Andrey Vyshedskiy

Autism Treatment Evaluation Checklist (ATEC) Norms: A “Growth Chart” for ATEC Score Changes as a Function of Age

Most early-intervention Autism Spectrum Disorder (ASD) clinical trials are limited by the availability of psychometric technicians who assess each child’s abilities before and after therapeutic intervention. If parents could administer regular psychometric evaluations of their children, then the cost of clinical trials will be reduced, enabling longer clinical trials with the larger number of participants. The Autism Treatment Evaluation Checklist (ATEC) was designed nearly two decades ago to provide such a tool, but the norms on the longitudinal changes in ATEC in the “treatment as usual” population were lacking. Here we report the norms of the observational cohort who voluntarily completed ATEC evaluations over the period of four years from 2013 to 2017.

Children with Autism Appear to Benefit from Parent-Administered Computerized Cognitive and Language Exercises Independent of the ChildâÂÂs Age or Autism Severity

We describe data from 1,514 young children with ASD who over the course of 4 to 12 months used a parentadministered tablet-based therapeutic application designed by the authors. Older children and children with milder forms of ASD performed better and progressed faster in cognitive and language exercises. However, most children were able to engage with and learn from exercises independent of their age or ASD severity. These data suggest that tablet-based cognitive and language exercises can be successfully administered by parents to children as young as two years of age over the course of many months, relatively independent of ASD severity.

Epidemiological Study of Autism Subgroups Using Autism Treatment Evaluation Checklist (ATEC) Score

Here we report the results of the subgroup analyses of an observational cohort of children whose parents completed the Autism Treatment Evaluation Checklist (ATEC) over the period of several years. A linear mixed effects model was used to evaluate longitudinal changes in ATEC scores within different patient subgroups. All groups decreased their mean ATEC score over time indicating improvement of symptoms, however there were significant differences between the groups. Younger children improved more than the older children. Children with milder ASD improved more than children with more severe ASD in the Communication subscale. There was no difference in improvement between females vs. males. One surprising finding was that children from developed English-speaking countries improved less than children from non-English-speaking countries.

Tablet-Based Cognitive Exercises as an Early Parent-Administered Intervention Tool for Toddlers with Autism - Evidence from a Field Study

Background: There is a broad scientific consensus that early and intensive behavioral intervention has the greatest chance of positive impact on an individual with autism spectrum disorder (ASD). However, the availability, quality, and general funding for early intervention programs is often lacking, leaving newly diagnosed children without adequate and sufficient therapy during the most critical early period of their development. Parent-administered iPad-assisted therapy has the potential to reduce the gap between the amount of therapy recommended for children with ASD and the amount they receive. However it is unclear at what age children with ASD are capable of being fully engaged in the process, and whether parents can administer such therapy. The objective of this study was to determine whether children as young as two who have been diagnosed with ASD could engage on a daily basis and over an extended period of time with a therapeutic application, and whether their parents would be willing to administer such an application. Methods and Findings: We developed a tablet-based therapeutic application and conducted a study of 823 children to determine whether children as young as two years of age could engage for an extended period of time with tablet-based cognitive exercises administered by their parents. In this manuscript, we describe data from the feasibility study of this therapeutic intervention. We report that the majority of children are able to understand and use the application as intended over the course of months, and that two-year-old children with ASD performed as well as older children in a multitude of measurements. In addition, we report that many parents are willing and able to administer such therapy over an extended period of time and many believe that the product has potential for improving their child’s ASD symptoms. Conclusions: This data confirm that tablet-based cognitive exercises can be administered by parents to children as young as two years of age over the course of months. Additional research is needed to gauge the feasibility of using a therapeutic application over a longer period of time, as it is likely to take years for any positive therapeutic effects to become evident.

Longitudinal Epidemiological Study of Autism Subgroups Using Autism Treatment Evaluation Checklist (ATEC) Score

Here we report the results of the subgroup analyses of an observational cohort of children whose parents completed the Autism Treatment Evaluation Checklist (ATEC) over the period of several years. A linear mixed effects model was used to evaluate longitudinal changes in ATEC scores within different patient subgroups. All groups decreased their mean ATEC score over time indicating improvement of symptoms, however there were significant differences between the groups. Younger children improved more than the older children. Children with milder ASD improved more than children with more severe ASD in the Communication subscale. There was no difference in improvement between females vs. males. One surprising finding was that children from developed English-speaking countries improved less than children from non-English-speaking countries.

Development of the Mental Synthesis Evaluation Checklist (MSEC): A Parent-Report Tool for Mental Synthesis Ability Assessment in Children with Language Delay

Mental synthesis is the conscious purposeful process of synthesizing novel mental images from objects stored in memory. Mental synthesis ability is essential for understanding complex syntax, spatial prepositions, and verb tenses. In typical children, the timeline of mental synthesis acquisition is highly correlated with an increasing vocabulary. Children with Autism Spectrum Disorder (ASD), on the other hand, may learn hundreds of words but never acquire mental synthesis. In these individuals, tests assessing vocabulary comprehension may fail to demonstrate the profound deficit in mental synthesis. We developed a parent-reported Mental Synthesis Evaluation Checklist (MSEC) designed to assess mental synthesis acquisition in ASD children. The psychometric quality of MSEC was tested with 3715 parents of ASD children. Internal reliability of the 20-item MSEC was good (Cronbach’s alpha >0.9). MSEC exhibited adequate test–retest reliability; good construct validity, supported by a positive correlation with the Autism Treatment Evaluation Checklist (ATEC) Communication subscale; and good known group validity reflected by the difference in MSEC scores for children of different ASD severity levels. The MSEC questionnaire is copyright-free and can be used by researchers as a complimentary subscale for the ATEC evaluation. We hope that the addition of MSEC will make the combined assessment more sensitive to small steps in a child’s development. As MSEC does not rely on productive language, it may be an especially useful tool for assessing the development of nonverbal and minimally verbal children.

Comparison of Performance on Verbal and Nonverbal Multiple-Cue Responding Tasks in Children with ASD

In this manuscript, we present data from an ongoing study of a tablet-based therapeutic application designed for newly diagnosed children with autism spectrum disorder (ASD) and modeled on language therapy, Applied Behavioral Analysis (ABA) and Pivotal Response Treatment (PRT), techniques known to be effective in educating children with ASD. We describe the creation of a variety of analogous tasks that were presented both verbally and nonverbally within the application. This work presents our hypothesis that children with ASD perform better when a command is presented nonverbally. This approach may have important implication for the most effective way of delivering early therapeutic interventions to children with ASD.

Language evolution to revolution: from a slowly developing finite communication system with many words to infinite modern language

There is overwhelming archeological and genetic evidence that modern speech apparatus was acquired by hominins by 600,000 years ago. There is also widespread agreement that modern syntactic language arose with behavioral modernity around 100,000 years ago. We attempted to answer two crucial questions: (1) how different was the communication system of hominins before acquisition of modern language and (2) what triggered the acquisition of modern language 100,000 years ago. We conclude that the communication system of hominins prior to 100,000 years ago was finite and not-recursive. It may have had thousands of words but was lacking flexible syntax, spatial prepositions, verb tenses, and other features that enable modern human language to communicate an infinite number of ideas. We argue that a synergistic confluence of a genetic mutation that dramatically slowed down the prefrontal cortex (PFC) development in monozygotic twins and their spontaneous invention of spatial prepositions 100,000 years ago resulted in acquisition of PFC-driven constructive imagination (mental synthesis) and converted the finite communication system of their ancestors into infinite modern language.Abstract There is an overwhelming archeological and genetic evidence that modern speech apparatus was acquired by hominins by 600,000 years ago 1. On the other hand, artifacts signifying modern imagination, such as (1) composite figurative arts, (2) bone needles with an eye, (3) construction of dwellings, and (4) elaborate burials arose not earlier than 70,000 years ago 2. It remains unclear (1) why there was a long gap between acquisition of modern speech apparatus and modern imagination, (2) what triggered the acquisition of modern imagination 70,000 years ago, and (3) what role language might have played in this process. Our research into evolutionary origin of modern imagination has been driven by the observation of a temporal limit for the development of a particular component of imagination. Modern children not exposed to recursive language in early childhood never acquire the type of active constructive imagination called Prefrontal Synthesis (PFS). Unlike vocabulary and grammar acquisition, which can be learned throughout one’s lifetime, there is a strong critical period for the development of PFS and individuals not exposed to recursive language in early childhood can never acquire PFS as adults. Their language will always lack understanding of spatial prepositions and recursion that depend on the PFS ability. In a similar manner, early hominins would not have been able to learn recursive language as adults and, therefore, would not be able to teach recursive language to their children. Thus, the existence of a strong critical period for PFS acquisition creates an evolutionary barrier for behavioral modernity. A mathematical model suggests that a synergistic confluence of three events (1) a genetic mutation that extended the critical period by slowing down the prefrontal cortex development simultaneously in two or more children, (2) invention of recursive elements of language, such as spatial prepositions, by these children and (3) their dialogic communications using these recursive elements, resulted in concurrent conversion of a non-recursive communication system of their parents to recursive language and acquisition of PFS around 70,000 years ago.There is overwhelming archeological and genetic evidence that modern speech apparatus was acquired by hominins by 600,000 years ago. There is also widespread agreement that behavioral modernity arose around 100,000 years ago. We attempted to answer three crucial questions: (1) what triggered the acquisition of behavioral modernity 100,000 years ago, (2) why there was a long gap between acquisition of modern speech apparatus and behavioral modernity, and (3) what role language might have played in the process. We conclude that the communication system of hominins prior to 100,000 years ago was finite and not-recursive. It may have had thousands of words but was lacking flexible syntax, spatial prepositions, verb tenses, and other features that enable modern recursive language to communicate an infinite number of ideas. We argue that a synergistic confluence of a genetic mutation that dramatically slowed down the prefrontal cortex (PFC) development in monozygotic twins and their spontaneous invention of recursive elements of language, such as spatial prepositions 100,000 years ago resulted in acquisition of special type of PFC-driven constructive imagination (called mental synthesis) and converted the finite communication system of their parents into infinite recursive language.

Performance Of Children With Autism In Parent-Administered Cognitive And Language Exercises

There is a broad scientific consensus that early and intensive therapy has the greatest chance of positive impact on an individual with autism spectrum disorder (ASD). However, the availability, quality, and general funding for early intervention programs is often lacking, leaving newly diagnosed children without adequate and sufficient therapy during the most critical early period of their development. Parent-administered iPad-assisted therapy has the potential to reduce the gap between the amount of therapy recommended for children with ASD and the amount they receive. However it is unclear how ASD severity and age influence a child’s ability to engage with and learn from computerized cognitive exercises. In this manuscript, we describe data from a tablet-based therapeutic application administered by parents to 1,514 young children with ASD over the course of four to twelve months. We report that older children and children with milder forms of ASD performed better and progressed faster in cognitive and language exercises. However, most children were able to engage with and learn from exercises independent of their age or ASD severity. This data confirm that tablet-based cognitive and language exercises can be successfully administered by parents to children as young as two years of age over the course of many months independent of ASD severity.