Taking 22 children with mild and moderate autism as subjects and using the TobiiX 120 eye-tracker to record their eye movements in visual search of images in picture books, the characteristics of the process of autistic children viewing picture books were explored. Two measures, fixation counts and gaze duration, were used alongside attention heatmap, to explore the visual patterns among children with autism viewing two types of researcher-made picture books and an ordinary picture book. Using a within-subject design, it was found that children with autism could sustain longer gaze duration and have more fixation points on the effective area of the picture book content when viewing researcher-made picture books than when viewing the ordinary picture book, suggesting better visual attention to single-object and single-pattern picture books. The study offers insights and support for related picture book reading and teaching in the future.
Traditional picture books for children come with colourful images and a multitude of elements to attract attention and increase the reading interest of typical-developing (TD) children. However, children with Autism Spectrum Disorder (ASD) are less capable of filtering out unimportant elements in pictures and focusing on social items (e.g., human faces). This study proposed that the removal of background and less important elements in the pictures of children's storybooks could facilitate better attention and enhance children with ASD's focus on the main object and thus the intended meaning of the storybook. We adopted pictures from a well-known children's book and modified them by removing the inessential background elements. Then, ASD children with intellectual disabilities (ASD+ID) (n = 40), children with ID (n = 38) and TD (n = 40) were asked to view the original and modified pictures in an eye-tracking experiment, respectively. Additionally, brain activation of ASD+ID participants (n = 10) was recorded as they were viewing those pictures in an fMRI scan. Eye-tracking found that ASD+ID children viewed the modified pictures with significantly longer average fixations, fewer fixations, fewer saccades, and higher fixation/saccade duration ratio. Contrary to the original pictures, no significant differences were found among ASD+ID, ID only and TD. Especially, ASD+ID group showed highly similar visual patterns to the TD participants when viewing the modified pictures and particularly focusing on the main character in the pictures. Additional fMRI evidence on ASD+ID group also revealed that modified pictures were associated with enhanced activation in bilateral fusiform gyri as compared to those from original pictures, which might suggest increased visual attention. Theoretical and practical implications were discussed in light of our findings.