Joint Attention in Infancy and the Emergence of Autism

Abstract

BACKGROUND: In typical infant development, parents and their children jointly contribute to establishing frequent episodes of joint attention that boost language acquisition and shape social cognition. Here we used novel live eyetracking technology to evaluate the degree to which autism spectrum disorder (ASD) is related to reduced responding to others' joint attention bids in infancy (RJA) and to a reduced tendency to initiate joint attention episodes (IJA). Because young infants use their gaze for both RJA and IJA, this approach allowed us to quantify these elusive processes early in life. METHODS: The final sample consisted of 112 infants (54 boys and 58 girls), of whom 81 were at familial risk for ASD and 31 were typically developing low-risk infants. At follow-up (36 months of age), 22 children in the high-risk group were diagnosed with ASD. RESULTS: At 10 months of age, rates of IJA were lower in infants later diagnosed with ASD than in the comparison groups (effect sizes d = 0.78-0.95) and followed an atypical developmental trajectory from 10 to 18 months (p , .002). RJA distinguished infants based on familial ASD risk, albeit not ASD diagnosis. The differences in IJA could not be explained by overall looking time, social preference, eye movement latencies, or number of fixations. CONCLUSIONS: This live eye-tracking study suggests that during an important period for the development of social cognition (10-18 months of age), infants later diagnosed with ASD show marked atypicalities in IJA but not in RJA. The results indicate that IJA is an important target for future prodromal intervention trials.

Does decreased visual attention to faces underlie difficulties interpreting eye gaze cues in autism?

“…Interestingly, these individual differences in social visual attention to faces are not related to autism severity, autism symptoms, or social behavior among the adolescents with ASD. These findings converge with those from infant [20], toddler [29], and child [21] studies reporting no differences in visual attention to faces at the group level. We also found that fixation durations to target objects were comparable in the ASD and TD groups (as was the variance among these durations) in the Gaze Following Task.…”

Gaze Following and Attention to Objects in Infants at Familial Risk for ASD

“…Few studies have measured gaze following in live interaction in infants with later ASD using eye-tracking. As in our study, Nyström et al (2019), found no outcome difference in the amount of first looks directed to referent vs. distractor in 10-month olds infants at risk for ASD. In contrast, Presmanes et al (2007) and Sullivan et al (2007) showed that HR-ASD infants directed fewer first looks to referents but they did not employ eye tracking which means we do not know where infants look when they did not correctly follow gaze, i.e., did they make an incorrect first look to another object or did they not disengage from the face?…”

A World Unto Itself: Human Communication as Active Inference

“…However, repeated attention to sources of sensory uncertainty (e.g., others' saccades), combined with an inability to adequately leverage predictions to explain away this uncertainty (owing to too much sensory precision), means that such individuals may develop idiosyncratic or atypical phenotypic expressions of the adaptive prior for alignment (e.g., avoiding eye gaze; Tanaka and Sung, 2016). In other words, early atypicalities in the internal dynamics generating evidence gathering cycles of action-perception may have downstream effects on joint attentional skills (Charman et al, 1997;Nyström et al, 2019), attunement to and use of communicative action policies (Loveland and Landry, 1986;Warlaumont et al, 2014), mental state inference (Tager-Flusberg, 2007), and other means for alignment (Heasman and Gillespie, 2019). In short, aberrant inference in a prosocial, developmental setting may easily lead to a pernicious kind of dyslexia -not for the written word -but for any communicative exchange (i.e., joint inference).…”