What children with and without ASD see: Similar visual experiences with different pathways through parental attention strategies

Abstract

Background and aims: Although young children's gaze behaviors in experimental task contexts have been shown to be potential biobehavioral markers relevant to autism spectrum disorder (ASD), we know little about their everyday gaze behaviors. The present study aims (1) to document early gaze behaviors that occur within a live, social interactive context among children with and without ASD and their parents, and (2) to examine how children's and parents' gaze behaviors are related for ASD and typically developing (TD) groups. A head-mounted eye-tracking system was used to record the frequency and duration of a set of gaze behaviors (such as sustained attention [SA] and joint attention [JA]) that are relevant to early cognitive and language development.

Methods: Twenty-six parent-child dyads (ASD group = 13, TD group = 13) participated. Children were between the ages of 3 and 8 years old. We placed head-mounted eye trackers on parents and children to record their parent- and child-centered views, and we also recorded their interactive parent-child object play scene from both a wall- and ceiling-mounted camera. We then annotated the frequency and duration of gaze behaviors (saccades, fixation, SA, and JA) for different regions of interest (object, face, and hands), and attention shifting. Independent group t-tests and ANOVAs were used to observe group comparisons, and linear regression was used to test the predictiveness of parent gaze behaviors for JA.

Results: The present study found no differences in visual experiences between children with and without ASD. Interestingly, however, significant group differences were found for parent gaze behaviors. Compared to parents of ASD children, parents of TD children focused on objects and shifted their attention between objects and their children's faces more. In contrast, parents of ASD children were more likely to shift their attention between their own hands and their children. JA experiences were also predicted differently, depending on the group: among parents of TD children, attention to objects predicted JA, but among parents of ASD children, attention to their children predicted JA.

Conclusion: Although no differences were found between gaze behaviors of autistic and TD children in this study, there were significant group differences in parents' looking behaviors. This suggests potentially differential pathways for the scaffolding effect of parental gaze for ASD children compared with TD children.

Implications: The present study revealed the impact of everyday life, social interactive context on early visual experiences, and point to potentially different pathways by which parental looking behaviors guide the looking behaviors of children with and without ASD. Identifying parental social input relevant to early attention development (e.g., JA) among autistic children has implications for mechanisms that could support socially mediated attention behaviors that have been documented to facilitate early cognitive and language development and implications for the development of parent-mediated interventions for young children with or at risk for ASD.Note: This paper uses a combination of person-first and identity-first language, an intentional decision aligning with comments put forth by Vivanti (Vivanti, 2020), recognizing the complexities of known and unknown preferences of those in the larger autism community.

Keywords: Autism spectrum disorders; cognition (attention; interaction; learning); memory; social behavior; social cognition.

Figure 1.

(A) Wall-mounted view of the parent–child play session. (B) The first-person view of the parent–child play session of the child. The blue calibration dot indicates the ROI to which the child looked during any given frame. (C) Ceiling-mounted view of the parent–child play session. (D) The first-person view of the parent–child play session of the parent. The blue calibration dot indicates the ROI to which the parent looked during any given frame.

Figure 2.

The distribution of children’s gaze behaviors. (A) Children’s gaze by ROIs counted by frequency. (B) Children’s gaze by ROIs counted by duration (second [sec]). (C) Children’s gaze by gaze type counted by frequency. (D) Children’s gaze by gaze type counted by duration (sec). A, Children’s gaze counted by frequency across ROIs. Significance levels: marginal, * <.05, ** <.01, *** <.001.

Figure 3.

The frequency distribution of children’s gaze shifting to objects (A) and parents’ gaze shifting to objects (B). A, No difference between children with and without ASD in the amount of gaze shifting; children in both groups were significantly more often to shift attention when the prior location was the parent’s hands than the child’s hands, and the parent’s face was the least. B, Parents of TD children had significantly more gaze shifting than parents of children with ASD did; parents in both groups had significantly more shift to objects when the prior location was child’s hands, followed by comparable amounts of shifting from the child’s face and the parent’s hands.

Figure 4.

The distribution of parents’ gaze behaviors. (A) Parents’ gaze by ROIs counted by frequency. (B) Parents’ gaze by ROIs counted by duration (sec). (C) Parent’s gaze by gaze type counted by frequency. (D) Parent’s gaze by gaze type counted by duration (sec). Significance levels: * <.05, ** <.01, *** <.001.

Figure 5.

Significant parent attention predictors for JA instances. (A) Parents’ attention to all of the regions of interest (objects, parent hands, child face, and child hands) frequency as a significant predictor of A frequency. (B) Parents’ hand-looking frequency as a significant predictor of JA frequency. (C) Parents’ object-looking duration as a significant predictor of JA duration.