Brief Report: A Pilot Study of Parent-Child Biobehavioral Synchrony in Autism Spectrum Disorder

Inter-brain synchrony during mother-infant interactive parenting in 3-4-month-old infants with and without an elevated likelihood of autism spectrum disorder

Maternal bonding for mammalian infants is critical for their survival. Additionally, it is important for human infants' development into social creatures. However, despite the ample neurobiological evidence of attachment for the mother's brain, the interplay of this system in infants is poorly understood. We aimed to identify the neural substrates of synchrony in mothers and infants under three interactive conditions and compare the differences between groups with (n = 16) and without (n = 71) an elevated likelihood of autism spectrum disorder by examining the inter-brain synchrony between mothers and their 3-4-month-old infants. Mother-infant hyperscanning with functional near-infrared spectroscopy was performed during breastfeeding and while each of the mother and experimenter was holding the infants. The results showed almost no group differences, with both groups demonstrating the strongest inter-brain coupling for breastfeeding. The cerebral foci underlying these couplings differed between mothers and infants: the ventral prefrontal cortex, focusing on the right orbitofrontal cortex, in the mother and the left temporoparietal junction in the infant were chiefly involved in connecting the two brains. Furthermore, these synchronizations revealed many significant correlations with behavioral measures, including subsequent language development. The maternal reward-motivational system and the infant's elementary mentalization system seem to underlie mother-infant coupling during breastfeeding.

Applying a Parent Training Program in a Naturalistic Behavior Analytic Context to Improve Attachment in Children with ASD

Infants develop attachment to their caregivers very early on. The quality of attachment is considered to be crucial for the emotional development of humans and animals alike. Despite its importance, very little is known about how attachment develops between children with Autism Spectrum Disorder (ASD) and their caregivers. The purpose of the present study was to assess the attachment patterns of two young children with ASD with their parents and to identify the means for promoting parent, child, and parent-child relational characteristics that may contribute to the development of secure attachment. The results replicated prior findings pertaining to attachment quality of children with ASD and demonstrated the effectiveness of a naturalistic, behavior-analytic intervention in improving the quality of their attachment.

Parent-Child Synchrony After Early Childhood: A Systematic Review

Parent-child synchrony, or the coordination of biological and behavioral processes between parent and child, is thought to promote healthy relationships and support youth adjustment. Although extensive work has been conducted on parent-child synchrony during infancy and early childhood, less is known about synchrony in middle childhood and adolescence and the contextual factors that impact synchrony, particularly physiological synchrony. This is a systematic and qualitative review of 37 studies of behavioral and physiological synchrony in parent-child interactions after early childhood (parents with youth ages 5-18). Behavioral and physiological synchrony were typically identified in youth and their parents beyond early childhood and related to positive outcomes; however, research on father-child synchrony is rarer with mixed findings. Multiple factors are associated with synchrony, including parent and youth psychological symptoms and disorders, parenting factors, such as over-controlling parenting, and parent characteristics, such as interparental aggression and conflict. Few studies have examined behavioral and physiological synchrony simultaneously and longitudinally, limiting our ability to understand the relationship between types of synchrony and later adjustment. Available studies suggest that the context, such as presence of psychopathology or exposure to trauma, influences whether synchrony is associated with positive or negative outcomes. This review highlights the need for additional research to understand the relationship between types of synchrony and the long-term effects and contextual factors that impact youth outcomes.

Interpersonal Physiological Synchrony for Detecting Moments of Connection in Persons With Dementia: A Pilot Study

Interpersonal physiological synchrony has been successfully used to characterize social interactions and social processes during a variety of interpersonal interactions. There are a handful of measures of interpersonal physiological synchrony, but those that exist have only been validated on able-bodied adults. Here, we present a novel information-theory based measure of interpersonal physiological synchrony-normalized Symbolic Transfer Entropy (NSTE)-and compare its performance with a popular physiological synchrony measure-physiological concordance and single session index (SSI). Using wearable sensors, we measured the electrodermal activity (EDA) of five individuals with dementia and six able-bodied individuals as they participated in a movement activity that aimed to foster connection in persons with dementia. We calculated time-resolved NSTE and SSI measures for case studies of three dyads and compared them against moments of observed interpersonal connection in video recordings of the activity. Our findings suggest that NSTE-based measures of interpersonal physiological synchrony may provide additional advantages over SSI, including resolving moments of ambiguous SSI and providing information about the direction of information flow between participants. This study also investigated the feasibility of using interpersonal synchrony to gain insight into moments of connection experienced by individuals with dementia and further encourages exploration of these measures in other populations with reduced communicative abilities.

Father-Child Interactions in Preschool Children with ASD: A Systematic Review

Studies on parental interaction in the context of ASD has mainly focused on mothers, even if fathers and their children seem to form close and supportive relationships that may have unique effects on child development. Given the impact of ASD symptoms on a child's ability to interact with significant others, recent findings strengthen the importance of including caregivers during treatment to guarantee a better adaptation to the child's impairments. Despite this, fathers are scarcely involved, and interventions seem to not be tailored to their interactive characteristics and needs. For this reason, a systematic review was conducted to investigate fathers and children with ASD behaviors during interaction. This review found 12 observational studies that identified social, cognitive, and affective interactive modalities in father-child dyads through three psychology-focused journal databases: PubMed, PsycINFO and Scopus. The significant variation in both sample size and in the measures used to assess dyadic outcomes limits the ability of this work to make robust recommendations for intervention. Despite this, the results revealed characteristic behaviors of this dyad that consequently allow specific targets to be worked on during intervention. In fact, from fathers' individual strengths and weaknesses, it is possible to implement interventions that are complementary with maternal characteristics from the perspective of personalized and optimized treatment.

Dysfunction in interpersonal neural synchronization as a mechanism for social impairment in autism spectrum disorder

Social deficits in autism spectrum disorder (ASD) have been linked to atypical activation of the mentalizing network. This work, however, has been limited by a focus on the brain activity of a single person during computerized social tasks rather than exploring brain activity during in vivo interactions. The current study assessed neural synchronization during a conversation as a mechanism for social impairment in adults with ASD (n = 24) and matched controls (n = 26). Functional near-infrared spectroscopy (fNIRS) data were collected from the prefrontal cortex (PFC) and tempoparietal junction (TPJ). Participants self-reported on their social communication and videos of the interaction were coded for utterances and conversational turns. As expected, controls showed more neural synchrony than participants with ASD in the TPJ. Also as expected, controls showed less social communication impairment than participants with ASD. However, participants with ASD did not have fewer utterances compared with control subjects. Overall, less neural synchrony in the TPJ was associated with higher social impairment and marginally fewer utterances. Our findings advance our understanding of social difficulties in ASD by linking them to decreased neural synchronization of the TPJ. LAY SUMMARY: The coordination of brain responses is important for efficient social interactions. The current study explored the coordination of brain responses in neurotypical adults and adults with ASD to investigate if difficulties in social interactions are related to difficulties coordinating brain responses in ASD. We found that participants with ASD had more difficulties coordinating brain responses during a conversation with an interacting partner. Additionally, we found that the level of coordination in brain responses was linked to problems with social communication.

Interpersonal Synchrony in the Context of Caregiver-Child Interactions: A Document Co-citation Analysis

Social interactions accompany individuals throughout their whole lives. When examining the underlying mechanisms of social processes, dynamics of synchrony, coordination or attunement emerge between individuals at multiple levels. To identify the impactful publications that studied such mechanisms and establishing the trends that dynamically originated the available literature, the current study adopted a scientometric approach. A sample of 543 documents dated from 1971 to 2021 was derived from Scopus. Subsequently, a document co-citation analysis was conducted on 29,183 cited references to examine the patterns of co-citation among the documents. The resulting network consisted of 1,759 documents connected to each other by 5,011 links. Within the network, five major clusters were identified. The analysis of the content of the three major clusters-namely, "Behavioral synchrony," "Towards bio-behavioral synchrony," and "Neural attunement"-suggests an interest in studying attunement in social interactions at multiple levels of analysis, from behavioral to neural, by passing through the level of physiological coordination. Furthermore, although initial studies on synchrony focused mostly on parent-child interactions, new hyperscanning paradigms are allowing researchers to explore the role of biobehavioral synchrony in all social processes in a real-time and ecological fashion. Future potential pathways of research were also discussed.

Brain and motor synchrony in children and adolescents with ASD-a fNIRS hyperscanning study

Brain-to-brain synchrony has been proposed as an important mechanism underlying social interaction. While first findings indicate that it may be modulated in children with autism spectrum disorder (ASD), no study to date has investigated the influence of different interaction partners and task characteristics. Using functional near-infrared spectroscopy hyperscanning, we assessed brain-to-brain synchrony in 41 male typically developing (TD) children (8–18 years; control sample), as well as 18 children with ASD and age-matched TD children (matched sample), while performing cooperative and competitive tasks with their parents and an adult stranger. Dyads were instructed either to respond jointly in response to a target (cooperation) or to respond faster than the other player (competition). Wavelet coherence was calculated for oxy- and deoxyhemoglobin brain signals. In the control sample, a widespread enhanced coherence was observed for parent–child competition, and a more localized coherence for parent–child cooperation in the frontopolar cortex. While behaviorally, children with ASD showed a lower motor synchrony than children in the TD group, no significant group differences were observed on the neural level. In order to identify biomarkers for typical and atypical social interactions in the long run, more research is needed to investigate the neurobiological underpinnings of reduced synchrony in ASD.

Improving a Parent Coaching Model of Music Interventions for Young Autistic Children

Parenting a child on the autism spectrum can be rewarding and enriching, but it may also increase risk of parental fatigue, stress, anxiety, and depression. Parent-mediated interventions contribute to increase family satisfaction and child social communication while helping to decrease parental stress and fatigue. Parent coaching, the education of parents in evidence-based strategies, has become common in the autism field. However, parent coaching in music therapy has only recently emerged and has limited research with families with an autistic member. In this study, we attempted to improve a previously published model of parent coaching, adapting only one aspect of the Early Start Denver Model (ESDM), the sensory social routine (SSR) to create a music intervention. Four parents participated in this 6-session parent coaching study. We compared the SSR-based intervention with and without music, in an alternating treatment design. Measures included parental responsiveness, child receptive and initiation joint attention, parent-child similar affect and synchronized gaze, and the Parent Coaching-ESDM (PC-ESDM) parent fidelity rating system. Results from these observational measures were mixed, with better parental responses in the no-music condition, but improved child responses and parent-child synchrony in the music condition for 3 out of the 4 participants. Parent learning increased for all participants, and 3 out of the 4 reached fidelity (a score of at least 80%), according to the PC-ESDM. Although mixed results were observed across participants, implications for practice are possible. Better outcome measures of this complex intervention are needed.

Quantifying the Child-Therapist Interaction in ASD Intervention: An Observational Coding System

BACKGROUND

Observational research plays an important part in developmental research due to its noninvasiveness. However, it has been hardly applied to investigate efficacy of the child-therapist interaction in the context of naturalistic developmental behavioral interventions (NDBI). In particular, the characteristics of child-therapist interplay are thought to have a significant impact in NDBIs in children with autism spectrum disorder (ASD). Quantitative approaches may help to identify the key features of interaction during therapy and could be translated as instruments to monitor early interventions.

METHODS

n = 24 children with autism spectrum disorder (ASD) were monitored from the time of the diagnosis (T0) and after about one year of early intervention (T1). A novel observational coding system was applied to video recorded sessions of intervention to extract quantitative behavioral descriptors. We explored the coding scheme reliability together with its convergent and predictive validity. Further, we applied computational techniques to investigate changes and associations between interaction profiles and developmental outcomes.

RESULTS

Significant changes in interaction variables emerged with time, suggesting that a favorable outcome is associated with interactions characterized by increased synchrony, better therapist's strategies to successfully engage the child and scaffold longer, more complex and engaging interchanges. Interestingly, data models linked interaction profiles, outcome measures and response trajectories.

CONCLUSION

Current research stresses the need for process measures to understand the hows and the whys of ASD early intervention. Combining observational techniques with computational approaches may help in explaining interindividual variability. Further, it could disclose successful features of interaction associated with better response trajectories or to different ASD behavioral phenotypes that could require specific dyadic modalities.

Attunement and Paternal Characteristics in Care Relationships in the Presence of Children Diagnosed with Autism

Parents of children with autism spectrum disorder (ASD) have to address various challenges mainly due to their children’s atypia related to communication, emotion regulation and behaviors, arising also within the relationship with their caregivers. Several studies have pointed out that children with ASD can exhibit many difficulties regarding initiating and maintaining meaningful relationships with others. To date, little research has explored the interactions between children with ASD and their fathers, focusing more on mothers. In the context of parent–child interactions in the presence of autism, recent studies have highlighted the importance of parental attunement but there is little research considering solely the affective-bodily dimension. Therefore, the aim of the present study was to explore the parental attunement in fathers of children with ASD observed during play interactions and to investigate the relationship between paternal attunement and the perception of their psychological characteristics related to care relationships. The results highlight that fathers who describe themselves as better in affective care and sensitivity toward others more likely have an absence of paternal attunement during play interactions. The data presented are discussed in the light of intervention hypotheses, aimed at improving the relationship between fathers and children with autism.

A systematic review of caregiver-child physiological synchrony across systems: Associations with behavior and child functioning

Extensive research has established a positive association between caregiver-child behavioral synchrony and child developmental functioning. Burgeoning research examining physiological synchrony has yet to elucidate its impact for children's developing self-regulation. The objectives of this systematic review were to: 1) determine whether there is evidence that caregiver-child physiological synchrony promotes positive child development, 2) examine developmental differences in physiological synchrony and its correlates, and 3) explore whether context, risk, and/or stress influence patterns of synchrony. Sixty-nine studies met the following criteria on PubMed and PsycINFO: 1) peer-reviewed empirical articles in English that 2) examine autonomic, hypothalamic-pituitary-adrenocortical, and/or central nervous system activity 3) for caregivers and children 4) in response to a task and 5) directly examine the association between caregiver and child physiology. Findings varied based on developmental period and current behavioral context. Functional differences may exist across physiological systems and contexts. Synchrony may have different developmental consequences for dyads with and without certain risk factors. Few studies examine physiological synchrony across multiple systems or contexts, nor do they measure child characteristics associated with synchrony. Statistical and methodological challenges impede interpretation. Findings generally support the idea that physiological synchrony may support children's developing self-regulation. Longitudinal research is needed to examine child developmental outcomes over time.

Mother-father physiological synchrony during conflict and moderation by parenting challenges: Findings from parents of children with autism spectrum disorder

INTRODUCTION

Despite robust evidence in the broader family process literature for within-couple associations between romantic partners' physiological responding, this linkage has not been tested directly among parents raising a child with autism spectrum disorder (ASD). Explicit attention to these parents is warranted on the basis of the established family-wide challenges associated with the persistent emotional, functional, and behavior impairments typically observed in children with ASD (see Karst & Van Hecke, 2012). The first purpose of this study is to extend examination of within-couple associations between electrodermal activity (EDA) to mothers and fathers of children with ASD. The second purpose is to test 2 potential moderators of EDA synchrony reflecting heightened challenges among parents of children with ASD, namely parenting as an observed conflict topic and global parenting stress.

METHOD

Both parents wore wrist sensors that captured continuous EDA during a recorded marital conflict interaction. Trained coders provided ratings of emotional intensity and conflict topics, including whether the topic of parenting was discussed. Parents reported their global level of parenting stress. Dyadic multilevel modeling was used to test our hypotheses and accounted for interaction factors (e.g., movement data, emotional intensity).

RESULTS

Findings identified significant positive associations between parents' EDA. One moderator result emerged; specifically, father EDA was a stronger predictor of mother EDA when parenting was discussed as a conflict topic.

CONCLUSION

This study extends evidence of within-couple physiological linkage to parents raising a child with ASD and provides a foundation for future research examining the family-wide implications of this linkage. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Synchrony of Respiratory Sinus Arrhythmia in Parents and Children with Autism Spectrum Disorder: Moderation by Interaction Quality and Child Behavior Problems

Parent-child physiological synchrony, the matching of physiological states between parents and children, is theorized to be important for typically developing (TD) children, but less is known about this process in families of children with autism spectrum disorder (ASD). In a sample of 29 children (M age = 8.00 years, SD = 1.51 years) with ASD and 39 TD-matched children (M age = 7.32 years, SD = 1.36 years) and their primary caregivers (n = 68), we examined whether parent-child dyads showed physiological synchrony indexed by respiratory sinus arrhythmia (RSA) during an interaction, and whether RSA synchrony differed by parent-child interaction quality and child behavior problems. Results indicated that dyads with TD children showed stronger positive RSA synchrony than dyads with children with ASD. Furthermore, for families of children with ASD, RSA synchrony was stronger in families with higher interaction quality and fewer child internalizing problems. These results provide preliminary evidence of parent-child RSA synchrony in families of children with ASD and identify factors that may influence this physiological process. Implications of these findings for social and emotional development in children with ASD are discussed. LAY SUMMARY: Parents and children can get "in tune" with one another at the biological level - a process called physiological synchrony. We studied physiological synchrony in families of children with autism spectrum disorder (ASD) in comparison to same-aged children who had no mental health disorders. We also examined how physiological synchrony might be associated with parent-child interaction quality and child behavior problems. We found that families with a child with ASD showed weaker physiological synchrony than families with a child who was typically developing. Further, we found that physiological synchrony was stronger when parents and children with ASD showed higher interaction quality and when children with ASD had lower internalizing problems. These findings contribute to our understanding of family functioning in the context of ASD and have potential implications for future work.

Parental Attunement, Insightfulness, and Acceptance of Child Diagnosis in Parents of Children With Autism: Clinical Implications

Early parent-child relationships are an important factor influencing many domains of child development, even in the presence of autism. In this study, we investigated the associations between parent-child attunement during play, parental insightfulness, and parental acceptance of their child's diagnosis of an autism spectrum disorder. A sample of 50 parents (26 mothers and 24 fathers) of 26 children aged between 24 and 58 months were videotaped during parent-child play interactions and then interviewed about what they thought had gone through their child's head during the play interaction, and about their feelings and thoughts about their child's diagnosis. Play interactions were evaluated using a coding protocol to assess parental attunement. The results showed that parents who were more able to accept their child's diagnosis and to see things from their child's perspective were more likely to also be attuned during play interactions with their children. These findings highlight the importance of studying the parental ability of insightfulness and acceptance of their child diagnosis of ASD for the implementation of intervention programs for supporting parental attunement and improving the interactions between the parents and the children with autism spectrum disorders.

Physiological arousal and observed behaviour in parent-child interactions involving young children with Down syndrome

BACKGROUND

Parents of children with Down syndrome (DS) play an important role in their child's development. Physiological measures, such as electrodermal activity (EDA), can shed light on parent-child relations beyond the behavioural level. The goals of the current study were to assess the feasibility of collecting EDA data in preschool age children with DS, examine the association between parent and child EDA during play-based interactions, and investigate the relation between parent and child EDA and observed parent behaviours.

METHOD

Two parents in 15 families participated in dyadic free play interactions with their child with DS (i.e., 15 mother-child and 15 father-child interactions). The children with DS (aged 24-61 months) and both of their parents wore multisensory wristbands measuring EDA. Parent behaviours were coded as requests for behavioural complies, requests for verbal complies, or comments.

RESULTS

Usable EDA data were collected for 13/15 children and 11/15 mothers during the mother-child interactions and 14/15 children and 12/15 fathers during the father-child interactions. Parent and child EDA variability was significantly positively related for father-child but not mother-child dyads. Maternal use of requests for behavioural complies was positively related to child EDA variability.

CONCLUSIONS

The collection of EDA data through wristbands worn by young children with DS during early parent-child interactions was feasible. Preliminary findings indicated that some aspects of parent and child physiology in DS may be related in different ways for mother-child and father-child dyads.

Adolescents at risk of anxiety in interaction with their fathers: Studying non-verbal and physiological synchrony

Adolescence is a vulnerable period in terms of the onset of anxiety disorders, and dyadic parent-adolescent interactions may play a key role in either increasing or reducing the risk of psychopathologies. This study examines the presence of physiological synchrony (specifically, linkage in interbeat interval series) and non-verbal synchrony in positive and negative interactions between adolescents (aged 13-16) and their fathers. Non-verbal synchrony was quantified through the coordination of the interactants' body movements, using an automated video-analysis algorithm (motion energy analysis). Participants were made up of 53 parent-adolescent dyads, the latter at either low (n = 28) or high (n = 25) risk of anxiety. Adolescents at low risk of anxiety displayed statistically significant levels of non-verbal synchrony with their fathers during positive interactions. Non-verbal synchrony was not found in the father-adolescent dyads featuring adolescents at high risk of anxiety. Physiological synchrony was not significantly present above chance level in either of the groups of adolescents. Overall, the results suggest that adolescents at high risk of anxiety may have difficulties in managing non-distressing interactions with their fathers. The results also suggest that physiological synchrony is not a straightforward phenomenon.

Interpersonal Synchrony in Autism

PURPOSE OF REVIEW

We review evidence for the presence, quality, and correlates of interpersonal synchrony in autism spectrum disorder (ASD) across four domains: motor, conversational, physiological, and neural. We also propose cognitive and neural mechanisms for the disruption of interpersonal synchrony and investigate synchrony as a mechanism of intervention in ASD.

RECENT FINDINGS

Across domains, synchrony is present but reduced or atypical in individuals with ASD during interactions with individuals with typical development (TD). Atypical synchrony may reflect the contribution of both intrapersonal mechanisms, such as atypical motor timing, and interpersonal mechanisms, such as atypical interindividual coupling. Research suggests evidence for synchrony interventions leading to improvements in some aspects of social behavior. Understanding synchrony in ASD has the potential to lead to biomarkers and interventions to support social functioning. However, further research should clarify mechanisms of atypical synchrony in ASD including taking features of the dyad into account.

Feasibility of Parent Coaching of Music Interventions for Children With Autism Spectrum Disorder

Parent-mediated interventions for children with autism spectrum disorder (ASD) have elicited emerging interest among music therapists. A conceptual framework (reported elsewhere) delineated the incorporation of music to an established parent coaching model (Parent-Early Start Denver Model [P-ESDM];). The purpose of this study was to explore the feasibility of adapting the P-ESDM to a music-based parent coaching model. An alternating treatments design with a parent–child dyad was implemented, with music and non-music conditions in each treatment session. Behavioral video analysis of parental verbal and non-verbal responsiveness, child joint attention and verbal behaviors, and parent and therapist adherence to treatment provided quantitative data. A semi-structured follow-up interview with a parent addressed concerns, preferences, and suggestions for improvement. Parental verbal responsiveness seemed lower during the music condition, but non-verbal responsiveness increased notably during the music condition. Parent adherence to treatment was achieved in the sixth session. Child receptive joint attention increased in the music condition only, and initiating joint attention was higher in most sessions during the music condition. Parental comfort with the music did not seem ideal with the brief time allotted to training despite familiarity with the music. Music-based parent coaching to enhance social communication of preschoolers with ASD seems feasible. This study provides initial support to a conceptual framework of parent coaching of music interventions. Further research should investigate other methods to teach the music, alternative session schedules, and more precise measures of parental responsiveness.

Pre-emptive Intervention for Autism Spectrum Disorder: Theoretical Foundations and Clinical Translation

Autism spectrum disorders (ASD) are an emergent public health problem, placing significant burden upon the individual, family and health system. ASD are polygenetic spectrum disorders of neural connectome development, in which one or more feedback loops amplify small genetic, structural, or functional variations in the very early development of motor and sensory-motor pathways. These perturbations trigger a 'butterfly effect' of unpredictable cascades of structural and functional imbalances in the global neuronal workspace, resulting in atypical behaviors, social communication, and cognition long-term. The first 100 days post-term are critically neuroplastic and comprise an injury-sensitive developmental window, characterized by a neural biomarker, the persistence of the cortical subplate, and a behavioral biomarker, the crying diathesis. By the time potential diagnostic signs are identified, from 6 months of age, ASD neuropathy is already entrenched. The International Society for Autism Research Special Interest Group has called for pre-emptive intervention, based upon rigorous theoretical frames, and real world translation and evaluation. This paper responds to that call. It synthesizes heterogenous evidence concerning ASD etiologies from both psychosocial and biological research literatures with complexity science and evolutionary biology, to propose a theoretical framework for pre-emptive intervention. This paper hypothesizes that environmental factors resulting from a mismatch between environment of evolutionary adaptedness and culture initiate or perpetuate early motor and sensory-motor lesions, triggering a butterfly effect of multi-directional cascades of atypical developmental in the complex adaptive system of the parent and ASD-susceptible infant. Chronic sympathetic nervous system/hypothalamic-pituitary-adrenal axis hyperarousal and disrupted parent-infant biobehavioral synchrony are the key biologic and behavioral mechanisms perpetuating these atypical developmental cascades. A clinical translation of this evidence is proposed, for application antenatally and in the first 6 months of life, as pre-emptive intervention for ASD.

Effectiveness of Noise-Attenuating Headphones on Physiological Responses for Children With Autism Spectrum Disorders

Objective: The purpose of this study was to evaluate the proof of concept of an intervention to decrease sympathetic activation as measured by skin conductivity (electrodermal activity, EDA) in children with an autism spectrum disorder (ASD) and auditory hypersensitivity (hyperacusis). In addition, researchers examined if the intervention provided protection against the negative effects of decibel level of environmental noises on electrodermal measures between interventions. The feasibility of implementation and outcome measures within natural environments were evaluated.

Method: A single-subject multi-treatment design was used with six children, aged 8–16 years, with a form of Autism (i.e., Autism, PDD-NOS). Participants used in-ear (IE) and over-ear (OE) headphones for two randomly sequenced treatment phases. Each child completed four phases: (1) a week of baseline data collection; (2) a week of an intervention; (3) a week of no intervention; and (4) a week of the other intervention. Empatica E4 wristbands collected EDA data. Data was collected on 16–20 occasions per participant, with five measurements per phase.

Results: Separated tests for paired study phases suggested that regardless of intervention type, noise attenuating headphones led to a significance difference in both skin conductance levels (SCL) and frequency of non-specific conductance responses (NS-SCRs) between the baseline measurement and subsequent phases. Overall, SCL and NS-SCR frequency significantly decreased between baseline and the first intervention phase. A protective effect of the intervention was tested by collapsing intervention results into three phases. Slope correlation suggested constant SCL and NS-SCR frequency after initial use of the headphones regardless of the increase in environmental noises. A subsequent analysis of the quality of EDA data identified that later phases of data collection were associated with better data quality.

Conclusion: Many children with ASD have hypersensitivities to sound resulting in high levels of sympathetic nervous system reactivity, which is associated with problematic behaviors and distress. The findings of this study suggest that the use of noise attenuating headphones for individuals with ASD and hyperacusis may reduce sympathetic activation. Additionally, results suggest that the use of wearable sensors to collect physiological data in natural environments is feasible with established protocols and training procedures.

Parental criticism and behavior problems in children with autism spectrum disorder

Associations between parent critical attitudes (a component of the Expressed Emotion construct) and behavior problems have been relatively well established in adolescents and young adults with autism spectrum disorder, but use of systems adapted for children with autism spectrum disorder and additional investigations with younger samples are needed. This study examined parental criticism, derived from a population-specific coding system, as related to behavior problems in children with autism spectrum disorder between the ages of 4 and 11 years, and considered parental warmth and children's psychophysiological reactivity as statistical moderators of these associations. In all, 40 children with autism spectrum disorder and their primary caregivers attended a visit involving collection of child electrodermal activity, parent-child interaction, a parent interview from which critical attitudes and warmth were coded, and parent report of child behavior problems. Criticism was directly related to higher child externalizing but not internalizing problems. Parental criticism interacted with warmth in the prediction of internalizing problems such that criticism was only associated with more problems in the context of moderate but not high warmth. Criticism was positively associated with externalizing problems under conditions of moderate and high, but not low, child electrodermal activity reactivity. Implications for conceptualizations of parental criticism in autism spectrum disorder, for understanding comorbid behavior problems in this population, and for intervention are discussed.

Broader autism phenotype and couple interactions in parents of children with autism

The broader autism phenotype refers to sub-clinical autism spectrum disorder characteristics involving socially and emotionally aloof and rigid personality traits and social communication difficulties. Relatives of individuals with autism spectrum disorder, including parents, evidence an increased rate of broader autism phenotype. The goal of this study was to evaluate the association between actor (one's own) and partner (their partner's) broader autism phenotype and the self-reported, observed, and physiological (i.e. electrodermal reactivity) markers of the quality of videotaped couple problem-solving interactions in 158 couples, who had a child with autism spectrum disorder (aged 5-12 years). The mean age of mothers was 39.79 (standard deviation = 5.06) years and the mean age of fathers was 41.77 (standard deviation = 6.02) years for fathers, and 36.6% of parents did not have a college degree. Actor-partner interdependence models, using structural equation modeling in analysis of moment structures, were conducted. Results indicated that parent broader autism phenotype was positively related to adverse couple problem-solving interactions across all measurement methods (observed codes, self-reported affect, and electrodermal reactivity). These effects were independent of child-related challenges. The effect of parent broader autism phenotype occurred through both actor and partner pathways and was strongest for father broader autism phenotype.

Parenting behavior and the development of children with autism spectrum disorder

Autism spectrum disorders (ASD) are neurodevelopmental disorders in which multiple genetic and environmental factors play roles. Symptoms of deficits in social communication and restrictive, repetitive behavioral patterns emerge early in a child's development. While parents do not cause these difficulties, impairments in social relatedness can strain parent child interactions and parental stress can have negative transactional effects that impede children development. Conversely, as with typically developing children, parental behavior can also enhance development in ASD and parents play a role in many interventions. In this review we examine parental contributions to the development of children with ASD, focusing on social communication and emotion regulation. We address parent and family characteristics that may impede development so they can be identified in families and interventions developed to target them.

Marching to the beat of your own drum?: A proof-of-concept study assessing physiological linkage in Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by difficulty in dynamically adjusting behavior to interact effectively with others, or social reciprocity. Synchronization of physiological responses between interacting partners, or physiological linkage (PL), is thought to provide a foundation for social reciprocity. In previous work we developed a new technique to measure PL using dynamic linear time series modeling to assess cardiac interbeat interval (IBI) linkage in typically developing same-sex unacquainted dyads (Scarpa et al., 2017). The current article describes a proof-of-concept study with three dyads of young adults with ASD interacting with same-sex unacquainted typically developing (TD) partners. This pilot data is applied to propose potential benefits of using this technique to quantify and assess PL in individuals with ASD, both for basic research and for intervention science. Discussion focuses on applications of this measure to potentially advance knowledge of the biology-behavior link in ASD.

A systematic review of parent-child synchrony: It is more than skin deep

This manuscript provides a critical review of the literature on parent-child physiological synchrony-the matching of biological states between parents and children. All eligible studies found some evidence of physiological synchrony, though the magnitude and direction of synchrony varied according to methodological factors, including the physiological system examined (i.e., parasympathetic or sympathetic nervous system activity, adrenocortical functioning) and the statistical approach used (e.g., multilevel modeling, correlation). The review underscores the need to consider the context in which physiological synchrony occurs (e.g., family risk) to best understand its significance. Furthermore, the review delineates vital avenues for future research, including the need to assess synchrony across multiple physiological systems and the importance of documenting continuity/change in physiological synchrony across developmental periods. Such research is crucial for understanding how the parent-child relationship unfolds at a physiological level and, in turn, how this relationship can facilitate or hinder parent, child, and family adjustment.

Neural signatures of chronic accessibility in parent - adult child attachment bonds

Some of the closest reciprocal relationships are between parents and their children. As part of the attachment characterizing many parent-child bonds, individuals form mental representations that are chronically accessible and calibrate expectations for future relationships. We predict that there exist unique neural signatures of this chronic accessibility. Young (N = 29, 16 females) and older adults (N = 27, 12 females) made trait judgments for parent or child, respectively, during fMRI scanning. Multivariate analysis identified whole-brain patterns of activation that covaried with the magnitude of parent-child attachment when thinking about that individual. Higher levels of parent and child attachment were associated with lower neural recruitment in anterior cingulate cortex, amygdala, posterior cingulate cortex, medial temporal lobe, and occipital face area. Results provide novel evidence for neural signatures of chronic accessibility, as bringing to mind one's attached parent or child requires less engagement of brain regions involved in distress relief, memory, and facial processing.

Sympathetic Under-Arousal and Externalizing Behavior Problems in Children with Autism Spectrum Disorder

Children with autism spectrum disorder (ASD) commonly exhibit co-occurring externalizing behavior problems, which can impede learning opportunities and contribute significantly to caregiver stress. Substantial theory and research has linked under-arousal of the sympathetic nervous system to increased externalizing problems in children without ASD, but under-arousal has not been considered as an explanatory mechanism for individual differences among children with ASD. We tested the notion that lower electrodermal activity (EDA) would predict more externalizing problems in children with ASD, and considered the degree to which parent co-regulatory support could buffer this risk. Forty children with ASD between the ages of 4 and 11 years and their primary caregivers participated in a laboratory visit that included various play, compliance, and problem-solving regulatory tasks. EDA was measured through wireless wrist sensors, parental scaffolding was observed during a dyadic problem-solving task, and parents rated their children's externalizing behavior problems. As predicted, low EDA during the compliance-oriented tasks directly predicted higher child externalizing problems. Parental scaffolding moderated the link between under-arousal during the problem-solving regulatory tasks and externalizing problems such that the relation was observed in the context of low, but not high, support. Implications for relevant theories (e.g., fearlessness theory, stimulation-seeking theory) are discussed, and the potential for psychophysiological patterns to inform intervention with these children is considered.

Leo Kanner and autism: a 75-year perspective

In 1943, Leo Kanner published the first systematic description of early infantile autism. He concluded that this was a neurodevelopmental disorder and that 'these children have come into the world with an innate inability to form the usual, biologically provided contact with people'. Moreover, his astute descriptions of parental behavior in his first publications were prescient and underlie later recognition of the importance of genetics. Our understanding has grown over the ensuing years with revisions in diagnostic classification, recognition of the broader autism phenotype in families, appreciation of the importance of developmental models, advances in genetic methodology, better understanding of the relationship to intellectual deficits, recognition of syndromic autism in neurogenetic sydromes, advances in neuroimaging, and advances in animal models, both mutant mouse models and transgenic non human primate models. Kanner recognized diagnostic heterogeneity and opined that the children had not read those diagnostic manuals and did not easily fall into clear cut categories. Such heterogeneity continues to confound our diagnostic efforts. Always an advocate for children, when reviewing the DSM III criteria in 1980, Kanner emphasized that no matter how well developed our criteria each child must be treated as a unique person.

Electrodermal Variability and Symptom Severity in Children with Autism Spectrum Disorder

Associations between variability in sympathetic nervous system arousal and individual differences in symptom severity were examined for children with autism spectrum disorder (ASD). Thirty-four families participated in a laboratory visit that included continuous measurement of electrodermal activity (EDA) during a battery of naturalistic and structured parent-child, child alone, and direct testing tasks. Multiple indices of EDA were considered. Greater variability in EDA was associated with higher levels of ASD symptoms, with findings generally consistent across tasks. Intellectual functioning did not moderate the relation between EDA and ASD symptoms. Sympathetic arousal tendencies may represent an important individual difference factor for this population. Future directions and conceptualizations of EDA are discussed.

Oxytocin and parent-child interaction in the development of empathy among children at risk for autism

This longitudinal study investigated whether variation in the oxytocin receptor gene (OXTR) and early parent-child interactions predicted later empathic behavior in 84 toddlers at high or low familial risk for autism spectrum disorder. Two well-studied OXTR single-nucleotide polymorphisms, rs53576 and rs2254298, were examined. Parent-child interaction was measured at 15 and 18 months of age during free play sessions. Empathy was measured at 24 and 30 months using a response to parental distress paradigm. While there was no direct association between parent-child interaction quality or OXTR and empathy, rs53576 moderated the relation between interaction quality and empathy. Results suggest that the interplay between OXTR and early parent-child interactions predicts individual differences in empathy in children at varying risk for atypical social development. Findings are consonant with a differential susceptibility model in which an OXTR variant may increase the social salience of interaction processes for specific allele carriers. These results increase our understanding of predictors of empathy development in young children with a wide range of social outcomes. (PsycINFO Database Record

Interpersonal Autonomic Physiology: A Systematic Review of the Literature

Interpersonal autonomic physiology is defined as the relationship between people’s physiological dynamics, as indexed by continuous measures of the autonomic nervous system. Findings from this field of study indicate that physiological activity between two or more people can become associated or interdependent, often referred to as physiological synchrony. Physiological synchrony has been found in both new and established relationships across a range of contexts, and it correlates with a number of psychosocial constructs. Given these findings, interpersonal physiological interactions are theorized to be ubiquitous social processes that co-occur with observable behavior. However, this scientific literature is fragmented, making it difficult to evaluate consistency across reports. In an effort to facilitate more standardized scholarly approaches, this systematic review provides a description of existing work in the area and highlights theoretical, methodological, and statistical issues to be addressed in future interpersonal autonomic physiology research.