New Methods for Unraveling Imitation Accuracy Differences Between Children with Autism and Typically Developing Peers.

This study applies methods used in sign language and gesture research to better understand reduced imitation accuracy (IA) of actions and gestures in children with autism spectrum disorder (ASD), and we addressed contrasting theories on IA in ASD and the role of objects and meanings in imitation. Eight male children with ASD with a mean chronological age (CA) of 86.76 months (SD = 10.74, range 70.5-104.4) and 22 male and female peers with typical development (TD) and a mean CA of 85.44 months (SD = 7.95, range 73.4-96.7) imitated videos of an adult performing actions with objects, representational gestures, conventional gestures and meaningless gestures. We measured accuracy as ability to effectively reproduce features (handshape, palm orientation, location, movement direction and type) and timing (speed) of observed actions/gestures, after ruling out cases of specular (i.e., mirror-like) versus anatomical imitation. Results highlighted significantly lower feature and timing accuracy in children with ASD with respect to the TD group across tasks, and these findings supported sensory-motor theories of IA in ASD. Our data also showed the different impact of objects and meanings within groups. Overall, these results suggest validity to our assessment method and suggested the importance of considering both discreet variables (i.e., variables describing action/gesture feature accuracy, e.g. handshape, movement direction) and continuous variables (i.e., kinematic variables, e.g. speed) in evaluating IA in autism.

Evaluating Handwriting Skills through Human-Machine Interaction: A New Digitalized System for Parameters Extraction.

Handwriting is an important component of academic curricula and grapho-motor skills (GMS) support learning, reading, memory and self-confidence. Teachers and clinicians report increase in children experiencing problems with acquiring fluid and legible handwriting. To date gold-standard tests evaluating children's GMS, mostly rely on pen and paper tests, requiring extensive coding time and subject to high inter-rater variability. This work presents preliminary data on a new digital platform for Grapho-motor Handwriting Evaluation & Exercise (GHEE), attempting to overcome limitations of available digitalized methods for GMS evalution. In fact, contrary to previous systems, GHEE design originated from comparisons among multiple standardized tests and was based on a human-machine interaction approach. GHEE hardware and software is presented as well as data on preliminary testing. Cursive handwriting data from six adult volunteers was analyzed according to six parameters of relevance, both automatically (i.e., using GHEE software) and manually (i.e., by a human coder). Comparisons among machine and human data sets allowed parsing out parameters to be extracted automatically and parameters requiring human-machine interaction. Results confirmed platform efficacy and feasibility of the proposed approach.

Functional play in young children with autism and Williams syndrome: A cross-syndrome comparison.

Functional play during early childhood paves the way to symbolic play and social communicative skills. However, functional play is surprisingly understudied in children with developmental disorders affecting social and communicative domains, such as Autism Spectrum Disorder (ASD) and Williams syndrome (WS). To address this issue and to evaluate both the quantity and quality of functional play in children with ASD and WS, we examined different play types using fine grained behavioral analysis with a group of age and IQ-matched developmentally delayed children with ASD (n = 14) and WS (n = 14) in comparison with 12 age-matched typically developing (TD) children. Significant differences were found in the quantity of functional play in the ASD and WS groups compared to TD children, with a limited breadth of object exploration found in children with ASD. While TD children engaged more frequently in functional versus nonfunctional play, this was not the case for children with ASD and WS, who showed the same amount of functional and nonfunctional play. Furthermore, functional play behavior was associated with intellectual and adaptive function in children with WS, but not ASD. These results point to the importance of intervention strategies that focus on functional play in improving developmental outcomes for children with ASD and WS.

From Using Tools to Using Language in Infant Siblings of Children with Autism.

Forty-one high-risk infants (HR) with an older sibling with autism spectrum disorder (ASD) were observed longitudinally at 10, 12, 18 and 24 months of age during a tool use task in a play-like scenario. Changes in grasp types and functional actions produced with a spoon were assessed during elicited tool use. Outcome and vocabulary measures were available at 36 months, distinguishing: 11 HR-ASD, 15 HR-language delay and 15 HR-no delay. Fewer HR-ASD infants produced grasp types facilitating spoon use at 24 months and functional actions at 10 months than HR-no delay. Production of functional actions in HR infants at 10 months predicted word comprehension at 12 months and word production at 24 and 36 months.

Differences in Action Style Recognition in Children with Autism Spectrum Disorders.

Vitality form is a term, originally introduced by Stern (2010), to describe "how" an action is performed. The capacity to perceive the vitality form of others' actions is a fundamental element of social interactions and a basic way of relating to and understanding others' behaviors. Although vitality forms characterize all human interactions, few studies have addressed their role in social and communicative disorders such as autism. The aim of the present study is to evaluate the ability to recognize different vitality forms during the observation of different motor actions in a group of children with autism spectrum disorders (ASD) compared to typically developing controls (TD). Results show a significant difference between children with ASD and TD in vitality forms recognition. This finding sheds new light on how children with ASD understand others' actions providing new ideas on overall social understanding as well as useful insights for professionals and caregivers alike.

Untrivial Pursuit: Measuring Motor Procedures Learning in Children with Autism.

Numerous studies have underscored prevalence of motor impairments in children with autism spectrum disorders (ASD), but only few of them have analyzed motor strategies exploited by ASD children when learning a new motor procedure. To evaluate motor procedure learning and performance strategies in both ASD and typically developing (TD) children, we built a virtual pursuit rotor (VPR) task, requiring tracking a moving target on a computer screen using a digitalized pen and tablet. Procedural learning was measured as increased time on target (TT) across blocks of trials on the same day and consolidation was assessed after a 24-hour rest. The program and the experimental setting (evaluated in a first experiment considering two groups of TD children) allowed also measures of continuous time on target (CTT), distance from target (DT) and distance from path (DP), as well as 2D reconstructions of children's trajectories. Results showed that the VPR was harder for children with ASD than for TD controls matched for chronological age and intelligence quotient, but both groups displayed comparable motor procedure learning (i.e., similarly incremented their TT). However, closer analysis of CTT, DT, and DP as well as 2D trajectories, showed different motor performance strategies in ASD, highlighting difficulties in overall actions planning. Data underscore the need for deeper investigations of motor strategies exploited by children with ASD when learning a new motor procedure.

What and why understanding in autism spectrum disorders and williams syndrome: similarities and differences.

Children with autism spectrum disorders (ASD) and children with Williams syndrome (WS) show divergent social phenotypes, but also several similarities in their socio-cognitive deficits. Cross-syndrome direct comparisons could lead to a better understanding of mechanisms that determine deficits in social cognition in the two syndromes. A fundamental factor for social cognition is the ability to understand and predict others' actions (e.g. what action is being done and why it is being done when observing a goal-related act). Here we compared the understanding of others' actions in children with ASD, WS and in children with typical development. Comprehension of what motor act was being done and of why it was being done was assessed with or without contextual cueing using a computer-based task. The results showed that what understanding was impaired in the WS group, but not in the ASD group, which showed mental-age appropriate performance. Why understanding was impaired in both experimental groups. Autism Res 2014, 7: 421-432. © 2014 International Society for Autism Research, Wiley Periodicals, Inc.

A new calibration methodology for thorax and upper limbs motion capture in children using magneto and inertial sensors.

Recent advances in wearable sensor technologies for motion capture have produced devices, mainly based on magneto and inertial measurement units (M-IMU), that are now suitable for out-of-the-lab use with children. In fact, the reduced size, weight and the wireless connectivity meet the requirement of minimum obtrusivity and give scientists the possibility to analyze children's motion in daily life contexts. Typical use of magneto and inertial measurement units (M-IMU) motion capture systems is based on attaching a sensing unit to each body segment of interest. The correct use of this setup requires a specific calibration methodology that allows mapping measurements from the sensors' frames of reference into useful kinematic information in the human limbs' frames of reference. The present work addresses this specific issue, presenting a calibration protocol to capture the kinematics of the upper limbs and thorax in typically developing (TD) children. The proposed method allows the construction, on each body segment, of a meaningful system of coordinates that are representative of real physiological motions and that are referred to as functional frames (FFs). We will also present a novel cost function for the Levenberg-Marquardt algorithm, to retrieve the rotation matrices between each sensor frame (SF) and the corresponding FF. Reported results on a group of 40 children suggest that the method is repeatable and reliable, opening the way to the extensive use of this technology for out-of-the-lab motion capture in children.

A developmental study on children's capacity to ascribe goals and intentions to others.

The capacity to ascribe goals and intentions to others is a fundamental step in child cognitive development. The aim of the present study was to assess the age at which these capabilities are acquired in typically developing children. Two experiments were carried out. In the first experiment, 4 groups of children (age range = 3 years 2 months-7 years 11 months) were shown pictures representing hand-object interactions and asked what the individual was doing (what task) and why (why task). In the why task, observed handgrip could be either congruent with the most typical action performed with that object (e.g., to drink in the case of a mug) or corresponding to the act of putting away the object. In the second experiment, children saw pictures showing a handgrip either within a context suggesting the most typical use of the object or its being put away. Results showed that by 3-4 years, children are able to state the goal relatedness of an observed motor act (what understanding), whereas the ability to report the intention underlying it (why understanding) is a later and gradual acquisition, reaching a high performance by 6-7 years. These results, besides their intrinsic value, provide an important baseline for comparisons with studies on developmental disorders, also highlighting the relevance of distinguishing what and why understanding.

Embedding inertial-magnetic sensors in everyday objects: assessing spatial cognition in children.

This paper describes an interdisciplinary approach to the assessment of children development of spatial cognition, with a focus on the technology. An instrumented toy (block-box) is presented which embeds magneto-inertial sensors for orientation tracking, specifically developed to assess the ability to insert objects into holes. The functional specifications are derived from experimental protocols devised by neuroscientists to assess spatial cognition skills in children. Technological choices are emphasized with respect to ecological requirements. Ad-hoc calibration procedures are presented which are suitable to unstructured environments. Preliminary results based on experimental trials carried out at a day-care on typically developing children (12-36 months old) show how the instrumented objects can be used effectively in a semi-automatic fashion (i.e., rater-independent) to derive accurate measurements such as orientation errors and insertion time which are relevant to the object insertion task. This study indicates that a technological approach to ecological assessment of spatial cognition in children is indeed feasible and maybe useful for identification and early assessment of developmental delay.

Understanding motor acts and motor intentions in Williams syndrome.

Williams syndrome (WS) is a rare genetic disorder associated with unusually hyper-social demeanor and ease with strangers. These personality traits are accompanied by difficulties in social interactions, possibly related, at least in part, to a difficulty in understanding others' mental states. Studies on mentalizing capacities in individuals with WS have often led to contrasting results, some studies revealing specific impairments, others highlighting spared mentalizing capacities. So far, however, no study investigated the performance of individuals with WS in non-inferential understanding of others' motor intentions. In the present study we investigated this capacity by using a computer-based behavioral task using pictures of hand-object interactions. We asked individuals with WS first to describe what the other was doing (i.e. a task implying no kind of intention reading), and secondly, if successful in answering the first question, to describe the motor intention underlying the observed motor acts (i.e. why an act was being done, a task requiring non-inferential motor intention understanding). Results showed that individuals with WS made more errors in understanding what the other was doing (i.e. understanding a motor act) compared to both mental-age matched controls and chronological-age matched peers with typical development, while showing mental-age appropriate performance in understanding why an individual was acting (i.e. understanding a motor intention). These findings suggest novel perspectives for understanding impairments in social behavior in WS.

Emotions in action through the looking glass.

The paper aims at highlighting how our primary understanding of others' actions is rooted in the mirror mechanism. To this end, the anatomical architecture of the mirror neuron system for action will be outlined as well as its role in grasping goals and intentions in others' motor behaviour. One further step through the looking glass of social cognition will be referring to the ubiquitous emotional colouring of actions and considering its links with the motor domain. This will allow a clearer perspective on the mechanism underlying our abilities for emotional understanding and on cases in which these abilities are amiss, as in autistic spectrum disorders.

Intention understanding in autism.

When we observe a motor act (e.g. grasping a cup) done by another individual, we extract, according to how the motor act is performed and its context, two types of information: the goal (grasping) and the intention underlying it (e.g. grasping for drinking). Here we examined whether children with autistic spectrum disorder (ASD) are able to understand these two aspects of motor acts. Two experiments were carried out. In the first, one group of high-functioning children with ASD and one of typically developing (TD) children were presented with pictures showing hand-object interactions and asked what the individual was doing and why. In half of the "why" trials the observed grip was congruent with the function of the object ("why-use" trials), in the other half it corresponded to the grip typically used to move that object ("why-place" trials). The results showed that children with ASD have no difficulties in reporting the goals of individual motor acts. In contrast they made several errors in the why task with all errors occurring in the "why-place" trials. In the second experiment the same two groups of children saw pictures showing a hand-grip congruent with the object use, but within a context suggesting either the use of the object or its placement into a container. Here children with ASD performed as TD children, correctly indicating the agent's intention. In conclusion, our data show that understanding others' intentions can occur in two ways: by relying on motor information derived from the hand-object interaction, and by using functional information derived from the object's standard use. Children with ASD have no deficit in the second type of understanding, while they have difficulties in understanding others' intentions when they have to rely exclusively on motor cues.