About 1 in 650 boys are born with an extra X chromosome (47,XXY or Klinefelter 
syndrome). 47,XXY is associated with vulnerabilities in socio-emotional 
development. This study was designed to assess types of cognitive deficits in 
individuals with 47,XXY that may contribute to social-emotional dysfunction, and 
to evaluate the nature of such deficits at various levels: ranging from basic 
visuospatial processing deficits, impairments in face recognition (FR), to 
emotion expression impairments. A total of 70 boys and men with 47,XXY, aged 8 
to 60 years old, participated in the study. The subtests feature identification, 
FR and identification of facial emotions of the Amsterdam Neuropsychological 
Tasks were used. Level of intellectual functioning was assessed with the child 
and adult versions of the Wechsler Intelligence Scales. Reaction time data 
showed that in the 47,XXY group, 17% had difficulties in visuospatial processing 
(no social load), 26% had difficulties with FR (medium social load) and an even 
higher number of 33% had difficulties with facial expressions of emotions 
(high-social load). Information processing impairments increased as a function 
of "social load" of the stimuli, independent of intellectual functioning. Taken 
together, our data suggest that on average individuals with XXY may have more 
difficulties in information processing when "social load" increases, suggesting 
a specific difficulty in the higher-order labeling and interpretation of social 
cues, which cannot be explained by more basic visuospatial perceptual skills. 
Considering the increased risk for social cognitive impairments, routine 
assessment of social cognitive functioning as part of neuropsychological 
screening is warranted.