Spatial Perspective-Taking in Children With Autism Spectrum Disorders: The Predictive Role of Visuospatial and Motor Abilities

Motor and visuospatial processing profile in a cross-conditions study: A comparison between developmental coordination disorder and nonverbal learning disability

BACKGROUND

Neurodevelopmental conditions often exhibit overlapping symptoms, posing challenges for differential diagnosis. Developmental Coordination Disorder (DCD) manifests as fundamental motor impairments, often along with co-occurring visuospatial difficulties. Nonverbal Learning Disorder (NLD) features visuospatial core challenges, with a less consistent characterization of its motor profile. Strikingly, to date no study has directly compared DCD and NLD profiles.

AIMS

The present study aimed to analyze whether DCD and NLD share any characteristics by contrasting their motor and visuospatial performances, comparing them with non-diagnosed (ND) peers.

METHODS AND PROCEDURES

A total of 102 participants (8-16 years; DCD N = 29, NLD N = 29, ND N = 44) completed motor and visuospatial tasks. The groups' performance was compared, and the discriminatory power of the measures administered was analyzed.

OUTCOMES AND RESULTS

Our findings support the substantial motor and visuospatial impairments in DCD and NLD, respectively. Regarding diagnostic efficacy, motor and visuospatial tasks effectively differentiated DCD or NLD from ND, with specificities related to each condition. Balance, and to a lesser extent, Spatial Processing revealed significant predictive power in distinguishing between DCD and NLD.

CONCLUSIONS AND IMPLICATIONS

Our results revealed cross-disorder similarities and highlighted specific hallmarks, corroborating the need of a comprehensive motor and visuospatial assessment for distinguishing between DCD and NLD.

Differential diagnosis: Understanding nonverbal learning disorder and autism spectrum disorder

Previous research has suggested that children with Nonverbal Learning Disorder (NLD) share similar clinical profiles to those with autism spectrum disorder (ASD). Three groups of children were identified for the purpose of the current study: NLD (n = 41), ASD (n = 55), and ASD with a NLD profile (n = 17). Children who met DSM-5 criteria for ASD after a neuropsychological evaluation were included in this sample. The NLD group was defined by VSI < VCI, with a minimum of a 15-point discrepancy between indices and average to above average verbal intelligence, whereas children who met DSM-5 criteria for ASD and also demonstrated visual-spatial deficits met criteria for the NLD + ASD group. As anticipated, the ASD group performed better on measures of VSI compared to the NLD and ASD + NLD groups. There was not a significant difference between groups on measures of visuomotor and construction abilities, visual integration, motor processing speed, and academic achievement. No significant differences between groups were found on the CBCL/TRF Social Problems, Attention Problems, or Internalizing/Externalizing Problems scales, indicating similar phenotypes. However, there was a significant difference between groups on the Thought Problems subscale for teacher and parent rating scales. Results corroborate previous research indicating similarities between neuropsychological profiles and suggest that the ASEBA Thought Problems scale may aid in discriminating individuals with ASD from those with NLD.

Perspective taking deficits and their relationship with theory of mind abilities in patients with relapsing-remitting multiple sclerosis (RRMS)

Introduction and objectives: In recent years, research has reported that between 45% and 70% of patients with Multiple Sclerosis (MS) have cognitive deficits, the most prominent being those associated with the frontal lobe. Among these deficits, we can find Theory of Mind (ToM), which is the ability to infer feelings and thoughts of others. Although it has been suggested that ToM relies on more basic skills, such as perspective taking (PT), no studies have investigated this association in patients with MS. The aim of this study was to investigate PT abilities in patients with MS and to establish their relationship with ToM deficits. Material and methods: 36 patients with relapsing-remitting multiple sclerosis (RRMS) and 42 healthy controls matched by age, sex and educational level were evaluated. Both groups were tested to estimate premorbid and current intellectual capacity, PT, ToM (Reading the Mind in the Eyes Test -RMET- and Faux Pas) and complementary scales (fatigue, depression and disability). Results: Patients with RRMS presented significant differences from controls in both PT and ToM tests. The PT test showed positive correlation with RMET, one of our ToM tests. Conclusion: The results show that there is a relationship between ToM and PT abilities. Our findings are of clinical and academic relevance to both the assessment and interpretation as well as the rehabilitation of social deficits in MS.

Measuring spatial navigation during locomotion in children: A systematic review

Spatial navigation allows us to move around our environment, walking being the most advanced form of human locomotion. Over the years, a range of tools has been developed to study spatial navigation in children. Aim. To describe the role of locomotion during the assessment of spatial navigation in children, providing an overview of the instruments available for assessing spatial navigation in typically developing children and those with neurodevelopmental disorders. Methods and Procedures. A systematic search was performed in six electronic databases between December 2022 and February 2023, then updated in July 2023. Cross-sectional and observational studies were included. Outcomes and results. Of the 3,385 studies screened, 47 were selected for this review. Five studies described the influence of locomotion on spatial navigation, and seven studies included locomotion as an explanatory variable in this area. Most studies focused on children from five to twelve years old, whereas only nine were centred on infants and preschoolers. Just eight assessed spatial abilities in individuals with neurodevelopmental disorders. Conclusions and implications. Children with or at risk of neurodevelopmental impairments show poorer spatial navigation skills. Having the choice to actively explore the space is more important than the way they locomote. It is necessary to have tools to assess spatial navigation during locomotion early in infancy.

"Picture this from there": spatial perspective-taking in developmental visuospatial disorder and developmental coordination disorder

Introduction

Either Developmental Visuospatial Disorder (DVSD) and Developmental Coordination Disorder (DCD) present with difficulties in visuospatial processing, even though entailing different degrees of impairment. Among the visuospatial domain, spatial perspective taking is essential to interact with the environment and is significantly involved in many daily activities (e.g., environment navigation and spatial orienting). Notwithstanding, no previous studies have investigated this spatial domain in children with DVSD and limited evidence is available regarding DCD. Consistent with a transdiagnostic approach, the first goal of the present study was to compare spatial perspective taking abilities of these groups, also including a control group of not diagnosed peers (ND). Secondly, the role of different fine-motor and visuo-spatial predictors on the spatial perspective taking performance was considered.

Method

A total of 85 participants (DVSD = 26; DCD = 26; ND = 33), aged between 8 and 16 years old, were included in the study. Tasks assessing spatial perspective taking, fine-motor, visual imagery, and mental rotation skills, as well as visuo-spatial working memory were administered.

Results and Discussion

Overall, our results confirmed weaknesses in spatial perspective taking in both clinical groups, with the DVSD obtaining the lowest scores. Similarities and differences in the predictors accounting for the performance in the spatial perspective taking task emerged, suggesting the possible employment of different fine-motor or visuospatial strategies by group. Findings are discussed considering the potential impact they may have both in research and clinical practice.

Malleability of spatial skills: bridging developmental psychology and toy design for joyful STEAM development

Previous research has established that advances in spatial cognition predict STEAM success, and construction toys provide ample opportunities to foster spatial cognition. Despite various construction toy designs in the market, mostly brick-shaped building blocks are used in spatial cognition research. This group of toys is known to enhance mental rotation; however, mental rotation is not the only way to comprehend the environment three-dimensionally. More specifically, mental folding and perspective taking training have not received enough attention as they can also be enhanced with the construction toys, which are framed based on the 2×2 classification of spatial skills (intrinsic-static, intrinsic-dynamic, extrinsic-static, extrinsic-dynamic). To address these gaps, we compile evidence from both developmental psychology and toy design fields to show the central role played by mental folding and perspective taking skills as well as the importance of the variety in toy designs. The review was conducted systematically by searching peer reviewed design and psychology journals and conference proceedings. We suggest that, over and above their physical properties, construction toys offer affordances to elicit spatial language, gesture, and narrative among child-caregiver dyads. These interactions are essential for the development of spatial skills in both children and their caregivers. As developmental psychology and toy design fields are two domains that can contribute to the purpose of developing construction toys to boost spatial skills, we put forward six recommendations to bridge the current gaps between these fields. Consequently, new toy designs and empirical evidence regarding malleability of different spatial skills can contribute to the informal STEAM development.

Sensory Profile of Children and Adolescents with Autism Spectrum Disorder and Tip-Toe Behavior: Results of an Observational Pilot Study

Atypical sensory processing is frequently reported in persons with autism spectrum disorders (ASD), and it is one of the described diagnostic criteria for ASD. There is also mounting literature supporting the presence of motor impairments in individuals with ASD. Among these motor signs, tip-toe behavior (TTB) is a possible clinical finding, but its etiology is not clearly understood. It is suggested that TTB in ASD could be a sign of a sensory modulation impairment, but evidence is lacking and controversial. The main aim of this pilot study is to explore sensory features in a sample (4 females; 28 males) of children and adolescents with ASD (age range: 7-18). All participants also presented Intellectual Disability. Participants were divided in two groups, matched for age and gender, on the basis of the presence or absence of TTB (16 ASD TTB group vs. 16 ASD NO-TTB group) and then evaluated by using the Short Sensory Profile. We found that both ASD groups tend to significantly present sensory-related behavioral symptoms, but ASD TTB individuals more frequently showed the specific pattern of "under responsive/seeks sensation" than ASD NO-TTB individuals. These preliminary findings support that sensory-motor features might be taken into consideration when rehabilitation for TTB in children and adolescents with ASD is necessary.

Do children with and without autism spectrum disorder use different visuospatial processing skills to perform the Rey-Osterrieth complex figure test?

Visuospatial organization abilities are closely related to other visuospatial processing skills, such as visuomotor coordination, perceptual abilities, mental rotation, and working memory (WM). One task that enables visuospatial organization abilities to be investigated is the Rey-Osterrieth complex figure test (ROCFT). When examining visuospatial functioning, individuals with autism spectrum disorder (ASD) have proved capable of operating both locally and globally, depending on the sub-domain embraced, with a preference for a locally-oriented processing of visuospatial information. The present research aimed to establish whether different underlying visuospatial skills might account for performance in the ROCFT in children and adolescents with ASD, compared with typically developing (TD), by considering the role of local/global visuospatial processing. The study involved 39 participants who have ASD without intellectual disability, and 57 TD aged 8-16 years. The participants were administered tasks assessing visuospatial organization abilities, manual dexterity, visual perception, mental rotation, spatial-sequential, spatial-simultaneous WM, and visuospatial processing. Our results suggest that manual dexterity and visuospatial processing similarly explain performance in both groups, while differences in visuospatial WM account for the two groups' visuospatial organization abilities. Spatial-simultaneous WM predicted performance in copy and recall conditions in the TD group but not in the ASD group, while spatial-sequential WM only did so in the latter group, reinforcing the tendency of children with ASD towards local bias in the visuospatial organization domain. The implications of these findings are discussed. LAY SUMMARY: The visuospatial organization abilities of children and adolescents with and without autism were compared, considering their underlying visuospatial skills. Visuospatial organization impairments emerged for children with autism, who differed from typically developing children in the underlying visuospatial skills involved. Given the crucial role of visuospatial organization abilities in everyday life, our results could inspire practitioners to develop training interventions that take into account the strengths and weaknesses of individuals with autism.

Can dog-assisted and relaxation interventions boost spatial ability in children with and without special educational needs? A longitudinal, randomized controlled trial

Children's spatial cognition abilities are a vital part of their learning and cognitive development, and important for their problem-solving capabilities, the development of mathematical skills and progress in Science, Technology, Engineering and Maths (STEM) topics. As many children have difficulties with STEM topic areas, and as these topics have suffered a decline in uptake in students, it is worthwhile to find out how learning and performance can be enhanced at an early age. The current study is the first to investigate if dog-assisted and relaxation interventions can improve spatial abilities in school children. It makes a novel contribution to empirical research by measuring longitudinally if an Animal-Assisted Intervention (AAI) or relaxation intervention can boost children's development of spatial abilities. Randomized controlled trials were employed over time including dog intervention, relaxation intervention and no treatment control groups. Interventions were carried out over 4 weeks, twice a week for 20 min. Children were tested in mainstream schools (N = 105) and in special educational needs (SEN) schools (N = 64) before and after interventions, after 6 weeks, 6 months and 1 year. To assess intervention type and to provide advice for subsequent best practice recommendations, dog-assisted interventions were run as individual or small group interventions. Overall, children's spatial abilities improved over the year with highest increases in the first 4 months. In Study 1, typically developing children showed higher scores and more continuous learning overall compared to children with special educational needs. Children in the dog intervention group showed higher spatial ability scores immediately after interventions and after a further 6 weeks (short-term). Children in the relaxation group also showed improved scores short-term after relaxation intervention. In contrast, the no treatment control group did not improve significantly. No long-term effects were observed. Interestingly, no gender differences could be observed in mainstream school children's spatial skills. In study 2, children in SEN schools saw immediate improvements in spatial abilities after relaxation intervention sessions. No changes were seen after dog interventions or in the no treatment control group. Participants' pet ownership status did not have an effect in either cohort. These are the first findings showing that AAI and relaxation interventions benefit children's spatial abilities in varied educational settings. This research represents an original contribution to Developmental Psychology and to the field of Human-Animal Interaction (HAI) and is an important step towards further in-depth investigation of how AAI and relaxation interventions can help children achieve their learning potential, both in mainstream schools and in schools for SEN.

Interactions between interoception and perspective-taking: Current state of research and future directions

Interoception, the sense of the physiological state of the body, and perspective-taking, the ability to take another's point of view, are two fundamental components contributing to our perception and interaction with the external world. However, whether the perception of our inner body influences how we perceive the external world and other people remains poorly understood. Here, we review recent behavioural and neuroimaging evidence investigating the links between dimensions of interoception (i.e., accuracy, sensibility and awareness) and perspective-taking (i.e., affective, cognitive and visual). So far, only a limited subset of these dimensions has been investigated together and the results suggest that interoceptive abilities may only interact with perspective-taking when embodied mental transformations are required. Furthermore, mainly the emotional aspects of perspective-taking are related to interoception, influencing the ability to empathise with others. Future research should systematically investigate the links between all dimensions of interoception and perspective-taking to provide full understanding of the specific role interoception has on how we perceive the world and take another's point of view.

Brain mechanisms of visuospatial perspective-taking in relation to object mental rotation and the theory of mind

Visuospatial perspective-taking (VPT) is a process of imagining what can be seen and how a scene looks from a location and orientation in space that differs from one's own. It comprises two levels that are underpinned by distinct neurocognitive processes. Level-2 VPT is often studied in relation to two other cognitive phenomena, object mental rotation (oMR) and theory of mind (ToM). With the aim to describe the broad picture of neurocognitive processes underlying level-2 VPT, here we give an overview of the recent behavioral and neuroscientific findings of level-2 VPT. We discuss its relation to level-1 VPT, which is also referred to as perspective-tracking, and the neighboring topics, oMR and ToM. Neuroscientific research shows that level-2 VPT is a diverse cognitive process, encompassing functionally distinct neural circuits. It shares brain substrates with oMR, especially those parietal brain areas that are specialized in spatial reasoning. However, compared to oMR, level-2 VPT involves additional activations in brain structures that are typically involved in ToM tasks and deal with self/other distinctions. In addition, level-2 VPT has been suggested to engage brain areas coding for internal representations of the body. Thus, the neurocognitive model underpinning level-2 VPT can be understood as a combination of visuospatial processing with social cognition and body schema representations.