Attention During Face-to-Face Interaction: When Do Infants at-Risk for Autism Shift Gaze?

Background: The developing ability to disengage from an arousing stimulus has salient implications for infant socio-emotional functioning. Infant siblings of children with autism spectrum disorder (ASD-sibs) are at an increased risk for the development of autistic disorders and subclinical deficits that impair socio-emotional functioning. Compared to the infant siblings of typically-developing children (COMP-sibs), young ASD-sibs spend similar amounts of time gazing at their parent's face; however, they shift their gaze to and from the parent's face less frequently than COMP-sibs. Research suggests that any group differences in emotional expressions during infancy are subtle. To date, there has been no research examining when infants at risk for ASD shift their attention. That is, are these infants more likely to shift their attention when emotionally aroused or when in a neutral state?

Objectives: The purpose of the current study was to examine whether 6-month-old ASD-sibs and COMP-sibs differ in the rate of shifting attention when exhibiting various emotional expressions.

Methods: ASD-sibs (n = 27) and COMP-sibs (n = 19) participated in the face-to-face/still-face (FFSF) at 6 months of age. The FFSF consists of three episodes: a 3 minute face-to-face (FF) episode, a 2 minute still-face (SF) episode, and a 3 minute reunion (RE) episode. FACS certified coders rated infant facial expressions (smile, cry-face, neutral [neither smile nor cry-face]). The onsets and offsets of infant gazes at and away from the parent's face were also reliably coded.

Results: No significant group differences for infant emotional expressions were found. When compared to COMP-sibs, ASD-sibs spent significantly more time gazing away from the parent's face during the SF episode. Both groups of infants shifted attention more frequently during the FF and RE episodes than during the SF episode. As previously reported, ASD-sibs shifted their attention less frequently than COMP-sibs during the FF and SF episodes (Ibanez et al., 2008). No significant differences for attention shifting during infant negative or positive expressions emerged. ASD-sibs, however, were less likely than COMP-sibs to shift attention when exhibiting a neutral expression during the FF and SF episodes.

Conclusions: Although there are previously documented deficits in the flexibility of attention allocation among ASD-sibs, studies have not examined the emotion state that was the context for attention shifts. The present study specifies when ASD-sibs exhibit developing deficits in gaze shifting. Infants spent the majority of their time in a neutral state. This state appeared to represent a ‘risk condition' for sticky attention for ASD-sibs as their attention shifts were slower during neutral expressions. It is possible that ASD-sibs are only motivated to shift attention under conditions of heightened arousal, suggesting a possible avenue for early efforts aimed at prevention and intervention. In sum, the results of the present study highlight the importance of considering the coordination of various modalities, as opposed to examining each one in isolation. Further analyses will be presented incorporating sequential analyses to micro-analytically investigate how infant gaze and emotional expression are temporally coordinated.