Objective

The primary aim of this study was to develop and validate eye tracking−based measures for estimating autism spectrum disorder (ASD) risk and quantifying autism symptom levels.

Method

Eye tracking data were collected from youth during an initial evaluation visit, with administrators blinded to all clinical information. Consensus diagnoses were given by the multidisciplinary team. Participants viewed a 5-minute video that included 44 dynamic stimuli from 7 distinct paradigms while gaze was recorded. Gaze metrics were computed for temporally defined regions of interest. Autism risk and symptom indices aggregated gaze measures showing significant bivariate relationships with ASD diagnosis and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) symptom severity levels in a training sample (75%, n = 150). Receiver operating characteristic curve analysis and nonparametric correlations were used to cross-validate findings in a test sample (25%; n = 51).

Results

Most children (n = 201, 92%) completed a valid eye tracking assessment (ages 1.6─17.6; 80% male; ASD n = 91, non-ASD n = 110). In the test subsample, the autism risk index had high accuracy for ASD diagnosis (area under the curve [AUC] = 0.86, 95% CI =0.75−0.95), whereas the autism symptom index was strongly associated with ADOS-2 total severity scores (r = 0.41, p < .001). Validity was not substantively attenuated after adjustment for language, nonverbal cognitive ability, or other psychopathology symptoms (r = 0.40−0.67, p > .001).

Conclusion

Eye tracking measures appear to be useful quantitative, objective measures of ASD risk and autism symptom levels. If independently replicated and scaled for clinical use, eye tracking−based measures could be used to inform clinical judgment regarding ASD identification and to track autism symptom levels.

中文翻译：

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基于客观和定量眼动追踪的自闭症风险和症状水平评估方法的开发和验证

客观的

这项研究的主要目的是开发和验证基于眼动追踪的措施，以估计自闭症谱系障碍（ASD）风险和量化自闭症症状水平。

方法

在初次评估访问期间，从青年时期收集了眼动数据，管理人员不了解所有临床信息。共识诊断由多学科团队进行。参与者观看了一个5分钟的视频，其中包含来自7个不同范例的44个动态刺激，同时记录了凝视。针对时间上定义的关注区域计算了注视度量。自闭症风险和症状指数汇总的注视量度显示出与训练样本中ASD诊断和《自闭症诊断观察时间表》（第二版）（ADOS-2）症状严重程度之间存在显着的双变量关系（75％，n = 150）。接收器工作特性曲线分析和非参数相关性用于交叉验证测试样品中的发现（25％； n = 51）。

结果

大多数儿童（n = 201，92％）完成了有效的眼动追踪评估（1.6‑17.6岁；男性80％； ASD n = 91，非ASD n = 110）。在测试子样本中，自闭症风险指数对ASD诊断具有很高的准确性（曲线下面积[AUC] = 0.86，95％CI = 0.75-0.95），而自闭症症状指数与ADOS-2总严重程度评分密切相关（r  ＝ 0.41，p  ＜.001）。调整语言，非语言认知能力或其他心理病理症状后，有效性并未得到实质性削弱（r  = 0.40-0.67，p > .001）。

结论

眼动追踪措施似乎是有用的定量，客观评估ASD风险和自闭症症状水平的方法。如果独立复制并按比例缩放以用于临床，则可以使用基于眼动追踪的方法来告知有关ASD识别的临床判断并跟踪自闭症症状水平。