Intact Prototype Formation but Impaired Generalization in Autism

Category learning in autistic individuals: A meta-analysis

Learning new categories is a fundamental human skill. In the present article, we report the first comprehensive meta-analysis of category learning in autism. Including studies comparing groups of autistic and nonautistic individuals, we investigated whether autistic individuals differ in category learning from nonautistic individuals. In addition, we examined moderator variables accounting for variability between studies. A multilevel meta-analysis of k = 50 studies examining n = 1,220 autistic and n = 1,445 nonautistic individuals based on 112 effect sizes in terms of the standardized mean difference revealed lower-level category learning skills for autistic compared with nonautistic individuals, g = -0.55, 95% CI = [-0.73, -0.38], p < .0001. According to moderator analyses, the significant amount of heterogeneity, Q(111) = 617.88, p < .0001, was explained by only one of the moderator variables under investigation-namely, study language. For the remaining variables-namely, age, year of publication, risk of bias, type of control group, IQ of autistic group, percentage of male autistic participants, type of category, type of task, and type of dependent measure-there were no significant effects. Although hat values and Cook's distance statistics confirmed the robustness of findings, results of Egger's test and a funnel plot suggested the presence of publication bias reflecting an overrepresentation of disadvantageous findings for autistic groups. Objectives for future work include identifying additional moderator variables, examining downstream effects of suboptimal category learning skills, and developing interventions.

Disentangling sensory precision and prior expectation of change in autism during tactile discrimination

Predictive coding theories suggest that core symptoms in autism spectrum disorders (ASD) may stem from atypical mechanisms of perceptual inference (i.e., inferring the hidden causes of sensations). Specifically, there would be an imbalance in the precision or weight ascribed to sensory inputs relative to prior expectations. Using three tactile behavioral tasks and computational modeling, we specifically targeted the implicit dynamics of sensory adaptation and perceptual learning in ASD. Participants were neurotypical and autistic adults without intellectual disability. In Experiment I, tactile detection thresholds and adaptation effects were measured to assess sensory precision. Experiments II and III relied on two-alternative forced choice tasks designed to elicit a time-order effect, where prior knowledge biases perceptual decisions. Our results suggest a subtler explanation than a simple imbalance in the prior/sensory weights, having to do with the dynamic nature of perception, that is the adjustment of precision weights to context. Compared to neurotypicals, autistic adults showed no difference in average performance and sensory sensitivity. Both groups managed to implicitly learn and adjust a prior that biased their perception. However, depending on the context, autistic participants showed no, normal or slower adaptation, a phenomenon that computational modeling of trial-to-trial responses helped us to associate with a higher expectation for sameness in ASD, and to dissociate from another observed robust difference in terms of response bias. These results point to atypical perceptual learning rather than altered perceptual inference per se, calling for further empirical and computational studies to refine the current predictive coding theories of ASD.

Generalization Task for Developing Social Problem-Solving Skills among Young People with Autism Spectrum Disorder

This study aims to examine the usefulness of an ad hoc worksheet for an Interpersonal Problem-Solving Skills Program (SCI-Labour) the effectiveness of which was tested by Bonete, Calero, and Fernández-Parra (2015). Data were taken from 44 adolescents and young adults with Autism Spectrum Disorder (ASD) (age M = 19.73; SD = 3.53; 39 men and 5 women; IQ M = 96.27, SD = 15.98), compared to a matched group (in age, sex, and nonverbal IQ) of 48 neurotypical participants. The task was conceived to promote the generalization of interpersonal problem-solving skills by thinking on different possible scenarios in the workplace after the training sessions. The results show lower scores in the worksheet delivered for homework (ESCI-Generalization Task) in the ASD Group compared to neurotypicals in total scores and all domains (Problem Definition, Quality of Causes, and Solution Suitability) prior to program participation. In addition, after treatment, improvement of the ASD Group was observed in the Total Score ESCI-Generalization Task and in the domains of Problem Definition, Quality of Causes, Number or Alternatives and Consequences, Time, and Solution Suitability. This is a valuable task in furthering learning within the SCI-Labour Program and may be a supplementary material in addressing the difficulties of interpersonal skills within this population, both in the workplace and in daily life. In conclusion, this task may provide useful information for identifying key difficulties among this population and could be implemented in a clinical setting as a complement to the SCI-Labour Program.

Neural correlates of schema-dependent episodic memory and association with behavioral flexibility in autism spectrum disorders and typical development

BACKGROUND

Conceptual knowledge frameworks termed schemas facilitate memory formation and are posited to support flexible behavior. In adults, the medial temporal lobe (MTL) and medial prefrontal cortex (mPFC) trade-off in supporting schema-based memory formation, such that encoding of subsequently remembered schema-congruent information relies on mPFC, whereas schema-incongruent information relies on MTL. Whether this is true in the immature brain and relates to behavioral flexibility is unknown. In this preliminary investigation, we aimed to replicate the adult findings in typically developing (TD) children and to investigate the relevance to behavioral flexibility by examining a disorder with pathognomonic behavioral rigidity, autism spectrum disorder (ASD).

METHODS

Children completed an associative subsequent memory paradigm, encoding object-scene pairs in an MRI scanner and subsequently completing a recognition test outside the scanner after a delay. Recognition performance was back sorted to construct remembered vs forgotten contrasts. One-way ANOVAS were conducted in MTL and mPFC masks for schema-congruency, followed by congruency by flexibility scores. Exploratory analyses were then conducted within the whole brain.

RESULTS

As reported in adults, episodic memory was strongest for schema-congruent object-scene pairs, followed by intermediate pairs, and lowest for schema-incongruent pairs in both TD and ASD groups. However, the trade-off between mPFC and MTL in TD children differed from adult reports such that mPFC supported memory for intermediate schema-congruency and left anterior MTL supported memory for schema-congruent pairs. In ASD, mPFC engagement interacted with flexibility such that activation supporting memory for intermediate schema-congruency varied with parent-reported flexibility and was higher in those with more flexible behavior. A similar interaction was also observed in both the left dorsolateral and rostrolateral PFC in whole-brain analysis.

CONCLUSION

Our findings provide the first preliminary evidence for the association of schema-based episodic memory formation and behavioral flexibility, an executive function impaired in multiple developmental disorders. Upon replication, this line of research holds promise for memory-based interventions addressing executive problems of behavioral rigidity.

Prototype-based category learning in autism: A review

Similarity-based categorization, as an important cognitive skill, can be performed by abstracting a categories' central tendency, the so-called prototype, or by memorizing individual exemplars of a category. The flexible selection of an appropriate strategy is crucial for effective cognitive functioning. The detail-focused cognitive style in individuals with autism spectrum disorders (ASD) has been hypothesized to specifically impair prototype-based categorization but to leave exemplar-based categorization unimpaired. We first give an overview of approaches to investigate prototype-based abstraction in the prototype-distortion task, with an emphasis on model-based approaches suitable to discern the two strategies on the individual level. The second part summarizes literature speaking to prototype-based categorization in ASD using that task. Despite considerable inconsistencies, most studies appear to confirm that autistic individuals have more difficulties to perform prototype-distortion tasks than non-autistic individuals. We highlight how inconsistencies in literature can be resolved by taking the differences in task designs into account. The current review illustrates the need for sensitive computational approaches, suitable to detect hidden individual differences and potential compensatory strategies.

Virtual Reality Immersion Rescales Regulation of Interpersonal Distance in Controls but not in Autism Spectrum Disorder

Interpersonal distance (IPD) is a simple social regulation metric which is altered in autism. We performed a stop-distance paradigm to evaluate IPD regulation in autism spectrum disorder (ASD) and control groups in a real versus a virtual environment mimicking in detail the real one. We found a bimodal pattern of IPDs only in ASD. Both groups showed high IPD correlations between real and virtual environments, but the significantly larger slope in the control group suggests rescaling, which was absent in ASD. We argue that loss of nuances like non-verbal communication, such as perception of subtle body gestures in the virtual environment, lead to changed regulation of IPD in controls, whilst ASD participants show similar deficits in perceiving such subtle cues in both environments.

Perceptual category learning in autism spectrum disorder: Truth and consequences

The ability to categorize is fundamental to cognitive development. Some categories emerge effortlessly and rapidly while others can take years of experience to acquire. Children with autism spectrum disorder (ASD) are often able to name and sort objects, suggesting that their categorization abilities are largely intact. However, recent experimental work shows that the categories formed by individuals with ASD may diverge substantially from those that most people learn. This review considers how atypical perceptual category learning can affect cognitive development in children with ASD and how atypical categorization may contribute to many of the socially problematic symptoms associated with this disorder. Theoretical approaches to understanding perceptual processing and category learning at both the behavioral and neural levels are assessed in relation to known alterations in perceptual category learning associated with ASD. Mismatches between the ways in which children learn to organize perceived events relative to their peers and adults can accumulate over time, leading to difficulties in communication, social interactions, academic performance, and behavioral flexibility.

Neural correlates of cognitive variability in childhood autism and relation to heterogeneity in decision-making dynamics

Heterogeneity in cognitive and academic abilities is a prominent feature of autism spectrum disorder (ASD), yet little is known about its underlying causes. Here we combine functional brain imaging during numerical problem-solving with hierarchical drift-diffusion models of behavior and standardized measures of numerical abilities to investigate neural mechanisms underlying cognitive variability in children with ASD, and their IQ-matched Typically Developing (TD) peers. Although the two groups showed similar levels of brain activation, the relation to individual abilities differed markedly in ventral temporal-occipital, parietal and prefrontal regions important for numerical cognition: children with ASD showed a positive correlation between functional brain activation and numerical abilities, whereas TD children showed the opposite pattern. Despite similar accuracy and response times, decision thresholds were significantly higher in the ASD group, suggesting greater evidence required for problem-solving. Critically, the relationship between individual abilities and engagement of prefrontal control systems anchored in the anterior insula was differentially moderated by decision threshold in subgroups of children with ASD. Our findings uncover novel cognitive and neural sources of variability in academically-relevant cognitive skills in ASD and suggest that multilevel measures and latent decision-making dynamics can aid in characterization of cognitive variability and heterogeneity in neurodevelopmental disorders.

Beyond intervention into daily life: A systematic review of generalisation following social communication interventions for young children with autism

Researchers have generally considered autistic individuals to have difficulties generalising learned skills across novel contexts. Successful generalisation is necessary for an intervention to have benefits in everyday life beyond the original learning environment. We conducted a systematic review of randomised controlled trials of early social communication interventions for children with autism in order to explore generalisation and its measurement. We identified nine RCTs that provided evidence of initial target learning and measured generalisation, of which eight demonstrated at least some successful generalisation across people, settings, and/or activities. The findings did not support the widely reported generalisation 'difficulties' associated with autism. However, generalisation was not consistent across all skills within studies, and one study found no generalisation despite evidence for initial target learning within the intervention context. In general, there are few methodologically sound social communication intervention studies exploring generalisation in autism and no consensus on how it should be measured. In particular, failure to demonstrate initial learning of target skills within the intervention setting and an absence of formal mediation analyses of the hypothesised mechanisms limit current research. We outline a framework within which measurement of generalisation can be considered for use in future trials. To maximise the effectiveness of interventions, the field needs to gain a better understanding of the nature of generalisation among autistic individuals and what additional strategies may further enhance learning. Autism Res 2020, 13: 506-522. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: It is generally considered that autistic individuals experience difficulties applying things they have learned in one context into different settings (e.g. from school to home). This is important to consider for intervention studies. Our review does not support a complete lack of generalisation but instead suggests that after early social communication intervention, autistic children can transfer some skills to new contexts. Overall, there is limited research in this area and further work is needed.

iPads for Teaching Graphic Symbols to People With Autism Spectrum Disorder

Individuals with low functioning autism spectrum disorders (LFASD) who demonstrate significant cognitive and communication needs benefit from using technology for learning graphic symbols for enhancing participation. This study investigated if an iPad application would increase identification of graphic symbols by children and adults with LFASD. Adults and children with LFASD used an application to learn 15 graphic symbols. Participants were able to focus for the duration of the activity and use the educational software for learning graphic symbols. By the end to the study, 50% of the participants in both groups recognized the meaning of more symbols after intervention. iPad use enabled control of the stimulus by reducing communication barriers, which increased participants' ability to learn symbols. Even participants with little ability to focus were able to complete the whole activity. Technology enabled learning of most of the symbols though the specially created application.

Exploring the neurocognitive basis of episodic recollection in autism

Increasing evidence indicates that the subjective experience of recollection is diminished in autism spectrum disorder (ASD) compared to neurotypical individuals. The neurocognitive basis of this difference in how past events are re-experienced has been debated and various theoretical accounts have been proposed to date. Although each existing theory may capture particular features of memory in ASD, recent research questions whether any of these explanations are alone sufficient or indeed fully supported. This review first briefly considers the cognitive neuroscience of how episodic recollection operates in the neurotypical population, informing predictions about the encoding and retrieval mechanisms that might function atypically in ASD. We then review existing research on recollection in ASD, which has often not distinguished between different theoretical explanations. Recent evidence suggests a distinct difficulty engaging recollective retrieval processes, specifically the ability to consciously reconstruct and monitor a past experience, which is likely underpinned by altered functional interactions between neurocognitive systems rather than brain region-specific or process-specific dysfunction. This integrative approach serves to highlight how memory research in ASD may enhance our understanding of memory processes and networks in the typical brain. We make suggestions for future research that are important for further specifying the neurocognitive basis of episodic recollection in ASD and linking such difficulties to social developmental and educational outcomes.

Promoting Generalized Advanced Language Skills of Children in Intensive Behavioral Intervention with Promoting the Emergence of Advanced Knowledge Generalization Module (PEAK-G)

The Promoting the Emergence of Advanced Knowledge Relational Training System Generalization Module (PEAK-G; Dixon, 2014) was used within a community-based intensive behavioral intervention (IBI) program to enhance the generalized advanced language skills of children diagnosed with autism spectrum disorder. Four multiple-baseline, across-behaviors designs were used to assess the effectiveness of the PEAK-G "train and test" discrete trial training (DTT) method on directly trained and generalized language skills. After implementing PEAK-G, directly trained language skills increased for all participants, and generalization to test stimuli was observed for two participants, with some generalization observed for a third participant. These data suggest that PEAK-G may be a viable option for community-based practitioners to promote more advanced generalized language skills to children who have mastered early language skills.

We see the orange not the lemon: typicality effects in ultra-rapid categorization in adults with and without autism spectrum disorder

Semantic meaning can be extracted from pictures presented very briefly, in the order of tens of milliseconds. This ultra-rapid categorization processing appears to respect a coarse-to-fine path where lower level representations of concepts, or more detailed information, need additional time. We question whether variations in the levels of typicality of the target-item would implicate additional processing for correct classification, both in neurotypical (NT) individuals and with autism spectrum disorder (ASD). Previous research in ASD points out that atypical exemplars of a category might be abnormally processed (e.g., longer times in identifying a penguin as a bird), an observation that we further tested with a rapid serial visual presentation (RSVP) task. In this study, we applied a RSVP task, with four different presentation times (13, 27, 50, and 80 ms) and with typical and atypical exemplars to a group of NT individuals and a sample of individuals with ASD. We found, overall, a strong effect of typicality with a higher detection rate for typical items. In addition, we observed a group × typicality × duration interaction. We interpret these findings in the light of the competences of the feedforward sweep of information through our visual system.

Autism: a transdiagnostic, dimensional, construct of reasoning?

The concept of autism has changed across time, from the Bleulerian concept, which defined it as one of several symptoms of dementia praecox, to the present-day concept representing a pervasive development disorder. The present theoretical contribution to this special issue of EJN on autism introduces new theoretical ideas and discusses them in light of selected prior theories, clinical examples, and recent empirical evidence. The overall aim is to identify some present challenges of diagnostic practice and autism research and to suggest new pathways that may help direct future research. Future research must agree on the definitions of core concepts such as autism and psychosis. A possible redefinition of the concept of autism may be a condition in which the rationale of an individual's behaviour differs qualitatively from that of the social environment due to characteristic cognitive impairments affecting reasoning. A broad concept of psychosis could focus on deviances in the experience of reality resulting from impairments of reasoning. In this light and consistent with recent empirical evidence, it may be appropriate to redefine dementia praecox as a developmental disorder of reasoning. A future challenge of autism research may be to develop theoretical models that can account for the impact of complex processes acting at the social level in addition to complex neurobiological and psychological processes. Such models could profit from a distinction among processes related to (i) basic susceptibility, (ii) adaptive processes and (iii) decompensating factors involved in the development of manifest illness.

Comparing two methods to promote generalization of receptive identification in children with autism spectrum disorders

PURPOSE

The purpose of our study was to compare the effects of serial and concurrent training on the generalization of receptive identification in children with autism spectrum disorders (ASD).

METHODS

We taught one to three pairs of stimulus sets to nine children with ASD between the ages of three and six. One stimulus set within each pair was taught using concurrent training and the other using serial training. We alternated the training sessions within a multielement design and staggered the introduction of subsequent pairs for each participant as in a multiple baseline design.

RESULTS

Overall, six participants generalized at least one stimulus set more rapidly with concurrent training whereas two participants showed generalization more rapidly with serial training.

CONCLUSIONS

Our results differ from other comparison studies on the topic and indicate that practitioners should consider assessing the effects of both procedures prior to teaching receptive identification to children with ASD.

Autism As a Disorder of High Intelligence

A suite of recent studies has reported positive genetic correlations between autism risk and measures of mental ability. These findings indicate that alleles for autism overlap broadly with alleles for high intelligence, which appears paradoxical given that autism is characterized, overall, by below-average IQ. This paradox can be resolved under the hypothesis that autism etiology commonly involves enhanced, but imbalanced, components of intelligence. This hypothesis is supported by convergent evidence showing that autism and high IQ share a diverse set of convergent correlates, including large brain size, fast brain growth, increased sensory and visual-spatial abilities, enhanced synaptic functions, increased attentional focus, high socioeconomic status, more deliberative decision-making, profession and occupational interests in engineering and physical sciences, and high levels of positive assortative mating. These findings help to provide an evolutionary basis to understanding autism risk as underlain in part by dysregulation of intelligence, a core human-specific adaptation. In turn, integration of studies on intelligence with studies of autism should provide novel insights into the neurological and genetic causes of high mental abilities, with important implications for cognitive enhancement, artificial intelligence, the relationship of autism with schizophrenia, and the treatment of both autism and intellectual disability.

Discrepancies between direct and indirect measures of interpersonal and neurocognitive skills in autism spectrum disorder children

BACKGROUND

Subjects with autistic spectrum disorders (ASD) show persistent deficits in social interaction. In order to explore the scope of their deficits, it is of great interest to compare the different interpersonal skills and executive functions of ASD subjects to those of children with typical development. Assessing these skills usually involves a large variety of informants (parents, teachers, other family members) and of measures, with frequent discrepancies between direct performance measures and indirect measures (third-party report). Different explanations of this mismatch between measures have been addressed in previous studies.

OBJECTIVES

We wish to analyze whether there are differences between children with ASD and children with typical development on several direct performance measures of interpersonal and neurocognitive skills and one third-party report on real-life performance of interpersonal skills; we also want to look at whether discrepancies appear between the two types of measurements in the two groups of participants.

METHOD

A total of 68 Spanish children between the ages of 7 and 12 years participated; 34 were children with ASD, and 34 showed typical development. All participants were tested for recognition of emotions, solving interpersonal conflicts, and executive function.

RESULTS

Significant differences between the two groups were not found on most of the direct performance measures, but they did appear in the report by third parties, in favor of the group with typical development. There was also a significant association between neurocognitive and social variables in the latter group.

CONCLUSIONS

There were intergroup differences and discrepancies between the direct performance and indirect measures in children with ASD, and these must be explained. For this reason, future studies could seek to explain the cause of these discrepancies with a greater number of measures for each of the skills.

Diminished neural adaptation during implicit learning in autism

Neuroimaging studies have shown evidence of disrupted neural adaptation during learning in individuals with autism spectrum disorder (ASD) in several types of tasks, potentially stemming from frontal-posterior cortical underconnectivity (Schipul et al., 2012). The aim of the current study was to examine neural adaptations in an implicit learning task that entails participation of frontal and posterior regions. Sixteen high-functioning adults with ASD and sixteen neurotypical control participants were trained on and performed an implicit dot pattern prototype learning task in a functional magnetic resonance imaging (fMRI) session. During the preliminary exposure to the type of implicit prototype learning task later to be used in the scanner, the ASD participants took longer than the neurotypical group to learn the task, demonstrating altered implicit learning in ASD. After equating task structure learning, the two groups' brain activation differed during their learning of a new prototype in the subsequent scanning session. The main findings indicated that neural adaptations in a distributed task network were reduced in the ASD group, relative to the neurotypical group, and were related to ASD symptom severity. Functional connectivity was reduced and did not change as much during learning for the ASD group, and was related to ASD symptom severity. These findings suggest that individuals with ASD show altered neural adaptations during learning, as seen in both activation and functional connectivity measures. This finding suggests why many real-world implicit learning situations may pose special challenges for ASD.

Heterogeneity in perceptual category learning by high functioning children with autism spectrum disorder

Previous research suggests that high functioning (HF) children with autism spectrum disorder (ASD) sometimes have problems learning categories, but often appear to perform normally in categorization tasks. The deficits that individuals with ASD show when learning categories have been attributed to executive dysfunction, general deficits in implicit learning, atypical cognitive strategies, or abnormal perceptual biases and abilities. Several of these psychological explanations for category learning deficits have been associated with neural abnormalities such as cortical underconnectivity. The present study evaluated how well existing neurally based theories account for atypical perceptual category learning shown by HF children with ASD across multiple category learning tasks involving novel, abstract shapes. Consistent with earlier results, children’s performances revealed two distinct patterns of learning and generalization associated with ASD: one was indistinguishable from performance in typically developing children; the other revealed dramatic impairments. These two patterns were evident regardless of training regimen or stimulus set. Surprisingly, some children with ASD showed both patterns. Simulations of perceptual category learning could account for the two observed patterns in terms of differences in neural plasticity. However, no current psychological or neural theory adequately explains why a child with ASD might show such large fluctuations in category learning ability across training conditions or stimulus sets.

Low endogenous neural noise in autism

‘Heuristic’ theories of autism postulate that a single mechanism or process underpins the diverse psychological features of autism spectrum disorder. Although no such theory can offer a comprehensive account, the parsimonious descriptions they provide are powerful catalysts to autism research. One recent proposal holds that ‘noisy’ neuronal signalling explains not only some deficits in autism spectrum disorder, but also some superior abilities, due to ‘stochastic resonance’. Here, we discuss three distinct actions of noise in neural networks, arguing in each case that autism spectrum disorder symptoms reflect too little, rather than too much, neural noise. Such reduced noise, perhaps a function of atypical brainstem activation, would enhance detection and discrimination in autism spectrum disorder but at significant cost, foregoing the widespread benefits of noise in neural networks.