Emotional Lexicon in Autism Spectrum Disorders: Impact of Emotion Recognition Training with a Serious Game

Research Article

Austin J Autism & Relat Disabil. 2016; 2(1): 1015.

Emotional Lexicon in Autism Spectrum Disorders: Impact of Emotion Recognition Training with a Serious Game

Hun S1,2, Thümmler S1,2, Askenazy F1,2 and Serret S1,2*

1Department of Child and Adolescent Psychiatry, Autism Resources Center, France

2University of Nice Sophia Antipolis, Cognition Behaviour Technology (CoBTek), France

*Corresponding author: Sylvie Serret, University Department of Child and Adolescent Psychiatry, Centre Ressources Autisme, Hôpitaux Pédiatriques de Nice CHU-Lenval, France

Received: January 13, 2016; Accepted: March 15, 2016; Published: March 16, 2016


Introduction: Autism Spectrum Disorders (ASD) are characterized by emotion processing difficulties in several dimensions (emotion recognition, empathy and emotional lexicon). Emotional training programs might have a positive effect on the emotional lexicon which has been described in children with Asperger Syndrome.

JeStiMulE is a serious game designed to teach emotional skills (emotion recognition and emotional lexicon) specifically for children and adolescents with ASD. The aim of the present study was to evaluate the impact of this serious game on the emotional lexicon of a heterogeneous ASD group. We expected that JeStiMulE enriched and diversified the emotional lexicon of children and adolescents with heterogeneous profiles of ASD (wide age range, heterogeneous intellectual, verbal, functioning and academic level).

Methods: Twenty nine children and adolescents with ASD played JeStiMulE on a computer, twice a week for four weeks. Participants were evaluated by means of 3 fluency tasks (emotions, animals, fruits) before and after training. Quantitative (repeated measures ANOVA, post-hoc LSD) and descriptive analyses were conducted on the number of emotional words pronounced by the participants.

Results: Quantitative analyses showed a significant improvement after training for emotional words (p <0.05). Descriptive analyses of after-training emotional words revealed 3 categories: 1) emotional words given before the training, 2) words presented during JeStiMulE, and 3) new emotional words.

Conclusion: JeStiMulE helped to guide the interest of individuals with ASD and different levels of functioning to emotional lexicon used in the serious game but also to new emotional words.

Keywords: Autism; Emotion; Computer-based intervention; Semantic fluency task; Cognition; JeStiMulE


ADI-R: Autism Diagnostic Interview-Revised; ADOS: Autism Diagnostic Observation Schedule; ANOVA: Analysis of variance; AS: Asperger Syndrome; ASD: Autism Spectrum Disorders; DSM-IV-R: Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition; ECOSSE: Epreuve de COmpréhension Syntaxico-SEmantique; IQ: Intelligence Quotient; PDD-NOS: Pervasive Developmental Disorder-Not Otherwise Specified; WASI: Wechsler Abbreviated Scale of Intelligence


Autism Spectrum Disorders (ASD) are characterized by qualitative impairments of social interactions and communication, as well as by repetitive, restricted or stereotyped activities and interests [1]. Social impairment is associated with atypical emotion processing. Individuals with ASD have difficulties to recognize facial emotions [2], whole-body emotional actions [3] and emotions in social scenes [4]. In addition, impairment in ASD has been related to a deficit of empathy [5,6]. Furthermore, emotion recognition and empathy skills, compose with others skills the concept of emotional competence.

Emotional competence is a developmental concept which corresponds to the ability to understand, express and regulate emotions appropriately [7]. This concept comprises several skills, acquired progressively by a child with caregiver support. These skills refer to the ability of a child to recognize his own emotions, those of others and the use of his emotions to interact and adapt to the environment. In addition, emotion recognition and empathy are also related to the use of emotional lexicon skills [8]. The acquisition of each skill is essential for the development of adequate social experience as emotional and social experiences are reciprocally influenced [9,10]. Consequently, the altered acquisition of one capacity, such as the emotional lexicon is likely to have an impact on social development.

In ASD, impairment of the social dimension has consequences for language skills. Indeed, individuals with ASD seem to have difficulties to process words with social components [11]. This is particularly important as affective variables influence word processing [12]. In addition, emotional lexicon has a key role in social development, promoting social interactions and permitting to be socially efficacious [8]. The lack of emotional lexicon can therefore contribute to social impairment. Enriching this lexicon might thus permit to improve the communication of individuals with ASD.

Research about social remediation in ASD focuses on emotion recognition since many years, with some training programs aiming to extend social skills. However, to our knowledge, only one of them has been interested in the emotional lexicon [13]. The Transporters designed by Golan and Baron Cohen’s team is a program developed to teach emotion recognition skills using animated vehicles with real emotional faces. Studies have shown that this program improves emotion recognition [13,14]. Golan et al. [13] evaluated 20 preschooler’s children with ASD before and after training. The training had an impact on their lexicon, showing an improvement after training. However, the children included in this study were diagnosed with Asperger Syndrome (AS) and they had to define predefined words, corresponding to emotional words used in the program. Therefore, the assessment was performed in participants with preserved verbal abilities and concerned only vocabulary of the program.

The originality of our study was to evaluate the improvement of the emotional lexicon after JeStiMulE training [15] in a heterogeneous ASD group. JeStiMulE is a game designed to teach emotional skills to individuals with ASD, independently of their age, intellectual, verbal, functional and academic level. We hypothesized that JeStiMulE would enrich the emotional lexicon of individuals with heterogeneous profiles of ASD. This improvement has been evaluated by means of tasks not related to JeStiMulE in order to extend our knowledge about its ability to increase emotional lexicon of individuals with ASD.

Materials and Methods

The procedure of this study was approved by the local ethical committee (“Comité de Protection des Personnes Sud Méditerranée V”, reference number 11.046). Participants and their parents signed informed consent prior to the study.


Twenty-nine children and adolescents were recruited in four daycare units by the Autism Resource Center PACA, Nice, France. All participants received an ASD diagnosis based on DSM-IV-R criteria for ASD (Diagnostic and Statistical Manual of Mental Diseases, Fourth Edition) [1], as well as on the Autism Diagnostic Interview-Revised (ADI-R) [16] and/or the Autism Diagnostic Observation Schedule (ADOS) [17]. The characteristics of the participants are presented in Table 1. Cognitive abilities were assessed using: 1) Wechsler Abbreviated Scale of Intelligence (WASI) [18] to define IQ; and 2) ECOSSE (Epreuve de COmpréhension Syntaxico-SEmantique) [19] to evaluate the semantic-syntactic level (age). Information about schooling and special care (educative and/or therapeutic) was collected for all participants.