Emotion recognition across visual and auditory modalities in autism spectrum disorder: A systematic review and meta-analysis

Spontaneous instrumental approach-avoidance learning in social contexts in autism

BACKGROUND

Individuals with Autism Spectrum Condition (ASC) are characterized by atypicalities in social interactions, compared to Typically Developing individuals (TD). The social motivation theory posits that these difficulties stem from diminished anticipation, reception, and/or learning from social rewards. Although learning from socioemotional outcomes is core to the theory, studies to date have been sparse and inconsistent. This possibly arises from a combination of theoretical, methodological and sample-related issues. Here, we assessed participants' ability to develop a spontaneous preference for actions that lead to desirable socioemotional outcomes (approaching/avoiding of happy/angry individuals, respectively), in an ecologically valid social scenario. We expected that learning abilities would be impaired in ASC individuals, particularly in response to affiliative social feedback.

METHOD

We ran an online social reinforcement learning task, on two large online cohorts with (n = 274) and without (n = 290) ASC, matched for gender, age and education. Participants had to indicate where they would sit in a waiting room. Each seat was associated with different probabilities of approaching/avoiding emotional individuals. Importantly, the task was implicit, as participants were not instructed to learn, and emotional expressions were never mentioned. We applied both categorical analyses contrasting the ASC and TD groups and dimensional factor analysis on affective questionnaires.

RESULTS

Contrary to our hypothesis, participants showed spontaneous learning from socioemotional outcomes, regardless of their diagnostic group. Yet, when accounting for dimensional variations in autistic traits, as well as depression and anxiety, two main findings emerged among females who failed to develop explicit learning strategies: (1) autism severity in ASC correlated with reduced learning to approach happy individuals; (2) anxiety-depression severity across both ASC and TD participants correlated with reduced learning to approach/avoid happy/angry individuals, respectively.

CONCLUSIONS

Implicit spontaneous learning from socioemotional outcomes is not generally impaired in autism but may be specifically associated with autism severity in females with ASC, when they do not have an explicit strategy for adapting to their social environment. Clinical diagnosis and intervention ought to take into account individual differences in their full complexity, including the presence of co-morbid anxiety and depression, when dealing with social atypicalities in autism.

A Randomized Trial Utilizing EEG Brain Computer Interface to Improve Facial Emotion Recognition in Autistic Adults

PURPOSE

Many individuals with autism spectrum disorder (ASD) experience challenges with facial emotion recognition (FER), which may exacerbate social difficulties in ASD. Few studies have examined whether FER can be experimentally manipulated and improved for autistic people. This study utilized a randomized controlled trial design to examine acceptability and preliminary clinical impact of a novel mixed reality-based neurofeedback program, FER Assistant, using EEG brain computer interface (BCI)-assisted technology to improve FER for autistic adolescents and adults.

METHODS

Twenty-seven autistic male participants (M age: 21.12 years; M IQ: 105.78; 85% white) were randomized to the active condition to receive FER Assistant (n = 17) or waitlist control (n = 10). FER Assistant participants received ten sessions utilizing BCI-assisted neurofeedback training in FER. All participants, regardless of randomization, completed a computerized FER task at baseline and endpoint.

RESULTS

Results partially indicated that FER Assistant was acceptable to participants. Regression analyses demonstrated that participation in FER Assistant led to group differences in FER at endpoint, compared to a waitlist control. However, analyses examining reliable change in FER indicated no reliable improvement or decline for FER Assistant participants, whereas two waitlist participants demonstrated reliable decline.

CONCLUSION

Given the preliminary nature of this work, results collectively suggest that FER Assistant may be an acceptable intervention. Results also suggest that FER may be a potential mechanism that is amenable to intervention for autistic individuals, although additional trials using larger sample sizes are warranted.

Mapping the differential impact of spontaneous and conversational laughter on brain and mind: an fMRI study in autism

Spontaneous and conversational laughter are important socio-emotional communicative signals. Neuroimaging findings suggest that non-autistic people engage in mentalizing to understand the meaning behind conversational laughter. Autistic people may thus face specific challenges in processing conversational laughter, due to their mentalizing difficulties. Using fMRI, we explored neural differences during implicit processing of these two types of laughter. Autistic and non-autistic adults passively listened to funny words, followed by spontaneous laughter, conversational laughter, or noise-vocoded vocalizations. Behaviourally, words plus spontaneous laughter were rated as funnier than words plus conversational laughter, and the groups did not differ. However, neuroimaging results showed that non-autistic adults exhibited greater medial prefrontal cortex activation while listening to words plus conversational laughter, than words plus genuine laughter, while autistic adults showed no difference in medial prefrontal cortex activity between these two laughter types. Our findings suggest a crucial role for the medial prefrontal cortex in understanding socio-emotionally ambiguous laughter via mentalizing. Our study also highlights the possibility that autistic people may face challenges in understanding the essence of the laughter we frequently encounter in everyday life, especially in processing conversational laughter that carries complex meaning and social ambiguity, potentially leading to social vulnerability. Therefore, we advocate for clearer communication with autistic people.

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.

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.

Improved emotion differentiation under reduced acoustic variability of speech in autism

BACKGROUND

Socio-emotional impairments are among the diagnostic criteria for autism spectrum disorder (ASD), but the actual knowledge has substantiated both altered and intact emotional prosodies recognition. Here, a Bayesian framework of perception is considered suggesting that the oversampling of sensory evidence would impair perception within highly variable environments. However, reliable hierarchical structures for spectral and temporal cues would foster emotion discrimination by autistics.

METHODS

Event-related spectral perturbations (ERSP) extracted from electroencephalographic (EEG) data indexed the perception of anger, disgust, fear, happiness, neutral, and sadness prosodies while listening to speech uttered by (a) human or (b) synthesized voices characterized by reduced volatility and variability of acoustic environments. The assessment of mechanisms for perception was extended to the visual domain by analyzing the behavioral accuracy within a non-social task in which dynamics of precision weighting between bottom-up evidence and top-down inferences were emphasized. Eighty children (mean 9.7 years old; standard deviation 1.8) volunteered including 40 autistics. The symptomatology was assessed at the time of the study via the Autism Diagnostic Observation Schedule, Second Edition, and parents' responses on the Autism Spectrum Rating Scales. A mixed within-between analysis of variance was conducted to assess the effects of group (autism versus typical development), voice, emotions, and interaction between factors. A Bayesian analysis was implemented to quantify the evidence in favor of the null hypothesis in case of non-significance. Post hoc comparisons were corrected for multiple testing.

RESULTS

Autistic children presented impaired emotion differentiation while listening to speech uttered by human voices, which was improved when the acoustic volatility and variability of voices were reduced. Divergent neural patterns were observed from neurotypicals to autistics, emphasizing different mechanisms for perception. Accordingly, behavioral measurements on the visual task were consistent with the over-precision ascribed to the environmental variability (sensory processing) that weakened performance. Unlike autistic children, neurotypicals could differentiate emotions induced by all voices.

CONCLUSIONS

This study outlines behavioral and neurophysiological mechanisms that underpin responses to sensory variability. Neurobiological insights into the processing of emotional prosodies emphasized the potential of acoustically modified emotional prosodies to improve emotion differentiation by autistics.

TRIAL REGISTRATION

BioMed Central ISRCTN Registry, ISRCTN18117434. Registered on September 20, 2020.

Let's face it! The role of social anxiety and executive functions in recognizing others' emotions from faces: Evidence from autism and specific learning disorders

Youth with different developmental disorders might experience challenges when dealing with facial emotion recognition (FER). By comparing FER and related emotional and cognitive factors across developmental disorders, researchers can gain a better understanding of challenges and strengths associated with each condition. The aim of the present study was to investigate how social anxiety and executive functioning might underlie FER in youth with and without autism spectrum disorders (ASD) and specific learning disorders (SLD). The study involved 263 children and adolescents between 8 and 16 years old divided into three groups matched for age, sex, and IQ: 60 (52 M) with ASD without intellectual disability, 63 (44 M) with SLD, and 140 (105 M) non-diagnosed. Participants completed an FER test, three executive functions' tasks (inhibition, updating, and set-shifting), and parents filled in a questionnaire reporting their children's social anxiety. Our results suggest that better FER was consistent with higher social anxiety and better updating skills in ASD, while with lower social anxiety in SLD. Clinical practice should focus on coping strategies in autistic youth who could feel anxiety when facing social cues, and on self-efficacy and social worries in SLD. Executive functioning should also be addressed to support social learning in autism.

Can repeated intranasal oxytocin administration affect reduced neural sensitivity towards expressive faces in autism? A randomized controlled trial

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties in social communication and interaction. Crucial for efficient social interaction is the ability to quickly and accurately extract information from a person's face. Frequency-tagging electroencephalography (EEG) is a novel tool to quantify face-processing sensitivity in a robust and implicit manner. In terms of intervention approaches, intranasal administration of oxytocin (OT) is increasingly considered as a potential pharmacological approach for improving socio-communicative difficulties in ASD, through enhancing social salience and/or reducing (social) stress and anxiety.

METHODS

In this randomized, double-blind, placebo-controlled, mechanistic pharmaco-neuroimaging clinical trial, we implemented frequency-tagging EEG to conduct an exploratory investigation into the impact of repeated OT administration (4 weeks, 12 IU, twice daily) on neural sensitivity towards happy and fearful facial expressions in children with ASD (8-12 years old; OT: n = 29; placebo: n = 32). Neural effects were assessed at baseline, post-nasal spray (24 hr after the last nasal spray) and at a follow-up session, 4 weeks after the OT administration period. At baseline, neural assessments of children with ASD were compared with those of an age- and gender-matched cohort of neurotypical (NT) children (n = 39).

RESULTS

Children with ASD demonstrated reduced neural sensitivity towards expressive faces, as compared to NT children. Upon nasal spray administration, children with ASD displayed a significant increase in neural sensitivity at the post- and follow-up sessions, but only in the placebo group, likely reflecting an implicit learning effect. Strikingly, in the OT group, neural sensitivity remained unaffected from the baseline to the post-session, likely reflecting a dampening of an otherwise typically occurring implicit learning effect.

CONCLUSIONS

First, we validated the robustness of the frequency-tagging EEG approach to assess reduced neural sensitivity towards expressive faces in children with ASD. Furthermore, in contrast to social salience effects observed after single-dose administrations, repeated OT administration dampened typically occurring learning effects in neural sensitivity. In line with OT's social anxiolytic account, these observations possibly reflect a predominant (social) stress regulatory effect towards emotionally evocative faces after repeated OT administration.

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.

The Sound of Emotion: Pinpointing Emotional Voice Processing Via Frequency Tagging EEG

Successfully engaging in social communication requires efficient processing of subtle socio-communicative cues. Voices convey a wealth of social information, such as gender, identity, and the emotional state of the speaker. We tested whether our brain can systematically and automatically differentiate and track a periodic stream of emotional utterances among a series of neutral vocal utterances. We recorded frequency-tagged EEG responses of 20 neurotypical male adults while presenting streams of neutral utterances at a 4 Hz base rate, interleaved with emotional utterances every third stimulus, hence at a 1.333 Hz oddball frequency. Four emotions (happy, sad, angry, and fear) were presented as different conditions in different streams. To control the impact of low-level acoustic cues, we maximized variability among the stimuli and included a control condition with scrambled utterances. This scrambling preserves low-level acoustic characteristics but ensures that the emotional character is no longer recognizable. Results revealed significant oddball EEG responses for all conditions, indicating that every emotion category can be discriminated from the neutral stimuli, and every emotional oddball response was significantly higher than the response for the scrambled utterances. These findings demonstrate that emotion discrimination is fast, automatic, and is not merely driven by low-level perceptual features. Eventually, here, we present a new database for vocal emotion research with short emotional utterances (EVID) together with an innovative frequency-tagging EEG paradigm for implicit vocal emotion discrimination.

Development and validation of the first adaptive test of emotion perception in music

ABSTRACTThe Musical Emotion Discrimination Task (MEDT) is a short, non-adaptive test of the ability to discriminate emotions in music. Test-takers hear two performances of the same melody, both played by the same performer but each trying to communicate a different basic emotion, and are asked to determine which one is "happier", for example. The goal of the current study was to construct a new version of the MEDT using a larger set of shorter, more diverse music clips and an adaptive framework to expand the ability range for which the test can deliver measurements. The first study analysed responses from a large sample of participants (N = 624) to determine how musical features contributed to item difficulty, which resulted in a quantitative model of musical emotion discrimination ability rooted in Item Response Theory (IRT). This model informed the construction of the adaptive MEDT. A second study contributed preliminary evidence for the validity and reliability of the adaptive MEDT, and demonstrated that the new version of the test is suitable for a wider range of abilities. This paper therefore presents the first adaptive musical emotion discrimination test, a new resource for investigating emotion processing which is freely available for research use.

Cognitive and Developmental Functions in Autistic and Non-Autistic Children and Adolescents: Evidence from the Intelligence and Development Scales-2

Autistic individuals often show impairments in cognitive and developmental domains beyond the core symptoms of lower social communication skills and restricted repetitive behaviors. Consequently, the assessment of cognitive and developmental functions constitutes an essential part of the diagnostic evaluation. Yet, evidence on differential validity from intelligence and developmental tests, which are commonly used with autistic individuals, varies widely. In the current study, we investigated the cognitive (i.e., intelligence, executive functions) and developmental (i.e., psychomotor skills, social-emotional skills, basic skills, motivation and attitude, participation during testing) functions of autistic and non-autistic children and adolescents using the Intelligence and Development Scales-2 (IDS-2). We compared 43 autistic (M_age = 12.30 years) with 43 non-autistic (M_age = 12.51 years) participants who were matched for age, sex, and maternal education. Autistic participants showed significantly lower mean values in psychomotor skills, language skills, and the evaluation of participation during testing of the developmental functions compared to the control sample. Our findings highlight that autistic individuals show impairments particularly in motor and language skills using the IDS-2, which therefore merit consideration in autism treatment in addition to the core symptoms and the individuals' intellectual functioning. Moreover, our findings indicate that particularly motor skills might be rather neglected in autism diagnosis and may be worthy of receiving more attention. Nonsignificant group differences in social-emotional skills could have been due to compensatory effects of average cognitive abilities in our autistic sample.

The Adaptive Test of Emotion Knowledge for 3-to 9-Year-Olds: Psychometric Properties and Validity

Children with an advanced knowledge of emotions are generally more socially competent, less likely to suffer from psychopathology, and more likely to succeed in school, both socially and academically. The assessment of children's emotion knowledge has thus gained importance in recent decades - both in psychiatric practice and in developmental and educational psychology. However, there is still a lack of appropriate instruments for assessing children's emotion knowledge in a performance test reliably, and for a broad age range. The Adaptive Test of Emotion Knowledge (ATEM 3-9) is a newly developed measure which encompasses seven components of emotion knowledge in 3-9-year-olds. The ATEM 3-9 is an adaptive test which uses skip and dropout rules to adjust for children's varying levels of knowledge. In addition to German, the ATEM has been translated into English and Hebrew. The German norming sample of the ATEM 3-9 comprises N = 882 (54% female, 21% bilingual) children between the ages of 3 and 9 years, who were divided into seven age groups. Test items, which are ordered according to the item response theory, showed a good fit to a seven-dimensional model reflecting the seven components. The internal consistencies of the dimensions are acceptable to good. Construct validity was examined by means of correlations with other measures of emotion knowledge, as well as measures on language skills and executive functions in a subsample. This resulted in medium size correlations in the expected directions. In addition, children with externalizing and internalizing disorders who were recruited in psychiatric in- and outpatient clinics showed deficits in various components of emotion knowledge when compared to their agemates in the norming sample. Overall, the ATEM 3-9 is well suited to measure individual components of emotion knowledge in children and to obtain a differentiated picture of the various aspects of emotion knowledge. The ATEM 3-9 thus supports the investigation of the development of social-emotional competencies in normative development (e.g., school readiness) and in social-emotional-learning interventions. Furthermore, it is suitable as an instrument for the differentiated assessment of (progress of) children's emotion knowledge in clinical child psychology and psychiatry.