Atypical gaze following in autism: a comparison of three potential mechanisms

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.

Nonlinear features of gaze behavior during joint attention in children with autism spectrum disorder

Since children with autism spectrum disorder (ASD) might exhibit a variety of aberrant response to joint attention (RJA) behaviors, there is growing interest in identifying robust, reliable and valid eye-tracking metrics for determining differences in RJA behaviors between typically developing (TD) children and those with ASD. Previous eye-tracking studies have not been deeply investigated nonlinear features of gaze time-series during RJA. As a main motivation, this study aimed to extract three nonlinear features (i.e., complexity, long-range correlation, and local instability) of gaze time-series during RJA in children with ASD, which can be measured by fractal dimension (FD), Hurst exponent (H), and largest Lyapunov exponent (LLE), respectively. To illustrate our idea, this study adopted a publicly accessible database, including eye-tracking data collected during RJA from 19 children with ASD (7.74 ± 2.73) and 30 TD children (8.02 ± 2.89), and conducted a battery of nonparametric analysis of covariance (ANCOVA), where gender was used as covariable. Findings showed that gaze time-series during RJA in autistic children may generally have greater FD but lower H than that in TD controls. This implies that children with ASD possess more complex and unpredictable gaze behaviors during RJA than TD children. Furthermore, nonlinear metrics outperformed traditional eye-tracking metrics in obtaining higher identification performance with an accuracy of 82% and an AUC value of 0.81, distinguishing the differences between successful and failed RJA trails, and predicting the severity of ASD symptoms. Findings might bring some new insights into the understanding of the impairments in RJA behaviors for children with ASD.

Eye-tracking correlates of response to joint attention in preschool children with autism spectrum disorder

BACKGROUND

A number of differences in joint attention behaviour between children with autism spectrum disorder (ASD) and typically developing (TD) individuals have previously been documented.

METHOD

We use eye-tracking technology to assess response to joint attention (RJA) behaviours in 77 children aged 31 to 73 months. We conducted a repeated-measures analysis of variance to identify differences between groups. In addition, we analysed correlations between eye-tracking and clinical measures using Spearman's correlation.

RESULTS

The children diagnosed with ASD were less likely to follow gaze compared to TD children. Children with ASD were less accurate at gaze following when only eye gaze information was available, compared to when eye gaze with head movement was observed. Higher accuracy gaze-following profiles were associated with better early cognition and more adaptive behaviours in children with ASD. Less accurate gaze-following profiles were associated with more severe ASD symptomatology.

CONCLUSION

There are differences in RJA behaviours between ASD and TD preschool children. Several eye-tracking measures of RJA behaviours in preschool children were found to be associated with clinical measures for ASD diagnosis. This study also highlights the construct validity of using eye-tracking measures as potential biomarkers in the assessment and diagnosis of ASD in preschool children.

Social Attention: Developmental Foundations and Relevance for Autism Spectrum Disorder

The use of the term "social attention" (SA) in the cognitive neuroscience and developmental psychopathology literature has increased exponentially in recent years, in part motivated by the aim to understand the early development of autism spectrum disorder (ASD). Unfortunately, theoretical discussions around the term have lagged behind its various uses. Here, we evaluate SA through a review of key candidate SA phenotypes emerging early in life, from newborn gaze cueing and preference for face-like configurations to later emerging skills such as joint attention. We argue that most of the considered SA phenotypes are unlikely to represent unique socioattentional processes and instead have to be understood in the broader context of bottom-up and emerging top-down (domain-general) attention. Some types of SA behaviors (e.g., initiation of joint attention) are linked to the early development of ASD, but this may reflect differences in social motivation rather than attention per se. Several SA candidates are not linked to ASD early in life, including the ones that may represent uniquely socioattentional processes (e.g., orienting to faces, predicting others' manual action goals). Although SA may be a useful superordinate category under which one can organize certain research questions, the widespread use of the term without proper definition is problematic. Characterizing gaze patterns and visual attention in social contexts in infants at elevated likelihood of ASD may facilitate early detection, but conceptual clarity regarding the underlying processes at play is needed to sharpen research questions and identify potential targets for early intervention.

Joint Attention and Its Relationship with Autism Risk Markers at 18 Months of Age

(1) Joint attention is the ability to coordinate attention to share a point of reference with another person. It has an early onset and is a clear indicator of understanding the representations of others, and it is essential in the development of symbolic thought and the acquisition of language. Deficiencies in this prelinguistic early communication skill are strong markers of the risk of autism spectrum disorder (ASD); (2) this longitudinal study aimed to evaluate joint attention skills in a group of 32 infants at two developmental moments (8 and 12 months) in order to explore whether their performance on this skill was related to the presence of early signs of ASD at 18 months. Logistic multiple regressions were carried out for the data analysis; (3) results of the analysis showed that the variables of initiating joint attention at 8 months and responding to joint attention at 12 months were linked to the risk of ASD at 18 months of age; (4) in conclusion, early joint attention skills had a pivotal role in defining early manifestations of ASD.

Enhancing Joint Attention Skills in Children on the Autism Spectrum through an Augmented Reality Technology-Mediated Intervention

In the present study, the effects of an intervention based on an augmented reality technology called Pictogram Room were examined. The objective of the intervention was to improve the responding to joint attention (RJA) skills of gaze following and pointing in six children on the autism spectrum between 3 and 8 years old. A multiple baseline single-subject experimental design was conducted for 12 weeks in a school setting. Results indicated that all of the participant children improved performance in RJA following the intervention. Improvements were maintained over time and generalised to real-world situations. These findings demonstrate that autistic children can improve their RJA skills with a targeted and engaging intervention based on an accessible augmented reality technology tool.

Social and non-social gaze cueing in autism spectrum disorder, attention-deficit/hyperactivity disorder and a comorbid group

Recent trends in literature, along with the changes to the Diagnostic and Statistical Manual (DSM), make it imperative to study Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) together, in order to better understand potential aetiological commonalities between these highly comorbid disorders. The present study examines social cueing, a highly studied construct in ASD, and intra-subject variability (ISV), a potential endophenotype of ADHD, in four groups of typically developing (TD), ADHD, ASD- (ASD without ADHD), ASD+ (ASD with ADHD) participants (N = 85) aged 10-13 years. Results showed that social cueing is intact in the 'pure' ASD group when task expectations are clear. The ADHD group showed faster saccadic reaction times, no increased ISV and a pattern of viewing comparable to the TD group. However, the ASD + group showed a differences in processing style and ISV. A secondary analysis gives evidence of non-additive effects of the ASD and ADHD factors.

The Gaze Cueing Effect and Its Enhancement by Facial Expressions Are Impacted by Task Demands: Direct Comparison of Target Localization and Discrimination Tasks

The gaze cueing effect is characterized by faster attentional orienting to a gazed-at than a non-gazed-at target. This effect is often enhanced when the gazing face bears an emotional expression, though this finding is modulated by a number of factors. Here, we tested whether the type of task performed might be one such modulating factor. Target localization and target discrimination tasks are the two most commonly used gaze cueing tasks, and they arguably differ in cognitive resources, which could impact how emotional expression and gaze cues are integrated to orient attention. In a within-subjects design, participants performed both target localization and discrimination gaze cueing tasks with neutral, happy, and fearful faces. The gaze cueing effect for neutral faces was greatly reduced in the discrimination task relative to the localization task, and the emotional enhancement of the gaze cueing effect was only present in the localization task and only when this task was performed first. These results suggest that cognitive resources are needed for gaze cueing and for the integration of emotional expressions and gaze cues. We propose that a shift toward local processing may be the mechanism by which the discrimination task interferes with the emotional modulation of gaze cueing. The results support the idea that gaze cueing can be greatly modulated by top-down influences and cognitive resources and thus taps into endogenous attention. Results are discussed within the context of the recently proposed EyeTune model of social attention.

Multiplayer Interaction Platform With Gaze Tracking for Individuals With Autism

Deficits in interpersonal communication along with difficulty in putting oneself into the shoes of others characterizes individuals with Autism Spectrum Disorder (ASD). Additionally, they exhibit atypical looking pattern causing them to miss aspects related to understanding other's preference for a context that is crucial for effective social communication. Prior research studies show the use of multiplayer platforms can improve interaction among these individuals. However, these multiplayer platforms do not demand players to understand each other's preference, important for effective social interaction. In this work, we have developed a multiplayer interaction platform using virtual reality augmented with eye-tracking technology. Thirty-six participants comprising of individuals with ASD (n = 18; Group_ASD) and typically developing (TD) individuals (n = 18; Group_TD) interacted in pairs within each participant group using our platform. Results indicate that both Group_ASD and Group_TD showed improvement in performance across the tasks with the Group_TD performing better than the Group_ASD. Additionally, the eye-gaze data indicated an underlying relationship between one's looking pattern and task performance that was differentiated between the Group_ASD and Group_TD. The current results indicate a potential of our multiplayer interaction platform to serve as a complementary tool in the hands of the interventionist promoting social reciprocity and interaction among individuals with ASD.

How accurate are autistic adults and those high in autistic traits at making face-to-face line-of-sight judgements?

LAY ABSTRACT

In order to effectively understand and consider what others are talking about, we sometimes need to follow their line-of-sight to the location at which they are looking, as this can provide important contextual information regarding what they are saying. If we are not able to follow other people's line-of-sight, this could result in social communication difficulties. Here we tested how effectively autistic and neurotypical adults are at following a social partner's line-of-sight during a face-to-face task. In a first study, completed by 14 autistic adult participants of average to above-average verbal ability and 14 neurotypical adult participants, we found that all participants were able to effectively follow the social partner's line-of-sight. We also found that participants tended to be as effective at making these judgements from both a brief, 1s, glance or a long, 5s, stare. However, autistic adults were less accurate, on average, than neurotypical adults overall. In a second study, a separate group of 65 neurotypical adults completed the same line-of-sight judgement task to investigate whether task performance was related to individual variation in self-reported autistic traits. This found that the amount of self-reported autistic traits was not at all related to people's ability to accurately make line-of-sight judgements. This research isolates and furthers our understanding of an important component part of the social communication process and assesses it in a real-world context.

Alterations of social attention in mental disorders: Phenomenology, scope, and future directions for research

Mental disorders often involve changes in the way subjects attend to other people. However, the nature of these modifications and how they unfold in different pathologies are not sufficiently clear. This article addresses these issues from the perspective of phenomenological psychopathology. The primary goal of the article is to suggest a new way of assessing and distinguishing the alterations of social attention in subjects with mental disorders. The first part of the article characterizes the essential properties of a capacity for social attention based on multidisciplinary evidence. This model is then used to examine anomalies in social attention in autism, schizophrenia, borderline personality disorder, and social anxiety disorder. The analysis of alterations in the way subjects with different types of pathologies attend to and with others is followed by a threefold typology, which clarifies the phenomenal nature of impairments of social attention in mental disorders.

Do minimally verbal and verbally fluent individuals with autism spectrum disorder differ in their viewing patterns of dynamic social scenes?

Attending preferentially to social information in the environment is important in developing socio-communicative skills and language. Research using eye tracking to explore how individuals with autism spectrum disorder deploy visual attention has increased exponentially in the past decade; however, studies have typically not included minimally verbal participants. In this study, we compared 37 minimally verbal children and adolescents with autism spectrum disorder with 34 age-matched verbally fluent individuals with autism spectrum disorder in how they viewed a brief video in which a young woman, surrounded by interesting objects, engages the viewer, and later reacts with expected or unexpected gaze-shifts toward the objects. While both groups spent comparable amounts of time looking at different parts of the scene and looked longer at the person than at the objects, the minimally verbal autism spectrum disorder group spent significantly less time looking at the person's face during the episodes where gaze following-a precursor of joint attention-was critical for interpreting her behavior. Proportional looking-time toward key areas of interest in some episodes correlated with receptive language measures. These findings underscore the connections between social attention and the development of communicative abilities in autism spectrum disorder.

Gaze Following and Attention to Objects in Infants at Familial Risk for ASD

Reduced gaze following has been associated previously with lower language scores in children with autism spectrum disorder (ASD). Here, we use eye-tracking in a controlled experimental setting to investigate whether gaze following and attention distribution during a word learning task associate with later developmental and clinical outcomes in a population of infants at familial risk for ASD. Fifteen-month-old infants (n = 124; n = 101 with familial risk) watched an actress repeatedly gaze toward and label one of two objects present in front of her. We show that infants who later developed ASD followed gaze as frequently as typically developing peers but spent less time engaged with either object. Moreover, more time spent on faces and less on objects was associated with lower concurrent or later verbal abilities, but not with later symptom severity. No outcome group showed evidence for word learning. Thus, atypical distribution of attention rather than poor gaze following is a limiting factor for language development in infants at familial risk for ASD.

Gaze Following Is Not Dependent on Ostensive Cues: A Critical Test of Natural Pedagogy

The theory of natural pedagogy stipulates that infants follow gaze because they are sensitive to the communicative intent of others. According to this theory, gaze following should be present if, and only if, accompanied by at least one of a set of specific ostensive cues. The current article demonstrates gaze following in a range of contexts, both with and without expressions of communicative intent in a between-subjects design with a large sample of 6-month-old infants (n = 94). Thus, conceptually replicating prior results from Szufnarowska et al. (2014) and falsifying a central pillar of the natural pedagogy theory. The results suggest that there are opportunities to learn from others' gaze independently of their displayed communicative intent.

Atypical Gaze Cueing Pattern in a Complex Environment in Individuals with ASD

Clinically, social interaction, including gaze-triggered attention, has been reported to be impaired in autism spectrum disorder (ASD), but psychological studies have generally shown intact gaze-triggered attention in ASD. These studies typically examined gaze-triggered attention under simple environmental conditions. In real life, however, the environment is complex. Previous studies have shown that an enhanced cueing effect was found when using eye gaze compared with arrow cues in unpredictably complex conditions in typically developing (TD) individuals. However, in the current study, compared with TD individuals, the cueing effect failed to enhance when using eye gaze compared with arrow cues under complex conditions in individuals with ASD. This may reflect the atypical style of gaze-triggered attention when individuals with ASD adapt to environmental complexity.

The integrity of lexical acquisition mechanisms in autism spectrum disorders: A research review

Research on autism spectrum disorders (ASD) has rapidly expanded in recent years, yielding important developments in both theory and practice. While we have gained important insights into how children with ASD differ from typically developing (TD) children in terms of phenotypic features, less has been learned about if and how development in ASD differs from typical development in terms of underlying mechanisms of change. This article aims to provide a review of processes subserving lexical development in ASD, with the goal of identifying contributing factors to the heterogeneity of language outcomes in ASD. The focus is on available evidence of the integrity or disruption of these mechanisms in ASD, as well as their significance for vocabulary development; topics include early speech perception and preference, speech segmentation, word learning, and category formation. Significant gaps in the literature are identified and future directions are suggested. Autism Res 2016, 9: 810-828. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

Gaze direction detection in autism spectrum disorder

Detecting where our partners direct their gaze is an important aspect of social interaction. An atypical gaze processing has been reported in autism. However, it remains controversial whether children and adults with autism spectrum disorder interpret indirect gaze direction with typical accuracy. This study investigated whether the detection of gaze direction toward an object is less accurate in autism spectrum disorder. Individuals with autism spectrum disorder (n = 33) and intelligence quotients-matched and age-matched controls (n = 38) were asked to watch a series of synthetic faces looking at objects, and decide which of two objects was looked at. The angle formed by the two possible targets and the face varied following an adaptive procedure, in order to determine individual thresholds. We found that gaze direction detection was less accurate in autism spectrum disorder than in control participants. Our results suggest that the precision of gaze following may be one of the altered processes underlying social interaction difficulties in autism spectrum disorder.

Eye Tracking Reveals Abnormal Visual Preference for Geometric Images as an Early Biomarker of an Autism Spectrum Disorder Subtype Associated With Increased Symptom Severity

BACKGROUND

Clinically and biologically, autism spectrum disorder (ASD) is heterogeneous. Unusual patterns of visual preference as indexed by eye tracking are hallmarks; however, whether they can be used to define an early biomarker of ASD as a whole or leveraged to define a subtype is unclear. To begin to examine this issue, large cohorts are required.

METHODS

A sample of 334 toddlers from six distinct groups (115 toddlers with ASD, 20 toddlers with ASD features, 57 toddlers with developmental delay, 53 toddlers with other conditions [e.g., premature birth, prenatal drug exposure], 64 toddlers with typical development, and 25 unaffected toddlers with siblings with ASD) was studied. Toddlers watched a movie containing geometric and social images. Fixation duration and number of saccades within each area of interest and validation statistics for this independent sample were computed. Next, to maximize power, data from our previous study (n = 110) were added for a total of 444 subjects. A subset of toddlers repeated the eye-tracking procedure.

RESULTS

As in the original study, a subset of toddlers with ASD fixated on geometric images >69% of the time. Using this cutoff, sensitivity for ASD was 21%, specificity was 98%, and positive predictive value was 86%. Toddlers with ASD who strongly preferred geometric images had 1) worse cognitive, language, and social skills relative to toddlers with ASD who strongly preferred social images and 2) fewer saccades when viewing geometric images. Unaffected siblings of ASD probands did not show evidence of heightened preference for geometric images. Test-retest reliability was good. Examination of age effects suggested that this test may not be appropriate with children >4 years old.

CONCLUSIONS

Enhanced visual preference for geometric repetition may be an early developmental biomarker of an ASD subtype with more severe symptoms.

Feasibility of Undertaking Off-Site Infant Eye-Tracking Assessments of Neuro-Cognitive Functioning in Early-Intervention Centres

Recent work suggests that differences in functional brain development are already identifiable in 6- to 9-month-old infants from low socio-economic status (SES) backgrounds. Investigation of early SES-related differences in neuro-cognitive functioning requires the recruitment of large and diverse samples of infants, yet it is often difficult to persuade low-SES parents to come to a university setting. One solution is to recruit infants through early intervention children's centres (CCs). These are often located in areas of high relative deprivation to support young children. Given the increasing portability of eye-tracking equipment, assessment of large clusters of infants could be undertaken in centres by suitably trained early intervention staff. Here, we report on a study involving 174 infants and their parents, carried out in partnership with CCs, exploring the feasibility of this approach. We report the processes of setting up the project and participant recruitment. We report the diversity of sample obtained on the engagement of CC staff in training and the process of assessment itself. We report the quality of the data obtained, and the levels of engagement of parents and infants. We conclude that this approach has great potential for recruiting large and diverse samples worldwide, provides sufficiently reliable data and is engaging to staff, parents and infants.

An Open Conversation on Using Eye-Gaze Methods in Studies of Neurodevelopmental Disorders

PURPOSE

Eye-gaze methods have the potential to advance the study of neurodevelopmental disorders. Despite their increasing use, challenges arise in using these methods with individuals with neurodevelopmental disorders and in reporting sufficient methodological detail such that the resulting research is replicable and interpretable.

METHOD

This tutorial presents key considerations involved in designing and conducting eye-gaze studies for individuals with neurodevelopmental disorders and proposes conventions for reporting the results of such studies.

RESULTS

Methodological decisions (e.g., whether to use automated eye tracking or manual coding, implementing strategies to scaffold children's performance, defining valid trials) have cascading effects on the conclusions drawn from eye-gaze data. Research reports that include specific information about procedures, missing data, and selection of participants will facilitate interpretation and replication.

CONCLUSIONS

Eye-gaze methods provide exciting opportunities for studying neurodevelopmental disorders. Open discussion of the issues presented in this tutorial will improve the pace of productivity and the impact of advances in research on neurodevelopmental disorders.

Intact Reflexive but Deficient Voluntary Social Orienting in Autism Spectrum Disorder

Impairment in social interactions is a primary characteristic of people diagnosed with autism spectrum disorder (ASD). Although these individuals tend to orient less to naturalistic social cues than do typically developing (TD) individuals, laboratory experiments testing social orienting in ASD have been inconclusive, possibly because of a failure to fully isolate reflexive (stimulus-driven) and voluntary (goal-directed) social orienting processes. The purpose of the present study was to separately examine potential reflexive and/or voluntary social orienting differences in individuals with ASD relative to TD controls. Subjects (ages 7–14) with high-functioning ASD and a matched control group completed three gaze cueing tasks on an iPad in which individuals briefly saw a face with averted gaze followed by a target after a variable delay. Two tasks were 100% predictive with either all congruent (target appears in gaze direction) or all incongruent (target appears opposite from gaze direction) trials, respectively. Another task was non-predictive with these same trials (half congruent and half incongruent) intermixed randomly. Response times (RTs) to the target were used to calculate reflexive (incongruent condition RT—congruent condition RT) and voluntary (non-predictive condition RT—predictive condition RT) gaze cueing effects. Subjects also completed two additional non-social orienting tasks (ProPoint and AntiPoint). Subjects with ASD demonstrate intact reflexive but deficient voluntary gaze following. Similar results were found in a separate test of non-social orienting. This suggests problems with using social cues, but only in a goal-directed fashion, in our sample of high-functioning individuals with ASD. Such findings may not only explain inconclusive previous findings but more importantly be critical for understanding social dysfunctions in ASD and for developing future interventions.

Perception of chasing in squirrel monkeys (Saimiri sciureus)

Understanding the intentions of others is crucial in developing positive social relationships. Comparative human and non-human animal studies have addressed the phylogenetic origin of this ability. However, few studies have explored the importance of motion information in distinguishing others' intentions and goals in non-human primates. This study addressed whether squirrel monkeys (Saimiri sciureus) are able to perceive a goal-directed motion pattern-specifically, chasing-represented by two geometric objects. In Experiment 1, we trained squirrel monkeys to discriminate a "Chasing" sequence from a "Random" sequence. We then confirmed that this discrimination transferred to new stimuli ("Chasing" and "Random") in a probe test. To determine whether the monkeys used similarities of trajectory to discriminate chasing from random motion, we also presented a non-chasing "Clone" sequence in which the trajectories of the two figures were identical. Three of six monkeys were able to discriminate "Chasing" from the other sequences. In Experiment 2, we confirmed humans' recognition of chasing with the stimuli from Experiment 1. In Experiment 3, the three monkeys for which discrimination did not transfer to the new stimuli in Experiment 1 were trained to discriminate between "Chasing" and "Clone" sequences. At testing, all three monkeys had learned to discriminate chasing, and two transferred their learning to new stimuli. Our results suggest that squirrel monkeys use goal-directed motion patterns, rather than simply similarity of trajectory, to discriminate chasing. Further investigation is necessary to identify the motion characteristics that contribute to this discrimination.

Face processing in autism spectrum disorders: From brain regions to brain networks

Autism spectrum disorder (ASD) is characterized by reduced attention to social stimuli including the human face. This hypo-responsiveness to stimuli that are engaging to typically developing individuals may result from dysfunctioning motivation, reward, and attention systems in the brain. Here we review an emerging neuroimaging literature that emphasizes a shift from focusing on hypo-activation of isolated brain regions such as the fusiform gyrus, amygdala, and superior temporal sulcus in ASD to a more holistic approach to understanding face perception as a process supported by distributed cortical and subcortical brain networks. We summarize evidence for atypical activation patterns within brain networks that may contribute to social deficits characteristic of the disorder. We conclude by pointing to gaps in the literature and future directions that will continue to shed light on aspects of face processing in autism that are still under-examined. In particular, we highlight the need for more developmental studies and studies examining ecologically valid and naturalistic social stimuli.

Referential gaze and word learning in adults with autism

While typically developing children can use referential gaze to guide their word learning, those with autism spectrum disorder are often described to have problems with that. However, some researchers assume that the ability to follow gaze to select the correct referent can develop in autism later compared to typically developing individuals. To test this assumption, we compared the performance of adults with and without autism on a word learning task while recording their gaze behavior using an eye tracker. Results showed that both groups mostly chose the correct referent, but less so for the autism spectrum disorder group when the distractor’s saliency was increased, suggesting that the ability to learn novel words by referring to gaze develops in autism spectrum disorder, but not fully, relative to their typically developing peers.

Effects of labeling and pointing on object gaze in boys with fragile X syndrome: an eye-tracking study

We examined the visual processing of a social learning stimulus and the ways in which visual attention was distributed to objects as well as to the examiner's face during word learning under conditions that varied only in the presence or absence of a label. The goal of the current study, then, was to evaluate the effects of differentially providing pointing and labeling during exposure to a novel target object in males with fragile X syndrome (FXS) (n=14, ages 4.33-10.02), autism spectrum disorder (ASD) (n=17, ages 4.04-10.4), or typical development (TD) (n=18, ages 2.05-5.33). In particular, the present study examined attention to the examiner's face as well as target and distracter objects that were presented as video stimuli. An eye-tracker captured gaze to the video stimuli as they were shown in order to examine the way in which children with FXS, ASD, or TD distributed their gaze toward the examiner and the objects. Results indicated that no group showed increased gaze toward the target object compared to the distracter object. However, results revealed that participants with FXS showed significantly increased face gaze compared to the novel objects, whereas children with ASD and TD both showed similar amounts of relative gaze toward the face and objects. Furthermore, the act of pointing at the target object was found to increase gaze toward the target objects compared to when there was no pointing in all groups. Together, these findings suggest that social cues like those employed in a word-learning task, when presented with video, may relate to gaze in FXS in context- or task-dependent ways that are distinct from those expected during live interaction.