孤独症谱系障碍儿童眼动研究进展

孤独症谱系障碍(ASD)是一组以社交障碍为主的神经发育性疾病,患病率呈逐年增加的趋势,且未见特效疗法,为此早诊断、早干预尤为重要.近些年,通过眼动技术研究,发现ASD在生命早期便存在异常的注视模式,有望将此作为ASD早期检测和诊断的生物标志物.现从ASD儿童异常的眼动模式、研究范式、大脑相关区域的联系及面孔加工四个方面,对ASD儿童运用眼动技术的研究文献进行梳理总结,阐述最新研究成果.     

Depression’s response to fear tactics: An integration of health promotion principles,eye-tracking technology and clinical tools

ObjectiveThe main objective of this study was to utilize eye-tracking technology and self-report measures to test the effectiveness of varying strengths of fear appeals when educating about the seriousness of depression and motivate depressed individuals to engage in health-information-seeking.MethodsWe analyzed data from 117 university employees affected by a range of depression symptoms who were randomly assigned to a low-threat, moderate threat, and high-threat message condition in a lab-based experimental setting. Attention patterns were captured while participants viewed the health message. A particular emphasis was placed on understanding the role of valence and arousal in determining attention patterns.ResultsAttentional processes induced emotions (valence) and intensity (arousal) and differed by strength of fear appeal, but were not influenced by symptoms of depression in this study. Arousal mediated the effects of strong fear appeals on attitudes toward information-seeking, whereas negative emotions did not.Conclusion and practice implicationsUntil further research suggests otherwise, caution is warranted when utilizing fear appeals that are highly arousing for health education and promotion.     

Attention during social interaction in children with autism: Comparison to specific language impairment,typical development,and links to social cognition

Eye-tracking studies have shown how people with autism spend significantly less time looking at socially relevant information on-screen compared to those developing typically. This has been suggested to impact on the development of socio-cognitive skills in autism. We present novel evidence of how attention atypicalities in children with autism extend to real-life interaction, in comparison to typically developing (TD) children and children with specific language impairment (SLI). We explored the allocation of attention during social interaction with an interlocutor, and how aspects of attention (awareness checking) related to traditional measures of social cognition (false belief attribution). We found divergent attention allocation patterns across the groups in relation to social cognition ability. Even though children with autism and SLI performed similarly on the socio-cognitive tasks, there were syndrome-specific atypicalities of their attention patterns. Children with SLI were most similar to TD children in terms of prioritising attention to socially pertinent information (eyes, face, awareness checking). Children with autism showed reduced attention to the eyes and face, and slower awareness checking. This study provides unique and timely insight into real-world social gaze (a)typicality in autism, SLI and typical development, its relationship to socio-cognitive ability, and raises important issues for intervention.     

Visual search strategies during facial recognition in children with ASD

Facial recognition is a complex skill necessary for successful human interpersonal and social interactions. Given that the most prevalent disorder of social interaction is autism spectrum disorder (ASD), a number of studies have investigated and found impaired facial recognition abilities in people with ASD. Further, this impairment may be critically involved in mediating the deficits in interpersonal and social interactions in people with ASD. We sought to address the question of whether face processing is impaired in children with ASD in the current study. While there were a number of differences in visual search behaviours between the 19 children with ASD and the 15 controls, this did not manifest in deficits in facial recognition accuracy. In addition, there were notable differences with respect to eye fixation behaviours and recognition accuracy in this study compared to the findings in a previous similar study conducted in adults with ASD. These differences suggest a performance enhancing developmental trajectory in facial processing in controls that may not be present in individuals with ASD.     

Recognition of facial emotions and identity in patients with mesial temporal lobe and idiopathic generalized epilepsy: An eye-tracking study

PurposeTo describe visual scanning pattern for facial identity recognition (FIR) and emotion recognition (FER) in patients with idiopathic generalized (IGE) and mesial temporal lobe epilepsy (MTLE). Secondary endpoint was to correlate the results with cognitive function.MethodsBenton Facial Recognition Test (BFRT) and Ekman&Friesen series were performed for FIR and FER respectively in 23 controls, 20 IGE and 19 MTLE patients. Eye movements were recorded by a Hi-Speed eye-tracker system. Neuropsychological tools explored cognitive function.ResultsCorrect FIR rate was 78% in controls, 70.7% in IGE and 67.4% (p = 0.009) in MTLE patients. FER hits reached 82.7% in controls, 74.3% in IGE (p = 0.006) and 73.4% in MTLE (p = 0.002) groups. IGE patients failed in disgust (p = 0.005) and MTLE ones in fear (p = 0.009) and disgust (p = 0.03). FER correlated with neuropsychological scores, particularly verbal fluency (r = 0.542, p < 0.001). Eye-tracking revealed that controls scanned faces more diffusely than IGE and MTLE patients for FIR, who tended to top facial areas. A longer scanning of the top facial area was found in the three groups for FER. Gap between top and bottom facial region fixation time decreased in MTLE patients, with more but shorter fixations in bottom facial region. However, none of these findings were statistically significant.ConclusionFIR was impaired in MTLE patients, and FER in both IGE and MTLE, particularly for fear and disgust. Although not statistically significant, those with impaired FER tended to perform more diffuse eye-tracking over the faces and have cognitive dysfunction.     

Patterns of gaze behavior during an eye-tracking measure of joint attention in typically developing children and children with autism spectrum disorder

This study evaluated whether diagnostic classifications or features of ASD were associated with individual differences in children's gaze pattern during an eye-tracking measure of joint attention. The sample included 21 children with ASD (mean age, 7.3 ± 1.5 years) and 24 typically developing children (mean age, 6.8 ± 1.6 years), matched on receptive language abilities. Results revealed no significant group differences on global measures of gaze allocation (total gaze time allocation). However, significant group differences emerged using a measure evaluating a microstructure of children's gaze (duration of first fixation). In addition, individual differences in children's gaze pattern were reliably predicted by parent report measures of children's social abilities. The majority of children in this sample (including all typically developing children and those children with ASD who scored lowest on the SRS Social Awareness subscale) showed significant modulation in eye-gaze between the two experimental conditions. In contrast, children with ASD who also scored the highest on the SRS Social Awareness subscale consistently failed to modulate their eye gaze in accordance with the experimental condition. This failure to flexibly modulate gaze in the context of a joint attention eye-tracking paradigm may reveal children's limited awareness of social cues that may further limit social learning.     

The effect of abnormality-prevalence expectation on naïve observer performance and visual search

ObjectiveTo measure the effect of abnormality-prevalence expectation on naïve observer performance during lesion detection on chest radiographs.MethodsA multi-reader, fixed-case receiver-operating characteristic (ROC) and eye-position analysis study to assess the effect of prevalence expectation on observer performance was conducted. Sixteen diagnostic radiography students (naïve observers) were divided into four prevalence expectation groups (four in each group) and each was asked to interpret thirty (15 abnormal) postero-anterior (PA) identical chest image sets twice to decide if pulmonary nodular lesions were present. Prior to each viewing they were told that the images contained a specific number of abnormal images: group 1: 9 & 15; group 2: 15 & 22; group 3: 9 & 22; group 4:15 & 15.ResultsROC-analysis demonstrated that no significant effect could be measured as a function of prevalence (p > 0.05). However, sensitivity analysis showed a significant change in Group 3 (p = 0.0237). Eye-positional analysis showed one significant change, which was found in Group 1 for mean fixation duration on a lesion (p = 0.0458).ConclusionOverall, the findings of this study showed evidence that the rudimentary performance of naïve observers is altered due to changing prevalence expectation rates.     

Sex Differences in Infants’ Visual Interest in Toys

Evidence indicating that sex-linked toy preferences exist in two nonhuman primate species support the hypothesis that developmental sex differences such as those observed in children’s object preferences are shaped in part by inborn factors. If so, then preferences for sex-linked toys may emerge in children before any self-awareness of gender identity and gender–congruent behavior. In order to test this hypothesis, interest in a doll and a toy truck was measured in 30 infants ranging in age from 3 to 8 months using eye-tracking technology that provides precise indicators of visual attention. Consistent with primary hypothesis, sex differences in visual interest in sex-linked toys were found, such that girls showed a visual preference (d > 1.0) for the doll over the toy truck and boys compared to girls showed a greater number of visual fixations on the truck (d = .78). Our findings suggest that the conceptual categories of “masculine” and “feminine” toys are preceded by sex differences in the preferences for perceptual features associated with such objects. The existence of these innate preferences for object features coupled with well-documented social influences may explain why toy preferences are one of the earliest known manifestations of sex-linked social behavior.     

Shyness and face scanning in children

Contrary to popular beliefs, a recent empirical study using eye tracking has shown that a non-clinical sample of socially anxious adults did not avoid the eyes during face scanning. Using eye-tracking measures, we sought to extend these findings by examining the relation between stable shyness and face scanning patterns in a non-clinical sample of 11-year-old children. We found that shyness was associated with longer dwell time to the eye region than the mouth, suggesting that some shy children were not avoiding the eyes. Shyness was also correlated with fewer first fixations to the nose, which is thought to reflect the typical global strategy of face processing. Present results replicate and extend recent work on social anxiety and face scanning in adults to shyness in children. These preliminary findings also provide support for the notion that some shy children may be hypersensitive to detecting social cues and intentions in others conveyed by the eyes. Theoretical and practical implications for understanding the social cognitive correlates and treatment of shyness are discussed.     

Surgeon's vigilance in the operating room

Objective

Surgeons' vigilance regarding patient condition was assessed using eye-tracking techniques during a simulated laparoscopic procedure.

Methods

Surgeons were required to perform a partial cholecystectomy in a virtual reality trainer (SurgicalSim; METI Inc, Sarasota, FL) while wearing a lightweight head-mounted eye-tracker (Locarna systems Inc, Victoria, British Columbia, Canada). Half of the patients were preprogrammed to present a mildly unstable cardiac condition during the procedure. Surgical performance (evaluated by task time, instrument trajectory, and errors), mental workload (by the National Aeronautics and Space Administration Task Load Index), and eye movement were recorded and compared between 13 experienced and 10 novice surgeons.

Results

Experienced surgeons took longer to complete the task and also made more errors. The overall workload reported by surgeons was similar, but expert surgeons reported a higher level of frustration and a lower level of physical demands. Surgeon workload was greater when operating on the unstable patient than on the stable patient. Novices performed faster but focused more of their attention on the surgical task. In contrast, experts glanced more frequently at the anesthetic monitor.

Conclusions

This study shows the usefulness of using eye-tracking technology to measure a surgeon's vigilance during an operation. Eye-tracking observations can lead to inferences about a surgeon's behavior for patient safety. The unsatisfactory performance of expert surgeons on the VR simulator suggests that the fidelity of the virtual simulator needs to improve to enable surgeons to transfer their clinical skills. This, in turn, suggests using caution when having clinical experts as instructors to teach skills with virtual simulators.