A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Fall, 2023 | Number 4, Volume 37

Eye-tracking assessment may aid in diagnosing ASD in very young children

An eye-tracking assessment that measures social visual engagement may be useful in diagnosing autism spectrum disorders (ASD) in children under three years of age, according to two separate studies. 

The assessment, developed by Warren Jones and Ami Klin, involves having children watch videos of other children interacting socially. Based on measurements of the children’s eye movements, the assessment indicates whether they are likely to have ASD or not. 

The researchers and their team conducted a multisite, double-blind study of their technology involving 475 children between the ages of 16 and 30 months. They found that measurements of social visual engagement had 71.0 percent sensitivity (meaning the accurate identification of cases of ASD) and 80.7 percent specificity (meaning the avoidance of false positives). In a subgroup of 335 children whose ASD diagnosis was certain, the test had 78.0 percent sensitivity and 85.4 percent specificity. 

Klin comments, “The far-reaching implications of these results may mean that children who currently have limited access to expert care, and face two or more years of waiting and referrals before finally being diagnosed at age four or five, may now be eligible for diagnosis between the ages of 16 and 30 months. In addition, this technology measures each child’s individual levels of social disability, verbal ability, and nonverbal learning ability, which is critical information for clinicians when developing personalized treatment plans to help each child make the greatest gains.” 

The researchers add, “It is important to note that the test results derived from measurements of social visual engagement are not intended to replace clinicians with expertise in developmental disabilities; to the contrary, a tool like this could be used by expert clinicians to aid in accurately and efficiently diagnosing autism as well as quantifying children’s strengths and vulnerabilities.”


“Eye-tracking–based measurement of social visual engagement compared with expert clinical diagnosis of autism,” Warren Jones, Cheryl Klaiman, Shana Richardson, Christa Aoki, Christopher Smith, Mendy Minjarez, Raphael Bernier, Ernest Pedapati, Somer Bishop, Whitney Ence, Allison Wainer, Jennifer Moriuchi, Sew-Wah Tay, and Ami Klin, Journal of the American Medical Association, September 5, 2023. Address: Warren Jones, Marcus Autism Center, Children’s Healthcare of Atlanta, 1920 Briarcliff Rd NE, Atlanta, GA 30329, warren. [email protected]


“Development and replication of objective measurements of social visual engagement to aid in early diagnosis and assessment of autism,” Warren Jones, Cheryl Klaiman, Shana Richardson, Meena Lambha, Morganne Reid, Taralee Hamner, Chloe Beacham, Peter Lewis, Jose Paredes, Laura Edwards, Natasha Marrus, John N. Constantino, Sarah Shultz, and Ami Klin, JAMA Network Open, September 5, 2023 (free online). (See address above.) 


“Tablet-based tool to spot autism validated in two studies,” Charles Q. Choi, Spectrum News, September 5, 2023. 


“Measuring children’s looking behavior yields new tool to help diagnose autism earlier, research shows,” news release, Children’s Healthcare of Atlanta, September 5, 2023.