START THAT COEXISTENCE: THREE STUDIES OF PARENT RESPONSIVENESS TO CHILDREN WITH OR AT-RISK FOR AUTISM SPECTRUM DISORDER

This dissertation includes three studies of parent responsiveness to children with or at-risk for autism spectrum disorder (ASD). The first study examined the usefulness of a rating system compared with a coding system to measure parent responsiveness in an intervention study for toddlers at-risk for ASD. Two issues were examined: (a) correlations between parent responsiveness measured by the coding and rating systems; and (b) the sensitivity of the coding and rating systems to group changes in responsiveness. The coding and rating systems were significantly correlated on domains of responsiveness and affect, but not achievement or directiveness. Parents in the intervention group increased more in responsivity from entry to follow-up than parents in the control group as measured by the coding system, but not the rating system. The purpose of the second and third studies was twofold: (a) to examine the success of a parent responsiveness intervention (Adapted Responsive Teaching) for improving the social-communication of young children with ASD from Spanish-speaking families; and (b) to explore the caregivers' perspectives about the feasibility and acceptability of this intervention. The second study used a combined multiple baseline across participants and behaviors design. Baseline data were collected on social-communication behaviors for three Hispanic children with ASD (age range in years and months was 2.9 - 4.4). In the intervention, parents were taught responsiveness strategies to improve their child's social-communication. Treatment effects were demonstrated in: (a) two out of three children and (b) four out of seven targeted behaviors. These results provide moderate evidence for the ART intervention's effectiveness at improving social-communication in Hispanic children with ASD. In the third study, semi-structured interviews were completed with the children's parents before and after participating in the intervention. Qualitative analysis was used explore themes in these families' experiences. Overall, parents perceived that the parent responsiveness intervention was feasible and acceptable for their families, and felt that it would also be applicable to other Hispanic families of children with ASD. Families' perceptions about early interventions seemed to depend on how well the intervention (a) addressed the families' concerns and priorities and (b) incorporated the families' strengths.Doctor of Philosoph

Predictors of Parent Responsiveness to 1-Year-Olds At-Risk for Autism Spectrum Disorder

Parent responsiveness is critical for child development of cognition, social-communication, and self-regulation. Parents tend to respond more frequently when children at-risk for autism spectrum disorder (ASD) demonstrate stronger social-communication; however, it is unclear how responsiveness is associated with sensory characteristics of children at-risk for ASD. To address this issue, we examined the extent to which child social-communication and sensory reactivity patterns (i.e., hyper- and hypo-reactivity) predicted parent responsiveness to 1-year-olds at-risk for ASD in a community sample of 97 parent-infant pairs. A combination of child social-communication and sensory hypo-reactivity consistently predicted how parents played and talked with their 1-year-old at-risk for ASD. Parents tended to talk less and use more play actions when infants communicated less and demonstrated stronger hypo-reactivity

Late Positive Potential ERP Responses to Social and Nonsocial Stimuli in Youth with Autism Spectrum Disorder

We examined the late positive potential (LPP) event related potential in response to social and nonsocial stimuli from 9-19 years old youth with (n = 35) and without (n = 34) ASD. Social stimuli were faces with positive expressions and nonsocial stimuli were related to common restricted interests in ASD (e.g., electronics, vehicles, etc.). The ASD group demonstrated relatively smaller LPP amplitude to social stimuli and relatively larger LPP amplitude to nonsocial stimuli. There were no group differences in subjective ratings of images, and there were no significant correlations between LPP amplitude and ASD symptom severity within the ASD group. LPP results suggest blunted motivational responses to social stimuli and heightened motivational responses to nonsocial stimuli in youth with ASD

Neural mechanisms of negative reinforcement in children and adolescents with autism spectrum disorders

Abstract Background Previous research has found accumulating evidence for atypical reward processing in autism spectrum disorders (ASD), particularly in the context of social rewards. Yet, this line of research has focused largely on positive social reinforcement, while little is known about the processing of negative reinforcement in individuals with ASD. Methods The present study examined neural responses to social negative reinforcement (a face displaying negative affect) and non-social negative reinforcement (monetary loss) in children with ASD relative to typically developing children, using functional magnetic resonance imaging (fMRI). Results We found that children with ASD demonstrated hypoactivation of the right caudate nucleus while anticipating non-social negative reinforcement and hypoactivation of a network of frontostriatal regions (including the nucleus accumbens, caudate nucleus, and putamen) while anticipating social negative reinforcement. In addition, activation of the right caudate nucleus during non-social negative reinforcement was associated with individual differences in social motivation. Conclusions These results suggest that atypical responding to negative reinforcement in children with ASD may contribute to social motivational deficits in this population

The effects of intranasal oxytocin on reward circuitry responses in children with autism spectrum disorder

Abstract Background Intranasal oxytocin (OT) has been shown to improve social communication functioning of individuals with autism spectrum disorder (ASD) and, thus, has received considerable interest as a potential ASD therapeutic agent. Although preclinical research indicates that OT modulates the functional output of the mesocorticolimbic dopamine system that processes rewards, no clinical brain imaging study to date has examined the effects of OT on this system using a reward processing paradigm. To address this, we used an incentive delay task to examine the effects of a single dose of intranasal OT, versus placebo (PLC), on neural responses to social and nonsocial rewards in children with ASD. Methods In this placebo-controlled double-blind study, 28 children and adolescents with ASD (age: M = 13.43 years, SD = 2.36) completed two fMRI scans, one after intranasal OT administration and one after PLC administration. During both scanning sessions, participants completed social and nonsocial incentive delay tasks. Task-based neural activation and connectivity were examined to assess the impact of OT relative to PLC on mesocorticolimbic brain responses to social and nonsocial reward anticipation and outcomes. Results Central analyses compared the OT and PLC conditions. During nonsocial reward anticipation, there was greater activation in the right nucleus accumbens (NAcc), left anterior cingulate cortex (ACC), bilateral orbital frontal cortex (OFC), left superior frontal cortex, and right frontal pole (FP) during the OT condition relative to PLC. Alternatively, during social reward anticipation and outcomes, there were no significant increases in brain activation during the OT condition relative to PLC. A Treatment Group × Reward Condition interaction revealed relatively greater activation in the right NAcc, right caudate nucleus, left ACC, and right OFC during nonsocial relative to social reward anticipation during the OT condition relative to PLC. Additionally, these analyses revealed greater activation during nonsocial reward outcomes during the OT condition relative to PLC in the right OFC and left FP. Finally, functional connectivity analyses generally revealed changes in frontostriatal connections during the OT condition relative to PLC in response to nonsocial, but not social, rewards. Conclusions The effects of intranasal OT administration on mesocorticolimbic brain systems that process rewards in ASD were observable primarily during the processing of nonsocial incentive salience stimuli. These findings have implications for understanding the effects of OT on neural systems that process rewards, as well as for experimental trials of novel ASD treatments developed to ameliorate social communication impairments in ASD

Neural Mechanisms of Reward Prediction Error in Autism Spectrum Disorder.

Few studies have explored neural mechanisms of reward learning in ASD despite evidence of behavioral impairments of predictive abilities in ASD. To investigate the neural correlates of reward prediction errors in ASD, 16 adults with ASD and 14 typically developing controls performed a prediction error task during fMRI scanning. Results revealed greater activation in the ASD group in the left paracingulate gyrus during signed prediction errors and the left insula and right frontal pole during thresholded unsigned prediction errors. Findings support atypical neural processing of reward prediction errors in ASD in frontostriatal regions critical for prediction coding and reward learning. Results provide a neural basis for impairments in reward learning that may contribute to traits common in ASD (e.g., intolerance of unpredictability).</p

Dynamic eye tracking as a predictor and outcome measure of social skills intervention in adolescents and adults with Autism Spectrum Disorder

To evaluate an eye tracking task as a predictor and outcome measure of treatment response for autism spectrum disorder (ASD) social skills interventions, adolescents and young adults with ASD completed the eye tracking task before, immediately after, and two months after completing Social Cognition and Interaction Training for Autism (SCIT-A). The study compared SCIT-A participants (n = 20) to participants with ASD who received treatment as usual (TAU; n = 21). Overall, increased visual attention to faces and background objects and decreased attention to hands playing with toys at baseline were associated with improved social functioning immediately following intervention, suggesting this eye tracking task may reliably predict ASD social intervention outcomes