Altered face scanning and impaired recognition of biological motion in a 15-month-old infant with autism

Mapping neural correlates of biological motion perception in autistic children using high-density diffuse optical tomography

BACKGROUND

Autism spectrum disorder (ASD), a neurodevelopmental disorder defined by social communication deficits plus repetitive behaviors and restricted interests, currently affects 1/36 children in the general population. Recent advances in functional brain imaging show promise to provide useful biomarkers of ASD diagnostic likelihood, behavioral trait severity, and even response to therapeutic intervention. However, current gold-standard neuroimaging methods (e.g., functional magnetic resonance imaging, fMRI) are limited in naturalistic studies of brain function underlying ASD-associated behaviors due to the constrained imaging environment. Compared to fMRI, high-density diffuse optical tomography (HD-DOT), a non-invasive and minimally constraining optical neuroimaging modality, can overcome these limitations. Herein, we aimed to establish HD-DOT to evaluate brain function in autistic and non-autistic school-age children as they performed a biological motion perception task previously shown to yield results related to both ASD diagnosis and behavioral traits.

METHODS

We used HD-DOT to image brain function in 46 ASD school-age participants and 49 non-autistic individuals (NAI) as they viewed dynamic point-light displays of coherent biological and scrambled motion. We assessed group-level cortical brain function with statistical parametric mapping. Additionally, we tested for brain-behavior associations with dimensional metrics of autism traits, as measured with the Social Responsiveness Scale-2, with hierarchical regression models.

RESULTS

We found that NAI participants presented stronger brain activity contrast (coherent > scrambled) than ASD children in cortical regions related to visual, motor, and social processing. Additionally, regression models revealed multiple cortical regions in autistic participants where brain function is significantly associated with dimensional measures of ASD traits.

LIMITATIONS

Optical imaging methods are limited in depth sensitivity and so cannot measure brain activity within deep subcortical regions. However, the field of view of this HD-DOT system includes multiple brain regions previously implicated in both task-based and task-free studies on autism.

CONCLUSIONS

This study demonstrates that HD-DOT is sensitive to brain function that both differentiates between NAI and ASD groups and correlates with dimensional measures of ASD traits. These findings establish HD-DOT as an effective tool for investigating brain function in autistic and non-autistic children. Moreover, this study established neural correlates related to biological motion perception and its association with dimensional measures of ASD traits.

Seeing through a robot's eyes: A cross-sectional exploratory study in developing a robotic screening technology for autism

The present exploratory cross-sectional case-control study sought to develop a reliable and scalable screening tool for autism using a social robot. The robot HUMANE, installed with computer vision and linked with recognition technology, detected the direction of eye gaze of children. Children aged 3-8 (M = 5.52; N = 199) participated, 87 of whom had been confirmed with autism, 55 of whom were suspected to have autism, and 57 of whom were not considered to cause any concern for having autism. Before a session, a human experimenter instructed HUMANE to narrate a story to a child. HUMANE prompted the child to return his/her eye gaze to the robot if the child looked away, and praised the child when it re-established its eye gaze quickly after a prompt. The reliability of eye gaze detection was checked across all pairs of human raters and HUMANE and reached 0.90, indicating excellent interrater agreement. Using the pre-specified reference standard (Autism Spectrum Quotient), the sensitivity and specificity of the index tests (i.e., the number of robot prompts and duration of inattentiveness) reached 0.88 or above and the Diagnostic Odds Ratios were beyond 190. These results show that social robots may detect atypical eye patterns, suggesting a potential future for screening autism using social robots.

Observational learning of atypical biological kinematics in autism

Observing and voluntarily imitating the biological kinematics displayed by a model underpins the acquisition of new motor skills via sensorimotor processes linking perception with action. Differences in voluntary imitation in autism could be related to sensorimotor processing activity during action-observation of biological motion, as well as how sensorimotor integration processing occurs across imitation attempts. Using an observational practice protocol, which minimized the active contribution of the peripheral sensorimotor system, we examined the contribution of sensorimotor processing during action-observation. The data showed that autistic participants imitated both the temporal duration and atypical kinematic profile of the observed movement with a similar level of accuracy as neurotypical participants. These findings suggest the lower-level perception-action processes responsible for encoding biological kinematics during the action-observation phase of imitation are operational in autism. As there was no task-specific engagement of the peripheral sensorimotor system during observational practice, imitation difficulties in autism are most likely underpinned by sensorimotor integration issues related to the processing of efferent and (re)afferent sensorimotor information during trial-to-trial motor execution.

Free viewing biases for complex scenes in preschoolers and adults

Adult gaze behaviour towards naturalistic scenes is highly biased towards semantic object classes. Little is known about the ontological development of these biases, nor about group-level differences in gaze behaviour between adults and preschoolers. Here, we let preschoolers (n = 34, age 5 years) and adults (n = 42, age 18-59 years) freely view 40 complex scenes containing objects with different semantic attributes to compare their fixation behaviour. Results show that preschool children allocate a significantly smaller proportion of dwell time and first fixations on Text and instead fixate Faces, Touched objects, Hands and Bodies more. A predictive model of object fixations controlling for a range of potential confounds suggests that most of these differences can be explained by drastically reduced text salience in pre-schoolers and that this effect is independent of low-level salience. These findings are in line with a developmental attentional antagonism between text and body parts (touched objects and hands in particular), which resonates with recent findings regarding 'cortical recycling'. We discuss this and other potential mechanisms driving salience differences between children and adults.

Distinct social attention profiles in preschoolers with autism contrasted to fragile X syndrome

Social attention is a critical skill for learning and development. Social attention difficulties are present in both non-syndromic autism spectrum disorder (nsASD) and fragile X syndrome (FXS), and our understanding of these difficulties is complicated by heterogeneity in both disorders, including co-occurring diagnoses like intellectual disability and social anxiety. Existing research largely utilizes a single index of social attention and rarely includes children with intellectual impairment or uses a cross-syndrome approach. This study investigated whether multi-trait social attention profiles including naturalistic initial eye contact, facial attention, and social scene attention differ in preschool children with nsASD and FXS matched on developmental ability (DQ) and contrasted to neurotypical (NT) controls. The relationship between DQ, ASD severity, and social anxiety and social attention profiles was also examined. Initial eye contact related to social scene attention, implicating that naturalistic social attention is consistent with responses during experimental conditions. Reduced eye contact and lower social scene attention characterized nsASD and FXS. Children with nsASD displayed less facial attention than FXS and NT children, who did not differ. Lower DQ and elevated ASD severity associated with decreased eye contact in nsASD and FXS, and lower DQ was associated with lower social scene attention in FXS. Sex, social anxiety, and age were not associated with social attention. These findings suggest social attention profiles of children with nsASD are highly similar to, yet distinct from, children with FXS. Children with nsASD may present with a global social attention deficit whereas FXS profiles may reflect context-dependent social avoidance.

Life is in motion (through a chick's eye)

Cognitive scientists, social psychologists, computer scientists, neuroscientists, ethologists and many others have all wondered how brains detect and interpret the motion of living organisms. It appears that specific cues, incorporated into our brains by natural selection, serve to signal the presence of living organisms. A simple geometric figure such as a triangle put in motion with specific kinematic rules can look alive, and it can even seem to have intentions and goals. In this article, we survey decades of parallel investigations on the motion cues that drive animacy perception-the sensation that something is alive-in non-human animals, especially in precocial species, such as the domestic chick, to identify inborn biological predispositions. At the same time, we highlight the relevance of these studies for an understanding of human typical and atypical cognitive development.

A constellation of eye-tracking measures reveals social attention differences in ASD and the broad autism phenotype

Background

Social attention differences, expressed through gaze patterns, have been documented in autism spectrum disorder (ASD), with subtle differences also reported among first-degree relatives, suggesting a shared genetic link. Findings have mostly been derived from standard eye-tracking methods (total fixation count or total fixation duration). Given the dynamics of visual attention, these standard methods may obscure subtle, yet core, differences in visual attention mechanisms, particularly those presenting sub-clinically. This study applied a constellation of eye-tracking analyses to gaze data from individuals with ASD and their parents.

Methods

This study included n = 156 participants across groups, including ASD (n = 24) and control (n = 32) groups, and parents of individuals with ASD (n = 61) and control parents (n = 39). A complex scene with social/non-social elements was displayed and gaze tracked via an eye tracker. Eleven analytic methods from the following categories were analyzed: (1) standard variables, (2) temporal dynamics (e.g., gaze over time), (3) fixation patterns (e.g., perseverative or regressive fixations), (4) first fixations, and (5) distribution patterns. MANOVAs, growth curve analyses, and Chi-squared tests were applied to examine group differences. Finally, group differences were examined on component scores derived from a principal component analysis (PCA) that reduced variables to distinct dimensions.

Results

No group differences emerged among standard, first fixation, and distribution pattern variables. Both the ASD and ASD parent groups demonstrated on average reduced social attention over time and atypical perseverative fixations. Lower social attention factor scores derived from PCA strongly differentiated the ASD and ASD parent groups from controls, with parent findings driven by the subset of parents demonstrating the broad autism phenotype.

Limitations

To generalize these findings, larger sample sizes, extended viewing contexts (e.g., dynamic stimuli), and even more eye-tracking analytical methods are needed.

Conclusions

Fixations over time and perseverative fixations differentiated ASD and the ASD parent groups from controls, with the PCA most robustly capturing social attention differences. Findings highlight their methodological utility in studies of the (broad) autism spectrum to capture nuanced visual attention differences that may relate to clinical symptoms in ASD, and reflect genetic liability in clinically unaffected relatives. This proof-of-concept study may inform future studies using eye tracking across populations where social attention is impacted.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13229-022-00490-w.

Exploring social emotion processing in autism: evaluating the reading the mind in the eyes test using network analysis

BACKGROUND

Features of autism spectrum disorder (ASD) include difficulties in processing and interpreting socioemotional information. The "Reading the Mind in the Eyes" test (RMET) is a validated measurement for processing socioemotional ability. However, previous RMET studies did not explore patterns of incorrect answers and the emotional valence of the test items. This study used the Taiwanese version of the RMET and the network analysis methods to examine the differences in underlying mechanisms of socioemotional processes between 30 males with autism spectrum disorder (ASD) (mean age = 18 years) and 30 healthy control males (mean age = 17 years). For each test item, a picture of a person's eyes and partial face was shown with four words describing the emotional status on picture corners. Participants were instructed to choose one of the four words that best matched the person's thinking or feeling. We further classified the words into three valences of emotional categories to examine socioemotional processes.

RESULTS

Our results showed that ASD males performed poorer on the RMET than the controls. ASD males had higher network density and in-degree scores, especially in negative words, than control males.

CONCLUSIONS

The findings suggest that males with ASD might have deficits in mapping the best emotional concept words to the target item, especially for processing negative emotion.

Preference for biological motion is reduced in ASD: implications for clinical trials and the search for biomarkers

BACKGROUND

The neurocognitive mechanisms underlying autism spectrum disorder (ASD) remain unclear. Progress has been largely hampered by small sample sizes, variable age ranges and resulting inconsistent findings. There is a pressing need for large definitive studies to delineate the nature and extent of key case/control differences to direct research towards fruitful areas for future investigation. Here we focus on perception of biological motion, a promising index of social brain function which may be altered in ASD. In a large sample ranging from childhood to adulthood, we assess whether biological motion preference differs in ASD compared to neurotypical participants (NT), how differences are modulated by age and sex and whether they are associated with dimensional variation in concurrent or later symptomatology.

METHODS

Eye-tracking data were collected from 486 6-to-30-year-old autistic (N = 282) and non-autistic control (N = 204) participants whilst they viewed 28 trials pairing biological (BM) and control (non-biological, CTRL) motion. Preference for the biological motion stimulus was calculated as (1) proportion looking time difference (BM-CTRL) and (2) peak look duration difference (BM-CTRL).

RESULTS

The ASD group showed a present but weaker preference for biological motion than the NT group. The nature of the control stimulus modulated preference for biological motion in both groups. Biological motion preference did not vary with age, gender, or concurrent or prospective social communicative skill within the ASD group, although a lack of clear preference for either stimulus was associated with higher social-communicative symptoms at baseline.

LIMITATIONS

The paired visual preference we used may underestimate preference for a stimulus in younger and lower IQ individuals. Our ASD group had a lower average IQ by approximately seven points. 18% of our sample was not analysed for various technical and behavioural reasons.

CONCLUSIONS

Biological motion preference elicits small-to-medium-sized case-control effects, but individual differences do not strongly relate to core social autism associated symptomatology. We interpret this as an autistic difference (as opposed to a deficit) likely manifest in social brain regions. The extent to which this is an innate difference present from birth and central to the autistic phenotype, or the consequence of a life lived with ASD, is unclear.

Visual Traces of Language Acquisition in Toddlers with Autism Spectrum Disorder During the Second Year of Life

Infants show shifting patterns of visual engagement to faces over the first years of life. To explore the adaptive implications of this engagement, we collected eye-tracking measures on cross-sectional samples of 10-25-month-old typically developing toddlers (TD;N = 28) and those with autism spectrum disorder (ASD;N = 54). Concurrent language assessments were conducted and relationships between visual engagement and expressive and receptive language were analyzed between groups, and within ASD subgroups. TD and ASD toddlers exhibited greater mouth- than eye-looking, with TD exhibiting higher levels of mouth-looking than ASD. Mouth-looking was positively associated with expressive language in TD toddlers, and in ASD toddlers who had acquired first words. Mouth-looking was unrelated to expressive language in ASD toddlers who had not yet acquired first words.

The feasibility of Gazefinder under 12 months of age infants

Eye-tracking to evaluate gaze patterns has developed as an assessment tool for children with autism spectrum disorder (ASD). Gazefinder is one of Eye-tracking devices and few studies have investigated whether it can measure the gaze data of infants under 12 months of age. We conducted a prospective cross-sectional study from April 2019 to March 2020 in a periodic health checkup in Ohchi County, Shimane, Japan. Participants included infants between 4 and 11 months of age who were not suspected the presence of developmental problems. Ninety-three participants’ datapoints were analyzed. The mean age was 6.5 months and mean developmental quotient was 88%. The mean fixation time percentage of all sequences was 81.0% (standard deviation; 4.4), and there was no significant difference in each age group. Infants in all groups showed a significantly higher predilection for eyes than for mouths. There was a positive association of age with human gaze and a negative association with geometric gaze. Moreover, we confirmed that joint attention skills were enhanced in accordance with their growth process. The eye-tracking data were almost corresponding to previous studies’ data of infant with typical development and Gazefinder could be applied to infants starting at 4 months of age.

Brain mechanisms of eye contact during verbal communication predict autistic traits in neurotypical individuals

Atypical eye contact in communication is a common characteristic in autism spectrum disorders. Autistic traits vary along a continuum extending into the neurotypical population. The relation between autistic traits and brain mechanisms underlying spontaneous eye contact during verbal communication remains unexplored. Here, we used simultaneous functional magnetic resonance imaging and eye tracking to investigate this relation in neurotypical people within a naturalistic verbal context. Using multiple regression analyses, we found that brain response in the posterior superior temporal sulcus (pSTS) and its connectivity with the fusiform face area (FFA) during eye contact with a speaker predicted the level of autistic traits measured by Autism-spectrum Quotient (AQ). Further analyses for different AQ subclusters revealed that these two predictors were negatively associated with attention to detail. The relation between FFA–pSTS connectivity and the attention to detail ability was mediated by individuals’ looking preferences for speaker’s eyes. This study identified the role of an individual eye contact pattern in the relation between brain mechanisms underlying natural eye contact during verbal communication and autistic traits in neurotypical people. The findings may help to increase our understanding of the mechanisms of atypical eye contact behavior during natural communication.

Adaptation to the Speed of Biological Motion in Autism

Autistic individuals often present atypicalities in adaptation-the continuous recalibration of perceptual systems driven by recent sensory experiences. Here, we examined such atypicalities in human biological motion. We used a dual-task paradigm, including a running-speed discrimination task ('comparing the speed of two running silhouettes') and a change-detection task ('detecting fixation-point shrinkages') assessing attention. We tested 19 school-age autistic and 19 age- and ability-matched typical participants, also recording eye-movements. The two groups presented comparable speed-discrimination abilities and, unexpectedly, comparable adaptation. Accuracy in the change-detection task and the scatter of eye-fixations around the fixation point were also similar across groups. Yet, the scatter of fixations reliably predicted the magnitude of adaptation, demonstrating the importance of controlling for attention in adaptation studies.

Autism spectrum disorder risk prediction: A systematic review of behavioral and neural investigations

A reliable diagnosis of autism spectrum disorder (ASD) is difficult to make until after toddlerhood. Detection in an earlier age enables early intervention, which is typically more effective. Recent studies of the development of brain and behavior in infants and toddlers have provided important insights in the diagnosis of autism. This extensive review focuses on published studies of predicting the diagnosis of autism during infancy and toddlerhood younger than 3 years using behavioral and neuroimaging approaches. After screening a total of 782 papers, 17 neuroimaging and 43 behavioral studies were reviewed. The features for prediction consist of behavioral measures using screening tools, observational and experimental methods, brain volumetric measures, and neural functional activation and connectivity patterns. The classification approaches include logistic regression, linear discriminant function, decision trees, support vector machine, and deep learning based methods. Prediction performance has large variance across different studies. For behavioral studies, the sensitivity varies from 20% to 100%, and specificity ranges from 48% to 100%. The accuracy rates range from 61% to 94% in neuroimaging studies. Possible factors contributing to this inconsistency may be partially due to the heterogeneity of ASD, different targeted populations (i.e., high-risk group for ASD and general population), age when the features were collected, and validation procedures. The translation to clinical practice requires extensive further research including external validation with large sample size and optimized feature selection. The use of multi-modal features, e.g., combination of neuroimaging and behavior, is worth further investigation to improve the prediction accuracy.

The Autism Biomarkers Consortium for Clinical Trials (ABC-CT): Scientific Context, Study Design, and Progress Toward Biomarker Qualification

Clinical research in neurodevelopmental disorders remains reliant upon clinician and caregiver measures. Limitations of these approaches indicate a need for objective, quantitative, and reliable biomarkers to advance clinical research. Extant research suggests the potential utility of multiple candidate biomarkers; however, effective application of these markers in trials requires additional understanding of replicability, individual differences, and intra-individual stability over time. The Autism Biomarkers Consortium for Clinical Trials (ABC-CT) is a multi-site study designed to investigate a battery of electrophysiological (EEG) and eye-tracking (ET) indices as candidate biomarkers for autism spectrum disorder (ASD). The study complements published biomarker research through: inclusion of large, deeply phenotyped cohorts of children with ASD and typical development; a longitudinal design; a focus on well-evidenced candidate biomarkers harmonized with an independent sample; high levels of clinical, regulatory, technical, and statistical rigor; adoption of a governance structure incorporating diverse expertise in the ASD biomarker discovery and qualification process; prioritization of open science, including creation of a repository containing biomarker, clinical, and genetic data; and use of economical and scalable technologies that are applicable in developmental populations and those with special needs. The ABC-CT approach has yielded encouraging results, with one measure accepted into the FDA’s Biomarker Qualification Program to date. Through these advances, the ABC-CT and other biomarker studies in progress hold promise to deliver novel tools to improve clinical trials research in ASD.

"Motion or Emotion? Recognition of Emotional Bodily Expressions in Children With Autism Spectrum Disorder With and Without Intellectual Disability"

The recognition of emotional body movement (BM) is impaired in individuals with Autistic Spectrum Disorder ASD, yet it is not clear whether the difficulty is related to the encoding of body motion, emotions, or both. Besides, BM recognition has been traditionally studied using point-light displays stimuli (PLDs) and is still underexplored in individuals with ASD and intellectual disability (ID). In the present study, we investigated the recognition of happy, fearful, and neutral BM in children with ASD with and without ID. In a non-verbal recognition task, participants were asked to recognize pure-body-motion and visible-body-form stimuli (by means of point-light displays-PLDs and full-light displays-FLDs, respectively). We found that the children with ASD were less accurate than TD children in recognizing both the emotional and neutral BM, either when presented as FLDs or PLDs. These results suggest that the difficulty in understanding the observed BM may rely on atypical processing of BM information rather than emotion. Moreover, we found that the accuracy improved with age and IQ only in children with ASD without ID, suggesting that high level of cognitive resources can mediate the acquisition of compensatory mechanisms which develop with age.

Anomalous Perception of Biological Motion in Autism: A Conceptual Review and Meta-Analysis

Despite its popularity, the construct of biological motion (BM) and its putative anomalies in autism spectrum disorder (ASD) are not completely clarified. In this article, we present a meta-analysis investigating the putative anomalies of BM perception in ASD. Through a systematic literature search, we found 30 studies that investigated BM perception in both ASD and typical developing peers by using point-light display stimuli. A general meta-analysis including all these studies showed a moderate deficit of individuals with ASD in BM processing, but also a high heterogeneity. This heterogeneity was explored in different additional meta-analyses where studies were grouped according to levels of complexity of the BM task employed (first-order, direct and instrumental), and according to the manipulation of low-level perceptual features (spatial vs. temporal) of the control stimuli. Results suggest that the most severe deficit in ASD is evident when perception of BM is serving a secondary purpose (e.g., inferring intentionality/action/emotion) and, interestingly, that temporal dynamics of stimuli are an important factor in determining BM processing anomalies in ASD. Our results question the traditional understanding of BM anomalies in ASD as a monolithic deficit and suggest a paradigm shift that deconstructs BM into distinct levels of processing and specific spatio-temporal subcomponents.

The two-process theory of biological motion processing

Perception, identification, and understanding of others' actions from motion information are vital for our survival in the social world. A breakthrough in the understanding of action perception was the discovery that our visual system is sensitive to human action from the sparse motion input of only a dozen point lights, a phenomenon known as biological motion (BM) processing. Previous psychological and computational models cannot fully explain the emerging evidence for the existence of BM processing during early ontogeny. Here, we propose a two-process model of the mechanisms underlying BM processing. We hypothesize that the first system, the 'Step Detector,' rapidly processes the local foot motion and feet-below-the-body information that is specific to vertebrates, is less dependent on postnatal learning, and involves subcortical networks. The second system, the 'Bodily Action Evaluator,' slowly processes the fine global structure-from-motion, is specific to conspecific, and dependent on gradual learning processed in cortical networks. This proposed model provides new insight into research on the development of BM processing.

Adults with autism are less proficient in identifying biological motion actions portrayed with point-light displays

BACKGROUND

Whether individuals with autism spectrum disorder (ASD) have impairments with biological motion perception has been debated. The present study examined the ability to identify point-light-displayed (PLD) human actions in neurotypical (NT) adults and adults with ASD.

METHOD

Twenty-seven adults with ASD (mean age = 28.36) and 30 NT adults (mean age = 22.45) were tested. Both groups viewed 10 different biological motion actions contacting an object/tool and 10 without making contact. Each action was presented twice, and participant's naming responses and reaction times were recorded.

RESULTS

The ASD group had a significantly lower total number of correct items (M = 29.30 ± 5.08 out of 40) and longer response time (M = 4550 ± 1442 ms) than NT group (M = 32.77 ± 2.78; M = 3556 ± 1148 ms). Both groups were better at naming the actions without objects (ASD group: 17.33 ± 2.30, NT group: 18.67 ± 1.30) than those with objects (ASD group: 11.96 ± 3.57, NT group: 14.10 ± 1.97). Correlation analyses showed that individuals with higher Autism-spectrum Quotient scale scores tended to make more errors and responded more slowly.

CONCLUSION

Adults with ASD were able to identify human point-light display biological motion actions much better than chance; however, they were less proficient compared with NT adults in terms of accuracy and speed, regardless of action type.

Biological motion perception is differentially predicted by Autistic trait domains

We tested the relationship between biological motion perception and the Autism-Spectrum Quotient. In three experiments, we indexed observers' performance on a classic left-right discrimination task in which participants were asked to report the facing direction of walkers containing solely structural or kinematics information, a motion discrimination task in which participants were asked to indicate the apparent motion of a (non-biological) random-dot stimulus, and a novel naturalness discrimination task. In the naturalness discrimination task, we systematically manipulated the degree of natural acceleration contained in the stimulus by parametrically morphing between a fully veridical stimulus and one where acceleration was removed. Participants were asked to discriminate the more natural stimulus (i.e., acceleration-containing stimulus) from the constant velocity stimulus. Although we found no reliable associations between overall AQ scores nor subdomain scores with performance on the direction-related tasks, we found a robust association between performance on the biological motion naturalness task and attention switching domain scores. Our findings suggest that understanding the relationship between the Autism Spectrum and perception is a far more intricate problem than previously suggested. While it has been shown that the AQ can be used as a proxy to tap into perceptual endophenotypes in Autism, the eventual diagnostic value of the perceptual task depends on the task's consideration of biological content and demands.

Understanding facial expressivity in autism spectrum disorder: An inside out review of the biological basis and clinical implications

Deficits in decoding and understanding facially expressed emotions occur commonly in persons with autism spectrum disorder (ASD), which contribute to the impairment of social communication that serves as one of its core diagnostic criteria. Research suggests that abnormalities of visual scanning of the face, activation of key nodes within the "social brain" by facially expressed emotions, functional connectivity within and between nodes of the "social brain", and transduction of specific neurotransmitter/neuromodulatory signals contribute to the pathogenesis of these deficits in at least some persons with ASD. Importantly, the etiologies of these deficits are heterogeneous and include genetic, immunologic, and inflammatory mechanisms, as well as in utero exposures to drugs and toxins. The manifestation and severity of these deficits can also be influenced by developmental age, IQ and genetic background. Consistent with the goals of the Special Issue, the current Review is intended to familiarize the readership with several of the leading neurobiological mechanisms proposed to underlie these deficits in decoding facially expressed emotions and stimulate interest in translational preclinical and clinical investigations, whose ultimate purpose is to attenuate their severity and, thereby, improve functional outcomes of persons with ASD.

Development and Validation of Objective and Quantitative Eye Tracking-Based Measures of Autism Risk and Symptom Levels

OBJECTIVE

The primary aim of this study was to develop and validate eye tracking-based measures for estimating autism spectrum disorder (ASD) risk and quantifying autism symptom levels.

METHOD

Eye tracking data were collected from youth during an initial evaluation visit, with administrators blinded to all clinical information. Consensus diagnoses were given by the multidisciplinary team. Participants viewed a 5-minute video that included 44 dynamic stimuli from 7 distinct paradigms while gaze was recorded. Gaze metrics were computed for temporally defined regions of interest. Autism risk and symptom indices aggregated gaze measures showing significant bivariate relationships with ASD diagnosis and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) symptom severity levels in a training sample (75%, n = 150). Receiver operating characteristic curve analysis and nonparametric correlations were used to cross-validate findings in a test sample (25%; n = 51).

RESULTS

Most children (n = 201, 92%) completed a valid eye tracking assessment (ages 1.6─17.6; 80% male; ASD n = 91, non-ASD n = 110). In the test subsample, the autism risk index had high accuracy for ASD diagnosis (area under the curve [AUC] = 0.86, 95% CI =0.75-0.95), whereas the autism symptom index was strongly associated with ADOS-2 total severity scores (r = 0.41, p < .001). Validity was not substantively attenuated after adjustment for language, nonverbal cognitive ability, or other psychopathology symptoms (r = 0.40-0.67, p > .001).

CONCLUSION

Eye tracking measures appear to be useful quantitative, objective measures of ASD risk and autism symptom levels. If independently replicated and scaled for clinical use, eye tracking-based measures could be used to inform clinical judgment regarding ASD identification and to track autism symptom levels.

Social Skills Deficits in Autism Spectrum Disorder: Potential Biological Origins and Progress in Developing Therapeutic Agents

Autism spectrum disorder is defined by two core symptoms: a deficit in social communication and the presence of repetitive behaviors and/or restricted interests. Currently, there is no US Food and Drug Administration-approved drug for these core symptoms. This article reviews the biological origins of the social function deficit associated with autism spectrum disorder and the drug therapies with the potential to treat this deficit. A review of the history of autism demonstrates that a deficit in social interaction has been the defining feature of the concept of autism from its conception. Abnormalities identified in early social skill development and an overview of the pathophysiology abnormalities associated with autism spectrum disorder are discussed as are the abnormalities in brain circuits associated with the social function deficit. Previous and ongoing clinical trials examining agents that have the potential to improve social deficits associated with autism spectrum disorder are discussed in detail. This discussion reveals that agents such as oxytocin and propranolol are particularly promising and undergoing active investigation, while other agents such as vasopressin agonists and antagonists are being activity investigated but have limited published evidence at this time. In addition, agents such as bumetanide and manipulation of the enteric microbiome using microbiota transfer therapy appear to have promising effects on core autism spectrum disorder symptoms including social function. Other pertinent issues associated with developing treatments in autism spectrum disorder, such as disease heterogeneity, high placebo response rates, trial design, and the most appropriate way of assessing effects on social skills (outcome measures), are also discussed.

Auditory noise increases the allocation of attention to the mouth, and the eyes pay the price: An eye-tracking study

We investigated the effect of auditory noise added to speech on patterns of looking at faces in 40 toddlers. We hypothesised that noise would increase the difficulty of processing speech, making children allocate more attention to the mouth of the speaker to gain visual speech cues from mouth movements. We also hypothesised that this shift would cause a decrease in fixation time to the eyes, potentially decreasing the ability to monitor gaze. We found that adding noise increased the number of fixations to the mouth area, at the price of a decreased number of fixations to the eyes. Thus, to our knowledge, this is the first study demonstrating a mouth-eyes trade-off between attention allocated to social cues coming from the eyes and linguistic cues coming from the mouth. We also found that children with higher word recognition proficiency and higher average pupil response had an increased likelihood of fixating the mouth, compared to the eyes and the rest of the screen, indicating stronger motivation to decode the speech.

A Longitudinal Investigation of Preferential Attention to Biological Motion in 2- to 24-Month-Old Infants

Preferential attention to biological motion is an early-emerging mechanism of adaptive action that plays a critical role in social development. The present study provides a comprehensive longitudinal mapping of developmental change in preferential attention to biological motion in 116 infants at 7 longitudinal time points. Tested repeatedly from 2 until 24 months of age, results reveal that preferential attention to biological motion changes considerably during the first months of life. Previously reported preferences in both neonates and older infants are absent in the second month but do reemerge by month 3 and become increasingly pronounced during the subsequent two years. These results highlight the second month of life as a potentially critical transition period in social visual engagement.

Heritable aspects of biological motion perception and its covariation with autistic traits

The ability to detect biological motion (BM) and decipher the meaning therein is essential to human survival and social interaction. However, at the individual level, we are not equally equipped with this ability. In particular, impaired BM perception and abnormal neural responses to BM have been observed in autism spectrum disorder (ASD), a highly heritable neurodevelopmental disorder characterized by devastating social deficits. Here, we examined the underlying sources of individual differences in two abilities fundamental to BM perception (i.e., the abilities to process local kinematic and global configurational information of BM) and explored whether BM perception shares a common genetic origin with autistic traits. Using the classical twin method, we found reliable genetic influences on BM perception and revealed a clear dissociation between its two components-whereas genes account for about 50% of the individual variation in local BM processing, global BM processing is largely shaped by environment. Critically, participants' sensitivity to local BM cues was negatively correlated with their autistic traits through the dimension of social communication, with the covariation largely mediated by shared genetic effects. These findings demonstrate that the ability to process BM, especially with regard to its inherent kinetics, is heritable. They also advance our understanding of the sources of the linkage between autistic symptoms and BM perception deficits, opening up the possibility of treating the ability to process local BM information as a distinct hallmark of social cognition.

Social motivation and implicit theory of mind in children with autism spectrum disorder

According to the social motivation theory of autism, children who develop Autism Spectrum Disorder (ASD) have early deficits in social motivation, which is expressed by decreased attention to social information. These deficits are said to lead to impaired socio-cognitive development, such as theory of mind (ToM). There is little research focused on the relation between social motivation and ToM in this population. The goal of the present study was to investigate the link between one aspect of social motivation, social orienting, and ToM in preschoolers with ASD. It was expected that, in contrast to typically developing (TD) children, children with ASD would show impaired performance on tasks measuring social orienting and ToM. It was also expected that children's performance on the social orienting tasks would be correlated with their performance on the ToM task. A total of 17 children with ASD and 16 TD children participated in this study. Participants completed two social orienting tasks, a face preference task and a biological motion preference task, as well an implicit false belief task. Results reveal that TD children, but not children with ASD, exhibited social preference as measured by a preference for faces and biological motion. Furthermore, children with ASD tended to perform worse on the ToM task compared to their TD counterparts. Performance on the social motivation tasks and the ToM task tended to be related but only for the TD children. These findings suggest that ToM is multifaceted and that motivational deficits might have downstream effects even on implicit ToM. Autism Res 2017, 10: 1834-1844. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

The goal of the present study was to examine the link between poor attention to social information and mindreading abilities in children with autism spectrum disorder (ASD). Results demonstrated that children with ASD tended to perform worse than neurotypical children on both social orienting and theory of mind tasks. Preference for human faces and motion tended to be related but only for the neurotypical children. These findings provide partial support for the social motivation theory.

[Exploring joint attention processes in young children with autism spectrum disorder]

OBJECTIVES

Symptoms in autism, a neurodevelopmental disorder, appear at an early age. Research consensus shows impairments in communication and especially joint attention, defined as the capacity to intentionally share attention between two persons or a person and an object. Recent studies in autism spectrum disorder (ASD) focus on infants' processes associated to joint attention, such as visual and auditive regulation, attentional engagement and social motivation. The present research's objective is to examine the role of these factors in joint attention.

METHODS

A group of 50 children with ASD, aged 21 to 50 months, were selected. They went through a clinical assessment which included evaluations of development and symptoms, a scale measuring auditive and visual regulation; a grid elaborated to quantify motivation behavior towards a person and an object in two different engagement states: alone or with an adult and finally a measure of the child's capacity to disengage from an object. A joint attention score was obtained with the Early Communication Scale for Children (ECSC). Results show: (1) an effect of visual regulation on joint attention, (2) a relation between visual regulation and joint attention partially mediated by motivation. Our results clarify the nature of the relationship between visual regulation and joint attention, with motivation modulating visual regulation in its relation to joint attention, (3) a relation between attentional disengagement and joint attention. Visual regulation, social and non-social motivation and attentional disengagement are all associated to joint attention. A clinical measure of motivation behaviors for children with ASD has been created and can be applied in clinical settings, as it is adapted to young children with ASD symptomatology and enriches diagnosis.

CONCLUSIONS

Statistical analyses of our clinical observations suggest a mediation model highlighting the influence of motivation in the mechanisms underlying joint attention. The measurement of processes and mechanisms associated with social communicative skills at a very early age, here motivation and attentional disengagement processes associated with joint attention, help include these factors in early intervention programs.

Social Orienting and Attention Is Influenced by the Presence of Competing Nonsocial Information in Adolescents with Autism

Background: Our experiences with the world play a critical role in neural and behavioral development. Children with autism spectrum disorder (ASD) spend a disproportionate amount of time seeking out, attending to, and engaging with aspects of their environment that are largely nonsocial in nature. In this study we adapted an established method for eliciting and quantifying aspects of visual choice behavior related to preference to test the hypothesis that preference for nonsocial sources of stimulation diminishes orientation and attention to social sources of stimulation in children with ASD. Method: Preferential viewing tasks can serve as objective measures of preference, with a greater proportion of viewing time to one item indicative of increased preference. The current task used gaze-tracking technology to examine patterns of visual orientation and attention to stimulus pairs that varied in social (faces) and nonsocial content (high autism interest or low autism interest). Participants included both adolescents diagnosed with ASD and typically developing; groups were matched on IQ and gender. Results: Repeated measures ANOVA revealed that individuals with ASD had a significantly greater latency to first fixate on social images when this image was paired with a high autism interest image, compared to a low autism interest image pairing. Participants with ASD showed greater total look time to objects, while typically developing participants preferred to look at faces. Groups also differed in number and average duration of fixations to social and object images. In the ASD group only, a measure of nonsocial interest was associated with reduced preference for social images when paired with high autism interest images. Conclusions: In ASD, the presence of nonsocial sources of stimulation can significantly increase the latency of look time to social sources of information. These results suggest that atypicalities in social motivation in ASD may be context-dependent, with a greater degree of plasticity than is assumed by existing social motivation accounts of ASD.

Early Predictors of Impaired Social Functioning in Male Rhesus Macaques (Macaca mulatta)

Autism spectrum disorder (ASD) is characterized by social cognition impairments but its basic disease mechanisms remain poorly understood. Progress has been impeded by the absence of animal models that manifest behavioral phenotypes relevant to ASD. Rhesus monkeys are an ideal model organism to address this barrier to progress. Like humans, rhesus monkeys are highly social, possess complex social cognition abilities, and exhibit pronounced individual differences in social functioning. Moreover, we have previously shown that Low-Social (LS) vs. High-Social (HS) adult male monkeys exhibit lower social motivation and poorer social skills. It is not known, however, when these social deficits first emerge. The goals of this study were to test whether juvenile LS and HS monkeys differed as infants in their ability to process social information, and whether infant social abilities predicted later social classification (i.e., LS vs. HS), in order to facilitate earlier identification of monkeys at risk for poor social outcomes. Social classification was determined for N = 25 LS and N = 25 HS male monkeys that were 1-4 years of age. As part of a colony-wide assessment, these monkeys had previously undergone, as infants, tests of face recognition memory and the ability to respond appropriately to conspecific social signals. Monkeys later identified as LS vs. HS showed impairments in recognizing familiar vs. novel faces and in the species-typical adaptive ability to gaze avert to scenes of conspecific aggression. Additionally, multivariate logistic regression using infant social ability measures perfectly predicted later social classification of all N = 50 monkeys. These findings suggest that an early capacity to process important social information may account for differences in rhesus monkeys' motivation and competence to establish and maintain social relationships later in life. Further development of this model will facilitate identification of novel biological targets for intervention to improve social outcomes in at-risk young monkeys.

The Structure of Social Cognition: In(ter)dependence of Sociocognitive Processes

Social cognition is a topic of enormous interest and much research, but we are far from having an agreed taxonomy or factor structure of relevant processes. The aim of this review is to outline briefly what is known about the structure of social cognition and to suggest how further progress can be made to delineate the in(ter)dependence of core sociocognitive processes. We focus in particular on several processes that have been discussed and tested together in typical and atypical (notably autism spectrum disorder) groups: imitation, biological motion, empathy, and theory of mind. We consider the domain specificity/generality of core processes in social learning, reward, and attention, and we highlight the potential relevance of dual-process theories that distinguish systems for fast/automatic and slow/effortful processing. We conclude with methodological and conceptual suggestions for future progress in uncovering the structure of social cognition.

Characterization of the Statistical Signatures of Micro-Movements Underlying Natural Gait Patterns in Children with Phelan McDermid Syndrome: Towards Precision-Phenotyping of Behavior in ASD

Background: There is a critical need for precision phenotyping across neurodevelopmental disorders, especially in individuals who receive a clinical diagnosis of autism spectrum disorder (ASD). Phelan-McDermid deletion syndrome (PMS) is one such example, as it has a high penetrance of ASD. At present, no biometric characterization of the behavioral phenotype within PMS exists.

Methods: We introduce a data-type and statistical framework that permits the personalized profiling of naturalistic behaviors. Walking patterns were assessed in 30 participants (16 PMS, 3 idiopathic-ASD and 11 age- and sex-matched controls). Each individual's micro-movement signatures were recorded at 240 Hz. We empirically estimated the parameters of the continuous Gamma family of probability distributions and calculated their ranges. These estimated stochastic signatures were then mapped on the Gamma plane to obtain several statistical indexes for each child. To help visualize complex patterns across the cohort, we introduce new tools that enable the assessment of connectivity and modularity indexes across the peripheral network of rotational joints.

Results: Typical walking signatures are absent in all children with PMS as well as in the children with idiopathic-ASD (iASD). Underlying these patterns are atypical leg rotational acceleration signatures that render participants with PMS unstable with rotations that are much faster than controls. The median values of the estimated Gamma parameters serve as a cutoff to automatically separate children with PMS 5–7 years old from adolescents with PMS 12–16 years old, the former displaying more randomness and larger noise. The fluctuations in the arm's motions during the walking also have atypical statistics that separate males from females in PMS and show higher rates of noise accumulation in idiopathic ASD (iASD) children. Despite high heterogeneity, all iASD children have excess noise, a narrow range of probability-distribution shapes across the body joints and a distinct joint network connectivity pattern. Both PMS and iASD have systemic issues with noise in micro-motions across the body with specific signatures for each child that, as a cohort, selectively deviates from controls.

Conclusions: We provide a new methodology for precision behavioral phenotyping with the potential to use micro-movement output noise as a natural classifier of neurodevelopmental disorders of known etiology. This approach may help us better understand idiopathic neurodevelopmental disorders and personalize the assessments of natural movements in these populations.

Early standard development assessment characteristics in very low birth weight infants later classified with autism spectrum disorder

BACKGROUND

The prevalence of autism spectrum disorder (ASD) symptoms is high among very low birth weight infants (VLBWIs). Early diagnosis of ASD is crucial, because early intervention for ASD is effective.

OBJECTIVE

To evaluate early standard development assessment characteristics in VLBWIs later classified with ASD.

METHODS

Thirty-five VLBWIs later diagnosed with ASD were compared with 169 children with typical development who were admitted to the neonatal intensive care unit at Nagano Children's Hospital between 2001 and 2005. We retrospectively evaluated developmental quotient (DQ) using the Kyoto Scale of Psychological Development (KSPD) at 6 and 18months post-term age (PTA) and 3year chronological age.

RESULTS

KSPD DQ was significantly lower in ASD infants than in typical development infants at all ages. Postural-motor DQs of ASD infants at 18months PTA and 3year chronological age showed some increase compared to that at 6months PTA.

CONCLUSION

Early recognition of ASD using standardized development assessment tools in VLBWIs might be possible.

Social visual engagement in infants and toddlers with autism: early developmental transitions and a model of pathogenesis

Efforts to determine and understand the causes of autism are currently hampered by a large disconnect between recent molecular genetics findings that are associated with the condition and the core behavioral symptoms that define the condition. In this perspective piece, we propose a systems biology framework to bridge that gap between genes and symptoms. The framework focuses on basic mechanisms of socialization that are highly-conserved in evolution and are early-emerging in development. By conceiving of these basic mechanisms of socialization as quantitative endophenotypes, we hope to connect genes and behavior in autism through integrative studies of neurodevelopmental, behavioral, and epigenetic changes. These changes both lead to and are led by the accomplishment of specific social adaptive tasks in a typical infant's life. However, based on recent research that indicates that infants later diagnosed with autism fail to accomplish at least some of these tasks, we suggest that a narrow developmental period, spanning critical transitions from reflexive, subcortically-controlled visual behavior to interactional, cortically-controlled and social visual behavior be prioritized for future study. Mapping epigenetic, neural, and behavioral changes that both drive and are driven by these early transitions may shed a bright light on the pathogenesis of autism.

Do individuals with autism spectrum disorder process own- and other-race faces differently?

Individuals with autism spectrum disorder (ASD) process human faces in atypical ways according to previous literature. We investigated whether individuals with ASD can process face race information and respond to own- and other-race faces differentially. Chinese individuals with ASD (n=24), typically developing (TD) individuals (n=28), and individuals with intellectual disabilities (ID, n=26) were asked to recognize Chinese and Caucasian faces in an old-new face paradigm using eye tracking. In terms of recognition, the ASD and ID groups did not perform differently and displayed superior own-race recognition compared with other-race faces; TD participants displayed similar recognition of the two types of faces. In terms of eye tracking, the TD, ASD, and ID groups displayed more looking on the eyes and less looking on the nose and mouth of Caucasian faces relative to Chinese faces. Overall, individuals with ASD manifested a behavioral other-race effect and displayed the same type of cross-racial differentiation in face scanning observed in TD individuals. The findings suggest that as is the case with TD individuals, face processing of individuals with ASD is influenced by differences in visual experience with different face categories.

Schematic and realistic biological motion identification in children with high-functioning autism spectrum disorder

Research investigating biological motion perception in children with ASD has revealed conflicting findings concerning whether impairments in biological motion perception exist. The current study investigated how children with high-functioning ASD (HF-ASD) performed on two tasks of biological motion identification: a novel schematic motion identification task and a point-light biological motion identification task. Twenty-two HFASD children were matched with 21 TD children on gender, non-verbal mental, and chronological, age (M years = 6.72). On both tasks, HF-ASD children performed with similar accuracy as TD children. Across groups, children performed better on animate than on inanimate trials of both tasks. These findings suggest that HF-ASD children's identification of both realistic and schematic biological motion identification is unimpaired.

From early markers to neuro-developmental mechanisms of autism

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Studies of infants at-risk could reveal the developmental origin of autism.

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Behavioral and brain markers differentiate infants that develop autism symptoms from controls, during the first year of life.

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Little evidence for decreased social orienting or social motivation.

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Some evidence for multiple developmental pathways to autism.

A fast growing field, the study of infants at risk because of having an older sibling with autism (i.e. infant sibs) aims to identify the earliest signs of this disorder, which would allow for earlier diagnosis and intervention. More importantly, we argue, these studies offer the opportunity to validate existing neuro-developmental models of autism against experimental evidence. Although autism is mainly seen as a disorder of social interaction and communication, emerging early markers do not exclusively reflect impairments of the “social brain”. Evidence for atypical development of sensory and attentional systems highlight the need to move away from localized deficits to models suggesting brain-wide involvement in autism pathology. We discuss the implications infant sibs findings have for future work into the biology of autism and the development of interventions.

Effect of propranolol on facial scanning in autism spectrum disorder: a preliminary investigation

BACKGROUND

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication impairments and restricted, repetitive behaviors. Whereas current pharmacological interventions for ASD focus primarily on psychiatric symptoms, including agitation and obsessive behaviors, few agents target core symptomatology. It has been previously hypothesized that abnormalities in facial scanning, such as reduced eye contact or increased mouth fixation, contribute to social communication deficits in ASD. In addition, previous reports have suggested elevated stress and anxiety in ASD, symptoms that are believed to impact facial scanning patterns.

OBJECTIVES

The present pilot study sought to explore the effects of pharmacological intervention via propranolol, a nonselective β-adrenergic antagonist and known anxiolytic, on facial scanning in ASD. Specifically, we wished to determine whether there is an increase in eye contact and a decrease in mouth fixation with administration of propranolol.

METHOD

A sample of 14 participants with ASD and 14 matched controls participated in two study sessions in which propranolol and placebo were administered in a counterbalanced, double-blinded manner. At each session, ocular fixation data were collected during presentation of video stimuli of 16 human faces. Fixation time on the eye, nose, and mouth regions of the face stimuli was analyzed.

RESULTS

The baseline fixation patterns for the ASD and control groups did not significantly differ; however, administration of propranolol was associated with a significant reduction in mouth fixation for the ASD group. Additionally, mouth fixation was positively related to nonverbal communication impairment in the ASD group.

CONCLUSIONS

Although eye fixation in ASD appears typical in the present study, the effect of propranolol in reducing mouth fixation suggests an important focus for further research. Future studies are needed to better characterize the relationship between stress and anxiety and facial scanning in ASD, as well as the effects of pharmacological intervention.

Disinhibited reactive attachment disorder symptoms impair social judgements from faces

Typically developing adults and children can rapidly reach consensus regarding the trustworthiness of unfamiliar faces. Maltreated children can have problems with trusting others, yet those with the disinhibited form of reactive attachment disorder (dRAD) can be indiscriminately friendly. Whether children with dRAD symptoms appraise and conform to typical judgements about trustworthiness of faces is still unknown. We recorded eye movements of 10 maltreated dRAD children and 10 age and gender matched typically developing control children while they made social judgements from faces. Children were presented with a series of pairs of faces previously judged by adults to have high or low attractiveness or trustworthiness ratings. Typically developing children reached a consensus regarding which faces were the most trustworthy and attractive. There was less agreement among the children with dRAD symptoms. Judgments from the typically developing children showed a strong correlation between the attractiveness and trustworthiness tasks. This was not the case for the dRAD group, who showed less agreement and no significant correlation between trustworthiness and attractiveness judgments. Finally, both groups of children sampled the eye region to perform social judgments. Our data offer a unique insight in children with dRAD symptoms, providing novel and important knowledge for their rehabilitation.

Interactions between concentric form-from-structure and face perception revealed by visual masking but not adaptation

Findings from diverse subfields of vision research suggest a potential link between high-level aspects of face perception and concentric form-from-structure perception. To explore this relationship, typical adults performed two adaptation experiments and two masking experiments to test whether concentric, but not nonconcentric, Glass patterns (a type of form-from-structure stimulus) utilize a processing mechanism shared by face perception. For the adaptation experiments, subjects were presented with an adaptor for 5 or 20 s, prior to discriminating a target. In the masking experiments, subjects saw a mask, then a target, and then a second mask. Measures of discriminability and bias were derived and repeated measures analysis of variance tested for pattern-specific masking and adaptation effects. Results from Experiment 1 show no Glass pattern-specific effect of adaptation to faces; results from Experiment 2 show concentric Glass pattern masking, but not adaptation, may impair upright/inverted face discrimination; results from Experiment 3 show concentric and radial Glass pattern masking impaired subsequent upright/inverted face discrimination more than translational Glass pattern masking; and results from Experiment 4 show concentric and radial Glass pattern masking impaired subsequent face gender discrimination more than translational Glass pattern masking. Taken together, these findings demonstrate interactions between concentric form-from-structure and face processing, suggesting a possible common processing pathway.