Novel Prefrontal Synthesis Intervention Improves Language in Children with Autism

Three mechanisms of language comprehension are revealed through cluster analysis of individuals with language deficits

Analysis of linguistic abilities that are concurrently impaired in individuals with language deficits allows identification of a shared underlying mechanism. If any two linguistic abilities are mediated by the same underlying mechanism, then both abilities will be absent if this mechanism is broken. Clustering techniques automatically arrange these abilities according to their co-occurrence and therefore group together abilities mediated by the same mechanism. This study builds upon the discovery of three distinct mechanisms of language comprehension in 31,845 autistic individuals1. The current clustering analysis of a more diverse group of individuals with language impairments resulted in the three mechanisms identical to those found previously: (1) the most-basic command-language-comprehension-mechanism; (2) the intermediate modifier-language-comprehension-mechanism mediating comprehension of color, size, and number modifiers; and (3) the most-advanced syntactic-language-comprehension-mechanism. This discovery calls for mapping of the three empirically-defined language-comprehension-mechanisms in the context of cognitive neuroscience, which is the main goal of this study.

Dietary Factors Impact Developmental Trajectories in Young Autistic Children

PURPOSE

The purpose of this research was to investigate the impact of dietary factors on developmental trajectories in young autistic children.

METHODS

A gluten-free and casein-free diets, as well as six types of food (meat and eggs, vegetables, uncooked vegetables, sweets, bread, and "white soft bread that never molds") were investigated observationally for up to three years in 5,553 children 2 to 5 years of age via parent-report measures completed within a mobile application. Children had a parent-reported diagnosis of Autism Spectrum Disorder (ASD); 78% were males; the majority of participants resided in the USA. Outcome was monitored on five orthogonal subscales: Language Comprehension, Expressive Language, Sociability, Sensory Awareness, and Health, assessed by the Autism Treatment Evaluation Checklist (ATEC) (Rimland & Edelson, 1999) and Mental Synthesis Evaluation Checklist (MSEC) (Arnold & Vyshedskiy, 2022; Braverman et al., 2018).

RESULTS

Consumption of fast-acting carbohydrates - sweets, bread, and "white soft bread that never molds" - was associated with a significant and a consistent Health subscale score decline. On the contrary, a gluten-free diet, as well as consumption of meat, eggs, and vegetables were associated with a significant and consistent improvement in the Language Comprehension score. Consumption of meat and eggs was also associated with a significant and consistent improvement in the Sensory Awareness score.

CONCLUSION

The results of this study demonstrate a strong correlation between a diet and developmental trajectories and suggest possible dietary interventions for young autistic children.

Combinatorial Language parent-report Scores Differ Significantly Between Typically Developing Children and Those with Autism Spectrum Disorders

Prefrontal synthesis (PFS) is a component of constructive imagination. It is defined as the process of mentally juxtaposing objects into novel combinations. For example, to comprehend the instruction "put the cat under the dog and above the monkey," it is necessary to use PFS in order to correctly determine the spatial arrangement of the cat, dog, and monkey with relation to one another. The acquisition of PFS hinges on the use of combinatorial language during early childhood development. Accordingly, children with developmental delays exhibit a deficit in PFS, and frequent assessments are recommended for such individuals. In 2018, we developed the Mental Synthesis Evaluation Checklist (MSEC), a parent-reported evaluation designed to assess PFS and combinatorial language comprehension. In this manuscript we use MSEC to identify differences in combinatorial language acquisition between ASD (N = 29,138) and neurotypical (N = 111) children. Results emphasize the utility of the MSEC in distinguishing language deficits in ASD from typical development as early as 2 years of age (p < 0.0001).

Language evolution is not limited to speech acquisition: a large study of language development in children with language deficits highlights the importance of the voluntary imagination component of language

Did the boy bite the cat or was it the other way around? When processing a sentence with several objects, one has to establish ‘who did what to whom’. When a sentence cannot be interpreted by recalling an image from memory, we rely on the special type of voluntary constructive imagination called Prefrontal synthesis (PFS). PFS is defined as the ability to juxtapose mental visuospatial objects at will. We hypothesised that PFS has fundamental importance for language acquisition. To test this hypothesis, we designed a PFS-targeting intervention and administered it to 6,454 children with language deficiencies (age 2 to 12 years). The results from the three-year-long study demonstrated that children who engaged with the PFS intervention showed 2.2-fold improvement in combinatorial language comprehension compared to children with similar initial evaluations. These findings suggest that language can be improved by training the PFS and exposes the importance of the visuospatial component of language. This manuscript reflects on the experimental findings from the point of view of human language evolution. When used as a proxy for evolutionary language acquisition, the study results suggest a dichotomy of language evolution, with its speech component and its visuospatial component developing in parallel. The study highlights the radical idea that evolutionary acquisition of language was driven primarily by improvements of voluntary imagination rather than by improvements in the speech apparatus.

Functionality of Apps for People with Autism: Comparison between Educators from Florence and Granada

BACKGROUND

Studies on the potential of smartphone apps for people with autism are currently increasing in number, given the large digital supply available and the benefits they offer. We analyzed the opinion of educators from Florence (Italy) and Granada (Spain) regarding the benefits and applicability of apps, frequency of their use, and the type of apps used for people with autism.

METHODS

The study involved 1261 professionals, of whom 286 worked with apps, using a non-experimental quantitative design, descriptive and frequency statistics, parametric inferential analyses (Student's t and one-factor ANOVA), and calculation of the effect size (Cohen's d and eta squared) and intrafactorial correlations.

RESULTS

Statistically significant differences were observed in respect of city, sex, age, years of experience, place of work, and type of teacher. The teachers from Granada found more benefits and applicability in apps, and revealed a slightly higher usage than those from Florence.

CONCLUSIONS

It is an arduous but worthy task for professionals from schools and associations that work with people with autism to acquire the necessary knowledge to apply methodologies based on information and communication technology (ICT), as this will help achieve the integrated development of people with different capabilities.

Parent-Reported Assessment Scores Reflect the ASD Severity Level in 2- to 7-Year-Old Children

We investigated the relationship between parent-reported assessments and autism spectrum disorder (ASD) severity level. Parents evaluated 9573 children with ASD on five subscales-combinatorial receptive language, expressive language, sociability, sensory awareness, and health-using the Autism Treatment Evaluation Checklist (ATEC) and Mental Synthesis Evaluation Checklist (MSEC). The scores in every subscale improved with age, and there were clear differences between the three diagnostic categories. The differences between mild and moderate ASD, and moderate and severe ASD reached statistical significance in each subscale and in every age group in children 3 years of age and older. These findings demonstrate a consistent relationship between children's diagnoses and their assessments and provide evidence in support of the reliability of parent-report evaluations for ASD. Additionally, this is the first investigation of the relationship between ASD severity level and the ATEC/MSEC scores for the age range from 2 to 7 years.

Psychometric Properties of the Questionnaire “Demands and Potentials of ICT and Apps for Assisting People with Autism” (DPTIC-AUT-Q)

Background: In education, Information and Communication Technology (ICT) has gone from being a convenient option to a permanent necessity. For students and people with functional diversity, it is of seminal importance. It is therefore worth learning how professionals perceive digital tools and apps for people and students with functional diversity and autism: its requirements and potential. As no instrument to measure this exists, we have designed a questionnaire on the requirements and potentials of ICT and apps for assisting people with autism (DP-TIC-AUT). Methods: Our questionnaire has been subjected to content validity using a panel of experts, and construct validity, using Exploratory Factor Analysis and Confirmatory Factor Analysis, and Cronbach’s alpha and Composite Reliability. Results: Optimal results were obtained in the above values, thus confirming the validity of DP-TIC-AUT for use in the contexts of its validation. Conclusions: DP-TIC-AUT is a valid instrument. This opens up a range of possibilities for research, firstly descriptive, then of other kinds, and for the adaptation of the instrument to other contexts. This is the first step in improving the creation and use of ICT for people with autism.

Internet-of-Things Devices in Support of the Development of Echoic Skills among Children with Autism Spectrum Disorder

A significant therapeutic challenge for people with disabilities is the development of verbal and echoic skills. Digital voice assistants (DVAs), such as Amazon’s Alexa, provide networked intelligence to billions of Internet-of-Things devices and have the potential to offer opportunities to people, such as those diagnosed with autism spectrum disorder (ASD), to advance these necessary skills. Voice interfaces can enable children with ASD to practice such skills at home; however, it remains unclear whether DVAs can be as proficient as therapists in recognizing utterances by a developing speaker. We developed an Alexa-based skill called ASPECT to measure how well the DVA identified verbalization by autistic children. The participants, nine children diagnosed with ASD, each participated in 30 sessions focused on increasing vocalizations and echoic responses. Children interacted with ASPECT prompted by instructions from an Echo device. ASPECT was trained to recognize utterances and evaluate them as a therapist would—simultaneously, a therapist scored the child’s responses. The study identified no significant difference between how ASPECT and the therapists scored participants; this conclusion held even when subsetting participants by a pre-treatment echoic skill assessment score. This indicates considerable potential for providing a continuum of therapeutic opportunities and reinforcement outside of clinical settings.

Assessment of Apps Aimed at Developing Basic Instrumental Skills in Autistic Children and Teenagers

It is crucial for families and professionals to promote basic instrumental skills in children with autism, as these skills can help with comprehensive growth and development, and are a starting point in acquiring the essential tools needed for one to live an independent and successful life. These skills include oral language, reading, writing, and mathematics. Therefore, given that ICT and mobile applications (apps) are effective tools that offer suitable content, and are designed exclusively for people with this disorder, working on these skills with apps is an interesting option that is worthy of our attention. We analyzed 88 apps that focused on these skills, through a duly validated system of indicators, calculating frequencies, percentages, measures of central tendency and dispersion, and non-parametric contrast statistics. The app search was carried out in the Google Play Store, with the keyword “autism”, in English and in Spanish. Most of the apps focused on aspects linked to oral language and reading, but few were aimed at reading and mathematics. In addition to the apps’ lack of specialization in the last two skills, the vast majority did not specify the age group for which their content was intended.

Watching Videos and Television Is Related to a Lower Development of Complex Language Comprehension in Young Children with Autism

The effect of passive video and television watching duration on 2- to 5-year-old children with autism was investigated in the largest and the longest observational study to date. Parents assessed the development of 3227 children quarterly for three years. Longer video and television watching were associated with better development of expressive language but significantly impeded development of complex language comprehension. On an annualized basis, low TV users (low quartile: 40 min or less of videos and television per day) improved their language comprehension 1.4 times faster than high TV users (high quartile: 2 h or more of videos and television per day). This difference was statistically significant. At the same time, high TV users improved their expressive language 1.3 times faster than low TV users. This difference was not statistically significant. No effect of video and television watching duration on sociability, cognition, or health was detected.

Embodied Imagination and Metaphor Use in Autism Spectrum Disorder

This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and metaphor. The paper describes a case study from a systemic therapeutic session with a child with ASD that makes use of metaphors. It concludes by outlining some theoretical insights into the imaginative skills of children with ASD that follow from taking the embodied-enactive perspective and proposes suggestions for interactive interventions to further enhance imaginative skills and metaphor understanding in children with ASD.

Imagination in Autism: A Chance to Improve Early Language Therapy

Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long frontoposterior connections to the temporal-parietal-occipital area. Previously disconnected visuospatial issues (stimulus overselectivity and tunnel vision) and language issues (lack of comprehension of spatial prepositions and complex recursive sentences) may be explained by the same voluntary imagination deficit. This review highlights the new insights into the mechanism of voluntary imagination, its difference from involuntary imagination, and its unusually strong critical period. Clearer developmental terminology and a better understanding of voluntary imagination have the potential to facilitate communication between therapists and parents, and improve therapy outcomes in children.