Comparison of visual fixation trajectories in toddlers with autism spectrum disorder and typical development: A markov chain model

Autism spectrum disorder (ASD) is a neurodevelopmental condition in which visual attention and visual search strategies are altered. Eye-tracking paradigms have been used to detect these changes. In our study, 18 toddlers with ASD and 18 toddlers with typical development (TD; age range 12–36 months) underwent an eye-tracking paradigm where a face was shown together with a series of objects. Eye gaze was coded according to three areas of interest (AOIs) indicating where the toddlers’ gaze was directed: ‘Face’, ‘Object’, and ‘No-stimulus fixation’. The fixation sequence for the ASD and TD groups was modelled with a Markov chain model, obtaining transition probabilities between AOIs. Our results indicate that the transition between AOIs could differentiate between toddlers with ASD or TD, highlighting different visual exploration patterns between the groups. The sequence of exploration is strictly conditioned based on previous fixations, among which ‘No-stimulus fixation’ has a critical role in differentiating the two groups. Furthermore, our analyses underline difficulties of individuals with ASD to engage in stimulus exploration. These results could improve clinical and interventional practice by considering this dimension among the evaluation process.