Attention to Eyes is Present But in Decline in 2–6 Month-Olds Later Diagnosed with Autism

Deficits in eye contact have been a hallmark of autism(1,2) since the condition’s initial description(3). They are cited widely as a diagnostic feature(4) and figure prominently in clinical instruments(5); however, the early onset of these deficits has not been known. Here we show in a prospective longitudinal study that infants later diagnosed with autism spectrum disorders (ASD) exhibit mean decline in eye fixation within the first 2 to 6 months of life, a pattern not observed in infants who do not develop ASD. These observations mark the earliest known indicators of social disability in infancy, but also falsify a prior hypothesis: in the first months of life, this basic mechanism of social adaptive action—eye looking—is not immediately diminished in infants later diagnosed with ASD; instead, eye looking appears to begin at normative levels prior to decline. The timing of decline highlights a narrow developmental window and reveals the early derailment of processes that would otherwise play a key role in canalizing typical social development. Finally, the observation of this decline in eye fixation—rather than outright absence—offers a promising opportunity for early intervention, one that could build on the apparent preservation of mechanisms subserving reflexive initial orientation towards the eyes.