False belief attribution in children with Williams syndrome: the answer is in the emotion

News insights into social cognition in Williams syndrome from a comprehensive assessment and a virtual reality task

Although the uneven neuropsychological profile of William Syndrome (WS) is well established, less is known about social perception and how profile characteristics may affect the ability to predict other's intentions, a main hallmark of social cognition. This study aimed at examining the neuropsychological profile, including social perception, of adolescents and adults with WS, and at verifying which neuropsychological outcome might account for their social prediction ability. Twenty-six individuals with WS were administered a comprehensive neuropsychological assessment, and a virtual reality scenario designed to assess social prediction in a dynamic, everyday life-like context. We found that social perception was a relative strength of the profile, although a dissociation emerged between impaired verbal ToM and relatively spared low-level components. Peaks and valleys were reported in other domains consistently with the expected profile. Both spatial and facial memory were significantly associated with the performance at the social prediction task. Results clarified that social perception per se should not be considered as typically impaired in WS. Weaknesses and strengths in specific abilities, particularly spatial and facial memory, might affect the ability to understand others' intentions in WS beyond domain-specific mechanisms. These findings might inform future syndrome-specific rehabilitative interventions.

Development of emotion comprehension in children with autism spectrum disorder and Williams syndrome

Although research has shed light on the development of emotion comprehension in typically developing children, little is known about emotion comprehension in children who are developing atypically. Thus, this study examined the developmental trajectory of emotion understanding in non-clinical (NC) children and children with autism spectrum disorder (ASD) and Williams syndrome (WS) using a Test of Emotion Comprehension. In the test, we measured children's understanding of (I) recognition of emotions based on facial expressions, (II) external causes of emotions, (III) desire-based emotions, (IV) belief-based emotions, (V) the influence of a reminder on a present emotional state, (VI) regulating an experienced emotion, (VII) hiding an emotional state, (VIII) mixed emotions, and (IX) moral emotions. A Bayesian modeling approach was applied to compare the developmental trajectories of emotion understanding across the syndrome groups. The results revealed that NC children and children with WS followed significantly different developmental trajectories in specific aspects of emotion understanding, while children with ASD followed a very similar path to NC children. Children with ASD and NC children gradually developed an understanding of each component of emotion comprehension as they matured. However, the understanding of some components, such as desire-based emotions, hiding an emotional state, and moral emotions, in children with WS was affected by their Autism Spectrum Quotient scores. This is one of the first cross-syndrome studies to assess the development of emotion comprehension in children with ASD and WS, providing important insights for understanding the nature of disability and advancing the development of intervention programs.

Computerized False Belief Tasks Impact Mentalizing Ability in People with Williams Syndrome

People with Williams syndrome (WS) are characterized by hyper sociability, fluency in languages, and advantageous face-processing skills, leading to the proposal of a social module. Previous studies on the mentalizing abilities of people with WS using two-dimensional pictures, including normal-like, delayed, and deviant behaviors, have yielded mixed results. Thus, this study examined the mentalizing ability of people with WS through structured computerized animations of false belief tasks to investigate whether inferences about other people's minds can be improved in this population. Participants were shown animations containing unexpected location and content changes. After viewing each animation, participants had to answer four types of questions relating to character identification, reality, memory, and false belief. Their responses were recorded and analyzed. A comprehension of false belief was observed in 4-year-old healthy children, whereas children with WS showed enhanced comprehension of false belief (until they attained a chronological age [CA] of 5.9 years), suggesting an improvement in the theory of mind resulting from viewing structured computerized animations. This age is earlier than that reported by previous studies for using theory of mind to pass false belief tests (CA 9 years), even challenging the age at which individuals failed to pass the tests (CA 17.11 years). Structured computerized animations enhanced the mentalizing ability of people with WS to a certain extent. Compared to the typically developing controls, people with WS presented with a lower developmental level in processing false belief tasks. This study has educational implications for the development of computerized social skills interventions for people with WS.

Investigating basic emotion knowledge of people with Williams syndrome

BACKGROUND

Emotional recognition is a key aspect of mentalizing other people's minds. People with Williams syndrome (WS) are reported to be hypersocial and empathetic; however, few studies have investigated their emotion processing ability.

AIMS

This study aimed to examine emotion knowledge in people with WS and to further understand their emotion-related mentalizing ability.

METHODS AND PROCEDURES

Six basic emotions (happiness, sadness, anger, fear, disgust, and surprise) were tested by narrating scenarios targeting specific emotions. Participants with WS (n = 16, 8F/8 M, CA = 8.46, MA = 5.27) listened to each scenario and pointed to an emoticon displayed on a card. Correct percentages of each target emotion and replacement by other emotions were analyzed. Comparison groups comprised mental age-matched controls (n = 16, 8F/8 M, CA = 5.26) and chronological age-matched controls (n = 16, 8 F/8 M, CA = 8.31), sixth graders (n = 20, 10F/10M, CA = 12.04), and college students (n = 20, 10F/10M, CA = 20.03). All were Chinese-speaking participants with right handedness.

OUTCOMES AND RESULTS

People with WS were delayed compared to the mental age-matched group but differed from the chronological age-matched group in emotion processing. The 6th graders showed different patterns from college students, suggesting that development of emotion processing takes time.

CONCLUSIONS AND IMPLICATIONS

These findings suggest (1) a gap in the maturation of emotion knowledge between people with WS and typically developing controls, (2) a nonequivalent chronological emotion-related mentalizing ability in people with WS, and (3) developmental changes in emotion processing from childhood to adulthood.

Understanding emotional language through events and words in people with Williams syndrome

Previous studies have mainly examined emotion recognition through face processing in individuals with Williams syndrome (WS). Contextual integration is an automatic and basic comprehension ability emerged from distinct modalities. This ability requires sensation to global configuration and local elements. However, neurodevelopmental disorders are characterized by local-focusing and global-ignoring in visuospatial perception. This causes cognitive atypicality as compared to typical development, including atypical face processing and emotion recognition. These impairments might result in deficits in theory of mind and social cognition. People with WS demonstrate impaired false-belief attribution, which was reported to be improved with emotional cues. Yet, no previous study has examined knowledge of emotional language in people with WS, which might be one of the factors affecting the development of the theory of mind in people with WS. In the present study, we examined knowledge of emotional language in people with WS by testing three emotions: positive, negative, and neutral. Participants were asked to press buttons indexing emotions in reaction to auditory targets. In the emotional event study, people with WS demonstrated responses to positive events in the normal range, delayed responses to negative events, and deviant responses to neutral events. In the emotion word study, people with WS showed the lowest accuracy and longest reaction times for neutral words. These findings indicated asymmetrical and atypical knowledge of emotional language in people with WS, confirming that knowledge of emotional expressions influences the development of the theory of mind and social cognition.

Parental report of cognitive and social-emotionality traits in school-age children with autism and Williams syndrome

The majority of the research examining children with Autism Spectrum Disorder (ASD) and Williams Syndrome (WS) focus on the social domain while few have examined cognitive style and emotionality. Accordingly, this current study assessed the day-to-day cognitive and behavioral functioning of school-age children with ASD, WS, and neurotypical development (ND) through caregiver-report inventories to further delineate commonalities and disparities in cognitive and social-emotional traits. Two caregiver-report inventories, the Children's Behavior Questionnaire and the Multidimensional Personality Questionnaire were employed to assess the day-to-day functioning of children ages 7-14 years. Participants included 64 caregivers of children, of these, 25 were caregivers of children with high functioning autism (HFA), 14 with WS, and 25 with ND. Multivariate analysis of covariance was computed to assess between-group differences for each subscale within a questionnaire. Covariates included age and full-scale IQ. For cognitive traits, group differences were observed across two categories while seven were present within the social-emotional categories. The majority of the group effects reflected differences in social-emotional traits between ND and both neurodevelopmental groups, while limited distinctions were found between the two clinical groups. This brief report provides additional evidence that HFA and WS may show similarities in cognitive traits but more divergent social-emotional tendencies, despite controlling for age and intellect. This study highlights the large social-emotional differences that supports prior phenotypic descriptions of both neurodevelopmental groups. Future research in these domains are needed to determine focused interventions to address social impairment.

Williams syndrome: recent advances in our understanding of cognitive, social and psychological functioning

PURPOSE OF REVIEW

Since the last review of Williams syndrome in Current Opinion (2001) there have been many advances in knowledge about the cognitive, social and psychological impairments that characterize the disorder. The present review focuses on current research in these areas.

RECENT FINDINGS

Williams syndrome is associated with a wide range of cognitive, linguistic, social and other difficulties. When young, these deficits may appear relatively mild - for example, many children are highly sociable and talkative - but with age the impact of these difficulties becomes more evident. Thus, inappropriate social behaviours can significantly increase the risk of social exclusion and vulnerability to abuse. Their superficially good speech can lead to educational and other services failing to understand the true extent of impairments or the need for specialist support. Mental health problems, especially related to anxiety, often become an increasing challenge from adolescence onwards.

SUMMARY

The core difficulties associated with Williams syndrome have a cascading effect on many areas of development over time. However, specialist provision is rare and intervention trials are almost nonexistent. Longitudinal research is needed to identify factors associated with cognitive, social and emotional problems and to develop more effective ways of minimizing and treating difficulties.