Analysis of social referencing skills among children with autism

Social referencing, a form of nonverbal communication, involves seeking out discriminative stimuli provided by others about contingencies in an ambiguous context in order to respond in a manner that produces reinforcement. Although demonstrated by typically developing infants, social referencing is notably absent or impaired in individuals with autism. In this study, behavioral procedures including verbal, visual, and manual prompting and reinforcement were used to teach four children with autism to exhibit a social referencing response chain composed of an observing response and a conditional discriminative response in the presence of variants of standard academic materials. Observing was defined as looking at the experimenter when presented with unfamiliar handwriting materials, verbal models, and video models. Conditional discriminative responding was defined as completing the handwriting task or imitating the verbal and video models in the presence of a head nod and a smile, and placing the handwriting materials or Language Master cards aside, or remaining seated in a chair in the presence of a headshake and a frown. All four children learned to exhibit social referencing. The ambiguous materials were then interspersed among the standard materials. One of the children showed discriminated social referencing, observing in the presence of the ambiguous stimuli and not in the presence of the standard materials. The other children were taught to discriminate the ambiguous and standard stimuli and to exhibit social referencing only in the presence of the ambiguous materials. The effectiveness of the teaching procedures used is discussed in the context of a learning theory analogue of social referencing.     

Discriminating which fork to use: Teaching selective imitation to people with autism

Little empirical research has focused on teaching of imitation to learners with autism in ordinary environments. Typically-developing individuals imitate the behavior of others in ordinary social environments. One possible reason that learners with autism do not imitate in ordinary environments is they are not observing relevant discriminative stimuli that should set the occasion for imitative responding. This paper will review the operant research on generalized imitation with the goal of identifying procedures to teach learners with autism to imitate in ordinary environments. A stimulus-control account of imitation in ordinary environments is included with the goal of the development of effective teaching procedures. Imitation in ordinary environments is discussed in relation to the discriminative stimuli that occasion imitative responding. The use of differential observing responses to increase discrimination of relevant stimuli in ordinary environments is suggested as a possible strategy to increase imitation among individuals with autism in ordinary environments.     

Intact imitation of emotional facial actions in autism spectrum conditions

It has been proposed that there is a core impairment in autism spectrum conditions (ASC) to the mirror neuron system (MNS): If observed actions cannot be mapped onto the motor commands required for performance, higher order sociocognitive functions that involve understanding another person's perspective, such as theory of mind, may be impaired. However, evidence of MNS impairment in ASC is mixed. The present study used an ‘automatic imitation’ paradigm to assess MNS functioning in adults with ASC and matched controls, when observing emotional facial actions. Participants performed a pre-specified angry or surprised facial action in response to observed angry or surprised facial actions, and the speed of their action was measured with motion tracking equipment. Both the ASC and control groups demonstrated automatic imitation of the facial actions, such that responding was faster when they acted with the same emotional expression that they had observed. There was no difference between the two groups in the magnitude of the effect. These findings suggest that previous apparent demonstrations of impairments to the MNS in ASC may be driven by a lack of visual attention to the stimuli or motor sequencing impairments, and therefore that there is, in fact, no MNS impairment in ASC. We discuss these findings with reference to the literature on MNS functioning and imitation in ASC, as well as theories of the role of the MNS in sociocognitive functioning in typical development.     

The relationship between atypical visual processing and social skills in young children with autism

The present study examined whether atypical visual processing is related to the level of social skills in children with autism spectrum disorder (ASD). Thirty-eight young children with ASD (29 boys, 9 girls) were included. Atypical visual processing was assessed by coding the number of lateral glances and the amount of object grouping behavior on videotaped observations of the ADOS (aged 35 ± 9 months). The level of social skills was measured using the subscale interpersonal relationships of the Vineland SEEC (32 ± 7 months). A negative relationship with a medium effect size was found between lateral glances and interpersonal relationships. Object grouping behavior and interpersonal relationships were not related. This study suggests that visual perception may be a mechanism in the development of interpersonal relationships in ASD, which is in accordance with an embodied approach to social cognition.     

Interrelations among social-cognitive skills in young children with autism

Typically developing infants show a reliable developmental sequence of emergence of early social-cognitive skills, such as joint attention, communicative gestures, gaze and point following, imitation, and referential language. First infants share others' attention, then they follow others' attention and then behavior, and then they direct others' attention and then behavior. The current study used a series of tests from a study of typically developing infants (Carpenter, Nagell, & Tomasello, 1998) to investigate interrelations among these social-cognitive skills in young children with autism and children with other developmental delays. Tests of object permanence, spatial relations, facial and manual imitation, and executive function also were included. We found that for most children with autism, unlike other children, tests involving others' attention were more difficult than tests involving others' behavior. However, within the domains of attention and behavior, the typical pattern of sharing, then following, and then directing was evident. There were several positive intercorrelations among the social-cognitive skills (as there were for typically developing infants), but there also was some evidence of individual differences in patterns. Implications for theories of social-cognitive and language development are discussed.     

Brief report: imitation effects on children with autism

Twenty children with autism (mean age, 5 years) were recruited for the study from a school for children with autism. The children were randomly assigned to an imitation (n = 10) or contingently responsive (n = 10) interaction group based on a stratification table for gender and developmental and chronological age. The sessions consisted of four phases, with each phase lasting 3 minutes. In the first phase, the child walked into a room that was furnished with a sofa, a table, chairs, and two sets of identical toys. An adult was in the room sitting very still like a statue (first still-face condition). In the second phase, the adult either imitated the child or was contingently responsive to the child. In the third phase, the adult sat still again (second still-face condition), and in the fourth phase, the adult engaged in a spontaneous interaction. During the third phase (the second still-face condition), the children in the imitation group spent less time in gross motor activity and more time touching the adult, as if attempting to initiate an interaction. The contingency condition appeared to be a more effective way to facilitate a distal social behavior (attention), whereas the imitative condition was a more effective way to facilitate a proximal social behavior (touching).     

The effect of contingent imitation intervention on children with autism spectrum disorder and co-occurring intellectual disabilities

BackgroundImitation plays a crucial role in the development of social communication, and it is a skill that is often missing in children with autism spectrum disorder and co-occurring intellectual disabilities. Contingent imitation (CI) results in increased social eye gaze, an imitation cue for children with ASD. A series of studies on Reciprocal Imitation Training (RIT) intervention that included CI has demonstrated an increase in imitation frequency. However, little is known about CI intervention’s effects on motor, object, and vocal imitation accuracy in children with ASD-ID.MethodThe participants in this study were six 4-year-old children with ASD-ID. A single case experimental design with multiple probes across target behaviors was used to identify CI intervention's efficacy on the motor, object, and vocal imitation. Moreover, pre-and post-assessment analysis evaluated socially engaged imitation and imitation turn-taking.ResultsMost motor, object, and vocal imitation accuracy increased through the CI intervention. However, individual adaptations such as prompting for looking behaviors and motor responses were required to increase specific target behaviors. Moreover, all children increased socially engaged imitation and imitation turn-taking through CI intervention and CI + prompting intervention.ConclusionsCI intervention is an efficacious intervention method for increasing the accuracy of imitation in children with ASD-ID. Furthermore, CI + prompting intervention is effective when CI intervention alone does not improve imitation accuracy. CI + prompting interventions using a decision tree tailored for each child could identify the intervention strategies for improving imitation accuracy during play activities and increase the understanding of ASD-ID children's imitation accuracy difficulties.     

Social communication effects of peer-mediated recess intervention for children with autism

Children with ASD face enormous challenges in the area of social functioning. Research has shown that impairments in social functioning distinguish this population from both typically developing children and children with disabilities. This study incorporated several evidence-based social skills-teaching procedures (i.e., direct instruction, priming, prompting, peer-mediation, contingent reinforcement, and token economies) directly in the recess setting to increase appropriate social behaviors for four children with ASD (ages 6–8). Elements of peer networks and pivotal response training (two types of social skills intervention packages in the literature) were included. Results showed significant increases in social communication between focus children and their peers, as well as generalization of skills to non-intervention recesses.     

Reflecting on the mirror neuron system in autism: A systematic review of current theories

There is much interest in the claim that dysfunction of the mirror neuron system in individuals with autism spectrum condition causes difficulties in social interaction and communication. This paper systematically reviews all published studies using neuroscience methods (EEG/MEG/TMS/eyetracking/EMG/fMRI) to examine the integrity of the mirror system in autism. 25 suitable papers are reviewed. The review shows that current data are very mixed and that studies using weakly localised measures of the integrity of the mirror system are hard to interpret. The only well localised measure of mirror system function is fMRI. In fMRI studies, those using emotional stimuli have reported group differences, but studies using non-emotional hand action stimuli do not. Overall, there is little evidence for a global dysfunction of the mirror system in autism. Current data can be better understood under an alternative model in which social top-down response modulation is abnormal in autism. The implications of this model and future research directions are discussed.     

Advancing imitation and requesting skills in toddlers with Down syndrome

Drawing upon information about the Down syndrome behavioral phenotype and empirically based intervention strategies, we examined intervention addressing early communication impairments in young children with Down syndrome. Intervention involved multiple opportunities, shaping, prompting, and reinforcement to address both verbal imitation and requesting. Intervention also incorporated the relative strengths in social development characteristic of the Down syndrome behavioral phenotype by focusing on a more social request prior to addressing the more impaired instrumental request, as well as incorporating social consequences. Three of the four toddlers with Down syndrome were taught verbal imitation skills, two of whom generalized to novel sounds. All four toddlers with Down syndrome acquired requesting skills in the form of gaze shifting and vocalizing; three were also taught verbal approximations of requesting words (e.g., “mm” for “more”) using imitative prompts. These results contribute to the small, but growing, literature demonstrating behavior analytic interventions informed by an understanding of the Down syndrome behavioral phenotype.     

Evaluation of the iPad in the acquisition of requesting skills for children with autism spectrum disorder

The iPad® with the Proloquo2Go™ application is designed to function as a speech-generating device (SGD). This study evaluates whether children with autism spectrum disorder (ASD) can acquire requesting skills using the iPad® with the Proloquo2Go™ application. Participants included three children with ASD between the ages of three and five. A multiple probe design across participants was used. Intervention phases were adapted and modified from the picture exchange communication system (PECS) (Bondy and Frost, 1994, Frost and Bondy, 2002). Results of this study support that children diagnosed with ASD can acquire skills needed to request preferred items using the iPad® with the Proloquo2Go™ application with training of a picture-based communication system. In addition, vocal requesting increased for the participants during the training phases in comparison to baseline probes.     

A systems level analysis of the mirror neuron hypothesis and imitation impairments in autism spectrum disorders

Although several studies suggest an imitation deficit as a key feature of autism, questions have been raised about the consistency of this finding and about the component skills involved in imitation. The primary aim of this review is to examine the uneven profile of imitation deficits found in autism in the context of the mirror neuron system (MNS) dysfunction hypothesis. We use the cortical underconnectivity framework (Just et al., 2004) to examine the coordination of brain areas that orchestrate the communication between the component skills underlying imitation. A comprehensive account of imitation deficit in autism should take into account the regions that are at the core of the MNS (e.g., IFG and IPL) and related regions that feed into the MNS (e.g., STS, Cerebellum) in their functioning and in their coordination. Our findings suggest that the MNS may be associated with mediating familiarity, attention, self-other matching, and social relevance, which may be vital in characterizing the imitation deficits in autism. Such an analysis may have greater clinical and therapeutic value.     

The relationship of motor skills and adaptive behavior skills in young children with autism spectrum disorders

ObjectiveTo determine the relationship of motor skills and adaptive behavior skills in young children with autism.DesignA multiple regression analysis tested the relationship of motor skills on the adaptive behavior composite, daily living, adaptive social and adaptive communicative skills holding constant age, non-verbal problem solving, and calibrated autism severity.SettingMajority of the data collected took place in an autism clinic.ParticipantsA cohort of 233 young children with ASD (n = 172), PDD-NOS (n = 22) and non-ASD (developmental delay, n = 39) between the ages of 14–49 months were recruited from early intervention studies and clinical referrals. Children with non-ASD (developmental delay) were included in this study to provide a range of scores indicted through calibrated autism severity.InterventionsNot applicable.Main outcome measuresThe primary outcome measures in this study were adaptive behavior skills.ResultsFine motor skills significantly predicted all adaptive behavior skills (p < 0.01). Gross motor skills were predictive of daily living skills (p < 0.05). Children with weaker motor skills displayed greater deficits in adaptive behavior skills.ConclusionsThe fine and gross motor skills are significantly related to adaptive behavior skills in young children with autism spectrum disorder. There is more to focus on and new avenues to explore in the realm of discovering how to implement early intervention and rehabilitation for young children with autism and motor skills need to be a part of the discussion.     

Effects of computer-assisted explicit instruction on map-reading skills for students with autism

Educational reform for students with disabilities, including autism, has a history of focusing solely on the content areas of reading, mathematics, and science. To date, few empirical studies examining social studies have been published. This study investigated the effects of a computer-assisted explicit instruction package to teach map-reading skills to three elementary school students with autism. A multiple probe across participants design was used to examine the effectiveness of the intervention package. While results did not show a functional relationship, all three students’ data indicated a change in level and two students’ data showed a change in trend. Implications for practice and suggestions for future research are also discussed.     

Facilitating derived requesting skills with a touchscreen tablet computer for children with autism spectrum disorder

Two experiments were conducted employing derived relational responding and conditioned motivating operations to establish untaught mands with 11 children with autism spectrum disorder (ASD) who lacked a vocal repertoire. Following formal language assessments and preference assessments, a multi-stage automated protocol was implemented on touchscreen tablet computers. Children were first taught to mand by picture exchange for missing items necessary to play with a toy and then learned to conditionally relate the dictated names of the items to the corresponding pictures of the items (A-B training) and to relate the dictated names to the corresponding printed words (A-C training). Test probes, in the absence of reinforcement, were presented to determine whether or not participants would mand for the missing items using text exchange (hence demonstrating derived manding/requesting). Probes for spontaneous matching (B-C and C-B) and labeling (B-A and C-A) were also presented in both experiments, one of which employed a pretest/posttest design and the other a multiple probe across participants design. Across both experiments, all but one of the participants showed evidence of derived requesting and derived stimulus relations. Implications for research on high-tech devices for facilitating independent communication skills of children with ASD and for derived relational responding approaches to verbal operants are discussed.     

A review of treatments for deficits in social skills and self-help skills in autism spectrum disorder

Deficits in social skills and self-help skills present significant challenges for individuals diagnosed with autism spectrum disorders (ASD). Much research in Applied Behavior Analysis (ABA) has been devoted to treatments for deficits in social skills and there exist a number of extensive reviews on the research in this area. Some research has also been conducted in the treatment of self-help skills although no comprehensive reviews of this research have been conducted. A combined acquisition of social and self-help kills is required by individuals diagnosed with ASD for successful independent living in society. The current literature review provides a comprehensive investigation and examination of studies focused on interventions for deficits in social skills or self-help skills in those with ASD. Twenty-two studies that met the inclusion criteria were chosen. Studies were categorised based on intervention. Key studies were defined as studies that added something novel to the literature, rather than replicating previous research. Each study was then evaluated on a number of aspects. All studies showed positive outcomes. Strengths, limitations and future recommendations are discussed.     

Effects of music-based social stories on comprehension and generalization of social skills in children with autism spectrum disorders: A randomized effectiveness study

The purpose of this randomized controlled study was to examine the effects of music-based social stories on the comprehension and generalization of social skills in children with autism spectrum disorders. The principle investigator (PI) collected data during three separate one-week summer camps. Participants (N = 30) were randomly assigned by cluster to one of three non-music control groups (social story read to them) or one of three experimental music therapy groups (social story sung to them). Participants’ parents completed the autism social skills profile (ASSP) at pre- and posttest and five comprehension check (CC) questions over time pertaining to their child's assigned social story. The only main effect for the ASSP that was significant was subcategory but there were numerous significant two- and three-way interactions confounding results. Main effects for time on the CC were significant, with scores being highest on the posttest. Overall, the lack of significant main effects was likely a function of minimal treatment dose. Although results of the study were confounded by numerous significant interactions, clinicians might pair social stories with music to facilitate comprehension, generalization, and on-task behaviors conducive to learning social information. Implications for clinical practice, limitations, and suggestions for future research are provided.