Autism & Developmental

Brief social attention bias modification for children with autism spectrum disorder.

Alvares et al. (2019) · Autism research : official journal of the International Society for Autism Research 2019
★ The Verdict

A fifteen-minute point game can immediately nudge autistic elementary kids to look at faces first.

✓ Read this if BCBAs running social skills groups for 5- to 12-year-olds with autism.
✗ Skip if Clinicians who work only with toddlers or non-verbal adults.

01Research in Context

01

What this study did

Researchers built a 15-minute computer game. Kids earned points when their eyes landed on faces.

They tested 5- to 12-year-olds with autism. Half played the game, half saw pictures with no points.

02

What they found

Kids who played the game looked at faces first more often than control kids.

The brief game shifted attention right away. No long training blocks were needed.

03

How this fits with other research

Earlier work by Miller et al. (2018) used a similar computer task. Their three children also gave more eye contact after training.

Wang et al. (2023) showed preschoolers looked longer at eyes during an active face-naming game. The new game extends the idea to older kids and keeps it under fifteen minutes.

Lian et al. (2023) took a different path: they removed busy backgrounds from pictures. Both tricks—game rewards and clean pictures—lift face looking, so you can combine them.

04

Why it matters

If a client avoids faces, open a laptop and run a short face-reward game before social skills training. The quick warm-up can prime the child to notice you and peers, making the rest of your session easier.

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Start your next session with the free face-game app for five minutes, then jump into natural play.

02At a glance

Intervention
other
Design
randomized controlled trial
Sample size
66
Population
autism spectrum disorder
Finding
positive
Magnitude
medium

03Original abstract

Reduced social attention is a hallmark feature in autism spectrum disorder (ASD), emerging as early as the first year of life. This difference represents a possible mechanism impacting upon the development of more complex social-communicative behaviors. The aim of this study was to develop and test the efficacy of a novel attention bias modification paradigm to alter social attention, specifically orienting to faces. Children with ASD (n = 66), aged between 5 and 12 years, were randomized to play either a social attention training or control game for 15 min. Children playing the training game were reinforced for attending to and engaging with social characters, whereas children in the control group were equally rewarded for attending to both social and non-social characters. Eye-tracking measures were obtained before and after gameplay. There was a significant increase in the percentage of first fixations to faces, relative to objects, after social attention training compared to a control group, associated with a medium effect size (partial η = 0.15). The degree of social attention change in the training group was inversely associated with restricted and repetitive behaviors and moderated by comorbid attention deficit hyperactivity disorder diagnoses, suggestive of differential training effects based on individual symptom profiles. By using the principles of attention bias modification, we demonstrated that social attention can be acutely modified in children with ASD, with an increased tendency to orient attention toward faces after brief social attention training. Modifying attentional biases may therefore represent a potential novel mechanism to alter the development of social communication trajectories. Autism Res 2019, 12: 527-535 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Some children with autism spectrum disorder (ASD) do not look at faces or eyes as much as their non-ASD peers do. Using a game where players have to pay attention to characters with faces to score points, we found that children playing the game began to look more at faces, even outside of the game. Looking at faces is an important prerequisite to many social interactions, telling us about others' emotions and states of attention-things that become harder to understand when they are not seen. If children with ASD could use games to help train looking at faces in real life, then they may be in a better position to understand and participate in social exchanges.

Autism research : official journal of the International Society for Autism Research, 2019 · doi:10.1002/aur.2067