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Home Exclusive Mental Health Autism

Children with autism show different patterns of attention during shared book reading, new study finds

by Eric W. Dolan
May 18, 2024
in Autism, Developmental Psychology
(Photo credit: Adobe Stock)

(Photo credit: Adobe Stock)

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A recent study reveals that children with autism spectrum disorder exhibit different patterns of attention compared to their neurotypical peers during shared book reading activities. Researchers found that autistic children tend to pay less attention to socially relevant cues, such as the reader’s face and the book, and more attention to nonsocial background objects. These findings have significant implications for understanding social learning and engagement in children with autism and suggest potential pathways for developing supportive interventions.

The new research was published in the Journal of Child Psychology and Psychiatry.

Social attention, the ability to focus on social cues such as faces and eye contact, is crucial for social, cognitive, and language development. Previous research has shown that children with autism often have reduced attention to social stimuli, impacting their development and learning. Given the importance of early intervention, the new study aimed to investigate how autistic and neurotypical children allocate their attention during a common educational activity—shared book reading.

“We wanted to try to develop an observation task that involves rich social learning behaviors so that we could understand responses that children have to these social scenarios,” said study author Adam Guastella, a clinical psychologist, the Michael Crouch Chair in Child and Youth Mental Health, and head of the Clinic for Autism and Neurodevelopmental Research at the University of Sydney’s Brain and Mind Centre.

“Social book reading is almost a universal task that caregivers and teachers do with children for learning and development. It involves lots of pointing, gesturing, joint attention opportunities, emotion expressions, and a lot of teaching moments. I even remember watching shows like ‘Play School’ where this reading behaviour was conducted daily to teach children over the TV.”

“Social book reading with caregivers has been linked to lots of good outcomes, such as vocabulary and academic development for children long term, and bonding between caregivers and their children. The way children engage and learn in such scenarios can teach us a lot about their own development and what supports they might need to learn.”

The study involved 90 children aged 3 to 12 years, including 56 diagnosed with autism and 34 neurotypical children. The participants were recruited from various sources, including the Clinic for Autism and Neurodevelopmental Research at the University of Sydney. The researchers ensured the groups were matched in age and gender to make valid comparisons.

Participants watched one of four videos of an adult reading a picture book. The setup was designed to mimic a naturalistic shared book reading environment, with toys and household objects in the background. Each video included eight bids for joint attention, where the reader made deliberate efforts to engage the child by pointing to illustrations and making comments or asking questions.

The children’s eye movements were tracked using a high-resolution eye-tracking system. This allowed researchers to measure how long the children spent looking at different areas of interest: the reader’s face, the book, the joint attention targets, and the background objects.

The researchers found that autistic children spent significantly less time focusing on the reader’s face and the book itself—areas of social relevance—compared to their neurotypical peers. Instead, they directed more of their attention toward nonsocial background objects. This shift in focus suggests that autistic children might find it challenging to engage with the socially rich aspects of shared book reading, which could have implications for their social, cognitive, and language development.

During the joint attention episodes — when the reader deliberately tried to engage the child by pointing to illustrations and making comments or asking questions — autistic children again showed reduced attention to the social aspects of the task. They were less likely to look at the reader’s face and the target illustrations meant to capture their interest. Instead, their attention remained more on the background objects.

“Time spent with children reading and teaching them is not only an opportunity to teach children about books and reading, it’s also a rich social learning opportunity to teach about how to engage in conversations, to ask questions and to join in emotive and fun discussions with imagination,” Guastella told PsyPost. “It really is a great opportunity to develop skills that can be important across the lifespan.”

“Our study shows that some kids have greater difficulty engaging in tasks, they can be easily distracted, or struggle more to get into storytelling. While our study shows that such challenges may represent markers for neurodevelopmental delays, our future work will look at how to provide supports to children to help ensure that they get the best opportunity to learn from such scenarios.”

The study also examined how these attention patterns related to various developmental measures within the autistic group. It found that children with better receptive language skills and higher nonverbal IQ were more likely to focus on the socially relevant aspects of the shared book reading task.

In contrast, those with higher levels of symptoms associated with autism showed greater attention to the nonsocial background objects. These correlations suggest that improving cognitive and language skills might help autistic children engage more with social stimuli during shared activities.

Children who spent more time focusing on socially relevant cues during the task also tended to engage similarly during free play with an assessor. This finding suggests that the patterns of social attention observed in a structured task like shared book reading might predict how children will behave in more natural, unstructured social interactions.

“I was surprised how well the gaze patterns kids had when watching these book reading videos mapped onto clinical assessment tools that track cognition, learning and development,” Guastella said. “I was also surprised that gaze spent engaged in the book tracked onto gaze in real play. I thought it would be a good task to understand development, but the data is very positive.”

The findings emphasize the challenges autistic children face in social engagement and highlight the need for tailored interventions. By understanding these attention patterns, educators and caregivers can develop strategies to better support autistic children’s social learning.

“I want to make sure we get sensitive measures of development that are relevant for everyday life,” Guastella said. “I think this task as a lot of relevance and if we test in many different populations we can see how well it tracks for development in kids with different needs. Most importantly, I want to see if we can develop supports that can help kids engage more and to see whether these supports can make a difference in everyday life.”

“Finally, we really lack good social measures that can be used in clinical trials to understand whether children are improving in their social learning. I think tasks such as this could be very very good to show whether kids are learning more effectively.”

The study, “Social and joint attention during shared book reading in young autistic children: a potential marker for social development,” was authored by Zahava Ambarchi, Kelsie A. Boulton, Rinku Thapa, Joanne Arciuli, Marilena M. DeMayo, Ian B. Hickie, Emma E. Thomas, and Adam J. Guastella.

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