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.

Background/Objectives: Children with Autism Spectrum Disorder (ASD) experience difficulties with interpersonal synchrony (IPS). While creative movement (CM) interventions have shown benefits for social, cognitive, and motor skills in children with ASD, the neural mechanisms underlying these improvements remain unclear. This pilot randomized control trial examined the behavioral and neural effects of CM, general movement (GM), and sedentary play (SP) interventions. Methods: Twenty-two children with ASD (Mean Age ± SE = 8.7 ± 1.9) participated. Functional Near-Infrared Spectroscopy (fNIRS) was used to measure cortical activation during a drumming synchrony task before and after 8 weeks of intervention. Results: The CM group demonstrated significant improvements in IPS and the most widespread increases in socially enhanced activation across the left middle frontal gyrus (MFG), inferior frontal gyrus (IFG), and superior temporal sulcus (STS). The GM group showed increased activation in the left IFG, while the SP group showed enhanced activation in the left STS. Children with lower baseline adaptive functioning and social responsiveness showed greater IPS improvement. Conclusions: These findings provide preliminary evidence for the efficacy of CM in improving IPS in children with ASD and support the use of fNIRS to capture neural effects following interventions.

Children with autism spectrum disorder (ASD) have difficulties with tool use and pantomime actions. The current study utilized functional near-infrared spectroscopy (fNIRS) to examine the neural mechanisms underlying these gestural difficulties. Thirty-one children with and without ASD (age (mean ± SE) = 11.0 ± 0.6) completed a naturalistic peg-hammering task using an actual hammer (hammer condition), pantomiming hammering actions (pantomime condition), and performing meaningless actions with similar joint motions (meaningless condition). Children with ASD exhibited poor praxis performance (praxis error: TD = 17.9 ± 1.7; ASD = 27.0 ± 2.6, p < 0.01), which was significantly correlated with their cortical activation (R = 0.257 to 0.543). Both groups showed left-lateralized activation, but children with ASD demonstrated more bilateral activation during all gestural conditions. Compared to typically developing children, children with ASD showed hyperactivation of the inferior parietal lobe and hypoactivation of the middle/inferior frontal and middle/superior temporal regions. Our findings indicate intact technical reasoning (typical left-IPL activation) but atypical visuospatial and proprioceptive processing (hyperactivation of the right IPL) during tool use in children with ASD. These results have important implications for clinicians and researchers, who should focus on facilitating/reducing the burden of visuospatial and proprioceptive processing in children with ASD. Additionally, fNIRS-related biomarkers could be used for early identification through early object play/tool use and to examine neural effects following gesture-based interventions.

Background/Objectives: Children with Autism Spectrum Disorder (ASD, here on termed autistic children) exhibit motor difficulties in social and non-social contexts. Although previous studies have reported behavioral and neural characteristics, their relationship remains largely unexplored. The current study aimed to investigate the behavioral and neural mechanisms underlying interpersonal synchrony in autistic children using simultaneous kinematic and Functional Near-Infrared Spectroscopy (fNIRS) recordings. Methods: Fifty-eight autistic or non-autistic children participated (mean age = 10.1, standard error = 0.3). fNIRS and an inertial measurement unit were used simultaneously to record the neural activity over frontotemporal and parietal regions and arm movement kinematics during a reach-to-clean-up task across three conditions: Watch—the child observed the tester clean up the blocks; Do—the child cleaned up the blocks independently; and Together—the child and tester cleaned up the blocks synchronously. Results: Behaviorally, autistic children demonstrated longer movement displacement, higher average velocity and acceleration, and a greater number of movement units. In terms of cortical activation, autistic children showed hypoactivation in the bilateral precentral gyrus and right inferior parietal lobe, along with hyperactivation in the right middle frontal gyrus, left inferior frontal gyrus, and left inferior parietal lobule. Correlations between kinematic and neural measures suggest that autistic children rely more on online/feedback control to compensate for reduced feedforward control. Conclusions: This study reveals unique compensatory strategies in autistic children, highlighting the connections between neural and behavioral characteristics. These findings have strong potential to inform the development of ASD screening tools and to guide targeted intervention strategies.

Background/Objectives: Autism spectrum disorder is associated with executive functioning (EF) challenges, yet the neural correlates of EF challenges in autistic youth remain unclear. This study aimed to examine EF performance and cortical activation in autistic versus non-autistic youth, using functional near-infrared spectroscopy (fNIRS) during a modified Flanker task. Methods: Thirty age-matched (11.6 ± 0.8 years) autistic (N = 15) and non-autistic youth (N = 15) completed congruent and incongruent conditions of a modified Flanker task while cortical activation in prefrontal, parietal, and temporal regions was recorded using fNIRS. The Behavior Rating Inventory of Executive Function (BRIEF) was used to assess general EF impairments. Behavioral data (i.e., Flanker task mean reaction time/accuracy, and reaction time variability) and cortical activation were analyzed using ANCOVAs. Pearson correlations were used to determine the relationship between cortical activation, EF performance, and clinical measures. The significance level was set at p < 0.05, with FDR corrections for multiple comparisons. Results: While mean reaction time and accuracy were comparable across groups, autistic youth exhibited greater reaction time variability (autistic youth = 34.8 ± 10.36; controls = 26.4 ± 1.94, p = 0.02, Hedges’ g = 0.85) and higher BRIEF index scores compared to controls (p_s < 0.001, Hedges’ gs > 1.3; e.g., Global Executive Composite Score for autistic youth = 71.3 ± 3.7; controls = 47.8 ± 2.4), indicative of delayed EF development. During the incongruent condition, compared to non-autistic controls, autistic youth showed lower left inferior parietal lobe (IPL) activation (Mean HbO₂ in autistic youth = −0.02 ± 0.006 mmol.mm; controls = 0.01 ± 0.006 mmol.mm, p_s < 0.001, Hedges’ g = 0.5) and a lack of left-lateralized activation (e.g., left vs. right STS activation, p < 0.001, Hedges’ g = 0.41 in the non-autistic youth). In the ASD group, lower activation in the left STS was associated with lower EF performance (r = −0.28, p = 0.007), whereas greater activation in various right-hemispheric ROIs was associated with better EF performance (r = −0.31 to −0.35, p_s < 0.005), suggesting potential compensatory activation. Conclusions: The findings revealed ASD-specific differences in the neural correlates of EF performance and possible alternative compensatory activation patterns. These potential neural correlates of EF performance highlight the utility of fNIRS-based neural measures to better understand the neural bases of EF differences in autism. Study Registration: This study was approved by the Institutional Review Board (IRB) at the University of Delaware (Protocol #: 1947455) on 4 October 2022.