Cortical activation during attention to sound in autism spectrum disorders

Individuals with autism spectrum disorders (ASDs) can demonstrate hypersensitivity to sounds as well as a lack of awareness of them. Several functional imaging studies have suggested an abnormal response in the auditory cortex of such subjects, but it is not known whether these subjects have dysfunction in the auditory cortex or are simply not listening. We measured changes in blood oxygenated hemoglobin (OxyHb) in the prefrontal and temporal cortices using near-infrared spectroscopy during various listening and ignoring tasks in 11 ASD and 12 control subjects. Here we show that the auditory cortex in ASD subjects responds to sounds fully during attention. OxyHb in the auditory cortex increased with intentional listening but not with ignoring of the same auditory stimulus in a similar fashion in both groups. Cortical responses differed not in the auditory but in the prefrontal region between the ASD and control groups. Thus, unawareness to sounds in ASD could be interpreted as due to inattention rather than dysfunction of the auditory cortex. Difficulties in attention control may account for the contrary behaviors of hypersensitivity and unawareness to sound in ASD.