The interplay between Theory of Mind inferencing and visual attention in narrative comprehension in autistic preschoolers

Autistic children often display difficulties in Theory of Mind (ToM) reasoning. Though ToM skills have been extensively investigated in autistic children through narrative comprehension, our knowledge of the moment-to-moment mechanisms underlying their ability to infer others' viewpoints is limited. This study administered a visual world eye tracking paradigm with a simultaneous narrative comprehension task to 36 autistic preschoolers and 36 age-matched non-autistic children. We aimed to investigate the groups' processing of the story protagonists' goals, thoughts and emotions through behavioral and eye gaze data. According to the results, autistic children answered questions about goals and cognitive ToM less accurately than their non-autistic peers. Across all three question-types, we found distinct eye gaze patterns between the two groups depending on whether the children responded accurately or not to the narrative comprehension questions. In accurate trials, autistic children exhibited more fixations and looked longer at the story characters than the non-autistic group, indicating that grasping others' cognitive and emotional viewpoint was more effortful for them. On the other hand, in inaccurate trials, we found an over-attention bias towards objects in the autistic group only. Findings highlight the importance of narrative eye tracking techniques when investigating the social-cognitive skills of autistic children.