Eye- Versus Mouth-Looking Patterns in Emotional Contexts in Children with ASD

Background: Previous literature reports that toddlers with ASD show increased looking at mouths compared to typically developing (TD) toddlers (Jones, Carr & Klin, 2008). However, other studies have found no between-group differences in eyes/mouth attention, though associations between attention to the mouth and language skills have been noted (Guillon, Hadjikhani, Baduel & Roge, 2014). Additional work suggests an important role of context, e.g. Hutchings & Brien (2016) report that children with ASD look more at the mouth when discussing feelings but not actions, with higher mouth gazing associated with poorer verbal ability. The evidence remains unclear as to whether eye- versus mouth-looking patterns can be differentiated between children with and without ASD, and whether the discrepancies are generally moderated by emotional context.

Objectives: To examine looking at the eye versus mouth in children with ASD versus non-ASD during a social-information-seeking task depicting escalating emotional expression.

Methods: Thirty-six 4 to 8 year-olds, ASD n = 14 (MDQ= 88, SD = 20) and non-ASD n = 22 (MDQ= 109, SD=12), watched a video of an actress involved in a stressful activity (e.g. blowing up a balloon until it pops) that ends in a Resolution (e.g. actress sighs in relief after balloon pops). Previous eye tracking analyses had shown that children with ASD spent significantly less time looking at the face (Face%) during the Resolution than non-ASD children (p < .05) (Foster et al., unpublished). We examined the components of %Face to examine between-group differences in eye- and mouth-looking (%Eyes and %Mouth) within this escalating emotional context.

Results: Immediately prior to the Resolution, there was no difference in face, eye or mouth gaze allocations between ASD and non-ASD children (see Figure 1). During the Resolution, there was a main effect of diagnosis on %Mouth (F(1,36), p < .05, ηp2 = .157) with children with ASD spending less time on the mouth (M = .76, SD = .42) than non-ASD children (M = .13, SD = .06). No diagnosis effect on %Eyes was observed between non-ASD and ASD (Ms = .22 and .17, SDs = .03 and .03, respectively). Across all participants, there was a positive correlation between %Mouth and DAS-II Verbal Reasoning Standard Scores (r = .381, p < .05).

Conclusions: Children with ASD spend less time viewing the face than do non-ASD children in Emotional Contexts but the difference is driven by lower mouth- as opposed to eye-scanning. Given that the Resolution sets up the expectation of an emotional context, it could be that non-ASD children look to the mouth for additional input during periods of emotional expectation, a tendency that may not be developed in children with ASD. If so, then the results support studies that find mouth gazing to be a functional and adaptive behavior that can supplement other communicative visual cues, especially in situations that warrant context deduction (i.e. how is the actress feeling now). However, the correlation between %Mouth and verbal scores suggests an alternative interpretation which links insensitivity to cues during Resolution to communicative competence rather than social disability, specifically.

See more of: Social Cognition and Social Behavior II
See more of: Social Cognition and Social Behavior