Nancy McIntyre

Social Attention in a Virtual Public Speaking Task in Higher Functioning Children With Autism

Impairments in social attention play a major role in autism, but little is known about their role in development after preschool. In this study, a public speaking task was used to study social attention, its moderators, and its association with classroom learning in elementary and secondary students with higher functioning autism spectrum disorder (HFASD). Thirty‐seven students with HFASD and 54 age‐ and intelligence quotient (IQ)‐matched peers without symptoms of ASD were assessed in a virtual classroom public speaking paradigm. This paradigm assessed the ability to attend to nine avatar peers seated at a table, while simultaneously answering self‐referenced questions. Students with HFASD looked less frequently to avatar peers in the classroom while talking. However, social attention was moderated in the HFASD sample such that students with lower IQ, and/or more symptoms of social anxiety, and/or more attention deficit/hyperactivity disorder inattentive symptoms, displayed more atypical social attention. Group differences were more pronounced when the classroom contained social avatars versus nonsocial targets. Moreover, measures of social attention rather than nonsocial attention were significantly associated with parent report and objective measures of learning in the classroom. The data in this study support the hypothesis of the Social Attention Model of ASD that social attention disturbance remains part of the school‐aged phenotype of autism that is related to syndrome‐specific problems in social learning. More research of this kind would likely contribute to advances in the understanding of the development of the spectrum of autism and educational intervention approaches for affected school‐aged children. Autism Res 2013, ●●: ●●–●●.

A Virtual Joy-Stick Study of Emotional Responses and Social Motivation in Children with Autism Spectrum Disorder

A new virtual reality task was employed which uses preference for interpersonal distance to social stimuli to examine social motivation and emotion perception in children with Autism Spectrum Disorders. Nineteen high function children with higher functioning Autism Spectrum Disorder (HFASD) and 23 age, gender, and IQ matched children with typical development (TD) used a joy stick to position themselves closer or further from virtual avatars while attempting to identify six emotions expressed by the avatars, happiness, fear, anger, disgust, sadness, and surprise that were expressed at different levels of intensity. The results indicated that children with HFASD displayed significantly less approach behavior to the positive happy expression than did children with TD, who displayed increases in approach behavior to higher intensities of happy expressions. Alternatively, all groups tended to withdraw from negative emotions to the same extent and there were no diagnostic group differences in accuracy of recognition of any of the six emotions. This pattern of results is consistent with theory that suggests that some children with HFASD display atypical social-approach motivation, or sensitivity to the positive reward value of positive social–emotional events. Conversely, there was little evidence that a tendency to withdraw from social–emotional stimuli, or a failure to process social emotional stimuli, was a component of social behavior task performance in this sample of children with HFASD.

The Scope and Nature of Reading Comprehension Impairments in School-Aged Children with Higher-Functioning Autism Spectrum Disorder

This study of 8-16-year-olds was designed to test the hypothesis that reading comprehension impairments are part of the social communication phenotype for many higher-functioning students with autism spectrum disorder (HFASD). Students with HFASD (n = 81) were compared to those with high attention-deficit/hyperactivity disorder symptomatology (ADHD; n = 39), or typical development (TD; n = 44), on a comprehensive battery of oral language, word recognition, and reading comprehension measures. Results indicated that students with HFASD performed significantly lower on the majority of the reading and language tasks as compared to TD and ADHD groups. Structural equation models suggested that greater ASD symptomatology was related to poorer reading comprehension outcomes; further analyses suggested that this relation was mediated by oral language skills.

Brief Report: Joint Attention and Information Processing in Children with Higher Functioning Autism Spectrum Disorders.

Theory suggests that information processing during joint attention may be atypical in children with Autism Spectrum Disorder (ASD). This hypothesis was tested in a study of school-aged children with higher functioning ASD and groups of children with symptoms of ADHD or typical development. The results indicated that the control groups displayed significantly better recognition memory for pictures studied in an initiating joint attention (IJA) rather than responding to joint attention (RJA) condition. This effect was not evident in the ASD group. The ASD group also recognized fewer pictures from the IJA condition than controls, but not the RJA condition. Atypical information processing may be a marker of the continued effects of joint attention disturbance in school aged children with ASD.

Attention and written expression in school-age, high-functioning children with autism spectrum disorders.

High-functioning children with autism spectrum disorders often find writing challenging. These writing difficulties may be specific to autism spectrum disorder or to a more general clinical effect of attention disturbance, as these children are often comorbid for attention-deficit/hyperactivity disorder (ADHD) symptomatology (and children with attention-deficit/hyperactivity disorder often also find writing challenging). To examine this issue, this study investigated the role of attention disturbance on writing in 155 school-age children across four diagnostic groups: high-functioning autism spectrum disorder (HFASD) with lower ADHD symptoms (HFASD-L), HFASD with higher ADHD symptoms (HFASD-H), ADHD symptoms but no autism spectrum disorder symptoms, and typical development. Both HFASD subgroups and the ADHD group displayed lower word production writing scores than the typical development group, but the clinical groups did not differ. The HFASD-H and ADHD groups had significantly lower theme development and text organization writing scores than the typical development group, but the HFASD-L and typical development groups were not significantly different. The findings support prior research reporting writing problems in children with autism spectrum disorder but also suggest that children with HFASD-H may be at greater risk for writing difficulties than children with HFASD-L. Better understanding the role of attention in writing development could advance methods for assessment and intervention for children with high-functioning autism spectrum disorder at risk for writing difficulties.

Joint-Attention and the Social Phenotype of School-Aged Children with ASD

The validity of joint attention assessment in school-aged children with ASD is unclear (Lord, Jones, Journal of Child Psychology and Psychiatry 53(5):490–509, 2012). This study examined the feasibility and validity of a parent-report measure of joint attention related behaviors in verbal children and adolescents with ASD. Fifty-two children with ASD and 34 controls were assessed with the Childhood Joint Attention Rating Scale (C-JARS). The C-JARS exhibited internally consistency, α = 0.88, and one factor explained 49% of the scale variance. Factor scores correctly identified between 88 and 94% of the children with ASD and 62–82% of controls. These scores were correlated with the ADOS-2, but not other parent-report symptom measures. The C-JARS appears to assess a unique dimension of the social-phenotype of children with ASD.

The Stability of Self-Reported Anxiety in Youth with Autism versus ADHD or Typical Development.

Children with autism spectrum disorder (ASD) are at risk for anxiety symptoms. Few anxiety measures are validated for individuals with ASD, and the nature of ASD raises questions about reliability of self-reported anxiety. This study examined longitudinal stability and change of self-reported anxiety in higher functioning youth with ASD (HFASD) compared to youth with symptoms of attention deficit hyperactivity disorder and typical development (TD) using the Multidimensional Anxiety Scale for Children (March, 2012; March et al. J Am Acad Child Adolesc Psychiatry 36(4):554–565, 1997). Diagnostic groups demonstrated comparable evidence of stability for most dimensions of anxiety. The HFASD group displayed higher anxiety than both comparison groups, especially physical symptoms. These findings have implications for identification and measurement of anxiety in ASD.

Self-Esteem, Internalizing Symptoms, and Theory of Mind in Youth With Autism Spectrum Disorder

Self-esteem is a potent indicator of mental health in typically developing (TYP) individuals. It is surprising that there have been few comprehensive investigations of self-esteem in children and adolescents with autism spectrum disorder (ASD), given that they are at high risk for comorbid mental health problems, such as depression and anxiety. The objectives of the current study were to assess how youth with ASD rate their self-esteem compared to age-matched TYP youth and to examine how self-esteem relates to internalizing psychopathology and theory of mind in the two groups. Seventy-three children and adolescents, ages 9 to 17, were administered a battery of questionnaires assessing self-esteem and internalizing symptoms, as well as tasks designed to measure theory of mind. Results indicated that youth with ASD rated their self-esteem significantly lower than did TYP youth. Self-esteem was strongly related to depression in both groups but was negatively related to theory of mind only for youth with ASD. These results may provide important insights into how individuals with ASD form evaluations of their own self-worth and illustrate how increasing self-awareness in individuals with ASD is not without risks.

Early reading skill profiles in typically developing and at-risk first grade readers to inform targeted early reading instruction

This study identified distinct, homogeneous latent profiles of at-risk (n = 141) and not at-risk (n = 149) first grade readers. Separate latent profile analyses were conducted with each subgroup using measures of phonological awareness, decoding, linguistic comprehension, and oral reading fluency. This study also examined which measures best differentiated the latent profiles. Finally, we examined differences on two measures of reading comprehension as a function of profile membership. Results showed two latent profiles of at-risk students and three latent profiles of not at-risk students. Latent profiles were generally rank ordered with regard to achievement across measures. However, the higher performing at-risk profile and the lowest performing not at-risk profile were nearly identical across measures. Phonological awareness and decoding measures were best at differentiating latent profiles, but linguistic comprehension was also important for the lowest performing students. Oral reading fluency was limited to distinguishing the highest achieving students from the other profiles, and did not perform well with the lower achieving profiles. Most of the pairwise comparisons of reading comprehension scores were consistent across measures, but the nearly identical profiles showed a significant difference on only one reading comprehension measure. Implications for identifying at-risk first grade readers and designing targeted early reading interventions for at-risk students are discussed.

Comparing growth in linguistic comprehension and reading comprehension in school-aged children with autism versus typically developing children: Reading development in ASD vs TD

Many children with autism spectrum disorders (ASD) struggle with reading comprehension. Linguistic comprehension is an important predictor of reading comprehension, especially as children progress through elementary school and later grades. Yet, there is a dearth of research examining longitudinal relations between linguistic comprehensions in school‐age children with ASD compared to typically‐developing peers (TD). This study compared the developmental trajectories of linguistic and reading comprehension in samples of children with ASD and age‐matched TD peers. Both groups were administered measures of linguistic and reading comprehension multiple times over a 30‐month period. Latent growth curve modeling demonstrated children with ASD performed at significantly lower levels on both measures at the first timepoint and these deficits persisted across time. Children with ASD exhibited growth in both skills comparable to their TD peers, but this was not sufficient to enable them to eventually achieve at a level similar to the TD group. Due to the wide age range of the sample, age was controlled and displayed significant effects. Findings suggest linguistic comprehension skills are related to reading comprehension in children with ASD, similar to TD peers. Further, intervention in linguistic comprehension skills for children with ASD should begin early and there may be a finite window in which these skills are malleable, in terms of improving reading comprehension skills. Autism Res 2018, 11: 624–635.