What Do Autistic People See? Understanding Visual Focus in Autism as a Path to Better Diagnosis and Treatment

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Fred Volkmar, M.D.,Yale University
Fred Volkmar, M.D.

From The Quarterly, Spring 2012

One of the key factors in autism is visual focus. From the time of birth, normal babies are drawn to look at faces, and particularly the top of the face, where the eyes are located. Dr. Volkmar’s research has been demonstrating that people with autism, from very early childhood, look at faces differently.

There is an area in the brain called the fusiform gyrus, or the fusiform face area, which, as the name implies, is involved in looking at faces. Studies in the Volkmar lab using functional magnetic resonance imaging (fMRI) have shown that in healthy control children the fusiform face area lights up when they look at pictures of faces. It does not light up when autistic children look at the pictures. In contrast to healthy control children, autistic children will more likely notice, for example, a hat the person in the picture is wearing rather than whether the person’s face looks happy or sad.

A unique innovation developed in the Yale lab is an eye-tracking device that shows by means of an infrared light what a viewer is looking at. The researchers use scenes from movies to test eye focus. A non-autistic viewer will look mainly at the actors’ eyes. The autistic viewer looks mainly at mouths—at who is speaking. In testing adult autistic viewers, the lab has used a clip from the movie “Who’s Afraid of Virginia Woolf” in which Elizabeth Taylor plays a woman seducing a young man as her husband, played by Richard Burton, looks on. The husband’s reaction is central to the scene, his troubled eyes are the focus of suspense, but he doesn’t speak. Viewers with autism don’t look at him, and entirely miss the point of the scene.

Until recently, autism was not diagnosed until around four to five years of age. Now, increasingly, diagnosis and intervention begin earlier. The goal is to minimize autism’s negative effects on learning, and maximize normal developmental processes. 

Researchers like Dr. Volkmar are trying to refine knowledge of which treatments work for which children and how much treatment is needed. There have been recent advances in research on the use of medications, including antipsychotics, tranquilizers and antidepressants, and on behavioral treatments. The lab is currently looking into the efficacy of combining behavioral and drug treatments.

Fred Volkmar, M.D.
Director, Child Study Center
Chief, Child Psychiatry, Children’s Hospital at Yale
Irving B. Harris Professor of Child Psychiatry, Pediatrics and Psychology
Yale University

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Please note that researchers cannot give specific recommendations or advice about treatment; diagnosis and treatment are complex and highly individualized processes that require comprehensive face-to- face assessment. Please visit our "Ask an Expert" section to see a list of Q & A with NARSAD Grantees.
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