Cross-modal extinction in a boy with severely autistic behaviour and high verbal intelligence

Yoram S. Bonneh, Matthew K. Belmonte, Francesca Pei, Portia E. Iversen, Tal Kenet, Natacha Akshoomoff, Yael Adini, Helen J. Simon, Christopher I. Moore, John F. Houde, Michael M. Merzenich

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Anecdotal reports from individuals with autism suggest a loss of awareness to stimuli from one modality in the presence of stimuli from another. Here we document such a case in a detailed study of A.M., a 13-year-old boy with autism in whom significant autistic behaviours are combined with an uneven IQ profile of superior verbal and low performance abilities. Although A.M.'s speech is often unintelligible, and his behaviour is dominated by motor stereotypies and impulsivity, he can communicate by typing or pointing independently within a letter board. A series of experiments using simple and highly salient visual, auditory, and tactile stimuli demonstrated a hierarchy of cross-modal extinction, in which auditory information extinguished other modalities at various levels of processing. A.M. also showed deficits in shifting and sustaining attention. These results provide evidence for monochannel perception in autism and suggest a general pattern of winner-takes-all processing in which a stronger stimulus-driven representation dominates behaviour, extinguishing weaker representations.

Original languageEnglish
Pages (from-to)635-652
Number of pages18
JournalCognitive Neuropsychology
Issue number5
StatePublished - Jul 2008
Externally publishedYes

Bibliographical note

Funding Information:
We thank William Hirstein, Stefano Baldassi, Russ Hamer, David Blake, and Tony Norcia for valuable consultation. We thank Dorit Ben Shalom for helpful comments. We thank the Smith-Kettlewell Eye Research Institute for hosting most of the testing. We acknowledge the contribution of the written evaluation of A.M. as severely autistic by Lorna Wing, Judith Gold, and Beate Hermelin. The study was supported by Cure Autism Now and by a grant from the National Institute for Psychobiology in Israel to the first author. Special thanks to our participant and his mother for their enormous effort and collaboration.


  • Attention
  • Auditory
  • Autism
  • Cross-modal
  • Extinction
  • Multimodal
  • Perception
  • Tactile
  • Visual


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