The Use of Visual Imagery in Asperger Syndrome

RATIONALE: Visual imagery (the act of imagining the exact replication of how a task is performed) enhances learning and performance of motor skills (Ietswaart, Butler, Jackson, & Edwards, 2015). Individuals with autism spectrum disorder (ASD) have capabilities in the use of visual imagery (Soulières, Zeffiro, Girard, & Mottron, 2011). To date, there is no research on the use of visual imagery to improve activity of daily living (ADL) performance in individuals with ASD. This study examined the following hypotheses: (1) The use of visual imagery by individuals with ASD will improve their level of independence while performing ADLs, and (2) participants who have an innate ability to image will show the greatest improvement in ADL performance.

DESIGN AND METHOD: This is a quantitative pretest–posttest pilot study with a convenience sample. All 22 participants, ranging in age from 17 to 21 yr, were recruited on the basis of having difficulty performing ADLs from a college for individuals with ASD. The Revised Kitchen Task Assessment (KTA; Baum, Edwards, Hahn, & Morrison, 2003; interrater reliability = .85, validity = .84) measured performance on a cooking task before and after the use of visual imagery. The Short Imaginal Process Inventory (SIPI; Huba, Singer, Aneshensel, & Antrobus, 1982) measured innate ability to image (internal consistency = .82, reliability = .80).

The experiment was conducted over eight sessions at the college (Session 1, SIPI; Session 2, KTA; Sessions 3–6, intervention; Session 7, KTA; Session 8, termination). During Session 3, participants were exposed to a series of 10 visual images for 6 s each via a Microsoft slide show of an individual washing her hands and making oatmeal. A script was read by the researcher describing the action depicted by each slide. After each picture was viewed, participants were asked to close their eyes and imagine themselves performing that task. In Sessions 4–6, participants practiced imagining themselves making oatmeal with guided visualization from the researcher without photos.

Paired t tests were used to test for significant differences between pre and post KTA scores. Pearson’s product–moment correlation coefficients were used to examine the relationship between SIPI scores and change in KTA scores. Power analyses revealed that an N of 12 was required for these analytic methods.

RESULTS: There was a significant improvement (p < .001) in the performance of the cooking task after visual imagery intervention. There was no relationship between innate ability to image and performance. The use of visual imagery may be associated with the ability of individuals with ASD to perform more independently on a cooking task regardless of their innate ability to image. Results support the need for a controlled randomized quantitative study, which was a limitation of this pilot study.

DISCUSSION AND CONCLUSION: Results indicate that four sessions of visual imagery practice improved cooking task performance in college students with ASD. It is possible that visual imagery can be used with this population to improve engagement in other occupations as well since visual imagery has been known to improve performance in music and sports. Findings provide implications for the use of visual imagery in helping individuals with AS increase their skills and engagement in everyday occupation. The use of mental imagery is a holistic type of intervention, which conforms to the current paradigm of occupation-based practice.

References

Baum, M., Edwards, D., Hahn, M., & Morrison, T. (2003). Revised Kitchen Task Assessment (KTA). Unpublished manuscript, Washington University School of Medicine, St. Louis, MO.

Huba, G. J., Singer, J. L., Aneshensel, C. S., & Antrobus, J. S. (1982). The Short Imaginal Processes Inventory. Port Huron, MI: Research Psychologists Press.

Ietswaart, M., Butler, A. J., Jackson, P. L., & Edwards, M. G. (2015). Editorial: Mental practice: Clinical and experimental research in imagery and action observation. Frontiers in Human Neuroscience, 9, 573. https://doi.org/10.3389/fnhum.2015.00573

Soulières, I., Zeffiro, T. A., Girard, M. L., & Mottron, L. (2011). Enhanced mental image mapping in autism. Neuropsychologia, 49, 848–857. https://doi.org/10.1016/j.neuropsychologia.2011.01.027