Marian E. Williams

Relaxation, Reduction in Angry Articulated Thoughts, and Improvements in Borderline Hypertension and Heart Rate

An intensive 7-week relaxation therapy was evaluated in a sample of unmedicated borderline hypertensive men. All subjects were provided state-of-the-art medical information regarding changes known to affect hypertension favorably, e.g., lower salt intake and regular exercise. In addition, relaxation subjects were trained in muscle relaxation that entailed audiotaped home practice. As predicted, relaxation combined with hygiene lowered blood pressure more than did hygiene alone. Neither treatment favorably affected a paper-and-pencil measure of anger but relaxation did lower anger-hostility on a new cognitive assessment procedure, Articulated Thoughts in Simulated Situations (ATSS). Moreover, ATSS anger-hostility reduction was correlated with blood pressure or heart rate reductions, for all subjects and especially for those in the Relaxation condition. This represents the first clinically demonstrated link between change in a cognitive variable and change in cardiovascular activity. Finally, results were especially strong in subjects high in norepinephrine, suggesting its importance in essential hypertension.

Assessment of Autism in Community Settings: Discrepancies in Classification.

Review of 78 evaluations for 29 young children examined practices used in assessment of autism spectrum disorders in three settings: public schools, developmental disabilities eligibility determinations, and our hospital-based early childhood mental health program. While similar rates of classification of autism spectrum disorders were found across sites, the rate of agreement by different evaluators for individual children was only 45%. Further, most community evaluators did not follow best practice guidelines nor use autism diagnostic tools with established psychometric properties. In this sample of primarily Latino, Spanish-speaking children, most community evaluators did not document assessment of the child in their native language, nor address the impact of language in their assessments.

The Psychologist as an Interlocutor in Autism Spectrum Disorder Assessment: Insights From a Study of Spontaneous Prosody

PURPOSE The purpose of this study was to examine relationships between prosodic speech cues and autism spectrum disorder (ASD) severity, hypothesizing a mutually interactive relationship between the speech characteristics of the psychologist and the child. The authors objectively quantified acoustic-prosodic cues of the psychologist and of the child with ASD during spontaneous interaction, establishing a methodology for future large-sample analysis. METHOD Speech acoustic-prosodic features were semiautomatically derived from segments of semistructured interviews (Autism Diagnostic Observation Schedule, ADOS; Lord, Rutter, DiLavore, & Risi, 1999; Lord et al., 2012) with 28 children who had previously been diagnosed with ASD. Prosody was quantified in terms of intonation, volume, rate, and voice quality. Research hypotheses were tested via correlation as well as hierarchical and predictive regression between ADOS severity and prosodic cues. RESULTS Automatically extracted speech features demonstrated prosodic characteristics of dyadic interactions. As rated ASD severity increased, both the psychologist and the child demonstrated effects for turn-end pitch slope, and both spoke with atypical voice quality. The psychologists acoustic cues predicted the childs symptom severity better than did the childs acoustic cues. CONCLUSION The psychologist, acting as evaluator and interlocutor, was shown to adjust his or her behavior in predictable ways based on the childs social-communicative impairments. The results support future study of speech prosody of both interaction partners during spontaneous conversation, while using automatic computational methods that allow for scalable analysis on much larger corpora.

Rachel: Design of an emotionally targeted interactive agent for children with autism

Increasingly, multimodal human-computer interactive tools are leveraged in both autism research and therapies. Embodied conversational agents (ECAs) are employed to facilitate the collection of socio-emotional interactive data from children with autism. In this paper we present an overview of the Rachel system developed at the University of Southern California. The Rachel ECA is designed to elicit and analyze complex, structured, and naturalistic interactions and to encourage affective and social behavior. The pilot studies suggest that this tool can be used to effectively elicit social conversational behavior. This paper presents a description of the multimodal human-computer interaction system and an overview of the collected data. Future work includes utilizing signal processing techniques to provide a quantitative description of the interaction patterns.

Mode-specific impact of relaxation training for hypertensive men with type a behavior pattern

Multimodal therapy calls for selection of interventions on the basis of the specific modes of functioning that they are expected to affect. Mode-specificity assumptions were tested in a study of progressive muscle relaxation (PMR) training for type A men with borderline hypertension. It was expected that PMR would be especially effective in reducing psychophysiological reactivity and not effective for hostile cognition or behavioral anger expression. Forty-three subjects were randomly assigned to a control group receiving medical information or to information + PMR. PMR subjects reduced blood pressure reactivity to an anger-instigating role-play more than did controls. Although trait questionnaire measures of hostility and outward anger expression showed no group differences, a think-aloud measure of hostility and an observational measure of anger expression favored PMR. Discussion focuses on alternative explanations for these results, including the possibility that measures failing to show treatment effects were those confounded with negative affectivity.

Autism assessment in children with optic nerve hypoplasia and other vision impairments

This study examined the utility of standard autism diagnostic measures in nine children (aged 5–9y) with severe vision impairment and a range of social and language functioning.

Barriers to Accessing Services for Young Children

This study investigates barriers to accessing services for children under age 3 presenting with language delays and behavioral difficulties, including language barriers for Spanish-speaking families. Using a telephone script, researchers called 30 agencies in Los Angeles County, including regional centers (the state network of Part C agencies for children with developmental disabilities), mental health centers, and schools, requesting services for a 2-year-old child. Outcomes of calls were compared by agency and by language of call (Spanish or English). Regional center calls resulted in an appointment 90% of the time, whereas schools and mental health centers were significantly less likely to link callers with services. Calls in Spanish revealed language access barriers, with fewer than half of Spanish-speaking callers to schools and mental health agencies obtaining an appointment. The study indicated barriers including basic access (e.g., reaching a live person; response in the home language), and obtaining appropriate appointment or referral.

Articulated thoughts of type A and B individuals in response to social criticism

To explore the hypothesis that individuals with Type A behavior pattern have an underlying sensitivity to social criticism, the Articulated Thoughts in Simulated Situations paradigm was used to examine differences in articulated cognitions between Types A and B individuals in response to simulated taped situations involving social criticism and nonevaluative stress. Individuals with Type B behavior pattern (as measured by the Jenkins Activity Survey) and extreme Type Bs (as measured by the structured interview) engaged in significantly more self-supportive self-talk than Type A individuals in response to social criticism. Types A and B subjects did not differ in their responses to the nonevaluative situation. These findings provide some support for the notion that sensitivity to criticism is a component of Type A. However, the prediction that Type As would respond with more self-deprecating or hostile cognitions than Type Bs was not confirmed.

Cognitive Tests in Early Childhood: Psychometric and Cultural Considerations.

Cognitive assessment of young children contributes to high-stakes decisions because results are often used to determine eligibility for early intervention and special education. Previous reviews of cognitive measures for young children highlighted concerns regarding adequacy of standardization samples, steep item gradients, and insufficient floors for young children functioning at lower levels. The present report extends previous reviews by including measures recently published or revised, nonverbal cognitive assessment tools, and issues specific to assessing bilingual or non-English-speaking children. Sixteen tests were reviewed, including all available measures of cognitive functioning for 2- to 4-year-old children normed in the United States. Test characteristics evaluated included (a) representativeness and recency of standardization data, (b) item bias analysis, (c) psychometric characteristics, and (d) appropriateness for assessing young children with developmental delays and non-English-speaking children. Implications are discussed for clinicians, researchers, and test developers.

Physiological and Behavioral Stress and Anxiety in Children with Autism Spectrum Disorders during Routine Oral Care

Background. Children with autism spectrum disorders (ASD) commonly exhibit uncooperative behaviors which impede oral care. Previous studies have utilized dentist-report measures of uncooperative behaviors in children with ASD but none have utilized an objective measure of childrens behavior or a physiological measure of distress. This study investigated behavioral and physiological distress in children with ASD during routine oral care and examined factors associated with this distress. Methods. Participants were 44 children (n = 22 typical, n = 22 ASD) aged 6–12 receiving routine dental cleanings. Behavioral and physiological measures of stress and anxiety were collected during dental cleanings. Results. Children with ASD exhibited greater distress, compared to the typical group, on dentist-report and researcher-coded measures of overt distress behaviors and on physiological measures. Correlations between physiological and behavioral measures of distress were found in the ASD but not in the typical group. Behavioral distress was correlated with age in the typical group and with expressive communication ability and sensory processing difficulties in the ASD group; physiological distress was correlated with parent-report of anxiety in the typical group and sensory processing difficulties in the ASD group. Conclusions. Novel strategies may be required to decrease behavioral and physiological distress in children with ASD in the dental clinic.