Initial evidence for intact emotion fluency in autism vs. ADHD and community groups

Background: The Emotion Word Fluency Test (EWFT) accounts for unique variance in Theory of Mind (ToM). As ToM weaknesses are observed in Autism Spectrum Disorder (ASD), it was hypothesized that an ASD group would demonstrate performance weakness on the EWFT. Method: A community sample for EWFT comparison (COM, n = 113, X̅_age=10.43) was obtained from a University day camp and faculty/staff children. The clinical sample included 38 children with ASD (mean_age=11.10) and 86 children with Attention-Deficit Hyperactivity Disorder (ADHD, mean_age=9.89). EWFT and Animals was administered as part of a comprehensive evaluation. Results: Analyses included EWFT-total and Animals-total (n-correct words in 60”), and the following EWFT scores: n-switches (changing between positive/negative emotions), n-clusters (groups of positive or negative emotions stated in order), and n-correct emotions in the first-15” and second-15” (automatically-accessed vs. strategically-accessed words, respectively). Controlling for age, no between-group differences mean differences were found for EWFT-total, n-switches, n-clusters, or second 15” interval.No within-subject differences between EWFT-total and Animals-total were observed. Autism Diagnostic Observation Schedule-2 scores were not significantly correlated with any EWFT/Animal scores. However, mediational analyses indicated that n-switches increased EWFT-total more efficiently for the COM vs. ASD/ADHD groups. Compared to the COM group, the ADHD group had a higher frequency of at least one EWFT set loss and generated fewer words in the first 15” interval of the EWFT. Conclusions: This study provides initial evidence for intact emotion word fluency in ASD, and suggest switching is a differentially efficient emotion-word-generation strategy depending on group membership. This study provides a basis for additional research.