Journal of Autism and Developmental Disorders

, Volume 46, Issue 4, pp 1255–1267 | Cite as

Bimodal Virtual Reality Stroop for Assessing Distractor Inhibition in Autism Spectrum Disorders

  • Thomas D. ParsonsEmail author
  • Anne R. Carlew
Original Paper


Executive functioning deficits found in college students with ASD may have debilitating effects on their everyday activities. Although laboratory studies tend to report unimpaired inhibition in autism, studies of resistance to distractor inhibition reveal difficulties. In two studies, we compared a Virtual Classroom task with paper-and-pencil and computerized Stroop modalities in typically developing individuals and individuals with ASD. While significant differences were not observed between ASD and neurotypical groups on the paper-and-pencil and computerized task, individuals with ASD performed significantly worse on the virtual task with distractors. Findings suggest the potential of the Virtual Classroom Bimodal Stroop task to distinguish between prepotent response inhibition (non-distraction condition) and resistance to distractor inhibition (distraction condition) in adults with high functioning autism.


Virtual reality Autism Neuropsychology Executive functioning Stroop Ecological validity 



The authors wish to thank Dean Klimchuk and Roman Mitura of Digital Media Works (Kenata, ON, Canada) for the use of their virtual classroom. We are also grateful to Dr. Timothy McMahan for his technical support, as well as Kevin Callahan and the Kristin Farmer Autism Center for assistance in recruiting participants. Finally, we wish to acknowledge the young adults who participated in our study for their time and efforts.

Author Contributions

Thomas Parsons led the conceptualization and design of the study, supervised the collection and analyses of the data, drafted the initial manuscript, and revised the manuscript. Anne Carlew collected data and contributed to the data analyses.


  1. Adams, N. C., & Jarrold, C. (2012). Inhibition in autism: Children with autism have difficulty inhibiting irrelevant distractors but not prepotent responses. Journal of Autism and Developmental Disorders, 42, 1052–1063.CrossRefPubMedGoogle Scholar
  2. Adreon, D., & Durocher, J. S. (2007). Evaluating the college transition needs of individuals with high-functioning autism spectrum disorders. Intervention in School and Clinic, 42, 271–279.CrossRefGoogle Scholar
  3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.Google Scholar
  4. An, K. Y., Zakzanis, K. K., & Joordens, S. (2012). Conducting research with non-clinical healthy undergraduates: Does effort play a role in neuropsychological test performance? Archives of Clinical Neuropsychology, 27, 849–857.CrossRefPubMedGoogle Scholar
  5. ANAM Manual. (2007). Automated Neuropsychological Assessment Metrics (Version 4) [Computer software]. Norman, OK: C-SHOP.Google Scholar
  6. Armstrong, C. M., Reger, G. M., Edwards, J., Rizzo, A. A., Courtney, C. G., & Parsons, T. D. (2013). Validity of the virtual reality stroop task (VRST) in active duty military. Journal of Clinical and Experimental Neuropsychology, 35, 113–123.CrossRefPubMedGoogle Scholar
  7. Christ, S. E., Holt, D. D., White, D. A., & Green, L. (2007). Inhibitory control in children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1155–1165.CrossRefPubMedGoogle Scholar
  8. Christ, S. E., Kester, L. E., Bodner, K. E., & Miles, J. H. (2011). Evidence for selective inhibitory impairment in individuals with autism spectrum disorder. Neuropsychology, 25(6), 690–701.CrossRefPubMedGoogle Scholar
  9. CDC. (2014). Prevalence of autism spectrum disorders among children aged 8 years: autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveillance Summaries, 63(2), 1–22.Google Scholar
  10. Cook, J., Swapp, D., Pan, X., Bianchi-Berthouze, N., & Blakemore, S. J. (2014). Atypical interference effect of action observation in autism spectrum conditions. Psychological Medicine, 44, 731–740.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Delis, D. C., Kaplan, E., & Kramer, J. H. (2001). Delis-Kaplan executive function system (D-KEFS). Psychological Corporation.Google Scholar
  12. Díaz-Orueta, U., Garcia-López, C., Crespo-Eguílaz, N., Sánchez-Carpintero, R., Climent, G., & Narbona, J. (2014). AULA virtual reality test as an attention measure: Convergent validity with conners’ continuous performance test. Child Neuropsychology, 20, 328–342.CrossRefPubMedGoogle Scholar
  13. Fleischer, A. S. (2012). Support to students with Asperger syndrome in higher education—the perspectives of three relatives and three coordinators. International Journal of Rehabilitation Research, 35, 54–61.CrossRefPubMedGoogle Scholar
  14. Gelbar, N. W., Smith, I., & Reichow, B. (2014). Systematic review of articles describing experience and supports of individuals with autism enrolled in college and university programs. Journal of Autism and Developmental Disorders, 44, 2593–2601.CrossRefPubMedGoogle Scholar
  15. Geurts, H., Luman, M., & van Meel, C. S. (2008). What’s in a game: The effect of social motivation on interference control in boys with ADHD and autism spectrum disorders. Child Psychology and Psychiatry, 49, 848–857.CrossRefGoogle Scholar
  16. Goldberg, M. C., Mostofsky, S. H., Cutting, L. E., Mahone, E. M., Astor, B. C., Denckla, M. B., & Landa, R. J. (2005). Subtle executive impairment in children with autism and children with ADHD. Journal of Autism and Developmental Disorders, 35, 279–293.CrossRefPubMedGoogle Scholar
  17. Goodwin, M. S. (2008). Enhancing and accelerating the pace of autism research and treatment. Focus on Autism and Other Developmental Disabilities, 23, 125–128.CrossRefGoogle Scholar
  18. Hart, M. (2005). Autism/excel study. In Proceedings of the 7th international ACM SIGACCESS conference on computers and accessibility (pp. 136–141). ACM.Google Scholar
  19. Hendricks, D. R., & Wehman, P. (2009). Transition from school to adulthood for youth with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 24, 77–88.CrossRefGoogle Scholar
  20. Henry, M., Joyal, C. C., & Nolin, P. (2012). Development and initial assessment of a new paradigm for assessing cognitive and motor inhibition: The bimodal virtual-reality Stroop. Journal of Neuroscience Methods, 210, 125–131.CrossRefPubMedGoogle Scholar
  21. Hill, E. L. (2004). Executive dysfunction in autism. Trends in Cognitive Sciences, 8, 26–32.CrossRefPubMedGoogle Scholar
  22. Hill, E. L., & Bird, C. A. (2006). Executive processes in Asperger syndrome: Patterns of performance in a multiple case series. Neuropsychologia, 44, 2822–2835.CrossRefPubMedGoogle Scholar
  23. Iriarte, Y., Diaz-Orueta, U., Cueto, E., Irazustabarrena, P., Banterla, F., & Climent, G. (2012). AULA—advanced virtual reality tool for the assessment of attention: Normative study in Spain. Journal of Attention Disorders. doi: 10.1177/1087054712465335.
  24. Johnson, K. A., Robertson, I. H., Kelly, S. P., Silk, T. J., Barry, E., Dáibhis, A., & Bellgrove, M. A. (2007). Dissociation in performance of children with ADHD and high-functioning autism on a task of sustained attention. Neuropsychologia, 45(10), 2234–2245.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Johnson, D. R., Vincent, A. S., Johnson, A. E., Gilliland, K., & Schlegel, R. E. (2008). Reliability and construct validity of the automated neuropsychological assessment metrics (ANAM) mood scale. Archives of Clinical Neuropsychology, 23, 73–85.CrossRefPubMedGoogle Scholar
  26. Just, M. A., Cherkassky, V. L., Keller, T. A., Kana, R. K., & Minshew, N. J. (2007). Functional and anatomical cortical underconnectivity in autism: Evidence from an FMRI study of an executive function task and corpus callosum morphometry. Cerebral Cortex, 17, 951–961.CrossRefPubMedPubMedCentralGoogle Scholar
  27. Just, M. A., Keller, T. A., Malave, V. L., Kana, R. K., & Varma, S. (2012). Autism as a neural systems disorder: A theory of frontal-posterior underconnectivity. Neuroscience and Biobehavioral Reviews, 36, 1292–1313.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Kipp, K. (2005). A developmental perspective on the measurement of cognitive deficits in attention-deficit/hyperactivity disorder. Biological Psychiatry, 57(11), 1256–1260.CrossRefPubMedGoogle Scholar
  29. Kandalaft, M. R., Didehbani, N., Krawczyk, D. C., Allen, T. T., & Chapman, S. B. (2013). Virtual reality social cognition training for young adults with high-functioning autism. Journal of Autism and Developmental Disorders, 43(1), 34–44.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Lalonde, G., Henry, M., Drouin-Germain, A., Nolin, P., & Beauchamp, M. H. (2013). Assessment of executive function in adolescence: A comparison of traditional and virtual reality tools. Journal of Neuroscience Methods, 219, 76–82.CrossRefPubMedGoogle Scholar
  31. Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2002). Autism diagnostic observation schedule. Los Angeles, CA: Western Psychological Services.Google Scholar
  32. Ozonoff, S. (1995). Reliability and validity of the Wisconsin card sorting test in studies of autism. Neuropsychology, 9, 491.CrossRefGoogle Scholar
  33. Ozonoff, S., & Jensen, J. (1999). Brief report: Specific executive function profiles in three neurodevelopmental disorders. Journal of Autism and Developmental Disorders, 29, 171–177.CrossRefPubMedGoogle Scholar
  34. Ozonoff, S., & Strayer, D. L. (1997). Inhibitory function in nonretarded children with autism. Journal of Autism and Developmental Disorders, 27, 59–77.CrossRefPubMedGoogle Scholar
  35. Parsons, T. D. (2014). Virtual teacher and classroom for assessment of neurodevelopmental disorders. In Technologies of inclusive well-being (pp. 121–137). Springer Berlin Heidelberg.Google Scholar
  36. Parsons, T. D., Bowerly, T., Buckwalter, J. G., & Rizzo, A. A. (2007). A controlled clinical comparison of attention performance in children with ADHD in a virtual reality classroom compared to standard neuropsychological methods. Child Neuropsychology, 13, 363–381.CrossRefPubMedGoogle Scholar
  37. Parsons, S., & Cobb, S. (2011). State-of-the-art of virtual reality technologies for children on the autism spectrum. European Journal of Special Needs Education, 26, 355–366.CrossRefGoogle Scholar
  38. Parsons, T. D., Courtney, C. G., & Dawson, M. E. (2013). Virtual reality Stroop task for assessment of supervisory attentional processing. Journal of Clinical and Experimental Neuropsychology, 35, 812–826.CrossRefPubMedGoogle Scholar
  39. Parsons, S., Leonard, A., & Mitchell, P. (2006). Virtual environments for social skills training: Comments from two adolescents with autistic spectrum disorder. Computers & Education, 47(2), 186–206.CrossRefGoogle Scholar
  40. Parsons, S., & Mitchell, P. (2002). The potential of virtual reality in social skills training for people with autistic spectrum disorders. Journal of Intellectual Disability Research, 46(5), 430–443.CrossRefPubMedGoogle Scholar
  41. Parsons, S., Mitchell, P., & Leonard, A. (2004). The use and understanding of virtual environments by adolescents with autistic spectrum disorders. Journal of Autism and Developmental Disorders, 34, 449–466.CrossRefPubMedGoogle Scholar
  42. Parsons, T. D., Rizzo, A. A., Rogers, S. A., & York, P. (2009). Virtual reality in pediatric rehabilitation: A review. Developmental Neurorehabilitation, 12, 224–238.CrossRefPubMedGoogle Scholar
  43. Pillay, Y., & Bhat, C. S. (2012). Facilitating support for students with asperger’s syndrome. Journal of College Student Psychotherapy, 26, 140–154.Google Scholar
  44. Rajendran, G., Law, A. S., Logie, R. H., Van Der Meulen, M., Fraser, D., & Corley, M. (2011). Investigating multitasking in high-functioning adolescents with autism spectrum disorders using the Virtual Errands Task. Journal of Autism and Developmental Disorders, 41, 1445–1454.CrossRefPubMedGoogle Scholar
  45. Remington, A., Swettenham, J., Campbell, R., & Coleman, M. (2009). Selective attention and perceptual load in autism spectrum disorder. Psychological Science, 20, 1388–1393.CrossRefPubMedGoogle Scholar
  46. Riby, D. M., Brown, P. H., Jones, N., & Hanley, M. (2012). Brief report: Faces cause less distraction in autism. Journal of Autism and Developmental Disorders, 42, 634–639.CrossRefPubMedGoogle Scholar
  47. Robertson, I. H., Manly, T., Andrade, J., Baddeley, B. T., & Yiend, J. (1997). Oops!': Performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia, 35(6), 747–758.CrossRefPubMedGoogle Scholar
  48. Rom, D. M. (1990). A sequentially rejective test procedure based on a modified Bonferroni inequality. Biometrika, 77, 663–665.CrossRefGoogle Scholar
  49. Sasson, N. J., Elison, J. T., Turner-Brown, L. M., Dichter, G. S., & Bodfish, J. W. (2011). Brief report: Circumscribed attention in young children with autism. Journal of Autism and Developmental Disorders, 41(2), 242–247.CrossRefPubMedPubMedCentralGoogle Scholar
  50. Sasson, N. J., Turner-Brown, L. M., Holtzclaw, T. N., Lam, K. S., & Bodfish, J. W. (2008). Children with autism demonstrate circumscribed attention during passive viewing of complex social and nonsocial picture arrays. Autism Research, 1, 31–42.CrossRefPubMedGoogle Scholar
  51. Semrud-Clikeman, M., Walkowiak, J., Wilkinson, A., & Butcher, B. (2010). Executive functioning in children with Asperger syndrome, ADHD-combined type, ADHD predominantly inattentive type, and controls. Journal of Autism and Developmental Disorders, 40, 1017–1027.CrossRefPubMedGoogle Scholar
  52. Shmulsky, S., & Gobbo, K. (2013). Autism spectrum in the college classroom: Strategies for instructors. Community College Journal of Research & Practice, 37, 490–495.CrossRefGoogle Scholar
  53. Strickland, D. (1997). Virtual reality for the treatment of autism. Studies in Health Technology and Informatics, 44, 81–86.PubMedGoogle Scholar
  54. Strickland, D., Marcus, L. M., Mesibov, G. B., & Hogan, K. (1996). Brief report: Two case studies using virtual reality as a learning tool for autistic children. Journal of Autism and Developmental Disorders, 26, 651–659.CrossRefPubMedGoogle Scholar
  55. Thorne, D. R. (2006). Throughput: A simple performance index with desirable characteristics. Behavior Research Methods, 38, 569–573.CrossRefPubMedGoogle Scholar
  56. Trepagnier, C. Y., Sebrechts, M. M., Finkelmeyer, A., Coleman, M., Stewart, W., & Werner-Adler, M. (2005). Virtual environments to address autistic social deficits. Annual Review of CyberTherapy and Telemedicine: A Decade of VR, 3, 101–107.Google Scholar
  57. Wechsler, D. (2001). Wechsler test of adult reading: WTAR. Psychological Corporation.Google Scholar
  58. Wechsler, D., & Hsiao-pin, C. (2011). WASI-II: Wechsler abbreviated scale of intelligence. Pearson.Google Scholar
  59. Wu, D., Lance, B., & Parsons, T. D. (2013). Collaborative filtering for brain-computer interaction using transfer learning and active class selection. PLoS ONE, 8(2), 1–18.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Computational Neuropsychology and Simulation (CNS), Department of PsychologyUniversity of North TexasDentonUSA

Personalised recommendations