Giacomo Vivanti

Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months

The Early Start Denver Model (ESDM) is an intervention program recommended for pre-schoolers with autism ages 12–48xa0months. The rationale for this recommendation is the potential for intervention to affect developmental trajectories during early sensitive periods. We investigated outcomes of 32 children aged 18–48xa0months and 28 children aged 48–62xa0months receiving the ESDM for one year (approximately 20xa0h per week). Younger children achieved superior verbal DQ gains compared to their older counterparts. There were no group differences with respect to non-verbal DQ and adaptive behavior (with both age-groups undergoing significant change), or ASD severity (with neither age-group showing improvements on the ADOS). The association between verbal DQ gains and age at intake was moderated by baseline verbal level.

Social affiliation motives modulate spontaneous learning in Williams syndrome but not in autism

BackgroundChildren with autism spectrum disorder (ASD) and those with Williams syndrome (WS) have difficulties with learning, though the nature of these remains unclear.MethodsIn this study, we used novel eye-tracking and behavioral paradigms to measure how 36 preschoolers with ASD and 21 age- and IQ-matched peers with WS attend to and learn novel behaviors (1) from the outcomes of their own actions (non-social learning), (2) through imitation of others’ actions (social learning), and across situations in which imitative learning served either an instrumental function or fulfilled social affiliation motives.ResultsThe two groups demonstrated similar abilities to learn from the consequences of their own actions and to imitate new actions that were instrumental to the achievement of a tangible goal. Children with WS, unlike those with ASD, increased their attention and imitative learning performance when the model acted in a socially engaging manner.ConclusionsLearning abnormalities in ASD appear to be linked to the social rather than instrumental dimensions of learning.

Anxiety in Autism Spectrum Disorder

Anxiety appears to be more common in Autism Spectrum Disorder (ASD) than in both the general population and various clinical groups, with possibly up to 40 % of individuals in the autism spectrum presenting elevated levels of at least on anxiety subtype. In this chapter we will critically evaluate the current state of knowledge on the nature of anxiety issues in individuals with ASD, provide an overview of clinical management issues and best practices, and discuss current and future research directions.

Others’ emotions teach, but not in autism: an eye-tracking pupillometry study

BackgroundMuch research has investigated deficit in emotional reactivity to others in people with autism, but scant attention has been paid to how this deficit affects their own reactions to features of their environment (objects, events, practices, etc.). The present study presents a preliminary analysis on whether calibrating one’s own emotional reactions to others’ emotional reactions about features of the world, a process we term social-emotional calibration, is disrupted in autism.MethodsTo examine this process, we used a novel eye-tracking pupillometry paradigm in which we showed 20 preschoolers with autism and 20 matched typically developing preschoolers’ videos of an actor opening a box and reacting to the occluded object inside, with fear or happiness. We expected preschoolers to come to perceive the box as containing a positive or threatening stimulus through emotionally calibrating to the actor’s emotional expressions. Children’s mean pupil diameter (indicating emotional reactivity) was measured whilst viewing an up-close, visually identical image of the box before and then after the scene, and this difference was taken as an index of social-emotional calibration and compared between groups.ResultsWhilst the typically developing preschoolers responded more emotionally to the box after, compared to before the scene (as indexed by an increase in pupil size), those with autism did not, suggesting their reaction to the object was not affected by the actor’s emotional expressions. The groups did not differ in looking duration to the emotional expressions; thus, the pupil dilation findings cannot be explained by differences in visual attention. More social-emotional calibration on the happy condition was associated with less severe autism symptoms.ConclusionsThrough the measurement of physiological reactivity, findings suggest social-emotional calibration is diminished in children with autism, with calibration to others’ positive emotions as particularly important. This study highlights a possible mechanism by which individuals with autism develop idiosyncratic reactions to features of their environment, which is likely to impact their active and harmonious participation on social and cultural practices from infancy, throughout the lifespan. More research is needed to examine the mediators and developmental sequence of this tendency to emotionally calibrate to others’ feelings about the world.

The social nature of overimitation: Insights from Autism and Williams syndrome.

When imitating novel actions, typically developing preschoolers often copy components of the demonstration that are unrelated to the modeled actions goal, a phenomenon known as overimitation. According to the social motivation account, overimitation fulfills social affiliation motives (i.e., the imitators drive to experience social connectedness with the demonstrator and the social context). Conversely, according to the social-cognitive account, overimitation reflects overattribution of causal relevance (i.e., the imitators failure to appreciate that some components of the demonstration are not relevant to the actions outcome). Autism Spectrum Disorder (ASD) and William syndrome (WS) are characterized by reduced and enhanced spontaneous social motivation, respectively, as well as similar impairments in social-cognition, thus providing helpful test cases to understand the nature of overimitation. Using a novel eye-tracking paradigm, we examined overimitation in 31 preschoolers with ASD, 18 age- and IQ-matched peers with WS, and 19 age-matched typically developing children. We found that children with WS and typically developing children were more likely to overimitate, and to increase their attention to the models face during demonstration of causally irrelevant actions, compared to those with ASD. These findings will be discussed in the context of support for the social-motivational account of overimitation.

Autism, attachment, and social learning: Three challenges and a way forward

HighlightsAttachment in Autism Spectrum Disorder (ASD) is poorly understood.Abnormal social reciprocity in ASD often co‐exists with normative secure attachment.Parent‐child attachment interventions fail to improve social reciprocity in ASD.Selective affiliation is observed in individuals with ASD.A model is proposed herein to explain this phenomena. Abstract We explore three challenges that Autism Spectrum Disorder (ASD) poses to our understanding of the processes underlying early attachment. First, while caregiver‐infant attachment and later social‐affiliative behavior share common biobehavioral mechanisms, individuals with ASD are able to form secure attachment relationships, despite reduced social‐emotional reciprocity and motivation for social interaction. Therefore, disruptions in social affiliation mechanisms can co‐exist with secure caregiver‐infant bonding. Second, while early attachment quality is associated with later social outcomes in typical development, interventions targeting caregiver‐child interaction in ASD often show positive effects on parental responsivity and attachment quality, but not on child social behavior. Therefore, improvements in parent‐child bonding do not necessarily result in improvements in social functioning in ASD. Third, individuals with ASD show normative brain activity and selective social affiliative behaviors in response to people that they know but not to unfamiliar people. We propose a conceptual framework to reformulate and address these three theoretical impasses posed by ASD, arguing that the dissociable pathways of child‐parent bonding and social development in ASD are shaped by (1) a dissociation between externally‐driven and internally‐driven attachment responses and (2) atypical learning dynamics occurring during child‐caregiver bonding episodes, which are governed by and influence social‐affiliation motives and other operant contingencies.

Heterogeneity of sensory features in autism spectrum disorder: Challenges and perspectives for future research

Pronounced heterogeneity is apparent across every facet of autism spectrum disorder (ASD) and it remains difficult to predict likely future potential among individuals who share a common diagnosis of ASD on the basis of early presentation. In this commentary we argue that a fine‐grained understanding of individual differences in sensory features and their influence across the life span can constrain noted clinical heterogeneity in ASD. We organize our discussion around the following three critical themes: (a) considering sensory features as dimensional construct; (b) taking an “individual differences” approach; and (c) adopting a comprehensive, multidimensional and multimodal approach to measurement of sensory features. We conclude that future research will need to investigate individual differences in sensory features via: (1) multidimensional and cross‐disciplinary examination, (2) prospective longitudinal designs, and (3) dimensional and developmental frameworks that emphasize the potential value of early individual variability as indicators of later outcomes, not only in relation to the categorical diagnostic outcome status but also the presence of other clinical features. This is a key time for sensory‐related research and in this commentary we provide some of the steps that, in our opinion, can shape future research in this area. Autism Res 2017, 10: 703–710.

Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder

Purpose of ReviewThis review aims to synthesize the most recent research on anxiety disorders and obsessive-compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD) and discuss the relationship between these conditions and challenges for assessment. Furthermore, implications for treatment and future directions are discussed.Recent FindingsResearch suggests that anxiety disorders and OCD are highly prevalent in individuals with ASD. However, the significant overlap of ASD features with anxiety and OCD symptomology makes differential diagnosis of these disorders particularly challenging. Though several treatments for anxiety have been adapted for youth with ASD (e.g., cognitive behavior therapy), pharmacological treatments and treatments for adults are still marked undeveloped.SummaryDespite the high prevalence of anxiety disorders and OCD in ASD and some recent advances in assessment and treatment, research is needed to clarify the multifaceted relationship of these conditions and develop tailored assessment and treatment approaches appropriate for a full range of individuals with ASD.

Verbal labels increase the salience of novel objects for preschoolers with typical development and Williams syndrome, but not in autism

BackgroundEarly research has documented that young children show an increased interest toward objects that are verbally labeled by an adult, compared to objects that are presented without a label. It is unclear whether the same phenomenon occurs in neurodevelopmental disorders affecting social development, such as autism spectrum disorder (ASD) and Williams syndrome (WS).MethodsThe present study used a novel eye-tracking paradigm to determine whether hearing a verbal label increases the salience of novel objects in 35 preschoolers with ASD, 18 preschoolers with WS, and 20 typically developing peers.ResultsWe found that typically developing children and those with WS, but not those with ASD, spent significantly more time looking at objects that are verbally labeled by an adult, compared to objects that are presented without a label.ConclusionsIn children without ASD, information accompanied by the speaker’s verbal label is accorded a “special status,” and it is more likely to be attended to. In contrast, children with ASD do not appear to attribute a special salience to labeled objects compared to non-labeled objects. This result is consistent with the notion that reduced responsivity to pedagogical cues hinders social learning in young children with ASD.

Implementing and evaluating early intervention for children with autism: Where are the gaps and what should we do?

Despite recent advances, the evidence base supporting early intervention for young children with autism spectrum disorder (ASD) remains relatively sparse. The International Society for Autism Research (INSAR) recently sponsored a Special Interest Group (SIG) on Implementing and Evaluating Community‐Based Early Intervention. Across three meetings, in 2015, 2016, and 2017, conveners of this SIG engaged >200 members to identify knowledge gaps and research priorities for moving the field forward. Here, we summarize the perspectives that emerged from group discussion at the SIG meetings as represented by scholars working actively in the field. Despite encouraging progress, critical gaps and research priorities were identified across all the stages of intervention development and testing from conceptualization to community implementation. Key issues include the need for (a) formal theories to guide early intervention development, evaluation, and implementation; and alignment of intervention goals with scientific knowledge and societal changes that have occurred in the decades since interventions were originally developed; (b) increased focus on feasibility of treatment procedures and alignment with stakeholder values during pilot evaluations; (c) use of research designs that allow for comparisons of different interventions and formats, analyses of active ingredients of treatment, and identification of moderators and mediators of outcome; (d) use of community‐partnered participatory research to guide adaptation of intervention models to community settings; (e) inclusion of constructs related to implementation processes and outcomes in treatment trials and; (f) an iterative approach to the progression of knowledge from intervention development to implementation. Autism Res 2018, 11: 16–23.