Eye Contact Enhances the Accuracy of Hand Imitation In Children with ASD

Background: Eye contact modulates social responses, for example it enhanced hand mimicry in typically developing (TD) adults (Wang et al., 2010). Children with autism spectrum disorder (ASD) had difficulty in imitation and they showed reduced attention to a model’s face when observing hand actions (Vivanti et al., 2008). In contrast, children with ASD imitated less accurately in the direct-gaze condition compared to TD children but not in the averted-gaze condition (Vivanti et al., 2011). Thus, the effects of eye contact in imitation remain unclear and more studies are necessary. 

Objectives: We investigated whether children with ASD performed more accurately in imitation of the hand postures when the eye contact was established. 

Methods: Participants consisted of 22 children with ASD (mean 9.7 years; range 6-12 years) and 26 TD children (mean 8.5 years; range 6-12 years) matched on the verbal mental age. Eight unimanual postures from the Japanese syllabary characters of sign language and these 180° rotated postures were presented. Participants sat opposite to the model. In Face block, participants were asked to look at the model’s face and to imitate the hand postures. In Object block, the model wore a colorful flower on the top of her head and bowed to hide her face. Participants were asked to look at the flower and to imitate the hand postures. Twelve children with ASD and 13 TD children were tested for the face block first, and the other the object block first. Form (e.g. number of fingers, correct position of fingers) and Orientation (the child’s palm was to the model when the model’s palm to the child, and vice versa) were analyzed. 

Results: On both Form and Orientation, children with ASD performed less accurately than TD children (p < .05), but the performance was better in Face condition compared to Object condition across the group (p < .05). In Orientation, the interaction was marginally significant (p = .09). The performance of Orientation was better in Face condition compared to Object condition in children with ASD (p < .01) but not in TD children (p > .6). Moreover, whereas children with ASD performed less accurately than TD children in Object condition (p < .01), the group difference did not reach significance in Face condition on Orientation (p = .07). 

Conclusions: Although children with ASD imitated the hand postures less accurately than TD children, they performed better when the eye contact was established.