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Citation: Di Renzo M, Bianchi Di Castelbianco F, Petrillo M, Racinaro L, Donaera F and Rea M. The Emotional
Contagion in Children with Autism Spectrum Disorder. Austin J Autism & Relat Disabil. 2016; 2(2): 1020.
Austin J Autism & Relat Disabil - Volume 2 Issue 2 - 2016
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Di Renzo et al. © All rights are reserved
Austin Journal of Autism & Related
Disabilities
Open Access
Abstract
Studies of the last decade have demonstrated that children with Autism
Spectrum Disorder (ASD) showed difculties in language, social and relational
areas, but they had also impairment in the mechanisms of embodied simulation,
namely the imitative behaviors that allow the body to give an experiential
meaning to own and other’s emotions. The identication of this specic emotional
response in ASD children, also dened as emotional contagion, allows to move
the therapeutic focus from reducing the behavioral symptomatic expressions of
the child to promoting the expression of his ability of emotional regulation. The
aim of this study was to investigate the presence of emotional contagion in 53
ASD children aged between 22 and 66 months, through the Test of emotional
contagion and verify the presence of compromised emotional contagion areas.
Our ndings have shown that the severity of the disorder is closely related to
the inability of the child to respond to the emotional stimuli, regardless from
cognitive abilities, and that emotion to which children responded most frequently
was happiness, while the one who responded less was anger.
Keywords: Autism; Autism spectrum; Autism Diagnostic Observation
Schedule (ADOS); Therapeutic efcacy; Developmental approach
for living among people of whom they perceive the intense emotion
without being able to understand it [16-18]. is allows to move the
therapeutic focus from reducing the behavioral symptomatic
expressions of the child to promoting the expression of his emotional
regulation skills [19]. Brazelton and Greenspan [20] argue, in fact,
that children’s emotional relationships are the foundation for the
development of all other representational processes. e block of the
emotional development of children with autism would be at this
archaic level of aective development, that is an area that Stern [21]
denes of aective attunement. e aective attunement is a
prerequisite in order to develop a good enough mother-child
attachment relationship with mirroring and emotional containment
functions that will allow the child to develop as a result the ability to
recognize his own emotions and dierentiate them from those of the
others [22]. e emotional contagion is a primitive form of empathy
and is present in the very early stages of development in which there
is still a distinction between the self and the other. Buhler [23] dened
the emotional contagion with the term of emotional mimicry,
describing it as the correlation between the child and the caregiver in
the rst months of life. Hateld et al. [24] have dened it as the innate
tendency to automatically imitate and synchronize with facial
expressions and thus to converge emotionally. One example is the
fact that during a conversation, people automatically and continuously
mimic and synchronize their movements with facial expressions,
voices, postures, movements, and instrumental behaviors of their
interlocutors. e emotional contagion diers from empathy because
this requires the mediation of cognitive conscious process and
involves the ability to understand what others feel and to attribute
these experiences to others and not to themselves. e emotional
contagion is instead an automatic and precognitive response of
assimilation and introjection of the emotional experiences of the
Abbreviations
ASD: Autism Spectrum Disorder; TCE: Test of Emotional
Contagion; ANOVA: Analysis of Variance; ADOS: Autism Diagnostic
Observation Schedule
Introduction
Not many studies have examined the emotional area in ASD
children, but clear evidence suggests a high level of impairment in the
emotional regulation skills [1-8] as well as diculties in language,
social and relational areas. ese children also showed impairment in
the mechanism of embodied simulation, namely those imitative
behaviors that allow the body to give an experiential meaning to own
and others’ emotions [9-11]. To track down the kind of emotional
response that ASD children are able to put in place is important to
monitor the developmental steps and have indicators that are more
specic on which base the therapeutic intervention”.e underlying
assumption is that in ASD children the primary decit is expected to
lie in the aective area before than in the cognitive [12-14]. Smith [15]
has suggested that there is an imbalance caused by an emotional
overload in contrast to a decit of cognitive strategies in dealing with
the emotional responses, in managing the internal states. is
assumption is the basis of the empathy imbalance hypothesis of
autism [15], which distinguishes the emotional and cognitive
component of empathy and attributes the aective dysregulation of
autistic children to an imbalance between the two. e overload of the
emotional component of empathy, in the absence of mentalizing
ability that can adjust the intensity, implies that the emotional impact
is too intense for ASD children. e autistic behaviors, such as the
avoidance of the gaze, the restricted and repetitive behaviors and the
attention to isolated parts and non-functional objects, are therefore a
defensive reaction to the archaic empathic imbalance, an adaptation
Research Article
The Emotional Contagion in Children with Autism
Spectrum Disorder
Di Renzo M*, Bianchi Di Castelbianco F, Petrillo
M, Racinaro L, Donaera F and Rea M
Institute of Ortofonologia (IdO), Italy
*Corresponding author: Magda Di Renzo, Institute of
Ortofonologia (IdO), Via Salaria 30, Rome, Italy
Received: March 15, 2016; Accepted: May 04, 2016;
Published: May 06, 2016
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other that are experienced as own [25]. According to other authors,
the emotional contagion can be learned within a relationship, such as
the primary, in which parent and child tend to mutually catch their
emotions [26,27]. e emotional contagion and aective attunement
are therefore contiguous and precursors of empathy, resulting in a
multidimensional development process that involves and integrates
the cognitive and aective system [15,28]. In the activation of
empathy is realized an emotional processing, in the experience of
mutual sharing with the other, that through the control of the
executive functions allows to adjust and modulate the emotional
experience, and to explain it rationally aware of the distinction
between own and others experiences [29]. In ASD children, it is
dicult to nd a kind of empathic response, which requires a complex
perceptual, introspective and communicative capacity, but above all
the ability to tolerate a strong emotional-cognitive state, which
highlights the diculties of the autistic child in sensorimotor and
perceptual integration and in the aective regulation [30]. It may be
useful, therefore, to investigate in ASD children, the presence of
emotional contagion as a precursor of the development of empathy.
A neurobiological level, the understanding of the mind and of the
emotional experiences of the other, is supported by the mirror
neurons, which are involved in the perception, understanding and
sharing of feelings and emotions. e mirror system is thus a
neurobiological predisposition favoring the emotional contagion
mechanisms and aective attunement, but that tends to reach its full
operation in the encounter with the other, through the relationship.
Some authors have emphasized a reduced ability to understand and
play actions and emotions when the mirror neuron system is damaged
[31-33], while others have disconrmed this hypothesis [34-36]. In a
study of Hobson and Lee [37] on ASD children, it has been shown
that cognition and decits of the theory of the mind are not the main
problems of these children, but it is the social mirroring, supported
by neural interactions between mirror neurons and limbic system
through the insula, to be compromised. It is as if autistic children had
remained xed at a stage of development that corresponds to six
months of life and, therefore, the dysfunction of the mirror neuron
system would be a consequence of something that happens at a very
early age. A study on the emotional resonance decits in autistic
children [38] showed a depletion in the processing of emotional and
social tasks in the context of imitation. Autistic children namely
would have some diculties to modulate the imitative responses
according to emotional and social cues. e nding of emotional
contagion in ASD children brings new evidence to the hypothesis of
an imitation disease already advanced by Gaddini [39,40]. For this
reason, to detect in ASD children the emotional response given by
emotional contagion may be important not only for research of
empathy precursors, but also for clinical practice, and then in the
choice of therapy. A recent study showed that two years old ASD
children responded signicantly less with emotional contagion
(measured in terms of hedonic tone and latencies in the emotional
response) than the typically developing children or with intellectual
disabilities. ey analyzed the responses of autistic children in
situations where they were elicited positive and negative reactions
(the experimenter opening a gi, or pretending to be injured) and
then was recorded the response showed in the rst 10 seconds. e
authors noted as the lower emotional contagion was also related to
the degree of impairment of social and communication skills of ASD
children. Similarly, at 5 and 8 years of age, ASD children are described
as little able to show adequate and appropriate emotions to
environmental stimuli [41]. In older children (8-13 years) it will
continue to observe the diculty of emotional contagion to specic
emotional expressions, such as anger and joy [42]. ese results
suggest the importance, from a clinical point of view, to consider the
impact that reduced emotional response can have on people with
whom the child relates; when the child does not show emotional
contingent and appropriate reactions, the adult who is with him
hardly understand the inner state and is likely to express, through
time, less emotional responses. Currently, there are very few works on
emotional contagion in ASD children and this is probably due to the
fact that the present assessment in clinical and research tools are not
very suited to clinical populations in which cognitive functioning and
language are deeply compromised. Typically, these tests provide for
the recognition of faces in photographs and / or videos in which
actors interpret their emotions as a result of micro events or short
stories. ey assume, therefore, that language is present and that
there is an adequate reading of the context in which emotions are
expressed. Finally, the response required by this type of testing is
oen verbal, that is little suited to the assessment of very young
children and/or with a severe autism spectrum disorder in absence of
language. In this work we investigated the presence of emotional
contagion in ASD children through a direct assessment with a
recently published instrument (TCE, Test of Emotional Contagion)
[43].
e objectives of this research are the following:
1. Verify the eect that the severity of autistic symptoms assessed
with the ADOS-2 scores and classications has on the emotional
contagion responses.
2. Identify the emotional contagion areas that are more or less
compromised.
3. Verify the correlation of the emotional responses of children
with the intelligence level (IQ) and the ADOS 2 areas (Social Aection
and Repetitive and Restricted Behaviors).
Method
Participants
e sample is composed of 53 children aged 22 to 66 months.
e children were divided according to age and ADOS-2 categories:
children with severe autistic symptoms over 30 months of age (AUT),
children with autism spectrum disorder diagnosis over 30 months
of age (SpD) and children at risk of autism under 30 months of age
(RISK). e RISK group consists of 2 children at Risk 1 (mild), 4
children at Risk 2 (moderate) and 13 children at Risk 3 (severe). 51
children in the sample are characterized by absence of spontaneous
speech and 2 children have simple nuclear sentences with poor
grammatical structure. e overall sample is composed of children
coming from Italy for the 92.5%, from Eastern Europe for the 1.9%,
from Asia for the 3.7% and from Africa for the 1.9%. e 58.5%
of the sample has at least one sibling and, of these, the 25.8% have
one sibling with problems (2 children have a sibling with autism, 4
children have a sibling with other kind of developmental delay and 2
children have a twin with typical development).
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Procedure
Participants were recruited from the Institute of Ortofonologia
(IdO) in the period that goes from January 2014 to December 2015.
e IdO works in agreement with the National Health System and
follows the procedures for taking charge of children and their families
according to the treatment plan established by the Regional Health
Agency.
e diagnosis of infantile autism of the children included in the
research was made by a group of experts with at least 10 years of
experience (psychologists/psychotherapist, neurologists, psychiatrist,
speech therapists and occupational therapists) according to the
DSM-5 criteria [44] and then conrmed by the administrations of the
Autism Diagnostic Observation Schedule- Second edition (ADOS-2)
[45,46]. Experts involved in the assessment are not the same as those
involved in therapy and in clinical work. is research meets the APA
ethical guidelines. Children with neurological disorders were not
included in the research, as well as children with sensory disabilities,
and children over 72 months or under 21 months. is research
met the ethical guidelines and legal requirements of the country in
which it was conducted. e research also complied with the ethical
standards of the American Psychiatric Association (APA). All subject
gave written informed consent in accordance with the Declaration of
Helsinki.
Instruments
Test for Emotional Contagion (TCE)
e TCE [43] enables the evaluation of the emotional contagion,
from both a quantitive and qualitative point of view, that is the
presence or absence of aective attunement in the child, through
the observation of his emotional and behavioral response while
facing a structured stimulus (video). e child is presented 4 video
recordings in which a child with typical development expresses in
nonverbal ways the four basic emotions: happiness, sadness, fear and
anger. Each video has a duration of 43 seconds (23 seconds is the
time during which the child expresses each single emotion, and then
20 seconds is the period during which the video darkens). For each
emotion presented, the observer codies on the protocol the absence
or presence of the expressive mimic reproductions corresponding to
the emotion stimulus and the relative body and behavioral responses
of the child. e codifying protocol is made of ve sections, four of
which are constituted by the graphical representation on which mark
the facial expression of each emotion and by the check list of 16
body expressions that allow a quantitative analysis of the emotional
contagion answers. e h section consists of the coding summary
that allows a global qualitative assessment of the emotional contagion
answers. e checklist of the four sections allows to notice if the
child reproduces the motor pattern of the emotion observed, if he
participates actively, if comments verbally or vocalizes, if reproduces
the intonation of the emotion, if he shows postural alterations, if the
child approaches the observer, or if he approaches the video or retreats
from it, if he starts stereotypies, if he ignores the video and so on. Each
response is considered as absent if the child does not reproduce the
motor pattern of the emotion and it is evaluated with 0; the response
is considered present if the child reproduces the motor pattern of the
emotion and it can be evaluated with 1, 2 or 3. It is scored with 1,
that is principle of emotional contagion, when there is one emotional
contagion response and 3/4 of hints of the stimulus reproduction; it
is scored with 2, that is emotional contagion, when there are from
2 to 4 responses of emotional contagion; it is scored with 3, that is
empathy, when the child recognizes the emotions and diers from his
own. Furthermore, the test is used to dene whether the child shows
veridical empathy or almost-egocentric empathy (Homan, 1987).
e rst assumes the dierentiation between the self and the other. In
the quasi-egocentric empathy, even though there is the recognition of
each emotion, the process of separation between the self and the other
is not complete, so the child does not dierentiate.
Autism diagnostic observation schedule, Second edition
All participants completed the ADOS-2 [45,46]. ADOS-2 is
a semi-structured, standardized assessment of communication,
social interaction, play, and restricted and repetitive behaviours.
It is considered the gold standard in research protocols and is the
most commonly used standardized diagnostic measure. It has strong
psychometric properties, including reliability and validity. e
ADOS-2 includes ve modules, each requiring just 40 to 60 minutes
to administer. e child evaluated is administered only one module,
selected on the basis of his or her expressive language level and
chronological age:
Toddler Module: for children between 12 and 30 months of age
who do not consistently use phrase speech. e Toddler Module is
designed specically for children who do not consistently use phrase
speech. is Module accurately identify toddlers at risk for ASD.
Module 1: for children 31 months and older who do not
consistently use phrase speech.
Module 2: for children of any age who use phrase speech but are
not verbally uent.
Module 3: for verbally uent children and young adolescents.
Module 4: for older verbally uent adolescents and adults.
In Modules from 1 to 4, algorithm scores are compared with cuto
scores to yield one of three classications: Autism, Autism Spectrum,
and No-spectrum. In the Toddler Module, algorithms yield “ranges
of concern” rather than classication scores. For modules from 1 to
4, the Comparison Scores, on a scale from 1 to 10, allow to compare
the overall level of symptoms related to the autistic child’s spectrum
with that shown by individuals diagnosed with Autism Spectrum
Disorder of same age and level of language skills. ADOS-2 scores
combine symptoms from the Social Aect (SA) and Restricted and
Repetitive Behaviors (RRB) domains. e Social Aect (SA) includes
the evaluation of aspects related to communication and reciprocal
social interaction. In Restricted and Repetitive Behaviors fall unusual
sensory interests, mannerisms, repetitive behaviors and interests, and
the stereotyped-idiosyncratic use of words and /or vocalizations. To
the behaviors of dierent areas is given a score of increasing severity
(0, 1, 2). e cut-o for the ADOS-2 classications vary according to
the module used and to the child’s language level.
Cognitive assessment
e Leiter International Performance Scale–Revised (Leiter–R)
[47] is a battery of individually, nonverbally administered subtests
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designed to assess cognitive functions in children, adolescents and
young adults aged 2 years 0 months, to 20 years 11 months. It is widely
used to measure nonverbal intelligence by assessing uid reasoning
and visualization, as well as memory and attention. e scale has
good evidence of validity from content analysis studies with data
from extensive item analyses, from criterion-related studies, from the
accuracy of classication of intellectual disabilities, and from various
studies related to the construct. e IQ scores had a mean of 100 and
a standard deviation of 15. Intellectual disability is indicated by a
composite score that deviates two standard deviation or more below
the mean, so the score 70 is the borderline value.
Data Analysis
Analyses were using the Statistical Package for Social Sciences
(SPSS) version 19. Significance level was set at alpha 0.05 (two-tailed).
Chi-squared analyses were conducted to examine group dierences
in demographic variables between the categorical variables and
Multivariate Analysis of Variance (MANOVA) was used to evaluate
dierences between groups on TCE subscales. Eect sizes were
reported as partial eta squared (ηp
2), A ηp
2 of 0.02 was considered a
small eect size, 0.13 a medium eect size and 0.23 a large eect size
[48]. Correlation analysis was performed to analyze the relationship
between emotional contagion, social aection, restricted and
repetitive behavior and cognitive development.
Results
Descriptive statistics
Table 1 describes the characteristics of the sample. e three
groups were identied according to the ADOS-2 classication. All
children under 30 months of age were evaluated with the Toddler
Module; 32 children over 30 months of age were assessed with
Module 1 and 2 children with Module 2. e three groups did not
dier with respect to gender; the AUT and SpD groups did not dier
with respect to mean age; the RISK and SpD groups have a similar
average IQ score, signicantly higher than AUT group.
Differences between subgroups in emotional contagion
e Analysis of the Univariate Variance (ANOVA) revealed no
signicant eect of variables such as gender (F1,52 = 1.85, P = 0.18),
chronological age (F2,52 = 1:37; P = 0.26), cognitive level (F1, 52 =
3.22, P = 0.08), and the presence of problematic siblings (F1,52 =
0.02, P = 0.92) on the emotional contagion capacity. However, the
symptom severity measured by the ADOS-2 aected the emotional
contagion (F2,52 = 7.12, P <.01, ηp
2 = .22), in fact AUT and RISK
groups have shown TCE scores signicantly lower than the SpD
group (Tuckey test: P <.01) (see Figure 1).
Moreover, as shown in Figure 2, the 25% (6 of 24) of AUT
children did not show emotional contagion, the 33% (8 of 24) of
them presented a principle of emotional contagion, the 42% (10 of
24) showed the emotional contagion, while no AUT child showed
empathy. e 21% (4 of 19) of RISK children showed no emotional
contagion, the 21% (4 of 19) of them presented a principle of
emotional contagion, the 53% (10 of 19) showed emotional contagion
and the 5% showed empathy (1 of 19; specically, it is a child at Risk
1, who aer two years of treatment is out of the ADOS-2 diagnosis
of autism). e 70% (7 of 10) of the SPD children showed emotional
contagion and the 30% (3 of 10) showed empathy (none of them has
absent or principle of emotional contagion).
Differences between groups in the responses to the
individual emotions
We also analyzed the frequencies of children who responded
or did not respond to the dierent types of emotions of TCE. We
have found that the children of the AUT group were easily more
AUT
(N = 24) SpD
(N = 10) RISK
(N = 19) Statistics
Male/female 16/8 9/1 16/3 Chi square = 3.2; p = .20
Age in months (mean, SD)
Range in months 40.5 (7.9)
31-61 43.1 (10.8)
32-66 25.6 (1.8)
22-30 F = 28.1; p = .01
AUT and SpD > RISK
IQ scores (mean, SD) 58.2 (14.3) 80.0 (21.3) 78.9 (17.4) F = 9.9; p = .01
RISK and SpD > AUT
ADOS-2 scores (mean, SD)
Toddler Module (N = 19)
Module 1 (N = 32)
Module 2 (N = 2)
16.5 (5.4)
17.7 (5.0)
7.5 (0.7)
Table 1: Sample Charateristics.
AUT: Children with autism; SpD: Children with spectrum disorder; RISK: Children less than 30 months at risk of autism; IQ score: Full-scale intelligence quotient.
,0
,5
1,0
1,5
2,0
2,5
AUT RISK SpD
TCE scores
Figure 1: Differences between groups in TCE scores.
AUT: Children with autism; SpD: Children with spectrum disorder; RISK:
Children less than 30 months at risk of autism.
0
10
20
30
40
50
60
70
80
AUT RISK SpD
% of TCE type responses
absent principle of contagion presence of contagion empathy
Figure 2: Type of TCE responses showed by the children of AUT, RISK and
SpD groups.
AUT: Children with autism; SpD: Children with spectrum disorder; RISK:
Children less than 30 months at risk of autism.
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contaminated by emotions of happiness and sadness, and less by fear
and anger (Chi-squared = 14.03; P < .005). Instead the children of
RISK and SpD groups showed no signicant dierences in responses
to dierent emotions (RISK: Chi-squared = 7.31; P = .29; SpD:
Chi-squared = 2.86; P = .24). In addition, within AUT group, the
percentage of children who responded to happiness and sadness was
similar to those that do not respond (Happiness: Chi-squared = 2.87;
P = .24; Sadness: Chi-squared = 0.20; P = .90), in fear and anger, the
percentage of children who did not show any emotional contagion
response was signicantly higher than that of children who showed
a response Fear: Chi-squared = 6.30; P < .05; Anger: Chi-squared
= 12.32; P < .01) (see gure 3). Even for RISK group happiness is
the emotion to which responds the most part of the children, but
the types of response are more homogeneous and children respond
similarly to all the emotions (see gure 3). Lastly, the children of the
SpD group respond with emotional contagion mainly to Happiness,
the Fear and Anger (see Figure 3).
Relationship between emotional contagion, Social
affection, Restricted and repetitive behavior and IQ
We have found that even the areas of Social Aection, Restricted
and Repetitive Behaviors and the Comparison Score measured by the
ADOS-2, are negatively correlated to emotional contagion. Instead,
the emotional contagion was not related to IQ (see Table 2).
Differences in social affection and restricted and repetitive
behaviors of children with or without emotional contagion
MANOVA was conducted to evaluate the eect of group variable
(AUT vs RISK vs SpD) and of TCE variable (presence vs absence of
contagion) on aection and restricted and repetitive behaviors. e
children of the AUT and RISK groups without emotional contagion
obtained higher scores (indicative of most disorder) than AUT and
RISK groups with emotional contagion on Social Aection (Wilks’s
lambda = 0.58, P <.01, ηp
2 = .24; Tukey test: P < 0.05). ere were no
children in SpD group without emotional contagion. Moreover, the
AUT Group showed more restricted and repetitive behaviors than
other groups, independently of the presence of emotional contagion
(Tukey test: P < 0.05). Within the RISK group, children with
emotional contagion show similar scores to those without contagion
on restricted and repetitive behaviors (Tukey test: P < 0.05). Figure 4
Discussion
Regarding the rst objective of this research, namely to verify the
Figure 3: Percentages of AUT, RISK and SpD children showing emotional
contagion in TCE. * P < .01.
SA RRB CS IQ TCE
ADOS-2 total score .95** .70** .91** -.36* -.52**
SA .43* .84** -.28* -.48**
RRB .73 -.41* -.42*
CS -.39* -.61**
IQ .25
Table 2: Correlation between TCE, ADOS-2 subscales and QI scores.
TCE: Test for Emotional Contagion; SA: Social Affect impairment; RRBL:
Restricted and Repetitive Behaviors; CS: Comparison Score; IQ: Intelligence
Quotient. * P < .01; ** P < .001.
Figure 4: Presence and Absence of emotional contagion and differences
between groups on Social Affection and on restricted and repetitive
behaviours. * P < .01; ** P < .001.
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eect of the severity of autistic disorder, as measured by the ADOS-2,
the presence of emotional response checked by the TCE, the results
showed a signicant correlation. is means that the severity of the
disorder is closely related to the inability of the child to respond to
emotional stimuli. Taking into account the three subgroups, the
AUT, the RISK, and the SpD in fact show that children of AUT and
RISK groups obtained TCE lower scores, compared with the SpD
group. Empathy is never present in the AUT group and is present in
one child of the RISK group, while it is present in the 30% of children
of the SpD group. As for the emotional contagion, it is present in
the 42% of children of the AUT group, in the 53% of children RISK
group and in 70% of children of the SpD group. ese data allow
to underline that the SpD group show a dierentiated emotional
response, as already said, between empathy (30%) and emotional
contagion (70%). In a previous study we have shown that the best
social and emotional conditions of the children of the SpD group,
measured by ADOS-2 sub-scales, supported by a developmental-
relational therapy, have brought very signicant improvements aer
only two years of treatment [14]. It will be interesting, in a future
research line, to check the predictive value of the presence of emotional
contagion for the purposes of therapeutic prognosis. As for the second
objective, namely to check whether there is a specic response to each
emotion, we found that the emotion that most closely meet children
of all groups is happiness. Specically it highlights the RISK group,
including children under the age of 30 months, a period in which the
disease has not yet taken shape, a greater response homogeneity, with
the present happiness in the 70% of cases and the 3 other emotions
present in 51% of cases. In the AUT group, instead, the greater
response concerns the happiness (52%), while the minor one regards
anger (present in 25%). Sadness and fear were respectively 46% and
32%. In the SpD group, nally, happiness and fear are present in the
80% of the cases, while the sadness standing at 50% to 90% and anger.
As regards, nally, the third objective, namely the correlation of
emotional response with the level of intelligence and the specic
areas evaluated with the ADOS-2 (AS and CRR), no correlations were
evidenced between TCE and IQ. erefore, the emotional response is
independent of the cognitive level, while the IQ is correlated to the
severity of the autistic disorder measured by the ADOS-2. Regarding
the correlation between AS, CRR and TCE, it is interesting to
highlight that the AS is directly connected to the emotional response
in the SpD group, which is characterized by lower presence of CRR,
while in the AUT group the smaller presence of emotional response
corresponds to a greater presence of CRR. is nding supports
the hypothesis of the emotional imbalance of Smith [15], for which
the majority presence of CRR would be the evidence of defensive
attitudes. e result of our study conrm that “the activity, cognitive
capacities, relationship and emotional well-being of ASD children
can be improved by a variety of non verbal, non cognitive activities in
which the therapist who engages sensitively with the individuality of
their impulses and felt experiences, accompanies the autistic children
in the emotions of intimate engagement to more productive and less
defensive state of activity and awareness. is type of relational and
creative therapy, which responds to and guides the primary actions,
interests and feelings of autistic children, much as mother engages her
aections with her animated infant from birth, can benet language
and both social and practical education” [49,50]. is consideration is
strengthened by the fact that the greatest number of answers regards
the emotional stimulus “happiness” in the three groups. In clinical
terms, this translates into the need to oer the child motivating and
engaging situations in a playful condition and absolutely no stress on
the part of caregivers.
Acknowledgement
is article is based on the activities of the Institute of
Ortofonologia (IdO) of Rome. We are grateful to the psychologist,
speech therapist, parents, and children whose participation made this
work possible.
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Citation: Di Renzo M, Bianchi Di Castelbianco F, Petrillo M, Racinaro L, Donaera F and Rea M. The Emotional
Contagion in Children with Autism Spectrum Disorder. Austin J Autism & Relat Disabil. 2016; 2(2): 1020.
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