Increased facial asymmetry in autism spectrum conditions is associated with symptom presentation

Author Identifier

Syed Gilani Orcid: https://orcid.org/0000-0002-7448-2327

Document Type

Journal Article

Publication Title

Autism Research




School of Science




Australian Government's Cooperative Research Centres Program.

National Health and Medical Research Council.

Telethon Kids Institute.

Cooperative Research Centre for Living with Autism.

Grant Number

NHMRC Number : 1077966


Boutrus, M., Gilani, S. Z., Alvares, G. A., Maybery, M. T., Tan, D. W., Mian, A., & Whitehouse, A. J. (2019). Increased facial asymmetry in autism spectrum conditions is associated with symptom presentation. Autism Research, 12(12), 1774-1783. Available here


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. 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.



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