AN ABSTRACT OF THE THESIS OF Anna Kallal, for the Masters of Science degree in Communication Disorders and Sciences presented on March 28, 2016, at Southern Illinois University Carbondale. TITLE: AUTISM AND OUR COMMUNITY: FEEDBACK FROM EARLY INTERVENTION PROVIDERS MAJOR PROFESSOR: Dr. Valerie Boyer Early Intervention (EI) providers often work closely with children who are diagnosed with autism spectrum disorder (ASD) or children who have signs and symptoms of ASD. An understanding of the characteristics in children at early ages can lead to an earlier diagnosis of ASD. The current study investigated specific characteristics that EI providers identify prior to making a referral for an ASD evaluation as well as what treatment strategies EI providers report utilizing when working with children who have ASD. Information was gathered for this study by use of a survey. The survey contained two vignettes of children with varying degrees of ASD characteristics. Speech-Language Pathologists (SLP) who work as EI providers responded to a survey. Results showed that respondents were more willing to make referrals for ASD evaluations when a child displayed more severe characteristics. Respondents listed treatment strategies they were likely to employ with children who display similar characteristics of the children in the vignettes. The researcher identified from survey responses that EI providers are more likely to identify social communication characteristics when describing features critical to referral. This study identifies the characteristics important to making earlier referrals for ASD evaluations, as well as what treatment strategies work best when working with children with ASD.

The high prevalence of autism spectrum disorder (ASD) results in large costs to individuals, families, and society. Among diagnosed individuals, restrictive and repetitive behaviors (RRBs) correlate with functional impairments substantially impacting wellbeing but remain less studied than social and communication deficits. Brain resting-state functional connectivity (fc) measures intrinsic, potentially RRB-associated neural dynamics. Here, whole-brain (WB), and iterated seed-based (SB)fc guided by the preceding WBfc and a priori hypotheses was performed. Combined results were used to model a brain network beginning with qualitative assessment of its potential functional association with RRBs. Once rigorously defined, the network was used to inform construction of a dynamical systems model of brain activity hypothesized to correlate with RRB severity. Qualitative model behavior tracked expectations of real cortical activity in RRB presentation. Model numerical output was found to correlate with behavioral measures of RRBs to a significantly greater degree than the underlying brain connectivity values themselves did. Some summary measures of model output were also found to correlate significantly, though near threshold, with severity measures in the other two ASD core deficit domains, and particularly, far more extensively than should be expected given the underlying brain connectivity values themselves were apparently effectively wholly uncorrelated with the measures. Significant findings are: (1) dynamical modeling of brain activity can identify significant correlations with symptom manifestation that fc alone cannot; (2) dynamical modeling of brain activity could potentially increase understanding of ASD’s extensive heterogeneity across symptom domains; (3) extensive overlap between the constructed network and known RRB-implicated brain divisions was identified, with cerebellum, increasingly implicated in distributed neocortical functional differences in RRBs in humans and animal models, centrally connected to multiple such divisions; (4) further overlap is found via striatal circuitry, implicated in multiple RRB-like behaviors previously, and forming at least 1/3 of the functional basis for the network’s hypothetical relationship with RRBs; (5) ASD-associated angular gyrus, PFC, ACC overlap was found. This successful tandem application of fc, dynamical modeling, and neurocognitive network theory illustrates the need for broad theoretical approaches in illuminating ASD heterogeneity and the neurocognitive underpinnings of specific ASD presentations. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2021. / FAU Electronic Theses and Dissertations Collection

Divided attention, or the ability to respond to more than one task simultaneously, is an important skill for navigating complex social, communicative, academic, and professional settings. The purpose of the current study was to understand the association between the volume of the posterior cerebellum and divided attention in individuals with autism spectrum disorders (ASDs) and control participants. It was hypothesized that the ASD group would have worse divided attention abilities and smaller posterior cerebellar volumes compared to the control group. Furthermore, reduced posterior cerebellar volume was expected to be associated with weaker divided attention abilities. Participants were young adult males with high-functioning autism spectrum disorders (n=15) and controls matched for age, handedness, and nonverbal IQ (n=19). Results showed partial support for worse divided attention performance in ASDs and for a positive association between posterior cerebellar volume and divided attention performance. There were no group differences in posterior cerebellar volume, and accounting for intracranial volume did not affect findings. Limitations of the current study and future directions are discussed. / text

Objectives: There has been a significant increase in the incidence rates and public awareness of autism spectrum disorder (ASD) in recent years. The DSM-5’s latest modification of diagnostic criteria for ASD has also stimulated considerable debate. Despite the rising concerns, few studies have been conducted in the Chinese population of Hong Kong, especially among youth and adolescents. This study investigates the clinical profile of ASD in adolescents in Hong Kong. In addition to using screening instruments commonly used to assess specific ASD characteristics, other psychometric measures for internalizing and externalizing problems are employed to examine their associations with the ASD symptoms. It also assesses the extent to which different ASD symptoms and their associated features predict parenting stress. Methods: A total of 143 adolescents aged between 11 and 17 (M = 14.17; SD = 1.76) completed this study with their parents, including 71 adolescents with ASD and 72 typically developing adolescents. Adolescents completed two self-report measures of emotional symptoms: the Spence Children’s Anxiety Scale (SCAS) and Children’s Depression Inventory (CDI). Their parents completed the Autism Spectrum Screening Questionnaire (ASSQ), Child Behaviour Checklist (CBCL), and Spence Children’s Anxiety Scale – Parent version (SCAS-P) for evaluating their child’s characteristics. Parents also completed the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Parenting Stress Index-Short Form (PSI-SF) for measuring their own parenting stress. Results: All measures showed good to excellent internal consistency. They were as reliable and internally consistent as the original English versions. Parent reports in the ASD group were significantly higher than in the control group on all measures. Mean ASSQ scores in the ASD group fell within the clinical range. Optimal ASSQ cutoff scores were estimated using receiver operating characteristics analysis. ASD symptoms, as well as internalizing and externalizing problems, were found to be significant discriminators between the ASD group and the controls. In addition, parents reported that their child’s emotional and behaviour problems were more distressing than the ASD symptoms. Discussion: This study highlights the importance of evaluating specific ASD characteristics and their associated symptoms of emotional and behavioural disturbances. This study suggests an optimal cutoff score of 9 for the ASSQ in Hong Kong. However, there is a need to assess its generalizability using large-scale community samples and other childhood clinical conditions. Although the findings appear to support the revised DSM-5 taxonomy of ASD, they must be interpreted with caution. Future treatments should provide parents with adequate professional support for reducing parenting stress and helping them cope with their child’s social, emotional, and behavioural impairments. Conclusions: This study documents preliminary norms for a broad range of measures for adolescents with ASD in Hong Kong. It also provides a useful empirical basis for future investigations of the interplay between specific ASD characteristics and their associated features. Regarding treatment planning, this study postulates a comprehensive treatment model for adolescents with ASD to guide treatment research. / published_or_final_version / Clinical Psychology / Doctoral / Doctor of Psychology

Pragmatic language impairments have been found in children with high-functioning Autism (HFA). Limited studies have investigated the contributing factors. This study compared 23 children with HFA with 28 typically-developing children on pragmatic language measures, with their age, cognitive ability and language ability matched or controlled. Deficit of children with HFA was found in making inferences in comprehension but not in narrative ability, and abilities to make inferences in narrative and about psychological state. Theory of mind was an impairment for children with HFA and correlated with inferences about psychological state. In the measure of executive functioning at visual-perceptual level, better performance was found in children with HFA. This cognitive factor did not correlate with any pragmatic language measure. / published_or_final_version / Educational Psychology / Master / Master of Social Sciences

Background: Autism Spectrum Disorder (ASD) is a neuro-developmental disorder characterized by a triad of impairments in social interaction, communication, and restricted and repetitive behaviors. For children with autism especially those with high functioning (HFA), it is common to discover from clinical observation and from care-givers’ report that there are uneven performance in their cognitive profile and also executive difficulties. In recent years, there were enormous amount of researches attempting to delineate the cognitive deficits and the executive impairments in autism. Executive Functions (EF) was a widely studied construct in autism. The vast pool of researches establishes various focuses of investigation, including: (1) the biological level; (2) the cognitive level; (3) the task performance level; and (4) the everyday functioning level. Each of them has its own significance, and contributes distinctly in delineating the executive impairments in ASD. Taking into account the complexity of the EF construct and the far-reaching impacts it imposing on our everyday functioning, a comprehensive approach encompassing different levels of investigation in one research design is suggested to investigate the performance and specific areas of impairment of children with HFA in respective levels; and to explore the possible relationships between the levels of investigations. Methods: Forty aged 12-15 children participated in the research, twenty with HFA and twenty typically developing controls (TD), matched by gender, age and IQ. In the first part of the study, the participants were administered four traditional EF tasks including: inhibition, working memory, flexibility and planning to examine EF in the cognitive level. In the second part, they completed a novel multitasking test, the Battersea Multitask Paradigm (BMP) to examine executive difficulties in the task performance level. Parent ratings of the Behavior Rating Inventory of Executive Function (BRIEF) were collected for further investigation of their executive difficulties in the daily functioning level. Results: The 3-levels of investigation demonstrated converged results in examining the executive ability of ASD. From the integrated analyses, more evidence was gained to speculate that the planning inefficiency of children with HFA was due to their inability to cognitively construct the plan rather than their ability to execute or implement the plan. In real-life situations, they have particular difficulties in time management, to prioritize multiple and interleaved tasks, and to coordinate intended actions for future goal attainment. Moreover, their cognitive inflexibility had a pattern of “get stuck” or perseverates on the same task till completion before moving onto the next task. Their inflexibility to switch seemed to be explained by the preference to follow a more structured kind of sequence or action, i.e. to persist and finish one task before moving to another one. They were actually excellent “rule follower”, might not be as rigid of not willing to change. Significant positive relationships were only observed between the EF measures and Multitask variables. / published_or_final_version / Educational Psychology / Doctoral / Doctor of Psychology

Adolescents with Autism and their families experience a significant increase in the number and nature of challenges faced when leaving the structure of the formal education system. Increased support and planning is required in order to prepare for and better manage this period, as a successful transition is associated with family well-being. An ecosystemic approach was used in order to better understand the experiences of the individual, the family, the school and the community during this period. The purpose of this study was to gain an understanding of parent and professional perspectives on various elements of the transition process, including planning and support, predicted outcomes and the feelings experienced, in order to develop awareness, improved planning and consequently; outcomes. A sample of 14 participants (7 parents and 7 professionals) was engaged in semi-structured interviews. The results indicate that both parents and professionals feel an overwhelming sense of fear and uncertainty with regards to the future of the adolescent with Autism; however a sense of optimism and hope also exists, as participants reported effective interventions were beginning to occur. The knowledge and understanding of the needs of these individuals is continuously growing within the parents and professionals who are directly involved in the lives of adolescents with Autism; however increased awareness is required within the community and government sectors in order to gain increased access to resources and services. With the appropriate support, individuals with Autism can experience increased quality of life within residential, employment, social and community settings. The results of the current study are discussed with reference to previous research studies, and recommendations for further research are provided.

Empathy is vital for relationships in the social world. Although definitions vary, theory and research has delineated empathy into cognitive and affective components. Recent ideas propose there are further aspects that are important to empathy, such as the ability versus the drive to empathise within both the cognitive and affective components. Various self-report indexes have been developed to measure empathy, yet current measures do not reflect all theories about empathy. The aim of this thesis was to develop and validate a new empathy questionnaire that included further components more consistent with recent ideas and theories about empathy. This thesis further aimed to use this questionnaire to investigate the components of empathy in autism, which is characterised in part by empathy deficits. The first study investigated the structure of empathy in the commonly-used Empathy Quotient (EQ) short-form to examine which empathy components it indexes. Results showed cognitive, affective and social skill components were extracted from the EQ-short, but also revealed ability and drive aspects captured within affective empathy but not within cognitive empathy components. This suggested items of the EQ-short incorporates some, but not all, components proposed to be important to empathy. Consequently, a new self-report empathy questionnaire called the Empathy Components Questionnaire (ECQ) was developed in order to fully capture all components of empathy. A five-factor solution was developed and confirmed for the ECQ across multiple independent samples in studies two through five, revealing five components of cognitive ability, cognitive drive, affective ability, affective drive, and affective reactivity. A final study revealed individuals with autism had lower self-reported cognitive empathy, affective drive and affective reactivity compared to controls, but comparable scores between groups for affective ability. This thesis produced a new measure of empathy more in-line with recent theories, which provided understanding about empathy and how it differs in autism.

Child-computer interaction researchers are increasingly recognising the benefits of directly involving children in the design of new technology. This has resulted in the development of several design methods for involving children in the technology design process, using approaches such as Participatory Design (PD). More recently there has been a greater focus on involving children with diverse needs, as technology can often be particularly beneficial within the education of these children. One such group is children with Autism Spectrum Disorders (ASD) and in recent years there has been a sharp rise in the amount of technology being developed specifically for this population. However, the needs and preferences of this user group can differ from the general child population due to the specific characteristics of ASD, with these differences making it more challenging for adult designers to develop appropriate technologies. This thesis therefore seeks to establish the potential of using PD to involve children with ASD within the technology design process through the development of a new PD method, which aims to support the typical difficulties of children with ASD at the same time as utilising their characteristic strengths. A qualitative approach has been followed in order to understand firstly the ability of children with ASD to undertake typical design tasks; secondly the degree children with ASD are able to participate in the design process; and thirdly the ability of children with ASD to collaborate within a design team. The results reveal that children with ASD can undertake typical design tasks, but some children may require additional support to generate and communicate their design ideas. It is shown that a flexible approach should be taken with regard to the involvement of children with ASD within the technology design process, and the importance of the adaptability of the adult’s role in supporting the children’s participation and collaboration is additionally highlighted. This research has led to the development of a new PD method, IDEAS, which is tailored to the specific needs of children with ASD through the incorporation of flexible structured and supportive features.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and the presence of stereotypic behaviors or restricted interests. To explore possible consequences of an excitatory/inhibitory (E/I) imbalance on the visual system in ASD, we investigated spatial suppression in 16 children with ASD and 16 neurotypical comparison children from 6 - 12 years of age using a visual motion processing task during high-density electroencephalography (EEG) recording in order to derive the N1 event related potential (ERP). Consistent with prior behavioral research, neurotypical participants displayed spatial suppression in conditions of large, high-contrast sinusoidal gratings as indexed by delayed N1 response latency. As predicted, children with ASD displayed weakened surround suppression, i.e. shorter N1 response latency to large, high-contrast sinusoidal gratings. However, this study also unexpectedly revealed that children with ASD showed longer N1 latencies in response to small, high-contrast sinusoidal gratings as compared to neurotypical control children. Although there were no statistically significant differences between children with ASD and NT children for N1 peak amplitude, there was a strong negative correlation between N1 amplitude represented in absolute values for large, high-contrast sinusoidal gratings and hyper-responsiveness item mean scores on the Sensory Experiences Questionnaire for children with ASD, but not for NT children. As predicted, no significant differences were found within or between groups in the low-contrast experiment. Our results are indicative of weakened spatial suppression and deficits in contrast gain in children with ASD, suggestive of an underlying E/I imbalance in ASD.