How Do Children with Autism, ADHD, and OCD Process Emotional Faces Differently?

What you need to know

• Children with autism, ADHD, and OCD show differences in brain activity when viewing emotional facial expressions compared to typically developing children.
• These neurodevelopmental disorders share some common patterns in emotional face processing, but also show some distinct differences.
• The differences in brain activity suggest these children may have difficulty recognizing and processing emotional expressions, which could impact social interactions.
• Understanding these shared and unique patterns may help develop better interventions to support social-emotional skills in children with these disorders.

Understanding emotions from faces

The ability to recognize and interpret emotions from facial expressions is a crucial skill for social interaction and communication. We process faces rapidly and automatically, gleaning important social and emotional information within milliseconds. For most people, this happens effortlessly. However, for individuals with certain neurodevelopmental disorders, reading emotions from faces can be challenging.

This study examined how children with three common neurodevelopmental disorders - autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD) - process emotional facial expressions differently than typically developing children. The researchers used dynamic (moving) images of faces expressing happiness and anger, as well as moving images of flowers opening, while measuring brain activity using functional magnetic resonance imaging (fMRI).

Why use dynamic facial expressions?

Most previous studies on emotional face processing have used static photographs. However, in real life, facial expressions are dynamic - they involve movement. Dynamic facial expressions provide richer emotional information and are more similar to what we encounter in everyday social interactions.

Studies have shown that dynamic facial expressions are more easily identified than static images and increase activity in brain areas involved in face and emotion processing. By using dynamic expressions, this study aimed to capture more realistic neural responses to emotional faces in children with neurodevelopmental disorders.

Shared difficulties across disorders

One of the key findings was that children with ASD, ADHD, and OCD showed some similar patterns of atypical brain activity when viewing emotional faces compared to typically developing children. This suggests there may be some shared neurobiological mechanisms underlying difficulties with emotional face processing across these disorders.

Specifically, the children with neurodevelopmental disorders showed less differentiation in brain activity between faces and non-face objects (flowers) in visual processing regions of the brain. While typically developing children showed distinct patterns of activity for faces versus flowers, the clinical groups had more similar responses to both.

This reduced differentiation was seen for both happy and angry facial expressions, primarily in areas of the occipital and temporal lobes involved in visual and face processing. The researchers suggest this may reflect difficulties in social-emotional information processing that are common across these neurodevelopmental disorders.

The occipital lobe is the visual processing center of the brain, located at the back of the head. It is responsible for processing visual information, including recognizing shapes, colors, and movement. The temporal lobe, located on the side of the brain, is involved in processing sensory input, including visual information related to facial recognition and interpreting emotions.

The reduced differentiation between faces and non-face objects in these brain regions may indicate that children with these disorders are not processing faces as efficiently or automatically as typically developing children. This could contribute to difficulties in quickly recognizing and interpreting emotional expressions in real-world social interactions.

Distinct patterns for each disorder

While there were some shared atypical patterns, the study also revealed some distinct differences in emotional face processing among the three clinical groups:

Autism Spectrum Disorder (ASD)

Children with ASD showed the most pronounced differences in processing angry versus happy faces. When viewing angry faces compared to happy faces, the ASD group had increased activity in regions of the brain involved in basic visual processing of faces. However, they showed decreased activity compared to typically developing children in areas involved in more complex face and emotion processing.

This suggests that children with ASD may rely more heavily on low-level visual features when processing angry faces, rather than engaging higher-level emotion processing regions. This could make it more difficult for them to accurately interpret the emotional meaning of angry expressions.

Obsessive-Compulsive Disorder (OCD)

The OCD group showed the least differentiation between faces and flowers, as well as between happy and angry faces, in visual processing regions. This may reflect generally reduced visual processing in emotional contexts in OCD.

Some studies have suggested that individuals with OCD have particular difficulty recognizing disgust expressions. While this study did not include disgust faces, the reduced differentiation for happy and angry faces suggests broader challenges in emotional face processing in OCD.

Attention-Deficit/Hyperactivity Disorder (ADHD)

Interestingly, the ADHD group showed the fewest differences from typically developing children in emotional face processing. While they did show some of the shared atypical patterns, their neural responses were more similar to the typically developing group than the ASD or OCD groups.

This aligns with some previous research suggesting that basic emotion recognition may be relatively intact in ADHD, although more subtle aspects of emotional processing and regulation may be impaired.

Changes with age

An important finding of this study was that brain responses to emotional faces changed differently with age in the clinical groups compared to typically developing children. Specifically, activity in a region of the frontal lobe involved in emotion processing showed different developmental trajectories.

In typically developing children, activity in this frontal region decreased with age when viewing happy faces compared to angry faces. This may reflect increasing efficiency in processing positive emotions as children develop.

However, in the ASD and OCD groups, activity in this region increased with age for happy compared to angry faces. This suggests these children may require more cognitive effort to process happy expressions as they get older, rather than becoming more efficient.

The ADHD group did not show any age-related changes in this region, maintaining a similar pattern across development.

The frontal lobe, located at the front of the brain, is involved in higher-order cognitive functions including emotional regulation, decision-making, and social behavior. The different age-related patterns seen in this frontal region suggest that emotional face processing may develop atypically in ASD and OCD.

Conclusions

• Children with autism, ADHD, and OCD show some shared differences in brain activity when processing emotional facial expressions compared to typically developing children.
• These shared differences primarily involve reduced differentiation between faces and non-face objects in visual processing regions, suggesting common difficulties in efficiently processing social-emotional information.
• Each disorder also shows some unique patterns, with ASD having the most pronounced differences for angry faces, OCD showing the least differentiation between emotions, and ADHD showing patterns more similar to typical development.
• The developmental trajectories of emotional face processing appear to differ in ASD and OCD compared to typical development, suggesting persistent or even increasing challenges as children get older.

This research highlights the complex nature of emotional face processing differences in neurodevelopmental disorders. Understanding these shared and unique patterns may help in developing targeted interventions to support social-emotional skills in children with these disorders. However, it’s important to note that there is significant variability among individuals, and not all children with these diagnoses will show the same patterns of emotional processing difficulties.