Training Attention and Eye Movement in ASD

Autism Spectrum Disorder (ASD) is a lifelong disorder that severely affects the ability to
learn and function in a social environment. In typical function, higher level social,
language and communication skills develop over the first few years of life and depend upon
the critical building blocks of sensory-motor and attention abilities. Similarly in autism,
higher level problems with social communication develop over the first two post-natal years
and are preceded by subtle but abnormal visual attention and motor skills. Trainings to
improve social interaction and communication are the most common of behavioral interventions
in ASD. These therapies may improve the specific behaviors that are targets of the training,
but rarely do they generalize to broader function or other clinical symptoms. The
investigators propose that interventions aimed instead at the early deficits that support
social and language skills would be more broadly effective. Because disruption of attention
is one of the earliest and most persistent symptoms in autism, and because attention is
highly subject to improvement with training, it is an important target for intervention.

This a novel intervention to train the speed and accuracy of attention orienting and eye
movement. The training is designed to target attentional behaviors that have been shown to be
impaired in autism, including attention orienting, disengagement and shifting, and a
restricted attentional field. Because eye movement and attention are tightly linked, eye
movement deficits in ASD parallel those found in spatial attention. Eye movements provide a
marker for attention and the proposed training is designed to improve speed, accuracy and
flexibility of eye movement and attention simultaneously. Training uses a series of
entertaining video games to gradually shape behavior using visual and auditory feedback
provided in real time. The investigators plan three levels of outcome measures for pre- and
post-training to test the effectiveness of the intervention (direct tests of attention and
eye movement; tests of improvement in attentional and visual monitoring and speed and
accuracy of response in a simulated environment; tests of behavior in an actual social
environment). The investigators will conduct clinical trials with control conditions (e.g.,
standard video games without training elements) with a small sample of ASD children aged
9-15. If this initial work is successful, the long term goal is to develop a readily
available inexpensive eyetracker-based system for home use that is suitable for a broad age
range of ASD children and adults.

Inclusion Criteria:

- Participant has a diagnosis of Autism Spectrum Disorder (on DSM-IV, ADOS, ADI-R)

- Participant has a nonverbal IQ of 85 or greater and verbal IQ of 70 or greater

- Cooperative and able to follow instructions

- Normal hearing acuity

- Normal or corrected-to-normal vision

Exclusion Criteria:

- Major medical or neurological problems including seizures, diagnosed epileptiform EEG
abnormalities, migraine, tuberous sclerosis, fragile X, static encephalopathies
resulting from prior CNS insults, significant premature birth, and history of exposure
to teratogens, metabolic abnormalities, and history of head trauma, cerebral palsy,
stroke, meningitis, brain tumor or additional psychiatric diagnoses

- Participants currently participating in vision therapy will be excluded