Browsing by Author "Su, Wan-Chun"
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Item Autism-Related Differences in Cortical Activation When Observing, Producing, and Imitating Communicative Gestures: An fNIRS Study(Brain Sciences, 2023-09-04) Su, Wan-Chun; Culotta, McKenzie; Mueller, Jessica; Tsuzuki, Daisuke; Bhat, Anjana N.Children with autism spectrum disorder (ASD) have difficulties in gestural communication during social interactions. However, the neural mechanisms involved in naturalistic gestural communication remain poorly understood. In this study, cortical activation patterns associated with gestural communication were examined in thirty-two children with and without ASD (mean age: 11.0 years, SE: 0.6 years). Functional near-infrared spectroscopy (fNIRS) was used to record cortical activation while children produced, observed, or imitated communicative gestures. Children with ASD demonstrated more spatial and temporal errors when performing and imitating communicative gestures. Although both typically developing (TD) children and children with ASD showed left-lateralized cortical activation during gesture production, children with ASD showed hyperactivation in the middle/inferior frontal gyrus (MIFG) during observation and imitation, and hypoactivation in the middle/superior temporal gyrus (MSTG) during gesture production compared to their TD peers. More importantly, children with ASD exhibited greater MSTG activation during imitation than during gesture production, suggesting that imitation could be an effective intervention strategy to engage cortical regions crucial for processing and producing gestures. Our study provides valuable insights into the neural mechanisms underlying gestural communication difficulties in ASD, while also identifying potential neurobiomarkers that could serve as objective measures for evaluating intervention effectiveness in children with ASD.Item Multisystem effects of creative movement intervention and associated changes in cortical activation in children with autism spectrum disorder (ASD)(University of Delaware, 2022) Su, Wan-ChunAutism Spectrum Disorder (ASD) is a multisystem neurodevelopmental disorder not only affects children’s core impairments in social communication and behavioral-affective states but also their comorbid impairments in perceptuo-motor performance. Children’s comorbid impairments in general motor (i.e., gross and fine motor) and socially embedded motor performance (i.e., interpersonal synchrony (IPS)) might eventually affect their social participation. ☐ The purpose of this dissertation was to identify ASD-related neurobiomarkers during IPS and to develop an evidence-based, multisystem intervention that targets multisystem difficulties of children with ASD. In Aims 1 and 2, we compared IPS performance and functional near-infrared spectroscopy (fNIRS)-related cortical activation between children with and without ASD during reaching and body sway synchrony tasks. Children with ASD showed significant IPS difficulties as well as associated atypical cortical activation such as reduced inferior frontal gyrus, superior temporal sulcus activation, and increased inferior parietal lobe activation. Moreover, unlike their typically developing peers, children with ASD did not scale up their cortical activation when more social-perceptual information was provided. The neurobiomarkers we identified in Aims 1 and 2 could be used as objective response measures to study intervention effects. ☐ In Aim 3 we conducted a comprehensive systematic review to understand the neural effects of movement intervention/physical activity in children with ASD and other developmental disabilities. Our systematic review revealed normalized resting state, cortical arousal/connectivity, as well as normalized electroencephalogram, and event-related potentials during multiple executive functioning tasks after physical activity and movement interventions. ☐ Aims 4-6, build on our past behavioral and neurobiomarker studies as well as recent systematic reviews, to conduct a Randomized Controlled Trial (RCT) comparing effects of 8 weeks of multisystem, synchrony-based Creative Movement (CM, using a blend of music, dance, and yoga approaches), General Movement (GM, control for movement), and Sedentary Play (SP, control for social interactions) interventions on the motor, social communication, behavioral-affective, and cognitive skills of school-age children with ASD. ☐ In Aim 4, we explored the effects of CM and SP interventions on general and socially embedded motor skills in children with ASD. Children in both CM and SP groups showed improved fine motor and imitation performance, while children in the CM group showed additional improvements in gross motor (i.e., body coordination, strength, agility, locomotor skills) and IPS performance. ☐ In Aim 5, we explored the cascading effects of CM and SP interventions on social communication, cognitive, and behavioral-affective performance in children with ASD. Only children in the CM group showed increased/improved socially directed verbalization, prosocial behavior, executive functions, and positive affect. ☐ Lastly, in Aim 6, we explored the neural effects of CM, GM, and SP interventions during a drumming synchrony task. GM group showed increased socially enhanced activation over the frontal regions, the SP group showed increased activation over the temporal regions, while the CM group showed a more widespread increase in socially enhanced activation over frontal and temporal regions. ☐ Overall, this dissertation work builds on our lab’s past work to confirm that creative movement interventions through their motor influences on body coordination and IPS have cascading effects on social communication skills, behavioral/affective, and cognitive skills of school-age children with ASD. Lastly, we offer supporting evidence for the use of fNIRS-based neurobiomarkers as intervention response measures following movement interventions.Item Telehealth Versus Face-to-Face Fine Motor and Social Communication Interventions for Children With Autism Spectrum Disorder: Efficacy, Fidelity, Acceptability, and Feasibility(American Journal of Occupational Therapy, 2023-12-04) Su, Wan-Chun; Cleffi, Corina; Srinivasan, Sudha; Bhat, AnjanaImportance: The efficacy of telehealth (TH) interventions needs to be studied. Objective: To compare the efficacy, fidelity, acceptability, and feasibility of face-to-face (F2F) versus TH seated play (SP) interventions among children with autism spectrum disorder (ASD). Design: As part of a larger randomized controlled trial, children were assigned to the SP group and received TH and F2F interventions over 8 wk using a pretest–posttest study design. Setting: A research lab or through videoconferencing. Participants: Fifteen children with ASD (ages 5–14 yr) were randomly assigned to the SP group and received the intervention F2F or through TH. Intervention: Children received 16 SP intervention sessions (2 sessions per week for 8 wk). Outcomes and Measures: Pretests and posttests included standardized fine motor assessments. Video coding compared socially directed verbalization during training sessions. Parents and trainers provided feedback on their experiences. Results: Seven children received the intervention F2F, whereas 8 received TH intervention. Children in both subgroups showed similar training improvements in fine motor skills and socially directed verbalizations (ps > .01). Parents rated both interventions as acceptable and feasible; however, they reported longer preparation time and effort during TH interventions (ps < .01). Trainers reported greater parental involvement but more communication and technological issues during TH interventions. Fidelity checks indicated fewer reinforcements during TH versus F2F sessions. Conclusions and Relevance: TH intervention is feasible and effective in improving fine motor and social communication performance. Clinicians should reduce parental burden and overcome technological issues. What This Article Adds: This study confirmed the efficacy, fidelity, acceptability, and feasibility of delivering seated play, standard of care interventions for children with autism spectrum disorder via telehealth. However, clinicians should work on reducing parental burden and overcoming communication and technological issues related to telehealth.