Autism & Developmental

Mechanisms of anxiety related attentional biases in children with autism spectrum disorder.

May et al. (2015) · Journal of autism and developmental disorders 2015
★ The Verdict

Anxious autistic kids do not show the threat-stare bias seen in typical anxiety, so treat the autism-specific signs, not the eye gaze.

✓ Read this if BCBAs assessing anxiety in cognitively able autistic clients
✗ Skip if Clinicians working with non-verbal or profoundly delayed populations

01Research in Context

01

What this study did

May et al. (2015) tracked eye movements of cognitively able kids with autism and matched peers.

They showed faces with angry, happy, or neutral expressions on a screen.

The goal was to see if anxious autistic kids stare longer at threatening faces.

02

What they found

Autistic kids reported high anxiety, but their eyes did not stick to angry faces.

Both anxious and non-anxious autistic kids looked the same as typical kids.

Attention bias is not the engine of anxiety in autism.

03

How this fits with other research

Wilson et al. (2019) ran a near-copy eye-tracking study and also found no disengagement deficit, a direct replication.

Adams et al. (2019) asked parents to describe anxiety at home; parents saw shutdowns and pacing, not face staring, extending the lab null into real life.

Rojahn et al. (2012) showed that insistence on sameness, not face watching, flags anxiety in autism, supporting the same mechanistic picture.

04

Why it matters

Stop assuming autistic anxiety works like typical anxiety. You will not spot it by watching for threat stare. Use parent and teacher reports of behavior change across settings, then target sameness routines and sensory triggers, not attention retraining.

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Swap threat-based attention probes for setting-specific behavior checklists when screening for anxiety in autism.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
90
Population
autism spectrum disorder, neurotypical
Finding
null

03Original abstract

Children with autism spectrum disorder (ASD) have high levels of anxiety. It is unclear whether they exhibit threat-related attentional biases commensurate with anxiety disorders as manifest in non-ASD populations, such as facilitated attention toward, and difficulties disengaging engaging from, threatening stimuli. Ninety children, 45 cognitively able with ASD and 45 age, perceptual-IQ, and gender matched typically developing children, aged 7-12 years, were administered a visual dot probe task using threatening facial pictures. Parent-reported anxiety symptoms were also collected. Children with ASD showed similarly high levels of anxiety compared with normative data from an anxiety disordered sample. Children with ASD had higher levels of parent-reported anxiety but did not show differences in disengaging from, or facilitated attention toward, threatening facial stimuli compared with typically developing children. In contrast to previously published studies of anxious children, in this study there were no differences in attentional biases in children with ASD meeting clinical cutoff for anxiety and those who did not. There were no correlations between attentional biases and anxiety symptoms and no gender differences. These findings indicate the cognitive mechanisms underlying anxiety in cognitively able children with ASD could differ from those commonly found in anxious children which may have implications for both understanding the aetiology of anxiety in ASD and for anxiety interventions.

Journal of autism and developmental disorders, 2015 · doi:10.1007/s10803-015-2500-z