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Biomedical subjects

Ami Klin

Publications and source records attributed to Ami Klin.

At least 37 records · Page 2Linked to original sources

Performance on Cambridge Neuropsychological Test Automated Battery subtests sensitive to frontal lobe function in people with autistic disorder: evidence from the Collaborative Programs of Excellence in Autism network.

Recent structural and functional imaging work, as well as neuropathology and neuropsychology studies, provide strong empirical support for the involvement of frontal cortex in autism. The Cambridge Neuropsychological Test Automated Battery (CANTAB) is a computer-administered set of neuropsychological tests developed to examine specific components of cognition. Previous studies document the role of frontal cortex in performance of two CANTAB subtests: the Stockings of Cambridge, a planning task, and the Intradimensional/Extradimensional Shift task, a measure of cognitive set shifting. To examine the integrity of frontal functions, these subtests were administered to 79 participants with autism and 70 typical controls recruited from seven universities who are part of the Collaborative Programs of Excellence in Autism network. The two groups were matched on age, sex, and full-scale IQ. Significant group differences were found in performance on both subtests, with the autism group showing deficits in planning efficiency and extradimensional shifting relative to controls. Deficits were found in both lower- and higher-IQ individuals with autism across the age range of 6 to 47 years. Impairment on the CANTAB executive function subtests did not predict autism severity or specific autism symptoms (as measured by the ADI-R and ADOS), but it was correlated with adaptive behavior. If these CANTAB subtests do indeed measure prefrontal function, as suggested by previous research with animals and lesion patients, this adds to the accumulating evidence of frontal involvement in autism and indicates that this brain region should remain an active area of investigation.

Adolescent↗

Adaptive behavior in autism and Pervasive Developmental Disorder-Not Otherwise Specified: microanalysis of scores on the Vineland Adaptive Behavior Scales.

The purpose of this study is to provide a microanalysis of differences in adaptive functioning seen between well-matched groups of school-aged children with autism and those diagnosed as having Pervasive Developmental Disorder-Not Otherwise Specified, all of whom functioned in the mild to moderate range of intellectual impairment. Findings indicate that the major area of difference between children with autism and those with Pervasive Developmental Disorder-Not Otherwise Specified, was expressive communication; specifically, the use of elaborations in syntax and morphology and in pragmatic use of language to convey and to seek information in discourse. Linear discriminant function analysis revealed that scores on just three of these expressive communication item sets correctly identified subjects in the two diagnostic categories with 80% overall accuracy. Implications of these findings for both diagnosis and intervention with children with Autism Spectrum Disorders will be discussed.

Activities of Daily Living↗

Autism and pervasive developmental disorders.

The quantity and quality of research into autism and related conditions have increased dramatically in recent years. Consequently we selectively review key accomplishments and highlight directions for future research. More consistent approaches to diagnosis and more rigorous assessment methods have significantly advanced research, although the boundaries of the 'broader phenotype' remain to be defined and the validity of Asperger's disorder as a discrete syndrome remains controversial. Recent epidemiological studies have shown that Autism Spectrum Disorders are common, but there continues to be debate about the causes of the increase in the frequency with which autism is diagnosed. Psychological research has helped to develop new developmental models for the disorder and there have also been significant advances in the molecular genetics of autism and understanding of the underlying neurobiological processes. Areas important for future research include the study of autism as it first develops, i.e., in infants and very young children, and of specific processes (psychological and neurobiological) which underlie the disorder. Significant challenges lie ahead in evaluating the growing number of treatments for autism and in integrating the results of research into treatment and educational settings.

Autistic Disorder↗

The enactive mind, or from actions to cognition: lessons from autism.

Normative-IQ individuals with autism are capable of solving explicit social cognitive problems at a level that is not matched by their ability to meet the demands of everyday social situations. The magnitude of this discrepancy is now being documented through newer techniques such as eye tracking, which allows us to see and measure how individuals with autism search for meaning when presented with naturalistic social scenes. This paper offers an approach to social cognitive development intended to address the above discrepancy, which is considered a key element for any understanding of the pathophysiology of autism. This approach, called the enactive mind (EM), originates from the emerging work on 'embodied cognitive science', a neuroscience framework that views cognition as bodily experiences accrued as a result of an organism's adaptive actions upon salient aspects of the surrounding environment. The EM approach offers a developmental hypothesis of autism in which the process of acquisition of embodied social cognition is derailed early on, as a result of reduced salience of social stimuli and concomitant enactment of socially irrelevant aspects of the environment.

Autistic Disorder↗

The role of the fusiform face area in social cognition: implications for the pathobiology of autism.

A region in the lateral aspect of the fusiform gyrus (FG) is more engaged by human faces than any other category of image. It has come to be known as the 'fusiform face area' (FFA). The origin and extent of this specialization is currently a topic of great interest and debate. This is of special relevance to autism, because recent studies have shown that the FFA is hypoactive to faces in this disorder. In two linked functional magnetic resonance imaging (fMRI) studies of healthy young adults, we show here that the FFA is engaged by a social attribution task (SAT) involving perception of human-like interactions among three simple geometric shapes. The amygdala, temporal pole, medial prefrontal cortex, inferolateral frontal cortex and superior temporal sulci were also significantly engaged. Activation of the FFA to a task without faces challenges the received view that the FFA is restricted in its activities to the perception of faces. We speculate that abstract semantic information associated with faces is encoded in the FG region and retrieved for social computations. From this perspective, the literature on hypoactivation of the FFA in autism may be interpreted as a reflection of a core social cognitive mechanism underlying the disorder.

Adult↗

Reduced thalamic volume in high-functioning individuals with autism.

BACKGROUND: In this study, specific consideration is given to a role for the thalamus in autism. METHODS: A volumetric analysis of the thalamus was conducted using magnetic resonance imaging, based on segmentation of continuous 1.2 mm(3) coronal images. The sample consisted of 12 high-functioning individuals with autism, mean age of 21.0 years (SD = 10.4) and mean IQ of 106.4 (SD = 18.3). Normal control subjects were selected to match this group; the mean age was 18.1 years (SD = 6.3); mean IQ was 108.8 (SD = 15.6). RESULTS: Unadjusted mean thalamic volume was not significantly different; however, there were significant differences in the relationship between thalamic volume and total brain volume (TBV). The correlation was strong and positive in the control group but statistically nonsignificant in the autism group. Group differences were found when adjustments were made for TBV, achieved by grouping subjects' measurements on this variable using a split median procedure. Mean thalamic volume was significantly reduced in the autism group relative to normal control subjects, specifically within the high TBV group. CONCLUSION: The increase in thalamic volume with increase in TBV was not seen in autism, suggesting underdeveloped connections between cortical and subcortical regions and indicating a need to examine this structure further.

Adolescent↗

Asperger syndrome: diagnosis and external validity.

This article provides an overview of the history and clinical features of Asperger syndrome and considers guidelines for clinical assessment and treatment. A review of issues related to external validity is provided that points out the limitations of current research and lists several potentially beneficial areas of investigation into the nosologic status of the condition. It concludes with a discussion of the unequivocal need of individuals with severe social disabilities for comprehensive and adequate educational services and other treatments, regardless of the fact that the validity and usefulness of this specific diagnostic concept is far from resolved.

Adolescent↗

Concurrent validity and classification accuracy of the Leiter and Leiter-R in low-functioning children with autism.

The concurrent validity of the Leiter International Performance Scale (Leiter) and Leiter International Performance Scale-Revised (Leiter-R) was examined in a sample of children with autism who could not be assessed with more traditional measures of intelligence (e.g., the Wechsler scales). The sample consisted of 26 children ranging in age from 4 to 16 years. The correlation between the Leiter scales was high (r = .87), and there was a difference of 3.7 points between the two mean scores, nonsignificant at both statistical and clinical levels. However, significant intraindividual discrepancies were present in 10 cases, 2 of which were both large (24 and 36 points) and clinically meaningful. The mean profile of performance on Leiter-R subtests is also presented for this sample of children with autism, to allow for comparison with other groups. Based on the results of this initial evaluation, together with the current normative data, good psychometric properties, and availability of global and subtest scores with the Leiter-R, the instrument is generally recommended for use with children with autism. However, because of changes in the design of the Leiter-R, there may be greater clinical success with the original Leiter for those children who are very low functioning and severely affected, particularly younger children.

Adolescent↗

Annotation: Hyperlexia: disability or superability?

BACKGROUND: Hyperlexia is the phenomenon of spontaneous and precocious mastery of single-word reading that has been of interest to clinicians and researchers since the beginning of the last century. METHODS: An extensive search of publications on the subject of hyperlexia was undertaken and all available publications were reviewed. RESULTS: The literature can be subdivided into discussions of the following issues: (1) whether hyperlexia is a phenomenon that is characteristic only of specific clinical populations (e.g., children with developmental delays) or whether it can also be observed in the general population; (2) whether hyperlexia is a distinct syndrome comorbid with a number of different disorders or whether it is a part of the spectrum of some other clinical condition(s); (3) whether hyperlexia should be defined through single-word reading superiority with regard to reading comprehension, vocabulary, general intelligence, any combination of the three, or all three characteristics; (4) whether there is a specific neuropsychological profile associated with hyperlexia; (5) whether hyperlexia is characterized by a particular developmental profile; and (6) whether hyperlexia should be viewed as a disability (deficit) or superability (talent). CONCLUSIONS: We interpret the literature as supporting the view that hyperlexia is a superability demonstrated by a very specific group of individuals with developmental disorders (defined through unexpected single-word reading in the context of otherwise suppressed intellectual functioning) rather than as a disability exhibited by a portion of the general population (defined through a discrepancy between levels of single-word reading and comprehension). We simultaneously argue, however, that multifaceted and multi-methodological approaches to studying the phenomenon of hyperlexia, defined within the research framework of understanding single-word reading, are warranted and encouraged.

Adolescent↗

Asperger syndrome: an update.

This article provides an overview of the history and clinical features of Asperger syndrome, and considers guidelines for clinical assessment and treatment. A review of issues related to external validity is provided, which points out the limitations of current research, and lists several potentially beneficial areas of investigation into the nosologic status of the condition. It concludes with a discussion of the unequivocal need of individuals with severe social disabilities for comprehensive and adequate educational services and other treatments irrespective of the fact that the validity and the utility of this specific diagnostic concept is far from resolved.

Asperger Syndrome↗

Visual fixation patterns during viewing of naturalistic social situations as predictors of social competence in individuals with autism.

BACKGROUND: Manifestations of core social deficits in autism are more pronounced in everyday settings than in explicit experimental tasks. To bring experimental measures in line with clinical observation, we report a novel method of quantifying atypical strategies of social monitoring in a setting that simulates the demands of daily experience. Enhanced ecological validity was intended to maximize between-group effect sizes and assess the predictive utility of experimental variables relative to outcome measures of social competence. METHODS: While viewing social scenes, eye-tracking technology measured visual fixations in 15 cognitively able males with autism and 15 age-, sex-, and verbal IQ-matched control subjects. We reliably coded fixations on 4 regions: mouth, eyes, body, and objects. Statistical analyses compared fixation time on regions of interest between groups and correlation of fixation time with outcome measures of social competence (ie, standardized measures of daily social adjustment and degree of autistic social symptoms). RESULTS: Significant between-group differences were obtained for all 4 regions. The best predictor of autism was reduced eye region fixation time. Fixation on mouths and objects was significantly correlated with social functioning: increased focus on mouths predicted improved social adjustment and less autistic social impairment, whereas more time on objects predicted the opposite relationship. CONCLUSIONS: When viewing naturalistic social situations, individuals with autism demonstrate abnormal patterns of social visual pursuit consistent with reduced salience of eyes and increased salience of mouths, bodies, and objects. Fixation times on mouths and objects but not on eyes are strong predictors of degree of social competence.

Adolescent↗

A descriptive study of hyperlexia in a clinically referred sample of children with developmental delays.

In this study, we evaluated the incidence of hyperlexia in a clinically referred sample of 80 children with developmental delays. Based on hypotheses previously formulated in the literature, the study investigated the frequency of hyperlexia among boys and girls, the incidence of hyperlexia in children with Pervasive Developmental Disorders (PDD)-spectrum compared with non-PDD diagnoses, the range of IQ and of various cognitive skills in children with and without hyperlexia, and the developmental outcomes of children with and without hyperlexia. The results revealed no significant differences in the frequency of hyperlexia in girls compared with boys. However, the frequency of hyperlexia was significantly elevated among children with PDD compared with children with non-PDD diagnoses. The range of IQ and other cognitive skills and the developmental outcomes of children with hyperlexia were comparable to those of children without hyperlexia.

Child↗

Defining and quantifying the social phenotype in autism.

OBJECTIVE: Genetic and neurofunctional research in autism has highlighted the need for improved characterization of the core social disorder defining the broad spectrum of syndrome manifestations. METHOD: This article reviews the advantages and limitations of current methods for the refinement and quantification of this highly heterogeneous social phenotype. RESULTS: The study of social visual pursuit by use of eye-tracking technology is offered as a paradigm for novel tools incorporating these requirements and as a research effort that builds on the emerging synergy of different branches of social neuroscience. CONCLUSIONS: Advances in the area will require increased consideration of processes underlying experimental results and a closer approximation of experimental methods to the naturalistic demands inherent in real-life social situations.

Adult↗