The Role of Theory of Mind, Executive Functions, and Central Coherence in Reading Comprehension for Children with ASD and Typical Development

Yael Kimhi , Yifat Mirsky , Nirit Bauminger-Zviely

Abstract

Many children with autism spectrum disorders (ASD) have challenges in reading comprehension, especially when implicit information in narrative texts is involved. Three interrelated factors influencing reading comprehension have been proposed to explain these challenges: Theory of Mind – ToM; executive functions – EF; and central coherence – CC. This study investigated the differential contribution of these cognitive abilities to reading comprehension among cognitively able children with ASD compared to matched peers with typical development (TD). 28 third-grade children with ASD and 28 third-grade children with TD participated in the study. Four measures were administered: ToM, CC, EF (working memory, planning, inhibitory control, cognitive flexibility), and reading comprehension. One-way ANOVAs were computed to examine group differences in cognitive characteristics (ToM, CC, EF) and reading comprehension. Regressions were performed to examine the contribution of cognitive characteristics (ToM, CC, EF) to reading comprehension abilities (explicit, implicit, and general score) in ASD and TD. The TD group outperformed the ASD group in ToM and various EF measures but not in CC or reading comprehension. Positive main effects were found for ToM, and EF measures (planning – 3rd level, inhibition, and cognitive flexibility), demonstrating their contribution to reading comprehension abilities in both groups. Interactions revealed positive main effects for EF planning and CC for the ASD group only, showing the contribution of EF planning and CC for better reading comprehension. Our findings suggest different processing mechanisms regarding reading comprehension in each group.

摘要

许多患有自闭症谱系障碍（ASD）的儿童在阅读理解方面存在挑战，尤其是当涉及叙事文本中的隐含信息时。影响阅读理解的三个相关因素被提出来解释这些挑战:心理理论；执行职能-EF；和中央相干- CC。这项研究调查了有认知能力的自闭症儿童与有典型发展（TD）的同龄人相比，这些认知能力对阅读理解的不同贡献。28名患有自闭症的三年级儿童和28名患有TD的三年级儿童参加了这项研究。实施了四项测量:ToM、CC、EF（工作记忆、计划、抑制控制、认知灵活性）和阅读理解。计算单向ANOVAs以检查认知特征（ToM、CC、EF）和阅读理解的组间差异。进行回归分析以检验认知特征（ToM、CC、EF）对阅读理解能力（显性、隐性和总分）的影响。TD组在心理理论和各种EF指标方面优于ASD组，但在交际能力或阅读理解方面则不然。发现ToM和EF测量（第三级规划、抑制和认知灵活性）具有积极的主要影响，表明它们对两组的阅读理解能力都有贡献。互动揭示了仅ASD组的EF计划和CC的积极主要影响，显示了EF计划和CC对更好的阅读理解的贡献。我们的研究结果表明，每组学生阅读理解的加工机制不同。

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Letter to the Editor: Supporting Drivers with Autism and Police Officer Interactions-Connecticut’s Blue Envelope Program

Meghan Brahm Gleeson , Harry Grindle , Mark M Gleeson

Abstract

The rising prevalence of autism spectrum disorder (ASD) has led to increased efforts to support individuals with ASD across numerous aspects of life, including driving. While obtaining a driver’s license substantially impacts quality of life and independence, it also creates distinct challenges for those with ASD. Challenges surrounding social communication, executive functioning, and sensory sensitivities are particularly evident when considering interactions between drivers with ASD and law enforcement personnel. Connecticut’s Blue Envelope Program aims to improve interactions between drivers with and ASD law enforcement by providing instructions for officers and drivers to follow during routine traffic stops on a physical, blue colored, envelope. The instructional guidelines aim to assist officers in understanding and appropriately responding to common ASD-related behaviors which may be otherwise misinterpreted and includes accommodations officers could consider during a stop. Additionally, the envelope outlines clear steps for drivers with ASD to follow through the stop as to support predictability and expectations. The widespread acceptance, efficacy and popularity of the Blue Envelope program underscores the importance of increasing awareness and understanding of ASD among law enforcement and the need for more supports to aid in these increasing interactions. Discussion is offered on a broader implementation of this program to support individuals with ASD and officers, while improving the outcomes of interactions.

摘要

自闭症谱系障碍（ASD）的患病率不断上升，导致人们在生活的许多方面（包括驾驶）加大了对自闭症患者的支持力度。虽然获得驾照极大地影响了生活质量和独立性，但它也给自闭症患者带来了独特的挑战。当考虑患有自闭症的司机与执法人员之间的互动时，围绕社会沟通、执行功能和感官敏感度的挑战尤为明显。康涅狄格州的蓝色信封计划旨在改善司机与ASD执法部门之间的互动，通过在蓝色信封上为官员和司机提供日常交通停车时应遵守的指示。指导方针旨在帮助官员理解和适当应对可能被误解的常见ASD相关行为，并包括官员在停车时可以考虑的便利措施。此外，信封还为患有自闭症的驾驶员列出了清晰的步骤，供他们在停车时遵循，以支持可预测性和期望值。蓝信封计划的广泛接受、功效和受欢迎程度强调了提高执法部门对自闭症的认识和理解的重要性，以及为这些日益增加的互动提供更多支持的必要性。讨论提供了更广泛的实施这一计划，以支持自闭症患者和官员，同时改善互动的结果。

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Autistic People’s Perspectives on Functioning Labels and Associated Reasons, and Community Connectedness

Nathan Keates , Farradeh Martin , Krysia Emily Waldock

Abstract

Purpose: Functioning labels have been used in relation to autistic people and differentiating between support needs. The main purpose of our study was to identify perspectives regarding language about being autistic. In regard to themselves and functioning. Furthermore, we investigated the influential factor of community connectedness on use of language acceptability and functioning labels.

Methods: 516 autistic respondents completed our survey. We asked about demographic characteristics, how respondents would like autistic people to be termed in the survey, and their acceptability (person with autism, Aspergers, disorder, conditions, living with autism, autistic). We also asked about respondents? Autistic Community Connectedness, acknowledging the implicit nature of language and identity (Stets & Serpe in New directions in identity theory and research, Oxford University Press, 2016). The main focus of our survey was whether or not to use functioning labels, and the supporting rationale.

Results: Qualitative study using Merleau-Ponty’s hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached.

Results: 97% of respondents stated that they find the term ‘autistic’ acceptable. Respondents who did see merit in using functioning labels to describe autistic people also reported not necessarily using them about themselves. Community membership was found to impact the participants’ language preferences to describe the support needs of autistic people, including the use of functioning labels.

Conclusion: The proposed best option for language preferences is not to find consensus but instead, opt for the optimal choice that people find the least offensive or disagreeable. This means using identity-first language and not using functioning labels.

摘要

目的:功能标签已用于自闭症患者和区分支持需求。我们研究的主要目的是确定关于自闭症语言的观点。关于他们自己和功能。此外，我们研究了社区连通性对语言可接受性和功能标签使用的影响因素。方法:516名自闭症受访者完成了我们的调查。我们询问了人口统计特征、受访者希望在调查中如何称呼自闭症患者以及他们的可接受性（自闭症患者、阿斯伯格症患者、障碍、状况、自闭症患者、自闭症患者）。我们还询问了受访者？自闭症社区连通性，承认语言和身份的隐含性质（Stets & Serpe在身份理论和研究的新方向中，牛津大学出版社，2016年）。我们调查的主要焦点是是否使用功能标签及其支持理由。结果:定性研究使用梅洛-庞蒂的解释学现象学作为哲学框架。数据收集于2020年至2021年在西班牙南部的一个省进行。总共进行了22次深度访谈，采用开放式问题，直到数据饱和。结果:97%的受访者表示他们认为“自闭症”一词是可以接受的。确实认为使用功能标签来描述自闭症患者有好处的受访者也表示不一定会在自己身上使用这些标签。研究发现，社区成员身份会影响参与者描述自闭症患者支持需求的语言偏好，包括使用功能标签。结论:建议的语言偏好的最佳选择不是寻找共识，而是选择人们认为最不冒犯或最不讨厌的最佳选择。这意味着使用身份优先的语言，而不是使用功能标签。

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Exploring Factors of Diagnostic Timing Among Black Autistic Youth

Harlee Onovbiona , Lauren Quetsch , Emily-Anne Del Rosario

Abstract

The goal of the present study was to compare profiles among Black families of autistic youth who were identified Early (≤ 2 years of age), Mid (age 3 or 4), and Delayed (≥ 5 years of age) to better identify the characteristics that contribute to early ASD identification and delayed ASD identification. Black caregivers with autistic youth (N = 101) were divided into Early (N = 34), Mid (N = 39), and Delayed (N = 28) groups and compared on (a) the age at which signs of autism signs were first noticed, (b) wait times, (c) previous misdiagnoses rates, and (d) racial barriers experienced during the diagnostic process. The results revealed differences between the diagnostic profiles. Specifically, (a) Delayed families noticed the first signs of autism significantly later, (b) Early families had significantly smaller wait times between age of noticing signs of autism and age of receiving the diagnosis, (c) the odds of receiving a later or delayed autism diagnosis was nearly three times higher for caregivers who reported receiving a misdiagnosis, and (d) there were no significant differences in racial barriers experienced between Early, Mid, and Delayed families. Challenges in receiving a timely diagnosis remain for some Black autistic youth. To improve early identification for Black autistic youth who are at risk for receiving delayed diagnostic care, further research should examine factors and practices that improve autism knowledge among professionals and caregivers, enhance assessment practices, and integrate culturally responsive practices into assessment and screening procedures.

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Effects of a Contingent Responses Intervention on the Quantity and Quality of Vocalizations of Preschool Children with Autism Spectrum Disorder

Jena McDaniel

Abstract

Multiple contemporary theories emphasize the quantity and quality of child vocalizations for promoting spoken language acquisition. Yet, empirical evidence for facilitating vocal development is strikingly lacking including for children with autism spectrum disorder (ASD) who have difficulty developing language. We evaluate use of contingent responses and vocal enhancement strategies to increase the quantity and quality of child vocalizations to which adults can respond with language-facilitating input for children with ASD. Three preschool children with ASD and minimal verbal skills participated. Using an alternating treatments design embedded within a multiple probe across participants design, we compared using contingent responses with and without vocal enhancement strategies versus a non-contingent control condition. Based on visual analysis and effect sizes, all participants showed a functional relation between both active intervention conditions and quantity of vocalizations, as predicted. For quality of vocalizations, changes under the active intervention conditions were less pronounced than those observed for quantity. Two participants showed a functional relation between at least one quality variable and the active interventions. Our hypothesis that vocal enhancement strategies would exhibit a value-added effect was partially supported for quantity and quality. Findings support using contingent responses to improve the quantity and to some degree the quality of vocalizations in young children with ASD and minimal verbal skills. Support for the added value of vocal enhancement strategies was mixed. Refining the intervention strategies is warranted to meet the needs of the understudied population of children with ASD and minimal verbal skills.

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In a Different Key: The Story of Autism

Nearly seventy-five years ago, Donald Triplett of Forest, Mississippi became the first child diagnosed with autism. Beginning with his family’s odyssey, In a Different Key tells the extraordinary story of this often misunderstood condition, and of the civil rights battles waged by the families of those who have it. Unfolding over decades, it is a beautifully rendered history of ordinary people determined to secure a place in the world for those with autism—by liberating children from dank institutions, campaigning for their right to go to school, challenging expert opinion on what it means to have autism, and persuading society to accept those who are different.

It is the story of women like Ruth Sullivan, who rebelled against a medical establishment that blamed cold and rejecting “refrigerator mothers” for causing autism; and of fathers who pushed scientists to dig harder for treatments. Many others played starring roles too: doctors like Leo Kanner, who pioneered our understanding of autism; lawyers like Tom Gilhool, who took the families’ battle for education to the courtroom; scientists who sparred over how to treat autism; and those with autism, like Temple Grandin, Alex Plank, and Ari Ne’eman, who explained their inner worlds and championed the philosophy of neurodiversity.

This is also a story of fierce controversies—from the question of whether there is truly an autism “epidemic,” and whether vaccines played a part in it; to scandals involving “facilitated communication,” one of many treatments that have proved to be blind alleys; to stark disagreements about whether scientists should pursue a cure for autism. There are dark turns too: we learn about experimenters feeding LSD to children with autism, or shocking them with electricity to change their behavior; and the authors reveal compelling evidence that Hans Asperger, discoverer of the syndrome named after him, participated in the Nazi program that consigned disabled children to death.

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The Reason I Jump: The Inner Voice of a Thirteen-Year-Old Boy with Autism

“One of the most remarkable books I’ve ever read. It’s truly moving, eye-opening, incredibly vivid.”—Jon Stewart, The Daily Show

NAMED ONE OF THE BEST BOOKS OF THE YEAR BY
NPR • The Wall Street Journal • Bloomberg Business • Bookish

FINALIST FOR THE BOOKS FOR A BETTER LIFE FIRST BOOK AWARD • NEW YORK TIMES BESTSELLER

You’ve never read a book like The Reason I Jump. Written by Naoki Higashida, a very smart, very self-aware, and very charming thirteen-year-old boy with autism, it is a one-of-a-kind memoir that demonstrates how an autistic mind thinks, feels, perceives, and responds in ways few of us can imagine. Parents and family members who never thought they could get inside the head of their autistic loved one at last have a way to break through to the curious, subtle, and complex life within.

Using an alphabet grid to painstakingly construct words, sentences, and thoughts that he is unable to speak out loud, Naoki answers even the most delicate questions that people want to know. Questions such as: “Why do people with autism talk so loudly and weirdly?” “Why do you line up your toy cars and blocks?” “Why don’t you make eye contact when you’re talking?” and “What’s the reason you jump?” (Naoki’s answer: “When I’m jumping, it’s as if my feelings are going upward to the sky.”) With disarming honesty and a generous heart, Naoki shares his unique point of view on not only autism but life itself. His insights—into the mystery of words, the wonders of laughter, and the elusiveness of memory—are so startling, so strange, and so powerful that you will never look at the world the same way again.

In his introduction, bestselling novelist David Mitchell writes that Naoki’s words allowed him to feel, for the first time, as if his own autistic child was explaining what was happening in his mind. “It is no exaggeration to say that The Reason I Jump allowed me to round a corner in our relationship.” This translation was a labor of love by David and his wife, KA Yoshida, so they’d be able to share that feeling with friends, the wider autism community, and beyond. Naoki’s book, in its beauty, truthfulness, and simplicity, is a gift to be shared.

Praise for The Reason I Jump

“This is an intimate book, one that brings readers right into an autistic mind.”—Chicago Tribune (Editor’s Choice)

“Amazing times a million.”—Whoopi Goldberg, People

“The Reason I Jump is a Rosetta stone. . . . This book takes about ninety minutes to read, and it will stretch your vision of what it is to be human.”—Andrew Solomon, The Times (U.K.)

“Extraordinary, moving, and jeweled with epiphanies.”—The Boston Globe

“Small but profound . . . [Higashida’s] startling, moving insights offer a rare look inside the autistic mind.”—Parade

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Friendship 101 : Helping Students Build Social Competence

Friendship 101 focuses on building social competence, friendship making, and recreation and leisure skills among students with autism spectrum disorder and other developmental disabilities. Chapters in this evidence-based, user-friendly guide address the needs of students in different developmental periods (from pre-K through young adulthood), providing teachers, parents, faculty and teacher educators with tools and strategies for enhancing the social skill development of these children and youth. Presented through an ecological perspective, together these chapters emphasize building social competence within and across school, home, and community contexts.

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患有发育和自闭症谱系障碍的青少年的社交技能： PEERS 治疗手册

这本书是任何与患有自闭症谱系障碍的青少年一起工作的临床医生或研究人员的必备读物。这种由父母协助的青少年干预是基于加州大学洛杉矶分校塞梅尔神经科学和人类行为研究所为期 14 周的全面、循证计划、流行的加州大学洛杉矶分校 PEERS 计划的手册化以及儿童友谊培训（Routledge，2002 年）儿童手册的成功。

在回顾了旨在帮助父母和治疗师根据与他们一起工作的青少年的需求定制手册的技术之后，本文继续讨论个人治疗课程和解决问题的策略，例如发展对话技巧、选择朋友、使用幽默、聚会、取笑、欺凌、八卦和处理分歧。每节课的章节都包括讲义、家庭作业、对期望的描述（以及如何应对提供干预的挑战），以及为父母和治疗师定制的技巧。

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自闭症的理解与治疗

几乎一半的自闭症患者会出现自残行为，这是最具破坏性和最具挑战性的治疗行为之一。有许多不同形式的自残，例如撞头、咬手、拉头发、过度抓挠等等。在研究和治疗领域领先专家的贡献下，该书对自闭症谱系障碍 （ASD） 或相关发育障碍患者的自残行为 （SIB） 以及可用于治疗他们的不同方法进行了全面分析。

医学和行为研究人员已经研究了 SIB 超过 50 年，但许多从业者和父母仍然不熟悉广泛的促成原因和治疗方案。从对 SIB 及其各种形式的解释开始，撰稿人概述了自伤的许多可能的潜在原因，例如癫痫发作、青少年荷尔蒙失调、胃肠道疾病、过敏和压力，并展示了在发现自伤原因时如何采用多学科方法可以导致成功的治疗策略。他们解释了 SIB 可用的治疗方案，包括营养、医学、精神病学、感官和行为方法，并展示了治疗自伤的综合方法如何对许多人有效。

这本书将成为任何与自闭症谱系障碍或相关疾病患者以及父母和直接护理提供者一起工作的从业者书架上的宝贵补充。

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