Shu H Yau

Autistic children experience higher rates of anxiety compared to their nonautistic peers; however, psychotherapeutic treatments for anxiety such as cognitive behavioral therapy often have limited effectiveness in this population. This study protocol presents a novel, co-designed video-recorded yoga intervention for anxiety, tailored to the unique needs of autistic children. The proposed randomized controlled trial aims to evaluate the efficacy of this intervention compared to a treatment-as-usual waitlist control group. Primary outcomes include changes in anxiety severity, assessed using the Anxiety Disorders Interview Schedule or DSM-5 (ADIS-5) and the Anxiety Scale for Children with Autism Spectrum Disorder (ASC-ASD). Secondary outcomes examine emotion regulation and intolerance of uncertainty using the Emotion Dysregulation Inventory (EDI) and the Intolerance of Uncertainty Scale Child version (IUSC), alongside physiological changes in heart rate variability. Data will be analyzed using repeated measures analysis to assess intervention effects, with mediation analysis exploring the roles of emotion regulation, intolerance of uncertainty, and autonomic function in anxiety reduction. Findings will contribute to the growing evidence base for complementary interventions in autistic populations. If effective, this co-designed yoga intervention could provide an accessible, adaptable, and scalable option for treating anxiety in autistic children, particularly those facing barriers to traditional therapies.

Augmentative alternative communication (AAC) devices or systems are often prescribed to minimally verbal or nonspeaking autistic individuals and other individuals with complex communication needs to facilitate communication or as an alternative to spoken language. AAC use can result in communication gains and improved quality of life for minimally verbal or nonspeaking individuals. Despite this, AAC abandonment is high, limiting societal participation of the individual on the autism spectrum with complex communication needs. Our study is a novel exploration of the barriers of AAC use from a multi-stakeholder perspective, and a qualitative analysis of similarities and differences between stakeholders. We conducted semi-structured interviews and focus groups with 30 parent-carers, educators and clinicians currently supporting AAC users in Western Australia and analysed the data using reflexive thematic analysis. Barriers from each stakeholder group were coded, resulting in 17 subthemes forming five main themes common to all stakeholders: Stakeholder Knowledge, Stakeholder Attitudes and Stigma, Resources, AAC User Engagement, and Device Fit. Contrasting perspectives included actual and perceived stigma associated with AAC use (parent-carers vs clinicians); different struggles with resources and knowledge (parent-carers vs clinicians and educators); and a lack of clinician communication in the processes that determined AAC-fit for school environments (educators only). Findings are discussed in the context of improving inter-stakeholder collaboration and capacity building in Australian health service and practice to better support minimally verbal or nonspeaking autistic individuals and individuals with complex communication needs. Suggestions are also offered for communication partner training.

The purpose of this systematic review was to examine the efficacy of mindfulness-based interventions for improving anxiety, social skills, and aggressive behaviors in children and young people (CYP) with Autism Spectrum Disorder (ASD); summarize the results across clinic, home, and school contexts; and evaluate the quality of these interventions for clinical practice.

A search of the PsycINFO, Medline (Ovid), Web of Science, and Scopus databases was conducted in June 2021, and no date restrictions were applied. Inclusion criteria were quantitative or qualitative research implementing a mindfulness-based intervention for CYP aged 6-25 years with a diagnosis of ASD, Pervasive Development Disorder, or Asperger's Syndrome.

We identified 23 articles for inclusion including within subject pre- and post-testing, multiple baselines, and randomized control trials, among other research designs. Of these, a quality analysis conducted using an ASD research-specific risk of bias tool found over half (14) were of weak methodological quality, whereas only four and five were found to be of strong and adequate quality, respectively.

While the results of this systematic review suggest promising evidence for the use of mindfulness-based interventions to improve anxiety, social skills, and aggressive behaviors in CYP with ASD, results should be interpreted with caution due to the limitations resulting from the overall weak quality of the studies.The review protocol was pre-registered on PROSPERO (CRD42021259125) and can be viewed at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=259125.

Purpose We aimed to develop a noninvasive neural test of language comprehension to use with nonspeaking children for whom standard behavioral testing is unreliable (e.g., minimally verbal autism). Our aims were threefold. First, we sought to establish the sensitivity of two auditory paradigms to elicit neural responses in individual neurotypical children. Second, we aimed to validate the use of a portable and accessible electroencephalography (EEG) system, by comparing its recordings to those of a research-grade system. Third, in light of substantial interindividual variability in individuals' neural responses, we assessed whether multivariate decoding methods could improve sensitivity. Method We tested the sensitivity of two child-friendly covert N400 paradigms. Thirty-one typically developing children listened to identical spoken words that were either strongly predicted by the preceding context or violated lexical–semantic expectations. Context was given by a cue word (Experiment 1) or sentence frame (Experiment 2), and participants either made an overall judgment on word relatedness or counted lexical–semantic violations. We measured EEG concurrently from a research-grade system, Neuroscan's SynAmps2, and an adapted gaming system, Emotiv's EPOC+. Results We found substantial interindividual variability in the timing and topology of N400-like effects. For both paradigms and EEG systems, traditional N400 effects at the expected sensors and time points were statistically significant in around 50% of individuals. Using multivariate analyses, detection rate increased to 88% of individuals for the research-grade system in the sentences paradigm, illustrating the robustness of this method in the face of interindividual variations in topography. Conclusions There was large interindividual variability in neural responses, suggesting interindividual variation in either the cognitive response to lexical–semantic violations and/or the neural substrate of that response. Around half of our neurotypical participants showed the expected N400 effect at the expected location and time points. A low-cost, accessible EEG system provided comparable data for univariate analysis but was not well suited to multivariate decoding. However, multivariate analyses with a research-grade EEG system increased our detection rate to 88% of individuals. This approach provides a strong foundation to establish a neural index of language comprehension in children with limited communication

Passive testing of auditory function is an important objective in individuals with ASD due to known difficulties in understanding and/or following task instructions. In present study the habituation to standard tones following deviants and the auditory discriminative processes were examined in two conditions: electronic and human sounds, in a sample of 16 ASD children. ASD children presented a reduced habituation in the P1 component and a decrease in the amplitude of the mismatch negativity indicating a lower auditory discrimination with respect to controls. MMN amplitude was related to sensory sensitivity. Results suggest an increased activation to repeatedly auditory stimulus and a poor auditory discrimination, for both: electronic and human sounds with consequences on the impaired sensory behavior of ASD subjects.

The US ‘decade of the brain’ in the 1990s saw the launch of a number of educational programmes that claimed to be ‘brain-based’. These were usually unscientific in their approach and motivated by commercial interests. Rather than inform education, these programmes often promoted misunderstandings about the brain: so-called ‘neuromyths’ (Howard-Jones, 2014). In contrast, the last two decades have seen a blossoming of authentic dialogue between education and neuroscience, aimed at enhancing teaching and learning with insights from the mind and brain. These more recent initiatives are very different from their predecessors, often including critiques of the myths that the brain-based industry helped to create. These efforts to identify genuine scientific insights that can inform teachers’ understanding and practice bear a variety of names, including ‘neuroeducation’, ‘educational neuroscience’ and ‘mind, brain and education’. Rather than producing brain-based approaches, they converged on the view that neuroscience is one important source of insight into learning that should be considered alongside other scientific and educational sources.

Some critics of these efforts have proposed that education is better served by psychology and that neuroscience can add nothing new to what psychology already offers (Bowers, 2016). In response, those working across neuroscience and education point to how our understanding of the mind and brain are complementary to each other (Howard-Jones, Varma, et al., 2016). Indeed, it is usually the collaboration of neuroscientists, psychologists and educators that characterises research involving neuroscience and education. Efforts to consider classroom practice in modern scientific terms have recently been referred to as the ‘science of learning’ (SoL). They do not promote a single model of classroom learning, but instead refer to a range of insights about learning that have been derived using the scientific method.

The Acoustic Change Complex (ACC), a P1-N1-P2-like event-related response to changes in a continuous sound, has been suggested as a reliable, objective, and efficient test of auditory discrimination. We used magnetoencephalography to compare the magnetic ACC (mACC) to the more widely used mismatch field (MMF). Brain responses of 14 adults were recorded during mACC and MMF paradigms involving the same pitch and vowel changes in a synthetic vowel sound. Analyses of peak amplitudes revealed a significant interaction between stimulus and paradigm: for the MMF, the response was greater for vowel changes than for pitch changes, whereas, for the mACC, the pattern was reversed. A similar interaction was observed for the signal to noise ratio and single-trial analysis of individual participants’ responses showed that the MMF to Pitch changes was elicited less consistently than the other three responses. Results support the view that the ACC/mACC is a robust and efficient measure of simple auditory discrimination, particularly when researchers or clinicians are interested in the responses of individual listeners. However, the differential sensitivity of the two paradigms to the same acoustic changes indicates that the mACC and MMF are indices of different aspects of auditory processing and should, therefore, be seen as complementary rather than competing neurophysiological measures.

It has been proposed that language impairments in children with Autism Spectrum Disorders (ASD) stem from atypical neural processing of speech and/or nonspeech sounds. However, the strength of this proposal is compromised by the unreliable outcomes of previous studies of speech and nonspeech processing in ASD. The aim of this study was to determine whether there was an association between poor spoken language and atypical event-related field (ERF) responses to speech and nonspeech sounds in children with ASD (n = 14) and controls (n = 18). Data from this developmental population (ages 6–14) were analysed using a novel combination of methods to maximize the reliability of our findings while taking into consideration the heterogeneity of the ASD population. The results showed that poor spoken language scores were associated with atypical left hemisphere brain responses (200 to 400 ms) to both speech and nonspeech in the ASD group. These data support the idea that some children with ASD may have an immature auditory cortex that affects their ability to process both speech and nonspeech sounds. Their poor speech processing may impair their ability to process the speech of other people, and hence reduce their ability to learn the phonology, syntax, and semantics of their native language.

An estimated 30% of individuals with autism spectrum disorders (ASD) remain minimally verbal into late childhood, but research on cognition and brain function in ASD focuses almost exclusively on those with good or only moderately impaired language. Here we present a case study investigating auditory processing of GM, a nonverbal child with ASD and cerebral palsy. At the age of 8 years, GM was tested using magnetoencephalography (MEG) whilst passively listening to speech sounds and complex tones. Where typically developing children and verbal autistic children all demonstrated similar brain responses to speech and nonspeech sounds, GM produced much stronger responses to nonspeech than speech, particularly in the 65–165 ms (M50/M100) time window post-stimulus onset. GM was retested aged 10 years using electroencephalography (EEG) whilst passively listening to pure tone stimuli. Consistent with her MEG response to complex tones, GM showed an unusually early and strong response to pure tones in her EEG responses. The consistency of the MEG and EEG data in this single case study demonstrate both the potential and the feasibility of these methods in the study of minimally verbal children with ASD. Further research is required to determine whether GM's atypical auditory responses are characteristic of other minimally verbal children with ASD or of other individuals with cerebral palsy.

Objective

The aim of this study was to design a novel experimental approach to investigate the morphological characteristics of auditory cortical responses elicited by rapidly changing synthesized speech sounds.

Methods

Six sound-evoked magnetoencephalographic (MEG) responses were measured to a synthesized train of speech sounds using the vowels /e/ and /u/ in 17 normal hearing young adults. Responses were measured to: (i) the onset of the speech train, (ii) an F0 increment; (iii) an F0 decrement; (iv) an F2 decrement; (v) an F2 increment; and (vi) the offset of the speech train using short (jittered around 135 ms) and long (1500 ms) stimulus onset asynchronies (SOAs). The least squares (LS) deconvolution technique was used to disentangle the overlapping MEG responses in the short SOA condition only.

Results

Comparison between the morphology of the recovered cortical responses in the short and long SOAs conditions showed high similarity, suggesting that the LS deconvolution technique was successful in disentangling the MEG waveforms. Waveform latencies and amplitudes were different for the two SOAs conditions and were influenced by the spectro-temporal properties of the sound sequence. The magnetic acoustic change complex (mACC) for the short SOA condition showed significantly lower amplitudes and shorter latencies compared to the long SOA condition. The F0 transition showed a larger reduction in amplitude from long to short SOA compared to the F2 transition. Lateralization of the cortical responses were observed under some stimulus conditions and appeared to be associated with the spectro-temporal properties of the acoustic stimulus.

Conclusions

The LS deconvolution technique provides a new tool to study the properties of the auditory cortical response to rapidly changing sound stimuli. The presence of the cortical auditory evoked responses for rapid transition of synthesized speech stimuli suggests that the temporal code is preserved at the level of the auditory cortex. Further, the reduced amplitudes and shorter latencies might reflect intrinsic properties of the cortical neurons to rapidly presented sounds.

Significance

This is the first demonstration of the separation of overlapping cortical responses to rapidly changing speech sounds and offers a potential new biomarker of discrimination of rapid transition of sound.