Novel Prefrontal Synthesis Intervention Improves Language in Children with Autism

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 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.

Embodied Imagination and Metaphor Use in Autism Spectrum Disorder

“…Voluntary imagination is said to enable complex semantic relationships. For instance, Vyshedskiy et al [1] take voluntary imagination to be "responsible for mental juxtaposition of objects into novel combinations [without which] it is impossible to understand the difference between sentences with identical words and grammar" (p. 3). Similarly, top-down imagination refers to the mechanism of imagination involving the lateral prefrontal cortex (LPFC).…”

“…However, voluntary imagination is also taken to rely on the development of prior linguistic reasoning. The acquisition of voluntary imagination is taken to be the function of using recursive language in early childhood [1,14]. Thus, the relationship between imaginative skills and linguistic skills is seen as closely interlinked and mutually dependent.…”

“…Imaginative capacities "malfunctioning" for children on the spectrum refer to poor mental integration and stimulus overselectivity. For instance, Dunn et al [26] clarify that the ability to juxtapose or mentally integrate multiple cues "is known to be a common challenge for children on the spectrum" (p. 3), while Vyshedskiy et al [1] clarify that the "autism community refers to the phenomenon whereby individuals cannot combine disparate objects into a novel mental image as stimulus overselectivity, tunnel vision, or the lack of multi-cue responsivity" (p. 3, see also [27]). Stimulus overselectivity refers to a phenomenon "whereby an individual focuses on only one aspect of an object or environment while ignoring others" [1].…”

“…In this paper we explore the notions of imagination and metaphor as they are predominantly used in discussions of Autism Spectrum Disorder (ASD). We begin by explaining that the concept of imagination referenced in such discussions is seen as strongly connected to (and even resting upon) linguistic capacities [1], just as the concept of metaphor is strongly connected to semantic skills [2]. In line with the findings that people on the autistic spectrum show linguistic deficiencies [3], many theorists have also suggested that the imaginative and metaphoric skills of autistic individuals are lacking.…”

“…We do not think that this connection between language and imagination is a coincidence. The descriptions of individuals with ASD as having "malfunctioning" imaginative skills or showing "lack of" metaphoric thought are correlated to the linguistic conceptual frameworks that the researchers are working with [1,5], and to the methods they use to test for imaginative and metaphoric skills of people with ASD that their frameworks inspire. Those conceptual frameworks we will collectively name "linguistic frameworks".…”