The relation of emotion recognition and social behavioral problems in children with neurofibromatosis type 1: An explorative study

OBJECTIVE: Children with neurofibromatosis type 1 (NF1) often show cognitive and behavioral problems (Martin et al., 2011). Huijbregts et al. (2010) investigated cognitive problems in children with NF1 focusing on social information processing. They found that bottom-up as well as top-down processes are involved. The authors suggested that the deficits in social information processing might be linked to social behavioral problems (Huijbregts et al., 2010). To further investigate this issue, the aim of the present study is to assess the relation between social behavioral problems and deficits in emotion recognition. PARTICIPANTS AND METHOD: 14 children with NF1 between 5.00-13.00 years of age (6 boys, 8 girls; MAge=8.3, SDAge=2.8; MIQ=100.71, SDIQ=11,56) took part in our study. 6 children were 10 years and older, 8 children were younger than 10. Emotion recognition was assessed with the Dutch shortened version of the Facial Expression of Emotions – Stimuli and Tests (FEEST-36; original test by Young et al. 2002) and parents reported social behavioral problems on the Child Behavior Checklist 6-18 (CBCL; Achenbach, 1991). Data of the FEEST-36 were compared to an age- gender- and IQ-matched control group (n=28; 15 boys, 13 girls; MAge=8.1, SDAge=1,10; MIQ=104.93, SDIQ=10.6).RESULTS: There was no significant difference in facial emotion recognition between children with NF1 and typically developing children younger than 10. Children with NF1 of 10 years and older were significantly less accurate in recognizing anger, fear and sadness in facial emotions than typically developing children. Four parents reported problematic social behavior for their child on the CBCL. The social behavioral problems were significantly correlated with recognition of sadness in children with NF1 of 10 years and older. DISCUSSION: In our sample, emotion recognition in children with NF1 younger than 10 years was not different from typically developing children. This might indicate a low sensitivity of the FEEST-36. The test does not seem to be able to detect emotion recognition deficits in children with NF1 younger than 10 years. For children with NF1 older than 10 years of age, we found impaired fear recognition. Furthermore, we also found an impairment of recognition of anger and sadness. Especially the recognition of sadness is related to social behavioral problems. More research is needed on the development of social cognition in children with NF1 and the relation with behavioral problems in order to tailor intervention strategies to improve social functioning of these children.