Early Mother and Child Interactions and the Transdiagnostic Factor of Eye Contact in Autism Spectrum and Callous-Unemotional Traits

Abstract

Understanding early gaze behaviour, particularly gaze directed at the eyes and face, is key to identifying mechanisms shaping children’s socioemotional development. Gaze patterns may serve as early indicators of developmental conditions such as autism and callous-unemotional (CU) traits. Although reduced eye contact is linked to both, the extent to which these behaviours overlap or differ in early development remains unclear. This thesis draws on longitudinal data from 788 mother–child dyads recruited at birth at Liverpool Hospital. Gaze behaviours were observed at 6–11 and 12–23 months using the face-to-face still-face paradigm. Maternal behaviours, including prosody and warmth, were coded during interactions. Autism and CU traits were assessed at 36–47 months using the Modified Checklist for Autism in Toddlers (MCHAT) and the Inventory of Callous-Unemotional Traits (ICU). Despite COVID-19 disruptions, 113 dyads completed all assessments. Findings highlight key differences in the developmental correlates of CU traits versus autism. CU traits were consistently associated with mutual gaze, especially in boys, and influenced by maternal prosody and warmth. In contrast, mutual gaze was not significantly related to autism traits, even when accounting for age or maternal behaviour. Instead, autism traits were more strongly linked to global functioning, with lower CGAS scores predicting higher MCHAT scores. Age was positively associated with ICU scores, but not with autism traits. These results offer a nuanced view of how CU and autism traits may diverge or converge in early childhood, emphasising the influence of gender and maternal scaffolding. The study contributes to early identification efforts and supports tailored interventions and longitudinal approaches.