Atypical gaze patterns in autism are heterogeneous across subjects but reliable within individuals

Summary People with autism spectrum disorder (ASD) have atypical gaze onto both static visual images 1,2 and dynamic videos 3,4 that could be leveraged for diagnostic purposes 5,6 . Eye tracking is important for characterizing ASD across the lifespan 7 and nowadays feasible at home (e.g., from smartphones 8 ). Yet gaze-based classification has been difficult to achieve, due to sources of variance both across and within subjects. Here we test three competing hypotheses: (a) that ASD could be successfully classified from the fact that gaze patterns are less reliable or noisier than in controls, (b) that gaze patterns are atypical and heterogeneous across ASD subjects but reliable over time within a subject, or (c) that gaze patterns are individually reliable and also homogenous among individuals with ASD. Leveraging dense eye tracking data from two different full-length television sitcom episodes in a total of over 150 subjects (N = 53 ASD, 107 controls) collected at two different sites, we demonstrate support for the second of these hypotheses. The findings pave the way for the investigation of autism subtypes, and for elucidating the specific visual features that best discriminate gaze patterns — directions that will also inform neuroimaging and genetic studies of this complex disorder.