The beneficial effect of early intervention is well described for children with autism spectrum disorder (ASD). Response to early intervention is, however, highly heterogeneous in affected children, and there is currently only scarce information about predictors of response to intervention. Based on the hypothesis that impaired social orienting hinders the subsequent development of social communication and interactions in children with ASD, we sought to examine whether the level of social orienting modulates treatment outcome in young children with ASD. We used eye-tracking technology to measure social orienting in a group of 111 preschoolers, comprising 95 young children with ASD and 16 children with typical development, as they watched a 29 s video of a woman engaging in child-directed speech. In line with previous studies, we report that attention to face is robustly correlated with autistic symptoms and cognitive and adaptive skills at baseline. We further leverage longitudinal data in a subgroup of 81 children with ASD and show that the level of social orienting at baseline is a significant predictor of developmental gains and treatment outcome. These results pave the way for identifying subgroups of children who show a better response to early and intensive intervention, a first step toward precision medicine for children with autism.

Atypical prosody in speech production is a core feature of Autism Spectrum Disorder (ASD) that can impact everyday life communication. Because the ability to modulate prosody develops around the age of speech acquisition, it might be affected by ASD symptoms and developmental delays that emerge at the same period. Here, we investigated the existence of a prosodic signature of developmental level and ASD symptom severity in a sample of 74 preschoolers with ASD. We developed an original diarization pipeline to extract preschoolers’ vocalizations from recordings of naturalistic social interactions. Using this novel approach, we found a robust voice quality signature of ASD developmental difficulties in preschoolers. Moreover, some prosodic measures were associated with one year later outcome in participants who had not acquired speech yet. Together, our results highlight the potential benefits of automatized diarization algorithms and prosodic metrics for digital phenotyping psychiatry, helping clinicians establish diagnosis and prognosis.

Atypical prosody in speech production is a core feature of Autism Spectrum Disorder (ASD) that can impact everyday life communication. Because the ability to modulate prosody develops around the age of speech acquisition, it might be affected by ASD symptoms and developmental delays that emerge at the same period. Here, we investigated the existence of a prosodic signature of developmental level and ASD symptom severity in a sample of 74 autistic preschoolers. We first developed an original diarization pipeline to extract preschoolers’ vocalizations from recordings of naturalistic social interactions. Using this novel approach, we then found a robust voice quality signature of ASD developmental difficulties in preschoolers. Furthermore, some prosodic measures were associated with one year later outcome in participants who had not acquired speech yet. Altogether, our results highlight the potential benefits of automatized diarization algorithms and prosodic metrics for digital phenotyping in psychiatry, helping clinicians establish early diagnosis and prognosis.

Background Imitation behaviors develop very early and increase in frequency and complexity during childhood. Most studies in children with autism spectrum disorder (ASD) support a general decrement in imitation performance. To better understand this phenomenon in ASD, factors related to visual attention and motor execution have been proposed. However, these studies used various paradigms and explored different types of imitation in heterogeneous samples, leading to inconsistent findings. The present study examines imitation performance related to visual attention and motor execution. We focused on gesture imitation, consistently reported as more affected than imitation of actions with objects in ASD. We also investigated the influence of meaningful and meaningless gestures on imitation performance. Methods Our imitation eye-tracking task used a video of an actor who demonstrated gestures and prompted children to imitate them. The demonstrations comprised three types of gestures: meaningful (MF) and meaningless (ML) hand gestures, and meaningless facial gestures. We measured the total fixation duration to the actor’ face during child-directed speech and gesture demonstrations. During the eye-tracking task, we video-recorded children to later assess their imitation performance. Our sample comprised 100 participants, among which were 84 children with ASD (aged 3.55 ± 1.11 years). Results Our results showed that the ASD and typically developing (TD) groups globally displayed the same visual attention toward the face (during child-directed speech) and toward gesture demonstrations, although children with ASD spent less time fixating on the face during FAC stimuli. Visual exploration of actors’ faces and gestures did not influence imitation performance. Rather, imitation performance was positively correlated with chronological and developmental age. Moreover, imitation of MF gestures was associated with less severe autistic symptoms, whereas imitation of ML gestures was positively correlated with higher non-verbal cognitive skills and fine motor skills. Conclusions These findings contribute to a better understanding of the complexity of imitation. We delineated the distinct nature of imitation of MF and ML hand gestures in children with ASD. We discuss clinical implications in relation to assessment and intervention programs.