The Role of Anxiety in Looking Patterns Among Children with ASD: Results from the ABC-CT Feasibility Study

Poster Presentation
Thursday, May 10, 2018: 5:30 PM-7:00 PM
Hall Grote Zaal (de Doelen ICC Rotterdam)
E. Hamo1, A. Naples1, B. Lewis1, K. Chawarska1, R. Bernier2, S. Jeste3, C. A. Nelson4, G. Dawson5, S. J. Webb2, M. Murias6, F. Shic7, C. Sugar3 and J. McPartland1, (1)Child Study Center, Yale University School of Medicine, New Haven, CT, (2)Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, (3)University of California, Los Angeles, Los Angeles, CA, (4)Boston Children's Hospital, Boston, MA, (5)Department of Psychiatry and Behavioral Sciences, Duke Center for Autism and Brain Development, Durham, NC, (6)Duke Center for Autism and Brain Development, Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, (7)Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA

Background: Previous literature reports high comorbidity rates of anxiety disorders in individuals with autism spectrum disorder (ASD). Up to 39.6% of those with ASD have at least one co-morbid anxiety disorder. Therefore, it is important to understand whether anxiety impacts responses to social stimuli, and whether this effect is different in clinical populations. Overall, exploring these relationships can help understand the influence of anxiety on ASD symptoms to inform research and intervention.

Objectives: To examine the relationship between anxiety and attention to social stimuli among children with and without ASD.

Methods: Data was collected across five sites from 26 typically developing (TD) children and 23 children with ASD between ages 4-11 (M=7.22, SD=2.20; 71% male) and their caregivers. Binocular eye-tracking data was collected at 500Hz using a SR Eyelink 1000 Plus. Participants were presented with six trials, each consisting of five images (face, phone, bird, car, scrambled face; matched in color and luminosity) presented in an array such that each was equidistant from the center of the screen. Percent looking at specific images was calculated as the number of valid gaze samples in a pre-defined region around the image content divided by the total number of onscreen gaze samples. Caregivers were asked to complete the Behavior Assessment for Children, Third Edition (BASC-3) and Childhood and Adolescent Symptom Inventory, 5th Edition (CASI-5). T-tests were conducted to identify differences between groups. Correlations were used to determine associations between anxiety symptoms, as measured by T-scores from the BASC-3 Anxiety subscale and CASI-5 Social Anxiety subscale, and percent of time attending to social information during the eye-tracking task.

Results: Children with ASD spent significantly less time looking at faces (M=.17, SD=.02) than TD children (M=.24, SD=.02) [t(45)=2.53, p=.02)]. Anxiety scores were significantly higher in children with ASD (M=52, SD=2.72) than in the TD group (M=44.08, SD=1.39) [t(46)=-2.72, p=.01)]. Higher anxiety symptoms in children with ASD was positively correlated with percent of time looking at non-social objects (rs=.426, p=.048). In particular, a higher anxiety score was significantly associated with more time spent looking at the technical objects (rs=.477, p=.02) among children with ASD. Social anxiety was not significantly related to time looking at social or non-social images among children with ASD. No significant relationships between anxiety and looking patterns were found among TD children.

Conclusions: Results reveal a relationship between anxiety symptomology in children with ASD and preferential looking patterns toward non-social stimuli. Social anxiety was not associated with looking patterns, suggesting that the results are not attributed to specific anxiety toward social stimuli. Neither relationship was found in the TD group; however, clinically significant levels of anxiety were exclusionary for the TD group in the larger study. Overall, these findings suggest that anxiety may be a significant factor in existing ASD symptomology by contributing to the preferential looking patterns towards non-social information. In other words, children with ASD may be more likely to avoid looking at faces due to the anxiety-producing social stimuli.