Autistic Children''s Knowledge of Thinking and Feeling States in Other People

Autistic children, pair matched on chronological and verbal mental age with control children, were given Hobson's task of recognition of emotions and Baron-Cohen's False Belief tasks to assess the replicability of their findings of deficits in understanding of feeling and mental states in autism. There were no group differences on the emotion tasks and performance was related to chronological and verbal mental age. An autism specific deficit was shown in only one of the false belief conditions and again performance was related to verbal comprehension ability. There was some consistency within the group in responses across the two kinds of tasks. Parent reported social behaviour and experience in the autistic children was only weakly related to the ability to pass the tasks. It is argued that the results reflect developmental factors and that claims for an autism specific problem in these kinds of social/cognitive processing may need further exploration.     

Theory of Mind in Children with Autistic Disorder: Evidence of Developmental Progression and the Role of Verbal Ability

Abstract— The present study investigated theory of mind in two groups of autistic children with markedly different verbal mental ages but comparable nonverbal ability and chronological ages, using a range of theory of mind belief tasks. The aims were to look for evidence of developmental progression of theory of mind ability in autistic children and to examine the role played by verbal ability in task performance. The results showed hierarchical patterns of performance across tasks, suggesting a developmental sequence of emerging aspects of theory of mind ability. There was clear evidence that verbal ability is an important contributor to successful task performance.     

Targets and Cues: Gaze-following in Children with Autism

Children with autism are known to have difficulties in sharing attention with others. Yet one joint attention behaviour, the ability to follow another person's head turn and gaze direction, may be achieved without necessarily sharing attention. Why, then, should autistic children have difficulties with it? In this study we examined the extent of this difficulty by testing school-aged autistic children across three different contexts; experiment, observation, and parent interview. We also tested whether the ability to orient to another person's head and gaze could be facilitated by increasing children's attention to environmental targets and social cues. Results for experiment and observation demonstrate that a sizeable proportion of children with autism did not have difficulties with following another's head turn. There was a difference between children with high and low verbal mental ages, however. Whereas children with higher mental ages (over 48 months) were able to orient spontaneously to another person's head turn, children with lower mental ages had difficulties with this response. When cues were added (pointing, language) or when feedback from targets was given, however, their performance improved. Parent interview data indicated that children with autism, whatever their mental age, began to follow head turn and gaze direction years later than typically developing children. Developments in attention and language are proposed as possible factors to account for this developmental delay.     

Reflexive orienting in response to eye gaze and an arrow in children with and without autism

BACKGROUND: This study investigated whether another person's social attention, specifically the direction of their eye gaze, and a non-social directional cue, an arrow, triggered reflexive orienting in children with and without autism in an experimental situation. METHODS: Children with autism and typically developed children participated in one of two experiments. Both experiments involved the localization of a target that appeared to the left or right of the fixation point. Before the target appeared, the participant's attention was cued to the left or right by either an arrow or the direction of eye gaze on a computerized face. RESULTS: Children with autism were slower to respond, which suggests a slight difference in the general cognitive ability of the groups. In Experiment 1, although the participants were instructed to disregard the cue and the target was correctly cued in only 50% of the trials, both groups of children responded significantly faster to cued targets than to uncued targets, regardless of the cue. In Experiment 2, children were instructed to attend to the direction opposite that of the cues and the target was correctly cued in only 20% of the trials. Typically developed children located targets cued by eye gaze more quickly, while the arrow cue did not trigger such reflexive orienting in these children. However, both social and non-social cues shifted attention to the cued location in children with autism. CONCLUSION: These results indicate that eye gaze attracted attention more effectively than the arrow in typically developed children, while children with autism shifted their attention equally in response to eye gaze and arrow direction, failing to show preferential sensitivity to the social cue. Difficulty in shifting controlled attention to the instructed side was also found in children with autism.     

Parent-Child Dyadic Gaze Patterns in Fragile X Males and in Non-fragile X Males with Autistic Disorder

Parent-child dyadic gaze patterns were examined in fragile X [fra(X)] males and in non-fra(X) autistic males across three age groups--early childhood, middle childhood and adolescence. Absolute probabilities of social gaze did not significantly differ across diagnostic groups. Event lag sequential analyses indicated that fra(X) males were sensitive to social gaze initiation by their parents but found eye contact aversive. Non-fra(X) autistic males, by contrast, were insensitive to parent-initiated social gaze, and did not find eye contact aversive. Implications for research on the social characteristics of fra(X) and autistic children are discussed.     

Attention orienting by another's gaze direction in children with autism

BACKGROUND: The aim of this study was to investigate attention orienting triggered by another's gaze direction in autism. METHOD: Twelve high-functioning children with autism and gender- and age-matched normal control children were studied using two tasks. In the first task, children were asked to detect laterally presented target stimuli preceded by centrally presented facial cue stimuli in which gaze was either straight ahead or averted. The direction of the cue was either congruent, neutral, or incongruent with respect to the laterality of the target stimulus. In the second task, children were asked to discriminate the direction of eye gaze. RESULTS: The results showed that another person's static gaze direction triggered an automatic shift of visual attention, both in children with autism and in normally developing children. The children in both groups were also able to overtly discriminate the direction of the gaze. CONCLUSION: These results seem to suggest that, in children with autism, the visual system processes information about another person's gaze direction and sends this information to those areas that subserve reflexive attention orienting. However, future studies are needed to investigate whether the processing of eyes and gaze direction relies on similar neural mechanisms in children with autism and in normally developing children.     

Differences in the Structure of Social Behaviour of Autistic Children and Non-Autistic Retarded Controls

Social and task-oriented behaviours of autistic children were compared to those of individually age- and IQ-matched non-autistic retarded controls. Autistic children showed deficits in visual reciprocity, in indicating joint attention and referential head gestures, and in the integration of gaze and gestures when reacting to tasks. The findings confirmed the notion of social and pragmatic communicative deficits in autism. The implications of these findings for theories of social behaviour in autism (avoidance, facial perception, theory of mind) are discussed.     

Towards a Cognitive Phenotype for Autism: Increased Prevalence of Executive Dysfunction and Superior Spatial Span amongst Siblings of Children with Autism

Two studies were conducted to examine executive function skills in siblings of children with autism. In Study 1, four computerised tasks (three executive tasks: the ID/ED set-shifting task; a spatial working memory task; and the Tower of London planning task; and a control spatial span task) from the CANTAB battery were used to compare 31 siblings of children with autism with 32 siblings of children with developmental delay and 32 children from unaffected families. In Study 2, the two sibling groups were compared on two manually administered executive tasks (verbal fluency and list recall). As a group, autism siblings showed superior spatial and verbal span, but a greater than expected number performed poorly on the set-shifting, planning, and verbal fluency tasks. There were no group differences in working memory performance. The implications of these findings for the broader phenotype of autism is discussed.     

Do children with autism perceive second‐order relational features? The case of the Thatcher illusion

BACKGROUND: This study presents two experiments that investigated whether children with autism were susceptible to the Thatcher illusion. Perception of the Thatcher illusion requires being able to compute second-order configural relations for facial stimuli. METHOD: In both experiments children with autism were matched for non-verbal and verbal ability with a group of children with moderate (non-specific) mental retardation (MLD) and a group of typically developing children respectively. Participants were asked to detect the 'unusual' face in a two-alternative-forced-choice version of the Margaret Thatcher illusion with grey-scale (Experiment 1) and monochrome 'Mooney' face images (Experiment 2). In Experiment 1 participants also performed a control task where buildings had been doctored in the same way as the facial stimuli. RESULTS: Children with autism were as susceptible to the Thatcher illusion as both control groups, in terms of accuracy and reaction time to make decisions about which face was unusual. Children with autism performed more accurately than children with MLD in the buildings task. CONCLUSION: Children with autism are able to compute second-order configural features in faces and exhibit no difference in face processing, relative to appropriate control groups.     

The relationship between vocabulary, grammar, and false belief task performance in children with autistic spectrum disorders and children with moderate learning difficulties

BACKGROUND: The aim of this study was to examine the relationship between language and theory of mind in children with autistic spectrum disorders (ASD) and children with moderate learning difficulties (MLD). Previous studies have found a strong association between language and theory of mind in a range of groups, but mostly have not included measures of both grammar and vocabulary; including these enables us to speculate about the causal direction of the relationship. METHODS: Fifty-eight children with ASD and 118 children with MLD were given standardised assessments of vocabulary and grammar, along with standard theory of mind tasks. RESULTS: The relationship between language and theory of mind was more evident in children with ASD than in those with MLD, and grammar was a particularly strong predictor of theory of mind performance in children with ASD. Children with MLD performed better on false belief (FB) tasks than did children with ASD, and their performance was more predictable across the different theory of mind tasks. CONCLUSIONS: Language, in particular grammar, and theory of mind appear to be more strongly related in children with ASD than in those with MLD. We speculate that this relationship may be causal, with some grammatical understanding being a precursor of theory of mind. The implications of these findings are discussed in relation to possible routes for compensatory strategies for mentalising in children with ASD.     

Executive Function Abilities in Autism and Tourette Syndrome: An Information Processing Approach

Abstract— This study used information processing paradigms to provide a detailed examination of executive function abilities in autism. The performance of non-retarded autistic children was compared with that of two matched control groups, one with Tourette Syndrome and the other developmentally normal. Autistic subjects performed as well as controls on tasks requiring global-local processing and inhibition of neutral responses. In contrast to both control groups, however, the autistic sample was significantly impaired on a measure of cognitive flexibility. The performance of children with Tourette Syndrome did not differ from that of normal controls on any task. These results refine our knowledge about executive dysfunction in autism and suggest a new conceptual framework and general method for investigating the cognitive underpinnings of neurodevelopmental disorders.     

PATTERNS OF INTELLECTUAL FUNCTIONING IN NON-RETARDED AUTISTIC AND SCHIZOPHRENIC CHILDREN

The WISC-R factor scores of non-retarded children meeting DSM III criteria for autism and schizophrenia were compared. The scores of the schizophrenic children on factor 3 were significantly lower than those of the autistic children, below the range of normal children, and significantly lower than the scores they obtained on the verbal comprehension and perceptual organization factors. The autistic children scored in the superior range on the block design subtest and did not show gross impairments in language function as indexed by scores on the verbal comprehension factor. The only subtest autistic children were impaired on was the comprehension subtest.     

Control of Action and Thought: Normal Development and Dysfunction in Autism: A Research Note

Thirty-six children with autism, 24 children with learning difficulties (matched with the autistic group for sentence comprehension), and 41 normally-developing preschoolers were given two simple tasks: a hand-game requiring inhibitory control, and a delayed-reward situation tapping metacognitive awareness of strategies for coping with the delay period. For both clinical groups, performance on the two tasks was correlated, even when the effect of comprehension level was partialled out. However, no such correlation was observed for the preschoolers, once age was taken into account. The results are discussed in terms of potential links between executive-function and mental-state awareness.     

Play and imitation skills in the diagnosis of autism in young children

Play behaviors and motor imitation skills of 91 children between the ages of 3 and 6 years were investigated to determine their utility in distinguishing autism from mental retardation and other communication disorders. The performance of 22 autistic children was compared with that of 15 mentally retarded, 15 hearing-impaired, 19 language-impaired, and 20 non-handicapped children. Play behaviors were assessed using structured observations of free-play activities, and imitation skills were measured using a set of 12 individually administered tasks. The autistic group spent less total time interacting with toys and using toys appropriately, engaged in fewer functional play acts, and obtained lower imitation scores compared with all other groups. Discriminant function analysis revealed that the latter three variables discriminated the autistic children from the nonautistic handicapped children, with motor imitation emerging as the most important differentiating measure. These results suggest that measuring play and imitation skills may be useful in the clinical diagnosis of autism.     

Do children with autism fail to process information in context?

BACKGROUND: This research investigated the proposal that children with autism are impaired in processing information in its context. To date, this proposal rests almost exclusively on evidence from verbal tasks. Given evidence of visuo-spatial proficiency in autism in other areas of functioning, it is possible that the ability to use context is spared in the visual domain but impaired in the verbal domain. METHOD: Fifteen children with autism and 16 age and IQ-matched typically developing children were tested on their ability to take account of visual context information (Experiment 1) and verbal context information (Experiment 2) using an adaptation of Palmer's (1975) visual context task. They were also given an adaptation of Tager-Flusberg's (1991) visual and verbal semantic memory task (Experiment 3) and Frith and Snowling's (1983) homograph task (Experiment 4). RESULTS: Experiment 1 showed that children with autism were facilitated by the provision of visual context information. Experiments 2 and 3 showed that the same children were also able to use both verbal context information when identifying words and semantic category information in a verbal task when naming and recalling words. However, in Experiment 4 these children had difficulties with a sentence-processing task when using sentence context to disambiguate homographs. CONCLUSIONS: These findings demonstrate that children with autism do not have a general difficulty in connecting context information and item information as predicted by weak central coherence theory. Instead the results suggest that there is specific difficulty with complex verbal stimuli and in particular with using sentence context to disambiguate meaning.     

Generating novel ideas: fluency performance in high-functioning and learning disabled individuals with autism

Tasks of fluency tap the ability to generate multiple responses spontaneously following a single cue or instruction. The present study compared the fluency performance of subjects with autism and clinical control subjects at two different levels of ability (high-functioning subjects with a verbal IQ of 76 or greater, and globally learning disabled subjects with a verbal IQ of 74 or below). A battery of tasks was employed to assess subjects' word fluency (for letters and semantic categories), ideational fluency (for uses of objects and interpretations of meaningless line drawings), and design fluency (for abstract meaningless designs). Subjects with autism showed reduced fluency for both the word and ideational fluency tasks, generating significantly fewer responses than the clinical control subjects. Results were particularly striking for the ideational fluency tasks. On these tasks, autistic subjects produced very low response totals, with the performance of the high-functioning subjects with autism equivalent to that of the learning disabled subjects with autism and significantly inferior to that of the learning disabled control individuals. In contrast, the results of the design fluency paradigm paint a different picture. This paradigm revealed no significant difference in the quantity of designs generated by the subjects with autism and the control subjects but a clear qualitative difference, with the autistic group producing significantly higher rates of disallowed and perseverative responses. Whilst the results of the word and ideational fluency tasks are suggested to support the hypothesis that individuals with autism are impaired in the generation of novel responses and behaviour, the results of the design fluency task are equally consistent with an impairment in the regulation of behaviour through inhibition and/or monitoring. The implications of these findings for the study of executive function abilities in autism are discussed.     

Are there Emotion Perception Deficits in Young Autistic Children?

Two studies were conducted to test the hypothesis that young autistic children are selectively impaired on emotion perception tasks. Results supporting the hypothesis were found on two of the four measures when the controls used were matched on non-verbal mental age; performance on the other tasks was consistent with global deficits across affective and non-affective domains, rather than specific deficits in emotion perception. When the autistic group was compared with controls matched on verbal mental age, no group differences were found. These results suggest that emotion perception impairment is not likely to be the primary underlying deficit in autism. Additional areas for further investigation were suggested.     

Can Children with Autism be Taught to Understand False Belief Using Computers?

A specially designed computer version of the Sally-Anne false belief task was used to teach understanding of false belief to three groups: children with autism, children with Down's Syndrome and young normal children. In an initial assessment children were selected for teaching only if they failed four false belief tasks: the dolls version of the Sally-Anne task (close transfer task) and three other false belief tasks involving different scenarios (distant transfer tasks). Following teaching, all three groups were able to pass the Sally-Anne task, but the children with autism alone were unable to pass the distant transfer tasks. The possibility that the children with autism had developed an alternative strategy in order to pass the instruction task is discussed.     

Social-cognition and the broad autism phenotype: identifying genetically meaningful phenotypes

BACKGROUND: Strong evidence from twin and family studies suggests that the genetic liability to autism may be expressed through personality and language characteristics qualitatively similar, but more subtly expressed than those defining the full syndrome. This study examined behavioral features of this 'broad autism phenotype' (BAP) in relation to performance on a measure of social-cognition in an attempt to tease out this complex clinical picture and identify markers of underlying neuropsychological systems of genetic significance to autism. We hypothesized that mild social-cognitive impairment would be associated with clinically defined social characteristics of the BAP (aloof personality style, lower quality social relationships, and impaired pragmatic language use). METHOD: Forty-eight parents of individuals with autism (13 of whom were identified as 'aloof'), and 22 control parents, were administered the 'Eyes Test', a social-cognitive measure that taps the ability to read complex psychological states from viewing only the eye region of faces. RESULTS: Whereas social-cognitive ability was unimpaired among parents of autistic children in general, the subgroup of parents defined as 'aloof' displayed significant social-cognitive deficits on the 'Eyes Test'. Impaired social-cognitive ability was associated with low quality of friendships and problems with pragmatic language use, associations which mirror those documented in autism. CONCLUSIONS: Findings suggest that social-cognitive impairments co-segregate with conceptually related personality, social, and language features that constitute the BAP, and point towards performance on the Eyes Test as a genetically meaningful endophenotype.     

Cognitive profiles and social-communicative functioning in children with autism spectrum disorder

BACKGROUND: Whether there is an unusual degree of unevenness in the cognitive abilities of children with autism spectrum disorder (ASD) and whether different cognitive profiles among children with ASD might index etiologically significant subgroups are questions of continued debate in autism research. METHOD: The Differential Ability Scales (DAS) and the Autism Diagnostic Observation Schedule (ADOS) were used to examine profiles of verbal and nonverbal abilities and their relationship to autistic symptomatology in 120 relatively high-functioning children with ADI-confirmed diagnoses of autism. RESULTS: Discrepancies between verbal and nonverbal ability scores occurred at a significantly higher rate than in the DAS normative sample (30%) in both a younger group of 73 children (56%) with a mean age of 5;5 and an older group of 47 children (62%) with a mean age of 8;11. Discrepancies were mainly in favor of nonverbal ability in the younger group, but occurred equally in favor of verbal and nonverbal abilities in the older group. Comparison of the two age groups suggested a growing dissociation between verbal and nonverbal (and particularly visual processing) skills with age. In the older group, children with discrepantly higher nonverbal abilities demonstrated significantly greater impairment in social functioning, as measured on the ADOS, independent of absolute level of verbal and overall ability. CONCLUSIONS: These findings demonstrate a high rate of uneven cognitive development in children with ASD. Indications of a dissociation between verbal and visual-perceptual skills among the older children, and the specific association of discrepantly high nonverbal skills with increased social symptoms suggest that the nonverbal > verbal profile may index an etiologically significant subtype of autism.