Targets and cues: gaze-following in children with autism.

Children with autism are known to have difficulties in sharing attention with others. Yet one joint attention behaviour, the ability to follow another person's head turn and gaze direction, may be achieved without necessarily sharing attention. Why, then, should autistic children have difficulties with it? In this study we examined the extent of this difficulty by testing school-aged autistic children across three different contexts; experiment, observation, and parent interview. We also tested whether the ability to orient to another person's head and gaze could be facilitated by increasing children's attention to environmental targets and social cues. Results for experiment and observation demonstrate that a sizeable proportion of children with autism did not have difficulties with following another's head turn. There was a difference between children with high and low verbal mental ages, however. Whereas children with higher mental ages (over 48 months) were able to orient spontaneously to another person's head turn, children with lower mental ages had difficulties with this response. When cues were added (pointing, language) or when feedback from targets was given, however, their performance improved. Parent interview data indicated that children with autism, whatever their mental age, began to follow head turn and gaze direction years later than typically developing children. Developments in attention and language are proposed as possible factors to account for this developmental delay.