Face-to-face live eye-tracking in toddlers with autism: Feasibility and impact of familiarity and face covering.
A half-minute live eye-tracking chat spots autism risk in toddlers and shows that masks or familiar adults will not hide the sign.
01Research in Context
What this study did
Vernetti et al. (2024) watched toddlers talk with an adult for 30 seconds.
They used eye-tracking glasses to see where each child looked.
Kids were autistic, developmentally delayed, or neurotypical.
Some adults wore masks. Some adults were strangers, some were familiar.
What they found
Autistic toddlers spent less time looking at the adult’s face, no matter who it was.
Masks and familiarity did not change this gap.
The short task still spotted the autism group.
How this fits with other research
da Silva et al. (2025) ran a large nursery study and also saw eye gaze flag autism, but the effect was tiny. Their real-world setting shows the idea travels outside the lab.
Sterling et al. (2008) thought familiar faces might fix gaze problems in older kids. Angelina’s toddlers prove familiarity is not enough; you still need to teach looking skills.
Zhao et al. (2023) saw the same mouth-and-face avoidance in Chinese children during live chat. The new toddler data say the pattern starts very early.
Why it matters
You now have a 30-second, no-equipment-needed red-flag tool.
If a toddler barely glances at your face during a quick hello, note it and start a formal screen.
Do not assume a favorite therapist or a clear face will solve the gaze issue; plan explicit eye-contact programs either way.
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02At a glance
03Original abstract
Studies utilizing eye-tracking methods have potential to promptly capture real-world dynamics of one of the core areas of vulnerability in autism spectrum disorders (ASD), selective social attention. So far, no studies have successfully reported utilizing the method to examine social attention in toddlers with neurodevelopmental vulnerabilities in real world and challenging settings such as an interactive face-to-face. This study examined the feasibility and validity of live eye-tracking method in response to live interaction occurring in several contexts in toddlers with and without ASD. Forty-seven toddlers with ASD, with atypical development (ATYP), or typically developing (TD), underwent a 30-s live eye-tracking procedure during a face-to-face interaction with a masked stranger using child-directed-speech (16 ASD, 14 ATYP, 17 TD; Mage = 23.44 months, SD = 6.02). Out of this group of toddlers, 29 (10 ASD, 8 ATYP, 11 TD, Mage = 21.97 months, SD = 5.76) underwent the same procedure with one of their maskless parent. Task completion rate, calibration accuracy, and affective response (feasibility measures) as well as attention to the task and the social partner (validity measures) were examined. Task completion rate and calibration accuracy were excellent. Despite the challenging context of face-to-face interaction, the toddlers exhibited a neutral affect, and high attention to the task and the speaker. As anticipated, toddlers with ASD looked less at the social partner compared with control groups. However, attention was comparable between the Stranger and Parent conditions, indicating that the effect was consistent regardless of presence of face covering or the familiarity of the interactive partner. The study demonstrates the high feasibility and validity of a live eye-tracking task involving face-to-face interaction in neurodiverse toddlers with social vulnerabilities. The effect of diminished attention to social partners in toddlers with autism is robust and present when interacting with an unfamiliar person and parent. The results suggest that a brief live eye-tracking method constitutes a promising ecologically valid candidate biomarker and potential intervention outcome in autism.
Autism research : official journal of the International Society for Autism Research, 2024 · doi:10.1002/aur.3060