Lay Abstract

Improvement in Social Deficits in Autism Spectrum Disorders Using a Theatre-Based, Peer-Mediated Intervention

Blythe A. Corbett, Deanna M. Swain, Catherine Coke, David Simon, Cassandra Newsom, Nea Houchins-Juarez, Ashley Jenson, Lily Wang, and Yanna Song


Social Emotional NeuroScience Endocrinology Theatre is a novel intervention program aimed at improving social interaction in youth with autism spectrum disorder (ASD) using behavioral and theatrical techniques. Previous research using a 3-month model showed improvement in face perception, social interaction, and reductions in stress. The current study assessed a 2-week summer camp model. Typically developing peers were trained and paired with 8- to 17-year-old youth with ASD. Social perception and interaction skills were measured before and after treatment using neuropsychological and parental measures. Behavior coding by reliable and independent raters was conducted within the theatre context and in a playground setting. Salivary cortisol levels were used to assess the physiological arousal of the participants in multiple contexts. Significant differences were found in face processing, social awareness, and social cognition. Duration of interaction with familiar peers increased significantly over the course of treatment. Cortisol levels rose on the first day of camp when compared with home values, but declined by the end of treatment and during posttreatment play with peers. The results corroborate previous findings that a peer-mediated theatre program model contributes to improvement in core social deficits in ASDs. Future studies will explore treatment length and peer familiarity as factors in optimizing and generalizing gains. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 4–16. DOI: 10.1002/aur.1341

Autonomic Responses to Social and Nonsocial Pictures in Adolescents With Autism Spectrum Disorders

Anneke Louwerse, Joke H. M. Tulen, Jos N. van der Geest, Jan van der Ende, Frank C. Verhulst, and Kirstin Greaves-Lord


Individuals with an autism spectrum disorder (ASD) tend to respond differently to other people. They look less at faces and seem to avoid eye contact with others. It remains unclear why individuals with ASD show atypical behavior during social interactions. A possible explanation is that individuals with ASD experience higher levels of autonomic activity (e.g. increased heart rate or increased transpiration) in response to other people. This study investigated these autonomic responses and the subjective experiences of individuals with ASD and controls when they looked at pictures with and without a social content (i.e. with and without humans depicted on the pictures). The pictures varied in pleasantness (pleasant, neutral, and unpleasant). The results of this study showed that, for both adolescents with and without ASD, affective social pictures triggered higher levels of transpiration than neutral social pictures. For nonsocial pictures, no differences among pleasant, neutral, and unpleasant pictures were found in transpiration levels. Unpleasant pictures, both with and without a social content, showed more heart rate deceleration than neutral pictures. The social and affective content of a picture influenced self-reported arousal ratings. However, no differences were found between adolescents with ASD and controls in their autonomic and subjective responses to the six categories. Our findings make it less likely that the often noted abnormal social behavior of individuals with ASD can be explained by atypical autonomic responses to social vs. nonsocial stimuli. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 17–27. DOI: 10.1002/aur.1327

Do Children With Autism Re-Enact Object Movements Rather Than Imitate Demonstrator Actions?

Deborah M. Custance, Jennifer L. Mayer, Emmelianna Kumar, Elisabeth Hill, and Pamela F. Heaton


Children with autism often exhibit imitative deficits. Because imitation is a quintessentially social activity, it is unsurprising that research suggests that children with autism rarely spontaneously imitate the actions of others. Interestingly, it has been suggested that autism-specific deficits in imitation may be reduced or spared in the context of copying actions on or with objects. However, most previous research has not sufficiently distinguished learning about object movements from learning about the topography of demonstrated actions. Twenty children with autism and 20 typically developing children were presented with six sets of puzzle objects. Test objects and experimental conditions were designed to isolate object- and action-related aspects of demonstrations. There were four types of video demonstrations: (a) a full demonstration by an adult; (b) a ghost demonstration with object movements alone; (c) mimed solutions with demonstrator actions alone; and (d) random actions performed on the surface of the objects. Although there was no evidence of an autism-specific imitative deficit, further analyses were conducted to explore the degree to which diagnosis, verbal intelligence quotient, nonverbal intelligence quotient,, age and motor coordination predicted matching scores and times to solution. These results are discussed in relation to the nature of the goals or rewards used in object-related tasks, and the interplay between motor coordination and the relative rigidity vs. pliability of objects. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 28–39. DOI: 10.1002/aur.1328

Age and Sensory Processing Abnormalities Predict Declines in Encoding and Recall of Temporally Manipulated Speech in High-Functioning Adults with ASD

Jennifer L. Mayer and Pamela F. Heaton


Individuals with autism spectrum disorder (ASD) experience temporal and perceptual processing abnormalities that are likely to impact their speech perception, and difficulties in processing fast speech may be linked to impaired language development. Research carried out with typically developing (TD) adults has shown that word recall declines in response to increases in the speed of speech, and it was predicted that the magnitude of these effects would be far greater in those with ASD. Nineteen high-functioning adults with ASD, and age- and intelligence-matched TD controls performed verbatim recall of sentences with fast speech. Reduced levels of word recall in response to fast speech were observed, and this effect increased with age in the ASD group. While increased communication and sensory processing abnormalities were associated with decreased recall of fast speech in the ASD group, the most striking finding was that the effect of age had a far greater impact on performance in the ASD group than in controls. Auditory processing deficits in ASD may be indicative of an association with the sensory abnormalities and social and communication impairments characterizing the disorder. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 40–49. DOI: 10.1002/aur.1333

The McGurk Effect in Children With Autism and Asperger Syndrome

James M. Bebko, Jessica H. Schroeder, and Jonathan A. Weiss


Children with autism may have difficulties putting together what they see and hear during speech, which has been linked to understanding of speech and language development. However, little has been done to examine children with Asperger syndrome as a group on tasks assessing integration of what is seen and heard during speech, despite this group's often greater language skills. Samples of children with autism, Asperger Syndrome, and Down syndrome, as well as a typically developing sample, were presented with an auditory-only condition, a speech-reading condition, and an audiovisual condition that involved mismatching auditory and visual signals. Children with autism demonstrated auditory-only and speech-reading performance at the same level as the other groups, yet showed a lower performance on the audiovisual condition compared with the Asperger, Down, and typical samples. These results suggest that children with autism may have unique difficulties integrating what is seen and heard during speech perception that may be linked to how they mentally representation speech sounds. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 50–59. DOI: 10.1002/aur.1343

Analysis of Fmr1 Deletion in a Subpopulation of Post-Mitotic Neurons in Mouse Cortex and Hippocampus

Anahita Amiri, Efrain Sanchez-Ortiz, Woosung Cho, Shari G. Birnbaum, Jing Xu, Renée M. McKay, and Luis F. Parada


Fragile X syndrome (FXS) is the most common form of inherited mental retardation and considered a leading genetic cause of autism. FXS is caused by a single-gene mutation in FMR1, which is expressed in neurons and has a role in neuronal development and function. Mice FMR1 gene function by mutation has been used as a model to study FXS. These mice have been reported to show a great degree of phenotypic variability based on the genetic background, environmental signals, and experimental methods. In this study, we deleted FMR1 gene in two brain regions (hippocampus and cortex) that have been implicated in FXS and autism. We show that ablating Fmr1 in mature neurons results in morphological and molecular changes that are brain region specific. However, these mice display no apparent behavioral phenotypes. These results highlight the importance of identifying additional factors that interact with Fmr1 to develop FXS. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 60–71. DOI: 10.1002/aur.1342

Do Individuals with and without Autism Spectrum Disorder Scan Faces Differently? A New Multi-Method Look at an Existing Controversy

Li Yi, Cong Feng, Paul C. Quinn, Haiyan Ding, Jiao Li, Yubing Liu, and Kang Lee


Individuals with autism spectrum disorder (ASD) are known to have deficits in face processing. However, previous studies reported conflicting results about whether ASD individuals also scan faces differently from typical individuals. We compared face scanning patterns of 19 young adults with ASD to 28 typically developing (TD) controls and 22 intellectually disabled (ID) but non-ASD individuals in a face recognition task, while their eye movements were recorded by an eye tracker. We used both traditional and state-of-the-art data analytic methods. We found that ASD individuals looked significantly shorter at the right eye than TD and ID individuals. Detailed analyses revealed that individuals with ASD looked more at the central nasal area than TD and ID individuals. These findings suggest the atypical face-scanning patterns in ASD were shown to be limited to fixations on the eyes and nose. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 72–83. DOI:10.1002/aur.1340

Cognitive Perspective-Taking During Scene Perception in Autism Spectrum Disorder: Evidence From Eye Movements

Sheena K. Au-Yeung, Johanna K. Kaakinen, and Valerie Benson


The present study investigates the differences between adults with autism spectrum disorders (ASD) and typically developing (TD) adults in the way they viewed scenes when they are required to take on the psychological perspective of another person. Participants had their eye movements recorded while they looked at some pictures of household scenes after being instructed to “imagine that you are a burglar” or “imagine that you are a repairman.” They also completed a non-perspective-taking control task in which they were asked to “look for the valuable items” or “look for the features of the house that need fixing” in another set of household scenes. No differences between the two groups were found for the burglar task and the non-perspective-taking equivalent “look for the valuable items” task. However, eye movements showed that participants with ASD were initially slower than TD participants to look to the relevant parts of a scene during the repairman task and the non-perspective-taking equivalent “look for the features of the house that need fixing” task. The subtle processing difference between our two groups is reflected in the patterns of eye movements, and we think that it is the ambiguity of relevant target items for the repairman and its non-perspective equivalent task that is driving the difficulty experienced by participants with ASD. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 84–93. DOI: 10.1002/aur.1352

Increased Prepulse Inhibition and Sensitization of the Startle Reflex in Autistic Children

Gitte Falcher Madsen, Niels Bilenberg, Cathriona Cantio, and Bob Oranje


There is increasing evidence of common neurobiological pathways in autism spectrum disorders (ASD) and schizophrenia, which is why any relation between the two is a matter of debate. As the diagnostic categories of autism and schizophrenia have both broadened over the years, this potential overlap between the two disorders has become increasingly relevant. The ability to filter and process sensory information successfully in the brain is an important feature in healthy individuals. Deficits in this sensory filtering have been demonstrated in schizophrenic patients, which may lead to an overflow of higher brain functions, and ultimately to the formation of psychoses. Our study aimed to examine whether schizophrenia-like deficits in auditory filtering could also be demonstrated in children with ASD, or specifically in diagnostic subcategories (According to DSM-IV-TR autistic disorder, Asperger's syndrome, or pervasive developmental disorder not otherwise specified [PDD-NOS]). We found no such schizophrenia-like deficits in ASD children. However, compared with healthy controls, the study showed that children with ASD processed very low-intensity stimuli and showed increased sensitization, that is an increase in response to the same stimuli over time. The sensitization correlated with parent-rated anxiety scores on the Child Behavior Checklist in the ASD subgroup PDD-NOS. Our results appear to reflect hypersensitivity in children with ASD to sensory information, a clinical trait that has been included in the DSM-V diagnostic criteria. © 2013 INSAR/Wiley Periodicals, Inc.

Article Citation: Autism Res 2014, 7: 94–103. DOI: 10.1002/aur.1337

Self-Rated Social Skills Predict Visual Perception: Impairments in Object Discrimination Requiring Transient Attention Associated with High Autistic Tendency


Autism is usually defined by impairments in the social domain, but has also been linked to deficiencies in specific visual pathways. The extent of these visual anomalies and their relationship to autism spectrum disorders (ASD) is still unclear. One possibility is that the ability of the visual system to rapidly activate attention to sudden events might be abnormal in ASD. We explored this hypothesis in a group of non-clinical participants with either higher or lower self-reported autistic traits. The Autism-spectrum Quotient (AQ) makes use of the idea that autism is merely one end of a spectrum that extends into the typically developing population. Participants viewed pictures of everyday objects in two separate tasks requiring recognition of a target object. In the first task objects were presented with an abrupt onset/offset, whilst in the second task the contrast of the object was gradually increased on, and decreased off. The High AQ participants performed worse than the Low AQ participants on both tasks. Importantly however, the High AQ group showed a greater impairment when objects were presented abruptly, compared with gradual onset/offset objects. Furthermore results suggested that one subscale from the AQ questionnaire in particular— self-reported social skills—predicted performance on the abrupt object task. This relationship between visual perception and autistic-like traits more generally, and social skills specifically, suggests that ASD could be related to a reduced utilization of fast activation of attention mechanisms for sudden or salient environmental changes. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 104–111. DOI: 10.1002/aur.1336

Can Adults With Autism Spectrum Disorders Infer What Happened to Someone From Their Emotional Response?

Sarah Cassidy, Danielle Ropar, Peter Mitchell, and Peter Chapman


The ability to infer others' thoughts and emotions is a skill that is essential for appropriate everyday social interaction. Researchers have argued that this ability may be impaired in adults with autism spectrum disorder (ASD), which could explain many of their socio-communicative difficulties. The literature exploring emotion processing in ASD has reported mixed findings, with more consistent difficulties being found with complex, dynamic stimuli that mimic the demands of everyday life.

This study used a novel method to investigate how adults with ASD process spontaneous emotions elicited during real-life social situations. Participants with and without ASD watched videos of individuals receiving gifts which varied in level of appropriateness (i.e. chocolate, monopoly money, or a homemade novelty). Individuals were asked to (a) guess which gift the participant had received based on his or her reaction and (b) state the emotion they thought the individual was expressing upon receiving the gift. Eye movements were also measured while participants watched the videos. The results showed that individuals with ASD had particular difficulty inferring when someone had received chocolate or the homemade gift, suggesting problems with distinguishing between genuine and feigned happy emotional responses. Eye-tracking results showed that although individuals with ASD looked slightly less to the eye region, this did not explain their difficulty interpreting these particular emotion expressions. Overall, these findings provide evidence of processing differences when inferring spontaneous emotion and situational antecedents of behaviour with real-life stimuli. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 112–123. DOI: 10.1002/aur.1351

Genetic Effects on Cerebellar Structure Across Mouse Models of Autism Using a Magnetic Resonance Imaging Atlas

Patrick E. Steadman, Jacob Ellegood, Kamila U. Szulc, Daniel H. Turnbull, Alexandra L. Joyner, R. Mark Henkelman, and Jason P. Lerch


Magnetic resonance imaging (MRI) can measure differences in brain structure between autism patients and people without autism. However, no two individuals are the same in genetic makeup and life experience, which can make it difficult to determine the cause of detected structural differences in the brain. To overcome this obstacle, mice whose DNA has been altered to recapitulate a genetic mutation found in human autism can undergo MRI similar to humans. The measurement of structural differences, with MRI, can show how specific mutations affect the shape of the brain. This study performed this analysis on three mouse models of autism representing three distinct mutations detected in patients with autism. The focus here was the cerebellum, a structure commonly implicated in autism. The cerebellum was divided into 39 different regions that were assessed individually. Using MRI and this 39-division definition of the cerebellum, it can be determined for each mouse the section of that mouse's MR image that corresponds to each cerebellum division. The results showed the cerebellum in the studied mouse models to have regional volume differences specific to areas involved in repetitive behaviors and initiating specific behaviors. This work demonstrates the strength of using MRI on mouse models of individual mutations associated with autism to understand each mutation's affect on brain structure and how the altered brain structure may influence behavior. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 124–137. DOI: 10.1002/aur.1344

Rare Single Nucleotide Polymorphisms in the Regulatory Regions of the Superoxide Dismutase Genes in Autism Spectrum Disorder

Jernej Kovač, Marta Macedoni Lukšič, Katarina Trebušak Podkrajšek, Gašper Klančar, and Tadej Battelino


Autism spectrum disorders (ASD) are pervasive developmental disorders characterized by communication and social impairment, restricted interests, and stereotypical behavior. One of the suspected contributing factors to the development of the ASD is oxidative stress. Oxidative stress is the state of lost equilibrium between the level of the reactive oxygen species (ROS) and the antioxidative mechanisms of the cell. The level of the ROS increases to the point where they can influence and damage the human health. We analyzed the genes of the superoxide dismutase enzymes that form one of the primary protection systems against the ROS. We discovered that there are genetic variants that are significantly more frequent in participants with the ASD compared to the healthy individuals. Those genetic variants may represent additional risk factors in the development of the ASD. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 138–144. DOI: 10.1002/aur.1345

A Randomized Controlled Trial of the Korean Version of the PEERS® Parent-Assisted Social Skills Training Program for Teens With ASD

Hee-Jeong Yoo, Geonho Bahn, In-Hee Cho, Eun-Kyung Kim, Joo-Hyun Kim, Jung-Won Min, Won-Hye Lee, Jun-Seong Seo, Sang-Shin Jun, Guiyoung Bong, Soochurl Cho, Min-Sup Shin, Bung-Nyun Kim, Jae-Won Kim, Subin Park, and Elizabeth A. Laugeson


Impaired social functioning is a hallmark feature of autism spectrum disorder (ASD), often requiring treatment throughout the lifespan. PEERS® (Program for the Education and Enrichment of Relational Skills) is a parent-assisted social skills training for teens with ASD. Although PEERS® has an established evidence base in improving the social skills of adolescents and young adults with ASD in North America, the efficacy of this treatment has yet to be established in cross-cultural validation trials. The objective of this study is to examine the feasibility and treatment efficacy of a Korean version of PEERS® for enhancing social skills through a randomized controlled trial (RCT). The English version of the PEERS® Treatment Manual (Laugeson & Frankel, 2010) was translated into Korean and reviewed by 21 child mental health professionals. Participants included 47 teens between 12 and 18 years of age with a diagnosis of ASD and a verbal intelligence quotient ≥ 65. Eligible teens were randomly assigned to a treatment group or delayed treatment control group. Despite cultural and linguistic differences, the PEERS® social skills intervention appears to be efficacious for teens with ASD in Korea with modest cultural adjustment. In an RCT, participants receiving the PEERS® treatment showed significant improvement in social skills knowledge, interpersonal skills, and play/leisure skills, as well as a decrease in depressive symptoms and ASD symptoms. This study represents one of only a few cross-cultural validation trials of an established evidence-based treatment for adolescents with ASD. © 2014 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 145–161. DOI: 10.1002/aur.1354

Evidence for Interaction Between Markers in GABA(A) Receptor Subunit Genes in an Argentinean Autism Spectrum Disorder Population

Carla V. Sesarini, Lucas Costa, Muriel Naymark, Nora Grañana, Andrea R. Cajal, Miguel García Coto, Roberto C. Pallia, and Pablo F. Argibay


Gamma-aminobutyric acid (GABA) is the major inhibitory neurotransmitter in the brain. GABAergic neurons participate in controlling functional integrity and providing inhibition. At least some forms of autism spectrum disorder (ASD) may be associated with increased excitation in neural circuits. A weakly inhibited cortex would lead to abnormalities in cognition and motor control, and would also be more susceptible to epilepsy. The present study sought to analyze gene variations related to GABA(A) receptor subunit genes in Argentinean ASD patients and to evaluate their contribution to the etiology of ASD.

Our results suggested an interaction between two GABA(A) receptor subunit genes: GABRB3 and GABRD in ASD, in our population.

Taken together with previous findings, the data presented here support the hypothesis that complex interactions between genes account for autism, even when genes involved show no independent effect. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 162–166. DOI: 10.1002/aur.1353

Classification of Functioning and Impairment: The Development of ICF Core Sets for Autism Spectrum Disorder

Sven Bölte, Elles de Schipper, John E. Robison, Virginia C.N. Wong, Melissa Selb, Nidhi Singhal, Petrus J. de Vries, and Lonnie Zwaigenbaum


In the International Classification of Diseases (ICD-10) by the World Health Organization (WHO), Autism Spectrum Disorder (ASD) is defined by patterns of atypical social-communication alongside repetitive and restricted behaviors. However, to form a more comprehensive picture of the impact of the condition, an instrument providing information about how a person with ASD is functioning in everyday life is needed. To date, there is no internationally agreed tool to quantify this specifically for ASD. The International Classification of Functioning, Disability and Health (ICF) offers a comprehensive framework for describing functioning that broadly covers body functions, body structures, activities, and participation in the context of environment. Nevertheless, its complexity and lack of specificity for particular diagnoses makes it often impractical for everyday use. In order to increase the ICF utility in clinical practice and scientific research, the development of ICF Core Sets for specific conditions has been initiated. ICF Core Sets are generally accepted selections of ICF categories that are relevant for a certain health condition. This paper describes the scientific process that will be adopted to develop the ICF Core Sets for ASD. © 2013 INSAR/Wiley Periodicals, Inc.

Article citation: Autism Res 2014, 7: 167–172. DOI: 10.1002/aur.1335