Domains of Social Communication Handicap in Autism Spectrum Disorder

doi:10.1097/00004583-199906000-00022

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 38, Issue 6, June 1999, Pages 738-745

https://doi.org/10.1097/00004583-199906000-00022 Get rights and content

ABSTRACT

Objective

To investigate whether specific “social communication” handicaps could be identified in autism spectrum disorder using the Autism Diagnostic Observation Schedule and to compare the results with those found in a previous factor-analysis study using the Autism Diagnostic Interview-Revised.

Method

All subjects were evaluated with both instruments. J.R. and RET. independently diagnosed autism, Asperger's disorder, or pervasive developmental disorder-not otherwise specified in 51 children. Items from the Autism Diagnostic Observation Schedule that represented social communication behaviors were factor-analyzed.

Results

Three factors were identified: joint attention, affective reciprocity, and theory of mind. These are the same social communication domains that were identified in the previous study.

Conclusions

These 3 social communication domains have been discussed in the literature regarding normal development and in previous research on autism spectrum disorders. If these domains are replicated in larger sample sizes, they could be used to monitor the results of pharmacological and psychotherapeutic interventions in autism spectrum disorders.

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Early studies linking air pollution and children’s neurodevelopment focused largely on cognitive outcomes (Block et al., 2012; Calderon-Garciduenas et al., 2014) with more recent studies shifting to focus on behavioral outcomes (Guxens et al., 2014; Lubczynska et al., 2017; Stingone et al., 2017; Sunyer et al., 2015). Deficits in social skills and communication, as measured using the DSD, are hallmarks of ASD (Bradstreet et al., 2017; Robertson et al., 1999). Several previous studies have found an increased risk of ASD among children with greater prenatal and/or early postnatal air pollution exposures (Flores-Pajot et al., 2016; McGuinn et al., 2020).
Childhood exposure to air pollution has been linked with maladaptive cognitive development; however, less is known about the association between prenatal fine particulate matter (PM_2.5) exposure and childhood behavior.
Our aim was to assess the association between prenatal PM_2.5 exposure and behavioral development in 4-6 year old children residing in Mexico City.
We used data from 539 mother-child pairs enrolled in a prospective birth cohort in Mexico City. We estimated daily PM_2.5 exposure using a 1 km² satellite-based exposure model and averaged over each trimester of pregnancy. We assessed childhood behavior at 4-6 years of age using the parent-completed Behavioral Assessment Scale for Children (BASC-2) composite scores and subscales. We used linear regression models to estimate change in BASC-2 T-scores with trimester specific 5-μg/m³ increases in PM_2.5. All models were mutually adjusted for PM_2.5 exposures during the other trimesters, maternal factors including age, education, socioeconomic status, depression, and IQ, child’s age at study visit, and season. We additionally assessed sex-specific effects by including an interaction term between PM_2.5 and sex.
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Exposure to PM_2.5 during early pregnancy may be associated with impaired behavioral development in children, particularly for measures of adaptive skills. These results suggest that air pollution impacts behavioral domains as well as cognition, and that the timing of exposure may be critical.
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2019, Brain Research
Citation Excerpt :
In a second analysis, we evaluated the extent to which connectivity within and between the action observation, social cognitive and attention networks correlated with symptom severity in ASD. This analysis compared patterns of connectivity with symptom severity using the two subscales of the ADOS-Revised loaded by unique factors that may underlie distinct endotypes of the heterogeneous ASD population: the social communicative (ADOS-SA) and the observed restricted behaviors and interests (ADOS-RRB) subdomains (Gotham et al., 2008; Robertson et al., 1999; Shuster et al., 2014). The results from this analysis are shown in Fig. 3 (all p < 0.01; see also Table 3).
Autism Spectrum Disorder (ASD) is a developmental disorder characterized by impaired social communication, including attending to and interpreting social cues, initiating and responding to joint attention, and engaging in abstract social cognitive reasoning. Current studies emphasize a underconnectivity in ASD, particularly for brain systems that support abstract social reasoning and introspective thought. Here, we evaluate intrinsic connectivity in children with ASD, targeting brain systems that support the developmental precursors to social reasoning, namely perception of social cues and joint attention. Using resting state fMRI made available through the Autism Brain Imaging Data Exchange (ABIDE), we compute functional connectivity within and between nodes in the action observation, attention and social cognitive networks in children and adolescents with ASD. We also compare connectivity strength to observational assessments that explicitly evaluate severity of ASD on two distinct subdomains using the ADOS-Revised schedule: social affective (SA) and restricted, repetitive behaviors (RRB). Compared to age-matched controls, children with ASD have decreased functional connectivity in a number of connections in the action observation network, particularly in the lateral occipital cortex (LOTC) and fusiform gyrus (FG). Distinct patterns of connections were also correlated with symptom severity on the two subdomains of the ADOS. ADOS-SA severity most strongly correlated with connectivity to the left TPJ, while ADOS-RRB severity correlated with connectivity to the dMPFC. We conclude that atypical connectivity in the action observation system may underlie some of the more complex deficits in social cognitive systems in ASD.
Examining the relationship between social communication on the ADOS and real-world reciprocal social communication in children with ASD
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While many children with autism spectrum disorders (ASDs) communicate better with adults than peers, diagnostic measures are given by adult examiners. These measures may not accurately capture the deficits that children with ASD have in communicating with their peers.
This study examined the ability of the Autism Diagnostic Observation Schedule (ADOS) Social Communication scale to predict reciprocal communication in children with ASD during natural play with peers using the Peer Interaction Paradigm (PIP). Thirty participants with ASD were given the ADOS and then participated in the PIP, after which their behavior was analyzed.
Using linear regression, we found that Social Communication was the primary significant predictor for reciprocal communication during play, and that reciprocal communication was not predicted by Verbal IQ or the Restrictive and Repetitive Behaviors scale on the ADOS.
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Citation Excerpt :
Such a method would potentially help to advance ASD research across genetic and epidemiological domains. Several studies that have used factor analysis to examine ADOS subfactors have revealed an additional JA factor (Gotham et al., 2008; Gotham, Risi, Pickles, & Lord, 2007; Oosterling et al., 2010; Robertson, Tanguay, Lecuyer, Sims, & Waltrip, 1999). The JA factor identified by Gotham et al. (2007, 2008) and replicated by (Oosterling et al., 2010) was comprised of a range of discrete social behaviors including JA but also including behavioral requesting (i.e., pointing, response to joint attention, gesturing, showing, initiation of joint attention and unusual eye contact).
Joint attention skills have been shown to predict language outcomes in children with autism spectrum disorder (ASD). Less is known about the relationship between joint attention (JA) abilities in children with ASD and cognitive and adaptive abilities. In the current study, a subset of items from the Autism Diagnostic Observation Schedule (ADOS), designed to quantify JA abilities, were used to investigate social attention among an unusually large cross-sectional sample of children with ASD (n = 1061). An examination of the association between JA and a range of functional correlates (cognitive and adaptive) revealed JA was significantly related to verbal (VIQ) and non-verbal (NVIQ) cognitive ability as well as all domains of adaptive functioning (socialization, communication, and daily living skills). Additional analyses examined the degree to which the relation between adaptive abilities (socialization, communication, and daily living skills) and JA was maintained after taking into account the potentially mediating role of verbal and nonverbal cognitive ability. Results revealed that VIQ fully mediated the relation between JA and adaptive functioning, whereas the relation between these adaptive variables and JA was only partially mediated by NVIQ. Moderation analyses were also conducted to examine how verbal and non-verbal cognitive ability and gender impacted the relation between JA and adaptive functioning. In line with research showing a relation between language and JA, this indicates that while JA is significantly related to functional outcomes, this appears to be mediated specifically through a verbal cognitive pathway.

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ORIGINAL ARTICLESDomains of Social Communication Handicap in Autism Spectrum Disorder

ABSTRACT

Objective

Method

Results

Conclusions

Psychiatr Clin North Am

J Appl Dev Psychol

J Am Acad Child Adolesc Psychiatry

Infant Behav Dev

Psychiatr Clin North Am

J Am Acad Child Psychiatry

J Am Acad Child Adolesc Psychiatry

Coordinating Attention to people and objects in mother-infant and peer–infant interactions

Child Dev

Joint-attention deficits in autism: towards a cognitive analysis

Dev Psychopathol

The development of emotional concepts in autism

J Child Psychol Psychiatry

The theory of mind hypothesis of autism: explanation, evidence and assessment

Br J Disord Comm

The relationship between joint attention and play in autism

Dev Psychopathol

Sensorimotor functioning and communication in mute autistic children

J Autism Child Schizophr

Children's relationships: bridging the divide between cognitive and social development

J Child Psychol Psychiatry

A cross-sequential assessment of the occurence of pointing in 3- to 12-month-old human infants

Infant Behav Dev

The autistic child's appraisal of the expressions of emotion: a further study

J Child Psychol Psychiatry

Understanding persons: the role of affect

Autistic disturbances of affective contact

Nerv Child

Affective sharing in the context of joint attention interactions of normal, autistic, and mentally retarded children

J Autism Dev Disord

Autism Diagnostic Interview: a standardized investigator-based interview

J Autism Dev Disord

Pretense and representation: the origins of “theory of mind”

Psychol Rev

Autistic children's understanding of seeing, knowing and believing

Br J Dev Psychol

ORIGINAL ARTICLES
Domains of Social Communication Handicap in Autism Spectrum Disorder