Clinical and parental predictors of emotion regulation following cognitive behaviour therapy in children with autism.

LAY ABSTRACT: Children with autism commonly experience difficulty controlling their emotions. Although existing treatments are successful in teaching critical emotion regulation skills, not all children improve. It is important to identify the factors that influence treatment response to be able to reach more children. This study aimed to identify child and parent characteristics that predict treatment response in a 10-week cognitive behaviour therapy treatment for children with autism, 8-12 years of age, and their parents. We found that youth who started the treatment with higher verbal abilities, who were more anxious in social situations, and had parents who were more anxious, were more likely to improve in learning new emotion regulation skills. We also found that children who had more physical discomforts or complaints before starting the treatment were less likely to improve in their negative expressions of emotion. Our study suggests that it is important for clinicians to promote active involvement and learning by avoiding complex language and to use more visual materials to supplement the learning process, and make sure that sessions are sensitive to the individual needs of participants.

Enhanced antisaccade abilities in children with Tourette syndrome: the Gap-effect Reversal.

Tourette Syndrome (TS) is a childhood onset disorder of motor and vocal tics. The neural networks underlying TS overlap with those of saccade eye movements. Thus, deviations on saccadic tasks can provide important information about psychopathology of TS. Tourette syndrome often coexists with Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD). Hence, we manipulated various components of a saccade task to measure its effects on saccades of children with TS-only, TS+ADHD, TS+ADHD+OCD and healthy controls. Children looked toward (prosaccade) or in the opposite direction (antisaccade) of a peripheral target as soon as it appeared. The prosaccade and antisaccade tasks were presented in three conditions. In the Gap200 condition, the fixation dot disappeared 200 ms prior to the appearance of the peripheral target, In the Gap800 condition, the fixation dot disappeared 800 ms prior to the appearance of the peripheral target and in Overlap200 the fixation dot disappeared 200 ms after the appearance of the peripheral target. Fixation-offset manipulations had different effects on each group's antisaccades. The TS+ADHD+OCD group's antisaccade latencies and error rates remained relatively unchanged in the three conditions and displayed a pattern of eye movements that can be interpreted as enhanced. Alternatively, the TS+ADHD group displayed an overall pattern of longer saccadic latencies. Findings corroborate the hypothesis that the combination of tic disorder and ADHD results in unique behavioral profiles. It is plausible that a subgroup of children with TS develop an adaptive ability to control their tics which generalizes to enhanced volitional control of saccadic behavior as well. Supporting evidence and other findings are discussed.

Smooth pursuit and fixation ability in children with Tourette syndrome.

OBJECTIVE: The smooth pursuit eye movements and fixation ability of children aged 8 to 16 years with Tourette syndrome (TS) were examined. BACKGROUND: Although several studies have examined the saccadic ability of patients with TS, there have been only a few studies examining pursuit ability in TS. METHOD: Pursuit gain (eye velocity/target velocity) and intrusive saccades during fixation were measured in children with TS-only, TS+attention deficit hyperactivity disorder (ADHD), and TS+ADHD+obsessive compulsive disorder (OCD), and in controls (8 to 16 y). Two pursuit tasks and 1 fixation task were used. In random pursuit 1 (RP1), each step and ramp cycle began from fixation; in random pursuit 2 (RP2), each cycle followed the next. In the fixation task, children were required to maintain fixation on a center dot and ignore distractor stimuli. RESULTS: All children had significantly higher pursuit gains in RP2 than in RP1 when pursuing a 30 degrees/s moving target. In addition, in RP2, the TS+ADHD+OCD group displayed significantly higher pursuit gains relative to the TS-only, TS+ADHD, and control groups. In the fixation task, the TS+ADHD group exhibited significantly more intrusive saccades than the TS+ADHD+OCD and control groups. CONCLUSIONS: Our findings support an enhanced oculomotor ability in the TS+ADHD+OCD group and the presence of an online gain control mechanism during ongoing pursuit. These findings are discussed in more detail.

Mixed pro and antisaccade performance in children and adults.

Pro and antisaccades are usually presented in blocks of similar type but they can also be presented such that prosaccade and antisaccade eye movements are mixed and a cue, usually the shape/colour of the fixation target or the peripheral target, determines which type of eye movement is required in a particular trial. A mixed-saccade task theoretically equalizes the inhibitory requirements for pro and antisaccades. Using a mixed-saccade task paradigm the aims of the study were to: 1) compare pro and antisaccades of children, 2) compare performance of children and adults and 3) explore the effect of increased working memory load in adults. The eye movements of 22 children (5-12 years) and 22 adults (20-51 years) were examined using a video-based eye tracking system (El-Mar Series 2020 Eye Tracker, Toronto, Canada). The task was a mixed-saccade task of pro and antisaccades and the colour of the peripheral target was the cue for whether the required saccade was to be a pro or an antisaccade. The children performed the mixed-saccade task and 11 adults performed the same mixed-saccade task alone and in a dual-task paradigm (together with mental subtraction or number repetition). A second group of 11 adults performed the mixed-saccade task alone. Children made mainly antisaccade errors. The adults' error rates increased in the mental subtraction dual-task condition but both antisaccade and prosaccade errors were made. It was concluded that the increased error rates of these two groups are reflective of different processing dynamics.