Autism spectrum disorder (ASD) is a complex and heterogeneous disorder that affects brain development and behaviour. It is believed to affect 1% to 2% of the general population, and its symptoms can appear as early as infancy or toddlerhood. Children with ASD may display atypical behaviours and patterns of restricted interest, and one of the more visible diagnostic criteria is a deficit in social skills and communication.
Social Skill Deficits in Children with ASD
Children with ASD seem to be less interested in people and more interested in other things in the environment. In studies, children with ASD pay more attention to objects or scenes than their social partners. This behaviour is not about a lack of attention; instead, it reflects their default behaviour of placing attention on objects or other interests. (Webb et al., 2017)
Children with ASD often display deficits in social skills, such as not maintaining eye contact, not responding to others, and not initiating social contact. With an intense focus on their areas of interest, it sometimes looks and feels like they live in a world of their own. They may not wish to maintain a conversation outside their interest, preferring to converse only about their interests. Moreover, since their focus of attention is not on people around them, they are often unaware of others’ thoughts and feelings. They cannot interpret verbal and nonverbal cues in social situations, leading to impairments in social communication and social skills.
Importance of Social Skills
Social skills are necessary for developing children as they facilitate relationship building, social learning and mental wellness. It fosters social integration and a sense of belonging. Children rely on social skills to communicate and interact with one another, such as initiating or responding to an invitation to play. Part of social skills is to be aware of social norms which guide appropriate speech and behaviour in different social settings, for example, taking turns in play, sharing toys or even joint problem-solving. More than speech, social communication includes other forms of verbal and non-verbal communication, such as gestures, body language, and facial expressions.
How Do Children with ASD Perceive Faces
From known behaviours, symptoms, and research, it is evident that children with ASD pay attention to and process social information differently from children with typical development. Many studies on scanning patterns and visual social attention, and gaze give us insight into how children with ASD see and process faces.
Understanding How They Scan Faces
In research from Wang et al. that sought to understand the face scanning patterns of children with ASD, they found that children with ASD have less consistent scanning patterns than children with typical development. Furthermore, they observed frequent changes to their inconsistent scanning patterns when presented with different faces. The variable and noisy scan patterns may delay and impair face processing, making them worse at recognising expressions of emotions. However, it does not affect their ability to identify faces. (2021b)
Their overly varied neural responses, as seen with the inconsistent scan patterns, reflect a less stable and predictable perception of the social environment. Humans, as compared to objects, exhibit more variable behaviours, thus social situations involve higher levels of unpredictability for children with ASD.
It is theorised that the erratic face scanning patterns create the perception of an unstable environment. For this reason, children with ASD may choose to retreat into the stability of repetitive behaviours and objects while avoiding social interaction. (Wang et al., 2021)
Understanding How They Process Faces
Babies are inclined to respond to faces more than other stimuli. As the infant grows, its face processing system develops from broad figure recognition into one finely tuned towards those frequently seen faces in its environment. However, it is not the same for children with ASD. The deficits in their face processing system, such as reduced eye contact and reduced use of facial information, would lead to an atypical trajectory of development, contributing to poor social skills and learning. (Webb et al., 2017)
A review of studies of face processing notes that children with ASD paid more attention to physical objects in their social environment, and if the objects moved, their fixation on them increased. When it came to faces, it took them significantly longer to habituate faces, suggesting a specific slowing in processing faces. When faces were included in the tasks, children with ASD quickly shifted their gaze to fixate on an object other than a face. This shift suggests that they can disengage from facial information easily compared to children with typical development. It may also indicate enhanced object processing and working memory for nonsocial stimuli.
In cases where they focused on the face, they paid more attention to the person’s mouth than the person’s eyes. During cognitive tasks, children with ASD appeared not to prioritise social information (such as the direction of gaze) over nonsocial information (such as the direction of an arrow). It also seems more challenging for them to detect direct eye contact from others. Children with ASD have fewer opportunities for eye contact, joint attention, and reciprocal social interaction, with diminished attention to faces and eyes.
Understanding How They Pay Social Attention
Besides the varied scanning patterns, researchers also looked at Visual Social Attention in children with ASD. This refers to the propensity of social stimuli (such as faces, eyes, gestures, and people) to affect visual attention.
Children with typical development learn early on in development how to prioritise visual information following other people’s gaze from as early as four months. By nine months, they can follow social cues and direct their attention to salient areas in the environment highlighted by others’ focus of attention. For instance, when an adult points at a bus, the child shifts their gaze to look at the bus. The bus becomes the shared focus of interest, and they share a moment in Joint Attention.
These episodes of joint attention and social feedback teach a child how and what to prioritise in their visual fields. They develop a priority map in how they scan their social environment. When doing a visual search or scan, the priority map directs their eye movements towards areas learnt as a priority. (Liberati et al., 2017)
Children with ASD, on the other hand, are less inclined to direct their visual social attention to another person’s social cues in natural contexts. They have atypical ways of exploring their visual field. Liberati et al. found that, compared to controls, the eyes of children with ASD moved quickly, simultaneously, and wider between one or more fixation points. Their eye movements were more dispersed when mapped on clustering analysis. (2017b)
The study hypothesised a few reasons for the wide dispersion of their eye movements. Children with ASD may not have developed a priority map in their developmental years; hence without a strategy, they over-explore their visual environment. Another possibility is that they intentionally switch their attention away from social cues and toward other stimuli, to avoid sensory overload. Lastly, the social stimuli presented to them may not be interesting or rewarding enough to motivate social interaction. As a result, they pay less attention to people.
Understanding Children with ASD
With the knowledge that children with ASD perceive and process faces in these atypical ways, we gain insight into their social behaviours and needs. As parents, teachers and caregivers, we can modify our approaches to meet them where they are. For example, we can increase the saliency of our social cues to improve their response towards them or to include physical objects with social stimuli.
These studies also help direct the course of future intervention strategies. Researchers have proposed to develop interventions that improve joint attention since the core of social learning, and social communication comes from being able to perceive and modify behaviour based on face perception.
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