Behavioural Brain Research 256 (2013) 441–450 Contents lists available at ScienceDirect Behavioural Brain Research j ourna l h om epage: www.elsevier.com/locate/bbr Research report Prospective examination of visual attention during play in infants at high-risk for autism spectrum disorder: A longitudinal study from 6 to 36 months of age Lori-Ann R. Sacrey a,∗ , Susan E. Bryson b,c , Lonnie Zwaigenbaum a,d a Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada b Departments of Pediatrics and Psychology, Dalhousie University, Halifax, Nova Scotia, Canada c IWK Health Centre, Halifax, Nova Scotia, Canada d Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada h i g h l i g h t s • We examine visual disengagement in infants at risk for autism using toy-based play. • Infants were filmed at 6, 9, 12, 15, 18, 24, and 36 months of age as they play with toys. • Infants who receive a diagnosis of autism at 36 months show delay in disengaging at 12 months. • The delay in disengagement continues at 15, 18, 24 for infants who get a autism diagnosis. a r t i c l e i n f o Article history: Received 25 June 2013 Received in revised form 14 August 2013 Accepted 18 August 2013 Available online 1 September 2013 Keywords: Disengage Engage Reaching Infant sibling Autism spectrum disorder Visual attention a b s t r a c t Regulation of visual attention is essential to learning about one’s environment. Children with autism spectrum disorder (ASD) exhibit impairments in regulating their visual attention, but little is known about how such impairments develop over time. This prospective longitudinal study is the first to describe the development of components of visual attention, including engaging, sustaining, and disengaging attention, in infants at high-risk of developing ASD (each with an older sibling with ASD). Non-sibling controls and high-risk infant siblings were filmed at 6, 9, 12, 15, 18, 24, and 36 months of age as they engaged in play with small, easily graspable toys. Duration of time spent looking at toy targets before moving the hand toward the target and the duration of time spent looking at the target after grasp were measured. At 36 months of age, an independent, gold standard diagnostic assessment for ASD was conducted for all participants. As predicted, infant siblings subsequently diagnosed with ASD were distinguished by prolonged latency to disengage (‘sticky attention’) by 12 months of age, and continued to show this characteristic at 15, 18, and 24 months of age. The results are discussed in relation to how the development of visual attention may impact later cognitive outcomes of children diagnosed with ASD. © 2013 Elsevier B.V. All rights reserved. 1. Background Mature goal-directed reaching for objects is associated with restricted visual attention, that is, the eyes orient toward the object just before the hand moves to begin the reach and the eyes look away from the object as it is grasped [1–8]. There is progres- sive restriction of visual attention during the first year of life. Six-month-old infants visually engage a target for an extended ∗ Corresponding author at: Autism Research Centre – E209, Glenrose Rehabilita- tion Hospital, 10230-111 Avenue, Edmonton, Alberta T5G 0B7, Canada. Tel.: +1 780 735 8280; fax: +1 780 735 8249. E-mail address: sacrey@ualberta.ca (L.-A.R. Sacrey). duration prior to hand movement onset and continue to engage the target after it is grasped and is being manipulated. Prolonged visual attention may be associated with learning about objects and monitoring the objects, to ensure proper finger placement, and to learn about the association of the grasped object and the grasp- ing hand [9]. Twelve-month-old infants display restricted visual attention during reaching; that is, they visually engage a target just before hand movement onset and disengage from the target as it is being grasped. This pattern of movement results in a brief period of visual attention to the target that is temporally coupled with advance of the hand to the target and then a redirection of visual attention away from the target as the target is grasped. Visual dis- engagement at the grasp may re-prioritize attention from vision to tactile feedback, enhance somatosensory awareness of the item for 0166-4328/$ – see front matter © 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.bbr.2013.08.028