Autism Science Research Articles

Unpacking the overlap between Autism and ADHD in adults: A multi-method approach

The overlap between Autism and Attention-Deficit Hyperactivity Disorder (ADHD) is widely observed in clinical settings, with growing interest in their co-occurrence in neurodiversity research. Until relatively recently, however, concurrent diagnoses of Autism and ADHD were not possible. This has limited the scope for large-scale research on their cross-condition associations, further stymied by a dearth of open science practices in the neurodiversity field. Additionally, almost all previous research linking Autism and ADHD has focused on children and adolescents, despite them being lifelong conditions. Tackling these limitations in previous research, 5504 adults – including a nationally representative sample of the UK (Study 1; n = 504) and a large pre-registered study (Study 2; n = 5000) – completed well-established self-report measures of Autism and ADHD traits. A series of network analyses unpacked the associations between Autism and ADHD at the individual trait level. Low inter-item connectivity was consistently found between conditions, supporting the distinction between Autism and ADHD as separable constructs. Subjective social enjoyment and hyperactivity-impulsivity traits were most condition-specific to Autism and ADHD, respectively. Traits related to attention control showed the greatest Bridge Expected Influence across conditions, revealing a potential transdiagnostic process underlying the overlap between Autism and ADHD. To investigate this further at the cognitive level, participants completed a large, well-powered, and pre-registered study measuring the relative contributions of Autism and ADHD traits to attention control (Study 3; n = 500). We detected age- and sex-related effects, however, attention control did not account for the covariance between Autism and ADHD traits. We situate our findings and discuss future directions in the cognitive science of Autism, ADHD, and neurodiversity, noting how our open datasets may be used in future research.

Anti-ableism and scientific accuracy in autism research: a false dichotomy.

It was recently argued that autism researchers committed to rejecting ableist frameworks in their research may sacrifice "scientifically accurate" conceptualizations of autism. In this perspective piece, we argue that: (a) anti-ableism vs. scientific accuracy is a false dichotomy, (b) there is no ideology-free science that has claim to scientific accuracy, and (c) autism science has a history of false leads in part because of unexamined ableist ideologies that undergird researcher framings and interpretations of evidence. To illustrate our claims, we discuss several avenues of autism research that were promoted as scientific advances, but were eventually debunked or shown to have much less explanatory value than initially proposed. These research programs have involved claims about autism etiology, the nature of autism and autistic characteristics, and autism intervention. Common to these false leads have been ableist assumptions about autism that inform researcher perspectives. Negative impacts of this work have been mitigated in some areas of autism research, but these perspectives continue to exert influence on the lives of autistic people, including the availability of services, discourses about autism, and sociocultural conceptualizations of autistic people. Examining these false leads may help current researchers better understand how ableism may negatively influence their areas of inquiry. We close with a positive argument that promoting anti-ableism can be done in tandem with increasing scientific accuracy.

The Foundations of Autistic Flourishing.

All people-including Autistic people-deserve to live flourishing lives. But what does a flourishing life look like for Autistic people? We suggest that the hidden biases, methodological errors, and key assumptions of autism science have obscured answers to this question. Here, we seek to initiate a broader discussion about what the foundations for a good Autistic life might be and how this discussion might be framed. We identify five ways in which autism science can help us all to secure those foundations, including by (1) giving Autistic well-being prominence in research, (2) amplifying Autistic autonomy, (3) attending better to everyday experiences, (4) acknowledging context, and (5) working in partnership with Autistic people and their families and allies to ensure that they are at the heart of research decision-making. Such an approach would direct the focus of autism research to help shape good Autistic lives.

Reaching Accuracy Assessment in Cerebellar Stroke using Virtual Reality (S20.010)

<h3>Objective:</h3> To investigate the application of virtual reality (VR) in the rapid quantification of reaching accuracy at the bedside for patients with cerebellar stroke (CS). <h3>Background:</h3> Dysmetria, the inability to measure distance in muscular tasks correctly, is a characteristic clinical feature of cerebellar injury. Even though dysmetria can be quickly detected during the neurological examination with the finger-to-nose test, objective quantification of reaching accuracy for clinical assessment is still lacking. Emerging VR technology, together with recent improvements in the hand-tracking feature, offers an opportunity to closely examine the speed, accuracy, and consistency of fine hand movements and proprioceptive function. <h3>Design/Methods:</h3> 29 individuals (10 CS patients and 19 age-matched not-disabled controls) performed a task measuring reaching accuracy on the VR headset (Oculus Quest 2). 50% of the trials displayed a visible rendering of the hand as the participant reached for the target (visible hand condition), while the remaining 50% only showed the target being extinguished (invisible hand condition). Reaching error was calculated as the difference in degrees between where the fingertip passed the arch and where the target was positioned. <h3>Results:</h3> Reaching error was higher in CS than in age-matched controls in both visible hand and invisible hand conditions. Reaching error was higher in the invisible hand condition than in the visible hand condition in both healthy controls and CS patients. Average time taken to perform each trial was higher in CS patients than in controls in both visible and invisible hand conditions. <h3>Conclusions:</h3> Reaching accuracy assessed by VR promises to be a non-invasive and rapid approach to quantifying fine motor functions in clinical settings. In addition, this device has the potential to be a useful supplemental technology in monitoring fine motor and proprioceptive functions during physical rehabilitation. Further studies are needed to examine quantitative changes in reaching accuracy during post-stroke progression. <b>Disclosure:</b> Mr. Du has nothing to disclose. Mr. Benavides has received personal compensation for serving as an employee of Stryker. Emily Isenstein has received research support from Autism Science Foundation. Prof. Tadin has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for NeuroTrainer. Prof. Tadin has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Finkelstein and partners. The institution of Prof. Tadin has received research support from NIH. The institution of Prof. Tadin has received research support from The Brain &amp; Behavior Research Foundation. Prof. Tadin has received intellectual property interests from a discovery or technology relating to health care. Dr. Busza has received research support from NIH/NINDS. Dr. Busza has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH.

Celebrating women in autism science

Celebrating women in autism science

Community Newsletter: Null on biomarkers; dopamine; sleep issues; funding

This week, researchers discussed a search for autism biomarkers, a surprising explanation for how the brain organizes spontaneous behavior, and sleep disturbances in children with genetic neurodevelopmental conditions. Also, four new projects on profound autism received funding from the Autism Science Foundation.

Integrating autistic perspectives into autism science: A role for autistic autobiographies.

Autism science faces challenges in how to think about autism and what questions to focus on, and sometimes contributes to stigma against autistic people. We examine one way that non-autistic researchers may start to combat these challenges: by reading and reflecting on autistic people's descriptions of their personal experiences (e.g. autobiographies) of what it is like to be autistic. In this article, we review some of the advantages and challenges of this approach and how it may help combat some of the challenges currently facing autism science by focusing studies on the questions autistic people find most important, counteracting stereotypes, and increasing understanding of autistic experiences.

Chronicle of a field retold: Autism science in profile

Chronicle of a field retold: Autism science in profile

Community Newsletter: Kavli Prize puts spotlight on autism science, plus a genetics PSA

Community Newsletter: Kavli Prize puts spotlight on autism science, plus a genetics PSA

Annual Research Review: Shifting from 'normal science' to neurodiversity in autism science.

Since its initial description, the concept of autism has been firmly rooted within the conventional medical paradigm of child psychiatry. Increasingly, there have been calls from the autistic community and, more recently, nonautistic researchers, to rethink the way in which autism science is framed and conducted. Neurodiversity, where autism is seen as one form of variation within a diversity of minds, has been proposed as a potential alternative paradigm. In this review, we concentrate on three major challenges to the conventional medical paradigm – an overfocus on deficits, an emphasis on the individual as opposed to their broader context and a narrowness of perspective – each of which necessarily constrains what we can know about autism and how we are able to know it. We then outline the ways in which fundamental elements of the neurodiversity paradigm can potentially help researchers respond to the medical model’s limitations. We conclude by considering the implications of a shift towards the neurodiversity paradigm for autism science.

Eric Fombonne: Crossing continents to expand autism science

Eric Fombonne: Crossing continents to expand autism science

Scientific Hegemony and the Field of Autism

Autism is one of the twenty-first century’s most contested illnesses. Early controversies around vaccine harm have irrevocably structured the field of autism science. Despite incredible investment in genetic research on autism over the past 30 years, scientists have failed to identify a set of “genes for” autism, and genomic causality has become more complex. Yet, orthodox genetic explanations for autism have retained dominance over a vociferous field of heterodox experts pointing to a series of environmental insults (vaccines, heavy metal exposure, overuse of antibiotics, toxic pollution) as the main causes of autism. To make sense of this puzzling trend, we develop a novel theoretical synthesis combining a Bourdieusian field analysis with a Gramscian conception of hegemony, centered around the concept of “subsumptive orthodoxy.” Analyzing multiple years of archival data from the Interagency Autism Coordinating Committee, we argue that when faced with heterodox challenges, dominant members of the field shore up hegemony by incorporating environmental causal factors into the genome, thus engaging in subsumptive orthodoxy. This move gives rhetorical space to environmental explanations without providing them substantive causal weight, which renders particular environmental causes (like vaccines) impossible. This article traces the strategies dominant members of the field use to retain control over the definition and etiology of autism. We develop the broader implications of the study within autism science and beyond.

Commentary: Broadening the research remit of participatory methods in autism science - a commentary on Happé and Frith (2020).

Autism science has transformed beyond recognition in the last two decades. International investment has grown extensively and the number of papers published on autism has increased 10-fold (Pellicano et al., 2014), far surpassing publications on related topics. The sheer amount of scientific research on autism has no doubt been instrumental in many of the discoveries and insights so eloquently described by Happé and Frith (2020). But, as autistic scientist Michelle Dawson reminds us, quality matters too and, for that reason, it is a delight to recognise the contribution that both Happé and Frith have made, dramatically changing our understanding of autism in a host of ways.

Hidden Aspects of the Research ADOS Are Bound to Affect Autism Science.

The research-grade Autism Diagnostic Observational Schedule (ADOS) is a broadly used instrument that informs and steers much of the science of autism. Despite its broad use, little is known about the empirical variability inherently present in the scores of the ADOS scale or their appropriateness to define change and its rate, to repeatedly use this test to characterize neurodevelopmental trajectories. Here we examine the empirical distributions of research-grade ADOS scores from 1324 records in a cross-section of the population comprising participants with autism between five and 65 years of age. We find that these empirical distributions violate the theoretical requirements of normality and homogeneous variance, essential for independence between bias and sensitivity. Further, we assess a subset of 52 typical controls versus those with autism and find a lack of proper elements to characterize neurodevelopmental trajectories in a coping nervous system changing at nonuniform, nonlinear rates. Repeating the assessments over four visits in a subset of the participants with autism for whom verbal criteria retained the same appropriate ADOS modules over the time span of the four visits reveals that switching the clinician changes the cutoff scores and consequently influences the diagnosis, despite maintaining fidelity in the same test's modules, room conditions, and tasks' fluidity per visit. Given the changes in probability distribution shape and dispersion of these ADOS scores, the lack of appropriate metric spaces to define similarity measures to characterize change and the impact that these elements have on sensitivity-bias codependencies and on longitudinal tracking of autism, we invite a discussion on readjusting the use of this test for scientific purposes.

The value of giving autistic testimony a substantial role in the science of autism

Abstract Jaswal &amp; Akhtar argue that taking seriously autistic testimony will help make the science of autism more humane, accurate, and useful. In this commentary, I pose two questions about autistic testimony's role(s) in a better science of autism and extract a general lesson about the value of autistic testimony from the authors’ arguments.

Supporting autistic flourishing

Abstract In response to the 32 commentaries, we clarify and extend two of the central arguments in our target article: (1) Social motivation is a dynamic, emergent process, not a static characteristic of individuals, and (2) autistic perspectives are essential to the study of autistic social motivation. We elaborate on how taking these two arguments seriously can contribute to a more accurate, humane, and useful science of autism.

Disturbing Behaviours: Ole Ivar Lovaas and the Queer History of Autism Science

This paper “queers” the history of autism science through an examination of the overlap between the regulation of autism with that of gender and sexuality in the work of Ole Ivar Lovaas. Lovaas is the founder of Applied Behaviour Analysis (ABA), the most commonly used and funded autism intervention today that seeks to extinguish autistic behaviors, primarily among children. Less commonly recognized is Lovaas’ involvement in the Feminine Boy Project, where he developed interventions into the gender identities and behaviors of young people. Turning to Lovaas’ published works, we perform a “history of the present” and argue that a queer disability studies lens opens up the richness of autism as a cultural nexus, and deepens understandings of intersecting and contested histories of science, professional scopes of practice, and dominant futurities. The article makes a significant and timely contribution to understanding the disabling material effects of autism science in the lives of autistic persons. In particular, this case study highlights the need for feminist science studies to further investigate the historical and contemporary links between dominant scientific constructions of disability, gender, and sexuality.

Being versus appearing socially uninterested: Challenging assumptions about social motivation in autism.

Progress in psychological science can be limited by a number of factors, not least of which are the starting assumptions of scientists themselves. We believe that some influential accounts of autism rest on a questionable assumption that many of its behavioral characteristics indicate a lack of social interest - an assumption that is flatly contradicted by the testimony of many autistic people themselves. In this article, we challenge this assumption by describing alternative explanations for four such behaviors: (a) low levels of eye contact, (b) infrequent pointing, (c) motor stereotypies, and (d) echolalia. The assumption that autistic people's unusual behaviors indicate diminished social motivation has had profound and often negative effects on the ways they are studied and treated. We argue that understanding and supporting autistic individuals will require interrogating this assumption, taking autistic testimony seriously, considering alternative explanations for unusual behaviors, and investigating unconventional - even idiosyncratic - ways in which autistic individuals may express their social interest. These steps are crucial, we believe, for creating a more accurate, humane, and useful science of autism.

Chapter 3 - Autism BrainNet: A network of postmortem brain banks established to facilitate autism research

Autism spectrum disorder (ASD or autism) is a neurodevelopmental condition that affects over 1% of the population worldwide. Developing effective preventions and treatments for autism will depend on understanding the genetic perturbations and underlying neuropathology of the disorder. While evidence from magnetic resonance imaging and other noninvasive techniques points to altered development and organization of the autistic brain, these tools lack the resolution for identifying the cellular and molecular underpinnings of the disorder. Postmortem studies of high-quality human brain tissue currently represent the only viable option to pursuing these types of studies. However, the availability of high-quality ASD brain tissue has been extremely limited. Here we describe the establishment of a privately funded tissue bank, Autism BrainNet, a network of brain collection sites that work in a coordinated fashion to develop an adequate library of human postmortem brain tissues. Autism BrainNet was initiated as a collaboration between the Simons Foundation and Autism Speaks, and is currently funded by the Simons Foundation Autism Research Initiative. Autism BrainNet has collection sites (nodes) in California, Texas, New York, and Massachusetts; an affiliated, international node is located in Oxford, England. All donations to this network become part of a consolidated pool of tissue that is distributed to qualified investigators worldwide to carry out autism research. An essential component of this program is a widespread outreach program that highlights the need for postmortem brain donations to families affected by autism, led by the Autism Science Foundation. Challenges include an outreach campaign that deals with a disorder beginning in early childhood, collecting an adequate number of donations to deal with the high level of biologic heterogeneity of autism, and preparing this limited resource for optimal distribution to the greatest number of investigators.

Failing, hacking, passing: Autism, entanglement, and the ethics of transformation.

One of the most notable recent changes in autism science is the belief that autism is a heterogeneous condition with no singular essence. I argue that this notion of 'autistic heterogeneity' can be conceived as an 'agential cut' and traced to uncertainty work conducted by cognitive psychologists during the early 1990s. Researchers at this time overcame uncertainty in scientific theory by locating it within autism itself: epistemological uncertainty was interwoven with ontological indeterminacy and autism became heterogeneous and chance like, a condition determined by indeterminacy. This paper considers not only the conceptual significance of this move but also the impact upon forms of subjectivity. This analysis is undertaken by integrating the agential realism of Karen Barad with the historical ontology of Michel Foucault. I argue that these two approaches are, firstly, concerned with ontologies of emergence and, secondly, foreground the inherently ethical nature of change. As such these theories can be used to articulate an 'ethics of transformation'. I argue that the agential cut which brought about autistic heterogeneity is potentially problematic within an ethics of transformation, limiting the possibility of future change in subjectivity by imagining difference and resistance as properties of autism rather than the individual.