Eye Tracking Analysis of Attention to Text for Children with Autism Spectrum Disorders

Background: Despite the pivotal nature of learning to read, a sub-group of individuals diagnosed with autism spectrum disorder (ASD), typically those with co-occurring intellectual disabilities or speech and language impairments, lack the reading skills needed to achieve independence (Howlin, Goode, Hutton, & Rutter, 2004). Reading instruction for these children should therefore begin at an early age, with procedures known to enhance early literacy outcomes. However, it is currently unknown whether strategies that promote early literacy for typical children, such as print-salient, repetitive books coupled with simple words and print referencing, have the same impact on children with ASD.  

Objectives: The primary objective of this study was to use eye tracking technology to examine how children with moderate to severe ASD differentially attended to pictures and text when presented with each on a computer screen. A second objective was to evaluate whether print referencing tactics (i.e., text highlighting) could increase the extent to which children attended to relevant textual and pictorial cues.  

Methods: Eleven children with moderate to severe ASD viewed two brief video displays, each lasting approximately 100 seconds, of textual and pictorial stimuli presented on a laptop computer. One display consisted of 14 unrelated slides of textual and pictorial stimuli and a second display consisted of a 13-page electronic book with related text and pictures across all pages. Presentation order was counterbalanced across participants. Eye gaze was assessed using the Tobii X2-60 portable eye tracking unit and Tobii Studio Professional Software. Using a within subject design, we compared total fixation duration (total seconds each child looks at the presented stimuli), total gaze directed toward text vs. picture, mean latency to fixation, and stimulus of initial fixation (text or picture) for each child during each video display.  

Results: Some participants demonstrated higher levels of attention to stimuli in the unrelated slides and others to stimuli in the electronic book. Almost all participants demonstrated greater attention to pictures than to text, though print referencing tactics (highlighting) led to an increase in attending to text for some participants. In addition to statistical and visual analyses, we will demonstrate videos that depict the temporal path including fixations and saccades, as well as a video and audio recording of the child during the eye tracking session.  

Conclusions: Overall, the participants in the present investigation were more likely to attend to pictorial and textual stimuli that was unrelated from one page to the next than to a repetitive electronic book. This is somewhat surprising given the consistent finding that children with ASD often perform better under predictable routines. The outcomes suggest print referencing, in the form of text highlighting, may be an effective early literacy intervention to increase attention to text among individuals with ASD. Eye tracking analyses of children with moderate to severe ASD when presented with pictures and text might provide important information that can be used to hypothesize potential early reading interventions for this group.