Integrating a Medical Toxicology Rotation into a Psychiatry Residency Program in Iran: Addressing an Urgent Educational Gap.

The ability to establish and maintain eye contact is a crucial social skill. Through making eye contact with another person in a social context, one can infer his or her identity, familiarity, emotional expressions, and potential intentions and mental states (). According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5; ), individuals on the autism spectrum have difficulties establishing and maintaining eye contact, which is considered a prerequisite skill for developing more complex social skills () and for functioning effectively in society (e.g., ). One of the most commonly adopted interventions for eye gaze issues is social skills training. Therapists usually follow the principle of applied behavioral analysis (ABA), which is widely considered a gold standard treatment for atypical eye gaze in autistic children (). In spite of its established effectiveness, however, such treatment relies on human professionals, who may be too costly or even inaccessible to many families of autistic children. This situation has given rise to technology-based interventions in recent decades (e.g., ). In that light, the present study examined whether a technology-based intervention could improve eye gaze in autistic children, in comparison to a human-based intervention (HBI) and no-intervention control. Reduced or avoided eye contact is often considered a red flag for autism (e.g., ; ). Many parents report that their children have this symptom before the children reach 2 years of age (). Studies have found that infants who were later diagnosed with autism had previously been found to look less at people's faces and to show reduced eye contact and gaze-following behavior (e.g., ; ). Reduction in eye gaze in the first 6 months of life has been correlated with the severity of later social difficulties, including joint attention, emotion recognition, and the theory of mind understanding, which are important precursors to communication (see ) for reviews). This symptom of atypical eye gaze can last for a lifetime (), especially if it is not addressed by intervention in early childhood. Enhancing a child's sensitivity to eye gaze cues is an important potential target for early intervention in autism that can improve young children's social communication behaviors, and ultimately their social interactions, in multiple ways. That said, an understanding of the underlying mechanisms for atypical eye gaze is important for designing effective early interventions.