molly helt

Online Parent Training in Early Behavioral Intervention (OPT-In-Early) is a self-directed resource for caregivers of autistic children. Sixty-three parent–child dyads from three states in were randomized to the OPT-In-Early or treatment as usual group. Parents in both groups completed baseline and post-treatment visits, which were targeted for 4 months apart but allowed to go up to 6 months. Compared to parents in the treatment as usual group, parents randomized to OPT-In-Early learned more evidence-based intervention principles from baseline to post-treatment and were rated by observers blind to group and time as increasing their use of these strategies during brief semi-structured interactions with their children. Parent participation in OPT-In-Early did not significantly influence children’s social communication as coded from one observation session. Results suggest that parents acquired knowledge and skills in intervention techniques from OPT-In-Early. Longer trials may be needed for gains in child behavior. Lay abstract Early intervention can help children learn language and improve social communication. However, many barriers, including the expense of services and an insufficient number of providers, prohibit families from accessing services when their children are young. We developed a comprehensive online program for caregivers of autistic children. The program, Online Parent Training in Early Behavioral Intervention (OPT-In-Early), uses text and video demonstrations to teach caregivers effective methods for improving their children’s language, social, and adaptive skills (e.g. using utensils, toilet training), and reducing their children’s disruptive behavior. Sixty-three parents from three states participated in the study. Half of the parents received access to the OPT-In-Early program. After 4 months, parents who had access to the OPT-In-Early program learned more effective intervention strategies, and started using these strategies during interactions with their children, than parents who did not receive access to the program. Parent participation in OPT-In-Early did not significantly influence children’s social communication compared to children whose parents did not have access to OPT-In-Early. A longer duration of parents using learned intervention skills with their children may be needed for children’s social communication skills to improve.

Background: Since Asperger's first descriptions, clinicians have reported striking differences in the conversational gestures produced by individuals with autism spectrum disorders (ASD), noting that gestures are clumsy and inappropriate. Currently, gestural quantity, quality, and integration with speech contribute to 1/3 of diagnostic items on the ADOS. The limited empirical literature focuses primarily on declarative (attention-drawing) pointing gestures in preschoolers. Furthermore, work from our lab and elsewhere indicates that individuals with ASD gesture as frequently as their peers. Objectives: Dynamical systems theory indicates that behaviors at multiple timescales (e.g., from milliseconds to minutes) can reliably drive behaviors at other timescales. For example, new cognitive structures emerge as a consequence of multi-scale behaviors. By examining hand movements as participants solve a computer-based gears puzzle, we assess (1) the contribution of multi-scale behaviors...

Both individuals with diagnosed with Autism Spectrum Disorder (ASD) and individuals high in psychopathic traits show reduced susceptibility to contagious yawning; that is, yawning after seeing or hearing another person yawn. Yet it is unclear whether the same underlying processes (e.g., reduced eye gaze) are responsible for the relationship between reduced contagion and these very different types of clinical traits. College Students (n = 97) watched videos of individuals yawning or scratching (a form of contagion not reliant on eye gaze for transmission) while their eye movements were tracked. They completed the Interpersonal Reactivity Index (IRI), the Autism-Spectrum Quotient (AQ), the Psychopathy Personality Inventory-Revised (PPI-R), and the Adolescent and Adult Sensory Processing Disorder Checklist. Both psychopathic traits and autistic traits showed an inverse relationship to contagious yawning, consistent with previous research. However, the relationship between autistic (but...

generally assumed to be lifelong, we review evidence that between 3 % and 25 % of children reportedly lose their ASD diagnosis and enter the normal range of cognitive, adaptive and social skills. Predictors of recovery include relatively high intelligence, receptive language, verbal and motor imitation, and motor development, but not overall symptom severity. Earlier age of diagnosis and treatment, and a diagnosis of Pervasive Developmental Disorder-Not Other-wise Specified are also favorable signs. The presence of seizures, mental retardation and genetic syndromes are unfavorable signs, whereas head growth does not predict outcome. Controlled studies that report the most recovery came about after the use of behavioral techniques. Residual vulnerabilities affect higher-order communication and at-tention. Tics, depression and phobias are frequent residual co-morbidities after recovery. Possible mechanisms of recovery include: normalizing input by forcing attention outward or enrichin...

Individuals with autism spectrum disorders (ASDs) have significant visuomotor processing deficits, atypical motoric behavior, and often substantial problems connecting socially. We suggest that the perceptual, attentional, and adaptive timing deficiencies associated with autism might directly impact the ability to become a socially connected unit with others. Using a rocking chair paradigm previously employed with typical adults, we demonstrate that typically-developing (TD) children exhibit spontaneous social rocking with their caregivers. In contrast, children diagnosed with ASD do not demonstrate a tendency to rock in a symmetrical state with their parents. We argue that the movement of our bodies is one of the fundamental ways by which we connect with our environment and, especially, ground ourselves in social environments. Deficiencies in perceiving and responding to the rhythms of the world may have serious consequences for the ability to become adequately embedded in a social...

The authors tested susceptibility to contagious itching, laughter, and yawning in 55 children with autism spectrum disorder (ASD), ages 8-14, and 106 typically developing (TD) children, ages 5-14. Children with ASD were less likely to yawn or laugh contagiously compared with TD peers, but showed increased susceptibility to contagious itching, under naturalistic conditions. Contagious yawning and laughter were positively correlated with emotional empathy in the TD group. In contrast, contagious itching showed no relationship to empathy, and was positively correlated with autism symptom severity in the ASD group. The authors explore the implications of these findings in terms of psychological theories about ASD.

Early intervention with parent participation is important for facilitating skill development in children with Autism Spectrum Disorder (ASD). However, many barriers delay or prohibit families from accessing care. We describe the development and acceptability of a novel, comprehensive, self-directed online program for caregivers of children with ASD. Program effectiveness will be presented in a subsequent manuscript. The program is based on behavioral, naturalistic, and developmental principles, and teaches caregivers to use evidence-based interventions to teach developmentally appropriate targets. Approximately two-thirds of enrolled parents completed all 14 modules; barriers to completion for the additional families are described. Parents reported that the program was clear, enjoyable, and useful in teaching them interventions and in improving their children's skills and behavior.

Although deficits in cognitive empathy are well established in individuals with autism spectrum disorder (ASD), the literature on emotional empathy, or emotional contagion, in individuals with ASD is sparse and contradictory. The authors tested susceptibility to contagious yawning and laughter in children with ASD (n = 60) and typically developing (TD) children (n = 60), ages 5–17 years, under various conditions, to elucidate factors that may affect emotional contagion in these populations. Although TD children showed equal amounts of emotional contagion across conditions, children with ASD were highly influenced by the familiarity of the target stimulus, as well as task instructions that encourage eye gaze to target. More specifically, children with ASD exhibited less contagious yawning and laughter than their TD peers except when their attention was explicitly directed to the eyes or (and even more so) when their parents served as the stimulus targets. The authors explore the impl...

Early autism research focused on behavior and cognition. In recent decades, the pace of research has accelerated, and advances in imaging and genetics have allowed the accumulation of biological data. Nevertheless, a coherent picture of the syndrome at either phenotypic or biological level has not emerged. We see two fundamental obstacles to progress in basic understanding of autism. First, the two defining features (impairment in social interactions and communication, and restricted, repetitive behaviors and interests) are historically seen as integrally related. Others hold that these two major traits are fractionable and must be studied independently, casting doubt on autism as a coherent syndrome. Second, despite much recent research on brain structure and function, environmental factors, and genetics/genomics, findings on the biological level have not generally aligned well with those on the phenotypic level. In the first two sections, we explore these challenges, and in the th...

Both social input and facial feedback appear to be processed differently by individuals with autism spectrum disorder (ASD). We tested the effects of both of these types of input on laughter in children with ASD. Sensitivity to facial feedback was tested in 43 children with ASD, aged 8-14 years, and 43 typically developing children matched for mental age (6-14), in order to examine whether children with ASD use bodily feedback as an implicit source of information. Specifically, children were asked to view cartoons as they normally would (control condition), and while holding a pencil in their mouth forcing their smiling muscles into activation (feedback condition) while rating their enjoyment of the cartoons. The authors also explored the effects of social input in children with ASD by investigating whether the presence of a caregiver or friend (companion condition), or the presence of a laugh track superimposed upon the cartoon (laugh track condition) increased the children's s...

Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Kelley, Naigles, & Fein (2010) reported small differences in language scores in OO compared to typically developing adolescents. Objectives: The current study examines semantic and syntactic language skills as measured on the Comprehensive Evaluation of Language Fundamentals (CELF-IV) in a small cohort of individuals once diagnosed with an ASD who have since lost their diagnosis, known as the “optimal outcome” (OO) group. The study compares performance in the OO group to performance...

Background: A study is currently following children who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for such a disorder. These children have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASDs, achieve "optimal outcomes" (OO; Sutera et al., 2007; Helt et al., 2008; Kelley, Naigles, & Fein, 2010). Kelley, Naigles, & Fein (2010) found that their OO group showed some small, but notable differences in language scores compared to a typically developing group. Objectives: The current study examines language skills as measured on the Clinical Evaluation of Language Fundamentals, 4th Edition (CELF-IV), California Verbal Learning Test (CVLT), Comprehensive Test of Phonological Processing Nonword Repetition subtest (CTOPP NR), and Test of Language Competence (TLC) in a cohort of O...

Background: A study is currently following children and adolescents who have a history of autism spectrum disorders (ASDs), but who no longer meet diagnostic criteria for such a disorder. These individuals have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of individuals, once diagnosed with ASDs, achieve "optimal outcomes" (OO, Sutera et al., 2007; Kelley, Naigles & Fein, 2010; Helt et al., 2008). Objectives: This study examines parent report of executive functioning (EF) among children and adolescents who achieved OO. Methods: Parents of 28 individuals who achieved OO completed the Behavior Rating Inventory of Executive Function (BRIEF) and their responses were compared to parent responses of 25 high-functioning individuals with a current ASD diagnosis (HFA), and 31 typically developing peers (TD). The BRIEF provides a Global Executive Composite sc...

Background: A study is currently following children and adolescents who have a history of autism spectrum disorder (ASD), but who no longer meet diagnostic criteria for the disorder. These individuals have achieved social and language skills within the average range for their ages and receive little or no school support. Several recent studies suggest that this small subset of children, once diagnosed with ASD, achieve an "optimal outcome (OO)" (Sutera et al., 2007, Kelley et al., 2010, and Helt et al., 2008). Objectives: Despite no longer meeting diagnostic criteria for an ASD, OO individuals may exhibit subtle deficits in the social domain. This study examines social functioning by assessing autism symptomatology and adaptive skills in a group of OO individuals. Methods: The Autism Diagnostic Observation Schedule (ADOS) was conducted with 32 OO individuals (M(age)=12.9), 33 individuals with high-functioning autism (HFA) (M(age)=13.4), and 25 typically developing (TD) pee...

Results: Χ² analyses revealed no significant differences between the ASD and DD groups in parentally reported spitting up/vomiting, food sensitivities or allergies, constipation, diarrhea, or other GI symptoms. Significantly higher rates of early feeding problems and gagging in ...

This study examines the academic abilities of children and adolescents who were once diagnosed with an autism spectrum disorder, but who no longer meet diagnostic criteria for this disorder. These individuals have achieved social and language skills within the average range for their ages, receive little or no school support, and are referred to as having achieved “optimal outcomes.” Performance of 32 individuals who achieved optimal outcomes, 41 high-functioning individuals with a current autism spectrum disorder diagnosis (high-functioning autism), and 34 typically developing peers was compared on measures of decoding, reading comprehension, mathematical problem solving, and written expression. Groups were matched on age, sex, and nonverbal IQ; however, the high-functioning autism group scored significantly lower than the optimal outcome and typically developing groups on verbal IQ. All three groups performed in the average range on all subtests measured, and no significant differ...