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Brief Report: Facial Asymmetry and Autistic-Like Traits in the General Population

Abstract

Atypical facial morphology, particularly increased facial asymmetry, has been identified in some individuals with Autism Spectrum Conditions (ASC). Many cognitive, behavioural and biological features associated with ASC also occur on a continuum in the general population. The aim of the present study was to examine subthreshold levels of autistic traits and facial morphology in non-autistic individuals. Facial asymmetry was measured using three-dimensional facial photogrammetry, and the Autism-spectrum Quotient was used to measure autistic-like traits in a community-ascertained sample of young adults (n = 289). After accounting for covariates, there were no significant associations observed between autistic-like traits and facial asymmetry, suggesting that any potential facial morphology differences linked to ASC may be limited to the clinical condition.

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References

  1. Aldridge, K., Boyadjiev, S. A., Capone, G. T., DeLeon, V. B., & Richtsmeier, J. T. (2005). Precision and error of three-dimensional phenotypic measures acquired from 3dMD photogrammetric images. American Journal of Medical Genetics. https://doi.org/10.1002/ajmg.a.30959.

    Article  PubMed  Google Scholar 

  2. Allanson, J. E., O’Hara, P., Farkas, L. G., & Nair, R. C. (1993). Anthropometric craniofacial pattern profiles in Down syndrome. American Journal of Medical Genetics, 47(5), 748–752. https://doi.org/10.1002/ajmg.1320470530.

    Article  PubMed  Google Scholar 

  3. Al Ali, A., Richmond, S., Popat, H., Toma, A. M., Playle, R., Zhurov, A. I., et al. (2014). The influence of asthma on face shape: A three-dimensional study. European Journal of Orthodontics. https://doi.org/10.1093/ejo/cjs067.

    Article  PubMed  Google Scholar 

  4. Altman, D. G. (1991). Practical statistics for medical research. London: Chapman and Hall.

    Google Scholar 

  5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). New York: American Psychiatric Association.

    Book  Google Scholar 

  6. Armstrong, R., Whitehouse, A. J. O., Scott, J. G., Copland, D. A., McMahon, K. L., Fleming, S., et al. (2017). A relationship between early language skills and adult autistic-like traits: Evidence from a longitudinal population-based study. Journal of Autism and Developmental Disorders, 47(5), 1478–1489. https://doi.org/10.1007/s10803-016-3014-z.

    Article  PubMed  Google Scholar 

  7. Austin, E. J. (2005). Personality correlates of the broader autism phenotype as assessed by the Autism Spectrum Quotient (AQ). Personality and Individual Differences, 38(2), 451–460. https://doi.org/10.1016/j.paid.2004.04.022.

    Article  Google Scholar 

  8. Auyeung, B., Baron-Cohen, S., Ashwin, E., Knickmeyer, R., Taylor, K., & Hackett, G. (2009). Fetal testosterone and autistic traits. British Journal of Psychology, 100(1), 1–22. https://doi.org/10.1348/000712608X311731.

    Article  PubMed  Google Scholar 

  9. Auyeung, B., Taylor, K., Hackett, G., & Baron-Cohen, S. (2010). Foetal testosterone and autistic traits in 18 to 24-month-old children. Molecular Autism. https://doi.org/10.1186/2040-2392-1-11.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Baron-Cohen, S., Auyeung, B., Nørgaard-Pedersen, B., Hougaard, D. M., Abdallah, M. W., Melgaard, L.,… Lombardo, M. V. (2015). Elevated fetal steroidogenic activity in autism. Molecular Psychiatry 20(3), 369–376. https://doi.org/10.1038/mp.2014.48.

  11. Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31(1), 5–17. https://doi.org/10.1023/A:1005653411471.

    Article  PubMed  Google Scholar 

  12. Boutrus, M., Gilani, S. Z., Alvares, G. A., Maybery, M. T., Tan, D. W., Mian, A., et al. (2019). Increased facial asymmetry in autism spectrum conditions is associated with symptom presentation. Autism Research. https://doi.org/10.1002/aur.2161.

    Article  PubMed  Google Scholar 

  13. Boutrus, M., Maybery, M. T., Alvares, G. A., Tan, D. W., Varcin, K. J., & Whitehouse, A. J. O. (2017). Investigating facial phenotype in autism spectrum conditions: The importance of a hypothesis driven approach. Autism Research. https://doi.org/10.1002/aur.1824.

    Article  PubMed  Google Scholar 

  14. Buitelaar, J. K. (1995). Attachment and social withdrawal in autism: Hypotheses and findings. Behaviour, 132(5–6), 319–350. https://doi.org/10.1163/156853995X00595.

    Article  Google Scholar 

  15. Chen, F. S., & Yoon, J. M. D. (2011). Brief report: Broader autism phenotype predicts spontaneous reciprocity of direct gaze. Journal of Autism and Developmental Disorders, 41(8), 1131–1134. https://doi.org/10.1007/s10803-010-1136-2.

    Article  PubMed  Google Scholar 

  16. Chinthapalli, K., Bartolini, E., Novy, J., Suttie, M., Marini, C., Falchi, M., et al. (2012). Atypical face shape and genomic structural variants in epilepsy. Brain. https://doi.org/10.1093/brain/aws232.

    Article  Google Scholar 

  17. Coetzee, V., Chen, J., Perrett, D. I., & Stephen, I. D. (2010). Deciphering faces: Quantifiable visual cues to weight. Perception, 39(1), 51–61. https://doi.org/10.1068/p6560.

    Article  PubMed  Google Scholar 

  18. Colvert, E., Tick, B., McEwen, F., Stewart, C., Curran, S. R., Woodhouse, E.,… Bolton, P. (2015). Heritability of autism spectrum disorder in a UK population-based twin sample. JAMA Psychiatry, 72(5), 415–423. https://doi.org/10.1001/jamapsychiatry.2014.3028.

  19. Constantino, J. N., & Todd, R. D. (2003). Autistic traits in the general population: A twin study. Archives of General Psychiatry, 60(5), 524–530. https://doi.org/10.1001/archpsyc.60.5.524.

    Article  PubMed  Google Scholar 

  20. Cribb, S. J., Olaithe, M., Di Lorenzo, R., Dunlop, P. D., & Maybery, M. T. (2016). Embedded figures test performance in the broader autism phenotype: A meta-analysis. Journal of Autism and Developmental Disorders, 46(9), 2924–2939. https://doi.org/10.1007/s10803-016-2832-3.

    Article  PubMed  Google Scholar 

  21. English, M., Gignac, G., Visser, T., Whitehouse, A., & Maybery, M. (2019). A comprehensive psychometric analysis of Autism-Spectrum Quotient factor models using two large samples: Model recommendations and the influence of divergent traits on total-scale scores. Autism Research. https://doi.org/10.13140/RG.2.2.11843.86564.

    Article  PubMed  Google Scholar 

  22. Ercan, I., Ozdemir, S. T., Etoz, A., Sigirli, D., Tubbs, R. S., Loukas, M., et al. (2008). Facial asymmetry in young healthy subjects evaluated by statistical shape analysis. Journal of Anatomy, 213(6), 663–669. https://doi.org/10.1111/j.1469-7580.2008.01002.x.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Farkas, L. G., Katic, M. J., Forrest, C. R., Alt, K. W., Bagič, I., Baltadjiev, G.,… Yahia, E. (2005). International anthropometric study of facial morphology in various ethnic groups/races. Journal of Craniofacial Surgery, 16(4), 615–646. https://doi.org/10.1097/01.scs.0000171847.58031.9e.

  24. Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders. https://doi.org/10.1023/A:1025054610557.

    Article  PubMed  Google Scholar 

  25. Gilani, S. Z., Mian, A., Shafait, F., & Reid, I. (2018). Dense 3D face correspondence. IEEE Transactions on Pattern Analysis and Machine Intelligence. https://doi.org/10.1109/TPAMI.2017.2725279.

    Article  PubMed  Google Scholar 

  26. Graham, J., & Özener, B. (2016). Fluctuating asymmetry of human populations: A review. Symmetry, 8(12), 154. https://doi.org/10.3390/sym8120154.

    Article  Google Scholar 

  27. Hammond, P., Forster-Gibson, C., Chudley, A. E., Allanson, J. E., Hutton, T. J., Farrell, S. A.,… Lewis, M. E. S. (2008). Face-brain asymmetry in autism spectrum disorders. Molecular Psychiatry, 13(6), 614–623. https://doi.org/10.1038/mp.2008.18.

  28. Hollier, L. P., Keelan, J. A., Jamnadass, E. S. L., Maybery, M. T., Hickey, M., & Whitehouse, A. J. O. (2015). Adult digit ratio (2D:4D) is not related to umbilical cord androgen or estrogen concentrations, their ratios or net bioactivity. Early Human Development, 91(2), 111–117. https://doi.org/10.1016/j.earlhumdev.2014.12.011.

    Article  PubMed  Google Scholar 

  29. Honda, H., Shimizu, Y., Misumi, K., Niimi, M., & Ohashi, Y. (1996). Cumulative incidence and prevalence of childhood autism in children in Japan. British Journal of Psychiatry, 169(2), 228–235. https://doi.org/10.1192/bjp.169.2.228.

    Article  Google Scholar 

  30. Kung, K. T. F., Spencer, D., Pasterski, V., Neufeld, S., Glover, V., O’Connor, T. G.,… Hines, M. (2016). No relationship between prenatal androgen exposure and autistic traits: Convergent evidence from studies of children with congenital adrenal hyperplasia and of amniotic testosterone concentrations in typically developing children. Journal of Child Psychology and Psychiatry and Allied Disciplines, 57(12), 1455–1462. https://doi.org/10.1111/jcpp.12602.

  31. Lewis, M. (2017). Factors affecting the perception of 3D facial symmetry from 2D projections. Symmetry, 9(10), 243. https://doi.org/10.3390/sym9100243.

    Article  Google Scholar 

  32. Linden, O. E., He, J. K., Morrison, C. S., Sullivan, S. R., & Taylor, H. O. B. (2018). The relationship between age and facial asymmetry. Plastic and Reconstructive Surgery, 142(5), 1145–1152. https://doi.org/10.1097/PRS.0000000000004831.

    Article  PubMed  Google Scholar 

  33. Manning, J. T., Baron-Cohen, S., Wheelwright, S., & Sanders, G. (2001). The 2nd to 4th digit ratio and autism. Developmental Medicine and Child Neurology, 43(3), 160–164.

    Article  Google Scholar 

  34. Marcucio, R., Hallgrimsson, B., & Young, N. M. (2015). Facial morphogenesis. Physical and molecular interactions between the brain and the face. Current Topics in Developmental Biology. https://doi.org/10.1016/bs.ctdb.2015.09.001.

    Article  PubMed  PubMed Central  Google Scholar 

  35. McKnight, C. M., Newnham, J. P., Stanley, F. J., Mountain, J. A., Landau, L. I., Beilin, L. J.,… Mackey, D. A. (2012). Birth of a cohort—The first 20 years of the raine study. Medical Journal of Australia 197(11), 608–610. https://doi.org/10.5694/mja12.10698.

  36. Morgan, B., Maybery, M., & Durkin, K. (2003). Weak central coherence, poor joint attention, and low verbal ability: Independent deficits in early autism. Developmental Psychology. https://doi.org/10.1037/0012-1649.39.4.646.

    Article  PubMed  Google Scholar 

  37. Morris, C. A., Demsey, S. A., Leonard, C. O., Dilts, C., & Blackburn, B. L. (1988). Natural history of Williams syndrome: Physical characteristics. The Journal of Pediatrics, 113(2), 318–326. https://doi.org/10.1016/S0022-3476(88)80272-5.

    Article  PubMed  Google Scholar 

  38. Ozgen, H., Hellemann, G. S., De Jonge, M. V., Beemer, F. A., & Van Engeland, H. (2013). Predictive value of morphological features in patients with autism versus normal controls. Journal of Autism and Developmental Disorders, 43(1), 147–155. https://doi.org/10.1007/s10803-012-1554-4.

    Article  PubMed  Google Scholar 

  39. Ozgen, H., Hellemann, G. S., Stellato, R. K., Lahuis, B., Van Daalen, E., Staal, W. G.,… Van Engeland, H. (2011). Morphological features in children with autism spectrum disorders: A matched case-control study. Journal of Autism and Developmental Disorders, 41(1), 23–31. https://doi.org/10.1007/s10803-010-1018-7.

  40. Pellicano, E., Maybery, M., Durkin, K., & Maley, A. (2006). Multiple cognitive capabilities/deficits in children with an autism spectrum disorder: “Weak” central coherence and its relationship to theory of mind and executive control. Development and Psychopathology. https://doi.org/10.1017/S0954579406060056.

    Article  PubMed  Google Scholar 

  41. Posserud, M. B., Lundervold, A. J., & Gillberg, C. (2006). Autistic features in a total population of 7–9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). Journal of Child Psychology and Psychiatry and Allied Disciplines, 47(2), 167–175. https://doi.org/10.1111/j.1469-7610.2005.01462.x.

    Article  Google Scholar 

  42. Robinson, E. B., Koenen, K. C., McCormick, M. C., Munir, K., Hallett, V., Happé, F.,… Ronald, A. (2011). Evidence that autistic traits show the same etiology in the general population and at the quantitative extremes (5%, 2.5%, and 1%). Archives of General Psychiatry, 68(11), 1113–1121. https://doi.org/10.1001/archgenpsychiatry.2011.119

  43. Robinson, E. B., Munir, K., Munaf, M. R., Hughes, M., McCormick, M. C., & Koenen, K. C. (2011). Stability of autistic traits in the general population: Further evidence for a continuum of impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 50(4), 376–384. https://doi.org/10.1016/j.jaac.2011.01.005.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Russell-Smith, S. N., Maybery, M. T., & Bayliss, D. M. (2011). Relationships between autistic-like and schizotypy traits: An analysis using the Autism Spectrum Quotient and Oxford-Liverpool inventory of feelings and experiences. Personality and Individual Differences, 51(2), 128–132. https://doi.org/10.1016/j.paid.2011.03.027.

    Article  Google Scholar 

  45. Senju, A., & Johnson, M. H. (2009). Atypical eye contact in autism: Models, mechanisms and development. Neuroscience and Biobehavioral Reviews. https://doi.org/10.1016/j.neubiorev.2009.06.001.

    Article  PubMed  Google Scholar 

  46. Voracek, M., & Dressler, S. G. (2006). Lack of correlation between digit ratio (2D:4D) and Baron-Cohen’s “Reading the Mind in the Eyes” test, empathy, systemising, and autism-spectrum quotients in a general population sample. Personality and Individual Differences, 41(8), 1481–1491. https://doi.org/10.1016/j.paid.2006.06.009.

    Article  Google Scholar 

  47. Weinberg, S. M., Scott, N. M., Neiswanger, K., Brandon, C. A., & Marazita, M. L. (2004). Digital three-dimensional photogrammetry: Evaluation of anthropometric precision and accuracy using a Genex 3D camera system. Cleft Palate-Craniofacial Journal. https://doi.org/10.1597/03-066.1.

    Article  Google Scholar 

  48. Whitehouse, A. J. O., Mattes, E., Maybery, M. T., Dissanayake, C., Sawyer, M., Jones, R. M., … Hickey, M. (2012). Perinatal testosterone exposure and autistic-like traits in the general population: A longitudinal pregnancy-cohort study. Journal of Neurodevelopmental Disorders, 4(1), 1–12. https://doi.org/10.1186/1866-1955-4-25.

  49. Wilson, J. M., & Manning, J. T. (1996). Fluctuating asymmetry and age in children: Evolutionary implications for the control of developmental stability. Journal of Human Evolution. https://doi.org/10.1006/jhev.1996.0041.

    Article  Google Scholar 

  50. Wing, L. (1994). The autistic continuum. In N. Bouras (Ed.), Mental health in mental retardation: Recent advances and practices (pp. 108–125). Cambridge: Cambridge University Press.

    Google Scholar 

  51. Yeargin-Allsopp, M., Rice, C., Karapurkar, T., Doernberg, N., Boyle, C., & Murphy, C. (2003). Prevalence of autism in a US metropolitan area. Journal of the American Medical Association, 289(1), 49–55. https://doi.org/10.1001/jama.289.1.49.

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to acknowledge the Raine Study participants and their families for their ongoing participation in the study, the Raine Study team for study co-ordination and data collection, and the University of Western Australia Centre for Sleep Science for utilisation of the facility and the sleep study technicians. The core management of the Raine Study is funded by the National Health and Medical Research Council (NHMRC), the University of Western Australia, Curtin University, Telethon Kids Institute, Women and Infants Research Foundation, Edith Cowan University, Murdoch University, the University of Notre Dame Australia and the Raine Medical Research Foundation. The Raine Study Gen2-22 year follow-up was funded by NHMRC project grants 1027449, 1044840 and 1021855. Authors M.B., G.A.A., and A.J.O.W. acknowledge support from the Cooperative Research Centre for Living with Autism (Autism CRC), established and supported under the Australian Government’s Cooperative Research Centres Program. Author M.B. was supported by an Australian Postgraduate Award/Australian Government Research Training Program (RTP) Scholarship, and a UWA Top-up Scholarship. Author G.A.A. is funded by an early career fellowship from the Western Australian Health Translation Network. Authors A.J.O.W. and P.R.E. are funded by NHMRC Senior Research Fellowships (APP1077966, APP1136548, respectively). The funders had no influence over the ideas contained in, or in the writing of, this manuscript.

Funding

Core Management of the Raine Study has been funded by the national Health and Medical Research Council (NHMRC), University of Western Australia (UWA), Curtin University, the UWA Faculty of Medicine, Dentistry and Health Sciences, the Raine Medical Research Foundation, the Telethon Institute for Child Health Research, and the Women’s and Infants Research Foundation. Authors M.B., G.A.A., and A.J.O.W. acknowledge support from the Cooperative Research Centre for Living with Autism (Autism CRC), established and supported under the Australian Government’s Cooperative Research Centres Program. Author G.A.A is funded by an early career fellowship from the Western Australian Health Translation Network. Author A.J.O.W. is funded by a National Health and Medical Research Council Senior Research Fellowship (APP1077966). The funders had no influence over the ideas contained in, or in the writing of, this manuscript. The authors are extremely grateful to all the families who took part in this study and the whole Raine Study team, which includes the Cohort Manager, Data Manager and data collection team.

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MB, AW, MM and GA conceived the presented idea. PE fascilitated the collection of facial images. SGZ and DT were involved in the landmark annotation of facial photographs. SGZ computed the FA scores in collaboration with AM. MB analysed the data and wrote the manuscript with input from all authors.

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Correspondence to Maryam Boutrus.

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Boutrus, M., Gilani, Z., Maybery, M.T. et al. Brief Report: Facial Asymmetry and Autistic-Like Traits in the General Population. J Autism Dev Disord 51, 2115–2123 (2021). https://doi.org/10.1007/s10803-020-04661-7

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Keywords

  • Autism
  • Facial asymmetry
  • Morphology
  • Neurotypical
  • Neurodevelopment