rehfeldt2007+(1)
rehfeldt2007+(1)
888-83
This investigation was supported by a research grant from TAP (The lilinois Autism
Project, funded by Illinois Department of Human Services), awarded to Ruth Anne
Rehfeldt. Portions of this paper were presented at the annual Southern Illinois University
Phi Kappa Delta & Phi Kappa Phi Research Day, Carbondale, Illinois, April 2005, and at
the annual meeting of the Association for Behavior Analysis, Chicago, lliinois, May 2005.
We acknowledge Rocio Rosales, Vors Garcia, and Holly L. Bihler for their help with data
collection and subject running. In addition, we thank the Center for Autism Spectrum
Disorders and the Rehabilitation Institute at Southern lliinois University for the use of space
for conducting experimental sessions. Finally, we thank Steve Hayes for comments and
suggestions on a previous version.
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24 REHFELDT ET AL.
26 REHFELDT ET AL.
with assessment scores, this would suggest that relational learning deficits
in perspective-taking may underlie the social deficits commonly observed
in persons with autism. The purpose of Experiment 2 was to determine
if in fact performance on the Barnes-Holmes protocol improved following
specific reinforcement for responding relationally. If so, it could be argued
that perspective-taking involves derived relational responding.
Experiment 1
Method
Participants
A nonprobability convenience sampie was used to obtain two groups
of 9 children to serve as participants. Participants were recruited via
newspaper ads and flyers distributed at local schools and clinics in the
greater southern Illinois region. Parents and children were financially
compensated for their time and travel. The experimental group consisted
of 9 males ranging in chronological age from 6 years and 8 months to
13 years and 4 months. All had been previously diagnosed with high-
functioning autism or Asperger syndrome; proof of diagnosis was provided
upon the parent and child's arrival for the experiment. Participants in the
control group consisted of 9 typically developing children (5 females and
4 males) ranging in chronological age from 6 years and 5 months to 13
years and 8 months. Control participants were matched to experimental
participants on the basis of three developmental age bands: Middle
Table 1
28 REHFELDT ET AL.
childhood (age range 6-8 years), late childhood (age range 9-11 years),
and adolescence (age range 12-14 years). This was done in attempts to
create groups that were generally homogeneous in chronological age.
Table 1 shows diagnosis, chronological age, and developmental stage for
each experimental participant and a matched control participant. Children
who did not read at their grade level were screened out of the experiment
via discussion with parents and practice trials prior to the experiment.
Procedure
Clinical assessments. Two clinical assessments, the Vi ne land
Adaptive Behavior Scales - Interview Edition (Sparrow, Balla, & Cicchetti,
1984) and the Social Communication Questionnaire (SCQ) - Current
Form (Rutter, Bailey, & Lord, 2004) were administered to one parent of
each participant by a Master's level graduate student trained in clinical
interviewing and in the scoring and interpretation of both instruments.
All interviews were videotaped. The Vineland Adaptive Behavior Scales
- Interview Edition was designed to be administered in a semistructured
interview format to a parent or caregiver of an individual between the ag es
of birth and 18 years and 11 months or an adult with low levels of cognitive
functioning. The Vineland scales measure an individual's adjustment to
the demands of everyday life, providing a profile of those skills in which an
individual habitually engages on a day-to-day basis (Sparrow et al. , 1984).
Scores are provided in each of the following domains: Communication,
Daily Living Skills, Socialization, Motor Skills, and Maladaptive behaviors.
This study assessed participants' functioning levels in the first three
domains only. The Vineland scales provide scores that are indicative of
the chronological age at which the individual is currently functioning in
each domain. The SCQ is a parent-report screening tool that provides
a dimensional measure of autism spectrum disorder symptomatology,
providing a cutoff score that indicates the likelihood that an individual has
an autism spectrum disorder (Rutter et al., 2004). The score can also be
used as an indication of the severity of ASO symptomatology. The SCQ-
Current Form is concerned only with behavior that has occurred during the
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past 3 months of the child's life, and assesses thme areas of functioning:
Reciprocal Social Interaction; Communication; ancl Restricted, Repetitive,
and Stereotyped Patterns of Behavior. A cutoff score of 15 or greater
suggests that the individual may have an autism spectrum disorder. Both
assessment interviews took between 1-2 hours t01tal.
The Vineland Adaptive Behavior Scales - Interview Edition is to
be conducted over the course of a semistructured interview with the
interviewer asking aseries of general open-ended questions. Alternatively,
the SCQ requires the parent to simply respond in the affirmative or
negative as to whether or not their child has displayed a particular
symptom in the last 3 months. For this reason, reliability was established
for the Vineland interviews only. Interobserver agreement was calculated
for 50% of the interviews by having a second Master's level graduate
student who was also trained in clinical interviewing skills and in the
scoring and interpretation of the Vineland Scales independently watch a
videotaped interview and score items on the behavior scales. The scores
were then compared on an item-by-item basis to the scores derived
from the interviewer. An agreement was scored if both the interviewer
and the observer scored an item the same. Percentage of agreement
was obtained overall and for all three domains separately. Interobserver
agreement was calculated by dividing the total number of agreements
by the total number of agreements plus disagmements, multiplied by
100. Interobserver agreement for the Communication domain was 95%
(range 86%-100%); interobserver agreement for the Daily Living Skills
domain was 95% (range 91 %-97%); and interobsE~rver agreement for the
Socialization domain was 93% (range 70%-100%). Overall interobserver
agreement was 94% (range 88%-96%).
Perspective-taking. All participants were exposed to the same
procedure. A modified version of the Barnes-Holmes protocol, as reported
by McHugh et al. (2004), was presented in an automated format. The
protocol was presented as a test, with no feedback presented for correct
or incorrect responses. However, the experimentm provided intermittent
general praise for compliance with the task (i.e., "~Iood working;" "you are
doing a great job paying attention."). Prior to the experiment, participants
were presented with aseries of practice trials to ensure that they had
sufficient reading comprehension skills to complete the task. Practice trials
consisted of word problems that would not be presented in the perspective-
taking task but were in the same format as the ques1tions in the perspective-
taking task (e.g., "if the sky is yellow and the sun is blue, what color is the
sky? What color is the sun?"). Participants were told that their job was to
read the question and select one of two command boxes below the question
to select their answer to the question. They were then oriented to the
questions presented on the screen and to operating the computer mouse
to answer the questions. Participants were requirBd to read the practice
trials aloud. Participants who did not read the practice trials correctly or
who answered the questions incorrectly did not complete the perspective-
taking task. Although some children were dismissEld from the experiment
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30 REHFELDT ET AL.
because of insufficient reading skills, all of the chi/dren in the reported study
read at grade level and displayed no reading comprehension problems.
The participants were required to intermittently read the trials aloud as they
worked through the perspective-taking task to ensure this.
The modified version of the Barnes-Holmes protocol that was used in
this study consisted of 57 total trials. Each trial consisted of two questions
(e.g., "which brick do I have?" "Which brick do you have?"). A participant
had to answer both questions correctly in order for the trial to be scored as
correct. If a participant asked the experimenter a question during the task,
the experimenter reminded the participant that his or her job was to answer
the questions and he or she was not allowed to help the participant. As was
the case in McHugh et al. (2004), three types of relations were presented
in the protocol. These included simple relations, reversed relations, and
double reversed relations. Within each of these three types of relations
were trials that evaluated responding to three different perspective-taking
frames (I-you, here-there, and now-then). Eight trials for the simple relations
were included in the protocol, inciuding 2 I-you, 2 here-there, and 4 now-
then trial types. Thirty-six trials for the reversed relations were presented,
including 8 I-you, 12 here-there, and 16 now-then relations. Thirteen trials
for the double reversed relations were presented, including 4 I-you/here-
there and 9 here-there/now-then trial types. The number of trials for each
relation and each trial type followed closely that used by McHugh et al.
(2004). Trials for all relation types and trial types were presented in a
random order. Table 2 shows the questions that were presented for each
of the three relations and for each of the trial types within each relation
tested. (The reader is also referred to McHugh et al., 2004, for additional
Table 2
32 REHFELDT ET AL.
Yesterday you were sitting there on the black chair, today you are sitting here on the blue chair. Ir here was there and
there was here.
Where would you be sitting now? (Black)
Where were you sitting hen? (Blue)
Yesterday you were sitting here on the black chair, today you are sitting there on the blue chair. If here was there and
there was here.
Where were you sitting then? (Blue)
Where would you be sitting now? (Black)
Reversed NOW-THEN:
Yesterday I was watehing television, today I am reading. II now was then and then was now.
What was I doing then? (Reading)
What would I be doing now? (Television)
Yesterday I was reading, today I am watching television. II now was then and then was now.
What would I be doing now? (Reading)
What was I doing then? (Television)
Yesterday I was watching television, today I am reading. Ir now was then and then was now.
What was I doing now? (Television)
What would I be doing then? (Reading)
Yesterday I was reading, today I am watching television. Ir now was then and then was now.
What was I doing then? (Television)
What would I be doing now? (Reading)
Yesterday you were watching television, today you are reading. II now was then and then was now.
What were you doing then? (Reading)
What would you be doing now? (Television)
Yesterday you were reading, today you are watehing television. II now was then and then was now.
What were you doing then? (Television)
What would you be doing now? (Reading)
Yesterday you were watehing television, today you are reading. II now was then and then was now.
What would you be doing now? (Television)
What were you doing then? (Reading)
Yesterday you were reading, today you are watohing television. Ir now was then and then was now.
What would you be doing now? (Reading)
What were you doing then? (Television)
Yesterday I was sitting there on the blue chair, today I am sitting here on the black chair. II now was then and then was now.
Where would I be sitting now? (Blue)
Where was I sitting then? (Black)
Yesterday I was sitting there on the blue chair, today I am sitting here on the black chair. II now was then and then was now.
Where was I sitting then? (Black)
Where would I be sitting now? (Blue)
Yesterday I was sitting there on the black chair, today I am sitting here on the blue chair. II now was then and then was now.
Where would I be sitting now? (Black)
Where was I sitting then? (Blue)
Yesterday I was sitting there on the black chair, today I am sitting here on the blue chair. Ir now was then and then was now.
Where was I sitting then? (Blue)
Where would I be sitting now? (Black)
Yesterday you were sitting there on the blue chair, today you are sitling here on the black chair. If now was then and
then was now.
Where were you si!ting then? (Black)
Where would you be sitting now? (Blue)
Yesterday you were sitting there on the blue chair, today you are sitting here on the black chair. II now was then and
then was now.
Where would you be sitting now? (Blue)
Where were you sitting hen? (Black)
Yesterday you were sitting there on the black chair, today you are sitting here on the blue chair. If now was then and
then was now.
Where were you sitting then? (Blue)
Where would you be sitting now? (Black)
Yesterday you were sitting there on the black chair, today you are si!ting here an the blue chair. II now was then and
then was now.
Where wauld you be sitting naw? (Black)
Where were you sitting then? (Blue)
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Note. The correct response lor each question is shown in parentheses. The reader is also relerred to McHugh et al., 2004.
detail on the Barnes-Holmes protocol. Correct answers to test trials for the
simple relations required responses that were idenltical to the arrangements
specified in the question. Correct answers to test trials for the reversed
relations required the participant to reverse the I-you, now-then, or here-
there arrangements specified in the question. Correct answers to test trials
for the double reversed relations required the participant to simultaneously
reverse the I-you and here-there or here-there and now-then arrangements
specified in the question. Correct answers for each trial type for each
relation type are shown in Table 2.
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34 REHFELDT ET AL.
SÜll' le I· Y
00 Relatioo R~(fSed Now·Then Relation Dooble R~trsoo Htre-
ThtreIN rJ{{ ·Th~
Figure 1. On-screen representation of simple, reversed, and double reversed relations trials.
30.00
CI
25.00
.
~
7i
c:
c:
o
; 20.00
:::11
a
c:
o
~ 15.00
u
'e:::11
E
E 10.00
o
o
ii
'ü
o 5.00
CI)
0.00
Experimental Comol
Partieipant Group
Figure 2. Mean scores on the Social Communication Questionnaire for the two experimental
groups.
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presented for the second question advanced to the next trial. The left-
right location of the correct and incorrect command boxes was randomly
determined across all trials.
210.00
.
.,
.
.,C
>
"5
I80.oo
fT
.,
W 1SO.oo
....
CI
<
~ 120.oo
o
..
."
C
Ci
C 90.00
o
4
:>
60.00
EXJ)enmertlll Conlrol
P~rticlpant Group
Figure 3. Overall mean age equivalence scores on the Vi ne land Adaptive Behavior scales
for the two experimental groups.
36 REHFELDT ET AL.
200.00
., 180.00
.,cv
~ 160.00
':;
IIT
W
., 140.00
:t C
o
.~
v
120.00
o
..
·C
~ 100.00
E
o
o 80.00
60.00
Control
Participant Group
Figure 4. Overall mean age equivalence scores for the !wo experimental groups on the
Communication scale of the Vineland Adaptive Behavior Scales.
100
90
EI) _tt"P,10
70 --KG1,6
Ö KG2,6
~
60
5 ER,13
# 50 --SG,8
iE 40
--eG,11
__ Cy,g
3J -TC,10
20 -AS,10
10
0
Simple Reversed Double Reversed
ReIMIon
Figure 5. Mean percentage of errors for each individual participant in the control group on
the simple, reversed, and double reversed relations.
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Perspective-Taking
Shown in Figures 5 and 6 is the mean percentage of errors on the
simple, reversed, and double reversed relations, for the control group
(Figure 5) and the experimental group (Figure 6). Figure 5 shows that
there was considerable variability ac ross the test trials for the different
relations for the control group. It can be seen from the figure that several
100
9)
-.-ZR,B
00 --RH,6
70 TM,11
i
WM,11
60 __ NW1,13
# 50 --NW2,11
iE 40 --BC, 11
-OG,10
3l
--OR,6
20
10
0
RBIaIUon TMJB
Figure 6. Mean percentage of errors for each individual participant in the experimental group
on the simple, reversed, and double reversed relations.
participants (MP, eG, and ER) made the fe west errors on the test trials
for the simple relations, and the most errors on test trials for the double
reversed relations. SG, AS, and KG2 made the most errors on test trials
for the reversed relations. Figure 6 shows that the participants with autism
typically made fewer errors on test trials for the simple relations, and more
errors on test trials for the reversed relations. NW1 (13 years old), an
outlier for the group, made fewer errors across nearly all test trials than
the other experimental participants, making no errors on test trials for the
simple relations and fewer than 10 errors on test trials for the reversed
relations. Overall, the figures show that most of the participants in both
groups made more errors on the reversed relations than the simple
relations, but it wasn't necessarily the case that the most errors were
made on test trials for the double reversed relations. No particular pattern
of errors between the I-you, here-there, now-then, I-you/here-there, and
here-there/now-then trial types was observed.
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38 REHFELDT ET AL.
'"
- - Experiment..
I \ -C_OI
\
\
,
I
55.00 I \
...o
...
W 50.00
.
•
GI
~
..
45.00
...u
a..
..
:i
::::E
4000
35.00
30.00
-- _-:iI
"
""
Particlpanl Group,
- - Expermentli
- Control
60.00
",
",
...o
... "
......
Il:i "
5500
"
ao
" 'J
c
..
~ 50.00
....
0.
c
:::E 45.00
40.00
40 REHFELDT ET AL.
versus simple, relations. This difference was most pronounced for the
group of participants with autism. These results suggest that the test
trials for the reversed relations required a more complex form of relational
responding than test trials for the simple relations: Test trials for the
reversed relations required the derivation of the deictic relations. The
difference in errors between the simple and double reversed relations
also approached statistical significance, but fewer errors were observed
ac ross all participants on test trials for the double reversed relations
relative to the reversed relations. This finding is somewhat surprising, as
the double reversed relations required a more complex form of relational
responding than the reversed relations. McHugh et al. (2004) did obtain
such systematic differences in errors between the simple, reversed,
and double reversed relations, with errors most likely on test trials for
the double reversed relations. However, correct responses for test trials
assessing the double reversed relations were the same as those required
for test relations assessing simple relations. Consider, for example, the
following problem: "I am sitting here on the blue chair and you are sitting
there on the black chair. If I was you and you were me and if here was
there and there was here." This problem can be answered correctly
simply by reading the first sentence. Thus, while McHugh et al. (2004)
contend that the double reversed relations require a more complex form
of derivation than the simple and reversed relations, it is possible that
participants were not responding relationally at all when presented with
double reversed relational tasks. Needed are analyses to confirm that
participants' performances on double reversed tasks are in fact indicative
of relational responding rather than a participant's reading the first part of
the problem only.
A modest correlation was found between participants' performance
on the perspective-taking task and scores on one domain of the Vineland
Adaptive Behavior Scales. This correlation was found between scores
on the now-then reversed relations and age equivalent scores on the
Daily Living scale. It would have been expected that performance on the
perspective-taking task would correlate with scores on the Communication
or Socialization domains, as perspective-taking deficits would seem to
contribute to an individual's overall adjustment in such areas. Nonetheless,
the present finding alludes to the rale of derived relational responding and
perspective-taking in adaptive behavior. Future research should explore
this relationship further.
The group differences detected in this study raise the question
whether indeed individuals with high-functioning autism are deficient
on relational learning tasks; more specifically, relational learning tasks
in perspective-taking, relative to their age-matched peers. Results fram
this experiment suggest that such group differences do exist. One might
be quick to attribute these differences to differences in reading ability,
which might be expected to be lower in children with autism. However,
efforts were made to ensure that all of the participants could read and
comprehend the practice and test questions, and no obvious delays in
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42 REHFELDT ET AL.
Experiment 2
Method
Participants
Two typically developing children with no known disabilities participated.
80th had served as control participants in Experiment 1. CY was a male
of 9 years and 2 months of age at the time of his participation. AS was a
female of 10 years and 4 months of age at the time of her participation.
Neither participant had scored higher than 80% on the simple, reversed,
or double reversed test trials in Experiment 1.
Procedure
Participants' scores on the simple, reversed, and double reversed
relations served as their pretest scores for the particular relations in
Experiment 2. Participants were first trained in the simple relations; once
a mastery criterion of 90% correct was achieved, a posttest for the simple
relations was presented. If the participant met the criterion for inferring
the emergence of the simple relations on the simple relations posttest,
training of the reversed relations was introduced. If the participant did
not meet criterion for inferring the emergence of the simple relations
on the simple relations posttest, training of the simple relations was
again instated, and the simple relations posttest was repeated once the
relations were again shown to be maste red. This process was repeated
for the reversed and double reversed relations. The same number of
trials for each relation type and for each trial type within each relation
type was presented as occurred in Experiment 1. A mastery criterion of at
least 90% correct on the pretests and posttests (7/8 test trials correct for
the simple relations, 32/36 correct for the reversed relations, and 11/13
correct for the double reversed relations) was taken as indicative of the
emergence of the particular relations. No feedback was presented during
pretests and posttests.
All trials presented in the pretests, posttests, and training phases
were identical to those presented in Experiment 1. The particular trial
types were presented within a random order within each pretest, training
phase, and posttest. As was the case in Experiment 1, both questions
presented had to be answered correctly in order for the trial to be
scored as correct. During training, a variety of 3-s animation clips were
presented as reinforcers following correct trials, whereas incorrect trials
produced a slide which read, "Try again," and the respective trial was
then repeated.
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GY
Figure 9 presents GY's performance on the pretests, posttests, and
training trials for the simple, reversed, and double reversed relations.
Although he initially did not meet criterion performance on the pretest for the
simple relations, GY required only one training block of eight trials to master
the simple relations, after which he responded with 100% accuracy on the
70 "'-H'
PIt-
o~
Prt·test
30
20
10 CY
4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21) 21
Sessicn
simple relations posttest. GY's pretest score for the reversed relations was
81 %. He mastered the reversed relations in five 36-trial training blocks,
but performed with only 36% accuracy on the first posttest. After six more
36-trial training blocks, GY demonstrated criterion performance on the
second posttest for the reversed relations. GY scored 46% accurate on
the pretest for the double reversed relations, and required only two 13-trial
training blocks to master the relations, after which Ile performed with 100%
accuracy on the double reversed relations posttest.
Shown in Appendix 1 is the percentage of correct trials per training
session for GY. These scores are shown separately for each frame (1-
you, here-there, and now-then), for the three relational tasks. In order
to ascertain the strengthening of each relational operant over training, it
would be expected that the percentage of correct responses would be low
for each frame early on in training, but increasing as training advances
(Hayes & Quinones, 2005). For the simple and reversed relations, it
appears that the three frames were sufficiently stmng at the beginning of
training. Thus, GY's failure to demonstrate mastery during test sessions
may have been caused by the difficulties associated with completing the
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44 REHFELDT ET AL.
AS
Shown in Figure 10 is AS's performance on the pretests, posttests,
and training trials for the simple, reversed, and double reversed relations.
The figure shows that the participant performed with 50% accuracy on the
pretest for the simple relations, and then maste red the relations in three
training blocks. She did not meet criterion performance on the second
posttest for the simple relations, but did following two more training
blocks. AS performed with 47% accuracy on the pretest for the reversed
100
J Oo
....
. , ,,,,t-
." I. RO\OfSod I I I •
..:
...... - -l-~~~----------------------- ---------0~L
I " I
go
" -,- ,
t
I j I I
.
• I I I
.,."..,.
I I I •
.
llel2rnll • " •
'Of ..
1t$1 I •
"
.,
I
cl
\ ..
.,
".,
:: :.
1
..,::, .:
'Of"TI:~1
..,, .
:::~,. ,.. --Mo:
..,,, ...
:: :
"
, I·:.
Simplo
:: :
2D
"
"
:: :
..
10
""
" ,
.,
..
1 3 ~ 7 11 13 1~ 17 1Q 21 23 2~ 27 2Q 31 33 3~ 37 3Q 41 43 4Ii 47
AS :::
40
.,
~1
.
~ ~~
Session
References
BARNES-HOLMES, D., HAYES, S. C., & DYMOND, S. (2001). Self and self-
directed rules. In S. C. Hayes, D. Barnes-Holmes, & B. T. Roche (Eds.),
Re/ational frame theory: A post-Skinnerian account of human language and
cognition (pp. 119-139). New York: Plenum.
BARON-COHEN, S. (1989). The autistic child's theory of mind: A case of specific
developmental delay. Journal of Child Psychology and Psychiatry, 30, 285-
297.
BARON-COHEN, S. (1995). Mindblindness: An essay on autism and theory of
mind. Cambridge, MA: Bradford Books, MIT Press.
BARON-COHEN, S., LESLlE, A. M. & FRITH, U. (198Ei). Does the autistic child
have a "Theory of Mind"? Cognition, 21, 37-46.
BARON-COHEN, S., TAGER-FLUSBERG, H., &COHEN, D. (2000). Understanding
other minds: Perspectives form developmental cognitive neuroscience
(2nd ed.). Oxford: Oxford University Press.
DAWSON, G., & FERNALD, M. (1987). Perspective-taking ability and its
relationship to the social behavior of autistic children. Journal of Autism and
DevelopmentalDisorders, 17(4), 487-498.
DIXON, J. A., & MOORE, C. F. (1990). The developmemt of perspective taking:
Understanding differences in information and weiglhing. Child Development,
61,1502-1513.
HAYES, S. C., BARNES-HOLMES, D., & ROCHE, B. (Eds.). (2001). Relational
frame theory: A post-Skinnerian account of language and cognition. New
York: Plenum.
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46 REHFELDT ET AL.
Appendix 1
Appendix 2
Percentage of Trials Correct per Training Session for AS
Simple Relations Reversed Relations Double Reversed
Relations
Session I-You Here-There Now-Then I-You Here-There Now-Then I-Youl Here-There
Here-There Now-Then
1 100 50 75 63 33 31 0 33
2 50 100 25 63 67 38 100 100
3 100 100 100 50 58 38
4 100 100 75 50 58 56
5 100 100 100 75 58 56
6 63 67 38
7 88 67 50
8 100 50 56
9 100 67 63
10 63 50 56
11 88 83 69
12 75 58 69
13 63 50 69
14 75 42 69
15 75 33 81
16 63 50 88
17 88 75 81
18 50 58 94
19 75 75 75
20 63 67 75
21 75 58 94
22 75 67 94
23 88 75 100
24 75 75 100
25 63 75 94
26 88 75 94
27 75 75 94
28 88 75 94
29 75 50 88
30 88 83 94
31 63 92 81
32 75 83 100
33 75 67 100
34 100 58 100
35 100 75 88
36 88 58 81
37 88 67 100
38 88 75 94
39 75 83 94
40 63 83 100
41 88 83 100
Note_ Scores are shown separately for each frame for each relational task_