Teaching Emotion Recognition Running head: Recognition of Emotion in Children with Autism Remediation of Deficits in Recognition of Facial Emotions in Autistic Children Paige Weinger Cornell University 1 Teaching Emotion Recognition 2 Abstract This study evaluated the efficacy of the Mind Reading interactive computer software to remediate emotion recognition deficits in children with autism spectrum disorders (ASD). Six unmedicated children with ASD and 11 unmedicated non-clinical control subjects participated in the study. The clinical sample used the Mind Reading software for five 30-45 minute sessions. The control subjects did not receive training, and were evaluated only on pre- and post-test performance to assess practice effects. Results showed that participants with ASD scored significantly higher on the post-test than on the pre-test. As level of emotion difficulty increased, mean scores on the pretest decreased, indicating that difficulty level had a valid effect. Findings also revealed that neither age nor diagnosis was correlated with performance or with one another. In addition, a trend indicated that greater initial performance leads to greater gains through training. The Mind Reading computer software appears to significantly improve the emotion recognition abilities in children with ASD. Teaching Emotion Recognition 3 Autistic Disorder, along with Asperger’s Syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), make up the three Autism Spectrum Disorders (ASD). Individuals with autism have a range of cognitive and affective abilities, resulting in differences in the capacity to form social relationships and to recognize emotions in both themselves and others. Despite the adequate cognitive abilities of many individuals with ASD, severe deficits in communication and repetitive and restrictive interests and behaviors become problematic. Indeed, impairments in reciprocal social interaction and deficits in communication are key symptoms of autism spectrum disorders (American Psychiatric Association, 1994). Although individuals with autism may have a desire to affiliate, the above impairments often result in a lack of social skills that are needed to form meaningful relationships (Bauminger & Kasari, 2000). A common explanation of the impaired social functioning in ASD is grounded in theory of mind (ToM). According to this notion, people’s perceptions of the behaviors of others allow them to gauge an individual’s mental state (Joseph & Tager-Flusberg, 2004). This information is then used to guide a person’s actions, thus allowing natural reciprocal communication to occur. Accordingly, theory of mind first requires an individual to have a perceptual understanding of others, and then the ability to use these perceptions as inferences that guide behavior in social situations. As a result, ToM permits typically functioning individuals to infer the mental and emotional states of others as a means of engaging in reciprocal communication and maintaining relationships. Often referred to as “mindblind” (Baron-Cohen, 1995), individuals with ASD lack the seemingly innate social intelligence abilities attributed to ToM. The inability of people with ASD to read facial expressions and non-verbal cues (Derulle, Rondan, Gepner & Tardif, 2004) creates Teaching Emotion Recognition 4 significant difficulties in the capacity for these individuals to interpret and understand the causes of emotion (Baron-Cohen, Spitz, & Cross, 1993). Consequently, individuals with ASD are unable to interpret and reflect on the emotions experienced by themselves and others. These theory of mind impairments may contribute to the core social interaction and communication deficits that are characteristic of individuals on the autism spectrum (BaronCohen, 1988, Tager-Flusberg, 1999; Joseph & Tager-Flusberg, 2004). According to the mindblind hypothesis, individuals with ASD lack an awareness of the motives, goals, or desires of others. Impairments in emotion recognition abilities are a fundamental difficulty in individuals who are considered “mindblind” (Baron-Cohen, 1995). While theories of executive functioning and central coherence have also targeted symptoms of ASD in relation to social and communication deficits (Baron-Cohen, & Swettenham, 1997, Tager-Flusberg, 2004), for the purpose of this study, ToM is examined only in terms of the capacity of individuals with ASD to recognize emotion. The empathizing-systemizing model (Baron-Cohen, 2002) of autism provides further explanation for the theory of mind deficits described above. In this model, ToM serves as the primary component, central to the deficits in emotion recognition, while difficulties in affective reactions represent a secondary area of impairment (Baron-Cohen, Wheelwright, Lawson, Griffin & Ashwin et al., 2005). The disturbance in affective functioning refers mainly to impairment in the ability of individuals with ASD to empathize. Empathizing is defined as a person’s desire to appraise the emotions and thoughts of others and to respond to these appraisals in an emotionally appropriate manner (Baron-Cohen & Belmonte, 2005). Examples of empathizing deficits include impairments in joint attention (Mundy, Sigman & Kasari, 1990); an inability to distinguish mental objects from physical objects (Oznoff, Pennington, & Rogers, Teaching Emotion Recognition 5 1990); and difficulty understanding complex emotions (Bauminger, 2002). These deficits demonstrate the need for an intact theory of mind in order to successfully empathize. Emotional understanding and a drive to care for others allow people to communicate responses in an appropriate manner. Individuals with ASD lack competence in these areas. The ability to systemize serves as the alternate component to the empathizing systemizing model. Systemizing refers to the desire to create and analyze systems as a means of making sense of and predicting behavior. Studies have concluded that the “intuitive physics” of children with ASD are significantly superior to their empathizing abilities (Baron-Cohen et al., 2005). Common behaviors in ASD, such as collecting specific items, a desire for structure and routine, excessive attention to detail, and restricted interests, can all be described as patterns of a concentrated desire to systemize (Baron-Cohen, 2002). Theory of mind serves as a foundation for many intervention methods presently used with individuals on the autism spectrum. There is a general consensus that deficits in social interaction and communication are caused by an impaired ability to recognize and understand emotion. The ability to recognize emotion is necessary in order to achieve ToM. Despite the poor empathizing abilities typical of individuals with ASD, the systemizing capacities in these individuals have been described as normal or above average (Baron-Cohen et al., 2005). Therefore, combining theory of mind with the empathizing-systemizing theory of autism may aid in the design of more modern methods to teach emotion recognition (ER). In tasks of emotion recognition, ASD populations have exhibited greater difficulty than non-clinical subjects (Deruelle et al. 2004, Castelli, 2005), especially in tasks using complex emotions (Adolphs, Sears, & Piven, 2001; Deruelle et al., 2004). However, social-emotional interventions have produced positive results. Studies have found that emotion recognition can be Teaching Emotion Recognition 6 taught, and that greater social understanding can result from such training (Bauminger, 2002). Most treatment programs, however, do not approach ER training in a systematic way. The majority of treatment methods focus on teaching conversational skills and daily living routines (Golan & Baron-Cohen, 2006). One goal of the current study’s ER intervention, then, is to make use of the superior systemizing abilities of individuals with ASD. The proficient computer abilities in many individuals with autism make the use of computer-based interventions not only practical, but in many ways advantageous. Studies generally find successful intervention outcomes, although the generalizability of these tools remains in question (Moore & Calvert, 2000; Bosseler & Massaro, 2003; Hetzroni & Tannous, 2004). The environment offered by computer-based intervention tools are habitual and persistent; levels of difficulty can be adjusted to fit the needs of the individual user; and lessons can be repeated, creating consistency in structure and the development of a training routine (Golan & Baron-Cohen, 2006). The goal of the tool is to present users with a “system” of emotions. Ideally, once learned, these systems can be applied by users to real-life situations. A recent computer-assisted approach for individuals with ASD shows promise. Mind Reading: The Interactive Guide to Emotions (Baron-Cohen, Golan, Wheelwright & Hill, 2004) is a multimedia computer program aimed at systematically teaching emotion recognition. This is the first program of its kind to teach ER in a systematic way using lifelike faces (Golan & BaronCohen, 2006). Golan and Baron-Cohen (2006) tested the efficacy of the Mind Reading software in a two-part study of adults with high-functioning autism and Asperger syndrome. The first experiment compared a clinical sample to a group of clinical and non-clinical controls who received no intervention. The second experiment added a social skills training component. Marked improvement in emotion recognition skills was seen in both experimental groups over Teaching Emotion Recognition 7 the 10-15 week period. Findings from the second study reflected the added benefit of social interaction which is addressed in the present study. A pilot study has also been administered to assess the Mind Reading software in a group of children. LaCava, Golan, Baron-Cohen, and Myle’s (2007) analysis, though limited by the small sample of 8 children, did find significant improvement in the recognition of both simple and complex emotions. Together, the results of these studies are promising; however, the novelty of the tool leaves a need for further analysis. The present study operationalizes theory of mind and the systemizing-empathizing models in an attempt to empirically test the efficacy of this remedial program. While there is no clear consensus on the assumptions proposed by these theories, there is overwhelming agreement regarding the urgent need for successful social-emotional intervention methods for children with ASD. The purpose of this study, then, is to evaluate ER remediation in a group of children with ASD with the Mind Reading software when used for a much shorter period of time than used in previous studies. Methods Participants Six unmedicated children on the autism spectrum (5 males, 1 female) ages 7 through 11 (M= 8.5, SD = 1.38) participated in the study. All participants had a formal diagnosis of ASD by an independently licensed psychiatrist or psychologist. Diagnoses were corroborated using the Autism-Spectrum Quotient (Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001). Diagnoses are shown in Table 1. Participants were recruited through schools and agencies that assist students with special needs in the Miami, FL community. No compensation was offered for participation; however, if successful, participants could potentially benefit from the use of the intervention. Teaching Emotion Recognition 8 Eleven healthy, unmedicated control subjects (6 males, 5 females) ages 7 through 12 (M= 9.27, SD =1.62) also participated in the study. These subjects were only administered the preand post-tests (described below) without training sessions as a means of assessing changes as a function of repeated testing only. Participants were recruited through a local elementary school in the Ithaca, NY community. No compensation was offered for participation. Table 1. Clinical Participant Diagnoses Diagnosis Number of Participants Asperger’s Syndrome 2 HighFunctioning Autism 2 Autism 2 Materials The material for the study was an interactive computer software program, Mind Reading: A Systematic Guide to Emotions. This program contains a taxonomy of 412 emotions and mental states. The software is organized according to groups of emotions and developmental levels. Level 3, designed for children up to 13 years of age, was used for this study. The 10 complex emotions that made up the emotion set used in this study are proud, lonely, aggressive, annoyed, bored, understanding, threatened, sorry, doubtful, and ignored. Emotions are introduced by a definition and a short video clip with an actor depicting the emotion (see Figure 1). Silent films and written examples of situations that evoke the emotion were used in this study. Each emotion contains a set of six films and six sentences (see Figure 1). The actors are of both genders, mixed ages, ethnicities and races. Teaching Emotion Recognition 9 Figure 1. Lesson Stimuli from Mind Reading Computer Software Screenshots from Mind Reading: The Interactive Guide to Emotions, by S. Baron-Cohen, O. Golan, S. Wheelwright, & J.J. Hill, 2004, London: Jessica Kingsley Limited. Copyright 2003 by the University of Cambridge. Teaching Emotion Recognition 10 There are three applications within the Mind Reading program: the emotion library, the learning center, and the game zone. The learning center contains lessons and quizzes. The “build-your-own” section within the learning center allows the user to select a set of emotions to focus on. Users can collect rewards (i.e. birds, spinning objects, trains) for answering questions correctly. There is also the option to have a helper provide assistance while using the program. Mind Reading lessons were used for practice lessons and quizzes were used for both preand post-testing (see Figure 2). An animated helper was also enabled during the study. Figure 2. Quiz Stimuli from Mind Reading Computer Software Screenshots from Mind Reading: The Interactive Guide to Emotions, by S. Baron-Cohen, O. Golan, S. Wheelwright, & J.J. Hill, 2004, London: Jessica Kingsley Limited. Copyright 2003 by the University of Cambridge. Autism-Spectrum Quotient (Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001): a 50-item survey designed to determine the extent of autistic traits and behaviors. Questions were answered using a Likert-type scale. Answer choices ranged from “definitely agree” to “definitely disagree.” The survey has generally been used on adults so a “not Teaching Emotion Recognition 11 applicable” answer choice was added by the experimenter for the present study. Parents were asked to complete this questionnaire with their child (see Appendix A). Subject Data Form: The subject data form, created by the experimenter, asked basic demographic questions (i.e. gender, age), child’s reported diagnosis, and child’s previous social skills training (see Appendix B). Procedure Participants completed the study in five 30-45 minute sessions over a three week period (see Figure 3). The experimenter remained with participants during the duration of each session. The Mind Reading computer software was loaded onto a Dell Lattitude D600 laptop computer. The computer was provided by the experimenter, and all sessions took place on the same computer. Lessons were conducted in the homes of participants. Figure 3. Procedure Session one was a 45-minute session. First, consent was obtained from both parent/guardian and child participants. Parents were asked to fill out a subject data form and the Autism-Spectrum Quotient (Baron-Cohen et al., 2001). Upon completion of informed consent and the distribution of parent forms, participants were given a computer-based pretest. A quiz from the Mind Reading software was used as the pretest. The 10 emotions used in this study’s pretest were selected based on results from a pilot study of children with ASD who used the Teaching Emotion Recognition 12 Mind Reading software over a 6-week period. Each of the participants in the pilot study incorrectly identified the 10 emotions used in the present study on the initial pretest, but with training each was able to identify the 10 selected emotions. Hence, the emotions used in the pretest are sufficiently difficult initially so as to allow progress as a function of the training sessions. Participants were also tested on their ability to recognize 6 basic emotions: happy, sad, angry, afraid, surprised, disgusted. After pretesting, the experimenter introduced participants to the computer program using an introductory sample computer lesson. During this lesson the experimenter demonstrated the use of the computer program to the subject. Participants were introduced to each of the 10 emotions taught over the three week period. The experimenter was available to answer any questions from participants. Sessions two through four lasted for 30-minutes. These sessions utilized the lessons section from the Mind Reading software. During each practice session, participants were briefly re-introduced to the emotion set. The lessons contained 20 practice items presented in a nonrandom mixed order. Using the computer mouse to point and click, subjects chose the video clip or emotional picture that correctly depicted the emotion named in the word on the screen. The fifth and final session was 45-minutes in length. During this session subjects were evaluated on a post-test, which used the same emotions as in the pretest. Upon completion of post-testing, the child participant and parent/guardian were free to ask any final questions. Results The dependent measure was the number of emotions correctly identified, expressed as a percent. First, all ASD subjects correctly identified the 6 basic emotions at a 100% level of accuracy. Concerning the test stimuli, Table 2 shows mean scores on the pre- and post-test by Teaching Emotion Recognition 13 level of difficulty of emotions. A paired-samples t-test revealed that participants with ASD scored significantly higher on the post-test (M = 90%, SD = 8.94) than on the pre-test (M = 26.7%, SD = 10.33), t(5) = -.19, p < .001. As level of emotion difficulty increased, mean scores on both the pre- and post-test decreased. As shown in Table 2, planned comparisons by use of paired-samples t-tests on just the pre-test scores comparing the three levels of difficulty of emotion showed a trend towards differences between levels 1 and 2, 1 and 3, but not between 2 and 3 in both control and ASD subjects. These differences can be seen in Figure 4, which shows performance means for the ASD sample on the pre- and post-test as a function of emotion difficulty level. Table 2. Average Scores (% correct) by Level of Emotion Difficulty Pretest Posttest 1 .56 .94 2 .17 .92 3 .11 .83 Level Figure 4. Teaching Emotion Recognition 14 Whether other factors affected changes in performance from pre-test to post-test was also assessed. First, no effects of repeated testing were found: controls, who received no training sessions, showed no significant improvement from pre-test (M = 89%, SD = 8.31) to post-test (M = 90%, SD = 10.95), t(10) = -.27, n.s. There was a fairly even distribution in directional change from pre- to post-test performance for the control sample, with a portion of the sample (27%) showing a decrease, 25% an increase, and the rest no change in performance from pre- to post-test. In addition, other variables can be ruled out: none of the children in the clinical sample were on medication, so results could not vary as a function of drug-status, and all had previously received equivalent levels of social skills training. Correlational analyses were conducted to test whether other subject variables were related to pre-postchanges within the ASD group. Neither age nor clinical diagnosis was correlated with degree of improved performance. Age and diagnosis also showed no correlation with each other in this sample. A trend (p<0.16) was found between initial performance and percent improvement, where higher performance on pre-test predicted greater levels of improvement. This is consistent with the finding that children who received perfect scores on the post-test all had a diagnosis of Aspergers syndrome. Discussion The Mind Reading computer software appears to significantly (p <.001) improve the emotion recognition abilities in children with ASD. With training, participants in the clinical sample reached levels of ER comparable to the levels of ER observed in our age-matched control sample of children (both groups having a mean of approximately 90%). Control’s showed no directional change from pre- to post-testing, thus enabling us to rule out the simple effects of testing as an explanation of ASD improvement. Results also indicated that neither age nor Teaching Emotion Recognition 15 diagnosis was correlated with performance. In addition, a trend indicated that greater initial performance leads to greater gains through training. The strength of this study may derive from several factors, one of which is the novelty of its design. This is one of few studies to test the Mind Reading computer-based intervention tool on children with ASD, and the first to use the software with a focus on a specific set of emotions. In addition, previous studies have required participants to use the software independently for a predetermined amount of time each week; participants in these studies were evaluated based on tests using a general bank of emotions. Furthermore, the present study also incorporated guided lessons, where all subjects were aided by the primary investigator throughout the duration of each session. This social interaction component may have positively influenced the performance change observed. Additionally, the composition of the clinical sample was an added benefit to the study’s design. This is the first study to use the Mind Reading tool on a group of individuals with mixed diagnoses. Previous studies have assessed Mind Reading only in individuals with high-functioning autism or Asperger’s syndrome. Typical of many studies using clinical samples, generalizability is not assured in this study due to the small size of the sample. In order to improve generalizability, however, the sample was selected to include a range in age, diagnosis, and ability. It is also important to mention that the primary investigator administered all pretests, lessons and posttests, and therefore was not blind to any child’s performance. In spite of this, all stimuli and scores were computer generated and recorded, thus any effects of the researcher on participant performance should be minimal. At this point there is also no measure of retest stability of the performance gains; this is currently being assessed in a 5-month follow up post-test of all ASD subjects. Teaching Emotion Recognition 16 The goal of the present study was to use the Mind Reading computer-based intervention tool to teach children with ASD to match a physical emotional face with both a meaning and a label. According to the assumption that individuals with ASD lack a basic understanding of human emotion, the improvement witnessed through Mind Reading training may have rectified some of these ER impairments. Additionally, while an impaired theory of mind might underlie deficits in emotion recognition of the human face, participants were all fully capable of facial identity. Without probing, participants freely referred to the stimulus characters by name. Each of the participants also demonstrated competence at recognizing basic emotions; this may be attributed to prior social skills training. Despite previous social skills training, in combination with proficient computer skills, none of the ASD participants had received emotion recognition training through a computerbased intervention nor had any participants engaged in any form of systematic ER instruction. The benefits of systematic ER training are clearly demonstrated here. Significantly, the improved performance in ASD subjects found in this study was accomplished through the use of a relatively short period of training (i.e., 3 sessions), which is much briefer than used in previous studies (e.g., 15 sessions), indicating that systematic training of ER may occur very rapidly. It is theoretically interesting to test whether one or two sessions of ER training might also be as effective with this population. If so, it implies that ASD deficits in the emotional domain may be more plastic than some have presumed. In any case, perhaps the significant improvement in ER performance may be attributed to the superior systemizing abilities of children with ASD. While ToM deficits could account for a lack of emotional understanding, the superior systemizing abilities of these children may explain the capacity for considerable improvement through training. Teaching Emotion Recognition 17 The present study demonstrated that significant improvement in the recognition of specific complex emotions is possible through training with the Mind Reading computer-based intervention tool when used for a short period of time by a group of children with ASD. Future studies should look into the generalizability of this tool, and whether benefits are present in the long-term. Teaching Emotion Recognition 18 References Adolphs, R., Sears, L., & Piven, J. (2001). Abnormal processing of social information from faces in autism. Journal of Cognitive Neuroscience,13, 232–240. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. Baron-Cohen, S. (1988). Social and pragmatic deficits in autism: Cognitive or affective? Journal of Autism and Developmental Disorders, 18, 379-402. Baron-Cohen, S. (1995). Mindblindness: An essay on autism and theory of mind. Cambridge, MA: MIT Press. Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences, 6, 248-254. Baron-Cohen S.& Belmonte, M. (2005). Autism: A window onto the development of the social and analytic brain. Annual Review of Neuroscience, 28, 109-126. Baron-Cohen, S., Golan, O., Wheelwright, S., & Hill, J. J. (2004). Mind Reading: The interactive guide to emotions. London: Jessica Kingsley Limited. Baron-Cohen, S., Spitz, A., & Cross, P. (1993). Do children with autism recognize surprise? Cognition and Emotion, 7, 507-516. Baron-Cohen, S., & Swettenham, J. (1997). Theory of mind in autism: It’s relationship to executive function and central coherence. In D. J. Cohen & F. R. Volkmar, (Eds.), Handbook of autism and pervasive developmental disorders New York: John Wiley and Sons, Inc. Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J. & Clubley, E. (2001). The AutismSpectrum Quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males Teaching Emotion Recognition 19 and females, scientists, and mathematicians. Journal of Autism and Developmental Disorders, 5-17. Baron-Cohen, S., Wheelwright, S., Lawson, J., Griffin, R., Ashwin, C., Billington, J. et al. (2005). Empathizing and systemizing in autism spectrum conditions. In Volkmar, F., Klin, A & Paul, R. (Eds.), Handbook of autism and pervasive developmental disorders. New York: John Wiley and Sons, Inc. Bauminger, N. (2002). The facilitation of social-emotional understanding and social interaction in high-functioning children with autism: Intervention outcomes. Journal of Autism and Developmental Disorders, 32, 283-298. Bauminger N. & Kasari, C. (2000). Loneliness and friendship in high-functioning children with autism. Child Development, 71, 447-456. Bosseler, A. & Massaro, D. (2003). Development and Evaluation of a Computer- Animated Tutor for Vocabulary and Language Learning in Children with Autism. Journal of Autism and Developmental Disorders, 33, 635-672. Castelli, F. (2005). Understanding emotions from standardized facial expressions in autism and normal development. Autism, 9, 428-449. Deruelle, C., Rondan, C., Gepner, B., & Tardif, C. (2004). Spatial frequency and face processing in children with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 34, 199-210. Golan, O., & Baron-Cohen, S. (2006a). Systemizing empathy: Teaching adults with Asperger Syndrome or high functioning autism to recognize complex emotions using interactive media. Development and Psychopathology, 18, 591-617. Teaching Emotion Recognition 20 Hetzroni, O. E., & Tannous, J. (2004). Effects of a computer-based intervention program on the communicative functions of children with autism. Journal of Autism and Developmental Disorders, 34, 95-113. Joseph, R. & Tager-Flusberg, H. (2004). The relationship of theory of mind and executive functions to symptom type and severity in children with autism. Developmental Psychopathology, 12, 137-155. LaCava, P. G., Golan, O., Baron-Cohen, S., & Myles, B. S. (2007). Using assistive technology to teach emotion recognition to students with Asperger syndrome. Remedial and Special Education, 28. Moore, M. & Calvert, S. (2000). Brief report: vocabulary acquisition for children with autism: teacher or computer instruction. Journal of Autism and Developmental Disorders, 30, 359362. Mundy, P., Sigman, M. & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. Journal of Autism and Developmental Disorders, 20, 115128. Oznoff, S., Pennington, B., & Rogers, S. (1990). Are there emotion perception deficits in young autistic children?, Journal of Child Psychology and Psychiatry, 31, 343-63. Tager-Flusberg, H. (1999). A psychological appraoch to understanding the social and language impairments in autism. International Review of Psychiatry, 11, 235-334. Tager-Flusberg, H. (2004). Strategies for conducting research on language in autism. Journal of Autism and Developmental Disorders, 34, 75-80. Teaching Emotion Recognition 21 Appendix A DIAGNOSIS VERIFICATION FORM PARTICIPANT ID PARTICIPANT GENDER PARTICIPANT AGE ADMINISTRATION DATE ADMINISTRATOR’S RELATIONSHIP TO CHILD Please respond to each statement by circling the appropriate response to the right of each statement. 1. My child prefers to do things with others rather than alone. 2. My child prefers to do things the same way over and over again. 3. If my child tries to imagine something, he/she finds it very easy to create a picture in his/her mind. 4. My child frequently gets so strongly absorbed in one thing that he/she loses sight of other things. 5. My child often notices small sounds when others do not. 6. My child usually notices license plates or similar strings of information. 7. Other people frequently tell my child that what he/she said is impolite, even though my child thinks it is polite. 8. When my child is reading a story, he/she can easily imagine what the characters might look like. 9. My child is fascinated by dates. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 10. In a social group, my child can easily keep track of several different people’s conversations. 11. My child finds social situations easy. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree definitely agree definitely agree definitely agree slightly agree slightly agree slightly agree slightly agree slightly disagree slightly disagree slightly disagree slightly disagree definitely disagree definitely disagree definitely disagree definitely disagree not applicable not applicable not applicable not applicable 15. My child finds himself/herself drawn more strongly to people than to things. 16. My child has strong interests and gets upset if he/she can’t pursue them. 17. My child enjoys social chit-chat. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 18. When my child talks, it isn’t always easy for others to get a word in. 19. My child is fascinated by numbers. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 20. When my reads or listens to a story, he/she finds it difficult to work out the characters’ intentions. 21. My child doesn’t particularly enjoy reading fiction. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 12. My child tends to notice details that others do not. 13. My child would rather go to a library than a party. 14. My child finds making up stories easy. Teaching Emotion Recognition 22 22. My child finds it hard to make new friends. definitely agree slightly agree slightly disagree definitely disagree not applicable Teaching Emotion Recognition 23 23. My child notices patterns in things all the time. definitely agree slightly agree slightly disagree definitely disagree not applicable 24. My child would rather go to the theater than a museum. 25. It does not upset my child if his/her daily routine is disturbed. 26. My child often finds that he/she don’t know how to keep a conversation going. 27. My child finds it easy to “read between the lines” when someone is talking to him/her. 28. My child usually concentrates more on the whole picture, rather than the small details. 29. My child is not very good at remembering phone numbers. 30. My child doesn’t usually notice small changes in a situation, or a person’s appearance. 31. My child knows how to tell if someone listening to him/her is getting bored. 32. My child finds it easy to do more than one thing at once. 33. When my child is on the phone, he/she is not sure when it’s his/her turn to speak. 34. My child enjoys doing things spontaneously. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 35. My child is often the last to understand the point of a joke. 36. My child finds it easy to work out what someone is thinking or feeling just by looking at their face. 37. If there is an interruption, my child can switch back to what he/she was doing very quickly. 38. My child is good at social chit-chat. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 39. People often tell my child that he/she goes on and on about the same thing. 40. When my child was young, he/she used to enjoy playing games involving pretending with other children. 41. My child likes to collect information about categories of things (e.g. types of car, types of bird, types of train, etc.). 42. My child finds it hard to imagine what it would be like to be someone else. 43. My child likes to plan any activities he/she participates in carefully. 44. My child enjoys social occasions. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 45. My child finds it difficult to work out people’s intentions. 46. New situations make my child anxious. definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree definitely agree definitely agree slightly agree slightly agree slightly agree slightly disagree slightly disagree slightly disagree definitely disagree definitely disagree definitely disagree not applicable not applicable not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable definitely agree slightly agree slightly disagree definitely disagree not applicable 47. My child enjoys meeting new people. 48. My child is a good diplomat. 49. My child is not very good at remembering people’s date of birth. 50. My child finds it easy to play games with that involve pretending. Baron-Cohen, Wheelwright, Skinner, Martin, & Clubley, 2001 Teaching Emotion Recognition 24 Appendix B Subject Data Form Evaluation of Mind Reading Software Package on Improving Autistic Children's Abilities to Recognize Emotion Parent or Guardian: Please complete all information inside the shaded box below. Please do not make any markings outside the shaded box. Child’s Gender: ____________________ Child’s Age: ____________________ Child’s Handedness: ____________________ (with which hand does your child typically write?) Child’s Reported Diagnosis: Additional Notes: ____________________ _______________________________ (please list any relevant information, i.e. IQ scores, previous social skills training, etc.) _______________________________ _______________________________ _______________________________ Date: ____________________ ID Number: ____________________ Start Date: ____________________ Investigator Notes: ________________________________________________ ________________________________________________