Alexithymic and autistic traits in children and adolescents: A systematic review of the current state of knowledge

Abstract

Research evidence suggests that heterogeneity in emotion processing difficulties in autistic individuals may reflect co-occurring alexithymia. Elevated levels of alexithymia is a robust finding in the adult autistic population but there is a relative poverty regarding the corresponding research in younger populations. The aim of this review is to investigate associations between autism and alexithymia in children and adolescents, so that we can better understand the nature and impact of alexithymia in autistic individuals early on in their lives. Online scientific databases were systematically reviewed for studies on autistic children and adolescents and co-occurring alexithymia. A total of eight studies were identified. Evidence indicated that alexithymia prevalence in autistic individuals is higher compared to their typically developing peers and is closely related to the emotional and social deficits involved in autism but not to the associated cognitive deficits. Main concerns associated with these results are related to the alexithymia assessment measures implemented in each study, their limitations, and potential effects on the validity of findings. This review sheds light on the topic of alexithymia in children and adolescents and underscores the difficulties in conducting this research, while providing insights for research with autistic children and adolescents. Lay abstract In this study, we aim to explore the ability of autistic children to process emotions and respond to a range of feelings in relation to a triad of difficulties known as alexithymia, namely children’s difficulties to recognize, describe, and distinguish emotions. Alexithymia is common in autistic adults but we know very little about children. To understand this condition better, within a large group of studies, first we study the extent to which alexithymia difficulties are present in autistic children. In reviewing the literature, we also present the assessment measures implemented in each study, their limitations, and potential effects on our understanding of findings. This knowledge will help us understand the extent to which alexithymia is present in autistic children and how it may be related to their emotional difficulties. Also, it will allow us to further detect challenges early on in children’s lives so that we recommend interventions that teach autistic children how to recognize, describe, and distinguish emotions in themselves and in others. Such interventions may include family members of autistic children to assist interactions with their child. Supporting children from an early age will help them develop skills that will ready them for school and life and it will enhance their ability to build supportive relationships and meet their fullest potential.