High-functioning Autism Research Articles

Auditory brainstem responses in adults with autism spectrum disorder

ObjectiveTo investigate possible differences in the auditory peripheral and brainstem functions between adults with autism spectrum disorder (ASD) and neurotypical (NT) adults. MethodsClick-evoked auditory brainstem responses (ABRs) were obtained from 17 high-functioning ASD adults (aged 21–38 years) and 20 NT adults (aged 22–36 years). A relatively large number of stimulus presentations (6000) were adopted, and ABRs by horizontal and vertical electrode montages were evaluated, in order to allow precise evaluations of early ABR components. ResultsWaves I, II, III, and V were identified in the vertical electrode montage, and wave I and the summating potential (SP) in electrocochleograms were identified in the horizontal electrode montage. There were no significant group differences in the wave I, II, III, and V latencies or the interpeak latencies (IPLs) in the vertical electrode montage. In the horizontal montage, the ASD adults exhibited significantly shortened SP latencies compared with the NT adults, whereas there was no significant group difference in the wave I latency. ConclusionThe ASD adults may have the abnormalities of processing more in the peripheral auditory system than in the brainstem. SignificanceThe current study suggests that the peripheral abnormality is associated with ASD.

Theory of Mind deficits and its impact on language among the Bengali High Functioning Autistic Children

Theory of Mind deficits and its impact on language among the Bengali High Functioning Autistic Children

A comparison study of alternative conceptions on impetus theory and projectile motion of adolescents with typical development and high functioning autism spectrum disorder

ABSTRACT The aim of the present study is to explore on the alternative conceptions of impetus theory and projectile motion of students with high functioning autism spectrum disorders and compare them with those of typical development. For this purpose, an experimental investigation was conducted with 19 students with high-functioning autism (age range: 12–16 yrs) and 55 typically development students (age range: 12–16 yrs). The two study groups were equivalent on both sex and non-verbal mental age. Drawing from theoretical approaches that emphasise the study of prior knowledge on the learning process, a structured, computerised tool was developed to explore the alternative conceptions of students with autism (T.E.A.I.A.). Research findings suggest that students with high-functioning autism use the same alternative conceptions with those used by students of typical development, on a different frequency thought. Moreover, they adopt impetus theory at a rate that is statistically different from that of typical development students. Findings of the current research study are likely to contribute to the basis for teaching projectile motion to students with autism spectrum disorder.

Influence of Primary Auditory Cortex in the Characterization of Autism Spectrum in Young Adults using Brain Connectivity Parameters and Deep Belief Networks: An fMRI Study.

The spectrum of autism encompasses High Functioning Autism (HFA) and Low Functioning Autism (LFA). Brain mapping studies have revealed that autism individuals have overlaps in brain behavioural characteristics. Generally, high functioning individuals are known to exhibit higher intelligence and better language processing abilities. However, specific mechanisms associated with their functional capabilities are still under research. This work addresses the overlapping phenomenon present in autism spectrum through functional connectivity patterns along with brain connectivity parameters and distinguishes the classes using deep belief networks. The task-based functional Magnetic Resonance Images (fMRI) of both high and low functioning autistic groups were acquired from ABIDE database, for 58 low functioning against 43 high functioning individuals while they were involved in a defined language processing task. The language processing regions of the brain, along with Default Mode Network (DMN) have been considered for the analysis. The functional connectivity maps have been plotted through graph theory procedures. Brain connectivity parameters such as Granger Causality (GC) and Phase Slope Index (PSI) have been calculated for the individual groups. These parameters have been fed to Deep Belief Networks (DBN) to classify the subjects under consideration as either LFA or HFA. Results showed increased functional connectivity in high functioning subjects. It was found that the additional interaction of the Primary Auditory Cortex lying in the temporal lobe, with other regions of interest complimented their enhanced connectivity. Results were validated using DBN measuring the classification accuracy of 85.85% for high functioning and 81.71% for the low functioning group. Since it is known that autism involves enhanced, but imbalanced components of intelligence, the reason behind the supremacy of high functioning group in language processing and region responsible for enhanced connectivity has been recognized. Therefore, this work that suggests the effect of Primary Auditory Cortex in characterizing the dominance of language processing in high functioning young adults seems to be highly significant in discriminating different groups in autism spectrum.

Expressivity in children with autism and Williams syndrome

PurposeThe purpose of this study is to investigate the social and affective aspects of communication in school-age children with HFA and school-age children with WS using a micro-analytic approach. Social communication is important for success at home, school, work and in the community. Lacking the ability to effectively process and convey information can lead to deficits in social communication. Individuals with high functioning autism (HFA) and individuals with Williams syndrome (WS) often have significant impairments in social communication that impact their relationships with others. Currently, little is known about how school-age children use and integrate verbal and non-verbal behaviors in the context of a social interaction.Design/methodology/approachA micro-analytic coding scheme was devised to reveal which channels children use to convey information. Language, eye gaze behaviors and facial expressions of the child were coded during this dyadic social interaction. These behaviors were coded throughout the entire interview, as well as when the child was the speaker and when the child was the listener.FindingsLanguage results continue to pose problems for the HFA and WS groups compared to their typically developing (TD) peers. For non-verbal communicative behaviors, a qualitative difference in the use of eye gaze was found between the HFA and WS groups. For facial expression, the WS and TD groups produced more facial expressions than the HFA group.Research limitations/implicationsNo differences were observed in the HFA group when playing different roles in a conversation, suggesting they are not as sensitive to the social rules of a conversation as their peers. Insights from this study add knowledge toward understanding social-communicative development in school-age children.Originality/valueIn this study, two non-verbal behaviors will be assessed in multiple contexts: the entire biographical interview, when the child is the speaker and when the child is the listener. These social and expressive measures give an indication of how expressive school-age children are and provide information on their attention, affective state and communication skills when conversing with an adult. Insights from this study will add knowledge toward understanding social-communicative development in school-age children.

Parent-led, stepped-care cognitive-behavioral therapy for youth with autism and co-occurring anxiety: study rationale and method.

Anxiety disorders affect up to 50% of individuals with autism spectrum disorder (ASD) and are significantly impairing to the person affected, as well as to their loved ones. Cognitive-behavioral therapy (CBT) has been established as the gold-standard treatment for anxiety disorders among typically developing youth and adults, and demonstrates similar efficacy among youth with high-functioning autism (HFA). Many CBT interventions utilize a “full-package” treatment approach to treat co-occurring anxiety in youth with ASD. However, these service delivery systems are often therapist-intensive, costly, and impractical, thereby compromising full engagement and treatment adherence. This paper describes the design, rationale, and methodology of a study examining stepped-care CBT for youth with HFA and co-occurring anxiety – a clinical trial examining the efficacy of low-intensity, parent-led CBT as the first line of treatment and utilizing a more intensive, therapist-led intervention for nonresponders. The study will evaluate the potential benefits of stepped-care and parent-led therapist-assisted interventions, predictors of treatment response, and the economic value of using a stepped-care model. Implications for practice will be discussed.

Effortful Control and Prefrontal Cortex Functioning in Children with Autism Spectrum Disorder: An fNIRS Study.

Effortful control (EC) is an important dimension of temperament, but is impaired in autism spectrum disorder (ASD). While EC is associated with the prefrontal cortex (PFC) functioning in typically developing (TD) children, it is unclear whether EC deficits are associated with PFC dysfunction in ASD. This study examines the relationship between EC and PFC activation and connectivity in children with high-functioning ASD. Thirty-nine right-handed children (ASD: n = 20; TD: n = 19) aged 8–12 years were recruited. The EC level was assessed with the Early Adolescent Temperament Questionnaire—Revised (EATQ-R), and PFC functioning, in terms of activation and connectivity during a frontal-sensitive (n-back) task, was assessed using functional near-infrared spectroscopy (fNIRS). Children with ASD showed a significant deficit in EC and its related constructs (i.e., executive, and socioemotional functions) compared to TD controls. They also showed significantly increased overall PFC activation and reduced right frontal connectivity during the n-back task. Among children with ASD, the EC level correlated significantly with neither PFC activation nor connectivity; it significantly correlated with social functioning only. This study demonstrated EC deficits and altered PFC functioning in children with ASD, but the exact neural basis of EC deficits remains to be determined.

Desempeño Intelectual en el Síndrome de Asperger

El propósito de este artículo fue determinar el desempeño de 25 niños y adolescentes con Síndrome de Asperger (SA) y autismo de alto funcionamiento (AAF) en tareas manipulativas y verbales, lo cual puede constituir un marcador clínico sensible en la diferenciación de subtipos de los trastornos del espectro autista (TEA). El perfil intelectual de los participantes se analizó a través de la Escala Wechsler de Inteligencia (WISC-IV). Este estudio permitió identificar cambios en el funcionamiento intelectual, verbal, perceptual, memoria y velocidad de procesamiento entre los grupos AS y AAF. Así mismo, supuso un avance en la evaluación de marcadores subclínicos distintivos dentro del SA involucrados en el desempeño cognitivo, lo cual remodela procesos de evaluación e intervención en este tipo de población.

Age-related Brain Morphological Alteration of Medication-naive Boys With High Functioning Autism

To investigate age-related brain morphological changes of boys with high functioning autism (HFA). Forty-six medication-naive boys with HFA and 48 age-matched typically developing boys (4-12 years old) were included in this study. Structural brain images were processed with FreeSurfer to calculate the brain morphometric features including regional volume, surface area, average cortical thickness, and Gaussian curvature. General linear model was used to identify significant effects of diagnosis and age-by-diagnosis interaction. Correlations between age and the brain morphometric variables of significant clusters were explored. Primarily, most of the regions with statistically significant intergroup differences were located in the temporal lobe gyri. Importantly, the volume of bilateral superior temporal gyrus (STG) and the average cortical thickness of the right STG demonstrated significantly age-related intergroup differences. Further age-stratified analysis also revealed morphological alterations of STG among subgroups of preschool and school-aged children with or without HFA. The findings demonstrated abnormal age-related volume and cortical thickness atrophy of the STG in HFA children, which reflect brain development trajectories of ASD may initiate to diverge from early overgrowth in childhood period. The anatomical localization of specific brain regions would help us better understand the neurobiology alterations of HFA patients and indicate the effect of age should be carefully delineated and examined in future studies about HFA.

Attention Deficits Influence the Development of Motor Abnormalities in High Functioning Autism

Early attentional dysfunction is one of the most consistent findings in autism spectrum disorder (ASD), including the high functioning autism (HFA). There are no studies that assess how the atypical attentional processes affect the motor functioning in HFA. In this study, we evaluated attentional and motor functioning in a sample of 15 drug-naive patients with HFA and 15 healthy children (HC), and possible link between attentional dysfunction and motor impairment in HFA. Compared to HC, HFA group was seriously impaired in a considerable number of attentional processes and showed a greater number of motor abnormalities. Significant correlations between attention deficits and motor abnormalities were observed in HFA group. These preliminary findings suggest that deficit of attentional processes can be implied in motor abnormalities in HFA.

Sleep quality among adults with attention deficit hyperactivity disorder or autism spectrum disorder: which is the role of gender and chronotype?

Both Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) present increased prevalence rates of sleep difficulties, which persist into adulthood. However, it is still unclear whether in adults these disorders show specific sleep patterns and which role is played by comorbidities, circadian preferences and gender. This study aimed to describe and compare subjective measures of sleep in adults with ADHD and high-functioning ASD, in relation to the levels of anxiety and depression, chronotype and gender. In a sample of 136 adults (43 ADHD, 43 high-functioning ASD, 50 controls) subjective sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI), and clinical scales were used to assess chronotype and the levels of anxiety and depression. The three groups showed a significant difference in the distribution of chronotypes, with greater prevalence of an Evening chronotype among ASD compared to controls. The MANCOVA using PSQI subscale scores as dependent variables and MEQ-SA score and depression range as covariates showed that the three groups significantly differ in quality, latency, efficiency, and dysfunction scores with a significant differences between ASD and ADHD in efficiency and dysfunction. Compared to men, women showed higher scores on PSQI total and quality subscale across the three groups and higher duration scores only within ASD group. Our results indicate that both ADHD and ASD adults show unique sleep disturbances and suggest that ASD patients, especially women, may display more pronounced disordered sleep.

MEG Theta during Lexico-Semantic and Executive Processing Is Altered in High-Functioning Adolescents with Autism.

Neuroimaging studies have revealed atypical activation during language and executive tasks in individuals with autism spectrum disorders (ASD). However, the spatiotemporal stages of processing associated with these dysfunctions remain poorly understood. Using an anatomically constrained magnetoencephalography approach, we examined event-related theta oscillations during a double-duty lexical decision task that combined demands on lexico-semantic processing and executive functions. Relative to typically developing peers, high-functioning adolescents with ASD had lower performance accuracy on trials engaging selective semantic retrieval and cognitive control. They showed an early overall theta increase in the left fusiform cortex followed by greater activity in the left-lateralized temporal (starting at ~250ms) and frontal cortical areas (after ~450ms) known to contribute to language processing. During response preparation and execution, the ASD group exhibited elevated theta in the anterior cingulate cortex, indicative of greater engagement of cognitive control. Simultaneously increased activity in the ipsilateral motor cortex may reflect a less lateralized and suboptimally organized motor circuitry. Spanning early sensory-specific and late response selection stages, the higher event-related theta responsivity in ASD may indicate compensatory recruitment to offset inefficient lexico-semantic retrieval under cognitively demanding conditions. Together, these findings provide further support for atypical language and executive functions in high-functioning ASD.

Suicidal Ideation and Suicidal Attempts in Referred Adolescents with High Functioning Autism Spectrum Disorder and Comorbid Bipolar Disorder: A Pilot Study.

Suicidal ideation and attempts in adolescents are closely associated to bipolar disorders (BD). Growing evidence also suggests that high functioning autism spectrum disorders (HF-ASD) are at increased risk for suicidal ideation and behaviors. Although BD and HF-ASD are frequently comorbid, no studies explored suicidality in these individuals. This exploratory study addressed this issue in a clinical group of inpatient adolescents referred to a psychiatric emergency unit. Seventeen adolescents with BD and HF-ASD and severe suicidal ideation or attempts (BD-ASD-S), were compared to 17 adolescents with BD and HF-ASD without suicidal ideation or attempts (BD-ASD-noS), and to 18 adolescents with BD and suicidal ideation or attempts without ASD (BD-noASD-S), using a structured assessment methodology. Individuals with BD-ASD-S had a higher intelligence quotient, more severe clinical impairment, more lethality in suicide attempts, more internalizing symptoms, less impulsiveness, and lower social competence. Severity of ASD traits in individuals and parents did not correlate with suicidal risk. Some dimensions of resilience were protective in terms of repulsion by life and attraction to death. Main limitations are the small sample size, the lack of a control group of typically developing adolescents. However, a better understanding of the specificities of bipolar HF-ASD individuals with suicidality may improve prevention and treatment strategies.

What is ‘high-functioning’ in high-functioning autism?

In several diagnostic manuals of disabilities and disorders, High-Functioning Autism (HFA) is omitted and/or remains an unofficial diagnostic term. However, in 2007, the American Academy of Special Education Professionals has given it an official diagnostic code AU-4.00 in its Educator’s Diagnostic Manual of Disabilities and Disorders (EDM). This has rekindled research to re-look at HFA if it deserves to be given its own diagnostic code. Today, HFA refers to autistics who possess average/above-average intelligence and function in typical settings. This paper explores what ‘high-functioning’ is in the enigmatic condition of HFA.

'DON'T CREATE AN ONLINE IMAGE THAT YOU CAN'T KEEP UP OUTSIDE': MEDIATING INVISIBLE COMMUNICATIVE DISABILITIES ON SOCIAL NETWORK SITES

The internet theoretically offers a socially inclusive space for disabled users and new forms of visibility vis-à-vis mediated communication. However, the prevalent perception of the internet as an idyllic space that liberates disabled people reflects an ableist mindset, as it views departure from the disabled body as the source of liberation. This paper challenges this perception by investigating how people with invisible disabilities that are clinically related to communication mediate their disabled life experience in Social Networking Sites (SNS). To this end, the study probed, through thematic analysis, 31 in-depth interviews with high-functioning autistics, stutterers and hard of hearing SNS users and 7 SNS documentation use diaries. The analysis identified a gamut of disability performances online, which varied based on one's perception of the disability and its visibility. For example, while some interviewees crafted a complex online persona that presented their disabilities through a nuanced perspective, others felt compelled to ‘pass’ as able-bodied. Many felt that their self-presentation was inhibited by a sense of social surveillance, imposed by the presence of friends from “the offline world”. The notion of “authenticity” posed another barrier for many interviewees: Sensing an expectation that their communicative style on SNS align with their physical communication led them to ironically adopt a less true-to-self persona by managing the visibility of their disability online to reflect their 'offline' constraints. Rather than providing an accessible and/or liberating sphere, this paper argues that social networking sites reproduce the ableist biases and power structures that underline the physical, “offline” sphere.

7.6 ASSESSMENT AND TREATMENT OF SUBSTANCE USE DISORDERS IN YOUNG PEOPLE WITH HIGH-FUNCTIONING AUTISM SPECTRUM DISORDER

Substance use disorders (SUDs) are associated with significant morbidity and mortality. Child and adolescent psychiatrists need to be aware of the risk for SUD and the age of onset of SUD in young people with high-functioning autism spectrum disorder (ASD). Child and adolescent psychiatrists need to be prepared to assess for SUD and associated risks in young people with high-functioning ASD. Child and adolescent psychiatrists also need to be familiar with the SUD treatment system and modifications for SUD treatment that may be needed when working with young people with co-occurring high-functioning ASD and SUD.

6.7 AUTISM SPECTRUM DISORDER–FOCUSED AUGMENTED REALITY SMARTGLASSES SYSTEM FOR ENHANCING ENGAGEMENT AND PARENT-CHILD INTERACTION

Autism spectrum disorder (ASD) is a prevalent childhood-onset neurodevelopmental disorder. The current ASD interventions are primarily based on in-person behavioral therapies that are both costly and difficult to access, and are targeting ASD deficits in social communication, and the presence of stereotypies and other ASD-related behaviors. This secondary analysis evaluates the impact of ASD-focused augmented-reality Brain Power Smartglasses (BPS) system on engagement and parent-child interaction of children with higher-functioning ASD.

Cognitive-behavioral family therapy as psychoeducation for adolescents with high-functioning autism spectrum disorders: Aware and Care for my Autistic Traits (ACAT) program study protocol for a pragmatic multisite randomized controlled trial

BackgroundOne aim of an autism spectrum disorder (ASD) diagnosis is to obtain special support for the disorder, though this does not guarantee practical support. We developed a psychoeducational program using cognitive-behavioral therapy (CBT) and Aware and Care for my Autistic Traits (ACAT) for Japanese adolescents with high-functioning ASD and their parents.MethodsThis multisite study is a randomized controlled trial. In total, 24 participants will be assigned to the ACAT group and 24 to the treatment-as-usual (TAU) group. The ACAT group will receive a weekly 100-min session for 6 weeks, regular medical care, and one follow-up session. In this ongoing clinical trial, we will compare the scores of the measures recorded in the pre- and post-intervention stages between the ACAT and TAU groups. A total of 41 patients out of a target of 48 have participated in the trial to date. The primary outcome measure is the Autism Knowledge Questionnaire. Secondary outcome measures include Barriers to Access to Care Evaluation 3rd Edition, the Strengths and Difficulties Questionnaire, the Vineland Adaptive Behavior Scales second edition, the Parenting Resilience Elements Questionnaire, the General Health Questionnaire 12, and the Depression Self-Rating Scale for Children assessments, as well as an electroencephalographic recording.DiscussionIt is expected that participants in the ACAT group will significantly increase their self-understanding and awareness of ASD symptoms compared to those in the TAU group. Additionally, the ACAT group is expected to exhibit improved social adaptation and mental health if children and parents are able to better understand the ASD characteristics through sessions. This intervention will contribute to the establishment of an effective evidence-based treatment strategy for adolescents with ASD.Trial registrationUMIN Register 000029851. Registered on January 06, 2018

Computer‐mediated intervention to foster prosocial ability among children with autism

AbstractThe study refers to the social aspect of Autism Spectrum Disorder (ASD) and focuses on pro‐social behaviour that has a positive effect on social adaptability. The first goal of the study was to determine whether there is a gap in prosocial‐behaviour between children with High‐Functioning ASD (HFASD) and children with typical‐development; and secondly, to foster prosocial‐behaviour with a computer‐mediated intervention versus a non‐computer‐mediated intervention. The study comprises 58 preschool children, divided into three groups: HFASD experiencing a computer‐mediated intervention, HFASD experiencing a non‐computer‐mediated intervention, and typically‐developing children with no intervention. The 2‐month intervention was based on the Cognitive Behavioural Therapy model, and pairs of children learned how to solve social‐problems. Following preliminary screening tests (PPVT; SCQ), observations designed to evaluate prosocial‐ability and Vineland questionnaires measuring prosocial‐behaviour were conducted pre‐ and post‐intervention. Pre‐intervention findings indicated that children with typical‐development exhibited higher prosocial‐behaviour than children with HFASD. This changed however, post‐intervention, as the gap between the two groups decreased. Additionally, the study found that the computer‐mediated intervention group improved in some prosocial measures compared to the non‐computer‐mediated intervention.

Emotional prosody recognition in children with high-functioning autism under the influence of emotional intensity: Based on the perspective of emotional dimension theory

This paper investigated the ability of Mandarin-speaking children with high-functioning autism (HFA) to recognize the four categories of emotional prosody, namely, happiness, anger, sadness and fear, in moderate- and high-intensity emotional conditions using auditory discrimination tasks. Thirty-four children with HFA between 5 and 7 years of age and 34 typically developing (TD) controls participated in this study. In moderate-intensity conditions, children with HFA scored lower than TD children in the recognition of the four categories of emotional prosody, indicating an overall impairment. With an increase in the intensity of emotion, children with HFA showed improved accuracy for anger, decreased accuracy for happiness, but no change in accuracy for either sadness or fear. An analysis of error patterns demonstrated that unlike TD children, children with HFA were inclined to mistake happiness for anger, with the two categories differing in valence, and this inclination deepened as the intensity increased. In discriminating between sadness and fear, which have a slight arousal difference, both groups showed difficulty in moderate-intensity conditions. In high-intensity conditions, TD children were inclined to perceive stimuli as exhibiting fear, which demonstrates comparatively high arousal; thus, they were more accurate for fear, while HFA children were not sensitive to increases in arousal, showing no noticeable effect. These findings indicated that children with HFA have a mechanism distinct from that of TD children in emotional prosody recognition, exhibiting various degrees of impairment in this regard.