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      Comparing virtual vs real faces expressing emotions in children with autism: An eye-tracking study

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          Abstract

          Difficulties in processing emotional facial expressions is considered a central characteristic of children with autism spectrum condition (ASC). In addition, there is a growing interest in the use of virtual avatars capable of expressing emotions as an intervention aimed at improving the social skills of these individuals. One potential use of avatars is that they could enhance facial recognition and guide attention. However, this aspect needs further investigation. The aim of our study is to assess differences in eye gaze processes in children with ASC when they see avatar faces expressing emotions compared to real faces. Eye-tracking methodology was used to compare the performance of children with ASC between avatar and real faces. A repeated-measures general linear model was adopted to understand which characteristics of the stimuli could influence the stimuli’s fixation times. Survival analysis was performed to understand differences in exploration behaviour between avatar and real faces. Differences between emotion recognition accuracy and the number of fixations were evaluated through a paired t-test. Our results confirm that children with autism have higher capacities to process and recognize emotions when these are presented by avatar faces. Children with autism are more attracted to the mouth or the eyes depending on the stimulus type (avatar or real) and the emotion expressed by the stimulus. Also, they are more attracted to avatar faces expressing negative emotions (anger and sadness), and to real faces expressing surprise. Differences were not found regarding happiness. Finally, they show a higher degree of exploration of avatar faces. All these elements, such as interest in the avatar and reduced attention to the eyes, can offer important elements in planning an efficient intervention.

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          Most cited references6

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          Diagnostic and Statistical Manual of Mental Disorders

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            Do children with autism recognise surprise? A research note

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              A Feasibility Clinical Trial to Improve Social Attention in Autistic Spectrum Disorder (ASD) Using a Brain Computer Interface

              Deficits in the interpretation of others' intentions from gaze-direction or other social attention cues are well-recognized in ASD. Here we investigated whether an EEG brain computer interface (BCI) can be used to train social cognition skills in ASD patients. We performed a single-arm feasibility clinical trial and enrolled 15 participants (mean age 22y 2m) with high-functioning ASD (mean full-scale IQ 103). Participants were submitted to a BCI training paradigm using a virtual reality interface over seven sessions spread over 4 months. The first four sessions occurred weekly, and the remainder monthly. In each session, the subject was asked to identify objects of interest based on the gaze direction of an avatar. Attentional responses were extracted from the EEG P300 component. A final follow-up assessment was performed 6-months after the last session. To analyze responses to joint attention cues participants were assessed pre and post intervention and in the follow-up, using an ecologic “Joint-attention task.” We used eye-tracking to identify the number of social attention items that a patient could accurately identify from an avatar's action cues (e.g., looking, pointing at). As secondary outcome measures we used the Autism Treatment Evaluation Checklist (ATEC) and the Vineland Adaptive Behavior Scale (VABS). Neuropsychological measures related to mood and depression were also assessed. In sum, we observed a decrease in total ATEC and rated autism symptoms (Sociability; Sensory/Cognitive Awareness; Health/Physical/Behavior); an evident improvement in Adapted Behavior Composite and in the DLS subarea from VABS; a decrease in Depression (from POMS) and in mood disturbance/depression (BDI). BCI online performance and tolerance were stable along the intervention. Average P300 amplitude and alpha power were also preserved across sessions. We have demonstrated the feasibility of BCI in this kind of intervention in ASD. Participants engage successfully and consistently in the task. Although the primary outcome (rate of automatic responses to joint attention cues) did not show changes, most secondary neuropsychological outcome measures showed improvement, yielding promise for a future efficacy trial. (clinical-trial ID: NCT02445625—clinicaltrials.gov).
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                Author and article information

                Contributors
                (View ORCID Profile)
                Journal
                Education and Information Technologies
                Educ Inf Technol
                Springer Science and Business Media LLC
                1360-2357
                1573-7608
                September 2021
                May 01 2021
                September 2021
                : 26
                : 5
                : 5717-5732
                Article
                10.1007/s10639-021-10552-w
                8333328d-666f-4292-a889-e0c45aa6df00
                © 2021

                https://creativecommons.org/licenses/by/4.0

                https://creativecommons.org/licenses/by/4.0

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