Child Psychiatry & Human Development

https://doi.org/10.1007/s10578-019-00870-z

ORIGINAL ARTICLE

The Nature of Facial Emotion Recognition Impairments in Children

on the Autism Spectrum
Nathaniel A. Shanok1   · Nancy Aaron Jones1 · Nikola N. Lucas1

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Abstract
This study examined socio-emotional skills, utilizing a facial emotion recognition (FER) task featuring unfamiliar and famil-
iar faces, in children with autism spectrum disorders (ASD) compared to typically developing (TD) children. Results showed
that the TD children were more proficient on the FER overall whereas ASD children recognized familiar expressions more
precisely than unfamiliar ones. Further, ASD children did not differ from TD children in recognizing happy expressions but
ASD children were less skilled with recognizing negative expressions. Findings suggest that ASD children possess more
adept FER abilities than previously thought especially for important social others. Ultimately, a task featuring an array of
positive and negative familiar and unfamiliar expressions may provide a more comprehensive assessment of socio-emotional
abilities in ASD children.

Keywords  Autism spectrum disorder · Facial emotion recognition · Developmental disorders · Socio-emotional
development · Emotional familiarity

Autism spectrum disorder (ASD) and autism are both gen-
eral terms for a group of complex disorders characterized by
impaired social interactions, in which children are hindered
by a lack of interest in initiating conversation, atypical eye-
contact, and especially struggles in recognizing the emotions
of others [1, 2]. The ability to infer emotions from facial
expressions is critical for interpreting important social cues
during conversation [3]. Facial emotion recognition (FER)
tasks have been devised to assess recognition ability and
overall emotional intelligence, with the general aim being to
match emotional labels to their corresponding facial expres-
sions [4, 5]. Performances on FER tasks are predictive of
individual differences in quality of social interactions [6].
While social and emotional impairments have been fre-
quently observed in case studies on individuals with ASD
[7], the literature regarding FER ability in both children
and adults with ASD has yielded surprisingly inconsistent
results. Some studies have highlighted significant impair-
ments in emotion recognition accuracy among clinically-
diagnosed children [8], adolescents [9], and adults [10], yet
* Nathaniel A. Shanok
nshanok@fau.edu
1 tasks which solely focus on the expressions of strangers.
Florida Atlantic University, Boca Raton, FL, USA
other studies have reported either marginal differences or
no differences in performance between ASD and (typically
developing) TD groups of similar ages [4, 11, 12]. Vari-
ation in experimental methodologies, samples, cognitive
variants, and neurological factors could be responsible for
the divergent findings obtained in prior studies. Many of the
null findings have occurred in studies investigating high-
functioning ASD (HF-ASD) samples, therefore this study
aimed to further evaluate HF-ASD emotion recognition
ability during a key time-period of social development, i.e.,
the period from preschool to elementary in which the child
moves from predominantly family to school social experi-
ences (4–8-years-old).
Previous FER studies have explored the influence of vari-
ables like gender, type of emotional expression, and amount
of allotted time on emotional processing [13] however, only
a few studies have looked at the factor of familiarity and its
effects on recognition ability in ASD [5, 14–16]. This gap in
the literature is surprising as familiar faces are representative
of a larger portion of an individual’s daily social interac-
tions, in that most interactions occur with family, friends,
and classmates [17]. It seems logical that an FER task featur-
ing familiar and unfamiliar stimuli may serve as a better tool
for assessing emotion recognition than conventional FER

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The existing research on familiarity in FER studies is
informative but exhibits important limitations that warrant
further investigation of the topic. Together, these studies
suggest that children and adults with ASD show reduced
eye-tracking behavior and fusiform gyrus/amygdala activa-
tion to unfamiliar expressions compared to familiar ones
[14–16]. However, none of the aforementioned studies pre-
sented participants with a diverse range of emotions; the
tasks consisted of only two types of expressions, “neutral”
and “emotional”. While these studies drew conclusions
regarding the neurological and motor responses to emotional
expressions in ASD, there was no assessment of recognition
ability at the “conscious level” (i.e. self-report).
Thus far, one study has assessed group differences in rec-
ognition accuracy for a diverse range of emotions (happy,
sad, fear, and anger) [18] and surprisingly found that the
ASD group had more proficient recognition for unfamiliar
facial expression stimuli than familiar ones. This finding,
which is the opposite of what we would expect may be in
part attributable to two characteristics of the study. Primar-
ily, the familiar stimuli consisted of expressions generated
by either the participant’s mother or teacher, which likely
represent varying degrees of familiarity to the participant.
Second, the participants consisted of a wide age-range of
children (4–15-years-old).
Therefore, the aim of this paper was to further examine
the influence of familiarity on group performance (ASD,
TD) in emotion recognition with a constant familiar
stimulus (i.e. participant’s mother) as well as with a more
targeted age range (4–8-years-old). A second aim was to
assess the variation in recognition ability for positive and
negative expression types between groups. Notably, there
is evidence that negative emotions (fear, anger, sadness,
disgust) are more challenging for children to recognize
in faces than positive emotions (happy, excitement, etc.)
[19]. In addition, some studies have noted that children
with ASD are more likely to display impairments in rec-
ognizing negative emotions compared to positive ones [20,
21]. Therefore, it was expected that ASD children would
show lower proficiency on the FER task and would show
reduced skills in recognizing negative expressions (sad,
angry, fear) in comparison to the TD group. No hypothesis
was formulated for the familiarity/unfamiliarity factor due
to the findings of past studies being less conclusive and
less theoretical than what is desirable [5, 8].
Methods
Participants
Twenty-eight, 4–8-years-old children (M age = 5.61 years,
SD = 1.23) were participants, with one group of children
diagnosed with HF-ASD (N = 12) and the other a TD
group (N = 16). See Table 1 for participant and family
demographic characteristics. All of the HF-ASD children
had been previously diagnosed by a clinician at a nearby
private practice. The participants in the ASD group were
sampled from several autism schools on a university cam-
pus and in a rural community while TD children were
recruited from university-based schools. This research
was reviewed and approved by the University’s IRB and
participants were treated in accordance with the “Ethical
Principles of Psychologists and Code of Conduct” (Ameri-
can Psychological Association, 1992).

Table 1  Comparing groups on Measurement ASD (N) ASD (%) TD (N) TD (%)

demographic variables
Age M = 5.75 SD = 0.97 M = 5.50 SD = 1.41
Gender
 Male 9 75.00 10 62.5
 Female 3 25.00 6 37.5
Race/ethnicity
 White/Caucasian 9 75.00 13 81.25
 Black/AA 1 8.33 0 0.00
 Hispanic/Latino 2 16.66 0 0.00
 Asian/Caucasian 0 0.00 3 18.75
GARS-2 score M = 55.50 SD = 6.09 M = 8.50 SD = 9.99
Family member with ASD
 Yes 3 25.00 0 0.00
 No 9 75.00 16 100.00
Family income (dollars) M = 96,000 SD = 33.38 M = 105,333 SD = 35.03
Mother’s education (years) M = 16.00 SD = 1.91 M = 16.38 SD = 1.67

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Child Psychiatry & Human Development
Materials
To independently verify the reliability of the group status for
all children, the Gilliam autism rating scale: second edition
(GARS-2) was administered to the mothers of participants
[22]. For the current study, the average composite GARS-2
score in the ASD group was 55.50 (SD = 26.09), and 8.50
(SD = 9.99) in the TD group. Notably, the GARS-2 is a
norm-referenced, 42-item instrument based on the diagnos-
tic guidelines of the DSM-V (three subscales are: stereo-
typed behaviors, communication, and social interaction) and
the Autism Society of America. It is used to gauge the sever-
ity of autism symptoms in individuals from 3- to 22-years.
NimStim and FER Stimuli
The unfamiliar FER stimuli used in this study were sampled
from the NimStim set [23]. The entire NimStim set consists
of 646 experimentally-tested facial emotion images, includ-
ing images of happiness, sadness, anger, fear, disgust, sur-
prise, neutral, and calm. For the current study, the number of
expressions was condensed down to five: happy, sad, anger,
fear, and neutral, with neutral serving as a control. Both
positive (happy) and negative emotions (anger, fear, sad)
were included because negative emotions are thought to be
more difficult to master in developing children [24]. From
the NimStim set (unfamiliar), three images were sampled
for each of the five emotional expressions used in this study,
resulting in 15 images. To create the familiar expressions,
the 15 unfamiliar expressions were replicated by the par-
ticipant’s mother. All images presented were of females to
control for any gender-induced effects.
The adjusted FER task was presented to participants
via the PowerPoint application on a MacBook Pro 13-inch
computer screen. The trials included a target emotion word
and only three images that each participant was directed to
choose among. The reason for this setup was to avoid over-
loading participants with processing demands [5]. The three
images included the correct matching image, an incorrect
one, and a neutral facial expression to serve as a control. All
trials included three images from the same female whether
it was the mother (familiar) or one of the actresses (unfa-
miliar). No images of the same actress were used for more
than one unfamiliar trial. Each set of emotional images were
paired with the other three emotion types an equal number
of times, and each possible order was presented to control
for any priming or ordering effects. The total FER task
consisted of 24 trials with each emotion type (happy, sad,
angry, fear) having the same number of correct trials (6). In
addition, 12 of the trials were familiar (3 for each emotion)
and 12 were unfamiliar (3 for each emotion). The primary
dependent variable in this study was emotion recognition
percent score across all trials, calculated by dividing the
number of trials that a participant answered correctly by the
total number of trials. Percent scores were also calculated
separately for familiar stimuli, unfamiliar stimuli, and each
of the four tested emotions (happy, sad, angry, fear). A criti-
cal goal was to include an adequate number of stimuli for
experimental validity without overloading participants or
inducing a fatigue effect. The 24 trials were randomized so
that each participant completed them in a different order and
reliability was assessed across two experimenters (100%)
who recorded the responses for all 28 participants across
the 24 stimuli.
Emotion Tutorial (Happy, Sad, Angry, Fear)
Prior to the presentation of the experimental task, a brief
tutorial was given on each of the four emotion labels tested
in this study (happy, sad, angry, fear) to ensure that partici-
pants had a conceptual understanding of these terms. The
tutorial consisted of descriptions/examples of these emo-
tions, and included a task requiring participants to match
sample phrases to the target words. No images were used in
the training, just sentences and phrases. Overall, this tuto-
rial took 10 min to complete and all 28 participants showed
a proficient understanding of the emotion labels (90% or
better).
Procedures
Testing took place in a research lab and all procedures
were completed in one sitting. After parental consent was
obtained, the mother began the process of creating the
familiar facial emotion expressions for their child. While
the pictures were being taken, child participants were play-
ing with a sensory toy or building blocks under the supervi-
sion of a research assistant. Mothers were prompted to rep-
licate three of each expression, including happy, sad, angry,
fear, and neutral, to the best of their ability. An image was
only deemed usable when two experimenters agreed that it
resembled the desired image. All images were captured, then
cropped and finally fit into the FER PowerPoint presentation,
utilizing the Photo Booth application on a MacBook Pro
laptop computer. After, mothers completed the demographic
and the GARS-2 questionnaires while the child executed the
FER task.
During the FER task, children were instructed to touch
the facial emotion expression on the computer screen that
they felt best matched the corresponding emotion word.
Each of the 24 trials were presented one at a time. The tar-
get emotion label (happy, sad, angry, fear) appeared at the
bottom of the screen and was read aloud to the participant.
If participants changed their answer, then the last answer
was recorded and used for analysis. Completion time was
approximately 1.5 h for each family.
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Results Two‑Way Interaction: Group X Familiarity and Group

Overall Group Differences on FER
A 2 × 2 × 4 mixed model analysis of variance was performed,
with group (ASD, TD) as the between-subjects variable
and both familiarity (familiar, unfamiliar) and emotion type
(happy, sad, angry, fear) as within-subjects variables. The
dependent variable was emotion recognition percent score,
computed as the percentage of correct responses out of 24
trials.
Overall, there was a significant three-way interaction
effect of group by familiarity by emotion type on emo-
tion recognition percent scores, F(3,78) = 2.98, p < .05,
η 2 = 0.10. The two-way interaction effect of group by
familiarity was also significant, F(1,26) = 10.11, p < .01,
η2 = 0.28, however the two-way interaction effect of group
by emotion type was not significant, F(3,78) = 2.47, p = .07,
η 2 = 0.09. Finally, there were significant main effects
for group, F(1,26) = 15.04, p < .001, η2 = 0.36, familiar-
ity, F(1,26) = 6.58, p < .05, η2 = 0.20, and emotion type,
F(3,78) = 7.13, p < .001, η2 = 0.22. To clarify, the specific
ASD and TD group means for overall emotion recognition
scores are presented in Table 2. Follow-up analyses were
conducted for the significant three-way interaction effect as
well as the two-way interaction effects.
X Emotion Type
The primary hypotheses were related to the two-way inter-
actions; such that it was expected that groups would show
different results based on stimuli familiarity and emotion
expression type. To understand the significant interaction
effect of group (ASD, TD) and familiarity (familiar, unfa-
miliar) on recognition proficiency, two independent samples
t tests were performed and revealed that the TD group scored
significantly better on unfamiliar expressions compared to
the ASD group, t(26) = 4.82, p < .001 yet there were no dif-
ferences between groups for the familiar stimuli, despite the
TD group having a higher mean percent score, t(26) = 1.45,
p = .16. To control for the familywise error-rate in the two t
test comparisons, a Bonferonni correction was used here and
in further analyses with the resulting alpha values p < .025
(0.05/2). Significant group differences remained for unfa-
miliar expressions. A paired samples t test revealed that the
ASD group scored significantly better on familiar than on
unfamiliar facial expressions, t(11) = − 2.53, p < .05. Sig-
nificant differences on these two measures did not exist for
the TD group (Table 2).
The two-way interaction of group and emotion type
approximated significance, F(3,78) = 2.47, p = .07, η2 = 0.09.
For exploratory purposes, follow-up independent samples
t tests were run to determine if recognition of any specific
emotions differed between the two groups, using a Bonfer-
onni correction, p < .0125 (0.05/4). It was found that sig-
nificant group differences in emotion recognition percent
scores existed for sad expressions, t(26) = 4.521, p < .001
only, with no differences for happy, t(26) = 1.72, p = .10,

Table 2  Comparing groups on Measurement: percent score ASD mean % (SD) TD mean % (SD) Significant group
emotion recognition percent differences (T-tests)
scores for all stimuli types
Overall score 85.39 (7.44) 95.31 (4.78) *p < .001
 Unfamiliar score 79.86 (10.33) 94.79 (5.99) *p < .001
 Familiar score 90.97 (10.92) 95.83 (6.80) p > .05
Total happy score 97.22 (6.49) 100.00 (0) p > .05
 Unfamiliar happy 94.44 (12.98) 100.00 (0) p > .05
 Familiar happy 100.00 (0) 100.00 (0) p > .05
Total fear score 83.28 (15.96) 93.75 (10.32) *p = .04
 Unfamiliar fear 86.11 (17.17) 93.75 (13.44) p > .05
 Familiar fear 83.33 (22.48) 93.75 (13.44) p > .05
Total sad score 72.22 (16.41) 94.79 (10.04) *p < .001
 Unfamiliar sad 69.44 (22.49) 95.83 (11.39) *p < .001
 Familiar sad 86.11 (17.17) 93.75 (13.44) p > .05
Total anger score 87.47 (7.56) 92.71 (10.49) p = .16
 Unfamiliar anger 77.77 (16.42) 93.75 (11.39) *p = .009
 Familiar anger 97.22 (14.91) 91.67 (14.99) p > .05

*p < .05

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Child Psychiatry & Human Development
fear, t(26) = 2.11, p = .04, nor angry, t(26) = 1.47, p = .16
(Table 2). Still these results must be taken with caution given
the non-significant two-way interaction effect.
Three‑Way Interaction: Group X Emotion Type X
Familiarity
To understand the significant three-way interaction effect,
eight independent samples t tests were run (unfamiliar
happy, familiar happy, unfamiliar sad, familiar sad, unfa-
miliar fear, familiar fear, unfamiliar angry, familiar angry),
utilizing the Bonferonni correction, p < .00625 (0.05/8).
Group differences remained significant only for unfamiliar
sad expressions, t(26) = 4.10, p < .001 (Table 2).
Discussion
To expand the literature regarding the facial emotion rec-
ognition abilities of individuals with HF-ASD, the current
study compared the FER abilities of 4–8-year-old children
on the ASD spectrum with TD children. In essence, the goal
was to assess whether children with ASD differed in their
recognition of emotions using an FER task that included
unfamiliar expressions as well as familiar ones (i.e., those
expressions exhibited by the child’s mother). The familiar
and unfamiliar images portrayed three negative emotions
(sad, angry, fear) and one positive emotion (happy). Nearly
all past investigations on this topic have presented images
of only unfamiliar adults, failing to appreciate and assess
a major portion of a child’s social interactions, ones that
commonly occur with family, friends, and teachers [5, 14,
18]. The results demonstrated that both groups have similar
ability to recognize familiar expressions and that the TD
children show additional proficiencies in recognizing unfa-
miliar expressions [13, 17, 25].
The finding that ASD children performed similarly to
TD children on familiar expressions is an interesting aspect
of the study as this result suggests children with ASD are
as in-tune with their mother’s feelings and emotions as TD
children [16, 26, 27]. Moreover, these findings show that
additional research is needed to understand how children
with ASD form emotional bonds or attachments with their
family members. The mother–child relationships may appear
to be slightly unconventional, but it is likely that quality
interactions in these relationships is vital for the well-being
of children with ASD. The results obtained here are in-line
with previous neurological and eye-tracking investigations
on the topic [14, 15, 28]. For example, research has shown
that children with ASD showed normative pupillary reac-
tions to familiar people showing fear, yet both attenuated
eye-tracking and EEG N400 neural responses to unfamiliar
people [28]. However, the results obtained here contrast with
Herba and colleagues [18] who found that surprisingly chil-
dren with ASD were more adept in recognizing unfamiliar
expressions than familiar ones. To extend this line of work, it
may be prudent to determine if children with ASD also have
enhanced emotion recognition when processing expressions
generated by other individuals in their lives, such as fathers,
siblings, peers, and teachers. Taken together, these findings
indicate that children with ASD are perceptive to their moth-
er’s emotions, which may indicate greater potential to learn
and socialize with close others rather than unfamiliar people.
An additional goal of this study was to understand rec-
ognition abilities to specific emotions (happy, sad, angry,
fear). Interestingly, TD children performed significantly bet-
ter (than the ASD children) on two negative emotions (sad,
fear), but group differences were not uncovered for happy
and angry expressions. In children with or without develop-
mental complications, it is often more challenging to master
negative than positive emotion recognition [29]. For chil-
dren with ASD, further difficulties in recognizing negative
or complex facial emotional expressions may be due in part
to variations in eye-contact and eye tracking behavior, with
studies demonstrating that ASD children focus less on the
eyes and more on other facial areas that are less informative
of an individual’s emotional state [4, 30]. Schurgin et al. [31]
found evidence that eye fixations in normative individuals
vary depending on which emotional expression is displayed
by a face. For example, when examining sad, angry, shame,
and disgust expressions, fixation of eyes occurs most in eye
regions whereas for happy expressions, individuals tend to
fixate more on the mouth region. The finding that children
with ASD tend to make less eye-contact during socio-emo-
tional processing may explain their further struggles with
recognizing sad and other negative expressions [32], and
also why they rarely struggle with recognizing happy expres-
sions, as was the case for this study too.
This study was not without limitations, as there was (1)
a restricted range of outcomes, (2) expected confines in the
duration of attention within the child-clinical sample and
(3) reduced sample size. Regarding the latter, a recent meta-
analysis on the topic [33] analyzed 51 studies on the topic
of emotion recognition and autism and found that only 20%
of the studies (10 studies) had group sample sizes over 20
participants. The sample size in the current investigation
was admittedly small but comparable to previous investiga-
tions. In addition, we examined a more targeted age-range
(4–8-years-old). Thus, replication of findings is still nec-
essary to enhance validity. Moreover, it is also important
to acknowledge that ceiling effects were present in the TD
group, especially with the happy faces. Ceiling effects are a
concern in that there is an increased risk in making a type 1
error or finding false significance [34]. To control for ceiling
effects, it may be sensible to present the task in a manner that
is more challenging, either by: (1) presenting participants
13

with more choices per trial; (2) evaluating additional expres-
sions such as surprise, disgust, or embarrassment; or (3)
examining dynamic changes in facial expression recogni-
tion in stimuli that gradually morph into specific expressions
thereby assessing the threshold for recognition. It is also
recommended for future studies to include a formal measure
for assessing the quality of created stimuli (familiar), how-
ever this was not likely a factor in this study as both groups
showed more proficient recognition of their mother’s images
compared to the actress’s images.
To conclude, the current study highlights the impor-
tance of understanding FER skills in children on the autism
spectrum and potentially enhancing FER tasks to include
expressions from both familiar and unfamiliar individuals.
Administering this type of task in children that vary in socio-
emotional processing skills may help developmental scien-
tists and clinicians to understand the types of social situa-
tions that are more challenging for this group. The results of
this study illustrate that children with ASD potentially have
adept and competent emotional processing when viewing
their mother’s faces, but are less skilled at processing emo-
tional information, especially sad faces, when viewing the
faces of strangers. It is unclear whether the latter is due to
genuine deficits in processing abilities of ASD children, the
aversive nature of negative emotions, or due to a general pat-
tern of disinterest in negative emotion displays or unfamiliar
people. Future research should continue to scrutinize the
socio-cognitive and neurodevelopmental processes involved
in emotion recognition, especially in children on the autism
spectrum. This study is further evidence that an FER task
can be an extremely useful resource in not only assessing
emotional intelligence in developing children, but also track-
ing the range of individual differences in the development of
socio-emotional abilities over time.
Summary
ASD and autism are common developmental disorders that
typically effect social and behavioral functioning, including
the ability to comprehend other’s emotions and intentions
though FER. This study provides evidence that TD children
are more proficient in recognizing unfamiliar facial emotion
expressions than children with ASD, particularly for nega-
tive emotions (sad, fear). Preliminary evidence also demon-
strated that children with ASD have adept and competent
emotional processing when viewing their mother’s faces, as
the two groups did not differ in recognizing familiar expres-
sions. This result is insightful as previous neurological and
eye-tracking investigations have hinted at this possibility,
but it has rarely been demonstrated at the conscious level
(i.e. self-report). Future large-scale studies should seek
to determine if this effect is also pertinent to expressions
13
Child Psychiatry & Human Development
from additional familiar individuals (i.e. fathers, siblings,
classmates).
Compliance with Ethical Standards 
Conflict of interest  All author declares that they have no conflict of
interest.
Ethical Approval  All procedures performed in studies involving human
participants were in accordance with the ethical standards of the insti-
tutional and/or national research committee and with the 1964 Helsinki
declaration and its later amendments or comparable ethical standards.
Informed Consent  Informed consent was obtained from all individual
participants included in the study.
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