A group of very preterm children characterized by atypical gaze patterns.

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Objective: Very preterm (VP) children are at risk for social difficulties, including autism spectrum disorder (ASD). This study used eye tracking to determine viewing behaviors that may reflect these difficulties. Design: The gaze patterns of 47 VP (mean gestational age: 28weeks, mean birth weight: 948g, and mean chronological age: 49months) were assessed while viewing dynamic social scenes and compared with those of 25 typically developing (TD) and 25 children with ASD. The temporo-spatial gaze patterns were summarized on a two-dimensional plane using multidimensional scaling (MDS) and the median of the TD children was used to characterize the gazes of the VP children. Time spent viewing the face was also compared. Results: The VP children formed two clusters: one had a mean MDS distance comparable to that of TD group (n = 32; VP-small), and the other had a larger mean distance comparable to that of ASD group (n = 15; VP-large). The VP-large were similar to the ASD group by spending significantly less time viewing the face. Their performance was comparable to the TD during the initial 1s, but they could not remain focused on the face thereafter. Conclusions: The VP children were objectively classified into two groups based on gaze behaviors. One group was comparable to TD children, whereas the other had difficulty maintaining attention and exhibited atypical viewing behaviors similar to those of the ASD group. Our method may be useful in identifying VP children at higher risk for experiencing social difficulties.