A New Virtual Environment Paradigm for High-Functioning Autism Intended to Help Attentional Disengagement in a Social Context

Background and Purpose. This article presents a review of the question regarding the link between social communication difficulties and altered executive functions (ie, cognitive functions involved in the control of behavior, such as planning, inhibition, working memory, etc) in high-functioning autism spectrum disorders (HFASD). Model Description and Evaluation. We first analyze the difficulties experienced by individuals with HFASD in processing contextual cues during social conversations. We extend this approach to include verbal and nonverbal communication. We then focus on alterations in the ability to process facial expressions during an ongoing conversation. This ability involves attentional resources that are discussed in light of the executive dysfunction attributed to autism spectrum disorders. On this basis, we hypothesize that the difficulties in appreciating the synergy between facial expressions and speech could be linked to impairments in shifting attention from one to the other. Outcomes. A new experimental paradigm designed for testing this hypothesis is presented. It relies on a virtual environment system based on eye-tracking technology that enables users to control the visual display via their gaze. The intent behind this apparatus is to compensate for the deficits in shifting attention attributed to autism spectrum disorders. Discussion and Conclusion. We describe the procedure devised for testing this new virtual environment paradigm and discuss the technological choices taken in order to comply with the issues addressed in HFASD. We conclude with preliminary observational data supporting the potential therapeutic use of this virtual environment system. Key Words: Pragmatics, Relevance theory, Executive dysfunction, Attentional disengagement, Emotion, Facial expression, Virtual environment, Eye-tracking, Gaze-contingency BACKGROUND AND PURPOSE Autism is defined as a pervasive developmental disorder.1 A triad of criteria comprise the diagnosis: qualitative alterations in social interaction; qualitative impairments in verbal and nonverbal communication; and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. Autism displays a high inter-individual variability and is usually referred to as a spectrum. Although autism frequently is paired with intellectual retardation,2 there are no limitations to the Intellectual Quotient (IQ) of people with autism spectrum disorders (ASD). High-functioning autism refers to the autistic spectrum subgroup that has average or above- average IQ. Despite preserved intellectual abilities and often well-developed vocabulary, individuals with high-functioning autism spectrum disorders (HFASD) exhibit profound communicative and social difficulties.2-5 ASD is considered to involve a primary deficit in pragmatics^ which refers to the ability to use language to communicate effectively in social contexts.3 People with HFASD often fail to form appropriate pragmatic inferences necessary for understanding irony, lies, jokes, metaphors, and deception.4 They have a tendency to interpret speech literally, rather than in reference to a context. For instance, an experiment on contextual disambiguation of homographs (words with the same spelling but different meanings) required determining the meaning of a homograph according to the context of a short text.5 Compared to typically developing controls, participants with HFASD selected the literal interpretation more often, thus displaying a tendency to omit context. The goal of this research is to develop effective computer-assisted training methods for people with HFASD through investigations of the multiple factors underlying cognitive and socio-emotional deficits. The present paper explains the rationale for a system designed to train individuals with HFASD to decipher social conversations. This system uses eye-tracking technologies to assist with understanding a socially expressive virtual character. …