Purpose: Children with high-functioning autism (HFA) frequently exhibit achievement difficulties, especially in the areas of reading comprehension and written expression. Social attention impairment, a symptom of autism, may play a critical role in the learning difficulties of these children. Social attention impairment in autism encompasses three related problem domains—joint attention, social orienting, and attention to faces. To engage effectively in social learning within a classroom, children must be motivated and readily able to attend to other people to share and receive meaningful information. The complex social and cognitive contexts of classrooms, in which social attention must be regulated in interaction with multiple social partners, makes social learning even more complicated for school-aged children with autism.

This project will apply new virtual reality technology to create visual and auditory settings that emulate complex social environments such as classrooms. Using such technology, researchers will examine the following questions: (1) Will students with autism display significant impairments in the development of social attention skills, and will individual differences in social attention be associated with measures of cognitive processes involved in learning, academic achievement (reading comprehension, written and oral expression, and mathematics), and social outcomes? (2) Will impairment in social attention make a unique contribution to processes that may inhibit learning, academic success, and social success in students with autism? (3) Will the presence of symptoms of attention deficit hyperactivity disorder (ADHD), which is often co-morbid with autism, mediate or moderate the impact of social attention on learning and development in students with autism? (4) Will social attention be malleable, with practice in social attention tasks leading to improved performance on those tasks for students with autism?

Project Activities: This research team will investigate social attention in children with autism, and the relation of social attention to learning, academic achievement, and social outcomes, by collecting data directly from students with autism and their parents and teachers. Children and their parents will visit a university-based laboratory for baseline data collection on all standardized child measures, standardized parent measures, and child measures of social attention and learning. Teachers will complete standardized measures through the mail. Primary teachers will be contacted for each elementary school student and two teachers will be contacted for middle and high school students (one English or Social Studies teacher, one Math or Science teacher). Follow-up data will be collected twice over the next 2.5 years. An independent sample of students with HFA will be randomly assigned to a "training" group (practice social attention using virtual reality tasks) or a control group.

Products: Products from this study will include published manuscripts and presentations on findings related to social attention in children with autism. The knowledge gained from this project is expected to lay the groundwork for developing classroom-based virtual reality, social-attention intervention methods aimed at improving education and social outcomes for school-aged students with autism.

Structured Abstract

Setting: Child and parent data will be collected in the Social Attention Virtual Reality Laboratory at the UC Davis Center for Mind and Brain. Teacher data will be collected via mail.

Sample: Two hundred children, ranging from 8 to 18 years of age (Grades 3 through 12), will participate in this study along with their parents and teachers. Eighty children with high-functioning autism (HFA), 40 children with ADHD only, and 40 typically developing children will participate in the group comparison and longitudinal research. At least 50 percent of the HFA sample is expected to include children with clinical levels of ADHD symptom presentation (co-morbid with autism). An additional sample of 40 children with HFA will be recruited for a preliminary study examining the effect of practice on social attention.

Intervention: In the practice study, the treatment will consist of training in social attention through six 90-minute practice sessions over the course of 4 weeks. This training (practice) will use virtual reality-based "games" that measure and present the opportunity for social attention development in domains including social orientation, face processing, and joint attention.

Research Design and Methods: This project uses a quasi-experimental design with virtual reality paradigms to assess visual social attention in a virtual classroom. The research uses both cross-sectional and longitudinal data collection. For the primary longitudinal sample, baseline data will be collected on 160 children in Grades 3 through 10. Follow-up assessments to measure change and growth will be administered to all children 15 and 30 months after their baseline assessments. These data will be used to determine the following: (1) whether children with HFA have significant impairments in the development of social attention and the degree to which social attention is associated with cognitive processes involved in learning, academic achievement, and social outcomes; (2) whether impairments in social attention make a unique contribution to the outcome measures; and (3) whether symptoms of ADHD mediate or moderate the impact of social attention on these outcomes in children with HFA. Each year of the project, a separate sample of HFA children will be randomly assigned to treatment and control conditions, with data collected at both baseline and after six 90-minute laboratory-based intervention trials. This independent sample will examine the malleability of social attention by investigating whether practice on social attention tasks can lead to positive changes in performance on those tasks.

Control Condition: For the longitudinal study, there are two comparison groups—children with ADHD (no autism) and typically developing children. In the control condition for the practice study, children with HFA will engage in six 90-minute sessions over the course of 4 weeks with computer activities that are not focused on social attention.

Key Measures: The Autism Diagnostic Observation Schedule will be used to confirm diagnoses of autism. Outcome measures include standardized child assessments of IQ, academic achievement, cognitive abilities (nonsocial attention and working memory), learning processes (transitive inference task), and social attention. Social attention measures include six virtual reality tasks (or "games") aimed at assessing social orientation to peers in a classroom, facial processing and recognition, and joint attention/following of eye gaze. Self-, parent-, and teacher-reports using the Conners-3 will assess learning problems, aggression, family relations, executive functions, and peer relations. Additional standardized parent report measures include assessments of autism symptoms, social responsiveness, and family life stress, and an additional standardized teacher assessment includes a measure of the child's social skills. Conners-3 reports of ADHD symptoms (hyperactivity, inattention) will be examined as potential mediators or moderators of the impact of social attention on developmental and learning outcomes.

Data Analytic Strategy: Multivariate analysis of variance will be used to test the first set of hypotheses about group differences. Multi-group latent growth modeling, using a structural equation modeling framework, will be used to test the remaining hypotheses with the longitudinal data and the training/practice data.

Products and Publications

Book

Mundy, P.C. (2016). Autism and Joint Attention: Development, Neuroscience, and Clinical Fundamentals. New York: Guilford Press.

Book chapter

Henderson, H., and Mundy, P. (2013). The Integration of Self and Other in the Development of Self-Regulation: Typical and Atypical Processes. In K. Barrett, N. Fox, G. Morgan, D. Fidler, and L. Daunhauer (Eds.), Handbook of Self-Regulatory Processes in Development: New Directions and International Perspectives (pp. 113–134). New York: Taylor and Francis.

Mundy, P. (2013). A Neural Networks, Information Processing Model of Joint Attention and Social-Cognitive Development. In P. Zelazo (Ed.), The Oxford Handbook of Developmental Psychology: Vol. 2–Self and Other (pp. 217–241). New York: Oxford University Press.

Mundy, P. (2013). Neural Connectivity, Joint Attention, and the Social-Cognitive Deficits of Autism. In M. Legerstee, D. Haley, and M. Bornstein (Eds.), The Developing Infant Mind: Origins of the Social Brain (pp. 324–352). New York: Guilford.

Book chapter, edition specified

Van Hecke, A., Oswald, T., and Mundy, P. (2016). Joint Attention and the Social Phenotype of Autism Spectrum Disorder: A Perspective From Developmental Psychopathology. In D. Cicchetti (Ed.), Developmental Psychopathology, Vol. 3 (3rd ed., pp. 116–144). Hoboken, NJ: John Wiley and Sons, Inc. doi:10.1002/9781119125556.devpsy304

Journal article, monograph, or newsletter

Burrows, C., Usher, L., Schwartz, C., Mundy, P., and Henderson, H. (2016). Supporting the Spectrum Hypothesis: Self-Reported Temperament in Children and Adolescents With High Functioning Autism. Journal of Autism and Related Disorder, 46(4): 1184–1195. doi:10.1007/s10803–015–2653–9

Henderson, H.A., Ono, K.E., McMahon, C., Schwartz, C.B., Usher, L., and Mundy, P.C. (2015). The Costs and Benefits of Self-Monitoring for Higher Functioning Children and Adolescents With Autism. Journal of Autism and Developmental Disorders, 45(2): 548–559. doi:10.1007/s10803–013–1968–7

Jarrold, W., Mundy, P., Gwaltney, M., Bailenson, J., Hatt, N., McIntyre, N., Kim, K., Solomon, M., Novotny, S., and Swain, L. (2013). Social Attention in a Virtual Public Speaking Task in Higher Functioning Children With Autism. Autism Research, 6(5): 393–410. doi:10.1002/aur.1302

Kim, K., and Mundy, P. (2012). Joint Attention, Social-Cognition, and Recognition Memory in Adults. Frontiers in Human Neuroscience, 6: 1–11. doi:10.3389/fnhum.2012.00172 Full text

Kim, K., Rosenthal, M.Z., Gwaltney, M., Jarrold, W., Hatt, N., McIntyre, N., Swain, L., Solomon, M., and Mundy, P. (2016). A Virtual Joy Stick Study of Emotional Responses and Social Motivation in Children With Autism Spectrum Disorders. Journal of Autism and Related Disabilities, 45(12): 3891–3899.

McIntyre, M., Solari, E., Gonzales, J. Solomon, M., Swain-Lerro, L., Novotny, S., Oswald, T., Mundy, P. (in press). The Scope and Nature of Reading Comprehension Impairments in Higher Functioning School-Aged Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders.

McIntyre, N., Solari, E., Grimm, R., Swain-Leroy, L., Gonzalez, J. & Mundy, P. (2017). A Comprehensive Examination of Reading Heterogeneity in Students with High Functioning Autism: Distinct Reading Profiles and their Relation to Autism Symptom Severity. Journal of Autism and Developmental Disorders, 47 (4), 1086–1101.

McMahon, C., Henderson, H., Newell, L., Jamie, M., and Mundy, P. (2016). Metacognitive Awareness of Facial Affect in Higher-Functioning Children and Adolescents With Autism Spectrum Disorder. Journal of Autism and Related Disorders, 46 (3): 882–898. doi:10.1007/s10803–015–2630–3

Mundy, P., Kim, K., McIntyre, N., Lerro, L., & Jarrold, W. (2016). Brief Report: Joint Attention and Information Processing in Children with Higher Functioning Autism Spectrum Disorders. Journal of Autism and Developmental Disorders, 1–6.

Mundy, P., Novotny, S., Swain-Lerro, L., McIntyre, N., Zajic, M., & Oswald, T. (2017). Joint-Attention and the Social Phenotype of School-Aged Children with ASD. Journal of Autism and Developmental Disorders, 47, 1423–1435.

Sheeren, A., Hans, K., Mundy, P., Mous, L., Sander, B. (2013). Empathetic Responsiveness of Children and Adolescents With High-Functioning Autism Spectrum Disorder. Autism Research, 6: 362–371.

Siller, M., Morgan, L., Turner-Brown, L., Baggett, K.M., Baranek, G. T., Brian, J., Bryson, S.E., Carter, A.S., Crais, E.R., Estes, A., Kasari, C., Landa, R.J., Lord, C., Messinger, D.S., Mundy, P., Odom, S.L., Reznick, J.S., Roberts, W., Rogers, S.J., Schertz, H.H., Smith, I.M., Stone, W.L., Watson, L.R., Wetherby, A.M., Yoder, P.J., and Zwaigenbaum, L. (2013). Designing Studies to Evaluate Parent-Mediated Interventions for Toddlers With Autism Spectrum Disorder. Journal of Early Intervention Research, 35(4): 355–377. doi:10.1177/1053815114542507

Solari, E., McIntyre, N., Grim, R., Swain-Lerro, L., Zajic, M., & Mundy, P. (in press). The relation between text reading, fluency, and reading comprehension for students with Autism Spectrum Disorders. esearch in Autism Spectrum Disorders.

Zajic, M., McIntyre, N., Swain-Lerro, L., Oswald, T., & Mundy, P. (2016). Written Communication Expression in Higher-Functioning, School-Age Children with Autism Spectrum Disorders. Autism.