Emotion Perception in Asperger\u27s Syndrome and High-functioning Autism: The Importance of Diagnostic Criteria and Cue Intensity

Asperger\u27s syndrome (AS) is a pervasive developmental disorder that is associated with marked social dysfunction. Deficits in the perception of nonverbal cues of emotion may be related to this social impairment. Research has indicated that children with autism are limited in their emotion perception abilities, but studies that have addressed this issue with individuals with AS or high-functioning autism (HFA) have yielded inconsistent findings. These inconsistencies may be related to methodological differences across studies including diagnostic criteria and failure to consider the intensity of the emotion cues. It was hypothesized that children with AS and HFA would both have deficits in emotion perception compared to typically-developing children. However, children with HFA were expected to have an even greater emotion perception deficit than children with AS and this difference was hypothesized to be most pronounced for low intensity cues of emotion. It is important to clarify whether individuals with AS and HFA differ in emotion perception because most studies of this skill combine them into one group or use poorly defined diagnostic criteria. This study examined the ability of 30 8- to 15-year-old children with either AS or HFA to perceive emotion from high and low intensity cues. In order to address limitations with the differential validity of the DSM-IV criteria for AS, diagnoses were based on diagnostic criteria proposed by Klin et al. (in press). A researcher who was blind to diagnosis administered a test that presented low and high intensity cues of emotion in photographs of facial expression and audiotapes of tone of voice. Comparison of the emotion perception accuracy of children with AS to the normative means of this instrument for typically-developing children did not reveal any significant differences. In contrast, the children with HFA were significantly less accurate in their perception of facial expressions and tone of voice than the normative sample and the participants with AS. Contrary to expectations, IQ was significantly related to emotion perception accuracy. After controlling for IQ, the difference in perception of facial expressions between children with AS and HFA was not significant. On the other hand, cue intensity moderated the relation between diagnosis and emotion perception accuracy for tone of voice even after IQ was taken into account. Children with AS perceived high and low intensity tone of voice cues with similar accuracy, but children with HFA had significantly poorer performance on the low intensity tone of voice cues. Although emotion perception accuracy was related to better adjustment, it was not correlated with the most sensitive measure of current social functioning. This suggests that even when children with AS or HFA perceive cues correctly, they may not know how or be able to properly integrate them for adaptive responses in social interaction. The findings have important implications for understanding inconsistencies in past research and identifying future directions

Future Directions for Research in Autism Spectrum Disorders

This article suggests future directions for research aimed at improved understanding of the etiology and pathophysiology of autism spectrum disorder (ASD) as well as pharmacologic and psychosocial interventions for ASD across the lifespan. The past few years have witnessed unprecedented transformations in the understanding of ASD neurobiology, genetics, early identification, and early intervention. However, recent increases in ASD prevalence estimates highlight the urgent need for continued efforts to translate novel ASD discoveries into effective interventions for all individuals with ASD. In this article we highlight promising areas for ongoing and new research expected to quicken the pace of scientific discovery and ultimately the translation of research findings into accessible and empirically supported interventions for those with ASD. We highlight emerging research in the following domains as particularly promising and pressing: (1) preclinical models; (2) experimental therapeutics; (3) early identification and intervention; (4) psychiatric comorbidities and the Research Domain Criteria (RDoC) initiative; (5) ecological momentary assessment; (6) neurotechnologies; and (7) the needs of adults with ASD. Increased research emphasis in these areas has the potential to hasten the translation of knowledge on the etiological mechanisms of ASD to psychosocial and biological interventions to reduce the burden of ASD on affected individuals and their families

The autism inpatient collection: Methods and preliminary sample description

© 2015 Siegel et al. Background: Individuals severely affected by autism spectrum disorder (ASD), including those with intellectual disability, expressive language impairment, and/or self-injurious behavior (SIB), are underrepresented in the ASD literature and extant collections of phenotypic and biological data. An understanding of ASD's etiology and subtypes can only be as complete as the studied samples are representative. Methods: The Autism Inpatient Collection (AIC) is a multi-site study enrolling children and adolescents with ASD aged 4-20 years admitted to six specialized inpatient psychiatry units. Enrollment began March, 2014, and continues at a rate of over 400 children annually. Measures characterizing adaptive and cognitive functioning, communication, externalizing behaviors, emotion regulation, psychiatric co-morbidity, self-injurious behavior, parent stress, and parent self-efficacy are collected. ASD diagnosis is confirmed by the Autism Diagnostic Observation Schedule - 2 (ADOS-2) and extensive inpatient observation. Biological samples from probands and their biological parents are banked and processed for DNA extraction and creation of lymphoblastoid cell lines. Results: Sixty-one percent of eligible subjects were enrolled. The first 147 subjects were an average of 12.6 years old (SD 3.42, range 4-20); 26.5 % female; 74.8 % Caucasian, and 81.6 % non-Hispanic/non-Latino. Mean non-verbal intelligence quotient IQ = 70.9 (SD 29.16, range 30-137) and mean adaptive behavior composite score = 55.6 (SD 12.9, range 27-96). A majority of subjects (52.4 %) were non- or minimally verbal. The average Aberrant Behavior Checklist - Irritability Subscale score was 28.6, well above the typical threshold for clinically concerning externalizing behaviors, and 26.5 % of the sample engaged in SIB. Females had more frequent and severe SIB than males. Conclusions: Preliminary data indicate that the AIC has a rich representation of the portion of the autism spectrum that is understudied and underrepresented in extant data collections. More than half of the sample is non- or minimally verbal, over 40 % have intellectual disability, and over one quarter exhibit SIB. The AIC is a substantial new resource for study of the full autism spectrum, which will augment existing data on higher-functioning cohorts and facilitate the identification of genetic subtypes and novel treatment targets. The AIC investigators welcome collaborations with other investigators, and access to the AIC phenotypic data and biosamples may be requested through the Simons Foundation (www.sfari.org)

Irritability in youth: A critical integrative review

Irritability, defined as proneness to anger that may reach an impairing extent, is common in youth. There has been a recent upsurge in relevant research. We combine systematic and narrative review approaches to integrate the latest clinical and translational findings and provide suggestions to address research gaps. Clinicians and researchers should assess irritability routinely; specific assessment tools are now available. Informant effects are prominent, stable, and vary by age and gender. The prevalence of irritability is particularly high in attention deficit hyperactivity disorder, autism spectrum disorder, and mood and anxiety disorders. Irritability is associated with impairment and suicidality risk independent of co-occurring diagnoses. Irritability trajectories have been identified that are differentially associated with clinical outcomes; some begin early in life. Youth irritability is associated with increased risk later in life for anxiety, depression, behavioral problems, and suicidality. Irritability is moderately heritable and genetic associations differ based on age and comorbid illnesses. Parent management training is effective for constructs related to irritability, but its efficacy in irritability should be tested rigorously, as should novel mechanism-informed interventions (e.g., those targeted to frustration exposure). Associations between irritability and suicidality and the impact of cultural context are important, under-researched topics. Large, diverse, longitudinal samples that extend into adulthood are needed. Data from both animal and human research indicate that aberrant responses to frustration and threat are central to the pathophysiology of irritability, thus affording important translational opportunities

Problem behaviors in autism spectrum disorder: association with verbal ability and adapting/coping skills.

Data from the Autism Inpatient Collection was used to examine the relationship between problem behaviors and verbal ability, which have generally, though not universally, been highly associated. In a comparison of 169 minimally-verbal and 177 fluently-verbal 4 to 20-year-old psychiatric inpatients with ASD, the severity of self-injurious behavior, stereotyped behavior, and irritability (including aggression and tantrums) did not significantly differ, when controlling for age and NVIQ. Verbal ability was not strongly related to the severity of problem behaviors. However, lower adapting/coping scores were significantly associated with increasing severity of each type of problem behavior, even when accounting for verbal ability. Interventions to develop adapting/coping mechanisms may be important for mitigation of problem behaviors across the spectrum of individuals with ASD

YOWB: Supporting Mental and Physical Wellbeing in Autistic Adults through Community-Based Mindful Movement

Autistic adults experience greater mental, emotional, and physical health (MEPH) challenges and engage in less physical activity than non-autistic adults. One approach to supporting MEPH is yoga or mindful movement (MM). The aim of this teaming project is to develop and evaluate a community-based MM program with and for autistic adults to support their MEPH. In phase one, we will create a development team consisting of 1) our community partner, Open Up Pittsburgh (OUP); 2) autistic adults who currently participate in OUP’s MM programming; and 3) an interdisciplinary team of University of Pittsburgh researchers specializing in autism and MEPH. The development team will use a mixed methods approach to gather evidence on the features of OUP’s ongoing MM classes that are most beneficial for supporting MEPH in autistic adults, and use the findings to develop a MM program specifically for supporting autistic adults’ MEPH. In phase two, the pilot MM program will be tested at OUP in a randomized waitlist-controlled trial. Further, we aim to develop a program that is a) manualized, b) feasible to implement in-person and online, c) rigorously evaluated for potential effectiveness, and d) highly likely to attract follow-on external funding

AUT703090_Lay_Abstract – Supplemental material for The combined impact of social support and perceived stress on quality of life in adults with autism spectrum disorder and without intellectual disability

<p> Supplemental material, AUT703090_Lay_Abstract for The combined impact of social support and perceived stress on quality of life in adults with autism spectrum disorder and without intellectual disability by Lauren Bishop-Fitzpatrick, Carla A Mazefsky and Shaun M Eack in Autism </p

The emotion dysregulation inventory: Psychometric properties and item response theory calibration in an autism spectrum disorder sample.

Individuals with autism spectrum disorder (ASD) often present with prominent emotion dysregulation that requires treatment but can be difficult to measure. The Emotion Dysregulation Inventory (EDI) was created using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS LAY SUMMARY: This paper describes a new measure of poor emotional control called the Emotion Dysregulation Inventory (EDI). Caregivers of 1,755 youth with ASD completed candidate items, and advanced statistical techniques were applied to identify the best final items. The EDI is unique because it captures common emotional problems in ASD and is appropriate for both nonverbal and verbal youth. It is an efficient and sensitive measure for use in clinical assessments, monitoring, and research with youth with ASD