The Bidirectional Social-Cognitive Mechanisms of the Social-Attention Symptoms of Autism

Mechanisms of Altered Imitation in Autism Spectrum Disorders

Imitation plays a critical role in enhancing social reciprocity and social/non-social skill learning. Accordingly, impaired imitation may have downstream implications on skill acquisition in autism. Social, motor, representational, and executive processes contribute to imitation performance, but it is unknown the degree to which differences in these domains contribute to imitation differences in autism. In the present study, we evaluated the role of various psychological mechanisms of autism-related imitation differences using mediation models. We assessed autistic and non-autistic 7-12-year-old children (n = 708) with FSIQ ≥ 80, using a wide battery of performance-based and parent-report tests that measured meaningful and non-meaningful gesture imitation performance, motor execution, action representation, social motivation, and executive function processes. Multiple marginal mediation analyses revealed that motor execution tests most strongly mediated imitation deficits in autism, though effects from social motivation, action representation, and executive function also partially mediated the relationship between autism diagnosis and imitation performance. Using cross-validated regression models, the domains tested here accounted for 39% of the variation in imitation performance. Results are contextualized across a broad range of experimental and observational studies with respect to the prompted imitation task utilized here. Future research will require longitudinal data, particularly from earlier stages of development.

Longitudinal stability and Autism Diagnostic Observation Scale-2 predictors of the Childhood Joint Attention Rating Scale

A recent study suggests that parent report on the Social Symptom and Prosocial scales of the Childhood Joint Attention Rating Scale provides useful information about differences in the social development of school-aged autistic children. The current study provides additional psychometric data on the Childhood Joint Attention Rating Scale regarding the longitudinal stability of its scales, its construct validity, and its sensitivity to differences in the social development of clinical samples of children. The study included 64 autistic children without co-occurring intellectual disability, 27 children with symptoms of attention deficit/hyperactivity disorder, and 36 neurotypical children between the ages of 10 and 18 years. Results indicated that scores from parent report on the Childhood Joint Attention Rating Scale were stable across a 15-month period in middle childhood for the three groups and groups received significantly different Childhood Joint Attention Rating Scale scores. Finally, construct validity was supported by the observation of correlations between tester observations of items on Autism Diagnostic Observation Scale-2 Social Affect and subsequent parent report on the Childhood Joint Attention Rating Scale. These results provide further evidence that the Childhood Joint Attention Rating Scale provides meaningful and potentially unique information about prosocial and social symptom development of school-aged autistic children.Lay abstractThis study tested a measure designed to capture social development in childhood and adolescence called the Childhood Joint Attention Rating Scale. This is important to study as most measures of social behavior are for preschool-aged children. We asked parents of 64 autistic children, 27 children with attention deficit/hyperactivity disorder, and 36 neurotypical children to fill out a new parent questionnaire designed to assess social skills. Specifically, our measure asks about both strengths and difficulties their child has with sharing experiences, engaging in cooperative efforts with others, and more. It is important to have strengths included in measures, as many autism measures only take difficulties into account. The findings of this study show that this new measure can assess social skill strengths and difficulties in children and adolescents. This measure may be useful in future research to help us understand how strengths and challenges in social behaviors develop or change throughout childhood and adolescence in autistic people.

Correlation Between Gaze Behaviors and Social Communication Skills of Young Autistic Children: A Meta-Analysis of Eye-Tracking Studies

This meta-analysis examined correlations between eye-tracking measures of gaze behaviors manifested during dynamic salient social stimuli and behavioral assessment measures of social communication skills of young autistic children. We employed a multilevel model with random effects to perform three separate meta-analyses for correlation between social communication skills and (a) all gaze behaviors, (b) gaze duration, and (c) gaze transition. Subsequently, we performed meta-regression to assess the role of four moderators, including age, continuum of naturalness of stimuli, gaze metric, and area of interest, on correlation effect sizes that were heterogeneous at the population level. A total of 111 correlation coefficients from 17 studies for 1132 young autistic children or children with high-likelihood for autism (Mage range = 6-95 months) were included in this meta-analysis. The correlation effect sizes for all three meta-analyses were significant, supporting the relation between improved gaze behaviors and better social communication skills. In addition, age, gaze metric, and area of interest were significant moderators. This suggests the importance of identifying meaningful gaze behaviors related to social communication skills and the increasingly influential role of gaze behaviors in shaping social communication skills as young autistic children progress through the early childhood stage. The continuum of naturalness of stimuli, however, was revealed to trend towards having a significant moderating effect. Lastly, it is important to note the evidence of potential publication bias. Our findings are discussed in the context of early identification and intervention and unraveling the complex nature of autism.

Comparative effectiveness of physical exercise interventions on sociability and communication in children and adolescents with autism: a systematic review and network meta-analysis

OBJECTIVE

To investigate the efficacy of physical activity as a crucial intervention for Autism spectrum disorder (ASD) in clinical settings, we conducted a network meta-analysis to evaluate the effect of various exercise interventions on sociability and communication in individuals with ASD. Our aim was to identify the exercise modalities most conducive to enhancing these essential skills.

METHODS

We searched Web of Science, PubMed, Cochrane Library, Scopus, Embase, and searched Chinese databases from inception to April 2024. We included randomized controlled trials that assessed the effects of different exercise types on sociability and communication in individuals with ASD. Network meta-analysis (NMA) was performed using a frequentist approach, and the node-splitting method was applied to assess inconsistency.

RESULTS

We included 38 original studies published between 2009 and 2024, with a total of 1,382 participants analyzed for sociability outcomes. Results indicated that sports games [SMD = 1.12, 95%CI (0.51, 1.73)], combination therapy [SMD = 1.11, 95%CI (0.13, 2.09)], group ball sports [SMD = 1.06, 95%CI (0.37, 1.75)], and outdoor exercise [SMD = 1.02, 95%CI (0.50, 1.55)] were more effective than passive controls. A total of 25 original literatures were included in the analysis of communication ability, involving 904 subjects, and the results showed that combination therapy [SMD = 1.57, 95% CI (0.74, 2.40)], sports games [SMD = 1.01, 95% CI (0.45, 1.56)], group ball games [SMD = 0.85, 95% CI (0.45, 1.26)], outdoor exercise [SMD = 0.79, 95% CI (0.48, 1.11)], and mind-body exercise [SMD = 0.79, 95% CI (0.29, 1.30)], all of which were more effective than passive controls.

CONCLUSION

Physical exercise plays a significant role in alleviating symptoms and enhancing sociability and communication in individuals with ASD. Our findings highlight that sports games, combination therapy, team ball sports, and outdoor exercise are particularly effective in improving sociability. In terms of communication skills, combination therapy, sports games, team ball sports, outdoor exercise, and mind-body exercise demonstrated the most substantial benefits. These results provide a robust foundation for future interventions aimed at improving the quality of life for individuals with ASD.

Evaluation of the Social Attention Hypothesis: Do Children with Autism Prefer to See Objects Rather than People?

A growing body of research shows that children with autism exhibit selective limitations in their ability to direct their visual attention to social stimuli. The cause of this selective limitation, however, remains unknown. The main purpose of this study is to determine whether the limitations in social attention are influenced by the objects in the environment. Specifically, the study examines the differences in visual attention between children with autism and typically developing (TD) children as they view videos of social interactions under two conditions, with and without objects. The sample consisted of 53 children with autism and 74 TD children, aged between 18 and 36 months. The findings indicated that young children with autism exhibited differences in their social attention compared to their TD peers. The results revealed that the presence of objects did not affect the visual attention differences between the two groups. However, removing objects from the environment positively impacted the social attention of both groups. In the condition without objects, both groups directed more visual attention more toward the Face and Body Areas of Interests (AoIs), whereas in the condition with objects, both groups prioritized looking at the Toy AoI. These findings have important implications for evidence-based decision-making, especially in designing early intervention environments for children with autism.

The Construct Validity of the Childhood Joint Attention Rating Scale (C-JARS) in School-Aged Autistic Children

Preliminary evidence from the Childhood Joint Attention Rating Scale (C-JARS; Mundy et al., 2017) suggests symptoms related to diminished joint attention and the spontaneous sharing of experience with others can be assessed with a parent-report measure in children and adolescents with autism. This study was designed to expand on the previous study by examining the validity of both a Social Symptom (SS) and a Prosocial (PS) scale of the C-JARS in a study of school-aged autistic children (n  = 89) with and without co-occurring intellectual disability (ID), as well as an age matched neurotypical sample (n  = 62). Results indicated that both C-JARS scales were sensitive and specific with respect to identifying the diagnostic status of the children. In addition, the PS scale was sensitive to differences in cognitive abilities (IQ) and sex differences in the autism group. These results are consistent with the hypothesis that joint attention and spontaneous sharing of experience symptoms are not only characteristic of preschool children with autism but may also constitute a developmentally continuous dimension of the social phenotype of autism that can be measured in school-aged children.

The Role of Pathways Early Autism Intervention in Improving Social Skills and Respeto for Young Hispanic Autistic Children

PURPOSE

We know very little about Hispanic autistic children's response to intervention as, historically, Hispanic children are underrepresented in intervention studies. Pathways parent-mediated early autism intervention is one of the few naturalistic developmental behavioral interventions (NDBIs) that is contextually and linguistically responsive to Hispanic families. However, some child-centered NDBI strategies do not align with the Hispanic caregiving value of respeto. A child exhibiting respeto demonstrates affiliative obedience by displaying deference and respect toward adults. Furthermore, theories of the ontogeny of cultural learning suggest that certain levels of social development may be necessary to learn cultural values. The current study investigates (1) the relationship between Hispanic autistic children's social skills and affiliative obedience and (2) the efficacy of Pathways in improving affiliative obedience in Hispanic children.

METHODS

This quasi-experimental design study used preexisting standardized test data and video recordings from 26 Hispanic participants who took part in a previous Pathways efficacy study. Recordings were coded for affiliative obedience and social connectedness. Residual change variables were used to measure progress from baseline to post-intervention, and correlation and hierarchical regression analyses were conducted to analyze the data.

RESULTS

We found significant positive correlations between social skills and children's affiliative obedience for baseline and change variables. In addition, we found Pathways had a significant medium-large magnitude effect on change in affiliative obedience skills.

CONCLUSION

This study highlights the benefits of NDBI interventions that advance social development in autistic children and support Hispanic parents in enculturating their children in the value of respeto.

No effect of autistic traits on social attention: evidence based on single-cue and conflicting-cues scenarios

Individuals often use others' gaze and head directions to direct their attention. To investigate the influence of autistic traits on social attention, we conducted two experiments comparing groups with high and low autistic traits in single-cue (Experiment 1) and conflicting-cue (Experiment 2) scenarios. Our findings indicate that individuals responded more rapidly to the direction of a single social cue or the consensus of multiple cues. However, we did not observe significant differences in social attention between individuals with high and low autistic traits. Notably, as the stimulus onset asynchrony (SOA) increased, individuals with low autistic traits exhibited greater improvements in reaction speed compared to those with high autistic traits. This suggests that individuals with low autistic traits excel at leveraging temporal information to optimize their behavioral readiness over time, hinting at potential variations in cognitive flexibility related to autistic traits.

Infant Social Attention Associated with Elevated Likelihood for Autism Spectrum Disorder: A Multi-Method Comparison

PURPOSE

The study aimed to compare eye tracking (ET) and manual coding (MC) measures of attention to social and nonsocial information in infants with elevated familial likelihood (EL) of autism spectrum disorder (ASD) and low likelihood of ASD (LL). ET provides a temporally and spatially sensitive tool for measuring gaze allocation. Existing evidence suggests that ET is a promising tool for detecting distinct social attention patterns that may serve as a biomarker for ASD. However, ET is prone to data loss, especially in young EL infants.

METHODS

To increase evidence for ET as a viable tool for capturing atypical social attention in EL infants, the current prospective, longitudinal study obtained ET and MC measures of social and nonsocial attention in 25 EL and 47 LL infants at several time points between 3 and 24 months of age.

RESULTS

ET data was obtained with a satisfactory success rate of 95.83%, albeit with a higher degree of data loss compared to MC. Infant age and ASD likelihood status did not impact the extent of ET or MC data loss. There was a significant positive association between the ET and MC measures of attention, and separate analyses of attention using ET and AC measures yielded comparable findings. These analyses indicated group differences (EL vs. LL) in age-related change in attention to social vs. nonsocial information.

CONCLUSION

Together, the findings support infant ET as a promising approach for identifying very early markers associated with ASD likelihood.

People with Autism Spectrum Disorder Could Interact More Easily with a Robot than with a Human: Reasons and Limits

Individuals with Autism Spectrum Disorder show deficits in communication and social interaction, as well as repetitive behaviors and restricted interests. Interacting with robots could bring benefits to this population, notably by fostering communication and social interaction. Studies even suggest that people with Autism Spectrum Disorder could interact more easily with a robot partner rather than a human partner. We will be looking at the benefits of robots and the reasons put forward to explain these results. The interest regarding robots would mainly be due to three of their characteristics: they can act as motivational tools, and they are simplified agents whose behavior is more predictable than that of a human. Nevertheless, there are still many challenges to be met in specifying the optimum conditions for using robots with individuals with Autism Spectrum Disorder.

Social interaction links active musical rhythm engagement and expressive communication in autistic toddlers

Rhythm is implicated in both social and linguistic development. Rhythm perception and production skills are also key vulnerabilities in neurodevelopmental disorders such as autism which impact social communication. However, direct links between musical rhythm engagement and expressive communication in autism is not clearly evident. This absence of a direct connection between rhythm and expressive communication indicates that the mechanism of action between rhythm and expressive communication may recruit other cognitive or developmental factors. We hypothesized that social interactions, including general interpersonal relationships and interactive music-making involving children and caregivers, were a significant such factor, particularly in autism. To test this, we collected data from parents of autistic and nonautistic children 14-36 months of age, including parent reports of their children's rhythmic musical engagement, general social skills, parent-child musical interactions, and expressive communication skills. Path analysis revealed a system of independent, indirect pathways from rhythmic musical engagement to expressive communication via social skills and parent-child musical interactions in autistic toddlers. Such a system implies both that social and musical interactions represent crucial links between rhythm and language and that different kinds of social interactions play parallel, independent roles linking rhythmic musical engagement with expressive communication skills.

Integrating Social Cognition Into Domain-General Control: Interactive Activation and Competition for the Control of Action (ICON)

Social cognition differs from general cognition in its focus on understanding, perceiving, and interpreting social information. However, we argue that the significance of domain-general processes for controlling cognition has been historically undervalued in social cognition and social neuroscience research. We suggest much of social cognition can be characterized as specialized feature representations supported by domain-general cognitive control systems. To test this proposal, we develop a comprehensive working model, based on an interactive activation and competition architecture and applied to the control of action. As such, we label the model "ICON" (interactive activation and competition model for the control of action). We used the ICON model to simulate human performance across various laboratory tasks. Our simulations emphasize that many laboratory-based social tasks do not require socially specific control systems, such as those that are argued to rely on neural networks associated with theory-of-mind. Moreover, our model clarifies that perceived disruptions in social cognition, even in what appears to be disruption to the control of social cognition, can stem from deficits in social representation instead. We advocate for a "default stance" in social cognition, where control is usually general, but representation is specific. This study underscores the importance of integrating social cognition within the broader realm of domain-general control processing, offering a unified perspective on task processing.

The Selective Social Attention task in children with autism spectrum disorder: Results from the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) feasibility study

The Selective Social Attention (SSA) task is a brief eye-tracking task involving experimental conditions varying along socio-communicative axes. Traditionally the SSA has been used to probe socially-specific attentional patterns in infants and toddlers who develop autism spectrum disorder (ASD). This current work extends these findings to preschool and school-age children. Children 4- to 12-years-old with ASD (N = 23) and a typically-developing comparison group (TD; N = 25) completed the SSA task as well as standardized clinical assessments. Linear mixed models examined group and condition effects on two outcome variables: percent of time spent looking at the scene relative to scene presentation time (%Valid), and percent of time looking at the face relative to time spent looking at the scene (%Face). Age and IQ were included as covariates. Outcome variables' relationships to clinical data were assessed via correlation analysis. The ASD group, compared to the TD group, looked less at the scene and focused less on the actress' face during the most socially-engaging experimental conditions. Additionally, within the ASD group, %Face negatively correlated with SRS total T-scores with a particularly strong negative correlation with the Autistic Mannerism subscale T-score. These results highlight the extensibility of the SSA to older children with ASD, including replication of between-group differences previously seen in infants and toddlers, as well as its ability to capture meaningful clinical variation within the autism spectrum across a wide developmental span inclusive of preschool and school-aged children. The properties suggest that the SSA may have broad potential as a biomarker for ASD.

Vasopressin, and not oxytocin, receptor gene methylation is associated with individual differences in receptive joint attention in chimpanzees (Pan troglodytes)

Joint attention (JA) is an important milestone in human infant development and is predictive of the onset of language later in life. Clinically, it has been reported that children at risk for or with a diagnosis of autism spectrum disorder (ASD) perform more poorly on measures of JA compared to neurotypical controls. JA is not unique to humans but has also been reported in great apes and to a lesser extent in more distantly related monkeys. Further, individual differences in JA among chimpanzees are associated with polymorphisms in the vasopressin and oxytocin genes, AVPR1A and OXTR. Here, we tested whether individual variation in DNA methylation of OXTR and AVPR1A were associated with performance on JA tasks in chimpanzees. We found that individual differences in JA performance was associated with AVPR1A methylation, but not OXTR methylation in the chimpanzees. The collective results provide further evidence of the role of AVPR1A in JA abilities in chimpanzees. The results further suggest that methylation values for AVPR1A may be useful biomarkers for identifying individuals at risk for ASD or related neurodevelopmental disorders associated with impairments in JA abilities.

Research on social attention in autism and the challenges of the research domain criteria (RDoC) framework

The fuzzy nature of categories of psychopathology, such as autism, leads to significant research challenges. Alternatively, focusing research on the study of a common set of important and well-defined psychological constructs across psychiatric conditions may make the fundamental etiological processes of psychopathology easier to discern and treat (Cuthbert, 2022). The development of the research domain criteria (RDoC) framework is designed to guide this new research approach (Insel et al., 2010). However, progress in research may be expected to continually refine and reorganize the understanding of the specifics of these mental processes (Cuthbert & Insel, 2013). Moreover, knowledge gleaned from the study of both normative and atypical development can be mutually informative in the evolution of our understanding of these fundamental processes. A case in point is the study of social attention. This Autism 101 commentary provides an educational summary of research over the last few decades indicates that social attention is major construct in the study of human social-cognitive development, autism and other forms of psychopathology. The commentary also describes how this research can inform the Social Process dimension of the RDoC framework.

Reexamining Pathways Early Autism Intervention in Children Before and After the Third Birthday: A Randomized Control Trial

We reexamined the efficacy of Pathways early autism intervention using generalized measures of social communication and language skills administered by an unfamiliar adult in a novel environment. Generalized measures improve on sources of measurement bias. Sixty-seven autistic children blocked on age (under versus over 3 years) were randomly assigned to 15 weeks of Pathways or services-as-usual. Age moderated the effects of Pathways for social communication. Specifically, Pathways had a significantly large effect for children under 3 and a small effect that approached significance for children over 3. Pathways also had a small effect on expressive speech/language skills. Results replicate previous findings of the efficacy of Pathways on proximal and distal skills and support the importance of early intervention.

Joint attention performance in preschool-aged boys with autism or fragile X syndrome

Early development marks a period of rapid learning facilitated by children's natural curiosity about the people around them. In children with typical development, these early social attentional preferences set the foundation for learning about and from the surrounding world of people. Much of this learning happens using joint attention, the ability to coordinate attention between people and objects of mutual interest. It is well documented that decreased gaze use is commonly observed in individuals with autism and individuals with fragile X syndrome (FXS). Despite the growing body of research comparing phenotypic similarities between individuals with autism and individuals with FXS, no studies have directly compared joint attention performance between these groups. In the present study, we considered the similarities and differences in joint attention between preschool-aged boys with autism or FXS, and the relation between joint attention, language, and other phenotypic characteristics known to differ between boys with autism and boys with FXS. Although joint attention appeared similar, between-group differences emerged when controlling for the influence of age, non-verbal IQ, and autism symptom severity. Differences were also observed when considering how joint attention performance related to other aspects of the phenotype. For example, strong positive associations were observed between joint attention and language performance in boys with autism but not boys with FXS, even after controlling for non-verbal IQ. In contrast, the negative association between joint attention and anxiety symptom severity was significant and stronger in boys with FXS than in autism. These data offer preliminary insights into the similarities and differences between the autism and FXS phenotypes.