Persons with autism spectrum conditions (ASDs) have skill deficits in facial identity and facial emotion recognition. For example, we recently showed that the time spent examining the eye region of the face by persons with an ASD distinguished them from a matched control group with %100 accuracy. Moreover, using fMRl we have shown that the function of 'fusiform face area' is abnormally hypo-active in persons with an ASD. The hypoactivation of the fusiform gyrus is, in fact, the most well replicated finding in the neuroimaging literature on autism, with at least 4 independent studies confirming it. Importantly, the degree of hypoactivation is also strongly predictive of the degree of social deficit (this relationship is not mediated by subject task performance during the fMRI). In addition, we now have fMRl data showing that persons with an ASD exhibit less activity in a cortical region specialized for decoding facial expressions (the superior temporal sulcus), and in the amygdala. A next logical step in this line of work is to test the plasticity of these brain areas by systematically training persons with autism and related conditions on a curriculum of face and facial expression computer games. Prior work with perceptual expertise training in typical persons has demonstrated that this approach can increase activation in a specialized region of the fusiform gyrus. This suggests that an intervention program for persons with an ASD may be able to normalize activations in these areas. We propose to use a computerized game platform, "Lets Face It!", in a randomized intervention trial (6 months in duration) for 63 children with an ASD in comparison to a matched group of 63 persons with an ASD in a delayed intervention group. This will be a multi-site trial at Yale University, Oberlin College and the Delaware Autism Program. Sixty of the participants will have pre- and post fMRl and eye tracking studies, in addition to a core battery of face and social skills assessments. We aim to test the effectiveness of a training curriculum based on "Lets Face It!" for improving (1) facial identity skills, (2) facial expression skills and (3) general social skills. In addition, we predict that a systematic training program will increases activation of the fusiform face area, the superior temporal sulcus region associated with facial expressions, and the amygdala.
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