Eye-tracking biomarkers of social attention are related to naturalistic social interactions in children with asd

ObjectivesEye-tracking (ET) measures indexing social attention have been proposed as sensitive biomarkers of ASD. However, less is known about the relationship between social attention biomarkers and naturalistic measures of social engagement. This study investigated ET biomarkers of social attention as predictors of social engagement during a naturalistic parent-child interaction. Sex was included as a moderator due to known sex differences in prevalence and behavioral features of ASD.MethodsParticipants included 132 children aged 2 to 7 years who met the DSM-5 criteria for ASD using the Autism Diagnostic Observation Schedule-2 (ADOS-2) (77% male). Measures were taken during the baseline visit of a clinical trial evaluating the efficacy of umbilical cord blood for improving social abilities. Participants engaged in a parent-child play interaction and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. ET biomarkers included the time looking at regions on the actor’s face and surrounding toys. The child’s social engagement during the parent-child interaction was coded by reliable raters with the Joint Engagement Rating Inventory (JERI).ResultsMultiple regression analyses revealed that ET biomarkers correlated with social engagement behaviors, including attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement (p < .007 for all). Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor’s mouth were more likely to engage in coordinated play with and without using language. Sex moderated the relationship between the time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play.ConclusionsIn this study of young children with ASD, social attention ET biomarkers were correlated with the level of social engagement during naturalistic play, with some sex differences. Biomarkers that are predictive of parent-child interaction patterns may provide insight into promoting positive social engagement between parents and their children with ASD, and can inform outcome monitoring and intervention development.ASD, EC, NEURODEV ObjectivesEye-tracking (ET) measures indexing social attention have been proposed as sensitive biomarkers of ASD. However, less is known about the relationship between social attention biomarkers and naturalistic measures of social engagement. This study investigated ET biomarkers of social attention as predictors of social engagement during a naturalistic parent-child interaction. Sex was included as a moderator due to known sex differences in prevalence and behavioral features of ASD. Eye-tracking (ET) measures indexing social attention have been proposed as sensitive biomarkers of ASD. However, less is known about the relationship between social attention biomarkers and naturalistic measures of social engagement. This study investigated ET biomarkers of social attention as predictors of social engagement during a naturalistic parent-child interaction. Sex was included as a moderator due to known sex differences in prevalence and behavioral features of ASD. MethodsParticipants included 132 children aged 2 to 7 years who met the DSM-5 criteria for ASD using the Autism Diagnostic Observation Schedule-2 (ADOS-2) (77% male). Measures were taken during the baseline visit of a clinical trial evaluating the efficacy of umbilical cord blood for improving social abilities. Participants engaged in a parent-child play interaction and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. ET biomarkers included the time looking at regions on the actor’s face and surrounding toys. The child’s social engagement during the parent-child interaction was coded by reliable raters with the Joint Engagement Rating Inventory (JERI). Participants included 132 children aged 2 to 7 years who met the DSM-5 criteria for ASD using the Autism Diagnostic Observation Schedule-2 (ADOS-2) (77% male). Measures were taken during the baseline visit of a clinical trial evaluating the efficacy of umbilical cord blood for improving social abilities. Participants engaged in a parent-child play interaction and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. ET biomarkers included the time looking at regions on the actor’s face and surrounding toys. The child’s social engagement during the parent-child interaction was coded by reliable raters with the Joint Engagement Rating Inventory (JERI). ResultsMultiple regression analyses revealed that ET biomarkers correlated with social engagement behaviors, including attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement (p < .007 for all). Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor’s mouth were more likely to engage in coordinated play with and without using language. Sex moderated the relationship between the time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Multiple regression analyses revealed that ET biomarkers correlated with social engagement behaviors, including attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement (p < .007 for all). Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor’s mouth were more likely to engage in coordinated play with and without using language. Sex moderated the relationship between the time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. ConclusionsIn this study of young children with ASD, social attention ET biomarkers were correlated with the level of social engagement during naturalistic play, with some sex differences. Biomarkers that are predictive of parent-child interaction patterns may provide insight into promoting positive social engagement between parents and their children with ASD, and can inform outcome monitoring and intervention development.ASD, EC, NEURODEV In this study of young children with ASD, social attention ET biomarkers were correlated with the level of social engagement during naturalistic play, with some sex differences. Biomarkers that are predictive of parent-child interaction patterns may provide insight into promoting positive social engagement between parents and their children with ASD, and can inform outcome monitoring and intervention development.