Kids with autism struggle to read facial expressions

Children with autism may have a harder time reading emotions on people’s faces than other kids, but they also misunderstand the feelings they see in a way that’s pretty similar to youth without autism, a small study suggests.

“We found that on average, young people with autism are a bit less accurate at recognizing all expressions, not just the subtle ones,” said lead study author Sarah Griffiths of the University of Cambridge’s Autism Research Center in the UK.

“The types of mistakes that children with autism make like confusing scared and surprised are the same types of mistakes made by typically developing children,” Griffiths, who did the research at the University of Bristol, said by email. “So it’s not just that children with autism interpret emotions completely differently, but they are more likely to make common misinterpretations.”

About one in 68 children have autism spectrum disorder (ASD), which includes autism as well as Asperger syndrome and other pervasive developmental disorders, according to the U.S. Centers for Disease Control and Prevention. It is more often diagnosed in boys than in girls.

People with autism often have problems with social, emotional and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with autism also have different ways of learning, paying attention or reacting to things.

Some previous research has linked autism to difficulties reading facial expressions, but results have been mixed and certain studies haven’t found this evidence of this connection, researchers note in the Journal of Autism Developmental Disorders.

For the study, researchers gave an online test of emotion recognition to 63 children and teens with autism and to 64 youth without this diagnosis. Participants saw “happy,” “sad,” “surprised,” “disgusted,” “scared” and “angry” facial expressions; some faces had exaggerated “high-intensity” emotions designed to be easy to read and others had subtle “low-intensity” feelings designed to be more challenging to interpret.

Participants were around 11 years old on average. Most of the kids in the autism group were male, compared to about half of the children in the group without autism.

The research team had expected to find a smaller difference between the groups in recognizing high-intensity emotions.

Instead, they found a bigger difference with more intense emotions, likely because children in both groups made similar errors in recognizing subtle feelings. This made it hard for researchers to detect clear differences between the kids with and without autism.

One limitation of the study is that many participants who started the online facial recognition test didn’t finish it; this happened with 30 percent of participants with autism, the authors note. This might be because people are less likely to complete a repetitive test online at home than they might be under supervision in a lab, the researchers speculate. Another drawback of online testing is that researchers lacked a confirmed clinical diagnosis of autism.

Still, previous brain imaging studies have found areas of the brain involved in decoding emotions and facial expressions are less active in people with autism, said Geraldine Dawson, director of the Duke Center for Autism in Durham, North Carolina.

“The good news is that we can help people with autism learn to interpret facial expressions,” Dawson, who wasn’t involved in the current study, said by email.

“Early behavioral intervention focuses on helping the young child with autism pay attention and respond appropriately to facial expressions,” Dawson added. “There are also training programs in which people with autism can be taught explicitly what each facial expression means and then practice these skills in real life settings.”