Gaze Fixation and Visual Searching Behaviors during an Immersive Virtual Reality Social Skills Training Experience for Children and Youth with Autism Spectrum Disorder: A Pilot Study.

Children and youth with Autism Spectrum Disorder (ASD) display difficulties recognizing and interacting with behavioral expressions of emotion, a deficit that makes social interaction problematic. Social skills training is foundational to the treatment of ASD, yet this intervention is costly, time-consuming, lacks objectivity, and is difficult to deliver in real-world settings. This pilot project investigated the use of an immersive virtual reality (IVR) headset to simulate real-world social interactions for children/youth with ASD. The primary objective was to describe gaze fixation and visual search behaviors during the simulated activity. Ten participants were enrolled and completed one social-skills training session in the IVR. The results demonstrate differential patterns between participants with mild, moderate, and severe ASD in the location and duration of gaze fixation as well as the patterns of visual searching. Although the results are preliminary, these differences may shed light on phenotypes within the continuum of ASD. Additionally, there may be value in quantifying gaze and visual search behaviors as an objective metric of interventional effectiveness for social-skills training therapy.