Using children's eye movements to diagnose, characterise and treat autism spectrum disorder

Autism spectrum disorder (ASD) is a developmental condition affecting around 1 in 68 children in New Zealand; about 14,000 children. 

Some children with autism have quite debilitating challenges with social interaction and communication, while others are highly focused, articulate, and function at a very high level because of (rather than despite) their autistic characteristics.

If children are struggling, but their challenges are overlooked, or unnoticed, these complications may become worse, precipitating further challenges as children grow older.

Research has shown that early diagnosis and subsequent support for children with ASD and their families can greatly improve their lives and long-term outcomes. However, ASD is complex, and there are still so many unknowns as to when, and how, it manifests in children, as well as what kind of support is most beneficial.

Prof Steven Dakin is the Head of School of Optometry and Vision Science at the University of Auckland, and is a pre-eminent expert in tracking eye movements to assist in diagnosing and treating child health disorders. 

It has long been known that children living with ASD are prone to the avoidance of looking at faces, and might be more likely to focus on geometric shapes. Current technology is capable of accurately measuring where children are looking, by tracking their eye movements while they look at movies.

Hidden behind the simple task of watching a movie, are complex demands placed on a child’s cognitive abilities. Understanding movies require that children keep track of many things: from visually tracking people and objects in dynamic complex scenes through to determining people’s intentions and likely behaviour from their facial expressions, where they are looking etc. 

Where children look in a scene can be revealing about what they do and what they do not understand and can provide a rich source of data about how the child interacts with natural and engaging environments. Prof Dakin and his team believe that this data can be revealing of limitations in specific cognitive processes.

Prof Dakin will use this technology to do two things:

• First, to determine if it could help better diagnose ASD, a condition that can present in many different ways.

• Second, to see if it could help children make sense of the world.

Typically developing (TD) children effortlessly acquire social information necessary to understand complex situations – as present in both movies and in everyday life – but acquiring such information may be challenging for children with ASD. Eyetracking could help disambiguate complex situations by proving pointers to important social elements which may otherwise be missed.

This study consists of three phases: 

• Phase 1 will see data collected on typically developing children to establish what might be a ‘normal’ fixation pattern when watching movies; 

• Phase 2 will capture the same data in children with already diagnosed ASD; 

• The final phase will be a proof of principle intervention to highlight important social information for 15 children with ASD.

There is great potential for this work to improve our understanding of autism as well as explore a novel behavioural therapy, aimed at helping children with ASD make sense of the world.