Stress in autism (STREAM): A study protocol on the role of circadian activity, sleep quality and sensory reactivity

Mental health issues are markedly increased in individuals with autism, making it the number one research priority by stakeholders. There is a crucial need to use personalized approaches to understand the underpinnings of mental illness in autism and consequently, to address individual needs. Based on the risk factors identified in typical mental research, we propose the following themes central to mental health issues in autism: sleep difficulties and stress. Indeed, the prevalence of manifold circadian disruptions and sleep difficulties in autism, alongside stress related to sensory overload, forms an integral part of autistic symptomatology. This proof-of-concept study protocol outlines an innovative, individualised approach towards investigating the interrelationships between stress indices, sleep and circadian activation patterns, and sensory sensitivity in autism. Embracing an individualized methodology, we aim to collect 14 days of data per participant from 20 individuals with autism diagnoses and 20 without. Participants' sleep will be monitored using wearable EEG headbands and a sleep diary. Diurnal tracking of heart rate and electrodermal activity through wearables will serve as proxies of stress. Those objective data will be synchronized with subjective experience traces collected throughout the day using the Temporal Experience Tracing (TET) method. TET facilitates the quantification of relevant aspects of individual experience states, such as stress or sensory sensitivities, by providing a continuous multidimensional description of subjective experiences. Capturing the dynamics of subjective experiences phase-locked to neural and physiological proxies both between and within individuals, this approach has the potential to contribute to our understanding of critical issues in autism, including sleep problems, sensory reactivity and stress. The planned strives to provide a pathway towards developing a more nuanced and individualized approach to addressing mental health in autism.

Reduced stereotypicality and spared use of facial expression predictions for social evaluation in autism

Background/Objective

Autism has been investigated through traditional emotion recognition paradigms, merely investigating accuracy, thereby constraining how potential differences across autistic and control individuals may be observed, identified, and described. Moreover, the use of emotional facial expression information for social functioning in autism is of relevance to provide a deeper understanding of the condition.

Method

Adult autistic individuals (n = 34) and adult control individuals (n = 34) were assessed with a social perception behavioral paradigm exploring facial expression predictions and their impact on social evaluation.

Results

Autistic individuals held less stereotypical predictions than controls. Importantly, despite such differences in predictions, the use of such predictions for social evaluation did not differ significantly between groups, as autistic individuals relied on their predictions to evaluate others to the same extent as controls.

Conclusions

These results help to understand how autistic individuals perceive social stimuli and evaluate others, revealing a deviation from stereotypicality beyond which social evaluation strategies may be intact.

Classifying autism in a clinical population based on motion synchrony: a proof-of-concept study using real-life diagnostic interviews

Predictive modeling strategies are increasingly studied as a means to overcome clinical bottlenecks in the diagnostic classification of autism spectrum disorder. However, while some findings are promising in the light of diagnostic marker research, many of these approaches lack the scalability for adequate and effective translation to everyday clinical practice. In this study, our aim was to explore the use of objective computer vision video analysis of real-world autism diagnostic interviews in a clinical sample of children and young individuals in the transition to adulthood to predict diagnosis. Specifically, we trained a support vector machine learning model on interpersonal synchrony data recorded in Autism Diagnostic Observation Schedule (ADOS-2) interviews of patient-clinician dyads. Our model was able to classify dyads involving an autistic patient (n = 56) with a balanced accuracy of 63.4% against dyads including a patient with other psychiatric diagnoses (n = 38). Further analyses revealed no significant associations between our classification metrics with clinical ratings. We argue that, given the above-chance performance of our classifier in a highly heterogeneous sample both in age and diagnosis, with few adjustments this highly scalable approach presents a viable route for future diagnostic marker research in autism.

Perceptual Grouping in Autism Spectrum Disorder: An Exploratory Magnetoencephalography Study

Visual information is organised according to visual grouping principles. In visual grouping tasks individuals with ASD have shown equivocal performance. We explored neural correlates of Gestalt grouping in individuals with and without ASD. Neuromagnetic activity of individuals with (15) and without (18) ASD was compared during a visual grouping task testing grouping by proximity versus similarity. Individuals without ASD showed stronger evoked responses with earlier peaks in response to both grouping types indicating an earlier neuronal differentiation between grouping principles in individuals without ASD. In contrast, individuals with ASD showed particularly prolonged processing of grouping by similarity suggesting a high demand of neural resources. The neuronal processing differences found could explain less efficient grouping performance observed behaviourally in ASD.

An evaluation of the German version of the Sensory Perception Quotient from an expert by experience perspective

Sensory processing is often altered in individuals with autism; thus, it is essential to develop reliable measurement tools to assess sensory perception. The Sensory Perception Quotient (SPQ) quantifies basic sensory sensitivities in adults via self-report. Adopting an expert by experience perspective, this study aimed to evaluate a German translation of the SPQ for its use in clinical and research applications, especially for autistic adults. 108 adults (n = 54 autistic) completed the German SPQ in an online assessment. A 92-item and a 35-item version of the German SPQ were analyzed for group differences and internal consistency. Our results show that adults with autism reported greater sensory sensitivity compared to non-autistic adults. Results further suggest good to excellent internal consistency for the 95-item and 35-item SPQ translations. This finding was supported by the correlative relationship between sensory sensitivity and autistic traits. These findings confirm the reliability of our SPQ translation, making it a suitable German assessment tool for basic sensory sensitivity in autistic adults.

Machine learning classification of autism spectrum disorder based on reciprocity in naturalistic social interactions

Autism spectrum disorder is characterized by impaired social communication and interaction. As a neurodevelopmental disorder typically diagnosed during childhood, diagnosis in adulthood is preceded by a resource-heavy clinical assessment period. The ongoing developments in digital phenotyping give rise to novel opportunities within the screening and diagnostic process. Our aim was to quantify multiple non-verbal social interaction characteristics in autism and build diagnostic classification models independent of clinical ratings. We analyzed videos of naturalistic social interactions in a sample including 28 autistic and 60 non-autistic adults paired in dyads and engaging in two conversational tasks. We used existing open-source computer vision algorithms for objective annotation to extract information based on the synchrony of movement and facial expression. These were subsequently used as features in a support vector machine learning model to predict whether an individual was part of an autistic or non-autistic interaction dyad. The two prediction models based on reciprocal adaptation in facial movements, as well as individual amounts of head and body motion and facial expressiveness showed the highest precision (balanced accuracies: 79.5% and 68.8%, respectively), followed by models based on reciprocal coordination of head (balanced accuracy: 62.1%) and body (balanced accuracy: 56.7%) motion, as well as intrapersonal coordination processes (balanced accuracy: 44.2%). Combinations of these models did not increase overall predictive performance. Our work highlights the distinctive nature of non-verbal behavior in autism and its utility for digital phenotyping-based classification. Future research needs to both explore the performance of different prediction algorithms to reveal underlying mechanisms and interactions, as well as investigate the prospective generalizability and robustness of these algorithms in routine clinical care.

Interacting with autistic virtual characters: intrapersonal synchrony of nonverbal behavior affects participants' perception

Temporal coordination of communicative behavior is not only located between but also within interaction partners (e.g., gaze and gestures). This intrapersonal synchrony (IaPS) is assumed to constitute interpersonal alignment. Studies show systematic variations in IaPS in individuals with autism, which may affect the degree of interpersonal temporal coordination. In the current study, we reversed the approach and mapped the measured nonverbal behavior of interactants with and without ASD from a previous study onto virtual characters to study the effects of the differential IaPS on observers (N = 68), both with and without ASD (crossed design). During a communication task with both characters, who indicated targets with gaze and delayed pointing gestures, we measured response times, gaze behavior, and post hoc impression formation. Results show that character behavior indicative of ASD resulted in overall enlarged decoding times in observers and this effect was even pronounced in observers with ASD. A classification of observer's gaze types indicated differentiated decoding strategies. Whereas non-autistic observers presented with a rather consistent eyes-focused strategy associated with efficient and fast responses, observers with ASD presented with highly variable decoding strategies. In contrast to communication efficiency, impression formation was not influenced by IaPS. The results underline the importance of timing differences in both production and perception processes during multimodal nonverbal communication in interactants with and without ASD. In essence, the current findings locate the manifestation of reduced reciprocity in autism not merely in the person, but in the interactional dynamics of dyads.

The role of interpersonal synchrony in forming impressions of autistic and non-autistic adults

When people meet, they almost instantaneously form an impression of each other. First impressions of character traits and rapport are less favourable when people with autism spectrum condition (ASC) are judged compared to non-autistic people. Little is known about the behavioural differences that drive these altered impressions. In the present study, we investigated the influence of interpersonal synchrony on impression formation of autistic and non-autistic people. Specifically, we used lagged cross-correlations to assess how much each interactant's motion energy, a measure which can be determined from video recordings, influenced the other interactant's motion energy. In short, silent clips of dyadic conversations, we asked non-autistic participants to rate their impression of one of the two interactants, which was solely based on the outlines of both interactants. We expected that the amount of leading of the target interactant, their diagnostic status as well as the interaction of these factors would influence impression formation. We found that while the amount of leading had a positive effect on the impressions of non-autistic interactants, this was not true for interactants with ASC. This suggests that interpersonal synchrony of motion energy is one driver of less favourable impressions of autistic compared to non-autistic people.

Differentiated, rather than shared, strategies for time-coordinated action in social and non-social domains in autistic individuals

Autism spectrum disorder (ASD) is a neurodevelopmental condition with a highly heterogeneous adult phenotype that includes social and non-social behavioral characteristics. The link between the characteristics assignable to the different domains remains unresolved. One possibility is that social and non-social behaviors in autism are modulated by a common underlying deficit. However, here we report evidence supporting an alternative concept that is individual-centered rather than deficit-centered. Individuals are assumed to have a distinctive style in the strategies they adopt to perform social and non-social tasks with these styles presumably being structured differently between autistic individuals and typically-developed (TD) individuals. We tested this hypothesis for the execution of time-coordinated (synchronized) actions. Participants performed (i) a social task that required synchronized gaze and pointing actions to interact with another person, and (ii) a non-social task that required finger-tapping actions synchronized to periodic stimuli at different time-scales and sensory modalities. In both tasks, synchronization behavior differed between ASD and TD groups. However, a principal component analysis of individual behaviors across tasks revealed associations between social and non-social features for the TD persons but such cross-domain associations were strikingly absent for autistic individuals. The highly differentiated strategies between domains in ASD are inconsistent with a general synchronization deficit and instead highlight the individualized developmental heterogeneity in the acquisition of domain-specific behaviors. We propose a cognitive model to help disentangle individual-centered from deficit-centered effects in other domains. Our findings reinforce the importance to identify individually differentiated phenotypes to personalize autism therapies.

What is specific about employment status, workplace experiences and requirements in individuals with autism in Germany?

The challenge of sustainably integrating highly educated individuals with ASD without intellectual disabilities in the first labor market is repeatedly described in literature. In a retrospective study, a group of 197 clinically late-diagnosed adults with ASD without intellectual disabilities was compared to a closely matched group of 501 individuals who did not meet the criteria for the diagnosis of ASD within a utilization population of the Cologne Autism Outpatient Clinic. Results indicated that the pronounced demand for reduction of social and interpersonal requirements at the workplace (including planned or limited contact with colleagues and customers) as well as the experience of difficulties following unexpected changes in the daily routine were specific for ASD. In addition, individuals with ASD reported greater difficulties in finding a suitable job and being able to live on their wages, taking age and educational qualification into account. Supported employment measures were provided significantly more frequently to individuals in the ASD group. In conclusion, impairments in social skills emerged as one of the main obstacles of workplace performance for individuals with ASD emphasizing the necessity to develop and apply ASD-specific support services.

Digitally assisted diagnostics of autism spectrum disorder

Digital technologies have the potential to support psychiatric diagnostics and, in particular, differential diagnostics of autism spectrum disorder in the near future, making clinical decisions more objective, reliable and evidence-based while reducing clinical resources. Multimodal automatized measurement of symptoms at cognitive, behavioral, and neuronal levels combined with artificial intelligence applications offer promising strides toward personalized prognostics and treatment strategies. In addition, these new technologies could enable systematic and continuous assessment of longitudinal symptom development, beyond the usual scope of clinical practice. Early recognition of exacerbation and simplified, as well as detailed, progression control would become possible. Ultimately, digitally assisted diagnostics will advance early recognition. Nonetheless, digital technologies cannot and should not substitute clinical decision making that takes the comprehensive complexity of individual longitudinal and cross-section presentation of autism spectrum disorder into account. Yet, they might aid the clinician by objectifying decision processes and provide a welcome relief to resources in the clinical setting.

Intrapersonal synchrony analysis reveals a weaker temporal coherence between gaze and gestures in adults with autism spectrum disorder

The temporal encoding of nonverbal signals within individuals, referred to as intrapersonal synchrony (IaPS), is an implicit process and essential feature of human communication. Based on existing evidence, IaPS is thought to be a marker of nonverbal behavior characteristics in autism spectrum disorders (ASD), but there is a lack of empirical evidence. The aim of this study was to quantify IaPS in adults during an experimentally controlled real-life interaction task. A sample of adults with a confirmed ASD diagnosis and a matched sample of typically-developed adults were tested (N = 48). Participants were required to indicate the appearance of a target invisible to their interaction partner nonverbally through gaze and pointing gestures. Special eye-tracking software allowed automated extraction of temporal delays between nonverbal signals and their intrapersonal variability with millisecond temporal resolution as indices for IaPS. Likelihood ratio tests of multilevel models showed enlarged delays between nonverbal signals in ASD. Larger delays were associated with greater intrapersonal variability in delays. The results provide a quantitative constraint on nonverbal temporality in typically-developed adults and suggest weaker temporal coherence between nonverbal signals in adults with ASD. The results provide a potential diagnostic marker and inspire predictive coding theories about the role of IaPS in interpersonal synchronization processes.

Figure-Disembedding Is Inferior in Non-autistic Compared to Autistic Individuals but Can Be Improved by Training

Background

Figure-disembedding is one of the most discussed visuo-cognitive functions, in which individuals with Autism Spectrum Disorder (ASD) have been reported to outperform non-autistic individuals. A local processing bias has been assumed to underlie such superior performance patterns. The aim of the current study is to investigate whether processing preferences can be modified by procedural priming.

Method

The current study used a procedural priming task (Navon figures) to induce more local or global processing in 25 autistic and 21 typically developing (TD) control participants, using hierarchical figures preceding the figure-disembedding task.

Results

Participants with ASD outperformed non-autistic individuals in the unprimed baseline task version. The performance was not modulated by priming in either direction (toward a local or global processing style) in both groups. However, the performance of TD control participants was improved by training to the same level as that observed in the ASD group.

Conclusion

Figure-disembedding performance in ASD is superior to that in TD control participants and robust against procedural priming or training. In contrast, performance in the TD control group can be improved up to the level of the ASD group. Any studies reporting superiority in individuals with ASD in figure-disembedding should consider training effects when evaluating group differences.

Autism traits outweigh alexithymia traits in the explanation of mentalising performance in adults with autism but not in adults with rejected autism diagnosis

Background

Pronounced alexithymia traits have been found in autism spectrum disorder (ASD) and recent research has been carving out the impact alexithymia traits might have on mentalising deficits associated with ASD.

Method

In this cross-sectional study, a large representative referral population for diagnostic examination for possible ASD (n = 400) was screened for clinical alexithymia with a German version of the Reading the Mind in the Eyes test (RME). In contrast to previous attempts to carve out the impact of alexithymia traits on mentalising deficits though, we employed dominance analysis to account for the correlation between predictors. The relative relationship between alexithymia traits and autism traits with RME performance was investigated in the group of individuals with confirmed ASD diagnosis (N = 281) and compared to the clinical referral sample in which ASD was ruled out (N = 119).

Results

Dominance analysis revealed autism traits to be the strongest predictor for reduced mentalising skills in the ASD sample, whereas alexithymia contributed significantly less. In the sample of individuals with ruled out diagnosis, autism traits were the strongest predictor, but alexithymia traits were in sum equally associated to mentalising, with the External-Oriented Thinking subscale as an important predictor of this association.

Limitations

It needs to be considered that the cross-sectional study design does not allow for causal inference. Furthermore, mentalising is a highly facetted capacity and measurements need to reduce this complexity into simple quantities which limits the generalizability of results.

Discussion

While alexithymia traits should be considered for their mental health importance, they do not dominate the explanation of reduced mentalising skills in individuals with ASD, but they might do to a larger degree in individuals with ruled out ASD.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13229-022-00510-9.

Alarmingly large unemployment gap despite of above-average education in adults with ASD without intellectual disability in Germany: a cross-sectional study

For individuals with autism spectrum disorder (ASD), both getting access to as well as staying in the labor market are very challenging. However, the detailed educational, vocational, and employment characteristics of persons with ASD without intellectual disabilities are not yet studied. We conducted a retrospective study on a sample of 232 clinically late-diagnosed adults with ASD without intellectual disabilities. Data were compared to the general German population obtained from the public database of the German Federal Employment Agency. Results showed that the majority of persons with ASD graduated from high school and obtained a university entrance qualification (ASD: 50.4%; general population: 32.5%). Also, lower rates of basic secondary education were found in the ASD sample (ASD: 16.5%, general population: 29.6%). Significantly less individuals with ASD completed vocational training (40.1%) in comparison to the German population (56.3%). Despite the above-average level of education, the unemployment rate of the sample substantially exceeds that of the general population by the factor 5 (ASD: 25.2%; general population: 5.2%). Periods of unwanted unemployment of persons with ASD lasted on average 23 months with interpersonal problems being the main reason for contract termination. A higher level of educational qualification does not protect against a higher risk of unemployment for individuals with ASD presumably due to autism-specific interpersonal difficulties. Data emphasize the necessity to develop and spread both specific employment support activities for individuals with ASD as well as adequate awareness raising strategies. Funded by a public grant of the "Landschaftsverband Rheinland (LVR)".

Are Executive Dysfunctions Relevant for the Autism-Specific Cognitive Profile?

Executive functions (EF) have been shown to be important for the understanding of Autism Spectrum Disorder (ASD), but dysfunctions of EF are not autism-specific. The specific role of EF in ASD, its relationship to core autism characteristics, such as mentalizing, needs to be explored. Medline- and PsychINFO databases were searched for studies published between 1990 and 2020 that included measures of EF in ASD and typically developing control persons (TD) in combination with either Theory of Mind (ToM) or Weak Central Coherence (WCC) tasks. A pre-registered meta-analysis and cross-study regression was performed including a total of 42 studies (ASD n = 1,546, TD n = 1,206). Results were reported according to PRISMA guidelines. In all cognitive domains, the ASD group showed significantly reduced performance. Importantly, EF subdomains and ToM were not significantly correlated. This finding rules out a significant association between EF subdomains and ToM and questions the relevance of EF dysfunctions for the autism-specific feature of reduced mentalizing.

Biobanking in everyday clinical practice in psychiatry-The Munich Mental Health Biobank

Translational research on complex, multifactorial mental health disorders, such as bipolar disorder, major depressive disorder, schizophrenia, and substance use disorders requires databases with large-scale, harmonized, and integrated real-world and research data. The Munich Mental Health Biobank (MMHB) is a mental health-specific biobank that was established in 2019 to collect, store, connect, and supply such high-quality phenotypic data and biosamples from patients and study participants, including healthy controls, recruited at the Department of Psychiatry and Psychotherapy (DPP) and the Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital of the Ludwig-Maximilians-University (LMU), Munich, Germany. Participants are asked to complete a questionnaire that assesses sociodemographic and cross-diagnostic clinical information, provide blood samples, and grant access to their existing medical records. The generated data and biosamples are available to both academic and industry researchers. In this manuscript, we outline the workflow and infrastructure of the MMHB, describe the clinical characteristics and representativeness of the sample collected so far, and reveal future plans for expansion and application. As of 31 October 2021, the MMHB contains a continuously growing set of data from 578 patients and 104 healthy controls (46.37% women; median age, 38.31 years). The five most common mental health diagnoses in the MMHB are recurrent depressive disorder (38.78%; ICD-10: F33), alcohol-related disorders (19.88%; ICD-10: F10), schizophrenia (19.69%; ICD-10: F20), depressive episode (15.94%; ICD-10: F32), and personality disorders (13.78%; ICD-10: F60). Compared with the average patient treated at the recruiting hospitals, MMHB participants have significantly more mental health-related contacts, less severe symptoms, and a higher level of functioning. The distribution of diagnoses is also markedly different in MMHB participants compared with individuals who did not participate in the biobank. After establishing the necessary infrastructure and initiating recruitment, the major tasks for the next phase of the MMHB project are to improve the pace of participant enrollment, diversify the sociodemographic and diagnostic characteristics of the sample, and improve the utilization of real-world data generated in routine clinical practice.

Acquisition and Use of 'Priors' in Autism: Typical in Deciding Where to Look, Atypical in Deciding What Is There

Individuals with Autism Spectrum Disorder (ASD) are thought to under-rely on prior knowledge in perceptual decision-making. This study examined whether this applies to decisions of attention allocation, of relevance for ‘predictive-coding’ accounts of ASD. In a visual search task, a salient but task-irrelevant distractor appeared with higher probability in one display half. Individuals with ASD learned to avoid ‘attentional capture’ by distractors in the probable region as effectively as control participants—indicating typical priors for deploying attention. However, capture by a ‘surprising’ distractor at an unlikely location led to greatly slowed identification of a subsequent target at that location—indicating that individuals with ASD attempt to control surprise (unexpected attentional capture) by over-regulating parameters in post-selective decision-making.

The Generalized Adaptation Account of Autism

The heterogeneous phenomenology of autism together with diverse patterns of comorbidities led in the past to formulation of manifold theories and hypotheses on different explanatory levels. We scrutinize most recent findings from genetics, neurobiology and physiology and derive testable hypotheses about possible physiological links between domains. With focus on altered sensory perception and neuronal processing in ASD, we assume two intertwined regulatory feedback circuits under the umbrella of genetics and environmental factors. Both regulatory circuits are highly variable between individuals in line with the heterogeneous spectrum of ASD. The circuits set off from altered pathways and connectivity in ASD, fueling HPA-axis activity and distress. In the first circuit altered tryptophan metabolism leads to higher neurotoxic substances and reinforces the excitation:inhibition imbalance in the brain. The second circuit focuses on the impact and interaction with the environment and its rhythms in ASD. With lower melatonin levels, as the pacemaker molecule of the circadian system, we assume misalignment to outer and inner states corroborated from the known comorbidities in ASD. Alterations of the microbiome composition in ASD are supposed to act as a regulatory linking factor for both circuits. Overall, we assume that altered internal balance on cellular and neurophysiological levels is one of the main reasons leading to a lower ability in ASD to adapt to the environment and own internal changing states, leading to the conceptualization of autism as a condition of generalized imbalance in adaptation. This comprehensive framework opens up new perspectives on possible intervention and prevention strategies.

Event timing in human vision: Modulating factors and independent functions

Essential for successful interaction with the environment is the human capacity to resolve events in time. Typical event timing paradigms are judgements of simultaneity (SJ) and of temporal order (TOJ). It remains unclear whether SJ and TOJ are based on the same underlying mechanism and whether there are fixed thresholds for resolution. The current study employed four visual event timing task versions: horizontal and vertical SJ and TOJ. Binary responses were analysed using multilevel binary regression modelling. Modulatory effects of potential explanatory variables on event timing perception were investigated: (1) Individual factors (sex and age), (2) temporal factors (SOA, trial number, order of experiment, order of stimuli orientation, time of day) and (3) spatial factors (left or right stimulus first, top or bottom stimulus first, horizontal vs. vertical orientation). The current study directly compares for the first time, performance on SJ and TOJ tasks using the same paradigm and presents evidence that a variety of factors and their interactions selectively modulate event timing functions in humans, explaining the variance found in previous studies. We conclude that SJ and TOJ are partially independent functions, because they are modulated differently by individual and contextual variables.

Brief Report: Social Anxiety in Autism Spectrum Disorder is Based on Deficits in Social Competence

This study differentially examined the relation between two clinical constructs: “social anxiety” and “social competence” in autism spectrum disorder (ASD). Employing two questionnaires (SASKO; IU), individuals with ASD (n = 23) showed increased scores of SOCIAL ANXIETY (SASKO) and of INTOLERANCE OF UNCERTAINTY (IU), compared to a non-clinical comparison group (NC; n = 25). SOCIAL ANXIETY scores were equally increased for ASD and a reference population of individuals with social anxiety disorder (SAD; n = 68). However, results showed increased SOCIAL COMPETENCE DEFICITS in ASD compared to SAD and NC groups. This study allows drawing the conclusion that social anxiety symptoms in ASD can be traced back to autism-specific deficits in social skills and are therefore putatively based on different, substantially “deeper” implemented cognitive mechanisms.

Reduced nonverbal interpersonal synchrony in autism spectrum disorder independent of partner diagnosis: a motion energy study

BACKGROUND

One of the main diagnostic features of individuals with autism spectrum disorders is nonverbal behaviour difficulties during naturalistic social interactions. The 'Interactional Heterogeneity Hypothesis' of ASD proposes that the degree to which individuals share a common ground substantially influences their ability to achieve smooth social interactions.

METHODS

To test this hypothesis, we filmed 29 autistic and 29 matched typically developed adults engaged in several conversational tasks. Windowed cross-lagged correlations were computed using the time series of motion energy of both individuals in a dyad. These coefficients were then compared across the three dyad types that were homo- or heterogenous with respect to diagnosis: pairs of two autistic individuals, two typically developed individuals or pairs of one autistic and one typically developed person.

RESULTS

We found that all dyad types achieved above-chance interpersonal synchrony, but that synchrony was more expressed in typical dyads compared to both autistic and mixed dyads.

LIMITATIONS

The method presented here provides only one, albeit objective and robust, approach to explore synchrony. The methodological choices as well as the lack of consideration for other communication modalities may limit our interpretation of the findings. Moreover, the sample size is small with respect to exploring associations between synchrony and various outcome and social skill measures.

CONCLUSIONS

The present results do not provide support for the Interactional Heterogeneity Hypothesis given that autistic individuals do not coordinate better when interacting with another autistic individual, compared to when interacting with a typical individual.

INTRApersonal Synchrony as Constituent of INTERpersonal Synchrony and Its Relevance for Autism Spectrum Disorder

INTERpersonal synchrony leads to increased empathy, rapport and understanding, enabling successful human-human interactions and reciprocal bonding. Research shows that individuals with Autism Spectrum Disorder (ASD) exhibit difficulties to INTERpersonally synchronize but underlying causes are yet unknown. In order to successfully synchronize with others, INTRApersonal synchronization of communicative signals appears to be a necessary prerequisite. We understand INTRApersonal synchrony as an implicit factor of INTERpersonal synchrony and therefore hypothesize that atypicalities of INTRApersonal synchrony may add to INTERpersonal synchrony problems in ASD and their interaction partners. In this perspective article, we first review evidence for INTERpersonal dissynchrony in ASD, with respect to different approaches and assessment methods. Second, we draft a theoretical conceptualization of INTRApersonal dissynchrony in ASD based on a temporal model of human interaction. We will outline literature indicating INTRApersonal dissynchrony in ASD, therefore highlighting findings of atypical timing functions and findings from clinical and behavioral studies that indicate peculiar motion patterns and communicative signal production in ASD. Third, we hypothesize that findings from these domains suggest an assessment and investigation of temporal parameters of social behavior in individuals with ASD. We will further propose specific goals of empirical approaches on INTRApersonal dissynchrony. Finally we present implications of research on INTRApersonal timing in ASD for diagnostic and therapeutic purposes, what in our opinion warrants the increase of research efforts in this domain.

Inferring power and dominance from dyadic nonverbal interactions in autism spectrum disorder

Research studies to date have revealed conflicting results with respect to the processing of nonverbal cues from social interactions in autism spectrum disorder (ASD). Therefore, the aim of the present study was to investigate the contribution of two important factors for the perception of dyadic social interactions, namely (a) the movement contingency and (b) the spatial context. To this end, 26 adult participants with ASD and 26 age-, sex-, and IQ-matched typically developed control participants observed animations presenting nonverbal interactions between two human virtual characters enacting power relationships. We manipulated (a) movement contingency by exchanging one of the two original agents with an agent from another dyad and (b) spatial context by changing agents' spatial orientation to a back-to-back position. Participants were asked to rate dominance and submissiveness of these agents. Results showed that the movement contingency manipulation affected accuracy and consistency of power perception and that the spatial context manipulation slowed down reaction times comparably in both groups. With regard to group differences, individuals with ASD were found to judge power relationships slower compared to control participants, potentially suggesting a more explicit processing style in ASD. Furthermore, the spatial context manipulation slowed down the reaction times more in the contingent compared to the non-contingent conditions only in the ASD group. These findings contribute to the ongoing debate whether individuals with ASD have difficulties in understanding nonverbal cues in a dyadic context by suggesting that they do so in more subtle ways than previously investigated. Autism Res 2019, 12: 505-516 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study shows that the ability and speed of judging who is dominant in a social interaction depends on two factors: (a) whether their movements are matched and (b) whether they are facing each other or not. This is similarly the case for participants with and without autism. Interestingly, however, individuals with autism seem to judge generally slower, suggesting a more explicit processing style. The two factors seem to interact, suggesting that nonverbal processing difficulties are subtler than previously thought.

Adults with autism spectrum condition have atypical perception of ambiguous figures when bottom-up and top-down interactions are incongruous

We examined the perception of an ambiguous squares stimulus evoking bistable perception in a sample of 31 individuals with autistic spectrum condition and 22 matched typical adults. The perception of the ambiguous figure was manipulated by adaptation to unambiguous figures and/or by placing the ambiguous figure into a context of unambiguous figures. This resulted in four conditions testing the independent and combined (congruent and incongruent) manipulations of adaptation (bottom-up) and spatial context (top-down) effects. The strength of perception, as measured by perception of the first reported orientation of the ambiguous stimulus, was affected comparably between groups. Nevertheless, the strength of perception, as measured by perceptual durations, was affected differently between groups: the perceptual effect was strongest for the autistic spectrum condition group when combined bottom-up and top-down conditions were congruent. In contrast, the strength of the perceptual effect in response to the same condition in the typical adults group was comparable to the adaptation, but stronger than both the context and the incongruent combined bottom-up and top-down conditions. Furthermore, the context condition was stronger than the incongruent combined bottom-up and top-down conditions for the typical adults group. Thus, our findings support the view of stimulus-specific top-down modulation in autistic spectrum condition.

Is there a generalized timing impairment in Autism Spectrum Disorders across time scales and paradigms?

Individuals with ASD have abnormal motor and perceptual functions that do not currently form diagnostic criteria of ASD, but nevertheless may affect everyday behaviour. Temporal processing seems to be one of such non-diagnostic yet impaired domains, although the lack of systematic studies testing different aspects of timing in the same sample of participants prevents a conclusive assessment of whether there is a generalized temporal deficit in ASD associated with diagnostic symptoms. 17 children diagnosed with ASD and 18 typically developing age- and IQ-matched controls carried out a set of motor and perceptual timing tasks: free tapping, simultaneity judgment, auditory duration discrimination, and verbal duration estimation. Parents of participants filled in a questionnaire assessing the sense and management of time. Children with ASD showed faster and more variable free tapping than controls. Auditory duration discrimination thresholds were higher in the ASD group than controls in a sub-second version of the task, while there were no group differences in a supra-second discrimination of intervals. Children with ASD showed more variable thresholds of simultaneity judgment, and they received lower parental scores for their sense and management of time. No group differences were observed in the verbal duration estimation task in the minute-range. Different timing functions were correlated in the ASD group but not among controls, whilst several timing measures correlated with ASD symptoms. We conclude that children with ASD show a broad range of abnormalities in temporal processing tasks including motor timing, perceptual timing, and temporal perspective.

Diminished neural resources allocation to time processing in Autism Spectrum Disorders

Background

Interval timing, the ability to judge the duration of short events, has been shown to be compromised in Autism Spectrum Disorders (ASD). Timing abilities are ubiquitous and underlie behaviours as varied as sensory integration, motor coordination or communication. It has been suggested that atypical temporal processing in ASD could contribute to some of the disorder's symptoms, in particular motor clumsiness and difficulties in social interaction and communication. Recent behavioural investigations have suggested that interval timing in ASD is characterised by intact sensitivity but reduced precision in duration judgements.

Methods

In this study we investigated the processing of duration as compared to pitch in a group of high-functioning individuals with ASD using magnetoencephalography (MEG). 18 adolescents and adults with ASD and 18 age- and IQ-matched typically-developing control (TDC) individuals compared two consecutive tones according to their duration or pitch in separate experimental blocks. The analysis was carried out exclusively on physically identical stimuli (500 Hz tones lasting 600 ms), which served, according to instruction, as standard or probe in a Duration or Pitch task respectively.

Results

Our results suggest that compared to TDC individuals, individuals with ASD are less able to predict the duration of the standard tone accurately, affecting the sensitivity of the comparison process. In addition, contrary to TDC individuals who allocate resources at different times depending on the nature of the task (pitch or duration discrimination), individuals with ASD seem to engage less resources for the Duration task than for the Pitch task regardless of the context. Although individuals with ASD showed top-down adaptation to the context of the task, this neuronal strategy reflects a bias in the readiness to perform different types of tasks, and in particular a diminished allocation of resources to duration processing which could have cascading effect on learning and development of other cognitive functions.

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We investigated MEG response associated with duration or pitch comparison in ASD.

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We found lower sensitivity for duration discrimination behaviourally in ASD.

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ASD adults are less able to predict the offset of a standard tone.

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ASD adults engage less neural resources in duration than pitch discrimination task.

Absence of sex differences in mental rotation performance in autism spectrum disorder

Mental rotation is one of the most investigated cognitive functions showing consistent sex differences. The 'Extreme Male Brain' hypothesis attributes the cognitive profile of individuals with autism spectrum disorder to an extreme version of the male cognitive profile. Previous investigations focused almost exclusively on males with autism spectrum disorder with only limited implications for affected females. This study is the first testing a sample of 12 female adults with high-functioning autism spectrum disorder compared to 14 males with autism spectrum disorder, 12 typically developing females and 14 typically developing males employing a computerised version of the mental rotation test. Reaction time and accuracy served as dependent variables. Their linear relationship with degree of rotation allows separation of rotational aspects of the task, indicated by slopes of the psychometric function, and non-rotational aspects, indicated by intercepts of the psychometric function. While the typical and expected sex difference for rotational task aspects was corroborated in typically developing individuals, no comparable sex difference was found in autism spectrum disorder individuals. Autism spectrum disorder and typically developing individuals did not differ in mental rotation performance. This finding does not support the extreme male brain hypothesis of autism.