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Nelson CA, Sullivan E, Engelstad AM. Annual Research Review: Early intervention viewed through the lens of developmental neuroscience. J Child Psychol Psychiatry 2024; 65:435-455. [PMID: 37438865 DOI: 10.1111/jcpp.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 07/14/2023]
Abstract
The overarching goal of this paper is to examine the efficacy of early intervention when viewed through the lens of developmental neuroscience. We begin by briefly summarizing neural development from conception through the first few postnatal years. We emphasize the role of experience during the postnatal period, and consistent with decades of research on critical periods, we argue that experience can represent both a period of opportunity and a period of vulnerability. Because plasticity is at the heart of early intervention, we next turn our attention to the efficacy of early intervention drawing from two distinct literatures: early intervention services for children growing up in disadvantaged environments, and children at elevated likelihood of developing a neurodevelopmental delay or disorder. In the case of the former, we single out interventions that target caregiving and in the case of the latter, we highlight recent work on autism. A consistent theme throughout our review is a discussion of how early intervention is embedded in the developing brain. We conclude our article by discussing the implications our review has for policy, and we then offer recommendations for future research.
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Affiliation(s)
- Charles A Nelson
- Department of Pediatrics and Neuroscience, Harvard Medical School, Boston, MA, USA
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Eileen Sullivan
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
| | - Anne-Michelle Engelstad
- Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Harvard Graduate School of Education, Cambridge, MA, USA
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2
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Maksimović S, Jeličić L, Marisavljević M, Fatić S, Gavrilović A, Subotić M. Can EEG Correlates Predict Treatment Efficacy in Children with Overlapping ASD and SLI Symptoms: A Case Report. Diagnostics (Basel) 2022; 12:1110. [PMID: 35626266 PMCID: PMC9139884 DOI: 10.3390/diagnostics12051110] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/11/2022] [Accepted: 04/22/2022] [Indexed: 11/26/2022] Open
Abstract
Evaluation of the rehabilitation efficacy may be an essential indicator of its further implementation and planning. The research aim is to examine whether the estimation of EEG correlates of auditory-verbal processing in a child with overlapping autism spectrum disorder (ASD) and specific language impairment (SLI) symptoms may be a predictor of the treatment efficacy in conditions when behavioral tests do not show improvement during the time course. The prospective case report reports follow-up results in a child aged 36 to 66 months. During continuous integrative therapy, autism risk index, cognitive, speech-language, sensory, and EEG correlates of auditory-verbal information processing are recorded in six test periods, and their mutual interrelation was analyzed. The obtained results show a high statistically significant correlation of all observed functions with EEG correlates related to the difference between the average mean values of theta rhythm in the left (F1, F3, F7) and right (F2, F4, F8) frontal region. The temporal dynamics of the examined processes point to the consistency of the evaluated functions increasing with time flow. These findings indicate that EEG correlates of auditory-verbal processing may be used to diagnose treatment efficacy in children with overlapping ASD and SLI.
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Affiliation(s)
- Slavica Maksimović
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, 11000 Belgrade, Serbia; (S.M.); (M.M.); (S.F.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Ljiljana Jeličić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, 11000 Belgrade, Serbia; (S.M.); (M.M.); (S.F.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Maša Marisavljević
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, 11000 Belgrade, Serbia; (S.M.); (M.M.); (S.F.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Saška Fatić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, 11000 Belgrade, Serbia; (S.M.); (M.M.); (S.F.); (M.S.)
- Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, 11000 Belgrade, Serbia
| | - Aleksandar Gavrilović
- Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia;
- Department of Neurophysiology, Clinic of Neurology, University Clinical Centre of Kragujevac, 34000 Kragujevac, Serbia
| | - Miško Subotić
- Cognitive Neuroscience Department, Research and Development Institute “Life Activities Advancement Center”, 11000 Belgrade, Serbia; (S.M.); (M.M.); (S.F.); (M.S.)
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Montagut-Asunción M, Crespo-Martín S, Pastor-Cerezuela G, D’Ocon-Giménez A. Joint Attention and Its Relationship with Autism Risk Markers at 18 Months of Age. CHILDREN 2022; 9:children9040556. [PMID: 35455600 PMCID: PMC9027970 DOI: 10.3390/children9040556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 11/16/2022]
Abstract
(1) Joint attention is the ability to coordinate attention to share a point of reference with another person. It has an early onset and is a clear indicator of understanding the representations of others, and it is essential in the development of symbolic thought and the acquisition of language. Deficiencies in this prelinguistic early communication skill are strong markers of the risk of autism spectrum disorder (ASD); (2) this longitudinal study aimed to evaluate joint attention skills in a group of 32 infants at two developmental moments (8 and 12 months) in order to explore whether their performance on this skill was related to the presence of early signs of ASD at 18 months. Logistic multiple regressions were carried out for the data analysis; (3) results of the analysis showed that the variables of initiating joint attention at 8 months and responding to joint attention at 12 months were linked to the risk of ASD at 18 months of age; (4) in conclusion, early joint attention skills had a pivotal role in defining early manifestations of ASD.
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Affiliation(s)
- Maite Montagut-Asunción
- Department of Neuropsychobiology, Methodology, and Basic and Social Psychology, Universidad Católica de Valencia San Vicente Mártir, 46100 Burjassot, Valencia, Spain;
| | - Sarah Crespo-Martín
- Department of Basic Psychology, Universitat de València, 46010 Valencia, Spain; (S.C.-M.); (A.D.-G.)
| | - Gemma Pastor-Cerezuela
- Department of Basic Psychology, Universitat de València, 46010 Valencia, Spain; (S.C.-M.); (A.D.-G.)
- Correspondence:
| | - Ana D’Ocon-Giménez
- Department of Basic Psychology, Universitat de València, 46010 Valencia, Spain; (S.C.-M.); (A.D.-G.)
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Mohammadzaheri F, Koegel LK, Soleymani Z, Khosrowabadi R, Bakhshi E. Neural Correlates of Enhancing Question Asking and Initiations in Children with Autism Spectrum Disorders: A Randomized Clinical Trial. Soc Neurosci 2022; 17:181-192. [PMID: 35296214 DOI: 10.1080/17470919.2022.2054858] [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] [Indexed: 10/18/2022]
Abstract
Children diagnosed with autism spectrum disorder (ASD) demonstrate challenges in various areas of social communication. The aim of this study was to examine the effect of Pivotal Response Treatment (PRT) targeting question-asking on brain activity in twenty 6-12-year-old autistic boys, using a Randomized Clinical Trial (RCT) design. Verbal children, diagnosed with autism, who lacked question asking in their communication were matched based on age and mean length utterance (MLU) and were randomly placed in either PRT intervention or treatment as usual (TAU) groups. Sessions were individually administered, lasting for 60 minutes three days a week for a two-month period. All children were tested before and after intervention to assess behavioral areas (questions, general communicative skills, and MLU) and both groups underwent electroencephalography for 10 minutes in open and closed eye resting-state conditions to assess neural correlates. Data were analyzed using covariance analysis and post-hoc using Mann-Whitney and Wilcoxon methods. Significant behavioral improvements in the PRT group were observed after intervention that correlated with changes in Electroencephalography (EEG) oscillations at several brain regions compared to the TAU group. The results of this study support other studies suggesting collateral neural changes following the PRT.
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Affiliation(s)
- Fereshteh Mohammadzaheri
- Department of Speech Therapy, Rehabilitation College, Tehran University of Medical Science, Tehran, Iran
| | - Lynn Kern Koegel
- Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford University, Palo Alto, California
| | - Zahra Soleymani
- Department of Speech Therapy, Rehabilitation College, Tehran University of Medical Science, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University GC, Tehran, Iran
| | - Enayatollah Bakhshi
- Department of Biostatics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Baker E, Veytsman E, Choy T, Blacher J, Stavropoulos KKM. Investigating Changes in Reward-Related Neural Correlates After PEERS Intervention in Adolescents With ASD: Preliminary Evidence of a "Precision Medicine" Approach. Front Psychiatry 2021; 12:742280. [PMID: 34803765 PMCID: PMC8595219 DOI: 10.3389/fpsyt.2021.742280] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/12/2021] [Indexed: 01/16/2023] Open
Abstract
Background: The Social Motivation Hypothesis proposes that individuals with autism spectrum disorder (ASD) experience social interactions as less rewarding than their neurotypical (TD) peers, which may lead to reduced social initiation. Existing studies of the brain's reward system in individuals with ASD report varied findings for anticipation of and response to social rewards. Given discrepant findings, the anticipation of and response to social rewards should be further evaluated, particularly in the context of intervention outcome. We hypothesized that individual characteristics may help predict neural changes from pre- to post-intervention. Methods: Thirteen adolescents with ASD received the Program for the Education and Enrichment of Relational Skills (PEERS) intervention for 16 weeks; reward-related EEG was collected before and after intervention. Fourteen TD adolescents were tested at two timepoints but did not receive intervention. Event-related potentials were calculated to measure anticipation of (stimulus-preceding negativity; SPN) and response to (reward-related positivity; RewP) social and non-social rewards. Additionally, measures of social responsiveness, social skills, and intervention-engagement were collected. Group differences were analyzed as well as individual differences using prediction models. Result: Parent-reported social responsiveness and social skills improved in adolescents with ASD after participation in PEERS. ASD adolescents displayed marginally decreased anticipation of social rewards at post-intervention compared to pre-intervention. Regression models demonstrated that older adolescents and those with lower parent-reported social motivation prior to participation in PEERS displayed marginally increased social reward anticipation (more robust SPN) from pre- to post-intervention. Participants who displayed more parent-reported social motivation before intervention and were more actively engaged in the PEERS intervention evidenced increased social reward processing (more robust RewP) from pre- to post-intervention. Conclusion: Findings suggest that there may be differences in saliency between wanting/anticipating social rewards vs. liking/responding to social rewards in individuals with ASD. Our findings support the hypothesis that identification of individual differences may predict which adolescents are poised to benefit the most from particular interventions. As such, reported findings set the stage for the advancement of "precision medicine." This investigation is a critical step forward in our ability to understand and predict individual response to interventions in individuals with ASD.
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Affiliation(s)
- Elizabeth Baker
- School of Education, University of California, Riverside, Riverside, CA, United States
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Ibrahim K, Soorya LV, Halpern DB, Gorenstein M, Siper PM, Wang AT. Social cognitive skills groups increase medial prefrontal cortex activity in children with autism spectrum disorder. Autism Res 2021; 14:2495-2511. [PMID: 34486810 DOI: 10.1002/aur.2603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 07/25/2021] [Accepted: 08/09/2021] [Indexed: 12/21/2022]
Abstract
Few studies have examined the neural mechanisms of change following social skills interventions for children with autism spectrum disorder (ASD). This study examined the neural effects of social cognitive skills groups during functional MRI (fMRI) tasks of irony comprehension and eye gaze processing in school-aged children with ASD. Verbally fluent children (ages 8-11) were randomized to social cognitive skills groups or facilitated play comparison groups. Behavioral assessments and fMRI scans were obtained at baseline and endpoint (12 weeks). During fMRI, children completed two separate tasks to engage social cognition circuitry: comprehension of potentially ironic scenarios (n = 34) and viewing emotionally expressive faces with direct or averted gaze (n = 24). Whole-brain analyses were conducted to examine neural changes following treatment. Regression analyses were also conducted to explore the relationship between neural and behavioral changes. When comparing the two groups directly, the social cognitive skills group showed greater increases in activity in the medial prefrontal cortex (mPFC), implicated in theory of mind, relative to the comparison group for both irony comprehension and gaze processing tasks. Increased mPFC activity during the irony task was associated with improvement in social functioning on the Social Responsiveness Scale across both groups. Findings indicate that social cognitive skills interventions may increase activity in regions associated with social cognition and mentalizing abilities. LAY SUMMARY: Social skills groups are a common intervention for school-aged children with ASD. However, few studies have examined the neural response to social skills groups in school-aged children with ASD. Here, we report on a study evaluating neural outcomes from an empirically supported social cognitive skills training curriculum using fMRI. This study seeks to understand the effects of targeting emotion recognition and theory of mind on the brain circuitry involved in social cognition in verbally fluent children ages 8-11. Results indicate increased neural activity in the mPFC, a region considered to be a central hub of the "social brain," in children randomized to social cognitive skills groups relative to a comparison group that received a high-quality, child-directed play approach. In addition, increased activation in the mPFC during an irony comprehension task was associated with gains in social functioning across both groups from pre- to post-treatment. This is the first fMRI study of social skills treatment outcomes following a randomized trial with an active treatment condition in school-aged children with ASD.
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Affiliation(s)
- Karim Ibrahim
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Latha V Soorya
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Rush Medical College, Rush University, Chicago, Illinois, USA
| | - Danielle B Halpern
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Gorenstein
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paige M Siper
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - A Ting Wang
- Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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7
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The Early Start Denver Model Intervention and Mu Rhythm Attenuation in Autism Spectrum Disorders. J Autism Dev Disord 2021; 52:3304-3313. [PMID: 34309743 DOI: 10.1007/s10803-021-05190-7] [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: 07/06/2021] [Indexed: 10/20/2022]
Abstract
We examined the relationship between the Early start Denver model (ESDM) intervention and mu rhythm attenuation, an EEG paradigm reflecting neural processes associated with action perception and social information processing. Children were assigned to either receive comprehensive ESDM intervention for two years, or were encouraged to pursue resources in the community. Two years after intervention, EEG was collected during the execution and observation of grasping actions performed by familiar and unfamiliar agents. The ESDM group showed significantly greater attenuation when viewing a parent or caregiver executing a grasping action, compared with an unfamiliar individual executing the same action. Our findings suggest that the ESDM may have a unique impact on neural circuitry underlying social cognition and familiarity.
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8
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Kala S, Rolison MJ, Trevisan DA, Naples AJ, Pelphrey K, Ventola P, McPartland JC. Brief Report: Preliminary Evidence of the N170 as a Biomarker of Response to Treatment in Autism Spectrum Disorder. Front Psychiatry 2021; 12:709382. [PMID: 34267691 PMCID: PMC8275957 DOI: 10.3389/fpsyt.2021.709382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by primary difficulties in social function. Individuals with ASD display slowed neural processing of faces, as indexed by the latency of the N170, a face-sensitive event-related potential. Currently, there are no objective biomarkers of ASD useful in clinical care or research. Efficacy of behavioral treatment is currently evaluated through subjective clinical impressions. To explore whether the N170 might have utility as an objective index of treatment response, we examined N170 before and after receipt of an empirically validated behavioral treatment in children with ASD. Method: Electroencephalography (EEG) data were obtained on a preliminary cohort of preschool-aged children with ASD before and after a 16-week course of PRT and in a subset of participants in waitlist control (16-weeks before the start of PRT) and follow-up (16-weeks after the end of PRT). EEG was recorded while participants viewed computer-generated faces with neutral and fearful affect. Results: Significant reductions in N170 latency to faces were observed following 16 weeks of PRT intervention. Change in N170 latency was not observed in the waitlist-control condition. Conclusions: This exploratory study offers suggestive evidence that N170 latency may index response to behavioral treatment. Future, more rigorous, studies in larger samples are indicated to evaluate whether the N170 may be useful as a biomarker of treatment response.
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Affiliation(s)
- Shashwat Kala
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
| | - Max J. Rolison
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
| | | | - Adam J. Naples
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
| | - Kevin Pelphrey
- Department of Neurology, University of Virginia, Charlottesville, VA, United States
| | - Pamela Ventola
- Child Study Center, Yale School of Medicine, New Haven, CT, United States
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DeMayo MM, Pokorski I, Song YJC, Thapa R, Patel S, Ambarchi Z, Soligo D, Sadeli I, Thomas EE, Hickie IB, Guastella AJ. The Feasibility of Magnetic Resonance Imaging in a Non-Selective Comprehensive Clinical Trial in Pediatric Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:1211-1222. [PMID: 33903957 DOI: 10.1007/s10803-021-05028-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 12/16/2022]
Abstract
There is an increasing interest in using magnetic resonance imaging (MRI) as a tool for precision medicine in autism spectrum disorder (ASD). This study investigated the feasibility of MRI scanning in a large comprehensive, inclusive and test heavy clinical trial for children (aged 3-12 years) with ASD, without functioning constraints for participation. Of the 71 participants enrolled who consented to the MRI, 24 participants (38%) successfully completed an MRI scan at baseline along with other assessments. This scanning followed a familiarization procedure at two preceding visits. At post-treatment, 21 participants successfully completed the MRI scan. This study highlights the challenge of completing MRI assessments in ASD populations when conducted as one of a number of tests in a clinical trial.
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Affiliation(s)
- Marilena M DeMayo
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Izabella Pokorski
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Yun J C Song
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Rinku Thapa
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Shrujna Patel
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Zahava Ambarchi
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | | | - Indra Sadeli
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Emma E Thomas
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Ian B Hickie
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia.,Faculty of Medicine and Health, Brain and Mind Centre, Central Clinical School, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Adam J Guastella
- Faculty of Medicine and Health, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Autism Clinic for Translational Research, University of Sydney, 100 Mallett Street, Camperdown, NSW, 2050, Australia.
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10
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Increased Neural Reward Responsivity in Adolescents with ASD after Social Skills Intervention. Brain Sci 2020; 10:brainsci10060402. [PMID: 32599849 PMCID: PMC7349909 DOI: 10.3390/brainsci10060402] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 12/05/2022] Open
Abstract
The reward system has been implicated as a potential neural mechanism underlying social-communication deficits in individuals with autism spectrum disorder (ASD). However, it remains unclear whether the neural reward system in ASD is sensitive to behavioral interventions. The current study measured the reward positivity (RewP) in response to social and nonsocial stimuli in seven adolescents with ASD before and after participation in the Program for the Education and Enrichment of Relational Skills (PEERS®) intervention. This study also included seven neurotypical adolescents who were tested at two time points but did not receive intervention. We examined the RewP across the course of a task by comparing brain activity during the first versus second half of trials to understand patterns of responsivity over time. Improvements in social skills and decreased social-communication impairments for teens with ASD were observed after PEERS®. Event-related potential (ERP) results suggested increased reward sensitivity during the first half of trials in the ASD group after intervention. Adolescents with ASD who exhibited less reward-related brain activity before intervention demonstrated the greatest behavioral benefits from the intervention. These findings have implications for how neuroscience can be used as an objective outcome measure before and after intervention in ASD.
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11
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Colombi C, Vivanti G, Rogers S. Evidenced-Based Practices. HANDBOOK OF INTERDISCIPLINARY TREATMENTS FOR AUTISM SPECTRUM DISORDER 2019. [DOI: 10.1007/978-3-030-13027-5_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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12
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Kaku SM, Jayashankar A, Girimaji SC, Bansal S, Gohel S, Bharath RD, Srinath S. Early childhood network alterations in severe autism. Asian J Psychiatr 2019; 39:114-119. [PMID: 30610990 DOI: 10.1016/j.ajp.2018.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/28/2018] [Accepted: 12/19/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To examine the differences in whole brain topology and connectivity in 17 children of the ages 3-8 years across severity of ASD, we performed resting state fMRI using a 3T MRI scanner and graph theoretical analysis of networks. METHOD Patients were partitioned into two cohorts based on the severity of ASD, determined using the Childhood Autism Rating Scale (CARS) scores (Mild, 30-36; Severe, 37+). Standard preprocessing pipeline was used, followed by independent component analysis (ICA) to identify regions of interest (ROIs) to construct subject-specific Z-correlation matrices representing the whole brain network. Following which, graph theory measures were calculated in the range of sparsity 6%-35% and statistically analyzed, and corrected for significance (FDR corrected, p < 0.05). Regional clustering coefficient that revealed significant between-group (mild vs. severe) differences were correlated against clinical scores (CARS). RESULTS Children with severe ASD revealed significantly increased clustering coefficient and small-worldness compared to those with mild or moderate ASD. Region of interest analysis revealed altered clustering in the Heschl's gyrus that significantly correlated with CARS scores. CONCLUSION The findings from the current study provide early stage evidence of aberrant brain connectivity appearing in severe ASD, prior to the effect of environmental bias and pruning mechanisms. The clustering of the Heschl's gyrus correlated to the severity of ASD symptoms and agrees with current literature on ASD-associated cortical changes, reflecting early changes to language processing regions.
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Affiliation(s)
- Sowmyashree Mayur Kaku
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Aditya Jayashankar
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Satish Chandra Girimaji
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Sonia Bansal
- Department of Neuroanaesthesia and Neuro-Critical Care, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Suril Gohel
- Department of Health Informatics, School of Health Professions, Rutgers University, Newark, NJ, USA
| | - Rose Dawn Bharath
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India.
| | - Shoba Srinath
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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13
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Heunis T, Aldrich C, Peters JM, Jeste SS, Sahin M, Scheffer C, de Vries PJ. Recurrence quantification analysis of resting state EEG signals in autism spectrum disorder - a systematic methodological exploration of technical and demographic confounders in the search for biomarkers. BMC Med 2018; 16:101. [PMID: 29961422 PMCID: PMC6027554 DOI: 10.1186/s12916-018-1086-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 05/23/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a worldwide prevalence of 1-2%. In low-resource environments, in particular, early identification and diagnosis is a significant challenge. Therefore, there is a great demand for 'language-free, culturally fair' low-cost screening tools for ASD that do not require highly trained professionals. Electroencephalography (EEG) has seen growing interest as an investigational tool for biomarker development in ASD and neurodevelopmental disorders. One of the key challenges is the identification of appropriate multivariate, next-generation analytical methodologies that can characterise the complex, nonlinear dynamics of neural networks in the brain, mindful of technical and demographic confounders that may influence biomarker findings. The aim of this study was to evaluate the robustness of recurrence quantification analysis (RQA) as a potential biomarker for ASD using a systematic methodological exploration of a range of potential technical and demographic confounders. METHODS RQA feature extraction was performed on continuous 5-second segments of resting state EEG (rsEEG) data and linear and nonlinear classifiers were tested. Data analysis progressed from a full sample of 16 ASD and 46 typically developing (TD) individuals (age 0-18 years, 4802 EEG segments), to a subsample of 16 ASD and 19 TD children (age 0-6 years, 1874 segments), to an age-matched sample of 7 ASD and 7 TD children (age 2-6 years, 666 segments) to prevent sample bias and to avoid misinterpretation of the classification results attributable to technical and demographic confounders. A clinical scenario of diagnosing an unseen subject was simulated using a leave-one-subject-out classification approach. RESULTS In the age-matched sample, leave-one-subject-out classification with a nonlinear support vector machine classifier showed 92.9% accuracy, 100% sensitivity and 85.7% specificity in differentiating ASD from TD. Age, sex, intellectual ability and the number of training and test segments per group were identified as possible demographic and technical confounders. Consistent repeatability, i.e. the correct identification of all segments per subject, was found to be a challenge. CONCLUSIONS RQA of rsEEG was an accurate classifier of ASD in an age-matched sample, suggesting the potential of this approach for global screening in ASD. However, this study also showed experimentally how a range of technical challenges and demographic confounders can skew results, and highlights the importance of probing for these in future studies. We recommend validation of this methodology in a large and well-matched sample of infants and children, preferably in a low- and middle-income setting.
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Affiliation(s)
- T Heunis
- Department of Mechanical and Mechatronic Engineering, Stellenbosch University, Stellenbosch, South Africa
- Division of Child and Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700, South Africa
| | - C Aldrich
- Department of Mining Engineering and Metallurgical Engineering, Western Australian School of Mines, Curtin University, Perth, Australia
- Department of Process Engineering, Stellenbosch University, Stellenbosch, South Africa
| | - J M Peters
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, USA
| | - S S Jeste
- Semel Institute of Neuroscience and Human Behavior, David Geffen School of Medicine, University of California Los Angeles, California, USA
| | - M Sahin
- Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, USA
| | - C Scheffer
- Department of Mechanical and Mechatronic Engineering, Stellenbosch University, Stellenbosch, South Africa
| | - P J de Vries
- Division of Child and Adolescent Psychiatry, University of Cape Town, 46 Sawkins Road, Rondebosch, 7700, South Africa.
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14
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Neuroimaging in neurodevelopmental disorders: focus on resting-state fMRI analysis of intrinsic functional brain connectivity. Curr Opin Neurol 2018; 31:140-148. [DOI: 10.1097/wco.0000000000000536] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Yang YJD, Allen T, Abdullahi SM, Pelphrey KA, Volkmar FR, Chapman SB. Neural mechanisms of behavioral change in young adults with high-functioning autism receiving virtual reality social cognition training: A pilot study. Autism Res 2018. [PMID: 29517857 PMCID: PMC6001642 DOI: 10.1002/aur.1941] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Measuring treatment efficacy in individuals with Autism Spectrum Disorder (ASD) relies primarily on behaviors, with limited evidence as to the neural mechanisms underlying these behavioral gains. This pilot study addresses this void by investigating neural and behavioral changes in a Phase I trial in young adults with high-functioning ASD who received an evidence-based behavioral intervention, Virtual Reality-Social Cognition Training over 5 weeks for a total of 10 hr. The participants were tested pre- and post-training with a validated biological/social versus scrambled/nonsocial motion neuroimaging task, previously shown to activate regions within the social brain networks. Three significant brain-behavior changes were identified. First, the right posterior superior temporal sulcus, a hub for socio-cognitive processing, showed increased brain activation to social versus nonsocial stimuli in individuals with greater gains on a theory-of-mind measure. Second, the left inferior frontal gyrus, a region for socio-emotional processing, tracked individual gains in emotion recognition with decreased activation to social versus nonsocial stimuli. Finally, the left superior parietal lobule, a region for visual attention, showed significantly decreased activation to nonsocial versus social stimuli across all participants, where heightened attention to nonsocial contingencies has been considered a disabling aspect of ASD. This study provides, albeit preliminary, some of the first evidence of the harnessable neuroplasticity in adults with ASD through an age-appropriate intervention in brain regions tightly linked to social abilities. This pilot trial motivates future efforts to develop and test social interventions to improve behaviors and supporting brain networks in adults with ASD. Autism Res 2018, 11: 713-725. © 2018 The Authors Autism Research published by International Society for Autism Research and Wiley Periodicals, Inc. LAY SUMMARY This study addresses how the behavioral changes after treatment for ASD reflect underlying brain changes. Before and after receiving VR-SCT, young adults with high-functioning ASD passively viewed biological motion stimuli in a MRI scanner, tapping changes in the social brain network. The results reveal neuroplasticity in this age population, extending the window of opportunity for interventions to impact social competency in adults with ASD.
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Affiliation(s)
- Y J Daniel Yang
- Autism and Neurodevelopmental Disorders Institute, The George Washington University and Children's National Health System, Washington, DC.,Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Tandra Allen
- Center for BrainHealth, The University of Texas at Dallas, Dallas, Texas
| | - Sebiha M Abdullahi
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Kevin A Pelphrey
- Autism and Neurodevelopmental Disorders Institute, The George Washington University and Children's National Health System, Washington, DC
| | - Fred R Volkmar
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
| | - Sandra B Chapman
- Center for BrainHealth, The University of Texas at Dallas, Dallas, Texas
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16
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Pivotal response treatment prompts a functional rewiring of the brain among individuals with autism spectrum disorder. Neuroreport 2018; 27:1081-5. [PMID: 27532879 DOI: 10.1097/wnr.0000000000000662] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Behavioral interventions for autism have gained prominence in recent years; however, the neural-systems-level targets of these interventions remain poorly understood. We use a novel Bayesian framework to extract network-based differences before and after a 16-week pivotal response treatment (PRT) regimen. Our results suggest that the functional changes induced by PRT localize to the posterior cingulate and are marked by a shift in connectivity from the orbitofrontal cortex to the occipital-temporal cortex. Our results illuminate a potential PRT-induced learning mechanism, whereby the neural circuits involved during social perception shift from sensory and attentional systems to higher-level object and face processing areas.
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17
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Maximo JO, Murdaugh DL, O'Kelley S, Kana RK. Changes in intrinsic local connectivity after reading intervention in children with autism. BRAIN AND LANGUAGE 2017; 175:11-17. [PMID: 28869842 DOI: 10.1016/j.bandl.2017.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 07/30/2017] [Accepted: 08/27/2017] [Indexed: 06/07/2023]
Abstract
Most of the existing behavioral and cognitive intervention programs in autism spectrum disorders (ASD) have not been tested at the neurobiological level, thus falling short of finding quantifiable neurobiological changes underlying behavioral improvement. The current study takes a translational neuroimaging approach to test the impact of a structured visual imagery-based reading intervention on improving reading comprehension and assessing its underlying local neural circuitry. Behavioral and resting state functional MRI (rs-fMRI) data were collected from children with ASD who were randomly assigned to an Experimental group (ASD-EXP; n=14) and a Wait-list control group (ASD-WLC; n=14). Participants went through an established reading intervention training program (Visualizing and Verbalizing for language comprehension and thinking or V/V; 4-h per day, 10-weeks, 200h of face-to-face instruction). Local functional connectivity was examined using a connection density approach from graph theory focusing on brain areas considered part of the Reading Network. The main results are as follows: (I) the ASD-EXP group showed significant improvement, compared to the ASD-WLC group, in their reading comprehension ability evidenced from change in comprehension scores; (II) the ASD-EXP group showed increased local brain connectivity in Reading Network regions compared to the ASD-WLC group post-intervention; (III) intervention-related changes in local brain connectivity were observed in the ASD-EXP from pre to post-intervention; and (IV) improvement in language comprehension significantly predicted changes in local connectivity. The findings of this study provide novel insights into brain plasticity in children with developmental disorders using targeted intervention programs.
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Affiliation(s)
- Jose O Maximo
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Donna L Murdaugh
- University of Alabama at Birmingham, Birmingham, AL, USA; Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Sarah O'Kelley
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajesh K Kana
- University of Alabama at Birmingham, Birmingham, AL, USA.
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18
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Duifhuis EA, den Boer JC, Doornbos A, Buitelaar JK, Oosterling IJ, Klip H. The Effect of Pivotal Response Treatment in Children with Autism Spectrum Disorders: A Non-randomized Study with a Blinded Outcome Measure. J Autism Dev Disord 2017; 47:231-242. [PMID: 27815645 PMCID: PMC5309302 DOI: 10.1007/s10803-016-2916-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose of this quasi-experimental trial was to investigate the effect of Pivotal response treatment (PRT) versus treatment as usual (TAU) on autism symptoms. Children with autism spectrum disorder (ASD), aged 3–8 years, received either PRT (n = 11) or TAU (n = 13). Primary outcome measure was the total score on the Autism Diagnostic Observation Schedule at pre- and posttreatment. Additionally, general problem behavior and parental stress levels were measured. Children in the PRT condition improved on the primary outcome measure compared to the TAU group with a small effect size [partial η2 = 0.22 (95 % CI 0.00–0.46)]. Neither group demonstrated significant changes in the secondary outcomes. This study suggests that PRT may improve autism symptoms in children with ASD over TAU.
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Affiliation(s)
- E A Duifhuis
- Karakter Child and Adolescent Psychiatry, Postbus 68, 6710 BB, Ede, The Netherlands.
| | - J C den Boer
- Karakter Child and Adolescent Psychiatry, Postbus 68, 6710 BB, Ede, The Netherlands
| | - A Doornbos
- Karakter Child and Adolescent Psychiatry, Vriezenveenseweg 213, 6700 AP, Almelo, The Netherlands
| | - J K Buitelaar
- Karakter Child and Adolescent Psychiatry University Center, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, P.O. Box 9101 (204), 6500 HB, Nijmegen, The Netherlands
| | - I J Oosterling
- Karakter Child and Adolescent Psychiatry University Center, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands
| | - H Klip
- Karakter Child and Adolescent Psychiatry University Center, Reinier Postlaan 12, 6525 GC, Nijmegen, The Netherlands
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19
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Abstract
Pivotal response treatment (PRT) is an evidence-based behavioral intervention based on applied behavior analysis principles aimed to improve social communication skills in individuals with autism spectrum disorder (ASD). PRT adopts a more naturalistic approach and focuses on using a number of strategies to help increase children's motivation during intervention. Since its conceptualization, PRT has received much empirical support for eliciting therapeutic gains in greater use of functional social communication skills in individuals with ASD. Building upon the empirical evidence supporting PRT, recent advancements have increasingly turned to using interdisciplinary research integrating neuroimaging techniques and behavioral measures to help identify objective biomarkers of treatment, which have two primary purposes. First, neuroimaging results can help characterize how PRT may elicit change, and facilitate partitioning of the heterogeneous profiles of neural mechanisms underlying similar profile of behavioral changes observed over PRT. Second, neuroimaging provides an objective means to both map and track how biomarkers may serve as reliable and sensitive predictors of responder profiles to PRT, assisting clinicians to identify who will most likely benefit from PRT. Together, a better understanding of both mechanisms of change and predictors of responder profile will help PRT to serve as a more precise and targeted intervention for individuals with ASD, thus moving towards the goal of precision medicine and improving quality of care. This review focuses on the recent emerging neuroimaging evidences supporting PRT, offering current perspectives on the importance of interdisciplinary research to help clinicians better understand how PRT works and predict who will respond to PRT.
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Affiliation(s)
- Jiedi Lei
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Pamela Ventola
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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20
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Liu P, Rigoulot S, Pell MD. Cultural immersion alters emotion perception: Neurophysiological evidence from Chinese immigrants to Canada. Soc Neurosci 2016; 12:685-700. [PMID: 27588442 DOI: 10.1080/17470919.2016.1231713] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To explore how cultural immersion modulates emotion processing, this study examined how Chinese immigrants to Canada process multisensory emotional expressions, which were compared to existing data from two groups, Chinese and North Americans. Stroop and Oddball paradigms were employed to examine different stages of emotion processing. The Stroop task presented face-voice pairs expressing congruent/incongruent emotions and participants actively judged the emotion of one modality while ignoring the other. A significant effect of cultural immersion was observed in the immigrants' behavioral performance, which showed greater interference from to-be-ignored faces, comparable with what was observed in North Americans. However, this effect was absent in their N400 data, which retained the same pattern as the Chinese. In the Oddball task, where immigrants passively viewed facial expressions with/without simultaneous vocal emotions, they exhibited a larger visual MMN for faces accompanied by voices, again mirroring patterns observed in Chinese. Correlation analyses indicated that the immigrants' living duration in Canada was associated with neural patterns (N400 and visual mismatch negativity) more closely resembling North Americans. Our data suggest that in multisensory emotion processing, adopting to a new culture first leads to behavioral accommodation followed by alterations in brain activities, providing new evidence on human's neurocognitive plasticity in communication.
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Affiliation(s)
- Pan Liu
- a School of Communication Sciences and Disorders , McGill University , Montréal , Canada.,b Centre for Research on Brain, Language, and Music (CRBLM) , McGill University , Montréal , Canada
| | - Simon Rigoulot
- b Centre for Research on Brain, Language, and Music (CRBLM) , McGill University , Montréal , Canada.,c International Laboratory for Brain, Music and Sound Research (BRAMS) , McGill University , Montréal , Canada
| | - Marc D Pell
- a School of Communication Sciences and Disorders , McGill University , Montréal , Canada.,b Centre for Research on Brain, Language, and Music (CRBLM) , McGill University , Montréal , Canada.,c International Laboratory for Brain, Music and Sound Research (BRAMS) , McGill University , Montréal , Canada
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21
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Björnsdotter M, Wang N, Pelphrey K, Kaiser MD. Evaluation of Quantified Social Perception Circuit Activity as a Neurobiological Marker of Autism Spectrum Disorder. JAMA Psychiatry 2016; 73:614-21. [PMID: 27096285 PMCID: PMC6475601 DOI: 10.1001/jamapsychiatry.2016.0219] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Autism spectrum disorder (ASD) is marked by social disability and is associated with dysfunction in brain circuits supporting social cue perception. The degree to which neural functioning reflects individual-level behavioral phenotype is unclear, slowing the search for functional neuroimaging biomarkers of ASD. OBJECTIVE To examine whether quantified neural function in social perception circuits may serve as an individual-level marker of ASD in children and adolescents. DESIGN, SETTING, AND PARTICIPANTS The cohort study was conducted at the Yale Child Study Center and involved children and adolescents diagnosed as having ASD and typically developing participants. Participants included a discovery cohort and a larger replication cohort. Individual-level social perception circuit functioning was assessed as functional magnetic resonance imaging brain responses to point-light displays of coherent vs scrambled human motion. MAIN OUTCOMES AND MEASURES Outcome measures included performance of quantified brain responses in affected male and female participants in terms of area under the receiver operating characteristic curve (AUC), sensitivity and specificity, and correlations between brain responses and social behavior. RESULTS Of the 39 participants in the discovery cohort aged 4 to 17 years, 22 had ASD and 30 were boys. Of the 75 participants in the replication cohort aged 7 to 20 years, 37 had ASD and 52 were boys. A relative reduction in social perception circuit responses was identified in discovery cohort boys with ASD at an AUC of 0.75 (95% CI, 0.52-0.89; P = .01); however, typically developing girls and girls with ASD could not be distinguished (P = .54). The results were confirmed in the replication cohort, where brain responses were identified in boys with ASD at an AUC of 0.79 (95% CI, 0.64-0.91; P < .001) and failed to distinguish affected and unaffected girls (P = .82). Across both cohorts, boys were identified at an AUC of 0.77 (95% CI, 0.64-0.86) with corresponding sensitivity and specificity of 76% each. Additionally, brain responses were associated with social behavior in boys but not in girls. CONCLUSIONS AND RELEVANCE Quantified social perception circuit activity is a promising individual-level candidate neural marker of the male ASD behavioral phenotype. Our findings highlight the need to better understand effects of sex on social perception processing in relation to ASD phenotype manifestations.
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Affiliation(s)
- Malin Björnsdotter
- Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden,Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Nancy Wang
- Center for Translational Developmental Neuroscience, Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Kevin Pelphrey
- Autism And Neurodevelopment Disorders Institute, The George Washington University and Children’s National Medical Center, Washington, DC
| | - Martha D. Kaiser
- Center for Translational Developmental Neuroscience, Child Study Center, Yale School of Medicine, New Haven, Connecticut
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22
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Mohammadzaheri F, Koegel LK, Rezaei M, Bakhshi E. A Randomized Clinical Trial Comparison Between Pivotal Response Treatment (PRT) and Adult-Driven Applied Behavior Analysis (ABA) Intervention on Disruptive Behaviors in Public School Children with Autism. J Autism Dev Disord 2016; 45:2899-907. [PMID: 25953148 DOI: 10.1007/s10803-015-2451-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Children with autism often demonstrate disruptive behaviors during demanding teaching tasks. Language intervention can be particularly difficult as it involves social and communicative areas, which are challenging for this population. The purpose of this study was to compare two intervention conditions, a naturalistic approach, Pivotal Response Treatment (PRT) with an adult-directed ABA approach on disruptive behavior during language intervention in the public schools. A randomized clinical trial design was used with two groups of children, matched according to age, sex and mean length of utterance. The data showed that the children demonstrated significantly lower levels of disruptive behavior during the PRT condition. The results are discussed with respect to antecedent manipulations that may be helpful in reducing disruptive behavior.
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Affiliation(s)
- Fereshteh Mohammadzaheri
- Faculty of Rehabilitation Sciences, Hamadan University of Medical Sciences and Health Services, Hamadan, Iran
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23
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Calderoni S, Billeci L, Narzisi A, Brambilla P, Retico A, Muratori F. Rehabilitative Interventions and Brain Plasticity in Autism Spectrum Disorders: Focus on MRI-Based Studies. Front Neurosci 2016; 10:139. [PMID: 27065795 PMCID: PMC4814657 DOI: 10.3389/fnins.2016.00139] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 03/18/2016] [Indexed: 12/20/2022] Open
Abstract
Clinical and research evidence supports the efficacy of rehabilitative intervention for improving targeted skills or global outcomes in individuals with autism spectrum disorder (ASD). However, putative mechanisms of structural and functional brain changes are poorly understood. This review aims to investigate the research literature on the neural circuit modifications after non-pharmacological intervention. For this purpose, longitudinal studies that used magnetic resonance imaging (MRI)-based techniques at the start and at the end of the trial to evaluate the neural effects of rehabilitative treatment in subjects with ASD were identified. The six included studies involved a limited number of patients in the active group (from 2 to 16), and differed by acquisition method (task-related and resting-state functional MRI) as well as by functional MRI tasks. Overall, the results produced by the selected investigations demonstrated brain plasticity during the treatment interval that results in an activation/functional connectivity more similar to those of subjects with typical development (TD). Repeated MRI evaluation may represent a promising tool for the detection of neural changes in response to treatment in patients with ASD. However, large-scale randomized controlled trials after standardized rehabilitative intervention are required before translating these preliminary results into clinical use.
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Affiliation(s)
| | - Lucia Billeci
- Department of Clinical and Experimental Medicine, University of Pisa Pisa, Italy
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of MilanMilan, Italy; Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at HoustonHouston, TX, USA
| | | | - Filippo Muratori
- IRCCS Stella Maris FoundationPisa, Italy; Department of Clinical and Experimental Medicine, University of PisaPisa, Italy
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Abstract
We investigated the mechanisms by which Pivotal Response Treatment (PRT) improves social communication in a case series of 10 preschool-aged children with Autism Spectrum Disorder (ASD). Functional magnetic resonance imaging (fMRI) identified brain responses during a biological motion perception task conducted prior to and following 16 weeks of PRT treatment. Overall, the neural systems supporting social perception in these 10 children were malleable through implementation of PRT; following treatment, neural responses were more similar to those of typically developing children (TD). However, at baseline, half of the children exhibited hypoactivation, relative to a group of TD children, in the right posterior superior temporal sulcus (pSTS), and half exhibited hyperactivation in this region. Strikingly, the groups exhibited differential neural responses to treatment: The five children who exhibited hypoactivation at baseline evidenced increased activation in components of the reward system including the ventral striatum and putamen. The five children who exhibited hyperactivation at baseline evidenced decreased activation in subcortical regions critical for regulating the flow of stimulation and conveying signals of salience to the cortex-the thalamus, amygdala, and hippocampus. Our results support further investigation into the differential effects of particular treatment strategies relative to specific neural targets. Identification of treatment strategies that address the patterns of neural vulnerability unique to each patient is consistent with the priority of creating individually tailored interventions customized to the behavioral and neural characteristics of a given person.
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25
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Crook A, Kenny J, Johnson H, Davidson B. Perspectives of a mobile application for people with communication disabilities in the community. Disabil Rehabil Assist Technol 2016; 12:184-196. [PMID: 26730522 DOI: 10.3109/17483107.2015.1111947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose To determine the perceptions of people with complex communication needs (CCN) and business staff regarding the uses and functionality of a mobile application to aid communication access. Method A qualitative study using thematic analysis of transcripts and field notes from focus groups and interviews of 19 people with CCN and nine business staff. Results Four themes and 10 subthemes were drawn from the data. Themes highlighted the desire for: increased communication strategies to support customer interactions, increased access to information, functionality of a mobile application to increase its utility, and preferred technical and visual features of mobile applications. Conclusion People with CCN and business staff perceived a mobile application as a useful tool to aid communication access. This research highlighted the importance of facilitating strategies to communicative interactions and information in the community as the fundamental goal of a mobile application developed to support communication access. Implications for Rehabilitation Mobile applications are widely accepted and used in modern customer service industries and have been identified as tools to increase communication access for people with complex communication needs (CCN). People with CCN identified accessibility, presentation, and customisation as important features of mobile applications for communication access. The diversity of user preferences and needs, and the rapid development of new technologies limit the applicability of a single design for mobile applications for people with CCN. People with CCN should be involved in application design and development. A mobile application for communication access would support customer-business interactions as well as enable more accessible information sharing about disability needs and services.
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Affiliation(s)
- Alice Crook
- a Department of Audiology and Speech Pathology , Melbourne School of Health Sciences, The University of Melbourne , Melbourne , Australia
| | - Julie Kenny
- b Communication and Inclusion Resource Centre, Scope Victoria , Melbourne , Australia
| | - Hilary Johnson
- b Communication and Inclusion Resource Centre, Scope Victoria , Melbourne , Australia
| | - Bronwyn Davidson
- a Department of Audiology and Speech Pathology , Melbourne School of Health Sciences, The University of Melbourne , Melbourne , Australia
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27
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Singletary WM. An integrative model of autism spectrum disorder: ASD as a neurobiological disorder of experienced environmental deprivation, early life stress and allostatic overload. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/15294145.2015.1092334] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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28
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Zwaigenbaum L, Bauman ML, Choueiri R, Fein D, Kasari C, Pierce K, Stone WL, Yirmiya N, Estes A, Hansen RL, McPartland JC, Natowicz MR, Buie T, Carter A, Davis PA, Granpeesheh D, Mailloux Z, Newschaffer C, Robins D, Smith Roley S, Wagner S, Wetherby A. Early Identification and Interventions for Autism Spectrum Disorder: Executive Summary. Pediatrics 2015; 136 Suppl 1:S1-9. [PMID: 26430167 PMCID: PMC9923899 DOI: 10.1542/peds.2014-3667b] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Lonnie Zwaigenbaum
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;
| | - Margaret L. Bauman
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, Massachusetts
| | - Roula Choueiri
- Division of Developmental and Behavioral Pediatrics, University of Massachusetts Memorial Children’s Medical Center, Worcester, Massachusetts
| | - Deborah Fein
- Department of Psychology, University of Connecticut, Storrs, Connecticut
| | - Connie Kasari
- Graduate School of Education & Information Studies, University of California Los Angeles, Los Angeles, California
| | - Karen Pierce
- Department of Neurosciences, University of California San Diego, La Jolla, California
| | | | - Nurit Yirmiya
- Department of Psychology, Hebrew University of Jerusalem Mount Scopus, Jerusalem, Israel
| | - Annette Estes
- Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Robin L. Hansen
- Department of Pediatrics, University of California Davis MIND Institute, Sacramento, California
| | | | | | - Timothy Buie
- Harvard Medical School and Massachusetts General Hospital for Children, Boston, Massachusetts
| | - Alice Carter
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | | | | | - Zoe Mailloux
- Department of Occupational Therapy, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Craig Newschaffer
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Diana Robins
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Susanne Smith Roley
- USC Mrs T.H. Chan Division of Occupational Science and Occupational Therapy, Los Angeles, California
| | - Sheldon Wagner
- Behavioral Development & Educational Services, New Bedford, Massachusetts; and
| | - Amy Wetherby
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, Florida
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29
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Levin B. Portraiture and social understanding. ADVANCES IN AUTISM 2015. [DOI: 10.1108/aia-05-2015-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to discuss the possible explanations for deficits in social understanding evident in individuals with autism spectrum disorder (ASD). A potential intervention technique is proposed that has not yet been examined in this population: viewing and drawing portraits. This portraiture-based intervention seeks to address some of the core issues set forth in each of the theories explaining impaired social functioning. Furthermore, this intervention is intended to specifically increase exposure to facial stimuli in a safe and controlled environment. Instructions about how to look closely at a social partner’s face and how to glean salient emotional information from the facial expression displayed can be developed through a focused exploration of drawing and viewing portraits. Current techniques such as eye tracking and fMRI are discussed in the context of this proposed intervention.
Design/methodology/approach
– This paper reviews existing research about ASD and seeks to present a new proposal for an intervention using portraiture. First the paper discusses existing interventions and reviews the current research about potential causes/areas of deficiency in individuals on the spectrum. This paper subsequently proposes a new type of intervention and discusses the reasons underpinning its potential success in the context of existing research.
Findings
– This was a proposed study so no empirical findings have been reported. However, observations of individuals on the spectrum engaging with artwork are discussed in this paper.
Originality/value
– No other research or study has been proposed in current literature relating specifically to the use of portraits (looking at and creating) to help individuals with ASD.
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Reese RM, Braun MJ, Hoffmeier S, Stickle L, Rinner L, Smith C, Ellerbeck K, Jamison R, Wendland M, Jarrett L, Hadorn M. Preliminary Evidence for the Integrated Systems Using Telemedicine. Telemed J E Health 2015; 21:581-7. [PMID: 25898157 DOI: 10.1089/tmj.2014.0124] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Autism affects as many as 1 in 68 children in the United States. Early identification and access to intervention services promote improved outcomes for children with autism and other developmental delays. Children living in rural and underserved areas have limited access to such services and are diagnosed later than those living more suburban and urban areas. Our Integrated Systems Using Telemedicine (ISUT) Model uses a cost-effective method for families to access diagnostic and other specialty care through telemedicine. This model links families, trained early intervention providers and educators, and university-based medical professionals. MATERIALS AND METHODS We trained autism diagnostic teams throughout the state who completed diagnostic measures and connected to university medical center teams for final diagnosis of autism and coexisting conditions. We gathered preliminary data to measure the impact of the ISUT model on access to services, potential cost savings for families, and parent satisfaction with the model. RESULTS Preliminary data indicate that our ISUT model provided families in rural and underserved areas improved access to diagnostic services as well as cost savings for travel. Our satisfaction data indicate that parents are equally satisfied with services received through the ISUT and through the University-Based Medical Center Team Model. CONCLUSIONS The ISUT model provides a unique collaboration among the family, educational system, autism experts in the community, and the university medical center autism team while providing a cost-effective means for families to access specialty care while promoting coordination of care within the community.
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Affiliation(s)
- R Matthew Reese
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Matthew J Braun
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Sarah Hoffmeier
- 2 Technical Assistance Support Network , University of Kansas Medical Center, Kansas City, Kansas
| | - Lee Stickle
- 2 Technical Assistance Support Network , University of Kansas Medical Center, Kansas City, Kansas
| | - Louann Rinner
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Catherine Smith
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Kathryn Ellerbeck
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Rene Jamison
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Maura Wendland
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Lindsey Jarrett
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
| | - Megan Hadorn
- 1 Center for Child Health and Development, University of Kansas Medical Center , Kansas City, Kansas
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31
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Cadogan S, McCrimmon AW. Pivotal response treatment for children with autism spectrum disorder: a systematic review of research quality. Dev Neurorehabil 2015; 18:137-44. [PMID: 24180635 DOI: 10.3109/17518423.2013.845615] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Research has indicated support for pivotal response treatment (PRT) as an effective, efficacious and naturalistic intervention for communication and social functioning of children with autism spectrum disorder (ASD). Previously not undertaken, this article describes a systematic evaluation of the adherence of PRT research studies to standards of ASD research quality. METHOD A systematic search was conducted on two databases. Seventeen PRT studies were evaluated on their use of seven specified research standards. RESULTS Strong adherence to research quality standards was demonstrated in the use of standardized protocols, systematic application of intervention procedures, inter-rater reliability and objective evaluators. Variation was found in adherence to treatment fidelity standards and in the use of longitudinal designs. Only two studies implemented comparison designs. CONCLUSION It is recommended that researchers compare interventions, use longitudinal designs, better describe their methodology and implement greater adherence to treatment fidelity to enhance research quality and strengthen conclusions.
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Affiliation(s)
- Sarah Cadogan
- Faculty of Education, University of Calgary , Calgary, Alberta , Canada
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32
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Ventola PE, Oosting DR, Keifer CM, Friedman HE. Toward optimal outcome following pivotal response treatment: a case series. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2015; 88:37-44. [PMID: 25745373 PMCID: PMC4345537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
There is a growing literature on children with autism spectrum disorder (ASD) who respond favorably to behavioral treatment, which is often termed "optimal outcome." Rates and definitions of optimal outcome vary widely. The current case series describes an empirically validated behavioral treatment approach called Pivotal Response Treatment (PRT). We present two preschool-aged children who received an intensive course of PRT and seem to be on a trajectory toward potential optimal outcome. Understanding response to treatment and predictors of response is crucial, not necessarily to predict who may succeed, but to individualize medicine and match children with customized treatment programs that will be best tailored to their unique and varied needs.
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Affiliation(s)
- Pamela E. Ventola
- Pamela Ventola, Yale Child Study Center, 230 South Frontage Road, New Haven, CT 06520; Tele: 203-785-5657;
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33
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Kasari C, Shire S, Factor R, McCracken C. Psychosocial treatments for individuals with autism spectrum disorder across the lifespan: new developments and underlying mechanisms. Curr Psychiatry Rep 2014; 16:512. [PMID: 25248342 DOI: 10.1007/s11920-014-0512-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Researchers have studied many interventions to address the core impairment in social interactions in autism spectrum disorder. We reviewed the social skills intervention literature over the past two years (2012-2014). Social skills intervention studies have increased by 35% over our previous review of 2010-2012. Nearly equal numbers of studies reported results using single subject research designs (n = 29) and group designs (n = 25). Consistent with our previous review, many studies focused on joint attention/joint engagement for young children and interventions addressing peer interactions for older children. Advancements in this review period included more replications of intervention models, longitudinal outcomes, and a focus on minimally verbal children. Notably absent are social interventions for adults, and interventions addressing school-based inclusion. In addition to these target areas, future studies should isolate active ingredients of social interventions, include broader participant representation, and further examine the relation between neural development and behavioral outcomes.
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Affiliation(s)
- Connie Kasari
- UCLA Center for Autism Research and Treatment, 760 Westwood Plaza, Los Angeles, CA, 90024, USA,
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34
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Retico A, Tosetti M, Muratori F, Calderoni S. Neuroimaging-based methods for autism identification: a possible translational application? FUNCTIONAL NEUROLOGY 2014; 29:231-239. [PMID: 25764253 PMCID: PMC4370436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Classification methods based on machine learning (ML) techniques are becoming widespread analysis tools in neuroimaging studies. They have the potential to enhance the diagnostic power of brain data, by assigning a predictive index, either of pathology or of treatment response, to the single subject's acquisition. ML techniques are currently finding numerous applications in psychiatric illness, in addition to the widely studied neurodegenerative diseases. In this review we give a comprehensive account of the use of classification techniques applied to structural magnetic resonance images in autism spectrum disorders (ASDs). Understanding of these highly heterogeneous neurodevelopmental diseases could greatly benefit from additional descriptors of pathology and predictive indices extracted directly from brain data. A perspective is also provided on the future developments necessary to translate ML methods from the field of ASD research into the clinic.
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Affiliation(s)
- Alessandra Retico
- INFN – National Institute for Nuclear Physics, Pisa Division, Pisa, Italy
| | | | - Filippo Muratori
- IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Developmental Medicine, University of Pisa, Italy
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35
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Vivanti G, Rogers SJ. Autism and the mirror neuron system: insights from learning and teaching. Philos Trans R Soc Lond B Biol Sci 2014; 369:20130184. [PMID: 24778379 PMCID: PMC4006185 DOI: 10.1098/rstb.2013.0184] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Individuals with autism have difficulties in social learning domains which typically involve mirror neuron system (MNS) activation. However, the precise role of the MNS in the development of autism and its relevance to treatment remain unclear. In this paper, we argue that three distinct aspects of social learning are critical for advancing knowledge in this area: (i) the mechanisms that allow for the implicit mapping of and learning from others' behaviour, (ii) the motivation to attend to and model conspecifics and (iii) the flexible and selective use of social learning. These factors are key targets of the Early Start Denver Model, an autism treatment approach which emphasizes social imitation, dyadic engagement, verbal and non-verbal communication and affect sharing. Analysis of the developmental processes and treatment-related changes in these different aspects of social learning in autism can shed light on the nature of the neuropsychological mechanisms underlying social learning and positive treatment outcomes in autism. This knowledge in turn may assist in developing more successful pedagogic approaches to autism spectrum disorder. Thus, intervention research can inform the debate on relations among neuropsychology of social learning, the role of the MNS, and educational practice in autism.
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Affiliation(s)
- Giacomo Vivanti
- Olga Tennison Autism Research Centre, School of Psychological Science, La Trobe University, Melbourne, Victoria, Australia
- Victorian Autism Specific Early Learning and Care Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Sally J. Rogers
- The MIND Institute, University of California, Davis Medical Center, Sacramento, CA 95817, USA
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36
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Mastrogiuseppe M, Capirci O, Cuva S, Venuti P. Gestural communication in children with autism spectrum disorders during mother–child interaction. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2014; 19:469-81. [DOI: 10.1177/1362361314528390] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Children with autism spectrum disorders display atypical development of gesture production, and gesture impairment is one of the determining factors of autism spectrum disorder diagnosis. Despite the obvious importance of this issue for children with autism spectrum disorder, the literature on gestures in autism is scarce and contradictory. The purpose of this study was to analyze gestural communication in children with autism spectrum disorder during spontaneous mother–child interaction. Participants were children with autism spectrum disorder (n = 20), Down’s syndrome (n = 20), and typical development (n = 20) and their mothers. Children’s mean developmental age was 24.16 months (standard deviation = 1.45 months) and did not differ across the groups. Gestural communication was analyzed with a specific coding scheme allowing a quantitative and qualitative analysis of gestural production. Results showed the following: (a) differences between autism spectrum disorder, typical development, and Down’s syndrome groups in the total number of gestures produced; (b) differences between the three groups in the distribution of gesture types; and (c) specific correlations between gestural production, cognitive development, and autism severity scores. The study of gestures in autism spectrum disorder could help us to identify different phenotypes in autism and could also lead to the development of new therapies.
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Affiliation(s)
| | - Olga Capirci
- Institute of Cognitive Sciences and Technologies (ISTC), CNR, Italy
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37
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Damiano CR, Mazefsky CA, White SW, Dichter GS. Future directions for research in autism spectrum disorders. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2014; 43:828-43. [PMID: 25216048 PMCID: PMC4163956 DOI: 10.1080/15374416.2014.945214] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article suggests future directions for research aimed at improving our understanding of the etiology and pathophysiology of autism spectrum disorder (ASD) as well as pharmacologic and psychosocial interventions for ASD across the lifespan. The past few years have witnessed unprecedented transformations in the understanding of ASD neurobiology, genetics, early identification, and early intervention. However, recent increases in ASD prevalence estimates highlight the urgent need for continued efforts to translate novel ASD discoveries into effective interventions for all individuals with ASD. In this article we highlight promising areas for ongoing and new research expected to quicken the pace of scientific discovery and ultimately the translation of research findings into accessible and empirically supported interventions for those with ASD. We highlight emerging research in the following domains as particularly promising and pressing: (a) preclinical models, (b) experimental therapeutics, (c) early identification and intervention, (d) psychiatric comorbidities and the Research Domain Criteria initiative, (e) ecological momentary assessment, (f) neurotechnologies, and (g) the needs of adults with ASD. Increased research emphasis in these areas has the potential to hasten the translation of knowledge on the etiological mechanisms of ASD to psychosocial and biological interventions to reduce the burden of ASD on affected individuals and their families.
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Affiliation(s)
- Cara R. Damiano
- Department of Psychology, University of North Carolina, Chapel Hill, NC
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC
| | - Carla A. Mazefsky
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Susan W. White
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA
| | - Gabriel S. Dichter
- Department of Psychology, University of North Carolina, Chapel Hill, NC
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
- Carolina Institute for Developmental Disabilities, University of North Carolina, Chapel Hill, NC
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38
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Canitano R. New experimental treatments for core social domain in autism spectrum disorders. Front Pediatr 2014; 2:61. [PMID: 24999471 PMCID: PMC4064155 DOI: 10.3389/fped.2014.00061] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 05/29/2014] [Indexed: 12/21/2022] Open
Abstract
Current therapeutics in autism spectrum disorders (ASD) only treat the associated symptoms, without addressing core social dysfunctions. A paradigm shift in research of the pathogenesis of ASD, its synaptic abnormalities and altered signaling in multiple dynamic systems, have led to new experimental treatments for treating the core social abnormalities of ASD. NMDA antagonists, especially memantine, have been introduced in clinical trials addressing glutamatergic transmission in children and adolescents with ASD. GABAergic signaling has been targeted in trials using the GABAB receptor agonist arbaclofen for ASD patients with promising results. Oxytocin has been recognized as implicated in social development and affiliative behaviors. Preliminary findings from clinical trials using oxytocin in children with ASD show encouraging improvements in social cognition, but larger studies are needed. In two of the single gene disorders associated with ASD, Insulin Growth Factor (IGF-1) is a new treatment that has been tested in Rett syndrome and Phelan-McDermid syndrome (Chromosome 22 deletion syndrome). IGF-1 has been demonstrated to reverse the reduction in the number of excitatory synapses and the density of neurons that characterize these conditions in animal studies and it is being introduced as an experimental treatment. As a novel approach to verify treatment efficacy, neural processing modifications were recently evaluated by fMRI after a pivotal response training intervention. Another study of neural changes in response to treatment examined variations in EEG signaling in patients after an Early Start Denver Model (ESDM) intervention.
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Affiliation(s)
- Roberto Canitano
- Division of Child Neuropsychiatry, University Hospital of Siena , Siena , Italy
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39
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Hadjikhani N, Zürcher NR, Rogier O, Ruest T, Hippolyte L, Ben-Ari Y, Lemonnier E. Improving emotional face perception in autism with diuretic bumetanide: A proof-of-concept behavioral and functional brain imaging pilot study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2013; 19:149-57. [DOI: 10.1177/1362361313514141] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Clinical observations have shown that GABA-acting benzodiazepines exert paradoxical excitatory effects in autism, suggesting elevated intracellular chloride (Cl–)i and excitatory action of GABA. In a previous double-blind randomized study, we have shown that the diuretic NKCC1 chloride importer antagonist bumetanide, that decreases (Cl–)i and reinforces GABAergic inhibition, reduces the severity of autism symptoms. Here, we report results from an open-label trial pilot study in which we used functional magnetic resonance imaging and neuropsychological testing to determine the effects of 10 months bumetanide treatment in adolescents and young adults with autism. We show that bumetanide treatment improves emotion recognition and enhances the activation of brain regions involved in social and emotional perception during the perception of emotional faces. The improvement of emotion processing by bumetanide reinforces the usefulness of bumetanide as a promising treatment to improve social interactions in autism.
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Affiliation(s)
- Nouchine Hadjikhani
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, USA; EPFL, Switzerland
- Gillberg Neuropsychiatric Center, Gothenburg, Sweden
| | - Nicole R Zürcher
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging, USA; EPFL, Switzerland
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40
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Ewing L, Pellicano E, Rhodes G. Using effort to measure reward value of faces in children with autism. PLoS One 2013; 8:e79493. [PMID: 24236140 PMCID: PMC3827355 DOI: 10.1371/journal.pone.0079493] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 09/23/2013] [Indexed: 11/19/2022] Open
Abstract
According to one influential account, face processing atypicalities in autism reflect reduced reward value of faces, which results in limited attention to faces during development and a consequent failure to acquire face expertise. Surprisingly, however, there is a paucity of work directly investigating the reward value of faces for individuals with autism and the evidence for diminished face rewards in this population remains equivocal. In the current study, we measured how hard children with autism would work to view faces, using an effortful key-press sequence, and whether they were sensitive to the differential reward value of attractive and unattractive faces. Contrary to expectations, cognitively able children with autism did not differ from typically developing children of similar age and ability in their willingness to work to view faces. Moreover, the effort expended was strongly positively correlated with facial attractiveness ratings in both groups of children. There was also no evidence of atypical reward values for other, less social categories (cars and inverted faces) in the children with autism. These results speak against the possibility that face recognition difficulties in autism are explained by atypical reward value of faces.
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Affiliation(s)
- Louise Ewing
- Australian Research Council Centre of Excellence in Cognition and its Disorders, School of Psychology, University of Western Australia, Perth, Australia
| | - Elizabeth Pellicano
- Australian Research Council Centre of Excellence in Cognition and its Disorders, School of Psychology, University of Western Australia, Perth, Australia
- Centre for Research in Autism and Education (CRAE), Institute of Education, University of London, London, United Kingdom
| | - Gillian Rhodes
- Australian Research Council Centre of Excellence in Cognition and its Disorders, School of Psychology, University of Western Australia, Perth, Australia
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41
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Verschuur R, Didden R, Lang R, Sigafoos J, Huskens B. Pivotal Response Treatment for Children with Autism Spectrum Disorders: A Systematic Review. REVIEW JOURNAL OF AUTISM AND DEVELOPMENTAL DISORDERS 2013. [DOI: 10.1007/s40489-013-0008-z] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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42
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Sex differences in the development of brain mechanisms for processing biological motion. Neuroimage 2013; 83:751-60. [PMID: 23876243 DOI: 10.1016/j.neuroimage.2013.07.040] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 07/12/2013] [Accepted: 07/15/2013] [Indexed: 11/23/2022] Open
Abstract
Disorders related to social functioning including autism and schizophrenia differ drastically in incidence and severity between males and females. Little is known about the neural systems underlying these sex-linked differences in risk and resiliency. Using functional magnetic resonance imaging and a task involving the visual perception of point-light displays of coherent and scrambled biological motion, we discovered sex differences in the development of neural systems for basic social perception. In adults, we identified enhanced activity during coherent biological motion perception in females relative to males in a network of brain regions previously implicated in social perception including amygdala, medial temporal gyrus, and temporal pole. These sex differences were less pronounced in our sample of school-age youth. We hypothesize that the robust neural circuitry supporting social perception in females, which diverges from males beginning in childhood, may underlie sex differences in disorders related to social processing.
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43
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McCleery JP, Elliott NA, Sampanis DS, Stefanidou CA. Motor development and motor resonance difficulties in autism: relevance to early intervention for language and communication skills. Front Integr Neurosci 2013; 7:30. [PMID: 23630476 PMCID: PMC3634796 DOI: 10.3389/fnint.2013.00030] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 04/11/2013] [Indexed: 01/03/2023] Open
Abstract
Research suggests that a sub-set of children with autism experience notable difficulties and delays in motor skills development, and that a large percentage of children with autism experience deficits in motor resonance. These motor-related deficiencies, which evidence suggests are present from a very early age, are likely to negatively affect social-communicative and language development in this population. Here, we review evidence for delayed, impaired, and atypical motor development in infants and children with autism. We then carefully review and examine the current language and communication-based intervention research that is relevant to motor and motor resonance (i.e., neural "mirroring" mechanisms activated when we observe the actions of others) deficits in children with autism. Finally, we describe research needs and future directions and developments for early interventions aimed at addressing the speech/language and social-communication development difficulties in autism from a motor-related perspective.
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Affiliation(s)
- Joseph P. McCleery
- School of Psychology, University of BirminghamWest Midlands, Birmingham, UK
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44
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Gaffney D. Established and emerging PTSD treatments. Ment Health Clin 2013. [DOI: 10.9740/mhc.n131766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Identifying and describing the numerous types of interventions to treat post-traumatic stress disorder (PTSD) can be a daunting task especially with the numerous therapeutic models and techniques with published case study support. This article will explore the physiology and neurobiology of PTSD. Additionally, it will discuss some of the most common categories of interventions and examples of each (e.g., prolonged exposure therapy, cognitive processing therapy, emotional freedom techniques, reprocessing therapy). Data on d-cycloserine, nabotulinumtoxin A, and methylenedioxymethamphetamine will also be elucidated.
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