Mirroring effect in 2- and 3-year-olds with autism spectrum disorder

Previous studies have suggested that being imitated by an adult is an effective intervention with children with autism and developmental delay. The purpose of this study wais to investigate whether “mirroring” interaction, which includes being imitated by an adult, can facilitate the social responsiveness of toddlers with autism spectrum disorder (ASD). Participants were 16 toddlers (2- and 3-year-olds) with ASD. This study consisted of three experimental phases: in the first baseline phase, the experimenter manipulated toys in front of the participant; in the second phase, the experimenter reproduced (mirrored) all of the child's behaviors; and in the third phase, the first baseline phase was repeated. Our results demonstrated that although the mirroring effect differed by age, the effect was observed in both 2- and 3-year-olds with ASD. In addition, the overall magnitude of the mirroring effect differed by IQ, but not by the severity of autistic symptoms. Mirroring interaction is promising as an early intervention for a wide range of children with ASD.     

Effect of Sensory Feedback on Immediate Object Imitation in Children with Autism

This study examined the effect of sensory feedback (e.g., flashing lights and sound) on the imitation performance of children with autism and typical children group-matched for mental age. Participants were administered an immediate object-imitation task with six novel toys constructed for this study: three with a sensory effect that could be activated by imitating the modeled action and three without a sensory effect. Although overall imitation performance did not differ significantly between the two groups, the imitation performance of the participants with autism was significantly higher with sensory toys than with nonsensory toys. Typical participants' imitation performance did not differ between the two sets of toys. Both groups played significantly more with the sensory toys during free play, indicating that sensory toys were more reinforcing for both groups. Additional results demonstrated that typical children used significantly more social behaviors during imitation than children with autism, but they did not differ in object-oriented behaviors, replicating previous findings. It is argued that children with autism may be less motivated to imitate by social interaction, but may be motivated to imitate to receive a nonsocial reward (sensory feedback).     

A Pilot Study of Maternal Sensitivity in the Context of Emergent Autism

Unstructured mother–toddler interactions were examined in 18-month-old high- and low-risk children subsequently diagnosed (n = 12) or not diagnosed (n = 21) with autism spectrum disorders (ASD) at 36 months. Differences in maternal sensitivity were not found as a function of emergent ASD status. A differential-susceptibility moderation model of child risk guided investigations linking maternal sensitivity to child behavior and language growth. Group status moderated the relation between sensitivity and concurrent child behavior problems, with a positive association present for children with emergent ASD. Maternal sensitivity at 18 months predicted expressive language growth from age 2 to 3 years among children with emergent ASD only. Findings underscore the importance of understanding parent–child interaction during this key period in the development of autism symptomatology.     

Linking Parental Perceptions to Interactions in Young Children with Autism

This study examines the relation of parental perceptions and observed parent–child interactive behaviors. Samples observed included normally developing children, children with autism, and children with mental retardation who were equivalent on mental age. Parental perceptions of children's temperament and parental feelings of parenting stress were examined. Results indicated that parental perceptions of autistic children's behavior were more often linked to actual child and parental behaviors than in the comparison samples. Parents who reported their autistic children as more difficult in temperamental style had children who were less engaged during a social game with the parent and less responsive in interaction with an experimenter. Parents who reported greater stress had autistic children who were less responsive in social interactions with others.     

Teaching caregivers to implement video modeling imitation training via iPad for their children with autism

Children with autism fail to imitate from an early age and this lack of imitation is a salient diagnostic marker for the disorder. For children with Autism Spectrum Disorder (ASD), increased imitation skills appear to be related to increased skill development in a variety of areas. Video modeling was recently validated as a technique to support imitation acquisition in young children with autism. The purpose of this research was to determine if there is a functional relation between caregiver implemented Video Modeling Imitation Training (VMIT) via iPad and increased imitation skills in young children with autism. In addition, a secondary analysis of language development after exposure to VMIT was also conducted. A multiple baseline design across four caregivers and their children with autism was implemented. Results indicated that all four caregivers were able to successfully create video models on an iPad when provided with minimal training and implement VMIT with fidelity for their children. All four children made substantial gains in their imitation skills during caregiver implemented treatment. Imitation skills maintained post treatment and, to varying degrees, generalized to imitation of live models. Expressive language skills increased to varying degrees for all participants.     

The effect of context on imitation skills in children with autism

Children with autism exhibit deficits in imitation skills. Previous authors have suggested that they may have particular difficulty imitating in natural social interactions, but properly controlled experiments investigating this possibility have not been conducted. To investigate this possibility, children with autism and typically developing children were compared on a series of imitation tasks presented either in a structured-elicited or naturalistic-spontaneous condition. Modeled actions were counterbalanced across conditions. Results suggest children with autism imitated less than typically developing children overall; however, this difference was mainly evident when the imitation task was presented in a spontaneous context. In addition, they exhibited less coordinated joint attention during imitation than the typically developing children. These findings support the hypothesis that children with autism are particularly impaired in their ability to imitate spontaneously.     

Verbal communication outcomes in children with autism after in-home father training

Background This retrospective study examined the efficacy of in‐home father training on the communicative outcomes of children with autism. The in‐home training consisted of two components: (1) expectant waiting; and (2) imitation with animation. Methods Efficacy of parent training was examined by measuring the ratio of utterances produced by the parents to the utterances produced by the children and the number of verbal imitation by the parents. Outcomes of the children's verbal production were examined by measuring the number of (1) single word utterances; (2) different words produced; and (3) verbal response to questions. Results Following training there was a decrease in the ratio of parent to child utterances and an increase in (1) the use of imitation by the parents; and (2) the number of single words and different words produced by the children. Discussion Results of this study suggested that the parents had learned to wait for their children to communicate verbally during communicative interactions and to interact more efficiently with their children by using verbal imitation. Overall, the results of this study support the efficacy of parent training that focuses on promotion of social reciprocity, and have important implications for clinicians and future research.     

Experimental functional analysis of aggression in children with Angelman syndrome

BackgroundKinship theory suggests that genomic imprinting could account for phenotypic behaviors that increase (in the case of Angelman syndrome) or decrease (for Prader-Willi syndrome) the drive to access social resources (adult contact) depending on the imprinting parent-of-origin. Difficult to manage behaviors, such as aggression that is common in Angelman syndrome, could serve the function of increasing social interaction. We hypothesise that the commonly reported aggressive behavior in children with Angelman syndrome will be attention maintained.MethodsExperimental functional analysis was carried out with twelve children with Angelman syndrome caused by either a deletion (n = 10) or uniparental disomy (n = 2).The relative increase and decrease of aggressive behaviors was observed in response to experimentally manipulated levels of adult attention and demand. Laughing and smiling, crying and frowning, and physical initiation with an adult were also measured.ResultsAggression was seen in ten of the twelve children. One child evidenced a pattern of aggression across conditions consistent with maintenance by attention, three children showed higher levels of aggression during social interaction and two children showed escape motivated aggression.DiscussionWith the exception of one child the results did not confirm the hypothesis. However, the pattern of increased aggression in the high social contact condition combined with evidence of positive affect during this condition suggests aggression may serve to both maintain and initiate social contact and this interpretation is consistent with previous research. The negative results may also have been influenced by the age of the children and the low levels of observed aggression.     

Autism Spectrum Disorders and Symptoms in Children with Molecularly Confirmed 22q11.2 Deletion Syndrome

In this study, we assessed the presence of autism spectrum disorders (ASD) among children with a confirmed 22q11.2 deletion (n = 98). The children’s caregivers completed screening measures of ASD behaviors, and for those whose scores indicated significant levels of these behaviors, a standardized diagnostic interview (Autism Diagnostic Interview-Revised; ADI-R) was administered. Results demonstrated that over 20% of children (n = 22) were exhibiting significant levels of autism spectrum symptoms based on the screening measures. Based upon the ADI-R, 14 children qualified for a diagnosis of an ASD, and for 11 of those children a diagnosis of autism was most appropriate. These findings increase our knowledge of developmental disorders associated with the 22q11.2 deletion and point to avenues for future investigation.     

Teaching Reciprocal Imitation Skills to Young Children with Autism Using a Naturalistic Behavioral Approach: Effects on Language, Pretend Play, and Joint Attention

Children with autism exhibit significant deficits in imitation skills which impede the acquisition of more complex behaviors and socialization, and are thus an important focus of early intervention programs for children with autism. This study used a multiple-baseline design across five young children with autism to assess the benefit of a naturalistic behavioral technique for teaching object imitation. Participants increased their imitation skills and generalized these skills to novel environments. In addition, participants exhibited increases in other social-communicative behaviors, including language, pretend play, and joint attention. These results provide support for the effectiveness of a naturalistic behavioral intervention for teaching imitation and offer a new and potentially important treatment option for young children who exhibit deficits in social-communicative behaviors.     

Links Between Social Understanding and Social Behavior in Verbally Able Children with Autism

This study investigated the relations between various measures of social understanding and social interaction competence in verbally able children with autism. Measures of social understanding included measures of verbalizable knowledge (false belief understanding, affective perspective taking), as well as measures of more intuitive forms of social responsiveness (empathy, concern to distress, and initiating joint attention). Two measures of social interaction competence were employed: level of engagement with peers on the playground, and prosocial behavior in a structured laboratory task. For children with autism, initiating joint attention and empathy were strongly related to both measures of social interaction competence. No understanding-behavior links were identified for a language-age matched comparison sample of developmentally delayed children. Several accounts of these understanding-behavior links are considered, including the possibility that for children with autism, more impaired forms of understanding are more closely linked to behavior because they serve as limits on competence.     

Promoting Imitation in Young Children with Autism: A Comparison of Reciprocal Imitation Training and Video Modeling

The inability to imitate is a salient diagnostic marker for autism. It has been suggested that for children with autism, imitation may be a prerequisite skill that can assist in the development of various skills. Using a multiple baseline design across subjects, the purpose of this research was to determine if two interventions, reciprocal imitation training and video modeling were effective in promoting imitation acquisition in young children with autism. Six boys were matched across various features (i.e., age, language, autism severity) and randomly placed in a treatment condition. Results indicated that all six participants increased their imitation skills to varying degrees in both conditions, and imitation maintained and generalized at higher than baseline levels post treatment.     

Atypical brain activation patterns during a face‐to‐face joint attention game in adults with autism spectrum disorder

Joint attention behaviors include initiating one's own and responding to another's bid for joint attention to an object, person, or topic. Joint attention abilities in autism are pervasively atypical, correlate with development of language and social abilities, and discriminate children with autism from other developmental disorders. Despite the importance of these behaviors, the neural correlates of joint attention in individuals with autism remain unclear. This paucity of data is likely due to the inherent challenge of acquiring data during a real‐time social interaction. We used a novel experimental set‐up in which participants engaged with an experimenter in an interactive face‐to‐face joint attention game during fMRI data acquisition. Both initiating and responding to joint attention behaviors were examined as well as a solo attention (SA) control condition. Participants included adults with autism spectrum disorder (ASD) (n = 13), a mean age‐ and sex‐matched neurotypical group (n = 14), and a separate group of neurotypical adults (n = 22). Significant differences were found between groups within social‐cognitive brain regions, including dorsal medial prefrontal cortex (dMPFC) and right posterior superior temporal sulcus (pSTS), during the RJA as compared to SA conditions. Region‐of‐interest analyses revealed a lack of signal differentiation between joint attention and control conditions within left pSTS and dMPFC in individuals with ASD. Within the pSTS, this lack of differentiation was characterized by reduced activation during joint attention and relative hyper‐activation during SA. These findings suggest a possible failure of developmental neural specialization within the STS and dMPFC to joint attention in ASD. Hum Brain Mapp 34:2511–2523, 2013. © 2012 Wiley Periodicals, Inc.     

Using Matched Groups to Explore Child Behavior Problems and Maternal Well-Being in Children with Down Syndrome and Autism

Mothers of children with Down syndrome, autism, and mixed etiology intellectual disabilities, matched on child age, gender, and communication skills (n = 19 in each group) completed measures of their child’s adaptive and problem behaviors, their own parenting stress, and positive perceptions of their child. Children with autism were rated as having more problem behaviors and lower levels of social competence than children with Down syndrome and mixed etiology intellectual disabilities. Mothers of children with autism scored lower on positive perceptions of their child, and higher on stress than the other two groups. After selecting closely matched groups, we found several group differences in child behavior but little evidence of group differences in maternal outcomes.     

Teaching Deception Skills in a Game-Play Context to Three Adolescents with Autism

Baron-Cohen (1992) found that students with autism are impaired in their ability to deceive. A multiple-baseline across-subjects design was conceptualized to test the hypothesis that such students could be taught to deceive. Two conditions were presented in baseline and treatment phases. In Condition 1, the student guessed in which hand a small object was hidden when the experimenter presented two closed fists. In Condition 2, the student hid the object and presented two closed fists to the experimenter for a guess. Reinforcement was delivered contingently upon independent guessing during Condition 1 in both baseline and treatment phases. Under Condition 2, reinforcement was delivered noncontingently during the baseline phase and contingently upon successive approximations to the target behavior of deception during the treatment phase. All students displayed the acquisition of at least three of the responses included in the deception response during the baseline phase, and two students showed an erratic acquisition of the total skill during the baseline phase. Results indicate that students with autism can learn to deceive, even without formal intensive training.     

Disseminating ASD Interventions: A Pilot Study of a Distance Learning Program for Parents and Professionals

There is a need for the adaptation of training in evidence-based interventions to non-traditional methods, particularly for individuals working with children with autism spectrum disorders (ASD). An internet-based self-directed distance learning program was created to teach reciprocal imitation training, a naturalistic behavioral intervention aimed at increasing imitation in children with ASD. A single-subject multiple-baseline design study evaluated the effect of the program on changes in therapist (sample 1) and parent (sample 2) knowledge and behavior, and changes in child behavior. Adult participants improved their knowledge and use of the intervention techniques, and child participants improved their rates of imitation. Results suggest that a self-directed distance learning program may be effective for disseminating evidence-based practices to individuals working with children with ASD.     

Differences and similarities in sexual behaviour among pre-schoolers in Sweden and USA

Studies of childhood sexual behaviour in a cross-cultural perspective are important in that they increase our knowledge of normative behaviour in general and enhance our understanding of cultural influences on child sexual development. Two studies, one from Sweden (n=185) and one from Minnesota, USA (n=467) of 3-6 year old children, were assessed with a 25-item scale derived from the Child Sexual Behaviour Inventory. Both studies were screened for the absence of sexual abuse. The Swedish parents completed the questionnaire about their child's behaviour at home and the US parents typically completed the questionnaire in the waiting room of a paediatric clinic. Pre-school children in Sweden exhibited more sexual behaviour than American children of the same age according to parental reports. These differences were most pronounced in boys. In both studies exhibitionistic or voyeuristic behaviour and touching behaviour was most frequent. Both intrusive and sexually explicit behaviour was very unusual. The results reflect how cultural context influences which behaviour is permitted in young children, and consequently what adults think constitutes normal and problematic childhood sexual behaviour.     

Examination of correlates of different imitative functions in young children with autism spectrum disorders

Children with autism spectrum disorders (ASD) have difficulties with social-communication skills, including imitation, language, joint attention, and play. This study investigated whether imitation performance in two different contexts (structured-elicited vs. social-interactive) was differentially related to attention-following, social reciprocity, language, and play in children with ASD. This study used a concurrent, correlational design to investigate the relationships between these skills in 23, 2–4-year-old children with autism. Participants imitated more actions on the structured-elicited than social-interactive task. After controlling for developmental level, imitation in the structured-elicited condition was correlated with vocabulary size and imitation in the social-interactive condition was correlated with vocabulary size, social reciprocity, and symbolic play. These findings suggest different skills may underlie imitation in different contexts. In addition, while imitation in both contexts appears to be important for vocabulary development at this age, imitation in a social context may be more important in the development of symbolic play skills.     

Acquisition of simple motor imitative behavior in mentally retarded and nonretarded children.

The effects of social reinforcement and population on two simple motor tasks which were embedded within a contingently reinforced imitation task were explored. A Social Reinforcement Type x Population interaction was observed, where the nonretarded children performed at higher levels under informative social reinforcement (right-correct) and at lower levels under affective social reinforcement (good-fine); the opposite was observed for the retarded children. In addition, one motor response was imitated to a higher degree than the other response.