Roberta Igliozzi

An android for enhancing social skills and emotion recognition in people with autism

It is well documented that the processing of social and emotional information is impaired in people with autism. Recent studies have shown that individuals, particularly those with high functioning autism, can learn to cope with common social situations if they are made to enact possible scenarios they may encounter in real life during therapy. The main aim of this work is to describe an interactive life-like facial display (FACE) and a supporting therapeutic protocol that will enable us to verify if the system can help children with autism to learn, identify, interpret, and use emotional information and extend these skills in a socially appropriate, flexible, and adaptive context. The therapeutic setup consists of a specially equipped room in which the subject, under the supervision of a therapist, can interact with FACE. The android display and associated control system has automatic facial tracking, expression recognition, and eye tracking. The treatment scheme is based on a series of therapist-guided sessions in which a patient communicates with FACE through an interactive console. Preliminary data regarding the exposure to FACE of two children are reported.

Search superiority in autism within, but not outside the crowding regime

Visual cognition of observers with autism spectrum disorder (ASD) seems to show an unbalance between the complementary functions of integration and segregation. This study uses visual search and crowding paradigms to probe the relative ability of children with autism, compared to normal developments children, to extract individual targets from cluttered backgrounds both within and outside the crowding regime. The data show that standard search follows the same pattern in the ASD and control groups with a strong effect of the set size that is substantially weakened by cueing the target location with a synchronous spatial cue. On the other hand, the crowding effect of eight flankers surrounding a small peripheral target is virtually absent in the clinical sample, indicating a superior ability to segregate cluttered visual items. This data, along with evidence of an impairment to the neural system for binding contours in ASD, bring additional support to the general idea of a shift of the trade-off between integration and segregation toward the latter. More specifically, they show that when discriminability is balanced across conditions, an advantage in odd-man out tasks is evident in ASD observers only within the crowding regime, when binding mechanism might get compulsorily triggered in normal observers.

Children with autism spectrum disorder show reduced adaptation to number

Significance It has long been known that perception is atypical in autism. The mechanisms underlying these atypicalities, however, are far from being well understood. Here, we test the integrity of one candidate mechanism, adaptation, in children with and without autism by assessing their susceptibility to number adaptation. We show that adaptation to numerosity is significantly attenuated in children with autism, with the size of their aftereffects only one-third of those of typical children. These results extend existing findings of reduced adaptation to high-level social stimuli and critically suggest that atypicalities in adaptive mechanisms may be pervasive in autism, at least at higher levels. These results fit well with recent Bayesian theories of autism, which propose fundamental problems with prediction. Autism is known to be associated with major perceptual atypicalities. We have recently proposed a general model to account for these atypicalities in Bayesian terms, suggesting that autistic individuals underuse predictive information or priors. We tested this idea by measuring adaptation to numerosity stimuli in children diagnosed with autism spectrum disorder (ASD). After exposure to large numbers of items, stimuli with fewer items appear to be less numerous (and vice versa). We found that children with ASD adapted much less to numerosity than typically developing children, although their precision for numerosity discrimination was similar to that of the typical group. This result reinforces recent findings showing reduced adaptation to facial identity in ASD and goes on to show that reduced adaptation is not unique to faces (social stimuli with special significance in autism), but occurs more generally, for both parietal and temporal functions, probably reflecting inefficiencies in the adaptive interpretation of sensory signals. These results provide strong support for the Bayesian theories of autism.

The FACE of autism

People with autism are known to possess deficits in processing emotional states, both their own and of others. A humanoid robot, FACE (Facial Automation for Conveying Emotions), capable of expressing and conveying emotions and empathy has been constructed to enable autistic children and adults to better deal with emotional and expressive information. We describe the development of an adaptive therapeutic platform which integrates information deriving from wearable sensors carried by a patient or subject as well as sensors placed in the therapeutic ambient. Through custom developed control and data processing algorithms the expressions and movements of FACE are then tuned and modulated to harmonize with the feelings of the subject postulated by their physiological and behavioral correlates. Preliminary results demonstrating the potential of adaptive therapy are presented.

Development and evaluation of a social robot platform for therapy in autism

People with ASD (Autism Spectrum Disorders) have difficulty in managing interpersonal relationships and common life social situations. A modular platform for Human Robot Interaction and Human Machine Interaction studies has been developed to manage and analyze therapeutic sessions in which subjects are driven by a psychologist through simulated social scenarios. This innovative therapeutic approach uses a humanoid robot called FACE capable of expressing and conveying emotions and empathy. Using FACE as a social interlocutor the psychologist can emulate real life scenarios where the emotional state of the interlocutor is adaptively adjusted through a semi closed loop control algorithm which uses the ASD subjects inferred ”affective” state as input. Preliminary results demonstrate that the platform is well accepted by ASDs and can be consequently used as novel therapy for social skills training.

Neural correlates of texture and contour integration in children with autism spectrum disorders.

In this study, we have used an electrophysiological paradigm to investigate the neural correlates of the visual integration of local signals across space to generate global percepts in a group of low functioning autistic kids. We have analyzed the amplitude of key harmonics of the Visual Evoked Potentials (VEPs) recorded while participants observed orientation-based texture and contour stimuli, forming coherent global patterns, alternating with visual patterns in which the same number of local elements were randomly oriented in order to loose any globally organized feature. Comparing the results of the clinical sample with those obtained in an age-matched control group, we have observed that in the texture conditions the 1st and 3rd harmonics, containing signature of global form processing (Norcia, Pei, Bonneh, Hou, Sampath, & Pettet, 2005), were present in the control group, while in the experimental group only the 1st harmonic was present. In the Contour condition the 1st harmonic was not present for both groups while the 3rd harmonic was significantly present in the control group but absent in the group with autism. Moreover, the amount of organization required to elicit significant 1st harmonic response in the texture condition was higher in the clinical group. The present results bring additional support to the idea that texture and contour processing are supported by independent mechanisms in normal vision. Autistic vision would thus be characterized by a preserved, perhaps weaker texture mechanism, possibly mediated by feedback interactions between visual areas, and by a disfunction of the mechanism supporting contour processing, possibly mediated by long-range intra-cortical connections. Within this framework, the residual ability to detect contours shown in psychophysical studies could be due to the contribution of the texture mechanism to contour processing.

Effects of Improvisational Music Therapy vs Enhanced Standard Care on Symptom Severity Among Children With Autism Spectrum Disorder: The TIME-A Randomized Clinical Trial

Importance Music therapy may facilitate skills in areas affected by autism spectrum disorder (ASD), such as social interaction and communication. Objective To evaluate effects of improvisational music therapy on generalized social communication skills of children with ASD. Design, Setting, and Participants Assessor-blinded, randomized clinical trial, conducted in 9 countries and enrolling children aged 4 to 7 years with ASD. Children were recruited from November 2011 to November 2015, with follow-up between January 2012 and November 2016. Interventions Enhanced standard care (n = 182) vs enhanced standard care plus improvisational music therapy (n = 182), allocated in a 1:1 ratio. Enhanced standard care consisted of usual care as locally available plus parent counseling to discuss parents’ concerns and provide information about ASD. In improvisational music therapy, trained music therapists sang or played music with each child, attuned and adapted to the child’s focus of attention, to help children develop affect sharing and joint attention. Main Outcomes and Measures The primary outcome was symptom severity over 5 months, based on the Autism Diagnostic Observation Schedule (ADOS), social affect domain (range, 0-27; higher scores indicate greater severity; minimal clinically important difference, 1). Prespecified secondary outcomes included parent-rated social responsiveness. All outcomes were also assessed at 2 and 12 months. Results Among 364 participants randomized (mean age, 5.4 years; 83% boys), 314 (86%) completed the primary end point and 290 (80%) completed the last end point. Over 5 months, participants assigned to music therapy received a median of 19 music therapy, 3 parent counseling, and 36 other therapy sessions, compared with 3 parent counseling and 45 other therapy sessions for those assigned to enhanced standard care. From baseline to 5 months, mean ADOS social affect scores estimated by linear mixed-effects models decreased from 14.08 to 13.23 in the music therapy group and from 13.49 to 12.58 in the standard care group (mean difference, 0.06 [95% CI, −0.70 to 0.81]; P = .88), with no significant difference in improvement. Of 20 exploratory secondary outcomes, 17 showed no significant difference. Conclusions and Relevance Among children with autism spectrum disorder, improvisational music therapy, compared with enhanced standard care, resulted in no significant difference in symptom severity based on the ADOS social affect domain over 5 months. These findings do not support the use of improvisational music therapy for symptom reduction in children with autism spectrum disorder. Trial Registration isrctn.org Identifier: ISRCTN78923965

Facial Automaton for Conveying Emotions as a Social Rehabilitation Tool for People with Autism

The terms Autistic Spectrum Disorders (ASD) and pervasive developmental disorders refer to a wide continuum of associated cognitive and neuro-behavioral disorders, including, but not limited to, three core-defining features: impairments in socialization , impairments in verbal and nonverbal communication, and restricted and repetitive patterns of behaviors. Although autism was first described over 50 years ago, our improved understanding of this complex disorder has emerged over the past two decades. Despite recent intense focus on autism, its study continues to be an art and science in fast evolution. There is marked variability in the severity of symptomatology across patients, and level of intellectual function can range from profound mental retardation through the superior range on conventional IQ tests. In ASD we can find: marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction. The communication impairments seen in the autistic spectrum are far more complex than presumed by simple speech delay and share some similarities with the deficits seen in children with developmental language disorders or specific language impairments. Young autistic children, even if verbal, almost universally have comprehension deficits, in particular deficits in understanding higher order complex questions. Deficits in pragmatics, the use of language to communicate effectively, are almost universally present too. Another core characteristic of ASD is the presence of stereotyped behaviors and circumscribed/unusual interests, which encompass qualitative deficits in several aspects of behavior. It is moreover well documented that individuals with autism have impairments in processing of social and emotional information, as evident in tasks assessing face and emotion recognition, imitation of body movements, interpretation and use of gestures and theory of mind [Baron-Cohen 1994, Davies 1994, Dawson 1998, Smith 1994]. Typically developing infants show preferential attention to social rather than inanimate stimuli; in contrast, individuals with autism seem to lack these early social predispositions [Spelke 1995, Maestro 2002]. This hypothesis was recently substantiated in a neurofunctional study [Schultz 2000] of face perception in autism, in which adequate task performance was accompanied by abnormal ventral temporal cortical activities, which in turn suggested that participants had treated faces as objects. Klin et al. [Klin 2002] created an experimental paradigm to measure social functioning in natural situations, in which they used eye-tracking technology to measure visual fixations of cognitively able

Application of the Repetitive Behavior Scale-Revised - Italian version - in preschoolers with autism spectrum disorder

Restricted repetitive and stereotyped patterns of behavior, interests, and activities (RRB) are mandatory features for a diagnosis of Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual of mental disorders-fifth edition (DSM-5). Despite the strong diagnostic role of RRB, their expressiveness and their relationship with other clinical/demographic features in ASD is not fully elucidated. The Italian version of the Repetitive Behavior Scale-Revised (RBS-R) was applied to a relatively large sample of preschool-aged children with ASD who underwent a comprehensive clinical assessment. The relationship between RRB and sex, age, non-verbal IQ, autism severity, as well as the diagnostic accuracy of the RBS-R were explored. Stereotyped and Ritualistic/Sameness behaviors were the most common RRB in preschoolers with ASD, without widespread differences between males and females. No significant correlations between RRB and chronological age, or non-verbal IQ were detected. The expressiveness of ritualistic/sameness behaviors positively correlated with autism severity, assessed through the Calibrated Severity Score (CSS) derived from the Autism Diagnostic Observation Schedule (ADOS). Receiver Operator Characteristic (ROC) analysis showed high diagnostic accuracy using the Global Rating Score, which represents the judgment of the parents of as the RRB affect the childs life. However, while the Global Rating Score performed well, the remaining subscales did not. This investigation extends the limited research on early pattern and associated features of RRB in young children with ASD. The use of the RBS-R may increase the knowledge of the RRB complexity and variability and in turn improve the diagnostic and therapeutic procedures within the autistic spectrum.

Olfactory Processing in Male Children with Autism: Atypical Odor Threshold and Identification

Sensory issues are of great interest in ASD diagnosis. However, their investigation is mainly based on external observation (parent reports), with methodological limitations. Unobtrusive olfactory assessment allows studying autism neurosensoriality. Here, 20 male children with high-functioning ASD and 20 matched controls were administered a complete olfactory test battery, assessing olfactory threshold, identification and discrimination. ASD children show lower sensitivity (p = 0.041), lower identification (p = 0.014), and intact odor discrimination (p = 0.199) than controls. Comparing olfactory and clinical scores, a significant correlation was found in ASD between olfactory threshold and the CBCL social problems (p = 0.011) and aggressive behavior (p = 0.012) sub-scales. The pattern featuring peripheral hyposensitivity, high-order difficulties in odor identification and regular subcortical odor discrimination is discussed in light of hypo-priors hypothesis for autism.