Exploring Emotional Dysregulation and Avoidance with Caregivers as the Mechanisms Linking Social Communication Understanding and Aggressive Behaviours.

Many autistic adolescents and young adults present with aggressive behaviours, which can be challenging for caregivers. The present study aimed to explore the underlying mechanisms between social communication understanding and aggressive behaviours in autistic and non-autistic adolescents, specifically the role of emotional dysregulation and its impact on avoidance with caregivers. Caregivers of autistic (n = 275) and non-autistic adolescents (n = 123) completed standardised caregiver-report questionnaires measuring social communication understanding, emotional dysregulation, avoidance between the adolescent and caregiver and aggressive behaviours. A serial mediation analysis indicated that levels of social communication understanding were indirectly associated with aggressive behaviours. This occurred through increased emotional dysregulation, which may have led to increased avoidance between the autistic and non-autistic adolescents and their caregivers. These findings support a sequential process by which adolescents with low social communication understanding are more likely to behave aggressively through being emotionally dysregulated and the impact of this on the increased avoidance within the caregiver-adolescent dyad. This process was found within autistic and non-autistic adolescents, suggesting a mechanism across individuals with aggression. These findings indicate that interventions based on improving emotion regulation ability and responses between adolescents and their caregivers may aid in reducing aggressive behaviours in adolescents and young adults with lower social communication understanding.

Camouflaging, not sensory processing or autistic identity, predicts eating disorder symptoms in autistic adults.

LAY ABSTRACT: This study aimed to explore the impact of Autistic identity (i.e. feeling like you belong to the Autistic community), sensory profiles (e.g. being over or under responsive to sensations) and camouflaging behaviours (i.e. masking) on eating disorder symptoms in Autistic adults. 180 Autistic people were recruited from the community and NHS. The Autistic people completed online questionnaires measuring Autistic identity, sensory profiles, camouflaging behaviours, autistic traits and eating disorder symptoms. The analysis showed that higher levels of camouflaging behaviour predicted higher levels of eating disorder symptoms. Sensory profiles were related to but did not predict eating disorder symptoms and there was no relationship between level of Autistic identity and eating disorder symptoms. This shows that camouflaging is the most important predictor of eating disorder symptoms in Autistic people, and warrants further exploration.

Avoidant Restrictive Food Intake Disorder (ARFID)-Looking beyond the eating disorder lens?

Avoidant Restrictive Food Intake Disorder (ARFID) was first included as a diagnostic category in 2013, and over the past 10 years has been adopted by the international eating disorder community. While greater awareness of these difficulties has increased identification, demand and enabled advocacy for clinical services, the heterogeneous nature of ARFID poses unique challenges for eating disorder clinicians and researchers. This commentary aims to reflect on some of these challenges, focussing specifically on the risk of viewing ARFID through an eating disorder lens. This includes potential biases in the literature as most recent research has been conducted in specialist child and adolescent eating disorder clinic settings, bringing in to question the generalisability of findings to the broad spectrum of individuals affected by ARFID. We also consider whether viewing ARFID predominantly through an eating disorder lens risks us as a field being blinkered to the range of effective skills our multi-disciplinary feeding colleagues may bring. There are opportunities that may come with the eating disorder field navigating treatment pathways for ARFID, including more joined up working with multi-disciplinary colleagues, the ability to transfer skills used in ARFID treatment to individuals with eating disorder presentations, and most notably an opportunity to provide more effective treatment and service pathways for individuals with ARFID and their families. However, these opportunities will only be realised if eating disorder clinicians and researchers step out of their current silos.

Associations between maternal smartphone use and mother-infant responsiveness: A cluster analysis of potential risk and protective factors.

Contradictory results in the extant literature suggests that additional risk factors should be considered when exploring the impacts of maternal smartphone use on mother-infant relationships. This study used cluster analysis to explore whether certain risk factors were implicated in mother-infant dyads with high smartphone use and low mother-infant responsiveness. A cross-sectional survey of 450 participants in the UK measured infant social-emotional development, maternal depressive, anxiety and stress symptoms, wellbeing, social support, smartphone use, and mother-infant responsiveness. Participants were predominantly White (95.3%) and living with a partner (95.2%), with infants who were born full-term (88.9%). Cluster analysis identified three clusters characterized as; cluster (1) "infant at risk" showing high infant development concerns, high maternal smartphone use, and low mother-infant responsiveness; cluster (2) "mother at risk" showing high maternal depressive, anxiety, and stress scores, low social support, high maternal smartphone use, and low mother-infant responsiveness, and cluster (3) "low risk" showing low maternal smartphone use and high mother-infant responsiveness. Significant differences were found between all risk factors, except for maternal smartphone use and mother-infant responsiveness between clusters 1 and 2 suggesting that both clusters require early intervention, although interventions should be tailored towards the different risk factors they are presenting with.

Resultados contradictorios en la literatura existente sugieren que se deben considerar factores de riesgo adicionales cuando se explora el impacto del uso que la madre hace del teléfono inteligente en las relaciones madre­infante. Este estudio usó un análisis de grupo para explorar si ciertos factores de riesgo estaban implicados en las díadas madre­infante con uso elevado del teléfono inteligente y la baja sensibilidad madre­infante. Una encuesta transversal de 450 participantes en el Reino Unido midió el desarrollo socioemocional del infante, los síntomas maternos depresivos, de ansiedad y estrés, el bienestar, el apoyo social, el uso del teléfono inteligente, así como la sensibilidad madre­infante. Las participantes eran predominantemente blancas (95.3%) y convivían con una pareja (95.2%), con infantes nacidos en un período de gestación completo (88.9%). Los análisis de grupo identificaron tres grupos caracterizados como: grupo 1) "infante bajo riesgo," mostrando altas preocupaciones sobre el desarrollo del infante, uso elevado del teléfono inteligente por parte de la madre, así como baja sensibilidad madre­infante; grupo 2) "madre bajo riesgo," mostrando altos puntajes de depresión, ansiedad y estrés maternos, bajo apoyo social, uso elevado del teléfono inteligente por parte de la madre, así como baja sensibilidad madre­infante; y grupo 3) "bajo riesgo," mostrando bajo uso del teléfono inteligente por parte de la madre, y alta sensibilidad madre­infante. Se encontraron diferencias significativas en todos los factores de riesgo, excepto en el caso del uso del teléfono inteligente por parte de la madre y la sensibilidad madre­infante entre los grupos 1 y 2, lo cual indica que ambos grupos requieren de una temprana intervención, aunque las intervenciones se deben moldear en términos de los diferentes factores de riesgo que se le presenta a cada grupo.

Les résultats contradictoires dans les recherches existantes suggèrent que des facteurs de risque supplémentaires devraient être pris en considération en explorant les impacts de l'utilisation maternelle du smartphone sur les relations mère­bébé. Cette étude a utilisé une analyse typologique afin d'explorer si certains facteurs de risque étaient impliqués chez les dyades mère­nourrisson avec une utilisation élevée du smartphone et une réaction mère­nourrisson faible. Une étude transversale de 450 participantes au Royaume Uni a mesuré le développement socio­émotionnel du bébé, les symptômes dépressives, d'anxiété et de stress maternel, le bien­être maternel, le soutien social, l'utilisation du smartphone et la réaction mère­nourrisson. Les participantes étaient essentiellement Blanches (95,3%), vivant avec un partenaire (95,2%), avec des bébés étant nés à terme (88,9%). Une analyse typologique a identifié trois clusters (types) avec ces caractéristiques: type 1) "nourrisson à risque" avec des problèmes de développement infantile élevés, une utilisation maternelle du smartphone élevée, et une réaction mère­bébé faible; type 2) "mère à risque" faisant état de scores maternels élevés de dépression, d'anxiété et de stress, d'un soutien social faible, avec une utilisation maternelle du smartphone élevée, et une réaction mère­bébé faible, et type 3) "risque faible" montrant peu d'utilisation maternelle du smartphone et une réaction élevée mère­bébé. Des différences importantes ont été trouvées entre tous les facteurs de risque, saut pour l'utilisation maternelle du smartphone et la réaction maternelle entre les types 1 et 2, ce qui suggère que les deux types exigent une intervention précoce, bien que les interventions devraient être adaptées aux différents facteurs de risque avec lesquelles elles se présentent.

Thinking about the next generation: The case for a mentalization-informed approach to perinatal and intergenerational mental health.

BACKGROUND: There has been substantial progress made across multiple disciplines to emphasize the importance of perinatal mental health both for parents and offspring. This focuses on what has been termed the 'First 1000 Days' from conception to the child's second birthday. We argue that our understanding of this issue can go further to create an intergenerational approach to mental health. Despite the existence of theoretical frameworks and practical approaches to implementation, there are gaps in the understanding of perinatal and intergenerational mental health including which psychological mechanisms are implicated in the transmission of risk and resilience within the perinatal period; and how to leverage these into treatment approaches. AIMS AND METHODS: In this paper, we explore the potential for mentalization as a candidate psychological approach to intergenerational mental health. RESULTS: We contextualize this issue in terms of the points of contact between mentalization and broader theoretical models such as the social determinants of health and the Developmental Origins of Health and Disease (DoHaD) model. Further, we provide an overview of the existing evidence base for the relevance of mentalization to perinatal mental health. DISCUSSION: Finally, we sketch out an outline model for integrating mentalization into perinatal and intergenerational mental health, highlighting several areas of opportunity to develop research and practice from diverse geographies and demographics. Here, we suggest that integration of mentalization with other conceptual frameworks such as DoHaD can mutually enrich the understanding of each model, pointing the way towards more effective early and preventative interventions.

"It's not about wanting to be thin or look small, it's about the way it feels": an IPA analysis of social and sensory differences in autistic and non-autistic individuals with anorexia and their parents.

BACKGROUND: Despite increasing evidence to support an overlap between autism and anorexia nervosa (AN), underlying mechanisms remain poorly understood. Social and sensory factors have emerged as promising targets in both autism and AN, however there remains scope to compare these differences across autistic and non-autistic experiences of AN. Drawing on dyadic multi-perspectives, this study explored experiences of social and sensory differences in autistic and non-autistic adults and their parents and/or carers. METHODS: Using interpretative phenomenological analysis (IPA), dyadic interviews were conducted with 14 dyads, with seven autistic dyads and seven non-autistic dyads. Data analysis was subjected to a triangulation of interpretations: (1) the participants themselves; (2) a neurotypical researcher; (3) and an Autistic researcher with lived/living experience of AN. RESULTS: IPA identified three themes in each group, with similarities and differences between autistic and non-autistic dyads. Similar themes were identified regarding the importance of social connectedness and socio-emotional difficulties, as well a common lack of trust in the social and sensory self and body. Autism-specific themes centred on feelings of social 'defectiveness', disparities between sensing and expressing certain cues, and lifelong, multi-sensory processing differences. Non-autistic themes reflected social comparisons and inadequacy, and sensitivities to the learning of ideals and behaviour through early experiences. CONCLUSIONS: While similarities were observed across both groups, there appeared to be notable differences in the perceived role and influence of social and sensory differences. These findings may have important implications on the delivery and modification of eating disorder interventions. Specifically, they suggest that while treatment targets may look similar, subtle differences in underlying mechanisms and approaches may be required for Autistic individuals with AN across sensory, emotion and communication-based interventions.

"You Feel Like You Kind of Walk Between the Two Worlds": A Participatory Study Exploring How Technology Can Support Emotion Regulation for Autistic People.

An increasing amount of technological solutions aiming to support emotion regulation are being developed for Autistic people. However, there remains a lack of understanding of user needs, and design factors which has led to poor usability and varied success. Furthermore, studies assessing the feasibility of emotion regulation technology via physiological signals for autistic people are increasingly showing promise, yet to date there has been no exploration of views from the autistic community on the benefits/challenges such technology may present in practice. Focus groups with autistic people and their allies were conducted to gain insight into experiences and expectations of technological supports aimed at supporting emotion regulation. Reflexive thematic analysis generated three themes: (1) communication challenges (2) views on emotion regulation technology (3) 'how' technology is implemented. Results provide meaningful insight into the socio-emotional communication challenges faced by autistic people, and explore the expectations of technology aimed at supporting emotion regulation.

The Impact of COVID-19 Restrictions on Psychological Distress in Family Caregivers of Children with Neurodevelopmental Disability in the UK.

Caregivers of a child with a neurodevelopmental disability are more vulnerable to mental health difficulties. These difficulties are influenced by the child's challenging behaviours, and the caregiver's coping strategies; factors impacted by the COVID-19 pandemic. An online mixed methods survey was conducted on caregivers of children with neurodevelopmental disabilities (n = 43) and children who are typically developing (n = 67). The results showed that presence of challenging behaviours related to neurodevelopmental disability, and caregiver coping strategies predicted caregiver psychological distress during lockdown. Themes that emerged included 'confusing messages and guidance', 'loss of freedom' and 'unsupported and forgotten'. The results demonstrate the pressing need for the implementation of appropriate support to protect the mental health of caregivers across the UK.

Investigating the challenges of teaching sex education to autistic learners: A qualitative exploration of teachers' experiences.

BACKGROUND: Sex education is essential as it equips individuals with the knowledge to live independent and safe sex lives. However, in the United Kingdom, sex education is not particularly accessible for autistic learners which may lead to a lack of knowledge around appropriate sexual behaviours. AIMS: The current study focusses on the challenges of teaching sex education to autistic learners. METHODS AND PROCEDURES: The data was produced through one-to-one interviews with thirteen educational practitioners that have experienced delivering sex education to autistic learners. OUTCOMES AND RESULTS: Reflexive thematic analysis (Braun & Clarke, 2006) was used to interpret the data, producing themes of (1) Pedagogical Restrictions, and (2) Sexual Impulses. CONCLUSIONS AND IMPLICATIONS: These findings demonstrated that the main challenges of teaching sex education to autistic learners pertained to Pedagogical Restrictions in the classroom, and learners' own sexual impulses. These findings are a positive step towards understanding how to adapt sex education lessons to make them more inclusive and accessible for learners with autism. This study contributes to developing understanding around how to support autistic learners, highlighting gaps in the current sex education curriculum for policy makers, and enabling those surrounding autistic individuals to best support them with body transformations.

What factors influence dyadic synchrony? A systematic review of the literature on predictors of mother-infant dyadic processes of shared behavior and affect.

Dyadic behavioral synchrony is a complex interactional process that takes place between the mother and her infant. In the first year of life, when the infant is prelinguistic, processes such as synchrony enable the dyad to communicate through shared behavior and affect. To date, no systematic review has been carried out to understand the risk and protective factors that influence behavioral synchrony in the mother-infant dyad. The aim of this review was to identify and evaluate the factors that influence behavioral synchrony in the mother-infant dyad, when the infant is between 3 and 9 months old. Key electronic databases were searched between 1970 and April 2021, and 28 eligible studies were identified for review. As the results were largely heterogeneous, four subgroups of factors were identified: (i) infant demographics, (ii) physiological factors, (iii) maternal mental health, and (iv) miscellaneous factors. Identified risk factors and covariates suggest that social determinants of health, underpinned by biological factors, play a large role in influencing behavioral synchrony within the dyad. Implications for the need to identify additional risk and protective factors, as well as design support for at-risk families are discussed.

La sincronía diádica del comportamiento es un proceso complejo de interacción que se lleva a cabo entre la madre y su infante, y en el primero año de vida, cuando el infante está en la época prelingüística. Los procesos como la sincronía le permiten a la díada comunicarse a través del comportamiento y el afecto compartido. Hasta la fecha, ninguna revisión sistemática se ha llevado a cabo para comprender los factores de riesgo y de protección que influyen la sincronía del comportamiento en la díada madre-infante. El propósito de esta revisión fue identificar y evaluar los factores que influyen la sincronía del comportamiento en la díada madre-infante, cuando el infante tiene entre 3 y 9 meses de nacido. Se investigaron bancos claves de datos electrónicos entre 1970 y abril de 2021, y se identificaron 28 estudios aptos para la revisión. Como los resultados fueron en gran parte heterogéneos, se identificaron cuatro subgrupos de factores: (i) datos demográficos del infante, (ii) factores fisiológicos, (iii) salud mental materna, y (iv) factores misceláneos. Los factores de riesgo y covariantes identificados señalan que los determinantes sociales de salud, sustentados por factores biológicos, juegan un papel grande en cuanto a influir la sincronía del comportamiento dentro de la díada. Se discuten las implicaciones para la necesidad de identificar factores de riesgo y de protección adicionales, así como también diseñar el apoyo para familias bajo riesgo.

La synchronie comportementale dyadique est un processus interactionnel complexe qui prend place entre la mère et son bébé. Dans la première année de la vie, quand le bébé ne parle pas, les processus tels que la synchronie permettent à la dyade de communiquer à travers un comportement et un affect partagés. Jusqu'à présent aucune revue systématique n'a été faite pour comprendre les facteurs de risque et les facteurs de protection qui influencent la synchronie comportementale chez la dyade mère-bébé. Le but de cette revue était d'identifier et d'évaluer les facteurs qui influencent la synchronie comportementale chez la dyade mère-bébé, quand le bébé avait entre 3-9 mois. Les bases de données électroniques clés ont fait l'objet des recherches entre 1970 et avril 2021, et 28 études admissibles ont été identifiée pour la revue. Puisque les résultats étaient largement hétérogènes, quatre sous-groupes de facteurs ont été identifiés: (1) données démographiques du bébé, (ii) facteurs physiologiques, (iii) santé mentale maternelle, et (iv) facteurs divers. Les facteurs de risque identifiés et les co-variables suggèrent que les déterminants sociaux de la santé, sous-tendus par des facteurs biologiques, jouent un rôle important en influençant la synchronie comportementale au sein de la dyade. Les implications quant au besoin d'identifier des facteurs de risque et de protection supplémentaire, ainsi que des soutiens aux familles à risque sont discutées.

Sensory processing and eating behaviours in autism: A systematic review.

OBJECTIVES: The aim of this study was to assess the relationship between sensory processing and a broad range of eating behaviours across the lifespan. METHODS: Five electronic databases of published and unpublished quantitative studies were systematically searched, evaluated for risk of bias and synthesised according to identified eating outcomes. RESULTS: Across 25 studies, there was consistent evidence of a relationship between sensory processing and a range of eating behaviours. There was early evidence for the particular role of taste/smell sensitivities, as well as hypersensitivities, although future research is needed looking at different sensory patterns and modalities. There was also tentative evidence to suggest this relationship extends across development. DISCUSSION: Study findings are discussed in relation to implications for sensory-based eating and feeding interventions and the development of eating disorders. Methodological and conceptual limitations are discussed and suggestions for future research are made to address these limitations. A broader investigation of multi-sensory issues and clearly defined eating behaviours, including disordered eating in clinically diagnosed samples, will allow for a more comprehensive and robust understanding of the relationship between sensory processing and eating behaviours in autism.

Transdiagnostic Clinical Staging for Childhood Mental Health: An Adjunctive Tool for Classifying Internalizing and Externalizing Syndromes that Emerge in Children Aged 5-11 Years.

Clinical staging is now recognized as a key tool for facilitating innovation in personalized and preventative mental health care. It places a strong emphasis on the salience of indicated prevention, early intervention, and secondary prevention of major mental disorders. By contrast to established models for major mood and psychotic syndromes that emerge after puberty, developments in clinical staging for childhood-onset disorders lags significantly behind. In this article, criteria for a transdiagnostic staging model for those internalizing and externalizing disorders that emerge in childhood is presented. This sits alongside three putative pathophysiological profiles (developmental, circadian, and anxious-arousal) that may underpin these common illness trajectories. Given available evidence, we argue that it is now timely to develop a transdiagnostic staging model for childhood-onset syndromes. It is further argued that a transdiagnostic staging model has the potential to capture more precisely the dimensional, fluctuating developmental patterns of illness progression of childhood psychopathology. Given potential improvements in modelling etiological processes, and delivering more personalized interventions, transdiagnostic clinical staging for childhood holds much promise for assisting to improve outcomes. We finish by presenting an agenda for research in developments of transdiagnostic clinical staging for childhood mental health.

Using social media to be 'social': Perceptions of social media benefits and risk by autistic young people, and parents.

Autistic individuals are reported to struggle with aspects of social interaction. Past research has shown that social media use can help to facilitate social functioning, however, the perceptions of risks and benefits when engaging on social media platforms remains unclear. The current study aimed to explore perceptions of social media participation in terms of online risk and online relationships in both autistic young people and parents. Eight autistic young people and six parents of autistic young people took part in semi-structured interviews, with the resultant data being transcribed and analysed using Braun and Clarke's (2006) inductive thematic analysis. Two themes were identified in relation to the impact social media has on autistic young people's relationships (Socialisation; Communication) and two themes were identified in relation to the perceived barriers and risks to engaging online (Abusive interactions; Talking to strangers). These findings show that social interaction is of particular value to young autistic people, in terms of affording them easier social interactions than there would be in 'real life'. The findings also show that the autistic young people were aware of risks online, and considered ways in which they try to manage this risk. Future research is needed to understand if similar interactions and risk take place across all platforms and whether online communication is successful between matched or mixed autistic and non-autistic groups.

When the mask comes off: Mothers' experiences of parenting a daughter with autism spectrum condition.

LAY ABSTRACT: Parents of children with autism spectrum condition report increased stress and difficulties compared with parents of typically developing children. Our knowledge and understanding of how autism spectrum condition presents in autistic females is currently limited and parents of this population may experience challenges when raising their daughter. Given that mothers are often the main caregiver of a child with autism spectrum condition, they may have useful insights into the experiences of parenting a daughter with autism spectrum condition. Therefore, a qualitative study was undertaken to explore what mothers' experiences are of parenting a daughter with autism spectrum condition. Semi-structured interviews were conducted with 10 mothers of daughters with autism spectrum condition. The interviews were analysed using interpretative phenomenological analysis. Five main themes emerged from the qualitative study ('Girls have autism too', 'She's a chameleon', 'The impact of the diagnosis', 'Impact on mums' and 'Day-to-day life'). The findings of this study expand our current knowledge of the experiences and challenges faced by mothers raising a daughter with autism spectrum condition. Mothers hold a vast amount of knowledge on their daughters' autism spectrum condition which could inform the diagnostic process and clinical practice. Considering these results, it is important that clinicians support mothers and the family system around children with an autism spectrum condition diagnosis.

The I in autism: Severity and social functioning in autism are related to self-processing.

It is well established that children with autism spectrum disorder (ASD) show impaired understanding of others and deficits within social functioning. However, it is still unknown whether self-processing is related to these impairments and to what extent self impacts social functioning and communication. Using an ownership paradigm, we show that children with ASD and chronological- and verbal-age-matched typically developing (TD) children do show the self-referential effect in memory. In addition, the self-bias was dependent on symptom severity and socio-communicative ability. Children with milder ASD symptoms were more likely to have a high self-bias, consistent with a low attention to others relative to self. In contrast, severe ASD symptoms were associated with reduced self-bias, consistent with an 'absent-self' hypothesis. These findings indicate that deficits in self-processing may be related to impairments in social cognition for those on the lower end of the autism spectrum. Statement of contribution What is already known on this subject? Impaired self-processing in autism is linked to social and cognitive deficits. There are discrepancies across the literature, with reports of both intact and impaired self-processing in autism. Ownership tasks are developmentally appropriate and have shown to induce self-memory bias in young children. What does this study add? Using an ownership task, children with autism showed a significant self-memory bias, greater than typical peers. Severity was negatively correlated with level of self-bias, potentially explaining the previous discrepancies. Severe autism symptoms are associated with an 'absent self', and mild autism symptoms reduce attention to others.

Spontaneous lexical alignment in children with an autistic spectrum disorder and their typically developing peers.

It is well established that adults converge on common referring expressions in dialogue, and that such lexical alignment is important for successful and rewarding communication. The authors show that children with an autistic spectrum disorder (ASD) and chronological- and verbal-age-matched typically developing (TD) children also show spontaneous lexical alignment. In a card game, both groups tended to refer to an object using the same name as their partner had previously used for the same or a different token of the object. This tendency to align on a pragmatically conditioned aspect of language did not differ between ASD and TD groups, and was unaffected by verbal/chronological age, or (in the ASD group) Theory of Mind or social functioning. The authors suggest that lexical priming can lead to automatic lexical alignment in both ASD and TD children's dialogue. Their results further suggest that ASD children's conversational impairments do not involve an all-encompassing deficit in linguistic imitation. (PsycINFO Database Record

Preterm birth is associated with atypical social orienting in infancy detected using eye tracking.

BACKGROUND: Preterm birth is closely associated with neurocognitive impairment in childhood including increased risk for social difficulties. Eye tracking objectively assesses eye-gaze behaviour in response to visual stimuli, which permits inference about underlying cognitive processes. We tested the hypothesis that social orienting in infancy is altered by preterm birth. METHODS: Fifty preterm infants with mean (range) gestational age (GA) at birth of 29(+1) (23(+2) -33(+0) ) weeks and 50 term infants with mean (range) GA at birth 40(+2) (37(+0) -42(+3) ) weeks underwent eye tracking at median age of 7 months. Infants were presented with three categories of social stimuli of increasing complexity. Time to first fixate (TFF) and looking time (LT) on areas of interest (AoIs) were recorded using remote eye tracking. RESULTS: Preterm infants consistently fixated for a shorter time on social content than term infants across all three tasks: face-scanning (fixation to eyes minus mouth 0.61s vs. 1.47s, p = .013); face pop-out task (fixation to face 0.8s vs. 1.34s, p = .023); and social preferential looking (1.16s vs. 1.5s p = .02). Time given to AoIs containing social content as a proportion of LT at the whole stimulus was lower in preterm infants across all three tasks. These results were not explained by differences in overall looking time between the groups. CONCLUSIONS: Eye tracking provides early evidence of atypical cognition after preterm birth, and may be a useful tool for stratifying infants at risk of impairment for early interventions designed to improve outcome.

Multiple Measures of Fixation on Social Content in Infancy: Evidence for a Single Social Cognitive Construct?

The preference of infants to fixate on social information in a stimulus is well known. We examine how this preference manifests across a series of free-viewing tasks using different stimulus types. Participants were thirty typically developing infants. We measured eye movements when viewing isolated faces, faces alongside objects in a grid, and faces naturally presented in photographed scenes. In each task, infants fixated social content for longer than nonsocial content. Social preference scores representing distribution of fixation to social versus general image content were highly correlated and thus combined into a single composite measure, which was independent of demographic and behavioral measures. We infer that multiple eye-tracking tasks can be used to generate a composite measure of social preference in infancy. This approach may prove useful in the early characterization of developmental disabilities.

That looks familiar: attention allocation to familiar and unfamiliar faces in children with autism spectrum disorder.

INTRODUCTION: Existing eye-tracking literature has shown that both adults and children with autism spectrum disorders (ASD) show fewer and slower fixations on faces. Despite this reduced saliency and processing of other faces, recognition of their own face is reported to be more "typical" in nature. This study uses eye-tracking to explore the typicality of gaze patterns when children with ASD attend their own faces compared to other familiar and unfamiliar faces. METHODS: Eye-tracking methodology was used to explore fixation duration and time taken to fixate on the Eye and Mouth regions of familiar, unfamiliar and Self Faces. Twenty-one children with ASD (9-16 years) were compared to typically developing matched groups. RESULTS: There were no significant differences between children with ASD and typically matched groups for fixation patterns to the Eye and Mouth areas of all face types (familiar, unfamiliar and self). Correlational analyses showed that attention to the Eye area of unfamiliar and Self Faces was related to socio-communicative ability in children with ASD. CONCLUSIONS: Levels of socio-communicative ability in children with ASD were related to gaze patterns on unfamiliar and Self Faces, but not familiar faces. This lack of relationship between ability and attention to familiar faces may indicate that children across the autism spectrum are able to fixate these faces in a similar way. The implications for these findings are discussed.

Designing AAC systems for children with autism: evidence from eye tracking research.

Autism is associated with a range of language difficulties that impact communication, behaviour management, and education. Consequently, a variety of augmentative and alternative communication (AAC) strategies may be employed to support people with autism to communicate. There is a growing body of evidence concerning the visual attention of individuals with autism, which may be relevant to AAC interventions. This review draws on evidence from eye tracking research specifically to inform the design of AAC systems for people with autism. In addition, we discuss the future of AAC for individuals with autism in light of relevant technological developments, and raise questions for future research.