Emotion recognition in ASD
Emotion recognition in ASD is positively linked to chronological age, verbal and nonverbal IQ, and female gender (e.g., Buitelaar, van der Wees, Swaab-Barneveld, & van der Gaag, 1999; Prior, Dahlstrom, & Squires, 1990; Taylor, Maybery, Grayndler, & Whitehouse, 2014; Wright et al., 2008). Disruption in emotion recognition has been linked to more general visual faceprocessing difficulties (e.g., Vlamings, Jonkman, van Daalen, van der Gaag, & Kemner, 2010; Wolf et al., 2008) and the presence of alexithymia[1] (for a review, see Bird & Cook, 2013). In addition, emotion recognition abilities have been linked to the type of visual stimulus. For instance, there is some agreement that, compared to static stimuli (e.g., photos), the use of dynamic stimuli (e.g., movies) is more likely to disrupt emotion recognition (Guillon, Hadjikhani, Badual, & Roge, 2014) which may be due to an effect of stimulus complexity. In a related vein, it has been argued that disruptions in the visual processing of dynamic changes in facial expressions underlies emotion recognition impairments in real-life social interactions among persons with ASD (Sato, Uono, & Toichi, 2013; for an excellent review of facial emotion recognition in ASD, see Harms, Martin, & Wallace, 2010). To complicate matters, it may also be that emotion type and stimulus type interact such that the recognition of specific emotions (i.e., sad) is hindered by the use of dynamic stimuli whereas the recognition of other emotions (i.e., anger) may be facilitated (Enticott et al., 2014).
With regard to emotion type, children with ASD may have particular difficulty with the recognition of negative emotions (e.g., mad, scared) which suggests amygdala involvement in some, but by no means all, children with ASD (e.g., Ashwin, Chapman, Colle, & Baron-Cohen, 2006). Moreover, many researchers distinguish between ‘basic’ emotions that are caused by situations(e.g., happy, sad, mad, scared), ‘cognitive’emotions that are caused by beliefs or attitudes(e.g., surprise, disgust), and ‘complex’emotions(e.g., worry, guilt, envy) for which emotion recognition accuracy requires an even more sophisticated understanding of mind(e.g., Lacroix, Guidetti, Roge, & Reilly, 2014). In fact, some have argued that although many high-functioning persons with ASD may be relatively able in the recognition of basic emotions, “they are completely lost” when “required to understand how cognition and emotion interact” (Baron-Cohen, Spitz, & Cross, 1993, p. 509). Such is the case in the recognition of surprise. Surprise is considered a cognitive emotion because it requires an attribution that another’s expectation was contradicted by reality.
As noted above, even greater difficulty may be evident in complex emotion understanding and persons with ASD may need to invest considerable effort to understand these emotions. Self-conscious emotions (e.g., embarrassment, pride) may be most difficult because they require an understanding of social norms. They are also considered second-order emotions because they involve an appraisal of others’ view of oneself. Complex emotions also present the greatest difficulty because, compared to the ‘basic’ and ‘cognitive’ emotions described above, they rely less on the decoding of overt facial expressionsand more on the ability to relate emotion expressions to subtle aspects of social context (Shamay-Tsoory, 2008). It is critical to also note that there are broad-ranging deficits in emotion processing inASD across the auditory and visual modality. “They cannot therefore be accounted for simply in terms of impairments in face processing or in the visual modality alone. [Indeed], a core deficit affecting the processing of a wide range of emotional information in ASD…contributes to the impairments in social function seen in people with this condition” (Philip et al., 2012, p. 1919).
Emotion recognition in ADHD
Although some researchers report no evidence for impaired emotion recognition in ADHD (Baribeau et al., 2015; Demurie, De Corel, & Roeyers, 2011; Downs & Smith, 2004; Gonzalez-Gadea et al., 2013; Sprouse, Hall, Webster, & Bolen, 1998), the vast majority of studies on this topic do document a deficit (Bisch et al., 2016; Cadesky, Mota, & Schachar, 2000; Corbett & Glidden, 2000; Czaplewska & Lipowska, 2008; Demopoulos et al., 2012; Kats-Gold, Besser, & Priel, 2007; Ludlow, Garrood, Lawrence & Gutierrez, 2014; Markovska-Simoska & Pop-Jordanova, 2010; Norvilitis, Casey, Brooklier, & Bonello, 2000; Oerlemans et al., 2014; Pelc, Kornreich, Foisy, & Dan, 2006; Rapport, Friedman, Tzelepis, & Van Voorhis, 2002; Shapiro, Hughes, August, & Bloomquist, 1993; Singh, Ellis, Winton, Singh, & Leung, & Oswald, 1998; Sinzig, Morsch, & Lehmkuhl, 2008) and such deficits have been found to be an important predictor of social dysfunction in this population (e.g., Kats-Gold et al., 2007). In a recent review, Uekermann et al. (2010) concluded that “ADHD is clearly associated with social cognition impairments involving emotional face perception” (p. 734).
In ADHD, emotion recognition is related to symptom severity (Norvilitis et al., 2000), executive function (e.g., sustained attention and inhibition; Sinzig et al., 2008), verbal ability (Bisch et al., 2016), and IQ (Baribeau et al., 2015)although emotion recognition deficits are commonly observed after the effects of these factors are controlled (Ludlow et al., 2014; Norvilitis et al., 2000; Oerlemans et al., 2014).There appears to be compellingevidence that, although vocal affect (prosody) processing is disrupted in ADHD (Corbett & Glidden, 2000; Norvilitis et al., 2000; Oerlemans et al., 2014; Rapport et al., 2002; Uekermann et al., 2010), emotion recognition may nonetheless be enhanced by multimodal perception (i.e., combining visual and audio information enhances accurate emotion recognition) (Bisch et al., 2016; Czaplewska & Lipowska, 2008).In addition, whether there is a specific or general emotion recognition deficitin ADHD remains unclear but it appears likely that there is an advantage of happy and sad recognition, whereas recognition of fear andanger may be more impaired (e.g., Kats-Gold et al., 2007; Ludlow et al., 2014; Markovska-Simoska & Pop-Jordanova, 2010; Pelc et al., 2006; Singh et al., 1998).Interestingly, unlike typically developing individuals for whom emotion recognition is positively correlated with the intensity of experienced emotion, a negative correlation between these factors is documented in individuals with ADHD. Persons with ADHD tend to experience their own emotions with greater intensity than adults without the disorder “yet, this does not generalize to sensitivity toward the emotions of others. In fact, their high level of emotional intensity may disrupt their ability to be sensitive to others” (Rapport et al., 2002, p. 207).
Potential mechanisms underlying the poor emotion recognition of individuals with ADHD include visual-perceptual abnormalities (e.g., Pelc et al., 2006), however, unlike the literature in ASD, there is some consensusthat emotion recognition abilities are intact at the stimulus perceptional (i.e., visuospatial) level (e.g., Rapport et al., 2002; Shapiro et al., 1993). Another potential mechanism involves a non-specific result of inattention and impulsivity and/or related executive function (EF) deficits (e.g., Cadesky et al., 2000). According to this theory, emotion recognition deficits are a result of impaired “behavior selection, performance or regulation, thereby leading to the hypothesis that the social deficits in ADHD are secondary to executive dysfunction” (Demopoulos et al., 2013; p. 1166). If EF is implicated, however, it seems that factors other than impulsivity are most responsible. This is because persons with ADHD evidence longer response latencies when identifying emotions (e.g., Rapport et al., 2002; which argues against impulsivity) and emotion recognition appears to beless disrupted in persons with impulsive, as opposed to primarily attention deficits (Miller et al., 2011). Still another theory attributes emotion recognition impairments to a more central social cognitive deficit and an inability to recognize social and contextual cues that are associated with various emotions (e.g., Kats-Gold et al., 2007). Of course, it is likely that several processes (e.g., attention, emotion regulation, social cognitive deficits) are operating to create emotion recognition challenges in persons with ADHD. Vis-à-vis EF (which refers to a constellation of cognitive processes), an important distinction has also been made between ‘hot’ and ‘cold’ cognition. The argument is that these different modes of cognition create different psychologicalconditions that have variableconsequences for emotion recognition. To illustrate, Norvilitis et al. (2000) observed deficits in the ability of children with ADHD to identify emotions in themselves and others in a variety of contexts, however, performance was better for ‘cold’ emotion recognition tasks compared to ‘hot’ or ‘live’ recognition tasks. As Norvilitis et al. (2000) explained:
“Children with ADHD demonstrate less awareness of their own expression of emotion and of others emotions. This deficit is more pronounced when the child is in a live ‘hot’ situation rather than engaging in ‘cold’ cognitive emotion identification tasks, such as looking at pictures of facial expression. In other words, children with ADHD would have a much more difficult time identifying emotions on the playground than looking at pictures in a storybook. However, although less pronounced, children with ADHD have difficulty identifying emotions in such cold tasks…In emotion regulation, children with ADHD are more susceptible to emotional contagion, that is, they are more likely to pick up and demonstrate another child’s emotion. Children with ASHD are also overly emotional, may be explosive, and become over-aroused when stimulated. Many deficits in regulation may be traced back to difficulties with emotion appraisal: children cannot regulate what they cannot identify” (p. 17).
Emotion recognition in DoHH
Early theorizing on this topic postulated the presence of ‘compensatory sensitivity’ that predicted superior emotion recognition in persons who are DoHH. As Vernon (1978) suggested, deaf people “are denied adequate verbal communication with most persons with whom they have interaction…they are almost dependent upon reading body language…[Therefore], they perceive the basic affects, feelings, and essence of people…they become astute judges of character” (p. 16). On the other hand, despite the fact that emotion recognition is considered a nonverbal skill, “it usually develops within an auditory, linguistic context. Therefore, an alternative hypothesis is that loss of auditory input during infancy has a detrimental effect upon DoHH children’s ability to identify facial expressions of emotion” (Gray, Hosie, Russell, & Ormel, 2001, p. 138). Themajorityof research on this topic has demonstrated that oral deaf and late-signing deaf children[2] are not superior in emotion recognition compared to their hearing counterparts but whether reliable deficits occur with regard to the basic emotions (i.e., happy, sad, mad, scared) remains an open question[3]. Some studies have reported no differencesbetween oral deaf and hearing children (Hao & Su, 2014; Hosie et al., 1998; Hopyan-Misakyan, Gordon, Dennis, & Pasin, 2009; Odom, Richard, Laukhuf, 1972; Weisel, 1985) in emotion recognition accuracy whereas others have reported significant developmental delays (Bachara, Raphael, & Phelan, 1980; Dyck & Denver, 2003; Dyck, Farragia, Shochet, & Holmes-Brown, 2004) that, in turn, predict deficits in other areas of social cognition (e.g., empathy, Bachara et al., 1980). One explanation for the mixed results involves the nature of the stimuli and tasks. For example, it is likely that emotion matching is easier than emotion labeling. In addition, studies that have reported no differences between DoHH and hearing controls tend to use static visual displays of exaggerated expressions whereas those that have detected results may be employing stimuli with less salient, butarguably more ecologically-valid, visual features (e.g., see Hao & Su, 2014 and Hopyan-Misakyan et al., 2009). With regard to the more complex emotions (e.g., guilt, pride, embarrassment) there are very few studies butperhaps a bit more consensus. Most researchers who have commented on the topic suggest that individuals who are DoHH experience difficulty not only recognizing the more complex emotions on the basis of their visual features but also in attributing these emotions to others and reasoning about their causes(Dyck et al., 2004; Rieffe, 2012)
As in true in the general population (and other clinical conditions), emotion recognition in children who are DoHH is correlated with language development (e.g., Dyck & Denver, 2003). Severity of emotion recognition deficits (when observed) are also related to hearing history with people with congenital and prelingual hearing loss having greater impairment than people with postlingual hearing loss (Bachara et al., 1980; Schiff, 1973).Finally, degree of impairment is inversely related to age (e.g., Dyck et al., 2004) which strongly suggests a developmental delay as opposed to deviant development (Gray, Hosie, Russell, Scott, & Hunter, 2007).All of these findings make sense in light of the “conversation hypothesis” (Dyck & Denver, 2003, p. 350) of theory of mind deficits in oral and late signing deaf children and comports with the results of intervention studies showing that, as a group, children who are DoHH respond favorably to social skills and social cognition curricula (Dyck & Denver, 2003; Rieffe & Terwogt, 2000).
REFERENCES
Ashwin, C., Chapman, E., Colle, L., & Baron-Cohen, S. (2006). Impaired recognition of negative basic emotions in autism: A test of the amygdala theory. Social Neuroscience, 1(3-4), 349-363.
Bachara, G., Raphael, J., & Phelan, W. (1980). Empathy development in deaf preadolescents. American Annals of the Deaf, 125(1), 38-41.
Baribeau, D., Doyle-Thomas, K., Dupuis, A., Iaboni, A., Crosbie, J., McGinn, H., et al. (2015). Examining and comparing social perception abilities across childhood-onset neurodevelopmental disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 54(6), 479-486.
Baron-Cohen, S., Spitz, A., & Cross, P. (1993). Do children with autism recognize surprise? Cognition and Emotion, 7(6), 507-516.
Bird, G., & Cook, R. (2013). Review: Mixed emotions: The contribution of alexithymia to the emotional symptoms of autism. Translational Psychiatry, 3, 1-8.
Bisch, J., Kreifelts, B., Bretscher, J., Wildgruber, D., Fallgatter, A., & Ethofer, T. (2016). Emotion perception in adult attention-deficit hyperactivity disorder. Journal of Neural Transmission, 123, 961-970.
Buitelaar, J. K., van der Wees, M., Swaab-Barneveld, H., & van der Gag, R. (1999). Verbal memory and performance IQ predict theory of mind and emotion recognition ability in children with autistic spectrum disorders and in psychiatric control children. Journal of Child Psychology and Psychiatry, 40(6), 869-881.
Cadesky, E., Mota, V., & Schachar, R. (2000). Beyond words: how do children with ADHD and/or conduct problems process nonverbal information about affect? Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1160-1167.
Corbett, B., & Glidden, H. (2000). Processing affective stimuli in children with attention-deficit hyperactivity disorder, Child Neuropsychology, 6(2), 144-155.
Czaplewska, E., & Lipowska, M. (2008). Perception of facially and vocally expressed emotions in children with ADHD. Acta Neuropsychologica, 6(4), 337-348.
Demopoulos, C., Hopkins, J., & Davis, A. (2013). A comparison of social cognitive profiles in children with autism spectrum disorders and attention-deficit/hyperactivity disorder: A matter of quantitative but not qualitative difference? Journal of Autism and Developmental Disabilities, 43, 1157-1170.
Demurie, E., De Corel, M., & Roeyers, H. (2011). Empathic accuracy in adolescents with autism spectrum disorders and adolescents with ADHD. Research in Autism Spectrum Disorders, 5, 126-134.
Downs, A., & Smith, R. (2004). Emotional understanding, cooperation, and social behavior in high-functioning children with autism. Journal of Autism and Developmental Disorders, 34(6), 625-635.
Dyck, M., & Denver, E. (2003). Can the emotion recognition ability of deaf children be enhanced? A pilot study. Journal of Deaf Studies and Deaf Education, 8(3), 348-356.
Dyck, M., Farrugia, C., Shochet, I., & Holmes-Brown, M. (2004). Emotion recognition/understanding ability in hearing or vision-impaired children: Do sounds, sights, or words make the difference? Journal of Child Psychology & Psychiatry, 45(4), 789-800.
Enticott, P., Kennedy, H., Johnston, P., Rinehart, N., Tonge, B., Taffe, J., & Fitzgerald, P. (2014). Emotion recognition of static and dynamic faces in autism spectrum disorder. Cognition and Emotion, 28(6), 1110-1118.
Gonzalez-Gadea, M., Torralva, T., Castellason, F.,Rattazzi,A.,Bein,V.,etal.(2013).CognitivevariabilityinadultswithADHDand AS: disentangling therolesofexecutivefunctionsandsocialcognition. Research in Developmental Disabilities, 34, 817–830.
Gray, C., Hosie, J., Russell, P., & Ormel, E. (2001). Emotional development in deaf children: Facial expressions, display rules, and theory of mind. Context, Cognition, and Deafness, 1, 135-160.
Gray, C., Hosie, J., Russell,P., Scott, C., & Hunter, (2007). Attribution of emotions to story characters by severely and profoundly deaf children. Journal of Developmental and Physical Disabilities, 19(2), 145-159.
Guillon, Q., Hadjikhani, N., Badual, S., & Roge, B. (2014). Visual social attention in autism spectrum disorder: Insights from eye tracking studies. Neuroscience and Biobehavioral Reviews, 42, 279-297.
Hao, J., & Su, Y. (2014). Deaf children’s use of clear visual cues in mindreading. Research in Developmental Disabilities, 35, 2849-2857.
Harms, M., Martin, A., & Wallace, G. L. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychological Review, 20, 290-322.
Hopyan-Misakyan, T., Gordon, K., Dennis, M., & Papsin, B. (2009). Recognition of affective speech prosody and facial affect in deaf children with unilateral right cochlear implants. Child Neuropsychology, 15, 136-146.
Hosie, J., Gray, C., Russell, P., Scott, C., Hunter, N. (1998). The matching of facial expression by deaf and hearing children and their production and comprehension of emotion labels. Motivation and Emotion, 22, 293-313.
Hutchins, T. L., Prelock, P. A., Morris, H., Benner, J., LaVigne, T., & Hoza, B. (2016). Explicit vs. applied theory of mind competence: A comparison of typically developing males, males with ASD, and males with ADHD. Research in Autism Spectrum Disorders, 21, 94-108.
Kats-Gold, I., Besser, A., & Priel, B. (2007). The role of simple emotion recognition skills among school aged boys at risk for ADHD. Journal of Abnormal Child Psychology, 35, 363-378.
Lacroix, A., Guidetti, M., Roge, B., & Reilly, J. (2014). Facial emotion recognition in 4- to 8-year-olds with autism spectrum disorder: A developmental trajectory approach. Research in Autism Spectrum Disorders, 8, 1146-1154.
Letourneau, S., & Mitchell, T. (2013). Visual field bias in hearing and deaf adults during judgments of facial expressions and identity. Frontiers in Psychology, 4, 1-9.
Ludlow, A., Garrood, A., Lawrence, K., & Gutierrez, R. (2014). Emotion recognition from dynamic emotional displays in children with ADHD. Journal of Social and Clinical Psychology, 33(5), 413-427.
Markovska-Simoska, S., & Pop-Jordanova, N. (2010). Face and emotion recognition by ADHD and normal adults. Acta Neuropsychologica, 8(2), 9-122.
McCullough, S., & Emmorey, K. (1997). Face processing by def ASL signers: Evidence for expertise in distinguished local features. Journal of Deaf Studies and Deaf Education, 2, 212-222.
Miller, M., Hanford, R., Fassbender, C., Duke, M., & Schweitzer, J. (2011). Affect recognition in adults with ADHD. Journal of Attention Disorders, 15(6), 452-460.
Norvilitis, J., Casey, R., Brookleir, M., & Bonello, P. (2000). Emotion appraisal in children with attention-deficit/hyperactivity disorder and their parents. Journal of Attention Disorders, 4(1), 15-26.
Odom, P., Blanton, R., & Laukhuf, C. (1972). Facial expressions and interpretation of emotion-arousing situations in deaf and hard of hearing children. Journal of Abnormal Psychology, 1(2), 139-151.
Pelc, K., Kornreich, C., Foisy, M., & Dan, B. (2006). Recognition of emotional facial expressions in attention-deficit hyperactivity disorder. Pediatric Neurology, 35(2), 93-97.
Philip, R., Whalley, H., Stanfield., Sprengelmeyer, R., Santos, I., Young, A., et al. . . . Hall, J. (2010). Deficits in facial, body movement and vocal emotional processing in autism spectrum disorders. Psychological Medicine, 40, 1919-1929.
Prior, M., Dahlstrom, B., & Squires, T. (1990). Autistic children’s knowledge of thinking and feeling states in other people. Journal of Child Psychology and Psychiatry, 31, 587-601.
Rapport, L., Friedman, S., Tzelepis, A., & Van Voorhis, A. (2002). Experienced emotion and affect recognition in adult attention-deficit hyperactivity disorder. Neuropsychology, 16(1), 102-110.
Rieffe, C. (2012). Awareness and regulation of emotions in deaf children. British Journal of Developmental Psychology, 30, 477-492.
Rieffe, C., & Terwogt, M. (2000). Deaf children’s understanding of emotion: Desires take precedence. Journal of Child Psychology & Psychiatry, 41, 601-608.