Patterns of Gaze Behavior During Live Interactions in Adults and Adolescents with Autism or High Autistic Traits: A Systematic Review

Abstract

Background:

Differences in social gaze are part of the diagnostic criteria for autism spectrum condition (ASC), but most studies examining gaze in individuals with autism or high autistic traits use computerized methods that bear little resemblance to authentic conversations. Progress in eye tracking now allows the use of live interaction paradigms. We report a systematic review of this emerging literature.

Methods:

Using a combination of academic search engines (Google Scholar, OVID, Connected Papers) and backwards citation searches, we identified fourteen studies that explored social gaze in adults and adolescents with autistic traits or an ASC diagnosis, using a live or believed-to-be-live interaction and modern eye-tracking technology.

Results:

Studies showed mixed results: when gaze is localized to broad regions (face, body, and background), patterns appear similar in all participants. However, when gaze is localized to precise regions (eyes, mouth, and nose) more group differences exist. Specifically, gaze to the eyes seems somewhat consistently reduced in individuals with autism or autistic traits. However, these participants appear to modulate their gaze according to contextual factors, similar to typically developing individuals (e.g., looking less toward the face when speaking than listening).

Conclusion:

We discuss these results in relation to two dominant theories of autism: low social motivation and aversion to the eyes. The finding that individuals with autism or autistic traits seem to specifically avoid the eyes but show facial orienting and gaze modulation similar to typically developing individuals lends supplemental support to aversive rather than motivational theories of ASC.

Community Brief

Why is this an important issue?

The idea that autistic people make less eye contact than non-autistic people is very common, but it has not often been studied in detail. Most research on the subject has recorded people’s gaze when they see photos and videos, not when they see real people during a real interaction. Gaze during a real interaction might be different, because it allows people to send social signals with their eyes. In fact, non-autistic adults often look at their partners’ eyes and face less during a real interaction compared with a video. This means researchers should study autistic individuals’ eye contact during real interactions, because it may be different compared with looking at photos and videos.

What was the purpose of this study?

In this article, the researchers review recent studies that use modern eye-tracking technology to explore eye contact in adults and adolescents with an autism diagnosis or with autistic traits during a real (or believed to be real) conversation.

What were the results of the study?

The researchers found that existing studies use many different kinds of methods and measures, too many to be able to compare them directly. It is therefore difficult to draw very strong conclusions, but they suggest that autistic individuals seem to look specifically less toward the eyes of the people they are speaking with, when compared with non-autistic individuals. However, it appears that autistic and non-autistic people look at the faces of their conversation partner to a similar extent. Furthermore, both groups seem to adjust where they look based on context, looking less at their partner when talking than when listening.

What do these findings add to what was already known?

There is an ongoing debate regarding whether autistic individuals’ reduced eye contact is better explained by (1) not being motivated to look at their conversation partner or (2) being overwhelmed when making direct eye contact specifically. This review supports the second explanation, since autistic individuals seem to look at the face of their conversation partner just as much as non-autistic individuals.

How will these findings help autistic adults now or in the future?

Eye contact is an important social tool that allows people to communicate and collect information from the people they speak to. Understanding if autistic individuals differ in their eye contact can help with understanding how autism works and whether autistic or non-autistic people should try to learn to use eye contact differently in conversations.