Assessing Child Life Specialists' Management of Challenging Behaviors in Autistic Pediatric Patients.

Given that autistic children are hospitalized at higher rates than neurotypical peers, it is important to understand the autism-specific preparedness of healthcare providers. Certified Child Life Specialists (CCLSs) play a crucial role in pediatric hospitalizations by providing socioemotional support and coping strategies. The present study assessed perceived competency and comfort levels among 131 CCLSs regarding the management of challenging behaviors exhibited by autistic pediatric patients, including aggression and self-injury. All participants reported experiences providing care to autistic children who exhibited challenging behaviors, but very few reported both high perceived competency and high comfort in managing these behaviors. Autism-specific training positively correlated with perceived competency and comfort. These results have implications for providing autistic children high quality hospital care.

Social-interactive reward elicits similar neural response in autism and typical development and predicts future social experiences.

Challenges in initiating and responding to social-interactive exchanges are a key diagnostic feature of autism spectrum disorder, yet investigations into the underlying neural mechanisms of social interaction have been hampered by reliance on non-interactive approaches. Using an innovative social-interactive neuroscience approach, we investigated differences between youth with autism and youth with typical development in neural response to a chat-based social-interactive reward, as well as factors such as age and self-reported social enjoyment that may account for heterogeneity in that response. We found minimal group differences in neural and behavioral response to social-interactive reward, and variation within both groups was related to self-reported social enjoyment during the task. Furthermore, neural sensitivity to social-interactive reward predicted future enjoyment of a face-to-face social interaction with a novel peer. These findings have important implications for understanding the nature of social reward and peer interactions in typical development as well as for future research informing social interactions in individuals on the autism spectrum.

Everyone's a Critic (Sometimes): Young Children Show High Awareness of, But Lower Adherence to, Prosocial Lying Norms.

From an early age, children are taught norms about socially-acceptable behaviors; however, children's ability to recognize these norms often predates their tendency to follow them. This conflict between understanding and action has been predominantly studied in cases when enacting the norm would be costly for the child (i.e. when sharing would result in forgoing resources), but is underexplored in more low-cost scenarios. The current study examined the gap between children's knowledge and behavior in a context with a low personal cost: telling a prosocial, or white, lie. Children (N = 46) evaluated objectively poor drawings in three contexts: in one context, children were asked how a third-party character should act in a story (to assess knowledge) and in the other two contexts, children were asked to provide real-time feedback to another person and to a puppet (to assess behavior). Results indicated that children endorsed prosocial lying norms (i.e. said the story character should give the drawing a good rating) at a significantly higher rate than they demonstrated through their own lie-telling behaviors (i.e. their willingness to give social partners good ratings). These data indicate that the discrepancy between children's knowledge of social norms and their actual behaviors cannot simply be attributed to the personal costs of enacting social norms. Instead, this competence-performance gap may be due to the fact that children are often taught social rules via hypothetical situations but enacting behaviors in real-world situations may require additional skills, such as inhibition and the processing of complex, multimodal social cues.

Disentangling relations between attention to the eyes and empathy.

Social interactions involve an interplay between lower-level social perceptual biases and higher-level cognition and affect. One particularly important building block of social interaction is attention to others' eyes. Previous research has found links between individual differences in eye-looking and complex social capacities, including empathy. Such research, however, has predominately used nonnaturalistic stimuli and has not addressed the directional relation between these processes. In this study, a large sample of adults (N = 164) were eye-tracked while watching naturalistic videos of complex social interactions. Additionally, participants completed measures of empathy and spontaneous and explicit mentalizing. To disentangle relations between variables, participants were assigned to one of three conditions: first, a baseline condition with no instructions; second, an eye-looking condition, where participants were told to look at the eyes of the characters; and, third, an empathy condition, where participants were told to become involved with the characters' thoughts and feelings. In the baseline condition, we found no relation between mentalizing and eye-looking, yet found that eye-looking and empathy were positively related. Inducing one behavior, however, did not affect the other. That is, participants in the eye-looking condition showed increased eye-looking but not increased empathy, and participants in the empathy condition scored more highly on empathy and mentalizing measures with no corresponding changes in eye-looking. These results suggest that the relations between visual attention and social cognition are complex and difficult to manipulate. Future research should examine the developmental links between these behaviors, as understanding their emergence has implications for social disabilities and interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Explaining Variance in Social Symptoms of Children with Autism Spectrum Disorder.

The social symptoms of autism spectrum disorder are likely influenced by multiple psychological processes, yet most previous studies have focused on a single social domain. In school-aged autistic children (n = 49), we compared the amount of variance in social symptoms uniquely explained by theory of mind (ToM), biological motion perception, empathy, social reward, and social anxiety. Parent-reported emotional contagion-the aspect of empathy in which one shares another's emotion-emerged as the most important predictor, explaining 11-14% of the variance in social symptoms, with higher levels of emotional contagion predicting lower social symptom severity. Our findings highlight the role of mutual emotional experiences in social-interactive success, as well as the limitations of standard measures of ToM and social processing in general.

Young children's willingness to deceive shows in-group bias only in specific social contexts.

The ability to deceive others is an early-emerging and socially complex skill, but relatively little is known about when and how a social partner's identity affects young children's willingness to lie. To understand how group membership affects children's lying, we used a minimal group paradigm to examine children's willingness to deceive in-group and out-group members across varied contexts that systematically varied in their costs and benefits. A total of 69 children aged 4 to 7 years played three versions of a sticker-hiding game: a Self-Benefit scenario (child could lie for personal gain), an Other-Benefit scenario (child could lie to help someone else), and a No-Benefit scenario (child could lie to spite someone else). Children lied the most in the Self-Benefit scenario, lying equally to in-group and out-group members in this context. When the potential for self-gain disappeared, however, in-group bias emerged. In the Other-Benefit scenario, children lied more to out-group members in order to help in-group members. Even when the potential to help another was removed (the No-Benefit scenario), children still engaged in more lie telling to out-group members. Results suggest that children's lying is sensitive to group membership, but only in certain social situations, as children's desire to benefit themselves may outweigh in-group bias. Future research should examine alternate contexts, such as lying to avoid punishment, to determine when group membership is most salient. Overall, results indicate that young children are able to flexibly apply a complex social cognitive skill based on group membership and contextual demands, with implications for social behavior and intergroup relations throughout development.

Minimal coherence among varied theory of mind measures in childhood and adulthood.

Theory of mind-or the understanding that others have mental states that can differ from one's own and reality-is currently measured across the lifespan by a wide array of tasks. These tasks vary across dimensions including modality, complexity, affective content, and whether responses are explicit or implicit. As a result, theoretical and meta-analytic work has begun to question whether such varied approaches to theory of mind should be categorized as capturing a single construct. To directly address the coherence of theory of mind, and to determine whether that coherence changes across development, we administered a diverse set of theory of mind measures to three different samples: preschoolers, school-aged children, and adults. All tasks showed wide variability in performance, indicating that children and adults often have inconsistent and partial mastery of theory of mind concepts. Further, for all ages studied, the selected theory of mind tasks showed minimal correlations with each other. That is, having high levels of theory of mind on one task did not predict performance on another task designed to measure the same underlying ability. In addition to showing the importance of more carefully designing and selecting theory of mind measures, these findings also suggest that understanding others' internal states may be a multidimensional process that interacts with other abilities, a process which may not occur in a single conceptual framework. Future research should systematically investigate task coherence via large-scale and longitudinal efforts to determine how we come to understand the minds of others.

Social and delay discounting in autism spectrum disorder.

Current literature is divided over whether and how processes such as perspective taking and reward sensitivity differ between individuals with autism spectrum disorder (ASD) versus neurotypical individuals. Discounting tasks may provide novel insight into how these processes operate. In delay discounting tasks, participants choose between smaller immediate rewards and larger delayed rewards, and in social discounting tasks, participants choose between a smaller monetary rewards for themselves versus a larger reward for partners of varied social distance (e.g., a close friend vs. an acquaintance). Delay and social discounting tasks thus implicitly measure the subjective value of rewards given to one's future self and to others, capturing constructs such as perspective taking, reward processing, and social closeness, all of which have been discussed as core cognitive mechanisms underlying ASD. Despite extensive research on discounting in other clinical populations, few studies have examined delay discounting in ASD and no research has examined social discounting in ASD. The goal of the current study was to assess delay and social discounting for monetary rewards in a single sample of adolescents and adults with ASD compared to a matched neurotypical sample. Overall, adults and adolescents with ASD valued both future rewards and rewards given to others less than their typical counterparts did, but rates of discounting were not significantly correlated across temporal and social domains. These results extend an important behavioral paradigm for understanding both perspective taking and reward processing to autism. Autism Res 2019, 12: 870-877. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Discounting tasks-which experimentally measure the subjective value of different rewards-have been used with a variety of clinical populations, but are underexplored in ASD. We found that compared to neurotypical individuals, individuals with ASD showed diminished subjective value for future rewards (compared to immediate rewards) and rewards for others (compared to rewards for self). This finding has implications for understanding perspective taking, reward processing, and social closeness in ASD.

Social interaction recruits mentalizing and reward systems in middle childhood.

Social cognition develops in the context of reciprocal social interaction. However, most neuroimaging studies of mentalizing have used noninteractive tasks that may fail to capture important aspects of real-world mentalizing. In adults, social-interactive context modulates activity in regions linked to social cognition and reward, but few interactive studies have been done with children. The current fMRI study examines children aged 8-12 using a novel paradigm in which children believed they were interacting online with a peer. We compared mental and non-mental state reasoning about a live partner (Peer) versus a story character (Character), testing the effects of mentalizing and social interaction in a 2 × 2 design. Mental versus Non-Mental reasoning engaged regions identified in prior mentalizing studies, including the temporoparietal junction, superior temporal sulcus, and dorsomedial prefrontal cortex. Moreover, peer interaction, even in conditions without explicit mentalizing demands, activated many of the same mentalizing regions. Peer interaction also activated areas outside the traditional mentalizing network, including the reward system. Our results demonstrate that social interaction engages multiple neural systems during middle childhood and contribute further evidence that social-interactive paradigms are needed to fully capture how the brain supports social processing in the real world.

A Social-Interactive Neuroscience Approach to Understanding the Developing Brain.

From birth onward, social interaction is central to our everyday lives. Our ability to seek out social partners, flexibly navigate and learn from social interactions, and develop social relationships is critically important for our social and cognitive development and for our mental and physical health. Despite the importance of our social interactions, the neurodevelopmental bases of such interactions are underexplored, as most research examines social processing in noninteractive contexts. We begin this chapter with evidence from behavioral work and adult neuroimaging studies demonstrating how social-interactive context fundamentally alters cognitive and neural processing. We then highlight four brain networks that play key roles in social interaction and, drawing on existing developmental neuroscience literature, posit the functional roles these networks may play in social-interactive development. We conclude by discussing how a social-interactive neuroscience approach holds great promise for advancing our understanding of both typical and atypical social development.

Developmental relations between amygdala volume and anxiety traits: Effects of informant, sex, and age.

Although substantial human and animal evidence suggests a role for the amygdala in anxiety, literature linking amygdala volume to anxiety symptomatology is inconclusive, with studies finding positive, negative, and null results. Clarifying this brain-behavior relation in middle to late childhood is especially important, as this is a time both of amygdala structural maturation and the emergence of many anxiety disorders. The goal of the current study was to clarify inconsistent findings in previous literature by identifying factors moderating the relation between amygdala volume and anxiety traits in a large sample of typically developing children aged 6-13 years (N = 72). In particular, we investigated the moderating effects of informant (parent vs. child), age, and sex. We found that children's reports (i.e., self-reports) were related to amygdala volume; children who reported higher anxiety levels had smaller amygdalae. This negative relation between amygdala volume and anxiety weakened with age. There was also an independent effect of sex, such that relations were stronger in males than in females. These results indicate the importance of considering sample and informant characteristics when charting the neurobiological mechanisms underlying developmental anxiety.

Let's chat: developmental neural bases of social motivation during real-time peer interaction.

Humans are motivated to interact with each other, but the neural bases of social motivation have been predominantly examined in non-interactive contexts. Understanding real-world social motivation is of special importance during middle childhood (ages 8-12), a period when social skills improve, social networks grow, and social brain networks specialize. To assess interactive social motivation, the current study used a novel fMRI paradigm in which children believed they were chatting with a peer. The design targeted two phases of interaction: (1) Initiation, in which children engaged in a social bid via sharing a like or hobby, and (2) Reply, in which children received either an engaged ("Me too") or non-engaged ("I'm away") reply from the peer. On control trials, children were told that their answers were not shared and that they would receive either engaged ("Matched") or non-engaged ("Disconnected") replies from the computer. Results indicated that during Initiation and Reply, key components of reward circuitry (e.g., ventral striatum) were more active for the peer than the computer trials. In addition, during Reply, social cognitive regions were more activated by the peer, and this social cognitive specialization increased with age. Finally, the effect of engagement type on reward circuitry activation was larger for social than non-social trials, indicating developmental sensitivity to social contingency. These findings demonstrate that both reward and social cognitive brain systems support real-time social interaction in middle childhood. An interactive approach to understanding social reward has implications for clinical disorders, where social motivation is more affected in real-world contexts.