Does Eye Contact Enhance the Accuracy of Hand Imitation in Children with ASD?: An Eye-Tracking Study

Background: 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). We previously demonstrated that children with ASD imitated hand postures more accurately when eye contact was established in a live task (Kikuchi et al., IMFAR 2012). However, their fixation pattern still remains unknown. Also, it is important to investigate whether this better performance by eye contact is due to live presentation or not. 

Objectives: By using an eye-tracker, we investigated whether children with ASD performed more accurately in imitation of video model’s hand postures when eye contact was established.  

Methods: Participants consisted of 21 children with ASD (mean age 9.3 years; range 6-12 years) and 24 TD children (mean age 8.3 years; range 6-12 years) matched on the verbal mental age. Eight unimanual postures and those 180° rotated postures were presented. 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. Form (e.g. number of fingers, correct position of fingers) and Orientation (a child’s palm was to the model when the model’s palm to the child, and vice versa) were analyzed. 

Results: Although the performance in the display presentation was less accurate than that in the live presentation, we replicated our previous results. On both Form and Orientation, children with ASD performed less accurately than TD children (ps < .05), but the performance was better in Face condition than Object condition across the group (ps < .05). In Orientation, the interaction between group and condition was significant (p < .05); the performance of Orientation was better in Face condition than Object condition in children with ASD (p < .01) but not in TD children (p > .7). In children with ASD, the ratio of the Face/Hand fixation time was larger than that of the Object/Hand fixation time (p < .05). 

Conclusions: In the display presentation, children with ASD also imitated the hand postures more accurately when the eye contact was established.