Gaze Aversion and Self-Soothing at 3-Months and Social-Communicative Outcome at 12-Months for Infants at High- and Low-Risk for ASD: An Exploration of Differences in Self-Regulatory Capacities

Background: Self-regulation in the face of highly stimulating or distressing events is the primary developmental task for 2-6-months-old infants. Effective self-regulation and self-soothing during social interactions allows for sustained alertness, enhanced learning opportunities, and the development of fluid, coordinated parent-infant interactions. 3-month-old infants primarily use two methods of behavioral regulation: self-regulation through gaze aversion and self-soothing through bringing the hand to the mouth (“hand-to-mouth”). Some studies have suggested that the use of gaze aversion to self-regulate during social interaction is disrupted in 6-month-old high-risk infant siblings (e.g., Ibanez et al., 2008). However little is known about how these regulatory capacities at 3-months may promote later social-communicative abilities for high-risk or even low-risk infants. Understanding the form of self-regulatory capacities in early infancy and the function they serve for later social development will illuminate novel developmental pathways for the emergence of social-communication and development of ASD. 

Objectives: The goal of the current study is to investigate self-regulatory strategies used by infants at high- and low-risk for ASD during parent-infant interactions and to associate these patterns with later developing social-communication skills

Methods: Participants included infants at high-risk (HR, N=13) and low-risk (LR, N=12) for ASD followed from 3-months through 12-months of age. At 3-months infants participated in a 30-second parent-infant interaction; parents were not touching or holding their infant to ensure the absence of potential external regulatory mechanisms. Parent-infant interactions were coded for the occurrence of self-regulatory gaze aversion (looking away from the caregiver) and self-soothing (“hand-to-mouth”). At 12-months, the Communication and Symbolic Behavior Scales (CSBS) was administered and the Social subscales were included as a measure of social-communicative ability. 

Results: Results revealed no significant differences between groups in the amount of time spent using either self-regulatory strategy. There was a significant association between the use of gaze aversion during parent-infant interactions at 3-months and nonverbal communication at 12-months for LR infants (r=.71,p<.05), but not HR infants (r=-.06,ns). A trend was observed for both HR and LR infants that suggested a negative association between self-soothing and nonverbal communication at 12-months (HR:r=-.45, LR:r=-.53, ns). That is, high rates of self-soothing at 3-months were associated with lower rates of nonverbal communication at 12-months. 

Conclusions: This study provides initial results indicating comparable use of self-regulatory strategies for high-risk and low-risk infants and unique relationships to social-communicative outcome. First, results suggest that using gaze aversion to self-regulate during social interactions promotes later social-communicative development for LR infants, but not HR infants. In contrast, self-soothing was marginally, negatively associated with nonverbal social-communication for both groups. Perhaps increased self-soothing is indicative of increased distress in response to social interaction, and thus these infants are less likely to communicate with an unfamiliar examiner in an unstructured setting at 12-months. Future analyses with additional participants will strengthen findings and further elucidate these patterns. Overall, this study highlights a novel approach for exploration of the unfolding of social behavior in very young infants and suggests that early self-regulatory strategies could provide a foundational context for the emergence of social-communication.