To read the full article by Carla A. Wall, Kayla Smith, Frederick Shic, Bridgette Kelleher, Abigail Hogan, Elizabeth A. Will and Jane E. Roberts, please click here.  

Studies exploring the periphery of social attention in individuals living with FXS have largely relied on an eye-tracking method. Many studies have used this assessment tool to profile social attention in children with FXS compared to their neurotypical peers. These studies have also associated visual social attention measured by eye-tracking with measures of observable social behavior, including features of autism, adaptive behavior, naturalistic

social attention, and play skills. 

The authors point out that traditional eye-tracking methods may only partially help us understand visual social attention in neurodiverse subjects for two reasons. Firstly, because visual attention does not consistently index cognitive engagement. Secondly, gaze aversion has been deployed in neurodiverse persons as a strategy for managing cognitive load. A multi-method approach is thus much needed. 

The authors suggest that combining this traditional approach with a method involving the monitoring of heart activity may be the answer, as there is clear evidence that cardiac indices of physiological regulation contribute to cognitive and social competency. Heart rate-defined sustained attention (HRDSA) is a credible physiological measure of sustained attention, defined by a period of sustained decrease in heart rate and heart rate variability. Periods of sustained attention are associated with cognitive engagement. When paired with observed looking behaviors, HRDSA combines behavioral and physiological measures to index cognitive engagement alongside visual attention, increasing validity in capturing states of sustained visual attention. 

Overall, the study found that children with FXS did not differ from neurotypical or autistic children in their overall visual attention to social scenes. The authors call for future studies to explore the possibility of combining physiological and behavioral measures of attention, as this practice may be of particular importance to neurodivergent and intellectually disabled children who may not benefit from or be able to access traditional assessment methods.