Lateral glances toward moving stimuli among young children with autism: Early regulation of locally oriented perception?

Large language models deconstruct the clinical intuition behind diagnosing autism

Efforts to use genome-wide assays or brain scans to diagnose autism have seen diminishing returns. Yet the clinical intuition of healthcare professionals, based on longstanding first-hand experience, remains the gold standard for diagnosis of autism. We leveraged deep learning to deconstruct and interrogate the logic of expert clinician intuition from clinical reports to inform our understanding of autism. After pre-training on hundreds of millions of general sentences, we finessed large language models (LLMs) on >4,000 free-form health records from healthcare professionals to distinguish confirmed versus suspected autism cases. By introducing an explainability strategy, our extended language model architecture could pin down the most salient single sentences in what drives clinical thinking toward correct diagnoses. Our framework flagged the most autism-critical DSM-5 criteria to be stereotyped repetitive behaviors, special interests, and perception-based behaviors, which challenges today's focus on deficits in social interplay, suggesting necessary revision of long-trusted diagnostic criteria in gold-standard instruments.

Battery-free head orientation measurement using passive RFID tags

Real-time measurement of head rotation, a primary human body movement, offers potential advantages in rehabilitating head or neck motor disorders, promoting seamless human-robot interaction, and tracking the lateral glance of children with autism spectrum disorder for effective intervention. However, existing options such as cameras capturing the entire face or skin-attached sensors have limitations concerning privacy, safety, and/or usability. This research introduces a novel method that employs a battery-free RFID tag-based wearable sensor for monitoring head orientation, as a substitute for the existing options like camera. By attaching a pair of passive RFID tags to the front of the head at a specific distance from each other, the signal strength of each tag within the pair differs based on the discrepancy in distance from the RFID reader caused by head rotation. Important parameters including distance between the tags, distance from the reader, and tag types, are investigated to suggest optimal sensor design. In tests involving random head rotations by 10 healthy adults, there was a significant correlation between the orientation of the head and gaze in the yaw direction and the differences in signal strength from the sensor pairs. The correlation coefficients () were satisfactory, at 0.88 for head and 0.83 for left eye pupil orientations. However, the sensor failed to estimate pitch rotations for head and gaze, due to the insufficient vertical spacing between the tags. No demographic factors appeared to influence the results.

Back to Actual Behavior - A Modest Proposal on the Example of Exploratory Behavior in Children on the Autism Spectrum

 Autism spectrum is characterized by difficulties in social communication and interactions and limited, restricted patterns of behavior, interests, and activity. It is diagnosed and described on the basis of behavioral characteristics. Therefore, behavior research plays a critical role in better understanding the functioning of this group of children. Studies on their interests and curiosity take mainly the form of experiments on visual and object exploration. We argue that important aspects of behavior might be neglected within these studies and propose to refine the approach by incorporating the achievements of classic ethology, contemporary measurement and analytical tools, and the theory of integrative levels. We conclude with an outline of the proposed approach in a short list of major methodological postulates.

A Study on the Screening of Children at Risk for Developmental Disabilities Using Facial Landmarks Derived From a Mobile-Based Application

OBJECTIVE

Early detection and intervention of developmental disabilities (DDs) are critical to improving the long-term outcomes of afflicted children. In this study, our objective was to utilize facial landmark features from mobile application to distinguish between children with DDs and typically developing (TD) children.

METHODS

The present study recruited 89 children, including 33 diagnosed with DD, and 56 TD children. The aim was to examine the effectiveness of a deep learning classification model using facial video collected from children through mobile-based application. The study participants underwent comprehensive developmental assessments, which included the child completion of the Korean Psychoeducational Profile-Revised and caregiver completing the Korean versions of Vineland Adaptive Behavior Scale, Korean version of the Childhood Autism Rating Scale, Social Responsiveness Scale, and Child Behavior Checklist. We extracted facial landmarks from recorded videos using mobile application and performed DDs classification using long short-term memory with stratified 5-fold cross-validation.

RESULTS

The classification model shows an average accuracy of 0.88 (range: 0.78-1.00), an average precision of 0.91 (range: 0.75-1.00), and an average F1-score of 0.80 (range: 0.60-1.00). Upon interpreting prediction results using SHapley Additive exPlanations (SHAP), we verified that the most crucial variable was the nodding head angle variable, with a median SHAP score of 2.6. All the top 10 contributing variables exhibited significant differences in distribution between children with DD and TD (p<0.05).

CONCLUSION

The results of this study provide evidence that facial landmarks, utilizing readily available mobile-based video data, can be used to detect DD at an early stage.

Leveraging Communication Partner Speech to Automate Augmented Input for Children on the Autism Spectrum Who Are Minimally Verbal: Prototype Development and Preliminary Efficacy Investigation

PURPOSE

Augmentative and alternative communication (AAC) technology innovation is urgently needed to improve outcomes for children on the autism spectrum who are minimally verbal. One potential technology innovation is applying artificial intelligence (AI) to automate strategies such as augmented input to increase language learning opportunities while mitigating communication partner time and learning barriers. Innovation in AAC research and design methodology is also needed to empirically explore this and other applications of AI to AAC. The purpose of this report was to describe (a) the development of an AAC prototype using a design methodology new to AAC research and (b) a preliminary investigation of the efficacy of this potential new AAC capability.

METHOD

The prototype was developed using a Wizard-of-Oz prototyping approach that allows for initial exploration of a new technology capability without the time and effort required for full-scale development. The preliminary investigation with three children on the autism spectrum who were minimally verbal used an adapted alternating treatment design to compare the effects of a Wizard-of-Oz prototype that provided automated augmented input (i.e., pairing color photos with speech) to a standard topic display (i.e., a grid display with line drawings) on visual attention, linguistic participation, and (for one participant) word learning during a circle activity.

RESULTS

Preliminary investigation results were variable, but overall participants increased visual attention and linguistic participation when using the prototype.

CONCLUSIONS

Wizard-of-Oz prototyping could be a valuable approach to spur much needed innovation in AAC. Further research into efficacy, reliability, validity, and attitudes is required to more comprehensively evaluate the use of AI to automate augmented input in AAC.

Visual abilities and exploration behaviors as predictors of intelligence in autistic children from preschool to school age

LAY ABSTRACT

At the time of diagnosis, parents of autistic children frequently wonder what the future holds for their children in terms of intellectual development. It remains however difficult to answer this question at such a young age. Indeed, while early precursors of intelligence are well known for children following a typical development, these precursors remain to be identified for autistic children. Some theoretical models of intelligence suggest that perceptual abilities or behaviors, as seen early in autistic cognitive development, could be early indicators of intelligence. However, research examining the relation between early perceptual predictors and autistic intelligence over time is needed. This article is the first to consider a variety of early perceptual abilities and behaviors as precursors/predictors of intelligence at school age in autistic children. We showed that better performance in perceptual tasks at preschool age predicted better intellectual abilities measured later in autistic children. Importantly, our sample of autistic children represented the whole spectrum, including children with few to no spoken words, who are an important proportion of autistic preschoolers. While early perceptual abilities and behaviors may not substitute for a formal intellectual assessment, our results support that these indices may help estimate later intellectual level in autistic children. Perceptual abilities have the advantage to be easy to observe at preschool age and seem to fit the cognitive style of autistic children. Assessment methods could probably gain from including and focusing more on the perceptual strengths of autistic children.

Different levels of visuospatial abilities linked to differential brain correlates underlying visual mental segmentation processes in autism

The neural underpinnings of enhanced locally oriented visual processing that are specific to autistics with a Wechsler's Block Design (BD) peak are largely unknown. Here, we investigated the brain correlates underlying visual segmentation associated with the well-established autistic superior visuospatial abilities in distinct subgroups using functional magnetic resonance imaging. This study included 31 male autistic adults (15 with (AUTp) and 16 without (AUTnp) a BD peak) and 28 male adults with typical development (TYP). Participants completed a computerized adapted BD task with models having low and high perceptual cohesiveness (PC). Despite similar behavioral performances, AUTp and AUTnp showed generally higher occipital activation compared with TYP participants. Compared with both AUTnp and TYP participants, the AUTp group showed enhanced task-related functional connectivity within posterior visuoperceptual regions and decreased functional connectivity between frontal and occipital-temporal regions. A diminished modulation in frontal and parietal regions in response to increased PC was also found in AUTp participants, suggesting heavier reliance on low-level processing of global figures. This study demonstrates that enhanced visual functioning is specific to a cognitive phenotypic subgroup of autistics with superior visuospatial abilities and reinforces the need to address autistic heterogeneity by good cognitive characterization of samples in future studies.

Differential neural correlates underlying mental rotation processes in two distinct cognitive profiles in autism

Enhanced visuospatial abilities characterize the cognitive profile of a subgroup of autistics. However, the neural correlates underlying such cognitive strengths are largely unknown. Using functional magnetic resonance imaging (fMRI), we investigated the neural underpinnings of superior visuospatial functioning in different autistic subgroups. Twenty-seven autistic adults, including 13 with a Wechsler's Block Design peak (AUTp) and 14 without (AUTnp), and 23 typically developed adults (TYP) performed a classic mental rotation task. As expected, AUTp participants were faster at the task compared to TYP. At the neural level, AUTp participants showed enhanced bilateral parietal and occipital activation, stronger occipito-parietal and fronto-occipital connectivity, and diminished fronto-parietal connectivity compared to TYP. On the other hand, AUTnp participants presented greater activation in right and anterior regions compared to AUTp. In addition, reduced connectivity between occipital and parietal regions was observed in AUTnp compared to AUTp and TYP participants. A greater reliance on posterior regions is typically reported in the autism literature. Our results suggest that this commonly reported finding may be specific to a subgroup of autistic individuals with enhanced visuospatial functioning. Moreover, this study demonstrated that increased occipito-frontal synchronization was associated with superior visuospatial abilities in autism. This finding contradicts the long-range under-connectivity hypothesis in autism. Finally, given the relationship between distinct cognitive profiles in autism and our observed differences in brain functioning, future studies should provide an adequate characterization of the autistic subgroups in their research. The main limitations are small sample sizes and the inclusion of male-only participants.

Eye Direction Detection and Perception as Premises of a Social Brain: A Narrative Review of Behavioral and Neural Data

The eyes and the gaze are important stimuli for social interaction in humans. Impaired recognition of facial identity, facial emotions, and inference of the intentions of others may result from difficulties in extracting information relevant to the eye region, mainly the direction of gaze. Therefore, a review of these data is of interest. Behavioral data demonstrating the importance of the eye region and how humans respond to gaze direction are reviewed narratively, and several theoretical models on how visual information on gaze is processed are discussed to propose a unified hypothesis. Several issues that have not yet been investigated are identified. The authors tentatively suggest experiments that might help progress research in this area. The neural aspects are subsequently reviewed to best describe the low-level and higher-level visual information processing stages in the targeted subcortical and cortical areas. A specific neural network is proposed on the basis of the literature. Various gray areas, such as the temporality of the processing of visual information, the question of salience priority, and the coordination between the two hemispheres, remain unclear and require further investigations. Finally, disordered gaze direction detection mechanisms and their consequences on social cognition and behavior are discussed as key deficiencies in several conditions, such as autism spectrum disorder, 22q11.2 deletion, schizophrenia, and social anxiety disorder. This narrative review provides significant additional data showing that the detection and perception of someone's gaze is an essential part of the development of our social brain.

Non-verbal IQ and change in restricted and repetitive behavior throughout childhood in autism: a longitudinal study using the Autism Diagnostic Interview-Revised

BACKGROUND

Restricted and repetitive behavior (RRB) is one of the characteristic features of Autism Spectrum Disorder. This domain of symptoms includes a broad range of behaviors. There is a need to study each behavior individually to better understand the role of each in the development of autistic children. Moreover, there are currently no longitudinal studies investigating change in these behaviors over development.

METHODS

The goal of the present study was to explore the association between age and non-verbal IQ (NVIQ) on 15 RRB symptoms included in the Autism Diagnostic Interview-Revised (ADI-R) over time. A total of 205 children with ASD were assessed using the ADI-R at time of diagnosis, at age 6 years, and at age 11 years, and with the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) at age 8 years.

RESULTS

The proportion of children showing each RRB tended to diminish with increasing age, except for sensitivity to noise and circumscribed interests, where the proportion increased over time. Although there was no significant main effect of NVIQ, there was a significant interaction between age and NVIQ. This was mainly driven by Difficulties with change in routine, for which higher NVIQ was associated with the behavior remaining relatively stable with age, while lower NVIQ was associated with the behavior becoming more prevalent with age.

LIMITATIONS

The study focused on the presence/absence of each RRB but did not account for potential changes in frequency or severity of the behaviors over development. Furthermore, some limitations are inherent to the measures used. The ADI-R relies on parent report and hence has some level of subjectivity, while the Wechsler intelligence scales can underestimate the intellectual abilities of some autistic children.

CONCLUSIONS

These results confirm that specific RRB are differentially linked to age and NVIQ. Studying RRB individually is a promising approach to better understanding how RRB change over the development of autistic children and are linked to other developmental domains.

Repetitive behavior with objects in infants developing autism predicts diagnosis and later social behavior as early as 9 months

We evaluated repetitive behavior with objects in infants at risk for autism spectrum disorder (ASD) from 9 to 36 months of age, and associations between early repetitive behavior and social engagement. Infant siblings of children with ASD (high-risk) or typical development (low-risk) were administered a task eliciting repetitive object use at 9, 12, 15, 18, 24, and 36 months of age. Infants (n = 147) were classified into 1 of 3 outcome groups at 36 months: Low-Risk Non-ASD (n = 58), High-Risk Non-ASD (n = 72), and ASD (n = 17). Behavior was coded from video for frequencies of unusual visual inspection, spinning, and rotating behaviors. Differences in unusual visual inspection were most prominent, consistent, and present earliest: At 9 months, the ASD group engaged in this behavior more frequently than both other groups, persisting through 36 months. Differences in frequencies of spinning and rotating were later-appearing, more time-limited, and/or related to familial ASD risk rather than ultimate diagnosis. Sensitivity and specificity estimates for the presence of unusual visual inspection at 9 months of age were in the moderate range (.60 and .68, respectively) for ASD versus Low-Risk Non-ASD comparisons, generally increasing over time. Unusual visual inspection at 9 months predicted 12-month social behavior controlling for 9-month social behavior, but not vice versa, with no evidence of moderation by ASD diagnosis. In summary, unusual visual inspection of objects is present and stable by 9 months of age in infants developing ASD and predicts reduced social engagement three-months later. Close monitoring of this behavior may aid early detection. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Visual Sensory Experiences From the Viewpoint of Autistic Adults

Although previous research has investigated altered sensory reactivity in autistic individuals, there has been no specific focus on visual sensory experiences, particularly in adults. Using qualitative methods, this study aimed to characterize autistic visual sensory symptoms, contextualize their impact and document any associated coping strategies. A total of 18 autistic adults took part in four focus groups which involved questions around visual experiences, the impact of these on daily life, and strategies for their reduction. Transcripts of each session were thematically analyzed allocating six key themes. Participants described a range of visual hypersensitivities, including to light, motion, patterns and particular colors, which contributed to distraction and were frequently part of a wider multisensory issue. Such experiences had significant negative impacts on personal wellbeing and daily life with participants describing fatigue, stress and hindrances on day-to-day activities (e.g., travel and social activities). However, the degree of understanding that participants had about their visual experiences influenced their emotional response, with greater understanding reducing concern. Participants employed a variety of coping strategies to overcome visual sensory experiences but with varied success. Discussions also highlighted that there may be a poor public understanding of sensory issues in autism affecting how well autistic individuals are able manage their sensory symptoms. In summary, autistic adults expressed significant concern about their visual experiences and there is a need to improve understanding of visual experiences on a personal and public level as well as for developing potential support.

Autism Detection in Children by Combined Use of Gaze Preference and the M-CHAT-R in a Resource-Scarce Setting

Most children with autism spectrum disorder (ASD), in resource-limited settings (RLS), are diagnosed after the age of four. Our work confirmed and extended results of Pierce that eye tracking could discriminate between typically developing (TD) children and those with ASD. We demonstrated the initial 15 s was at least as discriminating as the entire video. We evaluated the GP-MCHAT-R, which combines the first 15 s of manually-coded gaze preference (GP) video with M-CHAT-R results on 73 TD children and 28 children with ASD, 36–99 months of age. The GP-MCHAT-R (AUC = 0.89 (95%CI: 0.82–0.95)), performed significantly better than the MCHAT-R (AUC = 0.78 (95%CI: 0.71–0.85)) and gaze preference (AUC = 0.76 (95%CI: 0.64–0.88)) alone. This tool may enable early screening for ASD in RLS.

Using head-mounted eye tracking to examine visual and manual exploration during naturalistic toy play in children with and without autism spectrum disorder

Multimodal exploration of objects during toy play is important for a child's development and is suggested to be abnormal in children with autism spectrum disorder (ASD) due to either atypical attention or atypical action. However, little is known about how children with ASD coordinate their visual attention and manual actions during toy play. The current study aims to understand if and in what ways children with ASD generate exploratory behaviors to toys in natural, unconstrained contexts by utilizing head-mounted eye tracking to quantify moment-by-moment attention. We found no differences in how 24- to 48-mo children with and without ASD distribute their visual attention, generate manual action, or coordinate their visual and manual behaviors during toy play with a parent. Our findings suggest an intact ability and willingness of children with ASD to explore toys and suggest that context is important when studying child behavior.

Visual Perception in Autism Spectrum Disorder: A Review of Neuroimaging Studies

Although autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social impairments, patients with ASD frequently manifest atypical sensory behaviors. Recently, atypical sensory perception in ASD has received much attention, yet little is known about its cause or neurobiology. Herein, we review the findings from neuroimaging studies related to visual perception in ASD. Specifically, we examined the neural underpinnings of visual detection, motion perception, and face processing in ASD. Results from neuroimaging studies indicate that atypical visual perception in ASD may be influenced by attention or higher order cognitive mechanisms, and atypical face perception may be affected by disrupted social brain network. However, there is considerable evidence for atypical early visual processing in ASD. It is likely that visual perceptual abnormalities are independent of deficits of social functions or cognition. Importantly, atypical visual perception in ASD may enhance difficulties in dealing with complex and subtle social stimuli, or improve outstanding abilities in certain fields in individuals with Savant syndrome. Thus, future research is required to elucidate the characteristics and neurobiology of autistic visual perception to effectively apply these findings in the interventions of ASD.

Objects as Communicative Mediators in Children With Autism Spectrum Disorder

In recent years, the socio-material perspective has informed an important interdisciplinary debate concerning the role of the physical world (i.e., the objects) in human psychological development. Several studies in the field of developmental psychology showed positive achievements in explaining the relationship between the subject and the social context through a socio-material approach, in particular in the early development. The importance of objects was also recognized in children with autism spectrum disorder (ASD), showing that these children are characterized by alterations in the use of the objects from early development. Some studies highlighted that objects could be a facilitator in the interactions between children with ASD and peers. However, the role of objects was not sufficiently investigated in interactions between children with ASD and adults. The main purpose of the present study was to investigate in children with ASD the communicative function that the activities with objects assume in the interactions with adults, highlighting the mediator role of objects in these interactions. More generally, this study also aims to highlight the relevance of adopting a socio-material perspective to explore some neglected aspects of the psychological activity of children with ASD. To test this hypothesis, we conducted an extensive exploratory study, collecting data from a sample of 3-year-old (N = 18; F = 3) and 4-year-old (N = 26; F = 3) with ASD. Children were observed in a free-play situation with an adult. They were free to choose an object from a predefined set. Through quantitative data, we have described the general characteristics of the manipulation of objects; through qualitative data, we aimed to capture and describe, in microgenetic sequences, some characteristics of children's activities, defined as socio-material. The analysis of the socio-material activities suggested the role of objects as mediator of the interactions between children with ASD and adults.

The possible use of precision tinted lenses to improve social cognition in children with autism spectrum disorders

A masked randomised control design compared the effectiveness of precision ophthalmic tints in improving the recognition of emotion in Autism Spectrum Disorders (ASD). Fourteen children aged 10-14 with ASD and 14 control children matched on verbal and non-verbal IQ, wore spectacles with coloured lenses to complete two tasks that involved the observation of coloured video sequences in which social interactions were depicted. On one occasion (randomly first or second) the coloured lenses provided light of a colour that the child had one month previously selected as optimal for the clarity of text. On the other occasion the lenses differed in CIE UCS chromaticity by 0.077. Performance in the ASD group was superior in both social interaction tasks with the lenses that provided the optimal colour of light.

Autism spectrum heterogeneity: fact or artifact?

The current diagnostic practices are linked to a 20-fold increase in the reported prevalence of ASD over the last 30 years. Fragmenting the autism phenotype into dimensional "autistic traits" results in the alleged recognition of autism-like symptoms in any psychiatric or neurodevelopemental condition and in individuals decreasingly distant from the typical population, and prematurely dismisses the relevance of a diagnostic threshold. Non-specific socio-communicative and repetitive DSM 5 criteria, combined with four quantitative specifiers as well as all their possible combinations, render limitless variety of presentations consistent with the categorical diagnosis of ASD. We propose several remedies to this problem: maintain a line of research on prototypical autism; limit the heterogeneity compatible with a categorical diagnosis to situations with a phenotypic overlap and a validated etiological link with prototypical autism; reintroduce the qualitative properties of autism presentations and of current dimensional specifiers, language, intelligence, comorbidity, and severity in the criteria used to diagnose autism in replacement of quantitative "social" and "repetitive" criteria; use these qualitative features combined with the clinical intuition of experts and machine-learning algorithms to differentiate coherent subgroups in today's autism spectrum; study these subgroups separately, and then compare them; and question the autistic nature of "autistic traits".

Reduced visual evoked potential amplitude in autism spectrum disorder, a variability effect?

Atypical sensory behaviours represent a core symptom of autism spectrum disorder (ASD). Investigating early visual processing is crucial to deepen our understanding of higher-level processes. Visual evoked potentials (VEPs) to pattern-reversal checkerboards were recorded in ASD children and age-matched controls. Peak analysis of the P100 component and two types of single-trial analyses were carried out. P100 amplitude was reduced in the ASD group, consistent with previous reports. The analysis of the proportion of trials with a positive activity in the latency range of the P100, measuring inter-trial (in)consistency, allowed identifying two subgroups of ASD participants: the first group, as control children, showed a high inter-trial consistency, whereas the other group showed an inter-trial inconsistency. Analysis of median absolute deviation of single-trial P100 (st-P100) latencies revealed an increased latency variability in the ASD group. Both single-trial analyses revealed increased variability in a subset of children with ASD. To control for this variability, VEPs were reconstructed by including only positive trials or trials with homogeneous st-P100 latencies. These control analyses abolished group differences, confirming that the reduced P100 amplitude results from increased inter-trial variability in ASD. This increased variability in ASD supports the neural noise theory. The existence of subgroups in ASD suggests that the neural response variability is not a genuine characteristic of the entire autistic spectrum, but rather characterized subgroups of children. Exploring the relationship between sensory responsiveness and inter-trial variability could provide more precise bioclinical profiles in children with ASD, and complete the functional diagnostic crucial for the development of individualized therapeutical projects.

Is visuomotor training an effective intervention for children with autism spectrum disorders?

PURPOSE

Investigation of autism spectrum disorder (ASD) is somewhat dependent on addressing main core features of ASD. But it is not clear which kind of investigation can effect on more difficulties features. So, this study examines the effect of the visuomotor, motor, and computer-based training programs on social behavior, motor skills, and repetitive behaviors of children with ASD.

PATIENTS AND METHODS

Sixty children with ASD aged 6-12 years were recruited and assigned to one of the three experimental groups and the control group (each group n=15). Training was provided in 30 sessions, scheduled 3 times a week. Social behavior and repetitive behaviors were determined objectively using the observation method, and motor skills were evaluated by the Test of Gross Motor Development-2.

RESULTS

Our results suggested that children in the visuomotor group showed a significant reduction in the repetitive behaviors and an increase in gross motor skill scores in the post-test and follow-up. Also, the results exhibited that motor training group significantly improved in social behavior either in the post-test or follow-up. Although the post-test illustrated a considerable improvement of gross motor skills, this difference was not significant in follow-up. Similarly, no significant change was observed in visual training and control groups in relation to study variables.

CONCLUSION

Given the improvement of repetitive behaviors and gross motor skills in post-test and follow-up, it seems that this investigation had a positive effect with a good retention effect on two core features of children with ASD. But according to group-based training protocol in motor training group and improvement in social communication, and mutual effect on gross motor skills, it seems that group-based practice can also be used to achieve the benefits of social communication in the investigations.

A Developmental Perspective of Global and Local Visual Perception in Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) demonstrate superior performances on visuo-spatial tasks emphasizing local information processing; however, findings from studies involving hierarchical stimuli are inconsistent. Wide age ranges and group means complicate their interpretability. Children and adolescents with and without ASD completed a Navon task wherein they identified global and local stimuli composed of either consistent or inconsistent letters. Trajectories of reaction time in global and local conditions were similar within and between groups when consistent and inconsistent stimuli were considered together, but the effect of local-to-global interference was significantly higher in participants with than without ASD. Age was not a significant predictor of local-to-global interference, suggesting that this effect emerges in childhood and persists throughout adolescence in ASD.

Construct Validity and Cross Validity of a Test Battery Modeling Autism Spectrum Disorder (ASD) in Mice

Modeling in other organism species is one of the crucial stages in ascertaining the association between gene and psychiatric disorder. Testing Autism Spectrum Disorder (ASD) in mice is very popular but construct validity of the batteries is not available. We presented here the first factor analysis of a behavioral model of ASD-like in mice coupled with empirical validation. We defined fourteen measures aligning mouse-behavior measures with the criteria defined by DSM-5 for the diagnostic of ASD. Sixty-five mice belonging to a heterogeneous pool of genotypes were tested. Reliability coefficients vary from .68 to .81. The factor analysis resulted in a three- factor solution in line with DSM criteria: social behavior, stereotypy and narrowness of the field of interest. The empirical validation with mice sharing a haplo-insufficiency of the zinc-finger transcription factor TSHZ3/Tshz3 associated with ASD shows the discriminant power of the highly loaded items.

Implicit Measures of Receptive Vocabulary Knowledge in Individuals With Level 3 Autism

Implicit measures of cognition are essential for assessing knowledge in people with Level 3 autism because such individuals are often unable to make reliable overt behavioral responses. In this study, we investigated whether three implicit measures-eye movement (EM) monitoring, pupillary dilation (PD), and event-related potentials (ERPs)-can be used to reliably estimate vocabulary knowledge in individuals with Level 3 autism. Five adults with Level 3 autism were tested in a repeated-measures design with two tasks. High-frequency 'known' words (eg, bus, airplane) and low-frequency 'unknown' words (eg, ackee, cherimoya) were presented in a visual world task (during which EM and PD data were collected) and a picture-word congruity task (during which ERP data were collected). Using a case-study approach with single-subject analyses, we found that these implicit measures have the potential to provide estimates of receptive vocabulary knowledge in individuals with Level 3 autism. Participants differed with respect to which measures were the most sensitive and which variables best predicted vocabulary knowledge. These implicit measures may be useful to assess language abilities in individuals with Level 3 autism, but their use should be tailored to each individual.

Enhanced Early Visual Responses During Implicit Emotional Faces Processing in Autism Spectrum Disorder

Research on Autism Spectrum Disorder (ASD) has focused on processing of socially-relevant stimuli, such as faces. Nonetheless, before being 'social', faces are visual stimuli. The present magnetoencephalography study investigated the time course of brain activity during an implicit emotional task in visual emotion-related regions in 19 adults with ASD (mean age 26.3 ± 4.4) and 19 typically developed controls (26.4 ± 4). The results confirmed previously-reported differences between groups in brain responses to emotion and a hypo-activation in the ASD group in the right fusiform gyrus around 150 ms. However, the ASD group also presented early enhanced activity in the occipital region. These results support that impaired face processing in ASD might be sustained by atypical responses in primary visual areas.

What interests young autistic children? An exploratory study of object exploration and repetitive behavior

Behaviors characterized as restricted and repetitive (RRBs) in autism manifest in diverse ways, from motor mannerisms to intense interests, and are diagnostically defined as interfering with functioning. A variety of early autism interventions target RRBs as preoccupying young autistic children to the detriment of exploration and learning opportunities. In an exploratory study, we developed a novel stimulating play situation including objects of potential interest to autistic children, then investigated repetitive behaviors and object explorations in 49 autistic and 43 age-matched typical young children (20-69 months). Autistic children displayed significantly increased overall frequency and duration of repetitive behaviors, as well as increased specific repetitive behaviors. However, groups did not significantly differ in frequency and duration of overall object explorations, in number of different objects explored, or in explorations of specific objects. Exploratory analyses found similar or greater exploration of literacy-related objects in autistic compared to typical children. Correlations between repetitive behaviors and object explorations (their frequency and duration) revealed positive, not negative, associations in both groups. Our findings, from a novel situation incorporating potential autistic interests, suggest that RRBs do not necessarily displace exploration and its possibilities for learning in autism.

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.

Objective measurement of head movement differences in children with and without autism spectrum disorder

Background

Deficits in motor movement in children with autism spectrum disorder (ASD) have typically been characterized qualitatively by human observers. Although clinicians have noted the importance of atypical head positioning (e.g. social peering and repetitive head banging) when diagnosing children with ASD, a quantitative understanding of head movement in ASD is lacking. Here, we conduct a quantitative comparison of head movement dynamics in children with and without ASD using automated, person-independent computer-vision based head tracking (Zface). Because children with ASD often exhibit preferential attention to nonsocial versus social stimuli, we investigated whether children with and without ASD differed in their head movement dynamics depending on stimulus sociality.

Methods

The current study examined differences in head movement dynamics in children with (n = 21) and without ASD (n = 21). Children were video-recorded while watching a 16-min video of social and nonsocial stimuli. Three dimensions of rigid head movement—pitch (head nods), yaw (head turns), and roll (lateral head inclinations)—were tracked using Zface. The root mean square of pitch, yaw, and roll was calculated to index the magnitude of head angular displacement (quantity of head movement) and angular velocity (speed).

Results

Compared with children without ASD, children with ASD exhibited greater yaw displacement, indicating greater head turning, and greater velocity of yaw and roll, indicating faster head turning and inclination. Follow-up analyses indicated that differences in head movement dynamics were specific to the social rather than the nonsocial stimulus condition.

Conclusions

Head movement dynamics (displacement and velocity) were greater in children with ASD than in children without ASD, providing a quantitative foundation for previous clinical reports. Head movement differences were evident in lateral (yaw and roll) but not vertical (pitch) movement and were specific to a social rather than nonsocial condition. When presented with social stimuli, children with ASD had higher levels of head movement and moved their heads more quickly than children without ASD. Children with ASD may use head movement to modulate their perception of social scenes.

Electronic supplementary material

The online version of this article (10.1186/s13229-018-0198-4) contains supplementary material, which is available to authorized users.

Should we change targets and methods of early intervention in autism, in favor of a strengths-based education?

Early intensive behavioral intervention (EIBI) and its recent variant, naturalist developmental behavioral intervention (NDBI) aim to increase socialization and communication, and to decrease repetitive and challenging behaviors in preschool age autistic children. These behaviorist techniques are based on the precocity and intensity of the intervention, face-to-face interaction, errorless learning, and information fragmentation. Once considered to be "scientifically proven", the efficacy of these approaches has been called into question in the last decade due to poor-quality data, small effects, low cost-efficiency, and the evolution of ethical and societal standards. Grounded on a reappraisal of the genetic and cognitive neuroscience of autism, we question three aspects of EIBI/NDBI: their focus on prerequisites for typical socio-communicative behaviors, their lack of consideration of autistic language development and learning modes, and their negative view of repetitive behaviors and restricted interests. We propose alternative predictions for empirical validation, based on the strengths of prototypical autistic children: (a) their non-verbal intelligence should be normally distributed and within the normal range; (b) improving access to non-communicative verbal and written auditory language material should favor their subsequent speech development and

The Mechanisms Underlying the ASD Advantage in Visual Search

A number of studies have demonstrated that individuals with autism spectrum disorders (ASDs) are faster or more successful than typically developing control participants at various visual-attentional tasks (for reviews, see Dakin and Frith in Neuron 48:497-507, 2005; Simmons et al. in Vis Res 49:2705-2739, 2009). This "ASD advantage" was first identified in the domain of visual search by Plaisted et al. (J Child Psychol Psychiatry 39:777-783, 1998). Here we survey the findings of visual search studies from the past 15 years that contrasted the performance of individuals with and without ASD. Although there are some minor caveats, the overall consensus is that-across development and a broad range of symptom severity-individuals with ASD reliably outperform controls on visual search. The etiology of the ASD advantage has not been formally specified, but has been commonly attributed to 'enhanced perceptual discrimination', a superior ability to visually discriminate between targets and distractors in such tasks (e.g. O'Riordan in Cognition 77:81-96, 2000). As well, there is considerable evidence for impairments of the attentional network in ASD (for a review, see Keehn et al. in J Child Psychol Psychiatry 37:164-183, 2013). We discuss some recent results from our laboratory that support an attentional, rather than perceptual explanation for the ASD advantage in visual search. We speculate that this new conceptualization may offer a better understanding of some of the behavioral symptoms associated with ASD, such as over-focusing and restricted interests.

A Developmental Perspective of Global and Local Visual Perception in Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) demonstrate superior performances on visuo-spatial tasks emphasizing local information processing; however, findings from studies involving hierarchical stimuli are inconsistent. Wide age ranges and group means complicate their interpretability. Children and adolescents with and without ASD completed a Navon task wherein they identified global and local stimuli composed of either consistent or inconsistent letters. Trajectories of reaction time in global and local conditions were similar within and between groups when consistent and inconsistent stimuli were considered together, but the effect of local-to-global interference was significantly higher in participants with than without ASD. Age was not a significant predictor of local-to-global interference, suggesting that this effect emerges in childhood and persists throughout adolescence in ASD.

Visual function in autism spectrum disorders: a critical review

Studies have shown considerable evidence of visual dysfunction in autism spectrum disorders. Anomalies in visual information processing can have a major effect on the life quality of individuals with autism spectrum disorders. We summarise the hypotheses and theories underlying neural aetiologies and genetic factors that cause these disorders, as well as the possible influences of unusual sensory processing on the communications and behaviour characterised by the autistics. In particular, we review the impact of these dysfunctions on visual performance.

Atypical sensory reactivity influences auditory attentional control in adults with autism spectrum disorders

Frequent observations of atypical sensory reactivity in people with autism spectrum disorders (ASD) suggest that the perceptual experience of those on the Spectrum is dissimilar to neurotypicals. Moreover, variable attention abilities in people with ASD, ranging from good control to periods of high distractibility, may be related to atypical sensory reactivity. This study used auditory event-related potential (ERP) measures to evaluate top-down and bottom-up attentional processes as a function of perceptual load, and examined these factors with respect to sensory reactivity. Twenty-five age and IQ-matched participants (ASD: 22.5 year, SD = 4.1 year; Controls: 22.8 year, SD = 5.1 year) completed the Adolescent/Adult Sensory Profile prior to performing a modified 3-stimulus (target, non-target, and distractor) auditory oddball target detection task EEG was recorded during task completion. ERP analysis assessed early sensory processing (P50, ∼50 ms latency; N100, ∼100 ms latency), cognitive control (N200, ∼200 ms latency), and attentional processing (P3a and P3b, ∼300 ms latency). Behavioral data demonstrates participants with ASD and neurotypical performed similarly on auditory target detection, but diverged on sensory profiles. Target ERP measures associated with top-down control (P3b latency) significantly increased under greater load in controls, but not in participants with ASD. Early ERP responses associated with bottom-up attention (P50 amplitude) were positively correlated to increased sensory sensitivity. Findings suggest specific neural mechanisms for increased perceptual capacity and enhanced bottom-up processing of sensory stimuli in people with autism. Results from participants with ASD are consistent with load theory and enhanced perceptual functioning. Autism Res 2016, 9: 1079-1092. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Atypical object exploration in infants at-risk for autism during the first year of lifer

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder usually diagnosed by the end of the second year of life. Early signs of ASD within the first year of life are still unclear. The main purpose of the present study was to compare object exploration skills between infants at-risk for ASD and typically developing (TD) infants to determine early markers for autism within the first year of life. Sixteen at-risk infants and 16 TD infants were longitudinally followed from 6 to 15 months of age during an object exploration task involving three objects with distinct size, shape, and texture, i.e., a long rattle, a rigid circular ball, and a soft circular koosh ball. All sessions were videotaped for coding of manual exploration (grasping and dropping), oral exploration (mouthing), and visual exploration (looking). We also obtained follow-up outcomes using various developmental questionnaires at 18 months and email follow-up on developmental delays/ASD diagnosis after the infants' second birthdays. Our results showed object-based differences in exploration patterns that extended across both groups. We also noticed context-dependent group differences for various exploratory behaviors across objects and ages. Specifically, at 6 months, at-risk infants showed less grasping of the rigid ball as well as less mouthing and greater looking at the rattle compared to TD infants. At 9 and 12 months, at-risk infants demonstrated significantly lower levels of purposeful dropping of all objects and greater looking at the rattle. Lastly, at 15 months, at-risk infants showed persistent mouthing of the rigid ball and rattle compared to TD infants. In addition, 10 out of 16 at-risk infants developed various motor, social, and language delays or ASD diagnosis at follow-up. Taken together, early context-dependent delays/abnormalities in object exploration could be markers for future developmental delays in infants at-risk for autism. Moreover, promoting early object experiences through socially embedded, free and structured play could have significant implications for multisystem development including perceptuo-motor, social communication, and cognitive development in at-risk infants.

Judging the Intensity of Emotional Expression in Faces: the Effects of Colored Tints on Individuals With Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) often show atypical processing of facial expressions, which may result from visual stress. In the current study, children with ASD and matched controls judged which member of a pair of faces displayed the more intense emotion. Both faces showed anger, disgust, fear, happiness, sadness or surprise but to different degrees. Faces were presented on a monitor that was tinted either gray or with a color previously selected by the participant individually as improving the clarity of text. Judgments of emotional intensity improved significantly with the addition of the preferred colored tint in the ASD group but not in controls, a result consistent with a link between visual stress and impairments in processing facial expressions in individuals with ASD.

Motor functioning, exploration, visuospatial cognition and language development in preschool children with autism

In order to understand typical and atypical developmental trajectories it is important to assess how strengths or weaknesses in one domain may be affecting performance in other domains. This study examined longitudinal relations between early fine motor functioning, visuospatial cognition, exploration, and language development in preschool children with ASD and children with other developmental delays/disorders. The ASD group included 63 children at T1 (Mage = 27.10 months, SD = 8.71) and 46 children at T2 (Mage = 45.85 months, SD = 7.16). The DD group consisted of 269 children at T1 (Mage = 17.99 months, SD = 5.59), and 121 children at T2 (Mag e= 43.51 months, SD = 3.81). A subgroup nested within the total sample was randomly selected and studied in-depth on exploratory behavior. This group consisted of 50 children, 21 children with ASD (Mage = 27.57, SD = 7.09) and 29 children with DD (Mage = 24.03 months, SD = 6.42). Fine motor functioning predicted language in both groups. Fine motor functioning was related to visuospatial cognition in both groups and related to object exploration, spatial exploration, and social orientation during exploration only in the ASD group. Visuospatial cognition and all exploration measures were related to both receptive and expressive language in both groups. The findings are in line with the embodied cognition theory, which suggests that cognition emerges from and is grounded in the bodily interactions of an agent with the environment. This study emphasizes the need for researchers and clinicians to consider cognition as emergent from multiple interacting systems.

An eye-tracking method to reveal the link between gazing patterns and pragmatic abilities in high functioning autism spectrum disorders

The present study illustrates the potential advantages of an eye-tracking method for exploring the association between visual scanning of faces and inferences of mental states. Participants watched short videos involving social interactions and had to explain what they had seen. The number of cognition verbs (e.g., think, believe, know) in their answers were counted. Given the possible use of peripheral vision that could confound eye-tracking measures, we added a condition using a gaze-contingent viewing window: the entire visual display is blurred, expect for an area that moves with the participant’s gaze. Eleven typical adults and eleven high functioning adults with Autism Spectrum Disorders (ASD) were recruited. The condition employing the viewing window yielded strong correlations between the average duration of fixations, the ratio of cognition verbs and standard measures of social disabilities.

Linking neocortical, cognitive, and genetic variability in autism with alterations of brain plasticity: the Trigger-Threshold-Target model

The phenotype of autism involves heterogeneous adaptive traits (strengths vs. disabilities), different domains of alterations (social vs. non-social), and various associated genetic conditions (syndromic vs. nonsyndromic autism). Three observations suggest that alterations in experience-dependent plasticity are an etiological factor in autism: (1) the main cognitive domains enhanced in autism are controlled by the most plastic cortical brain regions, the multimodal association cortices; (2) autism and sensory deprivation share several features of cortical and functional reorganization; and (3) genetic mutations and/or environmental insults involved in autism all appear to affect developmental synaptic plasticity, and mostly lead to its upregulation. We present the Trigger-Threshold-Target (TTT) model of autism to organize these findings. In this model, genetic mutations trigger brain reorganization in individuals with a low plasticity threshold, mostly within regions sensitive to cortical reallocations. These changes account for the cognitive enhancements and reduced social expertise associated with autism. Enhanced but normal plasticity may underlie non-syndromic autism, whereas syndromic autism may occur when a triggering mutation or event produces an altered plastic reaction, also resulting in intellectual disability and dysmorphism in addition to autism. Differences in the target of brain reorganization (perceptual vs. language regions) account for the main autistic subgroups. In light of this model, future research should investigate how individual and sex-related differences in synaptic/regional brain plasticity influence the occurrence of autism.

ASD: Psychopharmacologic Treatments and Neurophysiologic Underpinnings

Autism Spectrum Disorder encompasses a range of neurodevelopmental disorders characterized by early deficits in social communication in addition to restricted and repetitive behaviors. Symptoms are increasingly understood to be associated with abnormalities in the coordination of neuronal assemblies responsible for processing information essential for early adaptive behaviors. Pharmacologic treatments carry evidence for clinically significant benefit of multiple impairing symptoms of ASD, yet these benefits are limited and range across a broad spectrum of medication classes, making it difficult to characterize associated neurochemical impairments. Increasing prevalence of both ASD and its pharmacologic management calls for greater understanding of the neurophysiologic basis of the disorder. This paper reviews underlying alterations in local brain regions and coordination of brain activation patterns during both resting state and task-related processes. We propose that new pharmacologic treatments may focus on realigning trajectories of network specialization across development by working in combination with behavioral treatments to enhance social and emotional learning by bolstering the impact of experience-induced plasticity on neuronal network connectivity.

The relationship between atypical visual processing and social skills in young children with autism

The present study examined whether atypical visual processing is related to the level of social skills in children with autism spectrum disorder (ASD). Thirty-eight young children with ASD (29 boys, 9 girls) were included. Atypical visual processing was assessed by coding the number of lateral glances and the amount of object grouping behavior on videotaped observations of the ADOS (aged 35 ± 9 months). The level of social skills was measured using the subscale interpersonal relationships of the Vineland SEEC (32 ± 7 months). A negative relationship with a medium effect size was found between lateral glances and interpersonal relationships. Object grouping behavior and interpersonal relationships were not related. This study suggests that visual perception may be a mechanism in the development of interpersonal relationships in ASD, which is in accordance with an embodied approach to social cognition.

Atypical cortical representation of peripheral visual space in children with an autism spectrum disorder

A key feature of early visual cortical regions is that they contain discretely organized retinotopic maps. Titration of these maps must occur through experience, and the fidelity of their spatial tuning will depend on the consistency and accuracy of the eye movement system. Anomalies in fixation patterns and the ballistics of eye movements are well documented in autism spectrum disorder (ASD), with off-center fixations a hallmark of the phenotype. We hypothesized that these atypicalities might affect the development of visuo-spatial maps and specifically that peripheral inputs might receive altered processing in ASD. Using high-density recordings of visual evoked potentials (VEPs) and a novel system-identification approach known as VESPA (visual evoked spread spectrum analysis), we assessed sensory responses to centrally and peripherally presented stimuli. Additionally, input luminance was varied to bias responsiveness to the magnocellular system, given previous suggestions of magnocellular-specific deficits in ASD. Participants were 22 ASD children (7-17 years of age) and 31 age- and performance-IQ-matched neurotypical controls. Both VEP and VESPA responses to central presentations were indistinguishable between groups. In contrast, peripheral presentations resulted in significantly greater early VEP and VESPA amplitudes in the ASD cohort. We found no evidence that anomalous enhancement was restricted to magnocellular-biased responses. The extent of peripheral response enhancement was related to the severity of stereotyped behaviors and restricted interests, cardinal symptoms of ASD. The current results point to differential visuo-spatial cortical mapping in ASD, shedding light on the consequences of peculiarities in gaze and stereotyped visual behaviors often reported by clinicians working with this population.

Self-monitoring of gaze in high functioning autism

Atypical visual behaviour has been recently proposed to account for much of social misunderstanding in autism. Using an eye-tracking system and a gaze-contingent lens display, the present study explores self-monitoring of eye motion in two conditions: free visual exploration and guided exploration via blurring the visual field except for the focal area of vision. During these conditions, thirteen students with High Functioning Autism Spectrum Disorders (HFASD) and fourteen typical individuals were presented naturalistic and interactive social stimuli using virtual reality. Fixation data showed a weaker modulation of eye movements according to the conditions in the HFASD group, thus suggesting impairments in self-monitoring of gaze. Moreover, the gaze-contingent lens induced a visual behaviour whereby social understanding scores were correlated with the time spent gazing at faces. The device could be useful for treating gaze monitoring deficiencies in HFASD.

Brief report: preliminary evidence of reduced sensitivity in the peripheral visual field of adolescents with autistic spectrum disorder

A number of studies have demonstrated atypical perception in individuals with ASD. However, the majority of these studies have presented stimuli to central vision. The aim of the study presented here was to test the sensitivity of peripheral vision in ASD. This was achieved by asking participants to detect brief flashes of light presented between 30 and 85 degrees away from fixation. We found that participants with ASD detected fewer ligh-flashes than the control participants. This deficit was more pronounced in the nasal hemifield than the temporal hemifield. We suggest that the imbalance between nasal and temporal hemifield sensitivity may contribute to the peripheral-field stimulation and lateral glances that are observed in ASD.

Postural hypo-reactivity in autism is contingent on development and visual environment: a fully immersive virtual reality study

Although atypical motor behaviors have been associated with autism, investigations regarding their possible origins are scarce. This study assessed the visual and vestibular components involved in atypical postural reactivity in autism. Postural reactivity and stability were measured for younger (12–15 years) and older (16–33 years) autistic participants in response to a virtual tunnel oscillating at different frequencies. At the highest oscillation frequency, younger autistic participants showed significantly less instability compared to younger typically-developing participants; no such group differences were evidenced for older participants. Additionally, no significant differences in postural behavior were found between all 4 groups when presented with static or without visual information. Results confirm that postural hypo-reactivity to visual information is present in autism, but is contingent on both visual environment and development.

Investigating gaze of children with ASD in naturalistic settings

BACKGROUND

Visual behavior is known to be atypical in Autism Spectrum Disorders (ASD). Monitor-based eye-tracking studies have measured several of these atypicalities in individuals with Autism. While atypical behaviors are known to be accentuated during natural interactions, few studies have been made on gaze behavior in natural interactions. In this study we focused on i) whether the findings done in laboratory settings are also visible in a naturalistic interaction; ii) whether new atypical elements appear when studying visual behavior across the whole field of view.

METHODOLOGY/PRINCIPAL FINDINGS

Ten children with ASD and ten typically developing children participated in a dyadic interaction with an experimenter administering items from the Early Social Communication Scale (ESCS). The children wore a novel head-mounted eye-tracker, measuring gaze direction and presence of faces across the child's field of view. The analysis of gaze episodes to faces revealed that children with ASD looked significantly less and for shorter lapses of time at the experimenter. The analysis of gaze patterns across the child's field of view revealed that children with ASD looked downwards and made more extensive use of their lateral field of view when exploring the environment.

CONCLUSIONS/SIGNIFICANCE

The data gathered in naturalistic settings confirm findings previously obtained only in monitor-based studies. Moreover, the study allowed to observe a generalized strategy of lateral gaze in children with ASD when they were looking at the objects in their environment.

Diagnostic differentiation of autism spectrum disorders and pragmatic language impairment

The present study examined diagnostic differentiation between school-aged children with autism spectrum disorders (ASD) and children with pragmatic language impairment (PLI). Standardized diagnostic instruments were used to investigate the relationship between severity of 'autism triad' impairments and group membership. The Autism Diagnostic Observation Schedule was administered to 19 children with PLI and 22 children with ASD. Parents completed the Social Communication Questionnaire. There was a significant difference between diagnostic groups in the level of the severity of behaviors represented by the Communication and Reciprocal Social Interaction sub-domains on both diagnostic measures. Currently displayed Repetitive and Restricted Behaviors and Interests were not found to be useful for differentiating between groups. The similarities found between groups have important implications for intervention.

Measuring gaze of children with Autism Spectrum Disorders in naturalistic interactions

In this paper, we report on a study on gaze behavior by children with Autism Spectrum Disorder (ASD) during a dyadic interaction in a naturalistic environment. Twelve children with ASD were contrasted to twelve typically developing (TD) children, in a semi-structured interaction with a selection of items from the Early Social Communication Scale (ESCS). We used the WearCam, a novel head-mounted eye-tracker designed for children, to obtain gaze information across the broad field of view from the viewpoint of the child. Children with ASD looked downwards more often, and explored their lateral field of view more extensively compared to TD children. We discuss a number of hypotheses in support of these observations.