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Gaze behavior and affect at 6 months: predicting clinical outcomes and language development in typically developing infants and infants at risk for autism
Open accessAbstract
This paper presents follow‐up longitudinal data to research that previously suggested the possibility of abnormal gaze behavior marked by decreased eye contact in a subgroup of 6‐month‐old infants at risk for autism (Merin, Young, Ozonoff & Rogers, 2007). Using eye‐tracking data and behavioral data recorded during a live mother–infant interaction involving the still‐face procedure, the predictive utility of gaze behavior and affective behaviors at 6 months was examined using diagnostic outcome data obtained longitudinally over the following 18 months. Results revealed that none of the infants previously identified as showing lower rates of eye contact had any signs of autism at outcome. In contrast, three infants who were diagnosed with autism demonstrated consistent gaze to the eye region and typical affective responses at 6 months. Individual differences in face scanning and affective responsivity during the live interaction were not related to any continuous measures of symptom frequency or symptom severity. In contrast, results of growth curve models for language development revealed significant relationships between face scanning and expressive language. Greater amounts of fixation to the mother's mouth during live interaction predicted higher levels of expressive language at outcome and greater rates of growth. These findings suggest that although gaze behavior at 6 months may not provide early markers for autism as initially conceived, gaze to the mouth in particular may be useful in predicting individual differences in language development.
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“Several previous studies have also used the strategy of contrasting ASD with no ASD outcome collapsed across risk group [11, 67–72].”
From Reduced engagement with social stimuli in 6-month-old infants with later autism spectrum disorder: a longitudinal prospective study of infants at high familial risk (2016) · cites this paper as [72]
Experimental — accuracy not yet measuredIn the citing paper
“This appears consistent with the surprising finding that attention to faces in 6 month old at-risk infants is not associated with later ASD diagnosis (Young, Merin, Rogers, & Ozonoff, 2009)”
From Atypical attentional networks and the emergence of autism (2013) · cites this paper as Young, Merin, Rogers, & Ozonoff, 2009
In the citing paper
“Typical orienting to faces and eyes is measured in 6-months old Sib-A during live interaction (Ozonoff et al., 2010; Young, Merin, Rogers, & Ozonoff, 2009), but a decrease in orienting becomes apparent from 12 months (Ozonoff et al., 2010).”
From From early markers to neuro-developmental mechanisms of autism (2014) · cites this paper as Young, Merin, Rogers, & Ozonoff, 2009
In the citing paper
“Behavioral responses to the ‘still face’ paradigm were measured in studies of high-risk infants, but were found to be typical at 6 months in Sib-A (Rozga et al., 2011; Young et al., 2009).”
From From early markers to neuro-developmental mechanisms of autism (2014) · cites this paper as Young et al., 2009
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Damiano, C. R., Mazefsky, C. A., White, S. W., & Dichter, G. S. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.945214 · Cited by 86
Preterm birth is associated with atypical social orienting in infancy detected using eye tracking
Telford, E. J., Fletcher‐Watson, S., Gillespie‐Smith, K., Pataky, R., Sparrow, S. A., Murray, I. C., O'Hare, A. E., & Boardman, J. P. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12546 · Cited by 84
Gangi, D. N., Ibañez, L. V., & Messinger, D. S. (2013) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-2002-9 · Cited by 73
“For example, early differences in infants’ gaze patterns—less fixation to the eyes relative to the mouth in a mother-infant interaction at 6 months—were characteristic of a high-risk group, but this pattern was not associated with later ASD outcome (Young et al. 2009).”
BackgroundCan family affectedness inform infant sibling outcomes of autism spectrum disorders?
Schwichtenberg, A. J., Young, G. S., Sigman, M., Hutman, T., & Ozonoff, S. (2010) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02267.x · Cited by 67
“Previous infant sibling studies have assessed whether differences in visual fixation and disengagement (Zwaigenbaum, 2005), face processing (Young et al., 2009), early communication and joint attention behaviors (Landa & Garrett-Mayer, 2006), object exploration (Ozonoff et al.”
BackgroundSelf-citationSwanson, M. R., Serlin, G., & Siller, M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1616-7 · Cited by 64
“However, in a follow up study reduced gaze to the eyes at 6 months was not related to symptom severity or symptom frequency at 24 months (Young et al. 2009).”
BackgroundIs mere exposure enough? The effects of bilingual environments on infant cognitive development
D’Souza, D., Brady, D., Haensel, J. X., & D’Souza, H. (2020) · Royal Society Open Science · doi:10.1098/rsos.180191 · Cited by 67
“Insight may come from two infant studies which demonstrated that selective attention to a talking mouth (versus eyes) facilitates concurrent language learning [32] and predicts later expressive language development [33].”
Advances in the early detection of autism
Zwaigenbaum, L. (2010) · Current Opinion in Neurology · doi:10.1097/wco.0b013e3283372430 · Cited by 64
Mastergeorge, A. M., Kahathuduwa, C. N., & Blume, J. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04731-w · Cited by 64
Atypical Hemispheric Specialization for Faces in Infants at Risk for Autism Spectrum Disorder
Keehn, B., Vogel‐Farley, V., Tager‐Flusberg, H., & Nelson, C. A. (2015) · Autism Research · doi:10.1002/aur.1438 · Cited by 63
“Equivalent patterns of attention between HRA and LRC infants has been shown at 6-(Young, Merin, Rogers, & Ozonoff, 2009), 9-(Key & Stone, 2012), and 12-months (Dundas et al., 2012).”
de Boisferon, A. H., Tift, A. H., Minar, N. J., & Lewkowicz, D. J. (2016) · Developmental Science · doi:10.1111/desc.12381 · Cited by 69
“…studies with infants older than 6 months of age (Hunnius & Geuze, 2004; Lewkowicz & Hansen-Tift, 2012; Pons et al., 2015; Tenenbaum et al., 2013; Young et al., 2009) and suggests that the attentional shift to the mouth by 8 months of age reflects the emergence of an explicit interest in…”
BackgroundResultKwon, M., Moore, A., Barnes, C. C., Cha, D., & Pierce, K. (2019) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2018.12.011 · Cited by 61
Righi, G., Tenenbaum, E. J., McCormick, C. E. B., Blossom, M., Amso, D., & Sheinkopf, S. J. (2018) · Autism Research · doi:10.1002/aur.1918 · Cited by 60
“A number of studies have demonstrated that attention to the mouth and eyes is correlated with greater success in language learning [Tenenbaum et al., 2014; Young et al., 2009].”
BackgroundAttention and word learning in autistic, language delayed and typically developing children
Tenenbaum, E. J., Amso, D., Abar, B. W., & Sheinkopf, S. J. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00490 · Cited by 62
“Young et al. (2009) posited that attention to the mouth facilitates language development because infants who make use of visual information are better able to process the speech stream by relying on their already developed audiovisual integration.”
BackgroundMethodInfluentialShic, F., Wang, Q., Macari, S. L., & Chawarska, K. (2019) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13118 · Cited by 58
Infancy Guidelines for Publishing Eye‐Tracking Data
Oakes, L. M. (2010) · Infancy · doi:10.1111/j.1532-7078.2010.00030.x · Cited by 59
Processing of novel and familiar faces in infants at average and high risk for autism
Key, A. P. F., & Stone, W. L. (2011) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2011.12.003 · Cited by 57
Early social communication development in infants with autism spectrum disorder
Bradshaw, J. L., McCracken, C., Pileggi, M. L., Brane, N., Delehanty, A. D., Day, T. N., Federico, A., Klaiman, C., Saulnier, C. A., Klin, A., et al. (2021) · Child Development · doi:10.1111/cdev.13683 · Cited by 57
Multilevel Differences in Spontaneous Social Attention in Toddlers With Autism Spectrum Disorder
Chawarska, K., Ye, S., Shic, F., & Chen, L. (2015) · Child Development · doi:10.1111/cdev.12473 · Cited by 63
The influence of bilingualism on the preference for the mouth region of dynamic faces
Ayneto, A., & Sebastián‐Gallés, N. (2016) · Developmental Science · doi:10.1111/desc.12446 · Cited by 57
Neonatal imitation predicts how infants engage with faces
Paukner, A., Simpson, E. A., Ferrari, P. F., Mrozek, T., & Suomi, S. J. (2014) · Developmental Science · doi:10.1111/desc.12207 · Cited by 55
The role of early visual attention in social development
Wagner, J., Luyster, R., Yim, J. Y., Tager-Flusberg, H. B., & Nelson, C. A. (2013) · International Journal of Behavioral Development · doi:10.1177/0165025412468064 · Cited by 56
The redeployment of attention to the mouth of a talking face during the second year of life
de Boisferon, A. H., Tift, A. H., Minar, N. J., & Lewkowicz, D. J. (2018) · Journal of Experimental Child Psychology · doi:10.1016/j.jecp.2018.03.009 · Cited by 55
Fujioka, T., Tsuchiya, K. J., Saito, M., Hirano, Y., Matsuo, M., Kikuchi, M., Maegaki, Y., Choi, D., Kato, S., Yoshida, T., et al. (2020) · Molecular Autism · doi:10.1186/s13229-020-00321-w · Cited by 53
“5 years (6 months) old predicted expressive language at 2 years old [68], and participants up to 5 years who show significant language development may gaze longer at the mouth region at approximately 5 years old even in the faces without mouth motion.”
BackgroundInfants at risk for autism: a European perspective on current status, challenges and opportunities
Bölte, S., Marschik, P. B., Falck‐Ytter, T., Charman, T., Roeyers, H., & Elsabbagh, M. (2013) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-012-0368-4 · Cited by 56
“On the other hand, in a recent US study decreased eye contact in high-risk siblings at 6 months was not related at all to ASD outcome at 24 months [16, 26].”
BackgroundDundas, E. M., Gastgeb, H. Z., & Strauss, M. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-012-1523-y · Cited by 56
Early Social Experience Affects the Development of Eye Gaze Processing
Senju, A., Vernetti, A., Ganea, N., Hudry, K., Tucker, L. A., Charman, T., & Johnson, M. H. (2015) · Current Biology · doi:10.1016/j.cub.2015.10.019 · Cited by 63
“As past studies indicated the possible relationship between language development and face scanning [8, 14, 15] or gaze”
BackgroundDyadic Synchrony and Responsiveness in the First Year: Associations with Autism Risk
Kellerman, A. M., Schwichtenberg, A. J., Abu‐Zhaya, R., Miller, M. R., Young, G. S., & Ozonoff, S. J. (2020) · Autism Research · doi:10.1002/aur.2373 · Cited by 51
“Consistent with previous research, dyadic behaviors during the first year did distinguish between familial-risk status/outcome classifications and more optimal dyadic behaviors were associated with better language skills, regardless of outcome status [e.g., Young et al., 2009].”
ResultSelf-citationVisual attention and autistic behavior in infants with fragile X syndrome
Roberts, J. E., Hatton, D. D., Long, A. C. J., Anello, V., & Colombo, J. (2012) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1316-8 · Cited by 50
The Bidirectional Social-Cognitive Mechanisms of the Social-Attention Symptoms of Autism
Mundy, P. C., & Bullen, J. C. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.752274 · Cited by 57
de Klerk, C. C. J. M., Gliga, T., Charman, T., & Johnson, M. H. (2013) · Developmental Science · doi:10.1111/desc.12141 · Cited by 55
Application of Eye Tracking Technology in Medicine: A Bibliometric Analysis
Zammarchi, G., & Conversano, C. (2021) · Vision · doi:10.3390/vision5040056 · Cited by 51
“00 Face processing [31] Nacewicz et al.”
Autism spectrum disorder in infancy
Brian, J. A., Bryson, S. E., & Zwaigenbaum, L. (2015) · Current Opinion in Neurology · doi:10.1097/wco.0000000000000182 · Cited by 51
Infants at risk of autism and developmental disorders: Establishing early social skills.
Neimy, H., Peláez, M., Carrow, J. N., Monlux, K. D., & Tarbox, J. (2017) · Behavioral Development · doi:10.1037/bdb0000046 · Cited by 49
“For example, home videos of children with autism and typically developing children at 1 and 2 years of age revealed significantly lower levels of facial recognition, pointing, reaching, eye contact, gaze shifting, and joint attention when compared with typically developing children (Adrien et al., 1992; Osterling & Da…”
BackgroundFranchini, M., Armstrong, V. L., Schaer, M., & Smith, I. M. (2018) · Child Neuropsychology · doi:10.1080/09297049.2018.1490706 · Cited by 52
Metadata
- Authors
- Young, G. S., Merin, N., Rogers, S. J., & Ozonoff, S.
- Affiliations
- University of California, Davis (US)
- Corresponding author
- Young, Gregory S.
- Venue
- Developmental Science
- Publisher
- Wiley
- Published
- 2009-08-11
- Volume
- 12
- Issue
- 5
- Pages
- 798-814
- ISSN
- 1363-755X (ISSN-L)
- 1467-7687
- PMC
- PMC2732664
- OpenAlex
- W2034621560
- Cited by
- 368
- References
- 66
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 8 · 2023: 9 · 2022: 27 · 2021: 28 · 2020: 56 · 2019: 22 · 2018: 20 · 2017: 20 · 2016: 29 · 2015: 25 · 2014: 16 · 2013: 25 · 2012: 22
- FWCI
- 9.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Developmental Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH068398)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Language Development and Disorders
- Keywords
- gaze behavior, eye contact, autism risk, infants, facial scanning, expressive language development, still-face procedure, mother-infant interaction, language outcome prediction
- MeSH terms
- Adaptation, Psychological, Affect, Attention, Autistic Disorder, Child Development, Child, Preschool, Communication, Female, Fixation, Ocular, Humans, Infant, Language Development, Male, Mother-Child Relations, Neuropsychological Tests, Predictive Value of Tests, Risk Factors, Chi-Square Distribution
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