The development and content validity of the emotional recognition memory training program (ERMTP) for children with autism spectrum disorder: A trial phase
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Abstract
Background: Facial expression, tone of voice, body language, and context are unrecognizable to children with autism. Emotional arousal and emotion recognition (required emotion empathy and cognitive processing empathy) induce downstream illnesses in children with ASD. Thus, the proposed study aimed to develop a computer-based Emotional Recognition Memory Training Program (ERMTP) for ASD.
Objective: Firstly, to develop and validate the ERMTP for social cognitive abilities in children with ASD and secondly, to conduct pilot-tested it in typically developing children and children with ASD.
Materials and methods: This study consisted of 3 phases. The first phase was developing the ERMTP from the literature review. The second phase was analyzed for content validity with five experts about Task 1 (two activities) and Task 2 (nine activities) comprising ERMTP. Computer-based learning of six fundamental facial emotions (happy, sad, angry, fear, disgusted, and surprised) improves social cognition. Finally, the pilot test was analyzed to discover the ERMTP’s challenges for five children with typical development and ASD.
Results: The ERMTP’s activity items have good content validity, especially regarding clarity and relevance. All five raters gave the intervention a 1.0 IOC for its distinct components. In the training program, we followed the expert instructions regarding background music or voice and the generalization task. Descriptive analysis indicated that all five normal-developing children followed emotional expressions and instructions (100%). All five parents reported there were changes in focus and memory skills. Emotion regulation, memory abilities, and the social cognition index demonstrated statistically significant (p<0.05) effects before and after ERMTP treatment in ASD.
Conclusion: ERMTP seeks to improve the social cognition of children with ASD by the use of feedback from both specialists and the children themselves. However, further research will be necessary to investigate ASD using a randomized control trial.
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
References
Achenbach TM. DSM-III in light of empirical research on the classification of child psychopathology. J Am Acad Child Psychiatry. 1980; 19(3): 395-412. doi: 10.1016/s0002-7138(09)61061-x
American Psychiatric Association DS, American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013 May 22. doi: 10.1176/appi.books.9780890425596
Markram K, Markram H. The intense world theory–a unifying theory of the neurobiology of autism. Front Hum Neurosci. 2010; 4: 224. doi: 10.3389/fnhum.2010.00224
Ekman P. Basic emotions. Handbook of Cognition and Emotion. 1999; 98(45-60): 16.
Mather M. Emotional arousal and memory bi nding: An object-based framework. Perspect Psychol Sci. 2007; 2(1): 33-52. doi: 10.1111/j.1745-6916.2007.00028.x
Bishop SJ. Trait anxiety and impoverished prefrontal control of attention. Nat Neurosci. 2009; 12(1): 92-8. doi: 10.1027/1618-3169/a000083
Brosch T, Scherer KR, Grandjean D, Sander D. The impact of emotion on perception, attention, memory, and decision-making. Swiss Med Wkly. 2013;143: w13786. Published 2013 May 14. doi: 10.4414/smw.2013.13786
Maras KL, Gaigg SB, Bowler DM. Memory for emotionally arousing events over time in Autism Spectrum Disorder. Emotion. 2012; 12(5): 1118-28. doi: 10.1037/a0026679
Banziger T, Grandjean D, Scherer KR. Emotion recognition from expressions in face, voice, and body: the Multimodal Emotion Recognition Test (MERT). Emotion. 2009; 9(5): 691. doi: 10.1037/a0017088
Baron-Cohen, Golan O, Wheelwright S, Hill J. Mind reading: The interactive guide to emotions. London, UK: Jessica Kingsley Press; 2004.
Rymarczyk K, Żurawski Ł, Jankowiak-Siuda K, Szatkowska I. Emotional Empathy and Facial Mimicry for Static and Dynamic Facial Expressions of Fear and Disgust. Front Psychol. 2016; 7: 1853. doi: 10.3389/fpsyg.2016.01853
Baron-Cohen, Golan O, Chakrabarti B, Belmonte MK. Social cognition and autism spectrum conditions. In: Fonagy P, Goodyer I, editors. Social Cognition and Developmental Psychopathology. Oxford, UK: Oxford University Press; 2013.
Itier RJ, Batty M. Neural bases of eye and gaze processing: the core of social cognition. Neurosci Biobehav Rev. 2009; 33(6): 843-63. doi: 10.1016/j.neubiorev.2009.02.004
Golan O, Ashwin E, Granader Y, McClintock S, Day K, Leggett V, et al. Enhancing emotion recognition in children with autism spectrum conditions: An intervention using animated vehicles with real emotional faces. J Autism Dev Disord. 2010; 40(3): 269-79. doi: 10.1007/s10803-009-0862-9
Golan O, Baron-Cohen S, Golan Y. The ‘reading the mind in films’ task [child version]: Complex emotion and mental state recognition in children with and without autism spectrum conditions. J Autism Dev Disord. 2008; 38(8): 1534-41. doi: 10.1007/s10803- 007-0533-7
Golan O, Baron-Cohen S, Hill JJ, Rutherford M. The ‘Reading the Mind in the Voice’test-revised: a study of complex emotion recognition in adults with and without autism spectrum conditions. J Autism Dev Disord. 2007; 37(6): 1096-106. doi: 10.1007/s10803- 006-0252-5
Philip R, Whalley H, Stanfield A, Sprengelmeyer R, Santos I, Young A, et al. Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders. Psychol Med. 2010; 40(11): 1919-29. doi: 10.1017/S0033291709992364
Lozier LM, Vanmeter JW, Marsh AA. Impairments in facial affect recognition associated with autism spectrum disorders: a meta-analysis. Dev Psychopathol. 2014; 26(4): 933-45. doi10.1017/S0954579414000479
Erfanian F, Hashemi Razini H, Ramshini M. The relationship between executive functions and sensory processing with emotional recognition in autism spectrum disorder. Int J Sport Stud Health. 2018; 1: e74071. doi: 10.5812/intjssh.74071
Kuusikko S, Haapsamo H, Jansson-Verkasalo E, Hurtig T, Mattila M-L, Ebeling H, et al. Emotion recognition in children and adolescents with autism spectrum disorders. J Autism Dev Disord. 2009; 39(6): 938-45. doi: 10.1007/s10803-009-0700-0
Hill EL, Frith U. Understanding autism: insights from mind and brain. Philos Trans R Soc Lond B Biol Sci. 2003; 358(1430): 281-9. doi: 10.1098/rstb.2002.1209
Howlin P. Interventions and outcome in autism. J Intellect Disabil Res. 2004; 48(4-5). doi: 10.1016/S1874-5911(02)80004-5
Lecavalier L. Behavioral and emotional problems in young people with pervasive developmental disorders: Relative prevalence, effects of subject characteristics, and empirical classification. J Autism Dev Disord 2006; 36: 1101-14. doi: 10.1007/s10803-006-0147-5
Mayes SD, Kokotovich C, Mathiowetz C, Baweja R, Calhoun SL, Waxmonsky J. Disruptive mood dysregulation disorder symptoms by age in autism, ADHD, and general population samples. J. Ment. Health Res. Intellect. Disabil. 2017; 10(4): 345-59. doi: 10.1080/19315864.2017.1338804
Fulton E, Eapen V, Crnčec R, Walter A, Rogers S. Reducing maladaptive behaviors in preschool-aged children with autism spectrum disorder using the early start denver model. Front Pediatr. 2014; 2: 40. doi: 10.3389/fped.2014.00040.
Inzlicht M, Bartholow BD, Hirsh JB. Emotional foundations of cognitive control. Trends Cogn Sci. 2015; 19(3): 126-32. doi: 10.1016/j.tics.2015.01.004.
Gaigg SB. The interplay between emotion and cognition in autism spectrum disorder: implications for developmental theory. Front Integr Neurosci. 2012; 6: 113. doi: 10.3389/fnint.2012.00113
Gasbarri A, Pompili A, d’Onofrio A, Cifariello A, Tavares MC, Tomaz C. Working memory for emotional facial expressions: role of the estrogen in young women. Psychoneuroendocrinology. 2008; 33(7): 964-72. doi: 10.1016/j.psyneuen.2008.04.007
Mallory C, Keehn B. Implications of Sensory Processing and Attentional Differences Associated with Autism in Academic Settings: An Integrative Review. Front Psychiatry. 2021; 12: 695825. doi: 10.3389/fpsyt.2021.695825.
Fabio RA, Esposito S, Carrozza C, Pino G, Caprì T. Correlations between facial emotion recognition and cognitive flexibility in autism spectrum disorder. Adv. Autism. 2020; 6(3): 195-204.
Mazefsky CA, Herrington J, Siegel M, Scarpa A, Maddox BB, Scahill L, White SW. The role of emotion regulation in autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2013; 52(7): 679-88. doi: 10.1016/j.jaac.2013.05.006.
Nielson KA, Bryant T. The effects of non-contingent extrinsic and intrinsic rewards on memory consolidation. Neurobiol Learn Mem. 2005; 84(1): 42-8. doi: 10.1016/j.nlm.2005.03.004
Nielson KA, Powless M. Positive and negative sources of emotional arousal enhance long-term word-list retention when induced as long as 30 min after learning. Neurobiol Learn Mem. 2007; 88(1): 40- 7. doi: 10.1016/j.nlm.2007.03.005
Crane L, Goddard L. Episodic and semantic autobiographical memory in adults with autism spectrum disorders. J Autism Dev Disord. 2008; 38(3): 498-506. doi: 10.1007/s10803-007-0420-2
Lind SE, Bowler DM. Recognition memory, self-other source memory, and theory-of-mind in children with autism spectrum disorder. J Autism Dev Disord. 2009; 39(9): 1231. doi: 10.1007/s10803-009-0735-2
Lind SE. Memory and the self in autism: A review and theoretical framework. Autism. 2010; 14(5): 430-56. doi: 10.1177/1362361309358700
Lind SE, Williams DM, Bowler DM, Peel A. Episodic memory and episodic future thinking impairments in high-functioning autism spectrum disorder: An underlying difficulty with scene construction or selfprojection? Neuropsychology. 2014; 28(1): 55. doi: 10.1037/neu0000005
Pellicano E. Links between theory of mind and executive function in young children with autism: Clues to developmental primacy. Dev Psychol. 2007; 43(4): 974. doi: 10.1037/0012-1649.43.4.974
Berggren S, Fletcher-Watson S, Milenkovic N, Marschik PB, Bölte S, Jonsson U. Emotion recognition training in autism spectrum disorder: A systematic review of challenges related to generalizability. Dev Neurorehabil. 2018; 21(3): 141-54. doi: 10.1080/17518423.2017.1305004
Chan, Cheung M-c, Sze SL. Effect of mind/body training on children with behavioral and learning problems: a randomized controlled study. Mind-Body and Relaxation Research Focus. 2008; 8: 165-93.
Chan, Han YM, Sze SL, Lau EM. Neuroenhancement of memory for children with autism by a mind–body exercise. Front Psychol. 2015; 6: 1893. doi: 10.3389/fpsyg.2015.01893
Chan, Han YMY, Cheung M-C. Chinese Chan-based prospective neuropsychological intervention for autistic children. In: Patel V, Preedy V, Martin C, editors. Comprehensive guide to autism. New York, NY: Springer; 2014. p. 2333-55. doi: 10.1007/978-1-4614-4788-7_142
Molnar-Szakacs I, Wang MJ, Laugeson EA, Overy K, Wu W-L, Piggot J. Autism, emotion recognition and the mirror neuron system: the case of music. McGill Journal of Medicine: MJM. 2009; 12(2). MID: 21264050; PMCID: PMC2997252.
Berger DS. Pilot study investigating the efficacy of tempo-specific rhythm interventions in musicbased treatment addressing hyper-arousal, anxiety, system pacing, and redirection of fight-or-flight fear behaviors in children with autism spectrum disorder (ASD). J. Biomed. Eng. 2012; 2: 1-15. doi: 10.4303/jbe/M110902
Orr TJ, Myles BS, Carlson JK. The impact of rhythmic entrainment on a person with autism. Focus Autism Other Dev Disabl. 1998; 13(3): 163-6. doi: 10.1177/108835769801300304
Woodman AC, Breviglia E, Mori Y, Golden R, Maina J, Wisniewski H. The Effect of Music on Exercise Intensity among Children with Autism Spectrum Disorder: A Pilot Study. J. Clin. Med. 2018; 7(3): 38. doi: 10.3390/jcm7030038
Kim, Wigram T, Gold C. The effects of improvisational music therapy on joint attention behaviors in autistic children: a randomized controlled study. J Autism Dev Disord. 2008; 38(9): 1758. doi: 10.1007/s10803-008-0566-6
Scarpa A, Reyes N, Attwood T. Cognitive-behavioral therapy for stress and anger management in young children with ASD. Cuban Landscapes: Heritage, Memory, and Place. 2009: 147.
Toglia JP. The dynamic interactional model of cognition in cognitive rehabilitation (2011).
Baron-Cohen. The empathising-systemising theory of autism: implications for education. Tizard Learn. Disabil. Rev. 2009; 14(3): 4-13. doi: 10.1108/13595474200900022
Sequeira S, Ahmed M. Meditation as a potential therapy for autism: A review. Autism res. treat. 2012; 2012: 1-11. doi: 10.1155/2012/835847
Greenberg DM, Rentfrow PJ, Baron-Cohen S. Can music increase empathy? Interpreting musical experience through the empathizing–systemizing (ES) theory: Implications for autism. Musicol. rev. Empirical Musicology Review. 2015 Apr 8; 10(1-2): 80-95.
White, Mazefsky CA, Dichter GS, Chiu PH, Richey JA, Ollendick TH. Social-cognitive, physiological, and neural mechanisms underlying emotion regulation impairments: Understanding anxiety in autism spectrum disorder. Int J Dev Neurosci. 2014; 39: 22- 36. doi: 10.1016/j.ijdevneu.2014.05.012
Bal E, Harden E, Lamb D, Van Hecke AV, Denver JW, Porges SW. Emotion recognition in children with autism spectrum disorders: Relations to eye gaze and autonomic state. J Autism Dev Disord. 2010; 40(3): 358-70. doi: 10.1007/s10803-009-0884-3
Hilton CL, Harper JD, Kueker RH, Lang AR, Abbacchi AM, Todorov A, et al. Sensory responsiveness as a predictor of social severity in children with high functioning autism spectrum disorders. J Autism Dev Disord. 2010; 40(8): 937-45. doi: 10.1007/s10803-010-0944-8
Duncan EA, Editor. Foundations for Practice in Occupational Therapy-E-BOOK. Elsevier Health Sciences; 2011 Apr 15
Smith A. The empathy imbalance hypothesis of autism: A theoretical approach to cognitive and emotional empathy in autistic development. Psychol. Rec. 2009; 59(3): 489-510. doi: 10.1007/BF03395675
Bradley EA, Summers JA, Wood HL, Bryson SE. Comparing rates of psychiatric and behavior disorders in adolescents and young adults with severe intellectual disability with and without autism. J Autism Dev Disord. 2004; 34: 151-61. doi: 10.1023/B:JADD.0000022606.97580.19
Joshi G, Wozniak J, Petty C, Martelon MK, Fried R, Bolfek A, Kotte A, Stevens J, Furtak SL, Bourgeois M, Caruso J. Psychiatric comorbidity and functioning in a clinically referred population of adults with autism spectrum disorders: a comparative study. J Autism Dev Disord. 2013; 43: 1314-25. doi: 10.1007/s10803-012-1679-5
Baker J. Preparing for life: The complete guide for transitioning to adulthood for those with autism and Asperger’s syndrome. Future Horizons; 2005.
Deffenbacher K, Brown E. Memory and cognition: An information processing model of man. Theory Decis. 1973; 4(2): 141-78. doi: 10.1007/BF00145150
Baddeley A. The episodic buffer: a new component of working memory? Trends Cogn Sci. 2000; 4(11): 417-23. doi: 10.1016/s1364-6613(00)01538-2
Golan O, Sinai-Gavrilov Y, Baron-Cohen S. The Cambridge Mindreading Face-Voice Battery for Children (CAM-C): complex emotion recognition in children with and without autism spectrum conditions. Mol Autism. 2015; 6(1): 1-9. doi: 10.1186/s13229-015-0018-z
Portney LG, Watkins MP. Foundations of clinical research: applications to practice: Pearson/Prentice Hall Upper Saddle River, NJ; 2009.
Graham JE, Karmarkar AM, Ottenbacher KJ. Small sample research designs for evidence-based rehabilitation: issues and methods. Arch Phys Med Rehabil. 2012; 93(8): S111-S6. doi: 10.1016/j.apmr.2011.12.017
Wechsler D. Wechsler intelligence scale for children– Fourth Edition (WISC-IV). (No Title). 2003.
Schopler E, Reichler RJ, Renner BR. The childhood autism rating scale (CARS). Los Angeles, CA: Western Psychological Services; 2010.
Hedges R, Drysdale K, Levick WR. The Children’s Memory Questionnaire-Revised. Appl. Neuropsychol. Child. 2015; 4(4): 285-96. doi: 10.1080/21622965.20 14.925806
Gonzalez LM, Anderson VA, Wood SJ, Mitchell LA, Heinrich L, Harvey AS. The Observer Memory Questionnaire-Parent Form: Introducing a new measure of everyday memory for children. J Int Neuropsychol Soc. 2008; 14(2): 337-42.
Bruni TP. Test review: Social responsiveness scale– Second edition (SRS-2). J. Psychoeduc. Assess. 2014 Jul; 32(4): 365-9. doi: 10.1177/0734282913517
Linstead E, Dixon DR, Hong E, Burns CO, French R, Novack MN, Granpeesheh D. An evaluation of the effects of intensity and duration on outcomes across treatment domains for children with autism spectrum disorder. Transl Psychiatry. 2017; 7(9): e1234. doi: 10.1038/tp.2017.207