The development and evaluation of a computer-based program to test and to teach the recognition of facial affect.

 

Bolte S, Feineis-Matthews S, Leber S, Dierks T, Hubl, D, Poustka F.

International Journal of Circumpolar Health 2002. 61 (Suppl. 2): 61-68.

Bottom Line

Can computer programs improve the ability to recognize facial expressions?

  • The students were shown both whole face and eyes-only photographs on a computer.
  • When the students correctly identified the facial expression, they were rewarded with a smiley face. Errors were corrected but otherwise not acknowledged.
  • The students were able to correctly identify facial expressions on the screens.
  • The comparison group made no progress.

Question: Is a computer-based program designed to test for and teach facial expression recognition to adolescents and adults with high functioning autism or Asperger Syndrome effective?

Background: One of the hallmark symptoms of autism spectrum disorders is difficulty understanding the facial expressions of other people. This can lead to social misunderstandings, confusion, and feelings of rejection on the part of the person with an ASD.

Design: A randomized trial design was used in this pilot project.

Setting: A child and adolescent psychiatry clinic, Frankfurt, Germany.

Participants: Ten adolescents and adults with high-functioning autism or Asperger syndrome took part. Their diagnoses were confirmed with the German version of the Autism Diagnostic Interview — Revised (ADI-R) and the Autism Diagnostic Observation Schedule — Generic (ADOS).

Intervention: A computer program that displayed photographs of whole face expressions and eyes-only photographs depicting the same emotional state was devised. When asked to identify the emotion depicted on the screen, the participants’ correct answers were rewarded with a "smiley face." The computer responded to incorrect answers with a feedback sign, which, when pressed, produced the correct answer on screen. The participant could then use a "comic strip" button to go to a screen showing illustrations from "Teaching Children with Autism How to Mind-Read" (Howlin P, Baron-Cohen S, Hadwin J. Chichester: John Wiley & Sons, 1999). Teaching sessions were conducted for 2 hours per week over 5 weeks.

Main outcome measures: Ability to recognize and successfully identify facial expressions presented on computer screens.

Main results: There was significant improvement in the intensive training group for the face and eyes-only tests in demonstrating the subjects’ ability to identify emotional states depicted in on-screen pictures. There was no improvement in the control group.

Conclusion: Computer-based programs can be used to teach facial expression recognition and thus improve theory of mind deficits found in high functioning autism and Asperger Syndrome. The small sample size makes these findings suggestive, and larger trials are necessary to demonstrate the effectiveness of the intervention.