Update about "minimally verbal" children with autism spectrum disorder.

OBJECTIVE: To review clinical and neurobiological features of minimally verbal children with autism spectrum disorder. DATA SOURCE: We carried out a narrative review using the PubMed database. We considered the following search terms combined through the Boolean operator "AND": "autism spectrum disorder"; "minimally verbal." DATA SYNTHESIS: To date, there is no shared definition of minimally verbal children with autism spectrum disorder. The heterogeneity in intellectual functioning and in linguistic abilities among these individuals suggests there is no single mechanism underlying their difficulties in learning to speak. However, the reasons why these children do not speak and the biological markers that can identify them are still unknown. Language impairment in these children can lead to several unfavorable consequences, including behavior problems (such as self-aggression, hetero-aggression, and property destruction), poorer daily living and social skills. Psychiatric comorbidities (including attention deficit/hyperactivity disorder, specific phobias, and compulsions) consist in a serious problem related to the lack of verbal language in individuals with autism spectrum disorder. Although in the literature there are very few evidence-based results, several findings suggest that an alternative and augmentative communication intervention, creating an extra-verbal communication channel, may be effective in these individuals. CONCLUSIONS: The exact definition, clinical characteristics, associated disorders, etiology, and treatment of minimally verbal subjects with autism spectrum disorder must still be further studied and understood

An Observational Study With the Janssen Autism Knowledge Engine (JAKE((R))) in Individuals With Autism Spectrum Disorder

Objective: The Janssen Autism Knowledge Engine (JAKE(R)) is a clinical research outcomes assessment system developed to more sensitively measure treatment outcomes and identify subpopulations in autism spectrum disorder (ASD). Here we describe JAKE and present results from its digital phenotyping (My JAKE) and biosensor (JAKE Sense) components. Methods: An observational, non-interventional, prospective study of JAKE in children and adults with ASD was conducted at nine sites in the United States. Feedback on JAKE usability was obtained from caregivers. JAKE Sense included electroencephalography, eye tracking, electrocardiography, electrodermal activity, facial affect analysis, and actigraphy. Caregivers of individuals with ASD reported behaviors using My JAKE. Results from My JAKE and JAKE Sense were compared to traditional ASD symptom measures. Results: Individuals with ASD (N = 144) and a cohort of typically developing (TD) individuals (N = 41) participated in JAKE Sense. Most caregivers reported that overall use and utility of My JAKE was easy (69%, 74/108) or very easy (74%, 80/108). My JAKE could detect differences in ASD symptoms as measured by traditional methods. The majority of biosensors included in JAKE Sense captured sizable amounts of quality data (i.e., 93-100% of eye tracker, facial affect analysis, and electrocardiogram data was of good quality), demonstrated differences between TD and ASD individuals, and correlated with ASD symptom scales. No significant safety events were reported. Conclusions: My JAKE was viewed as easy or very easy to use by caregivers participating in research outside of a clinical study. My JAKE sensitively measured a broad range of ASD symptoms. JAKE Sense biosensors were well-tolerated. JAKE functioned well when used at clinical sites previously inexperienced with some of the technologies. Lessons from the study will optimize JAKE for use in clinical trials to assess ASD interventions. Additionally, because biosensors were able to detect features differentiating TD and ASD individuals, and also were correlated with standardized symptom scales, these measures could be explored as potential biomarkers for ASD and as endpoints in future clinical studies. Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT02668991 identifier: NCT02668991

An Observational Study With the Janssen Autism Knowledge Engine (JAKE®) in Individuals With Autism Spectrum Disorder

Objective: The Janssen Autism Knowledge Engine (JAKE®) is a clinical research outcomes assessment system developed to more sensitively measure treatment outcomes and identify subpopulations in autism spectrum disorder (ASD). Here we describe JAKE and present results from its digital phenotyping (My JAKE) and biosensor (JAKE Sense) components.Methods: An observational, non-interventional, prospective study of JAKE in children and adults with ASD was conducted at nine sites in the United States. Feedback on JAKE usability was obtained from caregivers. JAKE Sense included electroencephalography, eye tracking, electrocardiography, electrodermal activity, facial affect analysis, and actigraphy. Caregivers of individuals with ASD reported behaviors using My JAKE. Results from My JAKE and JAKE Sense were compared to traditional ASD symptom measures.Results: Individuals with ASD (N = 144) and a cohort of typically developing (TD) individuals (N = 41) participated in JAKE Sense. Most caregivers reported that overall use and utility of My JAKE was “easy” (69%, 74/108) or “very easy” (74%, 80/108). My JAKE could detect differences in ASD symptoms as measured by traditional methods. The majority of biosensors included in JAKE Sense captured sizable amounts of quality data (i.e., 93–100% of eye tracker, facial affect analysis, and electrocardiogram data was of good quality), demonstrated differences between TD and ASD individuals, and correlated with ASD symptom scales. No significant safety events were reported.Conclusions: My JAKE was viewed as easy or very easy to use by caregivers participating in research outside of a clinical study. My JAKE sensitively measured a broad range of ASD symptoms. JAKE Sense biosensors were well-tolerated. JAKE functioned well when used at clinical sites previously inexperienced with some of the technologies. Lessons from the study will optimize JAKE for use in clinical trials to assess ASD interventions. Additionally, because biosensors were able to detect features differentiating TD and ASD individuals, and also were correlated with standardized symptom scales, these measures could be explored as potential biomarkers for ASD and as endpoints in future clinical studies.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT02668991 identifier: NCT0266899

Investigation Into the Physical Environmental Correlates of Aggressive Behaviour in Children with Neurodevelopmental Disorders (NDDs)

Background: Physical environmental influences on childhood aggression in children with neurodevelopmental disabilities is a severely under-researched research locus. The aim of this doctorate was to elucidate specific associations between children’s developmental environment and aggressive behaviours, using this evidence to reciprocally inform an experimental psychology project to investigate underlying mechanisms. To explore these effects, the programme of study was broadly divided into three reflexive workstreams using diverse research methodologies. Methods: In the first workstream, I conducted a systematic review of the current literature examining physical environmental influences on childhood aggressive behaviours in both typically developing children (aged 0 – 18) and those diagnosed with NDDs. The literature on children with NDDs was substantially limited in comparison to peers without NDDs. The second workstream was comprised of a large-scale secondary data analysis (multiply imputed growth curve modelling) to investigate environmental influences on conduct problems across early development. I used data from the Millennium Cohort Study (MCS) to assess how physical environmental metrics, such as neighbourhood greenspace, air pollution, household crowding, and presence of home damp influenced the development and severity of conduct problems in children with (n=8013) and without NDDs (n=155) between the ages of 3 – 11 years. Finally, building upon evidence from the previous two workstreams, I designed a proof-of-principle psychological experiment to examine the influence of urban nature exposure on children with NDDs. Specifically, simulating a real-world urban greenspace using a Person-Environment-Activity Research Laboratory (PEARL). This facilitated the ability to manipulate and isolate individual environmental aspects of urban nature exposure (light, sound, and projection). Following ethical review and approval, I recruited 3 children (100% male) with mild and moderate intellectual disability aged between 12 – 15 years (Mean age = 14) attending a local school for children with special educational needs. We examined their physiological reactions to four simulated urban green space aspects (light, sound, landscape projections, and vegetation) against a baseline control condition. I also collected demographic information on parent reported aggressive behaviours, exposure to local greenspace(s), physical and mental health history, medication, and adaptive behaviours (ABAS-3). This research lays the foundation for future large scale experimental paradigms that can disentangle the effects of nature exposure in these children, with the aim of translating these findings into real world therapeutic design interventions and relevant policy changes to improve the quality of the built environment for these children. Findings: From articles retrieved from my systematic review I found evidence for the beneficial influences of nature in both populations, and simultaneously negative effects of both noise and air pollution in typically developing children only. Evidence for other environmental aspects such as crowding, music, urbanicity, meteorology, and interior design had either insufficient or inconsistent evidence to extrapolate concreate conclusions. More evidence on the effect of these exposures on child aggression outcomes is recommended. From the analysis of the MCS cohort I found various sociodemographic factors (ethnicity, sex, poverty, family structure, maternal distress) and internal residential conditions were associated with increased childhood conduct problem trajectories in both groups of children. I also discovered potential evidence of a moderating influence effect of intellectual disability on the relationship between spatial density and conduct problems. From the final experimental project, I report preliminary evidence for the influence of urban greenspaces to reduce physiological arousal in children with complex neurodisability profiles. Initial evidence for the hierarchical nature of urban greenspace sensorial aspects was reported, for example: that urban nature soundscapes maybe a more influential environmental stimuli than lighting or landscape projections. Conclusion: Drawing together multi-disciplinary research methodologies facilitated the ability to identify disparities in research examining physical environmental determinants of aggression in neurodiverse child populations. Reciprocally, the systematic review and secondary data analysis contributed incrementally to filling this lacuna of research. Using findings from these two work streams, I identified that exploring the potentially therapeutic influences of urban nature exposure on children with neurodevelopmental disorders may provide novel indicators of its aetiological mechanisms. I reported original findings supporting these research aims, elucidating the potential hierarchical nature of urban greenspace elements. This was also the first study of its kind reporting the potential for simulated urban park spaces to reduce physiological arousal in neurodivergent children with aggressive behavioural difficulties

Pilot study for subgroup classification for autism spectrum disorder based on dysmorphology and physical measurements in Chinese children

Poster Sessions: 157 - Comorbid Medical Conditions: abstract 157.058 58BACKGROUND: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder affecting individuals along a continuum of severity in communication, social interaction and behaviour. The impact of ASD significantly varies amongst individuals, and the cause of ASD can originate broadly between genetic and environmental factors. Objectives: Previous ASD researches indicate that early identification combined with a targeted treatment plan involving behavioural interventions and multidisciplinary therapies can provide substantial improvement for ASD patients. Currently there is no cure for ASD, and the clinical variability and uncertainty of the disorder still remains. Hence, the search to unravel heterogeneity within ASD by subgroup classification may provide clinicians with a better understanding of ASD and to work towards a more definitive course of action. METHODS: In this study, a norm of physical measurements including height, weight, head circumference, ear length, outer and inner canthi, interpupillary distance, philtrum, hand and foot length was collected from 658 Typical Developing (TD) Chinese children aged 1 to 7 years (mean age of 4.19 years). The norm collected was compared against 80 ASD Chinese children aged 1 to 12 years (mean age of 4.36 years). We then further attempted to find subgroups within ASD based on identifying physical abnormalities; individuals were classified as (non) dysmorphic with the Autism Dysmorphology Measure (ADM) from physical examinations of 12 body regions. RESULTS: Our results show that there were significant differences between ASD and TD children for measurements in: head circumference (p=0.009), outer (p=0.021) and inner (p=0.021) canthus, philtrum length (p=0.003), right (p=0.023) and left (p=0.20) foot length. Within the 80 ASD patients, 37(46%) were classified as dysmorphic (p=0.00). CONCLUSIONS: This study attempts to identify subgroups within ASD based on physical measurements and dysmorphology examinations. The information from this study seeks to benefit ASD community by identifying possible subtypes of ASD in Chinese population; in seek for a more definitive diagnosis, referral and treatment plan.published_or_final_versio

Psychology

Psychology is designed to meet scope and sequence requirements for the single-semester introduction to psychology course. The book offers a comprehensive treatment of core concepts, grounded in both classic studies and current and emerging research. The text also includes coverage of the DSM-5 in examinations of psychological disorders. Psychology incorporates discussions that reflect the diversity within the discipline, as well as the diversity of cultures and communities across the globe.https://commons.erau.edu/oer-textbook/1000/thumbnail.jp