Conversational topic moderates visual attention to faces in autism spectrum disorder

Autism Spectrum Disorder (ASD) is often accompanied by atypical visual attention to faces. Previous studies have identified some predictors of atypical visual attention in ASD but very few have explored the role of conversational context. In this study, the fixation patterns of 19 typically developing (TD) children and 18 children with ASD were assessed during a SKYPED conversation where participants were asked to converse about mundane vs. emotion-laden topics. We hypothesized that 1) children with ASD would visually attend less to the eye region and more to the mouth region of the face compared to TD children and that 2) this effect would be exaggerated in the emotion-laden conversation. With regard to hypothesis 1, we found no difference between groups for either number of fixations or fixation time; however, children with ASD did evidence significantly more off-screen looking time compared to their TD peers. An additional analysis showed that compared to the TD group, the ASD group also had greater average fixation durations when looking at their speaking partner's face (both eyes and mouth) across conversational contexts. In support of hypothesis 2, eye tracking data (corrected for amount of time during conversation) revealed two interaction effects. Compared to the TD group, the ASD group showed 1) a decreased number of fixations to eyes and 2) an increased fixation time to mouths but only in the emotion-laden conversation. We also examined variables that predicted decreased number of eye fixations and increased mouth-looking in ASD in the emotion-laden conversation. Change scores (to be understood as the degree of visual attention shifting from the mundane to the emotion-laden condition) for the ASD group negatively correlated with age, perceptual reasoning skills, verbal ability, general IQ, theory of mind (ToM) competence, executive function (EF) subscales, and positively correlated with autism severity. Cognitive mechanisms at play and implications for theory and clinical practice are considered.