Multimodal Sensory Integration for Perception and Action in High Functioning Children with Autism Spectrum Disorder

Movement disorders are the earliest observed features of autism spectrum disorder (ASD) present in infancy. Yet we do not understand the neural basis for impaired goal-directed movements in this population. To reach for an object, it is necessary to perceive the state of the arm and the object using multiple sensory modalities (e.g. vision, proprioception), to integrate those sensations into a motor plan, to execute the plan, and to update the plan based on the sensory consequences of action. In this dissertation, I present three studies in which I recorded hand paths of children with ASD and typically developing (TD) controls as they grasped the handle of a robotic device to control a cursor displayed on a video screen. First, participants performed discrete and continuous movements to capture targets. Cursor feedback was perturbed from the hand\u27s actual position to introduce visuo-spatial conflict between sensory and proprioceptive feedback. Relative to controls, children with ASD made greater errors, consistent with deficits of sensorimotor adaptive and strategic compensations. Second, participants performed a two-interval forced-choice discrimination task in which they perceived two movements of the visual cursor and/or the robot handle and then indicated which of the two movements was more curved. Children with ASD were impaired in their ability to discriminate movement kinematics when provided visual and proprioceptive information simultaneously, suggesting deficits of visuo-proprioceptive integration. Finally, participants made goal-directed reaching movements against a load while undergoing simultaneous functional magnetic resonance imaging (MRI). The load remained constant (predictable) within an initial block of trials and then varied randomly within four additional blocks. Children with ASD exhibited greater movement variability compared to controls during both constant and randomly-varying loads. MRI analysis identified marked differences in the extent and intensity of the neural activities supporting goal-directed reaching in children with ASD compared to TD children in both environmental conditions. Taken together, the three studies revealed deficits of multimodal sensory integration in children with ASD during perception and execution of goal-directed movements and ASD-related motor performance deficits have a telltale neural signature, as revealed by functional MR imaging

Simultaneous Robotic Manipulation and Functional Magnetic Resonance Imaging: Feasibility in Children with Autism Spectrum Disorders

An unanswered question concerning the neural basis of autism spectrum disorders (ASD) is how sensorimotor deficits in individuals with ASD are related to abnormalities of brain function. We previously described a robotic joystick and video game system that allows us to record functional magnetic resonance images (FMRI) while adult humans make goal- directed wrist motions. We anticipated several challenges in extending this approach to studying goal-directed behaviors in children with ASD and in typically developing (TYP) children. In particular we were concerned that children with autism may express increased levels of anxiety as compared to typically developing children due to the loud sounds and small enclosed space of the MRI scanner. We also were concerned that both groups of children might become restless during testing, leading to an unacceptable amount of head movement. Here we performed a pilot study evaluating the extent to which autistic and typically developing children exhibit anxiety during our experimental protocol as well as their ability to comply with task instructions. Our experimental controls were successful in minimizing group differences in drop-out due to anxiety. Kinematic performance and head motion also were similar across groups. Both groups of children engaged cortical regions (frontal, parietal, temporal, occipital) while making goal- directed movements. In addition, the ASD group exhibited task- related correlations in subcortical regions (cerebellum, thalamus), whereas correlations in the TYP group did not reach statistical significance in subcortical regions. Four distinct regions in frontal cortex showed a significant group difference such that TYP children exhibited positive correlations between the hemodynamic response and movement, whereas children with ASD exhibited negative correlations. These findings demonstrate feasibility of simultaneous application of robotic manipulation and functional imaging to study goal-directed motor behaviors in autistic and typically developing children. The findings also suggest the presence of marked changes in neural activation during a sensorimotor task requiring goal- directed movement