Researchers said a device that tracks children’s eye movements while they watch a video showing social interaction between two children may help speed up the diagnosis of autism spectrum disorder.
Data from two new studies, published simultaneously on Tuesday in JAMA and JAMA Network Open, suggests that the tablet can identify the disorder in children ages 16 to 30 months as accurately as any professional.
The tool monitors the eye movements of the video viewer at a rate of 120 times per second. It allows professionals to identify the social information children are receiving moment by moment, as typically developing children focus on interaction while young children with autism look at other points in the video. Results can be available in 30 minutes.
“Currently, autism is diagnosed by a highly trained expert over several years,” said Warren Jones, lead author of the study, director of research for the Marcus Autism Center at Children’s Health Care Atlanta and associate professor in the department of pediatrics at the University of Atlanta. hours of testing. Emory University School of Medicine. Unfortunately, there are not enough of these experts.
Jones is also a scientific co-founder and consultant at EarliTec Diagnostics, which makes the devices.
Jones said a shortage of experts means most specialist centers have long waiting lists.
“Knowing children with autism before the age of three is really important,” he said. “While treatment can help children thrive at any age, studies have shown that there are better long-term outcomes in children who are diagnosed early.”
This is because younger children’s brains are more “plastic”, which means they can change more easily.
The American Academy of Pediatrics recommends that children be screened for autism at 18 months and 24 months of age. According to the Centers for Disease Control and Prevention, the average age of diagnosis is just under 4.5 years.
The research, published in JAMA Network Open, describes an initial test of the device on 1,089 children who had an average age of 22 months. JAMA reported on an experiment that took place at six of the country’s leading autism centers. During that trial, 499 children between the ages of 16 to 30 months were tested with the device for the first time and then evaluated by specialists.
Both studies found that the device’s diagnostic capabilities were similar to those of the specialists.
These experiments are the culmination of twenty years of research by Jones and his colleagues.
The device, called the EarliPoint Evaluation, received FDA approval on June 29 for use as a diagnostic tool for children being evaluated by professionals. The researchers are currently studying whether the device could be used by pediatricians and primary care physicians to screen a wide range of children.
EarliPoint is used at the Marcus Autism Center and three other centers are contracting. Other research is using eye tracking to learn more about autism, Jones said, although there is no other device doctors use to help diagnose the disorder.
The idea behind this technology is to identify autistic children by noting their apparent lack of interest in people. Children usually learn social skills by observing how the people around them interact. EarliPoint identifies children who have little, if any, interest in child-to-child interaction in the video.
If children do not learn how to act through observation, they may never learn. Experts say that once children are identified as autistic, they can get treatment that breaks down social interactions and behaviors into a series of steps and explicitly teaches children with autism what children who normally develop themselves pick up without thinking about it.
For Dawson, Renee Brett’s young son, the treatment appears to be working. At first Dawson seemed to be developing like a normal child, but he began to regress before he was two years old. “All of a sudden, he didn’t talk anymore and started struggling,” Brett said.
The boy had meltdowns when the family tried to go shopping for groceries or wait for orders at cafes.
Brett signed up for a trial version of an earlier version of EarliPoint. At the age of three, Dawson was diagnosed with autism and began treatment. Britt learned strategies to improve Dawson’s tolerance for shopping. They started with very short visits to the store, and the little one always got a little toy when they were done shopping. The boy began to associate shopping with a pleasant outcome, and the family was able to take longer and longer trips to the store.
Britt has learned to watch for the subtle signs that might come before a breakup. In a pep rally when the music got too loud for him, Dawson covered his ears and started tapping his foot. Brett asked the boy if he was okay. When he said no, I asked him if he wanted to walk around. it worked.
“When he was younger, there wasn’t any conversation,” she said. He was screaming and trying to run away.
Now, 12, Dawson is taking some school classes with his normally developing peers. When the family needs to go shopping, Brett said, “I can show him our list and he’ll help us get things on the list.”
Autism specialist Blythe Corbett welcomed the new studies.
“We really need objective tools to help with our diagnosis,” said Corbett, MD, chair of the department of psychiatry and behavioral sciences and professor of psychiatry and behavioral sciences at Vanderbilt University Medical Center.
Existing methods are time-consuming, Corbett, who was not involved in the new research, said, “and it would be very useful to identify these types of objective biomarkers that both studies use.”
In about 30 percent of cases, Corbett said, not even senior specialists are confident in their diagnoses. In those cases, eye-tracking information can be even more valuable. “The other great aspect of the eye-tracking index is that they use videos that seem to capture the normal social environments that a child between 16-30 months might be exposed to and learn from,” she added.
Corbett said the device may one day be used to triage children so that the most affected are fast tracked to see specialists, as well as speed up diagnosis so children don’t have to wait before they can get treatment.
The new data is “really promising in terms of being able to be applied to children who already have some developmental concerns as well as those in the general population,” said Dr. Child and Adolescent Psychiatry at Columbia University College of Physicians and Surgeons.
Veenstra-VanderWeele said the tools will be used to identify the children for further evaluation, but are not diagnostic.
“There are some children who are very predictable,” he said, suggesting that a follow-up study could determine whether the tool would speed up the diagnosis process.
“This could be very important if it turns out to shape clinical practice,” said Venstra VanderWell.