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In recent years there has been a growing interest in autism spectrum individuals in the expression and understanding of emotions. The objective of this work is through a literature review: a) to illustrate the emotional development and education of individuals on the spectrum b) to present the findings of investigations c) to present and raise key concerns about the emotional intelligence of children spectrum of autism (d) raise questions about the development of educational methods aimed at enhancing the emotional development of individuals in the autism spectrum and thereby the development of social feelings their maternal skills.
PaperAutism, Expression, and Understanding of Emotions: Literature Review
Autism, Expression, and Understanding of Emotions:
Literature Review
Irene Chaidi (), Athanasios Drigas
N.C.S.R. ‘Demokritos’, Agia Paraskevi, Athens, Greece
AbstractIn recent years there has been a growing interest in autism
spectrum individuals in the expression and understanding of emotions. The
objective of this work is through a literature review: a) to illustrate the
emotional development and education of individuals on the spectrum b) to
present the findings of investigations c) to present and raise key concerns about
the emotional intelligence of children spectrum of autism (d) raise questions
about the development of educational methods aimed at enhancing the
emotional development of individuals in the autism spectrum and thereby the
development of social feelings their maternal skills.
KeywordsAutism, autism spectrum, emotional intelligence
1 Introduction
Autism Spectrum Disorder (ASD) is a lifelong developmental disorder that
prevents people to understand correctly what they see, hear and generally feel. As a
result, they face serious problems in their social relationships, communication, and
behavior. Children with autism spectrum have significant difficulties in recognition,
in understanding and expressing emotions [1]. They tend to avoid human faces and
are difficult to understand why facial features are "moving", changing, as a result, the
inability to read the emotions in the human face weakens their ability to communicate
with other people [2]. The purpose of this paper is to present a literature overview
research on how people's emotions are expressed and understood in the autism
spectrum, as well as research on investigating the training of autistic people in
recognizing, expressing and understanding emotions.
2 Autistic Spectrum Disorder (ASD)
Autistic Spectrum Disorder is a severe, widespread developmental disorder a
person who has been accompanying the person throughout his or her life, affecting
their perception, thinking and behavior and is characterized by (a) significant
difficulties in developing the person's social and communication skills and mutual
PaperAutism, Expression, and Understanding of Emotions: Literature Review
interactions with those around him, and (b) limited and recurring stereotypical
interests and behaviors. [3], [4]
ASD is diagnosed by comparing one's behaviors with symptoms that are listed in
the official Diagnostic and Statistical Manual of the American Psychiatric Association
(DSM-V) and the World Health Organization (WTO) ICD-10 (International
Classification of Diseases) lists. Both the current diagnostic criteria and the
descriptions of modern researchers that concerning the Autism follow Wing's "Triple
Disorder of Social Interaction": a) Disruption of social relationships - incomplete
social interaction - interaction, lack of emotional reciprocity, social b)
Communication disruption - inadequate communication and communication) and
fantasy - a lack of social understanding and imagination (Happe, 1998). These three
categories, with the revised version DSM-V, were replaced by 2 groups: a) social
communication and b) stereotyped, repetitive behaviors, activities, and interests.
It should be emphasized that children with ASD are highly heterogeneity in terms
of social disorder. Other children have a lack of motivation for interaction, which in
some cases avoids interaction, that is, they avoid touch and eye contact, while others
actively seek interaction but either lack empathy or interact interactively. People with
ASD also have a disadvantage in their emotional organization, resulting in difficulty
in communicating with those around them, with consequences for socializing and
family problems.
3 Emotional Intelligence
The individual coexists with logic and emotional intelligence. The feelings they
have important in one's life because as a subjective response of the person to the event
that caused the emotion, they have the potential as an internal ethic to guide us in
decision making, changes in behavior, facial expression, and posture. Scientists
pointing out the importance of emotional intelligence in achieving personal and
collective goals emphasize that most of the time, one's general intelligence does not
guarantee success unless it is combined with a high degree of emotional intelligence.
The term intelligence has been given definitions that primarily refer to the
intelligentsia one's achievements and not so much what intelligence is,[5] points out.
Cognitive intelligence defines what we can measure ", while the scientific definition
defines:" intelligence is a complex and complex cognitive function, involving many
factors, including the ability to acquire new experiences, adapt to new situations. and
to build on previous experience in dealing with new difficulties or problems ”[6], [7]
The feeling from ancient times is defined as: "a function of the body, the which
either alone or in collaboration and interaction with mental functions contributes to
the overall development of man and enhances his ability to adapt. [5]. In
Psychology, the term emotion was first used in the mid-18th century by Hume to
describe passion or love [8], while in modern theories: Fredrickson's theory of
positive emotions [9], [10] but also in previous theories[11], [12], [13], the term
emotion expresses the multidimensional forms of the organism's response to
environmental challenges, manifested at various levels, such as expressive, cognitive,
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PaperAutism, Expression, and Understanding of Emotions: Literature Review
neurological, normal or biological, etc. [5] and seems to be accepted today by most
psychologists who study emotions.
The term "emotional intelligence" was recently used by Goleman [14], [15], while
its development as a scientific concept began long ago and has its roots in Thorndike's
social intelligence [16]. "Emotional Intelligence" is a multidimensional concept and
therefore exists several definitions, depending on the aspect of emotional intelligence
that scientists are trying to cover, although most analyze emotional intelligence in
four thematic areas: perception, understanding, control, and the use of emotion. It is
treated "as a complex concept that encompasses a range of dimensions (abilities,
characteristics, skills) and refers to various areas of human nature (cognitive potential,
personality, behavior)" [17].
According to the Greek Dictionary: Emotional Intelligence is defined as "the
ability to control one's emotions, to cope with emotional stress, to develop one's
abilities in areas such as imagination, art and human communication ", while
according to Goleman [15] it is defined as" the ability to know what you are feeling
and to be able to handle these emotions before letting them handle you, to be able to
motivate yourself to accomplish your goals, to be creative, to make the most of your
abilities, to understand what people are feeling others and be able to handle their
relationships effectively. " Finally, Salovey, Mayer, & Caruso [18] define emotional
intelligence as "the ability of a person to identify, accurately evaluate, and distinguish
his or her own, others' emotions, to understand, to" assimilate "them into their minds,
and to regulate both negative and positive emotions in oneself and others. "
In recent years they have been measuring and evaluating emotional intelligence
manufactured various psychometric tools (scales or tests), both scientifically and
popularly. [17].
Researchers support that there is a positive correlation between emotional
intelligence and one's cognitive processes, and this demonstrates the important role
that emotional intelligence plays in emotion and cognition, thereby enhancing
individuals and their personality and benefiting [19], [20]. They also emphasize that
emotional intelligence is a skill that can be "learned" and developed. [21], [22].
Researchers Dringas & Papoutsi [23] support in their research that the development
of emotional intelligence is based on the 9-level model. This model is based on the
concepts of Gardner's interpersonal and interpersonal meanings [24], [25].
The pyramid of emotional intelligence (9-level model).
1. Emotional Unity
2. Exceeding
3. Homogeneity of Emotions, Realization
4. Social Skills, Expertise in Emotions
5. Social Awareness, Empathy, Discrimination of Emotions
6. Self-management
7. Self-knowledge
8. Recognition of emotions, perception-expression of emotions
9. Emotional stimuli
PaperAutism, Expression, and Understanding of Emotions: Literature Review
Man strives to reach the last level of the pyramid, and at every level cultivates
important emotional, cognitive and metacognitive skills that are important resources.
4 Emotion and DAS: Expression-perception-understanding of
Feelings are the first way children communicate as well as the first weeks of their
lives are capable of expressing their core feelings of joy, sadness, anger, disgust, and
surprise. [26]
Leppanen & Nelson [27] support that one's ability to discern a person's sense of
facial expressions is considered essential for successful social interaction, and
conversely, social interaction, through increased experience in facial expression, may
be necessary for normal development of facial emotion recognition (Facial Emotion).
Recognition, -FER). Many people with an autism spectrum disorder, who are
characterized by severe difficulties with social interaction, have experienced
impairments in FER. Kanner [28] first described autism as a "disturbance of
emotional contact", emphasizing the social and emotional characteristics of autism
disorder and argued that it is "inherently" inability of children to develop emotional
contact with other persons, weakness they continue to emphasize social and emotional
deficits and the role of emotions in DIA is still under discussion. The taxonomic
systems of the World Health Organization ICD-10 and the American Psychiatric
Society DSM-V in the criteria for diagnosing autism spectrum status related to
deficits in the recognition and processing of emotions emphasize: "Deficits such as
nonverbal behavior manifest; the facial expression "and" lack of social or emotional
reciprocity ". These difficulties in using and responding to emotions correspond to
two components of the processing of emotions [29], [30], [31], the production of an
emotional state and the regulation of emotions. [32].
Researchers agree that in typically developing children the recognition of
Emotional facial expressions are an early development of social skills [32] from the
age of 4 months we distinguish expressions of anger, fear, sadness, happiness and
surprise in infants [33] in a familiar context while between 8 and 10 months infants
begin to use emotional expressions for social reference [34], and are a key source of
information about the sender's current emotional state [35], intentions [36] and the
significant if environment and lessons learned [37], [38]. The failure of these
fundamental emotion recognition skills will have serious consequences for the child's
social development, moving the child away from learning about other people's
emotions and reactions. [32].
In ASD, when we talk about a basic disorder of feeling we do not mean that
children with ASD have no emotions, nor the difficulty of children to read the
feelings of others and to reflect on their own, but this is a disorder of the connection
of emotion with perception and thinking, difficulties in understanding, managing of
emotions and personal meaning in what the child perceives. This is why scientists
argue that children with ASD can express their emotions, but their emotional
expressions differ from those of typical developmental children [1].
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PaperAutism, Expression, and Understanding of Emotions: Literature Review
5 Method
In the present work, reference is made to research on expression, perception and
understanding emotions in DIA. and categorized into two categories: a) research on
the recognition of emotions of people with autism and b) research on the development
of emotionally-empowering people with autism.
Research on the emotional intelligence of people with ASD, in particular, has
increased in the last decade, but the findings on the recognition of facial emotions in
autism are inconsistent: some studies find no deficits in autism, while others report
deep deficits [39], despite numerous studies, there is still no general acceptance as to
whether emotion recognition is a fundamental difficulty for people with autism or not.
Several of these studies have identified difficulties in the recognition of facial
expressions in individuals with autism [40] , [41], [42], [43], some other studies have
not [44], [45], [46], [47], [48], [49], while studies indicate deficits that are limited to
specific negative emotions, such as fear [50], [51], disgust, sadness, and anger [52],
The literature review refers to the results of 48 surveys, collected by Uljarevic &
Hamilton [32], with 980 participants with ASD of all ages. They focused on the
recognition of emotion from visual stimuli because they have been studied more and
are intended to determine whether recognition dysfunction exists at all ages of autism,
regardless of IQ and severity level, and whether deficits in recognition of visual
impairments and equivalents in size in all different emotions, The criteria set
included: sample number, autistic gender and control group, diagnosis and diagnostic
criteria , the mental age of the participants, the type of project, the research tools and
the emotion study category (basic or complex). The results of the literature review
showed that there was an objective difficulty in identifying emotions from people
with autism and that the age of the participants, their IQ and performance had no
effect on the sample performance.
Finally, issues that need to be addressed in subsequent investigations were
identified such as sample size, sample group, and the projects used [39], [54], [55],
Also, a new search [57] was limited to 31 articles about serious games, between
January 2001 and April 2014, and they were designed to improve social skills.
Sixteen of these games targeted facial emotion recognition or production. They
support that Although social skills required in real-life involve rich combinations of
perspective-taking, emotional regulation, cognitive flexibility, appropriate use of
language and so on, the literature search conducted here emphasized that a significant
part of the effort devoted to serious game design has been focusing on the basic
ability of emotion recognition, which sustains those more complex forms of social
5.1 Surveys of expression, recognition, and understanding of emotions
Hobson [58] supports that the cause of autism is the inability of individuals to
create emotional bonds with other people as they do not have the subjectivity of
PaperAutism, Expression, and Understanding of Emotions: Literature Review
recognizing emotions. The absence of this is the inability of the individual to perceive
emotional states and to understand the minds of others [58], [59], [60], a view
supported by researchers. [61], [45], [62], [63], [64], [65].
Hobson, Ouston & Lee [66], [67], also support that autistic individuals find it
difficult to grasp the emotional expressions in both their reading and their
understanding of the faces of others, because autistic children do not see the person as
a single form (Gestalt) but as a set of elements that are related in a specific way so
they can identify them in the experiment.
Other research reveals the inability of autistic children to interact and express their
feelings in expressions, not verbally. [1]. Yirmiga, Kasari, Sigman, & Mundy [69] by
videotaping the interactions of autistic, mentally retarded, and typically developing
children with an unknown adult and studying their reactions, concluded that autistic
children express abnormal or control, a view supported by Dawnson, Hill, Spencer,
Galpert & Watson [70], while Kasari, Sigman, Mundy, and Yirmiya [71] agree that
autistic children find it difficult to express their emotions when interacting with an
adult. .
Baron-Coen [72] in two studies asked children with ASD to describe their the
emotional state of a heroine and studied the difficulty of autistic children in
understanding emotions, asking whether it is the difficulty of autistic children to
understand primary anomalies [58] or the secondary consequence of Frith & Leslie
[74]. The conclusion was that children with ASD difficulty in understanding beliefs
are a primary deficit, but the difficulty in understanding emotions is a secondary
consequence, that is, autistic children understand certain situations or events that
cause specific emotions.
In addition to research on understanding and expression of basic emotions, research
has been conducted the ability to perceive, understand and express complex emotions
of people with ASD. Researchers Klim, Volkmar, & Sparrow [75] studied the basic
social behaviors of children with ASD, aged about 4 years with control groups of
typical developmental children and children with intellectual disabilities, aiming to
show that social behavior or lack thereof is independent of the kinetic activity of the
individual. Research has shown that autistic individuals cannot develop emotional
bonds with others, reinforcing the view that socialization is one of the three deficits of
autism [76] and their inability to connect emotionally with others. it deprives them of
social experiences.
Baron-Cohen,[77] thinks that children with autism are deficient in autism "Theory
of mind", in understanding others' mental states, resulting in difficulties in
understanding one's beliefs, desires, intentions, feelings and interpreting the behavior
of others. Misailides & Papoudi, [1] report that researches related to “theory of mind”
have shown that children's performance in autism in recognition of complex emotions
in facial expressions in photographs was commensurate with children's performance
in works. theory of mind, while Heerey, Kethner & Capps [78] believe that the
disorder of people with autism in the understanding, perception, and expression of
complex emotions is due to the abnormal development of the "theory of mind" that is
necessary for the development complex emotions, as complex emotions usually
manifest themselves when other people are present.
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PaperAutism, Expression, and Understanding of Emotions: Literature Review
In a study of Rump, Giovannelli, Minshew & Strauss [79] with 2 experiments
investigated the recognition of emotions in typically developing individuals and
people with autism at different ages. The results showed that the performance of the
subjects in the control group was better in the adult group, while the performance of
the individuals with autism was similar in all age groups, that is, the adults with
autism did not seem to reach the level of aptitude recognition about to with
concerning the emotions, typically developing adults.
Harms et al. [39] also refers to the results of optical surveys Coordination (Eye-
Tracking) and Brain-Based Studies pointing out that the results show that people with
ASD exhibit abnormalities in the recognition of emotional facial expressions.
Wallace, et al. [53] exploring the recognition of his emotional expressions facial and
perceptual sensitivity between high-functioning autistic adolescents and typically
developing adolescents (corresponding age, IQ, gender) in six key emotions and
examining the links between recognizing emotional facial expressions and adolescent
symptom / adaptive functioning, people with high functioning autism have difficulty
processing emotional facial expressions, perceptual sensitivity, and sad expressions.
ye not associated with autistic behavior and adaptive functioning, which may be
considered as in-awareness deficits.
In a recent, study Tanaka, et. al. [80] evaluate the expression process participants
with autistic disorders designed and used the computer project “Let's Face It! Emotion
Skills Battery” (LFI!) Consisting of three measures of verbal and perceptual facial
recognition skills. It was administered to groups of participants with ASD and
typically developing individuals of the same age and intelligence (IQ). The results of
the studies showed that people with autism were able to identify basic facial emotions
(except for anger expression) at the same level as typically developing control
subjects, but with a reduced ability to generalize emotions to different identities.
Researchers have made suggestions for designing effective emotion processing
interventions promoting the generalization of emotion recognition in people and
social situations to enhance social day-to-day skills.
Last discussed that responsible for the impairment of emotional ability is the
malfunction of the almond nucleus, the sickle [81]. The almond nucleus plays a key
role in emotional learning, regulates additional cognitive processes, such as memory
or attention [82], while stimulating it produces negative emotions (fear, sadness,
anxiety) or positive emotions (happiness). Researchers Bauman & Kemper [83] in
necrotizing studies of the autopsy of the sickle-cell of the autopsy showed that there
were abnormalities in the size, density and dendritic branches of the autopsy. and
found these findings to be evidence of abnormal development of the autistic almond
kernel [1], a view also supported by research in animals such as Bachevalier, Hagger
& Mishkin [84] rhesus, as well as those of Prather et al. [85] and Emey et al. [86] in
monkeys with localized damage to the tonsils, showed that macaque monkeys with
damage to the tonsils showed a lack of fear in stimuli that typically cause this emotion
Grossard, [57] mention that many serious games focus on recognizing
emotions in pictures, drawings, audio or video recordings. Although emotion
PaperAutism, Expression, and Understanding of Emotions: Literature Review
recognition is multimodal [87], visual facial stimuli were the most frequent, audio
stimuli were less frequent and body posture presentations were only proposed once.
5.2 Emotional development and autism spectrum training
Individual and minimal surveys have been conducted to investigate, based on
different intervention models and in a different population of autistic individuals,
whether children with ASD can be trained in understanding and expressing emotions.
Personalized psychoeducational intervention programs specifically aimed at teaching
emotional comprehension skills for children with autism do not exist while integrated
intervention programs have so far been developed and applied to autistic children, e.g.
Lovaas, PECS, TEACCH, etc., aim to improve the behavior of autistic children and to
train them in communication and social skills.
Based on the principles of behavior analysis, Gena, Krantz, Mc Clannahan and
Poulson [88] conducted a study with 4 autistic individuals aged 11-19 years and
aimed at: teaching socially acceptable emotional reactions to autistic individuals using
the combination of: reinforcement, imitation and verbal guidance, to evaluate the
effects of intervention with new therapists and in new situations after the arrival of
one month, and to train autistic people in emotional states related to acceptance by
their peers. The categories used to train autistic people were: 1) talking about favorite
objects, 2) laughing at nonsense, 3) showing sympathy, 4) showing appreciation, and
5) showing dissatisfaction. Indicative socially acceptable emotional responses were
considered: eye contact, as well as socially acceptable verbal response and emotional
expression. Participants were trained in 3 or 4 categories, and the results of the study
showed that all 4 participants benefited by presenting socially acceptable emotional
reactions, not only to the categories they were trained to but also to new situations
with new therapists and after one month.
Hadwin, Baron-Cohen, Howlin, and Hill [89], [90] studied, in the context of
'theory mind how children with autism aged 4-13 years and verbal age 6 years can be
taught to understand emotions, beliefs, and pretensions. The findings of the study
showed that autistic children could be taught and succeeded in tests that assessed the
above while retaining this ability after a 2-month evaluation, but it was observed that
there was no generalization to unstructured activities with a different structure from
the ones originally developed. Children were trained and that this intervention did not
contribute to improved communication in terms of the use of mental states and the
ability to expand into discussions.
In another study, Silver, and Oakes [91] using the program Emotional Computer-
assisted trainers teach people with autism or Asperger's syndrome to recognize and
anticipate others' emotions. The study involved 2 groups of 11 participants each, aged
12-18 years old and verbal aged 7 years and over, with a diagnosis of autism or
Asperger's syndrome. The experimental group used the program for 10 episodes
lasting 30 minutes over for 2-3 weeks while the control group subjects were watching
their class. Participants were assessed before and after the intervention using photos
with the 4 basic facial expressions, photos that refer to a person in a particular
emotional state that triggers the expression of a particular emotion, photos showing
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PaperAutism, Expression, and Understanding of Emotions: Literature Review
what the protagonist wants, what he or she is getting. finally and how it finally feels
and photos referring to a person and a particular situation triggering emotional
reactions The results of the intervention They showed that the experimental group
showed improvement in all parameters compared to the control group and that the
scores on emotion measurements were not correlated with age or verbal ability, and
the more they used the program on the computer, the more positive results there were.
However, it remains to be tested whether these positive effects can be generalized in
real life or contribute to better performance in measurements of mind theory.
Bauminger [92] used the principles of cognitive-behavioral therapy in a sample of
15 autistic individuals aged 8-17 years and Intelligence Score 60-109 on the WISC-R
to evaluate the effectiveness of an intervention on socio-emotional understanding and
social interaction. The intervention lasted 7 months for 3 hours a week at school by
the child's teacher in collaboration with a peer and his parents. Intervention with
emotional comprehension included teaching: basic emotions describing the rules for
each emotion, recognizing emotions in oneself and others through recognizing
emotional expressions, gestures and utterances, and recognizing emotions.
Intervention results showed that people with ASD: recognized and described more
emotions, used more complex emotions taking into account the presence of others,
and reported personal emotional experiences more frequently than using standard
stereotypical responses.
Golan et al [93] used computers to identify and emotion learning educational
software "The Transporters", a digital game for 4-8 -year- olds [94]. This software is a
series of animations with 'live' vehicles, eight characters with real human faces
designed to enhance the learning and understanding of emotions in children with ASD
and plays in a child's bedroom, in a predictable environment. The study sample
included 20 children with autism, aged 4-7 years, who attended the game daily for 4
weeks and were examined before and after intervention in emotional vocabulary and
emotion recognition at three levels of generalization. They were compared with two
child control groups: the first group of 18 children with ASD and the second group of
18 children with formal development. The intervention team showed significant
improvement, and the researchers concluded that using the software improved the
recognition of emotions in children with autism [93].
Researchers Hopkins, et al. [95] used the FaceSay program, one an interactive
avatar computer program designed to teach social skills and improve the social
interactions of children with ASDs in the natural environment, to increase their ability
to observe globally the interpretation of emotions in faces. Faces are one of three
games designed to improve attention skills and is based on the idea that people with
autism are deficient in central cohesion [96]. The study evaluated the efficacy of
FaceSay activities in 49 low- and high-functioning autism spectrum participants and
had the opportunity to practice eye gaze, facial expressions and face recognition and
emotion recognition in the structured environment of FaceSay. Low-functioning
children showed improvements in emotion recognition and social interaction, whereas
high-functioning children showed improvements in face recognition. The findings are
particularly encouraging.
PaperAutism, Expression, and Understanding of Emotions: Literature Review
The researchers, Machalicek, W.K. Others, [97], in a systematic review of studies,
using computational interventions (CBI) to improve the social and emotional skills
(eg, emotional recognition) of people with autism spectrum disorder (ASD), report
that these results studies have shown that the effect of CBI on social and emotional
skills was mixed, with most studies reporting unacceptable results after intervention
and pointing out that the comparison of CBI training with guidance and personal
social skills training suggests that the CBI can be just as effective as face-to-face
education. In general, this review indicates that the use of CBI to improve the social
and emotional abilities of people with ASD is a promising practice. They caution
professionals that they should carefully consider the preferences and existing
capabilities of people with ASD and adjust the software when deciding to use the CBI
and choosing a software program
Grossard,΄,[57] at his article support that four games of the sixteen, also
trained on producing emotions, often by having individuals mimic a model. Among
them, only Life- IsGame [98] includes emotion production exercises in a social
context with no visual support.
The researchers Tan et al., [99] fixed up the game” CopyMe”. It’s a very simple
game in its architecture and principles and has not been tested in a clinical study.
targets only facial expression production; the game is designed for an iPad. The player
must look at a picture of a facial expression with the name of the expression written
underneath it and then she/he has to reproduce it. There are 3 levels of difficulty: the
easy level includes happy and sad emotions; the intermediate level includes happy,
sad, angry and surprised; and the difficult level includes happy, sad, angry, surprised,
scared and yucky. A facial expression recognizer was built for this game.
Serret et al., [100], fixed up the game. ”Je Stimule" This game is a computer game
that targets expression recognition in context, more complex in its computation and
was tested in an open stratified clinical trial. This game is separated into 2 modes,
training and the game itself. The particularity of this game is that Lf-Asd (Low
Functioning Autism Spectrum Disorders) Individuals can play using color codes that
are associated with specific emotions (yellow for joy, for example). Players learn
these codes in the training mode. During the game, the player moves her/ his avatar in
a 3D environment and is exposed to different scenarios during which she/he has to
recognize emotions. Different levels of recognition exist: (1) recognizing the emotion
expressed by a virtual character due to a specific event (e.g. a child falls); (2) the same
task but the face of the virtual character is hidden; (3) recognising the emotion
conveyed by the non-verbal communicative behaviour of a virtual character speaking
with another virtual character when the verbal exchange is made inaudible.
6 Conclusions Perspectives
The results of the literature review to the results of 48 surveys collected by
Uljarevic & Hamilton [32] showed that there was objective difficulty in identifying
emotions from people with autism and that the age, participants, their IQ, and the task
used had no effect on sample performance.
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The researchers noted that there are critical issues that need to be addressed. Future
research concerns: sample size, sample group, and projects used [39], [101], [102],
[103]. Based on the evaluation studies, they recommend using larger sample sizes to
increase the reliability and reproducibility of the data, to fully record the results
(tables, graphs) for better documentation. They also raise questions about how
important time is in recognizing emotion, and people with autism may need more time
to recognize an emotion, or they may have difficulty recognizing emotions in moving
dynamic images from still images. The second concern they have is that there is a
greater failure to recognize negative emotions than people with ASD, and they
suggest more research with different emotions with large groups of participants in
combination with brain-imaging and visual resonance methods.
In Grossard’s et al [57] review is presented the presence or absence of the different
attributes of serious games described by Yusoff [104]. Games usually included
several attributes. However, three attributes appeared to be used less frequently:
attention span, reward and accommodating the learner. Each game was very different
with variations based on the authors’ choices.
Also, at the same review is presented the scale scoring from Connolly’s et al. [105]
study regarding clinical validation. Excellent scores were obtained only 6 games from
sixteen games: The Junior Detective Program [106], Emotion Trainer [80] FaceSay2
[47], JeStimule [100] Let's Face It [80] Mind Reading [107] and The Transporters
[93]. Regarding the targeted populations, 6 serious games are available exclusively
for high-functioning (HF) ASD or Asperger syndrome (AS) individuals, with no
adaptation for low functioning (LF) ASD patients. Two other games require that
players have good reading skills. Among the 16 games, 10 were assessed in
populations with ASD, only 7 studies used a control group, including a few with
sample sizes of 30 or more children per group and only 4 studies were randomized.
Also, one study (the serious game Let's Face It!) [80] included both a control group
and an ASD group matched for developmental age and diagnosis (AS or PDD-NOS)
and more than 30 children per group. In terms of efficacy, the individuals who played
Mind Reading [107] The Transporters [93], JeStimule [100] FaceSay2 [47], The
Junior Detective Program [106], and Emotion Trainer [80] showed improvement after
training but their results cannot be extended to the whole spectrum of autism disorders
given the limited representativeness of their samples. Also, no study showed evidence
of clinical relevance meaning that by playing with a serious game that focuses on
social interaction skills, the children were not shown to improve clinical social
interaction scores (like ADOS or Vineland).
7 References
[1] Misailidi, P. & Papoudi, D. (2009). Expression, perception, and understanding of emotions
in autism: Psychological and neurological findings. Step in Social Sciences, 54, 127 - 145.
[2] Chaidi, E. & Papoudi, D. (2010). Educational software for the emotional development of
people with autism spectrum, Proceedings: 2nd Panhellenic Conference on Special
Education "Special Education is the starting point for developments in science and
practice", Athens 2010, Grigoris Publications.
PaperAutism, Expression, and Understanding of Emotions: Literature Review
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8 Authors
Irene Chaidi is currently working as a special education teacher in Athens,
Greece. She is a Ph.D. Candidate in N.C.S.R. ‘Demokritos’, IIT - Net Media Lab, &
Mind-Brain R & D, Agia Paraskevi, 153 10, Athens, Greece (e-mail:
Athanasios Drigas is a Research Director at N.C.S.R. “Demokritos”, ΙΙΤ - Net
Media Lab & Mind- Brain R&D, Agia Paraskevi, 153 10, Athens, Greece (e-mail:
Article submitted 2019-10-24. Resubmitted 2019-12-01. Final acceptance 2019-12-03. Final version
published as submitted by the authors.
iJOE Vol. 16, No. 2, 2020
... Similarly, autistic individuals with strong adherence to routines and resistance to change may experience intense distress and hyperarousal in response to minute changes in their environment [49]. Emotion dysregulation may also be compounded by poor perspective taking abilities and emotional organization, which may lead to misunderstanding and intense frustration in social interactions [20,50]. As autistic individuals enter adulthood, they often present with high rates of internalizing symptoms (e.g. ...
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Emotional Intelligence (EI) has been an important and controversial topic during the last few decades. Its significance and its correlation with many domains of life has made it the subject of expert study. EI is the rudder for feeling, thinking, learning, problem-solving, and decision-making. In this article, we present an emotional–cognitive based approach to the process of gaining emotional intelligence and thus, we suggest a nine-layer pyramid of emotional intelligence and the gradual development to reach the top of EI.
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In this article, the author describes a new theoretical perspective on positive emotions and situates this new perspective within the emerging field of positive psychology. The broaden-and-build theory posits that experiences of positive emotions broaden people's momentary thought-action repertoires, which in turn serves to build their enduring personal resources, ranging from physical and intellectual resources to social and psychological resources. Preliminary empirical evidence supporting the broaden-and-build theory is reviewed, and open empirical questions that remain to be tested are identified. The theory and findings suggest that the capacity to experience positive emotions may be a fundamental human strength central to the study of human flourishing.
Conference Paper
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This article presents the LIFEisGAME project, a serious game that will help children with ASDs to recognize and express emotions through facial expressions. The game design tackles one of the main experiential learning cycle of emotion recognition: recognize and mimic (game mode: build a face). We describe the technology behind the game, which focus on a character animation pipeline and a sketching algorithm. We detailed the facial expression analyzer that is used to calculate the score in the game. We also present a study that analyzes what type of characters children prefer when playing a game. Last, we present a pilot study we have performed with kids with ASD.
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It is widely accepted that emotion processing difficulties are involved in Autism Spectrum Conditions (ASC). An increasing number of studies have focused on the development of training programs and have shown promising results. However, most of these programs are appropriate for individuals with high-functioning ASC (HFA) but exclude individuals with low-functioning ASC (LFA). We have developed a computer-based game called JeStiMulE based on logical skills to teach emotions to individuals with ASC, independently of their age, intellectual, verbal and academic level. The aim of the present study was to verify the usability of JeStiMulE (which is its adaptability, effectiveness and efficiency) on a heterogeneous ASC group. We hypothesized that after JeStiMulE training, a performance improvement would be found in emotion recognition tasks. A heterogeneous group of thirty-three children and adolescents with ASC received two one-hour JeStiMulE sessions per week over four weeks. In order to verify the usability of JeStiMulE, game data were collected for each participant. Furthermore, all participants were presented before and after training with five emotion recognition tasks, two including pictures of game avatars (faces and gestures) and three including pictures of real-life characters (faces, gestures and social scenes). Descriptive data showed suitable adaptability, effectiveness and efficiency of JeStiMulE. Results revealed a significant main effect of Session on avatars (ANOVA: F (1,32) = 98.48, P < .001) and on pictures of real-life characters (ANOVA: F (1,32) = 49.09, P < .001). A significant Session × Task × Emotion interaction was also found for avatars (ANOVA: F (6,192) = 2.84, P = .01). This triple interaction was close to significance for pictures of real-life characters (ANOVA: F (12,384) = 1.73, P = .057). Post-hoc analyses revealed that 30 out of 35 conditions found a significant increase after training. JeStiMulE appears to be a promising tool to teach emotion recognition not only to individuals with HFA but also those with LFA. JeStiMulE is thus based on ASC-specific skills, offering a model of logical processing of social information to compensate for difficulties with intuitive social processing. Trial registration Comité de Protection des Personnes Sud Méditerranée V (CPP): reference number 11.046 (
The topic of this thesis is the recognition and expression of pride, guilt, shame and coyness by children with autism. It was hypothesised that these self-conscious emotions develop through a child's ability to identify with others' attitudes towards the self and that children with autism have a limited ability to identify with others this way. Correspondingly, it is expected that they will be limited in their ability to express and perhaps experience these emotions. The series of studies presented in this thesis investigate the recognition and expression of these self- conscious emotions in children with autism, relative to a chronological and verbal age matched group of children without autism. In the first study, parents were asked to describe a range of socio-emotional behaviour of their children with autism. The second study focused on parent reports of the expression of pride, guilt and shame in their children. The third study examined participants' recognition of these emotions in video-clips of enacted scenarios. Participants were then interviewed to explore their own experiences of pride, guilt and shame. Finally situations were designed to elicit pride, guilt and coyness in participants and their responses were recorded and rated. The results from the studies offer substantial but qualified support for the hypothesis. Collectively, they present a complex picture of both spared and impaired aspects of pride, guilt, shame and coyness in children with autism.
The use of information communication technologies (ICTs) in therapy offers new perspectives for treating many domains in individuals with autism spectrum disorders (ASD) because they can be used in many different ways and settings and they are attractive to the patients. We reviewed the available literature on serious games that are used to teach social interactions to individuals with ASD. After screening the Medline, Science Direct and ACM Digital Library databases, we found a total of 31 serious games: 16 that targeted emotion recognition or production and 15 that targeted social skills. There was a significant correlation between the number of reports per year and the year of publication. Serious games appeared promising because they can support training on many different skills and they favour interactions in diverse contexts and situations, some of which may resemble real life. However, the currently available serious games exhibit some limitations: (i) most of them are developed for High-Functioning individuals; (ii) their clinical validation has rarely met the evidence-based medicine standards; (iii) the game design is not usually described; and, (iv) in many cases, the clinical validation and playability/game design are not compatible. Future research agendas should encompass (i) more robust studies in terms of methodology (large samples, control groups, longer treatment periods, follow-up to assess whether changes remain stable, etc.) to assess serious game efficacy; (ii) more collaboration between clinical and computer/game design experts; and (iii) more serious games that are adapted to Low-Functioning ASD individuals.
In this study we establish that autistic children have severe and specific difficulty with understanding mental states. Even with a mental age of 7 years, these children mostly fail in tasks which are normally passed around age 3 and 4. We confirm previous results on the poor understanding of false belief but also find that autistic children's grasp of the notion of limited knowledge is grossly delayed. We rule out various other explanations for these results and further show that the autistic child's performance is not limited by failure to understand the causal notion of seeing. Likewise, memory failure cannot be blamed. Language delay can be ruled out as a cause of failure since a group of children with specific language impairment, matched for verbal mental age, performed at ceiling. We propose that autistic children are specifically impaired in their meta-representational capacity and that this impedes their construction of a ‘theory of mind’.