Face perception in high-functioning autistic adults: evidence for superior processing of face parts, not for a configural face-processing deficit

Autistic adults exhibit holistic face processing: evidence from inversion and composite face effects

Holistic processing is commonly measured by the face inversion effect (FIE) and the composite face effect (CFE). Previous studies examining whether individuals with autism spectrum disorder (ASD) employ holistic processing using either FIE or CFE have reported inconclusive results. By adopting a customized composite face paradigm, the present study aims to simultaneously assess both the inversion and the composite effects of holistic processing in autistic and neurotypical adults. We tested 24 adults with ASD and 24 neurotypical (NT) adults matched in age, gender, and years of education. Participants viewed sequentially presented composite faces in three Presentation Modes (aligned, inverted, and misaligned) with three Stimuli Conditions (same, composite, and different) and judged whether the top half was the same. For the dependent variables, we calculated a "performance index" in the form of the accuracy/response time of each stimuli condition in each presentation mode. The FIE and CFE were computed to index the magnitude of holistic processing. Our results showed that the NT group responded more accurately in less time than the ASD group across task conditions. Notably, both the NT and the ASD groups exhibited a significant FIE with similar magnitude. Likewise, both the NT and the ASD groups showed a greater-than-zero CFE. Moreover, individuals' CFE positively correlated with FIE and negatively correlated with the AQ scores for all participants. In summary, individuals with ASD exhibit holistic processing when viewing faces, evidenced by the presence of both FIE and CFE and the positive correlations between the two effects.

Autistic traits specific to communication ability are associated with performance on a Mooney face detection task

Difficulties in global face processing have been associated with autism. However, autism is heterogenous, and it is not known which dimensions of autistic traits are implicated in face-processing difficulties. To address this gap in knowledge, we conducted two experiments to examine how identification of Mooney face stimuli (stylized, black-and-white images of faces without details) related to the six subscales of the Comprehensive Autistic Trait Inventory in young adults. In Experiment 1, regression analyses indicated that participants with poorer communication skills had lower task sensitivity when discriminating between face-present and face-absent images, whilst other autistic traits had no unique predictive value. Experiment 2 replicated these findings and additionally showed that autistic traits were linked to a reduced face inversion effect. Taken together, these results indicate autistic traits, especially communication difficulties, are associated with reduced configural processing of face stimuli. It follows that both reduced sensitivity for identifying upright faces amongst similar-looking distractors and reduced susceptibility to face inversion effects may be linked to relatively decreased reliance on configural processing of faces in autism. This study also reinforces the need to consider the different facets of autism independently.

Weak central coherence in neurodevelopmental disorders: a comparative study

Introduction

Central coherence is the normal tendency to process and give meaning to incoming information taking into account the context or global view of that information.

Methods

We assessed the central coherence of 252 school children of normal intelligence between 6 and 11 years old. We compared the performance of two groups: (a) a control group (n = 194), and (b) a clinical group (n = 58) comprising children with NVLD+ADHD (n = 24), ADHD alone (n = 16), SCD (n = 8) and level-1ASD (n = 10) (Kluskall-Wallis H and Mann-Whitney U were calculated to make comparisons within groups and between pairs of groups). The effects of medication were studied (Student's t test).

Results

The NVLD+ADHD, SCD and ASD1 groups showed weak central coherence. The performance of the ADHD group was normal and differed significantly from the NVLD+ADHD group.

Conclusion

Central coherence deficit was not exclusive to ASD1: it also characterizes NVLD and SCD.

EEG Biomarkers for Autism: Rational, Support, and the Qualification Process

In this chapter, we highlight the advantages, progress, and pending challenges of developing electroencephalography (EEG) and event-related potential (ERP) biomarkers for use in autism spectrum disorder (ASD). We describe reasons why global efforts towards precision treatment in ASD are utilizing EEG indices to quantify biological mechanisms. We overview common sensory processing and attention biomarkers and provide translational examples examining the genetic etiology of autism across animal models and human subgroups. We describe human-specific social biomarkers related to face perception, a complex social cognitive process that may prove informative of autistic social behaviors. Lastly, we discuss outstanding considerations for quantifying EEG biomarkers, the challenges associated with rigor and reproducibility, contexts of future use, and propose opportunities for combinatory multidimensional biomarkers.

Investigating the Face Inversion Effect in Autism Across Behavioral and Neural Measures of Face Processing: A Systematic Review and Bayesian Meta-Analysis

Importance

Face processing is foundational to human social cognition, is central to the hallmark features of autism spectrum disorder (ASD), and shapes neural systems and social behavior. Highly efficient and specialized, the face processing system is sensitive to inversion, demonstrated by reduced accuracy in recognition and altered neural response to inverted faces. Understanding at which mechanistic level the autistic face processing system may be particularly different, as measured by the face inversion effect, will improve overall understanding of brain functioning in autism.

Objective

To synthesize data from the extant literature to determine differences of the face processing system in ASD, as measured by the face inversion effect, across multiple mechanistic levels.

Data Sources

Systematic searches were conducted in the MEDLINE, Embase, Web of Science, and PubMed databases from inception to August 11, 2022.

Study Selection

Original research that reported performance-based measures of face recognition to upright and inverted faces in ASD and neurotypical samples were included for quantitative synthesis. All studies were screened by at least 2 reviewers.

Data Extraction and Synthesis

This systematic review and meta-analysis was conducted according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Multiple effect sizes were extracted from studies to maximize information gain and statistical precision and used a random-effects, multilevel modeling framework to account for statistical dependencies within study samples.

Main Outcomes and Measures

Effect sizes were calculated as a standardized mean change score between ASD and neurotypical samples (ie, Hedges g). The primary outcome measure was performance difference between upright and inverted faces during face recognition tasks. Measurement modality, psychological construct, recognition demand, sample age, sample sex distribution, and study quality assessment scores were assessed as moderators.

Results

Of 1768 screened articles, 122 effect sizes from 38 empirical articles representing data from 1764 individual participants (899 ASD individuals and 865 neurotypical individuals) were included in the meta-analysis. Overall, face recognition performance differences between upright and inverted faces were reduced in autistic individuals compared with neurotypical individuals (g = -0.41; SE = 0.11; 95% credible interval [CrI], -0.63 to -0.18). However, there was considerable heterogeneity among effect sizes, which were explored with moderator analysis. The attenuated face inversion effect in autistic individuals was more prominent in emotion compared with identity recognition (b = 0.46; SE = 0.26; 95% CrI, -0.08 to 0.95) and in behavioral compared with electrophysiological measures (b = 0.23; SE = 0.24; 95% CrI, -0.25 to 0.70).

Conclusions and Relevance

This study found that on average, face recognition in autism is less impacted by inversion. These findings suggest less specialization or expertise of the face processing system in autism, particularly in recognizing emotion from faces as measured in behavioral paradigms.

Brain structure and function in the fourth decade of life after extremely low birth weight: An MRI and EEG study

OBJECTIVE

To examine potential long-term effects of extremely low birth weight (ELBW; ≤ 1000 g) on adult brain structure, brain function, and cognitive-behavioral performance.

METHODS

A subset of survivors from the prospectively-followed McMaster ELBW Cohort (n = 23, MBW = 816 g) and their peers born at normal birth weight (NBW; ≥ 2500 g; n = 14, MBW = 3361 g) provided T1-weighted magnetic resonance imaging (MRI) brain scans, resting electroencephalographic (EEG) recordings, and behavioral responses to a face-processing task in their early thirties.

RESULTS

Visual discrimination accuracy for human faces, resting EEG alpha power, and long-distance alpha coherence were lower in ELBW survivors than NBW adults, and volumes of white matter hypointensities (WMH) were higher. Across groups, face-processing performance was correlated positively with posterior EEG spectral power and long-distance alpha and theta coherence, and negatively with WMH. The associations between face-processing scores and parietal alpha power and theta coherence were reduced after adjustment for WMH.

CONCLUSIONS

Electrocortical activity, brain functional connectivity, and higher-order processing ability may be negatively affected by WMH burden, which is greater in adults born extremely preterm.

SIGNIFICANCE

Decrements in electrocortical activity and behavioral performance in adult ELBW survivors may be partly explained by increased WMH volumes in this vulnerable population.

Active Viewing Facilitates Gaze to the Eye Region in Young Children with Autism Spectrum Disorder

Previous studies have shown reduced attention to the eyes in individuals with autism spectrum disorder (ASD). However, most eye-tracking evidence regarding this impairment has been derived from passive viewing tasks. Here, we compared the passive viewing of faces with an active task involving face identification with morphing faces. While typical controls prioritized the eyes over other facial features regardless of viewing condition, autistic children exhibited reduced eye-looking in passive viewing, but displayed increased attention allocation to the eyes when instructed to identify faces. The proportional eye-looking in ASD during facial recognition was negatively related to the autism symptoms severity. These findings provide evidence regarding the specific situations in which diminished eye-looking may rise in young ASD children.

Faster social attention disengagement in individuals with higher autism traits

INTRODUCTION

Atypical visual and social attention has often been associated with clinically diagnosed autism spectrum disorder (ASD), and with the broader autism phenotype. Atypical social attention is of particular research interest given the importance of facial expressions for social communication, with faces tending to attract and hold attention in neurotypical individuals. In autism, this is not necessarily so, where there is debate about the temporal differences in the ability to disengage attention from a face.

METHOD

Thus, we have used eye-tracking to record saccadic latencies as a measure of time to disengage attention from a central task-irrelevant face before orienting to a newly presented peripheral nonsocial target during a gap-overlap task. Neurotypical participants with higher or lower autism-like traits (AT) completed the task that included central stimuli with varied expressions of facial emotion as well as an inverted face.

RESULTS

High AT participants demonstrated faster saccadic responses to detect the nonsocial target than low AT participants when disengaging attention from a face. Furthermore, faster saccadic responses were recorded when comparing disengagement from upright to inverted faces in low AT but not in high AT participants.

CONCLUSIONS

Together, these results extend findings of atypical social attention disengagement in autism and highlight how differences in attention to faces in the broader autism phenotype can lead to apparently superior task performance under certain conditions. Specifically, autism traits were linked to faster attention orienting to a nonsocial target due to the reduced attentional hold of the task irrelevant face stimuli. The absence of an inversion effect in high AT participants also reinforces the suggestion that they process upright or inverted faces similarly, unlike low AT participants for whom inverted faces are thought to be less socially engaging, thus allowing faster disengagement.

Qualitative differences in the spatiotemporal brain states supporting configural face processing emerge in adolescence in autism

BACKGROUND

Studying the neural processing of faces can illuminate the mechanisms of compromised social expertise in autism. To resolve a longstanding debate, we examined whether differences in configural face processing in autism are underpinned by quantitative differences in the activation of typical face processing pathways, or the recruitment of non-typical neural systems.

METHODS

We investigated spatial and temporal characteristics of event-related EEG responses to upright and inverted faces in a large sample of children, adolescents, and adults with and without autism. We examined topographic analyses of variance and global field power to identify group differences in the spatial and temporal response to face inversion. We then examined how quasi-stable spatiotemporal profiles - microstates - are modulated by face orientation and diagnostic group.

RESULTS

Upright and inverted faces produced distinct profiles of topography and strength in the topographical analyses. These topographical profiles differed between diagnostic groups in adolescents, but not in children or adults. In the microstate analysis, the autistic group showed differences in the activation strength of normative microstates during early-stage processing at all ages, suggesting consistent quantitative differences in the operation of typical processing pathways; qualitative differences in microstate topographies during late-stage processing became prominent in adults, suggesting the increasing involvement of non-typical neural systems with processing time and over development.

CONCLUSIONS

These findings suggest that early difficulties with configural face processing may trigger later compensatory processes in autism that emerge in later development.

Identifying Age Based Maturation in the ERP Response to Faces in Children With Autism: Implications for Developing Biomarkers for Use in Clinical Trials

Recent proposals have suggested the potential for neural biomarkers to improve clinical trial processes in neurodevelopmental conditions; however, few efforts have identified whether chronological age-based adjustments will be necessary (as used in standardized behavioral assessments). Event-related potentials (ERPs) demonstrate early differences in the processing of faces vs. objects in the visual processing system by 4 years of age and age-based improvement (decreases in latency) through adolescence. Additionally, face processing has been proposed to be related to social skills as well as autistic social-communication traits. While previous reports suggest delayed latency in individuals with autism spectrum disorder (ASD), extensive individual and age based heterogeneity exists. In this report, we utilize a sample of 252 children with ASD and 118 children with typical development (TD), to assess the N170 and P100 ERP component latencies (N170L and P100L, respectively), to upright faces, the face specificity effect (difference between face and object processing), and the inversion effect (difference between face upright and inverted processing) in relation to age. First, linear mixed models (LMMs) were fitted with fixed effect of age at testing and random effect of participant, using all available data points to characterize general age-based development in the TD and ASD groups. Second, LMM models using only the TD group were used to calculate age-based residuals in both groups. The purpose of residualization was to assess how much variation in ASD participants could be accounted for by chronological age-related changes. Our data demonstrate that the N170L and P100L responses to upright faces appeared to follow a roughly linear relationship with age. In the ASD group, the distribution of the age-adjusted residual values suggest that ASD participants were more likely to demonstrate slower latencies than would be expected for a TD child of the same age, similar to what has been identified using unadjusted values. Lastly, using age-adjusted values for stratification, we found that children who demonstrated slowed age-adjusted N170L had lower verbal and non-verbal IQ and worse face memory. These data suggest that age must be considered in assessing the N170L and P100L response to upright faces as well, and these adjusted values may be used to stratify children within the autism spectrum.

Eye Tracking Research on the Influence of Spatial Frequency and Inversion Effect on Facial Expression Processing in Children with Autism Spectrum Disorder

Facial expression processing mainly depends on whether the facial features related to expressions can be fully acquired, and whether the appropriate processing strategies can be adopted according to different conditions. Children with autism spectrum disorder (ASD) have difficulty accurately recognizing facial expressions and responding appropriately, which is regarded as an important cause of their social disorders. This study used eye tracking technology to explore the internal processing mechanism of facial expressions in children with ASD under the influence of spatial frequency and inversion effects for improving their social disorders. The facial expression recognition rate and eye tracking characteristics of children with ASD and typical developing (TD) children on the facial area of interest were recorded and analyzed. The multi-factor mixed experiment results showed that the facial expression recognition rate of children with ASD under various conditions was significantly lower than that of TD children. TD children had more visual attention to the eyes area. However, children with ASD preferred the features of the mouth area, and lacked visual attention and processing of the eyes area. When the face was inverted, TD children had the inversion effect under all three spatial frequency conditions, which was manifested as a significant decrease in expression recognition rate. However, children with ASD only had the inversion effect under the LSF condition, indicating that they mainly used a featural processing method and had the capacity of configural processing under the LSF condition. The eye tracking results showed that when the face was inverted or facial feature information was weakened, both children with ASD and TD children would adjust their facial expression processing strategies accordingly, to increase the visual attention and information processing of their preferred areas. The fixation counts and fixation duration of TD children on the eyes area increased significantly, while the fixation duration of children with ASD on the mouth area increased significantly. The results of this study provided theoretical and practical support for facial expression intervention in children with ASD.

The N170 event-related potential reflects delayed neural response to faces when visual attention is directed to the eyes in youths with ASD

Atypical neural response to faces is thought to contribute to social deficits in autism spectrum disorder (ASD). Compared to typically developing (TD) controls, individuals with ASD exhibit delayed brain responses to upright faces at a face-sensitive event-related potential (ERP), the N170. Given observed differences in patterns of visual attention to faces, it is not known whether slowed neural processing may simply reflect atypical looking to faces. The present study manipulated visual attention to facial features to examine whether directed attention to the eyes normalizes N170 latency in ASD. ERPs were recorded in 30 children and adolescents with ASD as well as 26 TD children and adolescents. Results replicated prior findings of shorter N170 latency to the eye region of the face in TD individuals. In contrast, those with ASD did not demonstrate modulation of N170 latency by point of regard to the face. Group differences in latency were most pronounced when attention was directed to the eyes. Results suggest that well-replicated findings of N170 delays in ASD do not simply reflect atypical patterns of visual engagement with experimental stimuli. These findings add to a body of evidence indicating that N170 delays are a promising marker of atypical neural response to social information in ASD. LAY SUMMARY: This study looks at how children's and adolescents' brains respond when looking at different parts of a face. Typically developing children and adolescents processed eyes faster than other parts of the face, whereas this pattern was not seen in ASD. Children and adolescents with ASD processed eyes more slowly than typically developing children. These findings suggest that observed inefficiencies in face processing in ASD are not simply reflective of failure to attend to the eyes.

A Systematic Review of What Barriers and Facilitators Prevent and Enable Physical Healthcare Services Access for Autistic Adults

Autistic people are more likely to: be diagnosed with a range of physical health conditions (i.e. cardio-vascular disease); experience premature mortality (for most disease categories); and experience barriers to effectively accessing healthcare. This systematic review sought to identify studies that report on barriers and facilitators to physical healthcare access for autistic people. A total of 3111 records were screened and six studies were included: two quantitative, two qualitative, and two mixed-methodology studies. Patient-provider communication, sensory sensitivities, and executive functioning/planning issues emerged as important barriers to healthcare. Recommendations for clinicians and those planning services are discussed.

The Nature of Facial Emotion Recognition Impairments in Children on the Autism Spectrum

This study examined socio-emotional skills, utilizing a facial emotion recognition (FER) task featuring unfamiliar and familiar 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.

A potential mechanistic role for neuroinflammation in reward processing impairments in autism spectrum disorder

Accumulating evidence suggests that autism spectrum disorder (ASD) may be conceptualized within a framework of reward processing impairments. The Social Motivation Theory of Autism posits that reduced motivation to interact with people and decreased pleasure derived from social interactions may derail typical social development and contribute to the emergence of core social communication deficits in ASD. Neuroinflammation may disrupt the development of mesolimbic dopaminergic systems that are critical for optimal functioning of social reward processing systems. This neuroinflammation-induced disturbance of mesolimbic dopaminergic functioning has been substantiated using maternal immune activation rodent models whose offspring show aberrant dopaminergic corticostriatal function, as well as behavioral characteristics of ASD model systems. Preclinical findings are in turn supported by clinical evidence of increased mesolimbic neuroinflammatory responses in individuals with ASD. This review summarizes evidence for reward processing deficits and neuroinflammatory impairments in ASD and examines how immune inflammatory dysregulation may impair the development of dopaminergic mesolimbic circuitry in ASD. Finally, future research directions examining neuroinflammatory effects on reward processing in ASD are proposed.

Speeded Recognition of Fear and Surprise in Autism

Autism spectrum disorders (ASD) involve difficulties with socioemotional functioning; however, research on emotion recognition remains inconclusive. Children with ASD have been reported to show less susceptibility to spatial inversion. The aim of this study is to examine whether children with ASD utilize atypical abilities in socioemotional processing. This study tested 13 children with ASD (1 girl, M: 15.10 years, standard deviation [ SD]: 1.60 years), 13 children without ASD (3 girls, M: 15.92 years, SD: 1.03 years), and 20 control adults (11 women, M: 24.77 years, SD: 8.30 years) to investigate the speed and accuracy of their responses to images of neutral faces and faces expressing “easy” (happiness, anger) and “difficult” emotions (surprise, fear) in nonrotated (0°) and rotated (30°, 90°, 150°, 180°, 210°, 270°, and 330°) positions. The results showed that children with ASD recognized both easy and difficult emotions as accurately as did children and adults without ASD. Children with ASD, however, responded significantly faster to difficult emotions when the images were rotated. These results offer less support for a deficiency model than for an atypical, rapid featural type of processing used by children with ASD to encode and understand complex socioemotional stimuli.

Neurophysiological correlates of holistic face processing in adolescents with and without autism spectrum disorder

Background

Face processing has been found to be impaired in autism spectrum disorders (ASD). One hypothesis is that individuals with ASD engage in piecemeal compared to holistic face processing strategies. To investigate the role of possible impairments in holistic face processing in individuals with autism, the current study investigated behavioral and electroencephalography (EEG) correlates of face processing (P1/N170 and gamma-band activity) in adolescents with ASD and sex-, age-, and IQ-matched neurotypical controls.

Methods

Participants were presented with upright and inverted Mooney stimuli; black and white low information faces that are only perceived as faces when processed holistically. Participants indicated behaviorally the detection of a face. EEG was collected time-locked to the presentation of the stimuli.

Results

Adolescents with ASD perceived Mooney stimuli as faces suggesting ability to use holistic processing but displayed a lower face detection rate and slower response times. ERP components suggest slowed temporal processing of Mooney stimuli in the ASD compared to control group for P1 latency but no differences between groups for P1 amplitude and at the N170. Increases in gamma-band activity was similar during the perception of the Mooney images by group, but the ASD group showed prolonged temporal elevation in activity.

Conclusion

Overall, our results suggest that adolescents with ASD were able to utilize holistic processing to perceive a face within the Mooney stimuli. Delays in early processing, marked by the P1, and elongated elevation in gamma activity indicate that the neural systems supporting holistic processing are slightly altered suggesting a less automatic and less efficient facial processing system.

Trial registration

Non-applicable.

Electronic supplementary material

The online version of this article (10.1186/s11689-018-9244-y) contains supplementary material, which is available to authorized users.

Atypicality of the N170 Event-Related Potential in Autism Spectrum Disorder: A Meta-analysis

BACKGROUND

Autism spectrum disorder (ASD) is associated with impaired face processing. The N170 event-related potential (ERP) has been considered a promising neural marker of this impairment. However, no quantitative review to date has integrated the literature to assess whether the N170 response to faces in individuals with ASD differs from that of typically developing (TD) individuals.

METHODS

This meta-analysis examined the corpus of literature investigating difference in N170 response to faces in individuals with ASD and without ASD. Data from 23 studies (NASD = 374, NTD = 359) were reviewed. Meta-analysis was used to examine the effect size of the difference in N170 latency and amplitude among individuals with ASD and without ASD. Analyses were also conducted examining hemispheric differences, potential moderators, and publication bias.

RESULTS

On average, N170 latencies to faces were delayed in individuals with ASD, but amplitudes did not differ for individuals with ASD and TD individuals. Moderator analyses revealed that N170 amplitudes were smaller in magnitude in the ASD participants relative to the TD participants in adult samples and in those with higher cognitive ability. However, effects differed as a function of hemisphere of recording. No evidence of publication bias was found.

CONCLUSIONS

Atypicality of N170-particularly latency-to faces appears to be a specific biomarker of social-communicative dysfunction in ASD and may relate to differential developmental experiences and use of compensatory cognitive mechanisms. Future research should examine phenotypic differences that contribute to N170 heterogeneity, as well as specificity of N170 differences in ASD versus non-ASD clinical populations, and N170 malleability with treatment.

Vicarious Effort-Based Decision-Making in Autism Spectrum Disorders

This study investigated vicarious effort-based decision-making in 50 adolescents with autism spectrum disorders (ASD) compared to 32 controls using the Effort Expenditure for Rewards Task. Participants made choices to win money for themselves or for another person. When choosing for themselves, the ASD group exhibited relatively similar patterns of effort-based decision-making across reward parameters. However, when choosing for another person, the ASD group demonstrated relatively decreased sensitivity to reward magnitude, particularly in the high magnitude condition. Finally, patterns of responding in the ASD group were related to individual differences in consummatory pleasure capacity. These findings indicate atypical vicarious effort-based decision-making in ASD and more broadly add to the growing body of literature addressing social reward processing deficits in ASD.

Social cognition in autism: Face tuning

Faces convey valuable information for social cognition, effective interpersonal interaction, and non-verbal communication. Face perception is believed to be atypical in autism, but the origin of this deficit is controversial. Dominant featural face encoding is suggested to be responsible for face tuning scarcity. Here we used a recently developed Face-n-Food paradigm for studying face tuning in individuals with autistic spectrum disorders (ASD). The key benefit of these images is that single components do not explicitly trigger face processing. In a spontaneous recognition task, adolescents with autism and typically developing matched controls were presented with a set of Face-n-Food images in different degree resembling a face (slightly bordering on the Giuseppe Arcimboldo style). The set of images was shown in a predetermined order from the least to most resembling a face. Thresholds for recognition of the Face-n-Food images as a face in ASD individuals were substantially higher than in typically developing controls: they did not report seeing a face on the images, which controls easily recognized as a face, and gave overall fewer face responses. This outcome not only lends support to atypical face tuning, but provides novel insights into the origin of face encoding deficits in autism.

Face perception and learning in autism spectrum disorders

Autism Spectrum Disorder (ASD) is characterized by impairment in social communication and restricted and repetitive interests. While not included in the diagnostic characterization, aspects of face processing and learning have shown disruptions at all stages of development in ASD, although the exact nature and extent of the impairment vary by age and level of functioning of the ASD sample as well as by task demands. In this review, we examine the nature of face attention, perception, and learning in individuals with ASD focusing on three broad age ranges (early development, middle childhood, and adolescence/adulthood). We propose that early delays in basic face processing contribute to the atypical trajectory of social communicative skills in individuals with ASD and contribute to poor social learning throughout development. Face learning is a life-long necessity, as the social world of individual only broadens with age, and thus addressing both the source of the impairment in ASD as well as the trajectory of ability throughout the lifespan, through targeted treatments, may serve to positively impact the lives of individuals who struggle with social information and understanding.

The "Eye Avoidance" Hypothesis of Autism Face Processing

Although a growing body of research indicates that children with autism spectrum disorder (ASD) exhibit selective deficits in their ability to recognize facial identities and expressions, the source of their face impairment is, as yet, undetermined. In this paper, we consider three possible accounts of the autism face deficit: (1) the holistic hypothesis, (2) the local perceptual bias hypothesis and (3) the eye avoidance hypothesis. A review of the literature indicates that contrary to the holistic hypothesis, there is little evidence to suggest that individuals with autism do perceive faces holistically. The local perceptual bias account also fails to explain the selective advantage that ASD individuals demonstrate for objects and their selective disadvantage for faces. The eye avoidance hypothesis provides a plausible explanation of face recognition deficits where individuals with ASD avoid the eye region because it is perceived as socially threatening. Direct eye contact elicits a increased physiological response as indicated by heightened skin conductance and amygdala activity. For individuals with autism, avoiding the eyes is an adaptive strategy, however, this approach interferes with the ability to process facial cues of identity, expressions and intentions, exacerbating the social challenges for persons with ASD.

Local visual perception bias in children with high-functioning autism spectrum disorders; do we have the whole picture?

OBJECTIVE

While local bias in visual processing in children with autism spectrum disorders (ASD) has been reported to result in difficulties in recognizing faces and facially expressed emotions, but superior ability in disembedding figures, associations between these abilities within a group of children with and without ASD have not been explored.

METHODS

Possible associations in performance on the Visual Perception Skills Figure-Ground test, a face recognition test and an emotion recognition test were investigated within 25 8-12-years-old children with high-functioning autism/Asperger syndrome, and in comparison to 33 typically developing children.

RESULTS

Analyses indicated a weak positive correlation between accuracy in Figure-Ground recognition and emotion recognition. No other correlation estimates were significant.

CONCLUSION

These findings challenge both the enhanced perceptual function hypothesis and the weak central coherence hypothesis, and accentuate the importance of further scrutinizing the existance and nature of local visual bias in ASD.

Emotion Perception or Social Cognitive Complexity: What Drives Face Processing Deficits in Autism Spectrum Disorder?

Some, but not all, relevant studies have revealed face processing deficits among those with autism spectrum disorder (ASD). In particular, deficits are revealed in face processing tasks that involve emotion perception. The current study examined whether either deficits in processing emotional expression or deficits in processing social cognitive complexity drive face processing deficits in ASD. We tested adults with and without ASD on a battery of face processing tasks that varied with respect to emotional expression processing and social cognitive complexity. Results revealed significant group differences on tasks involving emotional expression processing, but typical performance on a non-emotional but socially complex task. These results support an emotion processing rather than a social complexity explanation for face processing deficits in ASD.

Context processing in adolescents with autism spectrum disorder: How complex could it be?

The ability of individuals with Autism Spectrum Disorder (ASD) to process context has long been debated: According to the Weak Central Coherence theory, ASD is characterized by poor global processing, and consequently-poor context processing. In contrast, the Social Cognition theory argues individuals with ASD will present difficulties only in social context processing. The complexity theory of autism suggests context processing in ASD will depend on task complexity. The current study examined this controversy through two priming tasks, one presenting human stimuli (facial expressions) and the other presenting non-human stimuli (animal faces). Both tasks presented visual targets, preceded by congruent, incongruent, or neutral auditory primes. Local and global processing were examined by presenting the visual targets in three spatial frequency conditions: High frequency, low frequency, and broadband. Tasks were administered to 16 adolescents with high functioning ASD and 16 matched typically developing adolescents. Reaction time and accuracy were measured for each task in each condition. Results indicated that individuals with ASD processed context for both human and non-human stimuli, except in one condition, in which human stimuli had to be processed globally (i.e., target presented in low frequency). The task demands presented in this condition, and the performance deficit shown in the ASD group as a result, could be understood in terms of cognitive overload. These findings provide support for the complexity theory of autism and extend it. Our results also demonstrate how associative priming could support intact context processing of human and non-human stimuli in individuals with ASD. Autism Res 2017, 10: 520-530. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Intact perception but abnormal orientation towards face-like objects in young children with ASD

There is ample behavioral evidence of diminished orientation towards faces as well as the presence of face perception impairments in autism spectrum disorder (ASD), but the underlying mechanisms of these deficits are still unclear. We used face-like object stimuli that have been shown to evoke pareidolia in typically developing (TD) individuals to test the effect of a global face-like configuration on orientation and perceptual processes in young children with ASD and age-matched TD controls. We show that TD children were more likely to look first towards upright face-like objects than children with ASD, showing that a global face-like configuration elicit a stronger orientation bias in TD children as compared to children with ASD. However, once they were looking at the stimuli, both groups spent more time exploring the upright face-like object, suggesting that they both perceived it as a face. Our results are in agreement with abnormal social orienting in ASD, possibly due to an abnormal tuning of the subcortical pathway, leading to poor orienting and attention towards faces. Our results also indicate that young children with ASD can perceive a generic face holistically, such as face-like objects, further demonstrating holistic processing of faces in ASD.

Morphing technique reveals intact perception of object motion and disturbed perception of emotional expressions by low-functioning adolescents with Autism Spectrum Disorder

A morphing procedure has been designed to compare directly the perception of emotional expressions and of moving objects. Morphing tasks were presented to 12 low-functioning teenagers with Autism Spectrum Disorder (LF ASD) compared to 12 developmental age-matched typical children and a group presenting ceiling performance. In a first study, when presented with morphed stimuli of objects and emotional faces, LF ASD showed an intact perception of object change of state together with an impaired perception of emotional facial change of state. In a second study, an eye-tracker recorded visual exploration of morphed emotional stimuli displayed by a human face and a robotic set-up. Facing the morphed robotic stimuli, LF ASD displayed equal duration of fixations toward emotional regions and toward mechanical sources of motion, while the typical groups tracked the emotional regions only. Altogether the findings of the two studies suggest that individuals with ASD process motion rather than emotional signals when facing facial expressions.

The effect of inversion on face recognition in adults with autism spectrum disorder

Face identity recognition has widely been shown to be impaired in individuals with autism spectrum disorders (ASD). In this study we examined the influence of inversion on face recognition in 26 adults with ASD and 33 age and IQ matched controls. Participants completed a recognition test comprising upright and inverted faces. Participants with ASD performed worse than controls on the recognition task but did not show an advantage for inverted face recognition. Both groups directed more visual attention to the eye than the mouth region and gaze patterns were not found to be associated with recognition performance. These results provide evidence of a normal effect of inversion on face recognition in adults with ASD.

Can They See It? The Functional Field of View Is Narrower in Individuals with Autism Spectrum Disorder

Although social cognitive deficits have long been thought to underlie the characteristic and pervasive difficulties with social interaction observed in individuals with autism spectrum disorder (ASD), several recent behavioral and neuroimaging studies have indicated that visual perceptual impairments might also play a role. People with ASD show a robust bias towards detailed information at the expense of global information, although the mechanisms that underlie this phenomenon remain elusive. To address this issue, we investigated the functional field of view in a group of high-functioning children with autism (n = 13) and a paired non-ASD group (n = 13). Our results indicate that the ability to correctly detect and identify stimuli sharply decreases with greater eccentricity from the fovea in people with ASD. Accordingly, a probe analysis revealed that the functional field of view in the ASD group was only about 6.62° of retinal eccentricity, compared with 8.57° in typically developing children. Thus, children with ASD appear to have a narrower functional field of view. These results challenge the conventional hypothesis that the deficit in global processing in individuals with ASD is solely due to weak central coherence. Alternatively, our data suggest that a narrower functional field of view may also contribute to this bias.

Developmental changes in face visual scanning in autism spectrum disorder as assessed by data-based analysis

Individuals with autism spectrum disorder (ASD) present reduced visual attention to faces. However, contradictory conclusions have been drawn about the strategies involved in visual face scanning due to the various methodologies implemented in the study of facial screening. Here, we used a data-driven approach to compare children and adults with ASD subjected to the same free viewing task and to address developmental aspects of face scanning, including its temporal patterning, in healthy children, and adults. Four groups (54 subjects) were included in the study: typical adults, typically developing children, and adults and children with ASD. Eye tracking was performed on subjects viewing unfamiliar faces. Fixations were analyzed using a data-driven approach that employed spatial statistics to provide an objective, unbiased definition of the areas of interest. Typical adults expressed a spatial and temporal strategy for visual scanning that differed from the three other groups, involving a sequential fixation of the right eye (RE), left eye (LE), and mouth. Typically developing children, adults and children with autism exhibited similar fixation patterns and they always started by looking at the RE. Children (typical or with ASD) subsequently looked at the LE or the mouth. Based on the present results, the patterns of fixation for static faces that mature from childhood to adulthood in typical subjects are not found in adults with ASD. The atypical patterns found after developmental progression and experience in ASD groups appear to remain blocked in an immature state that cannot be differentiated from typical developmental child patterns of fixation.

Judging the Intensity of Emotional Expression in Faces: the Effects of Colored Tints on Individuals With Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) often show atypical processing of facial expressions, which may result from visual stress. In the current study, children with ASD and matched controls judged which member of a pair of faces displayed the more intense emotion. Both faces showed anger, disgust, fear, happiness, sadness or surprise but to different degrees. Faces were presented on a monitor that was tinted either gray or with a color previously selected by the participant individually as improving the clarity of text. Judgments of emotional intensity improved significantly with the addition of the preferred colored tint in the ASD group but not in controls, a result consistent with a link between visual stress and impairments in processing facial expressions in individuals with ASD.

Autism spectrum traits in normal individuals: a preliminary VBM analysis

In light of the new DSM-5 autism spectrum disorders diagnosis in which the autism spectrum reflects a group of neurodevelopmental disorders existing on a continuum from mild to severe expression of autistic traits, and recent empirical findings showing a continuous distribution of autistic traits in the general population, our voxel based morphometry study compares normal individuals with high autistic traits to normal individuals with low autistic traits. We hypothesize that normal individuals with high autistic traits in terms of empathizing and systemizing [high systemizing (HS)/low empathizing (LE)] share brain irregularities with individuals that fall within the clinical autism spectrum disorder. We find differences in several social brain network areas between our groups. Specifically, we find increased gray matter (GM) volume in the orbitofrontal cortex, the cuneus, the hippocampus and parahippocampus and reduced GM volume in the inferior temporal cortex, the insula, and the amygdala in our HS/LE individuals relative to our HE/LS (low autistic traits in terms of empathizing and systemizing) individuals.

Face and object discrimination in autism, and relationship to IQ and age

The current study tested fine discrimination of upright and inverted faces and objects in adolescents with Autism Spectrum Disorder (ASD) as compared to age- and IQ-matched controls. Discrimination sensitivity was tested using morphed faces and morphed objects, and all stimuli were equated in low-level visual characteristics (luminance, contrast, spatial frequency make-up). Participants with ASD exhibited slight, non-significant impairments in discrimination sensitivity for faces, yet significantly enhanced discrimination sensitivity for objects. The ASD group also showed a protracted development of face and object inversion effects. Finally, for ASD participants, face sensitivity improved with increasing IQ while object sensitivity improved with age. By contrast, for controls, face sensitivity improved with age, but neither face nor object sensitivity was influenced by IQ. These findings suggest that individuals with ASD follow a qualitatively different path in the development of face and object processing abilities.

ERP responses to face repetition during passive viewing: a nonverbal measure of social motivation in children with autism and typical development

This study examined whether individual differences in social motivation affect the extent of processing of social versus nonsocial information. Event-related potentials were recorded in 13 children with autism spectrum disorder and 11 typically developing children during passive viewing of unfamiliar faces and houses. One image in each category was presented repeatedly, the rest were shown once. Analyses indicated no group differences in the early perceptual responses. Only typical children evidenced larger P600 for the repeated faces. These results were replicated during a retest session. Individual differences in memory for the repeated faces correlated with standardized behavioral assessments of social skills.

Facial emotion recognition in agenesis of the corpus callosum

BACKGROUND

Impaired social functioning is a common symptom of individuals with developmental disruptions in callosal connectivity. Among these developmental conditions, agenesis of the corpus callosum provides the most extreme and clearly identifiable example of callosal disconnection. To date, deficits in nonliteral language comprehension, humor, theory of mind, and social reasoning have been documented in agenesis of the corpus callosum. Here, we examined a basic social ability as yet not investigated in this population: recognition of facial emotion and its association with social gaze.

METHODS

Nine individuals with callosal agenesis and nine matched controls completed four tasks involving emotional faces: emotion recognition from upright and inverted faces, gender recognition, and passive viewing. Eye-tracking data were collected concurrently on all four tasks and analyzed according to designated facial regions of interest.

RESULTS

Individuals with callosal agenesis exhibited impairments in recognizing emotions from upright faces, in particular lower accuracy for fear and anger, and these impairments were directly associated with diminished attention to the eye region. The callosal agenesis group exhibited greater consistency in emotion recognition across conditions (upright vs. inverted), with poorest performance for fear identification in both conditions. The callosal agenesis group also had atypical facial scanning (lower fractional dwell time in the eye region) during gender naming and passive viewing of faces, but they did not differ from controls on gender naming performance. The pattern of results did not differ when taking into account full-scale intelligence quotient or presence of autism spectrum symptoms.

CONCLUSIONS

Agenesis of the corpus callosum results in a pattern of atypical facial scanning characterized by diminished attention to the eyes. This pattern suggests that reduced callosal connectivity may contribute to the development and maintenance of emotion processing deficits involving reduced attention to others' eyes.

Neural networks related to dysfunctional face processing in autism spectrum disorder

One of the most consistent neuropsychological findings in autism spectrum disorders (ASD) is a reduced interest in and impaired processing of human faces. We conducted an activation likelihood estimation meta-analysis on 14 functional imaging studies on neural correlates of face processing enrolling a total of 164 ASD patients. Subsequently, normative whole-brain functional connectivity maps for the identified regions of significant convergence were computed for the task-independent (resting-state) and task-dependent (co-activations) state in healthy subjects. Quantitative functional decoding was performed by reference to the BrainMap database. Finally, we examined the overlap of the delineated network with the results of a previous meta-analysis on structural abnormalities in ASD as well as with brain regions involved in human action observation/imitation. We found a single cluster in the left fusiform gyrus showing significantly reduced activation during face processing in ASD across all studies. Both task-dependent and task-independent analyses indicated significant functional connectivity of this region with the temporo-occipital and lateral occipital cortex, the inferior frontal and parietal cortices, the thalamus and the amygdala. Quantitative reverse inference then indicated an association of these regions mainly with face processing, affective processing, and language-related tasks. Moreover, we found that the cortex in the region of right area V5 displaying structural changes in ASD patients showed consistent connectivity with the region showing aberrant responses in the context of face processing. Finally, this network was also implicated in the human action observation/imitation network. In summary, our findings thus suggest a functionally and structurally disturbed network of occipital regions related primarily to face (but potentially also language) processing, which interact with inferior frontal as well as limbic regions and may be the core of aberrant face processing and reduced interest in faces in ASD.

Neural responses to emotional expression information in high- and low-spatial frequency in autism: evidence for a cortical dysfunction

Despite an overall consensus that Autism Spectrum Disorder (ASD) entails atypical processing of human faces and emotional expressions, the role of neural structures involved in early facial processing remains unresolved. An influential model for the neurotypical brain suggests that face processing in the fusiform gyrus and the amygdala is based on both high-spatial frequency (HSF) information carried by a parvocellular pathway, and low-spatial frequency (LSF) information separately conveyed by a magnocellular pathway. Here, we tested the fusiform gyrus and amygdala sensitivity to emotional face information conveyed by these distinct pathways in ASD individuals (and matched Controls). During functional Magnetical Resonance Imaging (fMRI), participants reported the apparent gender of hybrid face stimuli, made by merging two different faces (one in LSF and the other in HSF), out of which one displayed an emotional expression (fearful or happy) and the other was neutral. Controls exhibited increased fusiform activity to hybrid faces with an emotional expression (relative to hybrids composed only with neutral faces), regardless of whether this was conveyed by LSFs or HSFs in hybrid stimuli. ASD individuals showed intact fusiform response to LSF, but not HSF, expressions. Furthermore, the amygdala (and the ventral occipital cortex) was more sensitive to HSF than LSF expressions in Controls, but exhibited an opposite preference in ASD. Our data suggest spared LSF face processing in ASD, while cortical analysis of HSF expression cues appears affected. These findings converge with recent accounts suggesting that ASD might be characterized by a difficulty in integrating multiple local information and cause global processing troubles unexplained by losses in low spatial frequency inputs.

Recognition of facial expressions and prosodic cues with graded emotional intensities in adults with Asperger syndrome

This study investigated the ability of adults with Asperger syndrome to recognize emotional categories of facial expressions and emotional prosodies with graded emotional intensities. The individuals with Asperger syndrome showed poorer recognition performance for angry and sad expressions from both facial and vocal information. The group difference in facial expression recognition was prominent for stimuli with low or intermediate emotional intensities. In contrast to this, the individuals with Asperger syndrome exhibited lower recognition accuracy than typically-developed controls mainly for emotional prosody with high emotional intensity. In facial expression recognition, Asperger and control groups showed an inversion effect for all categories. The magnitude of this effect was less in the Asperger group for angry and sad expressions, presumably attributable to reduced recruitment of the configural mode of face processing. The individuals with Asperger syndrome outperformed the control participants in recognizing inverted sad expressions, indicating enhanced processing of local facial information representing sad emotion. These results suggest that the adults with Asperger syndrome rely on modality-specific strategies in emotion recognition from facial expression and prosodic information.

The local, global, and neural aspects of visuospatial processing in autism spectrum disorders

Behavioral studies have documented a relative advantage in some aspects of visuospatial cognition in autism although it is not consistently found in higher functioning individuals with autism. The purpose of this functional neuroimaging study was to examine the neural activity in high functioning individuals with autism while they performed a block design task that systematically varied with regard to whether a global pattern was present. Participants were 14 adults with high-functioning autism and 14 age and IQ matched typical controls. The task was to identify a missing block in target figures which had either an obvious global shape or was an arbitrary array of blocks. Behavioral results showed intact, but not superior, performance in our participants with autism. A key group difference was that the participants with autism showed reliably greater activation in occipital and parietal regions in both tasks suggesting an increased reliance of the autism group on posterior brain areas to mediate visuospatial tasks. Thus, increased reliance on relatively posterior brain regions in itself may not guarantee superior performance as seen in the present study.

Left visual field biases when infants process faces: a comparison of infants at high- and low-risk for autism spectrum disorder

While it is well-known that individuals with autism spectrum disorder (ASD) have difficulties processing faces, very little is known about the origins of these deficits. The current study focused on 6- and 11-month-old infants who were at either high-risk (n = 43) or low-risk (n = 31) for developing ASD based on having a sibling already diagnosed with the disorder. Eye-tracking data were collected while the infants viewed color photographs of faces. Similar to previous studies with both typically developing adults and infants, low-risk infants demonstrated a preference for looking at the left side of the face (known as a left visual field bias) that emerged by 11 months of age. In contrast, high-risk infants did not demonstrate a left visual field bias at either age. Comparisons of the amount of attention given to the eye versus mouth regions indicated no differences between the two risk groups.