Relações entre características do autismo, variáveis emocionais e o processamento olfativo na população geral

Although altered sensory processing is recognized as a key-feature of Autism Spectrum Disorder (henceforth “autism”), olfactory functioning is still poorly understood in this condition. Considering the role of olfaction in human social communication and well-being, it is crucial to investigate which variables are related to the often-observed inconsistent results concerning olfactory functioning in autism. Study of the expression of autism traits and other autism-related variables in the general population may be useful to understand which specific dimensions are related to the often-observed symptoms, alterations, and heterogeneity in the autism spectrum, including in the olfactory domain. The present work sought to contribute to the multidimensional assessment of anxiety and autism traits in adults of the general population, as well as to the understanding of the multivariate relationships between autism characteristics, olfactory processing, anxiety, and alexithymia. Study 1 and Study 2 aimed to extend the available evidence about the psychometric properties of the State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) and the Autism Spectrum Quotient (AQ). Results supported the adequacy of both instruments to measure anxiety and autism traits, respectively, in a multidimensional perspective. Consistent with the literature, Study 1 found support for a four-factor, as well as a two-factor structure within the state and traits forms of the STICSA. Moreover, measurement invariance across sex groups, and good nomological validity were also supported for the STICSA. Results also suggested that the cognitive and somatic dimensions of trait anxiety, as measured by the STICSA, are differently related with the subjective and psychophysiological responses in distinct emotional contexts. Results of Study 2 further supported a three-factor structure of the AQ, consistent with previous studies, as well as the role of alexithymia, particularly difficulties in identifying feelings, as a mediator of the relationship between autism traits and trait anxiety. Study 3 analyzed the impact of the social skills and attention to detail dimensions of autism traits, and cognitive/somatic trait anxiety, on the olfactory abilities of the general population. Results emphasized the roles of sex, attention to detail and trait-somatic anxiety as significant predictors of odor discrimination abilities. Finally, Study 4 provided an integrative review about olfactory processing in autism and how advancing research in this area may benefit the knowledge and practice regarding social cognition and behavior in autism. The findings of this research highlight the need to explore the distinct dimensions of autism-related variables to better understand their complex relationships and impact in the functioning of the spectrum, including in olfactory functioning.Embora alterações no processamento sensorial sejam uma característica-chave da Perturbação do Espetro do Autismo (daqui em diante “autismo”), o funcionamento olfativo ainda é pouco compreendido nesta condição. Considerando o papel do olfato na comunicação, interação social e bem-estar, é crucial investigar que variáveis estão relacionadas com os resultados inconsistentes frequentemente observados no âmbito do processamento olfativo no autismo. Estudar a expressão de traços de autismo na população geral, bem como a expressão multidimensional de outras variáveis relacionadas, pode ser útil para compreender que dimensões estão relacionadas com os sintomas, alterações e heterogeneidade frequentemente observados no autismo, incluindo no domínio olfativo. O presente trabalho pretendeu contribuir para a avaliação multidimensional da ansiedade e de traços de autismo em adultos da população geral, bem como para uma melhor compreensão da relação multivariada entre as características do autismo, processamento olfativo, ansiedade e alexitimia. O Estudo 1 e o Estudo 2 tiveram como objetivo estender a evidência disponível sobre as propriedades psicométricas do State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) e do Autism Spectrum Quotient (AQ). Os resultados suportaram a adequação de ambos os instrumentos para medir ansiedade e traços de autismo, respetivamente, numa perspetiva multidimensional. Em linha com a literatura, o Estudo 1 providenciou suporte para uma estrutura de quatro fatores, bem como para uma estrutura de dois fatores dentro das dimensões de ansiedade traço e estado do STICSA. Observou-se ainda invariância fatorial considerando a variável sexo, assim como boa validade nomológica. Os resultados também sugeriram que as dimensões cognitivas e somáticas da ansiedade traço, medidas pelo STICSA, estão relacionadas de forma distinta com as respostas subjetiva e psicofisiológica em diferentes contextos emocionais. Os resultados do Estudo 2, de modo consistente com estudos anteriores, suportaram uma estrutura de três fatores do AQ, bem como o papel da alexitimia, particularmente das dificuldades em identificar sentimentos e emoções, como mediadora da relação entre traços de autismo e ansiedade traço. O Estudo 3 analisou o impacto das dimensões de traços de autismo relacionadas com as capacidades sociais e atenção para os detalhes, e da ansiedade traço cognitiva/somática, nas capacidades olfativas da população geral. Os resultados evidenciaram o papel das variáveis sexo, atenção para os detalhes e ansiedade traço somática como preditores significativos da capacidade de discriminação olfativa. Por fim, o Estudo 4 apresentou uma revisão integrativa sobre o processamento olfativo no autismo, e como o avanço da investigação nesta área pode beneficiar o conhecimento e a prática no âmbito da cognição e comportamento social. Os resultados desta investigação destacam a importância de explorar as diferentes dimensões das variáveis relacionadas com o autismo para melhor compreender a complexidade das suas relações e impacto no funcionamento do espetro, incluindo no que diz respeito ao funcionamento olfativo.Programa Doutoral em Psicologi

Influences of Autism Spectrum Disorder on Sensory and Emotional Responses to Smell and Taste Cues

Autism spectrum disorder (ASD) is a developmental disability that causes social, communication, behavioral and sensory challenges. The prevalence has been on a rise, with the latest reports stating 1 in 59 children is diagnosed with ASD. These challenges play a significant role in feeding behavior, leading to reduced nutrition among individuals. Much research in this field has been attributed to children, however, this study was focused on the adult population, in an attempt to improve their quality of life. Building on previous findings and knowledge gaps, the objectives of this thesis were two-fold: To better understand the sensory experiences of adults with ASD and their responses toward food and beverages and 2) to determine whether ASD influences sensory and emotional responses to smell and taste stimuli. Participants with ASD reported abnormal and non-uniform sensory experiences, which combined with environmental factors, influenced their food choices and eating behavior. Odor identification and odor discrimination ability were reduced in adults with autism, as compared to their control counterparts. Additionally, the taste identification ability of adults with autism was also reduced. The perception of odors, in terms of arousal and intensity also differs among the two groups. Increased sensitivity to sweet taste and decreased liking of sour taste was observed. It seemed that both odors and tastes with a sour quality were perceived as more intense by the test group. Moreover, the emotions evoked by taste solutions differed among the two groups, people with ASD reported a lesser number of emotion attributes evoked by tastes and a higher number of negative emotions for sweet and sour tastes. In conclusion, ASD affects the olfactory and taste abilities of people. Keywords: Autism spectrum disorder, Sensory perception, Emotion, Eating behavior, Sensitivity

Odor Perception in Children with Autism Spectrum Disorder and its Relationship to Food Neophobia

Atypical sensory functioning in Autism Spectrum Disorder (ASD) has been well documented in the last decade for the visual, tactile and auditory systems, but olfaction in ASD is still understudied. The aim of the present study was to examine whether children with ASD and neuro-typically (NT) developed children differed in odor perception, at the cognitive (familiarity and identification ability), sensorimotor (olfactory exploration) and affective levels (hedonic evaluation). Because an important function of the sense of smell is its involvement in eating, from food selection to appreciation and recognition, a potential link between odor perception and food neophobia was also investigated. To these ends, 10 children between 6 and 13 years old diagnosed with ASD and 10 NT control children were tested. To compare performance, 16 stimuli were used and food neophobia was assessed by the parents on a short food neophobia scale. Results revealed that (i) significant hedonic discrimination between attractive and aversive odors was observed in NT (p=0.005; d=2.378) and ASD children (p=0.042; d=0.941), and (ii) hedonic discrimination level was negatively correlated with food neophobia scores in ASD (p=0.007) but not NT children. In conclusion, this study offers new insights into odor perception in ASD children, highlighting a relationship between odor hedonic reactivity and eating behavior. This opens up new perspectives on both (i) the role of olfaction in the construction of eating behavior in ASD children, and (ii) the measurement and meaning of food neophobia in this population

Perception visuelle et olfactive chez les enfants avec un trouble du spectre de l'autisme:: implications sur l'acceptation des aliments

La construction du comportement alimentaire est parfois compliquée : 13 à 50% des enfants au développement typique (DT) présentent des problèmes alimentaires. Cette proportion pourrait être de plus de 80 voire 90% des enfants avec un trouble du spectre de l’autisme (TSA). Différentes études font état d’un lien entre les particularités sensorielles et la présence de problèmes alimentaires chez ces enfants. Cette thèse de doctorat vise ainsi à mieux comprendre en quoi les particularités perceptives (vue et odorat) des enfants avec un TSA influencent leur acceptation d’un aliment. Le premier objectif de cette thèse était d’établir un lien, et de le caractériser, entre les particularités perceptives (vue et odorat) et le comportement alimentaire chez les enfants avec un TSA. Nos résultats montrent qu’ils se distinguent des enfants au DT dans la façon dont ils explorent les stimuli, ces différences dépendent de la nature (visuelle ou olfactive) des stimuli. Les enfants avec un TSA attribuent aussi des valences hédoniques plus basses aux stimuli a priori plaisants, et ce, plus significativement pour la modalité visuelle. Finalement, le jugement hédonique est associé au degré de néophobie chez les enfants avec un TSA, ce qui n’est pas le cas chez les enfants au DT. Le second objectif était d’évaluer les effets d’une familiarisation olfactive sur l’agrément intrinsèque d’une odeur et sur l’appréciation d’un aliment porteur de cette dimension par les enfants avec un TSA. Nos résultats montrent une augmentation de l’expression émotionnelle positive pour l’odeur familiarisée. Nous avons observé aussi que deux tiers des enfants, notamment ceux qui ont le plus de particularités sensorielles, choisissent l’aliment porteur de cette odeur lors du choix alimentaire. Le dernier objectif de cette thèse était de prendre en compte le point de vue des enfants avec un TSA en leur donnant la parole et de le mettre en dialogue avec les résultats issus des neurosciences. Nos observations relèvent la pertinence d’une posture de recherche et/ou d’accompagnement dialogique pour permettre la construction de savoirs sur l’alimentation. Nos études soulignent l’importance de prendre en compte le profil perceptif propre aux enfants avec un TSA lors de la conception d’outils pédagogiques pour accompagner la construction du comportement alimentaire.The development of eating behaviour is sometimes complicated: 13% to 50% of typically developing (TD) children display feeding problems. In children with Autism Spectrum Disorder (ASD), this figure could be above 80% or even 90%. A number of studies have established a link between sensory particularities and the presence of eating problems in these children. This doctoral thesis, therefore, aims to better understand the extent to which perceptual particularities (visual and olfactory) in children with ASD influence their acceptance of a particular food. The first objective of this thesis was to establish and describe a link between perceptual particularities (visual and olfactory) and eating behaviour in children with ASD. Firstly, our results show that they differ from TD children in the way they explore these stimuli, with these differences depending on the nature of the stimuli. Secondly, they attribute a lower valence to stimuli which are, in principle, pleasant. This was particularly true of visual stimuli. Finally, there is a link between hedonic judgement and the degree of neophobia in children with ASD. This is not the case in TD children. The second objective was to evaluate the effects of olfactory familiarisation on the valence of an odour and on the appreciation of food which carries this odour by children with ASD. Our results show an increase in positive emotional expression relating to the odour which has been familiarised. We also observed that two thirds of the children, notably those with the most sensory particularities, chose the food that carried this odour when given a choice of food. The final objective of this thesis was to consider the perspectives of children with ASD and to compare them with results obtained in neuroscience. Our observations highlight the relevance of establishing a dialogical research and/or support approach that allows children and researcher to build and develop knowledge of food and eating. Our studies underline the importance of considering the perceptual profiles of children with ASD when designing educational tools to support eating behaviour development.Die Entwicklung des Ernährungsverhaltens ist mitunter schwierig: Bei 13 bis 50 Prozent aller Kinder mit typischer Entwicklung (TE) treten Ernährungsprobleme auf. Bei Kindern mit einer Autismus-Spektrum-Störung (ASS) könnte dieser Anteil sogar 80 bis 90 Prozent betragen. In verschiedenen Studien wurde ein Zusammenhang zwischen den sensorischen Besonderheiten und dem Auftreten von Ernährungsproblemen bei diesen Kindern festgestellt. Die vorliegende Doktorarbeit untersucht, inwiefern die perzeptiven Besonderheiten (Gesichts- und Geruchssinn) von Kindern mit einer ASS deren Akzeptanz eines Lebensmittels beeinflusst. Hauptziel der Arbeit war es, einen Zusammenhang zwischen den perzeptiven Besonderheiten (Gesichts- und Geruchssinn) und dem Ernährungsverhalten bei Kindern mit einer ASS herzustellen und zu beschreiben. Unsere Ergebnisse zeigen, dass diese sich von TE-Kindern zunächst durch die Art und Weise unterscheiden, in der sie die Reize erforschen, und zwar abhängig von der Art der Reize. Des Weiteren geben sie Reizen, die eigentlich angenehm sind, eine niedrigere hedonische Valenz, und zwar mit höherer Signifikanz den visuellen Reizen. Schliesslich ist bei Kindern mit einer ASS das Werturteil mit dem Grad der Neophobie verknüpft, was bei TE-Kindern nicht der Fall ist. Zum Zweiten sollte die Auswirkung eines olfaktiven Vertrautmachens auf die hedonische Valenz eines Geruchs und die Beurteilung eines mit diesem behafteten Lebensmittel durch Kinder mit einer ASS eingeschätzt werden. Unsere Ergebnisse zeigen eine Verstärkung der positiven emotionalen Expression bei vertrauten Gerüchen. Ebenso beobachteten wir, dass zwei Drittel der Kinder, vor allem diejenigen mit den meisten sensorischen Besonderheiten, bei der Essenswahl das Lebensmittel mit diesem Geruch auswählen. Das dritte Ziel dieser Arbeit bestand darin, die eigene Sichtweise der Kinder mit einer ASS zu berücksichtigen, indem sie befragt und ihre Aussagen den neurowissenschaftlichen Erkenntnissen gegenübergestellt werden. Unsere Beobachtungen beruhen auf dem Ansatz einer dialogischen Forschung bzw. Begleitung, der es ermöglichen soll, einen Wissensschatz um die Ernährung aufzubauen. Unsere Untersuchungen unterstreichen, wie wichtig es ist, bei der Erstellung von Lehrmitteln das spezifische Wahrnehmungsprofil von Kindern mit einer ASS zu berücksichtigen, um die Entwicklung des Ernährungsverhaltens zu begleiten

Application of Supervised Machine Learning for Behavioral Biomarkers of Autism Spectrum Disorder Based on Electrodermal Activity and Virtual Reality

[EN] Objective: Sensory processing is the ability to capture, elaborate, and integrate information through the five senses and is impaired in over 90% of children with autism spectrum disorder (ASD). The ASD population shows hyper¿hypo sensitiveness to sensory stimuli that can generate alteration in information processing, affecting cognitive and social responses to daily life situations. Structured and semi-structured interviews are generally used for ASD assessment, and the evaluation relies on the examiner¿s subjectivity and expertise, which can lead to misleading outcomes. Recently, there has been a growing need for more objective, reliable, and valid diagnostic measures, such as biomarkers, to distinguish typical from atypical functioning and to reliably track the progression of the illness, helping to diagnose ASD. Implicit measures and ecological valid settings have been showing high accuracy on predicting outcomes and correctly classifying populations in categories. Methods: Two experiments investigated whether sensory processing can discriminate between ASD and typical development (TD) populations using electrodermal activity (EDA) in two multimodal virtual environments (VE): forest VE and city VE. In the first experiment, 24 children with ASD diagnosis and 30 TDs participated in both virtual experiences, and changes in EDA have been recorded before and during the presentation of visual, auditive, and olfactive stimuli. In the second experiment, 40 children have been added to test the model of experiment 1. Results: The first exploratory results on EDA comparison models showed that the integration of visual, auditive, and olfactive stimuli in the forest environment provided higher accuracy (90.3%) on sensory dysfunction discrimination than specific stimuli. In the second experiment, 92 subjects experienced the forest VE, and results on 72 subjects showed that stimuli integration achieved an accuracy of 83.33%. The final confirmatory test set (n = 20) achieved 85% accuracy, simulating a real application of the models. Further relevant result concerns the visual stimuli condition in the first experiment, which achieved 84.6% of accuracy in recognizing ASD sensory dysfunction. Conclusion: According to our studies¿ results, implicit measures, such as EDA, and ecological valid settings can represent valid quantitative methods, along with traditional assessment measures, to classify ASD population, enhancing knowledge on the development of relevant specific treatments.This work was supported by the Spanish Ministry of Economy, Industry, and Competitiveness-funded project Immersive Virtual Environment for the Evaluation and Training of Children with Autism Spectrum Disorder: T Room (IDI-20170912) and by the Generalitat Valenciana-funded project REBRAND (PROMETEU/2019/105).Alcañiz Raya, ML.; Chicchi-Giglioli, IA.; Marín-Morales, J.; Higuera-Trujillo, JL.; Olmos-Raya, E.; Minissi, ME.; Teruel García, G.... (2020). Application of Supervised Machine Learning for Behavioral Biomarkers of Autism Spectrum Disorder Based on Electrodermal Activity and Virtual Reality. 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Characterisation of physiological responses to odours in autism spectrum disorders: a preliminary study

Abnormal sensory perception is among the earliest symptoms of autism spectrum disorders (ASD). Despite mixed findings, olfactory perception seems to be altered in ASD. There is also evidence that automatic responses to odours can serve as biomarkers of ASD. However, this potential use of odour-based biomarkers for ASD is still underexplored. In this study, we aimed to investigate whether physiological responses to social and non-social odours, measured with electrocardiography (ECG) and facial electromyography (EMG), can be used to characterise and predict ASD in adults. For that, we extracted 32 signal features from a previously collected database of 11 adults with ASD and 48 adults with typical development (TD). Firstly, non-parametric tests were performed, showing significant differences between the ASD and the TD groups in 10 features. Secondly, a k-nearest-neighbour classifier with a leave-one-out strategy was employed, obtaining an F1-score of 67%. Although caution is needed due to the small sample size, this study provides preliminary evidence supporting the use of physiological responses to social and non-social odours as a potential diagnostic tool for ASD in adults.This work is also funded by national funds, European Regional Development Fund, FSE through COMPETE2020, through FCT, in the scope of the framework contract foreseen in the numbers 4, 5, and 6 of the article 23, of the Decree-Law 57/2016, of August 29, changed by Law 57/2017, of July 19.publishe

Machine Learning and Virtual Reality on Body Movements¿ Behaviors to Classify Children with Autism Spectrum Disorder

[EN] Autism spectrum disorder (ASD) is mostly diagnosed according to behavioral symptoms in sensory, social, and motor domains. Improper motor functioning, during diagnosis, involves the qualitative evaluation of stereotyped and repetitive behaviors, while quantitative methods that classify body movements' frequencies of children with ASD are less addressed. Recent advances in neuroscience, technology, and data analysis techniques are improving the quantitative and ecological validity methods to measure specific functioning in ASD children. On one side, cutting-edge technologies, such as cameras, sensors, and virtual reality can accurately detect and classify behavioral biomarkers, as body movements in real-life simulations. On the other, machine-learning techniques are showing the potential for identifying and classifying patients' subgroups. Starting from these premises, three real-simulated imitation tasks have been implemented in a virtual reality system whose aim is to investigate if machine-learning methods on movement features and frequency could be useful in discriminating ASD children from children with typical neurodevelopment. In this experiment, 24 children with ASD and 25 children with typical neurodevelopment participated in a multimodal virtual reality experience, and changes in their body movements were tracked by a depth sensor camera during the presentation of visual, auditive, and olfactive stimuli. The main results showed that ASD children presented larger body movements than TD children, and that head, trunk, and feet represent the maximum classification with an accuracy of 82.98%. Regarding stimuli, visual condition showed the highest accuracy (89.36%), followed by the visual-auditive stimuli (74.47%), and visual-auditive-olfactory stimuli (70.21%). Finally, the head showed the most consistent performance along with the stimuli, from 80.85% in visual to 89.36% in visual-auditive-olfactory condition. The findings showed the feasibility of applying machine learning and virtual reality to identify body movements' biomarkers that could contribute to improving ASD diagnosis.This work was supported by the Spanish Ministry of Economy, Industry, and Competitiveness funded project "Immersive virtual environment for the evaluation and training of children with autism spectrum disorder: T Room" (IDI-20170912) and by the Generalitat Valenciana funded project REBRAND (PROMETEO/2019/105). Furthermore, this work was co-founded by the European Union through the Operational Program of the European Regional development Fund (ERDF) of the Valencian Community 2014-2020 (IDIFEDER/2018/029).Alcañiz Raya, ML.; Marín-Morales, J.; Minissi, ME.; Teruel Garcia, G.; Abad, L.; Chicchi-Giglioli, IA. (2020). 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Superior identification of component odours in a mixture is linked to autistic traits in children and adults.

Most familiar odours are complex mixtures of volatile molecules which the olfactory system automatically synthesises into a perceptual whole. However, odours are rarely encountered in isolation, thus the brain must also separate distinct odour objects from complex and variable backgrounds. In vision, autistic traits are associated with superior performance in tasks that require focus on the local features of a perceptual scene. The aim of the present study was to determine whether the same advantage was observed in the analysis of olfactory scenes. To do this, we compared the ability of (i) Forty young adults (aged 16-35) with high (n=20) and low levels of autistic traits and, (ii) Twenty children (aged 7-11), with (n=10) and without an autism spectrum disorder diagnosis, to identify individual odour objects presented within odour mixtures. First, we used a 4-alternative forced choice task to confirm both adults and children were able to reliably identify eight blended fragrances, representing food related odours, when presented individually. We then used the same forced-choice format to test participants' ability to identify the odours when they were combined in either binary or ternary mixtures. Adults with high levels of autistic traits showed superior performance on binary but not ternary mixture trials. While children with an autism spectrum disorder diagnosis outperformed age matched neurotypical peers, irrespective of mixture complexity. These findings indicate, the local processing advantages associated with high levels of autistic traits in visual tasks are also apparent in a task requiring analytical processing of odour mixtures

The Role of Sensorimotor Difficulties in Autism Spectrum Conditions

AbstractIn addition to difficulties in social communication, current diagnostic criteria for autism spectrum conditions (ASC) also incorporate sensorimotor difficulties; repetitive motor movements and atypical reactivity to sensory input (APA, 2013). This paper explores whether sensorimotor difficulties are associated with the development and maintenance of symptoms in ASC. Firstly, studies have shown difficulties coordinating sensory input into planning and executing movement effectively in ASC. Secondly, studies have shown associations between sensory reactivity and motor coordination with core ASC symptoms, suggesting these areas each strongly influence the development of social and communication skills. Thirdly, studies have begun to demonstrate that sensorimotor difficulties in ASC could account for reduced social attention early in development, with a cascading effect on later social, communicative and emotional development. These results suggest that sensorimotor difficulties not only contribute to non-social difficulties such as narrow circumscribed interests, but also to the development of social behaviours such as effectively coordinating eye contact with speech and gesture, interpreting others’ behaviour and responding appropriately. Further research is needed to explore the link between sensory and motor difficulties in ASC, and their contribution to the development and maintenance of ASC