An impairment in recognizing distress is implicated in the development and severity of antisocial behavior. It has been hypothesized that a lack of attention to the eyes plays a role, but supporting evidence is limited. We developed a computerized training to improve emotion recognition in children and examined the role of eye gaze before and after training. Children referred into an intervention program to prevent antisocial outcomes completed an emotion recognition task with concurrent eye tracking. Those with emotion recognition impairments (n = 54, mean age: 8.72 years, 78% male) completed the training, while others (n = 38, mean age: 8.95 years, 84% male) continued with their usual interventions. Emotion recognition and eye gaze were reassessed in all children 8 weeks later. Impaired negative emotion recognition was significantly related to severity of behavioral problems at pretest. Children who completed the training significantly improved in emotion recognition; eye gaze did not contribute to impairment or improvement in emotion recognition. This study confirms the role of emotion recognition in severity of disruptive behavior and shows that a targeted intervention can quickly improve emotion impairments. The training works by improving children's ability to appraise emotional stimuli rather than by influencing their visual attention.

Twenty-eight children with autism and 33 MLD children were given two tasks tapping social understanding and a control task tapping probability understanding. For each task there was a measure of eye gaze (where children looked when anticipating the return of a story character or an object) and a verbal measure (a direct question). We found that eye gaze was better than verbal performance at differentiating children with autism from children with MLD. Children with autism did not look to the correct location in anticipation of the story character's return in the social tasks, but they did look to the correct location in the nonsocial probability task. We also found that within the autistic group, children who looked least to the correct location were rated as having the most severe autistic characteristics. Further, we found that whereas verbal performance correlated with general language ability in the autistic group, eye gaze did not. We argue that: (a) eye gaze probably taps unconscious but core insights into social behavior and as such is better than verbal measures at differentiating children with autism from mentally handicapped controls, (b) eye gaze taps either spontaneous processes of simulation or rudimentary pattern recognition, both of which are less based in language, and (c) the social understanding of children with autism is probably based mostly on verbally mediated theories whereas control children also possess more spontaneous insights indexed by eye gaze.