Inner speech impairments in autism

BACKGROUND: Three experiments investigated the role of inner speech deficit in cognitive performances of children with autism. METHODS: Experiment 1 compared children with autism with ability-matched controls on a verbal recall task presenting pictures and words. Experiment 2 used pictures for which the typical names were either single syllable or multisyllable. Two encoding conditions manipulated the use of verbal encoding. Experiment 3 employed a task-switching paradigm for which performance has been shown to be contingent upon inner speech. RESULTS: In Experiment 1, children with autism demonstrated a lower picture-superiority effect compared to controls. In Experiment 2, the children with autism showed a lower word-length effect when pictures were presented alone, but a more substantial word-length effect in a condition requiring overt labelling. In Experiment 3, articulatory suppression affected the task-switching performance of the control participants only. CONCLUSIONS: Individuals with autism have limitations in their use of inner speech.     

Perceptual processing among high-functioning persons with autism

Two tasks were used to assess the processing of whole versus parts of objects in a group of high-functioning children and adolescents with autism (N = 11) and a comparison group of typically developing peers (N = 11) matched for chronological age and IQ. In the first task, only the children with autism showed a global advantage, and the two groups showed similar interference between levels. In the second task, the children with autism, despite longer RTs, showed similar performance to the comparison group with regard to the effect of goodness on visual parsing. Contrary to expectations based on the central coherence and hierarchisation deficit theories, these findings indicate intact holistic processing among persons with autism. The implications of these findings are discussed in relation to apparently discrepant evidence from other studies.     

Executive functioning in children with specific language impairment

Background: A limited range of evidence suggests that children with specific language impairment (SLI) have difficulties with higher order thinking and reasoning skills (executive functioning, EF). This study involved a comprehensive investigation of EF in this population taking into account the contributions of age, nonverbal IQ and verbal ability. Methods: Ten separate measures of EF were assessed in 160 children: 41 had SLI; 31 had low language/cognitive functioning but did not fulfil the criteria for SLI (low language functioning or LLF); and 88 were typically developing with no language difficulties. Group differences in performance were assessed after controlling for age, nonverbal IQ and verbal ability in a series of regression analyses. Results: Children with SLI and LLF had significantly lower performance than typical children on 6 of the 10 EF tasks once age and nonverbal IQ had been controlled (verbal and nonverbal executive‐loaded working memory, verbal and nonverbal fluency, nonverbal inhibition and nonverbal planning). Performance on these EF tasks remained lower for those in the SLI group even when verbal IQ was entered in the regressions. Conclusions: Children with language impairments showed marked difficulties on a range of EF tasks. These difficulties were present even when adjustments were made for their verbal abilities.     

Cognitive profiles and social-communicative functioning in children with autism spectrum disorder

BACKGROUND: Whether there is an unusual degree of unevenness in the cognitive abilities of children with autism spectrum disorder (ASD) and whether different cognitive profiles among children with ASD might index etiologically significant subgroups are questions of continued debate in autism research. METHOD: The Differential Ability Scales (DAS) and the Autism Diagnostic Observation Schedule (ADOS) were used to examine profiles of verbal and nonverbal abilities and their relationship to autistic symptomatology in 120 relatively high-functioning children with ADI-confirmed diagnoses of autism. RESULTS: Discrepancies between verbal and nonverbal ability scores occurred at a significantly higher rate than in the DAS normative sample (30%) in both a younger group of 73 children (56%) with a mean age of 5;5 and an older group of 47 children (62%) with a mean age of 8;11. Discrepancies were mainly in favor of nonverbal ability in the younger group, but occurred equally in favor of verbal and nonverbal abilities in the older group. Comparison of the two age groups suggested a growing dissociation between verbal and nonverbal (and particularly visual processing) skills with age. In the older group, children with discrepantly higher nonverbal abilities demonstrated significantly greater impairment in social functioning, as measured on the ADOS, independent of absolute level of verbal and overall ability. CONCLUSIONS: These findings demonstrate a high rate of uneven cognitive development in children with ASD. Indications of a dissociation between verbal and visual-perceptual skills among the older children, and the specific association of discrepantly high nonverbal skills with increased social symptoms suggest that the nonverbal > verbal profile may index an etiologically significant subtype of autism.     

Language abilities of siblings of children with autism

BACKGROUND: Language abilities of siblings of children with autism were examined to explore the possibility that language abilities are behavioral markers specific to the genetic liability for autism, as part of the broader phenotype. METHOD: Language abilities were compared among 27 siblings of children with autism, 23 siblings of children with mental retardation of unknown etiology (MR), and 22 siblings of children with developmental language disorders (DLD). Groups were matched by siblings' age, gender, birth order, family size, ethnicity, family income and by probands' gender and mental age. RESULTS: Siblings of children with autism achieved higher scores than siblings of children with DLD on receptive, expressive, and total language scales of the Children's Evaluation of Language Fundamentals and on verbal IQ. Moreover, within the DLD group, school problems in the domains of reading and arithmetic were more prevalent than within the other two groups. Only 2 siblings of children with autism received clinical diagnoses based on DSM-IV criteria compared to 3 siblings of children with MR and 7 siblings of children with DLD. CONCLUSIONS: After excluding data of the diagnosed siblings, no differences in language abilities could be discerned among the groups, except that more siblings in the DLD group were identified as having language difficulties. In summary, although language deficits characterize autism, siblings of children with autism were not found to demonstrate deficits in language skills assessed by formal language tests, IQ, or academic skills.     

Psychosocial adjustment in siblings of children with autism

BACKGROUND: This study investigated psychosocial adjustment in siblings of children with autism compared to siblings of children with Down syndrome and siblings of normally developing children. In addition, the relationships between feelings of loneliness, social support and psychosocial adjustment, and the influence of gender and family size on psychological adjustment were examined. METHODS: Ninety siblings (30 per group) between the ages of 8 and 18 and one parent of each child participated in this study. RESULTS: Results indicated that siblings of children with autism, as well as comparison siblings, were well adjusted and reported low levels of loneliness. Siblings of children with autism also reported that they received high levels of social support in their lives. CONCLUSIONS: Large family size appears to facilitate healthy adjustment in siblings of children with autism.     

A study of memory functioning in individuals with autism

Memory tasks were administered to 14 high-functioning individuals with autism and 14 typically developing individuals matched on chronological age and verbal intelligence. The tasks consisted of free and cued recall of 15 semantically unrelated words in 3 encoding conditions: phonological encoding, semantic encoding, and a no encoding orientation. In both groups, semantic orientation led to better free recall than did orientation toward syllabic encoding or absence of orientation. In contrast, semantic cues at retrieval led to better cued recall than phonological cues in typically developing individuals, whereas both types of cue had the same effect in prompting cued recall for individuals with autism. These findings are incompatible with the hypothesis of an amnesic deficit and do not support the notion of executive or semantic deficits in the memory problems of autistic individuals, at least for those with a high level of functioning. It is proposed that these findings can be accounted for by enhanced phonological processing in autism. This interpretation is consistent with other findings of enhanced processing of low-level perceptual information in the visual and auditory modality in autism.     

Patterns of development in young children with autism

Objective: To determine the extent to which the developmental profile of children less than 4 years can help in distinguishing children with autism from children with developmental delay.Methods: Subjects were 32 children with autism as per the DSM IV criteria and 32 children with developmental delay matched on chronological and academic age. The Developmental Profile II was used to assess the developmental functioning in five domains including physical, social, self help, academic, and communication.Results: The two groups showed significantly different developmental profiles and these differences were accounted for mainly by significantly lower social skills and superior motor skills in the autistic group as compared to the developmentally delayed group.Conclusion: Developmental Profile II may help in distinguishing young children with autistic disorder from non-autistic children with comparable developmental delays     

Voice processing abilities in children with autism, children with specific language impairments, and young typically developing children

It is well established that people with autism have impaired face processing, but much less is known about voice processing in autism. Four experiments were therefore carried out to assess (1) familiar voice-face and sound-object matching; (2) familiar voice recognition; (3) unfamiliar voice discrimination; and (4) vocal affect naming and vocal-facial affect matching. In Experiments 1 and 2 language-matched children with specific language impairment (SLI) were the controls. In Experiments 3 and 4 language-matched children with SLI and young mainstream children were the controls. The results were unexpected: the children with autism were not impaired relative to controls on Experiments 1, 2 and 3, and were superior to the children with SLI on both parts of Experiment 4, although impaired on affect matching relative to the mainstream children. These results are interpreted in terms of an unexpected impairment of voice processing in the children with SLI associated partly, but not wholly, with an impairment of cross-modal processing. Performance on the experimental tasks was not associated with verbal or nonverbal ability in either of the clinical groups. The implications of these findings for understanding autism and SLI are discussed.     

Holistic and part-based face recognition in children with autism

BACKGROUND: There is substantial evidence that children with autism are impaired in face recognition. Although many researchers have suggested that this impairment derives from a failure of holistic face processing and a tendency to represent and encode faces on a part-by-part basis, this hypothesis has not been tested directly. METHOD: Holistic face processing was assessed by comparing children's ability to recognize a face part (eyes, nose, or mouth) in the context of the whole face in which it was learned with their ability to recognize the same face part in isolation. RESULTS: In Study 1, as expected, typically developing 9-year-olds (n = 27) and 11-year-olds (n = 30) were significantly better at recognizing face parts presented in the whole than in the part test condition, and this effect was limited to upright faces and not found for inverted faces. Consistent with prior findings, typically developing children were most accurate when face recognition depended on the eyes. In Study 2, high-functioning children with autism (n = 22) evidenced a whole-test advantage for mouths only, and were markedly deficient when face recognition depended on the eyes. Their pattern of performance diverged from age- and IQ-matched comparison participants (n = 20), who performed similarly to the typically developing children in Study 1. CONCLUSIONS: These findings suggest that face recognition abnormalities in autism are not fully explained by an impairment of holistic face processing, and that there is an unusual significance accorded to the mouth region when children with autism process information from people's faces.     

Adult outcome for children with autism

BACKGROUND: Information on long-term prognosis in autism is limited. Outcome is known to be poor for those with an IQ below 50, but there have been few systematic studies of individuals with an IQ above this. METHOD: Sixty-eight individuals meeting criteria for autism and with a performance IQ of 50 or above in childhood were followed up as adults. Their mean age when first seen was 7 years (range 3-15 years); at follow-up the average age was 29 years (range 21-48 years). Outcome measures included standardised cognitive, language and attainment tests. Information on social, communication and behavioural problems was obtained from the Autism Diagnostic Interview (ADI). RESULTS: Although a minority of adults had achieved relatively high levels of independence, most remained very dependent on their families or other support services. Few lived alone, had close friends, or permanent employment. Communication generally was impaired, and reading and spelling abilities were poor. Stereotyped behaviours or interests frequently persisted into adulthood. Ten individuals had developed epilepsy. Overall, only 12% were rated as having a 'Very Good' outcome; 10% were rated as 'Good' and 19% as 'Fair'. The majority was rated as having a 'Poor' (46%) or 'Very Poor' (12%) outcome. Individuals with a childhood performance IQ of at least 70 had a significantly better outcome than those with an IQ below this. However, within the normal IQ range outcome was very variable and, on an individual level, neither verbal nor performance IQ proved to be consistent prognostic indicators. CONCLUSIONS: Although outcome for adults with autism has improved over recent years, many remain highly dependent on others for support. This study provides some information on prognostic indicators, but more fine-grained research is needed into the childhood variables that are associated with good or poor outcome.     

Atypical interference of local detail on global processing in high-functioning autism and Asperger's disorder

This study explored the claim that individuals with autism and Asperger's disorder tend to process locally rather than holistically. Participants observed a large or "global" number composed of smaller or "local" numbers. The response was contingent upon the identification of either the large stimulus or the small stimuli. Relative to age, sex, and IQ matched controls, global processing in children and adolescents with autism (N = 12) and Asperger's disorder (N = 12) was more vulnerable when the local stimuli were incongruent. The autism group made more global errors than their matched control group, regardless of whether there was local incongruence. In contrast, the Asperger's disorder group made a similar number of global errors as their respective control group. These results were discussed in relation to an "absence of global precedence" notion, "weak central coherence" theory, and right-hemisphere dysfunction. The neurobiological significance of these findings were discussed in the context of a fronto-striatal model of dysfunction.     

Generating novel ideas: fluency performance in high-functioning and learning disabled individuals with autism

Tasks of fluency tap the ability to generate multiple responses spontaneously following a single cue or instruction. The present study compared the fluency performance of subjects with autism and clinical control subjects at two different levels of ability (high-functioning subjects with a verbal IQ of 76 or greater, and globally learning disabled subjects with a verbal IQ of 74 or below). A battery of tasks was employed to assess subjects' word fluency (for letters and semantic categories), ideational fluency (for uses of objects and interpretations of meaningless line drawings), and design fluency (for abstract meaningless designs). Subjects with autism showed reduced fluency for both the word and ideational fluency tasks, generating significantly fewer responses than the clinical control subjects. Results were particularly striking for the ideational fluency tasks. On these tasks, autistic subjects produced very low response totals, with the performance of the high-functioning subjects with autism equivalent to that of the learning disabled subjects with autism and significantly inferior to that of the learning disabled control individuals. In contrast, the results of the design fluency paradigm paint a different picture. This paradigm revealed no significant difference in the quantity of designs generated by the subjects with autism and the control subjects but a clear qualitative difference, with the autistic group producing significantly higher rates of disallowed and perseverative responses. Whilst the results of the word and ideational fluency tasks are suggested to support the hypothesis that individuals with autism are impaired in the generation of novel responses and behaviour, the results of the design fluency task are equally consistent with an impairment in the regulation of behaviour through inhibition and/or monitoring. The implications of these findings for the study of executive function abilities in autism are discussed.     

High motion coherence thresholds in children with autism

BACKGROUND: We assessed motion processing in a group of high functioning children with autism and a group of typically developing children, using a coherent motion detection task. METHOD: Twenty-five children with autism (mean age 11 years, 8 months) and 22 typically developing children matched for non-verbal mental ability and chronological age were required to detect the direction of moving dots in a random dot kinematogram. RESULTS: The group of children with autism showed significantly higher motion coherence thresholds than the typically developing children (i.e., they showed an impaired ability to detect coherent motion). CONCLUSIONS: This finding suggests that some individuals with autism may show impairments in low-level visual processing--specifically in the magnocellular visual pathway. The findings are discussed in terms of implications for higher-level cognitive theories of autism, and the suggestion is made that more work needs to be carried out to further investigate low-level visual processing in autism.     

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??Abstract?? Objective To investigate the occurrence of comorbidity in school-aged children with high-functioning and low-functioning autism disorder. Methods Sixty-two outpatients in Peking University Institute of Mental Health?? aged 6 to 16 years old?? meeting the criteria of the Diagnostic and Statistical Manual of Mental Disorders?? Fourth Edition??DSM-IV?? visiting the hospital for autism were included in this cross-sectional study from September 2011 to November 2011. They were assessed with the self-made general condition questionnaire and Chinese Wechsler Intelligence Scale for Children ??WISC??. Raven’s Standard Progressive Matrices??SPM????Stanford-Binet Intelligence Scale and Peabody picture vocabulary test??PPVT?? were performed for patients who could not perform WISC test??. Kiddie-Sade-Present and Lifetime Version ??K-SADS-PL?? ?? Child-Global Assessment Scale??C-GAS ??and Childhood Autism Rating Scale??CARS?? were also performed. Results The lifetime prevalence and current prevalence of comorbidity in high-functioning autism??HFA?? group??IQ≥70??were 100%??29/29?? and 96.5%??28/29?? respectively. The lifetime prevalence and current prevalence of comorbidity in low-functioning autism??LFA?? group??IQ??70??were all 100%??33/33??. The lifetime prevalence and current prevalence of mood disorders?? anxiety disorders?? generalized anxiety disorder?? attention deficit hyperactivity disorder?? oppositional defiant disorder and tic disorders in high-functioning autism group were higher those of low-functioning autism group ??all P??0.05??. High-functioning autism group had more psychiatric medication taking history and poor development history?? higher current percentage of attending school??and lower CARS score and higher C-GAS score than low-functioning autism group ??all P??0.05??. Conclusion Comorbidity in school-aged children with high-functioning and low-functioning autism disorder are very common. Children with high-functioning autism disorder have more emotional and behavior disorders?? milder symptoms of autism?? more psychiatric medication taking history?? and higher overall function than children with low-functioning autism disorder.     

Predictors of cognitive test patterns in autism families

In a case-control study of cognitive performance, tests of intelligence, reading, spelling, and pragmatic language were administered to the parents and siblings of 90 community-ascertained probands with autism (AU group) and to the parents and siblings of 40 similarly ascertained probands with trisomy 21 Down syndrome (DS group). The two samples were comparable for age and parents' education; both groups were well-educated and had above-average intelligence. AU parents scored slightly but significantly lower on the WAIS-R Full Scale and Performance IQ, on two subtests (Picture Arrangement and Picture Completion), and on the Word Attack Test (reading nonsense words) from the Woodcock-Johnson battery. There were no differences between AU and DS siblings. As in earlier studies, AU parents, more often than DS parents, reported a history of early language-related cognitive difficulties; we were not able to replicate this in siblings. AU parents who reported such difficulties scored significantly lower on Verbal IQ, spelling, and the nonsense reading test. AU parents without a history of early language-related cognitive difficulties often had a Verbal IQ that exceeded Performance IQ by more than one standard deviation. AU siblings with early language-related difficulties had similar findings: lower Verbal IQ, poorer spelling, and poorer reading scores, compared to AU siblings without such a history. Parents with a positive history also scored worse on a measure of pragmatic language,the Pragmatic Rating Scale, but not on measures of social-related components of the broader autism phenotype. We propose that cognitive differences in a subset of autism family members are manifestations of the language-related component of the broader autism phenotype, and separate from the social-related component. This is consistent with the hypothesis that there are several genes that may interact to cause autism which segregate independently and have distinguishable manifestations in family members. The hypothesis would be further supported by finding different patterns of genetic loci linked to autism in families where one or both parents has language difficulties.     

Autistic symptomatology and language ability in autism spectrum disorder and specific language impairment

Background: Autism spectrum disorders (ASD) and specific language impairment (SLI) are common developmental disorders characterised by deficits in language and communication. The nature of the relationship between them continues to be a matter of debate. This study investigates whether the co‐occurrence of ASD and language impairment is associated with differences in severity or pattern of autistic symptomatology or language profile. Methods: Participants (N = 97) were drawn from a total population cohort of 56,946 screened as part of study to ascertain the prevalence of ASD, aged 9 to 14 years. All children received an ICD‐10 clinical diagnosis of ASD or No ASD. Children with nonverbal IQ ≥80 were divided into those with a language impairment (language score of 77 or less) and those without, creating three groups: children with ASD and a language impairment (ALI; N = 41), those with ASD and but no language impairment (ANL; N = 31) and those with language impairment but no ASD (SLI; N = 25). Results: Children with ALI did not show more current autistic symptoms than those with ANL. Children with SLI were well below the threshold for ASD. Their social adaptation was higher than the ASD groups, but still nearly 2 SD below average. In ALI the combination of ASD and language impairment was associated with weaker functional communication and more severe receptive language difficulties than those found in SLI. Receptive and expressive language were equally impaired in ALI, whereas in SLI receptive language was stronger than expressive. Conclusions: Co‐occurrence of ASD and language impairment is not associated with increased current autistic symptomatology but appears to be associated with greater impairment in receptive language and functional communication.     

Social and emotional adjustment of siblings of children with autism

BACKGROUND: Social and emotional adjustment of siblings of children with autism was examined, to explore their risk or resilience to effects of genetic liability and environmental factors involved in having a sibling with autism. METHOD: Social-emotional adjustment, behavior problems, socialization skills, and siblings' relationships were compared among 30 siblings of children with autism, 28 siblings of children with mental retardation of unknown genetic etiology (MR), and 30 siblings of children with developmental language disorders (DLD). Groups were matched by probands' gender, siblings' chronological age, gender, IQ, and birth order, and by family size, ethnicity, and parental income, employment, and stress level. RESULTS: Four siblings of children with autism, three siblings of children with MR, and seven siblings of children with DLD received DSM-IV diagnoses. Nevertheless, most of the siblings were well adjusted. CONCLUSIONS: The adjustment of siblings of children with autism is in sharp contrast to the severe social and emotional disabilities characteristic of autism, and is noteworthy considering the stress involved in having a sibling with autism.