Attention to intentional versus incidental pointing gestures in young autistic children: An eye-tracking study

Whereas a reduced tendency to follow pointing gestures is described as an early sign of autism, the literature on response to joint attention indicates that autistic children perform better when a point is added to other social cues such as eye gaze. The purpose of this study was to explore pointing processing in autism when it is the only available cue and to investigate whether autistic children discriminate intentional pointing gestures from incidental pointing gestures. Eye movements of 58 autistic children (48 male) and 61 typically developing children (36 male) aged 3-5 years were recorded as the children were watching videos of a person uttering a pseudoword and pointing intentionally with one hand and incidentally with the other hand. After 3 s, two different potential referents for the pseudoword gradually emerged in both pointed-at corners. In comparison with typically developing children, autistic children's fixations were significantly farther away from both pointed-at zones. Upon hearing a novel word, typically developing children shifted their visual attention toward the zone pointed intentionally. This trend did not emerge in the group of autistic children regardless of their level of vocabulary. Autistic children, independently of their level of language, pay little attention to pointing when no other social cues are available and fail to discriminate intentional pointing gestures from incidental ones. They seem to grasp neither the spatial nor the social value of pointing.