Facial Affect Recognition in Autism, ADHD and Typical Development Steve Berggren 1,2 , Ann-Charlotte Engström2, Sven Bölte1,2 (1) Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND), Department of Women’s and Children’s Health, Stockholm, Sweden, (2) Child and Adolescent Psychiatry, Child and Adolescent Psychiatry, Center of Psychiatry Research, Stockholm County Council, Sweden Results Compared to TD, the ASD group performed less accurate and showed longer response times for general and specific FAR, mostly driven by problems in neutral and happy face identification. The ADHD group responded faster than the ASD group for global FAR. No differences between ADHD and TD were found. Attentional distractibility had a significant effect on FAR performance in ASD and ADHD. . Instruments Facial affect recognition Basic FAR was examined using the Swedish version of the computer-based Frankfurt Test for Facial Affect Recognition. The FEFA test uses the cross-cultural concept of seven fundamental affective states to assess explicit FAR skills by verbal labelling of emotions (happy, sad, angry, surprised, disgusted, fearful, and neutral) expressed in the eye regions and in whole faces. Attention The computerised Conners’ Continuous Performance Test II Version 5 was used to assess attention function. Testees are instructed to react by button press when presented with any letter except for an “X”. If “X” is shown, testees must refrain from reacting. Letters are presented on the screen with varying duration and intervals between them. Social communication The severity of social communication problems was assessed using the parent-report form of the Social Responsiveness Scale (SRS)   ASD M (SD) ADHD TD Group differences* FAR face test –accuracy Total score (global) Happy Sad Angry Surprised Disgusted Fearful Neutral FAR face test - response time Overall (global) 35.4 (7.5) 8.2 (1.4) 5.4 (1.6) 3.8 (1.8) 4.7 (1.8) 4.2 (1.5) 3.7 (1.8) 5.5 (1.9) 3.8 (1.3) 3.3 (1.2) 3.9 (1.3) 4.2 (1.3) 4.0 (1.5) 3.9 (1.4) 4.4 (1.5) 3.3 (1.6) 37.6 (6.5) 9.1 (1.6) 5.1 (1.2) 4.5 (1.7) 4.9 (1.8) 4.3 (1.7) 4.0 (1.9) 5.8 (0.8) 3.1 (1.1) 2.9 (1.3) 3.0 (1.1) 3.4 (1.3) 3.3 (1.3) 2.6 (1.0) 40.3 (5.5) 9.8 (1.3) 5.3 (1.3) 4.6 (1.9) 5.4 (1.8) 4.6 (1.0) 4.9 (2.2) 6.0 (0.8) 2.9 (1.1) 3.0 (1.2) 3.2 (0.9) 3.3 (1.0) 3.3 (1.4) 2.4 (1.1) ASD < TD ASD > ADHD & TD ASD > TD FAR eyes test- -accuracy FAR eyes test - response time 27.3 (5.3) 3.7 (1.3) 3.9 (1.7) 4.1 (1.7) 2.3 (1.2) 4.8 (1.6) 4.0 (2.0) 3.9 (2.3) 3.7 (1.7) 3.9 (1.6) 4.2 (1.7) 4.2 (2.4) 3.8 (2.1) 4.3 (2.2) 27.8 (5.1) 6.3 (1.5) 3.7 (1.1) 3.8 (1.6) 3.6 (1.4) 2.1 (1.1) 2.6 (1.2) 5.7 (1.5) 4.1 (1.9) 3.6 (1.8) 3.8 (1.4) 30.6 (4.6) 7.1 (1.2) 4.5 (1.2) 4.6 (1.6) 3.7 (1.0) 2.2 (1.0) 2.5 (1.1) 6.0 (1.4) 3.0 (1.3) 3.2 (1.0) 3.5 (1.3) 3.7 (1.5) 3.3 (1.5) 3.5 (1.8) 3.2 (1.3) Background Autism spectrum disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) have been associated with facial affect recognition (FAR) alterations. Method This study examined accuracy and response times for general and specific FAR in whole face and eye-region stimuli. FAR was assessed in matched samples of children and adolescents with ASD (n = 35), ADHD (n = 32), and typical development (TD) (n = 32) aged 8.6–15.9 years (M = 11.6; SD = 2.0). Table 2. Facial affect recognition results by group Note. *p < .05, ASD = autism spectrum disorder, ADHD = attention-deficit hyperactivity disorder, TD = typical developing; M = mean, SD = standard deviation   ASD ADHD TD N 35 32 Sex (f,m)a 17,18 15,17 14,18 Age [M (SD), range]a 11.6 (1.8), 8.6- 15.4 11.1 (2.1), 8.6-15.9 11.7 (1.8), 9.4- 15.5 IQ [M (SD), range]a 103.8 (11.9), 86-128 101.7 (12.9), 75- 128 102.9 (8.5), 77- 120 SRS-total [M (SD), range]b 79.8 (27.9), 10-141 41.1 (20.6), 1-86 21.5 (15.7), 3-39 CPT-II [M (SD), range] Omissions (distractibility) Commissions (impulsivity) 52.3 (9.9), 40.7-83.0 52.5 (11.8), 21.0-68.5 55.2 (11.6), 40.7- 82.8 53.4 (9.2), 32.1- 65.3 46.2 (5.5), 40.0- 62.9 48.0 (7.5),11.5- 66.6 ADOS [M (SD), range] 12.5 (3.8), 8- 21 / SDQ [M (SD), range] 1.6 (2.2), 0-8 Conclusion A well-controlled and sufficiently powered study of explicit FAR, we found significant general and specific FAR difficulties in participants with ASD for different stimuli regarding accuracy and response time, compared to TD, only few differences between ASD and ADHD, and no differences between ADHD and TD. Attentional distractibility explained a substantial proportion of variance of FAR performance in ASD and ADHD. The clinical implications of our study are that FAR training is meaningful in ASD. Note. aASD = ADHD = TD; bASD > ADHD; cASD & ADHD > TD (p<.05); f = female, m = male; ASD = autism spectrum disorder, ADHD = attention-deficit hyperactivity disorder, TD = typical developing; M = mean, SD = standard deviation; IQ = intelligence quotient (full scale); SRS = Social Responsiveness Scale; CPT-II = Conners’ Continuous Performance Scale; ADOS = Autism Diagnostic Observation Schedule [Social Communication score]; SDQ = Strengths and Difficulties Questionnaire total score. Acknowledgments We sincerely thank all participants for their contributions. We also thank Stockholm County Council and Swedish Research Council [Vetenskapsrådet] under Grant number [523-2009-7054]. Further reading Berggren…Bölte (2016), Facial affect recognition in autism, ADHD and typical development, Cognitive Neuropsychiatry, DOI:10.1080/13546805.2016.1171205 KIND - Center of Neurodevelopmental Disorders at Karolinska Institutet, Institutionen för kvinnor och barns hälsa Karolinska Institutet, Gävlegatan 22 B, 113 30 Stockholm, Sweden www.ki.se/kind Steve.Berggren@.ki.se