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. 2021 Sep;14(9):1975-1985.
doi: 10.1002/aur.2552. Epub 2021 Aug 4.

Puppets facilitate attention to social cues in children with ASD

Suzanne Macari  1 , Xinyuan Chen  2 , Ludivine Brunissen  1 , Eukyung Yhang  1 , Emma Brennan-Wydra  1 , Angelina Vernetti  1 , Fred Volkmar  1 , Joseph Chang  1   2 , Katarzyna Chawarska  1
Affiliations

Puppets facilitate attention to social cues in children with ASD

Suzanne Macari et al. Autism Res. 2021 Sep.

Abstract

Diminished visual attention to faces of social partners represents one of the early characteristics of autism spectrum disorder (ASD). Here we examine if the introduction of puppets as social partners alters attention to speakers' faces in young children with ASD and typically developing (TD) controls. Children with ASD (N = 37; Mage = 49.44 months) and TD (N = 27; Mage = 40.66 months) viewed a video depicting a puppet and a human engaged in a conversation. Dwell time on these faces was analyzed as a function of group and speaker's identity. Unlike TD controls, the ASD group exhibited limited visual attention to and chance-level visual preference for the human speaker. However, attention to and preference for the puppet speaker's face was greater than chance and comparable across the two groups. While there was a strong association between low human speaker preference and high autism severity, no association with autism severity was found for puppet speaker preference. Unlike humans, expressive and verbal puppets attracted the attention of children with ASD at levels comparable to that of TD controls. Considering that puppets can engage in reciprocal interactions and deliver simplified, salient social-communicative cues, they may facilitate therapeutic efforts in children with ASD. LAY SUMMARY: While studies have shown support for therapeutic uses of robots with children with autism, other similar agents such as puppets remain to be explored. When shown a video of a conversation between a puppet and a person, young children with ASD paid as much attention to the puppet's face as typically-developing (TD) children. Since puppets can engage in back-and-forth interactions and model social interactions and communication, they may play a promising role in therapeutic efforts for young children with ASD.

Keywords: attention; eye tracking; puppets.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors report no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Example frames from the video stimulus (left) without (top) and with a ball (bottom) and spatial allocation of the regions of interest (ROI) (right). ROIs considered in the analysis include: Background, puppet face, human face, puppet body, human body, and ball
FIGURE 2
FIGURE 2
(a) Proportion of looking time at the Human’s face in the human speaker (left) or the puppet speaker (right) conditions in the ASD and TD groups. (b) Proportion of looking time at the Puppet’s face in the human speaker (left) or the puppet speaker (right) conditions in the ASD and TD groups
FIGURE 3
FIGURE 3
Average speaker versus listener preference proportions in the human speaker (left) and puppet speaker (right) conditions in the ASD and TD groups
FIGURE 4
FIGURE 4
Associations between speaker preferences (x-axis) in the human speaker (left three plots) and puppet speaker (right three plots) conditions and severity of ADOS-2 autism symptoms and MSEL verbal and nonverbal DQ (y-axis)
See this image and copyright information in PMC

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