Autism: diagnosis through the eyes?

A combination of eye-tracking tests could help to speed up the diagnostic process and make it more efficient, according to the authors.

What you should know about eye tracking and autism:

Why are new diagnostic methods needed for autism?

The diagnosis of a spectrum disorder is not made lightly – as it should be. As a rule, many examinations by different specialists are necessary to definitively rule out or diagnose autism.

Doctors often have to rely on what parents or the children themselves tell them. It is possible that symptoms are not reported. In such cases, a reliable and non-invasive diagnostic test would be helpful. Furthermore, there is a gap in care in some countries. In the US, for example, not every child has adequate health insurance and the waiting time for appointments with psychologists can be long. Although some states have specialised paediatricians who play an important role in diagnosis, they are far from accessible to all children.

Eye measurements as markers?

In the United States, autism is usually diagnosed at the age of four, although a reliable diagnosis can be made as early as the second year of life. A team of researchers from Indiana in the United States has now investigated whether a test battery of eye tracking measurements can help to close this gap. They asked themselves whether these tests could reliably detect autism.

To do this, they used the relevant tests to examine children who had been sent by specialist paediatrician centres, but who did not all show the corresponding signs of the disease. All participants were also examined by specially trained psychologists, who used the current guidelines to either diagnose or rule out the disease. Their assessment served as a control to determine whether the disease was present or not. The results were then evaluated in terms of possible correlations.

Reliable results

The result showed that eye tracking itself had a specificity and sensitivity of over 70 per cent. When the results of these tests were combined with the examination results of the general practitioners and their assessment of the certainty of the diagnosis (very likely to not likely), sensitivity and specificity could be increased to about 90 per cent.

Conclusion for medical practice

Eye tracking could be a suitable biomarker for autism. When used in a multimodal approach, it appears to be highly specific and sensitive. Eye tracking could be a possible option for a quick, non-invasive and reliable diagnosis of the disorder.

Sources
  1. Keehn B, Monahan P, Enneking B, Ryan T, Swigonski N, McNally Keehn R. Eye-Tracking Biomarkers and Autism Diagnosis in Primary Care. JAMA Netw Open. 2024;7(5):e2411190. doi:10.1001/jamanetworkopen.2024.11190