Moriuchi Jennifer M, Klin Ami, Jones Warren
From the Department of Psychology, the Division of Autism and Related Disabilities, Department of Pediatrics, and the Center for Translational Social Neuroscience, Emory University, Atlanta; and the Marcus Autism Center, Children's Healthcare of Atlanta.
Am J Psychiatry. 2017 Jan 1;174(1):26-35. doi: 10.1176/appi.ajp.2016.15091222. Epub 2016 Nov 18.
Two hypotheses, gaze aversion and gaze indifference, are commonly cited to explain a diagnostic hallmark of autism: reduced attention to others' eyes. The two posit different areas of atypical brain function, different pathogenic models of disability, and different possible treatments. Evidence for and against each hypothesis is mixed but has thus far focused on older children and adults. The authors evaluated both mechanistic hypotheses in two sets of experiments at the time of initial diagnosis.
Eye-tracking data were collected in 86 2-year-olds: 26 with autism, tested at initial diagnosis; 38 matched typically developing children; and 22 matched developmentally delayed children. In two experiments, the authors measured response to direct and implicit cueing to look at the eyes.
When directly cued to look at the eyes, 2-year-olds with autism did not look away faster than did typically developing children; their latency varied neither categorically nor dimensionally by degree of eye cueing. Moreover, direct cueing had a stronger sustained effect on their amount of eye-looking than on that of typically developing children. When presented with implicit social cues for eye-looking, 2-year-olds with autism neither shifted their gaze away nor more subtly averted their gaze to peripheral locations.
The results falsify the gaze aversion hypothesis; instead, at the time of initial diagnosis, diminished eye-looking in autism is consistent with passive insensitivity to the social signals in others' eyes.
凝视回避和凝视冷漠这两种假说常被引用来解释自闭症的一个诊断标志：对他人眼睛的关注减少。这两种假说提出了不同的非典型脑功能区域、不同的残疾致病模型以及不同的可能治疗方法。支持和反对每种假说的证据都参差不齐，但迄今为止主要集中在大龄儿童和成年人身上。作者在初次诊断时通过两组实验对这两种机制假说进行了评估。
收集了86名2岁儿童的眼动追踪数据：26名患有自闭症，在初次诊断时接受测试；38名匹配的发育正常儿童；以及22名匹配的发育迟缓儿童。在两项实验中，作者测量了对直接和隐含的注视眼睛提示的反应。
当被直接提示注视眼睛时，患有自闭症的2岁儿童看向别处的速度并不比发育正常的儿童快；他们的反应潜伏期在类别上或维度上都不会因眼睛提示的程度而有所不同。此外，直接提示对他们注视眼睛的时长的持续影响比对发育正常儿童的影响更强。当呈现隐含的注视眼睛的社交提示时，患有自闭症的2岁儿童既不会将目光移开，也不会更微妙地将目光转向周边位置。
结果证伪了凝视回避假说；相反，在初次诊断时，自闭症患者注视眼睛减少与对他人眼睛中的社交信号的被动不敏感是一致的。
