Awareness but Avoidance: Gaze Behaviour in Adolescents with ASD Versus Controls

Background: Eye contact is an important aspect of social interaction and communication. Previous studies indicated that individuals with ASD look less at the eye-region than typically developing (TD) controls when social stimuli are presented. It is yet unclear whether individuals with ASD avoid the eye region in general, or whether this is related to social relevance, such as eye contact.

Objectives: The objective of this study was to determine the gaze behaviour of adolescents with ASD compared to TD adolescents, while looking at pictures of faces making direct eye contact versus faces with their eyes closed.

Methods: Participants in this study were 64 adolescents with ASD (mean age 16 years, mean total IQ = 98) and 48 TD adolescents (mean age 16 years, mean total IQ = 109). Twelve pictures of individuals with a natural face expression were shown for six seconds. Two conditions were used in the current study: 6 pictures with direct eye contact and 6 pictures with eyes closed. Eye tracking was recorded by means of the Tobii T120. The proportion of the fixation time toward the eyes relative to the entire fixation time was calculated. Differences between ASD and TD were studied in a repeated measures design, including IQ as a covariate.

Results: Both groups spend significantly more time looking at the eye region for the faces in the direct eye contact condition than in the eyes closed condition (main effect of condition: p = .001). Adolescents with ASD spent significantly less time looking at the eye region in the direct contact condition than their TD peers (p = .044) but not in the eyes closed condition (p = .955).

Conclusions: Both individuals with and without ASD spend more time looking at the eye region of faces showing direct eye contact, than at faces with their eyes closed. We conclude that adolescents with ASD do not avoid the eye region of faces in general. However, they do spend less time looking at the eye region of faces with direct eye contact (triggering social contact) than TD controls. Adolescents of ASD seem to be aware of direct eye contact, but they tend to avoid this social cue more than their TD peers.