The central coherence account of autism revisited: Evidence from the ComFor study

According to the central coherence account, people with autism have a tendency to focus on local rather than global processing. However, there is considerable controversy about the locus of the weak drive for central coherence. Some studies support enhanced bottom–up processing, whereas others claim reduced top–down feedback. The results of the standardization study of the ComFor – a clinical instrument for the indication of augmentative communication, based on the central coherence account – were reviewed within the perspective of this debate. One hundred fifty-five individuals with intellectual disability and the autistic disorder were individually matched with 155 individuals with intellectual disability without the autistic disorder according to their level of daily living skills. The finding that individuals with the autistic disorder exhibit a higher discrepancy between the presentation and representation scores of the ComFor is consistent with expectations on the basis of the central coherence theory, but does not stipulate whether this is due to enhanced bottom–up or reduced top–down processing. Item level analyses, however, show that enhanced local processing emerges most clearly on those items whereby the establishment of meaning (global processing) is not supportive, suggesting that enhanced bottom–up processing and reduced global feedback are interconnected.