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Speech perception is an inherently multisensory process. When having a face-to-face conversation, a listener not only hears what a speaker is saying, but also sees the articulatory gestures that accompany those sounds. Speech signals in visual and auditory modalities provide complementary information to the listener (Kavanagh and Mattingly, 1974), and when both are perceived in unison, behavioral gains in in speech perception are observed (Sumby and Pollack, 1954). Notably, this benefit is accentuated when speech is perceived in a noisy environment (Sumby and Pollack, 1954). To achieve a behavioral gain from multisensory processing of speech, however, the auditory and visual signals must be perceptually bound into a single, unified percept. The most commonly cited effect that demonstrates perceptual binding in audiovisual speech perception is the McGurk effect (McGurk and MacDonald, 1976), where a listener hears a speaker utter the syllable “ba,” and sees the speaker utter the syllable “ga.” When these two speech signals are perceptually bound, the listener perceives the speaker as having said “da” or “tha,” syllables that are not contained in either of the unisensory signals, resulting in a perceptual binding, or integration, of the speech signals (Calvert and Thesen, 2004).
published: 21 May 2014
doi: 10.3389/fpsyg.2014.00379
The impact of multisensory integration deficits on speech
perception in children with autism spectrum disorders
Ryan A. Stevenson
, Magali Segers
, Susanne Ferber
Mark T. Wallace
Department of Psychology, University of Toronto, Toronto, ON, Canada
Department of Psychology, York University, Toronto, ON, Canada
Rotman Research Institute, Toronto, ON, Canada
Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
Vanderbilt University Medical Center, Vanderbilt Brain Institute, Nashville, TN, USA
Vanderbilt Kennedy Center, Nashville, TN, USA
Department of Psychology, Vanderbilt University, Nashville, TN, USA
Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
Edited by:
Jean-Luc Schwartz, Centre National de la Recherche Scientifique, France
Reviewed by:
Julia Irwin, Haskins Laboratories, USA
Keywords: autism spectrum disorders (ASD), autism, multisensory integration, audiovisual, audiovisual processing, developmental disabilities, sensory
perception, speech perception
Speech perception is an inherently multi-
sensory process. When having a face-to-
face conversation, a listener not only hears
what a speaker is saying, but also sees
the art iculatory gestures that accompany
those sounds. Speech signals in v isual and
auditory modalities provide complemen-
tary information to the listener (Kavanagh
and Mattingly, 1974), and when both are
perceived in unison, behavior al gains in
in speech perception are observed (Sumby
and Pollack, 1954). Notably, this benefit is
accentuated when speech is perceived in
a noisy environment (Sumby and Pollack,
1954). To achieve a behavioral gain from
multisensory processing of speech, how-
ever, the auditory and visual signals must
be perceptually bound into a single, uni-
fied percept. The most commonly cited
effect that demonstrates perceptual bind-
ing in audiovisual speech perception is the
McGurk effect (McGurk and MacDonald,
1976), where a listener hears aspeaker
utter the syllable ba, and sees the speaker
utter the syllable ga. When these two
speech signals are perceptually bound, the
listener perceives the speaker as having said
da” or “tha, syllables that are not con-
tained in either of the unisensory signals,
resulting in a perceptual binding, or inte-
gration, of the speech signals (Calvert and
Thesen, 2004).
The ability to perceptually bind sen-
sory information is notably impaired in
a number of clinical populations, includ-
ing those with autism spectrum disor-
ders (ASD). ASD describes a cluster of
highly prevalent developmental disabili-
ties historically characterized by deficits in
three functional domains: language and
communication, social reciprocity, and the
presence of restricted interests/repetitive
behaviors (APA, 2000). Since its initial
description, alterations in sensory process-
ing have been described in this popu-
lation (Kanner, 1943), yet these deficits
were acknowledged only in the most
recent edition of the DSM (APA, 2013).
Impairments in multisensory perceptual
binding may be particularly relevant in
ASD, given that hallmark features of the
disorder include difficulties in speech,
communication, and social interactions.
Successful speech communication is heav-
ily reliant on binding across sensory
modalities, and as such, impaired binding
in individuals with ASD likely contributes
to these core deficits.
Impairments in perceptual binding
have not gone unstudied in ASD. In fact,
one of the leading theories describing ASD,
Weak Central Coherence, describes ASD as
tively attuned to individual components of
information to the exclusion of perceiv-
ing the larger whole; in short, losing the
proverbial forest for the trees (Frith and
Happé, 1994; Happé, 1999, 2005; Happé
and Frith, 2006). Evidence for this has
been found across a wide range of tasks.
For example, individuals with ASD bene-
fit less than individuals without ASD from
context when interpreting a sentence or
story (Happé, 1994; Jolliffe and Baron-
Cohen, 1999), but are more accurate than
individuals without ASD when focusing
on explicit local details of a passage (Noens
and Berckelaer-Onnes, 2005).
In the realm of sensory perception,
binding deficits in ASD have been stud-
ied most extensively in the visual modality.
Here too, individuals with ASD have been
shown to have a strong local bias at the
expense of global processing (Behrmann
et al., 2006). A clear example of this is
observed in response to hierarchical let-
ters (large letters composed of smaller let-
ters; Navon, 1977). When performing a
task reliant upon the identify the gestalt
of the image (the large letter) relative to
the individual units (small component let-
ters), individuals with ASD show impaired
performance (Behrmann et al., 2006).
The ability of individuals with ASD to
bind across sensory modalities has been
studied to a much lesser extent, but those
studies that have been conducted com-
monly find deficits in multisensory per-
ceptual binding, particularly w ith speech
signals. The majority of the research sug-
gests that individuals with ASD perceive
the McGurk illusion less often than their May2014|Volume5|Article379
| 1
Stevenson et al. Multisensory speech perception in ASD
peers without ASD (de Gelder et al., 1991;
Williams et al., 2004; Mongillo et al., 2008;
Irwin et al., 2011; Bebko et al., 2014;
Stevenson et al., 2014, in press;butsee
Iarocci and McDonald, 2006; Woynaroski
et al., 2013), often relying instead on the
auditory modality to the exclusion of the
visual information (Mongillo et al., 2008;
Stevenson et al., 2014, in press). While
individuals with ASD may be able to per-
ceptually bind information under optimal
conditions, these results imply that indi-
viduals with ASD show reduced efficiency
when binding speech information across
auditory and visual modalities, particu-
larly in noisy, real-world contexts (Foxe
et al., 2013). As a consequence, signals are
units rather than as a meaningful whole.
Thus, the efficiency gained from process-
ing multiple sensory signals as a single
percept, for example the visual sensory
inputs associated with a speaker integrated
with the auditory sensory inputs associ-
ated with a speaker (Stevenson et al., 2010,
2011), would be lost, resulting in more
inefficient sensory processing overall.
Given the findings that individuals with
ASD show reduced perceptual binding of
audiovisual speech signals, it has been
hypothesized that individuals with ASD
would not exhibit the behavioral gains
observed with the perception of multi-
sensor y signals. The few studies to date
that have investigated multisensory per-
ception of audiovisual speech have shown
that children with ASD do in fact show less
behavioral gain (i.e., less improved per-
ception) with audiovisual speech than do
their typically developing peers (Alcántara
et al., 2004; Smith and Bennetto, 2007;
Irwin et al., 2011; Foxe et al., 2013). This
finding is especially salient when speech is
embedded in a high degree of background
noise (Foxe et al., 2013), the very con-
dition in which (A) typically developing
children show a high level of multisensory
gain and (B), this multisensory integra-
tion would be most beneficial for success-
ful speech communication. The validity
of the relationship between multisensory
perception and real-world communication
has been demonstrated via correlations
between the accurate perception of audio-
visual speech and communication scores
from the Autism Diagnostic Observation
Schedule (Lord et al., 2000), the gold
standard for diagnostic testing in ASD.
Individuals who were better able to accu-
rately perceive audiovisual speech were less
impaired in terms of communicative abili-
ties (Woynaroski et al., 2013).
Interestingly, multisensor y speech inte-
gration is not a static process, but one that
continues to mature and fine tune over
development (Hillock et al., 2011; Hillock-
Dunn and Wallace, 2012). While young
children with ASD are clearly delayed in
their ability to benefit from multisensory
speech perception compared to their typ-
ically developing peers, there is evidence
that this impairment lessens w i th matura-
tion (Foxe et al., 2013). Likewise, the first
study of the McGurk Effect across devel-
opment showed a similar pattern, in which
young children with ASD perceived the
McGurk Effect much less frequently than
their peers without ASD, but caught up
later in development (Taylor et al., 2010;
but see Stevenson et al., in press).
A critical question then, is what is
the underlying cause of these disr u ptions
in speech perception observed in ASD?
One possibility is that individuals with
ASD have impaired temporal processing
abilities. One neurobiological account of
ASD, the temporal binding hypothesis of
autism (Brock et al., 2002) proposes just
that. In terms of binding across sensory
inputs, perceiving the timing of incom-
ing sensory information is paramount to
the ability to perceptually bind stimuli
across sensory modalities. The temporal
synchrony of such inputs is one, if not the
most, salient cue that two inputs should
be bound (Vroomen and Keetels, 2010).
Previous research shows a clear pattern
that individuals with ASD are significantly
impaired in judg ing the relative timing of
auditory and visual speech signals (Bebko
et al., 2006; Foss-Feig et al., 2010; Kwakye
et al., 2011; de Boer-Schellekens et al.,
2013; Woynaroski et al., 2013; Stevenson
et al., 2014), and importantly, this research
also showed a direct correlation between
multisensory temporal acuity and the abil-
ity to perceptually bind audiovisual speech
signals in individuals with ASD (Stevenson
et al., 2014).
These findings, taken in sum, suggest
that deficits in binding across auditory and
visual modalities in ASD may have a cas-
cading impact on speech perception and
social processing, key clinical symptoms
defining ASD. In most social communica-
tive interactions, failing to perceive the
auditory and visual components of the
environment can result in missing criti-
cal social cues, not to mention the con-
tent of the message being conveyed. Failing
to perceive a speaker’s message as a sin-
gle, unified percept, essentially doubles
the number of perceived inputs, result-
ing in an increasingly “noisy” or “intense”
world—as is often described in the case of
autism (Just et al., 2004; Markram et al.,
2007; Rippon e t al., 2007; Pouget et al.,
The impact of an inability to percep-
tually bind across senses on other aspects
of cognition has been well characterized
in a patient with bilateral par ietal hypop-
erfusion (Hamilton et al., 2006). This
patient, AWF, began to perceive what he
heard and what he saw as being out of
sync. As a result of this atypical mul-
tisensor y temporal processing, AWF was
unable to perceptually bind audiovisual
speech, indexed by an inability to perceive
the McGurk Effect. Additionally, AWF
no longer showed the typical behavioral
benefits with he was shown a speakers
mouth and articulatory gestures accompa-
nying auditory speech. While the etiology
of AWF’s impairment is clearly distinct
from ASD, the parallels in the p ercep-
tion of audiovisual speech are striking.
Furthermore, AWF’s describes coping with
his asynchronous environment by limit-
ing face-to-face conversations and looking
versations, both behaviors commonly seen
in ASD. Such a coping strategy may reflect
the perceived avoidance of social interac-
limiting the amount of perceptual noise in
the environment. A similar argument has
been made for self-stimulation or “stim-
ming” behaviors commonly observed in
ASD. It is possible that these repetitive
movements provide a predictable and con-
trolled sensory experience in an otherwise
chaotic world (Jones et al., 2003).
While the impact that atypical sen-
sor y binding appears to have on the core
symptoms associated with ASD is sup-
ported by research, the issue of how to
translate these findings into clinical prac-
tice has been largely unexplored (note
here that treatments commonly referred
to as “sensory integration therapy” do
Frontiers in Psychology | Language Sciences May2014|Volume5|Article379
| 2
Stevenson et al. Multisensory speech perception in ASD
not in fact focus on binding or integrat-
ing information across sensory modal-
ities). Intensive Behavioral Intervention
(IBI) is the evidence-based treatment of
choice for ASD; however, the degree of
gain made by any one child is difficult
to predict. While milder autism severity,
higher adaptive functioning, and higher
cognitive skills are related to better out-
comes, there remain unaccounted for fac-
tors which may predict which children
benefit most from treatment (Flanagan
et al., 2012). Given that sensory and mul-
tisensor y processing are foundational to
the higher-level cognitive, communicative,
and social functioning that treatments aim
to address, knowledge of an individual’s
ability to process sensory information is a
critical and necessary first step to benefit
maximally from intensive intervention.
These possible clinical implications are,
at this stage, highly speculative. The pos-
research from the laboratory into real-
world settings are significant. A clear
consensus of evidence suggests that indi-
viduals with ASD process and integrate
sensory information in an atypical man-
ner, and that this is strongly linked to
core impairments in communicative and
social abilities. A number of research
questions must b e a ddressed in order to
explore these possibilities. First, longitudi-
nal studies of individuals with ASD need
to be conducted to directly assess how
speech and communication skills develop
in conjunction with sensory processing,
specifically binding across sensory modali-
ties and multisensory temporal processing.
Second, the mediating or moderating
effect that specific sensory-processing phe-
notypes in ASD have on the efficacy of
evidence-based treatments such as IBI is
sorely needed (in addition to other vari-
ables such as IQ and gender; Woler y
and Garfinkle, 2002; Rogers and Vismara,
2008). Finally, research should ultimately
go beyond documenting the sensory and
multisensory processing abilities of indi-
viduals with ASD and in addition, should
also reveal how these abilities can be
dynamically modulated. Plasticity within
the relevant perceptual systems has been
amply demonstrated (Fujisaki et al., 2004;
Powers et al., 2009; Stevenson et al., 2013;
Schlessinger e t al., in press), but these
findings have been not yet been applied to
populations with ASD. Pursuing these and
related studies has the potential to not only
add to our understanding of ASD, but also,
through clinical application, to improve
the quality of life of individuals with ASD.
Funding for this work was provided
by a Banting Postdoctoral Fellowship
administered by the Government of
Canada It’s only a matter of time: Neural
networks underlying multisensory per-
ceptual binding,aUniversityofToronto
Department of Psychology Postdoctoral
Fellowship Grant, National Institutes
of Health F32 DC011993 Multisensory
Integration and Temporal Processing
in ASD, National Institutes of Health
R34 DC010927 Evaluation of Sensory
Integration Treatment in ASD,National
Institutes of Health R21 CA1834892
Multisensor y Processing Across Lifespan and
Links to Cognition, a Simons Foundation
research grant Exploring Links Between
Multisensory and Cognitive Function in
Autism, a Vanderbilt Institute for Clinical
and Translational Research grant VR7263
Neuroplasticity of Sens ory Processing in
Autism Spectrum Disorders, a Vanderbilt
Kennedy Center MARI/Hobbs Award,
the Vanderbilt Brain Institute, and the
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Conflict of Interest Statement: The authors declare
that the research was conducted in the absence of any
commercial or financial relationships that could be
construed as a potential conflict of interest.
Received: 05 March 2014; accepted: 10 April 2014;
published online: 21 May 2014.
MD and Wallace MT (2014) The impact of multisen-
sory integration deficits on speech perception in children
with autism spectrum disorders. Front. Psychol. 5:379.
doi: 10.3389/fpsyg.2014.00379
This article was submitted to Language Sciences, a
section of the journal Frontiers in Psychology.
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Frontiers in Psychology | Language Sciences May2014|Volume5|Article379
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... Multisensory integration has been studied widely in individuals with typical development and those with developmental and neurological issues such as schizophrenia (Stekelenburg et al., 2013), individuals suffering from medically unexplained symptoms (Funahashi, 2007), autism spectrum disorders (Vroomen, & van der Heide, 1991;Cascio et al., 2012;Paton et al., 2012;Palmer et al., 2013;Stevenson et al., 2014;Greenfield et al., 2015) and individuals with sensory processing disorder (Mottron et al., 2006;Russo et al., 2010) and many more. MSI plays a very important role in perception, therefore, in order to under the underlying processes that contribute to successful integration of multiple sensory inputs has been studied abundantly in the typically developing population using various different experimental paradigms. ...
... Individuals with autism demonstrated susceptibility to the flash-beep illusion, however, the integration of audiovisual sensory information is less selective in autism, compared to typically developing individuals. Stevenson et al., (2014) investigated audio visual integration in individuals with high functioning autism to measure the effects on speech perception using the 'McGurk Effect'. The researchers found that the performance of the HfA group in the multisensory temporal tasks was dependent on stimuli complexity, suggesting less precise integration as the task complexity increased compared to the typically developing group. ...
... Hillock-Dunn & Wallace (2012) suggested that the temporal binding window during which sensory inputs are integrated gets shorted as an individual's age increases. However, this has not found to be the case for those with autism, as they show a reduced ability to filter which inputs should be integrated or not and it does not improve with age, resulting in extended temporal binding window (Foss-Feig et al., 2010;Kwakye et al., 2011;Stevenson et al., 2014). An extended temporal binding window could possibly contribute to the sensory issues often seen in those with autism, this is because an extended binding window of sensory inputs would lead to inappropriate integration of sensory events resulting in atypical behaviors, such as the feelings of sensory overload often seen in ASD (Rogers & Ozonoff, 2005) particularly in during those social events where there is a high degree of changing multisensory inputs. ...
In order to have a comprehensible representation of scenes and events, the human brain must combine information from different sensory sources. Integration of visual, tactile, and proprioceptive information is considered vital to this process as it underpins the subjective sense of self and body ownership; which has been linked to the development of social processes such as empathy and imitation. This issue has been investigated using sensory illusions and suggests that individuals with autism are less prone to multimodal illusions due to atypical sensory integration, i.e. they tend to rely on a single sensory source more, rather than integrating concurrent sources of information (i.e. over-reliance on proprioception). Studies that have measured illusion susceptibility and ownership, especially in regards to body ownership have provided mixed results. Therefore, it is important to understand and advance our knowledge on illusion susceptibility using sensory illusions. In order to conduct this research, it was first required to identify typically developing individuals who have high and low autism tendencies using the Autistic Spectrum Quotient (Baron-Cohen et al., 2001b). This was important because previous research has indicated behavioral similarities between individuals with high autism traits and those with high-functioning autism (HfA). The primary aim of this research was to investigate whether individuals with high autism traits and those with a diagnosis of autism perform in a similar way in terms of illusion susceptibility and illusion ownership, as previous research has stated differences in illusion susceptibility (Palmer et al., 2013; Paton et al., 2012). Three different multisensory illusions were presented to all the participants using the MIRAGE mediated reality device. This device enables the experimenter to presentvarious illusions on the participants’ limbs, where manipulations can be applied over the hand. Illusion ownership and susceptibility statements were used to measure the subjective experience of the participants, whereas, finger localization tasks were used as an objective measure of susceptibility to the illusions. Experiments One and Two investigated the effects of crawling skin illusion which is a visual illusion that can produce somatosensory sensations without any tactile input- as this illusory percept manipulates an individual’s existing knowledge regarding their own hand (McKenzie & Newport, 2015). The results indicated that individuals with high AQ scores (compared to low AQ, Experiment 1) and HfA (compared to typically developing adults, Experiment 2) showed less influence of visual context. They reported reduced effects of the illusion, which could be due to a higher reliance on top- down knowledge. However, all the participating groups showed high ownership of their hand as viewed through the MIRAGE. Participants with high and low autism traits (Experiment 3) and adults with HfA as well as typically developing adults (Experiment 4) were presented with the finger stretching illusion (Newport et al., 2015) which involves an interplay of vision, touch and proprioception. The results obtained showed that participants across all groups had high ownership score, however, only the low AQ group and the control group were susceptible to the illusion. An estimation task was used to measure whether participants embodied the illusion, adults with high AQ scores and HfA showed superior performance during the estimation task, however, the control groups estimates were significantly further, hence, making them more susceptible to the visuo- tactile manipulation. The third illusion measured visuo- proprioceptive integration in individuals with high and low AQ scores (Experiment 5) and adults with HfA as well as typically developing adults (Experiment 6). The task involved participants estimating the location of their hidden index finger under different conditions i.e. participants were able to view their hand or the view of their hand was hidden. Participants first took part in an adaptation procedure (Newport & Gilpin, 2011) which involved relocating the hand from where the participants last saw their hand. This was to test whether individuals with high autism traits and those with HfA showed superior proprioceptive performance in estimating their index finger location. The results indicated that the HfA and the high AQ groups were less affected by the visuo- proprioceptive misalignment caused during the adaptation procedure. Participants with low AQ scores and the typically developing group’s estimates were more influenced by the visual input. In conclusion, none of the experiments found strong evidence of over-reliance on proprioception in individuals with high AQ or those with HfA, however, they showed superior estimation abilities than the control group. My findings suggest that there is a preference, but not over- reliance on, for proprioception as opposed to visual and tactile information in the high AQ scoring group and the HfA group. Over- relying on a single sensory source, while not integrating multisensory information could have a detrimental impact on sensory processing and social interactions, especially the visuo- tactile system as it enables an individual to experience the environment through touch and understand everyday sensations such as temperature, pressure, itching, pain, etc. For future research, this research highlights the importance of studying the visual-tactile domain. An individual’s ability to process tactile input is related to their ability to visually discriminate and to have appropriate body awareness, which in turn helps in developing emotional security, academic learning, and social skills that are some of the core issues often reported in individuals with autism (Corbett et al., 2009; Happé & Frith, 2006; Piek & Dyck, 2004; Tager-Flusberg, 2008). More so, research investigating such processes should involve the whole spectrum of autism rather than focusing on a smaller subset.
... Diverses recherches soulignent que les enfants TSA présentent, d'une part, un traitement visuel atypique et un fonctionnement attentionnel singulier : évitement du regard, poursuite oculaire d'un stimulus en mouvement non opérant [15], etc. Ils auraient d'autre part un traitement auditif inhabituel [16]. Enfin, ces enfants TSA auraient un trouble de l'intégration multisensorielle [17]. Additionnés, ces dysfonctionnements majoreraient leur difficulté à entrer en relation avec autrui. ...
... Nous faisons l'hypothèse que proposer aux enfants avec TSA de visionner au ralenti des dessins animés désaturerait leur champ d'attention [25]. Ralentir le contenu et le rejouer permettraient en ce sens d'amorcer une intégration multisensorielle [17]. Nous voyons d'ailleurs dans le cas clinique que lorsque ce processus d'intégration est à l'oeuvre, les enfants gagnent en capacité d'interaction et de communication. ...
Résumé Les enfants avec troubles du spectre autistique présentent bien souvent un intérêt privilégié pour des contenus vidéos, regardés compulsivement, de manière répétitive et autarcique. La présente étude exploratoire propose un dispositif thérapeutique intitulé Vidéodrame, basé sur le visionnement de dessins animés ralentis avec les enfants avec TSA et en modélise le processus thérapeutique. La revue de littérature permet de mettre en évidence d’une part l’intérêt de dispositifs cliniques basés sur la vidéo, d’autre part le nombre de questions de recherche encore en suspens sur ce thème. La présente étude a utilisé une méthodologie transdisciplinaire au carrefour de la psychologie clinique psychanalytique et des neurosciences, tant dans la conduite de la recherche que dans la construction même du dispositif. Ce dernier est présenté en détail. Un cas clinique de prise en charge en groupe de deux enfants avec des troubles modérés du spectre de l’autisme en pédopsychiatrie est exposé. L’analyse de cette clinique met en évidence les particularités sensorielles autistiques exprimées dans le rapport aux écrans. De plus, la discussion soulève l’idée que l’efficacité du Vidéodrame tiendrait dans la synergie au sein de ce dispositif thérapeutique entre temps de visionnage, comme espace d’expression des particularités sensorielles, et temps de jeu, comme lieu d’imitation et d’expérimentation de changement de rôle et d’état-mentaux, consolidant ainsi leurs appréhensions d’une théorie de l’esprit. Ce dispositif favorise aussi des moments de partage relationnel, permettant aux enfants une reprise du développement affectif et un accès à la narrativité. Ces premiers résultats interrogent également sur un possible changement du rapport des enfants aux écrans. De futures recherches sur ce dispositif clinique sont nécessaires.
... Concerning the acoustic domain, children with ASD show delayed evoked neural responses to auditory tones compared with TD [39,40], and this latency predicts their symptom severity [41]. Being observed in response to both pure tones and complex stimuli (such as speech) [40], the hypothesis was advanced that this difference might precipitate higher-order autistic difficulties in communication [42,43]. Comparing HF and LF, previous studies report better auditory capacities in HF [44], who can even surpass non-autistic young adults in terms of unexpected and expected sound detection [45]. ...
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Background: Sensory reactivity is considered one of the diagnostic criteria for Autism Spectrum Disorders (ASD) and has been associated with poorer functional outcomes, behavioral difficulties, and autism severity across the lifespan. The characterization of the sensory processing in ASD has thus become crucial to identify the sensory and motor features influencing the development of personal autonomy. Objectives: The present study has two aims: (1) to compare the sensory processing between school-aged children with ASD and typically developing peers (TD); (2) to evaluate whether, within the ASD sample, the cognitive level and reported sensory symptoms explain the scores exhibited at the Sensory Processing Measure (SPM-2). Methods: The SPM-2 test was administered to the parents of 105 children with ASD and 70 TD. The ASD group was further subdivided into two groups, namely high and low functioning based on their cognitive level (High Functioning (HF), IQ > 80; Low Functioning (LF), IQ < 80). Results: ASD children exhibited higher scores throughout the SPM-2 total score and its multiple subscales. Within ASD, while HF and LF children did not differ in terms of the SPM-2 total score, a significant difference was found for the hearing, social participation, and balance and motion subscales. Conclusions: Aside from classical knowledge that the ASD population suffers from sensory processing disorders, we revealed that different sensory patterns are associated with high or low cognitive functioning. Beyond its neurobiological interest, such knowledge may be of fundamental importance for individualizing psychoeducational interventions in preschool- and school-aged children and later developmental stages.
... Likewise, Smith and Bryson (1994) believe that imitative difficulties translate into a more basic deficit of perception and representation of events in the external world. What appears to be common are atypical behavioral responses to sensory information (Marco et al., 2011;Stevenson et al., 2014;Posa, Visconti, 2018). Over 96% of children with Autism Spectrum Disorder report hyper and hyposensitivity in multiple domains, although the sensory behavioral differences vary from mild to severe and these behavioral differences may not always last into adulthood. ...
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The imitative process may represent an opportunity for a child’s development to learn new actions, as well as to establish social relationships and communicate with each other at an early age. Nonetheless, difficulties in imitation shown by children with Autism Spectrum Disorder may hinder communication, language and intersubjectivity development. Hence, it’s essential to identify strategies that stimulate each child on an imitative level starting from multiple and diversified situations of play and daily life where partners and objects act as an activating function. Therefore, working on imitation skills constitutes a significant step to improve both social and communication skills of the child with Autism Spectrum Disorder by exploiting the potential of some educational approaches such as AAC, PECS and Video-modeling.
... Indeed, in behavioral experimental studies in multisensory integration, children with ASD performed more poorly in a multisensory single syllable task compared to TD children [18]. In contrast, Stewart et al. [19] reported shorter reaction times in a multisensory task than in a unisensory task in both children with ASD and TD. ...
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Background: Atypical sensory behavior disrupts behavioral adaptation in children with autism spectrum disorder (ASD); however, neural correlates of sensory dysfunction using magnetoencephalography (MEG) remain unclear. Method: We used MEG to measure the cortical activation elicited by visual (uni)/audiovisual (multisensory) movies in 46 children (7-14 years) were included in final analysis: 13 boys with atypical audiovisual behavior in ASD (AAV+), 10 without this condition, and 23 age-matched typically developing boys. Results: The AAV+ group demonstrated an increase in the cortical activation in the bilateral insula in response to unisensory movies and in the left occipital, right superior temporal sulcus (rSTS), and temporal regions to multisensory movies. These increased responses were correlated with severity of the sensory impairment. Increased theta-low gamma oscillations were observed in the rSTS in AAV+. Conclusion: The findings suggest that AAV is attributed to atypical neural networks centered on the rSTS.
Microglial cells (MGCs) are highly dynamic and have been implicated in shaping discrete neural maps in several unimodal systems. MGCs respond to numerous cues in their microenvironment, including the neuronally expressed chemokine, fractalkine (CX3CL1), via interactions with its corresponding fractalkine receptor (CX3CR1). The present study examines microglial and CX3CL1 patterns with regard to the emerging modular-extramodular matrix organization within the lateral cortex of the inferior colliculus (LCIC). The LCIC is a multisensory shell region of the midbrain inferior colliculus where discrete compartments receive modality-specific connections. Somatosensory inputs terminate within modular confines, while auditory inputs target the surrounding matrix. Glutamic acid decarboxylase (GAD) is an established marker of LCIC modules in developing mouse. During early postnatal development, multimodal LCIC afferents segregate into discrete, neurochemically defined compartments. Here, we analyzed neonatal GAD67-GFP (GFP is defined as green fluorescent protein) and CX3CR1-GFP mice to assess: (1) whether MGCs are recruited to distinct LCIC compartments known to be undergoing active circuit assembly, and (2) if such behaviors are fractalkine signaling-dependent. MGCs colonize the nascent LCIC by birth and increase in density until postnatal day 12 (P12). At the peak critical period (P4-P8), MGCs conspicuously border emerging LCIC modules, prior to their subsequent invasion by P12. CX3CL1 expression becomes distinctly modular at P12, in keeping with the notion of fractalkine-mediated recruitment of microglia to modular centers. In CX3CR1GFP/GFP mice with compromised fractalkine signaling, microglial recruitment into modules is delayed. Taken together, these results suggest a potential role for microglia and fractalkine signaling in sculpting multisensory LCIC maps during an early critical period.
Multisensory integration (MSI) is the ability to combine temporally synchronous, amodally specified sensory information to create rich, coordinated perceptual experiences. In early development, attention is directed toward such information in both social contexts (e.g., human speakers) and nonsocial contexts (e.g., multimodal toys). Parenting behaviors may support and sculpt multisensory integration by providing children with opportunities to experience amodally specified information (e.g., contingent face-to-face interactions). This study examined (a) whether 24-month-olds’ MSI abilities differed as a function of context (social or nonsocial) and competition for attention (low or high), (b) whether MSI predicted expressive vocabulary, and (c) whether maternal sensitivity (MS) was related to both MSI and language. A total of 32 24-month-olds were tested in the Multisensory Attention Assessment Protocol, an audiovisual task that presents laterally positioned social/nonsocial events with and without a central distractor. Their mothers completed the MacArthur–Bates Communicative Development Inventories and participated in a free-play period with their children for MS coding. Results showed MSI in both social and nonsocial conditions (i.e., toddlers paid more attention to the “match”), but only the ability to maintain attention to the social match was related to toddlers’ expressive vocabulary. In addition, MS was positively correlated with toddlers’ expressive language and social MSI performance. Taken together, the pattern of results shows important relations between emerging integration abilities and parenting behavior as well as the ability of both factors to positively influence word learning during early toddlerhood.
Deficits in audiovisual speech perception have consistently been detected in patients with Autism Spectrum Disorder (ASD). Especially for patients with a highly functional subtype of ASD, it remains uncertain whether these deficits and underlying neural mechanisms persist into adulthood. Research indicates differences in audiovisual speech processing between ASD and healthy controls (HC) in the auditory cortex. The temporal dynamics of these differences still need to be characterized. Thus, in the present study we examined 14 adult subjects with high-functioning ASD and 15 adult HC while they viewed visual (lip movements) and auditory (voice) speech information that was either superimposed by white noise (condition 1) or not (condition 2). Subject’s performance was quantified by measuring stimulus comprehension. In addition, event-related brain potentials (ERPs) were recorded. Results demonstrated worse speech comprehension for ASD subjects compared to HC under noisy conditions. Moreover, ERP-analysis revealed significantly higher P2 amplitudes over parietal electrodes for ASD subjects compared to HC.
Background A widened temporal window of integration (TWI) in audiovisual processing has been detected for children with autism spectrum disorder. However, research indicates a narrowing of this TWI and an associated change in audiovisual integration in the course of development. Methods To further elucidate audiovisual integration processes in adulthood, we compared adult participants with Asperger’s Syndrome (AS) to healthy controls (HC) by using the sound-induced double flash illusion. For a better understanding of underlying neural mechanisms, event-related potentials were measured via electroencephalography (EEG). Results The number of reported sound-induced flash illusions indicated audiovisual integration. A similar TWI size for both, participants with AS and HC, was found. Additionally, enhanced P2 amplitudes were detected for participants with AS compared to HC. Conclusion Results indicate an involvement of attentional processes in audiovisual perception in participants with AS.
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Guidance errors and unrefined neural map configurations appear linked to certain neurodevelopmental conditions, including autism spectrum disorders. Deficits in specific multisensory tasks that require midbrain processing are highly predictive of cognitive and behavioral phenotypes associated with such syndromes. The lateral cortex of the inferior colliculus (LCIC) is a shell region of the mesencephalon that integrates converging information from multiple levels and modalities. Mature LCIC sensory maps are discretely-organized, mimicking its compartmental micro-organization. Intermittent modular domains receive patchy somatosensory connections, while inputs of auditory origin terminate in the encompassing extramodular matrix.Eph-ephrin signaling mechanisms instruct comparable topographic arrangements in a variety of other systems. Whether Eph-ephrin interactions also govern the assembly of LCIC multimodal maps remains unaddressed. Previously, we identified EphA4 and ephrin-B2 as key mediators, with overlapping expression patterns that align with emerging LCIC modules. Here, we implicate another member of this guidance family, ephrin-B3, and quantify its transient expression with respect to neurochemically-defined LCIC compartments. Multiple-labeling studies in GAD67-GFP knock-in mice reveal extramodular ephrin-B3 expression, complementary to that of EphA4 and ephrin-B2. This distinctive pattern sharpens over the early postnatal period (birth to P8), prior to ephrin-B3 downregulation once multimodal LCIC inputs are largely segregated (P12). Channel-specific sampling of LCIC ROIs show ephrin-B3 signal periodicities that are out-of-phase with glutamic acid decarboxylase (GAD;modular marker) signal fluctuations, and match calretinin (CR) waveforms (matrix marker). Taken together, the guidance mosaic registry with emerging LCIC compartments and its interfacing afferent streams suggest a prominent role for Eph-ephrins in ordering behaviorally significant multisensory midbrain networks.
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Under noisy listening conditions, visualizing a speaker's articulations substantially improves speech intelligibility. This multisensory speech integration ability is crucial to effective communication, and the appropriate development of this capacity greatly impacts a child's ability to successfully navigate educational and social settings. Research shows that multisensory integration abilities continue developing late into childhood. The primary aim here was to track the development of these abilities in children with autism, since multisensory deficits are increasingly recognized as a component of the autism spectrum disorder (ASD) phenotype. The abilities of high-functioning ASD children (n = 84) to integrate seen and heard speech were assessed cross-sectionally, while environmental noise levels were systematically manipulated, comparing them with age-matched neurotypical children (n = 142). Severe integration deficits were uncovered in ASD, which were increasingly pronounced as background noise increased. These deficits were evident in school-aged ASD children (5-12 year olds), but were fully ameliorated in ASD children entering adolescence (13-15 year olds). The severity of multisensory deficits uncovered has important implications for educators and clinicians working in ASD. We consider the observation that the multisensory speech system recovers substantially in adolescence as an indication that it is likely amenable to intervention during earlier childhood, with potentially profound implications for the development of social communication abilities in ASD children.
The pulse oximeter is a critical monitor in anesthesia practice designed to improve patient safety. Here, we present an approach to improve the ability of anesthesiologists to monitor arterial oxygen saturation via pulse oximetry through an audiovisual training process. Fifteen residents' abilities to detect auditory changes in pulse oximetry were measured before and after perceptual training. Training resulted in a 9% (95% confidence interval, 4%-14%, P = 0.0004, t166 = 3.60) increase in detection accuracy, and a 72-millisecond (95% confidence interval, 40-103 milliseconds, P < 0.0001, t166 = -4.52) speeding of response times in attentionally demanding and noisy conditions that were designed to simulate an operating room. This study illustrates the benefits of multisensory training and sets the stage for further work to better define the role of perceptual training in clinical anesthesiology.
The new DSM-5 diagnostic criteria for autism spectrum disorders (ASDs) include sensory disturbances in addition to the well-established language, communication, and social deficits. One sensory disturbance seen in ASD is an impaired ability to integrate multisensory information into a unified percept. This may arise from an underlying impairment in which individuals with ASD have difficulty perceiving the temporal relationship between cross-modal inputs, an important cue for multisensory integration. Such impairments in multisensory processing may cascade into higher-level deficits, impairing day-to-day functioning on tasks, such as speech perception. To investigate multisensory temporal processing deficits in ASD and their links to speech processing, the current study mapped performance on a number of multisensory temporal tasks (with both simple and complex stimuli) onto the ability of individuals with ASD to perceptually bind audiovisual speech signals. High-functioning children with ASD were compared with a group of typically developing children. Performance on the multisensory temporal tasks varied with stimulus complexity for both groups; less precise temporal processing was observed with increasing stimulus complexity. Notably, individuals with ASD showed a speech-specific deficit in multisensory temporal processing. Most importantly, the strength of perceptual binding of audiovisual speech observed in individuals with ASD was strongly related to their low-level multisensory temporal processing abilities. Collectively, the results represent the first to illustrate links between multisensory temporal function and speech processing in ASD, strongly suggesting that deficits in low-level sensory processing may cascade into higher-order domains, such as language and communication.
Atypical communicative abilities are a core marker of Autism Spectrum Disorders (ASD). A number of studies have shown that, in addition to auditory comprehension differences, individuals with autism frequently show atypical responses to audiovisual speech, suggesting a multisensory contribution to these communicative differences from their typically developing peers. To shed light on possible differences in the maturation of audiovisual speech integration, we tested younger (ages 6-12) and older (ages 13-18) children with and without ASD on a task indexing such multisensory integration. To do this, we used the McGurk effect, in which the pairing of incongruent auditory and visual speech tokens typically results in the perception of a fused percept distinct from the auditory and visual signals, indicative of active integration of the two channels conveying speech information. Whereas little difference was seen in audiovisual speech processing (i.e., reports of McGurk fusion) between the younger ASD and TD groups, there was a significant difference at the older ages. While TD controls exhibited an increased rate of fusion (i.e., integration) with age, children with ASD failed to show this increase. These data suggest arrested development of audiovisual speech integration in ASD. The results are discussed in light of the extant literature and necessary next steps in research.
Children with autism may have difficulties in audiovisual speech perception, which has been linked to speech perception and language development. However, little has been done to examine children with Asperger syndrome as a group on tasks assessing audiovisual speech perception, despite this group's often greater language skills. Samples of children with autism, Asperger syndrome, and Down syndrome, as well as a typically developing sample, were presented with an auditory-only condition, a speech-reading condition, and an audiovisual condition designed to elicit the McGurk effect. Children with autism demonstrated unimodal performance at the same level as the other groups, yet showed a lower rate of the McGurk effect compared with the Asperger, Down and typical samples. These results suggest that children with autism may have unique intermodal speech perception difficulties linked to their representations of speech sounds. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
The theory of mind account of autism has been remarkably successful in making specific predictions about the impairments in socialization, imagination and communication shown by people with autism. It cannot, however, explain either the non-triad features of autism, or earlier experimental findings of abnormal assets and deficits on non-social tasks. These unexplained aspects of autism, and the existence of autistic individuals who consistently pass false belief tasks, suggest that it may be necessary to postulate an additional cognitive abnormality. One possible abnormality - weak central coherence - is discussed, and preliminary evidence for this theory is presented.
Autistic children individually matched for mental age with normal subjects were tested on memory for unfamiliar faces and on lip reading ability. The results show that autistic children are poorer than controls in memory for faces but comparable to controls in lip-reading. Autistic children show little influence on their auditory speech perception from visual speech. The results are discussed in relation to Bruce and Young's (1986) model of face recognition. The independence between facial speech and memory for faces is in accordance with this model but is only observed in autistic subjects.
This study examined unisensory and multisensory speech perception in 8-17 year old children with autism spectrum disorders (ASD) and typically developing controls matched on chronological age, sex, and IQ. Consonant-vowel syllables were presented in visual only, auditory only, matched audiovisual, and mismatched audiovisual ("McGurk") conditions. Participants with ASD displayed deficits in visual only and matched audiovisual speech perception. Additionally, children with ASD reported a visual influence on heard speech in response to mismatched audiovisual syllables over a wider window of time relative to controls. Correlational analyses revealed associations between multisensory speech perception, communicative characteristics, and responses to sensory stimuli in ASD. Results suggest atypical speech perception is linked to broader behavioral characteristics of ASD.