There is a general consensus that most children with autism have difficulty recognizing emotional expressions, especially in non-verbal contexts. This difficulty affects social interactions as children with autism often miss key emotion-related social cues preventing them from engaging in the ‘expected’ behavior (for example stopping a particular theme in a conversation when someone appears to be uncomfortable or upset about the topic). Yet, our understanding of the deficits in the processing of verbal information is more limited. For example, are children with high functioning autism impaired in recognizing the emotional content provided in the words of a conversation, the emotional content embedded in how the words are spoken, or both? In addition, what could be the underlying cause of such deficit? One possibility is that affected children differ from typically developing children in the way their brains process such emotional information. For example, it is thought that the right hemisphere plays a key role in the processing of ‘negative emotions’ while the left hemisphere plays a role in the processing of positive emotions (although there is a compelling alternative theory that refutes such ‘emotional valance’ explanation and instead proposes that different hemispheres process different motivational content [approach vs. withdrawal] with the left hemisphere processing approach related content and the right hemisphere processing withdrawal related information). Nonetheless, there is preliminary evidence that suggest that kids with autism do not show this ‘typical’ hemisphere specialization and instead show involvement of both hemispheres with processing emotional verbal content.

In an article to be published in the Journal of Autism and Developmental Disorders, Dr. Kimberly Baker and a team from the University of South Carolina report the findings from a very interesting study on the perception of spoken emotions by typically developing children and kids with high functioning autism and Aspergers’s disorder. The authors were interested in expanding our understanding the way children with HFA and Asperger’s process spoken emotions. The study included a combined group of 19 kids with HFA or Asperger’s (labeled High Functioning Forms of Autism, or HFFA) and 19 typically developing children. Both groups included 13 males and 6 females. The range in age from 10 to 14 years, with a mean age of 12 in both groups. All participants were right handed.

The study used 4 nonsense passages that were narrated to display four emotions: Anger, Happy, Sadness, and neutral. These passages were presented using a Dichotic Listening Task. In this task, two passages containing two different emotions were presented simultaneously to the right or left ear. For example, the happy passage was presented to the right ear while the sad passage was presented to the left ear.  The children then had to select the emotions included in both passages using a multiple-choice sheet.

The results:

  1. There was no difference between the autism and typically developing groups in the proportion of correct responses identifying emotions. See the figure below.
  2. There was no difference between the groups in the way the cerebral hemisphere processed the emotions
  3. When combining both groups,  sadness was processed better when presented to the left ear (processed by the right hemisphere). However, there was no hemisphere difference in the processing of anger or happiness.
hfalistening

HFA vs. Typically developing kids in the recognition of spoken emotions

Definitely the most critical limitation of this study is the sample size. The number of participants in each group (19) makes it very difficult to find statistically significant differences between the groups even when the differences actually exist. However, looking at the graphic above we can see that the HFFA group actually scored better (albeit not statistically significantly better) that then typically developing group when the emotion was presented to the left ear, and a bit worse when the emotion was presented to the right ear. The patterns for each emotion were also mixed, with the HFFA scoring better for some emotions (Anger, Neutral) and worse for others (Happy, Sadness). Therefore, there was no clear pattern or tendency in the results that would suggest that the lack of significant findings would be mostly due to limitations in the sample size. The authors stated that these findings are consistent with other recent examinations of emotion recognition deficits in autism that suggest that such deficits are more related to general cognitive deficits rather than the presence of autism.

The reference:

Baker, K., Montgomery, A., & Abramson, R. (2009). Brief Report: Perception and Lateralization of Spoken Emotion by Youths with High-Functioning Forms of Autism Journal of Autism and Developmental Disorders DOI: 10.1007/s10803-009-0841-1

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10 Responses to Understanding spoken emotions by children with autism

  1. “Definitely the most critical limitation of this study is the sample size.”

    I respectfully disagree.

    In my humble, and admittedly biased opinion, as the father of a Low Functioning autistic son, the failure to design studies which would tell us something about those who are most severely impaired by autism, the low functioning autistic persons with Autistic Disorder is the most critical limitation of this and other similar studies of HFA.

    Again, that is my humble, and admittedly biased opinion.

    • Hi Harold, I agree with you in that we know little about more severe forms of autism because most studies are conducted with kids with HFA or Asperger’s. I think that is a criticism of the field in general, but not necessarily a limitation of specific studies if the aim of that study was not to generalize to the entire autism community. In this case for example, the authors were clear in that their findings applied to high functioning forms of autism. So, if that was their aim, the most critical limitation of the methodology of the study is its small sample size, because that limitation affects the validity of their findings as it relates to HFA (their target population).

      But I completely agree; it would have been great to see this task conducted with children with severe autism. The lack of research with more severely affected children has created an inaccurate public/media perception of the extend of the limitation of people with ‘autism.’

  2. Kelly Stone says:

    Most interesting article, thank you.

  3. RAJ says:

    As the authors state,

    “The authors stated that these findings are consistent with other recent examinations of emotion recognition deficits in autism that suggest that such deficits are more related to general cognitive deficits rather than the presence of autism”.

    Similar results have been reported in schizophrenia:

    http://www.ncbi.nlm.nih.gov/pubmed/19285381?

    The search for a core defining symptom in autism has not been fruitful. Studies that use only typically developing contols cannot identify autism specific core symptomology. Future studies need to include representative groups of cognitively impaired people (mentally retarded, schizophrenic, language impaired, developmentally delayed groups, etc) as well as typically developing controls.

    In 1943 Kanner described the core defining feature. In his description of the 11 children he wrote that mother or father could absent themselves from the child for an afternoon or for months and upon returning the child would give the impression that child was aware that mother or father had ever been absent.

    The 1980 publication of DSM-III encoded Kanner’s definition and was required to qualify for a diagnosis of autism:

    “A pervasive lack of responsiveness to other people – autism”.

    Clinicians were concerned about the much larger group of children who were in troble developmentally but did not qualify for an autism diagnosis. To include these children DSM-III-R published new diagnostic criteria. Kanner’s definition was relegated to one of five isolated symptoms under the social domain and Kanner’s definition was no longer required.

    Volkmar did a field trial of DSM-III-R and found that autism was being overdiagnosed compared to DSM-III (1980) and clinical impression.

    To correct the problem DSM-III-R published a new set of diagnostic criteria. The authors identified the problem as too many isolated symptoms present in DSM-III and DSM-III-R sought to solve the problem of overdiagnosis by reducing the 16 isolated symptoms to 12 isolated symptoms.

    Among the changes was eliminating Kanner’s definition entirely. replaced by the vague and ambigous ‘A pervasive lack of social reciprocity’. ICD-10 quickly followed suit as did all the Gold Standard diagnostic tools (ADOS, ARI-R ADOS-G, etc).

    I had hope that the DSM-V working group on autism would reintroduce Kanner’s definition at least for the severe end of the spectrum (Autistic Disorder) but they appear to be headed in the opposite direction and there is discussion of adding normal variants of cognitive styles (autistic-like traits) under the umbrella the newly minted ‘Autism Spectrum Disorders’.

    Prevelance and incidence rates will continue to skyrocket and no specific symptom that differentiates ‘autism’ from other devlopmental problems is likely to identified which is the case for current definitions of autism.

    http://www.unstrange.com/dsm1.html

  4. RAJ says:

    Typo correction:
    I wrote:
    “In 1943 Kanner described the core defining feature. In his description of the 11 children he wrote that mother or father could absent themselves from the child for an afternoon or for months and upon returning the child would give the impression that child was aware that mother or father had ever been absent”.

    The statement should have stated :

    the child would give the impression that child was UNAWARE that mother or father had ever been absent.

    Sorry for the confusion

  5. [...] Children with autism do understand emotions. While autism does seem to impair recognition non-verbal emotional expressions, this study finds no difference between recognition of verbal emotional expression in high-function children with autism. [...]

  6. K and J Investigations and Case Management » High Functioning Autism (HFA) and “Spoken Emotions” says:

    [...] Psychology Research Blog has another excellent post in an ongoing series of them titled “Understanding spoken emotions by children with autism.” It should be no surprise to anyone who has read this blog to date of my passion for and [...]

  7. Meers says:

    Hi ,
    My view point is different.Thru my experience with my HFA daughter I can say that she definately recognises emotions like anger ,disciplinary tone of voice etc and she does react appropriately.She is verbal but still not a 100% .

  8. Alex Schulz says:

    Dear Harold.

    I understand your frustration and sympathise but the study of lower functioning individuals of any disorder is made so much more difficult by the level of function and studies in others giveing an insight to the disorder in general.

    I know it is hard but please be patient.

    I say this as a scientist and AFA sufferer with many others in my family suffering similar conditions.

    This study for me explains why I have to listen to people with my left ear even if both ears have excellent and above average capacity. I am now under my won steam very tuned into vocal tones especially the painful ones a wife will berate one with. (emotionally painful lessons).

    I would be interested if the impact of emotions has a significant impact on hearing the message and lessons intended to be learnt by ASD children.

    Alex

  9. stefanie says:

    im hf an still struggle with whsat there taking about .it look like i dont care to other becuse i sometime may not notice someone is upset or mad i cant read faces at all an sometimes get in trouble for laughing when someone is hurt if i notice at all .we are not all one size fits all .some with autism who can be lower f an have beter skills then use who are higher f an so on

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