Eye Tracking Screening for ASD in Nursery: Is Early Diagnosis Possible? A Large-scale Real-life Experiment
摘要
The goal of this study was to evaluate eye-tracking screening for ASD among 585 typically developing toddlers 7 to 48 months of age in vulnerable districts of São Paulo.
MethodsEye-tracking assessment was done with children in the participating community nurseries on Joint Attention, composed of the Initiation Joint Attention (IJA) and Responding to Joint Attention (RJA). All parents responded to the questionnaire on the educational level and socioeconomic family status (SES). Children received ratings on the Childhood Autism Rating Scale (CARS) by trained psychologists and those above 25 points underwent consultations with a pediatric neurologist to establish a clinical diagnosis according to DSM-5 criteria. Children were assigned to three groups: TD (typical development), ASD (autism spectrum) and nTD (impaired development without ASD). The groups were compared regarding the mean gaze time and proportion of transition betweene Areas of Interest (AOIs) on face to target and face to distractor.
ResultsASD group spend less time looking to the Face and Target AOIs than other groups (F [3.73, 765.98] = 2.49, p = .04, η2G = 0.01) and made less transitions (F [2, 411] = 4.33, p < .01, η2G = 0.01). The Receiver Operating Characteristic (ROC) Curve of the overall mean gaze was 0.65.
ConclusionThis study could identify neurodevelopmental alterations of ASD in a large sample of typically developing children. Considering the screening and diagnosis in ASD children before the age of 3 years old, eye tracking offers an important add-on alternative for early identification.