Attention to eyes is present but in decline in 2-6-month-old infants later diagnosed with autism

Nature. 2013 Dec 19;504(7480):427-31. doi: 10.1038/nature12715. Epub 2013 Nov 6.

Abstract

Deficits in eye contact have been a hallmark of autism since the condition's initial description. They are cited widely as a diagnostic feature and figure prominently in clinical instruments; however, the early onset of these deficits has not been known. Here we show in a prospective longitudinal study that infants later diagnosed with autism spectrum disorders (ASDs) exhibit mean decline in eye fixation from 2 to 6 months of age, a pattern not observed in infants who do not develop ASD. These observations mark the earliest known indicators of social disability in infancy, but also falsify a prior hypothesis: in the first months of life, this basic mechanism of social adaptive action--eye looking--is not immediately diminished in infants later diagnosed with ASD; instead, eye looking appears to begin at normative levels prior to decline. The timing of decline highlights a narrow developmental window and reveals the early derailment of processes that would otherwise have a key role in canalizing typical social development. Finally, the observation of this decline in eye fixation--rather than outright absence--offers a promising opportunity for early intervention that could build on the apparent preservation of mechanisms subserving reflexive initial orientation towards the eyes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autistic Disorder / diagnosis*
  • Autistic Disorder / physiopathology*
  • Case-Control Studies
  • Child Development
  • Child, Preschool
  • Disease Susceptibility
  • Eye Movements* / physiology
  • Female
  • Fixation, Ocular / physiology
  • Humans
  • Infant
  • Longitudinal Studies
  • Male
  • Risk
  • Social Behavior