Abstract: Objective    To study the social look characteristics of high risk toddlers with autism spectrum disorder（ASD）and their feasibility as an early screening marker of ASD. Methods    A total of 88 toddlers aged 12-18 months including 40 high-risk ASD toddlers（HR-ASD group）and 48 typical development toddlers（TD group）were recruited to the Child Mental Health Center of Nanjing Brain Hospital for social reference test from June 2020 to June 2021.Independent samples t-test was used to compare the difference in social look time and gaze switch between the two groups under different informant（caregiver/stranger）and different information（positive information/negative information）.Use the Autism Diagnostic Observation Scale-2（ADOS-2）to evaluate ASD symptoms（social interaction deficits）in the HR-ASD group and use multiple regression to analyze the relationship between HR-ASD children’s social look and ASD symptoms. Results    Regardless of the informant（caregivers or strangers），the HR-ASD group had a greater percentage of gaze ambiguity stimuli than the TD group，the percentage of gaze information providers was less than that of the TD group，and the gaze switch frequency was lower than that of the TD group（all P<0.01）. Regression analysis found that the percentage of gaze information providers and the gaze switch frequency were negative predictors of the social interaction dimension of ADOS-2（both P<0.05）. Conclusion    HR-ASD toddlers have deficits in social gaze maintenance and switch， which can predict social interaction deficits.

Key words: autism spectrum disorder, social reference, social look, gaze switch

摘要： 目的    研究孤独症谱系障碍（ASD）高危幼儿社会注视特征及其作为ASD早期筛查指标的可行性。方法    2020年6月至2021年6月招募12～18月龄40例高危ASD幼儿（HR-ASD组）和48例正常对照（TD组）至南京脑科医院儿童心理卫生中心进行社会参照试验。采用独立样本t检验比较两组在不同信息来源（照顾者、陌生人）和不同效价信息（积极信息、消极信息）下的注视时长和注视转换差异，使用《孤独症诊断观察量表-第2版》（ADOS-2）评估 HR-ASD组ASD症状（社会互动缺陷），采用多元线性回归分析HR-ASD组社会注视与ASD症状的关系。结果    无论信息来源照顾者或陌生人，HR-ASD组注视模糊刺激时长百分比>TD组，注视信息提供者时长百分比<TD组，注视转换频率低于TD组（均P<0.01）。回归分析发现注视信息提供者时长百分比和注视转换频率是ADOS-2社会互动维度的负向预测因子（均P<0.05）。结论    高危ASD幼儿存在社会注视维持和转换异常，该异常能够预测社会互动缺陷。

关键词: 孤独症谱系障碍, 社会参照, 社会注视, 注视转换