Concordance between a U.S. Educational Autism Classification and the Autism Diagnostic Observation Schedule.

States in the United States differ in how they determine special education eligibility for autism services. Few states include an autism-specific diagnostic tool in their evaluation. In research, the Autism Diagnostic Observation Schedule (ADOS for first edition, ADOS-2 for second edition) is considered the gold-standard autism assessment. The purpose of this study was to estimate the proportion of children with an educational classification of autism who exceed the ADOS/ADOS-2 threshold for autism spectrum (concordance rate). Data were drawn from 4 school-based studies across 2 sites (Philadelphia, Pennsylvania, and San Diego, California). Participants comprised 627 children (2-12 years of age; 83% male) with an autism educational classification. Analyses included (a) calculating the concordance rate between educational and ADOS/ADOS-2 classifications and (b) estimating the associations between concordance and child's cognitive ability, study site, and ADOS/ADOS-2 administration year using logistic regression. More San Diego participants (97.5%, all assessed with the ADOS-2) met ADOS/ADOS-2 classification than did Philadelphia participants assessed with the ADOS-2 (92.2%) or ADOS (82.9%). Children assessed more recently were assessed with the ADOS-2; this group was more likely to meet ADOS/ADOS-2 classification than the group assessed longer ago with the ADOS. Children with higher IQ were less likely to meet ADOS/ADOS-2 classification. Most children with an educational classification of autism meet ADOS/ADOS-2 criteria, but results differ by site and by ADOS version and/or recency of assessment. Educational classification may be a reasonable but imperfect measure to include children in community-based trials.

The development of emotion recognition in individuals with autism.

Emotion recognition was investigated in typically developing individuals and individuals with autism. Experiment 1 tested children (5-7 years, n = 37) with brief video displays of facial expressions that varied in subtlety. Children with autism performed worse than the control children. In Experiment 2, 3 age groups (8-12 years, n = 49; 13-17 years, n = 49; and adults n = 45) were tested on the same stimuli. Whereas the performance of control individuals was best in the adult group, the performance of individuals with autism was similar in all age groups. Results are discussed with respect to underlying cognitive processes that may be affecting the development of emotion recognition in individuals with autism.

Measuring social attention and motivation in autism spectrum disorder using eye-tracking: Stimulus type matters.

Autism Spectrum Disorder (ASD) is characterized by social impairments that have been related to deficits in social attention, including diminished gaze to faces. Eye-tracking studies are commonly used to examine social attention and social motivation in ASD, but they vary in sensitivity. In this study, we hypothesized that the ecological nature of the social stimuli would affect participants' social attention, with gaze behavior during more naturalistic scenes being most predictive of ASD vs. typical development. Eighty-one children with and without ASD participated in three eye-tracking tasks that differed in the ecological relevance of the social stimuli. In the "Static Visual Exploration" task, static images of objects and people were presented; in the "Dynamic Visual Exploration" task, video clips of individual faces and objects were presented side-by-side; in the "Interactive Visual Exploration" task, video clips of children playing with objects in a naturalistic context were presented. Our analyses uncovered a three-way interaction between Task, Social vs. Object Stimuli, and Diagnosis. This interaction was driven by group differences on one task only-the Interactive task. Bayesian analyses confirmed that the other two tasks were insensitive to group membership. In addition, receiver operating characteristic analyses demonstrated that, unlike the other two tasks, the Interactive task had significant classification power. The ecological relevance of social stimuli is an important factor to consider for eye-tracking studies aiming to measure social attention and motivation in ASD.

Prototype formation in autism: can individuals with autism abstract facial prototypes?

Prototype formation is a critical skill for category learning. Research suggests that individuals with autism may have a deficit in prototype formation of some objects; however, results are mixed. This study used a natural category, faces, to further examine prototype formation in high-functioning individuals with autism. High-functioning children (age 8-13 years) and adults with autism (age 17-53 years) and matched controls were tested in a facial prototype formation task that has been used to test prototype formation abilities in typically developing infants and adults [Strauss, 1979]. Participants were familiarized to a series of faces depicting subtle variations in the spatial distance of facial features, and were then given a forced choice familiarity test between the mean prototype and the mode prototype. Overall, individuals in the autism group were significantly less likely to select the mean prototype face. Even though the children with autism showed this difference in prototype formation, this pattern was driven primarily by the adults, because the adults with autism were approximately four times less likely to select the mean prototype than were the control adults. These results provide further evidence that individuals with autism have difficulty abstracting subtle spatial information that is necessary not only for the formation of a mean prototype, but also for categorizing faces and objects.