Exploring communicative competence in autistic children who are minimally verbal: The Low Verbal Investigatory Survey for Autism (LVIS).

LAY ABSTRACT: Approximately one in three autistic children is unable to communicate with language; this state is often described as minimally verbal. Despite the tremendous clinical implications, we cannot predict whether a minimally verbal child is simply delayed (but will eventually develop spoken language) or will continue to struggle with verbal language, and might therefore benefit from learning an alternative form of communication. This is important for clinicians to know, to be able to choose the most helpful interventions, such as alternative forms of communication. In addition, the field lacks a standard definition of "minimally verbal." Even when we do agree on what the term means (e.g. fewer than 20 words), describing a child based on their lack of words does not tell us whether that child is communicating in other ways or how they are using those 20 words. To address these concerns, we developed the Low Verbal Investigatory Survey (LVIS), a one-page parent-report measure designed to help us characterize how minimally verbal autistic children are communicating. Parents of 147 children (aged 1-8 years) completed the LVIS. Here, we ask (1) whether the survey measures what it was designed to measure, that is, communicative ability in children without much spoken language, and (2) how the LVIS relates to cognitive and language ability, and symptoms of autism. Results suggest that this survey, which takes only 5 min to complete, is a good estimate of the child's communication skills. Furthermore, LVIS survey scores are correlated with other measures of language and cognitive abilities as well as autism symptomatology. The LVIS has the potential to save time and money in both clinical and research efforts to assess communication skills in minimally verbal autistic children.

Investigation of the structural and electronic differences between silver and copper doped ceria using the density functional theory.

Using the density functional theory (DFT) we have investigated how Ag and Cu atoms, substitutional to Ce, arrange themselves within Ceria (CeO2) and their effect on the ceria lattice, the oxidation states of the metal atoms, and the oxygen vacancy formation energies. Noble metal doped ceria has been proposed in substitution of platinum for a number of catalytic reactions. We have considered single noble metal atoms substituting Ce atoms in the (111) CeO2surface unit cell, and investigated the thermodynamic stability of few configurations of one, two, and four Ag or Cu atoms in the unit cell. We have found that the noble metal atoms prefer to be located in the cation layer closer to the surface. An interesting result is that Cu causes a strong lattice distortion contrary to Ag. Ag, instead, causes a stronger reduction (oxygen loss) than Cu, since the electrons released in the oxygen vacancy formation are transferred mainly to Ag atoms, whose oxidation state tends towards +1, their preferred one, as found experimentally. In the Cu doped ceria, instead, part of the electrons reduces cerium atoms from +4 to +3 since Cu tends to stay in the +2 oxidation state, its preferred one. When we increase the concentration of Ag and Cu, substituting four Ce atoms, the noble metal atoms prefer to sit closer to each other, forming structural motifs resembling those typical of the Ag2O and CuO oxides.

Autism severity aggregates with family psychiatric history in a community-based autism sample.

The purpose of this study was to examine family psychiatric history in individuals with autism spectrum disorder (ASD) and its association with clinical presentation. Participants were 798 individuals with a clinical diagnosis of ASD, confirmed by the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), enrolled in Rhode Island Consortium for Autism Research and Treatment, a statewide research registry. Prior research suggests a specific behavioral phenotype in individuals with ASD who have family members with psychiatric diagnoses, including higher IQ and less severe language impairment. However, studies have not specifically investigated autism severity. We hypothesized that increased psychiatric family history would be associated with increased autism severity symptoms. Results show a strong association of increased burden of first-degree family psychiatric history with higher autism symptom severity as measured by Social Responsiveness Scale, Second Edition (SRS-2), but not with ADOS-2 severity scores, IQ, or adaptive functioning. These findings support the importance of investigating the contribution of psychiatric family history toward clinical ASD presentation. LAY SUMMARY: This study explored how family psychiatric history is related to clinical presentation of Autism Spectrum Disorder (ASD). Higher amounts of first-degree family psychiatric history was associated with higher autism symptom severity as measured by the Social Responsiveness Scale, Second Edition (SRS-2). The contribution of psychiatric family history requires ongoing investigation.

Emotion Dysregulation is Substantially Elevated in Autism Compared to the General Population: Impact on Psychiatric Services.

Emerging evidence suggests that emotion regulation (ER) impairment in those with ASD is associated with poor mental health. This study used the Emotion Dysregulation Inventory, a new norm-referenced ER measure with clinical cut-offs, developed and validated in ASD and non-ASD samples, to establish rates of ER impairment and understand its association with psychiatric service use in ASD. Parents of 6-17 year olds in three well-characterized samples (nationally representative US n = 1,000; community ASD n = 1,169; inpatient ASD n = 567) completed a battery of questionnaires about their child. The prevalence of ER impairment was significantly higher in the ASD groups compared to the nationally representative sample and highest in the psychiatric Inpatient ASD group. The community ASD and inpatient ASD samples were four and seven times more likely, respectively, to exceed clinical cutoffs for emotional reactivity than the general US sample. Similarly, history of psychiatric hospitalization, recent emergency services use (police contact, emergency room visits, or in-home crisis evaluations for emotional or behavioral concerns in the past 2 months), and psychotropic medication prescriptions were significantly higher in the ASD groups. ER impairment was significantly associated with all forms of psychiatric service use, after controlling for demographics (age, sex, race), co-occurring intellectual disability, and ADHD symptoms. This is the first large-scale study to document substantially higher rates of ER impairment in youth with ASD compared to the general population. The importance of ER impairment is underscored by its association with higher utilization of inpatient, emergency, and medication services in ASD, after accounting for demographics and ADHD-related symptoms.

Surface reducibility, reactivity, and stability induced by noble metal modifications on the γ -Fe2O3 maghemite (001) surfaces.

In these last years large research efforts have been devoted to the synthesis and investigation of reducible metal oxide surfaces modified with metal atoms and nanoparticles for improving their performance in a number of advanced applications. Among reducible metal oxides, iron oxides have the advantage to be made up from two of the most common elements on Earth. In this paper we analyze the structural, electronic, and magnetic consequences of the insertion of isolated noble metal atoms (Cu, Ag, Au) on the γ-Fe2O3 (001) surface. We have considered many different configurations for the single atoms: adsorbed, substitutional to iron atoms, or to oxygen atoms, and, using first principles calculations, we have studied how the presence of the noble metal atoms on the surface influences the surface stability, its reducibility, and, therefore, its catalytic activity, and how these properties depend on the kind of noble metal atom and its position. Our results show that noble metal atoms adsorbed on the surface facilitate the adsorption of CO molecules, and, among them, Cu atoms are those that bind best to the surface also providing the strongest adsorption energy for the CO molecule. At ambient temperature and pressure the noble metal atoms prefer to substitute the iron atoms than to just adsorb on the surface, but for Ag atoms the adsorption and substitutional energies are very close. The surfaces with Ag in place of Fe are the most reducible and reactive for exchange of oxygen atoms. Finally, Au is the best noble metal for oxygen substitution. Our results provide useful insights for the researchers designing and synthesizing new noble metal-iron oxides nanostructures for applications in biology, medicine, catalysis, and chemical analysis.

Surface Reactivity of Ag-Modified Ceria to Hydrogen: A Combined Experimental and Theoretical Investigation.

We investigate the mechanism of H2 activation on Ag-modified cerium oxide surfaces, of interest for different catalytic applications. The study is performed on thin epitaxial cerium oxide films, investigated by X-ray photoemission spectroscopy to assess the changes of both the Ag oxidation state and the concentration of Ce3+ ions, O vacancies, and hydroxyl groups on the surface during thermal reduction cycles in vacuum and under hydrogen exposure. The results are interpreted using density functional theory calculations to model pristine and Ag-modified ceria surfaces. Although the reactivity of ceria toward H2 oxidation improves when a fraction of Ce cations is substituted with Ag, the concentration of reduced Ce3+ ions in Ag-modified ceria is found to be lower than in pure ceria under the same conditions. This behavior is observed even though the number of surface oxygen vacancies caused by the thermal treatment under hydrogen exposure is larger for the Ag-modified surface. These results are explained in terms of a change of the oxidation state of the surface Ag, which is able to acquire some of the extra surface electrons created by the oxygen vacancies and the adsorbed hydrogen atoms. Our findings provide new insights into the reactivity of Ag-modified ceria, which has been proposed as a promising alternative to platinum electrodes in electrochemical devices.

Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample.

There is a wide range of emotion regulation (ER)-related impairment observed in autism spectrum disorder (ASD), which is associated with both internalizing and externalizing problems. Although the importance of ER is widely acknowledged in the ASD literature, little is known about factors associated with variability in ER impairment. Given the identified gender differences in ASD, gender may be a potential contributor to ER. This study examined gender differences in ER in an ASD inpatient psychiatric sample (n = 722; 146 females) aged 4-20 years, collected as part of the Autism Inpatient Collection. In addition, the study investigated whether age, nonverbal intelligence quotient (NVIQ), or verbal ability moderate the association between ER and gender. While both male and female inpatients with ASD presented with clinically elevated emotion dysregulation compared to general population norms, results suggest that female psychiatric inpatients have more severe dysregulation, including higher reactivity and dysphoria, than inpatient males. NVIQ and verbal ability did not moderate the association between gender and ER. Age moderated the association between gender and ER, with greater gender difference seen in older individuals, but only for dysphoria. However, overall, these effects were small. Improved understanding of ER presentation in males and females with ASD is critical, as these symptoms may differentially impact individuals with ASD and may warrant a different treatment emphasis. LAY SUMMARY: Previous research has identified several gender differences in presentation of autism spectrum disorder (ASD) symptoms, as well as difficulties with emotion regulation in individuals with ASD. In order to better understand the factors that may contribute to emotion regulation in ASD, this study examined whether psychiatrically hospitalized males and females with ASD differed in emotion regulation and what factors influenced the differences. Results suggest that females with ASD have slightly but significantly more difficulty with emotion regulation compared to males. Autism Res 2020, 13: 1343-1348. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

A Comparative Study of Suicidality and Its Association with Emotion Regulation Impairment in Large ASD and US Census-Matched Samples.

Evidence suggests increased rates of suicidality in autism spectrum disorder (ASD), but the research has rarely used comparison samples and the role of emotion dysregulation has not been considered. We compared the prevalence of parent-reported suicidality ideation and considered the role of emotion dysregulation in 330 psychiatric inpatient youth with ASD, 1169 community youth with ASD surveyed online, and 1000 youth representative of the US census. The prevalence of suicidal ideation was three and five times higher in the community and inpatient ASD samples, respectively, compared to the general US sample. In the ASD groups, greater emotion dysregulation was associated with suicidal ideation. Implications include consideration of emotion regulation as a potential mechanism and treatment target for suicidality in ASD.

Autism Heterogeneity in a Densely Sampled U.S. Population: Results From the First 1,000 Participants in the RI-CART Study.

The objective of this study was to establish a large, densely sampled, U.S. population-based cohort of people with autism spectrum disorder (ASD). The Rhode Island Consortium for Autism Research and Treatment (RI-CART) represents a unique public-private-academic collaboration involving all major points of service for families in Rhode Island affected by ASD. Diagnosis was based on direct behavioral observation via the Autism Diagnostic Observation Schedule, Second Edition. For the first 1,000 participants, ages ranged from 21 months to 64 years. Using Geographic Information System and published prevalence rates, the overall cohort is estimated to represent between 20% and 49% of pediatric age persons in Rhode Island with ASD, with demographics representative of U.S. Census. We observed a high rate of co-occurring medical and psychiatric conditions in affected individuals. Among the most prominent findings of immediate clinical importance, we found that females received a first diagnosis of ASD at a later age than males, potentially due to more advanced language abilities in females with ASD. In summary, this is the first analysis of a large, population-based U.S. cohort with ASD. Given the depth of sampling, the RI-CART study reflects an important new resource for studying ASD in a representative U.S. population. Psychiatric and medical comorbidities in ASD constitute a substantial burden and warrant adequate attention as part of overall treatment. Our study also suggests that new strategies for earlier diagnosis of ASD in females may be warranted. Autism Res 2020, 13: 474-488. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: The Rhode Island Consortium for Autism Research and Treatment (RI-CART) represents a unique public-private-academic collaboration involving all major points of service for families in Rhode Island affected by autism spectrum disorder (ASD). In this article, we provide results from the first 1,000 participants, estimated to represent >20% of affected families in the state. Importantly, we find a later age at first diagnosis of ASD in females, which potentially calls attention to the need for improved early diagnosis in girls. Also, we report a high rate of co-occurring medical and psychiatric conditions in affected individuals.

Sensitivity to audio-visual synchrony and its relation to language abilities in children with and without ASD.

Autism Spectrum Disorder (ASD) is often accompanied by deficits in speech and language processing. Speech processing relies heavily on the integration of auditory and visual information, and it has been suggested that the ability to detect correspondence between auditory and visual signals helps to lay the foundation for successful language development. The goal of the present study was to examine whether young children with ASD show reduced sensitivity to temporal asynchronies in a speech processing task when compared to typically developing controls, and to examine how this sensitivity might relate to language proficiency. Using automated eye tracking methods, we found that children with ASD failed to demonstrate sensitivity to asynchronies of 0.3s, 0.6s, or 1.0s between a video of a woman speaking and the corresponding audio track. In contrast, typically developing children who were language-matched to the ASD group, were sensitive to both 0.6s and 1.0s asynchronies. We also demonstrated that individual differences in sensitivity to audiovisual asynchronies and individual differences in orientation to relevant facial features were both correlated with scores on a standardized measure of language abilities. Results are discussed in the context of attention to visual language and audio-visual processing as potential precursors to language impairment in ASD. Autism Res 2018, 11: 645-653. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Speech processing relies heavily on the integration of auditory and visual information, and it has been suggested that the ability to detect correspondence between auditory and visual signals helps to lay the foundation for successful language development. The goal of the present study was to explore whether children with ASD process audio-visual synchrony in ways comparable to their typically developing peers, and the relationship between preference for synchrony and language ability. Results showed that there are differences in attention to audiovisual synchrony between typically developing children and children with ASD. Preference for synchrony was related to the language abilities of children across groups.

Behavioral Outcomes of Specialized Psychiatric Hospitalization in the Autism Inpatient Collection (AIC): A Multisite Comparison.

Psychiatric hospitalization of children with autism spectrum disorder (ASD) is relatively common and occurs at a higher rate than in non-ASD youth. This study compared changes in the severity of serious problem behaviors in 350 youth with ASD enrolled in the autism inpatient collection during and after hospitalization in six specialized child psychiatry units. There was a significant reduction in serious problem behaviors from admission (aberrant behavior checklist-irritability subscale M = 29.7, SD 9.6) to discharge (M = 15.0, SD 10.3) and 2-month follow-up (M = 19.3, SD 10.3). Between discharge and 2-month follow-up, tantrum-like behaviors but not self-injurious behaviors increased slightly. Improvement in the severity of problem behaviors was not uniform across sites, even after controlling for measured site differences.

Predictors of Inpatient Psychiatric Hospitalization for Children and Adolescents with Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is associated with significant healthcare expenditures and a greater utilization of psychiatric health services. High utilization may not be evenly distributed across individuals with ASD. The objective of this study was to identify individual and family characteristics that increase the risk of psychiatric hospitalization. Naturalistic study of two age- and gender-matched ASD cohorts, inpatients enrolled in the Autism Inpatient Collection (AIC) and outpatients enrolled in the Rhode Island Consortium of Autism Research and Treatment (RI-CART), revealed a number of factors associated with hospitalization. Multiple logistic regression analyses revealed that adaptive functioning, ASD symptom severity, primary caregiver's marital status, the presence of mood disorders, and the presence of sleep problems independently increased the risk of psychiatric hospitalization.

Attempting to "Increase Intake from the Input": Attention and Word Learning in Children with Autism.

Previous work has demonstrated that social attention is related to early language abilities. We explored whether we can facilitate word learning among children with autism by directing attention to areas of the scene that have been demonstrated as relevant for successful word learning. We tracked eye movements to faces and objects while children watched videos of a woman teaching them new words. Test trials measured participants' recognition of these novel word-object pairings. Results indicate that for children with autism and typically developing children, pointing to the speaker's mouth while labeling a novel object impaired performance, likely because it distracted participants from the target object. In contrast, for children with autism, holding the object close to the speaker's mouth improved performance.

Methylation of the Glucocorticoid Receptor (NR3C1) in Placenta Is Associated with Infant Cry Acoustics.

Epigenetic mechanisms regulating expression of the glucocorticoid receptor gene (NR3C1) promoter may influence behavioral and biological aspects of stress response in human infants. Acoustic features of infant crying are an indicator of neurobehavioral and neurological status not yet investigated in relation to epigenetic mechanisms. We examined NR3C1 methylation in placental tissue from a series of 120 healthy newborn infants in relation to a detailed set of acoustic features extracted from newborn infant cries. We identified significant associations of NR3C1 methylation with energy variation in infants' cries as well as with the presence of very high fundamental frequency in cry utterances. The presence of high fundamental frequency in cry (above 1 kHz) has been linked to poor vocal tract control, poor regulation of stress response, and may be an indicator or poor neurobehavioral integrity. Thus, these results add to evidence linking epigenetic alteration of the NR3C1 gene in the placenta to neurodevelopmental features in infants.

Category search speeds up face-selective fMRI responses in a non-hierarchical cortical face network.

The human brain is extremely efficient at detecting faces in complex visual scenes, but the spatio-temporal dynamics of this remarkable ability, and how it is influenced by category-search, remain largely unknown. In the present study, human subjects were shown gradually-emerging images of faces or cars in visual scenes, while neural activity was recorded using functional magnetic resonance imaging (fMRI). Category search was manipulated by the instruction to indicate the presence of either a face or a car, in different blocks, as soon as an exemplar of the target category was detected in the visual scene. The category selectivity of most face-selective areas was enhanced when participants were instructed to report the presence of faces in gradually decreasing noise stimuli. Conversely, the same regions showed much less selectivity when participants were instructed instead to detect cars. When "face" was the target category, the fusiform face area (FFA) showed consistently earlier differentiation of face versus car stimuli than did the "occipital face area" (OFA). When "car" was the target category, only the FFA showed differentiation of face versus car stimuli. These observations provide further challenges for hierarchical models of cortical face processing and show that during gradual revealing of information, selective category-search may decrease the required amount of information, enhancing and speeding up category-selective responses in the human brain.

Functional connectivity in the first year of life in infants at risk for autism spectrum disorder: an EEG study.

In the field of autism research, recent work has been devoted to studying both behavioral and neural markers that may aide in early identification of autism spectrum disorder (ASD). These studies have often tested infants who have a significant family history of autism spectrum disorder, given the increased prevalence observed among such infants. In the present study we tested infants at high- and low-risk for ASD (based on having an older sibling diagnosed with the disorder or not) at 6- and 12-months-of-age. We computed intrahemispheric linear coherence between anterior and posterior sites as a measure of neural functional connectivity derived from electroencephalography while the infants were listening to speech sounds. We found that by 12-months-of-age infants at risk for ASD showed reduced functional connectivity compared to low risk infants. Moreover, by 12-months-of-age infants later diagnosed with ASD showed reduced functional connectivity, compared to both infants at low risk for the disorder and infants at high risk who were not later diagnosed with ASD. Significant differences in functional connectivity were also found between low-risk infants and high-risk infants who did not go onto develop ASD. These results demonstrate that reduced functional connectivity appears to be related to genetic vulnerability for ASD. Moreover, they provide further evidence that ASD is broadly characterized by differences in neural integration that emerge during the first year of life.

Infants' experience-dependent processing of male and female faces: insights from eye tracking and event-related potentials.

The goal of the present study was to investigate infants' processing of female and male faces. We used an event-related potential (ERP) priming task, as well as a visual-paired comparison (VPC) eye tracking task to explore how 7-month-old "female expert" infants differed in their responses to faces of different genders. Female faces elicited larger N290 amplitudes than male faces. Furthermore, infants showed a priming effect for female faces only, whereby the N290 was significantly more negative for novel females compared to primed female faces. The VPC experiment was designed to test whether infants could reliably discriminate between two female and two male faces. Analyses showed that infants were able to differentiate faces of both genders. The results of the present study suggest that 7-month olds with a large amount of female face experience show a processing advantage for forming a neural representation of female faces, compared to male faces. However, the enhanced neural sensitivity to the repetition of female faces is not due to the infants' inability to discriminate male faces. Instead, the combination of results from the two tasks suggests that the differential processing for female faces may be a signature of expert-level processing.

Face categorization in visual scenes may start in a higher order area of the right fusiform gyrus: evidence from dynamic visual stimulation in neuroimaging.

How a visual stimulus is initially categorized as a face by the cortical face-processing network remains largely unclear. In this study we used functional MRI to study the dynamics of face detection in visual scenes by using a paradigm in which scenes containing faces or cars are revealed progressively as they emerge from visual noise. Participants were asked to respond as soon as they detected a face or car during the noise sequence. Among the face-sensitive regions identified based on a standard localizer, a high-level face-sensitive area, the right fusiform face area (FFA), showed the earliest difference between face and car activation. Critically, differential activation in FFA was observed before differential activation in the more posteriorly located occipital face area (OFA). A whole brain analysis confirmed these findings, with a face-sensitive cluster in the right fusiform gyrus being the only cluster showing face preference before successful behavioral detection. Overall, these findings indicate that following generic low-level visual analysis, a face stimulus presented in a gradually revealed visual scene is first detected in the right middle fusiform gyrus, only after which further processing spreads to a network of cortical and subcortical face-sensitive areas (including the posteriorly located OFA). These results provide further evidence for a nonhierarchical organization of the cortical face-processing network.

Neural systems underlying lexical competition: an eye tracking and fMRI study.

The present study investigated the neural bases of phonological onset competition using an eye tracking paradigm coupled with fMRI. Eighteen subjects were presented with an auditory target (e.g., beaker) and a visual display containing a pictorial representation of the target (e.g., beaker), an onset competitor (e.g., beetle), and two phonologically and semantically unrelated objects (e.g., shoe, hammer). Behavioral results replicated earlier research showing increased looks to the onset competitor compared to the unrelated items. fMRI results showed that lexical competition induced by shared phonological onsets recruits both frontal structures and posterior structures. Specifically, comparison between competitor and no-competitor trials elicited activation in two nonoverlapping clusters in the left IFG, one located primarily within BA 44 and the other primarily located within BA 45, and one cluster in the left supramarginal gyrus (SMG) extending into the posterior superior temporal gyrus. These results indicate that the left IFG is sensitive to competition driven by phonological similarity and not only to competition among semantic/conceptual factors. Moreover, they indicate that the SMG is not only recruited in tasks requiring access to lexical form but is also recruited in tasks that require access to the conceptual representation of a word.