Adaptive Cognition in Autism

Autism is a neurodevelopmental disorder characterised by qualitative
difficulties with social interactions, communication, and stereotyped and rigid
behaviours (APA, 2000). Its prevalence is relatively common and the impact it
has on both the patients and their parents and caregivers is tremendous. Most
individuals with autism would require a life-long support, both in their social
life and in work settings. The importance of a better understanding of the
origins of behavioural rigidity has recently gained more attention. Perhaps the
most clear example of this recent shift in emphasis is the importance that
rigid behaviours receive in the new version of the diagnostic manual, DSM V.
Full comprehension of its neurocognitive mechanisms is, however, still lacking.

Some empirical evidence for behavioural rigidity in autism comes from
neuropsychological tests, such as the Wisconsin Card Sorting Test, showing
difficulties with flexible adaptation to changes. Intriguingly, however, the
soonest individuals with autism are tested in experimental labs, the difficulty
seems to disappear (Poljac et al. 2010). In one of my previous studies, I have
asked adolescents with autism to switch between two simple cognitive tasks,
which were clearly specified by cues. The finding was that as long as the tasks
were unambiguously specified, adolescents with autism had no difficulty with
switching between them. The question arises then how to solve this paradox of
rigid behaviour in autism that seems to be present in daily lives but seems to
mysteriously disappear in experimental settings (Geurts et al. 2009).

Another very interesting finding of Poljac et al. (2010) was that our clinical
control group, consisting of adolescents with dyslexia, seemed to experience
clear difficulties with these rather simple cognitive tasks and in particular
with switching between tasks. This was surprising, since no indication of
cognitive control deficits were present in the literature for this patient
group, which was exactly the reason why we chose to include them in that study
as the clinical control group. In the current study, we want to include this
group again, for at least two reasons: 1) research on cognitive control
deficits in dyslexia deserves attention and has been almost non-existing so
far; 2) it is clear that individuals with dyslexia deal with task switching in
a different way than both their typically developing peers and individuals with
autism, which make them a perfect clinical control group for our main patient
group of interest- individuals with autism. In addition, since both autism and
dyslexia are a developmental disorder, to better understand how rigidity
develops across age, we will include participants from 12 to 25 years.

The way that the current study aims to solve the paradox of rigid behaviours in
autism is by focusing on the control processes that precede task execution,
that is the part in which people need to decide what they want to do
(intentions), rather than the part in which they implement their decision
(actions). One can imagine that if a person is instructed which task to
execute, that person does not necessarily need to fully rely on cognitive
control processes needed to make decisions, which we constantly do in our daily
lives. The intentional part of task performance is typically being omitted in
the experimental paradigms designed to test mental flexibility and task
switching capacities. It is hence possible that due to the use of these
paradigms, we have not succeeded so far to experimentally detect rigid
behaviours in autism. It is well known that individuals with autism have
problems with creative thinking, problem solving, spontaneous behaviour. The
current study tests hence the possibility that rigid behaviours in autism arise
from problems in intentions and decision making rather than in their
implementations (Poljac & Bekkering, 2012). The study allows us to provide
empirical evidence for rigid behaviour in autism and to specify their neural
(structural and functional) origins.

The main aim of the current study is to specify neurocognitive mechanisms
behind rigid behaviour in autism. For this reason, participants will be
required to execute a computer task, in which they will need to make their own
choice of tasks, during which brain activity will be measured (EEG). We expect
that individuals with autism will show deviant patterns of overt and covert
behaviour related to task intentions and decisions (task choice and
preparation), but not in their eventual implementation (task execution). For
participants with dyslexia, we expect this pattern to be reversed: they are
expected to experience no problems with task intentions and decisions, while
having problems with task execution. These data will be then connected to the
brain areas previously shown to be related to rigid behaviours (Gusnar et al.
2003). Finally, we intend to investigate the development of rigid behaviour in
autism by taking into account how behavioural and neural expressions of
rigidity are modulated by age (12-25 yrs) and by comparing these data patterns
to those of their typically developing peers and peers with dyslexia.

This is a non-invasive behavioural, EEG, and MRI study, with a developmental
character.

In a period of one year, data will be collected from 30 individuals with
autism, 30 clinical controls (dyslexia), and 60 typically developing controls,
equally distributed across age (12-25 yrs). The groups will be matched on IQ,
age, and gender. The testing will take place at the Donders Institute,
including a computer task, during which the brain activity will be recorded by
means of EEG. This part takes around 40-50 minutes. In addition, scanning of
the brain structure, brain connectivity and resting state connectivity will be
administered by means of a 1.5T MRI scanned for about 30 minutes.

Altogether, the project is estimated to last for around 2 years. Data
collection phase will take place at the Donders Institute and should be done
within one year, including the behavioural computer task that goes together
with the EEG recordings, and the scanning with the 1.5T scanner. After data
collection, one year is reserved for the analysis and different types of
reports (conference papers, peer- reviewed papers).

This study assesses brain activity related to behavioural rigidity through EEG,
and relates these functional measures to the more structural brain features
through MRI. In that sense, these measures might reveal a certain brain
(activity) deviation. In this case, an independent medical doctor (as specified
in our protocol) will be contacted.

Generally speaking, there is no risk connected to the participation in EEG or
MRI experiments. The load during the EEG part is not much different from the
load that goes together with a simple cognitive task measuring task switching
(with a similar version of this task previously assessed by the project leader,
E Poljac). Regarding the MRI part, the (cognitive) load is minimal, as the
participants will be required to lie still for around 30 minutes. The space is,
however, relatively small, with a relatively hard noise made by the scanner
itself, and this can indeed be experienced by some people as somehow
frightening. The Donders Institue is, however, highly experienced in this type
of research across all ages, and by means of the dummy scanner that allows for
a try out and practicing through a simulation of the real scanning situation,
the psychological load should be minimal: from previous research we know that
children and adolescents (with autism) do not usually experience any troubles
while participating in an MRI study. Obviously, all the participants can decide
whether to participate or not before coming to the Donders Institute, as well
as during the dummy practice and they can always stop with their participation
even during the real scanning itself.