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Children with autism spectrum disorder (ASD) are often placed in inclusive mainstream education (ME) or exclusive special education (SE) settings. While ME settings usually offer less-intensive and structured intervention programs than SE settings, they offer more exposure to typically developing peers. A total of 121 children (2-5 years old) with ASD, 85 in SE and 36 in ME, completed two Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) assessments. Repeated-measures analysis of covariance (ANCOVA) analyses were used to assess longitudinal changes in ADOS-2 calibrated severity scores (CSS) and language production (estimated from the ADOS-2), while accounting for baseline cognitive scores, age of diagnosis, and parent-reported intensity of intervention. Longitudinal changes in ADOS CSS did not differ significantly across educational settings but were strongly associated with the age of diagnosis, demonstrating that children diagnosed earlier improved more regardless of educational settings. These findings suggest that children with ASD placed in SE and ME exhibit similar longitudinal changes in core ASD symptoms. Further studies comparing additional outcome measures such as cognitive abilities and adaptive behaviors are highly warranted for establishing placement recommendations and public health policies.

Children with autism spectrum disorder (ASD) are often placed in inclusive mainstream education (ME) or exclusive special education (SE) settings. While ME settings usually offer less-intensive and structured intervention programs than SE settings, they offer more exposure to typically developing peers. A total of 121 children (2–5 years old) with ASD, 85 in SE and 36 in ME, completed two Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) assessments. Repeated-measures analysis of covariance (ANCOVA) analyses were used to assess longitudinal changes in ADOS-2 calibrated severity scores (CSS) and language production (estimated from the ADOS-2), while accounting for baseline cognitive scores, age of diagnosis, and parent-reported intensity of intervention. Longitudinal changes in ADOS CSS did not differ significantly across educational settings but were strongly associated with the age of diagnosis, demonstrating that children diagnosed earlier improved more regardless of educational settings. These findings suggest that children with ASD placed in SE and ME exhibit similar longitudinal changes in core ASD symptoms. Further studies comparing additional outcome measures such as cognitive abilities and adaptive behaviors are highly warranted for establishing placement recommendations and public health policies. Today, children with autism spectrum disorder (ASD) are placed in mainstream or special education settings somewhat arbitrarily with no clear clinical recommendations. Here, we compared changes in core ASD symptoms, as measured by the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) clinical assessment, across ASD preschool children placed in special or mainstream education. Longitudinal changes in ADOS-2 scores did not differ significantly across settings over a 1- to 2-year period. While some children improved in core ASD symptoms, others deteriorated in both settings. This highlights the need to identify specific criteria for establishing meaningful placement recommendations. [ABSTRACT FROM AUTHOR]

A variety of eye tracking studies have demonstrated that young children with ASD gaze at images and movies of social interactions differently than typically developing children. These findings have supported the hypothesis that gaze behavior differences are generated by a weaker preference for social stimuli in ASD children. The hypothesis assumes that gaze differences are not caused by abnormalities in oculomotor function including saccade frequency and kinematics. Previous studies of oculomotor function have mostly been performed with school‐age children, adolescents, and adults using visual search, anti‐saccade, and gap saccade tasks that are less suitable for young pre‐school children. Here, we examined oculomotor function in 144 children (90 with ASD and 54 controls), 1–10‐years‐old, as they watched two animated movies interleaved with the presentation of multiple salient stimuli that elicited saccades‐to‐targets. The results revealed that the number of fixations, fixation duration, number of saccades, saccade duration, saccade accuracy, and saccade latency did not differ significantly across groups. Minor initial differences in saccade peak velocity were not supported by analysis with a linear mixed model. These findings suggest that most children with ASD exhibit similar oculomotor function to that of controls, when performing saccades‐to‐targets or freely viewing child‐friendly movies. This suggests that previously reported gaze abnormalities in children with ASD are not due to underlying oculomotor deficiencies. Lay Summary This study demonstrates that children with ASD perform similar eye movements to those of controls when freely observing movies or making eye movements to targets. Similar results were apparent across groups in the number of eye movements, their accuracy, duration, and other measures that assess eye movement control. These findings are important for interpreting previously reported differences in gaze behavior of children with ASD, which are likely due to atypical social preferences rather than impaired control of eye movements. [ABSTRACT FROM AUTHOR]

Previous eye‐tracking studies have reported that children with autism spectrum disorders (ASD) fixate less on faces in comparison to controls. To properly understand social interactions, however, children must gaze not only at faces but also at actions, gestures, body movements, contextual details, and objects, thereby creating specific gaze patterns when observing specific social interactions. We presented three different movies with social interactions to 111 children (71 with ASD) who watched each of the movies twice. Typically developing children viewed the movies in a remarkably predictable and reproducible manner, exhibiting gaze patterns that were similar to the mean gaze pattern of other controls, with strong correlations across individuals (intersubject correlations) and across movie presentations (intra‐subject correlations). In contrast, children with ASD exhibited significantly more variable/idiosyncratic gaze patterns that differed from the mean gaze pattern of controls and were weakly correlated across individuals and presentations. Most importantly, quantification of gaze idiosyncrasy in individual children enabled separation of ASD and control children with higher sensitivity and specificity than traditional measures such as time gazing at faces. Individual magnitudes of gaze idiosyncrasy were also significantly correlated with ASD severity and cognitive scores and were significantly correlated across movies and movie presentations, demonstrating clinical sensitivity and reliability. These results suggest that gaze idiosyncrasy is a potent behavioral abnormality that characterizes a considerable number of children with ASD and may contribute to their impaired development. Quantification of gaze idiosyncrasy in individual children may aid in assessing symptom severity and their change in response to treatments. Autism Res 2020, 13: 935‐946. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Typically, developing children watch movies of social interactions in a reliable and predictable manner, attending faces, gestures, actions, body movements, and objects that are relevant to the social interaction and its narrative. Here, we demonstrate that children with ASD watch such movies with significantly more variable/idiosyncratic gaze patterns that differ across individuals and across movie presentations. We demonstrate that quantifying this gaze variability may aid in identifying children with ASD and in determining the severity of their symptoms. [ABSTRACT FROM AUTHOR]

Recent neuroimaging and eye-tracking studies have suggested that children with autism exhibit more variable and idiosyncratic brain responses and eye movements than typically developing (TD) children. Here, we extended this research to pupillometry recordings. We successfully acquired pupillometry recordings from 111 children (74 with autism), 4.5-years-old on average, who viewed three 90 s movies, twice. We extracted their pupillary time-course for each movie, capturing their stimulus evoked pupillary responses. We then computed the correlation between the time-course of each child and those of all others in their group as well as between each autistic child and all children in the TD group. This yielded an average inter-subject correlation value per child, representing how similar their pupillary responses were to all others in their group or the comparison group. Children with autism exhibited significantly weaker inter-subject correlations than TD children in all comparisons. These differences were independent of previously reported differences in gaze inter-subject correlations and were largest in responses to a naturalistic movie containing footage of a social interaction between two TD children. The results demonstrate the utility of measuring the idiosyncrasy of pupil regulation, which can be performed with passive viewing of movies even by young children with co-occurring intellectual disability. These findings reveal that a considerable number of children with autism have significantly less stable, idiosyncratic pupil regulation than TD children, indicative of more variable, weakly regulated, underlying neural activity., (© 2024 The Author(s). Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.)

Lay Abstract: Today, children with autism spectrum disorder (ASD) are placed in mainstream or special education settings somewhat arbitrarily with no clear clinical recommendations. Here, we compared changes in core ASD symptoms, as measured by the Autism Diagnostic Observation Schedule, 2nd edition (ADOS-2) clinical assessment, across ASD preschool children placed in special or mainstream education. Longitudinal changes in ADOS-2 scores did not differ significantly across settings over a 1- to 2-year period. While some children improved in core ASD symptoms, others deteriorated in both settings. This highlights the need to identify specific criteria for establishing meaningful placement recommendations.

A variety of eye tracking studies have demonstrated that young children with ASD gaze at images and movies of social interactions differently than typically developing children. These findings have supported the hypothesis that gaze behavior differences are generated by a weaker preference for social stimuli in ASD children. The hypothesis assumes that gaze differences are not caused by abnormalities in oculomotor function including saccade frequency and kinematics. Previous studies of oculomotor function have mostly been performed with school-age children, adolescents, and adults using visual search, anti-saccade, and gap saccade tasks that are less suitable for young pre-school children. Here, we examined oculomotor function in 144 children (90 with ASD and 54 controls), 1-10-years-old, as they watched two animated movies interleaved with the presentation of multiple salient stimuli that elicited saccades-to-targets. The results revealed that the number of fixations, fixation duration, number of saccades, saccade duration, saccade accuracy, and saccade latency did not differ significantly across groups. Minor initial differences in saccade peak velocity were not supported by analysis with a linear mixed model. These findings suggest that most children with ASD exhibit similar oculomotor function to that of controls, when performing saccades-to-targets or freely viewing child-friendly movies. This suggests that previously reported gaze abnormalities in children with ASD are not due to underlying oculomotor deficiencies. LAY SUMMARY: This study demonstrates that children with ASD perform similar eye movements to those of controls when freely observing movies or making eye movements to targets. Similar results were apparent across groups in the number of eye movements, their accuracy, duration, and other measures that assess eye movement control. These findings are important for interpreting previously reported differences in gaze behavior of children with ASD, which are likely due to atypical social preferences rather than impaired control of eye movements., (© 2021 International Society for Autism Research and Wiley Periodicals LLC.)

Previous eye-tracking studies have reported that children with autism spectrum disorders (ASD) fixate less on faces in comparison to controls. To properly understand social interactions, however, children must gaze not only at faces but also at actions, gestures, body movements, contextual details, and objects, thereby creating specific gaze patterns when observing specific social interactions. We presented three different movies with social interactions to 111 children (71 with ASD) who watched each of the movies twice. Typically developing children viewed the movies in a remarkably predictable and reproducible manner, exhibiting gaze patterns that were similar to the mean gaze pattern of other controls, with strong correlations across individuals (intersubject correlations) and across movie presentations (intra-subject correlations). In contrast, children with ASD exhibited significantly more variable/idiosyncratic gaze patterns that differed from the mean gaze pattern of controls and were weakly correlated across individuals and presentations. Most importantly, quantification of gaze idiosyncrasy in individual children enabled separation of ASD and control children with higher sensitivity and specificity than traditional measures such as time gazing at faces. Individual magnitudes of gaze idiosyncrasy were also significantly correlated with ASD severity and cognitive scores and were significantly correlated across movies and movie presentations, demonstrating clinical sensitivity and reliability. These results suggest that gaze idiosyncrasy is a potent behavioral abnormality that characterizes a considerable number of children with ASD and may contribute to their impaired development. Quantification of gaze idiosyncrasy in individual children may aid in assessing symptom severity and their change in response to treatments. Autism Res 2020, 13: 935-946. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Typically, developing children watch movies of social interactions in a reliable and predictable manner, attending faces, gestures, actions, body movements, and objects that are relevant to the social interaction and its narrative. Here, we demonstrate that children with ASD watch such movies with significantly more variable/idiosyncratic gaze patterns that differ across individuals and across movie presentations. We demonstrate that quantifying this gaze variability may aid in identifying children with ASD and in determining the severity of their symptoms., (© 2019 International Society for Autism Research, Wiley Periodicals, Inc.)