Neuropsychological findings in high-functioning men with infantile autism, residual state

Comparison of Mathematics Problem-Solving Abilities in Autistic and Non-autistic Children: the Influence of Cognitive Profile

This study examines relationships between mathematical problem-solving performance (in terms of strategies used and accuracy) and the main cognitive domains associated with mathematical learning (i.e. executive functions, verbal comprehension and social perception) of children with and without autism spectrum disorder (ASD and non-ASD resp.). The study involved 26 ASD and 26 non-ASD children without intellectual disabilities, between 6 and 12 years old, matched by sex, age and school (grade and classroom). The results show a higher percentage of ASD children with problem solving difficulties than non-ASD (57% vs. 23% resp.). Poor performing ASD children showed comparatively lower scores in inhibition, theory of mind and verbal comprehension. Implications for the design of mathematical interventions for ASD students are discussed.

FECTS: A Facial Emotion Cognition and Training System for Chinese Children with Autism Spectrum Disorder

Traditional training methods such as card teaching, assistive technologies (e.g., augmented reality/virtual reality games and smartphone apps), DVDs, human-computer interactions, and human-robot interactions are widely applied in autistic rehabilitation training in recent years. In this article, we propose a novel framework for human-computer/robot interaction and introduce a preliminary intervention study for improving the emotion recognition of Chinese children with an autism spectrum disorder. The core of the framework is the Facial Emotion Cognition and Training System (FECTS, including six tasks to train children with ASD to match, infer, and imitate the facial expressions of happiness, sadness, fear, and anger) based on Simon Baron-Cohen's E-S (empathizing-systemizing) theory. Our system may be implemented on PCs, smartphones, mobile devices such as PADs, and robots. The training record (e.g., a tracked record of emotion imitation) of the Chinese autistic children interacting with the device implemented using our FECTS will be uploaded and stored in the database of a cloud-based evaluation system. Therapists and parents can access the analysis of the emotion learning progress of these autistic children using the cloud-based evaluation system. Deep-learning algorithms of facial expressions recognition and attention analysis will be deployed in the back end (e.g., devices such as a PC, a robotic system, or a cloud system) implementing our FECTS, which can perform real-time tracking of the imitation quality and attention of the autistic children during the expression imitation phase. In this preliminary clinical study, a total of 10 Chinese autistic children aged 3-8 are recruited, and each of them received a single 20-minute training session every day for four consecutive days. Our preliminary results validated the feasibility of the developed FECTS and the effectiveness of our algorithms based on Chinese children with an autism spectrum disorder. To verify that our FECTS can be further adapted to children from other countries, children with different cultural/sociological/linguistic contexts should be recruited in future studies.

Modulation of atypical brain activation during executive functioning in autism: a pharmacological MRI study of tianeptine

Background

Autism spectrum disorder (ASD) is associated with deficits in executive functioning (EF), and these have been suggested to contribute to core as well as co-occurring psychiatric symptoms. The biological basis of these deficits is unknown but may include the serotonergic system, which is involved both in regulating EF in neurotypical populations and in the pathophysiology of ASD. We previously demonstrated that reducing serotonin by acute tryptophan depletion (ATD) shifts differences in brain function during performance of EF tasks towards control levels. However, ATD cannot be easily used in the clinic, and we therefore need to adopt alternative approaches to challenge the serotonin system. Hence, we investigated the role of the serotonergic modulator tianeptine on EF networks in ASD.

Method

We conducted a pharmacological magnetic resonance imaging study, using a randomized double-blind crossover design, to compare the effect of an acute dosage of 12.5 mg tianeptine and placebo on brain activation during two EF tasks (of response inhibition and sustained attention) in 38 adult males: 19 with ASD and 19 matched controls.

Results

Under placebo, compared to controls, individuals with ASD had atypical brain activation in response inhibition regions including the inferior frontal cortex, premotor regions and cerebellum. During sustained attention, individuals with ASD had decreased brain activation in the right middle temporal cortex, right cuneus and left precuneus. Most of the case–control differences in brain function observed under placebo conditions were abolished by tianeptine administration. Also, within ASD individuals, brain functional differences were shifted significantly towards control levels during response inhibition in the inferior frontal and premotor cortices.

Limitations

We conducted a pilot study using a single dose of tianeptine, and therefore, we cannot comment on long-term outcome.

Conclusions

Our findings provide the first evidence that tianeptine can shift atypical brain activation during EF in adults with ASD towards control levels. Future studies should investigate whether this shift in the biology of ASD is maintained after prolonged treatment with tianeptine and whether it improves clinical symptoms.

An examination of perseverative errors and cognitive flexibility in autism

Perseveration is a well-replicated finding in autism. The aim of this study was to examine how the context of the task influences performance with respect to this phenomenon. We randomly assigned 137 children aged 6–12 with and without autism to complete a modified card-sorting task under one of two conditions: Children were either told the sorting rules on each trial (Explicit), or were given feedback to formulate the rules themselves (Implicit). While performance was enhanced on the Explicit condition for participants without autism, the participants with autism were disadvantaged by this manipulation. In contrast, there were few differences in performance between groups on the Implicit condition. Exploratory analyses were used to examine this unexpected result; increased autism symptomology was associated with poorer performance.

The Role of the Noradrenergic System in Autism Spectrum Disorders, Implications for Treatment

Autism spectrum disorder (ASD) is frequently associated with anxiety and hyperarousal. While the pathological changes in the noradrenergic system in ASD are not entirely clear, a number of functional indices of the sympathetic/parasympathetic balance are altered in individuals with ASD, often with a high degree of inter-individual variability. The neuropsychopharmacological effects of α₂ agonists and β-adrenergic antagonists make agents targeting these receptors of particular interest. α₂ agonists have shown beneficial effects for attention deficit hyperactivity disorder (ADHD) and in other domains in individuals with ASD, but effects on core ASD symptoms are less clear. Case series and single dose psychopharmacological challenges suggest that treatment with β-adrenergic antagonists has beneficial effects on language and social domains. Additionally, psychophysiological markers and premorbid anxiety may predict response to these medications. As a result, β-adrenergic antagonists are currently being utilized in a clinical trial for improving core symptoms as well as anxiety in individuals with ASD.

Can cerebral lateralisation explain heterogeneity in language and increased non-right handedness in autism? A literature review

BACKGROUND

Autism is characterised by phenotypic variability, particularly in the domains of language and handedness. However, the source of this heterogeneity is currently unclear.

AIMS

To synthesise findings regarding the relationship between language, handedness, and cerebral lateralisation in autistic people and consider how future research should be conducted in order to progress our understanding of phenotypic variability.

METHODS AND PROCEDURES

Following a literature search and selection process, 19 papers were included in this literature review. Studies using behavioural, structural, and functional measures of lateralisation are reviewed.

OUTCOMES AND RESULTS

The studies reviewed provided consistent evidence of differential cerebral lateralisation in autistic people, and this appears to be related to between-group differences in language. Evidence relating this to handedness was less consistent. Many of the studies did not include heterogeneous samples, and/or did not specify the language process they investigated.

CONCLUSIONS AND IMPLICATIONS

This review suggests that further research is needed to fully understand the relationship between cerebral lateralisation and phenotypic variability within autism. It is crucial that future studies in this area include heterogeneous samples, specify the language process they are investigating, and consider taking developmental trajectories into account.

Characteristic Executive Dysfunction for High-Functioning Autism Sustained to Adulthood

The comprehensiveness and severity of executive dysfunction in high-functioning autism (HFA) spectrum disorder have not reached a unified conclusion especially in patients in adulthood. Clarifying this issue is critical for guiding clinical diagnosis and targeted intervention. The primary objective of the present meta-analysis was to study the characteristics of executive function (EF) in adults with HFA compared to typically developing (TD) adults, by taking five key components into consideration, including inhibition, working memory, flexibility, planning, and fluency. The PubMed and Embase databases were searched to identify peer-reviewed studies that compared EF in adults with and without HFA from 1980 to November 2018. Hedges' g effect sizes were computed to measure the primary outcome. Moderators like age, sex, and diagnostic tools were controlled using meta-regressions. Forty-two studies satisfying the selection criteria were included, which resulted in a large sample size of 2419 participants. A moderate overall effect size for reduced EF across domains was found in adults with HFA, compared with TD (g = 0.57, 95% confidence interval 0.47-0.66). Subsequently, a broad executive dysfunction was found in adults with HFA in this study (flexibility [g = 0.69], planning [g = 0.64], inhibition [g = 0.61], working memory [g = 0.48], fluency [g = 0.42]), with the predominated impairment on flexibility and planning. Taken together, these results provide evidence for the executive dysfunction hypothesis and may assist in the clinical diagnosis and targeted intervention, suggesting the necessity of sustained intervention on EF for individuals with HFA from childhood to adulthood. LAY SUMMARY: The meta-analysis explored the characteristics of EF in adults with high-functioning autism (HFA) comparing to typically developing controls. Moderate effect sizes for reduced EF across domains were found in adults with HFA, with the flexibility and planning being the most predominately impaired. A comprehensive measurement of EF in adults with HFA has important clinical implications for the diagnosis, treatment, prognosis, and a fundamental understanding for developmental trajectory of these patients.

Metabolome signature of autism in the human prefrontal cortex

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder with yet incompletely uncovered molecular determinants. Alterations in the abundance of low molecular weight compounds (metabolites) in ASD could add to our understanding of the disease. Indeed, such alterations take place in the urine, plasma and cerebellum of ASD individuals. In this work, we investigated mass-spectrometric signal intensities of 1,366 metabolites in the prefrontal cortex grey matter of 32 ASD and 40 control individuals. 15% of these metabolites showed significantly different intensities in ASD and clustered in 16 metabolic pathways. Of them, ten pathways were altered in urine and blood of ASD individuals (Fisher test, p < 0.05), opening an opportunity for the design of new diagnostic instruments. Furthermore, metabolic measurements conducted in 40 chimpanzees and 40 macaques showed an excess of metabolite intensity differences unique to humans, supporting the hypothesized disruption of evolutionary novel cortical mechanisms in ASD.

Exploring the relationship between fairness and 'brain types' in children with high-functioning autism spectrum disorder

BACKGROUND

Existing research typically focuses on only one domain of cognition with regard to fairness-theory of mind or executive function. However, children with High-functioning autism spectrum disorder (HF-ASD) are cognitively impaired in both domains. Moreover, little is known about fairness characteristics in children with HF-ASD in relation to both domains of cognition.

METHODS

Thirty children with HF-ASD as well as 39 children with typical development (TD) were evaluated in this study. We investigated the development of children's fairness characteristics as a responder in a mini ultimatum game (UG). The different 'brain types,' i.e., with or without HF-ASD, were evaluated using the Empathy Questionnaire-Systemizing Questionnaire (E/SC-Q). Furthermore, we explored the relationship between fairness and brain types using Pearson correlation analyses.

RESULTS

Children in the HF-ASD group were more likely to accept unfair offers than were children in the TD group (χ² = 17.513, p = .025). In the HF-ASD group, the acceptance rate of unfair offers was correlated with the discrepancy score (r = 0.363, p = .048), while there were no significant correlations in the TD group. In HF-ASD group, compared with Type S, acceptance rate of unfair offer was significant higher in Extreme Type S 'brain type' (F = 28.584, p < .001). While dividing TD participants by 'brain type', there was no significant difference in acceptance rate of unfair offer among five difference 'brain types' (F = 1.131, p = .358). Stepwise regression revealed that Extreme Type S positively predicted acceptance of unfair offers (F [1, 68] = 8.695, p < .001).

DISCUSSION

Our findings show that children with HF-ASD were more likely to accept an unfair offer; in particular, the more unbalanced the development of empathy and systemizing was, the more significant the unfairness preference observed. Extreme Type S positively predicted the acceptance of unfair offers by children with HF-ASD.

REGISTRATION OF CLINICAL TRIALS

World Health Organization class I registered international clinical trial platform, ChiCTR-ROC-17012877.

Visual-Tactile Speech Perception and the Autism Quotient

Multisensory information is integrated asymmetrically in speech perception: An audio signal can follow video by 240ms, but can precede video by only 60ms, without disrupting the sense of synchronicity (Munhall et al., 1996). Similarly, air flow can follow either audio (Gick et al., 2010) or video (Bicevskis et al., 2016) by a much larger margin than it can precede either while remaining perceptually synchronous. These asymmetric windows of integration have been attributed to the physical properties of the signals; light travels faster than sound (Munhall et al., 1996), and sound travels faster than air flow (Gick et al., 2010). Perceptual windows of integration narrow during development (Hillock-Dunn and Wallace, 2012), but remain wider among people with autism (Wallace and Stevenson, 2014). Here we show that, even among neurotypical adult perceivers, visual-tactile windows of integration are wider and flatter the higher the participant's Autism Quotient (AQ) (Baron-Cohen et al., 2001), a self-report measure of autistic traits. As "pa" is produced with a tiny burst of aspiration (Derrick et al., 2009), we applied light and inaudible air puffs to participants' necks while they watched silent videos of a person saying "ba" or "pa," with puffs presented both synchronously and at varying degrees of asynchrony relative to the recorded plosive release burst, which itself is time-aligned to visible lip opening. All syllables seen along with cutaneous air puffs were more likely to be perceived as "pa." Syllables were perceived as "pa" most often when the air puff occurred 50-100ms after lip opening, with decaying probability as asynchrony increased. Integration was less dependent on time-alignment the higher the participant's AQ. Perceivers integrate event-relevant tactile information in visual speech perception with greater reliance upon event-related accuracy the more they self-describe as neurotypical, supporting the Happé and Frith (2006) weak coherence account of autism spectrum disorder (ASD).

Executive Functions and Prosodic Abilities in Children With High-Functioning Autism

Little is known about the relationship between prosodic abilities and executive function skills. As deficits in executive functions (EFs) and prosodic impairments are characteristics of autism, we examined how EFs are related to prosodic performance in children with high-functioning autism (HFA). Fifteen children with HFA (M = 7.4 years; SD = 1.12), matched to 15 typically developing peers on age, gender, and non-verbal intelligence participated in the study. The Profiling Elements of Prosody in Speech-Communication (PEPS-C) was used to assess prosodic performance. The Children's Color Trails Test (CCTT-1, CCTT-2, and CCTT Interference Index) was used as an indicator of executive control abilities. Our findings suggest no relation between prosodic abilities and visual search and processing speed (assessed by CCTT-1), but a significant link between prosodic skills and divided attention, working memory/sequencing, set-switching, and inhibition (assessed by CCTT-2 and CCTT Interference Index). These findings may be of clinical relevance since difficulties in EFs and prosodic deficits are characteristic of many neurodevelopmental disorders. Future studies are needed to further investigate the nature of the relationship between impaired prosody and executive (dys)function.

Auditory Pitch Perception in Autism Spectrum Disorder Is Associated With Nonverbal Abilities

Atypical sensory perception and heterogeneous cognitive profiles are common features of autism spectrum disorder (ASD). However, previous findings on auditory sensory processing in ASD are mixed. Accordingly, auditory perception and its relation to cognitive abilities in ASD remain poorly understood. Here, children with ASD, and age- and intelligence quotient (IQ)-matched typically developing children, were tested on a low- and a higher level pitch processing task. Verbal and nonverbal cognitive abilities were measured using the Wechsler's Abbreviated Scale of Intelligence. There were no group differences in performance on either auditory task or IQ measure. However, there was significant variability in performance on the auditory tasks in both groups that was predicted by nonverbal, not verbal skills. These results suggest that auditory perception is related to nonverbal reasoning rather than verbal abilities in ASD and typically developing children. In addition, these findings provide evidence for preserved pitch processing in school-age children with ASD with average IQ, supporting the idea that there may be a subgroup of individuals with ASD that do not present perceptual or cognitive difficulties. Future directions involve examining whether similar perceptual-cognitive relationships might be observed in a broader sample of individuals with ASD, such as those with language impairment or lower IQ.

A theoretical approach to the deficits in infantile autism

Deficits specific to the syndrome of infantile autism appear in imitation, emotion sharing, theory of mind, pragmatics of communication, and symbolic play. Current competing theories of Hobson and of Baron-Cohen, Frith, and associates account for some, but not all, of these specific deficits. The present article suggests that early social capacities involving imitation, emotion sharing, and theory of mind are primarily and specifically deficient in autism. Further, these three capacities involve forming and coordinating social representations of self and other at increasingly complex levels via representational processes that extract patterns of similarity between self and other. Stern's theory of interpersonal development is offered as a continuous model for understanding the development and deficits of the autistic child and as a means for integrating competing theories about the primary deficits in autism. Finally, the article suggests a neuropsychological model of interpersonal coordination involving prefrontal cortex and executive function capacities that is consistent with the social deficits observed in autism.

Emotion Perception Mediates the Predictive Relationship Between Verbal Ability and Functional Outcome in High-Functioning Adults with Autism Spectrum Disorder

The aim of this study was to identify specific cognitive abilities that predict functional outcome in high-functioning adults with autism spectrum disorder (ASD), and to clarify the contribution of those abilities and their relationships. In total, 41 adults with ASD performed cognitive tasks in a broad range of neuro- and social cognitive domains, and information concerning functional outcomes was obtained. Regression analyses revealed that emotion perception and verbal generativity predicted adaptive functioning directly, and the former mediated between the other two. These findings provide the first evidence of a triadic relationship among neuro- and social cognition and functional outcome in this population. Our results suggest that psychosocial interventions targeting these cognitive abilities could benefit social adaptation in adults with ASD.

Effects of therapeutic recreation on adults with ASD and ID: a preliminary randomized control trial

BACKGROUND

The purpose of this research was to examine effects of a therapeutic recreation (TR) program designed to increase executive function (EF), social skills, adaptive behaviours and well-being of adults with autism spectrum disorder (ASD) and intellectual disability (ID).

METHOD

A preliminary pre-test, post-test randomized control group experimental design was used to measure effects of a 40-week TR program designed to increase EF (TR-EF). The TR-EF used instructional electronically based games delivered during 200 1-h sessions (5/week).

RESULTS

Participants (experimental group, n = 19; wait-list group, n = 18) were evaluated at baseline and 10 months later. There was a positive and direct impact of the program on several EF and indirect effect on social skills, adaptive behaviour and personal well-being.

CONCLUSIONS

Findings provide support for inclusion of EF enrichment as a way to enhance effects of TR interventions for adults with ASD and ID. Preliminary results of this study can be considered in planning TR services in the future. In addition to TR-EF program primary effects on EF, there were indirect benefits on adaptive behaviours, personal well-being and social skills.

Using inclusive sampling to highlight specific executive functioning impairments in autism spectrum disorder

Objectives: The aim of the study is to help identify the nature of impaired executive functioning (EF) in children with autism spectrum disorder (ASD). It is also argued that participant sampling by age alone should inform experimental research on EF, as selection through IQ matching may weaken any experimental effects. Methods: Sixteen children with ASD across a wide range of Nonverbal IQ (NVIQ) and 16 neurotypical control children matched on age alone were given two different types of computerized sequencing game. Both required top-down organization, but in one case the sequence had to be self-generated while in the second it had to be learned and strictly followed. Measures of learning success in relation to NVIQ, and information processing demands were made. Results: Children with ASD were significantly impaired on the first task only, especially when the processing demands were increased. The effects were particularly pronounced for children with below average NVIQ. Conclusions: The study indicates a selective problem with self-organized sequencing in ASD with implications for certain real world contexts, but also points to a need for more inclusive sampling of children in order to fully expose specific executive impairments in autism spectrum disorder.

Real-World Executive Functions in Adults with Autism Spectrum Disorder: Profiles of Impairment and Associations with Adaptive Functioning and Co-morbid Anxiety and Depression

Although executive functioning (EF) difficulties are well documented among children and adolescents with autism spectrum disorder (ASD), little is known about real-world measures of EF among adults with ASD. Therefore, this study examined parent-reported real-world EF problems among 35 adults with ASD without intellectual disability and their correlations with adaptive functioning and co-morbid anxiety and depression symptomatology. A variable EF profile was found with prominent deficits occurring in flexibility and metacognition. Flexibility problems were associated with anxiety-related symptoms while metacognition difficulties were associated with depression symptoms and impaired adaptive functioning (though the metacognition-adaptive functioning relationship was moderated by ADHD symptoms). These persistent EF problems are predictors of broader functioning and therefore remain an important treatment target among adults with ASD.

Disruption of an Evolutionarily Novel Synaptic Expression Pattern in Autism

Cognitive defects in autism spectrum disorder (ASD) include socialization and communication: key behavioral capacities that separate humans from other species. Here, we analyze gene expression in the prefrontal cortex of 63 autism patients and control individuals, as well as 62 chimpanzees and macaques, from natal to adult age. We show that among all aberrant expression changes seen in ASD brains, a single aberrant expression pattern overrepresented in genes involved synaptic-related pathways is enriched in nucleotide variants linked to autism. Furthermore, only this pattern contains an excess of developmental expression features unique to humans, thus resulting in the disruption of human-specific developmental programs in autism. Several members of the early growth response (EGR) transcription factor family can be implicated in regulation of this aberrant developmental change. Our study draws a connection between the genetic risk architecture of autism and molecular features of cortical development unique to humans.

Atypical Asymmetry for Processing Human and Robot Faces in Autism Revealed by fNIRS

Deficits in the visual processing of faces in autism spectrum disorder (ASD) individuals may be due to atypical brain organization and function. Studies assessing asymmetric brain function in ASD individuals have suggested that facial processing, which is known to be lateralized in neurotypical (NT) individuals, may be less lateralized in ASD. Here we used functional near-infrared spectroscopy (fNIRS) to first test this theory by comparing patterns of lateralized brain activity in homologous temporal-occipital facial processing regions during observation of faces in an ASD group and an NT group. As expected, the ASD participants showed reduced right hemisphere asymmetry for human faces, compared to the NT participants. Based on recent behavioral reports suggesting that robots can facilitate increased verbal interaction over human counterparts in ASD, we also measured responses to faces of robots to determine if these patterns of activation were lateralized in each group. In this exploratory test, both groups showed similar asymmetry patterns for the robot faces. Our findings confirm existing literature suggesting reduced asymmetry for human faces in ASD and provide a preliminary foundation for future testing of how the use of categorically different social stimuli in the clinical setting may be beneficial in this population.

Neuropsychological Profiles of Children with Asperger Syndrome and Autism

This study examined the possibility that diagnostic differentiation between children with autism and Asperger syndrome may be enhanced through the use of neuropsychological profiles. Two groups of children, clinically diagnosed as having Asperger syndrome ( n35) or autism ( n21), were tested with a neuropsychological battery to assess the propositions that these groups might differ in terms of Wechsler IQ profiles, brain hemispheric strengths and weaknesses, and executive functioning. Clinically diagnosed children with Asperger syndrome and autism were not differentiated on the basis of their neuropsychological profiles. The major difference between them was the overall higher IQ in Asperger syndrome, which was largely due to superior verbal abilities. Differences were also examined using DSM-IV/ICD-10 criteria: children were grouped according to the early history of presence or absence of language delay. No differences between the groups on any neurocognitive measure were found and there was no support for current neuropsychological theories purporting to support differential diagnostic status. It appears that current diagnostic differentiation in clinical practice may be primarily influenced by the child’s estimated verbal IQ level.

Executive Functioning and Memory Strategy Use in Children with Autism

An executive functioning deficit in autism should be reflected in a low level of active strategy use on memory tasks. This study was a direct examination of memory strategy use in two problem-solving situations by children with autism. Two groups with autism were tested, one high-functioning group and one with moderate cognitive impairments. All participants took part in two memory experiments to examine the effect of changing the nature of the learning situation on strategy use: one experiment used a serial recall task, and the other a recall readiness task. In contrast to previous studies, significant spontaneous strategy use was found on both memory tasks, particularly among the high-functioning group. Similarly, changing task structure was found to have an important impact on increasing strategy use, particularly for the moderate-functioning group. However, the overall rate of strategy use for the children with autism was still lower than would be expected for non-handicapped groups. The results support an executive functioning deficit interpretation, but a deficit that is less extensive among high-functioning individuals. Practical implications of the study in terms of cognitive training are also discussed.

Deficits in voice and multisensory processing in patients with Prader-Willi syndrome

Prader-Willi syndrome (PWS) is a rare neurodevelopmental and genetic disorder that is characterized by various expression of endocrine, cognitive and behavioral problems, among which a true obsession for food and a deficit of satiety that leads to hyperphagia and severe obesity. Neuropsychological studies have reported that PWS display altered social interactions with a specific weakness in interpreting social information and in responding to them, a symptom closed to that observed in autism spectrum disorders (ASD). Based on the hypothesis that atypical multisensory integration such as face and voice interactions would contribute in PWS to social impairment we investigate the abilities of PWS to process communication signals including the human voice. Patients with PWS recruited from the national reference center for PWS performed a simple detection task of stimuli presented in an uni-o or bimodal condition, as well as a voice discrimination task. Compared to control typically developing (TD) individuals, PWS present a specific deficit in discriminating human voices from environmental sounds. Further, PWS present a much lower multisensory benefits with an absence of violation of the race model indicating that multisensory information do not converge and interact prior to the initiation of the behavioral response. All the deficits observed in PWS were stronger for the subgroup of patients suffering from Uniparental Disomy, a population known to be more sensitive to ASD. Altogether, our study suggests that the deficits in social behavior observed in PWS derive at least partly from an impairment in deciphering the social information carried by voice signals, face signals, and the combination of both. In addition, our work is in agreement with the brain imaging studies revealing an alteration in PWS of the "social brain network" including the STS region involved in processing human voices.

Executive function is affected in autism spectrum disorder, but does not correlate with intelligence

INTRODUCTION

Studies of executive function in autism spectrum disorder without intellectual disability (ASD-WID) patients are contradictory. We assessed a wide range of executive functioning cognitive domains in a sample of children and adolescents with ASD-WID and compared them with age-, sex-, and intelligence quotient (IQ)-matched healthy controls.

METHODS

Twenty-four ASD-WID patients (mean age 12.8±2.5 years; 23 males; mean IQ 99.20±18.81) and 32 healthy controls (mean age 12.9±2.7 years; 30 males; mean IQ 106.81±11.02) were recruited.

RESULTS

Statistically significant differences were found in all cognitive domains assessed, with better performance by the healthy control group: attention (U=185.0; P=.0005; D=0.90), working memory (T51.48=2.597; P=.006; D=0.72), mental flexibility (U=236.0; P=.007; D=0.67), inhibitory control (U=210.0; P=.002; D=0.71), and problem solving (U=261.0; P=0.021; D=0.62). These statistically significant differences were also found after controlling for IQ.

CONCLUSION

Children and adolescents with ASD-WID have difficulties transforming and mentally manipulating verbal information, longer response latency, attention problems (difficulty set shifting), trouble with automatic response inhibition and problem solving, despite having normal IQ. Considering the low executive functioning profile found in those patients, we recommend a comprehensive intervention including work on non-social problems related to executive cognitive difficulties.

Mesial temporal lobe and memory function in autism spectrum disorder: an exploration of volumetric findings

Studies have shown that individuals with autism spectrum disorder (ASD) tend to perform significantly below typical developing individuals on standardized measures of memory, even when not significantly different on measures of IQ. The current study sought to examine within ASD whether anatomical correlates of memory performance differed between those with average-to-above-average IQ (AIQ group) and those with low-average to borderline ability (LIQ group) as well as in relations to typically developing comparisons (TDC). Using automated volumetric analyses, we examined regional volume of classic memory areas including the hippocampus, parahippocampal gyrus, entorhinal cortex, and amygdala in an all-male sample AIQ (n = 38) and LIQ (n = 18) individuals with ASD along with 30 typically developing comparisons (TDC). Memory performance was assessed using the Test of Memory and Learning (TOMAL) compared among the groups and then correlated with regional brain volumes. Analyses revealed group differences on almost all facets of memory and learning as assessed by the various subtests of the TOMAL. The three groups did not differ on any region of interest (ROI) memory-related brain volumes. However, significant size-memory function interactions were observed. Negative correlations were found between the volume of the amygdala and composite, verbal, and delayed memory indices for the LIQ ASD group, indicating larger volume related to poorer performance. Implications for general memory functioning and dysfunctional neural connectivity in ASD are discussed.

Age-related differences in cognition across the adult lifespan in autism spectrum disorder

It is largely unknown how age impacts cognition in autism spectrum disorder (ASD). We investigated whether age-related cognitive differences are similar, reduced or increased across the adult lifespan, examined cognitive strengths and weaknesses, and explored whether objective test performance is related to subjective cognitive challenges. Neuropsychological tests assessing visual and verbal memory, generativity, and theory of mind (ToM), and a self-report measure assessing cognitive failures were administered to 236 matched participants with and without ASD, aged 20-79 years (IQ > 80). Group comparisons revealed that individuals with ASD had higher scores on visual memory, lower scores on generativity and ToM, and similar performance on verbal memory. However, ToM impairments were no longer present in older (50+ years) adults with ASD. Across adulthood, individuals with ASD demonstrated similar age-related effects on verbal memory, generativity, and ToM, while age-related differences were reduced on visual memory. Although adults with ASD reported many cognitive failures, those were not associated with neuropsychological test performance. Hence, while some cognitive abilities (visual and verbal memory) and difficulties (generativity and semantic memory) persist across adulthood in ASD, others become less apparent in old age (ToM). Age-related differences characteristic of typical aging are reduced or parallel, but not increased in individuals with ASD, suggesting that ASD may partially protect against an age-related decrease in cognitive functioning. Despite these findings, adults with ASD experience many cognitive daily challenges, which highlights the need for adequate social support and the importance of further research into this topic, including longitudinal studies. Autism Res 2016, 9: 666-676. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

The dystrophin gene and cognitive function in the general population

The aim of our study is to investigate whether single-nucleotide dystrophin gene (DMD) variants associate with variability in cognitive functions in healthy populations. The study included 1240 participants from the Erasmus Rucphen family (ERF) study and 1464 individuals from the Rotterdam Study (RS). The participants whose exomes were sequenced and who were assessed for various cognitive traits were included in the analysis. To determine the association between DMD variants and cognitive ability, linear (mixed) modeling with adjustment for age, sex and education was used. Moreover, Sequence Kernel Association Test (SKAT) was used to test the overall association of the rare genetic variants present in the DMD with cognitive traits. Although no DMD variant surpassed the prespecified significance threshold (P<1 × 10(-4)), rs147546024:A>G showed strong association (β = 1.786, P-value = 2.56 × 10(-4)) with block-design test in the ERF study, while another variant rs1800273:G>A showed suggestive association (β = -0.465, P-value = 0.002) with Mini-Mental State Examination test in the RS. Both variants are highly conserved, although rs147546024:A>G is an intronic variant, whereas rs1800273:G>A is a missense variant in the DMD which has a predicted damaging effect on the protein. Further gene-based analysis of DMD revealed suggestive association (P-values = 0.087 and 0.074) with general cognitive ability in both cohorts. In conclusion, both single variant and gene-based analyses suggest the existence of variants in the DMD which may affect cognitive functioning in the general populations.

The neuropsychology of male adults with high-functioning autism or asperger syndrome

Autism Spectrum Disorder (ASD) is diagnosed on the basis of behavioral symptoms, but cognitive abilities may also be useful in characterizing individuals with ASD. One hundred seventy-eight high-functioning male adults, half with ASD and half without, completed tasks assessing IQ, a broad range of cognitive skills, and autistic and comorbid symptomatology. The aims of the study were, first, to determine whether significant differences existed between cases and controls on cognitive tasks, and whether cognitive profiles, derived using a multivariate classification method with data from multiple cognitive tasks, could distinguish between the two groups. Second, to establish whether cognitive skill level was correlated with degree of autistic symptom severity, and third, whether cognitive skill level was correlated with degree of comorbid psychopathology. Fourth, cognitive characteristics of individuals with Asperger Syndrome (AS) and high-functioning autism (HFA) were compared. After controlling for IQ, ASD and control groups scored significantly differently on tasks of social cognition, motor performance, and executive function (P's < 0.05). To investigate cognitive profiles, 12 variables were entered into a support vector machine (SVM), which achieved good classification accuracy (81%) at a level significantly better than chance (P < 0.0001). After correcting for multiple correlations, there were no significant associations between cognitive performance and severity of either autistic or comorbid symptomatology. There were no significant differences between AS and HFA groups on the cognitive tasks. Cognitive classification models could be a useful aid to the diagnostic process when used in conjunction with other data sources—including clinical history. Autism Res2014, 7: 568–581. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

Individuals with autism spectrum disorders do not use social stereotypes in irony comprehension

Social and communication impairments are part of the essential diagnostic criteria used to define Autism Spectrum Disorders (ASDs). Difficulties in appreciating non-literal speech, such as irony in ASDs have been explained as due to impairments in social understanding and in recognizing the speaker's communicative intention. It has been shown that social-interactional factors, such as a listener's beliefs about the speaker's attitudinal propensities (e.g., a tendency to use sarcasm, to be mocking, less sincere and more prone to criticism), as conveyed by an occupational stereotype, do influence a listener's interpretation of potentially ironic remarks. We investigate the effect of occupational stereotype on irony detection in adults with High Functioning Autism or Asperger Syndrome (HFA/AS) and a comparison group of typically developed adults. We used a series of verbally presented stories containing ironic or literal utterances produced by a speaker having either a "sarcastic" or a "non-sarcastic" occupation. Although individuals with HFA/AS were able to recognize ironic intent and occupational stereotypes when the latter are made salient, stereotype information enhanced irony detection and modulated its social meaning (i.e., mockery and politeness) only in comparison participants. We concluded that when stereotype knowledge is not made salient, it does not automatically affect pragmatic communicative processes in individuals with HFA/AS.

Age-related changes in conjunctive visual search in children with and without ASD

Visual-spatial strengths observed among people with autism spectrum disorder (ASD) may be associated with increased efficiency of selective attention mechanisms such as visual search. In a series of studies, researchers examined the visual search of targets that share features with distractors in a visual array and concluded that people with ASD showed enhanced performance on visual search tasks. However, methodological limitations, the small sample sizes, and the lack of developmental analysis have tempered the interpretations of these results. In this study, we specifically addressed age-related changes in visual search. We examined conjunctive visual search in groups of children with (n = 34) and without ASD (n = 35) at 7-9 years of age when visual search performance is beginning to improve, and later, at 10-12 years, when performance has improved. The results were consistent with previous developmental findings; 10- to 12-year-old children were significantly faster visual searchers than their 7- to 9-year-old counterparts. However, we found no evidence of enhanced search performance among the children with ASD at either the younger or older ages. More research is needed to understand the development of visual search in both children with and without ASD.

Neurocognitive performance of children with higher functioning autism spectrum disorders on the NEPSY-II

This study examined patterns of strengths and weaknesses in the neurocognitive performance of children with higher functioning autism spectrum disorder (ASD). The participants were 30 children with higher functioning ASD ranging from 6 to 11 years, and 60 typically developing (TD) children, who were matched with the children with higher functioning ASD in terms of age, gender, and maternal education. The TD children were drawn from the Finnish standardization sample for the NEPSY-II. The cognitive abilities of the children with higher functioning ASD were assessed with the WISC-III, and the neurocognitive performance of the children with higher functioning ASD and TD children on the NEPSY-II was compared. The children with higher functioning ASD were found to have strengths in verbal reasoning skills with respect to the population mean and weaknesses in set-shifting, verbal fluency, and narrative memory in comparison with the TD children. Minor weaknesses were also observed in facial memory and fine and visuomotor skills.

Atypical resource allocation may contribute to many aspects of autism

Based on a review of the literature and on reports by people with autism, this paper suggests that atypical resource allocation is a factor that contributes to many aspects of autism spectrum conditions, including difficulties with language and social cognition, atypical sensory and attentional experiences, executive and motor challenges, and perceptual and conceptual strengths and weaknesses. Drawing upon resource theoretical approaches that suggest that perception, cognition, and action draw upon multiple pools of resources, the approach hypothesizes that compared with resources in typical cognition, resources in autism are narrowed or reduced, especially in people with strong sensory symptoms. In narrowed attention, resources are restricted to smaller areas and to fewer modalities, stages of processing, and cognitive processes than in typical cognition; narrowed resources may be more intense than in typical cognition. In reduced attentional capacity, overall resources are reduced; resources may be restricted to fewer modalities, stages of processing, and cognitive processes than in typical cognition, or the amount of resources allocated to each area or process may be reduced. Possible neural bases of the hypothesized atypical resource allocation, relations to other approaches, limitations, and tests of the hypotheses are discussed.

The neurology of autism: many unanswered questions

Autism is a behaviorally defined developmental disorder of the brain almost always presenting in infancy or the preschool years. Its symptoms persist life-long, although partial compensation is possible through targeted special education that addresses children's deficits in sociability, verbal and non-verbal communication, and atypical range of interests, activities, and cognitive skills. Although a majority of autistic individuals are mentally deficient, IQ is not a defining feature and verbal autistic persons of normal intelligence are increasingly being identified, referred to as Asperger syndrome. Meager neuropathologic data have disclosed subtle prenatal cellular limbic and cerebellar abnormalities. Autism is associated with a variety of defined genetic and acquired conditions, with multifactorial genetic traits, alone or interacting with environmental events, presumably responsible for most unexplained cases. Autistic regression is frequent and poorly understood and may be associated with clinical or subclinical epilepsy. Unravelling the neurobiologic basis of a disorder that may affect 1-2 in 1000 children will require a concerted multidisciplinary attack.

Executive and visuo-motor function in adolescents and adults with autism spectrum disorder

This study broadly examines executive (EF) and visuo-motor function in 30 adolescent and adult individuals with high-functioning autism spectrum disorder (ASD) in comparison to 28 controls matched for age, gender, and IQ. ASD individuals showed impaired spatial working memory, whereas planning, cognitive flexibility, and inhibition were spared. Pure movement execution during visuo-motor information processing also was intact. In contrast, execution time of reading, naming, and of visuo-motor information processing tasks including a choice component was increased in the ASD group. Results of this study are in line with previous studies reporting only minimal EF difficulties in older individuals with ASD when assessed by computerized tasks. The finding of impaired visuo-motor information processing should be accounted for in further neuropsychological studies in ASD.

Motor and tactile-perceptual skill differences between individuals with high-functioning autism and typically developing individuals ages 5-21

We examined motor and tactile-perceptual skills in individuals with high-functioning autism (IHFA) and matched typically developing individuals (TDI) ages 5-21 years. Grip strength, motor speed and coordination were impaired in IHFA compared to matched TDI, and the differences between groups varied with age. Although tactile-perceptual skills of IHFA were impaired compared to TDI on several measures, impairments were significant only for stereognosis. Motor and tactile-perceptual skills should be assessed in children with IHFA and intervention should begin early because these skills are essential to school performance. Impairments in coordination and stereognosis suggest a broad though selective under-development of the circuitry for higher order abilities regardless of domain that is important in the search for the underlying disturbances in neurological development.

Aberrant neural mediation of verbal fluency in autism spectrum disorders

OBJECTIVE

Contrasts of verbal fluency and automatic speech provide an opportunity to evaluate the neural underpinnings of generativity and flexibility in autism spectrum disorders (ASD).

METHOD

We used functional magnetic resonance imaging (fMRI) to contrast brain activity in high functioning ASD (n=17, mean verbal IQ=117) and neurotypical (NT; n=20, mean verbal IQ=112) adolescent and young adult males (12-23years). Participants responded to three word generation conditions: automatic speech (reciting months), category fluency, and letter fluency.

RESULTS

Our paradigm closely mirrored behavioral fluency tasks by requiring overt, free recall word generation while controlling for differences in verbal output between the groups and systematically increasing the task demand. The ASD group showed reduced neural response compared to the NT participants during fluency tasks in multiple regions of left anterior and posterior cortices, and sub-cortical structures. Six of these regions fell in cortico-striatal circuits previously linked to repetitive behaviors (Langen, Durston, Kas, van Engeland, & Staal, 2011), and activity in two of them (putamen and thalamus) was negatively correlated with autism repetitive behavior symptoms in the ASD group. In addition, response in left inferior frontal gyrus was differentially modulated in the ASD, relative to the NT, group as a function of task demand.

CONCLUSIONS

These data indicate a specific, atypical brain response in ASD to demanding generativity tasks that may have relevance to repetitive behavior symptoms in ASD as well as to difficulties generating original verbal responses.

Neuropsychological investigation of motor impairments in autism

It is unclear how standardized neuropsychological measures of motor function relate to brain volumes of motor regions in autism spectrum disorder (ASD). An all-male sample composed of 59 ASD and 30 controls (ages 5-33 years) completed three measures of motor function: strength of grip (SOG), finger tapping test (FTT), and grooved pegboard test (GPT). Likewise, all participants underwent magnetic resonance imaging with region of interest (ROI) volumes obtained to include the following regions: motor cortex (precentral gyrus), somatosensory cortex (postcentral gyrus), thalamus, basal ganglia, cerebellum, and caudal middle frontal gyrus. These traditional neuropsychological measures of motor function are assumed to differ in motor complexity, with GPT requiring the most followed by FTT and SOG. Performance by ASD participants on the GPT and FTT differed significantly from that of controls, with the largest effect size differences observed on the more complex GPT task. Differences on the SOG task between the two groups were nonsignificant. Since more complex motor tasks tap more complex networks, poorer GPT performance by those with ASD may reflect less efficient motor networks. There was no gross pathology observed in classic motor areas of the brain in ASD, as ROI volumes did not differ, but FTT was negatively related to motor cortex volume in ASD. The results suggest a hierarchical motor disruption in ASD, with difficulties evident only in more complex tasks as well as a potential anomalous size-function relation in motor cortex in ASD.

Predicting literacy in children with a high-functioning autism spectrum disorder

The most commonly reported reading profile for children with a high-functioning autism spectrum disorder (HFASD) is one of intact decoding combined with reduced reading comprehension. Whether or not the variables that predict decoding and reading comprehension for children with a HFASD are exactly the same as those identified for a non-ASD population is unknown. Therefore, the ability of cognition, phonological processing, oral language, and vision to predict decoding and reading comprehension was investigated. Regression analysis revealed that cognition, phonological processing, and syntax predicted decoding and reading comprehension for the HFASD and non-ASD groups. One notable difference was that semantics predicted literacy for the non-ASD children but not their HFASD peers.

Abstract spatial reasoning as an autistic strength

Autistic individuals typically excel on spatial tests that measure abstract reasoning, such as the Block Design subtest on intelligence test batteries and the Raven’s Progressive Matrices nonverbal test of intelligence. Such well-replicated findings suggest that abstract spatial processing is a relative and perhaps absolute strength of autistic individuals. However, previous studies have not systematically varied reasoning level – concrete vs. abstract – and test domain – spatial vs. numerical vs. verbal, which the current study did. Autistic participants (N = 72) and non-autistic participants (N = 72) completed a battery of 12 tests that varied by reasoning level (concrete vs. abstract) and domain (spatial vs. numerical vs. verbal). Autistic participants outperformed non-autistic participants on abstract spatial tests. Non-autistic participants did not outperform autistic participants on any of the three domains (spatial, numerical, and verbal) or at either of the two reasoning levels (concrete and abstract), suggesting similarity in abilities between autistic and non-autistic individuals, with abstract spatial reasoning as an autistic strength.

Do adults with autism spectrum disorders compensate in naturalistic prospective memory tasks?

The present study is the first to directly compare event- and time-based prospective memory in Autism Spectrum Disorders (ASD) using a contextual task mirroring real life demands of prospective memory. Twenty-five individuals with ASD and 25 age- and ability-matched controls completed the Dresden Breakfast task which required participants to prepare breakfast following a set of rules and time restrictions. Overall, adults with ASD had less correct time- and event-based prospective memory responses in comparison to controls, which is consistent with previous research in children with ASD. Moreover, ASD participants completed fewer tasks, followed rules less closely, and monitored the elapsing time less closely than controls. Individuals with ASD seem not to be compensating in naturalistic prospective memory tasks.

Differential diagnosis between schizophrenia and autism in adulthood: a case report

The clinical distinction between autism spectrum disorders (ASD), also called pervasive developmental disorders (PDD), and schizophrenia is often difficult to make. Here we describe a case of an adult patient presenting with a diagnosis of schizophrenia based on a history of functional deterioration and presumed persecutory delusions. A psychiatric and psychological assessment conducted from a developmental perspective, in association with direct observation and neuropsychological evaluation for intellectual disabilities and autism, led to a diagnosis of PDD not otherwise specified, with revision of the initial diagnosis of schizophrenia.

Corpus Callosum Area in Children and Adults with Autism

Despite repeated findings of abnormal corpus callosum structure in autism, the developmental trajectories of corpus callosum growth in the disorder have not yet been reported. In this study, we examined corpus callosum size from a developmental perspective across a 30-year age range in a large cross-sectional sample of individuals with autism compared to a typically developing sample. Midsagittal corpus callosum area and the 7 Witelson subregions were examined in 68 males with autism (mean age 14.1 years; range 3-36 years) and 47 males with typical development (mean age 15.3 years; range 4-29 years). Controlling for total brain volume, increased variability in total corpus callosum area was found in autism. In autism, increased midsagittal areas were associated with reduced severity of autism behaviors, higher intelligence, and faster speed of processing (p=0.003, p=0.011, p=0.013, respectively). A trend toward group differences in isthmus development was found (p=0.029, uncorrected). These results suggest that individuals with autism benefit functionally from increased corpus callosum area. Our cross-sectional examination also shows potential maturational abnormalities in autism, a finding that should be examined further with longitudinal datasets.

Cognition in males and females with autism: similarities and differences

The male bias in autism spectrum conditions (ASC) has led to females with ASC being under-researched. This lack of attention to females could hide variability due to sex that may explain some of the heterogeneity within ASC. In this study we investigate four key cognitive domains (mentalizing and emotion perception, executive function, perceptual attention to detail, and motor function) in ASC, to test for similarities and differences between males and females with and without ASC (n = 128 adults; n = 32 per group). In the mentalizing and facial emotion perception domain, males and females with ASC showed similar deficits compared to neurotypical controls. However, in attention to detail and dexterity involving executive function, although males with ASC showed poorer performance relative to neurotypical males, females with ASC performed comparably to neurotypical females. We conclude that performance in the social-cognitive domain is equally impaired in male and female adults with ASC. However, in specific non-social cognitive domains, performance within ASC depends on sex. This suggests that in specific domains, cognitive profiles in ASC are modulated by sex.