Enhancing Face-Looking Behavior by Social Skills Training in Children with Autism Spectrum Disorders

Background: Due to the fact that children with autism show difficulties in social interaction, researches exploring related neurological basis have been carried out. Previous studies evaluating their visual fixation patterns when observing the human face have showed that there was a correlation between the short fixation duration to the eye area and the difficulty of social interaction. On the other hand, intervention studies improving social interaction have shown that children with autism could acquire social skills, such as attention to faces and imitation of facial expressions. However, not many studies about social skills training (SST) to children with autism have evaluated its effects on the face-looking behavior.

Objectives: The purpose of this study was to examine the effect of the SST on the face-looking behavior. We also examined the relationships between the amount of change of the visual fixation and the profile of the participants.

Methods: Four boys (between 7 to 8 years old) diagnosed with autistic disorder participated in the study. Japanese standard scale of development was used to assess their developmental age. Their severity of autism was rated by CARS (Schopler, Reichler, DeVellis, & Daly, 1980). Pre - post design was applied. Before and after the SST session, the participants watched a video of a woman on a computer monitor talking to them. Their visual fixations on the video were recorded by a Tobii X120 eye tracker. Areas of Interest (AOI) for their eyes and mouth regions were created on a Tobii Studio. SST sessions were conducted 3-4 days. Training time was approximately 50 minutes per session. During the SST session, for the three target behaviors (praise, sympathy and aid), participants were trained by video-modeling and role play.

Results: Visual fixation duration for each participant for each AOI was calculated for both pre and post sessions. After the SST sessions, the fixation duration of the eye region was increased in two of the four participants. In the remaining two, the visual fixation duration of the eye region was decreased. The functional relation of the effect of SST and the profile of the participants were examined by the difference in pre- and post- visual fixation duration of the eye region.　There was a significant positive correlation between the chronological age and the amount of change in the visual fixation duration of the eye region of the SST (r = .99, p <.001). With developmental age or autism severity, the amount of change had no significant correlation.

Conclusions: The results showed a tendency that the higher the chronological age, the easier to increase the visual fixation duration of the eye region by the SST.