Leveraging Mutual Gaze to Facilitate Social Attention in Autistic Children

Social orienting (SO) and coordinated joint attention (CJA) are early-emerging social attention skills that are often challenging for young autistic children. Mutual gaze is increasingly recognized as a developmentally meaningful behavior that facilitates these social attention skills. This study examined the influence of mutual gaze-a core component of the Pathways Early Autism Intervention (Pathways)-on SO and CJA, both individually and combined within a unified measure.

A secondary analysis was conducted using data from 47 autistic children (18-47 months) who participated in a prior randomized controlled trial evaluating Pathways. Parent-child interaction videos were coded for SO and CJA at baseline and post-intervention. Principal component analysis was used to combine SO and CJA into a unified measure. Hierarchical regression analyses assessed the effects of intervention group on the unified and individual measures of SO and CJA.

Children receiving Pathways demonstrated significant gains on the unified measure of SO and CJA, as well as on SO individually, compared to children in the services-as-usual group. No significant intervention effect was found for individual measure of CJA.

This study advances theoretical understanding of how mutual gaze interventions may differentially influence components of early social attention. The results suggest that short-term interventions implementing mutual gaze strategies may more readily support improvements in SO, an early-developing perceptual-affective skill, than in CJA, which may require more time or scaffolding to change. These findings underscore the clinical value of targeting mutual gaze to promote foundational social attention skills in young autistic children.