Evidence for shared deficits in identifying emotions from faces and from voices in autism spectrum disorders and specific language impairment

Eye-Tracking Methodology to Detect Differences in Attention to Faces Between Developmental Language Disorder and Autism

PURPOSE

Developmental language disorder (DLD) and autism sometimes appear as overlapping conditions in behavioral tests. There is much literature on the visual scanning pattern (VSP) of faces in autistic children, but this is scarce regarding those with DLD. The purpose of this study was to compare the VSP of faces in young children with DLD, those with autism, and typically developing peers, assessing the effect of three variables.

METHOD

Two eye-tracking experiments were designed to assess the effect of the emotion and the poser's gender (Experiment 1) and the poser's age (Experiment 2) on the VSP of participants (Experiment 1: N = 59, age range: 32-74 months; Experiment 2: N = 58, age range: 32-74 months). We operationalized the VSP in terms of attentional orientation, visual preference, and depth of processing of each sort of face. We developed two paired preference tasks in which pairs of images of faces showing different emotions were displayed simultaneously to compete for children's attention.

RESULTS

Data analysis revealed two VSP markers common to both disorders: (a) superficial processing of faces and (b) late orientation to angry and child faces. Moreover, one specific marker for each condition was also found: typical preference for child faces in children with DLD versus diminished preference for them in autistic children.

CONCLUSIONS

Considering the similarities found between children with DLD and those with autism, difficulties of children with DLD in attention to faces have been systematically underestimated. Thus, more effort must be made to identify and respond to the needs of this population. Clinical practice may benefit from the potential of eye-tracking methodology and the analysis of the VSP to assess attention to faces in both conditions. This would also contribute to the improvement of early differential diagnosis in the long run.

Enhancing Parental Understanding of Emotions in Children with Developmental Language Disorder: An Online Parent-Led Intervention Program

Many children with developmental language disorder (DLD) have emotion recognition and regulation difficulties, but there are currently no known interventions enhancing emotional awareness in this population. This study explores the impact of parents' perspectives regarding children with DLD emotional understanding through a parent-led online emotion recognition (ER) intervention. Ten parents of children with DLD aged 6-11 participated in the study. A nonconcurrent multiple baseline design was employed, allowing for a rigorous analysis of changes in parental beliefs over time. Weekly data were collected through the Parents' Beliefs About Children's Emotions Questionnaire. Interviews were also conducted to gain deeper insights into parents' perceptions regarding the ER skills of their children. Results indicated that parents' beliefs about the need for guiding and supporting their child's ER skills increased over the intervention. Interviews also supported this, and three main themes were generated. The intervention program increased parents' awareness of (a) the importance of ER for children with DLD, (b) emotion-focused communication and engagement with their child, and (c) the integration of emotions into daily life. This study is the first known study that explores parents' beliefs about children with DLD ER skills, highlighting the importance of supporting parents through accessible interventions.

How word meaning structure relates to executive functioning and theory of mind in children with developmental language disorder: A multiple case study

Background and aims

Many children with developmental language disorder (DLD) have difficulties in executive functioning (EF) and theory of mind (ToM). These difficulties might be explained by the theory that children's conceptual understanding changes over five stages of word meaning structure, from concrete and context-dependent to abstract and precise. We present a multiple case study examining how word meaning structure relates to EF and ToM in children with DLD.

Methods

Participants were five children with DLD aged 9-12 and five typically developing children matched for age, gender, and nonverbal intelligence. Word meaning structure was assessed using new dynamic test. EF was assessed using the Zoo Map Task and Behavioral Rating Inventory for EF. ToM was assessed using the ToM test, Frith-Happé Animations, and Bermond-Vorst Alexithymia Questionnaire. Behavioral problems were measured using the Child Behavior Checklist. Anamnestic interviews with the parents were conducted to describe the case histories.

Results

For the children with DLD, lower scores in the word meaning structure task were observed compared to those observed for their matched peers, with no statistical test applied. Word meaning structure related positively to EF and ToM, but not to behavioral problems. Instances in which word meaning structure dissociates from EF and ToM are discussed in individual case descriptions.

Conclusions

By linking language to conceptual development, variations in word meaning structure may explain some EF and ToM difficulties in children with DLD.

Implications

The present study offers a basis for future research on the relationships among word meaning structure, EF, and ToM.

Investigating the borders of autism spectrum disorder: lessons from the former diagnosis of pervasive developmental disorder not otherwise specified

Introduction

Autism Spectrum Disorder (ASD) diagnosis is relatively consensual in typical forms. The margins of the spectrum and their degree of extension, however, are controversial. This has far-reaching implications, which extend beyond theoretical considerations: first, peripheral forms of autism are more prevalent than central forms; second, we do not know how relevant typical-targeted recommendations are for atypical forms. In DSM-IV-TR, these margins of autism were studied within the category of Pervasive Developmental Disorder - Not Otherwise Specified (PDD-NOS). In spite of its low reliability, this former diagnosis was of particular interest to shed light on the gray area of margins. The aim of this systematic is therefore to investigate the clinical characteristics of PDD-NOS in comparison with Autistic Disorder.

Method

A stepwise systematic PRISMA literature review was conducted by searching PubMed and Web Of Science databases to select corresponding studies.

Results

The systematic review included 81 studies comprising 6,644 children with PDD-NOS. Cross-sectional and longitudinal studies comparing PDD-NOS and AD showed that PDD-NOS corresponds to milder form of autism with less impact and less associated disorder, with the exception of schizophrenia and mood disorder.

Discussion

Our review challenges initial views of PDD-NOS, and shows the clinical relevance of this diagnosis when dealing with the margins of autism, and the de facto diversity included in the spectrum. However, in view of the many limitations of PDD-NOS (low reliability, instability through time, low acceptability), we suggest taxonomic changes in DSM-5: we introduce a new category based on three main dimensions related to socialization impairment, emotional lability and psychotic symptoms.

Conclusion

Our review argues for a distinction between AD and PDD-NOS on clinical characteristics and thus highlights the need to study the margins of autism. While the limitations of the PDD-NOS category made it irrelevant to investigate these margins from a research perspective, we believe that a multidimensional approach for mental health professionals taping socialization, emotion lability and psychotic symptoms would be interesting. Our review therefore encourage future studies to test relevant criteria for a new category and possibly identify developmental trajectories, specific interventions and treatments.

Social Cognition in Adolescents with Developmental Language Disorder (DLD): Evidence from the Social Attribution Task

Social cognition impairments may explain social, emotional and behavioural difficulties (SEBD) in individuals with Developmental Language Disorder (DLD). In a novel approach, the Social Attribution Task (SAT) was used to examine this association. SAT narratives were coded from 53 participants [n = 26 DLD; n = 27 typical language development (TLD)] matched on age (Mage = 13;6) and gender (35.9% female). Parents reported SEBD. Adolescents with DLD performed worse than their TLD peers on the majority of SAT indices and had higher peer (d = 1.09) and emotional problems (d = .75). There was no association between social cognition abilities and SEBD. These exploratory findings suggest social cognition should be further examined in this population.

Aberrant Emotional Prosody Circuitry Predicts Social Communication Impairments in Children With Autism

BACKGROUND

Emotional prosody provides acoustical cues that reflect a communication partner's emotional state and is crucial for successful social interactions. Many children with autism have deficits in recognizing emotions from voices; however, the neural basis for these impairments is unknown. We examined brain circuit features underlying emotional prosody processing deficits and their relationship to clinical symptoms of autism.

METHODS

We used an event-related functional magnetic resonance imaging task to measure neural activity and connectivity during processing of sad and happy emotional prosody and neutral speech in 22 children with autism and 21 matched control children (7-12 years old). We employed functional connectivity analyses to test competing theoretical accounts that attribute emotional prosody impairments to either sensory processing deficits in auditory cortex or theory of mind deficits instantiated in the temporoparietal junction (TPJ).

RESULTS

Children with autism showed specific behavioral impairments for recognizing emotions from voices. They also showed aberrant functional connectivity between voice-sensitive auditory cortex and the bilateral TPJ during emotional prosody processing. Neural activity in the bilateral TPJ during processing of both sad and happy emotional prosody stimuli was associated with social communication impairments in children with autism. In contrast, activity and decoding of emotional prosody in auditory cortex was comparable between autism and control groups and did not predict social communication impairments.

CONCLUSIONS

Our findings support a social-cognitive deficit model of autism by identifying a role for TPJ dysfunction during emotional prosody processing. Our study underscores the importance of tuning in to vocal-emotional cues for building social connections in children with autism.

The impact of developmental language disorder in a defendant's description on mock jurors' perceptions and judgements

BACKGROUND

While it has been posited that young people with language needs may be viewed more negatively (e.g., as more rude, less cooperative) than those without language needs, the impact of knowing about a person's language needs on others' perceptions has yet to experimentally tested.

AIMS

To examine whether the presence of a developmental language disorder (DLD) diagnosis in a defendant's information would affect mock juror ratings of guilt, sentence length, credibility and blameworthiness.

METHODS & PROCEDURES

A total of 143 jury eligible participants read a vignette of a non-violent crime. Half of the participants (N = 73) were told the defendant has a diagnosis of DLD, while half (N = 70) were not told.

OUTCOMES & RESULTS

Preregistered analyses found that DLD information affected ratings of credibility and blameworthiness, though not judgements of guilt or sentence length. Unregistered content analyses were applied to the justifications participants gave for their ratings: these suggested that participants who did not have the DLD information judged the defendant more on his personality and attitude, and drew more links to his (perceived) background, while participants who received the DLD information condition made more reference to him having cognitive problems.

CONCLUSIONS & IMPLICATIONS

Unlike in previous studies of the impact of autism information, information about a defendant's DLD did not affect mock jurors' likelihood of finding them guilty, or lead participants to give longer sentences. However, our findings suggest knowing a person has DLD does affect others' perceptions of credibility and blameworthiness.

WHAT THIS PAPER ADDS

What is already known on the subject There is already evidence that some conditions that affect communication, specifically autism, also affect juror perceptions. Research also shows that knowing whether or not a defendant has autism influences how jurors rate defendants. However, autism is not the only condition that is relevant to juror perceptions, as we also know that a high rate of young offenders have language needs, and many have language profiles like DLD. What this paper adds to existing knowledge There is little research on how behaviours associated with DLD impact others' perceptions. This study reports the impact of knowing about a defendant's DLD on juror perceptions, investigating whether knowing about DLD improves judgements on guilt, sentencing lengths, credibility and culpability. Beyond the content of youth offending, this study suggests behaviours associated with DLD lead people to form more negative judgements about youth with DLD. This is important because there is still a lack of awareness of DLD both in- and outside the criminal justice system. What are the potential or actual clinical implications of this work? This study shows that knowing about a person's DLD has largely positive effects on others' perceptions of them. This implies that recognizing undetected language needs in young offenders, and supporting colleagues and members of the public to know what DLD is and how it affects people, is critical for youth with DLD to be judged fairly. This study will support the case for raising awareness of vulnerability within the youth justice population, and will assist in clinicians evidencing the need for our roles in justice settings.

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.

Language Intervention Isn't Just Spoken: Assessment and Treatment of a Deaf Signing Child With Specific Language Impairment

Purpose This case study describes the language evaluation and treatment of a 5-year-old boy, Lucas, who is Deaf, uses American Sign Language (ASL), and presented with a language disorder despite native access to ASL and no additional diagnosis that would explain the language difficulties. Method Lucas participated in an evaluation where his nonverbal IQ, fine motor, and receptive/expressive language skills were assessed. Language assessment included both formal and informal evaluation procedures. Language intervention was delivered across 7 weeks through focused stimulation. Results Evaluation findings supported diagnosis of a language disorder unexplained by other factors. Visual analysis revealed an improvement in some behaviors targeted during intervention (i.e., number of different verbs and pronouns), but not others. In addition, descriptive analysis indicated qualitative improvement in Lucas' language production. Parent satisfaction survey results showed a high level of satisfaction with therapy progress, in addition to a belief that Lucas improved in language areas targeted. Conclusions This study adds to the growing body of literature that unexplained language disorders in signed languages exist and provides preliminary evidence for positive outcomes from language intervention for a Deaf signing child. The case described can inform professionals who work with Deaf signing children (e.g., speech-language pathologists, teachers of the Deaf, and parents of Deaf children) and serve as a potential starting point in evaluation and treatment of signed language disorders. Supplemental Material https://doi.org/10.23641/asha.16725601.

The Role of Vocabulary Skills in a Storybook-Based Intervention to Stimulate Emotion Comprehension in Preschoolers

Understanding emotions is an important predictor of children's mental health and school adjustment. However, interventions to improve this skill are not always accessible to all children. In 2019, Roy, Dénommée, and Quenneville developed stories with content specifically designed to 'teach' about emotions. Because it is a literacy-oriented intervention, it is possible that vocabulary may play a role in learning. This project explored the role of vocabulary in understanding emotion in preschool children and its learning. Forty-three preschoolers (19 control and 24 experimental) were evaluated on vocabulary skills and emotion comprehension. For multiple components, results showed an effect of time of measure, regardless of group. However, the addition of receptive vocabulary as a covariate made this effect non-significant. Results revealed that the stories were an effective strategy in promoting emotion comprehension for Components Belief and Reminder; two skills that are in the process of development in this age group. Furthermore, vocabulary skills did not impact the interaction for Belief for post-test gains and, for Reminder, while emotional vocabulary skills impacted the interaction at post-test, receptive vocabulary did not.

Atypical Facial Emotion Recognition in Children with Autism Spectrum Disorders: Exploratory Analysis on the Role of Task Demands

People with autism spectrum disorders (ASDs) have difficulty with socio-emotional functioning; however, research on facial emotion recognition (FER) remains inconclusive. Individuals with ASD might be using atypical compensatory mechanisms that are exhausted in more complex tasks. This study compared response accuracy and speed on a forced-choice FER task using neutral, happy, sad, disgust, anger, fear and surprise expressions under both timed and non-timed conditions in children with and without ASD (n = 18). The results showed that emotion recognition accuracy was comparable in the two groups in the non-timed condition. However, in the timed condition, children with ASD were less accurate in identifying anger and surprise compared to children without ASD. This suggests that people with ASD have atypical processing of anger and surprise that might become challenged under time pressure. Understanding these atypical processes, and the environmental factors that challenge them, could be beneficial in supporting socio-emotional functioning in people ASD.

The Association between Parent and Child-Report Measures of Alexithymia in Children with and without Developmental Language Disorder

Accurate measures of alexithymia, an inability to recognise and describe one’s own emotions, that are suitable for children are crucial for research into alexithymia’s development. However, previous research suggests that parent versus child reports of alexithymia do not correlate. Potentially, children may report on the awareness of their emotions, whereas parent-report measures may reflect children’s verbal expression of emotion, which may be confounded by children’s communicative abilities, especially in conditions such as Developmental Language Disorder (DLD). Given theoretical arguments that alexithymia may develop due to language impairments, further research into alexithymia in DLD is also needed. This project examined parent and child report measures of alexithymia in children with DLD (n = 106) and without DLD (n = 183), and their association to children’s communication skills. Parent and child reports were not significantly correlated in either group, and children with DLD had higher alexithymia scores on the parent-report measure only. Thus, parent and child measures of alexithymia likely reflect different constructs. Pragmatic language problems related to more parent-reported alexithymia, over and above group membership. Structural language abilities were unrelated to alexithymia. We suggest decreased social learning opportunities, rather than a language measure artefact, underlie increased alexithymic difficulties in DLD.

A Multimodal Comparison of Emotion Categorization Abilities in Children With Developmental Language Disorder

Purpose Current research has demonstrated that behavioral, emotional, and/or social difficulties often accompany developmental language disorder (DLD). It is an open question to what degrees such difficulties arise as consequence of impaired language and communicative skills, or whether they might also be driven by deficits in verbal and nonverbal emotion processing (e.g., the reduced ability to infer and verbalize emotional states from facial expressions). Regarding the existence of nonverbal deficits, previous research has yielded inconsistent findings. This study was aimed at gaining deeper knowledge of the basic aspects of emotion understanding in children with DLD by comparing their performance on nonverbal and verbal emotion categorization tasks to that of typically developing children. Method Two verbal tasks (Lexical Decision and Valence Decision With Emotion Terms) and two nonverbal tasks (Face Decision and Valence Decision With Facial Expressions) were designed to parallel each other as much as possible, and conducted with twenty-six 6- to 10-year-old children diagnosed with DLD. The same number of typically developed children, carefully matched by age and gender, served as a control group. Results The children with DLD showed lower performance in both verbal tasks and exhibited noticeable problems in the nonverbal emotion processing task. In particular, they achieved lower accuracy scores when they categorized faces by their valence (positive or negative), but did not differ in their ability to distinguish these faces from pictures displaying animals. Conclusions This study provides evidence for the hypothesis that problems in emotion processing in children with DLD might be multimodal. Therefore, the results support the idea of mutual influences in the development of language and emotion skills and contribute to the current debate about the domain specificity of DLD (formerly referred to as specific language impairment).

Pragmatic Language and Social Communication Tests for Students Aged 8–18 Years: A Review of Test Accuracy

Purpose

The accuracy of commercially available pragmatic language and social communication tests was reviewed.

Method

Online sources were searched to identify tests providing stand-alone pragmatic or social communication scores. Test manuals were examined to extract information about clinical and typically developing group comparisons, including sample size, inclusionary/exclusionary criteria, and mean group differences. Classification accuracy metrics, including sensitivity, specificity, optimal cut scores, and likelihood ratios, were reviewed.

Results

Six domain-specific pragmatic language and social communication tests and four omnibus language tests were identified. Test content varied and included video and audio recordings and question-and-answer formats to address hypothetical social vignettes, retell and comprehend narratives, interpret nonliteral language and multiple-meaning words, identify and display emotions, and infer another's perspective. Sample size and inclusionary/exclusionary criteria for comparisons of students with typical development (TD), developmental language disorder (DLD), autism spectrum disorder (ASD), and social (pragmatic) communication disorder (SPCD) varied widely. Mean group differences between TD and ASD or SPCD groups were generally larger (i.e., > 0.5 SD to > 2.0 SD s) than TD and DLD comparisons. Test authors interpreted these results as support for the accuracy of tests to identify deficits associated with ASD and SPCD and not DLD. Classification accuracy was reported for five domain-specific tests. Optimal cut scores ranged from 85 to 92, with adequate sensitivity and specificity (i.e., ≥ 80%); however, positive likelihood ratios and associated confidence intervals revealed limited confidence in reported levels.

Conclusions

Inadequate sample description for comparison and classification studies limit a clinician's ability to compare a student's profile with those in the samples. Although none of the tests meet all standards for test accuracy reviewed in this report, a checklist to guide test selection is provided to assist in identifying the best available test for a student's profile, if a test is needed.

What is the nature of peer interactions in children with language disorders? A qualitative study of parent and practitioner views

Background and aims

Children with Language Disorders (LDs) can exhibit increased levels of social withdrawal, aggression and problems managing social conflicts. The reasons underlying this pattern of social interaction profiles remain unclear. This qualitative study aimed to document the nature of social interactions between children with LDs and their peers, and to evaluate explanations for their social behaviour, as understood by parents and practitioners.

Methods

This study focused on children with LDs who spend school hours with other children with LDs. Three parent focus groups (n = 8) and three practitioner focus groups (n = 10) were conducted with parents of children aged 4-12 attending specialist language schools and practitioners working at these schools. This was a mixed clinical sample. All children of participating parents had LD as their primary area of need, which was the reason they required specialist schooling. Focus groups were conducted across two specialist schools in the UK between March and June 2018.

Results

An inductive reflective thematic analysis of the data identified three themes; social knowledge, coping strategies, and emotional competence. Parents and school staff reported that children with LDs experience difficulties managing peer interactions due to a combination of challenges including difficulties with understanding and regulating emotions, and difficulties understanding social situations. Some of the children with LDs were described as having developed strategies to cope with their challenges, for example imposing structure on their social interactions to manage uncertainty, which has implications for their social interactions with peers.

Conclusions

Children with LDs have difficulties understanding emotions, difficulties understanding their peer's intentions and difficulties resolving conflict situations independently according to their parents and practitioners working with these children. Participants proposed a novel explanation that social withdrawal may be used adaptively by children with LDs to process information. This study demonstrates the complexity of the relationship between Language Disorders and peer interaction profiles.Implications: Suggestions are offered regarding future research directions, such as investigating the specific contribution language skills make to children's emotion understanding, to better understand the reasons for peer interaction difficulties in children with Language Disorders.

The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan

The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.

Early language competence, but not general cognitive ability, predicts children's recognition of emotion from facial and vocal cues

The ability to accurately identify and label emotions in the self and others is crucial for successful social interactions and good mental health. In the current study we tested the longitudinal relationship between early language skills and recognition of facial and vocal emotion cues in a representative UK population cohort with diverse language and cognitive skills (N = 369), including a large sample of children that met criteria for Developmental Language Disorder (DLD, N = 97). Language skills, but not non-verbal cognitive ability, at age 5–6 predicted emotion recognition at age 10–12. Children that met the criteria for DLD showed a large deficit in recognition of facial and vocal emotion cues. The results highlight the importance of language in supporting identification of emotions from non-verbal cues. Impairments in emotion identification may be one mechanism by which language disorder in early childhood predisposes children to later adverse social and mental health outcomes.

The Role of Diagnostic Instruments in Dual and Differential Diagnosis in Autism Spectrum Disorder Across the Lifespan

The heterogeneity inherent in autism spectrum disorder (ASD) makes the identification and diagnosis of ASD complex. We survey a large number of diagnostic tools, including screeners and tools designed for in-depth assessment. We also discuss the challenges presented by overlapping symptomatology between ASD and other disorders and the need to determine whether a diagnosis of ASD or another diagnosis best explains the individual's symptoms. We conclude with a call to action for the next steps necessary for meeting the diagnostic challenges presented here to improve the diagnostic process and to help understand each individual's particular ASD profile.

The role of linguistic and cognitive factors in emotion recognition difficulties in children with ASD, ADHD or DLD

BACKGROUND

Many children with neurodevelopmental disorders such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD) or developmental language disorder (DLD) have difficulty recognizing and understanding emotions. However, the reasons for these difficulties are currently not well understood.

AIMS

To compare the emotion recognition skills of children with neurodevelopmental disorders as well as those children's skills with the skills of their typically developing (TD) age peers. Also, to identify the role of underlying factors in predicting emotion recognition skills.

METHODS & PROCEDURES

The 6-10-year-old children (n = 50) who participated in the study had either ASD, ADHD or DLD and difficulties recognizing emotions from face and/or in voice. TD age peers (n = 106) served as controls. Children's skills were tested using six forced-choice tasks with emotional nonsense words, meaningful emotional sentences, the FEFA 2 test, photographs, video clips and a task in which facial expressions and tones of voice had to be matched. Expressive vocabulary, rapid serial naming, auditory and visual working memory and Theory of Mind skills were explored as possible explanatory factors of the emotion recognition difficulties of the diagnosed children.

OUTCOMES & RESULTS

Children with ASD, ADHD or DLD did not significantly differ from each other in their linguistic or cognitive skills. Moreover, there were only minor differences between children with these diagnoses in recognizing facial expressions and emotional tone of voice and matching the two. The only significant difference was that children with ADHD recognized facial expressions in photographs better than children with DLD. The participants with diagnoses scored significantly lower than the controls in all but one emotion recognition tasks presented. According to the linear regression analysis, first-order Theory of Mind skills predicted the delay relative to typical development in the recognition of facial expressions in the FEFA 2 test, and expressive vocabulary and working memory skills together predicted the delay in the recognition of emotions in the matching task.

CONCLUSIONS & IMPLICATIONS

Children with ASD, ADHD or DLD showed very similar emotion recognition skills and were also found to be significantly delayed in their development of these skills. Some predictive factors related to linguistic and cognitive skills were found for these difficulties. Information about impaired emotion recognition and underlying linguistic and cognitive skills helps to select intervention procedures. Without this information, therapy might unnecessarily focus on only symptoms.

Why is music therapeutic for neurological disorders? The Therapeutic Music Capacities Model

Music has cognitive, psychosocial, behavioral and motor benefits for people with neurological disorders such as dementia, stroke, Parkinson's disease (PD) and Autism Spectrum Disorder (ASD). Here we discuss seven properties or 'capacities' of music that interact with brain function and contribute to its therapeutic value. Specifically, in its various forms, music can be engaging, emotional, physical, personal, social and persuasive, and it promotes synchronization of movement. We propose the Therapeutic Music Capacities Model (TMCM), which links individual properties of music to therapeutic mechanisms, leading to cognitive, psychosocial, behavioral and motor benefits. We review evidence that these capacities have reliable benefits for people with dementia, stroke, PD and ASD when employed separately or in combination. The model accounts for the profound value that music affords human health and well-being and provides a framework for the development of non-pharmaceutical treatments for neurological disorders.

Emotion Recognition in Kindergarten Children

BACKGROUND/AIMS

Recognition and understanding of emotions are essential skills in nonverbal communication and in everyday social functioning. These are already evident in infancy. We aimed to compare how young children recognize facial emotional expressions from static faces versus vocal emotional expressions from speech prosody.

METHODS

Participants were 313 kindergarten children (162 girls, mean age = 51.01, SD 9.65 months; range 36-72). The design consisted of a visual and an auditory block (with 45 randomized trials each). Children were seated in front of a 14-inch laptop monitor and received visual stimuli (photos of faces) or auditory stimuli (spoken sentences) via loudspeakers.

RESULTS

Recognizing emotions from looking at static faces was found to be easier compared to interpreting emotions transmitted by speech prosody alone. The ability to interpret emotions from both faces and speech prosody increased with age. It was easier to identify a "happy" emotion from a facial expression than an "angry" or "sad" one, whereas a "sad" emotion could be more easily recognized from speech prosody alone than facial imagery alone. Girls were significantly better than boys in identifying "sad" facial expressions.

CONCLUSION

The results of the study are discussed in terms of educational implications for nonverbal communication.

Facial emotion recognition in children treated for posterior fossa tumours and typically developing children: A divergence of predictors

Facial emotion recognition (FER) deficits are evident and pervasive across neurodevelopmental, psychiatric, and acquired brain disorders in children, including children treated for brain tumours. Such deficits are thought to perpetuate challenges with social relationships and decrease quality of life. The present study combined eye-tracking, neuroimaging and cognitive assessments to evaluate if visual attention, brain structure, and general cognitive function contribute to FER in children treated for posterior fossa (PF) tumours (patients: n = 36) and typically developing children (controls: n = 18). To assess FER, all participants completed the Diagnostic Analysis of Nonverbal Accuracy (DANVA2), a computerized task that measures FER using photographs, while their eye-movements were recorded. Patients made more FER errors than controls (p < .01). Although we detected subtle deficits in visual attention and general cognitive function in patients, we found no associations with FER. Compared to controls, patients had evidence of white matter (WM) damage, (i.e., lower fractional anisotropy [FA] and higher radial diffusivity [RD]), in multiple regions throughout the brain (all p < .05), but not in specific WM tracts associated with FER. Despite the distributed WM differences between groups, WM predicted FER in controls only. In patients, factors associated with their disease and treatment predicted FER. Our study provides insight into predictors of FER that may be unique to children treated for PF tumours, and highlights a divergence in associations between brain structure and behavioural outcomes in clinical and typically developing populations; a concept that may be broadly applicable to other neurodevelopmental and clinical populations that experience FER deficits.

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Children treated for brain tumours have difficultly recognizing facial emotions.

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White matter predicts facial emotion recognition (FER) in typical development.

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Medical factors predict FER deficits in children treated for brain tumours.

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Brain-behaviour relations can diverge in the typical and atypical developing brain.

Emotional prosodic change detection in autism Spectrum disorder: an electrophysiological investigation in children and adults

Background

Autism spectrum disorder (ASD) is characterized by atypical behaviors in social environments and in reaction to changing events. While this dyad of symptoms is at the core of the pathology along with atypical sensory behaviors, most studies have investigated only one dimension. A focus on the sameness dimension has shown that intolerance to change is related to an atypical pre-attentional detection of irregularity. In the present study, we addressed the same process in response to emotional change in order to evaluate the interplay between alterations of change detection and socio-emotional processing in children and adults with autism.

Methods

Brain responses to neutral and emotional prosodic deviancies (mismatch negativity (MMN) and P3a, reflecting change detection and orientation of attention toward change, respectively) were recorded in children and adults with autism and in controls. Comparison of neutral and emotional conditions allowed distinguishing between general deviancy and emotional deviancy effects. Moreover, brain responses to the same neutral and emotional stimuli were recorded when they were not deviants to evaluate the sensory processing of these vocal stimuli.

Results

In controls, change detection was modulated by prosody: in children, this was characterized by a lateralization of emotional MMN to the right hemisphere, and in adults, by an earlier MMN for emotional deviancy than for neutral deviancy. In ASD, an overall atypical change detection was observed with an earlier MMN and a larger P3a compared to controls suggesting an unusual pre-attentional orientation toward any changes in the auditory environment. Moreover, in children with autism, deviancy detection depicted reduced MMN amplitude. In addition in children with autism, contrary to adults with autism, no modulation of the MMN by prosody was present and sensory processing of both neutral and emotional vocal stimuli appeared atypical.

Conclusions

Overall, change detection remains altered in people with autism. However, differences between children and adults with ASD evidence a trend toward normalization of vocal processing and of the automatic detection of emotion deviancy with age.

Victimization, Bullying, and Emotional Competence: Longitudinal Associations in (Pre)Adolescents With and Without Developmental Language Disorder

PURPOSE

Victimization is a common problem for many children but is exacerbated for children with a developmental language disorder (DLD). However, the severity of communication problems does not explain their victimization rates. In children without DLD, difficulties with emotional competence are a risk factor for victimization and also increase the risk of bullying. In this longitudinal study, we examined the extent to which the level and development of emotional competence (understanding of one's own emotions and levels of anger, sadness, and fear) contributed to the prediction of victimization and bullying in children with and without DLD, over and above the type and severity of communication problems of children with DLD.

METHOD

Clinically referred youngsters (8-16 years old) with (n = 112; 48% girls, 52% boys) and without (n = 233; 58% girls, 42% boys) DLD completed self-reports 3 times over an 18-month period. Parents of children with DLD reported on their children's communication problems.

RESULTS

Participants with DLD reported more victimization but comparable levels of bullying behavior compared with peers without DLD. Higher levels of sadness and fear were risk factors for more victimization in both groups. Better understanding of one's own emotions had a larger effect on less victimization in children with DLD, independent of their communication problems. In addition, increased levels of anger and lower levels of understanding of one's own emotions explained more bullying in both groups.

CONCLUSION

Outcomes indicate that secondary difficulties in emotional competence in children with DLD make these children more vulnerable to victimization and warrant specific support and interventions.

Impaired detection of happy facial expressions in autism

The detection of emotional facial expressions plays an indispensable role in social interaction. Psychological studies have shown that typically developing (TD) individuals more rapidly detect emotional expressions than neutral expressions. However, it remains unclear whether individuals with autistic phenotypes, such as autism spectrum disorder (ASD) and high levels of autistic traits (ATs), are impaired in this ability. We examined this by comparing TD and ASD individuals in Experiment 1 and individuals with low and high ATs in Experiment 2 using the visual search paradigm. Participants detected normal facial expressions of anger and happiness and their anti-expressions within crowds of neutral expressions. In Experiment 1, reaction times were shorter for normal angry expressions than for anti-expressions in both TD and ASD groups. This was also the case for normal happy expressions vs. anti-expressions in the TD group but not in the ASD group. Similarly, in Experiment 2, the detection of normal vs. anti-expressions was faster for angry expressions in both groups and for happy expressions in the low, but not high, ATs group. These results suggest that the detection of happy facial expressions is impaired in individuals with ASD and high ATs, which may contribute to their difficulty in creating and maintaining affiliative social relationships.

The power of stories: Facilitating social communication in children with limited language abilities

Children with limited language expression and comprehension abilities are at risk for academic failure, particularly in literacy acquisition. In addition, these children often have poor social outcomes, including difficulty forming friendships, social exclusion, withdrawal, and victimization. The academic and social difficulties that these children experience are associated with their poor language processing skills, limited conversational ability, and weak social and emotional knowledge. A social communication approach utilizing children’s literature is suggested as one approach to address these three areas simultaneously. This approach involves sharing books with a strong story structure, rich social and emotional content, and engaging illustrations. Flexible scripts are created to guide interventionists to elicit the production of complex sentence structures, highlight conversational cooperation, and facilitate emotion understanding. To provide continuity of instruction, these bibliotherapeutic procedures can be implemented by special service providers in intervention sessions as well as by teachers in general classroom activities.

Differential profiles in auditory social cognition deficits between adults with autism and schizophrenia spectrum disorders: A preliminary analysis

Impairment in social cognition, including emotion recognition, has been extensively studied in both Autism Spectrum Disorders (ASD) and Schizophrenia (SZ). However, the relative patterns of deficit between disorders have been studied to a lesser degree. Here, we applied a social cognition battery incorporating both auditory (AER) and visual (VER) emotion recognition measures to a group of 19 high-functioning individuals with ASD relative to 92 individuals with SZ, and 73 healthy control adult participants. We examined group differences and correlates of basic auditory processing and processing speed. Individuals with SZ were impaired in both AER and VER while ASD individuals were impaired in VER only. In contrast to SZ participants, those with ASD showed intact basic auditory function. Our finding of a dissociation between AER and VER deficits in ASD relative to Sz support modality-specific theories of emotion recognition dysfunction. Future studies should focus on visual system-specific contributions to social cognitive impairment in ASD.

Age, gender, and puberty influence the development of facial emotion recognition

Our ability to differentiate between simple facial expressions of emotion develops between infancy and early adulthood, yet few studies have explored the developmental trajectory of emotion recognition using a single methodology across a wide age-range. We investigated the development of emotion recognition abilities through childhood and adolescence, testing the hypothesis that children's ability to recognize simple emotions is modulated by chronological age, pubertal stage and gender. In order to establish norms, we assessed 478 children aged 6-16 years, using the Ekman-Friesen Pictures of Facial Affect. We then modeled these cross-sectional data in terms of competence in accurate recognition of the six emotions studied, when the positive correlation between emotion recognition and IQ was controlled. Significant linear trends were seen in children's ability to recognize facial expressions of happiness, surprise, fear, and disgust; there was improvement with increasing age. In contrast, for sad and angry expressions there is little or no change in accuracy over the age range 6-16 years; near-adult levels of competence are established by middle-childhood. In a sampled subset, pubertal status influenced the ability to recognize facial expressions of disgust and anger; there was an increase in competence from mid to late puberty, which occurred independently of age. A small female advantage was found in the recognition of some facial expressions. The normative data provided in this study will aid clinicians and researchers in assessing the emotion recognition abilities of children and will facilitate the identification of abnormalities in a skill that is often impaired in neurodevelopmental disorders. If emotion recognition abilities are a good model with which to understand adolescent development, then these results could have implications for the education, mental health provision and legal treatment of teenagers.