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Information-processing biases such as attentional, interpretation, and memory biases are believed to play a role in exacerbating and maintaining chronic pain (CP). Evidence suggests that individuals with CP show attentional bias toward pain-related information. However, the selective attentional processes that underpin this bias are not always well outlined in the literature. To improve current understanding, a systematic review was performed using a descriptive synthesis of reaction time-based studies. A random-effects meta-analysis was added to explore whether the results of previous meta-analyses would be confirmed using studies with a larger sample size. For this review, 2008 studies were screened from 4 databases, of which 34 (participant n = 3154) were included in the review and a subset of 15 (participant n = 1339) were included in the meta-analysis. Review results were summarised by producing a descriptive synthesis for all studies. Meta-analysis results indicated a mild significant attentional bias toward sensory pain-related information (k = 15, g = 0.28, 95% CI [0.16, 0.39], I2 = 43.2%, P = 0.038), and preliminary evidence of significant moderate bias towards affective pain-related information (k = 3, g = 0.48, 95% CI [0.23, 0.72], I2 = 7.1%, P = 0.341) for CP groups compared with control groups. We explored the main tasks, stimuli, and CP subtypes used to address attentional biases and related processes. However, variation across studies did not allow for a decisive conclusion about the role of stimulus, task type, or related attentional processes. In addition, a table of CP attention-related models was produced and tested for reliability. Finally, other results and recommendations are discussed.

Smartphones are widely used hubs of personal communication. With their many sensors, they are capable of monitoring social behaviours. Calls, messages, application usage and even face-to-face conversations can be captured by smartphones. These data are then used to study psychological, behavioural and clinical issues, thus providing an objective and continuous perspective on people’s social lives. However, compared with questionnaires, researchers are unfamiliar with the potential and challenges of smartphone social sensing. Moreover, previous studies utilised their own instruments and strategies, which caused repetitive work and threatened the generalisability or validity of results. To fill the gap between conceptual and empirical knowledge, we conducted a systematic review on empirical studies that applied passive smartphone social sensing. Forty-seven eligible articles were retrieved from 2,741 results from five major databases. A paradigm of reviewed studies was extracted, and the comprehensive procedures of passive smartphone social sensing, including applied sensors, experiment length and data analysis methods, were also summarised. This information can provide a general reference for researchers interested in applying passive smartphone social sensing. Benefits such as ubiquitousness, unobtrusiveness and personalisability and challenges such as privacy, accuracy and methodology were also reported. Moreover, fundamental research on reasonable sensor frequency choices, standardising features and implementing state-of-the-art technologies is recommended to enhance passive smartphone social sensing usability.

Action observation and imitation may facilitate movement and increase functional independence in Parkinson’s disease (PD). People with PD have been found to imitate intransitive actions in a similar manner to neurologically healthy older adults, but their ability to imitate object-directed hand movements has not been investigated using kinematic measures. The present study examined observation and imitation of object-directed hand movements in 18 participants with PD compared to 21 neurologically healthy age-matched control participants. Participants observed and immediately imitated sequences showing a human hand reaching for and transferring an object between horizontal positions. Both participants with PD and age-matched controls significantly modulated the vertical amplitude of their finger movements when imitating elevated vs. direct trajectories. Movements were lower in vertical amplitude and faster when imitating the reaching segment of the observed movement than the transfer segment. Eye-tracking revealed significant effects of predictability of the movement sequence on saccade amplitude in the control group, specifically when observing elevated movements, but no effects of predictability on eye movements were found for the PD group. This study provides quantitative evidence indicating that people with mild to moderate PD can imitate the kinematics of object-directed hand movements, although their observation and prediction of such movements may be somewhat altered. These findings suggest that interventions based on observation of object-directed actions may facilitate daily activities in PD through imitation of movement kinematics.

This article is a personal reflection on a long-standing patient and public involvement (PPI) partnership between a person with Parkinson’s and a cognitive neuroscience researcher. They describe how the partnership arose, was established and evolved to produce unexpected benefits to the research and more broadly. Initially, working together helped to communicate the purpose of the research to a lay audience and to make lab-based testing sessions for people with Parkinson’s as comfortable as possible. They then worked together on the steering group for a research project about Parkinson’s and imitation, which led to co-designing interventions using imitation and imagination of movements to improve movements, including a dance class. Further benefits were realised through co-teaching undergraduate students about Parkinson’s, establishing a broader culture of PPI within the research lab and sharing their expertise of PPI more broadly. They consider key ingredients for successful collaboration, including shared curiosity, open-mindedness and trust, as well as the importance of informal discussion and space. Challenges are also considered, including authorship of research articles and anonymity. Their account demonstrates the value of the collaboration to research itself, but also the broader (often unexpected) benefits that can emerge when a collaboration has space and time to flourish.

Altered motor coordination is common in autistic individuals affecting a range of movements such as manual dexterity, eye-hand coordination, balance and gait. However, motor coordination is not routinely assessed leading to undiagnosed and untreated motor coordination difficulties , particularly in adults. Few studies have investigated motor coordination difficulties and their impact from the viewpoint of autistic people. Therefore, the current study used FGs and thematic analysis to document the experience of motor coordination difficulties from the viewpoint of 17 autistic adults. Four main themes were identified. First, motor coordination difficulties were pervasive and variable, being present life-long and within multiple movements and affecting many aspects of life. Furthermore, the nature of the difficulties was variable within and between participants along with differing awareness of coordination ability. Second, participants described motor coordination as an active process, requiring concentration for most actions and at a level seemingly greater than other people. Third, motor coordination difficulties impacted upon social and emotional wellbeing by placing strain on relationships, prompting bullying and exclusion, putting safety at risk and causing a range of negative emotions. Fourth, in the absence of any support, participants described multiple learning and coping strategies. Findings highlight how it is essential to address the current lack of support for motor coordination considering the significant social and emotional consequences described by our participants. Further investigation of motor learning and interactions between sensory and motor performance in autistic adults is also warranted.

Parkinson's disease impairs motor function and cognition, which together affect language and communication. Cospeech gestures are a form of language-related actions that provide imagistic depictions of the speech content they accompany. Gestures rely on visual and motor imagery, but it is unknown whether gesture representations require the involvement of intact neural sensory and motor systems. We tested this hypothesis with a fine-grained analysis of cospeech action gestures in Parkinson's disease. Thirty-seven people with Parkinson's disease and 33 controls described 2 scenes featuring actions which varied in their inherent degree of bodily motion. In addition to the perspective of action gestures (gestural viewpoint/first- vs. third-person perspective), we analyzed how Parkinson's patients represent manner (how something/someone moves) and path information (where something/someone moves to) in gesture, depending on the degree of bodily motion involved in the action depicted. We replicated an earlier finding that people with Parkinson's disease are less likely to gesture about actions from a first-person perspective-preferring instead to depict actions gesturally from a third-person perspective-and show that this effect is modulated by the degree of bodily motion in the actions being depicted. When describing high-motion actions, the Parkinson's group were specifically impaired in depicting manner information in gesture and their use of third-person path-only gestures was significantly increased. Gestures about low-motion actions were relatively spared. These results inform our understanding of the neural and cognitive basis of gesture production by providing neuropsychological evidence that action gesture production relies on intact motor network function. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background. Parkinson’s disease (PD) causes difficulties with hand movements, which few studies have addressed therapeutically. Training with action observation (AO) and motor imagery (MI) improves performance in healthy individuals, particularly when the techniques are applied simultaneously (AO + MI). Both AO and MI have shown promising effects in people with PD, but previous studies have only used these separately. Objective. This article describes the development and pilot testing of an intervention combining AO + MI and physical practice to improve functional manual actions in people with PD. Methods. The home-based intervention, delivered using a tablet computer app, was iteratively designed by an interdisciplinary team, including people with PD, and further developed through focus groups and initial field testing. Preliminary data on feasibility were obtained via a six-week pilot randomised controlled trial (ISRCTN 11184024) of 10 participants with mild to moderate PD (6 intervention; 4 treatment as usual). Usage and adherence data were recorded during training, and semistructured interviews were conducted with participants. Exploratory outcome measures included dexterity and timed action performance. Results. Usage and qualitative data provided preliminary evidence of acceptability and usability. Exploratory outcomes also suggested that subjective and objective performance of manual actions should be tested in a larger trial. The importance of personalisation, choice, and motivation was highlighted, as well as the need to facilitate engagement in motor imagery. Conclusions. The results indicate that a larger RCT is warranted, and the findings also have broader relevance for the feasibility and development of AO + MI interventions for PD and other conditions.

Motor imagery (MI), the mental simulation of movement in the absence of overt motor output, has demonstrated potential as a technique to support rehabilitation of movement in neurological conditions such as Parkinson's disease (PD). Existing evidence suggests that MI is largely preserved in PD, but previous studies have typically examined global measures of MI and have not considered the potential impact of individual differences in symptom presentation on MI. The present study investigated the influence of severity of overall motor symptoms, bradykinesia and tremor on MI vividness scores in 44 individuals with mild to moderate idiopathic PD. Linear mixed effects modelling revealed that imagery modality and the severity of left side bradykinesia significantly influenced MI vividness ratings. Consistent with previous findings, participants rated visual motor imagery (VMI) to be more vivid than kinesthetic motor imagery (KMI). Greater severity of left side bradykinesia (but not right side bradykinesia) predicted increased vividness of KMI, while tremor severity and overall motor symptom severity did not predict vividness of MI. The specificity of the effect of bradykinesia to the left side may reflect greater premorbid vividness for the dominant (right) side or increased attention to more effortful movements on the left side of the body resulting in more vivid motor imagery.

Researchers from multiple disciplines have studied the simulation of actions through motor imagery, action observation, or their combination. Procedures used in these studies vary considerably between research groups, and no standardized approach to reporting experimental protocols has been proposed. This has led to under-reporting of critical details, impairing the assessment, replication, synthesis, and potential clinical translation of effects. We provide an overview of issues related to the reporting of information in action simulation studies, and discuss the benefits of standardized reporting. We propose a series of checklists that identify key details of research protocols to include when reporting action simulation studies. Each checklist comprises A) essential methodological details, B) essential details that are relevant to a specific mode of action simulation, and C) further points that may be useful on a case-by-case basis. We anticipate that the use of these guidelines will improve the understanding, reproduction, and synthesis of studies using action simulation, and enhance the translation of research using motor imagery and action observation to applied and clinical settings.

An emerging body of research suggests that temporal processing may be disrupted in autistic children, although little is known about behaviours relating to time in daily life. In the present study, 113 parents of autistic and 201 parents of neurotypical children (aged 7–12 years) completed the It’s About Time questionnaire and open-ended questions about their child’s behaviour relating to time. The questionnaire scores were lower in the autistic compared with the neurotypical group, suggesting that behaviours are affected. Three key themes were identified using thematic analysis: autistic children had problems with temporal knowledge, learning about concepts relating to time, such as how to use the clock and language around time. There were differences in prospection with autistic children having more difficulties with how they thought about the future and prepared themselves for upcoming events. The final theme, monotropism, described how autistic children viewed their time as precious so they could maximise engagement in their interests. The present study indicates that behaviours relating to time can have a considerable impact on the daily lives of autistic children and their families. Further work exploring the development of temporal cognition in autism would be valuable for targeting effective educational and clinical support. Lay abstract Many everyday activities require us to organise our behaviours with respect to time. There is some evidence that autistic children have problems with how they perceive and understand time. However, little is currently known about this, or the ways in which behaviours related to time are impacted in daily life. In this study, 113 parents of autistic children and 201 parents of neurotypical children completed a questionnaire and open-ended questions about their child’s behaviour relating to time. Questionnaire scores were lower in the autistic group compared with neurotypicals, which suggests that behaviours relating to time are affected in autistic children. The open-ended responses further confirmed that the autistic children struggled with time and that this impacted on them and their family. Three key themes were identified. Theme 1: autistic children have problems with learning about concepts relating to time such as telling the time from a clock and using words to describe time (hours, minutes, etc.) appropriately. Theme 2: autistic children think about the future differently. Planning and working under time pressure were described as a problem. Theme 3: autistic children have strong interests which take up a lot of their attention and worrying about having sufficient time to pursue these interests causes anxiety. This research indicates that behaviours related to time can have a considerable impact on the lives of autistic children and that targeted support may be required.

In an artistic exploration, clay hands and nonhand-like, unfeasible clay objects were created by the participant and used to perform an alternative version of the rubber hand illusion. Most participants felt ownership even over these unfeasible objects, raising questions about the embodied experience of objects that we make.

Background. Dance is found to provide a range of beneficial effects for older adults including individuals with age-related neurological conditions such as Parkinson’s disease (PD). The COVID-19 pandemic accelerated the development of at-home dance programs delivered digitally through live and pre-recorded media, but little is known about how participants may engage with and benefit from these resources. Objective. This study explored experiences and potential benefits of digital dance resources among healthy older adults and individuals with neurological conditions. Methods. An online survey consisting of fixed-choice and open questions was designed in collaboration with dance program providers and distributed between June and November 2020. Results. High levels of engagement in at-home dance programs were found among healthy older adults (N = 149) and individuals with PD (N = 178). Sensorimotor outcomes (e.g., balance, posture) were more widely reported among individuals with PD, while older adults reported similar numbers of sensorimotor and non-motor (e.g., mood, confidence) outcomes. The use of strategies (imagery and vocalising) during participation were differentially associated with outcomes in older adults and PD groups. At-home dance was found to offer convenience and flexibility, but participants missed the interaction, support and routine of in-person classes. The majority expressed a preference to continue with both digital and in-person participation in the future. Qualitative analysis of participants’ comments reinforced the quantitative findings, while also revealing that online dance could help to maintain connection and well-being, and identifying further considerations for improving accessibility and facilitating digital engagement. Conclusions. At-home dance programs appear to be accessible and engaging for older adults, including individuals with PD, although potential barriers to participation need to be addressed. Digital resources for home-based activities will be increasingly important to enable cost-effective, large-scale provision of therapeutic activities for older adults.

Motor imagery supports motor learning and performance, having the potential to be a useful tool for neurorehabilitation. However, motor imagery ability may be impacted by ageing and neurodegeneration, which could limit its therapeutic effectiveness. Motor imagery can be assessed implicitly using a hand laterality task (HLT), whereby laterality judgements are slower for stimuli corresponding to physically more difficult postures, as indicated by a “biomechanical constraint” effect for lateral versus medial orientations. Performance is also found to differ between back and palm views of the hand, which may differentially recruit visual and sensorimotor processes. Older adults are generally found to be slower at laterality judgement and show increased biomechanical effects than younger adults, and individuals with Parkinson’s disease (PD) have also shown altered performance. However, the effects of both ageing and PD on laterality judgements for the different hand views (back and palm) have not been examined within the same study.The present study compared healthy younger, healthy older, and PD groups on HLT performance from back and palm views, as well as an object-based mental rotation task and an explicit motor imagery measure (vividness questionnaire). The older and PD groups were slower than the young groups on the HLT, particularly when judging laterality from the back view, and exhibited increased biomechanical constraint effects for the palm. While response times were generally similar between older and PD groups, the PD group showed reduced accuracy for the back view. Letter rotation was slower and less accurate only in the PD group. There was no significant difference between groups in explicit motor imagery. These results suggest that motor imagery may be slowed but relatively preserved in both typical ageing and neurodegeneration, while a PD-specific impairment in visuospatial processing may influence task performance. The findings have implications for the use of motor imagery in rehabilitation protocols.

Undergraduate student mental health and wellbeing is becoming an increasingly important topic. In particular, students from backgrounds that have been traditionally underrepresented in higher education may have increased difficulties during the transition to university. Therefore, ‘Mind Your Mind’, a pilot, three-part programme of workshops facilitated by doctoral clinical psychology students to support first year undergraduate psychology students was developed. The workshops were formulation-based and explored ‘social media’, ‘anxiety’ and ‘belonging’. Students generally found the workshops useful and easy to understand, and felt that attending the workshops increased their wellbeing. The programme also provided an opportunity for the clinical psychology students to develop their skills and give something back. Reflections on the development, facilitation and sustainability of the programme are discussed.

This study investigated whether reduced visual attention to an observed action might account for altered imitation in autistic adults. A total of 22 autistic and 22 non-autistic adults observed and then imitated videos of a hand producing sequences of movements that differed in vertical elevation while their hand and eye movements were recorded. Participants first performed a block of imitation trials with general instructions to imitate the action. They then performed a second block with explicit instructions to attend closely to the characteristics of the movement. Imitation was quantified according to how much participants modulated their movement between the different heights of the observed movements. In the general instruction condition, the autistic group modulated their movements significantly less compared to the non-autistic group. However, following instructions to attend to the movement, the autistic group showed equivalent imitation modulation to the non-autistic group. Eye movement recording showed that the autistic group spent significantly less time looking at the hand movement for both instruction conditions. These findings show that visual attention contributes to altered voluntary imitation in autistic individuals and have implications for therapies involving imitation as well as for autistic people’s ability to understand the actions of others.

Successful interaction within the environment is contingent upon one’s ability to accurately perceive the extent over which they can successfully perform actions, known as action boundaries. Healthy young adults are accurate in estimating their action boundaries and can flexibly update them to accommodate stable changes in their action capabilities. However, there are conditions in which motor abilities are subject to variability over time such as in Parkinson’s disease (PD). PD impairs the ability to perform actions and can lead to variability in perceptual-motor experience, but the effect on the perceptions of their action boundaries remains unknown. This study investigated the influence of altered perceptual-motor experience during PD, on the perceptions of action boundaries for reaching, grasping, and aperture passing. Thirty participants with mild-to-moderate idiopathic PD and 26 healthy older adults provided estimates of their reaching, grasping, and aperture-passing ability. Participants’ estimates were compared with their actual capabilities. There was no evidence that individuals with PD’s perceptions were less accurate than those of healthy controls. Furthermore, there was some evidence for more conservative estimates than seen in young healthy adults in reaching (both groups) and aperture passing (PD group). This suggests that the ability to judge action capabilities is preserved in mild to moderate PD. Supplementary Information The online version contains supplementary material available at 10.3758/s13414-021-02340-y.

Selective attention to a sensory modality has been observed experimentally in studies of the modality-shift effect – a relative performance benefit for targets preceded by a target in the same modality, compared to a different modality. Differences in selective attention are commonly observed in autism and we investigated whether exogenous (automatic) shift costs between modalities are increased. Autistic adults and neurotypical controls made speeded discrimination responses to simple visual, tactile and auditory targets. Shift costs were observed for each target modality in participant response times and were largest for auditory targets, reflective of fast responses on auditory repeat trials. Critically, shift costs were similar between the groups. However, integrating speed and accuracy data using drift-diffusion modelling revealed that shift costs in drift rates (reflecting the quality of information extracted from the stimulus) were reduced for autistic participants compared with neurotypicals. It may be that, unlike neurotypicals, there is little difference between attention within and between sensory modalities for autistic people. This finding also highlights the benefit of combining reaction time and accuracy data using decision models to better characterise selective attention in autism.

Background Governments promote behavioral policies such as social distancing and phased reopening to control the spread of COVID-19. Digital phenotyping helps promote the compliance with these policies through the personalized behavioral knowledge it produces. Objective This study investigated the value of smartphone-derived digital phenotypes in (1) analyzing individuals’ compliance with COVID-19 policies through behavioral responses and (2) suggesting ways to personalize communication through those policies. Methods We conducted longitudinal experiments that started before the outbreak of COVID-19 and continued during the pandemic. A total of 16 participants were recruited before the pandemic, and a smartphone sensing app was installed for each of them. We then assessed individual compliance with COVID-19 policies and their impact on habitual behaviors. Results Our results show a significant change in people’s mobility (P Conclusions Our findings show that digital phenotyping has substantial value in understanding people’s behavior during a pandemic. Behavioral features extracted from digital phenotypes can facilitate the personalization of and compliance with behavioral policies. A rule-based messaging system can be implemented to deliver nudges on the basis of digital phenotyping.

Problems with timing and time perception have been suggested as key characteristics of autism spectrum condition (ASC). Studies and personal accounts from clinicians, parents, caregivers, and self-reports from autistic people themselves often refer to problems with time. Although a number of empirical studies have examined aspects relating to time in autistic individuals, there remains no clear consensus on whether or how timing mechanisms may be affected in autism. A key reason for this lack of clarity is the wide range of timing processes that exist and subsequently the wide range of methodologies, research paradigms, and samples that time-based studies have used with autism populations. In order to summarize and organize the available literature on this issue, a systematic review was conducted. Five electronic databases were consulted. From an initial 597 records (after duplicates were removed), 45 papers were selected and reviewed. The studies are reviewed within different sections based on the different types of timing ability that have been explored in the neurotypical (NT) population: time sensitivity, interval timing, and higher-order time perception. Within each section cognitive models, methodologies, possible clinical implications, and research results are discussed. The results show different consistency across studies between the three types of timing ability. The highest consistency of results showing atypical time perception abilities is found in high-level time perception studies. It remains unclear if autism is characterized by a fundamental time perception impairment. Suggestions for future research are discussed. Autism Res 2019, 12: 1440-1462. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This systematic review examines the different types of timing and time perception behavior that have been investigated in autism. Overall, there are a number of studies that show differences between autistic and non-autistic individuals, but some studies do not find such differences. Group differences are more consistent across studies using complex tasks rather than simpler more fundamental timing tasks. We suggest that experiments across a range of timing tasks would be fruitful to address gaps in our knowledge.

Background Drug-based therapeutic approaches for Parkinson’s disease dementia (PDD) and dementia with Lewy bodies (DLB) are moderately effective and not always tolerated. Tailoring psychosocial approaches in PDD and DLB may offer additional support and improve outcomes. We adapted home-based, care partner-delivered Cognitive Stimulation Therapy (CST) for individuals with PDD or DLB and their care partners (CST-PD). Objectives To evaluate the feasibility, acceptability, and tolerability of CST-PD. Methods This randomised controlled trial used mixed methods, including a process evaluation. People with PDD, DLB or mild cognitive impairment in PD (PD-MCI) and their care partners were randomised to 12 weeks of treatment as usual (TAU) or CST-PD. Outcomes were feasibility of the study conduct (i.e., recruitment, retention rate) and acceptability and tolerability of the intervention. Measures included rating scales, researcher field notes, therapy diaries, and exploratory clinical and care partner efficacy measures. Results The recruitment target was met with 76 consenting participant-dyads. Retention in both arms was high at over 70%. More than 90% of dyads undertook discrete sessions greater than 20 min duration, but the average number of sessions completed was lower than the recommended dose. Acceptability ratings (i.e., interest, motivation and sense of achievement) of the intervention were high. Participants reported no serious adverse events related to the intervention. Conclusions The field of psychosocial interventions for PDD and DLB is newly emerging, and we demonstrated that this type of intervention is acceptable and well tolerated. Evaluating its clinical effectiveness in a full-scale randomized controlled clinical trial is warranted. Trial registration number The trial is a psychosocial intervention with an allocated ISRCTN number 11455062. Electronic supplementary material The online version of this article (10.1007/s00415-019-09329-6) contains supplementary material, which is available to authorized users.

The “uncanny phenomenon” describes the feeling of unease associated with seeing an image that is close to appearing human. Prosthetic hands in particular are well known to induce this effect. Little is known, however, about this phenomenon from the viewpoint of prosthesis users. We studied perceptions of eeriness and human-likeness for images of different types of mechanical, cosmetic, and anatomic hands in upper-limb prosthesis users (n=9), lower-limb prosthesis users (n=10), prosthetists (n=16), control participants with no prosthetic training (n=20), and control participants who were trained to use a myoelectric prosthetic hand simulator (n=23). Both the upper- and lower-limb prosthesis user groups showed a reduced uncanny phenomenon (i.e., significantly lower levels of eeriness) for cosmetic prosthetic hands compared to the other groups, with no concomitant reduction in how these stimuli were rated in terms of human-likeness. However, a similar effect was found neither for prosthetists with prolonged visual experience of prosthetic hands nor for the group with short-term training with the simulator. These findings in the prosthesis users therefore seem likely to be related to limb absence or prolonged experience with prostheses.

Background: Action observation (AO) activates the motor system, influencing movement and increasing learning, and has been shown to improve speed and timing of movement in people with Parkinson's disease (PD). Importantly, however, effects on movement amplitude have not been quantitatively demonstrated. Additionally, motor imagery (MI) can increase behavioural and neural effects of AO, but the combined effects of AO+MI have never previously been explored in PD. The aim of this study was to investigate imitation of hand movement amplitude in people with PD following (i) AO and (ii) combined AO+MI. Methods: Twenty-four participants with mild to moderate PD and 24 healthy older adults observed and imitated videos showing a human hand moving between horizontal positions. Kinematics were recorded and modulation of vertical amplitude when replicating elevated vs. direct movements provided an index of imitation. After an initial set of AO trials, participants were instructed to engage in MI during observation for the remaining trials (AO+MI), emphasizing kinaesthetic (sensory) imagery. Results: Movement amplitude was imitated (modulated) for elevated vs. direct stimuli by both groups, and this imitation increased following MI instructions. Conclusions: These results demonstrate quantitatively for the first time that people with PD are able to modulate the amplitude of their hand movements following action observation, and that combining AO and MI increases imitation in PD. The effects parallel findings in healthy young participants, and indicate that combined action observation and motor imagery could be a promising therapeutic approach for PD.

This study, called for by autistic people and led by an autistic researcher, is the first to explore ‘autistic inertia,’ a widespread and often debilitating difficulty acting on their intentions. Previous research has considered initiation only in the context of social interaction or experimental conditions. This study is unique in considering difficulty initiating tasks of any type in real life settings, and by gathering qualitative data directly from autistic people. Four face-to-face and 2 online (text) focus groups were conducted with 32 autistic adults (19 female, 8 male, and 5 other), aged 23–64 who were able to express their internal experiences in words. They articulate in detail the actions they have difficulty with, what makes it easier or harder to act, and the impact on their lives. Thematic analysis of the transcripts found four overarching themes: descriptions of inertia, scaffolding to support action, the influence of wellbeing, and the impact on day-to-day activities. Participants described difficulty starting, stopping and changing activities that was not within their conscious control. While difficulty with planning was common, a subset of participants described a profound impairment in initiating even simple actions more suggestive of a movement disorder. Prompting and compatible activity in the environment promoted action, while mental health difficulties and stress exacerbated difficulties. Inertia had pervasive effects on participants’ day-to-day activities and wellbeing. This overdue research opens the door to many areas of further investigation to better understand autistic inertia and effective support strategies.