Examining Environmental Predictors of Community Participation for Adults with Autism Spectrum Disorder Using Geographic Information Systems (GIS).

A geographic information system (GIS) approach systematically assessed whether population density and distribution of community resources contributed to caregiver reported community participation outcomes for 124 adults with autism spectrum disorder (ASD). Regression analyses examined whether GIS measures predicted community participation in areas of social activities and use of services, while also accounting for adult age, conversation ability, and daily living skills (DLS). Results indicated that in addition to person factors of greater DLS and better conversation ability, access to specific community features, such as bus stops, contributed to improved participation. Unexpectedly, population density where one lived made minimal contribution to participation outcomes, except in getting together with friends outside of organized activities.

Assessing the convergence of self-report and informant measures for adults with autism spectrum disorder.

LAY ABSTRACT: Self-report measures are frequently used for research and clinical assessments of adults with autism spectrum disorder. However, there has been little research examining agreement between self-report and informant-report in this population. Valid self-report measures are essential for conducting research with and providing high quality clinical services for adults with autism spectrum disorder. This study collected measures from 40 pairs of adults with autism spectrum disorder and their caregivers on measures of symptom severity, daily living skills, quality of life, and unmet service needs. Caregiver and self-report responses were highly associated with one another on all measures, though there were significant gaps between scores on the measures of daily living skills and quality of life. It is also important to understand how each informant's responses relate to outcomes in the areas of employment and independent living. Using self-report and caregiver-report together better predicted outcomes for the adult with autism spectrum disorder than scores from either individual reporter alone. These findings show that there is unique and valuable information provided by both adults with autism spectrum disorder and their caregivers; a multi-informant approach is important for obtaining the most comprehensive picture of current functioning, identifying unmet service needs, and creating treatment plans. This research also highlights the importance of including and prioritizing self-report perspectives in shaping service planning.

Understanding Service Usage and Needs for Adults with ASD: The Importance of Living Situation.

With the increasing prevalence of adults with autism spectrum disorder (ASD), research examining the service experiences of this population is greatly needed. The current study investigated service use, unmet needs, and obstacles to service access for a large sample of adults with ASD. After accounting for various demographic factors known to impact service usage and needs, living situation was a significant predictor of service use, needs, and obstacles to services. Adults with ASD living with family reported less service use, higher unmet need, and more obstacles to accessing services. With more than half of this adult sample living with family, results have clear public policy implications to support the increasing population of adults with ASD living with aging caregivers.

Brief Report: Developmental Trajectories of Adaptive Behavior in Children and Adolescents with ASD.

Research suggests that individuals with autism spectrum disorder (ASD) have significant difficulties with adaptive behavior skills including daily living and functional communication skills. Few studies have examined the developmental trajectory of adaptive behavior across childhood and adolescence. The present study examined longitudinal trajectories of adaptive behavior in a community-based clinic sample of 186 individuals with ASD. The overall pattern indicated an initial increase in adaptive behavior during early childhood followed by a plateau in skills during adolescence for individuals of all IQ groups. Given the importance of adaptive behavior for employment and quality of life, this study emphasizes the importance of targeting adaptive behavior during adolescence to insure continued gains.

Patterns of Age-Related Cognitive Differences in Adults with Autism Spectrum Disorder.

Little is known about age-related cognitive differences in autism spectrum disorder (ASD). However, given the overlap in cognitive impairments in ASD to those seen in typical aging, it is possible that adults with ASD will face even greater cognitive difficulties as they age. The current study used a cross-sectional design to examine age-related cognitive differences in adults with ASD and age and IQ-matched adults with typical development (age range 30-67 years). Results indicated that both age and diagnosis were related to poorer cognitive performance. However, adults with ASD exhibited pronounced age effects on measures related to executive functioning compared to adults with typical development, suggesting that aging in ASD may disproportionately affect specific cognitive processes.

Neural networks underlying language and social cognition during self-other processing in Autism spectrum disorders.

The social communication impairments defining autism spectrum disorders (ASD) may be built upon core deficits in perspective-taking, language processing, and self-other representation. Self-referential processing entails the ability to incorporate self-awareness, self-judgment, and self-memory in information processing. Very few studies have examined the neural bases of integrating self-other representation and semantic processing in individuals with ASD. The main objective of this functional MRI study is to examine the role of language and social brain networks in self-other processing in young adults with ASD. Nineteen high-functioning male adults with ASD and 19 age-sex-and-IQ-matched typically developing (TD) control participants made "yes" or "no" judgments of whether an adjective, presented visually, described them (self) or their favorite teacher (other). Both ASD and TD participants showed significantly increased activity in the medial prefrontal cortex (MPFC) during self and other processing relative to letter search. Analyses of group differences revealed significantly reduced activity in left inferior frontal gyrus (LIFG), and left inferior parietal lobule (LIPL) in ASD participants, relative to TD controls. ASD participants also showed significantly weaker functional connectivity of the anterior cingulate cortex (ACC) with several brain areas while processing self-related words. The LIFG and IPL are important regions functionally at the intersection of language and social roles; reduced recruitment of these regions in ASD participants may suggest poor level of semantic and social processing. In addition, poor connectivity of the ACC may suggest the difficulty in meeting the linguistic and social demands of this task in ASD. Overall, this study provides new evidence of the altered recruitment of the neural networks underlying language and social cognition in ASD.

Motor learning in individuals with autism spectrum disorder: activation in superior parietal lobule related to learning and repetitive behaviors.

Motor-linked implicit learning is the learning of a sequence of movements without conscious awareness. Although motor symptoms are frequently reported in individuals with autism spectrum disorder (ASD), recent behavioral studies have suggested that motor-linked implicit learning may be intact in ASD. The serial reaction time (SRT) task is one of the most common measures of motor-linked implicit learning. The present study used a 3T functional magnetic resonance imaging scanner to examine the behavioral and neural correlates of real-time motor sequence learning in adolescents and adults with ASD (n = 15) compared with age- and intelligence quotient-matched individuals with typical development (n = 15) during an SRT task. Behavioral results suggested less robust motor sequence learning in individuals with ASD. Group differences in brain activation suggested that individuals with ASD, relative to individuals with typical development, showed decreased activation in the right superior parietal lobule (SPL) and right precuneus (Brodmann areas 5 and 7, and extending into the intraparietal sulcus) during learning. Activation in these areas (and in areas such as the right putamen and right supramarginal gyrus) was found to be significantly related to behavioral learning in this task. Additionally, individuals with ASD who had more severe repetitive behavior/restricted interest symptoms demonstrated greater decreased activation in these regions during motor learning. In conjunction, these results suggest that the SPL may play an important role in motor learning and repetitive behavior in individuals with ASD.

Decision-making skills in ASD: performance on the Iowa Gambling Task.

Decision making plays a key role in daily function, but little is known regarding how individuals with autism spectrum disorder (ASD) make decisions. The present studies examined decision making in persons with ASD using the Iowa Gambling Task (IGT), a computerized card game with the goal of earning money by deciding among decks of cards. To be successful, players need to figure out which decks are associated with winning and which are associated with losing money in the long run. Results of Study 1 indicated that participants with ASD made poorer decisions and showed slower learning of which decks earned more money compared with participants with typical development. Additionally, they made more frequent shifts between decks compared with participants with typical development. In Study 2, undergraduate students with typical development completed the IGT to examine whether instructing them to make frequent shifts between decks early in the IGT would negatively impact their decision making. Results of Study 2 suggested that when participants with typical development were required to make frequent shifts, they exhibited a slower rate of learning and poorer decision making, thus emulating participants with ASD in Study 1. The combined results suggest that the way that persons with ASD explore and attend to their environment may be related to poor decision making. Implications for cognitive learning styles are discussed.

The role of mirroring and mentalizing networks in mediating action intentions in autism.

BACKGROUND: The ability to interpret agents' intent from their actions is a vital skill in successful social interaction. However, individuals with autism spectrum disorders (ASD) have been found to have difficulty in attributing intentions to others. The present study investigated the neural mechanisms of inferring intentions from actions in individuals with ASD. METHODS: Functional magnetic resonance imaging (fMRI) data were acquired from 21 high-functioning young adults with ASD and 22 typically developing (TD) control participants, while making judgments about the means (how an action is performed) and intention (why an action is performed) of a model's actions. RESULTS: Across both groups of participants, the middle and superior temporal cortex, extending to temporoparietal junction, and posterior cingulate cortex, responded significantly to inferring the intent of an action, while inferior parietal lobule and occipital cortices were active for judgments about the means of an action. Participants with ASD had significantly reduced activation in calcarine sulcus and significantly increased activation in left inferior frontal gyrus, compared to TD peers, while attending to the intentions of actions. Also, ASD participants had weaker functional connectivity between frontal and posterior temporal regions while processing intentions. CONCLUSIONS: These results suggest that processing actions and intentions may not be mutually exclusive, with reliance on mirroring and mentalizing mechanisms mediating action understanding. Overall, inferring information about others' actions involves activation of the mirror neuron system and theory-of-mind regions, and this activation (and the synchrony between activated brain regions) appears altered in young adults with ASD.

Rule-based category learning in Down syndrome.

Rule-based category learning was examined in youths with Down syndrome (DS), youths with intellectual disability (ID), and typically developing (TD) youths. Two tasks measured category learning: the Modified Card Sort task (MCST) and the Concept Formation test of the Woodcock-Johnson-III ( Woodock, McGrew, & Mather, 2001 ). In regression-based analyses, DS and ID groups performed below the level expected for their nonverbal ability. In cross-sectional developmental trajectory analyses, results depended on the task. On the MCST, the DS and ID groups were similar to the TD group. On the Concept Formation test, the DS group had slower cross-sectional change than the other 2 groups. Category learning may be an area of difficulty for those with ID, but task-related factors may affect trajectories for youths with DS.

Contextual cueing effects across the lifespan.

The authors evaluated age-related variations in contextual cueing, which reflects the extent to which visuospatial regularities can facilitate search for a target. Previous research produced inconsistent results regarding contextual cueing effects in young children and in older adults, and no study has investigated the phenomenon across the life span. Three groups (6, 20, and 70 years old) were compared. Participants located a designated target stimulus embedded in a context of distractor stimuli. During exposure, the location of the target could be predicted from the location of the distracters in each display. During test, these predictable displays were intermixed with new displays that did not predict the target location. Response times to locating predictable relative to unpredictable targets were compared. All groups exhibited facilitation effects greater than 0 (95% CIs [.02, .11], d = .4; [.01, .12], d = .4; and [.01, .10], d = .4, for the children, young adults, and older adults, respectively) indicating that contextual cueing is robust across a wide age range. The relative magnitude of contextual cueing effects was essentially identical across the age range tested, F(2, 103) = 1.71, eta rho2 = .02. The authors argue that a mechanism that uses environmental covariation is available to all age ranges, but the expression of the contextual cueing may depend on the way it is measured.

Spatial and identity cues differentially affect implicit contextual cueing in adolescents and adults with autism spectrum disorder.

The present studies examined implicit contextual cueing in adolescents and adults with Autism Spectrum Disorder (ASD). In Study 1, 16 individuals with ASD and 20 matched individuals with typical development completed a contextual cueing task using stimulus-identity cues. In Study 2, 12 individuals with ASD and 16 individuals with typical development completed a revised version of the contextual cueing task, using both stimulus-identity cues and global spatial-configuration cues. The results suggest that when only stimulus-identity cues were provided, individuals with ASD had difficulty with implicit contextual cueing (Study 1). However, when both stimulus-identity and spatial-configuration contextual cues were provided, individuals with ASD demonstrated successful contextual cueing (Study 2). Nuances in implicit learning and clinical implications are discussed.

Psychopathy and depression as predictors of psychosocial difficulties in a sample of court evaluated adolescents.

Psychopathy and depression have rarely been studied together despite relatively high rates of both in court-referred adolescent samples. To determine if youth high in psychopathy and depression experience more psychosocial difficulties, the current study examined psychopathy and depression in 103 adolescent offenders using two well-validated assessments: The Psychopathy Checklist-Youth Version (PCL-YV; Forth, Kosson, & Hare, 1996/2003) and the depression scale of the Adolescent Psychopathology Scale (APS; Reynolds, 1998). Findings showed that psychopathy and depression interact to statistically predict much higher levels of anger, aggression, interpersonal problems, and substance use. Implications for these findings include that youth who are high in psychopathy and come in contact with the law are also at high risk for numerous problems. Clinical implications driven from the current findings are that assessment and treatment programs in juvenile justice settings should be tailored and systematized to address externalizing and internalizing symptoms in youth and also to consider the co-occurrence of the two. Juvenile justice systems might also benefit from developing clinical practices that require assessment and treatment units to undergo program training to ensure that they (a) account for possible co-occurring effects of commonly assessed disorders and (b) adequately treat complex youth mental health problems with customized treatment programs. Such training would allow for more effective treatment affording youth greater opportunities to succeed in society.

Motor difficulties in autism spectrum disorder: linking symptom severity and postural stability.

Postural stability is a fundamental aspect of motor ability that allows individuals to sustain and maintain the desired physical position of one's body. The present study examined postural stability in average-IQ adolescents and adults with Autism Spectrum Disorder (ASD). Twenty-six individuals with ASD and 26 age-and-IQ-matched individuals with typical development stood on one leg or two legs with eyes opened or closed on a Wii balance board. Results indicated significant group differences in postural stability during one-legged standing, but there were no significant group differences during two-legged standing. This suggests that static balance during more complex standing postures is impaired in average-IQ individuals with ASD. Further, current ASD symptoms were related to postural stability during two-legged standing in individuals with ASD. Future directions and clinical implications are discussed.

Motor-linked implicit learning in persons with autism spectrum disorders.

Fifteen adolescents and young adults with high-functioning autism spectrum disorders (ASD) and 18 age- and IQ-matched adults with typical development (TD) completed a serial reaction time task (SRT) to examine possible motor-linked implicit learning impairments in persons with ASD. Measures were taken to decrease the role of explicit learning in the SRT. Results showed that participants with ASD demonstrated intact motor-linked implicit learning. Furthermore, the motor-linked implicit learning appeared to take place at a similar rate across trials in the group with ASD compared to the group with TD. These results suggest that persons with ASD are successful in implicit learning of motor-linked behavior. The results of this study, coupled with past findings, suggest that people with ASD may be able to learn motor movements without conscious awareness, especially if the individual is older and is learning fine motor sequences.

Self responses along cingulate cortex reveal quantitative neural phenotype for high-functioning autism.

Attributing behavioral outcomes correctly to oneself or to other agents is essential for all productive social exchange. We approach this issue in high-functioning males with autism spectrum disorder (ASD) using two separate fMRI paradigms. First, using a visual imagery task, we extract a basis set for responses along the cingulate cortex of control subjects that reveals an agent-specific eigenvector (self eigenmode) associated with imagining oneself executing a specific motor act. Second, we show that the same self eigenmode arises during one's own decision (the self phase) in an interpersonal exchange game (iterated trust game). Third, using this exchange game, we show that ASD males exhibit a severely diminished cingulate self response when playing the game with a human partner. This diminishment covaries parametrically with their behaviorally assessed symptom severity, suggesting its value as an objective endophenotype. These findings may provide a quantitative assessment tool for high-functioning ASD.

Exogenous and endogenous attention orienting in autism spectrum disorders.

Fifteen children with high-functioning Autism Spectrum Disorder (ASD) and 15 children with typical development completed an attentional cuing task using peripheral cues (exogenous orienting) and central cues (endogenous orienting). Results showed that participants with ASD had impaired exogenous and intact endogenous orienting. The pattern of exogenous orienting was related to motor functioning. Individuals with ASD who had poor motor functioning displayed slowed exogenous orienting. However, individuals with ASD who had relatively good motor functioning showed typical levels of exogenous orienting when given a short time but decreased orienting when given a longer amount of time. These results suggest attention impairments in ASD may not be specific to social orienting and instead may represent a more general orienting impairment.

The effect of headache pain on attention (encoding) and memory (recognition).

Memory is a key cognitive variable in pain management. This study examined the effect of headaches on participants' encoding of words (attention) and later memory for words. The dependent measures were response time during encoding and recognition memory; headache pain was the independent measure. Eighty participants were randomized to one of four groups: two groups had the same condition (headache pain or no headache pain) for both the encoding and memory tasks and two groups had mixed conditions (i.e. pain during encoding/no pain during recognition; no pain during encoding/pain during recognition). Participants with pain during encoding judged words significantly slower (177.53ms) than participants without pain during encoding. Participants with pain during the memory task recognized significantly fewer words (5.4%) than participants without pain during the memory task, regardless of pain condition during encoding. Results from this and other pain and memory studies conducted in this laboratory suggest that pain, as it adversely affects memory, may operate at a threshold level rather than on a dose-response continuum.

Subliminal words activate semantic categories (not automated motor responses).

Semantic priming by visually masked, unidentifiable ("subliminal") words occurs robustly when the words appearing as masked primes have been classified earlier in practice as visible targets. It has been argued (Damian, 2001) that practice enables robust subliminal priming by automatizing learned associations between words and the specific motor responses used to classify them. Two experiments demonstrate that, instead, the associations formed in practice that underlie subliminal priming are between words and semantic categories. Visible words classified as pleasant or unpleasant in practice with one set of response key assignments functioned later as subliminal primes with appropriate valence, even when associations of keys with valences were reversed before the test. This result shows that subliminal priming involves unconscious categorization of the prime, rather than just the automatic activation of a practiced stimulus-response mapping.