Unimpaired Attentional Disengagement and Social Orienting in Children with Autism

Similar Gap-Overlap Profiles in Children with Fragile X Syndrome and IQ-Matched Autism

PURPOSE

Fragile X syndrome (FXS) is a single-gene disorder characterized by moderate to severe cognitive impairment and a high association with autism spectrum disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Atypical visual attention is a feature of FXS, ASD, and ADHD. Thus, studying early attentional patterns in young children with FXS can offer insight into early emerging neurocognitive processes underlying challenges and contribute to our understanding of common and unique features of ASD and ADHD in FXS.

METHODS

The present study examined visual attention indexed by the gap-overlap paradigm in children with FXS (n = 39) compared to children with ASD matched on intellectual ability and age (n = 40) and age-matched neurotypical controls (n = 34). The relationship between gap-overlap performance and intellectual ability, ASD, and ADHD across groups was characterized. Saccadic reaction times (RT) were collected across baseline, gap, and overlap conditions.

RESULTS

Results indicate no group differences in RT for any conditions. However, RT of the ASD and NT groups became slower throughout the experiment whereas RT of the FXS group did not change, suggesting difficulties in habituation for the FXS group. There was no relationship between RT and intellectual ability, ADHD, or ASD symptoms in the FXS and ASD groups. In the NT group, slower RT was related to elevated ADHD symptoms only.

CONCLUSION

Taken together, findings suggest that the social attention differences documented in FXS and ASD may be due to other cognitive factors, such as reward or motivation, rather than oculomotor control of visual attention.

Rhythmic attentional sampling in autism

Individuals diagnosed with autism often display alterations in visual spatial attention toward visual stimuli, but the underlying cause of these differences remains unclear. Recent evidence has demonstrated that covert spatial attention, rather than remaining constant at a cued location, samples stimuli rhythmically at a frequency of 4-8 Hz (theta). Here we tested whether rhythmic sampling of attention is altered in autism. Participants were asked to monitor three locations to detect a brief target presented 300-1200 ms after a spatial cue. Visual attention was oriented to the cue and modified visual processing at the cued location, consistent with previous studies. We measured detection performance at different cue-target intervals when the target occurred at the cued location. Significant oscillations in detection performance were identified using both a traditional time-shuffled approach and a new autoregressive surrogate method developed by Brookshire in 2022. We found that attention enhances behavioral performance rhythmically at the same frequency in both autism and control group at the cued location. However, rhythmic temporal structure was not observed in a subgroup of autistic individuals with co-occurring attention-deficit/hyperactivity disorder (ADHD). Our results imply that intrinsic brain rhythms which organize neural activity into alternating attentional states is functional in autistic individuals, but may be altered in autistic participants who have a concurrent ADHD diagnosis.

Comparative strengths and challenges on face-to-face and computer-based attention tasks in autistic and neurotypical toddlers

The objectives were to compare patterns of visual attention in toddlers diagnosed with autism spectrum disorder (ASD) as compared to their sex- and age-matched neurotypical (NT) peers. Participants included 23 toddlers with ASD and 19 NT toddlers (mean age: 25.52 versus 25.21 months, respectively) assessed using computerized tasks to measure sustained attention, disengaging attention, and cognitive control, as well as an in-person task to assess joint attention. Toddlers in the ASD group showed increased looking durations on the sustained attention task, as well as reduced frequencies of responding to and initiating joint attention compared to NT peers, but showed no differences on tasks of disengaging attention and cognitive control. The results suggest that toddlers with ASD have attentional strengths that may provide a foundation for building attention, communicative, and ultimately, academic skills.

Why do children with autism spectrum disorder have abnormal visual perception?

Autism spectrum disorder (ASD) is associated with severe impairment in social functioning. Visual information processing provides nonverbal cues that support social interactions. ASD children exhibit abnormalities in visual orientation, continuous visual exploration, and visual-spatial perception, causing social dysfunction, and mechanisms underlying these abnormalities remain unclear. Transmission of visual information depends on the retina-lateral geniculate nucleus-visual cortex pathway. In ASD, developmental abnormalities occur in rapid expansion of the visual cortex surface area with constant thickness during early life, causing abnormal transmission of the peak of the visual evoked potential (P100). We hypothesized that abnormal visual perception in ASD are related to the abnormal visual information transmission and abnormal development of visual cortex in early life, what's more, explored the mechanisms of abnormal visual symptoms to provide suggestions for future research.

Faster social attention disengagement in individuals with higher autism traits

INTRODUCTION

Atypical visual and social attention has often been associated with clinically diagnosed autism spectrum disorder (ASD), and with the broader autism phenotype. Atypical social attention is of particular research interest given the importance of facial expressions for social communication, with faces tending to attract and hold attention in neurotypical individuals. In autism, this is not necessarily so, where there is debate about the temporal differences in the ability to disengage attention from a face.

METHOD

Thus, we have used eye-tracking to record saccadic latencies as a measure of time to disengage attention from a central task-irrelevant face before orienting to a newly presented peripheral nonsocial target during a gap-overlap task. Neurotypical participants with higher or lower autism-like traits (AT) completed the task that included central stimuli with varied expressions of facial emotion as well as an inverted face.

RESULTS

High AT participants demonstrated faster saccadic responses to detect the nonsocial target than low AT participants when disengaging attention from a face. Furthermore, faster saccadic responses were recorded when comparing disengagement from upright to inverted faces in low AT but not in high AT participants.

CONCLUSIONS

Together, these results extend findings of atypical social attention disengagement in autism and highlight how differences in attention to faces in the broader autism phenotype can lead to apparently superior task performance under certain conditions. Specifically, autism traits were linked to faster attention orienting to a nonsocial target due to the reduced attentional hold of the task irrelevant face stimuli. The absence of an inversion effect in high AT participants also reinforces the suggestion that they process upright or inverted faces similarly, unlike low AT participants for whom inverted faces are thought to be less socially engaging, thus allowing faster disengagement.

Attentional Engagement and Disengagement Differences for Circumscribed Interest Objects in Young Chinese Children with Autism

The current study aimed to investigate attentional processing differences for circumscribed interest (CI) and non-CI objects in young Chinese children with autism spectrum condition (ASC) and typically developing (TD) controls. In Experiment 1, a visual preference task explored attentional allocation to cartoon CI and non-CI materials between the two groups. We found that ASC children (n = 22, 4.95 ± 0.59 years) exhibited a preference for CI-related objects compared to non-CI objects, and this effect was absent in the TD children (n = 22, 5.14 ± 0.44 years). Experiment 2 utilized the traditional gap-overlap paradigm (GOP) to investigate attentional disengagement from CI or non-CI items in both groups (ASC: n = 20, 5.92 ± 1.13 years; TD: n = 25, 5.77 ± 0.77 years). There were no group or stimulus interactions in this study. Experiment 3 adopted a modified GOP (MGOP) to further explore disengagement in the two groups (ASC: n = 20, 5.54 ± 0.95 years; TD: n = 24, 5.75 ± 0.52 years), and the results suggested that exogenous disengagement performance was preserved in the ASC group, but the children with ASC exhibited increased endogenous attentional disengagement compared to TD peers. Moreover, endogenous disengagement was influenced further in the presence of CI-related objects in the ASC children. The current results have implications for understanding how the nature of engagement and disengagement processes can contribute to differences in the development of core cognitive skills in young children with ASC.

High-level visual search in children with autism

Visual search has been classified as easy feature search, with rapid target detection and little set size dependence, versus slower difficult search with focused attention, with set size–dependent speed. Reverse hierarchy theory attributes these classes to rapid high cortical-level vision at a glance versus low-level vision with scrutiny, attributing easy search to high-level representations. Accordingly, faces “pop out” of heterogeneous object photographs. Individuals with autism have difficulties recognizing faces, and we now asked if this disability disturbs their search for faces. We compare search times and set size slopes for children with autism spectrum disorders (ASDs) and those with neurotypical development (NT) when searching for faces. Human face targets were found rapidly, with shallow set size slopes. The between-group difference between slopes (18.8 vs. 11.3 ms/item) is significant, suggesting that faces may not “pop out” as easily, but in our view does not warrant classifying ASD face search as categorically different from that of NT children. We also tested search for different target categories, dog and lion faces, and nonface basic categories, cars and houses. The ASD group was generally a bit slower than the NT group, and their slopes were somewhat steeper. Nevertheless, the overall dependencies on target category were similar: human face search fastest, nonface categories slowest, and dog and lion faces in between. We conclude that autism may spare vision at a glance, including face detection, despite its reported effects on face recognition, which may require vision with scrutiny. This dichotomy is consistent with the two perceptual modes suggested by reverse hierarchy theory.

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

Background

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

Methods

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

Results

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

Limitations

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

Conclusions

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

Supplementary Information

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

Atypical processing pattern of gaze cues in dynamic situations in autism spectrum disorders

Psychological studies have generally shown that individuals with Autism Spectrum Disorder (ASD) have particularity in the processing of social information by using static or abstract images. Yet, a recent study showed that there was no difference in their use of social or non-social cues in dynamic interactive situations. To establish the cause of the inconsistent results, we added gaze cues in different directions to the chase detection paradigm to explore whether they would affect the performance of participants with ASD. Meanwhile, eye-tracking methodology was used to investigate whether the processing patterns of gaze cues were different between individuals with ASD and TD. In this study, unlike typical controls, participants with ASD showed no detection advantage when the direction of gaze was consistent with the direction of movement (oriented condition). The results suggested that individuals with ASD may utilize an atypical processing pattern, which makes it difficult for them to use social information contained in oriented gaze cues in dynamic interactive situations.

Visual perceptual salience and novel referent selection in children with and without autism spectrum disorder

BACKGROUND & AIMS

Many young children with autism spectrum disorder (ASD) demonstrate striking delays in early vocabulary development. Experimental studies that teach the meanings of novel nonwords can determine the effects of linguistic and attentional factors. One factor that may affect novel referent selection in children with ASD is visual perceptual salience-how interesting (i.e., striking) stimuli are on the basis of their visual properties. The goal of the current study was to determine how the perceptual salience of objects affected novel referent selection in children with ASD and children who are typically developing (TD) of similar ages (mean age 3-4 years).

METHODS

Using a screen-based experimental paradigm, children were taught the names of four unfamiliar objects: two high-salience objects and two low-salience objects. Their comprehension of the novel words was assessed in low-difficulty and high-difficulty trials. Gaze location was determined from video by trained research assistants.

RESULTS

Contrary to initial predictions, findings indicated that high perceptual salience disrupted novel referent selection in the children with ASD but facilitated attention to the target object in age-matched TD peers. The children with ASD showed no significant evidence of successful novel referent selection in the high-difficulty trials. Exploratory reaction time analyses suggested that the children with autism showed "stickier" attention-had more difficulty disengaging (i.e., looking away)-from high-salience distracter images than low-salience distracter images, even though the two images were balanced in salience for any given test trial.

CONCLUSIONS AND CLINICAL IMPLICATIONS

These findings add to growing evidence that high perceptual salience has the potential to disrupt novel referent selection in children with ASD. These results underscore the complexity of novel referent selection and highlight the importance of taking the immediate testing context into account. In particular, it is important to acknowledge that screen-based assessments and screen-based learning activities used with children with ASD are not immune to the effects of lower level visual features, such as perceptual salience.

Social visual attentional engagement and memory in Phelan-McDermid syndrome and autism spectrum disorder: a pilot eye tracking study

BACKGROUND

The current study used eye tracking to investigate attention and recognition memory in Phelan-McDermid syndrome (PMS), a rare genetic disorder characterized by intellectual disability, motor delays, and a high likelihood of comorbid autism spectrum disorder (ASD). Social deficits represent a core feature of ASD, including decreased propensity to orient to or show preference for social stimuli.

METHODS

We used a visual paired-comparison task with both social and non-social images, assessing looking behavior to a novel image versus a previously viewed familiar image to characterize social attention and recognition memory in PMS (n = 22), idiopathic ASD (iASD, n = 38), and typically developing (TD) controls (n = 26). The idiopathic ASD cohort was divided into subgroups with intellectual disabilities (ID; developmental quotient < 70) and without (developmental quotient > 70) and the PMS group into those with and without a co-morbid ASD diagnosis.

RESULTS

On measures of attention, the PMS group with a comorbid ASD diagnosis spent less time viewing the social images compared to non-social images; the rate of looking back and forth between images was lowest in the iASD with ID group. Furthermore, while all groups demonstrated intact recognition memory when novel non-social stimuli were initially presented (pre-switch), participants with PMS showed no preference during the post-switch memory presentation. In iASD, the group without ID, but not the group with ID, showed a novelty preference for social stimuli. Across indices, individuals with PMS and ASD performed more similarly to PMS without ASD and less similarly to the iASD group.

CONCLUSION

These findings demonstrate further evidence of differences in attention and memory for social stimuli in ASD and provide contrasts between iASD and PMS.

Visual attention and inhibitory control in children, teenagers and adults with autism without intellectual disability: results of oculomotor tasks from a 2-year longitudinal follow-up study (InFoR)

BACKGROUND

Inhibitory control and attention processing atypicalities are implicated in various diseases, including autism spectrum disorders (ASD). These cognitive functions can be tested by using visually guided saccade-based paradigms in children, adolescents and adults to determine the time course of such disorders.

METHODS

In this study, using Gap, Step, Overlap and Antisaccade tasks, we analyzed the oculomotor behavior of 82 children, teenagers and adults with high functioning ASD and their peer typically developing (TD) controls in a two-year follow-up study under the auspices of the InFoR-Autism project. Analysis of correlations between oculomotors task measurements and diagnostic assessment of attentional (ADHD-RS and ADHD comorbidity indices) and executive functioning (BRIEF scales) were conducted in order to evaluate their relationship with the oculomotor performance of participants with ASD.

RESULTS

As indicated by the presence of a Gap and Overlap effects in all age groups, the oculomotor performances of ASD participants showed a preserved capability in overt attention switching. In contrast, the difference in performances of ASD participants in the Antisaccade task, compared to their TD peers, indicated an atypical development of inhibition and executive functions. From correlation analysis between our oculomotor data and ADHD comorbidity index, and scores of attention and executive function difficulties, our findings support the hypothesis that a specific dysfunction of inhibition skills occurs in ASD participants that is independent of the presence of ADHD comorbidity.

LIMITATIONS

These include the relatively small sample size of the ASD group over the study's two-year period, the absence of an ADHD-only control group and the evaluation of a TD control group solely at the study's inception.

CONCLUSIONS

Children and teenagers with ASD have greater difficulty in attention switching and inhibiting prepotent stimuli. Adults with ASD can overcome these difficulties, but, similar to teenagers and children with ASD, they make more erroneous and anticipatory saccades and display a greater trial-to-trial variability in all oculomotor tasks compared to their peers. Our results are indicative of a developmental delay in the maturation of executive and attentional functioning in ASD and of a specific impairment in inhibitory control.

Autistic differences in the temporal dynamics of social attention

LAY ABSTRACT

One behaviour often observed in individuals with autism is that they tend to look less towards social stimuli relative to neurotypical individuals. For instance, many eye-tracking studies have shown that individuals with autism will look less towards people and more towards objects in scenes. However, we currently know very little about how these behaviours change over time. Tracking these moment-to-moment changes in looking behaviour in individuals with autism can more clearly illustrate how they respond to social stimuli. In this study, adults with and without autism were presented with displays of social and non-social stimuli, while looking behaviours were measured by eye-tracking. We found large differences in how the two groups looked towards social stimuli over time. Neurotypical individuals initially showed a high probability of looking towards social stimuli, then a decline in probability, and a subsequent increase in probability after prolonged viewing. By contrast, individuals with autism showed an initial increase in probability, followed by a continuous decline in probability that did not recover. This pattern of results may indicate that individuals with autism exhibit reduced responsivity to the reward value of social stimuli. Moreover, our data suggest that exploring the temporal nature of gaze behaviours can lead to more precise explanatory theories of attention in autism.

Comparing visual preferences between autism spectrum disorder (ASD) and normal children to explore the characteristics of visual preference of ASD children by improved visual preference paradigm: a case-control study

BACKGROUND

One of features of Visual preference in autism spectrum disorder (ASD) is that they tend to social stimuli to nonsocial stimuli. Though it has been studied widely, until now the results are still not consistent. One of the most important reasons may be that the stimuli of the past visual preference paradigm have different movement patterns. Therefore, the present study aimed to improve the visual preference paradigm to reduce the bias caused by different movement of stimuli and explore the features of visual preference of ASD further.

METHODS

Two hundred and seven children who met DSM-5 criteria for ASD and 125 typically developmental (TD) children were enrolled. They were matched in age and gender. Visual preference was measured by eye tracking technology. The subjects presented simultaneously with dynamic object images (DOI) and dynamic social images (DSI) with the same type and same speed of repetitive movement. Social interaction deficits of ASD were assessed by parents with Aberrant Behavior Checklist (ABC).

RESULTS

Compared with TD children, the following findings were noted: (I) children with ASD paid less attention to social stimuli and more attention to nonsocial stimuli (t=6.417, P<0.001). (II) Increased preference to DSI was positively correlated with age (R=0.23, P=0.001). (III) No association was noted between visual preference and IQ in children with ASD (R=0.081, P=0.435). (IV) Reduced preference to DSI was negatively correlated with the severity of social interaction impairment rated by parents with ABC in children with ASD (R=0.237, P=0.010).

CONCLUSIONS

Children with ASD exhibited abnormal visual preference for social and nonsocial stimuli.

A cross-cultural study showing deficits in gaze-language coordination during rapid automatized naming among individuals with ASD

Individuals with autism spectrum disorder (ASD) and their first-degree relatives demonstrate automaticity deficits reflected in reduced eye-voice coordination during rapid automatized naming (RAN), suggesting that RAN deficits may be a genetically meaningful marker of ASD language-related impairments. This study investigated whether RAN deficits in ASD extend to a language typologically distinct from English. Participants included 23 Cantonese-speaking individuals with ASD and 39 controls from Hong Kong (HK), and age- and IQ-comparable groups of previously-studied English-speaking individuals with ASD (n = 45) and controls (n = 44) from the US. Participants completed RAN on an eye tracker. Analyses examined naming time, error rate, measures of eye movement reflecting language automaticity, including eye-voice span (EVS; location of eyes versus the named item) and refixations. The HK-ASD group exhibited longer naming times and more refixations than HK-Controls, in a pattern similar to that observed in the US-ASD group. Cultural effects revealed that both HK groups showed longer EVS and more fixations than US groups. Naming time and refixation differences may be ASD-specific impairments spanning cultures/languages, whereas EVS and fixation frequency may be more variably impacted. A potential underlying mechanism of visual "stickiness" may be contributing to this breakdown in language automaticity in ASD.

Attentional shift within and between faces: Evidence from children with and without a diagnosis of autism spectrum disorder

Evidence of attentional atypicalities for faces in Autism Spectrum Disorders (ASD) are far from being confirmed. Using eye-tracking technology we compared space-based and object-based attention in children with, and without, a diagnosis of ASD. By capitalizing on Egly's paradigm, we presented two objects (2 faces and their phase-scrambled equivalent) and cued a location in one of the two objects. Then, a target appeared at the same location as the cue (Valid condition), or at a different location within the same object (Same Object condition), or at a different location in another object (Different Object condition). The attentional benefit/cost in terms of time for target detection in each of the three conditions was computed. The findings revealed that target detection was always faster in the valid condition than in the invalid condition, regardless of the type of stimulus and the group of children. Thus, no difference emerged between the two groups in terms of space-based attention. Conversely the two groups differed in object-based attention. Children without a diagnosis of ASD showed attentional shift cost with phase-scrambled stimuli, but not with faces. Instead, children with a diagnosis of ASD deployed similar attentional strategies to focus on faces and their phase-scrambled version.

Reduced engagement of visual attention in children with autism spectrum disorder

LAY ABSTRACT

Limited eye contact and difficulty tracking where others are looking are common in people with autism spectrum disorder. It is unclear, however, whether these are specifically social differences; it is possible that they are a result of broader alterations in engaging and disengaging visual attention. We used eye-tracking technology with children with autism spectrum disorder (n = 35) and typical development (n = 32), showing them both social and nonsocial imaging to test their visual attention. Children with autism spectrum disorder had a significant difference in how long it took them to look from an image in the middle to one on the side, depending on whether the middle image stayed on the screen or flashed off before the one on the side appeared. This difference was present for both social and nonsocial images, and was related to cognitive ability for only the children with autism spectrum disorder. Our findings suggest that children with autism spectrum disorder have differences in general processes of engaging visual attention that are not specifically social in nature, and that these processes may relate to cognitive ability in autism spectrum disorder. Affected processes of visual engagement in autism spectrum disorder may contribute to symptoms like reduced eye contact, but social-specific symptoms of autism spectrum disorder likely do not stem from reduced visual engagement alone.

Social orienting and social seeking behaviors in ASD. A meta analytic investigation

Social motivation accounts of autism spectrum disorder (ASD) posit that individuals with ASD find social stimuli less rewarding than neurotypical (NT) individuals. Behaviorally, this is proposed to manifest in reduced social orienting (individuals with ASD direct less attention towards social stimuli) and reduced social seeking (individuals with ASD invest less effort to receive social stimuli). In two meta-analyses, involving data from over 6000 participants, we review the available behavioral studies that assess social orienting and social seeking behaviors in ASD. We found robust evidence for reduced social orienting in ASD, across a range of paradigms, demographic variables and stimulus contexts. The most robust predictor of this effect was interactive content - effects were larger when the stimulus involved an interaction between people. By contrast, the evidence for reduced social seeking indicated weaker evidence for group differences, observed only under specific experimental conditions. The insights gained from this meta-analysis can inform design of relevant task measures for social reward responsivity and promote directions for further study on the ASD phenotype.

Visuo-attentional correlates of Autism Spectrum Disorder (ASD) in children with Down syndrome: A comparative study with children with idiopathic ASD

BACKGROUND

Children with Down syndrome (DS) are at increased likelihood of Autism Spectrum Disorder (ASD) relative to the general population. To better understand the nature of this comorbidity, we examined the visuo-attentional processes associated with autistic trait expression in children with DS, focusing specifically on attentional disengagement and visual search performance.

METHOD

We collected eye-tracking data from children with DS (n = 15) and children with idiopathic ASD (iASD, n = 16) matched according to chronological age. Seven children with DS had a formal clinical diagnosis of ASD (DS+ASD).

RESULTS

In children with iASD, but not DS, higher autistic trait levels were associated with decreased temporal facilitation on a gap-overlap task, implying increased visuospatial orienting efficiency. In all cases, higher autistic trait levels were associated with improved visual search performance according to decreased target detection latency. On a visual search task, children with DS+ASD outperformed their peers with DS-ASD, mirroring the phenotypic advantage associated with iASD. We found no evidence of a relationship between attentional disengagement and visual search performance, providing preliminary evidence of a differentiation in terms of underlying visuo-attentional mechanism.

CONCLUSION

We illustrate the value of progressing beyond insensitive behavioural measures of phenotypic description to examine, in a more fine-grained way, the attentional features associated with ASD comorbidity in children with DS.

Giving meaning to the social world in autism spectrum disorders: Olfaction as a missing piece of the puzzle?

Altered social cognition is a core feature of Autism Spectrum Disorders (ASD). These impairments have been explained as the consequence of compromised social motivational mechanisms that limit social interest and activate a cascade of social deficits. Following this rational, we argue that approaches capable of surpassing ASD usual restraints (e.g., deficits in verbal abilities), and able to assign social meaning, could be more effective at responding to these difficulties. In this framework, we propose that olfaction, as well as cross-modal integration strategies involving both visual and olfactory domains, may have such potential. In fact, most of socioemotional processing deficits in ASD have been shown in an uni-modal perspective, mainly with visual stimuli. However, the social environment involves other modalities and is typically multisensorial. Given the potential of olfaction as a gateway for socioemotional information in ASD, we argue in favor of studying olfactory perception, as well as visuo-olfactory integration, given the potential of these approaches to drive effective interventions and give the access to a meaningful social world in ASD.

Visual Disengagement: Genetic Architecture and Relation to Autistic Traits in the General Population

Visual disengagement has been hypothesized as an endophenotype for autism. In this study we used twin modelling to assess the role of genetics in basic measures of visual disengagement, and tested their putative association to autistic traits in the general population. We used the Gap Overlap task in a sample of 492 twins. Results showed that most of the covariance among eye movement latencies across conditions was shared and primarily genetic. Further, there were unique genetic contributions to the Gap condition, but not to the Overlap condition-i.e. the one theorized to capture visual disengagement. We found no phenotypic association between autistic traits and disengagement, thus not supporting the hypothesis of visual disengagement as an endophenotype for autistic traits.

Attention Modification to Attenuate Facial Emotion Recognition Deficits in Children with Autism: A Pilot Study

Diminished attending to faces may contribute to the impairments in emotion recognition and expression in autism spectrum disorder (ASD). The current study evaluated the acceptability, feasibility, and preliminary efficacy of an attention modification intervention designed to attenuate deficits in facial emotion recognition (FER). During the 10-session experimental treatment, children (n = 8) with ASD watched dynamic videos of people expressing different emotions with the facial features highlighted to guide children's attention. Children and their parents generally rated the treatment as acceptable and helpful. Although FER improvement was not apparent on task-based measures, parents reported slight improvements and decreased socioemotional problems following treatment. Results suggest that further research on visual attention retraining for ASD, within an experimental therapeutic program, may be promising.

Empathy modulates the temporal structure of social attention

Individuals with low empathy often show reduced attention towards social stimuli. A limitation of this literature is the lack of empirical work that has explicitly characterized how this relationship manifests itself over time. We investigate this issue by analysing data from two large eye-tracking datasets (total n = 176). Via growth-curve analysis, we demonstrate that self-reported empathy (as measured by the empathy quotient-EQ) predicts the temporal evolution of gaze behaviour under conditions where social and non-social stimuli compete for attention. In both datasets, we found that EQ not only predicted a global increase in social attention, but predicted a different temporal profile of social attention. Specifically, we detected a reliable effect of empathy on gaze towards social images after prolonged viewing. An analysis of switch latencies revealed that low-EQ observers switched gaze away from an initially fixated social image more frequently and at earlier latencies than high-EQ observers. Our analyses demonstrate that modelling these temporal components of gaze signals may reveal useful behavioural phenotypes. The explanatory power of this approach may provide enhanced biomarkers for conditions marked by deficits in empathy-related processes.

Children with Autism Spectrum Disorder Prefer Looking at Repetitive Movements in a Preferential Looking Paradigm

The present study aimed to investigate the visual preference for repetitive movements in children with autism spectrum disorder (ASD). Young children with ASD and typically-developing (TD) children were presented simultaneously with cartoons depicting repetitive and random movements respectively, while their eye-movements were recorded. We found that: (1) the children with ASD spent more time fixating on the repetitive movements than the random movements, whereas the TD children showed no preference for either type of movements; (2) the children's preference for the repetitive movements was correlated with the parent reports of their repetitive behaviors. Our findings show a promise in using the preferential looking as a potential indicator for the repetitive behaviors and aiding early screening of ASD in future investigations.

Auditory Attentional Disengagement in Children with Autism Spectrum Disorder

Despite early differences in orienting to sounds, no study to date has investigated whether children with ASD demonstrate impairments in attentional disengagement in the auditory modality. Twenty-one 9-15-year-old children with ASD and 20 age- and IQ-matched TD children were presented with an auditory gap-overlap paradigm. Evidence of impaired disengagement in ASD was mixed. Differences in saccadic reaction time for overlap and gap conditions did not differ between groups. However, children with ASD did show increased no-shift trials in the overlap condition, as well as reduced disengagement efficiency compared to their TD peers. These results provide further support for disengagement impairments in ASD, and suggest that these deficits include disengaging from and shifting to unimodal auditory information.

What Can Eye Movements Tell Us about Subtle Cognitive Processing Differences in Autism?

Autism spectrum disorder (ASD) is neurodevelopmental condition principally characterised by impairments in social interaction and communication, and repetitive behaviours and interests. This article reviews the eye movement studies designed to investigate the underlying sampling or processing differences that might account for the principal characteristics of autism. Following a brief summary of a previous review chapter by one of the authors of the current paper, a detailed review of eye movement studies investigating various aspects of processing in autism over the last decade will be presented. The literature will be organised into sections covering different cognitive components, including language and social communication and interaction studies. The aim of the review will be to show how eye movement studies provide a very useful on-line processing measure, allowing us to account for observed differences in behavioural data (accuracy and reaction times). The subtle processing differences that eye movement data reveal in both language and social processing have the potential to impact in the everyday communication domain in autism.

Judging social interaction in the Heider and Simmel movie

Simple displays of moving shapes can give rise to percepts of animacy. These films elicit impoverished narratives in some individuals, such as those with an autism spectrum disorder. However, the verbal demand of producing a narrative limits the utility of this task. Non-verbal tasks have so far focused on detecting animate objects. Lacking from previous research is a task that relies less on verbal description but more than animacy perception. Here, we presented data using a new social interaction judgement task. Healthy young adults viewed the Heider and Simmel movie and pressed one button whenever they perceived social interaction and another button when no social interaction was perceived. We measured the time points at which social judgement began, the fluctuation of the judgement in relation to stimulus kinematic properties, and the overall mean of social judgement. Participants with higher autism traits reported lower levels of social interaction. Reversing the film in time produced lower social interaction judgements, though the temporal profile was preserved. Our study suggests that both low-level motion characteristics and high-level understanding contribute to social interaction judgement. The finding may facilitate future research on other populations and stimulate computational vision work on factors that drive social judgements.

Faster eye movements in children with autism spectrum disorder

Atypical visual exploration of both social and nonsocial scenes is often reported in Autism Spectrum Disorder (ASD) with less precise and longer saccades, potentially reflecting difficulties in oculomotor control. To assess a subset of oculomotor functions in ASD, 20 children with ASD and 21 age-matched typically developing (TD) children (2.6-11.5 years) partook in three tasks of increasing complexity, while no explicit instruction was provided: a prosaccade gap task, a color and a "categorical" visual search tasks (a face among butterflies and vice-versa). In addition to classical saccade metrics, we measured Distance error, (the distance between the target and the closest gaze position) and Time-to-target (the time taken to reach the target). In the prosaccade task, children with ASD were as accurate as TD children, yet faster to reach the stimulus. In the color visual search task, children with ASD were faster but less precise than TD children. In the categorical visual search, while TD children were more precise in orienting their gaze towards the face, children with ASD performed similarly in the two conditions; Time-to-target did not differ. Our results provide contradictory evidence regarding enhanced visual search ability in ASD: when considering response times, enhanced visual search performance was found in one task only, while when considering gaze precision no advantage was found. These three experiments demonstrate that the automatic saccadic system may function more rapidly in children with ASD. Nonetheless, a diminished sensitivity to bottom-up saliency and top-down influence might suppress this advantage in more complex visual environments. Autism Res 2019, 12: 212-224 © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Three experiments with no instructions were designed to assess oculomotor functions in children with Autism Spectrum Disorder (ASD). In a saccade task, children with ASD were faster than but as accurate as control children. In visual search tasks, accuracy and speed decreased with increasing complexity of visual environment. Children with ASD showed faster automatic visual orientation, but this might hinder exploratory behaviors, leading to difficulties in complex and social situations.

Neuromodulation and a Reconceptualization of Autism Spectrum Disorders: Using the Locus Coeruleus Functioning as an Exemplar

The Autism Spectrum Disorders (ASD) are a heterogeneous group of developmental disorders. Although, ASD can be reliably diagnosed, the etiology, pathophysiology, and treatment targets remain poorly characterized. While there are many atypical findings in anatomy, genetics, connectivity, and other biologic parameters, there remains no discreet hypothesis to explain the core signs as well as the very frequent comorbidities. Due to this, designing targets for treatments can only be done by assuming each symptom is a result of a discreet abnormality which is likely not the case. Neuronal circuity remains a major focus of research but rarely taking into account the functioning of the brain is highly dependent on various systems, including the neuromodulatory substances originating in the midbrain. A hypothesis is presented which explores the possibility of explaining many of the symptoms found in ASD in terms of inefficient neuromodulation using the functioning of the locus coeruleus and norepinephrine (LC/NE) as exemplars. The basic science of LC/NE is reviewed. Several functions found to be impaired in ASD including learning, attention, sensory processing, emotional regulation, autonomic functioning, adaptive and repetitive behaviors, sleep, language acquisition, initiation, and prompt dependency are examined in terms of the functioning of the LC/NE system. Suggestions about possible treatment directions are explored.

The Multisensory Attention Assessment Protocol (MAAP): Characterizing individual differences in multisensory attention skills in infants and children and relations with language and cognition

Multisensory attention skills provide a crucial foundation for early cognitive, social, and language development, yet there are no fine-grained, individual difference measures of these skills appropriate for preverbal children. The Multisensory Attention Assessment Protocol (MAAP) fills this need. In a single video-based protocol requiring no language skills, the MAAP assesses individual differences in three fundamental building blocks of attention to multisensory events-the duration of attention maintenance, the accuracy of intersensory (audiovisual) matching, and the speed of shifting-for both social and nonsocial events, in the context of high and low competing visual stimulation. In Experiment 1, 2- to 5-year-old children (N = 36) received the MAAP and assessments of language and cognitive functioning. In Experiment 2 the procedure was streamlined and presented to 12-month-olds (N = 48). Both infants and children showed high levels of attention maintenance to social and nonsocial events, impaired attention maintenance and speed of shifting when competing stimulation was high, and significant intersensory matching. Children showed longer maintenance, faster shifting, and less impairment from competing stimulation than infants. In 2- to 5-year-old children, duration and accuracy were intercorrelated, showed increases with age, and predicted cognitive and language functioning. The MAAP opens the door to assessing developmental pathways between early attention patterns to audiovisual events and language, cognitive, and social development. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Relationship Between Theory of Mind, Emotion Recognition, and Social Synchrony in Adolescents With and Without Autism

Difficulty in social communication and interaction is a primary diagnostic feature of ASD. Research has found that adolescents with ASD display various impairments in social behavior such as theory of mind (ToM), emotion recognition, and social synchrony. However, not much is known about the relationships among these dimensions of social behavior. Adolescents with and without ASD participated in the study. ToM ability was measured by viewing social animations of geometric shapes, recognition of facial emotions was measured by viewing pictures of faces, and synchrony ability was measured with a spontaneously arising interpersonal movement task completed with a caregiver and an intentional interpersonal task. Attention and social responsiveness were measured using parent reports. We then examined the relationship between ToM, emotion recognition, clinical measures of attention and social responsiveness, and social synchronization that arises either spontaneously or intentionally. Results indicate that spontaneous synchrony was related to ToM and intentional synchrony was related to clinical measures of attention and social responsiveness. Facial emotion recognition was not related to either ToM or social synchrony. Our findings highlight the importance of biological motion perception and production and attention for more fully understanding the social behavior characteristic of ASD. The findings suggest that the processes underlying difficulties in spontaneous synchrony in ASD are different than the processes underlying difficulties in intentional synchronization.

Relating Attentional Biases for Stimuli Associated with Social Reward and Punishment to Autistic Traits

Evidence for impaired attention to social stimuli in autism has been mixed. The role of social feedback in shaping attention to other, non-social stimuli that are predictive of such feedback has not been examined in the context of autism. In the present study, participants searched for a color-defined target during a training phase, with the color of the target predicting the emotional reaction of a face that appeared after each trial. Then, participants performed visual search for a shape-defined target while trying to ignore the color of stimuli. On a subset of trials, one of the non-targets was rendered in the color of a former target from training. Autistic traits were measured for each participant using the Autism Quotient (AQ). Our findings replicate robust attentional capture by stimuli learned to predict valenced social feedback. There was no evidence that autistic traits are associated with blunted attention to predictors of social outcomes. Consistent with an emerging body of literature, our findings cast doubt on strong versions of the claim that autistic traits can be explained by a blunted influence of social information on the attention system. We extend these findings to non-social stimuli that predict socially relevant information.

No evidence of atypical attentional disengagement in autism: A study across the spectrum

The ability to disengage attention and reengage elsewhere has been proposed as a fundamental deficit in the autism spectrum, potentially disrupting development of higher cognitive domains. Eye-movements were recorded while 16 autism spectrum children of mixed ability, and 18 typically developing age-matched controls, completed the Gap–Overlap paradigm. A significant difference in latency to fixate target was found between Gap and Overlap conditions. A significant interaction with group was due to autism spectrum participants’ shorter latencies to fixate target in the Gap condition, but similar group responses in the Overlap condition. Considerable within-group variability emerged. We predicted that attentional disengaging would be related to specific features of the phenotype; however, there was no evidence of an association with receptive language, non-verbal IQ, sensory behaviors, or autistic severity in autism spectrum or typically developing groups. In conclusion, while atypical visual attention mechanisms may be a feature of autism spectrum, this is not explained by impaired visual disengaging but is more likely due to increased susceptibility of visual fixation offset cueing. Despite best efforts, nine additional autism spectrum children could not complete testing, and data from a further six were unusable; more work is needed to develop research methods that enable individuals across the spectrum to participate.

Social Motor Synchronization: Insights for Understanding Social Behavior in Autism

Impairments in social interaction and communication are critical features of ASD but the underlying processes are poorly understood. An under-explored area is the social motor synchronization that happens when we coordinate our bodies with others. Here, we explored the relationships between dynamical measures of social motor synchronization and assessments of ASD traits. We found (a) spontaneous social motor synchronization was associated with responding to joint attention, cooperation, and theory of mind while intentional social motor synchronization was associated with initiating joint attention and theory of mind; and (b) social motor synchronization was associated with ASD severity but not fully explained by motor problems. Findings suggest that objective measures of social motor synchronization may provide insights into understanding ASD traits.

Brief Report: Biological Sound Processing in Children with Autistic Spectrum Disorder

There is debate whether social impairments in autism spectrum disorder (ASD) are truly domain-specific, or if they reflect generalized deficits in lower-level cognitive processes. To solve this issue, we used auditory-evoked EEG responses to assess novelty detection (MMN component) and involuntary attentional orientation (P3 component) induced by socially-relevant, human-produced, biological sounds and acoustically-matched control stimuli in children with ASD and controls. Results show that early sensory and novelty processing of biological stimuli are preserved in ASD, but that automatic attentional orientation for biological sounds is markedly altered. These results support the notion that at least some cognitive processes of ASD are specifically altered when it comes to processing social stimuli.

Responding to Other People's Direct Gaze: Alterations in Gaze Behavior in Infants at Risk for Autism Occur on Very Short Timescales

Atypical gaze processing has been reported in children with autism spectrum disorders (ASD). Here we explored how infants at risk for ASD respond behaviorally to others' direct gaze. We assessed 10-month-olds with a sibling with ASD (high risk group; n = 61) and a control group (n = 18) during interaction with an adult. Eye-tracking revealed less looking at the adult in the high risk group during 300-1000 ms after the adult initiated direct gaze: a short alteration that is likely to go unnoticed by the naked eye. Data aggregated over longer segments (the traditional eye-tracking approach) showed no group differences. Although findings are limited by lack of outcome data, they are in line with theories linking atypical eye processing to the emergence of ASD.

The disengagement of visual attention in the gap paradigm across adolescence

Attentional disengagement is important for successful interaction with our environment. The efficiency of attentional disengagement is commonly assessed using the gap paradigm. There is, however, a sharp contrast between the number of studies applying the gap paradigm to clinical populations and the knowledge about the underlying developmental trajectory of the gap effect. The aim of the present study was, therefore, to investigate attentional disengagement in a group of children aged 9–15. Besides the typically deployed gap and the overlap conditions, we also added a baseline condition in which the fixation point was removed at the moment that the target appeared. This allowed us to reveal the appropriate experimental conditions to unravel possible developmental differences. Correlational analyses showed that the size of the gap effect became smaller with increasing age, but only for the difference between the gap and the overlap conditions. This shows that there is a gradual increase in the capacity to disengage visual attention with increasing age, but that this effect only becomes apparent when the gap and the overlap conditions are compared. The gradual decrease of the gap effect with increasing age provides additional evidence that the attentional system becomes more efficient with increasing age and that this is a gradual process.

Reduced visual disengagement but intact phasic alerting in young children with autism

Children with autism may have difficulties with visual disengagement-that is, inhibiting current fixations and orienting to new stimuli in the periphery. These difficulties may limit these children's ability to flexibly monitor the environment, regulate their internal states, and interact with others. In typical development, visual disengagement is influenced by a phasic alerting network that increases the processing speed of the visual system after salient events. The role of the phasic alerting effect in the putative atypical disengagement performance in autism spectrum disorder (ASD) is not known. Here, we compared visual disengagement in six-year-old children with autism (N = 18) and typically developing children (N = 17) matched for age and nonverbal IQ. We manipulated phasic alerting during a visual disengagement task by adding spatially nonpredictive sounds shortly before the onset of the visual peripheral targets. Children with ASD showed evidence of delayed disengagement compared to the control group. Sounds facilitated visual disengagement similarly in both groups, suggesting typical modulation by phasic alerting in ASD in the context of this task. These results support the view that atypical visual disengagement in ASD is related to other factors than atypicalities in the alerting network. Autism Res 2017, 10: 539-545. © 2016 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

Eye-Gaze Analysis of Facial Emotion Recognition and Expression in Adolescents with ASD

Impaired emotion recognition and expression in individuals with autism spectrum disorder (ASD) may contribute to observed social impairment. The aim of this study was to examine the role of visual attention directed toward nonsocial aspects of a scene as a possible mechanism underlying recognition and expressive ability deficiency in ASD. One recognition and two expression tasks were administered. Recognition was assessed in force-choice paradigm, and expression was assessed during scripted and free-choice response (in response to emotional stimuli) tasks in youth with ASD (n = 20) and an age-matched sample of typically developing youth (n = 20). During stimulus presentation prior to response in each task, participants' eye gaze was tracked. Youth with ASD were less accurate at identifying disgust and sadness in the recognition task. They fixated less to the eye region of stimuli showing surprise. A group difference was found during the free-choice response task, such that those with ASD expressed emotion less clearly but not during the scripted task. Results suggest altered eye gaze to the mouth region but not the eye region as a candidate mechanism for decreased ability to recognize or express emotion. Findings inform our understanding of the association between social attention and emotion recognition and expression deficits.

Ocular motor disturbances in autism spectrum disorders: Systematic review and comprehensive meta-analysis

There has been considerable focus placed on how individuals with autism spectrum disorder (ASD) visually perceive and attend to social information, such as facial expressions or social gaze. The role of eye movements is inextricable from visual perception, however this aspect is often overlooked. We performed a series of meta-analyses based on data from 28 studies of eye movements in ASD to determine whether there is evidence for ocular motor dysfunction in ASD. Tasks assessed included visually-guided saccade tasks, gap/overlap, anti-saccade, pursuit tasks and ocular fixation. These analyses revealed evidence for ocular motor dysfunction in ASD, specifically relating to saccade dysmetria, difficulty inhibiting saccades and impaired tracking of moving targets. However there was no evidence for deficits relating to initiating eye movements, or engaging and disengaging from simple visual targets. Characterizing ocular motor abnormalities in ASD may provide insight into the functional integrity of brain networks in ASD across development, and assist our understanding of visual and social attention in ASD.

Spoken word recognition in children with autism spectrum disorder: The role of visual disengagement

Deficits in visual disengagement are one of the earliest emerging differences in infants who are later diagnosed with autism spectrum disorder. Although researchers have speculated that deficits in visual disengagement could have negative effects on the development of children with autism spectrum disorder, we do not know which skills are disrupted or how this disruption takes place. As a first step in understanding this issue, this study investigated the relationship between visual disengagement and a critical skill in early language development: spoken word recognition. Participants were 18 children with autism spectrum disorder (aged 4-7 years). Consistent with our predictions, children with poorer visual disengagement were slower and less accurate to process familiar words; disengagement explained over half of the variance in spoken word recognition. Visual disengagement remained uniquely associated with spoken word recognition after accounting for children's vocabulary size and age. These findings align with a recently proposed developmental model in which poor visual disengagement decreases the speed and accuracy of real-time spoken word recognition in children with autism spectrum disorder-which, in turn, may negatively affect their language development.

Eye Tracking Reveals Impaired Attentional Disengagement Associated with Sensory Response Patterns in Children with Autism

This study used a gap-overlap paradigm to examine the impact of distractor salience and temporal overlap on the ability to disengage and orient attention in 50 children (4-13 years) with ASD, DD and TD, and associations between attention and sensory response patterns. Results revealed impaired disengagement and orienting accuracy in ASD. Disengagement was impaired across all groups during temporal overlap for dynamic stimuli compared to static, but only ASD showed slower disengagement from multimodal relative to unimodal dynamic stimuli. Attentional disengagement had differential associations with distinct sensory response patterns in ASD and DD. Atypical sensory processing and temporal binding appear to be intertwined with development of disengagement in ASD, but longitudinal studies are needed to unravel causal pathways.

Insula response and connectivity during social and non-social attention in children with autism

Autism spectrum disorder (ASD) is characterized by reduced attention to salient social stimuli. Here, we use two visual oddball tasks to investigate brain systems engaged during attention to social (face) and non-social (scene) stimuli. We focused on the dorsal and ventral subdivisions of the anterior insula (dAI and vAI, respectively), anatomically distinct regions contributing to a 'salience network' that is known to regulate attention to behaviorally meaningful stimuli. Children with ASD performed comparably to their typically developing (TD) peers, but they engaged the right dAI and vAI differently in response to deviant faces compared with deviant scenes. Multivariate activation patterns in the dAI reliably discriminated between children with ASD and TD children with 85% classification accuracy, and children with ASD activated the vAI more than their TD peers. Children with ASD and their TD peers also differed in dAI connectivity patterns to deviant faces, with stronger within-salience network interactions in the ASD group and stronger cross-network interactions in the TD group. Our findings point to atypical patterns of right anterior insula activation and connectivity in ASD and suggest that multiple functions subserved by the insula, including attention and affective processing of salient social stimuli, are aberrant in children with the disorder.

Prospective Longitudinal Studies of Infant Siblings of Children With Autism: Lessons Learned and Future Directions

OBJECTIVE

The objectives of this review are to highlight the impact of the first decade of high-risk (HR) infant sibling work in autism spectrum disorder (ASD) and to identify potential areas of translational focus for the next decade of research.

METHOD

A group of clinicians and researchers in ASD working both inside and outside of the HR design met on a regular basis to review the infant sibling research, and came to an agreement on areas that had changed clinical practice and areas that had the potential to change practice with further research. The group then outlined several methodological and translational challenges that must be addressed in the next decade of research if the field is to reach its potential.

RESULTS

The review concluded that the HR design has yielded an understanding that ASD often, but not always, begins to emerge between 6 and 18 months, with early signs affecting social communication. Research using the HR design has also allowed a better understanding of the sibling recurrence risk (between 10% and 20%). Emerging areas of interest include the developmental trajectories of social communications skills in the early years, the expression of a milder phenotype in siblings not affected with ASD, and the possibility that early intervention with infant siblings may improve outcomes for those with ASD. Important challenges for the future include linking screening to intervention, collecting large sample sizes while ensuring cross-site reliability, and building in capacity for replication.

CONCLUSION

Although there are significant methodological and translational challenges for high-risk infant sibling research, the potential of this design to improve long-term outcomes of all children with ASD is substantial.

Social cognitive impairment and autism: what are we trying to explain?

Early psychological theories of autism explained the clinical features of this condition in terms of perceptual and sensory processing impairments. The arrival of domain-specific social cognitive theories changed this focus, postulating a 'primary' and specific psychological impairment of social cognition. Across the years, evidence has been growing in support of social cognitive and social attention explanations in autism. However, there has also been evidence for general non-social cognitive impairments in representational understanding, attention allocation and sensory processing. Here, I review recent findings and consider the case for the specificity and primacy of the social cognitive impairment, proposing that we should focus more explicitly on clinically valid features for insights on the integration of 'social' and 'non-social' cognition.

Unimpaired attentional disengagement in toddlers with autism spectrum disorder

A prominent hypothesis holds that 'sticky' attention early in life in children with autism spectrum disorder (ASD) limits their ability to explore and learn about the world. Under this hypothesis, the core clinical symptoms of ASD - restricted interests, repetitive behaviors and impaired social/communication abilities - could all result from impaired attentional disengagement during development. However, the existence of disengagement deficits in children with ASD is controversial, and a recent study found no deficit in 5- to 12-year-olds with ASD. Nonetheless, the possibility remains that disengagement is impaired earlier in development in children with ASD, altering their developmental trajectory even if the attentional deficit itself is remediated or compensated for by the time children with ASD reach school age. Here, we tested this possibility by characterizing attentional disengagement in a group of toddlers just diagnosed with ASD (age 21 to 37 months). We found strikingly similar performance between the ASD and age-matched typically developing (TD) toddlers, and no evidence of impaired attentional disengagement. These results show that even at a young age when the clinical symptoms of ASD are first emerging, disengagement abilities are intact. Sticky attention is not a fundamental characteristic of ASD, and probably does not play a causal role in its etiology.