Enhanced perceptual functioning in autism: an update, and eight principles of autistic perception

Sex differences in the relationship between autistic traits and face-change discrimination sensitivity in the general population: a psychophysical investigation

The findings on the effect of autistic traits on face recognition performance vary across previous studies. Even though people with higher autistic traits have difficulties identifying faces, the extent to which they have difficulties is unknown. Moreover, even though Autism Spectrum Disorder has sex differences in prevalence and symptoms, a limited number of studies consider sex differences in face recognition. The present study examined the relationship between face-change discrimination sensitivity and autistic traits considering sex differences. The participants included 82 females and 88 males in the general population. Face change blindness task using psychophysical method was used to evaluate the degree of sensitivity to faces in each participant. A psychometric function computed the Point of Subjective Equality (PSE) as the morphing level required to discriminate between faces. The Autism Spectrum Quotient (AQ) was also administered to participants. The results revealed a negative relationship between the total score of the AQ and the PSE in females but not males. This study suggests that sex differences should be considered when examining the relationship between autistic traits and other-face perception.

How autism impacts children's working memory for faces

This study investigates visual working memory (WM) performance in children aged 7-12 years with Autism Spectrum Disorder (ASD) compared to typically developing (TD) peers, focusing on face stimuli to evaluate social-relevant memory processing. The research aims to identify differences in visual WM functioning and determine whether errors in recall stem from reduced precision or increased random guessing. Participants completed a visual WM task requiring them to memorize and reproduce the orientations of faces presented on a screen. Results demonstrated that children with ASD exhibited significantly poorer overall visual WM accuracy than TD children. A fine-grained analysis of error patterns revealed that the ASD group showed markedly lower precision in recalling spatial details of the stimuli, indicating less stable or detailed memory representations. However, rates of random guessing-a measure of attentional lapses or task disengagement-did not differ significantly between groups. These findings underscore that visual WM deficits in ASD are primarily driven by reduced precision rather than fluctuations in attention or motivation. The study highlights the importance of precision-based mechanisms in understanding atypical cognitive profiles in ASD, offering insights into potential interventions targeting memory consolidation or perceptual encoding strategies to enhance functional outcomes. By isolating precision as a key deficit, this work advances theoretical models of visual WM and informs tailored approaches to support memory-related challenges in ASD.

Intact Susceptibility to Visual Illusions in Autistic Individuals

Altered sensory perception, a core characteristic of autism, has been attributed to attenuated use of stimuli context or prior information in perception. Reduced susceptibility to perceptual illusions was extensively used to support these accounts for autistic perception. However, empirical evidence has been inconsistent. The current study systematically investigated susceptibility to size illusions in autistic and non-autistic individuals using a standardized psychophysical battery. Eighty-one participants, 41 autistic and 40 non-autistic individuals, completed the Ben-Gurion University Test for Perceptual Illusions (BTPI), measuring susceptibility to the Ponzo, Ebbinghaus, and Height-width illusions. The results demonstrate clear evidence for susceptibility to illusions in the perception of size both in the autistic and non-autistic groups. No significant differences were found between groups in the magnitude of illusion on the perceived size, or on the perceptual resolutions of size (discrimination thresholds) in any of the illusory settings tested. The results challenge current theories suggesting reduced reliance on priors or enhanced sensory measurement in autism. Instead, using robust psychophysical methods, the study provides clear evidence for autistic people forming priors and using long-term knowledge in perception.

Genomic and Developmental Models to Predict Cognitive and Adaptive Outcomes in Autistic Children

Importance

Although early signs of autism are often observed between 18 and 36 months of age, there is considerable uncertainty regarding future development. Clinicians lack predictive tools to identify those who will later be diagnosed with co-occurring intellectual disability (ID).

Objective

To predict ID in children diagnosed with autism.

Design, Setting, and Participants

This prognostic study involved the development and validation of models integrating genetic variants and developmental milestones to predict ID. Models were trained, cross-validated, and tested for generalizability across 3 autism cohorts: Simons Foundation Powering Autism Research (SPARK), Simons Simplex Collection, and MSSNG. Autistic participants were assessed older than 6 years of age for ID. Study data were analyzed from January 2023 to July 2024.

Exposures

Ages at attaining early developmental milestones, occurrence of language regression, polygenic scores for cognitive ability and autism, rare copy number variants, de novo loss-of-function and missense variants impacting constrained genes.

Main Outcomes and Measures

The out-of-sample performance of predictive models was assessed using the area under the receiver operating characteristic curve (AUROC), positive predictive values (PPVs), and negative predictive values (NPVs).

Results

A total of 5633 autistic participants (4574 male [81.2%]) were included in this analysis. On average, participants were diagnosed with autism at 4 (IQR, 3-7) years of age and assessed for ID at 11 (8-14) years of age, with 1159 participants (20.6%) being diagnosed with ID. The model integrating all predictors yielded an AUROC of 0.653 (95% CI, 0.625-0.681), and this predictive performance was cross-validated and generalized across cohorts. This modest performance reflected that only a subset of individuals carried large-effect variants, high polygenic scores, or presented delayed milestones. However, combinations of genetic variants that are typically not considered clinically relevant by diagnostic laboratories achieved PPVs of 55% and correctly identified 10% of individuals developing ID. The addition of polygenic scores to developmental milestones specifically improved NPVs rather than PPVs. Notably, the ability to stratify ID probabilities using genetic variants was up to 2-fold higher in individuals with delayed milestones compared with those with typical development.

Conclusions and Relevance

Results of this prognostic study suggest that the growing number of neurodevelopmental condition-associated variants cannot, in most cases, be used alone for predicting ID. However, models combining different classes of variants with developmental milestones provide clinically relevant individual-level predictions that could be useful for targeting early interventions.

Large language models deconstruct the clinical intuition behind diagnosing autism

Efforts to use genome-wide assays or brain scans to diagnose autism have seen diminishing returns. Yet the clinical intuition of healthcare professionals, based on longstanding first-hand experience, remains the gold standard for diagnosis of autism. We leveraged deep learning to deconstruct and interrogate the logic of expert clinician intuition from clinical reports to inform our understanding of autism. After pre-training on hundreds of millions of general sentences, we finessed large language models (LLMs) on >4,000 free-form health records from healthcare professionals to distinguish confirmed versus suspected autism cases. By introducing an explainability strategy, our extended language model architecture could pin down the most salient single sentences in what drives clinical thinking toward correct diagnoses. Our framework flagged the most autism-critical DSM-5 criteria to be stereotyped repetitive behaviors, special interests, and perception-based behaviors, which challenges today's focus on deficits in social interplay, suggesting necessary revision of long-trusted diagnostic criteria in gold-standard instruments.

Perceptual discrimination learning in children with and without autism: The effect of feedback, modality, and progressive-learning

Research suggests autistic children learn and generalize visual family-resemblance categories atypically (e.g., Church, et al., 2010, 2015), particularly when learning incidentally from exposure. This may reflect differences in perceptual learning (Mercado et al., 2020). However, it is unknown whether perceptual discrimination learning is also atypical and if differences extend to other modalities. To address this, autistic children with normal language abilities and IQ and typically developing (TD) matched comparison children completed auditory and visual discrimination tasks, after either incidental exposure to or direct training with stimuli presented in either progressive (easy-to-hard) or random orders of difficulty. In the visual task, both autistic and TD children only performed well after progressive training, suggesting limited perceptual learning from incidental visual exposure. In the auditory task, autistic children showed a progressive learning advantage after both exposure and training, but TD children only showed this advantage after training. They also had significantly better auditory discrimination than TD children after progressive training. These findings suggest typical visual discrimination learning after progressive training and enhanced auditory discrimination learning after progressive training and exposure. This enhanced auditory perceptual learning may help explain why these autistic children are socially impaired while retaining the capacity to learn language.

Sensory-movement underpinnings of lifelong neurodivergence: getting a grip on autism

While the autism diagnosis emphasizes "deficits" in social communication, the article advances that sensory-movement differences underpin autism through a review of the following sources of evidence. This account critically challenges "autistic regression", with evidence that sensory-movement features appear by birth as the earliest signs of autism and underlie the behavioral differences used for diagnosis, which may reflect adaptations to inherent differences and misunderstandings from others. Sensory and motor differences are salient to autistic people, but they often go underrecognized by others. They cause cascading effects in infancy on behavior and communication through differences in sensorimotor learning, automatic imitation, eye contact, sensory perception, and interests. The article then explains how sensory processing differences may influence reduced perceptual narrowing, which involves a bottom-up information processing style grounded in the surrounding environment. Furthermore, this bottom-up processing may grow from reduced sensory integration in feedback loops potentially involving the cerebellum of the brain. The article then moves into implications for the widespread consequences of these inherent differences on quality of life. The article closes with implications for autism as a construct (including underestimated empathy and pain), testing the theory, providing sensory-sensitive support and acceptance of autistic people, and applications to diverse autistic people. The theory may apply particularly well to autistic women and girls, autistic people with speech divergence, autistic people with ADHD, and autistic people with co-occurring sensory and motor-related neurodivergences. Throughout the article, the theory also provides clinical, neurological, and experiential evidence for sensory and motor differences as lifelong, challenging the notion of "losing" (an) autism (diagnosis) as instead reflecting (risky and not necessarily "successful") camouflaging.

The effect of game-based interventions on children and adolescents with autism spectrum disorder: A systematic review and meta-analysis

Purpose

The purpose of this meta-analysis was to conduct a comprehensive evaluation of randomized controlled trials (RCTs) of game-based interventions (GBI) for children and adolescents with autism spectrum disorder (ASD) to identify the clinical efficacy of GBI on core symptoms and other concomitant symptoms of ASD.

Methods

PubMed, Web of Science, Embase and the Cochrane Library were systematically searched for articles published until July 2023.

Results

Twenty-four studies with 1,801 patients met the inclusion criteria. The results showed that GBI had a significant positive effect on social skills (g = -0.59, p = 0.004), social behaviors (g = 0.45, p < 0.001), and cognition (g = 0.57, p < 0.001) in children and adolescents with ASD, while the effects of language expression (g = 0.15), anxiety (g = -0.13), and parenting stress (g = -0.51) were small and nonsignificant.

Conclusions

The results of the current meta-analysis showed that GBI was effective in improving social skills, social behaviors and cognition in children and adolescents with ASD in the existing studies and was not significant in improving language skills, anxiety and parental stress, but due to the limited number and low quality of the included studies, the above conclusions need to be validated by conducting more large-sample, high-quality RCTs.

Systematic Review Registration

www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023390793, identifier: CRD42023390793.

Task-evoked pupil responses during free-viewing of hierarchical figures in relation to autistic traits in adults

Sensory processing differences, particularly within the visual domain, are common in neurodevelopmental conditions, including autism. Studies examining hierarchical processing of figures containing global (i.e., gist) and local (i.e., detail) elements are inconsistent but converge on a common theme in relation to autism: slowed global processing and a locally-oriented default. We examined behavioral and pupillary responses in adults with varying levels of autistic traits during a free-viewing hierarchical processing task. Results showed that participants were both more likely and faster to report global elements, but contrary to our hypothesis, differences in level of autistic traits were unrelated to spontaneous reporting of global vs. local elements. When examining phase-based analysis of pupillary responses, participants high on autistic traits showed more early and less later constriction within trials. Further, trajectory-based pupillary analysis revealed two trajectories, one characterized by constriction and the other dilation, and results showed that the dilation group disproportionately included low traits individuals. Findings suggest that although high and low traits groups showed similar behavioral responses, visual strategies used may differ, as indicated by pupillometry. This study advances our understanding of the relationship between autistic traits and visual processing, laying groundwork for further investigations into neurodivergent visual processing mechanisms.

Neural correlates of reading aloud on the autism spectrum

Individuals with autism can show intact decoding (i.e., ability to recognize and pronounce written words accurately). However, reading comprehension (i.e., ability to infer meaning from written text) in autistic individuals is often lower than expected based on age or grade level. Having intact decoding skills despite potentially atypical reading comprehension suggests altered reading pathways in autism, particularly when processing semantics (i.e., word meaning). To test for neural differences in word processing between autistic and non-autistic younger adults, we examined behavioral and neural responses to reading aloud words and pronounceable nonsense words (pseudowords). Additionally, we manipulated word imageability, word frequency, and word and pseudoword spelling-sound consistency as probes for different components (i.e., orthography, phonology and semantics) of the reading system. Behaviorally, the autistic group had a greater reduction in reaction time as word imageability increased. Neurally, pseudoword consistency effects, a probe of spelling-sound mappings without semantics, were only observed in the autistic group, where increased consistency was associated with decreased activity in bilateral intraparietal sulcus. Also compared to the non-autistic group, the autistic group showed greater effects of word consistency, where increasing word consistency was associated with increasing activation in the bilateral posterior superior temporal gyrus and ventral occipitotemporal cortex. Finally, the autistic group showed stronger effects of pseudoword consistency than the non-autistic group, that is increasing pseudoword consistency was associated with decreasing activation in the left ventral occipitotemporal cortex. Together, these results point to differences in how neural resources are used for reading, with more bilateral areas recruited during spelling-sound decoding in autistics to achieve comparable performance to non-autistics.

Understanding Sensory-Motor Disorders in Autism Spectrum Disorders by Extending Hebbian Theory: Formation of a Rigid-Autonomous Phase Sequence

Autism spectrum disorder is a neuropsychiatric disorder characterized by persistent deficits in social communication and social interaction and restricted, repetitive patterns of behavior, interests, or activities. The symptoms invariably appear in early childhood and cause significant impairment in social, occupational, and other important functions. Various abnormalities in the genetic, neurological, and endocrine systems of patients with autism spectrum disorder have been reported as the etiology; however, no clear factor leading to the onset of the disease has been identified. Additionally, higher order cognitive dysfunctions, which are represented by a lack of theory of mind, sensorimotor disorders, and memory-related disorders (e.g., flashbacks), have been reported in recent years, but no theoretical framework has been proposed to explain these behavioral abnormalities. In this study, we extended Hebb's biopsychology theory to provide a theoretical framework that comprehensively explains the various behavioral abnormalities observed in autism spectrum disorder. Specifically, we propose that a wide range of symptoms in autism spectrum disorder may be caused by the formation of a rigid-autonomous phase sequence (RAPS) in the brain. Using the RAPS formation theory, we propose a biopsychological mechanism that could be a target for the treatment of autism spectrum disorders.

Auditory Global-Local Processing Under Tonal Language Background: Effect of Attention and Autistic Traits

PURPOSE

Neurotypical individuals show a robust "global precedence effect (GPE)" when processing hierarchically structured visual information. However, the auditory domain remains understudied. The current research serves to fill the knowledge gap on auditory global-local processing across the broader autism phenotype under the tonal language background.

METHOD

This study examined auditory global-local processing styles in 37 Mandarin-speaking young adults (age: M = 20.35, SD = 2.32; 19 males) with varying autistic traits. The participants were required to judge global and local pitch structures in nine-tone melodies with both congruent and incongruent conditions under both directed attention and divided attention modes.

RESULTS

We found that GPE persisted independent of the attention modes during hierarchical processing. Autistic traits were among the potential contributors that reshaped GPE in auditory global-local processing under a tonal language background.

CONCLUSIONS

Our study provides an initial investigation into auditory global-local processing among Mandarin-speaking individuals across a range of autistic traits, revealing the presence of the GPE effect during hierarchical pitch structure processing. The advantage of global processing versus local processing expanded with increasing autistic traits, providing further support for the notion that auditory global processing may remain intact in autism and the broader phenotype. We highlight that GPE is a process of coarse-to-fine integration of sensory perception and cognitive feedback iteration, which both top-down and bottom-up processes wield influence on. These findings have implications for the study of atypical auditory processing in autism and may help to refine the early diagnosis and auditory-based intervention for autism.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.28114118.

Disentangling the perceptual underpinnings of autism: Evidence from a face aftereffects experiment

Existing literature has documented diminished norm-based adaptation (aftereffects) across several perceptual domains in autism. However, the exact underlying mechanisms, such as sensory dominance possibly caused by imprecise priors and/or increased sensory precision, remain elusive. The "Bayesian brain" framework offers refined methods to investigate these mechanisms. This study utilized both model-free (frequentist statistics) and model-based (hierarchical Drift Diffusion Modeling) analytical approaches to compare gender face aftereffects in male adolescents with autism (n = 29) to neurotypical controls (n = 39) using a behavioral choice experiment. Contrary to our initial hypotheses, our analyses did not find support for imprecise priors or increased sensory precision within the autistic group. Instead, we observed generally decreased drift rates towards male but not female stimuli in the autistic group. Thus, our findings suggest a lack of own-gender bias in face processing among the autistic participants. These findings align with more recent behavioral and neurophysiological research observing intact priors in individuals with autism, suggesting that other mechanisms may better explain the perceptual challenges in autism. Our study contributes to the ongoing discourse on perceptual processing in autism, emphasizing the necessity for more nuanced analytical approaches in order to unravel the complexity of this condition.

Autistic individuals benefit from gestures during degraded speech comprehension

LAY ABSTRACT

Our study explored how meaningful hand gestures, alongside spoken words, can help autistic individuals to understand speech, especially when the speech quality is poor, such as when there is a lot of noise around. Previous research has suggested that meaningful hand gestures might be processed differently in autistic individuals, and we therefore expected that these hand gestures might aid them less in understanding speech in adverse listening conditions than for non-autistic people. To this end, we asked participants to watch and listen to videos of a woman uttering a Dutch action verb. In these videos, she either made a meaningful gesture while speaking, or not, and speech was clear, or noisy. The task for participants was to identify the verb in the videos. Contrary to what we expected, we found that both autistic and non-autistic individuals use meaningful information from hand gestures when understanding unclear speech. This means that gestural information can aid in communication, especially when communicative settings are suboptimal.

Brief Report: Local-Global Processing and Co-occurrence of Anxiety, Autistic and Obsessive-Compulsive Traits in a Non-clinical Sample

PURPOSE

Increased local-to-global interference has been found in those with ASD, AD and OCD, and as such, may represent a transdiagnostic marker. As a first step to investigating this, we aimed to assess the overlap in traits of these disorders in a non-clinical sample, and whether local-global processing relates to the traits of the three conditions.

METHODS

Participants (n = 149) completed questionnaires including the Autism Quotient (AQ), the Obsessive-Compulsive Inventory (OCI-R) and the Zung Self-rating Anxiety Scale (SAS) and an online version of the Navon task. Behavioural metrics of interference and precedence were extracted from the task and correlated with trait scores.

RESULTS

We found moderate to strong correlations between the total scores for ASD, anxiety and OCD. Most local-global processing indices did not relate to traits.

CONCLUSION

The study found evidence for an overlap in autism, anxiety and obsessive-compulsive traits in a non-clinical sample. However, local-global processing, as measured by the Navon task, did not appear to underpin symptomatology in the sample and could not be considered a transdiagnostic marker. Future research should investigate the value of alternate metrics.

Linking Subclinical Autistic Traits and Perceptual Category Learning

Autism spectrum condition is a neurodevelopmental condition with difficulties in social interaction, communication and repetitive behaviours. Autistic individuals often exhibit difficulties in non-social cognitive processing, such as grouping items into meaningful categories based on their holistic visual appearance. Underlying mechanisms might be a deficit in abstracting a category's central tendency (i.e., the prototype) or more general atypicalities in visual category learning processes. Milder autistic traits often also extend to a broader autism phenotype in neurotypical individuals. Our study compared adult neurotypical individuals with high or low autistic traits on behavioural performances and neural correlates measured by event-related functional magnetic resonance imaging (fMRI) during a single-category perceptual categorization task, based on the well-known dot-pattern paradigm. Bayesian computational modelling was used to investigate links between autistic traits and representing category knowledge by the prototype or memorizing single exemplars. We found that a high degree of autistic traits was linked to worse accuracy for endorsing category members. Autistic trait groups also differed in neural correlates during the training phase related to visual processing in occipital regions, decision-making in midfrontal regions and the posterior cingulate, and feedback processing in the posterior cingulate and the ventral striatum. Model-based analyses did not support deficits in prototype abstraction but yielded a link between autistic traits and stricter decision policies. In sum, we found no relationship between high autistic traits and difficulties with the prototype strategy but more general atypicalities in visual category learning processes, namely, visual processing, decision-making and feedback processing.

Altered category learning and reduced generalization in autistic adults

Individuals with autism spectrum condition (ASC) are suggested to experience difficulties with categorization and generalization. However, empirical studies have mainly focused on one process at a time, and neglected underlying neural mechanisms. Here, we investigated categorization and generalization at a behavioral and neural level in 38 autistic and 38 neurotypical (NT) adults. By presenting shapes sampled from an artificial multidimensional stimulus space, we investigated (1) behavioral and neural underpinnings of category learning and (2) behavioral generalization of trained categorization to both an extended version of the stimulus space and a novel stimulus space. Our previous findings showed that individuals with autism were slower in category learning. In this study, we demonstrate that this slower learning in autism was not related to differences in applied categorization strategy. In contrast, electroencephalography recordings during training did reveal a reduced amplitude of the N1 component in the right occipital temporal cortex after stimulus presentation in autistic participants, which suggests atypical categorical proficiency. In addition, we observed delayed and higher activation in the frontal regions after receiving (negative) feedback in the autistic group, potentially suggesting more explicit feedback processing or a higher salience of prediction errors in autism. Finally, autistic and NT individuals were able to generalize their learned categorization after training. However, when generalizing to a novel set of shapes, autistic individuals were significantly less accurate. Reduced generalization significantly correlated with increased intolerance to uncertainty scores. This multi-level approach reveals behavioral and neural differences in learning and generalization that could be related to clinical symptoms in autism.

Developmental regression of novel space preference in an autism spectrum disorder model is unlinked to GABAergic and social circuitry

Autism spectrum disorder (ASD) is characterized by social deficits and restricted behaviors, with developmental defects in GABAergic circuits proposed as a key underlying etiology. Here, we introduce the V-Y assay, a novel space preference test in which one arm of the Y-maze is initially hidden and later revealed as a novel space. Using an ASD mouse model with FOXG1 haploinsufficiency, which exhibits ASD-like social impairments that can be either exacerbated or ameliorated by GABAergic circuit manipulations, we observed impaired novel space preference and exploratory behavior in the V-Y assay. Interestingly, unlike social phenotypes, novel space preference was initially established by 3 weeks of age but regressed by 6 weeks. Furthermore, alterations in GABAergic signaling via Gad2 mutation did not affect novel space preference, in contrast to their impact on social behaviors. These findings reveal that the regression of novel space preference in ASD follows a distinct developmental trajectory from GABA-driven social impairments, providing new insights into the mechanisms underlying ASD.

Suboptimal but intact integration of Bayesian components during perceptual decision-making in autism

BACKGROUND

Alterations in sensory perception, a core phenotype of autism, are attributed to imbalanced integration of sensory information and prior knowledge during perceptual statistical (Bayesian) inference. This hypothesis has gained momentum in recent years, partly because it can be implemented both at the computational level, as in Bayesian perception, and at the level of canonical neural microcircuitry, as in predictive coding. However, empirical investigations have yielded conflicting results with evidence remaining limited. Critically, previous studies did not assess the independent contributions of priors and sensory uncertainty to the inference.

METHOD

We addressed this gap by quantitatively assessing both the independent and interdependent contributions of priors and sensory uncertainty to perceptual decision-making in autistic and non-autistic individuals (N = 126) during an orientation categorization task.

RESULTS

Contrary to common views, autistic individuals integrated the two Bayesian components into their decision behavior, and did so indistinguishably from non-autistic individuals. Both groups adjusted their decision criteria in a suboptimal manner.

LIMITATIONS

This study focuses on explicit priors in a perceptual categorization task and high-functioning adults. Thus, although the findings provide strong evidence against a general and basic alteration in prior integration in autism, they cannot rule out more specific cases of reduced prior effect - such as due to implicit prior learning, particular level of decision making (e.g., social), and level of functioning of the autistic person.

CONCLUSIONS

These results reveal intact inference for autistic individuals during perceptual decision-making, challenging the notion that Bayesian computations are fundamentally altered in autism.

Predictive Processing Among Individuals with Autism Spectrum Disorder During Online Language Comprehension: A Preliminary Systematic Review

The present study aims to fill the research gap by evaluating published empirical studies and answering the specific research question: Can individuals with autism spectrum disorder (ASD) predict upcoming linguistic information during real-time language comprehension? Following the PRISMA framework, an initial search via PubMed, Web of Science, SCOPUS, and Google Scholar yielded a total of 697 records. After screening the abstract and full text, 10 studies, covering 350 children and adolescents with ASD ranging from 2 to 15 years old, were included for analysis. We found that individuals with ASD may predict the upcoming linguistic information by using verb semantics but not pragmatic prosody during language comprehension. Nonetheless, 9 out of 10 studies used short spoken sentences as stimuli, which may not encompass the complexity of language comprehension. Moreover, eye-tracking in the lab setting was the primary data collection technique, which may further limit the generalizability of the research findings. Using a narrative approach to synthesize and evaluate the research findings, we found that individuals with ASD may have the ability to predict the upcoming linguistic information. However, this field of research still calls for more studies that will expand the scope of research topics, utilize more complex linguistic stimuli, and employ more diverse data collection techniques.

Impact of Visual Clutter in VR on Visuomotor Integration in Autistic Individuals

Autistic individuals often exhibit superior local visual sensitivity but may struggle with global visual processing, affecting their visuomotor integration (VMI). Goal-directed overhand throwing is common in both the physical environment (PE) and virtual reality (VR) games, demanding spatial and temporal accuracy to perceive position and motion, and precise VMI. Understanding VMI in autistic individuals and exploring supportive designs in VR are crucial for rehabilitation and improving accessibility. We assessed static visuospatial accuracy and VMI with autistic ( ) and non-autistic ( ) adults using spatial estimation and overhand throwing tasks with eye and hand tracking, comparing VR to PE. In VR, all participants exhibited reduced visual accuracy, increased visual scanning, and shortened quiet eye duration and eye following duration after the ball release, which led to decreased throwing performance. However, simplifying visual information in VR throwing improved these measures, and resulted in autistic individuals outperforming non-autistic peers.

Language, theory of mind and cognitive skills in Arabic-speaking children with and without autism: Evidence from network and cluster analyses

INTRODUCTION

Autism spectrum disorder (ASD) is characterized by impairments in social interactions, social communication, and repetitive and stereotyped patterns of behavior. Previous studies have reported mixed findings regarding the links between language (i.e., phonology, morphosyntax, lexicon, and pragmatics), theory of mind (ToM), executive functions (EFs), and central coherence measures in children with ASD.

METHODS

A total of 163 Palestinian-Arabic-speaking children aged 4-11 participated: 76 with ASD and 87 with typical language development (TLD). The children`s phonological, morphosyntactic, lexical, and pragmatic skills, along with verbal and non-verbal ToM abilities were evaluated. Additionally, cognitive assessments included non-verbal IQ, EF, and central coherence processing.

RESULTS

Group-level results showed that children with ASD scored lower than their TLD peers in all measures. Network analysis revealed robust interconnections between language, ToM, and cognitive skills in both groups. In autistic children, language was a central node, with pragmatics prevailing over morphosyntax and lexicon, while age was central in the TLD group. Cluster analysis identified four language clusters within the ASD group, demonstrating dissociations between language domains: (1) high performance across all domains, (2) moderate performance in phonology and morphosyntax with low pragmatic abilities, (3) moderate performance in phonology and lexicon with low morphosyntax and pragmatics, and (4) moderate phonology and lexicon with extremely poor morphosyntax and pragmatics. Autistic children with enhanced language abilities performed better in verbal and non-verbal ToM and EF tasks.

CONCLUSIONS

Our findings underscore the variability in language, ToM, and cognitive profiles of autistic children, showing dissociation within and between different domains in some autistic children. These results offer insights for applied interventions.

Early numerical skills and mathematical domains in autistic students in primary school

Introduction

It is crucial to provide a quality educational response to the needs of autistic children across various mathematical domains. However, there is no consensus on which of the early skills have the greatest predictive effect in the short and long term within these domains. Therefore, this research aimed to a) compare early numerical skills and mathematics domains, and 2) analyze the predictive value of early numerical skills into mathematics domains.

Methods

Forty-two children (twenty-one autistic children and twenty-one non-autistic children) aged 6-12 years participated in the study. Three areas were evaluated through different tasks: 1) control tasks: reading, impulse control and manual speed, 2) early numerical skills: counting, verbal subitizing, magnitude comparison and estimation, and 3) mathematical domains: arithmetic calculation and arithmetic word problems.

Results

Significant differences were found in subitizing and estimation tasks. Both groups showed similar mathematical skills in arithmetic calculation and arithmetic word problems. For autistic students, several non-symbolic tasks predict performance in mathematical domains, whereas for non-autistic students, symbolic tasks were predictors.

Discussion

Although mathematics does not seem to be an area of concern for autistic children, future studies should explore early numerical and mathematical domains in children with cognitive support needs through longitudinal research.

High neural noise in autism: A hypothesis currently at the nexus of explanatory power

Autism is a neurodevelopmental difference associated with specific autistic experiences and characteristics. Early models such as Weak Central Coherence and Enhanced Perceptual Functioning have tried to capture complex autistic behaviours in a single framework, however, these models lacked a neurobiological explanation. Conversely, current neurobiological theories of autism at the cellular and network levels suggest excitation/inhibition imbalances lead to high neural noise (or, a 'noisy brain') but lack a thorough explanation of how autistic behaviours occur. Critically, around 15 years ago, it was proposed that high neural noise in autism produced a stochastic resonance (SR) effect, a phenomenon where optimal amounts of noise improve signal quality. High neural noise can thus capture both the enhanced (through SR) and reduced performance observed in autistic individuals during certain tasks. Here, we provide a review and perspective that positions the "high neural noise" hypothesis in autism as best placed to provide research direction and impetus. Emphasis is placed on evidence for SR in autism, as this promising prediction has not yet been reviewed in the literature. Using this updated approach towards autism, we can explain a spectrum of autistic experiences all through a neurobiological lens. This approach can further aid in developing specific support or services for autism.

Sex differences in autism spectrum disorder using class imbalance adjusted functional connectivity

Autism spectrum disorder (ASD) is an atypical neurodevelopmental condition with a diagnostic ratio largely differing between male and female participants. Due to the sex imbalance in participants with ASD, we lack an understanding of the differences in connectome organization of the brain between male and female participants with ASD. In this study, we matched the sex ratio using a Gaussian mixture model-based oversampling technique and investigated the differences in functional connectivity between male and female participants with ASD using low-dimensional principal gradients. Between-group comparisons of the gradient values revealed significant interaction effects of sex in the sensorimotor, attention, and default mode networks. The sex-related differences in the gradients were highly associated with higher-order cognitive control processes. Transcriptomic association analysis provided potential biological underpinnings, specifying gene enrichment in the cortex, thalamus, and striatum during development. Finally, the principal gradients were differentially associated with symptom severity of ASD between sexes, highlighting significant effects in female participants with ASD. Our work proposed an oversampling method to mitigate sex imbalance in ASD and observed significant sex-related differences in functional connectome organization. The findings may advance our knowledge about the sex heterogeneity in large-scale brain networks in ASD.

Interceptive abilities in autism spectrum disorder: Comparing naturalistic and virtual visuomotor tasks

A growing body of research reveals that autistic individuals exhibit motor coordination challenges. Multiple theoretical frameworks propose that the seemingly disparate features of autism may arise from a common underlying process: a diminished ability to make predictions. Sensorimotor skills, such as catching a ball, critically rely on predicting the ball's trajectory as well as anticipatory coordination of the entire body. Here, we assessed four different naturalistic and virtual interception tasks with 31 neurotypical and 23 autistic children (ages 7-12). In a naturalistic setting, participants caught the ball either with their hands or a hand-held funnel with an enlarged catch area that also prevented the ball from bouncing off. A virtual setup reduced whole-body demands, as children only moved a paddle to catch or bounce a ball on a screen. Control tasks, involving rapid reaching to grasp a static object and quiet standing, which largely eliminated the requirements for prediction, were also tested. Results from all task variations demonstrated that autistic children completed fewer successful interceptions, suggesting that predictive requirements, inherent to all interception tasks, played a critical role. Effect sizes in the virtual tasks were smaller. Correlations of the task metrics with behavioral assessments rendered the strongest correlations with Praxis scores. The control tasks showed no differences between autistic and neurotypical children. These findings lend support to the emerging hypothesis that predictive challenges are present in autism. Further research with larger sample sizes will help identify to what extent these visuomotor differences may inform core domains of autism.

Effect of Implicit Learning Methods With the External Focus of Attention on Bowling Skills in Children With Autism Spectrum Disorder: A Randomized Control Trial Study

PURPOSE

The aim of the current study was to compare implicit learning methods with an emphasis on the external focus of attention on bowling skill in autistic children.

METHOD

Twenty children with autism spectrum disorder (ASD) were selected. After the participants were randomly divided into two groups, the pretest was performed, evaluating the participants both quantitatively (score of bowling pins falling) and qualitatively (TGMD3 subscale test of underhand ball throwing). Group A was trained using the errorless learning method with the external focus of attention, while Group B was trained using the analogical learning method with the external focus of attention.

FINDINGS

The results showed that analogical learning with the external focus of attention has significant effects (p ≤ 0.05) on both bowling and underhand ball-throwing skills in autistic children. Errorless learning with external focus of attention, on the other hand, had a significant effect (p ≤ 0.05) on the bowling skill.

CONCLUSION

The results of the research showed that analogical learning with an external focus of attention can be effective in developing both bowling skill and underhand ball-throwing skill in children with ASD; however, errorless learning with an external focus of attention was useful in developing bowling skill and failed to show a significant effect on enhancing the underhand ball-throwing skill in children diagnosed with ASD.

TRIAL REGISTRATION

IRCT20220920056007N1.

Cicchetti's organizational-developmental perspective of Down syndrome: Contributions to the emergence of developmental psychopathology and the study of persons with neurodevelopmental conditions

Dante Cicchetti's earliest work, his studies of social-emotional development in infants and children with Down syndrome, set the stage for the emergence of the larger field of developmental psychopathology. By applying basic developmental principles, methodologies, and questions to the study of persons with Down syndrome, Dante took on the challenge of searching for patterns in atypical development. In doing so, he extended traditional developmental theory and introduced a more "liberal" approach that both continues to guide developmentally based research with persons with neurodevelopmental conditions (NDCs), including Down syndrome. We highlight five themes from Dante's work: (1) appreciating the importance of developmental level; (2) prioritizing the organization of development; (3) examining whether developmental factors work similarly in those with known genetic conditions; (4) rethinking narratives about ways of being; and (5) examining the influence of multiple levels of the environment on the individual's functioning. We highlight ways that these essential lessons anticipated present-day research with persons with a variety of NDCs, including Down syndrome, other genetic syndromes associated with intellectual disability, and autism. We conclude with visions to the future for research with these populations as well as for the field of developmental psychopathology more generally.

Differences in ongoing thought between autistic and non-autistic adults

Autistic people may be distinguishable from non-autistic individuals in the content and modality of their thoughts. Such differences potentially underlie both psychological vulnerability and strengths, motivating the need to better understand autistic thought patterns. In non-clinical undergraduates, a recent study found that autistic traits were associated with thinking more in words than images. However, it is unclear whether such differences in thought are present in clinically diagnosed autistic individuals. The current study applied the same methods (multidimensional experience sampling during an N-back task) to examine ongoing thought in autistic and non-autistic adults. We found that autistic individuals showed less variability in the modality of their thoughts between easy and difficult task contexts. While both non-autistic and autistic participants tended to report thinking more in words during the difficult task context, the difference between conditions was significantly smaller for the autistic group. In addition, autistic individuals showed a weaker coupling between task performance and off-task social thinking, a finding that may be related to differences in social processing during the off-task state. Overall, our results provide a clinical replication and extension of previous work, highlighting the differential effects of changing external context on internal mental states in autism.

Understanding cognitive flexibility in emotional evaluation in autistic males and females: the social context matters

BACKGROUND

Autistic individuals often have difficulty flexibly adjusting their behavior. However, laboratory experiments have yielded inconsistent results, potentially due to various influencing factors, which need to be examined in detail. This study aimed to investigate the hypothesis that the social content of stimuli could play a specific role in some of the flexibility challenges faced by autistic individuals. The second aim was to explore sex differences in this context.

METHODS

We analyzed data from 256 adult participants (124 with autism), matched on age, gender, and sex, who performed an emotional shifting task involving unpredictable shifts between positive and negative stimuli. Additionally, the task included both social and non-social conditions.

RESULTS

Our results revealed a larger switch cost in the social than in the non-social condition, and this was more pronounced in autistic than in non-autistic individuals. Furthermore, we observed that autistic females differed from autistic males in the non-social condition and from non-autistic females in the social condition.

LIMITATIONS

The online nature of the study reduced the control over participant conditions. In addition, further studies are needed to investigate whether these results apply to the broader autism spectrum.

CONCLUSIONS

Building on previous research demonstrating a greater switch cost in autistic than non-autistic individuals for socio-emotional stimuli, our study further extends these findings by highlighting that the social context, rather than the emotional nature of the stimuli alone, may play a significant role in the flexibility challenges faced by autistic individuals. Our findings also contribute to the literature on sex differences in autism.

Perception and Production of Pitch Information in Mandarin-Speaking Children with Autism Spectrum Disorders

This study investigated the categorical perception (CP) of linguistic pitch (lexical tones) and nonlinguistic pitch (pure tones), as well as tonal production in Mandarin-speaking children with autism spectrum disorders (ASD). A total of 26 Mandarin-speaking children with ASD and 29 age-matched typically developing (TD) children were recruited for this study. The Mandarin T2-T3 contrast and corresponding pure tones with identical pitch contours were adopted to assess the nuanced pitch processing abilities of the child participants via the CP paradigm. Accordingly, tonal production was focused on T2 and T3 with analyses of the dynamic pitch contours and tonal differentiation. Mandarin-speaking children with ASD exhibited atypical CP for linguistic pitch in comparison with their TD peers. However, the categorization of linguistic pitch exceeded that of nonlinguistic pitch among the ASD participants, indicating a global over local processing pattern contrary to autistic individuals in non-tonal languages. Additionally, despite atypical pitch contours in producing T2 and T3, the ASD group showed comparable differentiable degrees of the two tones in production to the TD group. Findings of this study served as a foray into contesting current theories' claims of local bias and/or global impairment in the autistic population, prompting further inspections on individuals with different language backgrounds and stimuli processing with various complexities. Additionally, findings of this study underscore the necessity of developing tailored assessments and interventions to enhance the perception and production of complex and confusable tones, thereby improving perceptual robustness and communication skills in Mandarin-speaking children with ASD.

Altered Functional Connectivity of Unimodal Sensory and Multisensory Integration Networks Is Related to Symptom Severity in Autism Spectrum Disorder

BACKGROUND

Atypical sensory processing is a prevalent feature of autism spectrum disorder (ASD) and constitutes a core diagnostic criterion in DSM-5. However, the neurocognitive underpinnings of atypical unimodal and multimodal sensory processing and their relationships with autism symptoms remain unclear.

METHODS

In this study, we examined intrinsic functional connectivity (FC) patterns among 5 unimodal sensory and multisensory integration (MSI) networks in ASD using a large multisite dataset (N = 646) and investigated the relationships between altered FC, atypical sensory processing, social communicative deficits, and overall autism symptoms using correlation and mediation analyses.

RESULTS

Compared with typically developing control participants, participants in the ASD group demonstrated increased FC of the olfactory network, decreased FC within the MSI network, and decreased FC of the MSI-unimodal sensory networks. Furthermore, altered FC was positively associated with autism symptom severity, and such associations were completely mediated by atypical sensory processing and social communicative deficits.

CONCLUSIONS

ASD-specific olfactory overconnectivity and MSI-unimodal sensory underconnectivity lend support to the intense world theory and weak central coherence theory, suggesting olfactory hypersensitivity at the expense of MSI as a potential neural mechanism underlying atypical sensory processing in ASD. These atypical FC patterns suggest potential targets for psychological and neuromodulatory interventions.

Difficulties in perceptual-motor coordination of reaching behavior in children with autism spectrum disorder

Increased risk of injury from collisions with objects is an important issue in children with autism spectrum disorder (ASD). The purpose of the present study was to examine whether impaired perceptual-motor coordination may underlie the high frequency of collisions. Specifically, we hypothesized that collisions are likely to occur frequently in children with ASD due to their difficulty with body-related spatial perception and their inadequate motor planning, due to their detail-focused processing style, i.e., a tendency to focus attention on specific details rather than on the overall context. To evaluate impairment of perceptual-motor coordination in children with ASD, an original action selection task was developed to assess (a) body-related spatial perception and (b) predictive attentional properties for planning the subsequent movements based on the measures of hand movement and gaze behavior. Twenty-six children (13 diagnosed as ASD and 13 with typical development [TD]) completed the task, and their parents completed a questionnaire regarding their child's susceptibility to injury. Results showed that children with ASD displayed inaccurate body-related spatial perception and inadequate motor planning under conditions that induced their detail-focused processing style. In addition, analyses of gaze behavior reflected the characteristics of a detail-focused processing in children with ASD. This was correlated with the severity of ASD and the measure of motor planning. The present findings suggest that difficulty with perceptual-motor coordination, resulting in part from the detail-focused processing style, might contribute to susceptibility to injury in children with ASD. We consider that our evaluation of the difficulty with perceptual-motor of individuals with ASD provides a framework for understanding their high rate of collision-related injuries and could inform strategies for preventing these injuries.

Perceptual discrimination of action formidableness and friendliness and the impact of autistic traits

The ability to determine whether the actions of other individuals are friendly or formidable are key decisions we need to make to successfully navigate our complex social environment. In this study we measured perceptual performance when discriminating actions that vary in their friendliness or formidableness, and whether performance was related to the autistic traits of individuals. To do this, we developed an action morphing method to generate novel actions that lied along the action quality dimensions of formidableness and friendliness. In Experiment 1 we show that actions that vary along the formidableness or friendliness continua were rated as varying monotonically along the respective quality. In Experiment 2 we measured the ability of individuals with different levels of autistic traits to discriminate action formidableness and friendliness using adaptive 2-AFC procedures. We found considerable variation in perceptual thresholds when discriminating action formidableness (~ 540% interindividual variation) or friendliness (~ 1100% interindividual variation). Importantly, we found no evidence that autistic traits influenced perceptual discrimination of these action qualities. These results confirm that sensory enhancements with autistic traits are limited to lower level stimuli, and suggest that the perceptual processing of these complex social signals are not affected by autistic traits.

Autistic traits linked to anxiety and dichotomous thinking: sensory sensitivity and intolerance of uncertainty as mediators in non-clinical population

A recent theoretical cognitive model posits that three cognitive constructs-intolerance of uncertainty, lack of predictive processing, and dichotomous thinking-may interact with anxiety in autistic individuals. However, the interrelationships among these constructs remain unclear. We investigated this relationship in a non-clinical population using five questionnaires (Autism Spectrum Quotient, Glasgow Sensory Questionnaire, Short Intolerance of Uncertainty Scale, Penn State Worry Questionnaire, and Dichotomous Thinking Inventory) and conducted a path analysis. Data were collected from 405 adults (aged 20-22 years) in Experiment 1 and 628 (aged 20-49 years) in Experiment 2. In both experiments, autistic traits were significantly associated with both anxiety and dichotomous thinking, mediated by intolerance of uncertainty. Autistic traits were linked to intolerance of uncertainty, mediated by atypical sensory processing. Furthermore, autistic traits were directly associated with anxiety. No direct association was observed between anxiety and dichotomous thinking. Our results confirm the validity of Stark's cognitive model in a non-clinical population. These findings provide new insights into anxiety and dichotomous thinking and shed light on the cognitive styles of autistic individuals.

Memory strategies in autistic and older adults

Memory strategies in autistic adults seem to mimic strategies at older age, as both younger autistic and older non-autistic individuals use fewer semantic features in visual memory tasks. Therefore, the current study aims to investigate whether early differences in memory strategies lead to altered age-related effects in autism, particularly whether initial difficulties in strategy use become advantageous at older age (i.e., "protective aging"). A total of 147 participants across four groups (autistic younger/older, non-autistic younger/older) completed an online assessment. This assessment included a recognition version of the Visual Patterns Test (VPT) to evaluate semantic strategy use in visual memory, the Just Noticeable Difference (JND) size task for assessing visual processing, and the Multifactorial Memory Questionnaire to evaluate subjective memory functioning and strategy use (MMQ). Unexpectedly, all groups benefited from semantic features on the VPT, although the older groups performed less accurately and slower than the younger groups. The JND Size task showed no group differences. Autistic adults rated their MMQ memory as worse than non-autistic adults, despite reporting greater strategy use. These results indicate that cognitive strategies might be more similar between younger/older and autistic/non-autistic people than previously expected, although notable discrepancies between objective and subjective measures were present. They also substantiate previously reported parallel (i.e., similar) age-related effects between autistic and non-autistic people.

Visual mental imagery abilities in autism

In autistic individuals, the role, performance, and autonomy of perceptual functioning are atypical. Overlapping underlying mechanisms of perception and mental imagery predict that the mental imagery abilities of autistic individuals should differ from those of non‐autistic individuals. While enhanced abilities to manipulate mental images have been demonstrated in autism, the other stages of mental imagery (generation, maintenance, inspection) remain to be explored. Forty‐four autistic adults and 42 typical participants performed four tasks to assess different stages of mental imagery: the Image generation task (mentally generating a letter on a grid and indicating whether it passes over a probe located in the grid), the Visual pattern test (maintaining visual patterns in memory), the Image scanning test (inspecting mental images) and the Mental rotation test (mentally manipulating representations of geometric figures). In the image generation task and the mental rotation test, autistic and typical individuals performed equivalently, both in accuracy and response time. The span observed in the visual pattern test was significantly higher in the autistic group, indicating better maintenance of mental images. In the image scanning test, response times were influenced by the distance to mentally inspect in the typical group but not in the autistic group. Autistic participants were equally fast regardless of distance to inspect. Preserved, greater or differently influenced visual mental imagery abilities are in line with an atypical perceptual functioning in autism, possibly reflecting an increased weight of perception‐based information relatively to the top‐down effect of knowledge and language‐based influence.

Symmetry Detection in Autistic Adults Benefits from Local Processing in a Contour Integration Task

Symmetry studies in autism are inconclusive possibly due to different types of stimuli used which depend on either local or global cues. Therefore, this study compared symmetry detection between 20 autistic and 18 non-autistic adults matched on age, IQ, gender and handedness, using contour integration tasks containing open and closed contours that rely more on local or global processing respectively. Results showed that the autistic group performed equally well with both stimuli and outperformed the non-autistic group only for the open contours, possibly due to a different strategy used in detecting symmetry. However, there were no group differences for the closed contour. Results explain discrepant findings in previous symmetry studies suggesting that symmetry tasks that favour a local strategy may be advantageous for autistic individuals. Implications of the findings towards understanding visual sensory issues in this group are discussed.

Intact Utilization of Contextual Information in Speech Categorization in Autism

Current theories of Autism Spectrum Disorder (ASD) suggest atypical use of context in ASD, but little is known about how these atypicalities influence speech perception. We examined the influence of contextual information (lexical, spectral, and temporal) on phoneme categorization of people with ASD and in typically developed (TD) people. Across three experiments, we found that people with ASD used all types of contextual information for disambiguating speech sounds to the same extent as TD; yet they exhibited a shallower identification curve when phoneme categorization required temporal processing. Overall, the results suggest that the observed atypicalities in speech perception in ASD, including the reduced sensitivity observed here, cannot be attributed merely to the limited ability to utilize context during speech perception.

Autistic traits specific to communication ability are associated with performance on a Mooney face detection task

Difficulties in global face processing have been associated with autism. However, autism is heterogenous, and it is not known which dimensions of autistic traits are implicated in face-processing difficulties. To address this gap in knowledge, we conducted two experiments to examine how identification of Mooney face stimuli (stylized, black-and-white images of faces without details) related to the six subscales of the Comprehensive Autistic Trait Inventory in young adults. In Experiment 1, regression analyses indicated that participants with poorer communication skills had lower task sensitivity when discriminating between face-present and face-absent images, whilst other autistic traits had no unique predictive value. Experiment 2 replicated these findings and additionally showed that autistic traits were linked to a reduced face inversion effect. Taken together, these results indicate autistic traits, especially communication difficulties, are associated with reduced configural processing of face stimuli. It follows that both reduced sensitivity for identifying upright faces amongst similar-looking distractors and reduced susceptibility to face inversion effects may be linked to relatively decreased reliance on configural processing of faces in autism. This study also reinforces the need to consider the different facets of autism independently.

Enhanced pitch discrimination in autistic children with unexpected bilingualism

Some autistic children acquire foreign languages from exposure to screens. Such unexpected bilingualism (UB) is therefore not driven by social interaction, rather, language acquisition appears to rely on less socially mediated learning and other cognitive processes. We hypothesize that UB children may rely on other cues, such as acoustic cues, of the linguistic input. Previous research indicates enhanced pitch processing in some autistic children, often associated with language delays and difficulties in forming stable phonological categories due to sensitivity to subtle linguistic variations. We propose that repetitive screen-based input simplifies linguistic complexity, allowing focus on individual cues. This study hypothesizes that autistic UB children exhibit superior pitch discrimination compared with both autistic and non-autistic peers. From a sample of 46 autistic French-speaking children aged 9 to 16, 12 were considered as UB. These children, along with 45 non-autistic children, participated in a two-alternative forced-choice pitch discrimination task. They listened to pairs of pure tones, 50% of which differed by 3% (easy), 2% (medium), or 1% (hard). A stringent comparison of performance revealed that only the autistic UB group performed above chance for tone pairs that differed, across all conditions. This group demonstrated superior pitch discrimination relative to autistic and non-autistic peers. This study establishes the phenomenon of UB in autism and provides evidence for enhanced pitch discrimination in this group. Acute perception of auditory information, combined with repeated language content, may facilitate UB children's focus on phonetic features, and help acquire a language with no communicative support or motivation.

Neural Hyperresponsivity During the Anticipation of Tangible Social and Nonsocial Rewards in Autism Spectrum Disorder: A Concurrent Neuroimaging and Facial Electromyography Study

BACKGROUND

Atypical anticipation of social reward has been shown to lie at the core of the social challenges faced by individuals with autism spectrum disorder (ASD). However, previous research has yielded inconsistent results and has often overlooked crucial characteristics of stimuli. Here, we investigated ASD reward processing using social and nonsocial tangible stimuli, carefully matched on several key dimensions.

METHODS

We examined the anticipation and consumption of social (interpersonal touch) and nonsocial (flavored milk) rewards in 25 high-functioning individuals with ASD and 25 neurotypical adult individuals. In addition to subjective ratings of wanting and liking, we measured physical energetic expenditure to obtain the rewards, brain activity with neuroimaging, and facial reactions through electromyography on a trial-by-trial basis.

RESULTS

Participants with ASD did not exhibit reduced motivation for social or nonsocial rewards; their subjective ratings, motivated efforts, and facial reactions were comparable to those of neurotypical participants. However, anticipation of higher-value rewards increased neural activation in lateral parietal cortices, sensorimotor regions, and the orbitofrontal cortex. Moreover, participants with ASD exhibited hyperconnectivity between frontal medial regions and occipital regions and the thalamus.

CONCLUSIONS

Individuals with ASD who experienced rewards with tangible characteristics, whether social or nonsocial, displayed typical subjective and objective motivational and hedonic responses. Notably, the observed hyperactivations in sensory and attentional nodes during anticipation suggest atypical sensory overprocessing of forthcoming rewards rather than decreased reward value. While these atypicalities may not have manifested in observable behavior here, they could impact real-life social interactions that require nuanced predictions, potentially leading to the misperception of reduced interest in rewarding social stimuli in ASD.

Reduced spatial frequency differentiation and sex-related specificities in fearful face detection in autism: Insights from EEG and the predictive brain model

Face processing relies on predictive processes driven by low spatial frequencies (LSF) that convey coarse information prior to fine information conveyed by high spatial frequencies. However, autistic individuals might have atypical predictive processes, contributing to facial processing difficulties. This may be more normalized in autistic females, who often exhibit better socio-communicational abilities than males. We hypothesized that autistic females would display a more typical coarse-to-fine processing for socio-emotional stimuli compared to autistic males. To test this hypothesis, we asked adult participants (44 autistic, 51 non-autistic) to detect fearful faces among neutral faces, filtered in two orders: from coarse-to-fine (CtF) and from fine-to-coarse (FtC). Results show lower d' values and longer reaction times for fearful detection in autism compared to non-autistic (NA) individuals, regardless of the filtering order. Both groups presented shorter P100 latency after CtF compared to FtC, and larger amplitude for N170 after FtC compared to CtF. However, autistic participants presented a reduced difference in source activity between CtF and FtC in the fusiform. There was also a more spatially spread activation pattern in autistic females compared to NA females. Finally, females had faster P100 and N170 latencies, as well as larger occipital activation for FtC sequences than males, irrespective of the group. Overall, the results do not suggest impaired predictive processes from LSF in autism despite behavioral differences in fear detection. However, they do indicate reduced brain modulation by spatial frequency in autism. In addition, the findings highlight sex differences that warrant consideration in understanding autistic females.

It's all in the timing: delayed feedback in autism may weaken predictive mechanisms during contour integration

Humans rely on predictive and integrative mechanisms during visual processing to efficiently resolve incomplete or ambiguous sensory signals. Although initial low-level sensory data are conveyed by feedforward connections, feedback connections are believed to shape sensory processing through automatic conveyance of statistical probabilities based on prior exposure to stimulus configurations. Individuals with autism spectrum disorder (ASD) show biases in stimulus processing toward parts rather than wholes, suggesting their sensory processing may be less shaped by statistical predictions acquired through prior exposure to global stimulus properties. Investigations of illusory contour (IC) processing in neurotypical (NT) adults have established a well-tested marker of contour integration characterized by a robust modulation of the visually evoked potential (VEP)-the IC-effect-that occurs over lateral occipital scalp during the timeframe of the visual N1 component. Converging evidence strongly supports the notion that this IC-effect indexes a signal with significant feedback contributions. Using high-density VEPs, we compared the IC-effect in 6- to 17-yr-old children with ASD (n = 32) or NT development (n = 53). Both groups of children generated an IC-effect that was equivalent in amplitude. However, the IC-effect notably onset 21 ms later in ASD, even though initial VEP afference was identical across groups. This suggests that feedforward information predominated during perceptual processing for 15% longer in ASD compared with NT children. This delay in the feedback-dependent IC-effect, in the context of known developmental differences between feedforward and feedback fibers, suggests a potential pathophysiological mechanism of visual processing in ASD, whereby ongoing stimulus processing is less shaped by visual feedback.NEW & NOTEWORTHY Children with autism often present with an atypical visual perceptual style that emphasizes parts or details over the whole. Using electroencephalography (EEG), this study identifies delays in the visual feedback from higher-order sensory brain areas to primary sensory regions. Because this type of visual feedback is thought to carry information about prior sensory experiences, individuals with autism may have difficulty efficiently using prior experience or putting together parts into a whole to help make sense of incoming new visual information. This provides empirical neural evidence to support theories of disrupted sensory perception mechanisms in autism.

Integrating genomic variants and developmental milestones to predict cognitive and adaptive outcomes in autistic children

Although the first signs of autism are often observed as early as 18-36 months of age, there is a broad uncertainty regarding future development, and clinicians lack predictive tools to identify those who will later be diagnosed with co-occurring intellectual disability (ID). Here, we developed predictive models of ID in autistic children (n=5,633 from three cohorts), integrating different classes of genetic variants alongside developmental milestones. The integrated model yielded an AUC ROC=0.65, with this predictive performance cross-validated and generalised across cohorts. Positive predictive values reached up to 55%, accurately identifying 10% of ID cases. The ability to stratify the probabilities of ID using genetic variants was up to twofold greater in individuals with delayed milestones compared to those with typical development. These findings underscore the potential of models in neurodevelopmental medicine that integrate genomics and clinical observations to predict outcomes and target interventions.

Erroneous predictive coding across brain hierarchies in a non-human primate model of autism spectrum disorder

In autism spectrum disorder (ASD), atypical sensory experiences are often associated with irregularities in predictive coding, which proposes that the brain creates hierarchical sensory models via a bidirectional process of predictions and prediction errors. However, it remains unclear how these irregularities manifest across different functional hierarchies in the brain. To address this, we study a marmoset model of ASD induced by valproic acid (VPA) treatment. We record high-density electrocorticography (ECoG) during an auditory task with two layers of temporal control, and applied a quantitative model to quantify the integrity of predictive coding across two distinct hierarchies. Our results demonstrate a persistent pattern of sensory hypersensitivity and unstable predictions across two brain hierarchies in VPA-treated animals, and reveal the associated spatio-spectro-temporal neural signatures. Despite the regular occurrence of imprecise predictions in VPA-treated animals, we observe diverse configurations of underestimation or overestimation of sensory regularities within the hierarchies. Our results demonstrate the coexistence of the two primary Bayesian accounts of ASD: overly-precise sensory observations and weak prior beliefs, and offer a potential multi-layered biomarker for ASD, which could enhance our understanding of its diverse symptoms.

Intact painful sensation but enhanced non-painful sensation in individuals with autistic traits

Somatosensory abnormalities are commonly recognized as diagnostic criteria in autism spectrum disorder (ASD), and may also exist in individuals with autistic traits. The present research included two studies to explore the painful and non-painful sensation and their cognitive-neurological mechanisms of individuals with autistic traits. Study 1 included 358 participants to assess the relationship between autistic traits and pain/non-pain sensitivities using questionnaires: the Autism Spectrum Quotient (AQ), the Pain Sensitivity Questionnaire, and the Highly Sensitive Person Scale, respectively. Study 1 found that autistic traits were positively correlated with non-pain sensitivity, but not associated with pain sensitivity. Study 2 recruited 1,167 participants whose autistic traits were assessed using the AQ. Subsequently, thirty-three participants who scored within the top 10% and bottom 10% on the AQ were selected into High-AQ and Low-AQ groups, respectively, to explore the cognitive-neural responses of individuals with autistic traits to both painful and non-painful stimuli with event-related potential (ERP) technology. Results of Study 2 showed that the High-AQ group showed higher intensity ratings, more negative emotional reactions, and larger N1 amplitudes than the Low-AQ group to the non-painful stimuli, but no difference of response to the painful stimuli was found between High-AQ and Low-AQ groups. These findings suggest that individuals with autistic traits may experience enhanced non-painful sensation but intact painful sensation.

Transdiagnostic Neurobiology of Social Cognition and Individual Variability as Measured by Fractional Amplitude of Low-Frequency Fluctuation in Schizophrenia and Autism Spectrum Disorders

Fractional amplitude of low-frequency fluctuation (fALFF) is a validated measure of resting-state spontaneous brain activity. Previous fALFF findings in autism and schizophrenia spectrum disorders (ASDs and SSDs) have been highly heterogeneous. We aimed to use fALFF in a large sample of typically developing control (TDC), ASD and SSD participants to explore group differences and relationships with inter-individual variability of fALFF maps and social cognition. fALFF from 495 participants (185 TDC, 68 ASD, and 242 SSD) was computed using functional magnetic resonance imaging as signal power within two frequency bands (i.e., slow-4 and slow-5), normalized by the power in the remaining frequency spectrum. Permutation analysis of linear models was employed to investigate the relationship of fALFF with diagnostic groups, higher-level social cognition, and lower-level social cognition. Each participant's average distance of fALFF map to all others was defined as a variability score, with higher scores indicating less typical maps. Lower fALFF in the visual and higher fALFF in the frontal regions were found in both SSD and ASD participants compared with TDCs. Limited differences were observed between ASD and SSD participants in the cuneus regions only. Associations between slow-4 fALFF and higher-level social cognitive scores across the whole sample were observed in the lateral occipitotemporal and temporoparietal junction. Individual variability within the ASD and SSD groups was also significantly higher compared with TDC. Similar patterns of fALFF and individual variability in ASD and SSD suggest some common neurobiological deficits across these related heterogeneous conditions.

Investigation of sex-related functional connectivity alterations in autism using class imbalance mitigation approach

Autism spectrum disorder is primarily diagnosed in males, leading to the lack of understanding of brain disorganization in female individuals with autism. To fill the gap, we applied a Gaussian mixture model-based oversampling technique to the functional connectivity data to adjust for the sex imbalance in autism. Leveraging a dimensionality reduction technique, we generated a low-dimensional principal component (i.e., gradient) and assessed its between-group differences between the sexes. We observed significant sex-related differences in sensorimotor, attention, and default mode networks, which were associated with higher-order cognitive control processes. Transcriptomic association analysis provided a potential biological underpinning, specifying gene enrichment in the cortex, thalamus, and striatum. Finally, symptom severity prediction analysis suggested that the functional gradient was only associated with symptoms in female individuals with autism.

Acoustic and Semantic Processing of Auditory Scenes in Children with Autism Spectrum Disorders

PURPOSE

Processing real-world sounds requires acoustic and higher-order semantic information. We tested the theory that individuals with autism spectrum disorder (ASD) show enhanced processing of acoustic features and impaired processing of semantic information.

METHODS

We used a change deafness task that required detection of speech and non-speech auditory objects being replaced and a speech-in-noise task using spoken sentences that must be comprehended in the presence of background speech to examine the extent to which 7-15 year old children with ASD (n = 27) rely on acoustic and semantic information, compared to age-matched (n = 27) and IQ-matched (n = 27) groups of typically developing (TD) children. Within a larger group of 7-15 year old TD children (n = 105) we correlated IQ, ASD symptoms, and the use of acoustic and semantic information.

RESULTS

Children with ASD performed worse overall at the change deafness task relative to the age-matched TD controls, but they did not differ from IQ-matched controls. All groups utilized acoustic and semantic information similarly and displayed an attentional bias towards changes that involved the human voice. Similarly, for the speech-in-noise task, age-matched-but not IQ-matched-TD controls performed better overall than the ASD group. However, all groups used semantic context to a similar degree. Among TD children, neither IQ nor the presence of ASD symptoms predict the use of acoustic or semantic information.

CONCLUSION

Children with and without ASD used acoustic and semantic information similarly during auditory change deafness and speech-in-noise tasks.