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People with ADHD struggle to recognize the facial expressions of others. Poor facial emotion recognition is linked to inattention, impulsivity, hyperactivity, and anxiety. Moreover, research has shown that individuals with ADHD are more likely to misinterpret social cues and experience social difficulties.  

  • ADHD can make it difficult to process the emotional displays of others.
  • Children, adolescents, and adults can all experience facial emotion recognition challenges.
  • Researchers hope to determine the root cause of impaired facial emotion recognition and whether it is related to other symptoms of ADHD.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent pediatric disorders, affecting about 5% of children. Children with ADHD often struggle with emotional regulation, which can manifest as poor facial emotion recognition (FER). There is conflicting research on FER in children with ADHD, and no study has shown a causal mechanism of altered FER.

Primary vs. Secondary Deficits in FER in ADHD 

A systematic literature review in the Journal of Attention Disorders investigated 14 previous reports of deficient FER in children, adolescents, and adults with ADHD. 

Some studies suggest that FER is a primary deficit, while others support the idea that FER is a secondary deficit arising from another dysfunction, such as impulsivity or inattention. For example, some studies found that after controlling for disruptive behavior scores and oppositional defiant symptoms, FER was still diminished in children with ADHD. There was also no correlation between FER and impulsive or inattentive behavior.

Correlations Between FER and Other Symptoms/Comorbidities of ADHD 

On the other hand, other studies have found inattention in children and adolescents to be correlated with FER accuracy, and a relationship between recognition deficits and the comorbidity of ADHD with conduct disorder. 

Importantly, recognition performance may differ depending on the patient’s age, the type of emotion portrayed, and comorbid disorders. Inattention, impulsivity, hyperactivity, and anxiety are most likely to be correlated with FER, which suggests that recognition deficits may be a secondary development stemming from one or more of these.

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FER Deficits Affect Daily Life and Social Interactions 

In children and adults with ADHD, processing of facial emotions can be a hindrance to everyday tasks and social interactions. To make more substantial claims about the root cause of FER, more experimental research must be completed. 


Olaya-Galindo, M. D., Vargas-Cifuentes, O. A., Vélez Van-Meerbeke, A., & Talero-Gutiérrez, C. (2023). Establishing the Relationship Between Attention Deficit Hyperactivity Disorder and Emotional Facial Expression Recognition Deficit: A Systematic Review. J Atten Disord, 10870547231154901. https://doi.org/10.1177/10870547231154901