No Evidence of Emotion Dysregulation or Aversion to Mutual Gaze in Pre-Schoolers with Autism – an Eye-Tracking Pupillometry Study

Background: Reduced engagement in mutual gaze is a consistently documented feature of autism. One theoretical account of this phenomenon, the “gaze aversion hypothesis”, suggests that people with autism actively avoid eye contact because they experience mutual gaze as aversive and/or hyper-arousing.

Objectives:  We aimed to test this hypothesis in a representative mixed-ability group of pre-schoolers with autism.

Methods:  We showed videos of faces displaying mutual and averted gaze to 23 pre-schoolers with autism and 21 typically developing pre-schoolers using eye-tracking technology to measure visual attention and emotional arousal (pupil dilation).

Results:  We found no evidence of emotion dysregulation or aversion to mutual gaze in the children with ASD. The ASD group looked less to the faces across eye gaze conditions and face regions (eyes and mouth) and there were no group differences in pupil dilation. The children with ASD, like the TD children, dilated their pupils more to mutual compared to averted gaze. More internalizing symptoms in the children with ASD related to less emotion arousal to mutual gaze.

Conclusions: The pattern of results suggests that people with ASD are not dysregulated in their responses to mutual gaze and do not find direct gaze to be aversive or hyper-arousing.