Evaluating the ability of serious game intervention to alter visual processing strategies in autism during eye gaze processing using computational modeling

Atypical visual attention to faces and difficulty interpreting eye gaze cues are core deficits of autism that have widespread consequences for social communication. We evaluated if serious game intervention could improve visual processing strategies used to interpret shifts in eye gaze for social communication in autistic adolescents. To capture both spatial and temporal dimensions of visual processing strategies during eye gaze processing, we utilized a novel, data-driven computational modeling approach. This approach summarizes a participant's eye movements (fixation locations and sequence) with person-specific regions of interest (ROIs) and transition probabilities among ROIs using a hidden Markov model; These can be clustered to discover common patterns among all participants. In this study, intervention (n=19) and control participants (n=20) completed an eye gaze perception task pre- and post-intervention. In this task, participants viewed an image of a person in a complex scene looking at a target object (TO); they had to identify the TO from a list of 4 plausible alternatives from the scene while we collected accuracy and eye-tracking data. We discovered “focused” (fixating narrowly to face first then to TO area) and “explorative” (fixating at diffuse area around the face then to TO area) patterns. At baseline, intervention participants did not differ in their likelihood of using focused or explorative patterns. However, post-intervention, the treatment group was more likely to use a focused pattern compared to the control group. Finally, we found that change in eye movement patterns across time were differentially associated with change in task performance across time between intervention and control participants. Therefore, we conclude that the serious game intervention altered the visual processing strategies used in autistic adolescents during eye gaze processing.