Visual Search Performance in Children With ASD: A Combined Case-Control and Longitudinal Study.

Autism Spectrum Disorder (ASD) is associated with altered attentional function. This has been associated with enhanced visual search performance. Addressing a gap in the literature, we investigate the longitudinal development of visual search alongside ASD symptoms. Using eye-tracking, we studied performance in a single-feature visual search task with visual search accuracy and time to target. We investigated preschoolers with ASD (n = 60, age = 47 months) and a cohort of developmental age-matched typically developing (TD) children (n = 50, age = 35 months) at baseline and after approximately 3 years. We further explored associations of visual search performance with parent-reported ASD symptom domains. Both groups showed similar visual search accuracy and time to target at baseline. At the 3-year follow-up, the ASD group showed significantly lower visual search accuracy and shorter time to target than the TD group. Within the ASD cohort, higher accuracy and shorter time to target were associated with higher social communication impairments. The often-reported ASD advantage in visual search may not be as pronounced as assumed to differentiate between ASD and neurotypical development. It may also be dependent on the measure reported. More accurate and faster search may be associated with certain symptom severity profiles of ASD, supporting broad heterogeneity in the autism spectrum.