Computerized Assessment of Motor Imitation as a Scalable Method for Distinguishing Children With Autism

Tunçgenç, Bahar; Pacheco, Carolina; Rochowiak, Rebecca; Nicholas, R. Stephen; Rengarajan, Sundararaman; Zou, Erin; Messenger, Brice; Vidal, René; Mostofsky, Stewart H.

doi:10.1016/j.bpsc.2020.09.001

Cited by 20 publications

(17 citation statements)

References 36 publications

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“…Importantly, these results also suggest that measurement of precision gripping variability at low force levels may help reliably differentiate children with ASD from age-matched TD children in line with recent data demonstrating that early emerging impairments in fine motor, but not gross motor, abilities were predictive of later ASD severity [ 25 ]. Our results also converge with recent studies demonstrating the importance of characterizing spatial and temporal aspects of visual-motor integration for characterizing heterogeneity across ASD symptom profiles and differentiating individuals with ASD from other neurodevelopmental disorders [ 35 , 70 ]. Deficits in early motor development in ASD appear to be predictive of familial recurrence suggesting that tracking select motor behaviors may provide important insights into both early emerging neurodevelopmental mechanisms and important targets for monitoring early emerging ASD risk factors [ 21 , 34 , 57 ].…”

Section: Discussionsupporting

confidence: 91%

Initial action output and feedback-guided motor behaviors in autism spectrum disorder

et al. 2021

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Background Sensorimotor issues are common in autism spectrum disorder (ASD), related to core symptoms, and predictive of worse functional outcomes. Deficits in rapid behaviors supported primarily by feedforward mechanisms, and continuous, feedback-guided motor behaviors each have been reported, but the degrees to which they are distinct or co-segregate within individuals and across development are not well understood. Methods We characterized behaviors that varied in their involvement of feedforward control relative to feedback control across skeletomotor (precision grip force) and oculomotor (saccades) control systems in 109 individuals with ASD and 101 age-matched typically developing controls (range: 5–29 years) including 58 individuals with ASD and 57 controls who completed both grip and saccade tests. Grip force was examined across multiple force (15, 45, and 85% MVC) and visual gain levels (low, medium, high). Maximum grip force also was examined. During grip force tests, reaction time, initial force output accuracy, variability, and entropy were examined. For the saccade test, latency, accuracy, and trial-wise variability of latency and accuracy were examined. Results Relative to controls, individuals with ASD showed similar accuracy of initial grip force but reduced accuracy of saccadic eye movements specific to older ages of our sample. Force variability was greater in ASD relative to controls, but saccade gain variability (across trials) was not different between groups. Force entropy was reduced in ASD, especially at older ages. We also find reduced grip strength in ASD that was more severe in dominant compared to non-dominant hands. Limitations Our age-related findings rely on cross-sectional data. Longitudinal studies of sensorimotor behaviors and their associations with ASD symptoms are needed. Conclusions We identify reduced accuracy of initial motor output in ASD that was specific to the oculomotor system implicating deficient feedforward control that may be mitigated during slower occurring behaviors executed in the periphery. Individuals with ASD showed increased continuous force variability but similar levels of trial-to-trial saccade accuracy variability suggesting that feedback-guided refinement of motor commands is deficient specifically when adjustments occur rapidly during continuous behavior. We also document reduced lateralization of grip strength in ASD implicating atypical hemispheric specialization.

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Section: Discussionsupporting

confidence: 91%

Initial action output and feedback-guided motor behaviors in autism spectrum disorder

et al. 2021

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“…Imitation difficulties are well documented in children with autism spectrum disorders (ASD) (DeMyer et al, 1972; Ritvo & Provence, 1953; Rogers & Pennington, 1991; Tunçgenç et al, 2021; Vivanti & Rogers, 2014). Children with ASD have been found to imitate others less frequently than do children with typical development (TD) and children with other developmental delays (Töret, 2021).…”

Section: Introductionmentioning

confidence: 99%

“…Most investigators relied on manual Human Observation Coding (HOC) in which children are asked to imitate observed acts that are later judged by two or more independent coders on different ordinal scales, based on how similar the imitations are to the observed behaviour (Tunçgenç et al, 2021). But HOC is a crude technique that relies on a “good enough” resemblance (Tunçgenç et al, 2021; Williams, 2018), and variance in scales leads to data that is not comparable across studies. An alternative method is to rely on more fine-grained analyses and coding schemes based on a fixed set of observable behavioral parameters, such as the ones used in sign language (e.g., American Sign Language, Italian Sign Language) and gesture studies.…”

Section: Introductionmentioning

confidence: 99%

“…Another limitation found in recent studies is an overreliance on human coding of discreet variables, which is often time-consuming and requires intensive coder training (Tunçgenç et al, 2021; Williams, 2018). To overcome this limitation some have begun to rely on machine-based automatic measurements of continuous variables (e.g., kinematic variables such as speed), which are comparatively less time-consuming and extremely promising.…”

Section: Introductionmentioning

confidence: 99%

“…To overcome this limitation some have begun to rely on machine-based automatic measurements of continuous variables (e.g., kinematic variables such as speed), which are comparatively less time-consuming and extremely promising. In fact, some authors suggest that these automatic and fast machine-based methods may one day be extended beyond research settings to assist diagnosis and treatment efforts in real-time (Gowen, 2012; Tunçgenç et al, 2021). However, these measurements have only rarely been applied to IA in patients with ASD, and, when also considering the role of objects or meanings, they have never been applied to children with ASD.…”

Section: Introductionmentioning

confidence: 99%

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New Methods for Unraveling Imitation Accuracy Differences Between Children with Autism and Typically Developing Peers

et al. 2022

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This study applies methods used in sign language and gesture research to better understand reduced imitation accuracy (IA) of actions and gestures in children with autism spectrum disorder (ASD), and we addressed contrasting theories on IA in ASD and the role of objects and meanings in imitation. Eight male children with ASD with a mean chronological age (CA) of 86.76 months ( SD = 10.74, range 70.5–104.4) and 22 male and female peers with typical development (TD) and a mean CA of 85.44 months ( SD = 7.95, range 73.4–96.7) imitated videos of an adult performing actions with objects, representational gestures, conventional gestures and meaningless gestures. We measured accuracy as ability to effectively reproduce features (handshape, palm orientation, location, movement direction and type) and timing (speed) of observed actions/gestures, after ruling out cases of specular (i.e., mirror-like) versus anatomical imitation. Results highlighted significantly lower feature and timing accuracy in children with ASD with respect to the TD group across tasks, and these findings supported sensory-motor theories of IA in ASD. Our data also showed the different impact of objects and meanings within groups. Overall, these results suggest validity to our assessment method and suggested the importance of considering both discreet variables (i.e., variables describing action/gesture feature accuracy, e.g. handshape, movement direction) and continuous variables (i.e., kinematic variables, e.g. speed) in evaluating IA in autism.

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Development of webcam‐collected and artificial‐intelligence‐derived social and cognitive performance measures for neurodevelopmental genetic syndromes

Frazier,

Busch,

Klaas

et al. 2023

American J of Med Genetics Pt C

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This study focused on the development and initial psychometric evaluation of a set of online, webcam‐collected, and artificial intelligence‐derived patient performance measures for neurodevelopmental genetic syndromes (NDGS). Initial testing and qualitative input was used to develop four stimulus paradigms capturing social and cognitive processes, including social attention, receptive vocabulary, processing speed, and single‐word reading. The paradigms were administered to a sample of 375 participants, including 163 with NDGS, 56 with idiopathic neurodevelopmental disability (NDD), and 156 neurotypical controls. Twelve measures were created from the four stimulus paradigms. Valid completion rates varied from 87 to 100% across measures, with lower but adequate completion rates in participants with intellectual disability. Adequate to excellent internal consistency reliability (α = 0.67 to 0.95) was observed across measures. Test–retest reproducibility at 1‐month follow‐up and stability at 4‐month follow‐up was fair to good (r = 0.40–0.73) for 8 of the 12 measures. All gaze‐based measures showed evidence of convergent and discriminant validity with parent‐report measures of other cognitive and behavioral constructs. Comparisons across NDGS groups revealed distinct patterns of social and cognitive functioning, including people with PTEN mutations showing a less impaired overall pattern and people with SYNGAP1 mutations showing more attentional, processing speed, and social processing difficulties relative to people with NFIX mutations. Webcam‐collected performance measures appear to be a reliable and potentially useful method for objective characterization and monitoring of social and cognitive processes in NDGS and idiopathic NDD. Additional validation work, including more detailed convergent and discriminant validity analyses and examination of sensitivity to change, is needed to replicate and extend these observations.

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Computerized Assessment of Motor Imitation as a Scalable Method for Distinguishing Children With Autism

Cited by 20 publications

References 36 publications

Initial action output and feedback-guided motor behaviors in autism spectrum disorder

Initial action output and feedback-guided motor behaviors in autism spectrum disorder

New Methods for Unraveling Imitation Accuracy Differences Between Children with Autism and Typically Developing Peers

Development of webcam‐collected and artificial‐intelligence‐derived social and cognitive performance measures for neurodevelopmental genetic syndromes

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