The role of limited salience of speech in selective attention to faces in toddlers with autism spectrum disorders.
Level 4 - case-series / case-control
Case-control study with prospective follow-up
PubMed 31471912 · doi:10.1111/jcpp.13118
What was done
Researchers evaluated selective attention to faces in 50 toddlers with autism spectrum disorder (ASD) and 47 typically developing (TD) controls (mean age 22.4 months, SD = 3.2). Using the Selective Social Attention 2.0 eye-tracking task, they presented four conditions systematically manipulating the presence (+) or absence (-) of direct gaze (DG) and speech (SP): DG-SP-, DG-SP+, DG+SP-, and DG+SP+. Autism symptom severity, verbal skills, and nonverbal skills were assessed concurrently at 22.4 months and prospectively at 39.8 months (SD = 4.3).
What was found
Toddlers with ASD looked significantly less at face and mouth regions compared to TD toddlers only during conditions containing speech: - Direct gaze absent with speech (DG-SP+): face region d = 0.99 (p < .001); mouth region d = 0.98 (p < .001). - Direct gaze present with speech (DG+SP+): face region d = 1.47 (p < .001); mouth region d = 1.01 (p < .001). - Toddlers with ASD looked less at the eye region only when both direct gaze and speech cues were present (DG+SP+: d = 0.46, p = .03). - No deficits in face looking were observed when speech was absent. Salience of combined direct gaze and speech cues correlated concurrently and prospectively with autism symptom severity, remaining significant after adjusting for verbal and nonverbal levels.
Why it matters
These findings suggest that reduced attention to faces in early ASD is driven by low salience of audiovisual speech cues rather than active face avoidance. This identifies speech-cued facial attention as a potential early predictive biomarker and therapeutic target.
Limits
The sample size was modest (50 ASD, 47 TD). Stimuli were pre-recorded video displays rather than live, naturalistic interactions. The abstract does not report participant sex distribution, longitudinal retention rates at 39.8 months, or exact numerical values for the prospective correlation models.
Cited by
- supports Social features such as eyes or who is talking have less of a weight on where autistic individuals look compared to distractors.