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Research on attention towards non-social stimuli in preschoolers with autism spectrum disorder (ASD) has increased over the past decade; however, findings have been inconsistent. It has been suggested that stimuli relating to common circumscribed interests (CIs) elicit more attention than non-CI related stimuli. This meta-analysis synthesizes results from 31 studies that compared attention towards non-social stimuli in children with ASD under the age of five with typically developing (TD) controls using eye-tracking. Additional subgroup analysis comparing studies that employed non-social stimuli related to CIs frequently reported in adults with ASD to studies using non-CI related stimuli were conducted. Meta-regressions with age, sex, stimulus dimension, nonverbal DQ, and symptom severity were conducted. Results show small (g = 0.39) but significantly higher attention towards non-social stimuli for the ASD group. However, when studies were split based on stimulus type no significant differences for non-CI related stimuli was found. Meanwhile studies employing CI related stimuli reported significant large effects on attention allocation (g = 0.69). None of the conducted regressions reached significance. The findings show increased non-social attention in children with ASD is driven by CI related content rather than a general non-social attentional bias. The findings and future research directions are discussed., (© 2024 The Author(s). Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.)

Studies utilizing eye-tracking methods have potential to promptly capture real-world dynamics of one of the core areas of vulnerability in autism spectrum disorders (ASD), selective social attention. So far, no studies have successfully reported utilizing the method to examine social attention in toddlers with neurodevelopmental vulnerabilities in real world and challenging settings such as an interactive face-to-face. This study examined the feasibility and validity of live eye-tracking method in response to live interaction occurring in several contexts in toddlers with and without ASD. Forty-seven toddlers with ASD, with atypical development (ATYP), or typically developing (TD), underwent a 30-s live eye-tracking procedure during a face-to-face interaction with a masked stranger using child-directed-speech (16 ASD, 14 ATYP, 17 TD; M age  = 23.44 months, SD = 6.02). Out of this group of toddlers, 29 (10 ASD, 8 ATYP, 11 TD, M age  = 21.97 months, SD = 5.76) underwent the same procedure with one of their maskless parent. Task completion rate, calibration accuracy, and affective response (feasibility measures) as well as attention to the task and the social partner (validity measures) were examined. Task completion rate and calibration accuracy were excellent. Despite the challenging context of face-to-face interaction, the toddlers exhibited a neutral affect, and high attention to the task and the speaker. As anticipated, toddlers with ASD looked less at the social partner compared with control groups. However, attention was comparable between the Stranger and Parent conditions, indicating that the effect was consistent regardless of presence of face covering or the familiarity of the interactive partner. The study demonstrates the high feasibility and validity of a live eye-tracking task involving face-to-face interaction in neurodiverse toddlers with social vulnerabilities. The effect of diminished attention to social partners in toddlers with autism is robust and present when interacting with an unfamiliar person and parent. The results suggest that a brief live eye-tracking method constitutes a promising ecologically valid candidate biomarker and potential intervention outcome in autism., (© 2023 International Society for Autism Research and Wiley Periodicals LLC.)

Difficulty with attention is an important symptom in many conditions in psychiatry, including neurodiverse conditions such as autism. There is a need to better understand the neurobiological correlates of attention and leverage these findings in healthcare settings. Nevertheless, it remains unclear if it is possible to build dimensional predictive models of attentional state in a sample that includes participants with neurodiverse conditions. Here, we use 5 datasets to identify and validate functional connectome-based markers of attention. In dataset 1, we use connectome-based predictive modeling and observe successful prediction of performance on an in-scan sustained attention task in a sample of youth, including participants with a neurodiverse condition. The predictions are not driven by confounds, such as head motion. In dataset 2, we find that the attention network model defined in dataset 1 generalizes to predict in-scan attention in a separate sample of neurotypical participants performing the same attention task. In datasets 3-5, we use connectome-based identification and longitudinal scans to probe the stability of the attention network across months to years in individual participants. Our results help elucidate the brain correlates of attentional state in youth and support the further development of predictive dimensional models of other clinically relevant phenotypes., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Importance: Enhanced selective attention toward nonsocial objects and impaired attention to social stimuli constitute key clinical features of autism spectrum disorder (ASD). Yet, the mechanisms associated with atypical selective attention in ASD are poorly understood, which limits the development of more effective interventions. In typically developing individuals, selective attention to social and nonsocial stimuli is associated with the informational value of the stimuli, which is typically learned over the course of repeated interactions with the stimuli., Objective: To examine value learning (VL) of social and nonsocial stimuli and its association with selective attention in preschoolers with and without ASD., Design, Setting, and Participants: This case-control study compared children with ASD vs children with developmental delay (DD) and children with typical development (TD) recruited between March 3, 2017, and June 13, 2018, at a university-based research laboratory. Participants were preschoolers with ASD, DD, or TD., Main Outcomes and Measures: Procedure consisted of an eye-tracking gaze-contingent VL task involving social (faces) and nonsocial (fractals) stimuli and consisting of baseline, training, and choice test phases. Outcome measures were preferential attention to stimuli reinforced (high value) vs not reinforced (low value) during training. The hypotheses were stated before data collection., Results: Included were 115 preschoolers with ASD (n = 48; mean [SD] age, 38.30 [15.55] months; 37 [77%] boys), DD (n = 31; mean [SD] age, 45.73 [19.49] months; 19 [61%] boys), or TD (n = 36; mean [SD] age, 36.53 [12.39] months; 22 [61%] boys). The groups did not differ in sex distribution; participants with ASD or TD had similar chronological age; and participants with ASD or DD had similar verbal IQ and nonverbal IQ. After training, the ASD group showed preference for the high-value nonsocial stimuli (mean proportion, 0.61 [95% CI, 0.56-0.65]; P < .001) but not for the high-value social stimuli (mean proportion, 0.51 [95% CI, 0.46-0.56]; P = .58). In contrast, the DD and TD groups demonstrated preference for the high-value social stimuli (DD mean proportion, 0.59 [95% CI, 0.54-0.64]; P = .001 and TD mean proportion, 0.57 [95% CI, 0.53-0.61]; P = .002) but not for the high-value nonsocial stimuli (DD mean proportion, 0.52 [95% CI, 0.44-0.59]; P = .64 and TD mean proportion, 0.50 [95% CI, 0.44-0.57]; P = .91). Controlling for age and nonverbal IQ, autism severity was positively correlated with enhanced learning in the nonsocial domain (r = 0.22; P = .03) and with poorer learning in the social domain (r = -0.26; P = .01)., Conclusions and Relevance: Increased attention to objects in preschoolers with ASD may be associated with enhanced VL in the nonsocial domain. When paired with poor VL in the social domain, enhanced value-driven attention to objects may play a formative role in the emergence of autism symptoms by altering attentional priorities and thus learning opportunities in affected children.

Background: Impaired attention to faces of interactive partners is a marker for autism spectrum disorder (ASD) in early childhood. However, it is unclear whether children with ASD avoid faces or find them less salient and whether the phenomenon is linked with the presence of eye contact or speech., Methods: We investigated the impacts of speech (SP) and direct gaze (DG) on attention to faces in 22-month-old toddlers with ASD (n = 50) and typically developing controls (TD, n = 47) using the Selective Social Attention 2.0 (SSA 2.0) task. The task consisted of four conditions where the presence (+) and absence (-) of DG and SP were systematically manipulated. The severity of autism symptoms, and verbal and nonverbal skills were characterized concurrently with eye tracking at 22.4 (SD = 3.2) months and prospectively at 39.8 (SD = 4.3) months., Results: Toddlers with ASD looked less than TD toddlers at face and mouth regions only when the actress was speaking (direct gaze absence with speech, DG-SP+: d = 0.99, p < .001 for face, d = 0.98, p < .001 for mouth regions; direct gaze present with speech, DG+SP+, d = 1.47, p < .001 for face, d = 1.01, p < .001 for mouth regions). Toddlers with ASD looked less at the eye region only when both gaze and speech cues were present (d = 0.46, p = .03). Salience of the combined DG and SP cues was associated concurrently and prospectively with the severity of autism symptoms, and the association remained significant after controlling for verbal and nonverbal levels., Conclusions: The study links poor attention to faces with limited salience of audiovisual speech and provides no support for the face avoidance hypothesis in the early stages of ASD. These results are consequential for research on early discriminant and predictive biomarkers as well as identification of novel treatment targets., (© 2019 Association for Child and Adolescent Mental Health.)

Young children with autism spectrum disorder (ASD) look less toward faces compared to their non-ASD peers, limiting access to social learning. Currently, no technologies directly target these core social attention difficulties. This study examines the feasibility of automated gaze modification training for improving attention to faces in 3-year-olds with ASD. Using free-viewing data from typically developing (TD) controls (n = 41), we implemented gaze-contingent adaptive cueing to redirect children with ASD toward normative looking patterns during viewing of videos of an actress. Children with ASD were randomly assigned to either (a) an adaptive Cue condition (Cue, n = 16) or (b) a No-Cue condition (No-Cue, n = 19). Performance was examined at baseline, during training, and post-training, and contrasted with TD controls (n = 23). Proportion of time looking at the screen (%Screen) and at actresses' faces (%Face) was analyzed. At Pre-Training, Cue and No-Cue groups did not differ in %Face (P > 0.1). At Post-Training, the Cue group had higher %Face than the No-Cue group (P = 0.015). In the No-Cue group %Face decreased Pre- to Post-Training; no decline was observed in the Cue group. These results suggest gaze-contingent training effectively mitigated decreases of attention toward the face of onscreen social characters in ASD. Additionally, larger training effects were observed in children with lower nonverbal ability, suggesting a gaze-contingent approach may be particularly relevant for children with greater cognitive impairment. This work represents development toward new social attention therapeutic systems that could augment current behavioral interventions. Autism Res 2020, 13: 61-73. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In this study, we leverage a new technology that combines eye tracking and automatic computer programs to help very young children with ASD look at social information in a more prototypical way. In a randomized controlled trial, we show that the use of this technology prevents the diminishing attention toward social information normally seen in children with ASD over the course of a single experimental session. This work represents development toward new social attention therapeutic systems that could augment current behavioral interventions., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.)

Objective: One of the common findings in autism spectrum disorder (ASD) is limited selective attention toward social objects, such as faces. Evidence from both human and nonhuman primate studies suggests that selection of objects for processing is guided by the appraisal of object values. We hypothesized that impairments in selective attention in ASD may reflect a disruption of a system supporting learning about object values in the social domain., Method: We examined value learning in social (faces) and nonsocial (fractals) domains in preschoolers with ASD (n = 25) and typically developing (TD) controls (n = 28), using a novel value learning task implemented on a gaze-contingent eye-tracking platform consisting of value learning and a selective attention choice test., Results: Children with ASD performed more poorly than TD controls on the social value learning task, but both groups performed similarly on the nonsocial task. Within-group comparisons indicated that value learning in TD children was enhanced on the social compared to the nonsocial task, but no such enhancement was seen in children with ASD. Performance in the social and nonsocial conditions was correlated in the ASD but not in the TD group., Conclusion: The study provides support for a domain-specific impairment in value learning for faces in ASD, and suggests that, in ASD, value learning in social and nonsocial domains may rely on a shared mechanism. These findings have implications both for models of selective social attention deficits in autism and for identification of novel treatment targets., (Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.)

This study examined the latent structure of spontaneous social attention in 11- to 26-month-olds with autism spectrum disorder (ASD, n = 90) and typically developing (n = 79) controls. Application of the joint and individual variance explained decomposition technique revealed that attention was driven by a condition-independent tuning into the dynamic social scenes construct and context-specific constructs capturing selection of the most relevant social features for processing. Gaze behavior in ASD is characterized by a limited tuning into the social scenes and by a selection of atypical targets for processing. While the former may be due to early disruption of the reward circuitry leading to limited appreciation of the behavioral relevance of social information, the latter may represent secondary deficits reflecting limited knowledge about social partners., (© 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.)

Variability in attention towards direct gaze and child-directed speech may contribute to heterogeneity of clinical presentation in toddlers with autism spectrum disorders (ASD). To evaluate this hypothesis, we clustered sixty-five 20-month-old toddlers with ASD based on their visual responses to dyadic cues for engagement, identifying three subgroups. Subsequently, we compared social, language, and adaptive functioning of these subgroups at 3 years of age. The cluster displaying limited attention to social scenes in general exhibited poor outcome at 3 years; the cluster displaying good attention to the scene and to the speaker's mouth was verbal and high functioning at 3 years. Analysis of visual responses to dyadic cues may provide a clinically meaningful approach to identifying early predictors of outcome.

Background: In typical development, the unfolding of social and communicative skills hinges upon the ability to allocate and sustain attention toward people, a skill present moments after birth. Deficits in social attention have been well documented in autism, though the underlying mechanisms are poorly understood., Methods: In order to parse the factors that are responsible for limited social attention in toddlers with autism, we manipulated the context in which a person appeared in their visual field with regard to the presence of salient social (child-directed speech and eye contact) and nonsocial (distractor toys) cues for attention. Participants included 13- to 25-month-old toddlers with autism (autism; n = 54), developmental delay (DD; n = 22), and typical development (TD; n = 48). Their visual responses were recorded with an eye-tracker., Results: In conditions devoid of eye contact and speech, the distribution of attention between key features of the social scene in toddlers with autism was comparable to that in DD and TD controls. However, when explicit dyadic cues were introduced, toddlers with autism showed decreased attention to the entire scene and, when they looked at the scene, they spent less time looking at the speaker's face and monitoring her lip movements than the control groups. In toddlers with autism, decreased time spent exploring the entire scene was associated with increased symptom severity and lower nonverbal functioning; atypical language profiles were associated with decreased monitoring of the speaker's face and her mouth., Conclusions: While in certain contexts toddlers with autism attend to people and objects in a typical manner, they show decreased attentional response to dyadic cues for attention. Given that mechanisms supporting responsivity to dyadic cues are present shortly after birth and are highly consequential for development of social cognition and communication, these findings have important implications for the understanding of the underlying mechanisms of limited social monitoring and identifying pivotal targets for treatment., (© 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.)

This study used eye-tracking to examine how 20-month-old toddlers with autism spectrum disorder (ASD) (n=28), typical development (TD) (n=34), and non-autistic developmental delays (DD) (n=16) monitored the activities occurring in a context of an adult-child play interaction. Toddlers with ASD, in comparison to control groups, showed less attention to the activities of others and focused more on background objects (e.g., toys). In addition, while all groups spent the same time overall looking at people, toddlers with ASD looked less at people's heads and more at their bodies. In ASD, these patterns were associated with cognitive deficits and greater autism severity. These results suggest that the monitoring of the social activities of others is disrupted early in the developmental progression of autism, limiting future avenues for observational learning., (Copyright © 2010 Elsevier B.V. All rights reserved.)

Context: Toddlers with autism spectrum disorders (ASD) exhibit poor face recognition and atypical scanning patterns in response to faces. It is not clear if face-processing deficits are also expressed on an attentional level. Typical individuals require more effort to shift their attention from faces compared with other objects. This increased disengagement cost is thought to reflect deeper processing of these socially relevant stimuli., Objective: To examine if attention disengagement from faces is atypical in the early stages of ASD., Design: Attention disengagement was tested in a variation of the cued attention task in which participants were required to move their visual attention from face or nonface central fixation stimuli and make a reactive saccade to a peripheral target. The design involved diagnosis as a between-group factor and central fixation stimuli type as a within-group factor., Setting: Participants were taken from a cohort of patients at a university-based specialized clinic or from a pool of subjects participating in a prospective study of social cognition in ASD., Participants: Toddlers with ASD (mean age, 32 months [n = 42]) were compared with toddlers with nonautistic developmental delays (mean age, 29 months [n = 31]) and with typically developing toddlers (mean age, 29 months [n = 46])., Main Outcome Measure: Saccadic reaction time., Results: Developmentally delayed and typically developing toddlers had more difficulties disengaging visual attention from faces than toddlers with ASD. This effect was not present in response to nonfacial stimuli. These results suggest that toddlers with ASD are not captivated by faces to the same extent as toddlers without ASD and that this effect is not driven by a generalized impairment in disengagement of attention., Conclusion: The results suggest that face-processing difficulties in toddlers with ASD involve disruption of an attentional mechanism that typically supports deeper processing of these highly socially relevant stimuli.

This study used eye-tracking to examine visual scanning and recognition of faces by 2- and 4-year-old children with autism spectrum disorder (ASD) (N = 44) and typically developing (TD) controls (N = 30). TD toddlers at both age levels scanned and recognized faces similarly. Toddlers with ASD looked increasingly away from faces with age, atypically attended to key features of faces, and were impaired in face recognition. Deficits in recognition were associated with imbalanced attention between key facial features. This study illustrates that face processing in ASD may be affected early and become further compromised with age. We propose that deficits in face processing likely impact the effectiveness of toddlers with ASD as social partners and thus should be targeted for intervention.

Purpose: This study tests the hypothesis that toddlers with autism spectrum disorders (ASD) will show differences from contrast groups in preferences for attending to speech., Method: This study examined auditory preferences in toddlers with ASD and matched groups of (a) typical age-mates, (b) age-mates with nonautistic developmental disabilities, and (c) younger children matched for language age. The experimental procedure measured time spent oriented to auditory stimuli that were created to exemplify language patterns that had been studied in typically developing infants., Results: Findings suggest that toddlers with ASD show a reduced preference for child-directed speech, compared with typical age-mates, but few differences from children with nonautistic developmental disorders. Correlational analysis revealed that time spent listening to child-directed speech by children with ASD was related to their concurrent receptive language ability as well as to receptive language abilities 1 year later. This relationship did not hold for the other groups., Conclusion: The present study supports the hypothesis that children with ASD perform differently from typical peers in auditory preference paradigms and that performance in these tasks is related to concurrent and later language development.

Automatic attention cueing by perceived changes in gaze direction was studied in 2-year-old children with autism and typically developing (TD) controls using a visual attention cueing paradigm. In Experiments 1 and 2 the cue consisted of an eye movement (Eyes) and a nonbiological movement (SimEyes), respectively. The results suggest that visual attention in children with autism and their TD counterparts is cued by perceived eye movement. Thus, although in naturalistic situations toddlers with autism do not follow the gaze of others, they are sensitive to directional cues inherent in eye movement. Cue-specific differences in performance related to the level of engagement and cue-processing time may suggest reliance on different underlying strategies for gaze processing in autism.

The development of expectations was investigated by using the Visual Expectations Procedure. In Experiment 1, 128 infants aged 6-, 9-, and 12-months-old saw two 40-trial sequences of a videotaped mechanical toy appearing in various locations. The sequences represented an alternation pattern (i.e., ABAB) or a complex pivot pattern (i.e., ABCBABCB). In Experiment 2, 76 infants aged 4-, 8-, and 12-months-old saw either a left-right alternation or a top-bottom alternation. Reaction time improved and the percentage of anticipations increased between 6 and 9 months in Experiment 1 and between 4 and 8 months in Experiment 2 but not thereafter. Anticipations for the pivot sequence and for younger infants on both sequences were often incorrect (i.e., gaze shifts occurred before stimulus onset but were not directed toward the upcoming stimulus). We conclude that young infants have expectations that reflect some degree of general or procedural knowledge, but it is not clear that this behavior implies specific, articulated expectations about upcoming events.