Ten autistic children were compared with 10 non-autistic children matched for chronological age and performance IQ on two tests of finding the odd face out of a set of photographs of faces, two tests of labelling photographs of faces, and a test of labelling photographs of common objects. The autistic children were significantly worse than the non-autistic children at finding the odd person out and the odd facial expression of emotion out, and at labelling facial expressions of emotion. They did no worse than the non-autistic children at labelling upside down faces or at labelling objects. The results, which replicate the findings of Hobson (J. Child Psychol, Psychiat. 27, 321-342, 671-680, 1986; Communication, 20, 12-17, 1986) are consistent with other evidence for a specific perceptual abnormality in at least some children with autism, the nature of which is discussed.

Children with diagnoses of either autism or Asperger's syndrome were matched on measures of verbal mental age with nonautistic control children. They were tested on their abilities to process both facial and nonfacial stimuli. There were no significant differences between the low ability autistic and control groups, but the high ability autistic and Asperger's children performed significantly worse than controls across all tests. Group averages masked substantial individual variation. The results are seen as indicating a general perceptual deficit that is not specific to faces or emotions. This appears to be a common correlate of autism and Asperger's syndrome, rather than a core symptom.

The distress and disability caused by Asperger syndrome are a consequence of the core syndrome itself, and any neurological or physical disorders which may be associated with it. Distress and disability are also influenced, to a much greater degree than has previously been recognized, by the personal reactions of the sufferer and the social reactions of those around him or her. One important type of personal reaction is the development of a psychological disorder secondary to Asperger syndrome. There is growing evidence that these reactions are commoner and more severe than has been thought previously. They include affective disorders, anxiety-related disorders and conduct disorders. Their manifestations may be altered by the presence of Asperger syndrome. Treatment usually involves a combination of psycho- education, social change, psychotropic medication and counselling.

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