27529
Integrative Nonverbal Communication in Children with ASD during Conversation and Free PLAY
Nonverbal communication (NVC) has long been recognized as a core deficit in Autism Spectrum Disorder (ASD). NVC is multi-channel by nature, and conveys meaning via a finely-tuned, integrative presentation of facial expressions, gaze, vocal expressions, and gestures. NVC is context-bound by nature, and influenced by the social situation in terms of activity type and identity of the interaction partner. Integrative NVC deficit is currently a mandatory diagnostic criterion for ASD in the DSM-5. However, integrative NVC has rarely been empirically studied, and existing studies have not evaluated more than two NVC channel combinations. In addition, most studies focused on infants and toddlers, with little attention given to NVC in school-aged children.
Objectives:
To compare integrative NVC in children with ASD to that of Typically Developing (TD) school-aged children, during two contexts: positive conversation and joint free play. It was predicted that, compared to children with TD, children with ASD will exhibit reduced integrative NVC abilities, and would rely more on intense single channel NVC expressions.
Methods:
Thirty-nine children (1 girl) with ASD (clinically diagnosed, and verified using ADOS2), aged 5-10 years, with no intellectual impairment, and 31 typically developing (TD) controls (1 girl), matched on gender and cognitive abilities, were video-recorded with their mothers during a free-play, and during a conversation. Videos were micro-coded for display of single channel NVC behaviors: facial expressions (low vs. high intensity expressions), vocal expressions (low vs. high intensity expressions), gesturing (gesture production vs. no production) and gaze (directed to/away from mother's face). Integrative NVC variables were computed, and represented co-occurring NVC single channel behaviors. Parental reports regarding children's autism symptomatology were collected with the SRS-2.
Results:
During conversation, compared to their TD peers, children with ASD showed reduced integrative use of NVC, and intensified vocal and facial expressions. Reduced NVC on a single channel during conversation was only found for gesturing. Gesturing during conversation was also negatively correlated with SRS-2 social-communication scores, over and above group.
During joint free-play, compared to their TD peers, children with ASD showed more intensified vocal expressions and directed more gaze to their mothers’ faces. These single channel group differences were found only when integrative NVC was examined, which suggests that children with ASD also exhibit integrative NVC deficits within a joint free play interaction with their mothers.
Conclusions:
The findings provide evidence for an integrative NVC deficit among children with ASD. In our elementary school-aged sample, Integrative NVC was found to be more indicative of NVC deficits of children with ASD, than single-channel NVC behaviors. Contextual differences were interpreted in terms of compensatory attempts during conversation (resulting in intensified facial and vocal expressions), and developmental delay during free-play (demonstrated through extensive gaze to mother’s face) of children with ASD. These findings validate the NVC deficits of individuals with ASD, which have mostly been described clinically. Findings highlight the importance of NVC integration, and the role of various contexts when diagnosing children with ASD, and when designing appropriate interventions.