Unique Perspectives: Harnessing Multimodal Assessment to Understand How Children with Autism Decode the Social World

It is well-known that children and adolescents with Autism Spectrum Disorder (ASD) see and make sense of the social world differently than their typically-developing (TD) peers. Often less appreciated is that the way the mind and brain give rise to this social perception and cognition is quite complex, with many interlocking abilities being necessary to decode a social scenario and then engage with it (and the people within it). In recent decades, numerous psychological scientists have attempted to map out these various abilities in TD populations (e.g., Crick & Dodge, 1994; Lipton & Nowicki, 2009; Beauchamp & Anderson, 2010). However, the field of ASD research has been slower to appreciate this complexity, often attributing differences in social cognition among individuals with ASD to a single “silver bullet” differentiating factor, such as perspective-taking, emotion recognition, or self-regulation.

In recent years, researchers, including those of us in the Social Competence and Treatment Lab (SCTL) at Stony Brook University, have started to assess various aspects of social cognition and perception within an individual with ASD. This approach allows for the evaluation of social patterns and profiles which differ within and between people. Utilizing such an approach has allowed us to begin answering important questions about which unique factors give rise to social challenges for a specific person, as well as which areas may not be impacted for that same person. In doing so, we can begin to tailor our interventions to more precisely address those issues which matter most for a given individual.

A key example of a project that aims to identify patterns and profiles of social perception and cognition is the SCTL’s study of the SELWeb program. Conducted in collaboration with colleagues at the Rush NeuroBehavioral Center (NBC), this study examines an interactive web-based tool set called SELWeb, which uses a series of game-like activities to examine each of the following discrete aspects of social cognition:

  • Non-verbal awareness – the perception and processing of gestures, facial expression and body language.
  • Social perspective taking (theory of mind)- the ability to guess or infer what another person may think about a social situation or interaction.
  • Social reasoning – the ability to understand, interpret and make decisions based on social information and context.
  • Emotion regulation- the ability to appropriately monitor and control one’s emotions in social situations.

The original SELWeb games were developed by our colleagues at Rush NBC with the goal of assessing these four facets of social emotional learning (SEL; McKown et al., 2013). After initial development, the tasks were pooled together, standardized, and tested across two studies which collectively involved approximately 9,500 school-age TD children and evaluated whether the SELWeb tasks indeed measure the specific aspects of social cognition they were designed to assess (McKown et al., 2015). Results showed that the SELWeb games do successfully measure their targeted domains of social cognition, are comparable across domains of social cognition, are consistent for each child over a six-month period, and can be administered in a variety of ways and settings.

With support from the Simons Foundation, we examined SELWeb further in a sample of 60 children with ASD. In addition to finding that SELweb seems to measure the same social cognitive abilities typically assessed using longer and more demanding assessment tools, we found that performance on the SELWeb games was closely associated with parent and clinician ratings of various aspects of social abilities. On average, individuals with ASD show impairments in most (but not all!) SELWeb domains. However, we found dramatic differences within and between children, with some exhibiting a pattern of strengths and challenges in certain domains (e.g., strong ability to read emotions but poor ability to plan social responses), and other exhibiting an entirely different pattern. Thus, SELWeb can be utilized to elucidate unique profiles of strengths and weaknesses in social cognition abilities that vary between individual children. However, to really understand the diversity of ways children with (and without) ASD understand social information, we must search deeper. Specifically, we must examine how the brain goes about processing social information – in real time.

Electroencephalography, or EEG, is a safe, non-invasive, and cost-effective method of measuring the electrical activity of the brain while the brain is processing information, features which make EEG an ideal tool for pinpointing the exact point in time when differences in social processing occur. One way of doing this is to use event related potentials (ERPs). ERPs represent specific neural responses to a specific event. For instance, when seeing a face, one’s brain first registers the visual input, then identifies it as a face, then begins the process of decoding its emotions, familiarity, and identity. ERPs can be used to differentiate each of these steps.

Through generous support provided by a grant from the Brain & Behavior Research Foundation (BBRF; formerly NARSAD), the SCTL adapted the original SELWeb paradigm to be compatible with simultaneous EEG data collection. Combining these methodologies allows our team to measure brain activity while children complete the SELWeb tasks. This allows us to assess not only whether an individual is experiencing problems (or strengths) in one aspect of social cognition, but when exactly their social processing may be going awry.

For example, it is well known that many individuals with ASD have difficulty accurately identifying emotions in faces. A child’s performance on the nonverbal emotion recognition SELWeb module would show us whether such a broad impairment is present. Our previous ERP research has shown that such challenges in reading emotions among teenagers with ASD can arise from difficulties in orienting to emotional faces, rather than difficulty decoding faces (Lerner et. al, 2013). Now, we can extend this type of fine-grained analyses across many aspects of social cognition. For instance, during our social perspective taking game, participants must make sense of what a cartoon character in a short scene thinks or does (e.g., where they will look for a lost mitten that has been moved without their knowledge). Perhaps a child provides an incorrect answer (e.g., looking for the mitten in the place to which it has been moved) – why does she do so? Is it because she cannot hold in mind the idea of the scene? Is it because she cannot understand what the cartoon character thinks? Looking at ERPs recorded during the task can help us answer these questions. Then, when knit together with the ERP responses to all SELWeb tasks, we can get a deeper, more precise picture of how a child is decoding her social world beyond their responses to questions, and across multiple domains – a capability that was not previously achievable.

Thus, support from the BBRF has helped us to begin to unlock a deeper understanding of how children with ASD think about and process their social world than has ever been possible. Tools such as SELWeb are vital for advancing our ability to understand the unique ways that individuals with ASD may differ in how they think about social situations, and how those differences impact social functioning. The addition of EEG introduces the ability to disentangle the various minute processes involved in specific areas of social cognition. This deepens not only our understanding of the science of ASD, but will also provide much more specific targets for the next generation of precision interventions for the core challenges of youth with ASD. At the SCTL, we aim to be among the groups to usher in this next generation. It is with support from organizations like BBRF to us and others that will accelerate its arrival.

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