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Interaction between Word Processing and Low-Level Visual Representation in Autistic College Students

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Title: Interaction between Word Processing and Low-Level Visual Representation in Autistic College Students
Language: English
Authors: Nicolás Acuña Luongo (ORCID 0000-0002-9329-9296), Valeria Arriaza (ORCID 0000-0002-5141-9966)
Source: Mind, Brain, and Education. 2025 19(2):50-60.
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 11
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Education Level: Higher Education
Postsecondary Education
Descriptors: Visual Perception, Autism Spectrum Disorders, College Students, Multisensory Learning, Sensory Integration, Visual Stimuli, Language Processing
DOI: 10.1111/mbe.70002
ISSN: 1751-2271
1751-228X
Abstract: Recent studies reported a differential multisensory integration (MSI) in autism spectrum disorder (ASD). Much of the research on MSI differences has focused on how visual stimuli influence speech processing. The present study takes a reverse perspective. We investigated if speech processing can affect the construction of low-level visual representations in autistic individuals when they detect a visual stimulus under the continuous flash suppression (CFS) effect. The results showed that nonautistic participants benefit from speech processing during visual object detection when the linguistic stimulus is congruent with the masked visual object. This effect was not observed in autistic participants. In turn, the reaction time (RT) of correct answers was significantly lower in the nonautistic group than in the ASD participants. This indicates that MSI between linguistic and visual stimuli is affected in both directions. Our findings are interpreted under the embodiment cognition framework and its relationship with ASD.
Abstractor: As Provided
Notes: https://osf.io/yuc3h/?view_only=b61787abde5d441086bfb63c74c77ef1
Entry Date: 2025
Accession Number: EJ1472193
Database: ERIC
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  Value: <anid>AN0185490534;[309x]01may.25;2025May30.07:07;v2.2.500</anid> <title id="AN0185490534-1">Interaction Between Word Processing and Low‐Level Visual Representation in Autistic College Students </title> <p>Recent studies reported a differential multisensory integration (MSI) in autism spectrum disorder (ASD). Much of the research on MSI differences has focused on how visual stimuli influence speech processing. The present study takes a reverse perspective. We investigated if speech processing can affect the construction of low‐level visual representations in autistic individuals when they detect a visual stimulus under the continuous flash suppression (CFS) effect. The results showed that nonautistic participants benefit from speech processing during visual object detection when the linguistic stimulus is congruent with the masked visual object. This effect was not observed in autistic participants. In turn, the reaction time (RT) of correct answers was significantly lower in the nonautistic group than in the ASD participants. This indicates that MSI between linguistic and visual stimuli is affected in both directions. Our findings are interpreted under the embodiment cognition framework and its relationship with ASD.</p> <p>We investigated whether speech listening can affect the detection of visual stimuli in autistic individuals. To achieve this, we applied a word listening and visual detection task to a nonautistic group and an autism spectrum disorder (ASD) group. Results revealed that nonautistic participants benefit from speech when detecting a masked visual object. In turn, nonautistic participants reacted faster when perceiving the stimulus than autistic participants. This indicates that autistic individuals do not benefit from speech processing to integrate a multisensory representation.</p> <p>Autism spectrum disorder (ASD) is a developmental condition characterized by differences in social and communicative interactions and producing restrictive and repetitive behavioral patterns (American Psychiatric Association, [<reflink idref="bib2" id="ref1">2</reflink>]). The prevalence of ASD has increased in recent years. According to a meta‐analysis by Zeidan <emph>et al</emph>. ([<reflink idref="bib66" id="ref2">66</reflink>]), the prevalence of ASD in the world is 1 in 100 people. Along with the increase in general prevalence, the number of students on the spectrum who can access college has also increased. Although the prevalence of autistic university students is still unknown, international estimates suggest that at least 1.9% of this population meets the diagnostic criteria (White, Ollendrick, & Bray, [<reflink idref="bib62" id="ref3">62</reflink>]). Every year, more autistic individuals are diagnosed with average or higher intellectual abilities (Christensen <emph>et al</emph>., [<reflink idref="bib13" id="ref4">13</reflink>]), and effective treatments allow many of these high school students to enter University (Volkmar, Jackson, & Hart, [<reflink idref="bib56" id="ref5">56</reflink>]). However, the probability of an autistic student completing college is low (38%) compared to nonautistic (52%) (Jackson, Hart, Brown, & Volkmar, [<reflink idref="bib26" id="ref6">26</reflink>]). The causes of difficulties in completing their studies are problems related to increased states of anxiety, loneliness, depression, and the establishment of social relationships between classmates and teachers (Gelbar, Smith, & Reichow, [<reflink idref="bib21" id="ref7">21</reflink>]). Nevertheless, problems associated with fundamental academic skills are also reported (Viezel, Williams, & Dotson, [<reflink idref="bib55" id="ref8">55</reflink>]). One of the factors that can influence academic challenges may be the sensory processing of autistic individuals (Butera <emph>et al</emph>., [<reflink idref="bib11" id="ref9">11</reflink>]).</p> <p>The latest version of the Diagnostic and Statistical Manual of Mental Disorders (2013) included sensory differences as part of the core symptoms of ASD. Over the past decade, several studies emphasized that one of the crucial aspects observed in sensory differences in autism corresponds to multisensory integration (MSI) skills (Cascio, Foss‐Feig, Burnette, Heacock, & Cosby, [<reflink idref="bib12" id="ref10">12</reflink>]; Feldman <emph>et al</emph>., [<reflink idref="bib17" id="ref11">17</reflink>]; Foxe <emph>et al</emph>., [<reflink idref="bib19" id="ref12">19</reflink>]; Stevenson <emph>et al</emph>., [<reflink idref="bib49" id="ref13">49</reflink>]; van Laarhoven, Stekelenburg, & Vroomen, [<reflink idref="bib54" id="ref14">54</reflink>]).</p> <hd id="AN0185490534-2">THE IMPORTANCE OF MSI IN HIGHER‐ORDER COGNITIVE PROCESSES</hd> <p>Integrating information from different sensory modalities offers perceptual and social benefits (Curti, Serret, & Askenasy, [<reflink idref="bib14" id="ref15">14</reflink>]; Wallace, Woynaroski, & Stevenson, [<reflink idref="bib60" id="ref16">60</reflink>]). For example, MSI can be beneficial for constructing a representation of oral discourse in the presence of environmental noise (Yuan, Lleo, Daniel, White, & Oh, [<reflink idref="bib64" id="ref17">64</reflink>]; Yuan, Wayland, & Oh, [<reflink idref="bib65" id="ref18">65</reflink>]). It can also help recognize the emotions and intentions of our interlocutors through the integration of extralinguistic information (Kawakami & Otsuka, [<reflink idref="bib27" id="ref19">27</reflink>]). If MSI is not carried out properly, then a cascade effect will prevent the construction of an accurate and meaningful perceptual representation of the world (Ostrolenk, Bao, Mottron, Collignon, & Bertone, [<reflink idref="bib33" id="ref20">33</reflink>]; Stevenson <emph>et al</emph>., [<reflink idref="bib46" id="ref21">46</reflink>]; Thye, Bednarz, Herringshaw, Sartin, & Kana, [<reflink idref="bib52" id="ref22">52</reflink>]). This could affect text comprehension, understood as a higher‐order cognitive process.</p> <p>From the perspective of embodied cognition, it is argued that language comprehension is closely linked to fundamental perceptual processes (Barsalou, [<reflink idref="bib5" id="ref23">5</reflink>]; Ostarek & Huettig, [<reflink idref="bib32" id="ref24">32</reflink>]; Zwaan, [<reflink idref="bib67" id="ref25">67</reflink>]). This perspective suggests that meaning construction relies on mental representations that simulate the perceptual and motor aspects of the events described in narrative texts. Consequently, a relationship exists between reading comprehension and mental imagery. Several studies indicate that motor and perceptual areas of the brain are coactivated during language comprehension (Barsalou, [<reflink idref="bib6" id="ref26">6</reflink>]; Fischer & Zwaan, [<reflink idref="bib18" id="ref27">18</reflink>]; Zwaan, [<reflink idref="bib67" id="ref28">67</reflink>]). Thus, differences in MSI, as conceptualized within an embodied cognition framework, may partly explain reading comprehension difficulties in autistic individuals, who often exhibit atypical sensory processing.</p> <p>Similarly, Stothers and Klein ([<reflink idref="bib50" id="ref29">50</reflink>]) examined the role of perceptual organization (PO) in reading comprehension. In cognitive psychology, PO refers to the perceptual grouping of experiences into meaningful wholes, following principles of Gestalt theory (Behrmann & Kimchi, [<reflink idref="bib9" id="ref30">9</reflink>]). Meaning emerges from perceiving interrelations among discrete components. In their study, Stothers and Klein found that, despite its nonverbal nature, PO consistently predicted reading comprehension. These findings were interpreted through the lens of mental imagery. The authors proposed that mental images support both PO and inferential activities involved in reading comprehension.</p> <p>Wallace <emph>et al</emph>. ([<reflink idref="bib60" id="ref31">60</reflink>]) and Hahn, Foxe, and Molholm ([<reflink idref="bib22" id="ref32">22</reflink>]) suggest that individuals with reading comprehension difficulties may exhibit impairments not only in phoneme‐grapheme mapping—a characteristic commonly associated with decoding deficits, such as in dyslexia—but also in more generalized MSI processes. However, reading difficulties are not homogeneous. While some individuals struggle with decoding due to phoneme‐grapheme mapping deficits, others, often referred to as "poor comprehenders," do not present decoding impairments but instead face challenges in processing and integrating the meaning of the text. Given that MSI plays a fundamental role in integrating sensory and linguistic information, deficits in this process could contribute to both types of reading difficulties. Neuroanatomical studies support this idea, as they have identified reduced activation in MSI‐related regions, such as the superior temporal sulcus and the temporoparietal region, in individuals with reading disorders (Blau <emph>et al</emph>., [<reflink idref="bib10" id="ref33">10</reflink>]; Rüsseler, Ye, Gerth, Szycik, & Münte, [<reflink idref="bib39" id="ref34">39</reflink>]).</p> <p>The interaction between language and perception has gained increasing attention as a key mechanism underlying cognitive processing. Language not only reflects our experiences but also actively modulates perceptual representations, guiding how we interpret and interact with the environment (Vulchanova, Vulchanov, Fritz, & Milburn, [<reflink idref="bib58" id="ref35">58</reflink>]). Specifically, language can shape visual processing by influencing visual attention and enhancing the detection of relevant stimuli, a phenomenon that highlights the close relationship between top‐down linguistic input and bottom‐up perceptual systems. For example, linguistic cues have been shown to direct visual search and shape low‐level visual representations, ultimately influencing object recognition and comprehension (Lupyan & Ward, [<reflink idref="bib30" id="ref36">30</reflink>]; Tanenhaus <emph>et al</emph>., [<reflink idref="bib51" id="ref37">51</reflink>]; Vulchanova <emph>et al</emph>., [<reflink idref="bib58" id="ref38">58</reflink>]). From a developmental perspective, children learn object labels through visual recognition and cognitive mechanisms, with a focus on the shape bias. This bias is crucial for noun acquisition, as children prioritize shape over other features like color or texture when labeling objects. The shape bias is linked to vocabulary growth, and its development is robust between 18 and 24 months. However, children with autism may show impaired shape bias, affecting their word learning abilities.</p> <p>Vulchanova <emph>et al</emph>. ([<reflink idref="bib58" id="ref39">58</reflink>]) suggest that gestures, particularly iconic ones, depict concrete actions and are closely linked to speech production. They can convey information not present in spoken language, highlighting the tight integration between gesture and speech. Brain imaging studies have concluded that during the construction of meaning in language comprehension, there is an integration between speech and gestures that involves classic language areas in the left frontal and temporal lobes (Andric & Small, [<reflink idref="bib3" id="ref40">3</reflink>]; Dick <emph>et al</emph>., [<reflink idref="bib16" id="ref41">16</reflink>]).</p> <p>If MSI is an important phenomenon for the development of higher cognitive skills, then it is to be expected that MSI may have an impact on school performance, especially on those school skills that depend on cognitive processes linked to MSI. Butera <emph>et al</emph>. ([<reflink idref="bib11" id="ref42">11</reflink>]) studied the relationship between sensory processing and school performance in autistic students with average intellectual abilities. They found that low school performance was related to greater hypersensitivity and fewer avoidance behaviors in autistic students. The authors conclude that sensory processing has an important impact on school performance in autism. Nonetheless, the authors did not consider MSI in their experimental design.</p> <hd id="AN0185490534-3">THE PRESENT STUDY</hd> <p>Despite the growing interest in the study of MSI in autism, important questions remain to be resolved. In particular, MSI research and its relation to autism can present nuances linked to the types of stimuli that are integrated (Stevenson <emph>et al</emph>., [<reflink idref="bib47" id="ref43">47</reflink>]), the specific sensory modalities affected (Woynaroski <emph>et al</emph>., [<reflink idref="bib63" id="ref44">63</reflink>]), the number of modalities that are simultaneously integrated, and the tasks used in the experimental designs. This situation could explain the conflicting evidence regarding MSI in autistic individuals (de Boer‐Schellekens, Keetels, Eussen, & Vroomen, [<reflink idref="bib15" id="ref45">15</reflink>]; Feldman <emph>et al</emph>., [<reflink idref="bib17" id="ref46">17</reflink>]; Gedek, Pantelis, & Kennedy, [<reflink idref="bib20" id="ref47">20</reflink>]; Weiland, Polderman, Smit, Begeer, & Van der Burg, [<reflink idref="bib61" id="ref48">61</reflink>]). Baum, Stevenson, and Wallace ([<reflink idref="bib7" id="ref49">7</reflink>]) suggest that although sensory processing problems are explored by distinguishing which difficulties are in each sensory domain, research must focus on processing across the different modalities and how those modalities are integrated. In turn, Bao, Doobay, Mottron, Collignon, and Bertone ([<reflink idref="bib4" id="ref50">4</reflink>]) propose that the exclusive use of sociocommunicative stimuli can be problematic for research on MSI in autism. The authors question whether there is a fundamental alteration of MSI in ASD when higher‐level complex stimuli are removed. Answering this question would allow us to distinguish whether integration problems are domain specific, affecting only the social domain, or whether they correspond to generalized difficulties. Some studies identified alterations in MSI only when sociocommunicative materials were used (Bebko, Weiss, Demark, & Gomez, [<reflink idref="bib8" id="ref51">8</reflink>]; Mongillo <emph>et al</emph>., [<reflink idref="bib31" id="ref52">31</reflink>]; Stevenson <emph>et al</emph>., [<reflink idref="bib48" id="ref53">48</reflink>]; Stevenson, Siemann, Schneider, <emph>et al</emph>., [<reflink idref="bib47" id="ref54">47</reflink>]), while other investigations reported general difficulties that involved both social and nonsocial situations (Bao <emph>et al</emph>., [<reflink idref="bib4" id="ref55">4</reflink>]; de Boer‐Schellekens <emph>et al</emph>., [<reflink idref="bib15" id="ref56">15</reflink>]).</p> <p>Many studies on MSI and autism focus on how the processing of one sensory modality can benefit from processing information from another modality (Curti <emph>et al</emph>., [<reflink idref="bib14" id="ref57">14</reflink>]; Ostrolenk <emph>et al</emph>., [<reflink idref="bib33" id="ref58">33</reflink>]; Smith & Bennetto, [<reflink idref="bib42" id="ref59">42</reflink>]). Typically, it has been reviewed how speech processing may or may not benefit from visual information (Iarocci, Rombough, Yager, Weeks, & Chua, [<reflink idref="bib25" id="ref60">25</reflink>]; Silverman, Bennetto, Campana, & Tanenhaus, [<reflink idref="bib41" id="ref61">41</reflink>]; Stevenson <emph>et al</emph>., [<reflink idref="bib44" id="ref62">44</reflink>]; Stevenson, Segers, Ferber, Barense, & Wallace, [<reflink idref="bib45" id="ref63">45</reflink>]). For example, Stevenson <emph>et al</emph>. ([<reflink idref="bib44" id="ref64">44</reflink>]) explored how visual information impacts speech perception in noisy environments.</p> <p>The research showed that autistic children benefited from MSI in phoneme recognition but not in whole‐word recognition.</p> <p>The present study adopts a reverse perspective to investigate a bidirectional relationship between oral language processing and visual perception. We investigated whether the construction of low‐level visual representations can benefit from linguistic processing. This objective is relevant to the extent that it allows us to determine whether sensory integration problems in autism are domain specific or whether they constitute a generalized strategy that affects any type of integration. Furthermore, unlike previous studies, we worked with the immediate detection of a visual stimulus modulated or not by a linguistic representation, which allows us to determine whether these integration difficulties emerge in the preconceptual stages of visual detection behavior.</p> <p>Studies in nonautistic participants show that linguistic processing can affect, under certain conditions, low‐level visual representations (Lupyan & Ward, [<reflink idref="bib30" id="ref65">30</reflink>]; Ostarek & Huettig, [<reflink idref="bib32" id="ref66">32</reflink>]; Paffen, Sahakian, Struiksma, & Van der Stigchel, [<reflink idref="bib34" id="ref67">34</reflink>]). Specifically, language can boost visual perception when the linguistic stimulus is congruent with a subsequent visual stimulus. In this sense, the present study seeks to determine whether word processing can affect the construction of low‐level visual representations in autistic individuals.</p> <p>This bidirectional relationship becomes particularly relevant when investigating MSI processes, which involve the dynamic interaction between sensory modalities and higher‐level cognitive systems such as language. Atypical MSI has been widely documented in autistic individuals, often characterized by differences in the integration of auditory and visual information (Bao <emph>et al</emph>., [<reflink idref="bib4" id="ref68">4</reflink>]; Stevenson <emph>et al</emph>., [<reflink idref="bib46" id="ref69">46</reflink>]). While much of the research has focused on how visual stimuli facilitate speech processing, the reverse relationship—how language influences visual perception—remains unexplored, particularly in autism. Vulchanova <emph>et al</emph>. ([<reflink idref="bib58" id="ref70">58</reflink>]) suggest that language plays a fundamental role in modulating perceptual experiences, which raises important questions about whether these modulatory effects occur in autistic individuals in the same manner as in nonautistic individuals. The present study addresses this gap by examining whether linguistic processing can facilitate the construction of low‐level visual representations and whether this process differs in autistic individuals.</p> <p>To achieve our purpose, we used the continuous flash suppression (CFS) experimental paradigm (Pournaghdali & Schwartz, [<reflink idref="bib38" id="ref71">38</reflink>]; Stein & Peelen, [<reflink idref="bib43" id="ref72">43</reflink>]). This paradigm is based on binocular rivalry. Different stimuli are presented in each visual field (right and left), causing alternation in the visual perception of both stimuli. However, the alternation in perception can be eliminated if one stimulus presents a low color contrast in the image of an object and the other stimulus presents a series of mondrian patterns that flash up with a high color contrast (Figure 1). In this way, the low‐contrast stimulus is masked under the suppression effect caused by the other stimulus (mondrian patterns). In general, researchers study whether prior linguistic processing exerts any influence on the detection of the masked stimulus when the linguistic stimulus is congruent with the object that appears under the masking effect (Lupyan & Ward, [<reflink idref="bib30" id="ref73">30</reflink>]; Ostarek & Huettig, [<reflink idref="bib32" id="ref74">32</reflink>]; Paffen <emph>et al</emph>., [<reflink idref="bib34" id="ref75">34</reflink>]). Under this paradigm, it was confirmed that word processing can activate low‐level visual representations. Participants listened to a word that could either be congruent or incongruent with the subsequent image of an object, which was masked using the CFS effect. Results showed that when participants listened to or read a word that was congruent with the masked object's image, they tended to report a higher detection rate for the stimulus compared to when the word was incongruent.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/309X/01may25/mbe70002-fig-0001.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="mbe70002-fig-0001.jpg" title="1 Binocular fusion was employed with an image presented to the right eye and the left eye observing a continuously changing CFS mask at approximately 10 Hz. Adapted from Ostarek and Huettig ([32])." /> </p> <p></p> <p>In the present study, we aim to investigate whether the facilitation effect of word congruency on low‐level visual representations is observed in autistic participants.</p> <hd id="AN0185490534-5">METHOD</hd> <p></p> <hd id="AN0185490534-6">Participants</hd> <p>Forty native Spanish‐speaking college students participated in this study. The sample included 20 nonautistic participants (M = 8, F = 12, mean age 19 years) and 20 autistic participants with average intellectual abilities (M = 12, F = 8, mean age 21 years). The diagnosis was confirmed by Chile's current legislation standards, based on the DSM V (2013), through the application of the <emph>Autism Diagnostic Observation Schedule, Second Edition</emph> (ADOS‐2) and <emph>The Autism Diagnostic Interview‐Revised</emph> (ADI‐R) instruments, which were applied by a multidisciplinary team that confirmed the diagnosis. To enter college, all participants passed a standardized test of basic cognitive skills. All participants have normal hearing and normal or corrected‐to‐normal vision. The number of participants and trials should yield adequate statistical power based on similar previous research (Lupyan & Ward, [<reflink idref="bib30" id="ref76">30</reflink>]; Ostarek & Huettig, [<reflink idref="bib32" id="ref77">32</reflink>]; Pinto, van Gaal, de Lange, Lamme, & Seth, [<reflink idref="bib37" id="ref78">37</reflink>]).</p> <p>Participation was voluntary, and all participants provided written informed consent, as approved by the Scientific Ethics Committee of the University of Valparaíso (protocol CEC‐UV 235‐21).</p> <hd id="AN0185490534-7">Design, Stimuli, and Procedure</hd> <p>The research used a 2 × 2 design. The first two factors were group conditions: one group consisted of nonautistic participants and the other consisted of autistic participants. The second two factors were the congruent and incongruent conditions. In the congruent condition, we refer to a match between the oral linguistic stimuli and a subsequent object image under the CFS effect. In the incongruent condition, we refer to a mismatch between the oral linguistic stimuli and a subsequent object image under the CFS effect.</p> <p>To ensure binocular rivalry and the CFS effect, participants were asked to wear prismatic glasses (prism diopter: ∆10) and noise‐canceling headphones. Participants rested their heads on a chinrest and sat 80 cm from the computer monitor (resolution 1900 × 720, refresh rate: 60 Hz). An acrylic divider was placed at the center of the screen extending to the participants' noses so that each eye could only see the ipsilateral half of the monitor. PsychoPy software version 3.0 was used to present the stimuli.</p> <p>To achieve the CFS effect, we designed 50 Mondrian‐type images consisting of 1000 overlapping colored rectangles of different sizes (similar to those used by Ostarek & Huettig, [<reflink idref="bib32" id="ref79">32</reflink>]). We converted the images to grayscale using Adobe Photoshop (version 21.0.6) to facilitate suppression.</p> <p>We recorded 16 cue words (average length: 500 ms, range: 390–620 ms) spoken by a male voice of a native Spanish speaker. Using Studio One version 4.0 software, each word was segmented into a different file.</p> <p>At the beginning of each trial, we presented a screen with a cross fixed to the center of a black rectangular frame (600 × 600 pixels) on both halves of the screen for 500 ms. Then, a spoken word was presented. In the picture‐present condition, 200 ms after word onset, a suppressed image appeared: The masking effect was presented on one side of the screen (random Mondrian‐type rectangular shapes changing at 12 Hz), and the target object image (gray scale of 350 × 350 pixels) was presented on the other side. Half of the stimuli corresponded to the no‐picture present condition where one half of the screen remained empty while the CFS effect was applied to the other.</p> <p>Following the standards of Lupyan and Ward ([<reflink idref="bib30" id="ref80">30</reflink>]) and Ostarek and Huettig ([<reflink idref="bib32" id="ref81">32</reflink>]), based on ocular dominance preferences, the target images were presented on the right side of the visual field. The visual stimulus remained on the screen for 400 ms. After that, the following question appeared: "Was there a picture?" (Figure 2). Participants were instructed to promptly respond using the left or right button (left for no‐image recognition and right for image recognition). Explicit instructions were given to detect an object distinct from the Mondrian patterns (rectangles). Participants were also informed that the spoken words would not necessarily indicate the subsequent appearance of an image on the screen, and they were unaware of which image would follow. Before starting the main experiment, participants completed a practice session of nine trials to ensure they understood the task and response requirements.</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/309X/01may25/mbe70002-fig-0002.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="mbe70002-fig-0002.jpg" title="2 Trial structure: The target image appeared 200 ms after the word onset, with the words extending until the target picture offset (average word length: 500 ms)." /> </p> <p></p> <p>The main experiment consisted of 256 trials in total. These included 128 trials with object images, evenly divided into 64 congruent trials, where the spoken word matched the object image (e.g., the word "pencil" paired with the image of a pencil) and 64 incongruent trials, where the spoken word did not match the object image (e.g., the word "car" paired with the image of a pencil). This design ensured that the semantic relationship between the auditory and visual stimuli was systematically manipulated to assess MSI. Additionally, there were 128 trials with a spoken word but no object image, in which only the Mondrian patterns were presented. Each of the 16 words and corresponding images was repeated eight times across the trials, ensuring a balanced distribution of conditions. The incongruent condition refers specifically to trials in which the spoken word and the picture did not match. This is distinct from the no‐picture condition, where no visual stimulus was presented alongside the Mondrian patterns. The no‐picture condition was included as a control to account for potential false positives, while the incongruent condition was designed to test the effect of semantic mismatch between auditory and visual stimuli.</p> <p>A prerequisite for conducting this study was to exert reasonable control over the suppression strength, to achieve an image detection rate close to 50% for each participant. We implemented a brief staircase procedure following the protocols outlined by Ostarek and Huettig ([<reflink idref="bib32" id="ref82">32</reflink>]). This procedure was carried out prior to data collection and was identical to that described above, except that the oral word stimulus was not presented. Additionally, we used different images from those employed in the final procedure. During the staircase procedure, each successful image detection led to a slight decrease in the contrast scale of the following image, whereas each miss resulted in a slight increase. Each participant's contrast adjustment aimed to maintain suppression strength at approximately 50% detection accuracy.</p> <p>In the staircase procedure, if the detection rate exceeded 75% accuracy due to differences in ocular dominance, the target object automatically shifted to the left side of the visual field. However, none of the participants exhibited this pattern, indicating that the CFS effect was successfully implemented under the typical conditions used in previous research (Lupyan & Ward, [<reflink idref="bib30" id="ref83">30</reflink>]; Ostarek & Huettig, [<reflink idref="bib32" id="ref84">32</reflink>]). By employing the staircase procedure, we ensured that the CFS effect functioned effectively for each participant and calibrated the exact image contrast to achieve approximately 50% recognition accuracy.</p> <hd id="AN0185490534-9">Analysis Plan</hd> <p>We analyzed the hit rates in a binomial mixed model, including congruence (congruent vs. incongruent) and group (autistic and nonautistic participants) as fixed effects and each participant and stimuli as a random effect (random intercepts and slopes). Next, we analyzed the reaction times (RTs) in all correct trials in the picture‐present condition using a linear mixed‐effect model with the same fixed and random effects structure as the binomial model used primarily. From the analysis, we removed each RT slower than 2.5 SD and further than 2.5 SD from the mean results.</p> <hd id="AN0185490534-10">RESULTS</hd> <p>Based on 4869 observations, the nonautistic group's hit rate analysis evidenced a 50.1% accuracy in the congruent condition, and in the incongruent condition, it was 44.1%. In the autistic group, the hit rate of the congruent condition was 48.4%, and in the incongruent condition, it was 50.1% (Graph 1). Mixed model analysis suggests an interaction effect between stimulus conditions and participant groups (<emph>E</emph> = 0.077, SE = 0.031, <emph>t</emph> = −2.472, <emph>p</emph> = 0.013) (Table 1).</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/309X/01may25/mbe70002-fig-0003.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="mbe70002-fig-0003.jpg" title="1 Hit rates including the condition of congruency (congruent vs. incongruent) and group (autistic, nonautistic participants)" /> </p> <p></p> <p>1 Table Binomial Mix Model for Hit Rates Including the Condition of Congruency (Congruent vs. Incongruent) and Group (Autistic, Nonautistic Participants)</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Term</th><th align="center">Estimate</th><th align="center">SE</th><th align="center">t</th><th align="center">p</th></tr></thead><tbody valign="top"><tr><td align="left">Intercept</td><td align="char" char=".">−0.073</td><td align="char" char=".">0.200</td><td align="char" char=".">−0.367</td><td align="char" char=".">0.713</td></tr><tr><td align="left">Congruency (1)</td><td align="char" char=".">0.043</td><td align="char" char=".">0.031</td><td align="char" char=".">1.396</td><td align="char" char=".">0.163</td></tr><tr><td align="left">Group (1)</td><td align="char" char=".">0.044</td><td align="char" char=".">0.089</td><td align="char" char=".">  0.0492</td><td align="char" char=".">0.623</td></tr><tr><td align="left">Congruency (1)* Group (1)</td><td align="char" char=".">−0.077</td><td align="char" char=".">0.031</td><td align="char" char=".">−2.472</td><td align="char" char=".">0.013</td></tr></tbody></table> </ephtml> </p> <p>Regarding the RT of the correct answers, based on 2365 observations, the mixed model analysis evidenced that in the nonautistic group, the congruent condition decreased the response time to the object recognition question. In the congruent condition, the mean was 0.741 ms (SD = 0.221). In the incongruent condition, the mean recognition was 0.797 (SD = 0.324). In the autistic group, the mean response time in the congruent condition was 0.763 ms (SD = 0.277); in the incongruent condition, it was 0.765 ms (SD = 0.310) (Graph 2). Although the differences in the RTs in both conditions are low, the mixed model analysis showed an interaction effect between the stimulus condition and the group (<emph>E</emph> = 0.013, SE = 0.006, <emph>t</emph> = 2.194, <emph>p</emph> = 0.028) (Table 2).</p> <p> <img src="https://imageserver.ebscohost.com/img/embimages/rdk/309X/01may25/mbe70002-fig-0004.jpg?ephost1=dGJyMNXb4kSepq84yOvqOLCmsE6epq5Srqa4SK6WxWXS" alt="mbe70002-fig-0004.jpg" title="2 Reaction times including the condition of congruency (congruent vs. incongruent) and group (autistic, nonautistic participants)." /> </p> <p></p> <p>2 Table Linear Mixed‐effect Model for Reaction Times (RTs), Including the Condition of Congruency (Congruent vs. Incongruent) and Group (Autistic, Nonautistic Participants)</p> <p> <ephtml> <table><thead valign="bottom"><tr><th align="left">Term</th><th align="center">Estimate</th><th align="center">SE</th><th align="center">df</th><th align="center">t</th><th align="center">p</th></tr></thead><tbody valign="top"><tr><td align="left">Intercept</td><td align="char" char=".">0.765</td><td align="char" char=".">0.011</td><td align="char" char=".">  32.812</td><td align="char" char=".">70.734</td><td align="char" char="."><0.001</td></tr><tr><td align="left">Congruency (1)</td><td align="char" char=".">−0.015</td><td align="char" char=".">0.006</td><td align="char" char=".">2326.762</td><td align="char" char=".">−2.660</td><td align="char" char=".">0.008</td></tr><tr><td align="left">Group (1)</td><td align="char" char=".">0.002</td><td align="char" char=".">0.011</td><td align="char" char=".">  39.075</td><td align="char" char=".">−0.165</td><td align="char" char=".">0.870</td></tr><tr><td align="left">Congruency (1)* Group (1)</td><td align="char" char=".">0.013</td><td align="char" char=".">0.006</td><td align="char" char=".">2329.509</td><td align="char" char=".">2.194</td><td align="char" char=".">0.028</td></tr></tbody></table> </ephtml> </p> <hd id="AN0185490534-13">DISCUSSION</hd> <p>Our findings constitute evidence that MSI challenges in autism not only affect the benefit obtained from visual stimuli for speech processing (Stevenson <emph>et al</emph>., [<reflink idref="bib46" id="ref85">46</reflink>]) but also the reverse process. Unlike nonautistic participants, autistic individuals do not exhibit an influence of linguistic processing on the construction of low‐level visual representations. We consider this evidence crucial because previous studies focus on how speech processing benefits from integrating visual information. However, linguistic communication is a dynamic phenomenon that often involves the visual perception of nonverbal resources that facilitate the comprehension of the intentions of our interlocutors (Hostetter, [<reflink idref="bib24" id="ref86">24</reflink>]). In this way, linguistic communication requires interactive information processing and occurs in top‐down and bottom‐up modes (Köhne‐Fuetterer, Drenhaus, Delogu, & Demberg, [<reflink idref="bib28" id="ref87">28</reflink>]; Kurby, Britt, & Magliano, [<reflink idref="bib29" id="ref88">29</reflink>]). Accordingly, our study aligns with research that suggests that autism privileges bottom‐up information processing (Phan <emph>et al</emph>., [<reflink idref="bib36" id="ref89">36</reflink>]; Ursino <emph>et al</emph>., [<reflink idref="bib53" id="ref90">53</reflink>]). The absence of the facilitation effect in autistic participants suggests important differences in MSI processes. Vulchanova <emph>et al</emph>. ([<reflink idref="bib58" id="ref91">58</reflink>]) emphasize that language and perception interact to construct meaningful cognitive representations by integrating top‐down and bottom‐up information. In autism, this dynamic interaction appears to be disrupted, leading to a greater reliance on sensory‐driven (bottom‐up) information and a reduced influence of linguistic context (Phan <emph>et al</emph>., [<reflink idref="bib36" id="ref92">36</reflink>]; Ursino <emph>et al</emph>., [<reflink idref="bib53" id="ref93">53</reflink>]).</p> <p>Our results lead to similar conclusions drawn by Phan <emph>et al</emph>. ([<reflink idref="bib36" id="ref94">36</reflink>]). They compared the N400 event‐related potential during an auditory semantic task in nonautistic and autistic children. Results exhibited that autistic participants used more bottom‐up strategies during language processing. This means they integrate each word as it appears, without anticipating or predicting upcoming words based on prior knowledge.</p> <p>Ursino <emph>et al</emph>. ([<reflink idref="bib53" id="ref95">53</reflink>]) used a different approach to reach the same conclusion. They analyzed brain connectivity in individuals with different levels of autistic traits. Findings showed that participants with higher autistic traits had strong connections from sensory areas toward higher‐order processing regions, such as from the primary visual cortex to the frontal areas. At the same time, they found a reduced top‐down connectivity in the same participants. Using hubness analysis, they found fewer connections from frontal and parietotemporal areas toward sensory regions than participants with lower autistic traits.</p> <p>Our findings align with these studies from a behavioral perspective. We observed that autistic participants rely more on sensory input and less on higher‐level predictions when processing information. For instance, in our experiment, linguistic congruency did not enhance the ability of autistic participants to detect a masked visual object. This suggests that they did not use the linguistic context to improve visual perception. Instead, they focused solely on what they could visually perceive, unaffected by prior linguistic cues. This behavior reflects Ursino <emph>et al</emph>. ([<reflink idref="bib53" id="ref96">53</reflink>]) findings of reduced top‐down connectivity, reinforcing the idea that sensory‐driven bottom‐up processing plays a dominant role autistic individuals.</p> <p>Some considerations need to be addressed in further research. This study did not manipulate the time difference between linguistic oral stimulus and visual object presentation. It could be appropriate to know if this temporal manipulation could affect MSI in ASD participants. By doing this, we could shed light on the temporal binding window debate (Bao <emph>et al</emph>., [<reflink idref="bib4" id="ref97">4</reflink>]; Stevenson, Siemann, Schneider, <emph>et al</emph>., [<reflink idref="bib47" id="ref98">47</reflink>]; Wallace & Stevenson, [<reflink idref="bib59" id="ref99">59</reflink>]; Weiland <emph>et al</emph>., [<reflink idref="bib61" id="ref100">61</reflink>]) by using the facilitation effect of speech perception on visual perception.</p> <p>Studies in nonautistic individuals using the CFS paradigm to analyze MSI during linguistic processing have been interpreted as evidence favoring the embodied perspective of language (Shapiro, [<reflink idref="bib40" id="ref101">40</reflink>]; Zwaan, [<reflink idref="bib67" id="ref102">67</reflink>]). According to this perspective, linguistic processing does not occur in a modular and domain‐specific way (Barsalou, [<reflink idref="bib6" id="ref103">6</reflink>]). On the contrary, during linguistic processing, there is a coactivation of brain areas associated with motor skills and perception. In this sense, our results support Hannant's ([<reflink idref="bib23" id="ref104">23</reflink>]) and Peleg, Ozer, Norman, and Segal's ([<reflink idref="bib35" id="ref105">35</reflink>]) conclusions. Both studies indicate that autistic individuals struggle to construct an embodied representation of language. Peleg <emph>et al</emph>. ([<reflink idref="bib35" id="ref106">35</reflink>]) show that autistic individuals are less able to spontaneously activate perceptual information based on the context of the sentence. Embodied representations of language have a fundamental role in the construction of a discourse situation model, which constitutes a central component of higher levels of discourse processing (Zwaan, [<reflink idref="bib68" id="ref107">68</reflink>]). In this sense, the difference in MSI can be constituted as an underlying explanation for the reading comprehension problems observed in autistic individuals (Acuña & Arriaza, [<reflink idref="bib1" id="ref108">1</reflink>]) because problems in MSI can generate a cascade effect (Stevenson <emph>et al</emph>., [<reflink idref="bib46" id="ref109">46</reflink>]) in other higher cognitive processes such as speech comprehension, reading comprehension, or mentalization.</p> <p>Finally, from a similar perspective, another key aspect that characterizes autistic individuals is the processing of nonliteral language. Vulchanova, Saldaña, Chahboun, and Vulchanov ([<reflink idref="bib57" id="ref110">57</reflink>]) emphasize that the challenges autistic individuals face in figurative language processing are rooted in broader integration deficits rather than isolated linguistic impairments. While autistic individuals often demonstrate intact structural language skills, their difficulties with pragmatic and figurative language, such as metaphors, idioms, and irony, point to impairments in integrating contextual, semantic, and sensory information in real‐time interaction. This observation suggests a dissociation between local language processing and the global integration required for higher‐order linguistic tasks. Although the present study did not work from an interactional perspective, the absence of a facilitation effect from linguistic congruency in autistic participants provides behavioral evidence for this dissociation. The present results align with Vulchanova <emph>et al</emph>.'s ([<reflink idref="bib57" id="ref111">57</reflink>]) assertion that autism is characterized by impairments in real‐time semantic integration, which become more pronounced as the complexity of stimuli increases. Real time semantic integration requires the combination of different sensory inputs including visual and linguistic inputs. According to Vulchanova <emph>et al</emph>. ([<reflink idref="bib57" id="ref112">57</reflink>]) the difficulties on nonliteral language comprehension arise from a cognitive profile marked by weak central coherence and a detail‐focused cognitive style. This profile prioritizes local over global processing, limiting the ability of autistic individuals to construct coherent mental representations of linguistic or sensory inputs. For instance, figurative language often relies on integrating disparate semantic or contextual elements, such as linking a metaphor's literal and figurative meanings. This integration requires drawing on prior knowledge, linguistic cues, and sensory information—processes that may be disrupted in autism due to differences in MSI.</p> <p>The difficulty in effectively integrating linguistic and visual context observed in our study may represent a foundational deficit that cascades into more complex cognitive processes, such as interpreting social cues or constructing coherent narrative models.</p> <hd id="AN0185490534-14">Acknowledgments</hd> <p>We are grateful to Markus Ostarek for his insightful comments and generous support, which contributed significantly to the development of this work.</p> <hd id="AN0185490534-15">FUNDING INFORMATION</hd> <p>This work was supported by the Agencia Nacional de Investigación y Desarrollo under Grant Fondecyt Project No. FONDECYT11241268.</p> <hd id="AN0185490534-16">CONFLICT OF INTEREST</hd> <p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p> <hd id="AN0185490534-17">ETHICAL APPROVAL</hd> <p>All participants signed a consent approved by the scientific ethics committee of the University of Valparaíso (protocol CEC‐UV 235‐21).</p> <hd id="AN0185490534-18">DATA AVAILABILITY STATEMENT</hd> <p>The data are available on the Open Science Framework at https://osf.io/yuc3h/?view_only=b61787abde5d441086bfb63c74c77ef1.</p> <ref id="AN0185490534-19"> <title> REFERENCES </title> <blist> <bibl id="bib1" idref="ref108" type="bt">1</bibl> <bibtext> Acuña, N., & Arriaza, V. 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Items – Name: Title
  Label: Title
  Group: Ti
  Data: Interaction between Word Processing and Low-Level Visual Representation in Autistic College Students
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Nicolás+Acuña+Luongo%22">Nicolás Acuña Luongo</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-9329-9296">0000-0002-9329-9296</externalLink>)<br /><searchLink fieldCode="AR" term="%22Valeria+Arriaza%22">Valeria Arriaza</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5141-9966">0000-0002-5141-9966</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Mind%2C+Brain%2C+and+Education%22"><i>Mind, Brain, and Education</i></searchLink>. 2025 19(2):50-60.
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  Label: Availability
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 11
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2025
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Visual+Perception%22">Visual Perception</searchLink><br /><searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Multisensory+Learning%22">Multisensory Learning</searchLink><br /><searchLink fieldCode="DE" term="%22Sensory+Integration%22">Sensory Integration</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+Stimuli%22">Visual Stimuli</searchLink><br /><searchLink fieldCode="DE" term="%22Language+Processing%22">Language Processing</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1111/mbe.70002
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1751-2271<br />1751-228X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Recent studies reported a differential multisensory integration (MSI) in autism spectrum disorder (ASD). Much of the research on MSI differences has focused on how visual stimuli influence speech processing. The present study takes a reverse perspective. We investigated if speech processing can affect the construction of low-level visual representations in autistic individuals when they detect a visual stimulus under the continuous flash suppression (CFS) effect. The results showed that nonautistic participants benefit from speech processing during visual object detection when the linguistic stimulus is congruent with the masked visual object. This effect was not observed in autistic participants. In turn, the reaction time (RT) of correct answers was significantly lower in the nonautistic group than in the ASD participants. This indicates that MSI between linguistic and visual stimuli is affected in both directions. Our findings are interpreted under the embodiment cognition framework and its relationship with ASD.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: Note
  Label: Notes
  Group: Note
  Data: https://osf.io/yuc3h/?view_only=b61787abde5d441086bfb63c74c77ef1
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  Label: Entry Date
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  Data: 2025
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  Data: EJ1472193
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        Value: 10.1111/mbe.70002
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 50
    Subjects:
      – SubjectFull: Visual Perception
        Type: general
      – SubjectFull: Autism Spectrum Disorders
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Multisensory Learning
        Type: general
      – SubjectFull: Sensory Integration
        Type: general
      – SubjectFull: Visual Stimuli
        Type: general
      – SubjectFull: Language Processing
        Type: general
    Titles:
      – TitleFull: Interaction between Word Processing and Low-Level Visual Representation in Autistic College Students
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          Name:
            NameFull: Nicolás Acuña Luongo
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            NameFull: Valeria Arriaza
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          Dates:
            – D: 01
              M: 05
              Type: published
              Y: 2025
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            – TitleFull: Mind, Brain, and Education
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