CYBER PSYCHOLOGY & BEHAVIOR Volume 5, Number 3, 2002 © Mary Ann Liebert, Inc.

Atypical Face Gaze in Autism
CHERYL TREPAGNIER, Ph.D., MARC M. SEBRECHTS, Ph.D., and REBECCA PETERSON, M.A.

ABSTRACT An eye-tracking study of face and object recognition was conducted to clarify the character of face gaze in autistic spectrum disorders. Experimental participants were a group of individuals diagnosed with Asperger’s disorder or high-functioning autistic disorder according to their medical records and confirmed by the Autism Diagnostic Interview–Revised (ADI-R). Controls were selected on the basis of age, gender, and educational level to be comparable to the experimental group. In order to maintain attentional focus, stereoscopic images were presented in a virtual reality (VR) headset in which the eye-tracking system was installed. Preliminary analyses show impairment in face recognition, in contrast with equivalent and even superior performance in object recognition among participants with autism-related diagnoses, relative to controls. Experimental participants displayed less fixation on the central face than did control-group participants. The findings, within the limitations of the small number of subjects and technical difficulties encountered in utilizing the helmet-mounted display, suggest an impairment in face processing on the part of the individuals in the experimental group. This is consistent with the hypothesis of disruption in the first months of life, a period that may be critical to typical social and cognitive development, and has important implications for selection of appropriate targets of intervention. INTRODUCTION pacity for social connection,2 impaired ability to shift attention,3 inability to represent and manipulate complex information,4 inability to conceive of others’ mental states,5 an impairment of central coherence, the ability to extract organizing principles,6 and more multifaceted cognitive deficits.7 Research has increasingly pointed to reductions in the connectivity among brain regions that typically work as integrated systems.8–10 It is important to note, however, that functional and structural brain differences can reflect as well as cause atypical behavior.11 Gaze-disruption hypothesis A hypothesis proposed by the first author12 suggests that disruption of social attention dur-

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is a behaviorally defined condition, diagnosed by severe impairments in social and communicative domains, and the presence of repetitive behaviors and/or restrictive, narrow interests.1 Asperger’s disorder, considered a less severe variant of autistic disorder, is similar to high-functioning autistic disorder, such that there remain unresolved questions about whether they should be treated as distinct diagnostic categories. For convenience, autistic disorder and Asperger’s disorder will be referred to here as autistic spectrum disorder, or simply, autism. Accounts of the core psychobiological deficit in autism have included impairment in the caUTISTIC DISORDER

Department of Psychology, The Catholic University of America, Washington, D.C.

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and then to view subsequently a longer series of images and indicate which they had already seen. with width determined by the outer corners of the eyes). including one individual with a graduate degree and a successful professional career. relative to controls. at . all experimental participants were very high-functioning. however. In each acquisition set. this was not the case for individuals with autism carrying out the same tasks. Participants were asked to indicate by saying “yes” or “no” whether or not they had seen the image before. but not in object recognition or recognition of inverted faces (in which configurational information is not preserved). Recognition stimuli remained present until the participant responded. and that persons with autistic spectrum disorder would spend less of their time than controls fixating on the central face region (from the eyebrows down to and including the mouth. Four blocks of trials were presented sequentially. each with eight acquisition trials (images to learn) followed by 16 recognition trials (images to evaluate as already seen or not). In contrast. and a videotaped recording was acquired. whose vision is restored by surgery even as early as age 2 months. Very early onset or precursor symptoms may disrupt infant social interaction by impairing the infant’s ability to tolerate the overwhelming excitement of social stimuli. cognitive. There is increasing evidence of elevated incidence of neuropsychiatric disorder of the anxiety disorders/depressive disorders type among individuals with autism and their first-degree relatives (prior to the birth of the disabled individual). ing the early months of life due to underlying neuropsychiatric disorder may be sufficient to bring about autistic development.22 carried out by the first author. and a group of controls of similar age. Point of regard (POR) was sampled at 60 Hz. with a 4-sec interstimulus interval.16 and adults with Asperger’s were more likely to look at someone’s face when they themselves were talking to that person. participants were shown four faces and four objects.18 A recent study of children with autism seen at the Yale Child Study Center over a period of several years found that all were impaired in face recognition relative to controls.20 In a pilot study using eye-tracking during a face recognition task. Verbal intelligence and nonverbal intelligence were not controlled for. Participants were asked to look at and remember a series of images of faces and objects presented stereoscopically in a virtual reality (VR) head-mounted display equipped with an ISCAN eye-tracking system. The acquisition images of the third and fourth blocks included inverted as well as upright images.214 TREPAGNIER ET AL. have a persistent impairment in configurational face processing. impaired configurational face processing may be the marker for a failure to engage in very early social interaction. typically developing infants routinely monitor their adults’ facial expressions.13 Individuals born blind because of cataracts. rather than looking at someone who was speaking to them. experience that is critical to normal social. Face attention and interpretation By 1 year of age. Each image was presented for 4 sec. and emotional development. a high-functioning young adult with autism spent much less time than controls looking at eyes and the central face. children and many adolescents and adults with autism do not. and modify their own actions and responses accordingly. MATERIALS AND METHODS Participants were individuals with autism spectrum diagnoses according to their medical records and confirmed by the Autism Diagnostic Interview–Revised (ADI-R).19 In functional imaging studies.15–17 Children with autistic disorder did not look at faces to discern intention. the fusiform gyrus of controls was activated during performance of face-recognition tasks. and successful students and college-bound adolescents.14 In the presence of intact vision. 21 This study of face and object recognition extends those preliminary findings and makes two predictions: that individuals with autistic spectrum disorders would be impaired in face recognition. Each recognition set included eight previously presented images and eight foils.

within approximately 1 degree of visual angle of the mean location of the points. Further constraints were introduced into the fixationdetection algorithm to reduce the effects of spurious points and dropped tracking.e. tism participants were slower overall than controls to make the shift from their starting point to active examination of the image (p < 0. Data are reported here from five individuals with autism spectrum disorder (one female. The same comparison for the initial second out of the four did not reach significance. Objects n. A.3 data visualizations for all files (up to 96 per participant) were reviewed to determine start time of the first fixation after shift. A > Cb n. The superior performance of the autism participants with objects. mean age 18. RECOGNITION ACCURACY Faces Block 1 Block 2 Block 3 Block 4 All upright All inverted ap bp approximately 30 frames/sec. were not helpful). one-tailed). Other candidates and some subsets of the data from the participants were excluded for the following reasons: failure to meet criterion for autism on the social subscale of the ADI-R (one participant). Examination revealed cases of artifact appended to the beginning of several files. and as expected.. the most salient features. there was a foil who was also a light-complexioned female with long.4 years).5 years). au- . Foils for faces were selected to resemble the corresponding target images. Individuals with severe disorder self-excluded when they or their parents were informed that the study involved wearing a headset that covered much of the front of the face.s. RESULTS Participants’ initial fixations occurred in the general area at which they had been looking as the image appeared.s.1. Results for allocation of gaze to the central face region for 4 sec of exposure (Table 2) are consistent with predictions. straight blonde hair (i. control group. they were in the expected direction. technical problems in the data-acquisition program (some of the data from two participants).. At the same time. and six controls (two females. and age (one participant). Verifiable artifacts were removed.ATYPICAL FACE GAZE IN AUTISM 215 TABLE 1. not significant. for a target female with light skin and long.s. one-tailed. such as hair length and color. resulting from technical difficulties in managing the buffer size of the Onyx workstation. A > Ca A > Ca n. familiarity with one or more of the people whose images were used (exclusion of three individuals. Since difficulty in shifting attention is expected to the autism population. attesting to the experimental group’s impairment in face recognition. exclusion of half the data from one participant). possibly an impairment in processing configurational information. recognition accuracy predictions were confirmed (Table 1). DISCUSSION When between-group differences in recognition accuracy reached significance. points to a face-recognition impairment. These were individuals who responded to a call for subjects disturbed via the Autism Society of America chapter newsletters and local physicians treating individuals with autism.s. n. along with their reduced success with faces. < 0. showing a cursor representing the PORs superimposed on a two-dimensional image of the stimulus. C. straight blonde hair.s.s.s. error (some of the data from one participant). Where differences reached significance.05. mean age 19. with the difference residing in features of color or detail. Fixation locations were examined with respect to predefined regions of the face stimuli. their relatively superior performance in recognizing objects does not support an underlying visual perceptual deficit or short-term visual memory impairment. C > Ab n. autistic group. for example. n. < 0. and skin color.05. C > Aa C > Aa n. Foils for objects such as a stapler or a chair were another stapler and another chair. Temporal and spatial thresholds were set to define fixation as a gaze of at least 100 msec in length.

A... CONCLUSION The results of this study must be regarded as provisional. Autistic 50% 46% 55% 57% Control 73% 78% 85% 88% t scores (p < 0. P. Sigman. P. and the program has been thoroughly tested to assure that no buffermanagement artifacts occur. H133E980025. may be beneficial. et al. Frith. Goldstein. Fein. they indicate a relationship between the face-recognition difficulties of autism and maladaptive allocation of face gaze. Department of Education under grant no. M. Accardo. S. B. S.J. Happe. Neurology 55:468–479. Cognitive explanations of autism. 2.60 t(8) = 3.216 TABLE 2. PERCENT OF FIXATIONS ON CENTRAL FACE R EGION TREPAGNIER ET AL. all the more so if provided early in development. P. J. (1986). Briskman.. Minshew. N. 6. Journal of Child Psychology and Psychiatry 38:813–822. the calibration difficulties encountered.J. D. Frith. (1990). non–threedimensional presentation of images will evoke similar responses. Acta Paediatrica Supplement 416:63–68. in view of the technical problems that taint the initial second of some of the files. The study is about to resume using a desk-top eye-tracking device and stimuli presented on a large monitor. Toward a neuropsychological model of infantile autism. and the small number of participants. Pennington. U. F. (1997).. C. 3. C. (2000). which is funded by the National Institute on Disability and Rehabilitation Research of the U. Practice parameter. pointing to very early disruption in the infant’s availability to social experience. Mortimore.16 t(9) = 2.. If these results are borne out. D. Journal of Child Psychology and Psychiatry 42:299–307. 5.J. These findings are also consistent with the hypothesis of failure to acquire configurational face-processing skills. G. . Jolliffe. are the social deficits primary? Journal of the American Academy of Child Psychiatry 25:198–212. Neuropsychologic functioning in autism. and the additional barrier it represented to enrollment of individuals with autistic spectrum disorders.. one-tailed) t(7) = 2. An Integraph computer is now being used to acquire the data. Baron-Cohen. Another advanced test of theory of mind.. Ashwal. Blocks 1 and 2 1 and 2 3 and 4 3 and 4 a Upright Task Acquisition (16 images) Recognition (32) Acquisitiona (8) Recognition (32) images only. P. screening and diagnosis of autism. REFERENCES 1. U. Markowitz. use of the headset-mounted system was discontinued.05. (1997). ACKNOWLEDGMENTS Partial support for this work was provided by the Rehabilitation Engineering Research Center on Telerehabilitation.S. 7.14 t(6) = 2. Kasari.. report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Filipek. et al. et al.01 Because of difficulties in achieving calibration of the VR helmet-mounted eye-tracking device. Exploring the cognitive phenotype of autism: weak “central coherence” in parents and siblings of children with autism: I.. Experimental tests.. This suggests that intervention directed at increasing attention to the informative area of the face. Journal of Autism and Developmental Disorders 20:115–128. It remains to be seen whether the nonimmersive. T. (1996). A longitudinal study of joint attention and language development in autistic children. profile of a complex information processing disorder. Siegel.. and teaching how to interpret faceborne information. Mundy. Journal of the International Neuropsychological Society (JINS) 3: 303–316.. (2001). evidence from very high functioning adults with autism or asperger syndrome.... 4.

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