Minimally verbal children with autism may see the point, but do not (always) point to what they see:A behavioral and eye-tracking study in visual perceptual processing
During typical development, non social visual object recognition emerges in the first year of life, engaging both low level cues (e.g., color, orientation) and higher level mechanisms involving inference and prior knowledge. Little is known about how these processes function in minimally verbal children with autism (mvASD). We studied 22 children with mvASD using touchscreen based oddball and contour detection tasks, targeting low level (e.g., shape, orientation) and mid level (e.g., Kanizsa figures, 3D shapes) visual stimuli, measuring both pointing and eye gaze responses. All children detected the oddball in the easiest condition with faint distractors, and approximately half succeeded across all low level tasks. Notably, some high performers showed reduced accuracy under mid level conditions with greater stimulus complexity. Strikingly, and not originally anticipated, several low performers who failed to point correctly nonetheless fixated on the correct target. In the Kanizsa oddball task, several mvASD participants, unlike typically developing (TD) peers, consistently pointed to local inducers rather than to the center of the illusory triangle. While the overall deterioration in performance with increased visual complexity suggests that mvASD visual perception may rely on low level representations with attenuated inference based processing, the dissociation between gaze and pointing, along with atypical local pointing behavior, indicates that performance depends not only on what is perceived, but also on how they use the visual signal to drive their behavior. They may, see the point, but not point to what they see.