A Study of Impaired Judgment of Eye-Gaze Direction and Related Face-Processing Deficits in Autism Spectrum Disorders

Slower Processing Speed in Autism Spectrum Disorder: A Meta-analytic Investigation of Time-Based Tasks

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition affecting information processing across domains. The current meta-analysis investigated whether slower processing speed is associated with the ASD neurocognitive profile and whether findings hold across different time-based tasks and stimuli (social vs. nonsocial; linguistic vs. nonlinguistic). Mean RTs of ASD and age-matched neurotypical comparison groups (N = 893 ASD, 1063 neurotypical; mean age ASD group = 17 years) were compared across simple RT, choice RT, and interference control tasks (44 studies, 106 effects) using robust variance estimation meta-analysis. Simple RT tasks required participants to respond to individual stimuli, whereas choice RT tasks required forced-choice responses to two or more stimuli. Interference control tasks required a decision in the context of a distractor or priming stimulus; in an effort to minimize inhibitory demands, we extracted RTs only from baseline and congruent conditions of such tasks. All tasks required nonverbal (motor) responses. The overall effect-size estimate indicated significantly longer mean RTs in ASD groups (g = .35, 95% CI = .16; .54) than comparison groups. Task type moderated effects, with larger estimates drawn from simple RT tasks than interference control tasks. However, across all three task types, ASD groups exhibited significantly longer mean RTs than comparison groups. Stimulus type and age did not moderate effects. Generalized slowing may be a domain-general characteristic of ASD with potential consequences for social, language, and motor development. Assessing processing speed may inform development of interventions to support autistic individuals and their diverse cognitive profiles.

The Time Course of Information Processing During Eye Direction Perception

Gaze directed at the observer (direct gaze) is a highly salient social signal. Despite the existence of a preferential orientation toward direct gaze, none of the studies carried out so far seem to have explicitly studied the time course of information processing during gaze direction judgment. In an eye direction judgment task, participants were presented with a sketch of a face. A temporal asynchrony was introduced between the presentation of the eyes and that of the rest of the face. Indeed, the face could be presented before the eyes, the eyes could be presented before the face, or the face and the eyes could be presented simultaneously. In a second time, the face direction was also manipulated. The results suggest that the time course of information processing during eye direction judgment follows a continuum that makes it possible to perceive the eyes first and then to use the facial context to judge the direction of gaze. Furthermore, the congruency between the direction of gaze and that of the face confirms this observation. Although these results are discussed in the light of existing theories about the mechanisms underlying gaze processing, our data provide new information suggesting that, despite their power to capture attention, the eyes probably have to stand out from a more general spatial configuration (i.e., the face) in order for their direction to be adequately processed.

Are people with autism prosopagnosic?

Difficulties in various face processing tasks have been well documented in autism spectrum disorder (ASD). Several meta-analyses and numerous case-control studies have indicated that this population experiences a moderate degree of impairment, with a small percentage of studies failing to detect any impairment. One possible account of this mixed pattern of findings is heterogeneity in face processing abilities stemming from the presence of a subpopulation of prosopagnosic individuals with ASD alongside those with normal face processing skills. Samples randomly drawn from such a population, especially relatively smaller ones, would vary in the proportion of participants with prosopagnosia, resulting in a wide range of group-level deficits from mild (or none) to severe across studies. We test this prosopagnosic subpopulation hypothesis by examining three groups of participants: adults with ASD, adults with developmental prosopagnosia (DP), and a comparison group. Our results show that the prosopagnosic subpopulation hypothesis does not account for the face impairments in the broader autism spectrum. ASD observers show a continuous and graded, rather than categorical, heterogeneity that span a range of face processing skills including many with mild to moderate deficits, inconsistent with a prosopagnosic subtype account. We suggest that pathogenic origins of face deficits for at least some with ASD differ from those of DP.

Integration of Facial Expression and Gaze Direction in Individuals with a High Level of Autistic Traits

BACKGROUND

We investigated whether individuals with high levels of autistic traits integrate relevant communicative signals, such as facial expression, when decoding eye-gaze direction.

METHODS

Students with high vs. low scores on the Autism Spectrum Quotient (AQ) performed a task in which they responded to the eye directions of faces, presented on the left or the right side of a screen, portraying different emotional expressions.

RESULTS

In both groups, the identification of gaze direction was faster when the eyes were directed towards the center of the scene. However, in the low AQ group, this effect was larger for happy faces than for neutral faces or faces showing other emotional expressions, whereas participants from high AQ group were not affected by emotional expressions.

CONCLUSIONS

These results suggest that individuals with more autistic traits may not integrate multiple communicative signals based on their emotional value.

The Bidirectional Social-Cognitive Mechanisms of the Social-Attention Symptoms of Autism

Differences in social attention development begin to be apparent in the 6th to 12th month of development in children with Autism Spectrum Disorder (ASD) and theoretically reflect important elements of its neurodevelopmental endophenotype. This paper examines alternative conceptual views of these early social attention symptoms and hypotheses about the mechanisms involved in their development. One model emphasizes mechanism involved in the spontaneous allocation of attention to faces, or social orienting. Alternatively, another model emphasizes mechanisms involved in the coordination of attention with other people, or joint attention, and the socially bi-directional nature of its development. This model raises the possibility that atypical responses of children to the attention or the gaze of a social partner directed toward themselves may be as important in the development of social attention symptoms as differences in the development of social orienting. Another model holds that symptoms of social attention may be important to early development, but may not impact older individuals with ASD. The alterative model is that the social attention symptoms in infancy (social orienting and joint attention), and social cognitive symptoms in childhood and adulthood share common neurodevelopmental substrates. Therefore, differences in early social attention and later social cognition constitute a developmentally continuous axis of symptom presentation in ASD. However, symptoms in older individuals may be best measured with in vivo measures of efficiency of social attention and social cognition in social interactions rather than the accuracy of response on analog tests used in measures with younger children. Finally, a third model suggests that the social attention symptoms may not truly be a symptom of ASD. Rather, they may be best conceptualized as stemming from differences domain general attention and motivation mechanisms. The alternative argued for here that infant social attention symptoms meet all the criteria of a unique dimension of the phenotype of ASD and the bi-directional phenomena involved in social attention cannot be fully explained in terms of domain general aspects of attention development.

Social cognitive skills groups increase medial prefrontal cortex activity in children with autism spectrum disorder

Few studies have examined the neural mechanisms of change following social skills interventions for children with autism spectrum disorder (ASD). This study examined the neural effects of social cognitive skills groups during functional MRI (fMRI) tasks of irony comprehension and eye gaze processing in school-aged children with ASD. Verbally fluent children (ages 8-11) were randomized to social cognitive skills groups or facilitated play comparison groups. Behavioral assessments and fMRI scans were obtained at baseline and endpoint (12 weeks). During fMRI, children completed two separate tasks to engage social cognition circuitry: comprehension of potentially ironic scenarios (n = 34) and viewing emotionally expressive faces with direct or averted gaze (n = 24). Whole-brain analyses were conducted to examine neural changes following treatment. Regression analyses were also conducted to explore the relationship between neural and behavioral changes. When comparing the two groups directly, the social cognitive skills group showed greater increases in activity in the medial prefrontal cortex (mPFC), implicated in theory of mind, relative to the comparison group for both irony comprehension and gaze processing tasks. Increased mPFC activity during the irony task was associated with improvement in social functioning on the Social Responsiveness Scale across both groups. Findings indicate that social cognitive skills interventions may increase activity in regions associated with social cognition and mentalizing abilities. LAY SUMMARY: Social skills groups are a common intervention for school-aged children with ASD. However, few studies have examined the neural response to social skills groups in school-aged children with ASD. Here, we report on a study evaluating neural outcomes from an empirically supported social cognitive skills training curriculum using fMRI. This study seeks to understand the effects of targeting emotion recognition and theory of mind on the brain circuitry involved in social cognition in verbally fluent children ages 8-11. Results indicate increased neural activity in the mPFC, a region considered to be a central hub of the "social brain," in children randomized to social cognitive skills groups relative to a comparison group that received a high-quality, child-directed play approach. In addition, increased activation in the mPFC during an irony comprehension task was associated with gains in social functioning across both groups from pre- to post-treatment. This is the first fMRI study of social skills treatment outcomes following a randomized trial with an active treatment condition in school-aged children with ASD.

Eye contact perception in high-functioning adults with autism spectrum disorder

LAY ABSTRACT

The detection of a self-directed gaze is often the starting point for social interactions and a person who feels as if they are being watched can prepare to respond to others' actions irrespective of the real gaze direction because the other person may likely be motivated to approach. Although many studies demonstrated that individuals with autism spectrum disorder have difficulty discriminating gaze direction, it remains unclear how the perception of self-directed gaze by individuals with autism spectrum disorder differs from that of age-, sex-, and IQ-matched typically developing individuals. Participants observed faces with various gaze directions and answered whether the person in the photograph was looking at them or not. Individuals with and without autism spectrum disorder were just as likely to perceive subtle averted gazes as self-directed gazes. The frequency of perceiving a self-directed gaze decreased as gaze aversion increased in both groups and, in general, individuals with autism spectrum disorder showed a comparable ability to perceive a self-directed gaze as that of typically developing individuals. Interestingly, considering face membership of photographs (ingroup or outgroup faces), typically developing individuals, but not individuals with autism spectrum disorder, were more likely to perceive self-directed gazes from ingroup faces than from outgroup faces. However, individuals with autism spectrum disorder had different affective experiences in response to ingroup and outgroup faces. These results suggest that individuals with autism spectrum disorder did not show an ingroup bias for the perception of a self-directed gaze, and raise a possibility that an atypical emotional experience contributes to the diminished ingroup bias.

Autistic adults show preserved normalisation of sensory responses in gaze processing

Progress in our understanding of autism spectrum disorder (ASD) has recently been sought by characterising how systematic differences in canonical neural computations employed across the sensory cortex might contribute to clinical symptoms in diverse sensory, cognitive, and social domains. A key proposal is that ASD is characterised by reduced divisive normalisation of sensory responses. This provides a bridge between genetic and molecular evidence for an increased ratio of cortical excitation to inhibition in ASD and the functional characteristics of sensory coding that are relevant for understanding perception and behaviour. Here we tested this hypothesis in the context of gaze processing (i.e., the perception of other people's direction of gaze), a domain with direct relevance to the core diagnostic features of ASD. We show that reduced divisive normalisation in gaze processing is associated with specific predictions regarding the psychophysical effects of sensory adaptation to gaze direction, and test these predictions in adults with ASD. We report compelling evidence that both divisive normalisation and sensory adaptation occur robustly in adults with ASD in the context of gaze processing. These results have important theoretical implications for defining the types of divisive computations that are likely to be intact or compromised in this condition (e.g., relating to local vs distal control of cortical gain). These results are also a strong testament to the typical sensory coding of gaze direction in ASD, despite the atypical responses to others' gaze that are a hallmark feature of this diagnosis.

Characterising variations in perceptual decision making

Current perspectives propose that observer models accounting for both optimal and suboptimal behaviour may yield real progress in understanding perception. We propose that such models could, in addition, be very useful for precisely characterising the variation in perception across healthy participants and those affected by psychiatric disorders, as well as the effects of neuromodulators such as oxytocin.

Deconstructing atypical eye gaze perception in autism spectrum disorder

The ability to discern the target of another person's gaze is critical for social and linguistic development, but functions atypically in autism spectrum disorder (ASD). A multi-pronged approach allowed us to deconstruct this complex ability, to uncover the fundamental bases of this impairment. We analyzed performance on a novel gaze perception task with classical psychophysical metrics (precision and accuracy), principal component analysis (in the analysis of spatial biases), and Bayesian computational modeling (in the analysis of individual subjects' use of contextual salience cues). Compared to controls, adults with ASD were less precise and less accurate in their judgments of gaze direction. Further, although nearly all controls exhibited a prototypical pattern of spatial bias in their judgments, this spatial prior was severely disrupted among a large subset of ASD participants. By contrast, Bayesian computational modeling revealed that both groups exploited contextual salience cues in their gaze judgments, and that the average strength of this contextual prior was similar for both groups. This comprehensive study revealed that although most ASD participants performed atypically in at least one aspect of gaze perception, the particular aspects disrupted varied idiosyncratically across individuals. Impairment in gaze perception in ASD likely arises via heterogeneous underlying mechanisms.

Gaze and visual search strategies of children with Asperger syndrome/high functioning autism viewing a magic trick

OBJECTIVE

To examine visual search patterns and strategies used by children with and without Asperger syndrome/high functioning autism (AS/HFA) while watching a magic trick. Limited responsivity to gaze cues is hypothesised to contribute to social deficits in children with AS/HFA.

METHODS

Twenty-one children with AS/HFA and 31 matched peers viewed a video of a gaze-cued magic trick twice. Between the viewings, they were informed about how the trick was performed. Participants' eye movements were recorded using a head-mounted eye-tracker.

RESULTS

Children with AS/HFA looked less frequently and had shorter fixation on the magician's direct and averted gazes during both viewings and more frequently at not gaze-cued objects and on areas outside the magician's face. After being informed of how the trick was conducted, both groups made fewer fixations on gaze-cued objects and direct gaze.

CONCLUSIONS

Information may enhance effective visual strategies in children with and without AS/HFA.

No evidence of reaction time slowing in autism spectrum disorder

A total of 32 studies comprising 238 simple reaction time and choice reaction time conditions were examined in individuals with autism spectrum disorder (n = 964) and controls (n = 1032). A Brinley plot/multiple regression analysis was performed on mean reaction times, regressing autism spectrum disorder performance onto the control performance as a way to examine any generalized simple reaction time/choice reaction time slowing exhibited by the autism spectrum disorder group. The resulting regression equation was Y (autism spectrum disorder) = 0.99 × (control) + 87.93, which accounted for 92.3% of the variance. These results suggest that there are little if any simple reaction time/choice reaction time slowing in this sample of individual with autism spectrum disorder, in comparison with controls. While many cognitive and information processing domains are compromised in autism spectrum disorder, it appears that simple reaction time/choice reaction time remain relatively unaffected in autism spectrum disorder.

The influences of face inversion and facial expression on sensitivity to eye contact in high-functioning adults with autism spectrum disorders

We examined the influences of face inversion and facial expression on sensitivity to eye contact in high-functioning adults with and without an autism spectrum disorder (ASD). Participants judged the direction of gaze of angry, fearful, and neutral faces. In the typical group only, the range of directions of gaze leading to the perception of eye contact (the cone of gaze) was narrower for upright than inverted faces. In both groups, the cone of gaze was wider for angry faces than for fearful or neutral faces. These results suggest that in high-functioning adults with ASD, the perception of eye contact is not tuned to be finer for upright than inverted faces, but that information is nevertheless integrated across expression and gaze direction.

Neural correlates of "social gaze" processing in high-functioning autism under systematic variation of gaze duration

Direct gaze is a salient nonverbal signal for social interest and the intention to communicate. In particular, the duration of another's direct gaze can modulate our perception of the social meaning of gaze cues. However, both poor eye contact and deficits in social cognitive processing of gaze are specific diagnostic features of autism. Therefore, investigating neural mechanisms of gaze may provide key insights into the neural mechanisms related to autistic symptoms. Employing functional magnetic resonance imaging (fMRI) and a parametric design, we investigated the neural correlates of the influence of gaze direction and gaze duration on person perception in individuals with high-functioning autism (HFA) and a matched control group. For this purpose, dynamically animated faces of virtual characters, displaying averted or direct gaze of different durations (1 s, 2.5 s and 4 s) were evaluated on a four-point likeability scale. Behavioral results revealed that HFA participants showed no significant difference in likeability ratings depending on gaze duration, while the control group rated the virtual characters as increasingly likeable with increasing gaze duration. On the neural level, direct gaze and increasing direct gaze duration recruit regions of the social neural network (SNN) in control participants, indicating the processing of social salience and a perceived communicative intent. In participants with HFA however, regions of the social neural network were more engaged by averted and decreasing amounts of gaze, while the neural response for processing direct gaze in HFA was not suggestive of any social information processing.

Getting a grip on social gaze: control over others' gaze helps gaze detection in high-functioning autism

We investigated the influence of control over a social stimulus on the ability to detect direct gaze in high-functioning autism (HFA). In a pilot study, 19 participants with and 19 without HFA were compared on a gaze detection and a gaze setting task. Participants with HFA were less accurate in detecting direct gaze in the detection task, but did not differ in their ability to establish direct gaze in the setting task. In the main experiment, the results of the pilot study were replicated with 37 participants with and 39 without HFA, suggesting that individuals with HFA have a specific deficit in the passive perception of social cues as opposed to the active control, which seems to be intact.

Atypical development of spontaneous social cognition in autism spectrum disorders

Individuals with autism spectrum disorders (ASD) have profound impairment in the development of social interaction and communication. However, it is also known that some 'high-functioning' individuals with ASD show apparently typical capacity to process social information in a controlled experimental settings, despite their difficulties in daily life. The current paper overviews the spontaneous social cognition, spontaneous processing of social information in the absence of explicit instruction or task demand, in individuals with ASD. Three areas of the researches, false belief attribution, imitation/mimicry, and eye gaze processing, have been reviewed. The literatures suggest that high-functioning individuals with ASD (a) do not spontaneously attribute false belief to others, even though they can easily do so when explicitly instructed, (b) can imitate others' goal-directed actions under explicit instruction and show spontaneous mimicry of others' actions when they attend to the action, but are less likely to show spontaneous mimicry without the task structure to navigate attention to others' action and (c) can process others' gaze direction and shift attention to others' gaze directions, but fail to spontaneously attend to another person's eyes in social and communicative context, and less likely to be prompted to respond in response to perceived eye contact. These results are consistent with the claim that individuals with ASD do not spontaneously attend to socially relevant information, even though they can easily process the same information when their attention is navigated towards it.

Reduced face identity aftereffects in relatives of children with autism

Autism is a pervasive developmental condition with complex aetiology. To aid the discovery of genetic mechanisms, researchers have turned towards identifying potential endophenotypes - subtle neurobiological or neurocognitive traits present in individuals with autism and their "unaffected" relatives. Previous research has shown that relatives of individuals with autism exhibit face processing atypicalities, which are similar in nature albeit of lesser degree, to those found in children and adults with autism. Yet very few studies have examined the underlying mechanisms responsible for such atypicalities. Here, we investigated whether atypicalities in adaptive norm-based coding of faces are present in relatives of children with autism, similar to those previously reported in children with autism. To test this possibility, we administered a face identity aftereffect task in which adaptation to a particular face biases perception towards the opposite identity, so that a previously neutral face (i.e., the average face) takes on the computationally opposite identity. Parents and siblings of individuals with autism showed smaller aftereffects compared to parents and siblings of typically developing children, especially so when the adapting stimuli were located further away from the average face. In addition, both groups showed stronger aftereffects for adaptors far from the average than for adaptors closer to the average. These results suggest that, in relatives of children with autism, face-coding mechanism are similar (i.e., norm-based) but less efficient than in relatives of typical children. This finding points towards the possibility that diminished adaptive mechanisms might represent a neurocognitive endophenotype for autism.

Brain mechanisms for processing direct and averted gaze in individuals with autism

Prior studies have indicated brain abnormalities underlying social processing in autism, but no fMRI study has specifically addressed the differential processing of direct and averted gaze, a critical social cue. Fifteen adolescents and adults with autism and 14 typically developing comparison participants viewed dynamic virtual-reality videos depicting a simple but realistic social scenario, in which an approaching male figure maintained either direct or averted gaze. Significant group by condition interactions reflecting differential responses to direct versus averted gaze in people with autism relative to typically developing individuals were identified in the right temporoparietal junction, right anterior insula, left lateral occipital cortex, and left dorsolateral prefrontal cortex. Our results provide initial evidence regarding brain mechanisms underlying the processing of gaze direction during simple social encounters, providing new insight into the social deficits in individuals with autism.

Deficits in adults with autism spectrum disorders when processing multiple objects in dynamic scenes

People with autism spectrum disorders (ASD) process visual information in a manner that is distinct from typically developing individuals. They may be less sensitive to people's goals and, more generally, focus on visual details instead of the entire scene. To examine these differences, people with and without ASD were asked to detect changes in dynamic scenes with multiple elements. Participants viewed a brief video of a person or an inanimate object (the "figure") moving from one object to another; after a delay, they reported whether a second video was the same or different. Possible changes included the figure, the object the figure was moving from, or the object the figure was moving toward (the "goal"). We hypothesized that individuals with ASD would be less sensitive to changes in scenes with people, particularly elements that might be the person's goal. Alternately, people with ASD might attend to fewer elements regardless of whether the scene included a person. Our results indicate that, like controls, people with ASD noticed a change in the "goal" object at the end of a person's movement more often than the object at the start. However, the group with ASD did not undergo the developmental improvement that was evident typically when detecting changes in both the start and end objects. This atypical development led to deficits in adults with ASD that were not specific to scenes with people or to "goals." Improvements in visual processing that underlie mature representation of scenes may not occur in ASD, suggesting that late developing brain processes are affected.

Face processing abilities in relatives of individuals with ASD

Individuals with an autism spectrum disorder (ASD) show difficulties identifying familiar faces, recognizing emotional expressions and judging eye-gaze direction. Recent research suggests that relatives of individuals with AS also show impairments in some aspects of face processing but no study has comprehensively assessed the nature and extent of face-processing difficulties in a group of relatives. This study compared the performance of 22 parents/adult siblings of individuals with ASD ("relatives" group), 26 adults with ASD, and 26 typically developing adults on tasks of face discrimination, facial expression recognition and judging eye-gaze direction. Relatives of individuals with ASD were less able to discriminate subtle differences between faces than typically developing adults, but were more sensitive to such differences than adults with ASD. Furthermore, relatives were significantly worse at identifying expressions of fear and disgust than typically developing adults and failed to show the typical sensitivity to direct compared with averted eye-gaze direction--a strikingly similar pattern to that observed in adults with ASD. These findings show that atypical patterns of face processing are found in some relatives of individuals with ASD and suggest that these difficulties may represent a cognitive endophenotype.

Vision in autism spectrum disorders

Autism spectrum disorders (ASDs) are developmental disorders which are thought primarily to affect social functioning. However, there is now a growing body of evidence that unusual sensory processing is at least a concomitant and possibly the cause of many of the behavioural signs and symptoms of ASD. A comprehensive and critical review of the phenomenological, empirical, neuroscientific and theoretical literature pertaining to visual processing in ASD is presented, along with a brief justification of a new theory which may help to explain some of the data, and link it with other current hypotheses about the genetic and neural aetiologies of this enigmatic condition.

Neural bases of eye and gaze processing: the core of social cognition

Eyes and gaze are very important stimuli for human social interactions. Recent studies suggest that impairments in recognizing face identity, facial emotions or in inferring attention and intentions of others could be linked to difficulties in extracting the relevant information from the eye region including gaze direction. In this review, we address the central role of eyes and gaze in social cognition. We start with behavioral data demonstrating the importance of the eye region and the impact of gaze on the most significant aspects of face processing. We review neuropsychological cases and data from various imaging techniques such as fMRI/PET and ERP/MEG, in an attempt to best describe the spatio-temporal networks underlying these processes. The existence of a neuronal eye detector mechanism is discussed as well as the links between eye gaze and social cognition impairments in autism. We suggest impairments in processing eyes and gaze may represent a core deficiency in several other brain pathologies and may be central to abnormal social cognition.

A parallel and distributed-processing model of joint attention, social cognition and autism

The impaired development of joint attention is a cardinal feature of autism. Therefore, understanding the nature of joint attention is central to research on this disorder. Joint attention may be best defined in terms of an information-processing system that begins to develop by 4-6 months of age. This system integrates the parallel processing of internal information about one's own visual attention with external information about the visual attention of other people. This type of joint encoding of information about self and other attention requires the activation of a distributed anterior and posterior cortical attention network. Genetic regulation, in conjunction with self-organizing behavioral activity, guides the development of functional connectivity in this network. With practice in infancy the joint processing of self-other attention becomes automatically engaged as an executive function. It can be argued that this executive joint attention is fundamental to human learning as well as the development of symbolic thought, social cognition and social competence throughout the life span. One advantage of this parallel and distributed-processing model of joint attention is that it directly connects theory on social pathology to a range of phenomena in autism associated with neural connectivity, constructivist and connectionist models of cognitive development, early intervention, activity-dependent gene expression and atypical ocular motor control.

Positive and negative gaze perception in autism spectrum conditions

Eyes are key social features providing a wealth of information about the attention, interest, emotion, and intention of others. Humans are typically very adept at detecting gaze direction, but there is a large decrement in gaze discrimination ability when eye images change from positive to negative polarity. This is thought to show an expert system for gaze perception that applies a contrast-specific heuristic to determine where someone else is looking. Autism spectrum conditions (ASC) are characterized by social deficits including difficulties in face-processing and in the social use of gaze. People with ASC are thought to have less expertise for gaze processing compared to typical controls, though little research has tested this. We investigated gaze direction perception in typical males and females, and males with ASC using facial stimuli with positive or negative polarity of the eyes. Results showed that the ASC group was worse at judging gaze direction with positive stimuli, and showed less of a decrement in performance when eye stimuli changed from positive to negative polarity. The differences in gaze perception for the ASC group were most evident when information from the eyes was more difficult and ambiguous. Typical females performed better at gaze direction detection with positive polarity than typical males, who in turn performed better than males with ASC. This latter finding is consistent with the extreme male brain theory of autism, and with the idea that people with ASC have less gaze expertise.