1. THE EMOTIONAL CONTAGION TEST
Dott. Federico Bianchi di Castelbianco
Dott. Magda Di Renzo
Dott. Lidia Racinaro

2. The emotional contagion appears in the early stages of development during which there is an incomplete differentiation between the self and the other.

3. The emotional contagion consists in the tendency to unintentionally imitate facial, vocal and postural expressions of another person, and consequently to emotionally converge (L. Inzani, I. Cazzaniga, D. Martelli & P.R. Salina, 2004).

4. The emotional contagion is an automatic and precognitive response of assimilation and introjection of the emotional experiences of the others, which are experienced as personal.

5. The emotional contagion is well distinguished from empathy which instead needs the mediation of conscious, cognitive processes.

6. THE EMOTIONAL CONTAGION TEST (TCE):
Allows to determine whether in the child there’s an emotional attunement in the relationship with the other.
Allows the evaluation of the emotional response of the child without the need to refer to verbal parameters.

7. THE EMOTIONAL CONTAGION TEST (TCE)
IS FOR THE OBSERVATION OF THE EMOTIONAL RESPONSE
Parameters observed:
Physiological correlates
Reproduction of the motor pattern with or without an emotional involvement
Postural changes
Eye contact
Verbalizations related to the personal or of the other emotional experience
Instrumental behaviors such as escape, approach or hit

8. Gallese (2001, 2006) exponent of neuroscience,
argues that autistic children lack those imitative behaviors of the body that allow to give an experiential content to emotions. We understand, then, how important it is to detect the type of emotional response in autistic children.

9. The basic assumption of our clinical work is that in autistic children the primary deficit is expected to lie in the affective area before that in the cognitive (Di Renzo, 2011).

10. In childhood, emotional relationships are the foundations for the development of all other representational processes.

11. In our view, the block in the emotional development of the autistic child would lie at this archaic level of affective development, in the sense of Stern’s “affective attunement” (1985).

12. Affective attunement is an indispensable prerequisite in order to develop a “good enough” mother-infant attachment relationship (Winnicott, 1958).

13. What characterizes the attunement is that it automatically happens, outside of any awareness.

14. Today we know from neuroscience that affective attunement and emotional contagion are supported by the mirror neuron system.

15. The mirror system is a neurobiological predisposition of the individual that, while supporting the mechanisms of emotional contagion and affective attunement, tends to reach its complete functioning in the encounter with the other, normalizing itself then through the relationship.

16. Mirroring and emotional containment are related to this attunement and enable the child to develop, later, the ability to recognize his own emotions and to differentiate them from those of the others.

17. The states of emotional contagion and affective attunement are contiguous and therefore precursors of the development of empathy.

18. Even if in the child with autism spectrum disorder the empathic response is therefore not what you would expect to find, we consider the “emotional contagion” very important as it represents a primitive form of empathy.

19. Buhler (1930) defines the contagion with the term "affective mimicry" describing it as a mimic concordance between the infant and the mother during the first few months of life.

20. It is on these basis of the international review, which puts autistic disorder in correlation with a dysfunction of mirror neurons, that we formulated the construct of the Emotional Contagion Test

21. The detection of the emotional contagion in children with autism spectrum disorder aims to identify the lack of imitative mechanisms and/or a pathology "in imitation” (Di Renzo, 2007).

22. For this reason, in children with autism spectrum disorder it is extremely important to determine the type of emotional response because it indicates the presence of the precursors of empathy

23. The TCE appears as an innovative tool for research because, in literature, scales about emotions are only based on questionnaires or face recognition through photographs and/or video in which actors interpret their own emotions as a result of micro events or short stories.

24. But this kind of scales assume the presence of language and the ability to read and understand the context in which emotions are expressed. The answer to them also involves the use of complex cognitive processes, and these tools are not appropriate and suitable for the administration to children with an autism spectrum disorder

25. Vocal (intonation of the voice), Haptic (physical touch),
The TCE explores the pre-verbal area of social interaction, taking into account the main systems that frame the non-verbal communication:
Kinesic (movements),
Vocal (intonation of the voice),
Haptic (physical touch),
Proxemic (distance)
And allows to identify which emotion is relevant to each child

26. The TCE consists of a video and of a coding sheet for a quantitative and qualitative assessment.
THE VIDEO has a length of 2.86 min. (4 items of 43 sec. each one, 4 emotions).

27. VIDEO’S CONTENT:
The menu consists of 4 video recordings in which a normal, non-disabled child expresses the four basic emotions: happiness, sadness, fear, anger. Each emotion expressed by the child has the same duration (23 sec.). At the end of each one, and for all the four recordings, the video goes dark for 20 sec. The 4 video recordings are out of sequence, to allow a random administration of the emotional stimuli.

28. CODING SHEET (five sections):
The first 4 sections correspond to the 4 basic emotions in the video: happiness, sadness, fear, anger. Each section is constituted by the image of a face drawn and corresponding to the emotion, and of 16 items. The single section, which refers to the single emotion and then to the child who expresses it, is divided in 2 parts.

29. The test enables a quantitative and a qualitative assessment.
The possible answers to encode the test consist of an "ABSENT" (no emotional response to any stimulus) and of a "PRESENT" (presence of the emotional response), and within this latest one we have identified an intermediate area of "EMOTIONAL CONTAGION".

30. SCORING:
Score-1, rudiment of emotional contagion: when there are 3/4 hints of reproduction of the stimulus or of the stimuli and 1 answer of emotional contagion.
Score-2, emotional contagion: when there are from 2 to 4 responses of emotional contagion.
Score-3, empathy: when the child recognizes the emotional stimuli, regardless of the fact that there is their reproduction, and he is able to differentiate between his own emotions and those expressed by the child of the video, even if there is just an immature and incomplete differentiation, and finally if the child is able to properly verbalize about it.

31. In the «qualitative description» area, on the coding sheet, will be also specified if it is a “veridical empathy” or a “quasi-egocentric empathy” (Hoffmann, 1987).

32. Veridical empathy presupposes the differentiation between self and other. In the quasi-egocentric empathy, despite there’s the recognition of each emotion and a contextual verbalization, the process of separation between self and other is uncomplete, so the child does not differentiate.

33. Our study and clinical work concerning the presence of "precursors of empathy: the emotional contagion" takes shape within an integrated view of the development in which emotion and cognition are interdependent for increasing levels of complexity.

34. The Emotional Contagion Test is the first test, about emotions, which investigate the pre-verbal area of social interaction, taking account of the main systems that form the non-verbal communication.

35. The test allows to identify what is the relevant emotion for each child, namely on what emotional area is necessary to work in order to restart the developmental process through the mechanism of embodied simulation.