Absence of preferential looking to the eyes of approaching adults predicts level of social disability in 2-year-old toddlers with autism spectrum disorder

• Authors: Warren Jones, Emory University; Katelin Carr, Yale Child Study Center; Ami Klin, Emory University
• Journal Title: Archives of General Psychiatry
• Volume: Volume 65, Number 8
• Publisher: American Medical Association (AMA) | 2008-08-01, Pages 946-954
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1001/archpsyc.65.8.946
• Subjects: Psychology, Cognitive; Psychology, Clinical; Psychology, Developmental
• Keywords: Science & Technology; Life Sciences & Biomedicine; Psychiatry; PERVASIVE DEVELOPMENTAL DISORDERS; CHIMPANZEES PAN-TROGLODYTES; HIGH-FUNCTIONING AUTISM; HUMAN AMYGDALA; BIOLOGICAL MOTION; GAZE; CHILDREN; RECOGNITION; FACE; MOVEMENTS

Abstract

Context: Within the first week of life, typical human newborns give preferential attention to the eyes of others. Similar findings in other species suggest that attention to the eyes is a highly conserved phylogenetic mechanism of social development. For children with autism, however, diminished and aberrant eye contact is a lifelong hallmark of disability. Objective: To quantify preferential attention to the eyes of others at what is presently the earliest point of diagnosis in autism. Design: We presented the children with 10 videos. Each video showed an actress looking directly into the camera, playing the role of caregiver, and engaging the viewer (playing pat-a-cake, peek-a-boo, etc). Children's visual fixation patterns were measured by eye tracking. Participants: Fifteen 2-year-old children with autism were compared with 36 typically developing children and with 15 developmentally delayed but nonautistic children. Main Outcome Measure: Preferential attention was measured as percentage of visual fixation time to 4 regions of interest: eyes, mouth, body, and object. Level of social disability was assessed by the Autism Diagnostic Observation Schedule. Results: Looking at the eyes of others was significantly decreased in 2-year-old children with autism (P<.001), while looking at mouths was increased (P<.01) in comparison with both control groups. The 2 control groups were not distinguishable on the basis of fixation patterns. In addition, fixation on eyes by the children with autism correlated with their level of social disability; less fixation on eyes predicted greater social disability (r=-0.669, P<.01). Conclusions: Looking at the eyes of others is important in early social development and in social adaptation throughout one's life span. Our results indicate that in 2-year-old children with autism, this behavior is already derailed, suggesting critical consequences for development but also offering a potential biomarker for quantifying syndrome manifestation at this early age.