Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders

Atypical neural encoding of faces in individuals with autism spectrum disorder

Individuals with autism spectrum disorder (ASD) experience pervasive difficulties in processing social information from faces. However, the behavioral and neural mechanisms underlying social trait judgments of faces in ASD remain largely unclear. Here, we comprehensively addressed this question by employing functional neuroimaging and parametrically generated faces that vary in facial trustworthiness and dominance. Behaviorally, participants with ASD exhibited reduced specificity but increased inter-rater variability in social trait judgments. Neurally, participants with ASD showed hypo-activation across broad face-processing areas. Multivariate analysis based on trial-by-trial face responses could discriminate participant groups in the majority of the face-processing areas. Encoding social traits in ASD engaged vastly different face-processing areas compared to controls, and encoding different social traits engaged different brain areas. Interestingly, the idiosyncratic brain areas encoding social traits in ASD were still flexible and context-dependent, similar to neurotypicals. Additionally, participants with ASD also showed an altered encoding of facial saliency features in the eyes and mouth. Together, our results provide a comprehensive understanding of the neural mechanisms underlying social trait judgments in ASD.

Single point motion kinematics convey emotional signals in children and adults

This study investigates whether humans recognize different emotions conveyed only by the kinematics of a single moving geometrical shape and how this competence unfolds during development, from childhood to adulthood. To this aim, animations in which a shape moved according to happy, fearful, or neutral cartoons were shown, in a forced-choice paradigm, to 7- and 10-year-old children and adults. Accuracy and response times were recorded, and the movement of the mouse while the participants selected a response was tracked. Results showed that 10-year-old children and adults recognize happiness and fear when conveyed solely by different kinematics, with an advantage for fearful stimuli. Fearful stimuli were also accurately identified at 7-year-olds, together with neutral stimuli, while, at this age, the accuracy for happiness was not significantly different than chance. Overall, results demonstrates that emotions can be identified by a single point motion alone during both childhood and adulthood. Moreover, motion contributes in various measures to the comprehension of emotions, with fear recognized earlier in development and more readily even later on, when all emotions are accurately labeled.

Investigating implicit emotion processing in autism spectrum disorder across age groups: A cross-modal emotional priming study

Cumulating evidence suggests that atypical emotion processing in autism may generalize across different stimulus domains. However, this evidence comes from studies examining explicit emotion recognition. It remains unclear whether domain-general atypicality also applies to implicit emotion processing in autism and its implication for real-world social communication. To investigate this, we employed a novel cross-modal emotional priming task to assess implicit emotion processing of spoken/sung words (primes) through their influence on subsequent emotional judgment of faces/face-like objects (targets). We assessed whether implicit emotional priming differed between 38 autistic and 38 neurotypical individuals across age groups as a function of prime and target type. Results indicated no overall group differences across age groups, prime types, and target types. However, differential, domain-specific developmental patterns emerged for the autism and neurotypical groups. For neurotypical individuals, speech but not song primed the emotional judgment of faces across ages. This speech-orienting tendency was not observed across ages in the autism group, as priming of speech on faces was not seen in autistic adults. These results outline the importance of the delicate weighting between speech- versus song-orientation in implicit emotion processing throughout development, providing more nuanced insights into the emotion processing profile of autistic individuals.

Vocal Emotion Recognition in Autism: Behavioral Performance and Event-Related Potential (ERP) Response

Autistic youth display difficulties in emotion recognition, yet little research has examined behavioral and neural indices of vocal emotion recognition (VER). The current study examines behavioral and event-related potential (N100, P200, Late Positive Potential [LPP]) indices of VER in autistic and non-autistic youth. Participants (N = 164) completed an emotion recognition task, the Diagnostic Analyses of Nonverbal Accuracy (DANVA-2) which included VER, during EEG recording. The LPP amplitude was larger in response to high intensity VER, and social cognition predicted VER errors. Verbal IQ, not autism, was related to VER errors. An interaction between VER intensity and social communication impairments revealed these impairments were related to larger LPP amplitudes during low intensity VER. Taken together, differences in VER may be due to higher order cognitive processes, not basic, early perception (N100, P200), and verbal cognitive abilities may underlie behavioral, yet occlude neural, differences in VER processing.

Emotion recognition and social functioning in individuals with autism spectrum condition and intellectual disability

OBJECTIVE

Most previous studies have examined emotion recognition in autism spectrum condition (ASC) without intellectual disability (ID). However, ASC and ID co-occur to a high degree. The main aims of the study were to examine emotion recognition in individuals with ASC and co-occurring intellectual disability (ASC-ID) as compared to individuals with ID alone, and to investigate the relationship between emotion recognition and social functioning.

METHODS

The sample consisted of 30 adult participants with ASC-ID and a comparison group of 29 participants with ID. Emotion recognition was assessed by the facial emotions test, while. social functioning was assessed by the social responsiveness scale-second edition (SRS-2).

RESULTS

The accuracy of emotion recognition was significantly lower in individuals with ASC-ID compared to the control group with ID, especially when it came to identifying angry and fearful emotions. Participants with ASC-ID exhibited more pronounced difficulties in social functioning compared to those with ID, and there was a significant negative correlation between emotion recognition and social functioning. However, emotion recognition accounted for only 8% of the variability observed in social functioning.

CONCLUSION

Our data indicate severe difficulties in the social-perceptual domain and in everyday social functioning in individuals with ASC-ID.

Differences in the link between social trait judgment and socio-emotional experience in neurotypical and autistic individuals

Neurotypical (NT) individuals and individuals with autism spectrum disorder (ASD) make different judgments of social traits from others' faces; they also exhibit different social emotional responses in social interactions. A common hypothesis is that the differences in face perception in ASD compared with NT is related to distinct social behaviors. To test this hypothesis, we combined a face trait judgment task with a novel interpersonal transgression task that induces measures social emotions and behaviors. ASD and neurotypical participants viewed a large set of naturalistic facial stimuli while judging them on a comprehensive set of social traits (e.g., warm, charismatic, critical). They also completed an interpersonal transgression task where their responsibility in causing an unpleasant outcome to a social partner was manipulated. The purpose of the latter task was to measure participants' emotional (e.g., guilt) and behavioral (e.g., compensation) responses to interpersonal transgression. We found that, compared with neurotypical participants, ASD participants' self-reported guilt and compensation tendency was less sensitive to our responsibility manipulation. Importantly, ASD participants and neurotypical participants showed distinct associations between self-reported guilt and judgments of criticalness from others' faces. These findings reveal a novel link between perception of social traits and social emotional responses in ASD.

Multimodal investigations of emotional face processing and social trait judgment of faces

Faces are among the most important visual stimuli that humans perceive in everyday life. While extensive literature has examined emotional processing and social evaluations of faces, most studies have examined either topic using unimodal approaches. In this review, we promote the use of multimodal cognitive neuroscience approaches to study these processes, using two lines of research as examples: ambiguity in facial expressions of emotion and social trait judgment of faces. In the first set of studies, we identified an event-related potential that signals emotion ambiguity using electroencephalography and we found convergent neural responses to emotion ambiguity using functional neuroimaging and single-neuron recordings. In the second set of studies, we discuss how different neuroimaging and personality-dimensional approaches together provide new insights into social trait judgments of faces. In both sets of studies, we provide an in-depth comparison between neurotypicals and people with autism spectrum disorder. We offer a computational account for the behavioral and neural markers of the different facial processing between the two groups. Finally, we suggest new practices for studying the emotional processing and social evaluations of faces. All data discussed in the case studies of this review are publicly available.

A uniform human multimodal dataset for emotion perception and judgment

Face perception is a fundamental aspect of human social interaction, yet most research on this topic has focused on single modalities and specific aspects of face perception. Here, we present a comprehensive multimodal dataset for examining facial emotion perception and judgment. This dataset includes EEG data from 97 unique neurotypical participants across 8 experiments, fMRI data from 19 neurotypical participants, single-neuron data from 16 neurosurgical patients (22 sessions), eye tracking data from 24 neurotypical participants, behavioral and eye tracking data from 18 participants with ASD and 15 matched controls, and behavioral data from 3 rare patients with focal bilateral amygdala lesions. Notably, participants from all modalities performed the same task. Overall, this multimodal dataset provides a comprehensive exploration of facial emotion perception, emphasizing the importance of integrating multiple modalities to gain a holistic understanding of this complex cognitive process. This dataset serves as a key missing link between human neuroimaging and neurophysiology literature, and facilitates the study of neuropsychiatric populations.

Neural sensitivity to facial identity and facial expression discrimination in adults with autism

The fluent processing of faces can be challenging for autistic individuals. Here, we assessed the neural sensitivity to rapid changes in subtle facial cues in 23 autistic men and 23 age and IQ matched non-autistic (NA) controls using frequency-tagging electroencephalography (EEG). In oddball paradigms examining the automatic and implicit discrimination of facial identity and facial expression, base rate images were presented at 6 Hz, periodically interleaved every fifth image with an oddball image (i.e. 1.2 Hz oddball frequency). These distinctive frequency tags for base rate and oddball stimuli allowed direct and objective quantification of the neural discrimination responses. We found no large differences in the neural sensitivity of participants in both groups, not for facial identity discrimination, nor for facial expression discrimination. Both groups also showed a clear face-inversion effect, with reduced brain responses for inverted versus upright faces. Furthermore, sad faces generally elicited significantly lower neural amplitudes than angry, fearful and happy faces. The only minor group difference is the larger involvement of high-level right-hemisphere visual areas in NA men for facial expression processing. These findings are discussed from a developmental perspective, as they strikingly contrast with robust face processing deficits observed in autistic children using identical EEG paradigms.

Emotion recognition in autism spectrum condition during the COVID-19 pandemic

LAY ABSTRACT

In the COVID-19 pandemic, wearing face masks became mandatory to prevent the spread of the virus. However, they restrict the ability to recognize emotions to the upper part of the face. Since individuals with autism spectrum condition often tend to look at the lower half of the face, they may be particularly restricted in emotion recognition by people wearing masks, since they are now forced to look at the upper half of the face. The current study compared the recognition of facially expressed emotions between individuals with and without autism spectrum condition. Each photo was shown in three types, once uncovered, once with face mask, and once with sunglasses. Our results revealed a reduction in accuracy of individuals with autism spectrum condition at recognizing emotions in all three stimulus types and exhibited more difficulties distinguishing anger, fear, pride, and embarrassment. During the emotion recognition task, there was no difference in which facial areas the groups looked at. We did not find evidence that the disadvantages of individuals with autism spectrum condition in emotion recognition were due to looking at different areas of the face.

Syntactic and affective prosody recognition: Schizophrenia vs. Autism spectrum disorders

Patients with a recent diagnosis of schizophrenia and individuals receiving a diagnosis of autism spectrum disorder without accompanying intellectual impairment (ASD w/o intellectual impairment) during their adulthood share several clinical characteristics. Exploring under-investigated aspects of these two clinical conditions may shed light on their possible connection and facilitate differential diagnosis at very early stages. To this end, we explored the ability of 15 adults with a recent diagnosis of schizophrenia, 15 individuals diagnosed with ASD w/o intellectual impairment as adults, and 15 healthy adults to resolve sentence ambiguities with the use of syntactic prosody, and to decode happiness, anger, sadness, surprise, fear, and neutrality based on affective prosody. Results revealed intact perception of syntactic prosody in adults with schizophrenia, but impaired affective prosody recognition, which could be attributed, however, to emotion processing difficulties overall. On the other hand, individuals with ASD w/o intellectual impairment were impaired on prosody comprehension per se, as evidenced in the most challenging conditions, namely the subject-reading condition and the emotion of surprise. The differences in prosody comprehension ability between the two clinical conditions may serve as an indicator, among other signs, during the diagnostic evaluation.

Construction and validation of the Dalian emotional movement open-source set (DEMOS)

Human body movements are important for emotion recognition and social communication and have received extensive attention from researchers. In this field, emotional biological motion stimuli, as depicted by point-light displays, are widely used. However, the number of stimuli in the existing material library is small, and there is a lack of standardized indicators, which subsequently limits experimental design and conduction. Therefore, based on our prior kinematic dataset, we constructed the Dalian Emotional Movement Open-source Set (DEMOS) using computational modeling. The DEMOS has three views (i.e., frontal 0°, left 45°, and left 90°) and in total comprises 2664 high-quality videos of emotional biological motion, each displaying happiness, sadness, anger, fear, disgust, and neutral. All stimuli were validated in terms of recognition accuracy, emotional intensity, and subjective movement. The objective movement for each expression was also calculated. The DEMOS can be downloaded for free from https://osf.io/83fst/ . To our knowledge, this is the largest multi-view emotional biological motion set based on the whole body. The DEMOS can be applied in many fields, including affective computing, social cognition, and psychiatry.

Impairment in reading negative social cues extends beyond the face in autism

Nonverbal expressions are essential to regulating social communication and interaction. Impaired emotion recognition from facial expressions has been linked to various psychiatric conditions characterized by severe social deficits such as autism. As body expressions as an additional source of social-emotional information have attracted little research attention, little is known about whether emotion recognition impairments are specific to faces, or extend to body expressions. This study explored and compared emotion recognition from face versus body expressions in autism spectrum disorder. We compared 30 men with autism spectrum disorder to 30 male age- and IQ-matched control participants in their ability to recognize angry, happy, and neutral expressions from dynamic face and body expressions. Participants with autism spectrum disorder showed impaired recognition of angry expressions from both faces and bodies, while there were no group differences in recognizing happy and neutral expressions. In autism spectrum disorder, recognizing angry face expressions was inversely predicted by gaze avoidance, while recognizing angry body expressions was inversely predicted by impairments in social interaction and autistic traits. These findings suggest that distinct mechanisms may underlie the impaired emotion recognition from face and body expressions in autism spectrum disorder, respectively. Overall, our study demonstrates that emotion-specific recognition difficulties in autism spectrum disorder are not limited to face expressions but extend to emotional body expressions.

Face processing in young adults with autism and ADHD: An event related potentials study

Background

Atypicalities in perception and interpretation of faces and emotional facial expressions have been reported in both autism and attention-deficit/hyperactivity disorder (ADHD) during childhood and adulthood. Investigation of face processing during young adulthood (18 to 25 years), a transition period to full-fledged adulthood, could provide important information on the adult outcomes of autism and ADHD.

Methods

In this study, we investigated event-related potentials (ERPs) related to visual face processing in autism, ADHD, and co-occurring autism and ADHD in a large sample of young adults (N = 566). The groups were based on the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2) and the Autism Diagnostic Observation Schedule-2 (ADOS-2). We analyzed ERPs from two passive viewing tasks previously used in childhood investigations: (1) upright and inverted faces with direct or averted gaze; (2) faces expressing different emotions.

Results

Across both tasks, we consistently found lower amplitude and longer latency of N170 in participants with autism compared to those without. Longer P1 latencies and smaller P3 amplitudes in response to emotional expressions and longer P3 latencies for upright faces were also characteristic to the autistic group. Those with ADHD had longer N170 latencies, specific to the face-gaze task. Individuals with both autism and ADHD showed additional alterations in gaze modulation and a lack of the face inversion effect indexed by a delayed N170.

Conclusion

Alterations in N170 for autistic young adults is largely consistent with studies on autistic adults, and some studies in autistic children. These findings suggest that there are identifiable and measurable socio-functional atypicalities in young adults with autism.

The Study on the Identification of Musical Passages for an Emotion Perception Scale for People With Developmental Disabilities

BACKGROUND

Emotion recognition is essential to the social adjustment and social interaction of people with intellectual and developmental disabilities (IDDs). Given that music is a medium for expressing and conveying human emotion, we conducted this preliminary study to identify musical passages representing the basic human emotions of happiness, sadness, and anger, with the goal of developing a music-based emotion perception scale for IDDs.

METHODS

To identify musical passages for emotion perception, 20 certified music therapists evaluated 100 selected musical passages and established 60 pieces that yielded the highest agreement for each emotion category. During the second phase of this study, 300 neurotypical participants rated 60 passages in terms of the perceived type and intensity of emotions expressed.

RESULTS

The 60 passages showed high reliability and were statistically classified into three factors: happiness, sadness, and anger. The k-means cluster analysis yielded a cut-off score of 41 for the low emotion perception group (F = 1120.63, P < 0.001). The hierarchical logistic regression analysis revealed that only model 3 (musical passages) was significantly associated with low emotion perception (step χ² = 227.8, P < 0.001).

CONCLUSION

The selected musical passages demonstrated high reliability and established three factors for identifying perceptions of happiness, sadness, and anger. Neither psychological status nor individual demographic characteristics affected the emotion perception results.

Emotion recognition in autism spectrum disorder across age groups: A cross-sectional investigation of various visual and auditory communicative domains

Previous research on emotion processing in autism spectrum disorder (ASD) has predominantly focused on human faces and speech prosody, with little attention paid to other domains such as nonhuman faces and music. In addition, emotion processing in different domains was often examined in separate studies, making it challenging to evaluate whether emotion recognition difficulties in ASD generalize across domains and age cohorts. The present study investigated: (i) the recognition of basic emotions (angry, scared, happy, and sad) across four domains (human faces, face-like objects, speech prosody, and song) in 38 autistic and 38 neurotypical (NT) children, adolescents, and adults in a forced-choice labeling task, and (ii) the impact of pitch and visual processing profiles on this ability. Results showed similar recognition accuracy between the ASD and NT groups across age groups for all domains and emotion types, although processing speed was slower in the ASD compared to the NT group. Age-related differences were seen in both groups, which varied by emotion, domain, and performance index. Visual processing style was associated with facial emotion recognition speed and pitch perception ability with auditory emotion recognition in the NT group but not in the ASD group. These findings suggest that autistic individuals may employ different emotion processing strategies compared to NT individuals, and that emotion recognition difficulties as manifested by slower response times may result from a generalized, rather than a domain-specific underlying mechanism that governs emotion recognition processes across domains in ASD.

Association Between Insulin-Like Growth Factor-1 and Social Cognition in Huntington's Disease

Background

Insulin-like growth factor 1 (IGF-1) seems to be involved in the neural circuits associated with social cognition and brain structure.

Objectives

To investigate the association of IGF-1 levels with social cognition and brain structure in Huntington's disease (HD).

Methods

We evaluated social cognition using the Ekman test in 22 HD patients and 19 matched controls. Brain structure was assessed using standard volume-based voxel-based morphometry and surface-based cortical thickness pipeline. We analyzed the association of IGF-1 levels with social cognition and brain structure using adjusted regression analysis.

Results

Social cognition was worse in HD patients (P < 0.001), on antidopaminergic drugs (P = 0.02), and with lower IGF-1 levels (P = 0.04). In neuroimaging analyses, lower IGF-1 levels were associated with social cognition impairment and atrophy mainly in frontotemporal regions (P < 0.05 corrected).

Conclusions

In HD, abnormal IGF-1 function seems to be associated with brain atrophy leading to clinical deficits in social cognition.

The perception of intonational and emotional speech prosody produced with and without a face mask: an exploratory individual differences study

Face masks affect the transmission of speech and obscure facial cues. Here, we examine how this reduction in acoustic and facial information affects a listener's understanding of speech prosody. English sentence pairs that differed in their intonational (statement/question) and emotional (happy/sad) prosody were created. These pairs were recorded by a masked and unmasked speaker and manipulated to contain audio or not. This resulted in a continuum from typical unmasked speech with audio (easiest) to masked speech without audio (hardest). English listeners (N = 129) were tested on their discrimination of these statement/question and happy/sad pairs. We also collected six individual difference measures previously reported to affect various linguistic processes: Autism Spectrum Quotient, musical background, phonological short-term memory (digit span, 2-back), and congruence task (flanker, Simon) behavior. The results indicated that masked statement/question and happy/sad prosodies were harder to discriminate than unmasked prosodies. Masks can therefore make it more difficult to understand a speaker's intended intonation or emotion. Importantly, listeners differed considerably in their ability to understand prosody. When wearing a mask, speakers should try to speak clearer and louder, if possible, and make intentions and emotions explicit to the listener.

Withdrawn Behavior in Preschool: Implications for Emotion Knowledge and Broader Emotional Competence

The present study investigated the respective roles of withdrawal, language, and context-inappropriate (CI) anger in the development of emotion knowledge (EK) among a subsample of 4 and 5 year-old preschoolers (n = 74). Measures included parent-reported withdrawn behavior, externalizing behavior, and CI anger, as well as child assessments of receptive language and EK. Ultimately, findings demonstrated that receptive language mediated the relationship between withdrawn behavior and situational EK. However, CI anger significantly interacted with receptive language, and, when incorporated into a second-stage moderated mediation analysis, moderate levels of CI anger rendered the indirect effect of withdrawn behavior on situational EK via receptive language insignificant. Cumulatively, these findings demonstrate a mechanism by which withdrawal may impact EK. They also indicate that such an effect may be attenuated in children with moderate levels of CI anger. Implications of these findings are discussed.

Music-Enhanced Emotion Identification of Facial Emotions in Autistic Spectrum Disorder Children: A Pilot EEG Study

The Autistic Spectrum Disorder (ASD) is characterized by a difficulty in expressing and interpreting others’ emotions. In particular, people with ASD have difficulties when interpreting emotions encoded in facial expressions. In the past, music interventions have been shown to improve autistic individuals’ emotional and social skills. The present study describes a pilot study to explore the usefulness of music as a tool for improving autistic children’s emotion recognition in facial expressions. Twenty-five children (mean age = 8.8 y, SD = 1.24) with high-functioning ASD and normal hearing participated in the study consisting of four weekly sessions of 15 min each. Twenty-five participants were randomly divided into an experimental group (N = 14) and a control group (N = 11). During each session, participants in the experimental group were exposed to images of facial expressions for four emotions (happy, sad, angry, and fear). Images were shown in three conditions, with the second condition consisting of music of congruent emotion with the shown images. Participants in the control group were shown only images in all three conditions. For six participants in each group, EEG data were acquired during the sessions, and instantaneous emotional responses (arousal and valence values) were extracted from the EEG data. Inter- and intra-session emotion identification improvement was measured in terms of verbal response accuracy, and EEG response differences were analyzed. A comparison of the verbal responses of the experimental group pre- and post-intervention showed a significant (p = 0.001) average improvement in emotion identification accuracy responses of 26% (SD = 3.4). Furthermore, emotional responses of the experimental group at the end of the study showed a higher correlation with the emotional stimuli being presented, compared with their emotional responses at the beginning of the study. No similar verbal responses improvement or EEG-stimuli correlation was found in the control group. These results seem to indicate that music can be used to improve both emotion identification in facial expressions and emotion induction through facial stimuli in children with high-functioning ASD.

Multichannel Perception of Emotion in Speech, Voice, Facial Expression, and Gesture in Individuals With Autism: A Scoping Review

PURPOSE

Numerous studies have identified individuals with autism spectrum disorder (ASD) with deficits in unichannel emotion perception and multisensory integration. However, only limited research is available on multichannel emotion perception in ASD. The purpose of this review was to seek conceptual clarification, identify knowledge gaps, and suggest directions for future research.

METHOD

We conducted a scoping review of the literature published between 1989 and 2021, following the 2005 framework of Arksey and O'Malley. Data relating to study characteristics, task characteristics, participant information, and key findings on multichannel processing of emotion in ASD were extracted for the review.

RESULTS

Discrepancies were identified regarding multichannel emotion perception deficits, which are related to participant age, developmental level, and task demand. Findings are largely consistent regarding the facilitation and compensation of congruent multichannel emotional cues and the interference and disruption of incongruent signals. Unlike controls, ASD individuals demonstrate an overreliance on semantics rather than prosody to decode multichannel emotion.

CONCLUSIONS

The existing literature on multichannel emotion perception in ASD is limited, dispersed, and disassociated, focusing on a variety of topics with a wide range of methodologies. Further research is necessary to quantitatively examine the impact of methodological choice on performance outcomes. An integrated framework of emotion, language, and cognition is needed to examine the mutual influences between emotion and language as well as the cross-linguistic and cross-cultural differences.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.19386176.

Reduced Pupil Oscillation During Facial Emotion Judgment in People with Autism Spectrum Disorder

People with autism spectrum disorder (ASD) show abnormal face perception and emotion recognition. However, it remains largely unknown whether these differences are associated with abnormal physiological responses when viewing faces. In this study, we employed a sensitive emotion judgment task and conducted a detailed investigation of pupil dilation/constriction and oscillation in high-functioning adult participants with ASD and matched controls. We found that participants with ASD showed normal pupil constriction to faces; however, they demonstrated reduced pupil oscillation, which was independent of stimulus properties and participants' perception of the emotion. Together, our results have revealed an abnormal physiological response to faces in people with ASD, which may in turn be associated with impaired face perception previously found in many studies.

Face-Processing Performance is an Independent Predictor of Social Affect as Measured by the Autism Diagnostic Observation Schedule Across Large-Scale Datasets

Face-processing deficits, while not required for the diagnosis of autism spectrum disorder (ASD), have been associated with impaired social skills-a core feature of ASD; however, the strength and prevalence of this relationship remains unclear. Across 445 participants from the NIMH Data Archive, we examined the relationship between Benton Face Recognition Test (BFRT) performance and Autism Diagnostic Observation Schedule-Social Affect (ADOS-SA) scores. Lower BFRT scores (worse face-processing performance) were associated with higher ADOS-SA scores (higher ASD severity)-a relationship that held after controlling for other factors associated with face processing, i.e., age, sex, and IQ. These findings underscore the utility of face discrimination, not just recognition of facial emotion, as a key covariate for the severity of symptoms that characterize ASD.

The structural neural correlates of atypical facial expression recognition in autism spectrum disorder

Previous studies have demonstrated that individuals with autism spectrum disorder (ASD) are worse at recognizing facial expressions than are typically developing (TD) individuals. The present study investigated the differences in structural neural correlates of emotion recognition between individuals with and without ASD using voxel-based morphometry (VBM). We acquired structural MRI data from 27 high-functioning adults with ASD and 27 age- and sex-matched TD individuals. The ability to recognize facial expressions was measured using a label-matching paradigm featuring six basic emotions (anger, disgust, fear, happiness, sadness, and surprise). The behavioural task did not find deficits of emotion recognition in ASD after controlling for intellectual ability. However, the VBM analysis for the region of interest showed a positive correlation between the averaged percent accuracy across six basic emotions and the grey matter volume of the right inferior frontal gyrus in TD individuals, but not in individuals with ASD. The VBM for the whole brain region under each emotion condition revealed a positive correlation between the percent accuracy for disgusted faces and the grey matter volume of the left dorsomedial prefrontal cortex in individuals with ASD, but not in TD individuals. The different pattern of correlations suggests that individuals with and without ASD use different processing mechanisms for recognizing others' facial expressions.

The autistic brain can process local but not global emotion regularities in facial and musical sequences

Whether autism spectrum disorder (ASD) is associated with a global processing deficit remains controversial. Global integration requires extraction of regularity across various timescales, yet little is known about how individuals with ASD process regularity at local (short timescale) versus global (long timescale) levels. To this end, we used event-related potentials to investigate whether individuals with ASD would show different neural responses to local (within trial) versus global (across trials) emotion regularities extracted from sequential facial expressions; and if so, whether this visual abnormality would generalize to the music (auditory) domain. Twenty individuals with ASD and 21 age- and IQ-matched individuals with typical development participated in this study. At an early processing stage, ASD participants exhibited preserved neural responses to violations of local emotion regularity for both faces and music. At a later stage, however, there was an absence of neural responses in ASD to violations of global emotion regularity for both faces and music. These findings suggest that the autistic brain responses to emotion regularity are modulated by the timescale of sequential stimuli, and provide insight into the neural mechanisms underlying emotional processing in ASD.

The Multidimensional Battery of Prosody Perception (MBOPP)

Prosody can be defined as the rhythm and intonation patterns spanning words, phrases and sentences. Accurate perception of prosody is an important component of many aspects of language processing, such as parsing grammatical structures, recognizing words, and determining where emphasis may be placed. Prosody perception is important for language acquisition and can be impaired in language-related developmental disorders. However, existing assessments of prosodic perception suffer from some shortcomings.  These include being unsuitable for use with typically developing adults due to ceiling effects and failing to allow the investigator to distinguish the unique contributions of individual acoustic features such as pitch and temporal cues. Here we present the Multi-Dimensional Battery of Prosody Perception (MBOPP), a novel tool for the assessment of prosody perception. It consists of two subtests: Linguistic Focus, which measures the ability to hear emphasis or sentential stress, and Phrase Boundaries, which measures the ability to hear where in a compound sentence one phrase ends, and another begins. Perception of individual acoustic dimensions (Pitch and Duration) can be examined separately, and test difficulty can be precisely calibrated by the experimenter because stimuli were created using a continuous voice morph space. We present validation analyses from a sample of 59 individuals and discuss how the battery might be deployed to examine perception of prosody in various populations.

The Multidimensional Battery of Prosody Perception (MBOPP)

Prosody can be defined as the rhythm and intonation patterns spanning words, phrases and sentences. Accurate perception of prosody is an important component of many aspects of language processing, such as parsing grammatical structures, recognizing words, and determining where emphasis may be placed. Prosody perception is important for language acquisition and can be impaired in language-related developmental disorders. However, existing assessments of prosodic perception suffer from some shortcomings.  These include being unsuitable for use with typically developing adults due to ceiling effects and failing to allow the investigator to distinguish the unique contributions of individual acoustic features such as pitch and temporal cues. Here we present the Multi-Dimensional Battery of Prosody Perception (MBOPP), a novel tool for the assessment of prosody perception. It consists of two subtests: Linguistic Focus, which measures the ability to hear emphasis or sentential stress, and Phrase Boundaries, which measures the ability to hear where in a compound sentence one phrase ends, and another begins. Perception of individual acoustic dimensions (Pitch and Duration) can be examined separately, and test difficulty can be precisely calibrated by the experimenter because stimuli were created using a continuous voice morph space. We present validation analyses from a sample of 59 individuals and discuss how the battery might be deployed to examine perception of prosody in various populations.

Bridging the communication gap in autistic children, one picture at a time

One of the main domains of paediatric dentistry is providing oral health care, especially to the children with special needs, like those affected with autism spectrum disorder (ASD). Such children exhibit poor oral hygiene primarily due to their limited communication ability, lack of joint attention, oversensitivity to sensory stimuli and motor coordination deficits. In such cases, multiple studies suggest and emphasize on the importance of early use of interventional services. Children affected with ASD tend to be visual learners, and therefore, are better suited for visual interventional methods. Amongst which, picture exchange communication system (PECS), originally developed by Bondy-Frost, is gaining rapid momentum. It is suggested to help individuals to initiate requests and communicate their needs via picture cards; hence aid in acquiring functional communication and speech, improve socio-communicative impairments, and decrease the behavioural problems. This scoping review aims to raise awareness on PECS amongst the dental fraternity, by emphasizing its usage pertaining to dentistry. PECS though rated hard, has proved to be beneficial in improving oral hygiene practices among autistic children.

Fostering Emotion Recognition in Children with Autism Spectrum Disorder

Facial expressions are of utmost importance in social interactions, allowing communicative prompts for a speaking turn and feedback. Nevertheless, not all have the ability to express themselves socially and emotionally in verbal and non-verbal communication. In particular, individuals with Autism Spectrum Disorder (ASD) are characterized by impairments in social communication, repetitive patterns of behaviour, and restricted activities or interests. In the literature, the use of robotic tools is reported to promote social interaction with children with ASD. The main goal of this work is to develop a system capable of automatic detecting emotions through facial expressions and interfacing them with a robotic platform (Zeno R50 Robokind® robotic platform, named ZECA) in order to allow social interaction with children with ASD. ZECA was used as a mediator in social communication activities. The experimental setup and methodology for a real-time facial expression (happiness, sadness, anger, surprise, fear, and neutral) recognition system was based on the Intel® RealSense™ 3D sensor and on facial features extraction and multiclass Support Vector Machine classifier. The results obtained allowed to infer that the proposed system is adequate in support sessions with children with ASD, giving a strong indication that it may be used in fostering emotion recognition and imitation skills.

Keep it simple: Identification of basic versus complex emotions in spoken language in individuals with autism spectrum disorder without intellectual disability: A meta-analysis study

Daily functioning involves identifying emotions in spoken language, a fundamental aspect of social interactions. To date, there is inconsistent evidence in the literature on whether individuals with autism spectrum disorder without intellectual disability (ASD-without-ID) experience difficulties in identification of spoken emotions. We conducted a meta-analysis (literature search following the PRISMA guidelines), with 26 data sets (taken from 23 peer-reviewed journal articles) comparing individuals with ASD-without-ID (N = 614) and typically-developed (TD) controls (N = 640), from nine countries and in seven languages (published until February 2020). In our analyses there was no sufficient evidence to suggest that individuals with HF-ASD differ from matched controls in the identification of simple prosodic emotions (e.g., sadness, happiness). However, individuals with ASD-without-ID were found to perform significantly worse than controls in identification of complex prosodic emotions (e.g., envy and boredom). The level of the semantic content of the stimuli presented (e.g., sentences vs. strings of digits) was not found to have an impact on the results. In conclusion, the difference in findings between simple and complex emotions calls for a new-look on emotion processing in ASD-without-ID. Intervention programs may rely on the intact abilities of individuals with ASD-without-ID to process simple emotions and target improved performance with complex emotions. LAY SUMMARY: Individuals with autism spectrum disorder without intellectual disability (ASD-without-ID) do not differ from matched controls in the identification of simple prosodic emotions (e.g., sadness, happiness). However, they were found to perform significantly worse than controls in the identification of complex prosodic emotions (e.g., envy, boredom). This was found in a meta-analysis of 26 data sets with 1254 participants from nine countries and in seven languages. Intervention programs may rely on the intact abilities of individuals with ASD-without-ID to process simple emotions.

Differences Between Autistic and Non-Autistic Adults in the Recognition of Anger from Facial Motion Remain after Controlling for Alexithymia

To date, studies have not established whether autistic and non-autistic individuals differ in emotion recognition from facial motion cues when matched in terms of alexithymia. Here, autistic and non-autistic adults (N = 60) matched on age, gender, non-verbal reasoning ability and alexithymia, completed an emotion recognition task, which employed dynamic point light displays of emotional facial expressions manipulated in terms of speed and spatial exaggeration. Autistic participants exhibited significantly lower accuracy for angry, but not happy or sad, facial motion with unmanipulated speed and spatial exaggeration. Autistic, and not alexithymic, traits were predictive of accuracy for angry facial motion with unmanipulated speed and spatial exaggeration. Alexithymic traits, in contrast, were predictive of the magnitude of both correct and incorrect emotion ratings.

Difficulties in Recognising Dynamic but not Static Emotional Body Movements in Autism Spectrum Disorder

In this study, we investigated whether the difficulties in body motion (BM) perception may led to deficit in emotion recognition in Autism spectrum disorder (ASD). To this aim, individuals with high-functioning ASD were asked to recognise fearful, happy, and neutral BM depicted as static images or dynamic point-light and full-light displays. Results showed slower response times in participants with ASD only in recognising dynamic stimuli, but no group differences in accuracy. This suggests that i) a deficit in action chaining mechanism in ASD may prevent the recognition of dynamic BM automatically and rapidly, ii) individuals with ASD and high cognitive resources can develop alternative—but equally successful—strategies to recognise emotional body expressions. Implications for treatment are discussed

Facial Emotions Are Accurately Encoded in the Neural Signal of Those With Autism Spectrum Disorder: A Deep Learning Approach

BACKGROUND

Individuals with autism spectrum disorder (ASD) exhibit frequent behavioral deficits in facial emotion recognition (FER). It remains unknown whether these deficits arise because facial emotion information is not encoded in their neural signal or because it is encodes but fails to translate to FER behavior (deployment). This distinction has functional implications, including constraining when differences in social information processing occur in ASD, and guiding interventions (i.e., developing prosthetic FER vs. reinforcing existing skills).

METHODS

We utilized a discriminative and contemporary machine learning approach-deep convolutional neural networks-to classify facial emotions viewed by individuals with and without ASD (N = 88) from concurrently recorded electroencephalography signals.

RESULTS

The convolutional neural network classified facial emotions with high accuracy for both ASD and non-ASD groups, even though individuals with ASD performed more poorly on the concurrent FER task. In fact, convolutional neural network accuracy was greater in the ASD group and was not related to behavioral performance. This pattern of results replicated across three independent participant samples. Moreover, feature importance analyses suggested that a late temporal window of neural activity (1000-1500 ms) may be uniquely important in facial emotion classification for individuals with ASD.

CONCLUSIONS

Our results reveal for the first time that facial emotion information is encoded in the neural signal of individuals with (and without) ASD. Thus, observed difficulties in behavioral FER associated with ASD likely arise from difficulties in decoding or deployment of facial emotion information within the neural signal. Interventions should focus on capitalizing on this intact encoding rather than promoting compensation or FER prostheses.

The Interpretation of E-Motions in Faces and Bodies Derived from Static Artworks by Individuals with High Functioning Autistic Spectrum

E-motions are defined as those affective states the expressions of which—conveyed either by static faces or body posture—embody a dynamic component and, consequently, convey a higher sense of dynamicity than other emotional expressions. An experiment is presented, aimed at testing whether e-motions are perceived as such also by individuals with autism spectrum disorders (ASDs), which have been associated with impairments in emotion recognition and in motion perception. To this aim we replicate with ASD individuals a study, originally conducted with typically developed individuals (TDs), in which we showed to both ASD and TD participants 14 bodiless heads and 14 headless bodies taken from eleven static artworks and four drawings. The Experiment was divided into two sessions. In Session 1 participants were asked to freely associate each stimulus to an emotion or an affective state (Task 1, option A); if they were unable to find a specific emotion, the experimenter showed them a list of eight possible emotions (words) and asked them to choose one from such list, that best described the affective state portrayed in the image (Task 1, option B). After their choice, they were asked to rate the intensity of the perceived emotion on a seven point Likert scale (Task 2). In Session 2 participants were requested to evaluate the degree of dynamicity conveyed by each stimulus on a 7 point Likert scale. Results showed that ASDs and TDs shared a similar range of verbal expressions defining emotions; however, ASDs (i) showed an impairment in the ability to spontaneously assign an emotion to a headless body, and (ii) they more frequently used terms denoting negative emotions (for both faces and bodies) as compared to neutral emotions, which in turn were more frequently used by TDs. No difference emerged between the two groups for positive emotions, with happiness being the emotion better recognized in both faces and in bodies. Although overall there are no significant differences between the two groups with respect to the emotions assigned to the images and the degree of perceived dynamicity, the interaction Artwork x Group showed that for some images ASDs assigned a different value than TDs to perceived dynamicity. Moreover, two images were interpreted by ASDs as conveying completely different emotions than those perceived by TDs. Results are discussed in light of the ability of ASDs to resolve ambiguity, and of possible different cognitive styles characterizing the aesthetical/emotional experience.

Brief Report: Emotional Picture and Language Processing in Adults with Autism Spectrum Disorder

There is currently limited research and a lack of consensus on emotional processing impairments among adults with autism spectrum disorder (ASD). The present pilot study sought to characterize the extent to which adults with ASD are impaired in processing emotions in both words and pictures. Ten adults with ASD rated word and picture stimuli on emotional valence and arousal. Their ratings were compared to normative data for both stimuli sets using item-level correlations. Adults with ASD rank-ordered stimuli similarly to typically developing individuals, demonstrating relatively typical understanding of emotional words and pictures. However, they used a narrower range of the scales which suggests more subtle impairments affecting emotion-processing. Future directions arising from the findings of this pilot study are discussed.

What Do New Findings About Social Interaction in Autistic Adults Mean for Neurodevelopmental Research?

Deficit-based accounts of social and communication abilities continue to dominate autism research. However, emerging findings suggest that this view may be overly simplistic and discount the two-way nature of interaction. Here we discuss the reconceptualization of social cognition to consider such difficulties as examples of bidirectional, multifaceted misattunement between autistic and nonautistic individuals. Aligned with progressive theoretical frameworks, emerging empirical research indicates that mismatches in communication styles can contribute to autistic social difficulties and the important role that nonautistic difficulties play. We highlight two areas of future research with the aim of providing empirical support for the views that the autistic community has proposed over the past 2 decades. We discuss the impact of such a paradigm shift on a number of levels, including how bridging the gap between different interaction styles can reduce stigma and increase understanding. Adopting such a framework will provide radical opportunities for transformative societal changes and education around inclusion.

Facial Imitation Improves Emotion Recognition in Adults with Different Levels of Sub-Clinical Autistic Traits

We used computer-based automatic expression analysis to investigate the impact of imitation on facial emotion recognition with a baseline-intervention-retest design. The participants: 55 young adults with varying degrees of autistic traits, completed an emotion recognition task with images of faces displaying one of six basic emotional expressions. This task was then repeated with instructions to imitate the expressions. During the experiment, a camera captured the participants’ faces for an automatic evaluation of their imitation performance. The instruction to imitate enhanced imitation performance as well as emotion recognition. Of relevance, emotion recognition improvements in the imitation block were larger in people with higher levels of autistic traits, whereas imitation enhancements were independent of autistic traits. The finding that an imitation instruction improves emotion recognition, and that imitation is a positive within-participant predictor of recognition accuracy in the imitation block supports the idea of a link between motor expression and perception in the processing of emotions, which might be mediated by the mirror neuron system. However, because there was no evidence that people with higher autistic traits differ in their imitative behavior per se, their disproportional emotion recognition benefits could have arisen from indirect effects of imitation instructions

Impaired Recognition of Static and Dynamic Facial Emotions in Children With Autism Spectrum Disorder Using Stimuli of Varying Intensities, Different Genders, and Age Ranges Faces

A multitude of research on facial emotion recognition (FER) in Autism Spectrum Disorders (ASD) have been published since several years. However, these studies have mainly used static high intensity stimuli, including adult and/or children facial emotions. This current study investigated FER in children with ASD using an innovative task, composed of a combination of static (114 pictures) and dynamic (36 videos) subtests, including children, adolescent, and adult male and female faces, with high, medium, and low intensity of basic facial emotions, and neutral expression. The ASD group consisted of 45 Tunisian verbal children, and the control group consisted of 117 tunisian typically developing children. Both groups were aged 7-12 years. After adjusting for sex, age, mental age, and school grade, the ASD group scored lower than controls on all tests except for the recognition of happiness and fear in the static subtest, and the recognition of happiness, fear, and sadness in the dynamic subtest (p ≥ 0.05). In the ASD group, the total score of both the static and the dynamic subtest were positively correlated with the school grade (p < 0.001), but not with age, or mental age. Children with ASD performed better in recognizing facial emotions in children than in adults and adolescents on videos and photos (p < 0.001). Impairments in FER would have negative impact on the child's social development. Thus, the creation of new intervention instruments aiming to improve emotion recognition strategies at an early stage to individuals with ASD seems fundamental.

Performance Differences Between Native and Non-Native Speakers on a New Happy-Sad Executive Function Measure

OBJECTIVE

The happy-sad task adapts the classic day-night task by incorporating two early acquired emotional concepts ("happy" and "sad") and demonstrates elevated inhibitory demands for native speakers. The task holds promise as a new executive function measure for assessing inhibitory control across the lifespan, but no studies have examined the influence of language of test administration on performance.

METHOD

Seventy adult native English speakers and 50 non-native speakers completed the computerized day-night and the new happy-sad tasks administered in English. In two conditions, participants were categorized pictorial stimuli either in a congruent manner ("happy" for a happy face) or in a more challenging, incongruent manner ("sad" for a happy face). Lexical decision performance was obtained to estimate levels of English language proficiency.

RESULTS

Native speakers and non-native speakers performed comparably except for the critical incongruent condition of the happy-sad task, where native speakers responded more slowly. A greater congruency effect for the happy-sad task was found for native than for non-native speakers. Lexical decision performance was associated with performance on the challenging incongruent conditions.

CONCLUSION

This study reinforced the usefulness of the happy-sad task as a new measure in evaluating inhibitory control in adult native-speakers. However, the language of test administration needs to be considered in assessment because it may lead to performance differences between native and non-native speakers.

An fMRI Feature Selection Method Based on a Minimum Spanning Tree for Identifying Patients with Autism

Autism spectrum disorder (ASD) is a neurodevelopmental disorder originating in infancy and childhood that may cause language barriers and social difficulties. However, in the diagnosis of ASD, the current machine learning methods still face many challenges in determining the location of biomarkers. Here, we proposed a novel feature selection method based on the minimum spanning tree (MST) to seek neuromarkers for ASD. First, we constructed an undirected graph with nodes of candidate features. At the same time, a weight calculation method considering both feature redundancy and discriminant ability was introduced. Second, we utilized the Prim algorithm to construct the MST from the initial graph structure. Third, the sum of the edge weights of all connected nodes was sorted for each node in the MST. Then, N features corresponding to the nodes with the first N smallest sum were selected as classification features. Finally, the support vector machine (SVM) algorithm was used to evaluate the discriminant performance of the aforementioned feature selection method. Comparative experiments results show that our proposed method has improved the ASD classification performance, i.e., the accuracy, sensitivity, and specificity were 86.7%, 87.5%, and 85.7%, respectively.

Social Cognition, Social Skill, and Social Motivation Minimally Predict Social Interaction Outcomes for Autistic and Non-Autistic Adults

Social cognition, social skill, and social motivation have been extensively researched and characterized as atypical in autistic people, with the assumption that each mechanistically contributes to the broader social interaction difficulties that diagnostically define the condition. Despite this assumption, research has not directly assessed whether or how these three social domains contribute to actual real-world social interaction outcomes for autistic people. The current study administered standardized measures of social cognition, social skill, and social motivation to 67 autistic and 58 non-autistic (NA) adults and assessed whether performance on these measures, both individually and relationally between dyadic partners, predicted outcomes for autistic and NA adults interacting with unfamiliar autistic and NA partners in a 5 minute unstructured "get to know you" conversation. Consistent with previous research, autistic adults scored lower than NA adults on the three social domains and were evaluated less favorably by their conversation partners. However, links between autistic adults' performance on the three social domains and their social interaction outcomes were minimal and, contrary to prediction, only the social abilities of NA adults predicted some interaction outcomes within mixed diagnostic dyads. Collectively, results suggest that reduced performance by autistic adults on standardized measures of social cognition, social skill, and social motivation do not correspond in clear and predictable ways with their real-world social interaction outcomes. They also highlight the need for the development and validation of more ecological assessments of autistic social abilities and the consideration of relational dynamics, not just individual characteristics, when assessing social disability in autism.

Emotional prosody recognition in children with high-functioning autism under the influence of emotional intensity: Based on the perspective of emotional dimension theory

This paper investigated the ability of Mandarin-speaking children with high-functioning autism (HFA) to recognize the four categories of emotional prosody, namely, happiness, anger, sadness and fear, in moderate- and high-intensity emotional conditions using auditory discrimination tasks. Thirty-four children with HFA between 5 and 7 years of age and 34 typically developing (TD) controls participated in this study. In moderate-intensity conditions, children with HFA scored lower than TD children in the recognition of the four categories of emotional prosody, indicating an overall impairment. With an increase in the intensity of emotion, children with HFA showed improved accuracy for anger, decreased accuracy for happiness, but no change in accuracy for either sadness or fear. An analysis of error patterns demonstrated that unlike TD children, children with HFA were inclined to mistake happiness for anger, with the two categories differing in valence, and this inclination deepened as the intensity increased. In discriminating between sadness and fear, which have a slight arousal difference, both groups showed difficulty in moderate-intensity conditions. In high-intensity conditions, TD children were inclined to perceive stimuli as exhibiting fear, which demonstrates comparatively high arousal; thus, they were more accurate for fear, while HFA children were not sensitive to increases in arousal, showing no noticeable effect. These findings indicated that children with HFA have a mechanism distinct from that of TD children in emotional prosody recognition, exhibiting various degrees of impairment in this regard.

Differential mirror neuron system (MNS) activation during action observation with and without social-emotional components in autism: a meta-analysis of neuroimaging studies

Background

Impaired imitation has been found to be an important factor contributing to social communication deficits in individuals with autism spectrum disorder (ASD). It has been hypothesized that the neural correlate of imitation, the mirror neuron system (MNS), is dysfunctional in ASD, resulting in imitation impairment as one of the key behavioral manifestations in ASD. Previous MNS studies produced inconsistent results, leaving the debate of whether “broken” mirror neurons in ASD are unresolved.

Methods

This meta-analysis aimed to explore the differences in MNS activation patterns between typically developing (TD) and ASD individuals when they observe biological motions with or without social-emotional components. Effect size signed differential mapping (ES-SDM) was adopted to synthesize the available fMRI data.

Results

ES-SDM analysis revealed hyperactivation in the right inferior frontal gyrus and left supplementary motor area in ASD during observation of biological motions. Subgroup analysis of experiments involving the observation of stimuli with or without emotional component revealed hyperactivation in the left inferior parietal lobule and left supplementary motor during action observation without emotional components, whereas hyperactivation of the right inferior frontal gyrus was found during action observation with emotional components in ASD. Subgroup analyses of age showed hyperactivation of the bilateral inferior frontal gyrus in ASD adolescents, while hyperactivation in the right inferior frontal gyrus was noted in ASD adults. Meta-regression within ASD individuals indicated that the right cerebellum crus I activation increased with age, while the left inferior temporal gyrus activation decreased with age.

Limitations

This meta-analysis is limited in its generalization of the findings to individuals with ASD by the restricted age range, heterogeneous study sample, and the large within-group variation in MNS activation patterns during object observation. Furthermore, we only included action observation studies which might limit the generalization of our results to the imitation deficits in ASD. In addition, the relatively small sample size for individual studies might also potentially overestimate the effect sizes.

Conclusion

The MNS is impaired in ASD. The abnormal activation patterns were found to be modulated by the nature of stimuli and age, which might explain the contradictory results from earlier studies on the “broken mirror neuron” debate.

Cognitive and Social Cognitive Self-assessment in Autistic Adults

An aspect of metacognition associated with broader functional abilities in several clinical conditions, but previously unexamined in autism, is self-assessment (i.e., the ability to accurately self-evaluate one's own performance). We compared self-assessment between 37 autistic adults without intellectual disability to 39 non-autistic (NA) controls on a series of three general cognitive and three social cognitive tasks. Whereas autistic adults and NA adults did not differ in their self-assessment accuracy on general cognitive tasks, they did on social cognitive tasks, with autistic adults demonstrating lower accuracy. The direction of their inaccuracy was variable (i.e., both over and underestimation), and self-assessment was largely unrelated to their level of social functioning. Over versus underestimation may have different functional implications, and warrants future investigation.

Patterns of autism symptoms: hidden structure in the ADOS and ADI-R instruments

We simultaneously revisited the Autism Diagnostic Interview-Revised (ADI-R) and Autism Diagnostic Observation Schedule (ADOS) with a comprehensive data-analytics strategy. Here, the combination of pattern-analysis algorithms and extensive data resources (n = 266 patients aged 7-49 years) allowed identifying coherent clinical constellations in and across ADI-R and ADOS assessments widespread in clinical practice. Our clustering approach revealed low- and high-severity patient groups, as well as a group scoring high only in the ADI-R domains, providing quantitative contours for the widely assumed autism subtypes. Sparse regression approaches uncovered the most clinically predictive questionnaire domains. The social and communication domains of the ADI-R showed convincing performance to predict the patients' symptom severity. Finally, we explored the relative importance of each of the ADI-R and ADOS domains conditioning on age, sex, and fluid IQ in our sample. The collective results suggest that (i) identifying autism subtypes and severity for a given individual may be most manifested in the ADI-R social and communication domains, (ii) the ADI-R might be a more appropriate tool to accurately capture symptom severity, and (iii) the ADOS domains were more relevant than the ADI-R domains to capture sex differences.

Effect of Stress on Neuroimmune Processes

PURPOSE

Psychological stress worsens many diseases, especially those with inflammatory components, such as atopic dermatitis (AD) and autism spectrum disorder (ASD), conditions that are significantly correlated in large epidemiologic studies. However, how stress contributes to these conditions is still poorly understood. This narrative review of the relevant literature advances the premise that stress affects inflammatory processes in AD and ASD via stimulation of mast cells (MCs).

METHODS

MEDLINE was searched between 1980 and 2019 using the terms allergies, atopic dermatitis, autism spectrum disorder, brain, corticotropin-releasing hormone, inflammation, hypothalamic-pituitary-adrenal axis, mast cells, neuropeptides, stress, neurotensin, and substance P.

FINDINGS

Exposure to psychological stress is associated with onset and/or exacerbation of AD and ASD. This association could be attributable to activation of MCs, which are ubiquitous in the body, including the brain, and could contribute to inflammation.

IMPLICATIONS

Understanding and addressing the connection between stress and MCs is important in clarifying the pathogenesis and developing effective treatments for diseases that worsen with stress and involve inflammation, such as AD and ASD.

"Motion or Emotion? Recognition of Emotional Bodily Expressions in Children With Autism Spectrum Disorder With and Without Intellectual Disability"

The recognition of emotional body movement (BM) is impaired in individuals with Autistic Spectrum Disorder ASD, yet it is not clear whether the difficulty is related to the encoding of body motion, emotions, or both. Besides, BM recognition has been traditionally studied using point-light displays stimuli (PLDs) and is still underexplored in individuals with ASD and intellectual disability (ID). In the present study, we investigated the recognition of happy, fearful, and neutral BM in children with ASD with and without ID. In a non-verbal recognition task, participants were asked to recognize pure-body-motion and visible-body-form stimuli (by means of point-light displays-PLDs and full-light displays-FLDs, respectively). We found that the children with ASD were less accurate than TD children in recognizing both the emotional and neutral BM, either when presented as FLDs or PLDs. These results suggest that the difficulty in understanding the observed BM may rely on atypical processing of BM information rather than emotion. Moreover, we found that the accuracy improved with age and IQ only in children with ASD without ID, suggesting that high level of cognitive resources can mediate the acquisition of compensatory mechanisms which develop with age.