Abstract
Children with autism spectrum disorder (ASD) display difficulties with response to joint attention in natural settings but often perform comparably to typically developing (TD) children in experimental studies of gaze following. Previous work comparing infants at elevated likelihood for ASD versus TD infants has manipulated aspects of the gaze cueing stimulus (e.g. eyes only versus head and eyes together), but the role the peripheral object being attended to is not known. In this study of infants at elevated likelihood of ASD (N = 97) and TD infants (N = 29), we manipulated whether or not a target object was present in the cued area. Performance was assessed at 10, 14, and 18 months, and diagnostic assessment was conducted at age 3 years. The results showed that although infants with later ASD followed gaze to the same extent as TD infants in all conditions, they displayed faster latencies back to the model’s face when (and only when) a peripheral object was absent. These subtle atypicalities in the gaze behaviors directly after gaze following may implicate a different appreciation of the communicative situation in infants with later ASD, despite their ostensively typical gaze following ability.Lay abstractDuring 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.
Highlights
MethodsParticipantsThe final sample consisted of 126 infants, but note that Ns vary between analyses as not all infants contributed data at all measurement points (see Table 1)
A group by condition interaction effect emerged in the latency analysis, indicating that infants with a later autism spectrum disorder (ASD) diagnosis were faster to look back at the model compared to typically developing (TD) infants in the Eyes and Head-No Object condition but not in the Eyes and Head-Object Present condition
Aspects pertaining to the cue seem to be more important than those pertaining to the target. This finding has possible implications for interventions for children with Joint attention (JA) impairments, and is in line with a previous study, in which we showed that increasing the interest level of the target objects led to more total looking at the objects, it did not lead to increased gaze following accuracy neither in autistic nor TD children (Thorup et al, 2017)
Summary
ParticipantsThe final sample consisted of 126 infants, but note that Ns vary between analyses as not all infants contributed data at all measurement points (see Table 1). One additional infant from the comparison group was excluded due to receiving an ASD diagnosis. Five additional infants (4 EL-no-ASD, 1 TD) were excluded due to not producing enough valid data (see Analysis). All EL infants had at least one older full sibling with a community diagnosis of ASD (verified via inspection of medical records). TD infants were recruited from live birth records and had at least one TD older full sibling, and no first or second degree relatives with ASD. Infants from both groups came predominantly from the larger Stockholm metropolitan area. Socioeconomic status was assessed based on family income and parental education level, and did not differ between groups.
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