In autism study, it’s all about the eyes

When Yale scientists wanted to find out what people with autism looked at, they turned for help to Elizabeth Taylor and Richard Burton. The investigators used brief clips from the 1966 movie Who’s Afraid of Virginia Woolf? and a baseball cap affixed with cameras to follow their subjects’ eye movements.

“It’s as if we can stand behind the eyes of a person with autism and see what they’re looking at. They are looking at very different things than the rest of us,” said Fred R. Volkmar, M.D., professor of child psychiatry, pediatrics and psychology, and principal investigator on the project.

Volkmar and colleagues reported the results of two similar experiments in the September issue of the Archives of General Psychiatry and in last June’s issue of The American Journal of Psychiatry. As subjects and controls watched the movie on a computer screen and reacted to emotional scenes, the researchers monitored what each viewer saw, using an infrared camera that captured eye movements. The camera was placed on the bill of a baseball cap worn by the subjects. Another miniature camera on the hat recorded images in each subject’s field of view.

The investigators found that the people with autism focused on individual features of the face, rather than the whole face. They looked at the mouth rather than the eyes, which contain many social clues. In fact, the control group looked at the eyes twice as often as did the group with autism. Those with autism also tended to focus on inanimate objects in the scenes they observed. The subjects with autism who fixated on mouths tended to have better social adjustment than those who concentrated on inanimate objects.

Volkmar said previous efforts to measure response to social stimuli tended to rely on still photographs. “That doesn’t tell us much about what happens in the real world,” he said, explaining the decision to use a movie. To eliminate distractions, the researchers looked for a movie depicting intense social interaction with a limited number of characters and few locations. “We didn’t want Rambo and Sylvester Stallone and Arnold Schwarzenegger chomping up scenery,” Volkmar said. “We were interested in a movie that focused on people and relationships.”

The experiments yielded clues as to what people with autism observe and the strategies they use to understand situations. They also suggested possible interventions, Volkmar said, such as new methods of screening for children at risk for autism.

Volkmar and another Yale scientist recently received $11 million in grants to pursue their studies. Two grants of $5 million each came from the Collaborative Programs of Excellence in Autism and the Studies to Advance Autism Research and Treatment Centers Program, under the auspices of the National Institutes of Health. Another $1 million grant came from the National Institute of Mental Health, for a study by Ami J. Klin, Ph.D., associate professor of child psychiatry.