A Meta-Analysis of Gaze Differences to Social and Nonsocial Information Between Individuals With and Without Autism

Abstract

Objective Numerous studies have identified abnormal gaze in individuals with autism. Yet only a limited number of findings have been replicated, the magnitude of effects is unclear, and the pattern of gaze differences across stimuli remains poorly understood. To address these gaps, we conducted a comprehensive meta-analysis of autism eye tracking studies. Method PubMed and manual search of 1,132 publications were used to identify studies comparing looking behavior to social and/or nonsocial stimuli between individuals with autism and controls. Sample characteristics, eye tracking methods, stimulus features, and regions-of-interest (ROI) were coded for each comparison within each study. Multivariate mixed-effects meta-regression analyses examined the impact of study methodology, stimulus features, and ROI on effect sizes derived from comparisons using gaze fixation metrics. Results The search revealed 122 independent studies with 1,155 comparisons. Estimated effect sizes tended to be small-to-medium, but varied substantially across stimuli and ROI. Overall, nonsocial ROIs yielded larger effect sizes than social ROIs; however, eye and whole face regions from stimuli with human interaction produced the largest effects (Hedge’s g=.47 and .50, respectively). Studies with weaker study designs/reporting yielded larger effects, but key effects remained significant and medium-sized, even for high-rigor designs. Conclusion Individuals with autism show a reliable pattern of gaze abnormalities that suggests a basic problem with selecting socially-relevant versus irrelevant information for attention and that is persistent across age and worsens during perception of human interactions. Aggregation of gaze abnormalities across stimuli and ROI could yield clinically useful risk assessment and quantitative, objective outcome measures.

Visual Exploration in Autism Spectrum Disorder: Exploring Age Differences and Dynamic Features Using Recurrence Quantification Analysis

“…This lead to a smaller, unbalanced, and less well characterized TD group; for example, this group was assumed to have an IQ within the normal range, and although sex was balanced across the group as a whole, the older TD group included significantly more females ( χ 2 (1) = 5.3221, P = 0.02). Frazier et al () did not find that IQ or sex differences were a mediating factor in determination of effect sizes in social attention in ASD. However, it is important to be aware of these limitations.…”

“…There is evidence that differences in visual attention emerge as early as within the first year in ASD (Ozonoff et al, ; Sasson & Elison, ; Chawarska, Macari, & Shic, ; Jones & Klin, ; Shic, Macari, & Chawarska, ), and a small study of children aged 2–5 years ( n = 10 ASD, 14 TD) using VET indicated reduced or atypical object exploration in the ASD group compared to a TD (Sasson, Elison, Turner‐Brown, Dichter, & Bodfish, ), which increases with age for both groups (Elison et al, 2012). Frazier et al's () review did not find that gaze deficits in attention to social stimuli were moderated by age, sex, or cognition. However, some observations appear to not hold stable across age in ASD (Guillon, Hadjikhani, Baduel, & Roge, ).…”

Autism spectrum disorder: advances in diagnosis and evaluation

“…Although visual orienting is directly observable, it may index a more basic neuropsychological process than other behavioral symptoms and can be objectively measured using eye tracking. A review of 122 studies indicated atypical gaze patterns across the lifespan in people with ASD, consistent with fundamental deficits in selecting and attending to information needed to perceive social interactions accurately 88. Numerous studies have examined early correlates of these findings in high risk infants 89909192939495969798.…”

Eye‐tracking research in eating disorders: A systematic review

“…For example, in the social domain, both adults and children with autism spectrum disorder (ASD) spend less time looking at eye and face regions, and more time looking at non-social stimuli than healthy controls (HCs) (Frazier et al, 2017). For example, in the social domain, both adults and children with autism spectrum disorder (ASD) spend less time looking at eye and face regions, and more time looking at non-social stimuli than healthy controls (HCs) (Frazier et al, 2017).…”

“…Eye-tracking research can provide insights into cognitive, social, and emotional processes in psychiatric disorders. For example, in the social domain, both adults and children with autism spectrum disorder (ASD) spend less time looking at eye and face regions, and more time looking at non-social stimuli than healthy controls (HCs) (Frazier et al, 2017). These differences are associated with impairments in areas of social cognition, for example, less time spent looking at the eyes predicts impairments in recognizing fearful expressions in adults with Asperger's syndrome (Corden, Chilvers, & Skuse, 2008).…”