Sex differences in social attention in autistic children – A meta-analysis

The primary research question for this meta analysis will be investigating the effect of sex difference on social attention in children with Autism Spectrum Disorder (ASD). The primary outcome will be sex differences in social attention within the ASD group. This will be measured using quantitative eye-tracking parameters that reflect visual attention to social stimuli, such as fixation duration, proportion of looking time, or time to first fixation on predefined social areas of interest (e.g., eyes, faces, or social scenes). Three secondary research questions will also be examined. First, we will assess whether sex differences in social attention differ between children with ASD and typically developing (TD) children in studies that include a control group. Second, we will investigate whether sex differences in autistic children vary across different eye-tracking measures and experimental paradigms (e.g., gaze cueing, joint attention, visual search, and emotion or face-processing tasks). Third, we will examine sex differences in autism symptom severity. Accordingly, secondary outcomes will include: (1) standardized measures of ASD symptom severity (e.g., ADOS, CARS), which will be extracted separately for autistic males and females and examined as potential correlates of sex-related differences in social attention; (2) task- and measure-specific social attention parameters within the ASD group; and (3) social attention indices comparing ASD and TD groups where available. We also plan to investigate the following variables as explanatory variables in the meta-regression analysis. These will include clinical factors (e.g., comorbid neurodevelopmental or emotional conditions), task characteristics (e.g., stimulus format, task duration, and delivery mode such as computerized, interactive, or virtual reality), demographic factors (e.g., age, socioeconomic status, and parental education level), and study quality indicators (e.g., journal impact factor at the time of publication, methodological quality ratings, and sample size).