrace.
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Affiliation(s)
- Santoshi Halder
- Fulbright Academic and Professional Excellence Fellow, YTI, ILR, Cornell University, Ithaca, NY, USA
- Department of Education, University of Calcutta, Kolkata, India
| | - Susanne Marie Bruyere
- K. Lisa Yang and Hock E. Tan Institute on Employment and Disability, Ithaca, NY, USA
- Disability Studies, Cornell University, Ithaca, NY, USA
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Roy D, Uddin LQ. Atypical core-periphery brain dynamics in autism. Netw Neurosci 2021; 5:295-321. [PMID: 34189366 PMCID: PMC8233106 DOI: 10.1162/netn_a_00181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/31/2020] [Indexed: 11/06/2022] Open
Abstract
The intrinsic function of the human brain is dynamic, giving rise to numerous behavioral subtypes that fluctuate distinctively at multiple timescales. One of the key dynamical processes that takes place in the brain is the interaction between core-periphery brain regions, which undergoes constant fluctuations associated with developmental time frames. Core-periphery dynamical changes associated with macroscale brain network dynamics span multiple timescales and may lead to atypical behavior and clinical symptoms. For example, recent evidence suggests that brain regions with shorter intrinsic timescales are located at the periphery of brain networks (e.g., sensorimotor hand, face areas) and are implicated in perception and movement. On the contrary, brain regions with longer timescales are core hub regions. These hubs are important for regulating interactions between the brain and the body during self-related cognition and emotion. In this review, we summarize a large body of converging evidence derived from time-resolved fMRI studies in autism to characterize atypical core-periphery brain dynamics and how they relate to core and contextual sensory and cognitive profiles.
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Affiliation(s)
- Dipanjan Roy
- Cognitive Brain Dynamics Lab, National Brain Research Centre, Manesar, India
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, FL, USA
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28
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Rosello R, Martinez-Raga J, Mira A, Girela B, Cortese S. Developmental outcomes in adolescence of children with autism spectrum disorder without intellectual disability: A systematic review of prospective studies. Neurosci Biobehav Rev 2021; 126:590-603. [PMID: 33872683 DOI: 10.1016/j.neubiorev.2021.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 03/23/2021] [Accepted: 04/10/2021] [Indexed: 11/30/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) without intellectual disability (ID) represent approximately two-thirds of the ASD population. Here we focused on prospective research assessing different areas of functioning of children with ASD, without ID, until adolescence. Based on a pre-registered protocol (PROSPERO CRD42020189029), a systematic review of prospective studies (published between 01.01.2010 and 01.01.2020) was conducted. Twenty-eight studies met eligibility criteria. Findings indicated that ASD diagnosis and the Intelligence Quotient were highly stable over time across studies. Executive Functioning, Theory of Mind and Central Coherence processes tended to improve, although deficits remained when compared to typically developed controls. Adaptive difficulties and psychiatric comorbidity were relatively stable over time. We discuss potential implications of the findings for clinicians and educators and suggest recommendations for future research.
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Affiliation(s)
- Rocio Rosello
- Division of Psychiatry, Imperial College London, UK.
| | - Jose Martinez-Raga
- Psychiatry Department, University Hospital Doctor Peset of Valencia & University of Valencia, Spain
| | - Alvaro Mira
- Division of Developmental and Educational Psychology, University of Valencia, Spain
| | | | - Samuele Cortese
- Centre for Innovation in Mental Health (CIMH), School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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29
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Hodge MA, Boulton KA, Sutherland R, Barnett D, Bennett B, Chan E, Cramsie J, Drevensek S, Eapen V, Ganesalingam K, Masi A, Ong N, Williamsz M, Guastella AJ, Silove N. Predictors of adaptive functioning in preschool aged children with autism spectrum disorder. Autism Res 2021; 14:1444-1455. [PMID: 33749170 DOI: 10.1002/aur.2501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/06/2021] [Indexed: 12/22/2022]
Abstract
Difficulties in adaptive functioning are common in autism spectrum disorder (ASD) and contribute to negative outcomes across the lifespan. Research indicates that cognitive ability is related to degree of adaptive functioning impairments, particularly in young children with ASD. However, the extent to which other factors, such as socioeconomic status (SES) and ASD symptom severity, predict impairments in adaptive functioning remains unclear. The goal of this study was to determine the extent to which SES, ASD symptom severity, and cognitive ability contribute to variability in domain-specific and global components of adaptive functioning in preschool-aged children with ASD. Participants were 99 preschool-aged children (2-6 years) with ASD who attended a tertiary diagnostic service. Results demonstrate that cognitive ability accounted for a significant proportion of variance in domain-specific and global components of adaptive functioning, with higher cognitive ability predicting better adaptive functioning. Results also demonstrate that SES accounted for some variability in domain-specific communication skills and global adaptive functioning when compared to basic demographic factors alone (age and gender). By contrast, ASD symptom severity did not predict variability in domain-specific or global components of adaptive functioning. These findings provide support for a relationship between cognitive ability and adaptive functioning in preschool-aged children with ASD and help to explain specific contributions of verbal and nonverbal ability to adaptive functioning; from this, we can better understand which children are likely to show the greatest degree of impairments across components of adaptive functioning early in development. LAY SUMMARY: People with autism often have difficulties with everyday communication, daily living, and social skills, which are also called adaptive functioning skills. This study investigated factors that might be related to these difficulties in preschoolers with autism. We found that better cognitive ability, but not autism symptoms, were associated with better adaptive functioning. This suggests that interventions for young children with autism should take into account cognitive ability to better understand which children are likely to have difficulties with adaptive functioning.
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Affiliation(s)
- Marie Antoinette Hodge
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kelsie A Boulton
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Rebecca Sutherland
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Diana Barnett
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Beverley Bennett
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Esther Chan
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Jane Cramsie
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Suzi Drevensek
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Kalaichelvi Ganesalingam
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Anne Masi
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Natalie Ong
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Marcia Williamsz
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Adam J Guastella
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Autism Clinic for Translational Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Natalie Silove
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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30
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Tsai TH, Chen YL, Gau SSF. Relationships between autistic traits, insufficient sleep, and real-world executive functions in children: a mediation analysis of a national epidemiological survey. Psychol Med 2021; 51:579-586. [PMID: 31769374 DOI: 10.1017/s0033291719003271] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although the literature documents low executive functions and sleep deficits in individuals with autism spectrum disorder or subclinical autistic traits, no study has simultaneously examined their relationships in the general child population. This study aimed to examine whether autistic traits impacted real-world executive functions through insufficient sleep in a nationally representative sample of children. METHODS This was a national survey of 6832 primary and secondary school students, aged 8-14 years old, with equal sex distribution (3479 boys, 50.8%). Parents reported their child's nocturnal sleep duration and the need for sleep to maintain their daytime function and the Social Responsiveness Scale and the Behavior Rating Inventory of Executive Function (BRIEF) for their children's autistic traits and real-world executive functions, respectively. RESULTS We found that autistic traits exerted indirect effects on real-world executive functions through sleep deficits, independent of sex, and age. Moreover, such an indirect effect was observed only from restricted and repetitive behaviors to executive functions through sleep deficits, but not in the other components of autistic traits (i.e. social communication and interaction). CONCLUSIONS Our novel findings underscore the importance of sleep and autistic traits in executive functions and suggest potential mechanisms that may underlie the observed correlational structure among autistic behaviors, sleep deficits, and low executive function performance.
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Affiliation(s)
- Tsung-Han Tsai
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Lung Chen
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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31
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Udhnani MD, Kenworthy L, Wallace GL, Yerys BE. Brief Report: Performance-Based Executive Functioning Abilities are Associated with Caregiver Report of Adaptive Functioning in Autism Spectrum Disorder. J Autism Dev Disord 2021; 50:4541-4547. [PMID: 32333300 DOI: 10.1007/s10803-020-04505-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Executive functioning is thought to contribute to adaptive behavior skills development in individuals with autism spectrum disorder (ASD). However, supporting data are largely based on caregiver reports of executive functioning. The current study evaluated whether performance-based measures of executive functioning (working memory and inhibition) explained unique variance in parent-reported adaptive functioning among youth with ASD without an intellectual disability. Both spatial and verbal working memory were associated with adaptive functioning, particularly communication and daily living skills. Our findings demonstrate a robust relationship between working memory and adaptive functioning that translates across different measurement modalities. This preliminary study highlights that targeting executive functioning may be a critical component of an adaptive function training program.
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Affiliation(s)
- Manisha D Udhnani
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children's National, Washington, DC, USA
| | - Gregory L Wallace
- Department of Speech, Language, and Hearing Sciences, The George Washington University, Washington, DC, USA
| | - Benjamin E Yerys
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA. .,Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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32
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Uddin LQ. Brain Mechanisms Supporting Flexible Cognition and Behavior in Adolescents With Autism Spectrum Disorder. Biol Psychiatry 2021; 89:172-183. [PMID: 32709415 PMCID: PMC7677208 DOI: 10.1016/j.biopsych.2020.05.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 02/08/2023]
Abstract
Cognitive flexibility enables appropriate responses to a changing environment and is associated with positive life outcomes. Adolescence, with its increased focus on transitioning to independent living, presents particular challenges for youths with autism spectrum disorder (ASD) who often struggle to behave in a flexible way when faced with challenges. This review focuses on brain mechanisms underlying the development of flexible cognition during adolescence and how these neural systems are affected in ASD. Neuroimaging studies of task switching and set-shifting provide evidence for atypical lateral frontoparietal and midcingulo-insular network activation during cognitive flexibility task performance in individuals with ASD. Recent work also examines how intrinsic brain network dynamics support flexible cognition. These dynamic functional connectivity studies provide evidence for alterations in the number of transitions between brain states, as well as hypervariability of functional connections in adolescents with ASD. Future directions for the field include addressing issues related to measurement of cognitive flexibility using a combination of metrics with ecological and construct validity. Heterogeneity of executive function ability in ASD must also be parsed to determine which individuals will benefit most from targeted training to improve flexibility. The influence of pubertal hormones on brain network development and cognitive maturation in adolescents with ASD is another area requiring further exploration. Finally, the intriguing possibility that bilingualism might be associated with preserved cognitive flexibility in ASD should be further examined. Addressing these open questions will be critical for future translational neuroscience investigations of cognitive and behavioral flexibility in adolescents with ASD.
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Affiliation(s)
- Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, and the Neuroscience Program, University of Miami Miller School of Medicine, Miami, Florida.
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33
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Di Sarro R, Di Santantonio A, Desideri L, Varrucciu N. Profiling planning skills and cognitive flexibility of adults with autism spectrum disorders: Preliminary results from an exploratory service-based study. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2021; 68:651-657. [PMID: 36210889 PMCID: PMC9542481 DOI: 10.1080/20473869.2020.1871311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 05/30/2023]
Abstract
Background: Executive functions (EF) impairments have long been observed in children and youths with autism spectrum disorders (ASD). Until very recently, little attention has been paid to examine EF profiles of adults with ASD. Given the importance of EF to cope with the demands of daily life and participate in society (e.g. maintaining an employment), this study reports on a preliminary investigation aimed at exploring planning skills and cognitive flexibility in a sample of adults with ASD and without intellectual disability. A secondary aim was to explore the contribution of both intellectual functioning and socio-demographic variables on efficiency of EF. Method: Twenty-nine autistic adults (age range 18-50) were assessed using the Tower of London (ToL) test and the Wisconsin Card Sorting Test (WCST). Intellectual functioning was assessed with the Wechsler Adult Intelligence Scale - IV. Results: From the evaluations emerged poor performances in sub-processes related to planning skills as assessed by ToL (number of Moves, Correct Reponses, and Execution time). In contrast, WCST performance did not result impaired in any of the indicators considered. Exploratory analyses revealed a strong relationship between the time needed to complete the planning tasks and visuo-spatial reasoning. Further, strong inverse associations were found between global intellectual functioning and chronological age in the WCST. Conclusions: The results of this study highlight mixed EF profiles in a sample of adults with ASD. Future investigations may build on the results of the present study to understand whether evaluating planning abilities of adults with ASD by means of measures that do not require a time-limit would yield different results compared to time-constrained assessment procedures.
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Affiliation(s)
- Rita Di Sarro
- Integrated Program Disability and Health, Emilia-Romagna Region, Bologna, Italy
| | - Anna Di Santantonio
- Integrated Program Disability and Health, Emilia-Romagna Region, Bologna, Italy
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Lorenzo Desideri
- Department of Psychology, University of Bologna, Bologna, Italy
- Regional Centre for Assistive Technology, Bologna, Italy
| | - Niccolò Varrucciu
- Integrated Program Disability and Health, Emilia-Romagna Region, Bologna, Italy
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34
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Alfieri P, Scibelli F, Digilio MC, Novello RL, Caciolo C, Valeri G, Vicari S. Comparison of Adaptive Functioning in Children with Williams Beuren Syndrome and Autism Spectrum Disorder: A Cross-Syndrome Study. Autism Res 2020; 14:748-758. [PMID: 33314766 DOI: 10.1002/aur.2455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 11/09/2022]
Abstract
Williams Beuren syndrome (WBS) and autism spectrum disorder (ASD) have been long considered as "polar opposite" disorders. Although children with WBS appears to be hypersociable, recent researches have revealed difficulties in socio-communicative skills such as shared attention, showing or giving objects, social relationships comprehension, pragmatic use of language, and emotion's recognition. The aim of this cross-syndrome study is to compare clinician-report adaptive profiles of two wide developmental range children by means of Vineland Adaptive Behavior Scales-Interview Edition, Survey Form. Eighty individuals, 40 with WBS and 40 with ASD (31 preschoolers and 49 scholars) with ASD and WBS matched for chronological age and developmental/cognitive level were recruited. Analysis of domains and subdomains have been reported. Results showed no significant difference in global adaptive level between WBS and ASD in both preschooler and scholar children. Communication domain significantly differ in preschoolers (higher in WBS children), but not in scholars. Expressive subdomain significantly differ in both preschoolers and scholars (higher in WBS children). Play and Leisure subdomain significantly differ in scholars (higher in WBS children), but not in preschoolers. Our results support hypothesis on a shared global adaptive impairment in children with WBS and ASD, by extending this findings to scholar-age children. Analysis of domains and subdomains differences highlight the need for interventions targeting social-pragmatic skills since first years of life. Differences in preschoolers and scholars adaptive profiles could be explained through a developmental perspective. LAY SUMMARY: Little is known about differences in adaptive profiles between Williams Beuren syndrome and autism spectrum disorder. Our results show similarities in global adaptive level and difference in communication level. Furthermore, expressive skills seem to be higher in Williams Beuren Syndrome. Autism Res 2021, 14: 748-758. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Paolo Alfieri
- Child & Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Scibelli
- Child & Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Maria C Digilio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Roberta L Novello
- Child & Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Cristina Caciolo
- Child & Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Giovanni Valeri
- Child & Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child & Adolescent Psychiatry Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.,Department of Life Sciences and Public Health, Catholic University, Rome, Italy
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35
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Wisner-Carlson R, Uram S, Flis T. The Transition to Adulthood for Young People with Autism Spectrum Disorder. Psychiatr Clin North Am 2020; 43:673-686. [PMID: 33127001 DOI: 10.1016/j.psc.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The transition to adulthood for individuals with autism spectrum disorder is difficult and outcomes are suboptimal. Social cognition deficits and executive dysfunction continue to be barriers to young people's success, lack of societal acceptance and loss of previous support can exacerbate the condition, and mental health issues increase. All areas of adult functioning are affected. To help manage the transition and improve outcomes for this population, psychiatrists and other health care providers need to be aware of the issues and possible interventions, including social skills training, educational transition programs, and supported employment programs.
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Affiliation(s)
- Robert Wisner-Carlson
- Neuropsychiatry Outpatient Program, Adult Developmental Neuropsychiatry Clinic, Adult Inpatient Intellectual Disability and Autism Unit, Sheppard Pratt Autism Registry, Ethics Committee, Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA.
| | - Sara Uram
- Adult Developmental Neuropsychiatry Clinic, Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA
| | - Thomas Flis
- Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA
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36
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Dirks B, Romero C, Voorhies W, Kupis L, Nomi JS, Dajani DR, Odriozola P, Burrows CA, Beaumont AL, Cardona SM, Parlade MV, Alessandri M, Britton JC, Uddin LQ. Neural Responses to a Putative Set-shifting Task in Children with Autism Spectrum Disorder. Autism Res 2020; 13:1501-1515. [PMID: 32840961 DOI: 10.1002/aur.2347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/24/2020] [Accepted: 05/15/2020] [Indexed: 12/18/2022]
Abstract
While much progress has been made toward understanding the neurobiology of social and communication deficits associated with autism spectrum disorder (ASD), less is known regarding the neurobiological basis of restricted and repetitive behaviors (RRBs) central to the ASD diagnosis. Symptom severity for RRBs in ASD is associated with cognitive inflexibility. Thus, understanding the neural mechanisms underlying cognitive inflexibility in ASD is critical for tailoring therapies to treat this understudied yet pervasive symptom. Here we used a set-shifting paradigm adopted from the developmental cognitive neuroscience literature involving flexible switching between stimulus categories to examine task performance and neural responses in children with ASD. Behaviorally, we found little evidence for group differences in performance on the set-shifting task. Compared with typically developing children, children with ASD exhibited greater activation of the parahippocampal gyrus during performance on trials requiring switching. These findings suggest that children with ASD may need to recruit memory-based neural systems to a greater degree when learning to flexibly associate stimuli with responses. LAY SUMMARY: Children with autism often struggle to behave in a flexible way when faced with unexpected challenges. We examined brain responses during a task thought to involve flexible thinking and found that compared with typically developing children, those with autism relied more on brain areas involved in learning and memory to complete the task. This study helps us to understand what types of cognitive tasks are best suited for exploring the neural basis of cognitive flexibility in children with autism. Autism Res 2020, 13: 1501-1515. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Bryce Dirks
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Celia Romero
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Willa Voorhies
- Department of Psychology, University of California Berkeley, Berkeley, California, USA
| | - Lauren Kupis
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Jason S Nomi
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Dina R Dajani
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| | - Catherine A Burrows
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Amy L Beaumont
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sandra M Cardona
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Meaghan V Parlade
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Michael Alessandri
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Jennifer C Britton
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Lucina Q Uddin
- Department of Psychology, University of Miami, Coral Gables, Florida, USA.,Neuroscience Program, University of Miami Miller School of Medicine, Miami, Florida, USA
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37
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Thornton CP, Ruble K, Jacobson LA. Beyond Risk-Based Stratification: Impacts of Processing Speed and Executive Function on Adaptive Skills in Adolescent and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2020; 10:288-295. [PMID: 32668177 DOI: 10.1089/jayao.2020.0059] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: The number of adolescent and young adult (AYA) survivors of childhood cancer is increasing, and the impacts of therapy on their daily lives are not well understood. Adaptive functions are required for age-appropriate interactions and day to day functioning, but are reduced in AYA survivors. Work in other pediatric populations suggests that additional neurocognitive skills may influence adaptive function and, thus, quality of life and personal attainment of AYA cancer survivors. Methods: Retrospective medical records review examined neurocognitive data from 139 AYA survivors. Hierarchical linear regression examined age at diagnosis, use of central nervous system (CNS) radiation, verbal intelligence, processing speed, and executive function as predictors of adaptive functioning domains. Results: AYA survivors exhibited weaknesses in all domains of adaptive functioning compared to normative reference values (Cohen's d = 0.660-0.864), as well as in processing speed (Cohen's d = 0.791) and metacognitive executive functioning (Cohen's d = 0.817). Processing speed and executive function provided substantial improvements in prediction of adaptive functioning beyond that of age at diagnosis and use of CNS-directed radiation therapy. Taken together these variables explained 37.1% of variability in adaptive conceptual skills, 26.1% in adaptive social skills, and 27.1% of adaptive practical skills. Conclusions: Intelligence, processing speed, and executive function significantly contribute to adaptive function scores in AYA cancer survivors and impact domains that are important to self-sufficiency and quality of life. Attention to neurocognitive function in all AYA cancer survivors is recommended in addition to referral for neuropsychological evaluation and tailoring interventions to address executive and adaptive functioning.
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Affiliation(s)
- Clifton P Thornton
- Herman & Walter Samuelson Children's Hospital at Sinai, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Kathy Ruble
- Division of Pediatric Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Lisa A Jacobson
- Department of Neuropsychology, Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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38
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Skinner C, Pauly R, Skinner SA, Schroer RJ, Simensen RJ, Taylor HA, Friez MJ, DuPont BR, Stevenson RE. Autistic Disorder: A 20 Year Chronicle. J Autism Dev Disord 2020; 51:677-684. [DOI: 10.1007/s10803-020-04568-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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39
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Pellicano E, Lawson W, Hall G, Mahony J, Lilley R, Davis C, Arnold S, Trollor J, Yudell M. Documenting the untold histories of late-diagnosed autistic adults: a qualitative study protocol using oral history methodology. BMJ Open 2020; 10:e037968. [PMID: 32474432 PMCID: PMC7264831 DOI: 10.1136/bmjopen-2020-037968] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Receiving a diagnosis of autism in adulthood is increasingly common for a subset of individuals who were either misdiagnosed in childhood or missed out on a diagnosis altogether. This qualitative study, coproduced with autistic people, invites late-diagnosed autistic adults to share their life histories to (1) understand better the consequences of living without a diagnosis, (2) elucidate what precipitates an autism diagnosis in mid-to-late adulthood and (3) identify the perceived impact of receiving that diagnosis. METHODS AND ANALYSIS Oral histories have been a successful way to uncover overlooked and marginalised voices. We therefore adopt qualitative, oral history methodology in this study to understand these adults' experiences, especially of living in an era when autism was not well known. We will recruit 24 participants who will (1) have been born before 1975, (2) have received a clinical, autism diagnosis after the age of 35, (3) be English-speaking and (4) have spent most of their childhood and adulthood living in Australia. Participants will take part in four sessions, including the main, qualitative, oral history interview, through a range of possible formats to facilitate inclusion. The interview data will be analysed using reflexive thematic analysis. ETHICS AND DISSEMINATION The protocol has received institutional research ethics approval from Macquarie University's Human Research Ethics Committee (Ref.: 52019556310562). This study will yield understanding of the life experiences of autistic adults, especially middle-aged and older Australians, should inform more effective diagnostic practices and provide insight into the key factors that might promote resilience and enhance quality of life in autistic people. The findings will be disseminated to academic and clinical audiences through journal articles and conference presentations and to the autistic and autism communities through accessible reports. The interviews will also be prepared for digital archiving, which will enable ongoing access for future generations and communities.
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Affiliation(s)
- Elizabeth Pellicano
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Wenn Lawson
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Gabrielle Hall
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Joanne Mahony
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
| | - Rozanna Lilley
- Macquarie School of Education, Macquarie University, Sydney, New South Wales, Australia
| | - Catherine Davis
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Samuel Arnold
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian Trollor
- Cooperative Research Centre for Living with Autism (Autism CRC), Brisbane, Queensland, Australia
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Yudell
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Wang JG, Cai KL, Liu ZM, Herold F, Zou L, Zhu LN, Xiong X, Chen AG. Effects of Mini-Basketball Training Program on Executive Functions and Core Symptoms among Preschool Children with Autism Spectrum Disorders. Brain Sci 2020; 10:brainsci10050263. [PMID: 32365853 PMCID: PMC7287705 DOI: 10.3390/brainsci10050263] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
This study examined the effects of a 12-week mini-basketball training program (MBTP) on executive functions and core symptoms among preschoolers with autism spectrum disorder (ASD). In this quasi-experimental pilot study, 33 ASD preschoolers who received their conventional rehabilitation program were assigned to either a MBTP group (n = 18) or control group (n = 15). Specifically, the experimental group was required to take an additional 12-week MBTP (five days per week, one session per day, and forty minutes per session), while the control group was instructed to maintain their daily activities. Executive functions and core symptoms (social communication impairment and repetitive behavior) were evaluated by the Childhood Executive Functioning Inventory (CHEXI), the Social Responsiveness Scale-Second Edition (SRS-2), and the Repetitive Behavior Scale-Revised (RBS-R), respectively. After the 12-week intervention period, the MBTP group exhibited significantly better performances in working memory (F = 7.51, p < 0.01, partial η2 = 0.195) and regulation (F = 4.23, p < 0.05, partial η2 = 0.12) as compared to the control group. Moreover, the MBTP significantly improved core symptoms of ASD preschoolers, including the social communication impairment (F = 6.02, p < 0.05, partial η2 = 0.020) and repetitive behavior (F = 5.79, p < 0.05, partial η2 = 0.016). Based on our findings, we concluded that the 12-week MBTP may improve executive functions and core symptoms in preschoolers with ASD, and we provide new evidence that regular physical exercise in the form of a MBTP is a promising alternative to treat ASD.
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Affiliation(s)
- Jin-Gui Wang
- College of Physical Education, Yangzhou University, Yangzhou 225127, China; (J.-G.W.); (K.-L.C.); (Z.-M.L.); (X.X.)
| | - Ke-Long Cai
- College of Physical Education, Yangzhou University, Yangzhou 225127, China; (J.-G.W.); (K.-L.C.); (Z.-M.L.); (X.X.)
| | - Zhi-Mei Liu
- College of Physical Education, Yangzhou University, Yangzhou 225127, China; (J.-G.W.); (K.-L.C.); (Z.-M.L.); (X.X.)
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany;
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Liye Zou
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China;
| | - Li-Na Zhu
- School of Physical Education and Sports Science, Beijing Normal University, Beijing 100000, China;
| | - Xuan Xiong
- College of Physical Education, Yangzhou University, Yangzhou 225127, China; (J.-G.W.); (K.-L.C.); (Z.-M.L.); (X.X.)
| | - Ai-Guo Chen
- College of Physical Education, Yangzhou University, Yangzhou 225127, China; (J.-G.W.); (K.-L.C.); (Z.-M.L.); (X.X.)
- Correspondence: ; Tel.: +86-514-8797-8013
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41
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Wisner-Carlson R, Uram S, Flis T. The Transition to Adulthood for Young People with Autism Spectrum Disorder. Child Adolesc Psychiatr Clin N Am 2020; 29:345-358. [PMID: 32169266 DOI: 10.1016/j.chc.2019.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The transition to adulthood for individuals with autism spectrum disorder is difficult and outcomes are suboptimal. Social cognition deficits and executive dysfunction continue to be barriers to young people's success, lack of societal acceptance and loss of previous support can exacerbate the condition, and mental health issues increase. All areas of adult functioning are affected. To help manage the transition and improve outcomes for this population, psychiatrists and other health care providers need to be aware of the issues and possible interventions, including social skills training, educational transition programs, and supported employment programs.
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Affiliation(s)
- Robert Wisner-Carlson
- Neuropsychiatry Outpatient Program, Adult Developmental Neuropsychiatry Clinic, Adult Inpatient Intellectual Disability and Autism Unit, Sheppard Pratt Autism Registry, Ethics Committee, Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA.
| | - Sara Uram
- Adult Developmental Neuropsychiatry Clinic, Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA
| | - Thomas Flis
- Sheppard Pratt Health System, 6501 North Charles Street, Baltimore, MD 21204, USA
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Valeri G, Casula L, Napoli E, Stievano P, Trimarco B, Vicari S, Scalisi TG. Executive Functions and Symptom Severity in an Italian Sample of Intellectually Able Preschoolers with Autism Spectrum Disorder. J Autism Dev Disord 2019; 50:3207-3215. [PMID: 31190199 DOI: 10.1007/s10803-019-04102-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A novel battery (BAFE; Valeri et al. 2015) was used in order to assess three executive function (EF) abilities (working memory, inhibition and shifting) in a sample of 27 intellectually able preschoolers with autism spectrum disorder (ASD) compared with 27 typically developing children matched on age and nonverbal IQ. Differences in EF skills were analyzed in participants with distinct ASD symptom severity. Children with ASD performed worse than typical controls on both set-shifting and inhibition, but not on visuo-spatial working memory. Additionally, children with more severe ASD symptoms showed a worse performance on inhibition than children with milder symptoms. These results confirm the presence of EF deficits and highlight a link between ASD symptoms and EF impairments in preschool age.
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Affiliation(s)
- Giovanni Valeri
- Department of Neuroscience, Child Neuropsychiatric Unit, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Laura Casula
- Department of Neuroscience, Child Neuropsychiatric Unit, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Eleonora Napoli
- Department of Neuroscience, Child Neuropsychiatric Unit, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | | | - Barbara Trimarco
- Department of Neuroscience, Child Neuropsychiatric Unit, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy.
| | - Stefano Vicari
- Department of Neuroscience, Child Neuropsychiatric Unit, Bambino Gesù Children's Hospital, Piazza Sant'Onofrio 4, 00165, Rome, Italy
| | - Teresa Gloria Scalisi
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
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