Predicting intervention use in autistic children: Demographic and autism-specific characteristics.

LAY ABSTRACT: Autism is a condition that is characterised by social communication difficulties and restrictive and repetitive behaviours or interests. Autism can present in many different ways and various interventions are available. Some interventions are conventional, and they are recommended to be used for children with autism (guideline therapies) or for other disorders such as anxiety or attention-deficit hyperactivity disorder (mainstream therapies or medication), while others are less conventional (other therapies or medication, they are discouraged, unknown or alternative). Little is known about who chooses which intervention. This study found that most autistic children use some kind of intervention. Children who attend special education or have an additional diagnosis (other than autism) tend to receive more therapies, while children with a lower IQ receive fewer therapies. Older children, children with a higher IQ and girls are more likely to use conventional (mainstream or guideline) therapies. Children whose parents have a lower educational level are more likely to have used conventional medication. Whereas, children with more sensory issues (e.g. sensitivity to sound, smell or movement) were more likely to have used unconventional medication. This study found that other autism-related characteristics such as the number of autism symptoms, social skills and repetitive and restrictive behaviours were not related to the interventions used. More treatments focussed on multiple problems should be available for children with autism who have additional difficulties.

Block Design Performance in Williams Syndrome: Visuospatial Abilities or Task Approach Skills?

The block design task (BDT) is a visuospatial measure that individuals with Williams syndrome (WS) perform poorly on. However, it is unclear what underlies their impaired performance. This study investigated whether poorer performance is a result of visuospatial difficulties, executive function (EF) difficulties, atypical looking strategies, or a combination of these. Eleven individuals with WS participated alongside mental age (MA)- and chronological age (CA)-matched control groups. Eye movements were recorded while they took the BDT. Dwell times and visits to areas of interest in WS differed from CA, but not MA, groups. Findings suggest that BDT abilities of individuals with WS are delayed, but not atypical. Delays result from visuospatial and attention-switching difficulties rather than atypical looking strategies.

Inferring Mental States From Dynamic Faces in Adolescents With Autism Spectrum Disorder: Insights From Eye Tracking.

There is mixed evidence concerning whether individuals with autism spectrum disorder (ASD) can infer mental states from the eyes. This study aims to elucidate whether they use less efficient strategies. Sixteen adolescents with ASD (11-16 year olds) were compared to a chronological age- and IQ-matched sample of 16 typically developing (TD) adolescents. Eight mental states were presented as full dynamic faces and in conditions altering the presence of expressive dynamic information from the eyes and mouth. Bayes factors revealed that adolescents with ASD had similar accuracy, response times (less conclusive), and fixations to TD adolescents. Findings imply that adolescents with ASD spontaneously fixate on the eyes, and not all individuals with ASD have difficulties inferring mental states from faces.

Revealing variations in perception of mental states from dynamic facial expressions: a cautionary note.

Although a great deal of research has been conducted on the recognition of basic facial emotions (e.g., anger, happiness, sadness), much less research has been carried out on the more subtle facial expressions of an individual's mental state (e.g., anxiety, disinterest, relief). Of particular concern is that these mental state expressions provide a crucial source of communication in everyday life but little is known about the accuracy with which natural dynamic facial expressions of mental states are identified and, in particular, the variability in mental state perception that is produced. Here we report the findings of two studies that investigated the accuracy and variability with which dynamic facial expressions of mental states were identified by participants. Both studies used stimuli carefully constructed using procedures adopted in previous research, and free-report (Study 1) and forced-choice (Study 2) measures of response accuracy and variability. The findings of both studies showed levels of response accuracy that were accompanied by substantial variation in the labels assigned by observers to each mental state. Thus, when mental states are identified from facial expressions in experiments, the identities attached to these expressions appear to vary considerably across individuals. This variability raises important issues for understanding the identification of mental states in everyday situations and for the use of responses in facial expression research.

Looking and thinking: how individuals with Williams syndrome make judgements about mental states.

Individuals with the neuro-developmental disorder Williams syndrome (WS) are characterised by a combination of features which makes this group vulnerable socially, including mild-moderate cognitive difficulties, pro-social drive, and indiscriminate trust. The purpose of this study was to explore a key socio-communicative skill in individuals with WS, namely, mental state recognition abilities. We explored this skill in a detailed way by looking at how well individuals with WS recognise complex everyday mental states, and how they allocate their attention while making these judgements. Participants with WS were matched to two typically developing groups for comparison purposes, a verbal ability matched group and a chronological age matched group. While eye movements were recorded, participants were shown displays of eight different mental states in static and dynamic form, and they performed a forced-choice judgement on the mental state. Mental states were easier to recognise in dynamic form rather than static form. Mental state recognition ability for individuals with WS was poorer than expected by their chronological age, and at the level expected by their verbal ability. However, the pattern of mental state recognition for participants with WS varied according to mental state, and we found some interesting links between ease/difficulty recognising some mental states (worried/do not trust) and the classic behavioural profile associated with WS (high anxiety/indiscriminate trust). Furthermore, eye tracking data revealed that participants with WS allocated their attention atypically, with less time spent attending the information from the face regions. This challenges the widely held understanding of WS being associated with prolonged face and eye gaze, and indicates that there is more heterogeneity within this disorder in terms of socio-perception than previous reports would suggest.

Can individuals with Williams syndrome interpret mental states from moving faces?

The Williams syndrome (WS) social phenotype is characterised by a high level of social engagement, heightened empathy and prolonged attention to people's faces. These behaviours appear in contradiction to research reporting problems recognising and interpreting basic emotions and more complex mental states from other people. The current task involved dynamic (moving) face stimuli of an actor depicting complex mental states (e.g., worried, disinterested). Cues from the eye and mouth regions were systematically frozen and kept neutrally expressive to help identify the source of mental state information in typical development and WS. Eighteen individuals with WS (aged 8-23 years) and matched groups of typically developing participants were most accurate inferring mental states from whole dynamic faces. In this condition individuals with WS performed at a level predicted by chronological age. When face parts (eyes or mouth) were frozen and neutrally expressive, individuals with WS showed the greatest decrement in performance when the eye region was uninformative. We propose that using moving whole face stimuli individuals with WS can infer mental states and the eye region plays a particularly important role in performance.

Two sources of evidence on the non-automaticity of true and false belief ascription.

A recent study by Apperly et al. (2006) found evidence that adults do not automatically infer false beliefs while watching videos that afford such inferences. This method was extended to examine true beliefs, which are sometimes thought to be ascribed by "default" (e.g., Leslie & Thaiss, 1992). Sequences of pictures were presented in which the location of an object and a character's belief about the location of the object often changed. During the picture sequences participants responded to an unpredictable probe picture about where the character believed the object to be located or where the object was located in reality. In Experiment 1 participants were not directly instructed to track the character's beliefs about the object. There was a significant reaction time cost for belief probes compared with matched reality probes, whether the character's belief was true or false. In Experiment 2, participants were asked to track where the character thought the object was located, responses to belief probes were faster than responses to reality probes, suggesting that the difference observed in Experiment 1 was not due to intrinsic differences between the probes, but was more likely to be due to participants inferring beliefs ad hoc in response to the probe. In both Experiments 1 and 2, responses to belief and reality probes were faster in the true belief condition than in the false belief condition. In Experiment 3 this difference was largely eliminated when participants had fewer reasons to make belief inferences spontaneously. These two lines of evidence are neatly explained by the proposition that neither true nor false beliefs are ascribed automatically, but that belief ascription may occur spontaneously in response to task demands.

The cost of thinking about false beliefs: evidence from adults' performance on a non-inferential theory of mind task.

Much of what we know about other people's beliefs comes non-inferentially from what people tell us. Developmental research suggests that 3-year-olds have difficulty processing such information: they suffer interference from their own knowledge of reality when told about someone's false belief (e.g., [Wellman, H. M., & Bartsch, K. (1988). Young children's reasoning about beliefs. Cognition, 30, 239-277.]). The current studies examined for the first time whether similar interference occurs in adult participants. In two experiments participants read sentences describing the real colour of an object and a man's false belief about the colour of the object, then judged the accuracy of a picture probe depicting either reality or the man's belief. Processing costs for picture probes depicting reality were consistently greater in this false belief condition than in a matched control condition in which the sentences described the real colour of one object and a man's unrelated belief about the colour of another object. A similar pattern was observed for picture probes depicting the man's belief in most cases. Processing costs were not sensitive to the time available for encoding the information presented in the sentences: costs were observed when participants read the sentences at their own pace (Experiment 1) or at a faster or a slower pace (Experiment 2). This suggests that adults' difficulty was not with encoding information about reality and a conflicting false belief, but with holding this information in mind and using it to inform a subsequent judgement.

Do the eyes have it? Inferring mental states from animated faces in autism.

The ability of individuals with autistic spectrum disorders (ASD) to infer mental states from dynamic and static facial stimuli was investigated. In Experiment 1, individuals with ASD (10- to 14-year olds; N=18) performed above chance but not as well as controls. Accuracy scores for mental states did not differ between dynamic and static faces. Furthermore, participants with ASD gained higher scores when the eyes conveyed information than when this region remained static and neutral. Experiment 2 revealed that those with ASD (11- to 15-year olds; N=18) were as successful as controls in recognizing mental states when the eyes were presented in isolation or in the context of the whole face. Findings challenge claims that individuals with ASD are impaired at inferring mental states from the eyes.