Center for Autism and Brain Development, Duke University Medical Center, Durham, North Carolina, USA.
Seattle Children's Research Institute, University of Washington, Seattle, Washington, USA.
Autism Res. 2023 Feb;16(2):340-354. doi: 10.1002/aur.2857. Epub 2022 Nov 21.
Social attention is a critical skill for learning and development. Social attention difficulties are present in both non-syndromic autism spectrum disorder (nsASD) and fragile X syndrome (FXS), and our understanding of these difficulties is complicated by heterogeneity in both disorders, including co-occurring diagnoses like intellectual disability and social anxiety. Existing research largely utilizes a single index of social attention and rarely includes children with intellectual impairment or uses a cross-syndrome approach. This study investigated whether multi-trait social attention profiles including naturalistic initial eye contact, facial attention, and social scene attention differ in preschool children with nsASD and FXS matched on developmental ability (DQ) and contrasted to neurotypical (NT) controls. The relationship between DQ, ASD severity, and social anxiety and social attention profiles was also examined. Initial eye contact related to social scene attention, implicating that naturalistic social attention is consistent with responses during experimental conditions. Reduced eye contact and lower social scene attention characterized nsASD and FXS. Children with nsASD displayed less facial attention than FXS and NT children, who did not differ. Lower DQ and elevated ASD severity associated with decreased eye contact in nsASD and FXS, and lower DQ was associated with lower social scene attention in FXS. Sex, social anxiety, and age were not associated with social attention. These findings suggest social attention profiles of children with nsASD are highly similar to, yet distinct from, children with FXS. Children with nsASD may present with a global social attention deficit whereas FXS profiles may reflect context-dependent social avoidance.
社会关注是学习和发展的关键技能。非综合征性自闭症谱系障碍(nsASD)和脆性 X 综合征(FXS)都存在社会关注困难,而这些困难的理解因两种疾病的异质性而变得复杂,包括智力障碍和社交焦虑等共病诊断。现有研究主要利用单一的社会关注指标,很少包括智力受损的儿童,也很少采用跨综合征方法。本研究调查了在发育能力(DQ)匹配的 nsASD 和 FXS 学龄前儿童中,是否存在包括自然初始眼接触、面部关注和社会场景关注在内的多特质社会关注特征,以及与神经典型(NT)对照组的差异。还研究了 DQ、ASD 严重程度和社交焦虑与社会关注特征之间的关系。初始眼接触与社会场景注意相关,这表明自然的社会关注与实验条件下的反应一致。nsASD 和 FXS 的特征是眼接触减少和社会场景注意力降低。nsASD 儿童的面部注意力低于 FXS 和 NT 儿童,而 FXS 和 NT 儿童之间没有差异。nsASD 和 FXS 的 DQ 较低和 ASD 严重程度较高与眼接触减少相关,而 FXS 的 DQ 较低与社会场景注意力较低相关。性别、社交焦虑和年龄与社会关注无关。这些发现表明,nsASD 儿童的社会关注特征与 FXS 儿童高度相似,但又有所不同。nsASD 儿童可能存在普遍的社会关注缺陷,而 FXS 特征可能反映了情境相关的社会回避。