Face Processing and Its Correlation to Theory of Mind in Autism Spectrum Disorders

Background:   Previous research has shown that individuals with Autism Spectrum Disorders (ASD) have impaired facial identity recognition and emotion recognition and are less likely to attend to faces when compared to typically developing controls (TDCs). Facial recognition and processing are important tools utilized to engage in social behaviors, which are often significantly impaired in individuals with ASD. Many have suggested that social functioning deficits found in ASD can be attributed to a deficient or a lack of theory of mind (ToM). However, no studies have investigated the correlation between face processing and ToM deficits in ASD.

Objectives:   The present study investigated face processing abilities in individuals with ASD using the Let’s Face It! (LFI) skills battery (Tanaka & Schultz, 2008). These results were compared to performance on ToM measures, as assessed by the Attribution of Intention (AIT) task (Brunet et al., 2003).

Methods:   One hundred and twenty seven participants with ASD (103 male, 6.2-17.9 years old) and 58 TDCs (43 male, 6.1-16.9 years old) were matched on age (ASD:  M = 10.1 ± 2.9; TDC: M = 10.2 ± 3.0), IQ (ASD: M = 105.8 ± 16.9; TDC: M = 109.4 ± 13.3), and sex ratio. ADI-R, ADOS, and expert clinical judgment were used to confirm diagnoses. Participants completed an abbreviated LFI battery, which consisted of one facial identity matching task (Match Maker Identity) and two facial expression matching tasks (Match Maker Expression and Name Game) and the AIT task.

Results: Individuals with ASD performed significantly worse in all three LFI tasks (Identity: t(185) = -3.337, p = .001, d = .529; Expression: t(185) = -5.579, p<.0001, , d = .827; Name Game: t(185) = -4.517, p<.0001, d = .659) and in the AIT task (t(185) = -2.958, p = .004, d = .470) when compared to the TDC group. Furthermore, performance on the three LFI tasks was significantly correlated to the AIT task in both groups (ASD group: r = .518, p<.0001; r = .372, p<.0001, and r = .368, p <.0001, for Identity, Expression and Name Game respectively; TDC group: r = .554, p<.0001; r =.304, p = .021, r = .564, p<.0001, for Identity, Expression and Name Game respectively).

Conclusions:   Differences in facial identity and emotion recognition as well as in ToM were found in this large sample. Furthermore, face processing skills and higher cognitive functions were strongly correlated. The directionality of this relationship should be further explored in order to better understand social deficits in autism.