The Influence of Distraction On Discrimination and Visuomotor Tracking in Sensory Deficient Processing & Autistic Children

Background:   Children with autism (ASD) and sensory processing disorders (SPD) are anecdotally reported to show difficulties with suppressing irrelevant sensory information. Recent work by our group and others suggests atypical cortical response to basic sensory information. Functional imaging work and structural connectivity assessment suggests altered frontal-parietal connectivity in children with ASD and SPD. However the nature of the behavioral dysregulation is still not well understood, nor are there readily-available behavioral tools for use at home or at school that are inherently engaging while diagnostically valid.  Furthermore, both the ASD and SPD clinical labels encompass a broad clinical phenotype with differences in distractibility and visuomotor control.  Better understanding at an individual level will greatly facilitate treatment for all affected children.

Objectives:  

This study seeks to investigate the ability to suppress visually distracting information in boys (8-11yo) with ASD, isolated SPD, and neurotypical controls. Furthermore, we looked to determine whether standard neuropsychology assessments, including those associated with visual attention, correlate with visuomotor tracking ability across diagnostic categories.

Methods:  

All ASD participants (n=10) met lifetime ASD criteria based on ADI-R and ADOS evaluation. SPD participants (n=12) scored above the definite difference threshold for auditory and/or tactile behavior on the Sensory Profile but did not meet ADI-R/ADOS criteria for ASD. Controls (n=14) met neither ASD nor SPD criteria.  We assessed cognitive and behavioral function using i) parent report measures of attention (child symptom inventory-CSI), ii) direct patient assessment with specific neuropsychology measures (motor speed, digit symbol & visual search), and iii) a custom perceptual discrimination video game (NeuroRacer) that requires visuomotor tracking under hierarchical distractibility demands.

Results:   On the CSI, the control participants showed less behavioral inattention & hyperactivity than the other groups (p< .05). No group differences were observed on the motor speed task; however, the ASD and SPD cohorts demonstrated significantly slower speed of processing than the control cohort on the digit symbol task (each comparison: p< .05). On the visual search task, the ASD participants were less accurate than controls when finding target stimuli amongst distractors (p< .05), with no differences between the SPD participants and either group (p> .50). While playing NeuroRacer during the visual distraction condition, we observed significant response time deficits to targets for the SPD group (p< .005) and similar trends in the ASD group (p= .059) versus the control cohort. Furthermore, we observed trends indicating impaired visuomotor tracking for both the ASD and SPD cohorts relative to controls (p =.12 and p=.09, respectively). When collapsing across groups, better visuomotor tracking during NeuroRacer correlated with visual search performance (r= -.37, p< .05).

Conclusions:

This study provides preliminary evidence that children with SPD and ASD are differentially impacted in the face of modality-congruent distraction for both visuomotor accuracy and reaction time.  NeuroRacer visuomotor distractibility correlated with a standard neuropsychological measures of visual distraction, raising the possibility of using a ‘fun’, scientifically-inspired video game to characterize cognitive differences in children with neurodevelopmental challenges and potentially remediate these deficits with practice.