Laura Grofer Klinger

Academic Underachievement and Attention-Deficit/Hyperactivity Disorder: The Negative Impact of Symptom Severity on School Performance.

Abstract Many children with Attention-Deficit/Hyperactivity Disorder (ADHD) achieve academically at a lower level than would be predicted given their intellectual abilities. However, the extent to which this is due to behavioral problems versus cognitive deficits associated with the disorder is unclear. In the present study, a group of children with ADHD (with average intellectual abilities) performed significantly below prediction in reading, writing, and mathematics skills and demonstrated a greater discrepancy between actual and predicted achievement than did a group of non-ADHD children. Even when controlling for performance on a measure of executive functioning, severity of ADHD symptoms, based on parent report, significantly predicted academic underachievement in reading, writing, and mathematics. These results indicate that the more severe the behavioral symptomatology of children with ADHD is, the more negatively impacted their school performance may be. Results are discussed in terms of diagnostic and intervention implications.

Prototype formation in autism

Individuals with autism have difficulty integrating information and generalizing previously learned concepts to new situations. It was hypothesized that these problems result from an underlying impairment in category formation. Persons with autism may not abstract a summary representation (a prototype) during category learning and, instead, may form categories by memorizing a list of rules. Children with autism, Down syndrome, and normal development participated in one set of category learning tasks that could be solved using a rule-based approach and a second set of tasks in which there was no rule that defined category membership (prototype tasks). In the rule-based tasks, all groups were successful at using a rule to learn a new category. In the prototype tasks, only the typically developing children were able to learn a new category. Neither the persons with autism nor the persons with Down syndrome appeared to develop a prototype during category learning. These data suggest that persons with autism and Down syndrome have difficulty categorizing new information by forming prototypes and, instead, tend to rely on a rule-based approach to learning.

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 ones 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.

Subgroups of autistic children based on social behavior display distinct patterns of brain activity.

Two questions were addressed in the present study: (1) Do autistic and normally developing children exhibit regionally specific differences in electroencephalographic (EEG) activity? (2) Do subgroups of autistic children classified according to Wing and Goulds (1979) system which emphasizes degree of social impairment exhibit distinct patterns of EEG activity? Twenty-eight children with autism (5 to 18 years of age) and two groups of normally developing children (one matched on chronological age and the other on receptive language level) participated. EEG was recorded from left and right frontal, temporal, and parietal regions during an alert baseline condition. Compared to normally developing children, autistic children exhibited reduced EEG power in the frontal and temporal regions, but not in the parietal region. Differences were more prominent in the left than the right hemisphere. Furthermore, subgroups of autistic children based on Wing and Goulds system displayed distinct patterns of brain activity. Compared to autistic children classified as “active-but-odd,” “passive” autistic children displayed reduced alpha EEG power in the frontal region.

The role of frontal lobe functioning in the development of infant self-regulatory behavior.

In the last two decades, there has been tremendous growth in two fields of study related to human infant development: (1) the development of neural processes during the early postnatal years and (2) the development of self-regulatory behavior. In an attempt to stimulate research on the relation between early brain development and self-regulatory processes, several hypotheses pertaining to the role of frontal lobe functioning in the development of emotion regulation during infancy are proposed. The results of a study of the relation between frontal electroencephalographic (EEG) activity and emotional behavior of 21-month-old infants are reported. It was found that increases in frontal lobe activation were associated with increases in emotional arousal, while EEG activity recorded from the parietal region showed either a reciprocal pattern of activation or did not change as a function of level of emotional arousal. These results provide evidence for the specialized role of the frontal lobe in mediating emotional behavior during infancy.

Implicit and explicit memory in autism : Is autism an amnesic disorder?

Medial temporal lobe amnesic disorder is characterized by an impairment in explicit memory (e.g., remembering a shopping list) and intact implicit memory (e.g., a woman seems familiar although you cannot remember having met her before). This study examined whether children with high-functioning autism have this same dissociation between explicit and implicit memory abilities. Children with autism and normal development participated in three memory tasks: one implicit task (perceptual identification) and two explicit tasks (recognition and recall). Children with autism showed intact implicit and explicit memory abilities. However, they did not show the typical pattern of recalling more items from both the beginning and end of a list and instead only recalled items from the end of the list. These results do not support the theory that high-functioning autism is a type of medial temporal lobe amnesia. However, these findings suggest that persons with autism use different organizational strategies during encoding or retrieval of items from memory.

Infants of mothers with depressive symptoms: Electroencephalographic and behavioral findings related to attachment status

Evidence suggests that the left frontal region is specialized for the expression of positive emotions, such as joy, whereas the right frontal region is specialized for certain negative emotions, such as distress. We previously reported that infants of mothers with depressive symptoms exhibited atypical patterns of frontal electroencephalographic (EEG) activity. We now extend these findings by examining the combined influence of maternal depression and attachment security on the infants behavior and brain activity. Participants were 26 infants, 11–17 months of age, and their mothers. Twelve mothers reported elevated levels of depressive symptoms. Attachment behavior was observed in the traditional Strange Situation. While left and right, frontal and parietal EEG was recorded, infants were exposed to a baseline and three emotion-eliciting conditions (play with mother, stranger approach, maternal separation). During baseline and the condition designed to elicit positive emotion (play with mother), securely attached infants of symptomatic mothers exhibited reduced left frontal brain activity, compared to securely attached infants of nonsymptomatic mothers. During maternal separation, the most robust finding was that infants of symptomatic mothers, regardless of their attachment classification, exhibited reduced right frontal activity and lower levels of behavioral distress. The results suggest that both the mothers emotional well-being and her attachment relationship with her infant can influence infant frontal brain activity and affective behavior.

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.

Performance-Based Measures in Autism: Implications for Diagnosis, Early Detection, and Identification of Cognitive Profiles

Provides a critical review of performance-based assessment measures in autism. Currently, performance-based measures of autism are being explored in two domains: structured play sessions and cognitive-neuropsychological assessments. Structured play sessions are designed to elicit the behavioral symptoms associated with autism to provide a consistent and valid means of early detection and diagnosis of autism across different evaluators and settings. These structured play sessions provide a supplement to diagnostic instruments based on parental report. Cognitive-neuropsychological tasks have been used to identify possible underlying cognitive impairments in autism including executive function, theory of mind, selective attention, and abstraction. Currently, cognitive tasks are useful in treatment planning but are inappropriate for diagnostic purposes. Important goals for the future will be to integrate parent-report diagnostic interviews and structured play observations and to identify a profile of cognitive impairments that are specific to pervasive developmental disorders that can be incorporated into diagnostic protocols.

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.