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The Relationship Between Auditory Processing and Restricted, Repetitive Behaviors in Adults with Autism Spectrum Disorders

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Abstract

Current views suggest that autism spectrum disorders (ASDs) are characterised by enhanced low-level auditory discrimination abilities. Little is known, however, about whether enhanced abilities are universal in ASD and how they relate to symptomatology. We tested auditory discrimination for intensity, frequency and duration in 21 adults with ASD and 21 IQ and age-matched controls. Contrary to predictions, there were significant deficits in ASD on all acoustic parameters. The findings suggest that low-level auditory discrimination ability varies widely within ASD and this variability relates to IQ level, and influences the severity of restricted and repetitive behaviours (RRBs). We suggest that it is essential to further our understanding of the potential contributing role of sensory perception ability on the emergence of RRBs.

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Abbreviations

ASDs:

Autism spectrum disorders

RRBs:

Restricted and repetitive behaviours

SRBI:

Stereotyped behaviours and restricted interests

ADT:

Auditory discrimination task

ADOS:

Autism diagnostic observation schedule

VIQ:

Verbal intelligence

PIQ:

Performance intelligence

FIQ:

Full scale intelligence

2IFC:

Two-interval forced-choice

TYP:

Typical group

MMN:

Mismatch negativity

MMF:

Magnetic mismatch field

References

  • Abrahams, B. S., & Geschwind, D. H. (2008). Advances in autism genetics: On the threshold of a new neurobiology. Nature Reviews Genetics, 9(5), 341–355. doi:10.1038/nrg2346.

    Article  PubMed Central  PubMed  Google Scholar 

  • Alcántara, J. I., Cope, T. E., Cope, W., & Weisblatt, E. J. (2012). Auditory temporal-envelope processing in high-functioning children with autism spectrum disorder. Neuropsychologia, 50(7), 1235–1251. doi:10.1016/j.neuropsychologia.2012.01.034.

    Article  PubMed  Google Scholar 

  • Alcántara, J. I., Weisblatt, E. J. L., Moore, B. C. J., & Bolton, P. F. (2004). Speech-in-noise perception in high-functioning individuals with autism or Asperger’s syndrome. Journal of Child Psychology and Psychiatry, 45(6), 1107–1114. doi:10.1111/j.1469-7610.2004.t01-1-00303.x.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association, A. P. A. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: APA.

    Google Scholar 

  • American Psychiatric Association, A. P. A. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Book  Google Scholar 

  • Asperger, H. (1944). Autistischen Psychopathen. Kindesalter, Archiv fur Psychiatrie und Nervenkrankheiten, 117, 76–136.

    Article  Google Scholar 

  • Baranek, G. T., Foster, L. G., & Berkson, G. (1997). Tactile defensiveness and stereotyped behaviors. American Journal of Occupational Therapy, 51, 91–95. doi:10.5014/ajot.51.2.91.

    Article  PubMed  Google Scholar 

  • Bertone, A., Mottron, L., Jelenic, P., & Faubert, J. (2005). Enhanced and diminished visuo-spatial information processing in autism depends on stimulus complexity. Brain, 128(10), 2430–2441. doi:10.1093/brain/awh561.

    Article  PubMed  Google Scholar 

  • Bodfish, J., Symons, F., Parker, D., & Lewis, M. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237–243. doi:10.1023/A%3A1005596502855.

    Article  PubMed  Google Scholar 

  • Bogdashina, O. (2003). Sensory perceptual issues in autism and Asperger syndrome. London: Jessica Kingsley Publishers.

    Google Scholar 

  • Bonnel, A.-M., & Haftser, E. (1998). Divided attention between simultaneous auditory and visual signals. Perception and Psychophysics, 60(2), 179–190. doi:10.3758/BF03206027.

    Article  PubMed  Google Scholar 

  • Bonnel, A., McAdams, S., Smith, B., Berthiaume, C., Bertone, A., Ciocca, V., et al. (2010). Enhanced pure-tone pitch discrimination among persons with autism but not Asperger syndrome. Neuropsychologia, 48(9), 2465–2475. doi:10.1016/j.neuropsychologia.2010.04.020.

    Article  PubMed  Google Scholar 

  • Bonnel, A., Mottron, L., Peretz, I., Trudel, M., Gallun, E., & Bonnel, A.-M. (2003). Enhanced pitch sensitivity in individuals with autism: A signal detection analysis. Journal of Cognitive Neuroscience, 15(2), 226–235. doi:10.1162/089892903321208169.

    Article  PubMed  Google Scholar 

  • Boyd, B. A., Baranek, G. T., Sideris, J., Poe, M. D., Watson, L. R., Patten, E., et al. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research. doi:10.1002/aur.124.

    PubMed Central  PubMed  Google Scholar 

  • Boyd, B. A., McBee, M., Holtzclaw, T., Baranek, G. T., & Bodfish, J. W. (2009). Relationships among repetitive behaviors, sensory features, and executive functions in high functioning autism. Research in Autism Spectrum Disorders, 3(4), 959–966. doi:10.1016/j.rasd.2009.05.003.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ceponiene, R., Lepisto, T., Shestakova, A., Vanhala, R., Alku, P., & Yaguchi, K. (2003). Speech–sound-selective auditory impairment in children with autism: They can perceive but do not attend. Proceedings of the National Academy of Sciences of the United States of America, 100(9), 5567–5572. doi:10.1073/pnas.0835631100.

    Article  PubMed Central  PubMed  Google Scholar 

  • Chen, Y.-H., Rodgers, J., & McConachie, H. (2009). Restricted and repetitive behaviours, sensory processing and cognitive style in children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(4), 635–642. doi:10.1007/s10803-008-0663-6.

    Article  PubMed  Google Scholar 

  • Coull, J. T., Cheng, R.-K., & Meck, W. H. (2011). Neuroanatomical and neurochemical substrates of timing. Neuropsychopharmacology, 36(1), 3–25. doi:10.1038/npp.2010.113.

    Article  PubMed Central  PubMed  Google Scholar 

  • Coull, J. T., Nazarian, B., & Vidal, F. (2008). Timing, storage, and comparison of stimulus duration engage discrete anatomical components of a perceptual timing network. Journal of Cognitive Neuroscience, 20(12), 2185–2197. doi:10.1016/j.neuroimage.2006.02.036.

    Article  PubMed  Google Scholar 

  • Dahlgren, O. S., & Gillberg, C. (1989). Symptoms in the first two years of life. European Archives of Psychiatry and Neurological Sciences, 238(3), 169–174. doi:10.1007/BF00451006.

    Article  PubMed  Google Scholar 

  • Dunlap, G., Dyer, K., & Koegel, R. L. (1983). Autistic self-stimulation and intertrial interval duration. American Journal of Mental Deficiency, 88(2), 194–202.

    PubMed  Google Scholar 

  • Ferri, R., Elia, M., Agarwal, N., Lanuzza, B., Musumeci, S. A., & Pennisi, G. (2003). The mismatch negativity and the P3a components of the auditory event-related potentials in autistic low-functioning subjects. Clinical Neurophysiology, 114(9), 1671–1680. doi:10.1016/S1388-2457(03)00153-6.

    Article  PubMed  Google Scholar 

  • Frith, U., & Baron-Cohen, S. (1987). Perception in autistic children. In S. Baron-Cohen (Ed.), Handbook of autism and pervasive developmental disorders (pp. 85–102).

  • Gabriels, R. L., Agnew, J. A., Miller, L. J., Gralla, J., Pan, Z., Goldson, E., et al. (2008). Is there a relationship between restricted, repetitive, stereotyped behaviors and interests and abnormal sensory response in children with Autism Spectrum Disorders? Research in Autism Spectrum Disorders, 2(4), 660–670. doi:10.1016/j.rasd.2008.02.002.

    Article  Google Scholar 

  • Gal, E., Dyck, M. J., & Passmore, A. (2002). Sensory differences and stereotyped movements in children in autism. Behaviour Change, 31(6), 921–934. doi:10.1375/bech.19.4.207.

    Google Scholar 

  • Gomot, M., Bernard, F. A., Davis, M. H., Belmonte, M. K., Ashwin, C., Bullmore, E. T., et al. (2006). Change detection in children with autism: An auditory event-related fMRI study. NeuroImage, 29(2), 475–484. doi:10.1016/j.neuroimage.2005.07.027.

    Article  PubMed  Google Scholar 

  • Gomot, M., Blanc, R., Clery, H., Roux, S., Barthelemy, C., & Bruneau, N. (2011). Candidate electrophysiological endophenotypes of hyper-reactivity to change in autism. Journal of Autism and Developmental Disorders, 41(6), 705–714. doi:10.1007/s10803-010-1091-y#page-1.

    Article  PubMed  Google Scholar 

  • Gomot, M., Giard, M. H., Adrien, J. L., Barthelemy, C., & Bruneau, N. (2002). Hypersensitivity to acoustic change in children with autism: Electrophysiological evidence of left frontal cortex dysfunctioning. Psychophysiology, 39, 577–584. doi:10.1111/1469-8986.3950577.

    Article  PubMed  Google Scholar 

  • Groen, W. B., Orsouw, L., Huurne, N. T., Swinkels, S., Gaag, R.-J., Buitelaar, J. K., et al. (2009). Intact spectral but abnormal temporal processing of auditory stimuli in autism. Journal of Autism and Developmental Disorders, 39(5), 742–750. doi:10.1007/s10803-008-0682-3.

    Article  PubMed  Google Scholar 

  • Haesen, B., Boets, B., & Wagemans, J. (2011). A review of behavioural and electrophysiological studies on auditory processing and speech perception in autism spectrum disorders. Research in Autism Spectrum Disorders, 5(2), 701–714. doi:10.1016/j.rasd.2010.11.006.

    Article  Google Scholar 

  • Heaton, P., Williams, K., Cummins, O., & Happé, F. (2008). Autism and pitch processing splinter skills: A group and subgroup analysis. Autism, 12(2), 203–219. doi:10.1177/1362361307085270.

    Article  PubMed  Google Scholar 

  • Hermelin, B., & O’Connor, N. (1970). Psychological experiments with autistic children. Oxford: Pergamon Press.

    Google Scholar 

  • Jeste, S. S., & Nelson, C. A, I. I. I. (2008). Event related potentials in the understanding of autism spectrum disorders: An analytical review. Journal of Autism and Developmental Disorders, 39(3), 495–510. doi:10.1007/s10803-008-0652-9.

    Article  PubMed  Google Scholar 

  • Jones, C. R. G., Happé, F., Baird, G., Simonoff, E., Marsden, A. J. S., Tregay, J., et al. (2009). Auditory discrimination and auditory sensory behaviours in autism spectrum disorders. Neuropsychologia, 47(13), 2850–2858. doi:10.1016/j.neuropsychologia.2009.06.015.

    Article  PubMed  Google Scholar 

  • Jones, R. G. C., & Jahanshahi, M. (2009). The substantia nigra, the basal ganglia, dopamine and temporal processing. In G. Giovanni, V. Di Matteo, & E. Esposito (Eds.), Journal of Neural Transmission. Supplementa (Vol. 73, pp. 161–171). Vienna: Springer. doi:10.1007/978-3-211-92660-4_13.

  • Jones, C. R. G., & Jahanshahi, M. (2014). Contributions of the basal ganglia to temporal processing: Evidence from Parkinson’s disease. Timing & Time Perception, 2(1), 87–127. doi:10.1163/22134468-00002009.

    Article  Google Scholar 

  • Kamner, C., Verbaten, N. M., Cuperus, M. J., Camfferman, G., & van Engeland, H. (1995). Auditory event-related brain potentials in autistic children and three different control groups. Society of Biological Psychiatry, 38, 150–165. doi:10.1016/0006-3223(94)00247-Z.

    Article  Google Scholar 

  • Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217–250.

    Google Scholar 

  • Karmiloff-Smith, A. (2009). Nativism versus neuroconstructivism: Rethinking the study of developmental disorders. Developmental Psychology, 45(1), 56–63. doi:10.1037/a0014506.

    Article  PubMed  Google Scholar 

  • Kasai, K., Hashimoto, O., Kawakubo, Y., Yumoto, M., Kamio, S., Itoh, K., et al. (2005). Delayed automatic detection of change in speech sounds in adults with autism: A magnetoencephalographic study. Clinical Neurophysiology, 116(7), 1655–1664. doi:10.1016/j.clinph.2005.03.007.

    Article  PubMed  Google Scholar 

  • Khalfa, S., Bruneau, N., Rogé, B., Georgieff, N., Veuillet, E., Adrien, J.-L., et al. (2004). Increased perception of loudness in autism. Hearing Research, 198(1–2), 87–92. doi:10.1016/j.heares.2004.07.006.

    Article  PubMed  Google Scholar 

  • Kujala, T., Kuuluvainen, S., Saalasti, S., Jansson-Verkasalo, E., von Wendt, L., & Lepisto, T. (2010). Speech-feature discrimination in children with Asperger syndrome as determined with the multi-feature mismatch negativity paradigm. Clinical Neurophysiology, 121(9), 1410–1419. doi:10.1016/j.clinph.2010.03.017.

    Article  PubMed  Google Scholar 

  • Kujala, T., Lepisto, T., & Näätänen, R. (2013). The neural basis of aberrant speech and audition in autism spectrum disorders. Neuroscience and Biobehavioral Reviews, 37(4), 697–704. doi:10.1016/j.neubiorev.2013.01.006.

    Article  PubMed  Google Scholar 

  • Kwakye, L. D., Foss-Feig, J. H., Cascio, C. J., Stone, W. L., & Wallace, M. T. (2011). Altered auditory and multisensory temporal processing in autism spectrum disorders. Frontiers in Integrative Neuroscience, 4(129), 1–11. doi:10.3389/fnint.2010.00129.

    Google Scholar 

  • Landa, R., & Garrett-Mayer, E. (2006). Development in infants with autism spectrum disorders: A prospective study. Journal of Child Psychology and Psychiatry, 47(6), 629–638. doi:10.1111/j.1469-7610.2006.01531.x.

    Article  PubMed  Google Scholar 

  • Langen, M., Kas, M. J. H., Staal, W. G., van Engeland, H., & Durston, S. (2011). The neurobiology of repetitive behavior: Of mice. Neuroscience and Biobehavioral Reviews, 35, 356–365. doi:10.1016/j.neubiorev.2010.02.004.

    Article  PubMed  Google Scholar 

  • Leek, R. M. (2001). Adaptive procedures in psychophysical research. Perception and Psychophysics, 63(8), 1279–1292. doi:10.3758/BF03194543.

    Article  PubMed  Google Scholar 

  • Leekam, R. S., Prior, M., & Uljarević, M. (2011). Restricted and repetitive behaviours in autism spectrum disorders: A review of research in the last decade. Psychological Bulletin, 137(4), 562–593. doi:10.1037/a0023341.

    Article  PubMed  Google Scholar 

  • Leong, V., Hämäläinen, J., Soltész, F., & Goswami, U. (2011). Rise time perception and detection of syllable stress in adults with developmental dyslexia. Journal of Memory and Language, 64(1), 59–73. doi:10.1016/j.jml.2010.09.003.

    Article  Google Scholar 

  • Lepistö, T., Kajander, M., Vanhala, R., Alku, P., Huotilainen, M., Näätänen, R., et al. (2008). The perception of invariant speech features in children with autism. Biological Psychology, 77(1), 25–31. doi:10.1016/j.biopsycho.2007.08.010.

    Article  PubMed  Google Scholar 

  • Lepistö, T., Kuitunen, A., Sussman, E., Saalasti, S., Jansson-Verkasalo, E., Nieminen-von Wendt, T., et al. (2009). Auditory stream segregation in children with Asperger syndrome. Biological Psychology, 82(3), 301–307. doi:10.1016/j.biopsycho.2009.09.004.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lepistö, T., Kujala, T., Vanhala, R., Alku, P., Huotilainen, M., & Näätänen, R. (2005). The discrimination of and orienting to speech and non-speech sounds in children with autism. Brain Research, 1066(1–2), 147–157. doi:10.1016/j.brainres.2005.10.052.

    Article  PubMed  Google Scholar 

  • Lepistö, T., Silokallio, S., Nieminen-von Wendt, T., Alku, P., Näätänen, R., & Kujala, T. (2006). Auditory perception and attention as reflected by the brain event-related potentials in children with Asperger syndrome. Clinical Neurophysiology, 117(10), 2161–2171. doi:10.1016/j.clinph.2006.06.709.

    Article  PubMed  Google Scholar 

  • Levitt, H. (1971). Transformed up–down methods in psychoacoustics. Journal of the Acoustical Society of America, 49, 467–477. doi:10.1121/1.1912375.

    Article  PubMed  Google Scholar 

  • Lidstone, J., Uljarević, M., Sullivan, J., Rodgers, J., McConachie, H., Freeston, M., et al. (2014). Relations among restricted and repetitive behaviors, anxiety and sensory features in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 8(2), 82–92. doi:10.1016/j.rasd.2013.10.001.

    Article  Google Scholar 

  • Lockwood, H. A., Salvi, J. R., Coad, L. M., Arnold, A. S., Wack, S. D., Murphy, W. B., et al. (1999). The functional anatomy of the normal human auditory system: Responses to 0.5 and 4.0 kHz tones at varied intensities. Oxford Journals, 9(1), 65–76. doi:10.1093/cercor/9.1.65.

    Google Scholar 

  • Loftin, R. L., Odom, S. L., & Lantz, J. F. (2008). Social interaction and repetitive motor behaviors. Journal of Autism and Developmental Disorders, 38(6), 1124–1135. doi:10.1007/s10803-007-0499-5.

    Article  PubMed  Google Scholar 

  • López, B. (2013). Beyond modularisation: The need of a socio-neuro-constructionist model of autism. Journal of Autism and Developmental Disorders, 1–11. doi:10.1007/s10803-013-1966-9.

  • Lord, C., Risi, S., Lambrecht, L., Cook, H. E., Leventhal, L. B., et al. (2000). The autism diagnostic observation schedule—Generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30(3), 205–223. doi:10.1023/A%3A1005592401947.

    Article  PubMed  Google Scholar 

  • Marco, J. E., Hinkley, B. N. L., Hill, S. S., & Nagarajan, S. S. (2011). Sensory processing in autism: A review of neurophysiologic findings. Pediatric Research, 69(5), 48R–54R. doi:10.1203/PDR.0b013e3182130c54.

    Article  PubMed Central  PubMed  Google Scholar 

  • Meck, W. H., Penney, T. B., & Pouthas, V. (2008). Cortico-striatal representation of time in animals and humans. Current Opinion in Neurobiology, 18(2), 145–152. doi:10.1016/j.conb.2008.08.002.

    Article  PubMed  Google Scholar 

  • Mongillo, E., Irwin, J., Whalen, D. H., Klaiman, C., Carter, A., & Schultz, R. (2008). Audiovisual processing in children with and without autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(7), 1349–1358. doi:10.1007/s10803-007-0521-y.

    Article  PubMed  Google Scholar 

  • Mottron, L., Dawson, M., Soulières, I., Hubert, B., & Burack, J. (2006). Enhanced perceptual functioning in autism: An update, and eight principles of autistic perception. Journal of Autism and Developmental Disorders, 36(1), 27–43. doi:10.1007/s10803-005-0040-7.

    Article  PubMed  Google Scholar 

  • Nayate, A., Bradshaw, J. L., & Rinehart, N. J. (2005). Autism and Asperger’s disorder: Are they movement disorders involving the cerebellum and/or basal ganglia? Brain Research Bulletin, 67(4), 327–334. doi:10.1016/j.brainresbull.2005.07.011.

    Article  PubMed  Google Scholar 

  • O’Connor, K. (2012). Auditory processing in autism spectrum disorder: A review. Neuroscience and Biobehavioral Reviews, 36(2), 836–854. doi:10.1016/j.neubiorev.2011.11.008.

    Article  PubMed  Google Scholar 

  • O’Riordan, M., & Passetti, F. (2006). Discrimination in autism within different sensory modalities. Journal of Autism and Developmental Disorders, 36(5), 665–675. doi:10.1007/s10803-006-0106-1.

    Article  PubMed  Google Scholar 

  • Ornitz, E. M. (1974). The modulation of sensory input and motor output in autistic children. Journal of Autism and Childhood Schizophenia, 4(3), 197–215. doi:10.1007/BF02115226.

    Article  Google Scholar 

  • Rodgers, J., Glod, M., Connolly, B., & McConachie, H. (2012). The relationship between anxiety and repetitive behaviours in autism spectrum disorder. Journal of Autism and Developmental Disorders, 42(11), 2404–2409. doi:10.1007/s10803-012-1531-y.

    Article  PubMed  Google Scholar 

  • Rosenhall, U., Nordin, V., Sanstrom, M., Ahlsen, G., & Gillberg, C. (1999). Autism and hearing loss. Journal of Autism and Developmental Disorders, 29(5), 349–357. doi:10.1023/A:1023022709710.

    Article  PubMed  Google Scholar 

  • Samson, F., Mottron, L., Jemel, B., Belin, P., & Ciocca, V. (2006). Can spectro-temporal complexity explain the autistic pattern of performance on auditory tasks? Journal of Autism and Developmental Disorders, 36(1), 65–76. doi:10.1007/s10803-005-0043-4.

    Article  PubMed  Google Scholar 

  • Seri, S., Cerquiglini, A., Pisani, F., & Curatolo, P. (1999). Autism in tuberous sclerosis: Evoked potential evidence for a deficit in auditory sensory processing. Clinical Neurophysiology, 100, 1825–1830. doi:10.1016/S1388-2457(99)00137-6.

    Article  Google Scholar 

  • Szelag, E., Kowalska, J., Galkowski, T., & Pöppel, E. (2004). Temporal processing deficits in high-functioning children with autism. British Journal of Psychology, 95(3), 269–282. doi:10.1348/0007126041528167.

    Article  PubMed  Google Scholar 

  • Valla, J. M., & Belmonte, M. K. (2013). Detail-oriented cognitive style and social communicative deficits, within and beyond the autism spectrum: Independent traits that grow into developmental interdependence. Developmental Review, 33(4), 371–398. doi:10.1016/j.dr.2013.08.004.

    Article  Google Scholar 

  • Wechsler, D. (1999). Wechsler abbreviated scale of intelligence. San Antonio, TX: The Psychological Corporation.

    Google Scholar 

  • Willemsen-Swinkels, S. N., Buitelaar, J., Dekker, M., & van Engeland, H. (1998). Subtyping stereotypic behavior in children: The association between stereotypic behavior, mood, and heart rate. Journal of Autism and Developmental Disorders, 28(6), 547–557. doi:10.1023/A%3A1026008313284.

    Article  PubMed  Google Scholar 

  • Williams, D. (1998). Nobody nowhere: The remarkable autobiography of an autistic girl. London: Jessica Kingsley Publishers.

    Google Scholar 

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Acknowledgments

The authors would like to thank all participants that took part in the study, the Autism Research Network, University of Portsmouth and a local support group for adults with autism for their invaluable help. We would also like to acknowledge the four anonymous reviewers for their helpful and constructive comments and suggestions on an earlier version of this manuscript. This project was funded by a doctoral bursary to the first author from the Department of Psychology, University of Portsmouth.

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Kargas, N., López, B., Reddy, V. et al. The Relationship Between Auditory Processing and Restricted, Repetitive Behaviors in Adults with Autism Spectrum Disorders. J Autism Dev Disord 45, 658–668 (2015). https://doi.org/10.1007/s10803-014-2219-2

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