Social Attention in Children with Fragile X Syndrome and Autism Spectrum Disorder

Objective Fragile X syndrome (FXS) is the most common cause of intellectual disability and autism spectrum disorder (ASD). This study examined social attention in children with FXS compared to children with ASD and their neurotypical peers. We hypothesized that children with FXS would display less social attention towards biological stimuli than their neurotypical peers due to social anxiety, but more than children with ASD due to high social motivation. Additionally, we expected a positive relationship between fixation time on biological stimuli and arousal, which would be strongest for children with FXS. Methods Social gaze behavior and arousal pattern were assessed using eye-tracking during a preferential looking paradigm (PLP) with biological and non-biological videos. Participants included children with FXS (n = 22, age = 6.32-17.84), ASD (n = 24, age = 10.96-18.34), and a neurotypical control group (n = 15, age = 6.92-18.12). Proportion fixation time on biological stimuli was...Show moreObjective Fragile X syndrome (FXS) is the most common cause of intellectual disability and autism spectrum disorder (ASD). This study examined social attention in children with FXS compared to children with ASD and their neurotypical peers. We hypothesized that children with FXS would display less social attention towards biological stimuli than their neurotypical peers due to social anxiety, but more than children with ASD due to high social motivation. Additionally, we expected a positive relationship between fixation time on biological stimuli and arousal, which would be strongest for children with FXS. Methods Social gaze behavior and arousal pattern were assessed using eye-tracking during a preferential looking paradigm (PLP) with biological and non-biological videos. Participants included children with FXS (n = 22, age = 6.32-17.84), ASD (n = 24, age = 10.96-18.34), and a neurotypical control group (n = 15, age = 6.92-18.12). Proportion fixation time on biological stimuli was modeled using a beta regressed multilevel analysis with group as a between-subject factor, controlling for age, biological sex and order switch during the task. Pupil dilation was modeled with group and its interaction with proportion fixation time on biological stimuli as predictors. Results No significant group differences in proportion fixation time were found (ASD group: β = 0.15, p = .334; neurotypical control group: β = 0.07, p = .712). interaction effects between group and proportion fixation time were also non-significant (ASD group: β = -0.012, p = .816; neurotypical control group: β = -0.043, p = .491). Contrary to our expectations, all groups fixated more on non-biological stimuli (proportion fixation time on biological stimuli: FXS group: M = .47; ASD group: M = .49; neurotypical control group: M = .47). A negative relationship between fixation time on biological stimuli and pupil dilation was observed in the FXS and ASD groups. Conclusion The results of our analyses suggest no differences in social attention patterns between children with FXS, ASD, and their neurotypical peers. However, non-randomized stimulus presentation, warrant cautious interpretation of our results. More elaborate research on rare genetic disorders with high ASD comorbidity is needed to further investigate the underlying neurocognitive mechanisms and possible genetical pathways for ASD. Simultaneously, this allows to better differentiate autism symptomatology from other explanatory underlying mechanisms, such as social anxiety.Show less

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Social Attention in Children with Fragile X Syndrome and Autism Spectrum Disorder