Cheryl Klaiman

Using computerized games to teach face recognition skills to children with autism spectrum disorder: the Let's Face It! program

BACKGROUND An emerging body of evidence indicates that relative to typically developing children, children with autism are selectively impaired in their ability to recognize facial identity. A critical question is whether face recognition skills can be enhanced through a direct training intervention. METHODS In a randomized clinical trial, children diagnosed with autism spectrum disorder were pre-screened with a battery of subtests (the Lets Face It! Skills battery) examining face and object processing abilities. Participants who were significantly impaired in their face processing abilities were assigned to either a treatment or a waitlist group. Children in the treatment group (N = 42) received 20 hours of face training with the Lets Face It! (LFI!) computer-based intervention. The LFI! program is comprised of seven interactive computer games that target the specific face impairments associated with autism, including the recognition of identity across image changes in expression, viewpoint and features, analytic and holistic face processing strategies and attention to information in the eye region. Time 1 and Time 2 performance for the treatment and waitlist groups was assessed with the Lets Face It! Skills battery. RESULTS The main finding was that relative to the control group (N = 37), children in the face training group demonstrated reliable improvements in their analytic recognition of mouth features and holistic recognition of a face based on its eyes features. CONCLUSION These results indicate that a relatively short-term intervention program can produce measurable improvements in the face recognition skills of children with autism. As a treatment for face processing deficits, the Lets Face It! program has advantages of being cost-free, adaptable to the specific learning needs of the individual child and suitable for home and school applications.

Multisystem study of 20 older adults with Williams syndrome

To address the natural history of Williams syndrome (WS), we performed multisystem assessments on 20 adults with WS over 30 years of age and documented a high frequency of problems in multiple organ systems. The most striking and consistent findings were: abnormal body habitus; mild–moderate high frequency sensorineural hearing loss; cardiovascular disease and hypertension; gastrointestinal symptoms including diverticular disease; diabetes and abnormal glucose tolerance on standard oral glucose tolerance testing; subclinical hypothyroidism; decreased bone mineral density on DEXA scanning; and a high frequency of psychiatric symptoms, most notably anxiety, often requiring multimodal therapy. Review of brain MRI scans did not demonstrate consistent pathology. The adults in our cohort were not living independently and the vast majority were not competitively employed. Our preliminary findings raise concern about the occurrence of mild accelerated aging, which may additionally complicate the long‐term natural history of older adults with WS. We provide monitoring guidelines to assist in the comprehensive care of adults with WS.

Specific impairment of face‐processing abilities in children with autism spectrum disorder using the Let's Face It! skills battery

Although it has been well established that individuals with autism exhibit difficulties in their face recognition abilities, it has been debated whether this deficit reflects a category‐specific impairment of faces or a general perceptual bias toward the local‐level information in a stimulus. In this study, the Lets Face It! Skills Battery [Tanaka & Schultz, 2008] of developmental face‐ and object‐processing measures was administered to a large sample of children diagnosed with autism spectrum disorder (ASD) and typically developing children. The main finding was that when matched for age and IQ, individuals with ASD were selectively impaired in their ability to recognize faces across changes in orientation, expression and featural information. In a face discrimination task, ASD participants showed a preserved ability to discriminate featural and configural information in the mouth region of a face, but were compromised in their ability to discriminate featural and configural information in the eyes. On object‐processing tasks, ASD participants demonstrated a normal ability to recognize automobiles across changes in orientation and a superior ability to discriminate featural and configural information in houses. These findings indicate that the face‐processing deficits in ASD are not due to a local‐processing bias, but reflect a category‐specific impairment of faces characterized by a failure to form view‐invariant face representations and discriminate information in the eye region of the face.

Audiovisual Processing in Children with and without Autism Spectrum Disorders

Fifteen children with autism spectrum disorders (ASD) and twenty-one children without ASD completed six perceptual tasks designed to characterize the nature of the audiovisual processing difficulties experienced by children with ASD. Children with ASD scored significantly lower than children without ASD on audiovisual tasks involving human faces and voices, but scored similarly to children without ASD on audiovisual tasks involving nonhuman stimuli (bouncing balls). Results suggest that children with ASD may use visual information for speech differently from children without ASD. Exploratory results support an inverse association between audiovisual speech processing capacities and social impairment in children with ASD.

The perception and identification of facial emotions in individuals with Autism Spectrum Disorders using the Let’s Face It! Emotion Skills Battery

BACKGROUND Although impaired social-emotional ability is a hallmark of autism spectrum disorder (ASD), the perceptual skills and mediating strategies contributing to the social deficits of autism are not well understood. A perceptual skill that is fundamental to effective social communication is the ability to accurately perceive and interpret facial emotions. To evaluate the expression processing of participants with ASD, we designed the Lets Face It! Emotion Skills Battery (LFI! Battery), a computer-based assessment composed of three subscales measuring verbal and perceptual skills implicated in the recognition of facial emotions. METHODS We administered the LFI! Battery to groups of participants with ASD and typically developing control (TDC) participants that were matched for age and IQ. RESULTS On the Name Game labeling task, participants with ASD (N = 68) performed on par with TDC individuals (N = 66) in their ability to name the facial emotions of happy, sad, disgust and surprise and were only impaired in their ability to identify the angry expression. On the Matchmaker Expression task that measures the recognition of facial emotions across different facial identities, the ASD participants (N = 66) performed reliably worse than TDC participants (N = 67) on the emotions of happy, sad, disgust, frighten and angry. In the Parts-Wholes test of perceptual strategies of expression, the TDC participants (N = 67) displayed more holistic encoding for the eyes than the mouths in expressive faces whereas ASD participants (N = 66) exhibited the reverse pattern of holistic recognition for the mouth and analytic recognition of the eyes. CONCLUSION In summary, findings from the LFI! Battery show that participants with ASD were able to label the basic facial emotions (with the exception of angry expression) on par with age- and IQ-matched TDC participants. However, participants with ASD were impaired in their ability to generalize facial emotions across different identities and showed a tendency to recognize the mouth feature holistically and the eyes as isolated parts.

Face composite effects reveal abnormal face processing in Autism spectrum disorders

Although it has been suggested that individuals with an Autism spectrum disorder (ASD) process faces less holistically than typically developing controls, there are few direct investigations of this hypothesis. This question was addressed before using the composite paradigm (Teunisse, J. P., & de Gelder, B. (2003). Face processing in adolescents with autistic disorder: The inversion and composite effects. Brain Cognition, 52(3), 285-294.). The results had revealed that adolescents with ASDs were less sensitive than controls to the misalignment of face parts and it was concluded their face processing was less holistic. However, because of shortcomings of the design, it was not possible to distinguish whether individuals with Autism processed both aligned and misaligned composites in a part-based fashion, or both in a holistic fashion. We compared adolescents with ASDs to controls matched on sex, age and IQ on a more complete version of the composite paradigm. The results indicate that individuals with ASDs, like controls, experience interference from facial features that they are told to ignore. However, while such interference is released for controls if parts of face composites are misaligned, individuals with ASDs show comparable interference from irrelevant parts regardless of alignment. Two different interpretations are discussed, both compatible with the idea that perceptual and or attentional abnormalities in ASDs result in a diminished level of expertise for faces.

The day of the week when you were born in 700 ms : Calendar computation in an autistic savant

Some individuals are able to determine the weekday of a given date in a few seconds (finding for instance that June 12, 1900, was a Tuesday). This ability has fascinated scientists for many years because it is predominantly observed in people with limited intelligence and may appear very early in life. Exceptional visual memory, exceptional concentration abilities, or privileged access to lower levels of information not normally available through introspection have been advanced to explain such phenomena. In the present article, the authors show that a simple cognitive model can explain all aspects of the performance of Donny, a young autistic savant who is possibly the fastest and most accurate calendar prodigy ever described.

A Comparison of Behavioral and Emotional Characteristics in Children with Autism, Prader-Willi Syndrome, and Williams Syndrome

In order to investigate unique and shared characteristics and to determine factors predictive of group classification, quantitative comparisons of behavioral and emotional problems were assessed using the Developmental Behavior Checklist (DBC-P) and the Vineland Adaptive Behavior Scales in autistic disorder, Williams syndrome (WS), and Prader-Willi syndrome (PWS). The DBC-P Total Behavior Problem Score did not differ between groups. However, at the subscale level, the autism group showed more behavioral and emotional problems in the Self-Absorbed and Communication Disturbance domains than the WS and PWS group. Discriminant analysis revealed 16 variables that predicted group membership with 90.9% accuracy. Within-group analyses revealed problems decreased with age among individuals with autism. However, as people with WS aged, they had greater difficulty with Social Relating. Distinct age and IQ correlates of adaptive behavior among groups were also found. These findings both confirm and refine the behavioral phenotypes of these developmental disorders.

Infant viewing of social scenes is under genetic control and is atypical in autism

Long before infants reach, crawl or walk, they explore the world by looking: they look to learn and to engage, giving preferential attention to social stimuli, including faces, face-like stimuli and biological motion. This capacity—social visual engagement—shapes typical infant development from birth and is pathognomonically impaired in children affected by autism. Here we show that variation in viewing of social scenes, including levels of preferential attention and the timing, direction and targeting of individual eye movements, is strongly influenced by genetic factors, with effects directly traceable to the active seeking of social information. In a series of eye-tracking experiments conducted with 338 toddlers, including 166 epidemiologically ascertained twins (enrolled by representative sampling from the general population), 88 non-twins with autism and 84 singleton controls, we find high monozygotic twin–twin concordance (0.91) and relatively low dizygotic concordance (0.35). Moreover, the characteristics that are the most highly heritable, preferential attention to eye and mouth regions of the face, are also those that are differentially decreased in children with autism (χ2 = 64.03, P < 0.0001). These results implicate social visual engagement as a neurodevelopmental endophenotype not only for autism, but also for population-wide variation in social-information seeking. In addition, these results reveal a means of human biological niche construction, with phenotypic differences emerging from the interaction of individual genotypes with early life experience.

Assessment of Autism Across the Lifespan: A Way Forward

The prevalence of autism spectrum disorders (ASDs) is currently estimated at 1 in 68 individuals in the US (Centers for Disease Control and Prevention (Morb Mortal Wkly Rep 63:1–21, 2014)), and recommendations for screening and best practices for diagnostic evaluations have been formulated in scientific, clinical, and institutional venues, if not successfully implemented. As such, this article reviews the best practices in the field for toddler, school-age and adolescent/adult assessments, describes at-risk symptomatology in toddlers, reviews common co-morbidities to be aware of at each time point, discusses cultural issues with regard to diagnoses, and brings forth new research, particularly with regard to earlier screening and diagnosis.