Attention to live eye contact in adolescents with autism spectrum disorder.

A number of studies have reported diminished attention to the eyes in individuals with autism spectrum disorder (ASD). These studies predominantly used static images of faces as stimuli. Recent studies, however, have shown enhanced response to eye contact in typically developing (TD) individuals when they observe a person in a live interaction. We investigated physiological orienting to perceived eye contact in adolescents with ASD and TD adolescents when they observed a person in live interaction or viewed a photograph of the same person's face. We measured heart rate (HR) deceleration as an index of attentional orienting. Adolescents with ASD, as well as TD adolescents, showed significant HR deceleration for the direct gaze compared to an averted gaze in the live condition, but not in the photographic condition. The results suggest an intact response to perceived eye contact in individuals with ASD during a live face-to-face interaction. LAY SUMMARY: Individuals with autism spectrum disorder (ASD) have a different eye gaze pattern when observing photographic faces. However, little is known about how individuals with ASD process a real person's face. We measured heart rate (HR) and found that adolescents with ASD showed the typical decline in HR when they made eye contact with a real person, which suggests that both groups of individuals directed their attention to eye contact in a live face-to-face interaction.

Reduced Personal Space in Individuals with Autism Spectrum Disorder.

Maintaining an appropriate distance from others is important for establishing effective communication and good interpersonal relations. Autism spectrum disorder (ASD) is a developmental disorder associated with social difficulties, and it is thus worth examining whether individuals with ASD maintain typical or atypical degrees of social distance. Any atypicality of social distancing may impact daily social interactions. We measured the preferred distances when individuals with ASD and typically developing (TD) individuals approached other people (a male experimenter) and objects (a coat rack with clothes) or when other people approached them. Individuals with ASD showed reduced interpersonal distances compared to TD individuals. The same tendency was found when participants judged their preferred distance from objects. In addition, when being approached by other people, both individuals with ASD and TD individuals maintained larger interpersonal distances when there was eye contact, compared to no eye contact. These results suggest that individuals with ASD have a relatively small personal space, and that this atypicality exists not only for persons but also for objects.

Preferential awareness of protofacial stimuli in autism.

It has been suggested that a subcortically mediated, innate sensitivity to protofacial stimuli leads to specialized face processing and to the development of the social brain. A dysfunction of this face-processing pathway has been associated with atypical social development in individuals with autism spectrum disorder (ASD). This study investigated whether individuals with ASD exhibit primary sensitivity to monochrome protoface stimuli using continuous flash suppression (CFS). Under CFS, visual stimuli are suppressed from awareness, and cortical processing is strongly reduced while subcortical regions continue to respond to invisible stimuli. We found that both adolescents with ASD and typically developing adolescents showed preferential detection of upright protoface stimuli under CFS but not in a non-CFS control condition. These results challenge the notion that a primitive sensitivity to protoface stimuli is essential for typical social development. Rather, our findings suggest such sensitivity is not a sufficient condition for typical social development and that the presence of other complementary factors is necessary for the development of the social brain.

Absence of preferential unconscious processing of eye contact in adolescents with autism spectrum disorder.

Eye contact plays an essential role in social interaction. Atypical eye contact is a diagnostic and widely reported feature of autism spectrum disorder (ASD). Here, we determined whether altered unconscious visual processing of eye contact might underlie atypical eye contact in ASD. Using continuous flash suppression (CFS), we found that typically developing (TD) adolescents detected faces with a direct gaze faster than faces with an averted gaze, indicating enhanced unconscious processing of eye contact. Critically, adolescents with ASD did not show different durations of perceptual suppression for faces with direct and averted gaze, suggesting that preferential unconscious processing of eye contact is absent in this group. In contrast, in a non-CFS control experiment, both adolescents with ASD and TD adolescents detected faces with a direct gaze faster than those with an averted gaze. Another CFS experiment confirmed that unconscious processing of non-social stimuli is intact for adolescents with ASD. These results suggest that atypical processing of eye contact in individuals with ASD could be related to a weaker initial, unconscious registration of eye contact.

Neural and behavioural responses to face-likeness of objects in adolescents with autism spectrum disorder.

Numerous studies have revealed atypical face processing in autism spectrum disorders (ASD) characterized by social interaction and communication difficulties. This study investigated sensitivity to face-likeness in ASD. In Experiment 1, we found a strong positive correlation between the face-likeness ratings of non-face objects in the ASD (11-19 years old) and the typically developing (TD) group (9-21 years old). In Experiment 2 (the scalp-recorded event-related potential experiment), the participants of both groups (ASD, 12-19 years old; TD, 12-18 years old) exhibited an enhanced face-sensitive N170 amplitude to a face-like object. Whereas the TD adolescents showed an enhanced N170 during the face-likeness judgements, adolescents with ASD did not. Thus, both individuals with ASD and TD individuals have a perceptual and neural sensitivity to face-like features in objects. When required to process face-like features, a face-related brain system reacts more strongly in TD individuals but not in individuals with ASD.

Presence of contagious yawning in children with autism spectrum disorder.

Most previous studies suggest diminished susceptibility to contagious yawning in children with autism spectrum disorder (ASD). However, it could be driven by their atypical attention to the face. To test this hypothesis, children with ASD and typically developing (TD) children were shown yawning and control movies. To ensure participants' attention to the face, an eye tracker controlled the onset of the yawning and control stimuli. Results demonstrated that both TD children and children with ASD yawned more frequently when they watched the yawning stimuli than the control stimuli. It is suggested therefore that the absence of contagious yawning in children with ASD, as reported in previous studies, might relate to their weaker tendency to spontaneously attend to others' faces.

Brief report: pointing cues facilitate word learning in children with autism spectrum disorder.

Children with autism spectrum disorder (ASD) reportedly have difficulty associating novel words to an object via the speaker's gaze. It has also been suggested that their performance is related to their gaze duration on the object and improves when the object moves and becomes more salient. However, there is a possibility that they have only relied on the object's movement and have not referenced the speaker's cue (i.e. gaze direction). The current study with children with ASD and typically developing children aged 6-11 years demonstrated that adding another speaker's cue (i.e. pointing) improves the performance of children with ASD. This suggests that additional speaker's cues may help referential word learning in children with ASD.

Atypical disengagement from faces and its modulation by the control of eye fixation in children with autism spectrum disorder.

By using the gap overlap task, we investigated disengagement from faces and objects in children (9-17 years old) with and without autism spectrum disorder (ASD) and its neurophysiological correlates. In typically developing (TD) children, faces elicited larger gap effect, an index of attentional engagement, and larger saccade-related event-related potentials (ERPs), compared to objects. In children with ASD, by contrast, neither gap effect nor ERPs differ between faces and objects. Follow-up experiments demonstrated that instructed fixation on the eyes induces larger gap effect for faces in children with ASD, whereas instructed fixation on the mouth can disrupt larger gap effect in TD children. These results suggest a critical role of eye fixation on attentional engagement to faces in both groups.

Atypical modulation of face-elicited saccades in autism spectrum disorder in a double-step saccade paradigm.

Atypical development of face processing is a major characteristic in autism spectrum disorder (ASD), which could be due to atypical interactions between subcortical and cortical face processing. The current study investigated the saccade planning towards faces in ASD. Seventeen children with ASD and 17 typically developing (TD) children observed a pair of upright or inverted face configurations flashed sequentially in two different spatial positions. The reactive saccades of participants were recorded by eye-tracking. The results did not provide evidence of overall impairment of subcortical route in ASD, However, the upright, but not the inverted, face configuration modulated the frequency of vector sum saccades (an index of subcortical control) in TD, but not in ASD. The current results suggests that children with ASD do not have overall impairment of the subcortital route, but the subcortical route may not be specialized to face processing.

The effect of gaze direction on the processing of facial expressions in children with autism spectrum disorder: an ERP study.

This study investigated the neural basis of the effect of gaze direction on facial expression processing in children with and without ASD, using event-related potential (ERP). Children with ASD (10-17-year olds) and typically developing (TD) children (9-16-year olds) were asked to determine the emotional expressions (anger or fearful) of a facial stimulus with a direct or averted gaze, and the ERPs were recorded concurrently. In TD children, faces with a congruent expression and gaze direction in approach-avoidance motivation, such as an angry face with a direct gaze (i.e., approaching motivation) and a fearful face with an averted gaze (i.e., avoidant motivation), were recognized more accurately and elicited larger N170 amplitudes than motivationally incongruent facial stimuli (an angry face with an averted gaze and a fearful face with a direct gaze). These results demonstrated the neural basis and time course of integration of facial expression and gaze direction in TD children and its impairment in children with ASD.

Absence of spontaneous action anticipation by false belief attribution in children with autism spectrum disorder.

Recently, a series of studies demonstrated false belief understanding in young children through completely nonverbal measures. These studies have revealed that children younger than 3 years of age, who consistently fail the standard verbal false belief test, can anticipate others' actions based on their attributed false beliefs. The current study examined whether children with autism spectrum disorder (ASD), who are known to have difficulties in the verbal false belief test, may also show such action anticipation in a nonverbal false belief test. We presented video stimuli of an actor watching an object being hidden in a box. The object was then displaced while the actor was looking away. We recorded children's eye movements and coded whether they spontaneously anticipated the actor's subsequent behavior, which could only have been predicted if they had attributed a false belief to her. Although typically developing children correctly anticipated the action, children with ASD failed to show such action anticipation. The results suggest that children with ASD have an impairment in false belief attribution, which is independent of their verbal ability.

Faces do not capture special attention in children with autism spectrum disorder: a change blindness study.

Two experiments investigated attention of children with autism spectrum disorder (ASD) to faces and objects. In both experiments, children (7- to 15-year-olds) detected the difference between 2 visual scenes. Results in Experiment 1 revealed that typically developing children (n = 16) detected the change in faces faster than in objects, whereas children with ASD (n = 16) were equally fast in detecting changes in faces and objects. These results were replicated in Experiment 2 (n = 16 in children with ASD and 22 in typically developing children), which does not require face recognition skill. Results suggest that children with ASD lack an attentional bias toward others' faces, which could contribute to their atypical social orienting.

Does gaze direction modulate facial expression processing in children with autism spectrum disorder?

Two experiments investigated whether children with autism spectrum disorder (ASD) integrate relevant communicative signals, such as gaze direction, when decoding a facial expression. In Experiment 1, typically developing children (9-14 years old; n = 14) were faster at detecting a facial expression accompanying a gaze direction with a congruent motivational tendency (i.e., an avoidant facial expression with averted eye gaze) than those with an incongruent motivational tendency. Children with ASD (9-14 years old; n = 14) were not affected by the gaze direction of facial stimuli. This finding was replicated in Experiment 2, which presented only the eye region of the face to typically developing children (n = 10) and children with ASD (n = 10). These results demonstrated that children with ASD do not encode and/or integrate multiple communicative signals based on their affective or motivational tendency.

Brief report: does eye contact induce contagious yawning in children with autism spectrum disorder?

Individuals with autism spectrum disorder (ASD) reportedly fail to show contagious yawning, but the mechanism underlying the lack of contagious yawning is still unclear. The current study examined whether instructed fixation on the eyes modulates contagious yawning in ASD. Thirty-one children with ASD, as well as 31 age-matched typically developing (TD) children, observed video clips of either yawning or control mouth movements. Participants were instructed to fixate to the eyes of the face stimuli. Following instructed fixation on the eyes, both TD children and children with ASD yawned equally frequently in response to yawning stimuli. Current results suggest that contagious yawning could occur in ASD under an experimental condition in which they are instructed to fixate on the yawning eyes.

Is anyone looking at me? Direct gaze detection in children with and without autism.

Atypical processing of eye contact is one of the significant characteristics of individuals with autism, but the mechanism underlying atypical direct gaze processing is still unclear. This study used a visual search paradigm to examine whether the facial context would affect direct gaze detection in children with autism. Participants were asked to detect target gazes presented among distracters with different gaze directions. The target gazes were either direct gaze or averted gaze, which were either presented alone (Experiment 1) or within facial context (Experiment 2). As with the typically developing children, the children with autism, were faster and more efficient to detect direct gaze than averted gaze, whether or not the eyes were presented alone or within faces. In addition, face inversion distorted efficient direct gaze detection in typically developing children, but not in children with autism. These results suggest that children with autism use featural information to detect direct gaze, whereas typically developing children use configural information to detect direct gaze.

Absence of contagious yawning in children with autism spectrum disorder.

This study is the first to report the disturbance of contagious yawning in individuals with autism spectrum disorder (ASD). Twenty-four children with ASD as well as 25 age-matched typically developing (TD) children observed video clips of either yawning or control mouth movements. Yawning video clips elicited more yawns in TD children than in children with ASD, but the frequency of yawns did not differ between groups when they observed control video clips. Moreover, TD children yawned more during or after the yawn video clips than the control video clips, but the type of video clips did not affect the amount of yawning in children with ASD. Current results suggest that contagious yawning is impaired in ASD, which may relate to their impairment in empathy. It supports the claim that contagious yawning is based on the capacity for empathy.