AI-enabled eye-movement and emerging multimodal frameworks for precision dyslexia screening and reading pattern...

Developmental dyslexia refers to a common neurodevelopmental disorder, which impairs the accuracy and fluency of reading, and early identification is vital for initiating timely intervention. Nonetheless, the traditional methods of formal assessment are time- and resource-intensive, which limits their scalability. Machine-learning approaches and eye-tracking technologies provide objective, data-driven solutions for dyslexia screening. This research integrates current evidence on eye-movement-based and emerging multimodal computational methods for dyslexia screening, risk identification, and algorithmic classification during reading tasks.

PubMed, Scopus, Web of Science, and CINAHL were searched systematically to identify studies published between January 2015 and March 2026. Eligible studies included analysis of eye-movement obtained via eye tracking or electrooculography (EOG), with or without predictive modeling. Methodological quality was assessed using JBI, PROBAST, ROBINS-I, and COSMIN tools.

Twenty-three articles were included out of 50 full-text articles screened comprising eye-movement biomarker/observational studies (n = 5), machine-learning prediction-model studies (n = 14), intervention response studies (n = 2), and reliability/feasibility studies (n = 2). The sample sizes ranged from small experimental cohorts (<20 participants) to larger datasets (>300 participants). In the literature, dyslexic readers were consistently found to exhibit longer fixation durations, increased regression behavior and reduced saccadic efficiency. Machine-learning algorithms using fixation, saccade, scan path, and signal-based features demonstrated classification accuracies ranging from approximately 80 to 95% with some studies reporting values approaching 99% under specific experimental conditions.

Nevertheless, there was a significant heterogeneity in datasets, feature extraction methods, outcome definitions and validation schemes. Notably, numerous studies used proxy diagnostic labels, small or internally derived datasets, and internal cross-validation, which introduces the risk of overfitting and performance inflation. Explicit multimodal or multi-source modeling was identified in three of 23 studies involving combinations of gaze data with demographic, cognitive, linguistic, VR-bed, text-derived, saliency-map, or CNN-based features. Two additional studies used EOG as an alternative eye-movement signal modality rather than true multi-source fusion. Therefore, the evidence base remains dominated by eye-movement and gaze-derived approaches, while multimodal evidence should be interpreted as emerging and exploratory. Altogether, eye-movement based computational systems are a promising, non-invasive method for scalable dyslexia screening.

PROSPERO, identifier (RD42061332527).