Externalizing and Internalizing Symptoms Moderate Longitudinal Patterns of Facial Emotion Recognition in Autism Spectrum Disorder.

Libero et al. (2016) tracked facial emotion recognition (FER) skills in autistic youth for 18 weeks. They wanted to know if kids got better at reading faces over time and whether mood symptoms changed the speed of that growth.

The team measured FER accuracy every few weeks. They also scored each child on internalizing worries and externalizing behaviors like tantrums or hyperactivity.

Overall, the group improved at naming emotions across the 18 weeks. The climb was not equal for everyone.

Kids with more anxiety or sadness picked up FER skills faster. Kids with more acting-out behaviors improved more slowly.

Wieckowski et al. (2020) tried to speed up FER with an attention-training program. They saw no gain on test scores, while E et al. saw natural growth without any teaching. The difference hints that spontaneous practice or daily social exposure may matter more than brief lab drills.

Kuang et al. (2025) pooled 25 brain-scan papers and found weaker left inferior frontal gyrus activity during emotion tasks in autistic people. E et al. show behavior can still improve even if that under-activation stays put, linking brain and behavior timelines.

Poppes et al. (2010) ran a social-skills group and also saw FER gains after lessons. Their positive result aligns with E et al.'s natural improvement, supporting the idea that these skills are malleable in autistic youth.

If you serve autistic clients, expect slow but real FER progress across a semester. Check for externalizing behaviors; these kids may need extra visual prompts, breaks, or reinforcement to keep pace. Pair anxious students with peer practice—they appear primed to benefit. You can stop hunting for magic programs and instead embed emotion labeling into daily routines, monitor symptoms, and adjust support as you go.