Sequence Learning in Minimally Verbal Children With ASD and the Beneficial Effect of Vestibular Stimulation.

People with autism spectrum disorder (ASD) and especially the minimally verbal, often fail to learn basic perceptual and motor skills. This deficit has been demonstrated in several studies, but the findings could have been due to the nonoptimal adaptation of the paradigms. In the current study, we sought to characterize the skill learning deficit in young minimally verbal children with ASD and explore ways for improvement. For this purpose, we used vestibular stimulation (VS) whose beneficial effects have been demonstrated in the typical population, but the data regarding ASD are limited. We trained 36 children ages 6-13 years, ASD (N = 18, 15 of them minimally verbal) and typical development (TD, N = 18), on a touch version of the visual-motor Serial-Reaction-Time sequence-learning task, in 10 short (few minutes) weekly practice sessions. A subgroup of children received VS prior to each training block. All the participants but two ASD children showed gradual median reaction time improvement with significant speed gains across the training period. The ASD children were overall slower (by ~250 msec). Importantly, those who received VS (n = 10) showed speed gains comparable to TD, which were larger (by ~100%) than the ASD controls, and partially sequence-specific. VS had no effect on the TD group. These results suggest that VS has a positive effect on learning in minimally verbal ASD children, which may have important therapeutic implications. Furthermore, contrary to some previous findings, minimally verbal children with ASD can acquire, in optimal conditions, procedural skills with few short training sessions, spread over weeks, and with a similar time course as non-ASD controls. Autism Res 2020, 13: 320-337. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Minimally verbal children with ASD who received specially adjusted learning conditions showed significant learning of a visual-motor sequence across 10 practice days. This learning was considerably improved with vestibular stimulation before each short learning session. This may have important practical implications in the education and treatment of ASD children.

Contrast sensitivity revealed by spontaneous eyeblinks: Evidence for a common mechanism of oculomotor inhibition.

Spontaneous eyeblinks are known to serve important physiological functions, and recent evidence shows that they are also linked to cognitive processes. It is yet unclear whether this link reflects a crude rate modulation or, alternatively, an automatic and precise process, tightly linked to the low-level properties of sensory stimuli. We have recently reported (Y. S. Bonneh, Adini, & Polat, 2015) that, for microsaccades, the onset and release from inhibition in response to transient stimuli depend systematically on the low-level stimulus parameters. Here we reanalyzed our previous data for both microsaccades and eyeblinks for observers with sufficient blinking (>10% of trials, 18 of 23 observers tested) who watched and silently counted sequences of Gabor patches at 1 Hz with varied contrast and spatial frequency. We found that spontaneous eyeblinks, although less frequent, were similar to microsaccades in their modulation pattern in response to transient stimuli, demonstrating inhibition and rebound, which were dependent on the contrast and spatial frequency of the stimuli. The average blink response time, measured as the latency of the first blink following its release from inhibition, was longer for lower contrast and higher spatial frequency. Importantly, it was highly correlated with a similar measure for microsaccades as well as with psychophysical measures of contrast sensitivity. These results suggest that both eyeblinks and microsaccades are linked to the same inhibitory mechanism that presumably turns off oculomotor events while processing previous events and generates a rebound effect upon its release. The onset of both eyeblinks and microsaccades may thus reflect the time course of this mechanism and the associated cognitive process.

The time course and characteristics of procedural learning in schizophrenia patients and healthy individuals.

Patients with schizophrenia have deficits in some types of procedural learning. Several mechanisms contribute to this learning in healthy individuals, including statistical and sequence-learning. To find preserved and impaired learning mechanisms in schizophrenia, we studied the time course and characteristics of implicitly introduced sequence-learning (SRT task) in 15 schizophrenia patients (seven mild and eight severe) and nine healthy controls, in short sessions over multiple days (5-22). The data show speed gains of similar magnitude for all groups, but the groups differed in overall speed and in the characteristics of the learning. By analyzing the data according to its spatial-position and temporal-order components, we provide evidence for two types of learning that could differentiate the groups: while the learning of the slower, severe group was dominated by statistical learning, the control group moved from a fast learning phase of statistical-related performance to subsequence learning (chunking). Our findings oppose the naïve assumption that a similar gain of speed reflects a similar learning process; they indicate that the slower performance reflects the activation of a different motor plan than does the faster performance; and demonstrate that statistical learning and subsequence learning are two successive stages in implicit sequence learning, with chunks inferred from prior statistical computations. Our results indicate that statistical learning is intact in patients with schizophrenia, but is slower to develop in the severe patients. We suggest that this slow learning rate and the associated slow performance contribute to their deficit in developing sequence-specific learning by setting a temporal constraint on developing higher order associations.

Contrast sensitivity revealed by microsaccades.

Microsaccades are small rapid and involuntary eye movements that occur during fixation in an apparently stochastic manner. They are known to be inhibited in response to sensory transients, with a time course that depends on the stimulus parameters and attention. However, the temporal precision of their onsets and the degree to which they can be used to assess the response of the visual system to basic stimulus parameters is currently unknown. Here we studied microsaccade response properties as a function of the contrast and spatial frequency of visual onsets. Observers (n = 18) viewed and silently counted 2-min sequences of Gabor patches presented briefly (100 ms) at 1 Hz. Contrast and spatial frequency were randomized in different experiments. We found that the microsaccade response time, as measured by the latency of the first microsaccade relative to stimulus onset following its release from inhibition, was sensitive to the contrast and spatial frequency of the stimulus and could be used to extract a contrast response function without the observers' response. We also found that contrast detection thresholds, measured behaviorally for different spatial frequencies, were highly and positively correlated (R = 0.87) with the microsaccade response time measured at high contrast (>4 times the threshold). These results show that different measures of microsaccade inhibition, especially the microsaccade response time, can provide accurate and involuntary measures of low-level visual properties such as contrast response and sensitivity.

Abnormal speech spectrum and increased pitch variability in young autistic children.

Children with autism spectrum disorder (ASD) who can speak often exhibit abnormal voice quality and speech prosody, but the exact nature and underlying mechanisms of these abnormalities, as well as their diagnostic power are currently unknown. Here we quantified speech abnormalities in terms of the properties of the long-term average spectrum (LTAS) and pitch variability in speech samples of 83 children (41 with ASD, 42 controls) ages 4-6.5 years, recorded while they named a sequence of daily life pictures for 60 s. We found a significant difference in the group's average spectra, with ASD spectra being shallower and exhibiting less harmonic structure. Contrary to the common impression of monotonic speech in autism, the ASD children had a significantly larger pitch range and variability across time. A measure of this variability, optimally tuned for the sample, yielded 86% success (90% specificity, 80% sensitivity) in classifying ASD in the sample. These results indicate that speech abnormalities in ASD are reflected in its spectral content and pitch variability. This variability could imply abnormal processing of auditory feedback or elevated noise and instability in the mechanisms that control pitch. The current results are a first step toward developing speech spectrum-based bio-markers for early diagnosis of ASD.

Cross-modal extinction in a boy with severely autistic behaviour and high verbal intelligence.

Anecdotal reports from individuals with autism suggest a loss of awareness to stimuli from one modality in the presence of stimuli from another. Here we document such a case in a detailed study of A.M., a 13-year-old boy with autism in whom significant autistic behaviours are combined with an uneven IQ profile of superior verbal and low performance abilities. Although A.M.'s speech is often unintelligible, and his behaviour is dominated by motor stereotypies and impulsivity, he can communicate by typing or pointing independently within a letter board. A series of experiments using simple and highly salient visual, auditory, and tactile stimuli demonstrated a hierarchy of cross-modal extinction, in which auditory information extinguished other modalities at various levels of processing. A.M. also showed deficits in shifting and sustaining attention. These results provide evidence for monochannel perception in autism and suggest a general pattern of winner-takes-all processing in which a stronger stimulus-driven representation dominates behaviour, extinguishing weaker representations.

Associative learning in early vision.

Sensory discriminations often improve with practice (perceptual learning). Recent results show that practice does not necessarily lead to the best possible performance on the task. It was shown that learning a task (contrast discrimination) that has already reached saturation could be enabled by a contextual change in the stimulus (the addition of surrounding flankers) during practice. Psychophysical results with varying context show a behavior that is described by a network of local visual processors with horizontal recurrent interactions. We describe a mathematical learning rule for the modification of cortical synapses that is inspired by the experimental results and apply it to recurrent cortical networks that respond to external stimuli. The model predicts that repeated presentation of the same stimulus leads to saturation of synaptic modification, such that the strengths of recurrent connections depend on the configuration of the stimulus but not on its amplitude. When a new stimulus is introduced, the modification is rekindled until a new equilibrium is reached. This effect may explain the saturation of perceptual learning when practicing a certain task repeatedly. We present simulations of contrast discrimination in a simplified model of a cortical column in the primary visual cortex and show that performance of the model is reminiscent of context-dependent perceptual learning.

Perceptual learning in contrast discrimination: the effect of contrast uncertainty.

Performance in perceptual tasks improves with repetition (perceptual learning), eventually reaching a saturation level. Typically, when perceptual learning effects are studied, stimulus parameters are kept constant throughout the training and during the pre- and post-training tests. Here we investigate whether learning by repetition transfers to testing conditions in which the practiced stimuli are randomly interleaved during the post-training session. We studied practice effects with a contrast discrimination task, employing a number of training methods: (i) practice with a single, fixed pedestal (base-contrast), (ii) practice with several pedestals, and (iii) practice with several pedestals that included a spatial context. Pre- and post-training tests were carried out with the base contrast randomized across trials, under conditions of contrast uncertainty. The results showed that learning had taken place with the fixed pedestal method (i) and with the context method (iii), but only the latter survived the uncertainty test. In addition, we were able to identify a very fast learning phase in contrast discrimination that improved performance under uncertainty. We contend that learned tasks that do not pass the uncertainty test involve modification of decision strategies that require exact knowledge of the stimulus.

Context-enabled learning in the human visual system.

Training was found to improve the performance of humans on a variety of visual perceptual tasks. However, the ability to detect small changes in the contrast of simple visual stimuli could not be improved by repetition. Here we show that the performance of this basic task could be modified after the discrimination of the stimulus contrast was practised in the presence of similar laterally placed stimuli, suggesting a change in the local neuronal circuit involved in the task. On the basis of a combination of hebbian and anti-hebbian synaptic learning rules compatible with our results, we propose a mechanism of plasticity in the visual cortex that is enabled by a change in the context.