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Brief Report: Assessment of the Social-Emotional Profile in Children with Autism Spectrum Disorders using a Novel Comic Strip Task

Abstract

This study investigated whether the novel Comic Strip Task (CST) could be used to detect Theory-of-Mind impairments (ToM) in 4- to 8-year-old children with high functioning Autism Spectrum Disorders (ASD). Twelve children with either high-functioning autism or Asperger’s Disorder and 12 typically-developing children completed the 21-item measure. The overall CST demonstrated moderate internal consistency but the Belief-understanding subscale was excluded from the test due to poor reliability. As predicted, the ASD group performed significantly more poorly than controls on the overall 2-subscale CST and on the intention-understanding subscale. No group differences were found in emotion-understanding subscale performance. Controlling for age, verbal ability was positively correlated with overall CST performance across groups. CST performance in the ASD group positively correlated with parent-reports of communication difficulties. Despite some limitations with the belief-understanding subscale, the CST has promising psychometric features warranting further development of this measure.

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Acknowledgments

We would like to thank the participants and their families for their generous participation in this study.

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Correspondence to Nicole J. Rinehart.

Appendices

Appendix 1: Control Emotion-Recognition Images

 

figure a

Appendix 2: Instructions for CST administration

Today I am going to show you some pictures (these are the control emotion images to be administered prior to the comic strips in the following order:)

  • Happy

  • Angry

  • Sad

  • Surprised

  • Worried/Scared

  • Confused

First, I am going to show you some pictures of children, one at a time, and I would like you to tell me how you think each child is feeling.

Example 1: Look at this picture. This child is smiling and is feeling happy (point to picture).

Example 2: Now look at this picture. How do you think this child feels?

Feedback: No feedback about whether response was right or wrong. Move on to the next image after reinforcing the response. e.g. Well done!

Continue for the other 5 emotions.

Now we are going to do something different. I am going to show you some pictures that tell a story about some children. I will show you three pictures for each story, one at a time, and I want you to decide what is happening in the story. I will show you two more pictures and I would like you to pick which picture should be the ending of the story.

Would you like to ask me anything?

Example 1: Now look at this story (show first 3 pictures). In this story, the child is picking shells on the beach. He sees something in the sand and runs to see what it is. He picks it up and finds out that it’s just an old shoe (point to each picture as described). Now look at these two pictures (show two endings). In this ending, the child throws the shoe into the water (point to picture). In this ending, the child throws the shoe into the bin (point to picture). I want you choose one of these two pictures to tell me what happens next in this story.

Feedback: Well done.

Example 2: Now look at this story (show first 3 pictures of another control scenario). What do you think happens next? (Show the 2 options)

Feedback: Good job!

Would you like to ask me anything before we look at the next story?

Scenarios 3–21(begin with Emotions, followed by Beliefs and lastly Intentions): Now look at this story (show first 3 pictures). What do you think happens next? (show two options)

Feedback: Good!

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Sivaratnam, C.S., Cornish, K., Gray, K.M. et al. Brief Report: Assessment of the Social-Emotional Profile in Children with Autism Spectrum Disorders using a Novel Comic Strip Task. J Autism Dev Disord 42, 2505–2512 (2012). https://doi.org/10.1007/s10803-012-1498-8

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Keywords

  • Theory of Mind
  • Early to middle childhood
  • Belief understanding
  • Intention understanding
  • Emotion understanding