Comparison of real and cartoon images for content recognition and memory in children with autism spectrum dis-order

HUANG Qiu-li; LEI Hai-yan; CHENG Xin-yu; ZHU Chang-sen; MA Zhuo-lan; WANG Nan; LI Yu-chang; CHEN Zhuo-ming

doi:10.13820/j.cnki.gdyx.20241634

Abstract：Objective Based on the Jingyun Rehabilitation system's noun teaching using cartoon and real images available on the Internet,this study aimed to determine which type of image-cartoon or real-is more easily recognized and remembered by children with autism spectrum disorder(ASD).Methods Eighty ASD children aged between 2 years 6 months and 6 years,who visited a rehabilitation center from May 2022 to February 2023,were enrolled.They were sequentially assigned into two groups:a cartoon image group(n=40)and a real image group(n=40).The target noun images-both cartoon and real-were sourced from the Jingyun Rehabilitation platform.The cartoon group underwent vo-cabulary teaching and testing using cartoon images,whereas the real image group received similar training with real ima-ges.Outcome measures included accuracy and reaction time during target word recognition in a familiarization test,admin-istered both before and after the teaching sessions,along with correlations between post-learning accuracy,pre-learning accuracy,reaction times,image type,and Childhood Autism Rating Scale(CARS)scores.Results In the familiariza-tion test,the real image group achieved a significantly higher accuracy in recognizing target words compared to the cartoon group(P<0.05).Across two image recognition tests,the reaction times in the real image group were significantly longer than those in the cartoon group(P<0.01).In both groups,the post-learning test accuracy was significantly higher than pre-learning accuracy(P<0.01);moreover,the real image group demonstrated higher post-learning accuracy than the cartoon group(P<0.01).The increase in accuracy(post-learning minus pre-learning)was greater in the real im-age group(P<0.01).Additionally,reaction times in the real image group were significantly longer than those in the car-toon group at both pre-and post-learning assessments(P<0.01).Although reaction times decreased after learning in both groups,the reduction was not statistically significant(P>0.05).Post-learning accuracy was positively correlated with pre-learning accuracy,familiarization test accuracy,and image type(r=0.367,0.284,0.333,P<0.01),and negatively correlated with CARS scores(r=-0.506,P<0.01).Image type was positively correlated with reaction times measured both before and after learning(P<0.01).Conclusion ASD children are more adept at recognizing and re-membering content from real images compared to cartoon images;however,real images are associated with longer reaction times.These findings have implications for designing effective educational interventions for children with ASD.