Measuring social attention and motivation in autism spectrum disorder using eye-tracking: Stimulus type matters

Autism Spectrum Disorder (ASD) is characterized by social impairments that have been related to deficits in social attention, including diminished gaze to faces. Eye-tracking studies are commonly used to examine social attention and social motivation in ASD, but they vary in sensitivity. In this study, we hypothesized that the ecological nature of the social stimuli would affect participants' social attention, with gaze behavior during more naturalistic scenes being most predictive of ASD vs. typical development. Eighty-one children with and without ASD participated in three eye-tracking tasks that differed in the ecological relevance of the social stimuli. In the "Static Visual Exploration" task, static images of objects and people were presented; in the "Dynamic Visual Exploration" task, video clips of individual faces and objects were presented side-by-side; in the "Interactive Visual Exploration" task, video clips of children playing with objects in a naturalistic context were presented. Our analyses uncovered a three-way interaction between Task, Social vs. Object Stimuli, and Diagnosis. This interaction was driven by group differences on one task only-the Interactive task. Bayesian analyses confirmed that the other two tasks were insensitive to group membership. In addition, receiver operating characteristic analyses demonstrated that, unlike the other two tasks, the Interactive task had significant classification power. The ecological relevance of social stimuli is an important factor to consider for eye-tracking studies aiming to measure social attention and motivation in ASD.