Sep 29 2008

A Behaviorial Marker for Autism

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Comments: 11

Autism researchers at the Yale Child Study Center have published the results of their research looking at the behavior of 2 year old children with autism. Specifically, they used eye-tracking software to see where they were focusing their gaze when looking at someone who is talking with them.

Lead author Warren Jones, with Ami Klin and Katelin Carr, found that children with autism tend to look at the mouth of someone who is talking, while children without autism tend to look at the eyes.

From the abstract:

Participants  Fifteen 2-year-old children with autism were compared with 36 typically developing children and with 15 developmentally delayed but nonautistic children.

Main Outcome Measure  Preferential attention was measured as percentage of visual fixation time to 4 regions of interest: eyes, mouth, body, and object. Level of social disability was assessed by the Autism Diagnostic Observation Schedule.

Results  Looking at the eyes of others was significantly decreased in 2-year-old children with autism (P < .001), while looking at mouths was increased (P < .01) in comparison with both control groups. The 2 control groups were not distinguishable on the basis of fixation patterns. In addition, fixation on eyes by the children with autism correlated with their level of social disability; less fixation on eyes predicted greater social disability (r = – 0.669, P < .01).

The hallmark of autism, or autism spectrum disorder (ASD), is decreased social ability. Children with autism simply do not engage socially as much as children without autism. In the most extreme cases children with autism will be withdrawn into their own world, uninterested in anyone around them.

There are many measures that can be used for this decrease in social interaction, but (being highly social creatures) parents are usually the first to recognize autism in their children simply by their subjective or emotional experience.

What this technique provides is a good quantitative measure. This is not the first study to use eye-tracking software to study autism. In this study, for example, researchers used eye tracking software and found that children with autism look at faces less often than controls, while children with another disorder, Williams Syndrome, which is characterized by decreased IQ but an increase in social behavior, had an increase attendance to faces. Therefore looking at human faces (and now eyes) appears to be a good marker for social ability.

The researchers speculate that those with autism prefer to look at the mouth when someone is speaking because they make a causal connection between the mouth moving and the words they are hearing. However, they are not making a social connection between the words and the person who is speaking. The physical has meaning for them while the social does not. This sounds plausible and consistent with our current understanding of autism.

The researchers next plan to study children prospectively from birth to see if preference for looking at mouths over eyes can predict the later development of autism.This may provide a powerful tool for the early screening and diagnosis of autism. The potential benefit of this is that it would allow for earlier intervention of behavioral therapy meant to compensate at least somewhat for the decreased social potential in these children.

Another potential benefit of such a study would be to confirm that, at least in some children, autism is present and detectable at birth or shortly thereafter. This has obvious implications for the vaccine-autism claim – if autism can be detected prior to the vaccine schedule, that would rule out vaccines as a contributing cause. Although the autism-vaccine claim has already been thoroughly debunked, it remains a public controversy.

There is already evidence that the signs of autism are detectable in infancy, but confidence in science comes from multiple independent lines of evidence pointing in the same direction. So this research would be welcome.

11 responses so far

11 Responses to “A Behaviorial Marker for Autism”

  1. lizditzon 29 Sep 2008 at 11:00 am

    Contrast your reasoned approach with that expressed in the comments at Age of Autism on the same study. guess they’re trying to show that since autism can be detected in newborns, it can’t be caused by vaccines. They don’t want people to realize that newborns have already been exposed to 25 mcg of mercury through the prenatal flu shot, then aluminum in the Hep B shot at birth. Expect waters to get muddy. Maybe by design. Hg loaded flu shots to pregnant women then 2X a year starting at six months. Needless Hep B 2nd day of life, still! Yeah you are seeing signs earlier! They are getting the toxins in before they even get out of the gate!

    It’s like ethnic cleansing, only those genetically susceptible are purged. The “non-sense” science is particularly insulting as you see families disintegrate for lack of answers and services but some bimbo scientist gets 3 million to study how asocial Autistic children are.’s beyond belief that these scientists express no serious alarm over so many kids lacking the most basic of communication skills.

    Studying these children as interesting anomalies to ‘enable the detection of vulnerabilities for autism in infancy,’ doesn’t nothing to stop this disorder from affecting more children and it sends the not-so-subtle message that children are born with autism.

    Anne Dachel
    Media editor Everyday I scan Pubmed for Autism research, it’s amazing how many “nonsense” studies you have to wade through to get to anything meaningful. Juxtaposed to the NIH canceling the chelation study – that parents when surveyed said helped over 50% of ASD children (ARI data).

    It’s hard (as a parent who lived through nursing a very sick child back to health) to see money spent on things that wouldn’t advance a mouse, much less a chronically ill child with Autism.

    You want to talk about “side tracking issues” talk about eye/mouth focus instead of bleeding gastrointestinal tracts.

  2. Minaon 29 Sep 2008 at 11:31 am

    I don’t really understand what information I’d gather if I paid attention to the eyes. At least with lips I can see whether someone is smiling.

    I also look at the mouth because I do some lip reading to fill in the gaps when I don’t hear what someone said.

  3. Fifion 29 Sep 2008 at 12:08 pm

    Mina – You can tell more about a smile by looking at someone’s eyes than their mouth. It’s the crinkling around the eyes that indicates whether a smile is genuine or fake – if you just looked at the mouth you’d be easily conned because you’d see the “obvious” marker of a smile but not the deeper signifying expressions that indicate what kind of smile it is.

    Clearly if you have difficulty hearing then reading someones lips is an effective way to fill in the auditory gaps. You would, however, probably be missing some of the non-verbal communication that was taking place.

  4. BAon 29 Sep 2008 at 1:03 pm

    These findings nicely fit in with other results produced by this excellent group of researchers. The attention to mouth (or lack of attention to social context) is consistently detected in eye-tracking in persons w/ASDs. Some others have suggested that autism is “like an imprinting error.” Perhaps people who are later diagnosed with autism do not have an inherited disposition to attend to eyes/faces. There is likely more going on in tipping the scales of social learning (such as a failure to habituate to auditory stimulation thus aud. stimulation may be more inherently aversive) but the slightest decrease in the salience of social stimulation sets a child’s learning down a very different path than one who is not similarly affected.

  5. Perky Skepticon 29 Sep 2008 at 3:05 pm

    WOW… OMG!!! It took me at least two decades to learn to hear what someone said when I couldn’t look at their mouths!!! I wonder if my little Asperger son is the same way? This helps shed light on so much!!!

    I have never been officially diagnosed with Asperger’s Syndrome, but when our son was being tested, and I had to fill out all those behavioral checklists, I saw soooooooooo much of my own childhood and teenage behavior reflected in the answers I was giving for my toddler! And of course, being a girl, I hid my social confusion very well– literally until I learned how to “act normal.” But I remember the echolalia, the parallel play, the trouble processing stuff that was said to me, the strange vocalizations… argh, I could go on and on. I am SO glad this condition is being studied so well nowadays, so that my little boy will get the learning assistance that I never received.

  6. sonicon 30 Sep 2008 at 1:55 am

    Does this open the door for possible treatment/cure? The brain is very plastic- if one taught youngsters to look at the eyes, would this produce the needed stimulation to overcome this problem?
    It seems such a training would be possible and if started early the results should be noticable fairly quickly.
    Has anyone done any research into this?

  7. anandamideon 30 Sep 2008 at 2:30 am

    This is the same group of researchers who published ‘The enactive mind, or from actions to cognition: lessons from autism’. As a psych undergrad I read the paper last year – it completely blew me away, not only in respect of autism but in my theoretical understanding of the brain and cognition . I think it might even be freely available; I would heartily recommend it to anyone with an interest in autism and the willingness to read technical material.

  8. sonicon 30 Sep 2008 at 3:14 am

    Your right

  9. Heraclideson 01 Oct 2008 at 8:30 pm

    My “instant” thought was whether they ran hearing tests on the kids or not–? (I know I should read the paper, but I’m a bit out of time at the moment: might later.)

    Others have made the link to lip-reading too, and this is what I was thinking of. I’m also thinking of links to (undiagnosed) deafness, but I wouldn’t want to over-reach.

    I’d also be curious to know how this might relate to propagnosia, too.

    Anne Dachel: I vaguely recall reading that there are other studies that examined hand movement/behaviour with similar predictive outcomes. (My memory is that it was a survey of 1st birthday videos, but do check it out for yourself as my memory is a bit vague on this one!)

    sonic: thanks for the link, lets hope I find time for that, too!

  10. […] Steven Novella wrote: Autism researchers at the Yale Child Study Center have published the results of their research looking at the behavior of 2 year old children with autism. Specifically, they used eye-tracking software to see where they were focusing their gaze when looking at someone who is talking with them. […]

  11. alyricon 09 Oct 2008 at 4:22 pm

    Best take a look at Michelle Dawson’s critique of this study at:

    message 8408

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