Eye Tracking as a Treatment Monitoring Tool for Autism: A Multilevel Meta-Analysis

There is a growing body of evidence suggesting a concurrent association between attentional indices measured via eye tracking and autism symptoms. This meta-analysis examined the utility of eye tracking within longitudinal frameworks for autism interventions, including treatment monitoring and prediction of treatment response. We conducted a multivariate random-effects meta-analysis with a multilevel structure on 25 studies (828 autistic participants; M _age = 3-28 years) to estimate: (a) changes in eye-tracking outcomes from pre- to post-treatment (k = 179); and (b) the correlation between baseline eye-tracking profiles and changes in developmental outcomes following treatment (k = 39). Our analysis revealed a moderate and significant summary effect size for changes in eye-tracking outcomes from pre- to post-treatment (Hedge's g = 0.32, p = 0.010). Additionally, a moderate but non-significant summary effect size was revealed for the correlation between baseline eye-tracking outcomes and changes in developmental outcomes following treatment (Fisher's z = 0.20, p = 0.115), with moderation effects observed based on developmental domain and sex. These findings highlight the potential of eye tracking as a tool for monitoring treatment-induced changes in autistic individuals, while its predictive utility remains less supported. Limitations and implications are discussed.