Gaze behavior and affect at 6 months: predicting clinical outcomes and language development in typically developing infants and infants at risk for autism

“…order to account for the possibility that expressive language may mediate the relationship between socialization scores and eye-mouth index scores (see Baron & Kenny, 1986), especially given the previous findings for expressive language and face scanning, a follow-up analysis was conducted using…”

“Perhaps one of the most long-standing lines of research demonstrating this is the McGurk effect (McGurk & MacDonald, 1976) which consists of the alteration of speech perception with the presentation of synchronized but unrelated audio and video input (e.g., the sound [ba] and the image of [ga]…”

“The interpretation offered by Klin et al. (2002) was that decreased gaze to the eyes, and the concomitant increased gaze to the mouth, was a compensatory strategy for increasing one’s understanding of social situations by focusing on language, a strategy revealed in higher socialization domain scores.”

“As noted, the interaction was structured using the still-face procedure developed by Tronick et al. (1978).”

“Indeed, other recent longitudinal studies examining diagnostic outcome of at-risk infants have not found any measurable differences at 6 months of age between those infants who were later diagnosed with autism and those who were not (e.g., Landa & Garrett-Mayer, 2006; Zwaigenbaum et al., 2005).”

“The Merin et al. (2007) study hypothesized that infants at risk for autism would exhibit abnormal gaze fixation patterns to the face.”

“…-PA Author M anuscript N IH -PA Author M anuscript perhaps initially facilitated by an infant’s ability to perceive the phonemic building blocks of spoken language (Aldridge, Stillman, & Bower, 2001; Eimas, Siqueland, Jusczyk, & Vigorito, 1971; Jusczyk & Aslin, 1995; Maye, Werker, & Gerken, 2002).”

“Even in infants as young as 2 months of age, visual input of speech is readily integrated with auditory input (Burnham & Dodd, 2004; Kuhl & Meltzoff, 1982; Patterson & Werker, 2003).”

“This strategy also allowed us to examine more subtle change in autism symptoms at different outcome ages by estimating within-subject error variances in a repeated measures model (Hardin & Hilbe, 2003).”

“…screening studies that have suggested observable deficits in social orientation and attention in the first year of life (e.g., Dietz et al., 2006; Osterling et al., 2002), and b) a variety of eye-tracking studies suggesting that older individuals with autism look significantly less at the eyes…”

“Indeed, other recent longitudinal studies examining diagnostic outcome of at-risk infants have not found any measurable differences at 6 months of age between those infants who were later diagnosed with autism and those who were not (e.g., Landa & Garrett-Mayer, 2006; Zwaigenbaum et al., 2005).”

“…typically diagnosed in the preschool years (Mandell, Novak, & Zuritsky, 2005), the dramatic social, emotional, and financial costs of the disorder (Ganz, 2007), coupled with the recent reports of increased prevalence rates (e.g., Baird et al., 2006; CDC, 2007) has given a particular sense of…”

“The degree to which such areas may be specifically impaired in autism compared to other disorders may ultimately provide important clues to the nature of language deficits in autism (cf., Oberman & Ramachandran, 2007).”

“…more gaze to the mouth region in autism than in comparison subjects (e.g., Hobson, Ouston, & Lee, 1988, Joseph & Tanaka, 2003; Klin et al., 2002; Langdell, 1978; Spezio et al., 2007).2 A third reason for using the eye-mouth index was the fact that gaze to the inner region of the face (i.e.,…”

“…the proposals that decreased social orientation in general and gaze to eyes in particular may be core behavioral features of autism that cascade throughout early development causing collateral deficits in theory of mind and language development (e.g., Dawson, Webb, & McPartland, 2005; Mundy, 2003).”

“…reported less gaze to the eye region and more gaze to the mouth region in autism than in comparison subjects (e.g., Hobson, Ouston, & Lee, 1988, Joseph & Tanaka, 2003; Klin et al., 2002; Langdell, 1978; Spezio et al., 2007).2 A third reason for using the eye-mouth index was the fact that gaze…”

“…the mouth region in autism than in comparison subjects (e.g., Hobson, Ouston, & Lee, 1988, Joseph & Tanaka, 2003; Klin et al., 2002; Langdell, 1978; Spezio et al., 2007).2 A third reason for using the eye-mouth index was the fact that gaze to the inner region of the face (i.e., left and right…”

“…and much milder features of autism symptoms such as language difficulties and poor social reciprocity found at greater rates in first-degree relatives of individuals with autism (Bailey, Palferman, Heavey, & Le Couteur, 1998; Stone, McMahon, Yoder, & Walden, 2007; Yirmiya et al., 2006).”

“Even in infants as young as 2 months of age, visual input of speech is readily integrated with auditory input (Burnham & Dodd, 2004; Kuhl & Meltzoff, 1982; Patterson & Werker, 2003).”

“Even in infants as young as 2 months of age, visual input of speech is readily integrated with auditory input (Burnham & Dodd, 2004; Kuhl & Meltzoff, 1982; Patterson & Werker, 2003).”

“, Dietz et al., 2006; Osterling et al., 2002), and b) a variety of eye-tracking studies suggesting that older individuals with autism look significantly less at the eyes when viewing static faces or dynamic social stimuli (e.g., Klin, Jones, Schultz, Volkmar, & Cohen, 2002; Speer, Cook, McMahon, & Clark, 2007; Spezio,…”

“…index and inner-outer face index were proportion scores, and that proportions have, by definition, a non-constant variance, we calculated the inverse sine of the square-root of these proportion scores in order to normalize the distribution and to stabilize the variance (Mosteller & Youtz, 1961).”

“As detailed in Merin et al. (2007), a number of infant behaviors during the mother-infant interaction were reliably coded from video and shown to be sensitive to the mother-infant interaction conditions.”

“For instance, Cassel et al. (2007) reported significantly less smiling during face-to-face interactions in high-risk infants at 6 months of age compared to low-risk infants. Similarly, Yirmiya et al. (2006) reported that high-risk infants at 4 months of age tended to be less upset by the still-face procedure than comp…”

“Recent research examining audiovisual speech integration in adolescents with autism using a speech-in-noise paradigm, has indeed demonstrated significant deficits in such integration (Alacantra, Weisblatt, Moore, & Bolton, 2004; Smith & Bennetto, 2007).”

“Consistent with prior research using the still-face paradigm (e.g., Gusella, Muir, & Tronick, 1988; Tarabulsy et al., 2003; Toda & Fogel, 1993; Tronick et al., 1978), all infants, regardless of risk-status, showed a significant decrease in smiling behavior and a significant increase in gaze…”

“…(e.g., Chawarska, Klin, Paul, & Volkmar, 2007), such diagnostic instability is relatively subtle (typically encompassing changes between a formal autism diagnosis to a more mild autism spectrum disorder) and appears to be due more to false positives than to false negatives (Turner & Stone, 2007).”

“Clearly, language development is severely affected in autism (see Tager-Flusberg & Caronna, 2007 for a review).”

“Nevertheless, it might still be argued that speech perception is primarily, if not entirely dependent on acoustic properties of speech (Ohala, 1996) and that individual differences in early speech perception abilities have little to do with visual attention to the mouth.”

“Moreover, this deficit is consistent with more general accounts of significant deficits in cross-modal integration (e.g., see Iarocci & McDonald, 2006), and in the visual processing of biological motion (e.g., Blake, Turner, Smoski, Pozdol & Stone, 2003; Gepner & Mestre, 2002).”

“Research on the links between cortical motor centers and speech perception (e.g., Fadiga, Craighero, Buccino, & Rizzolatti, 2002; Pekkola et al., 2006; Skipper, Nusbaum, & Small, 2005) further suggests that deficits in audiovisual integration during speech perception might be a function of…”

“Indeed, the majority of infant siblings of children with autism will exhibit typical development (Yirmiya & Ozonoff, 2007).”

“Consistent with prior research using the still-face paradigm (e.g., Gusella, Muir, & Tronick, 1988; Tarabulsy et al., 2003; Toda & Fogel, 1993; Tronick et al., 1978), all infants, regardless of risk-status, showed a significant decrease in smiling behavior and a significant increase in gaze aversion and negative affec…”

“Consistent with another report of 6-month-olds with ASD (27), no marked differences were found in the distribution of their attention to eyes or mouth.”

“mother’s mouth at 6 mo score higher on expressive language, size of vocabulary, and socialization measures at 24 mo of age (42).”

“5) [12-41] 24.”