Preservation of Emotional Awareness in ASD: A Preliminary Exploration Using the Leas-C

Background:

Deficits in awareness of one’s emotions and those of others are considered a fundamental weakness in ASD (Humphreys et al., 2007), and are a key target of psychosocial treatments for youth with ASD. Yet, hardly any studies characterize emotion awareness in ASD, and results from the extant literature are mixed. Some data show that youth with ASD perform comparably to TD controls when identifying situations associated with specific emotions (Capps et al., 1992), whereas other data indicate that youth with ASD have difficulty identifying emotional blends (e.g., “happy and sad”) in emotionally evocative vignettes (Reiffe et al., 2006). The Levels of Emotional Awareness Scale for Children (LEAS-C; Bajgar et al., 2005) assesses a child’s awareness of a broad range of emotions in oneself and others when presented with social vignettes. This scale has the potential to provide insight regarding capacity for emotional awareness in this population.

Objectives:

This study examines emotion awareness in ASD by exploring potential differences on the LEAS-C between youth with ASD and TD peers.

Methods:

Ninety-seven participants, 8 to 16 years, were enrolled from ongoing research studies. Two groups of children were examined: children with ASD and TD children without psychopathology. The ASD group was well-characterized using the ADOS-2, ADI-R and WISC-IV (VCI > 70). The LEAS-C was administered, which assesses children’s awareness of their own and others’ emotions in 12 real-life, social vignettes. The child reads each vignette and then writes the emotions s/he and a character in the story would feel. Time is unlimited. Responses are scored on a 5-point scale: 0 (unable to identify emotions; can identify cognitive states - “I’d feel confused”); 1 (can identify somatic features), 2 (can identify action or general emotional states - “I’d feel upset.”), 3 (can identify unidimensional emotions - “I’d feel sad”), 4 (blends of emotions - “I’d feel relieved and disappointed”). A total score rates the emotional complexity of both responses. Group differences were analyzed using independent t-tests, and correlations were examined using Spearman-rank order correlations.

Results:

There were no significant differences between ASD and TD controls on Self [t (95) = -1.026, p=.31], Other [t (95) = -1.710, p=.09], or Total [t (95) = -1.07, p=.29] LEAS-C scores. Both groups averaged scores of “2” and “3” by item, indicating that responses focused on emotion related actions and reporting unidimensional emotions (e.g., “I’d feel sad”). Of note, scores in the TD group were comparable to previous studies using the LEAS-C (Veirman et al., 2011). LEAS-C scores did not correlate with age, gender, or IQ.

Conclusions:

Youth with ASD performed comparably to TD controls on a written measure of emotional awareness. This suggests that youth with ASD have the capacity to identify simple emotions when provided written descriptions and unlimited response time. This capacity, however, might be compromised in real world settings involving fast-paced reciprocal social interactions and reliance on deeper levels of emotional awareness including interoceptive processing. Interventions that can use these strengths to deepen emotional awareness in real world settings will be critical.