Audiovisual speech integration in autism spectrum disorders: ERP evidence for atypicalities in lexical-semantic processing

Event-Related Potentials in Assessing Visual Speech Cues in the Broader Autism Phenotype: Evidence from a Phonemic Restoration Paradigm

Audiovisual speech perception includes the simultaneous processing of auditory and visual speech. Deficits in audiovisual speech perception are reported in autistic individuals; however, less is known regarding audiovisual speech perception within the broader autism phenotype (BAP), which includes individuals with elevated, yet subclinical, levels of autistic traits. We investigate the neural indices of audiovisual speech perception in adults exhibiting a range of autism-like traits using event-related potentials (ERPs) in a phonemic restoration paradigm. In this paradigm, we consider conditions where speech articulators (mouth and jaw) are present (AV condition) and obscured by a pixelated mask (PX condition). These two face conditions were included in both passive (simply viewing a speaking face) and active (participants were required to press a button for a specific consonant-vowel stimulus) experiments. The results revealed an N100 ERP component which was present for all listening contexts and conditions; however, it was attenuated in the active AV condition where participants were able to view the speaker's face, including the mouth and jaw. The P300 ERP component was present within the active experiment only, and significantly greater within the AV condition compared to the PX condition. This suggests increased neural effort for detecting deviant stimuli when visible articulation was present and visual influence on perception. Finally, the P300 response was negatively correlated with autism-like traits, suggesting that higher autistic traits were associated with generally smaller P300 responses in the active AV and PX conditions. The conclusions support the finding that atypical audiovisual processing may be characteristic of the BAP in adults.

Neural Correlates of Audiovisual Speech Processing in Autistic and Non-Autistic Youth

Autistic youth demonstrate differences in processing multisensory information, particularly in temporal processing of multisensory speech. Extensive research has identified several key brain regions for multisensory speech processing in non-autistic adults, including the superior temporal sulcus (STS) and insula, but it is unclear to what extent these regions are involved in temporal processing of multisensory speech in autistic youth. As a first step in exploring the neural substrates of multisensory temporal processing in this clinical population, we employed functional magnetic resonance imaging (fMRI) with a simultaneity-judgment audiovisual speech task. Eighteen autistic youth and a comparison group of 20 non-autistic youth matched on chronological age, biological sex, and gender participated. Results extend prior findings from studies of non-autistic adults, with non-autistic youth demonstrating responses in several similar regions as previously implicated in adult temporal processing of multisensory speech. Autistic youth demonstrated responses in fewer of the multisensory regions identified in adult studies; responses were limited to visual and motor cortices. Group responses in the middle temporal gyrus significantly interacted with age; younger autistic individuals showed reduced MTG responses whereas older individuals showed comparable MTG responses relative to non-autistic controls. Across groups, responses in the precuneus covaried with task accuracy, and anterior temporal and insula responses covaried with nonverbal IQ. These preliminary findings suggest possible differences in neural mechanisms of audiovisual processing in autistic youth while highlighting the need to consider participant characteristics in future, larger-scale studies exploring the neural basis of multisensory function in autism.

Remote Microphone Systems Can Improve Listening-in-Noise Accuracy and Listening Effort for Youth With Autism

OBJECTIVES

This study examined whether remote microphone (RM) systems improved listening-in-noise performance in youth with autism. We explored effects of RM system use on both listening-in-noise accuracy and listening effort in a well-characterized sample of participants with autism. We hypothesized that listening-in-noise accuracy would be enhanced and listening effort reduced, on average, when participants used the RM system. Furthermore, we predicted that effects of RM system use on listening-in-noise accuracy and listening effort would vary according to participant characteristics. Specifically, we hypothesized that participants who were chronologically older, had greater nonverbal cognitive and language ability, displayed fewer features of autism, and presented with more typical sensory and multisensory profiles might exhibit greater benefits of RM system use than participants who were younger, had less nonverbal cognitive or language ability, displayed more features of autism, and presented with greater sensory and multisensory disruptions.

DESIGN

We implemented a within-subjects design to investigate our hypotheses, wherein 32 youth with autism completed listening-in-noise testing with and without an RM system. Listening-in-noise accuracy and listening effort were evaluated simultaneously using a dual-task paradigm for stimuli varying in complexity (i.e., syllable-, word-, sentence-, and passage-level). In addition, several putative moderators of RM system effects (i.e., sensory and multisensory function, language, nonverbal cognition, and broader features of autism) on outcomes of interest were evaluated.

RESULTS

Overall, RM system use resulted in higher listening-in-noise accuracy in youth with autism compared with no RM system use. The observed benefits were all large in magnitude, although the benefits on average were greater for more complex stimuli (e.g., key words embedded in sentences) and relatively smaller for less complex stimuli (e.g., syllables). Notably, none of the putative moderators significantly influenced the effects of the RM system on listening-in-noise accuracy, indicating that RM system benefits did not vary according to any of the participant characteristics assessed. On average, RM system use did not have an effect on listening effort across all youth with autism compared with no RM system use but instead yielded effects that varied according to participant profile. Specifically, moderated effects indicated that RM system use was associated with increased listening effort for youth who had (a) average to below-average nonverbal cognitive ability, (b) below-average language ability, and (c) reduced audiovisual integration. RM system use was also associated with decreased listening effort for youth with very high nonverbal cognitive ability.

CONCLUSIONS

This study extends prior work by showing that RM systems have the potential to boost listening-in-noise accuracy for youth with autism. However, this boost in accuracy was coupled with increased listening effort, as indexed by longer reaction times while using an RM system, for some youth with autism, perhaps suggesting greater engagement in the listening-in-noise tasks when using the RM system for youth who had lower cognitive abilities, were less linguistically able, and/or have difficulty integrating seen and heard speech. These findings have important implications for clinical practice, suggesting RM system use in classrooms could potentially improve listening-in-noise performance for some youth with autism.

Speech Processing in Autism Spectrum Disorder: An Integrative Review of Auditory Neurophysiology Findings

Purpose Investigations into the nature of communication disorders in autistic individuals increasingly evaluate neural responses to speech stimuli. This integrative review aimed to consolidate the available data related to speech and language processing across levels of stimulus complexity (from single speech sounds to sentences) and to relate it to the current theories of autism. Method An electronic database search identified peer-reviewed articles using event-related potentials or magnetoencephalography to investigate auditory processing from single speech sounds to sentences in autistic children and adults varying in language and cognitive abilities. Results Atypical neural responses in autistic persons became more prominent with increasing stimulus and task complexity. Compared with their typically developing peers, autistic individuals demonstrated mostly intact sensory responses to single speech sounds, diminished spontaneous attentional orienting to spoken stimuli, specific difficulties with categorical speech sound discrimination, and reduced processing of semantic content. Atypical neural responses were more often observed in younger autistic participants and in those with concomitant language disorders. Conclusions The observed differences in neural responses to speech stimuli suggest that communication difficulties in autistic individuals are more consistent with the reduced social interest than the auditory dysfunction explanation. Current limitations and future directions for research are also discussed.

Enhanced attentional processing during speech perception in adult high-functioning autism spectrum disorder: An ERP-study

Deficits in audiovisual speech perception have consistently been detected in patients with Autism Spectrum Disorder (ASD). Especially for patients with a highly functional subtype of ASD, it remains uncertain whether these deficits and underlying neural mechanisms persist into adulthood. Research indicates differences in audiovisual speech processing between ASD and healthy controls (HC) in the auditory cortex. The temporal dynamics of these differences still need to be characterized. Thus, in the present study we examined 14 adult subjects with high-functioning ASD and 15 adult HC while they viewed visual (lip movements) and auditory (voice) speech information that was either superimposed by white noise (condition 1) or not (condition 2). Subject's performance was quantified by measuring stimulus comprehension. In addition, event-related brain potentials (ERPs) were recorded. Results demonstrated worse speech comprehension for ASD subjects compared to HC under noisy conditions. Moreover, ERP-analysis revealed significantly higher P2 amplitudes over parietal electrodes for ASD subjects compared to HC.

Developmental differences in neural connectivity for semantic processing in youths with autism

BACKGROUND

Youths with autism spectrum disorder (ASD) rely more on lower-level visual processing as revealed by greater occipital activation, yet less effectively engage higher-level processing of modality-independent semantic knowledge as indicated by reduced frontal activation, compared to typically developing (TD) youths. However, little is known about age-dependent differences in neural connectivity during semantic processing in youths with ASD as compared to TD youths.

METHODS

Four groups were recruited: 31 ASD children (mean age = 10.5 years old), 33 TD children (mean age = 10.4), 30 ASD adolescents (mean age = 14.9), and 34 TD adolescents (mean age = 15.1). We explored their differences in neural connectivity by using functional magnetic resonance imaging (fMRI) with psychophysiological interaction (PPI) during semantic judgments.

RESULTS

In comparison with TD children, children with ASD showed greater activation in the left cuneus and weaker connectivity between the left cuneus and left middle temporal gyrus (MTG). In comparison with TD adolescents, adolescents with ASD showed less activation in the left inferior frontal gyrus (IFG) and weaker functional connectivity between the left IFG and left MTG.

CONCLUSIONS

Children with ASD may rely more on visual processes in the occipital cortex that are disconnected from modality-independent semantics in the temporal cortex. However, adolescents with ASD may less effectively engage frontal mechanisms involved in the top-down control of modality-independent semantic knowledge in the temporal cortex. Our findings provide evidence of developmental differences in the neural substrates of the alterations in semantic processing in youths with ASD compared to TD youths.

Plasticity of Temporal Binding in Children with Autism Spectrum Disorder:A Single Case Experimental Design Perceptual Training Study

BACKGROUND

Many children with autism spectrum disorder (ASD) demonstrate atypical responses to multisensory stimuli. These disruptions, which are frequently seen in response to audiovisual speech, may produce cascading effects on the broader development of children with ASD. Perceptual training has been shown to enhance multisensory speech perception in typically developed adults. This study was the first to examine the effects of perceptual training on audiovisual speech perception in children with ASD.

METHOD

A multiple baseline across participants design was utilized with four 7- to 13-year-old children with ASD. The dependent variable, which was probed outside the training task each day using a simultaneity judgment task in baseline, intervention, and maintenance conditions, was audiovisual temporal binding window (TBW), an index of multisensory temporal acuity. During perceptual training, participants completed the same simultaneity judgment task with feedback on their accuracy after each trial in easy-, medium-, and hard-difficulty blocks.

RESULTS

A functional relation between the multisensory perceptual training program and TBW size was not observed. Of the three participants who were entered into training, one participant demonstrated a strong effect, characterized by a fairly immediate change in TBW trend. The two remaining participants demonstrated a less clear response (i.e., longer latency to effect, lack of functional independence). The first participant to enter the training condition demonstrated some maintenance of a narrower TBW post-training.

CONCLUSIONS

Results indicate TBWs in children with ASD may be malleable, but additional research is needed and may entail further adaptation to the multisensory perceptual training paradigm.

Processing of Real-World, Dynamic Natural Stimuli in Autism is Linked to Corticobasal Function

Many individuals with autism spectrum disorder (ASD) have been shown to perceive everyday sensory information differently compared to peers without autism. Research examining these sensory differences has primarily utilized nonnatural stimuli or natural stimuli using static photos with few having utilized dynamic, real-world nonverbal stimuli. Therefore, in this study, we used functional magnetic resonance imaging to characterize brain activation of individuals with high-functioning autism when viewing and listening to a video of a real-world scene (a person bouncing a ball) and anticipating the bounce. We investigated both multisensory and unisensory processing and hypothesized that individuals with ASD would show differential activation in (a) primary auditory and visual sensory cortical and association areas, and in (b) cortical and subcortical regions where auditory and visual information is integrated (e.g. temporal-parietal junction, pulvinar, superior colliculus). Contrary to our hypotheses, the whole-brain analysis revealed similar activation between the groups in these brain regions. However, compared to controls the ASD group showed significant hypoactivation in the left intraparietal sulcus and left putamen/globus pallidus. We theorize that this hypoactivation reflected underconnectivity for mediating spatiotemporal processing of the visual biological motion stimuli with the task demands of anticipating the timing of the bounce event. The paradigm thus may have tapped into a specific left-lateralized aberrant corticobasal circuit or loop involved in initiating or inhibiting motor responses. This was consistent with a dual "when versus where" psychophysical model of corticobasal function, which may reflect core differences in sensory processing of real-world, nonverbal natural stimuli in ASD. Autism Res 2020, 13: 539-549. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: To understand how individuals with autism perceive the real-world, using magnetic resonance imaging we examined brain activation in individuals with autism while watching a video of someone bouncing a basketball. Those with autism had similar activation to controls in auditory and visual sensory brain regions, but less activation in an area that processes information about body movements and in a region involved in modulating movements. These areas are important for understanding the actions of others and developing social skills.

Auditory Deficits in Audiovisual Speech Perception in Adult Asperger's Syndrome: fMRI Study

Audiovisual (AV) integration deficits have been proposed to underlie difficulties in speech perception in Asperger’s syndrome (AS). It is not known, if the AV deficits are related to alterations in sensory processing at the level of unisensory processing or at levels of conjoint multisensory processing. Functional Magnetic-resonance images (MRI) was performed in 16 adult subjects with AS and 16 healthy controls (HC) matched for age, gender, and verbal IQ as they were exposed to disyllabic AV congruent and AV incongruent nouns. A simple semantic categorization task was used to ensure subjects’ attention to the stimuli. The left auditory cortex (BA41) showed stronger activation in HC than in subjects with AS with no interaction regarding AV congruency. This suggests that alterations in auditory processing in unimodal low-level areas underlie AV speech perception deficits in AS. Whether this is signaling a difficulty in the deployment of attention remains to be demonstrated.

Overlaps and distinctions between attention deficit/hyperactivity disorder and autism spectrum disorder in young adulthood: Systematic review and guiding framework for EEG-imaging research

Attention deficit/hyperactivity disorders (ADHD) and autism spectrum disorders (ASD) frequently co-occur. However, we know little about the neural basis of the overlaps and distinctions between these disorders, particularly in young adulthood - a critical time window for brain plasticity across executive and socioemotional domains. Here, we systematically review 75 articles investigating ADHD and ASD in young adult samples (mean ages 16-26) using cognitive tasks, with neural activity concurrently measured via electroencephalography (EEG) - the most accessible neuroimaging technology. The majority of studies focused on event-related potentials (ERPs), with some beginning to capitalise on oscillatory approaches. Overlapping and specific profiles for ASD and ADHD were found mainly for four neurocognitive domains: attention processing, performance monitoring, face processing and sensory processing. No studies in this age group directly compared both disorders or considered dual diagnosis with both disorders. Moving forward, understanding of ADHD, ASD and their overlap in young adulthood would benefit from an increased focus on cross-disorder comparisons, using similar paradigms and in well-powered samples and longitudinal cohorts.

Audiovisual multisensory integration in individuals with autism spectrum disorder: A systematic review and meta-analysis

An ever-growing literature has aimed to determine how individuals with autism spectrum disorder (ASD) differ from their typically developing (TD) peers on measures of multisensory integration (MSI) and to ascertain the degree to which differences in MSI are associated with the broad range of symptoms associated with ASD. Findings, however, have been highly variable across the studies carried out to date. The present work systematically reviews and quantitatively synthesizes the large literature on audiovisual MSI in individuals with ASD to evaluate the cumulative evidence for (a) group differences between individuals with ASD and TD peers, (b) correlations between MSI and autism symptoms in individuals with ASD and (c) study level factors that may moderate findings (i.e., explain differential effects) observed across studies. To identify eligible studies, a comprehensive search strategy was employed using the ProQuest search engine, PubMed database, forwards and backwards citation searches, direct author contact, and hand-searching of select conference proceedings. A significant between-group difference in MSI was evident in the literature, with individuals with ASD demonstrating worse audiovisual integration on average across studies compared to TD controls. This effect was moderated by mean participant age, such that between-group differences were more pronounced in younger samples. The mean correlation between MSI and autism and related symptomatology was also significant, indicating that increased audiovisual integration in individuals with ASD is associated with better language/communication abilities and/or reduced autism symptom severity in the extant literature. This effect was moderated by whether the stimuli were linguistic versus non-linguistic in nature, such that correlation magnitudes tended to be significantly greater when linguistic stimuli were utilized in the measure of MSI. Limitations and future directions for primary and meta-analytic research are discussed.

Temporal synchrony and audiovisual integration of speech and object stimuli in autism

BACKGROUND

Individuals with Autism Spectrum Disorders (ASD) have been shown to have multisensory integration deficits, which may lead to problems perceiving complex, multisensory environments. For example, understanding audiovisual speech requires integration of visual information from the lips and face with auditory information from the voice, and audiovisual speech integration deficits can lead to impaired understanding and comprehension. While there is strong evidence for an audiovisual speech integration impairment in ASD, it is unclear whether this impairment is due to low level perceptual processes that affect all types of audiovisual integration or if it is specific to speech processing.

METHOD

Here, we measure audiovisual integration of basic speech (i.e., consonant-vowel utterances) and object stimuli (i.e., a bouncing ball) in adolescents with ASD and well-matched controls. We calculate a temporal window of integration (TWI) using each individual's ability to identify which of two videos (one temporally aligned and one misaligned) matches auditory stimuli. The TWI measures tolerance for temporal asynchrony between the auditory and visual streams, and is an important feature of audiovisual perception.

RESULTS

While controls showed similar tolerance of asynchrony for the simple speech and object stimuli, individuals with ASD did not. Specifically, individuals with ASD showed less tolerance of asynchrony for speech stimuli compared to object stimuli. In individuals with ASD, decreased tolerance for asynchrony in speech stimuli was associated with higher ratings of autism symptom severity.

CONCLUSIONS

These results suggest that audiovisual perception in ASD may vary for speech and object stimuli beyond what can be accounted for by stimulus complexity.

No rapid audiovisual recalibration in adults on the autism spectrum

Autism spectrum disorders (ASD) are characterized by difficulties in social cognition, but are also associated with atypicalities in sensory and perceptual processing. Several groups have reported that autistic individuals show reduced integration of socially relevant audiovisual signals, which may contribute to the higher-order social and cognitive difficulties observed in autism. Here we use a newly devised technique to study instantaneous adaptation to audiovisual asynchrony in autism. Autistic and typical participants were presented with sequences of brief visual and auditory stimuli, varying in asynchrony over a wide range, from 512 ms auditory-lead to 512 ms auditory-lag, and judged whether they seemed to be synchronous. Typical adults showed strong adaptation effects, with trials proceeded by an auditory-lead needing more auditory-lead to seem simultaneous, and vice versa. However, autistic observers showed little or no adaptation, although their simultaneity curves were as narrow as the typical adults. This result supports recent Bayesian models that predict reduced adaptation effects in autism. As rapid audiovisual recalibration may be fundamental for the optimisation of speech comprehension, recalibration problems could render language processing more difficult in autistic individuals, hindering social communication.

Flexible integration of visual cues in adolescents with autism spectrum disorder

Although children with autism spectrum disorder (ASD) show atypical sensory processing, evidence for impaired integration of multisensory information has been mixed. In this study, we took a Bayesian model-based approach to assess within-modality integration of congruent and incongruent texture and disparity cues to judge slant in typical and autistic adolescents. Human adults optimally combine multiple sources of sensory information to reduce perceptual variance but in typical development this ability to integrate cues does not develop until late childhood. While adults cannot help but integrate cues, even when they are incongruent, young children's ability to keep cues separate gives them an advantage in discriminating incongruent stimuli. Given that mature cue integration emerges in later childhood, we hypothesized that typical adolescents would show adult-like integration, combining both congruent and incongruent cues. For the ASD group there were three possible predictions (1) "no fusion": no integration of congruent or incongruent cues, like 6-year-old typical children; (2) "mandatory fusion": integration of congruent and incongruent cues, like typical adults; (3) "selective fusion": cues are combined when congruent but not incongruent, consistent with predictions of Enhanced Perceptual Functioning (EPF) theory. As hypothesized, typical adolescents showed significant integration of both congruent and incongruent cues. The ASD group showed results consistent with "selective fusion," integrating congruent but not incongruent cues. This allowed adolescents with ASD to make perceptual judgments which typical adolescents could not. In line with EPF, results suggest that perception in ASD may be more flexible and less governed by mandatory top-down feedback.

A Multidimensional Approach to the Study of Emotion Recognition in Autism Spectrum Disorders

Although deficits in emotion recognition have been widely reported in autism spectrum disorder (ASD), experiments have been restricted to either facial or vocal expressions. Here, we explored multimodal emotion processing in children with ASD (N = 19) and with typical development (TD, N = 19), considering uni (faces and voices) and multimodal (faces/voices simultaneously) stimuli and developmental comorbidities (neuro-visual, language and motor impairments). Compared to TD controls, children with ASD had rather high and heterogeneous emotion recognition scores but showed also several significant differences: lower emotion recognition scores for visual stimuli, for neutral emotion, and a greater number of saccades during visual task. Multivariate analyses showed that: (1) the difficulties they experienced with visual stimuli were partially alleviated with multimodal stimuli. (2) Developmental age was significantly associated with emotion recognition in TD children, whereas it was the case only for the multimodal task in children with ASD. (3) Language impairments tended to be associated with emotion recognition scores of ASD children in the auditory modality. Conversely, in the visual or bimodal (visuo-auditory) tasks, the impact of developmental coordination disorder or neuro-visual impairments was not found. We conclude that impaired emotion processing constitutes a dimension to explore in the field of ASD, as research has the potential to define more homogeneous subgroups and tailored interventions. However, it is clear that developmental age, the nature of the stimuli, and other developmental comorbidities must also be taken into account when studying this dimension.

Sensory integration in mouse insular cortex reflects GABA circuit maturation

Insular cortex (IC) contributes to a variety of complex brain functions, such as communication, social behavior, and self-awareness through the integration of sensory, emotional, and cognitive content. How the IC acquires its integrative properties remains unexplored. We compared the emergence of multisensory integration (MSI) in the IC of behaviorally distinct mouse strains. While adult C57BL/6 mice exhibited robust MSI, this capacity was impaired in the inbred BTBR T+tf/J mouse model of idiopathic autism. The deficit reflected weakened γ-aminobutyric acid (GABA) circuits and compromised postnatal pruning of cross-modal input. Transient pharmacological enhancement by diazepam in BTBR mice during an early sensitive period rescued inhibition and integration in the adult IC. Moreover, impaired MSI was common across three other monogenic models (GAD65, Shank3, and Mecp2 knockout mice) displaying behavioral phenotypes and parvalbumin-circuit abnormalities. Our findings offer developmental insight into a key neural circuit relevant to neuropsychiatric conditions like schizophrenia and autism.

Brain responses and looking behavior during audiovisual speech integration in infants predict auditory speech comprehension in the second year of life

The use of visual cues during the processing of audiovisual (AV) speech is known to be less efficient in children and adults with language difficulties and difficulties are known to be more prevalent in children from low-income populations. In the present study, we followed an economically diverse group of thirty-seven infants longitudinally from 6–9 months to 14–16 months of age. We used eye-tracking to examine whether individual differences in visual attention during AV processing of speech in 6–9 month old infants, particularly when processing congruent and incongruent auditory and visual speech cues, might be indicative of their later language development. Twenty-two of these 6–9 month old infants also participated in an event-related potential (ERP) AV task within the same experimental session. Language development was then followed-up at the age of 14–16 months, using two measures of language development, the Preschool Language Scale and the Oxford Communicative Development Inventory. The results show that those infants who were less efficient in auditory speech processing at the age of 6–9 months had lower receptive language scores at 14–16 months. A correlational analysis revealed that the pattern of face scanning and ERP responses to audiovisually incongruent stimuli at 6–9 months were both significantly associated with language development at 14–16 months. These findings add to the understanding of individual differences in neural signatures of AV processing and associated looking behavior in infants.

Atypical audiovisual speech integration in infants at risk for autism

The language difficulties often seen in individuals with autism might stem from an inability to integrate audiovisual information, a skill important for language development. We investigated whether 9-month-old siblings of older children with autism, who are at an increased risk of developing autism, are able to integrate audiovisual speech cues. We used an eye-tracker to record where infants looked when shown a screen displaying two faces of the same model, where one face is articulating/ba/and the other/ga/, with one face congruent with the syllable sound being presented simultaneously, the other face incongruent. This method was successful in showing that infants at low risk can integrate audiovisual speech: they looked for the same amount of time at the mouths in both the fusible visual/ga/− audio/ba/and the congruent visual/ba/− audio/ba/displays, indicating that the auditory and visual streams fuse into a McGurk-type of syllabic percept in the incongruent condition. It also showed that low-risk infants could perceive a mismatch between auditory and visual cues: they looked longer at the mouth in the mismatched, non-fusible visual/ba/− audio/ga/display compared with the congruent visual/ga/− audio/ga/display, demonstrating that they perceive an uncommon, and therefore interesting, speech-like percept when looking at the incongruent mouth (repeated ANOVA: displays x fusion/mismatch conditions interaction: F(1,16) = 17.153, p = 0.001). The looking behaviour of high-risk infants did not differ according to the type of display, suggesting difficulties in matching auditory and visual information (repeated ANOVA, displays x conditions interaction: F(1,25) = 0.09, p = 0.767), in contrast to low-risk infants (repeated ANOVA: displays x conditions x low/high-risk groups interaction: F(1,41) = 4.466, p = 0.041). In some cases this reduced ability might lead to the poor communication skills characteristic of autism.