Joint attention and children with autism: A review of the literature

Parent-implemented AAC verb symbol intervention with children with ASD

A multiple-probe across participants design was used to examine whether three young children diagnosed with autism spectrum disorder (ASD) could learn to use verb symbols presented on an AAC application to request actions. Using researcher coaching (involving joint planning, descriptive instructions, and guided practice) parents of participants were taught to (a) embed opportunities for children to request actions in daily home routines, (b) model AAC responses, (c) use a prompt hierarchy with a time delay, and (d) contingently reinforce correct aided AAC responses. Following intervention delivered by parents, all three participants increased their use of verb symbols to request actions and parents implemented procedures with high fidelity. There were, however, individualized differences in rate of acquisition, variability of responding, readiness for fading supports, and moving to more advanced skills. One of the three participants was able to master two-step responses involving navigation to a category folder. Generalization of requesting actions to labeling actions was limited.

Phenotyping variability in early socio-communicative skills in young children with autism and its influence on later development

Children with autism spectrum disorder (ASD) often face challenges in early social communication skills, prompting the need for a detailed exploration of specific behaviors and their impact on cognitive and adaptive functioning. This study aims to address this gap by examining the developmental trajectories of early social communication skills in preschoolers with ASD aged 18-60 months, comparing them to age-matched typically developing (TD) children. Utilizing the early social communication scales (ESCS), the research employs a longitudinal design to capture changes over time. We apply a principal component analysis (PCA) to ESCS variables to identify underlying components, and cluster analysis to identify subgroups based on preverbal communication profiles. The results reveal consistent differences in early social communication skills between ASD and TD children, with ASD children exhibiting reduced skills. PCA identifies two components, distinguishing objects-directed behaviors and social interaction-directed behaviors. Cluster analysis identifies three subgroups of autistic children, each displaying specific communication profiles associated with distinct cognitive and adaptive functioning trajectories. In conclusion, this study provides a nuanced understanding of early social communication development in ASD, emphasizing the importance of low-level behaviors. The identification of subgroups and their unique trajectories contributes to a more comprehensive understanding of ASD heterogeneity. These findings underscore the significance of early diagnosis, focusing on specific behaviors predicting cognitive and adaptive functioning outcomes. The study encourages further research to explore the sequential development of these skills, offering valuable insights for interventions and support strategies.

Sharing Our World: Impact of Group Motor Skill Learning on Joint Attention in Children with Autism Spectrum Disorder

Impaired joint attention is a common feature of autism spectrum disorder (ASD), affecting social interaction and communication. We explored if group basketball learning could enhance joint attention in autistic children, and how this relates to brain changes, particularly white matter development integrity. Forty-nine autistic children, aged 4-12 years, were recruited from special education centers. The experimental group underwent a 12-week basketball motor skill learning, while the control group received standard care. Eye-tracking and brain scans were conducted. The 12-week basketball motor skill learning improved joint attention in the experimental group, evidenced by better eye tracking metrics and enhanced white matter integrity. Moreover, reduced time to first fixation correlated positively with decreased mean diffusivity of the left superior corona radiata and left superior fronto-occipital fasciculus in the experimental group. Basketball-based motor skill intervention effectively improved joint attention in autistic children. Improved white matter fiber integrity related to sensory perception, spatial and early attention function may underlie this effect. These findings highlight the potential of group motor skill learning within clinical rehabilitation for treating ASD.

Characterization of dyadic interaction features between fathers and mothers playing with their autistic children

BACKGROUND

Socio-communicative difficulties are a core symptom of autism that deeply impact interaction with others. Despite that, research on bidirectional caregiver-child interaction variables has been notably scant and predominantly focused on autistic children's interactive differences and the consequences on parenting behaviors.

AIM

The study aimed to assess parent-child interaction in the context of autism through observational validated instruments that consider qualitative and structural features in a complementary way to obtain a comprehensive characterization of the exchange within the dyad.

METHODS AND PROCEDURES

This study involved 56 paired parent-child dyads of 28 autistic children (mean age = 38.60 months, sd = 9.50) playing with their mothers and their fathers for 10 min. The video-recorded sessions were coded through the Emotional Availability Scales (EAS) and the Interpersonal Synchrony (IS) coding system.

OUTCOMES AND RESULTS

Fathers and mothers do not show significant differences in ISexcept for mother widenings, which are more frequent and successful, and in Emotional Availability. Further, dyads present moderate levels of Emotional Availability, indicating that parents may struggle with structuring, sensitivity, and interactive abilities with their autistic children, which in turn present low levels of responsiveness and involvement. Further, we explored an association between IS and EA characteristics.

CONCLUSION AND IMPLICATIONS

This study suggests the need for interventions to target interaction considering both caregivers, ultimately targeting both interaction structure and affect features. Research that includes fathers fosters strategies for individualization and treatment optimization.

Evidence of mutual non-verbal synchrony in learners with severe learning disability and autism, and their support workers: a motion energy analysis study

Introduction

Some research indicates that neurodivergent people are less likely than "neurotypical" people to adapt their movements to a partner's movements to facilitate interpersonal motor synchrony. Researchers therefore suggest synchrony deficits underlie the social differences associated with autism and other neurodivergences. Intensive Interaction (II) is a client-led approach, where Learning Support Workers (LSW) follow the lead of learners to create balanced and reciprocal interactions.

Methods

We aimed to examine the balance of synchrony in learners with autism and Severe Learning Disabilities and their LSWs in a special education college where learners had prior experience with II. Using Motion Energy Analysis, we assessed the degree to which each partner acted as a leader, and hence which partner acted as a follower, during moments of close synchrony.

Results

Overall, learners and LSWs showed higher than chance synchrony. There were no differences in the degree to which each partner led the moments of synchrony, or the amount pairs synchronized with zero-lag, where there was no delay between each partners' movements.

Discussion

The equal balance of leading and following in the learner and LSW pairs demonstrates that both partners consistently adapted their movements to their partner's movements to facilitate synchrony. The findings tentatively challenge the notion of a synchrony deficit in autism and suggest synchrony can be present in cross-neurotype pairs in comfortable and engaging conditions. We discuss the potential for client-led, movement-based approaches to support smooth interactions across neurotypes.

Autistic young people adaptively use gaze to facilitate joint attention during multi-gestural dyadic interactions

LAY ABSTRACT

Autistic people have been said to have 'problems' with joint attention, that is, looking where someone else is looking. Past studies of joint attention have used tasks that require autistic people to continuously look at and respond to eye-gaze cues. But joint attention can also be done using other social cues, like pointing. This study looked at whether autistic and non-autistic young people use another person's eye gaze during joint attention in a task that did not require them to look at their partner's face. In the task, each participant worked together with their partner to find a computer-generated object in virtual reality. Sometimes the participant had to help guide their partner to the object, and other times, they followed their partner's lead. Participants were told to point to guide one another but were not told to use eye gaze. Both autistic and non-autistic participants often looked at their partner's face during joint attention interactions and were faster to respond to their partner's hand-pointing when the partner also looked at the object before pointing. This shows that autistic people can and do use information from another person's eyes, even when they don't have to. It is possible that, by not forcing autistic young people to look at their partner's face and eyes, they were better able to gather information from their partner's face when needed, without being overwhelmed. This shows how important it is to design tasks that provide autistic people with opportunities to show what they can do.

Social interaction links active musical rhythm engagement and expressive communication in autistic toddlers

Rhythm is implicated in both social and linguistic development. Rhythm perception and production skills are also key vulnerabilities in neurodevelopmental disorders such as autism which impact social communication. However, direct links between musical rhythm engagement and expressive communication in autism is not clearly evident. This absence of a direct connection between rhythm and expressive communication indicates that the mechanism of action between rhythm and expressive communication may recruit other cognitive or developmental factors. We hypothesized that social interactions, including general interpersonal relationships and interactive music-making involving children and caregivers, were a significant such factor, particularly in autism. To test this, we collected data from parents of autistic and nonautistic children 14-36 months of age, including parent reports of their children's rhythmic musical engagement, general social skills, parent-child musical interactions, and expressive communication skills. Path analysis revealed a system of independent, indirect pathways from rhythmic musical engagement to expressive communication via social skills and parent-child musical interactions in autistic toddlers. Such a system implies both that social and musical interactions represent crucial links between rhythm and language and that different kinds of social interactions play parallel, independent roles linking rhythmic musical engagement with expressive communication skills.

Digital tools for direct assessment of autism risk during early childhood: A systematic review

LAY ABSTRACT

The challenge of finding autistic children, and finding them early enough to make a difference for them and their families, becomes all the greater in parts of the world where human and material resources are in short supply. Poverty of resources delays interventions, translating into a poverty of outcomes. Digital tools carry potential to lessen this delay because they can be administered by non-specialists in children's homes, schools or other everyday environments, they can measure a wide range of autistic behaviours objectively and they can automate analysis without requiring an expert in computers or statistics. This literature review aimed to identify and describe digital tools for screening children who may be at risk for autism. These tools are predominantly at the 'proof-of-concept' stage. Both portable (laptops, mobile phones, smart toys) and fixed (desktop computers, virtual-reality platforms) technologies are used to present computerised games, or to record children's behaviours or speech. Computerised analysis of children's interactions with these technologies differentiates children with and without autism, with promising results. Tasks assessing social responses and hand and body movements are the most reliable in distinguishing autistic from typically developing children. Such digital tools hold immense potential for early identification of autism spectrum disorder risk at a large scale. Next steps should be to further validate these tools and to evaluate their applicability in a variety of settings. Crucially, stakeholders from underserved communities globally must be involved in this research, lest it fail to capture the issues that these stakeholders are facing.

The Acquisition of Relative Clauses in Autism: The Role of Executive Functions and Language

PURPOSE

Relative clauses present a well-known processing asymmetry between object-extracted and subject-extracted dependencies across both typical and atypical populations. The present study aimed at exploring the comprehension of object and subject relative clauses as conceptualized by the Relativized Minimality framework in autistic children and in a group of age- and IQ-matched typically-developing children. The study also explored the way performance in relative clauses would be affected by the children's language and executive function skills.

METHOD

Relative clause comprehension was tested through a sentence-picture matching task and language was tested with a receptive vocabulary task. Executive functions were assessed through backward digit recall and a Flanker test.

RESULTS

Object relative clauses were harder to parse for both groups than subject relatives, while number mismatch between the moved object Noun Phrase and the intervening subject Noun Phrase in object relatives boosted both groups' performances. Typically-developing children's performance in object relatives was predicted by both language and executive functions, while autistic children failed to use language and did not systematically draw on their executive functions in object relative clause comprehension.

CONCLUSION

The findings suggest that relative clause processing in autism follows a normal developmental trajectory, and that difficulty with parsing object relative clauses stems from reduced language and executive functions rather than deficits in the children's morphosyntactic skills.

Organizational benefits of neurodiversity: Preliminary findings on autism and the bystander effect

Although the bystander effect is one of the most important findings in the psychological literature, researchers have not explored whether autistic individuals are prone to the bystander effect. The present research examines whether autistic employees are more likely to report issues or concerns in an organization's systems and practices that are inefficient or dysfunctional. By bringing attention to these issues, autistic employees may foster opportunities to improve organizational performance, leading to the development of a more adaptive, high performing, and ethical culture. Thirty-three autistic employees and 34 nonautistic employees completed an online survey to determine whether employees on the autism spectrum (1) are more likely to report they would voice concerns about organizational dysfunctions, (2) are less likely to report they were influenced by the number of other witnesses to the dysfunction, (3) if they do not voice concerns, are more likely to acknowledge the influence of other people on the decision, (4) are less likely to formulate "elaborate rationales" for their decisions to intervene or not, and (5) whether any differences between autistic and nonautistic employees with regards to the first two hypotheses, intervention likelihood and degree of influence, are moderated by individual differences in camouflaging. Results indicate that autistic employees may be less susceptible to the bystander effect than nonautistic employees. As a result, autistic employees may contribute to improvements in organizational performance because they are more likely to identify and report inefficient processes and dysfunctional practices when they witness them. These preliminary findings suggesting potential benefits of neurodiversity in the workplace are promising. However, further research is required.

Qualitative and Quantitative Measures of Joint Attention Development in the First Year of Life: A Scoping Review

Joint attention (JA) is the purposeful coordination of an individual's focus of attention with that of another and begins to develop within the first year of life. Delayed, or atypically developing, JA is an early behavioral sign of many developmental disabilities and so assessing JA in infancy can improve our understanding of trajectories of typical and atypical development. This scoping review identified the most common methods for assessing JA in the first year of life. Methods of JA were divided into qualitative and quantitative categories. Out of an identified 13,898 articles, 106 were selected after a robust search of four databases. Frequent methods used were eye tracking, electroencephalography (EEG), behavioral coding and the Early Social Communication Scale (ECSC). These methods were used to assess JA in typically and atypically developing infants in the first year of life. This study provides a comprehensive review of the past and current state of measurement of JA in the literature, the strengths and limitations of the measures used, and the next steps to consider for researchers interested in investigating JA to strengthen this field going forwards.

Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children

Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.

Effects of Equine-Assisted Activities and Therapies for Individuals with Autism Spectrum Disorder: Systematic Review and Meta-Analysis

Autism spectrum disorder (ASD) has become a critical public health issue that affects more than 78 million people. In many recent studies, the authors have demonstrated that equine-assisted activities and therapies (EAATs) can substantially improve the social and behavioral skills of children with ASD. However, the qualities of the studies differ, and some authors reached opposite conclusions. In this review, we systematically and objectively examined the effectiveness of EAATs for people with ASD, combining both qualitative and quantitative methods. We searched five databases (PubMed, Scopus, ERIC, ProQuest, and MEDLINE) and added relevant references, and we identified 25 articles for data extraction and analysis. According to our results, EAAT programs can substantially improve the social and behavioral functioning and language abilities of children with ASD. However, among the subdomains, the results were inconsistent. According to the meta-analyses, there were considerable improvements in the social cognition, communication, irritability, and hyperactivity domains, but not in the domains of social awareness, mannerisms, motivation, lethargy, stereotypy, or inappropriate speech. Moreover, there was a lack of sufficient comparative data to conclude that EAAT programs lead to substantial improvements in motor and sensory functioning. In addition, among the included studies, we noted the indicator of whether EAAT programs decreased parental stress and improved family functioning, and although there were four articles in which the researchers considered this aspect, we were unable to draw any conclusions because of the insufficient data and conflicting descriptive evidence. However, we need to consider the improvement in parental mental health as a factor in the effectiveness of this complementary intervention. We hope that in future studies, researchers will focus on family functioning and conduct more randomized controlled trials (RCTs) with blinded assessments using different scales and measures.

Play with Me: How Fathers and Mothers Play with Their Preschoolers with Autism

(1) Background: Children can develop cognitive and social skills during play. Most research has focused on mothers, but the paternal features in interaction with children with autism spectrum disorder (ASD) are mainly unexplored. This study aimed to compare fathers’ and mothers’ interactive behaviors with their children with ASD to identify similarities and differences during playful exchanges. (2) Methods: A total of 72 mothers and 72 fathers of paired children with ASD (chronological age: M = 44.61 months; SD = 13.37) took part in this study. Data were collected during 10 min of video-recorded semi-structured interactions with mothers and fathers separately in interaction with their children. (3) Results: Mothers showed more symbolic play (W = 3537; p < 0.001) than fathers, who displayed higher levels of exploratory play (t(139.44) = −2.52; p = 0.013) compared to mothers. However, child cognitive functioning impacts maternal play but not the father’s play characteristics. (4) Conclusions: Highlighting mother−child and father−child features may have important service delivery implications for implementing personalized parental-based interventions based on the strengths and weaknesses of both caregivers in a complementary system.

Dynamic Assessment of AAC Action Verb Symbols for Children with ASD

Objectives

The purpose of this study was to determine whether children with autism spectrum disorder (ASD) make progress in learning to use action verb symbols on augmentative and alternative communication (AAC) applications across different communicative functions (requesting, labeling) and instructional formats (embedded instruction, discrete trial teaching).

Methods

Four preschool-aged children completed graduated prompting dynamic assessment sessions in which they were provided with varying levels of support (e.g., models, gestures) across three instructional conditions: (a) requesting actions embedded in play, (b) labeling actions embedded in play, and (c) labeling actions presented via video during discrete trial teaching. An adapted multielement single-case design was used to compare participants' abilities to use symbols with different levels of support across the instructional conditions and a control.

Results

Differences between instructional and control conditions were established for three participants. Three participants also reduced the levels of support they needed to use symbols in at least two instructional conditions. Although participants initially required lower levels of support (i.e., less restrictive prompts) in the requesting condition compared to labeling conditions, these differences only maintained for one participant. Across participants, differences between labeling conditions were minimal.

Conclusions

Although children with ASD can use verb symbols with low levels of support during DA, additional intervention may be needed to increase independent responding. Individual characteristics may influence success across communicative functions.

RJAfinder: An automated tool for quantification of responding to joint attention behaviors in autism spectrum disorder using eye tracking data

Deficits in responding to joint attention (RJA) are early symptoms of autism spectrum disorder (ASD). Currently, no automated tools exist for identifying and quantifying RJA behaviors. A few eye tracking studies have investigated RJA in ASD children but have produced conflicting results. In addition, little is known about the trajectory of RJA development through developmental age. Here, a new video was designed including 12 clips of an actor pointing to or looking at an object. Eye tracking technology was used to monitor RJA in three groups: 143 ASD children assessed with the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) (4-7 years old), 113 age- and gender-matched typically developing children (TDC), and 43 typically developing adults (TDA) (19-32 years old). RJAfinder was developed in R and MATLAB to quantify RJA events from the eye tracking data. RJA events were compared among the three groups. Spearman correlation coefficients between total number of RJA events in ASD and the Social Responsiveness Scale (SRS) scores were calculated. A logistic regression model was built using the average valid sampling rate and the total number of RJA events as two predictive variables to classify ASD and TDC groups. ASD children displayed statistically significantly less RJA events than the TDC and TDA groups with medium-to-large-sized effects. ASD and TDC children both displayed more RJA events in response to pointing stimuli than to looking stimuli. Our logistic regression model predicted ASD tendency with 0.76 accuracy in the testing set. RJA ability improved more slowly between the ages of 4-7 years old in the ASD group than in the TDC group. In ASD children, RJA ability showed negative correlation with SRS total T-score as well as the scores of five subdomains. Our study provides an automated tool for quantifying RJA and insights for the study of RJA in ASD children, which may help improve ASD screening, subtyping, and behavior interventions.

Examining Phenotypic Differences in Gaze Avoidance Between Autism Spectrum Disorder and Fragile X Syndrome

We examined potential phenotypic differences in eye gaze avoidance exhibited by boys with autism spectrum disorder (ASD) and boys with fragile X syndrome (FXS). In Study 1, the Eye Contact Avoidance Scale (ECAS) was administered to caregivers of boys aged 7-18 years with FXS (n = 148), ASD (n = 168), and mixed developmental disabilities (MDD; n = 128). In Study 2, subsets of boys with FXS (n = 31) and boys with ASD (n = 25) received a brief behavioral treatment probe to improve eye contact. Results showed that boys with FXS obtained significantly higher scores on the ECAS compared to boys with ASD and MDD. Exposure to the brief behavioral treatment probe resulted in significant decreases in scores for boys with FXS, but not for boys with ASD.

Joint attention in infants at high familial risk for autism spectrum disorder and the association with thalamic and hippocampal macrostructure

Autism spectrum disorder (ASD) is a heritable neurodevelopmental disorder. Infants diagnosed with ASD can show impairments in spontaneous gaze-following and will seldom engage in joint attention (JA). The ability to initiate JA (IJA) can be more significantly impaired than the ability to respond to JA (RJA). In a longitudinal study, 101 infants who had a familial risk for ASD were enrolled (62% males). Participants completed magnetic resonance imaging scans at 4 or 6 months of age. Subcortical volumes (thalamus, hippocampus, amygdala, basal ganglia, ventral diencephalon, and cerebellum) were automatically extracted. Early gaze and JA behaviors were assessed with standardized measures. The majority of infants were IJA nonresponders (n = 93, 92%), and over half were RJA nonresponders (n = 50, 52%). In the nonresponder groups, models testing the association of subcortical volumes with later ASD diagnosis accounted for age, sex, and cerebral volumes. In the nonresponder IJA group, using regression method, the left hippocampus (B = −0.009, aOR = 0.991, P = 0.025), the right thalamus (B = −0.016, aOR = 0.984, P = 0.026), as well as the left thalamus (B = 0.015, aOR = 1.015, P = 0.019), predicted later ASD diagnosis. Alterations in thalamic and hippocampal macrostructure in at-risk infants who do not engage in IJA may reflect an enhanced vulnerability and may be the key predictors of later ASD development.

Natura Non Facit Saltus: The Adaptive Significance of Arginine Vasopressin in Human Affect, Cognition, and Behavior

Hormones coordinate internal bodily systems with cognition, affect, and behavior, and thereby influence aspects of social interactions including cooperation, competition, isolation, and loneliness. The adaptive significance and contextuality of oxytocin (OXT) and testosterone (T) have been well-studied, but a unified theory and evolutionary framework for understanding the adaptive functions of arginine vasopressin (AVP) remain undeveloped. We propose and evaluate the hypothesis that AVP mediates adaptive variation in the presence and strength of social and sociosexual salience, attention and behavior specifically in situations that involve combinations of cooperation with conflict or competition. This hypothesis can help to explain the ancestral, original functions of AVP-like peptides, and their continuity with the current roles of AVP, for humans, in male-male competition, male-male reciprocity, male-to-female pair bonding, female-female interactions, social integration, and social attention and anxiety. In this context, social isolation and loneliness may be mediated by reduced abilities or interests in navigation of social opportunities and situations, due in part to low AVP levels or reactivity, and in part to reductions in levels of OXT-mediated social reward.

Neural responses to affective speech, including motherese, map onto clinical and social eye tracking profiles in toddlers with ASD

Affective speech, including motherese, captures an infant's attention and enhances social, language and emotional development. Decreased behavioural response to affective speech and reduced caregiver-child interactions are early signs of autism in infants. To understand this, we measured neural responses to mild affect speech, moderate affect speech and motherese using natural sleep functional magnetic resonance imaging and behavioural preference for motherese using eye tracking in typically developing toddlers and those with autism. By combining diverse neural-clinical data using similarity network fusion, we discovered four distinct clusters of toddlers. The autism cluster with the weakest superior temporal responses to affective speech and very poor social and language abilities had reduced behavioural preference for motherese, while the typically developing cluster with the strongest superior temporal response to affective speech showed the opposite effect. We conclude that significantly reduced behavioural preference for motherese in autism is related to impaired development of temporal cortical systems that normally respond to parental affective speech.

Addressing joint action challenges in HRI: Insights from psychology and philosophy

The vast expansion of research in human-robot interactions (HRI) these last decades has been accompanied by the design of increasingly skilled robots for engaging in joint actions with humans. However, these advances have encountered significant challenges to ensure fluent interactions and sustain human motivation through the different steps of joint action. After exploring current literature on joint action in HRI, leading to a more precise definition of these challenges, the present article proposes some perspectives borrowed from psychology and philosophy showing the key role of communication in human interactions. From mutual recognition between individuals to the expression of commitment and social expectations, we argue that communicative cues can facilitate coordination, prediction, and motivation in the context of joint action. The description of several notions thus suggests that some communicative capacities can be implemented in the context of joint action for HRI, leading to an integrated perspective of robotic communication.

Shorter average look durations to dynamic social stimuli are associated with higher levels of autism symptoms in young autistic children

LAY ABSTRACT

Many studies of autism look at the differences in how autistic research participants look at certain types of images. These studies often focus on where research participants are looking within the image, but that does not tell us everything about how much they are paying attention. It could be useful to know more about how well autistic research participants can focus on an image with people in it, because those who can look at images of people for longer duration without stopping may be able to easily learn other skills that help them to interact with people. We measured how long autistic research participants watched the video without breaking their attention. The video sometimes had a person speaking, and at other times had toys moving and making sounds. We measured the typical amount of time autistic research participants could look at the video before they looked away. We found that research participants with more severe autism tended to look at the video for shorter amounts of time. The ability to focus without stopping may be related to social skills in autistic people.

A Biological Inspired Cognitive Framework for Memory-Based Multi-Sensory Joint Attention in Human-Robot Interactive Tasks

One of the fundamental prerequisites for effective collaborations between interactive partners is the mutual sharing of the attentional focus on the same perceptual events. This is referred to as joint attention. In psychological, cognitive, and social sciences, its defining elements have been widely pinpointed. Also the field of human-robot interaction has extensively exploited joint attention which has been identified as a fundamental prerequisite for proficient human-robot collaborations. However, joint attention between robots and human partners is often encoded in prefixed robot behaviours that do not fully address the dynamics of interactive scenarios. We provide autonomous attentional behaviour for robotics based on a multi-sensory perception that robustly relocates the focus of attention on the same targets the human partner attends. Further, we investigated how such joint attention between a human and a robot partner improved with a new biologically-inspired memory-based attention component. We assessed the model with the humanoid robot iCub involved in performing a joint task with a human partner in a real-world unstructured scenario. The model showed a robust performance on capturing the stimulation, making a localisation decision in the right time frame, and then executing the right action. We then compared the attention performance of the robot against the human performance when stimulated from the same source across different modalities (audio-visual and audio only). The comparison showed that the model is behaving with temporal dynamics compatible with those of humans. This provides an effective solution for memory-based joint attention in real-world unstructured environments. Further, we analyzed the localisation performances (reaction time and accuracy), the results showed that the robot performed better in an audio-visual condition than an audio only condition. The performance of the robot in the audio-visual condition was relatively comparable with the behaviour of the human participants whereas it was less efficient in audio-only localisation. After a detailed analysis of the internal components of the architecture, we conclude that the differences in performance are due to egonoise which significantly affects the audio-only localisation performance.

Gaze facilitates responsivity during hand coordinated joint attention

The coordination of attention between individuals is a fundamental part of everyday human social interaction. Previous work has focused on the role of gaze information for guiding responses during joint attention episodes. However, in many contexts, hand gestures such as pointing provide another valuable source of information about the locus of attention. The current study developed a novel virtual reality paradigm to investigate the extent to which initiator gaze information is used by responders to guide joint attention responses in the presence of more visually salient and spatially precise pointing gestures. Dyads were instructed to use pointing gestures to complete a cooperative joint attention task in a virtual environment. Eye and hand tracking enabled real-time interaction and provided objective measures of gaze and pointing behaviours. Initiators displayed gaze behaviours that were spatially congruent with the subsequent pointing gestures. Responders overtly attended to the initiator’s gaze during the joint attention episode. However, both these initiator and responder behaviours were highly variable across individuals. Critically, when responders did overtly attend to their partner’s face, their saccadic reaction times were faster when the initiator’s gaze was also congruent with the pointing gesture, and thus predictive of the joint attention location. These results indicate that humans attend to and process gaze information to facilitate joint attention responsivity, even in contexts where gaze information is implicit to the task and joint attention is explicitly cued by more spatially precise and visually salient pointing gestures.

Rhythm and timing as vulnerabilities in neurodevelopmental disorders

Millions of children are impacted by neurodevelopmental disorders (NDDs), which unfold early in life, have varying genetic etiologies and can involve a variety of specific or generalized impairments in social, cognitive and motor functioning requiring potentially lifelong specialized supports. While specific disorders vary in their domain of primary deficit (e.g. autism spectrum disorder (social), attention-deficit/hyperactivity disorder (attention), developmental coordination disorder (motor) and developmental language disorder (language)), comorbidities between NDDs are common. Intriguingly, many NDDs are associated with difficulties in skills related to rhythm, timing and synchrony though specific profiles of rhythm/timing impairments vary across disorders. Impairments in rhythm/timing may instantiate vulnerabilities for a variety of NDDs and may contribute to both the primary symptoms of each disorder as well as the high levels of comorbidities across disorders. Drawing upon genetic, neural, behavioural and interpersonal constructs across disorders, we consider how disrupted rhythm and timing skills early in life may contribute to atypical developmental cascades that involve overlapping symptoms within the context of a disorder's primary deficits. Consideration of the developmental context, as well as common and unique aspects of the phenotypes of different NDDs, will inform experimental designs to test this hypothesis including via potential mechanistic intervention approaches. This article is part of the theme issue 'Synchrony and rhythm interaction: from the brain to behavioural ecology'.

Feline communication strategies when presented with an unsolvable task: the attentional state of the person matters

Research on social cognitive ability in domestic cats is limited. The current study investigated social referencing in cats when exposed to first, a solvable, and then, an unsolvable scenario (i.e., reachable and unreachable treats) in the presence of either an attentive or an inattentive caregiver. Cats expressed more gaze alternation (P = 0.013), but less interaction with the caregiver (P = 0.048) and approached the treat container less frequently (P = 0.017) during the unsolvable test, compared to the solvable test. When in the presence of an attentive caregiver, cats initiated first gaze at the caregiver faster (P = 0.001); gazed at the caregiver for longer (P = 0.034); and approached the treat more frequently (P = 0.040), compared to when the caregiver was inattentive. Significant interaction was observed between test and caregiver's attentional state on the expression of sequential behavior, a type of showing behavior. Cats exhibited this behavior marginally more with attentive caregivers, compared to inattentive caregivers, but only during the unsolvable test. There was a decrease in sequential behavior during the unsolvable test, compared to solvable test, but this was only seen with inattentive caregivers (P = 0.018). Our results suggest that gaze alternation is a behavior reliably indicating social referencing in cats and that cats' social communication with humans is affected by the person's availability for visual interaction.

Abnormal visual attention to simple social stimuli in 4-month-old infants at high risk for Autism

Despite an increasing interest in detecting early signs of Autism Spectrum Disorders (ASD), the pathogenesis of the social impairments characterizing ASD is still largely unknown. Atypical visual attention to social stimuli is a potential early marker of the social and communicative deficits of ASD. Some authors hypothesized that such impairments are present from birth, leading to a decline in the subsequent typical functioning of the learning-mechanisms. Others suggested that these early deficits emerge during the transition from subcortically to cortically mediated mechanisms, happening around 2–3 months of age. The present study aimed to provide additional evidence on the origin of the early visual attention disturbance that seems to characterize infants at high risk (HR) for ASD. Four visual preference tasks were used to investigate social attention in 4-month-old HR, compared to low-risk (LR) infants of the same age. Visual attention differences between HR and LR infants emerged only for stimuli depicting a direct eye-gaze, compared to an adverted eye-gaze. Specifically, HR infants showed a significant visual preference for the direct eye-gaze stimulus compared to LR infants, which may indicate a delayed development of the visual preferences normally observed at birth in typically developing infants. No other differences were found between groups. Results are discussed in the light of the hypotheses on the origins of early social visual attention impairments in infants at risk for ASD.

The Development of an Escape Room-Based Serious Game to Trigger Social Interaction and Communication Between High-Functioning Children With Autism and Their Peers: Iterative Design Approach

BACKGROUND

Children with autism spectrum disorder (ASD) have social deficits that affect social interactions, communication, and relationships with peers. Many existing interventions focus mainly on improving social skills in clinical settings. In addition to the direct instruction-based programs, activity-based programs could be of added value, especially to bridge the relational gap between children with ASD and their peers.

OBJECTIVE

The aim of this study is to describe an iterative design process for the development of an escape room-based serious game as a boundary object. The purpose of the serious game is to facilitate direct communication between high-functioning children with ASD and their peers, for the development of social skills on the one hand and strengthening relationships with peers through a fun and engaging activity on the other hand.

METHODS

This study is structured around the Design Research Framework to develop an escape room through an iterative-incremental process. With a pool of 37 children, including 23 children diagnosed with ASD (5 girls) and 14 children (7 girls) attending special primary education for other additional needs, 4 testing sessions around different prototypes were conducted. The beta prototype was subsequently reviewed by experts (n=12). During the design research process, we examined in small steps whether the developed prototypes are feasible and whether they have the potential to achieve the formulated goals of different stakeholders.

RESULTS

By testing various prototypes, several insights were found and used to improve the design. Insights were gained in finding a fitting and appealing theme for the children, composing the content, and addressing different constraints in applying the goals from the children's and therapeutic perspectives. Eventually, a multiplayer virtual escape room, AScapeD, was developed. Three children can play the serious game in the same room on tablets. The first test shows that the game enacts equal cooperation and communication among the children.

CONCLUSIONS

This paper presents an iterative design process for AScapeD. AScapeD enacts equal cooperation and communication in a playful way between children with ASD and their peers. The conceptual structure of an escape room contributes to the natural emergence of communication and cooperation. The iterative design process has been beneficial for finding a constructive game structure to address all formulated goals, and it contributed to the design of a serious game as a boundary object that mediates the various objectives of different stakeholders. We present 5 lessons learned from the design process. The developed prototype is feasible and has the potential to achieve the goals of the serious game.

The effect of non-communicative eye movements on joint attention

Eye movements provide important signals for joint attention. However, those eye movements that indicate bids for joint attention often occur among non-communicative eye movements. This study investigated the influence of these non-communicative eye movements on subsequent joint attention responsivity. Participants played an interactive game with an avatar which required both players to search for a visual target on a screen. The player who discovered the target used their eyes to initiate joint attention. We compared participants' saccadic reaction times (SRTs) to the avatar's joint attention bids when they were preceded by non-communicative eye movements that predicted the location of the target (Predictive Search), did not predict the location of the target (Random Search), and when there were no non-communicative eye gaze movements prior to joint attention (No Search). We also included a control condition in which participants completed the same task, but responded to a dynamic arrow stimulus instead of the avatar's eye movements. For both eye and arrow conditions, participants had slower SRTs in Random Search trials than No Search and Predictive Search trials. However, these effects were smaller for eyes than for arrows. These data suggest that joint attention responsivity for eyes is relatively stable to the presence and predictability of spatial information conveyed by non-communicative gaze. Contrastingly, random sequences of dynamic arrows had a much more disruptive impact on subsequent responsivity compared with predictive arrow sequences. This may reflect specialised social mechanisms and expertise for selectively responding to communicative eye gaze cues during dynamic interactions, which is likely facilitated by the integration of ostensive eye contact cues.

Effect of shared information and owner behavior on showing in dogs (Canis familiaris)

Dogs’ production of referential communicative signals, i.e., showing, has gained increasing scientific interest over the last years. In this paper, we investigate whether shared information about the present and the past affects success and form of dog–human interactions. Second, in the context of showing, owners have always been treated as passive receivers of the dog’s signals. Therefore, we examined whether the owner’s behavior can influence the success and form of their dog’s showing behavior. To address these questions, we employed a hidden-object task with knowledgeable dogs and naïve owners. Shared information about the present was varied via the spatial set-up, i.e., position of hiding places, within dog–owner pairs, with two conditions requiring either high or low precision in indicating the target location. Order of conditions varied between pairs, representing differences in shared knowledge about the past (communication history). Results do not support an effect of communication history on either success or showing effort. In contrast, the spatial set-up was found to affect success and choice of showing strategies. However, dogs did not adjust their showing effort according to different spatial set-ups. Our results suggest that the latter could be due to the owner’s influence. Owner behavior generally increased the effort of their dog’s showing behavior which was stronger in the set-up requiring low showing precision. Moreover, our results suggest that owners could influence their dog’s showing accuracy (and thereby success) which, however, tended to be obstructive.

Profiles of Early Actions and Gestures in Infants With an Older Sibling With Autism Spectrum Disorder

Purpose Infants with autism spectrum disorder (ASD) produce fewer play actions and gestures than neurotypical infants (e.g., Mastrogiuseppe et al., 2015; Veness et al., 2012; Zwaigenbaum et al., 2005). The purpose of this study was to investigate whether different "types" of actions and gestures are more or less likely to develop atypically in ASD. Method We examined eight types of actions and gestures longitudinally from ages 8 to 14 months in 80 infants with a heightened risk for developing ASD by virtue of having an affected older sibling (high risk [HR]; e.g., Ozonoff et al., 2011) and 25 infants with no such familial risk (low risk). Data were collected using the MacArthur-Bates Communicative Development Inventories (Fenson et al., 1994, 1993). Results HR infants later diagnosed with ASD showed less growth across nearly all types of actions and gestures compared to the low-risk comparison group. Importantly, these HR infants who were later diagnosed with ASD also exhibited reduced growth in frequent deictic gestures and in actions that involve object manipulation relative to HR infants with non-ASD language delay. Conclusions During infancy, it is challenging for clinicians to distinguish ASD from other early communicative delays (e.g., Camarata, 2014). Our results indicate that deictic gestures, as well as actions and gestures involving object manipulation, may be useful targets of surveillance strategies for HR infants and could support early detection efforts for ASD.

Heritability of reflexive social attention triggered by eye gaze and walking direction: common and unique genetic underpinnings

BACKGROUND

Social attention ability is crucial for human adaptive social behaviors and interpersonal communications, and the malfunction of which has been implicated in autism spectrum disorder (ASD), a highly genetic neurodevelopmental disorder marked by striking social deficits.

METHODS

Using a classical twin design, the current study investigated the genetic contribution to individual variation in social and non-social attention abilities, and further probed their potential genetic linkage. Moreover, individual autistic traits were further measured in an independent group of non-twin participants to examine the hypothetical link between the core social attention ability and ASD.

RESULTS

We found reliable genetic influences on the social attentional effects induced by two distinct cues (eye gaze and walking direction), with 91% of their covariance accounted for by common genetic effects. However, no evidence of heritability or shared genetic effects was observed for the attentional effect directed by a non-social cue (i.e. arrow direction) and its correlation with the social attention ability. Remarkably, one's autistic traits could well predict his/her heritable core social attention ability extracted from the conventional social attentional effect.

CONCLUSIONS

These findings together suggest that human social attention ability is supported by unique genetic mechanisms that can be shared across different social, but not non-social, processing. Moreover, they also encourage the identification of 'social attention genes' and highlight the critical role of the core human social attention ability in seeking the endophenotypes of social cognitive disorders including ASD.

Attenuated relationship between salivary oxytocin levels and attention to social information in adolescents and adults with autism spectrum disorder: a comparative study

BACKGROUND

Previous research studies have assessed the relationship between attention to social information and peripheral (e.g., plasma and salivary) oxytocin (OT) levels in typically developing (TD) children and children with autism spectrum disorder (ASD). A relationship between them was observed in TD children, but not in children with ASD. However, this relationship remains unexamined in other age groups. To clarify whether this lack of association is maintained throughout development in individuals with ASD, we aimed to assess the relationship between salivary OT levels and attention to social information in adolescents and adults with and without ASD.

METHODS

We recruited male adolescents and adults with ASD (n = 17) and TD participants (n = 24). Using the all-in-one eye-tracking system Gazefinder, we measured the percentage fixation time allocated to social information. We also measured the salivary OT levels and Autism Spectrum Quotient (AQ) of participants. Subsequently, we confirmed group differences and conducted a correlation analysis to investigate the relationships between these three measures.

RESULTS

Salivary OT levels did not show any significant difference between the ASD and TD groups and were negatively correlated with the AQ in the whole-group analysis, but not in within-group analysis. Individuals with ASD had significantly lower percentage fixation times than did TD individuals for eye regions in human faces with/without mouth motion, for upright biological motion, and for people regions in the people and geometry movies. The percentage of fixation for geometric shapes in the people and geometry movies was significantly higher in the ASD than in the TD group. In the TD group, salivary OT levels were positively correlated with percentage fixation times for upright biological motion and people and negatively correlated with inverted biological motion and geometry. However, no significant correlations were found in the ASD group.

CONCLUSIONS

Our exploratory results suggest that salivary OT levels in adolescents and adults with ASD are less indicative of attention to social stimuli than they are in TD adolescents and adults. It is suggested that their association is slightly weaker in adolescents and adults with ASD and that this attenuated relationship appears to be maintained throughout development.

Two-Person Approaches to Studying Social Interaction in Psychiatry: Uses and Clinical Relevance

Social interaction is ubiquitous in human society. The two-person approach-a new, powerful tool to study information exchange and social behaviors-aims to characterize the behavioral dynamics and neural mechanisms of real-time social interactions. In this review, we discuss the benefits of two-person approaches compared to those for conventional, single-person approaches. We describe measures and paradigms that model social interaction in three dimensions (3-D), including eye-to-eye, body-to-body, and brain-to-brain relationships. We then discuss how these two-person measures and paradigms are used in psychiatric conditions (e.g., autism, mood disorders, schizophrenia, borderline personality disorder, and psychotherapy). Furthermore, the advantages of a two-person approach (e.g., dual brain stimulation, multi-person neurofeedback) in clinical interventions are described. Finally, we discuss the methodological and translational challenges surrounding the application of two-person approaches in psychiatry, as well as prospects for future two-/multi-person studies. We conclude that two-person approaches serve as useful additions to the range of behavioral and neuroscientific methods available to assess social interaction in psychiatric settings, for both diagnostic techniques and complementary interventions.

Initiation and response of joint attention bids in autism spectrum disorder children depend on the visibility of the target

BACKGROUND AND AIMS

Response to joint attention (RJA) and initiation of joint attention (IJA) are impaired in pre-schoolers with autism spectrum disorder (ASD). Children's response to joint attention may depend on the presence of the target in the child's field of vision or on the type of deictic index (head and eye orientation, pointing and verbalisations) used by the adult to initiate joint attention.

METHODS

This study deals with 50 ASD children aged from 2 years 8 months to 11 years 7 months, with a communicative level comparable to children under 31 months of age, according to the French version of the Early Social Communication Scales (ECSP, by its French acronym). We compared the aforementioned ASD children with 50 typically developing (TD) children, aged 9 to 30 months who had no communication disorders according to the ECSP. During the ECSP test, we analysed joint attention behaviours on three posters present or absent from the children's visual field.

RESULTS

We did not observe any difference in the number of IJAs between groups, but ASD children were less responsive than TD children were. Our results showed a developmental progression in the responses of children with ASD if several deictic cues were used by an adult simultaneously (looking and pointing, or looking and verbalising to indicate a target), whether the referent was present or absent from the child's visual field. In addition, we observed developmental progression when the referent was behind the child and the adult only used their gaze to refer to it.

CONCLUSION

Thus, we argue that the type of cues used affects ASD children's response behaviours during joint attention towards a referent that may be present or absent from their visual field.Implications: Regarding the social and the sensory difficulties of children with ASD, many therapeutic approaches focus their intervention methods on non-verbal communication skills and joint attention. This fundamental research makes it possible to identify the most appropriate type of deictic index for children with ASD with developmental delay, depending on the presence or absence of the referent in the child's visual field.

Promoting social attention in 3-year-olds with ASD through gaze-contingent eye tracking

Young children with autism spectrum disorder (ASD) look less toward faces compared to their non-ASD peers, limiting access to social learning. Currently, no technologies directly target these core social attention difficulties. This study examines the feasibility of automated gaze modification training for improving attention to faces in 3-year-olds with ASD. Using free-viewing data from typically developing (TD) controls (n = 41), we implemented gaze-contingent adaptive cueing to redirect children with ASD toward normative looking patterns during viewing of videos of an actress. Children with ASD were randomly assigned to either (a) an adaptive Cue condition (Cue, n = 16) or (b) a No-Cue condition (No-Cue, n = 19). Performance was examined at baseline, during training, and post-training, and contrasted with TD controls (n = 23). Proportion of time looking at the screen (%Screen) and at actresses' faces (%Face) was analyzed. At Pre-Training, Cue and No-Cue groups did not differ in %Face (P > 0.1). At Post-Training, the Cue group had higher %Face than the No-Cue group (P = 0.015). In the No-Cue group %Face decreased Pre- to Post-Training; no decline was observed in the Cue group. These results suggest gaze-contingent training effectively mitigated decreases of attention toward the face of onscreen social characters in ASD. Additionally, larger training effects were observed in children with lower nonverbal ability, suggesting a gaze-contingent approach may be particularly relevant for children with greater cognitive impairment. This work represents development toward new social attention therapeutic systems that could augment current behavioral interventions. Autism Res 2020, 13: 61-73. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this study, we leverage a new technology that combines eye tracking and automatic computer programs to help very young children with ASD look at social information in a more prototypical way. In a randomized controlled trial, we show that the use of this technology prevents the diminishing attention toward social information normally seen in children with ASD over the course of a single experimental session. This work represents development toward new social attention therapeutic systems that could augment current behavioral interventions.

Spontaneous helping behavior of autistic and non-autistic (Pre-)adolescents: A matter of motivation?

Young autistic people have a range of social difficulties, but it is not yet clear how these difficulties can be explained. In addition, emerging research is suggesting that autistic girls may differ from boys in terms of their social behaviors, but yet unknown is if they differ in terms of their pro-social behavior, such as helping. The present study investigated spontaneous helping behavior using an in vivo paradigm and related this to participants' levels of social motivation (based on parent reports). Participants were 233 autistic and non-autistic (pre-)adolescents (M = 12.46 years, SD = 15.54 months). Our results demonstrated that autistic girls and boys have lower levels of social motivation compared to their non-autistic peers, but social motivation was unrelated to helping behavior in both groups. Furthermore, when the experimenter needed help, the autistic boys and girls looked and smiled to the same extent as their peers of the same gender, but they actually helped significantly less than their non-autistic peers. However, most autistic youngsters did help, highlighting the great individual differences in autistic individuals. We discuss the possibility that lower levels of helping behavior are due to difficulty initiating action in a social context, rather than lower social motivation. Autism Res 2019, 12: 1796-1804. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: This study examined the helping behavior of autistic boys and girls (aged 9-16). Many autistic young people did help, but compared to non-autistic individuals, autistic people did not help as much. This study also showed that when people did/did not help, it was not related to their interest in social relationships. It is important to teach young autistic people when and how to help others, to support them making friends.

The mediating role of joint attention in the relationship between motor skills and receptive and expressive language in siblings at risk for autism spectrum disorder

Language problems are highly prevalent in younger siblings of children with autism spectrum disorder (HR-sibs), yet little is known about early predictors. There is growing evidence that motor and language development are linked and this connection might be mediated by joint attention. Developmental changes in motor abilities change how children interact with objects and people (e.g., by showing), which may influence language development. This association has however not yet been studied in HR-sibs. The interrelationship between motor, joint attention and language skills was explored in younger siblings of typically developing children (LR-sibs, N = 31) and HR-sibs (N = 32). In both groups, motor skills (composite of fine and gross motor skills) at 10 months influenced receptive and expressive language at 36 months directly and indirectly through joint attention at 14 months. Group status moderated this direct and indirect effect with mainly significant effects in HR-sibs. This indicates that lower motor skills can have cascading effects on joint attention and language in HR-sibs. Consequently, assessment of early motor skills in HR-sibs might hold promise for early identification of motor difficulties but can also be indicative of language difficulties later in life, especially when difficulties with joint attention are also present.

Socio-Emotional Concern Dynamics in a Model of Real-Time Dyadic Interaction: Parent-Child Play in Autism

We used a validated agent-based model-Socio-Emotional CONcern DynamicS (SECONDS)-to model real-time playful interaction between a child diagnosed with Autism Spectrum Disorders (ASD) and its parent. SECONDS provides a real-time (second-by-second) virtual environment that could be used for clinical trials and testing process-oriented explanations of ASD symptomatology. We conducted numerical experiments with SECONDS (1) for internal model validation comparing two parental behavioral strategies for stimulating social development in ASD (play-centered vs. initiative-centered) and (2) for empirical case-based model validation. We compared 2,000 simulated play sessions of two particular dyads with (second-by-second) time-series observations within 29 play sessions of a real parent-child dyad with ASD on six variables related to maintaining and initiating play. Overall, both simulated dyads provided a better fit to the observed dyad than reference null distributions. Given the idiosyncratic behaviors expected in ASD, the observed correspondence is non-trivial. Our results demonstrate the applicability of SECONDS to parent-child dyads in ASD. In the future, SECONDS could help design interventions for parental care in ASD.

An Initial Psychometric Evaluation of the Joint Attention Protocol

The goal of this paper is to examine the psychometric properties of a live-coded behavioral measure of joint attention, the Attention-Following and Initiating Joint Attention Protocol (JA Protocol), in order to assist researchers and clinicians in identifying when this measure may meet their joint attention assessment needs. Data from 260 children with autism spectrum disorder, developmental delay, or typical development between the ages of 2 and 12 years were used to evaluate this measure using quality standards for measurement. Overall, the JA Protocol demonstrated good psychometric properties. Recommendations and limitations for use of this measure based on psychometric analysis results are reported.

Perceived Gaze Direction Differentially Affects Discrimination of Facial Emotion, Attention, and Gender - An ERP Study

The perception of eye-gaze is thought to be a key component of our everyday social interactions. While the neural correlates of direct and averted gaze processing have been investigated, there is little consensus about how these gaze directions may be processed differently as a function of the task being performed. In a within-subject design, we examined how perception of direct and averted gaze affected performance on tasks requiring participants to use directly available facial cues to infer the individuals' emotional state (emotion discrimination), direction of attention (attention discrimination) and gender (gender discrimination). Neural activity was recorded throughout the three tasks using EEG, and ERPs time-locked to face onset were analyzed. Participants were most accurate at discriminating emotions with direct gaze faces, but most accurate at discriminating attention with averted gaze faces, while gender discrimination was not affected by gaze direction. At the neural level, direct and averted gaze elicited different patterns of activation depending on the task over frontal sites, from approximately 220-290 ms. More positive amplitudes were seen for direct than averted gaze in the emotion discrimination task. In contrast, more positive amplitudes were seen for averted gaze than for direct gaze in the gender discrimination task. These findings are among the first direct evidence that perceived gaze direction modulates neural activity differently depending on task demands, and that at the behavioral level, specific gaze directions functionally overlap with emotion and attention discrimination, precursors to more elaborated theory of mind processes.

A new look at joint attention and common knowledge

Everyone agrees that joint attention is a key feature of human social cognition. Yet, despite over 40 years of work and hundreds of publications on this topic, there is still surprisingly little agreement on what exactly joint attention is, and how the jointness in it is achieved. Part of the problem, we propose, is that joint attention is not a single process, but rather it includes a cluster of different cognitive skills and processes, and different researchers focus on different aspects of it. A similar problem applies to common knowledge. Here we present a new approach: We outline a typology of social attention levels which are currently all referred to in the literature as joint attention (from monitoring to common, mutual, and shared attention), along with corresponding levels of common knowledge. We consider cognitive, behavioral, and phenomenological aspects of the different levels as well as their different functions, and a key distinction we make in all of this is second-personal vs. third-personal relations. While we focus mainly on joint attention and common knowledge, we also briefly discuss how these levels might apply to other 'joint' mental states such as joint goals.

Responding to joint attention bids in schizophrenia: An interactive eye-tracking study

This study investigated social cognition in schizophrenia using a virtual reality paradigm to capture the dynamic processes of evaluating and responding to eye gaze as an intentional communicative cue. A total of 21 patients with schizophrenia and 21 age-, gender-, and IQ-matched healthy controls completed an interactive computer game with an on-screen avatar that participants believed was controlled by an off-screen partner. On social trials, participants were required to achieve joint attention by correctly interpreting and responding to gaze cues. Participants also completed non-social trials in which they responded to an arrow cue within the same task context. While patients and controls took equivalent time to process communicative intent from gaze shifts, patients made significantly more errors than controls when responding to the directional information conveyed by gaze, but not arrow, cues. Despite no differences in response times to gaze cues between groups, patients were significantly slower than controls when responding to arrow cues. This is the opposite pattern of results previously observed in autistic adults using the same task and suggests that, despite general impairments in attention orienting or oculomotor control, patients with schizophrenia demonstrate a facilitation effect when responding to communicative gaze cues. Findings indicate a hyper-responsivity to gaze cues of communicative intent in schizophrenia. The possible effects of self-referential biases when evaluating gaze direction are discussed, as are clinical implications.

The categorisation of resistance: interpreting failure to follow a proposed line of action in the diagnosis of autism amongst young adults

Many characteristics typical of autism, a neurodevelopmental condition characterised by socio-communicative impairments, are most evident during social interaction. Accordingly, procedures such as the Autism Diagnosis Observation Schedule (ADOS) are interactive and intended to elicit interactional impairments: a diagnosis of autism is given if interactional difficulties are attributed as a persistent quality of the individual undergoing diagnosis. This task is difficult, first, because behaviours can be interpreted in various ways and, second, because conversation breakdown may indicate a disengagement with, or resistance to, a line of conversation. Drawing upon conversation analysis, we examine seven ADOS diagnosis sessions and ask how diagnosticians distinguish between interactional resistance as, on the one hand, a diagnostic indicator and, on the other, as a reasonable choice from a range of possible responses. We find evidence of various forms of resistance during ADOS sessions, but it is a resistance to a line of conversational action that is often determined to be indicative of autism. However, and as we show, this attribution of resistance can be ambiguous. We conclude by arguing for reflexive practice during any diagnosis where talk is the problem, and for a commitment to acknowledge the potential impact of diagnostic procedures themselves upon results.