Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal
Le bâillement, du réflexe à la pathologie
Le bâillement : de l'éthologie à la médecine clinique
Le bâillement : phylogenèse, éthologie, nosogénie
 Le bâillement : un comportement universel
La parakinésie brachiale oscitante
Yawning: its cycle, its role
Warum gähnen wir ?
Fetal yawning assessed by 3D and 4D sonography
Le bâillement foetal

mystery of yawning 



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mise à jour du
17 avril 2019
Dev Psychopathol. 2019:1-11
 Emotional contagion in children
with autism spectrum disorder
varies with stimulus familiarity
and task instructions
Helt MS, Fein DA, Vargas JE.  


 Tous les articles sur la contagion du bâillement
All articles about contagious yawning
Helt MS, Eigsti IM, Snyder PJ, Fein DA. Contagious yawning in autistic and typical development. Child Dev. 2010;81(5):1620-163
Although deficits in cognitive empathy are well established in individuals with autism spectrum disorder (ASD), the literature on emotional empathy, or emotional contagion, in individuals with ASD is sparse and contradictory.
The authors tested susceptibility to contagious yawning and laughter in children with ASD (n = 60) and typically developing (TD) children (n = 60), ages 5-17 years, under various conditions, to elucidate factors that may affect emotional contagion in these populations.
Although TD children showed equal amounts of emotional contagion across conditions, children with ASD were highly influenced by the familiarity of the target stimulus, as well as task instructions that encourage eye gaze to target. More specifically, children with ASD exhibited less contagious yawning and laughter than their TD peers except when their attention was explicitly directed to the eyes or (and even more so) when their parents served as the stimulus targets. The authors explore the implications of these findings for theories about the mechanisms underlying empathic deficits in ASD as well as the clinical implications of having parents involved in treatment.
Bien que les déficits en empathie cognitive soient bien établis chez les personnes atteintes de troubles du spectre autistique (TSA), la littérature sur l'empathie émotionnelle, ou la contagion émotionnelle, chez les personnes atteintes de TSA est modeste et contradictoire.
Les auteurs ont testé la sensibilité au bâillement et au rire contagieux chez les enfants atteints de TSA (n = 60) et les enfants normaux en croissance (TD) (n = 60 ans) âgés de 5 à 17 ans, dans diverses conditions, afin d'élucider les facteurs pouvant affecter la contagion émotionnelle dans ces populations.
Bien que les enfants TD aient présenté des niveaux égaux de contagion émotionnelle, quelles que soient les conditions, les enfants atteints de TSA étaient fortement influencés par la familiarité du stimulus cible, ainsi que par les instructions de tâches qui désigne le regard à cibler.
Plus spécifiquement, les enfants atteints de TSA manifestaient des bâillements et des rires moins contagieux que leurs pairs TD, sauf quand leur attention est explicitement dirigée vers les yeux ou (et plus encore) lorsque leurs parents servaient de cibles déclenchantes.
Les auteurs explorent les implications de ces résultats dans l'établissement de théories des mécanismes sous-jacents aux déficits empathiques de TSA, ainsi que les implications cliniques de la participation des parents au traitement.

Emotional contagion refers to the tendency to automatically assume some degree of the emotions of those with whom we interact (Hatfield, Cacioppo, & Rapson, 1994). Individuals with autism spectrum disorder (ASD) tend to demonstrate decreased emotional contagion and empathy under some circumstances (Baron-Cohen & Wheelwright, 2004). A better understanding of how and when emotional contagion is triggered in individuals with ASD, and its potential relationship to empathic development, has implications for both understanding the neural bases of the disorder and optimizing early intervention.
One mechanism by which emotional contagion may come about is via the underlying process of mimicry (HatÞeld et al., 1994). In contrast to imitation, which involves the conscious, effortful reproduction of another's behavior, mimicry refers to nonvolitional "matching" behavior (Want & Harris, 2002). Electromyography (EMG) research reveals that as human beings engage in face to face interaction, we unconsciously mimic (often at a level undetectable to the naked eye) one another's posture, facial expressions, vocal prosody, speech patterns, gestures, and emotional expressions (e.g., Niedenthal, Barsalou, Ric, & Krauth-Gruber, 2005). The classic James&endash;Lange hypothesis asserts that the observer perceives the target's posture and expressions, her musculature mimics that of the other, and the brain interprets feedback from its own musculature as signaling the emotion in question (e.g., James, 1890). Alternatively, the observer may represent and recognize the emotion that he/she infers from the other's actions; the recognition of that emotion may overþow its neuronal representation and become embodied in the observer's musculature, causing mimicry (Preston & de Waal, 2002). The embodiment may subsequently "feed back" cen- trally to generate or enhance the relevant emotion (Moody, McIntosh, Mann, & Weisser, 2007).
This emotional contagion or "embodied communication" (Kinsbourne & Jordan, 2009) between observer and target is often described as "emotional" or "affective" empathy (Davis, 1996; Preston & de Waal, 2002; although some definitions differ, e.g., see De Vignemont & Singer, 2006) and has been proposed to be a crucial component in developing cognitive empathy (Decety & Jackson, 2004; Preston & de Waal, 2002; Singer & Lamm, 2009), in which deficits among individuals with ASD are well documented (Baron-Cohen, 2000). The amount of automatic mimicry, observed via behavioral coding (Sonnby-Borgstrom, 2002), and measured in movements of the facial muscles via EMG (Andreasson & Dimburg, 2008), both correlate positively with an individual's level of emotional empathy (taking on the emotions of others; Andreasson & Dimburg, 2008; Kaplan & Iacoboni, 2006; Sonnby-Borgstrom, 2002), as well as cognitive empathy (taking on the perspective of others; Chartrand & Bargh, 1999).
Because mimicry automatically occurs when a person observes or engages with another person, neuroimaging studies in which participants passively observe the actions or the emotions of others presumably capture the neural correlates of nonvolitional mimicry, which consistently reveal common coding for first- and third-person experiences. Such common coding has been reported for disgust (Wicker et al., 2003), pain (Singer et al., 2004), touch (Keysers et al., 2004), emotional body language (de Gelder & Hadjikhani, 2006), and emotional expressions (Carr, Iacoboni, Dubeau, Mazziotta, & Lenzi, 2003) in the insula and anterior cingulate, while common coding for contagious actions, such as yawning and laughter, are observed in the inferior frontal cortices and sensorimotor cortices (Haker, Kawohl, Herwig, & Rossler, 2013; Meyer, Zysset, von Cramon, & Alter, 2005) with some studies showing insula activation. The insula (particularly, the anterior insular cortex) has been suggested to mediate the transformation of a perceived action into an emotional experience by relaying information about action representation from the superior temporal and inferior frontal cortices (sometimes referred to as "the mirror neuron system") to the limbic system (Carr et al., 2003). This relay is proposed to allow information about the actions of others (e.g., a facial expression) to provoke an emotional experience (e.g., emotional empathy), with the resulting shared neural representation providing an "embodied theory of mind" (Corradi-Dell'Acqua, Hofstetter, & Vuilleumier, 2011; Gu et al., 2015; Singer & Lamm, 2009; Wicker et al., 2003). The passive viewing of contagious actions and emotional expressions while undergoing functional magnetic resonance imaging reveals that individuals with greater activation in shared neural representations (i.e., greater embodiment of the target's state) are also associated with individual levels of emotional empathy (Gazzola, Aziz-Zadeh, & Keysers, 2006; Kaplan & Iacoboni, 2006), cognitive empathy (Gazzola et al., 2006; Platek, Myers, Critton, & Gallup, 2003), or both (Arnott, Singhal, & Goodale, 2009; Pfeifer, Iacoboni, Mazziotta, & Dapretto, 2008).
Some researchers have proposed that the empathy deficits observed in individuals with ASD can be attributed to a "broken mirror" system (Iacoboni & Dapretto, 2006; Oberman & Ramachandran, 2007; Ramachandran & Oberman, 2006; Rizzolatti & Fabbri-Destro, 2010; Williams, Whiten, Suddendor, & Perrett, 2001), or abnormalities in cortical and subcortical net- works involved in emotion contagion (Hadjikhani et al., 2009), which deny individuals with ASD the experience of shared neural representations and emotions during face to face interactions; however, these notions are hotly debated (see Leighton, Bird, Charman, & Heyes, 2008; Southgate & Hamilton, 2008).
Contagious Yawning
Contagious yawning is a type of mimicry in that it is a matching behavior that is produced automatically. However, unlike the miniscule muscular movements that mimicry typically entails, yawns are large, obvious sequences of movements. The explanation for this may derive from the fact that yawning is a Þxed action pattern (Provine, 1986), which is a species-typical behavioral sequence that is indivisible and, once initiated, runs to completion. Mimicking the Þrst part of a Þxed action pattern may trigger the release of the entire behavior.
In addition to being a form of mimicry, contagious yawning may involve an emotional component. Deputte (1994) identiÞed two contexts for yawns: the "rest yawn," when there is a change in arousal level, and the "emotion yawn," which is used as an unconscious communication of psychological decompression after a state of high alert. The construct of an emotion yawn suggests that contagious yawning may be considered a form of emotional contagion. Yawning is similar to other contagious acts (e.g., crying and laughing) in that it produces a distinct sound, as well as a distinct facial expression (Provine, 1996). In contrast, yawning may not signal an emotion but may simply be a facial expression that is unintentionally mimicked, as are other nonemotional facial expressions (Heyes, 2001). Ubiquitous facial mimicry may be adaptive because it facilitates contagion of "true" emotions. In either case, the disruption of mimicry, which may be demonstrated by a disruption in contagious yawning, should have consequences for emotional resonance with others. People with high levels of empathy exhibit greater amounts contagious yawning (Norscia & Palagi, 2011; Platek et al., 2003).
Automatic Mimicry and Emotional Contagion in ASD
Whereas TD individuals tend to automatically attend to and mimic emotional cues, individuals with ASD may show decreased (McIntosh, Reichmann-Decker, Winkielman, & Wilbarger, 2006; Yoshimura, Sato, Uono, & Toichi, 2015) and atypical (Beall, Moody, McIntosh, Hepburn, & Reed, 2008; Oberman, Winkielman, & Ramachandran, 2009) spontaneous mimicry and decreased emotional contagion. Helt, Eigsti, Snyder, and Fein (2010) assessed contagious yawning in children with ASD under naturalistic circumstances and reported its occurrence to be very low in children with mild ASD symptomology and absent in children with moderate to severe symptomology. Similarly, lab- oratory studies exposing individuals with ASD to prerecorded video (Senju et al., 2007) and audio (Giganti & Esposito Ziello, 2009) clips show markedly decreased rates of contagious yawning in individuals with ASD compared with their typiclly developing (TD) peers. Finally, Scambler, Hepburn, Rutherford, Wehner, and Rogers (2006) presented strong facial and bodily models of joy, disgust, pain, and fear, and reported that children with ASD responded with significantly fewer instances of emotional contagion than controls.
Sims, Van Reekum, Johnstone, and Chakrabarti (2012) found that TD participants with low (but not high) ASD traits demonstrated greater mimicry for faces that they had been trained to associate with high (vs. low) reward values, indicating that, in general, people will tend to show greater mimicry to faces they find more rewarding. In contrast, participants with high ASD traits showed similar amounts of mimicry to target stimuli regard- less of reward value, indicating that individuals with ASD may be less sensitive than their peers to cues associated with social reward. This evidence aligns with theories that posit that children with ASD experience reduced social reward sensitivity, which manifests in reduced ability to affectively tag socially relevant stimuli (Dawson, Bernier, & Ring, 2012; Fein, Pennington, Markowitz, Braverman, & Waterhouse, 1986; Klin, Jones, Schultz, & Volkmar, 2003; Waterhouse, Fein, & Modahl, 1996).
Although behavioral evidence consistently reveals that children with ASD show less emotional contagion than their TD peers, other studies suggest the possibility of intact or even heightened emotional contagion among individuals with ASD. Hadjikhani et al. (2009) showed that brain activation in individuals with ASD did not differ from controls when participants viewed fear or pain (Hadjikhani et al., 2014). Blair (1999) reported that children with ASD showed typical psychophysiological responses to images of distressed people. Meanwhile, Gu et al. (2015) reported that individuals with ASD showed heightened autonomic arousal (though reduced embodiment, or shared neural representation) when viewing others in pain. Self-report questionnaires, such as the Interpersonal Reactivity Index and the Multifaceted Empathy Test, have revealed impairments in cognitive empathy, but either normal (Dziobek et al., 2008) or heightened emotional empathy among adults with Asperger syndrome (Rogers, Dziobek, Hassenstab, Wolf, & Convit, 2007). Finally, Magnee, de Gelder, van Engeland, and Kemner (2007) used EMG to measure subtle emotional responses in a small group of high- functioning individuals with ASD. The researchers reported that the participants with ASD showed heightened electromyographic responsiveness both to happy and to fearful faces compared to controls. This evidence of heightened emotional empathy aligns with theories that posit that children with ASD begin life with normal social attention and then defensively turn their attention away from social stimuli because it is overarousing (Kinsbourne, 2011; Markram, Rinaldi, & Markram, 2007; Smith, 2009).`
Regardless of the underlying cause of impaired social attention in ASD, it undoubtedly plays a role in the reduced emotional contagion previously observed in individuals with ASD. Research in another area of social cognition, face perception, has demonstrated that under default circumstances, individuals with ASD show reduced fusiform face activity (FFA; Schultz et al., 2000) compared to controls; however, if participants are continuously cued to the eye region, these group differences disappear (Hadjikhani et al., 2004). Individuals with ASD have been documented to show very reduced attention to another's pain (Bacon, Fein, Morris, & Waterhouse, 1998; Sigman, Dissanayake, Corona, & Espinosa, 2003). However, Scambler et al. (2006) gained the child's attention before assessing emotional contagion, and found it still reduced, supporting the notion that social attention cannot account for all of the reduction in emotional contagion.
Eye contact with the target has been suggested to trigger contagious yawning. For example, Provine (1989) demonstrated that TD individuals will yawn contagiously if shown the disembodied eyes of a yawning face, but not the disembodied mouths. To test the possibility that diminished contagious yawning in ASD is due to diminished eye gaze, Senju et al. (2009) instructed children to fixate on the eyes of yawning faces and found no group differences in the rate of contagious yawning between TD and ASD children; however, as the TD group yawned the same amount, to yawn and control stimuli these results are difficult to interpret. Further complicating the picture, Giganti and Esposito Ziello (2009) found that individuals with ASD also showed reduced yawn contagion when presented with an auditory only yawning stimulus indicating that lack of eye gaze cannot completely explain diminished yawn contagion in ASD.
Research on other aspects of social&endash;emotional functioning in ASD has also revealed particularly strong effects of stimulus familiarity in this population. Individuals with ASD have been reported to show enhanced language, social skills, cognitive test scores, and even skin conductance responses when "high-interest" stimuli are used (Koegel, Koegel, & Smith, 1997; Pierce & Schreibman, 1997; van Engeland, Roelofs, Verbaten, & Slangen, 1991). Although Shultz et al., (2000) reported diminished FFA activation in response to faces in ASD, Pierce, Haist, Sedaghat, and Courchesne (2004) found that participants with ASD showed normal FFA activity to
familiar faces. Finally, although Bernier, Dawson, Webb, and Murias (2007) and Oberman et al. (2005) reported diminished mu wave suppression (taken to indicate "mirror" response) in participants with ASD when viewing the hand motions of strangers, Oberman, Ramachandran, and Pineda (2008) reported normal mu wave suppression in participants with ASD when viewing the hand movements of their family members.
Finally, mimicry studies on TD adults indicate that preexisting rapport increases the amount of mimicry one will show with an interaction partner (Likowski, Muhlberger, Seibt, Pauli, & Weyers, 2008; McIntosh, 2006; Tickle-Degnen, 2006), and that individuals are most likely to contagiously yawn when exposed to the yawn of a relative (Norscia & Palagi, 2011), indicating that among the general population the effects of social reward may be more pronounced than the effects of attention when it comes to mimicry. We know of no previous research that has explored the impact of stimulus familiarity on emotional contagion in individuals with ASD.
Current study
In summary, the majority of the literature shows reduced emotional contagion in ASD. This has been attributed to attaching less reward value to social stimuli, showing reduced social attention to the target stimuli, or innate neurological differences in the common coding of actions and emotions. However, a handful of studies implicate intact emotional contagion in ASD, and research in other aspects of social cognition reveal that individuals with ASD appear to be disproportionately influenced by study design, such as the familiarity or importance of the target, and the task instructions.
Contagious yawning and laughing offer a noninvasive approach (well tolerated by children with ASD) to the study of mimicry (i.e., mirrorlike phenomena; Provine 2005b). Laughter and yawning were chosen as the target responses because they share several traits: (a) they have emotional content; (b) they occur under both spontaneous and contagious conditions (Provine, 2005b); (c) their spontaneous occurrence has been shown not to be diminished in children with ASD (Giganti & Esposito Ziello, 2009; Hudenko, Stone, & Bachorowski, 2009); and (d) TD individuals show similar amounts of mimicry to both (as opposed to frowning; Estow, Jamieson, & Yates, 2007).
We explored emotional contagion in ASD under different conditions, including manipulating instructions to maximize eye gaze, and stimulus familiarity. We hypothesized that if differences are primarily mediated by eye gaze/social attention, then manipulating task instructions to maximize eye gaze to target should minimize group differences, as should delivering the stimuli in an auditory-only condition. If differences are mediated by decreased reward value of social stimuli, then increasing the familiarity, and thus the social reward value, of the stimuli should minimize group differences. Finally, if reduced emotional contagion is mainly due to innate neurological differences in the mirror neuron areas of the brain, then individuals with ASD should show reduced emotional contagion across all conditions.
Consistent with a great deal of previous research, children with ASD showed diminished emotional contagion compared to their TD peers under most conditions. However, when they were exposed to the familiar, and presumably rewarding, stimuli of their parents, or eye contact with the stimulus was cued via task instructions, they demonstrated rates of emotional contagion approaching or comparable to their TD peers. These findings offer a new perspective as to whether emotional empathy is reduced or intact among children with ASD, showing that children with ASD may show either typical or atypical rates of emotional contagion depending upon the circumstances. The finding that emotional contagion is intact in children under some circum- stances is inconsistent with the hypothesis that they have innate abnormalities in neural systems associated with emotional contagion, which prevent its expression. Rather, it seems that reduced emotional contagion may be secondary to problems with social orienting and attention, which were partially overcome in the cued to eyes condition, and completely overcome in the parents condition.
The TD group displayed roughly the same amount of emotional contagion across conditions. In contrast, the ASD group displayed highly varied amounts of emotional contagion depending on the condition. For participants with ASD, cueing-to-eyes resulted in more yawning and laughter contagion compared to other conditions (although not as powerfully as the parent stimuli) and eliminated significant differences in yawning contagion between groups. The latter finding is consistent with that of Senju et al. (2009) as well as the hypothesis that reduced social attention, in particular to the eyes, at least partially mediates the diminished emotional contagion previously reported among individuals with ASD. Continuous cueing to the eyes has previously been found to result in normal neural activation during face processing in an ASD population (Hadjikhani et al., 2004). The striking increase in rates of emotional contagion among children with ASD when eye gaze is cued supports the importance of teaching children with ASD early and often to attend to the eyes of others via explicit instruction or prompting (e.g., holding a desired object near the other's eyes) and delivering early intervention face-to-face so as to improve opportunities for automatic affective exchange.
However, the only conditions in which the ASD and TD means were truly comparable, and which produced the same percentage of contagious ASD responders as TD responders, were the conditions in which the child's parent served as the stimulus. These results align with previous research reporting normal neural responses to faces and actions in individuals with ASD only in studies in which the stimuli were composed of familiar individuals (Oberman et al., 2008; Pierce et al., 2004). Typical levels of emotional contagion between children with ASD and their parents is also consistent with previous research showing that children with ASD are more likely to laugh at cartoons if viewing them with their parents (Helt & Fein, 2016). In addition, previous research suggests that children with ASD display increased ability to match facial and vocal expressions of emotion when familiar adults are used as stimuli (Kaana-Kalman & Goldman, 2008). Furthermore, children with ASD show improved social interaction skills (Knott, Lewis, & Williams, 1995) as well as increased rates of physical and eye contact (Kasari, Sigman, & Yirmiya, 1993) when interacting with familiar, as opposed to unfamiliar, individuals.
ASD symptom severity was inversely correlated to both contagious yawning and laughter. This relationship was stronger in the "naturalistic" conditions and weaker in the parent condition, indicating that the amount of emotional contagion that participants with ASD show to strangers is more strongly indicative of their core ASD symptomology than is the amount of emotional contagion they show with their parents. Contagion for both laughter and yawning were also positively correlated with one another, showed similar patterns across conditions, and were both negatively correlated with ASD severity, consistent with the idea that emotional contagion is, to some degree, a unified construct rely- ing on similar component processes, one that is disrupted with strangers to a greater degree in individuals with more severe ASD symptoms.
Candidate mechanisms
ASD symptom severity was inversely correlated to both contagious yawning and laughter. This relationship was stronger in the "naturalistic" conditions and weaker in the parent condition, indicating that the amount of emotional contagion that participants with ASD show to strangers is more strongly indicative of their core ASD symptomology than is the amount of emotional conta- gion they show with their parents. Contagion for both laughter and yawning were also positively correlated with one another, showed similar patterns across conditions, and were both negatively correlated with ASD severity, consistent with the idea that emotional contagion is, to some degree, a unified construct relying on similar component processes, one that is disrupted with strangers to a greater degree in individuals with more severe ASD symptoms.
First of all, perhaps the initial cueing to the eyes was not enough to sustain the children's motivation to continue to attend to the eye region, whereas the connection with the parent pro- vided an ongoing source of motivation and reward to continue to attend. Alternatively, it is possible that these effects demonstrate what happens when the uncomfortable arousal or anxiety of viewing strangers is removed for the group with ASD. Dalton et al. (2005) reported that in individuals with ASD, but not controls, the amount of eye gaze was significantly correlated with amygdala activation while viewing both emotional and nonemotional faces, suggesting that for individuals with ASD, eye gaze fixation is associated with emotional arousal. Perhaps even when participants with ASD are cued to the eyes of others, there remains an aversion to looking for any longer than possible. Future research should engage eye tracking and skin conductance to address these questions.
Second, these effects could be interpreted as evidence that chil- dren with ASD place normal social reward value on their interactions with their parents and reduced social reward value on unfamiliar others. Research on healthy adults reveals that one aspect of automatic facial mimicry is the (unconscious) desire to affiliate with the target (Lakin & Chartrand, 2003; Stel & Vonk, 2010). Meanwhile, previous research on individuals with ASD and high ASD traits indicate atypical sensitivity to the social rewards of mimicking and being mimicked by strangers (Hsu, Neufeld, & Charkrabati, 2018; Sims et al., 2012). Although a core symptom of the disorder is reduced affiliation with others, children with ASD tend to have typical attachment rates to their parents (Capps, Sigman, & Mundy, 1994; Rutgers, Bakermans-Kranenburg, van Ijzendoorn, & Van Berckelaer-Onnes, 2004). Parents are presumably sources of reward of many kinds, in addition to being familiar. In order to disentangle the effects of familiarity from those of social reward, future studies should compare emotional contagion to strangers, to rewarding familiar adults, and to familiar but not rewarding adults. Nevertheless, these results imply that increasing the social reward value of the target may result in normal emotional empathy levels among children with ASD.
Finally, it is possible that multiple factors are contributing to the current findings. Emotional contagion is not an all-or-none phenomenon; familiarity, intensity, salience, and attention may modulate responses (Hatfield et al., 1994) just as they do for other forms of empathy (e.g., Avenanti, Paluello, Bufalari, & Aglioti, 2006) and face perception (e.g., Vuilleumier, Aromony, Driver, & Dolan, 2001). This definition of emotional empathy involves a representation of the target's inner state, which auto- matically activates in the observer a representation of the observed state. These representations, unless inhibited, prime associated autonomic and somatic responses in the observer (Baron-Cohen & Wheelwright, 2004). Perhaps, rather than being fully automatic, emotional contagion involves some form of rapid, nonconscious, contextual appraisal, and individuals with ASD have stricter parameters for evaluating an emotional cue in a manner consistent with a subsequent empathic response (rather than inhibiting either the response or the attention to the emotional cue).
If social signals are uncomfortably arousing, then perhaps only the above- mentioned factors are enough to overcome the tendency for subtle forms of attentional avoidance. Perhaps, rather than the scope of mirror neuron functioning being innately specified, mir- roring processes become automatic by means of a stream of con- tinuous emotional exchange with others early in development (Heyes, 2010), and so a history of impoverished social attention (due to ASD symptoms) results in a less efficient and automatic activation of shared neural representations with others. In other words, TD individuals may develop an "enactive mind" (Klin et al., 2003), facilitating automatic processing of the social signals of most people most of the time, at least once they have reached the age of 5. In contrast, children with ASD, having missed out on an early developmental milieu consisting of a continuous stream of emotional contagion (feeling at least a little bit of what most of their interaction partners are feeling) may seek out and attend to a different set of environmental cues as salient and rewarding, and only automatically affectively familiar people and certain types of emotional signals as behaviorally relevant stimuli, and others only when given explicit cueing or instructions.
Clinical Implications
The results of the current study reinforce that it is crucial to enhance attentional and motivational salience for children with ASD, in order to measure their true abilities (i.e., in order to tease apart what they can do from what they tend to do); this applies to both laboratory and educational settings. In addition, gaining the child's attention and creating opportunities for affective exchange may form a particularly important part of intervention or therapy carried out by unfamiliar individuals. Although it is always important for parents to be involved in their children's therapies no matter what disorder is being treated, this may be especially so in the case of children with ASD, who may only show their true capacity for empathic engagement with their parents.