Sven Bölte

Sensitivity to signals of communicative intent in infancy at low and high risk for autism

This project aims to investigate how infants process communicative signals, and how individual differences are related to later development. We will study both infants who are expected to develop normally, and infants at high risk for developing an Autism Spectrum Disorder (ASD), a chronic developmental condition coined by pervasive dysfunction of social reciprocity and mutual communication. Using eye-tracking, we will assess infants’ ability to follow an adult models gaze to objects in the environment and how this ability is influenced by the communicative intent of the model. Additionally, we will map the neural mechanisms that are active in this context using a non-invasive brain imaging technique. These measurements will take place at the Uppsala Babylab. At two and a half year, the same children will undergo clinical assessment at the Karolinska Insitutet Center of Neurodevelopmental Disorders (KIND). The goal of the current project is fourfold: i) to establish a common platform for clinical neuropsychiatry and basic developmental science in Sweden ii) to examine infants’ processing of communicative cues in general iii) to explore the relationship between infant gaze and brain activation data and continuous variables such as language development and social competence iv) to investigate infant performance and correlated brain activity indicative a of later clinical diagnosis of ASD in order to identify valid makers for early detection and treatment.
Final report

Sven Bölte, Karoliska institutet


The aim of this project was to understand how infants who later develop Autism Spectrum Disorder (ASD) process and respond to communicative signals. ASD is characterized by impairments in social communication and is associated with individual burden and substantial societal costs. Currently, ASD is seldom diagnosed before the age of 3 years - frequently much later. Little is known about the early development in infants who go on to develop ASD. To study this, we use a longitudinal design, in which we follow younger siblings of children with ASD. The risk of ASD is up to 20 times higher in this group than other children. We have centered on the infants ability to process communicative signals during the first year of life. Subsequently, when following up the children until 2-3 years of age, we classify the children according to diagnostic outcome. Knowing who developed ASD, one can compare data from the early time points across groups and identify developmental trajectories or other early signs that reliably predict ASD diagnosis. The project is conducted in collaboration between the Center of Neurodevelopmental Disorders at Karolinska Institutet (KIND) and Uppsala Child and Babylab (Uppsala University).

What are the most important results from this project that can be evaluated today?

The study has a longitudinal design in which we follow the children over several years. In such studies, a large sample size is necessary, which takes several years to recruit and follow up. Based on our grant from RJ, we have applied for funding to expand and continue the project. This has resulted in several new grants, from the Swedish Research Council as well as via EU-level funding mechanisms. Thus, the support from RJ has contributed to establishing a new long term approach to studying early autism in Sweden, and has strengthened the position of Swedish autism research in an international context. For example, the project is currently a part of one of the largest autism networks in the world: EU-AIMS ( During the course of the grant from RJ, Sven Bölte has acted as work group leader for studies of infants at risk within the EU-COST action ESSEA (Enhancing the Scientific Study of Early Autism). This too has contributed to new international collaborations and to development and capacity building within the field.
Although the most important publications from the project will first be available later (when we have followed up the whole sample), we have already published empirical works as well as review articles during the project period. For example, we have demonstrated that despite the fact that young children with ASD seemingly are able to follow other people's gaze to specific objects in the environment, they do not subsequently process information from this object more than information from other objects. This suggests that young children with ASD may not understand the communicative meaning of other people's non-verbal cues as well as other children. This in turn, would be expected to have important implications for their ability to learn new information and develop through social interaction.
The project as also generated a number of new research questions. For example, we have started studying how the parents of the infants in the project experience their situation, their attitudes, and their views on participating in a project which capitalizes on the increased risk. More knowledge about the parents' thoughts and attitudes could have important implications for ethical discussions related to research on early markers of ASD risk.
All publications have and will be published in scientific peer reviewed journals with open access. In addition to the scientific output, we have also in the context of this project published a number of popular science articles in Swedish (e.g. in Ögonblick, Best Practice, Medicinsk Vetenskap). The project has also received attention in the traditional media (e.g. Dagens Nyheter, Augusti 2012; TV4 Nyhetsmorgon, March 2015).


Bölte S, Marschik PB, Falck-Ytter T, Charman T, Roeyers H, Elsabbagh M. Infants at risk for autism: a European perspective on current status, challenges and opportunities. Eur Child Adolesc Psychiatry. 2013 Jun;22(6):341-8. doi: 10.1007/s00787-012-0368-4.

Falck-Ytter, T., Bölte, S., & Gredebäck, G. (2013). Eye tracking in early autism research. J Neurodev Disord, 5(28). doi: DOI: 10.1186/10.1186/1866-1955-5-28

Falck-Ytter T, Rehnberg E, Bölte S. Lack of visual orienting to biological motion and audiovisual synchrony in 3-year-olds with autism. PLoS One. 2013 Jul 8;8(7):e68816. doi: 10.1371/journal.pone.0068816.

Falck-Ytter, T., Thorup, E., & Bölte, S. (2014). Brief Report: Lack of Processing Bias for the Objects Other People Attend to in 3-Year-Olds with Autism. J Autism Dev Disords, 1-8. doi: 10.1007/s10803-014-2278-4

Nyström P, Gredebäck G, Bölte S, Falck-Ytter T; EASE team. Hypersensitive pupillary light reflex in infants at risk for autism. Mol Autism. 2015 Mar 3;6:10. doi: 10.1186/s13229-015-0011-6

Grant administrator
The Karolinska Institute Medical University
Reference number
SEK 2,427,000.00
RJ Projects
Health Sciences