1
|
Jording M, Hartz A, Vogel DHV, Schulte-Rüther M, Vogeley K. Impaired recognition of interactive intentions in adults with autism spectrum disorder not attributable to differences in visual attention or coordination via eye contact and joint attention. Sci Rep 2024; 14:8297. [PMID: 38594289 PMCID: PMC11004189 DOI: 10.1038/s41598-024-58696-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024] Open
Abstract
Altered nonverbal communication patterns especially with regard to gaze interactions are commonly reported for persons with autism spectrum disorder (ASD). In this study we investigate and differentiate for the first time the interplay of attention allocation, the establishment of shared focus (eye contact and joint attention) and the recognition of intentions in gaze interactions in adults with ASD compared to control persons. Participants interacted via gaze with a virtual character (VC), who they believed was controlled by another person. Participants were instructed to ascertain whether their partner was trying to interact with them. In fact, the VC was fully algorithm-controlled and showed either interactive or non-interactive gaze behavior. Participants with ASD were specifically impaired in ascertaining whether their partner was trying to interact with them or not as compared to participants without ASD whereas neither the allocation of attention nor the ability to establish a shared focus were affected. Thus, perception and production of gaze cues seem preserved while the evaluation of gaze cues appeared to be impaired. An additional exploratory analysis suggests that especially the interpretation of contingencies between the interactants' actions are altered in ASD and should be investigated more closely.
Collapse
Affiliation(s)
- Mathis Jording
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany.
- Department of Psychiatry, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Arne Hartz
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH, Aachen, Germany
| | - David H V Vogel
- Department of Psychiatry, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Martin Schulte-Rüther
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital RWTH, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine - University Hospital Heidelberg, Ruprechts-Karls University Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Georg-August University Göttingen, Göttingen, Germany
| | - Kai Vogeley
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Forschungszentrum Jülich, Jülich, Germany
- Department of Psychiatry, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
2
|
Schulte-Rüther M, Kulvicius T, Stroth S, Wolff N, Roessner V, Marschik PB, Kamp-Becker I, Poustka L. Using machine learning to improve diagnostic assessment of ASD in the light of specific differential and co-occurring diagnoses. J Child Psychol Psychiatry 2023; 64:16-26. [PMID: 35775235 DOI: 10.1111/jcpp.13650] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/08/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Diagnostic assessment of ASD requires substantial clinical experience and is particularly difficult in the context of other disorders with behavioral symptoms in the domain of social interaction and communication. Observation measures such as the Autism Diagnostic Observation Schedule (ADOS) do not take into account such co-occurring disorders. METHOD We used a well-characterized clinical sample of individuals (n = 1,251) that had received detailed outpatient evaluation for the presence of an ASD diagnosis (n = 481) and covered a range of additional overlapping diagnoses, including anxiety-related disorders (ANX, n = 122), ADHD (n = 439), and conduct disorder (CD, n = 194). We focused on ADOS module 3, covering the age range with particular high prevalence of such differential diagnoses. We used machine learning (ML) and trained random forest models on ADOS single item scores to predict a clinical best-estimate diagnosis of ASD in the context of these differential diagnoses (ASD vs. ANX, ASD vs. ADHD, ASD vs. CD), in the context of co-occurring ADHD, and an unspecific model using all available data. We employed nested cross-validation for an unbiased estimate of classification performance and made available a Webapp to showcase the results and feasibility for translation into clinical practice. RESULTS We obtained very good overall sensitivity (0.89-0.94) and specificity (0.87-0.89). In particular for individuals with less severe symptoms, our models showed increases of up to 35% in sensitivity or specificity. Furthermore, we analyzed item importance profiles of the ANX, ADHD, and CD models in comparison with the unspecific model revealing distinct patterns of importance for specific ADOS items with respect to differential diagnoses. CONCLUSIONS ML-based diagnostic classification may improve clinical decisions by utilizing the full range of information from detailed diagnostic observation instruments such as the ADOS. Importantly, this strategy might be of particular relevance for older children with less severe symptoms for whom the diagnostic decision is often particularly difficult.
Collapse
Affiliation(s)
- Martin Schulte-Rüther
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Leibniz ScienceCampus Primate Cognition, Göttingen, Germany
| | - Tomas Kulvicius
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Department for Computational Neuroscience, University of Göttingen, Göttingen, Germany
| | - Sanna Stroth
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Marburg, Philipps-University Marburg, Marburg, Germany
| | - Nicole Wolff
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Peter B Marschik
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Leibniz ScienceCampus Primate Cognition, Göttingen, Germany.,Department of Women's and Children's Health, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden.,iDN - interdisciplinary Developmental Neuroscience, Division of Phoniatrics, Medical University of Graz, Graz, Austria
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Marburg, Philipps-University Marburg, Marburg, Germany
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Leibniz ScienceCampus Primate Cognition, Göttingen, Germany
| |
Collapse
|