Linguistic and perceptual processing of communicative cues in Asperger Syndrome

(1)

Institute of Behavioural Sciences University of Helsinki

LINGUISTIC AND PERCEPTUAL

PROCESSING OF COMMUNICATIVE CUES IN ASPERGER SYNDROME

Satu Saalasti

ACADEMIC DISSERTATION Institute of Behavioural Studies

University of Helsinki

Academic dissertation to be presented with the assent of the Faculty of Behavioural Sciences, University of Helsinki, for public discussion in the Hall SH302,

Siltavuorenpenger 3A, Helsinki, on February 17^th 2012, at 12 o’clock.

(2)

6XSHUYLVRUV 3URIHVVRU/HQQDUWYRQ:HQGW 'HSDUWPHQWRI&KLOG1HXURORJ\

8QLYHUVLW\RI+HOVLQNL)LQODQG (LUD-DQVVRQ9HUNDVDOR3K''RFHQW

/RJRSHGLFV

8QLYHUVLW\RI7XUNX)LQODQG 0LQQD/DDNVR3K''RFHQW

,QVWLWXWHRI%HKDYLRXUDO6FLHQFHV6SHHFK6FLHQFHV 8QLYHUVLW\RI+HOVLQNL)LQODQG

.DLVD7LLSSDQD3K''RFHQW

,QVWLWXWHRI%HKDYLRXUDO6FLHQFHV3V\FKRORJ\

8QLYHUVLW\RI+HOVLQNL)LQODQG 5HYLHZHUV 3URIHVVRU3LUMR.RUSLODKWL

/RJRSHGLFV

8QLYHUVLW\RI7XUNX)LQODQG 3URIHVVRU-RKQ-)R[H 3HGLDWULFVDQG1HXURVFLHQFH

&KLOGUHQ¶V(YDOXDWLRQDQG5HKDELOLWDWLRQ&HQWHU&(5&

5RVH).HQQHG\,QWHOOHFWXDO 'HYHORSPHQWDO'LVDELOLWLHV 5HVHDUFK&HQWHU

$OEHUW(LQVWHLQ&ROOHJHRI0HGLFLQH1HZ<RUN86$

2SSRQHQW 3URIHVVRU-RKQ-)R[H

,661

,6%1SDSHUEDFN ,6%13') 8QLJUD¿D

+HOVLQNL

(3)

ABSTRACT

$VSHUJHU6\QGURPH$6EHORQJVWRDXWLVPVSHFWUXPGLVRUGHUVZKHUHERWKYHUEDO DQG QRQYHUEDO FRPPXQLFDWLRQ GLI¿FXOWLHV DUH DW WKH FRUH RI WKH LPSDLUPHQW 6RFLDOFRPPXQLFDWLRQUHTXLUHVDFRPSOH[XVHRIDIIHFWLYHOLQJXLVWLFFRJQLWLYHDQG SHUFHSWXDOSURFHVVHV,QWKHIRXUVWXGLHVLQFOXGHGLQWKHFXUUHQWWKHVLVVRPHRIWKH OLQJXLVWLFDQGSHUFHSWXDOIDFWRUVWKDWDUHLPSRUWDQWIRUIDFHWRIDFHFRPPXQLFDWLRQ ZHUHVWXGLHGXVLQJEHKDYLRXUDOPHWKRGV,QDOOIRXUVWXGLHVWKHUHVXOWVREWDLQHG IURPLQGLYLGXDOVZLWK$6ZHUHFRPSDUHGZLWKW\SLFDOO\GHYHORSHGDJHJHQGHUDQG ,4PDWFKHGFRQWUROV

)LUVWWKHODQJXDJHVNLOOVRIVFKRRODJHGFKLOGUHQZHUHFKDUDFWHUL]HGLQGHWDLO ZLWKVWDQGDUGL]HGWHVWVWKDWPHDVXUHGGLIIHUHQWDVSHFWVRIUHFHSWLYHDQGH[SUHVVLYH ODQJXDJH6WXG\,7KHFKLOGUHQZLWK$6ZHUHIRXQGWREHZRUVHWKDQWKHFRQWUROV LQ IROORZLQJ FRPSOH[ YHUEDO LQVWUXFWLRQV 1H[W WKH YLVXDO SHUFHSWLRQ RI IDFLDO H[SUHVVLRQVRIHPRWLRQZLWKYDU\LQJGHJUHHVRIYLVXDOGHWDLOZDVH[DPLQHG6WXG\

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

7KHUHVXOWVRIWKHVWXG\VHULHVGHPRQVWUDWHWKDWPDQ\IDFWRUVXQGHUSLQQLQJ IDFHWRIDFHVRFLDOFRPPXQLFDWLRQDUHDW\SLFDOLQ$6,QFRQWUDVWZLWKSUHYLRXV DVVXPSWLRQVDERXWLQWDFWODQJXDJHDELOLWLHVWKHFXUUHQWUHVXOWVVKRZWKDWFKLOGUHQ ZLWK$6KDYHGLI¿FXOWLHVLQXQGHUVWDQGLQJFRPSOH[YHUEDOLQVWUXFWLRQV)XUWKHUPRUH WKHVWXG\PDNHVFOHDUWKDWGHYLDWLRQVLQWKHSHUFHSWLRQRIJOREDOIHDWXUHVLQIDFHV H[SUHVVLQJHPRWLRQVDVZHOODVLQWKHPXOWLVHQVRU\SHUFHSWLRQRIVSHHFKDUHOLNHO\

WRKDUPIDFHWRIDFHVRFLDOFRPPXQLFDWLRQ

(4)

TIIVISTELMÄ

$VSHUJHULQ RLUH\KW\Pl $VSHUJHU 6\QGURPH $6 RQ \NVL DXWLVPLQ NLUMRQ KlLUL|LVWl6LLKHQNXXOXXROHHOOLVHQDRVDQDYDLNHXGHWNLHOHOOLVHVVlMDHLNLHOHOOLVHVVl NRPPXQLNDDWLRVVD6RVLDDOLQHQNRPPXQLNDDWLRHGHOO\WWllNLHOHOOLVNRJQLWLLYLVWHQ MDKDYDLQWRSURVHVVLHQPRQLPXWNDLVWD\KWHLVWRLPLQWDD7lPlQYlLW|VNLUMDQQHOMlVVl RVDWXWNLPXNVHVVDWXWNLWWLLQNDVYRWXVWHQWDSDKWXYDOOHVRVLDDOLVHOOHNRPPXQLNDDWLROOH WlUNHLWlNLHOHOOLVLlMDKDYDLWVHPLVHHQOLLWW\YLlSURVHVVHMDEHKDYLRUDDOLVLQPHQHWHOPLQ .DLNLVVDRVDWXWNLPXNVLVVDNRHU\KPllQNXXOXYLHQ$6KHQNLO|LGHQVXRULXWXPLVWD YHUUDWWLLQ LlQ VXNXSXROHQ MD lO\NN\\VRVDPllUlQ PXNDDQ VDPDQNDOWDLVHQ YHUURNNLU\KPlQVXRULXWXPLVHHQ

(QVLPPlLVHVVl WXWNLPXNVHVVD VHOYLWHWWLLQ NLHOHOOLVLl WDLWRMD NRXOXLlVVl 2VDWXWNLPXV , /DSVHW MRLOOD RQ $6 VXRULXWXLYDW YHUURNNHMD KHLNRPPLQ PRQLPXWNDLVWHQVDQDOOLVWHQRKMHLGHQQRXGDWWDPLVHVWD7lPlQMlONHHQWXWNLWWLLQ NDVYRMHQLOPHLGHQWXQQLVWDPLVWDDLNXLVLOOD2VDWXWNLPXV,,$LNXLVLOODMRLOODRQ$6 ROLYDLNHXNVLDNDVYRQLOPHLGHQWXQQLVWDPLVHVVDNRNRQDLVXXNVLHQKDKPRWWDPLVHQ SHUXVWHHOODHOLVLOORLQNXQNXYLVVDROLNl\WHWWlYLVVlYDLQPDWDOLDSDLNNDWDDMXXNVLD /LVlNVL VHOYLWHWWLLQ PRQLDLVWLVWD KDYDLWVHPLVWD DLNXLVLOOD WXWNLPDOOD NXXOOXQ MD QlKG\Q DXGLRYLVXDDOLVHQ SXKHHQ KDYDLWVHPLVWD 2VDWXWNLPXV ,,, $LNXLVHW MRLOODRQ$6KDYDLWVLYDWDXGLRYLVXDDOLVWDSXKHWWDODDGXOOLVHVWLHULWDYDOODYDLNND WXQQLVWLYDW SXKHWWD \KWl K\YLQ NXXOOXQYDUDLVHVWL MD ROLYDW \KWl K\YLl KXXOLOWD OXNLMRLWDNXLQYHUURNLW/LVlNVLVHOYLWHWWLLQWDUNNDDYDLVXXGHQYDLNXWXVWDSXKHHQ DXGLRYLVXDDOLVHHQKDYDLWVHPLVHHQWDUNDVWHOHPDOODSRLNNHDYDWNRWlPlQU\KPlQ VLOPlQOLLNNHHW2VDWXWNLPXV,,,MDWDUNNDDYDLVXXGHQWDKGRQDODLQHQVXXQWDDPLQHQ SXKHHQKDYDLWVHPLVHQDLNDQD2VDWXWNLPXV,9YHUURNNLHQYDVWDDYLVWDWRLPLQQRLVWD 6HNl VLOPlQOLLNNHHW HWWl WDUNNDDYDLVXXGHQ WDKGRQDODLQHQ VXXQWDDPLQHQ ROLYDW VDPDQNDOWDLVLDPROHPPLOODU\KPLOOl

7XWNLPXVVDUMDQ WXORNVHW RVRLWWLYDW HWWl PRQHW NDVYRWXVWHQ WDSDKWXYDOOH NRPPXQLNDDWLROOH WlUNHlW WDXVWDWHNLMlW WRLPLYDW SRLNNHDYDVWL $VSHUJHULQ RLUH\KW\PlVVl$LHPPDVWDNlVLW\NVHVWlSRLNHWHQWlPlQWXWNLPXNVHQPXNDDQ RLUH\KW\PllQ YRL NXXOXD YDLNHXWWD PRQLPXWNDLVWHQ VDQDOOLVWHQ RKMHLGHQ

\PPlUWlPLVHVVl/LVlNVLKHLNRPSLNDVYRQLOPHLGHQWXQQLVWDPLQHQNRNRQDLVXXNVLHQ KDKPRWWDPLVHQSHUXVWHHOODVHNlODDGXOOLVHVWLHULODLQHQPRQLDLVWLQHQKDYDLWVHPLQHQ WRGHQQlN|LVHVWLYDLNHXWWDYDWNDVYRNNDLQWDSDKWXYDDNRPPXQLNDDWLRWD

(5)

ACKNOWLEDGEMENTS

,DPGHHSO\JUDWHIXOIRUPDQ\SHRSOHWKDWKDYHKHOSHGPHLQPDNLQJWKLVWKHVLV)LUVW DQGIRUHPRVW,ZDQWWRH[SUHVVP\UHVSHFWDQGJUDWHIXOQHVVWRP\VXSHUYLVRUV'U (LUD-DQVVRQ9HUNDVDOR'U0LQQD/DDNVRDQG'U.DLVD7LLSSDQDZKRVXSSRUWHG PHQRWRQO\LQVFLHQWL¿FPDWWHUVEXWDOVRLQPDQ\RWKHUZD\V/DWH3URIHVVRU/HQQDUW YRQ:HQGWZDVWKHGULYLQJIRUFHRIWKHSUHVHQWVWXGLHV,W¿OOVPHZLWKVDGQHVVWKDW KHLVQRORQJHUZLWKXVWRUHFHLYHP\JUDWLWXGHIRUKLVLQSXWLQSHUVRQ

7KHVWXGLHVZHUHFDUULHGRXWLQWKH&RJQLWLYH%UDLQ5HVHDUFK8QLW6WXG\,

&%58 RI ,QVWLWXWH RI %HKDYLRXUDO 6WXGLHV 8QLYHUVLW\ RI +HOVLQNL DQG LQ WKH 'HSDUWPHQW RI %LRPHGLFDO (QJLQHHULQJ DQG &RPSXWDWLRQDO 6FLHQFH 6WXGLHV ,,,,,DQG,9%(&6RI$DOWR8QLYHUVLW\6FKRRORI6FLHQFH:RUNLQJLQVXFKD PXOWLGLVFLSOLQDU\HQYLURQPHQWZDVDQDPD]LQJRSSRUWXQLW\WROHDUQ7KHOHDGHUV RIWKHVHXQLWV3URIHVVRU7HLMD.XMDODLQ&%58DQG3URIHVVRU0LNNR6DPVLQ%(&6 ZHOFRPHGPHWRWKHLUWHDPVDQGVKDUHGWKHLUNQRZOHGJHLQDZD\WKDWFDQRQO\EH DGPLUHG,DPDOVRYHU\JUDWHIXOIRUP\RWKHUFRDXWKRUV'U7XXOLD/HSLVW|'U-DUL .lWV\UL0''U7DLQD1LHPLQHQ±YRQ:HQGW'U(VNR7RSSLODDQG0DUL/DLQH +HUQDQGH]'U-DUL.lWV\ULZDVHYHUVRSDWLHQWZLWKPHLQJXLGLQJWKHWHFKQLFDO DQGVWDWLVWLFDOLVVXHVRIWKLVVWXG\0DUL/DLQH+HUQDQGH]DOVRWDXJKWPHKRZWR XVHWKHH\HWUDFNLQJV\VWHPHVVHQWLDOIRUWKLVVWXG\LQWKH/DERUDWRU\RI0HGLD 7HFKQRORJ\RI$DOWR8QLYHUVLW\6FKRRORI6FLHQFH

7KLV WKHVLV KDV DOVR JLYHQ PH QHZ IULHQGV )HOORZ GRFWRUDO VWXGHQWV DQG URRPPDWHVLQ&%585LLNND/RYLRDQG6LQL.RVNLQHQVKDUHGWKHXSVDQGGRZQVRI WKHPDNLQJRIWKLVWKHVLVDQGZLOOEHIULHQGVIRUOLIH&RZRUNHUVDW6SHHFK6FLHQFHV HVSHFLDOO\UHVHDUFKHUVDW9LURQNDWXSURYLGHGPHDJUHDWDWPRVSKHUHWRZRUNLQ ,QNHUL6DOPHQOLQQDRIIHUHGPHLPSRUWDQWPHQWRULQJ³7KH0DJQHWKRXVHFUHZ´DW

%(&6JDYHPHPDQ\ODXJKVDQG7DSDQL6XLKNRQHQLVWRWKDQNIRUWKHSURJUDPPLQJ IRU6WXGLHV,,,DQG,9ZLWKVXSSRUWRIPDQ\RWKHUVZRUNLQJLQWKH0DJQHWKRXVH )LQDOO\,GRQRWWKLQN,ZRXOGKDYHEHHQUHDG\IRUWKHFKDOOHQJHVRIWKLVVWXG\

ZLWKRXWP\FOLQLFDOH[SHULHQFH7KHUHIRUHP\FRZRUNHUVLQERWKWKH&KLOGUHQ¶V

&DVWOH+RVSLWDODQGWKHSULYDWHFOLQLFVGHVHUYHVSHFLDOWKDQNV

,RZHWKDQNVWRWKHSDUWLFLSDQWVRIWKHIRXUVWXGLHVWKDWFRPSLOHWKLVWKHVLV :LWKRXWWKHSDUWLFLSDQWVZLWK$VSHUJHU6\QGURPHDQGWKHFRQWUROSDUWLFLSDQWV WKLVWKHVLVZRXOGQRWKDYHEHHQSRVVLEOH

,WKDQNWKH&XVWRV3URIHVVRU$QX.OLSSLDQG3URIHVVRU3LUMR.RUSLODKWLDQG 3URIHVVRU-RKQ-)R[HIRUSUHH[DPLQLQJWKLVWKHVLV,WLVDJUHDWKRQRUWKDW3URIHVVRU -RKQ-)R[HVXFKDSUHVWLJLRXVUHVHDUFKHUDOVRDJUHHGWRDFWDVP\RSSRQHQW )XUWKHUPRUH,WKDQN'U0DUWWL9DLQLRIRUVHUYLQJLQWKHJUDGLQJFRPPLWWHH

(6)

7KHPHDQLQJRIIXOOWLPHIXQGLQJLVJUDWHIXOO\DFNQRZOHGJHG,ZDVIRUWXQDWH WRUHFHLYHIXQGLQJIURP$UYRDQG/HD<OSS|)RXQGDWLRQ-HQQ\DQG$QWWL:LKXUL IRXQGDWLRQ)LQVND/lNDUHVlOOVNDSHWDQG/DQJQHW)LQQLVKGRFWRUDOSURJUDPPHIRU ODQJXDJHVWXGLHV

0\VLVWHU.DLVXDQGKHUKXVEDQG-XVVLDQGWKHLUFKLOGUHQ6R¿DDQG7RLYRP\

VLVWHU7DUXDQGKHUKXVEDQG+HLNNLDQGWKHLUFKLOGUHQ/DXUDDQG6DNDULDQGP\

EURWKHU.DULDQGKLVZLIH0HUMDDQGWKHLUFKLOGUHQ/HHYLDQG9LOLNHSWERWKP\IHHW RQWKHJURXQG0\PRWKHU$QMDDQGIDWKHU7DSDQL6DDODVWLDUHZRQGHUIXOSHRSOH ZKRKDYHVXSSRUWHGPHXQFRQGLWLRQDOO\$OVRP\SDUHQWVLQODZ6LQLNNDDQG0DUWWL +HOPLQHQGHVHUYHVSHFLDOWKDQNVIRUWDNLQJFDUHRIWKHOLWWOHRQHVZKHQQHHGHG 'XULQJPDNLQJRIWKLVWKHVLV,KDYHJRWWHQDIDPLO\RIP\RZQP\KXVEDQG-DDNNR +HOPLQHQDQGRXUWZRDPD]LQJFKLOGUHQ.HUWWXDQG,OPDULDUHWKHFRUHRIP\OLIH DQG,GHGLFDWHWKLVZRUNWRWKHP

+HOVLQNL)HEUXDU\ 6DWX6DDODVWL

(7)

LIST OF ORIGINAL PUBLICATIONS

, 6DDODVWL6/HSLVW|7.XMDOD7/DDNVR07RSSLOD(1LHPLQHQ

YRQ:HQGW7YRQ:HQGW/ -DQVVRQ9HUNDVDOR(

/DQJXDJH$ELOLWLHVRI&KLOGUHQZLWK$VSHUJHU6\QGURPH-RXUQDORI $XWLVPDQG'HYHORSPHQWDO'LVRUGHUV

,, .lWV\UL-6DDODVWL67LLSSDQD.YRQ:HQGW/ 6DPV0 ,PSDLUHGUHFRJQLWLRQRIIDFLDOHPRWLRQVIURPORZVSDWLDOIUHTXHQFLHVLQ $VSHUJHUV\QGURPH1HXURSV\FKRORJLD

,,, 6DDODVWL6.lWV\UL-7LLSSDQD./DLQH+HUQDQGH]0YRQ:HQGW /6DPV0$XGLRYLVXDO6SHHFK3HUFHSWLRQDQG(\H*D]H %HKDYLRURI$GXOWVZLWK$VSHUJHUV\QGURPH-RXUQDORI$XWLVP

DQG'HYHORSPHQWDO'LVRUGHUV'2,V

,9 6DDODVWL67LLSSDQD..lWV\UL- 6DPV07KHHIIHFWRI YLVXDOVSDWLDODWWHQWLRQRQDXGLRYLVXDOVSHHFKSHUFHSWLRQLQDGXOWVZLWK $VSHUJHUV\QGURPH([SHULPHQWDO%UDLQ5HVHDUFK

7KH SHUPLVVLRQ RI WKH IROORZLQJ FRS\ULJKW RZQHUV WR UHSURGXFH WKH RULJLQDOSDSHUVLVJUDWHIXOO\DFNQRZOHGJHG

6SULQJHU,,,,,9 (OVHYLHU,,

(9)

1. INTRODUCTION

1.1. ASPERGER SYNDROME IN THE AUTISM SPECTRUM DISORDERS

$VSHUJHU6\QGURPH$6LVDOLIHORQJGLVRUGHURIQHXURELRORJLFDORULJLQEHORQJLQJ WRWKHDXWLVPVSHFWUXPGLVRUGHUV$6'+LOO )ULWK9RONPDU .OLQ :LQJ7KHLPSDLUPHQWVRI$6'PDQLIHVWLQWKUHHGRPDLQVVRFLDOEHKDYLRU QRQYHUEDODQGYHUEDOFRPPXQLFDWLRQDQGVWHUHRW\SHGUHSHWLWLYHRUULWXDOLVWLF EHKDYLRU,&':+2'60,9$PHULFDQ3V\FKLDWULF$VVRFLDWLRQ$3$

7DEOH ,Q $6 FRJQLWLYH GHYHORSPHQW LV ZLWKLQ QRUPDO UDQJH EXW WKH GHYHORSPHQWRIVRFLDOLQWHUDFWLRQDQGSOD\LVDIIHFWHG7KHXVHRIH\HFRQWDFWLQ LQWHUDFWLRQLVDW\SLFDODQGIRUPLQJDSSURSULDWHUHODWLRQVKLSVZLWKSHHUVLVGLI¿FXOW 5HSHWLWLYH EHKDYLRU LV HYLGHQW LQ LQDSSURSULDWH URXWLQHV DQG D SUHRFFXSDWLRQ ZLWKVSHFLDOLQWHUHVWV)XUWKHUPRUHWKHUHLVDPDUNHGTXDOLWDWLYHLPSDLUPHQWLQ FRPPXQLFDWLRQ7KXVWKHFRUHLPSDLUPHQWVRI$6'DUHSUHVHQWLQ$6EXWZLWKRXW VLJQL¿FDQWGHOD\LQODQJXDJHRURWKHUFRJQLWLYHGHYHORSPHQW)XUWKHUPRUHLQ ,&':+2FOXPVLQHVVKDVEHHQDFNQRZOHGJHGDVDFRPPRQDGGLWLRQDO IHDWXUHEXWLWLVQRWUHTXLUHGIRUGLDJQRVLV2XWVLGHWKHGLDJQRVWLFFULWHULDDEQRUPDO SURFHVVLQJRIVHQVRU\LQIRUPDWLRQLVFRPPRQO\UHSRUWHGLQ$6DVLVWKHFDVHZLWK RWKHU$6'VDQGKDVHYHQEHHQVXJJHVWHGWKDWLWEHLQFRUSRUDWHGLQWKHGLDJQRVWLF FULWHULD0LQVKHZ +REVRQ1LHPLQHQYRQ:HQGWHWDO

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¿QHGVHSDUDWHO\7KHIRFXVRIWKHFXUUHQWWKHVLV LVWKHKLJKIXQFWLRQLQJHQGRIWKHVSHFWUXPDQGVSHFL¿FDOO\$VSHUJHU6\QGURPH

(10)

Table 1. DSM-IV/ICD-10 Diagnostic criteria for autism and Asperger Syndrome (adapted from Lord et al.

2000)

Autism

Delays or abnormal functioning in social interaction, language, and/or play by age 3.

Asperger syndrome

Age of onset No clinically signiﬁcant delay in language,

cognitive development, or development of age appropriate self-help skills, adaptive behaviour, and curiosity about the environment in childhood.

Same as autism.

No clinically signiﬁcant general delay in language.

Same as autism Social

Interaction

Qualitative impairment in social interaction, as manifested by at least two of the following:*

a) marked impairment in the use of multiple nonverbal behaviours, i.e., eye-to-eye gaze;

b) failure to develop peer relationships appropriate to developmental level;

c) lack of spontaneous seeking to share enjoyment with other people;

d) lack of social or emotional reciprocity.

Qualitative impairments in communication as manifested by at least one of the following:

a) delay in, or total lack of, the development of spoken language;

b) marked impairment in initiating or sustaining a conversation with others, in individuals with adequate speech;

c) stereotyped and repetitive use of language or idiosyncratic language;

d) lack of varied, spontaneous make- believe or imitative play.

Communication

Behaviour Restricted, repetitive, and stereotyped patterns of behaviour, as manifested by at least one of the following:

a) preoccupation with one or more stereotyped or restricted patterns of interest;

b) adherence to non-functional routines or rituals;

c) stereotyped and repetitive motor mannerisms;

d) persistent preoccupation with parts of objects.

*A total of six or more items are required for diagnosis.

(11)

7KHQXPEHURILQGLYLGXDOVGLDJQRVHGZLWK$6'KDVJURZQLQWKHSDVW\HDUVDQG KDVUDLVHGFRQFHUQ$FFRUGLQJWRDUHFHQWHSLGHPLRORJLFDOVWXG\LQ)LQODQGWKH

$6'DIIHFWVDURXQGSHUFHQWRIWKHSRSXODWLRQZLWK$6DIIHFWLQJDURXQG SHUFHQWRILQGLYLGXDOV0DWWLODHWDO7KHFDXVHRIWKHLQFUHDVHGQXPEHURI GLDJQRVHGLQGLYLGXDOVLVQRWNQRZQEXWLWKDVEHHQVXJJHVWHGWKDWRQHIDFWRUFRXOG EHWKHEHWWHUUHFRJQLWLRQRIPLOGHUIRUPVRI$6'VXFKDV$6DQGKLJKIXQFWLRQLQJ LQGLYLGXDOVZLWKDXWLVP+)$7KHFDXVHRI$6'LV\HWWREHLGHQWL¿HGEXWLWLVD PXOWLIDFWRULDOKHUHGLWDU\GLVRUGHUZKRVHJHQHWLFIDFWRUVDUHXQGHULQYHVWLJDWLRQHJ

%DLOH\HWDOIRUDUHYLHZVHH)UHLWDJ&RQVLGHULQJWKHKHWHURJHQRXV QDWXUHRI$6'LWLVSRVVLEOHWKDWQRVLQJOHH[SODQDWLRQZLOOEHIRXQGLWLVPRUH OLNHO\WKDWVHYHUDOGLIIHUHQWLQWHUDFWLQJPHFKDQLVPVZLWKGLIIHUHQWQHXUDORULJLQV ZLOOEHLGHQWL¿HG0RUHRYHUFXUUHQWDGYDQFHVLQQHXURSK\VLRORJLFDOVWXGLHVSURYLGH DEHWWHURSSRUWXQLW\WRPDNHGLUHFWOLQNVEHWZHHQEUDLQIXQFWLRQVDQGEHKDYLRUDO V\PSWRPV ,Q SDUWLFXODU VRFLDO LQWHUDFWLRQ DQG FRPPXQLFDWLRQ VKDUH VLPLODU EHKDYLRXUDODQGQHXURSK\VLRORJLFDOIDFWRUV+RZHYHULWLVSRVVLEOHWKDWVHYHUDO DW\SLFDOEUDLQIXQFWLRQVPD\PDQLIHVWLQVLPLODUEHKDYLRUDOIHDWXUHV7KHVXJJHVWLRQ PDGHE\+DSSp5RQDOGDQG3ORPLQVHHPVZHOODGYLVHGWKHFDXVHVDQG FXUHVIRU$6'VKRXOGQRWEHVHDUFKHGIRUDVDZKROHUDWKHUWKHWKUHHGRPDLQV RIWKHGLVRUGHUVKRXOGEHIUDFWLRQHGDQGVWXGLHGVHSDUDWHO\7KHFXUUHQWWKHVLV DWWHPSWVWR¿QGVRPHRIWKHIDFWRUVXQGHUSLQQLQJWKHTXDOLWDWLYHLPSDLUPHQWLQ VRFLDOFRPPXQLFDWLRQLQ$60RUHVSHFL¿FDOO\LWIRFXVHVRQSURFHVVLQJRIOLQJXLVWLF DQGSHUFHSWXDOFXHVLPSRUWDQWIRUÀXHQWFRPPXQLFDWLRQ

1.2. COMMUNICATION IMPAIRMENT IN ASPERGER SYNDROME

&RPPXQLFDWLRQ LV WKH FRQVFLRXV H[FKDQJH RI PHVVDJHV FRQYH\LQJ WKRXJKWV LQIRUPDWLRQQHHGVDQGHPRWLRQVDQGLWPD\EHOLQJXLVWLFVSRNHQDQGZULWWHQ ODQJXDJHRUQRQOLQJXLVWLFHPRWLRQVJHVWXUHV*RRGFRPPXQLFDWLYHFRPSHWHQFH LQVRFLDOLQWHUDFWLRQLQYROYHVWKHFRPSOH[LQWHUDFWLRQRIOLQJXLVWLFFRJQLWLYHDQG VHQVRULPRWRUIDFWRUV/RXNXVD0DUWLQ3HUNLQV7KHW\SLFDO IHDWXUHVRISRRUFRPPXQLFDWLYHFRPSHWHQFHLQ$6LQFOXGHGLI¿FXOW\LQDSSURSULDWHO\

DGMXVWLQJVSHHFKVW\OHWRWKHLQWHUSHUVRQDOVRFLDOFRQWH[W/DQGD9RONPDU .OLQWKHLGLRV\QFUDWLFH[SUHVVLRQRILQWHQWLRQV3DXO2UORYVNL0DUFLQNR 9RONPDUDQGWKHDW\SLFDOXVHRIQRQOLQJXLVWLFDQGOLQJXLVWLFVWUDWHJLHV IRUUHTXHVWV)XUWKHUPRUHWKHXVHRIH\HFRQWDFWLVQRWFRRUGLQDWHGDQGGRHVQRW UHÀHFWMRLQWDWWHQWLRQZKLFKLVHOHPHQWDU\IRUODQJXDJHGHYHORSPHQW7RPDVHOOR )DUUDU,QFRQYHUVDWLRQLQGLYLGXDOVZLWK$6KDYHGLI¿FXOWLHVLQSURYLGLQJ WKHFRUUHFWDPRXQWDQGW\SHRILQIRUPDWLRQDQGRUFRQVLGHULQJWKHRWKHUSHUVRQ¶V SHUVSHFWLYH ,QGLYLGXDOV ZLWK $6 KDYH GLI¿FXOW\ LQ PDQDJLQJ WRSLFV DQG WXUQV GLVFRXUVHPDQDJHPHQWDQGUHFLSURFDOVRFLDOEHKDYLRULVDOVROLPLWHG&RQVWDQW

(12)

IDLOXUHLQFRPPXQLFDWLRQLVDPDMRUFDXVHRIDQ[LHW\DQGFDQLQFUHDVHWKHWHQGHQF\

IRUZLWKGUDZDO$WWZRRG/RUGHWDO3DXO/DQGD 6FKRHQ 7KHUHIRUHLWZRXOGEHLPSRUWDQWWRLGHQWLI\WKHIDFWRUVEHKLQGWKHTXDOLWDWLYH LPSDLUPHQWRIFRPPXQLFDWLRQ

7UDGLWLRQDOO\WKHFRPPXQLFDWLRQLPSDLUPHQWLQ$6'KDVEHHQH[SODLQHGDV DJHQHUDOLPSDLUPHQWRIVRFLDOLQWHUDFWLRQDQGKDVEHHQFRQFHSWXDOL]HGLQWKH QHXURFRJQLWLYHPRGHOVRI7KHRU\RIPLQG7R0GH¿FLWDQGWKH0LQGEOLQGQHVV ERWKUHIHUUHGWRDVLPSDLUHGPHQWDOL]LQJDELOLW\%DURQ&RKHQ-ROOLIIH0RUWLPRUH 5REHUWVRQ%DURQ&RKHQ/HVOLH )ULWK)ULWK )ULWK+LOO )ULWK$FFRUGLQJWRWKHVHDFFRXQWVSUHGLFWLQJDQGH[SODLQLQJRWKHUSHRSOH¶V EHKDYLRULVGLI¿FXOWLQ$6EHFDXVHWKHDELOLW\WRXQGHUVWDQGRWKHUSHRSOH¶VPHQWDO VWDWHVLVSRRU$VDUHVXOWVNLOOVWKDWVWHPIURP720DELOLWLHVVXFKDVXQGHUVWDQGLQJ EHOLHIVSUHWHQFHLURQ\DQGQRQOLWHUDOODQJXDJHDUHXQFHUWDLQDQGWKLVDIIHFWV FRQYHUVDWLRQDOEHKDYLRXU%DURQ&RKHQ+LOO )ULWK1HXURFRJQLWLYH WKHRULHVRWKHUWKDQWKRVHWKDWFRQFHQWUDWHRQWKHOHYHORIVRFLDOFRJQLWLRQKDYHDOVR FRQWULEXWHGWRXQGHUVWDQGLQJRIWKHEDFNJURXQGRIFRPPXQLFDWLRQLPSDLUPHQWV ([HFXWLYHG\VIXQFWLRQPD\LQGLUHFWO\FRQWULEXWHWRLPSDLUPHQWVLQFRPPXQLFDWLRQ DOWKRXJKLWKDVWUDGLWLRQDOO\EHHQWKRXJKWWRRIIHUDQH[SODQDWLRQIRUWKHULJLGLW\

DQGSHUVHYHUDWLRQRIEHKDYLRULQ$6'+LOO5XVVHOO-DUUROG +RRG ([HFXWLYHFRQWUROSODQQLQJLQLWLDWLQJPRQLWRULQJRIDQDFWLRQDQGLQKLELWLQJ LUUHOHYDQW EHKDYLRXU LV HYHQ QHHGHG LQ VRPH WDVNV WKDW DUH D PHDVXUH RI WKH LPSDLUPHQWVRIWKHWKHRU\RIPLQGDELOLW\/HVOLH)ULHGPDQ *HUPDQ ,QFUHDVLQJO\LWKDVEHHQVXJJHVWHGWKDWWKHXQGHUO\LQJVRXUFHRIVRFLDOLQWHUDFWLRQ DQGFRPPXQLFDWLRQLPSDLUPHQWVLQYROYHVDW\SLFDOSHUFHSWXDOSURFHVVLQJ,QGHHG HYHQWKH¿UVWGHVFULSWLRQVRIERWKDXWLVPDQG$6PHQWLRQHGSHFXOLDUDQGLPSDLUHG SURFHVVLQJRIVHQVRU\VLJQDOVLHYLVXDODXGLWRU\WDFWLOHDQGJXVWDWRU\SHUFHSWV IURPWKHHQYLURQPHQW.DQQHU$VSHUJHU:LQJ,QDGGLWLRQWKH GLI¿FXOWLHVLQGLYLGXDOVZLWK$6'KDYHLQSURFHVVLQJVHQVRU\VLJQDOVFRPHWROLJKW WKURXJKE\FOLQLFDOH[SHULHQFHDQGWKHDXWRELRJUDSKLHV$WWZRRG:LOOLDPV

*UDQGLQDQGWKH\KDYHEHHQUHFHQWO\FRQ¿UPHGLQDVWXG\FRPELQLQJ VHOITXHVWLRQQDLUHDQGQHXURSV\FKRORJLFDOSUR¿OHV0LQVKHZ +REVRQ ,WVHHPVORJLFDOWKDWLIWKHSHUFHSWLRQRIVHQVRU\VLJQDOVIURPWKHHQYLURQPHQWLV GLIIHUHQWLWZLOODOVRDIIHFWWKHGHYHORSPHQWRIVRFLDODQGFRPPXQLFDWLYHEHKDYLRXU 7KHSHUFHSWXDOGLIIHUHQFHVLQ$6'DUHWKHIRFXVRIWKHQHXURFRJQLWLYHPRGHOVRI ZHDNFHQWUDOFRKHUHQFHDQGHQKDQFHGSHUFHSWXDOIXQFWLRQLQJ:KLOHWKHVHPRGHOV KDYHDVOLJKWO\GLIIHUHQWHPSKDVLVWKH\ERWKVXJJHVWWKDWLQGLYLGXDOVZLWK$6'KDYH DWHQGHQF\WRSURFHVVWKHHOHPHQWDU\SK\VLFDOHOHPHQWVRIDVWLPXOXVZKLFKOHDGV WRLPSDLUPHQWLQSHUFHLYLQJLWVJOREDOIHDWXUHV+DSSp )ULWK0RWWURQ 'DZVRQ6RXOLqUHV+XEHUW %XUDFN)RUWKHVDNHRIFODULW\ERWKPRGHOV ZLOOEHUHIHUUHGWRDVWKHH[WHQGHGZHDNFHQWUDOFRKHUHQFHPRGHOLQWKHFXUUHQW

(13)

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

1.2.1. LINGUISTIC ABILITIES

'HVSLWHWKHLUJRRGFRJQLWLYHDELOLWLHVDQGWKHSUHVHQFHRIWKHH[FOXVLRQFULWHULDIRU

$6RI³QRFOLQLFDOO\VLJQL¿FDQWGHOD\LQODQJXDJH´GHYHORSPHQWLQGLYLGXDOVZLWK$6 KDYHWKHTXDOLWDWLYHGLI¿FXOWLHVLQOLQJXLVWLFFRPPXQLFDWLRQW\SLFDORIWKHDXWLVWLF VSHFWUXP.OLQHWDO3DXO/DQGD 6FKRHQ/LQJXLVWLFDELOLWLHVDUH VHOIHYLGHQWO\UHOHYDQWIRUJRRGFRPPXQLFDWLYHFRPSHWHQFHDVODQJXDJHLVWKHPDLQ PHDQVRIFRPPXQLFDWLRQLQKXPDQV7KHUHLVQRFRQVHQVXVRQZKHWKHUODQJXDJH DELOLWLHVLQ$6FDQEHFRQVLGHUHGQRUPDODQGWKHUHVHHPVWREHDGLVFUHSDQF\

EHWZHHQWKHGLDJQRVWLFWD[RQRPLHVDQGFOLQLFDOH[SHULHQFH.OLQHWDO

$V$WWZRRGSRLQWVRXWWKHGLDJQRVWLFFULWHULDVKRXOGQRWEHLQWHUSUHWHG DV DQ DEVHQFH RI DQ\ SHFXOLDULWLHV LQ ODQJXDJH DELOLWLHV :KLOH VRPH ¿QGLQJV VKRZ WKDW EDVLF IRUPDO ODQJXDJH DELOLWLHV VXFK DV VHPDQWLFV ZRUG PHDQLQJ SKRQRORJ\SURGXFLQJVRXQGVV\QWD[DQGPRUSKRORJ\VHQWHQFHVWUXFWXUHDUH FRQVLGHUHGWRGHYHORSDFFRUGLQJWRWKHQRUPDOGHYHORSPHQWDOPLOHVWRQHV.OLQ 9RONPDU 6SDUURZ3DXO/DQGD 6FKRHQ7DJHU)OXVEHUJ3DXO /RUGLWKDVEHHQVXJJHVWHGKRZHYHUWKDWODQJXDJHFRPSUHKHQVLRQDQG SURGXFWLRQDUHVLPLODUO\LPSDLUHGLQDGXOWKRRGLQ$6DQGLQ+)$+RZOLQ 7KLVZRXOGVXJJHVWLPSDLUHGODQJXDJHGHYHORSPHQWLQFKLOGKRRG)XUWKHUPRUH VRPH GLI¿FXOWLHV FRQFHUQLQJ ODQJXDJH DELOLWLHV KDYH EHHQ UHSHDWHGO\ UHSRUWHG LQFOXGLQJWKHRYHUO\OLWHUDOLQWHUSUHWDWLRQRIXWWHUDQFHVZKLFKOHDGVWRGLI¿FXOWLHV LQXQGHUVWDQGLQJLGLRPVKXPRUPHWDSKRUVDQGLURQ\+DSSq.HUEHO

*UXQZHOO.MHOJDDUG 7DJHU)OXVEHUJ2]RQRII 0LOOHU5DSLQ DQGVXEVWDQWLDOGLI¿FXOWLHVLQWKHSURGXFWLRQDQGFRPSUHKHQVLRQRIVSHHFK SURVRG\HVSHFLDOO\ZKHQFRQYH\LQJHPRWLRQDOPHVVDJHVYRFDOTXDOLW\LQWRQDWLRQ DQGVWUHVVSDWWHUQV.RQLQJ 0DJLOO(YDQV.RUSLODKWLHWDO 6KULEHUJ HW DO ,Q DGGLWLRQ FRQWUROOLQJ WKH UDWH DQG UK\WKP RI VSHHFK SURGXFWLRQLVDW\SLFDODQGUHVLGXDOVSHHFKGLVWRUWLRQHUURUVDUHPRUHSUHYDOHQWLQ

$6WKDQLQW\SLFDOO\GHYHORSHGLQGLYLGXDOV2]RQRII 0LOOHU6KULEHUJHWDO

(14)

9RONPDUDQG.OLQ1HYHUWKHOHVVWKHLUVSHHFKLVRIWHQV\QWDFWLFDOO\

K\SHUFRUUHFWDQGWKLVPDNHVLWDW\SLFDOIRUWKHLUFKURQRORJLFDODJH$WWZRRG

*KD]LXGGLQ *HUVWHLQ*KD]LXGGLQHWDO5DSLQ,QOLJKWRI WKHVH¿QGLQJVWKHUHLVDQHHGWRFKDUDFWHUL]HWKHODQJXDJHDELOLWLHVRIFKLOGUHQ ZLWK$6LQGHWDLO

1.2.2. PERCEPTUAL PROCESSING OF COMMUNICATIVE CUES IN FACE-TO-FACE COMMUNICATION

&RQVLGHULQJWKHUHSRUWVRIDW\SLFDOVHQVRU\SURFHVVLQJLQ$6GH¿FLHQFLHVLQWKH SHUFHSWXDOSURFHVVHVUHOHYDQWIRUFRPPXQLFDWLRQPD\FRQWULEXWHWRTXDOLWDWLYH LPSDLUPHQWVLQFRPPXQLFDWLRQ'DNLQ )ULWK,DURFFL 0F'RQDOG 0LQVKHZ +REVRQ7KHGLI¿FXOWLHVPD\DULVHIURPGLIIHUHQWVWDJHVRI SHUFHSWLRQVHQVRU\VWLPXOLDUH¿UVWHQFRGHGDWORZOHYHODQGWKHQWKHVHSHUFHSWV DUHUHFRJQL]HGDVPHDQLQJIXOHQWLWLHVDWKLJKHUOHYHO,WKDVEHHQVXJJHVWHGWKDW LQGLYLGXDOVZLWK$6KDYHDVWURQJELDVWRZDUGVSURFHVVLQJORZOHYHOVHQVRU\VWLPXOL DWWKHH[SHQVHRIKROLVWLFDQGPHDQLQJIXOFRQFHSWVIRUDUHYLHZVHH+LOO )ULWK 7KHIDFHPHGLDWHVWKHPRVWLPSRUWDQWFRPPXQLFDWLYHFXHV±VSHHFKDQG IDFLDOH[SUHVVLRQV±WKHUHIRUHWKHSHUFHSWXDOSURFHVVHVUHOHYDQWIRUIDFHWRIDFH FRPPXQLFDWLRQDUHWKHIRFXVLQWKLVWKHVLV&OHDUO\KHUHWKHNH\SHUFHSWXDOSURFHVVHV DUHYLVLRQIDFLDOH[SUHVVLRQVDQGYLVXDOVSHHFKDQGKHDULQJDXGLWRU\VSHHFK

1.2.2.1. Recognition of the facial expressions of emotion

:HJHWLPSRUWDQWLQIRUPDWLRQERWKRQWKHVWDWHRIDQRWKHUSHUVRQ¶VPLQGDQGWKHLU OHYHORIHQJDJHPHQWLQWKHFRQYHUVDWLRQE\PRQLWRULQJWKHLUIDFLDOH[SUHVVLRQV,Q IDFWLQIHUHQFHVDERXWWKHSUHFHGLQJFRQWH[WDQGWKHH[SUHVVHU¶VFRJQLWLYHSURFHVVHV DQGKLVSK\VLFDOVWDWHDQGDFWLRQVFDQDOOEHPDGHIURPIDFLDOH[SUHVVLRQV(NPDQ .RKOHUHWDO7KHUHIRUHLQWKHFXUUHQWWKHVLVWKHIRFXVLVQDPHO\RQ WKHUHFRJQLWLRQRIEDVLFHPRWLRQVIURPIDFLDOH[SUHVVLRQV

%DVLFHPRWLRQVDQJHUGLVJXVWIHDUKDSSLQHVVVDGQHVVDQGDFFRUGLQJWRVRPH LQWHUSUHWDWLRQVDOVRFRQWHQWDUHFOHDUXQLYHUVDOSK\VLRORJLFDOUHDFWLRQVWRH[WHUQDO VWLPXOLZKHUHDVPRUHFRPSOH[VRFLDOVWLPXOLUHÀHFWWKHFRPSOH[LW\RIXQGHUVWDQGLQJ DQRWKHUSHUVRQ¶VPHQWDOVWDWH(NPDQ6RPHVWXGLHVRILQGLYLGXDOVZLWK$6' KDYHVXJJHVWHGSRRUUHFRJQLWLRQRIEDVLFHPRWLRQV$GROSKV6HDUV 3LYHQ

$VKZLQ&KDSPDQ&ROOH %DURQ&RKHQ%RUDVWRQ%ODNHPRUH&KLOYHUV 6NXVH']LREHN)OHFN5RJHUV:ROI &RQYLW+XPSKUH\V0LQVKHZ /HRQDUG %HKUPDQQEXWDVRI\HWWKHUHLVQRFRQVHQVXVRQWKHPDWWHU

(15)

6RPHRWKHUVWXGLHVKDYHVXJJHVWHGWKDWLQGLYLGXDOVZLWK$6KDYHGH¿FLWVRQO\LQ WKHUHFRJQLWLRQRIPRUHFRPSOH[PHQWDOVWDWHVIURPHPRWLRQDOGLVSOD\V$GROSKV HWDO%DURQ&RKHQ-ROOLIIH0RUWLPRUH 5REHUWVRQ%DURQ&RKHQ :KHHOZULJKW+LOO5DVWH 3OXPE%DURQ&RKHQ:KHHOZULJKW -ROOLIIH

*RODQ%DURQ&RKHQ +LOO)XUWKHUPRUH$6'VHHPVWRLQYROYH WKHVXSHULRUSURFHVVLQJRIVLQJOHIDFLDOIHDWXUHVEHFDXVHLQGLYLGXDOVZLWK$6'DUH OHVVLPSDLUHGWKDQW\SLFDOO\GHYHORSHGLQGLYLGXDOVE\SURFHGXUHVWKDWGLVUXSWWKH FRQ¿JXUDOSURFHVVLQJRIIDFHVVXFKDVIDFHLQYHUVLRQ+REVRQ2XVWRQ /HH RUPLVDOLJQPHQWRIIDFHSDUWV7HXQQLVVH GH*HOGHU,WLVQRWNQRZQKRZ WKHZHDNQHVVLQSURFHVVLQJJOREDOIHDWXUHVDIIHFWVWKHSHUFHSWLRQRILQIRUPDWLRQ IURPWKHIDFHLQDGXOWVZLWK$6+DSSp )ULWK,QDGGLWLRQSURVRSDJQRVLD LHWKHLPSDLUPHQWLQUHFRJQL]LQJLGHQWLW\IURPDIDFHKDVDKLJKHUSUHYDOHQFHLQ

$6%DUWRQHWDO%HKUPDQQ +XPSKUH\V1LHPLQHQYRQ:HQGW HWDO$OWKRXJKUHFRJQLWLRQRIIDFLDOLGHQWLW\LVWKRXJKWWREHVHSDUDWHIURP WKHSURFHVVLQJRIRWKHUIDFLDOLQIRUPDWLRQ%UXFH <RXQJ+HIWHU0DQRDFK %DUWRQLWLVQRWNQRZQLISURVRSDJQRVLDDIIHFWVWKHSURFHVVLQJRIJOREDO IHDWXUHVIURPWKHIDFH

1.2.2.2. Multisensory perception of speech

7KHLQWHJUDWLRQRILQIRUPDWLRQIURPPXOWLSOHVHQVRU\PRGDOLWLHVPXOWLVHQVRU\

LQWHJUDWLRQLVDNH\SHUFHSWXDOSURFHVVWKDWOHDGVWRHQKDQFHGSHUFHSWLRQDQG IDFLOLWDWHGUHVSRQVHVWRREMHFWVLQWKHQDWXUDOHQYLURQPHQW,DURFFL 0F'RQDOG ,WPD\ZHOOEHWKDWWKHLQWHJUDWLRQDQGRUJDQL]DWLRQRIGLIIHUHQWSHUFHSWXDO SURFHVVHVFRQWULEXWHVWRWKHSHUFHSWXDODW\SLFDOLWLHVUHOHYDQWIRUFRPPXQLFDWLRQ LQ $6' ,DURFFL 0F'RQDOG ,W KDV EHHQ VXJJHVWHG WKDW VHQVRU\

LQWHJUDWLRQSUREOHPVSDUWO\H[SODLQWKHDW\SLFDOVHQVRU\H[SHULHQFHVUHSRUWHGLQ WKHDXWRELRJUDSKLHVRIKLJKIXQFWLRQLQJLQGLYLGXDOVZLWK$6'HJ*UDQGLQ :LOOLDPV$WWZRRG7KLVKDVHYHQUHVXOWHGLQWKHGHYHORSPHQWRIVSHFL¿F LQWHUYHQWLRQPHWKRGVIRUVHQVRU\LQWHJUDWLRQ$\HUHV+RZHYHUWKHUHKDYH VWLOOEHHQUHODWLYHO\IHZHPSLULFDOVWXGLHVRQPXOWLVHQVRU\SURFHVVLQJLQ$6'DV 0ROKROPDQG)R[HDQG,DURFFLDQG0F'RQDOGSRLQWRXW

%\QDWXUHVSHHFKLVDPXOWLVHQVRU\SKHQRPHQRQLWLVDXGLRYLVXDODVERWK WKHVSHDNHU¶VYRLFHDQGIDFHJLYHLQIRUPDWLRQRIDUWLFXODWLRQ6HHLQJDUWLFXODWRU\

OLSPRYHPHQWVLPSURYHVVSHHFKUHFRJQLWLRQHVSHFLDOO\XQGHUQRLV\FRQGLWLRQVDV ZDVRULJLQDOO\UHSRUWHGDOUHDG\E\6XPE\DQG3ROODFN1HXURSK\VLRORJLFDO VWXGLHVRIW\SLFDOO\GHYHORSHGLQGLYLGXDOVKDYHLQGLFDWHGWKDWHYHQLQIDQWVEHQH¿W IURPYLVXDOVSHHFKLQODQJXDJHGHYHORSPHQW.XKO 0HOW]RII7HLQRQHQ

$VOLQ$ONX &VLEUD

(16)

7KHLQWHUDFWLRQRIDXGLWRU\DQGYLVXDOVSHHFKLVGHPRQVWUDWHGLQWKHVRFDOOHG

³0F*XUNHIIHFW´0F*XUN 0DF'RQDOG0DF'RQDOG 0F*XUNZKHUH GLVFUHSDQWYLVXDOVSHHFKDOWHUVDXGLWRU\VSHHFKSHUFHSWLRQ,QWKHRULJLQDOVWXG\

DYRLFHVD\LQJEDZDVSUHVHQWHGZLWKDIDFHDUWLFXODWLQJJDZKLFKUHVXOWHGLQ WKHSDUWLFLSDQWVKHDULQJGDDIXVLRQRIWKHDXGLRDQGYLVXDOFRPSRQHQWVRURQ WKHEDVLVRIWKHYLVXDOFRPSRQHQWDVJD7KHUHVSRQVHVUHÀHFWHGWKHLQÀXHQFH RIYLVLRQRQDXGLWRU\VSHHFKSHUFHSWLRQDQGDUHDOVRFRPPRQO\FRQVLGHUHGWR UHÀHFWDXGLRYLVXDOLQWHJUDWLRQ+HQFHWKHIHZHUUHVSRQVHVDFFRUGLQJWRWKHDXGLR FRPSRQHQWRIWKHLQFRQJUXHQWVWLPXOXVDQLQGLYLGXDOJLYHVWKHVWURQJHUWKH0F*XUN HIIHFWDQGWKXVDXGLRYLVXDOLQWHJUDWLRQ'XHWRWKHGLIIHUHQWUHVSRQVHRSWLRQVLWLV LPSRUWDQWWRDQDO\]HZKDWWKHSDUWLFLSDQWVDFWXDOO\UHVSRQGGXHWRWKHGHVFULEHG GLIIHUHQWSRVVLEOHRXWFRPHV

7KH0F*XUNHIIHFWKDVDOUHDG\EHHQDSSOLHGWRWKHVWXG\RIDXGLRYLVXDOVSHHFK SHUFHSWLRQLQ$6'%RWKLPSDLUHG0RQJLOORHWDO'H*HOGHU9URRPHQ YDQGHU+HLGHDQGLQWDFW0DVVDUR %RVVHOHU:LOOLDPV0DVVDUR 3HHO %RVVHOHU 6XGGHQGRUI DXGLRYLVXDO LQWHJUDWLRQ LQ FKLOGUHQ ZLWK DXWLVPKDVEHHQUHSRUWHG,QWKHODWWHUVWXGLHVLWLVDUJXHGWKDWWKHGLIIHUHQFHVLQ DXGLRYLVXDOVSHHFKSHUFHSWLRQDUHVLPSO\GXHWRSRRUHUOLSUHDGLQJDELOLW\WKDW FDXVHVWKHLQÀXHQFHRIWKHYLVXDOFRPSRQHQWWREHZHDNHULQ$6',QDGXOWKRRG KLJKIXQFWLRQLQJLQGLYLGXDOVZLWK$6'KDYHQRWEHHQIRXQGWRGLIIHUIURPFRQWUROVLQ WKHVWUHQJWKRIWKH0F*XUNHIIHFW.HDQH5RVHQWKDO&KXQ 6KDPV7KHUH DUHQRSUHYLRXVVWXGLHVVSHFL¿FDOO\RQDXGLRYLVXDOVSHHFKSHUFHSWLRQLQ$6

1.2.2.3. The effect of attention on perception

$WWHQWLRQDOPHFKDQLVPVHQVXUHWKDWZHSHUFHLYHWKHUHOHYDQWLQIRUPDWLRQIURP WKHHQYLURQPHQW)RUIXQFWLRQDOSHUFHSWLRQZHKDYHWRVHOHFWLYHO\DWWHQG±HLWKHU VSRQWDQHRXVO\RUFRQVFLRXVO\±WRUHOHYDQWLQIRUPDWLRQDQGLJQRUHGLVWUDFWLQJ LQIRUPDWLRQIRUDUHYLHZVHH/DFKWHU)RUVWHU 5XWKUXII7KHIRFXVRI DWWHQWLRQPD\EHPDLQWDLQHGRQRQHWDUJHWRUVKLIWHGIURPRQHWDUJHWWRDQRWKHUZKHQ QHHGHG7KHDWWHQGHGVSDFHRUWKHQXPEHURIDWWHQGHGVWLPXOLPD\EHEURDGHQHGRU QDUURZHGWRHQKDQFHWKHSURFHVVLQJRIWKHVWLPXOL)XUWKHUPRUHDWWHQWLRQPD\EH FXHGWKDWLVGLUHFWHGWRDSDUWLFXODUORFDWLRQE\HLWKHUH[RJHQRXVRUHQGRJHQRXV FXHV3RVQHU,QWHUHVWLQJO\DWWHQWLRQDOGLI¿FXOWLHVDUHRYHUUHSUHVHQWHGLQ

$6'DQGFRXOGDIIHFWWKHSHUFHSWLRQRIFRPPXQLFDWLYHO\UHOHYDQWLQIRUPDWLRQ

%RWKWKHLQWHQVLYHIRFXVLQJRIDWWHQWLRQRQWKLQJVRIVSHFLDOLQWHUHVWFRXSOHG

,QWKHFXUUHQWVWXG\WKHWHUPOLSUHDGLQJLVXVHGWRUHIHUWRYLVXDOVSHHFKUHFRJQLWLRQ+RZHYHULWVKRXOG EHQRWHGWKDWLQFUHDVLQJO\WKHWHUPVSHHFKUHDGLQJLVXVHGEHFDXVHLWGHVFULEHVWKHLQYROYHPHQWRIZLGHU PRYHPHQWDURXQGWKHOLSVPRUHDFFXUDWHO\

(17)

ZLWKVORZFKDQJHLQWKHIRFXVRIDWWHQWLRQDQGLQFRQWUDVWKLJKGLVWUDFWLELOLW\KDYH EHHQUHSRUWHGLQ$6'IRUDUHYLHZVHH$PHV )OHWFKHU:DWVRQ7KHUHIRUH LWLVOLNHO\WKDWVRPHDVSHFWVRIDWWHQWLRQDOFRQWURODUHLQWDFWLQ$6'EXWRWKHUV DUHDIIHFWHG7KHIRFXVRIYLVXDODWWHQWLRQLVQRWDOZD\VUHYHDOHGLQJD]H¿[DWLRQ VWUDWHJLHV3UHYLRXV¿QGLQJVKDYHVXJJHVWHGGLIIHUHQFHVLQJD]H¿[DWLRQSDWWHUQVWR WKHIDFHEHWZHHQLQGLYLGXDOVZLWK$6'DQGW\SLFDOO\GHYHORSHGLQGLYLGXDOVZKHQ YLHZLQJVWLOOLPDJHVRIHPRWLRQDOIDFLDOH[SUHVVLRQV'DOWRQHWDO1HXPDQQ 6SH]LR3LYHQ $GROSKV3HOSKUH\HWDORUZKHQYLHZLQJYLGHRV RIVRFLDOO\FRPSOH[VLWXDWLRQV.OLQ-RQHV6FKXOW]9RONPDU &RKHQ ,QGLYLGXDOVZLWK$6'WHQGWRIRFXVPRUHRQWKHQRQVDOLHQWIHDWXUHVRIIDFHVWKDQ RQWKHPRXWKQRVHDQGH\HVZKHQIUHHO\YLHZLQJSKRWRJUDSKVRIKXPDQIDFHV 3HOSKUH\HWDO)XUWKHUPRUHLQGLYLGXDOVZLWK$6'VSRQWDQHRXVO\¿[DWH PRUHRQWKHPRXWKWKDQWKHH\HVZKHQMXGJLQJHPRWLRQVIURPVWLOOSKRWRVDQG ZKHQYLHZLQJYLGHRVRIFRPSOH[VRFLDOVLWXDWLRQV.OLQHWDO3HOSKUH\HWDO 7KHUHLVOLWWOHDYDLODEOHNQRZOHGJHRIH\HJD]HEHKDYLRXUDQGLWVHIIHFWVRQ VSHHFKSHUFHSWLRQLQ$6'ZKHQYLHZLQJDWDONLQJIDFH,UZLQ

'LUHFWLQJRIYLVXDODWWHQWLRQFDQEHFRQWUROOHGDQGLWLVSRVVLEOHWRVHOHFWLYHO\

DWWHQGWRDORFDWLRQRWKHUWKDQZKHUHRXUH\HVDUH¿[DWHGLHZKHQIROORZLQJD VSHFL¿FLQVWUXFWLRQ3RVQHU3UHYLRXVVWXGLHVKDYHIRXQGWKDWLQGLYLGXDOV ZLWK$6'KDYHGLI¿FXOWLHVZKHQWKH\DUHUHTXLUHGWRVHOHFWLYHO\DWWHQGWRRQH VWLPXOXVDPRQJPDQ\FRPSHWLQJVWLPXOL%XUDFN%HFDXVHWKH\KDYHD ODUJHUSHUFHSWXDOFDSDFLW\WKH\WHQGWRSURFHVVGLVWUDFWLQJVWLPXOLDVZHOODVWKH WDUJHWLWHPDQGWKLVUHVXOWVLQKLJKHUGLVWUDFWDELOLW\5HPLQJWRQ6ZHWWHQKDP

&DPSEHOO &ROHPDQ$FFRUGLQJWRUHFHQWLPDJLQJVWXGLHVWKLVPLJKWEH UHODWHGQDPHO\WRVRFLDOO\UHOHYDQWYLVXDOVLJQDOVDVDGXOWVZLWK$6'VKRZHGQR DWWHQWLRQDOPRGXODWLRQIRUVRFLDOIDFHVVWLPXOLDOWKRXJKDWWHQWLRQDOPRGXODWLRQ IRUQRQVRFLDOKRXVHVVWLPXOLZDVVLPLODUZLWKFRQWUROSDUWLFLSDQWV,QVLWXDWLRQV ZKHUHWKHUHDUHPXOWLSOHVLPXOWDQHRXVFRPPXQLFDWLRQSDUWQHUVWKHDELOLW\WRIRFXV DWWHQWLRQVSDWLDOO\WRZDUGVRQHVSHDNHULVHVVHQWLDOIRUVXFFHVVIXOFRQYHUVDWLRQ%LUG

&DWPXU6LODQL)ULWK )ULWK,QGLYLGXDOVZLWK$6RIWHQH[SUHVVGLI¿FXOWLHV LQVLWXDWLRQVZLWKPXOWLSOHWDONHUV*UDQGLQ:LOOLDPV$WWZRRG DQGWKLVFRXOGEHGXHWRLQHI¿FLHQF\LQVHOHFWLYHO\DWWHQGLQJWRRQHWDONHUDQG GLUHFWLQJYLVXDOVSDWLDODWWHQWLRQ

1.3. SUMMARY

,QGLYLGXDOVZLWK$6KDYHTXDOLWDWLYHLPSDLUPHQWVLQVRFLDOFRPPXQLFDWLRQEXWWKH FDXVDOPHFKDQLVPVEHKLQGRIWKHVHLPSDLUPHQWVDUHQRW\HWIXOO\XQGHUVWRRG7KHUH LVFRQWURYHUV\RYHUWKHODQJXDJHDELOLWLHVRILQGLYLGXDOVZLWK$6DQGKRZPXFKWKLV

(18)

FRQWULEXWHVWRDW\SLFDOFRPPXQLFDWLRQ)XUWKHUPRUHGLIIHUHQFHVLQSHUFHSWLRQPD\

FRQWULEXWHWRDW\SLFDOFRPPXQLFDWLRQ,QSDUWLFXODUYLVXDOSHUFHSWLRQRIHPRWLRQDO FXHVIURPWKHIDFHDQGPXOWLVHQVRU\SHUFHSWLRQRIVSHHFKPLJKWFRQWULEXWHWRWKH DW\SLFDOSURFHVVLQJRIFRPPXQLFDWLYHO\UHOHYDQWFXHVLQIDFHWRIDFHFRPPXQLFDWLRQ 0RUHRYHUDWWHQWLRQWRWKHIDFHDQGYROXQWDU\FRQWURORIDWWHQWLRQLVQHFHVVDU\IRU SHUFHSWLRQRIWKHUHOHYDQWFRPPXQLFDWLYHFXHV7KXVWKHFXUUHQWWKHVLVIRFXVHVRQ WKHOLQJXLVWLFDQGSHUFHSWXDOSURFHVVLQJRIFRPPXQLFDWLYHFXHVLQ$6

(19)

2. AIMS OF THE STUDIES

6WXG\,DLPHGWRSURYLGHDGHWDLOHGH[SORUDWLRQRIWKHODQJXDJHDELOLWLHVRIFKLOGUHQ ZLWK$67RWKLVHQGWKHH[SUHVVLYHDQGUHFHSWLYHODQJXDJHDELOLWLHVRIVFKRRO DJHGFKLOGUHQZLWK$6ZHUHWHVWHGZLWKVWDQGDUGL]HGWHVWV7KHK\SRWKHVLVZDVWKDW FKLOGUHQZLWK$6ZRXOGSHUIRUPSRRUHULQVXEWHVWVPHDVXULQJUHFHSWLYHODQJXDJH DELOLWLHV

6WXG\,,DLPHGWR¿QGRXWZKHWKHULQGLYLGXDOVZLWK$6ZRXOGKDYHPRUHGLI¿FXOWLHV LQUHFRJQL]LQJIDFLDOHPRWLRQVRQWKHEDVLVRIJOREDOIDFLDOIHDWXUHV7KHUHFRJQLWLRQ RIEDVLFIDFLDOHPRWLRQVZDVWHVWHGXVLQJVWDWLFDQGG\QDPLFLPDJHVE\YDU\LQJWKH DPRXQWRIYLVXDOGHWDLOLQWKHLPDJHV7KHK\SRWKHVLVZDVWKDWDGXOWVZLWK$6ZRXOG KDYHPRUHGLI¿FXOW\LQUHFRJQL]LQJDQHPRWLRQZKHQWKHDPRXQWRIYLVXDOGHWDLO ZDVORZDVWKH\ZRXOGKDYHWRUHO\PRUHRQJOREDOSURFHVVLQJ

6WXG\,,,DLPHGWRGLVFRYHUZKHWKHULQGLYLGXDOVZLWK$6SHUFHLYHGPXOWLVHQVRU\

VLJQDOVGLIIHUHQWO\7KH0F*XUNHIIHFWZDVXVHGDVDWRROWRLQYHVWLJDWHWKHDXGLRYLVXDO SHUFHSWLRQRIVSHHFK7KHK\SRWKHVLVZDVWKDWDGXOWLQGLYLGXDOVZLWK$6ZRXOGVKRZ ZHDNHU0F*XUNHIIHFWDQGWKLVZRXOGEHPDQLIHVWHGLQJLYLQJPRUHUHVSRQVHV DFFRUGLQJWRWKHDXGLWRU\VWLPXOL)XUWKHUPRUHH\HJD]HEHKDYLRUZDVUHJLVWHUHG GXULQJVSHHFKSHUFHSWLRQDQGWKHK\SRWKHVLVZDVWKDWLQGLYLGXDOVZLWK$6ZRXOG JD]HPRUHDWPRXWKDQGOHVVDWH\HV

6WXG\,9DLPHGWRUHYHDOZKHWKHUDGXOWLQGLYLGXDOVZLWK$6KDGGLI¿FXOW\LQ DWWHQGLQJWRFRPPXQLFDWLYHO\UHOHYDQWLQIRUPDWLRQLQWKHSUHVHQFHRIGLVWUDFWLQJ LQIRUPDWLRQ,QRUGHUWRVWXG\WKLVZHLQYHVWLJDWHGWKHHIIHFWRIDGLVWUDFWRUIDFH RQDXGLRYLVXDOVSHHFKSHUFHSWLRQ7KHK\SRWKHVLVZDVWKDWLQGLYLGXDOVZLWK$6 ZRXOGEHPRUHGLVWUDFWHGWKDQW\SLFDOO\GHYHORSHGFRQWUROVE\DGLVWUDFWRUIDFH ZKHQDWWHQGLQJWRDWDUJHWIDFH

(20)

3. STUDIES

DIAGNOSTICS AND ETHICAL CONSIDERATIONS

,QDOOWKHVWXGLHVWKHSDUWLFLSDQWVLQWKH$6JURXSVZHUHUHFUXLWHGIURP+HOVLQNL 8QLYHUVLW\ &HQWUDO +RVSLWDO +8&+ DQG IURP +HOVLQNL $VSHUJHU &HQWHU DW 'H[WUDDSULYDWHPHGLFDOFHQWHU$6ZDVFOLQLFDOO\GLDJQRVHGDFFRUGLQJWRWKH ,&':+2DQG'60,9$PHULFDQ3V\FKLDWULF$VVRFLDWLRQ$3$

GLDJQRVWLFFULWHULDE\PXOWLGLVFLSOLQDU\WHDPVRISURIHVVLRQDOVDFKLOGQHXURORJLVW QHXURSV\FKRORJLVWDQGUHJLVWHUHGQXUVH0HWKRGVVXFKDVWKH$XWLVP6SHFWUXP 6FUHHQLQJ 4XHVWLRQQDLUH $664 (KOHUV HW DO WKH $XWLVP 'LDJQRVWLF ,QWHUYLHZ5HYLVHG$',5/RUGHWDODQGWKH$XWLVP'LDJQRVWLF2EVHUYDWLRQ 6FKHGXOH$'26/RUGHWDOZHUHXVHGWRFKDUDFWHUL]HWKHSDUWLFLSDQWV¶

EHKDYLRU'LDJQRVHVZHUHFRQ¿UPHGRQO\DIWHUDJUHHPHQWZLWKLQWKHGLDJQRVWLF JURXS

,Q6WXG\,WKHSDUWLFLSDQWVZHUHFKLOGUHQEXWLQ6WXGLHV,,,,,DQG,9WKH SDUWLFLSDQWVZHUHDGXOWV7DEOH7KHUHLVVWLOOOLWWOHNQRZOHGJHRIWKHGHYHORSPHQWDO IDFWRUVWKDWDIIHFWWKHRQSHUFHSWXDOSURFHVVHVLQYHVWLJDWHGLQWKHVHVWXGLHVLH WKHPDWXUDWLRQRIWKH0F*XUNHIIHFWLVQRWIXOO\XQGHUVWRRG7KHUHIRUHLQRUGHU WRPLQLPL]HWKHLPSRUWDQFHRIGHYHORSPHQWDOFRQVLGHUDWLRQVWKHVWXGLHVZHUH FRQGXFWHGZLWKDGXOWV

,QDOOWKHVWXGLHVWKHUHVXOWVZHUHFRPSDUHGZLWKPDWFKHGFRQWUROVZKRKDGD KLVWRU\RIW\SLFDOGHYHORSPHQWFRQ¿UPHGZLWKDTXHVWLRQQDLUHDQGQRGLDJQRVWLF FRQGLWLRQV$TXHVWLRQQDLUHZDVXVHGWRUXOHRXWDGLDJQRVLVRI$6LQDOOVWXGLHV

$664(KOHUVHWDORUDWWHQWLRQGLVRUGHU6WXG\,,,DQG,9$56YIRUWKH FRQWUROSDUWLFLSDQWV

$OOWKHVWXGLHVZHUHDSSURYHGE\WKHDSSURSULDWHHWKLFDOFRPPLWWHHRI+8&+

DQGDGGLWLRQDOO\6WXG\,ZDVDSSURYHGE\WKHHWKLFDOFRPPLWWHHRIWKH'HSDUWPHQW RI3V\FKRORJ\8QLYHUVLW\RI+HOVLQNL7KH6WXGLHVKDYHWKHUHIRUHEHHQSHUIRUPHG LQDFFRUGDQFHZLWKWKHHWKLFDOVWDQGDUGVIRUKXPDQVWXGLHVODLGGRZQLQWKH 'HFODUDWLRQRI+HOVLQNL$OOWKHSDUWLFLSDQWVJDYHWKHLUZULWWHQFRQVHQWLQ6WXG\, WKHFKLOGUHQ¶VSDUHQWVJDYHWKHLUFRQVHQWIRUWDNLQJSDUWLQWKHVWXG\

(21)

Table 2. Demographic variables for the participants of the study series.

N Age Gender

(male/female)

VIQ PIQ FIQ

AS Control AS Control AS Control AS Control AS Control AS Control Study I ²² ²³ ^{8.9 (0.9)} ^{9.0 (0.7)} ^{16 / 6} ^{17 / 6} ^{112 (17.3)} ^{112 (12.9)} ^{104 (17.1)} ^{108 (12.7)} ^{108 (13.5)} ^{110 (10.4)} Study II ²⁰ ²⁰ ^{32 (10)} ^{31 (8)} ^{13 / 7} ^{13 / 7} ^{110 (11)} ^{116 (8)} ^{113 (16)} ^{113 (16)} ^{112 (13)} ^{116 (11)} Study III

and IV

16 16 32 (10) 32 (8) 13 / 3 13 / 3 111 (13) 118 (8) 114 (16) 114 (16) 113 (14) 118 (9)

3.1. STUDY I: THE LANGUAGE ABILITIES OF CHILDREN WITH ASPERGER SYNDROME

INTRODUCTION

7KH GDWH WKH ODQJXDJH DELOLWLHV RI FKLOGUHQ ZLWK $6 KDYH EHHQ LQVXI¿HFLHQWO\

LQYHVWLJDWHG2QWKHEDVLVRIFOLQLFDOREVHUYDWLRQVDQGWKH¿QGLQJVRIVWXGLHVRQ DGXOWVZLWK$6DQG+)$+RZOLQLWLVWREHH[SHFWHGWKDWWKHODQJXDJH DELOLWLHVRIVFKRRODJHGFKLOGUHQZLWK$6GLIIHUIURPWKRVHRIW\SLFDOO\GHYHORSHG SHHUV,QSDUWLFXODUWKHUHFHSWLYHODQJXDJHDELOLWLHVFRPSUHKHQVLRQRIFKLOGUHQ ZLWK$6FRXOGEHPRUHLPSDLUHG)XUWKHUPRUHRQWKHEDVLVRIFOLQLFDO¿QGLQJV DQGSUHYLRXVVWXGLHV$OFiQWDUD:HLVEODWW0RRUH %ROWRQZHH[SHFWHG WKHSDUWLFLSDQWVZLWK$6WREHPRUHDIIHFWHGE\EDFNJURXQGQRLVH7KHUHIRUHWKH K\SRWKHVLVZDVWKDWFKLOGUHQZLWK$6ZRXOGSHUIRUPZRUVHWKDQWKHLUPDWFKHG FRQWUROVLQUHFHSWLYHVXEWHVWVRIODQJXDJHDQGWKHLUODQJXDJHFRPSUHKHQVLRQZRXOG EHPRUHDIIHFWHGE\EDFNJURXQGQRLVH

(22)

Table 3. Language tests used in Study I and the language abilities they measured.

TEST LANGUAGE ABILITY

NEPSY

(Finnish Developmental Phonological processing Neusopsychological Comprehension of instructions

Evaluation) Sentence comprehension

Non-word repetition Fluency

Sentence repetition

Boston naming test Naming

Rapid automized naming Speeded naming

PARTICIPANTS AND METHODS

7KHSDUWLFLSDQWVZHUH±\HDUVRIDJHPHDQDJH\HDUVDQGFRQVLVWHGRI FKLOGUHQZLWK$6DQGW\SLFDOO\GHYHORSHGFRQWUROV7DEOH

7KHODQJXDJHDELOLWLHVRIWKHSDUWLFLSDQWVZHUHDVVHVVHGZLWKVWDQGDUGL]HGWHVWV FRPPRQO\XVHGLQ)LQQLVKFOLQLFVIRUWKHGLDJQRVWLFDVVHVVPHQWRIODQJXDJHDQG RWKHU FRJQLWLYH DELOLWLHV 7DEOH %RWK H[SUHVVLYH QDPLQJ VSHHGHG QDPLQJ ÀXHQF\QRQZRUGUHSHWLWLRQSKRQRORJLFDOSURFHVVLQJDQGUHFHSWLYHODQJXDJH DELOLWLHVFRPSUHKHQVLRQRILQVWUXFWLRQVVHQWHQFHFRPSUHKHQVLRQZHUHPHDVXUHG )XUWKHUPRUHWKHHIIHFWRIQRLVHRQVSHHFKFRPSUHKHQVLRQZDVPHDVXUHGE\DGGLQJ WZRGLIIHUHQWVHWVRIQRLVHWKHVRFDOOHGZKLWHDQGFDIHWHULDQRLVHWRWKHEDFNJURXQG RIWKHVXEWHVWPHDVXULQJVHQWHQFHFRPSUHKHQVLRQ

7KH WHVWV ZHUH FDUULHG RXW DW WKH &RJQLWLYH %UDLQ 5HVHDUFK 8QLW &%58 ,QVWLWXWHRI%HKDYLRUDO6WXGLHV8QLYHUVLW\RI+HOVLQNLE\WKHDXWKRU7KHWHVWV ZHUHYLGHRWDSHGIRUODWHULQVSHFWLRQ

RESULTS AND DISCUSSION

7KHFKLOGUHQZLWK$6KDGPRUHGLI¿FXOWLHVLQWKHFRPSUHKHQVLRQRIWKHLQVWUXFWLRQV VXEWHVWWKDQWKHLUPDWFKHGQHXURW\SLFDOFRQWUROVS )XUWKHUPRUHWKHUHVXOWV UHYHDOHGWKDWWKHFKLOGUHQZLWK$6WHQGHGWRSHUIRUPZRUVHLQWKHSKRQRORJLFDO SURFHVVLQJVXEWHVWS ,QWKHRWKHUVXEWHVWVWKHUHZHUHQRVLJQL¿FDQWGLIIHUHQFHV EHWZHHQWKHJURXSV&RQVHTXHQWO\WKHFKLOGUHQZLWK$6SHUIRUPHGVLPLODUO\WRWKH FRQWUROSDUWLFLSDQWVLQWKHVXEWHVWVPHDVXULQJÀXHQF\QDPLQJVSHHGHGQDPLQJ QRQZRUGUHSHWLWLRQDQGVHQWHQFHUHSHWLWLRQ)XUWKHUPRUHWKHUHZHUHQRGLIIHUHQFHV EHWZHHQWKHJURXSVLQWKHHIIHFWRIQRLVHRQVHQWHQFHFRPSUHKHQVLRQ

(23)

Figure 1. Box-and-Whisker plot graphs of differences between groups in the subtests of Comprehension of Instructions and Phonological Processing (results for the AS group on the left). The range of the scores is greater in the group of children with AS than in the control group in both subtests.

7KHUHVXOWVRIWKHVWXG\VKRZHGWKDWWKHFKLOGUHQZLWK$6KDGPRUHGLI¿FXOWLHVLQ WKHFRPSUHKHQVLRQRILQVWUXFWLRQVWKDQWKHLUW\SLFDOO\GHYHORSHGFRQWUROV)LJ,W LVWKH¿UVWVWXG\WRGHPRQVWUDWHGLIIHUHQFHVLQUHFHSWLYHODQJXDJHDELOLWLHVEHWZHHQ FKLOGUHQZLWK$6DQGWKHLUW\SLFDOO\GHYHORSHGSHHUV7KHUHIRUHWKH¿QGLQJVRI WKHFXUUHQWVWXG\VXSSRUWWKHFKDQJHWRZDUGVDPRUHGLPHQVLRQDOUDWKHUWKDQ FDWHJRULFDOGLDJQRVLVRIDXWLVPVSHFWUXPGLVRUGHUVDQGWKLVLVDOVRWKHFDVHLQ UHVSHFWWRWKHODQJXDJHDELOLWLHV(LVHQPDMHUHWDO/HHNDP:LQJ*RXOG *LOOEHUJ /RUG /HYHQWKDO &RRN +RZHYHU SHUIRUPDQFH LQ FRPSUHKHQVLRQRILQVWUXFWLRQVYDULHGJUHDWO\DQGWKHUHZHUHFKLOGUHQZLWK$6ZKR SHUIRUPHGZHOOLQWKHWDVN)LJ7KHUHIRUHQRWDOOFKLOGUHQZLWK$6QHFHVVDULO\

FRPSUHKHQG LQVWUXFWLRQV SRRUO\ DOWKRXJK DW WKH JURXS OHYHO WKLV ZDV LQGHHG WKHFDVHDQGWKHDYHUDJHZDVVLJQL¿FDQWO\ORZHULQWKH$6JURXS,PSRUWDQWO\

SHUIRUPLQJZHOOLQWKLVSDUWLFXODUVXEWHVWGRHVQRWRQO\UHTXLUHOLQJXLVWLFDELOLWLHV 7KHFKLOGUHQVDZDVKHHWRISDSHUZLWKDQDUUD\RIGLIIHUHQWFRORUHGVKDSHVDQG WKH\ZHUHWKHQJLYHQLQVWUXFWLRQVZLWKLQFUHDVLQJGLI¿FXOW\LQZKLFKWKH\ZHUHDVNHG WRSRLQWWRWKHVKDSHVHJ³6KRZPHDJUHHQFLUFOHDQGWKHWKLUG¿JXUHIURPWKH VHFRQGURZ´7KHUHIRUHLQDGGLWLRQWROLQJXLVWLFVNLOOVWKHWDVNDOVRUHTXLUHVVKRUW WHUPPHPRU\NHHSLQJWKHYHUEDOLQVWUXFWLRQLQPLQGDQGVHOIUHJXODWLRQDQG

(24)

SODQQLQJDQGH[HFXWLQJPRWRUDFWLRQV7KXVWKHUHVXOWFDQDOVRUHÀHFWDG\VIXQFWLRQ LQH[HFXWLYHIXQFWLRQLQJZKLFKKDVSUHYLRXVO\EHHQFRQQHFWHGWR$6'5XVVHOO HWDO7KHGLIIHUHQFHVIRXQGLQODQJXDJHDELOLWLHVRIVFKRRODJHFKLOGUHQ FRQWULEXWHWRLPSDLUPHQWVLQFRPPXQLFDWLRQ'LI¿FXOW\LQFRPSUHKHQGLQJYHUEDO LQVWUXFWLRQVPD\FDXVHPLVXQGHUVWDQGLQJVDQGOHDGWRDYRLGDQFHRIFRQYHUVDWLRQ DWVFKRRODQGKRPH,WVKRXOGEHNHSWLQPLQGWKDWWKHVHFKLOGUHQPD\KDYHD ZLGHYRFDEXODU\ÀXHQWH[SUHVVLYHVSHHFKDQGDJRRGFRPPDQGRIV\QWD[DQG\HW KDYHSUREOHPVLQFRPSUHKHQGLQJLQVWUXFWLRQV,QWKHIXWXUHLWLVLPSRUWDQWWRXVH PRUHOLQJXLVWLFWHVWVWRLQYHVWLJDWHUHFHSWLYHODQJXDJHDELOLWLHVDQGKDYHDFRQWURO WHVWPHDVXULQJH[HFXWLYHIXQFWLRQVLQGHWDLO,QDGGLWLRQWRLPSDLUPHQWVLQVSHHFK FRPSUHKHQVLRQWKHFKLOGUHQZLWK$6WHQGHGWREHSRRUHUWKDQWKHFRQWUROVLQWKH VXEWHVWRQSKRQRORJLFDOSURFHVVLQJ7KLVWHQGHQF\VXJJHVWVGLI¿FXOWLHVLQGHFRGLQJ WKHSKRQRORJLFDOVWUXFWXUHRIDZRUGDQGLQDUWLFXODWLRQZKLFKLVUHODWHGWRGLI¿FXOWLHV LQFRQWUROOLQJWKHVHTXHQFHRIVSHHFKPRWRUPRYHPHQWV

3.2. STUDY II: IMPAIRED RECOGNITION OF FACIAL EMOTIONS FROM LOW SPATIAL FREQUENCIES IN ASPERGER SYNDROME

INTRODUCTION

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¿FLHQWSURFHVVLQJRIJOREDOELRORJLFDOPRWLRQ IRXQGLQ$6'%HUWRQH0RWWURQ-HOHQLF )DXEHUW%ODNH7XUQHU6PRVNL 3R]GRO 6WRQH3HOOLFDQR*LEVRQ0D\EHU\'XUNLQ %DGFRFN 7KHK\SRWKHVLVZDVWKDWDGXOWVZLWK$6ZRXOGEHDVDFFXUDWHDVWKHFRQWUROVDW UHFRJQL]LQJQRQEOXUUHGEDVLFHPRWLRQVWLPXOL+RZHYHULWZDVH[SHFWHGWKDWWKH

(25)

UHFRJQLWLRQDFFXUDF\IRUEOXUUHGVWLPXOLZRXOGEHORZHUEHFDXVHRIWKHLPSDLUHG JOREDOSURFHVVLQJIRXQGLQ$6

7KHSDUWLFLSDQWVZHUHDGXOWVZLWK$6PHDQDJHDQGWKHLUPDWFKHGFRQWUROV 7DEOH7KHSDUWLFLSDQWVZLWK$6ZHUHIXUWKHUFKDUDFWHUL]HGE\ZKHWKHURUQRW WKH\KDGGLI¿FXOWLHVLQIDFHUHFRJQLWLRQSURVRSDJQRVLDZKLFKZDVGLDJQRVHG XVLQJWKH)DFH5HFRJQLWLRQWDVNLQWKH1(36<'HYHORSPHQWDO1HXURSV\FKRORJLFDO

$VVHVVPHQWWHVWEDWWHU\.RUNPDQHWDOLQDGGLWLRQWRWKHSDUWLFLSDQWV¶

VXEMHFWLYHGHVFULSWLRQRIWKHLUGLI¿FXOWLHV7KHSDUWLFLSDQWVZHUHJLYHQWKH7RURQWR

$OH[LWK\PLD6FDOHZKLFKUHÀHFWVWKHDELOLW\WR¿QGYHUEDODQGV\PEROLFH[SUHVVLRQV RIDQH[SHULHQFHGHPRWLRQ7$6)LQQLVKWUDQVODWLRQ3DUNHU%DJE\7D\ORU (QGOHU 6FKLPW]

7KHUHFRJQLWLRQRIIRXUEDVLFHPRWLRQVDQJHUGLVJXVWIHDUKDSSLQHVVIURP VWDWLFDQGG\QDPLFYLGHRVHTXHQFHVGLVSOD\VRIIDFLDOH[SUHVVLRQZDVVWXGLHG7KH VWLPXOLZHUHVHOHFWHGIURPWKH³7..YLGHRVHTXHQFHFROOHFWLRQ´.lWV\UL RIEDVLFHPRWLRQV/RZSDVV¿OWHULQJZDVXVHGWREOXUWKHLPDJHDQGYDU\WKH DPRXQWRIYLVXDOGHWDLOLQWKHHPRWLRQDOGLVSOD\V7KHVWLPXOLZHUHVKRZQLQWKUHH GLIIHUHQW¿OWHULQJFRQGLWLRQVQR¿OWHULQJVOLJKWO\¿OWHUHGDQGVWURQJO\¿OWHUHG7KH SDUWLFLSDQWV¶WDVNZDVWRHYDOXDWHKRZZHOOWKHHPRWLRQVDSSOLHGWRHDFKSUHVHQWHG VWLPXOXVRQDVHYHQVWHS/LNHUWVFDOH

$V D JURXS SDUWLFLSDQWV ZLWK $6 KDG PRUH GLI¿FXOWLHV WKDQ WKHLU FRQWUROV LQ UHFRJQL]LQJHPRWLRQVIURPVWURQJO\EOXUUHGGLVSOD\VZKHQWKHORFDOIDFLDOIHDWXUHV ZHUHUHPRYHGS )LJ+RZHYHUWKLVZDVQRWWUXHIRUDOOLQGLYLGXDOV ZLWK$6DVVRPHLQGLYLGXDOVSHUIRUPHGDWWKHVDPHOHYHODVWKHFRQWUROSDUWLFLSDQWV 7KHUHZDVQRGLIIHUHQFHEHWZHHQWKHJURXSVLQWKHUHFRJQLWLRQRIQRUPDORUVOLJKWO\

EOXUUHGFRQGLWLRQVRULQWKHHIIHFWRIG\QDPLFLW\1RQEOXUUHGIDFLDOHPRWLRQV ZHUHEHWWHUUHFRJQL]HGWKDQVOLJKWO\¿OWHUHGDQGVOLJKWO\EOXUUHGVWLOOEHWWHUWKDQ VWURQJO\EOXUUHGLQERWKJURXSV)XUWKHUPRUHWKHG\QDPLFVKDGDVLPLODUHIIHFW

7KHUHVXOWVRI6WXG\,,KDYHSUHYLRXVO\EHHQSXEOLVKHGLQDSUHOLPLQDU\IRUPDVDSDUWRIWKHWKHVLVRI.lWV\UL -DUL+XPDQUHFRJQLWLRQRIEDVLFHPRWLRQVIURPSRVHGDQGDQLPDWHGG\QDPLFIDFLDOH[SUHVVLRQV$FDGHPLF 'LVVHUWDWLRQIRUWKHGHJUHHRI'RFWRURI3KLORVRSK\+HOVLQNL8QLYHUVLW\RI7HFKQRORJ\1RYHPEHU

(26)

(27)

3.3. STUDY III: THE PERCEPTION OF AUDIOVISUAL SPEECH IN ADULTS WITH ASPERGER SYNDROME

INTRODUCTION

,W KDV EHHQ VXJJHVWHG WKDW LQGLYLGXDOV ZLWK $6' KDYH LPSDLUHG LQWHJUDWLRQ RI PXOWLVHQVRU\LQIRUPDWLRQKRZHYHUWKHUHLVVWLOOLQVXI¿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

7KHSDUWLFLSDQWVZHUHDGXOWLQGLYLGXDOVPHDQDJHZLWK$6DQGWKHLUPDWFKHG FRQWUROV7DEOH$VZLWK6WXG\,,WKHSDUWLFLSDQWVZHUHIXUWKHUFKDUDFWHUL]HGE\

ZKHWKHUWKH\KDGDGGLWLRQDOSURVRSDJQRVLD

7KHVSHHFKVWLPXOLZHUHYLGHRFOLSVRIDIHPDOHDUWLFXODWLQJWKHPHDQLQJOHVV ZRUGVDNDDSDDQGDWD7KHZRUGVZHUHSUHVHQWHGLQDXGLR$S$N$WYLVXDO 9N9WDQGDXGLRYLVXDO$S9N$S9WFRQGLWLRQV7KHDXGLRYLVXDOVWLPXOLZHUH LQFRQJUXHQW0F*XUNVWLPXOLDQGZHUHPDGHE\GXEELQJDQDXGLRDSDRQWRHLWKHU DYLVXDODNDRUDWDLQVXFKDZD\WKDWWKHWLPLQJRIWKHVWLPXOLZDVSUHVHUYHG )LJ7KHDXGLRYLVXDOVWLPXOLSURGXFHGD0F*XUNHIIHFWZKLFKFDXVHGKHDULQJ WREHVWURQJO\LQÀXHQFHGE\WKHYLVXDOFRPSRQHQW,QWKHYLVXDODQGDXGLRYLVXDO WULDOVWKHSDUWLFLSDQWVVDZDWDONLQJIDFHLQWKHPLGGOHRIWKHVFUHHQDQGLQWKH DXGLWRU\WULDOVWKHYLVXDOVWLPXOXVZDVUHSODFHGE\DEOXUUHGVWLOOIDFLDOLPDJH7KH SDUWLFLSDQWV¶WDVNZDVWRUHVSRQGWRZKLFKFRQVRQDQWWKH\KHDUGLQWKHDXGLRYLVXDO DQGDXGLRFRQGLWLRQVDQGOLSUHDGLQWKHYLVXDOFRQGLWLRQ

(28)

Figure 3. A sample bitmap from the visual articulation video and the structure of the stimuli used in Study III and IV. The axes that delimit the regions of interest (ROI) ellipses used in the eye gaze analysis are also illustrated.

7KHGLUHFWLRQRIH\HJD]HZDVPRQLWRUHGZLWKDUHPRWHH\HWUDFNLQJV\VWHP60, L9LHZ;5('WUDFNLQJV\VWHPZZZVPLYLVLRQFRP$¿[DWLRQZDVGH¿QHGDVD FRQWLQXRXVH\HJD]HSRVLWLRQIRFXVHGZLWKLQDYLVXDODQJOHIRUDSHULRGJUHDWHU WKDQPV)RXUUHJLRQVRILQWHUHVWV52,ZHUHGH¿QHGRQWKHEDVLVRISUHYLRXV UHVHDUFK3DUp5LFKOHUWHQ+RYH 0XQKDOOWKHPRXWKQRVHH\HVDQG RWKHUWKHUHVWRIWKHIDFHH[FOXGLQJWKHRWKHU52,V

7KH XQLVHQVRU\ DXGLWRU\ DQG YLVXDO VWLPXOL ZHUH YHU\ ZHOO UHFRJQL]HG LQ ERWK JURXSV7DEOHDQGQRGLIIHUHQFHVEHWZHHQWKHJURXSVZHUHIRXQG7KHUHZHUH QRGLIIHUHQFHVEHWZHHQWKHJURXSVLQWKHDPRXQWRIµS¶UHVSRQVHVLQ)LJVRWKH VWUHQJWKRIWKH0F*XUNHIIHFWZDVVLPLODULQERWKJURXSV,QVWHDGWKHUHZDVDODUJH GLIIHUHQFHEHWZHHQWKHJURXSVLQWKHTXDOLW\RIWKH0F*XUNHIIHFW7KHDXGLRYLVXDO VWLPXOLDOPRVWXQLIRUPO\HOLFLWHGD0F*XUNHIIHFWRIKHDULQJDFFRUGLQJWRWKHYLVXDO FRPSRQHQWRIWKHVWLPXOXVLQWKHFRQWUROVEXWWKLVZDVQRWWKHFDVHIRUWKH$6JURXS :KHQWKHDXGLRDSDZDVSUHVHQWHGZLWKWKHYLVXDODND$S9NWKHUHZDVDODUJH GLIIHUHQFHLQWKHUHVSRQVHGLVWULEXWLRQEHWZHHQJURXSVLQµN¶UHVSRQVHVSDQG µW¶UHVSRQVHVS7KHUHVSRQVHVRIWKH$6JURXSZHUHGLYLGHGDOPRVWHTXDOO\

EHWZHHQWKHUHVSRQVHFDWHJRULHVµN¶DQGµW¶ZKHUHDVLQWKHFRQWUROV KHDULQJZDVVWURQJO\LQÀXHQFHGE\WKHYLVXDOFRPSRQHQWDQGWKH\JDYHRQO\

RIµW¶UHVSRQVHV+RZHYHUDVDJURXSWKH$6SDUWLFLSDQWVZHUHKHWHURJHQHRXV

7KHUHDUHQRFRPPRQO\DJUHHGYDOXHVIRUGH¿QLQJ¿[DWLRQVLQWKHOLWHUDWXUHDQGWKLVPD\FDXVHVRPH LQDFFXUDFLHVZKHQWKHUHVXOWVRIGLIIHUHQWVWXGLHVDUHFRPSDUHG$VORQJDVWKHUHLVQRFRQVHQVXVRQWKH FRUUHFW¿[DWLRQSDUDPHWHUVLWLVYHU\LPSRUWDQWWRUHSRUWWKHXVHGYDOXHVFOHDUO\

(29)

(30)

Figure 5. Gaze duration for 14 AS and 16 control participants in visual (top) and audiovisual (below) conditions (Figure by Jari Kätsyri).

&RQWUDU\WRRXUK\SRWKHVHVWKHDGXOWVZLWK$6GLGQRWJLYHPRUHµS¶UHVSRQVHVWRWKH DXGLRYLVXDOVWLPXOLDQGWKXVWKHVWUHQJWKRIWKH0F*XUNHIIHFWZDVVLPLODULQERWK JURXSV,QVWHDGWKHUHZDVDQRYHO¿QGLQJRIDTXDOLWDWLYHGLIIHUHQFHLQDXGLRYLVXDO VSHHFKSHUFHSWLRQLQDGXOWVZLWK$6FRPSDUHGWRWKHLUQHXURW\SLFDOO\GHYHORSHG FRQWUROV$FFRUGLQJWRDFXUUHQWPRGHORIDXGLRYLVXDOVSHHFKSHUFHSWLRQVHHLQJ YLVXDOVSHHFKJHVWXUHVDFWLYDWHVPRWRUFRPPDQGVIRUVSHHFKSURGXFWLRQWKDWVHUYH DVDUWLFXODWRU\SUHGLFWLRQV6NLSSHUYDQ:DVVHQKRYH1XVEDXP 6PDOO 7KHVHDUWLFXODWRU\SUHGLFWLRQVPD\EHOHVVDFFXUDWHIRUWKH$6SDUWLFLSDQWVDQG WKHUHIRUHDFWLYDWHGWKHPRWRUV\VWHPOHVVHIIHFWLYHO\WKDQLQWKHW\SLFDOO\GHYHORSHG FRQWUROV+RZHYHULQRUGHUWRFRQ¿UPWKLVQHXURSK\VLRORJLFDOHYLGHQFHLVQHHGHG 7KHGLIIHUHQFHLQSHUFHSWLRQZDVRQO\HYLGHQWIRUWKHDXGLRDSDSUHVHQWHGZLWKWKH YLVXDODNDEHFDXVHWKHYLVXDODUWLFXODWLRQDNDKDVOHVVFOHDUYLVXDOGHWDLOVDQG JLYHVVXSSRUWWRERWKLQWHUSUHWDWLRQVNDQGW$VWKHVLPXOWDQHRXVO\SUHVHQWHG DXGLRSLVFORVHUWRWWKDQLWLVNLWOHGWKH$6SDUWLFLSDQWVWRKHDUW,QVWHDG LQFRQWUROSDUWLFLSDQWVWKHDUWLFXODWRU\SUHGLFWLRQZDVVRFOHDUWKDWLWOHGWKHP

(31)

WRSHUFHLYHN7KHUHZHUHQRGLIIHUHQFHVLQJD]H¿[DWLRQSDWWHUQVLQWKHFXUUHQW VWXG\ZKLFKLVLQOLQHZLWKVRPHRWKHUUHFHQW¿QGLQJV)OHWFKHU:DWVRQ/HHNDP

%HQVRQ )LQGOD\5XWKHUIRUG 7RZQVEXWGLIIHUVIURPRWKHU¿QGLQJV RIGLPLQLVKHG¿[DWLRQRQWKHH\HUHJLRQ.OLQHWDO1RUEXU\HWDO 3HOSKUH\HWDO,WVHHPVPRVWOLNHO\WKDWWKHVLPLODUH\HJD]HSDWWHUQVEHWZHHQ WKHJURXSVZHUHWKHUHVXOWRIWKHKLJKFRJQLWLYHDELOLWLHVRIWKHDGXOWVZLWK$6DQG WKHVSHFL¿FWDVNRIVSHHFKUHFRJQLWLRQ5XWKHUIRUG 7RZQV,QSUHYLRXV UHVHDUFKWKHHPSKDVLVKDVEHHQPRUHRQVRFLDOSURFHVVLQJHPRWLRQUHFRJQLWLRQ DQGFRPSOH[VRFLDOVLWXDWLRQVZKHUHDVWKHFXUUHQWVWXG\UHTXLUHGSURFHVVLQJRI RUDOPRWRUSKRQHPLFVSHHFKLQIRUPDWLRQ)XUWKHUPRUHVWLPXOXVGXUDWLRQSUREDEO\

KDGDQHIIHFWEHFDXVHLWKDVEHHQIRXQGWKDWH\HJD]HLVPRUH¿[DWHGRQWKHH\HV GXULQJORQJVSHHFKVWLPXOLEXWIRUVKRUWHUVSHHFKVWLPXOL¿[DWLRQVFRQFHQWUDWHRQ WKHPRXWK%XFKDQ3DUp 0XQKDOO3DUp5LFKOHUWHQ+RYH 0XQKDOO 9DWLNLRWLV%DWHVRQ(LJVWL<DQR 0XQKDOO,PSRUWDQWO\H\HJD]H EHKDYLRUGRHVQRWH[SODLQWKHGLIIHUHQFHVLQDXGLRYLVXDOVSHHFKSHUFHSWLRQ7KH TXDOLWDWLYHGLIIHUHQFHLQDXGLRYLVXDOVSHHFKSHUFHSWLRQLVOLNHO\WRFRQWULEXWHWRWKH GLI¿FXOWLHVRILQGLYLGXDOVZLWK$6LQIDFHWRIDFHYHUEDOFRPPXQLFDWLRQDVPDQ\

FRPPXQLFDWLYHFXHVDUHDXGLRYLVXDOE\QDWXUH

3.4. STUDY IV: THE EFFECT OF VISUAL SPATIAL ATTENTION ON AUDIOVISUAL SPEECH PERCEPTION IN ASPERGER SYNDROME

INTRODUCTION

,QGLYLGXDOVZLWK$6'KDYHDUHGXFHGDELOLW\WRDWWHQGWRYLVXDOVWLPXOLLQWKHSUHVHQFH RIGLVWUDFWRUV%XUDFNDQGWKLVFRXOGDIIHFWVSHHFKSHUFHSWLRQLQVLWXDWLRQV RIPXOWLSOHVSHDNHUV,QWKHFXUUHQWVWXG\WKHK\SRWKHVLVZDVWKDWWKHDGXOWVZLWK

$6ZRXOGEHPRUHGLVWUDFWHGE\DFRPSHWLQJWDONLQJIDFHWKDQZRXOGWKHFRQWURO SDUWLFLSDQWVZKHQDWWHQGLQJWRDQRWKHUIDFH)XUWKHUPRUHZHH[SHFWHGWKDWWKHUH ZRXOGEHDTXDOLWDWLYHGLIIHUHQFHLQWKHLUSHUFHSWLRQRIDXGLRYLVXDOVSHHFKFRPSDUHG WRWKDWRIWKHW\SLFDOO\GHYHORSHGFRQWUROSDUWLFLSDQWV

(32)

7KHSDUWLFLSDQWVZHUHWKHVDPHDGXOWLQGLYLGXDOVPHDQDJHZLWK$6DQGWKHLU PDWFKHGFRQWUROVZKRWRRNSDUWLQ6WXG\,,,7DEOH)XUWKHUPRUHWKHH[LVWHQFHRI DQDGGLWLRQDODWWHQWLRQGH¿FLWZDVUXOHGRXWE\WKHXVHRIDTXHVWLRQQDLUH$56Y

7KHVSHHFKVWLPXOLZHUHWKHVDPHDVLQ6WXG\,,,EXWSUHVHQWHGLQDGLIIHUHQW VHWWLQJ 7ZR WDONLQJ IDFHV ZHUH SUHVHQWHG QH[W WR HDFK RWKHU ZLWK D ¿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µN¶EXWWKH$6JURXSJDYHIHZHUµN¶UHVSRQVHVWKDQ WKHFRQWUROVS DQGWKH\KDGPRUHUHVSRQVHVLQWKHµW¶FDWHJRU\S ,QFRQWUDVWWR6WXG\,,,WKHXQLVHQVRU\UHFRJQLWLRQRIWKHYLVXDONZDVSRRUHULQ WKH$6JURXSUHÀHFWHGLQWKDWWKHSDUWLFLSDQWVZLWK$6JDYHIHZHU.UHVSRQVHVS DQGPRUH7UHVSRQVHVS WKDQWKHFRQWUROSDUWLFLSDQWV7DEOH +RZHYHUWKHGLIIHUHQFHEHWZHHQWKHJURXSVLQDXGLRYLVXDOSHUFHSWLRQUHPDLQHG VLJQL¿FDQWHYHQDIWHUWKHHIIHFWRIOLSUHDGLQJDELOLW\UHFRJQLWLRQRIYLVXDONZDV FRQWUROOHGIRUE\WDNLQJLWLQWRDFFRXQWLQWKHVWDWLVWLFDODQDO\VLVDVDFRYDULDWH

&RQWUDU\WRRXUK\SRWKHVLVWKHHIIHFWRIYLVXDOVSDWLDODWWHQWLRQZDVVLPLODULQERWK WKHDGXOWVZLWK$6DQGWKHLUW\SLFDOO\GHYHORSHGFRQWUROV,QERWKJURXSVUHVSRQVHV DFFRUGLQJWRWKHDWWHQGHGIDFHGHFUHDVHGLQWKHGLVWUDFWRUSUHVHQWFRQGLWLRQDQG

(33)

(34)

Table 4. The distribution of responses for unisensory and multisensory speech simuli in Study III and IV (+SEM) ApVtApVkVtVk kptkptkptkpt Study III AS1% (0,01)3% (0,02)96% (0,02)49% (0,01)5% (0,03)46% (0,1)6% (0,05)1% (0,01)94% (0,05)91% (0,06)1% (0,01)8% (0,05) CONTROL1% (0,00)0% (0,00)99% (0,00)95% (0,02)1% (0,00)4% (0,02)0% (0,00)0% (0,00)100% (0,00)100% (0,00)0% (0,00)0% (0,00) Study IV distractorAS1% (0,01)11% (0,04)89% (0,04)49% (0,1)13% (0,06)38% (0,09)10% (0,05)3% (0,01)87% (0,06)83% (0,06)5% (0,04)12% (0,05) absentCONTROL4% (0,01)1% (0,00)94% (0,03)87% (0,05)5% (0,03)8% (0,03)2% (0,01)1% (0,00)96% (0,02)95% (0,03)4% (0,03)1% (0,01) Study IV distractorAS6% (0,02)9% (0,04)85% (0,05)36% (0,1)11% (0,05)53% (0,09)16% (0,06)3% (0,02)80% (0,07)72% (0,06)6% (0,04)22% (0,06) presentCONTROL17% (0,04)1% (0,01)82% (0,04)77% (0,05)4% (0,03)20% (0,04)11% (0,04)1% (0,01)88% (0,04)90% (0,03)3% (0,03)6% (0,02) AtApAk kptkptkpt Study III and IV AS1% (0,0)1% (0,0)99% (0,01)0% (0,0)94% (0,4)5% (0,04)99% (0,01)1% (0,01)0% (0,0) CONTROL0% (0,0)0% (0,0)100% (0,0)0% (0,0)96% (0,01)4% (0,01)100% (0,0)0% (0,0)0% (0,0)

(35)

4. GENERAL DISCUSSION

4.1. SEVERAL FACTORS UNDERPINNING THE COMMUNICATION IMPAIRMENT IN ASPERGER SYNDROME

7KHUHVXOWVRIWKHVWXG\VHULHVVKRZHGWKDWWKHUHDUHVHYHUDOOLQJXLVWLFDQGSHUFHSWXDO IDFWRUVXQGHUSLQQLQJWKHFRPPXQLFDWLRQLPSDLUPHQWLQ$66WXG\,DLPHGWR FKDUDFWHUL]H WKH ODQJXDJH DELOLWLHV RI FKLOGUHQ ZLWK $6 LQ GHWDLO ,Q SDUWLFXODU UHFHSWLYHODQJXDJHVNLOOVZHUHH[SHFWHGWREHSRRUHULQFKLOGUHQZLWK$67KHUHVXOWV RI6WXG\,FRQ¿UPHGWKLVDVWKHFKLOGUHQZLWK$6SHUIRUPHGZRUVHWKDQWKHLUW\SLFDOO\

GHYHORSHGSHHUVLQWKHFRPSUHKHQVLRQRILQVWUXFWLRQVVXEWHVW7KLVVKRZVWKDWLQ FKLOGKRRGDVLQDGROHVFHQFHWKHUHDUHGLIIHUHQFHVLQODQJXDJHSHUIRUPDQFHEHWZHHQ W\SLFDOO\GHYHORSHGLQGLYLGXDOVDQGLQGLYLGXDOVZLWK$6+RZOLQ+RZHYHU WKHLUSRRUHUSHUIRUPDQFHLQWKLVSDUWLFXODUVXEWHVWPD\DOVRUHÀHFWGLI¿FXOWLHVLQWKH H[HFXWLYHFRQWUROZRUNLQJPHPRU\LPSXOVHFRQWUROSODQQLQJLQKLELWLRQDQGWKH UHJXODWLRQDQGPRGXODWLRQRIPRWRUDFWV+LOO7KLV¿QGLQJLVRISDUWLFXODU LPSRUWDQFHDVLWVXSSRUWVWKHK\SRWKHVLVWKDW$6DQG+)$KDYHDVLPLODURULJLQ DQGIXUWKHUYDOLGDWHVWKHFKDQJHWRZDUGVPRUHGLPHQVLRQDOUDWKHUWKDQFDWHJRULFDO GLDJQRVWLFV+RZHYHUWKHGLIIHUHQFHVIRXQGDWSHUFHSWXDOSURFHVVLQJRIFXHVUHOHYDQW IRUIDFHWRIDFHFRPPXQLFDWLRQRIIHUIXUWKHULQVLJKWLQWRWKHEDFNJURXQGRILPSDLUHG FRPPXQLFDWLRQLQ$67KHVDPHFKLOGUHQWKDWSDUWLFLSDWHGLQ6WXG\,KDYHODWHU EHHQVKRZQWRKDYHGLI¿FXOWLHVLQDXGLWRU\SURFHVVLQJ'LIIHUHQFHVLQHYHQWUHODWHG SRWHQWLDOV(53VLQGLFDWHGDEQRUPDOHQFRGLQJDQGGLVFULPLQDWLRQRIVSHHFKVRXQGV .XMDODHWDODQGSRRUHUVHJUHJDWLRQRIDXGLWRU\VWUHDPV/HSLVW|HWDO )XUWKHUPRUHDW\SLFDOSHUFHSWLRQRIYLVXDOFRPPXQLFDWLYHFXHVKDVEHHQ IRXQGLQFKLOGUHQIURPWKHKLJKIXQFWLRQLQJHQGRIDXWLVPVSHFWUXPGLVRUGHUV .XXVLNNRHWDOZKHUHSRRUHUUHFRJQLWLRQRIEDVLFIDFLDOHPRWLRQVZDVIRXQG LQFKLOGUHQXQGHU\HDUVRIDJHFRPSDUHGWRWKDWRIW\SLFDOO\GHYHORSHGSHHUVDQG DQROGHUDJHJURXSZLWK$67KHUHIRUHVRPHLPSURYHPHQWZLWKDJHZDVHYLGHQW DVWKHGLIIHUHQFHEHWZHHQLQGLYLGXDOVZLWK$6DQGWKHLUW\SLFDOO\GHYHORSHGSHHUV ZDVQRWDVSURQRXQFHGLQDGROHVFHQFH

7KHFXUUHQWVWXG\UHYHDOHGGLIIHUHQFHVLQWKHYLVXDOSHUFHSWLRQRIFXHVUHOHYDQW WRIDFHWRIDFHFRPPXQLFDWLRQLQDGXOWVZLWK$66WXG\,,DLPHGWR¿QGRXWZKHWKHU DGXOWVZLWK$6KDGPRUHGLI¿FXOWLHVLQWKHUHFRJQLWLRQRIIDFLDOHPRWLRQVRQWKHEDVLV RIJOREDOIDFLDOIHDWXUHV,QDFFRUGDQFHZLWKWKHH[WHQGHGZHDNFHQWUDOK\SRWKHVLV +DSSp )ULWK0RWWURQHWDOWKHSDUWLFLSDQWVZLWK$6UHFRJQL]HG IDFLDOHPRWLRQVZRUVHRQWKHEDVLVRIJOREDOIDFLDOIHDWXUHV,QWHUHVWLQJO\WKHUHZDVD

(36)

GLIIHUHQFHLQWKHYLVXDOSHUFHSWLRQRIVSHHFKVLJQDOVEHWZHHQWKHWZRH[SHULPHQWVLQ 6WXG\,,,DQG,9ZKLFKPD\UHODWHWRWKHVDPHDVSHFWRISHUFHSWXDOSURFHVVLQJ:KHQ WKH¿QGLQJVRIWKHFXUUHQWWKHVLVDUHYLHZHGWRJHWKHUDWHQWDWLYHH[SODQDWLRQIRUWKH GLIIHUHQFHLQWKHOLSUHDGLQJDELOLW\PD\EHVXJJHVWHGQDPHO\WKDWWKHLQGLYLGXDOV ZLWK$6ZHUHPRUHDIIHFWHGE\WKHDUHDZKHUHWKHYLVXDOVWLPXOXVZDVSUHVHQWHG 7KH\ ZHUH VRPHZKDW SRRUHU LQ OLSUHDGLQJ LQ ERWK VWXGLHV EXW WKH GLIIHUHQFH EHWZHHQWKHJURXSVRQO\EHFDPHVLJQL¿FDQWZKHQWKHVWLPXOXVZDVSUHVHQWHGLQ WKHDUHDRISHULSKHUDOYLVLRQ6WXG\,99LVXDOUHVROXWLRQLVSRRUHULQSHULSKHUDO YLVLRQDQGWKHUHIRUHLWFDQEHDVVXPHGWKDWDVWLPXOXVSUHVHQWHGLQWKHSHULSKHU\

DSSHDUVDOLWWOHEOXUUHGFIORZVSDWLDOIUHTXHQFLHVLQ6WXG\,,VKRZLQJOHVVYLVXDO GHWDLO,QW\SLFDOO\GHYHORSHGLQGLYLGXDOVGLUHFWJD]HKLJKVSDWLDOIUHTXHQFLHVLV QRWQHFHVVDU\IRUWKHVXFFHVVIXOSURFHVVLQJRIYLVXDOVSHHFKLQIRUPDWLRQ3DUpHW DOEXWLQOLJKWRIWKHFXUUHQW¿QGLQJVGLUHFWJD]HDQGWKHDYDLODELOLW\RI YLVXDOGHWDLOPD\EHPRUHLPSRUWDQWIRULQGLYLGXDOVZLWK$6LQOLSUHDGLQJDQG LQSURFHVVLQJHPRWLRQDOH[SUHVVLRQVIURPWKHIDFH6WXG\,,&RQVHTXHQWO\WKH

¿QGLQJRISRRUHUOLSUHDGLQJDELOLW\LQWKHSHULSKHU\DQGLPSDLUHGUHFRJQLWLRQRI ORZVSDWLDOIUHTXHQFLHVPRVWOLNHO\VWHPIURPIHDWXUHVRIJHQHUDOYLVXDOSURFHVVLQJ UDWKHUWKDQDGLI¿FXOW\LQWKHSURFHVVLQJRIHPRWLRQVIURPIDFLDOH[SUHVVLRQVRUOLS UHDGLQJ,WZRXOGEHLQWHUHVWLQJWRNQRZLIDODUJHUGLIIHUHQFHEHWZHHQJURXSVLQ OLSUHDGLQJDELOLW\FRXOGEHDFFRPSOLVKHGE\EOXUULQJWKHLPDJHDQGSUHVHQWLQJLW LQWKHDUHDRIGLUHFWJD]HDVLQ6WXG\,,7KLVZRXOGVXJJHVWWKDWWKHELDVWRZDUGV SURFHVVLQJGHWDLOVUDWKHUWKDQJOREDOIHDWXUHVLHZHDNFHQWUDOFRKHUHQFHZRXOG DOVRKDYHDQHIIHFWRQOLSUHDGLQJ

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¿QGLQJ ZDVSURGXFHGLQ6WXG\,9ZKHQWKHVWLPXOLZHUHSUHVHQWHGLQWKHDUHDRISHULSKHUDO YLVLRQ$OWKRXJK6WXG\,9UHYHDOHGDVLJQL¿FDQWGLIIHUHQFHLQOLSUHDGLQJDELOLW\QRW IRXQGLQ6WXG\,,,WKHGLIIHUHQFHZDVQRWVWURQJHQRXJKWRIXOO\H[SODLQWKHGLIIHUHQFH LQDXGLRYLVXDOVSHHFKSHUFHSWLRQ0RUHRYHUZKHQWKHHIIHFWZDVFRQWUROOHGIRULQ WKHDQDO\VLVLWZDVFOHDUWKDWWKHGLIIHUHQFHVLQXQLVHQVRU\YLVXDOUHFRJQLWLRQGLG QRWIXOO\H[SODLQWKHGLIIHUHQFHVLQWKH0F*XUNHIIHFWEHWZHHQWKHJURXSV7KH VWXGLHVIRXQGQREHKDYLRXUDOGLIIHUHQFHVLQWKHXQLVHQVRU\UHFRJQLWLRQRIDXGLWRU\

VSHHFKVWLPXOL+RZHYHUXVLQJPRUHVHQVLWLYHPHWKRGVVXFKDVDXGLWRU\HYHQW UHODWHGSRWHQWLDOV(53VDW\SLFDOQHXUDODFWLYLW\IRUDXGLWRU\VSHHFKVLJQDOVKDV EHHQIRXQGLQLQGLYLGXDOVZLWK$6&HSRQLHQHHWDO-DQVVRQ9HUNDVDORHWDO .XMDODHWDO/HSLVW|7KHUHIRUHLWLVSRVVLEOHWKDWGLIIHUHQFHV

(37)

DWHDUOLHUOHYHOVRIDXGLWRU\SURFHVVLQJDUHUHÀHFWHGLQPXOWLVHQVRU\SHUFHSWLRQ,I WKLVLVWKHFDVHWKHHQKDQFHGSURFHVVLQJRIXQLVHQVRU\IHDWXUHVVXJJHVWHGLQWKH H[WHQGHGZHDNFHQWUDOFRKHUHQFHDFFRXQW+DSSp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

¿QGLQJV2EHUPDQ 5DPDFKDQGUDQ5XVVRHWDO+RZHYHUPXFK UHVHDUFKLVVWLOOQHHGHGWRLGHQWLI\WKHNH\SRLQWVRIZKHUHWKHGHYHORSPHQWRI PXOWLVHQVRU\LQWHJUDWLRQGHYLDWHVIURPWKHQRUPDOFRXUVH,QIDFWWKHTXDOLWDWLYH GLIIHUHQFHLQDGXOWKRRGPD\EHDUHVLGXDOVLJQRIPRUHLPSDLUHGPXOWLVHQVRU\

LQWHJUDWLRQLQFKLOGKRRG,WZRXOGEHLPSRUWDQWWRVWXG\DOOWKHVHQVRU\PRGDOLWLHV HVSHFLDOO\WKRVHWDFWLOHDQGDXGLRYLVXDOFXHVLPSRUWDQWIRUHDUO\LQWHUDFWLRQEHWZHHQ DFDUHUDQGFKLOG

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¿QGLQJVRIDW\SLFDODWWHQWLRQWRWKHIDFHDQGDW\SLFDO FRQWURORIYLVXDOVSDWLDODWWHQWLRQ7KLVGRHVQRWRIFRXUVHFRQ¿UPWKDWWKHUHDUH QRGLIIHUHQFHVLQDWWHQWLRQLQ$6,QVWHDGWKHVH¿QGLQJVVKRXOGEHVHHQDVHYLGHQFH WKDWLQVRPHYHU\EDVLFFRQGLWLRQVDGXOWVZLWK$6DUHDEOHWRGLUHFWWKHLUDWWHQWLRQ DSSURSULDWHO\7KHTXDOLW\RIWKHVWLPXOXVDQGWKHGLVWUDFWLRQPD\EHFULWLFDODV UHFHQWVWXGLHVKDYHVXJJHVWHGWKDWDWOHDVW\RXQJHULQGLYLGXDOVZLWK$6'DUHPRUH SURQHWRGLVWUDFWLRQE\REMHFWVWKDQE\VRFLDOVWLPXOL5LE\%URZQ-RQHV +DQOH\

0RUHRYHUWKHXVHRIPRUHQDWXUDOLVWLFUDWKHUWKDQWKHYHU\VLPSOHVWLPXOL XVHGKHUHPLJKWSURYLGHPRUHLQIRUPDWLRQRQH\HJD]HSDWWHUQVGXULQJVSHHFK SHUFHSWLRQ

4.2. CLINICAL IMPLICATIONS

6WXG\,VKRZHGWKDWDOWKRXJKFKLOGUHQZLWK$6VHHPWRKDYHJRRGODQJXDJHDELOLWLHV

±JRRGYRFDEXODU\ÀXHQWH[SUHVVLYHVSHHFKDQGJRRGFRPPDQGRIV\QWD[±WKH\

VWLOOIDFHFKDOOHQJHVLQFRPSUHKHQGLQJLQVWUXFWLRQV7KHUHIRUHXVLQJVKRUWDQGFOHDU

(38)

LQVWUXFWLRQVHJLQDFODVVURRPLVEHQH¿FLDOIRUFKLOGUHQZLWK$67KH¿QGLQJRI LPSDLUHGUHFHSWLYHODQJXDJHVXSSRUWVWKHIRUWKFRPLQJFKDQJHLQGLDJQRVWLFVZKHUH

$6ZLOOEHVXEVXPHGLQWRWKHFDWHJRU\RIDXWLVPVSHFWUXPGLVRUGHUVWRJHWKHUZLWK +)$,QFUHDVLQJO\DXWLVWLFLPSDLUPHQWVDUHVHHQWRUHSUHVHQWDVSHFWUXPUDWKHU WKDQVHSDUDWHFDWHJRULHVDQGWKLVLVDOVRWKHFDVHLQUHVSHFWWRODQJXDJHDELOLWLHV 6]DW]PDUL/RUGHWDO+RZHYHUDWWKHYHU\KLJKIXQFWLRQLQJHQGRI WKHVSHFWUXPGLI¿FXOWLHVRIODQJXDJHPD\EHKDUGWRLGHQWLI\ZLWKDYDLODEOHFOLQLFDO PHWKRGV

,Q DGGLWLRQ WR VOLJKW OLQJXLVWLF GLI¿FXOWLHV WKH UHVXOWV RI WKH FXUUHQW WKHVLV SRLQWDW\SLFDOSHUFHSWXDOSURFHVVHVUHOHYDQWIRUIDFHWRIDFHFRPPXQLFDWLRQ$

GH¿FLHQF\LQSURFHVVLQJJOREDOIHDWXUHVIURPWKHIDFHPD\DIIHFWWKHSURFHVVLQJ RIHPRWLRQDODQGRWKHULQIRUPDWLRQIURPWKHIDFH.QRZLQJDERXWWKLVVSHFL¿F GH¿FLHQF\PD\KHOSWRXQGHUVWDQGWKHFKDOOHQJHVDQLQGLYLGXDOKDVLQSURFHVVLQJ LQIRUPDWLRQIURPWKHIDFH,PSRUWDQWO\WKHTXDOLWDWLYHGLIIHUHQFHIRXQGLQWKH FXUUHQWVWXG\PD\EHDVLJQRIDW\SLFDOPXOWLVHQVRU\LQWHJUDWLRQ,QDGGLWLRQWR VSHHFKWKLVZRXOGDIIHFWSURFHVVLQJRILQPDQ\RWKHUFRPPXQLFDWLYHFXHVDVWKH\

DUHPXOWLVHQVRU\LQQDWXUHHPRWLRQVSURVRG\$OWKRXJKPRUHUHVHDUFKLVQHHGHG H[SOLFLWWHDFKLQJRIFRQQHFWLQJDXGLWRU\DQGYLVXDOLQIRUPDWLRQVLPXOWDQHRXVO\

PD\SURYHEHQH¿FLDO7RGDWHWKHUHDUHQRDSSURSULDWHPHWKRGVIRULGHQWLI\LQJLQ GHWDLOWKHVHVSHFL¿FGLIIHUHQFHVLQSHUFHSWLRQLQFOLQLFDOVHWWLQJV+RZHYHULWFRXOG EHLQIRUPDWLYHWRFRPSLOHPRUHGHWDLOHGSHUFHSWXDOSUR¿OHVRILQGLYLGXDOVXVLQJ TXHVWLRQQDLUHVLQWKHFRXUVHRIWKHGLDJQRVWLFSURFHGXUH*DWKHULQJLQIRUPDWLRQOLNH WKLVWKURXJKRXWWKHGLDJQRVWLFDQGIROORZXSSURFHGXUHZRXOGSURYLGHLQVLJKWLQWR WKHFKDUDFWHULVWLFVRISHUFHSWLRQDQGSRVVLEO\KHOSXVWRXQGHUVWDQGHDFKLQGLYLGXDO EHWWHU,QLQWHUYHQWLRQXQGHUVWDQGLQJWKHOLPLWVDQGVWUHQJWKVRIWKHSHUFHSWLRQ RIFRPPXQLFDWLYHFXHVHQDEOHVWKHPHWKRGVWREHEHWWHUDGDSWHGWRPHHWHDFK LQGLYLGXDO¶VVSHFL¿FQHHGV

4.3. INDIVIDUAL DIFFERENCES IN THE ASPERGER GROUP

,Q DOO WKH VWXGLHV WKH KHWHURJHQHLW\ RI LQGLYLGXDOV ZLWK $6 ZDV HYLGHQW 7KH SHUIRUPDQFHRIWKHLQGLYLGXDOVZLWK$6ZDVPXFKPRUHYDULHGWKDQWKRVHRIWKH FRQWUROJURXSDVZDVHYLGHQWIURPODUJHUVWDQGDUGHUURUVRIWKHPHDQ,Q6WXGLHV ,,,,,DQG,9WKHUHVSRQVHVRIWKH$6LQGLYLGXDOVZHUHKHWHURJHQHRXVDVVRPH RIWKHDGXOWVZLWK$6SHUIRUPHGVLPLODUO\WRWKHFRQWUROSDUWLFLSDQWVDQGRWKHUV SHUIRUPHGYHU\GLIIHUHQWO\7KHVH¿QGLQJVDUHLQOLQHZLWKWKHUHFHQWHPSKDVLVRQWKH KHWHURJHQHRXVQDWXUHRIWKHDXWLVPVSHFWUXPHJ6]DWPDUL,WLVSRVVLEOHWKDW WKHUHDUHVHYHUDOGLIIHUHQWHQGRSKHQRW\SHVWKDWUHÀHFWGLIIHUHQWJHQHWLFYDULDQWV7KH RXWFRPHIRUWKHVHLQGLYLGXDOVPD\YDU\JUHDWO\DQGWKH\FRXOGEHQH¿WIURPGLIIHUHQW LQWHUYHQWLRQVWUDWHJLHV8QIRUWXQDWHO\WKHUHVHDUFKGDWDRQLQGLYLGXDOGLIIHUHQFHV

Linguistic and perceptual processing of communicative cues in Asperger Syndrome