Visual Attention to Photograph and Cartoon Images in Social StoriesTM: A Comparison of Typically Developing Children and Children with ASD

ABSTRACT Autism Spectrum Disorder (ASD) is often accompanied by atypical attention to faces. Some previous studies have suggested that children with ASD demonstrate strengths when processing visual information from cartoons, whereas others have argued that photographic stimuli confer benefits. No previous studies have compared photograph and cartoon images of faces (i.e., Boardmaker [BM] images) in the context of a Social Story™ (Gray, 2010): a common intervention to support behavior and social cognition in children with ASD. In this study, we examined visual attention to static face stimuli in the context of Social Stories™. Participants were 19 typically developing (TD) children and 18 age-matched children with ASD. We addressed two questions: 1) Is there a difference between TD children and children with ASD in how they attend to cartoon and photographic stimuli in the context of a Social Story™? and 2) Do group differences in visual attention to BM and/or photographic stimuli correlate with age and indices of autism severity, executive function, intellectual functioning, and weak central coherence? With regard to question 1 and with one exception, we found no differences between groups when viewing images of faces. The exception involved our cartoon and photograph images that differed in content from the other face images in that they represented a person\u27s full body as well as a range of objects (i.e., it was a more complex scene). For these images an interaction was observed such that the TD and ASD groups were no different in their looking patterns in the BoardMaker condition but they were different in the photograph condition. More specifically, we found that a shift toward more mouth-looking in the photograph condition among children with ASD was negatively associated with attention shifting and verbal IQ and that a shift toward more other -looking (i.e., looking that occurred outside the eye and mouth region of the face) was negatively associated with attention shifting, age, and central coherence. These findings suggest that children with ASD demonstrate typical visual attention patterns to both cartoon and photographic stimuli representing faces but that children with ASD employ an atypical scanning strategy when presented with photographic stimuli representing more complex social scenes. The theoretical and clinical implications of the findings are discussed