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Orienting of Visual Attention among Persons with Autism Spectrum Disorders: Reading versus Responding to Symbolic Cues

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Title: Orienting of Visual Attention among Persons with Autism Spectrum Disorders: Reading versus Responding to Symbolic Cues
Language: English
Authors: Landry, Oriane, Mitchell, Peter L., Burack, Jacob A.
Source: Journal of Child Psychology and Psychiatry. Jul 2009 50(7):862-870.
Availability: Blackwell Publishing. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8599; Fax: 781-388-8232; e-mail: customerservices@blackwellpublishing.com; Web site: http://www.blackwellpublishing.com/jnl_default.asp
Peer Reviewed: Y
Physical Description: PDF
Page Count: 9
Publication Date: 2009
Document Type: Journal Articles
Reports - Research
Descriptors: Cues, Mental Age, Autism, Attention, Pervasive Developmental Disorders, Visual Perception, Comparative Analysis, Visual Stimuli, Reaction Time
DOI: 10.1111/j.1469-7610.2008.02049.x
ISSN: 0021-9630
Abstract: Background: Are persons with autism spectrum disorders (ASD) slower than typically developing individuals to read the meaning of a symbolic cue in a visual orienting paradigm? Methods: Participants with ASD (n = 18) and performance mental age (PMA) matched typically developing children (n = 16) completed two endogenous orienting conditions in which the cue exposure time and response preparation time were manipulated within a consistent series of cue-target stimulus onset asynchronies (SOAs). Results: Participants with ASD displayed facilitation effects at all SOAs, whereas typically developing children displayed facilitation effects only at shorter SOAs. The magnitude of the facilitation effect was greater for the group with ASD at 400ms SOA. Both groups showed similar effects of condition, with similar patterns of facilitation in both conditions. Conclusion: Persons with ASD were not slower to read the symbolic cue, as the effect was elicited by brief cues within longer SOAs before target onset. The participants with ASD were also less efficient in using the predictability of the cues to guide responding. The difficulties of participants with ASD on endogenous orienting occur at the response selection level, not the perceptual level. (Contains 4 figures and 2 tables.)
Abstractor: As Provided
Entry Date: 2009
Accession Number: EJ843677
Database: ERIC
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  Value: <anid>AN0041554391;jyy01jul.09;2024Jun04.07:35;v2.2.500</anid> <title id="AN0041554391-1">Orienting of visual attention among persons with autism spectrum disorders: reading versus responding to symbolic cues. </title> <p>Background:  Are persons with autism spectrum disorders (ASD) slower than typically developing individuals to read the meaning of a symbolic cue in a visual orienting paradigm? Methods:  Participants with ASD (n = 18) and performance mental age (PMA) matched typically developing children (n = 16) completed two endogenous orienting conditions in which the cue exposure time and response preparation time were manipulated within a consistent series of cue‐target stimulus onset asynchronies (SOAs). Results:  Participants with ASD displayed facilitation effects at all SOAs, whereas typically developing children displayed facilitation effects only at shorter SOAs. The magnitude of the facilitation effect was greater for the group with ASD at 400ms SOA. Both groups showed similar effects of condition, with similar patterns of facilitation in both conditions. Conclusion:  Persons with ASD were not slower to read the symbolic cue, as the effect was elicited by brief cues within longer SOAs before target onset. The participants with ASD were also less efficient in using the predictability of the cues to guide responding. The difficulties of participants with ASD on endogenous orienting occur at the response selection level, not the perceptual level.</p> <p>Keywords: endogenous orienting; attention; spatial cuing; voluntary control; autistic disorder; cognition; reaction time; visuo‐spatial functioning; Autism</p> <p></p> <ulist> <item> Abbreviations:</item> <p></p> <item> ASD autism spectrum disorders</item> <p></p> <item> PIQ Performance IQ</item> <p></p> <item> PMA performance mental age</item> <p></p> <item> SOA stimulus onset asynchrony</item> </ulist> <p>Autism spectrum disorders (ASD) are pervasive developmental disorders characterized by a triad of impairments in social behavior, communication, and repetitive/stereotyped behavior. In addition to these defining features, children and adults with ASD typically exhibit enhanced perceptual abilities concurrently with severe impairments in higher‐order cognitive skills, along with a unique constellation of attentional impairments. While ASD is typically not diagnosed until toddler or pre‐school years, abnormalities in attention not restricted to the social domain that emerged between 6 and 12 months predicted ASD diagnosis at 24 months in a prospective longitudinal study ([<reflink idref="bib23" id="ref1">23</reflink>]). Thus, early impairments in attention may have cascading effects throughout development as children and adults fail to attend to important cues for learning.</p> <p>On tasks of visual shifting, or orienting, of attention persons with ASD appear to have difficulty utilizing symbolic cues ([<reflink idref="bib22" id="ref2">22</reflink>]), whereas performance appears intact with respect to non‐symbolic cues ([<reflink idref="bib9" id="ref3">9</reflink>]). This dichotomy was highlighted by [<reflink idref="bib2" id="ref4">2</reflink>] who hypothesized that persons with ASD are slower to <emph>read</emph> a symbolic cue. The implication of this <emph>reading</emph> hypothesis is that the problem lies at the level of perceptual input; incoming sensory information is perceived too slowly for efficient responses to be made (e.g., what is that cue?). If this were true, then longer exposure to a symbolic cue would provide more time to read its meaning and performance should approximate that of persons without ASD. Alternatively, differences in performance could be attributed to differences in response selection to stimuli presentations (e.g., I know what it is, but what do I do with it?). According to this <emph>response hypothesis</emph>, lengthened exposure to a symbolic cue should improve performance because it incidentally provides more time to select the appropriate response; incoming sensory information is perceived efficiently but more time is needed to direct the shift of attention. The purpose of the current study was to test Burack et al.'s <emph>reading</emph> hypothesis against the <emph>response</emph> hypothesis among participants with ASD and a group of typically developing participants matched on performance mental age (PMA).</p> <hd id="AN0041554391-2">Visual orienting</hd> <p>Visual orienting is typically measured in the laboratory using variations of [<reflink idref="bib13" id="ref5">13</reflink>] cued target detection task in which participants are asked to fixate on the center of a computer screen and press a button when they see a target. Targets can appear either to the left or right of the fixation point. Cues are presented at variable stimulus onset asynchronies (SOAs) prior to the target, resulting in differential effects on target detection. A valid, or congruent, trial is when the cue and target appear on the same side. An invalid, or incongruent, trial is when the cue and target appear on different sides. The finding that target detection is faster on valid than invalid trials is referred to as a facilitation effect ([<reflink idref="bib13" id="ref6">13</reflink>]). Attention can be directed to a spatial location both by overtly moving the eyes or covertly, without an eye‐movement, and by both automatic and voluntary means. On an automatic exogenous orienting task, the cue is a stimulus that is presented in either of the regions where the target could appear, and an attention shift is elicited on the basis of the physical properties of the stimulus. In contrast, on a voluntary endogenous orienting task, a centrally presented symbol cues to a peripheral region, and an attention shift is elicited on the basis of the symbolic meaning of the cue. For example, a flash of lightening attracts attention to the location of the flash (exogenous), whereas an arrow on a sign symbolically directs attention from the sign to a specific location of interest (endogenous).</p> <p>[<reflink idref="bib12" id="ref7">12</reflink>] suggest that exogenous orienting is a basic process that develops earlier than endogenous orienting, which requires more strategic or controlled attention. [<reflink idref="bib6" id="ref8">6</reflink>] reported that children 6 to 8 years old displayed adult‐like exogenous orienting, while demonstrating difficulty on endogenous orienting tasks. In another series of experiments, [<reflink idref="bib20" id="ref9">20</reflink>] reported that exogenous orienting effects did not differ between 6‐, 10‐, 14‐year‐olds, and adults at a 100ms SOA, although the 6‐year‐olds showed stronger orienting effects at 800ms SOA than the older groups. [<reflink idref="bib21" id="ref10">21</reflink>] also reported that 6‐year‐olds failed to show an effect of SOA on an endogenous orienting task, whereas 10‐, 14‐year‐olds, and adults showed stronger orienting effects at 800ms than 100ms SOA. The developmental lag between exogenous and endogenous orienting supports a model of orienting in ASD whereby exogenous orienting may be <emph>intact</emph> while endogenous orienting may be <emph>impaired</emph>.</p> <hd id="AN0041554391-3">Visual orienting in autism spectrum disorders</hd> <p>Persons with ASD exhibit intact exogenous orienting relative to mental age ([<reflink idref="bib9" id="ref11">9</reflink>]), but do not appear to show facilitation effects to rapidly presented cues when an endogenous shift of attention is required ([<reflink idref="bib15" id="ref12">15</reflink>]; [<reflink idref="bib22" id="ref13">22</reflink>]). In one study, [<reflink idref="bib22" id="ref14">22</reflink>] tested a group of high‐functioning adults with ASD and age‐ and IQ‐matched typical adults on a Posner task with central arrows as cues. These cues remained onscreen for 100ms or 800ms and were predictive with a valid to invalid ratio of 4:1. Facilitation effects were found in both groups, although they differed with regard to cue duration effects. Regardless of cue duration, the typical adults responded faster to valid than to invalid trials and the magnitude of this effect was the same at both cue durations, whereas the adults with ASD only displayed facilitation effects in the long‐cue duration, and the magnitude of this effect was larger than for the typically developing group at the same duration. [<reflink idref="bib22" id="ref15">22</reflink>] concluded that the participants with ASD were impaired in either disengaging or shifting attention, or in the voluntary coordination of attention and motor systems. The finding of facilitation effects at the longer SOA suggests that the process of orienting to symbolic cues is slowed down in persons with ASD.</p> <p>As the evidence does not appear to support a general orienting deficit among persons with ASD but rather a delayed orienting effect specifically to symbolic cues, [<reflink idref="bib2" id="ref16">2</reflink>] suggested that the deficit exhibited on endogenous orienting reported by [<reflink idref="bib22" id="ref17">22</reflink>] might indicate that persons with ASD are slower to interpret the meaning of the symbolic cue. The presence of the orienting effect at longer SOAs could reflect a slower reading of the cue, but reports of slower overall reaction times ([<reflink idref="bib16" id="ref18">16</reflink>]; [<reflink idref="bib22" id="ref19">22</reflink>]) may be indicative of other un‐measured slowed processes that are prerequisite to a manual response. Specifically, persons with ASD may be able to read briefly presented cues just as well as typically developing persons, but may be slower to select or execute a shift of visual attention, a hitherto un‐measured process. For example, the onset of the target in an endogenous orienting trial with an SOA of 100ms could elicit an exogenous shift before the endogenous shift to the cue is complete, resulting in accurate target detection with no influence of the cue; the pattern typically reported for ASD. This possibility is supported by evidence of atypical performance among persons with ASD on other visuomotor tasks, including reach‐to‐grasp ([<reflink idref="bib11" id="ref20">11</reflink>]), visual pursuit ([<reflink idref="bib17" id="ref21">17</reflink>], [<reflink idref="bib18" id="ref22">18</reflink>]), and saccadic eye movements ([<reflink idref="bib10" id="ref23">10</reflink>]; [<reflink idref="bib17" id="ref24">17</reflink>], [<reflink idref="bib18" id="ref25">18</reflink>]), indicating that visuomotor performance is intact except in cases where control over visuomotor performance must be exercised. Similarly, impaired control over, rather than attention itself, may contribute to the difficulties observed among persons with ASD using symbolic cues to direct attention.</p> <hd id="AN0041554391-4">Current study</hd> <p>This study was designed to test [<reflink idref="bib2" id="ref26">2</reflink>] hypothesis that persons with ASD are slower to read the meaning of a symbolic cue against the rival hypothesis that persons with ASD are slower to select an attentional response to the symbol. If the <emph>reading</emph> hypothesis is correct, then increasing the duration of exposure time to the symbolic cue should facilitate the performance of persons with ASD on an endogenous visual orienting task. If the response selection hypothesis is correct, then performance should be facilitated by increasing the SOA duration while maintaining the cue duration. As increasing the cue duration necessarily increases the SOA duration, we designed an experiment to break down the SOA by manipulating the cue duration within the SOA.</p> <p>We used non‐predictive cues to tap 'pure' symbol reading, uncontaminated by the need for participants to learn the contingency within the experimental task. Arrows are highly salient and frequently occurring symbols with which all participants, controlling for age, should have similar experience. When presented to participants in a non‐predictive cueing task, these cues should elicit facilitation effects from both typically developing children ([<reflink idref="bib14" id="ref27">14</reflink>]) and persons with ASD ([<reflink idref="bib14" id="ref28">14</reflink>]; [<reflink idref="bib16" id="ref29">16</reflink>]; [<reflink idref="bib19" id="ref30">19</reflink>]). The use of non‐predictive cues also reduces the overall duration of the experiment, thereby reducing the likelihood of the participants becoming fatigued.</p> <p>In the Variable Cue Exposure condition, increases in SOA coincided with a lengthening of the onscreen duration of the cue. In contrast, in the Constant Cue Exposure condition, a consistently brief cue of 100ms was presented during different SOAs, such that increases in SOA coincided with a lengthening of the gap between the cue offset and the target onset. [<reflink idref="bib22" id="ref31">22</reflink>] reported that 100ms was the SOA at which persons with ASD failed to show facilitation with arrows, and thus 100ms could be interpreted as an insufficient viewing exposure for participants with ASD to read the cue. In accordance with the <emph>reading hypothesis,</emph> if participants with ASD require more time to read the cue, as implied by [<reflink idref="bib2" id="ref32">2</reflink>], they would be expected to exhibit facilitation effects on the Variable Cue Exposure condition at longer SOAs but no facilitation effects on the Constant Cue Exposure condition in which all cue presentations are brief. Alternatively, in accordance with the <emph>response selection hypothesis</emph>, the briefly seen cue may be perceived and interpreted, but response selection may be slower, in which case participants with ASD will exhibit facilitation effects for longer SOAs, regardless of the cue duration. Accordingly, similar performance should be seen in the two conditions.</p> <hd id="AN0041554391-5">Method</hd> <p></p> <hd id="AN0041554391-6">Participants</hd> <p>Twenty‐four participants with a diagnosis of ASD and 16 typically developing children and adolescents initially participated in the experiment. Six participants with ASD were excluded because their performance IQ (PIQ) was below 75, as measured with the performance subscales of the Wechsler Abbreviated Scale of Intelligence (WASI; [<reflink idref="bib7" id="ref33">7</reflink>]). There were no significant differences in raw scores on either subscale of the WASI between groups (Matrix Reasoning <emph>p </emph>= .5, Block Design <emph>p </emph>= .22).The participants with ASD had a lower mean PIQ than the typically developing children, <emph>t</emph>(<reflink idref="bib32" id="ref34">32</reflink>) = 2.96, <emph>p = </emph>.006, but did not differ on chronological age (<emph>p = </emph>.61), or PMA calculated from age and IQ (<emph>p = </emph>.41) (Table 1).</p> <p>1  Chronological age (CA), PIQ, calculated PMA, and WASI raw scores of participants with ASD and typically developing children</p> <p> <ephtml> <table><thead valign="bottom"><tr><th valign="bottom"> </th><th>Mean</th><th>Standard deviation</th><th>Sample Size</th></tr><tr><th>ASD</th><th>Typical</th><th>ASD</th><th>Typical</th><th>ASD</th><th>Typical</th></tr></thead><tbody valign="top"><tr><td>CA</td><td>11.52</td><td>11.00</td><td>3.07</td><td>2.66</td><td>18</td><td>16</td></tr><tr><td>PIQ</td><td>99.50</td><td>114.44</td><td>15.53</td><td>13.69</td><td>18</td><td>16</td></tr><tr><td>PMA</td><td>11.51</td><td>12.49</td><td>3.74</td><td>2.92</td><td>18</td><td>16</td></tr><tr><td>WASI blocks</td><td>29.39</td><td>38.87</td><td>20.70</td><td>17.85</td><td>18</td><td> 15*</td></tr><tr><td>WASI matrices</td><td>21.22</td><td>24.07</td><td>7.11</td><td>4.92</td><td>18</td><td> 15*</td></tr></tbody></table> </ephtml> </p> <p>1 *raw scores were not used for one child whose WASI scores were one year old at time of testing.</p> <p>The participants with ASD were recruited from special education schools for individuals with ASD, and had all received a formal clinical diagnosis of Asperger's syndrome (<emph>n </emph>=<emph> </emph>8) or autism (<emph>n </emph>=<emph> </emph>10) according to DSM‐IV ([<reflink idref="bib1" id="ref35">1</reflink>]) criteria. Most of these participants had participated in previous experiments and were known to be high‐functioning and amenable to this type of research. Typically developing children were recruited through word of mouth and were screened for ASD, learning, or behavioral disorders by parental report. Informed written consent was obtained from parents and verbal assent was obtained from participants themselves.</p> <p>The degree of current ASD symptomatology for all except five participants was assessed with the Autism Spectrum Screening Questionnaire (ASSQ; [<reflink idref="bib5" id="ref36">5</reflink>]), a 27‐item questionnaire completed by a parent or teacher. The items are rated on a three‐point scale. Respondents indicate whether the child 'stands out' from other children his/her age by responding <emph>no</emph> (0), <emph>somewhat</emph> (<reflink idref="bib1" id="ref37">1</reflink>), or <emph>yes</emph> (<reflink idref="bib2" id="ref38">2</reflink>) to each item. The range of possible scores is 0–54. The items address social interaction, communication, restricted and repetitive behavior, and motor clumsiness and associated symptoms. As expected, the participants with ASD scored higher on the ASSQ (<emph>M = </emph>21.8, <emph>SD = </emph>9.61) than the typically developing children (<emph>M = </emph>9.36, <emph>SD = </emph>11.87), <emph>t</emph>(<reflink idref="bib27" id="ref39">27</reflink>) = 3.11, <emph>p = </emph>.004.</p> <hd id="AN0041554391-7">Apparatus</hd> <p>The stimuli were presented using Superlab Pro 1.77 ([<reflink idref="bib4" id="ref40">4</reflink>]) software on a Macintosh G3/333mhz Powerbook computer with a 14.1‐inch LCD monitor with the screen resolution set at 1072 × 768. Responses were made on the computer keyboard using the (x) and (.) keys, which were clearly marked with stickers depicting the target (x).</p> <hd id="AN0041554391-8">Stimuli</hd> <p>The computerized orienting task comprised two experimental conditions. The stimuli consisted of central arrow cues that were presented in the middle of the screen, and a target X that was presented 200 pixels (61mm), or approximately 7 degrees of visual angle to the left or right of the center of the screen with participants seated at a distance of 50cm (Figure 1). The cues were solid black arrows that measured 20mm × 20mm (2.3 degrees of visual angle), and the target was a black letter X that measured 7mm × 10mm (.8 × 1.0 degrees visual angle). The participants were instructed to respond as fast as they could to the target, by responding to targets that were presented on the right side of the screen with a right button press, and to targets presented on the left side with a left button press. In all conditions, targets remained onscreen until the participant made a response, or until three seconds had elapsed.</p> <p>Graph: 1 Sequence of events for experimental (Variable Cue Exposure, Constant Cue Exposure) and control (Target, Cue) conditions</p> <hd id="AN0041554391-9">The experimental conditions</hd> <p>The experimental conditions included a Variable Cue Exposure condition and a Constant Cue Exposure condition, each with SOAs of 200, 400, 700, and 1100ms (Figure 1). In the Variable Cue Exposure condition, the length of the exposure time to the cue varied, while the gap between cue offset and target onset remained constant. The central arrow cue was presented for 100, 300, 600, or 1000ms, followed by a 100ms blank screen and then the presentation of the target stimulus (X). In the Constant Cue Exposure condition, the length of exposure time to the cue was constant (100ms), while the gap between cue offset and target onset was 100, 300, 600, or 1000ms. On 50% of trials in each condition, the direction of the arrow corresponded with the side on which the target appeared (valid), and on 50% of trials the arrow pointed to the side opposite that on which the target appeared (invalid). Each experimental condition included 24 practice trials that were not included in the analyses, and 240 experimental trials that were presented in blocks of 60 randomized trials with breaks in between blocks. The participants were allowed to control the duration of the breaks between each block by pressing any button on the keyboard to continue with the experiment.</p> <hd id="AN0041554391-10">The control conditions</hd> <p>Two control conditions were also included. The Target control condition was used to measure simple reaction time to a target. This condition included the presentation of the same targets used in the experimental conditions, but was not preceded by a cue. It included 16 practice trials and 30 experimental trials. The Cue control condition was used to measure reaction time to make a judgment regarding the directionality of an arrow. In this condition, the same central arrow cues used in the experimental conditions were presented, but not followed by a target.</p> <hd id="AN0041554391-11">Procedure</hd> <p>The participants were tested individually in a quiet room on university premises or in their school. When testing occurred on two of three school properties, teachers were present and quietly observed as per school regulations. At the university, some parents chose to observe a block of trials on the computer, but most waited in a separate room. No parents were in the testing room with their child during the administration of the WASI. Parents or teachers completed the ASSQ while the participant was being tested.</p> <p>All the participants were positioned to be at eye level and 50cm from the center of the computer screen. A chin rest maintained the head position of participants during testing. The participants were instructed to try to fixate on the center of the screen throughout all of the conditions. The conditions were presented in a quasi‐counterbalanced order, with the Target control condition presented first, followed by the experimental conditions in counterbalanced order, and the Cue control condition last. The Target control condition was always presented first, which allowed this condition to serve as a screening task to confirm that participants understood the task instructions. The instructions for this task were to press the button corresponding to the side of the screen on which the target appeared. The instructions for the experimental conditions were the same as for the Target control condition. The Cue control condition was always presented last, with the instruction to press the button that indicated the direction to which the arrow pointed. This condition was always administered last because the instruction to attend to arrow direction could have potentially affected performance on the experimental conditions.</p> <hd id="AN0041554391-12">Results</hd> <p>There were no differences between groups in overall error rates (ASD <emph>M </emph>= .03, <emph>SD</emph> = .02, typical <emph>M </emph>= .05, <emph>SD</emph> = .05). Median reaction times were computed for each participant for all correct responses within each condition and these values were entered for analysis. The median reaction times were examined using a 2 × 2 × 2 × 4 mixed‐model ANOVA with group (ASD vs. typically developing) as the between‐subjects factor, cue‐condition (variable vs. constant), validity (invalid vs. valid) and SOA (200 vs. 400 vs. 700 vs. 1100) as the within‐subjects factors. Significant main effects of validity, <emph>Multi F</emph>(<reflink idref="bib1" id="ref41">1</reflink>,<reflink idref="bib32" id="ref42">32</reflink>) = 44.20, <emph>p < </emph>.001, <emph>partial η</emph><sups><emph>2 </emph></sups><emph>=</emph><sups><emph> </emph></sups>.58, and SOA, <emph>Multi F</emph>(<reflink idref="bib3" id="ref43">3</reflink>,<reflink idref="bib30" id="ref44">30</reflink>) = 16.90, <emph>p < </emph>.001, <emph>partial η</emph><sups><emph>2 </emph></sups><emph>=</emph><sups><emph> </emph></sups>.63, were found; participants were faster on valid trials than on invalid trials, and reaction times decreased overall as SOA increased. No main effects of cue‐condition or group were found. A significant interaction was found between cue‐condition and SOA, <emph>Multi F</emph>(<reflink idref="bib3" id="ref45">3</reflink>,<reflink idref="bib30" id="ref46">30</reflink>) = 5.61, <emph>p = </emph>.004, <emph>partial η</emph><sups><emph>2 </emph></sups><emph>=</emph><sups><emph> </emph></sups>.36, and a three‐way interaction among validity, SOA, and group, <emph>Multi F</emph>(<reflink idref="bib3" id="ref47">3</reflink>,<reflink idref="bib30" id="ref48">30</reflink>) = 2.95, <emph>p = </emph>.049, <emph>partial η</emph><sups><emph>2 </emph></sups>=<sups><emph> </emph></sups>.23.</p> <p>The interactions were examined further using simple effects tests with Bonferroni corrections for multiple comparisons. The cue‐condition by SOA interaction was driven by a significant effect of cue‐condition in the longest SOA only, <emph>Multi F</emph>(<reflink idref="bib1" id="ref49">1</reflink>,<reflink idref="bib32" id="ref50">32</reflink>) = 7.52, <emph>p = </emph>.01, <emph>partial η</emph><sups><emph>2 </emph></sups>=<sups><emph> </emph></sups>.19, and no significant effects of cue‐condition in any of the other SOAs (Figure 2).</p> <p>Graph: 2 Reaction times on the Variable Cue Exposure (VCE) and Constant Cue Exposure (CCE) conditions by SOA. There are no significant differences between cue conditions at 200, 400, or 700ms SOA; however, there is a significant effect of cue condition at 1100ms SOA</p> <p>Due to a priori hypotheses about facilitation effects, for the three‐way interaction the simple effect of validity was tested within each level combination of group and SOA (Table 2). Participants with ASD showed significant facilitation effects at all levels of SOA (all <emph>p</emph>s < .001), whereas the typically developing children displayed significant facilitation effects at 200ms (<emph>p </emph>< .001) and 400ms SOA (<emph>p </emph>= .021), a trend at 700ms SOA (<emph>p </emph>= .065), and no facilitation at 1100ms SOA.</p> <p>2  Reaction times of participants with ASD and typically developing children collapsed across condition. Significant facilitation effects were found for all SOAs among participants with ASD, but only at 200 and 400ms SOAs among typically developing children</p> <p> <ephtml> <table><thead valign="bottom"><tr><th valign="bottom">SOA</th><th>200ms</th><th>400ms</th><th>700ms</th><th>1100ms</th></tr><tr><th><italic>M</italic></th><th><italic>SEM</italic></th><th><italic>M</italic></th><th><italic>SEM</italic></th><th><italic>M</italic></th><th><italic>SEM</italic></th><th><italic>M</italic></th><th><italic>SEM</italic></th></tr></thead><tbody valign="top"><tr><td>ASD (<italic>n </italic>=<italic> </italic>18)</td></tr><tr><td> invalid</td><td>550.14*</td><td>34.02</td><td>526.14*</td><td>30.81</td><td>504.33*</td><td>31.25</td><td>484.89*</td><td>29.77</td></tr><tr><td> valid</td><td>533.17</td><td>32.95</td><td>488.86</td><td>31.69</td><td>459.90</td><td>28.87</td><td>456.47</td><td>27.17</td></tr><tr><td>Typical (<italic>n </italic>=<italic> </italic>16)</td></tr><tr><td> invalid</td><td>496.22*</td><td>36.08</td><td>467.00*</td><td>32.68</td><td>449.47</td><td>33.15</td><td>433.19</td><td>31.58</td></tr><tr><td> valid</td><td>469.97</td><td>34.95</td><td>450.44</td><td>33.62</td><td>429.69</td><td>30.62</td><td>420.39</td><td>28.82</td></tr></tbody></table> </ephtml> </p> <p>To further understand this interaction, a 2 × 4 × 2 mixed‐model ANOVA on the difference scores (invalid – valid reaction times) with cue‐condition, SOA, and group was conducted to examine the magnitude of facilitation effects. A significant SOA by group interaction (<emph>p </emph>= .049) with simple effects tests revealed that the magnitude of the facilitation effect was significantly greater in the ASD group at 400ms SOA (<emph>p </emph>= .034), and a similar trend was noted at 700ms (<emph>p </emph>= .093). The mean difference between groups at these two SOAs was 21ms and 25ms respectively (Figure 3). There were no significant group differences at the other SOAs. There was no effect of condition on the magnitude of the orienting effect. There were no significant correlations between any measures of reaction time and ASSQ scores.</p> <p>Graph: 3 Magnitude of facilitation effects by group and SOA. Participants with ASD showed significantly larger facilitation effects than typically developing children at the 400ms SOA. Facilitation effects are significant (magnitude > 0) for the participants with ASD at all SOAs; however, the facilitation effect was significant only at the 200 and 400ms SOAs among the typically developing children</p> <p>Reaction times on the control conditions were analyzed using independent samples <emph>t</emph>‐tests. On the Target‐only condition, there was no significant difference in reaction time between groups. On the Cue‐only condition, participants with ASD showed a trend toward a slower response to the direction of the arrow than typically developing children, <emph>t</emph>(<reflink idref="bib32" id="ref51">32</reflink>) = 1.96, <emph>p </emph>= .058 (Figure 4). Thus, on a simple target detection task participants with ASD did not differ reliably in response speed from PMA matched peers; however, when the task requirement was to respond to the direction of the arrow, participants with ASD may be slower to make this judgment.</p> <p>Graph: 4 Reaction times on the control conditions. Participants with ASD showed a trend towards slower reaction times when simply responding to the target (without a cue) and significantly slower reaction times when responding to the direction of the arrow cue</p> <hd id="AN0041554391-13">Discussion</hd> <p>This experiment was designed to test whether participants with ASD require more time to read a symbolic cue, as suggested by [<reflink idref="bib2" id="ref52">2</reflink>] or whether a briefly seen cue is read, but the attention shift in response to the cue is slower. Contrary to [<reflink idref="bib2" id="ref53">2</reflink>] suggestion, the results support the response selection hypothesis. Both participants with and without ASD showed facilitation effects on both the Variable Cue Exposure and Constant Cue Exposure conditions. The presence of facilitation effects with the Constant Cue Exposure manipulation demonstrates specifically that the 100ms cue affected behavior. [<reflink idref="bib2" id="ref54">2</reflink>] would have predicted that a 100ms symbolic cue is too brief a presentation to be read by persons with ASD.</p> <p>The three‐way interaction among group, validity, and SOA revealed distinct patterns of facilitation across SOA in the two groups. As shown in Figure 3, the facilitation effect was present for the participants with ASD across SOA; however, the facilitation effect was no longer present for typically developing children at longer SOAs. This diminishing effect at longer SOAs among typically developing children suggests that they are better able to use their knowledge about the contingency of the arrow at longer trial lengths. It also suggests that participants with ASD either failed to learn over the course of the experiment that the arrows are in fact useless, or that they were unable to use this knowledge to control attention. Knowledge of the arrow contingency was not systematically recorded, although some participants in both groups spontaneously commented on this fact. One boy with autism reported that he knew the arrows were not helpful and ignored them; however, his data clearly indicated that he did not. Unlike previous studies in which contingency was manipulated (e.g., [<reflink idref="bib16" id="ref55">16</reflink>]), participants in this study were given no instruction with respect to the arrows. This finding raises several questions that will have to be addressed in future studies. One of these questions concerns learning, though the number of trials included in the experiment does not permit reliably examining learning over the course of this task.</p> <p>In a previous study ([<reflink idref="bib22" id="ref56">22</reflink>]), persons with ASD did not exhibit facilitation effects at 100ms SOA, but did exhibit facilitation at 800ms SOA. The prevailing interpretation was that longer viewing time enabled the facilitation effects ([<reflink idref="bib2" id="ref57">2</reflink>]), but the data presented in this study demonstrate that participants with ASD are influenced by an arrow presented for 100ms, suggesting instead that participants with ASD take longer to select the orienting response, and a longer cue presentation inherently provides a longer response preparation time. These findings fail to support the reading‐level explanation as increasing the duration of the presentation of the cue within the SOA had no effect above and beyond simply extending the duration of the SOA.</p> <p>We found further support for the special role played by the symbol, the arrow, in our control tasks. On a simple target detection task, similar in task demands to the experimental tasks, we found no reliable group differences in reaction time. The participants with ASD in our study were not simply slower at target detection. This was also seen in the lack of a main effect of group on the experimental tasks. However, on the cue‐only control task, participants with ASD showed a trend toward slower responses to indicate whether the arrow pointed left or right. The cue‐only control task illustrates the role of the symbol in the impairments of persons with autism on these types of tasks, but alone the task is unable to elucidate the reading versus responding hypotheses. Together with the results of the experimental manipulation, we see clear evidence for response selection impairments in voluntary orienting performance among participants with ASD.</p> <p>One potential concern with the current data is the significantly higher PIQ of the typically developing group. While the participants with ASD included in the experiment were high‐functioning, the typically developing participants skewed higher on PIQ. We attribute this to a self‐selection bias among families volunteering for experiments. There is little concern that this difference influenced the results of the experiment; while PIQ is relevant to processing speed, the raw scores on the WASI subtests did not differ reliably between groups. Thus, while the typically developing participants may be advanced for their age, their absolute performance was not advanced relative to the participants with ASD. A second potential concern is that we are measuring manual responses assuming that these manual responses reflect attentional shifts. Given the conclusion that response selection is impaired, we cannot conclusively argue that the attentional shift response selection was impaired and not the manual response selection without measuring overt gaze shifts. The finding that differences in magnitude of orienting effects were only observed at specific SOAs argues against a general manual response selection difficulty and we are thus confident that the manual response speed of the participants with ASD reflects attentional shift speed.</p> <hd id="AN0041554391-14">Impaired response selection: implications for autism spectrum disorders</hd> <p>This data supports the hypothesis that lengthened exposure to a symbolic cue improves performance for persons with ASD because it provides more time to respond to the cue, and, rather surprisingly, only a brief cue exposure is needed to trigger a response. Other findings that persons with ASD exhibit facilitation effects at 800ms SOA that were larger in magnitude to that of comparison groups ([<reflink idref="bib3" id="ref58">3</reflink>]; [<reflink idref="bib8" id="ref59">8</reflink>]; [<reflink idref="bib22" id="ref60">22</reflink>]) may in part be due to facilitation effects diminishing for the typically developing participants. We should be cautious in comparing our findings with those from studies with other SOA effects because non‐predictive arrows are rarely used. In the study with the most comparable design ([<reflink idref="bib16" id="ref61">16</reflink>]), children with ASD also demonstrated orienting effects to non‐predictive arrows at shorter SOAs, but not at longer SOAs. Two factors might explain the differences in findings between the two studies. One, [<reflink idref="bib16" id="ref62">16</reflink>], used larger stimuli, which might enhance performance relative to a smaller stimulus at any given SOA. Two, [<reflink idref="bib16" id="ref63">16</reflink>] explicitly told their participants that the arrow was meaningless and that they should ignore the arrow. In contrast, we provided no instructions regarding the arrows, as our participants were required to implicitly learn the contingency in order to know that they should ignore the arrow. This suggests that learning the association between the symbolic cue and the target may be a factor in the difficulties exhibited by children with ASD on voluntary orienting tasks. In line with this hypothesis, [<reflink idref="bib16" id="ref64">16</reflink>] also reported in a second experiment that children with ASD exhibited orienting effects to non‐predictive arrows in a 20% contingency condition at both 100ms and 300ms SOA, whereas typically developing children showed no effect at 100ms, and showed a reversal appropriate to the contingency of the arrow at 300ms and 700ms SOAs. The typically developing children were able to learn the contingency and use that knowledge to facilitate target detection, whereas the children with ASD were unable to do so. Further, [<reflink idref="bib15" id="ref65">15</reflink>] found that older adolescents and young adults with ASD were sensitive to the contingency of eye‐gaze cues, but only at longer SOAs. The group exposed to 80% predictive cues demonstrated orienting effects at 300, 600, and 1000ms SOAs, but not at 100ms, whereas the group exposed to 50% non‐predictive cues did not demonstrate orienting effects at any SOA. However, [<reflink idref="bib15" id="ref66">15</reflink>] findings are inconsistent with those reported by [<reflink idref="bib16" id="ref67">16</reflink>] and by [<reflink idref="bib19" id="ref68">19</reflink>], who reported orienting effects to 50% non‐predictive eye‐gaze cues for participants with ASD at SOAs between 300ms and 700ms, and orienting effects in line with the cue but not contingency in a 20% condition at 100ms SOA ([<reflink idref="bib16" id="ref69">16</reflink>]). Again, the size of the cues used across studies may contribute to the discrepancies in findings. Future studies will be needed to examine the role of contingency learning in voluntary orienting performance, as well as to examine age‐related changes in implicit contingency learning, both in children with ASD and in typical development.</p> <p>These findings also have implications for the clinical manifestation of ASD. Early impairments in attention have cascading effects throughout development as children fail to attend to important cues for learning. The real world is dynamic, with cues to attend to one location or another occurring rapidly. Children with ASD may from a very early age fail to respond to cues fast enough to derive meaning. For example, a child engaging in joint attention with a parent follows the parent's gesture or eye gaze to an interesting event. If that child were too slow responding to the parent's cue, the interesting event may have passed when the child's gaze arrives. If this occurred frequently, the child would have no impetus to follow gaze because he or she has not had the experiences necessary to learn that gaze following leads to interesting events. In our experiment, the children with ASD used the arrows as cues, indicating that they had learned that an arrow points to something interesting, but they may have taken more years to learn this than typically developing children. Future studies will be needed to test these effects in younger groups.</p> <hd id="AN0041554391-15">Conclusion</hd> <p>The purpose of this experiment was to test the hypothesis that persons with ASD are slower to read the meaning of symbolic cues in a visual orienting paradigm. The results clearly indicate that orienting is elicited even by a brief cue among persons with ASD. These findings are contrary to a previous interpretation ([<reflink idref="bib2" id="ref70">2</reflink>]) of findings that persons with ASD did not show facilitation effects to arrows presented for 100ms. Rather, we suggest that persons with ASD did not show facilitation effects in previous studies at 100ms SOA because the duration of the trial was too short. When we increased the SOA while maintaining the cue presentation at 100ms, the participants with ASD showed facilitation. This can be explained by suggesting that persons with ASD are affected more by variations in the time available to select a response than variations in the time available to read the cue. Persons with ASD are not impaired at reading the meaning of the symbolic cue, but rather the impairment is at the level of selecting the appropriate response.</p> <hd id="AN0041554391-16">Key points</hd> <p></p> <ulist> <item> • </item> <p></p> <item> Children with ASD have specific difficulty orienting in response to symbolic cues but are not impaired orienting to spatial cues. This difficulty occurs at the level of response selection, not perception.</item> <p></p> <item> • </item> <p></p> <item> Children with ASD show orienting effects that are larger in magnitude than performance mental age matched typically developing children at 400ms SOA, but no difference at 200 or 1100ms.</item> <p></p> <item> • </item> <p></p> <item> Typically developing children are able to suppress orienting effects to non‐predictive cues at 700 and 1100ms, whereas children with ASD are not.</item> <p></p> <item> • </item> <p></p> <item> Response selection difficulties may relate to other difficulties in early development such as joint attention whereby children with ASD may be too slow in executing a shift of attention to make the connection.</item> </ulist> <hd id="AN0041554391-17">Acknowledgements</hd> <p>This work was conducted in partial fulfillment of the first author's Ph.D. at McGill University. Funding was provided by a Social Sciences and Humanities Research Council of Canada grant awarded to J.A.B., and an Economic and Social Research Council (UK) grant awarded to P.L.M.</p> <p>The authors wish to thank all the schools and families who agreed to participate, both in Canada and the UK, as well as the members of the McGill Youth Study Team (Montreal) and the Autism Research Team (Nottingham) who assisted with recruitment and data collection.</p> <ref id="AN0041554391-18"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref35" type="bt">1</bibl> <bibtext> Conflict of interest statement: No conflicts declared.</bibtext> </blist> </ref> <ref id="AN0041554391-19"> <title> References </title> <blist> <bibtext> American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM‐IV‐TR (4th edn). 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  Data: Orienting of Visual Attention among Persons with Autism Spectrum Disorders: Reading versus Responding to Symbolic Cues
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  Data: <searchLink fieldCode="AR" term="%22Landry%2C+Oriane%22">Landry, Oriane</searchLink><br /><searchLink fieldCode="AR" term="%22Mitchell%2C+Peter+L%2E%22">Mitchell, Peter L.</searchLink><br /><searchLink fieldCode="AR" term="%22Burack%2C+Jacob+A%2E%22">Burack, Jacob A.</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Child+Psychology+and+Psychiatry%22"><i>Journal of Child Psychology and Psychiatry</i></searchLink>. Jul 2009 50(7):862-870.
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  Data: Blackwell Publishing. 350 Main Street, Malden, MA 02148. Tel: 800-835-6770; Tel: 781-388-8599; Fax: 781-388-8232; e-mail: customerservices@blackwellpublishing.com; Web site: http://www.blackwellpublishing.com/jnl_default.asp
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  Data: Journal Articles<br />Reports - Research
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  Data: <searchLink fieldCode="DE" term="%22Cues%22">Cues</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Age%22">Mental Age</searchLink><br /><searchLink fieldCode="DE" term="%22Autism%22">Autism</searchLink><br /><searchLink fieldCode="DE" term="%22Attention%22">Attention</searchLink><br /><searchLink fieldCode="DE" term="%22Pervasive+Developmental+Disorders%22">Pervasive Developmental Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+Perception%22">Visual Perception</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+Analysis%22">Comparative Analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+Stimuli%22">Visual Stimuli</searchLink><br /><searchLink fieldCode="DE" term="%22Reaction+Time%22">Reaction Time</searchLink>
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  Data: 10.1111/j.1469-7610.2008.02049.x
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  Data: 0021-9630
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  Data: Background: Are persons with autism spectrum disorders (ASD) slower than typically developing individuals to read the meaning of a symbolic cue in a visual orienting paradigm? Methods: Participants with ASD (n = 18) and performance mental age (PMA) matched typically developing children (n = 16) completed two endogenous orienting conditions in which the cue exposure time and response preparation time were manipulated within a consistent series of cue-target stimulus onset asynchronies (SOAs). Results: Participants with ASD displayed facilitation effects at all SOAs, whereas typically developing children displayed facilitation effects only at shorter SOAs. The magnitude of the facilitation effect was greater for the group with ASD at 400ms SOA. Both groups showed similar effects of condition, with similar patterns of facilitation in both conditions. Conclusion: Persons with ASD were not slower to read the symbolic cue, as the effect was elicited by brief cues within longer SOAs before target onset. The participants with ASD were also less efficient in using the predictability of the cues to guide responding. The difficulties of participants with ASD on endogenous orienting occur at the response selection level, not the perceptual level. (Contains 4 figures and 2 tables.)
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  Data: 2009
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  Data: EJ843677
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        Value: 10.1111/j.1469-7610.2008.02049.x
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      – SubjectFull: Cues
        Type: general
      – SubjectFull: Mental Age
        Type: general
      – SubjectFull: Autism
        Type: general
      – SubjectFull: Attention
        Type: general
      – SubjectFull: Pervasive Developmental Disorders
        Type: general
      – SubjectFull: Visual Perception
        Type: general
      – SubjectFull: Comparative Analysis
        Type: general
      – SubjectFull: Visual Stimuli
        Type: general
      – SubjectFull: Reaction Time
        Type: general
    Titles:
      – TitleFull: Orienting of Visual Attention among Persons with Autism Spectrum Disorders: Reading versus Responding to Symbolic Cues
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Landry, Oriane
      – PersonEntity:
          Name:
            NameFull: Mitchell, Peter L.
      – PersonEntity:
          Name:
            NameFull: Burack, Jacob A.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 07
              Type: published
              Y: 2009
          Identifiers:
            – Type: issn-print
              Value: 0021-9630
          Numbering:
            – Type: volume
              Value: 50
            – Type: issue
              Value: 7
          Titles:
            – TitleFull: Journal of Child Psychology and Psychiatry
              Type: main
ResultId 1