The impact of atypical sensory processing on social impairments in autism spectrum disorder.

We have developed a system for automatic facial expression recognition running on Google Glass, delivering real-time social cues to children with Autism Spectrum Disorder (ASD). The system includes multiple mechanisms to engage children and their parents, who administer this technology within the home. We completed an at-home design trial with 14 families that used the learning aid over a 3-month period. We found that children with ASD generally respond well to wearing the system at home and opt for the most expressive feedback choice. We further evaluated app usage, facial engagement, and model accuracy. We found that the device can act as a powerful training aid when used periodically in the home, that interactive video content from wearable therapy sessions should be augmented with sufficient context about the content to produce long-term engagement, and that the design of wearable systems for children with ASD should be heavily dependent on the functioning level of the child. We contribute general design implications for developing wearable aids used by children with ASD and other behavioral disorders as well as their parents during at-home parent-administered therapy sessions.

https://dl.acm.org/doi/pdf/10.1145/3130977

SuperpowerGlass: A Wearable Aid for the At-Home Therapy of Children with Autism

Background Recent advances in computer vision and wearable technology have created an opportunity to introduce mobile therapy systems for autism spectrum disorders (ASD) that can respond to the increasing demand for therapeutic interventions; however, feasibility questions must be answered first. Objective We studied the feasibility of a prototype therapeutic tool for children with ASD using Google Glass, examining whether children with ASD would wear such a device, if providing the emotion classification will improve emotion recognition, and how emotion recognition differs between ASD participants and neurotypical controls (NC). Methods We ran a controlled laboratory experiment with 43 children: 23 with ASD and 20 NC. Children identified static facial images on a computer screen with one of 7 emotions in 3 successive batches: the first with no information about emotion provided to the child, the second with the correct classification from the Glass labeling the emotion, and the third again without emotion information. We then trained a logistic regression classifier on the emotion confusion matrices generated by the two information-free batches to predict ASD versus NC. Results All 43 children were comfortable wearing the Glass. ASD and NC participants who completed the computer task with Glass providing audible emotion labeling (n = 33) showed increased accuracies in emotion labeling, and the logistic regression classifier achieved an accuracy of 72.7%. Further analysis suggests that the ability to recognize surprise, fear, and neutrality may distinguish ASD cases from NC. Conclusion This feasibility study supports the utility of a wearable device for social affective learning in ASD children and demonstrates subtle differences in how ASD and NC children perform on an emotion recognition task.

/pdf/feasibility-testing-of-a-wearable-behavioral-aid-for-social-1hxufe37ba.pdf

Feasibility Testing of a Wearable Behavioral Aid for Social Learning in Children with Autism.

We tested the relation between vocal emotion and vocal pitch perception abilities in adults with high-functioning autism spectrum disorder (ASD) and pairwise matched adults with typical development The ASD group had impaired vocal but typical non-vocal pitch and vocal timbre perception abilities The ASD group showed less accurate vocal emotion perception than the comparison group and vocal emotion perception abilities were correlated with traits and symptoms associated with ASD Vocal pitch and vocal emotion perception abilities were significantly correlated in the comparison group only Our results suggest that vocal emotion recognition difficulties in ASD might not only be based on difficulties with complex social tasks, but also on difficulties with processing of basic sensory features, such as vocal pitch

/pdf/the-relation-between-vocal-pitch-and-vocal-emotion-1hqbbp7145.pdf

The Relation Between Vocal Pitch and Vocal Emotion Recognition Abilities in People with Autism Spectrum Disorder and Typical Development.

Background 
The need for early treatment of autism spectrum disorders (ASD) necessitates early screening. Very few tools have been prospectively tested with infants of less than 12 months of age. The PREAUT grid is based on dyadic assessment through interaction and shared emotion and showed good metrics for predicting ASD in very-high-risk infants with West syndrome.


Methods 
We assessed the ability of the PREAUT grid to predict ASD in low-risk individuals by prospectively following and screening 12,179 infants with the PREAUT grid at four (PREAUT-4) and nine (PREAUT-9) months of age. A sample of 4,835 toddlers completed the Checklist for Autism in Toddlers (CHAT) at 24 months (CHAT-24) of age. Children who were positive at one screening (N = 100) were proposed a clinical assessment (including the Children Autism Rating Scale, a Developmental Quotient, and an ICD-10-based clinical diagnosis if appropriate) in the third year of life. A randomly selected sample of 1,100 individuals who were negative at all screenings was followed by the PMI team from three to five years of age to identify prospective false negative cases. The clinical outcome was available for 45% (N = 45) of positive children and 52.6% (N = 579) of negative children.


Results 
Of the 100 children who screened positive, 45 received a diagnosis at follow-up. Among those receiving a diagnosis, 22 were healthy, 10 were diagnosed with ASD, seven with intellectual disability (ID), and six had another developmental disorder. Thus, 50% of infants positive at one screening subsequently received a neurodevelopmental diagnosis. The PREAUT grid scores were significantly associated with medium and high ASD risk status on the CHAT at 24 months (odds ratio of 12.1 (95%CI: 3.0–36.8), p < 0.001, at four months and 38.1 (95%CI: 3.65–220.3), p < 0.001, at nine months). Sensitivity (Se), specificity, negative predictive values, and positive predictive values (PPVs) for PREAUT at four or nine months, and CHAT at 24 months, were similar [PREAUT-4: Se = 16.0 to 20.6%, PPV = 25.4 to 26.3%; PREAUT-9: Se = 30.5 to 41.2%, PPV = 20.2 to 36.4%; and CHAT-24: Se = 33.9 to 41.5%, PPV = 27.3 to 25.9%]. The repeated use of the screening instruments increased the Se but not PPV estimates [PREAUT and CHAT combined: Se = 67.9 to 77.7%, PPV = 19.0 to 28.0%].


Conclusions 
The PREAUT grid can contribute to very early detection of ASD and its combination with the CHAT may improve the early diagnosis of ASD and other neurodevelopmental disorders.

/pdf/infant-and-dyadic-assessment-in-early-community-based-hn05qzm1wc.pdf

Infant and dyadic assessment in early community-based screening for autism spectrum disorder with the PREAUT grid.

Although deficits in emotion recognition have been widely reported in Autism Spectrum Disorder (ASD), experiments have been restricted to either facial or vocal expressions. Here, we explored multimodal emotion processing in children with ASD (N=19) and with typical development (TD, N=19), considering uni (faces and voices) and multimodal (faces/voices simultaneously) stimuli and developmental comorbidities (neuro-visual, language and motor impairments). Compared to TD controls, children with ASD had rather high and heterogeneous emotion recognition scores but showed also several significant differences: lower emotion recognition scores for visual stimuli, for neutral emotion, and a greater number of saccades during visual task. Multivariate analyses showed that: (1) the difficulties they experienced with visual stimuli were partially alleviated multimodal stimuli. (2) Developmental age was significantly associated with emotion recognition in TD children, whereas it was the case only for the multimodal task in children with ASD. (3) Language impairments tended to be associated with emotion recognition scores of ASD children in the auditory modality. Conversely, in the visual or bimodal (visuo-auditory) tasks, the impact of developmental coordination disorder or neuro-visual impairments was not found. We conclude that impaired emotion processing constitutes a dimension to explore in the field of ASD, as research has the potential to define more homogeneous subgroups and tailored interventions. However, it is clear that developmental age, the nature of the stimuli, and other developmental comorbidities must also be taken into account when studying this dimension.

/pdf/a-multidimensional-approach-to-the-study-of-emotion-4v4fo7nn95.pdf

Violaine Vignaud

Papers

A Multidimensional Approach to the Study of Emotion Recognition in Autism Spectrum Disorders.