Eye Avoidance in Young Children With Autism Spectrum Disorder Is Modulated by Emotional Facial Expressions

Individuals with autism spectrum disorder (ASD) exhibit a reduced duration of eye contact compared with typically developing (TD) individuals. This reduced eye contact has been theorized to be a strategy to relieve discomfort elicited by direct eye contact (Tanaka & Sung, 2016). Looking at threatening facial expressions may elicit more discomfort and consequently more eye avoidance in ASD individuals than looking at nonthreatening expressions. We explored whether eye avoidance in children with ASD is modulated by the social threat level of emotional expressions. In this study, 2-to 5-year-old children with and without ASD viewed faces with happy, angry, sad, and neutral expressions, while their eye movements were recorded. We observed the following: (a) when confronted with angry faces, the children with ASD fixated less on the eyes than did TD children, persistently across time; (b) the group differences in the overall eye-looking time were rarely found for happy, neutral, and sad faces; (c) the ASD group showed eye avoidance for neutral faces between 1,000 ms and 2,900 ms after the stimulus onset. Additionally, both groups spent more time looking at the angry faces than the faces showing other emotions. Considering that the children with ASD spent less time looking at the eyes of the angry faces than other emotional faces, the results suggest a combination of vigilance to threatening faces and an avoidance of the eyes in children with ASD. Our study not only extends the gaze aversion hypothesis but also has implications for the treatment and screening of ASD. General Scientific Summary Previous studies have indicated that individuals with ASD exhibit an eye-avoidance pattern when scanning faces. This study observed that this pattern is modulated by facial expressions; the eye-avoidance pattern in young children with ASD is specific to threatening facial expressions, which suggests that eye avoidance may help children with ASD alleviate discomfort elicited by threatening facial expressions.