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Camero R, Gallego C, Martínez V. Gaze Following as an Early Diagnostic Marker of Autism in a New Word Learning Task in Toddlers. J Autism Dev Disord 2024; 54:3211-3224. [PMID: 37410255 PMCID: PMC11362356 DOI: 10.1007/s10803-023-06043-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/07/2023]
Abstract
The aim was to test the use of eye-tracking methodology for the early detection of ASD in a task of association between unfamiliar objects and pseudowords. Significant differences were found between ASD (n = 57) and TD (n = 57) Spanish speaking toddlers in the number and time of fixation. The TD children showed more and longer fixations on eyes and mouth while the ASD children attended almost exclusively to objects, making it difficult to integrate lexical and phonological information. Moreover, the TD toddlers looked at the mouth when the pseudoword was produced while the ASD toddlers did not. Gaze fixation on eyes and mouth during word learning recorded by eye-tracking may be used as a biomarker for the early diagnosis of ASD.
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Affiliation(s)
- Raquel Camero
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Asturias, Spain
| | - Carlos Gallego
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, University of Complutense of Madrid, Campus de Somosaguas, Pozuelo de Alarcón, 28223, Madrid, Spain
| | - Verónica Martínez
- Department of Psychology, University of Oviedo, Plaza Feijóo s/n, 33003, Oviedo, Asturias, Spain.
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Tepencelik ON, Wei W, Luo M, Cosman P, Dey S. Behavioral Intervention for Adults With Autism on Distribution of Attention in Triadic Conversations: A/B-Tested Pre-Post Study. JMIR Form Res 2024; 8:e55339. [PMID: 39133914 PMCID: PMC11347890 DOI: 10.2196/55339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 04/17/2024] [Accepted: 05/27/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Cross-neurotype differences in social communication patterns contribute to high unemployment rates among adults with autism. Adults with autism can be unsuccessful in job searches or terminated from employment due to mismatches between their social attention behaviors and society's expectations on workplace communication. OBJECTIVE We propose a behavioral intervention concerning distribution of attention in triadic (three-way) conversations. Specifically, the objective is to determine whether providing personalized feedback to each individual with autism based on an analysis of their attention distribution behavior during an initial conversation session would cause them to modify their orientation behavior in a subsequent conversation session. METHODS Our system uses an unobtrusive head orientation estimation model to track the focus of attention of each individual. Head orientation sequences from a conversation session are analyzed based on five statistical domains (eg, maximum exclusion duration and average contact duration) representing different types of attention distribution behavior. An intervention is provided to a participant if they exceeded the nonautistic average for that behavior by at least 2 SDs. The intervention uses data analysis and video modeling along with a constructive discussion about the targeted behaviors. Twenty-four individuals with autism with no intellectual disabilities participated in the study. The participants were divided into test and control groups of 12 participants each. RESULTS Based on their attention distribution behavior in the initial conversation session, 11 of the 12 participants in the test group received an intervention in at least one domain. Of the 11 participants who received the intervention, 10 showed improvement in at least one domain on which they received feedback. Independent t tests for larger test groups (df>15) confirmed that the group improvements are statistically significant compared with the corresponding controls (P<.05). Crawford-Howell t tests confirmed that 78% of the interventions resulted in significant improvements when compared individually against corresponding controls (P<.05). Additional t tests comparing the first conversation sessions of the test and control groups and comparing the first and second conversation sessions of the control group resulted in nonsignificant differences, pointing to the intervention being the main effect behind the behavioral changes displayed by the test group, as opposed to confounding effects or group differences. CONCLUSIONS Our proposed behavioral intervention offers a useful framework for practicing social attention behavior in multiparty conversations that are common in social and professional settings.
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Affiliation(s)
- Onur Necip Tepencelik
- Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, United States
| | - Wenchuan Wei
- Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, United States
| | - Mirabel Luo
- Carlsbad High School, Carlsbad, CA, United States
| | - Pamela Cosman
- Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, United States
| | - Sujit Dey
- Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, United States
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3
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Wong CM, Tan CS, Riard N, Padmini YS, Daniel LM, Prasath A, Tan AM, Tan TC, Sultana R, Lam JCM. Autologous umbilical cord blood infusion for the treatment of autism in young children: A within-subjects open label study on safety (assessed via caregiver report) and efficacy. Autism Res 2024; 17:1721-1734. [PMID: 38943428 DOI: 10.1002/aur.3187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/29/2024] [Indexed: 07/01/2024]
Abstract
This study aimed to document the safety and efficacy of a single infusion of autologous umbilical cord blood (UCB) in 20 autistic children aged 24-72 months. A pre-post treatment within-subjects open label design was used. At T = 0, 6, 12, and 18 months, participants underwent detailed and structured safety evaluations (via caregiver report), Vineland Adaptive Behavior Scale (Vineland-3), Stanford Binet Intelligence Scale (SB-5), Expressive One-Word Picture Vocabulary Test, Brief Observation of Social Communication Change (BOSCC), Pervasive Developmental Disorder-Behavior Inventory, Repetitive Behavior Scale-Revised, Sensory Experience Questionnaire (SEQ-2.1), Child Behavior Checklist, Clinical Global Impression-Severity and Improvement (CGI-I) Scales, and eye-gaze tracking. UCB infusion was conducted at T = 6 months, hence, 0-6 months was the control period, and 6-18 months the follow-up period. Of 20 children recruited, 19 completed the study and 1 was withdrawn due to UCB not meeting quality control criteria for infusion. There were 15 males and 4 females with an overall mean (SD) age of 4.15 (0.62) years. Mean (SD) cell dose administered was 38.16 (9.82) million cells/kg. None suffered serious adverse events although there were mild behavioral side effects and one unit grew coagulase negative staphylococcus from a post-thaw sample. There were no significant differences in Vineland-3, SB-5, BOSCC, and SEQ-2.1 scores at T = 12 and T = 18 months. Twelve participants had T = 18 CGI-I scores of 2-3 (minimally to much improved), seven participants had scores of 4 (no change). Autologous UCB infusion in autistic children is generally safe but not without risks, including that of infection. In this within-subjects study, some children showed global symptom improvements while others showed no change. Stem cell therapies for autism should only be conducted under strict clinical trial conditions with clear risk discussions.
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Affiliation(s)
- Chui Mae Wong
- Department of Child Development, KK Women's and Children's Hospital (KKH), Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | - Charmain Samantha Tan
- Department of Child Development, KK Women's and Children's Hospital (KKH), Singapore
| | - Natasha Riard
- Department of Child Development, KK Women's and Children's Hospital (KKH), Singapore
| | - Yeleswarapu Sita Padmini
- Department of Child Development, KK Women's and Children's Hospital (KKH), Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | - Lourdes Mary Daniel
- Department of Child Development, KK Women's and Children's Hospital (KKH), Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
| | | | - Ah Moy Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
- Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore
| | - Thiam Chye Tan
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
| | | | - Joyce Ching Mei Lam
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Singapore
- Children's Blood and Cancer Centre, KK Women's and Children's Hospital, Singapore
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4
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Bottema-Beutel K. Putting autism research in social contexts. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:1597-1601. [PMID: 38597134 DOI: 10.1177/13623613241245642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
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Vernetti A, Butler M, Banarjee C, Boxberger A, All K, Macari S, Chawarska K. Face-to-face live eye-tracking in toddlers with autism: Feasibility and impact of familiarity and face covering. Autism Res 2024; 17:1381-1390. [PMID: 38009948 DOI: 10.1002/aur.3060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
Studies utilizing eye-tracking methods have potential to promptly capture real-world dynamics of one of the core areas of vulnerability in autism spectrum disorders (ASD), selective social attention. So far, no studies have successfully reported utilizing the method to examine social attention in toddlers with neurodevelopmental vulnerabilities in real world and challenging settings such as an interactive face-to-face. This study examined the feasibility and validity of live eye-tracking method in response to live interaction occurring in several contexts in toddlers with and without ASD. Forty-seven toddlers with ASD, with atypical development (ATYP), or typically developing (TD), underwent a 30-s live eye-tracking procedure during a face-to-face interaction with a masked stranger using child-directed-speech (16 ASD, 14 ATYP, 17 TD; Mage = 23.44 months, SD = 6.02). Out of this group of toddlers, 29 (10 ASD, 8 ATYP, 11 TD, Mage = 21.97 months, SD = 5.76) underwent the same procedure with one of their maskless parent. Task completion rate, calibration accuracy, and affective response (feasibility measures) as well as attention to the task and the social partner (validity measures) were examined. Task completion rate and calibration accuracy were excellent. Despite the challenging context of face-to-face interaction, the toddlers exhibited a neutral affect, and high attention to the task and the speaker. As anticipated, toddlers with ASD looked less at the social partner compared with control groups. However, attention was comparable between the Stranger and Parent conditions, indicating that the effect was consistent regardless of presence of face covering or the familiarity of the interactive partner. The study demonstrates the high feasibility and validity of a live eye-tracking task involving face-to-face interaction in neurodiverse toddlers with social vulnerabilities. The effect of diminished attention to social partners in toddlers with autism is robust and present when interacting with an unfamiliar person and parent. The results suggest that a brief live eye-tracking method constitutes a promising ecologically valid candidate biomarker and potential intervention outcome in autism.
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Affiliation(s)
- Angelina Vernetti
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Maureen Butler
- Child Study Center, Northwestern University, Chicago, Illinois, USA
| | - Chitra Banarjee
- Child Study Center, University of Central Florida, Orlando, Florida, USA
| | - Alexandra Boxberger
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katherine All
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Suzanne Macari
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Ahn YA, Moffitt JM, Tao Y, Custode S, Parlade M, Beaumont A, Cardona S, Hale M, Durocher J, Alessandri M, Shyu ML, Perry LK, Messinger DS. Objective Measurement of Social Gaze and Smile Behaviors in Children with Suspected Autism Spectrum Disorder During Administration of the Autism Diagnostic Observation Schedule, 2nd Edition. J Autism Dev Disord 2024; 54:2124-2137. [PMID: 37103660 DOI: 10.1007/s10803-023-05990-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 04/28/2023]
Abstract
Best practice for the assessment of autism spectrum disorder (ASD) symptom severity relies on clinician ratings of the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2), but the association of these ratings with objective measures of children's social gaze and smiling is unknown. Sixty-six preschool-age children (49 boys, M = 39.97 months, SD = 10.58) with suspected ASD (61 confirmed ASD) were administered the ADOS-2 and provided social affect calibrated severity scores (SA CSS). Children's social gaze and smiling during the ADOS-2, captured with a camera contained in eyeglasses worn by the examiner and parent, were obtained via a computer vision processing pipeline. Children who gazed more at their parents (p = .04) and whose gaze at their parents involved more smiling (p = .02) received lower social affect severity scores, indicating fewer social affect symptoms, adjusted R2 = .15, p = .003.
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Affiliation(s)
- Yeojin A Ahn
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Yudong Tao
- Department of Electrical and Computer Engineering, University of Miami, Coral Gables, FL, USA
| | - Stephanie Custode
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Meaghan Parlade
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Amy Beaumont
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Sandra Cardona
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Melissa Hale
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Jennifer Durocher
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | | | - Mei-Ling Shyu
- Department of Electrical and Computer Engineering, University of Miami, Coral Gables, FL, USA
| | - Lynn K Perry
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Daniel S Messinger
- Department of Psychology, University of Miami, Coral Gables, FL, USA.
- Department of Electrical and Computer Engineering, University of Miami, Coral Gables, FL, USA.
- Departments of Pediatrics and Music Engineering, University of Miami, Coral Gables, FL, USA.
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., P.O. Box 248185, Coral Gables, FL, 33124, USA.
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7
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Falck-Ytter T. The breakdown of social looking. Neurosci Biobehav Rev 2024; 161:105689. [PMID: 38657844 DOI: 10.1016/j.neubiorev.2024.105689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/27/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Individual differences in social looking are commonly believed to reflect one single heritable dimension tightly linked to autism. Yet, recent data suggest that in human infants, looking to eyes (rather than mouth) and preference for faces (versus non-social objects) reflect distinct genetic influences, and neither appear to have a clear-cut relation to autism.
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Affiliation(s)
- Terje Falck-Ytter
- Development and Neurodiversity Lab, Department of Psychology, Uppsala University, Uppsala, Sweden; Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden.
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8
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Wright D, Kenny A, Eley S, McKechanie AG, Stanfield AC. Visual social attention in SYNGAP1-related intellectual disability. Autism Res 2024; 17:1083-1093. [PMID: 38698724 DOI: 10.1002/aur.3148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/23/2024] [Indexed: 05/05/2024]
Abstract
SYNGAP1-ID is a neurodevelopmental disorder caused by a mutation of the SYNGAP1 gene. Characterized by moderate to severe developmental delay, it is associated with several physical and behavioral issues as well as additional diagnoses, including autism. However, it is not known whether social cognitive differences seen in SYNGAP1-ID are similar to those previously identified in idiopathic or other forms of autism. This study therefore investigated visual social attention in SYNGAP1-ID. Eye movements were recorded across three passive viewing tasks (face scanning, pop-out, and social preference) of differing social complexity in 24 individuals with SYNGAP1-ID and 12 typically developing controls. We found that SYNGAP1-ID participants looked at faces less than the controls, and when they did look at faces, they had less time looking at and fewer fixations to the eyes. For the pop-out task, where social and nonsocial objects (Phone, car, face, bird, and face-noise) were presented in an array, those with SYNGAP1-ID spent significantly less time looking at the phone stimulus as well as fewer fixations to the face compared with the typically developing controls. When looking at two naturalistic scenes side by side, one social in nature (e.g., with children present) and the other not, there were no differences between the SYNGAP1-ID group and typically developing controls on any of the examined eye tracking measures. This study provides novel findings on the social attention of those with SYNGAP1-ID and helps to provide further evidence for using eye tracking as an objective measure of the social phenotype in this population in future clinical trials.
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Affiliation(s)
- Damien Wright
- Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Aisling Kenny
- Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Sarah Eley
- Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Andrew G McKechanie
- Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
| | - Andrew C Stanfield
- Patrick Wild Centre, Division of Psychiatry, Kennedy Tower, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK
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Ambarchi Z, Boulton KA, Thapa R, Arciuli J, DeMayo MM, Hickie IB, Thomas EE, Guastella AJ. Social and joint attention during shared book reading in young autistic children: a potential marker for social development. J Child Psychol Psychiatry 2024. [PMID: 38659350 DOI: 10.1111/jcpp.13993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Atypical patterns of social engagement and joint attention behaviors are diagnostic criteria for people with autism spectrum disorder. Experimental tasks using eye-tracking methodologies have, however, shown inconsistent results. The development of tasks with greater ecological validity and relevance for developmentally appropriate social milestones has been identified as important for the field. METHODS We developed a novel, dynamic eye-tracking task emulating a shared book reading (SBR) scenario. Four SBR videos of an adult reader engaging with the viewer while reading a children's picture book and including sequenced bids for joint attention were developed. Participants included 90 children (N = 56 autistic children, N = 34 neurotypical children; aged 3-12). Social attention was also measured in a live free play task between participants and an experimenter. RESULTS Compared to neurotypical children, autistic children displayed reduced attention to socially salient stimuli including the reader's face and picture book across SBR videos and during joint attention bids specifically. In contrast, they showed increased attention to nonsalient background stimuli compared to their neurotypical peers. These attention patterns in autistic children were associated with reduced verbal and nonverbal cognitive skills and increased symptoms associated with autism. Interestingly, positive correlations in the frequency of eye gaze between SBR and free play suggested a potential predictive value for social attention in live social interactions. CONCLUSIONS Findings highlight the utility of SBR eye-tracking tasks in understanding underlying divergences in social engagement and joint attention between autistic and neurotypical children. This commonly practiced early childhood activity may provide insights into the relationship between social engagement and learning to reveal how such attentional patterns might influence broader developmental and educational outcomes.
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Affiliation(s)
- Zahava Ambarchi
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Kelsie A Boulton
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rinku Thapa
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Joanne Arciuli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Marilena M DeMayo
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Ian B Hickie
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Emma E Thomas
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Adam J Guastella
- Clinic for Autism and Neurodevelopment Research (CAN Research), Brain and Mind Centre, Sydney Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
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Wohltjen S, Wheatley T. Interpersonal eye-tracking reveals the dynamics of interacting minds. Front Hum Neurosci 2024; 18:1356680. [PMID: 38532792 PMCID: PMC10963423 DOI: 10.3389/fnhum.2024.1356680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
The human eye is a rich source of information about where, when, and how we attend. Our gaze paths indicate where and what captures our attention, while changes in pupil size can signal surprise, revealing our expectations. Similarly, the pattern of our blinks suggests levels of alertness and when our attention shifts between external engagement and internal thought. During interactions with others, these cues reveal how we coordinate and share our mental states. To leverage these insights effectively, we need accurate, timely methods to observe these cues as they naturally unfold. Advances in eye-tracking technology now enable real-time observation of these cues, shedding light on mutual cognitive processes that foster shared understanding, collaborative thought, and social connection. This brief review highlights these advances and the new opportunities they present for future research.
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Affiliation(s)
- Sophie Wohltjen
- Department of Psychology, University of Wisconsin–Madison, Madison, WI, United States
| | - Thalia Wheatley
- Department of Psychological and Brain Sciences, Consortium for Interacting Minds, Dartmouth College, Hanover, NH, United States
- Santa Fe Institute, Santa Fe, NM, United States
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11
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Yoon CD, Xia Y, Terol AK, Meadan H, Lee JD. Correlation Between Gaze Behaviors and Social Communication Skills of Young Autistic Children: A Meta-Analysis of Eye-Tracking Studies. J Autism Dev Disord 2024:10.1007/s10803-024-06257-x. [PMID: 38400896 DOI: 10.1007/s10803-024-06257-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/26/2024]
Abstract
This meta-analysis examined correlations between eye-tracking measures of gaze behaviors manifested during dynamic salient social stimuli and behavioral assessment measures of social communication skills of young autistic children. We employed a multilevel model with random effects to perform three separate meta-analyses for correlation between social communication skills and (a) all gaze behaviors, (b) gaze duration, and (c) gaze transition. Subsequently, we performed meta-regression to assess the role of four moderators, including age, continuum of naturalness of stimuli, gaze metric, and area of interest, on correlation effect sizes that were heterogeneous at the population level. A total of 111 correlation coefficients from 17 studies for 1132 young autistic children or children with high-likelihood for autism (Mage range = 6-95 months) were included in this meta-analysis. The correlation effect sizes for all three meta-analyses were significant, supporting the relation between improved gaze behaviors and better social communication skills. In addition, age, gaze metric, and area of interest were significant moderators. This suggests the importance of identifying meaningful gaze behaviors related to social communication skills and the increasingly influential role of gaze behaviors in shaping social communication skills as young autistic children progress through the early childhood stage. The continuum of naturalness of stimuli, however, was revealed to trend towards having a significant moderating effect. Lastly, it is important to note the evidence of potential publication bias. Our findings are discussed in the context of early identification and intervention and unraveling the complex nature of autism.
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Affiliation(s)
- Christy D Yoon
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA.
| | - Yan Xia
- Department of Educational Psychology, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA
| | - Adriana Kaori Terol
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA
| | - Hedda Meadan
- Department of Special Education, University of Illinois Urbana-Champaign, 1310 South Sixth Street, Champaign, IL, 61820, USA
| | - James D Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington, 6901 Sand Point Way NE, Seattle, WA, 98115, USA
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Pino MC, Donne IL, Vagnetti R, Tiberti S, Valenti M, Mazza M. Using the Griffiths Mental Development Scales to Evaluate a Developmental Profile of Children with Autism Spectrum Disorder and Their Symptomatologic Severity. Child Psychiatry Hum Dev 2024; 55:117-126. [PMID: 35763176 PMCID: PMC10796491 DOI: 10.1007/s10578-022-01390-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2022] [Indexed: 11/03/2022]
Abstract
Early diagnosis is crucial for Autism spectrum disorder (ASD) and is achieved through a screening of developmental indicators to recognise children who are at risk of autism. One of the most widely used instruments in clinical practice for assessing child development is the Griffiths Mental Development Scale (GMDS). We sought (a) to assess longitudinally whether children diagnosed with ASD, with a mean age of 33.50 months (SD 7.69 months), show a developmental delay of abilities measured by the GMDS over time and (b) to analyse which skills of the GMDS could be associate to the symptomatologic severity of ASD. Our results showed lower scores of General Quotient and all sub-quotients of GMDS from first (T0) to second assessment (T1), except for the Performance sub-quotient. Three sub-quotients (Personal-Social, Hearing and Language and Practical Reasoning) also associate symptom severity at the time when the diagnosis of ASD is made.
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Affiliation(s)
- Maria Chiara Pino
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy.
| | - Ilenia Le Donne
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
| | - Roberto Vagnetti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Sergio Tiberti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
| | - Marco Valenti
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
- Abruzzo Region Health System, Reference Regional Centre for Autism, L'Aquila, Italy
| | - Monica Mazza
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, Via Vetoio, Località Coppito, 67100, L'Aquila, Italy
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Ziv I, Avni I, Dinstein I, Meiri G, Bonneh YS. Oculomotor randomness is higher in autistic children and increases with the severity of symptoms. Autism Res 2024; 17:249-265. [PMID: 38189581 DOI: 10.1002/aur.3083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/09/2023] [Indexed: 01/09/2024]
Abstract
A variety of studies have suggested that at least some children with autism spectrum disorder (ASD) view the world differently. Differences in gaze patterns as measured by eye tracking have been demonstrated during visual exploration of images and natural viewing of movies with social content. Here we analyzed the temporal randomness of saccades and blinks during natural viewing of movies, inspired by a recent measure of "randomness" applied to micro-movements of the hand and head in ASD (Torres et al., 2013; Torres & Denisova, 2016). We analyzed a large eye-tracking dataset of 189 ASD and 41 typically developing (TD) children (1-11 years old) who watched three movie clips with social content, each repeated twice. We found that oculomotor measures of randomness, obtained from gamma parameters of inter-saccade intervals (ISI) and blink duration distributions, were significantly higher in the ASD group compared with the TD group and were correlated with the ADOS comparison score, reflecting increased "randomness" in more severe cases. Moreover, these measures of randomness decreased with age, as well as with higher cognitive scores in both groups and were consistent across repeated viewing of each movie clip. Highly "random" eye movements in ASD children could be associated with high "neural variability" or noise, poor sensory-motor control, or weak engagement with the movies. These findings could contribute to the future development of oculomotor biomarkers as part of an integrative diagnostic tool for ASD.
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Affiliation(s)
- Inbal Ziv
- School of Optometry and Vision Science, Faculty of Life Science, Bar-Ilan University, Ramat Gan, Israel
| | - Inbar Avni
- Cognitive and Brain Sciences Department, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Ilan Dinstein
- Cognitive and Brain Sciences Department, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Psychology Department, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Gal Meiri
- Azrieli National Centre for Autism and Neurodevelopment Research, Ben Gurion University of the Negev, Be'er Sheva, Israel
- Pre-school Psychiatry Unit, Soroka Medical Center, Be'er Sheva, Israel
| | - Yoram S Bonneh
- School of Optometry and Vision Science, Faculty of Life Science, Bar-Ilan University, Ramat Gan, Israel
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Kojovic N, Cekic S, Castañón SH, Franchini M, Sperdin HF, Sandini C, Jan RK, Zöller D, Ben Hadid L, Bavelier D, Schaer M. Unraveling the developmental dynamic of visual exploration of social interactions in autism. eLife 2024; 13:e85623. [PMID: 38192197 PMCID: PMC10876216 DOI: 10.7554/elife.85623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Abstract
Atypical deployment of social gaze is present early on in toddlers with autism spectrum disorders (ASDs). Yet, studies characterizing the developmental dynamic behind it are scarce. Here, we used a data-driven method to delineate the developmental change in visual exploration of social interaction over childhood years in autism. Longitudinal eye-tracking data were acquired as children with ASD and their typically developing (TD) peers freely explored a short cartoon movie. We found divergent moment-to-moment gaze patterns in children with ASD compared to their TD peers. This divergence was particularly evident in sequences that displayed social interactions between characters and even more so in children with lower developmental and functional levels. The basic visual properties of the animated scene did not account for the enhanced divergence. Over childhood years, these differences dramatically increased to become more idiosyncratic. These findings suggest that social attention should be targeted early in clinical treatments.
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Affiliation(s)
- Nada Kojovic
- Psychiatry Department, Faculty of Medicine, University of GenevaGenevaSwitzerland
| | - Sezen Cekic
- Faculte de Psychologie et Science de l’Education, University of GenevaGenevaSwitzerland
| | - Santiago Herce Castañón
- Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México, Ciudad UniversitariaMexico CityMexico
| | | | - Holger Franz Sperdin
- Psychiatry Department, Faculty of Medicine, University of GenevaGenevaSwitzerland
| | - Corrado Sandini
- Psychiatry Department, Faculty of Medicine, University of GenevaGenevaSwitzerland
| | - Reem Kais Jan
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health SciencesDubaiUnited Arab Emirates
| | | | - Lylia Ben Hadid
- Psychiatry Department, Faculty of Medicine, University of GenevaGenevaSwitzerland
| | - Daphné Bavelier
- Faculte de Psychologie et Science de l’Education, University of GenevaGenevaSwitzerland
| | - Marie Schaer
- Psychiatry Department, Faculty of Medicine, University of GenevaGenevaSwitzerland
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Todd JT, Bahrick LE. Individual Differences in Multisensory Attention Skills in Children with Autism Spectrum Disorder Predict Language and Symptom Severity: Evidence from the Multisensory Attention Assessment Protocol (MAAP). J Autism Dev Disord 2023; 53:4685-4710. [PMID: 36181648 PMCID: PMC10065966 DOI: 10.1007/s10803-022-05752-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 01/27/2023]
Abstract
Children with autism spectrum disorders (ASD) show atypical attention, particularly for social events. The new Multisensory Attention Assessment Protocol (MAAP) assesses fine-grained individual differences in attention disengagement, maintenance, and audiovisual matching for social and nonsocial events. We investigated the role of competing stimulation on attention, and relations with language and symptomatology in children with ASD and typical controls. Findings revealed: (1) the MAAP differentiated children with ASD from controls, (2) greater attention to social events predicted better language for both groups and lower symptom severity in children with ASD, (3) different pathways from attention to language were evident in children with ASD versus controls. The MAAP provides an ideal attention assessment for revealing diagnostic group differences and relations with outcomes.
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Affiliation(s)
- James Torrence Todd
- Department of Psychology, Florida International University, 11200 South West 8 Street, Miami, FL, 33199, USA.
| | - Lorraine E Bahrick
- Department of Psychology, Florida International University, 11200 South West 8 Street, Miami, FL, 33199, USA
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16
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Thao PN, Nishijo M, Tai PT, Nghi TN, Hoa VT, Anh TH, Tien TV, Nishino Y, Nishijo H. Impacts of perinatal dioxin exposure on gaze behavior in 2-year-old children in the largest dioxin-contaminated area in Vietnam. Sci Rep 2023; 13:20679. [PMID: 38001134 PMCID: PMC10673870 DOI: 10.1038/s41598-023-47893-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023] Open
Abstract
Fifty-five children aged 2 years from a birth cohort in the largest dioxin-contaminated area in Bien Hoa city, Vietnam participated in this survey to examine gaze behavior. Exposure levels were indicated by 2,3,7,8-tetrachlorodibenzo-p-dibenzodioxin (TCDD) and toxic equivalent of polychlorinated dibenzo-p-dioxin and polychlorinated dibenzofuran (TEQ-PCDD/Fs) levels in maternal breast milk. The percentage of the total fixation duration on the face (% Face), mouth (% Mouth), and eye areas (% Eyes) when viewing silent and conversation scenes was used as gaze behavior indices. When they reached 3-year-old, autistic behavior was assessed using the Autism Spectrum Rating Scale (ASRS). A general linear model adjusted for confounding factors was used to compare gaze indices and ASRS scores between high and low dioxin exposure groups. Effects of perinatal dioxin exposure on gaze behavior were found only when viewing conversation scenes indicated by lower % Face for boys in high TCDD exposure group and lower % Eyes for girls in high TEQ-PCDD/Fs group. Increased autistic traits showed by higher ASRS scores at 3-year-old were found in both gender in the high TCDD exposure group. These findings indicate that perinatal TCDD and TEQ-PCDD/Fs exposure may reduce gaze behavior in 2-year-old children, predicting increased autistic traits at 3-year-old.
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Affiliation(s)
- Pham Ngoc Thao
- Department of Functional Diagnosis, 103 Military Hospital, Vietnam Military Medical University, 160 Phung Hung, Ha Dong, 12108, Ha Noi, Vietnam.
- Department of Functional Diagnosis, 103 Military Hospital, Vietnam Military Medical University, 261 Phung Hung Street, Phuc La Commune, Ha Dong District, Ha Noi, Vietnam.
| | - Muneko Nishijo
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Pham The Tai
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, 12108, Ha Noi, Vietnam
| | - Tran Ngoc Nghi
- Ministry of Health, Vietnamese Government, Hanoi, Vietnam
| | - Vu Thi Hoa
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Tran Hai Anh
- Department of Physiology, Vietnam Military Medical University, 12108, Ha Noi, Vietnam
| | - Tran Viet Tien
- Department of Tropical and Infectious diseases, 103 Military Hospital, Vietnam Military Medical University, 12108, Ha Noi, Vietnam
| | - Yoshikazu Nishino
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, 920-0293, Japan
| | - Hisao Nishijo
- Department of Sport and Health Sciences, Faculty of Human Sciences, University of East Asia, Shimonoseki-Shi, Yamaguchi, 751-8503, Japan
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Shic F, Barney EC, Naples AJ, Dommer KJ, Chang SA, Li B, McAllister T, Atyabi A, Wang Q, Bernier R, Dawson G, Dziura J, Faja S, Jeste SS, Murias M, Johnson SP, Sabatos-DeVito M, Helleman G, Senturk D, Sugar CA, Webb SJ, McPartland JC, Chawarska K. The Selective Social Attention task in children with autism spectrum disorder: Results from the Autism Biomarkers Consortium for Clinical Trials (ABC-CT) feasibility study. Autism Res 2023; 16:2150-2159. [PMID: 37749934 PMCID: PMC11003770 DOI: 10.1002/aur.3026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 08/25/2023] [Indexed: 09/27/2023]
Abstract
The Selective Social Attention (SSA) task is a brief eye-tracking task involving experimental conditions varying along socio-communicative axes. Traditionally the SSA has been used to probe socially-specific attentional patterns in infants and toddlers who develop autism spectrum disorder (ASD). This current work extends these findings to preschool and school-age children. Children 4- to 12-years-old with ASD (N = 23) and a typically-developing comparison group (TD; N = 25) completed the SSA task as well as standardized clinical assessments. Linear mixed models examined group and condition effects on two outcome variables: percent of time spent looking at the scene relative to scene presentation time (%Valid), and percent of time looking at the face relative to time spent looking at the scene (%Face). Age and IQ were included as covariates. Outcome variables' relationships to clinical data were assessed via correlation analysis. The ASD group, compared to the TD group, looked less at the scene and focused less on the actress' face during the most socially-engaging experimental conditions. Additionally, within the ASD group, %Face negatively correlated with SRS total T-scores with a particularly strong negative correlation with the Autistic Mannerism subscale T-score. These results highlight the extensibility of the SSA to older children with ASD, including replication of between-group differences previously seen in infants and toddlers, as well as its ability to capture meaningful clinical variation within the autism spectrum across a wide developmental span inclusive of preschool and school-aged children. The properties suggest that the SSA may have broad potential as a biomarker for ASD.
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Affiliation(s)
- Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Erin C. Barney
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adam J. Naples
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kelsey J. Dommer
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
| | - Shou An Chang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Beibin Li
- Center for Child Health, Behavior and Development, Seattle Children’s Research Institute, Seattle, Washington, USA
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Paul G. Allen School of Computer Science & Engineering, University of Washington, Seattle, Washington, USA
| | - Takumi McAllister
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Adham Atyabi
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Computer Science, University of Colorado - Colorado Springs, Colorado Springs, Colorado, USA
| | - Quan Wang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Xi’an Institute of Optics and Precision Mechanics, Chinese Academy of Sciences, Xi’an, China
| | - Raphael Bernier
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - James Dziura
- Emergency Medicine, Yale University, New Haven, Connecticut, USA
| | - Susan Faja
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Shafali Spurling Jeste
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, California, USA
- Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, California, USA
| | - Michael Murias
- Department of Medical Social Sciences, Northwestern University, Evanston, Illinois, USA
| | - Scott P. Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, California, USA
| | - Maura Sabatos-DeVito
- Duke Center for Autism and Brain Development, Duke University, Durham, North Carolina, USA
| | - Gerhard Helleman
- Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles, Los Angeles, California, USA
| | - Catherine A. Sugar
- Department of Biostatistics, University of California Los Angeles, Los Angeles, California, USA
| | - Sara Jane Webb
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, Seattle, Washington, USA
| | - James C. McPartland
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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18
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Mori T, Tsuchiya KJ, Harada T, Nakayasu C, Okumura A, Nishimura T, Katayama T, Endo M. Autism symptoms, functional impairments, and gaze fixation measured using an eye-tracker in 6-year-old children. Front Psychiatry 2023; 14:1250763. [PMID: 37850106 PMCID: PMC10577268 DOI: 10.3389/fpsyt.2023.1250763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/11/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder clinically characterized by abnormalities in eye contact during social exchanges. We aimed to clarify whether the amount of gaze fixation, measured at the age of 6 years using Gazefinder, which is an established eye-tracking device, is associated with ASD symptoms and functioning. Methods The current study included 742 participants from the Hamamatsu Birth Cohort Study. Autistic symptoms were evaluated according to the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), and the functioning of the participating children in real life was assessed using the Japanese version of the Vineland Adaptive Behavior Scales, Second Edition (VABS-II). The Gazefinder system was used for gaze fixation rates; two areas of interest (eyes and mouth) were defined in a talking movie clip, and eye gaze positions were calculated through corneal reflection techniques. Results The participants had an average age of 6.06 ± 0.14 years (males: 384; 52%). According to ADOS, 617 (83%) children were assessed as having none/mild ASD and 51 (7%) as severe. The average VABS-II scores were approximately 100 (standard deviation = 12). A higher gaze fixation rate on the eyes was associated with a significantly lower likelihood of the child being assigned to the severe ADOS group after controlling for covariates (odds ratio [OR], 0.02; 95% confidence interval [CI], 0.002-0.38). The gaze fixation rate on the mouth was not associated with ASD symptoms. A higher gaze fixation rate on the mouth was associated with a significantly lower likelihood of the child being assigned to the low score group in VABS-II socialization after controlling for covariates (OR, 0.18; 95% CI, 0.04-0.85). The gaze fixation rate on the eyes was not associated with functioning. Conclusion We found that children with low gaze fixation rates on the eyes were likely to have more ASD symptoms, and children with low gaze fixation rates on the mouth were likely to demonstrate poorer functioning in socialization. Hence, preschool children could be independently assessed in the general population for clinically relevant endophenotypes predictive of ASD symptoms and functional impairments.
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Affiliation(s)
- Toko Mori
- Faculty of Nursing, Shijonawate Gakuen University, Osaka, Japan
| | - Kenji J. Tsuchiya
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
| | - Taeko Harada
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
| | - Chikako Nakayasu
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Akemi Okumura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
| | - Tomoko Nishimura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
| | - Taiichi Katayama
- Department of Child Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University, and University of Fukui, Osaka, Japan
| | - Masayuki Endo
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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Howard J, Herold B, Major S, Leahy C, Ramseur K, Franz L, Deaver M, Vermeer S, Carpenter KLH, Murias M, Huang WA, Dawson G. Associations between executive function and attention abilities and language and social communication skills in young autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2023; 27:2135-2144. [PMID: 36802865 PMCID: PMC10439258 DOI: 10.1177/13623613231154310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
LAY ABSTRACT Executive functioning describes a set of cognitive processes that affect thinking and behavior. Past research has shown that autistic individuals often have delays in the acquisition of executive function abilities. Our study explored how differences in executive function and attention abilities relate to social abilities and communication/language in 180 young autistic children. Data were gathered via caregiver report (questionnaires/interviews) and an assessment of vocabulary skills. The ability to sustain attention to a dynamic video was measured via eye tracking. We found that children with higher levels of executive function skills demonstrated lower levels of social pragmatic problems, a measure of having difficulties in social contexts. Furthermore, children who were able to sustain their attention longer to the video displayed higher levels of expressive language. Our results emphasize the importance of executive function and attention skills across multiple areas of functioning in autistic children, in particular those that involve language and social communication.
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20
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Cao R, Zhang N, Yu H, Webster PJ, Paul LK, Li X, Lin C, Wang S. Comprehensive Social Trait Judgments From Faces in Autism Spectrum Disorder. Psychol Sci 2023; 34:1121-1145. [PMID: 37671893 PMCID: PMC10626626 DOI: 10.1177/09567976231192236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 07/13/2023] [Indexed: 09/07/2023] Open
Abstract
Processing social information from faces is difficult for individuals with autism spectrum disorder (ASD). However, it remains unclear whether individuals with ASD make high-level social trait judgments from faces in the same way as neurotypical individuals. Here, we comprehensively addressed this question using naturalistic face images and representatively sampled traits. Despite similar underlying dimensional structures across traits, online adult participants with self-reported ASD showed different judgments and reduced specificity within each trait compared with neurotypical individuals. Deep neural networks revealed that these group differences were driven by specific types of faces and differential utilization of features within a face. Our results were replicated in well-characterized in-lab participants and partially generalized to more controlled face images (a preregistered study). By investigating social trait judgments in a broader population, including individuals with neurodevelopmental variations, we found important theoretical implications for the fundamental dimensions, variations, and potential behavioral consequences of social cognition.
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Affiliation(s)
- Runnan Cao
- Department of Radiology, Washington University in St. Louis
- Lane Department of Computer Science and Electrical Engineering, West Virginia University
| | - Na Zhang
- Lane Department of Computer Science and Electrical Engineering, West Virginia University
| | - Hongbo Yu
- Department of Psychological & Brain Sciences, University of California, Santa Barbara
| | - Paula J. Webster
- Department of Chemical and Biomedical Engineering, West Virginia University
| | - Lynn K. Paul
- Division of the Humanities and Social Sciences, California Institute of Technology
| | - Xin Li
- Lane Department of Computer Science and Electrical Engineering, West Virginia University
| | - Chujun Lin
- Department of Psychology, University of California, San Diego
| | - Shuo Wang
- Department of Radiology, Washington University in St. Louis
- Lane Department of Computer Science and Electrical Engineering, West Virginia University
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21
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Wang H, Zhao X, Yu D. Nonlinear features of gaze behavior during joint attention in children with autism spectrum disorder. Autism Res 2023; 16:1786-1798. [PMID: 37530201 DOI: 10.1002/aur.3000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/16/2023] [Indexed: 08/03/2023]
Abstract
Since children with autism spectrum disorder (ASD) might exhibit a variety of aberrant response to joint attention (RJA) behaviors, there is growing interest in identifying robust, reliable and valid eye-tracking metrics for determining differences in RJA behaviors between typically developing (TD) children and those with ASD. Previous eye-tracking studies have not been deeply investigated nonlinear features of gaze time-series during RJA. As a main motivation, this study aimed to extract three nonlinear features (i.e., complexity, long-range correlation, and local instability) of gaze time-series during RJA in children with ASD, which can be measured by fractal dimension (FD), Hurst exponent (H), and largest Lyapunov exponent (LLE), respectively. To illustrate our idea, this study adopted a publicly accessible database, including eye-tracking data collected during RJA from 19 children with ASD (7.74 ± 2.73) and 30 TD children (8.02 ± 2.89), and conducted a battery of nonparametric analysis of covariance (ANCOVA), where gender was used as covariable. Findings showed that gaze time-series during RJA in autistic children may generally have greater FD but lower H than that in TD controls. This implies that children with ASD possess more complex and unpredictable gaze behaviors during RJA than TD children. Furthermore, nonlinear metrics outperformed traditional eye-tracking metrics in obtaining higher identification performance with an accuracy of 82% and an AUC value of 0.81, distinguishing the differences between successful and failed RJA trails, and predicting the severity of ASD symptoms. Findings might bring some new insights into the understanding of the impairments in RJA behaviors for children with ASD.
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Affiliation(s)
- Hongan Wang
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
| | - Xin Zhao
- Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongchuan Yu
- Key Laboratory of Child Development and Learning Science of Ministry of Education, School of Biological Science and Medical Engineering, Southeast University, Nanjing, China
- Henan Provincial Medical Key Lab of Child Developmental Behavior and Learning, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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22
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Artis J, Arunachalam S. Semantic and Syntactic Properties of Words and the Receptive-Expressive Gap in Autistic and Non-Autistic Children. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:1771-1791. [PMID: 37137280 PMCID: PMC10457093 DOI: 10.1044/2023_jslhr-22-00369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 11/17/2022] [Accepted: 02/09/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE The goal of this work was to examine the semantic and syntactic properties of the vocabularies of autistic and non-autistic infants and toddlers to see if children in these two groups know different kinds of words. We focused on both receptive and expressive vocabularies. For expressive vocabulary, we looked only at the "active" lexicon: Of those words that are already in children's receptive vocabulary, we asked which ones they also produce. METHOD We used an existing data set of 346 parent report vocabulary checklists (MacArthur-Bates Communicative Development Inventory: Words and Gestures) from 41 autistic and 27 non-autistic children at multiple timepoints between the ages of 6 and 43 months. We coded the words on the checklists for various semantic and syntactic properties and evaluated which properties predicted whether children understood and produced those words. RESULTS Overall, we replicated a common finding that autistic children have smaller receptive vocabularies than non-autistic children, but we found that of the words they understand, autistic children produce a similar proportion of those words as non-autistic children. While we found that some syntactic properties are more or less likely to be represented in children's early vocabularies (e.g., nouns are more likely to be understood and produced than words that are not nouns), these patterns did not differ across autistic and non-autistic children. CONCLUSIONS The semantic and syntactic compositions of autistic and non-autistic children's vocabularies are similar. Thus, while receptive vocabularies are relatively smaller for autistic children, they do not appear to have specific difficulty with words that have particular syntactic or semantic properties, or with adding words to the expressive vocabulary that they already understand.
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Affiliation(s)
- Jonet Artis
- Department of Communicative Sciences and Disorders, New York University, NY
| | - Sudha Arunachalam
- Department of Communicative Sciences and Disorders, New York University, NY
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de Belen RA, Pincham H, Hodge A, Silove N, Sowmya A, Bednarz T, Eapen V. Eye-tracking correlates of response to joint attention in preschool children with autism spectrum disorder. BMC Psychiatry 2023; 23:211. [PMID: 36991383 PMCID: PMC10061704 DOI: 10.1186/s12888-023-04585-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 02/02/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND A number of differences in joint attention behaviour between children with autism spectrum disorder (ASD) and typically developing (TD) individuals have previously been documented. METHOD We use eye-tracking technology to assess response to joint attention (RJA) behaviours in 77 children aged 31 to 73 months. We conducted a repeated-measures analysis of variance to identify differences between groups. In addition, we analysed correlations between eye-tracking and clinical measures using Spearman's correlation. RESULTS The children diagnosed with ASD were less likely to follow gaze compared to TD children. Children with ASD were less accurate at gaze following when only eye gaze information was available, compared to when eye gaze with head movement was observed. Higher accuracy gaze-following profiles were associated with better early cognition and more adaptive behaviours in children with ASD. Less accurate gaze-following profiles were associated with more severe ASD symptomatology. CONCLUSION There are differences in RJA behaviours between ASD and TD preschool children. Several eye-tracking measures of RJA behaviours in preschool children were found to be associated with clinical measures for ASD diagnosis. This study also highlights the construct validity of using eye-tracking measures as potential biomarkers in the assessment and diagnosis of ASD in preschool children.
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Affiliation(s)
- Ryan Anthony de Belen
- School of Computer Science and Engineering, University of New South Wales, Sydney, New South Wales Australia
| | - Hannah Pincham
- School of Psychiatry, University of New South Wales, Sydney, New South Wales Australia
| | | | - Natalie Silove
- Children’s Hospital Westmead, Sydney, New South Wales Australia
- School of Medicine, University of Sydney, Sydney, New South Wales Australia
| | - Arcot Sowmya
- School of Computer Science and Engineering, University of New South Wales, Sydney, New South Wales Australia
| | - Tomasz Bednarz
- School of Art & Design, University of New South Wales, Sydney, New South Wales Australia
| | - Valsamma Eapen
- School of Psychiatry, University of New South Wales, Sydney, New South Wales Australia
- Academic Unit of Child Psychiatry South West Sydney, Ingham Institute, Liverpool Hospital, Sydney, New South Wales Australia
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24
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Wall CA, Sabatos-DeVito M, Franz L, Howard J, Major S, Bey A, Dawson G. Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children. Autism Res 2023; 16:1052-1062. [PMID: 36942384 DOI: 10.1002/aur.2920] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.
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Affiliation(s)
- Carla A Wall
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Maura Sabatos-DeVito
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Jill Howard
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Samantha Major
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Alexandra Bey
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
| | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, 27705, USA
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25
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Suri KN, Whedon M, Lewis M. Perception of audio-visual synchrony in infants at elevated likelihood of developing autism spectrum disorder. Eur J Pediatr 2023; 182:2105-2117. [PMID: 36820895 DOI: 10.1007/s00431-023-04871-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
UNLABELLED The inability to perceive audio-visual speech as a unified event may contribute to social impairments and language deficits in children with autism spectrum disorder (ASD). In this study, we examined and compared two groups of infants on their sensitivity to audio-visual asynchrony for a social (speaking face) and non-social event (bouncing ball) and assessed the relations between multisensory integration and language production. Infants at elevated likelihood of developing ASD were less sensitive to audio-visual synchrony for the social event than infants without elevated likelihood. Among infants without elevated likelihood, greater sensitivity to audio-visual synchrony for the social event was associated with a larger productive vocabulary. CONCLUSION Findings suggest that early deficits in multisensory integration may impair language development among infants with elevated likelihood of developing ASD. WHAT IS KNOWN •Perceptual integration of auditory and visual cues within speech is important for language development. •Prior work suggests that children with ASD are less sensitive to the temporal synchrony within audio-visual speech. WHAT IS NEW •In this study, infants at elevated likelihood of developing ASD showed a larger temporal binding window for adynamic social event (Speaking Face) than TD infants, suggesting less efficient multisensory integration.
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Affiliation(s)
- Kirin N Suri
- Institute for the Study of Child Development, Rutgers Robert Wood Johnson Medical School, 89 French Street, New Brunswick, NJ, 08901, USA.,Children's Health at Hackensack Meridian, Hackensack, NJ, 07601, USA
| | - Margaret Whedon
- Institute for the Study of Child Development, Rutgers Robert Wood Johnson Medical School, 89 French Street, New Brunswick, NJ, 08901, USA.
| | - Michael Lewis
- Institute for the Study of Child Development, Rutgers Robert Wood Johnson Medical School, 89 French Street, New Brunswick, NJ, 08901, USA
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26
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Wall CA, Shic F, Varanasi S, Roberts JE. Distinct social attention profiles in preschoolers with autism contrasted to fragile X syndrome. Autism Res 2023; 16:340-354. [PMID: 36408848 PMCID: PMC9957831 DOI: 10.1002/aur.2857] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 11/11/2022] [Indexed: 11/22/2022]
Abstract
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.
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Affiliation(s)
- Carla A. Wall
- Duke University Medical Center, Center for Autism and Brain Development, 2424 Erwin Road, Suite 501, Durham, NC 27705
| | - Frederick Shic
- University of Washington, Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101
| | - Sreeja Varanasi
- University of South Carolina, School of Medicine, 6311 Garners Ferry Road, Columbia, SC 29209
| | - Jane E. Roberts
- University of South Carolina, Department of Psychology, 1512 Pendleton Street, Suite #220, Columbia, SC 29208
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27
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Weichselbaum C, Hendrix N, Albright J, Dougherty JD, Botteron KN, Constantino JN, Marrus N. Social attention during object engagement: toward a cross-species measure of preferential social orienting. J Neurodev Disord 2022; 14:58. [PMID: 36517753 PMCID: PMC9749210 DOI: 10.1186/s11689-022-09467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 11/15/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A central challenge in preclinical research investigating the biology of autism spectrum disorder (ASD) is the translation of ASD-related social phenotypes across humans and animal models. Social orienting, an observable, evolutionarily conserved behavior, represents a promising cross-species ASD phenotype given that disrupted social orienting is an early-emerging ASD feature with evidence for predicting familial recurrence. Here, we adapt a competing-stimulus social orienting task from domesticated dogs to naturalistic play behavior in human toddlers and test whether this approach indexes decreased social orienting in ASD. METHODS Play behavior was coded from the Autism Diagnostic Observation Schedule (ADOS) in two samples of toddlers, each with and without ASD. Sample 1 (n = 16) consisted of community-ascertained research participants, while Sample 2 involved a prospective study of infants at a high or low familial liability for ASD (n = 67). Coding quantified the child's looks towards the experimenter and caregiver, a social stimulus, while playing with high-interest toys, a non-social stimulus. A competing-stimulus measure of "Social Attention During Object Engagement" (SADOE) was calculated by dividing the number of social looks by total time spent playing with toys. SADOE was compared based on ASD diagnosis and differing familial liability for ASD. RESULTS In both samples, toddlers with ASD exhibited significantly lower SADOE compared to toddlers without ASD, with large effect sizes (Hedges' g ≥ 0.92) driven by a lower frequency of child-initiated spontaneous looks. Among toddlers at high familial likelihood of ASD, toddlers with ASD showed lower SADOE than toddlers without ASD, while SADOE did not differ based on presence or absence of familial ASD risk alone. SADOE correlated negatively with ADOS social affect calibrated severity scores and positively with the Communication and Symbolic Behavior Scales social subscale. In a binary logistic regression model, SADOE alone correctly classified 74.1% of cases, which rose to 85.2% when combined with cognitive development. CONCLUSIONS This work suggests that a brief behavioral measure pitting a high-interest nonsocial stimulus against the innate draw of social partners can serve as a feasible cross-species measure of social orienting, with implications for genetically informative behavioral phenotyping of social deficits in ASD and other neurodevelopmental disorders.
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Affiliation(s)
- Claire Weichselbaum
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO, 63110, USA
- Department of Genetics, Washington University School of Medicine, 660 S. Euclid Ave, Box 8232, St Louis, MO, 63110, USA
| | - Nicole Hendrix
- Department of Pediatrics, Marcus Autism Center, Emory University Pediatric Institute, 1920 Briarcliff Rd, Atlanta, GA, 30329, USA
| | - Jordan Albright
- Virginia Tech Autism Clinic & Center for Autism Research, Virginia Polytechnic Institute and State University, 3110 Prices Fork Rd, Blacksburg, VA, 24060, USA
| | - Joseph D Dougherty
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO, 63110, USA
- Department of Genetics, Washington University School of Medicine, 660 S. Euclid Ave, Box 8232, St Louis, MO, 63110, USA
| | - Kelly N Botteron
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO, 63110, USA
- Department of Radiology, Washington University School of Medicine, 660 S. Euclid, 35 Ave, St Louis, MO, 63110, USA
| | - John N Constantino
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO, 63110, USA
| | - Natasha Marrus
- Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Ave, Box 8504, St Louis, MO, 63110, USA.
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Chawarska K, Lewkowicz D, Feiner H, Macari S, Vernetti A. Attention to audiovisual speech does not facilitate language acquisition in infants with familial history of autism. J Child Psychol Psychiatry 2022; 63:1466-1476. [PMID: 35244219 DOI: 10.1111/jcpp.13595] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/10/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Due to familial liability, siblings of children with ASD exhibit elevated risk for language delays. The processes contributing to language delays in this population remain unclear. METHODS Considering well-established links between attention to dynamic audiovisual cues inherent in a speaker's face and speech processing, we investigated if attention to a speaker's face and mouth differs in 12-month-old infants at high familial risk for ASD but without ASD diagnosis (hr-sib; n = 91) and in infants at low familial risk (lr-sib; n = 62) for ASD and whether attention at 12 months predicts language outcomes at 18 months. RESULTS At 12 months, hr-sib and lr-sib infants did not differ in attention to face (p = .14), mouth preference (p = .30), or in receptive and expressive language scores (p = .36, p = .33). At 18 months, the hr-sib infants had lower receptive (p = .01) but not expressive (p = .84) language scores than the lr-sib infants. In the lr-sib infants, greater attention to the face (p = .022) and a mouth preference (p = .025) contributed to better language outcomes at 18 months. In the hr-sib infants, neither attention to the face nor a mouth preference was associated with language outcomes at 18 months. CONCLUSIONS Unlike low-risk infants, high-risk infants do not appear to benefit from audiovisual prosodic and speech cues in the service of language acquisition despite intact attention to these cues. We propose that impaired processing of audiovisual cues may constitute the link between genetic risk factors and poor language outcomes observed across the autism risk spectrum and may represent a promising endophenotype in autism.
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Affiliation(s)
- Katarzyna Chawarska
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Haskins Laboratories, New Haven, CT, USA
| | - David Lewkowicz
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Haskins Laboratories, New Haven, CT, USA
| | - Hannah Feiner
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Suzanne Macari
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Angelina Vernetti
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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29
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Haskins AJ, Mentch J, Botch TL, Garcia BD, Burrows AL, Robertson CE. Reduced social attention in autism is magnified by perceptual load in naturalistic environments. Autism Res 2022; 15:2310-2323. [PMID: 36207799 PMCID: PMC10092155 DOI: 10.1002/aur.2829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022]
Abstract
Individuals with autism spectrum conditions (ASC) describe differences in both social cognition and sensory processing, but little is known about the causal relationship between these disparate functional domains. In the present study, we sought to understand how a core characteristic of autism-reduced social attention-is impacted by the complex multisensory signals present in real-world environments. We tested the hypothesis that reductions in social attention associated with autism would be magnified by increasing perceptual load (e.g., motion, multisensory cues). Adult participants (N = 40; 19 ASC) explored a diverse set of 360° real-world scenes in a naturalistic, active viewing paradigm (immersive virtual reality + eyetracking). Across three conditions, we systematically varied perceptual load while holding the social and semantic information present in each scene constant. We demonstrate that reduced social attention is not a static signature of the autistic phenotype. Rather, group differences in social attention emerged with increasing perceptual load in naturalistic environments, and the susceptibility of social attention to perceptual load predicted continuous measures of autistic traits across groups. Crucially, this pattern was specific to the social domain: we did not observe differential impacts of perceptual load on attention directed toward nonsocial semantic (i.e., object, place) information or low-level fixation behavior (i.e., overall fixation frequency or duration). This study provides a direct link between social and sensory processing in autism. Moreover, reduced social attention may be an inaccurate characterization of autism. Instead, our results suggest that social attention in autism is better explained by "social vulnerability," particularly to the perceptual load of real-world environments.
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Affiliation(s)
- Amanda J. Haskins
- Department of Psychological & Brain SciencesDartmouth CollegeHanoverNew HampshireUSA
| | - Jeff Mentch
- Speech and Hearing Bioscience and TechnologyHarvard UniversityBostonMassachusettsUSA
- McGovern Institute for Brain Research, MITCambridgeMassachusettsUSA
| | - Thomas L. Botch
- Department of Psychological & Brain SciencesDartmouth CollegeHanoverNew HampshireUSA
| | - Brenda D. Garcia
- Department of Psychological & Brain SciencesDartmouth CollegeHanoverNew HampshireUSA
| | - Alexandra L. Burrows
- Department of Psychological & Brain SciencesDartmouth CollegeHanoverNew HampshireUSA
| | - Caroline E. Robertson
- Department of Psychological & Brain SciencesDartmouth CollegeHanoverNew HampshireUSA
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30
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Cilia F, Brisson J, Vandromme L, Garry C, Le Driant B. Multiple deictic cues allow ASD children to direct their visual attention. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03993-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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31
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Thorup E, Nyström P, Bölte S, Falck-Ytter T. What are you looking at? Gaze following with and without target objects in ASD and typical development. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2022; 26:1668-1680. [PMID: 34903076 PMCID: PMC9483193 DOI: 10.1177/13623613211061940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT During the first year of life, infants start to align their attention with that of other people. This ability is called joint attention and facilitates social learning and language development. Although children with autism spectrum disorder (ASD) are known to engage less in joint attention compared to other children, several experimental studies have shown that they follow other's gaze (a requirement for visual joint attention) to the same extent as other children. In this study, infants' eye movements were measured at age 10, 14, and 18 months while watching another person look in a certain direction. A target object was either present or absent in the direction of the other person's gaze. Some of the infants were at elevated likelihood of ASD, due to having an older autistic sibling. At age 3 years, infants were assessed for a diagnosis of ASD. Results showed that infants who met diagnostic criteria at 3 years followed gaze to the same extent as other infants. However, they then looked back at the model faster than typically developing infants when no target object was present. When a target object was present, there was no difference between groups. These results may be in line with the view that directly after gaze following, infants with later ASD are less influenced by other people's gaze when processing the common attentional focus. The study adds to our understanding of both the similarities and differences in looking behaviors between infants who later receive an ASD diagnosis and other infants.
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Affiliation(s)
| | | | - Sven Bölte
- Karolinska Institutet, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
- Curtin University, Australia
| | - Terje Falck-Ytter
- Uppsala University, Sweden
- Karolinska Institutet, Sweden
- Stockholm Health Care Services, Region Stockholm, Sweden
- Swedish Collegium for Advanced Study, Sweden
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32
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Riddiford JA, Enticott PG, Lavale A, Gurvich C. Gaze and social functioning associations in autism spectrum disorder: A systematic review and meta-analysis. Autism Res 2022; 15:1380-1446. [PMID: 35593039 PMCID: PMC9543973 DOI: 10.1002/aur.2729] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 03/08/2022] [Accepted: 03/28/2022] [Indexed: 12/11/2022]
Abstract
Autism spectrum disorder (ASD) is characterized by significant social functioning impairments, including (but not limited to) emotion recognition, mentalizing, and joint attention. Despite extensive investigation into the correlates of social functioning in ASD, only recently has there been focus on the role of low‐level sensory input, particularly visual processing. Extensive gaze deficits have been described in ASD, from basic saccadic function through to social attention and the processing of complex biological motion. Given that social functioning often relies on accurately processing visual information, inefficient visual processing may contribute to the emergence and sustainment of social functioning difficulties in ASD. To explore the association between measures of gaze and social functioning in ASD, a systematic review and meta‐analysis was conducted. A total of 95 studies were identified from a search of CINAHL Plus, Embase, OVID Medline, and psycINFO databases in July 2021. Findings support associations between increased gaze to the face/head and eye regions with improved social functioning and reduced autism symptom severity. However, gaze allocation to the mouth appears dependent on social and emotional content of scenes and the cognitive profile of participants. This review supports the investigation of gaze variables as potential biomarkers of ASD, although future longitudinal studies are required to investigate the developmental progression of this relationship and to explore the influence of heterogeneity in ASD clinical characteristics.
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Affiliation(s)
- Jacqueline A Riddiford
- Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Victoria
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Australia
| | - Alex Lavale
- Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Victoria
| | - Caroline Gurvich
- Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Victoria
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Nayar K, Shic F, Winston M, Losh M. A constellation of eye-tracking measures reveals social attention differences in ASD and the broad autism phenotype. Mol Autism 2022; 13:18. [PMID: 35509089 PMCID: PMC9069739 DOI: 10.1186/s13229-022-00490-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 02/10/2022] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Kritika Nayar
- Neurodevelopmental Disabilities Lab, Roxelyn and Richard Pepper, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Molly Winston
- Neurodevelopmental Disabilities Lab, Roxelyn and Richard Pepper, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Molly Losh
- Neurodevelopmental Disabilities Lab, Roxelyn and Richard Pepper, Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA.
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34
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Matsui T, Uchida M, Fujino H, Tojo Y, Hakarino K. Perception of native and non-native phonemic contrasts in children with autistic spectrum disorder: effects of speaker variability. CLINICAL LINGUISTICS & PHONETICS 2022; 36:417-435. [PMID: 34460348 DOI: 10.1080/02699206.2021.1947385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/07/2021] [Accepted: 06/17/2021] [Indexed: 06/13/2023]
Abstract
The current study investigated speech perception in children with ASD by directly comparing discrimination accuracy of phonemic contrasts in the native and non-native languages. The effect of speaker variability on phoneme perception was also examined. We also explored the relation between language impairment and accuracy in phoneme discrimination in children with ASD. Significant differences in performance were found between the ASD and TD groups on discrimination of the native phonemic contrasts. By contrast, no difference was found between the two groups on discrimination of the non-native phonemic contrasts. Further subgroup analysis revealed that the ALN group (ASD without language delay or impairment) showed significantly higher discrimination accuracy for the native syllable contrasts than the non-native counterpart. No significant difference was found in the discrimination accuracy between the native and non-native phonemic contrasts in the ALD group (ASD with language delay or impairment). The effect of speaker viability on phoneme discrimination was observed in the TD group but not in the ASD subgroups. Nonverbal reasoning ability was highly related to discrimination accuracy of both the native and non-native phonemic contrasts in children with ASD. The results of the present study suggest that speech perception in children with ASD is not as attuned to their native language as in their TD peers. Our findings also indicate that language delay or impairment is related to difficulty in perception of native phonemes in children with ASD.
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Affiliation(s)
- Tomoko Matsui
- Center for Research in International Education, Tokyo Gakugei University, Tokyo, Japan
| | - Mariko Uchida
- Center for Research in International Education, Tokyo Gakugei University, Tokyo, Japan
| | - Hiroshi Fujino
- Graduate School for Teacher Education, Tokyo Gakugei University, Tokyo, Japan
| | - Yoshikuni Tojo
- College of Education, Ibaraki University, Ibaraki, Japan
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Bradshaw J, Shi D, Hendrix CL, Saulnier C, Klaiman C. Neonatal neurobehavior in infants with autism spectrum disorder. Dev Med Child Neurol 2022; 64:600-607. [PMID: 34713902 PMCID: PMC9209845 DOI: 10.1111/dmcn.15096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
AIM To investigate neurobehavioral maturation for neonates who are later diagnosed with autism spectrum disorder (ASD). METHOD In a prospective longitudinal design, neonatal neurobehavior was examined monthly in 1- to 3-month-old infants at elevated and low familial likelihood of ASD (n=60). At 2 years, infants were seen for a clinical best-estimate evaluation, resulting in 18 infants with ASD and 36 typically developing infants. Repeated-measures analysis of variance models were conducted to examine the effects of age, diagnostic group, and their interactions. RESULTS Neurobehavioral maturation of infants diagnosed with ASD was largely comparable to typically developing infants from 1 to 3 months, with the exception of the development of attention. Object-focused attention was significantly attenuated for infants with ASD beginning at 2 to 3 months and was predictive of social-communication skills 2 years later. INTERPRETATION This is the first study to prospectively examine neonatal neurobehavior of infants at an elevated familial likelihood of ASD who later received a diagnosis. Despite relatively intact neurological and behavioral maturation in the neonatal period, attention to objects emerged as a key early indicator of ASD. This suggests a complex attentional vulnerability within the first 3 months of life that may be associated with cascading sequelae of social-communication challenges and the emergence of ASD.
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Affiliation(s)
- Jessica Bradshaw
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Dexin Shi
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Cassandra L Hendrix
- Department of Child and Adolescent Psychiatry, New York University, Langone Health, New York, NY, USA
| | - Celine Saulnier
- Neurodevelopmental Assessment & Consulting Services, Decatur, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Cheryl Klaiman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
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36
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Eye-Tracking Studies in Adults with Autism Spectrum Disorder: A Systematic Review and Meta-analysis. J Autism Dev Disord 2022; 53:2430-2443. [PMID: 35355174 DOI: 10.1007/s10803-022-05524-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
Eye-tracking studies have shown potential in effectively discriminating between autism spectrum disorder (ASD) and non-ASD groups. The main objective of the present study was to conduct a systematic review and meta-analysis of eye-tracking studies in adults with ASD. A total of 22 studies were included for meta-analysis. Eyes and Non-Social regions proved better for discriminating between ASD and non-ASD adults, while fixation duration seems to be the outcome to choose. Active engaged tasks seem to reduce differences between ASD and non-ASD adults, regardless of the emotional content of the stimuli/task. Proportional fixation duration on eyes and non-social areas in non-active tasks (e.g. free viewing) seems to be the best eye-tracking design for increasing the sensitivity and specificity in ASD adults.
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37
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Shic F, Naples AJ, Barney EC, Chang SA, Li B, McAllister T, Kim M, Dommer KJ, Hasselmo S, Atyabi A, Wang Q, Helleman G, Levin AR, Seow H, Bernier R, Charwaska K, Dawson G, Dziura J, Faja S, Jeste SS, Johnson SP, Murias M, Nelson CA, Sabatos-DeVito M, Senturk D, Sugar CA, Webb SJ, McPartland JC. The autism biomarkers consortium for clinical trials: evaluation of a battery of candidate eye-tracking biomarkers for use in autism clinical trials. Mol Autism 2022; 13:15. [PMID: 35313957 PMCID: PMC10124777 DOI: 10.1186/s13229-021-00482-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/20/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Eye tracking (ET) is a powerful methodology for studying attentional processes through quantification of eye movements. The precision, usability, and cost-effectiveness of ET render it a promising platform for developing biomarkers for use in clinical trials for autism spectrum disorder (ASD). METHODS The autism biomarkers consortium for clinical trials conducted a multisite, observational study of 6-11-year-old children with ASD (n = 280) and typical development (TD, n = 119). The ET battery included: Activity Monitoring, Social Interactive, Static Social Scenes, Biological Motion Preference, and Pupillary Light Reflex tasks. A priori, gaze to faces in Activity Monitoring, Social Interactive, and Static Social Scenes tasks were aggregated into an Oculomotor Index of Gaze to Human Faces (OMI) as the primary outcome measure. This work reports on fundamental biomarker properties (data acquisition rates, construct validity, six-week stability, group discrimination, and clinical relationships) derived from these assays that serve as a base for subsequent development of clinical trial biomarker applications. RESULTS All tasks exhibited excellent acquisition rates, met expectations for construct validity, had moderate or high six-week stabilities, and highlighted subsets of the ASD group with distinct biomarker performance. Within ASD, higher OMI was associated with increased memory for faces, decreased autism symptom severity, and higher verbal IQ and pragmatic communication skills. LIMITATIONS No specific interventions were administered in this study, limiting information about how ET biomarkers track or predict outcomes in response to treatment. This study did not consider co-occurrence of psychiatric conditions nor specificity in comparison with non-ASD special populations, therefore limiting our understanding of the applicability of outcomes to specific clinical contexts-of-use. Research-grade protocols and equipment were used; further studies are needed to explore deployment in less standardized contexts. CONCLUSIONS All ET tasks met expectations regarding biomarker properties, with strongest performance for tasks associated with attention to human faces and weakest performance associated with biological motion preference. Based on these data, the OMI has been accepted to the FDA's Biomarker Qualification program, providing a path for advancing efforts to develop biomarkers for use in clinical trials.
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Affiliation(s)
- Frederick Shic
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA.
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA.
| | - Adam J Naples
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Erin C Barney
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Shou An Chang
- Department of Psychology, Yale University, 2 Hillhouse Ave, New Haven, CT, 06520, USA
| | - Beibin Li
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA
| | - Takumi McAllister
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Minah Kim
- Department of Psychology, University of Virginia, 102 Gilmer Hall, P.O. Box 400400, Charlottesville, VA, 22904, USA
| | - Kelsey J Dommer
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
| | - Simone Hasselmo
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Adham Atyabi
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
- Department of Computer Science, University of Colorado - Colorado Springs, Colorado Springs, CO, USA
| | - Quan Wang
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Gerhard Helleman
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - April R Levin
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Helen Seow
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Raphael Bernier
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
| | - Katarzyna Charwaska
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, USA
| | - James Dziura
- Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Susan Faja
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Shafali Spurling Jeste
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Scott P Johnson
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael Murias
- Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, IL, USA
| | - Charles A Nelson
- Harvard Medical School, Boston, MA, USA
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Graduate School of Education, Harvard University, Boston, MA, USA
| | | | - Damla Senturk
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
| | - Catherine A Sugar
- Department of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA
- Division of Neurology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Sara J Webb
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Ave, Seattle, WA, 98101, USA
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, USA
| | - James C McPartland
- Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06520, USA.
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Wen TH, Cheng A, Andreason C, Zahiri J, Xiao Y, Xu R, Bao B, Courchesne E, Barnes CC, Arias SJ, Pierce K. Large scale validation of an early-age eye-tracking biomarker of an autism spectrum disorder subtype. Sci Rep 2022; 12:4253. [PMID: 35277549 PMCID: PMC8917231 DOI: 10.1038/s41598-022-08102-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/28/2022] [Indexed: 01/07/2023] Open
Abstract
Few clinically validated biomarkers of ASD exist which can rapidly, accurately, and objectively identify autism during the first years of life and be used to support optimized treatment outcomes and advances in precision medicine. As such, the goal of the present study was to leverage both simple and computationally-advanced approaches to validate an eye-tracking measure of social attention preference, the GeoPref Test, among 1,863 ASD, delayed, or typical toddlers (12-48 months) referred from the community or general population via a primary care universal screening program. Toddlers participated in diagnostic and psychometric evaluations and the GeoPref Test: a 1-min movie containing side-by-side dynamic social and geometric images. Following testing, diagnosis was denoted as ASD, ASD features, LD, GDD, Other, typical sibling of ASD proband, or typical. Relative to other diagnostic groups, ASD toddlers exhibited the highest levels of visual attention towards geometric images and those with especially high fixation levels exhibited poor clinical profiles. Using the 69% fixation threshold, the GeoPref Test had 98% specificity, 17% sensitivity, 81% PPV, and 65% NPV. Sensitivity increased to 33% when saccades were included, with comparable validity across sex, ethnicity, or race. The GeoPref Test was also highly reliable up to 24 months following the initial test. Finally, fixation levels among twins concordant for ASD were significantly correlated, indicating that GeoPref Test performance may be genetically driven. As the GeoPref Test yields few false positives (~ 2%) and is equally valid across demographic categories, the current findings highlight the ability of the GeoPref Test to rapidly and accurately detect autism before the 2nd birthday in a subset of children and serve as a biomarker for a unique ASD subtype in clinical trials.
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Affiliation(s)
- Teresa H Wen
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA.
| | - Amanda Cheng
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Charlene Andreason
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Javad Zahiri
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Yaqiong Xiao
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Ronghui Xu
- Herbert Wertheim School of Public Health and Department of Mathematics, University of California, San Diego, La Jolla, CA, USA
| | - Bokan Bao
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
- Department of Bioinformatics and Systems Biology, University of California, San Diego, La Jolla, CA, USA
| | - Eric Courchesne
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Cynthia Carter Barnes
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Steven J Arias
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA
| | - Karen Pierce
- Autism Center of Excellence, Department of Neurosciences, University of California, San Diego, 8110 La Jolla Shores Dr., La Jolla, CA, 92037, USA.
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Andreou G, Raxioni K. Language development, reading and word learning in Autism Spectrum Disorder (ASD): a review on eye tracking studies. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 70:2-19. [PMID: 38456140 PMCID: PMC10916904 DOI: 10.1080/20473869.2021.2024404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/16/2021] [Indexed: 03/09/2024]
Abstract
Objectives: The purpose of this article is to review research that has been conducted over the past five years on language development, reading skills and word learning with the use of the eye tracking machine as regards the population with autism spectrum disorder (ASD) in comparison to typically developed population. Materials and methods: A combination of relevant terms from Google Scholar, Research Gate and PsychINFO databases was used and as a result 24 studies emerged. The total number of studies that met the inclusion criteria was 21. Results: Studies focusing on the language development of people with ASD have presented significant findings regarding vocabulary processing and the preferential focus on specific stimuli (images, audio) over a wide range of ages that in some cases have not been investigated until then. Furthermore, studies on reading have found that adults with ASD showed a strong preference for images and symbols over texts, longer reading time and performances similar to the typical population in vocabulary processing. Studies on word learning demonstrated that adults with ASD are able to rely on gaze cues in order to learn a new word and they have the ability to use syntactic bootstrapping. For preschool and early school-aged children with ASD the results showed that they are capable of cross-situational learning. Conclusions: This review provides information on the effectiveness of the eye tracking method as a tool that can contribute to the identification of deficits in language processing on the part of individuals with ASD from early childhood to adulthood, and more specifically as regards the domains of language development, reading and word learning.
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Affiliation(s)
- Georgia Andreou
- Department of Special Education, University of Thessaly, Volos, Greece
| | - Katerina Raxioni
- Department of Special Education, University of Thessaly, Volos, Greece
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Santapuram P, Feldman JI, Bowman SM, Raj S, Suzman E, Crowley S, Kim SY, Keceli-Kaysili B, Bottema-Beutel K, Lewkowicz DJ, Wallace MT, Woynaroski TG. Mechanisms by which Early Eye Gaze to the Mouth During Multisensory Speech Influences Expressive Communication Development in Infant Siblings of Children with and without Autism. MIND, BRAIN AND EDUCATION : THE OFFICIAL JOURNAL OF THE INTERNATIONAL MIND, BRAIN, AND EDUCATION SOCIETY 2022; 16:62-74. [PMID: 35273650 PMCID: PMC8903197 DOI: 10.1111/mbe.12310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
Looking to the mouth of a talker early in life predicts expressive communication. We hypothesized that looking at a talker's mouth may signal that infants are ready for increased supported joint engagement and that it subsequently facilitates prelinguistic vocal development and translates to broader gains in expressive communication. We tested this hypothesis in 50 infants aged 6-18 months with heightened and general population-level likelihood of autism diagnosis (Sibs-autism and Sibs-NA; respectively). We measured infants' gaze to a speaker's face using an eye tracking task, supported joint engagement during parent-child free play sessions, vocal complexity during a communication sample, and broader expressive communication. Looking at the mouth was indirectly associated with expressive communication via increased higher-order supported joint engagement and vocal complexity. This indirect effect did not vary according to sibling status. This study provides preliminary insights into the mechanisms by which looking at the mouth may influence expressive communication development.
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Affiliation(s)
- Pooja Santapuram
- Vanderbilt School of Medicine, Vanderbilt University, Nashville, TN, USA
| | - Jacob I Feldman
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah M Bowman
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Present Affiliation: Augusta University/University of Georgia Medical Partnership at the Medical College of Georgia, Athens, GA, USA
| | - Sweeya Raj
- Neuroscience Undergraduate Program, Vanderbilt University, Nashville, TN, USA
| | - Evan Suzman
- Master's Program in Biomedical Sciences, Vanderbilt University, Nashville, TN, USA
| | - Shannon Crowley
- Lynch School of Education and Human Development, Boston College, Boston, MA, USA
| | - So Yoon Kim
- Present Affiliation: Department of Teacher Education, Duksung Women's University, Seoul, South Korea
| | - Bahar Keceli-Kaysili
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Mark T Wallace
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA
- Department of Psychology, Vanderbilt University, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Tiffany G Woynaroski
- Department of Hearing & Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Frist Center for Autism & Innovation, Vanderbilt University, Nashville, TN, USA
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41
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Zhang Y, Li D, Yang T, Chen C, Li H, Zhu C. Characteristics of emotional gaze on threatening faces in children with autism spectrum disorders. Front Psychiatry 2022; 13:920821. [PMID: 36072450 PMCID: PMC9441573 DOI: 10.3389/fpsyt.2022.920821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
Most evidence suggested that individuals with autism spectrum disorder (ASD) experienced gaze avoidance when looking at the eyes compared to typically developing (TD) individuals. Children with ASD magnified their fears when received threatening stimuli, resulting in a reduced duration of eye contact. Few studies have explored the gaze characteristics of children with ASD by dividing emotional faces into threatening and non-threatening pairs. In addition, although dynamic videos are more helpful in understanding the gaze characteristics of children with ASD, the experimental stimuli for some of the previous studies were still emotional pictures. We explored the viewing of dynamic threatening and non-threatening faces by children with ASD in different areas of interest (AOIs). In this study, 6-10 years old children with and without ASD viewed faces with threatening (fearful and angry) and non-threatening (sad and happy) expressions, respectively, with their eyes movements recorded. The results showed that when confronted with threatening faces, children with ASD, rather than TD, showed substantial eye avoidances, particularly non-specific avoidances in the fixation time on the mouths and significantly less time gazing at the mouths in any emotions, which was not observed for non-threatening faces. No correlations were found between the severity of symptoms and characteristics of gaze at the eyes and mouths in children with ASD. These results further enhance the understanding of the gaze characteristics of children with ASD on threatening and non-threatening faces and possibly provide additional evidence for their social interaction improvements.
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Affiliation(s)
- Yifan Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Dandan Li
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Tingting Yang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Chuanao Chen
- Anhui Province Hefei Kang Hua Rehabilitation Hospital, Hefei, China
| | - Hong Li
- Anhui Hospital Affiliated to the Pediatric Hospital of Fudan University, Hefei, China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
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Masedu F, Vagnetti R, Pino MC, Valenti M, Mazza M. Comparison of Visual Fixation Trajectories in Toddlers with Autism Spectrum Disorder and Typical Development: A Markov Chain Model. Brain Sci 2021; 12:10. [PMID: 35053753 PMCID: PMC8773751 DOI: 10.3390/brainsci12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 11/28/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition in which visual attention and visual search strategies are altered. Eye-tracking paradigms have been used to detect these changes. In our study, 18 toddlers with ASD and 18 toddlers with typical development (TD; age range 12-36 months) underwent an eye-tracking paradigm where a face was shown together with a series of objects. Eye gaze was coded according to three areas of interest (AOIs) indicating where the toddlers' gaze was directed: 'Face', 'Object', and 'No-stimulus fixation'. The fixation sequence for the ASD and TD groups was modelled with a Markov chain model, obtaining transition probabilities between AOIs. Our results indicate that the transition between AOIs could differentiate between toddlers with ASD or TD, highlighting different visual exploration patterns between the groups. The sequence of exploration is strictly conditioned based on previous fixations, among which 'No-stimulus fixation' has a critical role in differentiating the two groups. Furthermore, our analyses underline difficulties of individuals with ASD to engage in stimulus exploration. These results could improve clinical and interventional practice by considering this dimension among the evaluation process.
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Affiliation(s)
- Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (F.M.); (M.C.P.); (M.V.); (M.M.)
| | - Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (F.M.); (M.C.P.); (M.V.); (M.M.)
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (F.M.); (M.C.P.); (M.V.); (M.M.)
- Regional Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, 67100 L’Aquila, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (F.M.); (M.C.P.); (M.V.); (M.M.)
- Regional Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, 67100 L’Aquila, Italy
| | - Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (F.M.); (M.C.P.); (M.V.); (M.M.)
- Regional Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, 67100 L’Aquila, Italy
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Major S, Isaev D, Grapel J, Calnan T, Tenenbaum E, Carpenter K, Franz L, Howard J, Vermeer S, Sapiro G, Murias M, Dawson G. Shorter average look durations to dynamic social stimuli are associated with higher levels of autism symptoms in young autistic children. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:1451-1459. [PMID: 34903084 PMCID: PMC9192829 DOI: 10.1177/13623613211056427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT Many studies of autism look at the differences in how autistic research participants look at certain types of images. These studies often focus on where research participants are looking within the image, but that does not tell us everything about how much they are paying attention. It could be useful to know more about how well autistic research participants can focus on an image with people in it, because those who can look at images of people for longer duration without stopping may be able to easily learn other skills that help them to interact with people. We measured how long autistic research participants watched the video without breaking their attention. The video sometimes had a person speaking, and at other times had toys moving and making sounds. We measured the typical amount of time autistic research participants could look at the video before they looked away. We found that research participants with more severe autism tended to look at the video for shorter amounts of time. The ability to focus without stopping may be related to social skills in autistic people.
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Bagnall R, Russell A, Brosnan M, Maras K. Deceptive behaviour in autism: A scoping review. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2021; 26:293-307. [PMID: 34825581 PMCID: PMC8814957 DOI: 10.1177/13623613211057974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
LAY ABSTRACT The ability to deceive others is an important skill that usually develops in early childhood. In this review, we give an overview of studies that have examined deceptive behaviour in autistic children, adolescents and adults. We separated the study findings into three main categories and seven sub-categories: (1) Deception ability and prevalence (1a) gameplay deception; (1b) naturalistic deception; (2) Psychological processes in deception (2a) verbal, intellectual and social ability; (2b) ability to understand others' thoughts and beliefs; (2c) cognitive ability; and (3) Social learning (3a) training; (3b) social contexts. Contrary to some stereotypes, we found that autistic people can and do deceive but often find this more difficult than non-autistic people. We also found that autistic people may use different psychological processes than non-autistic people when deceiving and may get better at deception in adulthood.
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45
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Alcañiz M, Chicchi-Giglioli IA, Carrasco-Ribelles LA, Marín-Morales J, Minissi ME, Teruel-García G, Sirera M, Abad L. Eye gaze as a biomarker in the recognition of autism spectrum disorder using virtual reality and machine learning: A proof of concept for diagnosis. Autism Res 2021; 15:131-145. [PMID: 34811930 DOI: 10.1002/aur.2636] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/13/2021] [Accepted: 10/28/2021] [Indexed: 12/11/2022]
Abstract
The core symptoms of autism spectrum disorder (ASD) mainly relate to social communication and interactions. ASD assessment involves expert observations in neutral settings, which introduces limitations and biases related to lack of objectivity and does not capture performance in real-world settings. To overcome these limitations, advances in technologies (e.g., virtual reality) and sensors (e.g., eye-tracking tools) have been used to create realistic simulated environments and track eye movements, enriching assessments with more objective data than can be obtained via traditional measures. This study aimed to distinguish between autistic and typically developing children using visual attention behaviors through an eye-tracking paradigm in a virtual environment as a measure of attunement to and extraction of socially relevant information. The 55 children participated. Autistic children presented a higher number of frames, both overall and per scenario, and showed higher visual preferences for adults over children, as well as specific preferences for adults' rather than children's faces on which looked more at bodies. A set of multivariate supervised machine learning models were developed using recursive feature selection to recognize ASD based on extracted eye gaze features. The models achieved up to 86% accuracy (sensitivity = 91%) in recognizing autistic children. Our results should be taken as preliminary due to the relatively small sample size and the lack of an external replication dataset. However, to our knowledge, this constitutes a first proof of concept in the combined use of virtual reality, eye-tracking tools, and machine learning for ASD recognition. LAY SUMMARY: Core symptoms in children with ASD involve social communication and interaction. ASD assessment includes expert observations in neutral settings, which show limitations and biases related to lack of objectivity and do not capture performance in real settings. To overcome these limitations, this work aimed to distinguish between autistic and typically developing children in visual attention behaviors through an eye-tracking paradigm in a virtual environment as a measure of attunement to, and extraction of, socially relevant information.
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Affiliation(s)
- Mariano Alcañiz
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, Valencia, Spain
| | - Irene Alice Chicchi-Giglioli
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, Valencia, Spain
| | - Lucía A Carrasco-Ribelles
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, Valencia, Spain.,Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Javier Marín-Morales
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, Valencia, Spain
| | - Maria Eleonora Minissi
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, Valencia, Spain
| | - Gonzalo Teruel-García
- Instituto de Investigación e Innovación en Bioingeniería (i3B), Universitat Politécnica de Valencia, Valencia, Spain
| | - Marian Sirera
- Red Cenit, Centros de Desarrollo Cognitivo, Valencia, Spain
| | - Luis Abad
- Red Cenit, Centros de Desarrollo Cognitivo, Valencia, Spain
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46
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Zammarchi G, Conversano C. Application of Eye Tracking Technology in Medicine: A Bibliometric Analysis. Vision (Basel) 2021; 5:56. [PMID: 34842855 PMCID: PMC8628933 DOI: 10.3390/vision5040056] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Eye tracking provides a quantitative measure of eye movements during different activities. We report the results from a bibliometric analysis to investigate trends in eye tracking research applied to the study of different medical conditions. We conducted a search on the Web of Science Core Collection (WoS) database and analyzed the dataset of 2456 retrieved articles using VOSviewer and the Bibliometrix R package. The most represented area was psychiatry (503, 20.5%) followed by neuroscience (465, 18.9%) and psychology developmental (337, 13.7%). The annual scientific production growth was 11.14% and showed exponential growth with three main peaks in 2011, 2015 and 2017. Extensive collaboration networks were identified between the three countries with the highest scientific production, the USA (35.3%), the UK (9.5%) and Germany (7.3%). Based on term co-occurrence maps and analyses of sources of articles, we identified autism spectrum disorders as the most investigated condition and conducted specific analyses on 638 articles related to this topic which showed an annual scientific production growth of 16.52%. The majority of studies focused on autism used eye tracking to investigate gaze patterns with regards to stimuli related to social interaction. Our analysis highlights the widespread and increasing use of eye tracking in the study of different neurological and psychiatric conditions.
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Affiliation(s)
- Gianpaolo Zammarchi
- Department of Economics and Business Sciences, University of Cagliari, 09123 Cagliari, Italy;
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47
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Kaliukhovich DA, Manyakov NV, Bangerter A, Pandina G. Context Modulates Attention to Faces in Dynamic Social Scenes in Children and Adults with Autism Spectrum Disorder. J Autism Dev Disord 2021; 52:4219-4232. [PMID: 34623583 PMCID: PMC9508054 DOI: 10.1007/s10803-021-05279-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2021] [Indexed: 11/28/2022]
Abstract
Individuals with autism spectrum disorder (ASD) have been found to view social scenes differently compared to typically developing (TD) peers, but results can vary depending on context and age. We used eye-tracking in children and adults (age 6-63) to assess allocation of visual attention in a dynamic social orientation paradigm previously used only in younger children. The ASD group (n = 94) looked less at the actor's face compared to TD (n = 38) when they were engaged in activity (mean percentage of looking time, ASD = 30.7% vs TD = 34.9%; Cohen's d = 0.56; p value < 0.03) or looking at a moving toy (24.5% vs 33.2%; d = 0.65; p value < 0.001). Findings indicate that there are qualitative differences in allocation of visual attention to social stimuli across ages in ASD.ClinicalTrials.gov identifier: NCT02668991.
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Affiliation(s)
| | | | | | - Gahan Pandina
- Janssen Research & Development, LLC, Titusville, NJ, USA
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48
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Tenenbaum EJ, Major S, Carpenter KLH, Howard J, Murias M, Dawson G. Distance from Typical Scan Path When Viewing Complex Stimuli in Children with Autism Spectrum Disorder and its Association with Behavior. J Autism Dev Disord 2021; 51:3492-3505. [PMID: 33387244 PMCID: PMC9903808 DOI: 10.1007/s10803-020-04812-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2020] [Indexed: 01/14/2023]
Abstract
Eye-tracking is often used to study attention in children with autism spectrum disorder (ASD). Previous research has identified multiple atypical patterns of attention in children with ASD based on areas-of-interest analysis. Fewer studies have investigated gaze path, a measure which is dependent on the dynamic content of the stimulus presented. Here, rather than looking at proportions of looking time to areas of interest, we calculated mean fixations frame-by-frame in a group of typically developing children (36 to 72 months) and determined the distance from those typical fixations for 155 children with ASD (27-95 months). Findings revealed that distance from the typical scan path among the children with ASD was associated with lower communication abilities and greater ASD symptomatology.
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Affiliation(s)
- Elena J Tenenbaum
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, 27705, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA.
- Duke Institute for Brain Sciences, Duke University, Durham, NC, 27708, USA.
| | - Samantha Major
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, 27705, USA
| | - Kimberly L H Carpenter
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, 27705, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA
- Duke Institute for Brain Sciences, Duke University, Durham, NC, 27708, USA
| | - Jill Howard
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, 27705, USA
| | - Michael Murias
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, 27705, USA
- Medical Social Sciences, Northwestern University, Chicago, IL, 60622, USA
| | - Geraldine Dawson
- Duke Center for Autism and Brain Development, Duke University, Durham, NC, 27705, USA
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27705, USA
- Duke Institute for Brain Sciences, Duke University, Durham, NC, 27708, USA
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49
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Ma X, Gu H, Zhao J. Atypical gaze patterns to facial feature areas in autism spectrum disorders reveal age and culture effects: A meta-analysis of eye-tracking studies. Autism Res 2021; 14:2625-2639. [PMID: 34542246 DOI: 10.1002/aur.2607] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 08/07/2021] [Accepted: 08/21/2021] [Indexed: 12/28/2022]
Abstract
Children and adults with autism spectrum disorder (ASD) often present with atypical gaze patterns to others' faces, a finding substantiated throughout the literature. Yet, a quantification of atypical gaze patterns to different facial regions (e.g., eyes versus mouth) in ASD remains controversial. Also few study has investigated how age and culture impacted the pattern of gaze abnormalities in ASD. This research therefore conducted a meta-analysis of eye-tracking studies to evaluate age and culture effect on atypical gaze patterns of face processing in ASD. A total of 75 articles (91 studies) and 4209 individuals (ASD: 2027; controls: 2182) across all age ranges (i.e., childhood through to adulthood) from both Eastern and Western cultures were included in this meta-analysis. Individuals with ASD yielded shorter fixation durations to the eyes than individuals without ASD. Group differences in the time spent fixating on the eyes were not modulated by age, but affected by culture. Effect size in the eastern culture was larger than that in the western culture. In contrast, group differences on time spent looking at the mouth were not significant, but changed with age and modulated by culture. Relative to the neurotypical controls, Western individuals with ASD spent more time looking at the mouth from school age, whereas Eastern individuals with ASD did not gaze longer on mouth until adulthood. These results add to the body of evidence supporting atypical gaze behaviors to eyes in ASD and provide new insights into a potential mouth compensation strategy that develops with age in ASD. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) often show atypical gaze patterns when looking at others' faces compared to neurotypical individuals. This paper examines the role of age and culture on pattern of gaze abnormalities in individuals with ASD. Results show that reduction of gaze on eyes in ASD is stable across all ages and cultures, while increase of gaze on mouth emerges as individuals with ASD get older. The findings provide a developmental insight to the gaze patterns on the autism spectrum across culture.
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Affiliation(s)
- Xue'er Ma
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China
| | - Haixia Gu
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China
| | - Jingjing Zhao
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, China
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Macari S, Chen X, Brunissen L, Yhang E, Brennan-Wydra E, Vernetti A, Volkmar F, Chang J, Chawarska K. Puppets facilitate attention to social cues in children with ASD. Autism Res 2021; 14:1975-1985. [PMID: 34350712 PMCID: PMC8434944 DOI: 10.1002/aur.2552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/09/2021] [Accepted: 05/18/2021] [Indexed: 11/06/2022]
Abstract
Diminished visual attention to faces of social partners represents one of the early characteristics of autism spectrum disorder (ASD). Here we examine if the introduction of puppets as social partners alters attention to speakers' faces in young children with ASD and typically developing (TD) controls. Children with ASD (N = 37; Mage = 49.44 months) and TD (N = 27; Mage = 40.66 months) viewed a video depicting a puppet and a human engaged in a conversation. Dwell time on these faces was analyzed as a function of group and speaker's identity. Unlike TD controls, the ASD group exhibited limited visual attention to and chance-level visual preference for the human speaker. However, attention to and preference for the puppet speaker's face was greater than chance and comparable across the two groups. While there was a strong association between low human speaker preference and high autism severity, no association with autism severity was found for puppet speaker preference. Unlike humans, expressive and verbal puppets attracted the attention of children with ASD at levels comparable to that of TD controls. Considering that puppets can engage in reciprocal interactions and deliver simplified, salient social-communicative cues, they may facilitate therapeutic efforts in children with ASD. LAY SUMMARY: While studies have shown support for therapeutic uses of robots with children with autism, other similar agents such as puppets remain to be explored. When shown a video of a conversation between a puppet and a person, young children with ASD paid as much attention to the puppet's face as typically-developing (TD) children. Since puppets can engage in back-and-forth interactions and model social interactions and communication, they may play a promising role in therapeutic efforts for young children with ASD.
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Affiliation(s)
- Suzanne Macari
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Xinyuan Chen
- Department of Statistics and Data Science, Yale University, New Haven, Connecticut, USA
| | - Ludivine Brunissen
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Eukyung Yhang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Emma Brennan-Wydra
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Angelina Vernetti
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Fred Volkmar
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Joseph Chang
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Statistics and Data Science, Yale University, New Haven, Connecticut, USA
| | - Katarzyna Chawarska
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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