Atypical gaze patterns to facial feature areas in autism spectrum disorders reveal age and culture effects: A meta-analysis of eye-tracking studies.
Level 3 - non-randomized controlled study
Meta-analysis of non-randomized observational case-control studies
PubMed 34542246 · doi:10.1002/aur.2607
What was done
A meta-analysis of 75 articles containing 91 eye-tracking studies was conducted to evaluate fixation durations on facial feature areas (eyes and mouth) in individuals with autism spectrum disorder (ASD; n = 2,027) compared to neurotypical controls (n = 2,182). The analysis examined moderation effects by age (childhood through adulthood) and cultural background (Eastern versus Western cultures).
What was found
Individuals with ASD demonstrated significantly shorter fixation durations to the eye region compared to controls. This eye-gaze deficit was not modulated by age, though the effect size was larger in Eastern cultures than in Western cultures. Group differences in time spent looking at the mouth were not statistically significant overall, but varied by age and culture: Western individuals with ASD looked significantly longer at the mouth starting in school age, whereas Eastern individuals with ASD did not do so until adulthood. No numerical effect sizes, variances, or test statistics were reported in the abstract.
Why it matters
This synthesis demonstrates that reduced eye gaze in ASD is a persistent marker across the lifespan, while suggesting that increased mouth gaze represents an age-dependent, culturally moderated compensatory strategy.
Limits
The abstract reports no numerical effect sizes, confidence intervals, or between-study heterogeneity statistics. The underlying primary literature relies on cross-sectional observational laboratory paradigms rather than longitudinal tracking or naturalistic social interactions.
Cited by
- supports Individuals who score higher on autistic trait measures or have an autism diagnosis make less eye contact during social interaction tasks.