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

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