Eye-tracking measures of social versus nonsocial attention are related to level of social engagement during naturalistic caregiver-child interactions in autistic children.
Where an autistic child looks in a short lab clip—toys versus mouths—predicts later social play with caregivers, and the pattern flips by sex.
01Research in Context
What this study did
The team used eye-tracking while autistic kids watched short clips of an adult playing. They coded how long each child looked at toys, the adult’s mouth, or other spots. Then they filmed the same kids playing with their own caregivers and scored how socially engaged each child acted. Finally they asked whether the lab looking pattern predicted real-life play.
They also checked if the child’s sex changed the link between looking and engagement.
What they found
Kids who stared longer at toys in the lab later showed less shared smiling, talking, and turn-taking with caregivers. Kids who looked more at the adult’s mouth had more coordinated play. The toy-looking effect only held for boys; girls’ social engagement did not drop even when they looked a lot at toys.
How this fits with other research
The mouth-looking link backs up Gutierrez et al. (1998) and Caldani et al. (2020), who also found that mouth gaze is a strong social cue for autistic children. The toy-looking sex split extends Catania et al. (1982), an old paper that first noted boys with autism score lower on social-cognitive tasks than girls. It also aligns with the brand-new Agiovlasitis et al. (2025) report that autistic boys show less “male-typical” toy play than non-autistic boys, while girls look about the same. Król et al. (2020) used a similar eye-tracking set-up and saw the same pull toward nonsocial images, but they did not test real-world play, so the 2023 paper is the first to bridge lab looking time to live caregiver fun.
Why it matters
You can run a two-minute eye-tracking clip and get a heads-up on which kids may struggle to stay social during play. If a boy locks onto objects, plan extra social prompts and shared toy routines. If a girl does the same, don’t assume low engagement will follow; keep your usual interaction goals. Mouth-looking is a green light for coordinated play, so reinforce it when you see it in either sex.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a quick mouth-gaze prompt to your play routine: hold the toy near your face and wait for the child’s eyes to shift to your mouth before you hand it over.
02At a glance
03Original abstract
Eye-tracking (ET) measures indexing social attention have been proposed as sensitive measures related to autism, but less is known about the relationship between social and nonsocial attention and naturalistic measures of social engagement and whether sex moderates this relationship. This study investigated ET measures of social attention as predictors of social engagement during a naturalistic caregiver-child interaction (CCI). Participants included 132, 2-7-year-old autistic children (77% male) and their caregivers. Participants engaged in a CCI and an ET task in which they viewed a video of an actor making dyadic bids toward the child with toys in the background. Pearson correlations and multiple regression analyzes revealed that ET measures correlated with social engagement behaviors, including degree of attention to the caregiver and objects, joint engagement with the caregiver, and language-based joint engagement. Children who spent more time looking at toys were more likely to be unengaged during social interaction. Those who spent more time looking at the actor's mouth were more likely to engage in coordinated play with and without language. Sex moderated the relationship between time looking at toys and unengagement during play; males who spent more time looking at toys spent more time unengaged during play, whereas females who spent more time looking at toys spent less time unengaged during play. Overall, ET measures of social and nonsocial attention correlated with the level of social engagement during naturalistic play, with some sex differences. Eye-tracking measures that predict interaction patterns may provide insight into promoting social engagement between caregivers and their autistic children and can inform outcome monitoring and intervention development.
Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.2920