Efficacy of a Facial Emotion Training Program for Children and Adolescents with Autism Spectrum Disorders

Twenty-five high-functioning, verbal children and adolescents with autism spectrum disorders (ASD; age range 8-15 years) who demonstrated a facial emotion recognition deficit were block randomized to an active intervention (n = 12) or waitlist control (n = 13) group. The intervention was a modification of a commercially-available, computerized, dynamic facial emotion training tool, the MiX by HumintellA (c). Modifications were introduced to address the special learning needs of individuals with ASD and to address limitations in current emotion recognition programs. Modifications included: coach-assistance, a combination of didactic instruction for seven basic emotions, scaffold instruction which included repeated practice with increased presentation speeds, guided attention to relevant facial cues, and imitation of expressions. Training occurred twice each week for 45-60 min across an average of six sessions. Outcome measures were administered prior to and immediately after treatment, as well as after a delay period of 4-6 weeks. Outcome measures included (a) direct assessment of facial emotion recognition, (b) emotion self-expression, and (c) generalization through emotion awareness in videos and stories, use of emotion words, and self-, parent-, and teacher-report on social functioning questionnaires. The facial emotion training program enabled children and adolescents with ASD to more accurately and quickly identify feelings in facial expressions with stimuli from both the training tool and generalization measures and demonstrate improved self-expression of facial emotion.