Gaze Patterns during Parent-Child Versus Clinician-Child Interactions

Background: Atypical eye contact during social interactions is a hallmark of autism spectrum disorder (ASD). Prior literature suggests that social communication behavior varies in children with ASD depending on whether they are interacting with a familiar or unfamiliar person. It is unknown if young children with ASD will vary their gaze pattern depending on whether they are interacting with a clinician or their caregiver.

Objectives: We examined the frequency and duration of direct gaze in young children with ASD when engaging with their caregiver versus a clinician during a semi-structured play interaction.

Methods: 18 more verbally able children diagnosed with ASD (mean 40 months;25-59 months, mean VIQ= 80; mean NVIQ= 87) completed a modified version of the Brief Observation of Social Communication Change (BOSCC), while seated at a table. Children first completed the BOSCC with a clinician, and then completed the same procedures with their caregiver. The adult sat across from the child and wore a pair of Pivothead Kudo glasses that had an outward facing camera embedded between the eyes, so that the videocamera readily captured the child’s face and shifts in eye gaze to the adult. Video data was manually coded at the frame level using Mangold Interact for the child’s direct gaze to the adult. Repeated Measures ANOVAs determined differences in the duration and frequency of direct gaze across the two conditions (unfamiliar clinician versus caregiver). Age, verbal IQ and autism symptom severity (ADOS CSS) were included as covariates to determine whether child characteristics influenced gaze patterns.

Results: The frequency and duration of gaze were not significantly different during play interactions with a caregiver versus an unfamiliar clinician (p’s >0.2). Of note, there were no differences between caregivers and clinicians in how well they captured the child’s gaze with the Pivothead glasses, suggesting the lack of condition effects were not explained by sampling differences. There were no significant interaction effects with age, VIQ or ADOS severity scores (p’s > 0.1). A pilot sample of two children completed the procedures twice across three months, before and after their caregivers completed a 12-week behavior training program at the clinic and there were also no significant differences in gaze frequency or duration across condition (p=0.5) or time point (p=0.6) and no interaction (p=0.3).

Conclusions: Surprisingly, there were no differences in gaze patterns in young children with ASD when interacting with their caregiver compared to an unfamiliar clinician. This data represents a subset of participants as data collection is ongoing, thus a larger sample size may illuminate more subtle differences in gaze behavior across the two conditions. Determining whether familiarity can facilitate gaze patterns in young children with ASD may ultimately be a critical first step for designing treatment strategies that address social communication difficulties.