An Eye-movement Study Of Joint Attention In Children With Autism Spectrum Disorders In Dynamic Social Situations

Purpose: Autism spectrum disorder(ASD)is a common neurodevelopmental disorder that often begins in infancy and early childhood,and one of the core features of individuals with ASD is a deficit in social interaction,primarily in the form of impaired joint attention(JA).The development of social interaction and verbal communication in typically developing(TD)children is closely linked to their performance of JA.Further research has shown that children with ASD have deficits in attending to social interactions and facial social information,which may affect the development of normal social functioning.Building on previous studies that have explored children with ASD using static faces or social pictures,we adapted a dynamic social interaction paradigm and developed a dynamic cue-switching paradigm to explore the performance of JA in children with ASD.The aim of this study was to explore the gaze patterns of JA in school-aged children with ASD using two different dynamic interaction paradigms as experimental materials.Methods: There were two groups of subjects in this study: the ASD group and the normally developing group(typically developing,TD).A total of 56 children with ASD who met the inclusion criteria were included,and 57 children with age-and sexmatched TD were included.All subjects were given two separate eye tracking examinations.The dynamic social interaction paradigm consisted of ’shared focus’ and’mutual gaze’(Experiment 1),and the dynamic cue-switching paradigm consisted of’no-switch’,’cognitive cue switch’ and ’cognitive cue switch’(Experiment 2).Repeatedmeasures ANOVAs were conducted on normally distributed eye movement data(fixation time).The JA regions of interest were mainly toys and eyes in the dynamic social interaction paradigm,and eyes and mouth in the dynamic cue-switching paradigm.Result 1: A group(ASD,TD)x areas of interest(AOIs)(body,eyes,mouth,background,toy)repeated measures ANOVA was conducted on dynamic social interaction videos.Results found significant group and area of interest interactions.Post-hoc analyses found that children with ASD performed less well on JA.Children with ASD spent significantly less time looking at toys in ’shared focus’ than children with TD(p<0.001).Children with ASD spent significantly less time looking at their eyes than children with TD in ’mutual gaze’(P<0.05).Result 2: A group(ASD,TD)x AOIs(body,eyes,mouth,background)repeated measures ANOVA was conducted on the dynamic cue-switching video.The results found a significant group and area of interest interaction.Post-hoc analyses revealed that children with ASD had a deficit in JA and were unable to follow the gaze of others.Children with ASD spent significantly less time looking at their eyes than children with TD during ’emotional cue switch’(P<0.05),while no significant differences were found between the two groups during ’no-switch’ and ’cognitive cue switch’.There was no significant difference between the two groups.It was also found that children with ASD had gaze avoidance of the mouth.In all three switching modes,children with ASD spent significantly less time looking at their mouths than children with TD(P<0.01),and continued to avoid them throughout the video playback.Conclusions: 1.In dynamic social interaction situations,children with ASD showed significantly less attention to the JA area of interest than children with TD,and children with ASD were unable to follow another person’s gaze to another target object.2.In dynamic cue-switching situations,children with ASD showed significantly lower attention to the eyes than children with TD in the eyes-only cue-switching condition(’emotional cue switch’),as well as persistent avoidance of the mouth.