Increased facial asymmetry in autism spectrum conditions is associated with symptom presentation.
Kids with autism show more uneven faces, and the crookedness lines up with how intense their repetitive behaviors are.
01Research in Context
What this study did
Boutrus et al. (2019) took photos of autistic and non-autistic kids. They measured how much the left and right sides of each face differed. They also scored how severe each child's repetitive behaviors were.
The team used a simple ruler-like tool on the photos. They looked at eye height, nostril width, and mouth corner placement. More difference between sides equals more facial asymmetry.
What they found
Autistic children had more lopsided faces than their peers. The kids with the most uneven faces also showed the strongest repetitive behaviors. The link held only for the left-right axis, not up-down.
In plain words, when a child's face was more crooked, they flapped, lined up toys, or repeated phrases more often.
How this fits with other research
Tan et al. (2021) asked the same question in parents. Moms and dads of autistic kids also had more uneven faces, but the effect was tiny. This hints the trait runs in families and is partly genetic.
Spackman et al. (2023) seems to disagree. They found no extra brain asymmetry in autistic youth when they looked at EEG waves. The key difference is tissue: EEG measures brain electricity, while Maryam looked at bone and skin. Both can be true at once.
Older brain studies back the idea. Blanchard et al. (1979) and Hatton et al. (2005) already showed unusual left-right patterns inside autistic brains. Maryam moves the lens to the outside of the head.
Why it matters
You can't treat a face, but you can notice it. A quick photo or even eyeballing symmetry during intake can flag kids with stronger repetitive profiles. This saves assessment time and helps you tailor intervention intensity. No extra tools, no cost, just another data point sitting in plain sight.
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Join Free →Snap a straight-on photo during intake, draw a quick vertical line on the screen, and note any left-right mismatch in your intake form under 'physical markers.'
02At a glance
03Original abstract
A key research priority in the study of autism spectrum conditions (ASC) is the discovery of biological markers that may help to identify and elucidate etiologically distinct subgroups. One physical marker that has received increasing research attention is facial structure. Although there remains little consensus in the field, findings relating to greater facial asymmetry (FA) in ASC exhibit some consistency. As there is growing recognition of the importance of replicatory studies in ASC research, the aim of this study was to investigate the replicability of increased FA in autistic children compared to nonautistic peers. Using three-dimensional photogrammetry, this study examined FA in 84 autistic children, 110 typically developing children with no family history of the condition, and 49 full siblings of autistic children. In support of previous literature, significantly greater depth-wise FA was identified in autistic children relative to the two comparison groups. As a further investigation, increased lateral FA in autistic children was found to be associated with greater severity of ASC symptoms on the Autism Diagnostic Observation Schedule, second edition, specifically related to repetitive and restrictive behaviors. These outcomes provide an important and independent replication of increased FA in ASC, as well as a novel contribution to the field. Having confirmed the direction and areas of increased FA in ASC, these findings could motivate a search for potential underlying brain dysmorphogenesis. Autism Res 2019, 12: 1774-1783. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: This study looked at the amount of facial asymmetry (FA) in autistic children compared to typically developing children and children who have siblings with autism. The study found that autistic children, compared to the other two groups, had greater FA, and that increased FA was related to greater severity of autistic symptoms. The face and brain grow together during the earliest stages of development, and so findings of facial differences in autism might inform future studies of early brain differences associated with the condition.
Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1002/aur.2161