Researchers have unveiled a device capable of expediting the diagnosis of autism spectrum disorder in young children by tracking their eye movements as they observe a video depicting a social interaction between two children.
Two concurrent studies, jointly published in JAMA and JAMA Network Open, have furnished data suggesting that this tablet-based tool can accurately identify autism in children aged 16 to 30 months, aligning with the precision of assessments conducted by specialists.
The device operates by monitoring the eye movements of video viewers at a remarkable rate of 120 times per second. It empowers experts to discern, moment by moment, the social cues that children absorb. Typically developing children tend to focus on the interaction portrayed in the video, while toddlers with autism direct their gaze elsewhere within the footage. The results can be generated within just 30 minutes.
Warren Jones, the lead author of the study and the Director of Research at the Marcus Autism Center at Children’s Healthcare of Atlanta, as well as an Associate Professor at the Emory University School of Medicine’s Department of Pediatrics, emphasized the current diagnostic process for autism, which involves lengthy evaluations by highly trained experts. He noted the scarcity of these specialists, resulting in extended waiting lists at most specialty centers.
Identifying autism in children before the age of three carries significant importance, according to Jones. Studies indicate that earlier identification leads to more favorable long-term outcomes, as the brains of younger children exhibit greater plasticity, enabling them to adapt more readily.
The American Academy of Pediatrics recommends autism screening for children at 18 and 24 months, while the Centers for Disease Control and Prevention reports that the average age of diagnosis stands at just under 4.5 years.
The studies detailed in JAMA Network Open involved an initial assessment of the device on 1,089 children, with an average age of 22 months. The trial reported in JAMA was conducted at six of the nation’s leading autism centers, where 499 children aged 16 to 30 months underwent testing with the device before being evaluated by specialists. Both studies have corroborated the device’s diagnostic accuracy, which is comparable to that of specialists.
The development of this device, known as EarliPoint Evaluation, earned clearance from the Food and Drug Administration on June 29 as a diagnostic tool for children undergoing specialist evaluations. Researchers are currently exploring the possibility of extending its use to pediatricians and primary care physicians to broaden screening efforts among children.
Although other research employs eye tracking to study autism, EarliPoint Evaluation is unique in its clinical application for diagnosing the disorder, according to Jones.
The device operates on the principle of identifying children with autism by detecting their reduced interest in social interactions, a crucial aspect of typical development. While most children acquire social skills by observing those around them, EarliPoint identifies those who display minimal attention to interpersonal interactions depicted in the video.
Early identification permits children with autism to access therapy designed to break down social interactions into manageable steps, explicitly teaching them skills that typically developing children intuitively acquire.
For parents like Renee Britt, the early intervention has made a notable difference. Her son Dawson initially followed a typical developmental trajectory but regressed just before turning two. Participating in an earlier version of the EarliPoint trial allowed Dawson to receive an autism diagnosis at age three and commence therapy. Under guidance, Dawson learned strategies to improve his tolerance for activities like grocery shopping, enabling him to engage in more extended outings.
Dawson, now 12, attends some school classes with his typically developing peers and contributes to family shopping expeditions by referencing the shopping list.
Autism specialist Blythe Corbett praised the new studies, emphasizing the need for objective tools to aid in diagnoses. The current methods are labor-intensive, and the introduction of objective biomarkers, as employed in these studies, could be highly beneficial.
Corbett noted that in approximately 30% of cases, even top specialists may lack confidence in their diagnoses, making the eye-tracking information all the more valuable. She also highlighted the device’s use of videos that emulate natural social environments for children aged 16 to 30 months.
In the future, the device could potentially assist in triaging children to expedite specialist evaluations and accelerate diagnoses, ensuring that children receive timely therapy.
Dr. Jeremy Veenstra-VanderWeele, a professor of psychiatry and director of the division of child and adolescent psychiatry at Columbia University’s College of Physicians and Surgeons, lauded the tools for identifying children for further evaluation but cautioned that they are not diagnostic. He suggested that follow-up studies might determine whether the device can indeed streamline the diagnostic process, potentially reshaping clinical practice.
The implications of this research could be significant if it ultimately enhances early autism detection and intervention.