The fourth original article ‘An interactional ‘live eye tracking’ study in autism spec-trum disorder: Combining qualitative and quantitative approaches in the study of gaze’ (Dindar, Korkiakangas, Laitila, & Kärnä, 2017) takes an innovative approach in examining gaze practices in ASD by combining eye tracking technology with the CA approach. To our knowledge, this is the first study to combine eye tracking and CA with participants with ASD. By synchronising live eye tracking data and video record-ings collected from three children with ASD during Kinect game playing, the study set out to demonstrate how such data can be examined using CA to understand not only the quantity of gaze shifts to other people present in the room (educators, researchers, children), but essentially why children shifted their gaze to these co-participants (i.e.
the functions of the gaze shifts). This article was also designed to communicate the benefits of multimodal CA approach to researchers familiar with eye tracking research within the biomedical paradigm. Thus, the article combined both ‘traditional’ eye tracking analysis and multimodal CA in a comparative manner.
First the categorisation approach was used to map the location and duration of the gaze shifts in the eye tracking data, and an AOI-based quantification was conducted.
However, this decontextualised approach to gaze could not capture the interactional environment in which the gaze shifts occurred (a problem similar to that of original article I), warranting the examination of wide-angle video recordings using CA. The analysis located the gaze shifts in a stream of other actions and enabled an analysis of the eye tracking data as synchronised with the video recordings. This multimodally informed CA analysis focused on investigating how the children produced their gaze shifts and how co-participants responded to them. A function was understood and analysed in terms of how the co-participants treated and oriented to the gaze shift (e.g.
whether it had specific interactional implications for them), rather than attempting to interpret what the children seemed to ‘aim for’.
The analysis showed that the co-participants treated children’s gaze shifts differ-ently depending on when they occurred in a stream of activity (e.g. timing with the on-going game). The children’s gaze shifts were identified both in responsive and initiating environments. In the former, the children used their gaze to monitor others and respond to prompts, whereas in the latter gaze was used for eliciting assistance and for social sharing.
The study demonstrated to the biomedically-oriented readers that wide-angle video recordings are crucial for the examination of the social qualities of gaze and for a detailed understanding of ‘gaze-in-context’. Since live eye tracking is increasingly
conducted in ASD research, such studies would greatly benefit from the combina-tion of AOI-based quantificacombina-tion with the CA approach, since CA provides the scope to locate gaze behaviours within the actual interactions in which they emerge. This combination can inform us as to the gaze-related competencies of children with ASD, something that decontextualised eye tracking research cannot accomplish alone. The fourth article concludes that extending eye tracking research with CA examination can increase the ecological validity of gaze-related research in ASD. Building on such methodological innovation, the study can facilitate dialogue about ASD research in different paradigms.
7 Discussion
This thesis set out to examine how children with ASD participate in social interactions, and to consider how methodological decisions influence the way social interaction in ASD is understood. This led me to critically explore paradigms that underpin research, and the implications that the biomedical and social constructionist perspectives have on understanding ASD. The original articles delved into these issues with a focus on some of the key aspects of social interaction: how gaze is used in interaction; how joint attention is established, maintained, and responded to; and how interactional trouble is managed.
In the research process, or during the ‘journey’, the methodological approaches changed in order to examine questions about children’s interactional conduct. The interactional approach enabled a shift from the biomedical paradigm that focuses on social skills ‘within individuals’ to how social interactions are mutually constructed
‘in interaction’ (see Figure 6). Kuhn’s (1970) ideas about paradigm shifts have been relevant in rethinking how interactional competencies of children with ASD could be researched and which methodologies are apt for this task.
Figure 6: How a child with ASD is viewed in the biomedical and social constructionist para-digms
This shift in thinking that aligns with the social constructionist paradigm was visible in the four original articles that moved from focusing on a child’s abilities in using gaze (article I) to encompass the actions of the child’s co-participants and the interactional contexts in which the participants’ actions occurred (articles II, III, and IV). The eye tracking methodologies that have primarily been used in research within the biomedi-cal paradigm, were blended into the interactional approach (article IV) to shed new light on gaze in interaction. This research journey has resulted in a theoretical rethink-ing of concepts such as ‘(a)typical gaze’, ‘joint attention’, and ‘interactional trouble’ in ASD, which is also at the heart of critical autism studies. Rather than perceiving these concepts as intrapsychological skills (or impairments), they can be seen as essentially interactional and should not be detached from the on-going flow of activity (Kidwell
& Zimmerman, 2007). As an example, for a child’s gaze to be labelled as ‘atypical’, we first have to understand what is expected from that child: is gaze towards a co-participant or some other location made interactionally relevant in the first place? The
findings of original article III showed that the co-participants used pointing gestures to occasionally request responsive actions beyond mere gaze shifts. Such interactional details would be challenging to consider with the categorisation approach often used within the biomedical paradigm as they necessitate the examination of what other participants are doing in such situations, and not just the child with ASD. Even when a child does fail to respond with gaze, the interactional CA approach allows us to bring to light the contingencies under which such difficulties emerge. It thus has applicabil-ity for increasing our understanding of both competencies and challenges in ASD.
Furthermore, in terms of joint attention and interactional trouble, a conceptualisa-tion that merely focuses on a child’s abilities risks overlooking the multiple ways in which co-participants are involved in facilitating, managing, and occasionally com-plicating, these situations (as was shown in original articles II and III). For instance, Antaki et al. (2008) have shown that in interactions involving staff members and adult residents with intellectual disabilities, repeated well-meaning clarifications or checks following a resident’s answer could result in the resident changing his an-swer. Original article II had similar findings, showing that such practices resulted in further interactional trouble, rather than solving the initial trouble. Thus, the knowl-edge of how to better support children with ASD in interaction could be increased if co-participants’ contributions are better understood. CA offers a useful approach to transform our understanding of children with ASD through interactions – a shift that has also been called for by researchers engaged with ‘normal scientific’ work (e.g.
Adamson et al., 2012).
While this thesis has a methodological emphasis, and has described a journey from the biomedical paradigm and its categorisation approach, towards the social constructionist paradigm and its interactional approach, it builds on the foundations of previous CA work (section 4.1.). The thesis contributes to this body of work by deepening the understanding of co-participants’ use of pointing gestures in joint atten-tion, and how children manage interactional trouble and employ gaze in interaction.
Moreover, this thesis makes a methodological contribution to CA by suggesting a combination of the interactional approach and live eye tracking. These are discussed in more detail below and in section 7.2. The thesis also has some parallels with criti-cal autism studies in its attempt to rethink how children with ASD are portrayed in research, particularly within the biomedical paradigm. While this paradigm tends to pathologise children with ASD, the social constructionist paradigm provides scope to view how interactional challenges commonly linked with ASD are constructed in interaction, thus laying fertile soil for the claim that ASD itself is a social construction.
Furthermore, critical autism studies encourage a thorough rethinking of how chil-dren with ASD are described as research participants. While the biomedically-oriented way of describing them in the light of their psychometric test results (see Table 3 on pp. 48) and multiple other reported difficulties (see Table 2 on pp. 47) describes these children as ‘impaired’, a significantly different picture emerged when a shift to the social constructionist paradigm was made. Indeed, the findings of this thesis showed that children with ASD have competencies in the examined areas of social interac-tion. In reading psychometric test results, one should attend to the fact that the test scores have been produced in very specific settings that tell little about the children’s behaviour and interactions in everyday situations. The scores also do not reveal in-formation about how the test itself was administered, such as how the tester posed the questions and interacted with the children (see Rapley, 2004). Previous research has shown that interactions during testing situations are far from being ‘neutral’ or
‘standardised’ (e.g. Korkiakangas et al., 2016; Marlaire & Maynard, 1990) for why test scores should not be treated as unproblematic facts about the children. Thus, methodological decisions, whether related to describing the participants or selecting analytical approaches, cannot be neutral; they invariably produce a particular kind of knowledge and understanding about ASD (see also Dindar, Lindblom, & Kärnä, 2017).
This clearly does not mean that all children with ASD are skilled to an equal ex-tent, but the findings do not lend support to assuming a lack of skill a priori. Instead, what seems more useful in the light of the findings is to presume interactional com-petence in these children (see Biklen & Burke, 2006). The findings also show that an interactional approach that engages with understanding why children do what they do, rather than focusing on mere occurrences of (‘atypical’) behaviours, can bring im-portant insights which warrant rethinking the apparent ’asociality’ in ASD (Dickerson et al., 2005). The findings suggest that an observed lack of certain behaviours in one context should not be taken as evidence for a more general deficit in social interaction:
not all behaviours are relevant in all contexts (as shown by original article I). This is an important consideration as many studies suggest, for instance, the usefulness of technology-enhanced environments for children with ASD (Ploog et al., 2013; Wainer
& Ingersoll, 2011); however, within these environments there are multiple elements that influence the interactions taking place. Such contextual details can make certain behaviours more relevant than others, and thus it may not be fruitful to perceive these behaviours as indicative of children’s inner abilities.