Psychophysiological responses to wide-open eyes in children with autism spectrum disorders

Background: Eye contact avoidance in autism spectrum disorders (ASD) may be a consequence of negative physiological arousal elicited by direct gaze. In addition, wide-open eyes with increased amount of exposed sclera (such as in fearful eyes) may be misinterpreted as threatening by children with ASD.

Objectives: Our main aim was to investigate whether children with ASD become physiologically over-aroused when looking at faces with wide-open eyes. A secondary aim was to study whether face familiarity modulates the arousal responses in children with ASD.

Methods: Participants included 14 children with ASD and 15 age, gender and IQ matched typically developing children. Skin conductance responses (SCR) and heart rate were recorded as participants viewed pictures of three familiar and three unfamiliar faces with eyes closed, eyes normally open or eyes wide-open. The face pictures loomed toward the participants, creating an impression of an approaching person. In order to ensure that the participants were attending to the eyes, they were asked to make a button press after observing an eye blink.

Results: The results indicated that gaze condition affected SCRs in the children with autism, but not in the typically developing children. SCRs were larger in the wide-open eyes condition than in the eyes closed condition in children with autism, but not in typically developing children. Familiar faces elicited larger SCRs than did unfamiliar faces in both groups.

Conclusions: These findings suggest that children with ASD have atypical physiological responses to wide-open eyes directed at them. The data are interpreted in relation to current views suggesting that individuals with ASD show atypical neural and cognitive responses to direct gaze stimuli.