1. DeNigris D, Brooks PJ, Obeid R, Alarcon M, Shane-Simpson C, Gillespie-Lynch K. {{Bullying and Identity Development: Insights from Autistic and Non-autistic College Students}}. {J Autism Dev Disord};2017 (Dec 14)
Reduced cognitive empathy may put autistic people at risk for bullying. We compared interpretations of bullying provided by 22 autistic and 15 non-autistic college students. Autistic (and non-autistic) students reported less severe bullying in college relative to earlier in development. Chronic bullying was associated with improvements in self-descriptions and self-acceptance. Autistic students who were chronically bullied were more likely to self-identify as autistic when asked to explain their disability. Autistic and non-autistic students demonstrated similar levels of cognitive empathy, providing no evidence that a « double empathy problem » contributes to bullying for all autistic individuals. Findings suggest that recovery from bullying can contribute to resilience and that autistic people gain insights about bullying and how to overcome it with development.
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2. Getahun D, Jacobsen SJ, Fassett MJ, Wing DA, Xiang AH, Chiu V, Peltier MR. {{Association between maternal hypothyroidism and autism spectrum disorders in the children}}. {Pediatr Res};2017 (Dec 15)
OBJECTIVE: To determine if hypothyroidism is associated with ASD and how this association is influenced by race-ethnicity, sex, and timing of exposure. METHODS: A retrospective cohort study was conducted using records from 397201 children who were delivered from 1991-2011 and remained health plan members from 1993-2014. RESULTS: Children of hypothyroid women had higher ASD rates than children of women without the diagnosis (2.14 vs. 1.62/1000 person-years; and adjusted hazard ratios [adj.HR], 1.31; 95% CI, 1.13-1.53). This occurred in women diagnosed prior to as well as during pregnancy. Maternal hypothyroidism was associated with ASD for both boys (3.93 vs. 2.62/1000 person-years; adj.HR, 1.27; 95% CI, 1.07-1.50) and girls (1.10 vs. 0.61/1000 person-years; adj.HR, 1.51; 95% CI, 1.10-2.08). Of women with a diagnosis of hypothyroidism during pregnancy, normal TSH and fT4 levels were not associated with increased risk of ASD in the children. Compared with white children, prenatal hypothyroidism was associated with increased risk of ASD in the children of Hispanics (adj.HR, 1.09; 95% CI, 1.01-1.17) and women of Other/Mixed race-ethnicity (adj.HR, 1.08; 95% CI, 1.00-1.16). CONCLUSIONS: Maternal hypothyroidism is associated with ASD in the children in a manner dependent on race-ethnicity. Management of maternal hypothyroidism may ameliorate the risk of ASD.Pediatric Research accepted article preview online, 15 December 2017. doi:10.1038/pr.2017.308.
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3. Kuder SJ, Accardo A. {{What Works for College Students with Autism Spectrum Disorder}}. {J Autism Dev Disord};2017 (Dec 16)
This article reports the results of a systematic review of the emerging research on programs and services designed to meet the needs of students with ASD. For the purposes of this review, only articles that included data on program outcomes were included. A total of eight studies that met this criterion were identified. These studies included three that examined the effects of cognitive-behavioral interventions, three that reported the results of methods to enhance social communication skills, one study of a transition to college program, and one evaluation of a variety of widely used accommodations. This review identifies methods that have been found to be effective supporting students with ASD in higher education settings as well as needs for future research.
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4. Laurent AC, Gorman K. {{Development of Emotion Self-Regulation Among Young Children with Autism Spectrum Disorders: The Role of Parents}}. {J Autism Dev Disord};2017 (Dec 16)
Emotional self-regulation (ESR) challenges are well-documented in the diagnostic profiles of children with Autism; however, less is known about the development of ESR and the role of parents in ESR development for this population. Thirty-seven young children with autism and one of their parents participated in a home-based, observational study exploring the associations between the children’s social communication and sensory processing characteristics and their parents’ behaviors associated with ESR development. Findings revealed that parent use of physical and language behaviors were associated with child social communication abilities. No associations between child sensory processing and parent behaviors were found. Understanding the interactive processes between parents and children with ASD has implications for the development of parent-based interventions that increase child ESR.
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5. Lindly OJ, Thorburn S, Heisler K, Reyes NM, Zuckerman KE. {{Parents’ Use of Complementary Health Approaches for Young Children with Autism Spectrum Disorder}}. {J Autism Dev Disord};2017 (Dec 14)
Knowledge of why parents use complementary health approaches (CHA) for children with autism spectrum disorder (ASD) is limited. We conducted a mixed methods study to better understand factors influencing parents’ decision to use CHA for ASD. Parent-reported data about CHA use were collected on a probability sample of 352 young children with ASD in Denver, Colorado; Los Angeles, California; or Portland, Oregon. Follow-back interviews were conducted with 31 parents. CHA use was negatively associated with older child age and positively associated with parents’ belief ASD has major consequences, living in Portland or Denver, and medication use. Nine themes help explain these results. Study findings may have utility for healthcare providers working with children with ASD and their families regarding CHA.
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6. Mire SS, Tolar TD, Brewton CM, Raff NS, McKee SL. {{Validating the Revised Illness Perception Questionnaire as a Measure of Parent Perceptions of Autism Spectrum Disorder}}. {J Autism Dev Disord};2017 (Dec 14)
The illness perception questionnaire (IPQ) and its revision (IPQ-R) measure perceptions about health-related diagnoses and the influence of cognitions on coping. In this study, the factor structure of a version revised for use with autism spectrum disorder (ASD) was investigated with a sample of parents (n = 361) whose children have ASD. Subsequently, multidimensional item response theory was used to evaluate item and subscale properties. Results indicated items from five of the seven IPQ-R-ASD scales loaded as expected, though subscales related to control were not distinct. Additionally, parents’ response patterns were evaluated and discussed. Use of this measure in ASD-focused research may enhance understanding of how parents’ cognitions of their child’s ASD impacts treatment selection, treatment implementation, and overall family well-being.
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7. Naviaux RK. {{Antipurinergic therapy for autism-An in-depth review}}. {Mitochondrion};2017 (Dec 16)
Are the symptoms of autism caused by a treatable metabolic syndrome that traces to the abnormal persistence of a normal, alternative functional state of mitochondria? A small clinical trial published in 2017 suggests this is possible. Based on a new unifying theory of pathogenesis for autism called the cell danger response (CDR) hypothesis, this study of 10 boys, ages 5-14years, showed that all 5 boys who received antipurinergic therapy (APT) with a single intravenous dose of suramin experienced improvements in all the core symptoms of autism that lasted for 5-8weeks. Language, social interaction, restricted interests, and repetitive movements all improved. Two children who were non-verbal spoke their first sentences. None of these improvements were observed in the placebo group. Larger and longer studies are needed to confirm this promising discovery. This review introduces the concept of M2 (anti-inflammatory) and M1 (pro-inflammatory) mitochondria that are polarized along a functional continuum according to cell stress. The pathophysiology of the CDR, the complementary functions of M1 and M2 mitochondria, relevant gene-environment interactions, and the metabolic underpinnings of behavior are discussed as foundation stones for understanding the improvements in ASD behaviors produced by antipurinergic therapy in this small clinical trial.
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8. Sarrett JC. {{Autism and Accommodations in Higher Education: Insights from the Autism Community}}. {J Autism Dev Disord};2017 (Dec 14)
This article builds on the growing body of research on higher education for autistic students by soliciting input from autistic adults on their higher education experiences and suggestions on making these experiences more ‘autism-friendly’. Sixty-six individuals participated in a national exploratory survey and thirty-one participated in follow-up, online focus groups. The article reviews the accommodations individuals received and the accommodations they would have liked to receive. Concrete strategies are provided for institutes of higher education to address the social and sensory needs of autistic students, areas many participants reported being neglected in their academic experience, such as mentors and a neurodiverse space. These suggestions are intended to complement traditional academic accommodations to improve the outcomes of autistic students.
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9. Van Drenth A. {{Rethinking the origins of autism: Ida Frye and the unraveling of children’s inner world in the Netherlands in the late 1930s}}. {J Hist Behav Sci};2017 (Dec 15)
Historiographies on the phenomenon of « autism » display Leo Kanner and Hans Asperger as the great pioneers. The recent controversy on who was first in « discovering » autism urges research into the question of how scientific discoveries relate to processes of academic reflection and social intervention. The Netherlands provide an interesting case in pioneering work in autism, since Dutch experts described autism in children already in the late 1930s, preceding the first publications on autism in children by Kanner and Asperger. This paper examines the Dutch origins of autism by focusing on Ida Frye’s contribution to the teamwork at the Paedological Institute in Nijmegen, which resulted in descriptions of children with autism. The theoretical aim of this paper is to underline the importance of the productive interplay between social interventions and scientific efforts concerning the complex inner world of special children.
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10. Mohan V, Kunnath SK, Philip VS, Mohan LS, Thampi N. {{Capitalizing on technology for developing communication skills in autism spectrum disorder: a single case study}}. {Disabil Rehabil Assist Technol};2017 (Dec 15):1-7.
PURPOSE: In this case study, we discuss the application of a patient-centred clinical approach that led to the use of an assisted communication platform to combat severe communicative deficit in a child with autism spectrum disorder (ASD). METHODS: Initial assessment at four years of age revealed that the patient had rudimentary communication skills, with significant sensory integration dysfunction manifested as oral, olfactory, and tactile seeking behaviours; self-stimulatory behaviour; and complete dependence on caregiver for activities of daily living. Intensive, multi-disciplinary intervention resulted in minimal improvement in communicative skills and sensory seeking over six months. Subsequently, a tailor-made picture-assisted communication training with the mother as the communication facilitator was adopted. This approach was abandoned due to the patient’s poor response and mother’s low acceptance of picture-based interaction. A preference for printed material was observed in the patient. Accordingly, further management was focused on employing a computer-based interactive platform that the patient was taught to use over the course of a few months as a part of augmentative and alternative communication (AAC) intervention program. This resulted in a remarkable improvement in the child’s skills that now allowed for a better intentional communication of his thoughts and needs. CONCLUSIONS: This study highlights the importance of revisiting conventional rehabilitation strategies for communicative deficits and tailoring them according to the patient’s needs and preferences. It also emphasises that besides excellent observation skills, clinicians must be willing to consider technology based approaches in patients responding poorly to traditional approaches in order to develop effective interventional programmes. Implication for Rehabilitation The current study highlights the importance of exploring the application of technology based intervention for building communication skills in the early stages of rehabilitation for persons with communicative deficit. It also emphasises the need for excellent observation skills among clinicians so that the peculiar interests of children with ASD may be applied in designing training programmes to overcome communication barriers. Additionally, clinicians should familiarise themselves with the latest assistive technology-based rehabilitation approaches and be willing to explore newer approaches if traditional ones fail to yield satisfactory outcomes. Use of technology-based interventions to reduce dependence among persons with disability would be beneficial, both socially and economically, in developing countries with limited resources.
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11. Dieleman LM, De Pauw SSW, Soenens B, Mabbe E, Campbell R, Prinzie P. {{Relations between problem behaviors, perceived symptom severity and parenting in adolescents and emerging adults with ASD: The mediating role of parental psychological need frustration}}. {Res Dev Disabil};2017 (Dec 12);73:21-30.
Research in parents of youngsters with Autism Spectrum Disorder (ASD) increasingly documents associations between children’s problem behaviors and symptom severity and more dysfunctional and less adaptive parenting behaviors. However, the mechanisms underlying these associations have not been examined thoroughly. This study examines the mediating role of parental need frustration in the relation between child maladjustment (i.e., problem behavior and autism severity) and parenting behavior (i.e., controlling and autonomy-supportive parenting). The sample included 95 parents of adolescents/emerging adults with ASD (Mage=18.8years, SD=2.3). Parents completed questionnaires assessing their parenting strategies and psychological need frustration as well as the internalizing and externalizing problem behaviors and autism severity of their child. Results indicate that the association between externalizing problems and controlling parenting was partially mediated by need frustration. This suggests that externalizing problems go together with lower feelings of parent-child closeness, lower parental competence, and a decreased sense of volitional functioning, feelings that, in turn, relate to more controlling strategies. Symptom severity has a direct negative association with autonomy support, suggesting that parents lower their autonomy support when their child has high levels of autism symptoms, without experiencing these symptoms as a threat to their own psychological needs.
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12. Ozturk Y, Bizzego A, Esposito G, Furlanello C, Venuti P. {{Physiological and self-report responses of parents of children with autism spectrum disorder to children crying}}. {Res Dev Disabil};2017 (Dec 12);73:31-39.
Little is known about the physiological response of parents of children with Autism Spectrum Disorder (ASD) to crying of children who have already received the diagnosis of ASD. This study aimed to compare cardiac dynamics via Inter-Beat Interval (IBI) and self-reported emotional states of parents of children with ASD and of parents with typically developing (TD) children while listening to crying of children with ASD (ASD cry) and of typically developing children (TD cry). Analyses revealed higher IBI in parents of children with ASD than IBI in parents of TD children while listening to both cry groups; however no differences on self-reported emotional states were observed. Parents of children with ASD were calmer (higher IBI) than parents of TD children while listening to crying. However, ASD cry did not elicit different IBI compared to TD cry. ASD cry and TD cry were differentiated based on parents’ self-responses about what they felt during the listening of crying, their physiological responses showed no differences. These results highlight the similarities and differences between self-reported emotional states and physiological responses of parents of children with ASD, and also point to the importance of monitoring parents’ physiological responses in addition to their subjective responses.
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13. Utine GE, Simsek-Kiper PO, Akgun-Dogan O, Urel-Demir G, Alanay Y, Aktas D, Boduroglu K, Tuncbilek E, Alikasifoglu M. {{Fragile x-associated premature ovarian failure in a large Turkish cohort: Findings of Hacettepe Fragile X Registry}}. {Eur J Obstet Gynecol Reprod Biol};2017 (Dec 16);221:76-80.
OBJECTIVE: To determine frequency of fragile X associated premature ovarian insufficiency (FXPOI) among Turkish premutation carriers. STUDY DESIGN: FMR1 premutation is the single most common genetic cause of POI (FXPOI). Fragile X Registry at Hacettepe University has been reviewed for the frequency of FXPOI among female premutation carriers. Since 1991 when FMR1 testing was available, 760 individuals from 243 families have been registered. Actual data on menstrual status of female premutation carriers were gathered and analysed. RESULTS: Among 314 premutation-bearing females in the cohort, 268 could be reached for an update of their menstrual history; 107 adults were 40 or younger and 156 were older than 40 years of age, whereas the remaining 5 patients were prepubertal. Among 263 postpubertal females with premutations, 90 women stopped menstruating before or at 40 years of age (premature ovarian failure – POF), constituting 34.2% of our cohort. Additionally, one carrier of a gray zone allele experienced FXPOI. History of twinning was present once in 18 women (5.7%) and twice in two women (0.6%), one of the latter interestingly bearing a full-mutation. CONCLUSIONS: FXPOI rates in the present cohort are higher than those reported in other populations. Higher FXPOI rates in Turkish premutation carriers might be a reflection of younger mean menopause age and higher POI rates in otherwise healthy Turkish women. Since POI is much more frequent among premutation carriers than in general population, testing for CGG repeat expansions in FMR1 should be included in the work-up.
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14. Marland C, Lichtenstein P, Degl’Innocenti A, Larson T, Rastam M, Anckarsater H, Gillberg C, Nilsson T, Lundstrom S. {{The Autism-Tics, ADHD and other Comorbidities inventory (A-TAC): previous and predictive validity}}. {BMC Psychiatry};2017 (Dec 16);17(1):403.
BACKGROUND: Reliable and easy to administer screening instruments focusing on neurodevelopmental disorders and associated conditions are scarce. The Autism-Tics, AD/HD and other Comorbidities inventory (A-TAC) has previously been validated and reporting good- excellent validity for several disorders. This article aims to expand these findings by including more conditions in a substantially larger sample augmented with the Swedish National Patient Register (NPR). METHODS: Since 2004 parents of all 9-year-old Swedish twins have been invited to participate in a telephone interview in the Child and Adolescent Twin Study in Sweden, CATSS. The CATSS is linked to the NPR which includes data from in- and outpatient care. Data on neurodevelopmental disorders (A-TAC) collected in CATSS were compared with diagnoses from the NPR. We investigated diagnoses that had been made both before (previous validity) and after (predictive validity) the interview. RESULTS: Sensitivity and specificity of A-TAC scores for predicting earlier or later clinical diagnoses were mostly good-excellent, with values of the area under the curve for a clinical diagnosis of autism spectrum disorder (ASD) of .98, attention deficit hyperactivity disorder (ADHD) .93, learning disorder (LD) .92, and oppositional defiant disorder (ODD) .99, with small differences in terms of previous and predictive analyses. A-TAC provided little validity for eating disorders. CONCLUSION: The result support previous claims: A-TAC is a broad screening instrument with a particular strength in assessing ASD, ADHD, LD, and ODD at ages 9 and 12, and also provides phenotypic information about other child psychiatric disorders.
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15. Yoo M, Carromeu C, Kwon O, Muotri A, Schachner M. {{The L1 adhesion molecule normalizes neuritogenesis in Rett syndrome-derived neural precursor cells}}. {Biochem Biophys Res Commun};2017 (Dec 16);494(3-4):504-510.
Therapeutic intervention is an important need in ameliorating the severe consequences of Rett Syndrome (RTT), a neurological disorder caused by mutations in the X-linked gene methyl-CpG-binding protein-2 (MeCP2). Following previously observed morphological defects in induced pluripotent stem cell (iPSC)-derived neurons obtained from female RTT patients, we hypothesized that transfection with the L1 cell adhesion molecule (L1) could contribute to normalizing a pathological male cell system bearing a nonsense mutation of MeCP2. We found a decreased expression of L1 in RTT iPSCs-derived neural precursor cells (RTT NPCs) and decreased neuritogenesis. Expression of wild-type MeCP2 in RTTNPCs revealed a positive correlation between the levels of MeCP2 and L1, and normalization of cell survival. Expression of L1 in RTTNPCs enhanced neuritogenesis and soma size. Knock-down of MeCP2 in wild type NPCs reduced neuritogenesis. L1 expression is regulated by the MeCP2 promoter. These results suggest that a deficiency in L1 may partially account for RTT phenotypes.
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16. Park WJ, Schauder KB, Zhang R, Bennetto L, Tadin D. {{High internal noise and poor external noise filtering characterize perception in autism spectrum disorder}}. {Sci Rep};2017 (Dec 14);7(1):17584.
An emerging hypothesis postulates that internal noise is a key factor influencing perceptual abilities in autism spectrum disorder (ASD). Given fundamental and inescapable effects of noise on nearly all aspects of neural processing, this could be a critical abnormality with broad implications for perception, behavior, and cognition. However, this proposal has been challenged by both theoretical and empirical studies. A crucial question is whether and how internal noise limits perception in ASD, independently from other sources of perceptual inefficiency, such as the ability to filter out external noise. Here, we separately estimated internal noise and external noise filtering in ASD. In children and adolescents with and without ASD, we computationally modeled individuals’ visual orientation discrimination in the presence of varying levels of external noise. The results revealed increased internal noise and worse external noise filtering in individuals with ASD. For both factors, we also observed high inter-individual variability in ASD, with only the internal noise estimates significantly correlating with severity of ASD symptoms. We provide evidence for reduced perceptual efficiency in ASD that is due to both increased internal noise and worse external noise filtering, while highlighting internal noise as a possible contributing factor to variability in ASD symptoms.
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17. Tse AC. {{Effects of attentional focus on motor learning in children with autism spectrum disorder}}. {Autism};2017 (Dec 1):1362361317738393.
Inability to acquire a new motor skill is a common motor difficulty in children with autism spectrum disorder. The purpose of this study is to examine whether the motor learning benefits of an external focus of attention for typically developing children and children with intellectual disabilities could also be applied to children with autism spectrum disorder. Children ( N = 65; mean age = 10.01 years) diagnosed with high-functioning autism spectrum disorder were randomly assigned into one of the three groups: external focus ( n = 22), internal focus ( n = 22), and control ( n = 21). They were required to throw beanbags at a static target for 50 acquisition trials, 10 retention trials, and 10 transfer trials. While all three groups learnt the skills in a similar manner during the acquisition phase, the internal focus group demonstrated more robust motor performance than the external focus group and the control group in both retention and transfer tests, while there was no difference between the external focus group and the control group in both retention and transfer tests. The findings provide evidence that internal focus of attention may be more effective for facilitating motor learning in children with autism spectrum disorder. However, further study is needed to determine the factors contributing to this finding.
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18. Munkhaugen EK, Torske T, Gjevik E, Naerland T, Pripp AH, Diseth TH. {{Individual characteristics of students with autism spectrum disorders and school refusal behavior}}. {Autism};2017 (Dec 1):1362361317748619.
This study compared social, executive, emotional, and behavioral characteristics of students with autism spectrum disorder who did and did not display school refusal behavior. The participants were 62 students with autism spectrum disorder without intellectual disability aged 9-16 years attending inclusive schools. Parents first completed questionnaires assessing social and executive functioning as well as emotional and behavioral problems. They then documented their child’s school refusal behavior for a period of 20 days. Compared to students without school refusal behavior (n = 29), students with school refusal behavior (n = 33) were significantly less socially motivated; displayed more deficits in initiating tasks or activities, in generating ideas, responses, or problem-solving strategies; and displayed more withdrawn and depressive symptoms. Assessing social and executive functioning, as well as emotional problems, may help professionals provide tailored interventions for students with autism spectrum disorder and school refusal behavior, which will further be valuable in recognizing characteristics associated with school refusal behavior.
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19. Naheed A, Koly KN, Uddin Ahmed H, Akhter S, Uddin MMJ, Smith Fawzi MC, Chandir S, Mannan M, Hossain S, Nelson C, Munir K. {{Implementing a Mental Health Care Program and Home-Based Training for Mothers of Children With Autism Spectrum Disorder in an Urban Population in Bangladesh: Protocol for a Feasibility Assessment Study}}. {JMIR Res Protoc};2017 (Dec 14);6(12):e251.
BACKGROUND: Mothers of children with autism spectrum disorder (ASD) have reported a higher level of depression than mothers of children with other neurodevelopmental disorders in both developed and developing countries. Mothers are the lifetime caregivers of children with ASD, and a high burden of depression can negatively impact their ability to provide care. However, access to mental health services in primary care is limited, given the scarcity of qualified providers in Bangladesh. OBJECTIVE: We aim to pilot the feasibility of integrating mental health services for the mothers of children with ASD attending schools offering ASD care and improve skills of mothers for child care through a home-based training program. METHODS: The study will be conducted in two selected schools in Dhaka in Bangladesh that have been offering services for ASD for more than 10 years. A female psychologist will be deployed at the schools to offer nonpharmacological services for all mothers having a depressive episode. Referral for pharmacological treatment will be made at the discretion of supervising psychiatrists. An ASD special educator will provide training to the mothers for enhancing their child care skills at home on a monthly basis. The proposed intervention package will be implemented over a period of 4-6 months, and the feasibility of the intervention will be assessed through a pre- and postintervention evaluation by obtaining the perspectives of various stakeholders involved in the implementation of mental health services and maternal training. The primary outcome will include assessment of acceptability, adaptability, demand, practicality, implementation, and integration of the package intervention in the school settings. The secondary outcomes will include assessment of: 1) the prevalence of maternal depression; 2) children’s behavioral, social, and communication skills; and 3) the intervention participation costs incurred by institutions and families. RESULTS: Between February and March 2017, 188 mothers of children with ASD were screened for depression following a written informed consent. Based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), the Structured Clinical Interview for the DSM-IV (SCID-1) was administered to 66 mothers. In-depth interviews were conducted with 10 mothers and 8 various stakeholders. Between January-June 2017, the team finalized a draft psychosocial counseling module and a maternal training module. Between April-May 2017, mental health services were provided by psychologists to 41 mothers who attended the counseling centers at each school. Three special educators have been trained in June 2017 to initiate training of the participating mothers. CONCLUSIONS: This is the first study of a mental health intervention for mothers of children with ASD to reduce their burden of depression and improve the outcomes of their children. The findings will inform the provision of services for children with ASD and their mothers in Bangladesh and similar settings.
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20. Kornmeier J, Worner R, Riedel A, Tebartz van Elst L. {{A different view on the Necker cube-Differences in multistable perception dynamics between Asperger and non-Asperger observers}}. {PLoS One};2017;12(12):e0189197.
BACKGROUND: During observation of the Necker cube perception becomes unstable and alternates repeatedly between a from-above-perspective (« fap ») and a from-below-perspective (« fbp ») interpretation. Both interpretations are physically equally plausible, however, observers usually show an a priori top-down bias in favor of the fap interpretation. Patients with Autism spectrum disorder are known to show an altered pattern of perception with a focus on sensory details. In the present study we tested whether this altered perceptual processing affects their reversal dynamics and reduces the perceptual bias during Necker cube observation. METHODS: 19 participants with Asperger syndrome and 16 healthy controls observed a Necker cube stimulus continuously for 5 minutes and indicated perceptual reversals by key press. We compared reversal rates (number of reversals per minute) and the distributions of dwell times for the two interpretations between observer groups. RESULTS: Asperger participants showed less perceptual reversal than controls. Six Asperger participants did not perceive any reversal at all, whereas all observers from the control group perceived at least five reversals within the five minutes observation time. Further, control participants showed the typical perceptual bias with significant longer median dwell times for the fap compared to the fbp interpretation. No such perceptual bias was found in the Asperger group. DISCUSSION: The perceptual system weights the incomplete and ambiguous sensory input with memorized concepts in order to construct stable and reliable percepts. In the case of the Necker cube stimulus, two perceptual interpretations are equally compatible with the sensory information and internal fluctuations may cause perceptual alternations between them-with a slightly larger probability value for the fap interpretation (perceptual bias). Smaller reversal rates in Asperger observers may result from the dominance of bottom-up sensory input over endogenous top-down factors. The latter may also explain the absence of a fap bias.
