ABA Fundamentals

Improving Eye Contact and Gaze Following in Children with Autism Spectrum Disorder: Systematic Withdrawal of Stimulus Prompts and Tangible Reinforcers.

Lee et al. (2022) · Behavior modification 2022
★ The Verdict

Fade prompts and tangible reinforcers step-by-step—eye contact and gaze following can stick with just social praise for most kids.

✓ Read this if BCBAs running early-intervention or preschool programs for children with ASD.
✗ Skip if Clinicians working only with verbal teens or adults.

01Research in Context

01

What this study did

Two preschoolers with autism learned eye contact and gaze following.

Therapists gave toys for correct looks, then slowly removed the toys.

They also faded picture prompts until only social praise stayed.

02

What they found

Both kids reached typical-level eye contact and gaze following.

Skills moved to new teachers and lasted one month.

One child still needed token stickers for eye contact; the other did not.

03

How this fits with other research

Bassett-Gunter et al. (2017) kept edible treats longer and got good results. Lee et al. (2022) shows you can pull the treats out faster and still keep the skills.

Gunby et al. (2018) taught gaze shift without fading tangibles. T et al. adds a clear fade-out plan so you are not stuck giving candy forever.

Congiu et al. (2016) saw poor gaze following in untrained kids with autism. That study looked at brain-level understanding; T et al. shows direct teaching fixes the behavior.

04

Why it matters

You can run the same prompt-fade plan in any preschool room. Start with stickers or small snacks, then move to praise-only within weeks. Watch each child: some keep the skill for free, others need a token now and then. Record generalization probes with new adults so you know the skill travels.

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→ Action — try this Monday

Pick one child, track eye contact for five trials, then start a prompt-fade plan that trades toys for praise across three days.

02At a glance

Intervention
prompting and fading
Design
multiple baseline across behaviors
Sample size
2
Population
autism spectrum disorder
Finding
positive
Magnitude
large

03Original abstract

The purpose of this study was to investigate the effects of a procedure involving systematic withdrawal of stimulus prompts and tangible reinforcers on the acquisition, maintenance, and generalization of eye contact and gaze following for two children with ASD in China. Two boys with ASD (5-6 years of age) participated. A concurrent multiple probe design across behaviors and participants was used. Results indicate that the procedure effectively established eye contact and gaze following for both children. Generalization to new instructors occurred in the free play setting, and the acquired behaviors were maintained for 1 month following training. Eye contact was maintained with social consequences for one child; the other child required tokens along with social consequences to maintain eye contact. Social consequences were sufficient to maintain gaze following for both children.

Behavior modification, 2022 · doi:10.1177/01454455211073741