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Eye-tracking-based assessment of cognitive function in low-resource settings
Linda Forssman1, Per Ashorn1,2, Ulla Ashorn1
1Tampere Center for Child Health Research, School of Medicine, University of Tampere, Tampere, Finland.
Insights
Infrared eye tracking shows promise for assessing infant neurodevelopment, even in low-resource settings. This automated method achieved high completion rates and replicated cognitive patterns in infants across Finland and Malawi.
Area of Science:
- Developmental neuroscience
- Infant cognitive assessment
- Human-computer interaction
Background:
- Infant neurocognitive development is vulnerable to socioeconomic factors like poverty and malnutrition.
- Effective infant neurodevelopmental assessment requires tools usable early in life, across diverse settings.
- Current assessment methods may lack objectivity or broad applicability.
Purpose of the Study:
- To evaluate infrared eye tracking as a novel, automated infant assessment technique.
- To assess visual-orienting, sequence-learning, and facial expression attention in 9-month-old infants.
- To compare feasibility in high-resource (Finland) and low-resource (Malawi) settings.
Main Methods:
- Infrared eye tracking piloted in Finland (N=39) and field-tested in Malawi (N=40).
- Assessed visual-orienting, sequence-learning, and attention to facial expressions.
- Measured parent perception, infant test completion, and valid trial percentages.
Main Results:
- High parental acceptance (95% Finland, 92% Malawi) and infant test completion (95% Finland, 90% Malawi).
- Satisfactory valid trial percentages (69-85% Finland, 68-73% Malawi).
- Eye tracking showed higher completion rates than observational tests in Malawi; cognitive patterns replicated, though with slower processing in Malawian infants.
Conclusions:
- Eye tracking is feasible for infant development assessment in low-resource settings, evidenced by high completion rates and replicated cognitive patterns.
- The technique demonstrates potential for objective, automated infant assessment across diverse environments.
- Further research is required on test-retest stability and predictive validity in low-income contexts.
Background:
Early development of neurocognitive functions in infants can be compromised by poverty, malnutrition and lack of adequate stimulation. Optimal management of neurodevelopmental problems in infants requires assessment tools that can be used early in life, and are objective and applicable across economic, cultural and educational settings.
Objective And Design:
The present study examined the feasibility of infrared eye tracking as a novel and highly automated technique for assessing visual-orienting and sequence-learning abilities as well as attention to facial expressions in young (9-month-old) infants. Techniques piloted in a high-resource laboratory setting in Finland (N=39) were subsequently field-tested in a community health centre in rural Malawi (N=40).
Results:
Parents' perception of the acceptability of the method (Finland 95%, Malawi 92%) and percentages of infants completing the whole eye-tracking test (Finland 95%, Malawi 90%) were high, and percentages of valid test trials (Finland 69-85%, Malawi 68-73%) satisfactory at both sites. Test completion rates were slightly higher for eye tracking (90%) than traditional observational tests (87%) in Malawi. The predicted response pattern indicative of specific cognitive function was replicated in Malawi, but Malawian infants exhibited lower response rates and slower processing speed across tasks.
Conclusions:
High test completion rates and the replication of the predicted test patterns in a novel environment in Malawi support the feasibility of eye tracking as a technique for assessing infant development in low-resource setting. Further research is needed to the test-retest stability and predictive validity of the eye-tracking scores in low-income settings.
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