Feedback-Driven Learning Through Eye Movements in Autism Spectrum Disorder

Individuals with Autism Spectrum Disorder (ASD) face challenges in cognitive flexibility and rule-shifting. This study investigated a computerized Wisconsin Card Sorting Task (WCST) paired with eye-tracking to understand the cognitive dynamics of set-shifting difficulties in autistic children and adolescents. The study included 21 Spanish-speaking autistic children and adolescents (mean age: 14.5 years) and 22 typically developing peers (mean age: 15.1), matched by gender, age, language, working memory, and intelligence. Participants sorted cards by number, color, or shape, receiving feedback after each trial. The sorting criterion changed after 10 correct responses without participants' prior knowledge. The task included 128 trials, followed by three strategy-related verbal questions. Behavioral and eye movement data showed that the autistic group performed worse, completing fewer sets and making more errors. Both groups had increased fixations and dwell time after feedback, but controls had a greater increase after incorrect responses. Autistic individuals may struggle with error monitoring and response inhibition, impacting their adaptability and less efficient learning of sorting rules. They engaged less in error analysis and correction than controls. Targeted interventions to enhance feedback processing and adaptive learning strategies could benefit autistic individuals. Future research should explore mechanisms behind eye-movement differences and the effectiveness of related interventions.