This article reviews behavioral and electrophysiological studies of face processing and discusses hypotheses for understanding the nature of face processing impairments in autism. Based on results of behavioral studies, this study demonstrates that individuals with autism have impaired face discrimination and recognition and use atypical strategies for processing faces characterized by reduced attention to the eyes and piecemeal rather than configural strategies. Based on results of electrophysiological studies, this article concludes that face processing impairments are present early in autism, by 3 years of age. Such studies have detected abnormalities in both early (N170 reflecting structural encoding) and late (NC reflecting recognition memory) stages of face processing. Event-related potential studies of young children and adults with autism have found slower speed of processing of faces, a failure to show the expected speed advantage of processing faces versus nonface stimuli, and atypical scalp top...

Understanding the nature of face processing impairment in autism: insights from behavioral and electrophysiological studies.

Given the high incidence of brain injury in the population, brain damage rehabilitation is still a relatively undeveloped field. Virtual reality (VR) has the potential to assist current rehabilitation techniques in addressing the impairments, disabilities, and handicaps associated with brain damage. The main focus of much of the exploratory research performed to date has been to investigate the use of VR in the assessment of cognitive abilities, but there is now a trend for more studies to encompass rehabilitation training strategies. This review describes studies that have used VR in the assessment and rehabilitation of specific disabilities resulting from brain injury, including executive dysfunction, memory impairments, spatial ability impairments, attention deficits, and unilateral visual neglect. In addition, it describes studies that have used VR to try to offset some of the handicaps that people experience after brain injury. Finally, a table is included which, although not an exhaustive list of everything that has been published, includes many more studies that are relevant to the use of VR in the assessment and rehabilitation of brain damage. The review concludes that the use of VR in brain damage rehabilitation is expanding dramatically and will become an integral part of cognitive assessment and rehabilitation in the future.

Virtual Reality in Brain Damage Rehabilitation: Review

Background: People with autism experience profound and pervasive difficulties in the social domain. Attempts to teach social behaviours tend to adopt either a behavioural or a ‘theory of mind’ (ToM) approach. The beneficial aspects and limitations of both paradigms are summarized before an examination of how virtual reality technology may offer a way to combine the strengths from both approaches. Methods: This is not an exhaustive review of the literature; rather, the papers are chosen as representative of the current understanding within each broad topic. Web of Science ISI, EMBASE and PsycInfo were searched for relevant articles. Results: Behavioural and ToM approaches to social skills training achieve some success in improving specific skills or understanding. However, the failure to generalize learned behaviours to novel environments, and the unwieldy nature of some behavioural methodologies, means that there is a need for a training package that is easy to administer and successful in promoting learning across contexts. Conclusions: Virtual reality technology may be an ideal tool for allowing participants to practise behaviours in role-play situations, whilst also providing a safe environment for rule learning and repetition of tasks. Role-play within virtual environments could promote the mental simulation of social events, potentially allowing a greater insight into minds. Practice of behaviours, both within and across contexts, could also encourage a more flexible approach to social problem solving. Virtual environments offer a new and exciting perspective on social skills training for people with autistic spectrum disorders.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1365-2788.2002.00425.x

The potential of virtual reality in social skills training for people with autistic spectrum disorders

Background: There is substantial evidence that children with autism are impaired in face recognition. Although many researchers have suggested that this impairment derives from a failure of holistic face processing and a tendency to represent and encode faces on a part-by-part basis, this hypothesis has not been tested directly. Method: Holistic face processing was assessed by comparing children’s ability to recognize a face part (eyes, nose, or mouth) in the context of the whole face in which it was learned with their ability to recognize the same face part in isolation. Results: In Study 1, as expected, typically developing 9-year-olds (n ¼ 27) and 11-year-olds (n ¼ 30) were significantly better at recognizing face parts presented in the whole than in the part test condition, and this effect was limited to upright faces and not found for inverted faces. Consistent with prior findings, typically developing children were most accurate when face recognition depended on the eyes. In Study 2, high-functioning children with autism (n ¼ 22) evidenced a whole-test advantage for mouths only, and were markedly deficient when face recognition depended on the eyes. Their pattern of performance diverged from age- and IQ-matched comparison participants (n ¼ 20), who performed similarly to the typically developing children in Study 1. Conclusions: These findings suggest that face recognition abnormalities in autism are not fully explained by an impairment of holistic face processing, and that there is an unusual significance accorded to the mouth region when children with autism process information from people’s faces. Keywords: Autistic disorder; face perception; social cognition. Abbreviations: ADI-R: Autism Diagnostic Interview – Revised; FFA: Fusiform Face Area.

/pdf/holistic-and-part-based-face-recognition-in-children-with-448tpry350.pdf

Holistic and part-based face recognition in children with autism

Handbook of Autism and Pervasive Developmental Disorders

An eye-tracking study of face and object recognition was conducted to clarify the character of face gaze in autistic spectrum disorders. Experimental participants were a group of individuals diagnosed with Asperger's disorder or high-functioning autistic disorder according to their medical records and confirmed by the Autism Diagnostic Interview-Revised (ADI-R). Controls were selected on the basis of age, gender, and educational level to be comparable to the experimental group. In order to maintain attentional focus, stereoscopic images were presented in a virtual reality (VR) headset in which the eye-tracking system was installed. Preliminary analyses show impairment in face recognition, in contrast with equivalent and even superior performance in object recognition among participants with autism-related diagnoses, relative to controls. Experimental participants displayed less fixation on the central face than did control-group participants. The findings, within the limitations of the small number of subjects and technical difficulties encountered in utilizing the helmet-mounted display, suggest an impairment in face processing on the part of the individuals in the experimental group. This is consistent with the hypothesis of disruption in the first months of life, a period that may be critical to typical social and cognitive development, and has important implications for selection of appropriate targets of intervention.

Atypical face gaze in autism.

Virtual environments for the investigation and rehabilitation of cognitive and perceptual impairments

Human factors engineering and system design are critical elements in the newly developing field of telerehabilitation. Telerehabilitation is the remote delivery of rehabilitative services such as monitoring, training, and long-term care of persons with disabilities using telecommunications technology. This paper describes projects at the Rehabilitation Engineering Research Center (RERC) on Telerehabilitation in the context of three conceptual models: telecounseling and training, telemonitoring and assessment, and teletherapy. Issues pertaining to human factors engineering design are identified, and ongoing challenges are discussed.

Aspects of human factors engineering in home telemedicine and telerehabilitation systems.

It is hypothesized that some autism is due to onset of neuropsychiatric symptoms during a critical period of infant socialization. It is argued that disruption of social gaze in infancy has the potential to undermine development of social interaction, meaningful language, and higher order cognitive abilities. Studies of infant–caregiver interaction and infant face preference are discussed to support the claim that attention to faces in early life plays a vital role in communicative development. Studies of social gaze behavior, face recognition, and identification of facial expression by persons with autism are reviewed as suggestive evidence pointing to a deficiency in early experience of faces. The core social and communicative deficits of autism may stem from disruption of infant social gaze. In contrast, the other core feature of autism, obsessive interests and repetitive activities, may be a direct manifestation of the underlying neuropsychiatric disorder.

A Possible Origin for the Social and Communicative Deficits of Autism

This paper documents the engineering of a gaze contingent therapeutic environment for the exploration and validation of a proposed rehabilitative technique addressing attention deficits in 24 to 54 months old autistic subjects. It discusses the current state of progress and lessons learnt so far while highlighting the outstanding engineering challenges of this project. We focus on calibration issues for this target group of users, explain the architecture of the system and present our general workflow for the construction of the gaze contingent environment. While this work is being undertaken for therapeutic purposes, it is likely to be relevant to the construction of gaze contingent displays for entertainment.

/pdf/a-gaze-contingent-environment-for-fostering-social-attention-14kq3k9j8v.pdf

Cheryl Trepagnier

Papers

Atypical face gaze in autism.

Virtual environments for the investigation and rehabilitation of cognitive and perceptual impairments

Aspects of human factors engineering in home telemedicine and telerehabilitation systems.

A Possible Origin for the Social and Communicative Deficits of Autism

A gaze contingent environment for fostering social attention in autistic children