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Poster #48 - Heterogeneity of eye-tracking stimuli used with young children at risk for autism: Paradigm review

Fri, March 22, 2:30 to 3:45pm, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Introduction: Eye-tracking is an objective measure of visual attention that is feasible for use with both infants and very young children (Elsabbagh, et al., 2012; Murias et al., 2018). Eye-tracking also captures atypical visual attention patterns and visual information processing differences, which are potential biomarkers explored for early identification of children at risk of being diagnosed with autism spectrum disorder (ASD; Baduel, & Roge, 2014). Previous studies that compared visual attention of ASD vs. typically developing children have failed to produce consistent findings, possibly due to heterogeneous eye-tracking protocols (Billeci et al., 2016); Elsabbagh et al., 2013). This systematic review provides a comprehensive description of eye-tracking paradigms and stimuli utilized in experimental studies conducted on young children at risk of ASD.

Method: We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses Statement (PRISMA). Web of Science, MEDLINE, Scopus, and PsychINFO databases were searched for articles published between 2005 and 2018 to identify studies in which eye-tracking has been performed on children aged < 9 years with an ASD risk. Studies were evaluated on eye-tracking protocols and stimulus characteristics assigning mutually exclusive definitions to stimuli based on type, form, design, and participant exchange.

Results: Of 203 screened studies, 44 articles were identified as pertinent to this review (see Figure 1). Majority of studies have utilized Tobii systems. However, substantial variability of the eye-tracker protocols and stimuli were observed. Sampling rates ranged between 30 Hz (Young et al., 2009) and 500 Hz (Stagg et al., 2014), reported monitor sizes ranged from 17 (Pierce et al., 2016) to 24 (Chawarska et al., 2016) inches, and stimulus presentation distance ranged from 40 (Aresti-Bartoleme & Garcia-Zapirain, 2015) to 162 (Hannigen, 2014) cm. Thirty-one studies failed to describe lighting context, while descriptions included used imprecise terms like dark or dim. Stimuli quantities ranged, from 1 to 32 (median =5). Heterogeneity in dimensional descriptors of stimuli was also noted. Social stimuli were used in 39 studies and while 5 studies used non-social stimuli. Twenty-eight studies used dynamic stimuli and 16 studies used static stimuli. Regarding design, 14 studies presented paired stimuli and 30 studies used single stimuli. Participant exchange was classified as active in 5 studies and passive in 39 studies.

Conclusions: Currently there is a disconnect in the current literature that bridges basic research to clinical utility in distinguishing possible biomarkers and indicators of developmental risk. This systematic review highlights the heterogeneity of eye-tracking stimuli to be the norm, as opposed to the use of standardized, uniform experimental paradigms. Furthermore, lack of validated, accessible stimuli for eye-tracking experiments exacerbates the heterogeneity. Moreover, omission of experimental details in many of the reviewed manuscripts (Gliga et al., 2015) hinders comparison of methodology and replication of findings. Limitations resultant from these inconsistencies include inaccurate assumptions that stimuli are reliably targeting specific visual attention preferences and failure to rule out cultural, gender, or age bias to stimuli. Thus, future eye-tracking studies should focus on frameworks to develop publicly available, validated stimuli and protocols for use in eye-tracking experiments.

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