Social Functioning in Children with Autism: Which Processes to Measure?
Objectives: The purpose of this study was to investigate which neural mechanisms supporting social cognition (perception of vs. memory for faces) are associated with social behavior during peer interactions in children with autism.
Methods: Brian mechanisms supporting face perception and memory were evaluated using visual event-related potentials (ERPs) in 74 children with autism (age 7-16 years) during passive viewing of color photographs depicting unfamiliar smiling young adults or front views of houses, a subset of which were randomly selected and repeated throughout the test session while the rest were shown only once. Social cognition was assessed using NEPSY Memory for Faces test. Social behavior was documented using caregiver reports (Social Communication Questionnaire, Social Responsiveness Scale, Adaptive Behavior Assessment System, Child Behavior Checklist) and coded observations of playground behaviors with peers.
Results: All participants demonstrated perceptual discrimination of faces vs. houses as reflected in the larger N170 responses to the former, suggesting social perception mechanisms comparable to those of typical individuals, but only the youngest group (7-9 years) evidenced increased N170 amplitudes following stimulus repetition regardless of stimulus category. These effects on the N170 amplitude decreased with age (face vs. house: r=.526, p<.001; repeated vs. single: r=.416, p<.001). N170 latency varied with IQ, with shorter responses to houses vs. faces observed only in the high-IQ (>115) group. Examination of the social memory processes indexed by the frontal and parietal “old/new” responses in the 300-500ms interval revealed familiarity with (FN400) but not recall (parietal) of the repeated houses in the youngest (7-9 years) and oldest (13-16 years) groups, while no significant differences were observed for faces due to high inter-individual variability. Social brain-behavior correlations demonstrated that larger N170 amplitudes to faces and to repeated stimuli were associated with fewer parent-reported social problems (CBCL). Conversely, larger FN400 responses to repeated faces were associated with fewer autism symptoms (ADOS communication and total scores), higher verbal IQ, better performance on NEPSY memory for faces (immediate), fewer social problems (CBCL), as well as more cooperative play, gestures, and verbal communication during a playground interaction with peers. Perceptual and memory responses to houses correlated with age and IQ, but not social behavior.
Conclusions: Examination of social functioning in children with autism using neural, cognitive, and behavioral assessments suggests that neural measures of more complex social cognition processes, such as face memory reflected in the “old/new” ERP responses, may be more informative about social functioning in children with autism than early perceptual brain responses due to more extensive connections with social cognition and behavior.
Social functioning depends on optimal brain mechanisms, cognitive processes, and behavioral skills. Examining social deficits in children with ASD using a multidemensional approach should yield more detailed information about their strengths and weaknesses associated with social interactions.