Friday, December 11, 2015

New Findings related to Attention and Gaze Give Us Clues to Differences in Social Development for Individuals on the Autism Spectrum

Difficulty interpreting social information is one of the defining characteristics of autism spectrum disorders (ASD), but  there is still a lot we don't understand about the underlying causes of some of these social differences.  A key aim of our research at CAR is to advance our understanding about the origins of difficulty with processing social information that is so common in ASD. This knowledge will help us devise better therapies.

There are four key areas of social development that are commonly disrupted by autism which, when taken together, describe much of what it means to have ASD. They include (1) theory of mind, or the ability to understand the thoughts, beliefs, or intentions of others (2) joint attention, or the inclination to pay attention to the same object of interest as someone else, as it relates to speech development; (3) social perception, or the ability to recognize facial expressions or speech inflections; and (4) social attention, or the tendency to prioritize important social information, such as an angry or distressed facial expression, over non-social information, such as pictures on a wall or furniture in a room.

In this the next couple of blog posts, we take you on a deeper dive into a group of CAR studies that are beginning to unlock some answers as to how social attention develops in autism.

"Why on earth would I want to do that?": The Basics of Social Motivation in Autism Spectrum Disorders

New CAR Research: Attention and Gaze Hold Clues to Social Development in Autism

 

Holly Robinson Peete Visits CAR

We were excited to have a visit last month from Philadelphia's own Holly Robinson Peete during a trip back to her hometown, where she was being honored for her efforts in support of autism awareness. Holly and her husband, former Philadelphia Eagles QB Rodney Peete, created the HollyRod Foundation to support families living with ASD and with Parkinson's disease, both of which affect their family directly.

The HollyRod Foundation made a very generous donation of Puzzlepiece tablets and toys for CAR's waiting room, along with several copies of "My Brother Charlie", a book Holly co-wrote with her daughter to help children understand classmates and loved ones with ASD. The book was inspired by Holly's son, RJ (now 19 years old) who was diagnosed with ASD as a child.

Here are a few great shots from our visit!

Holly Robinson Peete checks out our CAR logo- which was originally a quick sketch made by a boy with ASD while visiting the center!

Holly poses with 11-year-old Corinne, who is showing off her signed copy of  "My Brother Charlie".

Testing out the PuzzlePiece tablets!


CAR researcher Eli Kim explains one of our research studies aimed at understanding common physical behaviors associated with autism spectrum disorders.


 

CAR Research: Attention and Gaze Hold Clues to Social Development in Autism

Children with autism spectrum disorders (ASD) focus their attention on social information differently from their neurotypical peers, and this gives us a glimpse into social development as they mature. Improving our understanding of how these differences work may provide clues to developing treatments and interventions to ease some of the social symptoms of autism spectrum disorders (ASD).

CAR psychologist
Benjamin Yerys, PhD, studies attention, impulsivity, and distractibility in ASD, as well as in ADHD and anxiety- ASD’s frequent companions. A pair of his studies contribute to our understanding of how children with ASD prioritize and respond to social information in their environment.


“Now you see it….”: The Attentional Blink Effect in Autism


The first study tested what’s known as the “attentional blink effect” in 8-14 year-old children diagnosed with an autism spectrum disorder (ASD) vs. typically developing peers. Attentional blink refers to a gap in the brain’s ability to detect visual information when it appears in rapid succession. (Think about trying to identify a single card as someone shuffles the deck.) This is a result of a brief “overload” in the brain’s capacity to process information. Essentially, the brain needs a brief moment of unawareness, equivalent to a “blink”, to recover its ability to pay attention to new visual information. This idea is best explained with an example. Imagine you’re shown a series of images of different shapes on a screen, each appearing for a fraction of a second. You’re told to look for a triangle, and that a heart shape may also appear in the series. It’s highly likely that you’ll notice the triangle, but will miss the heart shape while your brain recovers its ability to focus on the images.

The exception to this rule is when the visual information carries emotional weight. For example, if an angry face is among the images shown after the picture of the triangle, you will be more likely to notice it, meaning the “blink” effect is overridden by a strong emotional stimulus. 

When this study was previously conducted in adults with ASD, those on the autism spectrum were less likely than neurotypical adults to pick up emotionally-charged images. However, when Dr. Yerys tried this same test with children using photos of dogs, neutral facial expressions, and angry facial expressions, the children diagnosed with ASD performed just as well as – or slightly better than - their typically developing peers. This was a surprising finding because the amygdala area of the brain is very important for processing emotional information quickly, and this area of the brain develops atypically in ASD starting in toddlerhood. This means that in children with ASD, the ability to prioritize social-emotional information is somehow preserved. Further research is needed to determine if this would also hold true for children more severely affected by ASD.

“Although we were initially surprised, this finding does make developmental sense,” said Dr. Yerys. “In general, adolescents and pre-adolescents tend to have a heightened response to emotional information. It is important that emotionally-charged information may grab attention to the same degree for kids on the spectrum as those considered to be typically developing, because it means that this age range may present a window of opportunity for possible interventions.”


“Inhibition of Re…what?” Visual Search for Social Information Differs for Children on the Autism Spectrum


In a related study published in November, Dr. Yerys and his colleagues explored social attention in 8-17 year-old children by looking at how children shift their attention to search their environment, instead of responding by reflex to the environment as we saw in the attentional blink study. When children (or adults) search their environment, the brain tends to favor searching new locations instead of going to old locations. For example, if you lost your keys then you may be more interested to look for them in your desk rather than searching your pocket a second time. This process is called “
inhibition of return” (IOR).

In neurotypical development, people tend to automatically skew their attention toward social information (facial expressions, body language, emotional cues), as opposed to objects in their environment which carry no social significance (an electrical outlet, a tree, a particular toy).

Earlier studies have established that photos of angry or upset faces hold the attention of neurotypical individuals longer than smiling or neutral faces (because anger and worry indicate a potential threat). The threat-related faces override or delay the brain process that would usually cue the brain to move on and scan for new visual information. Until now, no studies have carefully examined whether this “override” effect would also hold true for people with ASD.

To test whether children with ASD would prioritize socially or emotionally charged information in a similar way, children in this study were given a series of tasks to complete on a laptop. They were instructed to respond as quickly as possible to various combinations of non-social symbols and sets of photos showing either neutral or angry facial expressions.

Dr. Yerys and his team found that young people with ASD were less accurate in their responses; they also had longer response times when compared with their typically developing peers. Children who had the most severe ASD symptoms were also the slowest to shift their attention. This is the first large study to show that this visual attention mechanism (IOR) is disrupted in children with ASD, and that this impaired attention is directly related to some of the core social symptoms of ASD.


The study also ruled out the possibility that this difference in attention is related to ADHD or anxiety symptoms, which are common in children diagnosed with ASD. The study results support the overarching hypothesis that problems with how children prioritize social or emotional information in visual attention is associated with more severe social impairments.

Putting it all together
Taken together, the “attentional blink” study and the “inhibition of return” studies indicate that emotional information captured the attention of adolescent and pre-adolescent children with ASD to the same degree as it did for their typically developing peers, when information was being gathered from a single point in space. However, adding the task of scanning a given area for information and then determining its social meaning may prove more difficult for children with ASD.

It also appears that social-emotional processing proved more difficult for children with more severe symptoms of ASD. The findings of both studies suggest that impairments in early visual attention processes have a cascading effect on social development in ASD. This is further borne out when we consider that similar studies done with adults showed greater impairments for those with ASD; and in studies with infants at high-risk for ASD [by virtue of having an older sibling with a diagnosis], infants with slower attention orienting are more likely be diagnosed with ASD later in childhood, compared with those infant siblings who do not go on to receive a diagnosis.

The two studies offer insight into specific cognitive and brain mechanisms that may contributing to core symptoms of ASD. Our center’s long-term goal is to translate this knowledge into opportunities for improving both diagnosis and intervention, with the goal of diminishing the cascading effect of early impairments to social-emotional development.



Special Thanks...We want to thank the 100+ families that made these two studies possible by participating in research! We’d love to hear your questions and feedback about your participation at
autism@email.chop.edu.

To learn more about participating in research at CAR, visit
www.autismMatch.org or email us to learn about studies for neurotypical and autism spectrum participants from infancy through young adulthood.

"Why on earth would I want to do that?": The Basics of Social Motivation in Autism Spectrum Disorders

Differences in social development are among the core symptoms which define autism spectrum disorder (ASD). In the last few years, the Social Motivation Theory of autism has gained broad acceptance to explain some of the reasons why children with ASD may not profit from their social learning opportunities.

 In 2012, several CAR faculty members published a scientific review which indicates that individuals with ASD might be able to engage with social cues, but are less motivated to do so than their neurotypical peers.

Although children receive some explicit social instruction from their parents or caregivers, most social learning happens implicitly, from observation and experience. Children interpret positive social responses- a smile, a hug- as “rewards” and then repeat those behaviors.  The social motivation model suggests children with ASD have altered reward pathways in the brain, and do not feel as rewarded by the act of engaging with others. This reduces motivation for social experiences, and sets in motion a negative spiral of missing out on social learning opportunities which leads to fewer social rewards and even less interest in social interactions. In the authors’ words, “when social information is not prioritized, there are profound, cascading effects on learning about — and from — the social world”1.

Researchers across various disciplines- from neuroscience, biology, psychology and education – are using this framework to help inform their understanding of how behavioral or pharmaceutical therapies might be developed to target the motivational component of social skills- rather than focusing only on teaching specific social skills. In this way, it opens the door to powerful social learning opportunities by making the social information in children’s environment more meaningful and rewarding. To read a full commentary on Social Motivation, check out this article from SFARI’s “Spectrum” blog.