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ASPartOfMe
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03 Jan 2019, 2:37 am

Meta-analysis highlights important challenges in cognitive processing for adults with ASD

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The first comprehensive, systematic review and meta-analysis of adults with autism shows that despite having an intact IQ, these adults have medium to large impairments in four key social- and non-social cognitive domains: theory of mind, emotion perception and knowledge, processing speed, and verbal learning and memory.

The meta-analysis was conducted by the Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai in collaboration with City University London and published Wednesday, January 2, in JAMA Psychiatry.

While autism affects functioning in many domains throughout an individual's lifespan, research and treatment efforts have largely been dedicated to children. A critical question that has remained largely unaddressed is whether there are cognitive domains that are more severely impaired than others. Despite the efforts of individual studies to increase the understanding of cognitive deficits in adults with autism, sample sizes were often small, yielding inconsistent findings.

To directly compare the relative severity of impairments across cognitive domains in adults, Mount Sinai researchers aggregated all available autism literature and conducted a systematic review and analysis. Specifically, researchers from the Seaver Autism Center conducted a systematic review and meta-analysis of autism-related studies published in the PubMed, PsychINFO, EMBASE, and MEDLINE databases between 1980 (first inclusion of autism diagnosis in the DSM-III (The Diagnostic and Statistical Manual of Mental Disorders) and July 2018. Studies were included if they were published as a primary peer-reviewed research paper in English, included individuals with autism aged 16 or over, and assessed at least one domain of neurocognitive functioning or social cognition using standard measures. The meta-analysis included 75 studies and a combined sample of 3,361 individuals with autism and 5,344 neurotypical adults.

Current interventions for these individuals are primarily focused on improving individual adaptive social skills and social functioning," says Tjasa Velikonja, PhD, a postdoctoral research fellow at the Seaver Autism Center and first author of the paper. "While our results support the key social cognitive theories of autism treatments, they also highlight the importance of a broader approach when studying cognition and support interventions that also include non-social cognitive domains."


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MrsPeel
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03 Jan 2019, 5:46 am

Interesting, thank you.
A good study for explaining why assistance / treatment should not be limited to social skills.



Catana
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02 Mar 2019, 2:18 pm

I haven't been around for quite a long time, so I'm coming to this question very late.

You always have to keep in mind with studies like this, that they're based on diagnosed autistics, most of whom have probably sought and used various services and supports. There is no way to study autistics who are, for all intents and purposes, invisible because they haven't sought diagnoses or services. So the study is unavoidably biased: it will always find problems of one sort or another.



BeaArthur
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02 Mar 2019, 4:27 pm

Article was vague on the cognitive domains. A meaningful meta-analysis requires at least a few features that are reasonably comparable across studies - for instance, relapse in smoking after smoking cessation (either you do, or you don't). This article claims cognitive domains with adult deficits are processing speed and verbal learning and memory, in addition to the more widely acknowledged social deficits. I'm not sure I even grasp what the conclusions are, from this short article, and I am not tracking down the original publication of the meta-analysis.

Also, the inclusion of studies from 1980 to 2018 spans too large a time period, given that diagnostic criteria had major changes over that interval.

Give me one well-designed study with a sufficient sample size, over a dozen sloppy meta-analyses.


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