Relationships between social functioning, ASD symptomatology and attention to faces and non-facial stimuli in children with Autism Spectrum Disorder (ASD) and Typically Developing (TD) children

Abstract

Individuals with ASD are impaired in social orienting, spending less time fixated on social stimuli than other groups. Early social orienting impairments may underlie the social deficits in ASD. However the extent of impaired social orienting and the nature of the relationship between social orienting and social impairments in ASD are unclear. The present study examined the visual fixation patterns of children with ASD in a semi-naturalistic and naturalistic setting. Relationships between social functioning, severity of ASD symptomatology and visual fixation patterns to social (i.e., faces) and non-social stimuli were also examined. Twenty high functioning 3- to 6-year-olds with ASD and 19 matched TD children were filmed during unstructured toy-play in the presence of an examiner and parent (semi-naturalistic setting) and time fixated on faces, bodies, objects or unfocused was calculated using frame-by-frame analysis. In the naturalistic setting, children were observed with peers at preschool or school; in each observation interval the presence or absence of looking at a peer’s face was recorded. Theory of mind, play skills, positive social behaviour with peers, and teacher ratings of social behaviour were assessed as measures of social functioning. Severity of ASD symptomatology was evaluated using scores from the Social Communication Questionnaire. In the semi-naturalistic setting, there were no group differences in the mean number of overall attention shifts per minute. Both groups of participants also fixated on faces and objects for similar durations, and made a comparable number of attention shifts between faces and objects. However, participants with ASD spent more time fixated on bodies or unfocused and made more attention shifts involving bodies than TD children. In the naturalistic setting, children with ASD fixated on peers’ faces on significantly fewer observation intervals than TD children. Children with ASD who obtained higher social functioning scores fixated on peers’ faces on a higher percentage of observation intervals in the naturalistic setting. They also spent more time fixated on faces and shifted their attention more frequently between faces and objects, faces and bodies, and objects and bodies in the semi-naturalistic setting. Children with ASD who demonstrated higher levels of ASD symptomatology spent more time unfocused, less time fixated on faces, and made fewer attention shifts between faces and objects than participants exhibiting less-severe ASD symptomatology. TD children who made fewer attention shifts between objects and fixated on objects for longer durations in the semi-naturalistic setting tended to obtain higher social functioning scores. Those who fixated on peers’ faces on a higher percentage of observation intervals in the naturalistic setting also tended to obtain higher social functioning scores. Findings suggest that impaired social orienting in ASD depends on the complexity of social stimuli, while even in more structured settings, children with ASD show atypicalities in the time they spend unfocused or fixated on bodies. Relationships between the distribution of attention and social functioning differ for children with ASD and TD children, however the ability to orient to faces in a naturalistic setting is important for social development in both groups of children