Atypical physiological orienting to direct gaze in low-functioning children with autism spectrum disorder.
Low-functioning preschoolers with ASD miss the automatic heart-rate orienting boost to eye contact, so you must explicitly teach and reinforce looking.
01Research in Context
What this study did
The team watched low-functioning preschoolers with autism while a face on a screen looked straight at them.
They measured each child’s heart rate to see if direct gaze triggered the quick orienting jump typical toddlers show.
Typical kids and kids with developmental delay served as comparison groups.
What they found
The autism group showed no heart-rate speed-up when eyes met theirs.
The other two groups did get the brief orienting boost.
For these low-functioning children, eye contact simply did not flip the automatic “pay-attention” switch.
How this fits with other research
Lemons et al. (2015) saw no arousal difference to mutual gaze in a broader preschool sample; the clash disappears when you note that M et al. studied only low-functioning toddlers while J et al. mixed severity levels.
Kylliäinen et al. (2006) and Kaartinen et al. (2012) found bigger skin-conductance spikes to direct gaze in older children with ASD, hinting that what starts as absent orienting can later feel aversive.
Wang et al. (2025) push the timeline even earlier, showing high-likelihood infants both slow to look toward eyes and quick to look away—supporting a dual route of indifference plus avoidance that M et al.’s heart-rate data fit neatly into.
Why it matters
If eye contact fails to grab a child’s automatic attention, don’t expect typical social learning to occur.
Start teaching eye contact with extra prompts and strong reinforcement rather than assuming the child finds it unpleasant.
Track small heart-rate or behavioral shifts during teaching to see when orienting finally kicks in.
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02At a glance
03Original abstract
Reduced use of eye contact is a prominent feature in individuals with autism spectrum disorder (ASD). It has been proposed that direct gaze does not capture the attention of individuals with ASD. Experimental evidence is, however, mainly restricted to relatively high-functioning school-aged children or adults with ASD. This study investigated whether 2-5-year-old low-functioning children with severe ASD differ from control children in orienting to gaze stimuli, as measured with the heart rate deceleration response. Responses were measured to computerized presentations of dynamic shifts of gaze direction either toward (direct) or away (averted) from the observing child. The results showed a significant group by gaze direction interaction effect on heart rate responses (permuted P = .004), reflecting a stronger orienting response to direct versus averted gaze in typically developing (N = 17) and developmentally delayed (N = 16) children but not in children with ASD (N = 12). The lack of enhanced orienting response to direct gaze in the ASD group was not caused by a lack of looking at the eye region, as confirmed by eye tracking. The results suggest that direct gaze is not a socially salient, attention-grabbing signal for low-functioning children with ASD. Autism Res 2017, 10: 810-820. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1738