Abstract
The study used an eye-tracking task to investigate whether preschool children with autism spectrum disorder (ASD) are able to make inferences about others’ behavior in terms of their mental states in a social setting. Fifty typically developing (TD) 4- and 5-year-olds and 22 5-year-olds with ASD participated in the study, where their eye-movements were recorded as automatic responses to given situations. The results show that unlike their TD peers, children with ASD failed to exhibit eye gaze patterns that reflect their ability to infer about others’ behavior by spontaneously encoding socially relevant information and attributing mental states to others. Implications of the findings were discussed in relation to the proposal that implicit/spontaneous Theory of Mind is persistently impaired in ASD.
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Notes
One reviewer suggested that we include the IQ scores of the seven participants who were excluded from the actual study. We have now calculated the IQ scores of the seven participants (mean = 103.18, SD = 11.54, range 90–124), and we wish to note that the seven participants were comparable with those who participated in the study on IQ scores.
Proportion of fixations is a now standard measure in assessing both children’s and adults’ cognitive abilities like language. We wish to extend this measure to other domains of cognition like ToM. We wanted to show that proportion of fixations is also a reliable eye gaze measure for assessing children’s social cognition like ToM. This is another novelty of the present study, in addition to using a novel task.
This comparison of fixation proportions on the man versus the tree was a response to one reviewer’s concern. The reviewer asked whether the lack an effect in the ASD group as compared to the TD groups could be due to the ASD group’s reduced tendency to fixate on the man as compared to the tree. The comparison showed that no difference in fixation proportions was observed on the two agents for all the three groups (see also Fig. 6; Table 2), excluding this alternative explanation.
In an eye tracking study using the visual world paradigm, participants’ current fixation in a specific area is heavily dependent on their previous fixation, both on the temporal dimension and on the spatial dimension. In addition, proportion of fixations (based on fixation count) is categorical in nature and bounded by the values 0 and 1, which follows a multinomial distribution rather than a normal distribution. Therefore, traditional statistical methods based on the hypotheses of independent sampling and normal distribution such as t tests and ANOVAs cannot be directly applied. It has now become a standard procedure to analyse the fixation data using generalised linear mixed models (GLMMs) that do not require the assumption of normal distribution (Barr 2008; Jaeger 2008; Zhan 2018).
One reviewer suggested that we could also run t-tests on differential looking scores. We have followed the reviewer’s suggestion and analysed the differential looking scores using t tests. The t tests yielded similar statistical results and thus confirmed our observations using GLMMs. The t-tests results are provided in “Appendix A” section.
One reviewer pointed out that the recognition of this deficit in making social inferences by parents and teachers should have an effect on how they respond to an affected child with ASD in both classroom and social settings, and then suggested that feedback in a cognitive remediation paradigm might have beneficial effects on high-functioning children with ASD. The idea is to improve their abilities to pause and think if they have correctly utilized information that they know in making social inferences, and in making children aware of their deficit in the capacity to make social inferences, we might improve their abilities to socially interact and communicate. We thank the reviewer for this helpful suggestion in designing treatment plans and this is definitely a future direction that is worth exploring.
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Acknowledgments
This work was supported by the National Social Science Foundation of China [Grant No. 16BYY076] to Peng Zhou. The authors would like to thank the children, the parents and the teachers at the Enqi Autism Platform and at the Taolifangyuan Kindergarten, Beijing, China, for their assistance and support in running the study.
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PZ conceived of the study, designed and implemented the study, performed the statistical analysis and the interpretation of the data, and drafted and revised the manuscript; LZ participated in designing and implementing the study, performing the statistical analysis and interpreting the data; HM participated in designing the study and interpreting the data.
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Appendix A
Appendix A
T-Tests Results on the Differential Looking Scores Between the Two Critical Conditions
Following one reviewer’s suggestion, we conducted a series of t tests on the differential looking scores between the two critical conditions. To conduct the analyses, we first calculated the differential scores between participants’ fixations when the agent was a man versus when the agent was a tree. We then used t tests to determine whether the difference was significantly different from zero. If it was, then this was treated as a significant difference between the two critical conditions. The results are summarized in the table below. The t tests yielded similar statistical results and thus confirmed our observations using GLMMs.
Area of interest | Group | Difference | t value | df | p value | Sig. |
|---|---|---|---|---|---|---|
High box | ||||||
ASD 5-year-olds | 0.18 | 1.47 | 21 | 0.16 | ||
TD 4-year-olds | 0.40 | 3.16 | 24 | 0.00 | ** | |
TD 5-year-olds | 0.38 | 4.63 | 24 | 0.00 | *** | |
Low box | ||||||
ASD 5-year-olds | − 0.06 | − 0.51 | 21 | 0.62 | ||
TD 4-year-olds | − 0.02 | − 0.12 | 24 | 0.91 | ||
TD 5-year-olds | 0.21 | 1.36 | 24 | 0.19 | ||
Agent | ||||||
ASD 5-year-olds | 0.18 | 0.70 | 21 | 0.49 | ||
TD 4-year-olds | 0.02 | 0.15 | 24 | 0.88 | ||
TD 5-year-olds | − 0.14 | − 0.63 | 24 | 0.53 | ||
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Zhou, P., Zhan, L. & Ma, H. Understanding Others’ Minds: Social Inference in Preschool Children with Autism Spectrum Disorder. J Autism Dev Disord 49, 4523–4534 (2019). https://doi.org/10.1007/s10803-019-04167-x
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DOI: https://doi.org/10.1007/s10803-019-04167-x