OBJECTIVES/AIMS: 1. To test the adequacy of a nonverbal social cognition task (Comic Strips Task – CST) to assess social cognition in high-functioning autism adults (HFAA); 2. To assess the adequacy of the CST under EEG monitoring for collection of event-related potentials (ERPs) in HFAA.
METHODS: Social cognition was assessed in a group of male HFAA and adult healthy controls (HC) using the CST, a verbal Theory of Mind (ToM) task loading on attribution of intentions (Hinting Task – HT) and an emotion perception task (Reading the Mind in the Eyes Revised Adult Version - RMET-RAV). We also assessed cognitive ability using the Hopkins Verbal Learning Test (HVLT) and the Trail Making Test (TMT-A and TMT-B). Wechsler Adult Intelligence Scale scores were available for HFAA. The CST protocol was performed under EEG monitoring for collection of ERPs.
RESULTS: We assessed 16 HFAA (mean age ± standard deviation: 24.7±2.6) and 30 HC (29.7±6.3; P=0.212 for age difference between groups). Compared to HC, HFAA performed significantly worse on the CST (proportion of correct answers in the attribution of intentions part: 75.4%±8.3% vs. 86.5%±9.6%; P=0.014) and RMET-RAV (score [0-36]: 24.0±2.9 vs. 26.4±2.9; P=0.03). HFAA performed marginally worse than controls on the HT (score [0-20]: 15.8±2.3 vs. 17.5±1.1; P=0.055). We found no significant differences between HFAA and HC on TMT-A, TMT-B or HVLT. For the full sample, performance on the CST correlated significantly with performance on the HT (Kendall’s tau: r=0.317; P=0.012) and with TMT-A processing speed (r=-0.359; P=0.003). No significant correlations were found between performance on the CST and RMET-RAV, HVLT and TMT-B. In HFAA, no correlation was found between performance on the CST and verbal IQ. The ERPs protocol was feasible in both groups.
CONCLUSIONS: CST has good convergent validity with a verbal and more widely used ToM paradigm, the HT. Moreover, it is more sensitive to social cognition deficits in cognitively able adults than the HT, and showed good discriminant validity in relation to a non-ToM social cognition task (RMET). Moreover, performance on the CST proved to be independent of verbal intelligence, making it an ideal tool to assess ToM in verbally and cognitively apt HFAA, with the added value of allowing for the simultaneous collection of electrophysiological biomarkers like ERPs.