News and Knowledge

Researchers

Marcus Thomeer, Ph.D., Assistant Professor; Co-Director, Institute for Autism Research; Canisius College, Buffalo, NY
Christopher Lopata, Psy.D., Associate Professor; Co-Director Institute for Autism Research; Canisius College, Buffalo, NY

Purpose

The purpose of this randomized clinical trial is to evaluate the efficacy of an innovative multi-component manualized treatment on the emotion recognition skills and autism features of 7- to 12-year-old children with HFASDs.

Why Is This Study Needed?

Children with high-functioning autism spectrum disorders (HFASDs) are characterized by core impairments in social-communication including deficits in recognition (decoding) and display (encoding) of facial and vocal emotions and expressions. These impairments are considered detrimental to social competence and social reciprocity as deficits in the ability to accurately perceive nonverbal cues. Because nonverbal communication skills are a key intervention objective for children with HFASDs and improvements in nonverbal communication skills may increase success in social interactions, research is needed to identify programs that effectively teach facial and vocal emotion recognition for these children.

Study Methodology In Brief

The study employs a pretest and a posttest follow-up as well as a control group. The study will include 44 children with HFASDs (22 randomly assigned to the treatment group and 22 to a waitlist control).

Treatment is administered during 24 90-minute sessions (over 3 months) and active components include an interactive emotion-recognition software program, Mind Reading; in vivo rehearsal trials; and a structured behavioral reinforcement system. Each treatment session is manualized to ensure implementation is standardized, participants meet time parameters using and accessing areas of the Mind Reading program, content is prescribed, and fidelity is monitored and maintained.

Mind Reading is an interactive software program featuring 412 emotions organized into 24 emotion groups and by 6 emotion levels. It includes an Emotions Library, Learning Center, Games Zone, and Rewards Zone. In the current intervention, participants will complete emotion groups of up to 10 emotions a total of two times over the 24 sessions from Levels 1, 2, and 3 (comprising 98 of the “Top 100” emotions). Mind Reading also includes an internal reinforcement system in which children earn tokens for accurately completing questions in lessons and quizzes within the program (to be used in the Mind Reading Rewards Zone).

Given reduced treatment effects on non-Mind Reading outcome tasks in prior studies and need for practice of new decoding skills in naturalistic situations, this study includes in vivo rehearsal trials. Each 90-minute session is divided into five intervals. During each interval, a staff clinician displays a facial emotion and asks the participant to identify the emotion (decoding) and to display a specific emotion (encoding). To receive point-based reinforcement for the in vivo trial, the participant is required to accurately respond within five seconds. In vivo trials are conducted in a one-to-one format between the staff clinicians and child participants. To foster generalization, emotions used during rehearsal trials parallel those taught during Mind Reading instruction.

A behavioral reinforcement program is used to generalize skills (via in vivo trials) and increase on-task behaviors. During each of the five session intervals, participants earn points for identifying/displaying emotions during in vivo trials, following program rules, exhibiting prosocial behaviors, and refraining from negative social behaviors. Each child’s performance in the behavioral reinforcement system is reinforced at home by parents and participants must earn at least 75 percent of their points to receive a home reward. Collaboration with parents in determining rewards is used to foster parental attention to target emotion-recognition skills and behaviors.

Outcome measures consist of a direct child measure of emotion recognition skills, a parent rating scale assessing child emotion recognition and display skills, a parent rating scale assessing autism features, and parent and child satisfaction surveys.

A follow up will be done one to two months after the treatment to assess skill generalization and maintenance.