Development of the Halifax Visual Scanning Test: A New Measure of Visual-Spatial Neglect for Personal, Peripersonal, and Extrapersonal Space.

OBJECTIVES: Visual-spatial neglect is a common attentional disorder after right-hemisphere stroke and is associated with poor rehabilitation outcomes. The presence of neglect symptoms has been reported to vary across personal, peripersonal, and extrapersonal space. Currently, no measure is available to assess neglect severity equally across these spatial regions and may be missing subsets of symptoms or patients with neglect entirely. We sought to provide initial construct validity for a novel assessment tool that measures neglect symptoms equally for these spatial regions: the Halifax Visual Scanning Test (HVST). METHODS: In Study I, the HVST was compared to conventional measures of neglect and functional outcome scores (wheelchair navigation) in 15 stroke inpatients and 14 healthy controls. In Study II, 19 additional controls were combined with the control data from Study I to establish cutoffs for impairment. Patterns of neglect in the stroke group were examined. RESULTS: In Study I, performance on all HVST subtests were correlated with the majority of conventional subtests and wheelchair navigation outcomes. In Study II, neglect-related deficits in visual scanning showed dissociations across spatial regions. Four inpatients exhibited symptoms of neglect on the HVST that were not detected on conventional measures, one of which showed symptoms in personal and extrapersonal space exclusively. CONCLUSIONS: The HVST appears a useful measure of neglect symptoms in different spatial regions that may not be detected with conventional measures and that correlates with functional wheelchair performance. Preliminary control data are presented and further research to add to this normative database appears warranted.

Brief parent training in pivotal response treatment for preschoolers with autism.

BACKGROUND: Evidence of improved outcomes with early behavioural intervention has placed the early treatment of autism as a health priority. However, long waiting lists for treatment often preclude timely access, raising the question of whether parents could be trained in the interim. Parent training in pivotal response treatment (PRT) has been shown to enhance the communication skills of children with autism. This is typically provided within a 25-hour programme, although less intensive parent training may also be effective. The main objective of the present study was to evaluate the efficacy of brief training in PRT for parents of preschoolers with autism, who were awaiting, or unable to access, more comprehensive treatment. METHOD: Eight preschoolers with autism and their parents participated in the study. A non-concurrent multiple (across-participants) baseline design was used, in which parents were seen individually for three 2-hour training sessions on PRT. Child and parent outcomes were assessed before, immediately after, and 2 to 4 months following training using standardised tests, questionnaires and behaviour coded directly from video recordings. RESULTS: Overall, children's communication skills, namely functional utterances, increased following training. Parents' fidelity in implementing PRT techniques also improved after training, and generally these changes were maintained at follow-up. A moderate to strong relationship was found between parents' increased ability to implement PRT techniques and improvement in the children's communication skills. CONCLUSION: Our findings suggest that brief parent training in PRT promises to provide an immediate, cost-effective intervention that could be adopted widely.

Brief report: pragmatic language in autism spectrum disorder: relationships to measures of ability and disability.

Pragmatic language skill is regarded as an area of universal deficit in Autism Spectrum Disorder (ASD), but little is known about factors related to its development and how it in turn might contribute to skills needed to function in everyday contexts or to the expression of ASD-related symptoms. This study investigated these relationships in 37 high-functioning children with ASD. Multiple regression analyses revealed that structural language skills significantly predicted pragmatic language performance, but also that a significant portion of variance in pragmatic scores could not be accounted for by structural language or nonverbal cognition. Pragmatic language scores, in turn, accounted for significant variance in ADOS Communication and Socialization performance, but did not uniquely predict level of communicative or social adaptive functioning on the Vineland. These findings support the notion of pragmatic language impairment as integral to ASD but also highlight the need to measure pragmatic skills in everyday situations, to target adaptive skills in intervention and to intervene in functional, community-based contexts.

Brief report: data on the Stanford-Binet Intelligence Scales (5th ed.) in children with autism spectrum disorder.

The Fifth Edition of the Stanford-Binet Intelligence Scales (SB5; Roid, G. H. (2003). Stanford Binet intelligence scales (5th ed.). Itasca, IL: Riverside Publishing) is relatively new, with minimal published research on general populations and none with special populations. The present study provides information on the cognitive profiles of children with ASD (N=63) and on the whether the abbreviated battery is representative of the full scale. A high percentage of the children had significantly stronger nonverbal (vs. verbal) skills. This pattern was not related to Full Scale IQ, age or diagnostic subgroup. IQs derived from the abbreviated battery accounted for a large proportion of the variance in FSIQ relative to comparable abbreviated batteries. However, caution is warranted when using the abbreviated battery, as it misrepresents actual ability in a small percentage of cases.

Comparing temporal order judgments and choice reaction time tasks as indices of exogenous spatial cuing.

Attentional disorders are common in individuals with neurological or psychiatric conditions and impact on recovery and outcome. Thus, it is critical to develop theory-based measures of attentional function to understand potential mechanisms underlying the disorder and to evaluate the effect of intervention. The present study compared two alternative methods to measure the effects of attentional cuing that could be used in populations of individuals who may not be able to make manual responses normally or may show overall slowing in responses. Spatial attention was measured with speeded and unspeeded methods using either manual or voice responses in two standard attention paradigms: the cued target discrimination reaction time (RT) paradigm and the unspeeded temporal order judgment (TOJ) task. The comparison of speeded and unspeeded tasks specifically addresses the concern about interpreting RT differences between cued and uncued trials (taken as a proxy for attention) in the context of drastically different baseline RTs. We found significant cuing effects for both tasks (speeded RT and untimed TOJ) and both response types (vocal and manual) giving clinicians and researchers alternative methods with which to measure the effects of attention in different populations who may not be able to perform the standard speeded RT task.

Perceptual biases in processing facial identity and emotion.

Normal observers demonstrate a bias to process the left sides of faces during perceptual judgments about identity or emotion. This effect suggests a right cerebral hemisphere processing bias. To test the role of the right hemisphere and the involvement of configural processing underlying this effect, young and older control observers and patients with right hemisphere damage completed two chimeric faces tasks (emotion judgment and face identity matching) with both upright and inverted faces. For control observers, the emotion judgment task elicited a strong left-sided perceptual bias that was reduced in young controls and eliminated in older controls by face inversion. Right hemisphere damage reversed the bias, suggesting the right hemisphere was dominant for this task, but that the left hemisphere could be flexibly recruited when right hemisphere mechanisms are not available or dominant. In contrast, face identity judgments were associated most clearly with a vertical bias favouring the uppermost stimuli that was eliminated by face inversion and right hemisphere lesions. The results suggest these tasks involve different neurocognitive mechanisms. The role of the right hemisphere and ventral cortical stream involvement with configural processes in face processing is discussed.