Resting Frontal Gamma Power is Associated with Both Expressive Language and Non-verbal Cognitive Abilities in Young Autistic Children.

Recent theories propose that domain-general deficits in prediction (i.e., the ability to anticipate upcoming information) underlie the behavioral characteristics associated with autism spectrum disorder (ASD). If these theories are correct, autistic children might be expected to demonstrate difficulties on linguistic tasks that rely on predictive processing. Previous research has largely focused on older autistic children and adolescents with average language and cognition. The present study used an eye-gaze task to evaluate predictive language processing among 3- to 4-year-old autistic children (n= 34) and 1.5- to 3-year-old, language-matched neurotypical (NT) children (n= 34). Children viewed images (e.g., a cake and a ball) and heard sentences with informative verbs (e.g., Eat the cake) or neutral verbs (e.g., Find the cake). Analyses of children's looking behaviors indicated that young autistic children, like their language-matched NT peers, engaged in predictive language processing. Regression results revealed a significant effect of diagnostic group, when statistically controlling for age differences. The NT group displayed larger difference scores between the informative and neutral verb conditions (in looks to target nouns) compared to the ASD group. Receptive language measures were predictive of looking behavior across time for both groups, such that children with stronger language skills were more efficient in making use of informative verbs to process upcoming information. Taken together, these results suggest that young autistic children can engage in predictive processing though further research is warranted to explore the developmental trajectory relative to NT development. LAY SUMMARY: This study found that 3- to 4-year-old autistic children and younger, language-matched neurotypical (NT) children both used verbs to predict upcoming nouns in sentences like "Eat the cake." For both autistic and NT children, those with stronger language skills were able to predict upcoming nouns more quickly.

Atypical patterns of social engagement and joint attention behaviors are diagnostic criteria for people with autism spectrum disorder. Experimental tasks using eye-tracking methodologies have, however, shown inconsistent results. The development of tasks with greater ecological validity and relevance for developmentally appropriate social milestones has been identified as important for the field. We developed a novel, dynamic eye-tracking task emulating a shared book reading (SBR) scenario. Four SBR videos of an adult reader engaging with the viewer while reading a children's picture book and including sequenced bids for joint attention were developed. Participants included 90 children (N = 56 autistic children, N = 34 neurotypical children; aged 3-12). Social attention was also measured in a live free play task between participants and an experimenter. Compared to neurotypical children, autistic children displayed reduced attention to socially salient stimuli including the reader's face and picture book across SBR videos and during joint attention bids specifically. In contrast, they showed increased attention to nonsalient background stimuli compared to their neurotypical peers. These attention patterns in autistic children were associated with reduced verbal and nonverbal cognitive skills and increased symptoms associated with autism. Interestingly, positive correlations in the frequency of eye gaze between SBR and free play suggested a potential predictive value for social attention in live social interactions. Findings highlight the utility of SBR eye-tracking tasks in understanding underlying divergences in social engagement and joint attention between autistic and neurotypical children. This commonly practiced early childhood activity may provide insights into the relationship between social engagement and learning to reveal how such attentional patterns might influence broader developmental and educational outcomes.

"Hot" or reward-based executive function describes the regulatory skills needed to suppress or delay actions in emotionally salient contexts. These delay-based executive function skills impact social development, mental health, and academic achievement. Accumulating evidence indicates that autistic children (3 years or older) show reduced delay-based executive function relative to neurotypical counterparts. The primary aim of this study was to determine whether these findings extend to younger children (younger than 3 years). Our secondary aim was to determine whether the strategies employed during delay-based executive function tasks differed between autistic and neurotypical toddlers, to understand why autistic children often experience difficulty in this domain. A behavioral battery was administered to measure delay-based executive function in autistic and neurotypical children, aged 2 and 4 years. Consistent with evidence in older children, delay-based executive function was reduced in autistic toddlers. Autistic 2-year-olds waited less during tasks that utilized food rewards, whereas autistic 4-year-olds waited less during tasks using both food- and non-food-based incentives. Autistic children also used significantly less adaptive strategies during tasks. These results are the first to indicate diagnostic differences in delay-based executive function among children as young as 2 years and may inform interventions that target these skills to improve related developmental outcomes.Lay Abstract"Hot" executive function involves the ability to control actions when emotions are involved. For example, a situation when an individual must resist a temptation requires hot executive function. These skills are important for social growth, mental health, and doing well in school. Research shows that autistic children over 3 years of age are less likely to use these skills compared to other children. This study examined whether autistic children under 3 years of age show similar difficulties. We also examined whether autistic children use different strategies than neurotypical children. To find out, we asked both autistic and neurotypical children, ages 2 and 4 years, to complete tasks that required them to delay their responses. The study found that, like older autistic children, younger autistic children also delayed their responses less than neurotypical children. Autistic 2-year-olds waited less for rewards, like food, compared to their neurotypical peers. Similarly, autistic 4-year-olds waited less for both food and other types of rewards, compared to their neurotypical peers. Relative to their neurotypical peers, autistic children also used fewer effective strategies during these tasks. These findings suggest that even very young autistic children have differences in impulse control, which might help in creating better support and interventions for them.

BackgroundUnusual behavioral reactions to sensory stimuli are frequently reported in individuals on the autism spectrum (AS). Despite the early emergence of sensory features (< age 3) and their potential impact on development and quality of life, little is known about the neural mechanisms underlying sensory reactivity in early childhood autism.MethodsHere, we used electroencephalography (EEG) to investigate tactile cortical processing in young children aged 3–6 years with autism and in neurotypical (NT) children. Scalp EEG was recorded from 33 children with autism, including those with low cognitive and/or verbal abilities, and 45 age- and sex-matched NT children during passive tactile fingertip stimulation. We compared properties of early and later somatosensory-evoked potentials (SEPs) and their adaptation with repetitive stimulation between autistic and NT children and assessed whether these neural measures are linked to “real-world” parent-reported tactile reactivity.ResultsAs expected, we found elevated tactile reactivity in children on the autism spectrum. Our findings indicated no differences in amplitude or latency of early and mid-latency somatosensory-evoked potentials (P50, N80, P100), nor adaptation between autistic and NT children. However, latency of later processing of tactile information (N140) was shorter in young children with autism compared to NT children, suggesting faster processing speed in young autistic children. Further, correlational analyses and exploratory analyses using tactile reactivity as a grouping variable found that enhanced early neural responses were associated with greater tactile reactivity in autism.LimitationsThe relatively small sample size and the inclusion of a broad range of autistic children (e.g., with low cognitive and/or verbal abilities) may have limited our power to detect subtle group differences and associations. Hence, replications are needed to verify these results.ConclusionsOur findings suggest that electrophysiological somatosensory cortex processing measures may be indices of “real-world” tactile reactivity in early childhood autism. Together, these findings advance our understanding of the neurophysiological mechanisms underlying tactile reactivity in early childhood autism and, in the clinical context, may have therapeutic implications.

Keeping a conversation going is the social glue of friendships. The DSM criteria for autism list difficulties with back-and-forth conversation but does not necessitate that all autistic children will be equally impacted. We carried out three studies (two pre-registered) with verbally fluent school children (age 5-9 years) to investigate how autistic and neurotypical children maintain a conversation topic. We also investigated within-group relationships between conversational ability and cognitive and sociocognitive predictors. Study 1 found autistic children were more likely than neurotypical controls to give off-topic and generic minimal responses (e.g. 'mm', 'oh') and were less likely to give non-verbal responses (e.g. nodding or use of facial affect to respond). Nonetheless, the autistic group provided topic-supporting responses 62% of the time, indicating some aspects of conversation topic maintenance are a relative strength. Studies 2 and 3 found large individual differences in topic-supporting conversational responding among both neurotypical and autistic children. These were positively related to theory of mind ability and age in both groups. Conversational skills lie on a continuum for the general population and differences by diagnostic group are a matter of degree. Given the importance for peer relationships, we suggest a whole classroom approach to supporting conversation skills in all children.Lay abstractChildren who struggle to maintain conversation with peers often have fewer friends and lower popularity ratings, which can affect wellbeing. Verbal social communication more broadly is linked to both behavioural difficulties and emotional problems. We carried out three studies to examine children's ability to provide responses which keep a back and forth conversation going. The first study found that while autistic children had on average greater difficulties than their neurotypical peers with certain aspects of conversation topic maintenance, for other aspects the autistic group showed considerable strengths. Both studies 2 (neurotypical children) and 3 (autistic children) found relationships between, on the one hand, conversational ability, and on the other, the ability to consider another's viewpoint and the ability to maintain and update information in short term memory. We suggest support for social conversation skills should be part of mainstream classroom curricula for autistic and neurotypical children alike.

Autistic monolingual children show heterogeneity in their language abilities in the school-age years. School-age bilingual neurotypical children also show heterogeneity in their second-language (L2) abilities as these are modulated by many factors including cumulative L2 input. This study compared school-age neurotypical and autistic children's L2 vocabulary development, as modulated by cumulative L2 input, to determine the extent to which the autistic children formed a distinct group from the neurotypical children. Participants were autistic (n = 23) and neurotypical (n = 26) bilingual children with English as their L2 and diverse first-language backgrounds, aged 4;7-9;6 (years;months). Children were matched groupwise for age. Children were administered a receptive vocabulary test, and conversational language samples yielded expressive lexical measures: word tokens and types and internal state term tokens and types. Linear regression modeling revealed that the autistic group had lower scores for all but one vocabulary measure and that higher scores were associated with more L2 input for children in both groups. A hierarchical cluster analysis revealed more nuanced results: One cluster, consisting of all but one of the neurotypical and the majority of the autistic children, overlapped in vocabulary abilities, with the autistic group having somewhat more L2 input. A second cluster consisted of all autistic children except for one neurotypical child and had extensive L2 input and very low vocabulary abilities. The autistic bilinguals in this study were not a homogeneous group separate from their neurotypical peers. Instead, only some autistic bilinguals showed distinct L2 profiles from their neurotypical peers.

Starting early in life, autistics are characterized as having atypical facial expressions, as well as decreased positive and increased negative affect. The literature on autistic facial expressions remains small, however, with disparate methods and results suggesting limited understanding of common autistic emotions. Furthermore, unlike non-autistics’ emotions, autistics’ emotions have been assessed without considering this population’s characteristics. In this study, the valence of young children’s facial expressions was thus rated as positive, negative, neutral, or “unknown”—a term for perceived emotions observers do not understand. Facial expressions were assessed using the Montreal Stimulating Play Situation, a context incorporating potential autistic interests. Comparing 37 autistic and 39 typical young (27–56 months) age-matched children, we found no group differences in expressed positive, negative, and neutral emotions. We did find differences in unknown emotions, which were unique to the autistic group. Preliminary data also showed that autistic children’s repetitive behaviors co-occurred with positive, neutral, and unknown emotions, but not with negative emotions. In a novel context that considers their characteristics, we did not find decreased positive or increased negative emotions in young autistic children. Instead, they uniquely expressed emotions perceived as unknown, showing the need to improve our understanding of their full emotional repertoire.Lay abstractAutistic people are believed to have emotions that are too negative and not positive enough, starting early in life. Their facial expressions are also persistently judged to be unusual, as reflected in criteria used to identify autism. But it is possible that common autistic facial expressions are poorly understood by observers, as suggested by a range of findings from research. Another issue is that autistic emotions have always been assessed in contexts suited to non-autistics. In our study, the facial expressions of young autistic and typical children were rated as positive, negative, neutral, or “unknown”—a category we created for emotions that observers notice but do not understand. These emotions were assessed using a context suited to autistic children, including objects of potential interest to them. We found that in this context, autistic and typical children did not differ in positive, negative, or neutral facial emotions. They did differ in unknown emotions, which were found only in autistic children. We also found that repetitive behaviors in autistic children co-occurred with positive, neutral, and unknown emotions, but not with negative emotions. In a context which suits their characteristics, autistic children do not show emotions that are too negative or not positive enough. They do show emotions perceived as unknown, which means we need to improve our understanding of their full emotional repertoire.

Successful word learning requires children to pay attention to corresponding auditory and visual input during naming events. However, differences in autistic children's visual attention that restrict their intake of information may impact encoding of novel word-referent associations in memory. This study investigated differences in autistic and neurotypical children's visual attention to stimuli, and whether these differences predicted referent selection and retention accuracy. Fifteen autistic (Mage = 91.87 months) and sixteen neurotypical (Mage = 52.31 months) children matched on receptive vocabulary (Mage autistic children = 53.27 months; Mage neurotypical children = 60.31) used a touch-screen computer to fast map novel words associated with animals (high-interest stimuli) and objects (neutral-interest stimuli). Retention was assessed after 5minutes and 24hours. Children's frequency and duration of looking towards targets was recorded directly via multiple cameras. Neurotypical children spent longer looking at targets during referent selection than autistic children. Autistic children looked at targets significantly more frequently than neurotypical children across word learning stages, and more frequently at targets in the animal condition at 5-minute retention. In-trial visual attention predicted response accuracy across word learning stages for both groups. Visual attention at referent selection also predicted 5-minute and 24-hour retention accuracy for both groups. Visual input during initial encoding influences children's likelihood of successfully forming long-term word-referent representations, indicating strong relationships between attention and learning accuracy. Moreover, population differences in visual attention may not have a detrimental impact on autistic children's word learning under experimental conditions when expectations are based on receptive vocabulary.

Exposure to multiple languages may support the development of Theory of Mind (ToM) in neurotypical (NT) and autistic children. However, previous research mainly applied group comparisons between monolingual and bilingual children, and the underlying mechanism of the observed difference remains unclear. The present study, therefore, sheds light on the effect of bilingualism on ToM in both NT and autistic children by measuring language experiences with a continuous operationalization. We measure ToM with a behavioral, linguistically simple tablet-based task, allowing inclusive assessment in autistic children. Analyses revealed no difference between monolingual and bilingual NT and autistic children. However, more balanced exposure to different languages within contexts positively predicted first-order false belief understanding in NT children but not autistic children. Mediation analysis showed that the impact in NT children was a direct effect and not mediated via other cognitive skills.

Breastfeeding is a complex task that requires proficiency at several key developmental skills to feed successfully. It is unclear how Autism Spectrum Disorder (ASD) affects an infant's breastfeeding experience and conflicting reports exist on shortened breastfeeding duration in infants later diagnosed with ASD. The purpose of this study was to describe the experiences of mothers breastfeeding both their autistic and neurotypical children to better understand the differences in their breastfeeding experiences and maternal and infant factors that contributed to breastfeeding cessation in their autistic child. Twenty-four mothers of an autistic child who had feeding difficulties in the first 12 months of life, initiated breastfeeding, and also had a neurotypical child participated in semi-structured interviews regarding breastfeeding initiation, cessation, and challenges encountered during breastfeeding. Analysis revealed four major themes: (1) the struggle with latch, including infant behavior that hindered latching; (2) breastfeeding challenges, including problematic breastfeeding behavior by the infant; (3) cessation of breastfeeding, including physical symptoms of the infant that lead to breastfeeding cessation; and (4) breastfeeding the neurotypical sibling, including mother's detection of different breastfeeding behaviors in neurotypical and autistic child. Breastfeeding behaviors described by mothers may indicate early signs of autism including early sensory sensitivity, lack of regulation, repetitive behaviors, and impaired social behaviors. Further research is needed to discern if these breastfeeding behaviors can be used to help identify early signs of autism and employed as additional surveillance for neurodevelopmental concerns at a young age.

BackgroundGaze following difficulties are considered an early marker of autism, thought likely to cumulatively impact the development of social cognition, language and social skills. Subtle differences in gaze following abilities may contribute to the diverse range social and communicative autistic characteristics observed across people with genetic syndromes, such as Cornelia de Lange (CdLS) and fragile X (FXS) syndromes. AimsTo compare profiles of 1) visual attention to the eye region at critical points of the attention direction process, 2) whether children follow the gaze cue to the object, and 3) participant looking time to the target object following the gaze cue between groups and conditions. Materials and methodsChildren with CdLS (N = 11) and FXS (N = 8) and autistic (N = 22) and neurotypical (N = 15) children took part in a passive viewing paradigm adapted from Senju and Csibra (2008), in which videos of a central cue (ball/cartoon face/human face) directed attention towards one of two objects. Visual attention patterns were recorded via eye tracking technology. ResultsNeurotypical children were used as a reference group against which the autistic, CdLS and FXS groups were compared. Although autistic children looked at the eye region for significantly less time, they looked at the target object as frequently and for a similar duration as neurotypical children. Children with FXS looked at the target as frequently as neurotypical children but looked at it for comparatively less time. Both neurotypical children and children with CdLS frequently looked at the eye region, but children with CdLS were less likely to look at the target than neurotypical children. ConclusionsFindings provide preliminary evidence of unique patterns of visual attention and gaze following strategies in children with CdLS, children with FXS and autistic children. These unique gaze following patterns may underpin the distinct profiles of social and communication autistic traits observed between these groups.

It has been suggested that mentalizing abilities underlie the distinct profiles of autism characteristics observed between Cornelia de Lange (CdLS) and fragile X syndromes (FXS) and autistic people without a genetic syndrome. However, traditional explicit mentalizing tasks have high language demands that may mask true mentalizing abilities in these populations. We compared performance on traditional explicit tasks and an implicit anticipatory looking mentalizing task in children with CdLS (N = 9), boys with FXS (N = 9), autistic (N = 22) and neurotypical (N = 34) children. The groups showed divergent patterns of performance. Neurotypical children had higher explicit mentalizing scores than all other groups. However, neurotypical, FXS and CdLS groups showed better implicit mentalizing performance than autistic children. Both chronological age and receptive language ability correlated with explicit mentalizing scores in neurotypical children. In autistic children, there was an association between explicit mentalizing score and receptive language ability but not chronological age. Explicit mentalizing score was not associated with receptive language ability or chronological age in the CdLS and FXS groups. Neither chronological age nor receptive language ability correlated with implicit mentalizing task performance in any group. Findings suggest that explicit tasks may mask true mentalizing abilities in autistic children, children with CdLS and children with FXS.

Objective Cognitive Disengagement Syndrome (CDS; previously called Sluggish Cognitive Tempo) refers to a constellation of cognitive and motor behaviors characterized by a predisposition toward mind wandering (cognitive subdomain) and slowed motor behavior (hypoactive). While there are a number of studies linking CDS traits to greater global impairment in children with attention-deficit/hyperactivity disorder (ADHD) and autistic children, there are few studies examining the prevalence and impact of CDS traits in autistic children with co-occurring ADHD (Autistic+ADHD). The current study explored CDS traits in autistic children with and without co-occurring ADHD, children with ADHD, and neurotypical children. Methods Participants were 196 children between 3- and 7-years-of-age comprising four groups: Neurotypical (N = 44), ADHD (N = 51), Autistic (N = 55), and Autistic+ADHD (N = 46). CDS traits, social and communication skills, repetitive behaviors, and sensory processing were all assessed via parent report. Results Children diagnosed with ADHD, autistic children, and Autistic+ADHD children exhibited similar levels of overall CDS traits. However, when explored separately, Autistic+ADHD children had higher cognitive CDS trait scores compared to children with ADHD alone. Both overall CDS traits and the cognitive subdomain were associated with greater social difficulties, particularly social withdrawal, higher levels of repetitive behaviors, and more sensory sensitivities, regardless of diagnosis. Conclusions Findings suggest that CDS traits may be an additional factor directly impact functional outcomes in both autistic and ADHD children. As such, clinicians should be assessing CDS traits in addition to other clinical domains associated with ADHD and autism when developing intervention plans for young neurodiverse children.

Recent theoretical accounts suggest that differences in the processing of probabilistic events underlie the core and associated traits of autism spectrum disorder (ASD). These theories hypothesize that autistic individuals are differentially impacted by disruptions in probabilistic input relative to neurotypical peers. According to this view, autistic individuals assign disproportionate weight to prediction errors such that novel input is overweighted relative to the aggregation of prior input; this is referred to as 'hyperplasticity' of learning. Prediction among autistic individuals has primarily been examined in nonverbal, visual contexts with older children and adults. The present study examined 32 autistic and 32 cognitively-matched neurotypical (NT) children's ability to generate predictions and adjust to changes in predictive relationships in auditory stimuli using two eye gaze tasks. In both studies, children were trained and tested on an auditory-visual cue which predicted the location of a reward stimulus. In Experiment 1 the cue was non-linguistic (instrumental sound) whereas in Experiment 2 the cue was linguistically-relevant (speaker gender). In both experiments, the cue-reward contingency was switched after the first block of trials, and predictive behavior was evaluated across a second block of trials. Analyses of children's looking behavior revealed similar performance in both groups on the non-linguistic task (Exp. 1). In the linguistically-relevant task (Exp. 2), predictive looking was less disrupted by the contingency switch for autistic children than NT children. Results suggest that autistic children may demonstrate hyperplastic learning in linguistically-relevant contexts, relative to NT peers.

Purpose Autism is a prevalent childhood neurodevelopmental condition with a high hereditary likelihood, and it manifests as a clinical syndrome with varying impairments in language and social behavior as well as the existence of constrictive interests and repetitive behaviors. It is essential for both early diagnosis and intervention to comprehend how autistic people behave visually when exposed to human facial expressions and emotions. The purpose of this study is to investigate how autistic individuals visually respond to human facial expressions and emotions, with the aim of supporting early diagnosis and intervention. Design/methodology/approach In this eye-tracking study, children from two different groups neurotypical (NT) children and autistic (AP) children – were compared in terms of their visual behavior. The authors showed them pictures of people with faces placed in the center, on the left and on the right of the stimuli to gauge how they were focusing on them. The study used eye-tracking technology to accurately capture and examine their eye gaze movements. Furthermore, the study investigated their reactions to sad emotions by showing dynamic stimuli with gradual changes in neutral to sad facial expressions, encompassing both male and female faces. Findings The research showed that when children with NT and AP were exposed to scenarios with human faces, there were substantial differences in their visual behavior. Notably, in contrast to NT children’s concentrated attention, AP children showed less interest in the facial region as seen by prolonged fixations on nonfacial locations. Furthermore, our examination of emotional responses revealed a major difference: NT children mainly focused on the eyes and mouth regions of sad faces, whereas AP children showed a lack of interest in these regions, frequently shifting their gaze from the facial stimuli. Originality/value This study offers important new understandings of the distinctive visual behavior displayed by autistic children when exposed to human faces and emotional stimuli. These findings have important implications for the early diagnosis and support of autism spectrum disorder (ASD). Eye-tracking technology has the potential to be a diagnostic tool that can help identify and support children with ASD early on, ultimately increasing their quality of life and fostering the growth of key sociocognitive abilities. This study helps lay the groundwork for additional investigations and diagnostic models geared toward solving the difficulties faced by people with autism spectrum disorders.