Social Orientation Among School-Age Children with Autism

Background: Failure to orient to social stimuli (e.g. one’s name) is an early-occurring impairment in autism. Research by Dawson and colleagues (1998; also 2004) reported that when presented with social (hand clapping / name calling) and non-social (rattle / musical toy) stimuli, children with autism tended to orient less, a failure more pronounced for social stimuli.

Objectives: We examined the ‘social’ quality of orientation in relation to sounds among school-age children with autism, who we predicted a) would be less likely to orientate towards testers and b) when they orientated, this would be less interpersonal in quality.

Methods: Participants were 12 children (2 girls) with ADOS-confirmed autism and 12 children (4 girls) with learning disability / specific language disorder.  Groups were matched for age (M = 8 years; 3 months). Cognitive ability scores on the Kaufman Brief Intelligence Test – 2^nd Edition (Kaufman & Kaufman, 2004) were 84 (range = 43 – 116) for participants with autism and 67 (range = 40 – 97) for those without autism. While the child worked on an independent task at a desk, with two testers seated several feet behind him/her, a series of eight sounds occurred in fixed order and four fixed positions: clearing the throat, a sentence about buying a present for the child’s birthday using the child’s name, a telephone, a person calling ‘hey you’, a sewing machine, a neutral spoken sentence, thunder, and a doorbell. If the child turned to the testers, they acknowledged the child’s response and redirected the child back to his / her task.

Results:  Two independent raters achieved excellent agreement (Kappa = .8) in ratings of orientation to the testers.  The 60 video clips which involved social orientation (autism n = 24, comparison n = 36) were coded by two fresh raters for degree of social contact with the testers on a scale of 0 – 3, with excellent inter-rater reliability (ICC = .81). Children with autism orientated to the testers almost as often as those in the comparison group (autism M = 2.08; comparison M = 3.00), and with similar distribution across most of the eight stimuli e.g., on hearing a sentence containing the child’s name, approximately half of the children in each group turned to look at the testers. Children with autism were less likely to orientate to the testers when a telephone rang (autism 2 of 12, comparison 7 of 12: Fisher’s Exact p = .045), and in response to the sound of a person calling ‘hey you’ (autism 1 of 12, comparison 6 of 12, Fisher’s Exact p = .034). Social orientation bids made by children with autism were rated as less interpersonal (M = 1.38) than those made by children without autism (M = 1.94), p < .05, one-tailed.

Conclusions: There were only subtle group differences in orientation to the sounds, and modest but significant differences in degree of social contact.  Children with autism may learn to orientate to social signals, even though the quality of the orientation may be atypical.