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Updated: Apr 9, 2026
Eye Tracking Young Children with Autism
Published on: March 27, 2012
Social Visual Engagement in Preterm and Term Children With Autism: Consistent Eye-tracking Patterns Irrespective of
Alexandra P Key1, Emma McQueen, Hannah Tokish
1Marcus Autism Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
Insights
Autism spectrum disorder (ASD) symptoms appear similarly in preterm and term-born toddlers, as shown by eye-tracking. This objective measure of social visual engagement can help identify ASD early in high-risk preterm infants.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Premature infants (<37 weeks gestation) face higher risks for neurodevelopmental delays and autism spectrum disorder (ASD).
- Distinguishing ASD symptoms from general developmental issues in preterm infants is challenging.
Purpose of the Study:
- To objectively assess social visual engagement in preterm and term-born toddlers using eye-tracking.
- To evaluate if early ASD symptoms differ between preterm and term-born toddlers.
Main Methods:
- 128 autistic term-born and 64 preterm-born toddlers (1-3 years) underwent eye-tracking during video viewing.
- Participants also received gold-standard behavioral diagnostic assessments for autism.
Main Results:
- Autistic preterm toddlers showed less visual focus on eyes/mouth and more on objects compared to non-autistic preterm toddlers.
- Eye-tracking metrics correlated with autism symptom severity and language skills.
- No significant differences in social visual engagement patterns were found between autistic term-born and preterm-born toddlers.
Conclusions:
- Early autism symptoms are objectively similar in preterm and term-born toddlers via eye-tracking.
- Social engagement alterations in ASD appear independent of prematurity-related developmental concerns.
- Eye-tracking offers a valuable tool for early ASD identification in preterm infants.
Objective:
Premature infants born before 37 weeks' gestation are at increased risk for neurodevelopmental delays and autism spectrum disorder (ASD) compared with the general population. This study aimed to evaluate ASD symptoms independently of the developmental sequelae of preterm birth by objectively assessing social visual engagement using eye-tracking procedures during free viewing of short, dynamic video clips.
Method:
One hundred twenty-eight autistic toddlers born at term and 64 toddlers born preterm (23-36 weeks; 31 diagnosed with autism) between 1 and 3 years of chronological age completed an experimental eye-tracking measure of social visual engagement and gold-standard diagnostic behavioral assessment by expert clinicians.
Results:
The preterm-born toddlers who were versus were not diagnosed with autism demonstrated significantly lower visual engagement with the eyes and mouth regions of the stimuli and increased fixation on objects. Individual differences in these eye-tracking metrics correlated with clinical measures of autism symptoms and receptive language. Comparisons of autistic toddlers born at term versus preterm identified no group differences in the patterns of social visual engagement. Greater gestational age at birth was associated only with better nonverbal developmental outcomes.
Conclusion:
Early symptoms of autism present similarly in preterm and term-born toddlers when evaluated using objective eye-tracking metrics of social visual engagement. Alterations in social engagement associated with autism seem independent of broader developmental concerns related to prematurity and therefore are a useful aid in the early identification of ASD-specific concerns in preterm toddlers for whom differential diagnosis based on behavior alone may be particularly challenging.
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