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Updated: Aug 16, 2025

Eye Tracking Young Children with Autism
Published on: March 27, 2012
High-Risk Siblings without Autism: Insights from a Clinical and Eye-Tracking Study
Valeria Costanzo1, Antonio Narzisi1, Sonia Cerullo2
1Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Calambrone, Italy.
Insights
High-risk toddlers without autism spectrum disorder (ASD) show unique social attention patterns. These unaffected siblings exhibit some typical development (TD) gaze behaviors but also share looking patterns with children with ASD.
Area of Science:
- Developmental Psychology
- Neuroscience
- Clinical Psychology
Background:
- Joint attention (JA) is crucial for social development and is impaired in Autism Spectrum Disorder (ASD).
- Limited understanding exists regarding JA skills in high-risk (HR) siblings who do not develop ASD.
- Investigating these siblings offers insights into early social attention development and potential risk factors.
Purpose of the Study:
- To examine joint attention (JA) skills in toddlers with ASD, high-risk (HR) siblings without ASD, and typically developing (TD) controls.
- To characterize the visual attention patterns during initiating joint attention (IJA) tasks in these groups.
- To understand the social attention profile of HR-noASD toddlers.
Main Methods:
- A prospective multicenter observational study involving three groups: ASD, HR-noASD, and TD toddlers (18-33 months).
- Comprehensive clinical assessments and eye-tracking experiments using pre-recorded stimuli for IJA tasks.
- Analysis of visual patterns including fixations, transitions, and gaze alternations.
Main Results:
- HR-noASD toddlers showed lower non-verbal cognitive skills than TD children.
- Compared to ASD children, HR-noASD toddlers had similar restricted/repetitive behaviors but better social communication.
- Eye-tracking revealed HR-noASD toddlers had TD-like target-object-to-face gaze alternations but ASD-like not-target-object-to-face gaze alternations.
Conclusions:
- High-risk, unaffected siblings display a mixed profile of initiating joint attention (IJA) eye-tracking measures.
- Their visual patterns share similarities with both ASD and TD groups, offering new insights into social attention.
- This suggests a unique social attention profile in toddlers with unaffected high-risk status.
Abstract:
Joint attention (JA)-the human ability to coordinate our attention with that of other people-is impaired in the early stage of Autism Spectrum Disorder (ASD). However, little is known about the JA skills in the younger siblings of children with ASD who do not develop ASD at 36 months of age [high-risk (HR)-noASD]. In order to advance our understanding of this topic, a prospective multicenter observational study was conducted with three groups of toddlers (age range: 18-33 months): 17 with ASD, 19 with HR-noASD and 16 with typical development (TD). All subjects underwent a comprehensive clinical assessment and an eye-tracking experiment with pre-recorded stimuli in which the visual patterns during two tasks eliciting initiating joint attention (IJA) were measured. Specifically, fixations, transitions and alternating gaze were analyzed. Clinical evaluation revealed that HR-noASD subjects had lower non-verbal cognitive skills than TD children, while similar levels of restricted and repetitive behaviors and better social communication skills were detected in comparison with ASD children. Eye-tracking paradigms indicated that HR-noASD toddlers had visual patterns resembling TD in terms of target-object-to-face gaze alternations, while their looking behaviors were similar to ASD toddlers regarding not-target-object-to-face gaze alternations. This study indicated that high-risk, unaffected siblings displayed a shared profile of IJA-eye-tracking measures with both ASD patients and TD controls, providing new insights into the characterization of social attention in this group of toddlers.
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