Measuring change in facial emotion recognition in individuals with autism spectrum disorder: A systematic review

Abstract

Children and adults with autism spectrum disorder are less accurate in facial emotion recognition, which is thought to contribute to impairment in social functioning. Although many interventions have been developed to improve facial emotion recognition, there is no consensus on how to best measure facial emotion recognition in people with autism spectrum disorder. This lack of agreement has led to wide variability in how facial emotion recognition is measured and, subsequently, inconsistent findings related to impact of intervention targeting facial emotion recognition impairment. The purpose of this review is to synthesize the extant research on measurement of facial emotion recognition in the context of treatment. We conducted an electronic database search to identify relevant, peer-reviewed articles published between January 1998 and November 2019 to identify studies evaluating change in facial emotion recognition in autism spectrum disorder. Sixty-five studies met inclusion criteria, utilizing a total of 36 different assessment measures for facial emotion recognition in individuals with autism spectrum disorder. Only six of the measures were used in multiple studies conducted by different investigative teams. The outcomes of the studies are reported and summarized with the goal of informing future research. Lay Abstract Children and adults with autism spectrum disorder show difficulty recognizing facial emotions in others, which makes social interaction challenging. While there are many treatments developed to improve facial emotion recognition, there is no agreement on the best way to measure such abilities in individuals with autism spectrum disorder. The purpose of this review is to examine studies that were published between January 1998 and November 2019 and have measured change in facial emotion recognition to evaluate the effectiveness of different treatments. Our search yielded 65 studies, and within these studies, 36 different measures were used to evaluate facial emotion recognition in individuals with autism spectrum disorder. Only six of these measures, however, were used in different studies and by different investigators. In this review, we summarize the different measures and outcomes of the studies, in order to identify promising assessment tools and inform future research.

Masking Emotions: Face Masks Impair How We Read Emotions

“…The latter is the most widespread, and typically consists of static (images) or dynamic (brief videos) human face stimuli. Such tests have been widely used in different domains to assess level of impairment in recognition of facial movements in the presence of psychiatric ( Rocca et al, 2009 ) or movement ( Argaud et al, 2018 ) disorders, autism ( Wieckowski et al, 2020 ), and developmental disabilities ( Rojahn et al, 1995 ). It is essential to carefully select the task characteristics since they have been proven to influence performance ( Hayes et al, 2020 ).…”

Psychometric properties of the Cambridge‐Mindreading Face‐Voice Battery for Children in children with ASD

“…Given the centrality of social impairment in ASD, researchers have examined emotion‐recognition skills in this group and studies/reviews have documented a range of FER and VER deficits. Despite common testing of emotion recognition as both a characteristic of, and treatment outcome for children with ASD, there is a recognized need for studies assessing the psychometric characteristics of emotion‐recognition measures (Wieckowski et al, 2020). The use of a range of researcher‐created measures has contributed to some mixed findings and measures have been limited in their scope (basic emotions) and use of static photo stimuli (Harms et al, 2010; Lozier et al, 2014; Uljarevic & Hamilton, 2013).…”

“…These studies have yielded variable results, which may be a function of the different measures utilized and/or dimensions assessed. Wieckowski et al (2020) evaluated the treatment sensitivity and emotion‐recognition measures used in FER intervention studies for ASD. Of the measures identified, the Cambridge Mindreading Face‐Voice Battery for Children (CAM‐C) was one of the most commonly used and treatment sensitive measures.…”

“…Additionally, whereas most measures test a narrow range of basic emotions, the CAM‐C assesses simple (basic) and complex emotions. Wieckowski et al (2020) concluded that more research is needed into measures used to assess emotion recognition in ASD. Similarly, in their review of computer interventions for emotion recognition and social skills in ASD, Ramdoss et al (2012) reported mixed results and noted that few studies used standardized measures with established reliability and validity; this led them to recommend that measures be tested for their reliability and criterion‐related validity.…”

“…Because functional level may impact a measure's properties, the study also addresses the need for testing of ASD‐related scales in well‐characterized samples and narrowly‐defined subgroups (ASD without ID; Lord & Corsello, 2005). Rigorous testing is especially needed for emotion‐recognition measures that have shown treatment sensitivity (Wieckowski et al, 2020). This study assessed: (a) internal consistency and test–retest reliability of the CAM‐C; (b) criterion‐related validity against another measure of emotion recognition; and (c) correlations between CAM‐C scores and child age, gender, race, IQ, language abilities, and parent‐reported ASD symptom severity and emotion recognition.…”