The hidden faces of autism and misdiagnosis in the lifespan: Clinical observations in adults with Autism Spectrum Disorders

The hidden faces of autism and misdiagnosis in the

lifespan: Clinical observations in adults with

Autism Spectrum Disorders

Abstract

Autism  Spectrum  Disorder  (ASD)  includes  early-onset  developmental

disorders  characterized  by   symptoms  ranging  from  impaired   social

communication   skills,   stereotyped   behaviors,   impairment   in   social

interactions,   to   poor   language   development.   Although   the   autistic

condition  is  stable  across  the  life  span,  a  substantial  number  of  adult

ASD  patients  may  be  undiagnosed  or  misdiagnosed  as  having  other

mental  disorders.  Twenty-three  ASD  adult  patients  underwent  clinical

examination   and   were   assessed   by   the   following   psychodiagnostic

instruments: the RAADS-R, the Y-BOCS, and the Rorschach inkblot test.

The  mean RAADS total  score  was higher than cut-off  threshold (126 ±

43;  cutoff  =  65).  Y-BOCS  total  scores  were  moderately  high  (21  ±  9;

cutoff   =   7).   Rorschach   protocols   were   characterized   by   a   mean

productivity (number of responses: 23 ± 12), a concrete intelligence with

traits  of  meticulousness  (D  =  39%,  Dd  =  8%),  inaccurate  formal

perception  with  falls  of  representation  (F-  >  F+),  poor  attention  to

human   contents,   and   perseveration   and   devitalization   as  particular

phenomena.    Adult    ASD    patients    are    characterized    by    peculiar

psychopathological features that can be effectively investigated with the

use   of   both   psychometric   and   projective   methods.   An   accurate

investigation  of  behavioral  and  clinical  features  and  personality  traits,

should  integrate  the  diagnostic  pathway  of  those  adult  subjects  often

presenting    with    comorbid    psychiatric    disorders    and    symptoms

heterogeneity.

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Improving social skills in children with ASD using a long-term, in-home social robot

Improving social skills in children with ASD using a long-term, in-home social robot

Social robots can offer tremendous possibilities for autism spectrum disorder (ASD) interventions. To date, most studies with this population have used short, isolated encounters in controlled laboratory settings. Our study focused on a 1-month, home-based intervention for increasing social communication skills of 12 children with ASD between 6 and 12 years old using an autonomous social robot. The children engaged in a triadic interaction with a caregiver and the robot for 30 min every day to complete activities on emotional storytelling, perspective-taking, and sequencing. The robot encouraged engagement, adapted the difficulty of the activities to the child’s past performance, and modeled positive social skills. The system maintained engagement over the 1-month deployment,
and children showed improvement on joint attention skills with adults when not in the presence of the robot. These results were also consistent with caregiver questionnaires. Caregivers reported less prompting over time and overall increased communication.

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Exploratory study examining the at-home feasibility of a wearable tool for social-affective learning in children with autism

Exploratory study examining the at-home feasibility of a wearable tool for social-affective learning in children with autism

Although standard behavioral interventions for autism spectrum disorder (ASD) are effective therapies for social deficits, they face criticism for being time-intensive and overdependent on specialists. Earlier starting age of therapy is a strong predictor of later success, but waitlists for therapies can be 18 months long. To address these complications, we developed Superpower Glass, a machine-learning-assisted software system that runs on Google Glass and an Android smartphone, designed for use during social interactions. This pilot exploratory study examines our prototype tool’s potential for social-affective learning for children with autism. We sent our tool home with 14 families and assessed changes from intake to conclusion through the Social Responsiveness Scale (SRS-2), a facial affect recognition task (EGG), and qualitative parent reports. A repeated-measures one-way ANOVA demonstrated a decrease in SRS-2 total scores by an average 7.14 points (F(1,13) = 33.20, p = <.001, higher scores indicate higher ASD severity). EGG scores also increased by an average 9.55 correct responses (F(1,10) = 11.89, p = <.01). Parents reported increased eye contact and greater social acuity. This feasibility study supports using mobile technologies for potential therapeutic purposes.

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Alexithymia and Autism Spectrum Disorder: A Complex Relationship

Alexithymia and Autism Spectrum

Disorder: A Complex Relationship

Alexithymia is a personality construct characterized by altered emotional awareness
which has been gaining diagnostic prevalence in a range of neuropsychiatric disorders,
with notably high rates of overlap with autism spectrum disorder (ASD). However, the
nature of its role in ASD symptomatology remains elusive. Here, we distill research at
the intersection of alexithymia and ASD. After a brief synopsis of the studies that played
a pioneering role in the identification of the overlapping fields between alexithymia and
ASD, we comb the literature for evidence of its overlap with ASD in terms of prevalence,
etiology, and behaviors. Through a formalized framework of the process of emotional
interpretation and expression, we explore evidence for where and how deficits arise in
this complex network of events. We portray how these relate to the dynamic interplay
between alexithymic and autistic traits and find emerging evidence that alexithymia is
both a cause and consequence of autistic behaviors. We end with a strategic proposal
for future research and interventions to dampen the impacts of alexithymia in ASD. 

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Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in School-Aged Children, Adolescents, and Young Adults With Autism via a Digital Smartglasses-Based Socioemotional Coaching Aid: Short-Term, Uncontrolled Pilot Study

Improvement of Attention-Deficit/Hyperactivity Disorder Symptoms in School-Aged Children, Adolescents, and Young Adults With Autism via a Digital Smartglasses-Based Socioemotional Coaching Aid: Short-Term, Uncontrolled Pilot Study

Abstract

Background: People with autism spectrum disorder (ASD) commonly experience symptoms related to
attention-deficit/hyperactivity disorder (ADHD), including hyperactivity, inattention, and impulsivity. One-third of ASD cases may be complicated by the presence of ADHD. Individuals with dual diagnoses face greater barriers to accessing treatment for ADHD and respond less positively to primary pharmacologic interventions. Nonpharmacologic technology-aided tools for hyperactivity and inattention in people with ASD are being developed, although research into their efficacy and safety remains limited.

Objective: The objective of this preliminary study was to describe the changes in ADHD-related symptoms in children, adolescents, and young adults with ASD immediately after use of the Empowered Brain system, a behavioral and social communication aid for ASD running on augmented reality smartglasses.

Methods: We recruited 8 children, adolescents, and young adults with ASD (male to female ratio of 7:1, mean age 15 years, range 11.7-20.5 years) through a Web-based research signup form. The baseline score on the hyperactivity subscale of the Aberrant Behavioral Checklist (ABC-H), a measure of hyperactivity, inattention, and impulsivity, determined their classification into a
high ADHD-related symptom group (n=4, ABC-H≥13) and a low ADHD-related symptom group (n=4, ABC-H<13). All participants received an intervention with Empowered Brain, where they used smartglasses-based social communication and behavioral modules while interacting with their caregiver. We then calculated caregiver-reported ABC-H scores at 24 and 48 hours after the session.

Results: All 8 participants were able to complete the intervention session. Postintervention ABC-H scores were lower for most participants at 24 hours (n=6, 75%) and for all participants at 48 hours (n=8, 100%). At 24 hours after the session, average participant ABC-H scores decreased by 54.9% in the high ADHD symptom group and by 20% in the low ADHD symptom group. At 48 hours after the session, ABC-H scores compared with baseline decreased by 56.4% in the high ADHD symptom group and
by 66.3% in the low ADHD symptom group.

Conclusions: This study provides initial evidence for the possible potential of the Empowered Brain system to reduce ADHD-related symptoms, such as hyperactivity, inattention, and impulsivity, in school-aged children, adolescents, and young adults with ASD. This digital smartglasses intervention can potentially be targeted at a broader array of mental health conditions that exhibit transdiagnostic attentional and social communication deficits, including schizophrenia and bipolar disorder. Further
research is required to understand the clinical importance of these observed changes and to conduct longitudinal studies on this intervention with control groups and larger sample sizes.

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Emotional face recognition in male adolescents with autism spectrum disorder or disruptive behavior disorder: an eye‑tracking study

 Emotional face recognition in male adolescents with autism spectrum disorder or disruptive behavior disorder: an eye‑tracking study

Abstract
Autism Spectrum Disorder (ASD), Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) are often associated with emotion recognition difficulties. This is the first eye-tracking study to examine emotional face recognition (i.e., gazing behavior) in a direct comparison of male adolescents with Autism Spectrum Disorder or Oppositional Defiant Disorder/ Conduct Disorder, and typically developing (TD) individuals. We also investigate the role of psychopathic traits, callous– unemotional (CU) traits, and subtypes of aggressive behavior in emotional face recognition. A total of 122 male adolescents (N = 50 ASD, N = 44 ODD/CD, and N = 28 TD) aged 12–19 years (M = 15.4 years, SD= 1.9) were included in the current study for the eye-tracking experiment. Participants were presented with neutral and emotional faces using a Tobii 1750 eye-tracking monitor to record gaze behavior. Our main dependent eye-tracking variables were: (1) fixation duration to the eyes of a face and (2) time to the first fixation to the eyes. Since distributions of eye-tracking variables were not completely Gaussian, non-parametric tests were chosen to investigate gaze behavior across the diagnostic groups with Autism Spectrum Disorder, Oppositional Defiant Disorder/Conduct Disorder, and Typically Developing individuals. Furthermore, we used Spearman correlations to investigate the links with psychopathy, callous, and unemotional traits and subtypes of aggression as assessed by questionnaires. The relative total fixation duration to the eyes was decreased in both the Autism Spectrum
Disorder group and the Oppositional Defiant Disorder/Conduct Disorder group for several emotional expressions. In both the Autism Spectrum Disorder and the Oppositional Defiant Disorder/Conduct Disorder group, increased time to first fixation on the eyes of fearful faces only was nominally significant. The time to first fixation on the eyes was nominally correlated with psychopathic traits and proactive aggression. The current findings do not support strong claims for differential cross-disorder
eye-gazing deficits and for a role of shared underlying psychopathic traits, callous–unemotional traits, and aggression subtypes. Our data provide valuable and novel insights into gaze timing distributions when looking at the eyes of a fearful face.

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Technology use as a support tool by secondary students with autism

 Technology use as a support tool by secondary students with autism

Abstract
The purpose of this study was to examine how secondary students with autism spectrum disorder use technology in supportive ways. In this self-report survey study, 472 adolescents with autism spectrum disorder enrolled in high school described the forms of technology they use and purposes for which they use it. Students reported the benefits as well as barriers to technology use at school. They reported using technology in school and home settings in a variety of supportive ways such as increasing their independence, reducing their anxiety, and increasing their social opportunities. Findings suggest that practitioners may benefit from learning how to integrate technology as an instructional and support
tool for their students with autism spectrum disorder. Recommendations for future research are provided.

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