Imagination in Autism

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (31 December 2020) | Viewed by 30533

Special Issue Editor


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Guest Editor
1. Biology Department, Metropolitan College, Boston University, One Silber Way, Boston, MA 02215, USA
2. ImagiRation LLC, Boston, MA 02135, USA
Interests: autism; behavioral therapy; pivotal response treatment; multiple cue responding; stimulus overselectivity
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Dear Colleagues,

Imagination is a multifaceted phenomenon. Simpler forms of imagination, such as dreaming and spontaneous insight, are innate, involuntary, and may even be present in non-human mammals. More complex voluntary forms of imagination, such as integration of modifiers and prefrontal synthesis, may be uniquely human. Voluntary imagination is essential for understanding complex language. Linking words with objects is the function of Wernicke’s area, while interpreting the grammatical structure of a sentence and assigning word forms to a grammatical group (such as noun, verb, or preposition) is the function of Broca’s area. Finally, combining objects from memory according to grammatically imposed rules into a novel mental image is the function of the lateral prefrontal cortex (LPFC). For example, the sentences “The dog bit my friend” and “My friend bit the dog” use identical words and grammar. Appreciating the misfortune of the first sentence and the humor of the second sentence depends on the LPFC ability to faithfully synthesize the two objects—the friend and the dog—into a novel mental image. Similarly, understanding spatial prepositions such as in, on, under, over, beside, in front of, and behind requires a subject to synthesize several objects in front of the mind’s eye using their LPFC.

Most people anthropomorphically assume innate voluntary imagination abilities in all individuals. However, therapists, parents, and researchers working with children with autism appreciate the challenges of voluntary imagination acquisition. Even with daily language therapy, some children never develop their LPFC connections, which are essential for a full imagination. The phenomenon whereby individuals cannot combine disparate objects into a novel mental image is known as stimulus overselectivity, tunnel vision, and the lack of multi-cue responsivity. Failure to acquire the ability to mentally juxtapose objects into novel combinations results in a life-long inability to understand spatial prepositions, recursion, and other complex sentences. Among individuals diagnosed with ASD, the prevalence of individuals exhibiting this problem is 30 to 40%.

This problem of voluntary imagination acquisition is exacerbated by confusion between voluntary and involuntary imagination and a misunderstanding of the strong critical period. It is not uncommon for parents to brush off their child’s language delay until elementary school, at which time it may be too late to develop voluntary imagination. It is also common for parents to mistake drawing, Lego constructions, and jigsaw puzzle assembly for manifestation of voluntary imagination. In children developing atypically, some aspects of creativity can be driven exclusively by involuntary imagination and do not reflect the development of voluntary imagination.

While clinicians are usually aware of the critical period and normally recommend early intervention at the time of diagnosis, they are often reluctant to emphasize the urgent nature of the problem to the parents, as most clinicians are uncertain about the distinction between voluntary and involuntary imagination and between weak and strong critical periods. Even when intensive therapy ensues early, the success is hindered by ambiguous goals. Many techniques used by speech language pathologists and ABA therapists are aimed at improving voluntary imagination: “combining adjectives, location/orientation, color, and size with nouns”, “following directions with increasing complexity”, “conditional discrimination”, “development of multi-cue responsivity”. However, voluntary imagination exercises are usually just a small part of intervention that primarily focuses on building up a child’s vocabulary. Vocabulary is easier to train, and most tests rely exclusively on a child’s vocabulary to measure success, thus encouraging focus on vocabulary training. Thus, ambiguous imagination terminology and lack of appreciation for the strong voluntary imagination critical period have a clear negative effect on the education of vulnerable children.

The goal of this Special Issue on imagination in autism is to highlight the importance of better understanding of the strong critical period for voluntary imagination and to review novel educational methodologies with the potential to improve diagnosis and therapy in young children with language delay. Multipronged approaches that combine efforts of therapists and parents will result in earlier and more effective therapy and eventually in many more high-functioning productive lives.

Please note the first five papers could have an opportunity to apply for full waiver for the article processing charges. Possible fundings will be announced soon for the rest of submissions.

Dr. Andrey Vyshedskiy
Guest Editor

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Keywords

  • Language therapy
  • Theory of mind (TOM)
  • Prefrontal synthesis
  • Voluntary imagination
  • Reduced imagination
  • Pretend play
  • Symbolic play
  • Low-functioning ASD
  • Language acquisition critical period
  • Following directions with increasing complexity
  • Building the multiple features in the sentence
  • Matrix training
  • Generative language
  • Conditional discrimination
  • Multi-cue responsivity
  • Stimulus overselectivity
  • Tunnel vision
  • Nonverbal autism
  • Receptive language

Published Papers (5 papers)

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12 pages, 555 KiB  
Article
Watching Videos and Television Is Related to a Lower Development of Complex Language Comprehension in Young Children with Autism
by Elisabeth Fridberg, Edward Khokhlovich and Andrey Vyshedskiy
Healthcare 2021, 9(4), 423; https://doi.org/10.3390/healthcare9040423 - 6 Apr 2021
Cited by 10 | Viewed by 3054
Abstract
The effect of passive video and television watching duration on 2- to 5-year-old children with autism was investigated in the largest and the longest observational study to date. Parents assessed the development of 3227 children quarterly for three years. Longer video and television [...] Read more.
The effect of passive video and television watching duration on 2- to 5-year-old children with autism was investigated in the largest and the longest observational study to date. Parents assessed the development of 3227 children quarterly for three years. Longer video and television watching were associated with better development of expressive language but significantly impeded development of complex language comprehension. On an annualized basis, low TV users (low quartile: 40 min or less of videos and television per day) improved their language comprehension 1.4 times faster than high TV users (high quartile: 2 h or more of videos and television per day). This difference was statistically significant. At the same time, high TV users improved their expressive language 1.3 times faster than low TV users. This difference was not statistically significant. No effect of video and television watching duration on sociability, cognition, or health was detected. Full article
(This article belongs to the Special Issue Imagination in Autism)
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20 pages, 312 KiB  
Article
Embodied Imagination and Metaphor Use in Autism Spectrum Disorder
by Zuzanna Rucińska, Thomas Fondelli and Shaun Gallagher
Healthcare 2021, 9(2), 200; https://doi.org/10.3390/healthcare9020200 - 13 Feb 2021
Cited by 5 | Viewed by 5020
Abstract
This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and [...] Read more.
This paper discusses different frameworks for understanding imagination and metaphor in the context of research on the imaginative skills of children with autism spectrum disorder (ASD). In contrast to a standard linguistic framework, it advances an embodied and enactive account of imagination and metaphor. The paper describes a case study from a systemic therapeutic session with a child with ASD that makes use of metaphors. It concludes by outlining some theoretical insights into the imaginative skills of children with ASD that follow from taking the embodied-enactive perspective and proposes suggestions for interactive interventions to further enhance imaginative skills and metaphor understanding in children with ASD. Full article
(This article belongs to the Special Issue Imagination in Autism)
21 pages, 2368 KiB  
Article
Novel Prefrontal Synthesis Intervention Improves Language in Children with Autism
by Andrey Vyshedskiy, Edward Khokhlovich, Rita Dunn, Alexander Faisman, Jonah Elgart, Lisa Lokshina, Yuriy Gankin, Simone Ostrovsky, Lauren deTorres, Stephen M. Edelson and Petr O. Ilyinskii
Healthcare 2020, 8(4), 566; https://doi.org/10.3390/healthcare8040566 - 16 Dec 2020
Cited by 20 | Viewed by 14105
Abstract
Prefrontal synthesis (PFS) is defined as the ability to juxtapose mental visuospatial objects at will. Paralysis of PFS may be responsible for the lack of comprehension of spatial prepositions, semantically-reversible sentences, and recursive sentences observed in 30 to 40% of individuals with autism [...] Read more.
Prefrontal synthesis (PFS) is defined as the ability to juxtapose mental visuospatial objects at will. Paralysis of PFS may be responsible for the lack of comprehension of spatial prepositions, semantically-reversible sentences, and recursive sentences observed in 30 to 40% of individuals with autism spectrum disorder (ASD). In this report we present data from a three-year-long clinical trial of 6454 ASD children age 2 to 12 years, which were administered a PFS-targeting intervention. Tablet-based verbal and nonverbal exercises emphasizing mental-juxtaposition-of-objects were organized into an application called Mental Imagery Therapy for Autism (MITA). The test group included participants who completed more than one thousand exercises and made no more than one error per exercise. The control group was selected from the rest of participants by a matching procedure. Each test group participant was matched to the control group participant by age, gender, expressive language, receptive language, sociability, cognitive awareness, and health score at first evaluation using propensity score analysis. The test group showed a 2.2-fold improvement in receptive language score vs. control group (p < 0.0001) and a 1.4-fold improvement in expressive language (p = 0.0144). No statistically significant change was detected in other subscales not targeted by the exercises. These findings show that language acquisition improves after training PFS and that a further investigation of the PFS-targeting intervention in a randomized controlled study is warranted. Full article
(This article belongs to the Special Issue Imagination in Autism)
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10 pages, 3448 KiB  
Case Report
Autism and Hidden Imagination: Raising and Educating Children Who Cannot Express Their Minds
by Clair Berube
Healthcare 2021, 9(2), 150; https://doi.org/10.3390/healthcare9020150 - 2 Feb 2021
Viewed by 2916
Abstract
This is a reflection on an article written in 2007, entitled Autism and the Artistic Imagination: The Link between Visual Thinking and Intelligence. The author is a parent of a 6-year-old with autism who is now 19 and is non-verbal who has trouble [...] Read more.
This is a reflection on an article written in 2007, entitled Autism and the Artistic Imagination: The Link between Visual Thinking and Intelligence. The author is a parent of a 6-year-old with autism who is now 19 and is non-verbal who has trouble expressing his thoughts, feelings and desires, and discusses some theories behind autism spectrum communication disorders and seeks to understand why there is so much difficulty with communication with some on the spectrum. The 2007 article employed Howard Gardner’s Multiple Intelligence Theory as a framework to discuss the visual and spatial learning abilities of kids with autism, and this update posits that the nonspeaking population of the autism community do indeed have different ways of understanding the world, theories of mind and awareness enough to be able to communicate if only the proper links and opportunities are provided. The lack of communication is not due to a lack of a sense of self, but of a lack of understanding of the neuro-typical community that people with autism are speaking a second language, and need help with the translation. Full article
(This article belongs to the Special Issue Imagination in Autism)
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11 pages, 704 KiB  
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Imagination in Autism: A Chance to Improve Early Language Therapy
by Andrey Vyshedskiy
Healthcare 2021, 9(1), 63; https://doi.org/10.3390/healthcare9010063 - 11 Jan 2021
Cited by 3 | Viewed by 4273
Abstract
Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long [...] Read more.
Children with autism often have difficulties in imaginative play, Theory of Mind, and playing out different scenarios in their minds. Research shows that the root of these problems may be the voluntary imagination network that involves the lateral prefrontal cortex and its long frontoposterior connections to the temporal-parietal-occipital area. Previously disconnected visuospatial issues (stimulus overselectivity and tunnel vision) and language issues (lack of comprehension of spatial prepositions and complex recursive sentences) may be explained by the same voluntary imagination deficit. This review highlights the new insights into the mechanism of voluntary imagination, its difference from involuntary imagination, and its unusually strong critical period. Clearer developmental terminology and a better understanding of voluntary imagination have the potential to facilitate communication between therapists and parents, and improve therapy outcomes in children. Full article
(This article belongs to the Special Issue Imagination in Autism)
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