Investigating joint attention in a guided interaction between a child with ASD and therapists: A pilot eye-tracking study

Abstract

Introduction Deficits in joint attention are commonly seen in children with autism spectrum disorder. Research examining joint attention in autism spectrum disorder commonly uses two broad strategies to cue and measure joint attention: behavioral observation and eye tracking. These strategies trade off prioritizing ecological validity vs. gaze measurement accuracy, with a focus on one sacrificing the other. The purpose of this case study was to develop a method to accurately measure gaze position while maintaining an ecologically valid dyadic interaction. Methods A child with autism spectrum disorder completed two developmentally appropriate tabletop activities. Each activity was guided by a different occupational therapist who purposefully used a different interaction style with the child. Mobile eye trackers worn by both the child and the therapist recorded the dyadic interactions. Data collection included audio and video recording of interactive behaviors, eye movements and visual fixations in regions of shared interest. Results Differences were detected in gaze use and interactive joint attention behaviors between the therapists working with the child and within the child’s respective dyadic interactions. Conclusions The proof of concept method maintained both ecological validity and measurement accuracy of therapist–child joint attention. This method has promise to be scaled for larger studies.