While people with autism may avoid eye contact in one-on-one conversations, they may not avoid looking at people in photos, according to Penn State researchers.

Krista Wilkinson, professor of communication sciences and disorders, said previously it was thought that people with autism had a hard time focusing on humans in photos, which could make it difficult for them to use certain communication aids. Communication boards, for example, use photos of people doing various activities to help users communicate when they choose a photo.

Wilkinson said the study’s findings—recently published in the Journal of Speech, Language, and Hearing Research—suggest these communication aids could still be useful to help people with autism communicate.

“There's still a myth out there that people with autism look at still images differently,” Wilkinson said. “But we're starting to see it's the social demands—not the visual demands—of face-to-face contact that is provoking gaze avoidance, and that people with autism do look at people within photos.”

The study included 30 participants: 10 people with autism spectrum disorder, 10 with Down syndrome, and 10 with typical development. Jiali Liang, doctoral student in communication sciences and disorders, explained that it was important to compare participants with autism to both typically developed peers as well as those with another disability.

“We included participants with Down syndrome because previous studies suggested that perhaps the eye gaze behaviors of kids with autism may not be specific just to autism, but also to those with other conditions,” Liang said. “We needed to include participants with another disability to see if these eye gaze patterns are specific to autism or if they show up in people with a wide range of disabilities.”

The researchers used eye-tracking technology to track where participants were looking as they viewed 32 different photographs on a screen. Each photo included two or three people either participating in a shared activity, like playing a board game, or simply sitting or standing alone.

“We used the eye-tracking technology to determine which part of the screen the participants were looking at and for how long,” Liang said. “We also looked at reaction time, like how long it took the participant to react to different components in the photos. Were they more likely to focus on people when there were two people in the photo or three? What about when the figures were doing a shared activity vs doing their own thing? All these factors may affect gaze behavior.”

The researchers found that both the participants with autism and the ones with Down syndrome spent less time than individuals without disabilities looking at the photos.

Additionally, they found that when there were three people in the photos, compared to just two, there was a higher chance that the participants with autism would avoid looking at the people. However, the opposite was true for participants with Down syndrome.

The researchers also found that both the participants with autism and the ones with Down syndrome took a longer time to fixate on the people in the photos than the participants without disabilities. But, Liang said these two groups simply responded slower to the screen itself, and that once they were looking at the screen, they focused on the people almost as quickly as peers without disabilities.

Wilkinson said these results specifically could have implications in how people without disabilities can improve how they communicate with those with disabilities.

“Even in conversation, we tend not to give kids with disabilities long enough to respond,” Wilkinson said. “For two people with typical development, a 2-second gap of silence might feel uncomfortable. But when you're interacting with someone with a disability, you may give a little more time, maybe 5 seconds, for them to respond. It might take longer for them to process what you've said or to compose their response.”

Wilkinson said the same may go for someone responding with a communication aid, and the results may reinforce that, while finding an image on a communication board may be fairly quick for a person without disabilities, it may not be the case for someone with a disability.

“Taking everything together, I think our findings imply that people with autism are not avoiding looking at people in pictures,” Wilkinson said. “We shouldn't avoid using these visual-scene display communication aids with people with autism just because they don't always look at us when we're interacting socially and in person, because they do pay attention to the people in the images. The still images can be used as communication supports for people with autism. We're not seeing gaze aversion.”

Wilkinson added that a critical part of the study was that while analyzing the data, the researchers were careful when calculating the percentage of time the participants spent looking at the people in the photos. For example, a participant might spend 4 seconds looking at the photo, with two of those seconds focused on the person, even though the photo was displayed for a total of 5 seconds.

The researchers did not count the time the child spent looking away from the computer, and instead only paid attention to the time the child was looking at the screen. Therefore, the percent of time spent looking at the photo would be 50% (instead of 40%, if the time looking away had been included).

In the future, the researchers said that studies could examine how people with autism use the communication aids while engaging with other people, and if the aids are effective at helping them communicate.